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As a New Covid-19 Treatment Arrives, Hospitals Scramble to Solve Logistical and Ethical Challenges

November 20, 2020

(STAT News) – When the federal government started handing out a newly authorized Covid-19 treatment last week, some hospitals weren’t sure they should accept their share. On the surface, it sounded crazy. Decline a medication that might keep patients from getting severely ill? But like so many other pandemic-time medical decisions, this one offered only flawed choices. The medication is bamlanivimab, Eli Lilly’s monoclonal antibody, and it’s meant for keeping high-risk patients out of the hospital. But its use comes with a Venn diagram of difficulties.

Dutch Euthanasia Rules Changed After Acquittal in Sedative Case

November 20, 2020

(The Guardian) – Doctors euthanising a patient with severe dementia may slip a sedative into their food or drink if there are concerns they will become “disturbed, agitated or aggressive”, under a change to the codes of practice in the Netherlands. The review committee for cases of euthanasia refreshed its guidance in response to the case of a former nursing home doctor, Marinou Arends, who was prosecuted for murder and cleared after putting a sedative in her 74-year-old patient’s coffee before giving a lethal injection.

‘People Are Going to Die’: Hospitals in Half the States Are Facing a Massive Staffing Shortage as Covid-19 Surges

November 20, 2020

(STAT News) – Hospitals in at least 25 states are critically short of nurses, doctors, and other staff as coronavirus cases surge across the United States, according to the industry’s trade association and a tally conducted by STAT. The situation has gotten so bad that in some places, severely ill patients have been transferred hundreds of miles for an available bed — from Texas to Arizona, and from central Missouri to Iowa. Many of these hospitals spent months building up stockpiles of medical equipment and protective gear in response to Covid-19, but the supplies are of little use without adequate staffing.

What Does Emergency Use for a COVID-19 Vaccine Mean?

November 20, 2020

(Associated Press) – What does emergency use of a COVID-19 vaccine mean? It’s when regulators allow shots to be given to certain people while studies of safety and effectiveness are ongoing. Before any vaccine is permitted in the U.S., it must be reviewed by the Food and Drug Administration, which requires study in thousands of people. Normally, the process to approve a new vaccine can take about a decade. But the federal government is using various methods to dramatically speed up the process for COVID-19 vaccines.

Hospitals Know What’s Coming

November 20, 2020

(The Atlantic) – In the past two weeks, the hospital had to convert an entire building into a COVID-19 tower, from the top down. It now has 10 COVID-19 units, each taking up an entire hospital floor. Three of the units provide intensive care to the very sickest people, several of whom die every day. One unit solely provides “comfort care” to COVID-19 patients who are certain to die. “We’ve never had to do anything like this,” Angela Hewlett, the infectious-disease specialist who directs the hospital’s COVID-19 team, told me. “We are on an absolutely catastrophic path.” To hear such talk from someone at UNMC, the best-prepared of America’s hospitals, should shake the entire nation.

Pfizer, BioNTech to Submit Emergency Authorization Request to FDA Friday for COVID-19 Vaccine

November 20, 2020

(ABC News) – Pfizer and partner BioNTech announced they will submit a request on Friday to the U.S. Food and Drug Administration for emergency use authorization of their COVID-19 vaccine candidate. The submission, which is based on a vaccine efficacy rate of 95% demonstrated in the Phase 3 clinical study with no serious safety concerns to date, will potentially enable the use of the drug in high-risk populations in the United States by the middle to end of December, according to a joint press release.

‘Encouraging’ Results for Older People from Oxford COVID-19 Vaccine

November 20, 2020

(Medscape) – The SARS-CoV-2 vaccine developed by the University of Oxford has shown an encouraging immune response in older adults, according to preliminary findings published in The Lancet. In phase 2 trials of ChAdOx1 nCoV-19, similar safety and immunogenicity results were seen in healthy participants aged 56 years and older to those seen in adults aged 18 to 55. The study also suggested that the vaccine, being developed in partnership with AstraZeneca, was better tolerated in older people compared to younger adults.

Europe’s Death Rate Over 3 Times Higher Than the U.S., as COVID Surges Globally

November 19, 2020

(Newsweek) – Europe recorded over three times as many COVID-19 deaths on Thursday than the U.S., as coronavirus cases continued to surge globally. Last week, Europe recorded over 29,000 new deaths, said Hans Henri P. Kluge, the World Health Organization’s regional director for Europe said during a news briefing on Thursday.

Not Just COVID: Nursing Home Neglect Deaths Surge in Shadows

November 19, 2020

(Associated Press) – As more than 90,000 of the nation’s long-term care residents have died in a pandemic that has pushed staffs to the limit, advocates for the elderly say a tandem wave of death separate from the virus has quietly claimed tens of thousands more, often because overburdened workers haven’t been able to give them the care they need. Nursing home watchdogs are being flooded with reports of residents kept in soiled diapers so long their skin peeled off, left with bedsores that cut to the bone, and allowed to wither away in starvation or thirst.

Ethiopia’s Multiple Crises: War, COVID-19, Even Locusts

November 19, 2020

(Associated Press) – Ethiopia could hardly bear another emergency, even before a deadly conflict exploded in its northern Tigray region this month. Now, tens of thousands of refugees are fleeing into Sudan, and food and fuel are running desperately low in the sealed-off Tigray region, along with medical supplies and even resources to combat a major locust outbreak. The United Nations warns of a “full-scale humanitarian crisis.”

