China has imposed restrictions on the publication of academic research on the origins of the novel coronavirus, according to a central government directive and online notices published by two Chinese universities, that have since been removed from the web. Under the new policy, all academic papers on Covid-19 will be subject to extra vetting before being submitted for publication. Studies on the origin of the virus will receive extra scrutiny and must be approved by central government officials, according to the now-deleted posts.

A medical expert in Hong Kong who collaborated with mainland researchers to publish a clinical analysis of Covid-19 cases in an international medical journal said his work did not undergo such vetting in February.The increased scrutiny appears to be the latest effort by the Chinese government to control the narrative on the origins of the coronavirus pandemic, which has claimed more than 100,000 lives and sickened 1.7 million people worldwide since it first broke out in the Chinese city of Wuhan in December.

Since late January, Chinese researchers have published a series of Covid-19 studies in influential international medical journals. Some findings about early coronavirus cases -- such as when human-to-human transition first appeared -- have raised questions over the official government account of the outbreak and sparked controversy on Chinese social media. And now, Chinese authorities appear to be tightening their grip on the publication of Covid-19 research.

According to the directive issued by the Ministry of Education's science and technology department, "academic papers about tracing the origin of the virus must be strictly and tightly managed."

The directive lays out layers of approval for these papers, starting with the academic committees at universities. They are then required to be sent to the Education Ministry's science and technology department, which then forwards the papers to a task force under the State Council for vetting. Only after the universities hear back from the task force can the papers be submitted to journals. Other papers on Covid-19 will be vetted by universities' academic committees, based on conditions such as the "academic value" of the study, and whether the "timing for publishing" is right. The directive is based on instructions issued during a March 25 meeting held by the State Council's task force on the prevention and control of Covid-19, it said.

lurker wrote: Tue Apr 14, 2020 9:43 am while these developments are encouraging, this is far from over.

Exactly what’s going on with blood clots in at least some COVID-19 patients is a mystery. Chinese doctors were first to sound the alarm. In March, Chinese heart specialists advised the American College of Cardiology to watch for clots and said certain blood tests showing a rise in clot risk might signal which patients were in greatest danger. Other reports suggested the clots can show up all over the body. But were they a cause of deterioration or an effect?

Already, many hospitals are attempting preventive doses of blood thinners to keep clots from forming. There’s huge debate over what kind to try, what dose is safe — the drugs can cause dangerous bleeding — and how soon to start.

Specialists at the University of Colorado and Harvard recently published a similar tPA [clot busting drugs] research call and cited three additional cases in which it was tried, as hospitals in Colorado and Massachusetts prepare for a study. “We’re taking care of extremely ill patients that are dying in front of us, and we can’t get any diagnostic testing,” yet still have to make treatment decisions, said Dr. Steven Pugliese, a pulmonologist at the University of Pennsylvania.

The immune system normally uses proteins called cytokines as weapons in fighting a disease. For unknown reasons in some COVID-19 patients, the immune system first fails to respond quickly enough and then floods the body with cytokines, destroying blood vessels and filling the lungs with fluid. The doctors tried a drug called Actemra, which was designed to treat rheumatoid arthritis but also approved in 2017 to treat cytokine storms in cancer patients. “Our role was to quiet the storm,” said Dr. Samuel Youssef, a cardiac surgeon. “Dr. Padgett was able to clear the virus” once his immune system was back in balance.

Bisbee wrote: Tue Apr 14, 2020 2:53 pm Ha ha...
We should also prescribe a healthy dose of prunes. To help flush Covfefe-45 from our system.

California’s Roadmap to Modify the Stay-at-Home Order

He went on to outline six key indicators that will guide the state’s decision as it considers lifting the stay-at-home order:

“The ability to monitor and protect our communities through testing, contact tracing, isolating, and supporting those who are positive or exposed;
The ability to prevent infection in people who are at risk for more severe COVID-19;
The ability of the hospital and health systems to handle surges;
The ability to develop therapeutics to meet the demand;
The ability for businesses, schools, and child care facilities to support physical distancing; and
The ability to determine when to reinstitute certain measures, such as the stay-at-home orders, if necessary.”

Even once the stay-at-home order is lifted, Newsom said society won’t snap back to normal. For example, he said restaurants will likely have to limit capacity and face coverings in public will likely be common.

