Daily briefing: What happens after you survive coronavirus

The long road to full recovery after being hit hard with COVID-19. Plus: why physicians are becoming more hesitant to use ventilators to treat the illness.

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US court: Clean water includes groundwater

The US Supreme Court has ruled that federal law does protect underground water that flows into lakes, rivers and the sea. The case concerned a municipal sewage-treatment plant in Hawaii that pumps around 15 million litres of treated wastewater into underground wells each day. In its decision, the court cited a complex study by the University of Hawaii in Honolulu that demonstrated a link between these discharges and algal blooms and coral-reef damage.

Science | 6 min read

COVID-19 coronavirus outbreak

A member of NGO "Team Humanity" shares handmade protective face masks to migrants.

An aid worker provides protective face masks to migrants in Greece.Credit: Manolis Lagoutaris/AFP/Getty

Refugee camps brace for deadly impacts

Close living quarters, widespread underlying health problems and limited access to sanitation and medical care mean that COVID-19 poses an outsized threat to the 70 million refugees, displaced people and asylum seekers around the world. “Any kind of epidemic is never good, but particularly not this one, where physical distancing is impossible and home isolation is a joke,” says Annick Antierens. (Nature | 3 min read)

Doctors rethink rush to ventilate COVID-19 patients

Mechanical ventilators are crucial for saving the lives of some people with COVID-19 — but physicians are increasingly becoming more hesitant to use them too often. Early data indicate that the survival rates of critically ill people with COVID-19 who are mechanically ventilated appear to be lower than expected. The treatment is invasive — it involves a tube in the airway and sedation — and requires a highly trained operator. “It’s not just about running out of ventilators, it’s running out of expertise,” says pulmonology and critical-care physician David Hill. (Reuters | 11 min read or in graphic form)

Makers turn to their 3D printers to stop COVID-19

Engineers, designers and hobbyists are turning to open-source methods to produce tools for testing and treating coronavirus. Explore some of the most successful designs, the challenges these designs face and how the open-source approach might bring lasting changes to how things are done. (Nature | 8 min read)

Draft remidesivir results released by accident

The premature release of results from a long-awaited clinical trial conducted in China dampens hopes that the antiviral medicine remdesivir might speed recovery of people with COVID-19. According to a summary that was temporarily visible on the World Health Organization website, remdesivir was “not associated with a difference in time to clinical improvement” compared with a standard-of-care control. The drug’s maker, Gilead Sciences, says the post was a draft, included “inappropriate characterization of the study” and didn’t reflect “trends in the data [that] suggest a potential benefit for remdesivir, particularly among patients treated early in disease”. Gilead says the study manuscript is now in peer review. (STAT | 6 min read)

What happens after you survive

For those people who recover from a severe bout of COVID-19, both the illness and the treatment can have lingering effects. Clinicians are learning lessons from other diseases about the physical, cognitive and mental-health problems that might be in store. (Science | 5 min read)

Don’t drink or inject bleach, you could die

Doctors and manufacturers are warning people against injecting or consuming bleach or any household cleaning product after statements by US President Donald Trump in today’s White House coronavirus task force briefing. Responding to research confirming that disinfectants kill the virus on surfaces, Trump suggested researchers investigate whether “we can do something like that, by injection inside”. Trump responded to evidence that sunlight impedes virus transmission via surfaces by suggesting “we hit the body with a tremendous — whether it's ultraviolet or just very powerful light”. Physician Deborah Birx, the US coronavirus response coordinator, stated in the same briefing that light is not a treatment for coronavirus. (BBC | 6 min read)

Read the latest coronavirus news, continuously updated on Nature.

Read Nature’s continuously updated selection of the must-read papers and preprints on COVID-19.

Notable quotable

“I’m kinda loving the minimal FOMO.”

Particle physicist Claire Lee is just one of the record numbers of attendees enjoying the virtual version of the huge April Meeting of the American Physical Society conference. (Nature | 5 min read) (FOMO is ‘fear of missing out’, BTW.)

Features & opinion

The forgotten climate-science pioneer

An ingenious experiment published in an 1856 paper by polymath Eunice Foote was the first to suggest that changes in the atmosphere’s composition could directly affect the climate. Foote’s findings predated John Tyndall’s similar but better-known work by three years, but we don’t know for sure whether Tyndall was aware of them, and her results slipped into obscurity. “I would like to see her known as the mother of global warming and climate change [science],” says historian John Perlin.

Chemistry World | 8 min read

Reference: Foote’s 1856 American Journal of Science and Arts paper

Podcast: Our Denisovan DNA

By combing through the DNA of over 27,000 modern-day Icelanders, researchers have uncovered new insights about the ancient hominin species who interbred with Homo sapiens. Plus, the scent of lemur love, a hidden Viking trade route and ‘gargantuan’ hail.

Nature Podcast | 23 min listen

Subscribe to the Nature Podcast on iTunes, Google Podcasts or Spotify.

Books & culture

A person closes the door on a doomsday bunker converted to shelter civilians

Many former military bunkers, such as this one near Edgemont, South Dakota, are being repurposed into doomsday communities.Credit: Jim Lo Scalzo/EPA-EFE/Shutterstock

Living in a prepper’s paradise

Mark O’Connell’s Notes From An Apocalypse is an eerily prescient mix of confession, political critique, meditation and comic monologue on living in the face of societal collapse. After a journey to various bunkers, including billionaire Peter Thiel’s luxury New Zealand bolthole, O’Connell finds a deeper solace in the way in which children connect with, rather than retreat from, the world.

Nature | 5 min read

Psychiatry in the aftermath of slavery

After emancipation, Georgia’s infamous Milledgeville hospital for people with mental illness began to accept black patients — but segregated them and treated them without concern for the extreme racial violence that they had experienced. Physician and historian Mical Raz examines a new book about the institution by feminist and anti-racist scholar Mab Segrest, which combines archival research with fictionalized scenes.

Nature | 4 min read

Where I work

Andrew Digby crouches down next to a kakapo

Andrew Digby is Science Adviser Kakapo/Takahe for the New Zealand Department of Conservation.Credit: Deidre Vercoe/New Zealand Department of Conservation

Andrew Digby works to protect the kakapo, a critically endangered New Zealand bird. To know them is to love them, Digby says of the large, flightless, nocturnal parrots. During the breeding season, which happens every few years when the rimu tree fruits, Digby spends months on the four predator-free sanctuary islands that are the kakapos’ last refuge.

Quote of the day

“It would be nearly impossible for a cat to briefly become a spacecraft-operations engineer, whether at NASA or ESA.”

The perils of working from home were illustrated when spacecraft-operations engineer Daniel Lakey’s cat invaded a European Space Agency teleconference. (The Atlantic | 6 min read)

This week, our intrepid friend Leif Penguinson is hiding among the beautiful swamp cypress (Taxodium distichum) trees of Sukko Lake, Russia. Can you spot the penguin? The answer will be in Monday’s e-mail, all thanks to Briefing photo editor Tom Houghton.

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Flora Graham, senior editor, Nature Briefing

With contributions by Smriti Mallapaty and Davide Castelvecchi

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