Coronavirus COVID-19 - Global Health Pandemic #45

[Reasonable & Just]

oh no, I think we're all headed that way

They can exercise before 10 and after 7pm, at least. Still, this is depressing, especially given that exercise helps to alleviate those underlying conditions that makes this virus so deadly. What a terrible time to be a child, especially a high-energy child. It's bad enough as an adult who needs to move.

 

[musicaljoke]

N95 Mask Decontamination using Standard Hospital Sterilization Technologies

Research on sterilizing and reusing masks ... not yet peer reviewed but in the process.

The response to the COVID19 epidemic is generating severe shortages of personal protective equipment around the world. In particular, the supply of N95 respirator masks has become severely depleted with supplies having to be rationed and health care workers having to use masks for prolonged periods in many countries. We sought to test the ability of 4 different decontamination methods including autoclave treatment, ethylene oxide gassing, ionized hydrogen peroxide fogging and vaporized hydrogen peroxide exposure to decontaminate 4 different N95 masks of experimental contamination with SARS-CoV-2 or vesicular stomatitis virus as a surrogate. In addition, we sought to determine whether masks would tolerate repeated cycles of decontamination while maintaining structural and functional integrity. We found that one cycle of treatment with all modalities was effective in decontamination and was associated with no structural or functional deterioration. Vaporized hydrogen peroxide treatment was tolerated to at least 5 cycles by masks. Most notably, standard autoclave treatment was associated with no loss of structural or functional integrity to a minimum of 10 cycles for the 3 pleated mask models. The molded N95 mask however tolerated only 1 cycle. This last finding may be of particular use to institutions globally due to the virtually universal accessibility of autoclaves in health care settings.

 

[Alethea]

It’s starting to get surreal: I woke up to the news that my childhood friend’s mom died in New York from COVID-19. I knew the odds were I would know someone affected but it’s still surreal. Now we’re really not going out anywhere for the next 3 weeks. It’s so serious, I wish more people could see it.

 

[SA55]

My 19 yo son is in the ER. He was there 2 days ago and told he had pleural effusion/water on his lung. He left NY state 2 weeks ago. He's clearly worse and struggling to breath. No one was allowed to go back in with him. A police officer was there to tell my mil the rules had now changed. Please pray for him and that he can advocate for himself while he can also barely breath. He's only 19 yo and he barely slept last night.

I know you have to be worried. Prayers with you and him and all those caring for him. Please keep us posted - we're all in this together. Scary to be in a hospital at present no matter what the reason or diagnosis, we understand this. Do your best to look at the overwhelming statistical prognosis for a healthy 19 yr old. We're all cheering for him - you've got this!
I believe most all of us will know someone very dear to our hearts that may contract this nasty virus.
Reach out if you need someone to talk with - I may not be able to offer him a quick definitive cure, but I certainly can listen. Take care of yourself also please.

 

[The•Qwill•Pen]

Inside the epic White House blowup over "game-changer" hydroxychloroquine


Just wondering what posters think about this and what is the consensus.

<sigh> (At the article, not you )


The “what do you have to lose” attitude is worrisome. We had a joke in school: death is always a possible side effect. But it’s true. In the medical world, even oxygen is considered a drug. Too much, too little, given under the wrong circumstances—can all lead to less-than-optimal outcomes.


You just can’t take one look at a drug, without extensive and methodological study, and declare it a miracle-worker. The rules are there for a reason. And even then, there are usually circumstances that haven’t been anticipated. They are already making allowances and relaxing regulations to expedite new or repurposed therapies in this state of emergency. But there’s a threshold before it becomes unsafe and the risk outweighs the benefit.


Additionally, data, studies, experiments, etc—they’re great, but you have to understand the context, condition, method, and much more in order to draw a legitimate conclusion. It’s incredibly tempting—especially under pressure—to cherrypick favorable data to support your claim. And no one is immune to that. It’s human nature. But you must be aware of it and mitigate it, especially when you have lives that depend on it.

Jmo

One of my favorite discoveries, that shows (often humorous) examples of how appearances can be deceiving in data analysis, is this site:
Spurious Correlations
Enjoy

 

[CeeCeeCat]

My 19 yo son is in the ER. He was there 2 days ago and told he had pleural effusion/water on his lung. He left NY state 2 weeks ago. He's clearly worse and struggling to breath. No one was allowed to go back in with him. A police officer was there to tell my mil the rules had now changed. Please pray for him and that he can advocate for himself while he can also barely breath. He's only 19 yo and he barely slept last night.

