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katherineharron

US Coronavirus: Michigan's Covid-19 crisis could be a sign of what's to come for the US... - 0 views

www.cnn.com/...index.html

covid

shared by katherineharron on 12 Apr 21 - No Cached
  • As the US races to vaccinate more Americans, Covid-19 cases and hospitalizations are rising, predominantly among younger people who haven't yet gotten a shot.
  • Some experts worry this might only be the start of what's to come in the next weeks. Michigan is already in the middle of a violent surge
  • "Michigan is really the bellwether for what it looks like when the B.1.1.7 variant ... spreads in the United States," Dr. Celine Gounder told CNN on Sunday. "It's causing a surge in cases and it's causing more severe disease, which means that even younger people, people in their 30s, 40s and 50s are getting very sick and being hospitalized from this."
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  • Michigan's surge is a combination of two factors, Gounder says: the spread of the B.1.1.7 variant combined with people relaxing on mitigation measures before enough residents are vaccinated.
  • Florida has the highest number of cases of the variant, followed by Michigan, Minnesota and Massachusetts, according to data from the Centers for Disease Control and Prevention.
  • Experts say it's more contagious, may cause more severe disease and may potentially be more deadly. And it's rapidly spreading across the country.
  • Here's why: It takes about two weeks after the Pfizer and Moderna second doses and about two weeks after the Johnson & Johnson vaccine before people are immune, she said. Meanwhile, Gounder added, "the incubation period, which is the time from when you are exposed to when you are infected with coronavirus, is four to five days."close dialogSign up for the Results Are In NewsletterGet the latest expert advice to live a healthier and happier lifeSign me upNo, ThanksBy subscribing you agree to ourPrivacy PolicySign up for the Results Are In NewsletterGet the latest expert advice to live a healthier and happier lifePlease enter aboveSign me upNo, ThanksBy subscribing you agree to ourPrivacy PolicyYou have successfully subscribed.By subscribing you agree to ourPrivacy Policyclose dialog
  • "So there is no way that a surge in vaccination is going to help curb this when transmission is happening right now," she said.
  • the only thing that will curb transmission right now are measures that take effect immediately.
  • Michigan is now reporting thousands of new Covid-19 cases daily, when just weeks ago, state data showed the daily reported case count was as low as 563 cases.
  • "Hospitals are being inundated," Dr. Jonathan Reiner, a professor of medicine and surgery at George Washington University, told CNN. "Michigan needs to shut down."
Javier E

Covid hospital bills arrive for patients as insurers restore deductibles and copays - T... - 0 views

www.washingtonpost.com/...tal-bills-insurance-deductible

hospital costs Covid-19 health care insurance

shared by Javier E on 19 Sep 21 - No Cached
  • Nationally, covid hospitalizations under insurance contracts on average cost $29,000, or $156,000 for a patient with oxygen levels so low that they require a ventilator and ICU treatment,
  • The calculus in place in 2020 changed with the advent of vaccines, which now makes most hospitalizations preventable,
  • Hospitals along the Connecticut River, the border between Vermont and New Hampshire, draw patients from both states. Vermont health plans are waiving deductibles and co-pays into 2022. In New Hampshire, where Anthem Blue Cross Blue Shield has a dominant presence, insurance companies have reinstated cost-sharing.
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  • Marvin Mallek, a doctor who treats covid patients from both sides of the river at Springfield Hospital in Vermont, said New Hampshire covid patients are now facing business as usual from insurers, suffering the same sort of financial stress that routinely affects patients with cancer, heart disease and other serious ailments.
  • “The inhumanity of our health-care system and the tragedies it creates will now resume and will now cover this one group that was exempted,'' he said. “The U.S. health-care system is sort of like a game of musical chairs where there are not enough chairs, and some people are going to get hurt and devastated financially.”
  • Hospitals also are in the position of having to resume billings and collections for individuals who may have been laid off because of the pandemic or been too sick to work, experts said.
  • “These waivers ended in January as we all had gained a better understanding of the virus, and people and communities became more familiar with best practices and protocols for limiting COVID-19 exposure and spread,” the company said in a statement. “Also, at this time vaccines, which are proven to be the safest and most effective way to protect oneself from COVID-19, were starting to become readily available.”Anthem took in $4.6 billion in profits in 2020, compared to $4.8 billion in 2019.
  • The reintroduction of cost-sharing mainly affects people with private or employer-based insurance. Patients with no insurance can have 100 percent of their expenses covered by the federal government, under a special program set up by the government for the pandemic, with hospitals reimbursed for care at Medicare rates.
  • Covid patients with Medicaid, the government plan for lower-income people that is paid for by states and the federal government, continue to be protected from cost-sharing, insurance specialists said
  • Patients on Medicare, the federal plan for the elderly, could face out-of-pocket costs if they do not have supplemental insurance.
  • Last year, according to the Kaiser Family Foundation, 88 percent of people covered by private insurance had their co-pays and deductibles for covid treatment waived. By August 2021, only 28 percent of the two largest plans in each state and D.C. still had the waivers in place, and another 10 percent planned to phase them out by the end of October,
  • general, a person with Azar’s type of plan would have an in-network deductible of $1,500 and an in-network out-of-pocket maximum of $4,000,
  • “We still don’t know where the numbers will land because the system makes the family wait for the bills,” s
  • Bills related to her stay at the out-of-network rehab hospital in Tennessee could climb as high as $10,000 more, her relatives have estimated, but they acknowledged they were uncertain this month what exactly to expect, even after asking UnitedHealthcare and the providers.
  • In 2020, as the pandemic took hold, U.S. health insurance companies declared they would cover 100 percent of the costs for covid treatment, waiving co-pays and expensive deductibles for hospital stays that frequently range into the hundreds of thousands of dollars.But this year, most insurers have reinstated co-pays and deductibles for covid patients, in many cases even before vaccines became widely available.
katherineharron

US coronavirus: America is at a crossroads in this pandemic as Covid-19 deaths near 500... - 0 views

www.cnn.com/...index.html

covid

shared by katherineharron on 22 Feb 21 - No Cached
  • On the brink of a devastating milestone -- 500,000 US Covid-19 deaths -- the US is at a crossroads in the course of this pandemic.
  • And while vaccinations slowly increase, some Americans say they won't get a Covid-19 vaccine -- hurting the chances of herd immunity and hindering a return to normal life.
  • More than 43.6 million Americans have received at least one dose of their two-dose vaccines, according to the US Centers for Disease Control and Prevention. close dialogCovid-19Your local resource.Set your location and log in to find local resources and information on Covid-19 in your area.Please enter aboveSet Locationclose dialog/* effects for .bx-campaign-1191325 *//* custom css .bx-campaign-1191325 *//* custom css from creative 50769 */.bx-custom.bx-campaign-1191325 .bx-row-validation .bx-input {border-color: white !important;border-width: 1px !important;background-color: white !important;box-shadow: 0px 2px 8px 1px rgba(0,0,0,0.12) !important;}.bx-custom.bx-campaign-1191325 .bx-row-validation .bx-vtext { color: #e53841 !important; font-size: 11px !important; position: absolute !important; bottom: -1.8em !important;} @media screen and (max-width:736px) { .bx-custom.bx-campaign-1191325 .bx-row-validation .bx-vtext {font-size: 10px !important; }}.bx-custom.bx-campaign-1191325 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  • About 18.8 million have been fully vaccinated. That's about 5.7% of the US population -- far less than the estimated 70% to 85% of Americans who would need to be immune to reach herd immunity.
  • To speed up vaccinations, some experts have suggested delaying second vaccine doses to get more first doses into people's arms.
  • Both vaccines on the US market -- developed by Pfizer-BioNTech and Moderna -- require two doses, the second of which are intended to be administered 21 days and 28 days after the first, respectively.
  • Nationwide, the rates of new Covid-19 cases, hospitalizations and deaths are declining.The number of patients hospitalized with Covid-19 has fallen for the 40th day in a row, according to the COVID Tracking Project.
  • Fauci hopes that doesn't happen, he said, adding it's "possible" people may be wearing masks in 2022.
  • And daily new cases have dropped 23% over the same time period, according to Johns Hopkins. (But testing is also down by 17%, according to the COVID Tracking Project.)
  • Daily deaths have declined 24% this past week compared to the previous week
  • Experts with the University of Washington's Institute for Health Metrics and Evaluation said over the weekend that while the B.1.1.7 strain likely accounts for less than 20% of current infections in the US, that number will likely soar to 80% by late April.
  • "Managing the epidemic in the next four months depends critically on scaling up vaccination, trying to increase the fraction of adults willing to be vaccinated above three-quarters, and strongly encouraging continued mask use and avoiding situations where transmission is likely, such as indoor dining, going to bars, or indoor gatherings with individuals outside the household," the team wrote.
  • "With new, more contagious variants of the virus circulating throughout the U.S., now is not the time to let your guard down and scale back on the measures that we know will work to prevent further illness and deaths -- wearing masks, practicing physical distancing, and washing hands," a joint statement said.
  • About 1,700 cases of variant strains first spotted in the UK, South Africa and Brazil have been reported in the US, according to the Centers for Disease Control and Prevention.
  • "I do think we're looking at some new normals. I think the handshake, for example, is probably going away," she said."I do think masks in the cough/cold/flu season in the winter months would make a lot of sense. That clearly, really insulated the Southeast Asian countries from some of the worst of this, understanding the importance of wearing masks."
  • "It's estimated that about 70% of Americans must be vaccinated before we get to herd immunity through vaccination," CNN medical analyst Dr. Leana Wen said. "That's the point where enough people have the immune protection that the virus won't spread anymore."
  • "The evidence was pretty compelling by last March or April that uniform wearing of masks would reduce transmission of this disease," National Institutes of Health Director Dr. Francis Collins told Axios on HBO on Sunday.
  • "A mask is nothing more than a life-saving medical device, and yet it got categorized in all sorts of other ways that were not factual, not scientific and frankly, dangerous," he added. "And I think you can make a case that tens of thousands of people died as a result."
andrespardo

