(WASHINGTON) — President Donald Trump said Friday that the U.S. will be terminating its relationship with the World Health Organization, saying it had failed to adequately respond to the coronavirus because China has “total control” over the global organization. He said Chinese officials “ignored” their reporting obligations to the WHO and pressured the WHO to mislead the world when the virus was first discovered. He noted that the U.S. contributes about $450 million to the world body while China provides about $40 million. The U.S. is the largest source of financial support to the WHO and its exit is expected to significantly weaken the organization. Trump said the U.S. would be “redirecting” the money to “other worldwide and deserving urgent global public health needs,” without providing specifics. The Trump administration may soon expel thousands of Chinese graduate students enrolled at U.S. universities and impose other sanctions against Chinese officials in the latest signs of tensions between Washington and Beijing that are raging over trade, the coronavirus pandemic, human rights and the status of Hong Kong. President Donald Trump said he would make an announcement about China on Friday, and administration officials said he is considering a months-old proposal to revoke the visas of students affiliated with educational institutions in China linked to the People’s Liberation Army or Chinese intelligence. Trump is also weighing targeted travel and financial sanctions against Chinese officials for actions in Hong Kong, according to the officials, who were not authorized to discuss the matter publicly and spoke on condition of anonymity. “We’ll be announcing what we’re doing tomorrow with respect to China and we are not happy with China,” Trump told reporters at an unrelated event Thursday, referring mainly to COVID-19. “We are not happy with what’s happened. All over the world people are suffering, 186 countries. All over the world they’re suffering. We’re not happy.” Although the student expulsions aren’t directly related to Hong Kong and China’s move to assert full control over the former British territory, potential sanctions against officials involved in that effort would be a result of Secretary of State Mike Pompeo’s determination that Hong Kong can no longer be considered autonomous from mainland China. Pompeo notified Congress on Wednesday that Hong Kong is no longer deserving of the preferential trade and commercial status it has enjoyed from the U.S. since it reverted to Chinese rule in 1997. Under a joint Sino-British agreement on the handover, Hong Kong was to be governed differently than the mainland for 50 years under a “one country, two systems” policy. Pompeo’s determination opened the door to possible sanctions and the loss of special perks Hong Kong has received from the United States. But neither Pompeo nor other officials were able Wednesday to describe what action the administration might take, an uncertainty related to the impact that such sanctions would have on U.S. companies that operate in Hong Kong and the city’s position as Asia’s major financial hub. Trump’s comments sparked a drop in U.S. financial markets. Serious consideration of the visa revocation proposal, first reported by The New York Times, has faced opposition from U.S. universities and scientific organizations who depend on tuition fees paid by Chinese students to offset other costs. In addition, those institutions fear possible reciprocal action from Beijing that could limit their students’ and educators’ access to China. In a nod to those concerns, the officials said any restrictions would be narrowly tailored to affect only students who present a significant risk of engaging in espionage or intellectual property theft. The officials could not say how many people could ultimately be expelled, although they said it would be only a fraction of the Chinese students in the country. Still, the possibility that the proposal may be implemented has drawn concerns from educators. “We’re very worried about how broadly this will be applied, and we’re concerned it could send a message that we no longer welcome talented students and scholars from around the globe,” said Sarah Spreitzer, director of government relations at the American Council on Education. “We don’t have a lot of details about how they are going to define ties to Chinese universities, what type of universities are they going to target, what would constitute a university having ties to the Chinese military,” she said. If the situation were reversed and another nation imposed limits on students from U.S. universities that receive Defense Department funding, she noted it would affect a wide range of schools. The U.S. hosted 133,396 graduate students from China in the 2018-19 academic year, and they made up 36.1% of all international graduate students, according to the Institute of International Education. Overall, there were 369,548 students from China, accounting for 33.7% of international students who contributed nearly $15 billion to the U.S. economy in 2018. The proposal to revoke the visas is not directly related to the dispute over Hong Kong, nor is it tied to U.S. criticism of China for its handling of the coronavirus outbreak. Rather, it is connected to various elements of trade and human rights issues that have seen U.S. officials complain about Chinese industrial espionage and spying and harassment of dissidents and religious and ethnic minorities. But the timing of a potential announcement could come at a time of increasingly heated rhetoric about the imposition of national security laws on Hong Hong in violation of the Sino-British accord. The proposal first began to be discussed last year when the administration moved to require Chinese diplomats based in the United States to report their domestic U.S. travel and meetings with American scientists and academics. At the time, U.S. officials said it was a reciprocal measure to match restrictions that American diplomats face in China. Those limits were followed by a requirement that Chinese state-run media in the U.S. register as “foreign diplomatic missions” and report their property holdings and employee rosters to the government. That was, in turn, followed by the limiting of the number of visas for Chinese journalists allowed to work in the United States. China retaliated for the visa limitations by expelling several reporters from U.S. media outlets, including The Washington Post and The New York Times. ____ AP Education Writer Collin Binkley in Boston contributed to this report. from https://ift.tt/2AlEfqp Check out https://takiaisfobia.blogspot.com/
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When Virginia Governor Ralph Northam announced the tentative reopening of Virginia Beach for Memorial Day, he warned antsy residents that, if they didn’t abide by new restrictions such as social distancing and limits on group activities to mitigate the risk of new COVID-19 infections, he wouldn’t hesitate to re-close the area. He’s not alone. Coastline municipalities around the country are now instituting or contemplating similar liberties. To test how feasible it is for public spaces to reopen to those restless from weeks of stay-at-home orders, we’ve built a simulation. It uses the real-world coordinates of a two-block stretch on the southern tip of Virginia Beach covering 4.4 acres of sandy respite along a 600-foot coastline, and runs a real-time computational experiment in which each digital person acts according a randomly assigned behavioral model. Each person is visualized as a circle with a six-foot diameter, meaning any time two circles overlap (and turn red), social distancing has been violated. Depending on where you place the slider at the top, a certain percentage of beachgoers in the simulation will rigorously try to observe social distancing while others will bend the rules by a few feet. In the default setting, 75% of the 200 simulated beachgoers aspire to maintain a minimum of a six-foot distance, while 25% are willing to fudge that distance down to between 3 and 5 feet. In this case, about 20% of our tiny friends head straight for the water, while 30% plop down to sunbathe and the remaining 50% wander up and down the beach. After one hour in simulated time, at least 1,000 violations of social distancing typically occur as people move about, according to many tests of the simulation, which involves a small amount of variation due to the random nature of where people chose to move. This sort of exercise, in which each person in a simulated group has a personal set of rules and goals, is more than just a thought experiment. The success of any policy whose outcome is dependent on voluntary compliance, like the rules for Virginia Beach, is difficult to predict ahead of time because small, simple differences in how individuals behave can create enormously complex patterns when they interact with one another—what’s known as “emergent” patterns. While TIME’s implementation uses only a handful of variables, many researchers use this style of computer science as a powerful means to predict emergent patterns of group behavior in anything from crowds to traffic to ecosystems. The emergence we see here suggests that at least a modest amount of interaction inside 6 feet is inevitable as public spaces reopen. Even when limiting the crowd to only 200 people and assuming 100% those beachgoers try to cooperate, the model suggests it’s basically assured