Oh gosh, you must be frantic. I’m so sorry. I’ll say prayers for your son (and for you) and will ask my Dad to add him to the church’s virtual prayer circle. Holding good thoughts for you both

 

[MimosaMornings]

My 19 yo son is in the ER. He was there 2 days ago and told he had pleural effusion/water on his lung. He left NY state 2 weeks ago. He's clearly worse and struggling to breath. No one was allowed to go back in with him. A police officer was there to tell my mil the rules had now changed. Please pray for him and that he can advocate for himself while he can also barely breath. He's only 19 yo and he barely slept last night.

Will say a prayer for your son from across the miles.

 

[10ofRods]

Circulating on nursing forums, this is a better explanation of a possible mechanism for CoVid (summarizing various juried publications and pre-prints, as well as computer analysis of observations):

///
"Might not even be a respiratory illness after all and that's just a byproduct of the wreckage it makes in blood haemoglobin (thus making ARDS a symptom not a cause).

I wish this would get more traction because if this computational analysis is correct, this could completely change the way we approach COVID, globally.

I will copy some summaries that explain this paper in layman's terms:

- Using computational analysis (modeling the behavior of a molecule in a computer), they've worked out the probable mechanism by which SARS-nCov-2 wreaks havoc on patients, as well as why chloroquine and favipiravir seem to work.

- Inside our red blood cells, there is a molecule called hemoglobin, which contains heme groups. Each heme group is a molecular "ring" (called a porphyrin) that can hold an iron (Fe) ion inside. Having an iron ion inside is what allows this heme to carry O2 (and CO2) in our blood. This is how our bodies move O2 to our tissues and remove CO2 waste products.

- The paper modeled these and found that the proteins produced when COVID replicates "collaborate" to knock iron ions out of heme groups (HBB) and replace them with one of the proteins. This makes the red blood cell unable to transport O2 and CO2!

- If the computer modeling is right, it shows that the virus hijacks our [red] blood [cells] and makes it unable to carry O2 to a patient's tissues/organs, and likewise unable to carry CO2 out of them. This would lead to organ and tissue death, roughly in the same way as if a patient were being suffocated. Even when a patient can breath (fill lungs with air), the oxygen isn't getting to the cells in their body.

- The inflammation in the lungs results from the lungs not being able to perform the oxygen/CO2 exchange, and would therefore appear to be a SECONDARY result of the hijacking of the blood. The lungs not working is a result of lack of O2 in blood, not the cause of it. Hence the "ground glass opacities".

- The paper models the behavior of chloroquine and faviparavir as well, which appear to bind to the non-structural viral proteins that hijack the heme groups, thus inhibiting them from knocking out the iron and wrecking the O2-carrying ability of the red blood cells.

- This also explains the observation made by various ER docs (incl this one in New Orleans) that patients tend to have elevated ferritin: ferritin is used to store excess iron. If a lot of iron is knocked out of heme groups and floating around, the body produces more ferritin

If true, this may mean a few things:

1. Starting drug treatment while symptoms are mild keeps virus from hijacking too much blood, enabling a still-healthy body to mount an immune response. Explains why early drug treatment (first week of symptoms) is often successful.

2. Drug treatment and intubation once patient is critical will rarely work because tissues/organs are already damaged, blood can't carry O2, and the body is too weak to produce new red blood cells able to carry Fe (and thus oxygen/CO2) even if drugs inhibit more hijacking.

3. Thus: start severe patients on drug treatment upon hospital intake to suppress further hijacking of blood by the virus, then give them a blood transfusion of new red blood cells immediately that are unhijacked. If all this is true, we would see rapid patient improvement.

---

The problem is we have not yet had studies testing whether patients will respond well to blood transfusions from people who have not had COVID-19. Right now medical attention is focused on blood transfusions from those who have beat COVID and have antibodies. This needs to be looked at

This research ties in to the fact that weight/age/high blood pressure are such risk factor and why certain blood types are less afflicted than other

////

 

[Herat]

Circulating on nursing forums, this is a better explanation of a possible mechanism for CoVid (summarizing various juried publications and pre-prints, as well as computer analysis of observations):

///
"Might not even be a respiratory illness after all and that's just a byproduct of the wreckage it makes in blood haemoglobin (thus making ARDS a symptom not a cause).

