Goodbye, brain scrapers. COVID-19 tests now use gentler nose swabs



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Craig Lockwood and Lucy Crawford

Early COVID-19 images of swabbing from Wuhan, China, looked more like an Ebola news story — health-care workers fully encased in personal protective equipment (PPE), inserting swabs so deeply that brain injury seemed imminent.

As COVID-19 (and testing) spread around the world, there were reports of “brain scraping”, “brain stabbing” or “brain tickling” swabs. Perhaps this was your experience early in the pandemic. Perhaps these stories have put you off getting tested so far.

But if you go to a drive-through clinic today, you’re likely to have a different swab, one that’s briefly inserted and not so far up as before.

So if fear of the swab itself is holding you back from getting tested, here’s what you need to know about these gentler swabs.

‘Brain scrapers’ not used so much in drive-through clinics

The swabs that gave COVID-19 testing its reputation are the nasopharyngeal swabs. Although these are considered the “gold standard” of testing, they are undeniably uncomfortable.

You remove your mask and blow your nose to clear your nasal passages. Then you try not to sneeze, cough or gag while a health worker inserts a long, flexible shaft about 12cm up your nose and into the back of your throat (until there’s resistance). They then swivel the swab against the back of your throat.

The distance for insertion is significant. Close your eyes and imagine a thin shaft being inserted the length of the space between your nostrils and the outer opening of the ear. The health worker needs to rotate the swab to maximise contact with the contents in the back of the nose before removing it.

The swab may cause your eyes to water, a reflex cough or sneeze. Because of this risk, staff must wear full PPE to avoid risk of being exposed to and inhaling infectious particles and aerosols.

This type of swab is still used in some clinics, and different jurisdictions around the world have different testing policies.




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Why some people don’t want to take a COVID-19 test


You’ll be pleased to hear, things changed

As the pandemic evolved, so have methods of testing, with evidence accumulating about how well they work.

For instance, some Australians have had their saliva tested, including Victorians towards the start of the state’s second wave.




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Explainer: what’s the new coronavirus saliva test, and how does it work?


But more widely used now in a typical drive-through clinic are a combined swab of the throat and nose.

You’ll be pleased to know the health worker swabs your throat first before using the same swab up your nose (and not the other way around)! This is the so-called oropharyngeal/nasal swab.

First the health worker will use a tongue depressor to keep your tongue down, then swab the area behind and next to the tonsils. Then they will take a nose swab.

If they take a superficial nose swab, they will ask you to look straight ahead before gently inserting the swab upwards until there’s some resistance. Then they will hold the swab in place for 10-15 seconds while rotating it, before repeating this in the other nostril.

If they take a mid-turbinate nasal (also known as a deep nasal) swab, you will tilt your head back slightly. The health worker will then insert the swab horizontally (instead of vertically) until there’s resistance (about two to three centimetres). They will then gently rotate the swab for 10-15 seconds before repeating on the other side.

Why did the swabs change?

If someone is going to stick a swab stick up our collective noses, the test needs to be accurate and reliable.

But what if other options were almost as good, without so much invasion, coughing and increased exposure risk for health-care workers?

So from late March and into April, organisations including the US Food and Drug Administration and US Centers for Disease Control, and Australia’s Public Health Laboratory Network,
announced they would move away from the deeper nasopharyngeal swabs to using nasal swabs for this type of testing.

The recommendation in Australia is to use a combined throat/deep nasal swab but if the health worker thinks it necessary, a nasopharyngeal swab.

Since then, studies suggest the gap between absolute best (nasopharyngeal) and avoiding a gag or cough-inducing reflex (nasal) might not matter as much as once thought.

Comparative studies show throat/nasal swabs are as sensitive as nasopharyngeal to detect SARS-CoV-2, the virus that causes COVID-19.

Other studies show throat/nasal swabs are practical, cheap, accurate and reliable.

Still not convinced? Your brain really is safe

The accumulating evidence suggests the newer nasal swabs are safe, reliable, cheaper to complete, and less unpleasant. They also save expensive, higher grade PPE for where it is needed — in our health-care facilities.

So with testing rates down in Victoria and calls for more testing in New South Wales, this is a reminder we must continue to test, test, test, as well as practise hand hygiene, social distancing, and wearing masks.




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The Conversation


Craig Lockwood, Associate Professor Implementation Science, JBI and Lucy Crawford, Clinical Lecturer

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Making coronavirus testing easy, accurate and fast is critical to ending the pandemic – the US response is falling far short



There are functional tests for coronavirus, but not enough of them are being done.
AP Photo/Paul Sancya

Zoë McLaren, University of Maryland, Baltimore County

For many people in the U.S., getting tested for COVID-19 is a struggle. In Arizona, testing sites have seen lines of hundreds of cars stretching over a mile. In Texas and Florida, some people were waiting for five hours for free testing.

The inconvenience of these long waits alone discourages many people from getting tested. With the surge in cases, many public testing sites have been reaching maximum capacity within hours of opening, leaving many people unable to get tested for days. Those that do get tested often face a week-long wait to get their test results.

Every person who isn’t tested could be spreading COVID-19 unknowingly. These overstretched testing programs are a weak link in the U.S. pandemic response.

I study public health policy to combat infectious disease epidemics. The key to overcoming this pandemic is to slow transmission of the virus by preventing contagious people from infecting others. A widespread quarantine would accomplish this, but is economically and socially burdensome. Testing offers a way to identify contagious people so they can be isolated to prevent the spread of the disease. This is especially important for COVID-19 because an estimated 40% or more of all people infected with SARS-CoV-2 have few or no symptoms so testing is the only way to identify them.

Some states are doing much better than others. But as a whole, the U.S. is falling far short of the amount of testing needed to control the pandemic. What are the challenges the U.S. is facing? And what is the way forward?

A lab technician using a swab to put a sample into a rapid test machine.
Currently, rapid tests that take about 15 minutes to process are a quick and easy way to diagnose COVID-19 infections, but there are concerns about accuracy.
AP Photo/Carlos Osorio

Testing should be free, easy, fast and accurate

The ultimate goal of testing is for everyone, regardless of symptoms, to know at all times whether they are infected with the coronavirus. To achieve this level of testing, tests should be free, very easy to perform and provide accurate results quickly.

