WHO classifies triple-mutant COVID-19 variant from India as global health risk

WHO classifies triple mutant COVID-19 variant in India as global health risk  - The Filipino Times

The World Health Organization said Monday that the coronavirus variant first identified in India last year will be reclassified as a “variant of concern,” indicating that it has become a global health threat.

The B.1.617 variant has been found to spread more easily than the original virus, with some evidence indicating that it may evade some of the protections provided by the vaccines, according to a preliminary study. But the shots are still considered effective. The agency will provide more details on Tuesday.

The highly contagious, triple-mutant variant is also the fourth variant to be designated as a global concern, prompting enhanced tracking and analysis. The other variants are those first detected in Britain, South Africa and Brazil.

“We are classifying this as a variant of concern at a global level,” said Maria Van Kerkhove, WHO technical lead on COVID-19, per Reuters. “There is some available information to suggest increased transmissibility.”

A variant is labeled as “of concern” if it is shown to be more contagious, more deadly or more resistant to current vaccines and treatments, according to the WHO.

The global agency said the predominant lineage of B.1.617 was first identified in India in December, although an earlier version was spotted in October 2020.

The variant has already spread to other countries, and many nations – including the U.S. – have moved to end or restrict travel from India.

“Even though there is increased transmissibility demonstrated by some preliminary studies, we need much more information about this virus variant and this lineage and all of the sub-lineages,” said Maria Van Kerkhove, the WHO’s technical lead for COVID-19.

India reported a record-high of daily coronavirus cases, averaging about 391,000 new daily cases and about 3,879 deaths per day, according to Johns Hopkins University data.

COVID-19 Is Still Devastating the World—Especially India

The pandemic won’t end for anyone until it ends for everyone. That sentiment has been repeated so many times, by so many people, it’s easy to forget it’s not just a cliche—particularly if you live in one of the wealthy countries, like the U.S. and Israel, that has made significant moves toward what feels like an end to the COVID-19 era.

Israel, for example, has fully vaccinated more than half of its population and about 90% of its adults 50 and older are now immune to the virus—enough that the country is “busting loose” and “partying like it’s 2019,” as the Washington Post put it last week. The U.S. is a bit further behind, with nearly 30% of its population fully vaccinated, but the possibility of a post-pandemic reality is already coming into focus. While daily case counts remain high, they are far lower than they were even a few months ago—about 32,000 diagnoses were reported on April 25, compared to daily tallies well above 250,000 in January. Deaths have also trended downward for most of 2021. The U.S. Centers for Disease Control and Prevention has relaxed its guidance on travel and indoor gatherings, and some states have repealed mask mandates and other disease precautions.

But while people in certain affluent countries celebrate a return to vacations and parties, COVID-19 remains a dire threat in many nations around the world—nowhere more so than India. For five days in a row, the country has set and reset the global record for new cases in a single day, tallying about 353,000 on April 26.

By official counts, about 2,000 people in India are dying from COVID-19 every day as hospitals grow overtaxed and oxygen supplies run short. Experts say the true toll is likely even higher than that. People are dying as they desperately seek treatment, and crematoriums nationwide are overwhelmed.

It can be difficult to grapple with that devastating reality when people in countries like the U.S. are reuniting with loved ones and cautiously emerging from lockdown. How can both scenarios be happening at once? The answer, as it often has during the pandemic, lies in disparity. As of April 26, 83% of vaccinations worldwide had been given in high- and upper-middle-income countries, according to a New York Times data analysis. In the developing world, many countries are preparing for the reality that it could take until 2022 or even 2023 to reach vaccination levels already achieved by richer countries today. Even in India, one of the world’s leading vaccine manufacturers, fewer than 10% of people have gotten a vaccine—a cruel irony, as people in India die in the streets while those thousands of miles away celebrate receiving their second doses.

To truly defeat COVID-19, we must reckon with that cognitive dissonance, says Dr. Rahel Nardos, who is originally from Ethiopia and now works in the University of Minnesota’s Center for Global Health and Social Responsibility. As an immigrant and global health physician who lives in the U.S., Nardos says she inhabits two worlds: one in which the U.S. may feasibly vaccinate at least 70% of its population this year, and another in which many countries struggle to inoculate even 20% of their residents in the same time frame.

“It’s a huge disparity,” Nardos says. “We need to get out of our silos and start talking to each other and hearing each other.”

That’s imperative, first and foremost because it could save lives. More than 13,000 people around the world died from COVID-19 on April 24. Remaining vigilant about disease prevention and monitoring, and working to distribute vaccines in countries that desperately need them to fight back COVID-19 surges, could help prevent more deaths in the future. That’s especially critical for developing countries, many of which are so overwhelmed by COVID-19 that nearly all other aspects of health care have suffered. “We may be looking at five, 10 years before they can get back to their baseline, which wasn’t that great to begin with,” Nardos says.

There’s also a global health argument for distributing vaccines more equitably. Infectious diseases do not respect borders. If even one country remains vulnerable to COVID-19, that could allow the virus to keep spreading and mutating, potentially evolving to such a point that it could infect people who are vaccinated against original strains of the disease. Already, vaccine makers are exploring the possibility of booster shots to add extra protection against the more transmissible variants currently circulating in various parts of the world.

We aren’t at that point yet; currently authorized vaccines appear to hold up well against these variants. But if the virus keeps spreading for years in some areas, there’s no telling what will happen, says Jonna Mazet, an epidemiologist and emerging infectious disease expert at the University of California, Davis.

