Features

If you’ve gained weight during the COVID-19 pandemic, you aren’t alone. The “Quarantine 15” — referring to weight gain some people have experienced since stay-at-home guidelines went into effect — is likely due to a disruption in daily routine and habits.

“People’s habits have changed quite a bit since we’re spending more time at home,” says Dr Donald Hensrud, medical director of Mayo Clinic’s Healthy Living Program. And those changes in habits can lead to health and medical issues down the road. Hensrud shares his thoughts on the disruption of habits and how people can find new habits.

“Now, I want to make a point for some people: getting enough food, getting enough calories and maintaining weight may be an issue,” says Hensrud. “Some people may have to worry about maintaining their weight not unintentionally losing weight. But for many of us, our habits have changed.”

Change in movement

“For example, people think about exercise right away, and they should,” says Hensrud. “Fitness centres are closed, people may be doing less exercise and burning less calories through activity that way. What people don’t think quite as much about though is low-level activity throughout the day. Even if we have a desk job, we have to walk at least to our car to get to work. We may walk throughout the day; we may walk to lunch. And, so, for spending time at home, that low-level activity may be causing us to burn fewer overall calories.”

Consuming more calories

“We may be consuming more calories. On the good side, we’re eating out less at restaurants. Sometimes that can be high-calorie. We still may be taking takeout at home, so there might be a little bit of a good thing there, a decrease in calories. However, many people are stocking up frozen foods and processed foods that have a long shelf life. Many times, they’re higher in calories and less healthy. On the flip side, for example, fruits and vegetables. They don’t last as long, and we may be consuming less of them. There are a number of reasons why we might be at risk for weight gain through our habits that have changed, both in burning activity and in consuming more calories,” says Hensrud.

Why weight gain matters

“A few kilos in the short term may not make a difference. It could be fluid. It might be just a little weight gain while we establish new routines. Obviously, the more weight we gain and the longer it’s maintained, the more it affects our health,” says Hensrud. “For children, for example, it’s been shown that children’s weight tracks to some extent. If children establish those habits, or lack of healthy habits when they’re young and they gain weight, that might persist as they go into adolescence and adulthood.”

“Similarly, with adults, as we maintain those habits, if we can establish a new routine, the longer this goes on, then we can arrest that weight gain and try and maintain a normal weight. It’s more important for some people than others. For example, people who have diabetes or high blood pressure. Just a modest amount of weight gain in some people, if they’re sensitive to that, can increase their blood glucose and blood pressure, and they won’t have as well a good control over these factors, over these conditions. So, it depends on the individual, it depends on their health conditions, and it depends on long-term habits or routines,” says Hensrud.

Establish new habits

“With all habits, it takes time to establish them, so everybody is getting accustomed to this new normal. I’d encourage people to establish those new healthy habits now. You have to be a little proactive about this, and that’ll make it easier in the long term. Break out of your comfort zone,” says Hensrud.

“Instead of giving in to large amounts of comfort food, this can be an opportunity to take foods that we may not think of as healthy — you can make burritos, bean burritos or even pizza. If you make it in the correct way, it can be a healthy food. Invest some time. Planning is a real key here if you plan ahead rather than just grabbing something at the last moment. Try and raise your culinary skills and do a little bit more cooking. It’s an opportunity for that, too. So, if we can embrace this, embrace our new normal, look for opportunities to establish new healthy routines.”

“Eating healthy and eating well don’t have to be drudgery. It can and should be an enjoyable way to live. And if we can do that, then we can better manage our weight and our overall health during this pandemic,” says Hensrud.

LOS ANGELES — At a flotation therapy studio in Marina Del Rey, California, the sensory deprivation tank is empty, but antibody tests for the coronavirus are selling at $149. Customers of a botox clinic in Venice don’t even have to get out of their cars to get tested; a worker collects blood samples with the prick of a finger.

A banner for a clinic in Las Vegas advertises antibody tests and throws in a doctor visit for $169. And $125 antibody tests have recently been added to the menu at a chiropractic clinic in Florida that also offers libido-boosting vitamins and nonsurgical face-lifts.

The test-takers, from nurses and firefighters to the unemployed, seek a sense of certainty. They ache to know whether a flu they had was in fact COVID-19, the disease caused by the novel coronavirus. Some hope a positive result means they can throw out their masks. Others want certificates showing employers they are immune and can go back to work.