Ideally, free COVID-19 tests would be delivered to everyone directly. The tests would be simple to perform – like a saliva test – and would give a perfectly accurate result within minutes. Everyone could test themselves weekly or anytime they were going to be in close contact with other people.

In this ideal scenario, most, if not all, contagious people would be detected before they could spread the virus to others. And because of the rapid results, there would be no burden of quarantining between doing the test and getting the result.

Researchers are working on better-quality tests, but access is a problem of infrastructure, not science. Right now, nowhere in the U.S. comes close to meeting surging demand for testing.

A line of people waiting in cars in front of a sign for COVID-19 testing.
Long lines, slow turnaround times for results and shortages of testing capacity all make Texas one of the worst places to get a test in the U.S.
AP Photo/David J. Phillip

One of the worst cases: Texas

The difficulty of getting a COVID-19 test varies by state, but currently, people in Texas face some of the biggest obstacles, which results in far fewer tests being done than is needed to control the pandemic.

First, Houston – which is experiencing a surge in cases – and many testing sites across the state recommend or offer testing only to people who have symptoms, were exposed to a COVID-19 case or are a member of a high-risk group.

Even people recommended for testing still face challenges. It is possible to request an appointment for a free COVID-19 test, but testing facilities can handle only so many patients a day and testing slots fill up quickly. Even if someone gets an appointment, they may face an hours-long wait at the testing site.

Finally, public health experts recommend that people who may have been exposed to COVID-19 should quarantine at home for 14 days or until they receive a negative test result. In Texas, patients are supposed to get results through an online portal in three to five days, but many labs have been taking seven to nine days to return results. These long delays mean people face a much higher burden of quarantining while waiting for results.

All of these challenges make it clear that Texas is simply not testing enough people to keep the spread of COVID-19 in check.

To gauge the success of COVID-19 testing programs, epidemiologists use a measure called test positivity. This is simply the percentage of tests that come back positive. The lower the test positivity, the better, because that means very few cases are going undetected. A high test-positivity rate is usually a sign that only the sickest people are getting tested and many cases are being missed.

The World Health Organization guidelines say that if more than 1 out of 20 COVID-19 tests comes back positive – a test positivity of more than 5% – this is an indication that a lot of cases are not diagnosed and the epidemic is not under control. Texas currently has a test-positivity of around 16%, which means that a lot of infected people are not getting tested and may be unknowingly spreading the disease.

A doctor using a nasal swab to test a state senator of New Mexico.
In New Mexico, it is relatively easy to get a test, so more people are getting tested.
AP Photo/Cedar Attanasio

One of the best cases: New Mexico

In stark contrast to Texas is New Mexico, which has one of the strongest testing programs in the U.S.

First, public health officials there encourage everyone to get tested for COVID-19 regardless of symptoms or exposure. The state has also prohibited health providers from charging patients for tests. People seeking a test have the option to walk in or to make an appointment ahead of time, whichever is more convenient.

All of this relatively good access to testing has resulted in one of the highest per capita testing rates in the country, at over 20,000 tests per 100,000 people, and a test-positivity rate of around 4%. New Mexico’s testing program is diagnosing a relatively high proportion of cases despite the state experiencing a recent surge.

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New Mexico still has room for improvement. Long lines, wait times and limited capacity are becoming more common as cases surge, but the foundation of a strong testing program has helped the state cope with the increase in cases.

The big-picture problems

The pre-pandemic infectious disease testing capabilities in the U.S. are clearly unable to meet the current demand. A nationwide response is needed, and there are three things that Congress, the federal government and local governments can do to help ensure COVID-19 tests will be easy to get, fast and accurate.

First, Congress can provide funding to stimulate the testing supply chain, scale up existing testing programs and promote innovation in test development. Second, governments can improve the management and coordination of testing programs to more efficiently use existing resources. And third, innovative testing methods that reduce the need for lab capacity – like paper-strip tests and pooled testing – need be approved and implemented more quickly.

Every little improvement in testing capabilities means more COVID-19 cases can be caught before the virus is transmitted. And slowing the spread of the virus is the key to overcoming the pandemic.The Conversation

Zoë McLaren, Associate Professor of Public Policy, University of Maryland, Baltimore County

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Victoria hits bleak record of 484 new cases, NSW at a critical point — if you feel sick, get tested then stay home


Hassan Vally, La Trobe University

Too many people are going out while experiencing COVID-19 symptoms or while awaiting test results, Victorian Premier Daniel Andrews said on Wednesday, after the state hit a bleak new record of 484 new cases. The state’s previous worst daily case number was 428 last Friday.

It’s always a shock to see a new record number, and certainly these numbers are bigger than we would have hoped. While it’s a psychological blow, it’s not cause for panic. Thankfully, we are not seeing a doubling or tripling of case numbers, which really would ring alarm bells.




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Too many people going out while sick

Andrews chastised people for taking too long to get tested after first experiencing symptoms, which include fever, cough and sore throat. He said:

From 3,810 cases, which are the cases between July 7 and July 21, I’m very unhappy and very sad to have to report that nearly nine in ten – or 3,400 cases – did not isolate between when they first felt sick and when they went to get a test […]

That means people have felt unwell and just gone about their business. They have gone out shopping, they have gone to work, they have been at the height of their infectivity and they have just continued on as usual […] The one and only thing that you can and must do when you feel sick is to go and get tested. Nothing else is acceptable.“

He also said 53% those 3,810 cases “did not isolate, that is, did not stay at home and have no contact with anybody else — between when they had their test taken and when they got the results of that test.”

Unless people stay home when unwell and isolate while awaiting test results, the case numbers will continue to climb, Andrews said.

The premier noted self-isolation would leave some people with no income, and urged people in that situation to call 1800 675 398 to apply for an emergency A$1500 payment.

It’s good to see the premier acknowledge income as one of the major drivers for these behaviours; people may not always have the financial flexibility to do the right thing.

Hopefully, making more people aware of the emergency payment option will help counteract this.

The government may have to work harder to ensure people know to self-isolate, and that the emergency payment is available, and I suspect this will be promoted more widely.

NSW at a critical point

In New South Wales, Premier Gladys Berejiklian said there were 16 new cases in the 24 hours to 8pm last night, all traced to known clusters. She called on people to avoid crowded places, wash hands, stay home if unwell and get tested if they have even mild symptoms.

