Coronavirus communication and trust

The global coronavirus disease (COVID-19) pandemic has already had an enormous impact and will surely have profound consequences for many years to come.

The authors reflect on three risk communication themes related to the pandemic: trust, tradeoffs, and preparedness. Trust is critically important during such a rapidly evolving event characterized by scientific uncertainty. Reflections focus on uncertainty communication, transparency, and long-term implications for trust in government and science. On tradeoffs, the positive and unintended negative effects of three key risk communication messages are considered (1) stay at home, (2) some groups are at higher risk, and (3) daily infections and deaths.

The authors argue that greater attention to message ‘tradeoffs’ over ‘effectiveness’ and ‘evaluation’ over ‘intuition’ would help guide risk communicators under pressure. On preparedness, past infectious disease outbreak recommendations are examined. Although COVID-19 was inevitably ‘unexpected’, important preparedness actions were largely overlooked such as building key risk communication capacities.

COVID-19: Reflections on trust, tradeoffs, and preparedness, April 2020

Journal of Risk Research

Dominic HP Balog-Way and Katherine A McComas

https://www.researchgate.net/publication/340958173_COVID-19_Reflections_on_trust_tradeoffs_and_preparedness/references?utm_medium=email&utm_source=researchgate&utm_campaign=re413&loginT=iZBjE6QqKQDtgm9mIth3elm18k_fuz-NWD_VJXbuMq0_VSlbSUu0QyWSAb06_bTWyEX92MLG8X_6SgQ&pli=1&utm_term=re413_p_pb&utm_content=re413_p_pb_p4&cp=re413_p_pb_p4&uid=nL3zUTnj0PdkgYxg8hJW1mCbrq7iJZlhMSga&ch=reg

When our eldest daughter was about six-weeks-old in 1987, my ex and I took her to a Grateful Dead concert at an outdoor amphitheater north of Toronto. We sat at the back. The dead did this Buddy Holly song as part of their encore and it was fabulous.

With restaurants still serving food, Florida conducted over 1,000 inspections in April

Despite the coronavirus pandemic, restaurants are, according to Jeff Weinsier of Local 10 news, still operating for take-out and delivery, and inspectors are out in full force.

Local 10 News’ Jeff Weinsier looked into the numbers and found that over 1,000 inspections have been made in Miami-Dade, Broward, Monroe and Palm Beach Counties during the month of April.

Sonny’s Famous Steak Hogies in Hollywood has been a staple in the community for over 60 years. Its dining room has become a storage area, but customers are keeping them extremely busy with take-out and delivery orders.

John Nigro of Sonny’s makes every one of his employees sign a copy of the restaurant’s rules, to ensure everything remains sanitary and follows the proper health guidelines. He knows a health inspector could pop in at any moment.

The good news is that no kitchens have been ordered shut over the past two weeks.

Vibrio and oysters: A review

Vibrio parahaemolyticus is a Gram‐negative bacterium that is naturally present in the marine environment. Oysters, which are water filter feeders, may accumulate this pathogen in their soft tissues, thus increasing the risk of V. parahaemolyticus infection among people who consume oysters. In this review, factors affecting V. parahaemolyticus accumulation in oysters, the route of the pathogen from primary production to consumption, and the potential effects of climate change were discussed. In addition, intervention strategies for reducing accumulation of V. parahaemolyticus in oysters were presented.

A literature review revealed the following information relevant to the present study: (a) managing the safety of oysters (for human consumption) from primary production to consumption remains a challenge, (b) there are multiple factors that influence the concentration of V. parahaemolyticus in oysters from primary production to consumption, (c) climate change could possibly affect the safety of oysters, both directly and indirectly, placing public health at risk, (d) many intervention strategies have been developed to control and/or reduce the concentration of V. parahaemolyticus in oysters to acceptable levels, but most of them are mainly focused on the downstream steps of the oyster supply chain, and (c) although available regulation and/or guidelines governing the safety of oyster consumption are mostly available in developed countries, limited food safety information is available in developing countries. The information provided in this review may serve as an early warning for managing the future effects of climate change on the safety of oyster consumption.

