CNN Republiek van Suid-Afrika
Club World Cup: Al Ahly's 'Chosen One' coach draws strength from Nelson Mandela - CNN International
Ah Ahly's Pitso Mosimane grew up in the apartheid era. Ahead of the Club World Cup, he says "it always looks impossible until somebody does it."
(CNN)He might be known as the "Pep Guardiola" of African football, but Al Ahly coach Pitso Mosimane's mantra is one coined by the iconic Nelson Mandela. "It always looks impossible until somebody does it," Mosimane tells CNN Sport. The 56-year-old coach is sitting in his office at the Cairo giants, with Al Ahly's famed red, black and white colors emblazoned on the walls around him. Mosimane won a record five league titles in seven years with South African club Mamelodi Sundowns, was part of the Bafana Bafana coaching staff at the inaugural FIFA World Cup hosted on the continent and became Al Ahly's first ever Black coach in 2020. He will now have an opportunity to prove his mettle to the world after leading the Egyptian outfit to the promised land of club football as Al Ahly is set to participate at FIFA's Club World Cup, which begins in Qatar on February 4, when it plays Al Duhail SC. If Al Ahly win that match, the Egyptian club will face Bayern Munich for a place in final. Bayern will be the favorite to win the semifinal, but expectations are always high at a club like Al Ahly, which says it has 60 million fans in the Arab world and has won 140 trophies. Mosimane grew up in apartheid South Africa, so he is understandably proud of his coaching achievements, given his humble roots. And it's Mandela's own legacy that rightly inspires him. "Have you ever thought, in our time, that South Africa can have a Black president as Nelson Mandela?" enthuses Mosimane as he reflects on the life of a man who was incarcerated for 27 years. "That is an amazing story." Mosimane himself has reached great heights, and his gilded touch has seen all of the club teams he's coached claim silverware. His proudest achievements came when he conquered the Confederation of African Football (CAF) Champions League on two separate occasions -- firstly with Sundowns in 2016 and then Al Ahly four years later. "Can you believe that somebody from the township like me, from the background of apartheid, from the humble beginnings, can be the first person to win the Champions League in South Africa? And win it twice and become coach of the year on the continent," he says with almost a sense of disbelief. Last season, Mosimane did what nobody in world football has achieved to date. He was a part of two teams that secured trebles in their respective countries. First, he won three trophies in South Africa, including the league, in what is widely regarded as the strongest African domestic competition. And then he followed this up with Al Ahly, leading it to the continental crown as it beat arch-rival Zamalek 2-1 in the CAF Champions League final. Al Ahly had in fact wrapped up the league title under René Weiler, who departed late in the season to be with his family in Switzerland, but Mosimane received a winner's medal as he took over the team for the final two league games of the campaign and then guided the Red Devils to another triumph in the Egyptian Cup. "Al Ahly is a club that demands success, and in Egypt and Africa, it's known as the club of the century," explained former Egyptian international turned pundit Yaser Elshanawany. "There's only one other club that's won more trophies than Al Ahly in the world and that's Real Madrid, so when you get this job there's lots of expectation." "From the people I've spoken to at the club, they all tell me technically he's very strong and knows how to analyze other teams. But he's really loved by the players and his staff because psychologically he knows how to connect with them, and build relationships with them," Elshanawany added. Mosimane masterminded Sundowns' 5-0 drubbing of the Red Devils in the 2019 CAF Champions League quarterfinals. It was a signature win that showcased Mosimane's ability and also persuaded Al Ahly that it didn't need to look outside the continent for a coach. One of Sundowns' stars over the last few years has been South African midfielder Hlompho Kekana. He has seen first hand what makes Mosimane the coach that he is, as he's been part of the Sundowns dynasty including that first CAF Champions League title. "Pitso is obsessed with the game, that's what gives him the edge," Kekana says. "He digs deeper than anyone I've worked with in football. "I'm not surprised to see his achievements. He's instilled that mentality with the players and we are told not to see football as just a career, but something that can change the world. "We're more than just football players, and he's told us we can use football to get an education and we can uplift our own lives and those around us." Kekana also understands why there have been comparisons with two-time UEFA Champions League winner Guardiola, famed for the stylish, attacking football he's coached at Barcelona, Bayern Munich and now Manchester City. "I've not met Pep, but I can see why they have similarities," says Kekana. "Both play a possession-based game, but are always looking for perfection. Pitso was always looking for us to win matches, but he always wanted us to go out and express ourselves within our structures, never to sit back. To press