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This shows what the Earth will endure, including 9 day Severe Wobble, 4.5 days static Lean to the Left, 2.5 days pr..."],["topImageUrl",null],["error",null]]}]}],["text","https://youtu.be/T4VNOJ1IR8w"],["replyRequests",{"__iterable":"List","data":[{"__iterable":"Map","data":[["id","1oftybr0axj38__j4S8C_CEoSv5iqXsvftqnWBA-GsK942MCIOaFQKgke1SwiDs0__RUMORS_LINE_BOT"],["reason",""],["positiveFeedbackCount",0],["negativeFeedbackCount",0]]}]}],["id","1oftybr0axj38"],["createdAt","2026-05-16T09:59:51.119Z"]]}],["replyConnections",{"__iterable":"List","data":[]}],["relatedArticles",{"__iterable":"List","data":[{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",2],["user",{"__iterable":"Map","data":[["id","j4S8C_WAuYYj2LVfJbSwWOWex9UXA7W6d3Pwk7voZng0aQP9s"],["name","厚道的中和蜜妮安"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","COVID 19 VACCINE WARNING! MARK OF THE BEAST! MANDATED VACCINE+CHIP"],["url","https://www.youtube.com/watch?v=IMc74QpJf04"],["summary","https://id2020.org/alliance\n\nhttps://www.nowtheendbegins.com/big-pharma-microsoft-silicon-valley-id2020-alliance-combine-vaccinations-with-implantable-microchip-digital-id-mark-beast-end-times/\n\nVACCINE plus MICROCHIP\nhttps://principia-scientific.org/id2020-alliance-will-combine-vaccinations-implantable-id-microchips/\n\nUS COMPANIES RACE TO TEST CORONA VIRUS VACCINE\nhttps://amp.cnn.com/cnn/2020/02/27/investing/coronavirus-vaccine/index.html\n\nUS VACCINE TRIALS\nhttps://www.cnbc.com/amp/2020/02/25/us-health-officials-say-human-trials-on-coronavirus-vaccine-to-start-in-6-weeks.html"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","ID2020 | Alliance & Governance"],["url","https://id2020.org/alliance"],["summary","No government, company or agency can solve this challenge alone. Setting the future course of digital ID and navigating the associated risks is a challenge that requires sustained collaboration and global partnership.\n \n \n \n Why the Alliance\n \n \n \n \n Partners\n \n \n \n \n Governance\n \n \n \n \n \n \n Explore\n \n \n \n \n \n \n \n The ID2020 Alliance is unique in its philosophy and transparent governance.\n \n \n ID2020 is building a new global model for the design, funding, and\nimplementation of digital ID solutions and technologies. There is no other multi-stakeholder effort focused on user-managed, privacy-protecting, and portable digital ID.\n \n \n Ad-hoc investments in single use-case projects (“business as usual”) will be insufficient to bring about transformative impact. Changing the flow of funds is necessary to re-align incentives. That’s why Alliance partners are pooling funds to invest in programs that consider digital ID holistically, as a platform for diverse benefits, services, and use cases throughout an individual’s life.\n \n \n Private sector engagement is critical for solving at scale. Alliance partners include companies with a collective footprint in the billions and a shared commitment to an ethical approach to digital ID. Decisions about how Alliance funds are administered, which programs to fund, and which technical standards to support are made jointly by Alliance partners through a transparent governance process, preventing dominance by any single institution or sector.\n \n \n \n \n \n \n Alliance Partners\n \n \n \n \n \n \n \n A global management consulting and professional services firm, Accenture joined as a founding partner in June 2017. Accenture representatives participate in ID2020’s Executive Board and Technical Advisory Committee.\n \n \n \n \n Gavi, the Vaccine Alliance brings together public and private sectors with the shared goal of creating equal access to new and underused vaccines for children living in the world’s poorest countries. Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance, sits on our Executive Board.\n \n \n \n \n Since 1913, the Rockefeller Foundation has sought to improve the well-being of humanity around the world. The Rockefeller Foundation provided ID2020 with seed funding in in 2017 and has been an ongoing supporter of ID2020’s work.\n \n \n \n \n The American multinational technology company joined ID2020 in January 2018 as a founding partner. Members of the Microsoft team sit on ID2020’s Technical and Program Delivery Advisory Committees.\n \n \n \n \n Created by IDEO, the international design and consulting firm, to design products, services, and experiences to improve the lives of people in poor and vulnerable communities, IDEO.org joined ID2020 in 2018. IDEO.org is represented on our Program Delivery and Ecosystem & Advocacy Advisory Committees.\n \n \n \n \n \n \n \n \n \n \n The Alliance, a collaborative effort of global partners, is solving for scale from day one \n \n \n \n \n \n \n Closing the identity gap is an enormous challenge. It will take the work of many committed people and organizations coming together across different geographies, sectors and technologies. But it’s exciting to imagine a world where safe and secure digital identities are possible, providing everyone with an essential building block to every right and opportunity they deserve.\n Peggy Johnson\n Executive VP, Business Development, Microsoft Corporation\n \n \n Digital identity has the capacity to enable access to vital, life-saving services in many different development and humanitarian contexts, including by accelerating access to basic health care systems. I am excited to join ID2020's Executive Board, and guide the organization and partners in harnessing innovative technologies and multi-sectoral collaboration to benefit the world's most vulnerable populations.\n Dr. Seth Berkley\n CEO, Gavi, the Vaccine Alliance\n \n \n Accenture has joined the ID2020 Alliance with partners like Microsoft to create an open, human-centric approach to identity. The alliance draws on advances in biometrics and innovative technologies and brings together expertise from business, government and non-government agencies.\n Christine Leong\n Digital Identity Innovations Lead\n \n \n \n \n \n \n \n \n \n \n\n \n \n \n \n \n Alliance Governance\n As an alliance, the success of this initiative depends on robust collaboration and a clearly defined means for stakeholder engagement.\n \n \n \n \n \n \n Board\n The governing body for the Alliance is the ID2020 Alliance Executive Board. The eleven mmeber board includes five independent Directors, two Directors nominated as representatives of the public sector Founding Partners, two Directors nominated as representatives of the private sector Founding Partners, one Director nominated as a privacy expert, and one Director representing funding organizations.\n \n \n \n \n \n \n Advisory Committees\n The Board is supported by four thematic Advisory Committees, which provide in-depth advice to the ID2020 Board. Membership in these committees is set by the Board, with Founding Partners eligible to nominate representatives to two Advisory Committees.\n \n \n \n \n \n \n Secretariat\n ID2020, a US-registered 501(c)(3) based in New York, NY, is the Secretariat for the Alliance. As such, ID2020 is responsible and accountable for day-to-day operations, including: raising money to fund digital ID projects, coordinating with implementing partners for project implementation, setting and managing technical standards, monitoring and evaluation, legal and financial management and administration of the governance system. Management of these activities is the responsibility of ID2020’s Executive Director."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Big Pharma And Microsoft Are Teaming Up In Something Called The 'ID2020 Alliance' That Will Combine Vaccinations With Implantable Microchips To Create Your Digital ID • Now The End Begins"],["url","https://www.nowtheendbegins.com/big-pharma-microsoft-silicon-valley-id2020-alliance-combine-vaccinations-with-implantable-microchip-digital-id-mark-beast-end-times/"],["summary","For years we’ve been watching as Microsoft founder Bill Gates, now retired from the company he founded, use his billions to give ‘free vaccinations‘ to people in third world countries. Now Bill has become a founding partner in another company, this one is called the ID2020 Alliance, and its goal is to give every human being on Earth a digital id. How do they plan on accomplishing this feat? By combining mandatory vaccinations with implantable microchips. Genius, isn’t it? And coming soon to a theater near you, as the saying goes.“And he causeth all, both small and great, rich and poor, free and bond, to receive a mark in their right hand, or in their foreheads: And that no man might buy or sell, save he that had the mark, or the name of the beast, or the number of his name. Here is wisdom. Let him that hath understanding count the number of the beast: for it is the number of a man; and his number is Six hundred threescore and six.” Revelation 13:16-18 (KJV)So now you know what Bill Gates and his wife Melinda were really doing over the past 10 years, travelling to third word countries and giving ‘free vaccinations’ to the poor, downtrodden natives. Those ‘free vaccinations‘ was research and a live testing lab to conduct the necessary experiments required to form ID2020. And as you will see today, this unholy hybrid of vaccinations and implantable microchips is already happening in Bangladesh, soon it will be Boston. A page on the Gates Foundation website says that Bill and Melinda have so far invested over $2.5 billion dollars to this project, with no end in sight. Can the man who put the world behind a personal computer now put a vaccination microchip digital ID into the global population? Bill Gates is absolutely positive he can, and indeed is well on his way to achieving that goal.“Let no man deceive you by any means: for that day shall not come, except there come a falling away first, and that man of sin be revealed, the son of perdition; Who opposeth and exalteth himself above all that is called God, or that is worshipped; so that he as God sitteth in the temple of God, shewing himself that he is God.” 2 Thessalonians 2:3,4 (KJV)We have been warning you about this for the past 10 years, and now it is happening. Are you ready for what comes next? I hope you are. Keep looking for that Blessed Hope, and thank God it comes before the time of Jacob’s trouble. If only my friend, Carl Sanders, the man who first revealed the inner-workings of the team that created the RFID microchip, had lived long enough to see this day.Vaccines now being used to harvest biometric identities of everyone; Big Brother merges with Big PharmaFROM NATURAL NEWS: The ID2020 Alliance, as it’s being called, is a digital identity program that aims to “leverage immunization” as a means of inserting tiny microchips into people’s bodies. In collaboration with the Global Alliance for Vaccines and Immunizations, also known as GAVI, the government of Bangladesh and various other “partners in government, academia, and humanitarian relief,” the ID2020 Alliance hopes to usher in this mark of the beast as a way to keep tabs on every human being living on Earth.Similar to how cattle are marked with ear tags, this globalist alliance wants all humans to be “vaccinated” with digital tracking chips that will create a seamless monitoring system for the New World Order to manage the populations of the world with ease.“We are implementing a forward-looking approach to digital identity that gives individuals control over their own personal information, while still building off existing systems and programs,” says Anir Chowdhury, a policy advisor at a2i, the Bangladesh government’s “Access to Information Program.”“The government of Bangladesh recognizes that the design of digital identity systems carries far-reaching implications for individuals’ access to services and livelihoods, and we are eager to pioneer this approach,” he adds.Look at what is on the wall at this high-level meeting of ID2020 employees. Anyone care to guess what you’re looking at? 🤔While the ID2020 program’s testing grounds are primarily in the Third World, the group says it’s also now working with governments here in the United States to start microchipping people through vaccination.In Austin, Texas, for example, the homeless population is now being exploited as a collective guinea pig for ID2020’s microchip vaccination program, which the group claims will help to “empower” homeless people by supposedly giving them “control” over their personal identity data.“The City of Austin, ID2020, and several other partners are working together with homeless people and the service providers who engage with them to develop a blockchain-enabled digital identity platform called MyPass to empower homeless people with their own identity data,” writes Chris Burt for BiometricUpdate.com.MEET THE END TIMES PLAYERS BEHIND ID2020 ALLIANCE, ALL THE USUAL SUSPECTS AND A FEW NEW ONESID2020 is also jabbing refugees with its microchip vaccinations through two inaugural pilot programs known as iRespond and Everest. According to reports, iRespond has “improved continuity of care” for more than 3,000 refugees receiving drug treatments for chronic illness. Everest, on the other hand, has “assisted with the provision of access to critical energy subsidies and a range of additional services with secure and user-centric digital identities without relying on a smartphone,” Burt writes.All of this is priming the public for an eventual mandate of microchip vaccinations, which will be required for every individual in order to buy and sell goods. Chowdhury openly admitted this in stating that digital identity systems will be necessary for “individuals’ access to services and livelihoods.”In other words, the Bible is right: A global identification system is in the works that will eventually be required for people to function in society, and ultimately survive. Without these microchips in their bodies, people won’t be able to work, let alone eat, and it’s all happening right before our very eyes.Keep in mind that ID2020 is a part of the so-called “REAL ID,” which will soon be required for those who wish to travel. REAL ID will also be used as a backdoor method of implementing mandatory vaccination policies for adults. READ MOREOur Manifesto | ID2020We believe the ability to prove one’s identity is a fundamental and universal human right. ID2020 Alliance partners jointly define functional requirements, influencing the course of technical innovation and providing a route to technical interoperability, and therefore trust and recognition. ID2020 Summit 2018: Part 1The ID2020 Alliance is a public-private partnership committed to improving lives through user-centric, portable, privacy-protecting digital identity. This year’s Summit, convened by ID2020 Alliance, brought together leaders and innovators in the field to discuss the technical and non-technical requirements to yield a collective roadmap that moves us towards broad adoption of “good” digital identity for all. Carl Sanders Helped Design The first Implantable MicrochipCarl Sanders was an engineer on the world’s first implantable microchip, and in the process of working on this incredible end times device, Carl got saved and spent the rest of his life warning people about what was coming. What you will hear in this video clip is taken from a cassette tape that was sent around churches back in the 1990’s, I had one of those copies. When the Lord had me start NTEB, Bro. Carl and I became friends and he was a guest on our program many times. This is the audio from that cassette tape. I had the privilege of interviewing Bro. Carl back in 2013, and you can listen to that interview here.Now The End Begins is your front line defense against the rising tide of darkness in the last days before the Rapture of the ChurchHOW TO DONATE:Click here to view our GoFundMe pageWhen you contribute to this fundraising effort, you are helping us to do what the Lord called us to do. The money you send in goes primarily to the overall daily operations of this site. When people ask for Bibles, we send them out at no charge. When people write in and say how much they would like gospel tracts but cannot afford them, we send them a box at no cost to them for either the tracts or the shipping, no matter where they are in the world. Even all the way to South Africa. We even restarted our weekly radio Bible study on Sunday nights again, thanks to your generous donations. All this is possible because YOU pray for us, YOU support us, and YOU give so we can continue growing.CLICK IMAGE TO ORDER YOUR BOX OF NTEB GOSPEL TRACTSBut whatever you do, don’t do nothing. Time is short and we need your help right now. If every one of the 13,131 people on our daily mailing list gave $4.50, we would reach our goal immediately. If every one of our 151,781 followers on Facebook gave $1.00 each, we would reach 300% of our goal. The same goes for our 14,500 followers on Twitter. But sadly, many will not give, so we need the ones who can and who will give to be generous. As generous as possible.“Looking for that blessed hope, and the glorious appearing of the great God and our Saviour Jesus Christ;” Titus 2:13 (KJV)“Thank you very much!” – Geoffrey, editor-in-chief, NTEBHOW TO DONATE: Click here to view our GoFundMe page"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","'ID2020 Alliance' Will Combine Vaccinations & Implantable ID Microchips | PSI Intl"],["url","https://principia-scientific.org/id2020-alliance-will-combine-vaccinations-implantable-id-microchips/"],["summary","Big Pharma is officially partnering with the tech industry to pair “immunization” with digital biometrics, meaning humans will soon be microchipped, tracked, and ultimately controlled through a global identification matrix.For years we’ve been watching as Microsoft founder Bill Gates, now retired from the company he founded, use his billions to give ‘free vaccinations‘ to people in third world countries. Now Bill has become a founding partner in another company, this one is called the ID2020 Alliance, and its goal is to give every human being on Earth a digital id. How do they plan on accomplishing this feat? By combining mandatory vaccinations with implantable microchips. Genius, isn’t it? And coming soon to a theater near you, as the saying goes.So now you know what Bill Gates and his wife Melinda were really doing over the past 10 years, travelling to third word countries and giving ‘free vaccinations’ to the poor, downtrodden natives. Those ‘free vaccinations‘ was research and a live testing lab to conduct the necessary experiments required to form ID2020.And as you will see today, this unholy hybrid of vaccinations and implantable microchips is already happening in Bangladesh, soon it will be Boston. A page on the Gates Foundation website says that Bill and Melinda have so far invested over $2.5 billion dollars to this project, with no end in sight.Can the man who put the world behind a personal computer now put a vaccination microchip digital ID into the global population? Bill Gates is absolutely positive he can, and indeed is well on his way to achieving that goal.“Let no man deceive you by any means: for that day shall not come, except there come a falling away first, and that man of sin be revealed, the son of perdition; Who opposeth and exalteth himself above all that is called God, or that is worshipped; so that he as God sitteth in the temple of God, shewing himself that he is God.” 2 Thessalonians 2:3,4 (KJV)We have been warning you about this for the past 10 years, and now it is happening. Are you ready for what comes next? I hope you are. Keep looking for that Blessed Hope, and thank God it comes before the time of Jacob’s trouble. If only my friend, Carl Sanders, the man who first revealed the inner-workings of the team that created the RFID microchip, had lived long enough to see this day.Vaccines now being used to harvest biometric identities of everyone; Big Brother merges with Big PharmaFROM NATURAL NEWS: The ID2020 Alliance, as it’s being called, is a digital identity program that aims to “leverage immunization” as a means of inserting tiny microchips into people’s bodies. In collaboration with the Global Alliance for Vaccines and Immunizations, also known as GAVI, the government of Bangladesh and various other “partners in government, academia, and humanitarian relief,” the ID2020 Alliance hopes to usher in this mark of the beast as a way to keep tabs on every human being living on Earth.Similar to how cattle are marked with ear tags, this globalist alliance wants all humans to be “vaccinated” with digital tracking chips that will create a seamless monitoring system for the New World Order to manage the populations of the world with ease.“WE ARE IMPLEMENTING A FORWARD-LOOKING APPROACH TO DIGITAL IDENTITY THAT GIVES INDIVIDUALS CONTROL OVER THEIR OWN PERSONAL INFORMATION, WHILE STILL BUILDING OFF EXISTING SYSTEMS AND PROGRAMS,” SAYS ANIR CHOWDHURY, A POLICY ADVISOR AT A2I, THE BANGLADESH GOVERNMENT’S “ACCESS TO INFORMATION PROGRAM.”“The government of Bangladesh recognizes that the design of digital identity systems carries far-reaching implications for individuals’ access to services and livelihoods, and we are eager to pioneer this approach,” he adds.Look at what is on the wall at this high-level meeting of ID2020 employees. Anyone care to guess what you’re looking at? While the ID2020 program’s testing grounds are primarily in the Third World, the group says it’s also now working with governments here in the United States to start microchipping people through vaccination.IN AUSTIN, TEXAS, FOR EXAMPLE, THE HOMELESS POPULATION IS NOW BEING EXPLOITED AS A COLLECTIVE GUINEA PIG FOR ID2020’S MICROCHIP VACCINATION PROGRAM, WHICH THE GROUP CLAIMS WILL HELP TO “EMPOWER” HOMELESS PEOPLE BY SUPPOSEDLY GIVING THEM “CONTROL” OVER THEIR PERSONAL IDENTITY DATA.“The City of Austin, ID2020, and several other partners are working together with homeless people and the service providers who engage with them to develop a blockchain-enabled digital identity platform called MyPass to empower homeless people with their own identity data,” writes Chris Burt for BiometricUpdate.com.MEET THE END TIMES PLAYERS BEHIND ID2020 ALLIANCE, ALL THE USUAL SUSPECTS AND A FEW NEW ONESID2020 is also jabbing refugees with its microchip vaccinations through two inaugural pilot programs known as iRespond and Everest. According to reports, iRespond has “improved continuity of care” for more than 3,000 refugees receiving drug treatments for chronic illness. Everest, on the other hand, has “assisted with the provision of access to critical energy subsidies and a range of additional services with secure and user-centric digital identities without relying on a smartphone,” Burt writes.All of this is priming the public for an eventual mandate of microchip vaccinations, which will be required for every individual in order to buy and sell goods. Chowdhury openly admitted this in stating that digital identity systems will be necessary for “individuals’ access to services and livelihoods.”In other words, the Bible is right: A global identification system is in the works that will eventually be required for people to function in society, and ultimately survive. Without these microchips in their bodies, people won’t be able to work, let alone eat, and it’s all happening right before our very eyes.Keep in mind that ID2020 is a part of the so-called “REAL ID,” which will soon be required for those who wish to travel. REAL ID will also be used as a backdoor method of implementing mandatory vaccination policies for adults. READ MOREOur Manifesto | ID2020We believe the ability to prove one’s identity is a fundamental and universal human right. ID2020 Alliance partners jointly define functional requirements, influencing the course of technical innovation and providing a route to technical interoperability, and therefore trust and recognition.ID2020 Summit 2018: Part 1The ID2020 Alliance is a public-private partnership committed to improving lives through user-centric, portable, privacy-protecting digital identity. This year’s Summit, convened by ID2020 Alliance, brought together leaders and innovators in the field to discuss the technical and non-technical requirements to yield a collective roadmap that moves us towards broad adoption of “good” digital identity for all.Carl Sanders Helped Design The first Implantable MicrochipCarl Sanders was an engineer on the world’s first implantable microchip, and in the process of working on this incredible end times device, Carl got saved and spent the rest of his life warning people about what was coming. What you will hear in this video clip is taken from a cassette tape that was sent around churches back in the 1990’s, I had one of those copies. When the Lord had me start NTEB, Bro. Carl and I became friends and he was a guest on our program many times. This is the audio from that cassette tape. I had the privilege of interviewing Bro. Carl back in 2013, and you can listen to that interview here.****PRINCIPIA SCIENTIFIC INTERNATIONAL, legally registered in the UK as a company incorporated for charitable purposes. Head Office: 27 Old Gloucester Street, London WC1N 3AX. Please DONATE TODAY To Help Our Non-Profit Mission To Defend The Scientific Method."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Drug companies race to test coronavirus vaccines"],["url","https://www.cnn.com/2020/02/27/investing/coronavirus-vaccine/index.html"],["summary","New York (CNN Business)Gilead Sciences stock was up slightly on Thursday, even as the Dow plunged into correction status. The reason? The biotech company is moving closer to finding a potential treatment for the deadly coronavirus. It plans to start administering its remdesivir drug to patients next month. Shares of Gilead Sciences (GILD) have risen more than 10% in the past five days as the race to find an effective treatment for the outbreak continues. It's not alone. The stocks of two smaller biotechs working on coronavirus vaccines -- Moderna (MRNA) and Novavax (NVAX) -- have both soared in the past few days on hopes that their treatments may show some success as well.Gilead said in a statement late Wednesday that it will be administering its remdesivir drug to \"approximately 1,000 patients at medical centers primarily across Asian countries, as well as other countries globally with high numbers of diagnosed cases, beginning in March.\"The World Health Organization has said that remdesivir may have the best chance of effectively treating the Wuhan coronavirus.Gilead said in its statement that it will conduct two randomized studies to evaluate the effectiveness of different dosing durations of remdesivir.One will be for about 400 patients with severe clinical manifestations of coronavirus. The other will be for about 600 patients with more moderate symptoms. Patients in both groups will receive the drug for either five or 10 days."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","US health officials say human trials on coronavirus vaccine to start in 6 weeks"],["url","https://www.cnbc.com/amp/2020/02/25/us-health-officials-say-human-trials-on-coronavirus-vaccine-to-start-in-6-weeks.html"],["summary","Human trials testing a potential vaccine for the COVID-19 coronavirus are expected to begin in six weeks, U.S. health officials announced Tuesday.\"We are on time at least and maybe even a little bit better,\" Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters.Passengers arrive at LAX from Shanghai, China, after a positive case of the coronavirus was announced in the Orange County suburb of Los Angeles, California, January 26, 2020.Ringo Chiu | ReutersHuman trials testing a potential vaccine for the COVID-19 coronavirus are expected to begin in six weeks, U.S. health officials announced Tuesday.\"We are on time at least and maybe even a little bit better,\" Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, an agency within the Department of Health and Human Services, told reporters at a press conference. \"Hopefully, no further glitches.\"The White House reportedly asked Congress on Monday for $1.25 billion in additional funding to bolster its coronavirus response, including money to develop a vaccine and therapeutics to treat the virus. The National Institutes of Health has been working with biotech company Moderna to develop a vaccine using the current strain of the coronavirus.Hopes to get a vaccine to market are high, but doctors want expectations to be low for how quickly it can happen. Developing, testing and reviewing any potential vaccine is a long, complex and expensive endeavor that could take months or even years, global health experts say. Before researchers can begin human trials, they must have a firm understanding of the pathogen, run safety tests and find enough human volunteers.U.S. health officials are fast-tracking work on a coronavirus vaccine.Fauci said Tuesday that the potential vaccine has so far been put into mice and is \"immunogenic,\" or triggers a response in the immune system, suggesting it could fight the virus.\"The gene has been expressed in the platform, in this case, a messenger RNA. The material has been produced, it's been put into mice. It's immunogenic,\" he said. \"It's now getting ready to go through the regulatory issues of getting it to go.\"Fauci said a vaccine may not solve \"problems in the next couple of months but it certainly would be an important tool that we would have.\" He said it's possible the virus will prove to be seasonal, thus likely to subside in the warmer months like the flu.There are currently no proven therapies for the latest outbreak, which has killed at least 2,704 and sickened more than 80,200 people worldwide since emerging from the Chinese city of Wuhan about two months ago.Local authorities in China have using Gilead Sciences' antiviral drug Remdesivir, which was tested as a possible treatment during the Ebola outbreak, U.S. health officials said last month. Some authorities are also using antiviral drug Kaletra, developed by drugmaker AbbVie, on a \"compassionate basis.\"Earlier in the day, the Centers for Disease Control and Prevention outlined what schools and businesses will likely need to do if the COVID-19 virus becomes an epidemic outbreak in the U.S.\"We are asking the American public to work with us to prepare for the expectation that this could be bad,\" Dr. Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, told reporters on a conference call.The CDC late Monday confirmed 53 cases in the U.S., a majority of which came from passengers repatriated from the Diamond Princess cruise ship that was quarantined off the coast of Japan. The data shows that 36 of the cases are attributed to the cruise ship, three patients were infected in Wuhan and later evacuated to the U.S., and the rest were largely infected while traveling overseas.Just two cases were contracted through person-to-person contact in the U.S., the CDC said.Later Tuesday, U.S. health officials said the outbreak will likely become a global pandemic. They also confirmed four new cases from the cruise ship.\"Current global circumstances suggest it's likely this virus will cause a pandemic,\" Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention told reporters at a news briefing.\"It's not so much a question of if this will happen any more, but rather more a question of when this will happen and how many people in this country will become infected and how many of those will develop severe or more complicated disease,\" she added.CNBC's Noah Higgins-Dunn contributed to this report."],["topImageUrl",null],["error",null]]}]}],["text","轉～值得參考儆醒防範\n——-\nCOVID 19 VACCINE WARNING! MARK OF THE BEAST! MANDATED VACCINE+CHIP\n疫苗警告！兽印！强制性疫苗+芯片\nhttps://www.youtube.com/watch?v=IMc74QpJf04\nWatchwoman 2020年2月27日\n今天是2020年2月27日。一礼拜之前主赐给我一个很长的梦。我今天在这个视频中，只将重要的一部分发布出来。通过这个梦，我要警告大家，务必抵挡政府要你注射的疫苗，因为那里面结合着一个植入芯片，而且这个疫苗将会在你的手上注射！这个芯片就是那“兽印”！\n还有，我们看到有一种防流感的疫苗，也要出来，那是一种严重的流感病毒。\n在梦里，有一个邪恶的女人，我已经是个成年人，能够允许她去对我做她要做的事情。她站在我前面，手里拿着一只注射针头，注射管是紫色薰衣草的颜色，里面有液体。她看着我说：“这是为了医治你的焦虑症。”我刚一同意，她立即就给我注射了。然后我感觉自己失去了知觉，无法控制我的身体了。当时我好像半睡半醒的状态，我向下看我的手，上面有两只创可贴，而不是一只创可贴。她说只给我注射一针，为何有两只创可贴呢？\n那个梦还在继续，我看到的下一件事就是，我的名字从生命册上被耶稣的眼泪涂抹了。祂的眼泪流到我的名字上，无论我多么努力，我再也无法将我的名字写回去了。\n当我醒来以后，就赶紧把这个梦的内容，详细记录下来。我明白了，这是神在提醒我，即将有一种疫苗，与兽印结合在一起，注射进入我们的人体里，而且还要给全世界的人注射。我认为，他们会知道他们自己正在接受一个芯片在手上，但是, 却以某种方式与疫苗相捆绑。有可能是在同一次注射当中植入的，也可能说是为了预防冠状病毒，或者说是预防即将到来的其它的坏病毒。你必须同意和允许他们在你手上植入这个兽印芯片。\n当我进行研究的时候，我发现了一些信息。我将链接放在本视频的下方的“Description Box”里面。\n有一种东西，叫做“ID 2020”。那是有世界上最富有的人们所计划运行的，包括比尔·盖茨基金会，以及其他世界上最有的钱人。他们企图要让人们接受一种联合疫苗和追踪芯片，称之为“ID 2020”。他们正在世界上的贫穷地区，开始试验这个东西。\n就在2月25日，两天前，CDC宣布，他们要开始在美国进行疫苗注射试验，在那些已经患上冠状病毒的人们身上进行。他们表示很高兴地宣布，他们已经有一种疫苗了，他们认为这看起来很好，但我觉得这很奇怪，怎么会这么快，似乎已经早有预备呢？好像他们早就准备要给人们注射这种疫苗了？\n如果你感染了冠状病毒，也不要参加任何一种像这样的试验，因为我很清楚，这种疫苗，是以某种方式，与兽印芯片相结合。他们企图植入你的右手上面，或是你的额头上面。\n我这是一个严重的警告，接受了他们的兽印的人，再也无法进入天国了！因为在圣经《启示录》13:16中说过：“牠又叫众人，无论大小贫富、自主的、为奴的，都在右手里，或是在额里，受一个印记。”14:9“若有人敬拜兽和兽像，在额里，或手里，受了牠的印记（接受了兽印），这人必喝神大怒的酒；此酒斟在神忿怒的杯中纯一不杂。他要在圣天使和羔羊面前，在火与硫磺之中受痛苦。他们受痛苦的烟往上冒，直到永永远远。有谁敬拜兽和兽像，受牠名之印记的，昼夜不得安宁。”\n耶稣很快就要回来了。我向那些没有跟随神的人们发出警告。你们很可能要面对这件事情。那些已经感染了冠状病毒的人们，生病的人们，考虑要接受疫苗试验的人们，要坚定持守你对耶稣基督的信仰，相信圣经，拒绝疫苗和兽印。这是从耶稣而来的强烈警告！而且我已经得到了多个印证，我非常清楚，他们要对我们做什么！\n请将此警告，尽可能多地传播出去！愿神祝福你！\n——-\n在此影片下方有說明\n內容如下：\n（可自行用網路翻譯下文）\n\nID2020\nhttps://id2020.org/alliance\n\nhttps://www.nowtheendbegins.com/big-pharma-microsoft-silicon-valley-id2020-alliance-combine-vaccinations-with-implantable-microchip-digital-id-mark-beast-end-times/\n\nVACCINE plus MICROCHIP\nhttps://principia-scientific.org/id2020-alliance-will-combine-vaccinations-implantable-id-microchips/\n\nUS COMPANIES RACE TO TEST CORONA VIRUS VACCINE\nhttps://www.cnn.com/2020/02/27/investing/coronavirus-vaccine/index.html\n\nUS VACCINE TRIALS\nhttps://www.cnbc.com/amp/2020/02/25/us-health-officials-say-human-trials-on-coronavirus-vaccine-to-start-in-6-weeks.html\n"],["id","2ova5eb307l8a"],["createdAt","2020-02-29T17:32:42.298Z"]]},{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",1],["user",null],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","★ How to Get to Mars. Very Cool! HD"],["url","http://www.youtube.com/embed/XRCIzZHpFtY?rel=0"],["summary","\"How To get to Mars\" is a clip from the IMAX documentary \"Roving Mars\" from 2006. This is an edited short version. \n\nMy photos: https://plus.google.com/u/0/b/105656643463219506384/+aheli\n\nDVD - Roving Mars 2006 : Spirit, Opportunity, and the Exploration of the Red Planet @ amazon.com http://www.amazon.com/Roving-Mars-Spirit-Opportunity-Exploration/dp/B003XU7W0A\n\n★ The Largest Stars in the Universe | Infographic Animation ► https://www.youtube.com/watch?v=JqAJnrL27OY\n★ The Most Astounding Fact - Neil deGrasse Tyson | Kinetic ►Typography https://www.youtube.com/watch?v=p2DXqJ7mjKY\n★ TOP 10 - Best of Hubble Space Telescope - 2015 ► http://www.youtube.com/watch?v=Lmx19_0GX8o\n\nGame Of Thrones - Theme (OneCamBand Western Cover) https://www.youtube.com/watch?v=Rln_qHoWIqg\n\nFrom Wiki : Spirit, MER-A (Mars Exploration Rover -- A), is a robotic rover on Mars, active from 2004 to 2010. It was one of two rovers of NASA's ongoing Mars Exploration Rover Mission. It landed successfully on Mars at 04:35 Ground UTC on January 4, 2004, three weeks before its twin, Opportunity (MER-B), landed on the other side of the planet. Its name was chosen through a NASA-sponsored student essay competition. The rover became stuck in late 2009, and its last communication with Earth was sent on March 22, 2010.\nThe rover completed its planned 90-sol mission. Aided by cleaning events that resulted in higher power from its solar panels, Spirit went on to function effectively over twenty times longer than NASA planners expected following mission completion. Spirit also logged 7.73 km (4.8 mi) of driving instead of the planned 600 m (0.4 mi), allowing more extensive geological analysis of Martian rocks and planetary surface features. Initial scientific results from the first phase of the mission (the 90-sol prime mission) were published in a special issue of the journal Science.\nOn May 1, 2009 (5 years, 3 months, 27 Earth days after landing; 21.6 times the planned mission duration), Spirit became stuck in soft soil. This was not the first of the mission's \"embedding events\" and for the following eight months NASA carefully analyzed the situation, running Earth-based theoretical and practical simulations, and finally programming the rover to make extrication drives in an attempt to free itself. These efforts continued until January 26, 2010 when NASA officials announced that the rover was likely irrecoverably obstructed by its location in soft soil, though it continued to perform scientific research from its current location.\nThe rover continued in a stationary science platform role until communication with Spirit stopped on sol 2210 (March 22, 2010). JPL continued to attempt to regain contact until May 24, 2011, when NASA announced that efforts to communicate with the unresponsive rover had ended. A formal farewell was planned at NASA headquarters after the Memorial Day holiday and was televised on NASA TV.\n\n\nHope you enjoyed it!"],["topImageUrl","https://i.ytimg.com/vi/XRCIzZHpFtY/hqdefault.jpg"],["error",null]]}]}],["text","超好看！NASA是如何登陸火星的，全程拍的非常清楚，一定要看!!\n\nhttp://www.youtube.com/embed/XRCIzZHpFtY?rel=0 \n太値得一看了"],["id","5509659771555-rumor"],["createdAt","2017-01-16T08:48:00.000Z"]]},{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",1],["user",{"__iterable":"Map","data":[["id","j4S8C_Thvr08ZwnFP7tCme_yny2p5SIsAdAtA2kR0ADYRSOuc"],["name","孜孜不倦的新豐布萊茲™"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Coronavirus: When the police knock at your door"],["url","https://www.bbc.co.uk/news/technology-52017993"],["summary","Image copyright\n Milo Hsieh\n \n \n \n Milo Hsieh is an American University student living in Taiwan under quarantine. The BBC asked him to write this article after one of his tweets about having his movements tracked by a satellite-based system was widely shared.I did not expect two police officers to come knocking at my door at 08:15 when I was still asleep in my bed on Sunday morning. My phone briefly ran out of battery at 07:30, and in less than an hour, four different local administrative units had called. A patrol was dispatched to check my whereabouts. A text was sent notifying that the government had lost track of me, and warned me of potential arrest if I had broken quarantine.I returned to Taiwan last Thursday to experience the island's zero-risk take on coronavirus. Since I was coming back from Europe, I am subjected to a mandatory 14 days home quarantine. Before I had my passport checked, I had to pass through a booth set up by the Ministry of Health and Welfare. I filled out a document detailing places I had visited in the last fortnight, my phone number, landline and address. They notified me that my phone would be \"satellite-tracked\" for enforcement.The level of precaution taken in Taiwan is nothing like what I saw in Europe.\n \n \n \n \n \n \n Image copyright\n Milo Hsieh\n \n \n \n \n Image caption\n \n People flying back into Taiwan must go into 14 days of quarantine to help combat the spread of coronavirus\n \n \n \n During the initial phase of lockdown in Belgium, which I had to leave after my study programme was cancelled, people still went out and lined up at fast food kiosks. Even as an outbreak was happening in northern Italy, I saw during my visit to London in the first weekend of March, that people were still going to pubs. Here, I am not allowed to step outside the apartment. I was not allowed to take public transport on my way back, and had to take special \"quarantine taxis.\" My entire family has to quarantine with me for two weeks. This includes Biscuit, our dog. \n \n \n \n \n \n \n \n \n How does Taiwan's system work?The island refers to its phone-tracking system as being an \"electronic fence\".Rather than ask users to download a special app or wear a location-transmitting wristband - as has been the case in some East Asian countries - it uses existing phone signals to triangulate the owner's locations.To ensure users comply, an alert is sent to the authorities if the handset is turned off for more than 15 minutes. More than 6,000 people subjected to home quarantine are simultaneously tracked this way.And to check that the phone has not simply been left behind, officials phone users up to twice a day to check they have their mobile to hand, and to ask about their health.\n \n \n \n \n \n \n \n \n Recently, many Taiwanese, especially students, have returned to the island, as their schools overseas have closed and life around the world has ground to a halt. Some see the mandatory quarantine they have to go through as a necessary measure.Frank Tseng is among them. He is one of my friends at American University, and he recently returned from Washington DC. \n \n \n \n \n \n \n Image copyright\n Milo Hsieh\n \n \n \n \n Image caption\n \n Arrivals to Taiwan have to sign a pledge saying they will stay behind closed doors for a fortnight and keep a record of their temperature\n \n \n \n \"I feel like even though it's a pain for the citizens who are coming back, I understand that it's a necessary process many of us have to take to go home,\" he told me.But some see the enforcement mechanism as problematic.Paul Huang, a local freelance journalist who was working abroad, decided to not go back to Taiwan because of surveillance fears. \"The government openly stated your phone will be digitally tracked to enforce quarantine - in the same way the authority usually tracks suspected criminals,\" he explained.\"Except this time they don't have or need a court-issued warrant to spy on your phone. \"You are being suspected of a crime by virtue of having travelled overseas.\" \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n Paul has published articles critical of the Taiwan government in the past, including one calling its military a \"hollow shell\". When entering the border, I was only notified that my phone would be tracked and that the local township official would give me a call daily. I was not made aware of any rights I had and did not sign documents consenting to surveillance. As cases of the virus rise in Taiwan, the people seem to have entrusted the government with more power to contain the pandemic. \n \n \n \n \n \n \n Image copyright\n Getty Images\n \n \n \n \n Image caption\n \n Metro station staff in Taiwan have used thermal scans to try to detect passengers who have the virus\n \n \n \n But as the Taiwan government showcases its mass surveillance capability amid the crisis, it brings into question how it can be used in the wrong hands.Brian Hioe, who runs New Bloom, a left-leaning publication focused on Taiwan, shared this concern with me. His worry is that \"the state may retain its expanded powers and continue with surveillance practices once the crisis has passed\".At the same time, despite analysis by some that Taiwan's alleged culture of obedience makes it easier to empower the state to contain the outbreak, Brian and I both agree that the vibrant civil society will readily fight back if the government oversteps its power.At the end of the day, I will be staying home to complete my mandatory 14 days of home quarantine without being too paranoid about what the government knows or does not know about me. But I do feel a little uncomfortable knowing that my neighbour could turn me in to the police if they see me outside of my apartment door, doing something as simple as taking out the trash."],["topImageUrl",null],["error",null]]}]}],["text","https://www.bbc.co.uk/news/technology-52017993"],["id","1n3kcuskx63ap"],["createdAt","2020-03-28T00:12:27.649Z"]]},{"__iterable":"Map","data":[["replyCount",2],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",2],["user",{"__iterable":"Map","data":[["id","j4S8C_Gt39E0beYXrqCc2Gd0j3fGn0m4ncYapmxj9ibHxBziw"],["name","精力充沛的前金畢夏普"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Vitamin C Protects Against Coronavirus"],["url","http://orthomolecular.org/resources/omns/v16n04.shtml"],["summary","This article may be reprinted free of charge provided 1) that there is clear attribution to the Orthomolecular Medicine News Service, and 2) that both the OMNS free subscription link http://orthomolecular.org/subscribe.html and also the OMNS archive link http://orthomolecular.org/resources/omns/index.shtml are included.\n\n\n\n\nFOR IMMEDIATE RELEASE \nOrthomolecular Medicine News Service, Jan 26, 2020\n\n\n\n\nby Andrew W. Saul, Editor \n\n\n(OMNS January 26, 2020) The coronavirus pandemic can be dramatically slowed, or stopped, with the immediate widespread use of high doses of vitamin C. Physicians have demonstrated the powerful antiviral action of vitamin C for decades. There has been a lack of media coverage of this effective and successful approach against viruses in general, and coronavirus in particular. \n\nIt is very important to maximize the body's anti-oxidative capacity and natural immunity to prevent and minimize symptoms when a virus attacks the human body. The host environment is crucial. Preventing is obviously easier than treating severe illness. But treat serious illness seriously. Do not hesitate to seek medical attention. It is not an either-or choice. Vitamin C can be used right along with medicines when they are indicated.\n\n\n\"I have not seen any flu yet that was not cured or markedly ameliorated by massive doses of vitamin C.\"(Robert F. Cathcart, MD)\n\nThe physicians of the Orthomolecular Medicine News Service and the International Society for Orthomolecular Medicine urge a nutrient-based method to prevent or minimize symptoms for future viral infection. The following inexpensive supplemental levels are recommended for adults; for children reduce these in proportion to body weight: \n\nVitamin C: 3,000 milligrams (or more) daily, in divided doses. \n\nVitamin D3: 2,000 International Units daily. (Start with 5,000 IU/day for two weeks, then reduce to 2,000)\n\nMagnesium: 400 mg daily (in citrate, malate, chelate, or chloride form) \n\nZinc: 20 mg daily\n\nSelenium: 100 mcg (micrograms) daily\n\nVitamin C [1], Vitamin D [2], magnesium [3], zinc [4], and selenium [5] have been shown to strengthen the immune system against viruses. \n\nThe basis for using high doses of vitamin C to prevent and combat virus-caused illness may be traced back to vitamin C's early success against polio, first reported in the late 1940s.[6] Many people are unaware, even surprised, to learn this. Further clinical evidence built up over the decades, leading to an anti-virus protocol published in 1980.[7]\n\nIt is important to remember that preventing and treating respiratory infections with large amounts of vitamin C is well established. Those who believe that vitamin C generally has merit, but massive doses are ineffective or somehow harmful, will do well to read the original papers for themselves. To dismiss the work of these doctors simply because they had success so long ago sidesteps a more important question: Why has the benefit of their clinical experience not been presented to the public by responsible governmental authorities, especially in the face of a viral pandemic? \n\n\n\n\nReferences:\n\n1. Vitamin C: \n\nCase HS (2018) Vitamin C questions answered. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v14n12.shtml.\n\n Gonzalez MJ, Berdiel MJ, Duconge J (2018) High dose vitamin C and influenza: A case report. J Orthomol Med. June, 2018, 33(3). \nhttps://isom.ca/article/high-dose-vitamin-c-influenza-case-report.\n\nGorton HC, Jarvis K (1999) The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manip Physiol Ther, 22:8, 530-533. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10543583 \n\nHemilä H (2017) Vitamin C and infections. Nutrients. 9(4). pii:E339. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28353648.\n\nHickey S, Saul AW (2015) Vitamin C: The real story. Basic Health Pub. ISBN-13: 978-1591202233.\n\nLevy TE (2014) The clinical impact of vitamin C. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v10n14.shtml\n\nOMNS (2007) Vitamin C: a highly effective treatment for colds. \nhttp://orthomolecular.org/resources/omns/v03n05.shtml.\n\nOMNS (2009) Vitamin C as an antiviral \nhttp://orthomolecular.org/resources/omns/v05n09.shtml.\n\nTaylor T (2017) Vitamin C material: where to start, what to watch. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n20.shtml.\n\nYejin Kim, Hyemin Kim, Seyeon Bae et al. (2013) Vitamin C is an essential factor on the anti-viral immune responses through the production of interferon-α/β at the initial stage of influenza A virus (H3N2) infection. Immune Netw. 13:70-74. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23700397.\n\n\n\n\n2. Vitamin D: \n\nCannell JJ, Vieth R, Umhau JC et al. (2006) Epidemic influenza and vitamin D. Epidemiol Infect. 134:1129-1140. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nCannell JJ, Zasloff M, Garland CF et al. (2008) On the epidemiology of influenza. Virol J. 5:29. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nGinde AA, Mansbach JM, Camargo CA Jr. (2009) Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 169:384-390. \nhttps://www.ncbi.nlm.nih.gov/pubmed/19237723.\n\nMartineau AR, Jolliffe DA, Hooper RL et al. (2017) Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 356:i6583. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28202713.\n\nUrashima M, Segawa T, Okazaki M et al. (2010) Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 91:1255-60. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20219962.\n\nvon Essen MR, Kongsbak M, Schjerling P et al. (2010) Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nat Immunol. 11:344-349. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20208539.\n\n\n\n3. Magnesium:\n\nDean C (2017) Magnesium. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n22.shtml\n\nDean C. (2017) The Magnesium Miracle. 2nd Ed., Ballantine Books. ISBN-13: 978-0399594441. \n\nLevy TE (2019) Magnesium: Reversing Disease. Medfox Pub. ISBN-13: 978-0998312408\n\n\n\n4. Zinc: \n\nFraker PJ, King LE, Laakko T, Vollmer TL. (2000) The dynamic link between the integrity of the immune system and zinc status. J Nutr. 130:1399S-406S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801951.\n\nLiu MJ, Bao S, Gálvez-Peralta M, et al. (2013) ZIP8 regulates host defense through zinc-mediated inhibition of NF-кB. Cell Rep. 3:386-400. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23403290.\n\nMocchegiani E, Muzzioli M. (2000) Therapeutic application of zinc in human immunodeficiency virus against opportunistic infections. J Nutr. 130:1424S-1431S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801955.\n\nShankar AH, Prasad AS. (1998) Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr. 68:447S-463S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/9701160.\n\n\n\n5. Selenium:\n\nBeck MA, Levander OA, Handy J. (2003) Selenium deficiency and viral infection. J Nutr. 133:1463S-1467S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/12730444.\n\nHoffmann PR, Berry MJ. (2008) The influence of selenium on immune responses. Mol Nutr Food Res. 52:1273-1280. \nhttps://www.ncbi.nlm.nih.gov/pubmed/18384097.\n\nSteinbrenner H, Al-Quraishy S, Dkhil MA et al. (2015) Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 6:73-82. \nhttps://www.ncbi.nlm.nih.gov/pubmed/25593145.\n\n\n\n6. Klenner FR. The treatment of poliomyelitis and other virus diseases with vitamin C. J South Med Surg 1949, 111:210-214. \nhttp://www.doctoryourself.com/klennerpaper.html.\n\n7. Cathcart RF. The method of determining proper doses of vitamin C for treatment of diseases by titrating to bowel tolerance. Australian Nurses J 1980, 9(4):9-13. \nhttp://www.doctoryourself.com/titration.html \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nNutritional Medicine is Orthomolecular Medicine\nOrthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org\n\n\n\nFind a Doctor\nTo locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml\n\n\n\nThe peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource.\n \n\n\n\nEditorial Review Board:\nIlyès Baghli, M.D. (Algeria)\nIan Brighthope, M.D. (Australia) \nProf. Gilbert Henri Crussol (Spain)\nCarolyn Dean, M.D., N.D. (USA) \nDamien Downing, M.D. (United Kingdom) \nMichael Ellis, M.D. (Australia) \nMartin P. Gallagher, M.D., D.C. (USA) \nMichael J. Gonzalez, N.M.D., D.Sc., Ph.D. (Puerto Rico) \nWilliam B. Grant, Ph.D. (USA) \nTonya S. Heyman, M.D. (USA)\nSuzanne Humphries, M.D. (USA) \nRon Hunninghake, M.D. (USA)\nMichael Janson, M.D. (USA) \nRobert E. Jenkins, D.C. (USA) \nBo H. Jonsson, M.D., Ph.D. (Sweden) \nJeffrey J. Kotulski, D.O. (USA)\nPeter H. Lauda, M.D. (Austria) \nThomas Levy, M.D., J.D. (USA) \nHomer Lim, M.D. (Philippines)\nStuart Lindsey, Pharm.D. (USA) \nVictor A. Marcial-Vega, M.D. (Puerto Rico) \nCharles C. Mary, Jr., M.D. (USA) \nMignonne Mary, M.D. (USA)\nJun Matsuyama, M.D., Ph.D. (Japan)\t\nDave McCarthy, M.D. (USA)\nJoseph Mercola, D.O. (USA)\nJorge R. Miranda-Massari, Pharm.D. (Puerto Rico) \nKarin Munsterhjelm-Ahumada, M.D. (Finland) \nTahar Naili, M.D. (Algeria)\nW. Todd Penberthy, Ph.D. (USA) \nDag Viljen Poleszynski, Ph.D. (Norway) \nJeffrey A. Ruterbusch, D.O. (USA) \nGert E. Schuitemaker, Ph.D. (Netherlands) \nThomas L. Taxman, M.D. (USA)\nJagan Nathan Vamanan, M.D. (India) \nGarry Vickar, MD (USA)\nKen Walker, M.D. (Canada)\nAnne Zauderer, D.C. (USA)\n\n\nAndrew W. Saul, Ph.D. (USA), Editor-In-Chief\nEditor, Japanese Edition: Atsuo Yanagisawa, M.D., Ph.D. (Japan)\nRobert G. Smith, Ph.D. (USA), Associate Editor\nHelen Saul Case, M.S. (USA), Assistant Editor\nMichael S. Stewart, B.Sc.C.S. (USA), Technology Editor\nJason M. Saul, JD (USA), Legal Consultant\n\nComments and media contact: drsaul@doctoryourself.com OMNS welcomes but is unable to respond to individual reader emails. Reader comments become the property of OMNS and may or may not be used for publication. \n\n\n\nTo Subscribe at no charge: http://www.orthomolecular.org/subscribe.html\n\nTo Unsubscribe from this list: http://www.orthomolecular.org/unsubscribe.html"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Vitamin C Protects Against Coronavirus"],["url","http://orthomolecular.org/resources/omns/v16n04.shtml"],["summary","This article may be reprinted free of charge provided 1) that there is clear attribution to the Orthomolecular Medicine News Service, and 2) that both the OMNS free subscription link http://orthomolecular.org/subscribe.html and also the OMNS archive link http://orthomolecular.org/resources/omns/index.shtml are included.\n\n\n\n\nFOR IMMEDIATE RELEASE \nOrthomolecular Medicine News Service, Jan 26, 2020\n\n\n\n\nby Andrew W. Saul, Editor \n\n\n(OMNS January 26, 2020) The coronavirus pandemic can be dramatically slowed, or stopped, with the immediate widespread use of high doses of vitamin C. Physicians have demonstrated the powerful antiviral action of vitamin C for decades. There has been a lack of media coverage of this effective and successful approach against viruses in general, and coronavirus in particular. \n\nIt is very important to maximize the body's anti-oxidative capacity and natural immunity to prevent and minimize symptoms when a virus attacks the human body. The host environment is crucial. Preventing is obviously easier than treating severe illness. But treat serious illness seriously. Do not hesitate to seek medical attention. It is not an either-or choice. Vitamin C can be used right along with medicines when they are indicated.\n\n\n\"I have not seen any flu yet that was not cured or markedly ameliorated by massive doses of vitamin C.\"(Robert F. Cathcart, MD)\n\nThe physicians of the Orthomolecular Medicine News Service and the International Society for Orthomolecular Medicine urge a nutrient-based method to prevent or minimize symptoms for future viral infection. The following inexpensive supplemental levels are recommended for adults; for children reduce these in proportion to body weight: \n\nVitamin C: 3,000 milligrams (or more) daily, in divided doses. \n\nVitamin D3: 2,000 International Units daily. (Start with 5,000 IU/day for two weeks, then reduce to 2,000)\n\nMagnesium: 400 mg daily (in citrate, malate, chelate, or chloride form) \n\nZinc: 20 mg daily\n\nSelenium: 100 mcg (micrograms) daily\n\nVitamin C [1], Vitamin D [2], magnesium [3], zinc [4], and selenium [5] have been shown to strengthen the immune system against viruses. \n\nThe basis for using high doses of vitamin C to prevent and combat virus-caused illness may be traced back to vitamin C's early success against polio, first reported in the late 1940s.[6] Many people are unaware, even surprised, to learn this. Further clinical evidence built up over the decades, leading to an anti-virus protocol published in 1980.[7]\n\nIt is important to remember that preventing and treating respiratory infections with large amounts of vitamin C is well established. Those who believe that vitamin C generally has merit, but massive doses are ineffective or somehow harmful, will do well to read the original papers for themselves. To dismiss the work of these doctors simply because they had success so long ago sidesteps a more important question: Why has the benefit of their clinical experience not been presented to the public by responsible governmental authorities, especially in the face of a viral pandemic? \n\n\n\n\nReferences:\n\n1. Vitamin C: \n\nCase HS (2018) Vitamin C questions answered. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v14n12.shtml.\n\n Gonzalez MJ, Berdiel MJ, Duconge J (2018) High dose vitamin C and influenza: A case report. J Orthomol Med. June, 2018, 33(3). \nhttps://isom.ca/article/high-dose-vitamin-c-influenza-case-report.\n\nGorton HC, Jarvis K (1999) The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manip Physiol Ther, 22:8, 530-533. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10543583 \n\nHemilä H (2017) Vitamin C and infections. Nutrients. 9(4). pii:E339. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28353648.\n\nHickey S, Saul AW (2015) Vitamin C: The real story. Basic Health Pub. ISBN-13: 978-1591202233.\n\nLevy TE (2014) The clinical impact of vitamin C. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v10n14.shtml\n\nOMNS (2007) Vitamin C: a highly effective treatment for colds. \nhttp://orthomolecular.org/resources/omns/v03n05.shtml.\n\nOMNS (2009) Vitamin C as an antiviral \nhttp://orthomolecular.org/resources/omns/v05n09.shtml.\n\nTaylor T (2017) Vitamin C material: where to start, what to watch. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n20.shtml.\n\nYejin Kim, Hyemin Kim, Seyeon Bae et al. (2013) Vitamin C is an essential factor on the anti-viral immune responses through the production of interferon-α/β at the initial stage of influenza A virus (H3N2) infection. Immune Netw. 13:70-74. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23700397.\n\n\n\n\n2. Vitamin D: \n\nCannell JJ, Vieth R, Umhau JC et al. (2006) Epidemic influenza and vitamin D. Epidemiol Infect. 134:1129-1140. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nCannell JJ, Zasloff M, Garland CF et al. (2008) On the epidemiology of influenza. Virol J. 5:29. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nGinde AA, Mansbach JM, Camargo CA Jr. (2009) Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 169:384-390. \nhttps://www.ncbi.nlm.nih.gov/pubmed/19237723.\n\nMartineau AR, Jolliffe DA, Hooper RL et al. (2017) Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 356:i6583. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28202713.\n\nUrashima M, Segawa T, Okazaki M et al. (2010) Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 91:1255-60. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20219962.\n\nvon Essen MR, Kongsbak M, Schjerling P et al. (2010) Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nat Immunol. 11:344-349. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20208539.\n\n\n\n3. Magnesium:\n\nDean C (2017) Magnesium. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n22.shtml\n\nDean C. (2017) The Magnesium Miracle. 2nd Ed., Ballantine Books. ISBN-13: 978-0399594441. \n\nLevy TE (2019) Magnesium: Reversing Disease. Medfox Pub. ISBN-13: 978-0998312408\n\n\n\n4. Zinc: \n\nFraker PJ, King LE, Laakko T, Vollmer TL. (2000) The dynamic link between the integrity of the immune system and zinc status. J Nutr. 130:1399S-406S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801951.\n\nLiu MJ, Bao S, Gálvez-Peralta M, et al. (2013) ZIP8 regulates host defense through zinc-mediated inhibition of NF-кB. Cell Rep. 3:386-400. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23403290.\n\nMocchegiani E, Muzzioli M. (2000) Therapeutic application of zinc in human immunodeficiency virus against opportunistic infections. J Nutr. 130:1424S-1431S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801955.\n\nShankar AH, Prasad AS. (1998) Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr. 68:447S-463S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/9701160.\n\n\n\n5. Selenium:\n\nBeck MA, Levander OA, Handy J. (2003) Selenium deficiency and viral infection. J Nutr. 133:1463S-1467S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/12730444.\n\nHoffmann PR, Berry MJ. (2008) The influence of selenium on immune responses. Mol Nutr Food Res. 52:1273-1280. \nhttps://www.ncbi.nlm.nih.gov/pubmed/18384097.\n\nSteinbrenner H, Al-Quraishy S, Dkhil MA et al. (2015) Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 6:73-82. \nhttps://www.ncbi.nlm.nih.gov/pubmed/25593145.\n\n\n\n6. Klenner FR. The treatment of poliomyelitis and other virus diseases with vitamin C. J South Med Surg 1949, 111:210-214. \nhttp://www.doctoryourself.com/klennerpaper.html.\n\n7. Cathcart RF. The method of determining proper doses of vitamin C for treatment of diseases by titrating to bowel tolerance. Australian Nurses J 1980, 9(4):9-13. \nhttp://www.doctoryourself.com/titration.html \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nNutritional Medicine is Orthomolecular Medicine\nOrthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org\n\n\n\nFind a Doctor\nTo locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml\n\n\n\nThe peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource.\n \n\n\n\nEditorial Review Board:\nIlyès Baghli, M.D. (Algeria)\nIan Brighthope, M.D. (Australia) \nProf. Gilbert Henri Crussol (Spain)\nCarolyn Dean, M.D., N.D. (USA) \nDamien Downing, M.D. (United Kingdom) \nMichael Ellis, M.D. (Australia) \nMartin P. Gallagher, M.D., D.C. (USA) \nMichael J. Gonzalez, N.M.D., D.Sc., Ph.D. (Puerto Rico) \nWilliam B. Grant, Ph.D. (USA) \nTonya S. Heyman, M.D. (USA)\nSuzanne Humphries, M.D. (USA) \nRon Hunninghake, M.D. (USA)\nMichael Janson, M.D. (USA) \nRobert E. Jenkins, D.C. (USA) \nBo H. Jonsson, M.D., Ph.D. (Sweden) \nJeffrey J. Kotulski, D.O. (USA)\nPeter H. Lauda, M.D. (Austria) \nThomas Levy, M.D., J.D. (USA) \nHomer Lim, M.D. (Philippines)\nStuart Lindsey, Pharm.D. (USA) \nVictor A. Marcial-Vega, M.D. (Puerto Rico) \nCharles C. Mary, Jr., M.D. (USA) \nMignonne Mary, M.D. (USA)\nJun Matsuyama, M.D., Ph.D. (Japan)\t\nDave McCarthy, M.D. (USA)\nJoseph Mercola, D.O. (USA)\nJorge R. Miranda-Massari, Pharm.D. (Puerto Rico) \nKarin Munsterhjelm-Ahumada, M.D. (Finland) \nTahar Naili, M.D. (Algeria)\nW. Todd Penberthy, Ph.D. (USA) \nDag Viljen Poleszynski, Ph.D. (Norway) \nJeffrey A. Ruterbusch, D.O. (USA) \nGert E. Schuitemaker, Ph.D. (Netherlands) \nThomas L. Taxman, M.D. (USA)\nJagan Nathan Vamanan, M.D. (India) \nGarry Vickar, MD (USA)\nKen Walker, M.D. (Canada)\nAnne Zauderer, D.C. (USA)\n\n\nAndrew W. Saul, Ph.D. (USA), Editor-In-Chief\nEditor, Japanese Edition: Atsuo Yanagisawa, M.D., Ph.D. (Japan)\nRobert G. Smith, Ph.D. (USA), Associate Editor\nHelen Saul Case, M.S. (USA), Assistant Editor\nMichael S. Stewart, B.Sc.C.S. (USA), Technology Editor\nJason M. Saul, JD (USA), Legal Consultant\n\nComments and media contact: drsaul@doctoryourself.com OMNS welcomes but is unable to respond to individual reader emails. Reader comments become the property of OMNS and may or may not be used for publication. \n\n\n\nTo Subscribe at no charge: http://www.orthomolecular.org/subscribe.html\n\nTo Unsubscribe from this list: http://www.orthomolecular.org/unsubscribe.html"],["topImageUrl",null],["error",null]]}]}],["text","【國際分子矯正醫學會總會即時新聞稿 ISOM Immediate Press Release 】\n“維他命Ｃ對於抵抗冠狀病毒的保護”\n\n(非常感謝柳澤厚生醫師的分享，以下為中文翻譯，可參考原文連結)\n\n為回應各國政府目前被動式的預防方式如戴口罩，勤洗手以及減少外出等政策，位於加拿大的國際分子矯正醫學會總會做出官方回應(目前總會主席為柳澤厚生醫師)，國際分子矯正醫學會總會中多達四十餘國的營養專家們對於預防新型冠狀病毒感染之建議如下：\n\n有許多臨床實證指出，額外營養補充來改善身體抗氧化能力以及免疫功能可幫助預防或減低呼吸道病毒感染發生機會：\n(1) 維他命C : 每天3克或以上。\n(2) 維他命D3 : 每天125微克(5000IU)持續兩週，兩週之後維持每天50微克(2000IU)\n(3) 鋅：每天20毫克\n(4) 鎂：每天400毫克(除了氧化鎂之外的形式)\n(5) 硒：每天100微克\n\n柳澤醫師分享自身臨床經驗：(1)和(2)就已經非常足夠。\n麻煩大家多多分享轉傳。\n\n國際分子矯正醫學會總會聲明原文連結如下：http://orthomolecular.org/resources/omns/v16n04.shtml\n\n【ISOM Immediate Press Release 】\n　\"Vitamin C Protects Against Coronavirus\"\n\nIn response to the government's passive measures such as masks, hand washing and going out, government officials from the Canadian headquarters of the International Association of Orthomolecular Medicine, my chairman, issued a statement on how to prevent groundbreaking new coronavirus infection. , Published by nutrition experts in 40 countries, including me.\nThere is a great deal of clinical evidence that taking supplements to improve the body's antioxidant capacity and immune function can help prevent or reduce the onset of respiratory viral infections.\n(1) Vitamin C: 3g or more per day\n(2) Vitamin D3: 125 μg (5,000 IU) per day for 2 weeks\n維持 After that, keep at 50μg (2,000IU)\n(3) Zinc: 20 mg per day\n(4) Magnesium: 400 mg per day (other than magnesium oxide)\n(5) Selenium: 100 μg / day\nIn my experience, (1) and (2) alone are sufficient. Please share by all means.