America didn’t have to have so many people die, as the example of Hong Kong proves…
This is the new normal in Hong Kong — both very different from before the virus and very different from an American-style lockdown.
Subway workers clean handrails frequently. Restaurants are open, with tables spaced five feet apart. Diners are often given a small paper bag in which to put their mask — so it doesn’t infect the table, or vice versa
Entrance to Hong Kong is limited mostly to residents, all of whom are tested and quarantined, even if the test is negative. And residents wear masks despite 90-degree heat. “They’re so hot,” Adrienne says. “But it feels second nature to me at this point.”
The most important point: Hong Kong’s strategy is working extremely well.
It hasn’t reported a new homegrown case in more than two weeks. Over all, only about 1,000 people — out of 7.5 million — have tested positive. Only four have died.
Via NYT newsletter.
Meanwhile, in one US area roughly the same population size as Hong Kong:
The Illinois Department of Public Health (IDPH) today announced 2,122 new cases of coronavirus disease (COVID-19) in Illinois, including 176 additional deaths.…Currently, IDPH is reporting a total of 65,962 cases, including 2,838 deaths, in 97 counties in Illinois. The age of cases ranges from younger than one to older than 100 years. Within the past 24 hours, laboratories have processed 13,139 specimens for a total of 346,286.
If only the US had competent leadership, and a president who trusted science and data, and we had ramped up testing back in February (or even January!)
Historically, scientists trying to anticipate the trajectory of infectious diseases focused on properties of the agent itself, like its level of contagion and lethality. But infectious diseases need help to spread their misery: humans meeting humans, in person. In the past decade or so, leading investigators have begun to incorporate social networks into their models, trying to identify and analyze patterns of individual behavior that amplify or mute potential pandemics.
Those findings, in turn, inform policy recommendations.
When does it make sense to shut down schools or workplaces? When will closing a border make a difference, and when won’t it? World health officials consult with social network modelers on a near daily basis, and Dr. Vespignani’s lab is part of one of several consortiums being consulted in the crucial and perhaps disruptive decisions coming in the next few weeks. On Friday, in an analysis posted by the journal Science, the group estimated that China’s travel ban on Wuhan delayed the growth of the epidemic by only a few days in mainland China and by two to three weeks elsewhere. “Moving forward we expect that travel restrictions to COVID-19 affected areas will have modest effects,” the team concluded.
“Today, with the enormous computing power available on the cloud, Dr. Vespignani and other colleagues can model the entire world using” publicly available data, said Dr. Elizabeth Halloran, a professor of biostatistics at the University of Washington and a senior researcher at the Fred Hutchinson Cancer Research Center. “On the one hand, there is the rise of network science, and on the other, there is the enormous rise in computing power.”
Meanwhile, the federal government forgot to increase staffing at international airports such as O’Hare and Dulles and elsewhere, of course there was chaos and confusion and people standing shoulder to shoulder for hours. Jeez, wonder if there will be consequences?
Airports around the country were thrown into chaos Saturday night as workers scrambled to roll out the Trump administration’s hastily arranged health screenings for travelers returning from Europe.
Scores of anxious passengers said they encountered jam-packed terminals, long lines and hours of delays as they waited to be questioned by health authorities at some of the busiest travel hubs in the United States.
The administration announced the “enhanced entry screenings” Friday as part of a suite of travel restrictions and other strategies aimed at slowing the spread of the coronavirus. Passengers on flights from more than two dozen countries in Europe are being routed through 13 U.S. airports, where workers check their medical histories, examine them for symptoms and instruct them to self-quarantine.
But shortly after taking effect, the measures designed to prevent new infections in the United States created the exact conditions that facilitate the spread of the highly contagious virus, with throngs of people standing shoulder-to-shoulder in bottlenecks that lasted late into the night.
“AT THIS MOMENT, HUNDREDS OF PEOPLE ARRIVING FROM NUMEROUS COUNTRIES ARE JAMMED TOGETHER IN A SINGLE SERPENTINE LINE VAGUELY SAID TO BE ‘FOR SCREENING,’” read a tweet from Tracy Sefl, who wrote that she waited for several hours to be screened at Chicago’s O’Hare International Airport.
