StemCell Therapy

OSWEGO Public health touches all levels of the community; from pre-natal health care to hospice care, from the food we eat to the water we drink, from rabies control to emergency preparedness. With a variety of programs focused on these issues and more, the Oswego County Health Department strives to promote good health and wellness practices and ensure that communities throughout the county are thriving.

The county first established its public health nursing division in the 1960s, so it has a long tradition of delivering quality services to residents. Then, as now, its highly trained staff is on-call to provide skilled care on a variety of fronts, including preventative health care.

We are lucky to have these people on the front lines of the COVID-19 pandemic in our county, said Oswego County Legislature Chairman James Weatherup, District 9. Not all counties have staff with this level of training and expertise in epidemiology. They work tirelessly every day to manage the countys response to the coronavirus while adhering to guidance set forth by the state.

Oswego County Legislator James Karasek, District 22, chairman of the Oswego County Health Committee agreed. Residents can be assured we have an excellent team responding to this crisis. Not only is our public health director a trained epidemiologist, but our nursing staff also has decades of combined experience in preventative health care.

Leading the team is Oswego County Public Health Director Jiancheng Huang. He arrived in Oswego County in 2012 after several years with the Maine Immunization Program of the Maine Centers for Disease Control (CDC); first as an epidemiologist, then as the programs director. A Harvard graduate with a degree in population and international health, Huang is experienced in biomedical research and has served various regional and national workgroups to promote the understanding of infectious disease and immunization.

Epidemiology is an important cornerstone of public health, said Huang. It is an evidence-based science that provides the foundation of our decision-making process. Only with thorough investigation and unbiased analysis can we identify cause and effect, and then determine the best course of action that is, the most effective and appropriate responses to public health issues.

It is these very life-saving practices that brought him into the field of public health.

I realized that as a doctor, I could only treat patients one by one, said Huang. But as a member of a public health agency, we can address many of the broader issues that impact the well-being of our residents and effect real change. In this way, the whole of the population is the patient and we can help educate and encourage people to improve the overall health of the community. This is what epidemiology is.

Choosing to work in a rural location is no accident either. Through his internship in a rural hospital, he recognized the need for quality public health practices in that setting and knew he could be the most help there.

While Huang has largely worked with rural populations, he nevertheless has had experience with major public health crises before this, including severe acute respiratory syndrome (SARS) and H1N1.

I worked with the SARS outbreak in 2003 and the H1N1 pandemic in 2009, said Huang. COVID-19 is perhaps the most challenging of the three in its effect on public health. None of the past outbreaks were at a scale that is close to this.

That being said, he continued. I have complete faith in the capabilities of our epidemiology team and in the skills and experience of our entire staff. Public health relies on teamwork. With the dedication of our health department team and the support of our community, I know that we will all get through this difficult time together.

Over the years, Oswego County has made a significant investment in its staff to increase their epidemiology capabilities.

Tina Bourgeois is a senior LPN with 30 years of experience focused on investigating communicable diseases and promoting immunizations.

COVID-19 hasnt really changed what I do most days, said Bourgeois. Every year, I investigate hundreds of reportable communicable diseases through contact tracing. The thing thats new is the virus itself, so were learning more about that every day.

When a patient tests positive for coronavirus, Bourgeois contacts that person to go over the results. She said that can be difficult because there is a lot of fear, confusion and uncertainty about this new virus.

Many people are scared, they dont know what to expect, she said. As an investigator you have to be kind. Listen to their concerns and give them some reassurance. Be honest and answer all their questions as best as you can. When I talk to people, I make sure they understand their diagnosis and are receiving the proper treatment so they can get well.

Investigators also ask if patients have been in contact with other people so they can determine if others may have been exposed or need treatment. We have to reduce the spread of this disease, so its not uncommon for me to have to tell people they need to stay home for a period of time, said Bourgeois. Well review work restrictions or talk about how to prevent exposing other family members in the home to the disease.

Huang said, Tinas experience is one of the strengths of this team. She asks so many good, detailed questions. We learn a lot from her about contact tracing.

Oswego County has long encouraged the use of educational and career incentives where possible to better develop an employees capabilities.

Chantel Eckert, DNP, RN, has repeatedly taken on the challenge of higher education to the benefit of the countys health department. She said, Advanced education has provided me with a solid foundation in clinical prevention and population health which has been instrumental in helping me see the big picture of this pandemic.

Eckert serves as program manager for Healthy Families Oswego County and, as a supervising public health nurse, continues to assist with coverage of the health departments nursing division. In the wake of the current pandemic, this includes helping with the nursing phone bank by answering medical questions and concerns from the public. She also exercises her analytical skills to track the virus activity.

The majority of my time is spent collecting and analyzing data related to the coronavirus, said Eckert. Using a systematic approach, I can identify trends with the virus and provide accurate and timely information to our team. This helps them with public reporting, contact investigations and, most importantly, determining the appropriate prevention and control measures to implement to reduce the spread of the disease.

Huang said, This is the science of epidemiology. It is how we respond to the pandemic and keep our residents safe. Scholarly data analysis is a critical skill during a public health crisis. Chantels doctoral education is a valuable asset to the team.

Jodi Martin, RN, BSN, continues along the path of higher learning to further enhance her skills and capabilities with the health department. She completed a Health Leadership Fellow

Program last year and is now pursuing her masters degree in nursing with an emphasis on public health.

My fellowship and current studies, combined with a decade-long career in public health have helped prepare me for this challenge, said Martin. I view the data in a new way which gives me a better understanding of public health activities and improves my ability to respond to this unprecedented crisis.

Martin, also a supervisory public health nurse, works with many public health programs in the departments preventative care unit, including communicable disease surveillance and the immunization program.

Last summer, Oswego County saw a spike in hepatitis A cases, the highest in the state. Im very proud of our work in identifying the high-risk populations and finding creative ways to reach out to them, she said. We were able to complete difficult contact investigations and provide vaccinations to at-risk individuals.

Huang added, Our team was very successful in containing this disease and received praise from the state Department of Health for our hard work. In addition, several other counties in the state asked us to share our disease containment activities. Jodis creative thinking was an integral part of that success. She continues to bring a fresh perspective on public health to the team.

Dr. Christina Liepke, medical director for Oswego County, brings nearly two decades of experience in family medicine to the team. A graduate of Upstate Medical University, Dr. Liepke served on the Oswego County Board for Health for several years before being named medical director for Oswego Countys Health Department and Hospice Program in 2014. She also maintains a family medicine practice with Port City Family Medicine.

The COVID-19 pandemic is a humbling experience; unprecedented in its magnitude, said Dr. Liepke. What I have learned from it is that we have an amazingly generous community and dedicated staff who are unwavering in their duties. Through it all, everyone on our health department team, from our nurses to the public health director, works day after day without complaint to safeguard our residents. It is a compassionate, collaborative and creative team qualities we need when facing such a unique disease and I am humbled and thankful to work with such amazing people.

Huang agreed, We have a wonderful team managing Oswego Countys response to the COVID-19 pandemic. Dr. Liepkes role is important to continue the countys long tradition of health care services and activities. Epidemiology is another branch of medicine and she brings great insights to our decision-making processes. Her input is indispensable to the entire team.

For more information about Oswego Countys COVID-19 response, go to oswegocounty.com or health.oswegocounty.com/covid-19. Additional questions can be directed to the Oswego County Health Department COVID-19 Hotline at 315-349-3330 from 8:30 a.m.-4 p.m. Monday through Friday. For information about emotional supports, visit the Oswego County Department of Social Services Division of Mental Hygiene at http://www.oswegocounty.com/mentalhygiene.

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'Teamwork Makes the Dream Work' behind the front lines with the Oswego County Health Department - NNY360

Throughout the past week, Ohio Governor Mike DeWine was joined by Lt. Governor Jon Husted, and provided updates on Ohio's response to the COVID-19 pandemic, as well as state initiatives.

On Tuesday, Governor DeWine endorsed Wright-Patterson Air Force Base (WPAFB) and the surrounding Dayton region as the ideal location for the new United States Space Command headquarters.

"Wright-Patterson Air Force Base and the Dayton region would be excellent hosts for the U.S. Space Command's new headquarters," said Governor DeWine. "This area is already home to the National Air and Space Intelligence Center, Air Force Research Laboratory, Air Force Life Cycle Management Center, and Air Force Material Command. It's a powerful combination and a synergy that you can't find anywhere else."

In a letter sent to the Assistant Secretary of the Air Force, Governor DeWine endorsed the nomination submitted by Beavercreek Mayor Bob Stone. A letter signed by 22 area mayors and four county commission presidents was also submitted expressing mutual support for the Dayton region to be considered for the permanent U.S. Space Command headquarters.

The Department of the Air Force, in coordination with the Office of the Secretary of Defense, announced in May that it would accept nominations for the headquarters' location based on specific criteria. WPAFB and the Dayton region met all of the screening requirements.

If selected, the new headquarters could bring up to 1,400 personnel to Ohio.

Copies of the letters sent can be found at governor.ohio.gov.

Also on Tuesday, Governor DeWine announced two public awareness campaigns aimed at spreading awareness of COVID-19 prevention measures that impact the well-being of Ohioans and the Ohio economy.

The messages of these ads are clear, said Governor DeWine. Ohioans, by continuing to practice good prevention, can do two things at once, help stop the spread of COVID-19, and responsibly and safely get back to work.

The first campaign, called I Believe, focuses on real Ohioans and the prevention measures they take to prevent the spread of COVID-19. These 15-second ads, provided by the Ohio Department of Health, will air for three weeks on broadcast, cable, and social media across the state. The PSAs feature two Ohio healthcare professionals.

I Believe (1)

Dr. Kevin Sharrett, MD, is a primary care physician with Cedarville and Jamestown Family Practice. He is the Medical Director for the Greene County Health Department and the Medical Director for Rural Health for the Kettering Health Network. He has served as the Greene County Coroner since 1997. A graduate of Wright State University School of Medicine, Dr. Sharrett also is a farmer and has dedicated his career to serving rural Ohioans.

I Believe (2)

Shareece Mashiska, RN, has been caring for patients in the Youngstown/Warren communities for more than 15 years. A nurse manager at Mercy Health St. Elizabeth Youngstown Hospital, Shareece began her career in the intermediate unit at Mercy Health St. Joseph Warren Hospital before becoming an intensive care nurse working both in-patient and on Mercy Healths mobile intensive care unit. Currently residing in the Mahoning Valley, Shareece believes social distancing remains a critical piece of keeping our communities safe, which includes her own husband and three children.

Up to All of Us

The second campaign, called Up to All of Us, focuses on the importance of taking proper preventative precautions, such as maintaining social distance and washing hands, to get Ohioans back to work and Ohio's economy working again. The ad, provided by the Ohio Bureau of Workers Compensation, will air for three weeks on broadcast and cable television and features an emergency room physician and a local restaurant owner and operator.

Laura Espy-Bell, MD, MHA, FACEP is a board-certified Emergency physician and a native of Columbus, Ohio. She is a graduate of Spelman College in Atlanta, GA where she received her Bachelor of Arts in Economics in 2003. Dr. Espy-Bell received her Master of Healthcare Administration (MHA) from the University of North Carolina at Chapel Hill in 2005. Dr. Espy-Bell graduated from The Ohio State University College of Medicine in 2011. Dr. Espy-Bell has been an active member of the OhioHealth medical staff for the past 6 years as an Emergency Medicine attending physician with Mid-Ohio Emergency Services (MOES) and has provided quality health care in several OhioHealth emergency departments.

Gary Callicoat is the president of Rusty Bucket Restaurant and Tavern, which he first opened in 2002. Reflecting a long record of giving back to the hospitality industry, Callicoat serves on the board of the Ohio Restaurant Association (ORA) and is equally committed to supporting charitable causes of the communities in which he does business. He is also on the board of the ORAs Education Foundation.

FIREWORKS

Lt. Governor Husted noted that Independence Day fireworks shows can proceed, but large gatherings are still prohibited at this time. He encouraged any community that plans on holding a fireworks event to do so safely. Spectators are encouraged to find ways to celebrate the Fourth of July in small groups, such as by watching displays from their porches, backyards, or cars.

CRIMINAL JUSTICE GRANTS

Governor DeWine announced the first round of funding being distributed to local criminal justice entities as part of the Coronavirus Emergency Supplemental Funding Grant.

Approximately $2.1 million will be awarded to a total of 65 local criminal justice agencies including law enforcement, probation/parole offices, corrections agencies, courts, and victim service providers.

The funding can be used toward COVID-19 expenses such as cleaning supplies, PPE, and medical supplies like thermometers. The funding will also be used to pay for technology upgrades that are needed for teleworking or other virtual services.

A complete list of grant recipients can be found at coronavirus.ohio.gov.

A total of nearly $16 million was awarded to Ohio's Office of Criminal Justice Services (OCJS) for this program as part of the CARES Act. OCJS continues to process other grant applications theyve already received and are still accepting new applications from agencies that have not yet requested funding.

More information on how to apply can be found at http://www.ocjs.ohio.gov.

