Across the globe, doctors, researchers and scientists are working around the clock to investigate the ways COVID-19 affects the human body – and there is a lot we are still learning.
Mild vs severe cases: Rate of recovery
Recovery time for those with COVID-19 varies. This is due to a number of factors, including whether a patient has underlying or associated chronic conditions, whether they have a mild or severe case, and whether or not they become critically ill.
Anecdotally, we know that the more critical a case is, the longer the duration of the illness. For severe cases that required hospitalisation, the average amount of time spent undergoing hospital treatment is between seven and 14 days. But for those who become critically ill, needing to go on a ventilator or into intensive care, this number may increase to between 30 and 40 days.
For those with mild symptoms, meaning they did not need hospital care, most experience a shorter illness and recover quickly. However, there are now reports of some people even with mild disease who continue to experience persistent symptoms, and do not return back to usual health – even months later.
COVID-19’s effect: The body can ‘malfunction’
If a patient has a mild illness, they usually experience symptoms such as a fever, cough, sore throat, fatigue and, in some cases, loss of smell or taste.
If a patient is critically ill, that usually means their respiratory system is not working or they have other organ problems – such as severe pneumonia, acute respiratory distress syndrome or sepsis, which can lead to multi-organ failure. In other words, the patient’s body is malfunctioning.
Critical patients may experience prolonged viral shedding – which is the period when the virus is detectable and potentially transmissible. But even if they are no longer infectious with SARS-CoV-2, their critical illness can be prolonged. It is likely that these patients are having an abnormal immune system response, which causes inflammation and injury to the cells lining the small blood vessels, tissue swelling, and injury to the organs themselves.
In the lungs, for example, this injury is called Acute Respiratory Distress Syndrome (ARDS). It develops as a result of injury to the cells lining the lung’s air sacs and the cells lining the small vessels (endothelium) that bring blood to the lungs for oxygen. This causes fluid and proteins to fill up the air sacs, and the injury to the endothelium can activate blood clotting, tissue swelling and low blood oxygen levels.
Sepsis: A life-threatening condition
COVID-19 is known to be a respiratory disease. So how does it cause organs to malfunction and fail? The answer can be found in a life-threatening condition called sepsis.
When faced with any infection, the body and the immune system reacts. But if an infection becomes severe, it can cause an abnormal immune response – like sepsis. If this happens, it is not the infection itself causing problems, but rather the body’s response to the infection, which causes injury to its own tissues and organs.
In some patients with a severe or critical case of COVID-19, the virus makes them sick, invades their lungs and causes severe pneumonia. In some patients, as their body tries to fight the infection it may overreact, and they develop sepsis. The combination of sepsis and COVID-19 means it is no longer just pneumonia in the patient’s lungs. Pneumonia will be there, but the additional abnormal immune response – the sepsis – can cause tissue damage, multi-organ failure and even death. Immunosuppressed people – patients with chronic diseases – are more likely to get sepsis than patients with a normal immune system.
To prevent sepsis from occurring, an effective COVID-19 vaccine is needed, or an antiviral treatment – which is an agent that suppresses a virus’s ability to replicate. But as yet, there are no approved options, so we cannot intervene against the virus in these ways.
Another approach is to modulate a patient’s immune system, asking what we can do to stop the abnormal immune response from causing damage. Steroids, like dexamethasone or hydrocortisone, have shown promise in this regard. They reduce mortality in patients with severe or critical COVID-19. However, if taken for mild cases, steroids do not work and may cause harm and even death.
Supportive care: A mainstay
In the absence of a viable vaccine and while other therapeutics are being tested, supportive care becomes the mainstay from the moment a patient shows the first signs of distress or severe symptoms, signalling that they need an intervention.
One of the first signs can be fast breathing and low oxygen levels, meaning the patient should get oxygen immediately. In patients who are critical, oxygen may need to be delivered via a ventilator or other higher-flow oxygen support systems. Without enough oxygen being pumped around the body via the bloodstream, the body’s cells get more damaged and this may cause the organs to fail faster.
One of the items on the WHO’s Essential Medicine List, oxygen is life-saving and countries should ensure their hospitals have an adequate supply. Good, optimised supportive care that helps maintain the patient’s oxygen level and blood pressure will hopefully allow the body to heal itself. After the organs have healed, the patient can be taken off supportive care so they can recover naturally.
There is still a lot we are learning about COVID-19, but the main symptoms and deficits we are watching out for in the long term are respiratory, neurological, cardiac and physical.
