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Nearly half of all American adults have some form of cardiovascular diseasean umbrella term that covers everything from high blood pressure to stroke. If youve been told youre among them, you may be confused or even a little scared. Thats normal, and everyone featured on HealthCentral with a chronic condition felt just like you do now. But weand theyare here for you. On this page alone, youll discover not only the realities and challenges of heart disease, but also the best treatments, helpful lifestyle changes, and critical information you need to help you not just managebut thrive. Were sure youve got a lot of questions. Were here to answer them.

The term heart disease encompasses a huge amount of cardiovascular territory. Thats because its not a single disease but one that refers to all sorts of heart-related health conditions, many of them chronic, that impact how well your heart functions.

Some of the more common forms of heart disease include:

Heart disease accounts for more deaths each year than any other health concern. According to the Centers for Disease Control and Prevention (CDC), nearly 650,000 people die of heart disease annually. Thats about one death every 37 secondsa shocking number, to be sure. And heart disease does not discriminate: Whether you are a man or a woman of any race or ethnicity, cardiovascular disease is your number-one health threat.

The good news? You can do a lot to prevent heart disease. And, if you already have some form of this condition, there are medications, lifestyle-management tips, and other strategies to help protect you and your ticker.

Before diving into what can go wrong, lets take a step-by-step look at the heart, what it does, and how it works:

How does your ticker make all this happen? For starters, the heart is made up of four chambers:

Those chambers work in tandem, employing a system of valves that open and close as your heart beats in order to bring blood in and pump blood out. Remember, the heart is a muscle, and when its healthy, its quite strong. As a pump, it provides sufficient pressure so that your entire blood supply cycles through your body every 60 seconds.

More heart smarts:

A healthy adults heart will beat anywhere from 60 to 100 times per minute while lounging around. If youre quite fitan athlete, for exampleyour heart works more efficiently, and your resting heart rate may be closer to 40 beats per minute.

Like the rest of the body, the heart requires blood in order to thrive. In fact, it needs a bigger supply of blood than any other muscle in the body, so it relies on its own network of coronary arteries to provide that blood.

Electricity powers the beating of your heart and sets its pace. Thats a critical function. You need your heart to beat properly in order to supply your body with sufficient blood and oxygen. Your heart contracts with each beat, and the timing of those beats must remain precise so that those contractions stay in sync.

These electrical signals originate in your hearts right atrium and are controlled by your central autonomic nervous system, telling your heart how fast or slow it should beat. When you exercise, your nervous system signals your heart to speed up in order to pump more blood. Other factorsnot all of them healthy, like smoking and over-indulging in alcoholcan also affect your heart rate.

Your heart functions in incredibly complex waysthis is just a thumbnail sketch. Needless to say, there are also a great number of ways in which things can go wrong that can lead to heart disease.

How does your body tell you that somethings troubling your heart? It depends on the type of trouble. While some diseases that affect the heart share similar symptoms, others vary greatly. And some types of heart disease have no symptoms at all.

Lets review some of the major types of heart disease and how to recognize them:

Having high blood pressure (HBD), aka hypertensionwhich has no symptomsups your odds of developing numerous other types of heart disease, including CAD. It is the result of plaque buildups in your arteries that reduce the amount of blood that reaches your heart, leaving you at higher risk for heart attack, heart failure, and stroke. HBP hardens and thickens your arteries, reducing blood flow. If you have a systolic pressure of 130 or higher, or a diastolic pressure of 80 or higher, its critical to reduce it.

The hearts two major arteries branch off from the aorta, the artery that sends blood to the rest of the body. These two arteries, in turn, branch off into smaller and smaller arteries that supply the heart with blood. CAD, the most common type of heart disease, develops when your arteries cant provide enough oxygen-rich blood to your heart. The heart receives its own supply of blood from the coronary arteries.

Often, CAD is caused by plaque buildups that restrict or block the flow of blood through your blood vessels. CAD often develops over many years, even decades, and it does not always make itself known until it has progressed significantly and youre closing in on a heart attack. At that stage, the affected blood vessel is about 70% blocked. Even people who have plaque blockages in the 40% to 50% range may have no symptoms. But when they do occur, they're typically:

A less common, but related, condition called coronary microvascular disease (MVD) or small vessel disease occurs when the walls of the small arteries in the heart are damaged. It is often diagnosed after a doctor finds little or no narrowing in the main arteries of your heart, despite your having symptoms that suggest heart disease, such as angina. MVD is more common in women and in people who have diabetes or HBP. The condition can be difficult to detect. Other symptoms of MVD include pain in your left arm, neck, jaw, abdomen, or back; pronounced fatigue; and shortness of breath.

A heart attack occurs when the plaque in your blood vessel ruptures, causing a clot to form as the body attempts to repair the damage. This blockage cuts off blood flow to the heart, starving the muscle of needed oxygen and other nutrients.

For men, this often happens suddenly; womens symptoms tend to be more gradual. While chest pain is the most common symptom of heart attack for both men and women, their symptoms can be different. For example, women are more likely to have shortness of breath, fatigue, and nausea. Men normally experience the classic symptom of crushing chest pain. Men are also more likely than women to have sudden heart attacks; women, on the other hand, have higher odds of developing symptoms over a period of hours, days, or even weeks.

Either way, common symptoms of heart attack include:

Angina, a radiating chest pain and pressure that can feel as if an elephant is sitting on your chest

Shortness of breath

Nausea

Indigestion

Heartburn

Abdominal pain

Fatigue

Lightheadedness and dizziness

Cold sweats

This progressive disease occurs when your tickers ability to pump blood starts to decline. CAD, heart attack, diabetes, obesity, and high blood pressure are among the common causes of heart failureso it doesnt happen overnight. As your heart can no longer pump as well as it used to, the blood that would normally cycle through it can get backed up. Your kidneys also filter less blood, leading to fluid retention and swelling in your extremities.

Several different symptoms can get worse as heart failure progresses. Some of the most common:

As its name implies, heart valve disease involves the system of four valves that helps regulate the flow of blood through the heart. For example, one of your valves might narrow to the point that a reduced amount of blood can pass through it. This is called valvular stenosis.

When one of your hearts valves stop working properly, a variety of symptoms, many of them similar to those of heart failure, can occur, including:

An abnormal heartbeat, called an arrhythmia, can trigger a variety of symptoms, some benign, some dangerous, depending on which kind of arrhythmia you have. Tachycardia, for example, accelerates your heartbeat to a too-fast rhythm, while bradycardia slows it down. Both can sometimes be dangerous and lead to higher risk of stroke and other complications, but not always. If you experience either type of arrhythmia, be sure to consult with your doctor.

Atrial fibrillation is the most common type of sustained arrhythmia, with anywhere between 2.7 and 6.1 million Americans currently sharing a diagnosis of it. (As the U.S. population ages, that number is expected to increase, reports the CDC.) A-fib, as its often called, causes your heart to beat erraticallyit can feel like it is skipping beatsrather than rhythmically. In some cases, abnormal heartbeats are not a cause of concern, but other times they can lead to stroke, heart failure, or even cardiac arrest, a quickly fatal event in which the heart stops beating. Its important to get to the root of A-fib, so you know whether or not your symptoms require treatment.

In general, abnormal heartbeats also lead to many symptoms shared by other forms of heart disease, including:

A stroke occurs when your hearts blood supply gets cut off, denying it the oxygen it needs to keep working. This can cause brain tissue to begin to die within a few minutes. Stroke is the fifth-leading cause of death in the U.S., accounting for one out of every 20 deaths that occur in this country annually, and its the leading cause of serious long-term disability, according to the CDC.

A stroke can greatly affect the brain. You may have trouble understanding what others are saying, you may slur your speech, and you may experience confusion.

Other symptoms include:

There are two major types of stroke plus a third, less-severe kind:

Lets go back to the good news: About four out of five cases of heart disease can be prevented. Thats because its most often caused by lifestyle factors, such as smoking, poor diet, lack of exercise, and by other health conditions that can arise, including diabetes and high blood pressure (HBP), that can arise from these choices. While its never too late to make positive, healthy changes, the sooner you begin, the better.

Before getting into the risk factors that you can work to reduce, lets cover the few that you cant do anything about.

Age

This ones pretty simple. The older you get, the likelier you are to develop heart disease. In fact, more than 80% people who die from heart disease are older than 65, because the heart tends to grow weaker as you move into your golden years.

Gender

While heart disease may be the number cause of death for both men and women, it tends to develop later in women. Why? Experts believe that hormones such as estrogen, which women have in much greater abundance than men, may provide some protection against heart disease. However, those hormones decline during menopause. By age 65, a womans odds of heart disease match those of a man of similar age.

Genetics and Family History

Its true: Heart disease tends to run in the family. Did your dad develop heart disease before the age of 55 or your mom before she turned 65? If so, your own risk is higher than normal because one or both of your parents may have passed along a genetic ingredient in the recipe for heart disease.

