Governments are attempting to control the COVID-19 pandemic with nonpharmaceutical interventions (NPIs). However, the effectiveness of different NPIs at reducing transmission is poorly understood. We gathered chronological data on the implementation of NPIs for several European, and other, countries between January and the end of May 2020. We estimate the effectiveness of NPIs, ranging from limiting gathering sizes, business closures, and closure of educational institutions to stay-at-home orders. To do so, we used a Bayesian hierarchical model that links NPI implementation dates to national case and death counts and supported the results with extensive empirical validation. Closing all educational institutions, limiting gatherings to 10 people or less, and closing face-to-face businesses each reduced transmission considerably. The additional effect of stay-at-home orders was comparatively small.

Background: Existing analyses of nonpharmaceutical interventions (NPIs) against COVID19 transmission have concentrated on the joint effectiveness of large-scale NPIs. With increasing data, we can move beyond estimating joint effects towards disentangling individual effects. In addition to effectiveness, policy decisions ought to account for the burden placed by different NPIs on the population. Methods: To our knowledge, this is the largest data-driven study of NPI effectiveness to date. We collected chronological data on 9 NPIs in 41 countries between January and April 2020, using extensive fact-checking to ensure high data quality. We infer NPI effectiveness with a novel semi-mechanistic Bayesian hierarchical model, modelling both confirmed cases and deaths to increase the signal from which NPI effects can be inferred. Finally, we study how much perceived burden different NPIs impose on the population with an online survey of preferences using the MaxDiff method. Results: Eight NPIs have a >95% posterior probability of being effective: closing schools (mean reduction in R: 50%; 95% credible interval: 39%-59%), closing nonessential businesses (34%; 16%-49%), closing high-risk businesses (26%; 8%-42%), and limiting gatherings to 10 people or less (28%; 8%-45%), to 100 people or less (17%; -3%-35%), to 1000 people or less (16%; -2%-31%), issuing stay-at-home orders (14%; -2%-29%), and testing patients with respiratory symptoms (13%; -1%-26%). As validation is crucial for NPI models, we performed 15 sensitivity analyses and evaluated predictions on unseen data, finding strong support for our results. We combine the effectiveness and preference results to estimate effectiveness-to-burden ratios. Conclusions: Our results suggest a surprisingly large role for schools in COVID-19 transmission, a contribution to the ongoing debate about the relevance of asymptomatic carriers in disease spreading. We identify additional interventions with good effectiveness-burden tradeoffs, namely symptomatic testing, closing high-risk businesses, and limiting gathering size. Closing most nonessential businesses and issuing stay-at-home orders impose a high burden while having a limited additional effect.

The idea behind the marine cloud-brightening (MCB) geoengineering technique is that seeding marine stratocumulus clouds with copious quantities of roughly monodisperse sub-micrometre sea water particles might significantly enhance the cloud droplet number concentration, and thereby the cloud albedo and possibly longevity. This would produce a cooling, which general circulation model (GCM) computations suggest could—subject to satisfactory resolution of technical and scientific problems identified herein—have the capacity to balance global warming up to the carbon dioxide-doubling point. We describe herein an account of our recent research on a number of critical issues associated with MCB. This involves (i) GCM studies, which are our primary tools for evaluating globally the effectiveness of MCB, and assessing its climate impacts on rainfall amounts and distribution, and also polar sea-ice cover and thickness; (ii) high-resolution modelling of the effects of seeding on marine stratocumulus, which are required to understand the complex array of interacting processes involved in cloud brightening; (iii) microphysical modelling sensitivity studies, examining the influence of seeding amount, seed-particle salt-mass, air-mass characteristics, updraught speed and other parameters on cloud–albedo change; (iv) sea water spray-production techniques; (v) computational fluid dynamics studies of possible large-scale periodicities in Flettner rotors; and (vi) the planning of a three-stage limited-area field research experiment, with the primary objectives of technology testing and determining to what extent, if any, cloud albedo might be enhanced by seeding marine stratocumulus clouds on a spatial scale of around 100×100 km. We stress that there would be no justification for deployment of MCB unless it was clearly established that no significant adverse consequences would result. There would also need to be an international agreement firmly in favour of such action.

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HIV-1 variants with genotypic resistance markers are present in the male genital tract and evolve over time on incompletely suppressive antiretroviral therapy. The absence of genotypic changes consistent with protease inhibitor resistance in the semen, despite their presence in blood plasma, suggests the possibility of limited penetration of these agents into the male genital tract. Sexual transmission of resistant variants may have a negative impact on treatment outcome in newly infected individuals and on the spread of the diseases within a population. Therapeutic strategies that fully suppress HIV-1 in the genital tract should be a public health priority.

Soluble markers of immune activation add prognostic information to CD4 counts and viral load for risk of disease progression in advanced HIV-1 infection. The robust performance of neopterin, an inexpensive and reliably measured serum marker, supports its potential suitability for patient monitoring, particularly in resource-limited settings.

Earthquake early warning (EEW) can be used to detect earthquakes and provide advanced notification of strong shaking, allowing pre-emptive actions to be taken that not only benefit infrastructure but reduce injuries and fatalities. Currently Aotearoa New Zealand does not have a nationwide EEW system, so a survey of the public was undertaken to understand whether EEW was considered useful and acceptable by the public, as well as perceptions of how and when such warnings should be communicated, before making an investment in such technology. We surveyed the public’s perspectives (N = 3084) on the usefulness of EEW, preferred system attributes, and what people anticipated doing on receipt of a warning. We found strong support for EEW, for the purposes of being able to undertake actions to protect oneself and others (e.g. family, friends, and pets), and to mentally prepare for shaking. In terms of system attributes, respondents expressed a desire for being warned at a threshold of shaking intensity MM5–6. They suggested a preference for receiving a warning via mobile phone, supported by other channels. In addition to being warned about impending shaking, respondents wanted to receive messages that alerted them to other attributes of the earthquake (including the possibility of additional hazards such as tsunami), and what actions to take. People’s anticipated actions on receipt of a warning varied depending on the time available from the warning to arrival of shaking. People were more likely to undertake quicker and easier actions for shorter timeframes of <10 s (e.g., stop, mentally prepare, take protective action), and more likely to move to a nearby safe area, help others, look for more information, or take safety actions as timeframes increased. Given the public endorsement for EEW, information from this survey can be used to guide future development in Aotearoa New Zealand and internationally with respect to system attributes, sources, channels and messages, in ways that promote effective action.

A group of gay-identified men (n = 81) and intravenous drug users (n = 88) diagnosed with AIDS in San Francisco were interviewed regarding their use of friends and family to meet their care needs. Analytic of quantitative data revealed that gay men relied more than did IDUs on friends for care. Neither group relied primarily on their families for care. Analysis of the qualitative data identified five primary barriers to care. First, many people with AIDS are not accustomed to asking for help and often avoid it when possible. Second, the social stigma surrounding AIDS sometimes leads to isolation. Third, some people with AIDS have kin with health problems of their own, thereby sometimes compromising this potential source of care. Fourth, the AIDS epidemic has devastated identifiable sub-populations, leaving surviving members of these groups emotionally exhausted and sometimes unable to provide as much help as they might have liked. Finally, some respondents choose to voluntarily cut themselves off from 'supportive' relationships that they perceive to be destructive now that they have been diagnosed with a fatal illness. Professional care providers and health care planners should be aware of dynamics within informal care networks of people with AIDS that may leave patients without necessary care.