First, we have to monitor former patients to see if the lungs heal and return to their pre-coronavirus state. Next, we must pay attention to neurological problems – psychological or psychiatric concerns, including depression and anxiety, but also poor concentration and complications such as a stroke. Finally, we need to pay attention to a patient’s physical mobility. After weeks in a hospital bed without much movement, the muscles and joints are affected, so we have to track any physical limitations.
Other than these three main areas, we need to monitor any organs that were affected while the patient was in hospital – such as the heart for those who developed cardiac issues. We need to watch to see whether those who experienced heart troubles while in hospital have similar problems later. We know now, that some patients with mild disease, can also experience persistent symptoms such as fatigue, shortness of breath, or headaches and not return to their usual health. Post-COVID-19 disorders need to be better understood.
The long-term immune response to the virus is also something we are slowly figuring out. It is still unclear how much immunity a person has after being infected, how different the immune response is for those who had mild, moderate and severe cases, and how long the immunity will last. Immune responses are complicated, as is our immune system – there is a lot we all still need to learn.
All the products we found to be the best during our testing this year
Throughout the year, CNN Underscored is constantly testing products — be it coffee makers or headphones — to find the absolute best in each respective category.
Our testing process is rigorous, consisting of hours of research (consulting experts, reading editorial reviews and perusing user ratings) to find the top products in each category. Once we settle on a testing pool, we spend weeks — if not months — testing and retesting each product multiple times in real-world settings. All this in an effort to settle on the absolute best products.
So, as we enter peak gifting season, if you’re on the hunt for the perfect gift, we know you’ll find something on this list that they (or you!) will absolutely love.
Beginner baristas and coffee connoisseurs alike will be pleased with the Baratza Virtuoso+, a conical burr grinder with 40 settings for grind size, from super fine (espresso) to super coarse (French press). The best coffee grinder we tested, this sleek look and simple, intuitive controls, including a digital timer, allow for a consistent grind every time — as well as optimal convenience.
Best drip coffee maker: Braun KF6050WH BrewSense Drip Coffee Maker ($79.95; amazon.com)
During our testing of drip coffee makers, we found the Braun KF6050WH BrewSense Drip Coffee Maker made a consistently delicious, hot cup of coffee, brewed efficiently and cleanly, from sleek, relatively compact hardware that is turnkey to operate, and all for a reasonable price.
Best single-serve coffee maker: Breville-Nespresso VertuoPlus ($165; originally $179.95; amazon.com)
Among all single-serve coffee makers we tested, the Breville-Nespresso VertuoPlus, which uses pods that deliver both espresso and “regular” coffee, could simply not be beat for its convenience. Intuitive and a snap to use right out of the box, it looks sleek on the counter, contains a detached 60-ounce water reservoir so you don’t have to refill it with each use and delivers perfectly hot, delicious coffee with a simple tap of a lever and press of a button.
Best coffee subscription: Blue Bottle (starting at $11 per shipment; bluebottlecoffee.com)
Blue Bottle’s coffee subscription won us over with its balance of variety, customizability and, most importantly, taste. We sampled both the single-origin and blend assortments and loved the flavor of nearly every single cup we made. The flavors are complex and bold but unmistakably delicious. Beyond its coffee, Blue Bottle’s subscription is simple and easy to use, with tons of options to tailor to your caffeine needs.
Best cold brewer coffee maker: Hario Mizudashi Cold Brew Coffeepot ($25; amazon.com)
This sleek, sophisticated and streamlined carafe produces 1 liter (about 4 1/4 cups) of rich, robust brew in just eight hours. It was among the simplest to assemble, it executed an exemplary brew in about the shortest time span, and it looked snazzy doing it. Plus, it rang up as the second-most affordable of our inventory.
Best nonstick pan: T-fal E76597 Ultimate Hard Anodized Nonstick Fry Pan With Lid ($39.97; amazon.com)
If you’re a minimalist and prefer to have just a single pan in your kitchen, you’d be set with the T-fal E76597. This pan’s depth gives it multipurpose functionality: It cooks standard frying-pan foods like eggs and meats, and its 2 1/2-inch sides are tall enough to prepare recipes you’d usually reserve for pots, like rices and stews. It’s a high-quality and affordable pan that outperformed some of the more expensive ones in our testing field.
Best blender: Breville Super Q ($499.95; breville.com)
With 1,800 watts of motor power, the Breville Super Q features a slew of preset buttons, comes in multiple colors, includes key accessories and is touted for being quieter than other models. At $500, it does carry a steep price tag, but for those who can’t imagine a smoothie-less morning, what breaks down to about $1.30 a day over a year seems like a bargain.