\nThe original text of this statement follows：http://orthomolecular.org/resources/omns/v16n04.shtml"],["id","1hfczhxc8b71q"],["createdAt","2020-01-29T02:03:24.657Z"]]},{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",3],["user",{"__iterable":"Map","data":[["id","j4S8C_xpwMw-S2qE1Jd4f6AwjPh8KqzGLPCQD1innQ2hucGeE"],["name","意志堅強的芎林維拉妮卡"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","The Tip of the Iceberg: Virologist David Ho (BS '74) Speaks About COVID-19"],["url","https://www.caltech.edu/about/news/tip-iceberg-virologist-david-ho-bs-74-speaks-about-covid-19?fbclid=IwAR1XVnPHq82gD97Y2Y06FkIFzAtNNfopnMgqa98fHAwX7WHzHGyBVbnZlIQ](https://www.caltech.edu/about/news/tip-iceberg-virologist-david-ho-bs-74-speaks-about-covid-19?fbclid=IwAR1XVnPHq82gD97Y2Y06FkIFzAtNNfopnMgqa98fHAwX7WHzHGyBVbnZlIQ))"],["summary","As of March 20, more than 8,700 people worldwide had died of COVID-19, the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Caltech trustee David Ho (BS '74) of the Aaron Diamond AIDS Research Center, Columbia University, says that this is just the tip of the iceberg. Ho, an expert on viral epidemics, has spent decades researching HIV/AIDS, having begun his career in Los Angeles, \"ground zero\" of the first outbreak, in the early 1980s. On March 18, Ho sat down with members of the Caltech community to discuss the novel coronavirus and the future of our society in the light of this global pandemic.Walk us through the spread of the virus in the United States. What does the country look like right now?Let me just give you a picture of what I see here in New York. About two weeks ago, we had our initial case, and now in New York City newly diagnosed confirmed cases are tripling every two days. In our New York Presbyterian Hospital, approximately 25 percent of the swab samples that are submitted for testing are positive. In the suburban communities outside of New York, approximately 10 percent of the swabs submitted are positive. So, the virus is everywhere. And in New York, we know that we are in the exponential growth phase of the epidemic.Looking back at what has transpired throughout the world, we saw the first wave hit China; the second wave hit South Korea, Italy, and Iran; and then, trailed by only about a week or so, France, Germany, Spain, and the U.S. We all know that China went through a period of great devastation. It has over 80,000 cases. Italy is rapidly catching up, with over 31,000 cases. We suspect that in the U.S. this will rapidly sweep from the coastal regions and it will hit middle America. It is already there, but we will see exponential growth very, very soon. Then of course we are all worried about what would happen when this epidemic strikes places like Africa and India where the health care system is less developed.Can you tell us about the pathology of the disease?COVID-19 typically causes fever and a dry cough. One may have aches in the body—the muscles—and if it's severe enough, there would be shortness of breath due to pneumonia.Gastrointestinal symptoms can occur and are an indication of more severe disease. It's not very common to have a runny nose or the sniffles, and a sore throat is not common either.The incubation period from exposure to onset of symptoms is between four and six days; and if you want to cover 95–98 percent of the cases it is between three and 10 days. It's pretty rare to have an incubation period outside of that range.What in particular makes this virus so dangerous?What is disturbing is that virus shedding, as detected in the mouth or nose, is very, very common and could be there prior to onset of symptoms. That's why transmission could occur from asymptomatic individuals. And virus shedding could continue for days up to three weeks after a person recovers. That is extremely worrisome for the spread of this virus. Furthermore, the stability of this virus is worrisome as well. If you put it in aerosol form and keep it in the air, the half-life is several hours; if you drop it on surfaces of copper or cardboard, it could survive about a day. But if it's on steel or plastic surfaces, you could still detect infectious virus after 72 hours, although the infectivity decreases with time.What do we know about the biology of the virus?The virus is highly related to another coronavirus called SARS coronavirus. That was another outbreak that occurred worldwide 17-18 years ago, and largely in China and Asia.The two viruses are about 80 percent identical. We know the origin of SARS was from a bat through an intermediary animal called the civet cat.Another virus called Middle Eastern Respiratory Virus, MERS, also originated in bats and infected camels, and camels passed it to humans. For COVID-19, we believe the original host must be a bat species, because that animal carries a virus that's 97 percent identical to what we're seeing now.Because of the SARS outbreak and the MERS outbreak, and research done on those two pathogens, we actually know quite a bit about coronaviruses.The outbreak began in China; how have they been dealing with the virus?This epidemic was first identified in a few cases with pneumonia in December 2019. In retrospect, there were scattered cases in November according to Chinese officials. I would say that initially there were missteps and lack of transparency that contributed to the explosive outbreak in the city of Wuhan in the central province of Hubei. That epidemic in central China accounts for 85 percent of the confirmed cases in China. It led Beijing officials to quarantine the entire province of 50 million people. The epidemic peaked in early February with 4,000 newly diagnosed cases each day. But since the lockdown and the various draconian measures applied, the number of new cases each day has been declining by half every week, and remarkably it's now down to about 20 per day. The rest of China's other provinces also applied very harsh measures and they indeed successfully flattened the curve outside of Hubei province.We know what they've done is not sustainable and the question is: What is China going to do now if it relaxes the infection control measures? Some of the recovered patients are still shedding virus and now China is surrounded by sick neighbors. Surely if they open up their borders, infection will come in the same way it came into the U.S. The world is waiting to see what China is going to do.Now in terms of the U.S., we obviously are undergoing exponential growth. The 10,400 confirmed cases is a gross underestimate. The lack of testing is embarrassing. It's an outright failure in leadership.What are the tests we need to detect coronavirus infection?Everybody's talking about testing and that's actually referring to PCR [polymerase chain reaction] testing, looking for viral RNA to determine whether a person is infected. But there's still no talk of antibody testing to determine which people have had it and are immune, and that is another crucial tool we need to combat this epidemic. Many research labs throughout the country—I'm sure at Caltech too—could be running antibody tests right now to survey the population and tell us what the real penetrance of this pathogen is in our communities. We are, on a research basis, embarking on that to understand the degree of infection in New York City and outside of New York City.How long before the U.S. sees test availability similar to what South Korea has implemented?The PCR testing, which is the one that's approved, is now ramping up very, very rapidly in state and local labs as well as in academic medical centers and in the commercial sector. Their production will grow tremendously. Roche has a machine that will run 1,000 samples at a time. If you go to a commercial lab, they take a swab, they package it, they quite often send it to another facility somewhere else. The turnaround time is typically 72 hours. In that period, it's very, very hard to manage patients and their contacts. It's a nightmare for the healthcare worker.We need point-of-care tests. Those kinds of tests are available for HIV and for many other diseases; you use a finger stick, drop the blood on a small device, and have a readout in 15 minutes. These tests measure antibody response to the virus and are extremely useful. Yet we don't have a single test licensed in the U.S. In China, in South Korea, and in Europe, those tests are used. The manufacturer for this rapid test is producing a million a day. It's there. But in the name of protecting the public, the FDA has moved very, very slowly. That delay, in my view, has caused more harm than good.Can you elaborate on point-of-care testing?It's almost like a home pregnancy test or home HIV test. These tests have been around for a long time. The test that I'm specifically referring to, coming out of China, South Korea, and approved in Europe, is an antibody test. You put a drop of blood on a plastic slide, add another drop of the buffer that comes with the test, and you let it sit for 15 minutes. Then, you look at the bands. You're negative if you have just one band, or you're positive if you have more than one band. The test also tells you type of antibody. There's a type of antibody called IgG [immunoglobulin G] and another type called IgM [immunoglobulin M]. Typically, when a person is infected, the IgM response is earlier and the IgG response is later. The two bands indicate the course of the infection.This kind of test is available all over the world for HIV. The technology is there, the tests are there. But they're not FDA approved. While I think they are fairly close to being approved, we have let several weeks go by and to me that's tragic.Will this coronavirus be seasonal?Everyone is asking whether this virus is here to stay. Initially, just based on what China did with SARS long ago, there was hope that warmer weather and more sunlight would help kill the virus in our environment and therefore lower the probability of transmission.But now this virus has gained such a strong foothold in the human population. It's already 25 times larger than SARS and it's already embedded in the Southern hemisphere. If you look at Australia, South Africa, Argentina, Brazil, there are cases there already, and community transmission is occurring. As the weather changes, perhaps the Northern hemisphere will gain an advantage. But the epidemic in the Southern hemisphere is going to accelerate.The long-term outcome may resemble influenza so that we have seasonal bouts, with the virus bouncing back and forth between the Northern and Southern hemispheres. This is of course just speculation, but that's what we see with influenza.Why does COVID-19 have less impact on children and more impact on the elderly?Well, the latter part is easy. Older people generally do less well with all sorts of respiratory infections, including influenza and SARS. So that's just the typical scenario we see. The children, however, are a mystery. As you know, children typically get flu or other respiratory viruses very quickly and bring them home to infect the parents. But in this particular case, the number of children infected in China, after extensive studies, don't seem to indicate that this is the case for this coronavirus.Some people seem to show mild symptoms while others have a more severe experience. Has the virus already mutated?RNA viruses all replicate with low fidelity. Mutations occur at pretty similar rates and these viruses typically don't have proofreading functions. In contrast, we replicate our DNA with high fidelity and we have a proofreading function to fix the errors. So, every time they replicate, there's a fixed rate of mutation. This virus is mutating but it has mutated very little so far. There are differences but probably they are functionally not important, so that's not the explanation for why you see different disease courses among the infected.For HIV it's the same thing: 10 people could be infected by the same strain but you have very different outcomes. With HIV, genetics and environmental factors play a role. Some of the genetics has been worked out; we know that there are certain tissue types that would protect and others that would harm. I suspect it's the same here.Once you become infected with the virus, can you get it again?There are a few anecdotes from China about re-infection but, if you look at those reports carefully, they're not well-documented. It could be that folks just continued to shed virus from the initial infection. Only one study was formally done and it is not a human study. It's a macaque study. They infected macaques with this virus, then waited until the monkeys recovered and tried to re-infect them. They could not. This just came out in the past few days. That bodes well for human immunity.We have now looked at a lot of serum from convalescent individuals and those serum samples have antibodies against the so-called spike protein of the virus. That's the protein that sits on the surface of the virus particle. By tightly binding, the antibody could neutralize the virus. Once an infected person develops antibodies, there should be protective immunity for quite some time. That's why we need to buy time for immunity to develop in the population.After a person recovers from the virus, how long are they still contagious?That's a very important question. We're not sure; one individual in China was shown to have persistent virus shedding for over a month. But typically, we're looking at a three-week period from onset of symptoms.What should we be doing to limit the spread of this epidemic?The social distancing and good hygiene strategies have been successfully applied, in South Korea for example, to bring their epidemic down. They're the only other country that has flattened the curve—slowed down the number of new infections to not overwhelm the healthcare system—and gradually brought this epidemic under control. There are many places that have done a pretty good job of not allowing the epidemic to explode, such as Taiwan and Hong Kong. These are places that had quite a bit of experience in fighting SARS, 17 years ago.Are you optimistic that these measures combined with research will be enough to combat the coronavirus?I personally believe we will blunt this epidemic, but I think we wasted a good four to six weeks largely because of lack of testing and lack of a certain preparedness. But I think we could still make a difference and bring it under control with very harsh measures.But again, are these measures sustainable? We've got to expect that businesses must reopen and schools must teach again. Whether it's travel or sports or live entertainment, we're going to have to return to some semblance of normalcy. But what are the measures that are effective and sustainable? That's a question we as a society have to deal with. We need to buy time so that gradually the population will have a degree of immunity.Most importantly, we need to buy time to allow science to deliver solutions. We're going to have to develop drugs, antibodies, and vaccines. I think the mobilization by the scientific community, from my perspective, is amazing. So many people have mobilized and jumped on this and are contributing, from discovering small-molecule drugs that could block various enzymes of this virus to coming up with antibodies that could neutralize the virus. Researchers have already come up with a few promising chemicals that could be a good start to drug development. There are already a few neutralizing antibodies isolated from infected individuals; my own group is in the midst of doing all that.And, of course, people are working on vaccines. A lot of companies are working on vaccines and those vaccines are at various stages. A couple are within weeks of entering human testing and that's quite, quite remarkable. There is one thing about vaccines, though: Some of the experiments previously done on SARS suggested that when animals developed antibodies and then were given the virus, they had greater lung injury due to the presence of the antibodies. The scientific community would have to resolve that issue quickly and its resolution would either halt the current approaches or unleash them to move full speed ahead. We certainly will take a part in doing that. I think we have the real possibility that COVID-19 may become a fact of life until science comes through as it has done for past epidemics.This is going to take some time. But I'm very confident that the science will rise to the task and provide a solution. But it's not going to be a few months as our president suggests. It's going to be much longer than that. I would say 18 months, or 24 months. I think we are all facing tough challenges ahead."],["topImageUrl",null],["error",null]]}]}],["text","一位北醫畢業目前在紐約當住院醫師的張銘凱醫師寫照顧COVID-19經驗，寫得非常棒，跟大家分享這篇文章：\n[經驗分享]\n我在紐約市的公立醫院擔任內科住院醫師即將完訓，七月開始會做美國感染科次專訓練。目前紐約災情慘重，我所在醫院確診加疑似病人就超過一百人，我這段其間都在顧ICU因此對於重症COVID的照顧也算有心得，我至少照顧過超過20位以上之住院病人，因為在ICU的關係大部分病人都插管，到目前為止，我應該比許多台灣醫生有武漢新冠肺炎治療之實戰經驗。因為台灣目前防疫做的非常好，多半輕症或無症狀隔離，但是我們隨時要準備如果已經是社區流行，那作為醫生該如何care這些病人，因此做個簡單的分享與教學，所以講解的對象應該是以臨床第一線之醫師或NP為主。但我要說很多evidence都不斷更新，以下是盡量有所依據的臨床處理方式，reference就不一一列舉，有些我可能覺得是一般臨床工作者應有的基本概念也許就沒有多加說明，如造成閱讀上不順暢，也請多多包涵。\n\n#流病學:相信台灣臨床醫生現在非常仰賴旅遊史畢竟沒有大規模社區感染，但是我要提醒的是如果有天已經大流行，旅遊史可能不是那麼重要了，懷疑就該驗。美國之前CDC一直很在意旅遊史而不隨意驗，結果後來發現根本大流行已經來不及了。在大爆發之前，可能會有一個空窗期就是很多原本我們以為低感染風險而沒有驗到的人，他們其實已經可能被感染。此外年輕人或沒有病史病人也非常多，這是在過去醫院前所未見的。在美國輕症就算陽性也不會住院讓他們回家，所以我所看到是真正的病人，我們已經擴充非常多病房了，但是病人真的很多，感染力真的很強要小心！至今我們已經有三個住院醫師中獎了。\n\n#臨床表現:除了發燒咳等呼吸道症狀，還常有拉肚子等GI症狀，我要特別提醒很多病人會有\"味覺失調或消失\"的症狀，這不是鼻塞引起的味覺降低。很多文獻少提味覺問題，但是一定要注意，這可能是一個sign就該檢驗。此外有些病人會表達胸痛，不一定就是很嚴重的myocarditis，就純粹是無法解釋的胸痛，但還是會建議驗一下CPK/Trop。這個病毒的潛伏期根據我看到的paper，大概平均是五天多，當然最長可能兩個禮拜，不過我現在講的是一個常態分佈的結果，你要算到最嚴苛標準，也許就兩個禮拜，但是平均還是五天多，所以你如果有接觸史，過了一個禮拜還是沒發病，你大概就safe了。\n\n#抽血:CBC(不一定會leukocytosis，反而容易lymphocytopenia and or thrombocytopenia), 常transaminitis(GOT/GPT高)。我們會大概三天監測一次Ferritin, ESR/CRP, LDH, D-dimer來觀察對藥物反應。基本blood culture, HIV, urine Legionella/strep pneumonia最好也住院時驗一下排除其他問題。\n\n#影像:CXR bilateral infiltrations。相信大家一定常常不知道病人什麼問題但是看到CXR有點白白髒髒就當肺炎收進來打抗生素住院(其實可能根本不明顯)。我要說的是這些COVID住院病人，不會只是CXR微微白白髒髒，而是一看就是明顯兩側蔓延，在我住院醫師期間真的從來沒有看到那麼多CXR都是長這個樣子的，現在我幾乎可以看到CXR就診斷。至於CT chest雖然比較清楚，但是我認為不需要，因為大部分CXR就很明顯了，加上抽血上述markers等等就算PCR還沒有等到就可以很有把握診斷了。安排CT chest只會讓醫院感控暴露風險(因為機器要大消毒，浪費時間也可能使真正需要CT的人沒辦法照到)\n\n#氧氣治療方面:如果有SOB or hypoxia，當然要監測O2 sat.一開始nasal cannula, simple mask 下一個nonrebreather mask，中間不要試BiPAP/CPAP/High flow NC你就要early intubation了！因為BiPAP等會有把病毒釋放出來空氣傳播的風險。而且COVID病人desaturation or decompensation進展真的非常快！sat keep不住就要early intubation。另外不要使用neubulizer等會霧化的藥物治療，如需支氣管闊張劑可以用MDI手壓的pump。另外ARDS常用的臥趴姿勢prone position效果感覺非常好，病人一prone血氧真的會稍微提升，有些病人甚至沒有被插管的，血氧稍微差一點的我們就會叫他趕快趴著!還真的很有用。很多插管病人我們也會給他prone，我看討論串好像台灣不是很喜歡prone因為很耗費護理師人力，不過至少我在我們醫院我看到是一大早三個主治醫師就一起合力把病人翻姿勢，其實美國醫師工作也是很辛苦的。\n\n#藥物治療:\n\n1.我知道很多診所喜歡開類固醇給\"感冒\"的病人，但是絕對要避免因為類固醇有延長viral shedding的副作用，之前在MERS等病人的研究也是類固醇壞處大於好處，因此使用類固醇除非是有其indication才用(例如septic shock等等)。\n\n2.高劑量Statin似乎有研究對防止病毒結合有幫助，因此如果LFT, CK允許可以考慮使用(lipitor 40 or 80, etc)。\n\n3.Litonavir愛滋病藥物nejm已經發表確定沒用。\n\n4.在美國我們幾乎每個病人都會給hydroxychloroquine(400mg bid for a day, then 200mg bid for 4 days)會影響lysosome fusion抑制病毒, 使用藥物前一定要EKG，如果QTc>500就不要用。我們醫院現在不加azithromycin了因為兩個一起用會延長QTc就有致死案例。對於法國研究Hydroxychloroquine+azithro很好但是我保持樂觀態度，那個研究病人量很少(n=21)，而且我實際臨床經驗覺得幫助好像有限，但是因為in vitro研究有效，我們還是會給病人就是了！\n\nCOVID似乎會跟其他呼吸道病毒一起co-infection所以還是要驗一下flu, 但是如果flu negative也不需要給tamiflu因為對covid無效。除了病毒還常bacterial superinfection，所以我們幾乎還是會給抗細菌抗生素，macrolide or levofloxacin擔心prolong QT所以我們醫院現在給doxycycline。記得驗一下Urine Legionella因為跟covid一樣都常有GI症狀。\n\n5.Remdesivir在美國第一個case就是靠這個治好的，各國都在臨床試驗中，我個人很看好，我們醫院也要開始實驗這個了...\n\n6.日本藥favipiravir聽說也很成功但是因為我在美國比較不熟。\n\n7.很多COVID病人為什麼這麼sick，明明年輕人卻full blown ARDS比老人更嚴重，因為很多是cytokine release syndrome的關係。所以IL-6 inhibitor如tocilizumab or sarilumab本來治rheumatoid arthritis的生物製劑或許也有用。現階段也還在臨床試驗中，可以抽血IL-6監測。聽說MGH用tocilizumab，而我的醫院也要開始臨床試驗sarilumab\n\n#Code status：COVID大部分還是胸腔性疾病，很多就是插管呼吸器ARDS mode來治療，因此插管是很重要的環節。但是有些運氣不是很好的病人，多重器官衰竭等等突然coded需要CPR的情況，這對醫療團隊來說是暴露極高風險甚至多半可能徒勞。我認為有必要一開始就要跟病人談好DNR，這不代表就要DNI，該插管還是要插管，但是真的不幸心跳停止等，要量力而為。\n\n#醫院管理：至少在紐約我們的物資設備都輸台灣很多也嚴重不足，不過也許可以給台灣要是不幸疫情大爆發做個借鏡。現在醫院幾乎都是COVID病人，也不可能一人一間病房了，因此直接把COVID病人直接放在同一間房間，反正都得病了也不怕被感染了。不過還是建議最好病房的門是有窗戶的至少從外面看進去可以知道病人好不好，而且就我剛剛所說，病人原本可能好好的就突然血氧掉非常喘需要趕快插管，每個住院病人真的像未爆彈。另外ICU病人因為常常有很多pump點滴，護理師要一直進出隔離房不方便穿脫PPE，可以考慮直接把pump放在房間外面，點滴線延長出去就好，這樣如果護理師要調sedation or pressors等等就可以不用進入房間更改設定。\n\n#國家防疫：現階段台灣防疫做很好，還在containment的階段，就是把最有可能的人抓出來隔離，但是對於平均每個個案的隔離成本很高，國家也很不容易控制，目前台灣有兩百多的個案，但是某天要是慢慢累積好幾百個病人甚至破千，我們也許就要調整策略，因為把全部只要是陽性的病人都抓到醫院關那是不可能的，台灣沒有那麼多的醫療能量，也不能這樣浪費，而且輕症染病的病人，要多久PCR會轉陰性，我還沒看到研究統計出來，應該也很少人會做這樣研究，因為很少國家會像台灣如此嚴格標準檢疫隔離的，就好像今天得influenza A，如果不太嚴重也是讓病人回家，病癒就是病癒，一般醫師也不會再重複flu swab；同樣如果有C.diff病人，把PO Vanc的療程吃完沒有再拉肚子，你也是當作好了不會再去驗糞便。個人覺得台灣可以把輕症病人平均多久時間PCR轉陰性做個統計發表研究。我最近看了世界著名病毒學專家何大一博士的專訪([https://www.caltech.edu/about/news/tip-iceberg-virologist-david-ho-bs-74-speaks-about-covid-19?fbclid=IwAR1XVnPHq82gD97Y2Y06FkIFzAtNNfopnMgqa98fHAwX7WHzHGyBVbnZlIQ](https://www.caltech.edu/about/news/tip-iceberg-virologist-david-ho-bs-74-speaks-about-covid-19?fbclid=IwAR1XVnPHq82gD97Y2Y06FkIFzAtNNfopnMgqa98fHAwX7WHzHGyBVbnZlIQ)) 個人覺得這篇寫得不錯，裡面他就有寫到目前也不知道陽性的病人過多久後才不會有傳染力，他說猜測大概三週。至於已經得過COVID的病人之後會不會再重複感染，他是覺得應該是不會，也就是現在所有的防疫工作，就是在爭取時間讓疫苗可以製造出來讓群體都可以有保護效果。現階段幾乎的國家都大爆發，就不可能像台灣還在containment的防疫階段，因為你要假設所有人都有可能是病人，那能做的就是#緩和曲線了flatten the curve，我覺得這個概念相當重要\n\n，基本上就是拖延戰術，減少不必要的社交和聚集，要social distancing，不必要的商業活動要停止，電影院酒吧夜店要關，餐廳只能外帶等等，這可以避免加速接觸感染，讓病人增加量不要達這麼快一下超出醫療能負荷的數量避免醫療崩壞，很多國家都在這麼做了，目前聽起來表現比較好的國家像是南韓，雖然他們一開始防疫沒有做好導致非常多人得病，但是經過大規模檢驗，還有避免出門要待在家等等，目前疫情也有和緩的趨勢，算是亡羊補牢，也不是不行。台灣目前表現全球數一數二，但是我們總是要做最壞的準備跟打算。\n\n#後記：沒想到一下就寫這麼多，這算是我第一線醫療工作者的紀實與經驗分享，目前紐約疫情雖然已嚴重崩壞，但實際上還只是開始而已不見緩和。不過美國參戰之後相信會有更多醫學研究與臨床治療準則可以參考，實際上也不完全是壞事。你問我會不會怕我每天也是提心吊膽的，都很怕生病，每天都要很注意自己的身體狀態，但偏偏美國住院醫師工時非常長(週休一日而已也沒有PM off)又不斷把我們明明不是在病房rotate的時候抓來上班取消我們的門診等等，我都盡量多休息有時間就睡覺保持免疫力。現在在醫院其實也是看到很多恐慌的面孔，我們醫院是公立醫院，平常病人多為社會最底層的人，吸毒的、遊民的、酗酒的，總之各種問題台灣一個比較健康的社會大概很難想像是一個怎麼樣的場所。不過最近因為COVID病人大爆發，我發現很多可能社會上的一般人或中產階級，他們可能是警察、可能是清潔工、就某天感染病毒生病了，這時候醫護站起來照顧他們治療他們，讓他們免於恐懼，這是作為醫學生涯也算比較榮光的時候，因為我們平常的訓練，就在這時候派上用場，也算是找到一點點行醫的意義跟價值。可以平安地活著其實就很好。目前台灣社會可以安全的生活著也真的很好。"],["id","ioxspw9mf0sf"],["createdAt","2020-03-29T01:46:42.817Z"]]},{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",1],["user",{"__iterable":"Map","data":[["id","j4S8C_MPeoh1MTjzdSeEZxnCB1uIajKpkm0I2euRaMmBqVx0U"],["name","乂貫徹始終的池上華莉絲乂"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","British Columbians warned of Salmonella infections"],["url","http://www.bccdc.ca/about/news-stories/news-releases/2020/british-columbians-warned-of-salmonella-infections"],["summary","British Columbia (B.C.) is one of five provinces experiencing an ongoing Salmonella outbreak. The outbreak has been linked to red onions, imported from the United States. To date, 43 cases have been reported in B.C. in all regional health authorities since mid-June.Until more is known about the outbreak, individuals in B.C., Alberta, Saskatchewan, Manitoba, and Ontario are advised to not eat any red onions imported to Canada from the U.S., including any food products that contain raw red onions imported from U.S.. Retailers and restaurants in these locations are also advised not to use, sell or serve red onions imported from the U.S.. Red onions grown in Canada are not affected by this advice.B.C. is collaborating with the Public Health Agency of Canada, provincial public health partners, the Canadian Food Inspection Agency, and Health Canada to investigate outbreak. Information about the investigation and food safety can be found on the Public Health Agency of Canada website. Salmonella infection causes symptoms including diarrhea, fever, and abdominal cramps that develop six to 72 hours after exposure and usually lasts four to seven days. Most people recover without treatment. Children under five years of age and adults over 65 years of age, and people with weakened immune systems are more likely to have a severe illness. If you are experiencing symptoms, contact your health care provider."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Outbreak of Salmonella Newport Infections Linked to Red Onions | Outbreak of Salmonella Infections | July 2020 | Salmonella | CDC"],["url","https://www.cdc.gov/salmonella/newport-07-20/index.html"],["summary","July 31, 2020\nSince the last update on July 24, 2020, an additional 184 ill people have been reported in this outbreak, including 37 from 11 new states: Alaska, Colorado, Indiana, Kansas, Kentucky, Maryland, Nevada, New York, Pennsylvania, South Carolina, Texas.\nAs of July 29, 2020, a total of 396 people infected with the outbreak strain of Salmonella Newporthave been reported from 34 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.\nIllnesses started on dates ranging from June 19, 2020, to July 12, 2020. Ill people range in age from less than 1 to 102 years, with a median age of 39. Fifty-two percent of ill people are female. Of 236 ill people with information available, 59 hospitalizations have been reported. No deaths have been reported.\nIllnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks. Please see the Timeline for Reporting Cases of Salmonella Infection for more details.\nWhole genome sequencing analysis of 48 isolates from ill people did not predict any antibiotic resistance. Standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory is underway.\nWhole genome sequencing analysis shows that an outbreak of Salmonella Newport infections in Canada is related genetically to this outbreak in the United States. This means that people in both of these outbreaks likely share a common source of infection.\nInvestigation of the Outbreak\nOn July 10, 2020, CDC PulseNet identified an outbreak of 13 Salmonella Newport infections in three states. Since being identified, the outbreak has rapidly grown to a total of 396 infections in 34 states.\nState and local public health officials are interviewing ill people to determine what they ate and other exposures in the week before their illness started.\nMany ill people were identified as part of illness clusters. An illness cluster is defined as two or more people who do not live in the same household who report eating at the same restaurant location, attending a common event, or shopping at the same location of a grocery store in the week before becoming ill. Investigating illness clusters can provide critical clues about the source of an outbreak. If several unrelated ill people ate or shopped at the same location of a restaurant or store within several days of each other, it suggests that the contaminated food item was served or sold there. Twenty-two illness clusters have been identified in seven states. Information from these clusters shows that many ill people ate red onions. The traceback information collected from these illness clusters identified Thomson International, Inc. of Bakersfield, CA as a likely source of red onions. Due to the way onions are grown and harvested, other onion types, such as, white, yellow or sweet may also be contaminated. Additional traceback is ongoing to determine if other onions are linked to the outbreak.\nThe Public Health Agency of Canada (PHAC)external icon is investigating an outbreak of Salmonella Newport infections, which is related by whole genome sequencing to this outbreak in the United States.\nOn July 30, Public Health Agency of Canada’s outbreak investigation identified U.S. red onions as a likely source of their outbreak.\nConsumers, restaurants, and retailers should not eat, serve, or sell any onions from Thomson International, Inc. of Bakersfield, CA.\nCDC will provide updates when more information is available.\nPrevious Updates >>"],["topImageUrl",null],["error",null]]}]}],["text","最近請大家就暫時先別吃美國進口的洋蔥 (紅、白、黃、甜) 唄！\n美國已經有34州共396個案例，因食用受到沙門氏菌汙染的洋蔥所引起的疾病。而BC省從六月中至昨天 (7/30) 為止，也已經有43個因美國紅洋蔥所引起的病例 (全加拿大則為55例)。以下是BC疾管中心所發佈的新聞：\nhttp://www.bccdc.ca/about/news-stories/news-releases/2020/british-columbians-warned-of-salmonella-infections\n以下是美國CDC的相關資訊：\nhttps://www.cdc.gov/salmonella/newport-07-20/index.html"],["id","17wspxn3mnn74"],["createdAt","2020-08-06T21:49:38.188Z"]]},{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",2],["user",{"__iterable":"Map","data":[["id","j4S8C_7bEI-joW4qmsKk9jUEkh7ekXvS4fLnU-z0UBebwmzYI"],["name","細節的六腳馬文"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Coronavirus Update (Live): 5,199,011 Cases and 334,698 Deaths from COVID-19 Virus Pandemic"],["url","https://www.worldometers.info/coronavirus/"],["summary","How dangerous is the virus?\n\nThere are three parameters to understand in order to assess the magnitude of the risk posed by this novel coronavirus: \n\nTransmission Rate (Ro) - number of newly infected people from a single case\nCase Fatality Rate (CFR) - percent of cases that result in death \nDetermine whether asymptomatic transmission is possible\n\nHow contagious is the Wuhan Coronavirus? (Ro) \nThe attack rate or transmissibility (how rapidly the disease spreads) of a virus is indicated by its reproductive number (Ro, pronounced R-nought or r-zero), which represents the average number of people to which a single infected person will transmit the virus.\nWHO's estimated (on Jan. 23) Ro to be between 1.4 and 2.5. [13]\nOther studies have estimated a Ro between 3.6 and 4.0, and between 2.24 to 3.58. [23]. \nPreliminary studies had estimated Ro to be between 1.5 and 3.5. [5][6][7]\nAn outbreak with a reproductive number of below 1 will gradually disappear.\nFor comparison, the Ro for the common flu is 1.3 and for SARS it was 2.0.\n\nFatality Rate (case fatality ratio or CFR) of the Wuhan Coronavirus\nSee full details: Coronavirus Fatality Rate\nThe novel coronavirus' case fatality rate has been estimated at around 2%, in the WHO press conference held on January 29, 2020 [16] . However, it noted that, without knowing how many were infected, it was too early to be able to put a percentage on the mortality rate figure.\n A prior estimate [9] had put that number at 3%. \nFatality rate can change as a virus can mutate, according to epidemiologists.\nFor comparison, the case fatality rate for SARS was 10%, and for MERS 34%.\nIncubation Period (how long it takes for symptoms to appear) \nSee full details: COVID-19 Coronavirus Incubation Period \nSymptoms of COVID-19 may appear in as few as 2 days or as long as 14 (estimated ranges vary from 2-10 days, 2-14 days, and 10-14 days, see details), during which the virus is contagious but the patient does not display any symptom (asymptomatic transmission).\nAge and conditions of Coronavirus cases \n See latest findings: Age, Sex, Demographics of COVID-19 Cases and Deaths \nAccording to early estimates by China's National Health Commission (NHC), about 80% of those who died were over the age of 60 and 75% of them had\npre-existing health conditions such as cardiovascular diseases and\ndiabetes.[24]\nAccording to the WHO Situation Report no. 7 issued on Jan. 27:\n\n\nThe median age of cases detected outside of China is 45 years, ranging from 2 to 74 years.\n 71% of cases were male.\n\nA study of 138 hospitalized patients with NCIP found that the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men.[25] \nThe WHO, in its Myth busters FAQs, addresses the question: \"Does the new coronavirus affect older people, or are younger people also susceptible?\" by answering that: \n\nPeople of all ages can be infected by the novel coronavirus COVID-19. \nOlder people, and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) appear to be more vulnerable to becoming severely ill with the virus.\n\n Patient who died in the Philippines was a 44-year old male\nThe patient who died in the Philippines on February 2, in what was the first death occurring outside of China, was a 44-year-old Chinese man from Wuhan who was admitted on Jan. 25 after experiencing fever, cough, and sore throat, before developing severe pneumonia. In the last few days, “the patient was stable and showed signs of improvement, however, the condition of the patient deteriorated within his last 24 hours resulting in his demise.\"\naccording to the Philippine Department of Health.\nSerious Cases of 30 year old patients in France \n\nAs of Jan. 29, according to French authorities, the conditions of the two earliest Paris cases had worsened and the patients were being treated in intensive care, according to French authorities. The patients have been described as a young couple aged 30 and 31 years old, both Chinese citizens from Wuhan who were asymptomatic when they arrived in Paris on January 18 [19].\nAge and Sex of the first deaths as reported by the China National Health Commission (NHC) \n The NHC reported the details of the first 17 deaths up to 24 pm on January 22, 2020. The deaths included 13 males and 4 females. The median age of the deaths was 75 (range 48-89) years.[21]\nWHO Risk Assessment: Global Emergency\nSee full details: WHO coronavirus updates\nOn January 30, the World Health Organization declared the coronavirus outbreak a Global Public Health Emergency.\nFor more information from the WHO regarding novel coronavirus: WHO page on Novel Coronavirus (2019-nCoV)"],["topImageUrl",null],["error",null]]}]}],["text","今日新聞報導，多國旅遊解封，但都未納入台灣，台灣自詡防疫成績不錯，為何會是這般結果。有分析說，台灣是被動篩檢新冠，篩檢總數及比例偏低，恐有漏網之魚。\n上網查了一下，台灣篩檢新冠肺炎總數7萬多，排名全球85，每百萬人篩檢數，僅有3000多，全球排名138，看來，我們還是不可掉以輕心，勤洗手，戴口罩，保持社交距離都不可偏廢。\n\nhttps://www.worldometers.info/coronavirus/"],["id","1ozp5wj935xi5"],["createdAt","2020-06-12T02:16:12.627Z"]]},{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",2],["user",null],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Edward M. Mautner Oral History"],["url","http://www.jsc.nasa.gov/history/oral_histories/NASA_HQ/Experts/MautnerEM/MautnerEM_3-22-12.htm"],["summary","NASA Johnson Space Center \n Oral History Project\n Edited Oral History Transcript\n Edward \n M. Mautner\n Interviewed by Jennifer Ross-Nazzal\n Chantilly, Virginia – 22 March 2012\n Ross-Nazzal: \n Today is March 22, 2012. This interview with Ed Mautner is being conducted \n at the [Smithsonian National Air and Space Museum] Steven Udvar-Hazy \n Center in Chantilly, Virginia, for the JSC Oral History Project. Interviewer \n is Jennifer Ross-Nazzal, assisted by Rebecca Wright. Thanks again \n for taking time out of your schedule.\n Mautner: \n You’re welcome, it’s my pleasure to do it.\n Ross-Nazzal: \n If you would, tell us about the state of [OV (orbiter vehicle)-101] \n Enterprise in 2003 before she was restored.\n Mautner: \n My familiarity with Enterprise was quite limited before I began work \n on it. When we received it, it had been stored both outdoors and in \n a non-climate-controlled hangar since the mid-80s, and a lot of deterioration \n of the surface coatings—the paint, the markings—had taken \n place. Woodpeckers had gotten up onto the vertical stabilizer and \n pecked a lot of holes into the polyurethane foam that they used as \n a mockup for tiles. I don’t recall the number of holes, but \n there were quite a few of them. \n And then just about every form of creature had made the Enterprise \n their habitat and playground. Birds had gotten into it; bugs had gotten \n into it. Hornets or wasps had made their little mud nests in the landing \n gear wells. They made it out of this beautiful red Virginia clay dirt \n that surrounds the area. In fact, when we started to clean them it \n almost seemed as if the aircraft was bleeding, the soil they made \n those nests out of was so red.\n It had basically suffered a lot of inattention. It hadn’t been \n cleaned or worked on to any great degree. I believe it was outside \n for about two years prior to them building the hangar for it, and \n it had been rained on. There were many ports of entries for water, \n and so water had pooled inside the bottom of the fuselage and it had \n left a lot of staining from dirt, waterlines, etc. and also had caused \n some minor pitting and corrosion. Nothing that would weaken the structure \n of the aircraft but certainly had caused some deterioration.\n Ross-Nazzal: \n Tell us about that move, when you decided to move her from that hangar \n into this facility.\n Mautner: \n Until I walked in March 1st of 2004, I had never touched Enterprise \n and I had really nothing to do with it. I recall being in the hangar \n the day they moved it in, and just about all the employees who were \n out here took a break to watch them tug it down the tow way from the \n airport and into the building.\n What was noteworthy at the time was that they had cut a notch in the \n back wall of the space hangar in order to permit the vertical [stabilizer] \n to come through. It was the only way to get Enterprise into that building \n without taking the vertical off, which would have been a prohibitively \n difficult task. I came back the next day and the blanking plate had \n been restored as if the building had never changed at all, so that \n was pretty neat. It was a well-prepared move.\n That took place in the early fall of 2003, and while I was aware that \n it was in the building, it was sometime after January 2004 that I \n was notified that I would be working on it in preparation for the \n opening of the space hall [James S. McDonnell Space Hangar].\n Ross-Nazzal: \n What was your expertise prior to working on Enterprise? Were you working \n on aircraft restoration?\n Mautner: \n My background is—the British would describe it as checkered. \n I did a whole lot of things before I got directly involved in airplanes. \n I started out as a kid building model airplanes, and I never gave \n that up. I always built model airplanes, and I continue to do so. \n And I was always a museum rat, an airplane museum rat. Whenever we \n traveled, wherever we went, there was always a stop at an airplane \n museum somewhere.\n Somewhere around the late 80s, my wife and I had moved our children \n to southern California, and I began to volunteer in some aircraft \n museums out there. Planes of Fame in [Air Museum] Chino, and later \n at the Command Museum at U.S. Marine Corps Air Station El Toro, which \n was right in the town I lived in so it was convenient to work there. \n I started doing structures work.\n In January of 1989 I left a former career and made a great midlife \n career change whereby I wanted to work in an aircraft museum. I had \n enjoyed volunteering on Saturdays so much, I went to Cal [California] \n State University, San Bernardino, for a Museum Studies certificate \n program. My background was in auto mechanics, and I needed to create \n a resume to get into working on aircraft, especially in museums. I \n enjoyed it immensely but had a problem with the hours of class.\n By great good fortune, McDonnell Douglas [Corporation] was hiring \n mechanics in the summer of 1989. Actually they’d been hiring \n prior to that, but that’s when I found out. I went and I applied, \n and they hired me immediately because of my automotive experience. \n I became a structures mechanic on the C-17 [aircraft] program in Long \n Beach, California. That was my first real hands-on experience with \n real aircraft manufacturing.\n I worked at McDonnell Douglas from August of 1989 until June of 1994, \n when there were massive layoffs. They were losing their contracts \n for MD-80s [airliners], and the MD-11 [airliner] never took off. The \n C-17 was in a state of flux because Congress and the Air Force were \n at loggerheads, so I and tens of thousands of others were laid off \n during that year.\n Meanwhile I had gone from my certificate program at Cal State, San \n Bernardino, to a Master’s program at Cal State, Dominguez Hills \n in Historic Preservation. Because John [F.] McDonnell of the McDonnell \n Douglas Corporation was interested in an educated workforce, they \n paid for almost all of my Master’s program, everything but my \n research courses and my thesis. \n I had early on decided that my thesis was going to be in aircraft \n preservation at the National Air and Space Museum. I thought that \n they were the best. They were the ones that were writing about aircraft \n preservation, and I really wanted to write about how they did it, \n because that seemed to be the benchmark.\n In June of 1994 I was laid off, and I immediately contacted the museum \n to do an internship back here so that I could do further research \n for my thesis. In August and September of ’94 I did a 60-day \n volunteer internship. I was outside of their regular program, so there \n was no stipend; I just came in and volunteered. I worked in the restoration \n shop during the day until about 3:30 [p.m.]. I’d then go across \n the river, downtown to the main museum and I would work in the archives.\n The people in the archives—I don’t know why, I was a total \n stranger to them—they let me stay after hours. In fact, at five \n o’clock when they left, they issued me instructions on what \n lights to turn off and how to shut down the computers. I would stay \n there till 8:30 so I’d get all my research. I had one other \n paper and I had my thesis to do, so I spent almost every weekday night \n at the museum doing that.\n They said, “Stay in touch; we’re going to be hiring.” \n The hiring was going to ramp up for this facility, this new Udvar-Hazy \n Center, so I stayed in touch. Every month I contacted somebody associated \n with the restoration facility, and finally in 1997 they said, “Something’s \n going to happen. Get back here; be nearby.” So I stayed with \n relatives and I hung out and I volunteered, and finally in February \n of 1998 they hired me. They did it because I had the academic background, \n but I also had, from McDonnell Douglas and my volunteer efforts, the \n mechanical background as well. I was very fortunate that the timing \n worked out. \n My background is chiefly in aircraft structures, which would be the \n main metal pieces that form the basis of the aircraft upon which everything \n else is hung. After I get through with my work, then the hydraulics \n people and the fuel people and the electrical people and the power \n plant people take over.\n Ross-Nazzal: \n What sort of planes have you worked on since you began working here?\n Mautner: \n The first one that I started working on was a Japanese single-engine \n floatplane bomber, [the Aichi M6A1 Seiran]. It looks more like a fighter \n with floats, but it was in fact a strategic bomber that the Japanese \n designed to fold up into an 11-foot diameter circle and fit into the \n tube on a submarine. This submarine was an aircraft carrier, literally, \n and it carried three of these. Very significant aircraft, because \n it was designed to bomb the Panama Canal locks. \n The submarine was probably more technologically advanced than the \n aircraft. It was designed to go 27,000 miles without refueling, and \n they actually did have plans to use these small bombers to bomb New \n York [City, New York] and possibly even Boston [Massachusetts]. It \n was a metal airplane, and my sheet metal experience came to good use \n there. \n After that, they put me on a World War I bomber, a twin-engine fabric-and-wood \n bomber. That airplane was a Caudron G.4, a French bomber that the \n United States tested but never purchased. Because we had no combat \n aircraft in World War I, we had to go to the French and the British \n and the Italians. That was an excellent experience because that broadened \n out my sheet metal and structures experience to wood and fabric. That \n airplane is also currently on display here.\n The next aircraft is one I’m still working on. We have a limited \n number of people here, so we get shifted off of whatever project we’re \n on to take care of other things in the museum, such as creating a \n display or working on the Enterprise for nine months in 2004. From \n about 2000 until this year, I’m still working on a World War \n II German night fighter, the Heinkel 219, a huge metal twin-engine \n aircraft, where again my airframe and sheet metal experience has come \n into use.\n Ross-Nazzal: \n Tell us what lessons you learned from working on those aircraft that \n you applied to the Enterprise.\n Mautner: \n In my case, precious few. It was a great departure from what we call \n restoration, where you actually have to fabricate or replicate or \n repair structural pieces of an aircraft. This was largely a massive \n clean-up and painting effort, so it falls under the role of preservation. \n That’s really our role here, preservation. Everybody talks about \n restoration, but restoration is the court of last resort when everything \n has pretty much gone to pot and needs to be drastically repaired or \n replaced.\n What we did on Enterprise fell under the heading of preservation, \n but we called it a refurbishment because we didn’t do anything \n to repair it. It was still considered to be NASA’s aircraft, \n and it came to us in such good structural condition that there really \n was nothing to repair on it except for the paint work.\n Ross-Nazzal: \n Would you tell us about working with NASA and USA [United Space Alliance] \n on this project? I understand they were involved.\n Mautner: \n Yes, they were. When we first began on March 1, 2004, we were pretty \n much on our own. There were just three of us: myself, Anne [C.] McCombs, \n and Steve Kautner. We walked into this big empty hangar. The only \n thing that was in it at the time was Enterprise, and it didn’t \n even have a barrier around it because the public wasn’t allowed \n in that building yet. We just kind of stood there and wondered, “Where \n the heck are we going to start on this thing?” \n We had no high-lift equipment—all we had access to were ladders—so \n we decided to start working on the landing gear. We had no contact \n with NASA outside of certain parameters that they gave us in cleaning \n and painting it, that we were given by the curator, Valerie Neal. \n Without anything else but ourselves, we began the cleaning process \n at the lowest part of the Space Shuttle, areas that were accessible \n initially to us.\n Our experience with NASA and USA came a little bit later, and [their] \n big project was the removal of all of the cockpit windscreens, the \n front ones. I believe that there were three panels in them, and there \n were some engineering discussions as to whether they could get away \n with just two panels. The challenge for us was to provide them with \n the platforms to get up there and work off of. \n Anne and I were involved, and at that point we had a lot of mechanics \n from United Airlines [Inc.] come in to assist us. Their bosses permitted \n them to give us some high-lift platforms that were attached to trucks. \n We could maneuver a truck in and then raise a platform and extend \n it out over the nose of Enterprise in order for the USA guys to remove \n those windshields. The other problem was these windscreens were very, \n very heavy. They required quite a bit of effort to crane off of the \n Shuttle.\n At that point, I began to get to meet some of the guys, most specifically \n from USA. One of them was a fellow named Tom [Thomas W.] Roberts, \n and Tom’s my friend now. He was back here for the last visit. \n There were several other mechanics that came up from KSC [NASA Kennedy \n Space Center, Florida] who I would count as really good acquaintances, \n friends, who we worked with. Got to meet Kevin [C.] Templin. He was \n always there, very personable fellow, and always a go-to guy for information \n and leadership. \n Whenever they came back, we dropped what we were doing and became \n assistants to them, to the point where in this last visit we were \n almost considered more one of their group than as a separate entity, \n which was kind of neat. The things I saw from everybody in NASA and \n USA was enthusiasm, expertise, positive attitude, and great great \n teamwork. The first thing we noticed is how well they worked as a \n team. \n Many times we didn’t know that these guys had never worked together \n before, and yet it was a seamless effort. You got to talking to them, \n you got to know them, and you realized, this guy never worked on the \n back end of the aircraft. He always worked on the front and didn’t \n even know the guys that they were working with. That was inspiring \n to us to see that kind of effort that they used to put in.\n Some of my recollection of my efforts with NASA and USA get a little \n bit confused, because some of their efforts were during that nine-month \n period when we worked on preparing Enterprise for the opening of the \n space hangar, but several of them came later. They would ask Anne \n or myself or others from the previous team to come back and assist \n them. I believe that the windshield effort was made during that nine \n months we were there, but our other efforts with them came later, \n so they’d be outside the parameters of my work on the Enterprise.\n Ross-Nazzal: \n I also read that you had to replace the OMS [orbital maneuvering system] \n pods because they had rotted.\n Mautner: \n Yes, we did. One of the first things we did was to remove those. Tony \n [Anthony W.] Carp was the team lead for the lifting of the OMS pods. \n They were a large aluminum plate that mated up to the surface of the \n Shuttle, but everything above that aluminum plate was basically wood. \n Plywood flooring, then 2 x 4 and 4 x 4 framework, and then they put \n a fiberglass cover over the top of that.\n We discovered how weak the structure was when we started to tighten \n up the fittings for the lifting rings. We’d gotten a guy inside \n to tighten the nuts up inside because they seemed loose, and he kept \n tightening and tightening and tightening. We suddenly realized that \n wood was so soft from moisture that he was just tightening the nut \n and the washer right into the wood. We had to be very, very careful \n lifting those OMS pods off.\n The OMS pods were never planned to be on the Shuttle when the space \n hall opened. That was something that we were going to install later, \n so our job now was to focus just on the Shuttle, and guys back in \n the shop worked on the OMS pods.\n Ross-Nazzal: \n Are they on there now, have they been replaced?\n Mautner: \n They were put on I think in 2005, 2006 time range, and before the \n last visit to get Enterprise ready we removed them. They’re \n out in the shop, on the floor. The guys from USA put the ALTA [Approach \n and Landing Test Article] pods on. Those are the travel pods. They \n look like OMS pods, but they’re real metal. They’re real \n structural, flightworthy, and the tail cone fits up to those components.\n Ross-Nazzal: \n Tell us about cleaning and painting the vehicle. That sounded like \n a very large chore.\n Mautner: \n Yes, it really was. I started on March 1st to clean the right main \n landing gear bay and ultimately the landing gear and tires. Steve \n Kautner took the left bay and did the same, and Anne McCombs worked \n on the nose gear and the nose gear bay. It wasn’t until March \n 22nd that Tony [Carp] came on the team, and his job was to clean the \n entire vertical surface with the ultimate purpose of coring or filling \n the holes that the woodpeckers had made.\n Somebody might at this point ask, why would woodpeckers go after polyurethane \n foam? The explanation we got—I’m not an ornithologist—is \n that woodpeckers make the noise they do as a mating call, not just \n to get to bugs inside of the tree. Once they got through that polyurethane \n foam, they were banging on an aluminum surface. It made quite a noise, \n and it was far-reaching. There were about 75 holes ranging from very \n small, smaller than your pinky, to much bigger than your thumb. \n We were using, on NASA’s recommendation, Amway LOC [liquid organic \n cleaner] cut, one part LOC to ten parts water, to wash everything. \n It’s a mild organic detergent, and it’s biodegradable. \n This was what USA used, so this was what we used. And this is where, \n in the wheel wells, I found most of the hornet nests. Once you got \n the water into them they just started running down the beautiful epoxy \n white paint panels inside.\n At that point, once Steve had finished his wheel well, he started \n working on the bottom. He started up at the nose where he could reach, \n because you couldn’t get a ladder under there. He’s all \n scrunched up, just scrubbing away—and he was a bear of a guy. \n He had a lot of strength, and he just kept working down the bottom \n of the aircraft, all of the black-painted area of the aircraft. \n At that point we started using some lift equipment, JLG [Industries, \n Inc.] lifts and scissor lifts, to get up on the wing. We began cleaning \n the wing while Tony is cleaning the vertical, and we did this day \n after day after day. Then sometime in the summer, I believe in July, \n we began prepping the center fuselage for paint. The center fuselage \n does not have polyurethane foam on it, and that center fuselage extends \n from just behind the cockpit to back underneath the OMS pods. We also \n had to clean the payload bay doors. At this point we finally were \n able to get scaffolding in. We had a local company contracted to put \n scaffolding all up the sides and then bridge the top of the Shuttle. \n \n This is where things kind of got interesting. Initially it was doing \n just a lot of sanding on the side. Apparently the aircraft had been \n painted with aerospace quality polyurethane or epoxy paint and primer, \n but when it went on tour in 1984 it had started to look a little bit \n secondhand. They used a latex house paint to give it a quick repaint \n to make it appear better at the [New Orleans, Louisiana] World’s \n Fair here in the United States, and then they went to the Paris Air \n Show with it. This was all prior to delivering it to us.\n This paint over the years had become very brittle and very hard and \n would be quite a challenge to remove. Taking it off the sides was \n pretty easy. We were able to use electric sanders or pneumatic sanding \n devices, hand-held devices, and literally sand all of that down to \n the original paint. The sanding gave the surface a real good surface \n for paint to adhere to once we finished it and cleaned it up, but \n the real challenge came with the payload bay doors. We were instructed \n by NASA to not use any metal tools, any caustic chemicals, or any \n abrasives to remove the paint.\n We got up there, and they thought it would be really easy because \n a lot of the paint on the payload bay doors had flaked off, and some \n of it was literally sitting up. They said, “Just use duct tape \n and press it down real hard and pull it off, and that paint will pull \n up.” Well, that didn’t work at all. \n All of our communications with them were through Valerie Neal, the \n curator. The other thing we weren’t supposed to use was heat, \n so we went to Valerie and said, “The duct tape just isn’t \n cutting it.” They said, “Use plexiglas scrapers.” \n Plexiglas is a real hard plastic. We would cut up sections of it, \n rectangles of it, and then make a sharp edge at one end with a grinding \n wheel. That wasn’t cutting it either.\n One day I’m sitting on the scaffolding, trying to get this stuff \n off, and I see to my left this movement from about chest height over \n the curvature of the door. I look over, and it’s Steve Kautner \n with a metal scraper and a heat gun. I’m going, “Steve, \n what are you doing?” He goes, “This is the only way it’s \n coming off.” I said, “Okay, stop. Let’s talk about \n this.” \n We went back to our conservator, and I asked him, “Do you have \n a surface temperature gauge?” We went back and attached this \n temperature surface gauge to the area that we were putting the heat \n on, and we got some heat parameters. We were getting heat in the range \n of about 175 degrees [Fahrenheit] if we kept the heat gun moving, \n so we went back to NASA and they said, “Okay, you can do that, \n but no temperatures over 200,” or 250.\n All of a sudden this became easy, but we now found out very quickly \n why they didn’t want heat up there. The doors are made of carbon \n graphite, or carbon–carbon. It’s skinned with an almost \n aluminum-foil thickness coating of aluminum. It’s not like sheet \n metal, it’s more like a foil, and if you left the heat on there \n too much it would blister. We got a couple of thumb-sized blisters; \n we damaged the door. This concerned us, and we kept talking to each \n other. We’d just make sure we’d keep that heat gun moving \n and don’t overheat one spot.\n It became very evident very quickly why they didn’t want heat \n up there. They had done the same thing at some time in the past, only \n their blisters were much bigger than ours. That told us a) it’s \n been done this way before, and b) there’s a repair for it. We \n did make a few more blisters, an inevitable result of what we were \n doing, but we knew that if they needed those doors, they could be \n made flightworthy. \n Then, because there was still a lot of paint residue clinging to the \n surface, we got down and used acetone. We were all garbed up with \n double-canister air masks. There’s terrific pictures of us all \n down on our hands and knees on the door, all tied off because we’re \n high up on the top of the Shuttle, scrubbing with Scotch-Brite scrubbers \n and acetone to get the surface completely clean and ready for paint.\n That was another thing they told us, “You can’t stand \n on the doors.” So we had these four bridges across, and we’re \n all leaning off these bridges and working off of them. Again, Steve \n Kautner’s the first one to step off right on the doors. There’s \n no other way to get out there, there was no way. I said, “Okay, \n stop. Let’s talk this over.” We went down inside the Shuttle, \n and we looked up at the doors and we could see the latching system. \n \n We knew that those doors in zero gravity could open without any support, \n but we knew that they had big supports on them when they opened them \n in the hangar down in KSC. We looked at those supports, and we looked \n at how the doors fit together. It’s built like a bridge as long \n as they’re closed and locked, so four, five, six of us all were \n out on our hands and knees on the doors, scrubbing away to get the \n last residue and make a really good surface for paint.\n That brings up another aspect for me. I couldn’t wait every \n single day to come in. I’m not a space guy, I’m an airplane \n guy. In truth, the Shuttle is probably more like an aircraft than \n a spacecraft, and that one [Enterprise] never did go into space so \n it really was just an aircraft. I never followed space, I never got \n excited about it, but I got excited by this project. I couldn’t \n wait to get in every single day. Every day was interesting and exciting, \n and we were making progress—slow—but we were making progress. \n \n When they put the scaffolding up in July, we now had to climb this \n scaffolding. We had our harnesses on and we had our tethers, but we \n couldn’t tether off anywhere on the way up. We’re climbing \n 30, 35, almost 40 feet in the air every morning, every break time, \n every time you had to leave, and then when we got up there we would \n tie off and secure ourselves. But that little element of danger made \n it exciting, and we talked about that a lot too.\n We had two injuries, but only one on Enterprise. One of our guys did \n abrade his hand, but working on something else while we were out there, \n nothing to do with the Shuttle. One injury, very minor, on the Shuttle. \n One of our members fell off the payload bay doors, but he was tethered \n and it stopped him, and all he did was bang up his knee. I think we \n lost him one day, but that was it. The fact that we talked almost \n every day about the safety issue, that he was tethered off—we \n didn’t have more issues. \n The other thing that made it interesting and fun is that we were on \n this huge, very obvious artifact in the middle of this totally empty \n hall, and the public could come in to the front of the hall—there’s \n an overlook up above—and watch us. I think the element of being \n on stage made it exciting and interesting, too.\n There were some stresses. We always seemed short of personnel. At \n one point I realized there were a whole bunch of guys working on the \n OMS pods, and I had to convince my management that the OMS pods aren’t \n needed by October 19th, but the Shuttle is, so can I have more guys? \n And I got more guys.\n Once we had sanded down the sides and had removed the paint from the \n doors, it was time for a final prep and primer and paint. We had four \n guys do that, and we had a couple of issues that we had to deal with. \n One, it had to be an aerospace quality paint. PPG, Pittsburgh Paint \n and Glass, has always supplied us with our paint system that we’ve \n used exclusively for 20 years back at the [Paul E.] Garber [Preservation, \n Restoration, and Storage Facility, Suitland, Maryland], our restoration \n shop. Dave Wilson got in touch with them, and they turned him over \n to their aerospace division. They donated what amounted to about $15,000 \n worth of white polyurethane aerospace paint and primer.\n Our next challenge was we could not spray in the building because \n the building had an open port, and some of the ventilation systems \n functioned with the aircraft hangar. Also, the filters in the ventilation \n system would get clogged up with any paint residue and dust, so we \n had to either brush or roll it. Dave talked with the people from PPG, \n and they had an additive that allowed the paint to flow so that it \n would not appear to be rolled-out paint. It wouldn’t be textured, \n it would be nice and smooth.\n We got the paint on September 17th—keeping in mind that this \n hall is supposed to open on October 19th of 2004. They had to rest \n assured that all the fumes would have dissipated by 10 o’clock \n opening the next day, so we painted at night. It was Tony, Dave, myself, \n and a fellow by the name of Bob Weihrauch who did it. We would come \n in, and that hall was completely black except for the Klieg lights \n that we worked under. We rolled out the primer, and then we rolled \n out the white. [We rolled out two coats of primer and two coats of \n white.]\n I love working here at night because there’s no people here, \n the lighting is all dim, and it’s like going into a great cathedral \n at night when nobody’s around. It’s just beautiful. It’s \n quiet. You’ve got all these objects that you love, many of which \n you’ve worked on, and there’s just a neat thing about \n working here at night. We had a really good time. We had a really \n good crew. I don’t recollect ever having any arguments or disagreements \n or problems, we just really had a good time.\n One outstanding recollection is this facility is used by organizations—police \n organizations, FBI [Federal Bureau of Investigation], the MWAA, Metropolitan \n Washington Airport Authority. They have their own SWAT [special weapons \n and tactics] team and security forces. They do a lot of work in here \n at night, but we didn’t know that. One night three of us are \n up on this scaffolding, and Dave Wilson is on a scissor lift bringing \n paint up to us, and all the sudden there’s movement in the hangar. \n \n Keep in mind that outside of this cone of light that we’re in, \n everything’s dark out there, but there’s movement. We \n look down, and there’s 20 or 30 guys in black helmets, black \n outfits carrying guns, and they’re swarming like ants through \n our hangar. Well, I immediately was not concerned because none of \n them are looking at us or pointing the gun at us. We’re in white \n bunny suits, paper coveralls, and the Klieg lights are on us. We’re \n out there, very obvious.\n One guy kind of moved up to Dave, and he goes, “Have you seen \n her?” And Dave goes, “Seen who?” He goes, “Have \n you seen her?” and then he had to move, because you’re \n not supposed to look for hints. Apparently they were on an exercise, \n and one of their supervisors came in two hours ahead of time and hid \n herself somewhere in the museum, and they had to find her. Nobody \n told us; our security had not advised us that this was going to happen. \n \n Another time, during the day, I was working on the Shuttle and nobody \n else was around. Security came up to me and said, “We have a \n congressman or a senator here with his daughter back from college, \n and he’s got his office manager and his security detail. Would \n you come down and talk to them?” So I walk inside of this circle \n of Secret Service people, and they’ve got their radios and they \n all look very, very official, and I started to talk to them. I said, \n “What state do you represent, sir?” He goes, “Oh, \n one of your neighbors.” Meanwhile, his handler, his office guy, \n did all the talking. \n I went back that night and I looked all over the Internet for our \n neighboring senators and congressmen, and I did not find him—because \n you can get the photos of all of them. I went back to security the \n next day and I said, “What was that all about?” He says, \n “Oh, it’s just a test.” It was Secret Service in \n a practice run, and these guys were just members of the Secret Service \n that were playing a role to make it seem realistic. There are a lot \n of activities that go on here that are very interesting. But again, \n I was not forewarned of that. \n The other two events that were really interesting—Joe [H.] Engle, \n one of the test pilots for Enterprise, came back and spent a day with \n us. He is just a prince of a guy, just a super guy. We got to tour \n him around and show him what we were doing, and he was just the friendliest \n guy and was very very grateful to us restoring “his” bird \n back to its original condition. A couple weeks later, we all got an \n 8 x 10 of him standing by Enterprise out at Palmdale [California] \n back in’77, ’78, with a beautiful handwritten note and \n one of the original patches from his missions. It was just neat, a \n neat thing. \n The other very very interesting visitor to us was Colonel Pamela Ann \n Melroy. She’s a two mission pilot and one mission command pilot \n [commander]. She was also on the Columbia [STS-107 accident] investigation \n team, and she led the cockpit reconstruction area. My recollection, \n she was about five-foot-five, five-foot-six. I immediately made a \n connection, because she was a test pilot on the C-17 program. As I \n had worked on it, we had some things to talk about. \n I got to tour her around, and the thing I recollect so well is that \n she made a comment when we were in the cockpit. The cockpit of Enterprise \n is for the most part empty. The dashboard is there, but there’s \n only about three instruments, and they’re all old analog instruments. \n The seats are not there. She looked at that dashboard and marveled \n at the fact that it was the first time she’d seen one in a long \n time that wasn’t bits and pieces, because she had been looking \n and reviewing and trying to reassemble pieces of Columbia’s \n instrument panel.\n This diminutive colonel in the Air Force—always at the end the \n photographer comes in and takes a picture of us with the VIP [very \n important person]. Anne and I were there at that time, and we’re \n all standing off to the side, a foot away or something. She says, \n “Hey, we’ve been together all day. Come here!” She \n pulled us in right next to her to take the picture. We also got an \n 8x10 from her, signed, with a thank you and mission patches. Those \n are two of my favorite treasures from that whole time there. \n Ross-Nazzal: \n Nice recollections of that time period. \n Mautner: \n Yes, it really was. We got it done. Everything seemed late—getting \n personnel, the scaffolding came late, the paint came late—but \n we got it done. We got it done on October 18th, and October 19th was \n the day the media and the museum VIPs and everybody showed up to see \n it. It was a moment of pride because it really looked good. \n Tony and I stayed after October 19th. Tony had some more work up on \n the vertical to do, and the one area that we hadn’t really addressed \n was the propulsion bay. I would work in the propulsion bay; he’d \n work up top. We did this at night because the gallery was open to \n the public, so we did a lot of night work from October until we went \n away on Christmas vacation.\n Most of cleanup in the propulsion bay—there was some FOD [Foreign \n Object Debris], there was old hardware. It went back to when it was \n delivered to us. There were some sections of insulating aluminum, \n nuts, bolts, washers, things like that. A lot of water had been back \n there, and the floor panel structure was a huge, thick piece of aluminum \n that they had milled out to look almost like a waffle. The floor looked \n like a large waffle pattern, so there’s all these thousands \n of little pockets that had held water, and I had to clean them.\n We had some nights where we had events, and the events usually allowed \n people to roam into the space hangar, so I would take my knapsack \n and my coffee and my lunch, my snacks, up into the propulsion bay. \n Something you don’t normally do around artifacts, but I didn’t \n think I could come out because of the events they had going on. I’d \n stay up there for eight hours. Well, there’d be a potty break.\n We finished before our Christmas break, and then both of us reported \n back to the Garber Facility the first week in January 2005. It was \n rewarding every day, but they also rewarded our team with the Museum’s \n Peer Award. The [museum] gives two Peer Awards every year, and the \n Enterprise Preservation Team was awarded [one of them] for 2004. It \n was a great experience.\n Ross-Nazzal: \n What are you working on now that Enterprise is getting ready to take \n a new journey in its history to go to the Intrepid [Sea, Air & \n Space Museum in New York City]? Are you working on that?\n Mautner: \n I did work on it. I don’t know what my role will be in April \n when they come back, but the whole month of February I was assigned \n out here, along with Anne and one or two other folks, to escort NASA, \n USA, and some folks from [the] Boeing [Company]. “Escort” \n has a kind of static sound to it. We were essentially here to open \n doors that they couldn’t get into, including getting to the \n restrooms, and we were able to get them discounts in our shop and \n at McDonalds. \n And then pretty soon it was, “Oh my gosh. We don’t have \n this; do you have this tool?” So we’re running for tools. \n Later, as our professional relationship evolved, we were forklifting \n equipment for them. They had forklifts, but we were able to help them \n with that. We had a JLG man lift that we were able to take them and \n some of their equipment up to different places on the Shuttle, and \n also on the tail cone, which they assembled right out here in this \n shop. As to my role when they come back on the 19th, I have not been \n told what that is yet. I hope [I] do, I have some friends I’d \n like to hang out with again.\n Ross-Nazzal: \n Are you preparing in any way to accept [OV-103] Discovery, or are \n you primarily working with the Enterprise?\n Mautner: \n I’m not. My responsibility is to work on this German night fighter. \n We still have a wing to complete. The airframe fuselage is out in \n the museum right here now, but the wing has to be done and a lot of \n other details. Between escort duties and whatnot, I’m working \n on that. We’re told that with everything else that’s going \n on, we’re going to be moving our shop from Maryland out here. \n I don’t know how that’s going to work out with the Discovery–Enterprise \n exchange, that’s yet to be determined.\n Ross-Nazzal: \n It must have been rewarding to receive that from your peers, that’s \n wonderful.\n Mautner: \n Very, yes. I think Valerie Neal, former NASA and our curator, was \n probably instrumental in getting that for us. It was pretty neat.\n Ross-Nazzal: \n Rebecca, did you have any questions for Ed?\n Wright: \n Just one, and I think you might have already answered it. Did you \n ever come back and do anything else with Enterprise?\n Mautner: \n I have once or twice, but it was generally just escort duty. Those \n were times where it was just sit around and wait for whatever the \n folks, predominately USA, needed. I did come back, and we did reinstall \n the OMS pods. That was pretty much the original team again that did \n that, and we brought a couple of other people in to assist because \n you need spotters and tag line holders. \n Wright: \n You mentioned that you would escort for whatever they needed. What \n were the types of things that they would be coming back for?\n Mautner: \n Every time USA came here, they had a lot of supplies. Rather than \n transport them back, they would leave them out and we would store \n them in our barn, which is out in the back corner of the property. \n So the first thing we’d have to do is get their supplies, and \n that ran anywhere from tape to paints to epoxy glues.\n Recently, within the past year, they came back and we took them up \n on a JLG man lift. They did the work, and I would just maneuver it \n around to a position that helped them. Like I said, “escort” \n sounds very static, and sometimes it is, but a lot of times there’s \n a dynamic component, which is the most fun of all. That’s how \n you get to know these guys and get to see what they do.\n Wright: \n Were they doing types of restoration themselves?\n Mautner: \n Yes, about last April they came back to begin the process of making \n Enterprise airworthy. That involved making an assessment of all systems, \n and they also did the [landing gear] retracts. The main job was to \n get the hydraulic system working so they could retract the landing \n gear. Part of our position as escort was to shut down areas of that \n hall to keep the public away, because the machine, what they call \n the mule, fires up the hydraulics system, makes a lot of noise. Also \n there’s part of the retract that there’s noise involved \n as well.\n We did a lot of work stanchioning off. Moving stanchions back, and \n then when it was all done, moving the stanchions closer. We were trying \n to do this juggle between making sure people were safe and USA had \n enough room to work in, and also still keeping the hall open to the \n public. Our whole purpose is to let them get as close to this stuff \n as we can.\n There were a couple of times where, yes, it was pretty static, but \n other times we were pretty involved in helping them. And everything \n back here is secured. You can’t get into the restrooms without \n our badge, so we were escorting to the restrooms. Eventually, and \n especially in this last trip in February where they did the final \n preparation for flight, the security office provided them with badges \n that allowed them to open all the things they had to get into. They \n had the same access employees had. \n I think that speaks of the type of relationship that we’ve always \n felt we had with NASA, that they weren’t an alien organization \n that comes in and invades our space but rather cohorts, colleagues \n that we feel—not exactly one with, our roles are different—but \n certainly very good friends with.\n Wright: \n Is this a very unique exhibit here compared to all the rest? Do you \n have any other kind of associations with other groups that come in \n and work on their planes?\n Mautner: \n No, there’s no other organization that has the relationship \n that NASA has with us. I think that’s historically because we’ve \n been the repository of first choice for NASA, but also because Valerie \n Neal, who came from NASA, has maintained a very, very good relationship \n with all the leadership there. It’s been a very collegial relationship \n from the very beginning. Because of that, your relationship personally \n to these people is much more relaxed, so it’s much much easier \n to make friends. I have a couple buddies that I email once in a while \n back at the Cape [Canaveral, Florida]. It’s a good relationship.