Not so fast, experts say. In the time of pandemic, opportunities can swing open for the nimble entrepreneur: storefront clinics and fancy spas once dedicated to beauty and wellness treatments now offer peace of mind through antibody testing. But misplaced trust in the tests, expert say, could be jeopardising public health at large.

The tests don’t necessarily tell people whether they are immune to COVID-19 because scientists haven’t confirmed whether the antibodies even prevent re-infection. Most of the more than 200 tests on the market

For several weeks, the Food and Drug Administration had allowed manufacturers to market antibody tests without supplying evidence that they are accurate. There is no FDA-approved test for antibodies related to COVID-19. And only 12 tests have been granted emergency authorisation, which meets a lower standard.

Last week the agency, after heightened scrutiny from lawmakers, tightened its policies on unregulated tests

Jim Flanigan, executive vice president of the American Society for Clinical Laboratory Science, expressed concern about the confusing nature of the regulations. “It truly could be snake oil,” he said of antibody tests that don’t have FDA authorisation. “Without that, people can claim whatever they like and there seems to be no recourse.”

Antibody tests are different than the nasal or oral swab exams that diagnose an active COVID-19 infection. Also known as serology tests, antibody tests signal whether a patient has been exposed to the virus in the past. Sometimes patients sit for a traditional blood draw that fills a whole vial and is shipped to a lab. Other times patients have their finger pricked for a single drop that’s analysed in about 10 minutes.

Antibody testing plays an important role in large studies because those can give a wide snapshot of the spread of the disease. But experts are sceptical about the tests being marketed to individuals.

The tests are advertised on everything from Instagram to roadside tents. Many of them are made in the US, but products from other countries have also entered the market, including some from China that have raised serious concerns over their quality.

At least one major pharmacy chain, Walgreens, is offering antibody tests, in partnership with LabCorp, that have received emergency authorisation from the FDA. At smaller clinics, though, it can be difficult for the average consumer to find out who makes the test being offered and whether it’s authorised.

Alpha Hydration Services, which operates an IV therapy lounge in Woodland Hills, sells a rapid finger-stick blood test for $125. The venue specialises in hooking people up to IVs for “beauty drips” or “wellness drips” of vitamins but doesn’t normally provide blood testing.

The owner, Dwayne Mariner, a registered nurse, said a local vendor sold him the tests, which he believes were made in Asia and bear the name iCare. He said they have only about 70 per cent accuracy. iCare is not among the manufacturers that have received emergency authorisation from the FDA.

“Clinically, you could use this as a guideline for being out in public. Maybe you don’t need a mask while you’re walking around the neighbourhood” if you test positive for antibodies, he said.

Mariner said he does not advise his patients on how to interpret the results and acknowledged the tests haven’t been rigorously inspected. Still, he suggested that patients who test positive for antibodies could use the information to determine for themselves whether to get a COVID-19 vaccine, once one is available.

“It gives someone more peace of mind if they didn’t want to get the vaccine anyway,” he said.

His comments are disputed by experts. It’s likely that people with positive antibody tests will still need the vaccine because scientists have not established that antibodies confer any immunity to COVID-19.

At the HOT Clinic, an IV therapy centre in Encino, operations manager Edward Zaghikian said previously symptomatic patients who test negative for an active infection and either negative or positive for the presence of antibodies, then get tested again with the same results, can present the information to an employer showing they’re safe to return to work.

“You could take a calculated risk that it could be OK to come back to work,” said Zaghikian, whose company has administered about 1,500 of its $95 rapid antibody tests. He reasoned that a positive antibody test would mean the person has some immunity, and a negative result would mean they were never exposed and are thus virus-free.

But infectious disease experts warn against this logic. Just because someone had not previously been exposed to the virus doesn’t mean they won’t be in the future. The antibody tests shouldn’t be used to make any life decisions, they say.

“I think it is unwise for places to sell [the tests] because we do not know what the results of the test mean or what to do with that information,” said Davey Smith, a professor of medicine and head of UC San Diego’s Division of Infectious Diseases and Global Public Health.

Danielle Ompad, a professor of epidemiology at New York University, said the setting where people get tested matters, including whether healthcare professionals are on hand to explain what the test results mean for their patients going forward.

“If your chiropractor doesn’t normally do diagnostic testing, you shouldn’t be getting these tests done there,” she said.

And because there are potential flaws in this first generation of antibody tests, she said, people should stick to those that have received emergency authorisation from the FDA.

Few tests being marketed — including ones from established labs — have such authorisation.