Evolution of those new strains could go into multiple directions. They may evolve to cause more severe or less severe disease. Some of the variants [could be] more concerning for young people,” Mazet says. “The whole dynamics of the disease change.”

And if the virus is mutating somewhere, chances are good it will eventually keep spreading in multiple areas, Mazet says. “Unless or until we have a major shift, we are still going to have large parts of every country that have a susceptible population,” she says. “The virus is going to find a way.”

The only way to stop a virus from mutating is to stop giving it new hosts, and vaccines help provide that protection. COVAX—a joint initiative of the World Health Organization; Gavi, the Vaccine Alliance; the Coalition for Epidemic Preparedness Innovations; and UNICEF—was meant to ensure that people in low-income countries could get vaccinated at the same time as people in wealthier ones. COVAX is providing free vaccines to middle- and low-income countries, using funds gained through purchase agreements and donations from richer countries. But supply and funding shortages have made it difficult for the initiative to distribute vaccines as quickly as it intended to. Many of the doses it planned to disseminate were supposed to have come from the Serum Institute of India, which delayed exporting doses in March and April as India focused on domestic vaccine rollout to combat its COVID-19 surge at home.

In the meanwhile, many poorer countries have been unable to vaccinate anywhere close to as many people as would be required to reach herd immunity. That will almost surely improve as new vaccines are authorized for use by regulators around the world, and as manufacturers scale up production, but those moves may be months away.

COVAX is also developing a mechanism through which developed countries could donate vaccine doses they don’t need. Some wealthy countries, including the U.S. and Canada, have contracts to purchase more than enough doses to vaccinate their entire populations, and have signaled their intent to eventually donate unneeded supplies—but timing is everything. That is, these countries will likely only donate once they are sure their own populations have been vaccinated at a level that ensures herd immunity.

On April 25, the Biden Administration said the U.S. would provide India with raw supplies for making AstraZeneca’s vaccine, as well as COVID-19 tests and treatments, ventilators, personal protective equipment, and funding. That’s a significant shift, since the export of raw vaccine materials was previously banned, but it still doesn’t provide India with ready-to-go vaccines. That step may be next, though. The U.S. will export as many as 60 million doses of AstraZeneca’s vaccine once the shot clears federal safety reviews, the Associated Press reports.

Gian Gandhi, UNICEF’s COVAX coordinator for supply, says he fears many wealthy countries’ vaccine donations may not come until late in 2021, just when global supply is expected to ramp up. That may cause a bottleneck effect: all doses may come in at once, rather than at a slow-but-steady pace that allows countries with smaller health care networks to distribute them. “We need doses now, when we’re not able to access them via other means,” Gandhi says.

The global situation is also critical now. Worldwide, more than 5.2 million cases and 83,000 deaths were reported during the week leading up to April 18. Indian hospitals are so overrun, crowds have formed outside their doors and desperate families are trying to source their own oxygen. Hospitals in Brazil are reportedly running out of sedatives. Iran last week broke daily case count records three days in a row. Countries across Europe remain under various forms of lockdown. Vaccines won’t change those realities immediately—but without them, the global community stands little chance of containing COVID-19 worldwide.

‘Distancing isn’t helping you’: Indoor COVID-19 exposure risk same at 6, 60 feet, MIT researcher says

Risk of COVID-19 indoors is the same at 6 feet and 60 feet apart even when  wearing a mask | Daily Mail Online

People who maintain 60 feet of distance from others indoors are no more protected than if they socially distanced by 6 feet, according to a peer-reviewed study published April 27 in the Proceedings of the National Academy of Science of the United States of America.

Cambridge-based Massachusetts Institute of Technology professors Martin Bazant and John Bush, PhD, developed a model to calculate indoor exposure risk to COVID-19 by factoring in the amount of time spent inside, air filtration and circulation, immunization, variant strains, mask use, and respiratory activity such as breathing, eating or talking.  

“We argue there really isn’t much of a benefit to the six-foot rule, especially when people are wearing masks,” Mr. Bazant told CNBC. “It really has no physical basis because the air a person is breathing while wearing a mask tends to rise and comes down elsewhere in the room so you’re more exposed to the average background than you are to a person at a distance.”

As with smoking, even people wearing masks can be affected by secondhand smoke that makes its way around the enclosed area and lingers. The same logic applies to airborne droplets of the virus, according to the study. However, the study did note that mask use by both infected and susceptible people reduces “respiratory plumes” and thus increases the amount of time people may safely spend together indoors. 

When crafting guidelines, the CDC and World Health Organization have overlooked the amount of time spent indoors, Mr. Bazant claims.  

“What our analysis continues to show is that many spaces that have been shut down in fact don’t need to be,” Mr. Bazant said. “Oftentimes, the space is large enough, the ventilation is good enough, the amount of time people spend together is such that those spaces can be safely operated even at full capacity, and the scientific support for reduced capacity in those spaces is really not very good.”  

Opening windows or installing new fans to keep air moving may be just as effective or more effective than purchasing a new filtration system, Mr. Bazant said.

The CDC currently recommends staying at least 6 feet away from other people and wearing a mask to slow the spread of COVID-19, citing the fact that the virus spreads mainly among people who are in close contact for a prolonged period.  