that people get too close to each other. Repeated trials indicate that the random movement of walkers, often impeded by stationary sunbathers, combined with the inevitable collisions between people at the bottlenecks at the entry to the beach, results in an average of about 200 accidental violations of social distancing in one hour. And that’s a highly ideal scenario, in which the crowd size remains unrealistically small and improbably obedient. As soon as you start adding more people or introducing even a small percentage of negligent actors, the number of collisions skyrockets. For 1,000 beachgoers at 75% compliance, there are typically more than 20,000 such run-ins over the 90 minutes (in simulation time) it takes for all of them to reach the beach. As desperate as the U.S. is for some form of normalcy over the warm summer months, every model we ran suggests that, without general acceptance of a new reality in which public spaces will need to be less populated, the health risks could be significant. As I wrote recently, even as new COVID-19 infections fall, Americans must reconsider the outdoors as an exhaustible resource that must be rationed. As this experiment tentatively indicates, even a fairly large amount of beachfront—4.4 acres is the equivalent of 3.3 football fields, not including the water—cannot tolerate more than a few hundred people without a dangerous degree of interactions that are too close for comfort, no matter how assiduous those people are trying to be. While Virginia Beach acknowledged this to some extent by limiting parking capacity to 50% over Memorial Day weekend, it could take far more drastic and undesirable limitations to make public spaces a place people can enjoy without an intolerable level of risk. MethodologyThis sort of experiment is known as “agent-based modeling,” in which each “participant” acts as an autonomous program that makes decisions based on its surrounding environment. While there are several JavaScript libraries that have implemented some degree of agent-based-modeling, this simulation was written from scratch to accommodate the specific use-case. In each step (which occur several times a second), every agent seeks to move approximately 20 feet toward their desired destination—either the water or an available spot on the sand. Unless the agent plans to sunbathe, one she reaches her destination she chooses a new one, whether it’s a spot on the beach on a nearby location in the water for swimmers. Except, As each time an agent “moves,” she “calculates” whether the move would violate another agent’s space below her minimum acceptable degree of social distancing—from 3 to 6 feet, depending how closely she is following recommended guidelines—and, if so, attempts a different route until one is appropriately spaced, up to five times. If, after five tries, the only option is to move inside another agent’s 6-foot radius, a collision occurs. The interactive tallies that as one violation. The simulation runs at about 40 times faster than reality and ends after either an hour or when every prospective person has reach the beach or water. This style of computer science was popularized by the free software NetLogo, a sophisticated descendant of the original LOGO program, popular in grade schools, that involved giving instructions to a “turtle” that would create patterns on the screen. While this simulation was not independently coded in that software, the author consulted a textbook on its structure to aid in the software design. from https://ift.tt/3cafmuU Check out https://takiaisfobia.blogspot.com/ When Eric Freeland, 34, started coughing at the end of March, he didn’t think much of it. But when his symptoms grew worse, Freeland’s mother began to worry. Freeland is a Native American living with his family in the Navajo Nation in the southwestern U.S., where access to healthcare is limited. He is also diabetic, putting him at greater risk to the coronavirus. When Freeland’s breathing became short and stuttered, his mother drove him to the nearest hospital where within minutes of arriving, he lost consciousness. He awoke three weeks later, hooked up to a ventilator, from a medically induced coma. “We’ve had epidemics before. We’ve had viruses before. In general, we’ve had a lot of things attack us before,” says Freeland, who has since recovered fully. But this is “the worst case scenario.” The Navajo Nation, home to more than 173,000 people and spans across parts of Utah, New Mexico and Arizona, has been hard hit by COVID-19, with 4,944 confirmed COVID-19 infections in the community and 159 deaths as of May 29. Before the pandemic, the nation already faced a host of challenges, with up to 40% of people not having access to running water in their homes and 10% not having access to electricity. But despite the outbreak, the Navajo Nation has received little support from the federal government. “The efforts for battling COVID-19 were solely the Navajo Nation’s doing,” says Jonathan Nez, the President of the Navajo Nation. “There was little federal assistance when we were going through the peak of the crisis.” The Navajo Nation is not alone. While Indigenous communities and cultures vary greatly in the United States, Canada, Australia, and New Zealand, they face similar challenges when it comes to health problems and accessing medical care. The close to 10 million Indigenous people in these four countries who are descendants from the original inhabitants of their countries, have higher rates of chronic health issues making them more susceptible to severe COVID-19 cases. And yet, they say, federal funding to these communities continues to be insufficient. The COVID-19 stimulus law passed by the U.S. Congress mandates $8 billion for relief to Native American communities, but they had to sue the Treasury Department to access the funds. The support only began reaching the Navajo Nation in mid-May, long after the outbreak had started. Delays in distributing funding left frontline workers without proper protection and forced the Urban Indian Organization to close some of its health facilities due to a shortage of critical resources. In Canada, where the government pledged to spend $216 million to protect Indigenous Canadians (who make up 4.9% of the population), experts pointed out it would only amount to only around $142 per person. The funding also does not go to Indigenous people living outside of Indigenous reserves, who make up over half of Canada’s Indigenous population. This prompted the Congress of Aboriginal People in Canada to file a federal court application on May 13, alleging that the government’s COVID-19 assistance is “inadequate and discriminatory.” (Prime Minister Justin Trudeau has since announced $54 million to support off-reserve Indigenous people.) Despite the lack of government support and limited resources, Indigenous communities are implementing public health measures to effectively curb the spread of the virus within their communities. Although the Navajo Nation has one of the highest infection rates per capita in the United States, surpassing New York and New Jersey, the community is testing far above the national average of 4.9%, with 15.64% of its population having been tested. “We are using our own sovereign ability to govern ourselves,” says President Nez. The community also implemented some of the strictest lockdown measures in the country after an outbreak began in their community, mandating that no one leaves home unless they are essential workers or there is an emergency. They say that has helped curb the spread of the virus. “The reason the Navajo Nation has managed this crisis isn’t because of the federal government,” President Nez says. “It’s because of us.” Indigenous communities have long received worse care during pandemics and witnessed higher mortality rates than the rest of the population. The New Zealand Māori mortality rate during the 1918 Spanish flu was 7.3 times higher than the non-Indigenous mortality rate. During the H1N1 Swine Flu outbreak in 2009, Indigenous Canadians accounted for 17.6% of deaths even though they account for only 4.3% of the country’s population. “Historically, we have not been treated well when it comes to pandemics,” says Chief David Monias of the Pimicikamak Cree Nation in northern Manitoba. “While the rest of Canada received services [during previous pandemics], we were just left to die.” The lack of federal support for Indigenous communities is particularly dangerous, given that these communities—who face higher rates of chronic illnesses—are more vulnerable to COVID-19. In Australia, 50% of Aboriginal people live with one major chronic disease such as cancer, cardiovascular or kidney disease and nearly 25% have two or more chronic ailments. “If you look at Indigenous Australians, they have onset of kidney and cardiovascular disease earlier than non-Indigenous Australians,” says Jason Agost, an epidemiologist focussed on Aboriginal and Torres Strait Islander health. In Canada, First Nations, Inuit and Métis communities have a lower life expectancy than the national average and in the United States, the mortality rates for preventable diseases such as asthma or diabetes are three to five times higher for Native Americans. While experts say there is no single reason for why Indigenous populations face poorer health outcomes, Stephane McLachlan, a researcher looking into effective responses to COVID-19 for Indigenous populations says it can be explained by “the