Early Menopause

According to a 2019 study in The Lancet Public Health, going through The Change before age 40 increases risk of heart diseases like CAD, heart failure, arrhythmia, and heart valve disease among the approximately 10% of women who experience early menopause. It remains unclear why, though a decline in estrogen may be a factor.

These four factors make up only part of the complex swirl of possible causes of heart disease. You cant change your genes or age, but dont despair. Instead, use that knowledge as motivation to address the risks you can change. These include:

High Blood Pressure (HBP)

Having hypertension, a.k.a. high blood pressure, is a red flag for other forms of heart disease, increasing your risk for CAD, heart attack, heart failure, and stroke. HBP results from plaque buildups in your arteries, thickening them and reducing blood flow.

High Cholesterol

Unhealthy cholesterol levels contribute to blockages in your blood vessels that can eventually lead to heart attack. Your body produces cholesterol naturallywe all need it to make important hormones and absorb Vitamin Dbut its easy to get more than you need by eating foods that are high in saturated and trans fats (like red meat, eggs, and dairy). There are two types of cholesterol: low-density lipoprotein (LDL, or bad cholesterol) and high-density lipoprotein (HDL, or good cholesterol). LDL contributes to plaque buildups in your arteries. HDL protects against heart disease by transporting excess LDL to the liver to be processed as waste.

Obesity

Being obese forces your heart to work harder because your body requires more of the oxygen and nutrients that your blood supplies. This leads to high blood pressure. Excess weight also increases risk for heart disease, or makes them worse if you already have them, including high cholesterol and type 2 diabetes. Obesity has been linked to heart failure and CAD.

Diabetes

Type 1 and type 2 diabetes both limit your bodys ability to maintain a healthy level of glucose, a form of sugar that your body produces and uses for energy. Uncontrolled blood glucose damages your blood vessels and the nerves that control your heart, eventually leading to heart disease. In fact, as many as three out of four people with diabetes die from some form of heart disease.

Physical Inactivity

The couch potato life not only directly puts you at higher risk of heart disease, it opens the door to other risk factors like HBP, high cholesterol, and type 2 diabetes.

Smoking or Vaping

Lighting up does more than damage your lungs. It accelerates your heartbeat while narrowing your blood vessels and contributes to the formation of blood clots that can lead to heart attack or stroke. Less is known about the risks of vaping, but many of the chemicals involved have been linked to heart disease.

Stress

Pressure and tension can elevate your heart rate and blood pressureand too much eventually damages your blood vessels. Stress also can lead some people to abuse alcohol and eat too much, as well as smoke. (And, remember, any amount of smoking or vaping is too much.)

Drinking Alcohol

Too much alcohol also can harm your heart. Excessive drinking ups your blood pressure and heart rate as well as your triglycerides, a type of fat linked to heart disease, because they may contribute to hardening and thickening of your arteries.

Sleep Apnea

This sleep disorder causes breathing trouble as you sleep, reducing the amount of oxygen to your blood and raising your blood pressure. Together, these can weaken your heart and put you at heightened risk chronic HBP, atherosclerosis, arrhythmia, and heart failure.

Before we get into how your doctor will determine whether you have heart disease, lets make one thing very clear: Diagnosis is your doctors job. If you have heart attack symptoms, such as shortness of breath or chest pain, dont waste time searching the internet to figure out the problem. Call 911 immediately. How fast you act just might save your life.

However, cardiac arrest is just one of many potentially serious heart concerns. Diagnosing heart disease involves a range of screening tests and, sometimes, tracking devices, too. Your doctor will ask you about your symptoms, your health history, and any risk factors you may have. He or she will also give you a physical exam in order to listen to your heart, check its rhythm and the timing of your pulse, and look for signs of swelling and accompanying weight gain due to fluid buildup in the hands, feet, legs, or abdomena possible indication of heart failure or heart valve disease.

You may undergo a variety of blood tests to measure your:

In addition to the above measurements, you could be given non-invasive diagnostic tests or tools to montior your heart rhythms. They include:

You may be given more invasive diagnostic tests, too, to screen for heart disease. They include:

There is no cure for heart disease. That said, theres a lot you can do to live well despite having it. Treating heart disease can include lifestyle changes, medication, and sometimes surgery, but this conditionor conditions, ratheris never one size fits all. Your individual plan will be based on numerous factors, such as your age, overall health, and other chronic conditions (such as diabetes or kidney disease) you might have.

You know the drill: Eat better, exercise, lose weight, and quit smoking. We knoweasier said than done, but so worth it. Thats because the everyday choices you make today can halt the progression of heart disease tomorrowleading to a healthier and likely longer life.

Lets walk through the basic lifestyle choices you can implement to help make happen:

Lower your cholesterol. Cut back and avoid plaque buildup by swapping red meats for lean poultry and fish, consuming fibrous veggies and whole grains, and limiting (or even avoiding altogether) the saturated and trans fats found in fried and processed foods. Additional ways to get your cholesterol in check? Lose a few pounds, exercise more, and if that still isnt enough, talk to your doctor about medication.

Lower your blood pressure. The same lifestyle changes that help bring down unhealthy cholesterol levels can also help manage your blood pressure, often in tandem with one of the various blood-pressure lowering medications available.

Do everything you can do to quit smoking. We knowits really hard. But we also know that smoking causes lung cancer and seriously hurts your heart. Plus, a nicotine or vaping habit damages your arteries, ups your risk of dangerous blood clots, raises your heart rate, and contributes to HBP and high cholesterol. So make quitting smoking your top priority. Going cold turkey works for some, while others have to slowly wean themselves from lighting up with the help of nicotine patches and other aids, including medications and support groups. Your doctor can walk you through your options, so have that conversation as soon as possible. Visit the American Heart Association to learn more about how to quit.

Get moving. Physical activity of just about any kind beats the couch potato life. Thats because exercise strengthens your heart muscle so that it can do its job more efficiently. It helps lower your cholesterol, blood pressure, and, if you have diabetes, blood sugar levels, too. An added benefit? Breaking a sweat leads to a slimmer, fitter you. Exactly how much exercise you can do depends on your current state of health. Talk to your doctor, who might advise you to start slow and gradually build up endurance. If a walk around the block is your limit, thats OKlace up your shoes and get going. Tomorrow, youll likely go even further. If youre recovering from a serious heart issue, cardiac rehabilitation programs can get you started safely.

Eat less, and eat better. Changing how you stock your fridge and pantry is often connected to lowering your cholesterol levelsso follow the same advice: Try lean proteins, vegetables, and whole grains, and skip overly processed junk food and fried fare. If you need guidance, consider enlisting a registered dietitian/nutritionist to outline a healthy eating plan for youand provide strategies to stick with your plan to reach your goals.

Lose weight. It cant be overstated: Being overweight or obese is hard on your heart. Your body mass index (BMI) measures body fat based on your weight in relation to your height. A BMI of 25 to 29 is considered overweight. You are considered obese if your BMI is 30 or higher. While use of BMI has been questioned by researchers as of late, partly because even the super-fit and muscle-bound may technically have unhealthy BMI numbers, some doctors still use it as a guide. More and more, however, physicians are concerned when excess body fat is concentrated around your waist, likely because a lot of belly fat can cause chronic inflammation, a risk factor for heart disease. The result? Your blood pressure and cholesterol go up and stay upand you want neither to happen.

If your heart health is at risk, and you find losing weight slowly and safely to be an impossible task, consider securing the services of a registered dietician, or ask your doctor if gastric bypass surgery is right for you.

Manage your diabetes. Diabetes and heart disease are a deadly combination. People with diabetes have as much as four times the risk of dying from heart disease than someone without this condition. This is in part due to the effect diabetes has on your blood vessels, and also because many other health conditions often accompany diabetes, including HBP, high cholesterol levels, and obesity. Controlling your diabetes through medication and lifestyle changes benefits your heart.

Consider medications for heart disease, if you need them. Many drugs treat coronary artery disease, or CAD. (Remember, CAD occurs when your arteries become clogged with plaque, restricting the flow of blood.) Here are the more commonly prescribed types of medication for CAD and other heart ailments:

Heart failure as well as heart valve disease are both treated with some of the same medications, such as diuretics, which help rid your body of excess fluids. In heart failure, for example, fluid can build up in your lungs and make it difficult to breathe. You may also be prescribed digitalis, a type of drug that strengthens the contractions of your heart and lowers your heart rate. Beta blockers and anti-clotting medications are also among the drugs that may be used to treat both conditions.

A wide range of surgical options also exists when heart disease requires more aggressive treatment, including:

Youve received your diagnosis of heart disease, and your doctor has presented you with a treatment plan. Whats next? How much of your old life will you be able to get back? Living with heart disease has challengessome physical, some emotional, some big, some small. Your goal: to take care of all of you and live your best life.

