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Exam Code: 300-615 Troubleshooting Cisco Data Center Infrastructure (DCIT) testing January 2024 by Killexams.com team

300-615 Troubleshooting Cisco Data Center Infrastructure (DCIT)

300-615 DCIT

Certifications: CCNP Data Center, Cisco Certified Specialist - Data Center Operations

Duration: 90 minutes



This exam tests your knowledge of troubleshooting a data center infrastructure, including:

- Network

- Compute platforms

- Storage network

- Automation

- Management and operations



Exam Description

The Troubleshooting Cisco Data Center Infrastructure v1.0 (DCIT 300-615) exam is a 90-minute exam associated with the CCNP Data Center and Cisco Certified Specialist - Data Center Operations certifications. This exam certifies a candidate's knowledge of troubleshooting a data center infrastructure including network, compute platforms, storage network, automation, management and operations. The course, Troubleshooting Cisco Data Center Infrastructure, helps candidates to prepare for this exam.



25% 1.0 Network

1.1 Troubleshoot routing protocols

1.1.a OSPFv2, OSPFv3

1.1.b MP-BGP

1.1.c PIM

1.1.d FHRP (HSRP, VRRP)

1.2 Troubleshoot switching protocols, such as RSTP+, LACP, and vPC

1.3 Troubleshoot overlay protocols, such as VXLAN EVPN and OTV

1.4 Troubleshoot Application Centric Infrastructure

1.4.a Fabric discovery

1.4.b Access policies

1.4.c VMM domain integration

1.4.d Tenant policies

1.4.e Packet flow (unicast, multicast, and broadcast)

1.4.f External connectivity

25% 2.0 Compute Platforms

2.1 Troubleshoot Cisco Unified Computing System rack servers

2.2 Troubleshoot Cisco Unified Computing System blade chassis

2.2.a Infrastructure such as chassis, power, IOM

2.2.b Network (VLANs, pools and policies, templates, QoS)

2.2.c Storage (SAN connectivity, FC zoning, VSANs, pools, policies, templates)

