London, United Kingdom:

UK families of some 240,000 people who died from Covid-19 have hung festive lights on a London wall, a symbol of love, anger and pain ahead of another Christmas overshadowed by loss.

As the fifth anniversary of the global pandemic approaches, emotions still run raw across the UK amid lingering accusations that the then government responded too slowly to the crisis.

Some 240,000 hearts have been painted by hand on the wall, nestled on the banks of the Thames, opposite the British parliament.

Each heart on the 500-metre-long (540-yard) wall represents one of the UK victims of the disease, which shattered and disrupted lives around the globe after being first detected in China in December 2019.

“We put up lights every Christmas, just as a way to reflect and remember those people who are not with us,” said Kirsten Hackman, 58, whose mother died from Covid in May 2020.

“For many of us, there is that empty place at the table this Christmas,” she added.

The wall is a collective “therapy session,” say volunteers.

Since 2019 more than seven million people have been reported to have died from Covid worldwide, according to the World Health Organization. But the true toll is believed to be much higher.

Thousands of messages written on the hearts on the London wall reveal the depth of the emotional toll and scars left by the pandemic on UK lives.

“Mamy, love you forever,” reads one, while another says: “Phil, always in my heart”.

The remembrance wall was originally meant to be temporary, and was constructed without permission in March 2021 in protest at then prime minister Boris Johnson’s handling of the pandemic.

He faced accusations of being too slow to recognise Covid’s threat and then taking too long to lock down the country to try to prevent the spread of the highly infectious disease.

The wall is an “outpouring of love, anger, rage”, Lorelei King, whose husband died of Covid in March 2020, told AFP.

The 71-year-old is part of the “Friends of the Wall” group, a dozen volunteers who come every Friday to clean the monument, repaint the rain-washed hearts and rewrite the messages.

“It’s quite meditative”, she said.

The group continues to draw new hearts as Covid claims new lives.

Wall ‘comforts me’

But on the Friday before Christmas, the volunteers met for another, more joyful mission: to hang lights along the wall.

They illuminated them on Monday, and the decorations will remain in place until the beginning of January.

Nearly five years after the start of the pandemic, the pain remains the same, said King, adding she was one of many who had not been able to grieve properly.

“We weren’t able to have a real funeral,” due to lockdown rules, she explained, referring to the severe restrictions put in place on visiting loved ones in their dying hours, and then from holding large gatherings to mourn their loss.

Instead, she focuses her energy on the wall. “It comforts me. And I don’t want the people we care about to be forgotten,” said King.

“We are all in the same boat”, added Michelle Rumball, 53, whose mother died of Covid in April 2020.

She was there on the first day that some hearts were painted, following a social media call by activist group Led By Donkeys.

Over the next 10 days, hundreds of people who had lost loved ones showed up to add their tribute, despite risking arrest for damaging a listed wall.

“I was very angry at that time. It was a demonstration,” recalled Rumball.

The group is in discussions with the authorities to make the wall, whose upkeep depends on donations, “permanent” and officially recognised, meaning it could be better protected.

And a few days before Christmas, they had a “very positive” meeting, King said.

According to the WHO, more than 232,000 people have died with Covid in the United Kingdom. By comparison, there have been around 168,000 deaths in France.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

While it’s one thing to acknowledge the limits to our knowledge of the microbial soup we live in, more recent attention has focused on how we might systematically approach future pandemic risks.

Former US Secretary of Defense Donald Rumsfeld famously talked about “known knowns” (things we know we know), “known unknowns” (things we know we don’t know), and “unknown unknowns” (the things we don’t know we don’t know).

Although this may have been controversial in its original context of weapons of mass destruction, it provides a way to think about how we might approach future pandemic threats.

Influenza: a ‘known known’

Influenza is largely a known entity; we essentially have a minor pandemic every winter with small changes in the virus each year. But more major changes can also occur, resulting in spread through populations with little pre-existing immunity. We saw this most recently in 2009 with the swine flu pandemic.

However, there’s a lot we don’t understand about what drives influenza mutations, how these interact with population-level immunity, and how best to make predictions about transmission, severity and impact each year.

The current H5N1 subtype of avian influenza (“bird flu”) has spread widely around the world. It has led to the deaths of many millions of birds and spread to several mammalian species including cows in the United States and marine mammals in South America.

Human cases have been reported in people who have had close contact with infected animals, but fortunately there’s currently no sustained spread between people.

While detecting influenza in animals is a huge task in a large country such as Australia, there are systems in place to detect and respond to bird flu in wildlife and production animals.

It’s inevitable there will be more influenza pandemics in the future. But it isn’t always the one we are worried about.