Berejiklian said from Friday, NSW businesses breaking rules on COVID-Safe registration, and breaching caps on group bookings, would “be fined — worse than that, if you breach again you will be shut down”.

NSW is on especially high alert. Despite this, it’s somewhat reassuring to know the state’s new cases can be traced to known outbreaks. However NSW residents are not out of the woods yet.

Speculation is rife that further lockdowns might be on the way in NSW. While nothing should be off the table, it doesn’t appear NSW is anywhere near this point yet. The state has more than enough capacity to bring things under control from where the numbers sit now.




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Today’s news serves as a grim reminder we must all follow the golden rules of pandemic management: get tested if you experience even mild symptoms, stay home if unwell or awaiting test results, wash your hands often, physically distance from others, limit social gatherings, and wear a mask if you can’t physically distance (face-coverings will be mandatory for residents of metropolitan Melbourne and Mitchell Shire as of midnight Wednesday).

As to where things move from here, much of that is in our hands as individuals. Each of us, by doing everything we can to prevent the spread of the virus, can make a massive contribution to saving lives and defeating COVID-19.

The silver lining is that we know what’s needed. What we’re being asked to do is not easy, but we do know how to bring this coronavirus pandemic under control. We’ve done it before and we can do it again.The Conversation

Hassan Vally, Associate Professor, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Keep your nose out of it: why saliva tests could offer a better alternative to nasal COVID-19 swabs



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Pingping Han, The University of Queensland

Saliva is one of our biggest foes in the COVID-19 pandemic, because of its role in spreading the virus. But it could be our friend too, because it potentially offers a way to diagnose the disease without using invasive nasal swabs.

Our research review, published in the journal Diagnostics, suggests saliva could offer a readily accessible diagnostic tool for detecting the presence of SARS-CoV-2, the virus that causes COVID-19, and might even be able to reveal whether someone’s immune system has already encountered it.

COVID-19 testing is a crucial part of the pandemic response, especially now countries are gradually lifting social distancing restrictions. This requires widespread, early, accurate and sensitive diagnosis of infected people, both with and without symptoms.

Our review looked at the results of three different studies, in Hong Kong, the nearby Chinese mainland city of Shenzhen, and Italy. All three studies found SARS-CoV-2 is indeed present in the saliva of COVID-19 patients (at rates of 87%, 91.6%, and 100% of patients, respectively). This suggests saliva is a potentially very useful source of specimens for detecting the virus.




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Saliva spreads the SARS-CoV-2 virus via breathing, coughing, sneezing, and conversation, which is why guidelines suggest we maintain a distance of at least 1.5 metres from one another. We also know SARS-CoV-2 can survive in tiny droplets of saliva in an experimental setting.


Author provided

Saliva is an attractive option for detecting SARS-CoV-2, compared with the current tests which involve taking swabs of mucus from the upper respiratory tract. Saliva is easy to access, which potentially makes the tests cheaper and less invasive. Saliva can hold up a mirror to our health, not just of our mouth but our whole body.

For this reason, saliva has already been widely investigated as a diagnostic tool for chronic systemic diseases, as well as for oral ailments such as periodontal disease and oral cancers. But less attention has been given to its potential usefulness in acute infectious diseases such as COVID-19, perhaps because researchers and clinicians don’t yet appreciate its full potential.

What a mouthful

When we get sick, much of the evidence is present in our saliva – from the germs themselves, to the antibodies and immune system proteins we use to fight them off. Saliva also contains genetic material and other cellular components of pathogens after we have broken them down (for the full biochemical breakdown of the weird and wonderful things in our saliva, see pages 51-61 of our review).


Author provided

Saliva is also hardy. It can be stored at –80℃ for several years with little degradation.

This means it would be relatively straightforward to track the progression of COVID-19 in individual patients, by collecting saliva at various times during the disease and recovery. Saliva tests from recovered patients could also tell us if they have encountered the disease for a second time, and how strong their immune response is.

However, there is no research yet available on using saliva to monitor immune responses. This will be well worth investigating, given the pressing need for a reliable and cost-effective way to monitor the population for immunity to COVID-19 as the outbreak continues.

Could saliva testing replace nasal swabs?

An ideal saliva test would be a disposable, off-the-shelf device that could be used at home by individuals, without exposing them or others to the risk of visiting a clinic.

One drawback with the research so far is that it has involved small numbers of patients (each of the three studies we reviewed involved no more than 25 people), and there is little published detail on exactly how these studies collected the saliva – whether from the mouth or throat, whether by spitting, drooling or swabbing, and whether collected by the patient or by a clinician.

Nevertheless, based on the modest amount of research done so far, saliva looks like a promising candidate for COVID-19 testing. More research is now needed, in larger groups of people, to learn more about how to confidently test for SARS-CoV-2 in the saliva of both symptomatic and non-symptomatic people.




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Earlier this month the US Food and Drug Administration approved the sale of saliva-based COVID-19 test kits that will allow people to collect their own samples and send them to a lab for analysis.

A reliable test would offer a cheaper, less invasive and potentially even more accurate way to detect the virus, which would also reduce the risk posed by routine COVID-19 checks to both patients and front-line medical professionals.The Conversation

Pingping Han, Postdoctoral Research Fellow, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Latest coronavirus modelling suggests Australia on track, detecting most cases – but we must keep going


Trent Yarwood, The University of Queensland

Late yesterday, epidemiologists from the Doherty Institute released what the Chief Medical Officer described as “nowcasting”: modelling that uses data from the previous 14 days to more accurately understand the present state of the COVID-19 epidemic.

In short, the findings are reassuring and suggest the inconvenience of social isolation is helping control the spread of SARS-CoV-2 in Australia.

It also indicates the spectre of “unidentified community transmission” is very unlikely indeed. This should be especially reassuring for healthcare workers, who may worry about coming into contact with COVID-positive patients presenting with a non-COVID problem.

What I don’t think it means, however, is that our outbreak control has been so effective that we should consider loosening the restrictions now.

Overseas methods, Australian data

The important thing to know is that this latest modelling uses Australian data.

One of the earlier criticisms of the Australian government’s response to COVID-19 was that the expert advice was kept behind closed doors.