long standing impacts of colonization” which have left Indigenous people poorer on average and lacking access to nutritious food, clean water and adequate housing. As well as higher rates of chronic illnesses that make them more vulnerable to the coronavirus, Indigenous communities often cannot implement precautionary measures to stop the virus spreading rapidly. In Canada, at least 61 First Nations communities have not had access to safe drinking water for at least a year. While some non potable water sources can be effective for washing hands, the Canadian government says that communities on a “Do Not Use Advisory” should not use tap water for washing hands. “The government keeps telling people to wash their hands,” Meredith Raimondi, a senior manager from the United States National Council of Urban Indian Health. “But how are Indigenous people supposed to do that when they don’t have clean water?” For many Indigenous people living in overcrowded homes, social distancing or isolation is also impossible. Aboriginal and Torres Strait Islanders are 16 times more likely to be living in an overcrowded house than non-Indigenous Australians. This was the case for Freeland, who like many Native Americans, lives with his extended family. Both his parents fell ill with the virus after he contracted it. “So many of us live in close quarters,” he says. “By the time my symptoms started to show, it was too late.” Keep up to date with our daily coronavirus newsletter by clicking here. Indigenous people also disproportionately struggle to access medical services if they do fall ill with COVID-19. Some Indigenous communities live in remote areas where governments have not invested in health infrastructure, resulting in people having to travel hundreds of miles to reach the nearest medical facility. In Northern Canada, many communities cannot be accessed by road and require planes or boats. Some remote communities in Australia only have a single nurse present on the ground, with doctors consulting patients over the phone. “So many Native Americans have to drive for hours to see a doctor or get to a grocery store,” Freeland says, noting that he is lucky he lives within close proximity to hospital facilities. “I wouldn’t have made it if, like other Native Americans, I had been a little further away.” For all the challenges Indigenous communities face—from a lack of federal funding to higher rates of pre-existing comorbidities that increase vulnerability to COVID-19—these communities have taken matters into their own hands. They say Indigenous led-responses are the key to mitigating the impacts of the virus. “Money is a good start but it’s not the whole story,” says Shannon MacDonald, a Canadian Indigenous physician and deputy chief medical officer for First Nations Health Authority, a health service delivery organization in British Columbia. “It’s about communities having the ability to respond within the communities.” Because Indigenous people often face systemic racism when seeking out medical attention, MacDonald says that “some of our community members are reluctant to access services unless it’s absolutely necessary.” Indigenous health providers, who understand Indigenous cultures, have proven to be better equipped to develop culturally-sensitive public health responses for these communities. Indigenous-led responses have already proven to be successful, and in some cases, more effective than federal responses. The Lummi Nation, a sovereign Native American community in the Pacific North-West have been preparing for COVID-19 since the virus appeared in China, gathering additional medical supplies including test kits and creating the country’s first field hospital. The Nation declared a state of emergency on March 3, 10 days before the Trump Administration did and has implemented health measures including social distancing, drive-through testing, essential good deliveries for the elderly and phone call consultation with doctors. The Lummi reservation, home to 5,583 people, has had 40 cases as of May 2—an infection rate in line with the national average. In Australia, Aboriginal communities have been less affected by the virus than anticipated, which experts attribute to having Aboriginal and Torres Strait Islander public health practitioners and researchers play a pivotal role in leading response efforts that are culturally sensitive. Aboriginal-led health services ensured that public health messages were communicated to communities in their local languages. Aboriginal communities also protected themselves by camping out in the bush to protect elders. Like many Indigenous Nations in Canada, some Australian Aboriginal communities also shut their borders before the federal government did to avoid disease transmission. “We can’t be waiting for the government to decide,” says Myrle Ballard, a Canadian Indigenous researcher studying effective health responses to COVID-19 for Indigenous communities. “We Indigenous people know what is best for us.” Please send any tips, leads, and stories to [email protected] from https://ift.tt/2XfpZbJ Check out https://takiaisfobia.blogspot.com/ Its Getting Worse. Nursing Home Workers Confront Risks in Facilities Devastated by Coronavirus5/29/2020 Days before she tested positive for COVID-19 in early April, Tanya Beckford was already worried about dying because of the conditions in the Connecticut nursing home where she has worked for 23 years. She wasn’t feeling well and says she and her co-workers, facing a shortage of masks, gloves and gowns, had started wearing plastic trash bags over their uniforms for protection as they cared for infected residents. Beckford, a certified nursing assistant (CNA) in the Alzheimer’s unit at Newington Rapid Recovery Rehab Center in Newington, Connecticut, had been running a low-grade fever but says the facility was only sending workers home if their temperature reached 100.4 degrees Fahrenheit — per Centers for Disease Control and Prevention guidelines. In an effort to ensure there were enough staff to care for all the residents, Beckford says, employees had been told they were not allowed to take any more time off. “I went to the administrator, like, ‘I am sick, and you guys are still keeping me in here, I don’t have the proper PPE (personal protective equipment) to work with now, and I just don’t want to die,'” says Beckford, 48. Days later, she tested positive for COVID-19. The coronavirus pandemic has devastated nursing homes across the country. There have been more than 35,000 COVID-19 deaths in long-term care facilities, according to the Associated Press — a figure that accounts for about a third of the country’s coronavirus deaths. The industry has been sharply criticized by relatives of the dead, who’ve accused nursing homes of being slow to take action against the virus and of trying to dodge responsibility for their loved ones’ deaths. But nursing home employees, who face serious occupational hazards even in non-pandemic times, say they’re caught in an impossible situation and being blamed for problems rooted in America’s failed elder-care system. Keep up to date with our daily coronavirus newsletter by clicking here. They’re struggling to protect themselves and support their families on menial salaries while caring for a population that is among the most vulnerable to COVID-19. Nursing home employees who contract COVID-19 have been forced to use up their limited sick time or vacation time, go without pay, or lose their jobs entirely. Through it all, they have dealt with grief and despair as elderly residents to whom they’ve become emotionally attached become sick with COVID-19 and die. “The worst thing that I get upset about is hearing the word hero, hero, hero being thrown around for us. And no one is treating us as such. We feel disrespected,” says Beckford, who has been on sick leave since April 10 and is still recovering from pneumonia caused by the virus. “I would love to see them give us the proper PPE that we need, give us some kind of compensation, and for goodness sake, I don’t have any more vacation or sick time now, and the year is just beginning. Give me back some kind of compensation and put back my time.” Newington Rapid Recovery Rehab Center denies Beckford’s allegations, including that employees were forced to use trash bags for protection. “At no time has our staff been without appropriate PPE. The building has been properly staffed throughout the crisis,” it said in a statement, adding: “We have been strictly following the CDC protocol for health care workers.” When she recovers, Beckford plans to return to work there. But recent lawsuits — brought by relatives of nursing home workers who died of COVID-19 and by former nursing home employees — are drawing attention to the conditions within some facilities that workers say put them and patients at unreasonably high risk. Carlenia Milanes, a licensed practical nurse, spent weeks unwittingly caring for COVID-19 patients at Alaris Health at Hamilton Park in Jersey City, N.J., while the facility initially prohibited employees from wearing masks, according to a lawsuit filed April 22. The suit claims the nursing home hid coronavirus cases from employees, “refused to test patients and pressured staff to work even if they had symptoms of the highly contagious and deadly disease, all while patients and staff alike were dying of COVID-19.” On April 3, Milanes sent an email to Jersey City officials sounding an alarm and saying the nursing