high and keep the pressure on, never to let off, play with high intensity" the Bafana Bafana player said. It's this type of philosophy that Al Ahly President and club great Mahmoud El Khatib had admired from afar, and when Weiler departed at short notice, "Bibo," as he's affectionately known, moved for Mosimane. "He's a legend ... it's like having Kenny Dalglish becoming president of Liverpool," explains Mosimane, referring to the former Scot who played and managed the English club. "His head was on the block for appointing the first sub-Saharan coach to lead Al Ahly ... Now, he's proven right. We won the trophy and everything is good." Al Ahly hadn't won the CAF Champions League in seven years and had lost two of the previous three finals. "So we need to take a different approach and let's get somebody who knows the continent -- who lives in it." Coaches from Egypt, Europe and South America had been previously appointed at Ah Ahly, but Mosimane was a step in a new direction -- the South African became the first Black and sub-Saharan to take charge of the Egyptian team. Mosimane admits it's probably "taken too long" for a Black coach to be appointed at the club, but said, "I don't want to dwell so much on why. But it has happened now. I'm the one. I'm the 'Chosen One.' And what brought me here was not a political movement. "I was brought here because of the titles that I won because I've defeated Al Ahly twice and one of the top teams here in Zamalek. And they know me. They know my name ... it has nothing to do with color or politics." Despite Mosimane's trophy-laden season, he was not recognized by FIFA on its coach of the season shortlist, as Liverpool's Jurgen Klopp secured the prize for his sterling work with Liverpool as the Reds lifted the Premier League trophy for the first time -- the club's first domestic league title in 30 years. "FIFA must also consider coaches outside of European nominees because these are world awards," said Mosimane of FIFA's Best Football Awards, suggesting that the Confederation of African Football (CAF) could lobby the world governing body to create a more "inclusive" shortlist of coaches, players and clubs. Mosimane also referenced former Flamengo coach Jorge Jesus' success in the 2018/2019 season when he guided the Rio-based club to the Brazilian league title and also South America's prized club cup competition the Copa Libertadores, but was not recognized by FIFA for his success. "Jesus, he's the coach of Benfica now. He was the coach at Flamengo, he won lots of trophies and also deserved to be nominated. It's not just about me. But it's okay, we have to move on," added Mosimane. In response to Mosimane's criticism, FIFA said: "The shortlist of candidates for the awards was selected by two expert panels: one for women's football and one for men's football. "The two expert panels include high profile representatives from all regions with the aim of ensuring that the awards reflect the views of world football. That being said, we appreciate Mr. Mosimane's comments as it is important that the protagonists express their views about the process." CNN did reach out to CAF for comment, but they did not respond to multiple requests. "Our lives should not be about awards as coaches, we need to change people's lives," Mosimane says, backing up what Kekana had said about his former mentor. Mosimane's success has created a stir on the African continent and many have debated if he can be the first African to move from the continent to coach in one of Europe's major leagues. "Is this a possibility? Yes," says Mosimane, before adding: "We have to be realistic to say Europe doesn't have a lot of African coaches. "I don't want to politicize this and make it a case of playing the race card, but some things need to be told as they are. "But I just believe that a medical doctor who is from South Africa, is the same medical doctor who is in Europe. I believe an architect who has qualified in South Africa, is an architect in Europe. So I just don't understand when it comes to football coaching, why these things get looked at differently. "I mean, you cannot tell me all these big players, African players, who won the Champions League in Europe, who are living there and none of those Africans can have an opportunity to coach. "Maybe in our children's generation, things can change. Things do change ... But first, Europe must accept and give chances to the European-born Africans, before we can talk about getting a chance ... so it's a long way." Mosimane needs no reminding that apartheid lasted almost five decades in South Africa, or that Al Ahly took over 100 years to appoint their first Black coach. While he is realistic about getting an opportunity in the biggest leagues in the world, having survived apartheid and carved out success across the African continent, Mosimane draws strength from this: "Never, ever, ever underestimate a Black South African who comes from the township." And having seen what Mosimane's done, perhaps it's just a matter of time before the "Chosen One" shatters another glass ceiling.
Just over a year since the first reported Covid-19 case in the US, the country nears 25 million infections - CNN
The US is again quickly approaching another grim milestone: 25 million Covid-19 cases in a little more than a year since the country reported its first infection.