2.2.d Server pools and boot policies

2.3 Troubleshoot packet flow from server to the fabric

2.4 Troubleshoot hardware interoperability

2.4.a Converged Network Adapters / port expanders

2.4.b Firmware

2.4.c I/O modules / FEX

2.4.d Fabric interconnects

2.5 Troubleshoot firmware upgrades, packages, and interoperability

15% 3.0 Storage Network

3.1 Troubleshoot Fibre Channel

3.1.a Switched fabric initialization

3.1.b Fibre Channel buffer credit starvation

3.1.c FCID

3.1.d Cisco Fabric Services

3.1.e Zoning

3.1.f Device alias

3.1.g NPV and NPIV

3.1.h VSAN

3.2 Troubleshoot FCoE Cisco Unified Fabric (FIP, DCB)

15% 4.0 Automation

4.1 Troubleshoot automation and scripting tools

4.1.a EEM

4.1.b Scheduler

1.1 Troubleshoot programmability

1.1.a Bash shell and guest shell for NX-OS

1.1.b REST API

1.1.c JSON and XML encodings

20% 5.0 Management and Operations

5.1 Troubleshoot firmware upgrades, packages, and interoperability

5.2 Troubleshoot integration of centralized management

5.3 Troubleshooting network security

5.3.a Fabric binding and port security

5.3.b AAA and RBAC

5.3.c First-hop security such as dynamic ARP, DHCP snooping, and port security

5.3.d Troubleshoot CoPP

5.4 Troubleshoot ACI security domains and role mapping

5.5 Troubleshoot data center compute security

5.5.a Troubleshoot AAA and RBAC

5.5.b Troubleshoot key management

5.6 Troubleshoot storage security

5.6.a AAA and RBAC

5.6.b Port security

5.6.c Fabric binding

Troubleshooting Cisco Data Center Infrastructure (DCIT)
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300-615
Troubleshooting Cisco Data Center Infrastructure (DCIT)
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Question: 143
An engineer removes a VMM domain from an endpoint group called EPG-1, but the distributed port group fails to be deleted.
Which action must be taken to resolve the issue?
A. Remove the port group manually.
B. Migrate all virtual machines in the EPG-1 to different hypervisors.
C. Remove the remaining EPGs from the VMM domain.
D. Migrate all virtual machines in the EPG-1 to different port groups.
Answer: C
Question: 144
Refer to the exhibit.
HSRP adjacency fails to form between Nexus7K-1 and Nexus7K-2.
Which action should be taken to solve the problem?
A. Configure preempt on one of the switches in the HSRP group.
B. Configure the same HSRP priority between the two switches.
C. Configure the correct subnet mask on Nexus7K-1.
D. Configure HSRP version 2 on Nexus7K-2.
Answer: D
Question: 145
Refer to an exhibit.
An engineer is troubleshooting an upgrade failure on a switch.
Which action resolves the issue?
A. Save the system image in NVRA
C. Use the same system image as the kickstart image.
D. Load a new system image.
E. Reload the same system image.
Answer: C
Question: 146
Refer to the exhibit.
Sw1 and Sw2 are two Cisco Nexus 9000 Series Switches that run Cisco NX-OS. They are VTEPs in the same vPC domain.
Which statement describes what happens in this scenario?
A. Sw1 drops all traffic because there is no (S, G) OIF list to encapsulate VXLAN multicast packets and send them out to the
underlay network through the uplink interfaces.
B. Sw1 performs the VxLAN multicast encapsulation and decapsulation for all traffic associated with the VxLAN VNIs.
C. Sw1 and switch 2 perform the VxLAN multicast encapsulation and decapsulation for all traffic associated with the VxLAN
VNIs, depending on the hashing.
D. Sw2 did not send an IP PIM register to the rendezvous point for the multicast group of the VXLAN VN
Answer: B
Question: 147
Refer to the exhibit.
After the configuration is performed, guestshell continues to use 2%CPU.
Which action resolves the issue?
A. Resync the database
B. Recreate the guestshell
C. Reboot the guestshell
D. Reboot the switch
Answer: C
Question: 148
A mission-critical server is connected to site A. Connectivity to this server is lost from site B because the MAC route is missing in
the OTV VDC of the Nexus 7000 in site B due to MAC aging.
Which action allows the flooding of the unknown unicast MAC on the Nexus 7000 in the OTV VDC?
A. Use route-map to advertise this MAC statically and redistribute with ISIS.
B. Unknown unicast flooding is not allowed.
C. Use the otv flood mac <> command to selectively flood traffic for a given MAC.
D. Use the otv isis bfd <> command to configure BFD protocol.
Answer: B
Question: 149
Refer to the exhibit.
vPC between switch1 and switch2 is not working.
Which two actions are needed to fix the problem? (Choose two.)
A. Match vPC domain ID between the two devices.
B. Configure IP address on the interface.
C. Activate VLANs on the vP
E. Configure vPC peer link and vPC peer keepalive correctly.
F. Configure one of the switches as primary for the vP
Answer: AC
Question: 150
DRAG DROP
A firmware upgrade on a fabric interconnect fails. A bootflash contains a valid image.
Drag and drop the recovery steps from the left onto the correct order on the right.
Answer:
Question: 151
An engineer is troubleshooting a custom AV pair that was created by a client on an external authentication server to map a read-
only role for a specific security domain.
Which AV pair solves the problem?
A. shell:domains=Security_Domain_1//Read_Role_1|Read_Role_2
B. shell:domains=Security_Domain_1/Write_Role_1|Read_Role_2
C. shell=Security_Domain_1/Read_Role_1|Read_Role_2
D. shell:domains=Security_Domain_1/Read_Role_1|Read_Role_2
Answer: A
Question: 152
Refer to the exhibit.
The HSRP instance on both switches is showing as active.
Which action resolves the issue?
A. Configure the HSRP timers to be the same.
B. Allow VLAN 100 between the switches.
C. Configure the IP address of N9K-B on the same subnet as N9K-A.
D. Configure preempt on only one of the switches.
Answer: B
Question: 153
Refer to the exhibit.
An engineer is configuring boot from iSCSI on a Cisco UCS B-Series Blade Server, but the LUN fails to mount.
Which action resolves the issue?
A. Statically configure the target information in the Boot Policy.
B. Configure an MTU size of 9000 on the appliance port.
C. Configure a QoS policy on the vNI
E. Set a connection timeout value of 250 in the iSCSI Adapter Policy.
Answer: A
Question: 154
Your client reports that many flaps and server cluster disconnects occur in their data center. While troubleshooting the issue, you
discover a network attack hitting their Cisco Nexus 7000 Series Switches and determine that the source IP addresses are spoofed.
Which first-line security solution resolves this issue?
A. Dynamic ARP Inspection
B. Unicast RPF
C. IP Source Guard
D. Storm Control
Answer: A
Question: 155
Refer to the exhibit.
An OSPF adjacency between Router-A and Router-B cannot reach the FULL state.
Which action resolves the issue?
A. Adjust the MTU on Router-A to 1600.
B. Disable the check of the MTU value.
C. Set the OSPF media type to point-to-point.
D. Adjust the MTU on Router-B to 1604.
Answer: B
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Cisco Troubleshooting testing - BingNews https://killexams.com/pass4sure/exam-detail/300-615 Search results Cisco Troubleshooting testing - BingNews https://killexams.com/pass4sure/exam-detail/300-615 https://killexams.com/exam_list/Cisco Chapter 19: Testing and Troubleshooting No result found, try new keyword!The troubleshooting of circuits and systems is a skill that has to be acquired by practice; this chapter is aimed at providing pointers to some common techniques and pitfalls. In order to test a ... Mon, 12 Mar 2018 11:32:00 -0500 en-US text/html https://www.globalspec.com/reference/82682/203279/chapter-19-testing-and-troubleshooting End-user experience – The only network metric that matters?

The traditional approach to network performance – and issue resolution – is being turned on its head. End-user experience scoring takes an outside-in approach that redefines performance around the experience of its users.

It's all too common for network engineers to spend more time hunting for the source of network performance issues than fixing them. The lack of performance metrics is not the issue. It's often a case of too many metrics obscuring the real root of the issue. In multi-cloud hybrid networking environments, problem validation, isolation, and resolution are getting harder. Yet, it's more important than ever for businesses to find a way of filtering the signal from the noise. As businesses and consumers alike embrace hyper-connectedness, the health of their digital services is increasingly a barometer of business performance. 

Complex KPIs are giving way to end-user experience 

Businesses have their set of go-to tools and metrics they use when a problem occurs. Faced with a multitude of performance indicators, this traditional inside-out approach to network performance is becoming inefficient for network teams and frustrating for end-users. For example, close to 60% of workers have technical issues that the service desk can't resolve. 

The tide is turning, with businesses increasingly recognizing the value of focusing performance metrics on the actual experience of users. Advanced tools can now dig deeper across the KPI clutter to zoom in on how users are experiencing digital interactions and provide a more comprehensive view of the state of the network. So-called end-user experience (EUE) scoring is a major shift away from complex infrastructure-centric indicators like latency or bandwidth, to name just two. By consolidating these and other metrics, businesses can get a holistic view of the health of their digital services through an easily understandable dashboard. 

End-user experience (EUE) scoring - a radical rethink

EUE scoring isn't just another metric. It turns the old troubleshooting model on its head. Instead of starting with the infrastructure and working outwards to resolve end-user issues, the EUE approach starts with the experience of its users, arguably the only metric that really matters. Rather than chasing red performance indicators, with a simple numeric EUE score, network teams can quickly understand if there's a problem impacting the business and how severe it is. 

When issues are detected, instead of wondering which users are impacted and why, multi-dimensional advanced analytics do the heavy lifting to eliminate the many operational variables and hone in on the root cause. This automated domain isolation is a game-changer for already-stretched network teams. Instead of lengthy consultations and war-room wrangling, isolating the root cause means that the appropriate experts tackle the issue earlier, improving resource utilization within the team and speeding up issue resolution. 

From prescriptive to predictive problem resolution

Faster troubleshooting might sound like a win-win for network teams and end users alike, but it's just the start. User-centric approaches to network management that leverage advanced analytics in real-time could anticipate and resolve problems before they occur. While self-optimizing networks may seem like a distant dream for stressed-out network engineers currently, user-centric metrics are already helping to alleviate capacity problems before they become critical in today's business environments. Similarly, having a holistic view of user experience can provide an invaluable first warning sign that an enterprise is under attack from a hack or a breach. 

By prioritizing the user’s perspective in network management, an EUE approach to network performances accelerates issue resolution, improves resource utilization, and even enables predictive problem resolution.