\n Ross-Nazzal: \n Any other last thoughts? \n Mautner: \n I think I’ve covered the important aspects of my relationship \n with the Shuttle Enterprise and with the folks from NASA and USA. \n We had a good team. I think it was kind of neat because management \n left us alone; they left us to make a lot of our own decisions. Everybody \n worked with the goal in mind, and we reached the goal. We finished \n Enterprise, it really looks beautiful. It took us nine months to get \n it in the shape that it’s in right now, and I have to say I \n am quite proud of how it came out. \n I do recollect one of the stories that I’ll tell you. When we \n began to strip all the paint off, we traced all of the markings—the \n NASA worm, the “United States” on the side, the “Enterprise” \n itself—so that after we painted it we could restore those. We \n noted and photographed the fact that these had been hand-brushed. \n Somebody had done a stencil, and then they hand-brushed in the black \n color. As we began to strip the aircraft, we realized that there were \n other markings, other NASA worms and another “Enterprise” \n and another “United States” underneath that exterior coat \n of latex house paint. \n We traced those as well, and at that point the curator had to make \n a decision. Are we going to restore it to when it was originally painted \n and lettered, or are we going to paint it as it was presented to us \n in 1985? The decision was made to paint it as it was delivered to \n us. Those letters were all in black, and the letters we found underneath \n were in lighter shades of dark gray. \n At the time that we traced them back on the aircraft, the question \n was asked, “Well, who feels comfortable painting them back on?” \n I mean, none of us are professional sign painters. Out of the five \n of us there, four chose to do it. So what you’ll see out there \n is our hand-lettered letters, and they are letter perfect. They came \n out really, really well. Three employees and one volunteer painted \n them all in. That too raised our level of pride and involvement and \n attachment to the Enterprise. \n I have mixed feelings about it going. On the one hand, it’s \n very important for us to have an orbiter, and Discovery is a much \n more significant vehicle to have in our collection, so I’m happy \n about that. On the other hand, all of our handwork is being sent off \n to somebody else. I’m not going to lose sleep over it, but I \n will think, how are they taking care of it? Is that beautiful paint \n job still squeaky clean and nice, and are all those tiles in good \n condition? So yes, I am concerned to some degree at it going off to \n other hands.\n Ross-Nazzal: \n Any plans to go to New York and see her once she’s in her permanent \n location?\n Mautner: \n No plans at this time, no.\n Wright: \n And will you be working on Discovery when it comes?\n Mautner: \n We’re not going to touch Discovery. This is another aspect that’s \n pretty neat about getting Discovery. The ideal airplane or spacecraft \n to get into our collection is the one that just went on its last mission. \n If we could get a Boeing B-17 [aircraft] that flew a mission from \n England in August or September of 1944, and then was transferred right \n back into our hall out front, that’s the idea. You don’t \n want to touch it. You want to mount it in such fashion that you preserve \n the tires and take any other stresses out of it, but it would be great \n if it had the gunpowder stains and the engine stains and the oil stains \n and the rough-hewn patches that the mechanics put on the planes back \n in those days. \n And that’s how Discovery is coming to us. They haven’t \n cleaned it, outside of taking out the toxic materials in all the tanks \n and systems, so it’s not going to look like Enterprise at all. \n In fact, one of the people from NASA commented that Enterprise looked \n like a toy. I think what she meant was it looked like a model, and \n Discovery looks like a real orbiter. So we’re happy about that.\n Wright: \n Well, thank you.\n Ross-Nazzal: \n Thank you for spending some time with us this morning. We appreciate \n it.\n Mautner: \n You’re very welcome. It’s my pleasure to do it.\n [End \n of interview]\n \n \n Return \n to JSC Oral History Website"],["topImageUrl","https://www.jsc.nasa.gov/history/oral_histories/head_images/sc.gif"],["error",null]]}]}],["text","美國太空總署員工表示，\n他們是使用太空總署建議的\n【安麗 LOC】以「1:10」濃度\n拿來清洗太空梭及所有東西。\n\n這就是表示該產品是【極度安全】的！\n\n這樣，還有什麼安麗產品是需要擔心呢？\n\n\nhttp://www.jsc.nasa.gov/history/oral_histories/NASA_HQ/Experts/MautnerEM/MautnerEM_3-22-12.htm"],["id","5484461227031-rumor"],["createdAt","2017-01-11T01:17:00.000Z"]]},{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",1],["user",{"__iterable":"Map","data":[["id","j4S8C_AO7U9UgO3jfO7w-_TCIO4Xtij_63hrFiTOAIF-wiO0o"],["name","忠誠的✖長濱✖法蘭克林"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Universal and reusable virus deactivation system for respiratory protection"],["url","https://www.nature.com/articles/srep39956#Sec8"],["summary","AbstractAerosolized pathogens are a leading cause of respiratory infection and transmission. Currently used protective measures pose potential risk of primary/secondary infection and transmission. Here, we report the development of a universal, reusable virus deactivation system by functionalization of the main fibrous filtration unit of surgical mask with sodium chloride salt. The salt coating on the fiber surface dissolves upon exposure to virus aerosols and recrystallizes during drying, destroying the pathogens. When tested with tightly sealed sides, salt-coated filters showed remarkably higher filtration efficiency than conventional mask filtration layer, and 100% survival rate was observed in mice infected with virus penetrated through salt-coated filters. Viruses captured on salt-coated filters exhibited rapid infectivity loss compared to gradual decrease on bare filters. Salt-coated filters proved highly effective in deactivating influenza viruses regardless of subtypes and following storage in harsh environmental conditions. Our results can be applied in obtaining a broad-spectrum, airborne pathogen prevention device in preparation for epidemic and pandemic of respiratory diseases.\n \n \n \n \n \n \n\n \n IntroductionAerosols take a prominent role in airborne transmission of respiratory diseases. Droplets with aerodynamic size (da) < 10 μm and 10 < da < 100 μm are known to infect the alveolar regions and upper respiratory tract, respectively1,2. Notably, aerosols can also be a route of infection in diseases that, contrary to for instance influenza, do not specifically target the respiratory tract, as it could be the case of Ebola virus3. While vaccination can greatly reduce morbidity and mortality, during a pandemic or epidemic new vaccines matching the specific strain would be available, at the earliest, six months after the initial outbreak. Additionally, following development of an effective viral vaccine, several potential problems would remain, such as limited supply due to insufficient production capacity and time-consuming manufacturing processes. As a result, individuals close to the point of an outbreak would be in imminent danger of exposure to infectious diseases during the non-vaccine period. In the absence of vaccination, respirators and masks can be worn to prevent transmission of airborne pathogenic aerosols and control diseases, such as influenza4.The main alternative, the N95 respirator, requires training prior to use, must be expertly fitted to address the risk of faceseal leakage at the face-mask interface, and must be disposed of as biohazard5. Due to these factors, the use of N95 respirators on a large scale is impractical and expensive during an epidemic or pandemic. Past experiences of severe acute respiratory syndrome (SARS), H1N1 swine flu in 2009, and Middle East respiratory syndrome (MERS) indicate that surgical masks have been most widely adopted by the public as personal protective measure, despite controversy on their effectiveness6,7,8,9. Currently, among other factors, filtration in respirators and masks depends on filter characteristics, including fiber diameter, packing density, charge of fibers and filter thickness, as well as particle properties, such as diameter, density and velocity10,11,12,13,14. However, in the lack of a system to deactivate the collected pathogens, safety concerns naturally arise about secondary infection and contamination from virus-laden filter media during utilization and disposal. Furthermore, since re-sterilization is not possible without causing damage, respirators and masks are recommended for single use only9,15,16. Scientific efforts have been focused on treatment of filters with materials possessing well-known antimicrobial properties, such as iodine, chlorine and metals17,18,19,20,21,22,23,24,25, although with limited effectiveness against virus aerosols26,27,28. Therefore, a key challenge is the development of an easy-to-use, universal virus negation system, which is reusable without reprocessing and capable of deactivating pathogens, thereby reducing potential risk of secondary infection and transmission.Here, we report a simple but efficient virus inactivation system exploiting the naturally occurring salt recrystallization. Our strategy is to modify the surface of the fibrous filtration layer within masks with a continuous salt film for virus deactivation via two successive processes: i) salt is locally dissolved by the viral aerosols and ii) supersaturation is followed by evaporation-induced salt recrystallization. Consequently, viruses are exposed to increasingly higher concentrations of saline solution during drying and physically damaged by recrystallization.ResultsPreparation and characterization of salt-functionalized filtersTo demonstrate the concept of virus deactivation system based on salt recrystallization, the middle layer of three-ply surgical mask, polypropylene (PP) microfiber filter, was coated with NaCl salt as an active virus negation unit (see Supplementary Fig. S1 for bare PP filter). The coating formulations contained surfactant to enhance wetting of saline solution on the surface of hydrophobic PP fibers. Bare PP filters (abbreviated as Filterbare) were pre-wet to contain about 600 μL of coating solution (abbreviated as Filterwet). The amount of NaCl salt (Wsalt in mg/cm2) coated on the filter per unit area, considering that the filters thickness is constant, was easily controlled by changing the coating solution volume (Vsalt in μL) during drying of pre-wet filter (radius: 3 cm, Wsalt = 3.011 + 0.013 × Vsat, n = 7) (Fig. S2). Scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) mapping analysis showed the formation of homogeneous NaCl coating during drying, as also confirmed by X-ray diffraction (XRD) (Fig. 1a,b and Supplementary Fig. S3). Both the formation of NaCl coating on PP fibers and presence of surfactant in the coating formulation appeared to alter the filter surface properties from hydrophobic (bare filter; contact angle, θc = 133.0 ± 4.7°) to completely hydrophilic (salt-coated filter; θc ~ 0°, n = 10) (Fig. 1c and Supplementary Fig. S4). Hydrophilic nature of salt coating can greatly improve adhesion of viral aerosols to PP fibers compared to Filterbare, as seen in Raman microscope images (Fig. 1d and Supplementary Fig. S5).Figure 1: Mask with salt-coated filter for prevention and deactivation of airborne pathogens.(a) SEM image of Filterwet+600μL (top left) and EDX mapping images of Na (red), Cl (green), and NaCl (combination of Na and Cl mapping images), showing the formation of NaCl coating, as also confirmed by XRD spectra (b) of Filterbare, Filterwet, Filterwet+100μL, Filterwet+300μL, Filterwet+600μL, Filterwet+900μL and Filterwet+1200μL (labelled as Bare, wet, wet+100 μL, wet+300 μL, wet+600 μL, wet+900 μL and wet+1200 μL, respectively; miller indices corresponding to NaCl crystal are shown at the top of XRD spectra for each position). (c) Optical microscope images for contact angle measurements using 3 μL DI water droplets on (i) Filterbare and (ii) Filterwet+600μL (n = 10). (d) Microscope images of aerosol on (i) Filterbare and (ii) Filterwet+600μL (n = 10).Filtration efficiency against viral aerosols and protective efficacy in vivoFiltration efficiency of salt-coated filters was tested against aerosols with volumetric mean diameter (VMD) of 2.5–4 μm containing H1N1 pandemic influenza virus (A/California/04/2009, abbreviated as CA/09) at different pressure conditions (see Fig. 2a for transmission electron microscope (TEM) image of H1N1 virus). Interestingly, as shown in Fig. 2b, Filterbare did not exhibit any significant level of resistance against penetration of virus under our experimental conditions (i.e., 0% filtration efficiency). Conversely, salt-coated filters showed substantially increasing filtration efficiency with pressure and amount of coated salt. In particular, in the case of Filterwet+600μL, filtration efficiency varied from 43 to 70%, with increasing pressure from 3 to 17 kPa, and Filterwet+1200μL exhibited persistent, high-level efficiency (~85%) (one-way ANOVA, P = 0.85).Figure 2: Filtration efficiency of salt-coated filters.(a) TEM image of CA/09 H1N1 influenza virus. (b) Pressure-dependent filtration efficiency (n = 8–10, mean ± standard deviation (SD)). (c–f) Effects of filtration efficiency on protective efficacy in vivo. Body weight change of mice after infection with the dosages of penetrated virus (n = 12, mean ± SD) (c), survival rates (mean; 100% means that all mice in the group survived as penetrated dosages were lower than lethal dose) (d), lung virus titers (n = 4, mean ± SD) (e), and lung inflammatory cytokine (interferon-γ (IFN-γ)) assay (n = 11, mean ± SD) (f). Legends: filters are labelled as in Fig. 1b.To probe the effects of filtration efficiency on protective efficacy, in vivo experiments were performed using mice intranasally (IN) infected with penetrated dosages of H1N1 virus under breathing pressure (~10 kPa)29. As shown in Fig. 2c, similarly to negative control groups (mice infected with lethal dose of virus stock and aerosolized virus), mice exposed to a dose penetrated through the bare filter showed rapid body weight loss, followed by death within 10 days after infection, in good agreement with the observed 0% filtration efficiency (Fig. 2b). In contrast, mice groups exposed to virus derived from salt-coated filters resulted in 100% survival rate (Fig. 2d). Furthermore, lungs of mice from negative control groups exhibited severe lung infection 4 days after challenge (Fig. 2e). Conversely, mice groups exposed to virus derived from salt-coated filters showed significantly lower levels of lung viral titers (t-test, P < 0.005). This is consistent with lower levels of inflammatory cytokines, interferon-γ (IFN-γ), from salt-coated filter groups compared to negative control and bare filter groups (t-test, P < 0.001) (Fig. 2f).Deactivation of virus on salt-functionalized filtersInfluenza virus stability tests were performed to investigate the effects of salt coating. The same amount of recovered viruses from the PP fibers was used, and, in the case of bare filters, viral aerosols exposure was conducted in the absence of pressure due to 100% penetration of viral aerosols. Unlike bare filters (Fig. S6a(i)), formation of micron-sized NaCl phase represents a typical feature of salt-coated filters due to recrystallization of NaCl salt, following local dissolution upon aerosols exposure (SEM images in Fig. S6a, ii to iv, and EDX mapping in Fig. S6b). In contrast to 8% HA activity loss of virus adsorbed onto Filterbare, salt-coated filters exhibited almost complete HA activity loss within 5 min of incubation (Fig. 3a). Such dramatic virus destabilization on salt-coated filters is further supported by negligible levels of viral titers compared to Filterbare with incubation time (t-test, P < 0.001) (Fig. 3b). It is also noted that virus titers exhibited significant decrease with increase of incubation time and amount of coated salt (ANOVA general linear model, P < 0.001). TEM analysis showed that influenza virus on Filterbare experiences morphological change into non-spherical shape during aerosol drying (Fig. 3c(i)). Notably, influenza virus was severely damaged on salt-coated filters even at 5 min of incubation (Fig. 3c(ii)). From microscopic analysis, aerosol drying time was about 3 min, indicating that destruction of virus observed at 5 min is associated with drying-induced salt crystallization. Physical damage of virus due to crystallization was similarly reported as a major destabilizing factor of inactivated influenza virus30,31. Lower levels of native fluorescence and nile red fluorescence from virus recovered from salt-coated filters accounted for more severe conformational change of antigenic proteins and destabilization of viral envelope, respectively, consistent with TEM analysis (t-test, P < 0.001) (Fig. 3d). In parallel, we investigated the separate effect of salt concentration increase on virus stability during the aerosol drying process, irrespective of crystal growth. As displayed in Supplementary Fig. S7, the materials collected in suspension from Filterwet+600μL induced visible morphological transformation of the virus (Supplementary Fig. S7b) compared to suspension of Filterbare (Supplementary Fig. S7a). This can be attributed to the high salt/surfactant concentration and osmotic pressure, which have been well-known to destabilize proteins and viruses31,32,33. Therefore, the marked virus destabilization on salt-coated PP fibers can be explained by the combined effects of salt concentration increase during drying and evaporation-induced salt crystallization.Figure 3: Inactivation of virus adsorbed on salt-coated filters.(a,b) HA activity (a) and virus titer (b) displaying the effects of incubation time on the remaining activity of virus (n = 4–8, mean ± SD). (c) TEM images of viruses reconstituted, after incubation for 5 and 60 min, from (i) Filterbare and (ii) Filterwet+600μL. (d) Native fluorescence/nile red fluorescence of viruses incubated for 60 min (n = 12, mean ± SD). (e,f) Body weight change of mice after infection with virus recovered from filters after incubation for 60 min (n = 12, mean ± SD) (e), and lung virus titers (n = 6, mean ± SD) (f). Asterisk (*): below detection limit. Legends: filters are labelled as in Fig. 1b.To verify in vitro virus stability on the filters, an in vivo study was performed by infecting mice with virus incubated for 60 min on PP filters. As shown in Fig. 3e, Filterbare group exhibited 5% body weight loss at day 9 post-infection, reaching a body weight lower than that of salt-coated filter groups by 10–15%. Thus, significantly higher lung virus titers in the negative control group were observed in contrast to no detectable titers in the salt-coated filter groups (Fig. 3f).Strain-nonspecific virus deactivation and effects of storage under harsh environmental conditions on salt coating stabilityBroad-spectrum protection of salt-coated filters against multiple subtypes of viral aerosols was evaluated by investigating both lethal infectivity by penetrated virus in vivo and infectivity by virus collected on filters during filtration in vitro using A/Puerto Rico/08/1934 (PR/34 H1N1) and A/Vietnam/1203/2004 (VN/04 H5N1). Similarly to CA/09 H1N1, 100% of mice survived viral infection (PR/34 and VN/04), with no evidence of weight loss, due to higher filtration efficiency of salt-coated filter than that of bare filter (Fig. 4a). This is supported by no significant level of viral titer in the lung. In addition, as shown in Fig. 4b, salt-coated PP filters destroyed adsorbed influenza viruses irrespective of both subtypes and amount of coated salts.Figure 4: Strain- and environment-dependent performance of salt-coated filters.(a) Body weight change of mice infected with penetrated PR/34 H1N1 and VN/04 H5N1 viruses through Filterwet+600μL (n = 12, mean ± SD). (b) Virus titers of recovered viruses from bare and salt-coated filters (n = 4, mean ± SD; data for Filterwet, Filterwet+600μL and Filterwet+1200μL are overlapped). (c,d) Body weight change (c) and survival rate (d) of mice infected with dosage of penetrated virus through Filterwet+600μL before and after exposure to harsh environmental conditions (37 °C and 70% RH) for 1 day (filled square and open square overlap in (d)). (e) EDX mapping image of NaCl-coated Filterwet+600μL after incubation for 15 days at 37 °C and 70% RH (combination of Na (red) and Cl (green) mapping images). (f) XRD spectra of Filterwet+600μL before and after incubation at 37 °C 70% for 1 day and 15 days. Legends: filters are labelled as in Fig. 1b.The stability of salt coating on PP fibers was tested under harsh environmental conditions. Incubation at 37 °C and 70% relative humidity (RH) for 1 day did not cause any significant difference in filtration efficiency (t-test, P = 0.718) (Supplementary Fig. S8). As a result, all mice infected with dosage of penetrated virus through the filter stored at high temperature and RH displayed 100% survival with 7% of body weight loss (Fig. 4c,d). Even after 15 days of incubation, salts remained to coat PP fibers (Fig. 4e, and Supplementary Fig. S9a,b), despite change in grain orientation due to recrystallization (Fig. 4f, and Supplementary Fig. S10a,b).DiscussionDevelopment of a universally applicable, low-cost, and efficient mechanism for virus negation is regarded as a major challenge in public health against general airborne biological threats. This led us to propose a new concept of personal/public preventive and control measures using salt-recrystallization against pathogenic aerosols based on two hypotheses. The salt-coating can enhance adsorption of virus on the filter fibers and inactivate virus by the increase of osmotic pressure followed by the crystallization of salts. As shown in Fig. 2b, salt-coated filters exhibited significantly higher levels of filtration efficiency than bare filters. Notably, the bacterial filtration efficiency (BFE) reported by the mask manufacturer is 99%. The different value of filtration efficiency for bare filters obtained under our experimental conditions may be partially due to the use of aerosols with different biological origins. The FDA-recognized ASTM F2101 – 14 standard for evaluation of BFE exposes surgical masks to Staphylococcus aureus aerosols, by employing S. aureus ATCC 653834, which has an average diameter of about 1 μm. In this study, filtration efficiency was calculated following exposure of bare and salt-coated filters to influenza virus, which exhibits a smaller diameter than that of S. aureus by one order of magnitude. Additionally, whereas during BFE evaluation all three layers of surgical masks are used, in this work filtration efficiency refers to mask filters (middle layer). It is worth noting that the conditions for BFE standard evaluation (such as flow rate and time of application of flow) do not coincide with the experimental procedure we used for measurement of the filtration efficiency, which may further contribute to the different result. The enhanced filtration efficiency of salt-coated filters against influenza virus aerosols as compared to bare filters can be explained by the observed wetting of aerosols, favoring greater adhesion to salt-coated filters. Furthermore, the significant improvement in filtration efficiency resulted in complete protection of mice against lethal influenza aerosols, which demonstrates the high level of protection provided by salt-coated filters, outperforming currently used bare filters.Rapid loss of HA activity and viral infectivity on salt-coated filters can be explained by physical destruction of virus during recrystallization of coated salts. When the salt-coated filter is exposed to virus aerosols, salt crystals below the aerosol droplet dissolve to increase osmotic pressure to virus. Due to evaporation, the salt concentration of the droplet significantly increases and reaches the solubility limit, leading to recrystallization of salt. As a consequence, virus particles are exposed to increasing osmotic pressure during the drying process and are physically damaged by crystallization. As shown in Fig. 3e,f, the superior advantage of physically destroying the virus adsorbed to the salt-coated PP filters through natural salt crystallization process was further confirmed in vivo. According to previous reports, hyperosmotic stress (>541 mOsm) and crystallization induce membrane perturbation with irreversible deformation of the viral envelope and structural virus damage, respectively, resulting in infectivity loss of virus30,31. Therefore, our data support that the extensive level of infectivity loss associated with a salt recrystallization process caused by physical contact between virus aerosols and salt coating can be used in developing virus negation systems that are reusable without reprocessing.Similarly to CA/09 H1N1 aerosols, increased protection in vivo due to higher filtration efficiency of salt-coated filters compared to bare filters and deactivation of virus on salt-coated filters were observed following exposure to PR/34 H1N1 and VN/04 H5N1 (Fig. 4a,b). This suggests that salt-coated filters prevent virus penetration and destroy virus attached to the filter in a non-specific way. Furthermore, the performance of salt-coated filters was not degraded by storage at 37 °C and 70% RH, demonstrating that salt recrystallization-based filters can ensure protection even under harsh environmental conditions. Notably, for demonstration of the concept of salt-recrystallization based virus deactivation system, NaCl salt was used, which has a critical RH of 75% at 30 °C35. However, salts with higher critical RH can be easily used, such as ammonium sulfate, potassium chloride and potassium sulfate, which have critical RH of 80%, 84% and 96.3% at 30 °C, respectively35. This suggests that salt-coated filters may be developed for specific environmental conditions.In conclusion, we demonstrated that the developed salt-recrystallization based filtration system provides high filtration efficiency and successfully deactivates multiple subtypes of adsorbed viruses. Moreover, we have shown that stability of the salt coating is not compromised by high temperature and humidity, which suggests safe use and long-term storage/reuse at such environmental conditions. Although our tests are based on exposure to different types of influenza virus, the significance of these results for personal and public protective measures may be generally extended to enveloped respiratory viruses where infection and transmission can occur by aerosol. Our salt-coated filter unit can promise the development of long-term stable, versatile airborne pathogen negation system, without safety concerns. In fact, the destruction mechanism of viruses solely depends on the simple, yet robust naturally occurring salt recrystallization process, combining the destabilizing effects of salt crystal growth and concentration increase during drying of aerosols. This idea can be easily applied to a wide range of existing technologies to obtain low-cost, universal personal and public means of protection against airborne pathogens, such as masks and air filters in hospitals. Therefore, we believe that salt-recrystallization based virus deactivation system can contribute to global health by providing a more reliable means of preventing transmission and infection of pandemic or epidemic diseases and bioterrorism.MethodsBare and salt-coated filter samples preparationThe commercial surgical masks had a three-ply structure. The middle layer is the filter media, whereas the inner and outer layers provide support and protect the filter against wear and tear. The metal nose clips and elastic ear loops were removed and circular samples (radius: 3 cm) were cut from the masks. The PP filters (middle layer) were isolated by removing the inner and outer protective layers (bare filters, Filterbare). The coating solution was prepared by dissolving sodium chloride (NaCl; Sigma Aldrich, St. Louis, MO) in filtered DI water (0.22 μm pore size; Corning, Tewksbury, MA) under stirring at 400 rpm and 90 °C, followed by the addition of Tween 20 (Fisher Scientific) to a final concentration of 29.03 w/v% of NaCl and 1 v/v% of Tween 20. To obtain the salt-coated filters, the mask bare PP filters were pre-wet to contain approximately 600 μL of coating solution by incubating overnight at room temperature. Any remaining dry areas were removed by applying gentle strokes with tweezers to the filters while immersed in the coating solution. Subsequently, the filters were deposited in the desired volume of coating solution (0, 100, 300, 600, 900 and 1200 μL, of which corresponding membranes are abbreviated as Filterwet, Filterwet+100μL, Filterwet+300μL, Filterwet+600μL, Filterwet+900μL, and Filterwet+1200μL, respectively) on petri dishes (60 × 15 mm; Fisher Scientific) to control the amount of NaCl per unit area and dried in an oven (Isotemp Incubator, Fisher Scientific) at 37 °C for 1 day.Influenza virus preparationInfluenza viruses A/California/04/2009 (CA/09, H1N1), A/Puerto Rico/8/34 (PR/34, H1N1) and A/Vietnam/1203/2004 (VN/04, H5N1) were grown in 10-day old embryonated hen eggs, in which H5N1 virus was derived by reverse genetics from HPAI A/Vietnam/1203/200436. Influenza viruses were purified from allantoic fluid using discontinuous sucrose gradient (15%, 30% and 60%) layers following the previously reported procedure37.Aerosols exposure to filtersFor experiments involving aerosols exposure, an aerosol chamber (L × W × H = 145 × 145 × 150 mm; Emka Inc., Middletown, PA) was used (Fig. S11). It has a connection to the vacuum line and a circular aperture in the top wall (diameter: 22 mm) to exactly accommodate the cylindrical part (diameter: 20 mm, height; 20 mm) of the nebulizer unit that is below the aerosol generator (Aeroneb Lab Nebulizer System; Aerogen, Galway, Ireland). Bleach was used as trap between the chamber and the vacuum pump (Welch 2522C-10, 22 L/min; Niles, IL). The filters were placed on top of the chamber aperture and the nebulizer unit was inserted, ensuring the tight seal of the filters against the side of the aperture. 5 μL of virus stock were added to the nebulizer unit, aerosols (VMD 2.5–4 μm from manufacturer specifications) were generated for 30 sec and subsequently the desired vacuum level (3, 10 or 17 kPa) was applied, by manual control, three times in 1 sec cycles. Notably, in the case of bare filters, pressure was only applied for filtration efficiency tests.For all assays and analysis, suspensions of the filters were prepared as follows, unless otherwise indicated. To reconstitute virus adsorbed onto filters, virus-laden filters were immersed in 400 μL of sterilized DI water for about 5 min, and then removed after vortexing from the suspension. The virus suspension was centrifuged at 19,800 g and 4 °C for 10 min (Centrifuge 5810 R, Eppendorf, Hauppauge, NY), followed by resuspension of pellets in 70 μL of DI water to eliminate any interference from materials in supernatant during assays.Filtration efficiency testsThe filters were exposed to the virus aerosols at 3, 10 and 17 kPa and suspensions of the filters were obtained, as described above. The filtration efficiency was calculated as the ratio of the amount of virus (i.e., total proteins measured from the virus) reconstituted from the filter to that from the virus in the exposure aerosols. The concentration of virus in aerosols was determined by generating viral aerosols into a 15 mL centrifuge tube, containing 1 mL of DI water. After vortexing, virus concentrations (i.e., total protein concentration) were measured with bicinchoninic acid assay (BCA protein assay kit; Thermo Fischer scientific, Waltham, IL) with bovine serum albumin as a standard. In the case of virus reconstituted from salt-coated filters, virus-laden filter suspension was replaced with DI water prior to BCA assay.In vivo infection testsLethal infectivity of influenza viruses (CA/09 H1N1) was examined in 8 week old female inbred BALB/c mice (Nara Biotech; Seoul, Korea) by using the intranasal route. For bare and salt-coated filters, 12 mice per group were infected with individual penetration dosage of influenza virus through each filter. The penetration dosage of the virus through the filters (Filterbare, Filterwet, Filterwet+600μL, and Filterwet+1200μL) was calculated from the filtration efficiency at 10 kPa (near breathing pressure) using the relationship: penetration dosage = virus dosage in lethal aerosol × penetration efficiency (%)/100, where penetration efficiency (%) = 100 − filtration efficiency (%). To examine the effects of the aerosolization process on the viral infectivity change, two mice groups were infected with a lethal dose of virus before and after aerosol formation, which served as negative control groups. Body weight changes and survival rate of mice were monitored daily for 15 days. Mice with body weight loss greater than 25% were euthanized. All animal protocols were approved by the Kyung Hee University (KHU) Institutional Animal Care and Use Committee (IACUC). All animal experiments and husbandry involved in this work were conducted under the approved protocols and guidelines of KHU IACUC. KHU IACUC operates under National Veterinary Research and Quarantine Service (NVRQS), and animal welfare law and regulations of the WOAH-OIE (World organization for animal health).To test strain-dependent lethal infection behavior, mice (12 per group) were infected with the penetrated dosage of viral aerosols (PR/34 H1N1 and VN/04 H5N1 viruses) through Filterwet+600μL at 10 kPa. Time-dependent body weight change was monitored in the same manner described above.Lung viral titer and lung inflammatory cytokine assays after infectionOn day 4 after infection 6 mice of each group were sacrificed for the collection of lung samples. Lung virus titers were measured on six-well plates containing confluent MDCK cell monolayers. Inflammatory cytokines (IFN-γ) were determined using BD OptEIA mouse IFN-γ ELISA kit (BD Biosciences, San Jose, CA) following the manufacturer’s procedure.Test of viral infectivity change on filtersTo investigate the effects of salt-coating on viral infectivity loss, lethal influenza aerosols were exposed to four different types of filters (Filterbare, Filterwet, Filterwet+600μL, and Filterwet+1200μL). Since Filterbare exhibited almost complete penetration upon pressure application, aerosols were exposed to the bare filter in the absence of pressure and samples were carefully handled to prevent mechanical agitation. To measure time-dependent stability change of virus, virus-laden filters were incubated at ambient conditions for 0, 5, 15, and 60 min after aerosol exposure, and suspended in DI water to reconstitute virus at each time point. In vitro stability of virus was characterized by measuring hemagglutinin activity (HA) and virus titers at the same concentration as lethal dose30. The conformational stability of antigenic proteins was characterized by measuring intrinsic fluorescence using 0.1 mg/mL of virus suspension38. To investigate morphological change of virus, lipid stability of viral wall was characterized by nile red fluorescence (Sigma Aldrich), a fluorescent lipid stain, following manufacturer’s protocol39. A decrease in fluorescence intensity can be used to examine the level of disintegration of the virus. Both intrinsic and nile red fluorescence were measured by using a fluorimeter (LB 50B; PerkinElmer, Waltham, MA). Intensity changes of fluorescent spectra were compared relative to those of a control from virus stock.To test infectivity difference observed from in vitro findings, in vivo study was performed for the virus reconstituted from the filters (Filterbare, Filterwet, Filterwet+600μL, and Filterwet+1200μL) after incubation for 60 min at RT (aerosol exposure at 10 kPa, except for Filterbare). 12 mice per group were infected with a lethal dose of virus collected from each type of filter. Body weight change and lung virus titers were measured as described above.Effects of environmental conditions on the performance of salt-coated filterSalt-coated filters (Filterwet, Filterwet+600μL, and Filterwet+1200μL) were stored at 37 °C, 70% RH in an incubator (Maru Max; Rcom, Gyeonggi-do, South Korea) for 15 days. Every day, the filters were collected and incubated at ambient conditions for 5 min. At 1-day incubation, filtration efficiency was measured at 10 kPa from Filterwet+600μL, followed by in vivo infection test. Lethal infectivity between two different filter groups (before and after incubation at 37 °C, 70% RH) was compared by measuring body weight change and survival rate of mice after exposure to lethal CA/09 H1N1 aerosols. XRD analysis was performed to salt-coated filters incubated for 1 and 15 days, and SEM/EDX mapping analysis for 15-day incubated samples.Contact angle measurements and imaging of aerosolsThe bare and salt-coated filters were fixed with carbon tape (Ted Pella, Inc., Redding, CA) to a metal, flat substrate and 3 μL of DI water were added on the surface of the filters. The contact angles were measured from images collected with an optical microscope (10× lens, Motic SMZ-140; Motic, Richmond, Canada) at RT. Images of aerosols on filter fibers were obtained using a dispersive Raman microscope (Nicolet Almega XR; Fisher Scientific).Aerosol drying time on filtersThe bare and salt-coated filters were fixed with carbon tape to a metal, flat substrate and exposed to aerosols generated from 5 μL of Sulforhodamine B Dye solution (1 mM, Sigma-Aldrich). Aerosol drying time was determined with timer by observation with optical microscope.Electron microscopy analysisFor virus stability tests, bare and salt-coated filters were exposed to CA/09 H1N1 aerosols and, after 5 and 60 min incubation, virus was recovered by suspension of the filters, as described above. To study the effects of the coating formulation during aerosol drying independently from crystal growth, bare and salt-coated filters were immersed in DI water and removed after 60 min. Subsequently, virus was incubated in the obtained suspension for 60 min. Additionally, the virus suspension was centrifuged at 19,800 g and 4 °C for 10 min to collect the samples and suspend them in DI water. For TEM analysis (200 kV, JEOL JEM 2100; JEOL, Peabody, MA), samples were deposited on copper grid (Electron Microscopy Sciences, Hatfield, PA) and negatively stained with solution comprised of phosphotungstic acid hydrate (1.5 w/v%, pH = 7.0; Sigma-Aldrich, Oakville, Canada).To identify the morphology of salt-coated filters and recrystallized salts, SEM/EDX analysis was performed for bare and salt-coated filters after coating with 10 nm thick gold layer. Scanning electron microscopy analysis (Hitachi S-3000N; Hitachi, Toronto, Canada) was operated in secondary electron mode at 20 kV and EDX analysis was obtained with EDX detector (Oxford Instruments, Concord, MA).XRD analysisTo confirm the formation of crystalline NaCl coating during drying process and its stability during storage at 37 °C and 70% RH, XRD analysis (BRU-1098; Bruker, Billerica, MA) was performed at different coating conditions. Filters (1 × 1 cm) were mounted on a slide glass for XRD analysis (θ–2θ mode) using a CuKα radiation.Statistical analysisTo compare multiple conditions, Student’s t-test, One-way analysis of variance (ANOVA), and general linear model were used (Minitab release 14; Minitab, State College, PA). P value of less than 0.05 was considered to be significant.Additional InformationHow to cite this article: Quan, F.-S. et al. Universal and reusable virus deactivation system for respiratory protection. Sci. Rep. 7, 39956; doi: 10.1038/srep39956 (2017).Publisher's note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\n \n\n References1Tellier, R. Review of aerosol transmission of influenza A virus. Emerging Infect. Dis. 12, 1657–1662 (2006).2Weber, T. P. & Stilianakis, N. I. Inactivation of influenza A viruses in the environment and modes of transmission: a critical review. J. Infect. 57, 361–373 (2008).3Duy, J. et al. Circulating microRNA profiles of Ebola virus infection. Sci. Rep. 6, 24496 (2016).4Morse, S. S., Garwin, R. L. & Olsiewski, P. J. Next flu pandemic: what to do until the vaccine arrives? Science 314, 929–929 (2006).5CDC. Laboratory performance evaluation of N95 filtering facepiece respirators, 1996. MMWR, Morbidity and Mortality Weekly Report 47, 1045 (1998).6Seto, W. H. et al. 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Cell Biol. 100, 965–973 (1985).Download referencesAcknowledgementsThis research was financially supported by startup funds from University of Alberta (H.J.C.), and grants from National Research Foundation of Korea (NRF) (NRF-2014R1A2A2A01004899) and Ministry of Health & Welfare, Republic of Korea (HI15C2928).Author informationAuthor notesFu-Shi Quan and Ilaria Rubino: These authors contributed equally to this work.AffiliationsDepartment of Medical Zoology, Kyung Hee University School of Medicine, Seoul, 130-701, KoreaFu-Shi QuanDepartment of Chemical and Materials Engineering, University of Alberta, Edmonton, AB T6G 1H9, CanadaIlaria Rubino, Brendan Koch & Hyo-Jick ChoiDepartment of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 130-701, KoreaSu-Hwa LeeAuthorsSearch for Fu-Shi Quan in:Search for Ilaria Rubino in:Search for Su-Hwa Lee in:Search for Brendan Koch in:Search for Hyo-Jick Choi in:ContributionsH.J.C. conceived and designed the experiments. F.S.Q., I.R., S.H.L., B.K., and H.J.C. performed the experiments. F.S.Q., I.R., S.H.L., B.K., and H.J.C. analyzed the data. I.R. and H.J.C. wrote the manuscript. F.S.Q. and B.K. edited the manuscript.Corresponding authorCorrespondence to\n Hyo-Jick Choi.Ethics declarations\n \n Competing interests\n The authors declare no competing financial interests.\n \n Supplementary informationRights and permissionsThis work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/Reprints and PermissionsAbout this articleCite this articleQuan, F., Rubino, I., Lee, S. et al. Universal and reusable virus deactivation system for respiratory protection.\n Sci Rep 7, 39956 (2017). https://doi.org/10.1038/srep39956Download citationReceived: 04 August 2016Accepted: 30 November 2016Published: 04 January 2017DOI: https://doi.org/10.1038/srep39956\n\n \n \n \n Further reading\n \n \n \n \n \n \n Survival of Microorganisms on Nonwovens Used for the Construction of Filtering Facepiece Respirators\n \n \n \n \n Katarzyna Majchrzycka, Małgorzata Okrasa, Justyna Szulc, Anita Jachowicz[…] & Beata Gutarowska- Show fewer authors\n \n \n International Journal of Environmental Research and Public Health\n (2019)\n \n \n \n \n \n \n Respiratory Protection against Pandemic and Epidemic Diseases\n \n \n \n \n Ilaria Rubino & Hyo-Jick Choi\n \n \n Trends in Biotechnology\n (2017)\n \n \n \n \n \n \n \n \n\n \n CommentsBy submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate."],["topImageUrl",null],["error",null]]}]}],["text","WIKILINK\n最新科技資訊\n\n \n口罩能否反復使用？浸鹽水後可100%讓H1N1病毒滅活，但對其他病毒需謹慎 | 《科學報告》期刊\nFebruary 5, 2020 admin\n曉查發自凹非寺 \n量子位報道 | 公眾號 QbitAI\n一場新冠肺炎讓中國的口罩嚴重告急。\n\n每齣一次門就要廢掉一個口罩，傢裏的口罩即將用完，藥店和網上都買不到，真是急死人瞭。\n\n彆怕，早在2016年，來自韓國慶熙大學的研究者就發現，口罩隻需用普通食鹽水處理後，就具有瞭一定的殺滅病毒能力，至少對2009年爆發的H1N1流感病毒有效。\n\n他們將處理後的口罩來過濾充滿H1N1病毒的空氣，然後再給小白鼠呼吸，結果發現小鼠的存活率達到瞭100%。\n\n\n\n\n \n空氣中的病毒濃度達到瞭緻死量。作為對照，如果使用普通醫用口罩過濾，小白鼠在4天後就會齣現嚴重的肺炎，10天後全部死亡。\n\n這篇文章發錶在2017年1月Nature旗下的Scientific Reports期刊上。\n\n\n\n△實驗中用到的過濾裝置\n早在3年前，該文章就預測瞭口罩短缺的可能性。\n\n作者在開頭說，在疫病大流行時期，生産能力不足和製造過程耗時，會導緻口罩供應有限。\n\nN95口罩雖然可以過濾空氣中形成的病毒氣溶膠，但是在嚴重的疫情麵前，大規模使用N95口罩是不切實際的，而且價格昂貴。\n\n過去的SARS、H1N1、MERS都錶明，醫用外科口罩是被公眾最廣泛采用的個人防護措施，盡管人們對它的效果存在爭議。\n\n因此需要開發一種通用、低成本且有效的防護病毒機製，最好能用在普通醫用口罩上。\n\n\n\n\n\n\n研究人員配置瞭濃度29.03 w/v%的氯化鈉溶液，並在其中加入瞭一些Tween 20錶麵活性劑，將口罩浸潤，然後在37℃的環境下乾燥一天。\n\n文章指齣，經過這種方法處理後的口罩無需再次處理即可重復使用。最終實驗發現，塗有氯化鈉的口罩上的病毒在5分鍾後就失去瞭活性。\n\n\n\n\n\n\n從顯微鏡分析來看，病毒氣溶膠乾燥時間約為3分鍾，錶明在5分鍾時觀察到的病毒破壞與乾燥引起的鹽結晶有關。\n\n作者推測，可能是帶有水分的病毒被吸附在口罩錶麵，濕潤後又重結晶的鹽破壞瞭病毒的結構。\n\n既然對H1N1病毒，自然就有網友很好奇，這種處理方法是否也對新型冠狀病毒有效。\n\n一些網友對此提齣瞭質疑，認為鹽結晶可能減小瞭口罩的通氣量，而且實驗隻對H1N1病毒進行瞭驗證，是否實用還有待商榷。\n\n所以在未經實驗驗證的情況下，請不要用這種方法來過濾新型冠狀病毒。口罩還是要保證一用一換，切不可自行處理後就重復使用，否則仍有被感染的風險。\n\n論文地址：\nhttps://www.nature.com/articles/srep39956#Sec8\n\n— 完 —\n\n"],["id","obwrpyiajxnx"],["createdAt","2020-02-09T01:53:22.130Z"]]},{"__iterable":"Map","data":[["replyCount",2],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",4],["user",{"__iterable":"Map","data":[["id","j4S8C_SGPqU25kWT9dgB7Sm3Cz8tQbcAia5BFcJwmHqtWpshs"],["name","富創造力的鼓山愛爾莎"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Taiwan’s Military Is a Hollow Shell"],["url","https://foreignpolicy.com/2020/02/15/china-threat-invasion-conscription-taiwans-military-is-a-hollow-shell/"],["summary","As threats of military aggression from China grow, the island nation of Taiwan needs a credible military deterrent more than ever. But Taiwan’s military is in a crisis it can barely admit exists.\nEven as the military refits itself with flashy U.S. arms purchases, such as M1 Abrams tanks and F-16V fighter jets, its front-line units are hollowed out, and the entire reserve system is so dysfunctional that few experts or serving military personnel believe it can make a real military contribution in the event of a war. These problems are well documented but continue to be downplayed, if not outright ignored, by Taiwan’s political leadership—and there is no clear plan to solve the crisis.\n\n \n Trending Articles\n \n \n \n \n \n Coronavirus Conspiracies Give Boost to Canada’s Far-Right\n Anti-Chinese sentiment and a public health backlash have vaulted Hong Kong-born Chief Public Health Officer Theresa…\n\n \n \n\n \n \n \nOn paper, Taiwan’s Ministry of National Defense (MND) has 215,000 budgeted positions among all branches, of which 188,000 are soldiers and the rest civilian employees. Only 153,000 of those positions were filled in 2018—just 81 percent of the personnel the military should have. But even that number doesn’t tell the complete story.Only 153,000 of those positions were filled in 2018—just 81 percent of the personnel the military should have. But even that number doesn’t tell the complete story.Only 153,000 of those positions were filled in 2018—just 81 percent of the personnel the military should have. But even that number doesn’t tell the complete story.\nAccording to a Taiwanese army lieutenant colonel in active service, who asked for only his last name, Lin, to be used, all the army’s front-line combat units he knows of—including armor, mechanized infantry, and artillery troops—currently have effective manpower levels of between 60 and 80 percent. This figure is consistent with Taiwanese media reports, which cite MND figures provided to Taiwan’s parliament, the Legislative Yuan, acknowledging that few front-line units have more than 80 percent of their positions filled.\n“That number might not seem so bad until you realize it means at least a third of your tanks are useless in a war because there’s no one to man them,” said Lin, who most recently served as a battalion commander within one of army’s armor brigades.\nThe personnel shortfalls are a clear consequence of the ill-executed transition from conscription to an all-volunteer military over the past few years. It was a political decision made during Ma Ying-jeou’s administration and continued by current President Tsai Ing-wen, despite their coming from different parties. And despite Tsai’s tough rhetoric about defending Taiwan during her successful recent reelection bid, and her vow to thwart Chinese aggression, she has shown no sign of stepping in to fix the problems.\nUniversal conscription is mandated in Article 20 of the Taiwanese Constitution, as in several other countries that face an imminent military threat, such as South Korea or Israel (where women are included but some minorities excluded). For some years, before 2017, the term of conscription service in Taiwan was just a year, which was already short compared with South Korea’s 18-22 months, depending on the military branch, or Israel’s 32 months. Most officers felt that the single year of service wasn’t enough for the military to utilize draftees’ full potential but enough to at least turn a recruit into an average soldier.\nBut 2017’s changes slashed the conscription period to just four months. Most draftees serve even less, as up to two weeks can be deducted if they’ve completed military training classes in high school and college. The four-month conscripts typically receive five weeks of basic training before they are assigned to field units for more specialty training. But they’re more a burden than an aid, not treated seriously by career or noncommissioned officers as their short stays mean they are seen as guests rather than soldiers.\n“By design, they don’t participate in any field exercise or combat readiness training anyway,” Lin said. “We just tell them to stay safe and don’t get into trouble. It’s basically a summer camp.” Several individuals who recently completed this four-month service described similar experiences in interviews.\nOne of the stated aims of the all-volunteer reform was to professionalize the service, staffing the military’s rank and file with a cadre of career-oriented volunteer soldiers who usually serve a minimum term of four years. Despite MND’s talking point that each year’s recruitment drive always hits the set targets and brings with it a fresh crop of volunteers, the rushed transition to an all-volunteer military has clearly damaged the Taiwanese army’s manpower pool—especially on the front line.\nThe reason for the hollowing out of front-line troops is simple. Unlike conscripts, who could be assigned entirely based on to the needs of the military, volunteer soldiers among the lower enlisted ranks can and usually do seek transfers to units considered desirable—rear-echelon troops such as training schools, garrison units, signal corps, and so forth. Although transfer opportunities are limited, soldiers almost always find a way. This means that armor, mechanized infantry, and artillery units are always in desperate shortage of enlisted soldiers—even though they are expected to be the ones bearing the brunt of ground fighting against the formidable People’s Liberation Army (PLA) ground force if it comes ashore.\nA popular yet cynical explanation as to why these Taiwanese soldiers dislike front-line units simply postulates a common aversion to tougher training and combat duty. But interviews with several enlisted ranks painted a more complex picture. Most complained that the food and living conditions left much to be desired—front-line soldiers must split their time between bases and on field exercises. That, on top of the fact they have far more weapons, vehicles, and equipment to clean and maintain, means these posts are perceived as more work for little reward. The existing shortages also cause an even heavier burden of work on the soldiers left—prompting more of them to put in for transfers.\nPolls show varied public opinion on these issues. In 2015, one legislator cited a poll that showed almost 60 support for a return to conscription. In response, the MND cited another poll that claimed 60 percent were satisfied with the transition to all-volunteer forces. At the end of the day, it all seems to come down to how the question is phrased by the pollsters.\nNo matter which poll you believe, it is clear that the two successive presidents over the past decade, Ma and Tsai, had little or no political interest in the political hassle of bringing back the longer conscription length, despite the evidence of the damage being done to military readiness. Even Kaohsiung Mayor Han Kuo-yu, who lost in the recent presidential election representing the Kuomintang (KMT) party, also declined to advocate a complete return to conscription but proposed a “hybrid approach” that he did not specify the details for.\nChieh Chung, a senior assistant research fellow at Taiwan’s National Policy Foundation, commented that the personnel shortage is a problem well documented by the military itself but has never entered their calculations. Chung, who has worked for several years in Taiwan’s parliament as a legislative advisor focusing on defense issues, said the military’s own exercises and computer simulations always assume all units would have at least 90 percent fighting strength at the beginning of a war—an assumption that might have been true in the conscription era but is a far cry from reality today.\nSeveral officers who have participated in the computer-simulated phase of the annual Han Kuang exercises in recent years also pointed out this obvious flaw. That raises the question of how many of the Taiwanese military’s simulations of its own ability to hold off a Chinese invasion are based on now purely hypothetical soldiers.\nThese personnel issues would not be so serious if the military had a functional reserve force. On paper, this enormous reserve force is said to be more than 2 million strong.These personnel issues would not be so serious if the military had a functional reserve force. On paper, this enormous reserve force is said to be more than 2 million strong. Once activated, these reservists are supposed to fill existing shortages across regular field units, and reinforce casualties, while creating fresh reserve formations from virtually nothing to bolster overall defense, according to the Reserve Command’s own words.These personnel issues would not be so serious if the military had a functional reserve force. On paper, this enormous reserve force is said to be more than 2 million strong.\nJust about everything in these talking points is pure fantasy, according to James Huang, a retired army lieutenant colonel who has since become a prolific writer on defense issues and military history, with many followers on Facebook. Huang said there was “no way whatsoever” any of Taiwan’s reserves would reinforce existing field units, despite the proven success of the system elsewhere in the world, especially Israel.\nThat’s the case regardless of whether the reservist is a conscript with four months’ training or a five-year veteran paratrooper just discharged from the special forces. The established practice of Taiwan’s Reserve Command, according to Huang, is not to send reservists back to their previous units but to lump everyone together into the newly activated reserve infantry brigades that possess no specialty, no vehicles, and no equipment except rifles (often older types) and are led by called-up reservist officers who have little experience commanding such ad hoc units.\nIn theory, all soldiers and officers (both conscripts and volunteers) are automatically enrolled as reservists on being discharged from active service. They are called up at most once every two years by the Reserve Command to receive refresher training for five to seven days. In practice, such training rarely consists of more than just basic drills and a short practice session at the rifle range. A reservist corporal who was a veteran M60 tank gunner, for example, will be activated only as an infantry rifleman even if one of the army’s active armor brigades has tanks sitting unmanned in the base.\n“If we go to war, the soldiers currently on roster are all that we have,” said Lin, the lieutenant colonel, who pointed out that he had never heard of any plan to reinforce units he commanded with reserve soldiers. “At best, they might start combining depleted units. We are supposed to fight until everyone is dead or can’t fight anymore.”\nAnd even if Taiwan somehow manages to muster dozens of fresh reserve infantry brigades before Chinese troops come ashore, Huang said they would be little more than cannon fodder consider how poorly the military has trained them in peacetime and the fact that there is not even a clear plan to fit them into the overall defense strategy.\n“Show me 2 million rifles in the stockpile, and I will believe Taiwan has a 2-million-strong reserve force,” Huang said. “The military can’t even tell how many reserve troops they will need to activate across Taiwan, let alone where and how to deploy them when the shooting starts across the Taiwan Strait.”\nOther military officers and defense experts confirmed the problems Huang cited. According to Jyun-yi Lee, an assistant research fellow at the Institute for National Defense and Security Research, a recently created think tank affiliated with Taiwan’s MND: “It’s indeed clear to most of us that Taiwan’s reserve system, as it currently stands, will not contribute much to the military’s fighting strength, if at all. No one is pretending soldiers trained by four-month conscription will be effective. They exist for political, not military, reasons. Politicians don’t want to bring back longer conscription or tougher reserve training, as they fear doing so might make them unpopular.”\nTo its credit, Taiwan’s MND finally began an experimental “reserve warrior program” in recent years that seeks to put skilled veterans back to their original units for refresher training up to a few days per month. Some 214 veterans were said to have signed up in 2019, which is obviously too low to function as a regular reserve force. The program so far seems to matter more to the air force, as it finally provides a channel for retired military pilots to fly again, according to one air force lieutenant familiar with the matter. So far one F-16 pilot and one C-130 pilot reportedly have signed up for the program.\nFormer KMT legislator Hsu “Jason” Yu-Jen said U.S. Defense Department officials have privately expressed dismal assessments regarding Taiwan’s current force level and reserve system. Hsu quoted Pentagon officials as saying in 2019 that Taiwan’s buying of new F-16s and M1 Abram tanks by the Tsai administration was a “nice political gesture” yet they will hardly matter in a war when Taiwan cannot even man them properly in peacetime.\nBut saying the problem out loud is a tough task in itself when both Taiwan’s international allies and the Taiwanese public want to hear a success story more than anything else—especially at a time when China’s propaganda machine is running at full speed to portrait Taiwan’s military as both incompetent and ineffective in the face of the PLA’s rapid expansion and modernization.\n“You have to acknowledge the existence of the problems before you can fix them,” said James Huang, who noted that some among the military community object to his outspokenness, though he decided to speak on record for this report anyway. “It’s about time someone starts telling the truth.”"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","「無兵可用、有兵誤用」的台灣國軍，如何「抗中保台」？ - The News Lens 關鍵評論網"],["url","https://www.thenewslens.com/article/131342"],["summary","政府宣稱可以抵擋中國武力侵略，一部分是想要反制中國共產黨政府宣傳機器，長年來一貫描繪台灣的軍隊無能也無力抵抗解放軍的入侵。然而隨著中國解放軍高速的現代化和軍力增強，中國政府的這種描述恐怕正從宣傳邁向現實。標籤: 國軍, 國防部, 後備軍人, 退役軍人, 徵兵制, 募兵制, 實戰部隊"],["topImageUrl",null],["error",null]]}]}],["text","美國智庫《外交政策》（Foreign Policy）報導\n\nTaiwan’s Military Is a Hollow Shell\n台灣軍隊是空殼\n\n上篇是原文，下篇是翻譯版\n1.\nhttps://foreignpolicy.com/2020/02/15/china-threat-invasion-conscription-taiwans-military-is-a-hollow-shell/\n\n2.\nhttps://www.thenewslens.com/article/131342"],["id","38cho9d29uveq"],["createdAt","2021-08-28T03:11:50.028Z"]]}]}],["relatedReplies",{"__iterable":"List","data":[{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",2],["user",{"__iterable":"Map","data":[["id","j4S8C_WAuYYj2LVfJbSwWOWex9UXA7W6d3Pwk7voZng0aQP9s"],["name","厚道的中和蜜妮安"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","COVID 19 VACCINE WARNING! MARK OF THE BEAST! MANDATED VACCINE+CHIP"],["url","https://www.youtube.com/watch?v=IMc74QpJf04"],["summary","https://id2020.org/alliance\n\nhttps://www.nowtheendbegins.com/big-pharma-microsoft-silicon-valley-id2020-alliance-combine-vaccinations-with-implantable-microchip-digital-id-mark-beast-end-times/\n\nVACCINE plus MICROCHIP\nhttps://principia-scientific.org/id2020-alliance-will-combine-vaccinations-implantable-id-microchips/\n\nUS COMPANIES RACE TO TEST CORONA VIRUS VACCINE\nhttps://amp.cnn.com/cnn/2020/02/27/investing/coronavirus-vaccine/index.html\n\nUS VACCINE TRIALS\nhttps://www.cnbc.com/amp/2020/02/25/us-health-officials-say-human-trials-on-coronavirus-vaccine-to-start-in-6-weeks.html"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","ID2020 | Alliance & Governance"],["url","https://id2020.org/alliance"],["summary","No government, company or agency can solve this challenge alone. Setting the future course of digital ID and navigating the associated risks is a challenge that requires sustained collaboration and global partnership.\n \n \n \n Why the Alliance\n \n \n \n \n Partners\n \n \n \n \n Governance\n \n \n \n \n \n \n Explore\n \n \n \n \n \n \n \n The ID2020 Alliance is unique in its philosophy and transparent governance.\n \n \n ID2020 is building a new global model for the design, funding, and\nimplementation of digital ID solutions and technologies. There is no other multi-stakeholder effort focused on user-managed, privacy-protecting, and portable digital ID.\n \n \n Ad-hoc investments in single use-case projects (“business as usual”) will be insufficient to bring about transformative impact. Changing the flow of funds is necessary to re-align incentives. That’s why Alliance partners are pooling funds to invest in programs that consider digital ID holistically, as a platform for diverse benefits, services, and use cases throughout an individual’s life.\n \n \n Private sector engagement is critical for solving at scale. Alliance partners include companies with a collective footprint in the billions and a shared commitment to an ethical approach to digital ID. Decisions about how Alliance funds are administered, which programs to fund, and which technical standards to support are made jointly by Alliance partners through a transparent governance process, preventing dominance by any single institution or sector.\n \n \n \n \n \n \n Alliance Partners\n \n \n \n \n \n \n \n A global management consulting and professional services firm, Accenture joined as a founding partner in June 2017. Accenture representatives participate in ID2020’s Executive Board and Technical Advisory Committee.\n \n \n \n \n Gavi, the Vaccine Alliance brings together public and private sectors with the shared goal of creating equal access to new and underused vaccines for children living in the world’s poorest countries. Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance, sits on our Executive Board.\n \n \n \n \n Since 1913, the Rockefeller Foundation has sought to improve the well-being of humanity around the world. The Rockefeller Foundation provided ID2020 with seed funding in in 2017 and has been an ongoing supporter of ID2020’s work.\n \n \n \n \n The American multinational technology company joined ID2020 in January 2018 as a founding partner. Members of the Microsoft team sit on ID2020’s Technical and Program Delivery Advisory Committees.\n \n \n \n \n Created by IDEO, the international design and consulting firm, to design products, services, and experiences to improve the lives of people in poor and vulnerable communities, IDEO.org joined ID2020 in 2018. IDEO.org is represented on our Program Delivery and Ecosystem & Advocacy Advisory Committees.\n \n \n \n \n \n \n \n \n \n \n The Alliance, a collaborative effort of global partners, is solving for scale from day one \n \n \n \n \n \n \n Closing the identity gap is an enormous challenge. It will take the work of many committed people and organizations coming together across different geographies, sectors and technologies. But it’s exciting to imagine a world where safe and secure digital identities are possible, providing everyone with an essential building block to every right and opportunity they deserve.\n Peggy Johnson\n Executive VP, Business Development, Microsoft Corporation\n \n \n Digital identity has the capacity to enable access to vital, life-saving services in many different development and humanitarian contexts, including by accelerating access to basic health care systems. I am excited to join ID2020's Executive Board, and guide the organization and partners in harnessing innovative technologies and multi-sectoral collaboration to benefit the world's most vulnerable populations.\n Dr. Seth Berkley\n CEO, Gavi, the Vaccine Alliance\n \n \n Accenture has joined the ID2020 Alliance with partners like Microsoft to create an open, human-centric approach to identity. The alliance draws on advances in biometrics and innovative technologies and brings together expertise from business, government and non-government agencies.\n Christine Leong\n Digital Identity Innovations Lead\n \n \n \n \n \n \n \n \n \n \n\n \n \n \n \n \n Alliance Governance\n As an alliance, the success of this initiative depends on robust collaboration and a clearly defined means for stakeholder engagement.\n \n \n \n \n \n \n Board\n The governing body for the Alliance is the ID2020 Alliance Executive Board. The eleven mmeber board includes five independent Directors, two Directors nominated as representatives of the public sector Founding Partners, two Directors nominated as representatives of the private sector Founding Partners, one Director nominated as a privacy expert, and one Director representing funding organizations.\n \n \n \n \n \n \n Advisory Committees\n The Board is supported by four thematic Advisory Committees, which provide in-depth advice to the ID2020 Board. Membership in these committees is set by the Board, with Founding Partners eligible to nominate representatives to two Advisory Committees.\n \n \n \n \n \n \n Secretariat\n ID2020, a US-registered 501(c)(3) based in New York, NY, is the Secretariat for the Alliance. As such, ID2020 is responsible and accountable for day-to-day operations, including: raising money to fund digital ID projects, coordinating with implementing partners for project implementation, setting and managing technical standards, monitoring and evaluation, legal and financial management and administration of the governance system. Management of these activities is the responsibility of ID2020’s Executive Director."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Big Pharma And Microsoft Are Teaming Up In Something Called The 'ID2020 Alliance' That Will Combine Vaccinations With Implantable Microchips To Create Your Digital ID • Now The End Begins"],["url","https://www.nowtheendbegins.com/big-pharma-microsoft-silicon-valley-id2020-alliance-combine-vaccinations-with-implantable-microchip-digital-id-mark-beast-end-times/"],["summary","For years we’ve been watching as Microsoft founder Bill Gates, now retired from the company he founded, use his billions to give ‘free vaccinations‘ to people in third world countries. Now Bill has become a founding partner in another company, this one is called the ID2020 Alliance, and its goal is to give every human being on Earth a digital id. How do they plan on accomplishing this feat? By combining mandatory vaccinations with implantable microchips. Genius, isn’t it? And coming soon to a theater near you, as the saying goes.“And he causeth all, both small and great, rich and poor, free and bond, to receive a mark in their right hand, or in their foreheads: And that no man might buy or sell, save he that had the mark, or the name of the beast, or the number of his name. Here is wisdom. Let him that hath understanding count the number of the beast: for it is the number of a man; and his number is Six hundred threescore and six.” Revelation 13:16-18 (KJV)So now you know what Bill Gates and his wife Melinda were really doing over the past 10 years, travelling to third word countries and giving ‘free vaccinations’ to the poor, downtrodden natives. Those ‘free vaccinations‘ was research and a live testing lab to conduct the necessary experiments required to form ID2020. And as you will see today, this unholy hybrid of vaccinations and implantable microchips is already happening in Bangladesh, soon it will be Boston. A page on the Gates Foundation website says that Bill and Melinda have so far invested over $2.5 billion dollars to this project, with no end in sight. Can the man who put the world behind a personal computer now put a vaccination microchip digital ID into the global population? Bill Gates is absolutely positive he can, and indeed is well on his way to achieving that goal.“Let no man deceive you by any means: for that day shall not come, except there come a falling away first, and that man of sin be revealed, the son of perdition; Who opposeth and exalteth himself above all that is called God, or that is worshipped; so that he as God sitteth in the temple of God, shewing himself that he is God.” 2 Thessalonians 2:3,4 (KJV)We have been warning you about this for the past 10 years, and now it is happening. Are you ready for what comes next? I hope you are. Keep looking for that Blessed Hope, and thank God it comes before the time of Jacob’s trouble. If only my friend, Carl Sanders, the man who first revealed the inner-workings of the team that created the RFID microchip, had lived long enough to see this day.Vaccines now being used to harvest biometric identities of everyone; Big Brother merges with Big PharmaFROM NATURAL NEWS: The ID2020 Alliance, as it’s being called, is a digital identity program that aims to “leverage immunization” as a means of inserting tiny microchips into people’s bodies. In collaboration with the Global Alliance for Vaccines and Immunizations, also known as GAVI, the government of Bangladesh and various other “partners in government, academia, and humanitarian relief,” the ID2020 Alliance hopes to usher in this mark of the beast as a way to keep tabs on every human being living on Earth.Similar to how cattle are marked with ear tags, this globalist alliance wants all humans to be “vaccinated” with digital tracking chips that will create a seamless monitoring system for the New World Order to manage the populations of the world with ease.“We are implementing a forward-looking approach to digital identity that gives individuals control over their own personal information, while still building off existing systems and programs,” says Anir Chowdhury, a policy advisor at a2i, the Bangladesh government’s “Access to Information Program.”“The government of Bangladesh recognizes that the design of digital identity systems carries far-reaching implications for individuals’ access to services and livelihoods, and we are eager to pioneer this approach,” he adds.Look at what is on the wall at this high-level meeting of ID2020 employees. Anyone care to guess what you’re looking at? 🤔While the ID2020 program’s testing grounds are primarily in the Third World, the group says it’s also now working with governments here in the United States to start microchipping people through vaccination.In Austin, Texas, for example, the homeless population is now being exploited as a collective guinea pig for ID2020’s microchip vaccination program, which the group claims will help to “empower” homeless people by supposedly giving them “control” over their personal identity data.