On Wednesday, Governor DeWine, First Lady Fran DeWine, and Lt. Governor Husted visited Lordstown Motors for a first look at the 2020 Endurance All-Electric Pickup Truck.

On Thursday, Governor DeWine invited President and CEO of UC Health Richard P. Lofgren, MD, MPH, FACP to give an update on the status of COVID-19 in Hamilton County and the surrounding areas.

The effective reproductive ratio, also known as R naught, measures how many people will be infected by a sick individual. The R naught had reached 2.4 in that region in April. In recent weeks, the R naught had declined to below one. However, in the last 10 days, the R naught has doubled over the last 10 days in the Cincinnati region.

Dr. Lofgren explained that the increase in cases is not only due to the tests being performed, but the increase shows there is a greater presence of the COVID-19 in the area, and it is spreading in the community. He said it serves as a reminder about the importance of wearing a mask in public, washing your hands, sanitizing frequently touched surfaces, and keeping social distance.

OHIO 2-1-1

Governor DeWine announced that the Ohio Department of Health will continue funding for the valuable 2-1-1 service as Ohio enters into the next phase of the COVID-19 pandemic.

2-1-1 is a phone service that connects thousands of Ohioans to local non-profit and government services for healthcare, food and meals, housing, transportation, mental health, and legal services.

At the beginning of the year, the service was available in 51 of Ohios 88 counties. When the pandemic began, Ohio EMA asked Ohio AIRS, the non-profit that governs Ohio 2-1-1, to provide service to the remaining 37 counties in Ohio, which happened in March.

Ohioans can also dial 877-721-8476 to get connected to 2-1-1.

Also on Thursday, Governor DeWine made several appointments to various boards and commissions, as well as two judicial appointments.

CURRENT OHIO DATA

As of Friday afternoon, there are 48,638 confirmed and probable cases of COVID-19 in Ohio and 2,788 confirmed and probable COVID-19 deaths. A total of 7,570 people have been hospitalized, including 1,904 admissions to intensive care units. In-depth data can be accessed by visiting coronavirus.ohio.gov.

For more information on Ohio's response to COVID-19, visit coronavirus.ohio.gov or call 1-833-4-ASK-ODH.

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Pandemic Response Week In Review - Vermilion Ohio - discoververmilion.org

Basel, 29 June 2020 - Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced that new data from its haemophilia A clinical programme will be presented at the International Society on Thrombosis and Haemostasis (ISTH) 2020 Congress on 12-14 July 2020. Data will include updated safety results from the phase IIIb STASEY study of Hemlibra (emicizumab) and new results from the phase III HAVEN 5 study of Hemlibra. Data will also include insights into the impact of living with haemophilia A. Spark Therapeutics (a member of the Roche Group) will also present data from the initial dose cohorts of its phase I/II SPK-8011 gene therapy study.

We are excited to share updated data from our combined haemophilia A programme at this years virtual ISTH 2020, said Levi Garraway, M.D., Ph.D., Chief Medical Officer and Head of Global Product Development. These data exemplify our efforts to increase our knowledge and capabilities in haemophilia A, including in the context of gene therapy, with the goal of advancing care and providing innovative treatment approaches for people living with this chronic condition.

SPK-8011 data presentationData from the initial dose cohorts of Sparks phase I/II SPK-8011 gene therapy study in haemophilia A will be presented at the congress. Updated data from five participants in the initial dose cohorts, who are up to 142 weeks post-vector infusion, show stable and durable factor VIII expression and a 91% reduction in annualised bleed rate (ABR). There is no evidence of decline in factor VIII expression after more than two years of follow up.1

These data indicate an acceptable safety profile, with no development of factor VIII inhibitors. Furthermore, they represent the longest stable expression of factor VIII following gene transfer and support the use of adeno-associated virus-mediated (AAV-mediated), liver directed gene therapy to achieve durable factor VIII expression for the treatment of haemophilia A.1

Key Hemlibra data presentationsData for Hemlibra will be featured in four poster presentations at the congress. This further supports the comprehensive body of clinical evidence available for Hemlibra, including from the HAVEN studies the most extensive clinical development programme in haemophilia A. This includes results from the second interim analysis of the phase IIIb STASEY study, evaluating the safety and tolerability of Hemlibra prophylaxis in people with haemophilia A with factor VIII inhibitors.

Further data from the STASEY study to be presented outline surgical experiences in the trial, as well as additional insights into the pharmacokinetics and pharmacodynamics profile of Hemlibra.

Roche will also share the first clinical data from the phase III HAVEN 5 study, evaluating the efficacy, safety and pharmacokinetics of Hemlibra in 70 people with haemophilia A with and without factor VIII inhibitors in the Asia-Pacific region. The study met its primary endpoint, demonstrating that Hemlibra prophylaxis dosed every week or every four weeks resulted in a statistically significant 96% (p<0.0001) reduction in the number of treated bleeds over time compared to those receiving no prophylaxis.5 In addition, all secondary bleed-related endpoints were met with clinically meaningful results. Overall, this study showed that Hemlibra was effective and well tolerated in this population.5 HAVEN 5 was conducted as part of the post-approval agreement with the Chinese health authorities to provide supportive data in people with haemophilia A in China, and was expanded to enrol patients from other Asia-Pacific countries.

Key data presentations on impact of haemophilia ARoche will also present two analyses providing insights into clinical outcomes from the CHESS II (Cost of Haemophilia in Europe: a Socioeconomic Survey-II) study evaluating disease burden in people with haemophilia A. The first analysis examines clinical outcomes in adults with mild, moderate and severe haemophilia A without factor VIII inhibitors, focusing on bleeding episodes and joint outcomes. Results show most people with mild and moderate haemophilia A (91% and 98% respectively) did not receive prophylaxis and the majority of these experienced one or more bleeds (74% and 85% respectively).6 These data demonstrate the potential treatment needs in these populations, and the clinical burden on those living with mild and moderate haemophilia A. Additional data from the CHESS II study explores the correlation between bleed frequency and physical activity levels in the same patient population, suggesting there is a correlation between the two.7

Key abstracts from Roche and Spark that will be presented at ISTH can be found in the table below.

Follow Roche and Spark on Twitter via @Roche and @Spark_tx respectively, and keep up to date with ISTH 2020 Congress news and updates by using the hashtag #ISTH2020.

Sunday 12 July 2020, 14:00 15:00 EST

Virtual Meeting Room 6

Sunday 12 July 2020, 14:00 15:00 EST

Virtual Meeting Room 6

Sunday 12 July 2020, 14:00 15:00 EST

Virtual Meeting Room 6

Sunday 12 July 2020, 14:00 15:00 EST

Virtual Meeting Room 6

Monday 13 July 2020, 10:39 - 10:51 EST

Virtual Meeting Room 2

Sunday 12 July 2020, 14:00 15:00 EST

Virtual Meeting Room 6

Sunday 12 July 2020, 11:03 - 11:15 EST

Virtual Meeting Room 3

Second of three presentations occurring in the session, State of the Art Session on Hemophilia and Rare Bleeding Disorders on Sunday 12 July 2020, 8:45 10:00am EST

About Hemlibra (emicizumab)Hemlibra is a bispecific factor IXa- and factor X-directed antibody. It is designed to bring together factor IXa and factor X, proteins involved in the natural coagulation cascade, and restore the blood clotting process for people with haemophilia A. Hemlibra is a prophylactic (preventative) treatment that can be administered by an injection of a ready-to-use solution under the skin (subcutaneously) once-weekly, every two weeks or every four weeks (after an initial once weekly dose for the first four weeks). Hemlibra was created by Chugai Pharmaceutical Co., Ltd. and is being co-developed globally by Chugai, Roche and Genentech. It is marketed in the United States by Genentech as Hemlibra (emicizumab-kxwh), with kxwh as the suffix designated in accordance with Nonproprietary Naming of Biological Products Guidance for Industry issued by the US Food and Drug Administration.

About haemophilia AHaemophilia A is an inherited, serious disorder in which a persons blood does not clot properly, leading to uncontrolled and often spontaneous bleeding. Haemophilia A affects around 320,000 people worldwide,8,9 approximately 50-60% of whom have a severe form of the disorder.10 People with haemophilia A either lack or do not have enough of a clotting protein called factor VIII. In a healthy person, when a bleed occurs, factor VIII brings together the clotting factors IXa and X, which is a critical step in the formation of a blood clot to help stop bleeding. Depending on the severity of their disorder, people with haemophilia A can bleed frequently, especially into their joints or muscles.8 These bleeds can present a significant health concern as they often cause pain and can lead to chronic swelling, deformity, reduced mobility, and long-term joint damage.11 A serious complication of treatment is the development of inhibitors to factor VIII replacement therapies.12 Inhibitors are antibodies developed by the bodys immune system that bind to and block the efficacy of replacement factor VIII,13 making it difficult, if not impossible to obtain a level of factor VIII sufficient to control bleeding.

About Roche in haematologyRoche has been developing medicines for people with malignant and non-malignant blood diseases for over 20 years; our experience and knowledge in this therapeutic area runs deep. Today, we are investing more than ever in our effort to bring innovative treatment options to patients across a wide range of haematologic diseases. Our approved medicines include MabThera/Rituxan (rituximab), Gazyva/Gazyvaro (obinutuzumab), Polivy (polatuzumab vedotin), Venclexta/Venclyxto (venetoclax) in collaboration with AbbVie, and Hemlibra (emicizumab). Our pipeline of investigational haematology medicines includes idasanutlin, a small molecule which inhibits the interaction of MDM2 with p53; T-cell engaging bispecific antibodies, glofitamab and mosunetuzumab, targeting both CD20 and CD3; Tecentriq (atezolizumab), a monoclonal antibody designed to bind with PD-L1; and crovalimab, an anti-C5 antibody engineered to optimise complement inhibition. Our scientific expertise, combined with the breadth of our portfolio and pipeline, also provides a unique opportunity to develop combination regimens that aim to improve the lives of patients even further.About Roche and Spark Therapeutics gene therapy research in haemophilia AWe believe gene therapy has the potential to revolutionise medicine and improve the lives of patients with genetic and other serious diseases. Pairing Roches long-standing commitment to developing medicines in haemophilia with Spark Therapeutics proven gene therapy expertise brings together the best team of collaborators researching gene therapies in haemophilia A.

It is our aligned objective to develop gene therapies for haemophilia A that, with the lowest effective dose and the optimal immunomodulatory regimen, demonstrate safety, predictability, efficacy, and durability for patients.

About RocheRoche is a global pioneer in pharmaceuticals and diagnostics focused on advancing science to improve peoples lives. The combined strengths of pharmaceuticals and diagnostics under one roof have made Roche the leader in personalised healthcare a strategy that aims to fit the right treatment to each patient in the best way possible.

Roche is the worlds largest biotech company, with truly differentiated medicines in oncology, immunology, infectious diseases, ophthalmology and diseases of the central nervous system. Roche is also the world leader in in vitro diagnostics and tissue-based cancer diagnostics, and a frontrunner in diabetes management.

Founded in 1896, Roche continues to search for better ways to prevent, diagnose and treat diseases and make a sustainable contribution to society. The company also aims to improve patient access to medical innovations by working with all relevant stakeholders. More than thirty medicines developed by Roche are included in the World Health Organization Model Lists of Essential Medicines, among them life-saving antibiotics, antimalarials and cancer medicines. Moreover, for the eleventh consecutive year, Roche has been recognised as one of the most sustainable companies in the Pharmaceuticals Industry by the Dow Jones Sustainability Indices (DJSI).

The Roche Group, headquartered in Basel, Switzerland, is active in over 100 countries and in 2019 employed about 98,000 people worldwide. In 2019, Roche invested CHF 11.7 billion in R&D and posted sales of CHF 61.5 billion. Genentech, in the United States, is a wholly owned member of the Roche Group. Roche is the majority shareholder in Chugai Pharmaceutical, Japan. For more information, please visit http://www.roche.com.

All trademarks used or mentioned in this release are protected by law.