Managing the risk of vibrio parahaemolyticus infections associated with oyster consumption: A review

Comprehensive Reviews in Food Science and Food Safety

Nodali Ndraha, Hin‐chung Wong, Hsin‐I Hsiao

https://doi.org/10.1111/1541-4337.12557

https://onlinelibrary.wiley.com/doi/full/10.1111/1541-4337.12557

Outbreak investigation of Listeria monocytogenes: Hard-boiled eggs (December 2019)

Why did Listeria appear in hard-boiled eggs? Insufficient cooking? Cross-contamination? Dirty pails? This report doesn’t say.

The U.S. Food and Drug Administration, the U.S. Centers for Disease Control, CDC, and state and local partners investigated an outbreak of Listeria monocytogenes infections linked to hard-boiled eggs produced by Almark Foods’ Gainesville, Georgia facility. Almark Foods announced an initial voluntary recall of hard-boiled and peeled eggs in pails on December 20, 2019, and then on December 23, 2019 expanded the recall to include all hard-boiled eggs produced at the Gainesville, Georgia facility. All recalled products are now past their “best by” dates.

CDC has announced this outbreak is over. FDA’s investigational activities, including an inspection, are complete. At this time, the firm is no longer producing products at this facility.

Recommendation

Recalled products are now past their “best by” dates and should be thrown away.

FDA recommends that food processors, restaurants and retailers who received recalled products use extra vigilance in cleaning and sanitizing any surfaces that may have come in contact with these products, to reduce the risk of cross-contamination.

Case Counts

Total Illnesses: 8
Illnesses in 2019: 5
Hospitalizations: 5
Deaths: 1
Last illness isolation date: December 7, 2019
States with Cases: FL (1), ME (2), PA (1), SC (2), TX (2)
States with Cases in 2019: FL (1), ME (2), SC (2), TX (1)
Product Distribution*: Nationwide
*Distribution has been confirmed for states list, but at this time we believe the product was distributed nationwide. Updates will be provided as more information becomes available.

What Products are Recalled?

Recalled products include bulk product sold in pails, as well as products sold at retail. Companies who received recalled product from Almark Foods have initiated recalls of products containing these eggs. A list of all these recalls is available on the FDA website.

 

It’s not a war: FDA arming itself with science to help prevent Cyclospora infections

Steven Musser Ph.D., Deputy Director for Scientific Operations, FDA’s Center for Food Safety and Applied Nutrition (CFSAN) and Alexandre da Silva, Ph.D., Lead Parasitologist at CFSAN’s Office of Applied Research and Safety Assessment, write that Cyclospora cayetanensis is so small that it can only be seen with a microscope. However, there is nothing small about the U.S. Food and Drug Administration’s work to help protect consumers from the foodborne illness that this parasite can cause.

Of course it’s small. So are the trillion of microorganisms inside each of us.

Cyclospora has been on the public radar since at least 1996.

Cyclosporiasis is an intestinal illness caused by consumption of foods, mainly fresh produce, that are contaminated with Cyclospora. The FDA has been working to help prevent contaminated product from reaching consumers, gathering the scientific knowledge that will help to better detect the parasite in food and the environment, and gathering data to better understand how food is contaminated by the parasite and help prevent contamination in the future. We’re also sharing what we know with stakeholders in the public and private sectors.

Because several past outbreaks have been associated with fresh herbs, the FDA has been conducting surveillance sampling of fresh cilantro, parsley and basil. A quarterly update on this food surveillance study was released today. As this effort continues, our goal is to collect enough samples to provide a precise estimate of the prevalence of contamination of Cyclospora in our food supply, enabling us to better understand our vulnerability to Cyclospora contamination.     

The FDA is also acting on what we already know about where Cyclospora is found and how contamination can be prevented.   

In 2019, 10% of the Cyclospora infections reported between May and August were linked to a multi-state outbreak associated with fresh imported basil that started in mid-June and was declared over in October. FDA increased its screening at the border of basil exported by the company tied to the outbreak before the company voluntarily recalled its product and ceased shipping while corrective measures were implemented.

