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Dutch Court Allows Euthanasia in Advanced Dementia Cases

April 27, 2020

(CNN) – Doctors in the Netherlands may legally euthanize patients with severe dementia who previously provided a written request for the procedure, the country’s highest court ruled Tuesday. In the landmark decision, the court said that a physician may respond to a written request for euthanasia made before someone develops advanced dementia, provided certain legal requirements are met — even if the patient’s condition means they become unable to confirm that request.

Favouring Young Over Old in Covid-19 Treatment Justifiable, Says Ethicist

April 27, 2020

(The Guardian) – Older people should be denied treatment for the coronavirus if a younger, healthy person needs help, according to Prof Arthur Caplan, a prominent US medical ethicist. Age, he said, was a “valid criterion” to use when making the “terrible choice” of who should receive scarce resources during the pandemic. “To the extent to which data supports the risk of failure or the odds of success, age can justifiably be used to ration care if maximisation of lives saved is the overarching goal,” said Caplan – who is ethics adviser to the US government – in remarks in a debate published on Wednesday in the British Medical Journal.

The Coronavirus Pandemic Is Forcing U.S. Doctors to Ration Care for All Patients

April 27, 2020

(TIME) – Soon after public health officials identified SARS-CoV-2 virus as the cause of a previously unknown illness in the Hubei province of China, doctors realized that the novel coronavirus seemed to zero in on certain demographics: older people, as well as those with existing chronic diseases and weakened immune systems like Kraemer, 43. “From very early on, I felt vulnerable and scared,” she says. “People were saying ‘everybody don’t worry, this will only affect the sick people.’ I felt vulnerable and expendable.”

The Hunt for a Coronavirus Vaccine–a Perilous and Uncertain Path

April 27, 2020

(The Guardian) – The stakes could hardly be higher; the prize still tantalisingly out of reach. It is no exaggeration to say that the fate of many millions of people rests on the discovery of a vaccine for Covid-19 – the only sure escape route from the pandemic. Yet the optimism that accompanied the launch of Oxford University’s human trials this week has to be put in context, and the hurdles facing the scientists need to be understood. The vaccine hunters are trying to outwit an invisible enemy so small that a million viral particles could fit inside a human cell, but whose biological ingenuity has brought everyday life to a standstill. So what is the path to success?

Hospitals Are Using AI to Predict the Decline of Covid-19 Patients–Before Knowing It Works

April 24, 2020

(STAT News) – Dozens of hospitals across the country are using an artificial intelligence system created by Epic, the big electronic health record vendor, to predict which Covid-19 patients will become critically ill, even as many are struggling to validate the tool’s effectiveness on those with the new disease. The rapid uptake of Epic’s deterioration index is a sign of the challenges imposed by the pandemic: Normally hospitals would take time to test the tool on hundreds of patients, refine the algorithm underlying it, and then adjust care practices to implement it in their clinics.

Do You Want to Die in an I.C.U.? Pandemic Makes Question All Too Real

April 24, 2020

(New York Times) – To date, there’s no clear evidence that older people are more apt to contract the new coronavirus, said Dr. Douglas White, a critical care specialist and the director of the Program on Ethics and Decision Making at the University of Pittsburgh School of Medicine. “What we do know is that older individuals are more likely to experience very severe disease if they do become infected,” he said. “The data are sobering.”

World Must Ensure Equal Access for All to COVID-19 Vaccines, Drugs: WHO

April 24, 2020

(Reuters) – All new vaccines, diagnostics and treatments against the new coronavirus must be made equally available to everyone worldwide, the World Health Organization said on Friday as it outlined a plan to accelerate work to fight COVID-19. Launching what he called a “landmark collaboration” to speed the development of effective drugs, tests and vaccines to prevent and treat COVID-19, WHO Director General Tedros Adhanom Ghebreyesus said the lung disease was a “common threat which we can only defeat with a common approach”.

Polio, Measles Outbreaks ‘Inevitable’, Say Vaccine Experts

April 24, 2020

(SciDevNet) – Interruptions to vaccination programmes caused by the COVID-19 pandemic could result in new waves of measles or polio outbreaks, health experts warn. A growing number of one-off immunisation campaigns and national routine vaccine introductions are being delayed amid social distancing and other measures to curb the spread of SARS-CoV-2, leaving millions unprotected.

Shortcuts in COVID-19 Drug Research Could Do Long-Term Harm, Bioethicists Worry

April 24, 2020

(Scientific American) – Does a widespread medical emergency justify speedier, and sometimes less rigorous, ways to test treatments and evaluate results? Doctors and patients urgently need to get their hands on drugs for the COVID-19 pandemic. But bioethicists Jonathan Kimmelman of McGill University and Alex John London of Carnegie Mellon University argue in an April 23 Science article that hurried trials and tests can do more harm than good. They highlight hastily published case reports that, they contend, can lead doctors to believe some drugs offer more of a benefit than has been proved.

FDA Issues Warning on Side Effects of Malaria Drug for Covid-19

April 24, 2020

(UPI) – The U.S. Food and Drug Administration on Friday issued a warning about serious and potentially life-threatening side effects of chloroquine and it’s sister drug hydroxychloroquine, including heart rhythm problems that have been seen in clinical trials. The drugs, which were granted an emergency use authorization by the FDA on March 28, have been shown to cause serious heart problems in patients with severe COVID-19, as evidenced by a new analysis published Friday in the journal JAMA Network Open.

