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Archive for the ‘Preventative Medicine’ Category

Spain virologists say the countrys second virus wave holds a valuable lesson for the rest of the world – MarketWatch

Sunday, September 13th, 2020

MADRID Just days away from the start of a new school year, Spains capital city rolled out fresh restrictions on Monday to cope with whats becoming a relentless second wave of cases.

But those measures strict controls on the distance between seats rather than tables in food-service settings, reducing funeral attendance to 25 people indoors and 50 outdoors, and 10-person limits on social gatherings seem modest as the countrys total infections close in on 500,000, according to the latest data from Johns Hopkins. Official numbers indicate that threshold has already been reached. Spains is the highest infection total in Europe, though it pales against the 6 millionplus cases in the U.S., which has seven times Spains population.

Madrids new measures are cold comfort to parents, including this journalist, who will be sending at least one child to all-in-person classes of 21 children. More than 2,000 of 66,000 Madrid teachers recently tested positive for COVID-19 and will have to be retested. Elsewhere in the country, two schools have already had to close due to infections.

At the heart of the resurgence of Spains cases has been a rush to return to normal. Spains experience has also been impacted by government desperation to get the tourism industry and bars back in operation; overly relaxed family gatherings; insufficient safety protocols for field workers; and the behavior of idle youth with effectively nothing to do but party, and spread the virus.

Much as New York did, Spain climbed out of the depths of COVID-19 infections with the strictest measures possible, but some parts of the country began to suffer two months later. To be clear, not all of the country has been equally affected in the second wave, with Madrid the hardest hit, while other regions are seeing low infection rates, as this government map shows.

How the country pulls itself out this time may be a blueprint for other countries and municipalities to follow. MarketWatch spoke to these experts via email in hope of shedding light on where Spain stands now and what should be done.

Juan Jess Gestal Otero, professor emeritus of preventative medicine and public health at the University of Santiago de Compostela in Galicia, was one of 20 experts who signed a letter in the British medical journal the Lancet asking for an independent review of Spains COVID-19 response.

MarketWatch: What key mistakes did Spain make after the lockdown in the spring, and what must it do now to fix the situation?

Otero: It took a long time to get contact tracing up and running. It should have started when the case curve began to decline. It would have helped to have the disease more controlled at the end of the de-escalation. Each autonomous community set up its own tracking system, many of them insufficiently staffed.

MarketWatch: Will Madrids new measures, such as cutting capacity at bars and restaurants, really help get the disease under control?

Otero: I dont think those measures help much to contain outbreaks. ... To have the disease under control, the most important thing at this time is to strengthen the tracking capacity of the national health system. If this is not done soon, the continued increase in outbreaks can eventually overwhelm the tracking capacity of the system and lead to a loss of control and aggravate the situation. National coordination is also very important.

Dont miss:To defeat COVID-19, we need a unified national strategy, says public health expert Dr. Howard Koh

MarketWatch: What are the differences between now and March that are encouraging and discouraging?

Otero: Now there is epidemiological surveillance capacity, although it needs much improvement, for the early diagnosis of cases and contact tracing, and there is the capacity to perform many tests, which allows for detection of a large number of asymptomatic patients. Most of the current cases are young people in whom the disease is less severe, unlike in March-April, and the health system is not under pressure. It is discouraging to observe how certain social groups, mostly young people, are encouraging outbreaks with their behaviors.

MarketWatch: What should other countries learn from Spain?

Otero: Strongly strengthen the epidemiological surveillance system. As soon as possible, start tracking the contacts of the cases and carry out many, many tests, to locate the largest possible number of asymptomatic patients. Make the return to the new normal very carefully to avoid new outbreaks. Do not authorize activities that are incompatible with a respiratory pandemic, such as those that involve spending time in closed, poorly ventilated places with many people, parties, nightlife activities. ... Raising awareness of the need to take protective measures in homes when they receive visitors, receive them in well-covered rooms, avoid family parties ... as it is in homes where the greatest number of infections occurs.

Dr. Vicente Soriano is the director of the UNIR Medical Center in Madrid and a clinician and professor of infectious diseases at the UNIR Health Sciences School and Medical Center.

MarketWatch: What do you think of Madrids new measures to try to contain the virus?

Soriano: The confluence of crowding, the return to working activities for many, and easier access to testing as compared with negligible in March largely accounts for the new surge in cases. It will go up for the next couple of weeks. Despite, to date, that many new PCR+ diagnoses have been found in young and asymptomatic people, this second wave will soon expand to the whole population, including again the most vulnerable populations. Indeed, although so far the situation at most large Madrid hospitals has not collapsed, it reminds us slightly of what happened in February, when overwhelming began to occur.

MarketWatch: What about contact tracing and other efforts?

Soriano: The advent of rapid antigen tests will be helpful, although there is room for further improvement, testing saliva (instead of nasopharynx fluid), selling in pharmacies, and allowing for self-testing at home, like pregnancy tests, as many times as convenient.

MarketWatch: What else needs to be done?

Soriano: Regional governments need to work further on three areas: (1.) increase the role of primary-care physicians as a first barrier to assess nonseriously ill patients and manage them with the help of telemedicine, avoiding the collapse of hospital emergency departments; (2.) medicalization and ensure enough health-care workers and protective equipment for nursing homes for the elderly and other institutionalized patients these places accounted for more than 60% of the death toll during the first COVID-19 tsunami wave in Spain; (3.) ensure stocks of diagnostic tests, protective equipment and enough doctors and nurses in clinics and hospitals for confronting the new COVID-19 surge. Acting upfront is always preferable to at the time of demand, when damage has already occurred.

MarketWatch: As a parent, how do you feel about sending your own children back to school?

Soriano: Reopening schools is a critical decision that is supported by the fact that youngsters very rarely become sick and allows parents to continue their jobs. So, I am in favor of reopening schools and therefore let my four children go to school, with the maximum guarantees they have established. I am aware that temporal closing of groups, classes and periodic cases will be reported. Inevitable. But working under this threat is preferable to paralyzing or closing the school.

Read on:Top coronavirus doctor in Spain has a message for revelers and tourists

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Vaccination key to preventing twindemic – North Platte Telegraph

Sunday, September 13th, 2020

Pop quiz time. Youve got a cough, fever, chills and a runny nose: Is it COVID-19 or influenza?

The only symptoms that are unique to COVID and not unique to the flu is the loss of taste and the loss of smell, Otherwise youll have the same symptoms, said Jenny Lantis, infection prevention coordinator with Great Plains Health.

However, there is something that can help you and your health care provider figure out what youve got without waiting on test results: Whether or not youve gotten the influenza vaccine.

If you get vaccinated that will definitely help, because once you become sick with the symptoms, it may be easier to diagnose you, because we can say, You had the flu vaccine, so quite possibly what you have is COVID rather than flu, Lantis said. Thats probably the biggest, most important thing this year you can do is to get the (flu) vaccination.

The Centers for Disease Control and Prevention estimated that there were as many as 56 million cases of influenza during the 2019-20 flu season. While this season isnt expected to be as severe, the ongoing novel coronavirus pandemic raises concerns of a twindemic that could strain the health care system.

We are concerned with influenza and COVID overlapping, and one of those reasons being is that we dont want to overwhelm our health care facilities, Lantis said. Currently with a mild flu season, that does tax the hospital already, so with the overlapping of the two infectious diseases, that could overwhelm the health care facility.

The best way to help prevent overburdening the system? Get your flu shot, Lantis repeated.

Influenza vaccination is probably more important this year than ever because of the threat of the twindemic and that we could be facing the two emergencies at the same time, Lantis said. Getting vaccinated because influenza is already a deadly disease we want to make sure everyone is protected. Another good reason for getting vaccinated is because having the flu and COVID-19 on top of it could be deadly.

Great Plains Health family medicine practitioner Dr. Kali Rubenthaler echoed that sentiment.

As we head into flu season, its going to be complicated, Rubenthaler said. The flu and COVID-19 look very similar as far as respiratory symptoms go. Thats why getting a flu shot this year is more important than ever. While the flu vaccine does not prevent 100% of flu cases, it does lessen the severity and keep people from being hospitalized.

Lantis and infectious disease specialist Dr. Eduardo Freitas are cautiously optimistic that measures in place to prevent COVID-19 spread will help lessen the severity of flu season.

Dr. Freitas and I actually forecast that this flu season wont be as bad if everyone continues to mask and do good sanitizing and social distancing, Lantis said. Were hoping that will help decrease the amount of flu that we see in our community, as long as everybody is doing those preventative measures to help prevent infection.

Despite the measures in place that may help decrease the spread of the flu, Lantis said she and Freitas are concerned that there will be large numbers of people who will forgo the flu vaccination just because of all the concerns with truthfulness and accuracy of information, which leads to concerns of a widespread outbreak.

Due to the pandemic, the hospital is exploring different options for administering the vaccine to avoid having large numbers of people in one clinic.

Some options were looking at are drive-thru flu clinics, where you can schedule your vaccination in advance, and well have staff outside, kind of like our drive-thru mobile clinics for COVID, Lantis said. Were looking at options where we dont have to bring all these people into clinics just for a vaccine.

GPH has also started administering the flu vaccine to patients, and encourages people to get the vaccine as soon as it is available. According to the CDC, manufacturers have projected that they will provide as many as 198 million doses of flu vaccine, which tops the 175 million dose record set during the previous flu season.

As of Friday, 47.6 million doses of the flu vaccine have been administered.

The vaccine is not perfect, but its still a good vaccine, Lantis said. Its important to get it so you can lessen the severity of your symptoms, which will also help in decreasing hospitalizations, so that were not overwhelmed here with as many flu patients, and we can make sure we can take care of our COVID patients.

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When You Can’t Trust The CDC: Red And Blue States Alike Flee Trump COVID Response – TPM

Sunday, September 13th, 2020

States, cities, and pharmaceutical companies are contradicting or ignoring the Trump administration in responding to COVID-19 as the White House continues to push for responses that could help the President politically while undermining the countrys ability to fight the pandemic.

The Trump administration has issued directives and statements in recent weeks that appear aimed at boosting the Presidents chances of re-election, be it predictions of a vaccine in time for Nov. 3, or a change in CDC guidance that, if followed, would reduce the volume tests, resulting in the appearance of fewer cases.

But the administrations ongoing battle against the political impact of COVID-19 rather than the disease itself has lowered confidence in the countrys public health agencies. The loss of influence has meant that states and local governments are far warier of federal public health advice.

Recent events had really shaken the confidence of health experts and the public alike,Dr. Howard Koh, a former assistant secretary for health at the Department of Health and Human Services, told TPM.

If people dont have trust and confidence in the vaccine and the FDA approval process, and in guidance from the CDC, Koh added, this pandemic will go on indefinitely.

The result is a situation in which the Trump administration issues politically motivated pronouncements that damage the federal governments ability to fight COVID-19, but which are sometimes so absurd on their face that institutions outside of the Presidents chain-of-command wont participate.

The political leadership has not been strong and it has tarnished the reputations of both the FDA and the CDC, Dr. Bill Schaffner, professor of preventative medicine and infectious diseases at Vanderbilt University Medical Center, told TPM.

The two agencies established to protect the health of the United States population have had their reputations injured, and they have been frequently sidelined by the national political mechanism, he continued. Thats painfully sad, and it will take many years for both of these agencies to restore their credibility.

TPM could identify virtually no body that took the CDCs recommendation to stop testing those exposed to COVID-19 but who displayed no symptoms. Rather, an array of states and localities across the political landscape said publicly that they would continue to test.

At the same time, President Trumps attempt to release a COVID-19 vaccine caused even the pharmaceutical firms developing the inoculation to issue an unprecedented statement affirming that they were committed to making sure that a vaccine was safe and effective before asking the government for approval.

The CDCs recommendation on asymptomatic testing last month came as a shock to many, and provoked an outcry from the public health community that caused the administration to waffle on what exactly the recommendation meant.

Experts voiced their concern that the recommendation would confuse local officials, leading them to reduce testing. But instead, states and localities decided to ignore the CDC.

Texas and Florida declined to change their guidance, and continue to recommend that those exposed to COVID-19 but who show no symptoms get tested.

North Dakotas Division of Disease Control Chief Kirby Kruger said that the state hasnt changed any of our recommendations here in North Dakota and were unlikely to because we believe our recommendations make sound public health sense.