The FDA is also tracking contamination in domestically-grown produce. The first confirmed evidence of Cyclospora in domestically grown produce was detected in 2018 in cilantro, a finding not associated with an outbreak of illnesses. As with bacterial pathogens, if the parasite is found on produce, the FDA follows up with inspections and sampling, working with the business to take the actions needed to protect public health.

The FDA has been reaching out to farmers to increase awareness of Cyclospora and actions that can be taken on the farm to reduce the likelihood of contamination. For example, ways to control sources of contamination include proper use, maintenance and cleaning of toilet and handwashing facilities. We created education and outreach materials for farmers, including the Cyclosporiasis and Fresh Produce Fact Sheet

In late 2014, the FDA’s Center for Food Safety and Applied Nutrition established a Foodborne Parasitology Research Program, and in collaboration with the CDC, has been sequencing the genomes of several different strains of C. cayetanensis, enabling the development of genetic typing methods. In 2016, we created a genome database named “CycloTrakr” to be used as a public repository of genomic data at the National Center for Biotechnology Information (NCBI). This is an important first step towards the goal of linking, in real-time, the genetic fingerprints of Cyclospora in contaminated food and sick people to pinpoint the source of the outbreaks.

The agency has also pioneered ways to detect the parasite, developing and validating new methods to test for Cyclospora in produce and water. The first of these new methods was used for the first time in 2018 to confirm the presence of the parasite in a salad mix product tied to an outbreak that sickened hundreds of people. 

In July 2019, the FDA made its second major advance in Cyclospora detection, completing studies that resulted in a novel, validated method to test agricultural water for the presence of the parasite. Water used on farms is a potential source of the contaminants that cause foodborne illnesses. Analysts from FDA laboratories are being trained in the use of this method for regulatory testing. 

Super sanitation cleaning: Caribbean Princess cruise ship turned back to US after more than 300 catch gastro bug

The Princess Cruises’ Caribbean Princess Ship left the U.S. on Feb 2 — and after more than a week at sea, was forced to turn back to the U.S. early when it was denied entry to the Caribbean.

The Caribbean Princess was set to have a 14-day trip around the Caribbean, but was forced to turn back to the U.S.

The cruise’s early return comes after it was denied entry to Trinidad and Tobago by the Government of Barbados due to the outbreak on board, according to a statement from the Ministry of Health.

Princess Cruises said in a statement to The Sun that the ship, which was on a 14-day cruise in the Caribbean, is now on its way back to the Port of Everglades in Fort Lauderdale.

The Caribbean Princess ship is scheduled to dock at 7 a.m. on Thursday, three days ahead of its previous Feb. 16 return.

A total of 299 passengers and 22 crew members of the 4,196 people on board got sick with a gastrointestinal bug, causing vomiting and diarrhea.

Princess Cruises said the cruise has “curtailed its voyage out of an abundance of caution due to guests reporting symptoms due to a mild gastrointestinal illness,” in a statement to The Sun.

The ship will undergo a “super sanitation cleaning” when it reaches the Florida port, according to a statement from the CDC.

Storytelling is vital, so is content: Doctors on TikTok try to go viral

For decades, sex education in the classroom could be pretty cringey. For some adolescents, it meant a pitch for abstinence; others watched their teachers put condoms on bananas and attempt sketches of fallopian tubes that looked more like modern art.

Me and my veterinarian first wife had no qualms about explaining biological reality to our young daughters– no stork, no parthenogenesis, no saviour prince.

Emma Goldberg of New York Times writes that on TikTok – which my children are still trying to explain to me — sex ed is being flipped on its head. Teenagers who load the app might find guidance set to the pulsing beat of “Sex Talk” by Megan Thee Stallion.

A doctor, sporting scrubs and grinning into her camera, instructs them on how to respond if a condom breaks during sex: The pill Plan B can be 95 percent effective, the video explains.

The video is the work of Dr. Danielle Jones, a gynecologist in College Station, Tex., and so far has racked up over 11 million views. Comments range from effusive (“this slaps”) to eye-rolling (“thanks for the advice mom” and “ma’am, I’m 14 years old”).

 “My TikTok presence is like if you had a friend who just happens to be an OB/GYN,” Dr. Jones said. “It’s a good way to give information to people who need it and meet them where they are.”

