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Three key government blunders are to blame for the intensity of Israels new COVID-19 wave, a former Health Ministry chief has claimed.

We could have [had] a smaller second wave if we would have treated the situation better, Gabi Barbash, a former director-general of the Health Ministry, told The Times of Israel.

And he cautioned against pointing fingers at citizens for their conduct, suggesting that the buck should stop with leaders. The public is not clear of responsibility, but I was raised in the army, with the saying there are no bad soldiers, there are bad commanders, said Barbash.

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His comments come as the number of new daily virus cases, which had dropped to low double digits through most of May, is soaring to some 1,000 per day, and the number of active cases is at an all-time high of more than 11,600. New restrictions reducing gathering sizes at synagogues and event halls to 50 went into effect Monday morning, and the cabinet is to consider further restrictions on Monday evening.

Magen David Adom medical workers perform COVID-19 tests at a mobile testing station, in Jerusalem, July 5, 2020 (Yonatan Sindel/Flash90)

But Barbash, professor of epidemiology and preventative medicine at Tel Aviv University and former CEO of the Tel Aviv Sourasky Medical Center, says the government could have prevented things getting this bad. He said that while the current government brought together Likud and its former foe Blue and White ostensibly so they could deal with the emergency, it didnt help in any way, it didnt do anything good.

Barbash added: Its a corona government that is really not about the corona.

In his view, the government both failed to take preventative measures and went too far in easing restrictions in late April and early May, because it didnt stand firm in the face of pressure from the public. As a result they have taken steps they shouldnt have taken, he said.

The intensity of the second wave has largely been caused by management issues, according to Barbash, who added that Israel should have responded more and earlier.

Gabi Barbash, Director General at Tel Aviv Sourasky Medical Center, April 7, 2020. (Channel 12)

In his view, these are the three main mistakes that account for Israels current situation:

1. Dangerous gatherings

Barbash says the government unnecessarily rushed to allow a resumption of gatherings in synagogues, at event halls and elsewhere. Im talking about gatherings of high density people in closed environments, he said. Wherever this happens, this is dangerous.

He added: They should have not opened these things.

He said there is no need for protracted discussions over which places should be open and which shouldnt, as one simple rule should govern all decisions. The issue is not the place; its gatherings of more than 10 or 15 people, he argued.

2. Testing neglected

Israel has neglected the development of efficient testing, according to Barbash.

He said: Were still waiting two to four days to get answers for tests and not enough of the people [who test positive] are being subjected to an investigation by an epidemiologist to trace their contacts.

If people they have encountered arent tracked down and quarantined, part of the potential benefit of testing is lost, he noted.

Barbash acknowledged that thousands of tests are performed per day, but said that the long turnaround time means that valuable time is lost in putting people who encountered carriers into quarantine. He also believes that it makes some people hesitant to get tested, given than the wait for results can be long, and they are expected to self-isolate as a precautionary measure while their sample is in the lab.

3. Schools mismanaged

Israeli students and teachers wear protective face masks as they return to school, at Hashalom School in Mevaseret Zion, near Jerusalem, May 17, 2020. (Yonatan Sindel/Flash90)

When schools reopened in early May, children studied in small groups, smaller than regular classes, as a measure to stop the spread of the virus. But this so-called capsule arrangement was quickly stopped, and regular class sizes were restored.

According to Barbash this was a major mistake. Schools should have either stayed closed or allowed only 15 kids in classes, he said. Kids who are above nine should be treated like adults, and shouldnt gather in groups of more than 10 to 15.

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Where we went wrong: Expert says these 3 blunders caused new Israeli COVID chaos - The Times of Israel

By Lalit K Jha

Washington, Jul 8 (PTI) The use of hydroxychloroquine to treat coronavirus patients has become highly politicized in the US but it is used widely in India, a top White House official has said, asserting latest research showed the malaria drug is highly effective in early stages of COVID-19.

It''s the politicization of this medicine by the mainstream media and portions of the medical community that somehow made this a battle between President Trump and them and created this undue fear and hysteria over a drug, a medicine that has been used for over 60 years relatively safely and is regularly prescribed to pregnant women if they are going to a malaria zone, White House Office of Trade and Manufacturing Policy Director Peter Navarro told reporters.

The idea that this is a dangerous drug is just silly, but if you ask the American people based on the media''s coverage of it, that is kind of the state of play right now, he said.

Navarro said a day earlier four doctors at the Detroit Hospital System filed a request for emergency use authorization for hydroxychloroquine. The request was for three things.

One, for early treatment use in a hospital setting. Number two, treatment between a doctor and his patient in an outpatient setting. Three, not just as a therapeutic but also as a possible prophylaxis for preventative use, he said.

This request to the FDA comes on the heels of the publication of their study in the Journal of Infectious Diseases last week that showed an astonishing 50 percent reduction in the mortality rate for patients taking hydroxychloroquine, Navarro said.

Give hydroxy a chance, and please don''t contribute to hydroxy hysteria because if it''s prescribed under the supervision of a doctor, the odds that it can harm you are way, way smaller than the odds that it can help you, Navarro said.

This has become a highly politicized, but India uses this widely for prophylaxis. There is a number of studies which point to this actually working, White House Office of Trade and Manufacturing Policy Director Peter Navarro told reporters.

The official said if he were to show any kind of symptoms, he would first ask his doctor whether hydroxychloroquine is appropriate. And then I wouldn''t hesitate to take it, he said.

He said if one looks at the 14-day arc of the virus from the beginning of symptoms, the first seven days are critical: when a person may have fever, dry cough, possibly a profound sense of fatigue.

At that point, your lungs are still intact, and the virus is not appreciably spread to the rest of your organs. Hydroxychloroquine, based on the science in articles like the one that originally appeared in 2005 in the Journal of Virology, works in a therapeutic way by raising the alkalinity of your cells which slows the replication of the virus and also can kill the virus, he said.

It also has an anti-inflammatory effect, which is why it is used for rheumatoid arthritis, and the drug can therefore also help manage what is called the cytokine storm, he said.

The latest request to the FDA also comes on the heels of two decisions by the FDA over the last several months to shut down hydroxychloroquine.

The first was what is called a black box warning, the second was a withdrawal of an EUA and what I can tell you as someone who works with the Health and Human Services Department and FEMA to manage the stockpiles of hydroxychloroquine the FDA decisions that they made which I think were precipitous and based on bad science had a tremendously negative effect on two things, he noted.

One is the ability for American people to use this medicine to protect themselves and two, the ability for hospitals like the Detroit Hospital System to recruit patients for the kind of randomized blind clinical trials that everybody wants to settle once and for all the questions of efficacy and safety, he added.

FDA''s previous decision to reject the emergency use authorization, he said, was based on two types of studies. One set of studies that were poorly designed and basically doomed to failure, another set of studies where if you look carefully at the data it is very clear that these were late treatment studies where the medicine would not work, he added.

Navarro said the Detroit doctors are bringing back to the FDA a clear case for early treatment.

If the results of the Detroit study are confirmed in later studies, President Trump was absolutely right that hydroxychloroquine can save lives and if in fact early treatment use can lead to a 50 percent reduction in mortality that is tens of thousands of American lives that are at stake by a phenomenon which I call hydroxy hysteria, Navarro said. PTI LKJ ABHABH

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Hydroxychloroquine has become highly politicised in US but India uses it widely: White House official - Outlook India

As a result of these efforts and sustained public activism, HIV-related deaths in the United States have plummeted by more than 80 percent since 1995.

But even as we celebrate these achievements, inequities stand out in black and white.

While Black Americans make up just 13 percent of the population, they represented 42 percent of new HIV diagnoses in 2018. If youre a gay or bisexual Black man in the United States, you have a 50 percent lifetime chance of being diagnosed with HIV, compared with just 9 percent for gay or bisexual white men. In the American Southhome to the fastest-growing rates of HIV infection in the U.S. gay and bisexual Black men account for 60 percent of new diagnoses. Black trans women are more vulnerable still: As of last year, an estimated 44 percent of all Black trans women were living with HIV. Worst of all, Black people living with HIV/AIDS are seven times more likely than white people to die from the virus.

Read: The gay men who have lived for years with someone waiting on their death

These disparities are not random. Rather, they reflect centuries of discrimination. Persistent structural inequities in economic opportunity, education, and housing disproportionately expose Black families to serious health risks, including HIV/AIDS. And a lack of representation, combined with a painful history of racism in medicine, has undermined the Black communitys trust in health-care systems and made people less likely to seek care. The same disparities have become glaringly apparent as the world battles the coronavirus pandemic; Black Americans are dying at more than two times the rate of white Americans, and the death rate rises to sixfold in pandemic hot spots.

I started the Elton John AIDS Foundation in 1992 because I believe that everyone deserves the right to a healthy life, no matter who you love, who you are, or where youre from. Today, Im proud that it supports organizations that serve and uplift marginalized communities.