And in Mississippi, State Health Officer Thomas Dobbs described the guidance as outdated and poorly communicated before saying that the state would not change its recommendations.

HHS spokesman Michael Caputo did not reply to a request for comment from TPM regarding examples of states or localities that had taken the CDCs recommendation.

President Trump has repeatedly promised a vaccine by Election Day, and publicly pressured the FDA to approve a vaccine by that time.

That flies in the face of timelines needed for the current vaccine trials to determine safety and efficacy. One government official told CNN that he did not know any scientist involved in this effort who thinks we will be getting shots into arms any time before Election Day.

Officials from multiple states have told TPM that they would refuse to distribute a vaccine that received federal approval without completing the necessary trials, or without receiving approval from an independent board of scientists.

Theres a process for vaccine approval thats been followed for years, and people perceiving that there were shortcuts this time is going to be disastrous, Koh said. It just cannot happen.

The seven pharmaceutical firms involved in developing COVID-19 vaccines issued a joint pledge on Tuesday morning, saying that the firms would only ask for FDA approval following convincing data showing that a vaccine candidate is safe and effective.

Dr. Schaffner, who also serves as a member of the CDCs Advisory Committee on Immunization Practices, told TPM that the statement is impressive and unprecedented.

But, Schaffner added, it falls short of specifying what the firms would do to ensure safety.

Theyre not saying they are committed to running the trial until its completion, Schaffner said. They are not saying that they insist on the FDA taking whatever decision they make and bringing it to the advisory committee that the FDA already has.

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When You Can't Trust The CDC: Red And Blue States Alike Flee Trump COVID Response - TPM

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Flu vaccine vital as COVID-19 deaths rise and America tries to avoid dueling winter crises – NBC News

Sunday, September 13th, 2020

As many as 34 million people sick from a respiratory virus. 490,000 hospitalizations. 34,000 deaths.

Are we talking about the coronavirus?

Nope. Just the flu. And its lurking just around the corner. In the United States, influenza (aka the flu) season typically starts in September or October and peaks between December and February, although viral activity can begin as early as September and as late as May, according to the U.S. Centers for Disease Control and Prevention. And its on a collision course with the worst infectious disease outbreak weve experienced since the 1918 pandemic.

As bad as this all sounds, in a matter of a few weeks, life as we know it will become drastically worse if we dont act now.

For the past seven months, the attention of the world has been monopolized by COVID-19. It is now the beginning of September and the novel coronavirus has infected over 27 million and killed over 832,000 worldwide at the time of publishing. The U.S. close to five percent of the worlds population comprises nearly one-quarter of all cases and deaths: surpassing 6 million and 190,000, respectively.

New cases and deaths are increasing in multiple states nationwide, as well as in Puerto Rico. The ripple effects of this health crisis have been unprecedented: record high unemployment; widespread school and university closures; staggering food and housing insecurity; escalating depression and other mental health issues; and unrelenting fatigue and burnout among front-line health care workers.

As bad as this all sounds, in a matter of a few weeks, life as we know it will become drastically worse if we dont act now. This means focusing on stopping the spread of the coronavirus while also using all of our preventative measures to prevent the spread of other respiratory illnesses such as pertussis and RSV (respiratory syncical virus), in addition to influenza. The combination of COVID-19, influenza and a panoply of acute and chronic illnesses such as heart attacks, strokes, cancer and accidents may, and likely will, paralyze our existing health care system.

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The flu comes every year, but that doesnt make it any less deadly. The CDC estimates that over five consecutive fall-winter seasons, from 2014-2015 to 2018-2019, influenza was associated with nearly 207,000 deaths of which, 81 percent were among people ages 65 and older. The widely publicized 1918 influenza pandemic was associated with 675,000 deaths in the U.S. and 50 million worldwide.

Like COVID-19, influenza can also cause a whole host of nasty complications. While most people who get influenza will recover in less than two weeks, others can experience life-threatening conditions such as pneumonia, myocarditis, encephalitis and multi-organ failure.

Also like COVID-19, the flu disproportionately impacts racial/ethnic communities. Between 1929 and 1931, the influenza mortality rate per 100,000 was 30.3 among whites and 71.3 among nonwhites. By 1950, the influenza and pneumonia mortality rates were 44.8 and 76.7, respectively.

But unlike COVID-19, which seems to have mostly milder effects on children, healthy kids are at higher risk of complications for influenza, according to the CDC. (However, infants and children with underlying conditions are at increased risk for both viral infections.)

Unfortunately, influenza and COVID-19 are not the only respiratory viral infections that will tax our health care system and use competing resources such as point-of-care testing, hospital beds, ventilators and supportive medications. Many other viruses cause infections deep in the chest. Layered atop widespread COVID-19, these infectious pathogens will likely wreak havoc on an already overburdened health care system.

In addition, the fall and winter of 2020 will bring us another complicated seasonal respiratory infection: enterovirus D68. Although rarely seen in the U.S. prior to 2014, weve been seeing this infection circulate over the past several years. The good news? It usually causes a mild to moderate respiratory infection in children. The bad news is that enterovirus D68 can lead to acute flaccid myelitis, a rare but serious neurologic condition that can evolve over hours to days. Health officials are concerned that parents may hesitate to take their children for evaluation and treatment of mild neurologic symptoms out of concern for COVID-19 infection risk.

Lets focus on the infections we can mitigate at this point. The good news with influenza? Unlike with COVID-19, we have:

Rapid testing that, while not sensitive, remains a helpful specific tool. There are also multiple available and safe treatments. Four FDA-approved antiviral drugs have been approved just this year: oseltamivir (Tamiflu), zanamivir (Relenza), peramivir (Rapivab) and baloxavir (Xofluza). There are also multiple FDA-licensed vaccines produced each year, not to mention the decades of information that scientists are always consulting to make sure we have data to track flu mutations and adjust treatment and prevention methods.

Despite the availability of a flu vaccine, at best an estimated 40 to 50 percent of the population opts for this preventive measure. But now more than ever, the medical community is united in its support of this vaccine.

As with the coronavirus pandemic, we will need strong leadership from our elected officials including massive funding of public health agencies, consistent messaging rooted in science and targeted outreach to our most vulnerable communities in order to avoid a tsunami of medical crises this fall and winter.

Is it possible that current mitigation efforts against COVID-19 will reduce the anticipated burden of influenza infections? Yes, and that would be a welcome outcome to all health professionals, especially those working on the front lines. So lets do everything we can to soften the blow of COVID-19 and the flu.

Related:

Dr.LipiRoy is aninternal medicine physician and NYUfaculty member. She has provided medical relief to earthquake victims in Haiti and is currently the medical director at Housing Works, overseeing medical services at COVID-19 isolation and quarantine sites in New York. She is also an MSNBC and NBC News medical contributor.

Dr. L. Brett Jaggers

Dr. L. Brett Jaggers is an infectious disease expert who has specialized in respiratory viruses and pandemic response. She was co-director for the Duke University Health System response to the Influenza H1N1 emergence in 2009. She currently treats patients in Denver, Colorado.

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Dane County, UW prepared to handle influx of COVID-19 cases on campus – UW Badger Herald

Sunday, September 13th, 2020

Dane County officials said the University of Wisconsin and Dane County have proper policies in place to keep COVID-19 under control on campus this fall.

This May, Public Health Madison and Dane County released the Forward Dane plan, which set standards for workplaces, schools and recreational facilities as the county began to reopen. In June, Dane County entered phase two of the Forward Dane plan, which allows post-secondary education institutions to operate as usual, no longer restricted to distance learning as they were in phase one.

Despite the growing list of universities across the country whose reopening plans have failed due to spikes in COVID-19, students moved into dorms in late August and many registered for in-person classes.

UPDATED: Teaching assistants march to UW Chancellors house, challenge safety of fall semester restart planThe Teaching Assistants Association protested in-person classes Saturday in a march to the official residence of the University of Wisconsin Read

Communications Director for Public Health Madison & Dane County, Sarah Mattes, said student behavior is key in Dane Countys success as a community in preventing an increase in cases.

The driver of disease transmission isnt happening in the classroom it is happening as students socialize, Mattes said.

The University of North Carolina at Chapel Hill became a national example of student socializing gone wrong when COVID-19 clusters appeared in three residence halls and a fraternity house within the first week of the fall term, according to the Washington Post. A video surfaced on Twitter of a group of UNC students who did not socially distance or wear masks at an off-campus sorority party, according to CBS 17.

Chapel Hill police also reported an increase in 911 calls concerning large crowds not practicing social distancing. In response, UNC announced students who violate state or local ordinances or do not comply with standards relating to COVID-19 will be subject to disciplinary action through the Student Affairs Office, according to the Daily Tar Heel.

UPDATED: UW System releases official COVID-19 guidelines for the fall semesterThe University of Wisconsin System released official guidelines Sunday for universities to safely reopen their campuses this fall during the Read

UW spokesperson Meredith McGlone said UW will follow the Dane County Public Health Order which outlaws indoor gatherings of more than 10 people.

McGlone also said UW fraternities and sororities pledged all events will follow county public health guidelines and have prohibited social gatherings which include alcohol.

UW freshman Rachel Dimeo said she is doubtful these policies will be followed.

If dorms could actually social distance and wear masks, I do not think COVID would be a rapid problem, but I know this is not the case, Dimeo said. I have seen many people congregating together without masks and are crammed into little dorm rooms and even parties.

Man breaks into Langdon Street Fraternity, uses samurai sword to cause damage, open doorsWednesday, a man broke into the Delta Chi fraternity house on the 100 block of Langdon Street, going through several Read

Apress release from UW explained classes this fall would offer in-person instruction in many courses until the Thanksgiving recess, after which they will switch to a virtual format for all courses for the final nine days of instruction plus exams.

The Smart Restart plan describes UWs three-part testing plan, which includes unlimited free drop-in tests, surveillance testing to track the prevalence of the virus on campus and target testing for all students and staff living in residence halls. Additionally, everyone on campus will be required to wear a face covering, practice social distancing and self monitor for symptoms.

Hundreds of colleges across the country reversed or remedied their reopening plans, including many Big Ten universities. Michigan State closed undergraduate residence halls and moved classes online, according to Inside Higher Ed, and theUniversity of Minnesotas governing board voted to delay the opening of dormitories and the start of in-person undergraduate classes by at least two weeks, according to the Star Tribune.

As a premier residential university, we believe deeply in the value of face-to-face instruction, McGlone said. We believe students want to be in Madison to learn in person and that they will rise to this opportunity for in-person learning. Having students on campus and providing in-person instruction, where feasible, provides a better set of educational opportunities for students lacking suitable technology or spaces to effectively study at home.

Families, off-campus students deal with financial impact of COVID-19Mayor Satya Rhodes-Conway sent a request Aug. 10 to the Wisconsin Public Service Commission, which regulates public utilities in Wisconsin, Read

Not all Big Ten universities changed their reopening plans. Ohio State allowed students to return to campus and is now monitoring the virus with consistent testing, according to Ohio State News.

As of early September, the overall student positivity rate at Ohio State was 3.13%, with 882 students testing positive, according to the Columbus Dispatch. Only 165 isolation and quarantine beds remain available on campus a decrease from the 351 beds available as of late August.

UW is also using quarantine and isolation housing to keep students safe this fall, according to University Health Services Chief Preventative Medicine Resident Colin Pitts. There are approximately 700 spaces available in quarantine housing and 400 in isolation housing. There is currently no data available on the University Health Services website regarding the number of students living in quarantine and isolation housing.

If you test positive [for COVID-19] you are isolated, Pitts said. We have isolation facilities for that, where essentially, if you [test] positive, you go into this dorm for 10 days after the positive test. We send you a symptom survey to see how youre doing and housing checks in on you. If you are close contact, so 15 minutes unmasked, close together, within six feet, or if you are in the same living space, so same door room that causes close contact, we have a quarantine facility.

Students are tested twice while in quarantine, once in the early days of their stay and once near the end, Pitts said. Quarantined students are also monitored with a symptom tracker.

While students are technically able to go home as opposed to living in quarantine or isolation housing if they are exposed to the virus, Pitts said students are strongly encouraged to quarantine on campus because of access to testing within quarantine and isolation housing and because their symptoms can be monitored.