Desperately Trying to Wipe the Virus Away

November 19, 2020

(The Washington Post) – The pandemic had transformed these poorly paid caregivers into essential workers who risked their lives to protect the disabled from a virus that could easily kill them. But while state and federal funding has poured into hospitals and nursing homes, those who care for the disabled have been repeatedly snubbed. The agencies they work for have had to cut staff, end programming, beg for promised Medicaid reimbursements and scramble for personal protective equipment. No one is keeping track of how many direct support professionals across the country have become infected or how many have died.

People Proving to Be Weakest Link for Apps Tracking COVID Exposure

November 19, 2020

(Kaiser Health News) – The app builders had planned for pranksters, ensuring that only people with verified COVID-19 cases could trigger an alert. They’d planned for heavy criticism about privacy, in many cases making the features as bare-bones as possible. But, as more states roll out smartphone contact-tracing technology, other challenges are emerging. Namely, human nature.

The Last Children of Down Syndrome

November 18, 2020

(The Atlantic) – Denmark is not on its surface particularly hostile to disability. People with Down syndrome are entitled to health care, education, even money for the special shoes that fit their wider, more flexible feet. If you ask Danes about the syndrome, they’re likely to bring up Morten and Peter, two friends with Down syndrome who starred in popular TV programs where they cracked jokes and dissected soccer games. Yet a gulf seems to separate the publicly expressed attitudes and private decisions. Since universal screening was introduced, the number of children born with Down syndrome has fallen sharply. In 2019, only 18 were born in the entire country. (About 6,000 children with Down syndrome are born in the U.S. each year.)

Hospitals Can’t Go On Like This

November 18, 2020

(The Atlantic) – Now new data released by the Department of Health and Human Services quantify the crisis in America’s hospitals in closer detail. At The Atlantic’s request, HHS provided data on the number of hospitals experiencing staffing shortages. From November 4 to November 11, 958 hospitals—19 percent of American hospitals—faced a staffing shortage. This week, 1,109 hospitals reported that they expect to face a staffing shortage. That’s 22 percent of all American hospitals.

The Vaccines Will Probably Work. Making The Fast Will Be the Hard Part.

November 18, 2020

(The New York Times) – Industry analysts and company executives are optimistic that hundreds of millions of doses will be made by next spring. But the companies — backed with billions of dollars in federal money — will have to overcome hurdles they’ve encountered in the early days of making vaccines. Moderna’s and Pfizer’s vaccines use new technology that has never been approved for widespread use. They are ramping up into the millions for the first time. Other challenges include promptly securing raw vaccine ingredients and mastering the art of creating consistent, high-quality batches.

The Ethical Questions That Haunt Facial-Recognition Research

November 18, 2020

(Nature) – In September 2019, four researchers wrote to the publisher Wiley to “respectfully ask” that it immediately retract a scientific paper. The study, published in 2018, had trained algorithms to distinguish faces of Uyghur people, a predominantly Muslim minority ethnic group in China, from those of Korean and Tibetan ethnicity. China had already been internationally condemned for its heavy surveillance and mass detentions of Uyghurs in camps in the northwestern province of Xinjiang — which the government says are re-education centres aimed at quelling a terrorist movement. According to media reports, authorities in Xinjiang have used surveillance cameras equipped with software attuned to Uyghur faces.

Health Systems Are Using AI to Predict Severe Covid-19 Cases. But Limited Data Could Produce Unreliable Results

November 18, 2020

(STAT News) – As the United States braces for a bleak winter, hospital systems across the country are ramping up their efforts to develop AI systems to predict how likely their Covid-19 patients are to fall severely ill or even die. Yet most of the efforts are being developed in silos and trained on limited datasets, raising crucial questions about their reliability.

Pfizer and BioNTech to Submit Covid-19 Vaccine Data to FDA as Full Results Show 95% Efficacy

November 18, 2020

(STAT News) – Pfizer and BioNTech announced Wednesday that the efficacy portion of their Covid-19 vaccine trial has been completed, showing the vaccine to prevent 95% of cases of the disease. The companies said that they plan to submit to the Food and Drug Administration for an emergency use authorization “within days,” and will also submit to regulatory agencies around the globe.

More People Are Getting COVID-19 Twice, Suggesting Immunity Wanes Quickly in Some

November 18, 2020

(Science) – Scientists are keenly interested in cases like hers, which are still rare but on the rise. Reinfections hint that immunity against COVID-19 may be fragile and wane relatively quickly, with implications not just for the risks facing recovered patients, but also for how long future vaccines might protect people. “The question everybody wants to answer is: Is that second one going to be less severe most of the time or not?” says Derek Cummings, who studies infectious disease dynamics at the University of Florida. “And what do reinfections teach us about SARS-CoV-2 immunity in general?”

Children in U.S. May Miss 9 Million Vaccine Doses in 2020, Report Warns

November 18, 2020

(The New York Times) – Children in the United States are on pace this year to miss nine million vaccine doses for measles, polio and other highly contagious diseases, according to medical claims data — a disruption that health care authorities called alarming and attributed to the coronavirus pandemic. The data was made public on Wednesday by the Blue Cross Blue Shield Association, one of the nation’s largest federations of insurance companies, which said that routine childhood vaccinations had declined by as much as 26 percent, compared with 2019.

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