(CNN)The US is again quickly approaching another grim milestone: 25 million Covid-19 cases in a little more than a year since the country reported its first infection. The devastating number is more than double the number of infections reported in India, which has the second-highest number of cases after the US, according to Johns Hopkins University data. And it's nearly triple the number of cases in Brazil -- with the third-highest number of cases in the world, according to Johns Hopkins. And while some states have reported encouraging trends in the past weeks, experts warn the US is still not out of the woods -- and Covid-19 variants could pose further challenges. Particularly one variant, which was first identified in the UK. It's now been detected in at least 22 states, according to data posted Friday by the Centers for Disease Control and Prevention. Washington state health officials announced Saturday they found the variant in "testing samples" in the state. "We're now in that second half of fighting this pandemic," Washington Secretary of Health Umair A. Shah said during a news conference. "It's very important for us to really double down on our efforts to prevent this strain as well as any strain from taking over, because we want to make sure that transmission does not happen in our state and the best way to do that is prevention, prevention, prevention." Earlier this month, the CDC warned the variant appeared to be more easily transmissible and its numbers in the US could see "rapid growth" in early 2021. Now scientists at the CDC are speaking with UK health officials to learn more about data suggesting the same variant could be more deadly. A UK report released Friday states there is "a realistic possibility" that the new variant has a higher death rate than other variants. "The data is mounting -- and some of it I can't share -- that clearly supports that B.1.1.7 is causing more severe illness and increased death," infectious disease expert Michael Osterholm said. "Already we know this variant has increased transmission, and so this is more very bad news." But National Institutes of Health Director Dr. Francis Collins said Saturday it's still too soon to tell if the variant is more deadly, telling MSNBC, "this is very preliminary data." "It looks as if, if you look at 1,000 people who got infected with Covid-19, generally about 1%, 10 of them, would die of it. Maybe with this virus, it would be 13 instead of 10," Collins said. "That's a small difference." He added that the numbers could possibly also be a "consequence of the fact that the UK health system is really overwhelmed." "That has an effect also on mortality," Collins added. The good news? Studies so far suggest vaccines will also protect against the variant and that the same measures that can help prevent infections -- including mask wearing, social distancing and regular hand washing -- continue to be key in the effort to curb the spread. More than 20 million vaccine doses administered in US CDC data shows more than 20.5 million vaccine doses have been administered across the country -- with more than 3 million Americans having received both doses. While the vaccine rollout throughout the country has been slower than officials had hoped, Dr. Anthony Fauci said Saturday that if Johnson & Johnson's vaccine is authorized for emergency use, the US could see a significant boost in available doses by May. That vaccine only requires one dose, instead of the two necessary for the current Covid-19 vaccines. "I would anticipate that within a period of likely no more than two weeks, that the data will be looked at by the Data and Safety Monitoring Board," Fauci told MSNBC. And if the data is strong enough, the next step would be presenting it to the Food and Drug Administration for an emergency use authorization, he said. "Let's say they do ... get an EUA in February, by the time they get a meaningful amount of doses, it likely will be a month or two following that," he said. "Once they get going into May, June, July, August, then you're going to see a sharp escalation of additional doses of this one-dose vaccine." Meanwhile, the FDA also told CNN Saturday that if absolutely necessary, "modest delays" between first and second doses of the current Covid-19 vaccines are not expected to decrease protection against the virus. The agency said it "recognizes that getting as many people as possible across the country fully immunized will help to curtail the spread of the virus that causes COVID-19 and should be a priority." Previously, the FDA had warned changes to vaccine schedules without appropriate data could put public health at risk. The CDC also updated its guidance to say second doses of vaccines may be scheduled up to six weeks after initial doses, if necessary, adding second doses should be administered as close as possible to the recommended interval -- three weeks after the first dose for the Pfizer/BioNTech vaccine and four weeks for the Moderna vaccine. Hospital leader: 'We truly are in the darkest days' That all comes as the US continues to fight a brutal battle against the virus. More than 113,600 Americans are hospitalized with the virus nationwide, according to the COVID Tracking Project. Los Angeles County -- which for weeks has been the epicenter of the state's Covid-19 crisis -- has now surpassed 15,000 Covid-19 deaths, health officials said Saturday. And more than 6,800 people remain hospitalized with the virus -- 24% of whom are in the ICU. "While we are seeing some positive data in daily new cases and hospitalizations, we are far from out of the woods," Public Health Director Barbara Ferrer said in a statement. "It is critically important we slow COVID-19 spread to decompress the strain on our healthcare system and save lives." In Georgia, one healthcare official described a grim image of the grip of the virus. "We truly are in the darkest days of this pandemic," Dr. Deepak Aggarwal, at the Northeast Georgia Medical Center, told CNN Saturday night. "We are seeing more than 200 patients per day now, than we normally see at this time of the year. " "And also, we're dealing with the increasing number of deaths. Our system normally deals with less than 10 deaths per month and we have already had 169 deaths as of January 21." CNN's Michael Nedelman, Lauren Mascarenhas, Elizabeth Cohen and Carma Hassan contributed to this report.
The latest on the coronavirus pandemic and vaccines: Live updates - CNN International
The coronavirus pandemic has brought countries to a standstill. Meanwhile, vaccinations have already started in some countries as cases continue to rise. Follow here for the latest.
