The finding adds to growing evidence that gut microbes can play a role in brain diseases. And while the new study found the plasma cells in the brains of healthy mice, previous research has found other gut-trained cells in the brains of mice with multiple sclerosis, an autoimmune disease of the brain and the spinal cord. For now, the researchers want to understand what cues plasma cells follow in the guts to know it is time for them to embark on a journey to the brain. In Europe, where the coronavirus was largely under control for much of the summer and fall, cases are skyrocketing nearly everywhere.
Twenty countries, including the United Kingdom and France, have shuttered restaurants, introduced curfews or generally urged people to stay at home, though most schools and universities are staying open for now. Cases are surging across the United States, too, where more than , new infections are being reported each day. Already in November, more than half of states have set records for the most cases in a week, and in places such as Minnesota, Utah and Wisconsin, some hospitals are nearing capacity. In North Dakota, nearly 1 in every 14 people has already contracted the coronavirus, with 2, cases reported November 8 alone in a state of , people.
That sweet spot is indoors, where people are spending more time as the weather in the Northern Hemisphere turns colder — and where the virus can spread more easily.
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Shutting down borders, businesses and schools are among the most drastic measures to do that. Worries over economic consequences may hold governments back from issuing widespread stay-at-home orders this time around, though. President-elect Joe Biden, who unveiled a COVID advisory board November 9, has proposed a multipronged plan for controlling the pandemic, including nationwide mask mandates and expanded testing. That means getting through the winter will require falling back on the familiar public health tools of physical distancing, mask wearing, and testing and isolating infected people, Shaman says.
But all of those measures fall short unless everyone is willing to follow the rules.
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Alone, none of those measures is perfect, but doing them all together can boost protection, like layering slices of Swiss cheese so that holes in one slice are covered by another slice. It goes for individual actions, too. Scientists know much more about the virus than they did in March, and that knowledge can help make the most of all the public health tools at our disposal. Dozens of studies have made it abundantly clear that wearing a mask is one of the most effective steps an individual can take to help curb the pandemic.
The U. In a study published October 23 in Nature Medicine , scientists estimate that if 95 percent of people wore masks when outside their homes, nearly , deaths from COVID might be averted in the United States between the end of September and the end of February If 85 percent of people wear masks, about 96, lives might be saved, the researchers calculate. When it comes to ubiquitous cloth masks, only one randomized clinical trial in the world is testing their effectiveness in preventing COVID That trial in Guinea-Bissau is giving all 66, expected participants advice about how to avoid respiratory illnesses.
Half of those people will each also get two locally sewn cloth masks. The trial is expected to wrap up in November. That caused a lot of angst during the pandemic.
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In March and April, I had a lot of health workers in the U. Is it better I wear no mask than wear a cloth mask? That prompted MacIntyre and colleagues to examine unpublished data from the trial. Both surgical and cloth masks get contaminated with respiratory viruses, the researchers found. But surgical masks are disposable. But workers who hand-washed their masks had double the risk of infection of those wearing a medical mask, the researchers reported September 28 in BMJ Open.
Shrinkage from hot water also tightens up pores in the mask, keeping the virus from slipping through easily. Health care workers should also wear protective goggles to prevent rare cases of infection through the eye, MacIntyre says. But determining whether people going about their daily lives need goggles, face shields or other eye protection in addition to masks is a tricky bit of calculus, she says. Early in the pandemic, lockdowns and social distancing measures of varying severity enacted in many countries largely worked.
Circumstances are different now. Now that scientists have a better understanding of transmission, blanket lockdowns may not be needed. Instead, restrictions could focus on crowded, poorly ventilated spaces like restaurants and bars. If cases continue to grow exponentially, however, stricter lockdowns may be the only tool left to prevent hospitals from being overwhelmed. But such measures are increasingly less palatable to many Americans, Osterholm says. In a sample of homes with a positive coronavirus test, 53 percent of other people living in those homes became quickly infected , researchers reported in the Nov.
And not everyone can stay home, which has contributed to inequities in who is getting sick in this pandemic. Cell phone mobility data suggest that this difference stems from work-related demands , according to a study published November 3 in Nature Human Behavior. Residents of the highest-income neighborhoods reduced days at work outside the home by But when there was a choice, people in these neighborhoods did limit their activities, Jay says.