Observer Apex from VIAVI offers a comprehensive approach to end-user experience monitoring. By generating an end-user experience score for every data transaction, it provides a granular view of network performance. Harnessing machine-learning powered automated EUE scoring and offering customizable dashboards for global operational intelligence, Observer Apex not only monitors but helps IT teams elevate the digital experience for users. 

For more information, see our solutions.

Tue, 19 Dec 2023 09:59:00 -0600 en text/html https://www.networkworld.com/article/1269944/end-user-experience-the-only-network-metric-that-matters.html
Best IT Certifications for 2024

Earning specialized certifications is a surefire way to advance your career in the IT field, regardless of industry or current career level. The right certification validates your skills and knowledge, which makes you more desirable to future employers who want to attract and retain the best employees. Below, we’ll explore the top IT certifications and share how to examine your goals to choose the right path forward. 

We’ve narrowed IT certifications into specific categories to help IT professionals assess what’s available and pursue the best certifications to show their willingness to learn and develop the in-demand career skills employers want.

Best database certifications 

Database platforms have changed greatly over the years, but database technology remains important for various applications and computing tasks. Available certifications for IT professionals include those for database administrators (DBAs), database developers, data analysts and architects, business intelligence, and data warehousing specialists, and other data professionals.

Obtaining database certifications demonstrates an understanding of database concepts, design, implementation, administration and security. This can boost your credibility in the job market and show potential employers that you have the skills needed to work with databases. The best database certifications include the following:

Best SAS certifications 

SAS is one of the world’s leading firms for business analytics, data warehousing and data mining. Today, the SAS Global Certification Program offers 23 credentials across categories including foundation tools, advanced analytics, business intelligence, data management and administration.

SAS programmers remain in high demand, with a quick search of job boards showing thousands of open positions. Obtaining SAS certification shows employers that you are proficient in the company’s popular suite of tools. Some of SAS’s certification programs include the following: 

Many professionals earn certifications to help navigate their career paths. According to the IT Salary Report, 92 percent of information technology professionals have at least one certification.

Best Cisco certifications 

Cisco Systems is a market leader not only in networking and communications products, but also storage networking and solutions for data centers. Cisco offers a variety of certifications for IT professionals, ranging from entry level credentials to expert-level exams. 

These certifications prepare professionals for Cisco-related careers. A search of job boards reveals thousands of open positions for Cisco experts, underscoring the continued relevance of these skills. Some of Cisco’s certifications include the following:

Best Dell certifications 

Dell Technologies remains one of the world’s leading computing companies. In addition to its well-known hardware lineup, Dell also offers solutions for networks, storage, servers, gateways and embedded computing, as well as a broad range of IT and business services.

Becoming certified in Dell products can help make IT professionals competitive in engineering roles for server, virtualization, networking, systems, integration and data security. Additional roles include consultants, account executives, system administrators, IT managers and deployment managers.

Best mobility certifications 

In the mobile era, it has become increasingly important for network engineers to support local, remote and mobile users, as well as provide proper infrastructure. The focus on application and app development now leans more toward mobile environments, requiring security professionals to thoroughly address mobility from all perspectives.

Due to the fast-changing nature of mobile technology, not many mobility certifications have become widely adopted. However, a few of the top mobility certifications can help IT professionals stand out in this rapidly evolving field. 

If part of your job includes selling and implementing an IT solution, you may want to pursue the best sales certifications. You’ll show your organization that you’re willing to go above and beyond to reach sales targets.

Best computer hardware certifications 

As remote and computer-based work has become more common, it’s more important than ever that businesses and individuals be able to maintain their hardware. While discussions about potential computer-related jobs often revolve around software work and coding, jumping into the IT field by becoming a computer technician is an excellent starting point.

Today, thousands of hardware technician jobs are available across the country. Entering this industry becomes more accessible for those who acquire computer hardware certifications. These certifications can showcase your expertise and proficiency in the upkeep of computers, mobile devices, printers and other hardware components.

Best Google Cloud certifications 

IT pros with solid cloud computing skills continue to be in high demand as more companies adopt cloud technologies. Today, Google Cloud is one of the market leaders in the cloud computing space. 

Regardless of where you are in your IT career, engaging with certification programs can demonstrate your willingness to keep on top of rapidly evolving cloud technologies. To that end, Google has introduced a host of certifications for its cloud platform, including the following: 

Best evergreen IT certifications

In the fast-changing world of technology, it can help to focus on certifications that have stood the test of time. “Evergreen” refers to certifications that remain popular year after year. 

The top evergreen certifications are based on recent pay surveys in IT, reports from IT professionals about certifications they want or pursue the most, and those that appear most frequently in online job postings. Obtaining these credentials is one step toward ensuring that your skills remain relevant for a long time: 

Best IT governance certifications 

IT governance provides structure for aligning a company’s IT with its business strategies. Organizations faced with compliance rigors always need experienced IT pros who can see the big picture and understand technology risks. This means certified IT governance professionals are likely to remain in high demand.

Earning one of the following certifications proves a commitment to understanding the role of IT governance and its position in a company’s current and future success. Getting certified can validate your expert knowledge and lead to advanced career opportunities.

Best system administrator certifications 

An IT system administrator is responsible for managing and maintaining the information technology infrastructure within an organization. The position demands sought-after career skills, ranging from configuring and maintaining servers and clients to managing access controls, network services, and addressing application resource requirements.

If you’re in charge of managing modern servers, there’s a long list of tools and technologies that system administrators must master. Obtaining some of the most prominent system administrator certifications can demonstrate your mastery to potential employers. 

Best ITIL certifications 

ITIL, or Information Technology Infrastructure Library, was developed to establish standardized best practices for IT services within government agencies. Over the ensuing four decades, businesses of all types embraced, modified, and extended ITIL, shaping it into a comprehensive framework for managing IT service delivery. 

The ITIL framework remains the benchmark for best practices in IT service and delivery management, offering certification programs that cater to IT professionals at all levels. These training and certification courses ensure that IT professionals stay well-prepared for the ongoing evolution in IT service delivery management. There are four certifications in the ITIL certification program:

Best enterprise architect certifications 

An IT enterprise architect is responsible for designing and managing the overall structure and framework of an organization’s information technology system. Enterprise architect certifications are among the highest that an IT professional can achieve; fewer than 1 percent ultimately reach this level. 

Enterprise architects are among the highest-paid employees and consultants in the tech industry. These certifications can put IT professionals on a path to many lucrative positions. The average worker earns over six figures annually. Some top enterprise architect certifications are listed below:

To become an enterprise IT architect, you’ll need knowledge of systems deployment, design and architecture, as well as a strong business foundation.