Some of our most inspiring partners are in my adopted hometown of Atlanta, home to 37,000 people living with HIVmore than 70 percent of whom are Black. These partners include Thrive SS, a self-help support network for gay Black men living with HIV/AIDS, and Positive Impact Health Centers, which offer HIV preventive care and treatment, as well as services for those struggling with mental health and substance abuse. To ensure continued HIV care and treatment during the pandemic, my foundation has helped organizations transition from face-to-face to virtual appointments and provided personal protective equipment for staff members and the people they serve, as well as at-home delivery of lifesaving treatments and HIV self-testing kits. This tackles the immediate needs, but not the long-lasting stigma.

Read: The LGBTQ health clinic that faced a dark truth about the AIDS crisis

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We Cant End AIDS Without Fighting Racism - The Atlantic

Editor: We have the medicine we need to slow the coronavirus. As we wait for COVID-19 vaccine and drug therapies, we have powerful tools to reduce the transmission of coronavirus. Washing hands, social distancing and mask wearing all slow the spread of the virus.

While we normally do not think of physical barriers and actions as preventative medicine, these are the tools we have available today. These are simple, effective, affordable and accessible tools in slowing the spread of coronavirus. They do not have side effects and have limited environmental impacts. They are being employed at a global level to slow the virus.

Economic research has shown that a national mask mandate would save 5% of the GDP. To support our economy, keep our schools open and maintain quality health care, wash hands, wear a mask and social distance. The pandemic has had a significant, long term economic and social impact on all Americans. The pandemic has left millions of Americans unemployed and reduced state and local budgets which will cause cuts in social, medical and infrastructure programs. The pandemic has closed schools, increasing the burden on working parents and compromising the education of American children.

Let's not amplify these economic and social costs. Use the tools available today to save money, jobs and lives tomorrow.

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Letters to the Editor: July 9, 2020 | Opinion - Sonoma West

Congress should make primary care a top priority for the Medicaid program, the nonpartisan Bipartisan Policy Center said in a report Monday.

The group called on Congress to support a comprehensive framework to improve primary care by directing HHS to help states share best practices and innovations and measure and report "spending on primary care as a percentage of total healthcare spending." In addition, Congress should fully fund the Primary Care Extension Program.

Lawmakers should also boost access to insurance coverage by allowing states to expand Medicaid. States could follow traditional expansion to adults making up to 138% of the federal poverty level and receive 100% matching federal funds, eventually phasing down to 90%. Or they could expand Medicaid coverage to people making 100% of the federal poverty level and receive 88% matching federal funds if they do it within two years.

Likewise, Congress should allow states to automatically enroll eligible people in Medicaid, Children's Health Insurance Program or marketplace subsidies. States would only be permitted to enroll people in marketplace subsidies if the subsidies fully covered an individual's premium costs. BPC also recommended creating a new option for states to sign up eligible adults in 12 months of continuous Medicaid coverage, preventing coverage lapses and reducing reporting for enrollees.

Congress should also mandate fee-for-service Medicaid to cover preventative care services with no cost-sharing to make sure beneficiaries aren't discouraged from seeking high-value care.

"Access to primary care can help individuals live longer and help avoid or delay the onset of costly chronic conditions such as diabetes, heart disease and cancer," according to the report. "Access to primary care can also help reduce more expensive care, including hospitalizations and emergency department visits."

Hemi Tewarson, director of the National Governors Association's health division, said during a panel discussion that she's concerned states won't have enough resources to invest in primary care because of the downward pressure on state budgets caused by the COVID-19 pandemic, which could have long-term ramifications on the U.S. healthcare system.

The Bipartisan Policy Center also recommended boosting Medicaid's matching federal funds to 100% for primary care services for five years if states pay for them at the Medicare rate. According to the report, higher reimbursements for primary care services would ensure enough primary care providers to deliver care to Medicaid enrollees.

Likewise, HHS should delay any changes to network adequacy requirements for Medicaid managed care organizations until the Medicaid and CHIP Payment and Access Commission develops data-driven access standards. According to the report, Congress should order HHS to regulate network adequacy for Medicaid MCOs "based on the new data-driven standard."

The Bipartisan Policy Center recommended several other actions to increase the primary care workforce, including increased federal coordination of workforce development efforts and more visa waivers for foreign medical graduates.

The report also includes a wide range of recommendations to address racial, ethnic and economic disparities in Medicaid. They include blocking implementation of the June rule eliminating nondiscrimination regulations, requiring HHS to issue guidance to states about how to pay community health workers to address chronic conditions and empowering HHS to approve Medicaid coverage of non-medical services to address the social determinants of health.

Congress created the Primary Care Extension Program under the Affordable Care Act to improve primary care quality, but it never funded the program. According to the legislation, it was supposed to transform primary care by educating "providers about preventive medicine, health promotion, chronic disease management, mental and behavioral health services, and evidence-based and evidence-informed therapies and techniques."

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Primary care should be a top Medicaid priority, think tank says - ModernHealthcare.com

IN March this year we reported Dr Jennifer Brown Tomlinson, medical director at Jamaica AIDS Support for Life (JASL), urging people living with HIV to ensure that they take their medication daily.

A compromised immune system, Dr Tomlinson cautioned, may not be able to function at its optimum to fight against the coronavirus.

Said Dr Tomlinson: People living with HIV who are on their antiretroviral medication have the same risk [of contracting the novel coronavirus] as the normal population. All of the precautions that are being advised for the general population also apply to people living with HIV who are adherent to their antiretovirals.

That very sound advice takes on more relevance now as we are being told by health experts that Covid-19 could cause an additional half a million AIDS deaths if treatment is disrupted long term.

That chilling projection was made Monday at the start of the virtual International AIDS Conference at which it was noted that the Covid-19 pandemic was jeopardising years of progress against HIV.

The United Nations (UN), in its annual report, pointed out that the world was already way off course in its plan to end the HIV/AIDS threat before the Covid-19 outbreak.

According to the UN, despite the fact that AIDS-related deaths have fallen by 60 per cent since the peak of the HIV epidemic in 2004, approximately 690,000 people still died from the virus and 1.7 million people were infected last year.

The emergence and spread of the novel coronavirus now means that the UNs target of reducing AIDS-related deaths and new HIV infections to fewer than 500,000 this year will now be missed.

A key contributor to that danger is that the pandemic is impacting access to preventative medicine among communities at risk because of lockdowns and distribution difficulties.

A report from the UN conference tells us that one model run in conjunction with the World Health Organisation (WHO) showed that if Covid-19 measures disrupted HIV treatment programmes for six months it could leave an additional 500,000 people dead.

Indeed, WHO Director General Dr Tedros Adhanom Ghebreyesus is reported as saying: We cannot let the Covid-19 pandemic undo the hard-won gains in the global response to this disease.

The information coming out of the UN conferences should not be lost on the just over 32,000 people living with HIV in Jamaica. Those who are not compliant with their medication need to heed Dr Tomlinsons advice. In fact, anyone living with HIV should not, in the first place, be in a position of non-compliance.

As it now stands, our health authorities, and indeed the government, need to ensure that the Covid-19 pandemic does not result in a shortage of antiretroviral medicines here.

For, while, as we have already stated, we are disappointed that Jamaica will not meet the Joint United Nations Programme on HIV/AIDS 90-90-90 target, which was set to be attained this year, we are encouraged that JASL has already achieved one of the targets and is close to the 2020 goal of having 90 per cent of its more than 730 HIV-positive clients virally suppressed.

Courtesy Jamaica Observer

Originally posted here:
Frightening projection of Covid-19s effect on HIV treatment - Trinidad & Tobago Express Newspapers

For decades, the premise of diets have revolved around what you eat.

Atkins dieters believe that carbs are the devil, keto dieters are all about that high-fat lifestyle, while Paleo dieters wont eat grains that didnt exist pre-agricultural revolution. Today, that focus has shifted to not what we eat, but when we eat.

Everything that happens in our daily life revolves around the time of the day, and as much as wed like to think that we have total control over our meals, a lot of what we eat and when we eat has been scheduled around work, appointments, and everything in between.

This pattern of eating means that people often find themselves eating at odd hours and often too close to bedtime, leaving their brains confused and their bodies struggling to keep up.

Like sleeping, how we process food is also deeply reliant on the bodys circadian rhythm. Essentially an internal daily timetable, the cycle responds primarily to light and darkness, with sleeping at night and being awake during the day being the most common example.

Chronically disrupted circadian rhythms not only affect sleep, but also prevent the body systems from working efficiently,leading to insulin resistance, fat storage, and increased risk of disease over time, which explains why the most widely touted preventative medicine today is at least eight hours of good sleep every night.

Chances are your eating pattern now lasts over 15 hours a day and well past dark, which clashes with the bodys release of melatonin and lowered insulin resistance as it prepares for sleep.

Like intermittent fasting, the circadian rhythm diet advocates time-restricted eating of your daily calories within an eight to 10 hour block when the sun is up, leaving a 14-hour fast between your last meal of the day and the first meal of the next day.

For this diet, experts have suggested swapping your dinner for breakfast. Instead of bagels or processed cereal, eggs and avocado with toast or a portion of salmon with pasta will help keep you more satisfied and less hangry thoughout the day, especially after the long overnight fast.

Lunch should be less heavy but with a good proportion of protein, fat, and healthy carbohydrates, while dinner should be the smallest meal of the day, especially as your bodys insulin sensitivity decreases before bed. Ideally, you should consume bout 75 percent of your nutrition before 3pm.