COVID-19 in College: Students recovered from COVID-19 share experiences as year beginsIn the past few months, much of the college experience has been reduced to watching. Watching Netflix, watching online lectures Read

At the University of Iowa, 500 students self-reported positive COVID-19 tests in late August. A university notice announced if the positive case rate did not flatten over the next week, the university would consider additional actions, according to Iowa City Press-Citizen.

Our plans are informed by the latest science and public health information, McGlone said. They include a robust testing regime, contact tracing, symptom monitoring, enhanced cleaning protocols, mandatory wearing of face coverings in university buildings and public spaces where physical distancing isnt possible, and physical distancing in all classrooms.

McGlone said the percentage of students testing positive, available beds in on-campus isolation and quarantine, Dane County policy, percentage of Dane County residents testing positive, the capacity of the UW health care system and the consultation of on-campus infectious disease experts are all taken into consideration.

McGlone and Mattes said no one criterion will take precedence over another in the decision-making process, and multiple contingency plans gave UW flexibility during uncertain times.

UW-Madison is a part of [Dane Countys] community, and decisions made for campus will affect the rest of our community, Mattes said. Everyone, including college campuses and other venues which bring large groups of people together, must take the necessary steps to prevent the spread of COVID-19 if we are to keep the pandemic under control.

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Learning from the history of pandemics – East Asia Forum

Sunday, September 13th, 2020

Author: Michael Shiyung Liu, Shanghai Jiao Tong University

In 1972 microbiologists Macfarlane Burnet and David White predicted that the future of infectious diseases will be very dull. COVID-19 has been anything but.

The pandemic has mocked modern public health and medical science worldwide. The United States the society with the most advanced medicine and public health tops mortality rates. It had an epidemic policy and infrastructure in place that the Trump administration dismantled in 2018. China a country with a population of 1.43 billion saw only a slim fraction compared to the cases discovered among a US population of 330 million.

Columnists at The New York Times scoffed at Wuhans January lockdown policy, but two months later several European cities enacted similar restrictions. There is no major difference between the Wuhan lockdown and the cordon sanitaire that prevented yellow fever or cholera in 19th century Britain. In a megacity like Wuhan, modern information exchange technologies, transportation of medical resources and even the effective execution of political power all play crucial roles in stopping the spread of an unknown virus.

But rather than recognise the effectiveness of Wuhans lockdown, the column focused instead on the non-transparency of the policies, while questioning the credibility of the public health sectors in China. In the following months, the debate about the transparency of Chinas pandemic statistics further blocked mutual coordination and damaged trust between societies.

The debate on the transparency of official epidemic reporting has a long history and featured during the establishment in the 1920s of the League of Nations Health Organization, the predecessor to the World Health Organization (WHO). International coordination for pandemic prevention has weathered many obstacles since the 18th century. The accomplishment of an international health infrastructure under the WHO is therefore a centrepiece of globalisation in the 21st century.

Diseases have no political boundaries is the widely-used expression for advocating international coordination in the public health arena. Looking back in East Asia, for example, the public health risks that acquired international attention were associated with the panic of pandemics during the first half of 20th century. The inequalities between colonial societies and western powers brought obstacles to information exchange and health promotion. The competition between colonial powers and sovereign states also added to tensions between colonial medicine and the practices of international health, both of which played essential roles in shaping health governance.

But common ground for public health did exist in East Asia in the 1930s among three major organisations: The League of Nations Health Organization (LNHO), the Far Eastern Association of Tropical Medicine (FEATM) and the International Health Division (IHD) of the Rockefeller Foundation. The LNHO brought an international framework to link the health needs of the East and the West, the FETM created an unofficial network to bypass the limitations of the Westphalian system, while the IHD poured funding and medical ideas into the key institutions of international health in East Asia.

It still took four decades for the United States to harvest former efforts and put old wine in new bottles, in the form of the WHO Regional Office for the Western Pacific (WPRO). The WPRO would promote international health as a means to protect US interests and provide an agency to secure allies in the region, a mission that was written in pages of documents and correspondences among the three organisations. The Trump administrations withdrawal from the WHO makes a mockery of the historical endeavour to create a foundation for international health.

From AIDS to Ebola and SARS, now COVID-19, contagious viruses continue to threaten and disrupt. Historians, who never lost interest in pandemics, have much to offer. Learning the history of the interactions between East Asian organisations of international health illuminates a constant phenomenon: as medical technologies advance, social biases and political frictions prevent international cooperation, particularly in the exchanging of experiences with public health measures like quarantine and medical and scientific research on disease.

Charles Rosenberg argues for the importance of identifying similarities between pandemics, especially in the ways that societies inquire into the origin of an outbreak, the ways they demand urgent state intervention and the ways in which collective responsibility can be a framework for communal support. These insights should inspire societies to consider why various strategies are adopted in different contexts.

While all societies demand a political response, the response to pandemics varies from restrictive quarantine without concern for human rights to ignoring public health warnings and preventative actions. All these responses have repeatedly appeared in the past. Pandemics eventually resolve by a process, as Rosenberg put it, that starts at a moment in time, proceeds on a stage limited in space and duration, follows a plotline of increasing revelatory tension, moves to a crisis of individual and collective character, then drifts toward closure.

This drama is playing out with COVID-19 first in China and then in many countries worldwide. History can be a resource to provide inspiration and understanding for controlling pandemics under different social contexts and is just as essential as the natural sciences are for generating quarantine strategies and treatments. The end of the pandemic depends on a combination of the life cycle of the virus and earnest human efforts at vaccine development and treatment. Equally important is the social awareness to prevent human bias impeding international cooperation.

Michael Shiyung Liu is Distinguished Professor at the School of Humanities, Shanghai Jiao Tong University, and Professor at the Asian Studies Center, the University of Pittsburgh, Pennsylvania.

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electroCore to Present at the HC Wainwright Virtual 22nd Annual Global Investment Conference – Yahoo Finance

Sunday, September 13th, 2020

BASKING RIDGE, N.J., Sept. 11, 2020 (GLOBE NEWSWIRE) -- electroCore, Inc.(Nasdaq: ECOR), a commercial-stage bioelectronic medicine company, today announced that management is scheduled to present at the HC Wainwright Virtual 22nd Annual Global Investment Conference, which is being held from September 14-16, 2020.

Presentation details:

Date: Wednesday, September 16, 2020Time: 1:30-1:50pm EDT

A live webcast of the presentation will be available on the Investors section of the company's website:www.electrocore.com

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 current indications are the preventative treatment of cluster headache and migraine and acute treatment of migraine and episodic cluster headache.

For more information, visit:www.electrocore.com

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

or

Media Contact:Jackie DorskyelectroCore973-290-0097

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electroCore to Present at the HC Wainwright Virtual 22nd Annual Global Investment Conference - Yahoo Finance

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The aging brain: Exploring the connection between neurology and elevation – Summit Daily News

Sunday, September 13th, 2020

ASPEN It isnt noticeable at first. It starts with changes for which the brain can compensate, meaning no real impact on day-to-day functions or cognition.

But as time passes, the brain can no longer compensate for the damage its experiencing. Subtle problems with memory and thinking begin to pop up. Subtle turns to noticeable. Noticeable turns to difficulty carrying out everyday activities. Eventually, around-the-clock care is required.

This is the broad view progression from preclinical to severe Alzheimers disease, a degenerative brain disease that becomes worse with time and age, and is the most common cause of dementia, according to the Alzheimers Association.

In Colorado, an estimated 76,000 people are living with Alzheimers dementia, and that number is expected to increase 21% to 92,000 by 2025, a 2020 Alzheimers Association report states. As of July 2019, 14.6% of Coloradans, or about 840,000 people, were 65 or older, U.S. Census Bureau data shows.

While its been shown that living in higher elevation communities can lead to a more active, healthier lifestyle and even prolonged life, its less clear how living at high elevation correlates with degenerative brain diseases.

In short, the answer is complicated and not well researched.

As far as I know, there isnt a lot of evidence one way or another about high altitudes versus low altitudes for Alzheimers disease risk, said Dr. Huntington Potter, director of the Alzheimers and Cognition Center at the University of Colorado Anschutz Medical Campus. We cant say one way or another whether high altitude is a risk factor for Alzheimers.

At the Alzheimers and Cognition Center, which is part of the CU Anschutz Medical Campus and School of Medicine, clinicians and researchers are dedicated to discovering effective early diagnostics, preventions, treatments and ultimately cures for Alzheimers disease and related neurodegenerative disorders, according to its website.

For Potter, that means looking at biomarkers or diagnostic proteins in the blood that can help clinicians predict the disease earlier, conducting projects that look at the lifespan of people with Alzheimers disease, and other research that can quickly be translated to better care, treatment and hopefully a cure.

Right now, the center is studying a drug called Leukine, which preliminary data shows might improve Alzheimers disease in the short term, Potter explained. The center also is studying other drugs that attack the disease.

Leukine may be the first one we found that looks promising, but we have several coming up that look promising, as well, Potter said.

When it comes to looking at the potential correlation between living at high elevation and the risk for dementia-inducing diseases, Potter and Dr. Peter Pressman of the Alzheimers and Cognition Center said it would take great effort, time and funding to research.

Assistant professor for the Department of Neurology, Dr. Peter S. Pressman works in his office at the University of Colorados Anschutz Medical Campus in Aurora on Thursday, Sept. 10. Photo by Liz Copan / Studio Copan

Assistant professor for the Department of Neurology, Dr. Peter S. Pressman is pictured outside his office building at the University of Colorados Anschutz Medical Campus in Aurora on Thursday, Sept. 10.Photo by Liz Copan / Studio Copan

Assistant professor for the Department of Neurology, Dr. Peter S. Pressman works in his office at the University of Colorados Anschutz Medical Campus in Aurora on Thursday, Sept. 10. Photo by Liz Copan / Studio Copan

Assistant professor for the Department of Neurology, Dr. Peter S. Pressman works in his office at the University of Colorados Anschutz Medical Campus in Aurora on Thursday, Sept. 10. Photo by Liz Copan / Studio Copan

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Pressman, who is a behavioral neurologist and researcher with the center, said on top of securing and carefully selecting a large group of people living at elevation to participate in a study, researchers also would have to follow that group for about a decade to get meaningful results.

Its easy to fund a study for a few years, Pressman said. People give you money to do something for two to three years, but two to three years is not enough time for a process as slow as Alzheimers and dementia to really even pick up. Im not saying thats not possible. Its doable, but it would take some effort.

Dr. Brooke Allen, neurologist, founder of Roaring Fork Neurology in Basalt and medical director at Renew Roaring Fork, an assisted living and memory care center in Glenwood Springs, expressed similar thoughts.

As a part of any mild cognitive impairment or dementia evaluation, Allen said her team checks the oxygen level a patient has and considers the elevation at which that person spends most of their time.

Lower oxygen levels can contribute to people experiencing confusion, dizziness and mild short-term memory issues. But outside of looking at oxygen levels and how they could be contributing to symptoms, Allen said she doesnt consider elevation a higher risk situation.

Allen said she feels High Country residents 65 and older tend to be much younger than their age in terms of their lifestyle, which is a positive in terms of dementia prevention.

About four years ago, Allen and her team conducted a long-term preclinical Alzheimers trial as part of the Alzheimers Prevention Initiatives Generation Program, a study that looked at the effectiveness of preventative treatments for individuals between 65 and 75 who had no symptoms of dementia.

Allen said more than 250 people came in to participate in the study and all generally led healthy, active lifestyles.

I think in our valley, Ive experienced meeting those kinds of people and not thinking of altitude as a risk factor but as a lifestyle opportunity in a rural area like ours, Allen said about the people who participated in the study.

Looking at the potential correlation between living at high elevation and risk of degenerative brain diseases is not just a difficult feat for Colorado researchers. Little research with concrete findings exists nationally or globally.

One study published in 2015 by Dr. Stephen Thielke in JAMA Psychiatry looked at deaths attributed to Alzheimers dementia reported in 58 counties in California to try to determine whether rates of dementia were associated with average elevation of residence. The study found that the counties at higher elevation generally had lower rates of dementia mortality.

Additional work is needed to determine whether this relationship holds in other populations, the study notes.

But beyond this study, there isnt much conclusive evidence for or against a correlation, as emphasized by Dr. Brent Kious, a psychiatrist, assistant professor and researcher with University of Utah Health and the schools Department of Psychiatry.