I wish this would get more traction because if this computational analysis is correct, this could completely change the way we approach COVID, globally.

I will copy some summaries that explain this paper in layman's terms:

- Using computational analysis (modeling the behavior of a molecule in a computer), they've worked out the probable mechanism by which SARS-nCov-2 wreaks havoc on patients, as well as why chloroquine and favipiravir seem to work.

- Inside our red blood cells, there is a molecule called hemoglobin, which contains heme groups. Each heme group is a molecular "ring" (called a porphyrin) that can hold an iron (Fe) ion inside. Having an iron ion inside is what allows this heme to carry O2 (and CO2) in our blood. This is how our bodies move O2 to our tissues and remove CO2 waste products.

- The paper modeled these and found that the proteins produced when COVID replicates "collaborate" to knock iron ions out of heme groups (HBB) and replace them with one of the proteins. This makes the red blood cell unable to transport O2 and CO2!

- If the computer modeling is right, it shows that the virus hijacks our [red] blood [cells] and makes it unable to carry O2 to a patient's tissues/organs, and likewise unable to carry CO2 out of them. This would lead to organ and tissue death, roughly in the same way as if a patient were being suffocated. Even when a patient can breath (fill lungs with air), the oxygen isn't getting to the cells in their body.

- The inflammation in the lungs results from the lungs not being able to perform the oxygen/CO2 exchange, and would therefore appear to be a SECONDARY result of the hijacking of the blood. The lungs not working is a result of lack of O2 in blood, not the cause of it. Hence the "ground glass opacities".

- The paper models the behavior of chloroquine and faviparavir as well, which appear to bind to the non-structural viral proteins that hijack the heme groups, thus inhibiting them from knocking out the iron and wrecking the O2-carrying ability of the red blood cells.

- This also explains the observation made by various ER docs (incl this one in New Orleans) that patients tend to have elevated ferritin: ferritin is used to store excess iron. If a lot of iron is knocked out of heme groups and floating around, the body produces more ferritin

If true, this may mean a few things:

1. Starting drug treatment while symptoms are mild keeps virus from hijacking too much blood, enabling a still-healthy body to mount an immune response. Explains why early drug treatment (first week of symptoms) is often successful.

2. Drug treatment and intubation once patient is critical will rarely work because tissues/organs are already damaged, blood can't carry O2, and the body is too weak to produce new red blood cells able to carry Fe (and thus oxygen/CO2) even if drugs inhibit more hijacking.

3. Thus: start severe patients on drug treatment upon hospital intake to suppress further hijacking of blood by the virus, then give them a blood transfusion of new red blood cells immediately that are unhijacked. If all this is true, we would see rapid patient improvement.

---

The problem is we have not yet had studies testing whether patients will respond well to blood transfusions from people who have not had COVID-19. Right now medical attention is focused on blood transfusions from those who have beat COVID and have antibodies. This needs to be looked at

This research ties in to the fact that weight/age/high blood pressure are such risk factor and why certain blood types are less afflicted than other

////

Ferritin is also a non-specific acute phase reactant.

All sorts of acute inflammatory situations can cause elevated ferritin.

 

[Auntie Cipation]

I have an android. I turn my location on and my phone tracks every location I go to,
How many miles I traveled and how long I was on the road.
All I have to do is go to my activity and a map pops up with everywhere I went.
My March and April History has my one trip to the butcher on April 3rd.
It shows I never left my address any other day.
(If you forget your phone at home, then obviously you won't get any data) < I do that sometimes! I usually carry it in my purse though.
For anyone interested...
Here's a link.
Moo
How to view your location history in Google Maps

Personally I have no smartphone and keep location services turned off on my ipad etc.

But I agree that phone tracking can help many folks. But -- more than that is needed. If I go to the store or the post office, electronic tracking will not tell me which cashier checked me out, or which neighbor I saw and chatted with on the way.

And when I'm digging in the garden and a friend walks past and we shout hello from 50 feet away, that is a different kind of contact than if I go up to the fence and we talk for several minutes only ten feet apart.

I've even recorded when I noticed someone cough!