References[1] George L et al. Phase I/II Trial of SPK-8011: Stable and Durable FVIII Expression for >2 Years with Significant ABR Improvements in Initial Dose Cohorts Following AAV-Mediated FVIII Gene Transfer for Hemophilia A. [oral presentation no. OC03.5] International Society on Thrombosis and Haemostasis (ISTH) 2020 Congress, 12-14 July, 2020[2] Jimenez-Yuste V et al. Second Interim Analysis Results from STASEY Trial: A Single-arm, Multicenter, Open-Label, Phase III Clinical Trial to Evaluates the Safety and Tolerability of Emicizumab Prophylaxis in People with Hemophilia A (PwHA) with FVIII inhibitors. [poster no. 0958] International Society on Thrombosis and Haemostasis (ISTH) 2020 Congress, 12-14 July, 2020[3] Oldenburg J et al. Emicizumab Prophylaxis in Hemophilia A with Inhibitors. NEJM 2017; 377:809-818.[4] Young G et al. Emicizumab prophylaxis provides flexible and effective bleed control in children with hemophilia A with inhibitors: results from the HAVEN 2 study. Blood 2018; 132 (Supplement 1): 632.[5] Wang S et al. A Randomized, Multicenter, Open-label, Phase III Clinical Trial to Evaluate the Efficacy, Safety, and Pharmacokinetics of Prophylactic Emicizumab Versus No Prophylaxis in Persons with Hemophilia A in the Asia-Pacific region (HAVEN 5). [poster no. 0957] International Society on Thrombosis and Haemostasis (ISTH) 2020 Congress, 12-14 July, 2020[6] Nissen F et al. An Insight into Clinical Outcomes in Mild, Moderate, and Severe Hemophilia A (HA): A Preliminary Analysis of the CHESS II Study [oral presentation no.OC 09.3] International Society on Thrombosis and Haemostasis (ISTH) 2020 Congress, 12-14 July, 2020[7] Nissen F et al. Associations Between Physical Activity Levels and Bleeding Frequency in People with Mild, Moderate, and Severe Hemophilia A (HA): A Preliminary Analysis of the CHESS II Study. [poster no. 0943] International Society on Thrombosis and Haemostasis (ISTH) 2020 Congress, 12-14 July, 2020[8] WFH. Guidelines for the management of haemophilia. 2012 [Internet; cited 2019 July]. Available from: http://www1.wfh.org/publications/files/pdf-1472.pdf.%5B9%5D Berntorp E, Shapiro AD. Modern haemophilia care. The Lancet 2012; 370:1447-1456.[10] Marder VJ, et al. Hemostasis and Thrombosis. Basic Principles and Clinical Practice. 6th Edition, 2013. Milwakee, Wisconsin. Lippincott Williams and Wilkin.[11] Franchini M, Mannucci PM. Haemophilia A in the third millennium. Blood Rev 2013; 179-84.[12] Gomez K, et al. Key issues in inhibitor management in patients with haemophilia. Blood Transfus. 2014; 12:s319-s329.[13] Whelan, SF, et al. Distinct characteristics of antibody responses against factor VIII in healthy individuals and in different cohorts of haemophilia A patients. Blood 2013; 121:1039-48.

Roche Group Media RelationsPhone: +41 61 688 8888 / e-mail: media.relations@roche.com- Nicolas Dunant (Head)- Patrick Barth- Daniel Grotzky- Karsten Kleine- Nathalie Meetz- Barbara von Schnurbein

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Roche announces new data at the ISTH 2020 Congress, demonstrating ongoing commitment to advancing care for people with haemophilia A - GlobeNewswire

RAWLINS The MHCC Family Practice Clinic would like to introduce their newest provider, Dr. Gary Mikesell, D.O.

Born and raised in Rawlins, Mikesell began his medical career in 1982 with Memorial Hospital of Carbon County where he worked as a patient transporter. After graduating from Rawlins High School, he attended the University of Wyoming for a year before completing a two year mission with Church of Jesus Christ of Latter-Day Saints. Mikesell then returned to the University of Wyoming where he majored in Microbiology. After transferring to Brigham Young University, he graduated with a degree in Microbiology and Pre-Med. He was then accepted to medical school at Western University/College of Osteopathic Medicine of the Pacific in southern California. Dr. Mikesell completed medical school in 1996.

Dr. Mikesell has built his career on family practice and urgent care, with over 21 years experience in both. In addition, he also has a strong interest in preventative medicine and sports medicine. He is trained to do spinal and musculoskeletal manipulations to help with back, neck and musculoskeletal pain. Dr. Mikesell also has a Buprenorphine Waiver which allows him to treat patients with narcotic addictions.

Dr. Mikesell enjoys hunting, fishing, camping and taking vacations with his wife, Leticia, and four children. He is very involved in the church and has a strong faith in God. Starting today, Dr. Mikesell will begin seeing patients at the MHCC Family Practice Clinic. Contact the clinic at 307-324-8494 to schedule an appointment.

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Rawlins native returns home to practice medicine | Hospitality & Tourism - Wyoming Business Report

Nearly 35,000 Children in the Asia Pacific Receive Eye Exams with Myopia Screening

Johnson & Johnson Vision, a global leader in eye health and part of the Johnson & Johnson Medical Devices Companies, has announced new clinical research on Myopia progression in children and detailed significant child Myopia screening and education progress in the Asia Pacific region. The clinical research and public health programs are part of the comprehensive Myopia research collaboration with the Singapore Eye Research Institute (SERI) and Singapore National Eye Centre (SNEC) launched in April 2019.

Current estimates show that by 2050 half of the worlds population is expected to be myopic, with a disproportionate impact on our children, said Xiao-Yu Song, MD, PhD, Global Head of Research and Development, Johnson & Johnson Vision Care, Inc. Through close collaborations with SERI, SNEC, and other aligned public health groups, we are helping to address this crisis by building a better understanding of the science and biology behind Myopia and developing comprehensive programs to address and treat the disease.

Researchers for the collaboration presented some of its first clinical research findings at the Association for Research in Vision and Ophthalmology (ARVO) annual meeting. The collaborations five studies at ARVO focus on new techniques and practices to better predict Myopia progression and vision impairment, significant challenges for eye care professionals when so much of Myopia disease progression is still to be understood.

The research team presented new findings on Myopia progression from one of the largest clinical research studies with children. In the study of 674 myopic children aged seven to 10-years old over two-years, the authors found that a childs prior year Myopia progression correlates with immediate subsequent year progression. That is, the investigators found that children with slow Myopia progression during the first year generally had slow progression in year two, while children with fast Myopia progression in year one generally had fast progression in year two.

However, the authors report that year-over-year progression as a single factor does not fully predict long-term Myopia progression and that a childs age and parental Myopia are important additional variables to consider in choosing whether to treat a childs progression.

Globally, for parents of children with Myopia, and eye care professionals, an important takeaway is the need for myopic patients to receive regular annual check-ups, said study lead author Noel Brennan, PhD, Global Lead, Myopia Control, Johnson & Johnson Vision. While Myopia progression rates will naturally be followed from year-to-year, it is also important that eye care professionals consider the age of Myopia onset and parental Myopia.

The author presentation and study, Annual Myopia Progression and Subsequent Year Progression in Singaporean Children, is published on ARVOLearn as part of ARVOs virtual congress.

MYOPIA SCREENING AND EDUCATION PROGRAM PROGRESS IN ASIA PACIFIC

Since the formal launch of the collaboration just over a year ago, Johnson & Johnson Vision, Johnson & Johnson Global Community Impact, SERI, and SNEC have also been working to advance critical Myopia screening and education programs in the Asia Pacific region where current prevalence rates among young people are as high as 80 to 97 percent in urban areas in East Asia and Singapore.

In China, among children ages six to 18, Myopia prevalence rises from less than 10 to 80 percent. In Singapore, one in two children develop Myopia by the age of 12, and 75 percent of teenagers are myopic and rely on glasses.Left unchecked, in some patients, Myopia can lead to blindness or other eye health conditions that can severely impact vision and overall well-being.

Tackling the Myopia epidemic globally requires a comprehensive approach that includes critical education and screening campaigns, said Dr. Song. We are very pleased by the progress of the public health programs in Asia being supported by the collaboration, and that young children are receiving comprehensive eye exams and necessary referrals when diagnosed with Myopia. We look forward to continued progress as we learn to manage these initiatives through the COVID-19 pandemic.

Working through the Fred Hollows Foundation, and Chinas Yunnan Provincial Health Commission and Provincial Education Department, the collaboration launched its three-and-a-half-year Child Eye-Health Program in Chinas Yunnan Province in August 2019. The program trains ophthalmologists, refractionists, community health workers, and teachers in screening techniques and supports student screening programs. In the second half of 2019, the collaboration has already supported the screening of nearly 30,000 primary school students in Yunnan Province, and provided eye health and myopia prevention knowledge to almost 20,000 students.

The collaboration has also become a strategic partner with the Ministry of Educations Research Center for Prevention, Control and Diagnosis of Myopia to support the improvement of Myopia public awareness and the development of Myopia awareness education tools. In addition, the collaboration is working with the Beijing Preventative Medicine Association and Beijing CDC on a Myopia school screening program that is seeking to examine 4,000 students from September 2019 to the end of 2020.

Read more:
J&J presents Significant Progress in Myopia Screening and Education in APAC - BSA bureau

A research report on the Medical Wellness market has been presented by Market Expertz, offering an extensive analysis of the Global Medical Wellness Market where the readers can benefit from the complete market study with all the relevant information about the market.

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Leading Medical Wellness manufacturers/companies operating at both regional and global levels:

Massage EnvySteiner Leisure LimitedWorld GymFitness WorldUniversal CompaniesBeauty FarmVLCC Wellness CenterNanjing ZhaohuiEdge Systems LLCHEALING HOTELS OF THE WORLDGolds Gym International

This report consists of reliable data on the investment opportunities, market dynamics, competition analysis, major market players, basic industry facts, important figures, prices, sales, revenues, gross margins, market shares, key business strategies, top regions, among others.

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Complementary and Alternative MedicineBeauty Care and Anti-AgingPreventative & Personalized Medicine and Public HealthHealthy Eating, Nutrition & Weight LossRejuvenationOther

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FranchiseCompany Owned Outlets

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Geographically, regions covered in the research report are North America, Europe, Latin America, Asia Pacific, and Middle East & Africa. The analysts provide competitive analysis for each region and competitor separately.

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It offers an in-depth assessment of the growth aspects of the market in the key countries. The competitive landscape chapter of the global Medical Wellness market report delivers key information regarding the market players including the company overview, company profiles, total revenue, market potential, growth prospects, global presence, sales and revenue, market share, production sites and facilities, product offerings, latest developments and innovations and key strategies adopted.

Key Coverage:

Table of Contents1. Executive Summary2. Assumptions and Acronyms Used3. Research Methodology4. Market Overview5. Global Market Analysis and Forecast by Types6. Global Market Analysis and Forecast by Applications7. Global Market Analysis and Forecast by Regions8. North America Market Analysis and Forecast9. Latin America Market Analysis and Forecast10. Europe Market Analysis and Forecast11. Asia Pacific Market Analysis and Forecast12. Middle East & Africa Market Analysis and Forecast13. Competition Landscape

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To summarize, the global Medical Wellness market report studies the contemporary market to forecast the growth prospects, challenges, opportunities, risks, threats, and the trends observed in the market that can either propel or curtail the growth rate of the industry. The market factors impacting the global sector also include provincial trade policies, international trade disputes, entry barriers, and other regulatory restrictions.

About Us:Planning to invest in market intelligence products or offerings on the web? Then marketexpertz has just the thing for you reports from over 500 prominent publishers and updates on our collection daily to empower companies and individuals catch-up with the vital insights on industries operating across different geography, trends, share, size and growth rate. Theres more to what we offer to our customers. With marketexpertz you have the choice to tap into the specialized services without any additional charges.

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Medical Wellness Market Demand (2020-2027) | Covering Products, Financial Information, Developments, SWOT Analysis And Strategies | Market Expertz -...

Can people spread the coronavirus if they don't have symptoms? 5 questions answered about asymptomatic COVID-19 Screening for symptoms can catch some cases of COVID-19, but about people who are infected but not showing any symptoms? AP Photo/John Raoux Monica Gandhi, University of California, San Francisco

Screening for symptoms of COVID-19 and self-quarantine are good at preventing sick people from spreading the coronavirus. But more and more evidence is suggesting that people without symptoms are spreading the virus too. Monica Gandhi, an infectious diseases physician and researcher at the University of California, San Francisco, explains what is known about asymptomatic spread and why she thinks it may be a big part of what is driving the pandemic.

SARS-CoV-2 the virus that causes COVID-19 can produce a range of clinical manifestations.

Some people who are infected never develop any symptoms at all. These patients are considered true asymptomatic cases.

When people do get sick from the coronavirus, it takes on average five days and as many as two weeks to develop symptoms that can range from very mild to extremely dangerous. The time between initial infection and the first symptoms is called the pre-symptomatic phase.

As an infectious disease physician, when I hear about asymptomatic spread of SARS-CoV-2, I think of a person who doesnt have symptoms at the moment they give the virus to someone else. It doesnt matter whether they are a true asymptomatic case or just pre-symptomatic; the public health risk is the same.

Estimates of the proportion of true asymptomatic cases those who are infected and never develop symptoms range from 18% to over 80%. The reasons for the huge range in estimates are still unclear, but some studies are better than others.

The most accurate way to determine the rate of asymptomatic cases is to test people regardless of whether or not they have symptoms an approach called universal mass testing and track them over time to see if they develop symptoms later. A recent mass testing campaign in San Francisco found that 53% of infected patients were asymptomatic when first tested and 42% stayed asymptomatic over the next two weeks.

Another recent paper compared the evidence from 16 studies and estimated the overall rate of asymptomatic infection to be 40%-45%. This is in line with the San Francisco finding, but the studies sampled were of various quality and size and likely include some pre-symptomatic cases.

Though none of these studies is perfect, a lot of evidence supports a true asymptomatic rate of around 40%, plus some addition fraction of patients who are pre-symptomatic.