No one likes being hungry and thats why diets like these are hard to stick with. The team kindly suggested I gave this diet a go earlier this week and so quite begrudgingly, I sacrificed my happiness for the sake of an honest report and lasted all but two days. If youre someone whos used to small meals and lives for snacking in between, this diet will be a difficult one to get used to.

The reported benefits, however, make it worth it. When the body is depleted of sugar, it taps into the bodys reserves, such as the carbohydrates that get stored in the liver. Fasting overnight allows the body to convert fat to ketone bodies, which fuel the brain and heart. Besides, your body isnt struggling to digest your leftover pizza binge while also trying to repair itself. Youll also be more inclined to skip dessert after dinner, which is truly a habit we could all get behind.

Interestingly, the circadian rhythm works for exercising too; working out outside in the early morning can be a big mood booster, especially since thats when your cortisol levels begin to rise before peaking. To fight the midday slum, a quick visit to the gym brings oxygen back into the body after hours spent hunched over the desk while rushing deadlines. An evening sweat session, on the hand, is associated with lower stress levels,better endurance and improved anaerobic performance, like sprinting and resistance training.

Unlike many diets, the circadian rhythm diet isnt about skipping meals or cutting calories. Its about listening to what your body needs and not what your mind wants, and not eating during the time when you dont need fuel can make a whole lot of difference to how your body takes on the day, whether the sun is up or not.

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Everything you need to know about the circadian rhythm diet - Lifestyle Asia

You might not be able to run to the local MMJ outlet to buy a cure-all for COVID-19, but cannabis is still on the menu, with at least two clinical studies underway evaluating CBDs for prevention and treatment of the novel coronavirus.

Even if it is not the panacea the world is looking for, use of MMJ is probably a lot safer than injecting disinfectant into your veins.

While studies for coronavirus therapies are in the infancy stages, some have shown promise blocking the virus, and as an anti-inflammatory agent for those afflicted with the disease. Two such studies, originating in Canada and Israel, have recently caught the attention of medicinal cannabis advocates hoping to further legitimize the herb as mainstream medicine.

The studies are not for an anti-virus vaccine, but as therapies that could enhance primary treatment and "prevention strategies" to deny the virus entry into the body or as an anti-inflammatory treatment that may help prevent acute respiratory distress for those afflicted with the disease.

The Canadian study is a collaboration between the University of Lethbridge, Pathway Rx, a Canadian pharmaceutical research company that develops cannabis therapies and Swysh, Inc., a cannabinoid-based oral health company.

In April, the group released a preclinical study for peer review titled, "In Search of Preventative Strategies: Novel Anti-Inflammatory High-CBD Cannabis Sativa Extracts Modulate ACE2 Expression in COVID-19 Gateway Tissues."

The study looked at hundreds of strains of cannabis and their effect on artificial lung, oral/nasal and intestinal tissue and their ability to modulate angiotensin-converting enzyme 2 (ACE2). According to researchers involved in the study, ACE2 is a receptor required for COVID to enter the cells.

"ACE2 may be the way COVID enters the cell," Heather Moroso, NMD said. "If you make more of it, it's basically like opening more doors for the virus to enter. If you make less or block ACE2, then potentially that's fewer doors for the virus to enter."

If the research proves successful, the resulting medications could be administered in the form of mouthwash, gargle, inhalants or gel caps, according to those involved with the study. Smoking cannabis, on the other hand, might exacerbate lung problems brought on by the virus.

"There is some evidence that smoking in general may make one more vulnerable to COVID," Moroso said.

Researchers say a fraction of the strains that have been tested have shown success in reducing virus receptors by as much as 73 percent.

Studies may have hit roadblocks though, as a lack of clinical trials and insufficient funding has kept the work in its infancy phase.

The Israeli study, a collaboration between InnoCan Pharma of Israel and Tel Aviv University, focuses on products using CBD-loaded exosomes to treat lung inflammation.

The exosomes could be safely administered without adverse reactions, creating a potentially safe delivery system via inhalation for a variety of lung infections in COVID patients. The study focused on CBDs in order to reduce patient impairment that may be caused by higher levels of THC in other forms of the drug.

While the studies represent something of a boon for cannabis advocates, locally, response to the reports is that it's "not ready for prime time."

To begin with, the Canadian study utilized artificial tissue models, so it is not clear if the results would be the same if conducted on living humans.

"The [Lethbridge] paper utilizes tissue models which are very far removed from human, or animal, organs in-situ and hence any conclusions must be taken with great caution," said a retired Tucson neuroscientist who declined to be identified for this report. "In my opinion, the results are extremely preliminary and may not have any relevance to the question at hand: adjunct therapies to combat COVID-19 infection."

There is also a problem of "confirmation bias," which means there may be a subconscious desire for a cannabis "miracle cure" that may lead to a loss of objectivity in processing the results of studies on the drug.

"Everybody wants cannabis to be a cure-all miracle drug," Moroso said, adding that while the state of Arizona does not recognize sleep issues as qualifying conditions, sleep can be an important aspect to stress reduction.

Additionally, during the current state of the pandemic, MMJ can have positive effects on patients experiencing anxiety over their lives and futures, as the economic and health impacts of a global pandemic make the future murky, at best.

"Cannabis can help people suffering from anxiety, depression and post-traumatic stress disorder," Moroso said. "The stress and anxiety of being in isolation; unknown job and family situations; domestic abuse and isolation? I'm not a rocket scientist, but sensible use of the drug can help reduce the anxiety."

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Cannabis and Coronavirus - Tucson Weekly

BASKING RIDGE, N.J., July 09, 2020 (GLOBE NEWSWIRE) -- electroCore Inc.(Nasdaq: ECOR), a commercial-stage bioelectronic medicine company, announced today that Dan Goldberger, Chief Executive Officer, will participate in three upcoming investor conferences:

Maxim Group/M-Vest COVID-19 Virtual Conference Series: Re-Engaging Medical Practices in an Era of COVID-19Format: panel discussionDate: Thursday, July 16Panel 2, Cant Touch This! Time for These Devices to Shine!Time: 12:30pm 1:45pm ET

To access the panel discussion, please RSVP HERE

Zooming with LD MicroFormat: corporate presentation followed by 1x1 virtual investor meetingsDate: Tuesday, July 21Time: 8:00am 8:40am PT

Investors can register for the presentation HERE.

Canaccord Genuity 40th Annual Growth ConferenceFormat: 1x1 virtual investor meetingsDate: Tuesday, August 11

About electroCore, Inc.

electroCore, Inc. is a commercial-stage bioelectronic medicine company dedicated to improving patient outcomes through its platform non-invasive vagus nerve stimulation therapy initially focused on the treatment of multiple conditions in neurology. The companys initial targets are the preventative treatment of cluster headache and migraine and acute treatment of migraine and episodic cluster headache.

For more information, visit http://www.electrocore.com.

About gammaCoreTM

gammaCoreTM (nVNS) is the first non-invasive, hand-held medical therapy applied at the neck to treat migraine and cluster headache through the utilization of a mild electrical stimulation to the vagus nerve that passes through the skin. Designed as a portable, easy-to-use technology, gammaCore can be self-administered by patients, as needed, without the potential side effects associated with commonly prescribed drugs. When placed on a patients neck over the vagus nerve, gammaCore stimulates the nerves afferent fibers, which may lead to a reduction of pain in patients.

gammaCore is FDA cleared in the United States for adjunctive use for the preventive treatment of cluster headache in adult patients, the acute treatment of pain associated with episodic cluster headache in adult patients, the acute treatment of pain associated with migraine headache in adult patients, and the prevention of migraine in adult patients. gammaCore is CE-marked in the European Union for the acute and/or prophylactic treatment of primary headache (Migraine, Cluster Headache, Trigeminal Autonomic Cephalalgias and Hemicrania Continua), Bronchoconstriction and Medication Overuse Headache in adults.

In the US, the FDA has not cleared gammaCore for the treatment of pneumonia and/or respiratory disorders such as acute respiratory stress disorder associated with COVID-19.

Please refer to the gammaCore Instructions for Use for all of the important warnings and precautions before using or prescribing this product.

Investors:

Hans VitzthumLifeSci Advisors617-430-7578hans@lifesciadvisors.com

or

Media Contact:

Jackie DorskyelectroCore973-290-0097jackie.dorsky@electrocore.com

Continued here:
electroCore to Participate in Three Upcoming Virtual Investor Conferences - BioSpace

Louisiana is now one of the leading states in the nation for most new coronavirus cases.

It ranks third in the U.S. this week for most new cases per capita on a rolling seven-day average, according to new data from Harvards T.H. Chan School of Public Health. Its a trajectory that could spark another shutdown. But you wouldnt know it by listening to state Rep. Danny McCormick.

The Constitution is being shredded before our very eyes, McCormick claimed in a video he released this week railing against the new mandate to wear a mask in public in Shreveport. Kenner and Jefferson Parish have also announced mask mandates, which are already in place in New Orleans and Baton Rouge.

McCormick represents parts of Caddo Parish, including Shreveport, where 243 people have died since the pandemics outbreak and where Black people have died at twice the rate of white people. Its also one of the parishes with the highest rates of new daily COVID-19 cases per capita in the state.

