Category Archives: Preventative Medicine

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

Respected Dallas cardiologist and Vice Chief of Medicine Dr. Peter McCullough, has written an article providing clear guidance to physicians on how to treat COVID-19 at home to prevent hospitalizations and death.

The paper is already available at the National Library of Medicine and is set to be published in the American Journal of Medicine. McCullough has been published over 1,000 times and is joined by 22 other doctors in the article.

In my view, doctors can do a big part in turning the tide on this debacle, McCullough told The Texan. He believes more experts need to step forward and recommend treatment based on what has already been learned.

His advice for early treatment of patients, who may even be awaiting for test results but are manifesting symptoms, revolves around four principles: (1) reduction of reinoculation, (2) combination antiviral therapy, (3) immunomodulation, and (4) antithrombotic therapy.

To reduce the chance of a coronavirus patient continuously breathing in more of their own infected air particles, which in turn may increase their viral load, McCullough advises that rooms be open to fresh air, fans be used to circulate air, and infected persons not wear a face covering.

To further reduce the viral load (or amount of virus in a persons blood), McCullough recommends the use of zinc, antimalarials like hydroxychloroquine, antibiotics such as azithromycin or doxycycline which are known to have antiviral properties, and favipiravir, which has shown treatment promise in Russia and India.

As the disease progresses, a common occurrence is inflammation and cytokine activation, where the body starts to attack its own cells instead of the disease. In this situation, McCullough recommends that doctors consider using immunomodulators like dexamethasone, a corticosteroid.

In order to avoid pulmonary thrombosis, or blood clots, which McCullough theorizes is a cause of the chest heaviness described by some COVID-19 patients, aspirin is suggested. Heparin or other short-acting anticoagulants can also be considered.

The paper includes an algorithm for doctors to follow that demonstrates McCulloughs current advice and practice in treating COVID-19.

Previously all experts have advised on wearing masks, washing hands, and quarantine but gave no expert advice on treatment at home. This has led to nearly 180,000 American deaths and a population that is held in fear when COVID develops. The average person over age 50 and or with medical problems waits in complete terror while being ill for two weeks before coming into [a] hospital where they may never see their loved ones again. In my view this is a national tragedy, McCullough asserted.

McCullough believes that many of the measures discussed in his article could be extended to successfully treat seniors in nursing homes and other non-hospital settings.

His father, a nursing home resident, contracted coronavirus in April and recovered after 60 days. His treatment included hydroxychloroquine, azithromycin, and an anticoagulant used to prevent blood clots known as Lovenox.

The North Texas doctor also attributes his fathers recovery to fresh air and windows open constantly to reduce the viral reloading in the air and all surfaces and personal items sterilized in the room daily.

If the information was known about steroids, I believe treating with prednisone on day five could have shortened his course of illness, McCullough added.

While McCullough supports the use of randomized trials to test treatments, he acknowledges that they are not well-suited in the circumstances of an emergency pandemic.

In the U.S., definitive randomized double blind placebo controlled trials are very expensive and take many years to complete. In the setting of an acute pandemic with potentially fatal outcomes, our clinical trials system is not equipped to deliver timely results to impact the population. To date, there are no definitive randomized trials for the treatment of COVID at home and I do not anticipate any for many months if not years to come, McCullough explained.

McCullough is also leading a study at Baylor University Medical Center that is testing the use of hydroxychloroquine as a prophylaxis or preventative for frontline healthcare workers. While the results have not yet been released, McCullough said that they have reported to the FDA that hydroxychloroquine was found to be safe and well-tolerated.

Additionally, McCullough and fellow cardiologist Dr. Kevin R. Wheelan issued a letter supporting the emergency use authorization (EUA) of hydroxychloroquine for outpatient treatment and prophylaxis for COVID-19 to the FDA.

Disclosure: Unlike almost every other media outlet, The Texan is not beholden to any special interests, does not apply for any type of state or federal funding, and relies exclusively on its readers for financial support. If youd like to become one of the people were financially accountable to, click here to subscribe.