Compared to most other viral infections, SARS-CoV-2 produces an unusually high level of viral particles in the upper respiratory tract specifically the nose and mouth. When those viral particles escape into the environment, that is called viral shedding.

Researchers have found that pre-symptomatic people shed the virus at an extremely high rate, similar to the seasonal flu. But people with the flu dont normally shed virus until they have symptoms.

The location of the shedding is also important. SARS-CoV the virus that caused the SARS epidemic in 2003 does not shed very much from the nose and mouth. It replicates deep in the lungs. Since SARS-CoV-2 is present in high numbers in a persons nose and mouth, it is that much easier for the virus to escape into the environment.

When people cough or talk, they spray droplets of saliva and mucus into the air. Since SARS-CoV-2 sheds so heavily in the nose and mouth, these droplets are likely how people without symptoms are spreading the virus.

Public health experts dont know exactly how much spread is caused by asymptomatic or pre-symptomatic patients. But there are some telling hints that it is a major driver of this pandemic.

An early modeling estimate suggested that 80% of infections could be attributed to spread from undocumented cases. Presumably the undocumented patients were asymptomatic or had only extremely mild symptoms. Though interesting, the researchers made a lot of assumptions in that model so it is hard to judge the accuracy of that prediction.

A study looking at outbreaks in Ningbo, China, found that people without symptoms spread the virus as easily as those with symptoms. If half of all infected people are without symptoms at any point in time, and those people can transmit SARS-CoV-2 as easily as symptomatic patients, it is safe to assume a huge percentage of spread comes from people without symptoms.

Even without knowing the exact numbers, the Centers for Disease Control and Prevention believes that transmission from people without symptoms is a major contributor to the rapid spread of SARS-CoV-2 around the world.

Any time a virus can be spread by people without symptoms, you have to turn to preventative measures.

Social distancing measures and lockdowns work, but have large economic and social repercussions. These were necessary when epidemiologists didnt know how the virus was spreading, but now we know it sheds at high quantities from the upper respiratory tract.

This means that universal mask wearing is best tool to limit transmission, and there is evidence to back that idea up.

On April 3, the CDC recommended that all members of the public wear facial coverings when outside of the house and around others. The World Health Organization finally followed suit and recommended universal public masking on June 5.

At this point, no one knows exactly how many cases of COVID-19 are from asymptomatic spread. But I and many other infectious diseases researchers are convinced that it is playing a major role in this pandemic. Wearing a mask and practicing social distancing can prevent asymptomatic spread and help reduce the harm from this dangerous virus until we get a vaccine.

[You need to understand the coronavirus pandemic, and we can help. Read The Conversations newsletter.]

Monica Gandhi, Professor of Medicine, Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read more:
Can people without symptoms spread COVID-19? Five questions answered about how the virus is spread | Opinion - pennlive.com

What is dexamethasone? Is it effective vs COVID-19?

MANILA, Philippines As the world struggles to find solutions to the novel coronavirus disease 2019 (COVID-19) pandemic, an occasional dose of hope comes to break the strain of dead ends.

Recently, the World Health Organization celebrated the steroid dexamethasone for its life-saving potential for critically ill COVID-19 patients.

The next challenge is to increase production and rapidly and equitably distribute dexamethasone worldwide, focusing on where it is needed most. Demand has already surged, following the UK trial results showing dexamethasone's clear benefit. Fortunately, this is an inexpensive medicine and there are many dexamethasone manufacturers worldwide, who we are confident can accelerate production, WHO Director-General Doctor Tedros Adhanom Ghebreyesus said in a Monday briefing.

This came after University of Oxford researchers found that dexamethasone reduces death in hospitalized patients with severe respiratory complications of COVID-19.

Here are your questions about dexamethasone, including its pros and cons, answered.

WHO: Dexamethasone is a corticosteroid used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects.

Dexamethasone was tested on hospitalized COVID-19 patients as part of the United Kingdoms national clinical trial RECOVERY (Randomised Evaluation of COVID-19 Therapy).

It was found to benefit critically ill patients in particular.

According to preliminary findings shared with WHO (and now available as a preprint), for patients on ventilators, the treatment was shown to reduce mortality by about one third, and for patients requiring only oxygen, mortality was cut by about one fifth.

WHO took care to remind global stakeholders that dexamethasone should only be used for patients with severe or critical disease, under close clinical supervision. There is no evidence this drug works for patients with mild disease or as a preventative measure, and it could cause harm.

The local Food and Drug Administration likewise warned against misuse or unsupervised chronic use of the drug, which they said could lead to serious adverse health reactions like:

If stopped abruptly, it may cause withdrawal symptoms such as hypotension, shockand coma.

Related: FDA warns public vs non-prescribed use of steroid dexamethasone

Similar to WHO, the Department of Health has warned the Filipino public against non-prescribed use of dexamethasone, reminding that no prophylaxis (preventive treatment) or cure exists yets for COVID-19.

We strongly urge the public not to rush to the drugstores, buy this drug, and take it without the supervision of a doctor, in order to be cured or be protected from the virus... It is highly important to note that though this may be considered as a breakthrough in science, the study on this drug as a cure for COVID-19 is yet to be peer-reviewed, Health Undersecretary Maria Rosario Vergeire said last week.

Dexamethasone is yet to undergo further trials and review, but we assure the public that the DOH is in coordination with the global medical community. The department remains in close collaboration with different experts both locally and internationally in the search for a cure and other treatments that are safe and effective against COVID-19.

Related: DOH: Steroid dexamethasone no 'magic pill' vs COVID-19

The FDA also issued an advisory reminding that the unauthorized sale of dexamethasone is strictly prohibited.

There are Dexamethasone products that are currently registered with the FDA. The drug should be only dispensed by licensed establishments to patients with valid prescription. The sale of unregistered Dexamethasone or sale of the drug without valid prescription or through online platforms is strictly prohibited.

See the original post:
What is dexamethasone? Is it effective vs COVID-19? - Philippine Star

Marco Bertorello via Getty Images

In March, as Vadim Gladyshev shifted through the reams of data detailing the kinds of people who were more likely to fall victim to Covid-19, the Harvard biochemist started to wonder if we were thinking about the viral infection in the wrong way.

In Europe, 95 per cent of those killed by the disease were aged 60 or over. According to the UN, the fatality rate for those over 80 is five times the global average. Although many infectious diseases impact older people disproportionately, with Covid-19 the skew towards older people is devastating. Given all this, Gladyshev wondered, why arent we treating Covid-19 as a disease of ageing?

As he watched the global arms race to try and find a treatment which either neutralised the SARS-CoV-2 virus or dampen the overactive immune response which leads to many of the deaths, Gladyshev one of the worlds leading experts on the causes of ageing could not help but ponder if academics and pharmaceutical companies across the world were heading down the wrong path. If Covid-19 has the greatest impact on the elderly, rather than targeting the virus, should we not be focusing more on strengthening the host? he says.

Since the 1930s, scientists have sought clues on how to turn back the ageing process in humans by first trying to extend lifespan in rodents, with two drugs rapamycin and metformin showing signs of promise. While it is doubtful that these drugs would be useful in severe cases of Covid-19 where patients are already on ventilator support, Gladyshevs idea was simple. Could prescribing these drugs to the elderly as preventative measures could give the most vulnerable a better chance of fighting off Covid-19, and prevent them getting to that stage?

Since April, his idea has been taken up by a series of scientists across the US ranging from pharmacologists at Thomas Jefferson University to the Boston-based biotech company resTORbio, who are now testing forms of rapamycin in a series of clinical trials over the coming months.

While rapamycin and metformin are typically known for their clinical uses in cancer and diabetes respectively, the reason why Gladyshev and other longevity scientists think that these drugs could protect the elderly from covid-19 is linked to theories regarding biological age. We typically measure age chronologically based on the number of years a person has been alive, but there is a school of thought that biological age determined by biomarkers varying from DNA expression to the length of telomeres, the tips of chromosomes can vary depending on factors ranging from lifestyle to genetics.

Nir Barzilai, founder of the Institute of Ageing Research at the Einstein College of Medicine in New York, argues that the reason some people are less prone to age-related diseases such as cardiovascular disease, dementia, cancer and infections, is because their biological age is much younger. By the age of 65, half of people in Europe have two diseases or more, but half have less, says Barzilai. For me, this is due to their differing biological ages.

Most of the evidence that drugs might be able to reverse some of the hallmarks of ageing, and thus make an elderly person more resilient to viral infections, comes from studies either in human cells or rodents. This data suggests that rapamycin has the potential to revitalise the bodys natural defence mechanisms within the lungs, stimulating cells such as macrophages which are designed to seek out and remove viruses to work more efficiently.

But there have also been further findings in humans which has given longevity researchers increased confidence that they are on the right lines. Back in March, doctors in Wuhan published a study showing that diabetics taking metformin were much less likely to die of Covid-19 than diabetics not on the drug, an interesting finding which backed up previous epidemiological data showing that it can improve lifespan in diabetics. An earlier clinical trial conducted by resTORbio, using a formulation of rapamycin called RTB101, reported that it could reduce rates of respiratory viral infections in healthy people over 65.

Nevertheless when the Covid-19 pandemic began, few specialists outside of longevity research were aware of the anti-ageing properties of these drugs. At the start of April, Edwin Lam a pharmacology researcher at Thomas Jefferson University was looking at a study from molecular biologists across the US which used computer models to predict which drugs performed best when it came to helping the body remove the virus. To his surprise, rapamycin and metformin ranked top, ahead of many highly touted alternatives such as hydroxychloroquine.

Initially I thought this seemed far-fetched, says Lam. But then I looked further and found that some scientists had previously used a form of rapamycin called Sirolimus to treat people with severe cases of H1N1 bird flu. They saw a reduction in the viral load and better clinical outcomes. It had also shown antiviral activity in a preclinical model of Middle East Respiratory Syndrome. I presented this to my colleagues and we became really intrigued.

Lam has now designed a placebo-controlled clinical trial to see whether rapamycin can reduce the viral load in 20 patients with mild to moderate cases of Covid-19. A similar study is also taking place at the University of Cincinnati. ResTORbio are now looking at whether giving 550 nursing home residents an oral capsule of RTB101 each day over a period of one month, could protect them from becoming severely infected with the virus, and needing hospitalisation.

Nursing home residents have a very high risk of dying from Covid-19, says Joan Mannick, co-founder and chief medical officer of resTORbio. This elevated mortality has made the public acutely aware of the dysfunction of the aging immune system. I think the pandemic has the potential to catalyse interest in therapeutics that target aging biology as a new way to improve the function of aging organ systems.

But other scientists looking at ways to protect the elderly from Covid-19 caution that while they will be monitoring the results of the trials with interest, the evidence regarding the effectiveness of anti-ageing drugs remains limited. Its an interesting approach, but the data will have to speak for itself, says Ofer Levy, who heads the Precision Vaccines Program at Boston Childrens Hospital. Its all about safety and efficacy. Is it safe, how long can they be on it, and then is it effective? But its something to consider.

Levy points to another potentially promising approach for protecting the elderly from Covid-19, vaccines which are specifically designed for older people. These typically contain additional chemicals known as adjuvants to try and kick-start the ageing immune system. Its an approach which was successfully used by British pharma company GlaxoSmithKline to create the Shingrix vaccine in the past five years. This has shown to be highly effective in preventing shingles in people over 50, and Levy is looking to apply this strategy to a Covid-19 vaccine.

One of the ironies of vaccine development is that while over 65s stand to benefit most from immunisation, research has often shown that vaccines against influenza and other infections are at their least effective in the very old. This is thought to be due to changes in the blood which affect the immune response. As we age, the blood plasma changes and we tend to develop a low level of inflammation in our bloodstream, Levy says. Because of this, when you try to immunise someone, you often get an incomplete response to the vaccine.

Instead, Levys group is designing a vaccine which is specifically modelled on older immune systems. Our approach is to take blood donations from elderly volunteers, and then we isolate the immune cells in a dish, he says. We then screen lots of small molecules until we find ones which are like rocket fuel to the immune system, we add them to the vaccine and select the formulations which seem to work best against the coronavirus. This is completely different to normal vaccine development as were actually designing it with the ageing immune system in mind.

He hopes that such a vaccine could be in clinical trials by autumn 2021. Barzilai points out that in the meantime there is some evidence to suggest that supplementary treatment with rapamycin could enhance the effectiveness of the first wave of vaccines when they become available, with Japanese company AnGes hoping to make their Covid-19 vaccine available at the start of next year. Rapamycin has previously been shown to enhance the effectiveness of the influenza vaccine. Im sure that the initial vaccines will not be effective in the elderly, because their designs ignore their immune deficiencies, Barzilai says. But rapamycin could make a difference.

With the increased interest in rapamycin, longevity scientists predict that Covid-19 could prove to be a major boon for the field of anti-ageing research, a sector which has already been benefiting from injections of funding in recent years. Last year Barzilai received $75 million (60.5m) to conduct the TAME clinical trial, looking at whether giving metformin to elderly people over a period of four to five years can give them more years of good health. Gladyshev says that the three Covid-19 clinical trials involving rapamycin could provide a whole host of information regarding its ability to reduce biological age.