Attention has been focused on avian influenza since 1997 when an outbreak in birds in Hong Kong caused severe disease in humans. However the subsequent pandemic in 2009 originated in pigs in central Mexico.

Coronaviruses: an ‘unknown known’

Although Rumsfeld didn’t talk about “unknown knowns”, coronaviruses would be appropriate for this category. We knew more about coronaviruses than most people might have thought before the COVID pandemic.  

We’d had experience with severe acute respiratory syndrome (SARS) and Middle Eastern respiratory syndrome (MERS) causing large outbreaks. Both are caused by viruses closely related to SARS-CoV-2, the coronavirus that causes COVID. While these might have faded from public consciousness before COVID, coronaviruses were listed in the 2015 WHO list of diseases with pandemic potential.

Previous research into the earlier coronaviruses proved vital in allowing COVID-19 vaccines to be developed rapidly. For example, the Oxford group’s initial work on a MERS vaccine was key to the development of AstraZeneca’s COVID-19 vaccine.

Similarly, previous research into the structure of the spike protein – a protein on the surface of coronaviruses that allows it to attach to our cells – was helpful in developing mRNA vaccines for COVID.

It would seem likely there will be further coronavirus pandemics in the future. And even if they don’t occur at the scale of COVID, the impacts can be significant. For example, when MERS spread to South Korea in 2015, it only caused 186 cases over two months, but the cost of controlling it was estimated at US$8 billion (A$11.6 billion).

The 25 viral families: an approach to ‘known unknowns’

Attention has now turned to the known unknowns. There are about 120 viruses from 25 families that are known to cause human disease. Members of each viral family share common properties and our immune systems respond to them in similar ways.

An example is the flavivirus family, of which the best-known members are yellow fever virus and dengue fever virus. This family also includes several other important viruses, such as Zika virus (which can cause birth defects when pregnant women are infected) and West Nile virus (which causes encephalitis, or inflammation of the brain).

The WHO’s blueprint for epidemics aims to consider threats from different classes of viruses and bacteria. It looks at individual pathogens as examples from each category to expand our understanding systematically.

The US National Institute of Allergy and Infectious Diseases has taken this a step further, preparing vaccines and therapies for a list of prototype pathogens from key virus families. The goal is to be able to adapt this knowledge to new vaccines and treatments if a pandemic were to arise from a closely related virus.

Pathogen X, the ‘unknown unknown’

There are also the unknown unknowns, or “disease X” – an unknown pathogen with the potential to trigger a severe global epidemic. To prepare for this, we need to adopt new forms of surveillance specifically looking at where new pathogens could emerge.

In recent years, there’s been an increasing recognition that we need to take a broader view of health beyond only thinking about human health, but also animals and the environment. This concept is known as “One Health” and considers issues such as climate change, intensive agricultural practices, trade in exotic animals, increased human encroachment into wildlife habitats, changing international travel, and urbanisation.

This has implications not only for where to look for new infectious diseases but also for how we can reduce the risk of “spillover” from animals to humans. This might include targeted testing of animals and people who work closely with animals. Currently, testing is mainly directed towards known viruses, but new technologies can look for as yet unknown viruses in patients with symptoms consistent with new infections.

We live in a vast world of potential microbiological threats. While influenza and coronaviruses have a track record of causing past pandemics, a longer list of new pathogens could still cause outbreaks with significant consequences.

Continued surveillance for new pathogens, improving our understanding of important virus families, and developing policies to reduce the risk of spillover will all be important for reducing the risk of future pandemics.

This article is part of a series on the next pandemic.

Allen Cheng, Professor of Infectious Diseases, Monash University 

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A pulse oximeter is placed in the hand of a COVID-19 patient. A team of researchers from the University of Nottingham (UoN) have developed a laboratory-based test to assess the performance of POs under the effects of varying melanin (pigment responsible for colour) concentration and oxygen saturation (SpO2) values.
| Photo Credit: File photo

Given that the performance of pulse oximeters (POs) is known to vary with the colour of skin, a team of researchers from the University of Nottingham (UoN) have developed a laboratory-based test to assess the performance of POs under the effects of varying melanin (pigment responsible for colour) concentration and oxygen saturation (SpO2) values.

A study pertaining to this, titled ‘Pulse oximeter bench tests under different simulated skin tones’, has been published in Medical and Biological Engineering and Computing, a peer reviewed medical journal.

Pulse oximeters were the most commonly used devices during the covid pandemic as they allowed for non-invasive, painless, continuous and inexpensive real-time monitoring of oxygen levels in the blood using light (commonly, red and infrared light).