A $249 antibody test at Next Health, a longevity centre in Los Angeles, hasn’t been cleared by the FDA. The test’s manufacturer, Vibrant America, a certified lab, validated the test internally and has an application for emergency authorisation pending before the federal agency.

Darshan Shah, founder and chief executive of Next Health, says he’s offering the test because he wants to give patients as much information as possible about their health during the pandemic. Shah, a physician, acknowledged the tests don’t have huge clinical significance in signalling how patients should be treated going forward or whether they can take fewer precautions, but his clinic is working to facilitate possible plasma donation by those who test positive for antibodies.

A rapid blood test made by Phamatech, available at the Westside Walk-in Clinic in Venice, which focuses on botox and coolsculpting, also doesn’t have emergency authorisation from the FDA. Hannah Veal, the clinic’s owner, said she felt confident in selling it because the manufacturer has a good track record in rapid tests and has also submitted its validation data to the FDA, awaiting authorisation.

Ideally, Veal said, she would only offer a test that has received emergency authorisation.

“The problem is we are not in an ideal world right now. The reality is if manufacturers are making a test with 95 per cent accuracy, why not offer it?” said Veal, a physician’s assistant, adding that she is open with her customers about the fact that the test is not FDA-approved.

Veal said some of her patients who test negative for the antibodies are disappointed that they have to continue wearing a mask. She said she counsels clients they shouldn’t get rid of their masks no matter their results.

Results from antibody tests could be sent to the federal Centres for Disease Control and Prevention, but it’s unclear whether the agency is receiving results from all possible test administrators.

Experts say the tests may not even be worth getting for individual patients, other than to satisfy their curiosity.

“From a clinician’s perspective, [the testing] probably is not very useful right now,” said Flanigan, of the laboratory science group.

“I cannot think of any circumstances under which people in massage parlours or float tank studios should be giving people antibody tests,” he said.

By Maya Lau

NEW YORK — Decades after grunge's reluctant poster boy took his own life, Kurt Cobain's guitar played during his legendary MTV Unplugged performance is hitting the auction block at a starting estimate of $1 million.

The retro acoustic-electric 1959 Martin D-18E Cobain strummed for Nirvana's career-defining performance in New York — just five months before his shock death at age 27 — will be open to the highest bidder the weekend of June 19th in Beverly Hills and online via Julien's Auction's.

Considering the starting estimate of $1 million for Cobain's guitar, it will likely go for more than double that of a guitar that played a key role in Bob Dylan's artistic evolution from folk to rock, which in 2018 fetched just under half a million.

Nirvana's acoustic performance during the taping for the popular MTV Unplugged series on November 18th, 1993 became what is considered one of history's greatest live albums.

It included renditions of Nirvana's hits "About A Girl" and "Come As You Are" along with covers including David Bowie's "The Man Who Sold the World."

The guitar will be on display in the front window of London's Piccadilly Circus Hard Rock Cafe starting May 15 until May 31.

Other Cobain memorabilia going up for sale includes a black custom-made and smashed Fender Stratocaster guitar played during 1994's In Utero Tour — starting at $60,000 — and a metallic silver lame long sleeve button-down shirt the artist wore in the 1993 "Heart-shaped Box" music video, starting at $10,000.

In October 2019 Cobain's iconic cigarette-singed cardigan worn during the "Unplugged" performance sold for $334,000.

And a paper plate Cobain had eaten pizza off of — and then written a Nirvana set list on for a performance at Washington's intimate 9:30 club — that same year went for $22,400.

WASHINGTON — In a world suddenly fearful of touch, voice technology is getting a fresh look.

Voice-activated systems such as Google Assistant, Amazon Alexa and Apple's Siri have seen strong growth in recent years, and the virus pandemic could accelerate that, analysts say.

Voice assistants are not only answering queries and shopping, but also being used for smart home control and for a range of business and medical applications which could see increased interest as people seek to limit personal contact.

"Voice has already made significant inroads into the smart home space and voice control can mean avoiding commonly touched surfaces around the home from smartphones, to TV remotes, light switches, thermostats, door handles and more," said analyst Jonathan Collins of ABI Research.

The pandemic is likely to provide "additional motivation and incentive for voice control in the home that will help drive awareness and adoption for a range of additional smart home devices and applications," Collins said.

ABI estimates that voice control device shipments for smart home devices hit 141 million last year, and in 2020 will grow globally by close to 30 per cent.

For the broader market of voice assistants, Juniper Research estimates 4.2 billion devices in use this year, growing to 8.4 billion by 2024, with much of the interactions on smartphones.