If youre not doing well emotionally, you might struggle with all of the other aspects of your treatment, from eating right and exercising to taking your medications. Often, depression is to blame. In fact, about one in five heart disease patients develops serious depression, while many others have milder cases. Research is mixed on why this is, although some scientists believe inflammation is involved. Fortunately, counseling and medication can help. Talk to your doctor if you feel down, unmotivated, or discouraged for more than a week.

Heart disease can feel scary. But those worries can overwhelm you and interfere with enjoying your life. If you struggle with anxiety, try to shift your focus to whats happening today rather than looking with worry at the future. Talk about your concerns with friends and family and ask them for support. And consider joining a support group to connect with others who face the same struggles that you do. Join the American Heart Association's Support Network.

Regular exercise and other physical activity help your heart. A minimum of 150 minutes of exercise will not only improve your heart function. It also may enable you stop taking some of your heart medications. But first, ask your doctor what exercises are right for you.

If youre recovering from a heart attack or surgery, it may be a few weeks before you can return to your job, but youll likely be able to pick up right where you left off. Of course, it depends on the jobif your current one puts too much strain on your heartphysical and, perhaps mental, in the form of stress--you may have to dial back your workload. The Americans with Disabilities Act, a federal law, offers workplace protections for people with heart disease.

You may have to wait up to six weeks before you resume your sex lifeand only your doctor can tell you when you can safely return to romance. How long abstinence lasts will depend on your symptoms, like lingering chest pain or other complications. To get the all-clear, you may have to undergo an exercise stress test to measure your hearts capacity to handle any under-the-sheets action.

Before you climb behind the steering wheel, check your states regulations for driving after a serious illness. Also, if you have symptoms like chest pain, dont drive until they clear up.

You can kickstart your new life with cardiac rehabilitation. This is a medically supervised program that typically lasts for three months. Working with doctors, nurses, exercise specialists, dietitians and mental health counselors, you will receive exercise training, lessons in healthy eating, methods to reduce stress, and other education designed to help you reduce your risk of worsening heart health.

See the rest here:
What is Heart Disease? And Other Heart Disease Questions - HealthCentral.com

In the midst of all the worry and chaos associated with the COVID-19 pandemic we all are restricted as to daily activities and social interaction and contacts. I would suggest this might be a good time to try and improve our personal health. We definitely have time to consider this and contemplate on ourselves and our families, and it may help in so many ways no matter what challenges we have in the future.

I would start by remembering the 10 steps I mentioned in my last article headlined A 10-step approach to better health.

1. Eat Right Choose more vegetables, fruits and whole grain

2. Be Physically Active Exercise daily for 30 minutes, like

3. Control Your Weight Work toward normal waist size and

4. Rest for your Health seven to eight hours of sleep daily for your

5. Exam by your Doctor Yearly physical exam by your doctor:

6. Reject the Big Killer Smoking is the leading preventable

cause of death in the United States.

7. Practice Safety Wear seat belts and drive safely, and dont

8. Enjoy Relationships Relationships and Love is a key to

9. Improve your Mental and Spiritual Health Take time to pray, meditate, slow down, attend church of your choice.

1.0 Promote Peace in your Life Express gratitude, laughing and serving others.

Let us all consider these steps and decide to make this part of our daily routine.

In America today, 70% of people are overweight and 40% of people are obese. Healthy weight is a BMI between 18.5 and 24.9, overweight is a BMI between 25 and 29.9 and obese is between 30 and 39.9. A BMI over 40 is classified as morbidly obese. Being overweight can contribute to so many health problems such as sleep apnea, hypertension, heart disease, diabetes, osteoarthritis, allergies, and cancer. The medical costs of obesity in the United States per year are $147 billon and average medical costs for a person who is obese is $1,429 dollars higher than for those of normal weight.

Lets consider losing weight if we are overweight and maintaining a normal weight to improve our health. Dr. Ann Kulze, who puts out a weekly message on the internet on improving health, mentioned a new innovative painless way to lose weight. This new method is called Time Restricted Eating and the scientific data behind this is very strong. A recent study has shown that simply restricting daily eating times to an eight- to 10-hour window, regardless of the amount and no requirement for dieting or exercise caused significant weight loss. This can simply be done by restricting your eating to a 10-hour window each day. For most people this would be eating daily meals and food as they normally would, but eating breakfast later and dinner earlier: so you only eat during a 10-hour period daily. The study showed during a three-month period of time those who stuck to this would lose 3-4% body weight. For instance, if you weighed 250 pounds, your weight loss would be up to 10 pounds in three months and possibly 40 pounds in a year.

The other good news was that those in this study that stuck with the time-restricted eating had not only a decrease in body weight, but also a decrease in belly fat, waist size, blood pressure, cholesterol levels and improvement in sleep, insulin and blood sugar levels. Scientists say the reason it works is because it leverages and optimizes our bodies natural 24-hour circadian rhythms, which are foundations for health. Restricting our eating gives our bodies a predictable 14 hours to rest and restore each night.

Dr. Ann, even though she has normal weight, has done this herself and believes it significantly improves overall health and longevity, plus helps weight control.

A wise man should consider that health is the greatest of human blessings! Hippocrates.

Eichelberger practices part-time office gynecology at Greenwood Obstetrics and Gynecology and teaches on the Montgomery Family Practice Residency Program. He is also co-chairman of the Ethics Committee at Self Regional Healthcare and serves as the Associate Medical Director of HospiceCare of the Piedmont. Send comments to: The Doctors Prescription, PO Box 36, Ninety Six, SC 29666.

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Guest column: Now's a good time to focus on health - Index-Journal

The SlowBurn Shelter-in Special!

Covid 19 has put a damper on many of our fitness routines. But no worries! The SlowBurn method is a powerful way to stay tight, toned and tough in just 30 minutes a week all in the privacy of your own home!

The method was created by ACE certified instructor Fredrick Hahn, an Upper West Sider for over 30 years who founded and established his private one-to-one studio on 78th and Amsterdam in 1998.

His best-selling fitness book, The SlowBurn Fitness Revolution, has both a gym and a home workout program that will strengthen, tighten and tone in a SAFE and time-efficient manner.

So, what is the SlowBurn method? It is a method of strength training using very slow, smooth and controlled lifting and lowering movements that build strength, tone, muscle, bone, cardio fitness and flexibility safely and efficiently.

Heres Fred demonstrating a couple of his workouts on NBCs Today!

SlowBurn is similar in essence to the gentle yet powerful martial art Tai Chi. By eliminating any sudden and abrupt movements (which produce excessive force and lead to many injuries similar to Crossfit), you will never be injured. All SlowBurn instructors utilize the SlowBurn method.

Along with being extremely safe, research indicates that the SlowBurn technique produces superior overall physical benefits than traditional methods of weight training. And this translates into greater self-esteem and contributes to stress relief.

Picture this: In just 30 minutes a week of SlowBurn exercise, your investment in yourself will:

Hard to believe, I know. But they fully guarantee it.

Though Fred Hahn charges for these home workout exercises, he is offering them to you free of charge during this pandemic. They were created several years ago but are still used today in the exact same way. When something works, it works!

Here are some home workout videos that you can start doing right away. (NOTE: These are not listed on his business YouTube page. They were downloaded by a client to their page.)

Important tips:

To time yourself, you can use a stopwatch and use anonline metronome set at 60bpmto keep your pace and tempo correct. This is all explained in the first two videos below.

Fredrick Hahns Introduction to SlowBurn:

Getting started The tools youll need:

Pushups

Side shoulder raises:

Pull-ups (Tommy Day instructing)

Biceps curls:

Hamstrings curls:

Side glutes:

Doorknob squats:

Abdominal crunches (Tommy Day instructing)

This is full body routine that will improve every aspect of your health!

Once this pandemic is over, if youre interested in becoming a client, here is their information:

SlowBurn Personal Training Studios:169 West 78th Street, between Amsterdam and Columbus, NYC (212) 579-932025 Watchung Plaza in Montclair New Jersey (973) 233-1013

Says owner Fredrick Hahn:

In 1993, I developed the SlowBurn method at the Hospital for Joint Diseases Sports Medicine Centerin order to make patients as strong as possible in a safe and time-efficient manner. It is suitable for all ages from kids to baby boomers to folks from the great generation. The method improves strength, endurance, cardio, flexibility and bone density and even makes you younger at the genetic level in just 30 minutes a week.

For the past two decades, SlowBurns method has transformed thousands of people.

SlowBurn instructors also educate the client using science-based nutritional guidance and work with clients to develop an eating plan to maximize lose fat and gain musclesimultaneously. Few if any fitness studios can prove this using InBody 570 body testing technology.

Each SlowBurn instructor will teach you everything you need to know about eating the correct foods (without counting calories) in order to maximize improvements in your health. This will result in steady and permanent fat loss, improved mood, sleep, concentration and an overall sense of well being.

They emphasize eating real foods low in sugars and adequate in healthful amounts of fat and protein. Intermittent fasting is also suggested as a method to help cut fat and build lean tissue. While strength training contributes to fat loss, the specific types of foods you eat are the number one factor in losing (or gaining) fat. By combining diet and exercise, most people can be their absolute best in a very short period of time.

