Friday, May 8, 2020

Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19

https://www.nejm.org/doi/full/10.1056/NEJMoa2012410


Conclusions

In this observational study involving patients with Covid-19 who had been admitted to the hospital, hydroxychloroquine administration was not associated with either a greatly lowered or an increased risk of the composite end point of intubation or death. Randomized, controlled trials of hydroxychloroquine in patients with Covid-19 are needed. (Funded by the National Institutes of Health.)
 

Justice Department drops criminal case against Michael Flynn


Trump puts political goals above facts in CDC and Flynn dramas

https://edition.cnn.com/2020/05/07/politics/donald-trump-coronavirus-cdc-michael-flynn-william-barr-russia-investigation/index.html

 President Donald Trump has spent three years discrediting and sidelining institutional sources of facts, truth and trust that threaten his political and personal goals.
Rarely has that mission combined in a single day to such a grave result as it did this week. The White House rejected new Centers for Disease Control and Prevention guidance on safely reopening the country -- with US deaths from the coronavirus surpassing 75,000 -- and the handpicked officials leading the Justice Department dropped charges against former national security adviser Michael Flynn.
Both cases show how Trump disdains government structures meant to dispense independent and fact-based policymaking, science and justice free from corrupting political influences.

Thursday, May 7, 2020

Silent hypoxia: Covid-19 patients who should be gasping for air but aren't

https://edition.cnn.com/2020/05/06/health/happy-hypoxia-pulse-oximeter-trnd-wellness/index.html

 In hospitals around the world, doctors are shaking their heads in disbelief as they watch Covid-19 patients who should be comatose or "seizing" from hypoxia -- a lack of oxygen in the body's tissues -- check social media, chat with nurses and barely complain of discomfort while breathing.
 
Some have dubbed them "happy hypoxics," a terrible misnomer for what could be a long, slow recovery -- or worse.
The proper medical term is "silent hypoxia." It happens when people are unaware they are being deprived of oxygen and are therefore showing up to the hospital in much worse health than they realize.
Typically, these patients have experienced some Covid-19 symptoms for two to seven days before they show up at the hospital complaining of sudden chest tightness or an inability to breathe deeply, said Dr. Richard Levitan, who's been an emergency room physician for some 30 years.
 
There he watched patients come into the emergency room with blood oxygen levels as low as 50%, so low they should have been incoherent, even unconscious. Normal blood oxygen saturation is between 95% and 100%, and anything below 90% is considered abnormal.
 
 
"We found two out of three patients can avoid a ventilator during the first 24 hours by putting them on oxygen and doing these positioning maneuvers, such as laying them prone on their stomach," he said.

Republicans praise Trump's pandemic response with Senate majority at risk

https://www.politico.com/news/2020/05/06/senate-republicans-trump-coronavirus-response-240454


Senate Republicans are settling on their pandemic message as they fight to save their majority: President Donald Trump did a tremendous job.
The coronavirus has killed more than 70,000 Americans, tanked the once-soaring U.S. economy and shows no signs of abating. And Trump’s ineffective leadership is largely to blame, say Democrats who are growing optimistic they can seize the Senate after being relegated to the minority for six years.

After POLITICO reported that candidates received a memo instructing them to blame China and not defend Trump on the coronavirus, the Senate GOP campaign arm publicly rejected the strategy and made clear that Republicans are sticking with the president.

Trump boosters: Don’t believe the coronavirus death toll

https://www.politico.com/news/2020/05/07/trump-death-toll-coronavirus-241819


 
More than 70,000 Americans have died from the coronavirus — if you believe the government.
An increasing number of conservatives are convinced the medical community and the media are inflating the coronavirus death toll for political purposes, despite nearly all evidence indicating that, if anything, the figure is an undercount. 

Young said conservatives were more likely to distrust outlets running with the death toll offered by leading researchers.
“Why would a conservative, Republican, or Trump supporter, after seeing those consistent left-leaning commentary decisions, continue to view that source as unbiased and trustworthy?” he said.
Politics aside, Lobelo said the factor driving people’s suspicion of the models “all boils down to uncertainty.”
“The scientists are used to uncertainty because that's how we operate. That's part of the scientific premise of trial and error until you have a better understanding of the complex issue,” he said. “But for regular day-to-day people, uncertainty is more difficult to tolerate.”

The doctor making Trump queasy

https://www.politico.com/news/2020/05/07/world-health-organization-tedros-adhanom-ghebreyesus-242030


As head of the World Health Organization, Tedros Adhanom Ghebreyesus has achieved what he set out to accomplish: injecting politics into public health and casting it as “a political choice.”
With the coronavirus crisis, the former Ethiopian foreign minister who took over the WHO in 2017 has got far more than he bargained for.

 Now, as Tedros leads the global response to a worldwide pandemic in an age of rising nationalism and shifting world order, his message is: "Please don't politicize this virus.”

With the death toll mounting and the economic costs of lockdowns beginning to bite, he finds himself caught between two of the United Nations health agency’s most powerful members.

One, the United States, is the WHO’s biggest single source of cash. The other, China, is a major supplier of the medical equipment and machinery that will be needed to bring economies back online. It’s also the original epicenter of the pandemic — and thus key to understanding the virus that’s brought the globe to its knees.