Coronavirus mask guidance is endangering US health workers, experts say | US news | The... - 0 views

www.theguardian.com/...cal-coronavirus-health-workers

coronavirus pandemic US economics safety

shared by andrespardo on 28 Apr 20 - No Cached
  • Coronavirus mask guidance is endangering US health workers, experts say
  • With crucial protective gear in short supply, federal authorities are saying health workers can wear lower-grade surgical masks while treating Covid-19 patients – but growing evidence suggests the practice is putting workers in jeopardy.
  • But scholars, not-for-profit leaders and former regulators in the specialized field of occupational safety say relying on surgical masks – which are considerably less protective than N95 respirators – is almost certainly fueling illness among frontline health workers, who probably make up about 11% of all known Covid-19 cases.
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  • The allowance for surgical masks made more sense when scientists initially thought the virus was spread by large droplets. But a growing body of research shows that it is spread by minuscule viral particles that can linger in the air as long as 16 hours.
  • A properly fitted N95 respirator will block 95% of tiny air particles – down to 0.3 micron in diameter, which are the hardest to catch – from reaching the wearer’s face. But surgical masks, designed to protect patients from a surgeon’s respiratory droplets, aren’t effective at blocking particles smaller than 100 microns, according to the mask maker 3M. A Covid-19 particle is smaller than 0.1 micron, according to South Korean researchers, and can pass through a surgical mask.
  • The CDC’s recent advice on surgical masks contrasts with another CDC web page that says surgical masks do “NOT provide the wearer with a reliable level of protection from inhaling smaller airborne particles and is not considered respiratory protection”.
  • A 2013 Chinese study found that twice as many health workers, 17%, contracted a respiratory illness if they wore only a surgical mask while treating sick patients, compared to 7% who continuously used an N95, per a study in the American Journal of Respiratory and Critical Care Medicine.
  • Earlier this month, the national Teamsters Union reported that 64% of its healthcare worker membership – which includes people working in nursing homes, hospitals and other medical facilities – could not get N95 masks.
  • said Katie Scott, an RN at the hospital and vice-president of the Michigan Nurses Association. Employees who otherwise treat Covid-19 patients receive surgical masks.
  • That matches CDC protocol, but leaves nurses like Scott – who has read the research on surgical masks versus N95s – feeling exposed.
  • At Michigan Medicine, employees are not allowed to bring in their own protective equipment, according to a complaint the nurses’ union filed with the Michigan Occupational Safety and Hazard Administration. Scott said friends and family have mailed her personal protective equipment (PPE), including N95 masks. It sits at home while she cares for patients.
  • “To think I’m going to work and am leaving this mask at home on my kitchen table, because the employer won’t let me wear it,”
  • News reports from Kentucky to Florida to California have documented nurses facing retaliation or pressure to step down when they’ve brought their own N95 respirators.
  • In New York, the center of the US’s outbreak, nurses across the state report receiving surgical masks, not N95s, to wear when treating Covid-19 patients, according to a court affidavit submitted by Lisa Baum, the lead occupational health and safety representative for the New York State Nurses Association (NYSNA).
  • White House to invoke the Defense Production Act, a Korean war-era law that allows the federal government, in an emergency, to direct private business in the production and distribution of goods.
  • provide health care workers with protective equipment, including N95s masks, when they interact with patients suspected to have Covid-19.
  • “Nurses are not afraid to care for our patients if we have the right protections,” said Bonnie Castillo, the executive director of National Nurses United, “but we’re not martyrs sacrificing our lives because our government and our employers didn’t do their job.”
anonymous

Form of quinine pushed to fight covid-19 - The Washington Post - 0 views

www.washingtonpost.com/...ng-similar-drug-fight-covid-19

history US trump

shared by anonymous on 21 May 20 - No Cached
  • On May 11, 1838, the Vicksburg Register in Mississippi carried an ad for a miracle drug to fight a disease ravaging the country. The potion worked safely without purging the bowels or upsetting the stomach. And it would break a fever within 48 hours.
  • Once known as the Jesuits’ Powder, and the “English remedy” after its early promoters, the drug’s key ingredient was quinine.Now President Trump is promoting a synthetic form of quinine — hydroxychloroquine — as a treatment for covid-19, the disease caused by the novel coronavirus.
  • The drug still is used to combat malaria and has been found to work on other ailments. But there’s scant evidence it can fight covid-19.
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  • It also was used by Nazi doctors in human malaria experiments in the Dachau concentration camp during World War II.German scientist Claus Schilling, an expert in tropical diseases, infected hundreds of patients with malaria by exposing them to parasite-carrying mosquitoes.He then treated them with quinine and other drugs to see how they reacted.“Thirty or forty died from the malaria itself,” Franz Blaha, a physician and Czech inmate at Dachau, testified after the war. “Three hundred to four hundred died later … because of the physical condition resulting from the malaria attacks. In addition there were deaths resulting from poisoning due to overdoses.”
  • At that time, malaria was mostly treated with the quinine-like synthetic Atabrine, a medicine designed by German chemists in the early 1930s.
  • But Atabrine, like quinine, had side effects, including gastritis, hallucinations and psychosis, Masterson wrote. Plus, it turned the skin of GIs and Marines yellow.“The most hair-raising [side effects] were rashes that … progressed grotesquely, with skin falling off in sheets, creating open sores that attracted flies,” Masterson wrote. Other side effects included “erratic mood swings, violent anger, and deep depression …[along with] the standard diarrhea, vomiting, and cramps.”Then came the rumor the drug caused impotence.During the fight for the Pacific island of Guadalcanal, Marines rejected Atabrine. Their officers had to watch them take the pills and make sure the pills were swallowed. But the Marines would later spit them out.Thousands got sick. “For every battle casualty, ten men lay sick with malaria,” Masterson wrote.
  • Other bizarre remedies hadn’t worked, Duran-Reynals, the quinine historian, reported.One ancient cure went: “Take the urine of the patient and mix it with some flour to make … seventy-seven small cakes … Proceed before sunrise to an anthill and throw the cakes therein. As soon as the insects have devoured the cakes the fever vanishes.”
  • “A tree grows which they call ‘the fever tree’ … whose bark, of the color of cinnamon, made into powder … and given as a beverage, cures the fevers … it has produced miraculous results,” he reported.“Thus … did Father Calancha announce to the world that a cure had been found for the most widespread disease of the time,” Duran-Reynals wrote.
  • In the 1670s, despite the hidebound medical establishment, a young English pharmacist, Robert Talbor, became an expert in treating fevers. He had moved to the southeast coast of England, where fevers were “epidemical."By trial and error, he came up with a secret formula — “my particular … medicine,” he called it. He would reveal only that it was “a preparation of four vegetables,” and he warned people about using the “Jesuits’ Powder.”
  • The whole virtue of the pills consisted in the quinine alone.
brickol