home’s strategy “is to put blinders on even at the cost of human life.” “Something needs to be done or more people and staff get sick and possibly die,” Milanes wrote, according to the lawsuit. “I need your help.” Milanes, 28, called in sick for the following day after developing symptoms of COVID-19, but her suit alleges that she was told she would be fired if she didn’t present a doctor’s note. In her lawsuit, Milanes also alleges the facility allowed seemingly healthy residents to share rooms with residents who had symptoms of COVID-19. By May 27, there were 110 COVID-19 cases among the facility’s residents, including 31 deaths, and 42 COVID-19 cases among staff, including two deaths, according to data reported to the state. Milanes was among the affected staff members; the COVID-19 test she took on April 6 came positive. “I’m not afraid to work. I would take care of anyone, but if I’m sick, how am I going to be any good for a patient?” says Milanes, a single mother whose 7- and 10-year-old daughters have since shown symptoms of COVID-19 as well. “I’m somebody’s mother. I’m somebody’s sister. I’m somebody’s daughter. And granted yes, this is what I signed up for, but protect me.” LaDawn Chapman, a CNA at the same facility, also filed a lawsuit against Alaris on April 22 that echoes many of Milanes’ allegations, including that the facility lacked adequate protective gear for employees and did not notify employees about coronavirus cases. The lawsuit says Chapman was likely exposed to COVID-19 through a patient and multiple coworkers and had a doctor’s note advising her to self-isolate for two weeks. She was told that unless she had symptoms of the disease, she had to come to work, her lawsuit alleges. Both women say they were fired, but Alaris Health denies this. Five days after the suits were filed, Alaris Health sent each woman a letter saying they were “mistaken” about being fired and setting dates that each was expected to return to work. In a statement, Alaris spokesperson Matt Stanton also denied the lawsuits’ other allegations. “I can tell you that each and every allegation in this case is false,” he said. “No employees were terminated. At no time was information withheld from staff, our residents or their loves ones [sic]. Thankfully, adequate PPE has never been an issue at any of our facilities. In fact Alaris required N95 masks and PPE for all staff well before the (New Jersey Department of Health) and CDC mandates. Finally, no employees were ever pressured to work while sick. Staff showing COVID-19 symptoms were sent home and required to adhere to strict return to work protocols as published by the NJ DOH.” In Texas, Maurice Dotson, a CNA at West Oaks Nursing and Rehabilitation Center in Austin, died on April 17 after contracting COVID-19. His mother sued the nursing home on May 13, accusing it of failing to provide staff with protective equipment and exposing workers and patients to “unreasonable risks of serious harm.” A spokesperson for West Oaks said Dotson “touched countless lives and was a respected and comforting presence,” but declined to comment on pending litigation. Leaders in the long-term care industry have argued that nursing homes need more support and funding from state and federal governments. And the industry has sought immunity from potential lawsuits related to the pandemic, but the laws and executive orders granting them immunity from civil liability in some states, including New Jersey, might not protect them from all legal claims. “While I understand that you can’t judge a nursing home that’s in the midst of a pandemic by the same standards you would on a regular day, it doesn’t give these nursing homes the license or the right to behave recklessly or engage in willful misconduct,” says Bill Matsikoudis, an attorney who is representing nursing home workers and residents in the lawsuits against Alaris Health at Hamilton Park. ‘It’s not getting better, it’s getting worse’Infection control has long been a challenge in long-term care facilities, where hands-on care is a necessity, and the pandemic has exacerbated that problem. The U.S. Government Accountability Office, in a report released May 20, said that 82% of nursing homes surveyed from 2013 to 2017 were cited for infection prevention and control deficiencies. Meanwhile, the median pay for nursing assistants was $29,640 last year — just above the national poverty level for a family of four, which is $26,200. By comparison, the median salary for a full-time worker last year was about $49,000, according to weekly earnings data from the Bureau of Labor Statistics. In part because of that low pay, many nursing home employees work second jobs, which increases their risk of contracting the virus and unwittingly carrying it to residents. “If the aides were paid a living wage, they would not need to have multiple jobs,” says Joanne Spetz, director of the Health Workforce Research Center for Long-Term Care at the University of California, San Francisco. “That forces the workers to put themselves at more and more risk to support themselves, and that also puts their clients at risk and their residents at risk.” The median pay for nursing assistants was $29,640 last year — just above the national poverty level for a family of four, which is $26,200.And while staff shortages have long been an issue at nursing homes, the problem becomes worse when workers stay home sick. As their colleagues take on the extra work, the care and time they’re able to give patients suffers. “A lot of nursing homes are worried,” says David Grabowski, a professor of health care policy at Harvard Medical school who focuses on long-term care. “Who steps in here? Maybe it’s the National Guard, maybe it’s contract nurses. But it’s not like these places have a big roster of folks ready to plug into these positions.” In New York City on May 20, Mayor Bill de Blasio announced that the city would provide staff to fill in for nursing home workers who contract COVID-19 and must stay home. All of this suggests that the looming shortage of elder care workers in the U.S. is likely to worsen, now that the pandemic has laid bare many of the problems in the industry. “It’s a two-way street. We need to pay them a rate commensurate with all we’re asking of them and support them,” Grabowski says. “Otherwise they’re not going to be there to do this.” The response to coronavirus outbreaks in nursing homes has varied by state. In Maryland— where nursing home residents and staff account for more than half the state’s coronavirus deaths — Gov. Larry Hogan required in early April that all nursing home workers wear masks at all times and then ordered testing of all residents and workers, whether they showed symptoms or not. In New York, Gov. Andrew Cuomo recently mandated twice-weekly COVID-19 testing of nursing home workers. But he also faced criticism from the nursing home industry and residents for originally directing long-term care facilities to accept back coronavirus patients released from the hospital. He walked back that policy on May 10 amid concerns that it would cause the virus to further spread within nursing homes. On May 5, Illinois Rep. Jan Schakowsky and New Jersey Sen. Cory Booker introduced legislation that would require nursing homes to provide workers with training in how to avoid COVID-19 exposure, sufficient personal protective equipment, increased testing and at least two weeks of paid sick leave. Parts of the bill were incorporated into the new $3 trillion pandemic relief package that passed the House, but that legislation is unlikely to become law as it faces overwhelming Republican opposition in the Senate. Following complaints about a lack of transparency within nursing homes, the Centers for Medicare and Medicaid Services is now requiring them to report coronavirus cases to the Centers for Disease Control and Prevention, as well as to residents and their families. The Occupational Safety and Health Administration (OSHA) — which has received at least 230 COVID-19 complaints related to nursing homes -- released guidance on May 14 aimed at reducing workers’ exposure to the virus. It recommends that facilities encourage workers to stay home if they’re sick, develop a process for decontamination and reuse of protective gear, and train workers on how to protect themselves. Debbie Berkowitz, program director for the worker safety and health program at the National Employment Law Project, says there needs to be stronger oversight at state and federal levels and that nursing homes should ramp up training of employees on treating COVID-19 and increase testing of workers and patients within their facilities. She says any solution will also hinge on staffers having enough protective equipment — a consistent obstacle for frontline workers. “Mentally, physically, emotionally, you’re fighting a disease. And on top of that, we have to fight administrators to give us protective gear,” says Nicole Jefferson, a part-time CNA at Apple Rehab in Rocky Hill, Conn., who thinks of her 3-year-old and 14-year-old daughters each time she enters a COVID-19 room. “I don’t want to die. I don’t want my kids to die. What more can we do?” An Apple Rehab administrator reached by phone said “we have plenty of protective gear,” but directed further questions to a spokesperson, who did not respond to a request for comment. In Illinois, thousands of nursing home employees who are members of the SEIU Healthcare union had voted to strike on May 