“The distancing isn’t helping you that much and it’s also giving you a false sense of security, because you’re as safe at six feet as you are at 60 feet if you’re indoors. Everyone in that space is at roughly the same risk, actually,” Mr. Bazant said. 

After three rounds of peer review, Mr. Bazant says he hopes the study will influence social distancing policies.

India’s devastating outbreak is driving the global coronavirus surge

India's covid surge is bringing its healthcare system to the brink -  Washington Post

NEW DELHI — More than a year after the pandemic began, infections worldwide have surpassed their previous peak. The average number of coronavirus cases reported each day is now higher than it has ever been.

“Cases and deaths are continuing to increase at worrying rates,” said World Health Organization chief Tedros Adhanom Ghebreyesus on Friday.

A major reason for the increase: the ferocity of India’s second wave. The country accounts for about one in three of all new cases.

It wasn’t supposed to happen like this. Earlier this year, India appeared to be weathering the pandemic. The number of daily cases dropped below 10,000 and the government launched a vaccination drive powered by locally made vaccines.

But experts say that changes in behavior and the influence of new variants have combined to produce a tidal wave of new cases.

India is adding more than 250,000 new infections a day — and if current trends continue, that figure could soar to 500,000 within a month, said Bhramar Mukherjee, a biostatistician at the University of Michigan.

While infections are rising around the country, some places are bearing the brunt of the surge. Six states and Delhi, the nation’s capital, account for about two-thirds of new daily cases. Maharashtra, home to India’s financial hub, Mumbai, represents about a quarter of the nation’s total.

Mohammad Shahzad, a 40-year-old accountant, was one of many desperately seeking care. He developed a fever and grew breathless on the afternoon of April 15. His wife, Shazia, rushed him to the nearest hospital. It was full, but staffers checked his oxygen level: 62, dangerously low.

For three hours, they went from hospital to hospital trying to get him admitted, with no luck. She took him home. At 3:30 a.m., with Shahzad struggling to breathe, she called an ambulance. When the driver arrived, he asked if Shahzad truly needed oxygen — otherwise he would save it for the most serious patients.

The scene at the hospital was “harrowing,” said Shazia: a line of ambulances, people crying and pleading, a man barely breathing. Shahzad finally found a bed. Now Shazia and her two children, 8 and 6, have also developed covid-19 symptoms.

From early morning until late at night, Prafulla Gudadhe’s phone does not stop ringing. Each call is from a constituent and each call is the same: Can he help to arrange a hospital bed for a loved one?

Gudadhe is a municipal official in Nagpur, a city in the interior of Maharashtra. “We tell them we will try, but there are no beds,” he said. About 10 people in his ward have died at home in recent days after they couldn’t get admitted to hospitals, Gudadhe said, his voice weary. “I am helpless.”

Kamlesh Sailor knows how bad it is. Worse than the previous wave of the pandemic, like nothing he’s ever seen.

Sailor is the president of a crematorium trust in the city of Surat. Last week, the steel pipes in two of the facility’s six chimneys melted from constant use. Where the facility used to receive about 20 bodies a day, he said, now it is receiving 100.

“We try to control our emotions,” he said. “But it is unbearable.”

AstraZeneca stumbles again in it its vaccine rollout

https://mailchi.mp/3e9af44fcab8/the-weekly-gist-march-26-2021?e=d1e747d2d8

U.S. Health Officials Raise Concerns Over AstraZeneca Vaccine Data - WSJ

It was a relatively quiet week on the COVID front—so quiet that President Biden held his first White House press conference last week and wasn’t asked a single question about the pandemic, which continues to be a race between vaccinations and virus variants.

Not that nothing happened this week: it was a rocky week for AstraZeneca, which was hoping to change the narrative over its vaccine, which has stumbled in its rollout in Europe, by reporting positive results from US trials.

After a press release announcing that the vaccine was found to be 79 percent effective against symptomatic COVID, an independent review board called the results into question, pointing out that the report was based on data that had not been fully updated. That earned a swift and unusual rebuke from the National Institutes of Health (NIH), forcing the company to correct its findings—to 76 percent.

A relatively minor difference, but the dust-up served to further undermine confidence in the company’s COVID jab, especially troubling in Europe where hesitancy and distribution have been a vexing problem, and concerns about blood clots associated with the AstraZeneca shot caused several countries to pause inoculations. Given the supply of already-approved vaccines from other manufacturers in the US, it’s not clear that the AstraZeneca shot will play a big role here, but it is critical in other parts of the world, especially as part of the global COVAX initiative targeted at developing countries, since the vaccine can be stored at normal refrigerator temperatures.

The company’s set-to with American regulators also highlighted another challenge that’s become common during the COVID pandemic: conducting scientific review by press release, as the global emergency has required the otherwise slow-moving research community to move at lightning pace.

Meanwhile, back at that relatively dull White House press conference, one piece of encouraging news: President Biden doubled his “first 100 days” goal for vaccinations to 200M shots, a goal that seems wholly achievable, given that 2.5M Americans are being vaccinated every day, on average.

Who Can and Can’t Get Vaccinated Right Now

Who Can and Can’t Get Vaccinated Right Now

Some countries have stockpiles. Others have nothing. Getting a vaccine means living in the right place — or knowing the right people.


A 16-year-old in Israel can get a vaccine.

So can a 16-year-old in Mississippi.

And an 18-year-old in Shanghai.