Coronavirus heroes: the doctors carrying an immense burden to care for us | World news ... - 0 views

www.theguardian.com/...s-coronavirus-pandemic-stories

us COVID-19 crisis

shared by brickol on 25 Mar 20 - No Cached
  • Doctors across North America are bracing for a surge of critically ill patients, knowing that the more patients they see, the greater their risk of becoming infected with Covid-19.Their commitment to work comes with a heavy psychological burden that their many hours in hospitals could harm their families.
  • Five weeks ago, Dr Erin Bruce, an anesthesiologist, and her husband, Dr Michael Szava-Kovats, had their first child, a daughter. He agonizes over the thought of exposing his young daughter and wife to infection. He accepts that he may get coronavirus. The risks to his family are outside his comfort zone, he says.Last weekend, he moved into an empty condo owned by friends.
  • He worked five days in a row after his move. On his first day off, the sadness of their separation hit him. He feels a combination of guilt that he’s not there to help with a newborn and heartache that he missing out on the first months of his daughter’s life. He longs to be with his wife during an event that’s changing their lives and history.
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  • Drs Bonnie Larson and Alan Chu met at medical school and bonded over their shared interest in global health. They’re married with two children.Larson is a frontline physician working with the city’s homeless. She’s working to keep Covid-19 out of local shelters. Chu is leading online training for residents about coronavirus and airway management, but is readying for a crush of sick patients to arrive in the ICU.They wonder what it will be like for their kids, ages eight and 10, to go through the pandemic without at least one parent home all the time.
  • Dr Zara Mathews is 34 weeks pregnant and mother of a toddler. She plans to work for another week and half, keeping to the schedule that she set out months ago.Her home and work lives have never felt so intertwined, she says. Now there’s this question of whether doing what I need to at work is potentially going to put my family at risk “Normally, when I’m at work, my patients are my priority and when I’m at home, my family is my priority,” she says. “But now there’s this question of whether doing what I need to at work is potentially going to put my family at risk.”
  • Dr Mathews says her parents and husband worry about her, but she is more concerned for her kids and her patients. Most physicians feel the same, she said. Everyone has concerns about risks that they bring to our family but the primary focus is doing everything they can for our patients.
  • Dr Christine Carter Toevs, who has worked in medicine for more than 30 years, says she always worries about bringing home illnesses that could affect her husband. He has respiratory issues and diabetes. When he gets a cold, it lasts for ages.
  • She is concerned about what will happen if high numbers of staff get sick, or she gets sick. Even if one trauma surgeon becomes unable to work in a community of this size, it affects the hospital’s ability to provide care.
  • Everybody has a responsibility in this pandemic, she says. Non-essential workers have a social obligation to stay home to minimize the risk for everyone. Her responsibility is to care for patients. “I get up every day and make a commitment to take care of people. To sit at home and live in fear is a terrible way to live life.”
Javier E

Who's Afraid of Early Cancer Detection? - WSJ - 0 views

www.wsj.com/...on-grail-fda-approval-94f071a9

wsj health cancer detection test

shared by Javier E on 04 Feb 24 - No Cached
  • A diagnosis of pancreatic cancer usually means a quick death—but not for Roger Royse, who was in Stage II of the disease when he got the bad news in July 2022. The five-year relative survival rate for late-stage metastatic pancreatic cancer is 3%—which means that patients are 3% as likely to live five years after their diagnosis as other cancer-free individuals. But if pancreatic cancer is caught before it has spread to other organs, the survival rate is 44%.
  • some public-health experts think that’s just as well. They fret that widespread use of multicancer early-detection tests would cause healthcare spending to explode. Those fears have snarled Galleri and similar tests in a web of red tape.
  • Early diagnosis is the best defense against most cancers,
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  • But only a handful of cancers—of the breast, lung, colon and cervix—have screening tests recommended by the U.S. Preventive Services Task Force
  • Many companies are developing blood tests that can detect cancer signals before symptoms occur, and Grail’s is the most advanced. A study found it can identify more than 50 types of cancer 52% of the time and the 12 deadliest cancers in Stages I through III 68% of the time.
  • There’s a hitch. The test costs $949 and isn’t covered by Medicare or most private insurance.
  • The trouble is that this cancer is almost never caught early. There’s no routine screening for it, and symptoms don’t develop until it is advanced. Mr. Royse, 64, had no idea he was sick until he took a blood test called Galleri, produced by the Menlo Park, Calif., startup Grail. He had surgery and chemotherapy and is now cancer-free.
  • Mr. Royse visited Grail’s website, which referred him to a telemedicine provider who ordered a test. Another telemedicine doctor walked him through his results, which showed a cancer signal likely emanating from the pancreas, gallbladder, stomach or esophagus.
  • An MRI revealed a suspicious mass on his pancreas, which a biopsy confirmed was cancerous. Mr. Royse had three months of chemotherapy, surgery and another three months of chemotherapy, which ended last February. Because pancreatic cancer often recurs, he gets CT and MRI scans every three months. In addition, he has signed up for startup Natera’s Signatera customized blood test, which checks DNA specific to the patient’s cancer and can signal its return before signs are visible on the scans
  • Grail’s test likewise looks for DNA shed by cancer cells, which is tagged by molecules called methyl groups that are specific to a cancer’s origin. Grail uses genetic sequencing and machine learning to recognize links between DNA methyl groups and particular cancers
  • The test “is based on how much DNA is being shed by tumor,” Grail’s president, Josh Ofman, says. “Some tumors shed a lot of DNA. Some shed almost none.
  • ut slow-growing tumors typically aren’t shedding a lot of DNA.” That reduces the probability that Grail’s test will identify indolent cancers that pose no immediate danger.
  • Grail’s test has a roughly 0.5% false-positive rate, meaning 1 in 200 patients who don’t have cancer will get a positive signal
  • Its positive predictive value is 43%, so that of every 100 patients with a positive signal, 43 actually have cancer
  • the legislation’s price tag could reduce political support. According to one private company’s estimate, the test could cost the government $39 billion to $145 billion over a decade. Mr. Goldman counters that analysts usually overestimate the costs and underestimate the benefits of medical interventions.
  • Because Grail uses machine learning to detect DNA-methylation cancer linkages, the Grail test’s accuracy should improve as more tests and patient data are collected
  • regulators may balk at approving the test, and insurers at covering it, until it becomes cheaper and more reliable.
  • How would the FDA weigh the risk that a false positive on a test like Grail’s could require invasive follow-up testing against the dire but hard-to-quantify risk that a deadly cancer wouldn’t be caught until it’s much harder to treat? It’s unclear.
  • some experts urge the FDA to require large randomized controlled trials before approving blood cancer tests. “Multicancer screening would entail tremendous costs and potentially substantial harms,” H. Gilbert Welch and Tanujit Dey of Brigham and Women’s Hospital wrote
  • Dr. Welch and Mr. Dey also suggested that companies should be required to prove their tests reduce overall mortality, even though the FDA doesn’t require drugmakers to prove their products reduce deaths or extend life. Clinical trials for the mRNA Covid vaccines didn’t show they reduced deaths.
  • One alternative is to rely on real-world studies, which Grail is already doing. One study of patients 50 and older without signs of cancer showed that the test doubled the number of cancers detected.
  • One recurring problem he has seen: “Epidemiologists are always getting cancer wrong,” he says. “Epidemiologists a decade ago said U.S. overtreats cancers. Well, no, the EU undertreats cancer.”
  • A 2012 study that he co-authored found that the higher U.S. spending on cancer care relative to Europe between 1983 and 1999 resulted in significantly higher survival rates for American patients than for those in Europe
  • By his study’s calculation, U.S. spending on cancer treatments during that period resulted in $556 billion in net benefits owing to reduced mortality.
  • He expects Galleri and other multicancer early-detection tests to reduce deaths and produce public-health and economic benefits that exceed their monetary costs
  • Expanding access to multicancer early-detection tests could also help solve the chicken-and-egg problem of drug development. Because few patients are diagnosed at early stages of some cancers, it’s hard to develop treatments for them
  • the positive predictive value for some recommended cancer screenings is far lower. Fewer than 1 in 10 women with an abnormal finding on a mammogram are diagnosed with breast cancer.
  • Mr. Royse makes the same point with personal force. “I would be dead right now if not for multicancer early-detection testing,” Mr. Royse told an FDA advisory committee last fall. “The longer the FDA waits, the more people are going to die. It’s that simple.”
Javier E