“The City of Austin, ID2020, and several other partners are working together with homeless people and the service providers who engage with them to develop a blockchain-enabled digital identity platform called MyPass to empower homeless people with their own identity data,” writes Chris Burt for BiometricUpdate.com.MEET THE END TIMES PLAYERS BEHIND ID2020 ALLIANCE, ALL THE USUAL SUSPECTS AND A FEW NEW ONESID2020 is also jabbing refugees with its microchip vaccinations through two inaugural pilot programs known as iRespond and Everest. According to reports, iRespond has “improved continuity of care” for more than 3,000 refugees receiving drug treatments for chronic illness. Everest, on the other hand, has “assisted with the provision of access to critical energy subsidies and a range of additional services with secure and user-centric digital identities without relying on a smartphone,” Burt writes.All of this is priming the public for an eventual mandate of microchip vaccinations, which will be required for every individual in order to buy and sell goods. Chowdhury openly admitted this in stating that digital identity systems will be necessary for “individuals’ access to services and livelihoods.”In other words, the Bible is right: A global identification system is in the works that will eventually be required for people to function in society, and ultimately survive. Without these microchips in their bodies, people won’t be able to work, let alone eat, and it’s all happening right before our very eyes.Keep in mind that ID2020 is a part of the so-called “REAL ID,” which will soon be required for those who wish to travel. REAL ID will also be used as a backdoor method of implementing mandatory vaccination policies for adults. READ MOREOur Manifesto | ID2020We believe the ability to prove one’s identity is a fundamental and universal human right. ID2020 Alliance partners jointly define functional requirements, influencing the course of technical innovation and providing a route to technical interoperability, and therefore trust and recognition. ID2020 Summit 2018: Part 1The ID2020 Alliance is a public-private partnership committed to improving lives through user-centric, portable, privacy-protecting digital identity. This year’s Summit, convened by ID2020 Alliance, brought together leaders and innovators in the field to discuss the technical and non-technical requirements to yield a collective roadmap that moves us towards broad adoption of “good” digital identity for all. Carl Sanders Helped Design The first Implantable MicrochipCarl Sanders was an engineer on the world’s first implantable microchip, and in the process of working on this incredible end times device, Carl got saved and spent the rest of his life warning people about what was coming. What you will hear in this video clip is taken from a cassette tape that was sent around churches back in the 1990’s, I had one of those copies. When the Lord had me start NTEB, Bro. Carl and I became friends and he was a guest on our program many times. This is the audio from that cassette tape. I had the privilege of interviewing Bro. Carl back in 2013, and you can listen to that interview here.Now The End Begins is your front line defense against the rising tide of darkness in the last days before the Rapture of the ChurchHOW TO DONATE:Click here to view our GoFundMe pageWhen you contribute to this fundraising effort, you are helping us to do what the Lord called us to do. The money you send in goes primarily to the overall daily operations of this site. When people ask for Bibles, we send them out at no charge. When people write in and say how much they would like gospel tracts but cannot afford them, we send them a box at no cost to them for either the tracts or the shipping, no matter where they are in the world. Even all the way to South Africa. We even restarted our weekly radio Bible study on Sunday nights again, thanks to your generous donations. All this is possible because YOU pray for us, YOU support us, and YOU give so we can continue growing.CLICK IMAGE TO ORDER YOUR BOX OF NTEB GOSPEL TRACTSBut whatever you do, don’t do nothing. Time is short and we need your help right now. If every one of the 13,131 people on our daily mailing list gave $4.50, we would reach our goal immediately. If every one of our 151,781 followers on Facebook gave $1.00 each, we would reach 300% of our goal. The same goes for our 14,500 followers on Twitter. But sadly, many will not give, so we need the ones who can and who will give to be generous. As generous as possible.“Looking for that blessed hope, and the glorious appearing of the great God and our Saviour Jesus Christ;” Titus 2:13 (KJV)“Thank you very much!” – Geoffrey, editor-in-chief, NTEBHOW TO DONATE: Click here to view our GoFundMe page"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","'ID2020 Alliance' Will Combine Vaccinations & Implantable ID Microchips | PSI Intl"],["url","https://principia-scientific.org/id2020-alliance-will-combine-vaccinations-implantable-id-microchips/"],["summary","Big Pharma is officially partnering with the tech industry to pair “immunization” with digital biometrics, meaning humans will soon be microchipped, tracked, and ultimately controlled through a global identification matrix.For years we’ve been watching as Microsoft founder Bill Gates, now retired from the company he founded, use his billions to give ‘free vaccinations‘ to people in third world countries. Now Bill has become a founding partner in another company, this one is called the ID2020 Alliance, and its goal is to give every human being on Earth a digital id. How do they plan on accomplishing this feat? By combining mandatory vaccinations with implantable microchips. Genius, isn’t it? And coming soon to a theater near you, as the saying goes.So now you know what Bill Gates and his wife Melinda were really doing over the past 10 years, travelling to third word countries and giving ‘free vaccinations’ to the poor, downtrodden natives. Those ‘free vaccinations‘ was research and a live testing lab to conduct the necessary experiments required to form ID2020.And as you will see today, this unholy hybrid of vaccinations and implantable microchips is already happening in Bangladesh, soon it will be Boston. A page on the Gates Foundation website says that Bill and Melinda have so far invested over $2.5 billion dollars to this project, with no end in sight.Can the man who put the world behind a personal computer now put a vaccination microchip digital ID into the global population? Bill Gates is absolutely positive he can, and indeed is well on his way to achieving that goal.“Let no man deceive you by any means: for that day shall not come, except there come a falling away first, and that man of sin be revealed, the son of perdition; Who opposeth and exalteth himself above all that is called God, or that is worshipped; so that he as God sitteth in the temple of God, shewing himself that he is God.” 2 Thessalonians 2:3,4 (KJV)We have been warning you about this for the past 10 years, and now it is happening. Are you ready for what comes next? I hope you are. Keep looking for that Blessed Hope, and thank God it comes before the time of Jacob’s trouble. If only my friend, Carl Sanders, the man who first revealed the inner-workings of the team that created the RFID microchip, had lived long enough to see this day.Vaccines now being used to harvest biometric identities of everyone; Big Brother merges with Big PharmaFROM NATURAL NEWS: The ID2020 Alliance, as it’s being called, is a digital identity program that aims to “leverage immunization” as a means of inserting tiny microchips into people’s bodies. In collaboration with the Global Alliance for Vaccines and Immunizations, also known as GAVI, the government of Bangladesh and various other “partners in government, academia, and humanitarian relief,” the ID2020 Alliance hopes to usher in this mark of the beast as a way to keep tabs on every human being living on Earth.Similar to how cattle are marked with ear tags, this globalist alliance wants all humans to be “vaccinated” with digital tracking chips that will create a seamless monitoring system for the New World Order to manage the populations of the world with ease.“WE ARE IMPLEMENTING A FORWARD-LOOKING APPROACH TO DIGITAL IDENTITY THAT GIVES INDIVIDUALS CONTROL OVER THEIR OWN PERSONAL INFORMATION, WHILE STILL BUILDING OFF EXISTING SYSTEMS AND PROGRAMS,” SAYS ANIR CHOWDHURY, A POLICY ADVISOR AT A2I, THE BANGLADESH GOVERNMENT’S “ACCESS TO INFORMATION PROGRAM.”“The government of Bangladesh recognizes that the design of digital identity systems carries far-reaching implications for individuals’ access to services and livelihoods, and we are eager to pioneer this approach,” he adds.Look at what is on the wall at this high-level meeting of ID2020 employees. Anyone care to guess what you’re looking at? While the ID2020 program’s testing grounds are primarily in the Third World, the group says it’s also now working with governments here in the United States to start microchipping people through vaccination.IN AUSTIN, TEXAS, FOR EXAMPLE, THE HOMELESS POPULATION IS NOW BEING EXPLOITED AS A COLLECTIVE GUINEA PIG FOR ID2020’S MICROCHIP VACCINATION PROGRAM, WHICH THE GROUP CLAIMS WILL HELP TO “EMPOWER” HOMELESS PEOPLE BY SUPPOSEDLY GIVING THEM “CONTROL” OVER THEIR PERSONAL IDENTITY DATA.“The City of Austin, ID2020, and several other partners are working together with homeless people and the service providers who engage with them to develop a blockchain-enabled digital identity platform called MyPass to empower homeless people with their own identity data,” writes Chris Burt for BiometricUpdate.com.MEET THE END TIMES PLAYERS BEHIND ID2020 ALLIANCE, ALL THE USUAL SUSPECTS AND A FEW NEW ONESID2020 is also jabbing refugees with its microchip vaccinations through two inaugural pilot programs known as iRespond and Everest. According to reports, iRespond has “improved continuity of care” for more than 3,000 refugees receiving drug treatments for chronic illness. Everest, on the other hand, has “assisted with the provision of access to critical energy subsidies and a range of additional services with secure and user-centric digital identities without relying on a smartphone,” Burt writes.All of this is priming the public for an eventual mandate of microchip vaccinations, which will be required for every individual in order to buy and sell goods. Chowdhury openly admitted this in stating that digital identity systems will be necessary for “individuals’ access to services and livelihoods.”In other words, the Bible is right: A global identification system is in the works that will eventually be required for people to function in society, and ultimately survive. Without these microchips in their bodies, people won’t be able to work, let alone eat, and it’s all happening right before our very eyes.Keep in mind that ID2020 is a part of the so-called “REAL ID,” which will soon be required for those who wish to travel. REAL ID will also be used as a backdoor method of implementing mandatory vaccination policies for adults. READ MOREOur Manifesto | ID2020We believe the ability to prove one’s identity is a fundamental and universal human right. ID2020 Alliance partners jointly define functional requirements, influencing the course of technical innovation and providing a route to technical interoperability, and therefore trust and recognition.ID2020 Summit 2018: Part 1The ID2020 Alliance is a public-private partnership committed to improving lives through user-centric, portable, privacy-protecting digital identity. This year’s Summit, convened by ID2020 Alliance, brought together leaders and innovators in the field to discuss the technical and non-technical requirements to yield a collective roadmap that moves us towards broad adoption of “good” digital identity for all.Carl Sanders Helped Design The first Implantable MicrochipCarl Sanders was an engineer on the world’s first implantable microchip, and in the process of working on this incredible end times device, Carl got saved and spent the rest of his life warning people about what was coming. What you will hear in this video clip is taken from a cassette tape that was sent around churches back in the 1990’s, I had one of those copies. When the Lord had me start NTEB, Bro. Carl and I became friends and he was a guest on our program many times. This is the audio from that cassette tape. I had the privilege of interviewing Bro. Carl back in 2013, and you can listen to that interview here.****PRINCIPIA SCIENTIFIC INTERNATIONAL, legally registered in the UK as a company incorporated for charitable purposes. Head Office: 27 Old Gloucester Street, London WC1N 3AX. Please DONATE TODAY To Help Our Non-Profit Mission To Defend The Scientific Method."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Drug companies race to test coronavirus vaccines"],["url","https://www.cnn.com/2020/02/27/investing/coronavirus-vaccine/index.html"],["summary","New York (CNN Business)Gilead Sciences stock was up slightly on Thursday, even as the Dow plunged into correction status. The reason? The biotech company is moving closer to finding a potential treatment for the deadly coronavirus. It plans to start administering its remdesivir drug to patients next month. Shares of Gilead Sciences (GILD) have risen more than 10% in the past five days as the race to find an effective treatment for the outbreak continues. It's not alone. The stocks of two smaller biotechs working on coronavirus vaccines -- Moderna (MRNA) and Novavax (NVAX) -- have both soared in the past few days on hopes that their treatments may show some success as well.Gilead said in a statement late Wednesday that it will be administering its remdesivir drug to \"approximately 1,000 patients at medical centers primarily across Asian countries, as well as other countries globally with high numbers of diagnosed cases, beginning in March.\"The World Health Organization has said that remdesivir may have the best chance of effectively treating the Wuhan coronavirus.Gilead said in its statement that it will conduct two randomized studies to evaluate the effectiveness of different dosing durations of remdesivir.One will be for about 400 patients with severe clinical manifestations of coronavirus. The other will be for about 600 patients with more moderate symptoms. Patients in both groups will receive the drug for either five or 10 days."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","US health officials say human trials on coronavirus vaccine to start in 6 weeks"],["url","https://www.cnbc.com/amp/2020/02/25/us-health-officials-say-human-trials-on-coronavirus-vaccine-to-start-in-6-weeks.html"],["summary","Human trials testing a potential vaccine for the COVID-19 coronavirus are expected to begin in six weeks, U.S. health officials announced Tuesday.\"We are on time at least and maybe even a little bit better,\" Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters.Passengers arrive at LAX from Shanghai, China, after a positive case of the coronavirus was announced in the Orange County suburb of Los Angeles, California, January 26, 2020.Ringo Chiu | ReutersHuman trials testing a potential vaccine for the COVID-19 coronavirus are expected to begin in six weeks, U.S. health officials announced Tuesday.\"We are on time at least and maybe even a little bit better,\" Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, an agency within the Department of Health and Human Services, told reporters at a press conference. \"Hopefully, no further glitches.\"The White House reportedly asked Congress on Monday for $1.25 billion in additional funding to bolster its coronavirus response, including money to develop a vaccine and therapeutics to treat the virus. The National Institutes of Health has been working with biotech company Moderna to develop a vaccine using the current strain of the coronavirus.Hopes to get a vaccine to market are high, but doctors want expectations to be low for how quickly it can happen. Developing, testing and reviewing any potential vaccine is a long, complex and expensive endeavor that could take months or even years, global health experts say. Before researchers can begin human trials, they must have a firm understanding of the pathogen, run safety tests and find enough human volunteers.U.S. health officials are fast-tracking work on a coronavirus vaccine.Fauci said Tuesday that the potential vaccine has so far been put into mice and is \"immunogenic,\" or triggers a response in the immune system, suggesting it could fight the virus.\"The gene has been expressed in the platform, in this case, a messenger RNA. The material has been produced, it's been put into mice. It's immunogenic,\" he said. \"It's now getting ready to go through the regulatory issues of getting it to go.\"Fauci said a vaccine may not solve \"problems in the next couple of months but it certainly would be an important tool that we would have.\" He said it's possible the virus will prove to be seasonal, thus likely to subside in the warmer months like the flu.There are currently no proven therapies for the latest outbreak, which has killed at least 2,704 and sickened more than 80,200 people worldwide since emerging from the Chinese city of Wuhan about two months ago.Local authorities in China have using Gilead Sciences' antiviral drug Remdesivir, which was tested as a possible treatment during the Ebola outbreak, U.S. health officials said last month. Some authorities are also using antiviral drug Kaletra, developed by drugmaker AbbVie, on a \"compassionate basis.\"Earlier in the day, the Centers for Disease Control and Prevention outlined what schools and businesses will likely need to do if the COVID-19 virus becomes an epidemic outbreak in the U.S.\"We are asking the American public to work with us to prepare for the expectation that this could be bad,\" Dr. Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, told reporters on a conference call.The CDC late Monday confirmed 53 cases in the U.S., a majority of which came from passengers repatriated from the Diamond Princess cruise ship that was quarantined off the coast of Japan. The data shows that 36 of the cases are attributed to the cruise ship, three patients were infected in Wuhan and later evacuated to the U.S., and the rest were largely infected while traveling overseas.Just two cases were contracted through person-to-person contact in the U.S., the CDC said.Later Tuesday, U.S. health officials said the outbreak will likely become a global pandemic. They also confirmed four new cases from the cruise ship.\"Current global circumstances suggest it's likely this virus will cause a pandemic,\" Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention told reporters at a news briefing.\"It's not so much a question of if this will happen any more, but rather more a question of when this will happen and how many people in this country will become infected and how many of those will develop severe or more complicated disease,\" she added.CNBC's Noah Higgins-Dunn contributed to this report."],["topImageUrl",null],["error",null]]}]}],["text","轉～值得參考儆醒防範\n——-\nCOVID 19 VACCINE WARNING! MARK OF THE BEAST! MANDATED VACCINE+CHIP\n疫苗警告！兽印！强制性疫苗+芯片\nhttps://www.youtube.com/watch?v=IMc74QpJf04\nWatchwoman 2020年2月27日\n今天是2020年2月27日。一礼拜之前主赐给我一个很长的梦。我今天在这个视频中，只将重要的一部分发布出来。通过这个梦，我要警告大家，务必抵挡政府要你注射的疫苗，因为那里面结合着一个植入芯片，而且这个疫苗将会在你的手上注射！这个芯片就是那“兽印”！\n还有，我们看到有一种防流感的疫苗，也要出来，那是一种严重的流感病毒。\n在梦里，有一个邪恶的女人，我已经是个成年人，能够允许她去对我做她要做的事情。她站在我前面，手里拿着一只注射针头，注射管是紫色薰衣草的颜色，里面有液体。她看着我说：“这是为了医治你的焦虑症。”我刚一同意，她立即就给我注射了。然后我感觉自己失去了知觉，无法控制我的身体了。当时我好像半睡半醒的状态，我向下看我的手，上面有两只创可贴，而不是一只创可贴。她说只给我注射一针，为何有两只创可贴呢？\n那个梦还在继续，我看到的下一件事就是，我的名字从生命册上被耶稣的眼泪涂抹了。祂的眼泪流到我的名字上，无论我多么努力，我再也无法将我的名字写回去了。\n当我醒来以后，就赶紧把这个梦的内容，详细记录下来。我明白了，这是神在提醒我，即将有一种疫苗，与兽印结合在一起，注射进入我们的人体里，而且还要给全世界的人注射。我认为，他们会知道他们自己正在接受一个芯片在手上，但是, 却以某种方式与疫苗相捆绑。有可能是在同一次注射当中植入的，也可能说是为了预防冠状病毒，或者说是预防即将到来的其它的坏病毒。你必须同意和允许他们在你手上植入这个兽印芯片。\n当我进行研究的时候，我发现了一些信息。我将链接放在本视频的下方的“Description Box”里面。\n有一种东西，叫做“ID 2020”。那是有世界上最富有的人们所计划运行的，包括比尔·盖茨基金会，以及其他世界上最有的钱人。他们企图要让人们接受一种联合疫苗和追踪芯片，称之为“ID 2020”。他们正在世界上的贫穷地区，开始试验这个东西。\n就在2月25日，两天前，CDC宣布，他们要开始在美国进行疫苗注射试验，在那些已经患上冠状病毒的人们身上进行。他们表示很高兴地宣布，他们已经有一种疫苗了，他们认为这看起来很好，但我觉得这很奇怪，怎么会这么快，似乎已经早有预备呢？好像他们早就准备要给人们注射这种疫苗了？\n如果你感染了冠状病毒，也不要参加任何一种像这样的试验，因为我很清楚，这种疫苗，是以某种方式，与兽印芯片相结合。他们企图植入你的右手上面，或是你的额头上面。\n我这是一个严重的警告，接受了他们的兽印的人，再也无法进入天国了！因为在圣经《启示录》13:16中说过：“牠又叫众人，无论大小贫富、自主的、为奴的，都在右手里，或是在额里，受一个印记。”14:9“若有人敬拜兽和兽像，在额里，或手里，受了牠的印记（接受了兽印），这人必喝神大怒的酒；此酒斟在神忿怒的杯中纯一不杂。他要在圣天使和羔羊面前，在火与硫磺之中受痛苦。他们受痛苦的烟往上冒，直到永永远远。有谁敬拜兽和兽像，受牠名之印记的，昼夜不得安宁。”\n耶稣很快就要回来了。我向那些没有跟随神的人们发出警告。你们很可能要面对这件事情。那些已经感染了冠状病毒的人们，生病的人们，考虑要接受疫苗试验的人们，要坚定持守你对耶稣基督的信仰，相信圣经，拒绝疫苗和兽印。这是从耶稣而来的强烈警告！而且我已经得到了多个印证，我非常清楚，他们要对我们做什么！\n请将此警告，尽可能多地传播出去！愿神祝福你！\n——-\n在此影片下方有說明\n內容如下：\n（可自行用網路翻譯下文）\n\nID2020\nhttps://id2020.org/alliance\n\nhttps://www.nowtheendbegins.com/big-pharma-microsoft-silicon-valley-id2020-alliance-combine-vaccinations-with-implantable-microchip-digital-id-mark-beast-end-times/\n\nVACCINE plus MICROCHIP\nhttps://principia-scientific.org/id2020-alliance-will-combine-vaccinations-implantable-id-microchips/\n\nUS COMPANIES RACE TO TEST CORONA VIRUS VACCINE\nhttps://www.cnn.com/2020/02/27/investing/coronavirus-vaccine/index.html\n\nUS VACCINE TRIALS\nhttps://www.cnbc.com/amp/2020/02/25/us-health-officials-say-human-trials-on-coronavirus-vaccine-to-start-in-6-weeks.html\n"],["id","2ova5eb307l8a"],["createdAt","2020-02-29T17:32:42.298Z"]]}],["reply",{"__iterable":"Map","data":[["id","fmI82G8Bd3n3h-WY3-mA"],["user",{"__iterable":"Map","data":[["id","AVqVwjqQyrDaTqlmmp_a"],["name","MrOrz"],["avatarUrl","https://avatars2.githubusercontent.com/u/108608?s=100"],["level",18]]}],["type","OPINIONATED"],["text","這是反疫苗的陰謀論。\n\n古彥男醫師以古今中外案例表示，當疫苗接種率過低，會造成 (1) 傳染病爆發、 (2) 疫苗預算下修而導致藥廠不賣、疫苗短缺、(3) 增加病毒變異機會、(4) 醫療需求壓垮醫療系統。因此，不接種疫苗不只是影響個人，其後果是全國人民共同承擔。\n\n聯合國也譴責這些反疫苗接種的訊息，已經造成了海島國家麻疹的惡化；聯合國兒童基金會表示，這類在推特、臉書、Instagram 等網路平台上的反疫苗言論「極不負責任」。"],["reference","2016/10/25 如果大家都不打疫苗－流感疫情揭露的醜陋真相\nhttp://yennanku.blogspot.com/2016/10/blog-post.html\n\n2019/12/6 聯合國：反疫苗運動助長薩摩亞麻疹疫情惡化\nhttps://www.cna.com.tw/news/aopl/201912060005.aspx"],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","如果大家都不打疫苗－流感疫情揭露的醜陋真相 | 古彥男醫師｜兒科醫師的分享室"],["url","http://yennanku.blogspot.com/2016/10/blog-post.html"],["summary","作者：古彥男醫師\n\n病毒的全境擴散\n\n2011 年上映的電影『全境擴散』，是身為醫護人員的我看過最寫實也最貼近我們生活的傳染病電影。片中有包括麥特戴蒙、葛妮絲派特蘿、凱特溫絲蕾，以及裘德洛等好萊塢巨星，但電影本身想表達給觀眾的內容，並沒有因為演員的星光熠熠而顯得黯淡（不過評價兩極，很多人覺得劇情過於沉悶而看到睡著）。\n\n故事描述著一種病毒，在蝙蝠跟豬之間交互傳染後產生了變異，對人的傳染力大增，迅速造成了全球的大流行以及節節高升的死亡人數。電影中對於政府官員、醫護人員、平民百姓，以及先進與落後國家的社會，面對來勢洶洶的疫情的各種反應，有深刻的刻劃。\n\n\n其實這部電影主要是根據 2003 年令全球陷入恐慌的 SARS 疫情改編而成，電影中病毒的變異模式與散播途徑，也跟我們熟悉的流感病毒十分相像......\n接種率最低的公費疫苗\n\n\n\n對台灣的民眾來說，我們擁有方便就醫的醫療環境，醫療費用也非常便宜，近幾年來一些原本很昂貴的自費疫苗，也慢慢被列入公費施打的計畫之中（如肺炎鏈球菌疫苗）。然而在眾多高接種率的公費疫苗中，流感疫苗的接種率可說是一枝獨秀的低。\n\n由於流感病毒變異的速度快，每年流行的病毒株都不一樣，世界衛生組織只能預測每一年度可能流行的病毒株，以此製作成疫苗。這樣會產生兩個讓大家不想接種疫苗的原因：一是每年都必須接種，無法注射一兩劑後就有長久的保護力；二是萬一預測錯誤，挨了針最後還是得了流感，許多人在情感上無法接受。\n\n再加上媒體對流感疫苗不良反應個案的重點報導，以及對 2009 年 H1N1 流感疫苗安全性的質疑，導致台灣近幾年的接種率幾乎都是在谷底徘徊。\n\n\n\n\n\n\n根據民國 104 年疾病管制署的統計資料，符合公費疫苗接種的對象，其接種率不到五成，如果放大到全國人口來看，接種率甚至連兩成都不到。當大家因為擔心疫苗的不良反應選擇不接種，且因為短期內沒有重大疫情發生而漸漸忘記傳染病的恐怖時，就在同一年，流感病毒給台灣的民眾與醫療系統帶來了沉重的負擔......\n不接種疫苗的結果－全國人民共同承擔\n\n\n\n\n\n我們可以看到，從 2011 年之後，流感病毒在台灣並沒有造成太重大的疫情。然而這不代表危機不在我們身邊－就在 2015 年 (民國 104 年)，流感病毒讓我們體驗到，傳染病的傳播與爆發，可以在短短的幾個月內，造成重症病例數破千，死亡人數破百！而且根據統計，95% 以上流感重症患者未接種疫苗！\n\n你覺得這只是單一年度或單一疾病的狀況，不代表每一年的疫情或其他傳染病？你覺得等到疫情要升溫了再接種也不遲？還是你覺得自己身強體壯，不怕傳染病侵襲，就算染病了在台灣這種便宜又方便的醫療環境也不怕沒得醫？\n\n讓我來告訴你甚麼是『醜陋的真相』。\n\n真相一：疫苗接種率過低，造成傳染病爆發，中外皆然。\n\n除了上述台灣的流感疫情，歐美國家早發生過更為知名的狀況。 1998 年一位英國醫師發表了一篇論文，內容指出接種三合一疫苗（麻疹、腮腺炎、德國麻疹）會造成小孩自閉症的發生率上升，雖然該論文最後被證實是假造的無稽之談，但仍造成歐美國家興起一股反疫苗運動，三合一疫苗的接種率更是逐年下降。\n\n疫苗接種率過低的結果永遠只有一個：傳染病的爆發。英國從 2000 年開始感染麻疹的人數逐漸上升，到現在仍是麻疹流行地區；美國曾經在 2000 年宣布麻疹病毒已在其境內絕跡，結果在 2014~2015 年加州爆發大流行。\n\n那你說台灣安全嗎？如果你的小孩有接種疫苗，那大可放心，但如果沒有怎麼辦？那就不要出國、不要去機場、不要坐高鐵、不要坐捷運、不要......\n\n\n真相二：你不打疫苗，政府下修預算，藥廠寧願不賣。\n\n由於疫苗這種生物製劑，在運輸及保存上的要求相當高，也有一定的保存期限，此外如流感疫苗，其內含的病毒株每年不一樣，今年的疫苗無法留到隔年再使用。當政府買得太多會增加運輸及保存的成本，用不完而過期的疫苗更是浪費已經捉襟見肘的疫苗預算。\n\n因此衛服部疾管署會根據各種公費疫苗施打的比率，以及未來需要接種的人口數，來編列預算。當施打人數下降時，預算金額就可能會下修，如果剛好遇到購買數量下降而需求又突然暴增，就會發生有人打不到疫苗的狀況（2015 年流感疫情爆發後，一直到隔年三月都還有家屬帶小孩來打早就用完的疫苗）。\n\n再來是台灣的市場跟歐美等大國比已經很小了，如果政府購買的數量一直在減少，我們又拿不出有力的購買價格跟別人競爭，最後就是落得疫苗搶輸人家，以及民眾有錢也打不到疫苗的後果。真相三：疫情升溫，病毒快速變異，補打疫苗也沒效。\n\n流感疫苗之所以每年都要接種才有效，就是因為流感病毒非常容易產生變異，讓我們的免疫系統無法在感染過後，或是接種一次疫苗後就能提供終身的保護力。\n\n病毒的變異從哪裡來？一個方式是當病毒在宿主體內大量複製時，本身的基因發生突變，另一個則是當同一個宿主（可以是人、豬、或是禽鳥類），體內有兩種以上的流感病毒時，不同的病毒間會互換基因，重組出一個新的病毒（如 2009 年的 H1N1）。這樣的變異都可以使我們的免疫系統與疫苗失效，造成大流行。\n\n因此當疫情升溫了，代表病毒在大量的傳播與複製，大大的增加了變異的機會，一旦產生變異，就算補打了本來有效的疫苗，也擋不住已經變身的病毒。所以先接種疫苗預防感染，不給病毒有大流行且變異的機會，才是最好的防治策略。真相四：醫療系統早已負擔沉重，疫情爆發醫院一床難求。\n\n當很多人因為健保的福利，以為醫療本來就是這麼便宜與便利時，台灣的醫療系統早就因為政策問題以及民眾的就醫習慣而負擔沉重，一旦因天災人禍或是傳染病流行，在短時間內造成大量的醫療需求，往往成為壓倒駱駝的最後一根稻草。\n\n從過去的八仙塵爆，以及流感疫情的爆發，各大醫學中心急診及加護病房都被塞爆，有的醫院兩度關閉急診，有的醫學中心重症病人多到連救命的葉克膜都不夠用，急診等住院病床的人數節節高升，醫護人員跟病人都叫苦連天。\n\n然而政府相關單位不僅連政策的調整不夠迅速，連對疫情的嚴重度還有醫療資源的分配都掌握不住，你還認為台灣的醫療在你生病的時候真能萬無一失？\n疫苗並不完美，但仍是預防疾病的有效方法\n\n我們知道有打疫苗不是每個人都會產生可以對抗疾病的抗體，我們也知道沒有疫苗可以百分之百不會有不良反應，然而疫苗從問世以來，也被證實是可以有效預防疾病，挽救許多生命的重要方法。當不良反應造成的損失大於預防疾病的利益時，這種疫苗就會被停止施打或是根本不會上市。\n\n在我們的社會中有許多人可能因為年紀太小、對疫苗有過敏反應、或是有其他禁忌症無法藉由接種疫苗獲得對疾病的保護力，他們也常常是傳染病造成重症的高風險群。如果我們接種疫苗的比率夠高，不僅獲得保護自己的抗體，同時也因為疾病不容易傳播而可以間接保護到這些容易被感染的族群。\n\n今年的公費流感疫苗已經開始施打，請問『你』會怎麼選擇呢？"],["topImageUrl","https://3.bp.blogspot.com/-DYZ77tZgdWE/WAJSVTbVolI/AAAAAAAABnY/Q5S7SQ1Dz_Ahnkupi8xzzdP1bFvqbPuJQCLcB/w1200-h630-p-k-no-nu/vaccinedeniedtitlepicture.jpg"],["error",null]]},{"__iterable":"Map","data":[["title","聯合國：反疫苗運動助長薩摩亞麻疹疫情惡化 | 國際 | 中央社 CNA"],["url","https://www.cna.com.tw/news/aopl/201912060005.aspx"],["summary","（中央社威靈頓5日綜合外電報導）聯合國兒童基金會（UNICEF）太平洋島嶼負責人今天表示，社群媒體巨頭必須嚴厲取締反疫苗接種貼文，這些貼文助長薩摩亞（Samoa）致命麻疹疫情惡化。UNICEF地區代表耶特（Sheldon Yett）表示，推特（Twitter）、臉書（Facebook）和Instagram（IG）等網路平台上「極不負責任」的反疫苗接種訊息，加劇了薩摩亞爆發的麻疹疫情，自10月中旬以來已造成62人死亡。耶特告訴法新社：「很明顯地它們必需負起企業責任並展開行動，確保那些人民，特別是弱勢族群能獲得正確資訊，讓孩童得以存活。」在麻疹疫情爆發前，薩摩亞的疫苗接種率降至只剩略超過30%，遠低於公認最佳接種率90%，這也使得該海島國家極易受到感染。世界衛生組織（WHO）把矛頭指向反疫苗宣傳運動。耶特表示，這項運動主要是由海外倡議人士在網路上展開。「很不幸的是，這項運動在薩摩亞找到願意相信的民眾，那裡有一部分人懷疑醫療保健服務品質，且可能不信任當地（疫苗）供應者。」他說，來自諸如美國和澳洲等富裕已開發國家的運動人士，在網路上張貼反疫苗訊息，他們必須意識到自己的所作所為會對開發中國家帶來衝擊。他在薩摩亞首都阿庇亞（Apia）表示：「這對薩摩亞孩童來說可能形同死刑，因為當地除了低疫苗接種率，可能還面臨其他健康問題。」（實習編譯：趙珮宇/核稿：劉學源）1081205"],["topImageUrl","https://imgcdn.cna.com.tw/www/website/img/pic_fb.jpg"],["error",null]]}]}],["createdAt","2020-03-01T09:07:27.741Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",1],["user",null],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","★ How to Get to Mars. Very Cool! HD"],["url","http://www.youtube.com/embed/XRCIzZHpFtY?rel=0"],["summary","\"How To get to Mars\" is a clip from the IMAX documentary \"Roving Mars\" from 2006. This is an edited short version. \n\nMy photos: https://plus.google.com/u/0/b/105656643463219506384/+aheli\n\nDVD - Roving Mars 2006 : Spirit, Opportunity, and the Exploration of the Red Planet @ amazon.com http://www.amazon.com/Roving-Mars-Spirit-Opportunity-Exploration/dp/B003XU7W0A\n\n★ The Largest Stars in the Universe | Infographic Animation ► https://www.youtube.com/watch?v=JqAJnrL27OY\n★ The Most Astounding Fact - Neil deGrasse Tyson | Kinetic ►Typography https://www.youtube.com/watch?v=p2DXqJ7mjKY\n★ TOP 10 - Best of Hubble Space Telescope - 2015 ► http://www.youtube.com/watch?v=Lmx19_0GX8o\n\nGame Of Thrones - Theme (OneCamBand Western Cover) https://www.youtube.com/watch?v=Rln_qHoWIqg\n\nFrom Wiki : Spirit, MER-A (Mars Exploration Rover -- A), is a robotic rover on Mars, active from 2004 to 2010. It was one of two rovers of NASA's ongoing Mars Exploration Rover Mission. It landed successfully on Mars at 04:35 Ground UTC on January 4, 2004, three weeks before its twin, Opportunity (MER-B), landed on the other side of the planet. Its name was chosen through a NASA-sponsored student essay competition. The rover became stuck in late 2009, and its last communication with Earth was sent on March 22, 2010.\nThe rover completed its planned 90-sol mission. Aided by cleaning events that resulted in higher power from its solar panels, Spirit went on to function effectively over twenty times longer than NASA planners expected following mission completion. Spirit also logged 7.73 km (4.8 mi) of driving instead of the planned 600 m (0.4 mi), allowing more extensive geological analysis of Martian rocks and planetary surface features. Initial scientific results from the first phase of the mission (the 90-sol prime mission) were published in a special issue of the journal Science.\nOn May 1, 2009 (5 years, 3 months, 27 Earth days after landing; 21.6 times the planned mission duration), Spirit became stuck in soft soil. This was not the first of the mission's \"embedding events\" and for the following eight months NASA carefully analyzed the situation, running Earth-based theoretical and practical simulations, and finally programming the rover to make extrication drives in an attempt to free itself. These efforts continued until January 26, 2010 when NASA officials announced that the rover was likely irrecoverably obstructed by its location in soft soil, though it continued to perform scientific research from its current location.\nThe rover continued in a stationary science platform role until communication with Spirit stopped on sol 2210 (March 22, 2010). JPL continued to attempt to regain contact until May 24, 2011, when NASA announced that efforts to communicate with the unresponsive rover had ended. A formal farewell was planned at NASA headquarters after the Memorial Day holiday and was televised on NASA TV.\n\n\nHope you enjoyed it!"],["topImageUrl","https://i.ytimg.com/vi/XRCIzZHpFtY/hqdefault.jpg"],["error",null]]}]}],["text","超好看！NASA是如何登陸火星的，全程拍的非常清楚，一定要看!!\n\nhttp://www.youtube.com/embed/XRCIzZHpFtY?rel=0 \n太値得一看了"],["id","5509659771555-rumor"],["createdAt","2017-01-16T08:48:00.000Z"]]}],["reply",{"__iterable":"Map","data":[["id","AV6zaZCAyCdS-nWhugmO"],["user",{"__iterable":"Map","data":[["id","AV6utJYWyCdS-nWhugj2"],["name","Hiroaki Pang"],["avatarUrl","https://www.gravatar.com/avatar/?s=100&d=mp"],["level",4]]}],["type","OPINIONATED"],["text","根據原影片在YouTube的說明欄位，這是來自2006年的IMAX紀錄片《漫遊火星／火星奇境》（Roving Mars）的剪輯片段。該紀錄片使用少量來自火星的真實影像，其他則是以來自探測車和其他火星探測器資料為基礎，以電腦繪製成的動畫影像，並非實際拍攝。然而該剪輯片段是屬於少量真實影像的部分，或是屬於電腦動畫的部分，則暫時不得而知。"],["reference","維基百科－漫遊火星 https://zh.wikipedia.org/wiki/漫遊火星#特色\nAllis, Sam (2009-01-25). \"With 'Roving Mars,' Butler shoots for the stars - The Boston Globe\". Boston.com http://archive.boston.com/ae/movies/arti⋯mars_documentarian_shoots_for_the_stars/\n台北市立天文館－火星奇境介紹 http://www.tam.gov.tw/public/Attachment/992917453434.pdf"],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","漫遊火星 - 维基百科，自由的百科全书"],["url","https://zh.wikipedia.org/wiki/漫遊火星#特色"],["summary","提示：本条目的主题不是火星任务。\nRoving Mars基本资料导演\n喬治·巴特勒监制\n喬治·巴特勒法蘭克·馬歇爾编剧\nRobert Andrus喬治·巴特勒旁白\n保羅·紐曼（只有引言）配乐\n菲利普·格拉斯詩格洛絲摄影\nT.C. Christensen剪辑\nNancy Baker制片商\nThe Kennedy/Marshall Company片长\n40分鐘产地\n 美國语言\n英語上映及发行上映日期\n2006年\n\n\n\n\n\n\n\n发行商\n华特迪士尼影片\n漫遊火星（Roving Mars）是一個關於火星探测漫游者計畫下的兩台火星車勇气号和机遇号從開發、發射直到登陸後操作的 IMAX 紀錄片。 \n\n目录\n\n1 特色\n2 票房\n3 其他\n4 參考資料\n5 外部連結\n\n\n\n特色[编辑]\n該影片使用少量來自火星的真實影像，其他則是以來自探測車和其他火星探測器資料為基礎，以電腦繪製成的影像[1]。發行商华特迪士尼影片已推出該影片的藍光光碟版。\n\n票房[编辑]\n漫遊火星的票房直到2009年1月25日已超過1千萬美金[2]。\n\n其他[编辑]\nRoving Mars 同時也是火星探測漫游者主持人史蒂夫·斯奎爾斯出版的一本非小說書籍標題。\n\n參考資料[编辑]\n\n\n跳转 ^ Allis, Sam. With 'Roving Mars,' Butler shoots for the stars - The Boston Globe. Boston.com. 2009-01-25 [2012-05-07].\n\n跳转 ^ Movie Box Office | Highest Grossing Movies - Yahoo! Movies. Movies.yahoo.com. 2011-04-20 [2012-05-07].\n\n\n外部連結[编辑]\nRoving Mars\n互联网电影数据库（IMDb）上《漫遊火星》的资料（英文）\nAllMovie上《漫遊火星》的资料（英文）\nBoston Globe article about the development of the film"],["topImageUrl","https://upload.wikimedia.org/wikipedia/commons/thumb/b/b2/%C3%96rebro_slott_resynth.jpg/77px-%C3%96rebro_slott_resynth.jpg"],["error",null]]},{"__iterable":"Map","data":[["title","Page Not Found - Boston.com"],["url","http://archive.boston.com/ae/movies/arti⋯mars_documentarian_shoots_for_the_stars/"],["summary","404 Error: Page Not Found\n\t\t\t\tThis page isn't the first thing to get lost in Boston.\n\t\t\t\t Keep calm and return to the previous page. To report an issue, please contact us at feedback@boston.com"],["topImageUrl","data:image/svg+xml;base64,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"],["error",null]]},{"__iterable":"Map","data":[["title",null],["url","http://www.tam.gov.tw/public/Attachment/992917453434.pdf"],["summary",null],["topImageUrl",null],["error","UNSUPPORTED"]]}]}],["createdAt","2017-09-24T10:23:13.540Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",1],["user",{"__iterable":"Map","data":[["id","j4S8C_Thvr08ZwnFP7tCme_yny2p5SIsAdAtA2kR0ADYRSOuc"],["name","孜孜不倦的新豐布萊茲™"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Coronavirus: When the police knock at your door"],["url","https://www.bbc.co.uk/news/technology-52017993"],["summary","Image copyright\n Milo Hsieh\n \n \n \n Milo Hsieh is an American University student living in Taiwan under quarantine. The BBC asked him to write this article after one of his tweets about having his movements tracked by a satellite-based system was widely shared.I did not expect two police officers to come knocking at my door at 08:15 when I was still asleep in my bed on Sunday morning. My phone briefly ran out of battery at 07:30, and in less than an hour, four different local administrative units had called. A patrol was dispatched to check my whereabouts. A text was sent notifying that the government had lost track of me, and warned me of potential arrest if I had broken quarantine.I returned to Taiwan last Thursday to experience the island's zero-risk take on coronavirus. Since I was coming back from Europe, I am subjected to a mandatory 14 days home quarantine. Before I had my passport checked, I had to pass through a booth set up by the Ministry of Health and Welfare. I filled out a document detailing places I had visited in the last fortnight, my phone number, landline and address. They notified me that my phone would be \"satellite-tracked\" for enforcement.The level of precaution taken in Taiwan is nothing like what I saw in Europe.\n \n \n \n \n \n \n Image copyright\n Milo Hsieh\n \n \n \n \n Image caption\n \n People flying back into Taiwan must go into 14 days of quarantine to help combat the spread of coronavirus\n \n \n \n During the initial phase of lockdown in Belgium, which I had to leave after my study programme was cancelled, people still went out and lined up at fast food kiosks. Even as an outbreak was happening in northern Italy, I saw during my visit to London in the first weekend of March, that people were still going to pubs. Here, I am not allowed to step outside the apartment. I was not allowed to take public transport on my way back, and had to take special \"quarantine taxis.\" My entire family has to quarantine with me for two weeks. This includes Biscuit, our dog. \n \n \n \n \n \n \n \n \n How does Taiwan's system work?The island refers to its phone-tracking system as being an \"electronic fence\".Rather than ask users to download a special app or wear a location-transmitting wristband - as has been the case in some East Asian countries - it uses existing phone signals to triangulate the owner's locations.To ensure users comply, an alert is sent to the authorities if the handset is turned off for more than 15 minutes. More than 6,000 people subjected to home quarantine are simultaneously tracked this way.And to check that the phone has not simply been left behind, officials phone users up to twice a day to check they have their mobile to hand, and to ask about their health.\n \n \n \n \n \n \n \n \n Recently, many Taiwanese, especially students, have returned to the island, as their schools overseas have closed and life around the world has ground to a halt. Some see the mandatory quarantine they have to go through as a necessary measure.Frank Tseng is among them. He is one of my friends at American University, and he recently returned from Washington DC. \n \n \n \n \n \n \n Image copyright\n Milo Hsieh\n \n \n \n \n Image caption\n \n Arrivals to Taiwan have to sign a pledge saying they will stay behind closed doors for a fortnight and keep a record of their temperature\n \n \n \n \"I feel like even though it's a pain for the citizens who are coming back, I understand that it's a necessary process many of us have to take to go home,\" he told me.But some see the enforcement mechanism as problematic.Paul Huang, a local freelance journalist who was working abroad, decided to not go back to Taiwan because of surveillance fears. \"The government openly stated your phone will be digitally tracked to enforce quarantine - in the same way the authority usually tracks suspected criminals,\" he explained.\"Except this time they don't have or need a court-issued warrant to spy on your phone. \"You are being suspected of a crime by virtue of having travelled overseas.\" \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n Paul has published articles critical of the Taiwan government in the past, including one calling its military a \"hollow shell\". When entering the border, I was only notified that my phone would be tracked and that the local township official would give me a call daily. I was not made aware of any rights I had and did not sign documents consenting to surveillance. As cases of the virus rise in Taiwan, the people seem to have entrusted the government with more power to contain the pandemic. \n \n \n \n \n \n \n Image copyright\n Getty Images\n \n \n \n \n Image caption\n \n Metro station staff in Taiwan have used thermal scans to try to detect passengers who have the virus\n \n \n \n But as the Taiwan government showcases its mass surveillance capability amid the crisis, it brings into question how it can be used in the wrong hands.Brian Hioe, who runs New Bloom, a left-leaning publication focused on Taiwan, shared this concern with me. His worry is that \"the state may retain its expanded powers and continue with surveillance practices once the crisis has passed\".At the same time, despite analysis by some that Taiwan's alleged culture of obedience makes it easier to empower the state to contain the outbreak, Brian and I both agree that the vibrant civil society will readily fight back if the government oversteps its power.At the end of the day, I will be staying home to complete my mandatory 14 days of home quarantine without being too paranoid about what the government knows or does not know about me. But I do feel a little uncomfortable knowing that my neighbour could turn me in to the police if they see me outside of my apartment door, doing something as simple as taking out the trash."],["topImageUrl",null],["error",null]]}]}],["text","https://www.bbc.co.uk/news/technology-52017993"],["id","1n3kcuskx63ap"],["createdAt","2020-03-28T00:12:27.649Z"]]}],["reply",{"__iterable":"Map","data":[["id","yAnWKnEBrhVJn3LNanWh"],["user",{"__iterable":"Map","data":[["id","HkXxOXABHjv_5zI2Qlbz"],["name","Ann"],["avatarUrl",null],["level",16]]}],["type","OPINIONATED"],["text","1. 本名謝和軒（Milo Hsieh）的留學生因在twitter發表隔離檢疫的貼文被大量轉發，受bbc之邀撰寫此文詳述經驗。\n2. 自1月28日，指揮中心宣佈升級防疫監控措施，以發放手機方式掌握隔離者定位，而後居家檢疫電子化系統再度整合升級，只要持有國內各電信業者手機門號，都可在登機前線上填寫健康資料，抵台時自動接收簡訊、追蹤。\n這種智慧防疫系統並非台灣首創，韓國在MERS防疫上即有相關運用，香港目前則以「電子手環」追蹤居家檢疫者。針對台灣的電子圍籬政策，有民眾、外媒讚賞高科技防疫措施，但也有民眾對隱私疑慮表達擔憂，「台灣人權促進會」副秘書長認為政府應交代明確的法源依據，並說明大規模的串接資料與揭露的具體「退場機制」，才不會傷害民主體制。"],["reference","手機沒電1小時「警察一早來敲門」　BBC揭美大學生返台檢疫經驗\nhttps://www.ettoday.net/news/20200326/1677413.htm\n\n手機沒電警察上門　台人BBC撰文寫台灣檢疫經驗\nhttps://tw.appledaily.com/international/20200326/GYK3IEU24PKP4IXWOGPTJNA2UY/\n\n肺炎疫情：面對抗疫科技，中港台在隱私保護與有效性間艱難平衡（2020.03.25）\nhttps://www.bbc.com/zhongwen/trad/chinese-news-52003034\n\n武漢肺炎》「電子圍籬監控系統」啟動外媒讚：台灣引領防疫新浪潮（2020.03.20）\nhttps://news.ltn.com.tw/news/life/breakingnews/3106943\n\n何明諠／肺炎疫情引恐慌：電子監控的「民主內傷」誰來顧？（2020.03.09）\nhttps://opinion.udn.com/opinion/story/10124/4401087\n\n手機監控武漢肺炎隔離者指揮中心借鏡南韓經驗（2020.01.30）\nhttps://www.rti.org.tw/news/view/id/2049796"],["hyperlinks",null],["createdAt","2020-03-30T09:47:07.301Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",2],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",2],["user",{"__iterable":"Map","data":[["id","j4S8C_Gt39E0beYXrqCc2Gd0j3fGn0m4ncYapmxj9ibHxBziw"],["name","精力充沛的前金畢夏普"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Vitamin C Protects Against Coronavirus"],["url","http://orthomolecular.org/resources/omns/v16n04.shtml"],["summary","This article may be reprinted free of charge provided 1) that there is clear attribution to the Orthomolecular Medicine News Service, and 2) that both the OMNS free subscription link http://orthomolecular.org/subscribe.html and also the OMNS archive link http://orthomolecular.org/resources/omns/index.shtml are included.\n\n\n\n\nFOR IMMEDIATE RELEASE \nOrthomolecular Medicine News Service, Jan 26, 2020\n\n\n\n\nby Andrew W. Saul, Editor \n\n\n(OMNS January 26, 2020) The coronavirus pandemic can be dramatically slowed, or stopped, with the immediate widespread use of high doses of vitamin C. Physicians have demonstrated the powerful antiviral action of vitamin C for decades. There has been a lack of media coverage of this effective and successful approach against viruses in general, and coronavirus in particular. \n\nIt is very important to maximize the body's anti-oxidative capacity and natural immunity to prevent and minimize symptoms when a virus attacks the human body. The host environment is crucial. Preventing is obviously easier than treating severe illness. But treat serious illness seriously. Do not hesitate to seek medical attention. It is not an either-or choice. Vitamin C can be used right along with medicines when they are indicated.\n\n\n\"I have not seen any flu yet that was not cured or markedly ameliorated by massive doses of vitamin C.\"(Robert F. Cathcart, MD)\n\nThe physicians of the Orthomolecular Medicine News Service and the International Society for Orthomolecular Medicine urge a nutrient-based method to prevent or minimize symptoms for future viral infection. The following inexpensive supplemental levels are recommended for adults; for children reduce these in proportion to body weight: \n\nVitamin C: 3,000 milligrams (or more) daily, in divided doses. \n\nVitamin D3: 2,000 International Units daily. (Start with 5,000 IU/day for two weeks, then reduce to 2,000)\n\nMagnesium: 400 mg daily (in citrate, malate, chelate, or chloride form) \n\nZinc: 20 mg daily\n\nSelenium: 100 mcg (micrograms) daily\n\nVitamin C [1], Vitamin D [2], magnesium [3], zinc [4], and selenium [5] have been shown to strengthen the immune system against viruses. \n\nThe basis for using high doses of vitamin C to prevent and combat virus-caused illness may be traced back to vitamin C's early success against polio, first reported in the late 1940s.[6] Many people are unaware, even surprised, to learn this. Further clinical evidence built up over the decades, leading to an anti-virus protocol published in 1980.[7]\n\nIt is important to remember that preventing and treating respiratory infections with large amounts of vitamin C is well established. Those who believe that vitamin C generally has merit, but massive doses are ineffective or somehow harmful, will do well to read the original papers for themselves. To dismiss the work of these doctors simply because they had success so long ago sidesteps a more important question: Why has the benefit of their clinical experience not been presented to the public by responsible governmental authorities, especially in the face of a viral pandemic? \n\n\n\n\nReferences:\n\n1. Vitamin C: \n\nCase HS (2018) Vitamin C questions answered. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v14n12.shtml.\n\n Gonzalez MJ, Berdiel MJ, Duconge J (2018) High dose vitamin C and influenza: A case report. J Orthomol Med. June, 2018, 33(3). \nhttps://isom.ca/article/high-dose-vitamin-c-influenza-case-report.\n\nGorton HC, Jarvis K (1999) The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manip Physiol Ther, 22:8, 530-533. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10543583 \n\nHemilä H (2017) Vitamin C and infections. Nutrients. 9(4). pii:E339. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28353648.\n\nHickey S, Saul AW (2015) Vitamin C: The real story. Basic Health Pub. ISBN-13: 978-1591202233.\n\nLevy TE (2014) The clinical impact of vitamin C. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v10n14.shtml\n\nOMNS (2007) Vitamin C: a highly effective treatment for colds. \nhttp://orthomolecular.org/resources/omns/v03n05.shtml.\n\nOMNS (2009) Vitamin C as an antiviral \nhttp://orthomolecular.org/resources/omns/v05n09.shtml.\n\nTaylor T (2017) Vitamin C material: where to start, what to watch. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n20.shtml.\n\nYejin Kim, Hyemin Kim, Seyeon Bae et al. (2013) Vitamin C is an essential factor on the anti-viral immune responses through the production of interferon-α/β at the initial stage of influenza A virus (H3N2) infection. Immune Netw. 13:70-74. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23700397.\n\n\n\n\n2. Vitamin D: \n\nCannell JJ, Vieth R, Umhau JC et al. (2006) Epidemic influenza and vitamin D. Epidemiol Infect. 134:1129-1140. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nCannell JJ, Zasloff M, Garland CF et al. (2008) On the epidemiology of influenza. Virol J. 5:29. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nGinde AA, Mansbach JM, Camargo CA Jr. (2009) Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 169:384-390. \nhttps://www.ncbi.nlm.nih.gov/pubmed/19237723.\n\nMartineau AR, Jolliffe DA, Hooper RL et al. (2017) Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 356:i6583. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28202713.\n\nUrashima M, Segawa T, Okazaki M et al. (2010) Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 91:1255-60. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20219962.\n\nvon Essen MR, Kongsbak M, Schjerling P et al. (2010) Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nat Immunol. 11:344-349. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20208539.\n\n\n\n3. Magnesium:\n\nDean C (2017) Magnesium. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n22.shtml\n\nDean C. (2017) The Magnesium Miracle. 2nd Ed., Ballantine Books. ISBN-13: 978-0399594441. \n\nLevy TE (2019) Magnesium: Reversing Disease. Medfox Pub. ISBN-13: 978-0998312408\n\n\n\n4. Zinc: \n\nFraker PJ, King LE, Laakko T, Vollmer TL. (2000) The dynamic link between the integrity of the immune system and zinc status. J Nutr. 130:1399S-406S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801951.\n\nLiu MJ, Bao S, Gálvez-Peralta M, et al. (2013) ZIP8 regulates host defense through zinc-mediated inhibition of NF-кB. Cell Rep. 3:386-400. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23403290.\n\nMocchegiani E, Muzzioli M. (2000) Therapeutic application of zinc in human immunodeficiency virus against opportunistic infections. J Nutr. 130:1424S-1431S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801955.\n\nShankar AH, Prasad AS. (1998) Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr. 68:447S-463S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/9701160.\n\n\n\n5. Selenium:\n\nBeck MA, Levander OA, Handy J. (2003) Selenium deficiency and viral infection. J Nutr. 133:1463S-1467S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/12730444.\n\nHoffmann PR, Berry MJ. (2008) The influence of selenium on immune responses. Mol Nutr Food Res. 52:1273-1280. \nhttps://www.ncbi.nlm.nih.gov/pubmed/18384097.\n\nSteinbrenner H, Al-Quraishy S, Dkhil MA et al. (2015) Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 6:73-82. \nhttps://www.ncbi.nlm.nih.gov/pubmed/25593145.\n\n\n\n6. Klenner FR. The treatment of poliomyelitis and other virus diseases with vitamin C. J South Med Surg 1949, 111:210-214. \nhttp://www.doctoryourself.com/klennerpaper.html.\n\n7. Cathcart RF. The method of determining proper doses of vitamin C for treatment of diseases by titrating to bowel tolerance. Australian Nurses J 1980, 9(4):9-13. \nhttp://www.doctoryourself.com/titration.html \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nNutritional Medicine is Orthomolecular Medicine\nOrthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org\n\n\n\nFind a Doctor\nTo locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml\n\n\n\nThe peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource.\n \n\n\n\nEditorial Review Board:\nIlyès Baghli, M.D. (Algeria)\nIan Brighthope, M.D. (Australia) \nProf. Gilbert Henri Crussol (Spain)\nCarolyn Dean, M.D., N.D. (USA) \nDamien Downing, M.D. (United Kingdom) \nMichael Ellis, M.D. (Australia) \nMartin P. Gallagher, M.D., D.C. (USA) \nMichael J. Gonzalez, N.M.D., D.Sc., Ph.D. (Puerto Rico) \nWilliam B. Grant, Ph.D. (USA) \nTonya S. Heyman, M.D. (USA)\nSuzanne Humphries, M.D. (USA) \nRon Hunninghake, M.D. (USA)\nMichael Janson, M.D. (USA) \nRobert E. Jenkins, D.C. (USA) \nBo H. Jonsson, M.D., Ph.D. (Sweden) \nJeffrey J. Kotulski, D.O. (USA)\nPeter H. Lauda, M.D. (Austria) \nThomas Levy, M.D., J.D. (USA) \nHomer Lim, M.D. (Philippines)\nStuart Lindsey, Pharm.D. (USA) \nVictor A. Marcial-Vega, M.D. (Puerto Rico) \nCharles C. Mary, Jr., M.D. (USA) \nMignonne Mary, M.D. (USA)\nJun Matsuyama, M.D., Ph.D. (Japan)\t\nDave McCarthy, M.D. (USA)\nJoseph Mercola, D.O. (USA)\nJorge R. Miranda-Massari, Pharm.D. (Puerto Rico) \nKarin Munsterhjelm-Ahumada, M.D. (Finland) \nTahar Naili, M.D. (Algeria)\nW. Todd Penberthy, Ph.D. (USA) \nDag Viljen Poleszynski, Ph.D. (Norway) \nJeffrey A. Ruterbusch, D.O. (USA) \nGert E. Schuitemaker, Ph.D. (Netherlands) \nThomas L. Taxman, M.D. (USA)\nJagan Nathan Vamanan, M.D. (India) \nGarry Vickar, MD (USA)\nKen Walker, M.D. (Canada)\nAnne Zauderer, D.C. (USA)\n\n\nAndrew W. Saul, Ph.D. (USA), Editor-In-Chief\nEditor, Japanese Edition: Atsuo Yanagisawa, M.D., Ph.D. (Japan)\nRobert G. Smith, Ph.D. (USA), Associate Editor\nHelen Saul Case, M.S. (USA), Assistant Editor\nMichael S. Stewart, B.Sc.C.S. (USA), Technology Editor\nJason M. Saul, JD (USA), Legal Consultant\n\nComments and media contact: drsaul@doctoryourself.com OMNS welcomes but is unable to respond to individual reader emails. Reader comments become the property of OMNS and may or may not be used for publication. \n\n\n\nTo Subscribe at no charge: http://www.orthomolecular.org/subscribe.html\n\nTo Unsubscribe from this list: http://www.orthomolecular.org/unsubscribe.html"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Vitamin C Protects Against Coronavirus"],["url","http://orthomolecular.org/resources/omns/v16n04.shtml"],["summary","This article may be reprinted free of charge provided 1) that there is clear attribution to the Orthomolecular Medicine News Service, and 2) that both the OMNS free subscription link http://orthomolecular.org/subscribe.html and also the OMNS archive link http://orthomolecular.org/resources/omns/index.shtml are included.\n\n\n\n\nFOR IMMEDIATE RELEASE \nOrthomolecular Medicine News Service, Jan 26, 2020\n\n\n\n\nby Andrew W. Saul, Editor \n\n\n(OMNS January 26, 2020) The coronavirus pandemic can be dramatically slowed, or stopped, with the immediate widespread use of high doses of vitamin C. Physicians have demonstrated the powerful antiviral action of vitamin C for decades. There has been a lack of media coverage of this effective and successful approach against viruses in general, and coronavirus in particular. \n\nIt is very important to maximize the body's anti-oxidative capacity and natural immunity to prevent and minimize symptoms when a virus attacks the human body. The host environment is crucial. Preventing is obviously easier than treating severe illness. But treat serious illness seriously. Do not hesitate to seek medical attention. It is not an either-or choice. Vitamin C can be used right along with medicines when they are indicated.\n\n\n\"I have not seen any flu yet that was not cured or markedly ameliorated by massive doses of vitamin C.\"(Robert F. Cathcart, MD)\n\nThe physicians of the Orthomolecular Medicine News Service and the International Society for Orthomolecular Medicine urge a nutrient-based method to prevent or minimize symptoms for future viral infection. The following inexpensive supplemental levels are recommended for adults; for children reduce these in proportion to body weight: \n\nVitamin C: 3,000 milligrams (or more) daily, in divided doses. \n\nVitamin D3: 2,000 International Units daily. (Start with 5,000 IU/day for two weeks, then reduce to 2,000)\n\nMagnesium: 400 mg daily (in citrate, malate, chelate, or chloride form) \n\nZinc: 20 mg daily\n\nSelenium: 100 mcg (micrograms) daily\n\nVitamin C [1], Vitamin D [2], magnesium [3], zinc [4], and selenium [5] have been shown to strengthen the immune system against viruses. \n\nThe basis for using high doses of vitamin C to prevent and combat virus-caused illness may be traced back to vitamin C's early success against polio, first reported in the late 1940s.[6] Many people are unaware, even surprised, to learn this. Further clinical evidence built up over the decades, leading to an anti-virus protocol published in 1980.[7]\n\nIt is important to remember that preventing and treating respiratory infections with large amounts of vitamin C is well established. Those who believe that vitamin C generally has merit, but massive doses are ineffective or somehow harmful, will do well to read the original papers for themselves. To dismiss the work of these doctors simply because they had success so long ago sidesteps a more important question: Why has the benefit of their clinical experience not been presented to the public by responsible governmental authorities, especially in the face of a viral pandemic? \n\n\n\n\nReferences:\n\n1. Vitamin C: \n\nCase HS (2018) Vitamin C questions answered. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v14n12.shtml.\n\n Gonzalez MJ, Berdiel MJ, Duconge J (2018) High dose vitamin C and influenza: A case report. J Orthomol Med. June, 2018, 33(3). \nhttps://isom.ca/article/high-dose-vitamin-c-influenza-case-report.\n\nGorton HC, Jarvis K (1999) The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manip Physiol Ther, 22:8, 530-533. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10543583 \n\nHemilä H (2017) Vitamin C and infections. Nutrients. 9(4). pii:E339. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28353648.\n\nHickey S, Saul AW (2015) Vitamin C: The real story. Basic Health Pub. ISBN-13: 978-1591202233.\n\nLevy TE (2014) The clinical impact of vitamin C. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v10n14.shtml\n\nOMNS (2007) Vitamin C: a highly effective treatment for colds. \nhttp://orthomolecular.org/resources/omns/v03n05.shtml.\n\nOMNS (2009) Vitamin C as an antiviral \nhttp://orthomolecular.org/resources/omns/v05n09.shtml.\n\nTaylor T (2017) Vitamin C material: where to start, what to watch. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n20.shtml.\n\nYejin Kim, Hyemin Kim, Seyeon Bae et al. (2013) Vitamin C is an essential factor on the anti-viral immune responses through the production of interferon-α/β at the initial stage of influenza A virus (H3N2) infection. Immune Netw. 13:70-74. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23700397.\n\n\n\n\n2. Vitamin D: \n\nCannell JJ, Vieth R, Umhau JC et al. (2006) Epidemic influenza and vitamin D. Epidemiol Infect. 134:1129-1140. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nCannell JJ, Zasloff M, Garland CF et al. (2008) On the epidemiology of influenza. Virol J. 5:29. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nGinde AA, Mansbach JM, Camargo CA Jr. (2009) Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 169:384-390. \nhttps://www.ncbi.nlm.nih.gov/pubmed/19237723.\n\nMartineau AR, Jolliffe DA, Hooper RL et al. (2017) Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 356:i6583. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28202713.\n\nUrashima M, Segawa T, Okazaki M et al. (2010) Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 91:1255-60. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20219962.\n\nvon Essen MR, Kongsbak M, Schjerling P et al. (2010) Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nat Immunol. 11:344-349. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20208539.\n\n\n\n3. Magnesium:\n\nDean C (2017) Magnesium. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n22.shtml\n\nDean C. (2017) The Magnesium Miracle. 2nd Ed., Ballantine Books. ISBN-13: 978-0399594441. \n\nLevy TE (2019) Magnesium: Reversing Disease. Medfox Pub. ISBN-13: 978-0998312408\n\n\n\n4. Zinc: \n\nFraker PJ, King LE, Laakko T, Vollmer TL. (2000) The dynamic link between the integrity of the immune system and zinc status. J Nutr. 130:1399S-406S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801951.\n\nLiu MJ, Bao S, Gálvez-Peralta M, et al. (2013) ZIP8 regulates host defense through zinc-mediated inhibition of NF-кB. Cell Rep. 3:386-400. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23403290.\n\nMocchegiani E, Muzzioli M. (2000) Therapeutic application of zinc in human immunodeficiency virus against opportunistic infections. J Nutr. 130:1424S-1431S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801955.\n\nShankar AH, Prasad AS. (1998) Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr. 68:447S-463S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/9701160.\n\n\n\n5. Selenium:\n\nBeck MA, Levander OA, Handy J. (2003) Selenium deficiency and viral infection. J Nutr. 133:1463S-1467S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/12730444.\n\nHoffmann PR, Berry MJ. (2008) The influence of selenium on immune responses. Mol Nutr Food Res. 52:1273-1280. \nhttps://www.ncbi.nlm.nih.gov/pubmed/18384097.\n\nSteinbrenner H, Al-Quraishy S, Dkhil MA et al. (2015) Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 6:73-82. \nhttps://www.ncbi.nlm.nih.gov/pubmed/25593145.\n\n\n\n6. Klenner FR. The treatment of poliomyelitis and other virus diseases with vitamin C. J South Med Surg 1949, 111:210-214. \nhttp://www.doctoryourself.com/klennerpaper.html.\n\n7. Cathcart RF. The method of determining proper doses of vitamin C for treatment of diseases by titrating to bowel tolerance. Australian Nurses J 1980, 9(4):9-13. \nhttp://www.doctoryourself.com/titration.html \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nNutritional Medicine is Orthomolecular Medicine\nOrthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org\n\n\n\nFind a Doctor\nTo locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml\n\n\n\nThe peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource.\n \n\n\n\nEditorial Review Board:\nIlyès Baghli, M.D. (Algeria)\nIan Brighthope, M.D. (Australia) \nProf. Gilbert Henri Crussol (Spain)\nCarolyn Dean, M.D., N.D. (USA) \nDamien Downing, M.D. (United Kingdom) \nMichael Ellis, M.D. (Australia) \nMartin P. Gallagher, M.D., D.C. (USA) \nMichael J. Gonzalez, N.M.D., D.Sc., Ph.D. (Puerto Rico) \nWilliam B. Grant, Ph.D. (USA) \nTonya S. Heyman, M.D. (USA)\nSuzanne Humphries, M.D. (USA) \nRon Hunninghake, M.D. (USA)\nMichael Janson, M.D. (USA) \nRobert E. Jenkins, D.C. (USA) \nBo H. Jonsson, M.D., Ph.D. (Sweden) \nJeffrey J. Kotulski, D.O. (USA)\nPeter H. Lauda, M.D. (Austria) \nThomas Levy, M.D., J.D. (USA) \nHomer Lim, M.D. (Philippines)\nStuart Lindsey, Pharm.D. (USA) \nVictor A. Marcial-Vega, M.D. (Puerto Rico) \nCharles C. Mary, Jr., M.D. (USA) \nMignonne Mary, M.D. (USA)\nJun Matsuyama, M.D., Ph.D. (Japan)\t\nDave McCarthy, M.D. (USA)\nJoseph Mercola, D.O. (USA)\nJorge R. Miranda-Massari, Pharm.D. (Puerto Rico) \nKarin Munsterhjelm-Ahumada, M.D. (Finland) \nTahar Naili, M.D. (Algeria)\nW. Todd Penberthy, Ph.D. (USA) \nDag Viljen Poleszynski, Ph.D. (Norway) \nJeffrey A. Ruterbusch, D.O. (USA) \nGert E. Schuitemaker, Ph.D. (Netherlands) \nThomas L. Taxman, M.D. (USA)\nJagan Nathan Vamanan, M.D. (India) \nGarry Vickar, MD (USA)\nKen Walker, M.D. (Canada)\nAnne Zauderer, D.C. (USA)\n\n\nAndrew W. Saul, Ph.D. (USA), Editor-In-Chief\nEditor, Japanese Edition: Atsuo Yanagisawa, M.D., Ph.D. (Japan)\nRobert G. Smith, Ph.D. (USA), Associate Editor\nHelen Saul Case, M.S. (USA), Assistant Editor\nMichael S. Stewart, B.Sc.C.S. (USA), Technology Editor\nJason M. Saul, JD (USA), Legal Consultant\n\nComments and media contact: drsaul@doctoryourself.com OMNS welcomes but is unable to respond to individual reader emails. Reader comments become the property of OMNS and may or may not be used for publication. \n\n\n\nTo Subscribe at no charge: http://www.orthomolecular.org/subscribe.html\n\nTo Unsubscribe from this list: http://www.orthomolecular.org/unsubscribe.html"],["topImageUrl",null],["error",null]]}]}],["text","【國際分子矯正醫學會總會即時新聞稿 ISOM Immediate Press Release 】\n“維他命Ｃ對於抵抗冠狀病毒的保護”\n\n(非常感謝柳澤厚生醫師的分享，以下為中文翻譯，可參考原文連結)\n\n為回應各國政府目前被動式的預防方式如戴口罩，勤洗手以及減少外出等政策，位於加拿大的國際分子矯正醫學會總會做出官方回應(目前總會主席為柳澤厚生醫師)，國際分子矯正醫學會總會中多達四十餘國的營養專家們對於預防新型冠狀病毒感染之建議如下：\n\n有許多臨床實證指出，額外營養補充來改善身體抗氧化能力以及免疫功能可幫助預防或減低呼吸道病毒感染發生機會：\n(1) 維他命C : 每天3克或以上。\n(2) 維他命D3 : 每天125微克(5000IU)持續兩週，兩週之後維持每天50微克(2000IU)\n(3) 鋅：每天20毫克\n(4) 鎂：每天400毫克(除了氧化鎂之外的形式)\n(5) 硒：每天100微克\n\n柳澤醫師分享自身臨床經驗：(1)和(2)就已經非常足夠。\n麻煩大家多多分享轉傳。\n\n國際分子矯正醫學會總會聲明原文連結如下：http://orthomolecular.org/resources/omns/v16n04.shtml\n\n【ISOM Immediate Press Release 】\n　\"Vitamin C Protects Against Coronavirus\"\n\nIn response to the government's passive measures such as masks, hand washing and going out, government officials from the Canadian headquarters of the International Association of Orthomolecular Medicine, my chairman, issued a statement on how to prevent groundbreaking new coronavirus infection. , Published by nutrition experts in 40 countries, including me.\nThere is a great deal of clinical evidence that taking supplements to improve the body's antioxidant capacity and immune function can help prevent or reduce the onset of respiratory viral infections.\n(1) Vitamin C: 3g or more per day\n(2) Vitamin D3: 125 μg (5,000 IU) per day for 2 weeks\n維持 After that, keep at 50μg (2,000IU)\n(3) Zinc: 20 mg per day\n(4) Magnesium: 400 mg per day (other than magnesium oxide)\n(5) Selenium: 100 μg / day\nIn my experience, (1) and (2) alone are sufficient. Please share by all means.\nThe original text of this statement follows：http://orthomolecular.org/resources/omns/v16n04.shtml"],["id","1hfczhxc8b71q"],["createdAt","2020-01-29T02:03:24.657Z"]]}],["reply",{"__iterable":"Map","data":[["id","5sOK9XwBucwAqrba1WVD"],["user",{"__iterable":"Map","data":[["id","1alMSHgB9w1KR1IkWx8e"],["name","SophHSIEH"],["avatarUrl",null],["level",12]]}],["type","RUMOR"],["text","目前尚無實證可以證明維生素 C、維生素 D3、鋅、奎寧可以治療、預防 COVID-19。公衛專家指出，重要的影響因素應是國家防疫政策與人民配合度，通常是透過施打疫苗和封鎖等措施控制疫情。"],["reference","TFC：新冠肺炎疫情的事實查核—羥氯奎寧如何被政治人物誇大為神藥靈丹\nhttps://tfc-taiwan.org.tw/articles/3660\n\n【錯誤】網傳「天大的好消息，科學研究終於發現，人體因為缺少維他命D3，才會讓疫情爆發控制不下來...連最嚴重印度經過醫療團隊改用大量吃維他命D，竟然能讓疫情控制下來」？\nhttps://tfc-taiwan.org.tw/articles/5980"],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","新冠肺炎疫情的事實查核—羥氯奎寧如何被政治人物誇大為神藥靈丹"],["url","https://tfc-taiwan.org.tw/articles/3660"],["summary","編譯／何蕙安"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","【錯誤】網傳「天大的好消息，科學研究終於發現，人體因為缺少維他命D3，才會讓疫情爆發控制不下來...連最嚴重印度經過醫療團隊改用大量吃維他命D，竟然能讓疫情控制下來」？"],["url","https://tfc-taiwan.org.tw/articles/5980"],["summary","【報告將隨時更新 2021/7/12 版】一、公衛專家指出，從國家人口健康角度，維生素D缺乏在此次全球疫情中影響非常低，重要因素應是國家防疫政策及人民配合程度，決定該國疫情控制及受疫情影響的程度。二、公衛專家指出，印度在今年1月到3月期間疫情爆發，主因包括印度變種病毒株影響，以及舉辦人群聚集的宗教活動，使確診個案急劇增加。疫情爆發後，印度政府透過積極施打疫苗、嚴格封鎖等多項管制措施來控制疫情。三、公衛專家指出，印度政府雖有提供維生素D，以改善人民全體的健康狀態，但維生素D並非唯一抗疫手段，無法直接推論「印度透過維生素D控制疫情」。傳言稱「科學研究發現，人體缺維他命D3，讓疫情控制不下來」‘「印度讓民眾吃大量維他命D，讓疫情控制下來」，科學研究尚未有足夠證據，傳言過度放大維他命D功效。因此，為錯誤訊息。【查核聲明】維生素D與新冠疫情，是尚未有定論的科學研究主題。本報告在爭議點三，整理專家說法，供民眾參考。"],["topImageUrl",null],["error",null]]}]}],["createdAt","2021-11-06T13:58:08.969Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",2],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",2],["user",{"__iterable":"Map","data":[["id","j4S8C_Gt39E0beYXrqCc2Gd0j3fGn0m4ncYapmxj9ibHxBziw"],["name","精力充沛的前金畢夏普"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Vitamin C Protects Against Coronavirus"],["url","http://orthomolecular.org/resources/omns/v16n04.shtml"],["summary","This article may be reprinted free of charge provided 1) that there is clear attribution to the Orthomolecular Medicine News Service, and 2) that both the OMNS free subscription link http://orthomolecular.org/subscribe.html and also the OMNS archive link http://orthomolecular.org/resources/omns/index.shtml are included.\n\n\n\n\nFOR IMMEDIATE RELEASE \nOrthomolecular Medicine News Service, Jan 26, 2020\n\n\n\n\nby Andrew W. Saul, Editor \n\n\n(OMNS January 26, 2020) The coronavirus pandemic can be dramatically slowed, or stopped, with the immediate widespread use of high doses of vitamin C. Physicians have demonstrated the powerful antiviral action of vitamin C for decades. There has been a lack of media coverage of this effective and successful approach against viruses in general, and coronavirus in particular. \n\nIt is very important to maximize the body's anti-oxidative capacity and natural immunity to prevent and minimize symptoms when a virus attacks the human body. The host environment is crucial. Preventing is obviously easier than treating severe illness. But treat serious illness seriously. Do not hesitate to seek medical attention. It is not an either-or choice. Vitamin C can be used right along with medicines when they are indicated.\n\n\n\"I have not seen any flu yet that was not cured or markedly ameliorated by massive doses of vitamin C.\"(Robert F. Cathcart, MD)\n\nThe physicians of the Orthomolecular Medicine News Service and the International Society for Orthomolecular Medicine urge a nutrient-based method to prevent or minimize symptoms for future viral infection. The following inexpensive supplemental levels are recommended for adults; for children reduce these in proportion to body weight: \n\nVitamin C: 3,000 milligrams (or more) daily, in divided doses. \n\nVitamin D3: 2,000 International Units daily. (Start with 5,000 IU/day for two weeks, then reduce to 2,000)\n\nMagnesium: 400 mg daily (in citrate, malate, chelate, or chloride form) \n\nZinc: 20 mg daily\n\nSelenium: 100 mcg (micrograms) daily\n\nVitamin C [1], Vitamin D [2], magnesium [3], zinc [4], and selenium [5] have been shown to strengthen the immune system against viruses. \n\nThe basis for using high doses of vitamin C to prevent and combat virus-caused illness may be traced back to vitamin C's early success against polio, first reported in the late 1940s.[6] Many people are unaware, even surprised, to learn this. Further clinical evidence built up over the decades, leading to an anti-virus protocol published in 1980.[7]\n\nIt is important to remember that preventing and treating respiratory infections with large amounts of vitamin C is well established. Those who believe that vitamin C generally has merit, but massive doses are ineffective or somehow harmful, will do well to read the original papers for themselves. To dismiss the work of these doctors simply because they had success so long ago sidesteps a more important question: Why has the benefit of their clinical experience not been presented to the public by responsible governmental authorities, especially in the face of a viral pandemic? \n\n\n\n\nReferences:\n\n1. Vitamin C: \n\nCase HS (2018) Vitamin C questions answered. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v14n12.shtml.\n\n Gonzalez MJ, Berdiel MJ, Duconge J (2018) High dose vitamin C and influenza: A case report. J Orthomol Med. June, 2018, 33(3). \nhttps://isom.ca/article/high-dose-vitamin-c-influenza-case-report.\n\nGorton HC, Jarvis K (1999) The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manip Physiol Ther, 22:8, 530-533. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10543583 \n\nHemilä H (2017) Vitamin C and infections. Nutrients. 9(4). pii:E339. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28353648.\n\nHickey S, Saul AW (2015) Vitamin C: The real story. Basic Health Pub. ISBN-13: 978-1591202233.\n\nLevy TE (2014) The clinical impact of vitamin C. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v10n14.shtml\n\nOMNS (2007) Vitamin C: a highly effective treatment for colds. \nhttp://orthomolecular.org/resources/omns/v03n05.shtml.\n\nOMNS (2009) Vitamin C as an antiviral \nhttp://orthomolecular.org/resources/omns/v05n09.shtml.\n\nTaylor T (2017) Vitamin C material: where to start, what to watch. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n20.shtml.\n\nYejin Kim, Hyemin Kim, Seyeon Bae et al. (2013) Vitamin C is an essential factor on the anti-viral immune responses through the production of interferon-α/β at the initial stage of influenza A virus (H3N2) infection. Immune Netw. 13:70-74. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23700397.\n\n\n\n\n2. Vitamin D: \n\nCannell JJ, Vieth R, Umhau JC et al. (2006) Epidemic influenza and vitamin D. Epidemiol Infect. 134:1129-1140. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nCannell JJ, Zasloff M, Garland CF et al. (2008) On the epidemiology of influenza. Virol J. 5:29. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nGinde AA, Mansbach JM, Camargo CA Jr. (2009) Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 169:384-390. \nhttps://www.ncbi.nlm.nih.gov/pubmed/19237723.\n\nMartineau AR, Jolliffe DA, Hooper RL et al. (2017) Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 356:i6583. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28202713.\n\nUrashima M, Segawa T, Okazaki M et al. (2010) Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 91:1255-60. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20219962.\n\nvon Essen MR, Kongsbak M, Schjerling P et al. (2010) Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nat Immunol. 11:344-349. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20208539.\n\n\n\n3. Magnesium:\n\nDean C (2017) Magnesium. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n22.shtml\n\nDean C. (2017) The Magnesium Miracle. 2nd Ed., Ballantine Books. ISBN-13: 978-0399594441. \n\nLevy TE (2019) Magnesium: Reversing Disease. Medfox Pub. ISBN-13: 978-0998312408\n\n\n\n4. Zinc: \n\nFraker PJ, King LE, Laakko T, Vollmer TL. (2000) The dynamic link between the integrity of the immune system and zinc status. J Nutr. 130:1399S-406S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801951.\n\nLiu MJ, Bao S, Gálvez-Peralta M, et al. (2013) ZIP8 regulates host defense through zinc-mediated inhibition of NF-кB. Cell Rep. 3:386-400. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23403290.\n\nMocchegiani E, Muzzioli M. (2000) Therapeutic application of zinc in human immunodeficiency virus against opportunistic infections. J Nutr. 130:1424S-1431S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801955.\n\nShankar AH, Prasad AS. (1998) Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr. 68:447S-463S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/9701160.\n\n\n\n5. Selenium:\n\nBeck MA, Levander OA, Handy J. (2003) Selenium deficiency and viral infection. J Nutr. 133:1463S-1467S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/12730444.