Daily Archives: June 4, 2021

Patients receiving dialysis are required to receive their treatments in clinics multiple times a week, meaning they were unable to effectively self-isolate.

Patients receiving dialysis treatments for kidney failure faced increased risks associated with the COVID-19 pandemic, according to a study published in the Clinical Journal of the American Society of NephrologyCJASN. These individuals are required to receive their treatments in clinics multiple times a week, meaning they were unable to effectively self-isolate.1

In order to conduct this study, investigators examined information on 5755 patients who received dialysis in London at 51 different clinics. Between March 2 and May 31, 2020, 17% a total of 990of the studied (17%) patients tested positive for COVID-19, and 465 (8%) were admitted to hospitals with suspected COVID-19. The risk of COVID-19 was higher in patients who were older, had diabetes, lived in local communities with higher COVID-19 rates, and received treatment at dialysis clinics that served a larger number of patients. Conversely, risks were lower for patients who received dialysis in clinics with a higher number of available side rooms and that had mask policies for asymptomatic patients. The researchers found no independent association with sex, ethnicity, or measures of deprivation.1

Taken together, the findings confirm the high rates of symptomatic COVID-19 among patients receiving in-center dialysis and suggest sources of transmission both within dialysis units and patients' home communities, said Ben Caplin, MBChB, PhD, in a press release. The work also suggests that in addition to isolation of confirmed cases, addressing factors that might reduce transmission from patients without suspected or confirmed disease might provide an additional opportunity to further modify the impact of COVID-19 in this population.1

The researchers note that the findings remained consistent when adjusting for community burden of disease, which suggests that COVID-19 disease risk associated with dialysis treatment overwhelms social and demographic factors. They recommend any planning for future waves of disease take account of how these results may be affected by the wider availability of testing patients that are asymptomatic, patients and those providing care using surgical facemasks, and the potential impact of vaccination and/or acquired immunity.2

REFERENCES

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Study: Patients Receiving Dialysis at Higher Risk of COVID-19 Infection - Pharmacy Times

Did COVID-19 originate with bats or scientists? Most experts continue to contend that the most likely origin of SARS-CoV-2 (the novel coronavirus that causes COVID-19) is a natural zoonotic spillover event between an animal reservoir (most likely bats) and humans. But over the last year of the pandemic, another theory has gained momentum: The SARS-CoV-2 virus may have resulted from an accident in a laboratory in China where scientists were working with closely related viruses. In the wake of the World Health Organization-led mission to Wuhan to examine the origins of the pandemic, proponents of the lab-leak theory have charged the investigative team with conflicts of interest, and suggested that the teams efforts failed to rule out the possibility of a lab release. Some have gone on to claim that scientists have maintained a conspiracy of silence about the possibility of a lab release in order to protect their funding or avoid a backlash from their government.

The desire to identify the origins of the novel coronavirus is perfectly understandable. COVID-19 has killed millions of people and upended everyday life. Theres an intuitive sense that finding out how the pandemic began might help to prevent another one from occurring. The Biden administration is redoubling efforts to determine the origins of COVID-19 after the intelligence community indicated that it had insufficient information to make a determination.

However, while answering the question of where the novel coronavirus came from is important, many of the most important policy decisions the United States needs to make to prevent future pandemics do not depend on viral origins. Very little about pandemic response or preparedness for future pandemics turns on the particulars of how this one started. Laboratory biosafety was already an issue before the pandemic, and the origins of this particular virus dont change the need for reform to prevent these rare but potentially catastrophic events. Regardless of how COVID-19 began, U.S. policy priorities should focus on both identifying and preventing the spread of zoonotic pathogens and bolstering safety and security in high-containment laboratories.