Dr. Jones is one of many medical professionals working their way through the rapidly expanding territory of TikTok, the Chinese-owned short-form video app, to counter medical misinformation to a surging audience. The app has been downloaded 1.5 billion times as of November, according to SensorTower, with an audience that skews young; 40 percent of its users are ages 16 to 24.

That would be the food service audience. Guess I better get hip.

I’ve learned to text more. Seems like an entire generation missed e-mail.

Although medical professionals have long taken to social media to share healthy messages or promote their work, TikTok poses a new set of challenges, even for the internet adept. Popular posts on the app tend to be short, musical and humorous, complicating the task of physicians hoping to share nuanced lessons on health issues like vapingcoronavirusnutrition and things you shouldn’t dip in soy sauce. And some physicians who are using the platform to spread credible information have found themselves the targets of harassment.

Dr. Rose Marie Leslie, a family medicine resident physician at the University of Minnesota Medical School, said TikTok provided an enormous platform for medical public service announcements.

“It has this incredible viewership potential that goes beyond just your own following,” she said.

Dr. Leslie’s TikToks on vaping-associated lung diseases drew over 3 million views, and posts on the flu and HPV vaccines also reached broad audiences beyond her hospital.

Striking a chord on TikTok, Dr. Leslie said, means tailoring medical messaging to the app’s often goofy form. In one post, she advised viewers to burn calories by practicing a viral TikTok dance. She takes her cues from teen users, who often use the app to offer irreverent, even slapstick commentary on public health conversations. She noted one trend in which young TikTokers brainstormed creative ways to destroy your e-cigarette, like running it over with a car.

TikTok’s executives have welcomed the platform’s uses for medical professionals. “It’s been inspiring to see doctors and nurses take to TikTok in their scrubs to demystify the medical profession,” said Gregory Justice, TikTok’s head of content programming.

Earlier this month, Dr. Nicole Baldwin, a pediatrician in Cincinnati, posted a TikTok listing the diseases that are preventable with vaccines and countering the notion that vaccines cause autism.

Her accounts on TikTok, Twitter, Facebook and Yelp were flooded with threatening comments, including one that labeled her “Public Enemy #1” and another that read, “Dead doctors don’t lie.”

A team of volunteers that is helping Dr. Baldwin monitor her social media has banned more than 5,200 users from her Facebook in recent weeks.

Dr. Baldwin said she started out feeling enthusiastic about the opportunity TikTok provides to educate adolescents, but her experience with harassment gave her some pause.

 “There’s a fine line physicians are walking between trying to get a message out that will appeal to this younger generation without being inappropriate or unprofessional,” Dr. Baldwin said. “Because of the short content and musical aspect of TikTok, what adolescents are latching onto is not the professional persona we typically put out there.”

There is so much beauty in the world: New Zealand edition

Beautiful, Emma (she of long-time carerrer of Sorenne back to Kansas days).

I’m looking forward to the end of Feb. when Canadian daughters 3 and 4 of 4 arrive for an Australian visit.
And Emma, you and partner are always welcome here.
There is so much beauty in the world.
And too many exclamation marks.

Mercier Kiwi Adventures


Samoa with Maria: Day 3

Posted: 08 Feb 2020 04:28 PM PST

On day three, we intended to hop on and off the bus to visit a variety of landmarks around Upolu. We had both done quite a bit of research on the Samoan buses and understood that they make a constant loop around the (basically circular) island, and there is no predicting when they will come, but if you hang out by the main road long enough, you can flag one down. Alright, simple enough. Well, when we told our Matareva hostess of our plans, she was horrified, saying we’d have to take at least three different buses in order to get to just the first of our several stops. Then she explained the we could sign up for their “Adventure Tour” which went everywhere we wanted to go, plus a lava tube. This was the first of many experiences we had in Samoa when someone seemed extremely helpful and knowledgeable about a system that didn’t made sense to us, but also their suggestions benefited them, so we while we wanted to trust them, it was hard to be certain. (The longer we spent in Samoa the more convinced we were that these people were too nice to mislead us, and I continue to believe/hope that that’s true.) In this case, the price for the tour was very reasonable, and fighting with multitudes of unpredictable buses sounded awful, so we decided to do it. And we’re so glad we did, because the tour was definitely a highlight of our trip, in ways that doing those things on our own, even if the bus plan had worked perfectly, would not have been.
We got in the van in the morning with a group of strangers, who by the end of the day felt like friends. We were accompanied by a man and two boys (perhaps 12 and 16) who were members of the family who owned Matareva Beach Fales. We assumed that the man was our tour guide, but soon found out that he didn’t speak English, and the two boys would be showing us around. They were hilarious and enthusiastic tour guides, with unorthodox but very entertaining methods, and I’m so glad we spent the day with them!

