Now on bbc news, with coronavirus outbreaks at different stages around the world, we explore what might happen as restrictions change and people adjust to a new reality. Hello, and welcome to the latest in our special programmes on the coronavirus pandemic. Im annita mcveigh. On todays programme, a widely available steroid can help some of the most seriously ill coronavirus patients, according to new research from the uk. Plus, what kind of long term changes could the pandemic have on our urban landscapes . And a reminder that you can keep up to date with the latest information about the pandemic on our website. But first, official figures show more than 400,000 people have died because of coronavirus, but what is the real number . How many people died because they couldnt get treatment for other illnesses . A bbc investigation has looked at 27 Different Countries and has found that the total number of deaths caused by the virus, both directly and indirectly, is much worse than it has been reported. At least another 130,000 deaths havent been counted. This report by sofia bettiza starts in indonesia. A father buries his youngest son. A mother distraught. Three year old rafa did not have coronavirus, but his parents say he died because of it. He had leukaemia. When his condition got worse, his parents raced to hospital. Translation it was around midnight. The hospital said he would need to be tested for covid 19 before he could be admitted anywhere. Another hospital told us there wasnt a childrens doctor on duty and the quick covid tests they had were only being used for pregnant women. Rafas parents drove him to three more hospital that night with no success. The next day, they eventually found a hospital that would accept him but he died before doctors could see him. Translation i still believe that if my son was given prompt treatment, he would still be alive. But he was turned away and tossed from one hospital to another. I could do nothing. Rafa is one of tens of thousands of people whose deaths are not officially counted as being caused by coronavirus, but are still victims of this pandemic. Since the outbreak of the virus, lots of countries are recording more deaths than usual. You can see a bump in the graph here. These are called excess deaths. Now, many of these have officially been linked to coronavirus, as you can see here in red, but that still leaves a huge number of lives lost which are not accounted for in the covid statistics. The Italian Region of lombardy saw more than double the number of deaths than expected. One of them was lucas mother. Luciana had pancreatic cancer. When she tested positive for covid i9, her chemotherapy was stopped immediately. But when she got better, her treatment was never resumed. Translation yes, i believe so, because her doctor said everything was under control as the cancer hadnt spread to her liver. My mum was optimistic. We made the plans for the future. But the virus accelerated her death. She could have been with me for many more months oi even years. In brazil, a similar story of grief. Translation my mother was a warrior who fought for her children all her life. Andrea says that after her mum had a stroke, the hospital discharged her too soon because they needed to free up beds for Covid Patients. A few days after she came back home, her heart suddenly stopped beating. She did not die from the disease, but she died because of the disease. And so many other people are dying in brazil and in the world that they are not counting. It is scary, it is scary. For the first time, a drug has been shown to reduce the risk of dying from covid i9. A cheap and widely available steroid called dexamethasone has been found to help some of the most seriously ill patients. Trials in the uk have shown the drug cuts the risk of death by a third for patients on a ventilator. For those on oxygen, it cuts deaths by a fifth. Our medical correspondent fergus walsh reports. Beeping. For those laid low by covid i9, for the very sickest hospital patients, at last a drug that can tip the odds in their favour. 6000 nhs Covid Patients were part of the trial and the results were so overwhelmingly positive, they were rushed out days after the study was completed. It found that dexamethasone saves one life for every eight patients on a ventilator. And one life saved for every 25 patients on oxygen. If it had been used from the outset of the pandemic, it is thought it could have saved 4,000 5,000 lives in the uk. If it had been used from the outset of the pandemic, its thought it catherine milbank from buckinghamshire spent 12 days on a ventilator with covid i9. She received dexamethasone after her husband paul gave consent over the phone for her to take part in the trial. When someone tells you that your wifes hanging on the edge of something that could go either way and you know that theres current proven drugs that are already in the medical industry already that are prescribed to people, when you know that they are around and theres a chance that might help, you grab it. Without trying these things, without the researchers, no ones going to get anywhere finding out the right drugs to help the pandemic thats happening and still going on. Were coming through it, but i am just eternally grateful and will be for the rest of my life. Dexamethasone has been around for decades. A steroid, its widely used for arthritis, asthma and other conditions. This is a genuine breakthrough in the treatment of covid