When the modelling was made public, those determined to find fault (especially on Twitter) pivoted to “But it’s based on overseas data!”

That’s not a criticism that can be levelled at this latest Doherty Institute modelling, which borrows methods developed by the London School of Tropical Medicine and Hygiene but uses really recent Australian data to build some estimates.




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We are likely detecting most COVID-19 cases

First, the modelling suggests there’s probably not some huge secret cohort of COVID-19 cases out there that we are not picking up due to insufficient testing.

The researchers compared the reported case-fatality rates (the proportion of COVID-19 positive people who died) in Australian states with that from a large Chinese study (1.38%).

This is then used to infer the proportion of cases with symptoms which have been found by testing.

All states/territories have case detection rates above 80% – meaning that in each state, of all the people who have COVID-19 with symptoms, we are picking up about 80% or more.

If it wasn’t for the recent outbreaks in Tasmania, then all states would be above 90%. And in fact, the overall estimated case detection rate Australia-wide is 93%. Good news!

And as time goes on, the researchers are growing more certain about this conclusion (the technical term for this is the change in the “90% confidence interval” but in plain English that means the scientists are growing more confident these estimates are pretty accurate).

The change in the light blue shaded area means scientists are growing more confident that their estimates are accurate as more Australian data becomes available.
Doherty Institute

An effective R below 1: meaning social distancing is working

What scientists call the effective R is the way the virus spreads in a world where social distancing measures are in place. It refers to the average number of people each COVID-19 positive person is infecting. If it is below one, then it means the social distancing measures are working well.

The next model in the new Doherty Institute paper looks at the effective R ₀ in the six states over time.

The effective R ₀ is under one in all states except Tasmania, but treat the Tasmanian data with caution: they have a small number of cases and a recent uptick, so that could be blowing out the average.
Doherty Institute

In most states, the effective R has always been below one – indicating Australia has been effective at controlling spread since the beginning of the outbreak.

However, the numbers in Tasmania should be interpreted with caution. Their overall case numbers are small and they just had a big cluster, which affected their average disproportionately.

Crucially, the study team calculated the effective R based on cases identified as local transmission, rather than imported cases. That means, in real life, the effective R may be even better than this model estimates (because this estimate doesn’t account for border restrictions and quarantine of travellers).

In other words, this modelling is aiming to look at how effective our domestic control measures are. And the answer is: they’re working pretty well.

Too soon to relax social distancing rules

The social distancing measures take time to have an effect in stopping transmission.

It would also take time to become visible if we back off too early.

See-sawing our control measures would probably be far more disruptive than holding the course for just a little bit longer, and pose a risk of coronavirus rebound.The Conversation

Trent Yarwood, Infectious Diseases Physician, Senior Lecturer, James Cook University and, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Antibody tests: to get a grip on coronavirus, we need to know who’s already had it


Larisa Labzin, The University of Queensland

With much of society now effectively in lockdown, how will we know when it’s safe to resume something like normality?

It will largely depend on being able to say who is safe from contracting the coronavirus, officially named SARS-CoV-2, which causes the disease called COVID-19, and who still needs to stay out of harm’s way. A blood test to detect who has antibodies against the virus would be a crucial aid.

An antibody test – which would identify those whose immune systems have already encountered the virus, as opposed to current tests that reveal the presence of the virus itself – will be an important part of efforts to track the true extent of the outbreak.

This is because the antibody test will be able to determine whether someone has been infected with virus, even if they haven’t shown symptoms.




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When we get infected with the novel coronavirus (SARS-CoV-2), one of the ways our immune system fights the virus is by making antibodies. These small molecules bind specifically to SARS-CoV-2 (and not other viruses or bacteria), and combat the infection, mainly by preventing the virus from entering our cells.

Even after we’ve cleared a particular virus infection, these antibodies stay in our bloodstream, ready to protect us if we encounter the same virus again. This is the principle behind vaccination.

Because antibodies are specific to a particular virus, that means if we can detect SARS-CoV-2 specific antibodies in someone’s blood, we know that person has already been infected with the coronavirus.

Scientists in the United States and Europe have already developed specific antibody tests for SARS-CoV-2. Laboratory tests show that only antibodies from SARS-CoV-2 patients will bind to SARS-CoV-2 (and not to the 2003 SARS virus, for example). This tells us the test is specific.

Testing times

Antibody tests are different from the current testing kits used at COVID-19 clinics, which reveal the presence of the virus itself (by detecting its genetic material), rather than our antibodies against it.

That is useful for determining whether someone is currently infected, but cannot spot people who have already fought off the virus. In contrast, the antibody tests won’t be able to detect if someone is newly infected with SARS-CoV-2, as it takes our immune system a week or more to make antibodies. So we still need to do the existing tests to accurately diagnose a current infection.

Many companies have developed rapid test kits for detecting anti-SARS-CoV-2 antibodies. The UK is already rolling out 3.5 million antibody tests, while Australia has ordered 1.5 million antibody tests to determine whether patients showing symptoms of fever and cough are infected.

What still needs to be tested is how specific those kits are. It’s vital that these antibody test kits are only able to detect antibodies against SARS-CoV-2, and not other coronaviruses or even viruses of other types. Otherwise, people might think they are protected against SARS-CoV-2 when in fact they aren’t.

Additionally, because the onset of symptoms may appear within 2-14 days after exposure, a person might test negative to the antibody test but actually be infected. So we really still need to use the two tests together to accurately diagnose patients with COVID-19.

A new test developed by NSW Health Pathology will also be able to determine whether the antibodies in the blood are able to kill the virus. These kinds of tests will help clinicians and scientists measure exactly how soon after infection we develop antibodies, what levels are needed to be protective, and how long these antibodies stay in our body.

This will also help scientists track the spread of the virus and know if someone is going to be immune to reinfection with SARS-CoV-2.

Rapid response

These antibody tests have been developed much more rapidly than vaccines, which are still many months away. This is because the antibody tests are done outside the body, using just a small blood sample, perhaps just a pinprick.

In contrast, a vaccine needs to be injected into the body, so it has to be tested for safety as well as effectiveness.

