Daily Archives: September 6, 2021

HAMILTON A Butler County judge sided with a local hospital and reversed a previous court order forcing it to honor a prescription of ivermectin, which infectious disease experts have warned against as a COVID-19 treatment, for a patient who has spent weeks in the ICU with the disease.

After two days of testimony and arguments, Common Pleas Judge Michael Oster issued an order Monday siding with West Chester Hospital. He said the hospital bears no duty to honor a prescription written for Jeffrey Smith, 51, for ivermectin, a drug used as a dewormer in horses and an anti-parasitic in humans.

The drug has surged in popularity as a COVID-19 treatment, egged on by conservative politicians and media figures, despite adverse warnings from the Centers for Disease Control, the Food and Drug Administration, the American Medical Association, the drugs manufacturer and others.

This Court is not determining if ivermectin will ever be effective and useful as a treatment for COVID-19, Oster said.

However, based upon the evidence, it has not been shown to be effective at this juncture. The studies that tend to give support to ivermectin have had inconsistent results, limitations to the studies, were open label studies, were of low quality or low certainty, included small sample sizes, various dosing regiments, or have been so riddled with issues that the study was withdrawn.

Julie Smith brought the lawsuit on behalf of her husband, Jeffrey Smith, who tested positive for COVID-19 and was admitted to the ICU July 15, where he remains today. He has been sedated, intubated and on a ventilator since Aug. 1.

The hospital refused to honor the prescription, prompting the lawsuit. On Aug. 23, another judge wrote an order demanding the hospital administer the ivermectin as prescribed. Mondays order nixes the August order.

Julie Smith testified that neither she nor her husband were vaccinated against COVID-19. She said it was experimental, so she didnt trust it.

We didnt feel confident it had been out long enough, she said during a hearing Thursday.

She later connected with Dr. Fred Wagshul, a founding physician of the Front Line COVID-19 Critical Care Alliance, a nonprofit that touts ivermectin as a wonder drug. Wagshul is a licensed physician but is not board certified within any specialty and hasnt worked in a hospital for 10 years, according to his testimony.

He prescribed Jeffrey Smith 21 days worth of ivermectin without reviewing Jeffrey Smiths clinical information or talking to any of his treating physicians. He said the pharmaceutical industry and U.S. government have smeared ivermectin and censored its allegedly undeniable beneficial value.

However, when asked if it had benefitted Smith, he hedged.

I honestly dont know, but the rule of thumb is, when something is working, you dont stop it, he said.

Several witnesses for the hospital cast doubt on Wagshuls testimony and credibility as a physician. Dr. Ferhan Asghar, a surgeon and chief of staff at the hospital, said a physician who is not board certified would never be admitted to practice at West Chester, per hospital policy. He said it was also a concern that a physician would issue such a controversial prescription without seeing the patient or reviewing his information.

Dr. Jaime Robertson is an infectious disease physician who sits on a committee at UC Health, which staffs West Chester Hospital, to review available evidence to guide treatment for COVID-19 patients. He said the evidence doesnt necessarily conclude ivermectin doesnt work; instead, he said ivermectin bears risks just like any treatment but theres no conclusive evidence to show enough benefit exists to outweigh that risk.

I think the problem here is there are conflicting outcomes in public health literature, he said.

Dr. Daniel Tanase, Jeffrey Smiths treating physician, disputed any notion that the ivermectin demonstrably helped his patient, and said theres not enough evidence to support the use of ivermectin on COVID-19 patients.

We follow science and we follow what the guidelines are, he said. So yes, I dont think ivermectin is what he needs at this time.

On Aug. 26, the CDC issued a health alert warning of a five-fold increase of calls to poison control centers regarding ivermectin exposure compared to a pre-pandemic baseline. These included exposures related to topical and veterinary formulations of the drug.

Clinical effects of ivermectin overdose include gastrointestinal symptoms such as nausea, vomiting, and diarrhea, the CDC states. Overdoses are associated with hypotension and neurologic effects such as decreased consciousness, confusion, hallucinations, seizures, coma, and death. Ivermectin may potentiate the effects of other drugs that cause central nervous system depression such as benzodiazepines and barbiturates.