Best CompTIA certifications

CompTIA is a nonprofit trade association made up of more than 2,000 member organizations and 3,000 business partners. The organization’s vendor-neutral certification program is one of the best recognized in the IT industry. Since CompTIA developed its A+ credential in 1993, it has issued more than two million certifications.

CompTIA certifications are grouped by skill set and focus on the real-world skills IT professionals need. Armed with these credentials, you can demonstrate that you know how to manage and support IT infrastructure. 

Best Oracle certifications 

A longtime leader in database software, Oracle also offers cloud solutions, servers, engineered systems, storage, and more. The company has more than 430,000 customers in 175 countries. 

Today, Oracle’s training program offers six certification levels that span 16 product categories with more than 200 individual credentials. Considering the depth and breadth of this program — and the number of Oracle customers — it’s no surprise that Oracle certifications are highly sought after. 

Vendor-specific certifications address a particular vendor’s hardware and software. For example, you can pursue Oracle certifications and Dell certifications to become an expert in those companies’ environments.

Best business continuity and disaster recovery certifications

Business continuity and disaster recovery keep systems running and data available in the event of interruptions or faults. These programs bring systems back to normal operation after a disaster has occurred.

Business continuity and disaster recovery certifications are seeing a healthy uptrend as new cloud-based tools grow in popularity. While business continuity planning and disaster recovery planning have always been essential, they’re becoming more critical than ever — and IT certifications are following suit.

Tue, 02 Jan 2024 09:59:00 -0600 en text/html https://www.businessnewsdaily.com/10953-best-it-certifications.html
What Blood Testing Data Reveals About Runners’ Health

I used to think running was a panacea. “If the furnace is hot enough, anything will burn, even Big Macs,” as the fictional miler Quenton Cassidy once said. Then, about a decade ago, there was a big surge of doubt about the health effects of running. Most prominent was the suggestion that even modest amounts of running might damage your heart—“One Running Shoe in the Grave,” as the Wall Street Journal put it—but running was also accused of broader sins like promoting inflammation, causing muscle loss, and wreaking havoc on blood sugar levels.

As a runner and a journalist, I spent a lot of time trying to understand these claims, and reevaluating my own understanding of running’s health effects—a process that continues to this day. Part of that process involved going back to the original research that led us to believe that running is healthy. And to be honest, the evidence wasn’t as clear as I’d assumed. Does running (or aerobic exercise more generally) really improve health markers, or is it just that healthy people are more likely to choose to run? Do the benefits max out after a few minutes per day, or do they keep growing? Can you outrun a bad diet?

I have opinions about all these questions, but I no longer assume that the answers are obvious. So I’m always interested in new data, like a recent study in PLoS ONE from the science team at InsideTracker, a company that sells personalized blood testing to track various health biomarkers. The paper offers a peek at the aggregated results of more than 23,000 customers who report various levels of running, divided into three groups: low volume (less than three hours of running per week), medium volume (three to ten hours per week), and high volume (more than ten hours per week). For comparison, they also include results from 4,400 sedentary non-runners, and at the opposite end of the spectrum, 82 professional distance runners.

There are two important caveats to point out before diving into the data. First, this is observational data, not a randomized trial. That makes it hard to determine whether running causes any of the patterns in the data (though, as we’ll see below, there are some ways to test our assumptions about causation). Second, this is a self-selected cohort. Even the sedentary group is made up of people who are interested enough in their health that they’ve decided to spring for a service that starts at $699 for a single battery of blood tests. Since this control group is already fairly healthy, detecting any improvements will be more challenging.

The Raw Data

The journal article (which is free to read online) presents data on 27 different biomarkers that were significantly different between runners and non-runners. I’m just going to pick out a few categories that are particularly interesting.

First, here’s HDL (i.e. “good”) cholesterol levels, for females (f) and males (m) in each of the five groups: pro runners, high-, medium-, and low-volume amateurs (HVAM, MVAM, and LVAM, respectively), and sedentary people.

(Illustration: PLoS ONE)

The biggest difference is between runners and non-runners: runners have clearly higher levels, which is good. And among the runners, the trend is that more running is associated with higher levels. Similar patterns are seen for LDL (“bad”) cholesterol and triglycerides: running is good, and more running is better.

Here are the fasting glucose (i.e. blood sugar) levels:

(Illustration: PLoS ONE)

The pattern here is much less pronounced. There’s still a significant difference between runners and non-runners, but the dose-response effect of more mileage is smaller in men and non-existent for women. The same is true when looking at HgbA1c levels, which offer an estimate of long-term average blood sugar levels rather than a single snapshot. In that case, there’s a more pronounced difference between runners and non-runners, but no dose-response response effect. For blood sugar, then, running is good but more running isn’t necessarily better.

One key point: the sedentary control group has remarkably good blood sugar levels, with an average below the prediabetes cutoff. Given that 98 million Americans have prediabetes, this confirms that the control group is already pretty healthy. If you were to compare runners to the average population, you’d probably see a bigger effect.

Another group of biomarkers is associated with chronic low-grade inflammation. The pattern here is a little more complicated, but data on C-reactive protein, white blood cell count, and ferritin collectively suggest that greater volumes of running are associated with lower levels of inflammation. The fact that ferritin is considered a marker of inflammation was a surprise to me, since I think of it as an indicator of iron levels in endurance athletes. But it turns out ferritin levels can mean different things in different contexts.

For most of the biomarkers, there’s a fairly smooth trend from sedentary to pro runners. But there are a few examples where the pro runners are noticeably different from everyone else, even the amateurs who claim they’re running more than ten hours a week. Most notably, the pro runners tended to have low magnesium levels—an observation that mirrors earlier data from British Olympic track athletes. The British study also found that athletes with a history of tendon problems were most likely to have low magnesium levels, which suggests that it’s something to watch for if you’re training hard.

Is It All About BMI?

All the results I mentioned above were statistically adjusted for body-mass index, age, and sex. That’s important, because there were significant differences in BMI among the groups. Here’s that data:

(Illustration: PLoS ONE)

Now, I look at this graph and think, “Yep, all else being equal, the more you run the less you weigh.” This used to strike me as a painfully obvious statement. The current scientific consensus, on the other hand, is that exercise is ineffective for weight loss. And it’s true that lots of studies have assigned people to exercise, sometimes quite vigorously, and have seen underwhelming results for weight loss. This is a complex topic whose nuances I’ll leave for another day, but suffice to say that the new data agrees with my feeling that, if you’re running more than an hour a day, you very likely weigh less than you would if you weren’t running.