Preparing for the Next Pandemic

Whatever the origins of this pandemic, the United States has its work cut out to prepare for the next one. Lets assume, for the sake of argument, that the lab hypothesis is true. Efforts to prepare for natural spillover events do not then become less important. Since the 1940s, roughly 350 emerging infectious diseases have been identified. Of these, nearly three-quarters have zoonotic origins. Our understanding of how such diseases emerge is incomplete, but we know that there are a number of human behaviors that are likely contributing to this pattern: increasing demand for animal protein, factory farming and other agricultural intensification measures, wildlife trade, urbanization, extraction industries, changes in the food supply chain, and pet ownership, as well as increases in temperature, humidity, and other factors related to global climate change. Zoonotic crossover events are not limited to China, or even to Asia. Emerging infectious diseases have appeared all over the world: Zika in Latin America, Ebola virus disease in sub-Saharan Africa, H1N1 in bird reservoirs as disparate as Vietnam or Mexico; and henipaviruses in Australia. Coronaviruses have reservoirs in China, yes, but also in Africa, the Americas, the Middle East, and Southeast Asia.

If investigators are able to conclusively prove that the COVID-19 pandemic originated in a laboratory conducting research into coronaviruses, humanity will continue to confront the risk that a future spillover will result in another pandemic that is equally or more devastating. Fortunately, there are steps that the scientific community can take to manage this risk, including using predictive surveillance and developing other zoonotic risk-assessment tools. Early detection of such pathogens can help experts to isolate and contain them so that they do not spread widely. We can also promote behavioral change in high-risk populations and fund research into universal vaccines for zoonotic frequent-flyers like coronaviruses.

Lets say the converse is true, however. If evidence is found that satisfies even the most ardent lab-leak proponent that COVID-19 originated in an animal population, does that obviate the need to address laboratory biosafety and biosecurity? Absolutely not. Even as COVID-19 emerged, questions arose about the role of high-containment labs around the world. As the number of these labs increases, the risk of a consequential accident also increases.

Policymakers have debated biological safety in high-containment labs for most of this century. Biosafety, biosecurity, and awareness-raising among life scientists are ongoing topics of discussion at the Biological Weapons Convention. Biosafety is a major focus in the Global Health Security Agenda. The World Health Organization has maintained a guide for the responsible conduct of life sciences research with dual-use potential for more than a decade. In short, biosafety and biosecurity receive significant policymaker attention at the highest levels of international organizations, but that awareness doesnt necessarily translate into national-level action to manage biological risk and ensure protection from accidents. Even the states that have been most vocal in driving discussion of biosafety and biosecurity in international spheres have struggled with their own biorisk management. The United States has had a number of high profile laboratory incidents over the years, involving anthrax, highly pathogenic avian influenza, and smallpox, even as it has continued to develop and expand its high-containment lab capacity already the largest in the world.

Transparency and Biosecurity

Critics might claim that lab releases in the United States can be investigated transparently, while the potential COVID-19 release in China cannot. Indeed, China has put severe restrictions on research into the origins of the virus and prohibited scientists from speaking with journalists. During the World Health Organization-led investigation, members of the team were prevented from accessing patient data and other important research. After Australia pressed for an independent inquiry into the origins of the pandemic, China responded with threats and economic retaliation.

However, opacity surrounding public health is not a problem that is limited to authoritarian societies like China. Globally, biosafety norms are poorly implemented and reviews of biosafety and biosecurity are often conducted in secret. Even in the United States, there is no coordinated approach to laboratory biosafety or reporting laboratory accidents. As a result, public awareness of biosafety incidents often relies on local engagement between towns and specific labs, or comes from journalists filing Freedom of Information requests. The U.S. Government Accountability Office has consistently criticized U.S. biological security and safety for decades, but even recent developments in regulating the funding of potentially high-consequence gain of function research have been criticized as lacking transparency around the makeup of the review board, decision-making procedure, and notification of funded experiments. If this is the case for the United States, it is easy to imagine that other countries with less experience with biosafety and security might see it as politically advantageous to remain mum about incidents or problems. Clearly, more work is needed around the world to make sure that all countries have biorisk management policies and appropriate oversight measures in place, and that theyre open about the problems they encounter and their efforts to solve them.

Global norms and incentives are where the rubber hits the road for pandemic preparedness. Its reasonable in fact, vital to seek new ways to prevent laboratory accidents in the future. The worlds chief solution to this pandemic was the development of vaccines, a process driven by life sciences research, much of which took place in high-containment labs. Consequently, many political leaders may well choose to invest in more high-level biological research in the near future. If the solution to a lab release is more laboratory science, it makes sense to ensure that that science is carried out in a safe and secure manner. There is room for all countries to do better, and the United States should consider revitalizing its approach to promoting biosafety and biosecurity in the wake of the pandemic regardless of its origins.