In the video, McCormick says mask mandates one of the key preventative measures to prevent the spread of the coronavirus, especially in urban hotspots such as Shreveport are an attack on liberty. Then he attempts to destroy a mask with a chainsaw.

McCormick also makes the goading claim that people who dont wear masks will be treated like Jews in Nazi Germany.

While other Republican leaders Texas Gov. Greg Abbott among them have shifted to embracing mask mandates, McCormick isnt the only Louisiana politician to attack mask-wearing. Thats despite the swelling pandemic and medical consensus that theyre not just helpful, but imperative.

Congressman Clay Higgins represents Lake Charles and Calcasieu Parish, one of the most worrying regions in the state, and has repeated conspiracy theories about the coronavirus, made false claims about the efficacy of masks, and called wearing a mask part of the dehumanization of the children of God.

In Lafayette, another alarming hot-spot, Mayor-President Josh Guillory rejected a mask mandate this week. He claimed he made the move based on the information Im getting on the medical task force, but The Advocate reported the task force wasnt asked for its opinion and would actually support such a mandate.

Republicans in Baton Rouge spent most of the legislative session resisting requests to wear masks. And it appears that many people across the state have been doing the same.

Louisianas startling trajectory

Louisianas jump to the top of the list for most new coronavirus cases cannot be explained by increased testing. Hospitalizations grew by more than 50 percent over the last two weeks, and the percentage of positive tests in the state has also been rising. On Thursday the latter rate hit 12 percent positive over the 10 percent threshold set by the state for safe opening in Phase 2. The 7-day rolling average is 8.7 percent, according to AH Datalyitcs.

But that could already be too high. The World Health Organizations recommended goal is 5 percent. A high positivity rate indicates that the viruss spread is too great for contact tracing to work and thats assuming contact tracing is actually being broadly embraced by the public, which hasnt been the case in Louisiana.

Dr. Vin Gupta, an assistant professor of pulmonary and critical care medicine at the University of Washington, is among the medical experts warning that contact tracing is now useless across much of the U.S. because the virus has already spread too widely.

On Wednesday, Gov. John Bel Edwards said the state has lost all the gains made in June and is now seeing some numbers that rival our peak back in April.

And while Texas, Florida and Arizona are seeing higher increases in hospitalizations, Dr. Thomas Tsai, a surgeon and assistant professor at Harvards School of Public Health, said it could be a matter of time.

My worry is that Louisiana may just be a few weeks behind Texas and Arizona and Florida, unless more concerted efforts are taken, he said.

Its unclear whether theres public appetite for that or even to abide by the guidelines already in place. Health officials say that as the state reopened too many people have ignored public health guidelines, particularly around wearing masks and keeping distance. Bars in particular have become a key source of outbreaks.

Frankly, it's been really, really frustrating. Because just a few weeks ago, we were in a really, pretty good place, said Suan Hassig, an infectious disease epidemiologist at Tulane University.

The curve is going to bounce back up if we don't keep jumping on it and stomping it down.

The plea of local public health leaders

If Louisianas hospitals are overwhelmed, if deaths once again spike, and if more people contract a virus that were learning could have long-term impacts on major organs including the brain and the heart, it wont be because public health leaders across the state havent been sounding the alarm.

Amanda Logue, the chief medical officer for Lafayette General Health, released a video on Facebook last week talking with another hospital leader about the alarming rise of COVID-19 cases in Acadiana. She said her hospital had seen about a 200 percent increase in hospitalizations over the last three weeks, which really correlated with the timing of Phase 2.

For Lake Charles mayor Nic Hunter, the time has come to plead with the public to take the advice of local health leaders.

God help us if we've come to a point in our society where during the middle of a pandemic, he said, if we want to know medical or scientific information, we are trusting a meme on Facebook, or what my brother-in-law overheard at the supermarket, more than guys like Dr. Tim Haman and Dr. Mac Jordan.

Hunter was introducing Haman and Jordan the head physicians of two Lake Charles hospitals in a video on Monday. The Lake Charles area has the highest rate of new cases in the state. Hospitalizations for COVID-19 have doubled from their previous peak in April. And the rate of positive tests has hit 25 percent.

All three denounced the polarization of mask-wearing, and Haman said he hates that masks have become a political football.

We wear them in the hospital all day. We wear them 10 to 12 hours at a time here. So I don't think it's asking too much of someone to wear a mask for 20 minutes while you're in a grocery store, he said. I think it puts people at risk. We don't think anything of following traffic laws, wearing seatbelts, holding the door for somebody.

Haman fears the consequences if people dont change their behaviors.

We are approaching the situation we're seeing in other cities like San Antonio and Houston where the healthcare system is on the verge of being overwhelmed, he said.

How New Orleans became a relative bright spot in the state

Whats happened in Louisiana is the same story across the country: Areas that werent initially hit hard by the pandemic in the spring are now seeing an exponential growth in cases.

According to Harvards data, 26 parishes in Louisiana and the entire state are past a tipping point where stay-at-home measures should be implemented.

Amid that, New Orleans is now one of the bright spots in the state, with some of lowest rates of new cases. But even here, the trajectory is in the wrong direction.

On Wednesday, Mayor Latoya Cantrell announced new restrictions based on trends in new cases and hospitalizations. Now, bar seating is prohibited in restaurants and bars only table seating is allowed. Private indoor events are being limited to 25 people.

And theres now the added worry of another shortage of test supplies.

New Orleans has had to nearly cut in half the number of daily tests it performs for free at its mobile testing site, amid rising demand. The citys mobile testing sites have run out of spots even before they opened twice this week.

Dr. Jennifer Avegno, director of the citys health department, said shortages in materials needed for the machines that analyze the tests are to blame, along with surging cases across the country.

My great concern is that if there's a shortage, there's a shortage. And I don't know how they're prioritizing where they're sending the materials, she said.

Testing is also being cut back by some hospital groups in the state Ochsner Health is now only testing people with symptoms. And while Louisiana has been testing far above its goal of 200,000 tests per month, the Harvard analysis suggested that in order to suppress the virus, that could need to be quadrupled.

For Steven Procopio, the Policy Director at the Public Affairs Research Council of Louisiana, the one bright spot in the exponential growth of cases is that deaths so far have not followed the same trajectory.

It may be because of the younger ages of people who are getting it, or we have better treatments, or it just could be there's a lag and we havent been hit, he said.

Hassig, the epidemiologist, said she wants to see mask mandates in every urban area. It could be that local leaders will be forced to make that call, because the governor has so far said he wont implement such a requirement statewide.

Link:
Louisiana's COVID-19 Surge Is Among The Worst In The U.S. And Some Leaders Are Still Fighting Mask - WRKF

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As Canada continues to reopen, some grocery stores, salons and other businesses have implemented temperature screening an approach that uses a touchless scanner to measure a persons body temperature in an attempt to prevent the spread of the novel coronavirus.

The process was made mandatory for all air travellers in Canada in mid-June. Any passenger who shows a fever on two measurements, taken 10 minutes apart, will be asked to rebook after 14 days.

However, some experts wonder whether the step is effective given a person can shed the COVID-19 virus without having a fever or any change in body temperature. The tool often used to measure temperature has also been shown to be unreliable.

READ MORE: Temperature screening not always reliable to mitigate coronavirus risk, experts say

For those reasons, temperature screening has not been recommended by Canadas chief public health officer Theresa Tam. In fact, she quickly shut down the approach when more businesses began implementing the practice in May.

The more you actually understand this virus, the more you begin to know that temperature-taking is not effective at all, Tam said in a ministerial update that month.

Tam said the likelihood of screening someone who was symptomatic was relatively inefficient in comparison to those who were asymptomatic.

If we have a significant number of asymptomatic or pre-symptomatic people, that also even reduces the effectiveness even more.

Dr. Susy Hota, the medical director of the Infection Prevention and Control and Medical Device Reprocessing department at the University Health Network in Toronto, agrees.

"There really are a lot of limitations to temperature checks, and I'm not really convinced that they're worth investing in for this purpose," Hota said.

READ MORE: Canada to screen air travellers for fever amid coronavirus pandemic: Trudeau

There are also inaccuracies with the temperature probes used for this purpose, Hota said.

She worries they can give patrons and business owners a "false sense of security."

Temperature screening is typically not an effective way to detect COVID-19 when used on its own, and that's because of the way the virus spreads.

"When we talk about the issue of pre-symptomatic shedding and transmission, we're talking about people who have no symptoms yet so no fever," Hota said.

"Once you've developed the fever, we know what we're dealing with ... but in the pre-symptomatic phase, a temperature check won't help."

Problems can also arise from the touch-less temperature probes currently being used in airports, grocery stores and by other businesses.

"It's a variable that ... isn't infallible," said Dr. Leighanne Parkes, infectious disease specialist and microbiologist at the Jewish General Hospital in Montreal.

"It depends on the instrument that we're using, the ambient temperature, (if) the instrument is calibrated correctly, is the individual coming in from a hot outside or a cold outside?"

All these things come into play when a temperature probe is used, making true measures hard to come by.

READ MORE: You might be wearing your mask, gloves wrong. How to use PPE properly

There are also other reasons a person's body temperature could be elevated that don't have to do with COVID-19.