 

First we walked through some amazing native bush, with all kinds of incredible flora…
… to arrive at a lava tube. Our tour guides told us that it’s not on any websites or maps, but they’d like to make it more well-known in conjunction with their fales. It was too dark inside for pictures, but it was amazing in there, although extremely hot and humid (so much so that you could see the water in the air in the flashlight beams). There was also condensation on the walls, and when it beaded up on top of some kinds of lichen it glittered like gold. Our tour guides explained that people would shelter in these tubes (which are miles long) if there was a natural disaster, and showed us a grave deep inside it. They didn’t know the story of who the person was, but you can imagine hard times.

 

Next, we headed to Savaia, where there is a Giant Clam Sanctuary.
Having no underwater photo-taking ability, I am reduced to internet photos, but I can assure you that this is exactly what these clams looked like! Unbelievable, right? They are amazing! The ones that colour were mostly about 120cm (47in or almost 4 feet) long. And we learned that if you drop a rock on it, it will shut on it, then jettison it out with a jet of water! Click here for an underwater video around the sanctuary (apologies for the annoying music) and here for more information about endangered Giant Clams.

 

Also, bonus – sea turtles live there too! Unfortunately Maria and I were not together when another tourist pointed one out to me, so she didn’t get to see it, but I swam near it for several minutes, and it was amazing! There are places in Samoa that specifically advertise swimming with sea turtles, but they had mixed reviews on how happy the turtles were about coming into a confined space with people, so we decided not to go. But meeting this one in its natural habitat was so special!

 

Next, we headed to Togitogiga Waterfall.
(A note before I continue: In order for Anglophones to pronounce the Samoan ‘g’, it’s helpful to imagine that it has an ‘n’ in front of it, as it sounds much like the end of ‘ing’. So this waterfall is pronounced as if it was spelled Tongitonginga. I find this very cook, because keeping it in mind as I read Samoan made me much more able to find overlap between it and Māori.)
This beautiful waterfall was not only visually stunning but very adventurous (as promised by the tour name). We spent a little while swimming around the freezing water at the bottom (a welcome change from the heat of the day at first, but really too cold for extended enjoyment) and challenging ourselves to swim against the current to get near the bottom of the falls.
Then Walter, the younger of our tour guides, showed us how to climb up the side of the falls and where to jump into the pool. (This is a stock photo, as we were much too busy adventuring to take any.) On the left, you can see people jumping from one place we jumped from, but above them you can also see a little fence – we also climbed up and jumped from there. It was much more exhilarating, because you had to make sure to jump as far out as possible to make sure you cleared the lower ledge. It was not physically challenging to do so, but added an extra sense of adventure.
Our last stop of the day was to To Sua Giant Swimming Hole. Rather than regurgitating the information from this information panel, I thought I’d just include it – if you click on it, it should get big enough that you can read the words.
The whole area surrounding the swimming holes was very beautiful, although we explored very little. If we read the map right, this is the area where the lava tube connected to the swimming hole joins the ocean. Plus, look at that lovely little pool in the middle of the volcanic rock. Stunning.
This is the picture we took of the more open side of the lava tube. It was a bit overcast when we were there, for which we were very thankful, as it kept the temperature at a manageable 30C (86F), but it did mean that the colours of the water were a bit muted. It might also have kept some tourists away, because we were extremely lucky to find it mostly empty and ready for our exploration, whereas I’ve heard it can be quite busy.
Just for comparison’s sake, however, here is a photo of what it looks like under full sun.
This is looking back from the smaller of the two places where the roof of the lava tube collapsed. It was pretty exciting to swim through the tube part – I have a rather irrational fear of dark water, so I did take a deep breath or two before striking out into the tunnel, but it was worth it, and unsurprisingly, no sea monsters attacked me at all! Plus the view was amazing! So that’s a win for adventure.
This is looking down at that smaller pool from on top. I wish I could find a picture of looking up out of it, because seeing the light filtering down through all that lush greenery (and especially the ferns) was really special.
As I mentioned, the lava tube is connected to the ocean by an underwater section, so as the waves/tides roll in/out an enormously powerful suction is created. This causes an intense current within the swimming hole that changes direction rapidly every minute or so. There are ropes strung across the main section, and then one that you can pull yourself along to go through the tunnel. There is just enough of a threat in the idea of getting sucked into the underwater tube to get your adrenaline pumping, and this combined with the acrobatic potential of an underwater rope and a conveniently placed submerged rock results in some amazing playfulness, even in adults. By this time we had bonded with our fellow tourists and were ready to join together in all kinds of shenanigans and comfortable laughing with/at each other. This last bit was important, as we tested the limits of how far we could stray from the rope, how high we could balance on the rock, or which body parts we could link to the rope before the indomitable water inevitably returned us to our tightfisted grip on the lifeline. I think we all felt that we could do it forever and never get bored, but also realized fairly quickly that it was fatigue, not boredom, that would limit our adventures. What a workout! Walter again led the way in jumping from crazy heights (the exhilarating of the jump replaced immediately by the driving need to find the rope as soon as you hit the water), and then after that, we retreated to the car, exhausted but satisfied. Both of our young tour guides collapsed into the front seat in exhaustion, and were fast asleep by the time we got back to the fales. They’d made us laugh all day and shown us a truly amazing adventurous side to Samoa, and they deserved their rest.
The combination of adorable and entertaining guides, incredible sights, fantastic company, and invigorating adventure made this a day we will never forget!