Smart locks, doorbells

Collins said he expected to see growing interest in smart locks and doorbells, along with other smart home systems, to eliminate the need for personal contact and face-to-face interaction as a result of the pandemic.

Avi Greengart, a technology analyst and consultant with Techsponential, said data is not yet available but that "anecdotally, voice assistant usage is way up" as a result of lockdowns.

Greengart said he expects a wider range of business applications for voice technologies in response to health and safety concerns.

"Looking forward, office spaces will need move towards more touch-free controls; voice can be a solution, although motion triggers for lighting is often easier and more friction-free," he said.

"However, I do expect smart speakers — along with an emailed list of commands — to be a common feature at hotels and other rental properties. The fewer touch points, the better."

Post-pandemic outlook

Julian Issa of Futuresource Consulting said there appears to be "an uptick in the use of voice assistants since the virus outbreak" during the pandemic.

"Whilst avoiding touching surfaces may play a small part in this, it is mainly due to consumers spending far more time at home with their devices," Issa said.

Chris Pennell, another Futuresource analyst, said he expects adoption of digital assistants is likely to accelerate, "especially in client facing areas such as healthcare, retail and entertainment."

One example of this already in use is a Mayo Clinic tool using Amazon Alexa which allows people to assess their symptoms and access information on the virus.

Other medical applications are also in the works for voice technologies.

Veton Kepuska, a Florida Tech computer engineering professor who specialises in speech recognition technologies, is seeking to develop voice-activated medical robots that can help limit physical contact and contagion.

"If we had this infrastructure in place, we would have been better off today," said Kepuska, who was spurred by the COVID-19 outbreak to seek funding for the research effort.

Kepuska said this effort could lead to a "humanoid" medical robot that can take over many tasks from doctors or nurses with voice interaction.

"The pandemic has created a situation where we need to think about how to deliver services to people who need our help without putting ourselves in danger," he said.

By Rob Lever

A quick, comfortable and highly well equipped midsize premium crossover utility vehicle (CUV) introduced last year, the Lincoln Nautilus is both successor and evolution of the Lincoln MKX, circa 2016. 

The second to junior model in an expanding and revitalised model range now consisting primarily of SUVs and crossovers, the Nautilus ditches both its nominal predecessor’s nomenclature and ‘eagle wing’ grille design for a look and naming strategy more in tune with Lincoln’s emerging model range, and includes a number of tech, design and hardware improvements including a new 8-speed gearbox and down-sized entry-level engine option.

Sporty sensibility

Stylish and perhaps classier and more conservative in grille design than its somewhat more flamboyantly futuristic predecessor, the Nautilus is built on the same platform as the MKX and shares much in common. But nevertheless, it strikes a more mature and grounded chord with its new, broad and rectangular chrome mesh grille. Beyond its front fascia re-design and the adoption of a more expressive and emotive name, the Nautilus is otherwise little changed aesthetically. Comparatively compact, low and wide, the Nautilus’ dimensions have a sporty and seemingly ground-hugging demeanour, yet it enjoys generous ground clearance.

Styled to more closely resemble Lincoln’s flagship Continental saloon and Navigator SUV flagships, albeit with its own eager and pouncing sensibility, the Nautilus similarly adopts subtle improvements inside for a more upmarket cabin feel. Focusing on the passenger and driver experience inside, the Nautilus’ cabin is quiet and refined, utilising noise cancellation technology, while an optional panoramic roof provides and airy ambiance. Incorporating quality leathers and materials with uncomplicated, sleek and user-friendly layouts, the Nautilus also features vertical dash-mounted pushbutton gearbox controls coupled with steering-mounted paddle shifters for manual mode driving.

Urgent abilities

Offered with choice of two direct injection turbocharged engines including a 2-lire 4-cylinder entry-level version, the driven range-topping Nautilus is powered by a twin-turbo 2.7-litre V6. Potent and efficient, the Nautilus 2.7T’s engine is inherited from its MKX predecessor and proves just as prodigious, eager and responsive here. Developing 335BHP at 5,500rpm and 380lb/ft torque at 3,250rpm the 2-tonne all-wheel-drive Nautilus digs and darts through 0-100km/h in approximately 6.5-seconds along to an urgent yet subdued snarling soundtrack. Fuel economy is meanwhile estimated at around 11.2l/100km on the combined cycle.