i9. Dexamethasone, either in tablet or injectable form, is available in every hospital pharmacy. The treatment costs around £5 on the nhs and will be even cheaper in developing countries. So, this drug has the potential to save lives across the world. Weve been on a huge search for treatments that actually will improve survival for patients with covid. This is the first drug. Not only is this the first drug that improves survival, but its available worldwide immediately and is affordable. Thats fantastic news for patients. The drug helps stop the immune system from overreacting to covid. Its not a cure, but it will help more of the sickest patients to overcome this disease. Fergus walsh, bbc news. To the United States now, and businesses around the country are beginning to reopen amid the covid i9 induced economic collapse. There was an improvement in the overall unemployment numbers last month, but the Unemployment Rate for African Americans went up, making it the highestjobless rate for black americans in more than a decade. Its a reminder of economic inequality that could serve as an Early Warning sign for the recovery to come. Samira hussain reports from new york. Natasha wattersons hair salon has been closed since the middle of march. Shes had to lay off her entire staff, who are all african american, and has been using her savings to stay afloat. I think i was more concerned about clients because they were anxious, just trying to manage their anxieties, not only around their hair but their own personal issues, and then, of course, employees. Im responsible for seven people. How are they going to get money . Cristo has been struggling since the pandemic in new york. Hes out of work and found himself depending on food banks again. I only saw people that looked like me in my line, and thatjust made me so angry. And then i see all of these unemployment has gone down and, oh, thejobs are opening up now, and its like i dont see that in my own community. He has a point. The latestjobs report may have shown unemployment fell overall, but not for African Americans. Americas racial divides have shown up vividly in this pandemic. The virus may not discriminate on who it infects, but death rates in predominantly black communities like this one are higher than in mainly white communities, just like unemployment disproportionately affects African Americans. What do we want . Justice when do we want it . Now so, while the protests over the past few weeks may have started because of the death of george floyd, they have also reflected a wide ranging anger about americas systemic racism. Before the coronavirus hit, black unemployment was actually at an all time low, but those gains have now been obliterated. Once again, black america is bearing the brunt of the countrys economic failures. What we often find is that black workers are among the last group of workers to recover fully from an economic downturn. Both in terms of the peak Unemployment Rate experienced by black workers and the amount of time that it takes to bring that Unemployment Rate down to anything near what we would consider normal. We are going to be openjuly ist. Do you want me to take down your information . Despite the uncertain future, particularly if you are black, natasha is looking forward to when she can reopen her business and get back to work optimism and endeavour that americas battered economy needs now more than ever. Samira hussain, bbc news, new york. Samira hussain reporting. Job loss, self isolation and the fear of contracting covid i9 are just some of the factors affecting people all over the world during this difficult time. Angelica casas reports now on the Mental Health effects of coronavirus and how our brains are processing the pandemic. The pandemic has been described so often as an invisible enemy. The problem is it isnt completely invisible because we see its effects everywhere. Every time you turn on the news, everything on your twitter feed, people with face masks socially distanced nothing about life is normal. Nothing about life is normal. The coronavirus pandemic has taken over the world, and its notjust the virus itself that poses a threat. Our brains and our bodies dont really know what to do with this ongoing strain that reallyjust outdoes anything any of us have been exposed to. So, how is our brain processing the pandemic . We are processing this in fits and starts, i would say. In part, were processing things very well and were adapting and people are coming up with all sorts of Creative Solutions to the many challenges of daily life, and in part werejust running really scared. Were looking over a cliff that we cannot see the bottom of. And the uncertainty surrounding job losses, the economy, isolation and fear of getting the virus all lead to stress. When its a stress thats ongoing, youre constantly aroused, your autonomic nervous system is going with the fight or flight syndrome, but theres no flight. You end up with your Blood Pressure higher than normal. Its much more difficult to process, cognitively even, and you find yourself distracted and worried and preoccupied. So, all of these reactions are existing simultaneously in your body and in your mind, and you dont know and are trying to figure out how to sort this all out. And then theres the social isolation. Weve never had to self isolate and shelter in place like we have today, and i dont think anybody alive has probably experienced Something Like this. Prolonged social isolation is definitely