However, Barzilai is still frustrated that many within the medical community appear to be unaware of the potential of these drugs. He points to the Wuhan study in March, saying that while similar findings have been observed in Italy and Spain, no one has conducted a clinical trial looking at whether administering metformin to the elderly population in general, can offer protective benefits against Covid-19.

The major problem is that our health organisations are in silo and so ageing is often overlooked as a risk factor in these diseases, he says. For me, the question is why are we not using these two drugs on a wider scale to try and protect the vulnerable, when we already have information that they can offer benefit? Metformin has been used clinically for 60 years, its already known to be safe. If we just focus on stopping the disease in older people, the whole mortality issue would be different, the lockdowns wouldnt need to happen, and the economic impacts would be less as well.

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To slow the coronavirus death toll we may need to slow down ageing - Wired.co.uk

Although diaper rash is never something you want to deal with, odds are you've probably fought the good fight with this red, irritating and super common baby and toddler skin ailment more than once during your time as a mama.

Almost every baby suffers through diaper rash at some point during their first few years of life. Prolonged wetness, friction and sensitive baby skin combine into a recipe for disaster when it comes to baby bums and, although generally harmless, diaper rash can be pretty painful and irritating for those little tushes.

Enter diaper cream: A mama's best friend for treatment and prevention of diaper rash, and a staple on the changing table and in every diaper bag.

But with so many to choose from, you need to know which diaper creams actually get the job done. (Because let's be real, you're already spending enough time trying to wrangle your little one for a diaper change in the first place!)

A longstanding favorite among moms, Triple Paste medicated ointment delivers the double whammy of not only healing diaper rash quickly (seriously, mamas, this stuff is magic) but preventing it, as well. It's fragrance-free and hypoallergenic. Plus, a little goes a long way, which means one tub will last for quite a while.

We love a product that can multitask. This ultra-gentle, 100% natural olive oil based gel-to-cream balm not only prevents and knocks out diaper rash, it also works as a nipple balm, cradle cap treatment, lip balm and to soothe eczema. The non-greasy, fragrance-free formula is perfect for even the most sensitive skin of newborns through adults.

Aquaphor is the stuff of dreamsfrom chapped lips to minor cuts + scrapes, there's hardly anything that this magical ointment can't help with. And diaper rash is no exception!

Aquaphor protects baby's skin from wetness, acidity and chafing, and unlike petroleum jelly, creates a barrier over the skin which heals while still enabling the flow of water and air. Added bonusit also works great on mama's dry hands!

Made with 100% natural ingredients from Mongolia, this rich and creamy balm melts right in to protect and soothe baby bums, rolls and creases. The main ingredient, tallow, has been used for centuries by nomadic herders across their harsh climate is ethically and sustainably sourced and provides an unparalleled barrier against moisture and irritation. Bonus: After washing hands a million times a day, this is the only thing that helped my super chapped hands.

How can we not love a diaper rash cream with the slogan "let's kick some rash?" Developed by a pharmacist with four kids who wasn't satisfied with any of the diaper rash creams on the market, Boudreaux's is effective and is made without any harsh chemicals, which is a major win in our book.

This rich and creamy formula might be the most luxurious diaper cream we've ever slathered on a baby bum. It's packed with 18 natural and organic ingredients which have all been carefully selected to nourish and calm irritation. Calendua and chamomile help soothe while things like zinc and shea butter protect against moisture. A little goes a long way!

Desitin takes a spot on our best-of list because it contains the maximum level of zinc oxide available without a prescription, making it a top choice for serious diaper rash. It's thick and rich, creating a strong protective barrier between your baby's diaper and her sensitive skin. It also acts as an anti-inflammatory, reducing the redness and pain that goes along with diaper rash.

This calming salve uses calendulaa flower used to treat inflammation and painto soothe baby bottoms and treat and prevent diaper rash. Infused with other herbs like tea tree oil and shea butter, we love it as one of the more natural diaper rash creams on the market.

Cetaphil is one of our faves for our own skin, so using it on our little ones' sensitive bottoms is a no-brainer. The soothing cream is filled with vitamins and other organic ingredients, and the fresh scent isn't overpowering.

Honest Company is about more than just adorable diapers. Made without phthalates, parabens, fragrances, dyes and other potentially harmful ingredients, this quick-acting diaper rash cream uses zinc oxide and other organic ingredients to relieve even the most stubborn of rashes. It also helps moisturize those tiny bottoms + is easy to apply.

Like a few of our other picks, this European brand also features calendula, along with other natural extracts and oils, to combat diaper rash. Because of its natural makeup, we've found this diaper rash cream to be especially effective for babies with super sensitive skin.

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A+D stands the test of time as one of the best diaper rash creams around. The soothing ointment easily glides onto skin, so it's great to apply on-the-regular for continuous protection against a diaper rash.

Maker of some of our favorite baby skin care products around, California Baby has been known for over 20 years as a go-to for safe, natural, and effective products for babies and kids with sensitive skin. This preservative-free, fragrance-free and super concentrated cream uses zinc oxide and other natural ingredients to treat and prevent diaper rash. It's also safe to use with cloth diapers.

We independently select and share the products we loveand may receive a commission if you choose to buy. You've got this.

The rest is here:
13 diaper rash creams that *really* work - Motherly Inc.

Adebisi Tijani

Throughout ages and millennia, human societies across the world have always had well-established indigenous healthcare systems that helped sustain life and their respective civilisations.

It is, therefore, clear that no culture nor nation on earth has any monopoly over or exclusive rights to the application of pharmacology for the effective treatment of diseases. This draws from the fact that pharmacology has been a common therapeutic art of every culture on earth before the modern scientific wave of pharmaceutics.

It was, therefore, heartwarming news for Africa when Madagascar announced a locally manufactured drug for the cure of the coronavirus pandemic sweeping the world.

Madagascar, quarantined around 400 kilometres off the East African country of Mozambique, instantly leapt out of obscurity.

The medical feat came through as a result of a collaboration between the Malagasy Institute of Applied Research (MIRA) and the National Pharmacology Research Centre.

The herbal medicinal potion or drink, known as COVID ORGANICS (CVO), has since been stirring predictable controversies between herbal medicine and big pharma drugs and outright racists that would never see anything good from Africa.

But the Malagasy President, Andry Rajoeiina, would not be browbeaten. He endorsed and launched the herbal drug for the treatment of COVID-19 patients. According to Rajoeiina, the thrust of promoting the locally-made herbal drug is not only to help save lives in his country and the world, but to also help raise funds that will be re-invested in more advanced medical and sundry scientific pursuits at the Malagasy Institute of Applied Research.

Africanews, quoted the President as saying: All trials and tests have been conducted and its effectiveness has been proven in the reduction and elimination of symptoms of the COVID-19 patients in Madagascar.

Herbal medicine, in pulverized or liquid form, known as agbo across West Africa, is a common indigenous medicine among Black people in Africa. It has been used for both curative and preventative purposes since time immemorial.

But the World Health Organization (WHO) did not join the Halleluyah chorus for the indigenous Malagasy medical breakthrough. In its initial reactions, WHO officially declared that it had not recommended the drug as a cure for COVID-19, and, as such, warned against its prescription for the treatment of the disease. Upon such stance,the WHO tagged the nationally recommended use of Covid Organics as being tantamount to self-medication, as against medication by scientific prescription.

But Africans have roundly ignored the WHO on this, particularly since there is yet no known cure for the disease. Moreover, the Malagasy President had declared that the medication would be given away for free to the most vulnerable but sold at very low and affordable prices to those outside such bracket. He backed it up, deploying soldiers for door-to-door free distribution of Covid Organics.

In Antananarivo, the capital of Madagascar, pharmacies and supermarkets are said to be stocking up their shelves with CVO. And its been widely reported that no sooner were the drugs displayed than they disappeared from the shelves as a result of the relatively insatiable demand.

Experts at the Academy of Medicine of Madagascar have reassured residents of the island nation that it has duly established the medicinal properties of the herbal drug. But then, for thorough scientific self-assessment, the academy has put up a monitoring system to appraise the efficacy of the medicine across the various demographic spheres of its consumption. It equally explained that it was not putting up Covid Organics as an exclusive cure for COVID -19 and, therefore, upheld the individuals discretionary choices. It also urged users to strictly comply with the recommended dosage.

According to local media reports, Rakoto Fanomezantsoa, a military doctor and director-general of Suavinandriana Hospital, has shed further light on Covid Organics. The doctor explained that one of the medicinal qualities of CVO is that it not only strengthens the immune system, it helps eliminate viruses as well.

Among the early African leaders to endorse the innovative indigenous medicine were the heads of state of Guinea Bissau, Senegal, Cameroon, Comoros and Tanzania.

The miracle plant behind the global appeal of Covid Organics is known by the scientific name Artemesia annua, otherwise referred to as sweet wormwood, which belongs to the daisy family. Clinical studies carried out in Western laboratories, in efforts to ascertain the vaunted curative powers of Artemesia annua, have been rated as both interesting and promising.

The plant was introduced to Madagascar from Asia in the 1970s for the treatment of malaria, and forms the base of the popular drug, artemisinin.

Following a heated outcry across Africa against the WHO over the drug, it has since modified its stance. Matshidiso Moesi, WHOs regional director for Africa, in a recent media briefing, declared: We are advising the government of Madagascar to take this product through a clinical trial and we are prepared to collaborate with them.

Last month, visiting President of Guinea Bissau, Vinaro Sisoko Embalo, presented to the Nigerian head of state, President Muhamadu Buhari, a sample of Covid Organics as a gift from President Rajoeiina.

Upon praising the medical innovation from a fellow African country, Buhari called for its validation by Nigerias medical establishment.

Africa keeps on working out indigenous ways of solving her numerous problems without worrying much about Western bias. Whereas a kit for private testing of coronavirus is sold for 250 in London, Senegalese medical scientists have come up with an equally effective kit for an incredible price of $1.

Writing in The Guardian of London, Afua Hirsch noted: The African continent has a stellar way of innovating its way out of problems just look at how mobile money and fintech has turned it into one the most digitally savvy regions of the world.

It has been well documented how a patronising attitude towards East Asia is what allowed European countries to be caught by such surprise at the spread of this (coronavirus) disease. Now a similar mindset seems to ensure we dont learn the lessons Africa has to offer in overcoming it.

On French television, President Andry Rajoeiina of Madagascar put across a poser: If it was a European country that had actually discovered this (Covid Organics) remedy, would there be so much doubt?

He did not wait for a response.

And, on behalf of Africa, he declared: CERTAINLY NOT!

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Covid Organics: Malagasy potion and patronising West - Daily Sun

Staff and congregants should stay home and not attend service if they have any symptoms like fever, cough or shortness of breath. If you have been diagnosed with COVID-19 infection, you should not leave your home until approved by your medical provider or the health department. If you are on home quarantine for 14 days because you have been in contact with someone with COVID-19 infection, you should not attend in-person worship services.

Screening individuals before they enter place of worship will ensure that individuals who are attending worship service are currently healthy and not experiencing any COVID-19 related symptoms. Asking a few simple questions and taking the temperature of individuals entering is a great step in preventing the spread of COVID-19. Below is what should be asked prior to entering the worship facility:

Have you had close contact (within 6 feet for at least 10 minutes) in the last 14 days with someone diagnosed with COVID-19, or has any health department or health care provider been in contact with you and advised you to quarantine?

Have you experienced any of the following symptoms in the last 72 hours Fever Chills Shortness of breath or difficulty breathing New cough New loss of taste of smell

Have you been diagnosed with COVID-19?

If anyone responds yes to any of the above questions, has symptoms, or has been exposed to COVID-19 they should go home, stay away from other people, and call their doctor.

If you are a senior citizen or have an underlying health condition, you are at high risk for severe disease. Consider asking your pastor to video the service for you. This allows you to view the service from the safety of your home.

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Health department urges COVID-19 preventative measures upon returning to places of worship - Statesville Record & Landmark

This Pride Month,Rewire.Newsrecognizes that celebrating during the pandemic will look very different for many of us, which is why were putting together tools of resistance and hope to help us all survive (and even thrive)Pride 2020.

When pre-exposure prophylaxisbetter known as PrEPhit the market in 2012, it was quickly recognized as a highly effective method for preventing HIV infections. So why isnt the life-saving medication free and accessible for all?

After someshort-lived handwringing that the drug wouldencourage gay men to have condomless sex, PrEP rapidly found a place in public health arsenals around the world. The medication is free or costs a few dollars a month in countries like France, New Zealand, and Kenya, but in the United States, that kind of easy access is elusive. In the worst-case scenario,if a PrEP userhad no insurance, no Medicaid, and lived in, say, rural Indiana (among many other places), they could be on the hook for a little under $2,000 a month (or $64 per pill), plus doctors fees for the prescription.

The group predominantly responsible for that price tag is Gilead Sciences, a pharmaceutical giantthat recorded over $22 billion in total revenue in 2019. Gilead has exclusive rights to produce and sell Truvada and Descovythe only approved forms of PrEP in the United Statesand it has the freedom to set prices wherever it likes.