\n\nHoffmann PR, Berry MJ. (2008) The influence of selenium on immune responses. Mol Nutr Food Res. 52:1273-1280. \nhttps://www.ncbi.nlm.nih.gov/pubmed/18384097.\n\nSteinbrenner H, Al-Quraishy S, Dkhil MA et al. (2015) Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 6:73-82. \nhttps://www.ncbi.nlm.nih.gov/pubmed/25593145.\n\n\n\n6. Klenner FR. The treatment of poliomyelitis and other virus diseases with vitamin C. J South Med Surg 1949, 111:210-214. \nhttp://www.doctoryourself.com/klennerpaper.html.\n\n7. Cathcart RF. The method of determining proper doses of vitamin C for treatment of diseases by titrating to bowel tolerance. Australian Nurses J 1980, 9(4):9-13. \nhttp://www.doctoryourself.com/titration.html \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nNutritional Medicine is Orthomolecular Medicine\nOrthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org\n\n\n\nFind a Doctor\nTo locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml\n\n\n\nThe peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource.\n \n\n\n\nEditorial Review Board:\nIlyès Baghli, M.D. (Algeria)\nIan Brighthope, M.D. (Australia) \nProf. Gilbert Henri Crussol (Spain)\nCarolyn Dean, M.D., N.D. (USA) \nDamien Downing, M.D. (United Kingdom) \nMichael Ellis, M.D. (Australia) \nMartin P. Gallagher, M.D., D.C. (USA) \nMichael J. Gonzalez, N.M.D., D.Sc., Ph.D. (Puerto Rico) \nWilliam B. Grant, Ph.D. (USA) \nTonya S. Heyman, M.D. (USA)\nSuzanne Humphries, M.D. (USA) \nRon Hunninghake, M.D. (USA)\nMichael Janson, M.D. (USA) \nRobert E. Jenkins, D.C. (USA) \nBo H. Jonsson, M.D., Ph.D. (Sweden) \nJeffrey J. Kotulski, D.O. (USA)\nPeter H. Lauda, M.D. (Austria) \nThomas Levy, M.D., J.D. (USA) \nHomer Lim, M.D. (Philippines)\nStuart Lindsey, Pharm.D. (USA) \nVictor A. Marcial-Vega, M.D. (Puerto Rico) \nCharles C. Mary, Jr., M.D. (USA) \nMignonne Mary, M.D. (USA)\nJun Matsuyama, M.D., Ph.D. (Japan)\t\nDave McCarthy, M.D. (USA)\nJoseph Mercola, D.O. (USA)\nJorge R. Miranda-Massari, Pharm.D. (Puerto Rico) \nKarin Munsterhjelm-Ahumada, M.D. (Finland) \nTahar Naili, M.D. (Algeria)\nW. Todd Penberthy, Ph.D. (USA) \nDag Viljen Poleszynski, Ph.D. (Norway) \nJeffrey A. Ruterbusch, D.O. (USA) \nGert E. Schuitemaker, Ph.D. (Netherlands) \nThomas L. Taxman, M.D. (USA)\nJagan Nathan Vamanan, M.D. (India) \nGarry Vickar, MD (USA)\nKen Walker, M.D. (Canada)\nAnne Zauderer, D.C. (USA)\n\n\nAndrew W. Saul, Ph.D. (USA), Editor-In-Chief\nEditor, Japanese Edition: Atsuo Yanagisawa, M.D., Ph.D. (Japan)\nRobert G. Smith, Ph.D. (USA), Associate Editor\nHelen Saul Case, M.S. (USA), Assistant Editor\nMichael S. Stewart, B.Sc.C.S. (USA), Technology Editor\nJason M. Saul, JD (USA), Legal Consultant\n\nComments and media contact: drsaul@doctoryourself.com OMNS welcomes but is unable to respond to individual reader emails. Reader comments become the property of OMNS and may or may not be used for publication. \n\n\n\nTo Subscribe at no charge: http://www.orthomolecular.org/subscribe.html\n\nTo Unsubscribe from this list: http://www.orthomolecular.org/unsubscribe.html"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Vitamin C Protects Against Coronavirus"],["url","http://orthomolecular.org/resources/omns/v16n04.shtml"],["summary","This article may be reprinted free of charge provided 1) that there is clear attribution to the Orthomolecular Medicine News Service, and 2) that both the OMNS free subscription link http://orthomolecular.org/subscribe.html and also the OMNS archive link http://orthomolecular.org/resources/omns/index.shtml are included.\n\n\n\n\nFOR IMMEDIATE RELEASE \nOrthomolecular Medicine News Service, Jan 26, 2020\n\n\n\n\nby Andrew W. Saul, Editor \n\n\n(OMNS January 26, 2020) The coronavirus pandemic can be dramatically slowed, or stopped, with the immediate widespread use of high doses of vitamin C. Physicians have demonstrated the powerful antiviral action of vitamin C for decades. There has been a lack of media coverage of this effective and successful approach against viruses in general, and coronavirus in particular. \n\nIt is very important to maximize the body's anti-oxidative capacity and natural immunity to prevent and minimize symptoms when a virus attacks the human body. The host environment is crucial. Preventing is obviously easier than treating severe illness. But treat serious illness seriously. Do not hesitate to seek medical attention. It is not an either-or choice. Vitamin C can be used right along with medicines when they are indicated.\n\n\n\"I have not seen any flu yet that was not cured or markedly ameliorated by massive doses of vitamin C.\"(Robert F. Cathcart, MD)\n\nThe physicians of the Orthomolecular Medicine News Service and the International Society for Orthomolecular Medicine urge a nutrient-based method to prevent or minimize symptoms for future viral infection. The following inexpensive supplemental levels are recommended for adults; for children reduce these in proportion to body weight: \n\nVitamin C: 3,000 milligrams (or more) daily, in divided doses. \n\nVitamin D3: 2,000 International Units daily. (Start with 5,000 IU/day for two weeks, then reduce to 2,000)\n\nMagnesium: 400 mg daily (in citrate, malate, chelate, or chloride form) \n\nZinc: 20 mg daily\n\nSelenium: 100 mcg (micrograms) daily\n\nVitamin C [1], Vitamin D [2], magnesium [3], zinc [4], and selenium [5] have been shown to strengthen the immune system against viruses. \n\nThe basis for using high doses of vitamin C to prevent and combat virus-caused illness may be traced back to vitamin C's early success against polio, first reported in the late 1940s.[6] Many people are unaware, even surprised, to learn this. Further clinical evidence built up over the decades, leading to an anti-virus protocol published in 1980.[7]\n\nIt is important to remember that preventing and treating respiratory infections with large amounts of vitamin C is well established. Those who believe that vitamin C generally has merit, but massive doses are ineffective or somehow harmful, will do well to read the original papers for themselves. To dismiss the work of these doctors simply because they had success so long ago sidesteps a more important question: Why has the benefit of their clinical experience not been presented to the public by responsible governmental authorities, especially in the face of a viral pandemic? \n\n\n\n\nReferences:\n\n1. Vitamin C: \n\nCase HS (2018) Vitamin C questions answered. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v14n12.shtml.\n\n Gonzalez MJ, Berdiel MJ, Duconge J (2018) High dose vitamin C and influenza: A case report. J Orthomol Med. June, 2018, 33(3). \nhttps://isom.ca/article/high-dose-vitamin-c-influenza-case-report.\n\nGorton HC, Jarvis K (1999) The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manip Physiol Ther, 22:8, 530-533. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10543583 \n\nHemilä H (2017) Vitamin C and infections. Nutrients. 9(4). pii:E339. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28353648.\n\nHickey S, Saul AW (2015) Vitamin C: The real story. Basic Health Pub. ISBN-13: 978-1591202233.\n\nLevy TE (2014) The clinical impact of vitamin C. Orthomolecular Medicine News Service, \nhttp://orthomolecular.org/resources/omns/v10n14.shtml\n\nOMNS (2007) Vitamin C: a highly effective treatment for colds. \nhttp://orthomolecular.org/resources/omns/v03n05.shtml.\n\nOMNS (2009) Vitamin C as an antiviral \nhttp://orthomolecular.org/resources/omns/v05n09.shtml.\n\nTaylor T (2017) Vitamin C material: where to start, what to watch. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n20.shtml.\n\nYejin Kim, Hyemin Kim, Seyeon Bae et al. (2013) Vitamin C is an essential factor on the anti-viral immune responses through the production of interferon-α/β at the initial stage of influenza A virus (H3N2) infection. Immune Netw. 13:70-74. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23700397.\n\n\n\n\n2. Vitamin D: \n\nCannell JJ, Vieth R, Umhau JC et al. (2006) Epidemic influenza and vitamin D. Epidemiol Infect. 134:1129-1140. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nCannell JJ, Zasloff M, Garland CF et al. (2008) On the epidemiology of influenza. Virol J. 5:29. \nhttps://www.ncbi.nlm.nih.gov/pubmed/16959053.\n\nGinde AA, Mansbach JM, Camargo CA Jr. (2009) Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 169:384-390. \nhttps://www.ncbi.nlm.nih.gov/pubmed/19237723.\n\nMartineau AR, Jolliffe DA, Hooper RL et al. (2017) Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 356:i6583. \nhttps://www.ncbi.nlm.nih.gov/pubmed/28202713.\n\nUrashima M, Segawa T, Okazaki M et al. (2010) Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 91:1255-60. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20219962.\n\nvon Essen MR, Kongsbak M, Schjerling P et al. (2010) Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nat Immunol. 11:344-349. \nhttps://www.ncbi.nlm.nih.gov/pubmed/20208539.\n\n\n\n3. Magnesium:\n\nDean C (2017) Magnesium. OMNS, \nhttp://www.orthomolecular.org/resources/omns/v13n22.shtml\n\nDean C. (2017) The Magnesium Miracle. 2nd Ed., Ballantine Books. ISBN-13: 978-0399594441. \n\nLevy TE (2019) Magnesium: Reversing Disease. Medfox Pub. ISBN-13: 978-0998312408\n\n\n\n4. Zinc: \n\nFraker PJ, King LE, Laakko T, Vollmer TL. (2000) The dynamic link between the integrity of the immune system and zinc status. J Nutr. 130:1399S-406S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801951.\n\nLiu MJ, Bao S, Gálvez-Peralta M, et al. (2013) ZIP8 regulates host defense through zinc-mediated inhibition of NF-кB. Cell Rep. 3:386-400. \nhttps://www.ncbi.nlm.nih.gov/pubmed/23403290.\n\nMocchegiani E, Muzzioli M. (2000) Therapeutic application of zinc in human immunodeficiency virus against opportunistic infections. J Nutr. 130:1424S-1431S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/10801955.\n\nShankar AH, Prasad AS. (1998) Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr. 68:447S-463S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/9701160.\n\n\n\n5. Selenium:\n\nBeck MA, Levander OA, Handy J. (2003) Selenium deficiency and viral infection. J Nutr. 133:1463S-1467S. \nhttps://www.ncbi.nlm.nih.gov/pubmed/12730444.\n\nHoffmann PR, Berry MJ. (2008) The influence of selenium on immune responses. Mol Nutr Food Res. 52:1273-1280. \nhttps://www.ncbi.nlm.nih.gov/pubmed/18384097.\n\nSteinbrenner H, Al-Quraishy S, Dkhil MA et al. (2015) Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 6:73-82. \nhttps://www.ncbi.nlm.nih.gov/pubmed/25593145.\n\n\n\n6. Klenner FR. The treatment of poliomyelitis and other virus diseases with vitamin C. J South Med Surg 1949, 111:210-214. \nhttp://www.doctoryourself.com/klennerpaper.html.\n\n7. Cathcart RF. The method of determining proper doses of vitamin C for treatment of diseases by titrating to bowel tolerance. Australian Nurses J 1980, 9(4):9-13. \nhttp://www.doctoryourself.com/titration.html \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nNutritional Medicine is Orthomolecular Medicine\nOrthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org\n\n\n\nFind a Doctor\nTo locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml\n\n\n\nThe peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource.\n \n\n\n\nEditorial Review Board:\nIlyès Baghli, M.D. (Algeria)\nIan Brighthope, M.D. (Australia) \nProf. Gilbert Henri Crussol (Spain)\nCarolyn Dean, M.D., N.D. (USA) \nDamien Downing, M.D. (United Kingdom) \nMichael Ellis, M.D. (Australia) \nMartin P. Gallagher, M.D., D.C. (USA) \nMichael J. Gonzalez, N.M.D., D.Sc., Ph.D. (Puerto Rico) \nWilliam B. Grant, Ph.D. (USA) \nTonya S. Heyman, M.D. (USA)\nSuzanne Humphries, M.D. (USA) \nRon Hunninghake, M.D. (USA)\nMichael Janson, M.D. (USA) \nRobert E. Jenkins, D.C. (USA) \nBo H. Jonsson, M.D., Ph.D. (Sweden) \nJeffrey J. Kotulski, D.O. (USA)\nPeter H. Lauda, M.D. (Austria) \nThomas Levy, M.D., J.D. (USA) \nHomer Lim, M.D. (Philippines)\nStuart Lindsey, Pharm.D. (USA) \nVictor A. Marcial-Vega, M.D. (Puerto Rico) \nCharles C. Mary, Jr., M.D. (USA) \nMignonne Mary, M.D. (USA)\nJun Matsuyama, M.D., Ph.D. (Japan)\t\nDave McCarthy, M.D. (USA)\nJoseph Mercola, D.O. (USA)\nJorge R. Miranda-Massari, Pharm.D. (Puerto Rico) \nKarin Munsterhjelm-Ahumada, M.D. (Finland) \nTahar Naili, M.D. (Algeria)\nW. Todd Penberthy, Ph.D. (USA) \nDag Viljen Poleszynski, Ph.D. (Norway) \nJeffrey A. Ruterbusch, D.O. (USA) \nGert E. Schuitemaker, Ph.D. (Netherlands) \nThomas L. Taxman, M.D. (USA)\nJagan Nathan Vamanan, M.D. (India) \nGarry Vickar, MD (USA)\nKen Walker, M.D. (Canada)\nAnne Zauderer, D.C. (USA)\n\n\nAndrew W. Saul, Ph.D. (USA), Editor-In-Chief\nEditor, Japanese Edition: Atsuo Yanagisawa, M.D., Ph.D. (Japan)\nRobert G. Smith, Ph.D. (USA), Associate Editor\nHelen Saul Case, M.S. (USA), Assistant Editor\nMichael S. Stewart, B.Sc.C.S. (USA), Technology Editor\nJason M. Saul, JD (USA), Legal Consultant\n\nComments and media contact: drsaul@doctoryourself.com OMNS welcomes but is unable to respond to individual reader emails. Reader comments become the property of OMNS and may or may not be used for publication. \n\n\n\nTo Subscribe at no charge: http://www.orthomolecular.org/subscribe.html\n\nTo Unsubscribe from this list: http://www.orthomolecular.org/unsubscribe.html"],["topImageUrl",null],["error",null]]}]}],["text","【國際分子矯正醫學會總會即時新聞稿 ISOM Immediate Press Release 】\n“維他命Ｃ對於抵抗冠狀病毒的保護”\n\n(非常感謝柳澤厚生醫師的分享，以下為中文翻譯，可參考原文連結)\n\n為回應各國政府目前被動式的預防方式如戴口罩，勤洗手以及減少外出等政策，位於加拿大的國際分子矯正醫學會總會做出官方回應(目前總會主席為柳澤厚生醫師)，國際分子矯正醫學會總會中多達四十餘國的營養專家們對於預防新型冠狀病毒感染之建議如下：\n\n有許多臨床實證指出，額外營養補充來改善身體抗氧化能力以及免疫功能可幫助預防或減低呼吸道病毒感染發生機會：\n(1) 維他命C : 每天3克或以上。\n(2) 維他命D3 : 每天125微克(5000IU)持續兩週，兩週之後維持每天50微克(2000IU)\n(3) 鋅：每天20毫克\n(4) 鎂：每天400毫克(除了氧化鎂之外的形式)\n(5) 硒：每天100微克\n\n柳澤醫師分享自身臨床經驗：(1)和(2)就已經非常足夠。\n麻煩大家多多分享轉傳。\n\n國際分子矯正醫學會總會聲明原文連結如下：http://orthomolecular.org/resources/omns/v16n04.shtml\n\n【ISOM Immediate Press Release 】\n　\"Vitamin C Protects Against Coronavirus\"\n\nIn response to the government's passive measures such as masks, hand washing and going out, government officials from the Canadian headquarters of the International Association of Orthomolecular Medicine, my chairman, issued a statement on how to prevent groundbreaking new coronavirus infection. , Published by nutrition experts in 40 countries, including me.\nThere is a great deal of clinical evidence that taking supplements to improve the body's antioxidant capacity and immune function can help prevent or reduce the onset of respiratory viral infections.\n(1) Vitamin C: 3g or more per day\n(2) Vitamin D3: 125 μg (5,000 IU) per day for 2 weeks\n維持 After that, keep at 50μg (2,000IU)\n(3) Zinc: 20 mg per day\n(4) Magnesium: 400 mg per day (other than magnesium oxide)\n(5) Selenium: 100 μg / day\nIn my experience, (1) and (2) alone are sufficient. Please share by all means.\nThe original text of this statement follows：http://orthomolecular.org/resources/omns/v16n04.shtml"],["id","1hfczhxc8b71q"],["createdAt","2020-01-29T02:03:24.657Z"]]}],["reply",{"__iterable":"Map","data":[["id","GWSO728Bd3n3h-WYojnb"],["user",{"__iterable":"Map","data":[["id","kMzVlWwBqwaEkHKweY5K"],["name","Lopez"],["avatarUrl","https://www.gravatar.com/avatar/751f376f9925146f9752ec17ea482d64?s=100&d=identicon&r=g"],["level",13]]}],["type","RUMOR"],["text","1. 並沒有臨床實證指出，維他命Ｃ對於抵抗冠狀病毒的保護。此部分為假。\n2. 分子矯正醫學 Ortho Molecular Medicine 是一種另類醫學，沒有醫學實證，療效也不明顯，能不能稱為醫學都很有爭議。(詳見維基[1])\n《orthomolecular medicine are not supported by sound medical evidence, and the therapy is not effective; even the validity of calling the orthomolecular approach a form of medicine has been questioned since the 1970s.》\n3. 追求還沒有經過科學驗證的另類治療而延遲了經過科學驗證的正規治療，可能會發生危險。"],["reference","維基：Orthomolecular_medicine\nhttps://en.wikipedia.org/wiki/Orthomolecular_medicine"],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Orthomolecular medicine - Wikipedia"],["url","https://en.wikipedia.org/wiki/Orthomolecular_medicine"],["summary","Orthomolecular medicine[1][2] is a form of alternative medicine that aims to maintain human health through nutritional supplementation. The concept builds on the idea of an optimal nutritional environment in the body and suggests that diseases reflect deficiencies in this environment. Treatment for disease, according to this view, involves attempts to correct \"imbalances or deficiencies based on individual biochemistry\" by use of substances such as vitamins, minerals, amino acids, trace elements and fatty acids.[3][4][5] The notions behind orthomolecular medicine are not supported by sound medical evidence, and the therapy is not effective;[6][7] even the validity of calling the orthomolecular approach a form of medicine has been questioned since the 1970s.[8]\nThe approach is sometimes referred to as megavitamin therapy,[1][2] because its practice evolved out of, and in some cases still uses, doses of vitamins and minerals many times higher than the recommended dietary intake. Orthomolecular practitioners may also incorporate a variety of other styles of treatment into their approaches, including dietary restriction, megadoses of non-vitamin nutrients and mainstream pharmaceutical drugs.[1][9] Proponents argue that non-optimal levels of certain substances can cause health issues beyond simple vitamin deficiency and see balancing these substances as an integral part of health.[10]\nAmerican chemist Linus Pauling coined the term \"orthomolecular\" in the 1960s to mean \"the right molecules in the right amounts\" (ortho- in Greek implies \"correct\").[11] Proponents of orthomolecular medicine hold that treatment must be based on each patient's individual biochemistry.[12][13]\nThe scientific and medical consensus holds that the broad claims of efficacy advanced by advocates of orthomolecular medicine are not adequately tested as drug therapies.[6] It has been described as a form of food faddism and as quackery.[14] Proponents point to mainstream sources that have published research supporting the benefits of nutrient supplementation[15][16] and to instances where conventional medicine uses vitamins as treatments for some diseases.\nSome vitamins in large doses have been linked to increased risk of cardiovascular disease, cancer and death.[17][18][19] The scientific consensus view is that for normal individuals, a balanced diet contains all necessary vitamins and minerals and that routine supplementation is not necessary outside of specific diagnosed deficiencies.[20]\n\n\n\nHistory and development[edit]\nIn the early 20th century, some doctors hypothesised that vitamins could cure disease, and supplements were prescribed in megadoses by the 1930s.[21] Their effects on health were disappointing, though, and in the 1950s and 1960s, nutrition was de-emphasised in standard medical curricula.[21] Riordon's organization cite figures from this period as founders of their movement,[22] although the word \"orthomolecular\" was coined by Linus Pauling only in 1967.\nAmongst the individuals described posthumously as orthomolecularists are Max Gerson, who developed a diet that he claimed could treat diseases, which the American Medical Association's 1949 Council on Pharmacy and Chemistry found ineffective;[23] and the Shute brothers, who attempted to treat heart disease with vitamin E.[24] Several concepts now cited by orthomolecularists, including individual biochemical variation[13] and inborn errors of metabolism,[21][25][26] debuted in scientific papers early in the 20th century.\nIn 1948, William McCormick theorized that vitamin C deficiency played an important role in many diseases and began to use large doses in patients.[27] In the 1950s, Fred R. Klenner also tried vitamin C megadosage as a therapy for a wide range of illnesses, including polio.[28] Irwin Stone stated that organisms that do not synthesise their own vitamin C due to a loss-of-function mutation have a disease he called \"hypoascorbemia\".[29] This term is not used by the medical community, and the idea of an organism-wide lack of a biosynthetic pathway as a disease was not endorsed by Stone's contemporaries.[30]\nIn the 1950s, some individuals believed that vitamin deficiencies caused mental illness.[21] Psychiatrists Humphry Osmond and Abram Hoffer gave people having acute schizophrenic episodes high doses of niacin,[31] while William Kaufman used niacinamide. While niacin has no known efficacy in psychiatric disease, the use of niacin in combination with statins and other medical therapies has become one of several medical treatments for cardiovascular disease.[32][33]\nIn the late 1960s, Linus Pauling introduced the expression \"orthomolecular\"[11] to express the idea of the right molecules in the right amounts.[11] Since the first claims of medical breakthroughs with vitamin C by Pauling and others, findings on the health effects of vitamin C have been controversial and contradictory.[34][35] Pauling's claims have been criticised as overbroad.[36]\nLater research branched out into nutrients besides niacin and vitamin C, including essential fatty acids.[37]\n\nScope[edit]\nAccording to Abram Hoffer, orthomolecular medicine does not purport to treat all diseases, nor is it \"a replacement for standard treatment. A proportion of patients will require orthodox treatment, a proportion will do much better on orthomolecular treatment, and the rest will need a skillful blend of both.\"[38] Nevertheless, advocates have said that the right nutrients at the optimum dose for the individual concerned can prevent,[39] treat, and sometimes cure a wide range of medical conditions. Conditions for which orthomolecular practitioners have claimed some efficacy are: acne,[40] alcoholism,[41] allergies, arthritis, autism, bee stings, bipolar disorder, burns, cancer,[42][43] the common cold, depression, drug addiction, drug overdose, epilepsy, heart diseases, heavy metal toxicity, acute hepatitis, herpes, hyperactivity, hypertension, hypoglycemia, influenza, learning disabilities, mental and metabolic disorders,[44] migraine, mononucleosis, mushroom poisoning, neuropathy & polyneuritis (including multiple sclerosis), osteoporosis,[45] polio, a hypothesised condition called \"pyroluria\", radiation sickness, Raynaud's disease, mental retardation, schizophrenia,[4] shock, skin problems, snakebite, spider bite, tetanus toxin and viral pneumonia.[46]\n\nOrthomolecular psychiatry[edit]\n\nHoffer believed that particular nutrients could cure mental illness. In the 1950s, he attempted to treat schizophrenia with niacin, although proponents of orthomolecular psychiatry say that the ideas behind their approach predate Hoffer.[47][48] According to Hoffer and others who called themselves \"orthomolecular psychiatrists\", psychiatric syndromes result from biochemical deficiencies, allergies, toxicities or several hypothetical contributing conditions which they termed pyroluria, histadelia and histapenia. These purported causes were said to be found during an \"individual biochemical workup\" and treated with megavitamin therapy and dietary changes including fasting.[49] These diagnoses and treatments are not accepted by evidence-based medicine.[50]\n\nPrinciples[edit]\nAccording to Abram Hoffer, \"primitive\" peoples do not consume processed foods and do not have \"degenerative\" diseases.[51] In contrast, typical \"Western\" diets are said to be insufficient for long-term health, necessitating the use of megadose supplements of vitamins, dietary minerals, proteins, antioxidants, amino acids, ω-3 fatty acids, ω-6 fatty acids, medium-chain triglycerides, dietary fiber, short and long chain fatty acids, lipotropes, systemic and digestive enzymes, other digestive factors, and prohormones to ward off hypothetical metabolism anomalies at an early stage, before they cause disease.[38]\nOrthomolecularists say that they provide prescriptions for optimal amounts of micronutrients after individual diagnoses based on blood tests and personal histories.[3][12] Lifestyle and diet changes may also be recommended. The battery of tests ordered includes many that are not considered useful by medicine.[50]\n\nPrevalence[edit]\nOrthomolecular medicine is practiced by few medical practitioners.[52][53]\nA survey released in May, 2004 by the National Center for Complementary and Alternative Medicine focused on who used alternative medicine, what was used, and why it was used in the United States by adults age 18 years and over during 2003. The survey reported uses in the previous twelve months that include orthomolecular related uses: Nonvitamin, nonmineral, natural products 18.9%, Diet-based therapies 3.5%, Megavitamin therapy 2.8%.[54]\nAnother recent CAM survey reported that 12% of liver disease patients used the antioxidant silymarin, more than 6% used vitamins, and that \"in all, 74% of patients reported using CAM in addition to the medications prescribed by their physician, but 26% did not inform their physician of their CAM use.\"[55]\nEven though the health benefits are not established, the use of high doses of vitamins is also common in people who have been diagnosed with cancer.[56] According to Cancer Research UK, cancer patients should always seek professional advice before taking such supplements, and using them as a substitute for conventional treatment \"could be harmful to [their] health and greatly reduce the chance of curing or controlling [their] cancer\".[57]\n\nMedical and scientific reception[edit]\nMethodology[edit]\nOrthomolecular therapies have been criticized as lacking a sufficient evidence base for clinical use: their scientific foundations are too weak, the studies that have been performed are too few and too open to interpretation, and reported positive findings in observational studies are contradicted by the results of more rigorous clinical trials.[52][58] Accordingly, \"there is no evidence that orthomolecular medicine is effective\". Proponents of orthomolecular medicine strongly dispute this statement by citing studies demonstrating the effectiveness of treatments involving vitamins, though this ignores the belief that a normal diet will provide adequate nutrients to avoid deficiencies, and that orthomolecular treatments are not actually related to vitamin deficiency.[10] The lack of scientifically rigorous testing of orthomolecular medicine has led to its practices being classed with other forms of alternative medicine and regarded as unscientific.[59][60][61] It has been described as food faddism and quackery, with critics arguing that it is based upon an \"exaggerated belief in the effects of nutrition upon health and disease.\"[62][63][64] Orthomolecular practitioners will often use dubious diagnostic methods to define what substances are \"correct\"; one example is hair analysis, which produces spurious results when used in this fashion.[10]\nProponents of orthomolecular medicine contend that, unlike some other forms of alternative medicine such as homeopathy, their ideas are at least biologically based, do not involve magical thinking,[65] and are capable of generating testable hypotheses.[66] Orthomolecular is not a standard medical term, and clinical use of specific nutrients is considered a form of chemoprevention (to prevent or delay development of disease) or chemotherapy (to treat an existing condition).[67]\nDespite a lack of evidence for its efficacy, interest in intravenous high dose vitamin C therapy has not been permanently extinguished, and some research groups continue to investigate whether it has an effect as a possible cancer treatment.[68][69]\n\nViews on safety and efficacy[edit]\nIn general, the vitamin megadoses advocated by orthomolecular medicine are unsupported by scientific consensus.[32] Some vitamins are toxic in high doses,[70] including niacin (B3),[71] cholecalciferol (D)[72] and tocopherol (E).[73] The view of the medical community is that there is no evidence for the efficacy of Orthomolecular medicine as a treatment for cancer,[6] and that high vitamin doses may – on the contrary – increase overall mortality.[74] Nutritional treatments are not generally accepted as being helpful for psychological health.[75] Its claims have been criticized by most medical organizations, including the American Cancer Society, the American Psychiatric Association, the National Institute of Mental Health,[50] the American Academy of Pediatrics,[76] CHAMPUS, and the Canadian Paediatric Society. The American Medical Association describes as \"myths\" the ideas that adequate nutrition is not readily achievable with normal food, all food grown with pesticide is poisonous, all food additives are poisonous, vitamin and mineral deficiencies are common, that the cause of most disease is poor diet, which can be prevented by nutritional supplements.\n[77]\nSimilarly, the American Cancer Society comments that the current scientific evidence does not \"support use of orthomolecular therapy for most of the conditions for which it is promoted.\" Some supplements have exhibited benefits for specific conditions, while a few have been confirmed to be harmful; the consumption of nutritious foods is the best recognized method to obtain vitamins, minerals, and nutrients crucial for good health.[32] Barrie Cassileth, an adviser on alternative medicine to the National Institutes of Health, stated that \"scientific research has found no benefit from orthomolecular therapy for any disease,\"[52] and medical textbooks also report that there is \"no evidence that megavitamin or orthomolecular therapy is effective in treating any disease.\"[78]\nA 1973 task force of the American Psychiatric Association unanimously concluded:\n\nThis review and critique has carefully examined the literature produced by megavitamin proponents and by those who have attempted to replicate their basic and clinical work. It concludes in this regard that the credibility of the megavitamin proponents is low. Their credibility is further diminished by a consistent refusal over the past decade to perform controlled experiments and to report their new results in a scientifically acceptable fashion. Under these circumstances this Task Force considers the massive publicity which they promulgate via radio, the lay press and popular books, using catch phrases which are really misnomers like \"megavitamin therapy\" and \"orthomolecular treatment,\" to be deplorable.[79]\nIn response to claims that orthomolecular medicine could cure childhood psychoses and learning disorders, the American Academy of Pediatrics labelled orthomolecular medicine a \"cult\" in 1976.[80]\nProponents of orthomolecular medicine counter that some vitamins and nutrients are now used in medicine as treatments for specific diseases, such as megadose niacin and fish oil for dyslipidemias, and megavitamin therapies for a group of rare inborn errors of metabolism.[21] A review in the Annals of Internal Medicine concluded that while some therapies might be beneficial, others might be harmful or interfere with effective medical therapy.[81] A recent study of over 161,000 individuals provided, in the words of the authors, \"convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease, or total mortality in postmenopausal women.\"[82] A recent meta-analysis in JAMA suggested that supplementation with combinations of antioxidant vitamins (beta-carotene, vitamin A, and vitamin E) may increase mortality, although with respect to beta-carotene this conclusion may be due to the known harmful effect in smokers.[83]\n\nSafety[edit]\nIn the United States, pharmaceuticals must be proven safe and effective to the satisfaction of the FDA before they can be marketed, whereas dietary supplements must be proven unsafe before regulatory action can be taken.[84] A number of orthomolecular supplements are available in the US in pharmaceutical versions that are sometimes quite similar in strength and general content, or in other countries are regulated as pharmaceuticals. The US regulations also have provisions to recognize a general level of safety for established nutrients that can forgo new drug safety tests. Proponents of orthomolecular medicine argue that supplements are less likely to cause dangerous side-effects or harm, since they are normally present in the body.[5] Some vitamins are toxic in high doses[70] and nearly all (with the possible exception of Vitamin C[85]) will cause adverse effects given high levels of overdosing for prolonged periods as recommended by orthomolecular practitioners.[10] Forgoing medical care in favor of orthomolecular treatments can lead to adverse health outcomes.[6]\nHealth professionals see orthomolecular medicine as encouraging individuals to dose themselves with large amounts of vitamins and other nutrients without conventional supervision, which they worry might be damaging to health. Potential risks[86] of inappropriate vitamin and supplement regimes include an increased risk of coronary heart disease,[87] hypertension, thrombophlebitis, peripheral neuropathy, ataxia, neurological effects, liver toxicity, congenital abnormalities, spontaneous abortion, gouty arthritis, jaundice, kidney stones, and diarrhea.[7][17][88][89][90][91][92] In their book Trick or Treatment?, Edzard Ernst and Simon Singh conclude that \"The concepts of orthomolecular medicine are not biologically plausible and not supported by the results of rigorous clinical trials. These problems are compounded by the fact that orthomolecular medicine can cause harm and is often very expensive.\"[10]\n\nExample: vitamin E[edit]\nOrthomolecular proponents claim that even large doses of vitamin E pose no risk to health and are useful for the treatment and prevention of a broad list of conditions, including heart and circulatory diseases, diabetes and nephritis.[93] Initial hopes for the usefulness of vitamin E in orthomolecular medicine were based on epidemiological studies suggesting that people who consumed more vitamin E had lower risks of chronic disease, such as coronary heart disease.[94] These observational studies could not distinguish between whether the higher levels of vitamin E improved health themselves, or whether confounding variables (such as other dietary factors or exercise) were responsible.[95][96] To distinguish between these possibilities, a number of randomized controlled trials were performed and meta-analysis of these controlled clinical trials have not shown any clear benefit from any form of vitamin E supplementation for preventing chronic disease.[97][98][99][100] Further clinical studies show no benefit of vitamin E supplements for cardiovascular disease.[101] The current position of the American National Institutes of Health is that there is no convincing evidence that vitamin E supplements can prevent or treat any disease.[102]\nBeyond the lack of apparent benefit, a series of three meta-analyses reported that vitamin E supplementation is associated with an increased risk of death; one of the meta-analyses performed by the Cochrane Collaboration also found significantly increased mortality for the antioxidant vitamins A and beta-carotene.[103][104][105] A subsequent meta-analysis found no mortality benefit from vitamin E, but also no increase in mortality either.[106]\n\nUse in AIDS[edit]\nSeveral articles in the alternative-medicine literature have suggested that orthomolecular-related dietary supplementation might be helpful for patients with HIV/AIDS.[107][108] \nA study using 250 mg and 1000 mg doses of vitamin C along with other antioxidants to treat people with AIDS did not find any benefit.[109]\nA meta analysis in 2010 found that micronutrient supplementation decreased the risk of death and improved outcomes in pregnant women with HIV in Africa.[110] A 2017 Cochrane review found no strong evidence to suggest that micronutrient supplementation prevents death or is effective at slowing the progression of disease for adults with HIV.[111] It is important for people living HIV to eat a healthy adequate diet.[111] For people with HIV that have clinically demonstrated deficiencies in micronutrients or for people who are not able to consume the recommended daily quantities of minerals and vitamins, supplementation is still encouraged.[111] Vitamin A in children with HIV appears to be safe and beneficial.[112] Vitamin A deficiency is found in children with HIV infection who may or may not have symptoms of AIDS. Vitamin A supplementation reduces morbidity and mortality in AIDS symptomatic children, but has no effect on asymptomatic children. It does not prevent HIV infection, cannot treat the chronic HIV infection, and will not cure AIDS.[113][114]\n\nDeaths resulting from illegal vitamin trials in South Africa[edit]\n\nMatthias Rath has been extensively criticized for presenting his vitamin supplements as a treatment for AIDS and for testing them in illegal trials in South Africa.[115][116] A former associate of Linus Pauling, Rath has promoted vitamins as a treatment for HIV infection, describing treatment with effective antiretroviral drugs as toxic and part of a global conspiracy serving the financial interests of the pharmaceutical industry.[117] In a lawsuit that found against Rath, the South African Medical Association blamed his vitamin products for several deaths.[116][118][119] The World Health Organization and two health agencies of the United Nations also described Rath’s advertisements as “wrong and misleading” and “an irresponsible attack on ARV (antiretroviral) therapy.”[120] The South African Centre for Social Science Research described the trials as \"state sponsored pseudo-science\".[121] Rath's trials, conducted with the aid of AIDS denialist David Rasnick, were declared unlawful by the Cape High Court; Rath, Rasnick and their foundation were barred from conducting further unauthorised clinical trials and from advertising their products.[122]\n\nAlleged institutional bias[edit]\nAdvocates of orthomolecular medicine, including Pauling, Hoffer and Ewan Cameron have claimed that their findings are actively suppressed by the medical and pharmaceutical industry. Hoffer wrote \"There is no conspiracy led and directed by a single person or by a single organization. There is no Mafia in psychiatry. However, there is a conspiracy led and directed by a large number of professionals and their associations who have a common aim to protect their hard-earned orthodoxy, no matter what the cost to their opponent colleagues or to their patients.\".[123][124]\nThe Journal of Orthomolecular Medicine, founded in 1967 as the Journal of Schizophrenia, is a major publication of orthomolecular medicine. As Abram Hoffer wrote:\n\nWe had to create our own journals because it was impossible to obtain entry into the official journals of psychiatry and medicine. Before 1967 I had not found it difficult to publish reports in these journals, and by then I had about 150 articles and several books in the establishment press.[125]\nOther members of the medical community deny the existence of such an institutional prejudice.[126][127] A review in the Journal of Clinical Oncology denied that physicians collude against unconventional treatments.[128] Claims of conspiracy were limited to the now defunct Linus Pauling Institute of Science and Medicine. In its current iteration, the Linus Pauling Institute derives a significant amount of funding from the National Institutes of Health and other federal sources.[129] Some orthomolecular therapies were reported as being sanctioned in Japan.[130]\n\nSee also[edit]\n\nCitations[edit]\n\n\n^ Jump up to: a b c Saul AW; Hoffer A (2008). Orthomolecular Medicine For Everyone: Megavitamin Therapeutics for Families and Physicians. Laguna Beach, California: Basic Health Publications. ISBN 978-1-59120-226-4. OCLC 232131968. OL 16944688M.\n\n^ Jump up to: a b McMichael AJ (January 1981). \"Orthomolecular medicine and megavitamin therapy\". Med. J. Aust. 1 (1): 6–8. doi:10.5694/j.1326-5377.1981.tb135275.x. PMID 7207301.\n\n^ Jump up to: a b Hoffer A, Walker M (2000). Smart Nutrients. Avery. ISBN 978-0-89529-562-0.\n\n^ Jump up to: a b \nSkinner Patricia (2004). \"Gale encyclopedia of alternative medicine: holistic medicine\". Thomson Gale.\n\n^ Jump up to: a b \"Orthomolecular medicine\". orthomed.org. Retrieved August 2013. [verification needed]\n\n^ Jump up to: a b c d \nAaronson S, et al. (2003). \"Cancer medicine\". In Frei Emil, Kufe Donald W, Holland James F (eds.). Cancer medicine 6. Hamilton, Ontario: BC Decker. p. 76. ISBN 978-1-55009-213-4. There is no evidence that megavitamin or orthomolecular therapy is effective in treating any disease.\n\n^ Jump up to: a b \n\"NIH state-of-the-science conference statement on multivitamin/mineral supplements and chronic disease prevention\". NIH Consens State Sci Statements. 23 (2): 1–30. 2006. PMID 17332802.\n\n^ \nLipton M, et al. (1973). \"Task Force Report on Megavitamin and Orthomolecular Therapy in Psychiatry\". American Psychiatric Association. \n\n^ Braverman Eric (1979). \"Orthomolecular Medicine and Megavitamin Therapy: Future and Philosophy\" (PDF). Journal of Orthomolecular Medicine. 8 (4): 265.\n\n^ Jump up to: a b c d e Singh, S; Ernst, Edzard (2008). Trick or Treatment: The Undeniable Facts About Alternative Medicine. Norton. p. 320. ISBN 978-0-393-06661-6.\n\n^ Jump up to: a b c \nPauling L (April 1968). \"Orthomolecular psychiatry. Varying the concentrations of substances normally present in the human body may control mental disease\". Science. 160 (3825): 265–71. Bibcode:1968Sci...160..265P. doi:10.1126/science.160.3825.265. PMID 5641253.\n\n^ Jump up to: a b Baumel Syd (August 2000). Dealing with depression naturally : complementary and alternative therapies for restoring emotional health (2nd ed.). Los Angeles: McGraw-Hill. ISBN 978-0-658-00291-5. OCLC 43641423.\n\n^ Jump up to: a b Williams RJ (1998). Biochemical individuality: the basis for the genetotrophic concept (2 ed.). New Canaan, Connecticut: Keats. ISBN 978-0-87983-893-5. OCLC 38239195.\n\n^ Jarvis WT (1983). \"Food faddism, cultism, and quackery\". Annu. Rev. Nutr. 3: 35–52. doi:10.1146/annurev.nu.03.070183.000343. PMID 6315036.\n\n^ Research Newsletter-Fall/Winter 2009 Archived 2013-04-11 at the Wayback Machine. Linus Pauling Institute. Cites research by Gesch summarized in Science magazine's The Theory? Diet Causes Violence. The Lab? Prison.\n\n^ Gesch CB, et al. (2002). \"Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. Randomised, placebo-controlled trial\". The British Journal of Psychiatry : The Journal of Mental Science. 181: 22–28. doi:10.1192/bjp.181.1.22. PMID 12091259.\n\n^ Jump up to: a b Satia JA, Littman A, Slatore CG, Galanko JA, White E (April 2009). \"Long-term Use of β-Carotene, Retinol, Lycopene, and Lutein Supplements and Lung Cancer Risk: Results From the VITamins And Lifestyle (VITAL) Study\". Am. J. Epidemiol. 169 (7): 815–28. doi:10.1093/aje/kwn409. PMC 2842198. PMID 19208726.[unreliable medical source?]\n\n^ Brody, Jane (March 23, 2009). \"Extra Vitamin E: No Benefit, Maybe Harm\". New York Times. Retrieved March 24, 2009.\n\n^ \"High dose vitamin E death warning\". BBC. November 11, 2004. Retrieved March 24, 2009.\n\n^ \nDuff, Roberta Larson: American Dietetic Association Complete Food and Nutrition Guide, ISBN 0470912073\n\n^ Jump up to: a b c d e \nMenolascino FJ, Donaldson JY, Gallagher TF, Golden CJ, Wilson JE (1988). \"Orthomolecular therapy: its history and applicability to psychiatric disorders\". Child Psychiatry Hum Dev. 18 (3): 133–50. doi:10.1007/BF00709727. PMID 2898324.\n\n^ \n\"History of orthomolecular medicine\". riordonclinic.org. Retrieved 26 August 2013.\n\n^ \nAMA Council on Pharmacy and Chemistry (January 8, 1949). \"Report of the council: cancer and the need for facts\". JAMA. 139 (2): 93–98. doi:10.1001/jama.1949.02900190023007.\n\n^ \n\"Evan Shute & Wilfrid Shute\". Hall of Fame. Riordonclinic.org. Retrieved 2013-08-26.\n\n^ Mason SF (1997). \"The science and humanism of Linus Pauling (1901–1994)\". Chemical Society Reviews. 26 (1): 29–39. doi:10.1039/cs9972600029. Archived from the original on 2009-05-15. Retrieved 2009-02-16.\n\n^ \nMagner Lois N (2005). A history of medicine (Second ed.). Washington, DC: Taylor & Francis. ISBN 978-0-8247-4074-0. OCLC 142979953.\n\n^ \nMcCormick WJ (January 1951). \"Vitamin C in the prophylaxis and therapy of infectious diseases\". Arch Pediatr. 68 (1): 1–9. PMID 14800557.\n\n^ \nSaul AW (2007). \"Hidden in plain sight: the pioneering work of Frederick Robert Klenner, M.D\". 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Current Opinion in Lipidology. 18 (4): 415–20. doi:10.1097/MOL.0b013e3282364add. PMID 17620858.\n\n^ \nChen Q, Espey MG, Sun AY, et al. (August 2008). \"Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice\". Proceedings of the National Academy of Sciences of the United States of America. 105 (32): 11105–11109. Bibcode:2008PNAS..10511105C. doi:10.1073/pnas.0804226105. PMC 2516281. PMID 18678913.\n\n^ \nHeaney ML, Gardner JR, Karasavvas N, et al. (October 2008). \"Vitamin C antagonizes the cytotoxic effects of antineoplastic drugs\". Cancer Research. 68 (19): 8031–8. doi:10.1158/0008-5472.CAN-08-1490. PMC 3695824. PMID 18829561. Lay summary – New York Times (2008-10-01).\n\n^ \nBarrett, SJ (2001-05-05). \"The dark side of Linus Pauling's legacy\". Quackwatch. Retrieved 2008-04-04.\n\n^ \nKidd PM (September 2007). \"Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids\". Alternative Medicine Review. 12 (3): 207–27. PMID 18072818.\n\n^ Jump up to: a b \nHuemer RP (August 1977). \"A theory of diagnosis for orthomolecular medicine\". J Theor Biol. 67 (4): 625–35. doi:10.1016/0022-5193(77)90250-8. PMID 904336.\n\n^ Moyad Mark A (September 24, 2007). \"Clinical data shows vitamin C may reduce risks of cancer, heart disease and variety of other health disorders\". Genetic Engineering & Biotechnology News (reporting on seminars in preventive and alternative medicine ed.). 3 (1): 25–35. Retrieved October 2007. \n\n^ \nLeung Lit-Hung (1997). \"A stone that kills two birds: how pantothenic acid unveils the mysteries of acne vulgaris and obesity\". J Orthomol Med. 12 (2): 99–114. ISSN 0834-4825. OCLC 15726974.\n\n^ \nFrancis Hartigan (2000). Bill W. : a biography of Alcoholics Anonymous cofounder Bill Wilson. New York: Thomas Dunne Books. pp. 204–209. ISBN 978-0-312-20056-5. OCLC 42772358.\n\n^ \nCameron Ewan; Pauling Linus (1976). \"Supplemental ascorbate in the supportive treatment of cancer: Prolongation of survival times in terminal human cancer\". Proceedings of the National Academy of Sciences. 73 (10): 3685–9. Bibcode:1976PNAS...73.3685C. doi:10.1073/pnas.73.10.3685. PMC 431183. PMID 1068480. (self published)\n\n^ \nCameron Ewan; Pauling Linus (1979). Cancer and vitamin C : a discussion of the nature, causes, prevention, and treatment of cancer with special reference to the value of vitamin C. New York: Norton. ISBN 978-0-393-50000-4. OCLC 5788147.\n\n^ Princeton Brain Bio Center. Brochure, distributed to patients. Skillman, New Jersey, 1983, The Center.\n\n^ \nPlaza, S. M.; Lamson, D. W. (2005). \"Vitamin K2 in bone metabolism and osteoporosis\". Alternative Medicine Review. 10 (1): 24–35. PMID 15771560.\n\n^ \nKlenner FR (1971). \"Observations on the dose and administration of ascorbic acid when employed beyond the range of a vitamin in human pathology\". J Appl Nutr. 23: 61–88. as reprinted with edits in Hoffer A, ed. (1998). \"Observations on the dose and administration of ascorbic acid when employed beyond the range of a vitamin in human pathology\" (PDF). J Orthomol Med. 13 (4): 198–210. ISSN 0834-4825. OCLC 15726974. (self published)\n\n^ \nReiter, PJ (1927). \"Behandlung von Dementia Praecox mit metallsalzen. Mangan. Z\". Neur. 108: 464–80. doi:10.1007/bf02863975. as cited in Pfeiffer, C; LaMola, S (1983). \"Zinc and Manganese in the Schizophrenias\". Journal of Orthomolecular Psychiatry. 12 (3).\n\n^ \nKay Lily E (1993). The molecular vision of life: Caltech, the Rockefeller Foundation, and the rise of the new biology. Oxford: Oxford University Press. ISBN 978-0-19-511143-9.\n\n^ \nEdelman Eva (2001). 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(September 2002). \"Use of complementary and alternative medicine in patients with liver disease\". Am J Gastroenterol. 97 (9): 2391–7. doi:10.1111/j.1572-0241.2002.05993.x. PMID 12358262.\n\n^ \nVelicer CM, Ulrich CM (2008). \"Vitamin and mineral supplement use among US adults after cancer diagnosis: a systematic review\". J Clin Oncol. 26 (4): 665–73. doi:10.1200/JCO.2007.13.5905. PMID 18235127.\n\n^ \"The safety of vitamins and diet supplements\". Cancer Research UK. Retrieved August 2013. \n\n^ \n\"Vitamin C for SARS?\". Canadian Statistical Assessment Service. June 12, 2003. Archived from the original on September 25, 2005.\n\n^ \nLeibovici L (1999). \"Alternative (complementary) medicine: a cuckoo in the nest of empiricist reed warblers\". BMJ. 319 (7225): 1629–32. doi:10.1136/bmj.319.7225.1629. PMC 1127092. PMID 10600974.\n\n^ \nSampson W, Atwood K (2005). \"Propagation of the Absurd: demarcation of the Absurd revisited\" (PDF). Med J Aust. 183 (11–12): 580–1. doi:10.5694/j.1326-5377.2005.tb00040.x. PMID 16336135.\n\n^ \nTask Force on Complementary; Alternative Medicine; Burch T; et al. (2000). \"Report on complementary and alternative medicine\" (PDF). Frankfort, Kentucky: Legislative Research Commission.\n\n^ \nJarvis WT (1983). \"Food faddism, cultism, and quackery\". Annu Rev Nutr. 3 (1): 35–52. doi:10.1146/annurev.nu.03.070183.000343. PMID 6315036.\n\n^ \nJukes TH (1990). \"Nutrition science from vitamins to molecular biology\". Annual Review of Nutrition. 10 (1): 1–20. doi:10.1146/annurev.nu.10.070190.000245. PMID 2200458. A short summary is in the journal's preface.\n\n^ \nBraganza SF; Ozuah PO (2005). \"Fad therapies\". Pediatrics in Review. 26 (10): 371–376. doi:10.1542/pir.26-10-371. PMID 16199591.\n\n^ \nLindeman M, Keskivaara P, Roschier M (April 1, 2000). \"Assessment of magical beliefs about food and health\". Journal of Health Psychology. 5 (2): 195–209. doi:10.1177/135910530000500210. PMID 22049010.\n\n^ \nJonas WB (1999). \"Magic and methodology: when paradigms clash\". The Journal of Alternative and Complementary Medicine. 5 (4): 319–21. doi:10.1089/acm.1999.5.319. PMID 10471010.\n\n^ \nMartínez ME, Marshall JR, Giovannucci E (2008). \"Diet and cancer prevention: the roles of observation and experimentation\". Nature Reviews Cancer. 8 (9): 694–703. doi:10.1038/nrc2441. PMID 19143054.\n\n^ Ohno, S; Ohno, Y; Suzuki, N; Soma, G; Inoue, M (2009). \"High-dose vitamin C (ascorbic acid) therapy in the treatment of patients with advanced cancer\". Anticancer Research. 29 (3): 809–15. PMID 19414313.\n\n^ Levine, M.; Padayatty, S. J.; Espey, M. G. (2011). \"Vitamin C: A Concentration-Function Approach Yields Pharmacology and Therapeutic Discoveries\". Advances in Nutrition. 2 (2): 78–88. doi:10.3945/an.110.000109. ISSN 2156-5376. PMC 3065766. PMID 22332036.\n\n^ Jump up to: a b \nNutrition Committee; Canadian Paediatric Society (January 1, 1990). \"Megavitamin and megamineral therapy in childhood. Nutrition Committee, Canadian Paediatric Society\". CMAJ. 143 (10): 1009–13. PMC 1452516. PMID 1699646.\n\n^ National Library of Medicine (March 2009). \"Niacin\". MedlinePlus Encyclopedia. National Library of Medicine. Retrieved 2010-04-28. Large doses of niacin can cause liver damage, peptic ulcers, and skin rashes. Even normal doses can be associated with skin flushing. It can be prescribed as a treatment for elevated total cholesterol and other types of lipid disorders, but it should only be used with medical supervision due to its potential for severe side effects.\n\n^ National Library of Medicine (March 2009). \"Vitamin D\". MedlinePlus Encyclopedia. National Library of Medicine. Retrieved 2010-04-28. Vitamin D deficiency can lead to osteoporosis in adults or rickets in children. Too much vitamin D can make the intestines absorb too much calcium. This may cause high levels of calcium in the blood. High blood calcium can lead to calcium deposits in soft tissues such as the heart and lungs. This can reduce their ability to function. Kidney stones, vomiting, and muscle weakness may also occur in someone who has too much vitamin D.\n\n^ National Library of Medicine (March 2009). \"Vitamin E\". MedlinePlus Encyclopedia. National Library of Medicine. Retrieved 2010-04-28. In November, 2004, the American Heart Association stated that high amounts of vitamin E can be harmful. Taking 400 IU per day, or higher, may increase the risk of death. Taking smaller amounts, such as those found in a typical multivitamin, was not harmful.\n\n^ Bjelakovic, G; Nikolova, D; Simonetti, RG; Gluud, C (16 July 2008). \"Antioxidant supplements for preventing gastrointestinal cancers\". The Cochrane Database of Systematic Reviews (3): CD004183. doi:10.1002/14651858.CD004183.pub3. PMID 18677777.\n\n^ \nMiller M (1996). \"Diet and psychological health\". Altern Ther Health Med. 2 (5): 40–8. PMID 8795935.\n\n^ \nBennett, Forrest C (November 1983). \"Vitamin and mineral supplementation in Down's syndrome\". Pediatrics. 72 (5): 707–713.\n\n^ \nCouncil on Scientific Affairs (June 1997). \"Report 12: Alternative medicine\". American Medical Association. Retrieved 2009-02-18.\n\n^ \nFrei Emil; Kufe Donald W; Holland James F (2003). \"20.76. Complementary and alternative cancer therapies\". Cancer medicine 6. Hamilton, Ontario: BC Decker. p. 76. ISBN 978-1-55009-213-4. Retrieved 2008-04-04.\n\n^ \nLipton M, et al. (1973). Task force report on megavitamin and orthomolecular therapy in psychiatry. Washington DC: American Psychiatric Association.; as cited in Barrett, Stephen (2000-07-12). \"Orthomolecular Therapy\". Quackwatch. Retrieved 2008-01-02.\n\n^ \nAmerican Academy of Pediatrics Committee on Nutrition (1976). \"Megavitamin therapy for childhood psychoses and learning disabilities\". Pediatrics. 58 (6): 910–2. PMID 995522.\n\n^ \nEisenberg DM, Cohen MH, Hrbek A, Grayzel J, Van Rompay MI, Cooper RA (December 2002). \"Credentialing complementary and alternative medical providers\". Ann Intern Med. 137 (12): 965–73. doi:10.7326/0003-4819-137-12-200212170-00010. PMID 12484712.\n\n^ \nNeuhouser ML, Wassertheil-Smoller S, Thomson C, et al. (February 2009). \"Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts\". Arch Intern Med. 169 (3): 294–304. doi:10.1001/archinternmed.2008.540. PMC 3868488. PMID 19204221.\n\n^ \nBjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C (2007). \"Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis\". 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PMID 10513271.\n\n^ \"Vitamin E: Safe, Effective, and Heart-Healthy\". Orthomolecular Medicine News Service. 2005-03-23.\n\n^ \nTraber MG (November 2006). \"How much vitamin E?... Just enough!\". Am J Clin Nutr. 84 (5): 959–60. doi:10.1093/ajcn/84.5.959. PMID 17093143.\n\n^ \nGaziano JM (December 2004). \"Vitamin E and cardiovascular disease: observational studies\". Ann N Y Acad Sci. 1031 (1): 280–91. Bibcode:2004NYASA1031..280G. doi:10.1196/annals.1331.028. PMID 15753154.\n\n^ \nHemilä H, Miller ER (July 1, 2007). \"Evidence-based medicine and vitamin E supplementation\". Am J Clin Nutr. 86 (1): 261–2, author reply 262–4. doi:10.1093/ajcn/86.1.261. PMID 17616790.\n\n^ \nVivekananthan DP, Penn MS, Sapp SK, Hsu A, Topol EJ (2003). \"Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomised trials\". The Lancet. 361 (9374): 2017–23. doi:10.1016/S0140-6736(03)13637-9. PMID 12814711.\n\n^ \nStocker R (2007). Vitamin E. Novartis Found Symp. Novartis Foundation Symposia. 282. pp. 77–87, discussion 87–92, 212–8. doi:10.1002/9780470319444.ch6. ISBN 978-0-470-31944-4. PMID 17913225.\n\n^ \nCherubini A, Vigna GB, Zuliani G, Ruggiero C, Senin U, Fellin R (2005). \"Role of antioxidants in atherosclerosis: epidemiological and clinical update\". Curr Pharm Des. 11 (16): 2017–32. doi:10.2174/1381612054065783. PMID 15974956.\n\n^ \nKline K, Lawson KA, Yu W, Sanders BG (2007). Vitamin E and cancer. Vitam Horm. Vitamins & Hormones. 76. pp. 435–61. doi:10.1016/S0083-6729(07)76017-X. ISBN 9780123735928. PMID 17628185.\n\n^ \nSesso HD, Buring JE, Christen WG, et al. (November 2008). \"Vitamins E and C in the Prevention of Cardiovascular Disease in Men: The Physicians' Health Study II Randomized Trial\". J Am Med Assoc. 300 (18): 2123–33. doi:10.1001/jama.2008.600. PMC 2586922. PMID 18997197.\n\n^ \"Vitamin E\". National Institutes of Health. 2009.\n\n^ Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C (2012). \"Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases\". Cochrane Database Syst Rev. 3 (3): CD007176. doi:10.1002/14651858.CD007176.pub2. hdl:10138/136201. PMID 22419320.\n\n^ Miller ER, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E (2005). \"Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality\". Ann Intern Med. 142 (1): 37–46. doi:10.7326/0003-4819-142-1-200501040-00110. PMID 15537682.\n\n^ Bjelakovic G, Nikolova D, Gluud L, Simonetti R, Gluud C (2007). \"Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis\". J Am Med Assoc. 297 (8): 842–57. doi:10.1001/jama.297.8.842. PMID 17327526.\n\n^ Abner, E. L.; Schmitt, F. A.; Mendiondo, M. S.; Marcum, J. L.; Kryscio, R. J. (2011). \"Vitamin E and all-cause mortality: A meta-analysis\". Current Aging Science. 4 (2): 158–170. doi:10.2174/1874609811104020158. PMC 4030744. PMID 21235492.\n\n^ Patrick Lyn (December 1999). \"Nutrients and HIV: part one -- beta carotene and selenium\" (PDF). Altern Med Rev. 4 (6): 403–13. PMID 10608913. Archived from the original (PDF) on 2008-10-06. Retrieved 2008-08-25.\n\n^ \nLichtenstein BS (1995). \"Nutrition and HIV\". STEP Perspect. 7 (1): 2–5. PMID 11362399.\n\n^ Batterham M, Gold J, Naidoo D, et al. (February 2001). \"A preliminary open label dose comparison using an antioxidant regimen to determine the effect on viral load and oxidative stress in men with HIV/AIDS\". Eur J Clin Nutr. 55 (2): 107–14. doi:10.1038/sj.ejcn.1601124. PMID 11305623.\n\n^ Irlam, JH; Visser, MM; Rollins, NN; Siegfried, N (8 December 2010). \"Micronutrient supplementation in children and adults with HIV infection\". The Cochrane Database of Systematic Reviews (12): CD003650. doi:10.1002/14651858.CD003650.pub3. PMID 21154354.\n\n^ Jump up to: a b c Visser, Marianne E.; Durao, Solange; Sinclair, David; Irlam, James H.; Siegfried, Nandi (2017). \"Micronutrient supplementation in adults with HIV infection\". The Cochrane Database of Systematic Reviews. 5: CD003650. doi:10.1002/14651858.CD003650.pub4. PMC 5458097. PMID 28518221.\n\n^ Irlam, James H.; Siegfried, Nandi; Visser, Marianne E.; Rollins, Nigel C. (2013-10-11). \"Micronutrient supplementation for children with HIV infection\". The Cochrane Database of Systematic Reviews (10): CD010666. doi:10.1002/14651858.CD010666. ISSN 1469-493X. PMID 24114375.\n\n^ \nGrotto I, Mimouni M, Gdalevich M, Mimouni D (March 2003). \"Vitamin A supplementation and childhood morbidity from diarrhea and respiratory infections: a meta-analysis\". J Pediatr. 142 (3): 297–304. doi:10.1067/mpd.2003.116. PMID 12640379.\n\n^ \nMehta Saurabh; Fawzi Wafaie (2007). Effects of vitamins, including vitamin A, on HIV/AIDS patients. Vitam Horm. Vitamins & Hormones. 75. pp. 355–83. doi:10.1016/S0083-6729(06)75013-0. ISBN 978-0-12-709875-3. PMID 17368322.\n\n^ Kapp C (November 2006). \"South Africans hope for a new era in HIV/AIDS policies\". Lancet. 368 (9549): 1759–60. doi:10.1016/S0140-6736(06)69717-1. PMID 17120343.\n\n^ Jump up to: a b Smith TC, Novella SP (August 2007). \"HIV Denial in the Internet Era\". PLoS Med. 4 (8): e256. doi:10.1371/journal.pmed.0040256. PMC 1949841. PMID 17713982.\n\n^ \nBoseley Sarah (May 14, 2005). \"Discredited doctor's 'cure' for Aids ignites life-and-death struggle in South Africa\". Manchester: The Guardian.*\"Apartheid a pharmaceutical plot - Rath\". Cape Town: Independent Online. May 10, 2007.\n\n^ \nWatson J (January 2006). \"Scientists, activists sue South Africa's AIDS 'denialists'\". Nat Med. 12 (1): 6. doi:10.1038/nm0106-6a. PMID 16397537.\n\n^ \n\"TAC hails ruling on Rath\". Cape Town: Independent Online. June 13, 2008.\n\n^ \nReed John (July 25, 2005). \"HIV fight focuses on ads\". Los Angeles Times.\n\n^ Geffen N (2005). \"Echoes of Lysenko: State-sponsored pseudo-science in South Africa\" (PDF). Social Dynamics. 31 (2): 183–210. doi:10.1080/02533950508628713. hdl:11427/19344.\n\n^ \n\"South African court bans AIDS vitamin trials\". Reuters. June 13, 2008. Retrieved June 20, 2008.\n\n^ \nHoffer A (1987). \"Is there a conspiracy?\" (PDF). J Orthomol Med. 2 (3): 158.\n\n^ \nThomas Hager (1995). Force of nature: the life of Linus Pauling. New York: Simon & Schuster. ISBN 978-0-684-80909-0.\n\n^ \nHoffer Abram. \"History\". J Orthomol Med. Archived from the original on 2007-11-01. (via archive.org) archived on November 1, 2007\n\n^ \nRazzouk N, Seitz V (2003). \"Marketing to the heart: a practical approach to dealing with health care quackery\" (PDF). Clinical Research and Regulatory Affairs. 20 (4): 469–478. doi:10.1081/CRP-120026128.\n\n^ \nWeitzman S (1998). \"Alternative nutritional cancer therapies\". Int J Cancer Suppl. 11: 69–72. doi:10.1002/(SICI)1097-0215(1998)78:11+<69::AID-IJC20>3.0.CO;2-7. PMID 9876483.\n\n^ \nGertz MA, Bauer BA (May 2003). \"Caring (really) for patients who use alternative therapies for cancer\". J Clin Oncol. 21 (9 Suppl): 125s–128s. doi:10.1200/JCO.2003.01.195. PMID 12743218.\n\n^ Frei, Balz (June 2006). \"From the Director\". LPI Research Newsletter (Spring 2006). Archived from the original on 2011-09-19. Retrieved 2006-09-21.\n\n^ Kaitin, K. I.; Brown, J. S. (1995). \"A Drug Lag Update\". Therapeutic Innovation & Regulatory Science. 29 (2): 361–373. doi:10.1177/009286159502900203.\n\n\nFurther reading[edit]\nHoffer Abram; with Pauling Linus (2004). Healing cancer : complementary vitamin & drug treatments. Toronto: Canadian College of Naturopathic Medicine. ISBN 978-1-897025-11-6. OCLC 56682217.\nBarrett Stephen (1980). The health robbers : how to protect your money and your life (Second ed.). Philadelphia: G. F. Stickley. p. 52. ISBN 978-0-89313-023-7. OCLC 6994138.\nCassileth Barrie R (1998). Alternative medicine handbook: the complete reference guide to alternative and complementary therapies. New York: W.W. Norton. ISBN 978-0-393-04566-6. OCLC 36727947.\nBender David A (2003). Nutritional biochemistry of the vitamins (Second ed.). Cambridge; New York: Cambridge University Press. p. 230. ISBN 978-0-521-80388-5. OCLC 50948594.\nGratzer Walter B (2005). Terrors of the table : the curious history of nutrition. Oxford; New York: Oxford University Press. pp. 210. ISBN 978-0-19-280661-1. OCLC 60837725.\nExternal links[edit]\nBiologically based practices: an overview, National Institute of Health National Center for Complementary and Alternative Medicine"],["topImageUrl",null],["error",null]]}]}],["createdAt","2020-01-29T04:28:20.064Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",3],["user",{"__iterable":"Map","data":[["id","j4S8C_xpwMw-S2qE1Jd4f6AwjPh8KqzGLPCQD1innQ2hucGeE"],["name","意志堅強的芎林維拉妮卡"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","The Tip of the Iceberg: Virologist David Ho (BS '74) Speaks About COVID-19"],["url","https://www.caltech.edu/about/news/tip-iceberg-virologist-david-ho-bs-74-speaks-about-covid-19?fbclid=IwAR1XVnPHq82gD97Y2Y06FkIFzAtNNfopnMgqa98fHAwX7WHzHGyBVbnZlIQ](https://www.caltech.edu/about/news/tip-iceberg-virologist-david-ho-bs-74-speaks-about-covid-19?fbclid=IwAR1XVnPHq82gD97Y2Y06FkIFzAtNNfopnMgqa98fHAwX7WHzHGyBVbnZlIQ))"],["summary","As of March 20, more than 8,700 people worldwide had died of COVID-19, the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Caltech trustee David Ho (BS '74) of the Aaron Diamond AIDS Research Center, Columbia University, says that this is just the tip of the iceberg. Ho, an expert on viral epidemics, has spent decades researching HIV/AIDS, having begun his career in Los Angeles, \"ground zero\" of the first outbreak, in the early 1980s. On March 18, Ho sat down with members of the Caltech community to discuss the novel coronavirus and the future of our society in the light of this global pandemic.Walk us through the spread of the virus in the United States. What does the country look like right now?Let me just give you a picture of what I see here in New York. About two weeks ago, we had our initial case, and now in New York City newly diagnosed confirmed cases are tripling every two days. In our New York Presbyterian Hospital, approximately 25 percent of the swab samples that are submitted for testing are positive. In the suburban communities outside of New York, approximately 10 percent of the swabs submitted are positive. So, the virus is everywhere. And in New York, we know that we are in the exponential growth phase of the epidemic.Looking back at what has transpired throughout the world, we saw the first wave hit China; the second wave hit South Korea, Italy, and Iran; and then, trailed by only about a week or so, France, Germany, Spain, and the U.S. We all know that China went through a period of great devastation. It has over 80,000 cases. Italy is rapidly catching up, with over 31,000 cases. We suspect that in the U.S. this will rapidly sweep from the coastal regions and it will hit middle America. It is already there, but we will see exponential growth very, very soon. Then of course we are all worried about what would happen when this epidemic strikes places like Africa and India where the health care system is less developed.Can you tell us about the pathology of the disease?COVID-19 typically causes fever and a dry cough. One may have aches in the body—the muscles—and if it's severe enough, there would be shortness of breath due to pneumonia.Gastrointestinal symptoms can occur and are an indication of more severe disease. It's not very common to have a runny nose or the sniffles, and a sore throat is not common either.The incubation period from exposure to onset of symptoms is between four and six days; and if you want to cover 95–98 percent of the cases it is between three and 10 days. It's pretty rare to have an incubation period outside of that range.What in particular makes this virus so dangerous?What is disturbing is that virus shedding, as detected in the mouth or nose, is very, very common and could be there prior to onset of symptoms. That's why transmission could occur from asymptomatic individuals. And virus shedding could continue for days up to three weeks after a person recovers. That is extremely worrisome for the spread of this virus. Furthermore, the stability of this virus is worrisome as well. If you put it in aerosol form and keep it in the air, the half-life is several hours; if you drop it on surfaces of copper or cardboard, it could survive about a day. But if it's on steel or plastic surfaces, you could still detect infectious virus after 72 hours, although the infectivity decreases with time.What do we know about the biology of the virus?The virus is highly related to another coronavirus called SARS coronavirus. That was another outbreak that occurred worldwide 17-18 years ago, and largely in China and Asia.The two viruses are about 80 percent identical. We know the origin of SARS was from a bat through an intermediary animal called the civet cat.Another virus called Middle Eastern Respiratory Virus, MERS, also originated in bats and infected camels, and camels passed it to humans. For COVID-19, we believe the original host must be a bat species, because that animal carries a virus that's 97 percent identical to what we're seeing now.Because of the SARS outbreak and the MERS outbreak, and research done on those two pathogens, we actually know quite a bit about coronaviruses.The outbreak began in China; how have they been dealing with the virus?This epidemic was first identified in a few cases with pneumonia in December 2019. In retrospect, there were scattered cases in November according to Chinese officials. I would say that initially there were missteps and lack of transparency that contributed to the explosive outbreak in the city of Wuhan in the central province of Hubei. That epidemic in central China accounts for 85 percent of the confirmed cases in China. It led Beijing officials to quarantine the entire province of 50 million people. The epidemic peaked in early February with 4,000 newly diagnosed cases each day. But since the lockdown and the various draconian measures applied, the number of new cases each day has been declining by half every week, and remarkably it's now down to about 20 per day. The rest of China's other provinces also applied very harsh measures and they indeed successfully flattened the curve outside of Hubei province.We know what they've done is not sustainable and the question is: What is China going to do now if it relaxes the infection control measures? Some of the recovered patients are still shedding virus and now China is surrounded by sick neighbors. Surely if they open up their borders, infection will come in the same way it came into the U.S. The world is waiting to see what China is going to do.Now in terms of the U.S., we obviously are undergoing exponential growth. The 10,400 confirmed cases is a gross underestimate. The lack of testing is embarrassing. It's an outright failure in leadership.What are the tests we need to detect coronavirus infection?Everybody's talking about testing and that's actually referring to PCR [polymerase chain reaction] testing, looking for viral RNA to determine whether a person is infected. But there's still no talk of antibody testing to determine which people have had it and are immune, and that is another crucial tool we need to combat this epidemic. Many research labs throughout the country—I'm sure at Caltech too—could be running antibody tests right now to survey the population and tell us what the real penetrance of this pathogen is in our communities. We are, on a research basis, embarking on that to understand the degree of infection in New York City and outside of New York City.How long before the U.S. sees test availability similar to what South Korea has implemented?The PCR testing, which is the one that's approved, is now ramping up very, very rapidly in state and local labs as well as in academic medical centers and in the commercial sector. Their production will grow tremendously. Roche has a machine that will run 1,000 samples at a time. If you go to a commercial lab, they take a swab, they package it, they quite often send it to another facility somewhere else. The turnaround time is typically 72 hours. In that period, it's very, very hard to manage patients and their contacts. It's a nightmare for the healthcare worker.We need point-of-care tests. Those kinds of tests are available for HIV and for many other diseases; you use a finger stick, drop the blood on a small device, and have a readout in 15 minutes. These tests measure antibody response to the virus and are extremely useful. Yet we don't have a single test licensed in the U.S. In China, in South Korea, and in Europe, those tests are used. The manufacturer for this rapid test is producing a million a day. It's there. But in the name of protecting the public, the FDA has moved very, very slowly. That delay, in my view, has caused more harm than good.Can you elaborate on point-of-care testing?It's almost like a home pregnancy test or home HIV test. These tests have been around for a long time. The test that I'm specifically referring to, coming out of China, South Korea, and approved in Europe, is an antibody test. You put a drop of blood on a plastic slide, add another drop of the buffer that comes with the test, and you let it sit for 15 minutes. Then, you look at the bands. You're negative if you have just one band, or you're positive if you have more than one band. The test also tells you type of antibody. There's a type of antibody called IgG [immunoglobulin G] and another type called IgM [immunoglobulin M]. Typically, when a person is infected, the IgM response is earlier and the IgG response is later. The two bands indicate the course of the infection.This kind of test is available all over the world for HIV. The technology is there, the tests are there. But they're not FDA approved. While I think they are fairly close to being approved, we have let several weeks go by and to me that's tragic.Will this coronavirus be seasonal?Everyone is asking whether this virus is here to stay. Initially, just based on what China did with SARS long ago, there was hope that warmer weather and more sunlight would help kill the virus in our environment and therefore lower the probability of transmission.But now this virus has gained such a strong foothold in the human population. It's already 25 times larger than SARS and it's already embedded in the Southern hemisphere. If you look at Australia, South Africa, Argentina, Brazil, there are cases there already, and community transmission is occurring. As the weather changes, perhaps the Northern hemisphere will gain an advantage. But the epidemic in the Southern hemisphere is going to accelerate.The long-term outcome may resemble influenza so that we have seasonal bouts, with the virus bouncing back and forth between the Northern and Southern hemispheres. This is of course just speculation, but that's what we see with influenza.Why does COVID-19 have less impact on children and more impact on the elderly?Well, the latter part is easy. Older people generally do less well with all sorts of respiratory infections, including influenza and SARS. So that's just the typical scenario we see. The children, however, are a mystery. As you know, children typically get flu or other respiratory viruses very quickly and bring them home to infect the parents. But in this particular case, the number of children infected in China, after extensive studies, don't seem to indicate that this is the case for this coronavirus.Some people seem to show mild symptoms while others have a more severe experience. Has the virus already mutated?RNA viruses all replicate with low fidelity. Mutations occur at pretty similar rates and these viruses typically don't have proofreading functions. In contrast, we replicate our DNA with high fidelity and we have a proofreading function to fix the errors. So, every time they replicate, there's a fixed rate of mutation. This virus is mutating but it has mutated very little so far. There are differences but probably they are functionally not important, so that's not the explanation for why you see different disease courses among the infected.For HIV it's the same thing: 10 people could be infected by the same strain but you have very different outcomes. With HIV, genetics and environmental factors play a role. Some of the genetics has been worked out; we know that there are certain tissue types that would protect and others that would harm. I suspect it's the same here.Once you become infected with the virus, can you get it again?There are a few anecdotes from China about re-infection but, if you look at those reports carefully, they're not well-documented. It could be that folks just continued to shed virus from the initial infection. Only one study was formally done and it is not a human study. It's a macaque study. They infected macaques with this virus, then waited until the monkeys recovered and tried to re-infect them. They could not. This just came out in the past few days. That bodes well for human immunity.We have now looked at a lot of serum from convalescent individuals and those serum samples have antibodies against the so-called spike protein of the virus. That's the protein that sits on the surface of the virus particle. By tightly binding, the antibody could neutralize the virus. Once an infected person develops antibodies, there should be protective immunity for quite some time. That's why we need to buy time for immunity to develop in the population.After a person recovers from the virus, how long are they still contagious?That's a very important question. We're not sure; one individual in China was shown to have persistent virus shedding for over a month. But typically, we're looking at a three-week period from onset of symptoms.What should we be doing to limit the spread of this epidemic?The social distancing and good hygiene strategies have been successfully applied, in South Korea for example, to bring their epidemic down. They're the only other country that has flattened the curve—slowed down the number of new infections to not overwhelm the healthcare system—and gradually brought this epidemic under control. There are many places that have done a pretty good job of not allowing the epidemic to explode, such as Taiwan and Hong Kong. These are places that had quite a bit of experience in fighting SARS, 17 years ago.Are you optimistic that these measures combined with research will be enough to combat the coronavirus?I personally believe we will blunt this epidemic, but I think we wasted a good four to six weeks largely because of lack of testing and lack of a certain preparedness. But I think we could still make a difference and bring it under control with very harsh measures.But again, are these measures sustainable? We've got to expect that businesses must reopen and schools must teach again. Whether it's travel or sports or live entertainment, we're going to have to return to some semblance of normalcy. But what are the measures that are effective and sustainable? That's a question we as a society have to deal with. We need to buy time so that gradually the population will have a degree of immunity.Most importantly, we need to buy time to allow science to deliver solutions. We're going to have to develop drugs, antibodies, and vaccines. I think the mobilization by the scientific community, from my perspective, is amazing. So many people have mobilized and jumped on this and are contributing, from discovering small-molecule drugs that could block various enzymes of this virus to coming up with antibodies that could neutralize the virus. Researchers have already come up with a few promising chemicals that could be a good start to drug development. There are already a few neutralizing antibodies isolated from infected individuals; my own group is in the midst of doing all that.And, of course, people are working on vaccines. A lot of companies are working on vaccines and those vaccines are at various stages. A couple are within weeks of entering human testing and that's quite, quite remarkable. There is one thing about vaccines, though: Some of the experiments previously done on SARS suggested that when animals developed antibodies and then were given the virus, they had greater lung injury due to the presence of the antibodies. The scientific community would have to resolve that issue quickly and its resolution would either halt the current approaches or unleash them to move full speed ahead. We certainly will take a part in doing that. I think we have the real possibility that COVID-19 may become a fact of life until science comes through as it has done for past epidemics.This is going to take some time. But I'm very confident that the science will rise to the task and provide a solution. But it's not going to be a few months as our president suggests. It's going to be much longer than that. I would say 18 months, or 24 months. I think we are all facing tough challenges ahead."],["topImageUrl",null],["error",null]]}]}],["text","一位北醫畢業目前在紐約當住院醫師的張銘凱醫師寫照顧COVID-19經驗，寫得非常棒，跟大家分享這篇文章：\n[經驗分享]\n我在紐約市的公立醫院擔任內科住院醫師即將完訓，七月開始會做美國感染科次專訓練。