So yes, use phone tracking to help, but I suggest folks keep more detailed notes than the gps can provide. MOO

 

[Victoria Chambers]

Aww, my partners Grandfather passed away due to Coronavirus less than 24hrs ago. He was one of many residents residing at the Oak Springs Care Home, Liverpool UK, who had tested positive since the 1st death which occurred just 8 days ago. My partners Grandfather became the 10th resident to pass away from infection. The home was well into its Lockdown period, and it seems likely that a staff member who tested positive, was the person who unwittingly had passed the infection unto the residents. It has been an awful, emotional week for all involved. A number of residents remain in critical condition. Bless X
Myself and my partner barely had time to react to the news of Grandads passing when a News Bulletin was interrupted with the announcement of our Prime Minister, having been taken into ICU.
So just when we thought there could be no more sadness...
Suddenly there was.
As Labour Supporters, Boris Johnson would never ever have gotten our vote.
However, he certainly has gotten our Respect. For he is right now, like many thousands of men and women around the Globe, fighting for his very life. And his battle began just 4 days since he stood, applauding our beloved NHS with the rest of our grateful Country. And just over one week since the announcement of him having tested positive for the virus.. every day leading up to that, he stood at his podium, Live every day and addressed the nation. But first and foremost, his fight for life comes just over 1 month since Boris announced that he was to become a new Father. Number 10 is expecting a baby!! And with that, now comes the realisation of just how very, very far into the future, the damage caused by this 2020 Pandemic has the potential of reaching. Already affecting the tiny, new lives, as yet unborn. And I pray hard for AAALL of our lives to be spared.
Today, especially though, I pray for that Boris does pull through, if only to be at the birth of his child.
And I pray even harder for the day to hurry and arrive, whereby this blasted 2020 Pandemic can take its place in the history books. AMEN X
And as ever peeps, TAKE REAL CARE! X

 

[Trudie]

So sorry, Alethea. Hopefully more people are getting on board with isolating & distancing. I went for a drive, just to drive, lol, the box stores looked less busy. Maybe everyone has shopped til they dropped.

It’s starting to get surreal: I woke up to the news that my childhood friend’s mom died in New York from COVID-19. I knew the odds were I would know someone affected but it’s still surreal. Now we’re really not going out anywhere for the next 3 weeks. It’s so serious, I wish more people could see it.

 

[Yesiamapirate]

Aww, my partners Grandfather passed away due to Coronavirus less than 24hrs ago. He was one of many residents residing at the Oak Springs Care Home, Liverpool UK, who had tested positive since the 1st death which occurred just 8 days ago. My partners Grandfather became the 10th resident to pass away from infection. The home was well into its Lockdown period, and it seems likely that a staff member who tested positive, was the person who unwittingly had passed the infection unto the residents. It has been an awful, emotional week for all involved. A number of residents remain in critical condition. Bless X
Myself and my partner barely had time to react to the news of Grandads passing when a News Bulletin was interrupted with the announcement of our Prime Minister, having been taken into ICU.
So just when we thought there could be no more sadness...
Suddenly there was.
As Labour Supporters, Boris Johnson would never ever have gotten our vote.
However, he certainly has gotten our Respect. For he is right now, like many thousands of men and women around the Globe, fighting for his very life. And his battle began just 4 days since he stood, applauding our beloved NHS with the rest of our grateful Country. And just over one week since the announcement of him having tested positive for the virus.. every day leading up to that, he stood at his podium, Live every day and addressed the nation. But first and foremost, his fight for life comes just over 1 month since Boris announced that he was to become a new Father. Number 10 is expecting a baby!! And with that, now comes the realisation of just how very, very far into the future, the damage caused by this 2020 Pandemic has the potential of reaching. Already affecting the tiny, new lives, as yet unborn. And I pray hard for AAALL of our lives to be spared.
Today, especially though, I pray for that Boris does pull through, if only to be at the birth of his child.
And I pray even harder for the day to hurry and arrive, whereby this blasted 2020 Pandemic can take its place in the history books. AMEN X
And as ever peeps, TAKE REAL CARE! X

I am so sorry to hear about your partners granddad. You are in my thoughts. And thank you for the update from your area. I find it is such a small world these days. Love from Michigan USA

 

[The•Qwill•Pen]

Just wanted to insert a little reminder from my beloved orchid garden (mostly for myself) that in the midst of even the most dire of circumstances, there’s still beauty and hope in this world.


Orchids are a lesson in patience and re-birth.