For a vaccine, we first need to understand how the immune response to the virus itself works, because essentially a vaccine is trying to trick the immune system into thinking it’s seen the virus before so it makes protective antibodies. Then, we need to thoroughly test any candidate vaccine to ensure it doesn’t make people ill. This means we probably won’t see any vaccines for at least 12 months.

The new antibody tests will also help guide vaccine development. By measuring antibody levels in infected and recovered patients, we’ll have a much better idea of the levels of protective antibodies a vaccine needs to elicit.




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While we wait for a vaccine, the new antibody tests will give scientists, doctors and public health officials much more information about who gets infected, who has already been infected and recovered, and how protected we are against reinfection.

But there is still a long way to go before we can test people’s blood for antibodies against SARS-CoV-2 and confidently say it is safe for people to go back to work or into the community without getting sick.

Ultimately it is up to our community leaders and public health officials to decide when it is safe for us to resume normal life.The Conversation

Larisa Labzin, Research Fellow, Institute for Molecular Bioscience, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Grattan on Friday: Winners and losers on the tests of judgement, temperament and character


Michelle Grattan, University of Canberra

It’s obvious, but easily underestimated, that in politics judgement and temperament are key. Together with character, with which they’re often entwined, they are probably more important than high intelligence, or low cunning.

We just need to look at the federal scene today.

Barnaby Joyce provides the current case study about the importance of judgement or in his instance, lack or it. Here is a career, so carefully built, dramatically torn down by his own hand.

And as for temperament, we have the contrasting examples of Mathias Cormann and Greg Hunt, of whom more later.

Joyce burst onto the political scene in 2005 as a larger-than-life high profile Nationals senator. Because of tight numbers, he started with disproportionate power; for his Coalition peers and betters, he was a headache.

But he had charisma out in the bush, and ambition, and he set his sights on becoming Nationals leader, eventually adopting (mostly) the discipline needed to get there. When he reached the deputy prime ministership he began well, and his party outperformed the Liberals at the 2016 election.

But soon after, his private life became complicated, with his staffer Vikki Campion the new woman in his life.

Campion says in Sunday’s interview on Seven, “you can’t help who you fall in love with.”

That may or may not be true, but you can manage the implications. A public figure can separate the work and private parts of their lives. Joyce let the two merge messily, as Campion shifted to colleagues’ offices. With this failure of judgment, his fall began.

Now we have the paid interview. You only need political instinct, not even judgement, to know it’s unacceptable.

Then, when things became hot, Joyce this week took leave. Leader of the House Christopher Pyne said Joyce had a doctor’s sick- leave certificate, “and any other person in a workplace who produced such a certificate would get the same kind of leave.”

Give us all a break! The guy gets a reported $150,000 for the couple’s “tell all” interview, and when people are critical, he goes on stress leave.




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To people away from politics, coping with serious stresses often not of their own making, this saga just comes across as self-indulgence.

Now there is speculation about Joyce’s future – will he, should he, stay on in his seat of New England?

This ought to be resolved quickly, for Joyce’s own sake, and that of the Nationals, who don’t want to risk the emergence of a new strong independent, remembering that Tony Windsor grabbed and held this electorate for many years.

If Joyce wants to stay, he’ll have a big rebuilding job, locally and in Canberra. If – and it would probably be the more sensible course – he feels it would be better to strike out into another career, he should announce that decision without delay (while of course remaining in place until the election).




Read more:
Politics podcast: Michael McCormack on Barnaby’s future, latte sippers and other matters


Probably no one would be surprised to hear of a few expletives from Joyce, but this week’s News Corp story that Greg Hunt had sworn at the mayor of the Northern Territory town of Katherine, Fay Miller, in a private meeting last year, telling her she needed to “f…ing get over” herself, would have raised eyebrows among those who see the very reasonable-sounding Health minister on TV. Hunt only apologised to Miller – who’d been leading a delegation from the town to discuss a health package following contamination from RAAF Base Tindal – when the story was about to break.

Hunt’s temperament is of the “street-angel, house-devil” type; he is known for private outbursts of temper, and has now been rather dramatically “outed”.

In question time on Thursday, pursued by the Opposition, he also admitted that he’d been subject of a complaint after what he described as a “strong discussion” with a former health department secretary (Martin Bowles).

He told Parliament: “The Prime Minister himself raised it and asked that I speak with the secretary of Prime Minister and Cabinet.” The nature of Hunt’s behaviour can be judged by the fact that departmental secretaries – robust characters, for the most part – don’t usually complain upwards, to the head of the Prime Minister’s department, when their ministers have “strong discussions” with them.

Colleagues might recall such incidents, if Hunt in years to come eyes his party’s deputy leadership – a position that ideally requires an even temperament.

Fortunately for the government, Hunt isn’t in the sort of position occupied by Senate leader Mathias Cormann, who has to manage relationships and negotiate in perennially-testing circumstances.

Cormann has a few heated clashes with opponents, especially recently with Labor’s Senate leader Penny Wong, but he manages political conflict in a civilised, quite respectful way. In dealing with a Senate crossbench packed with volatile and unpredictable characters surfing atop inflated egos, Cormann displays inexhaustible patience and general good humour.

Beyond judgement and temperament, there is another quality that is crucial in politics: character.

The voters are like sniffer dogs when it comes to character – if that hadn’t been the case Mark Latham might have won the 2004 election.

For years, the government has been on a constant mission to fan doubts about Bill Shorten’s character. It knows that if such an attack is effective, it can be lethal for a leader’s chances.

That was in part behind the Abbott government establishing the royal commission into trade unions. And it’s why Michaelia Cash set the Registered Organisations Commission onto the 2005 $100,000 Australian Workers Union donation to GetUp, when Shorten was union secretary. But as we saw this week, the donation affair has so far inflicted more pain on the government than on Shorten.




Read more:
Jobs Minister Michaelia Cash resists call to give evidence in AWU court case


The ConversationWe know from the polls the public don’t warm to the opposition leader. So far, however, Labor’s two-party lead indicates people haven’t concluded that he is not fit to rule. Shorten hasn’t failed the character test, but he hasn’t entirely passed it yet, either.

Michelle Grattan, Professorial Fellow, University of Canberra

This article was originally published on The Conversation. Read the original article.