A free bi-weekly commentary on current events by Konni Burton.

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Dallas Cardiologist Offers Guidance on Early Treatment of COVID-19 - The Texan

Wellness describes itself as complete physical mental and social well-being. It comprises all the components used to lead a healthy life. Wellness is multidirectional and constitutes social, emotional, physical, spiritual, intellectual and emotional wellbeing. According to National Wellness Institute, two more component of wellness includes cultural and environmental wellness. Mental health and well-being are an integral and essential component of health. Wellness goes further than disease or disability and highlights the maintenance and improvement of health and well-being of the person. Wellness includes activities that improve health, enhance the quality of life and increase the levels of well-being of the person. Different types of wellness include workplace wellness, wellness tourism, lifestyle wellness and others. In order to help prevent disease, reduce stress, and enhance the overall quality of life Global Wellness Institute (GWI) organizes e Global Spa & Wellness Summit (GSWS) annually, that brings together leaders and visionaries to discuss various aspects of health and wellbeing.

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Nowadays, people are focusing on preventive, proactive aspects of wellness, wellness economy incorporates industrial sector that enables consumers to incorporate wellness into their lives. Consumers are inclining towards preventive measures to prevent diseases and maintain good health. The key sector of wellness includes wellness tourism, fitness, complementary & alternative medicine, lifestyle wellness, rejuvenation and spa industry, workplace wellness and others.

Wellness is self-responsibility and is opening new opportunities for wellness market as due to increase in geriatric population, rise in disease population due to sedentary lifestyle, new research on wellness procedures using alternative medicines, expansion of consumer base and wellness industries, tourism is growing, that will incorporate wellness into travel, shift of consumers towards personal care products are some of the factors that will drive the medical wellness market. The awareness about medical wellness will help consumers, spread wellness to homes and their workplace and help the right way to exercise, include healthy eating in their diet, focus on preventive and personalized health and others. Lack of awareness about medical wellness, rise in products and services of wellness industry, lack of workforce and others are some of the factors restraining the market growth.

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The global medical wellness market is segmented on basis of wellness sector, distribution channel and geography:

Segment by Wellness Sector

Segment by Distribution Channel

The global medical wellness market is segmented into wellness sector and distribution channel. Based on the wellness sector, the medical wellness market is segmented into complementary and alternative medicine, beauty care and anti-aging (surgical and non-surgical), preventative and personalized medicine, healthy eating, nutrition and weight loss, rejuvenation and others. The beauty care and anti- aging segment will dominate the wellness market due to rise in number of aesthetics procedures and increase in number of beauty care wellness sectors. Based on the end user, the medical wellness market is segmented as franchise and company owned outlets. The global medical wellness market is going to increase significantly is near future due to shift of consumers towards proactive approaches and include wellness in day to day life

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By regional presence, the global medical wellness market is segmented into five broad regions viz. North America, Latin America, Europe, Asia-Pacific, and the Middle East & Africa. North America market is expected to dominate in terms of revenue share, owing to the high availability of advanced products and services, wellness tourism, expenditures growth, , increasing penetration of leading companies in the region along with increase in patient population. Significant economic development has led to an increase in healthcare availability in Asia Pacific region, growing number of multi-specialty care centers, rejuvenation and fitness centers and penetration of global players in Asia is expected to fuel the medical wellness market

Some of the major players in medical wellness market are Enrich Hair & Skin Solutions, VLCC Wellness Center, Guardian Lifecare, Healthkart, WTS International, The Body Holiday, Bon Vital, Biologique Recherch, MINDBODY Inc., Massage Envy, ClearCost Health, Golds Gym International, Inc., World Gym, Spafinder Wellness 365, Kaya Skin Clinic, Body master and others

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To support companies in overcoming complex business challenges, we follow a multi-disciplinary approach. At PMR, we unite various data streams from multi-dimensional sources. By deploying real-time data collection, big data, and customer experience analytics, we deliver business intelligence for organizations of all sizes.