Several other federal authorities have issued similar warnings. Even Merck, which manufactures the drug, issued a statement in February affirming its position that theres no scientific basis for a potential therapeutic effect against COVID-19 from ivermectin. The company also noted a concerning lack of safety data in the majority of studies.

Areview of available literature conducted in August by the journal Nature found theres no certainty in the available data on potential benefits of ivermectin.

Ohio Hospital Association President Mike Abrams said in a statement before Oster issued his order stating there is insufficient data to support ivermectin as a treatment for COVID-19. He called the initial order concerning in regards to forcing a hospital to use a drug unapproved for use.

OHA believes it is an extraordinarily dangerous precedent for judges to practice medicine and order unproven medical treatments over the objections of highly-trained clinicians and against all standards established by the medical community, Baker said.

Bill Paiobeis, an attorney for West Chester Hospital, declined comment Monday, citing the potential for an appeal.

Ralph Lorigo, an attorney representing Smith, said he won the lawsuit in a way. He said Jeffrey Smith obtained 13-days worth of ivermectin, and the hospital has since told Julie Smith that theyre ready to begin to ween him off the ventilator.

Julie has won this case; I dont care what this judge says, Lorigo said in an interview. We are believers hes going to survive because of ivermectin.

He said hes not planning any appeal as one would effectively be moot.

This is a man who has been helped by the medication, and this is a judge who just doesnt get it right, Lorigo said.

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Judge reverses order forcing hospital to give ivermectin to COVID-19 patient - Ohio Capital Journal

Kentucky saw its fourth highest number of new coronavirus cases Friday and again set new records for Covid-19 hospitalizations, intensive-care-unit and ventilator use, prompting Gov. Andy Beshear to call this "one of the most dangerous times we've had in this pandemic."

"I hope I can convey how real this is," Beshear said in a Facebook post. "I hope that we'll see more people out there wearing masks when they're in public, but indoors. Folks, it is a scary time -- definitely if you are unvaccinated, but if you are vaccinated too. Please get your shot of hope; put on your mask. We need everybody's help to stop this."

The state reported 5,111 new cases Friday, with 1,547, or 30 percent, in people 18 and under. The seven-day average is 4,282, a new high.

The share of Kentuckians testing positive for the virus dropped for the third straight day, to 13.17%. Beshear said Thursday that the drops are likely due to more testing.

Kentucky's infection rate is third in the nation,accordingtoThe New York Times. Only Tennessee and South Carolina have higher rates. The Times reports that Kentucky's daily average number of cases has risen 34% in the last two weeks.

The state says its daily rate of new cases over the last seven days is 89.89 per 100,000 residents. Counties with double that rate areOwsley, 262.1; Perry, 226.8; Leslie, 224.2; Bell, 219.5; Clay, 211; Whitley, 195.4; Russell, 183.3; and Breathitt, 179.8.

All but three counties remain in the red zone, for counties with more than 25 daily cases per 100,000 residents, considered a high level of transmission. They are Woodford, Trigg and Carlisle counties.

Kentucky hospitals reported 2,365 Covid-19 patients; 661 in intensive care, and 425 on mechanical ventilation.

All but two of the state's hospital readiness regions are using more than 90% of their staffed intensive-care beds, with the Lake Cumberland region and the western region that includes Owensboro and Hopkinsville at 100% capacity.

The state reported 24 more Covid-19 deaths Friday, bringing the death toll to 7,845.

Hazard ARH Regional Medical Center's morgue reached capacity on Wednesday night,accordingto a hospital news release posted on the hospital'sFacebookpage.Engle-Bowling Funeral Homein Hazard is providing additional morgue space as families make their funeral arrangements.

"This morgue capacity issue is a tragic consequence of this pandemic that could easily be prevented if more people would choose to be vaccinated against Covid-19 and take other precautions to help protect themselves and limit the spread of the virus to others by wearing a mask while indoors and social distancing," Dr. Maria Braman, ARH chief medical officer, said in a news release.

Vaccination rates have inched up in Kentucky, showing a 9% increase in the last seven days, with an average of 14,642 doses per day administered,accordingtoThe Washington Post.

The percentage of Kentuckians 18 and older who have received at least one dose of a vaccine is 69% and 57% of the total population has received at least one dose.

Other pandemic news Friday:

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Beshear calls it 'a scary time' because Covid-19 case average and hospital numbers hit new high; many intensive-care units full - Times Tribune of...