8, before reaching a last-minute deal on a new contract. It includes an increase in base pay to $15 an hour, an extension of $2 hazard pay and five additional paid sick days for coronavirus. The new contract also guarantees that staffers won’t be required to work without adequate protective equipment. But Francine Rico, a CNA at the Villa at Windsor Park nursing home in Chicago who was on the bargaining committee, says workers still don’t have enough. Rico says she was given a raincoat to wear for protection and takes care of her N95 mask “like it’s gold.” “How do they expect for this virus, this pandemic, to even lift if we’re still wearing the same PPE gear in and out of the rooms?” says Rico, 52. The nursing home has had 143 cases of coronavirus and 33 deaths as of May 23, according to data reported by the state. In a statement, Villa at Windsor Park called its workers “heroic” and said the facility is screening staff for symptoms at the start and end of their shifts. “In as much as there has been a national shortage of PPE, Villa at Windsor Park has at all times had sufficient levels PPE, including those necessary for infection control and personal protection, to ensure that we meet the needs within the center,” the statement said. Rico’s sister, Eartha Sears, is a CNA in the same facility and says she recently returned to work after using up all her sick time and vacation time while recovering from COVID-19. “I wish they’d [use] better judgment about safety — not just our safety, the residents’ safety as well,” says Sears, 56. “Because it’s not getting better, it’s getting worse.” Meanwhile, employees are contending with the mental and emotional toll of continuing to work in places ravaged by illness, losing residents and coworkers they’ve known for years. “They teach you when you’re in school as a CNA not to take any of this personally,” says Beckford. “But if you’re a human being with a heart, you’re going to feel something for the people that you’re working with for such a long time.” Beckford graduated with a master’s degree in 2018, planning to transition into social work, but she stayed at the nursing home to continue caring for her oldest residents. “Unfortunately, once I return to work, the majority of my residents will not be there,” she says. Milanes says many of the residents she cared for have died in the past two months. She says she recently received a job offer from a different nursing home, and she plans to start when she tests negative for COVID-19. But everything about the career she once loved has changed. “Maybe I’m afraid because I cared about them, and I know that they’re all dead,” she says. “I’ve cried, I just don’t think that I’ve had time to really grieve.” from https://ift.tt/3gyxLFd Check out https://takiaisfobia.blogspot.com/ Dr. Raj Panjabi Warns of an Impending Viral Apartheid If We Dont Change Our COVID-19 Approach5/28/2020 As nations around the world scramble to bring coronavirus outbreaks under control, Dr. Raj Panjabi is worried that the world’s poor populations will be excluded from accessing treatments and prevention measures, a scenario he calls “viral apartheid.” “I don’t use that term lightly,” said Panjabi, speaking with TIME Senior Writer Alice Park during a TIME 100 Talks discussion on May 28. “The idea that a group of people—whether it’s the vaccines, the test or treatments—will get access to those vital life-saving tools, and that those will likely be the rich nations and the powerful within those nations, and the poor within those nations and the poorer nations in the world will get excluded from that, is in fact the story of every pandemic that has happened in humanity.” Panjabi, CEO and founder of Last Mile Health, has spent a career batting just those sorts of issues. His organization trains community health workers in essential medical services, like providing vaccines and neonatal care, in order to bridge the “last mile” to remote communities in countries like Liberia, where Last Mile Health has been working for the past 10 years. As Panjabi tells TIME, that sort of community-based health infrastructure can both save lives and help to address the economic portion of the coronavirus crisis. For instance, countries can hire unemployed workers to be contact tracers, a tactic that can mitigate the health crisis while also creating much needed jobs in the health sector. By tracking and isolating exposed individuals before they spread the virus farther, those contact tracers can also help keep economies open and more people employed. “Outbreaks start and stop in the community,” he says. “If we can hire the people from the communities most affected to be part of the medical team, I think we have a better chance of closing the equity gap.” And when vaccines are eventually produced, those newly-trained health workers may be able to expand their skills in order to distribute and administer vaccines. “One of the opportunities I think the United States has, as well as other countries, is to really break this false narrative that’s been created, that we need to save lives or save jobs,” he explains. “We can actually create jobs and save lives.” Panjabi holds no illusions about the magnitude of the worldwide crisis, especially in developing countries. An April United Nations Economic Commission for Africa report predicted that the continent could see between 300,000 and 3.3 million coronavirus-related deaths this year. In places with limited health infrastructure, the pandemic could also create setbacks in battles against other health scourges, like measles, which caused more than 140,000 deaths worldwide in 2018. “We’re seeing that in many low and middle-income countries that there’s a dual threat, the virus itself, but there’s a threat from the fact that people will die from other epidemics because the virus is disrupting the healthcare systems,” Panjabi says. Still, there have been notable successes, Panjabi says, such as South Africa’s deployment of 28,000 contact tracers. “They were able in the first month to screen seven million people. That’s one out of 10 South Africans.” Such measures can offer lessons for building community health infrastructure in the U.S., which on May 27 passed 100,000 coronavirus deaths. “Imagine if Boston screened one out of 10 Bostonians,” Panjabi says. “Community health workers are vital for helping us test, trace, refer those for treatment and those for isolation and supporting them. And we simply can’t do this without a community-based approach.” from https://ift.tt/2XCP3bv Check out https://takiaisfobia.blogspot.com/ Americas Assisted Living Residents Are Falling Through the Cracks of COVID-19 Response Families Say5/28/2020 On May 7, Craig Martin sent what would be the first of many emails to administrators at the company that runs The Wellington at Lake Manassas, his mother’s assisted living facility in Gainesville, Va. Another resident had tested positive for COVID-19 days earlier while being treated at a local hospital, and Martin and his brother were getting nervous. In their eyes, The Wellington was relying on measures, like social distancing and monitoring residents for symptoms, that were designed to keep the virus out—when the virus was already inside. In his email, Martin urged administrators to test residents “early and often,” even if they weren’t showing symptoms. “We just want to be sure that Wellington is doing all that it can to prevent a massive outbreak and additionally ensure that our mother is not infected,” Martin wrote. By May 11, his 81-year-old mother had tested positive for COVID-19. She’d developed a fever and gastrointestinal distress, so Martin and his brother called her physician outside the facility, who requested a coronavirus test for her. Though her condition is stable as of May 27, Martin says he fears the worst. “What’s infuriating,” Martin says, “is I think it could have been avoided.” The realities of assisted livingFamilies like Martin’s are learning a hard truth. Assisted living facilities, home to about 800,000 older Americans, have been largely overlooked in coronavirus-relief efforts, leaving many facilities underregulated, understaffed and underfunded. As a result, families and caregivers say, their residents are “falling through the cracks.” Assisted living facilities struggled with safety, funding and staffing issues well before COVID-19 hit. They’re set up mainly to provide domestic support to seniors, as opposed to nursing homes, which can perform a higher level of medical care; they’re also less likely to be covered by Medicaid or Medicare than nursing homes. Accordingly, assisted living facilities are not subject to as many federal regulations as nursing homes. Nursing homes—which themselves have a spotty safety record—have become a high priority for lawmakers and public-health officials during the pandemic, following several devastating coronavirus clusters in long-term care facilities. Roughly 42% of U.S. coronavirus deaths have occurred in nursing homes and assisted living facilities, according to a May 22 analysis from the Foundation for Research on Equal Opportunity.