Social Media and the Devolution of Friendship: Full Essay (Pts I & II) » Cybo... - 0 views

thesocietypages.org/...friendship-full-essay-pts-i-ii

friendship devolution social media social culture

shared by Javier E on 01 Jan 13 - No Cached
  • social networking sites create pressure to put time and effort into tending weak ties, and how it can be impossible to keep up with them all. Personally, I also find it difficult to keep up with my strong ties. I’m a great “pick up where we left off” friend, as are most of the people closest to me (makes sense, right?). I’m decidedly sub-awesome, however, at being in constant contact with more than a few people at a time.
  • the devolution of friendship. As I explain over the course of this essay, I link the devolution of friendship to—but do not “blame” it on—the affordances of various social networking platforms, especially (but not exclusively) so-called “frictionless sharing” features.
  • I’m using the word here in the same way that people use it to talk about the devolution of health care. One example of devolution of health care is some outpatient surgeries: patients are allowed to go home after their operations, but they still require a good deal of post-operative care such as changing bandages, irrigating wounds, administering medications, etc. Whereas before these patients would stay in the hospital and nurses would perform the care-labor necessary for their recoveries, patients must now find their own caregivers (usually family members or friends; sometimes themselves) to perform free care-labor. In this context, devolution marks the shift of labor and responsibility away from the medical establishment and onto the patient; within the patient-medical establishment collaboration, the patient must now provide a greater portion of the necessary work. Similarly, in some ways, we now expect our friends to do a greater portion of the work of being friends with us.
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  • Through social media, “sharing with friends” is rationalized to the point of relentless efficiency. The current apex of such rationalization is frictionless sharing: we no longer need to perform the labor of telling our individual friends about what we read online, or of copy-pasting links and emailing them to “the list,” or of clicking a button for one-step posting of links on our Facebook walls. With frictionless sharing, all we have to do is look, or listen; what we’ve read or watched or listened to is then “shared” or “scrobbled” to our Facebook, Twitter, Tumblr, or whatever other online profiles. Whether we share content actively or passively, however, we feel as though we’ve done our half of the friendship-labor by ‘pushing’ the information to our walls, streams, and tumblelogs. It’s then up to our friends to perform their halves of the friendship-labor by ‘pulling’ the information we share from those platforms.
  • We’re busy people; we like the idea of making one announcement on Facebook and being done with it, rather than having to repeat the same story over and over again to different friends individually. We also like not always having to think about which friends might like which stories or songs; we like the idea of sharing with all of our friends at once, and then letting them sort out amongst themselves who is and isn’t interested. Though social media can create burdensome expectations to keep up with strong ties, weak ties, and everyone in between, social media platforms can also be very efficient. Using the same moment of friendship-labor to tend multiple friendships at once kills more birds with fewer stones.
  • sometimes we like the devolution of friendship. When we have to ‘pull’ friendship-content instead of receiving it in a ‘push’, we can pick and choose which content items to pull. We can ignore the baby pictures, or the pet pictures, or the sushi pictures—whatever it is our friends post that we only pretend to care about
  • Within devolved friendship interactions, it takes less effort to be polite while secretly waiting for someone to please just stop talking.
  • While I won’t go so far as to say they’re definitely ‘problems,’ there are two major things about devolved friendship that I think are worth noting. The first is the non-uniform rationalization of friendship-labor, and the second is the depersonalization of friendship-labor.
  • In short, “sharing” has become a lot easier and a lot more efficient, but “being shared with” has become much more time-consuming, demanding, and inefficient (especially if we don’t ignore most of our friends most of the time). Given this, expecting our friends to keep up with our social media content isn’t expecting them to meet us halfway; it’s asking them to take on the lion’s share of staying in touch with us. Our jobs (in this role) have gotten easier; our friends’ jobs have gotten harder.
  • The second thing worth noting is that devolved friendship is also depersonalized friendship.
  • Personal interaction doesn’t just happen on Spotify, and since I was hoping Spotify would be the New Porch, I initially found Spotify to be somewhat lonely-making. It’s the mutual awareness of presence that gives companionate silence its warmth, whether in person or across distance. The silence within Spotify’s many sounds, on the other hand, felt more like being on the outside looking in. This isn’t to say that Spotify can’t be social in a more personal way; once I started sending tracks to my friends, a few of them started sending tracks in return. But it took a lot more work to get to that point, which gets back to the devolution of friendship (as I explain below).
  • I’ve been thinking since, however, on what it means to view our friends as “generalized others.” I may now feel like less of like “creepy stalker” when I click on a song in someone’s Spotify feed, but I don’t exactly feel ‘shared with’ either. Far as I know, I’ve never been SpotiVaguebooked (or SubSpotified?); I have no reason to think anyone is speaking to me personally as they listen to music, or as they choose not to disable scrobbling (if they make that choice consciously at all). I may have been granted the opportunity to view something, but it doesn’t follow that what I’m viewing has anything to do with me unless I choose to make it about me. Devolved friendship means it’s not up to us to interact with our friends personally; instead it’s now up to our friends to make our generalized broadcasts personal.
  • When we consider the lopsided rationalization of ‘sharing’ and ‘shared with,’ as well as the depersonalization of frictionless sharing and generalized broadcasting, what becomes clear is this: the social media deck is stacked in such a way as to make being ‘a self’ easier and more rewarding than being ‘a friend.’
  • It’s easy to share, to broadcast, to put our selves and our tastes and our identity performances out into the world for others to consume; what feedback and friendship we get in return comes in response to comparatively little effort and investment from us. It takes a lot more work, however, to do the consumption, to sift through everything all (or even just some) of our friends produce, to do the work of connecting to our friends’ generalized broadcasts so that we can convert their depersonalized shares into meaningful friendship-labor.
  • We may be prosumers of social media, but the reward structures of social media sites encourage us to place greater emphasis on our roles as share-producers—even though many of us probably spend more time consuming shared content than producing it. There’s a reason for this, of course; the content we produce (for free) is what fuels every last ‘Web 2.0’ machine, and its attendant self-centered sociality is the linchpin of the peculiarly Silicon Valley concept of “Social” (something Nathan Jurgenson and I discuss together in greater detail here). It’s not super-rewarding to be one of ten people who “like” your friend’s shared link, but it can feel rewarding to get 10 “likes” on something you’ve shared—even if you have hundreds or thousands of ‘friends.’ Sharing is easy; dealing with all that shared content is hard.
  • t I wonder sometimes if the shifts in expectation that accompany devolved friendship don’t migrate across platforms and contexts in ways we don’t always see or acknowledge. Social media affects how we see the world—and how we feel about being seen in the world—even when we’re not engaged directly with social media websites. It’s not a stretch, then, to imagine that the affordances of social media platforms might also affect how we see friendship and our obligations as friends most generally.
Javier E

Coronavirus fatality rate remains unknown as officials plan to reopen the economy - The... - 0 views