“Authorities are going to have to deal with the ramifications of the breakdown of whatever this system is supposed to be,” she wrote. “Not to mention needless exposure risks from containing thousands of passengers like this.”
Illinois authorities made it clear that this is 100% a federal problem
This is unacceptable. The reactionary, poorly planned travel ban has left thousands of travelers at ORD forced into even greater health risk. @realdonaldtrump and @CBP: no one has time for your incompetence. Fully staff our airport right now, and stop putting Americans in danger. https://t.co/gswIaHwelx
Beginning Saturday, processing through United States Customs was taking longer than usual inside the Federal Inspection Services facility due to “enhanced #COVID19 screening for passengers coming from Europe,” the airport said via Twitter. Angry international travelers also took to social media to express dismay at the handling of events, which caused thousands of people to stand in close proximity with potential carriers of COVID-19. As of Sunday morning, “O’Hare Airport” was trending on Twitter as a result.
“So last night as people were flooding into O’Hare Airport, they were stuck in a small area, hundreds and hundreds of people, and that’s exactly what you don’t want in this pandemic,” Pritzker said on the NBC News program. “So we have that problem. And then today, it’s going to be even worse. There are a larger number of flights with more people coming and they seem completely unprepared.”
Many Americans who are sick and seeking a coronavirus test continue to be turned away, creating a vexing problem for patients and health officials as the virus spreads. The problem persists, doctors and patients across the country say, despite increased production and distribution of the tests in recent days.
At a time when U.S. fatalities from the virus have risen, there remain limited numbers of tests and the capacity of laboratories is under strain.
The constraints are squeezing out patients who don’t meet rigid government eligibility criteria, even if their doctors want them tested, according to dozens of interviews with doctors and patients this week.
The gap between real-life obstacles to testing and President Trump’s sweeping assurances that “anybody that needs a test gets a test” has sown frustration, uncertainty and anxiety among patients who have symptoms consistent with covid-19, the disease caused by the virus, but have been unable to find out whether they are infected.
Having competent leadership really does matter. Trump’s people knew about the virus in early January, did nothing to ramp up the nation’s pandemic infrastructure, twiddled their thumbs, and now we are all paying the price, or about to.
If Trump had any love of America1 he’d resign in shame.
The vaccine won’t be available for a while in any case…
Los Angeles Times:
Nothing can stop a global outbreak in its tracks better than a vaccine. Unfortunately, creating a vaccine capable of preventing the coronavirus that causes COVID-19 will probably take at least a year to 18 months, health officials say.
“That is the time frame,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the House Oversight and Reform Committee this week. Anyone who says they can do it faster “will be cutting corners that would be detrimental.”
While there are about 10 vaccine candidates in the works — and at least one of them could begin clinical trials in April — it would still take about three more months to conduct the first stage of human testing and another eight months or so to complete the next stage of the trial process, he added.
New vaccines require copious research and time-consuming testing that can cost hundreds of millions of dollars. There’s no guarantee of success, but even if everything goes well, the final product might not hit the market until after an outbreak has subsided.
Here’s a look at how vaccines are made and why the process takes so long.
Keep washing your hands, we are in for a long, bumpy ride…
Now, however, we face a much bigger crisis with the coronavirus. And Trump’s response has been worse than even his harshest critics could have imagined. He has treated a dire threat as a public relations problem, combining denial with frantic blame-shifting.
His administration has failed to deliver the most basic prerequisite of pandemic response, widespread testing to track the disease’s spread. He has failed to implement recommendations of public health experts, instead imposing pointless travel bans on foreigners when all indications are that the disease is already well established in the United States.
And his response to the economic fallout has veered between complacency and hysteria, with a strong admixture of cronyism.
It’s something of a mystery why the Centers for Disease Control and Prevention, normally a highly competent agency, have utterly failed to provide resources for widespread coronavirus testing during the pandemic’s crucial early stages. But it’s hard to avoid the suspicion that the incompetence is related to politics, perhaps to Trump’s desire to play down the threat.
