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South China Sea

Morton B, Blackmore G

Mar Pollut Bull, 2001 Dec;42(12):1236-63.
PMID: 11827109

The South China Sea is poorly understood in terms of its marine biota, ecology and the human impacts upon it. What is known is most often contained in reports and workshop and conference documents that are not available to the wider scientific community. The South China Sea has an area of some 3.3 million km2 and depths range from the shallowest coastal fringe to 5377 m in the Manila Trench. It is also studded with numerous islets, atolls and reefs many of which are just awash at low tide. It is largely confined within the Tropic of Cancer and, therefore, experiences a monsoonal climate being influenced by the Southwest Monsoon in summer and the Northeast Monsoon in winter. The South China Sea is a marginal sea and, therefore, largely surrounded by land. Countries that have a major influence on and claims to the sea include China, Malaysia, the Philippines and Vietnam, although Thailand, Indonesia and Taiwan have some too. The coastal fringes of the South China Sea are home to about 270 million people that have had some of the fastest developing and most vibrant economies on the globe. Consequently, anthropogenic impacts, such as over-exploitation of resources and pollution, are anticipated to be huge although, in reality, relatively little is known about them. The Indo-West Pacific biogeographic province, at the centre of which the South China Sea lies, is probably the world's most diverse shallow-water marine area. Of three major nearshore habitat types, i.e., coral reefs, mangroves and seagrasses, 45 mangrove species out of a global total of 51, most of the currently recognised 70 coral genera and 20 of 50 known seagrass species have been recorded from the South China Sea. The island groups of the South China Sea are all disputed and sovereignty is claimed over them by a number of countries. Conflicts have in recent decades arisen over them because of perceived national rights. It is perhaps because of this that so little research has been undertaken on the South China Sea. What data are available, however, and if Hong Kong is used, as it is herein, as an indicator of what the perturbations of other regional cities upon the South China Sea are like, then it is impacted grossly and an ecological disaster has probably already, but unknowingly, happened.
Fulltext Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Kartsonaki C, Baillie JK, Barrio NG, Baruch J, Beane A, Blumberg L, et al.

Int J Epidemiol, 2023 Apr 19;52(2):355-376.
PMID: 36850054 DOI: 10.1093/ije/dyad012

BACKGROUND: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients.
METHODS: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV).
RESULTS: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%.
CONCLUSIONS: Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death.

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