Eager off the line with its four-wheel-drive traction and quick spooling turbos courtesy of short gas flow paths, the Nautilus 2.7T almost all but eliminates turbo lag and sets off with confident alacrity. A star among Ford and Lincoln engines, the Nautilus’s twin-turbo 2.7 pulls hard and energetically from low-end, and builds urgently to a muscularly flexible mid-range, helped by a smooth and quick-shifting 8-speed automatic gearbox. Versatile in mid-range, the Nautilus overtakes effortlessly and accumulates speed with verve, but nevertheless remains eager and willing to its comparatively high 6,500rpm rev limit.

Confidence and comfort

Responsive to throttle input for accurate control and with an intense power build-up underwritten by a rich and broad layer of torque, the Nautilus delivers a distinctly sporty experience coupled with a luxurious ambiance in a relatively un-sporty segment. If not a dedicated sports CUV, the Nautilus nevertheless turns into corners tidily, with its 265/40R21 tyres and wide track providing reassuring road-holding and stability. Meanwhile its disconnectable all-wheel-drive system allocates power to the rear when needed for additional traction, and its’ speed sensitive steering is quick and precise with decent road feel for its class.

Direct, responsive and with a quick ratio, the Nautilus’ steering allows one to keep both hands on the wheel in most situations, and is offered with an optional evasive steering assistance and forward sensing safety system to avoid collisions. Confident, poised and stable at speed, the Nautilus is well refined from noise, vibration and harshness, and is available with adaptive dampers in 2.7T specification, which serve to tighten through corners to tautly contain body lean. Adaptive dampers meanwhile also provide a comfortably smooth ride on straights, despite vast optional 21-inch alloy wheels and low profile tyres.

Classy and contemporary

Supple over imperfections in town and on highway bar the sharpest of cracks and bumps, the Nautilus is a forgiving and comfortable ride, and feels fluent and settled with good rebound control over dips and crests. Refined, luxuriously appointed with soft textures and surfaces, the Nautilus is well-organised inside, and features clear instrumentation, good front visibility and comfortable, supportive and 22-way adjustable front seating. Spacious inside, the nautilus can accommodate 1053-litres of luggage when loaded to the roof, which expands up to a cavernous 1948-litres with the rear seats folded.

Setting its stall in the more individualist end of the premium segment, not too unlike Audi or Saab would have been positioned not too long ago, the Nautilus has a clean and contemporary style inside and out. Meanwhile, standard equipment is generous, and optional features are extensive and include driver assistance systems such as stop/go adaptive cruise control, lane-keeping and centring assistance, blind-spot warning, cross-traffic alert system for when backing out of a parking spot, and pre-collision assistance with pedestrian detection. Also available are a 360° camera and parking assistance system that helps to manoeuvre into spaces.

Specifications

• Engine: 2.7-litre, transverse, twin-turbocharged V6-cylinders
• Bore x stroke: 83 x 83mm
• Compression ratio: 10:1
• Valve-train: 24-valve, DOHC, direct injection
• Redline: 6,500rpm
• Gearbox: 8-speed automatic, four-wheel-drive
• Gear ratios: 1st 4.48; 2nd 3.15; 3rd 2.87; 4th 1.84; 5th 1.41; 6th 1.0; 7th 0.74; 8th 0.62
• Reverse / final drive: 2.88 / 3.65
• Power, BHP (PS) [kW]: 335 (340) [250] @5,500rpm
• Specific power: 124.3BHP/litre
• Torque, lb/ft (Nm): 380 (515) @3,250rpm
• Specific torque: 191.1Nm/litre
• 0-100km/h: approximately 6.5-seconds (est.)
• Fuel consumption, combined; 11.2-litres/100km (estimate)
• Fuel capacity: 70-litres
• Length: 4,826mm
• Width: 1,999mm (mirrors folded)
• Height: 1,681mm
• Wheelbase: 2,850mm
• Track, F/R: 1,646/1,643mm
• Headroom, F/R: 1,013/995mm
• Legroom, F/R: 1,087/1,005mm
• Shoulder room, F/R: 1,496/1,498mm
• Ground clearance: 198mm
• Cargo volume min/max (to roof): 1,053-/1,948-litres
• Kerb weight: 2,000kg (estimate)
• Weight distribution, F/R: 60/40 per cent
• Towing capacity: 1,587kg
• Suspension, F/R: MacPherson struts / integral link
• Steering: Electric-assisted rack & pinion
• Steering ratio: 17.7
• Turning circle: 12-metres
• Brakes: Ventilated discs, 345mm
• Tyres: 265/40R21

Millions of children may be at risk of missing or delaying their routine childhood vaccines due to the COVID-19 pandemic. Dr Tina Ardon, a Mayo Clinic family medicine specialist, says she understands being thoughtful about taking your children outside the home for doctor’s visits during this time.