As a final point, if the lab release hypothesis is true, we really shouldnt be surprised. An analysis in 2016 of gain of function research by Gryphon Scientific operated on the assumption that, eventually, a laboratory release of a potential pandemic pathogen would occur, a small number of those would lead to a local cluster, and a small number of those would seed a global pandemic. In other words, if COVID-19 did result from a lab release in China, it might simply have been bad luck, on top of whatever biosafety lapses China may have had which is all the more reason why, in addition to strengthening laboratory safety and security, the international community should do everything it can to develop appropriate infrastructure to handle a future pandemic.

Looking Ahead

There is one important scenario in which it would be absolutely vital to know the origins of COVID-19 in order to decide what to do next. If, as some scientists and politicians have suggested, the pandemic stemmed from a deliberate attempt to develop a biological warfare agent, this would have serious implications for the Biological Weapons Convention and the broader norm against the use of disease as a weapon. If a state party had violated its commitment to the treaty by developing biological weapons, the international community would need to determine how to hold that government accountable for its non-compliance a process with which states parties to the treaty have struggled in the past. Even treaties that have extensive verification provisions have grappled with what to do when a state party has demonstrably violated a treatys prohibitions. While some might criticize the Biological Weapons Convention for lacking a mechanism to verify compliance, such mechanisms dont solve the knotty political problem of what to do when flagrant violations take place. Moreover, the deliberate use of biological weapons could inspire copycat behavior by others, leading to the weakening of the norm against the use of disease as a weapon. Fortunately, to our knowledge no serious analysis of COVID-19s origins even from those who support a laboratory release hypothesis has concluded that anyone deliberately introduced the SARS-CoV-2 virus to the global population.

While its important to discover the origins of the pandemic, theres a danger in taking these efforts too far. Some have argued that conclusively demonstrating the pandemics origins in a lab release might help nations seeking to encourage China to pay financial reparations for the global economic cost of the virus to make their case. This could be a problematic approach. Not only is there no legal precedent under international law to hold a country liable for a pandemic, but in the long run this might be an unwise road for the United States, given its own history of laboratory accidents and safety lapses. Insisting that China bears responsibility for the pandemic and should be expected to pay compensation to other countries or the families of coronavirus victims could backfire in the future if the United States finds itself attempting to mitigate the consequences from a laboratory accident. Furthermore, legal efforts to blame China could fuel additional xenophobia against Asian-Americans, or even undermine U.S. foreign policy interests.

Meanwhile, the focus on where the virus came from should not divert attention from whats even more important preparing for the next pandemic. Political finger-pointing might make it far more difficult for researchers to collaborate internationally on pandemic preparedness efforts. Experts are already noting the possible implications for the National Institutes of Health and other research institutions of the growing tension between the United States and China, exacerbated by the allegations and skepticism around the viruss origins. This pandemic is far from over, despite the rollout of vaccines in the United States, and new potential pandemic diseases are already testing global health efforts elsewhere in the world. American experts therefore need to keep a laser-like focus on the real enemy: the causative agents of disease.

There will be far more blame to share if the international community becomes so fixated on the circumstances surrounding this unique case that its unable to see the big picture and predict or prepare for the next pandemic. Theres work that can be done in that respect while maintaining agnosticism about the origins of COVID-19. Regardless of the source, we need to be better prepared to respond to the next virus.

Amanda Moodie is a policy fellow at the National Defense Universitys Center for the Study of Weapons of Mass Destruction (WMD Center) in Washington, D.C. Her policy support at the center focuses on the international legal regimes that regulate the proliferation of chemical and biological weapons. She regularly serves as a member of the U.S. delegation to meetings of the states parties of the Biological Weapons Convention.

Nicholas G. Evans is an assistant professor in the Department of Philosophy at the University of Massachusetts Lowell, where he teaches biomedical ethics and security studies. He has been published in the British Medical Journal, Nonproliferation Review, and ELife. His book, The Ethics of Neuroscience and National Security, was released with Routledge in May 2021.