According to Reuters, the Trump administration has ordered health agencies to treat all coronavirus deliberations as classified. This makes no sense and is indeed destructive in terms of public policy, but it makes perfect sense if the administration doesn’t want the public to know how its actions are endangering American lives.
A looming shortage in lab materials is threatening to delay coronavirus test results and cause officials to undercount the number of Americans with the virus.
The slow pace of coronavirus testing has created a major gap in the U.S. public health response. The latest problem involves an inability to prepare samples for testing, creating uncertainties in how long it will take to get results.
The growing scarcity of these “RNA extraction” kits is the latest trouble for U.S. labs, which have struggled to implement widespread coronavirus testing in the seven weeks since the country diagnosed its first case. Epidemiologists and public health officials say that the delayed rollout, caused in part by a botched CDC test, has masked the scope of the U.S. outbreak and hobbled efforts to limit it.
If enough processing kits aren’t available, the risk that testing will be disrupted is “huge,” said Michael Mina, associate medical director of molecular diagnostics at Brigham and Women’s Hospital in Boston.
“RNA extraction is the first step in being able to perform” a coronavirus test, he said. “If we cannot perform this step, the [coronavirus] test cannot be performed.”
Qiagen, a major supplier of the kits, confirmed that its product is backordered due to “the extraordinary pace” at which the world has increased coronavirus testing over the last few weeks.
With more than a hundred cases already discovered in the U.S., which had resulted in six deaths (the virus has since infected nearly four hundred people in the U.S., and killed at least nineteen of them), Trump was concerned. But he was also confused, despite having had several previous briefings with the Administration’s top health officials. Grasping for some good news, he pressed the executives to deliver a vaccine within a few months, at which point Anthony Fauci, the longtime director of the National Institute of Allergy and Infectious Diseases (N.I.A.I.D.), spoke up. “A vaccine that you make and start testing in a year is not a vaccine that’s deployable,” he said. The earliest it would be deployable, Fauci added, is “in a year to a year and a half, no matter how fast you go.”
Never a good sign when incompetence is the first word that executive leadership brings to mind.
And private industry is not going to give away billions of dollars of R&D, only governments can handle that, and should handle projects of that size.
John Shiver, the global head of vaccine research and development at the multinational pharmaceutical company Sanofi, which is developing a covid-19 vaccine, was at the meeting with Trump. “There was some confusion there,” Shiver said, that certain officials did not understand that “being in people,” as in human trials, is not the same as having a product. Clinical trials are conducted on healthy people, which is inherently challenging. “You certainly don’t want a vaccine that can make it worse,” Shiver said. “There have been some vaccine candidates historically that could actually enhance the disease.” Sanofi is working with the United States Biomedical Advanced Research and Development Authority, a sort of biomedical darpa, to advance a covid-19 vaccine based largely on the vaccine candidate it had developed for sars. Shiver told me that the authority doesn’t expect to have anything ready for human trials until much later this year. “It’s difficult,” Shiver said, “to see how, even in the case of an emergency, a vaccine could be fully ready for licensure in a year and a half.”
The Coalition for Epidemic Preparedness Innovations (cepi), an Oslo-based nonprofit organization, was established at Davos, in 2017, to help the world prepare for a “disease X” pandemic. One of its aims is to dramatically hasten the process of vaccine development. To create a viable, scalable vaccine “takes vast amounts of funding and R. & D.,” Rachel Grant, the advocacy and communications director at cepi, told me. “It is a long and complex business. It’s all doable, science can meet the challenges, but there is lots of attrition” before any vaccine gets to the point of licensure. The problem is twofold. First, there may never be a market for a vaccine at the end of the development process, because the epidemic is contained, or never comes to pass. Then, traditionally, if there is an epidemic, it may take hold in a developing country where the costs of research and development cannot be recouped. “The resources and expertise sit in biotech and pharma, and they’ve got their business model,” Grant said. “They’re not charities. They can’t do this stuff for free.”