You can get another level of insight by adding in some of the genetic data that InsideTracker also collects from some of its customers. There are a large number of separate gene variants that are associated with higher BMI; by checking which of these variants a given individual has, the researchers calculated a “polygenic risk score” for obesity. In the sedentary group, those with higher risk scores tended to have higher BMI. Among the high-volume and pro runners, in contrast, that trend was flattened: those with higher risk scores had similar BMI to those with lower scores. Though the sample size was too small to draw definitive conclusions (since relatively few customers opted to get genetic testing), the results suggest that running counteracted the gene variants associated with obesity.

The BMI data raises another important question: are all the other apparent health benefits of running just secondary effects of lower BMI? Here they use a cool technique called Mendelian randomization (which I wrote about in another context earlier this year). It’s a way of turning a large observational study into a randomized trial. The randomization occurs at birth: as noted above, some people have gene variants that predispose them to have a higher BMI. These variants are randomly distributed, so if people with the low-BMI versions tend to also have better cholesterol scores (for example) regardless of whether or not they run, it suggests that BMI is what’s driving the cholesterol scores.

The results of the Mendelian randomization—again limited by low sample numbers—are somewhere in the middle. It does appear that BMI explains much of the group’s difference in cholesterol and inflammation levels, for example—but not all of it. For example, gene variants didn’t predict LDL levels, suggesting that it’s an independent effect of running.

But the closer you look, the blurrier the line between genes and behavior gets. Some of the genes associated with exercise are also associated with motivation and self-control; people who exercise a lot are also more highly motivated to eat healthily; and so on. We’re back to the challenge I mentioned at the top: teasing out the independent health effects of going for a run is really hard. The InsideTracker researchers conclude that “a holistic wellness lifestyle approach is in practice the most likely to be most effective toward preventing cardiometabolic disease.” That borders on tautological, but their data adds another small brick to the pile of evidence suggesting that endurance exercise, even or perhaps especially in large quantities, is a useful part of that holistic wellness lifestyle.


For more Sweat Science, join me on Threads and Facebook, sign up for the email newsletter, and check out my book Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance.

Tue, 02 Jan 2024 22:59:00 -0600 en-US text/html https://www.outsideonline.com/health/training-performance/runners-blood-testing-study/
Calculus Testbank

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Sun, 09 Jan 2022 13:36:00 -0600 en-US text/html https://www.uab.edu/cas/mathematics/calculus-testbank
Twinsies! How Digital Twin Technology Is Rebooting the Automotive World No result found, try new keyword!The reality is a little more mundane—but if you're in the automotive world, quite a bit more profound. Digital twin technology is one of the most significant disruptors of global manufacturing seen ... Fri, 29 Dec 2023 00:00:00 -0600 text/html https://www.motortrend.com/features/digital-twin-technology-virtual-car-copy/ Problems with communication, testing spurred virus outbreak

Michael Rembis, Maui Health President/CEO The Maui News/ MATTHEW THAYER photo

WAILUKU — Slow testing turnaround times, a lack of communication and circulation of staff and patients through the hospital were at the heart of the COVID-19 outbreak at Maui Memorial Medical Center that grew to include more than 50 patients and staff.

The cluster of cases, which began in late March among 15 employees and was announced in early April, mostly centered around two units at the hospital that had cared for the very first COVID-19 patients. As cases mounted, the outbreak spurred criticism from health care workers who were frustrated over hospital policies and called for the removal of its leadership.

Now, with just one COVID-19 patient at Maui Memorial and the cluster officially considered “closed” by the state Department of Health, hospital officials sat down with The Maui News on Thursday to talk about how the outbreak began and spread, the hard lessons they learned and what they plan to do differently should a second wave of coronavirus cases appears on Maui. Perhaps chief among the takeaways was the need to communicate better — with workers and the community.

“We fumbled the communication. That was a major problem,” said Dr. Michael Shea, ICU medical director and physician lead for the hospital’s Emergency Operations Center. “Not communicating with the community and also more importantly, not communicating with our staff effectively. And I think we fixed that. I think that was a really important lesson.”

The first patients

Maui Memorial Medical Center officials describe the events that led to a COVID-19 cluster at the hospital that ensnared more than 50 workers and patients. The Maui News / MATTHEW THAYER photo

On Maui, the cases were a trickle at first — visitors who’d come from areas of high risk, residents who’d returned home from the Mainland. Many were travel related, and most communities limited their testing to those who met the criteria of having traveled to China and showed symptoms like coughing and fever.

Kelly Catiel, director of infection control, said that the hospital’s first COVID-19 patient exposure was March 28. A person that she described as “Patient A” was admitted to the hospital with a

diagnosis unrelated to COVID. The following day, the charge nurse learned that the patient had been exposed to the virus by a caregiver in the community. The patient was placed in isolation and tested for COVID-19; two days later, the swab came back positive.

Hospital officials then began contact tracing. Anyone who was identified as possibly in contact or exposed to the patient was put on paid furlough until they could be cleared for the virus. Two health care workers in the telemetry unit who’d been exposed to the patient ended up testing positive.

Around the same time, a person known as “Patient B” was admitted to the hospital with pneumonia “and a high suspicion of COVID-19,” Catiel said. Patient B was immediately placed in an isolation unit and given a test on March 21, which came out negative two days later. Catiel explained that because the guidelines at the time didn’t require “serial or sequential testing,” the patient was taken out of isolation and moved to another unit, where the person stayed until discharge.

Hospital aide Reynita Franco sanitizes a door in a Maui Memorial Medical Center COVID-19 unit that was being prepared to be closed and returned May 14 to its former duty as a telemetry unit. The Maui News / MATTHEW THAYER photo

But a week later, Patient B still showed the same symptoms. The person was brought back and reswabbed on April 3. Two days later, the result came out positive, prompting more contact tracing.

“Ultimately, we were able to identify the outpatient area where another health care worker was found, which led to the furlough of the entire remaining staff who were there,” Catiel said.

The unit was closed and cleaned, and temporary staff were brought in to fill in for the furloughed workers.

“During tracing, we were able to identify another positive health care worker on the unit where Patient B was previously discharged from,” Catiel said. “This included the health care worker who was identified in the media for working ill when in fact the health care worker likely acquired COVID while providing care to Patient B when the patient had tested negative.”