“The current situation with the novel coronavirus shows us how scary the world can be when we have a disease that we can’t treat or prevent,” says Ardon. “When we talk about childhood vaccines, the whole concept is that we have vaccines that can prevent serious illnesses that can be harmful and even fatal for our children, so we don’t want to lose that opportunity to stay on top of those things that we have control over right now.”

Immunisations keep children safe by protecting them from vaccine-preventable diseases like measles and whopping cough. They provide immunity before children are exposed to diseases.

One of the greatest concerns is the risk of children missing the measles vaccine.

Measles is a highly contagious virus and one of the most vaccine-preventable diseases. In the US, there were more reported cases of measles in 2019 since 1992. The World Health Organisation reported there were more than 140,000 measles deaths globally — mostly among children under 5 in 2018.

“We know that there have been outbreaks in measles here in the US, and that is a potentially deadly illness that we want to prevent. That’s a vaccine we’ve had a lot of attention on for some time, but we don’t want to get off track with the timing of that vaccine. I also think about pertussis, or whooping cough. That’s another disease that can be extremely harmful for our babies and our younger children, so we want to make sure we are staying on top of the schedule for pertussis, as well,” says Ardon.

Parents are encouraged to follow the Centres for Disease Control and Prevention’s (CDC) vaccination schedule to ensure that their child is protected from disease and illness. The CDC offers a complete list of recommended immunisations for all ages, including infants, adolescents, teens and adults.

Parents and caregivers who are concerned about bringing their children in for an appointment are encouraged to talk with their health care provider and paediatrician.

“Many clinics and hospitals have been weighing the risks and benefits of seeing children in the outpatient setting and making sure we have some good processes in place to make that as safe as possible, knowing how important these vaccines are for the child,” says Ardon.

10 Minutes 38 Seconds in This Strange World

Elif Shafak

London: Viking/Penguin Random House: 2019

Pp. 312

Imagination figures prominently in Elif Shafak’s fiction, whether in how the British-Turkish author tells her stories, or as a trait of her individual characters.

A mix of realism and fantasy enables Shafak to vividly recreate long-ago worlds, as in “The Forty Rules of Love” and “The Architect’s Apprentice”, and equally to depict contemporary society.

In her latest novel, imagination is pushed into a whole new realm, namely, the “10 minutes 38 seconds” during which a dead person’s mind still functions post-mortem.

In Shafak’s rendering, imagination is neither divorced from scientific knowledge, nor an escape from reality, but rather reveals lesser-known aspects of reality or previously unthought-of possibilities. As she declares in a note to the reader: “Many things in this book are true and everything is fiction”. (p. 307)

The concept of post-mortem consciousness structures the novel, which begins with the death of Leila, a prostitute in Istanbul, her body unceremoniously thrown into a rubbish bin. In Part One: The Mind, successive chapters record her thoughts and memories during the “10 minutes and 38 seconds” left to her in this world. “Although her heart had stopped beating, her brain was resisting, a fighter till the end”. (p. 11)

 Starting with her birth, one follows Leila’s childhood in Van in Eastern Turkey, learning what made this brave, intelligent and creative girl flee to Istanbul at the age of 17, where she was sold into prostitution, and her life thereafter.

Throughout this account, Shafak shines a harsh light on the cruelty inflicted on women, on those who are different and those who simply ask inconvenient questions. There is the deception forced upon Leila’s young mother, driving her into mental illness; the birth of her Down’s Syndrome brother; her repressive school experience; her father’s increasingly draconian rules as he becomes a fundamentalist, banning TV, music and reading. Most damaging of all is her sexual abuse by her uncle from the age of six, which the rest of the family denies.

In Istanbul, there is freedom, but it comes with a price. Leila’s murder is the fourth committed against prostitutes in a month, calling attention to the dangers threatening the marginalised.

Parallel to Leila’s memories are references to their historical context, from the Vietnam War and American civil rights movement, to the left-right battles in Istanbul’s streets, the massacre of students in the 1970s, and the UN Security Council’s 1990 authorisation of military intervention in Iraq.