Trump Won't Wear a Mask & Backpedals After Task Force Backlash | The Daily Social Distancing Show


China’s Coronavirus Vaccine Drive Empowers a Troubled Industry

https://www.nytimes.com/2020/05/04/business/coronavirus-china-vaccine.html

China wants to beat the world in the race to find a coronavirus vaccine — and, by some measures, it is doing just that.
Desperate to protect its people and to deflect growing international criticism of how it handled the outbreak, it has slashed red tape and offered resources to drug companies. Four Chinese companies have started testing their vaccine candidates on humans, more than the United States and Britain combined.

There's No Good Way to Make China 'Pay' for the Pandemic | Opinion

https://www.newsweek.com/theres-no-good-way-make-china-pay-pandemic-opinion-1501910

 President Donald Trump wants China to pay for the destruction COVID-19 has wrought. After initially praising China's approach to the now-pandemic illness, Trump has recently taken a far harsher line on Beijing. "We're doing very serious investigations," he said at a press conference last week, "and we are not happy with China."
The extent of Beijing's culpability is yet to be determined, but Trump is correct that its early mishandling of COVID-19 had dire consequences, both within China and around the world. It's also true that many of Beijing's failings here, like its suppression of inconvenient information and deliberate public deception, are characteristic of its unreformed authoritarianism.
But granting those realities leaves open the question of whether there's any meaningful, feasible and prudent way to exact reparations from China. Any policy of making China pay should go beyond political theater, be realistically achievable and not—to borrow a recent favorite phrase of Trump's—make the cure worse than the problem. Unfortunately, such an option for retribution probably doesn't exist. It's certainly not among the ideas presently on the table.

As U.S. investigations shed new light on Beijing's responsibility for COVID-19's spread, the Trump administration should consider how it can put that information to better use than retribution doomed to either futility or self-harm. The wisest course is to diplomatically leverage evidence of culpability for more transparency and information-sharing going forward. If the first COVID-19 vaccine is developed in China, as is entirely possible, we want access to it. Likewise, if another pandemic illness originates in China, we want to avoid a repetition of this one's lost time and opportunities. The proper goal of holding Beijing accountable, then, isn't payback but preventing another global catastrophe and mitigating this one.

China Criticizes Pompeo Over Coronavirus Wuhan Lab Allegation, Claims Leaked GOP Memo Discredits Trump Theory

https://www.newsweek.com/china-criticizes-pompeo-over-coronavirus-wuhan-lab-allegation-claims-leaked-gop-memo-discredits-1502426
 
Hua cited a recently leaked 57-page memo, written by a top GOP strategist and sent by the National Republican Senatorial Committee, advised the party's candidates to aggressively attack Beijing when publicly addressing the pandemic.
 
The April 17 memo, titled "Corona Big Book," details suggestions on how to link Democratic candidates to the Chinese Communist government, as well as ways to handle allegations of racism from critics. The document provides for three main talking points: Democrats do not adequately hold China to account, Beijing is responsible for the virus because they covered it up and Republicans will retaliate by pushing for sanctions.

No lockdown, but ministers ban bonfires, close off Meron ahead of Lag B’Omer

https://www.timesofisrael.com/no-lockdown-but-ministers-ban-bonfires-close-off-meron-ahead-of-lag-bomer/

 Ministers on Wednesday night reportedly gave the green light to a ban on lighting bonfires and to seal off the Meron pilgrimage site in northern Israel ahead of next week’s Lag B’Omer festival, to prevent gatherings amid fears of a fresh outbreak of the coronavirus.

Coronavirus Task Force Gets Its ‘Mission Accomplished’ Moment

https://www.nytimes.com/2020/05/06/opinion/coronavirus-trump-taskforce.html?action=click&module=Opinion&pgtype=Homepage

 By Wednesday morning, Mr. Trump had changed the contours, though not the essence, of his plan. In a tweet thread, he said the coronavirus task force would, in fact, “continue on indefinitely” but shift its efforts — and most likely some of its members — to “focus on SAFETY & OPENING UP OUR COUNTRY AGAIN.” He closed with, “The Task Force will also be very focused on Vaccines & Therapeutics. Thank you!”
Whether dissolved or repurposed, the White House Task Force focused on coordinating the administration’s public-health response to the pandemic is soon to be no more. To which we can only say: No big loss.
 
In theory, bringing together a collection of experts to oversee a coordinated federal response to a national emergency makes perfect sense. In practice, the first phase of Mr. Trump’s coronavirus task force was its own form of disaster.
For starters, the president made clear early on that he wasn’t interested in marshaling a coordinated response. Time and again, he ducked responsibility, pushing it off on the governors. On challenges ranging from acquiring critical medical supplies to coordinating and expanding testing (which remains a problem) to managing social-distancing restrictions, the task force has provided consistently uneven guidance and insufficient assistance.

 Mr. Trump often has undermined the recommendations it has made. Whether pushing dangerous treatments of unproven efficacy or urging his supporters to protest the basic social distancing guidelines put forward by the task force, the president has repeatedly scrambled the public-health message.

President Trump vetoes Iran war powers resolution

https://www.jpost.com/breaking-news/president-trump-vetoes-iran-war-powers-resolution-627170

 US President Donald Trump on Wednesday vetoed legislation that intends to limit his ability to wage war against Iran. The bill passed both chambers of Congress with the support of a few Republican members but lacked enough votes to get a veto-proof majority.
 The resolution, which passed the House of Representatives in March and the Senate in April, was the latest effort by Congress to wrest back from the White House its constitutionally guaranteed authority to declare war.