From there, “the exposure continued to cascade within the hospital because staff members were being floated to different units” due to the low amount of patients in their own units that had been closed during the pandemic, like the surgical unit, Catiel explained.

Kelly Catiel, Director of Infection Control

On April 8, a second unit within the hospital was identified as part of the COVID-19 cluster. Both the telemetry and chronic care units that had been exposed were closed to all patient and staff movement, and everyone was tested for the virus even if they were asymptomatic, Catiel said. The mass testing revealed two positive workers from the telemetry unit where Patient A had been and 14 positive patients and 32 health care workers from the chronic care unit where Patient B had been.

Catiel explained that the risk of spreading the virus was greater in the chronic care unit where patients are unable to do daily activities on their own and need the help of nurses. Because of the heavier workload, the manager rotated staff on a daily basis, which helped prevent burnout but also meant that multiple staff could come in contact with the same patient during their stay.

Contact tracing, notifying staff

Contact tracing was a struggle. When COVID-19 first began, the process had to be done manually, with Catiel and other infection control staff pinpointing the date the symptoms began and looking three days prior to find any staff or units the patient had visited, including “ancillary staff.”

“So did the patient go to have an X-ray done? Did the patient have a procedure off the unit? Was the patient transported by a hospital transporter somewhere?” Catiel said. “So it did take a lot of time. It took days in some instances.”

Once the hospital set up an Emergency Operations Center on April 15, brought in a team to help with contact tracing and switched to an electronic program that helps pull data from the hospital’s medical record system, the process went much faster, but Catiel acknowledged that the time it took to notify people in the early days was a factor in the spread of the cluster.

Catiel said the hospital followed “a waterfall process,” notifying managers who would then let their units know. But some employees, who said they only learned of the cluster through the media and not hospital leadership, have questioned why administration wouldn’t use a hospital-wide broadcast system to notify them of positive cases.

Shea said because of privacy laws, hospital officials were limited in what they could share.

“HIPAA has always said we’re not allowed to disclose personal information, so if a patient or a health care worker is now sick, we’re not allowed to say to the entire staff, ‘Hey, John Smith has COVID,’ ” Shea said.

“You couldn’t hint at who that person was, and so it became very difficult to be able to spread that out broadly without violating the law. So I think the federal government realized that and has made some changes to those laws to allow better notification of potential contacts.”

Long turnaround times for tests and a lack of communication between the different sectors that were testing — commercial labs, primary care physicians, community drive-thru testing — also created delays in notifying people that they were positive or had been in contact with someone who was.

Shea said that channel of communication between these sectors is improving. The Department of Health and the hospital have learned to be “in lockstep, talking frequently about what testing is being done, making sure the results are shared, both sides, same time, so that everyone is taking the same action.”

“The more rapid turnaround time on the tests has really helped a lot, as well as the increasing in testing capacity in the state,” Shea said. “The tests are actually getting done in state now and in some cases on site.”

The cluster grows

As the outbreak grew, the hospital created “warm units,” areas where patients who were suspected of having the virus or who tested positive for it could be isolated. Each warm unit was walled off with plastic with a zippered door and an antechamber where staff could don protective equipment.

At the peak of the outbreak, there were five warm units, four of which could handle up to 24 patients each, Shea said. The hospital is now down to one 13-bed warm unit in the Wailuku Tower, which is an ICU ward that can take care of a wide range of patients.

Dr. Vijak Ayasanonda, co-medical director of the Emergency Department, said the hospital was prepared to set up a 10-bed warm unit in the ER but never had to.

Maui Memorial stopped visitation, closed all but one entrance for employees and began screening at the door for temperatures and symptoms. They also stopped “floating” staff through the hospital.

Catiel said mass testing of the two units was part of the reason “why that number grew so significantly in such a short amount of time,” swelling from about 15 employees and eight patients when the cluster was announced April 8 to 26 staff, 14 patients and one undetermined case on April 17.

People who got the virus included a Maui Medical Group provider who worked at Maui Memorial, three Hale Makua seniors who were discharged from the hospital and a Lanai resident who came to the hospital for treatment unrelated to COVID-19.

And, most tragically of all, five patients died at the hospital — one case was related to travel, another was community acquired and three were connected with the cluster and were in the chronic care unit, Catiel said. Both officials and the Department of Health said they are continuing to investigate the cause of the deaths, as the patients had COVID-19 as well as underlying medical conditions.

Hospital officials said they haven’t recently been testing patients post-mortem to see if their deaths were related to COVID-19. When asked how they knew that the death toll wasn’t higher due to the lack of testing post-mortem, Shea said that the hospital has been doing systematic testing and that the long-term care unit has been tested at least three separate times.

“Any patients who could’ve been exposed in the cluster have been tested,” he said. “The emergency room still has a very high suspicion and tests pretty aggressively patients who are coming through the ER. So I’m confident that we would have caught any other cases that could’ve been related to this cluster.”

In the wake of the initial negative test for Patient B that led to the widespread exposure of other patients and staff, Shea said that there is now a process in place where a patient who is suspected will in many cases get a second test, and if both are negative, they can move out of isolation. Patients who are leaving the hospital for long-term care or home health services need two screening tests 24 hours apart to show they don’t have COVID-19 “before they go into those high-risk populations,” Shea said.

Dispute over masks

Many have also questioned whether the administration’s policies on wearing masks contributed to the cluster, long a point of contention for staff who said they had been discouraged from bringing their own masks or from wearing them in general when treating non-COVID patients.

After a Kaiser official indicated that masks could help stop the spread of the virus and allowed staff to wear masks in non-clinical settings, Maui Memorial staff had hoped they would be able to do the same. But, the Kaiser-affiliated Maui Health said it would not be changing its policy in light of conserving supplies. On March 31, Maui Health CEO Mike Rembis reversed course, but by that time, some employees had already treated the first COVID-19 patient.

During a news conference after the announcement of the cluster, DOH Director Bruce Anderson said that the hospital’s issues with equipment protocols “might’ve contributed to the outbreak.”

Shea said he didn’t think the mask policy contributed to the cluster, as he thought the delay in getting testing results “was a much bigger factor.”

“At the time with the information that we had, there wasn’t science to suggest that was the right thing to do, and we were concerned that if we started masking early, we could run out when we really needed them,” Shea said.

