• Boris Johnson Must End the Absurd, Dystopian and Tyrannical Lockdown

    Only on 3 May did the stay-at-home restrictions promulgated by the British government on 23 and 26 March, rules enforcing the most draconian restrictions in British history, come before the Commons for retrospective endorsement with just two hours debate and no division. Steve Baker writes in The Telegraph that “We have lived under house arrest for weeks by ministerial decree – a statutory instrument that parliament had no foresight of and no opportunity to scrutinize or approve before it changed life in this country as we know it. The situation is appalling.” He argues that governments do have to take decisive action to protect public health, “But this suspension of freedom comes with a cost too. Millions of people in our country have been plunged into idleness at public expense and unemployment, facing financial and psychological hardship on a scale never seen before.” He emphasizes: “These extraordinary measures require not only legal authority but democratic consent. There is a real possibility that they have had neither,” adding: “The world just changed but British values have not.”

  • U.K. Coronavirus Lockdown May Be Eased Using “Traffic Light” System, Say Government Scientists

    A “traffic light” system advising the public about the risks of different activities could be used to ease lockdown, the Government’s scientific advisors have said. Laura Donnelly writes in The Telegraph that the proposals, drawn up last month, suggest lockdown restrictions should be eased “very gradually” and warn against relaxing the rules for workers without allowing social activities to resume. The paper was drawn up by the scientific pandemic influenza group on behavior (SPI-B), and considered by the scientific advisory group for emergencies (Sage) at its 2 April meeting. It warns that the abrupt lifting of restrictions and any subsequent increase in infections could undermine public trust in health policy, and mean people are less likely to comply with future demands. The documents are among 17 papers submitted to Sage in recent weeks, for consideration by the scientists who advise Government. 

  • Recent Coronavirus Protest Rallies Draw Extremists and Non-Extremists Alike

    Starting with the 30 April 2020 protest in Lansing, Michigan, a wave of protests against coronavirus restrictions has swept across the country over the past week, with attendees calling for stay-at-home orders to be lifted and state economies to be reopened. While the earliest protests in March were largely organized by extremists, the latest rounds of rallies have been planned primarily by conservative activists, and have drawn extremists and non-extremists alike.

  • Restless citizenry; clinical success and failure; holding China to account

    These four major developments on the coronavirus front in the past week caught our eye:

    1. Difficult reopening. More and more countries are moving to reopen their economies, schools, and other parts of society, and each offers a different mix of measures aiming to balance economic recovery, societal (new) normalcy, and health security, with an eye to avoiding a second wave of infections in the fall. They all share one thing: Their citizens are becoming restless.
    2. Clinical success. The FDA om Friday allowed emergency use of remdesivir, the first drug that appears to help some COVID-19 patients recover faster, a milestone in the global search for effective therapies against the coronavirus.
    3. Clinical failure. Hydroxychloroquine and azithromycin have been aggressively promoted by President Trump as possibly “the biggest game changer in the history of medicine.” But in the largest clinical trial yet of the two drugs, they failed to have any benefit for infected patients, while significantly increasing the risk of electrical changes to the heart and cardiac arrhythmias, which could lead to heart attacks, strokes, and death.
    4. The China syndrome. More and more countries are calling for an impartial and credible investigation of China’s conduct regarding the coronavirus between November 2019 and the end of February 2020.

  • U.S. Allows Use of Remdesivir, 1st Drug Shown to Help Virus Recovery

    U.S. regulators on Friday allowed emergency use of remdesivir, the first drug that appears to help some COVID-19 patients recover faster, a milestone in the global search for effective therapies against the coronavirus. Matthew Perrone and Marilynn Marchione write for AP that the Food and Drug Administration cleared Gilead Science’s intravenous drug for hospitalized patients with “severe disease,” such as those experiencing breathing problems requiring supplemental oxygen or ventilators. The FDA acted after preliminary results from a government-sponsored study showed that the drug, remdesivir, shortened the time to recovery by 31%, or about four days on average, for hospitalized COVID-19 patients. Those given the drug were able to leave the hospital in 11 days on average vs. 15 days for the comparison group. The drug may also help avert deaths, but that effect is not yet large enough for scientists to know for sure. The National Institutes of Health’s Dr. Anthony Fauci said Wednesday the drug would become a new standard of care for severely ill COVID-19 patients. Remdesivir, which blocks an enzyme the virus uses to copy its genetic material, has not been tested on people with milder illness. The FDA previously allowed narrow use of a malaria drug, hydroxychloroquine, for hospitalized patients who were unable to take part in ongoing studies of the medication. President Trump touted the drug as a “game changer” and repeatedly promoted it as a possible COVID-19 treatment, but no large high-quality studies have shown the drug works for that and it has significant safety concerns.