The first patient in the UK has received the Oxford University/AstraZeneca vaccine. Brian William Pinker, 82, received the shot early Monday morning at the Churchill Hospital in Oxford. "I am so pleased to be getting the Covid vaccine today and really proud that it is one that was invented in Oxford," he said. The vaccine means everything to me, to my mind it is the only way to get back to normal life. This virus is terrible, isnt it? Pinker said he first knew on Saturday that he was going to get vaccinated and was told he would be the very first patient. Took me long enough to be a star, he said. The AstraZeneca vaccine rollout began today in the UK and the countrys health secretary described it as a real pivotal moment" as Covid-19 cases continue to rise in parts of the country. Chief Nurse Sam Foster, who administered the vaccine, said: It was a real privilege to be able to deliver the first Oxford vaccine at the Churchill Hospital here in Oxford, just a few hundred meters from where it was developed." Pinker is a retired maintenance manager who has been having dialysis for kidney disease at the hospital. Others should get vaccinated too because it is a no brainer, he said. "The nurses, doctors and staff today have all been brilliant and I can now really look forward to celebrating my 48th wedding anniversary with my wife Shirley later this year. The NHS is the first health service in the world to deploy the AstraZeneca vaccine and it's the only one approved that can be stored at fridge temperatures. The first vaccinations will be delivered at a small number of hospitals for the first few days for surveillance purposes, as is standard practice, before the bulk of supplies are sent to more GP-led services later in the week, NHS England said in a statement.
Fitness video games can break your Covid pandemic exercise slump - CNN International
If you're finding it hard to motivate these days, you might consider fitness video games while sheltering in place in the pandemic. Even if you aren't into gaming or workouts, there is something for almost everyone.
(CNN)Some discover their preferred method of exercise early on and have the self-discipline to stick with it for decades. The rest of us, well, we get a little bored. Among the many challenges brought on by the pandemic, some far more urgent than others, is the inability to spice up our workout routines. Gyms and exercise studios are either closed or risky, and team sports are far from ideal. Zoom classes and YouTube classes are better than nothing, but the one-sidedness of the interaction makes it oh-so-easy to bring it at 50% -- or less. Exercising outside is becoming less and less appealing as temperatures drop and the sun sets before you've had a chance to digest lunch. If you, too, are finding it hard to motivate these days, you might consider fitness video games. Even if you are not a gamer. Even if you never work out. Fitness video games require you to use your whole body to engage with the game, instead of just your fingers. They've grown in sophistication and variety over the past decades, and are designed to give you an extra incentive to workout. Some do this by gamifying the session, and others by monitoring movement and tracking progress. Texting friends instead of doing another set of lunges? The game will know. "Fitness games give us an immediate reward for doing something that pays off in the long term," said Renee Gittins, executive director of the International Game Developers Association who has consulted on the development of fitness video games. "Unfortunately, humans are not good at processing long-term benefits, so that immediate positive feedback can be a great way to encourage habit creation." Important note: If you experience pain while performing any movements while playing a fitness video game, stop immediately. Check with your doctor before beginning any new exercise program. There is something for almost everyone when it comes to fitness games. Some fitness games are like workout videos or personal trainer sessions, but with an extra interactive twist. Fitness Boxing on Nintendo Switch walks users through a customizable, and challenging, boxing workout. There are also Zumba games for a variety of systems, which make use of controllers or motion sensors to track movements and progress. Other fitness video games offer a more fanciful backdrop for working out. Arms, which is available on Nintendo Switch, is a fighting game in which users choose between a variety of extendable, customizable arms and attempt to knock out opponents in different settings. Common Sense gives it the greenlight for kids 10 and up. Beat Saber, which is a virtual reality game available on PlayStation 4 and other devices, allows users to slice blocks representing musical beats in a neon universe. Ring Fit Adventure, a Nintendo Switch game that comes with a physical ring, is an action game, in which users roam around a large, virtual and brightly colored world and defeat enemies. It offers one of the more challenging workouts. Dance Dance Revolution is one of the oldest fitness video games, dating back to the late 1990s, and requires a floor pad to track movement. The latest versions can be played on a PC; older ones are compatible with Xbox and PlayStation. Just Dance is a simpler, more kid-friendly dance game, Gittins said. Dance games are particularly good at getting heart rates up, which can benefit body and mind. Those with a virtual reality system have a wide range of deeply realized fictional worlds to choose from like Sprint Vector, which mixes extreme sports with an intergalactic game show. Those with no systems can try out cellphone-friendly games like Pokémon Go and Harry Potter Wizards Unite, both of which require users to get moving outside and are also good for kids. Hot tip: For those who have a system and would prefer to try a game before buying one, there is a decent chance your local library has one you could borrow. For many, the ease of these home-based workouts is the big draw. Hweimei Tsou, a 31-year-old self-identified gamer and digital communications manager in the Bay Area, had never found herself in a workout groove before Fitness Boxing. She appreciates how easy fitness games are to integrate into her schedule, and that she can get a targeted, customized workout that taps into her sense of competition. She also finds it fun. "Right when you start the game, it tells you how many calories you have burned this