BAINBRIDGE, Ga. A Georgia couple who were well-known business owners in their small community died on the same day of COVID-19.

Edwin (66) and Linda (58) McCullers both died at Memorial Hospital in Bainbridge on Aug. 28.

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Edwin McCullers was the owner of Flint River Outfitters, which sells hunting, fishing and other outdoor equipment. The business was closed until further notice after his death. Linda McCullers owned a hair salon.

The couple contracted the virus in mid-August.

They were both of the Methodist faith.

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There were dozens of tributes to the couple on social media.

Edwin and his dear wife Linda McCullers were two of the hardest working people I ever knew, one friend wrote on Facebook. They built several highly successful businesses over the years, but they always took the time to personally attend to each customer.

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The family encouraged everyone to wear masks in their joint obituary. Their funeral service will be private.

Bainbridge is a close-knit community that is home to around 13,000 people. It is the county seat of Decatur County and the hometown of UGA head football coach Kirby Smart.

A total of 66 people in Decatur County have died of COVID-19 since the start of the pandemic.

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South Georgia couple who were business owners die of COVID-19 on the same day - WSB Atlanta

FRANKFORT, Ky. -- Democratic Gov. Andy Beshear announced Saturday that he's calling Kentucky's Republican-led legislature into a special session to shape pandemic policies as the state struggles with a record surge of COVID-19 cases and hospitalizations.

The return of lawmakers to the state Capitol starts Tuesday and marks a dramatic power shift in coronavirus-related policymaking in the Bluegrass State following a landmark court ruling. Since the pandemic hit Kentucky, the governor mostly acted unilaterally in setting statewide virus policies, but the state Supreme Court shifted those decisions to the legislature.

Now, that burden will fall in large part on the General Assembly," Beshear said Saturday. "It will have to carry much of that weight to confront unpopular choices and to make decisions that balance many things, including the lives and the possible deaths of our citizens.

Beshear had sole authority to call a special session and set the agenda. At a news conference Saturday, he outlined pandemic issues he wants lawmakers to consider, including policies on mask-wearing and school schedules amid growing school closures due to virus outbreaks. But GOP House and Senate supermajorities will decide what measures ultimately pass.

Beshear told reporters Saturday he's had good conversations with top GOP lawmakers and that draft legislation was exchanged.

Republican House Speaker David Osborne said the proposals offered by lawmakers were the culmination of 18 months of research, discussion and input from groups and individuals directly engaged in responding to this pandemic.

While we are not yet in agreement regarding the specific language of the legislation we will consider, we are continuing discussions and have agreed it is in the best interests of our commonwealth to move forward with the call, Osborne said in a statement.

Lawmakers will be asked to extend the pandemic-related state of emergency until mid-January, when the legislature would be back in regular session, Beshear said. They will be asked to review his virus-related executive orders and other actions by his administration, the governor said.

On the issue of masks, the governor said his call will ask them to determine my ability to require masking in certain situations, depending on where the pandemic goes and how bad any area is.

Beshear ordered statewide mask mandates to confront previous virus surges and said Saturday he sees that authority as absolutely necessary to tackle the delta variant. Acknowledging the issue will be contentious, he suggested a more targeted approach.

If they wont consider providing that authority in general, my hope is that they will consider a threshold to where they will provide me that authority," the governor said.

Beshear also asked lawmakers to provide more school scheduling flexibility as many districts have had to pause in-person learning because of virus outbreaks. Several ideas are being considered, he said, including allowing local school leaders to use a more tailored approach when shifting to remote learning, allowing them to apply it to a single school or even a classroom rather than the entire district. That idea was discussed at a recent legislative committee hearing.

Key GOP lawmakers have signaled their preference for policies favoring local decision-making over statewide mandates to combat COVID-19.

Lawmakers also will be asked to appropriate leftover federal pandemic aid to further the fight against the coronavirus, the governor said. The funding would support pandemic mitigation and prevention efforts, including testing and vaccine distribution.

More than 7,840 Kentuckians have died from COVID-19, include 69 deaths announced on Thursday and Friday. The delta variant has put record numbers of virus patients in Kentucky hospitals, including in intensive care units and on ventilators. The state reported Friday that nearly 90% of ICU beds statewide were occupied.

