Saturday, May 02, 2020

Coronavirus News (74)

Inside the extraordinary race to invent a coronavirus vaccine Companies are launching trials at an unprecedented pace, but some worry about the trade-offs between speed and safety. ....... He volunteered to be a test subject knowing about the risks and unknowns, but eager to do his part to help end the worst pandemic in a century. ........ A coronavirus vaccine has become the light at the end of a very long tunnel, the tool that will bring the virus to heel, allowing people to attend sports events, hug friends, celebrate weddings and grieve at funerals. ........ With at least 115 vaccine projects in laboratories at companies and research labs, the science is hurtling forward so fast and bending so many rules about how the process usually works that even veteran vaccine developers do not know what to expect. ......... “The 26 years it took us to make the rotavirus vaccine is pretty typical. If it’s 12 to 18 months, you’re skipping steps” ........ Designing a promising vaccine is, in some ways, the easy part. Showing that it is safe and effective, and then scaling up production can takes years, or even decades. ............ “We’re not going to be able to say in 18 months that we have enough for all the world’s people to be immunized with two doses.” ................ “My motto is a woodworking one: Measure twice, cut once. The only change to that motto is: Measure quickly twice, cut quickly once” ........... the risk that the vaccines could actually make the disease worse in some people, as happened in some animal studies of vaccines for severe acute respiratory syndrome (SARS), through a mechanism called antibody dependent enhancement. ......... Scientific debate is still raging about a dengue vaccine used in the Philippines in recent years that increased the risk of hospitalization for dengue in children who had not previously been infected. ............ the trust in vaccines generally, considered one of the most successful public health interventions in human history





The last time the government sought a ‘warp speed’ vaccine, it was a fiasco It was 1976, and President Gerald Ford was racing to come up with a vaccine for a new strain of swine flu ........... The federal government has launched “Operation Warp Speed” to deliver a covid-19 vaccine by January, months ahead of standard vaccine timelines. ...The last time the government tried that, it was a total fiasco........... The government had never attempted such an endeavor — both in its breadth and speed. .......Almost immediately, there was chaos............ One manufacturer produced 2 million doses with the wrong strain. As tests progressed, more scientific problems emerged — even as there were few, if any, signs that a pandemic was materializing. In June, tests showed the vaccine was not effective in children, prompting a public squabble between Salk and Sabin over who should be vaccinated. .......... There were reports of sporadic deaths possibly connected to the vaccine. Cases of Guillain-Barre syndrome also emerged, and are still cited today by the anti-vaccine movement. Panic emerged, with dozens of states pausing vaccinations. .......... By December, following 94 reports of paralysis, the entire program was shut down. .......... Almost immediately, in grand Washington fashion, fingers were pointed. Scientists and government officials turned on each other, with allegations that Ford acted recklessly for political gain without knowing for sure whether a pandemic would emerge — an impossible predictive game, his defenders argued.......

The recriminations were fueled by the fact that the swine flu pandemic hadn’t materialized.

.......... Ford had the initial backing of the world’s foremost vaccine experts — Salk and Sabin.


Smallest caseload to biggest death toll: Coronavirus decimates D.C.’s poorest ward “We’ve been suffering from people dying in Ward 8 for the last 30, 40 years,” he fumed, listing the reasons: diabetes, high blood pressure, asthma, suicide, homicide. “It’s always people of color dying in the city. It’s not nothing new.” .............. For decades, the neighborhoods east of the Anacostia River — a stretch encompassing the poorest and most heavily African American population in the nation’s capital — have contended with an array of seemingly intractable challenges that include unemployment, violent crime, and drug addiction. ........The coronavirus has added a new layer of lethal pain. ......... As a council member, White (D) is known more for street activism and showing up at crime scenes than for policy proposals. He is often compared to the late D.C. Mayor Marion Barry, who also represented the ward, though White delivers his populist touch on social media as well as in person. ........