The data showed that people of all income groups reduced outings unrelated to work at roughly similar levels. Lockdowns by themselves will not end the pandemic. They are only supposed to be temporary measures that buy time for local and state health departments to beef up other infection-control strategies. Contact tracing and isolation is most powerful when cases are identified early in the course of infection, their contacts are traced and informed of their exposure quickly, and those contacts comply with requests to quarantine.
Such a system requires broadly available testing and lots of contact tracers to do the detective work. In October, only three states and the District of Columbia had enough full-time contact tracers to deal with current caseloads, according to a survey conducted by NPR and the Johns Hopkins Center for Health Security. And as cases climb, even well-staffed systems could be overwhelmed.
Currently, there are just over 50, contact tracers nationwide. Robust contact tracing systems work only if people comply with public health officials and share their contact history or quarantine if necessary. Yet only 58 percent of Americans would be likely to speak with a public health official who contacted them by phone or text message about the coronavirus outbreak, according to a Pew Research survey released October Clearer and more consistent public health messaging could improve these numbers.
He and colleagues simulated what would have happened had states done exactly what they did at the beginning of the U. Enacting social distancing and stay-at-home orders on March 1 instead of March 8 would have headed off about , confirmed cases and 32, deaths.
Acting two weeks earlier would have avoided more than 1 million cases and about 60, deaths nationwide , Shaman and colleagues reported November 6 in Science Advances.
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No one can turn back the clock. But countries including Vietnam, Taiwan, Singapore, New Zealand and Australia have shown that acting aggressively can curb the spread of the virus. For instance, at the end of September, 89 counties in Tennessee eased or removed social distancing restrictions. Cell phone mobility data as of October 21 suggest that business dropped once restrictions were lifted and was 24 percent below where it was during the same time in In the 16th century, an eminent French barber surgeon named Ambroise Pare noted—with amazement—that some of his patients who had undergone limb amputation complained months later that they still felt sensations including pain coming from their missing limb.
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Today, phantom sensations are recognized as a common experience in those who have lost a limb. The presentation of phantom sensations can vary from patient to patient. In most cases, the sensations begin almost immediately after the surgery or injury that led to the loss of the limb after consciousness has returned and any anesthetic has worn off. But in about a quarter of patients , the sensations may not appear for several days or weeks. Sometimes the phantom sensations fade away after a few days or weeks, but in other cases they persist for years—or even decades.
In many patients, the phantom limb takes on a habitual posture e. But that posture may change spontaneously, and some patients complain that their phantom limb ends up in awkward positions that generate discomfort and pain. One anecdotal report describes a patient who lost a limb after a grenade exploded in it. He complained that his phantom hand was perpetually held in a painful, tightly-clenched fist. Phantom limb is still not very well understood. The prevailing explanation for phantom limb sensations is an idea known as cortical reorganization or cortical remapping.
Before the accident, neurons that carried sensations from the arm communicated with neurons in a region known as the somatosensory cortex , which receives information about touch, pain, temperature, and proprioception i.
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Specifically, neurons carrying information from the arm interact with neurons in a part of the somatosensory cortex devoted to processing information about arm sensations. After the accident, however, those somatosensory neurons are deprived of their normal source of neuronal input. Consequently, they begin to respond to signaling from other nearby neurons. This can cause sensations felt in other parts of the body e. The extent to which this type of maladaptive cortical reorganization occurs is correlated with the severity of phantom limb pain.
It should be noted that reorganization in non-cortical areas, like the thalamus a subcortical structure involved in processing nearly all incoming sensory information also seems to play a role in some phantom sensations. Another popular explanation for phantom limb centers around the idea that the brain typically relies on an internal representation of the body for generating an awareness of where our body is in space—and thus for maintaining posture, making movements, etc.
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This internal representation of the body is likely created by networks of neurons that integrate information of various types in the brain e. According to some researchers, the internal representation of the body can be the root of phantom limb sensations and pain. This might occur when, after a limb is lost, the body representation remains intact. This might lead to abnormal sensations, discomfort, or pain when incoming sensory information conflicts with the neural body representation e.