“There’s no light switch here. It’s more like a dimmer,” he said at a news briefing. “Normal, it will not be until we have herd immunity and a vaccine. You may be having dinner with the waiter wearing gloves and maybe a face mask...where your temperature is checked before walking in. These are likely scenarios.”

Newsom declined to offer a timeline on when the order might be lifted, but he told reporters that if the six requirements are met by the first week of May, “ask me the question then.” However, he cautioned that lifting the order too early could have dire consequences if the virus begins to spread rapidly. Ultimately, he said, society will have to remain vigilant at least until there is a vaccine for Covid-19, which is unlikely to be discovered and produced before 2021.

California’s relatively early and strict response to the outbreak appears to have paid off. While hundreds have died, it’s managed to avoid the situation of New York state, which has more confirmed Covid-19 cases than any country outside of the U.S. However, the stringent measures have come with consequences for the state of nearly 40 million people. California processed about 2.3 million unemployment insurance claims in the four weeks leading up to April 9, Newsom said last week, which is more than the total number of claims filed in 2019.

highdesert wrote: Tue Apr 14, 2020 9:29 am Police states - don't look for any unedited papers coming our of Iran or Russia either.

...on the April 6 phone call, members of the National Academy of Sciences' Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats told members of the White House Office of Science and Technology Policy there are issues with the availability and reliability of the antibody tests in the United States right now. "In three words: Work in progress," said Dr. David Relman, a member of the National Academy of Sciences committee who was on the call.
There are several layers of issues with the antibody tests.

First, the US Food and Drug Administration relaxed its rules, and now companies can sell antibody tests without submitting validation data that shows they actually work. The American Public Health Lab Association says that has resulted in "crappy" tests flooding the market. "It's like the wild, wild West out there -- or wild East," said association CEO Scott Becker, a reference to the fact that at least half the companies making these tests are in China. Becker said that in conference call Tuesday that FDA Commissioner Dr. Stephen Hahn said antibody tests would undergo scientific review by the National Cancer Institute. There has been concern that some of the tests might confuse the coronavirus causing the current pandemic with one of several coronaviruses that cause the common cold. "Lots of tests confuse the two," Relman said. The tests would then end up telling people they had antibodies to the pandemic coronavirus when they didn't, and people might think they're immune when they're not.

Second, there are good tests in the midst of the bad ones, but they're not yet widely and easily available throughout the country.

Third, it's not entirely clear that having antibodies to Covid-19 means that you truly have immunity and won't get the disease again. "That's the $64 question," said Dr. Harvey Fineberg, chairman of the NAS committee, who was also on the phone call with the White House. "Does antibody level equate to resistance to getting ill again?"

Fineberg added that antibody tests are important on a national scale, to gauge what proportion of the population might be immune, but also on a personal level. "Everybody wants to know -- am I immune? Can I now visit Grandma so that I'm not a threat to her and she's not a threat to me?" he said. "How do we discern the people who can now safely go out and about? That's an important personal and social question."

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, says experts "don't have all the answers" when it comes to antibodies.

In an interview on the "Today" show, Fauci was asked to comment on a report out of South Korea's CDC that found coronavirus had been reactivated in a number of patients thought to have recovered.

"We don't know how common that is," Fauci said. "It's likely an uncommon event and won't have a public health impact."

"The things that we don't know is that -- in general with viruses we deal with all the time -- when you develop an antibody after infection, it almost invariably means you're protected. We don't absolutely know that for sure yet," Fauci said.

He added there is also uncertainty about how long antibodies can protect a person.

"So are you protected for a month or two or three, a half a year or a year? We need to get experience to know that," Fauci said.

Abbott’s new antibody test could handle up to 20 million screenings in June

Abbott Laboratories launched its third test for the coronavirus and said it could be screening up to 20 million people for antibodies for Covid-19 by June. Abbott said it plans to distribute 4 million of the new antibody tests by the end of this month, after an initial shipment of 1 million tests this week to US customers, beginning Thursday.

“Antibody testing is an important next step to tell if someone has been previously infected,” Abbott said in a press release. “It will provide more understanding of the virus, including how long antibodies stay in the body and if they provide immunity,” the company said.