Israel Is Using AI to Flag High-Risk Covid-19 Patients

April 24, 2020

(MIT Technology Review) – One of Israel’s largest health maintenance organizations is using artificial intelligence to help identify which of the 2.4 million people it covers are most at risk of severe covid-19 complications. Maccabi Healthcare Services says the system—which it developed with AI company Medial EarlySign—has already flagged 2% of its members, amounting to around 40,000 people. Once identified, individuals are put on a fast track for testing.

Trauma on the Pandemic’s Front Line Leaves Health Workers Reeling

April 23, 2020

(NPR) – Hospital workers around the world face similar, sustained trauma, and it’s taking an emotional toll. A recent study underscored the severity of those risks: Half of Chinese health care workers studied who treated COVID-19 patients earlier this year now suffer from depression. Nearly as many — 44.6% — have anxiety, and a third have insomnia.

Ecuador’s Coronavirus Case Total Is Twice as High as Confirmed: Minister

April 23, 2020

(Reuters) – Ecuador’s health minister said on Thursday the country’s coronavirus case total was twice as high as previously confirmed, as authorities added 11,000 new infections that resulted from delayed testing.  With 560 confirmed deaths, the outbreak has ravaged the economy of the oil-producing country and overwhelmed sanitary authorities in the largest city of Guayaquil, where corpses remained in homes or for hours on the streets. 

Hopes Dashed as Coronavirus Drug Remdesivir Fails First Trial

April 23, 2020

(BBC) – A potential antiviral drug for the coronavirus has reportedly failed in its first randomised clinical trial. There had been widespread hope that remdesivir could treat Covid-19. But a Chinese trial showed that the drug had not been successful, according to draft documents accidentally published by the World Health Organization. The drug did not improve patients’ condition or reduce the pathogen’s presence in the bloodstream, it said. The US firm behind the drug, Gilead Sciences, said the document had mischaracterised the study.

Dutch Supreme Court Expands Euthanasia Law for Dementia Patients

April 23, 2020

(UPI) – The Netherlands’ Supreme Court on Tuesday ruled that Dutch doctors may euthanize patients with severe dementia if at any time they gave written consent to do so. Previously, doctors were required by law to have patients reconfirm their wish to be euthanized. 

For Ecuador’s Guayaquil, Tides of Death and Disappearance

April 22, 2020

(Undark) – And yet the official numbers have been a matter of some dispute. According to public health officials, in the first two weeks of April alone — a period where the region might see 1,000 people die for any number of reasons, natural and otherwise — Guayas province registered more than 6,700 deaths. As of this week, however, Ecuador has only been able to officially confirm, through testing, that 537 people have died due to Covid-19. Another 952 are considered probable Covid-19 deaths, with the victims having shown symptoms, but without definitive testing. 

What Life Is Like After Being Taken Off a Ventilator

April 22, 2020

(The Atlantic) – In hospitals across America, thousands of the sickest COVID-19 patients are now needing intensive care. The marvels of 21st-century medicine will help keep them alive in the best-case scenarios. But surviving can be just the start of a long recovery, and even after this pandemic fades, some survivors might have to face lingering aftereffects. For reasons still not entirely understood, some patients may develop what’s known as “post-intensive-care syndrome,” which can include a constellation of physical, cognitive, and psychological symptoms. About 1 in 10 of all patients who have been in the ICU have PTSD. About thirty percent experience depression. Thirty percent have symptoms of anxiety. And another 40 percent report cognitive impairment on par with moderate brain injury.

Covid-19 Causes Sudden Strokes in Young Adults, Doctors Say

April 22, 2020

(CNN) – The new coronavirus appears to be causing sudden strokes in adults in their 30s and 40s who are not otherwise terribly ill, doctors reported Wednesday. They said patients may be unwilling to call 911 because they have heard hospitals are overwhelmed by coronavirus cases. There’s growing evidence that Covid-19 infection can cause the blood to clot in unusual ways, and stroke would be an expected consequence of that.

New Covid-19 Antibody Study Results Are In. Are They Right?

April 22, 2020

(Wired) – The results, posted Friday by the Stanford researchers as a preprint, haven’t been peer-reviewed. But they have gotten a lot of attention. And they’ve quickly become emblematic of this age of rapid-fire scientific communications: Surprising results are widely shared before they’re published in an academic journal, followed by an attempt at peer review by Twitter thread. First, the results: The Stanford researchers calculated that between 2.5 percent and 4.2 percent of the county’s residents were infected as of early April. That sounds like a reasonably small number, but if true, it would mean Covid-19 is drastically more widespread than local swab testing suggests: 50- to 85-fold, the researchers calculated.

Solving the Mysteries of Coronavirus with Genetic Fingerprints

April 22, 2020

(New York Times) – Using advanced technology that allows them to rapidly identify the tiny mutations that the virus makes in its virulent path through human hosts, the scientists working in Washington and several other states made two disconcerting discoveries. The first was that the virus brought in by the man from Wuhan — or perhaps, as new data has suggested, by someone else who arrived carrying a nearly identical strain — had managed to settle into the population undetected. Then they began to realize how far it had spread. 

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