cepi, with funding from the government of Norway, the Gates Foundation, the Wellcome Trust, and several other countries (the United States is not among them), is trying to bridge the gap. The challenge of vaccine development is “what cepi was set up to solve,” Grant told me, “played out writ large in an episode like this.” Since the novel coronavirus emerged, cepi has ramped up its grant-making expenditures to more than nineteen million dollars. Two grant recipients—a Massachusetts-based biotech startup named Moderna and a lab at the University of Queensland, in Brisbane, Australia—have, remarkably, already developed a vaccine candidate that they will start testing in human trials in the next few months, and another biotech startup supported by cepi is not far behind. But, ultimately, to get three different vaccines through the final phase of clinical testing, Nick Jackson, cepi’s head of programs and innovative technology, told me, will require an estimated two billion dollars.
Put President Trump in a room full of scientists, and he’s going to start to feel very insecure. Put him in a crisis he can’t boast his way out of, and things are going to go very badly.
That’s what we now face with the coronavirus. The crisis is not happening only in a foreign country, or in just one spot in America. It threatens to touch all of us. By all accounts, the president’s handling of it so far has been somewhere between awful and disastrous. Worst of all, from his perspective, it threatens the reality distortion field he works so hard to maintain.
Trump is plainly more concerned with how the virus affects his public image than how it affects Americans’ health. He blurted out that he wanted to keep a cruise ship off the coast of California “because I like the numbers being where they are. I don’t need to have the numbers double because of one ship.”
But when Trump feels the need to remind you that he is related to a smart person, it’s pretty obvious that he’s afraid people might not think he’s smart enough.
We are tracking the COVID-19 spread in real-time on our interactive dashboard with data available for download. We are also modeling the spread of the virus. Preliminary study results are discussed on our blog.
(Via Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE.)
The United States is one of the few wealthy democracies in the world that does not mandate paid sick leave. As a result, roughly 25 percent of American workers have none, leaving many with little choice but to go into work while ill, transmitting infections to co-workers, customers and anyone they might meet on the street or in a crowded subway car.
As a nation, in other words, we are sicker than we need to be. That reality could make a widespread coronavirus outbreak here worse than it would be in a comparable country that takes sick leave seriously.
The absence of paid sick days creates “a near-guarantee that workers will defy public health warnings and trudge into their workplaces, regardless of symptoms,” as Karen Scott, a doctoral student studying workplace issues at the Massachusetts Institute of Technology, put it recently in The Conversation. “In this way, a manageable health crisis can spiral out of control.”
The service industry — comprising the people who prepare our meals and care for our children — has one of the nation’s lowest rates of paid sick leave in the private sector at 58 percent. The CDC reports, for instance, that “1 in 5 food service workers have reported working at least once in the previous year while sick with vomiting or diarrhea.”
I’m still rather blasé about covid-19, in general. However, the US is ripe for a major health disaster, especially after years of GOP cost cutting in areas like CDC and related budgets.
Having a robust health care for all citizens would help immeasurably.
And retrain your brain to not touch your face:
Like all our habits, touching our face has been reinforced over time: It begins with an itch or an irritation, which feels better, temporarily, when scratched or rubbed. That reaction then becomes a tic, Sawyer said.
But passing unseen are the legions of germs living on your hands — picked up from your phone, keyboard, a doorknob or elsewhere — hitching a ride on the way to your throat, sinuses and lungs.
Not touching your facial mucous membranes, an area known as the “T-zone,” is perhaps the most important step you can take to prevent an infection, Sawyer said.
“It’s the one behavior that would be better than any vaccine ever created,” he said. “Just stop this simple behavior. Stop picking, licking, biting, rubbing — it’s the most effective way to prevent a pandemic.”
People are more likely to get the virus by picking it up from a surface and touching their face, than they are to breathe in droplets directly from someone who is infected, Sawyer said.