Need for caution

Suvvi K. Narayana Swamy, lead author of the study, told The Hindu that POs did not show any deviations in SpO2 readings due to skin colour in the laboratory tests. “However, the tests also did not conclusively demonstrate that melanin does not affect SpO2 measurements. So, we need to be cautious not to over interpret these results. Further research is underway,” she said.

“In the United Kingdom, the COVID Oximetry @home programme was launched as part of the National Health Service (NHS) response to the pandemic. Through this programme, commercially available peripheral POs were delivered to allow patients with COVID-19, or at high risk, to remotely monitor their SpO2 levels at home. These devices were widely used globally by healthcare professionals to make timely clinical decisions when admitting patients (particularly with the absence of any noticeable symptoms) to hospitals for critical care and treatment,” Ms. Swamy said.

The study gains significance in a context where several recent retrospective clinical studies have highlighted that SpO2 may be overestimated in patients with non-white skin types. This phenomenon is generally termed occult hypoxemia, where SpO2 measured by a PO is greater than 90%, despite true oxygen saturation value being less than 88%,” she explained. 

“In this study, the performance of POs used in the NHS COVID Oximetry @home programme and in hospitals in UK was investigated. The test enabled the POs to be subjected to low signal and varying melanin concentration, which are the two main principal effects of melanin in the skin through simulation. The effects of low signal levels were simulated by neutral density filters (NDFs) that reduced red and infrared radiation light in the same manner while the effects of melanin concentration were achieved by utilising melanin filters (MFs) that decreased both red and IR light by unequal amounts.In these tests, the SpO2 overestimation, which has often been observed clinically, was not reproduced,” she explained.

Significant variations

Stating that a laboratory simulation was used to mimic different SpO2 values (~ 70 to 100%), Ms Swamy said different neutral density and synthetic melanin filters were used to reproduce low signal and varying melanin reduction levels. “POs from six different brands were reviewed and their response documented. Significant variations were observed in the recorded SpO2 values among different POs when exposed to identical simulated signals.  Differences were greatest for lower SpO2 (<80%) where empirical data is limited,” Ms. Swamy said.

“All PO responses under low signal and melanin concentration did not change across various simulated SpO2 values. The tests do not provide conclusive evidence that melanin does not affect in vivo SpO2 measurements. Research in the areas of instrument calibration, theory and design needs to be further developed,” she added.

A multi-millionaire property developer from Australia has sparked outrage after saying that he wants unemployment to rise in his country because workers have become ”too arrogant”. Tim Gurner, CEO of Australian real estate company Gurner Group said that the Covid pandemic had changed employees’ work ethic and they need to be put in their place through unemployment, Independent reported. 

”I think the problem that we’ve had is that people decided they didn’t really want to work so much anymore through COVID. They have been paid a lot to do not too much in the last few years, and we need to see that change” he told the Australian Financial Review Property Summit in Sydney.

According to him, the key to curbing “arrogance” in the labour market is higher unemployment.

”We need to see unemployment rise. Unemployment has to jump 40, to 50 percent in my view. We need to see the pain in the economy. We need to remind people that they work for the employer, not the other way around,” he added.

”There’s been a systematic change where employees feel the employer is extremely lucky to have them, as opposed to the other way around. We’ve got to kill that attitude and that has to come through hurting the economy,” he further said. 

The unemployment rate in Australia is 3.6 per cent, or roughly 500,000 people, meaning an estimated 250,000 workers would lose their jobs in a 50 per cent increase.

A video of his controversial comments has gone viral on social media, sparking instant backlash. ”Why doesn’t he do us a favour and volunteer his job as the first step to the 50%,” one user wrote. Another said, ”Everything a business leader should not say. Kind of unbelievable.”

His comments also drew a fierce reaction from the US democrat Alexandria Ocasio-Cortez.

”Reminder that major CEOs have skyrocketed their own pay so much that the ratio of CEO-to-worker pay is now at some of the highest levels *ever* recorded,” Ocasio-Cortez wrote on X.

After receiving backlash for his statements, he said in a LinkedIn post on Thursday that he was “wrong” to say what he did. He admitted that his comments were ”deeply insensitive”.

“At the AFR Property Summit this week I made some remarks about unemployment and productivity in Australia that I deeply regret and were wrong. There are clearly important conversations to have in this environment of high inflation, pricing pressures on housing and rentals due to a lack of supply, and other cost-of-living issues. My comments were deeply insensitive to employees, tradies and families across Australia who are affected by these cost-of-living pressures and job losses. 

”I want to be clear: I do appreciate that when someone loses their job it has a profound impact on them and their families and I sincerely regret that my words did not convey empathy for those in that situation,” Mr Gurner wrote.

Mr Gurner, who has been featured in Forbes Australia, and is one of Australia’s richest men, has a net worth of $912 million as per The Australian Financial Review’s estimates.