The views expressed in this paper are those of the authors and are not an official policy or position of the National Defense University, the Department of Defense, or the U.S. government.

Image: Xinhua (Photo by Fei Maohua)

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The Origin of COVID-19 and Preventing the Next Pandemic - War on the Rocks

IMMOKALEE

A heartbroken family in Immokalee is grappling with the loss of a fourth loved one to COVID-19.

Their father fought the virus for weeks and hoped to have a bilateral lung transplant, but Raul Diaz died last Saturday.

The Diaz family is preparing for his funeral, and they want to lay him to rest in style. He never got his dream car, so they hope someone with it can lead his funeral.

Its been a tragedy what weve been through, son Luis Diaz said.

In May, the family grasped onto faith. They cheered when their dad was his own battle with COVID-19 and was taken to Tampa from NCH.

Raul was approved for a bilateral lung transplant because COVID-19 destroyed his own. In order to have the surgery, he needed to get better first.

But now, the family is grieving their fourth loss to COVID-19.

My grandfather passed away. My uncle passed away. My grandmother passed away, and my father passed away Saturday, son Wilfredo Diaz said.

They want to make their dads dream come true even in death.

Theyre hoping someone out there has a 1957 Chevy Bel Air, their dads dream car, to lead the way during his funeral.

My father was my mechanic, my father was my electrician, my father was my plumber, my father was my everything, and when this first started, my car had messed up, and it was very difficult to not be able to reach out to him to come fix something for me, Luis said. I have depended on him my entire life, and it is very hard with what we are going through.

If you happen to own the Rauls dream car, the Diaz family would love to hear from you. They can be reached at (239) 503-0579.

The rest is here:

Immokalee family loses 4th loved one to COVID-19, have special wish - Wink News

Dr. Emond in 2008 had lured Dr. Kato away from the University of Miami, for his rare expertise in intestinal transplants and so-called ex vivo operations for cancer, in which the surgeon cuts out abdominal organs to get at hard-to-reach tumors, and then sews the organs back in. Most important, Dr. Emond saw in Dr. Kato a willingness to push the limits of what could be done surgically to help patients.

He brought his culture of innovation, Dr. Emond said. And his personal capability, his ability to work for long hours, never quitting, never giving up, no matter how difficult the situation, carrying out operations that many would deem impossible.

In his first year at Columbia, Dr. Kato and his team operated successfully on a 7-year-old girl, Heather McNamara, whose family had been told by several other hospitals that her abdominal cancer was inoperable. The surgery, which involved removing six organs and then putting them back in, took 23 hours.

More and more patients from around the country, and around the world, began seeking out Dr. Kato for operations that other hospitals could not or would not perform. He had also begun making trips to Venezuela to perform liver transplants for children and teach the procedure to local surgeons, and he created a foundation to help support the work there as well as in other Latin American countries.

As Dr. Katos colleagues struggled to save him, a waiting list of surgical patients clung to hopes that he would soon be able to save them.

Gradually, Dr. Pereira said, there were signs of recovery.

You come in early in the morning to see him, he said. The hospital hallways are empty and everybodys looking at each other, scared and anxious. You go into the intensive care unit dreading bad news, and the team is giving you a sort of hopeful thumbs-up that maybe hes looking better.

Dr. Kato spent about a month on a ventilator, and a week on ECMO. Like many people with severe Covid, he was tormented by frightening and vivid hallucinations and delusions. In one, he was arrested at the Battle of Waterloo. In another, he had been deliberately infected with anthrax; only a hospital in Antwerp could save him, but he could not get there. He saw the white light that some people describe after near-death experiences. I felt like I died, he said.

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When a Surgeon Became a Covid-19 Patient: I Had Never Faced the Reality of Death - The New York Times

The following are North Dakota's COVID-19 case rates, deaths and hospitalizations during the week of Saturday, May 29 to Friday, June 4.

From May 29 to June 4, North Dakota reported 285 additional positive cases, and active cases declined by 83 during the week.

As of Friday, Burleigh County had at least 80 people known to be infected with the virus the most of North Dakota's 53 counties. Following Burleigh County is Ward County with 54 cases, and Cass County with 43 known cases.