week," Tsou said. "The game helps you find your sweet spot (in terms of exercise intensity), and then it keeps you going by pushing you to your limit." Fitness video games are also appealing to those who don't feel comfortable exercising in front of others. Duane Montague, a 51-year-old account director in Chino Hills, California, lost 65 pounds through the now discontinued Xbox Fitness. It's something the self-described creative type doesn't think would have ever happened in the gym. "The idea of going to the gym, or running on a treadmill or lifting weights ... that's just not me," said Montague. Through the videos and the sensors, he was able to slowly build up his strength and endurance, and make sure he was doing the movements correctly. Eventually, he built up his fitness confidence and did go to the gym; gaming became his supplemental workout. Another perk of fitness gaming is that one can virtually compete or exercise alongside a friend or family member somewhere else as long as both parties have the game and an internet connection. Games like Just Dance, Arms and Beat Saber all have multiplayer capabilities. How fitness games are made Making fitness games tends to be an elaborate process, involving a combination of game designers, sports scientists and test audiences, and it can take years, Gittins said. Often, the goal is to make something that appeals to a wide audience, and not just the gaming crowd. "Game development is an extremely iterative process. It can be very hard to define fun," she said. "They want to make you forget you are working out." There are developers who emphasize the fun and fantasy side of the game, and others focus more on the exercise experience. Some do both. "Nintendo, for example, often works with fitness professionals to make sure they are encouraging proper movement and working multiple muscle groups," she said. As with all workouts, it's a good idea to start slowly. How to make the most of fitness games Julien Tripette, a researcher in physical activity and sports science at the National Institutes of Biomedical Innovation, Health and Nutrition in Japan, said users of these games should be aware of the games' limitations should they become their primary source of exercise. Tripette and his colleagues have researched the effectiveness of active video games and discovered that they don't necessarily lead to a sustained improvement in fitness. "Laboratory studies on active video games are promising," he said, explaining that some games require as much effort as their offline counterparts. "But real-life studies are more conflicted," Tripette said. He said the problem is often that the games lose their appeal after some time and are not replaced with another form of exercise. Or they weren't demanding enough in the first place. There are active video games that are effective at toning muscles or improving balance, but they fail to get one's heart rate up and therefore don't improve cardiovascular health. Tripette said the research supports that the active video games are better than nothing for most people -- particularly those of us housebound during this pandemic winter -- though are less of a sure thing with children. Playing active video games didn't encourage more overall movement or increase fitness in children, according to a 2012 study. That said, this research took place long before advances in graphics, systems and shelter-in-place conditions. Today's children and their parents might see different results. Considering the high levels of cabin fever anticipated by so many people over the next few months, there has never been a better time to experiment with fitness video games. Like Montague, who eased into physical activity with the help of a video game, perhaps you too can use this as a jumping-off point for a more involved exercise routine. You might even want to invest in a simple heart rate tracker along with your new game. Ensuring results can be as simple as asking yourself if you are breaking a sweat during the game. Is your heart beating faster (check that monitor!) and are you returning to the game on a regular basis? If the answer is yes to all of the above, these games might just be the virtual fitness shake-up the whole family needs to establish a fun -- and pandemic-friendly -- exercise habit. Elissa Strauss is a regular contributor to CNN, where she writes about the politics and culture of parenthood.
In Japan, more people died from suicide last month than from Covid in all of 2020. And women have been impacted most - CNN
More people died from suicide in Japan in October than succumbed to Covid-19 all year. And more women are taking their own lives, as they lose part-time work and take on the bulk of family responsibilities at home.
By Selina Wang, Rebecca Wright and Yoko Wakatsuki, CNN Updated 8:47 PM ET, Sat November 28, 2020 Tokyo (CNN)Eriko Kobayashi has tried to kill herself four times. The first time, she was just 22 years old with a full-time job in publishing that didn't pay enough to cover her rent and grocery bills in Tokyo. "I was really poor," said Kobayashi, who spent three days unconscious in hospital after the incident. Now 43, Kobayashi has written books on her mental health struggles and has a steady job at an NGO. But the coronavirus is bringing back the stress she used to feel. "My salary was cut, and I cannot see the light at the end of the tunnel," she said. "I constantly feel a sense of crisis that I might fall back into poverty." Experts have warned that the pandemic could lead to a mental health crisis. Mass unemployment, social isolation, and anxiety are taking their toll on people globally. In Japan, government statistics show suicide claimed more lives in October than Covid-19 has over the entire year to date.The monthly number of Japanese suicides rose to 2,153 in October, according to Japan's National Police Agency.As of Friday, Japan's total Covid-19 toll was 2,087, the health ministry said. Japan is one of the few major economies to disclose timely suicide data -- the most recent national data for the US, for example, is from 2018. The Japanese data could give other countries insights into the impact of pandemic measures on mental health, and which groups are the most vulnerable. "We didn't even have a lockdown, and the impact of Covid is very minimal compared to other countries ... but still we see this big increase in the number of suicides," said Michiko Ueda, an associate professor at