Having had the pleasure to spend much of Friday at the vet, and enjoy many visits recently, I would sincerely like for one of the Democratic Presidential candidates to add Medicare For All Pets as a possibility. Elizabeth Warren, Bernie Sanders, Cory Booker, Andrew Yang, doesn’t matter, the proposal would get a lot of votes because pets are part of the family, and they need healthcare too. Insulin, for instance, is expensive, and it shouldn’t be.
The Kentucky General Assembly is considering this bill (with at least 40 co-sponsors):
Create a new section of KRS Chapter 311 to provide that if the United States Supreme Court reverses Roe v. Wade, or an amendment is adopted to the United State Constitution restoring state authority to prohibit abortion, no person shall knowingly administer to, prescribe for, procure for, or sell to any pregnant woman any medicine, drug, or other substance with the specific intent of causing or abetting the termination of the life of an unborn human being and no person shall use or employ any instrument or procedure upon a pregnant woman with the specific intent of causing or abetting the termination of the life of an unborn human being; any person who violates the prohibition is guilty of a Class D felony; provide an exemption for a licensed physician to perform a medical procedure necessary in reasonable medical judgment to prevent the death or substantial risk of death due to a physical condition, or to prevent the serious, permanent impairment of a life-sustaining organ of a pregnant woman; specify that this Act shall also be effective to the appropriation of Medicaid funds that set forth the limited circumstances in which states must fund abortion to remain eligible to receive federal Medicaid funds; repeal KRS 311.710; provide that this Act may be cited as the Human Life Protection Act.
and Representative Mary Lou Marzian has tongue-in-cheek proposed the following amendment:
On page 3, between lines 3 and 4, by inserting the following: “SECTION 2. A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO READ
All women who are Kentucky residents, and of child bearing age, shall acquire a signed and notarized statement from a practitioner licensed pursuant to this chapter each month that states whether she is pregnant or not pregnant. If pregnant, the signed and notarized statement shall provide the status of the pregnancy. The woman shall submit the signed and notarized statement to the Cabinet for Health and Family Services each month. Any woman who fails to provide this monthly signed and notarized statement to the cabinet shall be subject to arrest and fines. Any woman who is pregnant and fails to provide this monthly signed and notarized statement to the cabinet will be fitted with an ankle monitor for the duration of the pregnancy in addition to any arrest and fines.”; and Renumber subsequent sections accordingly.
Is this real? Or an elaborate prank? I’m guessing this amendment will not pass, but maybe it should. If the government can dictate what women can do with their bodies, why not take this to its logical conclusion?
There’s a new war raging in health care, with hundreds of millions of dollars at stake and thousands of lives in the balance. The battle, pitting drug companies against doctors and patient advocates, is being fought over the unlikeliest of substances: human excrement.
The clash is over the future of fecal microbiota transplants, or F.M.T., a revolutionary treatment that has proved remarkably effective in treating Clostridioides difficile, a debilitating bacterial infection that strikes 500,000 Americans a year and kills 30,000.
The therapy transfers fecal matter from healthy donors into the bowels of ailing patients, restoring the beneficial works of the community of gut microbes that have been decimated by antibiotics. Scientists see potential for using these organisms to treat diseasesfrom diabetes to cancer.
At the heart of the controversy is a question of classification: Are the fecal microbiota that cure C. diff a drug, or are they more akin to organs, tissues and blood products that are transferred from the healthy to treat the sick? The answer will determine how the Food and Drug Administration regulates the procedure, how much it costs and who gets to profit.
The 2,000-page law, however, covers a vast array of other health-care issues, touching almost every part of the health-care industry in the United States.
For that reason, if the ruling were to take effect, it could create major disruptions across the U.S. health-care system — affecting which drugs patients can buy, preventive services for older Americans, the expansion of Medicaid in most states and the structure of the Indian Health Service.
“There’s really no American that’s not affected by this law,” said Yale law professor Abbe Gluck, who filed an amicus brief with other lawyers in the Texas case.
The judge’s ruling, she said, flouts settled legal doctrine and places key acts of Congress in reverse order.
By ignoring that Congress specifically declined to strike down the ACA in 2017 when it chose to alter only one portion of the bill, she said, the judge decreed that the 2010 Congress, which first passed the law, has more authority than the same legislative body in 2017.