Among Frederick Hahns impressive roster of clients are manybusy CEOs, popular celebrities, and even lifestyle coaches including Tony Robbins.

When asked about her experience with SlowBurn, Kathleen Hays, Business/News Anchor for Bloomberg Television, said:

When this pandemic ends, try your firstcomplimentarySlowBurn workout.

Follow SlowBurn on social for updates:

instagram.com/slowburnpersonaltraining

facebook.com/SlowBurnPersonalTraining

twitter.com/SeriousStrength

Sharing is caring!

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Staying Strong and Fit at Home - Courtesy of SlowBurn Personal Training Studios - I Love the Upper West Side

Quick pitch: The Good Care Group partners with online fitness and wellbeing provider Rosemary Online to offer wellness support to live-in carers during these challenging times.

10th April, 2020 - The Good Care Group, the UKs most awarded care company offering exceptional live-in-home care, announces a unique initiative; partnering with Rosemary Online to boost the physical and mental wellbeing of its carers who are working tirelessly through COVID-19 lockdown stipulations.

From today, and for the duration of twelve weeks, Rosemary Online will be offering The Good Care Groups carers free access to the highly successful exercise videos and healthy eating recipes, as well as chat forums, coaching support and blogs. This will be hugely beneficial to both the professional live-in carers, and also to their clients whilst in isolation.

Live-in carers currently offer vital support to the overstretched NHS by helping the extremely vulnerable - often with complicated medical or anxiety-based needs - to stay at home during the pandemic.

Dominique Kent, MD of The Good Care Group explains: The partnership with Rosemary Online came about because we wanted to do something to celebrate the amazing dedication of our wonderful carers, so many of whom are working for longer than usual at the sacrifice of seeing their own loved ones to ensure that our clients are safe. In addition, they are remaining inside in isolation with their clients to ensure they are not exposed to COVID-19.

"We recruit carers from overseas also, and with the travel restrictions currently in place many are not able to return home, so are instead choosing to isolate themselves in local hotels to minimise the risk to the clients. Our ethos at The Good Care Group is very much person-centred. It is not just about delivering high quality care, but also companionship whilst delivering the very best healthcare outcomes.

"Through maintaining the wellbeing of our staff, were helping them to be their best selves to support their clients through this intense and challenging time. As Rosemary Online has been helping people to feel good about themselves for many years, we feel that this is a really positive partnership.

Sarah Skelton CEO of Rosemary Online, adds: The Good Care Groups live-in carers do a wonderful job, but right now they will be experiencing high levels of loneliness in isolation, as they put the needs of their clients before their own. I hope that with free access to the full range of Rosemary Online resources carers will be able to maintain good health and nutrition as well as reach out for a friendly online chat. The Good Care Group is committed to excellence in their field, and recognising the need for staff and client wellness is a brilliant example of this.

This initiative is the first time that Rosemary Online (owned by Digital Wellbeing Limited) has worked with a care provider in this way.

Dominique Kent and Sarah Skelton are available for comment or interviews to discuss this initiative. The Good Care Group can also offer insights and thought leadership on broader challenges facing live-in carers and the profession.

For more information or to arrange an interview please contact Firgas Esack on 07540688506, firgasesack@publicist.com

Media assets available include: testimonials from The Good Care Groups carers, images including headshots

Notes to Editors:

The initiative will launch on 3rd April and run until 23nd June 2020

Rosemary Online has allocated 1000 places to carers, to access resources from the platform https://www.rosemaryconley.com/

About Rosemary Online:

Rosemary Online is one of the UK's leading online weight loss clubs.

Providing support and advice on fitness, wellbeing and weight-loss with real life qualified coaches, fitness videos, health and wellbeing articles healthy eating plans and over 2800 healthy recipes suitable for ages 18+.

About The Good Care Group:

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Caring is Sharing: Rosemary Online brings good news to live-in carers - Press Release - Digital Journal

On April 11, 1970, at 19:13 GMT, Apollo 13 lifted off from Launch Complex 39A at the Kennedy Space Center in Florida. Atop the giant Saturn V booster sat Command Module 109 and Service Module 109, which together formed CSM-109 (otherwise known as Odyssey), and the lunar module (LM) Aquarius.

In the couches of the command module were mission commander James A. Lovell, Jr., age 42, a US Navy captain on his third space mission and his second visit to the Moon. Next to him was command module pilot John L. "Jack" Swigert, Jr., 38, a space rookie who was a last-minute replacement for astronaut Ken Mattingly, who was scrubbed after being exposed to the measles. On the other side of Lovell was lunar module pilot Fred W. Haise, Jr., 35, on his first and only spaceflight.

This was to be the most ambitious Apollo mission to date. Building on the lessons learned from Apollo 12, it was to make a precise landing on the Moon in the highlands of the Fra Mauro region, farther north from the equator than Apollo 11 or 12, meaning that both the Saturn V booster and the lunar module carried more fuel than any other mission.

But another thing that marked the mission was a sense of complacency, even apathy. If the Apollo missions now seemed routine to the men and women of NASA, the public was downright indifferent. They'd been sold Apollo as a great adventure and they were getting bored with the repeats of the same plot. It was a sentiment shared by the US Congress. NASA's budget had been going down ever since the main work on Apollo was completed in 1964, but now Apollo 20 was canceled and the trimming looked set to go much deeper.A bomb aboardThis complacency wouldn't have lasted long if NASA knew Apollo 13 had a bomb on board. It wasn't the work of terrorists or enemy saboteurs but the result of the kind of oversight that can occur in any super-complex endeavor. In fact, it was a credit to NASA that such errors didn't happen more often. However, this time, the oversight was nearly fatal.

NASA

Behind the conical command module that acted as a home for the Apollo astronauts is the service module. This cylindrical assembly with a bell-like cone at one end contained the main engine and supplied Odyssey with oxygen, water, electricity, and long-range communications with Earth.

Inside the service module was a bay holding a number of systems, including two liquid oxygen tanks that were the primary source of oxygen for the command module. Also in the bay were a tank of liquid hydrogen and three fuel cells. The hydrogen and oxygen feeding into the fuel cells provided Odyssey with power and water.

There was a history to one of these units. The No. 2 oxygen tank had been previously installed in the service module of Apollo 10 but was then taken out for modification, during which it was damaged and then sent back to the factory for repairs. It was then installed in the Apollo 13 service module.

Like all NASA flight gear, the No. 2 tank was tested and retested even after installation. On March 16, 1970, the tank suddenly developed a fault. It wouldn't drain properly. It was finally decided to run the tank's electrical heater to boil the oxygen. This didn't resolve the problem entirely, but because the oxygen tanks didn't need to drain in space and due to time constraints, No. 2 was cleared for flight.

NASA

However, the heaters had been upgraded so that they could operate at 68 volts instead of the previous 28 volts, but the thermostatic switches that controlled the heaters weren't changed. As a result, during the final test, the switches welded shut and the wiring was frayed. Another problem was the use of aluminum components and Teflon insulation both of which burn in pure oxygen.

To put it more simply, No. 2 tank was now a bomb waiting to detonate.

There was no sign of any trouble as Apollo 13 lifted off from the pad. The weather was good and the only difference from previous Saturn V launches was that it cleared the tower a bit slower because of the extra fuel it carried. When the second stage fired, the center of the five engines started to go into severe pogo operations and shut down. The other four engines throttled up to compensate and Mission Control and the crew thought that the mission had passed its one major glitch.

NASA

Once the S-IVB third stage separated and fired for the first time, Apollo 13 settled into an orbit 120 mi (193 km) above the Earth. Two hours later, the rocket fired its engine again and the astronauts were on their way to the Moon. The CSM Odyssey then separated from the S-IVB, Swigert turned the craft around, docked with the lunar module Aquarius and eased it out. With a slight course correction, Apollo 13 was on a trajectory to circle the Moon, while the S-IVB went on a collision course with the lunar surface where it would impact three days later an event that would be recorded by the seismograph left behind by Apollo 12.

It was all like a Space Age milk run.

Everything was relaxed for the first two days of the mission. At 55 hours into the flight, Lovell used the command module's television camera to provide the audience back on Earth with a tour of Odyssey and Aquarius. Unfortunately, since none of the US networks carried the broadcast, the audience was reduced to Mission Control and a few of the astronauts' relatives.

At hour 56, 210,000 mi (330,000 km) from Earth, after completing the broadcast, NASA gave the men a few minutes to recover before they went back to work, with Lovell stowing the camera and Haise testing and shutting down the lunar module's systems. Meanwhile, Swigert was carrying out routine maintenance tests on the service module's oxygen tanks to track down a sensor malfunction.

NASA

Back at Mission Control in Houston, the Electrical, Environmental, and Communication officer (EECOM) Sy Liebergot asked Swigert to activate the fans to stir the liquid oxygen in No.2 tank, so it wouldn't settle into layers.