Waseda University in Tokyo, and an expert on suicides. "That suggests other countries might see a similar or even bigger increase in the number of suicides in the future." Japan has long struggled with one of the highest suicide rates in the world, according to the World Health Organization. In 2016, Japan had a suicide mortality rate of 18.5 per 100,000 people, second only to South Korea in the Western Pacific region and almost triple the annual global average of 10.6 per 100,000 people. While the reasons for Japan's high suicide rate are complex, long working hours, school pressure, social isolation and a cultural stigma around mental health issues have all been cited as contributing factors. But for the 10 years leading up to 2019, the number of suicides had been decreasing in Japan, falling to about 20,000 last year, according to the health ministry -- the lowest number since the country's health authorities started keeping records in 1978. The pandemic appears to have reversed that trend, and the rise in suicides has disproportionately affected women. Although they represent a smaller proportion of total suicides than men, the number of women taking their own lives is increasing. In October, suicides among women in Japan increased almost 83% compared to the same month the previous year. For comparison, male suicides rose almost 22% over the same time period. There are several potential reasons for this. Women make up a larger percentage of part-time workers in the hotel, food service and retail industries -- where layoffs have been deep. Kobayashi said many of her friends have been laid off. "Japan has been ignoring women," she said. "This is a society where the weakest people are cut off first when something bad happens." In a global study of more than 10,000 people, conducted by non-profit international aid organization CARE, 27% of women reported increased challenges with mental health during the pandemic, compared to 10% of men. Compounding those worries about income, women have been dealing with skyrocketing unpaid care burdens, according to the study. For those who keep their jobs, when children are sent home from school or childcare centers, it often falls to mothers to take on those responsibilities, as well as their normal work duties. Increased anxiety about the health and well-being of children has also put an extra burden on mothers during the pandemic. Akari, a 35-year-old who did not want to use her real name, said she sought professional help this year when her premature son was hospitalized for six weeks. "I was pretty much worried 24 hours," Akari said. "I didn't have any mental illness history before, but I could see myself really, really anxious all the time." Her feelings got worse as the pandemic intensified, and she worried her son would get Covid-19. "I felt there was no hope, I felt like I always thought about the worst-case scenario," she said. In March, Koki Ozora, a 21-year-old university student, started a 24-hour mental health hotline called Anata no Ibasho (A Place for You). He said the hotline, a nonprofit funded by private donations, receives an average of over 200 calls a day, and that the vast majority of callers are women. "They lost their jobs, and they need to raise their kids, but they didn't have any money," Ozora said. "So, they attempted suicide." Most of the calls come through the night -- from 10 p.m. to 4 a.m. The nonprofit's 600 volunteers live around the world in different timezones and are awake to answer them. But there aren't enough volunteers to keep up with the volume of messages, Ozora said. They prioritize the texts that are most urgent -- looking for keywords such as suicide or sexual abuse. He said they respond to 60% of texts within five minutes, and volunteers spend an average of 40 minutes with each person. Anonymously, over online messaging, people share their deepest struggles. Unlike most mental health hotlines in Japan, which take requests over the phone, Ozora says many people -- especially the younger generation -- are more comfortable asking for help via text. In April, he said the most common messages were from mothers who were feeling stressed about raising their kids, with some confessing to thoughts of killing their own children. These days, he says messages from women about job losses and financial difficulties are common -- as well as domestic violence. "I've been accepting messages, like 'I'm being raped by my father' or 'My husband tried to kill me,'" Ozora said. "Women send these kinds of texts almost every day. And it's increasing." He added that the spike in messages is because of the pandemic. Before, there were more places to "escape," like schools, offices or friend's homes. Japan is the only G-7 country where suicide is the leading manner of death for young people aged 15 to 39. And suicides among those under 20 had been increasing even before the pandemic, according to health ministry. As pandemic restrictions take children out of school and social situations, they're dealing with abuse, stressful home lives, and pressures from falling behind on homework, Ozora said. Some children as young as five years old had messaged the hotline, he added. School closures during the pandemic in the spring have contributed to homework piling up; kids also have less freedom to see friends, which is also contributing to stress, according to Naho Morisaki, of the National Center for Child Health and Development. The center recently conducted an internet survey of more than 8,700 parents and children and found that 75% of Japanese schoolchildren showed signs of stress due to the pandemic. Morisaki says he thinks there's a big correlation between the anxiety of children and their parents. "The children who are self-injuring themselves have the stress, and then they can't speak out to their family because probably they see that their moms or dads are not able to listen to them." Stigma of solving the problem In Japan, there is still a stigma against admitting loneliness and struggle. Ozora said it's common for women and parents to start the conversation with his service with the phrase: "I know it's bad to ask for help, but can I talk?" Ueda says the "shame" of talking about depression often holds people back. "It's not something that you talk about in public, you don't talk about it with friends or anything," she said. "(It) could lead to a delay in seeking help, so that's one potential cultural factor that we have in