But a 70-year-old in Shanghai can’t get one. Older people are at high risk for severe illness from Covid-19. But Chinese officials have been reluctant to vaccinate seniors, citing a lack of clinical trial data. Neither can an 80-year-old in Kenya. Low vaccine supply in many countries means only health care employees and other frontline workers are eligible, not the elderly.

Nor a 90-year-old in South Korea. Koreans 75 and older are not eligible until April 1. Only health care workers and nursing-home residents and staff are currently being vaccinated. The government initially said it was awaiting assurances that the AstraZeneca vaccine was safe and effective for older groups.


Anyone in Haiti.

Anyone in Papua New Guinea.

Anyone in these 67 countries. These countries have not reported any vaccinations, according to Our World in Data. Official figures can be incomplete, but many countries are still awaiting their first doses.

It wasn’t supposed to be like this: Covax, the global vaccine-sharing initiative, was meant to prevent unequal access by negotiating vaccine deals on behalf of all participating nations. Richer nations would purchase doses through Covax, and poorer nations would receive them for free.

But rich nations quickly undermined the program by securing their own deals directly with pharmaceutical companies. In many countries, they have reserved enough doses to immunize their own multiple times over.

Anyone who can afford a smartphone or an internet connection in India and is over 60 can get one. Mostly wealthy Indians are being inoculated in New Delhi and Mumbai, hospitals have reported, since vaccine appointments typically require registering online. Less than half of India’s population has access to the internet, and even fewer own smartphones.

And anyone who can pay $13,000 and travel to the U.A.E. for three weeks and is 65 or older or can prove they have a health condition.

A British travel service catering to the rich offered vaccination packages abroad, and wealthy travelers to the U.A.E. have acknowledged they were vaccinated there.


member of Congress in the United States. Friends of the mayor of Manaus, Brazil. Lawmakers in Lebanon. A top-ranking military leader in Spain. The extended family of the deputy health minister in Peru. The security detail to the president of the Philippines. Government allies with access to a so-called “V.I.P. Immunization Clinic” in Argentina. Around the world, those with power and connections have often been first in line to receive the vaccine — or have cut the line altogether.


A smoker in Illinois can get one. But not a smoker in Georgia.

A diabetic in the United Kingdom can. A diabetic in Connecticut can’t.

Countries have prioritized different underlying health conditions, with the majority focusing on illnesses that may increase the risk of severe Covid-19. In the U.S., health issues granted higher priority differ from state to state, prompting some people to travel across state borders.

A pregnant woman in New York. Not a pregnant woman in Germany. Up to two close contacts of a pregnant woman in Germany. Pregnant women were barred from participating in clinical trials, prompting many countries to exclude them from vaccine priority groups. But some experts say the risks to pregnant women from Covid-19 are greater than any theoretical harm from the vaccines.


A grocery worker in Texas, no. A grocery worker in Oklahoma, yes.

Many areas aim to stop the virus by vaccinating those working in frontline jobs, like public transit and grocery stores. But who counts as essential depends on where you live.

A police officer in the U.K. A police officer in Kenya. A postal worker in California. A postal worker in North Carolina. A teacher in Belgium. A teacher in Campeche, Mexico. Other jobs have been prioritized because of politics: Mexico’s president made all teachers in the southern state of Campeche eligible in a possible bid to gain favor with the teacher’s union.


Medical staff at jails and prisons in Colombia. A correctional officer in Tennessee. A prisoner in Tennessee. A prisoner in Florida. The virus spread rapidly through prisons and jails, which often have crowded conditions and little protective equipment. But few places have prioritized inoculating inmates.


An undocumented farm worker in Southern California. A refugee living in a shelter in Germany. An undocumented immigrant in the United Kingdom. Britain has said that everyone in the country is eligible for the vaccine, regardless of their legal status.

A Palestinian in the West Bank without a work permit. Despite leading the world in per-capita vaccinations, Israel has so far not vaccinated most Palestinians, unless they have permits to work in Israel or settlements in the occupied West Bank.


An adult in Bogotá, Colombia. An adult in the Amazonian regions of Colombia that border Brazil. In most of Colombia, the vaccine is only available to health care workers and those over 80.

But the government made all adults in Leticia, Puerto Nariño, Mitú and Inírida eligible, hoping to prevent the variant first detected in Brazil from arriving in other areas. A police officer in Mexico City. A teacher in rural Mexico.The government of populist president Andrés Manuel López Obrador has prioritized vaccinating the poor and those in rural communities, despite the country’s worst outbreaks occurring in major cities.

Native populations not federally recognized in the United States. The pandemic has been particularly deadly for Native Americans. But only tribes covered by the Indian Health Service have received vaccine doses directly, leaving about 245 tribes without a direct federal source of vaccines. Some states, including Montana, have prioritized all Native populations.

Indigenous people living on official indigenous land in Brazil.


These 43 countries, mostly high income, are on pace to be done in a year. These 148 countries, mostly low income, are on pace to take until next year or even longer. Countries like the U.S. continue to stockpile tens of millions of vaccine doses, while others await their first shipments.

“The vaccine rollout has been inequitable, unfair, and dangerous in leaving so many countries without any vaccine doses at all,” said Gavin Yamey, director of Duke University’s Center for Policy Impact in Global Health.

“It’s a situation in which I, a 52-year-old white man who can work from home and has no pre-existing medical conditions, will be vaccinated far ahead of health workers or a high-risk person in a middle- or low-income country.”