www.washingtonpost.com/...a-a3ee-13e1ae0a3571_story.html

fatality rate pandemic Covid-19

shared by Javier E on 18 Apr 20 - No Cached
  • a fundamental question about the coronavirus pandemic remains unanswered: Just how deadly is this disease?
  • In Germany, fewer than three out of every 100 people with confirmed infections have died. In Italy the rate is almost five times higher, according to official figures.
  • Singapore, renowned for its careful testing, contact tracing and isolation of patients, saw only 10 deaths out of 4,427 cases through April 16. That yields a strikingly low case fatality rate of 0.2 percent, about twice the rate of seasonal influenza.
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  • No one knows exactly how many people died from influenza in 1918; estimates range from 15 million to 100 million globally. Historians estimate that the virus killed about 675,000 people in the United States across three waves of the pandemic
  • confirmed cases. But in this global crisis, both the numerator and the denominator are fuzzy.
  • the rising rate may reflect the disease’s gradual progression, combined with discoveries of additional deaths.
  • The “virulence” of the virus — its ability to cause illness — has been steadily coming into focus.
  • One scholarly estimate finds that the 1918-1920 pandemic killed 218 out of every 100,000 people living in the world at that time
  • In Spain, the death toll already stands at 41 out of 100,000 people; in Belgium the number is 45. In New York state, it is 63, and that number rises even higher if you consider the “probable” death toll in New York City.
  • So is the coronavirus as deadly? “This depends on how long this continues,”
  • The disease is far more likely to cause severe outcomes in older people, with the oldest cohorts the most vulnerable. That said, in every age group — even 85-plus — most people who contract the disease will recover.
  • But more than a month later, the WHO number has gone even higher: On April 16, the WHO showed a global fatality rate of 6.6 percent among confirmed cases.
  • Preliminary research indicates that the virus is not mutating significantly as it spreads, and so there is no evidence that some countries are dealing with a more virulent strain of SARS-CoV-2.
  • the median age of patients in Italy is 63 or 64 years; the median age of patients in Germany is 47. The mortality is much lower [in Germany] because they avoided having the older population affected.”
  • The other major factor in mortality is chronic disease. Most people hospitalized with severe cases of covid-19 have chronic health conditions such as diabetes, lung disease and heart disease. Where there is a high percentage of noncommunicable diseases like high blood pressure, the coronavirus will also be more deadly
  • “We saw it everyday. African Americans have three times the rate of chronic kidney disease that Caucasians have, and 25 percent higher heart disease. They’ve got higher rates of diabetes, hypertension and asthma,” Duggan said. “I fully expect that when people are hit hard and they are on a ventilator to breathe and their body needs to fight the infection, that people who already have compromised hearts or kidneys or lungs are that much more in jeopardy.”
  • Also critical is the nature, and robustness, of the national health system. For instance, Japan, where the current case fatality rate is 1.6 percent, and Singapore are reporting extremely high rates of hospitalization for coronavirus patients, at 80 percent and higher, figures that are unheard of in the United States. But this probably helps improve treatment and also reduces disease spread by isolating patients. The result is fewer deaths.
  • Several of the countries with low fatality rates — Germany, South Korea, Norway — have very high rates of coronavirus testing. This gave them a better look at the disease within their borders.
  • San Francisco General Hospital, noted that the hospital nearly tripled the capacity of its intensive care unit by adding doctors, nurses and technicians while the city adopted social distancing measures shortly ahead of New York.
  • “We were ready for a surge that never happened,” Balmes said. “They’re every bit as good as we are in intensive care in New York, but the system was overwhelmed. We did physical distancing just a few days earlier than New York, but it was a few days to the good.”
  • in a news conference that the global case fatality rate was 3.4 percent. That was treated as a revelation about the innate deadliness of the disease, but in fact was simply the WHO’s crude mortality ratio for confirmed covid-19 cases up to that point in time.
  • “If, in fact, the case fatality rate is higher than the 1918 flu, then this one has the potential to kill even more people,
  • A new study from researchers at Stanford, not yet peer-reviewed, looked for coronavirus antibodies in a sample population in Santa Clara County, Calif., and concluded that the actual infection rate in the county by early April was 50 to 85 times greater than the rate of confirmed cases.
  • “The story of this virus is turning out to be more about its contagiousness and less about its case fatality rate,” said David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia and a University of Pennsylvania professor of pediatrics. “It’s less fatal than we thought, but it’s more contagious.”
  • Where extensive testing has been done, estimates for the case fatality rate are often below 1 percent, The Post has found, suggesting these countries are getting closer to a rate that takes into account all infections
  • In Iceland, which has tested over 10 percent of the population, vastly more than other countries, the fatality rate is just 0.5 percent.
  • Harvard epidemiologist Marc Lipsitch has written that he and most experts suspect the fatality rate is about 1 to 2 percent for symptomatic cases. A 1 percent fatality rate is 10 times the average fatality rate for seasonal flu.
  • “It’s probably about an order of magnitude higher for covid-19,” said Viboud, the NIH epidemiologist. “It’s more severe in terms of mortality than the pandemics we’ve seen since 1918.”
clairemann

AstraZeneca Says Vaccine 76% Effective After Its Spat With Public Health Regulators | H... - 0 views

www.huffpost.com/...lth_n_605c1113c5b65d1c28127544

Politics US crisis pandemic

shared by clairemann on 25 Mar 21 - No Cached
  • AstraZeneca updated an analysis of its COVID-19 vaccine on Wednesday, saying it was 76% effective at preventing the disease, after an extraordinary rebuke by top public health officials earlier this week.
  • The company said it analyzed data from more than 32,000 participants in a clinical trial and found the vaccine is 100% effective at preventing severe or critical cases of the coronavirus should patients be infected, a significant finding that will help blunt the effect of the pandemic worldwide. The vaccine was also 85% effective in patients 65 and older, a group among the most vulnerable to COVID-19.
  • In an unusual move, an independent panel published a late-night rebuke of those figures, alleging AstraZeneca had cherry-picked data that gave an “incomplete view” of the vaccine.
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  • “Decisions like this are what erode public trust in the scientific process,”
  • Dr. Anthony Fauci, the top infectious disease expert in the U.S., predicted Tuesday that the AstraZeneca shot would likely “turn out to be a good vaccine,” saying he hoped the company would combat any public mistrust of its inoculations.
cartergramiak

N.Y. Severely Undercounted Virus Deaths in Nursing Homes, Report Says - The New York Times - 0 views

www.nytimes.com/...nursing-home-deaths-cuomo.html

politics pandemic US crisis history

shared by cartergramiak on 05 Mar 21 - No Cached
  • ALBANY, N.Y. — For most of the past year, Gov. Andrew M. Cuomo has tried to brush away a persistent criticism that undermined his national image as the man who led New York through the pandemic: that his policies had allowed thousands of nursing home residents to die of the virus.
  • He also asserted that the lack of data on hospital deaths of nursing home residents was due to concern and caution about the accuracy of data that nursing homes supplied — an issue also raised by the attorney general. “D.O.H. does not disagree that the number of people transferred from a nursing home to a hospital is an important data point,” he said.
  • The report also cast a critical eye on perhaps the governor’s most criticized decision since the beginning of the pandemic last year: a March 25 directive from the Health Department that ordered nursing homes to accept and readmit patients who had tested positive..css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-c7gg1r{font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:0.875rem;line-height:0.875rem;margin-bottom:15px;color:#121212 !important;}@media (min-width:740px){.css-c7gg1r{font-size:0.9375rem;line-height:0.9375rem;}}.css-1sjr751{-webkit-text-decoration:none;text-decoration:none;}.css-1sjr751 a:hover{border-bottom:1px solid #dcdcdc;}.css-rqynmc{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.9375rem;line-height:1.25rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-rqynmc{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-rqynmc strong{font-weight:600;}.css-rqynmc em{font-style:italic;}.css-yoay6m{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}@media (min-width:740px){.css-yoay6m{font-size:1.25rem;line-height:1.4375rem;}}.css-1dg6kl4{margin-top:5px;margin-bottom:15px;}#masthead-bar-one{display:none;}#masthead-bar-one{display:none;}.css-1pd7fgo{background-color:white;border:1px solid #e2e2e2;width:calc(100% - 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-1pd7fgo{padding:20px;width:100%;}}.css-1pd7fgo:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-1pd7fgo{border:none;padding:20px 0 0;border-top:1px solid #121212;}.css-1pd7fgo[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-1pd7fgo[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-1pd7fgo[data-truncated] .css-5gimkt:after{content:'See more';}.css-1pd7fgo[data-truncated] .css-6mllg9{opacity:1;}.css-k9atqk{margin:0 auto;overflow:hidden;}.css-k9atqk strong{font-weight:700;}.css-k9atqk em{font-style:italic;}.css-k9atqk a{color:#326891;-webkit-text-decoration:none;text-decoration:none;border-bottom:1px solid #ccd9e3;}.css-k9atqk a:visited{color:#333;-webkit-text-decoration:none;text-decoration:none;border-bottom:1px solid #ddd;}.css-k9atqk a:hover{border-bottom:none;}
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  • The Democratic chairman of the investigations and government operations committee in the State Senate, James Skoufis, who has accused the Health Department of stonewalling investigators, suggested on Thursday that he would use a subpoena to compel the release of data from Dr. Zucker’s office.
  • The attorney general asked 62 nursing homes — about a tenth of the state’s total — for information about on-site and in-hospital deaths related to the virus; investigators then cross-referenced that information with public reports of deaths issued by the Health Department. The deaths reported to the attorney general’s office at most of those facilities totaled 1,914, compared to the state’s much lower count of 1,229.
  • Under normal circumstances, the attorney general’s office “would issue a report with findings and recommendations after its investigations and enforcement activities are completed,” Ms. James said in her report. “However, circumstances are far from normal.”
anonymous