But because of this activist Republican judge, the country will be unsettled until his ruling gets studied by the next level of judicial review. Crazy. And who is supporting the ACA in court? Certainly not Trump’s Justice Department, they want the bill to be overturned as well.
The Justice Department, which had been defending the law in court for years, announced in June that it would no longer argue for the mandate, and, as a result, the Trump administration said, a separate requirement that insurance companies cannot reject people who have preexisting conditions was also invalid.
Researchers say air pollution may increase risk of autism. Two studies concluded there may be a link, but more research is needed.
Two new studies have found an association between relatively low levels of air pollution and children’s risk of autism spectrum disorder (ASD).
One study, published in JAMA Pediatrics, studied 132,000 births in Vancouver, Canada, from 2004 to 2009. Researchers concluded there was a link between exposure to nitric oxide from car exhaust during pregnancy and greater incidence of childhood ASD.
The second study, published in Environmental Epidemiology, observed more than 15,000 infants born in Denmark between 1989 and 2013. It found that air pollution exposure during the first months of life and later was also associated with ASD.
“The study showed a small increase in autism for infants exposed before birth to one of the pollutants: nitric oxide. While it’s a small increase, if large populations are exposed, it could still affect many children,” Lynn Singer, PhD, professor of population and quantitative health sciences, pediatrics, psychiatry, and psychology at the School of Medicine at Case Western Reserve University in Ohio, told Healthline.
If the Democrats were smart, they would hammer this talking point over and over, despite it not being scientifically proven (yet). Take a page from the GOP/NRA playbook, and link the EPA’s (original) mission of clean air for everyone vs. pollution created by coal/chemical plants being encouraged to pollute so as to make more profits. Say it a million times, say it unprompted. Say the Trump admin is knowingly causing autism by their deregulatory fever, etc.
Gluten Free, Certified Vegan, Top 8 Allergen Free, Pareve, Non-GMO
I’m of two minds on this: sure, there is no need to ban dihydrogen monoxide, or other harmless chemicals from packaged foods. Even MSG turns out to be useful, and non-harmful.
On the other hand, food scientists shouldn’t get an automatic pass to put whatever they want in foods, especially if there are untested ingredients. Or too many additives. The best foods are simple, and don’t require 500 word ingredient lists. I’m with Charlie Baggs…
Products free from artificial colors, preservatives, high fructose corn syrup and certain other additives make up roughly 30% of food and beverage sales and are the fastest-growing segment, according to Nielsen.
The Food and Drug Administration acknowledges its requirements for describing ingredients can be confusing. Anna Abram, an FDA deputy commissioner, points to vitamin B12, which in line with FDA regulations appears on some food labels as cyanocobalamin.
“That sounds like cyanide,” she says. B12, which helps cell and nerve function, occurs naturally in beef and tuna. Breakfast cereals are often fortified with it. She said the FDA is considering ways to make such ingredients sound more palatable.
That’s welcome news to Charlie Baggs, a “clean-label” research chef in Chicago who slashed the list of ingredients in one frozen dinner from 60 to 15. One common foe is xanthan gum, an emulsifier used to stabilize sauces and soups that is widely considered safe and natural .
“It doesn’t sound like something your grandma would use,” he says. “Who wants to eat that?”
MedMen buying into Illinois. But to me the bigger story is that the upcoming gubernatorial race is about cannabis legalization in Illinois…
The sale is timely because Gov. Bruce Rauner last month signed into law a measure allowing any patient who would qualify for an opioid painkiller prescription to also qualify for medical marijuana. The new law also eliminated requirements for fingerprints and criminal background checks. Those changes are expected to greatly expand a market that had about 44,000 certified customers and $12 million in monthly sales as of August.
In addition, industry leaders expect Illinois lawmakers to legalize marijuana for recreational use next year if Democrat J.B. Pritzker wins this November’s election for governor. Pritzker supports allowing and taxing adult use, while Rauner, a Republican, opposes it.