“ ‘You don’t deliver food by phone’ — I want you to get that quote,” he said, repeating the line for emphasis

one afternoon as he dropped off dinners at a public housing complex. ........ When he urges people to disperse, he said, “They go off and they come right back.” ........ On April 19, he posted on Instagram that Veronica Norman, 76, his grandmother, had died. Her family had urged her to retire from the nursing job she held for 40 years at St. Elizabeths Hospital. ...... She kept working until her last days........ The coroner, White wrote, declined to transport her body to a funeral home “because it [was] a COVID-19 case.” ...... “This broke us down even more.” ....... The pandemic has exacerbated the ward’s socioeconomic challenges, including an 11 percent unemployment rate as of February, the highest in the city. As the health crisis deepened, people lost restaurant and service jobs. Others were forced to work at home, often in cramped apartments, alongside children navigating school online. ........

“I have families calling because they’re literally losing their minds,” she said. “People looking for food, for testing. They’re breaking emotionally.”

....... “Most of our focus is usually on stopping violence and helping people get jobs,” said Derek Floyd, a community activist and hip-hop artist who was distributing food one recent afternoon. “Now it’s about keeping the desperation at bay as much as we can. It’s about the basics — food, masks and gloves.” ....... As he traverses the ward, dreadlocks falling down his back, White describes himself as a one-man “social services office.” He is known for his relentless activism and nexus of relationships ....... Two years later, White was widely rebuked and accused of anti-Semitism after posting a Facebook video in which he espoused a conspiracy theory that the Rothschilds, a Jewish banking family, controlled the weather. ......... “Happy corona day,” Pepi Miller, 52, a laid-off welder, said as White passed out groceries the other day from the back of a van in Anacostia.

“I have no money, but look at the bright side: I’m not dead.”

....... A couple of hours later, White appeared on a friend’s Instagram live broadcast. The topic of discussion was anxiety and depression. ....... “There are a lot of people who may lose their jobs, their career, their house, their apartment and some people might lose their minds,” White said.




Coronavirus News (73)

FDA OKs Remdesivir Emergency Use for Severe COVID-19 — From the first case diagnosed to a therapeutic in just weeks ........ the drug met its primary endpoint, a 31% significantly faster time to recovery over controls. ..... Department of Health and Human Services Secretary Alex Azar said the EUA is "another example of the Trump Administration moving as quickly as possible to use science to save lives" ....... the U.S. government will help to distribute remdesivir to hospitals in cities most heavily affected by the COVID-19 outbreak, adding "hospitals with intensive care units and other hospitals that the government deems most in need" will be prioritized, in part due to limited availability of drug supply.



COVID-19 Killing African Americans at Shocking Rates — Wildly disproportionate mortality

highlights need to address longstanding inequities

....... In Louisiana, African Americans accounted for 70% of COVID-19 deaths, while comprising 33% of the population. In Michigan, they accounted for 14% of the population and 40% of deaths, and in Chicago, 56% of deaths and 30% of the population. In New York, black people are twice as likely as white people to die from the coronavirus. .......... decades of spatial segregation, inequitable access to testing and treatment, and withholding racial/ethnicity data from reports on virus outcomes. ......

"There is nothing different biologically about race. It is the conditions of our lives"

....... Predominantly black U.S. counties are experiencing a three-fold higher infection rate and a six-fold higher death rate than predominantly white counties. ........ Many of these communities are located in poor areas with high housing density, limited access to education, and high unemployment rates. Low socioeconomic status is independently a risk factor for poorer health outcomes and is forcing some individuals residing in these communities out of their homes and into the workforce. ......... African Americans are overrepresented in frontline jobs like the postal service or home health aid industry, leading to higher rates of exposure, Jones said........ In New York City, the national epicenter, 75% of frontline workers are people of color. ........ "People are starting to recognize these people as being part of the essential workforce and those people are disproportionately black and brown," Jones told MedPage Today. "We have not honored the essential nature of that work, just as we have not equipped respiratory technicians, nurses, and doctors in the hospital with the [personal protective equipment] they need." ........... African Americans shoulder a higher burden of chronic disease, with 40% higher rates of hypertension and 60% higher rate of diabetes than white Americans ....... a long legacy of spatial and occupational segregation ........ Bias was shown to permeate the medical treatment of black patients long before the pandemic ........ when the state initially launched drive-through testing, it became clear -- when one 90-year-old woman walked a mile in the heat to get tested -- this would not be accessible to many low-income individuals who didn't have cars ...... As Georgia Gov. Brian Kemp (R) forges ahead with plans to reopen tattoo parlors, hair salons, and bowling alleys, for example, the state's National Association for the Advancement of Colored People (NAACP) chapter criticized that decision, saying it would disproportionately affect people of color. Newly released CDC data showed more than 80% of hospitalized COVID-19 patients in the state were black. ........