目前紐約災情慘重，我所在醫院確診加疑似病人就超過一百人，我這段其間都在顧ICU因此對於重症COVID的照顧也算有心得，我至少照顧過超過20位以上之住院病人，因為在ICU的關係大部分病人都插管，到目前為止，我應該比許多台灣醫生有武漢新冠肺炎治療之實戰經驗。因為台灣目前防疫做的非常好，多半輕症或無症狀隔離，但是我們隨時要準備如果已經是社區流行，那作為醫生該如何care這些病人，因此做個簡單的分享與教學，所以講解的對象應該是以臨床第一線之醫師或NP為主。但我要說很多evidence都不斷更新，以下是盡量有所依據的臨床處理方式，reference就不一一列舉，有些我可能覺得是一般臨床工作者應有的基本概念也許就沒有多加說明，如造成閱讀上不順暢，也請多多包涵。\n\n#流病學:相信台灣臨床醫生現在非常仰賴旅遊史畢竟沒有大規模社區感染，但是我要提醒的是如果有天已經大流行，旅遊史可能不是那麼重要了，懷疑就該驗。美國之前CDC一直很在意旅遊史而不隨意驗，結果後來發現根本大流行已經來不及了。在大爆發之前，可能會有一個空窗期就是很多原本我們以為低感染風險而沒有驗到的人，他們其實已經可能被感染。此外年輕人或沒有病史病人也非常多，這是在過去醫院前所未見的。在美國輕症就算陽性也不會住院讓他們回家，所以我所看到是真正的病人，我們已經擴充非常多病房了，但是病人真的很多，感染力真的很強要小心！至今我們已經有三個住院醫師中獎了。\n\n#臨床表現:除了發燒咳等呼吸道症狀，還常有拉肚子等GI症狀，我要特別提醒很多病人會有\"味覺失調或消失\"的症狀，這不是鼻塞引起的味覺降低。很多文獻少提味覺問題，但是一定要注意，這可能是一個sign就該檢驗。此外有些病人會表達胸痛，不一定就是很嚴重的myocarditis，就純粹是無法解釋的胸痛，但還是會建議驗一下CPK/Trop。這個病毒的潛伏期根據我看到的paper，大概平均是五天多，當然最長可能兩個禮拜，不過我現在講的是一個常態分佈的結果，你要算到最嚴苛標準，也許就兩個禮拜，但是平均還是五天多，所以你如果有接觸史，過了一個禮拜還是沒發病，你大概就safe了。\n\n#抽血:CBC(不一定會leukocytosis，反而容易lymphocytopenia and or thrombocytopenia), 常transaminitis(GOT/GPT高)。我們會大概三天監測一次Ferritin, ESR/CRP, LDH, D-dimer來觀察對藥物反應。基本blood culture, HIV, urine Legionella/strep pneumonia最好也住院時驗一下排除其他問題。\n\n#影像:CXR bilateral infiltrations。相信大家一定常常不知道病人什麼問題但是看到CXR有點白白髒髒就當肺炎收進來打抗生素住院(其實可能根本不明顯)。我要說的是這些COVID住院病人，不會只是CXR微微白白髒髒，而是一看就是明顯兩側蔓延，在我住院醫師期間真的從來沒有看到那麼多CXR都是長這個樣子的，現在我幾乎可以看到CXR就診斷。至於CT chest雖然比較清楚，但是我認為不需要，因為大部分CXR就很明顯了，加上抽血上述markers等等就算PCR還沒有等到就可以很有把握診斷了。安排CT chest只會讓醫院感控暴露風險(因為機器要大消毒，浪費時間也可能使真正需要CT的人沒辦法照到)\n\n#氧氣治療方面:如果有SOB or hypoxia，當然要監測O2 sat.一開始nasal cannula, simple mask 下一個nonrebreather mask，中間不要試BiPAP/CPAP/High flow NC你就要early intubation了！因為BiPAP等會有把病毒釋放出來空氣傳播的風險。而且COVID病人desaturation or decompensation進展真的非常快！sat keep不住就要early intubation。另外不要使用neubulizer等會霧化的藥物治療，如需支氣管闊張劑可以用MDI手壓的pump。另外ARDS常用的臥趴姿勢prone position效果感覺非常好，病人一prone血氧真的會稍微提升，有些病人甚至沒有被插管的，血氧稍微差一點的我們就會叫他趕快趴著!還真的很有用。很多插管病人我們也會給他prone，我看討論串好像台灣不是很喜歡prone因為很耗費護理師人力，不過至少我在我們醫院我看到是一大早三個主治醫師就一起合力把病人翻姿勢，其實美國醫師工作也是很辛苦的。\n\n#藥物治療:\n\n1.我知道很多診所喜歡開類固醇給\"感冒\"的病人，但是絕對要避免因為類固醇有延長viral shedding的副作用，之前在MERS等病人的研究也是類固醇壞處大於好處，因此使用類固醇除非是有其indication才用(例如septic shock等等)。\n\n2.高劑量Statin似乎有研究對防止病毒結合有幫助，因此如果LFT, CK允許可以考慮使用(lipitor 40 or 80, etc)。\n\n3.Litonavir愛滋病藥物nejm已經發表確定沒用。\n\n4.在美國我們幾乎每個病人都會給hydroxychloroquine(400mg bid for a day, then 200mg bid for 4 days)會影響lysosome fusion抑制病毒, 使用藥物前一定要EKG，如果QTc>500就不要用。我們醫院現在不加azithromycin了因為兩個一起用會延長QTc就有致死案例。對於法國研究Hydroxychloroquine+azithro很好但是我保持樂觀態度，那個研究病人量很少(n=21)，而且我實際臨床經驗覺得幫助好像有限，但是因為in vitro研究有效，我們還是會給病人就是了！\n\nCOVID似乎會跟其他呼吸道病毒一起co-infection所以還是要驗一下flu, 但是如果flu negative也不需要給tamiflu因為對covid無效。除了病毒還常bacterial superinfection，所以我們幾乎還是會給抗細菌抗生素，macrolide or levofloxacin擔心prolong QT所以我們醫院現在給doxycycline。記得驗一下Urine Legionella因為跟covid一樣都常有GI症狀。\n\n5.Remdesivir在美國第一個case就是靠這個治好的，各國都在臨床試驗中，我個人很看好，我們醫院也要開始實驗這個了...\n\n6.日本藥favipiravir聽說也很成功但是因為我在美國比較不熟。\n\n7.很多COVID病人為什麼這麼sick，明明年輕人卻full blown ARDS比老人更嚴重，因為很多是cytokine release syndrome的關係。所以IL-6 inhibitor如tocilizumab or sarilumab本來治rheumatoid arthritis的生物製劑或許也有用。現階段也還在臨床試驗中，可以抽血IL-6監測。聽說MGH用tocilizumab，而我的醫院也要開始臨床試驗sarilumab\n\n#Code status：COVID大部分還是胸腔性疾病，很多就是插管呼吸器ARDS mode來治療，因此插管是很重要的環節。但是有些運氣不是很好的病人，多重器官衰竭等等突然coded需要CPR的情況，這對醫療團隊來說是暴露極高風險甚至多半可能徒勞。我認為有必要一開始就要跟病人談好DNR，這不代表就要DNI，該插管還是要插管，但是真的不幸心跳停止等，要量力而為。\n\n#醫院管理：至少在紐約我們的物資設備都輸台灣很多也嚴重不足，不過也許可以給台灣要是不幸疫情大爆發做個借鏡。現在醫院幾乎都是COVID病人，也不可能一人一間病房了，因此直接把COVID病人直接放在同一間房間，反正都得病了也不怕被感染了。不過還是建議最好病房的門是有窗戶的至少從外面看進去可以知道病人好不好，而且就我剛剛所說，病人原本可能好好的就突然血氧掉非常喘需要趕快插管，每個住院病人真的像未爆彈。另外ICU病人因為常常有很多pump點滴，護理師要一直進出隔離房不方便穿脫PPE，可以考慮直接把pump放在房間外面，點滴線延長出去就好，這樣如果護理師要調sedation or pressors等等就可以不用進入房間更改設定。\n\n#國家防疫：現階段台灣防疫做很好，還在containment的階段，就是把最有可能的人抓出來隔離，但是對於平均每個個案的隔離成本很高，國家也很不容易控制，目前台灣有兩百多的個案，但是某天要是慢慢累積好幾百個病人甚至破千，我們也許就要調整策略，因為把全部只要是陽性的病人都抓到醫院關那是不可能的，台灣沒有那麼多的醫療能量，也不能這樣浪費，而且輕症染病的病人，要多久PCR會轉陰性，我還沒看到研究統計出來，應該也很少人會做這樣研究，因為很少國家會像台灣如此嚴格標準檢疫隔離的，就好像今天得influenza A，如果不太嚴重也是讓病人回家，病癒就是病癒，一般醫師也不會再重複flu swab；同樣如果有C.diff病人，把PO Vanc的療程吃完沒有再拉肚子，你也是當作好了不會再去驗糞便。個人覺得台灣可以把輕症病人平均多久時間PCR轉陰性做個統計發表研究。我最近看了世界著名病毒學專家何大一博士的專訪([https://www.caltech.edu/about/news/tip-iceberg-virologist-david-ho-bs-74-speaks-about-covid-19?fbclid=IwAR1XVnPHq82gD97Y2Y06FkIFzAtNNfopnMgqa98fHAwX7WHzHGyBVbnZlIQ](https://www.caltech.edu/about/news/tip-iceberg-virologist-david-ho-bs-74-speaks-about-covid-19?fbclid=IwAR1XVnPHq82gD97Y2Y06FkIFzAtNNfopnMgqa98fHAwX7WHzHGyBVbnZlIQ)) 個人覺得這篇寫得不錯，裡面他就有寫到目前也不知道陽性的病人過多久後才不會有傳染力，他說猜測大概三週。至於已經得過COVID的病人之後會不會再重複感染，他是覺得應該是不會，也就是現在所有的防疫工作，就是在爭取時間讓疫苗可以製造出來讓群體都可以有保護效果。現階段幾乎的國家都大爆發，就不可能像台灣還在containment的防疫階段，因為你要假設所有人都有可能是病人，那能做的就是#緩和曲線了flatten the curve，我覺得這個概念相當重要\n\n，基本上就是拖延戰術，減少不必要的社交和聚集，要social distancing，不必要的商業活動要停止，電影院酒吧夜店要關，餐廳只能外帶等等，這可以避免加速接觸感染，讓病人增加量不要達這麼快一下超出醫療能負荷的數量避免醫療崩壞，很多國家都在這麼做了，目前聽起來表現比較好的國家像是南韓，雖然他們一開始防疫沒有做好導致非常多人得病，但是經過大規模檢驗，還有避免出門要待在家等等，目前疫情也有和緩的趨勢，算是亡羊補牢，也不是不行。台灣目前表現全球數一數二，但是我們總是要做最壞的準備跟打算。\n\n#後記：沒想到一下就寫這麼多，這算是我第一線醫療工作者的紀實與經驗分享，目前紐約疫情雖然已嚴重崩壞，但實際上還只是開始而已不見緩和。不過美國參戰之後相信會有更多醫學研究與臨床治療準則可以參考，實際上也不完全是壞事。你問我會不會怕我每天也是提心吊膽的，都很怕生病，每天都要很注意自己的身體狀態，但偏偏美國住院醫師工時非常長(週休一日而已也沒有PM off)又不斷把我們明明不是在病房rotate的時候抓來上班取消我們的門診等等，我都盡量多休息有時間就睡覺保持免疫力。現在在醫院其實也是看到很多恐慌的面孔，我們醫院是公立醫院，平常病人多為社會最底層的人，吸毒的、遊民的、酗酒的，總之各種問題台灣一個比較健康的社會大概很難想像是一個怎麼樣的場所。不過最近因為COVID病人大爆發，我發現很多可能社會上的一般人或中產階級，他們可能是警察、可能是清潔工、就某天感染病毒生病了，這時候醫護站起來照顧他們治療他們，讓他們免於恐懼，這是作為醫學生涯也算比較榮光的時候，因為我們平常的訓練，就在這時候派上用場，也算是找到一點點行醫的意義跟價值。可以平安地活著其實就很好。目前台灣社會可以安全的生活著也真的很好。"],["id","ioxspw9mf0sf"],["createdAt","2020-03-29T01:46:42.817Z"]]}],["reply",{"__iterable":"Map","data":[["id","zQnmKXEBrhVJn3LNnVt-"],["user",{"__iterable":"Map","data":[["id","r_6F7mcBP8WrztivFgAI"],["name","Pei-Chi Lo"],["avatarUrl",null],["level",14]]}],["type","NOT_RUMOR"],["text","這篇文章的確是正在紐約市公立醫院擔任內科住院醫師的張凱銘2020年3月27日於FB的貼文，是該住院醫師的臨床實戰經驗分享、醫師間教學交流之用。\n　\n經查，有提及文獻部分皆有對應論文，連結如下。"],["reference","2020年3月20日刊在國際抗微生物劑雜誌的文章，說明法國Hydroxychloroquine+azithro臨床試驗結果：(36人的小型試驗)\nhttps://www.sciencedirect.com/science/article/pii/S0924857920300996\n　\n2020年3月20日刊在mBio的文章，認為中國與各國應進行研究，確認Statin等可否提高生存率：\nhttps://www.ncbi.nlm.nih.gov/pubmed/32198163\n　\n2020年3月18日刊在新英格蘭醫學雜誌的文章，說明愛滋用藥lopinavir–ritonavir用於住院重症的COVID-19患者並未觀察到額外益處：\nhttps://www.nejm.org/doi/full/10.1056/NEJMoa2001282\n\n2020年2月WHO與中國聯合任務專家組報告，P12提及潛伏期平均是5-6天，最長14天：\nhttps://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf\n\n2020年1月31日刊在新英格蘭醫學雜誌的文章，說明美國第一例確診病人使用Remdesivir：\nhttps://www.nejm.org/doi/full/10.1056/NEJMoa2001191\n　\n2018年3月15日刊在美國呼吸和重症監護醫學雜誌的文章，提到MERS病人用類固醇治療可能風險大於益處：\nhttps://www.ncbi.nlm.nih.gov/pubmed/29227752\n\nFavipiravir的效果在中、日、韓評價不同：\nhttps://cofacts.g0v.tw/article/kdmr185e5ut2\n\n--\n2020年3月27日張凱銘原始FB貼文連結：\nhttps://www.facebook.com/photo.php?fbid=3096597913707226"],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial"],["url","https://www.sciencedirect.com/science/article/pii/S0924857920300996"],["summary","AbstractBackgroundChloroquine and hydroxychloroquine have been found to be efficient on SARS-CoV-2, and reported to be efficient in Chinese COV-19 patients. We evaluate the role of hydroxychloroquine on respiratory viral loads.Patients and methodsFrench Confirmed COVID-19 patients were included in a single arm protocol from early March to March 16th, to receive 600mg of hydroxychloroquine daily and their viral load in nasopharyngeal swabs was tested daily in a hospital setting. Depending on their clinical presentation, azithromycin was added to the treatment. Untreated patients from another center and cases refusing the protocol were included as negative controls. Presence and absence of virus at Day6-post inclusion was considered the end point.ResultsSix patients were asymptomatic, 22 had upper respiratory tract infection symptoms and eight had lower respiratory tract infection symptoms.Twenty cases were treated in this study and showed a significant reduction of the viral carriage at D6-post inclusion compared to controls, and much lower average carrying duration than reported of untreated patients in the literature. Azithromycin added to hydroxychloroquine was significantly more efficient for virus elimination.ConclusionDespite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin.Key words2019-nCoVSARS-CoV-2COVID-19hydroxychloroquineazithomycinclinical trialLoading...View Abstract© 2020 Published by Elsevier B.V."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Hiding in Plain Sight: an Approach to Treating Patients with Severe COVID-19 Infection. - PubMed"],["url","https://www.ncbi.nlm.nih.gov/pubmed/32198163"],["summary","mBio. 2020 Mar 20;11(2). pii: e00398-20. doi: 10.1128/mBio.00398-20.Author information157, chemin du Lavoir, Sergy Haut, France davidsfedson@gmail.com.2Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.3Fyordgata 59, Trondheim, Norway.AbstractPatients with COVID-19 infection are at risk of acute respiratory disease syndrome (ARDS) and death. The tissue receptor for COVID-19 is ACE2, and higher levels of ACE2 can protect against ARDS. Angiotensin receptor blockers and statins upregulate ACE2. Clinical trials are needed to determine whether this drug combination might be used to treat patients with severe COVID-19 infection.Copyright © 2020 Fedson et al.KEYWORDS: COVID-19; endothelial dysfunction; generic drugs; host response treatment [Indexed for MEDLINE] Free full textMeSH terms, Substances, Supplementary conceptsMeSH termsAngiotensin II Type 2 Receptor Blockers/therapeutic useBetacoronavirus*Coronavirus Infections/metabolism*Coronavirus Infections/therapy*Coronavirus Infections/virologyHumansHydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic usePeptidyl-Dipeptidase A/metabolismPneumonia, Viral/metabolism*Pneumonia, Viral/therapy*Pneumonia, Viral/virologyReceptor, Angiotensin, Type 2/biosynthesis*Receptors, Virus/biosynthesis*SubstancesAGTR2 protein, humanAngiotensin II Type 2 Receptor BlockersHydroxymethylglutaryl-CoA Reductase InhibitorsReceptor, Angiotensin, Type 2Receptors, Viruscoronavirus receptorsPeptidyl-Dipeptidase Aangiotensin converting enzyme 2Supplementary conceptsCOVID-19severe acute respiratory syndrome coronavirus 2"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19"],["url","https://www.nejm.org/doi/full/10.1056/NEJMoa2001282"],["summary","logo-32"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title",""],["url","https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf"],["summary",""],["topImageUrl",null],["error","UNSUPPORTED"]]},{"__iterable":"Map","data":[["title","First Case of 2019 Novel Coronavirus in the United States"],["url","https://www.nejm.org/doi/full/10.1056/NEJMoa2001191"],["summary","Original ArticleBrief ReportList of authors.Michelle L. Holshue, M.P.H., Chas DeBolt, M.P.H., Scott Lindquist, M.D., Kathy H. Lofy, M.D., John Wiesman, Dr.P.H., Hollianne Bruce, M.P.H., Christopher Spitters, M.D., Keith Ericson, P.A.-C., Sara Wilkerson, M.N., Ahmet Tural, M.D., George Diaz, M.D., Amanda Cohn, M.D., LeAnne Fox, M.D., Anita Patel, Pharm.D., Susan I. Gerber, M.D., Lindsay Kim, M.D., Suxiang Tong, Ph.D., Xiaoyan Lu, M.S., Steve Lindstrom, Ph.D., Mark A. Pallansch, Ph.D., William C. Weldon, Ph.D., Holly M. Biggs, M.D., Timothy M. Uyeki, M.D., and Satish K. Pillai, M.D. for the Washington State 2019-nCoV Case Investigation Team*\n\n \n\n \n \n \n \n\n\n\n\n\n\n\n\n\n \n \n\n \n \n\n\n\n\n\n\n\n\n\n\n\n \n \n \n\n\n\n\n\n\n \n \n \n\n\n\n\n \n \n \n Article\n \n \n \n\n\n\n\n\n \n \n Figures/Media\n \n \n\n \n \n \n \n Metrics\n \n \n \n \n\n \n\n \n \n 20 ReferencesSummary An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient’s initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection. IntroductionOn December 31, 2019, China reported a cluster of cases of pneumonia in people associated with the Huanan Seafood Wholesale Market in Wuhan, Hubei Province.1 On January 7, 2020, Chinese health authorities confirmed that this cluster was associated with a novel coronavirus, 2019-nCoV.2 Although cases were originally reported to be associated with exposure to the seafood market in Wuhan, current epidemiologic data indicate that person-to-person transmission of 2019-nCoV is occurring.3-6 As of January 30, 2020, a total of 9976 cases had been reported in at least 21 countries,7 including the first confirmed case of 2019-nCoV infection in the United States, reported on January 20, 2020. Investigations are under way worldwide to better understand transmission dynamics and the spectrum of clinical illness. This report describes the epidemiologic and clinical features of the first case of 2019-nCoV infection confirmed in the United States. Case Report On January 19, 2020, a 35-year-old man presented to an urgent care clinic in Snohomish County, Washington, with a 4-day history of cough and subjective fever. On checking into the clinic, the patient put on a mask in the waiting room. After waiting approximately 20 minutes, he was taken into an examination room and underwent evaluation by a provider. He disclosed that he had returned to Washington State on January 15 after traveling to visit family in Wuhan, China. The patient stated that he had seen a health alert from the U.S. Centers for Disease Control and Prevention (CDC) about the novel coronavirus outbreak in China and, because of his symptoms and recent travel, decided to see a health care provider. Figure 1. Figure 1. Posteroanterior and Lateral Chest Radiographs, January 19, 2020 (Illness Day 4). No thoracic abnormalities were noted. Apart from a history of hypertriglyceridemia, the patient was an otherwise healthy nonsmoker. The physical examination revealed a body temperature of 37.2°C, blood pressure of 134/87 mm Hg, pulse of 110 beats per minute, respiratory rate of 16 breaths per minute, and oxygen saturation of 96% while the patient was breathing ambient air. Lung auscultation revealed rhonchi, and chest radiography was performed, which was reported as showing no abnormalities (Figure 1). A rapid nucleic acid amplification test (NAAT) for influenza A and B was negative. A nasopharyngeal swab specimen was obtained and sent for detection of viral respiratory pathogens by NAAT; this was reported back within 48 hours as negative for all pathogens tested, including influenza A and B, parainfluenza, respiratory syncytial virus, rhinovirus, adenovirus, and four common coronavirus strains known to cause illness in humans (HKU1, NL63, 229E, and OC43). Given the patient’s travel history, the local and state health departments were immediately notified. Together with the urgent care clinician, the Washington Department of Health notified the CDC Emergency Operations Center. Although the patient reported that he had not spent time at the Huanan seafood market and reported no known contact with ill persons during his travel to China, CDC staff concurred with the need to test the patient for 2019-nCoV on the basis of current CDC “persons under investigation” case definitions.8 Specimens were collected in accordance with CDC guidance and included serum and nasopharyngeal and oropharyngeal swab specimens. After specimen collection, the patient was discharged to home isolation with active monitoring by the local health department. On January 20, 2020, the CDC confirmed that the patient’s nasopharyngeal and oropharyngeal swabs tested positive for 2019-nCoV by real-time reverse-transcriptase–polymerase-chain-reaction (rRT-PCR) assay. In coordination with CDC subject-matter experts, state and local health officials, emergency medical services, and hospital leadership and staff, the patient was admitted to an airborne-isolation unit at Providence Regional Medical Center for clinical observation, with health care workers following CDC recommendations for contact, droplet, and airborne precautions with eye protection.9 On admission, the patient reported persistent dry cough and a 2-day history of nausea and vomiting; he reported that he had no shortness of breath or chest pain. Vital signs were within normal ranges. On physical examination, the patient was found to have dry mucous membranes. The remainder of the examination was generally unremarkable. After admission, the patient received supportive care, including 2 liters of normal saline and ondansetron for nausea. Figure 2. Figure 2. Symptoms and Maximum Body Temperatures According to Day of Illness and Day of Hospitalization, January 16 to January 30, 2020. On days 2 through 5 of hospitalization (days 6 through 9 of illness), the patient’s vital signs remained largely stable, apart from the development of intermittent fevers accompanied by periods of tachycardia (Figure 2). The patient continued to report a nonproductive cough and appeared fatigued. On the afternoon of hospital day 2, the patient passed a loose bowel movement and reported abdominal discomfort. A second episode of loose stool was reported overnight; a sample of this stool was collected for rRT-PCR testing, along with additional respiratory specimens (nasopharyngeal and oropharyngeal) and serum. The stool and both respiratory specimens later tested positive by rRT-PCR for 2019-nCoV, whereas the serum remained negative. Treatment during this time was largely supportive. For symptom management, the patient received, as needed, antipyretic therapy consisting of 650 mg of acetaminophen every 4 hours and 600 mg of ibuprofen every 6 hours. He also received 600 mg of guaifenesin for his continued cough and approximately 6 liters of normal saline over the first 6 days of hospitalization. Table 1. Table 1. Clinical Laboratory Results. The nature of the patient isolation unit permitted only point-of-care laboratory testing initially; complete blood counts and serum chemical studies were available starting on hospital day 3. Laboratory results on hospital days 3 and 5 (illness days 7 and 9) reflected leukopenia, mild thrombocytopenia, and elevated levels of creatine kinase (Table 1). In addition, there were alterations in hepatic function measures: levels of alkaline phosphatase (68 U per liter), alanine aminotransferase (105 U per liter), aspartate aminotransferase (77 U per liter), and lactate dehydrogenase (465 U per liter) were all elevated on day 5 of hospitalization. Given the patient’s recurrent fevers, blood cultures were obtained on day 4; these have shown no growth to date. Figure 3. Figure 3. Posteroanterior and Lateral Chest Radiographs, January 22, 2020 (Illness Day 7, Hospital Day 3). No acute intrathoracic plain-film abnormality was noted. Figure 4. Figure 4. Posteroanterior Chest Radiograph, January 24, 2020 (Illness Day 9, Hospital Day 5). Increasing left basilar opacity was visible, arousing concern about pneumonia. A chest radiograph taken on hospital day 3 (illness day 7) was reported as showing no evidence of infiltrates or abnormalities (Figure 3). However, a second chest radiograph from the night of hospital day 5 (illness day 9) showed evidence of pneumonia in the lower lobe of the left lung (Figure 4). These radiographic findings coincided with a change in respiratory status starting on the evening of hospital day 5, when the patient’s oxygen saturation values as measured by pulse oximetry dropped to as low as 90% while he was breathing ambient air. On day 6, the patient was started on supplemental oxygen, delivered by nasal cannula at 2 liters per minute. Given the changing clinical presentation and concern about hospital-acquired pneumonia, treatment with vancomycin (a 1750-mg loading dose followed by 1 g administered intravenously every 8 hours) and cefepime (administered intravenously every 8 hours) was initiated. Figure 5. Figure 5. Anteroposterior and Lateral Chest Radiographs, January 26, 2020 (Illness Day 10, Hospital Day 6). Stable streaky opacities in the lung bases were visible, indicating likely atypical pneumonia; the opacities have steadily increased in density over time. On hospital day 6 (illness day 10), a fourth chest radiograph showed basilar streaky opacities in both lungs, a finding consistent with atypical pneumonia (Figure 5), and rales were noted in both lungs on auscultation. Given the radiographic findings, the decision to administer oxygen supplementation, the patient’s ongoing fevers, the persistent positive 2019-nCoV RNA at multiple sites, and published reports of the development of severe pneumonia3,4 at a period consistent with the development of radiographic pneumonia in this patient, clinicians pursued compassionate use of an investigational antiviral therapy. Treatment with intravenous remdesivir (a novel nucleotide analogue prodrug in development10,11) was initiated on the evening of day 7, and no adverse events were observed in association with the infusion. Vancomycin was discontinued on the evening of day 7, and cefepime was discontinued on the following day, after serial negative procalcitonin levels and negative nasal PCR testing for methicillin-resistant Staphylococcus aureus. On hospital day 8 (illness day 12), the patient’s clinical condition improved. Supplemental oxygen was discontinued, and his oxygen saturation values improved to 94 to 96% while he was breathing ambient air. The previous bilateral lower-lobe rales were no longer present. His appetite improved, and he was asymptomatic aside from intermittent dry cough and rhinorrhea. As of January 30, 2020, the patient remains hospitalized. He is afebrile, and all symptoms have resolved with the exception of his cough, which is decreasing in severity. Methods Specimen Collection Clinical specimens for 2019-nCoV diagnostic testing were obtained in accordance with CDC guidelines.12 Nasopharyngeal and oropharyngeal swab specimens were collected with synthetic fiber swabs; each swab was inserted into a separate sterile tube containing 2 to 3 ml of viral transport medium. Serum was collected in a serum separator tube and then centrifuged in accordance with CDC guidelines. The urine and stool specimens were each collected in sterile specimen containers. Specimens were stored between 2°C and 8°C until ready for shipment to the CDC. Specimens for repeat 2019-nCoV testing were collected on illness days 7, 11, and 12 and included nasopharyngeal and oropharyngeal swabs, serum, and urine and stool samples. Diagnostic Testing for 2019-nCoV Clinical specimens were tested with an rRT-PCR assay that was developed from the publicly released virus sequence. Similar to previous diagnostic assays for severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), it has three nucleocapsid gene targets and a positive control target. A description of this assay13 and sequence information for the rRT-PCR panel primers and probes14 are available on the CDC Laboratory Information website for 2019-nCoV.15 Genetic Sequencing On January 7, 2020, Chinese researchers shared the full genetic sequence of 2019-nCoV through the National Institutes of Health GenBank database16 and the Global Initiative on Sharing All Influenza Data (GISAID)17 database; a report about the isolation of 2019-nCoV was later published.18 Nucleic acid was extracted from rRT-PCR–positive specimens (oropharyngeal and nasopharyngeal) and used for whole-genome sequencing on both Sanger and next-generation sequencing platforms (Illumina and MinIon). Sequence assembly was completed with the use of Sequencher software, version 5.4.6 (Sanger); minimap software, version 2.17 (MinIon); and freebayes software, version 1.3.1 (MiSeq). Complete genomes were compared with the available 2019-nCoV reference sequence (GenBank accession number NC_045512.2). Results Specimen Testing for 2019-nCoV Table 2. Table 2. Results of Real-Time Reverse-Transcriptase–Polymerase-Chain-Reaction Testing for the 2019 Novel Coronavirus (2019-nCoV). The initial respiratory specimens (nasopharyngeal and oropharyngeal swabs) obtained from this patient on day 4 of his illness were positive for 2019-nCoV (Table 2). The low cycle threshold (Ct) values (18 to 20 in nasopharyngeal specimens and 21 to 22 in oropharyngeal specimens) on illness day 4 suggest high levels of virus in these specimens, despite the patient’s initial mild symptom presentation. Both upper respiratory specimens obtained on illness day 7 remained positive for 2019-nCoV, including persistent high levels in a nasopharyngeal swab specimen (Ct values, 23 to 24). Stool obtained on illness day 7 was also positive for 2019-nCoV (Ct values, 36 to 38). Serum specimens for both collection dates were negative for 2019-nCoV. Nasopharyngeal and oropharyngeal specimens obtained on illness days 11 and 12 showed a trend toward decreasing levels of virus. The oropharyngeal specimen tested negative for 2019-nCoV on illness day 12. The rRT-PCR results for serum obtained on these dates are still pending. Genetic Sequencing The full genome sequences from oropharyngeal and nasopharyngeal specimens were identical to one another and were nearly identical to other available 2019-nCoV sequences. There were only 3 nucleotides and 1 amino acid that differed at open reading frame 8 between this patient’s virus and the 2019-nCoV reference sequence (NC_045512.2). The sequence is available through GenBank (accession number MN985325).16 Discussion Our report of the first confirmed case of 2019-nCoV in the United States illustrates several aspects of this emerging outbreak that are not yet fully understood, including transmission dynamics and the full spectrum of clinical illness. Our case patient had traveled to Wuhan, China, but reported that he had not visited the wholesale seafood market or health care facilities or had any sick contacts during his stay in Wuhan. Although the source of his 2019-nCoV infection is unknown, evidence of person-to-person transmission has been published. Through January 30, 2020, no secondary cases of 2019-nCoV related to this case have been identified, but monitoring of close contacts continues.19 Detection of 2019-nCoV RNA in specimens from the upper respiratory tract with low Ct values on day 4 and day 7 of illness is suggestive of high viral loads and potential for transmissibility. It is notable that we also detected 2019-nCoV RNA in a stool specimen collected on day 7 of the patient’s illness. Although serum specimens from our case patient were repeatedly negative for 2019-nCoV, viral RNA has been detected in blood in severely ill patients in China.4 However, extrapulmonary detection of viral RNA does not necessarily mean that infectious virus is present, and the clinical significance of the detection of viral RNA outside the respiratory tract is unknown at this time. Currently, our understanding of the clinical spectrum of 2019-nCoV infection is very limited. Complications such as severe pneumonia, respiratory failure, acute respiratory distress syndrome (ARDS), and cardiac injury, including fatal outcomes, have been reported in China.4,18,20 However, it is important to note that these cases were identified on the basis of their pneumonia diagnosis and thus may bias reporting toward more severe outcomes. Our case patient initially presented with mild cough and low-grade intermittent fevers, without evidence of pneumonia on chest radiography on day 4 of his illness, before having progression to pneumonia by illness day 9. These nonspecific signs and symptoms of mild illness early in the clinical course of 2019-nCoV infection may be indistinguishable clinically from many other common infectious diseases, particularly during the winter respiratory virus season. In addition, the timing of our case patient’s progression to pneumonia on day 9 of illness is consistent with later onset of dyspnea (at a median of 8 days from onset) reported in a recent publication.4 Although a decision to administer remdesivir for compassionate use was based on the case patient’s worsening clinical status, randomized controlled trials are needed to determine the safety and efficacy of remdesivir and any other investigational agents for treatment of patients with 2019-nCoV infection. We report the clinical features of the first reported patient with 2019-nCoV infection in the United States. Key aspects of this case included the decision made by the patient to seek medical attention after reading public health warnings about the outbreak; recognition of the patient’s recent travel history to Wuhan by local providers, with subsequent coordination among local, state, and federal public health officials; and identification of possible 2019-nCoV infection, which allowed for prompt isolation of the patient and subsequent laboratory confirmation of 2019-nCoV, as well as for admission of the patient for further evaluation and management. This case report highlights the importance of clinicians eliciting a recent history of travel or exposure to sick contacts in any patient presenting for medical care with acute illness symptoms, in order to ensure appropriate identification and prompt isolation of patients who may be at risk for 2019-nCoV infection and to help reduce further transmission. Finally, this report highlights the need to determine the full spectrum and natural history of clinical disease, pathogenesis, and duration of viral shedding associated with 2019-nCoV infection to inform clinical management and public health decision making. \n Funding and Disclosures The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.This article was published on January 31, 2020, at NEJM.org.We thank the patient; the nurses and clinical staff who are providing care for the patient; staff at the local and state health departments; staff at the Washington State Department of Health Public Health Laboratories and at the Centers for Disease Control and Prevention (CDC) Division of Viral Disease Laboratory; CDC staff at the Emergency Operations Center; and members of the 2019-nCoV response teams at the local, state, and national levels.Author AffiliationsFrom the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) — all in Washington.Address reprint requests to Ms. Holshue at the Washington State Department of Health Public Health Laboratories, 1610 NE 150th St., Shoreline, WA 98155, or at michelle.holshue@doh.wa.gov. A full list of the members of the Washington State 2019-nCoV Case Investigation Team is provided in the Supplementary Appendix, available at NEJM.org. \n Supplementary Material\n References (20)1. World Health Organization. Pneumonia of unknown cause — China. 2020 (https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/. opens in new tab).2. World Health Organization. Novel coronavirus — China. 2020 (https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/. opens in new tab).3. Chan JF-W, Yuan S, Kok K-H, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020 January 24 (Epub ahead of print).4. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 January 24 (Epub ahead of print).5. Centers for Disease Control and Prevention. 2019 Novel coronavirus, Wuhan, China: 2019-nCoV situation summary. January 28, 2020 (https://www.cdc.gov/coronavirus/2019-nCoV/summary.html. opens in new tab).6. Phan LT, Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med. DOI: 10.1056/NEJMc2001272.7. Johns Hopkins University CSSE. Wuhan coronavirus (2019-nCoV) global cases (https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6. opens in new tab).8. Centers for Disease Control and Prevention. Interim guidance for healthcare professionals: criteria to guide evaluation of patients under investigation (PUI) for 2019-nCoV. 2020 (https://www.cdc.gov/coronavirus/2019-nCoV/clinical-criteria.html. opens in new tab).9. Centers for Disease Control and Prevention. Infection control. 2019 Novel coronavirus, Wuhan, China. 2020 (https://www.cdc.gov/coronavirus/2019-nCoV/infection-control.html. opens in new tab).10. Mulangu S, Dodd LE, Davey RT Jr, et al. A randomized, controlled trial of ebola virus disease therapeutics. N Engl J Med 2019;381:2293-2303.11. Sheahan TP, Sims AC, Leist SR, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun 2020;11:222-222.12. Centers for Disease Control and Prevention. Interim guidelines for collecting, handling, and testing clinical specimens from patients under investigation (PUIs) for 2019 novel coronavirus (2019-nCoV). 2020 (https://www.cdc.gov/coronavirus/2019-nCoV/guidelines-clinical-specimens.html. opens in new tab).13. Centers for Disease Control and Prevention, Respiratory Viruses Branch, Division of Viral Diseases. Real-time RT-PCR panel for detection 2019-novel coronavirus. 2020 (https://www.cdc.gov/coronavirus/2019-ncov/downloads/rt-pcr-panel-for-detection-instructions.pdf. opens in new tab).14. Centers for Disease Control and Prevention, Respiratory Viruses Branch, Division of Viral Diseases. 2019-novel coronavirus (2019-nCoV) real-time rRT-PCR panel primers and probes. 2020 (https://www.cdc.gov/coronavirus/2019-ncov/downloads/rt-pcr-panel-primer-probes.pdf. opens in new tab).15. Centers for Disease Control and Prevention. Information for laboratories. 2019 novel coronavirus, Wuhan, China. 2020 (https://www.cdc.gov/coronavirus/2019-nCoV/guidance-laboratories.html. opens in new tab).16. National Institutes of Health. GenBank overview (https://www.ncbi.nlm.nih.gov/genbank/. opens in new tab).17. GISAID (Global Initiative on Sharing All Influenza Data) home page (https://www.gisaid.org/. opens in new tab).18. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. DOI: 10.1056/NEJMoa2001017.19. Washington State Department of Health. Novel coronavirus outbreak 2020 (https://www.doh.wa.gov/Emergencies/Coronavirus. opens in new tab).20. Chen N, Zhou M, Dong X Jr, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020 January 30 (Epub ahead of print).Table 1. Clinical Laboratory Results.* MeasureReference RangeIllness Day 6, Hospital Day 2†Illness Day 7, Hospital Day 3Illness Day 9, Hospital Day 5Illness Day 11, Hospital Day 7Illness Day 13, Hospital Day 9Illness Day 14, Hospital Day 10White-cell count (per μl)3800–11,000“Slight decrease”3120‡3300‡540056006500Red-cell count (per μl)4,200,000–5,700,000—4,870,0005,150,0005,010,0004,650,0005,010,000Absolute neutrophil count (per μl)1900–7400—1750‡1700‡370038003200Absolute lymphocyte count (per μl)1000–3900—10701400140014002100Platelet count (per μl)150,000–400,000“Adequate”122,000‡132,000‡151,000150,000239,000Hemoglobin (g/dl)13.2–17.012.2‡14.214.814.813.514.2Hematocrit (%)39.0–50.036.0‡42.043.043.039.342.0Sodium (mmol/liter)136–145134‡136138138135‡138Potassium (mmol/liter)3.5–5.13.3‡3.63.4‡3.64.13.9Chloride (mmol/liter)98–10799101105106100103Calcium (mg/dl)8.7–10.4—8.5‡9.39.08.6‡9.3Carbon dioxide (mmol/liter)20–31—2624252336§Anion gap (mmol/liter)5–16—997129Glucose (mmol/liter)65–14010410312096148§104Blood urea nitrogen (mg/dl)9–231510131322§18Creatinine (mg/dl)0.7–1.31.01.061.060.881.080.84Total protein (g/dl)5.7–8.2—6.97.16.86.96.8Albumin (g/dl)3.2–4.8—4.24.74.52.9‡4.4Total bilirubin (mg/dl)0.3–1.2—1.01.11.5§0.81.0Procalcitonin (ng/ml)<0.05——<0.05<0.05——Alanine aminotransferase (U/liter)10–49—68§105§119§219§203§Aspartate aminotransferase (U/liter)≤33—37§77§85§129§89§Alkaline phosphatase (U/liter)46–116—5068§88§137§163§Fibrinogen (mg/dl)150–450—477§————Lactate dehydrogenase (U/liter)120–246—250§465§——388§Prothrombin time (sec)12.2–14.6—11.9‡11.9‡——12.7International normalized ratio0.9–1.1—0.90.9——1.0Creatine kinase (U/liter)62–325—353§332§———Venous lactate (mmol/liter)0.4–2.0—1.31.7———Table 2. Results of Real-Time Reverse-Transcriptase–Polymerase-Chain-Reaction Testing for the 2019 Novel Coronavirus (2019-nCoV).* SpecimenIllness Day 4Illness Day 7Illness Day 11Illness Day 12Nasopharyngeal swabPositive(Ct, 18–20)Positive(Ct, 23–24)Positive(Ct, 33–34)Positive(Ct, 37–40)Oropharyngeal swabPositive(Ct, 21–22)Positive(Ct, 32–33)Positive(Ct, 36–40)NegativeSerumNegativeNegativePendingPendingUrineNTNegativeNTNTStoolNTPositive(Ct, 36–38)NTNT\n\n \n \n \n\n \n \n \n\n \n\n \n\n \n \n \n \n \n\n\n \n\n\n\n\n\n\n\n\n\n\n\n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n\n \n\n \n \n \n \n \n \n \n \n \n\n \n \n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n\n \n \n \n\n \n\n \n \n\n \n \n \n \n \n \n \n \n \n\n \n\n \n\n \n \n \n \n \n \n \n\n\n \n\n\n\n\n \n\n \n \n\n\n\n\n \n \n \n Article\n \n \n \n\n\n\n\n\n \n \n Figures/Media\n \n \n\n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n \n\n\n\n\n\n\n\n\n\n \n \n\n \n \n \n \n \n\n \n\n\n\n\n \n\n \n\n \n\n \n\n\n \n\n \n\n\n\n\n\n\n\n\n\n \n\n \n\n\n\n\n \n \n \n \n\n\n \n\n \n \n\n \n\n\n\n\n\n\n\n\n \n \n\n\n\n\n \n\n\n\n\n\n\n\n\n \n \n\n\n\n \n \n\n\n\n\n\n\n\n\n\n \n \n\n\n \n\n\n\n\n\n\n \n \n \n \n \n\n\n\n \n \n \n\n\n\n\n\n\n\n\n\n \n \n\n \n \n\n \n\n\n \n \n \n \n \n \n \n \n\n \n\n \n\n \n \n\n\n\n\n\n\n\n\n\n \n \n\n\n\n \n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n\n\n\n\n \n \n \n \n \n \n\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n \n\n \n \n\n \n \n \n\n \n \n \n \n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n \n \n \n \n \n\n \n \n\n \n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n THIS SITE USES COOKIES to personalize content, to measure website and advertising performance, and to present relevant advertising."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Systemic Corticosteroid Therapy May Delay Viral Clearance in Patients with Middle East Respiratory Syndrome Coronavirus Infection. - PubMed"],["url","https://www.ncbi.nlm.nih.gov/pubmed/29227752"],["summary","Search databaseSearch term"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title",""],["url","https://cofacts.g0v.tw/article/kdmr185e5ut2"],["summary",""],["topImageUrl",null],["error","NOT_REACHABLE"]]},{"__iterable":"Map","data":[["title","Kai-Ming Chang"],["url","https://www.facebook.com/photo.php?fbid=3096597913707226"],["summary","[經驗分享] 我在紐約市的公立醫院擔任內科住院醫師即將完訓，七月開始會做美國感染科次專訓練。目前紐約災情慘重，我所在醫院確診加疑似病人就超過一百人，我這段其間都在顧ICU因此對於重症COVID的照顧也算有心得，我至少照顧過超過20位以上之住院病人，因為在ICU的關係大部分病人都插管，到目前為止，我應該比許多台灣醫生有武漢新冠肺炎治療之實戰經驗。因為台灣目前防疫做的非常好，多半輕症或無症狀隔離，但是我們隨時要準備如果已經是社區流行，那作為醫生該如何care這些病人，因此做個簡單的分享與教學，所以講解的對象應該是以臨床第一線之醫師或NP為主。但我要說很多evidence都不斷更新，以下是盡量有所依據的臨床處理方式，reference就不一一列舉，有些我可能覺得是一般臨床工作者應有的基本概念也許就沒有多加說明，如造成閱讀上不順暢，也請多多包涵。 #流病學:相信台灣臨床醫生現在非常仰賴旅遊史畢竟沒有大規模社區感染，但是我要提醒的是如果有天已經大流行，旅遊史可能不是那麼重要了，懷疑就該驗。美國之前CDC一直很在意旅遊史而不隨意驗，結果後來發現根本大流行已經來不及了。在大爆發之前，可能會有一個空窗期就是很多原本我們以為低感染風險而沒有驗到的人，他們其實已經可能被感染。此外年輕人或沒有病史病人也非常多，這是在過去醫院前所未見的。在美國輕症就算陽性也不會住院讓他們回家，所以我所看到是真正的病人，我們已經擴充非常多病房了，但是病人真的很多，感染力真的很強要小心！至今我們已經有三個住院醫師中獎了。 #臨床表現:除了發燒咳等呼吸道症狀，還常有拉肚子等GI症狀，我要特別提醒很多病人會有\"味覺失調或消失\"的症狀，這不是鼻塞引起的味覺降低。很多文獻少提味覺問題，但是一定要注意，這可能是一個sign就該檢驗。此外有些病人會表達胸痛，不一定就是很嚴重的myocarditis，就純粹是無法解釋的胸痛，但還是會建議驗一下CPK/Trop。這個病毒的潛伏期根據我看到的paper，大概平均是五天多，當然最長可能兩個禮拜，不過我現在講的是一個常態分佈的結果，你要算到最嚴苛標準，也許就兩個禮拜，但是平均還是五天多，所以你如果有接觸史，過了一個禮拜還是沒發病，你大概就safe了。 #抽血:CBC(不一定會leukocytosis，反而容易lymphocytopenia and or thrombocytopenia), 常transaminitis(GOT/GPT高)。我們會大概三天監測一次Ferritin, ESR/CRP, LDH, D-dimer來觀察對藥物反應。基本blood culture, HIV, urine Legionella/strep pneumonia最好也住院時驗一下排除其他問題。另外有觀察到很多人procalcitonin一開始低，之後高起來，但不代表一定是bacterial superinfection，目前原因不明。 #影像:CXR bilateral infiltrations。相信大家一定常常不知道病人什麼問題但是看到CXR有點白白髒髒就當肺炎收進來打抗生素住院(其實可能根本不明顯)。我要說的是這些COVID住院病人，不會只是CXR微微白白髒髒，而是一看就是明顯兩側蔓延，在我住院醫師期間真的從來沒有看到那麼多CXR都是長這個樣子的，現在我幾乎可以看到CXR就診斷。至於CT chest雖然比較清楚，但是我認為不需要，因為大部分CXR就很明顯了，加上抽血上述markers等等就算PCR還沒有等到就可以很有把握診斷了。安排CT chest只會讓醫院感控暴露風險(因為機器要大消毒，浪費時間也可能使真正需要CT的人沒辦法照到) #氧氣治療方面:如果有SOB or hypoxia，當然要監測O2 sat.一開始nasal cannula, simple mask 下一個nonrebreather mask，中間不要試BiPAP/CPAP/High flow NC你就要early intubation了！因為BiPAP等會有把病毒釋放出來空氣傳播的風險。而且COVID病人desaturation or decompensation進展真的非常快！sat keep不住就要early intubation。另外不要使用neubulizer等會霧化的藥物治療，如需支氣管闊張劑可以用MDI手壓的pump。另外ARDS常用的臥趴姿勢prone position效果感覺非常好，病人一prone血氧真的會稍微提升，有些病人甚至沒有被插管的，血氧稍微差一點的我們就會叫他趕快趴著!還真的很有用。很多插管病人我們也會給他prone，我看討論串好像台灣不是很喜歡prone因為很耗費護理師人力，不過至少我在我們醫院我看到是一大早三個主治醫師就一起合力把病人翻姿勢，其實美國醫師工作也是很辛苦的。 #藥物治療: 1.我知道很多診所喜歡開類固醇給\"感冒\"的病人，但是絕對要避免因為類固醇有延長viral shedding的副作用，之前在MERS等病人的研究也是類固醇壞處大於好處，因此使用類固醇除非是有其indication才用(例如septic shock等等)。 2.高劑量Statin似乎有研究對防止病毒結合有幫助，因此如果LFT, CK允許可以考慮使用(lipitor 40 or 80, etc)。 3.Litonavir愛滋病藥物nejm已經發表確定沒用。 4.在美國我們幾乎每個病人都會給hydroxychloroquine(400mg bid for a day, then 200mg bid for 4 days)會影響lysosome fusion抑制病毒, 使用藥物前一定要EKG，如果QTc>500就不要用。我們醫院現在不加azithromycin了因為兩個一起用會延長QTc就有致死案例。對於法國研究Hydroxychloroquine+azithro很好但是我保持保守態度，那個研究病人量很少(n=36)，而且我實際臨床經驗覺得幫助好像有限，但是因為in vitro研究有效，我們還是會給病人就是了！用hydroxychloroquine之前最好先驗一下G6PD deficiency因為可能蠶豆症hemolysis，但機會不高，可以再等G6PD結果前就使用藥。 COVID似乎會跟其他呼吸道病毒一起co-infection所以還是要驗一下flu, 但是如果flu negative也不需要給tamiflu因為對covid無效。除了病毒還常bacterial superinfection，所以我們幾乎還是會給抗細菌抗生素，macrolide or levofloxacin擔心prolong QT所以我們醫院現在給doxycycline。記得驗一下Urine Legionella因為跟covid一樣都常有GI症狀。 5.Remdesivir在美國第一個case就是靠這個治好的，各國都在臨床試驗中，我個人很看好，我們醫院也要開始實驗這個了... 6.日本藥favipiravir聽說也很成功但是因為我在美國比較不熟。 7.很多COVID病人為什麼這麼sick，明明年輕人卻full blown ARDS比老人更嚴重，因為很多是cytokine release syndrome的關係。所以IL-6 inhibitor如tocilizumab or sarilumab本來治rheumatoid arthritis的生物製劑或許也有用。現階段也還在臨床試驗中，可以抽血IL-6監測。聽說MGH用tocilizumab，而我的醫院也要開始臨床試驗sarilumab #Code status：COVID大部分還是胸腔性疾病，很多就是插管呼吸器ARDS mode來治療，因此插管是很重要的環節。但是有些運氣不是很好的病人，多重器官衰竭等等突然coded需要CPR的情況，這對醫療團隊來說是暴露極高風險甚至多半可能徒勞。我認為有必要一開始就要跟病人談好DNR，這不代表就要DNI，該插管還是要插管，但是真的不幸心跳停止等，要量力而為。 #醫院管理：至少在紐約我們的物資設備都輸台灣很多也嚴重不足，不過也許可以給台灣要是不幸疫情大爆發做個借鏡。現在醫院幾乎都是COVID病人，也不可能一人一間病房了，因此直接把COVID病人直接放在同一間房間，反正都得病了也不怕被感染了。不過還是建議最好病房的門是有窗戶的至少從外面看進去可以知道病人好不好，而且就我剛剛所說，病人原本可能好好的就突然血氧掉非常喘需要趕快插管，每個住院病人真的像未爆彈。另外ICU病人因為常常有很多pump點滴，護理師要一直進出隔離房不方便穿脫PPE，可以考慮直接把pump放在房間外面，點滴線延長出去就好，這樣如果護理師要調sedation or pressors等等就可以不用進入房間更改設定。 #國家防疫：現階段台灣防疫做很好，還在containment的階段，就是把最有可能的人抓出來隔離，但是對於平均每個個案的隔離成本很高，國家也很不容易控制，目前台灣有兩百多的個案，但是某天要是慢慢累積好幾百個病人甚至破千，我們也許就要調整策略，因為把全部只要是陽性的病人都抓到醫院關那是不可能的，台灣沒有那麼多的醫療能量，也不能這樣浪費，而且輕症染病的病人，要多久PCR會轉陰性，我還沒看到研究統計出來，應該也很少人會做這樣研究，因為很少國家會像台灣如此嚴格標準檢疫隔離的，就好像今天得influenza A，如果不太嚴重也是讓病人回家，病癒就是病癒，一般醫師也不會再重複flu swab；同樣如果有C.diff病人，把PO Vanc的療程吃完沒有再拉肚子，你也是當作好了不會再去驗糞便。個人覺得台灣可以把輕症病人平均多久時間PCR轉陰性做個統計發表研究。我最近看了世界著名病毒學專家何大一博士的專訪(https://www.caltech.edu/about/news/tip-iceberg-virologist-david-ho-bs-74-speaks-about-covid-19?fbclid=IwAR1XVnPHq82gD97Y2Y06FkIFzAtNNfopnMgqa98fHAwX7WHzHGyBVbnZlIQ) 個人覺得這篇寫得不錯，裡面他就有寫到目前也不知道陽性的病人過多久後才不會有傳染力，他說猜測大概三週。至於已經得過COVID的病人之後會不會再重複感染，他是覺得應該是不會，也就是現在所有的防疫工作，就是在爭取時間讓疫苗可以製造出來讓群體都可以有保護效果。現階段幾乎的國家都大爆發，就不可能像台灣還在containment的防疫階段，因為你要假設所有人都有可能是病人，那能做的就是#緩和曲線了flatten the curve，我覺得這個概念相當重要，基本上就是拖延戰術，減少不必要的社交和聚集，要social distancing，不必要的商業活動要停止，電影院酒吧夜店要關，餐廳只能外帶等等，這可以避免加速接觸感染，讓病人增加量不要達這麼快一下超出醫療能負荷的數量避免醫療崩壞，很多國家都在這麼做了，目前聽起來表現比較好的國家像是南韓，雖然他們一開始防疫沒有做好導致非常多人得病，但是經過大規模檢驗，還有避免出門要待在家等等，目前疫情也有和緩的趨勢，算是亡羊補牢，也不是不行。台灣目前表現全球數一數二，但是我們總是要做最壞的準備跟打算。 #後記：沒想到一下就寫這麼多，這算是我第一線醫療工作者的紀實與經驗分享，目前紐約疫情雖然已嚴重崩壞，但實際上還只是開始而已不見緩和。不過美國參戰之後相信會有更多醫學研究與臨床治療準則可以參考，實際上也不完全是壞事。你問我會不會怕我每天也是提心吊膽的，都很怕生病，每天都要很注意自己的身體狀態，但偏偏美國住院醫師工時非常長(週休一日而已也沒有PM off)又不斷把我們明明不是在病房rotate的時候抓來上班取消我們的門診等等，我都盡量多休息有時間就睡覺保持免疫力。現在在醫院其實也是看到很多恐慌的面孔，我們醫院是公立醫院，平常病人多為社會最底層的人，吸毒的、遊民的、酗酒的，總之各種問題台灣一個比較健康的社會大概很難想像是一個怎麼樣的場所。不過最近因為COVID病人大爆發，我發現很多可能社會上的一般人或中產階級，他們可能是警察、可能是清潔工、就某天感染病毒生病了，這時候醫護站起來照顧他們治療他們，讓他們免於恐懼，這是作為醫學生涯也算比較榮光的時候，因為我們平常的訓練，就在這時候派上用場，也算是找到一點點行醫的意義跟價值。可以平安地活著其實就很好。目前台灣社會可以安全的生活著也真的很好。"],["topImageUrl",null],["error",null]]}]}],["createdAt","2020-03-30T05:25:11.733Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",1],["user",{"__iterable":"Map","data":[["id","j4S8C_MPeoh1MTjzdSeEZxnCB1uIajKpkm0I2euRaMmBqVx0U"],["name","乂貫徹始終的池上華莉絲乂"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","British Columbians warned of Salmonella infections"],["url","http://www.bccdc.ca/about/news-stories/news-releases/2020/british-columbians-warned-of-salmonella-infections"],["summary","British Columbia (B.C.) is one of five provinces experiencing an ongoing Salmonella outbreak. The outbreak has been linked to red onions, imported from the United States. To date, 43 cases have been reported in B.C. in all regional health authorities since mid-June.Until more is known about the outbreak, individuals in B.C., Alberta, Saskatchewan, Manitoba, and Ontario are advised to not eat any red onions imported to Canada from the U.S., including any food products that contain raw red onions imported from U.S.. Retailers and restaurants in these locations are also advised not to use, sell or serve red onions imported from the U.S.. Red onions grown in Canada are not affected by this advice.B.C. is collaborating with the Public Health Agency of Canada, provincial public health partners, the Canadian Food Inspection Agency, and Health Canada to investigate outbreak. Information about the investigation and food safety can be found on the Public Health Agency of Canada website. Salmonella infection causes symptoms including diarrhea, fever, and abdominal cramps that develop six to 72 hours after exposure and usually lasts four to seven days. Most people recover without treatment. Children under five years of age and adults over 65 years of age, and people with weakened immune systems are more likely to have a severe illness. If you are experiencing symptoms, contact your health care provider."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Outbreak of Salmonella Newport Infections Linked to Red Onions | Outbreak of Salmonella Infections | July 2020 | Salmonella | CDC"],["url","https://www.cdc.gov/salmonella/newport-07-20/index.html"],["summary","July 31, 2020\nSince the last update on July 24, 2020, an additional 184 ill people have been reported in this outbreak, including 37 from 11 new states: Alaska, Colorado, Indiana, Kansas, Kentucky, Maryland, Nevada, New York, Pennsylvania, South Carolina, Texas.\nAs of July 29, 2020, a total of 396 people infected with the outbreak strain of Salmonella Newporthave been reported from 34 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.\nIllnesses started on dates ranging from June 19, 2020, to July 12, 2020. Ill people range in age from less than 1 to 102 years, with a median age of 39. Fifty-two percent of ill people are female. Of 236 ill people with information available, 59 hospitalizations have been reported. No deaths have been reported.\nIllnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks. Please see the Timeline for Reporting Cases of Salmonella Infection for more details.\nWhole genome sequencing analysis of 48 isolates from ill people did not predict any antibiotic resistance. Standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory is underway.\nWhole genome sequencing analysis shows that an outbreak of Salmonella Newport infections in Canada is related genetically to this outbreak in the United States. This means that people in both of these outbreaks likely share a common source of infection.\nInvestigation of the Outbreak\nOn July 10, 2020, CDC PulseNet identified an outbreak of 13 Salmonella Newport infections in three states. Since being identified, the outbreak has rapidly grown to a total of 396 infections in 34 states.\nState and local public health officials are interviewing ill people to determine what they ate and other exposures in the week before their illness started.\nMany ill people were identified as part of illness clusters. An illness cluster is defined as two or more people who do not live in the same household who report eating at the same restaurant location, attending a common event, or shopping at the same location of a grocery store in the week before becoming ill. Investigating illness clusters can provide critical clues about the source of an outbreak. If several unrelated ill people ate or shopped at the same location of a restaurant or store within several days of each other, it suggests that the contaminated food item was served or sold there. Twenty-two illness clusters have been identified in seven states. Information from these clusters shows that many ill people ate red onions. The traceback information collected from these illness clusters identified Thomson International, Inc. of Bakersfield, CA as a likely source of red onions. Due to the way onions are grown and harvested, other onion types, such as, white, yellow or sweet may also be contaminated. Additional traceback is ongoing to determine if other onions are linked to the outbreak.\nThe Public Health Agency of Canada (PHAC)external icon is investigating an outbreak of Salmonella Newport infections, which is related by whole genome sequencing to this outbreak in the United States.\nOn July 30, Public Health Agency of Canada’s outbreak investigation identified U.S. red onions as a likely source of their outbreak.\nConsumers, restaurants, and retailers should not eat, serve, or sell any onions from Thomson International, Inc. of Bakersfield, CA.\nCDC will provide updates when more information is available.\nPrevious Updates >>"],["topImageUrl",null],["error",null]]}]}],["text","最近請大家就暫時先別吃美國進口的洋蔥 (紅、白、黃、甜) 唄！\n美國已經有34州共396個案例，因食用受到沙門氏菌汙染的洋蔥所引起的疾病。而BC省從六月中至昨天 (7/30) 為止，也已經有43個因美國紅洋蔥所引起的病例 (全加拿大則為55例)。以下是BC疾管中心所發佈的新聞：\nhttp://www.bccdc.ca/about/news-stories/news-releases/2020/british-columbians-warned-of-salmonella-infections\n以下是美國CDC的相關資訊：\nhttps://www.cdc.gov/salmonella/newport-07-20/index.html"],["id","17wspxn3mnn74"],["createdAt","2020-08-06T21:49:38.188Z"]]}],["reply",{"__iterable":"Map","data":[["id","oOdm2XMBb3SlMKoAv0gi"],["user",{"__iterable":"Map","data":[["id","HkXxOXABHjv_5zI2Qlbz"],["name","Ann"],["avatarUrl",null],["level",16]]}],["type","OPINIONATED"],["text","北美確實爆發「沙門氏菌」感染，但目前亞洲並未有相關病例。\n\n1. 此次感染，來源為南加州湯姆森國際公司(Thomson International Inc.)所生產的紅洋蔥，目前該公司已經召回可能受交叉污染的紅、黃、白和甜洋蔥。加拿大衛生機關也呼籲民眾，若不確定洋蔥是否來自湯姆森公司，則應立即丟棄，並消毒可能與這些產品接觸的容器。截至8月8日，加拿大已有239名病例、美國已有600名以上病例。\n\n2. 湯姆森公司的洋蔥以Thomson Premium、TLC Thomson International、Tender Loving Care、El Competitor、Hartley's Best等品牌名稱販售，主要銷售範圍為北美。"],["reference","【衛福部國際重要疫情】美國-沙門氏菌\nhttps://www.cdc.gov.tw/TravelEpidemic/Detail/l3pMhSuOr0TDuWIW-_y94A?epidemicId=2M1za-H_QNWaYO99VUqCeg\n\nAt least 879 people have been sickened in a salmonella outbreak linked to onions sold at grocery stores including Walmart and Kroger\n沙門氏菌暴發至少導致879人患病與沃爾瑪和克羅格等商店出售的洋蔥有關\nhttps://www.businessinsider.com/onions-sold-at-walmart-kroger-recalled-after-516-ill-salmonella-2020-8\n\n【美國FDA】Thomson International Inc. Conducts Voluntary Recall of Red, Yellow, White, and Sweet Yellow Onions Because of Possible Salmonella Risk\n由於可能存在沙門氏菌的風險，Thomson International Inc.自願回收了紅，黃，白和甜黃洋蔥\nhttps://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/thomson-international-inc-conducts-voluntary-recall-red-yellow-white-and-sweet-yellow-onions-because\n\n【加拿大公共衛生局】Public Health Notice: Outbreak of Salmonella infections linked to red onions imported from the United States\n公共衛生通告：沙門氏菌感染暴發與美國進口紅洋蔥有關\nhttps://www.canada.ca/en/public-health/services/public-health-notices/2020/outbreak-salmonella-infections-under-investigation.html\n"],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title",""],["url","https://www.cdc.gov.tw/TravelEpidemic/Detail/l3pMhSuOr0TDuWIW-_y94A?epidemicId=2M1za-H_QNWaYO99VUqCeg"],["summary",""],["topImageUrl",null],["error","NOT_REACHABLE"]]},{"__iterable":"Map","data":[["title","At least 879 people have been sickened in a salmonella outbreak linked to onions sold at grocery stores including Walmart and Kroger"],["url","https://www.businessinsider.com/onions-sold-at-walmart-kroger-recalled-after-516-ill-salmonella-2020-8"],["summary","Onions are being recalled in the US and Canada because of a salmonella outbreak that has sickened at least 879 people in the two countries."],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Thomson International Inc. Conducts Voluntary Recall of Red, Yellow, White, and Sweet Yellow Onions Because of Possible Salmonella Risk"],["url","https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/thomson-international-inc-conducts-voluntary-recall-red-yellow-white-and-sweet-yellow-onions-because"],["summary","Thomson International Inc. of Bakersfield, California is recalling Red, Yellow, White, and Sweet Yellow Onions shipped from May 1, 2020 through the present. The onions are being recalled because they have the potential to be contaminated with Salmonella, an organism that can cause serious and somet"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Public Health Notice: Outbreak of Salmonella infections linked to red onions imported from the United States - Canada.ca"],["url","https://www.canada.ca/en/public-health/services/public-health-notices/2020/outbreak-salmonella-infections-under-investigation.html"],["summary","August 2, 2020 – Update\nSince July 30, there have been six additional illnesses reported in the ongoing Canadian investigation, including illnesses in Saskatchewan and Québec. There are now 120 confirmed cases in Canada. Investigators have determined that potentially contaminated red onions are coming from Thomson International Inc. of Bakersfield, California, United States of America (USA). \nAlthough the investigation has determined that red onions are the likely source of the outbreak, Thomson International Inc. has recalled all varieties of onions that could have come in contact with potentially contaminated red onions, due to the risk of cross-contamination. Onion varieties includes red, white, yellow, and sweet yellow onions. \nThe Canadian Food Inspection Agency (CFIA) has issued food recall warnings for related products that came to Canada. Some of these products were possibly distributed nationally. Additional food recall warnings in Canada are possible. More information on recalled products is available on CFIA’s website.\n\nGiven this new information, and until more is known about the outbreak, do not eat, use, sell or serve any red, white, yellow, and sweet yellow onions from Thomson International Inc., Bakersfield, California, USA, or any products made with these onions. This advice applies to all individuals across Canada, as well as retailers, distributors, manufacturers and food service establishments such as hotels, restaurants, cafeterias, hospitals and nursing homes.\nOnions grown in Canada are not affected by this advice.\nOn this page\n\n Why you should take note\n Investigation summary\n Who is most at risk\n What you should do to protect your health\n Symptoms\n What the Government of Canada is doing\n Epidemiological information\n Additional information\n Media contact\n Public inquiries\n Investigation history\n\nWhy should you take note\nThe Public Health Agency of Canada (PHAC) is collaborating with federal and provincial public health partners, the United States Centers for Disease Control and Prevention (U.S. CDC), and the U.S. Food and Drug Administration to investigate an outbreak of Salmonella infections occurring in seven provinces.\nIn Canada, based on the investigation findings to date, exposure to red onions imported from the USA has been identified as a likely source of the outbreak. Many of the ill individuals under investigation reported having eaten red onions before getting sick.\nThrough a collaborative investigation between public health and food safety partners in Canada and the U.S., traceback information has identified that the contaminated red onions are coming from Thomson International Inc. of Bakersfield, California, USA. \nThe CFIA has issued food recall warnings for related products that came to Canada. Some of these products were possibly distributed nationally. Additional food recall warnings in Canada are possible. More information is needed to determine the cause of contamination in red onions imported from Thomson International Inc. The outbreak is ongoing, as recent illnesses continue to be reported to the PHAC.\n\nGiven this new information, and until more is known about the outbreak, do not eat, use, sell or serve any red, yellow, white, and sweet yellow onions grown by Thomson International Inc. of Bakersfield, California, USA, or any products made with these onions. This advice applies to all individuals across Canada, as well as retailers, distributors, manufacturers and food service establishments such as hotels, restaurants, cafeterias, hospitals and nursing homes. \nOnions grown in Canada are not affected by this advice.\nAs the investigation is ongoing, it is possible that additional sources could be identified, and additional food recall warnings related to this outbreak may be issued. This public health notice will be updated as the investigation evolves.\nInvestigation summary\nAs of August 2, 2020, there have been 120 confirmed cases of Salmonella Newport illness linked to this outbreak in the following provinces: British Columbia (43), Alberta (56), Saskatchewan (4), Manitoba (13), Ontario (2), Quebec (1) and Prince Edward Island (1). \nIndividuals became sick between mid-June and mid-July 2020. Seventeen individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between 3 and 100 years of age. The majority of cases (56%) are female.\nIndividuals who became ill reported eating red onions at home, in menu items ordered at restaurants and in residential care settings.\nThe Canadian Food Inspection Agency (CFIA) is conducting a food safety investigation and has issued related food recall warnings. Additional food recall warnings in Canada are possible. More information on recalled products is available on CFIA’s website.\n\nThe U.S. CDC is also investigating an outbreak of Salmonella Newport illnesses that have a similar genetic fingerprint to illnesses reported in this outbreak. Investigators in Canada and the U.S. continue to collaborate to exchange information and identify commonalities in the outbreak information that may identify additional sources of illness or help to identify the cause of contamination in the red onions.\nIt is possible that more recent illnesses may be reported in the outbreak because there is a period of time between when a person becomes ill and when the illness is reported to public health officials. For this outbreak, the illness reporting period is between two and four weeks.\nWho is most at risk\nAnyone can become sick with a Salmonella infection, but children aged 5 years and under, older adults, pregnant women or people with weakened immune systems are at higher risk for contracting serious illness.\nMost people who become ill from a Salmonella infection will recover fully after a few days. It is possible for some people to be infected with the bacteria and to not get sick or show any symptoms, but to still be able to spread the infection to others.\nWhat should you do to protect your health\nDo not eat, use, sell or serve any red, white, yellow, and sweet yellow onions from Thomson International Inc., of Bakersfield, California, USA, or any products made with these onions. This advice applies to all individuals across Canada, as well as retailers, distributors, manufacturers and food service establishments such as hotels, restaurants, cafeterias, hospitals and nursing homes.\nAdvice to consumers\nIndividuals are asked to check their homes for red, white, yellow, and sweet varieties, including whole, sliced, or chopped onions, and any prepared foods that contain onions as an ingredient, such as premade salads, sandwiches, wraps, salsas or dips. \n\n If you have onions at home:\n \n Look for a label showing where the onion was grown. It may be printed on the package or on a sticker. \n If the packaging or sticker shows that it is from Thomson International Inc., don't eat it. Throw it away and wash your hands.\n If it isn't labeled, don't eat it. Throw it away and wash your hands.\n If you don't know whether the onion found in a premade salad, sandwich, wrap, salsa or dip contains onions from Thomson International Inc., don't eat it. Throw it away and wash your hands.\n Wash and sanitize any surfaces that may have come in contact with onions or their packaging, such as countertops, fridge drawers, pantry shelves, knives, and cutting boards.\n \n \n If you buy onions at grocery or convenience stores:\n \n Make sure they are not selling onions from Thomson International Inc., or serving fresh foods prepared with them. \n If you can't confirm that the onion in stores is not from Thomson International Inc., don't buy it.\n \n \n If you order salad or any other food items containing onions at a restaurant or food establishment:\n \n Ask the staff whether their onions come from Thomson International Inc. If they did, or they don’t know, don’t eat it.\n \n \n Do not eat any recalled food products. Check to see if you have recalled food products at home. If you do, throw them out and wash your hands. \n If you have been diagnosed with a Salmonella infection or any other gastrointestinal illness, do not cook food for other people.\n Contact your local public health authority to report any food safety concerns at restaurants or grocery stores, or if you suspect food poisoning from a restaurant or other food establishments.\n\nAdvice to restaurants, retailers, suppliers and distributors\n\n Check the label on bags or boxes of onions, or ask their suppliers about the source of their onions.\n Do not ship or sell onions from Thomson International Inc. of Bakersfield, California, USA, or any products made with these onions.\n Clean and sanitize all surfaces and storage bins that onions may have come in contact with, including cutting boards, countertops, slicers, utensils, and containers used to store or transport them.\n\nSymptoms\nSymptoms of a Salmonella infection, called salmonellosis, typically start 6 to 72 hours after exposure to Salmonella bacteria from an infected animal, person or contaminated product.\nSymptoms include:\n\n fever\n chills\n diarrhea\n abdominal cramps\n headache\n nausea\n vomiting\n\nThese symptoms usually last for 4 to 7 days. In healthy people, salmonellosis often clears up without treatment, but sometimes antibiotics may be required. In some cases, severe illness may occur and hospitalization may be required. People who are infected with Salmonella bacteria can be infectious from several days to several weeks. People who experience symptoms, or who have underlying medical conditions, should contact their health care provider if they suspect they have a Salmonella infection.\nWhat is the Government of Canada doing\nThe Government of Canada is committed to protecting the health of Canadians from enteric disease outbreaks. \nThe Public Health Agency of Canada leads the human health investigation into an outbreak and is in regular contact with its federal, provincial and territorial partners to monitor the situation and to collaborate on steps to address an outbreak.\nHealth Canada provides food-related health risk assessments to determine whether the presence of a certain substance or microorganism poses a health risk to consumers.\nThe Canadian Food Inspection Agency conducts food safety investigations into the possible food source of an outbreak.\nThe Government of Canada will continue to update Canadians if new information related to this investigation becomes available.\nEpidemiological information\nFigure 1 is an epidemiological curve for this outbreak, which shows the numbers of new cases by week. Outbreak investigators use this information to show when illnesses begin, when they peak and when they trail off. It can take several weeks from the time a person becomes ill to when the illness is reported and testing confirms a link to the outbreak. Data are available for 119 cases.