A stark global vaccine divide

The vaccine divide: Wealthy nations have 23 jabs for every one in a poorer  country | World News | Sky News

Wealthy nations — including the U.S., the U.K. and the EU — have vaccinated their citizens at a rate of one person per second over the last month, while most developing countries still haven’t administered a single shot, according to the People’s Vaccine Alliance.

Why it matters: As higher-income countries aim to achieve herd immunity in a matter of months, most of the world’s vulnerable people will remain unprotected.

  • Experts say that mutations that may arise while the virus spreads could be a danger to us all, vaccinated or not.

The big picture: Even though more vaccines will arrive in developing nations soon, only 3% of people in those countries are likely to be vaccinated by mid-2021.

  • At best, only a fifth of their population will be vaccinated by the end of the year, per the People’s Vaccine Alliance.

What we’re watching: Three dozen countries have bought several times the amount of vaccine that they’ll need to vaccinate their entire population.

  • The U.S. alone has ordered more than a billion extra dosesScience Magazine reports. Global health leaders are saying it’s time to figure out where all of these excess doses will go.
  • “Over the next year or two, U.S. surplus doses and those from other countries could add up to enough to immunize everyone in the many poorer nations that lack any secured COVID-19 vaccine,” Science writes.

Florida’s COVID Response Includes Missing Deadlines and Data

Blog | Florida's COVID-19 Data: What We Know, What's Wrong, and What's  Missing | The COVID Tracking Project

 Since the beginning of the coronavirus pandemic, Florida has blocked, obscured, delayed, and at times hidden the COVID-19 data used in making big decisions such as reopening schools and businesses.

And with scientists warning Thanksgiving gatherings could cause an explosion of infections, the shortcomings in the state’s viral reporting have yet to be fixed.

While the state has put out an enormous amount of information, some of its actions have raised concerns among researchers that state officials are being less than transparent.

It started even before the pandemic became a daily concern for millions of residents. Nearly 175 patients tested positive for the disease in January and February, evidence the Florida Department of Health collected but never acknowledged or explained. The state fired its nationally praised chief data manager, she says in a whistleblower lawsuit, after she refused to manipulate data to support premature reopening. The state said she was fired for not following orders.

The health department used to publish coronavirus statistics twice a day before changing to once a day, consistently meeting an 11 a.m. daily deadline for releasing new information that scientists, the media and the public could use to follow the pandemic’s latest twists.

But in the past month the department has routinely and inexplicably failed to meet its own deadline by as much as six hours. On one day in October, it published no update at all.

News outlets were forced to sue the state before it would publish information identifying the number of infections and deaths at individual nursing homes.

Throughout it all, the state has kept up with the rapidly spreading virus by publishing daily updates of the numbers of cases, deaths and hospitalizations.

“Florida makes a lot of data available that is a lot of use in tracking the pandemic,” University of South Florida epidemiologist Jason Salemi said. “They’re one of the only states, if not the only state, that releases daily case line data (showing age, sex and county for each infected person).”

Dr. Terry Adirim, chairwoman of Florida Atlantic University’s Department of Integrated Biomedical Science, agreed, to a point.

“The good side is they do have daily spreadsheets,” Adirim said. “However, it’s the data that they want to put out.”

The state leaves out crucial information that could help the public better understand who the virus is hurting and where it is spreading, Adirim said.

The department, under state Surgeon General Dr. Scott Rivkees, oversees 53? health agencies covering Florida’s 67 counties, such as the one in Palm Beach County headed by Dr. Alina Alonso.

Rivkees was appointed in April 2019. He reports to Gov. Ron DeSantis, a Republican who has supported President Donald Trump’s approach to fighting the coronavirus and pressured local officials to reopen schools and businesses despite a series of spikes indicating rapid spread of the disease.

At several points, the DeSantis administration muzzled local health directors, such as when it told them not to advise school boards on reopening campuses.

DOH Knew Virus Here Since January

The health department’s own coronavirus reports indicated that the pathogen had been infecting Floridians since January, yet health officials never informed the public about it and they did not publicly acknowledge it even after The Palm Beach Post first reported it in May.

In fact, the night before The Post broke the story, the department inexplicably removed from public view the state’s dataset that provided the evidence. Mixed among listings of thousands of cases was evidence that up to 171 people ages 4 to 91 had tested positive for COVID-19 in the months before officials announced in March the disease’s presence in the state.

Were the media reports on the meaning of those 171 cases in error? The state has never said.

No Testing Stats Initially

When positive tests were finally acknowledged in March, all tests had to be confirmed by federal health officials. But Florida health officials refused to even acknowledge how many people in each county had been tested.

State health officials and DeSantis claimed they had to withhold the information to protect patient privacy, but they provided no evidence that stating the number of people tested would reveal personal information.

At the same time, the director of the Hillsborough County branch of the state health department publicly revealed that information to Hillsborough County commissioners.

And during March the state published on a website that wasn’t promoted to the public the ages and genders of those who had been confirmed to be carrying the disease, along with the counties where they claimed residence.

Firing Coronavirus Data Chief

In May, with the media asking about data that revealed the earlier onset of the disease, internal emails show that a department manager ordered the state’s coronavirus data chief to yank the information off the web, even though it had been online for months.

A health department tech supervisor told data manager Rebekah Jones on May 5 to take down the dataset. Jones replied in an email that was the “wrong call,” but complied, only to be ordered an hour later to put it back.