here." Akari, the mother of the premature baby, agrees. She had previously lived in the US, where she says it seems easier to seek help. "When I lived in America, I knew people who went through therapy, and it's a more common thing to do, but in Japan it's very difficult," she said. Following the financial crisis in the 1990s, Japan's suicide rate surged to a record high in 2003, when roughly 34,000 people took their own lives. Experts say the shame and anxiety from layoffs, of mostly men at the time, contributed to depression and increased suicide rates. In the early 2000s, the Japanese government accelerated investment and efforts around suicide prevention and survivor support, including passing the Basic Act for Suicide Prevention in 2006 to provide support to those affected by the issue. But both Ozora and Kobayashi say it has not been nearly enough: reducing the suicide rate requires Japanese society to change. "It's shameful for others to know your weakness, so you hide everything, hold it in yourself, and endure," Kobayashi said. "We need to create the culture where it's OK to show your weakness and misery." A succession of Japanese celebrities have taken their lives in recent months. While the Japanese media rarely details the specifics of such deaths -- deliberately not dwelling on method or motive -- the mere reporting on these cases often causes an increase in suicide in the general public, according to experts such as Ueda. Hana Kimura, a 22-year-old professional wrestler and star of the reality show "Terrace House," died by suicide over the summer, after social media users bombarded her with hateful messages. Hana's mother, Kyoko Kimura, says she was conscious that media reports on her daughter's death may have affected others who were feeling suicidal. "When Hana died, I asked the police repeatedly not to disclose any concrete situation of her death, but still, I see the reporting of information only the police knew," Kimura said. "It's a chain reaction of grief." Kimura said the pandemic led her daughter to spend more time reading toxic social media messages, as she was unable to wrestle because of coronavirus restrictions. Kimura is now setting up an NGO called "Remember Hana" to raise awareness about cyberbullying. "She found her reason to live by fighting as a professional wrestler. It was a big part of her. She was in a really tough situation as she could not wrestle," Kimura said. "The coronavirus pandemic made society more suffocating." In recent weeks, Japan has reported record-high daily Covid-19 cases, as doctors warn of a third wave that could intensify in the winter months. Experts worry that the high suicide rate will get worse as the economic fallout continues. "We haven't even experienced the full economic consequences of the pandemic," Ueda said. "The pandemic itself can get worse, then maybe there's a semi-lockdown again; if that happens, then the impact can be huge." Compared with some other nations, Japan's coronavirus restrictions have been relatively relaxed. The country declared a state of emergency but has never imposed a strict lockdown, for example, and its quarantine restrictions for international arrivals have not been as unbending as those in China. But as cases rise, some worry harsher restrictions will be needed -- and are concerned about how that could affect mental health. "We didn't even have a lockdown, and the impact of Covid is very minimal compared to other countries ... but still we see this big increase in the number of suicides," Ueda said. "That suggests other countries might see a similar or even bigger increase in the number of suicides in the future." Despite having to deal with a salary cut and constant financial insecurity, Kobayashi says she is now much better at managing her anxiety. She hopes that by speaking publicly about her fears, more people will do the same and realize they are not alone, before it's too late. "I come out to the public and say that I have been mentally ill and suffered from depression in the hope that others might be encouraged to speak out," Kobayashi said. "I am 43 now and life starts to get more fun in the middle of my life. So, I feel it's good that I am still alive." How to get help: In the US, call the National Suicide Prevention Lifeline at 1-800-273-8255. The International Association for Suicide Prevention and Befrienders Worldwide also provide contact information for crisis centers around the world.
Why deaths aren't rising as fast in Covid-19's second wave, despite big spikes in new infections - CNN
Europe is drowning in the second wave of the coronavirus epidemic. Infection rates are skyrocketing across the continent. Governments are imposing strict lockdowns. Economies are shutting down again. But there is a glimmer of hope: The virus, while still dead…
(CNN)Europe is drowning in the second wave of the coronavirus epidemic. Infection rates are skyrocketing across the continent. Governments are imposing strict lockdowns. Economies are shutting down again. But there is a glimmer of hope: The virus, while still deadly, appears to be killing fewer people on average. Recent case and fatality figures from the European Centre for Disease Prevention and Control (ECDC) show that while recordedCovid-19 cases are spiking in the United Kingdom, France, Spain, Germany and other European countries, deaths are not rising at the same rate. "The fatality rate has declined, in the UK, we can see it going down from around June to a low point in August," said Jason Oke, a senior statistician at the Nuffield Department of Primary Care Health Sciences. "Our current estimate is that the infection fatality rate is going up a little bit, but it hasn't come up to anywhere near where we were and that's unlikely to change dramatically unless we see a really surprising increase in the numbers of deaths." Oke has been tracking Covid-19 fatality rates along with his colleague Carl Heneghan of the Centre for Evidence-Based Medicine and health economist Daniel Howdon. Their research shows that, at the end of June, the fatality rate was just below 3% in the UK. By August, it had dropped as low as about 0.5%. It now stands at roughly 0.75%. "We think it's probably driven a lot by age, but also other factors, like treatment," Oke said. The lower death rate isn't unique to Europe. In New York, the death rate for those hospitalized with coronavirus-related illnesses has also dropped since earlier this year, according to a