Abbott’s two other coronavirus tests, which only recently were introduced, determine whether a person has Covid-19 now. One of those tests can tell in 13 minutes or less if a person at a testing site is currently infected, while the other test is performed in labs.

The new antibody test announced Wednesday will reveal if a person also had been infected in the past, even if they were no longer sick.

K9s wrote: Wed Apr 15, 2020 12:10 pm JHU has a new US map at https://coronavirus.jhu.edu/us-map

You can view graphs by state. Georgia and others look really bad when you look at the death rate graphs. So does the entire USA as a whole.

New York City has drastically increased its estimate of the number of people killed by COVID-19 to include probable victims who were not tested. The new number is 10,367. For weeks, firefighters and paramedics have been recording a massive spike in deaths at home around New York City. The deceased were presumed to be victims of the coronavirus but were never tested. Now city officials have recalculated the toll that the virus has taken and reached a staggering number — adding nearly 4,000 to the total.

The increase shows that New York's outbreak is among the worst in the world, and it is sure to renew questions about whether the city should have shut its businesses and public schools sooner.

K9s wrote: Wed Apr 15, 2020 3:51 pm Remember when some people used to make fun of Tokyo citizens walking around with masks on? I expect this to be more common in the US from now on. When would you feel safe to NOT wear a mask and gloves in the near future in a big, crowded city?

As federal leaders and states coordinate with each other in an effort to develop a plan to lift social distancing, a study conducted at Harvard’s T.H. Chan School of Public Health indicates the measure may need to be practiced until 2022 without a vaccine. The research published Tuesday highlighted the fact that unlike its closest genetic relative, COVID-19 will likely resemble influenza and circulate seasonally after its initial global wave.

Researchers said if immunity to COVID-19 is not permanent, it will likely enter into regular circulation. Even long term immunization of 104 weeks, researchers said, could provide biennial occurrences of the virus. A permanent immunization would likely prevent a resurgence for at least five years if not much longer, the study said. Without a permanent vaccine, researchers suggested intermittent social distancing may need to be maintained into 2022 depending on the season. Without the measure, health care facilities could continue to be overwhelmed by the virus. Amid social distancing and without a vaccine, adding to critical care capacity allowed population immunity to grow more rapidly, the study said. In scenarios where capacity was doubled, the virus concluded by July 2022 and social distancing measures could be fully relaxed by early- to mid- 2021, depending on the degree of seasonal factors. The longer the virus exists, the longer the social distancing needs to be practiced, the study said.

Researchers also looked at the impact of one-time social distances efforts and the effect it had on the peak of the virus. Under all scenarios, there was a resurgence of the virus when the simulated social distancing measures were lifted without a vaccine.

A few weeks ago, I came down with a mild cough and a runny nose. I heard seasonal allergies were starting early and didn’t think much of it. The next day, I was exhausted and had a splitting headache. As a doctor, I was required to get tested for Covid-19 before I could go back to work in the emergency room. The result was positive.

Fortunately, I’m already back to feeling like myself. I was one of the lucky people with relatively mild symptoms. Now that I’m well, my blood could be used as an experimental cure for the new coronavirus [convalescent plasma]. But because of homophobia, that won’t happen.

The FDA says I can’t donate blood or plasma because I’m gay. In 1985, during the AIDS epidemic, the FDA placed a lifetime blood donation ban on all men who have ever had sex with men.

The policy was created to prevent blood banks from collecting blood that contains HIV. Since the AIDS crisis though, the US has instituted extensive procedures to test blood donations for infectious diseases, including HIV, to minimize this risk. It’s true that gay and bisexual men account for a large proportion of new HIV infections each year. It’s also true that tests to screen blood aren’t perfect. The risk of contracting HIV from a blood transfusion isn’t zero. But it is currently around 1 in 1.5 million.

The problem is that being gay isn’t the real risk factor here. Why should a monogamous gay man who has sex only with his husband be barred from donating blood when a heterosexual man who had condomless sex with 100 female partners in the past three months can? The latter is at dramatically greater risk of HIV infection.

Earlier this month, the FDA shortened the ban to three months of abstinence from sex with other men, due in large part to the drastic drop in blood donations since the start of the coronavirus pandemic. (Just prior, [Tammy] Baldwin and other senators, including Elizabeth Warren, Bernie Sanders, Cory Booker, and Kamala Harris, submitted another letter to the FDA asking them to end the discriminatory policy entirely.)