detrimental. We need people, we need human contact, and in a world where we dont have that, there is a risk for a number of disorders to become exacerbated. Mood disorders, anxiety, depression and worry are all a function of prolonged social isolation. We can look at other pandemics and other epidemics and we can make predictions on how well were going to do. The pandemic of 1918, i mean, eventually people started hugging again and holding railings and shaking hands. Our memory for this will fade as the risks fade. Throughout history, pandemics and Public Health crises have acted as catalysts for urban development and have shaped the way people in and around cities lived. My colleague yalda hakim spoke to three experts, professor Richard Sennett in london, sameh wahba in washington, dc, and solly angel in new york, about what lasting effects covid 19 might have on our urban landscapes and how cities could change as a result of the pandemic. I think were going to have to figure out new ways to make cities dense, so that weve got all the advantages of a dense, efficient environment but where people dont crowd themselves in ways that can be unhealthy as they would be during a pandemic. That probably means we have to change the way we think about transport and the way we build buildings. So, the impact is going to be lasting if we want to a healthy city thats also efficient, sustainable in terms of climate issues. Lets go to solly. If you look at a city like new york, its densely populated, people live in small apartments. Do you think attitudes are starting to change, given weve been in this lockdown for so many months . I think that new york is geared up to go back to where it was before. I dont think that the pandemic will create lasting changes in density. I think people are addicted to the buzz that is associated with density and with the rubbing shoulders with each other, and theyre not going to give up on that. And i think the pandemic has exposed the limitation of zoom and skype and interacting on the internet, and that Companies Might want to take advantage of that to lower their labour costs by decentralising some jobs, but density is with us to stay. But do you think it becomes a Public Health issue, solly, in a city like new york when we are being told for the foreseeable future, until a vaccine is found, we need to socially distance, we need to be mindful of those around us, and frankly, in a city like new york its quite difficult . New york is very disciplined. New york is like the example of how to behave during the pandemic. It has had many, many cases and now has a very small share of new cases and new deaths. People are very disciplined, they keep distanced, they keep their masks on and they learn how to live in a pandemic, which doesnt mean that they wont go back to where they were before once we have a vaccine. Solly, we talked there cities like new york, but what about places like mumbai, rio,jakarta, you know, the developing world . Just like richard and solly have mentioned, i dont think its really about density or the scale of the cities. So, its notjust the large density cities that got poorly hit. They were the ones where density is poorly managed, and by that i mean neighbourhoods that have substandard housing, lack of public spaces, they have either poor infrastructure or absent infrastructure, and these are the places where slums and poor settlements and the like have had exacerbated the inequalities and have become hotspots for the transmission of the virus. So, i suppose when were thinking or when we are thinking about how to reshape some of these cities, what do you think needs to fundamentally be done Going Forward to protect Peoples Health and to reimagine these cities . I think the first and most important thing is to tackle the inequalities that have been laid bare by covid 19. Basically fixing the infrastructure and housing and open spaces, conditions in the settlements where the poor and vulnerable live. And i think the second thing that is needed is also particular attention to the poor and the vulnerable, especially those who work in sectors whose livelihoods have been affected and therefore policies such as social or physical distancing have hit them worst because their livelihoods are at stake. Richard, ill come back to you. Tell us about what smart cities are because there has been this push for smart cities and more surveillance during this pandemic. Yes. I think that would be a very sad outcome of the pandemic if what remained permanently in place were many, many more surveillance cameras and in general more control of cities. We had to have a lot of control to deal with the crest of the pandemic, but we shouldnt maximise that. Technologys been used in outside of privileged places like new york to create social Networks Among people who dont have much access to Public Services or weak Public Services, and thats a good thing, thats a smart use of smart technology, but a frightening use of it would be the pandemic recedes and the control remains. Are you talking about places like hungary, for example . Yes, i am, or britain, im sorry to say, in which the test and trace apps are pretty frightening. They give people much more. They give the government much more information than just about whether somebody is sick or not. So, we have to guard against that, we have to use technology smartly and democratically. Solly, theres been a lot of discussion about infrastructure, certainly this has remained