Medication, certain pre-existing conditions, weather and what you were doing immediately prior to having your temperature checked are all factors that can affect your body temperature, Hota said.

"It is possible that your ambient temperature and what you were doing before ... might register a higher temperature than you really would have otherwise," she said.

However, Parkes believes temperature screening could be helpful when it's "bundled" with other preventative health measures.

"If you have an adequately calibrated machine, you're [testing the person's temperature] indoors using appropriate techniques and ... you're also symptom-screening for things that are not fever, and risk factors including contact, those altogether can pick up some of the most high-risk cases," Parkes said.

Temperature screening should be considered just one layer in a "pyramid of prevention," she said.

"It's not a replacement for the other means that we have in place, such as social distancing, masking in public spaces, adequate ventilation, adequate environmental cleaning ... all those things combined."

Although temperature screening may not accurately detect COVID-19, it's still within the rights of a business to deny you service on the grounds of a high temperature.

This is because employers and employees have the right to a safe working environment.

"You can't be denied entry on grounds of race or religion ... because that's discrimination, but if your temperature is above some arbitrary scale, then you can be denied entry," said Bernard Dickens, professor emeritus of health law and policy in the faculty of law, faculty of medicine and Joint Centre for Bioethics at the University of Toronto.

READ MORE:Planes, salons and grocery stores: Companies that require masks in Canada

"It's a security ground ... to protect the staff who work in the facility. They have a right to a safe working environment, and the store is responsible for the safety of its employees."

Basically, any business can make conditions for who they serve as long as they don't discriminate [and they're not] in violation of the human rights code.

For this reason, you can refuse to take a temperature test, but the store can refuse your entry upon doing so.

"You have no right to go into the store ... because the store can set reasonable conditions [for protection]," Dickens said.

Questions about COVID-19? Here are some things you need to know:

Symptoms can include fever, cough and difficulty breathing very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out.

In situations where you can't keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.

For full COVID-19 coverage from Global News, click here.

With files from Global News' Emerald Bensadoun

Meghan.Collie@globalnews.ca

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Can I refuse a temperature check? What to know about the COVID-19 screening tool - MSN Canada

Researchers are still uncovering the different ways that COVID-19 can affect the body.

Now, a new study out of the United Kingdom has found that COVID-19s neurological complications can include delirium, brain inflammation, stroke, and nerve damage.

A rare and sometimes fatal inflammatory neurological condition also appears to be increasing in prevalence due to the pandemic, according to a new study by British scientists.

The study, which appears this week in the journal Brain, was led by researchers from University College London and University College London Hospital.

In particular, researchers found a spike in adults with acute disseminated encephalomyelitis (ADEM), a rare condition typically seen in children and that can be triggered by viral infection, during the study period. The researchers typically see one adult patient with this condition each month.

During that study period, however, they saw an average of one adult per week with ADEM.

For this study, researchers retrospectively reviewed the clinical, radiological, laboratory and neuropathological findings of 43 people ranging in age from 16 to 85 who had either confirmed or suspected COVID-19. The patients were treated at the National Hospital for Neurology and Neurosurgery in London. In all, there were 24 males and 19 females. Twenty-nine of these patients were defined as definite COVID-19, eight were probable and six were possible. The severity of the COVID-19 symptoms varied from mild to critical.

The researchers identified 10 cases of transient encephalopathies, or temporary brain dysfunction with delirium. There were also 12 cases of brain inflammation, 8 cases of strokes, and 8 others with nerve damage.

The researchers found evidence that the brain inflammation was likely caused by an immune response to the disease. The researchers say this suggests that some neurological complications of COVID-19 might come from the immune response rather than the virus itself.

Researchers say this new study confirms previously reported findings of a higher than expected number of stroke patients conditions that were triggered by the excessive stickiness of the blood in COVID-19 patients.

Still they say that because the disease has only been around for a few months, the long-term damage of COVID-19 remains unclear.

Additionally, experts are not certain exactly why the virus increases the risk of these neurological challenges.

Possibilities include direct effects of the virus, the bodys own immune or inflammatory response, the effects of hypoxia (low body oxygen levels), changes to blood vessels, changes in the coagulability (stickiness) of the blood, the effects of severe illness (including prolonged ICU stay in some patients), or a combination of these factors, Dr. Rachel Brown, a clinical research fellow at University College London and a joint first author of the paper, said by email.

We saw neurological effects of COVID-19 in adult patients of all ages, genders, and ethnicities, and in patients both with or without underlying health conditions and with both mild and severe COVID-19 infection. As a retrospective cohort study, we cannot at this stage say why these particular patients were affected but this should be a focus of future study.

Brown added that while researchers cannot give a definite estimate of the numbers affected, neurological complications of COVID-19 are likely to be rare.

We are probably reporting on the more severe end of the spectrum in this respect, she said. For patients who have been affected by neurological complications however, the effects can be life changing and should not be downplayed. As ever, we need to consider COVID-19 seriously, and continue to follow public health advice to limit the spread of the virus and the number of people affected.

Dr. Serena Spudich, a professor of neurology at the Yale School of Medicine, called the study a very valuable collection of descriptions by a group of world-class neurological experts, all putting their heads together to try to draw cohesive conclusions from a disparate group of patients. It represents the best, most thoughtful sort of clinical case series.

Still, Dr. Guilherme Dabus, an interventional neuroradiologist at the Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, said the study demonstrates that we are yet to have a good understanding of why some patients may develop neurological syndromes and why there are so many different types of neurological manifestations among those who do.

He noted that this emphasizes the need for the medical community to be aware of possible neurological syndromes that may affect COVID-19 patients, so they are attentive to the signs and symptoms.

Some of these neurological manifestations such as stroke are time sensitive, and a prompt suspicion and diagnosis may be the difference between life and death, he said.

Added Dr. George Teitelbaum, an interventional neuroradiologist and director of the Stroke & Aneurysm Center at Providence Saint Johns Health Center in Santa Monica, California, the study shows that COVID-19 is turning out to be a very virulent virus that has a variety of presentations.

Its turning out to be a more complex virus than we thought it was, he said.

He added that one of the lessons of this study is a reminder about the need to follow basic preventative guidelines such as the use of face masks, hand sanitizer, and social distancing.

Those are things that are highly effective at reducing the spread, he said. This is not a political issue; its a public health issue. For some people, it is a life and death issue, particularly if they are older and have underlying conditions. This is not rocket science.

Read more:
COVID-19 Linked to Major Neurological Conditions Including Stroke - Healthline

INDIANAPOLIS Dr. Herman G. Morgan, the 33-year-old secretary of the Indianapolis Board of Health, presented the situation in simple terms.

In November 1918, Indianapolis and the rest of the world were in the grips of the worst influenza pandemic in history. Less than two months had passed since the city's newspapers reported the first cases among soldiers stationed at the Indiana School for the Deaf and Fort Benjamin Harrison.

Morgan's Board of Health issued sweeping orders in early October 1918, similar to those the city imposed in March and April 2020 in the fight against the COVID-19 pandemic.

Schools and churches closed. Businesses and theaters shut down. Public meetings were banned. Streets emptied.

Newspapers.com

By November, Indianapolis began reopening and its citizens gathered in celebration of victory in World War I, leading to another rise in cases, according to Bill Beck, a current member of the Marion County Historical Society's board of directors.

"Flu cases had spiked late the week before in the wake of the Armistice celebrations on Monday, Nov. 11, and the Board of Health reacted by trying to get ahead of the curve," Beck said.

Morgan determined it was time for citizens to wear masks in public or risk the city shutting down for a second time.

"The board of health has placed on the individual and, to a larger extent, his employer, the matter decided of whether business shall continue in Indianapolis," Morgan said in the Indianapolis Star on Nov. 20, two days after the mask requirement was announced. "If there is a tendency on the part of the public to disregard the health regulation, the only resort is to close up all business houses and public gathering places."

No ordinary flu

The H1N1 flu, also known as the Spanish Flu and La Grippe, was both rapid and violent.

Fueled by soldiers moving around the globe at the end of World War I, the Centers for Disease Control and Prevention estimates the flu infected one-third of the world's population and killed at least 50 million people worldwide, including 675,000 Americans.

The author John H. Barry wrote in his book "The Great Influenza" the first confirmed cases appeared on March 4, 1918, at Fort Riley, Kansas. It finally subsided in the summer of 1919 after arriving in three waves. The second wave in the fall of 1918 was the most severe.

Newspapers.com

In his book, Barry described the swiftness with which the virus struck its victims and the horrifying symptoms many experienced.

"Symptoms were terrifying," Barry wrote. "Blood poured from the noses, ears, eye sockets; some victims lay in agony; delirium took others away while living."

The Indianapolis Star reported on Nov. 24 that 3,266 Hoosiers died statewide from the flu in October, and 3,020 children became orphans. The illness struck the youngest and strongest adults the hardest.

"More than 53 percent of the 3,266 persons who died of influenza-pneumonia in Indiana during October were between the ages of 20 and 40 years," the Star reported.

Beck said his grandfather was a mortician in Indianapolis during the pandemic.