However, many infection control practices have changed since the pandemic began. Prior to COVID-19, “the idea of someone wearing the same cloth mask made at home from patient to patient would’ve been an infection control nightmare,” Shea said. He and his colleagues acknowledged that “if we could go back, knowing what we know now, we would change what we did.”

Ayasanonda also agreed that “looking back at it, of course, we would’ve said something is better than nothing.”

“There was a lot of reasons why it didn’t happen, and it’s unfortunate. It really is,” he said. “It would’ve been better off if someone had something better than nothing. None of us are disputing that part.”

The long road back

As of Friday, the Health Department put the total number of cases related to the hospital at 57 — 36 staff and 21 patients, though the hospital continues to believe the number will be reduced once investigations are complete.

“No additional testing is being conducted related to this cluster,” DOH spokeswoman Janice Okubo said Friday. “Because investigation findings are preliminary at this time, it is possible final cluster counts may change as additional information is gathered.”

The outbreak forced many changes that officials said they will keep in place in preparation for a second wave. Rembis said that one of the lessons administration learned was that “we need to communicate more.”

“Communicating everything we can with our employees to make them feel more secure is absolutely important,” Rembis said. “And to move quicker and take actions quicker and not necessarily follow the CDC guidelines and the Joint Commission guidelines, but if intuitively we feel we need to do more, try to do things quicker and faster.”

Rembis said the hospital is also ordering as much protective equipment and supplies as possible and is working with medical staff to create a surge plan “so that we are far, far more prepared than anybody could’ve been the first time around.”

Ayasanonda added that the hospital’s surveillance “is much better right now.”

“So although we might be cooling down, if you want to call it that, that we would be prepared,” he said. “We’re not taking down the plastic. We’re not taking down the tent. We might not be utilizing it as much, but we’re not taking it down because we do anticipate the return of COVID.”

Shea said that the hospital will continue to have the Emergency Operations Center and the contact tracing team, and that Employee Health and the Emergency Department will continue to work together on not only data collection but making sure workers could be taken care of in-house.

He and his colleagues said they know it will take time to restore faith in the hospital.

“Trust is earned . . . and it takes one person at a time and one good experience at a time and one story at a time,” Ayasanonda said. “It will be brought back in by those who we take care of.”

Shea said that those who work at the hospital want it to be safe for their friends and family.

“Please believe that everything I do is to make this place as safe as possible for the people here who need it,” Shea said. “The nurses, the respiratory therapists, everybody who works here has loved ones who live on this island, and we don’t want to have to fly somewhere else to get medical care. We want our medical care here, and that has been the mission of everybody sitting in this room from Day 1.”

“We’re saddened that we had a cluster here, and I think we’ve learned all the lessons that we could from that.”

* Colleen Uechi can be reached at cuechi@mauinews.com.

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Fri, 22 May 2020 12:00:00 -0500 en-US text/html https://www.mauinews.com/news/local-news/2020/05/problems-with-communication-testing-spurred-virus-outbreak/
Coronavirus: Testing problems leaving families in limbo

By Chris BellBBC News

Schools are back, businesses are reopening and winter bugs are starting to spread - meaning more and more people are asking for a coronavirus test.

Three families explain how the testing problems are affecting them.

'I'd drive 100 miles'

Maria Aziz, from west London, has been trying to book a test since Sunday, when her nine-year-old daughter, Mishal, complained of a sore throat. By 04:00 Monday, her daughter had developed a fever.

"I had been trying all of Sunday to try and get a test. I must have tried between seven and 10 times," she told the BBC. "And then yesterday I probably tried about four times at various intervals across the day, starting early in the morning and ending late at night."

After again trying and failing to book a test today, she said she's frustrated. Her eldest daughter, Eimann, 14, has also had to be withdrawn from school while she tries to book a test for her younger daughter.

"Even if I have to drive 100 miles to get a test, I'd rather get her tested than not have a test," she said. "If she has it, then that's fine. We will know we need to continue self-isolating. But if she doesn't then it's unfair on my older daughter. She's missed enough school already.

"I'm trying through the government website and then yesterday there was also a number on the website to call - 119 - so I tried that as well. Each time there were no tests available. No home kits. No walk-in slots. No drive-through slots. Nothing.

"It's very frustrating. They've just about managed a week of school before they've had to be off again. It would be good to know one way or the other."

'We'll have to close our cafe'

Scott Vining's daughter fell ill with a temperature on Saturday. By Sunday, the rest of the family, who live near Dunstable, in Bedfordshire, had also developed symptoms.

"We've tried hundreds of times," he told the BBC about trying to book a test. "We started to try and book tests for my daughter on Sunday, to no avail, and then we started at 08:00 on Monday morning for us all."

At one point Scott was offered a test in Warwickshire, 65 miles away from his home, through the government website. But by the time he'd entered the details of his family, the spaces had disappeared.

"This is the problem I've found," he said. "When you're doing it for a family of four, either no tests were available at all or after a while it kept taking you right back to the start to put all your details in again.

"In the end, I just put my wife's details in because she's the most important one to get back to work."

Scott managed to secure a test for his wife today in Luton. He has since managed to book tests for himself and his children at a separate testing centre, in Bedford.

"Both the walk-in centre in Luton and the drive-in car park in Bedford were empty," he said. "The walk-in centre had at least 12 available test booths with only three people there. The drive-in had space for maybe 30 cars. There was only one other car there."

If it happens again, however, the small cafe the family runs may have to close. The business only survived lockdown with the help of a crowd-funding drive and a grant.

"We've only got my wife and another member of staff there. She wouldn't be able to run it on her own so we would have to shut," he said.

"Inevitably, kids are going to come home from school with sniffles and colds. We have to shut our business because of that," he said. "So it's not really worth sending the kids in if this going to happen again. We have to really think about it."

Who should get a test?

  • The government says anyone can get a test if they have coronavirus symptoms - namely a high temperature, a new or continuous cough, and/or a loss or change to your sense of smell or taste
  • You can also get a test for someone you live with if they have these symptoms
  • But you should not get a test or ask for tests for people you live with who do not have Covid-19 symptoms
  • If you have symptoms or test positive, you should remain at home for at least 10 days
  • Other members of your household, including those who do not have any symptoms, should then also stay at home and not leave the house for 14 days

Source: UK government testing guidance

'It's an absolute nightmare'

As a family of eight, not everyone has been able to get tested

For larger families, it's not just testing availability that can be an issue. "It's an absolute nightmare trying to navigate the website as a family of eight," Christina Fox, from Stockton on Tees, said.