a problem in a city like new york, do you think this pandemic has further highlighted the issues with infrastructure in new york and whether that will bring about any kind of change . Yes. I do think that the main impact of the pandemic has been on the Public Transportation system. It has basically ground to a halt, it has lost a lot of money, it has lost a lot of appeal, were worried that going back will involve people bringing cars rather than going back into Public Transit, and i think that that might be the death now of a lot of new Public Transit projects that will not be able to be financed because of the loss of public funds. I think that much of the money is being spent giving back to people, giving back to corporations, but the tax money that is lost is not replenished. And a lot of interesting green projects, new Infrastructure Projects are going to be either postponed or completely eliminated as a result of the economic crisis brought about by this pandemic. Certainly in many cities in europe, were seeing the use of bicycles, people getting around in bicycles and bike lanes being created, are we seeing that in new york . Yes and no. Yes, we are seeing bikes in new york, but new york is a metropolitan area of 20 million people. Most people commute far longer distances than those required by bicycles. Most commuters have to rely on longer distance commuting, either by cars or public transport. Youve said a city is as weak as the weakest link. What did you mean by that . What i meant is that places, such as slums and informal settlements, that are becoming hotspots for virus transmission because a citys is interconnected, it is one unified Labour Market with mobility back and forth, then a city that is suffering an increase in the transmission of covid 19 in certain neighbourhoods where public spaces are lacking and where social distancing is impractical, then these places will affect the rest of the city. Weve done some work at the world bank where weve used Artificial Intelligence and information infrastructure to detect places that could be hotspots for transmission when communities have public water fountains and public toilets and you do not have individual connections at home, then these are places that increase the risk and therefore the city will be as weak as the weakest link in terms of the epidemic transmission. Thats it for now. A reminder, you can follow me on twitter, annita mcveigh, or head to the bbc news website for the latest information. Take care and thanks for watching. Hello. Sunday gets off to a wet start for many of us, but for many, it will brighten up. But following the rain, dont put the umbrella away because there will be further showers. Some of those could be heavy on what will be quite a blustery day for many of us, a bit cooler than it was on saturday. Now, the rain courtesy of this area of low pressure. It will start to pull away from easternmost parts of england by late morning. Still has to push northwards through scotland, though, in the morning and then across the Northern Isles as the day goes on. Now, this is how the day begins temperature wise. Were looking at temperatures around 10 14 degrees. A very blustery start, particularly where youre still seeing this rain. And, again, it clears from Eastern England late morning, still has to push on northwards across the Northern Isles during the day. But notice behind the rain, brightening up very nicely. Therell be decent sunny spells around, but quite heavy down towards running in towards Northern Ireland, scotland, parts of northern england. It could be thundery. Showers scattered about elsewhere through england and wales. It will move through quite quickly on these brisk winds. These are average speeds. There will be gusts, though, around 30 110 mph in places. And for many, it will be a bit cooler, though still some spots in Eastern England creeping into the low 20s. Now, still some of these downpours around initially on sunday evening, but they will tend to fade. So, actually, for many of us, therell be increasing sunshine to end the day, largely clear overnight and into monday morning. Will allow temperatures to dip down a little bit lower, some spots down to single figures as monday begins. Your eyes may be drawn, though, to our next weather system coming in, these weather fronts that will head in through parts of Northern Ireland and scotland in particular. And with fairly strong winds still associated with the next spell of rain moving in here. So, heres a look at how monday is shaping up, some rain into Northern Ireland, parts of scotland. May just brush parts of north west england and wales as well, especially the north and west here, but elsewhere in wales and across the rest of england, it looks to stay mainly dry, variable cloud and sunny spells. And here, temperatures will creep up a little bit higher, and higher still as the week goes on because this is the picture midweek. Well have low pressure to the northwest and this weather front in scotland and Northern Ireland, so here, well keep temperatures closer to average, bit of warmth in the sunshine, may see a bit of rain at times. Closer to high pressure, though, across a large part of england and wales. Itll be mainly dry with a feed of air not from the atlantic, but coming in from a hot continent. This is where temperatures will be heading up. Hottest weather of the summer so far, and some spots reaching into the low 30s
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