They’re aloof, finicky, and frustratingly operate on their own timetable—the felines of the botanic world.

But they’re well worth the effort.

 

[margarita25]

Full contents of letter, link courtesy of @tresir2012 from the last thread:

PM letter to nation on coronavirus

Just received our letter in the post. This is the link to see what the letter says. Various versions in different languages plus a public info leaflet.

“THE PRIME MINISTER
1O DOWNING STREET LONDON SW1A 2AA
I am writing to you to update you on the steps we are taking to combat coronavirus.
In just a few short weeks, everyday life in this country has changed dramatically. We all feel the profound impact of coronavirus not just on ourselves, but on our loved ones and our communities.
I understand completely the difficulties this disruption has caused to your lives, businesses and jobs. But the action we have taken is absolutely necessary, for one very simple reason.
If too many people become seriously unwell at one time, the NHS will be unable to cope. This will cost lives. We must slow the spread of the disease, and reduce the number of people needing hospital treatment in order to save as many lives as possible.
That is why we are giving one simple instruction – you must stay at home.
You should not meet friends or relatives who do not live in your home. You may only leave your home for very limited purposes, such as buying food and medicine, exercising once a day and seeking medical attention. You can travel to and from work but should work from home if you can.
When you do have to leave your home, you should ensure, wherever possible, that you are two metres apart from anyone outside of your household.
These rules must be observed. So, if people break the rules, the police will issue fines and disperse gatherings.

I know many of you will be deeply worried about the financial impact on you and your family. The Government will do whatever it takes to help you make ends meet and put food on the table.
The enclosed leaflet sets out more detail about the support available and the rules you need to follow. You can also find the latest advice at gov.uk/coronavirus
From the start, we have sought to put in the right measures at the right time. We will not hesitate to go further if that is what the scientific and medical advice tells us we must do.
It’s important for me to level with you – we know things will get worse before they get better. But we are making the right preparations, and the more we all follow the rules, the fewer lives will be lost and the sooner life can return to normal.
I want to thank everyone who is working flat out to beat the virus, in particular the staff in our fantastic NHS and care sector across England, Scotland, Wales and Northern Ireland. It has been truly inspirational to see our doctors, nurses and other carers rise magnificently to the needs of the hour.
Thousands of retired doctors and nurses are returning to the NHS – and hundreds of thousands of citizens are volunteering to help the most vulnerable. It is with that great British spirit that we will beat coronavirus and we will beat it together.
That is why, at this moment of national emergency, I urge you, please, to stay at home, protect the NHS and save lives.”

PM letter to nation on coronavirus

 

[HongKongPhooey]

My 19 yo son is in the ER. He was there 2 days ago and told he had pleural effusion/water on his lung. He left NY state 2 weeks ago. He's clearly worse and struggling to breath. No one was allowed to go back in with him. A police officer was there to tell my mil the rules had now changed. Please pray for him and that he can advocate for himself while he can also barely breath. He's only 19 yo and he barely slept last night.

Beatrix I am so sorry to hear this. Please keep us updated. Thinking of you xX

 

[Victoria Chambers]

I am just like you and feel the same!
Thank you very much. Your comment means so much to me. God Bless Xx

 

[Rose in SC]

Circulating on nursing forums, this is a better explanation of a possible mechanism for CoVid (summarizing various juried publications and pre-prints, as well as computer analysis of observations):

///
"Might not even be a respiratory illness after all and that's just a byproduct of the wreckage it makes in blood haemoglobin (thus making ARDS a symptom not a cause).

I wish this would get more traction because if this computational analysis is correct, this could completely change the way we approach COVID, globally.

I will copy some summaries that explain this paper in layman's terms:

- Using computational analysis (modeling the behavior of a molecule in a computer), they've worked out the probable mechanism by which SARS-nCov-2 wreaks havoc on patients, as well as why chloroquine and favipiravir seem to work.

- Inside our red blood cells, there is a molecule called hemoglobin, which contains heme groups. Each heme group is a molecular "ring" (called a porphyrin) that can hold an iron (Fe) ion inside. Having an iron ion inside is what allows this heme to carry O2 (and CO2) in our blood. This is how our bodies move O2 to our tissues and remove CO2 waste products.