Then, 95 seconds later, things went wrong. There was a short circuit in the heater in tank No. 2, which started a fire. Pressure increased suddenly as the oxygen flashed into a gas, and the tank's structure gave way with explosive force.

Though an entire panel fore and aft on the service module was blasted away and there was extensive damage, the first clue the astronauts had that something was wrong was a loud bang. At the same time, telemetry with Earth went out for 1.8 seconds, the power readings on the instrument panel started fluctuating, and the spacecraft was jolting as the automatic pilot kept firing the attitude control thrusters to compensate against some unknown force.

NASA

Twenty-six seconds after the bang, Swigert called back to mission control, "Okay, Houston, we've had a problem here."

Lovell then repeated and elaborated. "Houston, we've had a problem. We've had a Main B Bus undervolt."

The initial fear was that Odyssey or Aquarius had been hit by a meteorite and that one or both of the crew modules had been holed, but there was no evidence of a serious loss of pressure. The Main Bus B undervolt fault indicated that the service module's three fuel cells were malfunctioning. Then Bus A started losing power and two of the fuel cells were fading, with both dead in under half an hour.

The more Mission Control and the astronauts checked, the worse things looked. Oxygen tank No. 2 had zero pressure and No. 1 was leaking fast. Also, the computer had reset and was running a fault check, while the high gain antenna had switched to a secondary mode.

NASA

Back on Earth, Liebergot couldn't believe what he was seeing on his panel. The service module was designed with multiple redundancies and constructed out of components that didn't need maintenance in flight, but he saw numerous systems failures of the sort that one only saw in simulators when the operator wanted to make sure the astronauts were paying attention.

At first, Liebergot thought that it had to be an instrument failure, but Lovell reported that he could see debris outside the ship and an expanding cloud of gas. It was this that was pushing on Odyssey and against which the autopilot was fighting. Worse, No. 1 tank was leaking fast and when it went, the service module would start sucking oxygen from the command module's tiny reserve surge tank.

Lead Flight Director Gene Kranz, who had such high authority at Mission Control that the only way to veto his decisions was to fire him, ordered the command module surge tank sealed off, but the rapidly depleted tank No. 1 would only keep the remaining fuel cell going for about two hours. After that, the only power would be from the command module batteries, which were only meant to last a few hours.

NASA

It was obvious that the Odyssey was a dying ship and that the lunar landing was scrubbed. The most obvious next step was to preserve what was left in the command module's batteries by powering down its systems literally turning it off. This was something that had never been done on a mission before and the engineers weren't sure how to turn it back on again for the return to Earth. This raised two more obvious questions: How to get back to Earth and how to keep the three men alive during the trip.

The answer to the second question was to use the lunar module as a lifeboat a scenario that had already been considered as an emergency measure for Apollo 10, 11, and 12. It was possible. The LM was intact, had plenty of oxygen in its life support systems, engines, and spacesuit backpacks, but the LM was only designed to support two men for 45 hours. Now it had to keep three alive for four days.

One limiting factor was power. Instead of fuel cells, the LM used silver-oxide/zinc batteries with only 2,181 Ah capacity. Some of this was needed to keep the command module's batteries charged, so everything not absolutely essential on the LM was shut down and energy consumption kept below 20 percent.

NASA

It would be a very cold, dark journey home.

Water was another problem. It was not only required to keep the astronauts alive, but it was also used to cool the LM's systems. The crew was rationed to six ounces (177 ml) each a day and instructed to only eat wet-packed foods. Even then, the spacecraft would run out of water five hours before reentry, but experience on Apollo 11 indicated that the LM could continue to function for that long without it.

Under normal circumstances, the way to get Apollo 13 back to Earth would have been using a direct abort trajectory, which would have involved firing the service module's main engine to place the spacecraft in a truncated orbit home. This would have been the fastest way, but Kranz vetoed this because no one knew how badly damaged the engine was.

The alternative was to carry on, loop around the Moon, and swing back to earth, using the attitude control rockets for any course corrections. Had this been one of the earlier Apollo missions, such a free return orbit would have needed little more than sitting back and letting gravity do the work.

NASA

But that wasn't possible for Apollo 13 because its goal of landing in the lunar highlands put it in a hybrid orbit a variation of the free return orbit, except that it needed an engine burn to make actual reentry on reaching Earth. Otherwise, the craft would simply have swung back into deep space.

Since the service module was unavailable, this left the crew with only the less powerful descent stage engines on the LM. Before shutting down the command module, Lovell wrote down the guidance readouts regarding the spacecraft's orientation and did the calculations (without a calculator but with Mission Control checking his sums) needed to feed the data into the LM's guidance system. However, making the necessary maneuvers using the LM required both Lovell and Haise at the controls and a lot of learning by doing.

There was also the question of whether to jettison the service module. This would have meant less weight for the lunar module's engine to push and cut the return trip by 36 hours. Unfortunately, this would have meant exposing the Command Module's phenol resin heat shield to the cold of space and the engineers weren't sure what damage this would do, so the service module stayed.

NASA

A 34-second burn with the LM's engine put the craft back on a free return trajectory but more burns would be needed if the command module was to land on Earth where it could be recovered safely. This meant one of three options: The Indian Ocean, where the US had few recovery units; the South Atlantic Ocean, where the same problem arose; and the South Pacific, where a recovery fleet was already steaming.

In the end, NASA opted to make another engine burn two hours after Apollo 13 passed its closest point to the Moon and 73 hours, 46 minutes into the flight. This would shorten the return by 12 hours and put the command module in the Pacific. This second four-minute burn was difficult enough, but with all the debris floating around it wasn't possible to orient the spacecraft using the stars, as was standard procedure, so the crew lined up using the Sun and the Moon again, using the LM's guidance system. This brought them to within a half a degree of the desired angle.

There was still much to do on the way back to Earth, but a more immediate problem was the men's own breath, which was pumping carbon dioxide into the confined space of the LM. At first, this wasn't a threat because there were lithium hydroxide canisters that scrubbed the CO2 from the air. However, these were meant for two men for 45 hours and within 36 hours after moving into the LM, the atmosphere warning light came on. The air in Aquarius was turning deadly and, if the problem wasn't solved, the crew would be dead a day before reaching Earth.

NASA

In an ideal world, this would have been an easy fix. The command module also had scrubber canisters more than enough for the trip home. Why not just move them over and plug them in? The crew couldn't because the canisters aboard Aquarius were round and the ones from Odyssey were square. Like a bad joke, the round holes of Aquarius' life support system wouldn't accept Odyssey's square pegs.

Like those school exercises where students are given a bag of items and are told to build a crane or a hovercraft, NASA engineers had to as quickly as possible figure out how to build an adapter using materials known to be on the spacecraft, write up clear and detailed instructions on how to assemble it, and relay this to the astronauts.

According to Apollo astronaut Ken Mattingly, the solution was from a simulator exercise for training the Apollo 8 mission crew, where a similar emergency was solved by blowing air through a canister using the spacecraft's vacuum cleaner hose.

NASA

They soon came up with a contraption called the "mailbox," which was made from plastic, covers from procedure manuals, vent hoses, and other bits and pieces, all held together with duct tape. Just reading the procedures over the radio took an hour.MiseryOnce the burns were completed, all but the most essential lunar module systems were shut down. This helped to conserve precious resources, but it also made the spacecraft a miserable place to be as both the command module and the LM went dark and dropped to the temperature of a refrigerator, reaching as low as 3 C (38 F).

There were the spacesuits, but their non-porous rubberized construction would have made the astronauts unbearably hot and sweat too much. Since they had only their flight suits, Lovell and Haise put on their EVA boots, while Swigert wore an extra coverall. Swigert was especially uncomfortable because his feet were wet after a spill while filling bags with drinking water.

NASA

As if to add insult to injury, the crew couldn't even dump their urine overboard for fear of altering the spacecraft's trajectory, so more plastic bags were used for storing the waste. The cold also caused the moisture in the air to condense on the bulkheads and behind the equipment panels in both the CM and the LM. Fortunately, the electronics were all well-insulated, but it was still like living in a leaky tin shed during a winter rainstorm.

Using the Earth's terminator line between day and night as a target, the LM made two more course corrections, which was tricky because the LM's computer had been shut down to conserve power.

About half an hour later, the service module was jettisoned by firing the explosive bolts that secured it to the command module. As it drifted away, the astronauts could see the damage caused by the explosion, including to the main engine, showing that the decision to not use it was justified.

NASA

However, they were not home free. Powering up the command module was hard enough, the protocols having been worked out in only three days, but without the reaction thrusters on the service module, the LM couldn't be jettisoned because the command module couldn't move away. This was solved by closing the hatches between Aquarius and Odyssey, leaving the air in the trunk instead of depressurizing. As the clamps were released, the air pushed the two craft apart as it escaped.