In this way, Shafak zooms in on the link between the injustice suffered by children and the powerless, and the world-wide atrocities of war and racism. She also calls attention to the pervasive influence of American culture in Turkey. At an early age, Leila knew of Rita Hayworth and Elvis Presley and was wild to get her hands on a hula hoop. On a more sinister note, the Sixth Fleet’s 1968 landing in Istanbul’s harbour is a big event.

Still, the novel’s depiction of life and men is not all negative. Leila forges four meaningful friendships that will last her whole, if short, life. A transvestite from Anatolia, a Lebanese dwarf, a Somali who had been trafficked, and a nightclub singer escaping domestic violence — each of them has a story to tell of how she was robbed of her dignity due to being poor and different.

Two men mingle well with these women: Ali, a revolutionary artist with whom Leila experiences a brief period of happiness, and Sinan, her only friend from Van, who follows her to Istanbul. While Sinan loves Leila and shares her open-mindedness, he is a coward. After completing his studies, he takes a routine job and enters into a conventional, not very happy, marriage.

His happiest hours are those spent with Leila and her friends, but he is afraid to introduce them to his family, so he leads a double life. Only in Parts Two and Three, when he joins Leila’s friends to grieve and then to embark on an audacious project to honour her after her death, does he realise he “had to stop hiding, pretending, dividing his life into compartments, and find a way to bring his many realities together”. (p. 299)

Sinan’s awakening highlights the many gems of wisdom imparted by this novel, simple truths that should be obvious but are so often ignored or violated, plunging humanity into crisis after crisis. Through her story, Shafak implicitly argues for a saner world free of violence and discrimination, where people acquire power by working together, by being honest with themselves and others, by accepting differences and empathising with the marginalised. She makes a strong case for the idea that what makes human beings happy is the right thing to do. In Shafak’s dictionary, happiness is a human right.

Into the framework dictated by Leila’s last 10 minutes 38 seconds, Shafak pours the lush, stunning imagery for which she is known, to describe human suffering and to celebrate imagination, courage and diversity. She also engages in a debate with Istanbul and its speckled history, its many contradictory impulses and social groups — “the city where all the discontented and all the dreamers eventually ended up”, Leila and her friends fitting neatly into both categories. (p. 90)

PARIS — The coronavirus' constant mutation is unlikely to have changes its potency or its contagiousness, disease experts say, despite recent research suggesting the emergence of a more virulent strain.

A pre-paper — that is, not reviewed by a collection of the researchers' peers — released last month by Los Alamos National Laboratory claimed to have identified a new strain of the virus.

A mutation on one of the virus' protein spikes made the strain currently circulating in Europe and the United States potentially more potent than the one that emerged from China at the end of last year, the authors claimed.

"The mutation Spike is of urgent concern; it began spreading in Europe in early February, and when introduced to new regions it rapidly becomes the dominant form," they wrote.

They said that any new strain might have implications on the efficacy of treatments or vaccines against COVID-19 currently in development.

The study made headlines but provoked calls for caution from disease experts, mainly due to the fact that the theory of increased transmissibility had not been tested in the lab.

"This variant might have been lucky and got introduced to places outside Wuhan and different approaches to social distancing early on," William Hanage, associate professor at Harvard University's T. H. Chan School of Public Health, said on Twitter.

"Essentially the virus has been mutating... That don't mean that much. Mutations are what happens when genomes replicate. Comes with the territory like showers with the springtime."

'Speculation'

Viruses such as COVID-19 are essentially bundles of coded material — RNA — containing instructions for how to build copies of themselves.

Since they need the cells of another organism in order to replicate, tiny errors occur as the RNA is reproduced, leading to mutations.

A paper by researchers at University College London found that at least 198 sites in the virus' genome had already undergone sustained mutation.

This was "consistent with multiple introductions of the virus to regions throughout the world seeding local transmission events," the authors said.

Reacting to both the UCL and Los Alamos studies, Lawrence Young, professor of Molecular Oncology at the University of Warwick, said any talk of more virulent strains was "speculation" right now.

He noted that unlike other viral diseases such as HIV, COVID-19 doesn't appear to be mutating at a high rate.

"There is currently no compelling evidence that the mutations have had a significant effect on how the virus affects us," he said.

'Virus doing well enough'

In a paper published this week in the journal Virus Evolution, researchers from the University of Glasgow said they had only found evidence of one type of the virus.

"By analysing the extensive genetic sequence variation present in the genomes of the SARS-CoV-2 virus, the evolutionary analysis shows why these claims that multiple types of the virus are currently circulating are unfounded," said Oscar MacLean, from the university's Centre for Virus Research.