That day, she emailed reporters and researchers following a listserv she created, saying she had been removed from handling coronavirus data because she refused to manipulate datasets to justify DeSantis’ push to begin reopening businesses and public places.

Two weeks later, the health department fired Jones, who in March had created and maintained Florida’s one-stop coronavirus dashboard, which had been viewed by millions of people, and had been praised nationally, including by White House Coronavirus Task Force Coordinator Deborah Birx.

The dashboard allows viewers to explore the total number of coronavirus cases, deaths, tests and other information statewide and by county and across age groups and genders.

DeSantis claimed on May 21 that Jones wanted to upload bad coronavirus data to the state’s website. To further attempt to discredit her, he brought up stalking charges made against her by an ex-lover, stemming from a blog post she wrote, that led to two misdemeanor charges.

Using her technical know-how, Jones launched a competing COVID-19 dashboard website, FloridaCOVIDAction.com in early June. After national media covered Jones’ firing and website launch, people donated more than $200,000 to her through GoFundMe to help pay her bills and maintain the website.

People view her site more than 1 million times a day, she said. The website features the same type of data the state’s dashboard displays, but also includes information not present on the state’s site such as a listing of testing sites and their contact information.

Jones also helped launch TheCOVIDMonitor.com to collect reports of infections in schools across the country.

Jones filed a whistleblower complaint against the state in July, accusing managers of retaliating against her for refusing to change the data to make the coronavirus situation look better.

“The Florida Department of Health needs a data auditor not affiliated with the governor’s office because they cannot be trusted,” Jones said Friday.

Florida Hides Death Details

When coronavirus kills someone, their county’s medical examiner’s office logs their name, age, ethnicity and other information, and sends it to the Florida Department of Law Enforcement.

During March and April, the department refused requests to release that information to the public, even though medical examiners in Florida always have made it public under state law. Many county medical examiners, acknowledging the role that public information can play in combating a pandemic, released the information without dispute.

But it took legal pressure from news outlets, including The Post, before FDLE agreed to release the records it collected from local medical examiners.

When FDLE finally published the document on May 6, it blacked out or excluded crucial information such as each victim’s name or cause of death.

But FDLE’s attempt to obscure some of that information failed when, upon closer examination, the seemingly redacted details could in fact be read by common computer software.

Outlets such as Gannett, which owns The Post, and The New York Times, extracted the data invisible to the naked eye and reported in detail what the state redacted, such as the details on how each patient died.

Reluctantly Revealing Elder Care Deaths, Hospitalizations

It took a lawsuit against the state filed by the Miami Herald, joined by The Post and other news outlets, before the health department began publishing the names of long-term care facilities with the numbers of coronavirus cases and deaths.

The publication provided the only official source for family members to find out how many people had died of COVID-19 at the long-term care facility housing their loved ones.

While the state agreed to publish the information weekly, it has failed to publish several times and as of Nov. 24 had not updated the information since Nov. 6.

It took more pressure from Florida news outlets to pry from the state government the number of beds in each hospital being occupied by coronavirus patients, a key indicator of the disease’s spread, DeSantis said.

That was one issue where USF’s Salemi publicly criticized Florida.

“They were one of the last three states to release that information,” he said. “That to me is a problem because it is a key indicator.”

Confusion Over Positivity Rate

One metric DeSantis touted to justify his decision in May to begin reopening Florida’s economy was the so-called positivity rate, which is the share of tests reported each day with positive results.

But Florida’s daily figures contrasted sharply with calculations made by Johns Hopkins University, prompting a South Florida Sun-Sentinel examination that showed Florida’s methodology underestimated the positivity rate.

The state counts people who have tested positive only once, but counts every negative test a person receives until they test positive, so that there are many more negative tests for every positive one.

John Hopkins University, on the other hand, calculated Florida’s positivity rate by comparing the number of people testing positive with the total number of people who got tested for the first time.

By John Hopkins’ measure, between 10 and 11 percent of Florida’s tests in October came up positive, compared to the state’s reported rate of between 4 and 5 percent.

Health experts such as those at the World Health Organization have said a state’s positivity rate should stay below 5 percent for 14 days straight before it considers the virus under control and go forward with reopening public places and businesses. It’s also an important measure for travelers, who may be required to quarantine if they enter a state with a high positivity rate.

Withholding Detail on Race, Ethnicity

The Post reported in June that the share of tests taken by Black and Hispanic people and in majority minority ZIP codes were twice as likely to come back positive compared to tests conducted on white people and in majority white ZIP codes.

That was based on a Post analysis of internal state data the health department will not share with the public.

The state publishes bar charts showing general racial breakdowns but not for each infected person.

If it wanted to, Florida’s health department could publish detailed data that would shed light on the infection rates among each race and ethnicity or each age group, as well as which neighborhoods are seeing high rates of contagion.

Researchers have been trying to obtain this data but “the state won’t release the data without (making us) undergo an arduous data use agreement application process with no guarantee of release of the data,” Adirim said. Researchers must read and sign a 26-page, nearly 5,700-word agreement before getting a chance at seeing the raw data.

While Florida publishes the ages, genders and counties of residence for each infected person, “there’s no identification for race or ethnicity, no ZIP code or city of the residence of the patient,” Adirim said. “No line item count of negative test data so it’s hard to do your own calculation of test positivity.”

While Florida doesn’t explain its reasoning, one fear of releasing such information is the risk of identifying patients, particularly in tiny, non-diverse counties.