North Korea tests not just a bomb but the global nuclear monitoring system



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Lassina Zerbo, Executive Secretary of the CTBTO at a press briefing following the recent suspected nuclear test in North Korea.
CTBTO, CC BY-NC

Trevor Findlay, University of Melbourne

North Korea’s apparent nuclear detonation on September 3 has drawn our attention to a remarkable international organisation that helps detect and identify nuclear tests.

For the Vienna-based Comprehensive Test Ban Treaty Organization (CTBTO), the latest North Korean explosion was easy to detect and locate. With a seismic magnitude of 6.1 and a blast yield of 160 kilotons (Hiroshima was around 15), the purported hydrogen bomb test mimicked a major earthquake. It was quickly sourced to North Korea’s nuclear test site.

Confirming that the event was definitely a nuclear test, as opposed to another type of explosion or an earthquake, is trickier.


Read more: King Jong-Un’s nuclear ambition: what is North Korea’s endgame?


For that we rely on detection of short-lived radioactive isotopes that may leak from the test site, notably the noble gas xenon. The CTBTO has not yet announced such a finding, although South Korean monitors have reportedly detected xenon-133.

Other potential sources of the gas must be eliminated before a definitive conclusion can be reached.

Global network of seismic and radionuclide monitoring stations.
CTBTO / The Conversation, CC BY-ND

In the past, such fallout has usually been discerned after a North Korean test, but not always. Much depends on whether the cavity created by the test leaks or collapses.

Nuclear test ban treaty

The CTBTO’s International Monitoring System, which detected the North Korean test, is designed to verify compliance with the 1996 Comprehensive Nuclear Test Ban Treaty, which bans all nuclear tests in all environments for all time.

Network of infrasound monitoring stations.
CTBTO / The Conversation, CC BY-ND

The International Monitoring System comprises 321 monitoring systems worldwide, using four technologies:

  • seismic – to detect tests under ground
  • radionuclide detection – to detect breakdown products
  • hydroacoustic – to detect tests under water, and
  • infrasound – for atmospheric tests.

The CTBTO’s international monitoring system is sensitive enough to detect underground nuclear tests below one kiloton.

Construction of the system began in 1996 and is now 90% complete.

Network of hydroacoustic monitoring stations.
CTBTO / The Conversation, CC BY-ND

Australia hosts six seismic, two infrasound and one hydroacoustic station, including a large seismic array and infrasound station at Warramunga in the Northern Territory.


CTBTO / The Conversation, CC BY-ND

Data from the International Monitoring System is transmitted to Vienna via a global communications satellite network, mostly in real time, where it is compiled, analysed and distributed to member states. Sixteen laboratories are available for analysing radioactive fallout.

The treaty also provides for on-site inspections to confirm that a nuclear test has been conducted. The system is funded by member states according to the usual United Nations formula based on national GDP.

A difficult, important achievement

As a member of the Australian delegation, I observed the complex preparatory scientific talks on the system at the Committee on Disarmament in Geneva in the early 1980s. It is a miracle of statecraft and science that this collaborative international infrastructure has actually come into being.

The scientists did not get everything they wanted due to political and financial constraints. Some errors were made in the rush to complete the technical specifications. Installation of some of the stations in remote and inaccessible areas has proved daunting.

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The hydroacoustic system, for instance, passed a significant milestone in June when the final station was completed, on France’s Crozet Islands in the southern Indian Ocean.

After 20 years of planning and construction and the investment of millions of dollars, not only is the International Monitoring System almost complete, but it is functioning far better than its designers anticipated.

It also has unexpected side benefits, such as providing early warning of tsunamis and detecting nuclear disasters. The network successfully detected the 2004 Indian Ocean tsunami and tracked radioactive plumes from the 2011 Fukushima nuclear disaster.

Nuclear test ban treaty

The test ban treaty itself is not in such good shape. More than two decades after it was opened for signature it is still not in force, rendering the CTBTO only “provisional”. This is due to the requirement that all 44 states with a significant nuclear capacity must ratify it.

Currently 183 states have signed, and 162 have ratified. But 8 of the 44 with a nuclear capacity have still not ratified: China, Egypt, India, Iran, Israel, Pakistan, North Korea and the United States. China, Egypt, Iran, Israel and the US have at least signed. China says it is awaiting US ratification before it moves.

After a flawed lobbying effort, President Bill Clinton’s administration failed to secure Senate approval for US ratification in 1999. The treaty has not been resubmitted since, despite President Barack Obama’s undertaking that he would try.

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Given President Donald Trump’s apparent focus on emphasising American military prowess, it seems unlikely that he will favour ratification of the treaty.

More immediately threatening is the return of periodic Republican attempts to defund the CTBTO. These are usually beaten back on the grounds that the US benefits greatly from the worldwide monitoring that only a global system can provide, notwithstanding impressive US national capabilities.


Read more: What earthquake science can tell us about North Korea’s nuclear test


As it has in the past, the Australian government should make representations in Washington in support of CTBT ratification and preservation of funding for the system.

Paradoxically though, even if the other seven holdouts ratify, the one country that continues to conduct nuclear tests into the 21st century, North Korea, can stymie entry into force forever. Its accession to the CTBT should be part of any negotiation with North Korea on its nuclear program.

The good news is that the global monitoring system continues to go from strength to strength, providing reassurance that all nuclear tests, including those less brazen than North Korea’s, will be caught.

The ConversationThe CTBTO’s verification system provides hope that science can quietly triumph while political solutions elude us.

Trevor Findlay, Senior Research Fellow Department of Social and Political Sciences, University of Melbourne

This article was originally published on The Conversation. Read the original article.

Police in Pakistan Shoot Mourners at Funeral of Christian


Authorities allegedly kill young man in custody on contrived charge of desecrating Quran.

LAHORE, Pakistan, September 17 (CDN) — At a funeral for a Christian man allegedly tortured to death while in custody on a spurious charge of blaspheming the Quran, police in Sialkot, Pakistan yesterday fired on mourners trying to move the coffin to another site.

Area Christians suspect police killed 22-year-old Robert Danish, nicknamed “Fanish” or “Falish” by friends, by torturing him to death on Tuesday (Sept. 15) after the mother of his Muslim girlfriend contrived a charge against him of desecrating Islam’s scripture. The allegation led to calls from mosque loudspeakers to punish Christians, prompting an Islamic mob to attack a church building in Jathikai village on Friday (Sept. 11) and beat several of the 30 families forced to flee their homes.