Kious has studied the link between living at high elevations and major depressive disorder, anxiety and suicide, and he said he and his research team have been interested in the impact of elevation on the incidence and median age of onset of Parkinsons disease.

However, Kious said decrements in cognitive performance due to chronic exposure to moderately high elevation might not necessarily translate into an increased risk of dementia.

It is not clear whether altitude would affect those neurodegenerative processes or not, though there is some reason to think that they involve oxidative damage so relative hypoxia might slow them, Kious wrote in an email. He went on to note that relative and prolonged hypoxia, or a lack of oxygen, has been associated with dementia risk. In any case, a good epidemiological study of the association between altitude and dementia should control for things that might be associated with both.

Karen Eck, 60, of Silverthorne, picks tomatoes at the Timberline Adult Day Program garden in Frisco on Thursday, Sept. 10. Eck, who was diagnosed with early onset Alzheimers, attends programs three to four times a week at the center.Photo by Jason Connolly / Jason Connolly Photography

Karen Eck, 60, of Silverthorne, waters tomatoes at the Timberline Adult Day Program garden in Frisco on Thursday, Sept. 10. Eck, who was diagnosed with early onset Alzheimers, attends programs three to four times a week at the center.Photo by Jason Connolly / Jason Connolly Photography

Karen Eck, 60, of Silverthorne, poses for a portrait at the Timberline Adult Day Program garden in Frisco on Thursday, Sept. 10. Eck, who was diagnosed with early onset Alzheimers, attends programs three to four times a week at the center.Photo by Jason Connolly / Jason Connolly Photography

Karen Eck, 60, of Silverthorne, enters the Timberline Adult Day Program in Frisco on Thursday, Sept. 10. Eck has early onset Alzheimers.Photo by Jason Connolly / Jason Connolly Photography

Karen Eck, 60, of Silverthorne, leaves the Timberline Adult Day Program garden in Frisco after watering tomatoes on Thursday, Sept. 10. Jason ConnollyPhoto by Jason Connolly / Jason Connolly Photography

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While theres not good data for or against high elevation as a risk factor for degenerative brain diseases, there is evidence that people living in more rural communities do not have the same access to dementia care and treatment as those living in urban areas.

According to the 2020 Snapshot of Rural Health in Colorado, produced by the Colorado Rural Health Center, 721,500 people are living in rural Colorado and 19% of the rural population is age 65 or older. Rural is defined as a nonmetropolitan county with no cities over 50,000 residents.

Chad Federwitz a gerontologist, or specialist in the study of aging, and manager of Pitkin County senior services said he hasnt seen any correlation between living at high elevation and dementia risk. Anecdotally, he does know that people move to Grand Junction or the Front Range if they have dementia because of a lack of care resources in the High Country.

Given the nature of our rural-ish community, we dont have the same resources, Federwitz said, referring to things like long-term assisted living and memory care options. You can go to Grand Junction or the Front Range and have pages and pages of resources as opposed to here.

While there are some dementia care resources in more rural Colorado communities, the Alzheimers and Cognition Center is working to do more to develop meaningful relationships with health care providers and dementia patients in the states mountain communities as part of its mission.

According to Pressman, who is heading this charge on behalf of the CU center, a lot of projects are in the planning stages but include virtually educating medical providers, nurse practitioners and primary care doctors on Alzheimers and general healthy brain aging as well as mutual, participatory research with rural Colorado communities and communities of color.

Pressman explained that a lot of research related to Alzheimers overwhelmingly is based on middle-class, well-educated, white participants. And so while researchers think they know a lot about the disease in general, they really only know about the disease related to this demographic group.

Through the centers outreach and efforts to better connect with underrepresented communities, Pressman hopes to conduct better science and better serve the larger Colorado community.

What motivates me is trying to do good work, trying to do good science and to make sure our results actually represent real life, Pressman said. We want to make sure were helping everybody, not just a niche group, and that our services are available equitably to as many people as possible.

Editors note: This is Part 2 of a four-part series on longevity in the High Country. The series is being produced in partnership with The Aspen Times, Glenwood Springs Post Independent, Steamboat Pilot & Today and Vail Daily. Read more at SummitDaily.com/longevity.

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We’ve known for over a century that our environment shapes our health, so why are we still blaming unhealthy lifestyles? – The Conversation UK

Sunday, September 13th, 2020

Were healthier and live longer than our ancestors, yet were constantly reminded of deaths caused by war, terrorism and natural disasters. As terrible as these events are, they accounted for less than 1% of the 56 million worldwide deaths in 2017.

Another colossal distraction is the focus on lifestyle as a way to better peoples health and reduce health inequalities. Of course, what people eat, how much they exercise, whether they smoke and how much alcohol they drink have a bearing on their health. But what matters much more is the circumstances in which people are born, live, work and age the social determinants of health.

The fact that the environment shapes peoples lives and health has been known for a long time. In 1842, Edwin Chadwicks Report on the Sanitary Condition of the Labouring Population of Great Britain highlighted how the ill health of the poor was not the result of their idleness but of their terrible living conditions.

In his semi-autobiographical novel The Ragged Trousered Philanthropists, written over a century ago, Robert Tressell explained how the poor health of the hero of the book, impoverished painter and decorator Frank Owen, could not be solved by medicine alone. It was social medicine that he needed:

The medicine they prescribed [Frank Owen] and which he had to buy did him no good, for the truth was that it was not medicine that he like thousands of others needed, but proper conditions of life and proper food.

And over 70 years ago, Sir William Beveridge, the architect of the British welfare state, called for action to tackle the root causes of poor health: poverty, low education, unemployment, poor housing and other public health issues, such as malnutrition and inadequate healthcare.

There is no denying that great progress has been made since the work of Chadwick, Tressell and Beveridge. Far fewer people in the UK experience the absolute poverty, squalor and overcrowding they described.

But the fact remains: the profound health inequalities between rich and poor that have been highlighted throughout the past century most notably in the Black Report, which was published 40 years ago remain today. In 2020, a baby boy born in wealthy Kensington, London, can expect to live over ten years longer and nearly 20 more years in good health than a baby boy born in relatively deprived Kensington, Liverpool.

Today, a proportion of children still live in absolute poverty. They lack sufficient nutritious food and their families rely on food charity. They dont have a stable, decent home and are exposed to damp, excess cold, and dangerous levels of carbon monoxide. The proportion of people sleeping rough is also rising.

Beveridge saw employment as the solution to poverty, yet the number of people in in-work poverty is close to 4 million, and a growing number of jobs are part time, low paid or temporary.

The solution to poor health is to prevent it from happening in the first place. But rather than taking a preventative approach and fostering healthy lives through bettering the environments and conditions in which people live, national health services, such as the UKs NHS, are primarily set up to treat the symptoms of poor health.

Essentially, the UK has a National Disease Service. Its an incredibly good one, but the primary drive should be to prevent these expensive-to-treat chronic health conditions arising in the first place. Unfortunately, the big loss in public-health grant funding for local councils in the UK in recent years is testament to the governments continued focus on treatment.

The public health education campaigns that do exist encourage people to move more, eat healthier and limit alcohol consumption. They disregard underlying economic factors and neglect the fact that many people simply dont have the same opportunities or resources to be as healthy as others do.

The economic basis of poor health is all too relevant today given the increasing return of diseases of poverty and the emergence of devastating new epidemics such as COVID-19.

The reality is that peoples health choices are heavily influenced by the conditions in which they live. Whether they have a job thats safe, secure and decently paid, and one that gives them control, flexibility and meaning. Whether theyre able to afford a well-heated, well-lit, stable home in a safe area. Whether they have the money, time and resources to buy and cook healthy food and have an active lifestyle. Whether they have a walkable community that provides access to green space and essential services.

Lifestyle is also important for health, but lifestyle behaviours have causes and these causes have causes, too. Its these wider determinants of health that affect our health most.

That the most deprived areas experience almost ten times as many child pedestrian fatalities than the least deprived areas is a fitting example of how still to this day where you live can kill you.

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We've known for over a century that our environment shapes our health, so why are we still blaming unhealthy lifestyles? - The Conversation UK

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Boston to randomly test teachers and other educators weekly for COVID-19 – msnNOW

Sunday, September 13th, 2020

David L. Ryan/Globe Staff At the Mather Elementary School in Dorchester, letters A and B on desks are for students to alternate on separate days during the week to keep a social distance.

Boston officials and the teachers union unveiled plans on Thursday to randomly test teachers and other educators on a weekly basis for COVID-19, making the citys school system one of the first in the state to commit to routine testing.

Under the plan, the district will test up to 5 percent of the members of the Boston Teachers Union on a weekly basis, giving high priority to those working in schools in neighborhoods with high COVID-19 positivity rates as well as employees who work directly with students where social distancing is not possible, such as those providing hands-on support for some students with profound disabilities.

The move part of a broader agreement with the Boston Teachers Union on reopening schools that was announced Thursday comes as the city has been grappling with wide variations in coronavirus cases among its neighborhoods. Of particular concern is East Boston, which has the highest weekly positivity rate, 8.7 percent.

If East Boston were its own school system, state guidelines would strongly recommend keeping classrooms closed because its positivity rate is so high. However, Bostons overall weekly positivity rate is 1.7 percent, according to the most recent city data, enabling the districts classrooms to reopen.

Boston will begin online classes citywide on Sept. 21 and then gradually bring students back into classrooms in waves, starting in October with the highest-need students, including those with profound disabilities and those who do not know English.

Mayor Martin J. Walsh announced the union agreement as part of his routine briefings on the citys virus efforts. He highlighted the provision about the routine COVID-19 testing of union employees and other measures in the agreement such as additional training for educators on how to teach remotely and the ability to bring their own children to school if they cant secure child care.

The focus of this framework is ensuring the safety of everyone in our schools, Walsh said.

Jessica Tang, president of the Boston Teachers Union, described the testing program as a good first step, but said she would like to see more wide-scale testing of staff. She noted educators report to their schools from across the city and the region while students also criss-cross the city to get to their schools many relying on public transit creating ripe conditions for a widespread outbreak.

If we are focusing efforts on places with highest risk of infection, hopefully it will help prevent or limit spread, Tang said.

She said she would like the district to administer rapid testing for educators exhibiting symptoms to determine whether they have been infected or are instead suffering from the flu, allergies, or something else. Tang said the move would decrease potentially unnecessary quarantines that would keep teachers away from their students.

Boston appears to be one of just a handful of districts in the state that is planning to test teachers.

Cambridges school committee made routine testing for teachers a condition of reopening school buildings for students next month. The city is finalizing plans with the Cambridge-based Broad Institute to offer a testing program for all staff who will work in school buildings, said Lyndsay P. Brown, chief strategy officer for Cambridge Public Schools. The plan will not have to be approved by the school committee, said Brown.

Wellesley and Hanover plan to test staff before they enter schools, according to union agreements with the districts. Wellesley will also provide free testing once a week for staff for preventative monitoring. Watertown, Everett, Revere, and Lexington are also planning to offer at least some testing to school staff, according to the Massachusetts Teachers Association.

Debate over whether to routinely test educators has been unfolding over the summer as districts prepare to reopen schools. It intensified after Governor Charlie Baker announced plans to dispatch mobile COVID-19 testing units to schools experiencing potential clusters of cases. Teachers unions criticized the move as too reactive as they pressed for wide-scale free testing of teachers and students as a preventative measure.

The Massachusetts Department of Elementary and Secondary Education, however, has not issued any guidelines on routine testing, while the Centers for Disease Control and Prevention doesnt recommend universal testing for asymptomatic school employees and students.

In its guidance, the CDC said it is not known if testing in school settings provides any additional reduction in person-to-person transmission of the virus beyond what would be expected with implementation of other infection preventive measures, such as social distancing, mask wearing, hand washing, and enhanced cleaning procedures.

The guidance also says universal testing could present some challenges, including whether all students, parents, and staff would be receptive to the idea.

But Joshua Barocas, an infectious disease physician at Boston Medical Center and a faculty member at Boston University School of Medicine, said there can be value in doing sample testing if it is part of a broader COVID-19 prevention plan. He compared it to the kind of surveillance and population testing occurring in nursing homes, shelters, and other congregate settings, which aim to test between 20 to 40 percent of people every two or four weeks.

It can be effective at recognizing an outbreak early, said Barocas, but it also can lead to the need for further investigation and testing. Im hopeful if someone sees a possible signal of an outbreak . . . that they would increase testing to determine if its actually a signal or just noise.