  • Timing of Immune Response to COVID-19 May Contribute to Disease Severity

    A new USC study suggests that temporarily suppressing the body’s immune system during the early stages of COVID-19 could help a patient avoid severe symptoms. That’s because the research, just published online in the Journal of Medical Virology, shows that an interaction between the body’s two main lines of defense may be causing the immune system to go into overdrive in some patients. USC notes that the body’s first line of defense, the innate immune response, starts right after an infection, like an infantry going after a foreign invader, killing the virus and any cells damaged by it. The second line of defense, the adaptive immune response, kicks in days later if any virus remains, employing what it has learned about the virus to mobilize a variety of special forces such as T cells and B cells. The researchers say that unlike the common flu, a fast-moving infection which attacks certain target cells on the surface of the upper respiratory system and kills almost all of the target cells within two to three days, the COVID-19 targets surface cells throughout the respiratory system including in the lungs, and it has an average incubation of six days and a much slower disease progression. This leads the adaptive immune response to kick in before the target cells are depleted, slowing down the infection and interfering with the innate immune response’s ability to kill off most of the virus quickly.

  • WHO Extends COVID-19 Emergency; Cases Soar in Brazil, Russia

    The World Health Organization (WHO) COVID-19 emergency committee met yesterday to review the latest pandemic developments, and the WHO’s director-general yesterday accepted the group’s recommendation that the event still warrants a public health emergency of international concern (PHEIC) under the International Health Regulations. The global total rose to 3,329,740 cases yesterday in 187 countries, and at least 237,647 people have died from their infections.

  • Hydroxychloroquine for Treatment of COVID-19 Linked to Increased Risk of Cardiac Arrhythmias

    In a brief report published today in JAMA Cardiology, a team of pharmacists and clinicians at Beth Israel Deaconess Medical Center (BIDMC) found evidence suggesting that patients who received hydroxychloroquine for COVID-19 were at increased risk of electrical changes to the heart and cardiac arrhythmias. The combination of hydroxychloroquine with azithromycin was linked to even greater changes compared to hydroxychloroquine alone. Hydroxychloroquine and azithromycin each can cause an electrical disturbance in the heart known as a QTc prolongation, indicated by a longer space between specific peaks on an electrocardiogram. QTc prolongation denotes that the heart muscle is taking milliseconds longer than normal to recharge between beats. The researchers note that the delay can cause cardiac arrhythmias, which in turn increases the likelihood of cardiac arrest, stroke, or death. “While hydroxychloroquine and azithromycin are generally well-tolerated medications, increased usage in the context of COVID-19 will likely increase the frequency of adverse drug events (ADEs),” said co-first author Nicholas J. Mercuro, PharmD, a pharmacy specialist in infectious diseases at BIDMC. Senior author Howard S. Gold, MD, an infectious disease specialist at BIDMC and an assistant professor of medicine at Harvard Medical School, said: “Based on our current knowledge, hydroxychloroquine for the treatment of COVID-19 should probably be limited to clinical trials.”

  • Epidemic Dictates an Open Exchange of Modeling Knowledge

    It has become increasingly clear that, depending on the computer model used, either we could still be in the midst of the pandemic with rising numbers of cases and deaths or we could be nearing the time to reintroduce society to normal operations. Why such disparity? Because each model works a bit differently and depending on the model used and assumptions added in, the results will change, sometimes dramatically.

  • Coronavirus Models Aren't Crystal Balls. So What Are They Good For?