Best knife set: Chicago Cutlery Fusion 17-Piece Knife Block Set ($119.74; amazon.com)
The Chicago Cutlery Fusion 17-Piece Knife Block Set sets you up to easily take on almost any cutting job and is a heck of a steal at just $119.97. Not only did the core knives included (chef’s, paring, utility and serrated) perform admirably, but the set included a bevy of extras, including a full set of steak knives. We were blown away by their solid construction and reliable execution for such an incredible value. The knives stayed sharp through our multitude of tests, and we were big fans of the cushion-grip handles that kept them from slipping, as well as the classic look of the chestnut-stained wood block. If you’re looking for a complete knife set you’ll be proud of at a price that won’t put a dent in your savings account, this is the clear winner.
Best true wireless earbuds: AirPods Pro ($199, originally $249; amazon.com)
Apple’s AirPods Pro hit all the marks. They deliver a wide soundstage, thanks to on-the-fly equalizing tech that produces playback that seemingly brings you inside the studio with the artist. They have the best noise-canceling ability of all the earbuds we tested, which, aside from stiff-arming distractions, creates a truly immersive experience. To sum it up, you’re getting a comfortable design, a wide soundstage, easy connectivity and long battery life.
Best noise-canceling headphones: Sony WH-1000XM4 ($278, originally $349.99; amazon.com)
Not only do the WH-1000XM4s boast class-leading sound, but phenomenal noise-canceling ability. So much so that they ousted our former top overall pick, the Beats Solo Pros, in terms of ANC quality, as the over-ear XM4s better seal the ear from outside noise. Whether it was a noise from a dryer, loud neighbors down the hall or high-pitched sirens, the XM4s proved impenetrable. This is a feat that other headphones, notably the Solo Pros, could not compete with — which is to be expected considering their $348 price tag.
Best on-ear headphones: Beats Solo 3 ($119.95, originally $199.95; amazon.com)
The Beats Solo 3s are a phenomenal pair of on-ear headphones. Their sound quality was among the top of those we tested, pumping out particularly clear vocals and instrumentals alike. We enjoyed the control scheme too, taking the form of buttons in a circular configuration that blend seamlessly into the left ear cup design. They are also light, comfortable and are no slouch in the looks department — more than you’d expect given their reasonable $199.95 price tag.
The Stila Stay All Day Liquid Lipstick has thousands of 5-star ratings across the internet, and it’s easy to see why. True to its name, this product clings to your lips for hours upon hours, burritos and messy breakfast sandwiches be damned. It’s also surprisingly moisturizing for such a superior stay-put formula, a combo that’s rare to come by.
The Stila Stay All Day Waterproof Liquid Eyeliner is a longtime customer favorite — hence its nearly 7,500 5-star reviews on Sephora — and for good reason. We found it requires little to no effort to create a precise wing, the liner has superior staying power and it didn’t irritate those of us with sensitive skin after full days of wear. As an added bonus, it’s available in a whopping 12 shades.
The Steelcase Series 1 scored among the highest overall, standing out as one of the most customizable, high-quality, comfortable office chairs on the market. At $415, the Steelcase Series 1 beat out most of its pricier competitors across testing categories, scoring less than a single point lower than our highest-rated chair, the $1,036 Steelcase Leap, easily making it the best bang for the buck and a clear winner for our best office chair overall.
Best ergonomic keyboard: Logitech Ergo K860 ($129.99; logitech.com)
We found the Logitech Ergo K860 to be a phenomenally comfortable keyboard. Its build, featuring a split keyboard (meaning there’s a triangular gap down the middle) coupled with a wave-like curvature across the body, allows both your shoulders and hands to rest in a more natural position that eases the tension that can often accompany hours spent in front of a regular keyboard. Add the cozy palm rest along the bottom edge and you’ll find yourself sitting pretty comfortably.
Best ergonomic mouse: Logitech MX Master 3 ($99.99; logitech.com)
The Logitech MX Master 3 is an unequivocally comfortable mouse. It’s shaped to perfection, with special attention to the fingers that do the clicking. Using it felt like our fingers were lounging — with a sculpted ergonomic groove for nearly every finger.
Best ring light: Emart 10-Inch Selfie Ring Light ($25.99; amazon.com)
The Emart 10-Inch Standing Ring Light comes with a tripod that’s fully adjustable — from 19 inches to 50 inches — making it a great option whether you’re setting it atop your desk for video calls or need some overhead lighting so no weird shadows creep into your photos. Its three light modes (warm, cool and a nice mix of the two), along with 11 brightness levels (among the most settings on any of the lights we tested), ensure you’re always framed in the right light. And at a relatively cheap $35.40, this light combines usability and affordability better than any of the other options we tested.