He said going with a sampling of 5 percent of union members each week is a good starting point and from there the district could assess whether its large enough to be effective in either spotting potential outbreaks or instilling confidence among educators, students, and parents that they will be safe.

At 5 percent, the testing program is a potentially ambitious effort for the BPS, and could mean testing up to approximately 375 educators a week or 1,500 over the course of a month, according to Globe calculations. The Boston Teachers Union has about 7,500 active members, including nurses, classroom aides, and guidance counselors across 125 buildings.

But not all union members would be eligible for testing. The agreement limits testing to only those who report to school buildings with students inside. Members can only be tested every 14 days. Results would be available within 24 to 48 hours.

The district will provide weekly public reports on incidents of infection by school, according to the agreement.

Many details of the testing program are still being worked out with the Boston Public Health Commission, a school spokesman said Thursday night. The school system also had no estimated cost for the program and did not say where the money would come from to cover the testing.

Thomas Scott, executive director for the Massachusetts Association of School Superintendents, said he has mixed feelings about routine testing, especially the cost and the possibility of false positives for employees with no symptoms.

Having regular testing probably has some value," he said, but he added, "I dont know if it will make a difference for districts in preventing transmissions.

Beth Kontos, president of the American Federation of Teachers Massachusetts, which Boston teachers belong to, said she views the BPS COVID-19 testing as a win for public health. But she wishes the state would create a routine testing program for all districts instead of just providing emergency testing.

Its a shame we have to wait for people to get sick until we do the right thing, she said.

Felicia Gans and Naomi Martin of the Globe staff contributed to this report.

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Wearing a mask could reduce COVID-19 severity, researchers say | TheHill – The Hill

Sunday, September 13th, 2020

Masks have become commonplace for most Americans venturing out in public as the coronavirus pandemic has dragged on for several months.

Face coverings have proven to be a key preventative measure for slowing the transmission of COVID-19 as the world waits for a safe and effective vaccine.

Our country is in a historic fight. Add Changing America to yourFacebookorTwitterfeed to stay on top of the news.

But a new paper argues there may be an additional benefit.

Monica Gandhi and George Rutherford from the University of California, San Francisco theorize in commentary published in The New England Journal of Medicine that mask-wearing could also significantly reduce the severity of the disease in those who become infected and ensure a greater number of infections are asymptomatic.

Studies show masks do not filter all airborne droplets, and its still possible for the virus to sneak through and infect the wearer.

But the ideabehind the theory is that masks can block a significant number of coronavirus droplets, lowering the dose of the virus a person inhales and reducing the chances the person will experience serious illness.

An immune response could also potentially be triggered in the mask-wearer with a small amount of virus.

SARS-CoV-2 has the protean ability to cause myriad clinical manifestations, ranging from a complete lack of symptoms to pneumonia, acute respiratory distress syndrome, and death. Recent virologic, epidemiologic, and ecologic data have led to the hypothesis that facial masking may also reduce the severity of disease among people who do become infected, the paper said.

If this hypothesis is borne out, universal masking could become a form of variolation that would generate immunity and thereby slow the spread of the virus in the United States and elsewhere, as we await a vaccine, researchers wrote.

Researchers cited several examples of masks leading to less severe outcomes in infections.

A study involving hamsters showed those living in mask-shrouded cages were less likely to be infected and showed fewer symptoms compared with unmasked hamsters, researchers said.

An outbreak on a closed Argentinian cruise ship where passengers were provided with surgical masks and staff with N95 masks resulted in 81 percent of infected passengers never developing symptoms. Thats compared to the coronavirus outbreak on the Diamond Princess cruise ship outside of China where only 18 percent of the passengers infected were asymptomatic.

During two outbreaks at U.S. food-processing plants where all workers were issued masks each day and were required to wear them, 95 percent of those who tested positive were asymptomatic while 5 percent experienced mild symptoms, the researchers noted.

Researchers noted further studies comparing the rate of asymptomatic infection in areas with and without universal mask-wearing are needed.

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Wearing a mask could reduce COVID-19 severity, researchers say | TheHill - The Hill

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electroCore Announces Publication in Brain Stimulation Highlighting Non-Invasive Vagal Nerve Stimulations (nVNS) Potential Role in Treatment of…

Saturday, August 29th, 2020

BASKING RIDGE, N.J., Aug. 27, 2020 (GLOBE NEWSWIRE) -- electroCore, Inc.(Nasdaq: ECOR), a commercial-stage bioelectronic medicine company, today announced the publication of a paper, entitled, Non-invasive vagal nerve stimulation decreases brain activity during trauma scripts1,by Wittbrodt, Bremner et. al. in the journalBrain Stimulation.

The paper reports on a double-blind sham-controlled study of nineteen participants who had experienced trauma but did not have the diagnosis of PTSD and highlights the ability of nVNS to decrease the fear associated with emotional stress. The authors hypothesized that nVNS could mitigate the stress associated with traumatic triggers compared to a sham device based on its ability to decrease the level of neural activity in areas of the brain believed to be responsible for the negative reaction.

Throughout several regions of the brain, stimulation with nVNS lead to significant (P<0.005) improvements in the brains ability to react to and process traumatic stimuli as measured by High Resolution Positron Emission Tomography (HR-PET). The data further suggests the activity of nVNS was seen immediately upon exposure to the traumatic stimuli and provided a benefit throughout the duration of emotional stress. The authors suggest that the results of this study provide evidence that nVNS may have utility as a treatment for many psychiatric disorders such as PTSD.

Dr. Doug Bremner, Professor of Psychiatry and Behavioral Sciences and Radiology at the Emory University School of Medicine and an author of the study, commented, Current treatments for PTSD, including medications and psychotherapy, have limitations. In fact, a report from the Institute of Medicine concluded that there is insufficient evidence for standard antidepressant treatments for PTSD. In light of that, new forms of treatment are needed, and non-invasive VNS is a good candidate that could be widely implemented in the field of psychiatry.

We compliment the authors on the publication of this rigorous research highlighting nVNS as a possible treatment for conditions like PTSD for which there are few well studied or available treatments, saidPeter Staats, MD, Chief Medical Officer of electroCore. We look forward to announcing additional grant supported studies in this area as they are initiated.

The paper is available via open access at:https://www.brainstimjrnl.com/article/S1935-861X(20)30199-6/fulltext

This work was sponsored by the Defense Advanced Research Projects Agency (DARPA) Biological Technologies Office (BTO) Targeted Neuroplasticity Training (TNT) program through the Naval Information Warfare Center (NIWC) Cooperative Agreement No. N66001-16-4054. See publication for disclosures.

About gammaCoregammaCore(nVNS) is the first non-invasive, hand-held medical therapy applied at the neck as an adjunctive therapy 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 inthe United Statesfor 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 theEuropean Union for the acute and/or prophylactic treatment of primary headache (Migraine, Cluster Headache, Trigeminal Autonomic Cephalalgias and Hemicrania Continua) and Medication Overuse Headache in adults. In 2019, NICE published an evidence-based Medical Technology Guidance document recommending the use of gammaCore for cluster headache withinNHSEngland.

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.

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

The United States FDA has authorized use of the gammaCore Sapphire CV device for acute use at home or in a healthcare setting to treat adult patients with known or suspected COVID-19 who are experiencing exacerbation of asthma-related dyspnea and reduced airflow, and for whom approved drug therapies are not tolerated or provide insufficient symptom relief as assessed by their healthcare provider, by using non-invasive vagus nerve stimulation (VNS) on either side of the patients neck, available under an emergency access mechanism called an EUA.

gammaCore Sapphire CV has neither been cleared nor approved for acute use at home or in a healthcare setting to treat adult patients with known or suspected COVID-19 who are experiencing exacerbation of asthma-related dyspnea and reduced airflow, and for whom approved drug therapies are not tolerated or provide insufficient symptom relief as assessed by their healthcare provider, by using non-invasive Vagus nerve Stimulation (nVNS) on either side of the patients neck during the Coronavirus Disease 2019 (COVID-19) pandemic.

gammaCore Sapphire CV has been authorized for the above emergency use by FDA under an Emergency Use Authorization.

gammaCore Sapphire CV has been authorized only for the duration of the declaration that circumstances exist justifying the authorization of the emergency use of medical devices under section 564(b)(1) of the Act, 21 U.S.C. 360bbb-3(b)(1), unless the authorization is terminated or revoked.

Further information is available at:

Authorization Letter:https://www.fda.gov/media/139967/download

Fact Sheet for Healthcare Providers:https://www.fda.gov/media/139968/download

Fact Sheet for Patients:https://www.fda.gov/media/139969/download

Instructions for gammaCore usehttps://www.fda.gov/media/139970/download

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 current indications are the preventative treatment of cluster headache and migraine and acute treatment of migraine and episodic cluster headache.

For more information, visitwww.electrocore.com.

Forward-Looking StatementThis press release may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Such forward-looking statements include, but are not limited to, statements about electroCore's business prospects, sales and marketing, and product development plans, future cash flow projections, anticipated costs, its pipeline or potential markets for its technologies, the availability and impact of payer coverage, the potential product use for other indications, anticipated funding arrangements provided by theNHS, and other statements that are not historical in nature, particularly those that utilize terminology such as "anticipates," "will," "expects," "believes," "intends," other words of similar meaning, derivations of such words and the use of future dates. Actual results could differ from those projected in any forward-looking statements due to numerous factors. Such factors include, among others, the ability to raise the additional funding needed to continue to pursue electroCores business, sales and marketing, and product development plans, the inherent uncertainties associated with developing new products or technologies, the ability to successfully commercialize gammaCore, competition in the industry in which electroCore operates and overall market conditions. Any forward-looking statements are made as of the date of this press release, and electroCore assumes no obligation to update the forward-looking statements or to update the reasons why actual results could differ from those projected in the forward-looking statements, except as required by law. Investors should consult all of the information set forth herein and should also refer to the risk factor disclosure set forth in the reports and other documents electroCore files with theSECavailable atwww.sec.gov.

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

or

Media Contact:Jackie DorskyelectroCore973-290-0097

___________________________1 M.T. Wittbrodt et al. / Brain Stimulation 13 (2020) 1333-1348

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The pandemics of 1918 and 2020: What have we learned? – Fluvanna Review

Saturday, August 29th, 2020

By Page H. GiffordCorrespondent

It is new and frightening, and Americans today have never witnessed or experienced anything like this pandemic. Our grandparents or great grandparents may have lived through the horrific death toll and economic impact of the 1918-1919 pandemic. But what was different? What have we learned?

Tricia Johnson, director of the Fluvanna County Historical Society, said the impact of the 1918 pandemic was devastating on Fluvanna residents. There were 8,500 residents of Fluvanna at the time and an estimated that 2,833 people were infected or about a third of the population. All told, 46 people died. (With COVID-19, to date, Fluvanna has 207 cases and nine deaths.)

Among the first fatalities in the 1918 pandemic were five Fork Union Military cadets all of whom died within four consecutive days. The fifth died later at home. Following this was the death of 72-year-old Sheriff Robert S. Campbell. The virus did not discriminate when it came to age.

Also, Alfred Lee Profitt of Shores, a W.W. I soldier discharged due to scrofula (a form of TB) died. His system was already compromised and along with complications of influenza, he died on December 10, 1918. He is buried in his family plot, which still exists today on private property off Shores Rd. not far from Caring for Creatures.

In Virginia in 1918, there were two million people and 326,000 were infected (15 percent) and 16,000 died. (With COVID-19, to date, Virginias 8.5 million in population has suffered 111,000 cases and 2,436 reported deaths.) By the end of the 1918 pandemic, 675,000 people lost their lives in the U.S. As of Aug. 23, deaths in this country has risen to slightly over 175,000.

In 1918, people had less contact than they do nowadays. Traveling meant walking, or riding on horseback; very few had cars though some traveled by train or ship. The most likely culprit in the spread of the 1918 pandemic was soldiers being discharged from overseas who had already contracted the disease. The FUMA cadets were not an isolated incident and not surprising when most of the infection rates were rampant among World War I soldiers returning home or in army camps.

There were three waves: the spring of 1918, the fall of 1918, and the spring of 1919. The second wave was most likely due to the Armistice Day (Veterans Day) celebration and the end of the war. That sounds familiar. In 2020, cases escalated due to Memorial Day and July 4th celebrations.