As a result, about a dozen states have taken steps to support, and in some cases even mandate, universal coronavirus testing for nursing home residents and employees, and the Centers for Medicare and Medicaid Services (CMS) called universal testing a prerequisite for nursing homes thinking of easing disease-containment restrictions. Nursing homes have a long way to go, and many are still struggling to get access to the tests they need—but assisted living facilities are even further behind. Many of the policies on the books for nursing homes don’t apply to assisted living facilities, meaning many facilities have no legal requirement to carry out precautions like wide-scale testing, and few resources even if they want to do so. The Department of Health and Human Services has so far earmarked at least $4.9 billion in aid funding for skilled nursing facilities, but none for assisted living. “We are asking for additional consideration for all long term care facilities, whether it be in regard to additional testing, personal protective equipment, or funding,” the American Health Care Association and National Center for Assisted Living said in a May 22 statement. As Massachusetts Senator Elizabeth Warren noted at a May 21 Senate Special Committee on Aging hearing, assisted living facilities are also not subject to the same reporting requirements as nursing homes, which must notify residents, their families and the Centers for Disease Control and Prevention when they confirm a COVID-19 case on their premises. “Assisted living facility residents and their families deserve to know whether their facilities are experiencing a coronavirus outbreak, just like nursing home residents,” Warren said, adding that she and colleagues in the Senate are launching an investigation into America’s assisted living facilities. “Falling through the cracks”That focus is long overdue, families say. “I understand the focus on nursing homes, but I feel like assisted living facilities haven’t gotten as much attention,” says Craig Crawford, a 62-year-old living in Washington, D.C., whose 93-year-old father lives in a Florida assisted living facility. “Assisted living facilities have been kind of the orphans in this process.” Without state assistance, Crawford’s father’s facility was so desperate for help securing supplies like tests and personal protective equipment (PPE) that it urged family members to call Florida’s elected officials, he says. On the same day Crawford called the office of Val Demings, the Democratic Representative for Florida’s 10th district, the facility announced it had gotten PPE and access to tests, Crawford says. Other families have had a tougher road. When Martin first contacted staff at The Wellington’s parent company, Retirement Unlimited, Inc. (RUI), he claims they told him they had no obligation to test all residents since they ran an assisted living facility, not a nursing home. “It’s the same demographic,” Martin says. “The virus doesn’t care [where] it’s going to spread.” When Martin raised his concerns with the company’s executive vice president of clinical services, he was allegedly told it wasn’t feasible to test all staff members, because doing so could create staffing shortages if employees tested positive and needed to be quarantined. “At that point I knew his goal was very different than mine,” Martin says. “He saw having a staffing concern as a bigger problem than a global pandemic ravaging through his assisted living facility.” A spokesperson for RUI said The Wellington is following guidance from the U.S. Centers for Disease Control and Prevention (CDC) and its local health department, and noted that there are “many and varied reasons why universal testing may or may not be prescribed by the Department of Health.” The spokesperson said the facility has implemented precautions including restricting visitors and resident trips in and out of the facility, enforcing social distancing, doing extra cleaning, monitoring residents and staff members for symptoms and requiring employees to wear PPE—though Martin says he and his brother have seen staffers flouting that rule during video chats and socially distant visits. The Wellington tested all residents within its memory care unit, where Martin’s mother lives, for COVID-19 on May 14, the spokesperson says, but Martin continues to push for testing for all residents and staff members. One man, who asked to remain anonymous to avoid possible negative consequences for his father’s care, had a similar experience with his dad’s facility: Brookdale Senior Living in Arlington, Va. The roughly 120-person facility has suffered multiple deaths and more than 30 COVID-19 cases, but for weeks refused to test any residents who were not showing symptoms, even when questioned by family members on weekly video calls with the facility’s administrators, the man says. His father finally got a test on May 18 and results came back negative, but the man says Brookdale still has no plan for consistent testing moving forward. A spokesperson for Brookdale says the facility is following state and local public-health guidance, and performed universal testing as soon as it had the resources to do so. “As soon as community-wide testing for assisted living communities was available in Virginia, Brookdale Arlington worked with the National Guard, who was charged with overseeing such testing, to ensure the residents and associates of the community were tested,” the spokesperson said. The Brookdale representative said case and fatality counts are shared with residents, their families and health authorities, but cannot be disclosed externally. The whole experience, the resident’s son says, has made him painfully aware that his father’s facility was not ready for a disease outbreak. “You start recognizing what ‘assisted living’ is,” he says. “I refer to them as motels, basically. But they present themselves as health care facilities.” An industry begging for helpKayla Van Rossum, who directs an assisted living facility outside Phoenix, Az., says it’s more complicated than that. She says she’s desperate for testing and PPE, but isn’t getting what she needs from the state government. When it came time to designate essential businesses during the pandemic, Arizona declared long-term care facilities necessary for “human services”—but Van Rossum says Arizona hasn’t offered the support and resources she needs to function like an essential service during the crisis. So far, at least one of Van Rossum’s 70 residents has gotten seriously ill with COVID-19, and two of her 70 staff members have tested positive and been quarantined. And just down the road, a similar facility lost 30 of its residents when the virus started spreading inside, Van Rossum says—a constant reminder of how much could go wrong for hers. “It’s horrible and absolutely heartbreaking because we don’t have what we need,” she says. Other assisted living directors are also speaking out. The CEO of Sunrise Senior Living, a national chain of long-term care facilities, is coordinating a letter-writing campaign to Congress, asking for federal funding to help with testing, PPE acquisition and other coronavirus-related necessities. But for many families, the damage has already been done. The Brookdale resident’s son says he was never happy knowing his father was in an assisted living facility—it’s an area of contention within his family—but he’s now become even more disillusioned with the system. “I think assisted living is an oversold product,” he says. “It basically is our laziness in dealing with aging care in our country.” But people like Martin continue to fight for better testing and disease-control practices in his mother’s facility, even as she lies sick with COVID-19, in hopes of securing a safer future. “It might be too late for mom,” Martin says. “But if my experience can help others, that could be of value—I hope.” from https://ift.tt/3ddV3xS Check out https://takiaisfobia.blogspot.com/ In one cruise-ship coronavirus outbreak, more than 80% of people who tested positive for COVID-19 did not show any symptoms of the disease, according to a new paper published in the journal Thorax. The research shows just how prevalent asymptomatic transmission of COVID-19 may be—a reality that both suggests official case counts are drastic underestimates, and emphasizes the importance of practicing social distancing even if you feel healthy. Researchers have known for months that asymptomatic transmission of COVID-19 is possible and common, but without population-wide testing, it’s been difficult to estimate how many people get infected without showing symptoms. The new paper provides an example of how widespread asymptomatic transmission can be, at least in a contained environment. The (unnamed) cruise ship in the new paper left Argentina in mid-March, with plans to travel around the Antarctic Peninsula and over to South Georgia Island in the south Atlantic ocean. All passengers were checked for coronavirus symptoms before departure, and people who had traveled through COVID-19 hotspots were not allowed on board. Even still, a passenger developed a fever eight days into the trip, triggering a ship-wide lockdown. Crew members and additional passengers began to develop coronavirus symptoms over the next few days. The ship was not allowed to re-dock in Argentina after the country closed its borders, so it continued on to Uruguay, where eight people were evacuated to a hospital. Uruguayan officials eventually arranged for everyone remaining on board to get tested before the boat docked. Out of 217 people on board, 128 tested positive for COVID-19—but only 24 of those people showed symptoms prior to testing. The remaining 104 people—81% of those who tested positive—had not experienced any symptoms, the researchers report. There were also 10 instances of people testing