The state's rolling 14-day average positivity rate for its COVID-19 cases sits at 2.96%, the lowest since March.

ACTIVE HOSPITALIZATIONS AS OF JUNE 4: 24

DEATHS, NEWLY REPORTED: 0

TOTAL DEATHS THROUGHOUT PANDEMIC: 1,515

Hospitalizations steadily declined during the week of May 29, with 24 residents hospitalized because of COVID-19 as of Friday. The majority of those currently hospitalized in North Dakota due to COVID-19 are in their 60s and 70s.

Even though the Department of Health reported three additional COVID-19 deaths in the last week, no deaths have been reported in June so far.

FIRST DOSE ADMINISTERED AS OF JUNE 3: 294,624 (49.4% of population)

COMPLETED SERIES (TWO DOSES) AS OF JUNE 3: 275,383 (46.1% of population)

A total of 4,948 shots were administered from May 29 to June 3, the latest data available. The number of North Dakotans seeking vaccinations has stalled, and last month North Dakota sent 70,000 vaccine doses to other states because so few North Dakotans were seeking the shot.

On Friday, the Centers for Disease Control and Prevention urged parents to vaccinate their teenagers, because nationwide the hospitalization rate among adolescents has increased, according to the Washington Post. In May, the CDC updated its guidance and recommended that everyone 12 and older receive the vaccine. The Pfizer vaccine, after vigorous testing, was approved for adolescents last month.

The Department of Health urges residents to seek more information at http://www.health.nd.gov/covidvaccinelocator.

Readers can reach reporter Michelle Griffith, a Report for America corps member, at mgriffith@forumcomm.com.

As a public service, weve opened this article to everyone regardless of subscription status. If this coverage is important to you, please consider supporting local journalism by clicking on the subscribe button in the upper righthand corner of the homepage.

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North Dakota saw continuing decline in COVID-19 cases, hospitalizations in the last week - INFORUM

Produced by Lauren Leatherby, Craig Allen, Josh Holder, Allison McCann, Jeffrey Furticella and Andrew Rodriguez.

How fear, neglect and Covid-19 tore apart a single New Delhi neighborhood.

Asha lit up the neighborhood. The 54-year-old woman, who insisted people call her by one name, took care of neighbors when they got sick. She planted trees up and down the block. She was friendly with just about everybody at the local market.

When Covid-19 swept through Ms. Ashas New Delhi suburb, Nangli Vihar, the death toll didnt set any records. The neighborhood is not the poorest, the worst-hit or the most crowded in the city. It could have been any street in New Delhi.

But as the virus ricocheted from house to house, it did more than kill. With hospitals full and the government largely absent, fear began to spread. People shut their doors, shattering many of the relationships that make up a neighborhood.

Now New Delhi is starting to reopen after suffering one of the worlds deadliest outbreaks. We spent a week with the residents of a few close-knit blocks in Nangli Vihar as they begin to emerge from fear and isolation and often after tremendous loss.

Neeraj Kumar lost

his father on May 14.

Ms. Asha lived

on this street.

Birat Devi died

almost a week after

getting vaccinated.

People lined up outside a clinic,

complaining of fever and

Covid-like symptoms.

Someone died here

recently. Neighbors

suspect Covid.

Ajay Pal Singh and his family got Covid

in April after his wife returned from

a visit to a Hindu holy site.

Desperate for an income,

Shanno keeps her shop open

but faces stigma.

On this corner alone, more

than a dozen shops were

shuttered during the lockdown.

Mukesh Diwakar, a blacksmith, has

been out of work for almost two months.

His family sometimes goes hungry.

Ms. Asha lived

on this street.

Neeraj Kumar lost

his father on May 14.

Birat Devi died

almost a week after

getting vaccinated.

People lined up outside a

clinic, complaining of fever

and Covid-like symptoms.

Someone died here

recently. Neighbors

suspect Covid.

Ajay Pal Singh and his family got Covid

in April after his wife returned from

a visit to a Hindu holy site.

Desperate for an income,

Shanno keeps her shop open

but faces stigma.

On this corner alone, more

than a dozen shops were

shuttered during the lockdown.

Mukesh Diwakar, a blacksmith, has

been out of work for almost two months.