Yellow Fever killed 10 percent in Philadelphia - The Washington Post - 0 views

www.washingtonpost.com/...n-percent-residents-still-died

history US

shared by anonymous on 21 May 20 - No Cached
  • In summer 1793, a malignant visitation spread over the nation’s capital, carrying off young and old, poor and prosperous in agonizing ways.People collapsed in the streets untended and died horrible deaths at home, their skin turning yellow, their vomit dark with blood.
  • Families were wiped out. Handshaking stopped. Citizens avoided one another and covered their faces with cloth.Half the residents fled the city, including President George Washington. Schools were closed. Some roads outside town were guarded to keep refugees away.This was Philadelphia, the U.S. capital from 1790 to 1800. Wagons arriving from the city were burned as a precaution. Letters and newspapers from Philadelphia were handled with tongs.
  • During the worst of it, a hundred people were buried a day. Historian J.H. Powell’s classic 1949 account is entitled “Bring Out Your Dead,” after the calls of the roving burial teams.What was destroying them, scientists say, was the first virus found to cause human disease.
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  • “For every death, there’s about 21 other infections,” she said modeling showed. So most of Philadelphia’s 50,000 people probably were infected. “They were either lucky that they didn’t develop disease or had mild disease compared to those that were unlucky and died.”Yellow fever is one of more than 200 known human viruses, according to the National Institutes of Health. They include those that cause HIV/AIDS, Ebola, polio, smallpox, measles, mumps, rabies, the common cold and now the novel coronavirus.
  • In the late 1800s, scientists were just starting to realize that strange microbes smaller than bacteria were causing disorders in plants and animals. Bacteria, which had been discovered in the 1670s, had been associated with human illnesses such as typhoid fever, cholera and tuberculosis.
  • U.S. Army physician Walter Reed reported in 1900 that the leading suspect bacteria was not found in the blood of fever cases he studied in Cuba.There was an alien “parasite” at work, he believed.“At the time they didn’t even call it a virus,” Staples said. “They didn’t know really what a virus was.”
  • In 1900, Reed set up what he called an “experimental sanitary station” in Cuba, where yellow fever was prevalent. He named it Camp Lazear, for Jesse W. Lazear, a medical colleague who had died of the fever that year.
  • After extensive testing on volunteer patients who were infected, Reed confirmed that mosquitoes were the carrier and eliminated bacteria as a cause.
  • The yellow fever virus was isolated in 1927, and scientists soon came up with an effective vaccine, called 17D, a weakened form of the virus itself. It’s still in use, and a recent scholarly paper called it “one of the most outstanding human vaccines ever developed.”
  • But in Philadelphia in 1793, the only remedy would be something that killed mosquitoes.
xaviermcelderry

C.D.C. Warns New Virus Variant Could Fuel Huge Spikes in Covid Cases - The New York Times - 0 views

www.nytimes.com/...covid-cdc-variant.html

Covid

shared by xaviermcelderry on 15 Jan 21 - No Cached
  • ederal health officials sounded the alarm Friday about a fast spreading, far more contagious variant of the coronavirus that is projected to become the dominant source of infection in the country by March, potentially fueling another wrenching surge of cases and deaths.
  • Only 76 cases of the variant have been identified so far in the U.S., but the actual number is believed to be higher and is expected to spiral upward in the next few weeks, officials said.
  • But spikes in cases threaten to cripple already overwhelmed hospitals and nursing homes in many parts of the country. Some are at or near capacity. Others have faced troubling rates of infection among their staff, causing shortages and increasing patient loads.
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  • “I want to stress that we are deeply concerned that this strain is more transmissible and can accelerate outbreaks in the U.S.
  • Covid cases and deaths have broken record after record across the country, with a peak number of deaths, 4,400, announced on Tuesday. At least 3,973 new deaths and 238,390 new cases were reported on Thursday, and the nation is nearing a milestone of 400,000 deaths.
  • The new variant, called B 1.1.7 was first identified in Britain, where it rapidly became the primary source of infections, accounting for as many 60 percent of new cases diagnosed in London and surrounding areas.
  • In the new report, C.D.C. scientists modeled how quickly the variant might spread in the United States, assuming about 10 percent to 30 percent of people have pre-existing immunity to the virus, and another 1 million people will be vaccinated each week beginning this month.
  • It’s not yet clear what makes the new variants more contagious. They share at least one mutation, called N501Y, that is thought to be involved. One possibility, researchers said, is that the mutation may increase the amount of virus in the nose but not in the lungs — potentially explaining why it is more contagious, but not more deadly.A higher amount of virus in the nose means anyone infected would expel more virus while talking, singing, coughing or even breathing, said Trevor Bedford, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle
  • Federal health officials sounded the alarm Friday about a fast spreading, far more contagious variant of the coronavirus that is projected to become the dominant source of infection in the country by March, potentially fueling another wrenching surge of cases and deaths.
  • The variant is not known to be more deadly or to cause more severe disease. But the dire warning — hedged by limited data about just how prevalent the variant first identified in Britain has become — landed in a week where the nation’s nascent vaccination campaign was hampered by confusion and limited supplies as demand grew among growing numbers of eligible people
  • Only 76 cases of the variant have been identified so far in the U.S., but the actual number is believed to be higher and is expected to spiral upward in the next few weeks, officials said.
  • One in 860 Americans have died of Covid-19 in the last year, according to new figures released by the C.D.C. But the burden of deaths has not fallen equally across racial, ethnic lines and geographic regions, and there is concern that vaccines will not reach the hardest hit communities, where access to health services is limited and distrust is rampant. Editors’ PicksFor Pro Athlete Leading Social Justice Push, a Victory and UncertaintyJames Comey’s View of Justice — and How It Differs From Donald Trump’sHow ‘Orwellian’ Became an All-Purpose InsultAdvertisementContinue reading the main storyImage
  • But spikes in cases threaten to cripple already overwhelmed hospitals and nursing homes in many parts of the country. Some are at or near capacity. Others have faced troubling rates of infection among their staff, causing shortages and increasing patient loads.
  • If the variant is about 50 percent more contagious, as suggested by data from Britain, it will become the predominant source of all infections in the United States by March, the model showed. A slow rollout of vaccinations will hasten that fate.
rachelramirez

One Man Was Wrongly Blamed For Bringing AIDS to America - The Atlantic - 0 views

www.theatlantic.com/...505412

aids patient 0 US history

shared by rachelramirez on 27 Oct 16 - No Cached
  • How One Man Was Wrongly Blamed for Bringing AIDS to America
  • One of those 40 cases was a Canadian flight attendant named Gaëtan Dugas.
  • “When the study got written up and was circulated beyond the immediate team to other people within the CDC, that ambiguous oval got interpreted by some as a zero,”
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  • As the 57th AIDS patient to reach the CDC team’s attention, Dugas was originally billed as Case 057. But since he came from outside California, and wasn’t even a U.S. resident, the investigators started referring to him offhandedly as the “Out-of-California patient”—or “Patient O” for short.
  • The CDC team did their best to naysay this misconception, but it gained steam globally in 1987, after the journalist Randy Shilts published his bestselling book And The Band Played On.
  • The idea fit with the prejudices of the day: Here was a modern Typhoid Mary, whose homosexuality and irresponsible promiscuity had brought a plague to American shores.
  • He sequenced the complete genomes of HIV taken from U.S. samples collected in the late 1970s, and showed that Dugas could not possibly have been the first AIDS patient in the U.S. Indeed, the disease likely entered the country from Haiti in 1971, flying under the radar for a decade before anyone realized what was happening.
  • HIV first started infecting humans somewhere in West Africa, having jumped into us from chimpanzees.
  • He also concluded that the virus must have arrived in the U.S. around 12 years before AIDS was formally recognized in 1981.
  • They reveal that HIV had spread from Africa to the Caribbean by around 1967, and had jumped into the U.S. by around 1971. It landed in New York City and began diversifying rapidly
  • By the time anyone noticed the first sign of AIDS in 1981, the virus had already hopped from coast to coast, and become genetically diverse.
  • This means that not only did Dugas not bring AIDS to America, but he didn’t spread it west either. He was a totally mundane part of a very unusual epidemic.
  • In 2010, evolutionary biologists used gene trees to prove that a man named Anthony Eugene Whitfield had knowingly infected many women with HIV. More recently, biologists used a pocket-sized DNA sequencer to track the evolution of Ebola in real-time, providing details about routes of transmission that helped to curtail the recent west African outbreak.
knudsenlu

Fertility clinic informs hundreds of patients their eggs may have been damaged - The Wa... - 0 views

www.washingtonpost.com/...8-b79d-f3d931db7f68_story.html

fertility clinic damaged women health science culture US

shared by knudsenlu on 12 Mar 18 - No Cached
  • A long-established San Francisco fertility clinic experienced a liquid nitrogen failure in a storage tank holding thousands of frozen eggs and embryos for future use, jeopardizing tissue hundreds of women had stored in hopes of having children.
  • “We can’t say definitively nothing like this has ever happened, but we are certainly not aware of anything,” said Sean Tipton, the association’s chief policy, advocacy and development officer. “Now that we have a second incident, it becomes very important that we learn as much as we can about both, to search for commonalities and see if there are . . . risks that have now come to light that need to be addressed.”
  • On Saturday night, the half-dozen doctors who work at Pacific Fertility were finally able to begin making phone calls to some 400 patients who had all their eggs or embryos stored in storage tank No. 4.
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  • Herbert said the extent of the damage is not yet clear. When clinic staff thawed a few eggs affected by the malfunction, they found that the tissue remained viable. Staff have not checked any of the embryos, he said.
  • For affected patients who are still eager to use their eggs or embryos to try to become pregnant, Herbert said the clinic plans to first thaw them and check for viability. If the tissue is not viable, he said, “we are going to make our patients happy one way or another.”
  • The emergencies mentioned in the guidance are fires, floods, power failures and terrorist attacks — but do not include instances in which a clinic’s own equipment fails.
Javier E