The delta variant is spreading at a rate never seen before, impacting businesses, shuttering schools and worse causing severe illness and death, Beshear said Saturday.

We need as many tools as possible to fight this deadly surge in order to save lives, keep our children in school and keep our economy churning, he added.

Various emergency measures issued by Beshear are set to expire as a result of the court decision issued two weeks ago. Lawmakers will decide whether to extend, alter or discontinue each emergency order, while putting their own stamp on the state's response to COVID-19.

Throughout the pandemic, Republican lawmakers watched from the sidelines as Beshear waged an aggressive response that included statewide mask mandates and strict limits on gatherings. Republicans criticized the governor for what they viewed as overly broad and stringent restrictions, most of which were lifted in June.

The state Supreme Court recently shifted those virus-related decisions to the legislature. The court cleared the way for new laws to limit the governors emergency powers, which he used to impose virus restrictions. The justices said a lower court wrongly blocked the GOP-backed measures.

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Kentucky governor calls special session on handling COVID-19 - ABC News

Workers load empty oxygen cylinders onto a supply truck for refilling, at the Medical College and Hospital, amid the spread of the coronavirus disease (COVID-19), in Kolkata, India, May 5, 2021. REUTERS/Rupak De Chowdhuri

BENGALURU, Sept 6 (Reuters) - India aims to ramp up its medical oxygen production capacity to 15,000 tonnes per day before a potential third wave of coronavirus infections that is expected to hit the country as soon as mid-September, an industry executive said.

The target implies a 50% jump from the maximum output of almost 10,000 tonnes reached earlier this year during the peak of the second COVID-19 wave, when hospitals ran short of the gas and relatives of patients had to search out oxygen cylinders.

Linde India (LIND.NS) supplied nearly one-third of the total oxygen demand during the peak.

Moloy Banerjee, head of Linde South Asia, said that while the government is targeting 15,000 tonnes of medical oxygen per day, Linde and other manufacturers were hoping to hit production of at least 13,500 tonnes per day ahead of the third wave.

As of Monday, India's total COVID-19 cases had reached 33.03 million, with the death toll at 440,752, according to health ministry data.

While demand for medical oxygen in India has considerably reduced since the peak, reaching near pre-COVID levels, gas companies along with the government are gearing up for a scenario where the third wave could be worse than the previous one.

The New Delhi government said last month it will increase oxygen production by setting up new manufacturing units or expanding the production capacity of existing units for uninterrupted oxygen supply during a health crisis.

Shares of Linde India rose to record levels in the days following the Delhi government's notification and have more than doubled for the year as of Monday's closing price.

"There have been discussions with the Delhi government since the second wave of COVID-19. We are still reviewing the policy and trying to see if it is workable for Linde," Banerjee added.

The company has not entered any formal agreement with the government.

Linde has also been in touch with the governments of Andhra Pradesh and Madhya Pradesh states to support setting up of additional oxygen storage capacities and manufacturing units.

Reporting by Shivani Singh in Bengaluru; Editing by Angus MacSwan

Our Standards: The Thomson Reuters Trust Principles.

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India plans 50% increase in oxygen production before third COVID-19 wave - Reuters India

This obituary is part of We Will Remember, a series about those weve lost to the coronavirus.

Her daughter encouraged her to get testedeven though she had been fully vaccinated since February. Thats when Suzanne Martha Madigan found out she waspositive for COVID-19.

Madigan, 74, died May 16 at Ascension St. John Hospital in Detroit as a result ofcomplications from the illness.

The Warren resident was born in Detroit and grew up in St. Clair Shores, where she graduated from Lakeview High School. Madigan received a bachelors degree from Michigan State University and a masters degreein education from Wayne State University. She taught in the Grosse Pointe Public School System for 26 years.

Madigan met her husband, John, to whom she was married for more than 40 years, while at Michigan State University.They had five children and 13 grandchildren. He died in 2013.

After the death of her husband, Madigan spent a lot of time with her family and often found herself running from one event to the next, according todaughter Kelly Salamango.Her activities included spending time at her cottage off Lake St. Clair, attending grandchildrens sporting events, going out for dinner with her sisters and babysitting her grandchildren.

Madigan, known to many as Susy,loved flowers and spent lots of time tending to her meticulous garden.