Best linen sheets: Parachute Linen Sheet Set (starting at $149; parachute.com)
Well made, luxurious to the touch and with the most versatile shopping options (six sizes, nine colors and the ability to order individual sheets), the linen sheets from Parachute were, by a narrow margin, our favorite set. From the satisfying unboxing to a sumptuous sleep, with a la carte availability, Parachute set the gold standard in linen luxury.
Best shower head: Kohler Forte Shower Head (starting at $74.44; amazon.com)
Hands down, the Kohler Forte Shower Head provides the best overall shower experience, offering three distinct settings. Backstory: Lots of shower heads out there feature myriad “settings” that, when tested, are pretty much indecipherable. The Forte’s three sprays, however, are each incredibly different and equally successful. There’s the drenching, full-coverage rain shower, the pulsating massage and the “silk spray” setting that is basically a super-dense mist. The Forte manages to achieve all of this while using only 1.75 gallons per minute (GPM), making it a great option for those looking to conserve water.
Best humidifier: TaoTronics Cool Mist Humidifier (starting at $49.99; amazon.com)
The TaoTronics Cool Mist Humidifier ramped up the humidity in a room in about an hour, which was quicker than most of the options we tested. More importantly, though, it sustained those humidity levels over the longest period of time — 24 hours, to be exact. The levels were easy to check with the built-in reader (and we cross-checked that reading with an external reader to confirm accuracy). We also loved how easy this humidifier was to clean, and the nighttime mode for the LED reader eliminated any bright lights in the bedroom.
Best TV: TCL 6-Series (starting at $579.99; bestbuy.com)
With models starting at $599.99 for a 55-inch, the TCL 6-Series might give you reverse sticker shock considering everything you get for that relatively small price tag. But can a 4K smart TV with so many specification standards really deliver a good picture for $500? The short answer: a resounding yes. The TCL 6-Series produces a vibrant picture with flexible customization options and handles both HDR and Dolby Vision, optimization standards that improve the content you’re watching by adding depth to details and expanding the color spectrum.
Best streaming device: Roku Ultra ($99.99; amazon.com)
Roku recently updated its Ultra streaming box and the 2020 version is faster, thanks to a new quad-core processor. The newest Ultra retains all of the features we loved and enjoyed about the 2019 model, like almost zero lag time between waking it up and streaming content, leading to a hiccup-free streaming experience. On top of that, the Roku Ultra can upscale content to deliver the best picture possible on your TV — even on older-model TVs that don’t offer the latest and greatest picture quality — and supports everything from HD to 4K.
Best carry-on luggage: Away Carry-On ($225; away.com)
The Away Carry-On scored high marks across all our tests and has the best combination of features for the average traveler. Compared with higher-end brands like Rimowa, which retail for hundreds more, you’re getting the same durable materials, an excellent internal compression system and eye-catching style. Add in smart charging capabilities and a lifetime warranty, and this was the bag to beat.
Best portable charger: Anker PowerCore 13000 (starting at $31.99; amazon.com)
The Anker PowerCore 13000 shone most was in terms of charging capacity. It boasts 13,000 mAh (maH is a measure of how much power a device puts out over time), which is enough to fully charge an iPhone 11 two and a half times. Plus, it has two fast-charging USB Type-A ports so you can juice a pair of devices simultaneously. While not at the peak in terms of charging capacity, at just $31.99, it’s a serious bargain for so many mAhs.
Trump’s misleading tweet about changing your vote, briefly explained
Searches for changing one’s vote did not trend following the recent presidential debate, and just a few states appear to have processes for changing an early vote. But that didn’t stop President Trump from wrongly saying otherwise on Tuesday.
In early morning posts, the president falsely claimed on Twitter and Facebook that many people had Googled “Can I change my vote?” after the second presidential debate and said those searching wanted to change their vote over to him. Trump also wrongly claimed that most states have a mechanism for changing one’s vote. Actually, just a few states appear to have the ability, and it’s rarely used.
Trump’s claim about what was trending on Google after the debate doesn’t hold up. Searches for changing one’s vote were not among Google’s top trending searches for the day of the debate (October 22) or the day after. Searches for “Can I change my vote?” did increase slightly around the time of the debate, but there is no way to know whether the bump was related to the debate or whether the people searching were doing so in support of Trump.