\n\n \n Figure 1: Number of people infected with Salmonella Newport \n \n \n \n Figure 1 - Text Description\n \n \n Table 1 – Number of people confirmed to be infected with Salmonella Newport by week of illness onset or specimen collection\n \n \n \n Week of symptom onset or specimen collection\n Number of cases\n \n \n \n \n 2020-06-14\n 2\n \n \n 2020-06-21\n 11\n \n \n 2020-06-28\n 42\n \n \n 2020-07-05\n 43\n \n \n 2020-07-12\n 19\n \n \n 2020-07-19\n 2\n \n \n \n \n\nAdditional information\n\n CFIA’s food safety investigation\n\n \n U.S. CDC’s Salmonella Newport investigation notice \n Salmonella\n Safe food handling practices\n COVID-19 and food safety\n Recalls and safety alerts mobile application\n\nMedia contact\nPublic Health Agency of Canada\n Media Relations\n 613-957-2983\nPublic inquiries\nCall toll-free: 1-866-225-0709\n Email: info@hc-sc.gc.ca\nInvestigation history \n\n Public Health Notice: July 30, 2020 \n Since July 24, there have been 55 additional illnesses in Canada reported in the ongoing investigation. Investigators have determined that red onions imported from the United States (U.S.) are a likely source of the outbreak.\n Until more is known about the outbreak, individuals in British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario are advised to not eat any red onions imported to Canada from the U.S., including any food products that contain raw red onions imported from U.S.. Retailers and restaurants in these locations are also advised not to use, sell or serve red onions imported from the U.S.. Red onions grown in Canada are not affected by this advice.\n\n Why should you take note \n The Public Health Agency of Canada (PHAC) is collaborating with federal and provincial public health partners, the United States Centers for Disease Control and Prevention (U.S. CDC), and U.S. health officials to investigate an outbreak of Salmonella infections occurring in five provinces.\n In Canada, based on the investigation findings to date, exposure to red onions imported from the U.S. has been identified as a likely source of the outbreak. Many of the ill individuals under investigation reported having eaten red onions before getting sick.\n Through a collaborative investigation between public health and food safety partners in Canada and the U.S., traceback information indicates that the contaminated red onions are being imported to Canada from the U.S. and distributed in central and western Canada. Red onions grown in Canada are not associated with this outbreak. More information is needed to determine the cause of contamination in red onions imported from the U.S.. The outbreak is ongoing, as recent illnesses continue to be reported to the PHAC.\n Given this new information, and until more is known about the outbreak, the Public Health Agency of Canada advises individuals in British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario to not eat any red onions imported to Canada from the U.S., including any food products that contain raw red onions imported from U.S.. Retailers and restaurants in these locations are also advised not to use, sell or serve red onions imported from the U.S.. Red onions grown in Canada are not affected by this advice.\n Investigation summary\n As of July 30, 2020, there have been 114 confirmed cases of Salmonella Newport illness linked to this outbreak in the following provinces: British Columbia (43), Alberta (55), Manitoba (13), Ontario (2), and Prince Edward Island (1). The individual from Prince Edward Island reported travelling to Alberta before becoming ill. Saskatchewan has not reported any confirmed illnesses related to this outbreak, but provincial public health authorities are investigating some Salmonella Newport illnesses in the province.\n Individuals became sick between mid-June and mid-July 2020. Information is available for 102 illnesses. Out of 102 people, 16 individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between 3 and 100 years of age. The majority of cases (56%) are female.\n Individuals who became ill reported eating red onions at home, in menu items ordered at restaurants and in residential care settings.\n The Canadian Food Inspection Agency (CFIA) is conducting a food safety investigation. If contaminated food products are identified, CFIA will take the necessary steps to protect the public, including recalling the product as required.\n The U.S. CDC is also investigating an outbreak of Salmonella Newport illnesses that have a similar genetic fingerprint to illnesses reported in this outbreak. Investigators in Canada and the U.S. continue to collaborate to exchange information and identify commonalities in the outbreak information that may identify additional sources of illness or help to identify the cause of contamination in the red onions.\n It is possible that more recent illnesses may be reported in the outbreak because there is a period of time between when a person becomes ill and when the illness is reported to public health officials. For this outbreak, the illness reporting period is between two and four weeks.\n What should you do to protect your health \n Individuals in British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario are advised to not eat any red onions imported to Canada from the U.S., including any food products that contain raw red onions imported from U.S..\n Retailers and restaurants in these locations are also advised not to use, sell or serve red onions imported from the U.S.. Red onions harvested in Canada are not affected by this advice.\n Individuals are asked to check their homes for red onions, including whole, sliced, or chopped, as well as prepared foods that contain red onions as an ingredient, such as premade salads, sandwiches, wraps, or dips.\n \n If you have red onions at home:\n \n Look for a label showing where the red onion was grown. It may be printed on the package or on a sticker.\n If the packaging or sticker shows that it is from the U.S., don't eat it. Throw it away and wash your hands.\n If it isn't labeled, don't eat it. Throw it away and wash your hands.\n If you don't know whether the red onion found in a premade salad, sandwich, wrap or dip contains red onion from the U.S., don't eat it. Throw it away and wash your hands.\n Wash and sanitize drawers or shelves in areas (such as fridges and cupboards) where red onions were stored.\n \n \n If you buy red onions at a store:\n \n Look for a label showing where the red onion was grown. It may be printed on the package or on a sticker.\n If the packaging shows that it is from the U.S., don't buy it.\n If it is an unpackaged product, or is not labelled, ask the retailer whether the red onion comes from the U.S.\n If you can't confirm that the red onion in stores is not from the U.S., don't buy it.\n \n \n If you order salad or any other food item containing red onions at a restaurant or food establishment, ask the staff whether the red onions come from the U.S. If they did, or they don’t know, don’t eat it.\n Restaurants and retailers should check the label on bags or boxes of red onions, or ask their suppliers about the source of their red onions.\n Suppliers, distributors and others in the supply chain should not ship or sell red onions imported from the U.S.\n If you have been diagnosed with a Salmonella infection or any other gastrointestinal illness, do not cook food for other people.\n Contact your local public health authority to report any food safety concerns at restaurants or grocery stores, or if you suspect food poisoning from a restaurant or other food establishments. \n \n \n\n\n Public Health Notice: July 24, 2020\n Why should you take note \n The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency, and Health Canada to investigate an outbreak of Salmonella infections occurring in five provinces. \n At this time, the source of the outbreak has not been identified, but health and food safety partners are investigating what is making people sick. The outbreak is ongoing, as recent illnesses continue to be reported to the Public Health Agency of Canada.\n Salmonella bacteria are found naturally in the intestines of animals, reptiles and birds. The bacteria are most-often transmitted to people when they eat contaminated foods. Contaminated foods often come from animal sources, such as poultry, beef, milk or eggs, but can also include fruits, vegetables, and herbs. \n In an effort to prevent further illnesses, Canadians are advised to wash their hands frequently and use safe food handling practices to prevent Salmonella infections. \n This public health notice will be updated as the investigation evolves.\n Investigation summary\n As of July 24, 2020, there have been 59 confirmed cases of Salmonella Newport illness linked to this outbreak in the following provinces: British Columbia (23), Alberta (31), Manitoba (3), Ontario (1), and Prince Edward Island (1). Individuals became sick between mid-June and mid-July 2020. Information is available for 28 illnesses. Out of 28 people, six individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between 11 and 77 years of age. The majority of cases (54%) are female.\n The United States Centers for Disease Control and Prevention (U.S. CDC) is also investigating an outbreak of Salmonella Newport illnesses that have a similar genetic fingerprint to illnesses reported in this outbreak. Investigators in Canada and the U.S. are collaborating to exchange information to identify the source of the outbreak. \n It is possible that more recent illnesses may be reported in the outbreak because there is a period of time between when a person becomes ill and when the illness is reported to public health officials. For this outbreak, the illness reporting period is between two and four weeks.\n What should you do to protect your health \n It is difficult to know whether a product is contaminated with Salmonella because you can't see, smell or taste it. To help prevent Salmonella infections, the Public Health Agency of Canada recommends following safe food handling tips. The following tips may help reduce your risk of getting sick, but they may not fully eliminate the risk of illness.\n \n Wash your hands with soap and warm water for at least 20 seconds before and after handling raw meat and fresh produce.\n Cook food to a safe internal temperature that has been checked using a digital thermometer. \n Always read and follow cooking instructions on the package of any food items.\n Keep raw food away from other food while shopping, storing, repackaging, cooking and serving food.\n Wash fresh produce thoroughly under fresh, cool, running water, even if you plan to peel them. This helps prevent the spread of any bacteria that may be present.\n Never rinse raw meat before using it because the bacteria can spread everywhere the water splashes, creating more of a safety hazard.\n Sanitize countertops, cutting boards and utensils before and after preparing food. Use a kitchen sanitizer (following the directions on the container) or a bleach solution (5 mL household bleach to 750 mL of water), and rinse with water.\n Use paper towels to wipe kitchen surfaces, or change dishcloths daily to avoid the risk of cross-contamination and the spread of bacteria, and avoid using sponges as they are harder to keep bacteria-free.\n Use one cutting board for produce, and a separate one for raw meat, poultry, fish and seafood.\n Place peeled or cut fruits and vegetables on a separate clean plate or in a container to prevent them from becoming cross-contaminated.\n If you have been diagnosed with a Salmonella infection or any other gastrointestinal illness, do not cook food for other people.\n \n Contact your local public health authority to report any food safety concerns at restaurants or grocery stores, or if you suspect food poisoning from a restaurant or other food establishments."],["topImageUrl",null],["error",null]]}]}],["createdAt","2020-08-10T17:24:16.301Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",2],["user",{"__iterable":"Map","data":[["id","j4S8C_7bEI-joW4qmsKk9jUEkh7ekXvS4fLnU-z0UBebwmzYI"],["name","細節的六腳馬文"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Coronavirus Update (Live): 5,199,011 Cases and 334,698 Deaths from COVID-19 Virus Pandemic"],["url","https://www.worldometers.info/coronavirus/"],["summary","How dangerous is the virus?\n\nThere are three parameters to understand in order to assess the magnitude of the risk posed by this novel coronavirus: \n\nTransmission Rate (Ro) - number of newly infected people from a single case\nCase Fatality Rate (CFR) - percent of cases that result in death \nDetermine whether asymptomatic transmission is possible\n\nHow contagious is the Wuhan Coronavirus? (Ro) \nThe attack rate or transmissibility (how rapidly the disease spreads) of a virus is indicated by its reproductive number (Ro, pronounced R-nought or r-zero), which represents the average number of people to which a single infected person will transmit the virus.\nWHO's estimated (on Jan. 23) Ro to be between 1.4 and 2.5. [13]\nOther studies have estimated a Ro between 3.6 and 4.0, and between 2.24 to 3.58. [23]. \nPreliminary studies had estimated Ro to be between 1.5 and 3.5. [5][6][7]\nAn outbreak with a reproductive number of below 1 will gradually disappear.\nFor comparison, the Ro for the common flu is 1.3 and for SARS it was 2.0.\n\nFatality Rate (case fatality ratio or CFR) of the Wuhan Coronavirus\nSee full details: Coronavirus Fatality Rate\nThe novel coronavirus' case fatality rate has been estimated at around 2%, in the WHO press conference held on January 29, 2020 [16] . However, it noted that, without knowing how many were infected, it was too early to be able to put a percentage on the mortality rate figure.\n A prior estimate [9] had put that number at 3%. \nFatality rate can change as a virus can mutate, according to epidemiologists.\nFor comparison, the case fatality rate for SARS was 10%, and for MERS 34%.\nIncubation Period (how long it takes for symptoms to appear) \nSee full details: COVID-19 Coronavirus Incubation Period \nSymptoms of COVID-19 may appear in as few as 2 days or as long as 14 (estimated ranges vary from 2-10 days, 2-14 days, and 10-14 days, see details), during which the virus is contagious but the patient does not display any symptom (asymptomatic transmission).\nAge and conditions of Coronavirus cases \n See latest findings: Age, Sex, Demographics of COVID-19 Cases and Deaths \nAccording to early estimates by China's National Health Commission (NHC), about 80% of those who died were over the age of 60 and 75% of them had\npre-existing health conditions such as cardiovascular diseases and\ndiabetes.[24]\nAccording to the WHO Situation Report no. 7 issued on Jan. 27:\n\n\nThe median age of cases detected outside of China is 45 years, ranging from 2 to 74 years.\n 71% of cases were male.\n\nA study of 138 hospitalized patients with NCIP found that the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men.[25] \nThe WHO, in its Myth busters FAQs, addresses the question: \"Does the new coronavirus affect older people, or are younger people also susceptible?\" by answering that: \n\nPeople of all ages can be infected by the novel coronavirus COVID-19. \nOlder people, and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) appear to be more vulnerable to becoming severely ill with the virus.\n\n Patient who died in the Philippines was a 44-year old male\nThe patient who died in the Philippines on February 2, in what was the first death occurring outside of China, was a 44-year-old Chinese man from Wuhan who was admitted on Jan. 25 after experiencing fever, cough, and sore throat, before developing severe pneumonia. In the last few days, “the patient was stable and showed signs of improvement, however, the condition of the patient deteriorated within his last 24 hours resulting in his demise.\"\naccording to the Philippine Department of Health.\nSerious Cases of 30 year old patients in France \n\nAs of Jan. 29, according to French authorities, the conditions of the two earliest Paris cases had worsened and the patients were being treated in intensive care, according to French authorities. The patients have been described as a young couple aged 30 and 31 years old, both Chinese citizens from Wuhan who were asymptomatic when they arrived in Paris on January 18 [19].\nAge and Sex of the first deaths as reported by the China National Health Commission (NHC) \n The NHC reported the details of the first 17 deaths up to 24 pm on January 22, 2020. The deaths included 13 males and 4 females. The median age of the deaths was 75 (range 48-89) years.[21]\nWHO Risk Assessment: Global Emergency\nSee full details: WHO coronavirus updates\nOn January 30, the World Health Organization declared the coronavirus outbreak a Global Public Health Emergency.\nFor more information from the WHO regarding novel coronavirus: WHO page on Novel Coronavirus (2019-nCoV)"],["topImageUrl",null],["error",null]]}]}],["text","今日新聞報導，多國旅遊解封，但都未納入台灣，台灣自詡防疫成績不錯，為何會是這般結果。有分析說，台灣是被動篩檢新冠，篩檢總數及比例偏低，恐有漏網之魚。\n上網查了一下，台灣篩檢新冠肺炎總數7萬多，排名全球85，每百萬人篩檢數，僅有3000多，全球排名138，看來，我們還是不可掉以輕心，勤洗手，戴口罩，保持社交距離都不可偏廢。\n\nhttps://www.worldometers.info/coronavirus/"],["id","1ozp5wj935xi5"],["createdAt","2020-06-12T02:16:12.627Z"]]}],["reply",{"__iterable":"Map","data":[["id","L9fquXIBb3SlMKoACveb"],["user",{"__iterable":"Map","data":[["id","HkXxOXABHjv_5zI2Qlbz"],["name","Ann"],["avatarUrl",null],["level",16]]}],["type","OPINIONATED"],["text","1. 截至6月11日，至少已有14個歐洲國家宣布放寬觀光入境，其中英國、西班牙、希臘、冰島、土耳其5國已開放台灣旅客入境。\n\n據《天下雜誌》報導，目前紐西蘭、帛琉也有望與台灣開放互惠入境。而網路傳言泰國解封不含台灣，外交部也已回應「台灣並未被排除在優先名單外」，但目前尚無正式名單。6月中下旬，台灣與史丹佛大學也即將啟動舊金山飛往台北的千人規模跨國旅遊實驗，找出國際旅行「最短安全隔離期」的規範與檢疫隔離方式。\n\n2. 雖有評論認為，部分國家解封不含台灣，是由於台灣無大規模篩檢，但指揮中心李秉穎表示，台灣已對上萬例不符通報條件者採檢，均無潛伏感染者，顯示沒有普篩必要。醫師也提醒，仍要持續遵守防疫生活規則，以免秋冬疫情捲土重來。"],["reference","各國邊境管制漸解封歐洲5國開放台客入境\nhttps://tw.stock.yahoo.com/news/各國邊境管制漸解封-歐洲5國開放台客入境-001728341.html\n\n疫情放緩各地嘗試「旅行泡泡」解封邊境\nhttps://www.bbc.com/zhongwen/trad/world-53007098\n\n不用隔離14天？台美千人跨境實驗，替全球邊境解封鋪路\nhttps://www.cw.com.tw/article/article.action?id=5100651\n\n我與史丹佛合作研究「最短隔離期」／透過實驗找出邊境檢疫新模式可望立下恢復國際旅行規範\nhttps://news.ltn.com.tw/news/life/paper/1373567\n\n泰國將解封首波含台灣？外交部證實了\nhttps://tw.news.yahoo.com/泰國將解封首波含台灣-外交部證實了-032011789.html\n\n疫情降溫普篩聲浪未減李秉穎：根本沒有必要\nhttps://www.cna.com.tw/news/firstnews/202005290198.aspx"],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","各國邊境管制漸解封歐洲5國開放台客入境 - Yahoo奇摩股市"],["url","https://tw.stock.yahoo.com/news/各國邊境管制漸解封-歐洲5國開放台客入境-001728341.html"],["summary","希臘、英國、西班牙、冰島、土耳其5國開放台灣旅客入境，須配合檢疫隔離(圖/Booking.com　提供)"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","疫情放緩各地嘗試「旅行泡泡」解封邊境"],["url","https://www.bbc.com/zhongwen/trad/world-53007098"],["summary","歐洲的愛沙尼亞、拉脫維亞和立陶宛已經互相開放邊境。另外澳洲和新西蘭，還有香港、澳門和廣東也凖備互相開放。"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","不用隔離14天？台美千人跨境實驗，替全球邊境解封鋪路｜天下雜誌"],["url","https://www.cw.com.tw/article/article.action?id=5100651"],["summary","台灣與美國史丹佛大學合作，將啟動跨國旅遊實驗，招募千人從舊金山飛抵台北，配合檢驗與檢疫規劃。這場跨越太平洋東西岸的大型實驗，試圖找出安全的跨國對飛新模式。"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","我與史丹佛合作研究「最短隔離期」／透過實驗找出邊境檢疫新模式可望立下恢復國際旅行規範 - 生活 - 自由時報電子報"],["url","https://news.ltn.com.tw/news/life/paper/1373567"],["summary","全球武漢肺炎（新型冠狀病毒病，COVID-19）疫情雖有緩和跡象，但各國對於重新開放空中交通仍不敢大意。英國《金融時報》十八日指出，防疫成效卓著的台灣政府，將與美國史丹佛大學醫學院合作，在台、美兩地針對外國旅客進行檢疫和隔離方式的研究比對，找出「最短安全隔離期（shortest safe quarantine period）」，研究結果可望為恢復國際旅行立下新規範。中央流行疫情指揮中心專家諮詢小組召集人張上淳昨表示，對方希望六月執行，但相關細節仍在討論中，希望討論清楚再執行。出境國篩檢確認陰性入境或可縮短檢疫期"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","泰國將解封首波含台灣？外交部證實了 | 新聞 - Yahoo奇摩行動版"],["url","https://tw.news.yahoo.com/泰國將解封首波含台灣-外交部證實了-032011789.html"],["summary","政治中心／綜合報導泰國武漢肺炎疫情緩和，研擬逐步開放國際觀光客入境，泰國政府計畫與有效控制疫情的國家簽署協議，放開彼此國家人民有條件入境觀光，不需要隔離14天，傳出中國、香港、台灣"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","疫情降溫普篩聲浪未減李秉穎：根本沒有必要 | 生活 | 重點新聞 | 中央社 CNA"],["url","https://www.cna.com.tw/news/firstnews/202005290198.aspx"],["summary","國內武漢肺炎疫情降溫，但普篩聲浪未減。指揮中心專家諮詢小組委員李秉穎表示，台灣已對上萬例不符通報條件者採檢，均無潛伏感染者，顯示根本沒有普篩必要。"],["topImageUrl",null],["error",null]]}]}],["createdAt","2020-06-15T21:37:02.624Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",2],["user",null],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Edward M. Mautner Oral History"],["url","http://www.jsc.nasa.gov/history/oral_histories/NASA_HQ/Experts/MautnerEM/MautnerEM_3-22-12.htm"],["summary","NASA Johnson Space Center \n Oral History Project\n Edited Oral History Transcript\n Edward \n M. Mautner\n Interviewed by Jennifer Ross-Nazzal\n Chantilly, Virginia – 22 March 2012\n Ross-Nazzal: \n Today is March 22, 2012. This interview with Ed Mautner is being conducted \n at the [Smithsonian National Air and Space Museum] Steven Udvar-Hazy \n Center in Chantilly, Virginia, for the JSC Oral History Project. Interviewer \n is Jennifer Ross-Nazzal, assisted by Rebecca Wright. Thanks again \n for taking time out of your schedule.\n Mautner: \n You’re welcome, it’s my pleasure to do it.\n Ross-Nazzal: \n If you would, tell us about the state of [OV (orbiter vehicle)-101] \n Enterprise in 2003 before she was restored.\n Mautner: \n My familiarity with Enterprise was quite limited before I began work \n on it. When we received it, it had been stored both outdoors and in \n a non-climate-controlled hangar since the mid-80s, and a lot of deterioration \n of the surface coatings—the paint, the markings—had taken \n place. Woodpeckers had gotten up onto the vertical stabilizer and \n pecked a lot of holes into the polyurethane foam that they used as \n a mockup for tiles. I don’t recall the number of holes, but \n there were quite a few of them. \n And then just about every form of creature had made the Enterprise \n their habitat and playground. Birds had gotten into it; bugs had gotten \n into it. Hornets or wasps had made their little mud nests in the landing \n gear wells. They made it out of this beautiful red Virginia clay dirt \n that surrounds the area. In fact, when we started to clean them it \n almost seemed as if the aircraft was bleeding, the soil they made \n those nests out of was so red.\n It had basically suffered a lot of inattention. It hadn’t been \n cleaned or worked on to any great degree. I believe it was outside \n for about two years prior to them building the hangar for it, and \n it had been rained on. There were many ports of entries for water, \n and so water had pooled inside the bottom of the fuselage and it had \n left a lot of staining from dirt, waterlines, etc. and also had caused \n some minor pitting and corrosion. Nothing that would weaken the structure \n of the aircraft but certainly had caused some deterioration.\n Ross-Nazzal: \n Tell us about that move, when you decided to move her from that hangar \n into this facility.\n Mautner: \n Until I walked in March 1st of 2004, I had never touched Enterprise \n and I had really nothing to do with it. I recall being in the hangar \n the day they moved it in, and just about all the employees who were \n out here took a break to watch them tug it down the tow way from the \n airport and into the building.\n What was noteworthy at the time was that they had cut a notch in the \n back wall of the space hangar in order to permit the vertical [stabilizer] \n to come through. It was the only way to get Enterprise into that building \n without taking the vertical off, which would have been a prohibitively \n difficult task. I came back the next day and the blanking plate had \n been restored as if the building had never changed at all, so that \n was pretty neat. It was a well-prepared move.\n That took place in the early fall of 2003, and while I was aware that \n it was in the building, it was sometime after January 2004 that I \n was notified that I would be working on it in preparation for the \n opening of the space hall [James S. McDonnell Space Hangar].\n Ross-Nazzal: \n What was your expertise prior to working on Enterprise? Were you working \n on aircraft restoration?\n Mautner: \n My background is—the British would describe it as checkered. \n I did a whole lot of things before I got directly involved in airplanes. \n I started out as a kid building model airplanes, and I never gave \n that up. I always built model airplanes, and I continue to do so. \n And I was always a museum rat, an airplane museum rat. Whenever we \n traveled, wherever we went, there was always a stop at an airplane \n museum somewhere.\n Somewhere around the late 80s, my wife and I had moved our children \n to southern California, and I began to volunteer in some aircraft \n museums out there. Planes of Fame in [Air Museum] Chino, and later \n at the Command Museum at U.S. Marine Corps Air Station El Toro, which \n was right in the town I lived in so it was convenient to work there. \n I started doing structures work.\n In January of 1989 I left a former career and made a great midlife \n career change whereby I wanted to work in an aircraft museum. I had \n enjoyed volunteering on Saturdays so much, I went to Cal [California] \n State University, San Bernardino, for a Museum Studies certificate \n program. My background was in auto mechanics, and I needed to create \n a resume to get into working on aircraft, especially in museums. I \n enjoyed it immensely but had a problem with the hours of class.\n By great good fortune, McDonnell Douglas [Corporation] was hiring \n mechanics in the summer of 1989. Actually they’d been hiring \n prior to that, but that’s when I found out. I went and I applied, \n and they hired me immediately because of my automotive experience. \n I became a structures mechanic on the C-17 [aircraft] program in Long \n Beach, California. That was my first real hands-on experience with \n real aircraft manufacturing.\n I worked at McDonnell Douglas from August of 1989 until June of 1994, \n when there were massive layoffs. They were losing their contracts \n for MD-80s [airliners], and the MD-11 [airliner] never took off. The \n C-17 was in a state of flux because Congress and the Air Force were \n at loggerheads, so I and tens of thousands of others were laid off \n during that year.\n Meanwhile I had gone from my certificate program at Cal State, San \n Bernardino, to a Master’s program at Cal State, Dominguez Hills \n in Historic Preservation. Because John [F.] McDonnell of the McDonnell \n Douglas Corporation was interested in an educated workforce, they \n paid for almost all of my Master’s program, everything but my \n research courses and my thesis. \n I had early on decided that my thesis was going to be in aircraft \n preservation at the National Air and Space Museum. I thought that \n they were the best. They were the ones that were writing about aircraft \n preservation, and I really wanted to write about how they did it, \n because that seemed to be the benchmark.\n In June of 1994 I was laid off, and I immediately contacted the museum \n to do an internship back here so that I could do further research \n for my thesis. In August and September of ’94 I did a 60-day \n volunteer internship. I was outside of their regular program, so there \n was no stipend; I just came in and volunteered. I worked in the restoration \n shop during the day until about 3:30 [p.m.]. I’d then go across \n the river, downtown to the main museum and I would work in the archives.\n The people in the archives—I don’t know why, I was a total \n stranger to them—they let me stay after hours. In fact, at five \n o’clock when they left, they issued me instructions on what \n lights to turn off and how to shut down the computers. I would stay \n there till 8:30 so I’d get all my research. I had one other \n paper and I had my thesis to do, so I spent almost every weekday night \n at the museum doing that.\n They said, “Stay in touch; we’re going to be hiring.” \n The hiring was going to ramp up for this facility, this new Udvar-Hazy \n Center, so I stayed in touch. Every month I contacted somebody associated \n with the restoration facility, and finally in 1997 they said, “Something’s \n going to happen. Get back here; be nearby.” So I stayed with \n relatives and I hung out and I volunteered, and finally in February \n of 1998 they hired me. They did it because I had the academic background, \n but I also had, from McDonnell Douglas and my volunteer efforts, the \n mechanical background as well. I was very fortunate that the timing \n worked out. \n My background is chiefly in aircraft structures, which would be the \n main metal pieces that form the basis of the aircraft upon which everything \n else is hung. After I get through with my work, then the hydraulics \n people and the fuel people and the electrical people and the power \n plant people take over.\n Ross-Nazzal: \n What sort of planes have you worked on since you began working here?\n Mautner: \n The first one that I started working on was a Japanese single-engine \n floatplane bomber, [the Aichi M6A1 Seiran]. It looks more like a fighter \n with floats, but it was in fact a strategic bomber that the Japanese \n designed to fold up into an 11-foot diameter circle and fit into the \n tube on a submarine. This submarine was an aircraft carrier, literally, \n and it carried three of these. Very significant aircraft, because \n it was designed to bomb the Panama Canal locks. \n The submarine was probably more technologically advanced than the \n aircraft. It was designed to go 27,000 miles without refueling, and \n they actually did have plans to use these small bombers to bomb New \n York [City, New York] and possibly even Boston [Massachusetts]. It \n was a metal airplane, and my sheet metal experience came to good use \n there. \n After that, they put me on a World War I bomber, a twin-engine fabric-and-wood \n bomber. That airplane was a Caudron G.4, a French bomber that the \n United States tested but never purchased. Because we had no combat \n aircraft in World War I, we had to go to the French and the British \n and the Italians. That was an excellent experience because that broadened \n out my sheet metal and structures experience to wood and fabric. That \n airplane is also currently on display here.\n The next aircraft is one I’m still working on. We have a limited \n number of people here, so we get shifted off of whatever project we’re \n on to take care of other things in the museum, such as creating a \n display or working on the Enterprise for nine months in 2004. From \n about 2000 until this year, I’m still working on a World War \n II German night fighter, the Heinkel 219, a huge metal twin-engine \n aircraft, where again my airframe and sheet metal experience has come \n into use.\n Ross-Nazzal: \n Tell us what lessons you learned from working on those aircraft that \n you applied to the Enterprise.\n Mautner: \n In my case, precious few. It was a great departure from what we call \n restoration, where you actually have to fabricate or replicate or \n repair structural pieces of an aircraft. This was largely a massive \n clean-up and painting effort, so it falls under the role of preservation. \n That’s really our role here, preservation. Everybody talks about \n restoration, but restoration is the court of last resort when everything \n has pretty much gone to pot and needs to be drastically repaired or \n replaced.\n What we did on Enterprise fell under the heading of preservation, \n but we called it a refurbishment because we didn’t do anything \n to repair it. It was still considered to be NASA’s aircraft, \n and it came to us in such good structural condition that there really \n was nothing to repair on it except for the paint work.\n Ross-Nazzal: \n Would you tell us about working with NASA and USA [United Space Alliance] \n on this project? I understand they were involved.\n Mautner: \n Yes, they were. When we first began on March 1, 2004, we were pretty \n much on our own. There were just three of us: myself, Anne [C.] McCombs, \n and Steve Kautner. We walked into this big empty hangar. The only \n thing that was in it at the time was Enterprise, and it didn’t \n even have a barrier around it because the public wasn’t allowed \n in that building yet. We just kind of stood there and wondered, “Where \n the heck are we going to start on this thing?” \n We had no high-lift equipment—all we had access to were ladders—so \n we decided to start working on the landing gear. We had no contact \n with NASA outside of certain parameters that they gave us in cleaning \n and painting it, that we were given by the curator, Valerie Neal. \n Without anything else but ourselves, we began the cleaning process \n at the lowest part of the Space Shuttle, areas that were accessible \n initially to us.\n Our experience with NASA and USA came a little bit later, and [their] \n big project was the removal of all of the cockpit windscreens, the \n front ones. I believe that there were three panels in them, and there \n were some engineering discussions as to whether they could get away \n with just two panels. The challenge for us was to provide them with \n the platforms to get up there and work off of. \n Anne and I were involved, and at that point we had a lot of mechanics \n from United Airlines [Inc.] come in to assist us. Their bosses permitted \n them to give us some high-lift platforms that were attached to trucks. \n We could maneuver a truck in and then raise a platform and extend \n it out over the nose of Enterprise in order for the USA guys to remove \n those windshields. The other problem was these windscreens were very, \n very heavy. They required quite a bit of effort to crane off of the \n Shuttle.\n At that point, I began to get to meet some of the guys, most specifically \n from USA. One of them was a fellow named Tom [Thomas W.] Roberts, \n and Tom’s my friend now. He was back here for the last visit. \n There were several other mechanics that came up from KSC [NASA Kennedy \n Space Center, Florida] who I would count as really good acquaintances, \n friends, who we worked with. Got to meet Kevin [C.] Templin. He was \n always there, very personable fellow, and always a go-to guy for information \n and leadership. \n Whenever they came back, we dropped what we were doing and became \n assistants to them, to the point where in this last visit we were \n almost considered more one of their group than as a separate entity, \n which was kind of neat. The things I saw from everybody in NASA and \n USA was enthusiasm, expertise, positive attitude, and great great \n teamwork. The first thing we noticed is how well they worked as a \n team. \n Many times we didn’t know that these guys had never worked together \n before, and yet it was a seamless effort. You got to talking to them, \n you got to know them, and you realized, this guy never worked on the \n back end of the aircraft. He always worked on the front and didn’t \n even know the guys that they were working with. That was inspiring \n to us to see that kind of effort that they used to put in.\n Some of my recollection of my efforts with NASA and USA get a little \n bit confused, because some of their efforts were during that nine-month \n period when we worked on preparing Enterprise for the opening of the \n space hangar, but several of them came later. They would ask Anne \n or myself or others from the previous team to come back and assist \n them. I believe that the windshield effort was made during that nine \n months we were there, but our other efforts with them came later, \n so they’d be outside the parameters of my work on the Enterprise.\n Ross-Nazzal: \n I also read that you had to replace the OMS [orbital maneuvering system] \n pods because they had rotted.\n Mautner: \n Yes, we did. One of the first things we did was to remove those. Tony \n [Anthony W.] Carp was the team lead for the lifting of the OMS pods. \n They were a large aluminum plate that mated up to the surface of the \n Shuttle, but everything above that aluminum plate was basically wood. \n Plywood flooring, then 2 x 4 and 4 x 4 framework, and then they put \n a fiberglass cover over the top of that.\n We discovered how weak the structure was when we started to tighten \n up the fittings for the lifting rings. We’d gotten a guy inside \n to tighten the nuts up inside because they seemed loose, and he kept \n tightening and tightening and tightening. We suddenly realized that \n wood was so soft from moisture that he was just tightening the nut \n and the washer right into the wood. We had to be very, very careful \n lifting those OMS pods off.\n The OMS pods were never planned to be on the Shuttle when the space \n hall opened. That was something that we were going to install later, \n so our job now was to focus just on the Shuttle, and guys back in \n the shop worked on the OMS pods.\n Ross-Nazzal: \n Are they on there now, have they been replaced?\n Mautner: \n They were put on I think in 2005, 2006 time range, and before the \n last visit to get Enterprise ready we removed them. They’re \n out in the shop, on the floor. The guys from USA put the ALTA [Approach \n and Landing Test Article] pods on. Those are the travel pods. They \n look like OMS pods, but they’re real metal. They’re real \n structural, flightworthy, and the tail cone fits up to those components.\n Ross-Nazzal: \n Tell us about cleaning and painting the vehicle. That sounded like \n a very large chore.\n Mautner: \n Yes, it really was. I started on March 1st to clean the right main \n landing gear bay and ultimately the landing gear and tires. Steve \n Kautner took the left bay and did the same, and Anne McCombs worked \n on the nose gear and the nose gear bay. It wasn’t until March \n 22nd that Tony [Carp] came on the team, and his job was to clean the \n entire vertical surface with the ultimate purpose of coring or filling \n the holes that the woodpeckers had made.\n Somebody might at this point ask, why would woodpeckers go after polyurethane \n foam? The explanation we got—I’m not an ornithologist—is \n that woodpeckers make the noise they do as a mating call, not just \n to get to bugs inside of the tree. Once they got through that polyurethane \n foam, they were banging on an aluminum surface. It made quite a noise, \n and it was far-reaching. There were about 75 holes ranging from very \n small, smaller than your pinky, to much bigger than your thumb. \n We were using, on NASA’s recommendation, Amway LOC [liquid organic \n cleaner] cut, one part LOC to ten parts water, to wash everything. \n It’s a mild organic detergent, and it’s biodegradable. \n This was what USA used, so this was what we used. And this is where, \n in the wheel wells, I found most of the hornet nests. Once you got \n the water into them they just started running down the beautiful epoxy \n white paint panels inside.\n At that point, once Steve had finished his wheel well, he started \n working on the bottom. He started up at the nose where he could reach, \n because you couldn’t get a ladder under there. He’s all \n scrunched up, just scrubbing away—and he was a bear of a guy. \n He had a lot of strength, and he just kept working down the bottom \n of the aircraft, all of the black-painted area of the aircraft. \n At that point we started using some lift equipment, JLG [Industries, \n Inc.] lifts and scissor lifts, to get up on the wing. We began cleaning \n the wing while Tony is cleaning the vertical, and we did this day \n after day after day. Then sometime in the summer, I believe in July, \n we began prepping the center fuselage for paint. The center fuselage \n does not have polyurethane foam on it, and that center fuselage extends \n from just behind the cockpit to back underneath the OMS pods. We also \n had to clean the payload bay doors. At this point we finally were \n able to get scaffolding in. We had a local company contracted to put \n scaffolding all up the sides and then bridge the top of the Shuttle. \n \n This is where things kind of got interesting. Initially it was doing \n just a lot of sanding on the side. Apparently the aircraft had been \n painted with aerospace quality polyurethane or epoxy paint and primer, \n but when it went on tour in 1984 it had started to look a little bit \n secondhand. They used a latex house paint to give it a quick repaint \n to make it appear better at the [New Orleans, Louisiana] World’s \n Fair here in the United States, and then they went to the Paris Air \n Show with it. This was all prior to delivering it to us.\n This paint over the years had become very brittle and very hard and \n would be quite a challenge to remove. Taking it off the sides was \n pretty easy. We were able to use electric sanders or pneumatic sanding \n devices, hand-held devices, and literally sand all of that down to \n the original paint. The sanding gave the surface a real good surface \n for paint to adhere to once we finished it and cleaned it up, but \n the real challenge came with the payload bay doors. We were instructed \n by NASA to not use any metal tools, any caustic chemicals, or any \n abrasives to remove the paint.\n We got up there, and they thought it would be really easy because \n a lot of the paint on the payload bay doors had flaked off, and some \n of it was literally sitting up. They said, “Just use duct tape \n and press it down real hard and pull it off, and that paint will pull \n up.” Well, that didn’t work at all. \n All of our communications with them were through Valerie Neal, the \n curator. The other thing we weren’t supposed to use was heat, \n so we went to Valerie and said, “The duct tape just isn’t \n cutting it.” They said, “Use plexiglas scrapers.” \n Plexiglas is a real hard plastic. We would cut up sections of it, \n rectangles of it, and then make a sharp edge at one end with a grinding \n wheel. That wasn’t cutting it either.\n One day I’m sitting on the scaffolding, trying to get this stuff \n off, and I see to my left this movement from about chest height over \n the curvature of the door. I look over, and it’s Steve Kautner \n with a metal scraper and a heat gun. I’m going, “Steve, \n what are you doing?” He goes, “This is the only way it’s \n coming off.” I said, “Okay, stop. Let’s talk about \n this.” \n We went back to our conservator, and I asked him, “Do you have \n a surface temperature gauge?” We went back and attached this \n temperature surface gauge to the area that we were putting the heat \n on, and we got some heat parameters. We were getting heat in the range \n of about 175 degrees [Fahrenheit] if we kept the heat gun moving, \n so we went back to NASA and they said, “Okay, you can do that, \n but no temperatures over 200,” or 250.\n All of a sudden this became easy, but we now found out very quickly \n why they didn’t want heat up there. The doors are made of carbon \n graphite, or carbon–carbon. It’s skinned with an almost \n aluminum-foil thickness coating of aluminum. It’s not like sheet \n metal, it’s more like a foil, and if you left the heat on there \n too much it would blister. We got a couple of thumb-sized blisters; \n we damaged the door. This concerned us, and we kept talking to each \n other. We’d just make sure we’d keep that heat gun moving \n and don’t overheat one spot.\n It became very evident very quickly why they didn’t want heat \n up there. They had done the same thing at some time in the past, only \n their blisters were much bigger than ours. That told us a) it’s \n been done this way before, and b) there’s a repair for it. We \n did make a few more blisters, an inevitable result of what we were \n doing, but we knew that if they needed those doors, they could be \n made flightworthy. \n Then, because there was still a lot of paint residue clinging to the \n surface, we got down and used acetone. We were all garbed up with \n double-canister air masks. There’s terrific pictures of us all \n down on our hands and knees on the door, all tied off because we’re \n high up on the top of the Shuttle, scrubbing with Scotch-Brite scrubbers \n and acetone to get the surface completely clean and ready for paint.\n That was another thing they told us, “You can’t stand \n on the doors.” So we had these four bridges across, and we’re \n all leaning off these bridges and working off of them. Again, Steve \n Kautner’s the first one to step off right on the doors. There’s \n no other way to get out there, there was no way. I said, “Okay, \n stop. Let’s talk this over.” We went down inside the Shuttle, \n and we looked up at the doors and we could see the latching system. \n \n We knew that those doors in zero gravity could open without any support, \n but we knew that they had big supports on them when they opened them \n in the hangar down in KSC. We looked at those supports, and we looked \n at how the doors fit together. It’s built like a bridge as long \n as they’re closed and locked, so four, five, six of us all were \n out on our hands and knees on the doors, scrubbing away to get the \n last residue and make a really good surface for paint.\n That brings up another aspect for me. I couldn’t wait every \n single day to come in. I’m not a space guy, I’m an airplane \n guy. In truth, the Shuttle is probably more like an aircraft than \n a spacecraft, and that one [Enterprise] never did go into space so \n it really was just an aircraft. I never followed space, I never got \n excited about it, but I got excited by this project. I couldn’t \n wait to get in every single day. Every day was interesting and exciting, \n and we were making progress—slow—but we were making progress. \n \n When they put the scaffolding up in July, we now had to climb this \n scaffolding. We had our harnesses on and we had our tethers, but we \n couldn’t tether off anywhere on the way up. We’re climbing \n 30, 35, almost 40 feet in the air every morning, every break time, \n every time you had to leave, and then when we got up there we would \n tie off and secure ourselves. But that little element of danger made \n it exciting, and we talked about that a lot too.\n We had two injuries, but only one on Enterprise. One of our guys did \n abrade his hand, but working on something else while we were out there, \n nothing to do with the Shuttle. One injury, very minor, on the Shuttle. \n One of our members fell off the payload bay doors, but he was tethered \n and it stopped him, and all he did was bang up his knee. I think we \n lost him one day, but that was it. The fact that we talked almost \n every day about the safety issue, that he was tethered off—we \n didn’t have more issues. \n The other thing that made it interesting and fun is that we were on \n this huge, very obvious artifact in the middle of this totally empty \n hall, and the public could come in to the front of the hall—there’s \n an overlook up above—and watch us. I think the element of being \n on stage made it exciting and interesting, too.\n There were some stresses. We always seemed short of personnel. At \n one point I realized there were a whole bunch of guys working on the \n OMS pods, and I had to convince my management that the OMS pods aren’t \n needed by October 19th, but the Shuttle is, so can I have more guys? \n And I got more guys.\n Once we had sanded down the sides and had removed the paint from the \n doors, it was time for a final prep and primer and paint. We had four \n guys do that, and we had a couple of issues that we had to deal with. \n One, it had to be an aerospace quality paint. PPG, Pittsburgh Paint \n and Glass, has always supplied us with our paint system that we’ve \n used exclusively for 20 years back at the [Paul E.] Garber [Preservation, \n Restoration, and Storage Facility, Suitland, Maryland], our restoration \n shop. Dave Wilson got in touch with them, and they turned him over \n to their aerospace division. They donated what amounted to about $15,000 \n worth of white polyurethane aerospace paint and primer.\n Our next challenge was we could not spray in the building because \n the building had an open port, and some of the ventilation systems \n functioned with the aircraft hangar. Also, the filters in the ventilation \n system would get clogged up with any paint residue and dust, so we \n had to either brush or roll it. Dave talked with the people from PPG, \n and they had an additive that allowed the paint to flow so that it \n would not appear to be rolled-out paint. It wouldn’t be textured, \n it would be nice and smooth.\n We got the paint on September 17th—keeping in mind that this \n hall is supposed to open on October 19th of 2004. They had to rest \n assured that all the fumes would have dissipated by 10 o’clock \n opening the next day, so we painted at night. It was Tony, Dave, myself, \n and a fellow by the name of Bob Weihrauch who did it. We would come \n in, and that hall was completely black except for the Klieg lights \n that we worked under. We rolled out the primer, and then we rolled \n out the white. [We rolled out two coats of primer and two coats of \n white.]\n I love working here at night because there’s no people here, \n the lighting is all dim, and it’s like going into a great cathedral \n at night when nobody’s around. It’s just beautiful. It’s \n quiet. You’ve got all these objects that you love, many of which \n you’ve worked on, and there’s just a neat thing about \n working here at night. We had a really good time. We had a really \n good crew. I don’t recollect ever having any arguments or disagreements \n or problems, we just really had a good time.\n One outstanding recollection is this facility is used by organizations—police \n organizations, FBI [Federal Bureau of Investigation], the MWAA, Metropolitan \n Washington Airport Authority. They have their own SWAT [special weapons \n and tactics] team and security forces. They do a lot of work in here \n at night, but we didn’t know that. One night three of us are \n up on this scaffolding, and Dave Wilson is on a scissor lift bringing \n paint up to us, and all the sudden there’s movement in the hangar. \n \n Keep in mind that outside of this cone of light that we’re in, \n everything’s dark out there, but there’s movement. We \n look down, and there’s 20 or 30 guys in black helmets, black \n outfits carrying guns, and they’re swarming like ants through \n our hangar. Well, I immediately was not concerned because none of \n them are looking at us or pointing the gun at us. We’re in white \n bunny suits, paper coveralls, and the Klieg lights are on us. We’re \n out there, very obvious.\n One guy kind of moved up to Dave, and he goes, “Have you seen \n her?” And Dave goes, “Seen who?” He goes, “Have \n you seen her?” and then he had to move, because you’re \n not supposed to look for hints. Apparently they were on an exercise, \n and one of their supervisors came in two hours ahead of time and hid \n herself somewhere in the museum, and they had to find her. Nobody \n told us; our security had not advised us that this was going to happen. \n \n Another time, during the day, I was working on the Shuttle and nobody \n else was around. Security came up to me and said, “We have a \n congressman or a senator here with his daughter back from college, \n and he’s got his office manager and his security detail. Would \n you come down and talk to them?” So I walk inside of this circle \n of Secret Service people, and they’ve got their radios and they \n all look very, very official, and I started to talk to them. I said, \n “What state do you represent, sir?” He goes, “Oh, \n one of your neighbors.” Meanwhile, his handler, his office guy, \n did all the talking. \n I went back that night and I looked all over the Internet for our \n neighboring senators and congressmen, and I did not find him—because \n you can get the photos of all of them. I went back to security the \n next day and I said, “What was that all about?” He says, \n “Oh, it’s just a test.” It was Secret Service in \n a practice run, and these guys were just members of the Secret Service \n that were playing a role to make it seem realistic. There are a lot \n of activities that go on here that are very interesting. But again, \n I was not forewarned of that. \n The other two events that were really interesting—Joe [H.] Engle, \n one of the test pilots for Enterprise, came back and spent a day with \n us. He is just a prince of a guy, just a super guy. We got to tour \n him around and show him what we were doing, and he was just the friendliest \n guy and was very very grateful to us restoring “his” bird \n back to its original condition. A couple weeks later, we all got an \n 8 x 10 of him standing by Enterprise out at Palmdale [California] \n back in’77, ’78, with a beautiful handwritten note and \n one of the original patches from his missions. It was just neat, a \n neat thing. \n The other very very interesting visitor to us was Colonel Pamela Ann \n Melroy. She’s a two mission pilot and one mission command pilot \n [commander]. She was also on the Columbia [STS-107 accident] investigation \n team, and she led the cockpit reconstruction area. My recollection, \n she was about five-foot-five, five-foot-six. I immediately made a \n connection, because she was a test pilot on the C-17 program. As I \n had worked on it, we had some things to talk about. \n I got to tour her around, and the thing I recollect so well is that \n she made a comment when we were in the cockpit. The cockpit of Enterprise \n is for the most part empty. The dashboard is there, but there’s \n only about three instruments, and they’re all old analog instruments. \n The seats are not there. She looked at that dashboard and marveled \n at the fact that it was the first time she’d seen one in a long \n time that wasn’t bits and pieces, because she had been looking \n and reviewing and trying to reassemble pieces of Columbia’s \n instrument panel.\n This diminutive colonel in the Air Force—always at the end the \n photographer comes in and takes a picture of us with the VIP [very \n important person]. Anne and I were there at that time, and we’re \n all standing off to the side, a foot away or something. She says, \n “Hey, we’ve been together all day. Come here!” She \n pulled us in right next to her to take the picture. We also got an \n 8x10 from her, signed, with a thank you and mission patches. Those \n are two of my favorite treasures from that whole time there. \n Ross-Nazzal: \n Nice recollections of that time period. \n Mautner: \n Yes, it really was. We got it done. Everything seemed late—getting \n personnel, the scaffolding came late, the paint came late—but \n we got it done. We got it done on October 18th, and October 19th was \n the day the media and the museum VIPs and everybody showed up to see \n it. It was a moment of pride because it really looked good. \n Tony and I stayed after October 19th. Tony had some more work up on \n the vertical to do, and the one area that we hadn’t really addressed \n was the propulsion bay. I would work in the propulsion bay; he’d \n work up top. We did this at night because the gallery was open to \n the public, so we did a lot of night work from October until we went \n away on Christmas vacation.\n Most of cleanup in the propulsion bay—there was some FOD [Foreign \n Object Debris], there was old hardware. It went back to when it was \n delivered to us. There were some sections of insulating aluminum, \n nuts, bolts, washers, things like that. A lot of water had been back \n there, and the floor panel structure was a huge, thick piece of aluminum \n that they had milled out to look almost like a waffle. The floor looked \n like a large waffle pattern, so there’s all these thousands \n of little pockets that had held water, and I had to clean them.\n We had some nights where we had events, and the events usually allowed \n people to roam into the space hangar, so I would take my knapsack \n and my coffee and my lunch, my snacks, up into the propulsion bay. \n Something you don’t normally do around artifacts, but I didn’t \n think I could come out because of the events they had going on. I’d \n stay up there for eight hours. Well, there’d be a potty break.\n We finished before our Christmas break, and then both of us reported \n back to the Garber Facility the first week in January 2005. It was \n rewarding every day, but they also rewarded our team with the Museum’s \n Peer Award. The [museum] gives two Peer Awards every year, and the \n Enterprise Preservation Team was awarded [one of them] for 2004. It \n was a great experience.\n Ross-Nazzal: \n What are you working on now that Enterprise is getting ready to take \n a new journey in its history to go to the Intrepid [Sea, Air & \n Space Museum in New York City]? Are you working on that?\n Mautner: \n I did work on it. I don’t know what my role will be in April \n when they come back, but the whole month of February I was assigned \n out here, along with Anne and one or two other folks, to escort NASA, \n USA, and some folks from [the] Boeing [Company]. “Escort” \n has a kind of static sound to it. We were essentially here to open \n doors that they couldn’t get into, including getting to the \n restrooms, and we were able to get them discounts in our shop and \n at McDonalds. \n And then pretty soon it was, “Oh my gosh. We don’t have \n this; do you have this tool?” So we’re running for tools. \n Later, as our professional relationship evolved, we were forklifting \n equipment for them. They had forklifts, but we were able to help them \n with that. We had a JLG man lift that we were able to take them and \n some of their equipment up to different places on the Shuttle, and \n also on the tail cone, which they assembled right out here in this \n shop. As to my role when they come back on the 19th, I have not been \n told what that is yet. I hope [I] do, I have some friends I’d \n like to hang out with again.\n Ross-Nazzal: \n Are you preparing in any way to accept [OV-103] Discovery, or are \n you primarily working with the Enterprise?\n Mautner: \n I’m not. My responsibility is to work on this German night fighter. \n We still have a wing to complete. The airframe fuselage is out in \n the museum right here now, but the wing has to be done and a lot of \n other details. Between escort duties and whatnot, I’m working \n on that. We’re told that with everything else that’s going \n on, we’re going to be moving our shop from Maryland out here. \n I don’t know how that’s going to work out with the Discovery–Enterprise \n exchange, that’s yet to be determined.\n Ross-Nazzal: \n It must have been rewarding to receive that from your peers, that’s \n wonderful.\n Mautner: \n Very, yes. I think Valerie Neal, former NASA and our curator, was \n probably instrumental in getting that for us. It was pretty neat.\n Ross-Nazzal: \n Rebecca, did you have any questions for Ed?\n Wright: \n Just one, and I think you might have already answered it. Did you \n ever come back and do anything else with Enterprise?\n Mautner: \n I have once or twice, but it was generally just escort duty. Those \n were times where it was just sit around and wait for whatever the \n folks, predominately USA, needed. I did come back, and we did reinstall \n the OMS pods. That was pretty much the original team again that did \n that, and we brought a couple of other people in to assist because \n you need spotters and tag line holders. \n Wright: \n You mentioned that you would escort for whatever they needed. What \n were the types of things that they would be coming back for?\n Mautner: \n Every time USA came here, they had a lot of supplies. Rather than \n transport them back, they would leave them out and we would store \n them in our barn, which is out in the back corner of the property. \n So the first thing we’d have to do is get their supplies, and \n that ran anywhere from tape to paints to epoxy glues.\n Recently, within the past year, they came back and we took them up \n on a JLG man lift. They did the work, and I would just maneuver it \n around to a position that helped them. Like I said, “escort” \n sounds very static, and sometimes it is, but a lot of times there’s \n a dynamic component, which is the most fun of all. That’s how \n you get to know these guys and get to see what they do.\n Wright: \n Were they doing types of restoration themselves?\n Mautner: \n Yes, about last April they came back to begin the process of making \n Enterprise airworthy. That involved making an assessment of all systems, \n and they also did the [landing gear] retracts. The main job was to \n get the hydraulic system working so they could retract the landing \n gear. Part of our position as escort was to shut down areas of that \n hall to keep the public away, because the machine, what they call \n the mule, fires up the hydraulics system, makes a lot of noise. Also \n there’s part of the retract that there’s noise involved \n as well.\n We did a lot of work stanchioning off. Moving stanchions back, and \n then when it was all done, moving the stanchions closer. We were trying \n to do this juggle between making sure people were safe and USA had \n enough room to work in, and also still keeping the hall open to the \n public. Our whole purpose is to let them get as close to this stuff \n as we can.\n There were a couple of times where, yes, it was pretty static, but \n other times we were pretty involved in helping them. And everything \n back here is secured. You can’t get into the restrooms without \n our badge, so we were escorting to the restrooms. Eventually, and \n especially in this last trip in February where they did the final \n preparation for flight, the security office provided them with badges \n that allowed them to open all the things they had to get into. They \n had the same access employees had. \n I think that speaks of the type of relationship that we’ve always \n felt we had with NASA, that they weren’t an alien organization \n that comes in and invades our space but rather cohorts, colleagues \n that we feel—not exactly one with, our roles are different—but \n certainly very good friends with.\n Wright: \n Is this a very unique exhibit here compared to all the rest? Do you \n have any other kind of associations with other groups that come in \n and work on their planes?\n Mautner: \n No, there’s no other organization that has the relationship \n that NASA has with us. I think that’s historically because we’ve \n been the repository of first choice for NASA, but also because Valerie \n Neal, who came from NASA, has maintained a very, very good relationship \n with all the leadership there. It’s been a very collegial relationship \n from the very beginning. Because of that, your relationship personally \n to these people is much more relaxed, so it’s much much easier \n to make friends. I have a couple buddies that I email once in a while \n back at the Cape [Canaveral, Florida]. It’s a good relationship.\n Ross-Nazzal: \n Any other last thoughts? \n Mautner: \n I think I’ve covered the important aspects of my relationship \n with the Shuttle Enterprise and with the folks from NASA and USA. \n We had a good team. I think it was kind of neat because management \n left us alone; they left us to make a lot of our own decisions. Everybody \n worked with the goal in mind, and we reached the goal. We finished \n Enterprise, it really looks beautiful. It took us nine months to get \n it in the shape that it’s in right now, and I have to say I \n am quite proud of how it came out. \n I do recollect one of the stories that I’ll tell you. When we \n began to strip all the paint off, we traced all of the markings—the \n NASA worm, the “United States” on the side, the “Enterprise” \n itself—so that after we painted it we could restore those. We \n noted and photographed the fact that these had been hand-brushed. \n Somebody had done a stencil, and then they hand-brushed in the black \n color. As we began to strip the aircraft, we realized that there were \n other markings, other NASA worms and another “Enterprise” \n and another “United States” underneath that exterior coat \n of latex house paint. \n We traced those as well, and at that point the curator had to make \n a decision. Are we going to restore it to when it was originally painted \n and lettered, or are we going to paint it as it was presented to us \n in 1985? The decision was made to paint it as it was delivered to \n us. Those letters were all in black, and the letters we found underneath \n were in lighter shades of dark gray. \n At the time that we traced them back on the aircraft, the question \n was asked, “Well, who feels comfortable painting them back on?” \n I mean, none of us are professional sign painters. Out of the five \n of us there, four chose to do it. So what you’ll see out there \n is our hand-lettered letters, and they are letter perfect. They came \n out really, really well. Three employees and one volunteer painted \n them all in. That too raised our level of pride and involvement and \n attachment to the Enterprise. \n I have mixed feelings about it going. On the one hand, it’s \n very important for us to have an orbiter, and Discovery is a much \n more significant vehicle to have in our collection, so I’m happy \n about that. On the other hand, all of our handwork is being sent off \n to somebody else. I’m not going to lose sleep over it, but I \n will think, how are they taking care of it? Is that beautiful paint \n job still squeaky clean and nice, and are all those tiles in good \n condition? So yes, I am concerned to some degree at it going off to \n other hands.\n Ross-Nazzal: \n Any plans to go to New York and see her once she’s in her permanent \n location?\n Mautner: \n No plans at this time, no.\n Wright: \n And will you be working on Discovery when it comes?\n Mautner: \n We’re not going to touch Discovery. This is another aspect that’s \n pretty neat about getting Discovery. The ideal airplane or spacecraft \n to get into our collection is the one that just went on its last mission. \n If we could get a Boeing B-17 [aircraft] that flew a mission from \n England in August or September of 1944, and then was transferred right \n back into our hall out front, that’s the idea. You don’t \n want to touch it. You want to mount it in such fashion that you preserve \n the tires and take any other stresses out of it, but it would be great \n if it had the gunpowder stains and the engine stains and the oil stains \n and the rough-hewn patches that the mechanics put on the planes back \n in those days. \n And that’s how Discovery is coming to us. They haven’t \n cleaned it, outside of taking out the toxic materials in all the tanks \n and systems, so it’s not going to look like Enterprise at all. \n In fact, one of the people from NASA commented that Enterprise looked \n like a toy. I think what she meant was it looked like a model, and \n Discovery looks like a real orbiter. So we’re happy about that.\n Wright: \n Well, thank you.\n Ross-Nazzal: \n Thank you for spending some time with us this morning. We appreciate \n it.\n Mautner: \n You’re very welcome. It’s my pleasure to do it.\n [End \n of interview]\n \n \n Return \n to JSC Oral History Website"],["topImageUrl","https://www.jsc.nasa.gov/history/oral_histories/head_images/sc.gif"],["error",null]]}]}],["text","美國太空總署員工表示，\n他們是使用太空總署建議的\n【安麗 LOC】以「1:10」濃度\n拿來清洗太空梭及所有東西。\n\n這就是表示該產品是【極度安全】的！\n\n這樣，還有什麼安麗產品是需要擔心呢？\n\n\nhttp://www.jsc.nasa.gov/history/oral_histories/NASA_HQ/Experts/MautnerEM/MautnerEM_3-22-12.htm"],["id","5484461227031-rumor"],["createdAt","2017-01-11T01:17:00.000Z"]]}],["reply",{"__iterable":"Map","data":[["id","AV_TT0CjyCdS-nWhujcr"],["user",{"__iterable":"Map","data":[["id","AV_TJNx9yCdS-nWhujbL"],["name","Victor Cheng"],["avatarUrl","https://www.gravatar.com/avatar/b0924f092282f5a2cc895e7f4b4c9cbc?s=100&d=identicon&r=g"],["level",4]]}],["type","NOT_ARTICLE"],["text","送出文章的人在嘗試與機器人聊天。\n未指定所謂“安全”之範疇，可以拿來洗東西不代表可以拿來吃。\n同理一間公司的其中一項產品安全也不代表所有東西安全，就像Samsung s7好棒棒，不代表Note 7不會爆炸。"],["reference",""],["hyperlinks",{"__iterable":"List","data":[]}],["createdAt","2017-11-19T08:05:07.366Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",1],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",1],["user",{"__iterable":"Map","data":[["id","j4S8C_AO7U9UgO3jfO7w-_TCIO4Xtij_63hrFiTOAIF-wiO0o"],["name","忠誠的✖長濱✖法蘭克林"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Universal and reusable virus deactivation system for respiratory protection"],["url","https://www.nature.com/articles/srep39956#Sec8"],["summary","AbstractAerosolized pathogens are a leading cause of respiratory infection and transmission. Currently used protective measures pose potential risk of primary/secondary infection and transmission. Here, we report the development of a universal, reusable virus deactivation system by functionalization of the main fibrous filtration unit of surgical mask with sodium chloride salt. The salt coating on the fiber surface dissolves upon exposure to virus aerosols and recrystallizes during drying, destroying the pathogens. When tested with tightly sealed sides, salt-coated filters showed remarkably higher filtration efficiency than conventional mask filtration layer, and 100% survival rate was observed in mice infected with virus penetrated through salt-coated filters. Viruses captured on salt-coated filters exhibited rapid infectivity loss compared to gradual decrease on bare filters. Salt-coated filters proved highly effective in deactivating influenza viruses regardless of subtypes and following storage in harsh environmental conditions. Our results can be applied in obtaining a broad-spectrum, airborne pathogen prevention device in preparation for epidemic and pandemic of respiratory diseases.