As Odyssey entered the Earth's atmosphere, the build-up of hot, ionized plasma around the capsule caused a radio blackout. If you saw the film Apollo 13, you may remember the tense scene as Mission Control waited anxiously to reestablish radio contact. This wasn't just a bit of Hollywood suspense building. The four-minute blackout stretched to six minutes, raising the fear that the heat shield had failed.

Fortunately, it did work, though exactly why the blackout was so long is still not entirely explained.

On April 17, 1970, at 18:07 GMT, Odyssey splashed down in the South Pacific Ocean and was recovered by the aircraft carrier USS Iwo Jima. The mission lasted five days, 22 hours, 54 minutes, and 41 seconds.

The astronauts were in good condition despite being dehydrated and losing 50 percent more weight than any other space crew, though Haisse did have a serious urinary tract infection due to his lack of water.

NASA

When the crew of Apollo 13 stepped onto the deck of the Iwo Jima, they were unaware that the whole world had been following their ordeal in numbers not seen since Apollo 11.

"Nobody believes me, but during this six-day odyssey we had no idea what an impression Apollo 13 made on the people of Earth," said Lovell. "We never dreamed a billion people were following us on television and radio, and reading about us in banner headlines of every newspaper published. We still missed the point onboard the carrier Iwo Jima, which picked us up, because the sailors had been as remote from the media as we were. Only when we reached Honolulu did we comprehend our impact: there we found President Nixon and [NASA Administrator] Dr. Paine to meet us, along with my wife Marilyn, Fred's wife Mary, and bachelor Jack's parents, in lieu of his usual airline stewardesses."

So what really got Apollo 13 home when the odds were so stacked against them? Certainly, courage played a part. All three men were test pilots and reacted like test pilots. Knowing that panic would do nothing other than waste precious time, they concentrated on the job at hand. Training was also important, as was innovation, as was the combination of relentless training combined with quick, expert thinking from the team on the ground.

NASA

But a later NASA report showed that luck had its part to play as well. This isn't to diminish the part played by the astronauts, NASA, or the contractors, because luck favors the prepared.

For one thing, it was fortunate that Gene Kranz and Glynn Lunny, the most experienced flight directors, were present when the accident happened. It was also good fortune that the LM had extra fuel aboard for the course corrections. In addition, Lovell had extensive carrier landing experience, allowing him to adapt quickly to the spacecraft's counterintuitive gyrations.

There was also the timing of the accident. If the explosion had occurred while the Odyssey was undocked from Aquarius, the crew would have been without their lifeboat and the engine needed to return to Earth.

NASA

Then there was the high-gain antenna surviving the explosion despite being damaged. This meant less than two seconds of vital data was lost. The timing of the explosion coming just after the television broadcast meant that some of the LM's systems were powered up, so emergency power wasn't needed to turn the spacecraft on. The broadcast also meant that the crew was not sleeping as scheduled, so they were already alert and active when the accident happened.

Even tragedy helped. The Apollo 1 fire in 1967 led to improvements in CM design, such as a better caution and warning system, and there were extensive electrical insulation improvements, protecting the systems against water damage.

In the short term, Apollo 13 was the mission that NASA wanted to forget. Despite the daring rescue, it was like Dunkirk a successful defeat. The space agency played down the event. The command module was gutted as part of the accident investigation and the capsule itself was unceremoniously carted off to the Muse de l'air et de l'espace in Paris, though it has since been, put back together, and is on display at the Cosmosphere in Hutchinson, Kansas.

NASA

But the years have a way of changing things. In the past half-century, the legend of Apollo 13 has grown. Many lessons were learned from the harrowing adventure that were used to improve the design of later spacecraft and how they were operated. The story became the stuff of a number of best-selling books, two television plays, a feature film, and many documentaries. It's a story that continues to inform and inspire.

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"Houston, we've had a problem": The story of NASA's most successful failure - New Atlas

In the mid-2010s, an outbreak of Ebola ravaged West Africa. Between December 2013 and June 2016, the disease officially killed 11,308 people in Liberia, Guinea and Sierra Leone, although the World Health Organisation (WHO) believes the real figure is probably much higher.

Ebola's virulence and lethality it has a mortality rate of around 40 per cent; Covid-19, the disease caused by the novel coronavirus, kills roughly one per cent of sufferers, although the exact number is currently unclear made containing it an international priority. By mobilising labs around the world, a prophylactic Ebola vaccine rVSV-ZEBOV was rushed through development. In December last year, six years after the first cases were discovered in West Africa, and three years after the outbreak was officially deemed over, the Food and Drug Administration (FDA) finally OKed it for use in the US. Compared to the normal timelines for these things, that still represents astonishing speed.

In the wake of the Ebola outbreak, WHO has taken a front-foot approach. Every year it publishes a list of key diseases it sees as the major issues the medical research community needs to tackle. The Blueprint For Diseases, as its called, highlights the diseases that could break out into epidemics in the next 12 months. It's a guide for the research community, an attempt to steer its resources to where they're most required. Currently, Covid-19 tops the list. Lurking at the bottom, as it has been every year since the Blueprint was first published in 2016, is something that sounds like it's been pulled from the pages of a comic: Disease X.

To create a vaccine in 18 months is unprecedented in human history. No vaccine has ever been developed at that speed.

Thats the unknown, brand new pathogen that springs up, says Rachel Grant, of the Coalition for Epidemic Preparedness Innovations. CEPI was formed in 2017, after the Ebola crisis made apparent the lack of a single, coordinating voice in the research and development (R&D) of vaccines. Its founding partners included the nation of Norway, the Gates Foundation, the Wellcome Trust, and the UK Research Foundation. (Since then, Germany and Japan have signed up, too.) What happened with Ebola was the world tragically realised they reacted too late," says Grant. "The whole system was too fragmented to respond in an effective way.

Disease X has long been recognised as an issue. Before coronavirus, the last brand new pathogen to spring up was the mosquito-borne Zika virus, which infected an estimated half-a-million people between 2015 and 2016. At the time of writing, Covid-19 had infected at least 1.5 million people and killed 90,000 (see the most recent numbers at Johns Hopkins Universitys live map of global cases).

The focus of the R&D world is now squarely on Covid-19, and the race is on to develop a vaccine. If the boffins and academics are to succeed, they will have to move at a previously unheard-of pace. Vaccine researchers are used to working on vaccines for decades, but with coronavirus, we cant wait that long. More than 60 teams across the globe are trying to find a way to protect the worlds population up from around 40 two weeks ago and the more optimistic among them think there could be a vaccine ready in 12 to 18 months. That is unprecedented in human history, says Grant. No vaccine has ever been developed at that speed. But they have to try.

Professor Katie Ewer hated immunology when she was an undergraduate. She had been interested in biology since she was a child, fascinated by seemingly endless processes that occur in our cells and organs every second of our lives without us knowing about it. When she didn't get into medical school she trained as a microbiologist instead, and grew fascinated by infectious diseases. Ive always had a real obsession with the human body, anatomy and how it works, she says. Eventually, she came to see immunology as its "ultimate expression". After a PhD in the subject she landed at Oxford University's Jenner Institute, and has spent the 13 years since working on a malaria vaccine, to try and halt the spread of a disease that kills 500,000 people every year.

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Thirteen years may sound like a long time, but vaccines are difficult to develop, especially when they're for diseases that largely impact the poorer parts of the world. A malaria vaccine would save tens of millions of lives, but it would be less profitable than, say, a drug that reverses hair loss or makes you lose weight. So not-for-profits like the Jenner Institute, where Ewer is a senior scientist, do the work that big pharma won't prioritise. According to The Global Fund, $5 billion is needed to keep development of a malaria vaccine on track. In 2018, researchers received $2.8 billion, a drop from the year before. That Covid-19 has spread through the global west has, perversely, probably accelerated the search for its vaccine.

To create a vaccine, you need to know what you're fighting, which is why, on 11 January, researchers in Shanghai leaked the genetic sequence of the coronavirus, after realising that Chinese authorities had no intention of releasing it globally. The next day, their lab was closed for "rectification". Their sacrifice enabled teams around the world to mobilise.

"We go round the lab with a tape measure, measure two metres, work out the number of people who can safely work in a particular area"

Vaccines work by training your body to react in a certain way, like teaching a child to catch a ball. The first time you throw it, it bounces off them. The second time, maybe they put up an arm to protect themselves. Eventually, they'll learn to predict its flight, get their hands in the right place, and time when they should wrap their fingers around the ball. It's become an innate reaction that happens almost without thinking.

In the same way, the first time your body is exposed to a new virus, it doesn't know how to react. Being infected with Covid-19 is like turning a tennis ball launcher on that child before they've learnt to catch they'll be overwhelmed. But introduce a measured, non-fatal dose and our body learns to battle it, even when confronted by a larger amount. This is done by injecting antigens (or small molecules of the virus, which is a pathogen) into the body. The immune system recognises a harmful alien presence and, through a process of trial and error, creates antibodies to battle it. Once it's been destroyed, your body remembers the specific antibodies it needs to produce if the virus returns say, through live infection so it can mobilise more quickly. (This is also why those who've already been infected almost certainly can't catch Covid-19 a second time, unless the virus mutates.)