Confusion Over Lab Results

Florida’s daily report shows how many positive results come from each laboratory statewide. Except when it doesn’t.

The report has shown for months that 100 percent of COVID-19 tests conducted by some labs have come back positive despite those labs saying that shouldn’t be the case.

While the department reported in July that all 410 results from a Lee County lab were positive, a lab spokesman told The Post the lab had conducted roughly 30,000 tests. Other labs expressed the same confusion when informed of the state’s reporting.

The state health department said it would work with labs to fix the error. But even as recently as Tuesday, the state’s daily report showed positive result rates of 100 percent or just under it from some labs, comprising hundreds of tests.

Mistakenly Revealing School Infections

As DeSantis pushed in August for reopening schools and universities for students to attend in-person classes, Florida’s health department published a report showing hundreds of infections could be traced back to schools, before pulling that report from public view.

The health department claimed it published that data by mistake, the Miami Herald reported.

The report showed that COVID-19 had infected nearly 900 students and staffers.

The state resumed school infection reporting in September.

A similar publication of cases at day-care centers appeared online briefly in August only to come down permanently.

Updates Delayed

After shifting in late April to updating the public just once a day at 11 a.m. instead of twice daily, the state met that deadline on most days until it started to falter in October. Pandemic followers could rely on the predictability.

On Oct. 10, the state published no data at all, not informing the public of a problem until 5 p.m.

The state blamed a private lab for the failure but the next day retracted its statement after the private lab disputed the state’s explanation. No further explanation has been offered.

On Oct. 21, the report came out six hours late.

Since Nov. 3, the 11 a.m. deadline has never been met. Now, late afternoon releases have become the norm.

“They have gotten more sloppy and they have really dragged their feet,” Adirim, the FAU scientist, said.

No spokesperson for the health department has answered questions from The Post to explain the lengthy delays. Alberto Moscoso, the spokesman throughout the pandemic, departed without explanation Nov. 6.

The state’s tardiness can trip up researchers trying to track the pandemic in Florida, Adirim said, because if one misses a late-day update, the department could overwrite it with another update the next morning, eliminating critical information and damaging scientists’ analysis.

Hired Sports Blogger to Analyze Data

As if to show disregard for concerns raised by scientists, the DeSantis administration brought in a new data analyst who bragged online that he is no expert and doesn’t need to be.

Kyle Lamb, an Uber driver and sports blogger, sees his lack of experience as a plus.

“Fact is, I’m not an ‘expert’,” Lamb wrote on a website for a subscribers-only podcast he hosts about the coronavirus. “I also don’t need to be. Experts don’t have all the answers, and we’ve learned that the hard way throughout the entire duration of the global pandemic.”

Much of his coronavirus writings can be found on Twitter, where he has said masks and mandatory quarantines don’t stop the virus’ spread, and that hydroxychloroquine, a drug touted by President Donald Trump but rejected by medical researchers, treats it successfully.

While DeSantis says lockdowns aren’t effective in stopping the spread and refuses to enact a statewide mask mandate, scientists point out that quarantines and masks are extremely effective.

The U.S. Food and Drug Administration has said hydroxychloroquine is unlikely to help and poses greater risk to patients than any potential benefits.

Coronavirus researchers have called Lamb’s views “laughable,” and fellow sports bloggers have said he tends to act like he knows much about a subject in which he knows little, the Miami Herald reported.

DeSantis has yet to explain how and why Lamb was hired, nor has his office released Lamb’s application for the $40,000-a-year job. “We generally do not comment on such entry level hirings,” DeSantis spokesman Fred Piccolo said Tuesday by email.

It could be worse.

Texas health department workers have to manually enter data they read from paper faxes into the state’s coronavirus tracking system, The Texas Tribune has reported. And unlike Florida, Texas doesn’t require local health officials to report viral data to the state in a uniform way that would make it easier and faster to process and report.

It could be better.

In Wisconsin, health officials report the number of cases and deaths down to the neighborhood level. They also plainly report racial and ethnic disparities, which show the disease hits Hispanic residents hardest.

Still, Salemi worries that Florida’s lack of answers can undermine residents’ faith.

“My whole thing is the communication, the transparency,” Salemi said. “Just let us know what’s going on. That can stop people from assuming the worst. Even if you make a big error people are a lot more forgiving, whereas if the only time you’re communicating is when bad things happen … people start to wonder.”

Inhaled Interferon May Aid Hospitalized COVID-19 Patients

Inhaled Interferon May Aid Hospitalized COVID-19 Patients | MedPage Today

Hospitalized COVID-19 patients receiving SNG001, inhaled nebulized interferon beta-1a, were more likely to show clinical improvement than those receiving placebo, a small pilot study in the U.K. found.

Patients randomized to receive SNG001 for 14 days had greater odds of improvement on the World Health Organization (WHO) ordinal scale for clinical improvement (OSCI; OR 2.32, 95% CI 1.07-5.04, P=0.033) on day 15 or 16 compared with those receiving placebo, reported Tom Wilkinson, PhD, of University of Southampton in England, and colleagues.

Moreover, patients in the intervention group were more likely to revert to an OSCI score of 1, or no limitation of activities, on day 15 or 16 (HR 2.19, 95% CI 1.03-4.69, P=0.043), the authors wrote in the Lancet Respiratory Medicine.