The new FDA guidance is a good but insufficient step forward. It’s still going to leave out the vast majority of men who have sex with men. And it still promotes the internalized homophobia many gay men experience from growing up in a homophobic society: You can only be good and pure if you don’t have gay sex. This is psychologically damaging, unscientific, and wrong.

The rules need to change and be based on scientific behavioral risk factors. “Instead of a blanket ban on recent sex between men, we need to explore an approach that asks all donors about their recent behaviors, including condom use, number of partners, and use of pre-exposure prophylaxis [PREP], which we know is highly effective in preventing HIV,” explains Dr. Julia Marcus, an assistant professor of population medicine at Harvard Medical School, where she studies the epidemiology of HIV. Such risk-based screening systems have been successfully implemented in Spain, Chile, Argentina, and South Africa. As written, the FDA rules aren’t supported by science. They simply discriminate against gay and bisexual men.

Plasma donations are critical. If the experimental treatment works, countless deaths from Covid-19 could be prevented. But in addition to plasma, the US also has a dire shortage of whole blood.

Due to social distancing, there have been 150,000 fewer blood donations since the pandemic began. More blood is leaving the blood banks than is coming in. This blood is desperately needed for trauma victims who are bleeding out, cancer patients undergoing chemotherapy, and children with sickle cell disease, to name a few in-need groups. Federal officials have been begging the public to donate blood. They should know that gay men like me are ready to roll up our sleeves and help.

America is in the midst of a public health crisis. Old homophobic policies are making it worse: leaving trauma victims without donor blood and withholding plasma donations that could potentially save people dying from the coronavirus. It’s time for the FDA to lift the ban and save lives. When they do, I’ll be the first in line.

Jack Turban MD, MHS is a resident physician in psychiatry at the Massachusetts General Hospital

In the first phone call convened between President Donald Trump and some members of his newly formed business council, industry leaders reiterated to the President what public health experts and governors have been telling him for weeks: that there would need to be guarantees of ramped-up coronavirus testing before people return to work, according to one person briefed on the discussions.

Six weeks after the president and other senior officials promised that any American would soon be able to get a test for coronavirus, testing continues to lag, prompting an escalating call from leading medical centers, lawmakers and others for the administration to put in place a coordinated national strategy.

Effective testing is considered essential before state and local governments can lift restrictions on Americans’ movements, reopening schools and businesses and allowing the nation’s faltering economy to recover. But multiple, persistent problems continue to sharply limit the number of tests that can be done.

“Right now, we are preventing the spread of the disease by extreme social distancing, by keeping people away from each other,” said Dr. Ashish Jha, director of the Global Health Institute at Harvard University.

“If we want to end that and let people interact with each other, we need to make sure infected people are not interacting with uninfected people. And the only way to know who is sick and pull them away from the uninfected is testing,” he said. “That is literally Disease Outbreak 101.”

Jha estimated that the U.S. would have to be able to run at least 500,000 tests per day before the current social distancing rules could be relaxed. That would be more than three times the current level, according to data from the COVID Tracking Project, which has been gathering state-by-state testing data.

President Trump, who in recent days has been urging a swift return to normal activity, suggested last week that more widespread testing wouldn’t be necessary and this week indicated he might try to force state and local officials to lift restrictions soon.

On Tuesday, however, the president appeared to back away from a confrontation with states while minimizing federal responsibility for testing failures. “The governors are supposed to do testing,” Trump told reporters at the White House. “It hasn’t been up to the federal government.” Dr. Anthony Fauci, who as the head of the National Institute of Allergy and Infectious Diseases has emerged as the federal government’s most trusted pandemic expert, cautioned Tuesday that testing would need to be more comprehensive before the current restrictions can be lifted. “We have to have something in place that is efficient and that we can rely on, and we’re not there yet,” Fauci said in an interview with the Associated Press.

Overall testing is also well shy of the promises made more than a month ago by Trump and other administration officials, including Health and Human Services Secretary Alex Azar, who told a Fox interviewer on March 4 that more than 1 million tests were being sent to “hospitals and labs and others who want that.”

As of Tuesday, the country had run a total of about 2.9 million tests since the outbreak began three months ago, according to the COVID Tracking Project.