How South Korea Successfully Managed Coronavirus - WSJ - 0 views

www.wsj.com/...ow-to-manage-covid-11601044329

korea pandemic response

shared by Javier E on 26 Sep 20 - No Cached
  • South Korea appears to have cracked the code for managing the coronavirus. Its solution is straightforward, flexible and relatively easy to replicate.
  • The country has averaged about 77 new daily cases since early April and recently suppressed a spike in infections. Adjusting for population, that would be the equivalent of about 480 cases a day in the U.S., where new daily cases have averaged about 38,000 over the same period.
  • South Korea halted virus transmission better than any other wealthy country during the pandemic’s early months. It was about twice as effective as the U.S. and U.K. at preventing infected individuals from spreading the disease to other
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  • South Korea’s economy is expected to decline by just 0.8% this year, the best among the Organization for Economic Cooperation and Development’s forecasts for member nations.
  • When the supply of face masks ran short early on in the crisis, the government seized production.
  • The nation fast-tracked approval of domestic testing kits as soon as cases began hitting
  • It tapped into its relative wealth and hyperconnectivity, blasting text alerts to citizens if infections occurred in their area
  • The key to South Korea’s success came from blending technology and testing like no other country, centralized control and communication—and a constant fear of failure.
  • Some parts of its playbook wouldn’t work in most Western societies—and received backlash in South Korea as well
  • Nearly everyone in the country wears masks.
  • Every confirmed patient, even those with no or mild symptoms, gets isolated at hospitals or converted dormitories run by the government. Treatment is free.
  • As a result, South Korea never had to mandate a lockdown, so restaurants and business were able to stay open, cushioning the blow to the economy.
  • “No country has adapted to living with, and containing, the virus like South Korea,”
  • “You don’t need or want to eradicate the virus. But you modify your behavior and get on with life.”
  • It detected the country’s first case 10 days later using a test that screened for all known coronavirus strains—the same tactic practiced during the December simulation.
  • Health officials have unfettered access to individuals’ private mobile data, and early on used government websites to share the whereabouts of confirmed patients, plucked from smartphone GPS history
  • The government now offers anonymous testing and leaves out identifying information and specific names of places visited in contact-tracing disclosures.
  • After a major cluster linked to a megachurch in the city of Daegu emerged on Feb. 18, the government made a flurry of moves
  • Cases peaked in 11 days.
  • The day after cases reached a five-month high of 441 on Aug. 27, South Korea’s top public-health official gave a grim forecast: “We could see 800 to 2,000 infections next week
  • South Koreans took the advice and adjusted. Population mobility, as measured by local telecom operators, soon fell by one-quarter. Most schools closed and diners had to leave restaurants by 9 p.m. Aug. 27 turned out to be the peak.
  • At twice-a-day briefings, health officials express worry when they can only trace the origins of three-quarters of confirmed cases.
  • In total, South Korea, with a population of 52 million, has reported 23,455 cases and 395 deaths.
  • One reason South Korea was prepared: It learned painful lessons in 2015 from an outbreak of Middle East respiratory syndrome
  • “The only way to make the government prepared is to actually have an outbreak,”
  • After MERS, the government started twice-a-year training sessions simulating a rapid spread of viral disease
  • “Oddly enough, last December’s ‘war game’ was a novel coronavirus,”
  • After two weeks of aggressive social distancing, South Koreans could again head back to schools, gyms and sports stadiums.
  • One firm, Kogene Biotech Co., demonstrated a successful test and got the regulatory green light within four days. A second manufacturer would be added by Feb. 12. The tests all used the same methodology and could be sent to any of the country’s roughly 120 laboratories that promised turnaround times of between six to 24 hours.
  • Cases, which had been slowly rising, suddenly doubled in a day, to over 100. Experts predicted it would soon surge to levels seen nowhere else but China.
  • That triggered a Feb. 20 late-night message in a group chat with eight South Korean infectious-disease experts: “We need to quickly devise a way to conduct mass testing,”
  • an answer: drive-through clinics.
  • Dr. Kim sent a PowerPoint presentation to the group within hours, at 3:53 a.m., outlining how tests would take just 10 minutes and saved much-needed protective gear since outdoor workers didn’t have to change gowns after each patient
  • Two days later, cars rumbled through the country’s first drive-through clinic. Testing capacity multiplied 100 times, giving South Korea a critical early edge.
  • As South Korea’s coronavirus problems mounted, Mr. Moon intentionally kept his profile low. “His stance is that it’s more objective for an expert to hold the briefings, and that is the way to gain the trust of the people,”
  • Even with the swift response, a lack of hospital beds became a major issue. In just 11 days, South Korea’s case count had gone from 31 to 3,150. Thousands were waiting to be hospitalized. A handful died while waiting.
  • South Korea’s infectious-disease experts had a proposal. Confirmed patients should be divided into four categories, based on the risk profile and severity of symptoms, with only the most serious cases hospitalized. Those with mild or no symptoms should be isolated at makeshift treatment facilities.
  • Dr. Peck set up a meeting with senior officials from the Samsung conglomerate, asking that an empty facility near Daegu be lent to the South Korean government. By first having a company volunteer a venue, Dr. Peck recalled thinking, it would pressure South Korea’s health ministry to act.
  • About 80% of South Korea’s coronavirus patients have been hospitalized in the community treatment centers. Those who are asymptomatic or have mild symptoms are still sent there.
  • That changed in August. Unlike February’s outbreak, the new wave of infections fanned out across South Korea to all 15 of the country’s major cities and provinces. The country’s national testing capacity had by then expanded to 50,000 a day with test results notified within 24 hours, up from 20,000 in February
  • The U.S. conducted about 900,000 tests a day over the past week through Thursday, according to data from the Covid Tracking Project. But South Korea performs six times as many tests per confirmed Covid-19 case than the U.S. doe
  • South Korea’s three-tier system created in June for social distancing went off script. With health experts split on whether to adopt the maximum levels last month, a government advisory committee landed at a “level 2.5” social-distancing for the Seoul area that closed schools and banned church services and gatherings of more than 10 people.
  • On Tuesday, South Korea reported its lowest one-day infections in over a month, with just 61 cases.
Javier E

When Hospitals Buy Doctors' Offices, and Patient Fees Soar - NYTimes.com - 0 views

www.nytimes.com/...ould-even-out-doctors-pay.html

medical medicare fee hospital policy funding

shared by Javier E on 08 Feb 15 - No Cached
  • Medicare, the government health insurance program for those 65 and over or the disabled, pays one price to independent doctors and another to doctors who work for large health systems — even if they are performing the exact same service in the exact same place.
  • This week, the Obama administration recommended a change to eliminate much of that gap. Despite expected protests from hospitals and doctors, the idea has a chance of being adopted because it would yield huge savings for Medicare and patients.
  • The heart doctors are a great example. In 2009, the federal government cut back on what it paid to cardiologists in private practice who offered certain tests to their patients. Medicare determined that the tests, which made up about 30 percent of a typical cardiologist’s revenue, cost more than was justified, and there was evidence that some doctors were overusing them. Suddenly, Medicare paid about a third less than it had before.But the government didn’t cut what it paid cardiologists who worked for a hospital and provided the same test. It actually paid those doctors more, because the payment systems were completely separate. In general, Medicare assumes that hospital care is by definition more expensive to provide than office-based care.
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  • Cardiologists are not the only doctors who have been migrating toward hospital practice. In the last few years, there have been increases in the number of doctors working for hospitals across the specialties. And spreads between fees for office services exist in an array of medical services, down to the basic office visit. The president's proposal would apply to all doctors working in off-campus, hospital-owned practices.
  • Like Medicare, most private insurers pay higher prices to hospitals than to independent doctors.Private insurers tend to copy many of Medicare’s payment policies. And, in general, large hospital groups tend to have more negotiating clout with insurers, meaning they can bargain for higher prices than smaller practices.
  • Hospitals don’t like the idea. Nearly all the money would come out of their pockets, and they argue that running a medical practice really does cost more for hospitals than it does for independent physician practices. Hospitals have to stay open at all hours, run emergency rooms and comply with an array of regulatory requirements that physician-owned practices don't need to worry about.
  • The Medicare Payment Advisory Committee, a group of experts that advises Congress, thinks that the pay differences should be narrowed, but only for a select set of medical services in which it’s really clear that there’s no difference between the care offered by a hospital and a physician office.
  • The pay differences, of course, are not the only reason that more doctors are going to work for hospitals. There are generational trends: Younger doctors are less interested in entrepreneurship and more interested in predictable hours and salary. And another Medicare program is trying to create financial incentives for health systems to manage patients’ entire health care experience, which many hospitals find easier to do if they employ the doctors.
  • in contrast to a lot of things in the president’s budget, it’s hard to dismiss this proposal as mere wishful thinking. Congress is often looking for places to save money in the Medicare budget, in part because it must find money every year to keep all doctors’ pay from declining precipitously — the result of a misguided payment formula passed in the 1990s.
Javier E