"To us, it is another signal that maybe our lives are not valued."

the slumber of racism denial.




Are Stockholm's Hospitals About to Break? — "The situation is not improving and there are concerns of not enough PPE and health professionals" ....... The Swedish healthcare system has thus far withstood an onslaught of COVID-19 cases under the country's less restrictive approach to fighting the pandemic, but it can't hold out much longer unless cases subside, public health experts there warned. ........

Over the past month, the cumulative number of cases has climbed sharply with no sign of flattening

...... reaching about 22,000 in a nation of roughly 10 million. That's less on a per-capita basis than in the United States, but not by much. ...... this pertains mainly to Stockholm, which has been the hardest-hit part of the country. ........ there are concerns of not enough personal protective equipment [PPE] and health professionals." ........ Last week, a group of 22 clinicians, virologists, and researchers penned an op-ed in a Swedish business newspaper calling for the closure of schools and restaurants, and requiring PPE for those who work with the elderly. More than a month ago, 2,300 academics urged the government to tighten restrictions in order to protect the healthcare system. .......... "No one has tried this route, so why should we test it first in Sweden, without informed consent?" Cecilia Soderberg-Naucler, PhD, an immunologist at the Karolinska Institute ......... only high schools and universities have closed; businesses have remained open. Swedes have been asked to keep their distance in public, refrain from non-essential travel, and work from home when possible. Gatherings of more than 50 people are also banned, as are home care visits. ............ "Apart from a few popular streets in central Stockholm, the pedestrian traffic elsewhere is down anywhere from 50% to 90%" ........ "Home delivery of groceries has exploded in popularity, making it difficult to make an order." ......... Sweden's death rate has been far higher than its Scandinavian neighbors: about 250 per million as of Thursday, compared with roughly 75 per million in Denmark and 42 per million in Norway, both of which instituted lockdowns in mid-March. ......... attributed the higher death rate to extensive infections in the country's elderly care homes. He has said nearly half of the country's deaths have occurred in those facilities .......... has denied claims that their approach was to create herd immunity. ........... Time will simply tell and no one knows today what the correct strategy is, hence, the Swedish strategy is no more experimental than any other country. We are all groping in the dark." .......... "I like the idea of 'freedom with responsibility' as the Swedes have adopted; it'll probably also be easier on the economy," Knop told MedPage Today. "However, as a medical doctor it's tough to see the immediate greater impact on health."


This 7-Minute Morning Routine Will Change Your (Work) Life This routine takes seven minutes each morning before you start work. Will you follow it? ...... It's like the approach you make to the tee on a golf course. You plan out how you will hit the shot, which is more important than the actual swing. ........ You'll also need a journal. ......... You have to clear your head. ........ breathing deeply creates a calming effect in your brain and helps you focus. Intentional breathing is important at all times of the day. ....... Draw a picture or doodle an idea. It's a way to figure out what is important, and what is stressing you out. It is a record of your preparation and a way to help you look back and see, for these seven minutes, what was really important. Make sure you don't get too focused on the writing and not enough on the thinking. ......... make a brief plan--in only 30 seconds--to act on one of the items on your list. Just one. If you jotted down a note to deal with a conflict or to finish a report, decide to focus on that task and make sure you are intentional about addressing it.