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According to James Krellenstein, co-founder of the advocacy group PrEP4All, PrEPs lofty price tag means that a sizable chunk of government spending on HIV prevention goes directly to the company that sets the price, instead ofother prevention strategies, like community outreach.

All of the resources dont go to addressing [other] barriersthey go to pay off a company like Gilead, Krellenstein told Rewire.News.

Even then, government spending on PrEP is patchy. The most straightforward way to get free PrEP is to be on Medicaid, but low-income, uninsured adults dont meet the eligibility criteria in many states. But some municipalities like New York state and the cities of Atlanta and San Francisco do fund programs to make PrEP freefor lower-income people.

The United States Preventative Service Taskforce (USPSTF), an independent panel of experts in prevention and evidence-based medicine, recommended in 2019 that PrEP be covered fully by all private insurance plans. While the recommendation isnt a legal requirement, the Affordable Care Act (ACA) requires that most private insurance plans, as well as states with expanded Medicaid as part of the ACA, cover the full cost of any preventative service given an A or B rating by the task force. Starting January 2021, these insurance plans will be required to cover PrEP, as well as all lab work and clinic visits, with no co-pays or deductibles, according to the recommendation. (By the way, none of this helpspeople who are uninsured.)

For now, theres private insurance and its myriad co-pays and deductibles. Those left with a bill after insurance kicks in have one more option: asking Gilead for help. The company has a program that covers a chunk of out-of-pocket costs for PrEP ifinsurance already covers it to some degree.

According to Krellenstein, this isnt a particularly philanthropic move from Gileadrather, its a discount on a product that they priced in the first place.

A lot of people rely on that co-pay program, but at the end of the day, it doesnt get around the fact that even with the co-pay program theyre making $10,000 a year on a drug that costs $80 [to make], Krellenstein said, making a rough estimate on the manufacturing cost.

It doesnt seem that this mishmash of corporate and public coverage works: The Center for Disease Control and Prevention (CDC) suggests that out of 1.2 million people in the United States in the high-risk category for contracting HIV, only around 200,000 take PrEP. Plus, infection rates have declined by less than 10 percent since PrEP was approved in 2012. HIV/AIDS is an ongoing, very active epidemic, Krellenstein said.

Meanwhile, countries like Australia have closer to half of their high-risk population on PrEP. And its not because Australia is willing to spend more public moneythey have agenericversionon the market, along witha robust public system that can bargain prices down.

In the United States, Gileads Truvada patent runs out later this year, but only one genericis expected to surface in September, so only a modest price drop should be expected. Gilead is also encouraging PrEP users to switch from Truvada to Descovy, which is billed as safer (but is also patent-protected for longer) to protect its market.

While Gileads nefarious pricing is an obvious and convenient boogeyman in this case, advocates say the federal government also shoulders ashare of the blame.

The U.S. government may have had the ability to force down Gileads high prices, but didnt act on it until 2019, when it filed a series of lawsuits alleging that Gilead infringed on CDC researchers patents in developing Truvada and Descovy; Gilead has in turn claimed that the CDC infringed on its patents. While the status quo still stands, initial hearings have come down on the governments side, prompting advocates to question why the CDC didnt act earlier.

These patents were the CDCs domain they chose to do nothing about it even when they knew about these massive problems with access to the medication, Krellenstein said.

Not only that, aTrump administration program that aims to supply free PrEP to 200,000 people enrolled just 891 people since it began in December.

While the government secured the drug supply for the campaign, it didnt do the necessary outreach, particularly into Black communities where HIV infection rates are higher and PrEP use is lower, said Matthew Rose, director of U.S. policy and advocacy at Health GAP (Global Access Project), an international organization dedicated to ensuring that all people with HIV have access to affordable, life-saving medicines.

Preventative medicine has had a low uptake in these communities, he said. Some of this is due to medical mistrust and racism. It can be hard to get a provider, people may be reluctant to talk to a provider the government has to work to build the trust within those communities.

But even if the government had a flawless outreach program, 200,000 more people with access to PrEP still wouldnt be enough, Rose said. Between Gileads dominance and the high price of medical services, the health-care system simply isnt cut out for free PrEP.

Weve got to get hold of the insurance companies and the drug companiestheres just not enough money and coverage to go around to get people to live their best health outcomes, Rose said.

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If the Government Cared About HIV, PrEP Would Be Free - Rewire.News

A Japanese supercomputer has taken the top prize in a renowned global speed competition for the first time since 2011, beating out the Chinese and American competitors that usually win. Fugaku, as the supercomputer is called, clocked in a score of 415.53 petaflops on the biannual Top500 List.

To put that into context, a system capable of one-petaflop speed can perform one quadrillion "floating point operations," or computer arithmetic calculations. To keep up with a one-petaflop supercomputer, you'd have to perform one calculation every second for 31,688,765 years, according to Indiana University. Multiply that by 415.53 petaflops, and that's one calculation every second for about 13.2 billion years. Phew.

This marks the first time an Advanced Reduced instruction set computing Machine (ARM) supercomputer has taken the lead slot on the Top500 List. Usually, ARM processorswhich require fewer transistors, are cheaper, use less power, and create less heatare relegated to the world of mobile devices like smartphones, tablets, or laptops, making Fugaku's win particularly compelling.

"For Arm, this achievement showcases the power efficiency, performance and scalability of our compute platform, which spans from smartphones to the worlds fastest supercomputer," Rene Haas, president of Arm's IP Products Group, said in a prepared statement. Arm Holdings is the Softbank-owned semiconductor company that first introduced ARM chips.

Fugaku beat out its nearest competitor, Summitan IBM-developed supercomputer that lives at Oak Ridge National Laboratory in Tennesseeby 266.93 petaflops. That supercomputer previously topped the Top500 List in the last round of competition, back in November, when it ranked in at 148.6 petaflops.

The latest ranking included four supercomputers from the U.S., two from Italy, two from China, one from Japan, and one from Switzerland.

Fugaku is installed at the RIKEN Center for Computational Science in Kobe, Japan. The original idea came about back in 2014, and the supercomputer won't even be fully operational until April 2021.

At RIKEN, around 3,000 researchers use the machine for drug discovery; personalized and preventative medicine; natural disaster simulations; and studies into the fundamental laws of the universe. And on an experimental basis, researchers are even using Fugaku for COVID-19 research into diagnostics, therapeutics, and simulations showing the spread of the virus.

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"Fugaku was developed based on the idea of achieving high performance on a variety of applications of great public interest...and we are very happy that it has shown itself to be outstanding on all the major supercomputer benchmarks," Satoshi Matsuoka, director of the RIKEN Center, said in the statement. "I hope that the leading-edge IT developed for it will contribute to major advances on difficult social challenges such as COVID-19."

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Meet Fugaku, the New Fastest Computer in the World - Popular Mechanics

On the same Monday in June, two studies emerged challenging most of what everyone thinks we know about the battle against the deadly pandemic SARS-CoV-2 coronavirus, and both suggest a fundamental frailty in the way humans think:

We are prejudiced by a desire to believe in human dominion over nature.

That fundamental belief, the studies suggest, might have prejudiced conclusions that non-pharmaceutical efforts to contain the pandemic have been successful even though the evidence doesnt appear to support that conclusion.

After modeling real-world data from 40 countries, professor Harald Walach from the Poznan University of Medical Sciences in Poland and German health consultant Stefan Hockertz concluded that little of what has been done to battle the disease to date has proven truly effective and some actions might have made things worse.

Interestingly, none of the variables that code for the preparedness of the medical system, for health status or other population parameters were predictive (of lower death rates), they wrote. Of the public health variables, only border closure had the potential of preventing cases and none were predictors for preventing deaths. School closures, likely as a proxy for social distancing, was associated with increased deaths.

The pandemic seems to run its autonomous course and only border closure has the potential to prevent cases. None of them contributes to preventing deaths.

The study was published on the preprint server MedRxiv and has not been peer-reviewed. The authors appeared to concede that, but they werent pulling any punches.

It is interesting to observe that closure of schools emerges as a strong positive predictor for the number of deaths, i.e. school closures are associated with more deaths, they wrote. This could be an indicator for strong social distancing rules in a country which might be counterproductive in preventing deaths, as social distance for very ill and presumably also very old patients, might enhance anxiety and stress and could then become a nocebo.

It could also reflect the fact that countries which saw a rising tendency of deaths closed schools as an emergency measure, and hence school closure is an indicator of fear in a country. But considering the prevention of deaths, none of the public health measures studied are associated with the prevention of deaths.

Conceding that their work contradict(s) new modeling data using time series models that report clear evidence for the effectiveness of non-pharmaceutical interventions, they took direct aim at those findings.

The major shortfall of these models is that they ignore the most likely reason why we find the data we find: immunity in the population and neglecting the strength ofnatural immunity, they write. Thus, a new reliability study of such models shows that they are crucially dependent on assumptions, parameters assumed and the time point at which they capture data. If the wrong assumption about a potential resistance against an infection in a population is made, the results are far off from true values.

Walach and Hockertz are not alone in this thinking. Another study new on the MedRxiv server Monday also concluded that while actions taken to slow the spread of the disease appear to have reduced demand for space in intensive-care units none of the proposed mitigation strategies reduces the predicted total number of deaths below 200,000. Surprisingly, some interventions such as school closures were predicted to increase the projected total number of deaths.

A team of researchers from the University of Edinburgh reached those conclusions after investigating the United Kingdoms response to the pandemic as guided by the advice of the countrys Imperial College against the subsequent trajectory of the disease.

Like Walach and Hockertz, the Edinburgh group led by Professor Ken Rice, an astrophysicist who specializes in modeling, concluded that closing schools actually increased the number of deaths, but the Edinburgh scientists didnt stop there.

We confirm that adding school and university closures to case isolation, household quarantine, and social distancing of those over 70 would lead to more deaths when compared to the equivalent scenario without school and university closures, they write. Similarly, adding general social distancing to a case isolation and household quarantine scenario was also projected to increase the total number of deaths.

Though this conclusion might at first appear counter-intuitive, the logic is sound. As with all viruses, SARS-CoV-2 needs new hosts to infect in order keep spreading. The fewer people it is capable of infecting, the harder it for the disease to travel through a population.

Thus if a large number of young people are infected and subsequently develop antibodies to ward off future infections, the virus has an increasingly harder time finding hosts and the spread of the disease slows.

The qualitative explanation for this is that within all mitigation scenarios in the model, the epidemic ends with herd immunity with a large fraction of the population infected, the Edinburgh researchers wrote. Strategies which minimize deaths involve having theinfected fraction primarily in the low-risk younger age groups. These strategies are different from those aimed at reducing the ICU burden.

Younger people for reasons still not fully clear have far better odds of beating SARS-CoV-2 than old people. Some do get very sick from COVID-19 the disease caused by the coronavirus but overall death rates are relatively low.

The U.S. Centers for Disease Control (CDC) currently estimates a COVID-19 case fatality rate of 0.05 percent for those age 49 and under. It rises to 0.2 percent for those age 49 to 64 and climbs to a deadly 1.3 percent for those 65 and older.

When the data is further broken down, it lays things out even more clearly. The CDC charts a COVID-19 death rate that starts at 3.5 deaths per 100,000 for those aged 5 to 17 and climbs steadily to 535.2 deaths per 100,000 for those age 85 and older.

The chart reflects that those 50 to 64 years old are dying at a rate almost five times greater than those age 18 to 29, and by age 65, the death rate for the 65-and-older group is approaching 10 times that of those under 30.

For comparison sake as to the death rates for younger ages, U.S. drug deaths for those age 18 to 34 (the closest available cohort to the 18 to 29 group for COVID) are 30.9 per 100,000.

A 2009, peer-reviewed meta-analysis of studies of the common flu published in the journal Epidemiology reported that most estimates for that disease fell in the range of 5 to 50 deaths per 100,000, but as with COVID-19 rose monotonically with age, from approximately one death per 100,000 symptomatic cases in children to approximately 1,000 deaths per 100,000 symptomatic cases in the elderly, although with substantial variation in the estimates within each age group.

Other than trying to protect the most vulnerable while growing herd immunity among the less vulnerable, both studies suggest there is not a whole lot that humans can do to change the course of the COVID-19 at this time.

The image that emerges from the data and the attempt to understand their relationship through modeling is that of a largely autonomous development, Walach and Hockertz write. It affects mainly the elderly. Smoking is somewhat protective and border closures is associated with a lower number of cases. But other measures closing of schools and lockdown of whole countries do not contribute to a reduced number of cases or deaths.

The data does indicate, they add, that if suspected cases are tracked and traced fast enough as in Taiwan and Hong Kong containment is possible.(but) once infectionsare in the vulnerable segments of a population, like in hospitals or homes for the elderly,political actions like school closures or country lockdowns do not prevent deaths.

If anything, social distancing seems to be harmful. What might be useful but cannot be seen in our coarse-grained data are special protective measures geared to protect these vulnerable populations, such as protective masks for personnel and visitors in hospitals and old peoples homes, or the wearing of face masks in places with bad ventilation and close proximity of people.