negative even when their cabin mate tested positive, which the authors say suggests there were some false-negative test results. It’s difficult to extrapolate the results to larger populations, since the people on board the ship were living in close quarters while entirely isolated from outside life for about a month. Even still, the results are a stark reminder of how likely COVID-19 is to spread within communities, and how difficult it can be to tell when it does. That’s a particularly important lesson to consider as states reopen and nice weather eats away at many people’s resolve to stay home. The virus can and does spread undetected—and an asymptomatic case can still cause serious illness if it spreads to someone else. Until a vaccine is available, the safest way to keep coronavirus from spreading is to keep your distance from others, whether you’re sick or not. from https://ift.tt/3c7rMDN Check out https://takiaisfobia.blogspot.com/ Four months after the first case of COVID-19 was confirmed in the U.S., the nation’s coronavirus death toll has surpassed 100,000, hitting 100,047 as of 6 PM eastern on May 27, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. That’s the most confirmed deaths of any country in the world. It’s equivalent to the entire population of mid-sized cities like Albany, N.Y. or Boca Raton, Fla. It’s more American lives than were lost to the Korean War, the Vietnam War and the Sept. 11, 2001 attacks combined. It’s also on the low end of projected death estimates. In April, for example, White House officials warned that between 100,000 and 240,000 Americans could die from COVID-19, even with preventive measures like social distancing. Independent researchers have often produced even higher estimates. A Harvard health policy expert told NPR on May 26 that the U.S. could see an additional 100,000 COVID-19 deaths this summer alone. Daily U.S. coronavirus cases and deaths have declined substantially since a peak in April—including in many of the country’s hardest-hit areas, like New York City—but experts have warned that rural areas may not have seen the worst of COVID-19 yet. And despite the progress we’ve seen so far, hundreds of people in the U.S. are still dying from coronavirus each day. During the week ending May 26, about 7,000 people in the U.S. died from COVID-19, according to data from Johns Hopkins University’s COVID-19 tracker. Though new diagnoses are starting to decrease, the U.S. leads the world in coronavirus cases, as well as deaths. As of 6 PM eastern on May 27, nearly 1.7 million cases have been reported in the U.S., according to Johns Hopkins data. (That’s an underestimate, if anything, given inadequate testing capacity and the number of people who develop mild illnesses and do not seek medical attention.) And after steady declines in the numbers of new confirmed cases each day, the trend seems to have reversed itself in recent days. That’s likely in part because the country’s commitment to social distancing appears to be faltering as states reopen and summer weather draws people out of their homes. Though it may feel like the worst of the pandemic is behind us, a top World Health Organization official warned on May 26 that “we’re right in the middle of the first wave [of coronavirus cases] globally” and said “we’re still very much in a phase where the disease is actually on the way up” in many parts of the world. It’s impossible to predict exactly when COVID-19 cases and deaths will level off for good. But experts do know that, in the absence of a vaccine that can provide widespread immunity, social distancing is among the best—and only—ways to keep infection, hospitalization and death rates as low as possible. A Columbia University analysis published May 20 estimated that 36,000 lives could have been saved if the U.S. broadly adopted social-distancing policies a week earlier than many places did, in mid-March. The 100,000 lives already lost in the U.S. serve as a painful reminder of what happened instead. from https://ift.tt/2X8heQL Check out https://takiaisfobia.blogspot.com/ Aspen was an early COVID-19 hot spot in Colorado, with a cluster of cases in March linked to tourists visiting for its world-famous skiing. Tests were in short supply, making it difficult to know how the virus was spreading. So in April, when the Pitkin County Public Health Department announced it had obtained 1,000 COVID-19 antibody tests and that they would be offered to residents at no charge, it seemed like an exciting opportunity to evaluate the efforts underway to stop the spread of the virus. “This test will allow us to get the epidemiological data that we’ve been looking for,” Aspen Ambulance District director Gabe Muething said during an April 9 community meeting held online. However, the plan soon fell apart amid questions about the reliability of the test from Aytu BioScience. Other ski towns such as Telluride, Col., and Jackson, WY, as well as the less wealthy border community of Laredo, TX, were also drawn to antibody testing to inform decisions about how to exit lockdown. But they, too, determined the tests weren’t living up to their promise. The allure of antibody tests is understandable. Although they can’t find active cases of COVID-19, they can identify people who previously have been infected with SARS-CoV-2, the coronavirus that causes the disease, which could give health officials important epidemiological information about how widely it has spread in a community and the extent of asymptomatic cases. In theory, at least, antibodies would be present in such people whether they had a severe case, little more than a dry cough or no complaints at all. Even more enticing: These tests were billed as a path to restart local economies by identifying people who might be immune to the virus and could therefore safely return to the public sphere. But, in these and other communities, testing programs initially slated to test hundreds or thousands have been scaled back or put on hold. “I don’t think these tests are ready for clinical use yet,” says University of California-San Francisco immunologist Dr. Alexander Marson, who has studied their reliability. He and his team vetted 12 different antibody tests and found all but one turned up false positives—implying that someone had antibodies when they didn’t―with false-positive rates reaching as high as 16%. (The study is preliminary and has not been peer-reviewed yet.) More than 100 antibody tests are currently available in the U.S., including offerings by commercial labs, academic centers and small entrepreneurial ventures. As serious questions emerged in early May about the accuracy of these tests and the usefulness of their results, the U.S. Food and Drug Administration (FDA) said it will require companies to submit validation data and apply for emergency-use authorizations for their products. (Previously, companies were allowed to sell their tests without review from the FDA, as long as they did their own validation and included a disclaimer.) The American Medical Association said on May 14 that the tests should not be used to assess an individual’s immunity or when to end physical distancing. And this week, the Centers for Disease Control and Prevention released new guidelines warning that antibody test results can have high false positive rates and should not be used to make decisions about returning people to work, schools, dorms or other places where people congregate. Once hailed as a solution, the current crop of tests, which have not been thoroughly vetted by any regulatory agency, now seem more likely to add chaos and uncertainty to a situation already fraught with anxiety. “To give people a false sense of security has a lot of danger right now,” says Dr. Travis Riddell, the health officer for Teton County, which includes Jackson, WY. Accuracy Questions RaisedThe gold standard for confirming an active COVID-19 infection is to take a swab sample from the nasopharynx and test it for the presence of viral RNA. So far, there is no gold standard for the test that can determine if the infection has come and gone—the antibody tests that parse the blood for antibodies produced by the immune system to fight off SARS-CoV-2. It takes time for an infected person to produce antibodies, so these tests can’t diagnose an ongoing infection, only indicate that a person has encountered the virus. In Aspen, county officials knew the FDA had not approved the test from Aytu BioScience, which the Colorado-based company was importing from China. So they first conducted their own validation tests, says Bill Linn, spokesperson for the Pitkin County Incident Management Team. “We weren’t reassured enough by our own testing to feel like we should move ahead.” In Laredo, officials had been told by one of the community members helping to arrange the purchase of 20,000 tests from the Chinese company Anhui DeepBlue Medical Technology that they were FDA-approved, but the city’s own validation trials revealed only about a 20% accuracy rate, says Laredo spokesperson Rafael Benavides. Before Laredo could pay for the tests, Benavides says, an arm of U.S. Immigration and Customs Enforcement seized them and launched an investigation. Neither Anhui DeepBlue Medical Technology, nor Aytu returned requests for comment. In March, Covaxx, a company led by two part-time Telluride residents, offered to test residents of town and the surrounding county with an antibody test it had developed. But the project was suspended