The public health response was swift and organized, but President Wilson, being preoccupied with a world war, never made a statement regarding the pandemic or its impact on the civilian population. The administration tried not to distract from the war effort which was responsible for the spread of the virus and increasing deaths. There were limited resources for the pandemic and unlimited resources given to the war effort.

There was a shortage of doctors with 30 percent serving in the armed services.

Not unlike where we are today, similar responses included uncertainty, fear, ignorance, and wishful thinking, influencing civilian and government behavior. In 2020, Americans are repeating some of the same behaviors.

Preventative measures were implemented by state and local governments, but officials were lacking transparency in communicating with the public, causing more widespread panic and fear and jeopardizing their credibility. In one example in 1918, in Chicago, when one hospital reached 40 percent capacity, the health commissioner announced, Worry kills more people than the epidemic. Experts agree that government transparency is key during a public health crisis. Denial may be a safer alternative but has been proven to make a situation worse.

Public Health Departments grew out of these advances and the belief in the ability of man to control nature. Sanitation, vaccination programs, and other public hygiene efforts in the late 19th century enabled public health officials to gain power and authority. However, the enormity of the 1918-1919 pandemic challenged the public health agencies. The massive death toll from the pandemic was puzzling and alarming. Many of the measures formerly known to work were ineffective. Lacking the organization and infrastructure and constrained by the war, they were unprepared for an event of this magnitude. Dr. Victor C. Vaughn, Dean of the University of Michigan School of Medicine, and adviser to the U.S Surgeon General during W.W. I, observing cramped hospital wards and flooded morgues, stated, Bodies stacked like cordwood.

Their aim was to reduce the transmission of the pathogen by preventing contact following the ancient guidelines of the past and like we do today. Back then, public health orders were based on scientific understanding of the microorganisms of influenza and how it is spread. Today, we do it the same way with scientific evidence. The conclusions are the same to prevent the spread of the disease.

The most frequently discussed and debated public health measure in the journals of the time was school closings. In the United States, school closure was not as widely accepted as it was in Europe. One article in the Journal of American Medical Association in 1918, stated that the desirability of closing schools in a large city in the presence of an epidemic is a measure of doubtful value. The American Public Health Association (APHA) debated the effectiveness of closing schools against the loss of educational studies. They believed school closings were thought to be less effective in large urban rather than in rural areas where the school represented the point of exposure of the infectious agent an ill-conceived idea considering spread was more prevalent among larger groups of people in closed areas in cities then isolated people in rural areas. The closing of schools and other public institutional to reduce the epidemic were not widely accepted. Many were in favor of herd immunity in Europe, believing, as we do today, that shutting everything down would cause greater unemployment and depression.

The more restrictive methods of infection control were quarantines and isolating those who were ill. Because of the strain on facilities, only severe cases were to be hospitalized while mild influenza patients were to remain at home. The APHA also supported institutional quarantines to protect people from the outside world in establishments like asylums and colleges, and military camps similar to our quarantine of long-term care facilities.

They set up hospital wards with social distancing, practiced good hygiene, and used disinfectants and sterilization methods. The JAMA describes in graphic detail the procedures for disinfecting areas from hospital beds to troop trains even to the placement of antiseptic hand solution in influenza wards. Today, its rubbing alcohol, Lysol, and Clorox. Nurses would wear special blouses inside the wards, removing them when the left to reduce transmission. A precursor of our PPE today in isolation wards.

There is little that separates us from the past in how we responded and proves history does repeat itself.

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Day in the life: Drishiya Vats – Jill Lopez

Tuesday, August 25th, 2020

As a student studying in India, Itry to experience as much medicine as Ican by getting involved in clinical rotations. I am in my last year of school, I hope to graduate in July. Our program is a five year course that includes six months of internship at different hospitals plus an internship at a zoo. Soon, I will be working with the World Veterinary Services on a project in Goa.

As the rest of the world, we are also experiencing a lockdown, so our classes now are online only and our rotations are on hold for the time being. We are hoping to go back into our school by the end of the year, but there is still uncertainty if we will.

This is what Iget up to on a typical day (pre-pandemic) as a veterinary student atKerala Veterinary and Animal Sciences University.

Breakfast the beginning of a new day

I live in a large dormitory complex called a hostel, which hosts veterinary students only. We have 100 students in my class. In my unit, most of my roommates are night owls, so Im usually one of the few awake in the early morning. Some of my friends are Muslim and they also get up around this time for their morning prayers.

My day starts at 5am, so Ihave time for breakfast and a workout. At 7:30 I go to our college mess (cafeteria) and eat typical south Indian breakfast, like idli dosha sambhar, or eggs and oatmeal. Afterwards, I come back to my room and check my emails.

Clinics in the morning

My university is located in Kerala, a state on the southwesternMalabar CoastofIndia.

Around 8:45am, I leave my hostel and ride my bike to our universitys veterinary clinic. We first work in the veterinary clinic assisting a licensed veterinarian on their duties. A typical day may be treating a sick dog, vaccinating puppies, or monitoring anesthesia during surgery. We dont just see dogs and cats, we will also have goats, cattle, birds as patients. My favorite types of cases are dermatology or ophthalmology.

Lunch

At 12:30pm we come back to the hostels mess hall for our lunch. A typical lunch for me would be rice chapati or fish and rice. I like to eat lunch with my classmates and we mostly talk about the morning cases.

Lectures and wet labs in the afternoon

After lunch, I head back to campus and we have lectures from 1-3pm on a variety of subjects like surgery, preventative medicine, and toxicology. From 3-5pm we have a practical hands on training, for example, we may learn how to perform a certain surgery or treat a certain type of case.

Dinner feeding the body and soul

Several times a week, Iplay cricket or go to the gym after Iam done with classes. Cricket is very popular here, so its always easy to find a game to join. I also spend my free time at a local stable, riding and also caring for the horses. I hope to join the army following graduation, and having an equine background will make me a better candidate.

Dinner is served at 7:30pm in the mess hall. For dinner I typically have veggies, soup, and naan, which is a round flat wheat bread. Our room and board at the hostel includes meals, but we dont get many choices, one dish is usually prepared for each meal.

After dinner, I catch up on my textbook reading or work on my assignments. When thats all done, I will grab a friend to play chess or just talk with friends. I usually go to bed around 11:30pm.

Weekends

On Friday and Saturday nights, Ilike to have a meal with friends or to watch a movie. Definitely more cricket and horseback riding.

I also like traveling, especially to places where I can enjoy nature. Kerala is one of the prominenttourist destinationsof India, with beautiful beaches. The state is wedged between theLakshadweep Seaand theWestern Ghats and has a humidtropical rainforest climate.

My family lives in Uttar Pardesh -which is in Central India and is 3500 km away from Kerala . It takes almost three days by train to travel from Kerala to Uttar Pradesh. Needless to say, I dont often visit my family during the school year.

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Hating cops is a slippery slope (opinion) – SILive.com

Tuesday, August 25th, 2020

By tolerating attacks on police, politicians are setting a reckless example that will inevitably and seriously damage not just other communities, but the very fabric of intergroup relations upon which our city depends.

Over $1 million of damage has been done to police vehicles in vandalism shared on social media and celebrated. Cops out working - diverse men and women who are your siblings, cousins, parents, children and neighbors - are now regularly attacked and disparaged with language that in any other situation would be hate speech.

In the midst of a public health crisis with no end in sight, police and other first responders are depended on to keep a city of nearly 9 million people safe. But no first responders other than cops are being vilified. No first responders other than cops are having their jobs micromanaged by politicians who are rushing to out left one another. No first responders other than cops are being threatened with arrest for doing their job in situations that are always unpredictable, always dangerous and always involving people who do not want to be interacting with law enforcement.

Discussions about policing and accountability are happening locally, statewide and nationally. Recent events, some tragic, have put police work in a spotlight. Police unions are an important voice in those discussions, so lets really talk.

Engage in a thought exercise with me.

Education policy and politics deeply impact issues of diversity, opportunity and equity. There is inequality in our school system that damages outcomes for generations. How to address these problems in ways that keep all students and families engaged in our city is incredibly complicated. Tempers often flare among families, students, unions, activists and public officials.

On the issue of student demographics at Stuyvesant High School, the most prestigious of the specialized high schools students test into, there is an allegation that the school is too Asian, with not nearly enough students of color attending.

Would debate and legislation around that issue justify attacks on Asian-American students? Or vandalizing stores in Chinatown, Flushing, Sunset Park or Dyker Heights? Would it legitimize encampments outside Department of Education headquarters? Would it excuse vicious anti-Asian slurs spray painted on government buildings? Would violence against Chinese and Korean Americans become an acceptable form of social protest?

How to protect tenants from the economic devastation wrought by the COVID-19 pandemic is a constant worry. Whether increased unemployment benefits, hardship vouchers to cover back rent, allowing security deposits to be used for payments or pausing eviction proceedings -- policymakers and advocates have been creative in addressing this critical problem.

Gentrifying neighborhoods have luxury condo towers across the street from affordable housing. Balancing the worries of tenants and the needs of owners to cover their costs is difficult. Anger towards landlords is spiking, fueled by radical tenant activists who want to cancel rent and believe that property itself is a form of theft from the collective good. A prominent tenant organizers profile, when she was on the Steering Committee of the NYC Democratic Socialists, said she hates landlords.

Would any of the above justify violence against landlords? Would City Hall make excuses for a firebomb thrown into a property owners car? How would social media characterize vandalism against the owner of a building in Crown Heights? In the Bronx? In Sheepshead Bay? In East New York?

Race and class impact healthcare. Maternal health, cancer treatment, preventative medicine, emergency care, addiction services and mental health are just some examples of areas in which the race and economic status of the patient contribute to lesser care. Despite enormous gains addressing this disparity, challenges still exist that cost lives. Are healthcare executives targeted the way police are? Hospitals? Doctors? Nurses?

The anti-cop crowd driving too many of the conversations about law enforcement insist that the venom and violence and hate being hurled at cops is a form of expression. Change the nouns in their slogans and you get an entirely different view of things, a more honest view.

Activists -- from the ones inside City Hall to the ones who were camped outside City Hall -- are being intellectually dishonest. Their behavior and their excuses are a slippery slope which is going to hurt us all.

(Ed Mullins is president of the Sergeants Benevolent Association of the NYPD.)

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Study: Short Term Use of HIV-Prevention Medication Protects At-Risk Men on Vacation – Pharmacy Times

Tuesday, August 25th, 2020

Study: Short Term Use of HIV-Prevention Medication Protects At-Risk Men on Vacation

The findings indicate that short-term use of pre-exposure prophylaxis (PrEP) medication could be a successful way to prevent the spread of HIV in men who have sex with men (MSM) and who have difficulty with long-term PrEP use. In addition, it may work to transition men to long-term PrEP, which has been shown to be highly effective in reducing HIV transmission, according to the study.

We started this as a feasibility study to see if we could identify barriers to short-term PrEP use and make adjustments. But we were excited when we got the results and discovered that almost all the participants were adherent to the point of protection against HIV, said study author James Egan, PhD, MPH, assistant professor ofbehavioral and community health sciences at Pitt Public Health, in a press release. This gives us a promising strategy to pursue in engaging at-risk men in HIV prevention efforts that work for them.

The research team followed 48 MSM from Pittsburgh or Boston in a pilot program to test the daily use of PrEP for 30 days, which included an out-of-town vacation, with the men starting the medication 7 days before the trip and continuing for at least 7 days after vacation. In addition, the men were given a brief session introducing them to the use of PrEP.

According to the study authors, 94% of the men had blood concentrations protective against HIV after their vacations, consistent with regular use of the medication. Moreover, nearly 75% reported condomless sex during vacation, while about one-third reported recreational drug use.

None of the men contracted HIV during their vacation, though one of the men contracted the virus during the 3-month post-vacation follow-up period when he had a lapse in use of PrEP associated with loss of health insurance and a move to a new city. Additionally, 70% of the participants indicated an interest in continuing daily PrEP use long-term.

That really stood out to us, said senior author Kenneth Mayer, MD, medical research director at The Fenway Institute at Fenway Health in Boston and professor of medicine at Harvard, in a press release. It shows us that introducing short-term use of PrEP before a vacation could lead to longer-term use. This presents an enticing opportunity to reduce HIV transmission.