They admit its nice to believe the existing public health measures work, but argue the data just doesnt support that conclusion.

We have pointed out that the peak of the cases had been reached in Wuhan already on January 26th, only three days after the city lockdown, they write. This was surely too short to be an effect of public health measures as cases manifest with a delay of at least five and rather more days. And a careful analysis shows that, if one uses realistic retrodiction (back-tracking of time) of cases, then effects of public health measures cannot be seen.

The Edinburgh study gives more credit to the interventions but concludes that when they are relaxed which must inevitably be done since governments cant hold people in lockdown forever anything that has been gained by the lock down is lost and maybe worse.

The consequence of some interventions, they warn, is that they suppress the first wave so that a second wave, occurring after the interventions have lifted, then leads to a total number of deaths that exceeds the total for the equivalent scenario without this additional intervention.

Both studies argue for protecting the elderly and others most vulnerable while growing herd immunity among younger citizens. If they are right, the U.S. might now be accidentally engaged in this practice given the Black Lives Matter protests that have drawn together large numbers of primarily young demonstrators.

As of this time, there have been no reports of deadly disease outbreaks tied to those protests, but there is no way of knowing how many people might have been infected who are asymptomatic and presymptomatic and destined to show up infections counts in the days ahead.

The Swedes, who have taken a beating for a more liberal response to dealing with the pandemic, generally followed the model suggested in the studies, but did a terrible job of protecting the elderly.

An estimated 90 percent of the 5,100 dead in Sweden are over 70 years old and three-quarters were in nursing homes or receiving home care, according to a report from Barrons magazine.

Swedish national epidemiologist Anders Tegnell described it as a weakness of the nations elderly care.

The Swedish death rate of 507 per 100,0000, according to the Worldometer COVID-19 tracker, is far higher than that of its Scandanavian neighbors, but less than that of Italy (573/100,000) and Spain (606/100,000) two countries that engaged in onerous lockdowns.

Swedens rate is less than a third that of New York (1,607/100,000) and near a third of that of New Jersey (1,467/100,000). A number of studies have flagged population density as a possible contributing factor there, but the latest studies point to age being a bigger issue.

Since being elderly is a risk factor for many diseases, and eventually death, and cannot be changed, political actions in future pandemics would likely need to focus on protecting these members of society first, Walach and Hockertz written. Apparently, closing schools and locking down countries is not the right method to preventdeaths.

The study is sure to be controversial.

Back in March, Dr. David Katz a specialist in preventative medicine and public health, and the founding director of Yale Universitys Yale-Griffin Prevention Research Center wrote an op-ed for the New York Times (NYT) suggesting that idea.

Not long after, Katz appeared on CNN where NYT Science and Health writer Donald McNeil called the op-end an extremely dangerous way of thinking and demanded the doctor take that paper back and apologize for it because I think it provided a scientific underpinning for (President) Donald Trump to say things like the cure is worse than the disease.

McNeil called for a lengthy lockdown to save lives, arguing were not going to be able to think about our 401Ks or take retirement at the time we want to. Were going to have to think about getting enough calories, for perhaps the next year until a vaccine is here.

McNeil seemed wholly unaware of economic realities. And a year-long down lockdown seems even more unrealistic now and then.

After a lockdown of only a couple months, the country has been split by the biggest protests since the Vietnam War as Americans, largely the young, demand racial justice, a noble goal no one is quite sure how to achieve in a society that has become only more tribal in the past decade.

Katz, meanwhile, is sticking to his original suggestion for dealing with SARS-CoV-2. He is continuing to call for a risk-based response to the disease.

Currently there is no guidance for what comes after flattening the curve,' he writes. It delays but does not prevent a spike in hospital need and mortality, unless maintained until a vaccine is available.

Everybody back to the world now means a high, unacceptable rate of severe infection and death among those at elevated risk.

Hunker in a bunker until theres a vaccine ignores the potentially massive adverse health effects of social determinants of health as lives, livelihoods, goods, services, and supply chains are disrupted and degraded.

He has been criticized as putting economics ahead of health, but the two new studies would suggest the equation is not that simple.

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CHICAGO, June 18, 2020 /PRNewswire/ -- With the COVID-19 pandemic interrupting non-urgent medical care, physicians are concerned that important gains in preventing colorectal cancer could be lost and their patients could miss out on life-saving preventive care or treatment.

Colorectal cancer is the second-leading cause of cancer death, yet it is highly preventable and treatable with screening and early diagnosis, said Laura J. Zimmermann, MD, MS, medical director of Rush's Prevention Center and assistant professor of Preventive Medicine and Internal Medicine at Rush Medical College.

"If it's caught early, it has a really high cure rate, but if by delaying we find something later, it may be harder to treat," she said.

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While Rush is starting to perform screening colonoscopies again, colorectal surgeon Dana Hayden, MD, MPH, associate professor and chief of the Division of Colon and Rectal Surgery at Rush Medical College, worries that the delay in care will linger and patients who had taken the important step of scheduling a colonoscopy may put off rescheduling and others who are due to be screened won't.

"We really don't know how long the delay could last," Hayden said. "Patients may be focused on more urgent matters than preventative care and may also be nervous about coming to the hospital while the pandemic continues."

That would reverse a positive, lifesaving trend:

The rate of people over age 50 who are up to date on colorectal cancer screening has improved greatly in the past several years, from 38% in 2000 to 66% in 2018, according to the American Cancer Society.

"As the rate of screening has increased in these age groups (over 55 years old), the incidence of colorectal cancer has decreased," Hayden said. And the mortality rate has declined as well.

Delayed screening means people will miss the opportunity to prevent or treat the disease early. That leads to a greater incidence of cancer, which is diagnosed at later stages with more severe symptoms and higher mortality, she said.

While it is impossible to know how much screening will be missed because of the pandemic, a look at the number of new colorectal cancer cases projected for 2020 in the U.S., two months with little or no screening theoretically could postpone diagnosis of cancer in 24,650 patients, among those some 9,860 cancers that may be at an advanced stage already.

Link:
Covid-related delays In colorectal cancer screening jeopardizes preventive care, early treatment - DOTmed HealthCare Business News

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For many residents of the Okanagan, the fatalities caused by illicit drug use may seem a distant problem with little to no impact on your life. However, everyone has a role to play in preventing overdoses.

BC has recorded the highest number of fatal overdoses in a single month, with deaths overtaking those due to COVID-19 in the whole year. During May, 170 individuals lost their lives due to illicit drug overdoses, where COVID-19 has caused 167 deaths in the entirety of 2020.

Of these overdose deaths, 82% involved fentanyl. Fentanyl is a strong opioid painkiller, 100 times stronger than morphine. It is often mixed with heroin or crack cocaine to enhance the effects, not always with the users knowledge.

Despite an initial reduction in overdose related deaths in 2019, fatalities have surged since the start of the pandemic. This is in part due to regular supply chains being cut off, and users having limited access to overdose prevention sites or drug checking services.

Interestingly, there were no deaths at supervised consumption or drug overdose prevention sites across B.C. in May, when these figures were released.

So what can you do?

There are several steps you can take to have a positive impact on the community in Kelowna, in terms of reducing harm caused by illicit drug use.

If you see someone in the street that looks like they could be having an overdose, stop and check theyre OK. If you feel uncomfortable doing this, call RCMP for a wellness check or 911 for an ambulance.

The signs of an overdose include not breathing or breathing very slowly, blue tinged lips or fingertips, an unusual gargling or snoring sound, or that the individual cant be woken and doesnt respond to pain.

If you see someone that could be overdosing, shake the person, shout at them and try to get a response to pain (squeeze their shoulder tightly in your hand). If theres no response, call 911 immediately.

Turn the individual on their side to prevent them from choking, and stay with them until help arrives.

To provide even more help, carrying and understanding how to use a naloxone kit is the best way to prevent deaths from overdose. The kits are free, and available from most pharmacies without a prescription. Carrying a kit in your car is a hugely important step in helping to save someones life; even if you dont feel comfortable using it, someone else at the scene may be able to.

Aside from saving someones life from the immediate effects of an overdose, there are other ways you can help in the bigger picture.

If you know someone that actively uses, support them in seeking help. Connecting with someone in the grips of addiction can be tough, but your support is vital in empowering them to get treatment and stay clean. Offer to accompany them to appointments, and ask them how you can help. Even alcohol addiction can lead to overdosing, so reach out now to anyone you know that is struggling.

Help to reduce the stigma around illicit drug use and overdosing by talking openly with your kids, teenagers and adult children about drug use. Discuss the reasons people use drugs, as well as the risks involved, to help reduce the likelihood of harm and encourage healthy behaviours.

The Okanagan has many supportive housing facilities and centres with drug overdose prevention sites or drug checking facilities. Although you may feel uncomfortable with one of these centres being in your neighbourhood, engage with the staff and residents at the centre to fully understand what it means to be tackling addiction, and how overdose prevention sites are helping. Many centres run community engagement days to help build bridges in the neighbourhood; even if you dont approve, educating yourself is key to understanding the reasons behind these facilities.

Overdoses are common, but they are also preventable. Empower yourself and your family to reduce stigma, help others and ultimately save lives.

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Every Married to Medicine cast member is a millionaire but does the newest addition really have a net worth of $500 million? Maybe at least she compared herself to someone with that fortune.

Buffie Purselleis married to a physician but has created her own empire as a personal finance and tax expert. She shared on CNBC in 2017 she built her net worth through a number of businesses shes created. She admits to working up to 12 hours a day and only sleeps a total of 40 hours per week.

Known as Buffie the Tax Heiress Purselle said, Im going to quote Beyonce when she said that she thinks she might be the black Bill Gates. I think I just might be the black, curvy, fabulous Marcus Lemonis-in-the-making. Marcus Lemonis has a net worth of $500 million. Shes undoubtedly a resourceful and powerful entrepreneur. However, other resources put Purselles net worth closer to $1 million.

Toya Bush-Harris and Dr. Heavenly Kimes both have a reported net worth of $4 million each. Kimes runs a successful dental practice in Atlanta who specializes in cosmetic dentistry. She often shares success stories on Instagram and patient transformation photos. Replacing missing teeth can restore your smile to optimal health, function and appearance. Dental implants are a great option for restoring your smile because the implants are designed to look, function and feel just like your natural teeth, and with proper care, they can last a lifetime, she recently shared along with a video.

RELATED: This Is How Much the Stars of Married to Medicine Make in Real Life

Bush-Harris is married to a physician and is a published author. She released the childrens book, SleepyHead Please Go To Bed!Bush-Harris created a tremendous social media following using the hashtag, #MommyChronicles.

Also worth $4 million is Mariah Huq who is a Married to Medicine creator and producer. Huq is married to Dr. Aydin Huq and she often entertains at her lavish home on the series.

Married to Medicine top docs all have a net worth ranging from $3.5 to $3 million. Dr. Simone Whitmore has a net worth of $3.5 million as one of the most sought after OB/GYNs in the Atlanta area. Whitmore is a mother of two and has been with husband Cecil for 23 years. Viewers witnessed the couple experiencing rocky moments throughout the series.

Dr. Jacqueline Walters has a net worth of $3 million is also a highly respected OB/GYN in Atlanta. Walters is a published author and a two-time breast cancer survivor. She also openly discussed her infertility on the series.

RELATED: After Hesitating To Start a Family With Her Ex-Husband, Married To Medicine Star Quad Webb Has Adopted a Daughter

Also, with a net worth of $3 million is Dr. Contessa Metcalfe. Metcalfe focuses her practice on preventative medicine and became friends with Dr. Britten Cole while in the Navy. Metcalfe became the crossover cast member between Married to Medicine and Married to Medicine Los Angeles.

Quad Webb is a millionaire in her own right. With a reported net worth of $1.5 million, Webb was a medical sales representative when she first joined the series. But now owns Picture Perfect Pup, a specialty brand designed for dogs. She was originally married to Dr. Gregory Lunceford but the couple has since divorced. Webb recently adopted a baby.

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Does a 'Married to Medicine' Cast Member Have a Net Worth of $500 Million? - Showbiz Cheat Sheet

Jeff Williams, chief operating officer of Apple Inc., speaks during an Apple event at the Steve Jobs Theater at Apple Park on September 12, 2018 in Cupertino, California.

Justin Sullivan | Getty Images News | Getty Images

Apple has grand ambitions to move into the health care field. The company's CEO Tim Cook once referred to health as the company's "greatest contribution to mankind."

In the last five years or so, the company has built up a big internal team staffed with doctors, health coaches, and engineers. It has developed health-focused software and hardware, and even started medical clinics for its own employees.

But with a concrete strategy and a biomedical breakthrough, such as non-invasive blood pressure or blood sugar monitoring, it could do a lot more. Ahead of its World Wide Developer Conference (WWDC) next week, here's what people in the health and technology sector think of Apple's influence and achievements so far -- and where it needs to go next.

Apple has a slew of products and services in health care.