It was only after Trump’s posts that searches about changing your vote spiked significantly. It’s worth noting that people were also searching for “Can I change my vote?” during a similar period before the 2016 presidential election.
Google declined to comment on the accuracy of Trump’s post.
Trump also claimed that these results indicate that most of the people who were searching for how to change their vote support him. But the Google Trends tool for the searches he mentioned does not provide that specific information.
Perhaps the most egregiously false claim in Trump’s recent posts is about “most states” having processes for changing your early vote. In fact, only a few states have such processes, and they can come with certain conditions. For instance, in Michigan, voters who vote absentee can ask for a new ballot by mail or in person until the day before the election.
The Center for Election Innovation’s David Becker told the Associated Press that changing one’s vote is “extremely rare.” Becker explained, “It’s hard enough to get people to vote once — it’s highly unlikely anybody will go through this process twice.”
At the time of publication, Trump’s false claims had drawn about 84,000 and 187,000 “Likes” on Twitter and Facebook, respectively. Trump’s posts accelerated searches about changing your vote in places like the swing state of Florida, where changing one’s vote after casting it is not possible. Those numbers are a reminder of the president’s capacity to spread misinformation quickly.
On Facebook, the president’s post came with a label directing people to Facebook’s Voting Information Center, but no fact-checking label. Twitter had no annotation on the president’s post. Neither company responded to a request for comment.
That Trump is willing to spread misinformation to benefit himself and his campaign isn’t a surprise. He does that a lot. Still, just days before a presidential election in which millions have already voted, this latest episode demonstrates that the president has no qualms about using false claims about voting to cause confusion and sow doubt in the electoral process.
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Nearly 6,000 civilian casualties in Afghanistan so far this year
From January to September, 5,939 civilians – 2,117 people killed and 3,822 wounded – were casualties of the fighting, the UN says.
Nearly 6,000 Afghan civilians were killed or wounded in the first nine months of the year as heavy fighting between government forces and Taliban fighters rages on despite efforts to find peace, the United Nations has said.
From January to September, there were 5,939 civilian casualties in the fighting – 2,117 people killed and 3,822 wounded, the UN Assistance Mission in Afghanistan (UNAMA) said in a quarterly report on Tuesday.
“High levels of violence continue with a devastating impact on civilians, with Afghanistan remaining among the deadliest places in the world to be a civilian,” the report said.
Civilian casualties were 30 percent lower than in the same period last year but UNAMA said violence has failed to slow since the beginning of talks between government negotiators and the Taliban that began in Qatar’s capital, Doha, last month.
The Taliban was responsible for 45 percent of civilian casualties while government troops caused 23 percent, it said. United States-led international forces were responsible for two percent.
Most of the remainder occurred in crossfire, or were caused by ISIL (ISIS) or “undetermined” anti-government or pro-government elements, according to the report.
Ground fighting caused the most casualties followed by suicide and roadside bomb attacks, targeted killings by the Taliban and air raids by Afghan troops, the UN mission said.
Fighting has sharply increased in several parts of the country in recent weeks as government negotiators and the Taliban have failed to make progress in the peace talks.
The Taliban has been fighting the Afghan government since it was toppled from power in a US-led invasion in 2001.
Washington blamed the then-Taliban rulers for harbouring al-Qaeda leaders, including Osama bin Laden. Al-Qaeda was accused of plotting the 9/11 attacks.
Calls for urgent reduction of violence
Meanwhile, the US envoy for Afghanistan, Zalmay Khalilzad, said on Tuesday that the level of violence in the country was still too high and the Kabul government and Taliban fighters must work harder towards forging a ceasefire at the Doha talks.
Khalilzad made the comments before heading to the Qatari capital to hold meetings with the two sides.
“I return to the region disappointed that despite commitments to lower violence, it has not happened. The window to achieve a political settlement will not stay open forever,” he said in a tweet.
There needs to be “an agreement on a reduction of violence leading to a permanent and comprehensive ceasefire”, added Khalilzad.
1/4 I return to the region disappointed that despite commitments to lower violence, it has not happened. The window to achieve a political settlement will not stay open forever. https://t.co/hVl4b032W6
— U.S. Special Representative Zalmay Khalilzad (@US4AfghanPeace) October 27, 2020
A deal in February between the US and the Taliban paved the way for foreign forces to leave Afghanistan by May 2021 in exchange for counterterrorism guarantees from the Taliban, which agreed to sit with the Afghan government to negotiate a permanent ceasefire and a power-sharing formula.
But progress at the intra-Afghan talks has been slow since their start in mid-September and diplomats and officials have warned that rising violence back home is sapping trust.
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