Jathikai was Danish’s native village, and some family members and other Christians wished to transfer his coffin to his hometown. Eyewitnesses at the funeral in Christian Town, Sialkot, said police fired shots directly at the Christians, injuring three, when mourners began to move the coffin toward nearby Jathikai. Mourners fled.

Sialkot is 125 kilometers (78 miles) northwest of Lahore in Punjab Province.

Controversy swirled around the cause of Danish’s death, with Christians refusing to accept police claims that he committed suicide. Results of forensic tests are expected within a week.

The dark moment for Danish’s family grew gloomier yesterday when police seemed to be seeking the first excuse for heavy-handed tactics at the funeral attended by hundreds of people, Christian sources said. When the family and other Christians tried to take the coffin to his hometown of Jathikai, police fired on them, charged them with batons and snatched the body from them, Christian sources said. 

Eyewitness Sajawal Masih told Compass that as soon as mourners lifted the coffin, police began firing tear gas.

“We were running when police opened fire and one bullet went through my foot, and two others also were injured,” he said.

There were reports of Christian youths pelting officers with stones, and police reportedly said that they needed to rush the crowd and make arrests to prevent “further disturbances.”

On Tuesday night (Sept. 15), Danish’s survivors and other Christians had decided that the body would be buried in Christian Town because of the dangers of potential attack in Jathikai, according to Christian Town Councilor Tanveer Saqib. Saqib said that the funeral was to be held at 10 a.m. on Wednesday (Sept. 16) at the Christian Technical Institute (CTI) Ground in Christian Town, Sialkot city.

Pakistan Muslim League-Quaid (PML-Q) Member of National Assembly (MNA) Akram Gill said that when he and several youths took the body from the CTI Ground and began heading toward Jathikai village, police began firing. Gill told Compass that police opened fire on them as well as the crowd, injuring three Christians.

Gill, a Christian, added that police also shot tear gas, and that officers arrested about 100 Christians. The national assembly member said police arrested him and took Danish’s body to the Christian Town Graveyard in Sialkot. In spite of the tear gas, Gill said, he and others went to the graveyard but encountered armed police who also fired tear gas, turning them back.

For three hours, Gill said, Criminal Investigation Department police detained him, and although he was released, police arrested PML-Q Member of Provincial Assembly (MPA) Shehzad Elahi and his whereabouts were still unknown. He said that whenever Pakistan Muslim League-Nawaz (PML-N) members come into power in the province, problems for Christians multiply.

Cause of Death

How Danish died remained unclear. Allama Iqbal Hospital Deputy Medical Superintendent Sajid Hussein told Compass that on Danish’s body there was a large welt on the back of the neck and “marks on the legs and back.” He said it was too soon to determine cause of death but that police had pronounced it a suicide.

Tissues taken from the body have been sent to Lahore for chemical and histopathology tests. He said these tests would indicate how the wounds were made, including whether they were inflicted after death.

“The report of these tests would come within a week, and I would inform the media of its findings,” he said. “I cannot comment on whether he committed suicide or not, as the matter is before the court.”

There were unconfirmed reports that state officials were pressuring doctors at Allama Iqbal Hospital to declare Danish’s death a suicide; Hussein denied these statements, telling Compass that they were “mere rumors.”

Hussein said that two Christian doctors, one from Bethania Hospital and the medical superintendent of Jalalpur Jattan Mission Hospital, were allowed to observe the autopsy. Christian Town Councilor Tanveer Saqib said that after the autopsy, the two Christian doctors came out and told media in front of thousands of Christians that Danish had been tortured to death.

Saqib said Danish’s father received the body and, accompanied by thousands of Christians, took it to Baithania Mission Hospital. The procession was so big that it took nearly four hours, though the route was not far.

Over the weekend Danish’s father had been unduly arrested, and upon his release a station house officer told Danish’s uncle, Saleem Masih, that even though Danish’s father was being released, Danish never would be. Saleem Masih told Compass that Danish’s father went back to his jailed son and told him, “My son, we have been trying our best to save you, but it doesn’t seem we will succeed. I think it is the last time I’m seeing you, so I commit you in the Lord’s hands.”

Councilor Saqib said that a Christian constable posted at the Sialkot District Jail told him that he saw Danish in the jail at around 7 a.m. and that he appeared unharmed. At about 10 a.m., however, jail administrators called important figures in the Christian community and told them that Danish had committed suicide, Saqib said.

Danish’s body was taken to a trauma center for a CT scan, he said, then to Riffat Idrees Hospital for an MRI.

“Along with the body were two Christian doctors – Dr. Tariq Malik and Dr. Qammar Sohail – and we were confident that they would tell the facts,” he said, adding that Malik had all medical reports of these tests.

The Punjab provincial government has ordered an investigation into the death, and three prison officials have reportedly been suspended.

Tragic Love

A paternal cousin of Danish identified only as Parveen confirmed reports that the conflict grew out of a romantic relationship between Danish and Hina Asghar, a young Muslim woman. She said Danish and Asghar were neighbors and had been seeing each other for three or four years.

On the night of Sept. 10, Parveen told Compass, Danish and Asghar met on the roof, angering the young Muslim’s mother. Early the next morning, Asghar’s mother spoke of the affair with the wife of local Muslim cleric identified only as Amanullah; the cleric’s wife in turn warned Asghar that both she and Danish could lose their lives if the relationship continued, Parveen said.

When Danish met Asghar on the road the next morning, Parveen said, the young Muslim woman refused to talk to him but tried to hand him a letter explaining the warning she had received. Upset, Danish batted her hand away as she was trying to give him the letter.

“Because he pushed her hand with a jerk, supara 21 [a section of the Quran larger than a sura, or chapter] fell from her hand and dropped onto a nearby sewage stream and got smeared with garbage,” Parveen said.

Saleem Masih, Danish’s uncle, questions that what fell from Asghar’s hand was a part of the Quran. He told Compass that Asghar was trying to give Danish a green-colored diary that only looked like the similarly green-covered section of the Quran. After the rumor began circulating that Danish had blasphemed the Quran, Saleem Masih said, Danish told his mother that it was not the Quran but a green diary that Asghar was trying to give him which fell.