Type 1 interferon is “one of the first cytokines induced by viral infection of a cell and is a primary driver of innate immune responses in the human lung,” the researchers noted. They explained that SNG001 is a formulation of recombinant interferon beta “for inhaled delivery by [nebulizer],” which has been well tolerated in clinical studies among patients with asthma or chronic obstructive pulmonary disease.

Interestingly, an accompanying editorial by Nathan Peiffer-Smadja, MD, and Yazdan Yazdanpanah, MD, PhD, both of Assistance-Publique Hôpitaux de Paris in France, noted that interferon failed in preliminary results from the WHO’s SOLIDARITY trial.

In addition to different composition of the two trials, the editorialists found another key difference: route of administration. SOLIDARITY used subcutaneous interferon beta-1a, whereas this trial used nebulized therapy that “delivers interferon beta-1a directly to the respiratory tract.”

“[Nebulized] therapy allows targeted delivery of interferon to the lungs, where it can induce the expression of interferon-stimulated genes that participate directly … or indirectly … in the antiviral response in the mucosa,” Peiffer-Smadja and Yazdanpanah wrote.

For the new study, Wilkinson and colleagues randomized adults hospitalized with COVID-19 symptoms, who tested positive for SARS-CoV-2 via reverse-transcriptase polymerase chain reaction or point-of-care test to receive either SNG001 or inhaled placebo for 14 days. Primary outcome was change in clinical condition on the WHO OSCI (a 9-point scale where 0 means no infection and 8 means death).

From March 30 to May 30, a total of 48 patients were randomized to SNG001 and 50 to placebo in an intent-to-treat analysis. Patients were a mean age of 57, 59% were men, and 80% were white. Baseline comorbidities included hypertension, cardiovascular disease, diabetes, chronic lung condition, and cancer.

Demographic characteristics between groups were similar, although the SNG001 group had more severe disease, with 77% of patients receiving oxygen therapy vs 58% in the placebo group. Mean duration of symptoms before treatment initiation was 10 days.

In the SNG001 group, the odds of improvement were more than three-fold greater on day 28 versus placebo (OR 3.15, 95% CI 1.39-7.14, P=0.046), the authors noted.

Five patients underwent intubation or died compared with three in the intervention group. Over the 14 days of treatment, patients in the intervention group were more than twice as likely to recover.

There was no difference in the odds of hospital discharge or time to hospital discharge between groups. By day 14, 73% of the placebo group and 69% of the intervention group had been discharged.

Regarding safety, 54% of patients in the intervention group and 60% in the placebo group reported treatment-emergent adverse events, the most common of which was headache (15% and 10%, respectively). Fewer patients in the intervention group had serious adverse events compared with placebo (15% vs 28%), and the most common were respiratory failure (6% vs 12%) and pneumonia (6% each).

One patient in the placebo group had multiple organ dysfunction syndrome and one had pulmonary embolism, which caused them to withdraw from the study. These patients later died, along with a third patient in the placebo group, who died of COVID-19 pneumonia.

In their editorial, Peiffer-Smadja and Yazdanpanah noted that the study was not powered to assess mortality outcomes, and called for large randomized trials to investigate the effectiveness of nebulized interferon beta-1a, speculating that it might benefit patients in an early stage of disease in the outpatient setting.

“In patients with severe COVID-19, an exacerbated inflammatory response has been identified as a cause of pulmonary complications, and interferon beta-1a — a pro-inflammatory cytokine — could increase the inflammatory response and be associated with safety issues,” the editorialists wrote.

They added that safety will also be a concern, as “[nebulization] of interferon has no marketing [authorization] for any indication yet.”

Notably, COVID-19 guidelines from the National Institutes of Health recommend against the use of interferon, except within a randomized clinical trial.

Biden’s 7 point plan for the pandemic

https://www.beckershospitalreview.com/hospital-management-administration/biden-s-plan-for-the-pandemic-7-things-to-know.html?utm_medium=email

Trump's And Biden's Coronavirus Plans: Vaccines, Testing : NPR

President-elect Joe Biden and Vice President-elect Kamala Harris have released a seven-point plan regarding the COVID-19 pandemic.

The Biden administration’s seven pandemic plans:

1. Ensure all Americans have access to regular, reliable and free testing by doubling the number of drive-thru testing sites, investing in next-generation testing, developing a pandemic testing board to produce and distribute tests, and establishing a U.S. Public Health Jobs Corps.

2. Provide all states, cities, tribes and territories with critical supplies. Efforts will include full use of the Defense Production Act, building American-sourced and manufactured capabilities. 

3. Provide clear, consistent and evidence-based guidance for how communities should navigate the pandemic. Planned resources will be tailored to the needs of schools, small businesses and families.

4. Plan for effective and equitable distribution of treatments and vaccines. The administration intends to invest in a $25 billion manufacturing and distribution plan to guarantee every American can receive the vaccine for free. The administration also said it will work to ensure that politics won’t play a role in determining the safety and efficacy of vaccines.   

5. Protect older Americans and other high-risk groups. Efforts will include establishing a COVID-19 racial and ethnic disparities task force and a nationwide pandemic dashboard that can be checked in real-time to gauge local transmission.

6. Rebuild and expand defenses to prevent and mitigate pandemic threats, including the restoration of the White House National Security Council Directorate for Global Health Security and Biodefense and the nation’s membership with the World Health Organization.

7. Implement nationwide mask mandates.