Its primary product is the Apple Watch, and health is both a major use case and selling point. Its smartwatch device offers activity tracking, heart rate monitoring, an electrocardiogram to detect irregularities with the heart's rhythm, fall detection alerts, integrations with third-party health apps, and more.

The Apple Watch has other benefits, but overall, "the greatest use case for Apple Watch still remains health," said Ben Bajarin, an analystwith Creative Strategies specializing in consumer technology.

Henrik Berggren, founder of a diabetes-focused virtual medical clinic called Steady Health, said the Apple Watch is most helpful when it comes to tracking exercise and incorporating data from existing blood-sugar tracking devices. Many of Steady Health's patients already have Apple Watches or iPhones, and the group will look at that data in addition to their blood glucose levels and eating habits. "That exercise part they're doing quite well today," he says.

Beyond the Watch, vice president of technology Kevin Lynch is working to let customers bring medical information, including lab results and medical history, to their iPhones. That software, known as Apple Health Records, is continuing to make strides, but is still held back by the fact that consumers have to remember which doctors and hospitals they've been to in recent years and log into those systems separately.

The company has also developed software kits for third-party developers to build health applications. Among the most widely used is ResearchKit, which helps academics recruit people to their clinical trials via mobile devices.

Internally, Apple's California-based employees can use a health-care system known asAC Wellness. The company doesn't speak about it much and hasn't said whether it plans to expand those clinics to consumers more broadly. For now, it likely functions as a way for the health teams to learn about the practice of delivering medicine - and not just building tech.

During the Covid-19 pandemic, Apple teamed up with Google to release contact tracing technology for mobile phones, which public health researchers can use to build apps to track exposure to the virus. The company has seen the most traction for that in Europe and Asia.

Doctors have mixed feelings about the role of consumer health devices, including Apple's.

While some are bullish on their potential, others say that it's highly cumbersome for them to analyze this patient-generated information, and they don't currently get paid for the extra work. Many are simply refusing to look at data from wearable devices.

When John Koetsier, a technology consultant and writer, tried to share his Apple Watch data with a doctor, he was essentially told to keep it to himself. Koetsier had been tracking his food intake, weight and exercise on his own. But his doctor said that he had too many information sources already, and was feeling overwhelmed.

There are also questions about the accuracy of wearable devices when tracking health data.

"I trust Apple's step tracking, but heart rate I'm more concerned about," said Dr. Josh Emdur, a telemedicine doctor with SteadyMD. Emdur said he once admitted a patient into the hospital a few years ago because of an Apple Watch result, but it turned out to be a false alarm. He acknowledges that the data seems to have improved since then, and he's now using Apple Watches as a heart health screening tool. But he'll still recommend a medical device, like a Zio cardiac monitor, as a followup.

"To make the use- generated data actionable from devices like the Apple Watch, it needs to integrate better with electronic health record dashboard so a care team can see trends and it all comes in in a structured way," he said.

New York-based cardiologist Dr. Jeffrey Wessler says the Apple Watch offers more benefits than harms. "It really was a catalyst for the industry because it was the first time a consumer device began to infiltrate the clinical environment in a high volume way," said Wessler, who runs preventative heart health clinics called Heartbeat. "

But he notes that it can be frustrating patients come in with a concerning Apple Watch reading but no risk factors. In that case, there might not be a clear treatment pathway, and they're simply sent back home and told to come in if they develop symptoms.

"That's taking visits and time away from people who really need us," said Wessler.

Apple could make money in health by using it as a way to market and sell more of its devices. But there are much bigger opportunities in the $3.5 trillion health care sector.

The company has already announced partnerships with insurers, like Aetna, where users can "earn off" the cost of a device by engaging in healthy behaviors. It's also talking to some private Medicare plans about subsidizing the cost of the device for seniors.

Imagine if the company could somehow build a body of clinical evidence to get into the business of taking on risk for a population. If it can truly prove that it could improve the quality of care and bring down costs, that would be a huge opportunity. That vision would take many years to achieve, but it would certainly meet Cook's goal of having a major impact on health care.

Another game-changer would be if Apple can introduce more sophisticated sensors, including non-invasive glucose or blood sugar monitoring or a blood-pressure monitor. At that point, its device could reach a much bigger market -- 6 in 10 Americans - with one or more chronic diseases, as well as prevention. More than 1 in 3 Americans, for instance, are at high risk for type 2 diabetes.

"If they came out with a blood sugar or blood pressure monitor that was non-invasive and continuous, it would be a complete game changer," said Berggren. "That's what we dream about for the watch."

"I think there's a lot of opportunity for Apple still in the space," said Bajarin. "For me, it's really hinges on preventative health (as) that really expands the potential of the Apple Watch."

Other experts suggested the following areas where Apple should go next:

Better sleep tracking: "I'd love to see more in that direction," said Dr. CalvinWu, an endocrinologist with Steady Health. "They're just scratching the surface on sleep."

Telemedicine: Wessler, the cardiologist, believes that there needs to be an intermediary layer that helps triage patients. Instead of rushing to the emergency room or to a specialist, Apple could direct patients to an online visit and even offer its own video-based online medicine service.

More women's health focus: Several of the doctors wanted to see more thorough tracking for menstruation, fertility, and reproductive health.

More interoperability and integration with other medical devices: Apple already has close relationships with companies like Dexcom in the diabetes space, but the doctors agreed that it would be helpful to expand on that.

More validated clinical trialswould give Emdur, the telemedicine doctor, more confidence about the medical features in its products, including arrhythmia detection. Apple has done some trials, but it could double down.

Food logging: Helping people track the nutritional content of their food is another opportunity. Imagine snapping a picture of the food and algorithms figure out what's in the food. "It's a really hard problem but if anyone could solve it, that would probably be Apple," said Berggren.

More focus on seniors: The company has a fall-detection feature and many of its heart health features are useful to seniors, but it could do more to make its devices more accessible to older groups.

Apple Pay integrations: Apple could use its expertise in payments to help people navigate their health care bills.

More health features in Airpods: For Bajarin from Creative Strategies, that's an obvious move. It's easier to measure some vitals from the ear, which could make it a powerful health-focused wearable.

What's on your Apple Health wishlist? Let us know at @CNBCTech.

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Apple still has a lot of room to grow in the $3.5 trillion health care sector - CNBC

DURHAM, N.C. -- Speculation that a vaccine for COVID-19 might be widely available by the end of this year is overly optimistic, three Duke experts said Wednesday.

While there may be substantial scientific progress by the end of 2020, there will still be significant manufacturing hurdles to clear before a vaccine is available to most people, the experts said during a briefing for media.

Below are excerpts from the briefing:

David Ridley, health economist

Dr. Fauci is quite optimistic. I think optimism is good. I think optimism has a really important role. We need people within these companies being optimistic. If everyone sits back and talks gloom and doom nothings ever going to get done. So I respect that optimism.

But will you and I get vaccinated this year? No way. Its possible a vaccine will be approved this year. But not at scale. We wont have a lot of doses of this.

We might have some people vaccinated this year. But the average person wont be vaccinated this year.

Thomas Denny, chief operating officer, Duke Human Vaccine Institute

If youre going into a tough game, you need a coach thats getting the team revved up. We may have some good science by the end of the year and think we have some leading candidates. But manufacturing them to have it all administered, thats a tall order to be ready by the beginning of 2021.

Ooi Eng Eong, deputy director, Emerging Infectious Diseases Programme, Duke-NUS Medical School in Singapore

Once we get to the efficacy phase and ask the question of whether this vaccine will work to prevent infection, that depends on how common the infection is at that time. If the situation still goes on as it is, we shouldnt have any problem testing efficacy."

But if for whatever reason the prevalence of the disease goes down, it will take us a much longer time to assess efficacy.

Were not going to get rid of the coronavirus in a hurry. Its going to stay with us. Even if we can vaccinate people, protect them from infection the question is how long will immunity last?

If we think about using vaccines in stages, potentially we could get one, possibly at the soonest to me, about this time next year. Anything sooner than that is extremely optimistic. Others have said we could get it by the end of this year. Im an optimistic person, but Im not that optimistic.

David Ridley

Were preparing to manufacture at scale. Fortunately, some of these vaccine makers are already manufacturing now. Sanofi said theyre going to be able to make 100 million doses this year and a billion doses next year. Thats really unprecedented. Usually youd wait to see if your vaccine is having some success. If you think theres a 1-in-8 chance that youre going to get on the market, and youre already spending tens of millions, hundreds of millions of dollars, thats kind of crazy. But thats the crazy world we live in and I salute them for it.

Usually it takes years to manufacture. You want to be sure you got a good vaccine before you begin making it at scale. Typically this is going to take four or five years. Maybe now we can do it in one or two years. Part of this is going to depend on the appetite of these manufacturers to start building something now that they probably will never use.

My guess is this will take longer than people will assume because there will be a little bit of foot-dragging. If you drag your feet a little bit longer and make sure its a good vaccine, that its going to work before you make the huge investments in manufacturing, you can save a lot of money.

Thomas Denny

The duration of immunity post-vaccination is a major scientific issue were trying to understand. Were also trying to understand right now whats the duration of immunity after natural infection. That will help us probably understand how well or how well not vaccines will work for us.

One of the approaches were taking at the vaccine institute, were also exploring the potential development of a pan-coronavirus vaccine.

If we can develop a vaccine that would cover protection to all types of coronaviruses that may be a threat to us we think that would be a big benefit. Thats a longer-term goal for ours. Its 18 months to two years out. I dont think there are many playing in that space currently. Most are looking at the short-term COVID-19 pathogen and trying to get a rapid vaccine developed for that one.

Ridley

Its very common for the second product, a later product to be better than the first. Lipitor was fifth to market for cholesterol drugs and was arguably better than the previous four.

Its reasonable to expect that later entrants will be better. Assuming the virus is still with us and still a threat, Id expect other companies to continue product development.

Ooi Eng Eong

Obviously theres pressure. Theres pressure from the demand from the public for a solution so they can go back to some level of normality in their lives. Theres pressure from colleagues in the hospitals saying we need to deal with this.

Theres also competition from other groups working on vaccines. I think competition is good. It forces us to think harder to come up with better, more innovative ways of doing things. There is pressure but I think at some level of pressure is good to really push the boundaries.

Ridley

We need a lot of materials in this process. Some are very simple. Gowns and masks are pretty simple things. Swabs for diagnostics are pretty simple things. Rubber stoppers, medical glass sound pretty simple. But we really have a high standard for those because anytime we have something coming into contact with the vaccine thats going to go straight into your blood stream, we have a really high standard for sterility.

Sterile water always seems to be in shortage. Water should be easy to make. But it has to be sterile because its going straight into the bloodstream. We cant underestimate the importance of all these products along the line.

We might be a little concerned about hoarding. Theres cost to scaling up PPE. Theres cost to scaling up medical glass and rubber stoppers. Someone might hoard those. One of the vaccine manufacturers, one of the hospitals might try to grab those materials. Theres all sorts of parts in this process and if one of them breaks down, it slows the process of getting the vaccine to people."

Ridley

None of the major vaccine manufacturers will charge ridiculous prices. Theyre in this game to try to do good, to try to impress their employees, to try to impress their shareholders. Theyre not going to do that by charging ridiculous prices.

Ooi Eng Eong

Were testing (our vaccine) as a preventative vaccine. But is an intriguing possibility. Our fight against the virus relies on the body to recognize first of all its infected with the virus. It triggers a series of processes. So it is entirely possibly theoretically that because were using an RNA vaccine, the vaccine will trigger the processes that will allow the (body) to fight an RNA pathogen.

Weve only had this virus for seven months now. Theres a lot we dont know about this virus.

Think about it like a thief breaking into your house. If this person is very skilled at overcoming your alarm, they will be able to break into your house. If you have another system that can activate the alarm while the break-in is in process, you would actually trap the thief. So it is something that is possible.

Denny

Those with underlying medical conditions, and first-line responders. Hospital workers, theyre the highest priority. If we cant keep those folks going, were in trouble.

Faculty participants

Thomas N. DennyThomas Dennyis chief operating officer of the Duke Human Vaccine Institute, a professor of medicine and an affiliate member of the Duke Global Health Institute. His administrative oversight includes a research portfolio of more than $400 million. Denny has served on numerous committees for the NIH over the last two decades.thomas.denny@duke.edu

Ooi Eng EongOoi Eng Eongis a professor of medicine and deputy director of the Emerging Infectious Diseases Programme at Duke-NUS Medical School in Singapore. He also co-directs the Viral Research and Experimental Medicine Centre at the SingHealth Duke-NUS Academic Medical Centre (ViREMiCS), which studies therapies and vaccines against viral infections.engeong.ooi@duke-nus.edu.sg

David RidleyDavid Ridleyis a professor of the practice at Dukes Fuqua School of Business, where he is faculty director of the Health Sector Management program.He was lead author of the paper proposing a review program to encourage development of drugs for neglected diseases that became U.S. law in 2007.david.ridley@duke.edu

---Duke experts on a variety of other topics related the coronavirus pandemic can be found here.

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COVID-19 Vaccine in 2020 Highly Unlikely, Experts Caution - Duke Today