\n \n \n \n \n \n \n\n \n IntroductionAerosols take a prominent role in airborne transmission of respiratory diseases. Droplets with aerodynamic size (da) < 10 μm and 10 < da < 100 μm are known to infect the alveolar regions and upper respiratory tract, respectively1,2. Notably, aerosols can also be a route of infection in diseases that, contrary to for instance influenza, do not specifically target the respiratory tract, as it could be the case of Ebola virus3. While vaccination can greatly reduce morbidity and mortality, during a pandemic or epidemic new vaccines matching the specific strain would be available, at the earliest, six months after the initial outbreak. Additionally, following development of an effective viral vaccine, several potential problems would remain, such as limited supply due to insufficient production capacity and time-consuming manufacturing processes. As a result, individuals close to the point of an outbreak would be in imminent danger of exposure to infectious diseases during the non-vaccine period. In the absence of vaccination, respirators and masks can be worn to prevent transmission of airborne pathogenic aerosols and control diseases, such as influenza4.The main alternative, the N95 respirator, requires training prior to use, must be expertly fitted to address the risk of faceseal leakage at the face-mask interface, and must be disposed of as biohazard5. Due to these factors, the use of N95 respirators on a large scale is impractical and expensive during an epidemic or pandemic. Past experiences of severe acute respiratory syndrome (SARS), H1N1 swine flu in 2009, and Middle East respiratory syndrome (MERS) indicate that surgical masks have been most widely adopted by the public as personal protective measure, despite controversy on their effectiveness6,7,8,9. Currently, among other factors, filtration in respirators and masks depends on filter characteristics, including fiber diameter, packing density, charge of fibers and filter thickness, as well as particle properties, such as diameter, density and velocity10,11,12,13,14. However, in the lack of a system to deactivate the collected pathogens, safety concerns naturally arise about secondary infection and contamination from virus-laden filter media during utilization and disposal. Furthermore, since re-sterilization is not possible without causing damage, respirators and masks are recommended for single use only9,15,16. Scientific efforts have been focused on treatment of filters with materials possessing well-known antimicrobial properties, such as iodine, chlorine and metals17,18,19,20,21,22,23,24,25, although with limited effectiveness against virus aerosols26,27,28. Therefore, a key challenge is the development of an easy-to-use, universal virus negation system, which is reusable without reprocessing and capable of deactivating pathogens, thereby reducing potential risk of secondary infection and transmission.Here, we report a simple but efficient virus inactivation system exploiting the naturally occurring salt recrystallization. Our strategy is to modify the surface of the fibrous filtration layer within masks with a continuous salt film for virus deactivation via two successive processes: i) salt is locally dissolved by the viral aerosols and ii) supersaturation is followed by evaporation-induced salt recrystallization. Consequently, viruses are exposed to increasingly higher concentrations of saline solution during drying and physically damaged by recrystallization.ResultsPreparation and characterization of salt-functionalized filtersTo demonstrate the concept of virus deactivation system based on salt recrystallization, the middle layer of three-ply surgical mask, polypropylene (PP) microfiber filter, was coated with NaCl salt as an active virus negation unit (see Supplementary Fig. S1 for bare PP filter). The coating formulations contained surfactant to enhance wetting of saline solution on the surface of hydrophobic PP fibers. Bare PP filters (abbreviated as Filterbare) were pre-wet to contain about 600 μL of coating solution (abbreviated as Filterwet). The amount of NaCl salt (Wsalt in mg/cm2) coated on the filter per unit area, considering that the filters thickness is constant, was easily controlled by changing the coating solution volume (Vsalt in μL) during drying of pre-wet filter (radius: 3 cm, Wsalt = 3.011 + 0.013 × Vsat, n = 7) (Fig. S2). Scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) mapping analysis showed the formation of homogeneous NaCl coating during drying, as also confirmed by X-ray diffraction (XRD) (Fig. 1a,b and Supplementary Fig. S3). Both the formation of NaCl coating on PP fibers and presence of surfactant in the coating formulation appeared to alter the filter surface properties from hydrophobic (bare filter; contact angle, θc = 133.0 ± 4.7°) to completely hydrophilic (salt-coated filter; θc ~ 0°, n = 10) (Fig. 1c and Supplementary Fig. S4). Hydrophilic nature of salt coating can greatly improve adhesion of viral aerosols to PP fibers compared to Filterbare, as seen in Raman microscope images (Fig. 1d and Supplementary Fig. S5).Figure 1: Mask with salt-coated filter for prevention and deactivation of airborne pathogens.(a) SEM image of Filterwet+600μL (top left) and EDX mapping images of Na (red), Cl (green), and NaCl (combination of Na and Cl mapping images), showing the formation of NaCl coating, as also confirmed by XRD spectra (b) of Filterbare, Filterwet, Filterwet+100μL, Filterwet+300μL, Filterwet+600μL, Filterwet+900μL and Filterwet+1200μL (labelled as Bare, wet, wet+100 μL, wet+300 μL, wet+600 μL, wet+900 μL and wet+1200 μL, respectively; miller indices corresponding to NaCl crystal are shown at the top of XRD spectra for each position). (c) Optical microscope images for contact angle measurements using 3 μL DI water droplets on (i) Filterbare and (ii) Filterwet+600μL (n = 10). (d) Microscope images of aerosol on (i) Filterbare and (ii) Filterwet+600μL (n = 10).Filtration efficiency against viral aerosols and protective efficacy in vivoFiltration efficiency of salt-coated filters was tested against aerosols with volumetric mean diameter (VMD) of 2.5–4 μm containing H1N1 pandemic influenza virus (A/California/04/2009, abbreviated as CA/09) at different pressure conditions (see Fig. 2a for transmission electron microscope (TEM) image of H1N1 virus). Interestingly, as shown in Fig. 2b, Filterbare did not exhibit any significant level of resistance against penetration of virus under our experimental conditions (i.e., 0% filtration efficiency). Conversely, salt-coated filters showed substantially increasing filtration efficiency with pressure and amount of coated salt. In particular, in the case of Filterwet+600μL, filtration efficiency varied from 43 to 70%, with increasing pressure from 3 to 17 kPa, and Filterwet+1200μL exhibited persistent, high-level efficiency (~85%) (one-way ANOVA, P = 0.85).Figure 2: Filtration efficiency of salt-coated filters.(a) TEM image of CA/09 H1N1 influenza virus. (b) Pressure-dependent filtration efficiency (n = 8–10, mean ± standard deviation (SD)). (c–f) Effects of filtration efficiency on protective efficacy in vivo. Body weight change of mice after infection with the dosages of penetrated virus (n = 12, mean ± SD) (c), survival rates (mean; 100% means that all mice in the group survived as penetrated dosages were lower than lethal dose) (d), lung virus titers (n = 4, mean ± SD) (e), and lung inflammatory cytokine (interferon-γ (IFN-γ)) assay (n = 11, mean ± SD) (f). Legends: filters are labelled as in Fig. 1b.To probe the effects of filtration efficiency on protective efficacy, in vivo experiments were performed using mice intranasally (IN) infected with penetrated dosages of H1N1 virus under breathing pressure (~10 kPa)29. As shown in Fig. 2c, similarly to negative control groups (mice infected with lethal dose of virus stock and aerosolized virus), mice exposed to a dose penetrated through the bare filter showed rapid body weight loss, followed by death within 10 days after infection, in good agreement with the observed 0% filtration efficiency (Fig. 2b). In contrast, mice groups exposed to virus derived from salt-coated filters resulted in 100% survival rate (Fig. 2d). Furthermore, lungs of mice from negative control groups exhibited severe lung infection 4 days after challenge (Fig. 2e). Conversely, mice groups exposed to virus derived from salt-coated filters showed significantly lower levels of lung viral titers (t-test, P < 0.005). This is consistent with lower levels of inflammatory cytokines, interferon-γ (IFN-γ), from salt-coated filter groups compared to negative control and bare filter groups (t-test, P < 0.001) (Fig. 2f).Deactivation of virus on salt-functionalized filtersInfluenza virus stability tests were performed to investigate the effects of salt coating. The same amount of recovered viruses from the PP fibers was used, and, in the case of bare filters, viral aerosols exposure was conducted in the absence of pressure due to 100% penetration of viral aerosols. Unlike bare filters (Fig. S6a(i)), formation of micron-sized NaCl phase represents a typical feature of salt-coated filters due to recrystallization of NaCl salt, following local dissolution upon aerosols exposure (SEM images in Fig. S6a, ii to iv, and EDX mapping in Fig. S6b). In contrast to 8% HA activity loss of virus adsorbed onto Filterbare, salt-coated filters exhibited almost complete HA activity loss within 5 min of incubation (Fig. 3a). Such dramatic virus destabilization on salt-coated filters is further supported by negligible levels of viral titers compared to Filterbare with incubation time (t-test, P < 0.001) (Fig. 3b). It is also noted that virus titers exhibited significant decrease with increase of incubation time and amount of coated salt (ANOVA general linear model, P < 0.001). TEM analysis showed that influenza virus on Filterbare experiences morphological change into non-spherical shape during aerosol drying (Fig. 3c(i)). Notably, influenza virus was severely damaged on salt-coated filters even at 5 min of incubation (Fig. 3c(ii)). From microscopic analysis, aerosol drying time was about 3 min, indicating that destruction of virus observed at 5 min is associated with drying-induced salt crystallization. Physical damage of virus due to crystallization was similarly reported as a major destabilizing factor of inactivated influenza virus30,31. Lower levels of native fluorescence and nile red fluorescence from virus recovered from salt-coated filters accounted for more severe conformational change of antigenic proteins and destabilization of viral envelope, respectively, consistent with TEM analysis (t-test, P < 0.001) (Fig. 3d). In parallel, we investigated the separate effect of salt concentration increase on virus stability during the aerosol drying process, irrespective of crystal growth. As displayed in Supplementary Fig. S7, the materials collected in suspension from Filterwet+600μL induced visible morphological transformation of the virus (Supplementary Fig. S7b) compared to suspension of Filterbare (Supplementary Fig. S7a). This can be attributed to the high salt/surfactant concentration and osmotic pressure, which have been well-known to destabilize proteins and viruses31,32,33. Therefore, the marked virus destabilization on salt-coated PP fibers can be explained by the combined effects of salt concentration increase during drying and evaporation-induced salt crystallization.Figure 3: Inactivation of virus adsorbed on salt-coated filters.(a,b) HA activity (a) and virus titer (b) displaying the effects of incubation time on the remaining activity of virus (n = 4–8, mean ± SD). (c) TEM images of viruses reconstituted, after incubation for 5 and 60 min, from (i) Filterbare and (ii) Filterwet+600μL. (d) Native fluorescence/nile red fluorescence of viruses incubated for 60 min (n = 12, mean ± SD). (e,f) Body weight change of mice after infection with virus recovered from filters after incubation for 60 min (n = 12, mean ± SD) (e), and lung virus titers (n = 6, mean ± SD) (f). Asterisk (*): below detection limit. Legends: filters are labelled as in Fig. 1b.To verify in vitro virus stability on the filters, an in vivo study was performed by infecting mice with virus incubated for 60 min on PP filters. As shown in Fig. 3e, Filterbare group exhibited 5% body weight loss at day 9 post-infection, reaching a body weight lower than that of salt-coated filter groups by 10–15%. Thus, significantly higher lung virus titers in the negative control group were observed in contrast to no detectable titers in the salt-coated filter groups (Fig. 3f).Strain-nonspecific virus deactivation and effects of storage under harsh environmental conditions on salt coating stabilityBroad-spectrum protection of salt-coated filters against multiple subtypes of viral aerosols was evaluated by investigating both lethal infectivity by penetrated virus in vivo and infectivity by virus collected on filters during filtration in vitro using A/Puerto Rico/08/1934 (PR/34 H1N1) and A/Vietnam/1203/2004 (VN/04 H5N1). Similarly to CA/09 H1N1, 100% of mice survived viral infection (PR/34 and VN/04), with no evidence of weight loss, due to higher filtration efficiency of salt-coated filter than that of bare filter (Fig. 4a). This is supported by no significant level of viral titer in the lung. In addition, as shown in Fig. 4b, salt-coated PP filters destroyed adsorbed influenza viruses irrespective of both subtypes and amount of coated salts.Figure 4: Strain- and environment-dependent performance of salt-coated filters.(a) Body weight change of mice infected with penetrated PR/34 H1N1 and VN/04 H5N1 viruses through Filterwet+600μL (n = 12, mean ± SD). (b) Virus titers of recovered viruses from bare and salt-coated filters (n = 4, mean ± SD; data for Filterwet, Filterwet+600μL and Filterwet+1200μL are overlapped). (c,d) Body weight change (c) and survival rate (d) of mice infected with dosage of penetrated virus through Filterwet+600μL before and after exposure to harsh environmental conditions (37 °C and 70% RH) for 1 day (filled square and open square overlap in (d)). (e) EDX mapping image of NaCl-coated Filterwet+600μL after incubation for 15 days at 37 °C and 70% RH (combination of Na (red) and Cl (green) mapping images). (f) XRD spectra of Filterwet+600μL before and after incubation at 37 °C 70% for 1 day and 15 days. Legends: filters are labelled as in Fig. 1b.The stability of salt coating on PP fibers was tested under harsh environmental conditions. Incubation at 37 °C and 70% relative humidity (RH) for 1 day did not cause any significant difference in filtration efficiency (t-test, P = 0.718) (Supplementary Fig. S8). As a result, all mice infected with dosage of penetrated virus through the filter stored at high temperature and RH displayed 100% survival with 7% of body weight loss (Fig. 4c,d). Even after 15 days of incubation, salts remained to coat PP fibers (Fig. 4e, and Supplementary Fig. S9a,b), despite change in grain orientation due to recrystallization (Fig. 4f, and Supplementary Fig. S10a,b).DiscussionDevelopment of a universally applicable, low-cost, and efficient mechanism for virus negation is regarded as a major challenge in public health against general airborne biological threats. This led us to propose a new concept of personal/public preventive and control measures using salt-recrystallization against pathogenic aerosols based on two hypotheses. The salt-coating can enhance adsorption of virus on the filter fibers and inactivate virus by the increase of osmotic pressure followed by the crystallization of salts. As shown in Fig. 2b, salt-coated filters exhibited significantly higher levels of filtration efficiency than bare filters. Notably, the bacterial filtration efficiency (BFE) reported by the mask manufacturer is 99%. The different value of filtration efficiency for bare filters obtained under our experimental conditions may be partially due to the use of aerosols with different biological origins. The FDA-recognized ASTM F2101 – 14 standard for evaluation of BFE exposes surgical masks to Staphylococcus aureus aerosols, by employing S. aureus ATCC 653834, which has an average diameter of about 1 μm. In this study, filtration efficiency was calculated following exposure of bare and salt-coated filters to influenza virus, which exhibits a smaller diameter than that of S. aureus by one order of magnitude. Additionally, whereas during BFE evaluation all three layers of surgical masks are used, in this work filtration efficiency refers to mask filters (middle layer). It is worth noting that the conditions for BFE standard evaluation (such as flow rate and time of application of flow) do not coincide with the experimental procedure we used for measurement of the filtration efficiency, which may further contribute to the different result. The enhanced filtration efficiency of salt-coated filters against influenza virus aerosols as compared to bare filters can be explained by the observed wetting of aerosols, favoring greater adhesion to salt-coated filters. Furthermore, the significant improvement in filtration efficiency resulted in complete protection of mice against lethal influenza aerosols, which demonstrates the high level of protection provided by salt-coated filters, outperforming currently used bare filters.Rapid loss of HA activity and viral infectivity on salt-coated filters can be explained by physical destruction of virus during recrystallization of coated salts. When the salt-coated filter is exposed to virus aerosols, salt crystals below the aerosol droplet dissolve to increase osmotic pressure to virus. Due to evaporation, the salt concentration of the droplet significantly increases and reaches the solubility limit, leading to recrystallization of salt. As a consequence, virus particles are exposed to increasing osmotic pressure during the drying process and are physically damaged by crystallization. As shown in Fig. 3e,f, the superior advantage of physically destroying the virus adsorbed to the salt-coated PP filters through natural salt crystallization process was further confirmed in vivo. According to previous reports, hyperosmotic stress (>541 mOsm) and crystallization induce membrane perturbation with irreversible deformation of the viral envelope and structural virus damage, respectively, resulting in infectivity loss of virus30,31. Therefore, our data support that the extensive level of infectivity loss associated with a salt recrystallization process caused by physical contact between virus aerosols and salt coating can be used in developing virus negation systems that are reusable without reprocessing.Similarly to CA/09 H1N1 aerosols, increased protection in vivo due to higher filtration efficiency of salt-coated filters compared to bare filters and deactivation of virus on salt-coated filters were observed following exposure to PR/34 H1N1 and VN/04 H5N1 (Fig. 4a,b). This suggests that salt-coated filters prevent virus penetration and destroy virus attached to the filter in a non-specific way. Furthermore, the performance of salt-coated filters was not degraded by storage at 37 °C and 70% RH, demonstrating that salt recrystallization-based filters can ensure protection even under harsh environmental conditions. Notably, for demonstration of the concept of salt-recrystallization based virus deactivation system, NaCl salt was used, which has a critical RH of 75% at 30 °C35. However, salts with higher critical RH can be easily used, such as ammonium sulfate, potassium chloride and potassium sulfate, which have critical RH of 80%, 84% and 96.3% at 30 °C, respectively35. This suggests that salt-coated filters may be developed for specific environmental conditions.In conclusion, we demonstrated that the developed salt-recrystallization based filtration system provides high filtration efficiency and successfully deactivates multiple subtypes of adsorbed viruses. Moreover, we have shown that stability of the salt coating is not compromised by high temperature and humidity, which suggests safe use and long-term storage/reuse at such environmental conditions. Although our tests are based on exposure to different types of influenza virus, the significance of these results for personal and public protective measures may be generally extended to enveloped respiratory viruses where infection and transmission can occur by aerosol. Our salt-coated filter unit can promise the development of long-term stable, versatile airborne pathogen negation system, without safety concerns. In fact, the destruction mechanism of viruses solely depends on the simple, yet robust naturally occurring salt recrystallization process, combining the destabilizing effects of salt crystal growth and concentration increase during drying of aerosols. This idea can be easily applied to a wide range of existing technologies to obtain low-cost, universal personal and public means of protection against airborne pathogens, such as masks and air filters in hospitals. Therefore, we believe that salt-recrystallization based virus deactivation system can contribute to global health by providing a more reliable means of preventing transmission and infection of pandemic or epidemic diseases and bioterrorism.MethodsBare and salt-coated filter samples preparationThe commercial surgical masks had a three-ply structure. The middle layer is the filter media, whereas the inner and outer layers provide support and protect the filter against wear and tear. The metal nose clips and elastic ear loops were removed and circular samples (radius: 3 cm) were cut from the masks. The PP filters (middle layer) were isolated by removing the inner and outer protective layers (bare filters, Filterbare). The coating solution was prepared by dissolving sodium chloride (NaCl; Sigma Aldrich, St. Louis, MO) in filtered DI water (0.22 μm pore size; Corning, Tewksbury, MA) under stirring at 400 rpm and 90 °C, followed by the addition of Tween 20 (Fisher Scientific) to a final concentration of 29.03 w/v% of NaCl and 1 v/v% of Tween 20. To obtain the salt-coated filters, the mask bare PP filters were pre-wet to contain approximately 600 μL of coating solution by incubating overnight at room temperature. Any remaining dry areas were removed by applying gentle strokes with tweezers to the filters while immersed in the coating solution. Subsequently, the filters were deposited in the desired volume of coating solution (0, 100, 300, 600, 900 and 1200 μL, of which corresponding membranes are abbreviated as Filterwet, Filterwet+100μL, Filterwet+300μL, Filterwet+600μL, Filterwet+900μL, and Filterwet+1200μL, respectively) on petri dishes (60 × 15 mm; Fisher Scientific) to control the amount of NaCl per unit area and dried in an oven (Isotemp Incubator, Fisher Scientific) at 37 °C for 1 day.Influenza virus preparationInfluenza viruses A/California/04/2009 (CA/09, H1N1), A/Puerto Rico/8/34 (PR/34, H1N1) and A/Vietnam/1203/2004 (VN/04, H5N1) were grown in 10-day old embryonated hen eggs, in which H5N1 virus was derived by reverse genetics from HPAI A/Vietnam/1203/200436. Influenza viruses were purified from allantoic fluid using discontinuous sucrose gradient (15%, 30% and 60%) layers following the previously reported procedure37.Aerosols exposure to filtersFor experiments involving aerosols exposure, an aerosol chamber (L × W × H = 145 × 145 × 150 mm; Emka Inc., Middletown, PA) was used (Fig. S11). It has a connection to the vacuum line and a circular aperture in the top wall (diameter: 22 mm) to exactly accommodate the cylindrical part (diameter: 20 mm, height; 20 mm) of the nebulizer unit that is below the aerosol generator (Aeroneb Lab Nebulizer System; Aerogen, Galway, Ireland). Bleach was used as trap between the chamber and the vacuum pump (Welch 2522C-10, 22 L/min; Niles, IL). The filters were placed on top of the chamber aperture and the nebulizer unit was inserted, ensuring the tight seal of the filters against the side of the aperture. 5 μL of virus stock were added to the nebulizer unit, aerosols (VMD 2.5–4 μm from manufacturer specifications) were generated for 30 sec and subsequently the desired vacuum level (3, 10 or 17 kPa) was applied, by manual control, three times in 1 sec cycles. Notably, in the case of bare filters, pressure was only applied for filtration efficiency tests.For all assays and analysis, suspensions of the filters were prepared as follows, unless otherwise indicated. To reconstitute virus adsorbed onto filters, virus-laden filters were immersed in 400 μL of sterilized DI water for about 5 min, and then removed after vortexing from the suspension. The virus suspension was centrifuged at 19,800 g and 4 °C for 10 min (Centrifuge 5810 R, Eppendorf, Hauppauge, NY), followed by resuspension of pellets in 70 μL of DI water to eliminate any interference from materials in supernatant during assays.Filtration efficiency testsThe filters were exposed to the virus aerosols at 3, 10 and 17 kPa and suspensions of the filters were obtained, as described above. The filtration efficiency was calculated as the ratio of the amount of virus (i.e., total proteins measured from the virus) reconstituted from the filter to that from the virus in the exposure aerosols. The concentration of virus in aerosols was determined by generating viral aerosols into a 15 mL centrifuge tube, containing 1 mL of DI water. After vortexing, virus concentrations (i.e., total protein concentration) were measured with bicinchoninic acid assay (BCA protein assay kit; Thermo Fischer scientific, Waltham, IL) with bovine serum albumin as a standard. In the case of virus reconstituted from salt-coated filters, virus-laden filter suspension was replaced with DI water prior to BCA assay.In vivo infection testsLethal infectivity of influenza viruses (CA/09 H1N1) was examined in 8 week old female inbred BALB/c mice (Nara Biotech; Seoul, Korea) by using the intranasal route. For bare and salt-coated filters, 12 mice per group were infected with individual penetration dosage of influenza virus through each filter. The penetration dosage of the virus through the filters (Filterbare, Filterwet, Filterwet+600μL, and Filterwet+1200μL) was calculated from the filtration efficiency at 10 kPa (near breathing pressure) using the relationship: penetration dosage = virus dosage in lethal aerosol × penetration efficiency (%)/100, where penetration efficiency (%) = 100 − filtration efficiency (%). To examine the effects of the aerosolization process on the viral infectivity change, two mice groups were infected with a lethal dose of virus before and after aerosol formation, which served as negative control groups. Body weight changes and survival rate of mice were monitored daily for 15 days. Mice with body weight loss greater than 25% were euthanized. All animal protocols were approved by the Kyung Hee University (KHU) Institutional Animal Care and Use Committee (IACUC). All animal experiments and husbandry involved in this work were conducted under the approved protocols and guidelines of KHU IACUC. KHU IACUC operates under National Veterinary Research and Quarantine Service (NVRQS), and animal welfare law and regulations of the WOAH-OIE (World organization for animal health).To test strain-dependent lethal infection behavior, mice (12 per group) were infected with the penetrated dosage of viral aerosols (PR/34 H1N1 and VN/04 H5N1 viruses) through Filterwet+600μL at 10 kPa. Time-dependent body weight change was monitored in the same manner described above.Lung viral titer and lung inflammatory cytokine assays after infectionOn day 4 after infection 6 mice of each group were sacrificed for the collection of lung samples. Lung virus titers were measured on six-well plates containing confluent MDCK cell monolayers. Inflammatory cytokines (IFN-γ) were determined using BD OptEIA mouse IFN-γ ELISA kit (BD Biosciences, San Jose, CA) following the manufacturer’s procedure.Test of viral infectivity change on filtersTo investigate the effects of salt-coating on viral infectivity loss, lethal influenza aerosols were exposed to four different types of filters (Filterbare, Filterwet, Filterwet+600μL, and Filterwet+1200μL). Since Filterbare exhibited almost complete penetration upon pressure application, aerosols were exposed to the bare filter in the absence of pressure and samples were carefully handled to prevent mechanical agitation. To measure time-dependent stability change of virus, virus-laden filters were incubated at ambient conditions for 0, 5, 15, and 60 min after aerosol exposure, and suspended in DI water to reconstitute virus at each time point. In vitro stability of virus was characterized by measuring hemagglutinin activity (HA) and virus titers at the same concentration as lethal dose30. The conformational stability of antigenic proteins was characterized by measuring intrinsic fluorescence using 0.1 mg/mL of virus suspension38. To investigate morphological change of virus, lipid stability of viral wall was characterized by nile red fluorescence (Sigma Aldrich), a fluorescent lipid stain, following manufacturer’s protocol39. A decrease in fluorescence intensity can be used to examine the level of disintegration of the virus. Both intrinsic and nile red fluorescence were measured by using a fluorimeter (LB 50B; PerkinElmer, Waltham, MA). Intensity changes of fluorescent spectra were compared relative to those of a control from virus stock.To test infectivity difference observed from in vitro findings, in vivo study was performed for the virus reconstituted from the filters (Filterbare, Filterwet, Filterwet+600μL, and Filterwet+1200μL) after incubation for 60 min at RT (aerosol exposure at 10 kPa, except for Filterbare). 12 mice per group were infected with a lethal dose of virus collected from each type of filter. Body weight change and lung virus titers were measured as described above.Effects of environmental conditions on the performance of salt-coated filterSalt-coated filters (Filterwet, Filterwet+600μL, and Filterwet+1200μL) were stored at 37 °C, 70% RH in an incubator (Maru Max; Rcom, Gyeonggi-do, South Korea) for 15 days. Every day, the filters were collected and incubated at ambient conditions for 5 min. At 1-day incubation, filtration efficiency was measured at 10 kPa from Filterwet+600μL, followed by in vivo infection test. Lethal infectivity between two different filter groups (before and after incubation at 37 °C, 70% RH) was compared by measuring body weight change and survival rate of mice after exposure to lethal CA/09 H1N1 aerosols. XRD analysis was performed to salt-coated filters incubated for 1 and 15 days, and SEM/EDX mapping analysis for 15-day incubated samples.Contact angle measurements and imaging of aerosolsThe bare and salt-coated filters were fixed with carbon tape (Ted Pella, Inc., Redding, CA) to a metal, flat substrate and 3 μL of DI water were added on the surface of the filters. The contact angles were measured from images collected with an optical microscope (10× lens, Motic SMZ-140; Motic, Richmond, Canada) at RT. Images of aerosols on filter fibers were obtained using a dispersive Raman microscope (Nicolet Almega XR; Fisher Scientific).Aerosol drying time on filtersThe bare and salt-coated filters were fixed with carbon tape to a metal, flat substrate and exposed to aerosols generated from 5 μL of Sulforhodamine B Dye solution (1 mM, Sigma-Aldrich). Aerosol drying time was determined with timer by observation with optical microscope.Electron microscopy analysisFor virus stability tests, bare and salt-coated filters were exposed to CA/09 H1N1 aerosols and, after 5 and 60 min incubation, virus was recovered by suspension of the filters, as described above. To study the effects of the coating formulation during aerosol drying independently from crystal growth, bare and salt-coated filters were immersed in DI water and removed after 60 min. Subsequently, virus was incubated in the obtained suspension for 60 min. Additionally, the virus suspension was centrifuged at 19,800 g and 4 °C for 10 min to collect the samples and suspend them in DI water. For TEM analysis (200 kV, JEOL JEM 2100; JEOL, Peabody, MA), samples were deposited on copper grid (Electron Microscopy Sciences, Hatfield, PA) and negatively stained with solution comprised of phosphotungstic acid hydrate (1.5 w/v%, pH = 7.0; Sigma-Aldrich, Oakville, Canada).To identify the morphology of salt-coated filters and recrystallized salts, SEM/EDX analysis was performed for bare and salt-coated filters after coating with 10 nm thick gold layer. Scanning electron microscopy analysis (Hitachi S-3000N; Hitachi, Toronto, Canada) was operated in secondary electron mode at 20 kV and EDX analysis was obtained with EDX detector (Oxford Instruments, Concord, MA).XRD analysisTo confirm the formation of crystalline NaCl coating during drying process and its stability during storage at 37 °C and 70% RH, XRD analysis (BRU-1098; Bruker, Billerica, MA) was performed at different coating conditions. Filters (1 × 1 cm) were mounted on a slide glass for XRD analysis (θ–2θ mode) using a CuKα radiation.Statistical analysisTo compare multiple conditions, Student’s t-test, One-way analysis of variance (ANOVA), and general linear model were used (Minitab release 14; Minitab, State College, PA). P value of less than 0.05 was considered to be significant.Additional InformationHow to cite this article: Quan, F.-S. et al. Universal and reusable virus deactivation system for respiratory protection. Sci. 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Cell Biol. 100, 965–973 (1985).Download referencesAcknowledgementsThis research was financially supported by startup funds from University of Alberta (H.J.C.), and grants from National Research Foundation of Korea (NRF) (NRF-2014R1A2A2A01004899) and Ministry of Health & Welfare, Republic of Korea (HI15C2928).Author informationAuthor notesFu-Shi Quan and Ilaria Rubino: These authors contributed equally to this work.AffiliationsDepartment of Medical Zoology, Kyung Hee University School of Medicine, Seoul, 130-701, KoreaFu-Shi QuanDepartment of Chemical and Materials Engineering, University of Alberta, Edmonton, AB T6G 1H9, CanadaIlaria Rubino, Brendan Koch & Hyo-Jick ChoiDepartment of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 130-701, KoreaSu-Hwa LeeAuthorsSearch for Fu-Shi Quan in:Search for Ilaria Rubino in:Search for Su-Hwa Lee in:Search for Brendan Koch in:Search for Hyo-Jick Choi in:ContributionsH.J.C. conceived and designed the experiments. F.S.Q., I.R., S.H.L., B.K., and H.J.C. performed the experiments. F.S.Q., I.R., S.H.L., B.K., and H.J.C. analyzed the data. I.R. and H.J.C. wrote the manuscript. F.S.Q. and B.K. edited the manuscript.Corresponding authorCorrespondence to\n Hyo-Jick Choi.Ethics declarations\n \n Competing interests\n The authors declare no competing financial interests.\n \n Supplementary informationRights and permissionsThis work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/Reprints and PermissionsAbout this articleCite this articleQuan, F., Rubino, I., Lee, S. et al. Universal and reusable virus deactivation system for respiratory protection.\n Sci Rep 7, 39956 (2017). https://doi.org/10.1038/srep39956Download citationReceived: 04 August 2016Accepted: 30 November 2016Published: 04 January 2017DOI: https://doi.org/10.1038/srep39956\n\n \n \n \n Further reading\n \n \n \n \n \n \n Survival of Microorganisms on Nonwovens Used for the Construction of Filtering Facepiece Respirators\n \n \n \n \n Katarzyna Majchrzycka, Małgorzata Okrasa, Justyna Szulc, Anita Jachowicz[…] & Beata Gutarowska- Show fewer authors\n \n \n International Journal of Environmental Research and Public Health\n (2019)\n \n \n \n \n \n \n Respiratory Protection against Pandemic and Epidemic Diseases\n \n \n \n \n Ilaria Rubino & Hyo-Jick Choi\n \n \n Trends in Biotechnology\n (2017)\n \n \n \n \n \n \n \n \n\n \n CommentsBy submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate."],["topImageUrl",null],["error",null]]}]}],["text","WIKILINK\n最新科技資訊\n\n \n口罩能否反復使用？浸鹽水後可100%讓H1N1病毒滅活，但對其他病毒需謹慎 | 《科學報告》期刊\nFebruary 5, 2020 admin\n曉查發自凹非寺 \n量子位報道 | 公眾號 QbitAI\n一場新冠肺炎讓中國的口罩嚴重告急。\n\n每齣一次門就要廢掉一個口罩，傢裏的口罩即將用完，藥店和網上都買不到，真是急死人瞭。\n\n彆怕，早在2016年，來自韓國慶熙大學的研究者就發現，口罩隻需用普通食鹽水處理後，就具有瞭一定的殺滅病毒能力，至少對2009年爆發的H1N1流感病毒有效。\n\n他們將處理後的口罩來過濾充滿H1N1病毒的空氣，然後再給小白鼠呼吸，結果發現小鼠的存活率達到瞭100%。\n\n\n\n\n \n空氣中的病毒濃度達到瞭緻死量。作為對照，如果使用普通醫用口罩過濾，小白鼠在4天後就會齣現嚴重的肺炎，10天後全部死亡。\n\n這篇文章發錶在2017年1月Nature旗下的Scientific Reports期刊上。\n\n\n\n△實驗中用到的過濾裝置\n早在3年前，該文章就預測瞭口罩短缺的可能性。\n\n作者在開頭說，在疫病大流行時期，生産能力不足和製造過程耗時，會導緻口罩供應有限。\n\nN95口罩雖然可以過濾空氣中形成的病毒氣溶膠，但是在嚴重的疫情麵前，大規模使用N95口罩是不切實際的，而且價格昂貴。\n\n過去的SARS、H1N1、MERS都錶明，醫用外科口罩是被公眾最廣泛采用的個人防護措施，盡管人們對它的效果存在爭議。\n\n因此需要開發一種通用、低成本且有效的防護病毒機製，最好能用在普通醫用口罩上。\n\n\n\n\n\n\n研究人員配置瞭濃度29.03 w/v%的氯化鈉溶液，並在其中加入瞭一些Tween 20錶麵活性劑，將口罩浸潤，然後在37℃的環境下乾燥一天。\n\n文章指齣，經過這種方法處理後的口罩無需再次處理即可重復使用。最終實驗發現，塗有氯化鈉的口罩上的病毒在5分鍾後就失去瞭活性。\n\n\n\n\n\n\n從顯微鏡分析來看，病毒氣溶膠乾燥時間約為3分鍾，錶明在5分鍾時觀察到的病毒破壞與乾燥引起的鹽結晶有關。\n\n作者推測，可能是帶有水分的病毒被吸附在口罩錶麵，濕潤後又重結晶的鹽破壞瞭病毒的結構。\n\n既然對H1N1病毒，自然就有網友很好奇，這種處理方法是否也對新型冠狀病毒有效。\n\n一些網友對此提齣瞭質疑，認為鹽結晶可能減小瞭口罩的通氣量，而且實驗隻對H1N1病毒進行瞭驗證，是否實用還有待商榷。\n\n所以在未經實驗驗證的情況下，請不要用這種方法來過濾新型冠狀病毒。口罩還是要保證一用一換，切不可自行處理後就重復使用，否則仍有被感染的風險。\n\n論文地址：\nhttps://www.nature.com/articles/srep39956#Sec8\n\n— 完 —\n\n"],["id","obwrpyiajxnx"],["createdAt","2020-02-09T01:53:22.130Z"]]}],["reply",{"__iterable":"Map","data":[["id","tmgTKHABd3n3h-WYriSs"],["user",{"__iterable":"Map","data":[["id","_1YnAG8BV0DITCqGm7go"],["name","uienwt"],["avatarUrl",null],["level",18]]}],["type","OPINIONATED"],["text","目前沒有證據顯示鹽水有助於消除新型冠狀病毒。用鹽殺菌的原理是應用在醃漬食物，讓細菌無法生長，但人不可能用高濃度的鹽水來浸泡口罩，因此傳言指稱用淡鹽水漱口是沒有效果的。"],["reference","https://tfc-taiwan.org.tw/articles/2119\n"],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","【錯誤】網傳「鐘院士的防病毒高招：建議各位去醫院或其他公共場合之前用淡鹽水漱一下嚥喉部位，回家後再漱一次...」？"],["url","https://tfc-taiwan.org.tw/articles/2119"],["summary","【錯誤】網傳「鐘院士的防病毒高招：建議各位去醫院或其他公共場合之前用淡鹽水漱一下嚥喉部位，回家後再漱一次...」？\n \n \n\n網傳「鐘院士的防病毒高招：建議各位去醫院或其他公共場合之前用淡鹽水漱一下嚥喉部位，回家後再漱一次...」，經查：\n\n一、中國工程院院士、中國「新型冠狀病毒聯防聯控工作機制科研攻關組」組長鐘南山的團隊指出，此傳言為網路謠言。\n\n二、專家指出，鹽水漱口不能預防新型冠狀病毒。\n\n因此，此傳言為「錯誤」訊息。\n\n背景\n\n社群平台、通訊軟體流傳訊息指出：「鐘院士的防病毒高招：建議各位去醫院或其他公共場合之前用淡鹽水漱一下嚥喉部位，回家後再漱一次...由於病毒或細菌首先通過鼻腔潛伏於咽部，淡鹽水可以在第一時間殺滅它們，從而達到預防感染的目的」？\n\n\n\n圖1：社群平台流傳訊息擷圖\n\n查核\n\n爭議點一、鐘南山是否有發出此警告？\n\n鐘南山是衛生領域的中國工程院院士，日前接任中國「新型冠狀病毒聯防聯控工作機制科研攻關組」的組長，是中國2003年抗SARS的重要專家。鐘南山團隊所在的廣州醫科大學附屬第一醫院官方微博帳號，於2020年1月22日發布闢謠貼文，指出此貼文為網路謠言。\n\n\n\n圖2：鐘南山團隊發布闢謠貼文擷圖\n\n爭議點二、「用鹽水漱口」可以預防武漢肺炎嗎？傳言指稱「由於病毒或細菌首先通過鼻腔潛伏於咽部，淡鹽水可以在第一時間殺滅它們，從而達到預防感染的目的」，是否屬實？\n\n鐘南山團隊所在的廣州醫科大學附屬第一醫院官方微博指出，鹽水漱口有助於清潔口腔和咽喉，但新型冠狀病毒侵犯的是呼吸道，漱口並沒有辦法清潔呼吸道。目前也沒有證據顯示鹽水有助於消除新型冠狀病毒。\n\n查核中心透過新興科技媒體中心，採訪中興大學獸醫病理生物學研究所教授吳弘毅。他表示，用鹽殺菌的原理是應用在醃漬食物，讓細菌無法生長，但人不可能用高濃度的鹽水來清洗鼻腔或咽喉，因此傳言指稱用淡鹽水漱口是沒有效果的。此外，生理食鹽水反而是病毒可以停留比較久的環境。\n\n台灣感染症醫學會理事長、台大醫院小兒部主任黃立民說，病毒很快就會進入細胞，所以去用鹽水清洗鼻腔或咽喉，並沒有任何作用，而且，鹽水也沒有消毒殺菌的作用。\n\n查核中心採訪長庚大學新興病毒感染研究中心主任施信如，她說此種方法沒有科學根據，也沒有辦法達到預防感染的效果。\n\n結論\n\n一、中國工程院院士、中國「新型冠狀病毒聯防聯控工作機制科研攻關組」組長鐘南山的團隊指出，此傳言為網路謠言。\n\n二、專家指出，鹽水漱口不能預防新型冠狀病毒。\n\n因此，此傳言為「錯誤」訊息。\n\n參考資料\n\n廣州醫科大學附屬第一醫院官方微博"],["topImageUrl","https://tfc-taiwan.org.tw/sites/default/files/upload/node/field_blog_images/image1_2.png"],["error",null]]}]}],["createdAt","2020-02-09T03:52:23.478Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",2],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",4],["user",{"__iterable":"Map","data":[["id","j4S8C_SGPqU25kWT9dgB7Sm3Cz8tQbcAia5BFcJwmHqtWpshs"],["name","富創造力的鼓山愛爾莎"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Taiwan’s Military Is a Hollow Shell"],["url","https://foreignpolicy.com/2020/02/15/china-threat-invasion-conscription-taiwans-military-is-a-hollow-shell/"],["summary","As threats of military aggression from China grow, the island nation of Taiwan needs a credible military deterrent more than ever. But Taiwan’s military is in a crisis it can barely admit exists.\nEven as the military refits itself with flashy U.S. arms purchases, such as M1 Abrams tanks and F-16V fighter jets, its front-line units are hollowed out, and the entire reserve system is so dysfunctional that few experts or serving military personnel believe it can make a real military contribution in the event of a war. These problems are well documented but continue to be downplayed, if not outright ignored, by Taiwan’s political leadership—and there is no clear plan to solve the crisis.\n\n \n Trending Articles\n \n \n \n \n \n Coronavirus Conspiracies Give Boost to Canada’s Far-Right\n Anti-Chinese sentiment and a public health backlash have vaulted Hong Kong-born Chief Public Health Officer Theresa…\n\n \n \n\n \n \n \nOn paper, Taiwan’s Ministry of National Defense (MND) has 215,000 budgeted positions among all branches, of which 188,000 are soldiers and the rest civilian employees. Only 153,000 of those positions were filled in 2018—just 81 percent of the personnel the military should have. But even that number doesn’t tell the complete story.Only 153,000 of those positions were filled in 2018—just 81 percent of the personnel the military should have. But even that number doesn’t tell the complete story.Only 153,000 of those positions were filled in 2018—just 81 percent of the personnel the military should have. But even that number doesn’t tell the complete story.\nAccording to a Taiwanese army lieutenant colonel in active service, who asked for only his last name, Lin, to be used, all the army’s front-line combat units he knows of—including armor, mechanized infantry, and artillery troops—currently have effective manpower levels of between 60 and 80 percent. This figure is consistent with Taiwanese media reports, which cite MND figures provided to Taiwan’s parliament, the Legislative Yuan, acknowledging that few front-line units have more than 80 percent of their positions filled.\n“That number might not seem so bad until you realize it means at least a third of your tanks are useless in a war because there’s no one to man them,” said Lin, who most recently served as a battalion commander within one of army’s armor brigades.\nThe personnel shortfalls are a clear consequence of the ill-executed transition from conscription to an all-volunteer military over the past few years. It was a political decision made during Ma Ying-jeou’s administration and continued by current President Tsai Ing-wen, despite their coming from different parties. And despite Tsai’s tough rhetoric about defending Taiwan during her successful recent reelection bid, and her vow to thwart Chinese aggression, she has shown no sign of stepping in to fix the problems.\nUniversal conscription is mandated in Article 20 of the Taiwanese Constitution, as in several other countries that face an imminent military threat, such as South Korea or Israel (where women are included but some minorities excluded). For some years, before 2017, the term of conscription service in Taiwan was just a year, which was already short compared with South Korea’s 18-22 months, depending on the military branch, or Israel’s 32 months. Most officers felt that the single year of service wasn’t enough for the military to utilize draftees’ full potential but enough to at least turn a recruit into an average soldier.\nBut 2017’s changes slashed the conscription period to just four months. Most draftees serve even less, as up to two weeks can be deducted if they’ve completed military training classes in high school and college. The four-month conscripts typically receive five weeks of basic training before they are assigned to field units for more specialty training. But they’re more a burden than an aid, not treated seriously by career or noncommissioned officers as their short stays mean they are seen as guests rather than soldiers.\n“By design, they don’t participate in any field exercise or combat readiness training anyway,” Lin said. “We just tell them to stay safe and don’t get into trouble. It’s basically a summer camp.” Several individuals who recently completed this four-month service described similar experiences in interviews.\nOne of the stated aims of the all-volunteer reform was to professionalize the service, staffing the military’s rank and file with a cadre of career-oriented volunteer soldiers who usually serve a minimum term of four years. Despite MND’s talking point that each year’s recruitment drive always hits the set targets and brings with it a fresh crop of volunteers, the rushed transition to an all-volunteer military has clearly damaged the Taiwanese army’s manpower pool—especially on the front line.\nThe reason for the hollowing out of front-line troops is simple. Unlike conscripts, who could be assigned entirely based on to the needs of the military, volunteer soldiers among the lower enlisted ranks can and usually do seek transfers to units considered desirable—rear-echelon troops such as training schools, garrison units, signal corps, and so forth. Although transfer opportunities are limited, soldiers almost always find a way. This means that armor, mechanized infantry, and artillery units are always in desperate shortage of enlisted soldiers—even though they are expected to be the ones bearing the brunt of ground fighting against the formidable People’s Liberation Army (PLA) ground force if it comes ashore.\nA popular yet cynical explanation as to why these Taiwanese soldiers dislike front-line units simply postulates a common aversion to tougher training and combat duty. But interviews with several enlisted ranks painted a more complex picture. Most complained that the food and living conditions left much to be desired—front-line soldiers must split their time between bases and on field exercises. That, on top of the fact they have far more weapons, vehicles, and equipment to clean and maintain, means these posts are perceived as more work for little reward. The existing shortages also cause an even heavier burden of work on the soldiers left—prompting more of them to put in for transfers.\nPolls show varied public opinion on these issues. In 2015, one legislator cited a poll that showed almost 60 support for a return to conscription. In response, the MND cited another poll that claimed 60 percent were satisfied with the transition to all-volunteer forces. At the end of the day, it all seems to come down to how the question is phrased by the pollsters.\nNo matter which poll you believe, it is clear that the two successive presidents over the past decade, Ma and Tsai, had little or no political interest in the political hassle of bringing back the longer conscription length, despite the evidence of the damage being done to military readiness. Even Kaohsiung Mayor Han Kuo-yu, who lost in the recent presidential election representing the Kuomintang (KMT) party, also declined to advocate a complete return to conscription but proposed a “hybrid approach” that he did not specify the details for.\nChieh Chung, a senior assistant research fellow at Taiwan’s National Policy Foundation, commented that the personnel shortage is a problem well documented by the military itself but has never entered their calculations. Chung, who has worked for several years in Taiwan’s parliament as a legislative advisor focusing on defense issues, said the military’s own exercises and computer simulations always assume all units would have at least 90 percent fighting strength at the beginning of a war—an assumption that might have been true in the conscription era but is a far cry from reality today.\nSeveral officers who have participated in the computer-simulated phase of the annual Han Kuang exercises in recent years also pointed out this obvious flaw. That raises the question of how many of the Taiwanese military’s simulations of its own ability to hold off a Chinese invasion are based on now purely hypothetical soldiers.\nThese personnel issues would not be so serious if the military had a functional reserve force. On paper, this enormous reserve force is said to be more than 2 million strong.These personnel issues would not be so serious if the military had a functional reserve force. On paper, this enormous reserve force is said to be more than 2 million strong. Once activated, these reservists are supposed to fill existing shortages across regular field units, and reinforce casualties, while creating fresh reserve formations from virtually nothing to bolster overall defense, according to the Reserve Command’s own words.These personnel issues would not be so serious if the military had a functional reserve force. On paper, this enormous reserve force is said to be more than 2 million strong.\nJust about everything in these talking points is pure fantasy, according to James Huang, a retired army lieutenant colonel who has since become a prolific writer on defense issues and military history, with many followers on Facebook. Huang said there was “no way whatsoever” any of Taiwan’s reserves would reinforce existing field units, despite the proven success of the system elsewhere in the world, especially Israel.\nThat’s the case regardless of whether the reservist is a conscript with four months’ training or a five-year veteran paratrooper just discharged from the special forces. The established practice of Taiwan’s Reserve Command, according to Huang, is not to send reservists back to their previous units but to lump everyone together into the newly activated reserve infantry brigades that possess no specialty, no vehicles, and no equipment except rifles (often older types) and are led by called-up reservist officers who have little experience commanding such ad hoc units.\nIn theory, all soldiers and officers (both conscripts and volunteers) are automatically enrolled as reservists on being discharged from active service. They are called up at most once every two years by the Reserve Command to receive refresher training for five to seven days. In practice, such training rarely consists of more than just basic drills and a short practice session at the rifle range. A reservist corporal who was a veteran M60 tank gunner, for example, will be activated only as an infantry rifleman even if one of the army’s active armor brigades has tanks sitting unmanned in the base.\n“If we go to war, the soldiers currently on roster are all that we have,” said Lin, the lieutenant colonel, who pointed out that he had never heard of any plan to reinforce units he commanded with reserve soldiers. “At best, they might start combining depleted units. We are supposed to fight until everyone is dead or can’t fight anymore.”\nAnd even if Taiwan somehow manages to muster dozens of fresh reserve infantry brigades before Chinese troops come ashore, Huang said they would be little more than cannon fodder consider how poorly the military has trained them in peacetime and the fact that there is not even a clear plan to fit them into the overall defense strategy.\n“Show me 2 million rifles in the stockpile, and I will believe Taiwan has a 2-million-strong reserve force,” Huang said. “The military can’t even tell how many reserve troops they will need to activate across Taiwan, let alone where and how to deploy them when the shooting starts across the Taiwan Strait.”\nOther military officers and defense experts confirmed the problems Huang cited. According to Jyun-yi Lee, an assistant research fellow at the Institute for National Defense and Security Research, a recently created think tank affiliated with Taiwan’s MND: “It’s indeed clear to most of us that Taiwan’s reserve system, as it currently stands, will not contribute much to the military’s fighting strength, if at all. No one is pretending soldiers trained by four-month conscription will be effective. They exist for political, not military, reasons. Politicians don’t want to bring back longer conscription or tougher reserve training, as they fear doing so might make them unpopular.”\nTo its credit, Taiwan’s MND finally began an experimental “reserve warrior program” in recent years that seeks to put skilled veterans back to their original units for refresher training up to a few days per month. Some 214 veterans were said to have signed up in 2019, which is obviously too low to function as a regular reserve force. The program so far seems to matter more to the air force, as it finally provides a channel for retired military pilots to fly again, according to one air force lieutenant familiar with the matter. So far one F-16 pilot and one C-130 pilot reportedly have signed up for the program.\nFormer KMT legislator Hsu “Jason” Yu-Jen said U.S. Defense Department officials have privately expressed dismal assessments regarding Taiwan’s current force level and reserve system. Hsu quoted Pentagon officials as saying in 2019 that Taiwan’s buying of new F-16s and M1 Abram tanks by the Tsai administration was a “nice political gesture” yet they will hardly matter in a war when Taiwan cannot even man them properly in peacetime.\nBut saying the problem out loud is a tough task in itself when both Taiwan’s international allies and the Taiwanese public want to hear a success story more than anything else—especially at a time when China’s propaganda machine is running at full speed to portrait Taiwan’s military as both incompetent and ineffective in the face of the PLA’s rapid expansion and modernization.\n“You have to acknowledge the existence of the problems before you can fix them,” said James Huang, who noted that some among the military community object to his outspokenness, though he decided to speak on record for this report anyway. “It’s about time someone starts telling the truth.”"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","「無兵可用、有兵誤用」的台灣國軍，如何「抗中保台」？ - The News Lens 關鍵評論網"],["url","https://www.thenewslens.com/article/131342"],["summary","政府宣稱可以抵擋中國武力侵略，一部分是想要反制中國共產黨政府宣傳機器，長年來一貫描繪台灣的軍隊無能也無力抵抗解放軍的入侵。然而隨著中國解放軍高速的現代化和軍力增強，中國政府的這種描述恐怕正從宣傳邁向現實。標籤: 國軍, 國防部, 後備軍人, 退役軍人, 徵兵制, 募兵制, 實戰部隊"],["topImageUrl",null],["error",null]]}]}],["text","美國智庫《外交政策》（Foreign Policy）報導\n\nTaiwan’s Military Is a Hollow Shell\n台灣軍隊是空殼\n\n上篇是原文，下篇是翻譯版\n1.\nhttps://foreignpolicy.com/2020/02/15/china-threat-invasion-conscription-taiwans-military-is-a-hollow-shell/\n\n2.\nhttps://www.thenewslens.com/article/131342"],["id","38cho9d29uveq"],["createdAt","2021-08-28T03:11:50.028Z"]]}],["reply",{"__iterable":"Map","data":[["id","ofQPk3sBqH8xU4Aw0Zik"],["user",{"__iterable":"Map","data":[["id","kMzVlWwBqwaEkHKweY5K"],["name","Lopez"],["avatarUrl","https://www.gravatar.com/avatar/751f376f9925146f9752ec17ea482d64?s=100&d=identicon&r=g"],["level",13]]}],["type","OPINIONATED"],["text","(1) 本文出於 Foreign Policy, 是獲得多項獎的雙月刊紙媒和網媒。參考\nhttps://en.wikipedia.org/wiki/Foreign_Policy#Awards\n(2) (ForeignAffairs.com 是另外一個老牌的雙月刊紙媒和網媒，不是美國政府的外交事務官網。兩者皆是可信的媒體。)\nhttps://en.wikipedia.org/wiki/Foreign_Affairs\n\n"],["reference","文中討論國軍從徵兵制改採募兵制所帶來的人員不足的轉型問題，在台灣也廣受討論，可受公論。但是標題說 Taiwan’s Military Is a Hollow Shell 太慫恿，到底國軍軍力強大，世界排名第13的事實，不可忽略。\nhttps://zh.wikipedia.org/wiki/国家的军力强度指数列表"],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Foreign Policy - Wikipedia"],["url","https://en.wikipedia.org/wiki/Foreign_Policy#Awards"],["summary",""],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Foreign Affairs - Wikipedia"],["url","https://en.wikipedia.org/wiki/Foreign_Affairs"],["summary",""],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","国家的军力强度指数列表 - 维基百科，自由的百科全书"],["url","https://zh.wikipedia.org/wiki/国家的军力强度指数列表"],["summary",""],["topImageUrl",null],["error",null]]}]}],["createdAt","2021-08-29T17:58:12.648Z"]]}]]},{"__iterable":"Map","data":[["article",{"__iterable":"Map","data":[["replyCount",2],["references",{"__iterable":"List","data":[{"__iterable":"Map","data":[["type","LINE"]]}]}],["replyRequestCount",4],["user",{"__iterable":"Map","data":[["id","j4S8C_SGPqU25kWT9dgB7Sm3Cz8tQbcAia5BFcJwmHqtWpshs"],["name","富創造力的鼓山愛爾莎"],["avatarUrl",null],["level",0]]}],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Taiwan’s Military Is a Hollow Shell"],["url","https://foreignpolicy.com/2020/02/15/china-threat-invasion-conscription-taiwans-military-is-a-hollow-shell/"],["summary","As threats of military aggression from China grow, the island nation of Taiwan needs a credible military deterrent more than ever. But Taiwan’s military is in a crisis it can barely admit exists.\nEven as the military refits itself with flashy U.S. arms purchases, such as M1 Abrams tanks and F-16V fighter jets, its front-line units are hollowed out, and the entire reserve system is so dysfunctional that few experts or serving military personnel believe it can make a real military contribution in the event of a war. These problems are well documented but continue to be downplayed, if not outright ignored, by Taiwan’s political leadership—and there is no clear plan to solve the crisis.\n\n \n Trending Articles\n \n \n \n \n \n Coronavirus Conspiracies Give Boost to Canada’s Far-Right\n Anti-Chinese sentiment and a public health backlash have vaulted Hong Kong-born Chief Public Health Officer Theresa…\n\n \n \n\n \n \n \nOn paper, Taiwan’s Ministry of National Defense (MND) has 215,000 budgeted positions among all branches, of which 188,000 are soldiers and the rest civilian employees. Only 153,000 of those positions were filled in 2018—just 81 percent of the personnel the military should have. But even that number doesn’t tell the complete story.Only 153,000 of those positions were filled in 2018—just 81 percent of the personnel the military should have. But even that number doesn’t tell the complete story.Only 153,000 of those positions were filled in 2018—just 81 percent of the personnel the military should have. But even that number doesn’t tell the complete story.\nAccording to a Taiwanese army lieutenant colonel in active service, who asked for only his last name, Lin, to be used, all the army’s front-line combat units he knows of—including armor, mechanized infantry, and artillery troops—currently have effective manpower levels of between 60 and 80 percent. This figure is consistent with Taiwanese media reports, which cite MND figures provided to Taiwan’s parliament, the Legislative Yuan, acknowledging that few front-line units have more than 80 percent of their positions filled.\n“That number might not seem so bad until you realize it means at least a third of your tanks are useless in a war because there’s no one to man them,” said Lin, who most recently served as a battalion commander within one of army’s armor brigades.\nThe personnel shortfalls are a clear consequence of the ill-executed transition from conscription to an all-volunteer military over the past few years. It was a political decision made during Ma Ying-jeou’s administration and continued by current President Tsai Ing-wen, despite their coming from different parties. And despite Tsai’s tough rhetoric about defending Taiwan during her successful recent reelection bid, and her vow to thwart Chinese aggression, she has shown no sign of stepping in to fix the problems.\nUniversal conscription is mandated in Article 20 of the Taiwanese Constitution, as in several other countries that face an imminent military threat, such as South Korea or Israel (where women are included but some minorities excluded). For some years, before 2017, the term of conscription service in Taiwan was just a year, which was already short compared with South Korea’s 18-22 months, depending on the military branch, or Israel’s 32 months. Most officers felt that the single year of service wasn’t enough for the military to utilize draftees’ full potential but enough to at least turn a recruit into an average soldier.\nBut 2017’s changes slashed the conscription period to just four months. Most draftees serve even less, as up to two weeks can be deducted if they’ve completed military training classes in high school and college. The four-month conscripts typically receive five weeks of basic training before they are assigned to field units for more specialty training. But they’re more a burden than an aid, not treated seriously by career or noncommissioned officers as their short stays mean they are seen as guests rather than soldiers.\n“By design, they don’t participate in any field exercise or combat readiness training anyway,” Lin said. “We just tell them to stay safe and don’t get into trouble. It’s basically a summer camp.” Several individuals who recently completed this four-month service described similar experiences in interviews.\nOne of the stated aims of the all-volunteer reform was to professionalize the service, staffing the military’s rank and file with a cadre of career-oriented volunteer soldiers who usually serve a minimum term of four years. Despite MND’s talking point that each year’s recruitment drive always hits the set targets and brings with it a fresh crop of volunteers, the rushed transition to an all-volunteer military has clearly damaged the Taiwanese army’s manpower pool—especially on the front line.\nThe reason for the hollowing out of front-line troops is simple. Unlike conscripts, who could be assigned entirely based on to the needs of the military, volunteer soldiers among the lower enlisted ranks can and usually do seek transfers to units considered desirable—rear-echelon troops such as training schools, garrison units, signal corps, and so forth. Although transfer opportunities are limited, soldiers almost always find a way. This means that armor, mechanized infantry, and artillery units are always in desperate shortage of enlisted soldiers—even though they are expected to be the ones bearing the brunt of ground fighting against the formidable People’s Liberation Army (PLA) ground force if it comes ashore.\nA popular yet cynical explanation as to why these Taiwanese soldiers dislike front-line units simply postulates a common aversion to tougher training and combat duty. But interviews with several enlisted ranks painted a more complex picture. Most complained that the food and living conditions left much to be desired—front-line soldiers must split their time between bases and on field exercises. That, on top of the fact they have far more weapons, vehicles, and equipment to clean and maintain, means these posts are perceived as more work for little reward. The existing shortages also cause an even heavier burden of work on the soldiers left—prompting more of them to put in for transfers.\nPolls show varied public opinion on these issues. In 2015, one legislator cited a poll that showed almost 60 support for a return to conscription. In response, the MND cited another poll that claimed 60 percent were satisfied with the transition to all-volunteer forces. At the end of the day, it all seems to come down to how the question is phrased by the pollsters.\nNo matter which poll you believe, it is clear that the two successive presidents over the past decade, Ma and Tsai, had little or no political interest in the political hassle of bringing back the longer conscription length, despite the evidence of the damage being done to military readiness. Even Kaohsiung Mayor Han Kuo-yu, who lost in the recent presidential election representing the Kuomintang (KMT) party, also declined to advocate a complete return to conscription but proposed a “hybrid approach” that he did not specify the details for.\nChieh Chung, a senior assistant research fellow at Taiwan’s National Policy Foundation, commented that the personnel shortage is a problem well documented by the military itself but has never entered their calculations. Chung, who has worked for several years in Taiwan’s parliament as a legislative advisor focusing on defense issues, said the military’s own exercises and computer simulations always assume all units would have at least 90 percent fighting strength at the beginning of a war—an assumption that might have been true in the conscription era but is a far cry from reality today.\nSeveral officers who have participated in the computer-simulated phase of the annual Han Kuang exercises in recent years also pointed out this obvious flaw. That raises the question of how many of the Taiwanese military’s simulations of its own ability to hold off a Chinese invasion are based on now purely hypothetical soldiers.\nThese personnel issues would not be so serious if the military had a functional reserve force. On paper, this enormous reserve force is said to be more than 2 million strong.These personnel issues would not be so serious if the military had a functional reserve force. On paper, this enormous reserve force is said to be more than 2 million strong. Once activated, these reservists are supposed to fill existing shortages across regular field units, and reinforce casualties, while creating fresh reserve formations from virtually nothing to bolster overall defense, according to the Reserve Command’s own words.These personnel issues would not be so serious if the military had a functional reserve force. On paper, this enormous reserve force is said to be more than 2 million strong.\nJust about everything in these talking points is pure fantasy, according to James Huang, a retired army lieutenant colonel who has since become a prolific writer on defense issues and military history, with many followers on Facebook. Huang said there was “no way whatsoever” any of Taiwan’s reserves would reinforce existing field units, despite the proven success of the system elsewhere in the world, especially Israel.\nThat’s the case regardless of whether the reservist is a conscript with four months’ training or a five-year veteran paratrooper just discharged from the special forces. The established practice of Taiwan’s Reserve Command, according to Huang, is not to send reservists back to their previous units but to lump everyone together into the newly activated reserve infantry brigades that possess no specialty, no vehicles, and no equipment except rifles (often older types) and are led by called-up reservist officers who have little experience commanding such ad hoc units.\nIn theory, all soldiers and officers (both conscripts and volunteers) are automatically enrolled as reservists on being discharged from active service. They are called up at most once every two years by the Reserve Command to receive refresher training for five to seven days. In practice, such training rarely consists of more than just basic drills and a short practice session at the rifle range. A reservist corporal who was a veteran M60 tank gunner, for example, will be activated only as an infantry rifleman even if one of the army’s active armor brigades has tanks sitting unmanned in the base.\n“If we go to war, the soldiers currently on roster are all that we have,” said Lin, the lieutenant colonel, who pointed out that he had never heard of any plan to reinforce units he commanded with reserve soldiers. “At best, they might start combining depleted units. We are supposed to fight until everyone is dead or can’t fight anymore.”\nAnd even if Taiwan somehow manages to muster dozens of fresh reserve infantry brigades before Chinese troops come ashore, Huang said they would be little more than cannon fodder consider how poorly the military has trained them in peacetime and the fact that there is not even a clear plan to fit them into the overall defense strategy.\n“Show me 2 million rifles in the stockpile, and I will believe Taiwan has a 2-million-strong reserve force,” Huang said. “The military can’t even tell how many reserve troops they will need to activate across Taiwan, let alone where and how to deploy them when the shooting starts across the Taiwan Strait.”\nOther military officers and defense experts confirmed the problems Huang cited. According to Jyun-yi Lee, an assistant research fellow at the Institute for National Defense and Security Research, a recently created think tank affiliated with Taiwan’s MND: “It’s indeed clear to most of us that Taiwan’s reserve system, as it currently stands, will not contribute much to the military’s fighting strength, if at all. No one is pretending soldiers trained by four-month conscription will be effective. They exist for political, not military, reasons. Politicians don’t want to bring back longer conscription or tougher reserve training, as they fear doing so might make them unpopular.”\nTo its credit, Taiwan’s MND finally began an experimental “reserve warrior program” in recent years that seeks to put skilled veterans back to their original units for refresher training up to a few days per month. Some 214 veterans were said to have signed up in 2019, which is obviously too low to function as a regular reserve force. The program so far seems to matter more to the air force, as it finally provides a channel for retired military pilots to fly again, according to one air force lieutenant familiar with the matter. So far one F-16 pilot and one C-130 pilot reportedly have signed up for the program.\nFormer KMT legislator Hsu “Jason” Yu-Jen said U.S. Defense Department officials have privately expressed dismal assessments regarding Taiwan’s current force level and reserve system. Hsu quoted Pentagon officials as saying in 2019 that Taiwan’s buying of new F-16s and M1 Abram tanks by the Tsai administration was a “nice political gesture” yet they will hardly matter in a war when Taiwan cannot even man them properly in peacetime.\nBut saying the problem out loud is a tough task in itself when both Taiwan’s international allies and the Taiwanese public want to hear a success story more than anything else—especially at a time when China’s propaganda machine is running at full speed to portrait Taiwan’s military as both incompetent and ineffective in the face of the PLA’s rapid expansion and modernization.\n“You have to acknowledge the existence of the problems before you can fix them,” said James Huang, who noted that some among the military community object to his outspokenness, though he decided to speak on record for this report anyway. “It’s about time someone starts telling the truth.”"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","「無兵可用、有兵誤用」的台灣國軍，如何「抗中保台」？ - The News Lens 關鍵評論網"],["url","https://www.thenewslens.com/article/131342"],["summary","政府宣稱可以抵擋中國武力侵略，一部分是想要反制中國共產黨政府宣傳機器，長年來一貫描繪台灣的軍隊無能也無力抵抗解放軍的入侵。然而隨著中國解放軍高速的現代化和軍力增強，中國政府的這種描述恐怕正從宣傳邁向現實。標籤: 國軍, 國防部, 後備軍人, 退役軍人, 徵兵制, 募兵制, 實戰部隊"],["topImageUrl",null],["error",null]]}]}],["text","美國智庫《外交政策》（Foreign Policy）報導\n\nTaiwan’s Military Is a Hollow Shell\n台灣軍隊是空殼\n\n上篇是原文，下篇是翻譯版\n1.\nhttps://foreignpolicy.com/2020/02/15/china-threat-invasion-conscription-taiwans-military-is-a-hollow-shell/\n\n2.\nhttps://www.thenewslens.com/article/131342"],["id","38cho9d29uveq"],["createdAt","2021-08-28T03:11:50.028Z"]]}],["reply",{"__iterable":"Map","data":[["id","N_RGknsBqH8xU4Awc5gd"],["user",{"__iterable":"Map","data":[["id","G0I813oBgBgcuemXCMFW"],["name","vanillam"],["avatarUrl",null],["level",13]]}],["type","RUMOR"],["text","這是一個網名稱為美國「外交政策」的網站，看起來是要誤導讀者誤會為美國政府的外交事務官網，網址是https://www.foreignaffairs.com\n同時，「Taiwan’s Military Is a Hollow Shell」這篇文章作者Paul Huang，是一位自由記者，從2019至今在訊息中所謂的美國「外交政策」網站亦只有共三篇「文章」，網上也找不到「他」其他任何的新聞報道。"],["reference","美國外交事務網站\nhttps://www.foreignaffairs.com\n\nPaul Huang is a freelance journalist\nhttps://foreignpolicy.com/author/paul-huang/"],["hyperlinks",{"__iterable":"List","data":[{"__iterable":"Map","data":[["title","Foreign Affairs"],["url","https://www.foreignaffairs.com"],["summary","Foreign Affairs is the leading magazine for in-depth analysis and debate of foreign policy, geopolitics and global affairs"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Foreign Affairs"],["url","https://www.foreignaffairs.com"],["summary","Foreign Affairs is the leading magazine for in-depth analysis and debate of foreign policy, geopolitics and global affairs"],["topImageUrl",null],["error",null]]},{"__iterable":"Map","data":[["title","Paul Huang - Foreign Policy"],["url","https://foreignpolicy.com/author/paul-huang/"],["summary","Paul Huang is a freelance journalist and a nonresident fellow with the Taiwanese Public Opinion Foundation. He is currently based in Taipei, Taiwan, where he conducts research into China’s military and global influence operations. "],["topImageUrl",null],["error",null]]}]}],["createdAt","2021-08-29T14:18:15.713Z"]]}]]}]}],["searchArticles",{"__iterable":"List","data":[]}],["searchReplies",{"__iterable":"List","data":[]}]]}]]},"replyDetail":{"__iterable":"Map","data":[["state",{"__iterable":"Map","data":[["isLoading",false],["isAuthLoading",false],["isReplyLoading",false]]}],["data",{"__iterable":"Map","data":[["reply",null],["originalReplyConnection",null]]}]]},"auth":{"__iterable":"Map","data":[["state",{"__iterable":"Map","data":[["isLoading",false],["isDialogShown",false]]}],["user",null]]}}

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