indefinitely after results from the first of two intended rounds of testing were delayed when the company’s testing facility fell behind on processing them. The county is committed to doing a second round of testing but is evaluating how to proceed, says San Miguel County spokesperson Susan Lilly. “The question is how do you target it to be the most relevant clinically and for the public health team’s decision-making moving forward?” Officials Back Off, Community Members Step InOn May 4, the FDA updated its antibody test policy to require that manufacturers submit validation data, but it is still allowing the tests to be sold without the normal lengthy vetting and approval process, which includes demonstrating safety and effectiveness. In some wealthy areas, government officials had been offering free tests from startups with local investors. In Jackson, WY, for example, a venture capitalist with an investment in Covaxx, the test used in Telluride, offered to help the city obtain 1,000 tests. But after reviewing the offer, Teton County declined over concerns about the test’s accuracy. “If a person tests positive, what does that mean? And is that useful information? We just don’t know yet,” Riddell says. Covaxx spokesperson John Schaefer said in a statement that the test had been validated on more than 900 blood samples and is being reviewed by the FDA. After Teton County officials decided against community antibody testing, a private nonprofit, Test Teton Now, sprung up to provide free COVID-19 antibody testing for roughly 8,000 people, about a third of the county’s residents. As of May 22, they’d raised $396,000 from the community and tested 843 samples. The group has “done a lot” to verify the Covaxx tests, says Test Teton Now president Shaun Andrikopoulos. “I don’t want to call it validation, because we didn’t go through an independent review board, but we have sent our samples out to other labs.” Organizers of Test Teton Now don’t share others’ concerns about the test’s utility. “We don’t encourage people to make any decisions about what they’re going to do or how they’re going to behave based on the results,” says the nonprofit’s spokesperson, Jennifer Ford. What good is a test that can’t be used for practical purposes? “We think knowledge is power, and data is the beginning of knowledge,” Ford says. But unreliable data doesn’t give knowledge, it gives an illusion of knowledge. So many unknowns remain, and false data may be worse than none. Even a very accurate test will produce a large number of false positives when used in a population where few people have been infected. If only 4% of people have actually been infected, a test with 95% accuracy would produce nine positive results for every 100 tests, five of which are false positives. And that creates a danger that the tests could lead people to incorrectly think that they have antibodies that make them immune, which could have disastrous consequences if they changed their behavior as a result. Consider, for example, a person falsely told she had antibodies going to work at a nursing home, believing she couldn’t catch or spread the virus to anyone. It’s not even known for sure that having antibodies makes someone immune. Researchers are hopeful that exposure can confer some level of immunity, but how strong that immunity might be and how long it might last remain unknown, says Harvard epidemiologist Marc Lipsitch. So, having been burned once, Aspen has put antibody testing on hold and is instead focusing on identifying and isolating people who are sick or at risk of becoming so. “It’s actually a step back to where we started,” Linn says. Given the remaining unknowns about immunity and COVID-19, the best methods for addressing the pandemic in communities may be the most time-tested ones, Linn says. “Put the sick people in places where they can’t get anyone else sick. It’s the bread and butter of epidemiology.” Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente. from https://ift.tt/2zAfnuV Check out https://takiaisfobia.blogspot.com/ Only about half of Americans say they would get a COVID-19 vaccine if the scientists working furiously to create one succeed, according to a new poll from The Associated Press-NORC Center for Public Affairs Research. That’s surprisingly low considering the effort going into the global race for a vaccine against the coronavirus that has sparked a pandemic since first emerging from China late last year. But more people might eventually roll up their sleeves: The poll, released Wednesday, found 31% simply weren’t sure if they’d get vaccinated. Another 1 in 5 said they’d refuse. Health experts already worry about the whiplash if vaccine promises like President Donald Trump’s goal of a 300 million-dose stockpile by January fail. Only time and science will tell — and the new poll shows the public is indeed skeptical. “It’s always better to under-promise and over-deliver,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. “The unexpected looms large and that’s why I think for any of these vaccines, we’re going to need a large safety database to provide the reassurance,” he added. Among Americans who say they wouldn’t get vaccinated, 7 in 10 worry about safety. “I am not an anti-vaxxer,” said Melanie Dries, 56, of Colorado Springs, Colorado. But, “to get a COVID-19 vaccine within a year or two … causes me to fear that it won’t be widely tested as to side effects.” Dr. Francis Collins, who directs the National Institutes of Health, insists safety is the top priority. The NIH is creating a master plan for testing the leading COVID-19 vaccine candidates in tens of thousands of people, to prove if they really work and also if they’re safe. “I would not want people to think that we’re cutting corners because that would be a big mistake. I think this is an effort to try to achieve efficiencies, but not to sacrifice rigor,” Collins told the AP earlier this month. “Definitely the worst thing that could happen is if we rush through a vaccine that turns out to have significant side effects,” Collins added. Among those who want a vaccine, the AP-NORC poll found protecting themselves, their family and the community are the top reasons. “I’m definitely going to get it,” said Brandon Grimes, 35, of Austin, Texas. “As a father who takes care of his family, I think … it’s important for me to get vaccinated as soon as it’s available to better protect my family.” And about 7 in 10 of those who would get vaccinated say life won’t go back to normal without a vaccine. A site foreman for his family’s construction business, Grimes travels from house to house interacting with different crews, and said some of his coworkers also are looking forward to vaccination to minimize on-the-job risk. The new coronavirus is most dangerous to older adults and people of any age who have chronic health problems such as diabetes or heart disease. The poll found 67% of people 60 and older say they’d get vaccinated, compared with 40% who are younger. And death counts suggest black and Hispanic Americans are more vulnerable to COVID-19, because of unequal access to health care and other factors. Yet the poll found just 25% of African Americans and 37% of Hispanics would get a vaccine compared to 56% of whites. Among people who don’t want a vaccine, about 4 in 10 say they’re concerned about catching COVID-19 from the shot. But most of the leading vaccine candidates don’t contain the coronavirus itself, meaning they can’t cause infection. And 3 in 10 who don’t want a vaccine don’t fear getting seriously ill from the coronavirus. Over 5.5 million people worldwide have been confirmed infected by the virus, and more than 340,000 deaths have been recorded, including nearly 100,000 in the U.S., according to a tally kept by Johns Hopkins University. Experts believe the true toll is significantly higher. And while most people who get COVID-19 have mild cases and recover, doctors still are discovering the coronavirus attacks in far sneakier ways than just causing pneumonia — from blood clots to heart and kidney damage to the latest scare, a life-threatening inflammatory reaction in children. Whatever the final statistics show about how often it kills, health specialists agree the new coronavirus appears deadlier than the typical flu. Yet the survey suggests a vaccine would be no more popular than the yearly flu shot. Worldwide, about a dozen COVID-19 vaccine candidates are in early stages of testing or poised to begin. British researchers are opening one of the biggest studies so far, to test an Oxford University-created shot in 10,000 people. For all the promises of the Trump administration’s “ Operation Warp Speed,” only 20% of Americans expect any vaccine to be available to the public by year’s end, the poll found. Most think sometime next year is more likely. Political divisions seen over how the country reopens the economy are reflected in desire for a vaccine, too. More than half of Democrats call a vaccine necessary for reopening, compared to about a third of Republicans. While 62% of Democrats would get the vaccine, only 43% of Republicans say the same. “There’s still a large amount of uncertainty around taking the vaccine,” said Caitlin Oppenheimer, who leads NORC’s public health research. “There is a lot of opportunity to communicate with Americans about the value and the safety of a vaccine.” from https://ift.tt/36BuHUa Check out https://takiaisfobia.blogspot.com/ |
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