My dad remembered never seeing his father that whole fall because he was so busy burying people," Beck said. This thing was so lethal that people would basically come down with it one morning and be dead the next morning."

'But we gotta do it'

With cases rising, on Nov. 18, the Indianapolis Board of Health announced an order requiring face masks, along with the closure of all schools.

In that evening's edition of The Indianapolis News, Morgan said masks "should be made of cheese cloth, surgeon's gauze or other porous material." The News reported the board considered re-closing the city, but first wanted to attempt the mask order.

"The board said the order requiring the wearing of masks was adopted in the hope that thereby the necessity for a renewal of the general closing order would be avoided," the News reported. "It is up to the business men and the managers of business houses, theaters, poolrooms, barber shops and all other public places to see to it that persons without masks are barred. Places which violate this ruling will be closed."

Newspapers.com

In a Nov. 20 piece headlined, "All Dressed Up Like a Horse, With a Goshawful Nosebag--but We Gotta Do It," Indianapolis Star columnist Mary E. Bostwick described the scene in offices and streets as people acclimated themselves to wearing face masks.

"On the street, the masks were seen yesterday at intervals, although not frequently enough to keep the unmasked citizens from snickering at their brethren who were going around with their faces all under cover," Bostwick wrote. "But the mask wearers did not care. No one could tell who they were anyway."

While she found some humor and ridiculousness in the situation, in the end, Bostwick concluded the mask order was necessary.

"Whether we want to or not, we positively must not go anyplace indoors with our faces undressed," she wrote. "And if we get to chortling raucously at somebody so adorned, remember we look just as funny ourselves."

Newspapers.com

Still, same as today, there were those who fought against the mask order.

While the penalty for violating Marion County's order that is scheduled to go into effect Thursday is a fine of up to $1,000, the city treated "mask slackers" harshly in 1918. On Nov. 22, The Indianapolis Star reported three men were arrested in a hotel lobby after they refused to wear masks.

"They were released at the City Prison on their own recognizance," according to the Star.

As objections to wearing masks continued, Morgan spoke about the importance of following the order. In the Star on Nov. 24, he pleaded with citizens to wear masks in order to prevent the city from being shut down for a second time.

He emphasized the wearing of masks "is not a pet whim of any member of the health department" and that "the cooperation of the majority of people is absolutely necessary to make any preventative measure a success."

In full, Morgan said:

This was not for the purpose of causing an inconvenience to the public, as some conscientious objectors have stated, but to prevent infection from being transferred from one individual to another. The wearing of gauze masks is not a pet whim of any member of the health department. This method of preventing cross infection has been successfully used in a number of cities and has been used by surgeons for years to prevent droplet infection from reaching the field of operation. The mask has been adopted by military hospitals in both the general and infectious wards. Medical literature is full of data which proves conclusively the efficiency of this method.

When a community is confronted with a serious epidemic, the cooperation of the majority of the people is absolutely necessary to make any preventative measure a success. This is not a time for destructive criticism, petty jealousies or all-time 'knockers,' but an occasion for every individual to aid in the enforcement of the preventative measure to end that disease and death may be reduced to a minimum.

A turn for the better

At the beginning of the following week, however, Morgan was pleased with the results of the city's mask campaign. He urged caution, but with infection rates decreasing, on Nov. 25, the Board of Health rescinded the city's mask order. Schools remained closed until Dec. 2.

"This measure enabled the board to bridge over a very alarming influenza situation and to reduce the chances of cross-infection," Morgan said in The Indianapolis News on Nov. 25.

Morgan, who led the Indianapolis Board of Health for 33 years until his death in 1946, added that the wearing of masks allowed the city to continue business and retain at least a semblance of normalcy.

"It prevented a large number of persons from being deprived of employment, a situation that would have developed if a closing ban on all forms of business had been established," he said. "While the mask recommendation was met with some opposition, the spirit of cooperation in the beginning was all that could have been expected and enabled the board to cut short the present epidemic."

Newspapers.com

By the time flu pandemic passed, Indianapolis had a rate of 290 deaths per 100,000 people, one of the lowest among U.S. cities, according to the "Influenza Encyclopedia," produced by the University of Michigan Center for the History of Medicine and Michigan Publishing.

Bill Beck, of the Marion County Historical Society, said he and Dr. William McNiece, the Historical Society's president, estimate 950 people in Indianapolis died from the flu in October, November and December 1918.

I get the impression that both the state board of health and the county board of public health were very proactive," Beck said.

Being proactive will be a necessity in the days, weeks and months ahead in the current battle against COVID-19, which has killed at least 132,000 Americans, including more than 2,500 Hoosiers.

"This pandemic has not gone away," current Indianapolis Mayor Joe Hogsett said last week while announcing a face mask mandate. "And across the country, we are seeing examples of what can happen when a city lets its guard down."

If there is a singular lesson we can apply from Morgan's campaign against the influenza pandemic of 1918 to the coronavirus pandemic of 2020, it is that the path toward defeating a virus leads only through cooperation and collective will.

This virus obeys the laws of physics. It obeys the laws of chemistry. It obeys the laws of biology," Beck said. "It couldn't care less about anything else. You have to just keep your focus on the virus. You don't focus on anything else, you focus on the virus.

The Indiana Medical History Museum will host a virtual presentation featuring Bill Beck and Dr. William McNiese titled "The 1918 Pandemic: Indianapolis Confronts the 1918 Spanish Influenza" at 2 p.m. Sunday, July 12.

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In 1918, Indianapolis required masks during the fight against 'The Great Influenza' - WRTV Indianapolis

With the number of people affected by autoimmune diseases on the rise, Executive Medicine of Texas is dedicated to help. Their new Autoimmune Concierge Program is aimed at diagnosing and treating patient who may have begun to lose hope.

SOUTHLAKE, Texas (PRWEB) July 07, 2020

The National Institutes of Health reports that as much as 7% of the American population is suffering from some sort of autoimmune disease, equal to about 23.5 million Americans. They also report that the prevalence of such diseases continues to rise.

Executive Medicine of Texas, a company that's renowned for their half-day executive physicals and all-inclusive concierge packages, knows first-hand how much damage an untreated autoimmune condition can do. "Autoimmune diseases are notorious for causing chronic inflammation. We know that this inflammation can lead to heart disease, cancer, and a number of other serious health complications," says Walter Gaman, MD. "That's why we have to get these patients diagnosed and treated as soon as possible.

Dr. Gaman, one of the founders of the practice, knows first hand how complicated these conditions can be, as he has dealt with his own diagnosis of celiac disease for almost two decades. "I was diagnosed long before patients were being screened so regularly for the disease. Sometimes we study conditions because we want to, and sometimes it's because we have to. Mine started as the latter, but now I study and treat autoimmune disease because I know I can make a difference in the lives of these patients."

Lyme disease, another common autoimmune condition, accounts for much of the rise in this category of illness. The Center for Disease Control reported that there are approximately 329,000 new cases per year in the United States. Mark Anderson, MD said, "When our CEO came down with neuro lyme disease a few years back, it certainly got our attention. Subsequently, we began to see more patients with lyme-like symptoms, many of which tested positive. While not all have long term affects from this disease, many do. That's why proper management is so important."

Celiac and lyme disease are not the only illnesses that fall into this category, there are over 80 conditions that belong to the autoimmune family. Since symptoms can be wide-spread and often mimic other conditions, patients are often misdiagnosed prior to finding the correct diagnosis and form of treatment.

The Autoimmune Concierge Program at Executive Medicine starts with a half-day exam with over one hundred different lab values, some of which are specific for these types of conditions. Because autoimmune disease can cause a host of other health problems, the patients are also screened for cardiac and autonomic nervous system abnormalities. "The goal," Dr. Gaman says, "is to listen to the patient, gather all the right information through extensive testing, and then develop a plan to help them live a healthier and longer life. Part of that plan will be to significantly reduce inflammation and repairing damage when possible."

About:Executive Medicine of Texas is a luxury medical practice that focuses on preventative and proactive medicine. Their clients come from all over the globe and include individuals, as well as many corporate clients. Located in Southlake, Texas, half-way between Dallas and Fort Worth, many patients fly in to DFW airport or one of the many private airports within the area. You can obtain a FREE copy of their award-winning book Age to Perfection: How to Thrive to 100, Happy, Healthy, and Wise by clicking HERE.

For the original version on PRWeb visit: https://www.prweb.com/releases/executive_medicine_of_texas_announces_new_autoimmune_disease_program/prweb17240078.htm

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Executive Medicine of Texas Announces New Autoimmune Disease Program - Benzinga

GENEVA/LONDON (Reuters) - The World Health Organization (WHO) should soon get results from clinical trials it is conducting of drugs that might be effective in treating COVID-19 patients, its Director General Tedros Adhanom Ghebreyesus said on Friday.

World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus attend a news conference organized by Geneva Association of United Nations Correspondents (ACANU) amid the COVID-19 outbreak, caused by the novel coronavirus, at the WHO headquarters in Geneva Switzerland July 3, 2020. Fabrice Coffrini/Pool via REUTERS

Nearly 5,500 patients in 39 countries have so far been recruited into the Solidarity trial, he told a news briefing, referring to clinical studies the U.N. agency is conducting.