The family was advised to book a test after phoning 111 when Christina's seven-year-old daughter developed a high fever and a cough.

After trying for seven hours on Sunday, they had managed to secure three tests - for her seven-year-old, whose symptoms were worst, for another daughter who works for NHS 111 and couldn't return before testing negative, and for herself.

"We had the app open on my phone, my daughter's phone and on the computer," Ms Fox said. "It really is like a pot of gold. You have to be there at the right time, the right second, and suddenly a test might appear."

Despite those test results coming back negative, other family members have now developed symptoms, so they have had to continue to isolate.

"We managed to get two more tests this morning," Christina said. "Because my 12-year-old goes to a different school to the younger kids, when I rang this morning they indicated that I should really be getting her tested.

"It's just ridiculous. If they want kids back at school and college and they want the economy to start running again they need to make the provisions for proper testing."

A government spokesperson said it was "processing more than a million tests a week and we recently announced new facilities and technology to process results even faster.

"If you do not have symptoms and are not eligible to get a test you can continue to protect yourself if you wash your hands, wear a face covering and follow social distancing rules."



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Tue, 15 Sep 2020 03:24:00 -0500 text/html https://www.bbc.com/news/uk-54150204 HVACR Troubleshooting Fundamentals Technician Training Package

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Coronavirus: Testing problems to be solved in weeks, says Hancock

The testing system is facing an "enormous challenge" after a "sharp rise" in those seeking a Covid-19 test, Health Secretary Matt Hancock has said.

When asked about reports of people struggling to get tested, Mr Hancock said it would take a "matter of weeks" to resolve the issues.

He said No 10 would update its testing policy shortly to prioritise the most urgent cases.

Test slots have been limited due to bottlenecks in lab processing of swabs.

The rise in demand for tests had led to local shortages, with Labour saying no tests were available in virus "hotspots" over the weekend.

Hospital bosses have also warned that a lack of tests for NHS workers is putting services at risk.

People have told the BBC of their frustration at being turned away from a walk-in test centre in Oldham, Greater Manchester.

A woman attending the walk-in centre said staff told her that labs were struggling to turn tests around.

BBC Health editor Hugh Pym said: "There seem to be enough testing sites, but there are bottlenecks in the labs for processing the swabs taken. That's why they're limiting the amount of slots for the public, just when more people want to get tested."

One Cabinet minister told BBC political editor Laura Kuenssberg this was a "classic government problem" where demand for a public service outstrips supply.

The minister, she said, was confident that "underneath the noise", the majority of people were getting the service they needed, when they needed it.

The BBC spoke to people trying to get tests at a centre in Oldham

On Saturday, Cabinet Office minister Michael Gove told the BBC that the government was working to boost testing capacity through investment in new testing centres and so-called lighthouse labs.

Scotland's First Minister Nicola Sturgeon has said she is hopeful that a backlog in test results will be resolved shortly, after "constructive" talks with Mr Hancock.

The UK government announced 3,105 new lab-confirmed cases on Tuesday, bringing the total number of positive tests to 374,228. Another 27 people have died within 28 days of a positive coronavirus test, bringing the overall death toll to 41,664.

The number of patients in mechanical ventilation beds across the UK has passed 100 for the first time in nearly two months. There were 106 patients on ventilation in the UK on Monday - the first time the figure has been over 100 since 24 July.

UK-wide figures for today are yet to be published but there were 101 patients on ventilation in England alone on Tuesday.

Around 220,000 tests are processed each day, according to government figures released last week, with a testing capacity of more than 350,000 - which includes swab tests and antibody tests. The aim is to increase that to 500,000 a day by the end of October.

Speaking in the House of Commons, Mr Hancock said there were "operational challenges" with testing which the government was "working hard" to fix.

He said throughout the pandemic they had prioritised testing according to need.

Mr Hancock said the "top priority is and always has been acute clinical care", followed by social care, where the government is sending "over 100,000 tests a day" due to the virus risks in care homes.

Matt Hancock: "We're working around the clock to make sure everyone who needs a test can get a test"

Conservative chairman of the Health and Social Care Committee Jeremy Hunt was among the MPs to question Mr Hancock on testing, saying a number of his constituents had to travel for tests, while one key worker had to wait a week for her results.

"A week ago today, the secretary of state told the Health Select Committee that he expected to have this problem solved in two weeks," Mr Hunt said.

"Is the secretary of state, given the efforts that his department is making, still confident that in a week's time we will have this problem solved?"

"I think that we will be able to solve this problem in a matter of weeks," Mr Hancock replied.

He said demand was "high" but "record capacity" was being delivered, with plans to ensure tests are prioritised for those that need them most.

Despite the health secretary's promises, there will be no easy solution to the shortages of tests.

All the expectations are that cases will go up. People are circulating more as society reopens and we are entering the period when respiratory viruses thrive.

As cases go up so will demands on the testing system. Even with the promise of more testing capacity in the coming weeks, the chances of shortages continuing remains a distinct possibility.

A new lab is due to open later this month which will be able to carry out 50,000 tests a day. But this could easily be swallowed up.

What it means is that testing will have to be prioritised where it is needed most. That will be in care homes, hospitals and among key workers, as well as where there are local outbreaks. The government's surveillance programme run by the Office for National Statistics will also be protected.

But this is not unique to the UK. Other countries are facing similar pressures. In fact, the UK is testing more people per head of population than Spain, France and Germany.

It promises to be a difficult winter across Europe.

Labour's shadow health secretary Jonathan Ashworth said Mr Hancock was "losing control of this virus".

He said that after schools and offices reopened, extra demand on the system was "inevitable". He questioned why Mr Hancock did not use the summer "to significantly expand" NHS lab capacity and "fix" contact tracing.

Responding, Mr Hancock said it was "inevitable" that demand would rise with a free service, adding the "challenge" was to ensure tests are prioritised for those who most need them.

Earlier, Home Secretary Priti Patel told BBC Breakfast the government was "surging capacity" where it was needed.

She said there is "much more work" to be done with Public Health England (PHE) and local public health bodies; and that No 10 would continue to work with PHE to "surge where there is demand" in hotspots.

Ms Patel also said England's new rule of six meant families should not stop in the street to talk to friends.



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Tue, 15 Sep 2020 01:02:00 -0500 text/html https://www.bbc.com/news/uk-54163683




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