His family sometimes goes hungry.

Neeraj Kumar lost

his father on May 14.

Ms. Asha lived

on this street.

Birat Devi died

almost a week after

getting vaccinated.

People lined up outside a

clinic, complaining of fever

and Covid-like symptoms.

Someone died here

recently. Neighbors

suspect Covid.

Ajay Pal Singh and his family got Covid

in April after his wife returned from

a visit to a Hindu holy site.

Desperate for an income,

Shanno keeps her shop open

but faces stigma.

On this corner alone, more than

a dozen shops were shuttered

during the lockdown.

Mukesh Diwakar, a blacksmith, has

been out of work for almost two months.

His family sometimes goes hungry.

Neeraj Kumar lost

his father on May 14.

Ms. Asha lived

on this street.

Birat Devi died

almost a week

after getting

vaccinated.

People lined up outside

a clinic with fever and

Covid-like symptoms.

Someone died here

recently. Neighbors

suspect Covid.

This family got Covid

in April after a

visit to a holy site.

Mukesh Diwakar has

been out of work for

Here is the original post:

How Fear and Covid-19 Tore Apart One New Delhi Neighborhood - The New York Times

A federal relief program that recently ended contributed over $1.1 billion to the Tysons area to help workers.

The money came through the CARES Act, the COVID-19 relief package passed by Congress in 2020 that created the Paycheck Protection Program. In the area, it helped around 1,700 businesses, nonprofits, and sole proprietors with forgivable loans of $150,000 and more.

According to data from the Small Business Administration, which oversaw the program, the Tysons-area businesses and nonprofits that landed the most money in terms of a single award were:

Businesses that received less than $150,000 werent included in the $1.1 billion figure that Tysons Reporter calculated using SBA data. Other businesses may have also received multiple awards but arent part of the list of top awards for an individual loan.

The money was given in the form of forgivable loans. To be forgiven, at least 60% of the money must have gone to payroll.

Details regarding businesses that received the money are available through online databases, such as ProPublica and the SBA. The program ended Monday (May 31).

The Paycheck Protection Program provided over 8.5 million small businesses and nonprofits the lifeline they needed to survive during a once-in-[a]-generation economic crisis, SBA administrator Isabella Casillas Guzman said in a news release on Tuesday (June 1). Ive heard story after story from small business owners across the country about how PPP funds helped them keep the lights on, pay their employees and gave them hope.

The PPP rollout came with some controversy. After reports showed that some loans went to large corporations, hundreds of companies returned the money. The SBA says that 96% of the loans went to businesses with fewer than 20 employees.

Companies that received an initial PPP loan and met other criteria were able to get a second loan. The average amount awarded this year by the program overall was $42,000.

Original post:

Small business COVID-19 relief brought over $1B to Tysons area - Tysons Reporter

We're making this important information available without a subscription as a public service. But we depend on reader support to do this work. Please consider supporting independent journalism in Alaska, at just $3.69 a week for an online subscription.

Alaskas average daily case counts are now trending down significantly statewide. The state last month went from a high alert level to an intermediate alert level for the first time since September, indicating less spread and fewer cases overall, though a couple regions remain at a high alert level due to higher case rates.

By Thursday, at least 320,315 people about 53% of Alaskans 12 and older had received at least their first dose of vaccine. At least 281,397 people about 46% of eligible Alaskans were considered fully vaccinated, according to the states vaccine monitoring dashboard.

Also by Thursday, there were 20 people with confirmed or suspected cases of COVID-19 in hospitals throughout the state, far below a peak in late 2020.

Of the 44 cases reported among Alaska residents Wednesday, there were 10 in Anchorage; seven in Wasilla; seven in Juneau; five in Fairbanks; three in the Prince of Wales-Hyder Census Area; two in Tok; one in Chugiak; one in Eagle River; one in Seward; one in Soldotna; one in Nikiski; one in North Pole; one in Delta Junction; one in Palmer; one in Ketchikan; and one in Wrangell.

There was also one nonresident case in Anchorage as well as one in Wasilla.

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Tracking COVID-19 in Alaska: 46 cases and no deaths reported Thursday - Anchorage Daily News