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Before the advent of genetic medicine, vaccines worked by injecting patients with either a dead form of a virus, so it couldn't replicate inside the body, or a similar but less harmful pathogen (Edward Jenner, for whom the Jenner Institute is named, all-but invented vaccination in the 1790s when he realised that if you deliberately infected someone with the comparatively harmless cowpox virus, they wouldn't catch smallpox). Today, making a vaccine isn't simple, but it is standardised. The actual platform the backbone of the vaccine is always the same, whatever the disease, says Ewer. Researchers just slot in a little bit of the genetic information from the new virus.

The Jenner Institute develops a multitude of different vaccines at any one time, and at the start of the year, Ewers colleague, Professor Theresa Lamb, was handling its coronavirus research. By the middle of February, the Institute had recognised that the early stages of their vaccine production had gone well, and were preparing to test it in a clinical trial. Suddenly the small number of people working on the vaccine under Lamb ballooned. Ewer was drafted to help in the effort, one of around 60 people including doctors and nurses who are screening potential trial participants and laboratory staff developing tests and assays working on the project. Many are working from home: the lab doesnt want people in unnecessarily, in case they contract or spread the disease. We go round [the laboratory] with a tape measure, we measure two metres, work out the number of people who can safely work at that distance in a particular area of the lab, says Ewer. Its really boring, just the same as any other supermarket or shop.

The potential outcome is far from boring. Covid-19 has changed our scientific landscape in terms of how fast things are moving, says Dr Melvin Sanicas, a vaccinologist and medical director at Takeda, a Japanese pharmaceutical company. Since its genetic sequence was released, two teams have got candidate vaccines into clinical trials. One is based on an Ebola vaccine, developed by CanSino Biological Inc, a Hong Kong company, in collaboration with the Beijing Institute of Biotechnology. The other is from a Massachusetts-based pharmaceutical company, Moderna (who declined to speak for this story).

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In the 70 years since the first identified coronavirus infection in humans, no vaccine has ever got beyond Phase II trials, which means labs are taking diverse approaches to finding one now. The Asian plan uses a non-replicating viral vector essentially, the dead vaccine. The Moderna plan uses an RNA vaccine, in which human cells are injected with the disease's RNA a simpler version of DNA, used by cellular organisms like viruses in the hope that it will absorb it and start to produce antibodies. The former isn't so different from Jenner's original method; the Moderna plan is based on science that, so far, is largely theoretical, but which will be much quicker to test and produce than those made by the traditional method. If it works.

But finding a vaccine that defeats a disease is merely step one. You test the vaccine candidates in cell cultures or animal models to see if the vaccine candidate is safe and whether its able to induce an immune response, says Sanicas. The right immune response sees the body fight back against the pathogen, without being overwhelmed by it some candidate vaccines have to be shelved because the virus wins. Get it to work in cell cultures or animal models, and youre through the pre-clinical phase. You can now try and test it in humans.

"With any vaccine there is a risk of rare serious adverse events."

Testing is the time-consuming part. The team at Oxford University recently put out a call for participants across the Thames Valley area, asking for 510 participants in total. More than half will be given the actual vaccine, and 250 will be given a control. Theyll be monitored over the next six months to see how the vaccine is working researchers are looking for an immune response, but also check for side-effects that might be worse than the disease. In exchange, the participants will get up to 625, and the pride of knowing theyre helping save the world. The amount is relatively low (participants in a botched clinical trial in the mid-2000s got 2,000 each), and the risk real: an accompanying document acknowledges with any vaccination there is a risk of rare serious adverse events.

All vaccines entering clinical trials on humans go through three stepped stages. The Oxford trial will test only a few people to start with, to make sure everything works correctly and safely, before increasing the numbers. Well try and get up to vaccinating some quite big numbers of people in a short space of time, says Ewer. In less urgent times, that means thousands of participants over several years, because it can take months for an immune response to show up in healthy subjects.

To progress, a vaccine needs to produce positive results at all three stages. Normally, that means an effectiveness of at least 97 per cent, says Sanicas, although the pandemic is so severe that any potential coronavirus vaccine could be rolled out with results as low as 70 per cent.

Next, you start applying to national regulatory bodies the FDA in the US, the Medicines and Healthcare Products Regulatory Agency in the UK, and the European Medicines Agency in the EU for approval. Once theyve determined the vaccine is safe, effective and made using quality production mechanisms, they approve the vaccine for use, says Sanicas. Getting from identification to commercial vaccine normally takes the best part of a decade.

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Faced with a pandemic, there's always a temptation to cut corners. Every extra day jumping through red tape means thousands of people dead, tens of thousands more infected. But the scientific community has learned that a bad vaccine is worse than no vaccine. In the mid-2000s, trials of an experimental leukaemia drug in London went wrong, seriously damaging six participants without that testing, actual patients could have been given a drug that was more likely to kill them than their disease. And all vaccine development lives in the shadow of a terrible series of events in 1976, when the threat of a swine flu epidemic across the US led the government to instigate mass vaccination. To speed up production, they opted to use a "live" virus, rather than an inactive strain. Of the inoculated, one in 100,000 contracted a neurological disease called GuillainBarr syndrome, in which the bodys immune system attacks its own nerves, causing permanent paralysis. Since then, speed has always come second to safety.

But time can be saved if you can organise people properly. "Getting the regulatory authorities to focus, to come together, to really understand the data, all of that will make a difference to the timeframe for this," says Grant. Medical advances have also sped up the process of getting a vaccine to trial safely. The Oxford team is also changing the way they work, to speed things up without sacrificing safety, says Ewer. Were doing a lot of things in parallel that we would ordinarily do one after the other."

But they arent the only team on the cusp of clinical trials.

A tobacco warehouse in Owensboro, Kentucky may seem like an odd place for a coronavirus vaccine to emanate, but we live in strange times. British American Tobacco (BAT), which some might say is a company best known for killing people, has also entered the race to save lives. Right now, I would hope we could leave the politics of tobacco and smoking to one side," says Kingsley Wheaton, who leads marketing at BAT, "in order that we try and focus on the matter at hand right here, right now, which is solving this Covid-19 problem globally."

A few years ago, recognising it was selling fewer cigarettes every year, BAT invested in a company called Kentucky BioProcessing, to help find new uses for the tobacco plants it was growing but which people weren't smoking. They were especially interested in a protein that could be harvested and processed as animal feed. You take a small, hardy Australian tobacco varietal, and around halfway through its growing cycle impregnate it with an antigen for the protein. It replicates at a tremendous scale. The plant is a mini-factory, if you like, says Wheaton.

It became clear that this might also be a way to produce vaccines quickly and cheaply. Instead of an antigen developing a feedstock protein, Kentucky BioProcessing realised they could develop the antigens of viruses. You could clone in fields, rather than Petri dishes. In 2014, as Ebola was killing people in Africa, Kentucky BioProcessing put its newly acquired company to work. Improbably, Kentucky BioProcessing developed ZMapp, an Ebola drug that the World Health Organisation concluded, in 2018, had benefits [that] outweigh the risks (science has since thrown doubts on its effectiveness, however).

Every year since, Kentucky BioProcessing has worked on a seasonal flu vaccine; this year's was heading into the first stage of clinical trials when the coronavirus began its rampage across the globe. Now, the business has been reoriented to aid Covid-19 vaccine development: 50 staff members are devoted to growing an antigen that can create a vaccine in tobacco plants in a matter of weeks. You extract it, purify it and hey presto theres a vaccine. Results from pre-clinical trials in animals are pending, at which point it will move into clinical trials which may be anything from 12 to 18 months, even with a fair wind, Wheaton says.

What if they all worked together? Wouldnt it get done in half the time? No.

Not that theyre waiting that long. Even if BAT's vaccine is ineffective, its production technique could be a game-changer. Because a pandemic is different from an epidemic, and the need for a vaccine is everywhere and at the same time, youve also got to think about manufacturing capacity, says CEPIs Grant. If youre thinking about developing a vaccine for an epidemic, youre talking millions of doses of whatever it is youve developed. A pandemic, youre talking about billions.

BAT plans to start production on their vaccine even before it knows whether it works, making between one and three million a week, just in case. Wheaton is at pains to point out that if the vaccine isnt approved, it wont be used, but if it turns out our candidate vaccine is the right one, it would be good to have a stockpile of these things.

This is where research diversity becomes so important. People may look at the vast array of organisations, private companies, university laboratories and oddball developers trying to produce different vaccines simultaneously in all four corners of the world and think, What if they all worked together? Wouldnt it get done in half the time? Not so, says Grant, whose list of teams working on a vaccine tops 90. You are always better to have a diversified approach than you are to have a really narrow one, she says. You never want a single point of failure in a situation like this." With vaccines, there are too many potential failure points to count.