We expect interim results within the next two weeks.

The Solidarity Trial started out in five parts looking at possible treatment approaches to COVID-19: standard care; remdesivir; the anti-malaria drug touted by U.S. President Donald Trump, hydroxychloroquine; the HIV drugs lopinavir/ritonavir; and lopanivir/ritonavir combined with interferon.

Earlier this month, it stopped the arm testing hydroxychloroquine, after studies indicated it showed no benefit in those who have the disease, but more work is still needed to see whether it may be effective as a preventative medicine.

Mike Ryan, head of the WHOs emergencies programme, said it would be unwise to predict when a vaccine could be ready against COVID-19, the respiratory disease caused by the novel coronavirus that has killed more than half a million people.

While a vaccine candidate might show its effectiveness by years end, the question was how soon it could be mass produced, he told the U.N. journalists association ACANU in Geneva.

There is no proven vaccine against the disease now, while 18 potential candidates are being tested on humans.

WHO officials defended their response to the virus that emerged in China last year, saying they had been driven by the science as it developed. Ryan said what he regretted was that global supply chains had broken, depriving medical staff of protective equipment.

I regret that there wasnt fair, accessible access to COVID tools. I regret that some countries had more than others, and I regret that front-line workers died because of (that), he said.

He urged countries to get on with identifying new clusters of cases, tracking down infected people and isolating them to help break the transmission chain.

People who sit around coffee tables and speculate and talk (about transmission) dont achieve anything. People who go after the virus achieve things, he said.

Editing by Michael Shields and Andrew Cawthorne

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WHO sees first results from COVID drug trials within two weeks - Reuters

Omar P. Haqqani, for the Daily News

Dr. Haqqani: Eliminating disparity in health care

The medical community should make every effort to eliminate the impact of racism in health care. Although the disparities are being brought to light by the current pandemic, the problem has been acknowledged in the past. Now is the time for health care professionals to aggressively seek to reverse the impact of negative attitudes and practices that have long been in place.

Causes and effects of racism in health care

There is an alarmingly high national rate of COVID-19 hospitalizations and deaths within the minority community, according to The Centers for Disease Control and Prevention. It is 4.5% higher for African Americans than that of the non-minority population. It also rises for Hispanic or Latino individuals and Native Americans.

Aside from the increases brought to light by the coronavirus, the disparity in general good health can be seen across the board in every medical arena. The higher rates of diabetes, obesity, hypertension and other conditions among minorities have contributed not only to higher coronavirus consequences, but to cardiovascular issues, kidney failure and other dangerous circumstances.

In a report published in the archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health's National Library of Medicine in 2019, unequal access to medical care for minorities is a major factor in fostering health inequities. Other factors in maintaining or widening the gap include a lack of childhood development, a higher rate of poverty, and income inequality between minority workers and non-minority workers. Housing and other social and economic factors are also important in the health care disparity discussion. While they may not all seem related specifically to medical care, they result in inadequate circumstances for minorities.

Lack of preventative care

The economic disadvantages more frequently faced by minorities in childhood and adulthood lead to less consistent medical care. Infrequent checkups and less education about signs of disease increase the odds of major health difficulties. According to the NIH/NLM report, only 3% of all health care money in the United States is spent on preventative care. Many dangerous medical conditions, including cardiovascular issues, are preventable, or at least more controllable when warning signs are detected.

The economic factors of racism decrease the probability of prevention. Because wages are lower, doctor visits are infrequent. Many low paying jobs do not include health benefits. Workers may also resist relinquishing a day's pay to go to a doctor's office for a checkup, as well.

Availability and procedural disparities

The there is also a fracture quality of health care for minorities once a diagnosis is made and treatment is prescribed. The impact of this is obvious in all age groups. Infant mortality rates are higher and life expectancy is shorter in minority communities. In one example of specific treatment recommendations, the Journal of the American Society of Nephrology cites a study that revealed that 35% fewer minority patients who were eligible for kidney transplants received them, versus the non-minority eligible patients.

Steps the medical community must take

Addressing social risk factors among minorities, diversifying the health care work force, improving the availability of health care and providing more avenues to primary care are among the strategies that can help.

There are programs in place that provide outreach into minority and underprivileged communities to provide better health care. Medical institutions should encourage their doctors and nurses to participate in programs that deal with childhood intervention, senior care and assistance to the disabled.

The American Medical Association has acknowledged that bias exists within health systems and peripheral institutions that contribute to the disparities. Health professionals and institutions are being urged to examine and correct it.

Ask Dr. Haqqani

If you have questions about your cardiovascular health, including heart, blood pressure, stroke lifestyle and other issues, we want to answer them. Please submit your questions to Dr. Haqqani by e-mail at questions@vascularhealthclinics.org.

Dr. Omar P. Haqqani is the chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland: http://www.vascularhealthclinics.org

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Dr. Haqqani: Eliminating disparity in health care - Midland Daily News

As record breaking numbers continue in Georgia, health officials weigh in on what it means.

ATLANTA It was another record-breaking day for new COVID-19 cases in Georgia. Wednesday, the Department of Public Health reported 2,946 new cases.

The number of current COVID-19-related hospital patients now stands at 1,570, as shown in the graphic below. Thats not the highest number of active patients weve had in this pandemic, but it is the largest since Georgia Emergency Management started providing the data on May first.

I think were seeing a diagnosis made earlier in the course of disease than we did in March or April, and thats because of increased access to testing, said Dr. Danny Branstetter, who serves as the Medical Director of Wellstars Infection Prevention.

Wellstar Kennestone sits in Health District N, which, according to Georgia Emergency Management, is already using 89 percent of its ICU beds between COVID-19 and other illnesses.

Im really concerned about what the next week holds as far as the demand on our ICU level care," Branstetter said.

The line on the chart above indicates the number of active COVID-19 patients since May.

Branstetter said hospitals are ready for it and have room to care for patients, despite how that GEMA data might sound.

We probably operate on a normal basis, without COVID, at a little bit higher than that at capacity. So, those numbers are not too concerning, Branstetter added. "If anything, it says, 'yes, weve got room to take care of people.' And remember, that number does not include our surge capacity planning."

What is making Branstetter concerned, is the unnecessary risk too many are taking by not wearing masks or social distancing.

All of these infections are preventable if we just continue to push on and persist. I know everyones got COVID fatigue. I have COVID fatigue. Its important though we get up every day and realize we still have to do our part. We still have to get up and do all those things we really dont enjoy," Branstetter said.

Hes especially concerned about the rise in cases among 18 to 29 year olds. They now account for 22 percent of the state's positive cases, as shown in the graphic below.

Thats concerning a little bit because theyre the most mobile members of society, so theyre likely to bring it places, Branstetter explained. The one thing I want that age group particularly to know, theyre not immune to the complications of COVID infections.

Thats because young adults tend to visit doctors less for preventative medicine, so they dont know if they have any of the underlying factors that increase risk. He said now that theyre coming in, doctors are seeing an increase in high blood pressure and diabetes diagnosis.

Piedmont Health System shared a chart with us, based on internal surveys regarding patient care. It seems people were just starting to feel comfortable with the idea of going back to the hospital for treatment of chronic illnesses and elective surgeries until mid-June.

Despite a dip in confidence, both Piedmont and Wellstar say theyre well-equipped to handle patients of any kind and urged those in need of care not to wait.

Dont delay. Were very prepared to separate those with COVID infection or potential infection from everyone else, so its very safe to come to receive your health care," Branstetter said.

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Here's what is - and isn't -concerning to health experts watching coronavirus in Georgia - 11Alive.com WXIA

GLOBAL

However, such mobile phone apps have raised data privacy and bioethical issues around their use in public health.

Public health relies on good quality surveillance, noted Angus Dawson, professor of bioethics and director of Sydney Health Ethics at the University of Sydney, Australia.

However, contact tracing can generate all kinds of ethical problems, he said, speaking at a June webinar organised by the bioethics group of the Association of Pacific Rim Universities (APRU) Global Health Program, noting that it raises issues of privacy, informed consent and confidentially.

One of the concerns is what actually is the data being collected, said Dawson. How much of it is identifiable data in relation to particular individuals?

It is not just a technical issue but a medical one too, he said, adding that every intervention in the COVID area has to involve ethical considerations whether we are talking about distribution of protective equipment, ICU beds, or hopefully in the future when we might have some vaccines.

Apps in use in the region include the Alipay Health Code app in China, which codes people as green or red depending on their health status and requires identity card details as well as full face scans.

Hong Kong has the StayHomeSafe app combined with a wristband linked with the app. Developed by Gary Chan, a professor at Hong Kong University of Science and Technology, the app maps a unique footprint of a persons locality. Stepping out beyond certain perimeters triggers an alert. Taiwans Intelligent Electronic Fences System app uses different measures, but with similar functionality.

New Zealands NZ COVID Tracer app is based on a digital diary of places visited by individuals by scanning the official QR codes, which can alert and be shared with contact tracers.

Singapores TraceTogether app, developed by the Government Technology Agency together with the Ministry of Health, exchanges short-distance Bluetooth signals between mobile phones to detect other TraceTogether users in close proximity. The data is shared once the individual is contacted by contact tracers. The Singaporean app has also been adopted in Japan and Australia.