In May 2019, Madigan was struck by a car in a parking lot after visiting her brother Duke, who had just undergonesurgery. She ended up breaking both of her wrists and femur and had to undergo surgery.

She spent the next few months in a rehab facility learning to walk again while her brother was in another rehab facility doing the same thing after his surgery, Salamango said. The joke between the two of them was who would get out first and get to go to their cottage.

Duke died in September2020. Salamango noted:Duke and Susy would talk every day (let's be honest multiple times a day) and were inseparable.

In April,Madigan, who was fully vaccinated, thought she had a sinus infection, so she had a telehealth appointment with her doctor. Her doctor agreed her symptoms suggesteda sinus infection, so he called in a prescription. Just to be safe, Salamango urged her mother to get tested for COVID-19. Theresults came back positive.

The next week, Madiganhad mild symptoms, was overly tired and didnt have much energy. Herson Matt took her to the hospital to be monitored becauseher oxygen levels were low. She was put on oxygen, and after her oxygen levels droppedagain, she was put on a ventilator.

Madigans family members relied on the hospital staff to give them updates two times a day and had Zoom calls becauseshe was unable to have visitors. Even though she was unable to respond, it was important for her family to let her know they were there with her, Salamango noted. Her mother diedMay 16.

It's surreal that she has gone through so much the last few years. We thought she was more protected from the virus since she was fully vaccinated and was very cautious if she had to go out, Salamango said. Yet the virus was just too powerful. We do find comfort in knowing she's reunited with our dad, her brother Duke, and her parents and other sister Nancy, who have all passed before her.

Madigan leaves to cherish her memory children Matthew (Shannon), Patrick (Rosanna), Timothy (Jennifer), Michael (Amber), and Kelly (Jason) Salamango; grandchildren Brady, Jack, Katie, Aubrey, Liam, Molly, Haley, Lacey, Lachlan, Stella, Miles, Quinn and Finnegan; and many family members and friends.

If you have a family member or close friend who has died from COVID-19 and you would like to share their story, please visit our memorial wall and select Share a story.

Brendel Hightower is an assistant editorat the Detroit Free Press.Contact her at bhightower@freepress.com.

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Retired teacher from Warren died of COVID-19 several months after being vaccinated - Detroit Free Press

The report was published online Sept. 1 in the journal BMJ .

It's not surprising that the risk to teachers is not higher than other groups, said Douglas Harris, Schlieder Foundation Chair in public education at Tulane University in New Orleans, and director of the Education Research Alliance for New Orleans.

In schools where masks and social distancing are mandated, the risk of spreading COVID-19 is cut dramatically, he said.

"I think, for the most part, schools are handling it in a sensible way and I think, for the most part, it's sensible keeping the kids in school when it's safe," Harris said.

Of course, vaccination is the key to beating the pandemic, he added.

"I think in the U.S., there's an ongoing debate about whether vaccines can be mandated. That's the elephant in the room. I think that that almost has to happen if we're really going to get back to normal," Harris said.

Harris believes that school systems should mandate COVID-19 vaccinations for teachers and all students, including young children once a vaccine has been approved.

"We already do that for, for children, they're already required to get vaccinated for other things," he said. "It's hard to see why you wouldn't require it. In this case and really that is the only way we get back to normal, this could go on for years."

As more adults are vaccinated, the virus will attack mostly the unvaccinated, especially children, Harris said.

But everything should be done to minimize the spread of the virus and keep schools open, he said.

"There are health consequences to closing schools," Harris said. "We tend to focus on the immediate effect of schools opening and spreading the virus, which is clearly important and probably the first consideration, but when you close the schools you create a new set of problems, mental illness and child abuse, and all sorts of economic side effects."

More information

For more on COVID-19 and schools, see the U.S. Centers for Disease Control and Prevention.

SOURCES: David McAllister, MD, MPH, professor, clinical epidemiology and medical informatics, Institute of Health and Wellbeing, University of Glasgow, Scotland; Douglas Harris, PhD, professor, economics, and Schlieder Foundation Chair, public education, Tulane University, New Orleans, and director, Education Research Alliance for New Orleans; BMJ , Sept. 1, 2021, online

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Teachers Have No Higher Risk of Severe COVID-19 - WebMD