- The paper modeled these and found that the proteins produced when COVID replicates "collaborate" to knock iron ions out of heme groups (HBB) and replace them with one of the proteins. This makes the red blood cell unable to transport O2 and CO2!

- If the computer modeling is right, it shows that the virus hijacks our [red] blood [cells] and makes it unable to carry O2 to a patient's tissues/organs, and likewise unable to carry CO2 out of them. This would lead to organ and tissue death, roughly in the same way as if a patient were being suffocated. Even when a patient can breath (fill lungs with air), the oxygen isn't getting to the cells in their body.

- The inflammation in the lungs results from the lungs not being able to perform the oxygen/CO2 exchange, and would therefore appear to be a SECONDARY result of the hijacking of the blood. The lungs not working is a result of lack of O2 in blood, not the cause of it. Hence the "ground glass opacities".

- The paper models the behavior of chloroquine and faviparavir as well, which appear to bind to the non-structural viral proteins that hijack the heme groups, thus inhibiting them from knocking out the iron and wrecking the O2-carrying ability of the red blood cells.

- This also explains the observation made by various ER docs (incl this one in New Orleans) that patients tend to have elevated ferritin: ferritin is used to store excess iron. If a lot of iron is knocked out of heme groups and floating around, the body produces more ferritin

If true, this may mean a few things:

1. Starting drug treatment while symptoms are mild keeps virus from hijacking too much blood, enabling a still-healthy body to mount an immune response. Explains why early drug treatment (first week of symptoms) is often successful.

2. Drug treatment and intubation once patient is critical will rarely work because tissues/organs are already damaged, blood can't carry O2, and the body is too weak to produce new red blood cells able to carry Fe (and thus oxygen/CO2) even if drugs inhibit more hijacking.

3. Thus: start severe patients on drug treatment upon hospital intake to suppress further hijacking of blood by the virus, then give them a blood transfusion of new red blood cells immediately that are unhijacked. If all this is true, we would see rapid patient improvement.

---

The problem is we have not yet had studies testing whether patients will respond well to blood transfusions from people who have not had COVID-19. Right now medical attention is focused on blood transfusions from those who have beat COVID and have antibodies. This needs to be looked at

This research ties in to the fact that weight/age/high blood pressure are such risk factor and why certain blood types are less afflicted than other

////

10ofRods - Thank you for posting this excellent, easy to understand summation! I find it fascinating! My one-year old grandson has a rare genetic mutation resulting in "methemoglobinemia, type 2," a very rare, devastating blood disorder in which too little oxygen is delivered to his cells/tissues. No cure. No treatment. Oddly enough, only compounded Vitamin C (which some doctors are now recommending for CV-19) and compounded riboflavin (vitamin B-2) offer some measure of help. Of course, I'm not saying methemoglobinemia is the same or even similar to COVID-19, but it's interesting nonetheless.

If you haven't already, would it be possible to summarize the research of your last statement: "the fact that weight/age/high blood pressure are such risk factors and why certain blood types are less afflicted than others"? I'm in my 50s, overweight, with Type A+ blood. From what I've read, those are all BAD!

 

[drama_farmer]

Full contents of letter, link courtesy of @tresir2012 from the last thread:



“THE PRIME MINISTER
1O DOWNING STREET LONDON SW1A 2AA
I am writing to you to update you on the steps we are taking to combat coronavirus.
In just a few short weeks, everyday life in this country has changed dramatically. We all feel the profound impact of coronavirus not just on ourselves, but on our loved ones and our communities.
<snip>

I know many of you will be deeply worried about the financial impact on you and your family. The Government will do whatever it takes to help you make ends meet and put food on the table.
The enclosed leaflet sets out more detail about the support available and the rules you need to follow. You can also find the latest advice at gov.uk/coronavirus
<snip>


PM letter to nation on coronavirus

snipped and BBM
That sentence must bring comfort and reassurance to Brits. Of course, time will tell if that will actually come to fruition. Still, I wish our government would have the message for the U.S. IMO

 

[gngr~snap]

This was posted in the last thread.
I thought I would repost with the bullet points from the report he is citing.
The demographic in London is different than the US, but I must say some of these figures are surprising!
The link it came from is in blue on the first page and can be located under the the video on YouTube MOO

Clicking the downward arrow under the video will expand so link can be clicked on.
https://www.icnarc.org/DataServices/Attachments/Download/76a7364b-4b76-ea11-9124-00505601089b