Pedro VilelaGetty Images

During the West African Ebola crisis, pharma giant Merck was one of the first to get a drug through clinical trials. Its vaccine, rVSV Zebov-GP, had 100 per cent efficacy, but a zero per cent chance of actually being used at scale; it needed to be stored at 80C. You try getting a vaccine supposed to be stored at 80C out to war-torn Democratic Republic of Congo and youve got massive supply problems, says Grant. Which is why it was handy there was investment in another vaccine, by Johnson & Johnson, that wasn't so temperamental.

Most drug research works on a winner-takes-all model: invent Viagra, or Minoxodil, or Oxycontin, and you get a 20-year exclusivity licence (in the US). That means you can charge as much for it as you like. Once the licence lapses, competitors can create generic versions and the price falls. With a pandemic vaccine, the rules of the marketplace make less sense. There's healthy competition, but its against nature, not each other.

"Im trying to do as much as I can do in the working day and then go home and try and be a mum to my kids at home."

That said, there are economic incentives at play: make the vaccine everyone wants and you can at least recoup the costs of developing it. CEPI has ploughed $23 million into the eight programmes it's supporting underway, and estimates it will cost something like $2 billion more to get three of those into clinical testing. Altruism is fuelling initial development, but at some point realism steps in. Still, any CEPI-developed vaccines wont result in a free-for-all (the US government's reported attempts to buy German pharmaceutical group CureVac, to get at its potential coronavirus vaccine first, hint at what could happen with international cooperation). CEPI has a stringent policy on equitable access and believes that work needs to be done now at an intra-governmental level to decide a way for people who need the vaccine most, such as healthcare workers and the vulnerable, to access it first.

Regardless, developers are keen to help in any way they can. Were one of many in that area, but wed also be delighted to take a candidate vaccine and become a fast-scale manufacturer through our plant-based system, says Wheaton.

For those in the labs, competition isn't a concern. They worry about the pressure of getting a vaccine right and getting it quickly. When I ask Ewer if the process of developing a vaccine has been stressful, she replies with one word: "Yes".

I try not to think about it too much, she eventually adds. Shes stopped watching the news; a regular Twitter user, shes now shunning the app. I had to stop engaging with it because if I think too much about it, I get really stressed. If I think too much about what happens if none of this works, then I feel a bit overwhelmed, so Im trying to do as much as I can do in the working day and then go home and try and be a mum to my kids at home, try and keep things as normal for them as possible, because its weird for the family as well as it is for everybody.

"Hopefully one of us will produce a vaccine that is effective. I dont really mind if its ours or anybody elses, as long as one of them works."

It can be easy to forget, as we praise our scientists and our doctors, our nurses and the collective brainpower of the experts working to lead us out of this crisis, that theyre human beings, too. The risks of getting it wrong are real and they feel them every day.

If you ask me whether I want this really quick, or I want a robust process, I would pick the safe and robust process, says Sanicas, who worries were all getting caught up in the hype around 18 months to a vaccine. I dont want this to be just a vaccine you bring quickly to the market but were not sure about the long-term effects. He thinks itll take two years for anything to come to fruition.

Near the end of our conversation, I ask Ewer if theres one thing she wishes the general public who are clamouring for a Covid-19 vaccine as eagerly as they are for sufficient testing capacity knew about her work. I expected her to explain the challenges of the vaccine, or to caution about its progress (she believes the best case scenario is that by autumn this year the Oxford team will have evidence of the vaccine being safe and able to induce a good immune response). I didnt expect her to answer as she did.

I think I would like people to know there are lots of people working very, very hard on this, she explains. Making vaccines is difficult and its expensive, but there are at least 30 different groups around the world, all trying to produce a vaccine against this disease, and hopefully one of us will produce a vaccine that is effective. I dont really mind if its ours or anybody elses, but as long as one of them works, thats the most important thing.

She pauses for a moment, then picks up her train of thought. As long as somebody gets there, we dont mind if its us, or Moderna, or anyone else. As long as one of us gets there, and we can make enough of it quickly enough to make an impact.

The information in this story is accurate as of the publication date. While we are attempting to keep our content as up-to-date as possible, the situation surrounding the coronavirus pandemic continues to develop rapidly, so it's possible that some information and recommendations may have changed since publishing. For any concerns and latest advice, visit the World Health Organisation. If you're in the UK, the National Health Service can also provide useful information and support, while US users can contact the Center for Disease Control and Prevention.

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When Will There Be A Coronavirus Vaccine? - esquire.com

The Daily Bruin isnt printing this quarter, but this isnt the first time weve scaled back on print production.

Just this week, the Daily Bruins upper management announced that the Daily Bruin would cease print production through the end of the 2019-2020 academic year, in light of the ongoing COVID-19 pandemic.

After all, it doesnt really make much sense to print 6,000 copies of a student newspaper every day when most of the student body has left campus and instruction is entirely remote.

Originally, managements plan was to cease printing until April 10 in line with the schools initial plans to return for in-person instruction by week three. But the ever-changing nature of the pandemic has lead to the extension of remote instruction and, consequently, the extension of digital-only production for the Daily Bruin.

The Daily Bruin staff had to make a similar decision regarding print production back in the 1940s, when the United States entered World War II. In Aprils updated letter from the editors, The Bruins upper management notes that this is the first time since World War II that the paper has ceased to be printed five days a week. However, this is the first time in our entire history that the paper has ceased printing entirely during the war, the paper continued printing three days a week, on Monday, Wednesday and Friday.

While the impact of the coronavirus outbreak on The Bruin certainly draws parallels to that of World War II, the situation necessitated different responses in the way the paper scaled back its print production. The response to the current situation came relatively swiftly, but in the 1940s, the shifts in the papers production cycle were much slower and evolved throughout the course of the war.

As UCLA alumnus George Garrigues noted in his history of the Daily Bruin, the U.S. entered World War II right around the same time students were gearing up for finals. Late in the evening on Sunday, Dec. 7, 1941, the papers staff scratched its original layout for Mondays front page and replaced it with a number of articles about the bombing of Pearl Harbor from the United Press wire service with the bold-faced headline Japan Declares War!

Print production didnt slow down right away. Through the end of the semester this was decades before the university switched over to the quarter system, of course Garrigues writes that war news blanketed The Bruins front page.

The paper did produce a shortened version on Dec. 11 this was, however, unintentional. During wartime, governments across the world used to impose blackouts, during which lights would be shut off for short periods of time, in an effort to prepare for potential attacks as well as to make it more difficult for bombers to navigate urban areas that would normally be well-lit at night. Garrigues writes that the first U.S. blackout of the war struck Southern California on Dec. 10, 1941 and the Daily Bruin editors had to publish a shortened three-page paper, composed of a broadsheet front page and two compact tabloid pages following it.

Due to the loss of time during last nights blackout the Daily Bruin today appears in a form unique in the annals of journalism a three-page paper, wrote the then-Editor-in-Chief Malcolm Steinlauf on the front page of the paper.

It wasnt until 1943 that the papers print format began to change for good. As staffers were drafted into the war, the size of the staff shrank, and so did the paper. On Jan. 4, 1943, The Bruin switched from the lengthy broadsheet layout it had been printing for decades before and as it is typically printed today to a smaller tabloid one, comparable in size and shape to that of papers like LA Weekly.

Later that year, the paper shifted to printing only three times a week. Following the publication of the papers 1943 Registration Issue, The Bruin began publishing three times a week during the week of July 5 (Interestingly, The Bruin only publishes a paper once a week during summer sessions nowadays).

In terms of wartime content, Garrigues notes that The Bruin took a largely liberal stance, with especial opposition against the internment of Japanese Americans; conservative groups in particular, those investigating communism at UCLA did not look upon The Bruin favorably. Then-dean Earl J. Miller even went as far as saying that UCLA would be better off without a school newspaper entirely, Garrigues writes.

Luckily, Miller didnt get his way as we all know, the paper survived opposition from conservative admins and readers. Following the end of the war, the paper resumed daily production, and has consistently published five days a week since fall of 1945. Until today, that is, when the pandemic once again puts us in a situation in which print production is not in the best interest of our students or staff.

Fortunately for the UCLA community, were living in an age in which cutting print production doesnt hold quite the same weight that it would have in the 1940s had the Daily Bruins then-upper management decided to cease printing the paper entirely, its possible there would have been no Daily Bruin at all. It goes without saying that temporarily switching to a digital-only media source would have been, well, impossible without any sort of internet to get things going.

While reading Daily Bruin stories online might not have the same novelty as picking up a paper and skimming through it on your daily walk to class, its a reminder that were all going through different adjustments to the current pandemic and doing our best to get through this safely and sanely. Just like The Bruin returned full-time in 1945, the papers staff is excited to come back to Kerckhoff Hall 118 and get the printers running once its safe to do so again whenever that may be.

Read more from the original source:
Press Pass: Looking back on when the Daily Bruin reduced print production during World War II - Daily Bruin