According to Parveen, Asghar returned home and began cleaning the recovered scripture part, and her mother asked how it became sullied, Parveen said. Asghar’s mother subsequently rushed to cleric Amanullah’s wife, who then told her husband about the incident.

Saleem Masih told Compass that he and his wife, along with Danish’s parents, went to Hina Asghar’s father, Asghar Ali, bowed before him and pleaded for him to stop the false rumors of desecration of the Quran. He responded that Muslim cleric Amanullah would decide on it after the Friday prayers, and that the matter was not in their hands anymore.

On that day, Sept. 11, at about 11 a.m., the Muslim cleric announced during the Friday prayer that a Christian had blasphemed by desecrating the Quran, Parveen said.

Islamic mobs brandishing sticks were already arriving in the village, shouting against Danish and demanding that he be hung to death. They also occupied a house that he owned. Surrounding families fled their homes, leaving domestic animals without food and water.

Relatives Thrashed

Nadeem Masih, a paternal cousin of Danish, said that when he arrived at the village by motorbike that day, a large number of emotionally charged Muslims were setting Calvary Church on fire.

He said several Muslims had surrounded Danish’s father, Riasat Masih, and that he managed to get his uncle onto his motorbike to try to escape. They sped through several mob attempts to stop them and were eventually pursued by two Muslims on motorcycles. As Nadeem and Riasat Masih entered the main road, their motorbike slid and fell as they barely avoided an approaching truck. Nadeem Masih escaped but his uncle, Danish’s father, was captured.

Saleem Masih said that the Muslim mob took hold of Danish’s father, tied him up and were about to set him on fire when elderly men intervened, saying punishment for that crime would be too great, and suggested they instead only beat him. After beating Danish’s father, the Muslim mob untied him and took him into the church, where they burned Bibles, hymn books and other items and continued beating him.

Christian sources said police arrived and arrested Riasat Masih – not his attackers – and took him to the police station. Riasat Masih filed a crime report against the jailor and police officials at the Civil Lines Police Station, according to Christian Town Councilor Saqib.

Saleem Masih told Compass that he also was beaten. He said he was with Calvary Church Senior Pastor Dilshad Masih when they arrived in the village to find the mob setting church articles on fire and striking it with whatever they could find on hand. Realizing he could do nothing, Saleem Masih said he ran to his farmhouse, also owned by a Muslim named Bao Munir.

Munir took hold of him, he said.

“He brought out my cot and other belongings and set them on fire, and then he also tried to burn me in this fire,” Saleem Masih said.

Munir told him he could either be burned or go with him back to the village, and he forced all of the Christian’s clothes off of him except a cloth covering his loins and burned them, Saleem Masih said. After some struggle, he said, he managed to escape.

Danish, meantime, was hiding in a house in Jathikai village but was arrested the next morning (Sept. 12) when he went out for drinking water.

Tensions escalated, a source told Compass, when cleric Sabir Ali announced from his mosque in nearby Bhopalwala village that a Christian boy had blasphemed Islam by throwing the Quran in a drain.

Church Fire

After Calvary Church was set on fire, about 30 nearby families fled from the brutal beatings. Eyewitnesses told Compass that the assailants first went to Danish’s house. Not finding anyone there, they attacked the locked church which was only three houses from his.

The eyewitnesses, who were still in hiding and fearing further attacks, said that the assailants burned Bibles and hymnbooks. The assailants brought the church cross out, they said, and beat it with their shoes. The sources said the attackers were mainly from Shabab-e-Milli, a wing of the Muslim extremist Jamaat-e-Islami.

Christian Town Councilor Saqib said that the mob got hold of Calvary Church Senior Pastor Masih and severely beat him while police stood by. Police kept Saqib and his team from going to the blazing Calvary Church building, signaling them from afar not to come near, he said. He added that they had to turn back as the rampaging Muslims turned on them to attack, which police made no effort to stop. 

Pastor Masih told Compass that when he and Saleem Masih arrived at the church building, Muslims shouted at them, “Catch these Christians!” He remained standing as others fled, he said, and the mob beat him and took his mobile phone.

“They wanted to kill me, but miraculously I managed to run from there,” he said.

Saqib said MPA Kamran Michael of the Pakistan Muslim League-Nawaz (PLM-N), the ruling party in Punjab province, reached the village on Friday, but police did not allow him to go to the burning church, citing security threats. About 500 Christians later gathered in Sialkot to protest the church fire, with Michael addressing the crowd.

Michael said that one of the protestors reminded him that after Islamic mobs burned homes in Gojra last month, he had vowed to resign if further attacks took place. The crowd then began demanding that he resign, and police opened fire and charged the crowd with batons. He added that throughout the incident there were several media vans, but none of the major television stations covered the protest.

Several Non-Governmental Organizations (NGOs) and Christian media also faced difficulties in getting in the village, though in all previous incidents media and NGOs were allowed access. In this case, however, police told them that they were not allowed due to security reasons. Also unable to gain access to Jathikai was Pakistan People’s Party provincial Assembly Member Amna Buttar and minority rights groups.

George and Butta Masih, along with four family members, were in Jathikai tending to their five cows on Sunday (Sept. 13). George Masih told a Compass reporter who had somehow got into the village that they stayed home all day and went out only at night to bring some fodder for the animals. They said that Muslims would beat any Christians seen during the day.

On Sunday about 500 to 700 Muslim women staged a protest in Sialkot to refute the notion that a Muslim woman could fall in love with a Christian man.

Several Christian and secular organizations in Lahore have scheduled a candle-light vigil today (Sept. 17) as a memorial for Danish and other members of Pakistan’s minority communities who have been killed or attacked in Islamist attacks.

A field officer for advocacy group Community Development Initiative, Napoleon Qayyum, said such attacks were weakening the Christian community. 

“After the Gojra incident, several Christians said that their Muslim employers had told them not to come to work anymore,” Qayyum said. “This economic dependence further plays part in seeking justice.” 

He added that in the June 30 Islamist attack on Bahmaniwala, in Kasur district, Christians did not want to pursue justice as they worked on Muslims’ land and could not afford confrontation.

“Their fear is that they would be left without jobs,” he said. “Due to economic dependence and poor status, Christians neither pursue their cases, nor do they defend themselves in such instances.”

Report from Compass Direct News