The study had limitations, including only involving men who were motivated to enroll and did not address the likelihood of physicians prescribing PrEP for short-term use, the ease of obtaining PrEP for use only during vacation, or the impact of the studys brief counseling on the use of PrEP.These are all areas that our findings suggest warrant future explorations, Egan said. Our study tells us short-term adherence to PrEP during high-risk periods is tolerable in men who have sex with men, and that it could lead to long-term use. Now we need to determine how to make it possible in the real-world setting.

REFERENCEShort-term use of HIV-prevention medication protects at-risk men on vacation. UPMC. https://www.upmc.com/media/news/081220-hiv-prevention-medication-protects-men-on-vacation. Published August 12, 2020. Accessed August 20, 2020.

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Erin O’Toole wins and the overdose crisis: In The News for Aug. 24 – Lethbridge News Now

Tuesday, August 25th, 2020

His victory over rival Peter MacKay will be a blow to some progressives, who had hoped by choosing the former longtime cabinet minister the party could finally move past some of the social conservative issues that weighed it down in the last election.

Thehours-long delay wasa less-than-auspicious beginning for the new leader, who now is racing to get a team in place before Parliament returns next month.

OToole will have to make swift choices on who will be in his inner circle, including campaign director, new party staffers, and aides on Parliament Hill.

Findinga place for Leslyn Lewis will also be key, as her climb from political newcomer to an impressive finish cements the power of social conservatives in the party.

Also this

VANCOUVER Canada needs a new approach to tackle its overdose crisis.

Thats according to the lead author of a new study that highlights a prevalence of overdoses involving non-prescribed fentanyl and stimulants in British Columbia.

There have been more than 15,000 apparentopioid-related deaths in Canada since 2016.

British Columbia has recorded more than 5,000 deaths from illicit drug overdoses since declaring a public health emergency in 2016.

The study, published today in the Canadian Medical Association Journal,looked at 1,789 overdose deaths in British Columbiabetween 2015 and 2017 in which the coroner was able to determine the substances relevant to the deaths.

Itreported thatdespite decreases in the prescription of opioids across the province, the death rate from illegal drug overdoses has continued to rise.

Dr. Alexis Crabtree, the studys lead author and resident physician in public health and preventative medicine at the Universityof British Columbia, saysit highlights what isnt working when it comes to tackling the overdose crisis.

ICYMI (in case you missed it)

OTTAWA Foreign Affairs Minister Francois-Philippe Champagne is heading to Lebanon this week to get a firsthand look at the devastation caused by this months deadly explosions in Beirut.

The trip will mark Champagnes first overseas travel since March, when countries around the world, including Canada, closed their borders to slow the spread of COVID-19.

It comes nearly three weeks after a powerful explosion at Beiruts port ripped through the city, killing at least 180 people, injuring more than 6,000 and leaving much of Lebanons capital in ruins.

Canada has so far committed $30 million to help pay for emergency food, water, shelter and medical assistance in the immediate aftermath.

During his visit, Champagne is expected to meet international aid workersand members of Lebanons embattled government, which many Lebanese believe is culpable for the explosion due to endemic government corruption and negligence.

Champagne is also scheduled to visit Switzerland, Italy and Britain during his overseas trip for meetings with UN officials and several of his European counterparts.

What we are watching in the U.S.

WASHINGTON U-S President Donald Trump says the federal government has granted emergency authorization for treating COVID-19 patients with convalescent plasma.

While Trump is calling the move a breakthrough and one of his top health officials says it is promising, other health experts say the therapeutic needs more study before it can be celebrated.

The blood plasma is taken from patients who have recovered from the coronavirus and is rich in antibodies.

It may provide benefits to those battling the disease, but the evidence has been inconclusive as to how it works or how best to administer it.

Also this

WASHINGTON One of Donald Trumps most influential and longest-serving advisers, Kellyanne Conway, says she will be leaving the White House at the end of the month.

Conway was Trumps campaign manager during the stretch run of the 2016 race, and she was the first woman to successfully steer a White House bid.

She then became a senior counsellor to the president.

Conway cites a need to spend time with her four children in a resignation letter she posted Sunday night.

What we are watching in the rest of the world

PORT-AU-PRINCE, Haiti Newly downgraded tropical storm Marco is approaching Louisiana for an expected landfall around midday today.

Tropical storm Laura, meanwhile, is forecast to move along Cubas southern coast during the day before entering the Gulf of Mexico and heading toward the same stretch of U.S. coast later in the week, most likely a hurricane.

Laura caused the deaths of at least 11 people in the Dominican Republic and Haiti, while knocking out power and causing flooding Sunday.

Marco was a hurricane most of Sunday, but the National Hurricane Center says its maximum sustained winds decreased to 110 kph after nightfall.

The centre cautions that Marco could still cause life-threatening storm surges and dangerous winds along the Gulf Coast.

This report by The Canadian Press was first published on August 24, 2020.

The Canadian Press

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‘Apartheid and Jim Crow are really no different’: Why George Floyd’s death reverberated in Africa – ABC News

Sunday, July 12th, 2020

LONDON -- Bongani Sibeko was just a toddler when he and his family were forced to flee their home in apartheid South Africa, as Black men, women and children were dying at the hands of authorities upholding the country's legal system of racial segregation.

As the son of revolutionaries, he found things weren't much different in the United States when they moved to New York City in the 1970s. Although apartheid wasn't the law of the land there, he said he grew up as a Black man knowing that if he encountered police on the streets, "there was a very good chance I would not make it home."

"Cops [in New York City] used to drive around at night looking for young Black folks to beat the hell out of," Bongani Sibeko, now 59, told ABC News in a recent telephone interview. "I was a victim of that and so was a majority of my friends."

Promised as the land of opportunity, America has long heralded itself as the world's beacon of democracy, freedom and progress. But many Black Africans and African Americans alike see the United States in a different light, saying the country's racist past is still very much a part of its present and that the recent death of George Floyd in police custody is a global tipping point for systemic racism. Africa-based experts also point out close parallels between the plight of Black people in America and in southern Africa.

"The distinction between first-, second- and third-world countries is no longer a stable set of distinctions, because from the founding of the United States to the present there's always been an excluded, dehumanized population," Dr. Joel Modiri, a senior lecturer in jurisprudence at South Africa's University of Pretoria, told ABC News in a recent telephone interview. "Apartheid and Jim Crow are really no different."

While some are holding out hope that the groundswell of support from millions in the United States will propel systemic change through the Black Lives Matter movement, others are looking beyond America's shores to Africa for fresh perspective and in some cases a fresh start.

American history is a violent one. When European explorers and settlers arrived hundreds of years ago on the shores of what they called the "New World," they claimed the land as their own and slaughtered Indigenous tribes in the process. The Atlantic slave trade was born when European colonizers kidnapped Africans and began selling them as slaves to the British colonies in North America in 1619.

The United States abolished slavery in 1865, after the American Civil War had ended. But the racial segregation and economic discrimination of Black people was enforced openly in the South until the mid-20th century through state and local legislation known as Jim Crow laws.

A woman bars the way as a group of African Americans were about to enter the lunch counter of a department store in Memphis to protest the segregation policy of the establishment, June 9, 1961.

Experts said racial inequality remains deeply entrenched in American society today, as a lingering legacy of slavery and segregation.

"My view is that the United States has structural racism," Dr. Jibrin Ibrahim, a political scientist and senior fellow at the Center for Democracy and Development in Abuja, Nigeria, told ABC News in a recent telephone interview. "The whole society is structured against basically the Black community, that has a very high level of incarceration and has very brutal policing."

A large gathering of protesters affiliated with the Occupy Wall Street Movement attend a rally in Union Square on Nov. 17, 2011, in New York, attempting to shut down Wall Street by blocking roads and tying up traffic in Lower Manhattan.

For instance, Black adults make up just 12% of the U.S. population but represented 33% of the country's sentenced prison population in 2018, according to a report from the Bureau of Justice Statistics, the statistical agency of the U.S. Justice Department.

And though there is little research on police violence and racial bias, a peer-reviewed study published in the American Journal of Preventative Medicine in November 2016, which examined data from a public health surveillance system on the use of lethal force by on-duty law enforcement officers from 2009 to 2012 in 17 U.S. states, found that the victims were disproportionately Black -- 32% -- with a fatality rate 2.8 times higher among Blacks than whites.

Protesters take part in the civil disobedience campaign, in June 1952, in Johannesburg, by occupying places for white people.

Experts said South Africa shares many of the features of structural racism that are found in the United States. When the National Party gained power in South Africa after the 1948 general election, its all-white government immediately started implementing its apartheid policy of racial segregation and economic discrimination against non-whites in the country as well as in the territory of South West Africa, the name for modern-day Namibia when it was under South African rule.

"South Africa really is unique because it's the place where we've had the most sustained period of white supremacy," Modiri told ABC News.

A South African police officer charges after a United Democratic Front demonstrator with a sjambok whip during a demonstration in Johannesburg, circa 1985.

The system of apartheid was dismantled in the early 1990s through a series of bilateral negotiations between the National Party and the African National Congress, the leading anti-apartheid political movement at the time. Nelson Mandela, president of the African National Congress party, was then elected as the country's first Black head of state during the 1994 general election, the first in which South African citizens of all races were allowed to vote. The African National Congress has been the ruling party of post-apartheid South Africa ever since.

However, experts said white South Africans have retained economic, social and cultural power, enjoying a far better standard of living and quality of life than their non-white counterparts. National Transfer Accounts data from 2015 shows the average lifetime work-related earnings for whites peaks at over 300,000 South African rand per year, while for non-whites the peak is 70,000, according to a recent paper by the United Nations University World Institute for Development Economics Research.

"So in a way, Black South Africans here -- although a numerical majority -- are nonetheless still a political, social and economic minority," Modiri said, "not unlike African Americans."

People swim and sunbathe near a notice board with the rules under which blacks were barred from swimming at the "Whites Only" section at a beach in Durban, South Africa, Jan. 5, 1987.

Police brutality also remains an issue in post-apartheid South Africa as well as in other African nations, including Kenya and Nigeria.

"This brutality is not structured racially but it is structured against the poor in society," Ibrahim told ABC News. "The African police systems never succeeded in making the transition from the colonial to the post-colonial police and retained a lot of the brutality and illegalities associated with colonial police."

Experts agreed that the only major distinction between the apartheid system and Jim Crow is the fact that Black people make up a majority of the population in South Africa, while they are the minority in the United States.

"Black South Africans and Americans are bound together in a long history of racial segregation, and it has not ended" Modiri said. "The struggle against white supremacy is a transnational one."

The year was 1963 and Bongani Sibeko's father, David Sibeko, was a rising member of the Pan Africanist Congress, a Black South African political movement that had broken away from the African National Congress. Both groups were working to end racial segregation and white majority rule in South Africa, and they had taken up arms in the wake of the 1960 Sharpeville massacre, when the national police force opened fire on a group of unarmed Black protesters, killing 69 of them.

As commander of the Pan Africanist Congress' paramilitary unit in the Vaal area, David Sibeko devised a plan to sabotage a train carrying South Africa's then-minister of justice, who had allegedly ordered the secret hangings of more than a dozen anti-apartheid activists. But he was captured on the night of the operation and held in detention for months.

David Sibeko was ultimately acquitted of the charges, and the Pan Africanist Congress leadership advised him to go into exile with his wife and children. Bongani Sibeko was 3 at the time.

South African police beat black women with clubs after anti-apartheid protesters raided and set a beer hall on fire in Durban, South Africa in 1959.

The family was smuggled out of the country via a train from Johannesburg. When they eventually arrived at a refugee camp in Botswana, a bomb allegedly planted by South Africas apartheid regime tore through the offices. So they had to stay on the move.

They were after my father," Bongani Sibeko told ABC News.

From there, they traveled to Zambia and then Tanzania. They moved to London in 1968, when David Sibeko was appointed head of the Pan Africanist Congress' mission to Europe and the Americas. A few years later, he became the group's permanent observer at the United Nations headquarters in New York City, in association with the U.N. Special Committee Against Apartheid.

The family put down roots in a predominately Black neighborhood on the Upper West Side. Bongani Sibeko, who was 13 at the time, recalled knowing that he was South African but still feeling amongst my own. Both his parents became involved with African American grassroots movements.

