About the public’s health
Cloth Masks May Prevent Transmission of COVID-19: An Evidence-Based, Risk-Based Approach: “When we apply the principles of evidence-based medicine to public policy, there is high-quality, consistent evidence that many (but not all) cloth masks reduce droplet and aerosol transmission and may be effective in reducing contamination of the environment by any virus, including SARS-CoV-2. No direct evidence indicates that public mask wearing protects either the wearer or others. Given the severity of this pandemic and the difficulty of control, we suggest that the possible benefit of a modest reduction in transmission likely outweighs the possibility of harm.” A major caveat: Effectiveness depends on the material, number of layers, how the mask is worn and how often it is used.
WHO warns that 1st wave of pandemic not over, dampens hopes: “As Brazil and India struggle with surging coronavirus cases, a top health expert is warning that the world is still in the very middle of the outbreak, dampening hopes for a speedy global economic rebound and renewed international travel.
‘Right now, we're not in the second wave. We're right in the middle of the first wave globally,’ said Dr. Mike Ryan, the World Health Organization's executive director.”
77 Nobel Laureates Denounce Trump Officials For Pulling Coronavirus Research Grant: “In an open letter to a top Trump Administration official, 77 Nobel prize-winning American scientists say they are ‘gravely concerned’ about the recent abrupt cancellation of a federal grant to a U.S. non-profit that was researching coronaviruses in China. The laureates say that the move, announced on April 24, ‘sets a dangerous precedent by interfering in the conduct of science’ and ‘deprives the nation and the world of highly regarded science that could help control one of the greatest health crises in modern history and those that may arise in the future.”
WHO says 80 million babies are missing out on routine childhood vaccines: As perviously reported, the COVID-19 pandemic has severely curbed needed routine immunizations, particularly for children. This article further quantifies how serious this problem is.
For Parents: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19: From the CDC: This publication explains the severe form of COVID-19 that can afflict children.
Safety of sugar substitutes remains inconclusive after years of research: The message is in the headline but the article offers a good summary of the data and current opinions.
‘This Is Not the Hunger Games’: National Testing Strategy Draws Concerns: “The Trump administration’s new testing strategy, released Sunday to Congress, holds individual states responsible for planning and carrying out all coronavirus testing, while planning to provide some supplies needed for the tests.
The proposal also says existing testing capacity, if properly targeted, is sufficient to contain the outbreak. But epidemiologists say that amount of testing is orders of magnitude lower than many of them believe the country needs.”
Here’s How Wuhan Tested 6.5 Million for Coronavirus in Days: And on a similar theme, why can Wuhan test so many people in such a short time and this country cannot do the same?
Findings from investigation and analysis of re-positive cases: From the Korean CDC:
○ Investigation and contact investigation have been completed for 285 (63.8%) of the total 447 re-positive cases (as of 15 May).
○ 59.6% were tested as a screening measure, and 37.5% were tested because of symptom onset. Of the 284 cases for which symptoms were investigated, 126 (44.7%) were symptomatic.
○ From the 285 re-positive cases, a total of 790 contacts were identified (351=family; 439=others). From the monitoring of contacts, as of now, no case has been found that was newly confirmed from exposure during re-positive period alone.” (Emphasis added)
The dynamics of humoral immune responses following SARS-CoV-2 infection and the potential for reinfection : “It is clear that most people infected with SARS-CoV-2 display an antibody response between 10 and 14 days after infection. In some mild cases, detection of antibodies requires a long time after symptoms, and in a small number of cases, antibodies are not detected at all, at least during the time scale of the reported studies. There is a paucity of information about the longevity of the antibody response to SARS-CoV-2, but it is known that antibodies to other human coronaviruses wane over time, and there are some reports of reinfection with homologous coronaviruses after as little as 80 days. Thus, reinfection of previously mild SARS-CoV-2 cases is a realistic possibility that should be considered in models of a second wave and the post-pandemic era. Obtaining longitudinal serological data where both binding titres and functional neutralization titres are stratified by age groups and previous disease severity status should be undertaken as a matter of urgency.”
SARS-CoV-2 infection protects against rechallenge in rhesus macaques: And one more article that may provide useful information in humans: “These data show that SARS-CoV-2 infection induced protective immunity against re-exposure in nonhuman primates.”
What Role Should Employers Play in Testing Workers?: Companies have an interest in their workers’ testing results for two reasons: They want them to return to work safely and they act as the insurer for many employees. “While public health experts and government officials have emphasized that widespread testing will be critical to reopening, there is little clear guidance from state and federal agencies on the role employers should play in detecting and tracking the coronavirus. As a result, businesses are largely on their own in sorting out whether to test — and how to do it — to reassure employees and customers. For now, many companies are just waiting.”
The government has spent decades studying what a life is worth. It hasn’t made a difference in the covid-19 crisis:”The calculation — known as Value of a Statistical Life or VSL — is the amount people are willing to spend to cut risk enough to save one life. The VSL at most federal agencies, developed over several decades, is about $10 million. If a new regulation is estimated to avoid one death a year, it can cost up to $10 million and still make economic sense…
Two key federal agencies that previously have used this type of research to support policy decisions under Trump — including the Centers for Disease Control and Prevention and the White House Office of Management and Budget, which oversees federal regulations — say they are not using this type of cost-benefit analysis in their response to the pandemic.” This measure is obviously very different from a Quality Adjusted Life Year (QALY) which economists generally value at $100 thousand.
About pharma
Japan delays approval of Fujifilm drug for treating coronavirus: “Japan has delayed the approval of an anti-flu drug as a potential coronavirus treatment after interim results from its first randomised clinical trial provided no solid evidence of its effectiveness.”
WHO halts hydroxychloroquine trial for coronavirus amid safety fears:”The WHO’s director-general Tedros Adhanom Ghebreyesus said in light of a paper published last week in the Lancet that showed people taking hydroxychloroquine were at higher risk of death and heart problems than those who were not, it would pause the hydroxychloroquine arm of its solidarity global clinical trial.”
Remdesivir for the Treatment of Covid-19 — Preliminary Report: “Remdesivir was superior to placebo in shortening the time to recovery in adults hospitalized with Covid-19 and evidence of lower respiratory tract infection.” Note the focus on hospitalized patients with evidence of lower respiratory tract infection.
About health insurance
Congress said COVID-19 tests should be free — but who’s paying?: This article raises a question I previously asked- who picks up the final bill if COVID-19 related services are”free” to the patient? The article explains a variety of practices but does not give any firm answers. Ultimately, the insurer is responsible but getting to that point is not straightforward.
CMS caps out-of-pocket insulin costs for Medicare: “CMS is capping out-of-pocket insulin costs for Medicare beneficiaries at $35 per month, the agency said May 26.
More than 1,750 standalone Medicare Part D prescription drug plans will offer the lower insulin copays through the Part D Senior Savings Model for the 2021 plan year.”
About healthcare IT
COVID-19 contact tracing text message scams: This warning comes from the FTC and has examples of scams.
Money still makes the cyber-crime world go round - Verizon Business 2020 Data Breach Investigations Report is live: “Basic human error accounted for 31 percent of Healthcare breaches, with external breaches at 51 percent (up from 42 percent in the 2019 DBIR), slightly more common than insiders at 48 percent (59 percent last year). This vertical remains the industry with the highest number of internal bad actors, due to greater access to credentials.”