Chipotle: The food safety gift that keeps on giving

In a previous life I was the scientific advisor for the Canadian Council of Grocery Distributors.

We would meet a couple of times a year, and I would provide my food safety thoughts on what was going on at retail, but what struck me was that the first three hours of every meeting were like a self-help therapy session.

These heads of food safety at major Canadian retailers would bemoan their diminishing status at the corporate level: No one cares about food safety until there’s an outbreak. Twenty years later, the song remains the same.

Alexis Morillo of Delish writes that Chipotle workers claim that food safety practices are at risk at the fast casual restaurant due to managerial procedures that cause workers to “cut corners.”

A total of 47 current and former Chipotle workers from New York City locations came forward about the malpractice in a report to Business Insider. This news follows recent allegations that the company has been violating child labor laws.

In the report obtained by Business Insider, workers outlined concerns about the way things are done behind the scenes at Chipotle. It said that many incentives like pay bonuses let other responsibilities like cleanliness audits and food safety fall to the wayside.

Workers said in the report that working at Chipotle is “highly pressurized environment” with goals that include “minimizing labor costs.”

It was also said that managers are often told in advance when a restaurant will be inspected for cleanliness so they can be prepared. Meanwhile, when an inspection isn’t taking place the cleanliness standard is much more laid back. In the past, people have questioned Chipotle’s safety standards because of the E. Coli outbreak a couple years back. The chain also has an interesting sick day policy, where there are on call nurses for workers to check if they’re actually sick.

Chipotle said in a statement to Delish that the company is committed to safe food and a safe work environment and that the pay bonuses actually incentivize workers to be even more precise when following company policies.

The song remains the same.

Recommend using a thermometer instead of piping hot: FSA food safety culture

Jose Bolanos of the UK Food Standards Agency writes in Organizations, culture and food safety, 2020that FSA has a longstanding interest in organisational culture and its impact on the capability of a food business to provide food that is safe and what it says it is.

However, while there has been some work carried out on assessing organisational culture in some regulatory areas, there has been limited progress in the development of a regulatory approach specifically for food safety culture.

And on it goes in bureau-speak.

Can’t take an agency seriously when they still recommend that meat be cooked until piping hot.