"It is important people are not concerned about virus mutations — these are normal and expected as a virus passes through a population."

While mutations don't mean that COVID-19 is getting more potent or more infectious, experts stressed it was still important to track its evolution.

"Sequencing more genomes will help us to better understand the spread of the virus and whether some of the minor changes observed are important in the behaviour of the virus and how we should develop effective vaccines," said Young.

For Ian Jones, a professor of virology at the University of Reading, the issue of mutation was of less importance than testing and treating people who become infected.

"At our cost the virus is doing well enough colonising the human population, I don't see the drive for it to get nastier anytime soon," he said.

By Amélie Bottollier-Depois

LOS ANGELES — Tom Cruise will film his next Hollywood blockbuster on location — 250 miles up in the air and orbiting the Earth once every 90 minutes.

The "Top Gun" star will fly through the stratosphere to shoot an as-yet-unknown film aboard the International Space Station (ISS), NASA recently said.

The American space agency's director Jim Bridenstine confirmed the news on Twitter, saying he was excited that the move would "inspire a new generation of engineers and scientists" to work on space travel.

Cruise, 56, famously still does his own cliff-hanging, car-rolling stunts.

He gained his commercial piloting license after his role in Top Gun as Pete "Maverick" Mitchell, a hotshot US Navy pilot who has a dangerous and reckless flying style, and reportedly flew some aircraft in the long-awaited sequel to the 1986 classic due later this year.

But if his latest daring project goes ahead, Cruise will be the first Hollywood A-lister to appear onscreen from outside the planet's atmosphere.

Entertainment website Deadline Hollywood first reported rumours of the film shoot on the weekend, adding that tech mogul Elon Musk's SpaceX venture was attached to the project.

SpaceX is slated to launch astronauts to space from US soil for the first time in nearly a decade later this month aboard the Crew Dragon, which will dock with the ISS.

Musk and SpaceX have yet to confirm their involvement in the film venture, but Musk responded to Bridenstine's tweet to say the project "should be a lot of fun."

His firm has established itself as a leader in the private space sector with billions of dollars in funding from NASA since the late 2000s, and its rockets have been supplying cargo to the ISS since 2012.

SpaceX was one of three companies awarded almost $1 billion in contracts to build lunar landers, as part of efforts by the United States to return human beings to the moon.

Deadline Hollywood said there were few other details known about Cruise's movie project but reported it was not part of his box office hit franchise "Mission: Impossible."

The seventh film in that series is set to hit screens next year after production was delayed by the coronavirus pandemic.

The concept of herd immunity, or community immunity, has sparked debate about whether it would control the spread of COIVD-19. According to the Centres for Disease Control and Prevention (CDC), herd immunity is a situation in which sufficient proportions of a population are immune to an infectious disease to make its spread from person to person unlikely.

Dr Gregory Poland, a Mayo Clinic infectious diseases expert and director of the Vaccine Research Group, explains the idea behind herd immunity.

“Herd immunity basically means, if you could envision a circle, let’s say, of 100 people inside this circle and if you can imagine the susceptible people being in the centre of that, the more immune people around the susceptible people, the less likely is it that the virus can penetrate in and actually infect somebody,” says Poland.

Acquiring herd immunity can happen with two approaches, and can come with a deadly cost, according to Poland.

“There are really only two ways. [The first is] you become immune because you got infected. In the context of COVID-19 that means you have to be willing to accept a lot of severe illnesses and even deaths to get there,” he explains. “You’ve seen some countries do this and say, ‘No restrictions, we’re going to go for herd immunity.’ In some countries, for example, some of them have done that and they’ve had very high death rates compared to countries that didn’t.”

“Or you have a strategy like a vaccine, where you can make somebody immune by tricking the body into thinking it has seen the virus, make antibodies and that antibody be protective,” says Poland.

Poland says the consequence of going the latter route and implementing social distancing practices means waiting for a vaccine to be developed.

“That means we have lower number of cases, but we push them out longer and slower so we don’t overwhelm the medical system. And at some point we have therapies or a vaccine and overall reduce the burden of infection,” says Poland.

The next big question tends to be how much herd immunity is needed to effectively control the spread of COVID-19? Poland says that’s not yet known.

“We know with influenza we need somewhere around 60 per cent of the population to be immune to have herd protection, with measles it’s about 95 per cent. The novel coronavirus is probably going to fall into the neighbourhood of 70 per cent or so,” says Poland.