study by a team of researchers at NYU Grossman School of Medicine, published in the Journal of Hospital Medicine. Younger, healthier people are getting infected The most obvious reason for the lower death toll is age. The first wave of the pandemic hit Europe's elderly people particularly hard, spreading in hospitals and care homes, but this has changed over the summer, with the virus circulating more widely among younger people going to restaurants, bars and other public places. The median age of those becoming infected across Europe declined from 54 during the period from January to May, to 39 in June and July, according to the ECDC. Older people face a much higher risk of becoming seriously ill if they get infected, so an outbreak affecting a care home is likely to be much more deadly than one on a college campus. In fact, data gathered by researchers from London School of Economics' long-term care responses to Covid-19 group shows that, on average, 46% of all Covid-19 deaths across 21 countries happened in care homes. The researchers found that in several countries, including Belgium, Ireland, Spain, the UK and the US, the proportion of care home residents whose deaths have been linked to coronavirus was higher than 4% in some cases. That means that more than one in 25 care home residents who died since the beginning of the pandemic did so because of Covid-19. With more young people getting infected, the overall fatality rate has dropped, but this doesn't mean the virus itself has become any less deadly. If it starts spreading widely among older people again, the rate may go up once more. This is already happening is some countries, including the UK where Oke and his colleagues have observed a slight increase in the fatality rate. "The Covid-19 virus is very stable, it is not mutating much at all," said Dr. Julian Tang, clinical virologist and honorary associate professor at the University of Leicester. "The variation in severity of Covid-19 illness is really due to individual host immune responses together with age, sex, ethnicity and certain pre-existing medical conditions," he added. Treatments are getting better The demographic shift may have contributed to the lower death toll, but experts suspect the fact that healthcare providers are now more experienced in dealing with Covid-19 patients is another factor. "While Covid-19 remains a terrible disease, our efforts to improve treatment are probably working," said the NYU study's lead author Dr. Leora Horwitz, an associate professor in the Department of Population Health at NYU Langone Health. Horwitz and her team found that, when adjusted for demographic and clinical factors, mortality among those hospitalized within the NYU system dropped from 25.6% in March to 7.6% in August. The way coronavirus patients are treated has also changed. Ventilators, which were used widely early in the pandemic, are now used less because doctors have learned more about how they may injure the lungs of Covid-19 patients. In turn, laying patients face-down, on their stomachs, has become more common as it has been shown to help increase the amount of oxygen getting into some patients' lungs. Statistics show that people who end up in a hospital in the UK are facing better outcomes. The Intensive Care National Audit and Research Centre found that Covid-19 patients treated in intensive care units in England, Wales and Northern Ireland after September 1 had much better chances of survival than those admitted before that: 12% of patients have died since the beginning of September, compared to 39% of those admitted between the start of the pandemic and the end of August. "That suggests that either the treatment is better and [the healthcare workers] know now what to do, or possibly that people are presenting with milder symptoms," Oke said. And although there isn't yet a silver bullet cure for the coronavirus, there are some treatment options that appear to help some patients. The antiviral remdesivir has been approved by the US Food and Drug Administration for the treatment of coronavirus infection. Earlier this month, a World Health Organization-sponsored global study found remdesivir did not help patients survive or even recover faster, but a US study found the drug shortened recovery times for some patients by about a third. Dexamethasone, a steroid, has been used for some of the sickest Covid-19 patients who require ventilation or oxygen, after trials showed it can increase their chances of survival. While the lower death rates do look encouraging, there are plenty of caveats to consider. Covid-19 mortality is calculated as the number of deaths out of the total number of infections, which means it is only accurate if the underlying numbers reflect the reality. And that almost certainly wasn't the case early in the pandemic, when testing wasn't widely available and only those who were seriously ill were tested. "If you only test the symptomatic cases you may massively underestimate the number of infecteds if the proportion of asymptomatic infecteds is large," Tang said, adding that some studies suggest that up to 60% to 70% of Covid-19 cases may be asymptomatic. "So the reported [case fatality rate] may be disproportionately high at the start of the pandemic but then drops later as the pandemic progresses, as we test more asymptomatic cases to 'dilute' down this apparent death rate," Tang added. The main danger, Tang said, is that more widespread testing of the less vulnerable younger population may mask mortality rates in those who are older or have underlying conditions. "There is a risk of complacency," he said. "The elderly, and the vulnerable will still die from Covid-19 related complications ... but this may not be noticed if all age groups with COVID-19 are examined together. The death rate also varies across different countries. According to a tally by Johns Hopkins University, mortality among the 20 worst-affected countries now ranges from 10% in Mexico to 0.8% in the Czech Republic. This is partly down to different approaches to counting their Covid-19 cases. While some count only lab-confirmed infections, others include untested suspected cases. There's also the issue of time lag. "The time difference between when we think people are getting infected and when they might die, on average it's about three weeks, but what we're seeing is that the [infection fatality rate] is staying lower even as the preceding infections have gone up," said Oke.