Protesters march outside of the courthouse during the trial of New York City Police Officer Thomas Shea, who shot Clifford Glover, 10, and was acquitted in New York, June 12, 1974.

As a young Black man growing up in the United States, Bongani Sibeko said he had to quickly learn the rules of survival when dealing with law enforcement. He said his first brush with New York City police happened just after they had moved there, when his mother sent him out to buy groceries on Broadway.

"As I got onto Broadway, I saw a lot of people gathered around, police were everywhere," he recalled. "I saw this one cop and, you know, I basically asked him, 'Officer, what's going on?' He looked at me, spat at me and he said, 'F--- you n----! Get the hell out of here!'"

That encounter set the tone for the rest of his young adult life in New York City, he said, including one instance when he was beaten up in the street by seven white officers who he said had baited him into a confrontation.

"There's that moment that your life is at the cop's mercy, and if there's more than one you know that you're in serious trouble," he told ABC News. "One thing you have to understand is, your life is on the line."

Over the years, there have been several high-profile cases of police using deadly force against Black people that have energized America's debate on racism and inequality. The most recent was George Floyd.

Floyd, an unarmed 46-year-old Black man, died in Minneapolis on May 25 after a white police officer was filmed kneeling on his neck as three other officers watched. His death has sparked anti-racism protests and calls for police reform across the United States and around the world, including in Africa. The continent voiced its anger in a statement released on May 29 through its regional bloc, the African Union, describing Floyd's death as an act of "murder."

The chair of the African Union Commission, Moussa Faki Mahamat, condemned Floyd's killing and urged "authorities in the United States of America to intensify their efforts to ensure the total elimination of all forms of discrimination based on race or ethnic origin."

South Africa's Economic Freedom Fighters supporters gather in front of the United States Embassy in Pretoria, on June 8, 2020, in solidarity with the global Black Lives Matter movement.

Then in June, Burkina Faso's ambassador to the United Nations in Geneva penned a letter on behalf of 54 African nations, asking the U.N. Human Rights Council for an "urgent debate" on "racially inspired human rights violations, police brutality against people of African descent and the violence against the peaceful protests that call for these injustices to stop."

Although the letter called for a debate on racism around the world, Ambassador Dieudonne Desire Sougouri highlighted the situation in the United States, saying that Floyd's death "is unfortunately not an isolated incident, with many previous cases of unarmed persons of African descent suffering the same fate due to unchecked police brutality."

"The protests the world is witnessing are a rejection of the fundamental racial inequality and discrimination that characterize life in the United States for black people, and other people of color," Sougouri wrote.

Protesters hold signs as they demonstrate against the death of George Floyd in the U.S., and Collins Khoza, who died after a confrontation with South African security forces, outside the U.S. embassy in Pretoria, South Africa, June 5, 2020.

Experts said the widespread outrage over Floyd's death and the ensuing global support for the Black Lives Matter movement give reason for cautious hope, but substantial and meaningful change in the United States would be difficult. The same is true for post-apartheid South Africa.

"When a system becomes so deeply entrenched, it becomes harder and harder to uproot it," Modiri told ABC News. "The nature of the racial antagonism and racial conflict, and the trauma and the damage that racism has done in both the United States and in South Africa is fundamentally irreparable. It's unlikely that we can ever come out of it the same."

Still, Modiri added that "we should always be hopeful when communities of people refuse to accept the way things are."

Experts noted how the widening rift between liberals and conservatives in the United States has made legislative reform a challenge.

"I've seen many such demonstrations in the past and they never led to reform," Ibrahim told ABC News. "It's important for the Black Lives Matter movement to forge alliances with liberal Americans so they can sustain movement for a longer time, create more traction and, above all, ensure that the protests would be sustained up to the level where reforms are introduced."

When the coronavirus pandemic hit earlier this year and countries around the world began closing borders, Rashad McCrorey found himself at a crossroads.

The 40-year-old New York City native was in Ghana for a trip organized by his tourism company, Africa Cross Culture, which specializes in bringing Black Americans and the African diaspora to visit the continent. He could either return home immediately or stay in Ghana indefinitely. He chose the latter.

"I did some soul-searching," McCrorey told ABC News in a recent telephone interview. "I felt like I could run my business remotely and not only survive in Ghana but thrive out here."

Ghana, a former slave trading hub, has long advocated for Africans and those of African descent abroad to return to the continent. Many Black Americans, such as civil rights leader W. E. B. Du Bois, settled there in the 1960s. Last year, the West African nation launched the "Year of Return, Ghana 2019" on the 400th anniversary of slaves being brought to the United States with the goal of encouraging visits.

Reports estimate thousands of African Americans live in Ghana's capital of Accra, some looking to escape racism and other strife in the U.S.

Rashad McCrorey poses for a photo along the coast of Elmina, Ghana, in June 2020.

As civil unrest unfolds back home in America, McCrorey said he's confident he made the right decision to stay.

"Its the same merry-go-round," he said. "I saw the same thing in 2014."

In 2014, McCrorey was among thousands of protesters who took to the streets following the death of Eric Garner, an unarmed 43-year-old Black man who famously shouted "I can't breathe" as a white officer was filmed putting him in a chokehold while arresting him in the New York City borough of Staten Island. Black Lives Matter demonstrations soon spread across the country and the globe.

Marchers approach the West Side Highway after a Grand Jury decided not to indict the police officer who placed Eric Garner in a chokehold, Dec. 4, 2014, in New York.

Although the officer involved in Garner's death is no longer patrolling the streets, McCrorey expressed frustration that there has been no real reform or structural change.

"Over time, things calm down, people go back to their regular lives until the next outrage happens," he told ABC News.

McCrorey visited Africa for the first time a few weeks after Garner's death. He fell in love with the country of Ghana and its people, and the trip inspired him to start his back-to-Africa travel company.

Rashad McCrorey (center) is welcomed by the royal family of Iture, a suburb of Elmina, Ghana, on June 20, 2020.

McCrorey described the experience of returning to the continent as an African American as healing and revitalizing, even if it's only for a visit. He said it's empowering to be surrounded by people who look like you in all aspects of society, from street vendors and shop owners to doctors, lawyers and politicians.

"We look to Africa to find our roots," he said. "We can look at Mother Africa as a rehab center to kind of get out of this systematic oppression."

Bongani Sibeko had not yet turned 19 when his father was murdered.

David Sibeko had risen through the ranks of the Pan Africanist Congress, becoming a leading member of the group's central committee and being appointed director of foreign affairs. Meanwhile, he was doing important work for the U.N. Security Council and investigating South Africa's apartheid regime -- all of which put a target on his back.

On June 12, 1979, David Sibeko was assassinated during a meeting in Tanzania by sleeper agents of the apartheid regime who had infiltrated the Pan Africanist Congress, according to Bongani Sibeko. He was 39, leaving behind his wife and their four children.

Activists hold placards as they march from the U.S. Embassy in Pretoria, South Africa, during a protest against the death of George Floyd, June 6, 2020.

Nearly 15 years after his father's death, Bongani Sibeko left New York City and moved back to South Africa when apartheid had ended. He has lived there ever since and said he is a proponent of Africans and the diaspora returning to the motherland.

"Our continent has been robbed of its people, and they should be welcomed back home," Bongani Sibeko told ABC News.

He expressed hope in the global momentum and support of America's Black Lives Matter movement in the wake of Floyd's death, recalling how the world in the same way backed the fight against apartheid in South Africa.

"This is a very emotional time for me because it reflects the global support that's happening for George Floyd and the plight of African Americans, it's very similar to the struggle we faced in that we did not struggle alone," he said. "Without the world, we would have never been freed."

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'Apartheid and Jim Crow are really no different': Why George Floyd's death reverberated in Africa - ABC News

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How old is your dog? New equation shows how to calculate its age in human years – NBC News

Sunday, July 12th, 2020

Common wisdom has long held that each dog year is equivalent to seven human years. But a new equation developed to measure how a dog ages finds the family pup may be a lot older than we realize.

Researchers studying chemical changes to canine DNA found that dogs age very quickly during their first five years and much more slowly later on.

The findings, published recently in the journal Cell Systems, calculate that a 5-year-old dog would be pushing 60 in human years.

Puppies age super quickly, said Trey Ideker, the studys senior author and a professor of genetics at the University of California, San Diego, School of Medicine. By the time a dog is a year old, at a molecular level, hes much more like a 30-year-old human. Retrospectively, we did know these things. It didnt make any sense that the equivalent to a 7-year-old human would be able to have puppies.

Ideker and colleagues noticed that dogs, just like humans, have chemical marks on their DNA, called methylation marks, that change with age.

The genome itself doesnt change with age, Ideker said. "What does change is marks on the genes that control a dog or human's growth pattern."

The methylation marks, or as Ideker calls them wrinkles on the genome, change in predictable ways as we and dogs age.

We are able to quantify this at the molecular level and tell how fast someone is aging, and we can align it across dogs and humans, Ideker said. But we dont know exactly what it all means.

To find the mathematical relationship connecting dog aging to human aging, Ideker and his colleagues studied 104 Labrador retrievers whose ages ranged from weeks-old puppies to 16-year-old dogs.

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When they compared the dog DNA data to information from humans, the researchers came up with a new equation to figure out the dog's comparable human age.

The equation: 16 ln(dog age) + 31 = human age.

For iPhone calculators that have the natural logarithm, or "ln," function, first type in the dog's age. Then hit the "ln" button. Multiply that result by 16; then add 31.

If you're using Googles scientific calculator: First, hit "ln," then type in the dogs age, then equal it out. Next, multiply by 16, and then add 31.

Using that equation:

By this time, dog aging has slowed down, so an 8-year-old dog is like a 64-year-old human.

According to this equation, the average 12-year Labrador lifespan is equivalent to a human living to about 70.

Ideker suspects there will be some variation based on dog breed but that they will all follow a similar pattern.

The new dog-age math has given Ideker some pause when he thinks about taking his own dogs on runs: He now realizes his 6-year-old dog is actually pushing 60 in human years.

Margret Casal, a specialist in veterinary genetics, said the new calculations match what shes observed in her dog patients.

It validates what a lot of other researchers have been saying, said Casal, a professor of medical genetics, pediatrics and reproduction at the University of Pennsylvania School of Veterinary Medicine.

Researchers knew the 1-to-7 comparison was off, but they did not know what the specific relationship was, she added.

It will be interesting to look at different breeds," Casal said. "We know that some smaller breeds live longer and some larger ones dont live quite as long.

For owners hoping to help a beloved dog live as long as possible, Casal offered a few tips:

Lastly, take your dog for yearly wellness visits.

Thats really important, Casal said. I can say as an owner of a dog, sometimes you dont see something is wrong and your vet might be able to see it better.

Linda Carroll is a regular health contributor to NBC News and Reuters Health. She is coauthor of "The Concussion Crisis: Anatomy of a Silent Epidemic" and "Out of the Clouds: The Unlikely Horseman and the Unwanted Colt Who Conquered the Sport of Kings."

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How old is your dog? New equation shows how to calculate its age in human years - NBC News

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HCQ for Covid-19 highly politicised in US, widely used in India: White House official – Hindustan Times

Sunday, July 12th, 2020

HCQ for Covid-19 highly politicised in US, widely used in India: White House official - world news - Hindustan Times "; forYoudata += ""; forYoudata += ""; forYoudata += ""; count++; if (i === 7) { return false; } }); forYouApiResponse=forYoudata; $(forutxt).html('Recommended for you'); $(foruContent).html(forYoudata); } } }); } else if(forYouApiResponse!=''){ $(forutxt).html('Recommended for you'); $(foruContent).html(forYouApiResponse); } } function getUserData(){ $.ajax({ url:"https://www.hindustantimes.com/newsletter/get-active-subscription?usertoken="+user_token, type:"GET", dataType:"json", success: function(res){ if(res.length>0) { $("[id^=loggedin]").each(function(){ $(this).hide(); }); } } }); } function postUserData(payLoad, elm){ var msgelm=$(elm).parents(".subscribe-update").nextAll("#thankumsg"); $.ajax({ url:"https://www.hindustantimes.com/newsletter/subscribe", type:"POST", data:payLoad, contentType: "application/json", dataType: "json", success: function(res){ if(res.success===true){ $(msgelm).show(); 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HCQ for Covid-19 highly politicised in US, widely used in India: White House official - Hindustan Times

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