Opinion | Germany Has Relatively Few Deaths From Coronavirus. Why? - The New York Times - 0 views

www.nytimes.com/...germany-coronavirus.html

germany pandemic deaths culture testing

shared by Javier E on 29 Mar 20 - No Cached
  • Germany, it seems, is not immune to the ravages of the pandemic.
  • Except in one way: Very few people seem to be dying. As of Saturday, of the 56,202 confirmed cases of the coronavirus, just 403 patients have died. That’s a fatality rate of 0.72 percent. By contrast, the current rate in Italy — where over 10,000 people have died — is 10.8 percent. In Spain, it’s 8 percent. Over twice as many people have died in Britain, where there are around three times fewer cases, than in Germany.
  • What is going on here? And what can we learn from it?
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  • First and foremost: Early and persistent testing helps. And so does tracking people.
  • Across the country, the pattern was repeated. Local health departments and federal authorities worked together to test, track and quarantine exposed citizens.
  • Germany has also been better at protecting its older residents, who are at much greater risk. States banned visits to the elderly, and policymakers issued urgent warnings to limit contact with older people
  • Patients over the age of 80 make up around 3 percent of the infected, though they account for 7 percent of the population. The median age for those infected is estimated to be 46; in Italy, it’s 63.
  • many more young people in Germany have tested positive for the virus than in other countries
  • “Both skiing and carnival may have affected the low average age of the first wave of confirmed cases,”
  • In general, countries that test less and reserve it for those already very ill, like Italy, have higher fatality rates.
  • Though Germany’s health care system is overall in good shape — recently modernized, well staffed and funded, with the highest number of intensive-care beds per 100,000 patients in Europe — it hasn’t really been tested yet.
  • On average, a severely ill Covid-19 patient dies 30 days after being infected
  • It’s quite possible that Germany is just behind the curve
rerobinson03

Alzheimer's Drug Poses a Dilemma for the F.D.A. - The New York Times - 0 views

www.nytimes.com/...alzheimers-aducanumab-fda.html

shared by rerobinson03 on 07 Jun 21 - No Cached
  • On Monday, the agency will rule on the drug, aducanumab, which aims to slow progression of memory and thinking problems early in the disease. If approved, it would be the first new Alzheimer’s medication since 2003 and the first treatment on the market that attacks the disease process rather than just easing symptoms.
  • Beyond the status of this particular drug, some experts worry approval could lower standards for future drugs — an especially important question at a time when public trust in science is teetering.
  • Debate centers on two never fully completed Phase 3 trials that contradicted each other. One suggested that a high dose could slightly slow cognitive decline; the other showed no benefit. Biogen says that given the need for Alzheimer’s medications, the single positive trial, plus results from a small safety trial and aducanumab’s ability to reduce a key protein, should justify approval.The F.D.A. typically follows advisory committee recommendations and usually requires two convincing studies for approval, but it has made exceptions, especially for severe diseases that lack treatments.
  • ...7 more annotations...
  • But that October, Biogen announced it found benefit in one trial after evaluating data from 318 participants who finished before the trials were stopped but after the cutoff point for results the monitoring committee assessed.
  • Both trials were stopped early, in March 2019, when an independent data monitoring committee said aducanumab didn’t appear to be working. Consequently, 37 percent of participants never completed the 78-week trials.
  • Aducanumab, a monoclonal antibody, targets a protein, amyloid, that clumps into plaques in the brains of Alzheimer’s patients. Many amyloid-reducing drugs failed to slow symptoms in trials, a history that, some experts say, makes it especially important that aducanumab’s data be convincing. If effective, it would support a long-held, unproven theory that attacking amyloid can help if done early enough.
  • By contrast, Dr. Stephen Salloway, who has received research and consulting fees from Biogen but wasn’t paid for being an aducanumab trial site principal investigator, called himself a “passionate” supporter of approval. He considers the evidence sufficient because Alzheimer’s is so disabling.
  • Advocates and many patients say delaying deterioration even slightly is meaningful. But some experts say the single trial’s slowing of 0.39 on an 18-point scale rating memory, problem-solving skills and function may be imperceptible to patients’ experience and doesn’t justify approving a drug that floundered in another trial and carries risk of harm.
  • Dr. Salloway said one trial patient whose dementia had remained mild considerably longer than he’d expected was Henry Magendantz, a retired obstetrician-gynecologist in Providence, R.I. Dr. Magendantz, 84, started the safety trial after his wife, Kathy Jellison, noticed him having trouble following steps to assemble furniture.
  • Dr. Woskie said the couple yearns for treatments but that if the F.D.A. told Biogen, “‘No, we don’t fast-track approve you; come back when you have more data,’ that wouldn’t surprise me, and it might make sense.”
katherineharron

US Coronavirus: As US inches closer to 350,000 Covid-19 deaths, one model projects abou... - 0 views

www.cnn.com/...index.html

covid

shared by katherineharron on 02 Jan 21 - No Cached
  • The US topped 20 million total infections and inched closer to 350,000 Covid-19 deaths on the first day of 2021 -- proof of a grim reality continuing into the new year.
  • 115,000 could die over the next month
  • The US topped 20 million total infections and inched closer to 350,000 Covid-19 deaths on the first day of 2021 -- proof of a grim reality continuing into the new year.
  • ...12 more annotations...
  • more than 77,500 died in December, the country's deadliest month.
  • The US reported a record 125,379 hospitalized Covid-19 patients nationwide Thursday, according to the Covid Tracking Project. That number dipped slightly Friday, with 125,057 hospitalizations reported -- about an 163% increase from two months ago.
  • "We're also worried that at some point soon we're going to have a really tough time finding the space and the staff to take care of all the sick patients coming in with Covid-19 who really need our help," said Dr. Nicole Van Groningen of Cedars-Sinai Medical Center in Los Angeles.
  • Experts fear that in the coming weeks -- following holiday travel and gatherings -- the US could see another surge of cases that could drive hospitalizations and deaths even higher.
  • Georgia announced Friday a total of more than 8,700 new Covid-19 cases in the state -- a new high. Maryland on the same day reported its second-highest number of daily cases. New York, meanwhile, added nearly 16,500 new cases -- a day after it hit its highest ever one-day case count.
  • Texas health officials reported record-high Covid-19 hospitalizations across the state for the fifth day in a row, with more than 12,400 patients.
  • ICU capacity in many parts of the state remains dangerously low. In Southern California and the San Joaquin Valley, zero beds are available. One health official said earlier this week the surge of patients has been pushing hospitals to the "brink of catastrophe."
  • The variant has been found in at least 30 countries and has also been detected in Colorado, California and Florida.
  • "The discovery of the additional cases leads county health officials to believe that the new strain of the virus is widespread in the community," a county spokesperson said.The new cases were found in two men in their 40s and a man in his 50s, officials said.
  • "Currently, the US is doing less sequencing than many other countries -- a recent report from (genomics database) GISAID estimated that the US is sequencing 0.3% of positive cases versus the UK that's at about 7%."
  • the vaccines approved in the US require two doses based a few weeks apart. And the nation will continue to do it that way and will not follow the UK's decision to potentially delay second doses, Fauci told CNN on Friday.
  • "The fact is we want to stick with what the science tells us, and the data that we have for both [vaccines] indicate you give a prime, followed by a boost in 21 days with Pfizer and 28 days with Moderna. And right now, that's the way we're going with it, and that's the decision that is made," Fauci said. "We make decisions based on data. We don't have any data of giving a single dose and waiting for more than the normal period of time" to give the second dose, he added.
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