Some of the apps have supplementary functions where individuals can input symptoms to create an alert.

What happens to the data?

Calvin Ho, associate professor in the faculty of law at the University of Hong Kong researching health and biomedical technologies, said international health regulations drawn up by the World Health Organization (WHO) put a lot of emphasis on technological surveillance as well as rapid technological advances, but it did not quite anticipate the developments that have arisen from this particular [coronavirus] outbreak.

In many of the countries and cities where mobile phone use is high, such apps have been very effective in controlling the rate of infections many of the cities did not have to introduce a complete lockdown, Ho said during the webinar.

However, privacy is a huge question. We do not yet know what is going to happen to the data, Ho said. There needs to be public discussion on what principles of data protection have to be observed.

For the public to be willing to take part, trust and transparency is crucial, he added.

In the midst of an outbreak, as we have seen in South Korea, for example, people are very conscious about social responsibility. Theres a very strong societal and peer emphasis so people tend not to invoke their right [to privacy] straight away. That seems to be the phenomena right across East Asia, he said. But also in Australia and New Zealand, people were extremely cooperative.

In Western Europe and the United States, people have been more vocal on privacy issues.

Privacy has not been highlighted as a huge issue across Asia, particularly in the initial stages, Ho said. But it does not mean these concerns are not there. Individuals remain concerned about whats going to be used out of all the data thats been collected about them. Its very vivid in their minds.

Involvement of tech giants

Ho described the use of such mobile technologies as a form of mass surveillance. Some ethical principles are not always followed with surveillance, he noted.

The WHO Guidelines on Ethical Issues in Public Health Surveillance, published in 2017, state: Those responsible for surveillance should identify, evaluate, minimise and disclose risks for harm before surveillance is conducted. Monitoring for harm should be continuous, and, when any is identified, appropriate action should be taken to mitigate it.

Ho, who helped draft the WHO guidelines, noted that they were drawn up with governments and public health systems in mind, rather than corporations or NGOs.

Ho pointed to the involvement of technology giants such as Google and Apple in developing some of the apps in use during the pandemic, which raises questions of whether we are further empowering very powerful industry players with control over public health measures, and added that it is unclear what such companies will do with the data.

Technically, the data will be owned by these commercial developers. With other contact-tracing apps there should be an agreement with the public at the authority and then the data belongs to the public health authority, Ho told University World News.

Ho added that if such companies are not carefully monitored, then ultimately it does mean that these huge commercial entities could potentially exploit public health systems and potentially vulnerable individuals, essentially for political gains or some kind of influence over government.

Balance of public health and privacy

Dawson, who is also one of the drafters of the WHO guidelines, said COVID needs to be thought about as a global ethical issue, and not just a concern to an individual.

Issues of data ethics and the balance of personal privacy often come down to the advantages we might have through having that data, Dawson said. Public health systems can have very good reasons to try to understand what the levels of infection are in different regions and cities across the world and then use that to plan how they are going to respond.

He noted that with some of the recent contact-tracing apps, some of that data is identifiable and some is not.

We should not just think public good versus privacy. There are ways to try to think about how they are both important and we can put protections in place, for example putting coding attached to individual level data to make sure individuals cant be identified, Dawson said.

Research ethics

Bioethical principles used in conducting medical research can be useful in guiding use and data issues surrounding such apps.

This kind of surveillance is very similar to research in many ways, said Ho. It can involve similar methodologies and activities. These can include systematic investigation, medical record review and data mining.

Both involve human subjects and both can raise similar ethical issues, including exposure of subjects to risk, standards of care and questions about informed consent. However, Ho pointed out: Informed consent is a basic tenet of research ethics, but it is often not sought in the context of surveillance.

Biomedical research has strong regulations in place and systems overseen by ethical committees in universities, hospitals and research institutions.

There is less institutional oversight for surveillance, which means app-based surveillance, data and research derived from it may not undergo ethics committee reviews, Ho said.

With academics and researchers well trained and experienced with research ethics, they can contribute to improving bioethical aspects of surveillance, Ho said, adding that university input into issues of data governance, accountability and transparency measures were likely in the wake of the pandemic.

Mellissa Withers, associate professor at the department of preventive medicine at the University of Southern California in the US and director of the APRU Global Health Program, said the bioethics group within the APRU programme would continue to look at such issues to inform policy-makers.

A lot of the experts are involved in research ethics committees, and they are very active in reviewing the ethics of human subject research in their own universities, but more needs to be done across universities and, in particular, there is a real need for sharing and doing training in low- and middle-income countries, she noted.

There was a lot of interest from [those in] the Philippines and Indonesia attending the webinar which shows they really want some guidelines and recommendations on bioethics. They are interested in building capacity around these areas and learning whats going on in the field.

Structured regulation needs to be in place or at least these ethical issues need to be considered because there is the opportunity for [data] misuse by governments, Withers told University World News.

We need more standardised policies that can be implemented across countries because it wont go away even after COVID-19. The amount of data collected for public health purposes is growing exponentially every year.

More here:
COVID-19 apps Are there enough ethical safeguards? - University World News

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The state recorded another 499 confirmed cases of COVID-19, the Utah Department of Health announced Wednesday with one more Utahn dying from the disease.

A Salt Lake County man, between ages 65 and 84 and in a hospital, was the latest person in Utah to die from COVID-19, UDOH reported. His death brings the states toll due to the coronavirus to 173 people.

Another 32 people were hospitalized with COVID-19, according to the state report. There were 194 people hospitalized in Utah as of Tuesday (hospitalization figures are a day behind case counts), and there have been 1,476 Utahns hospitalized with COVID-19 since the first cases were reported in March.

Wednesdays new cases bring the states total number of cases to 22,716. Of those, 12,707 are considered recovered meaning, by the states definition, its been three weeks since they were diagnosed and theyre still alive.

Another 2,605 tests were administered Wednesday, bringing the total number of Utahns tested to 343,358. The rate of positive tests for the last seven days is 11.8%, and its at 6.6% since the first cases were reported in March.

The state has averaged 561.7 cases per day in the last week. Thats well above the 200-cases-per-day average the states epidemiologist, Dr. Angela Dunn, said in an internal memo last month would be necessary by July 1 for the state to avoid a complete shutdown of the states economy.

Also Wednesday, researchers at the University of Utah announced the latest results from the Utah HERO study, measuring the spread of COVID-19 in Utah.

Counting nearly 9,000 residents in Davis, Salt Lake, Summit and Utah counties, the studys first phase found about 1% tested positive for COVID-19 antibodies. The results match the preliminarily findings, announced Friday in a webinar.

Antibody tests are a lagging indicator, showing more of where the virus has been than where its going, said Dr. Stephen Alder, the Utah HERO studys director of field operations and a professor in the U.s Department of Family and Preventative Medicine.

Were looking a few weeks in the past, when were looking at antibodies, Alder said. Its a good historical marker.

The second wave of the study will expand past the four counties measured in the first phase, into hot spots of viral activity that were going to go into and understand those areas better, Alder said.

Originally posted here:
Utah tallies another 499 cases of COVID-19, and one more death - Salt Lake Tribune

By: Reuters | Geneva, London | Published: July 4, 2020 6:39:32 am There is no proven vaccine against the disease now, while 18 potential candidates are being tested on humans.

The World Health Organization (WHO) should soon get results from clinical trials it is conducting of drugs that might be effective in treating COVID-19 patients, its Director General Tedros Adhanom Ghebreyesus said on Friday.

Nearly 5,500 patients in 39 countries have so far been recruited into the Solidarity trial, he told a news briefing, referring to clinical studies the U.N. agency is conducting.We expect interim results within the next two weeks.

The Solidarity Trial started out in five parts looking at possible treatment approaches to COVID-19: standard care; remdesivir; the anti-malaria drug touted by U.S. President Donald Trump, hydroxychloroquine; the HIV drugs lopinavir/ritonavir; and lopanivir/ritonavir combined with interferon.

Earlier this month, it stopped the arm testing hydroxychloroquine, after studies indicated it showed no benefit in those who have the disease, but more work is still needed to see whether it may be effective as a preventative medicine.

Mike Ryan, head of the WHOs emergencies programme, said it would be unwise to predict when a vaccine could be ready against COVID-19, the respiratory disease caused by the novel coronavirus that has killed more than half a million people.

While a vaccine candidate might show its effectiveness by years end, the question was how soon it could be mass produced, he told the U.N. journalists association ACANU in Geneva.

There is no proven vaccine against the disease now, while 18 potential candidates are being tested on humans.

WHO officials defended their response to the virus that emerged in China last year, saying they had been driven by the science as it developed. Ryan said what he regretted was that global supply chains had broken, depriving medical staff of protective equipment.

I regret that there wasnt fair, accessible access to COVID tools. I regret that some countries had more than others, and I regret that front-line workers died because of (that), he said.

He urged countries to get on with identifying new clusters of cases, tracking down infected people and isolating them to help break the transmission chain.

People who sit around coffee tables and speculate and talk (about transmission) dont achieve anything. People who go after the virus achieve things, he said.

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WHO sees first results from coronavirus drug trials within two weeks - The Indian Express