    Epidemiologists and data scientists have become unlikely heroes during the coronavirus pandemic. Wave-shaped COVID-19 models that present “best” and “worst-case” scenarios for the virus trajectory are now commonplace in news stories and on screens behind governors during press conferences. “Flatten the curve” is scribbled on signs that hang in neighbors’ windows. Local governments are using algorithms to make decisions about stay-at-home orders and supplies. The University of Pennsylvanianotes that during a time of unprecedented uncertainty, it makes sense that we would put stock in these models. We are hoping they will be able to forecast the future and offer a glimmer of sunshine. But math cannot account for the unpredictability of human behavior, and epidemiologists are not in the business of fortune-telling, Levy cautions. “A model isn’t a crystal ball to make predictions,”says Michael Z. Levy, PhD,an associate professor of Epidemiology in the Perelman School of Medicine at Penn. “It’s more like a pensieve — you take what you already have in your brain, you pull it out, and you swirl it around, so that you can better understand the ramifications of your assumptions. That’s all these models are for — to get our head around what’s already going on and what we can do about it.”

     

  • Rutgers Engineer’s Mathematical Model Can Predict Cumulative Deaths in U.S.

    A Rutgers engineer has created a mathematical model that accurately estimates the death toll linked to the COVID-19 pandemic in the United States and could be used around the world. “Based on data available on April 28, the model showed that the COVID-19 pandemic might be over in the United States, meaning no more American deaths, by around late June 2020,” said Hoang Pham, a distinguished professor in the Department of Industrial and Systems Engineering. “But if testing and contact tracing strategies, social-distancing policies, reopening of community strategies or stay-at-home policies change significantly in the coming days and weeks, the predicted death toll will also change.”

  • UN: COVID-19 Deaths for People over 80 Are 5 Times Average

    U.N. Secretary-General Antonio Guterres said Friday that the COVID-19 pandemic is causing “untold fear and suffering” for older people around the world who are dying at a higher rate, and especially for those over age 80, whose fatality rate is five times the global average. Edith M. Lederer writes for AP that the U.N. chief said that beyond the health risks, “the pandemic is putting older people at greater risk of poverty,” with an especially devastating impact on the elderly in developing countries. Guterres issued a 16-page policy briefing on the impact of COVID-19 on older people with several key messages, most importantly that “no person, young or old, is expendable” and “older people have the same rights to life and health as everyone else.”

  • Ways to Address Life Under COVID-19

    An international team of researchers has outlined ways to manage different facets of life under the spread of the COVID-19 virus, ranging from how we can combat racially driven bias and fake news to how we can increase cooperation and better manage stress. “The COVID-19 pandemic represents a massive, global health crisis,” observes Jay Van Bavel, an associate professor in New York University’s Department of Psychology, who led the project with Stanford’s Robb Willer. “Because the crisis requires large-scale behavior change and poses significant psychological burdens on individuals, insights from the social and behavioral sciences are likely going to be very helpful for optimizing pandemic response.”

  • The Data Is in — Stop the Panic and End the Total Isolation

    “Leaders must examine accumulated data to see what has actually happened rather than keep emphasizing hypothetical projections,” Dr. Scott W. Atlas writes. The policymakers should “combine that empirical evidence with fundamental principles of biology established for decades; and then thoughtfully restore the country to function.” He say that the appropriate policy, based on fundamental biology and the evidence already in hand, is to institute a more focused strategy like some outlined in the first place: Strictly protect the known vulnerable, self-isolate the mildly sick and open most workplaces and small businesses with some prudent large-group precautions.

  • COVID-19 and America’s Counter-Terrorism Response

    Since the Sept. 11 attacks, U.S. foreign policy, national security, and law enforcement have been dominated by counter-terrorism considerations, even while a number of counter-terrorism experts have cautioned against overemphasizing the terrorist threat. Lydia Khalil writes that, at the same time, for various reasons, U.S. law enforcement has found it more challenging to deal with the more serious threat of terrorism the United States is facing – far-right domestic terrorism – a threat which now eclipses the threat posed by foreign Islamist jihadists, and which is only going to grow. If anything could ever shake the United States out of its counter-terrorism fixation it would be a crisis of even greater magnitude than 9/11. It seemed like that moment finally came with the COVID-19 pandemic, “[y]et what we have seen so far is the opposite. Instead of reorienting toward other paradigms and reexamining its strategic priorities, the United States continues to reflexively overextend its counter-terrorism tools to deal with some of the more problematic aspects of the virus’ spread,” she writes.