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Global Medical Wellness Market to Witness Increased Revenue Growth Owing to Rapid Increase in Demand - Scientect

This week, Amazon launched a new wearable device and service, while Fitbit tweaked its product offering to include the Sense, a device designed to offer health monitoring as opposed to simple activity tracking. The launch of both devices has me wondering whether this is an inflection point for wearables, one that will allow them to become the first and most personal link in our health care delivery system. Conversely, Im wondering if they will fail to make the leap and instead remain a fad for those focused on their health and wellness.

In short, will COVID-19 do for our health interactions what Amazons Alexa did for our control of connected smart home products? In five years, are we going to look back at the delivery of health care and see that it started with an earbud, a smartwatch, or a wrist strap? This is the future that Amazon and Fitbit are betting on with their new products, and the future that Apple, Samsung, and others are hoping to make real.

There are three trends here, and only one of them has to do with the pandemic. The first is a new focus on wellness and preventative health. The second is a focus on personalization thats rooted in individual health data and decisions. And the third is a change in the delivery of health care that has been a long time in the making, but thanks to COVID-19 is rapidly occurring.

The focus on wellness has been happening for a long time. As far back 2014, I was wearing activity trackers and even a device that tracked my respiration to determine whether or not I was stressed. Companies at that time were also building sensors to track sleep quality that fit under mattresses or could be placed next to a bed. The hope was that technology and data could help all of us lead healthier lives.

As time passed, the sensors multiplied, the algorithms got better, and the regulatory bodies got involved. Now the medical research community is starting to come around to the potential benefits of using these devices, and is testing them for accuracy and clinical relevance. Such testing will determine whether a consumer wearable device becomes a gateway to our personalized health care or just another faddish gadget.

Most of these devices arent formally validated today, and the studies that show some of them can predict COVID a day or two ahead of symptoms onset, while good PR, arent medically useful yet. To get to that point, we need to create a bridge between these devices and actual health care.

Ivecovered companies that are trying to create that bridge, such as Elektra Labs andGlooko. Big-name consumer companies such as Apple, Samsung, and even Fitbit are also working toward it with FDA-approved products. Apples HealthKit, a framework for taking in device data and storing medical records, is one such effort.But these firms have to get doctors on board.

We also see companies building products designed to send data to health care providers, effectively acting as proxies for in-clinic visits.Bodyport, which is building a scale that tracks heart health, is one.NuvoAir, which is building a connected spirometer to send lung health data for COPD patients to doctors, is another. When building these products, the target audience is comprised of medical professionals who want devices that send clinically validated data and offer a product that a doctor can prescribe to a user. Which means developers are building both for doctors and consumers. This is tough.

And despite the hype, none of the big tech brands are really there yet. I cant get a COVID-19 test in my home state based solely on data from my Fitbit; I need to have recognizable symptoms. Theres also a legitimate question about privacy related to these devices. Andy Coravos, the co-founder and CEO of Elektra Labs, once told me that personalized medicine is just a fancy name for constant surveillance. Shes right.

These devices will know so much about us that the thought of them in the hands of a consumer tech company that isnt really subject to laws that protect our privacy is chilling. Mark Rolston, the founder, and chief creative officer at Argodesign, says the issue around privacy is that the better these devices become, the less you want to use them because they become frighteningly knowledgeable about you on a personal level.

With the Halo, Amazon is really pushing user trust to the limit. The device, which costs $99.99 and also requires a subscription fee of $3.99 a month for the advanced features, tracks heart rate, steps, and body composition. But it also tracks your emotions based on your tone of voice. To be clear, users have to opt into the feature, and it isnt always listening. Instead, it is an intermittent check on the wearers emotional state that gets reported back to the user. Basically, it has the potential to become a giant pool of training data so Amazons Alexa can gain some emotional intelligence. This may seem far-fetched, but there are plenty of research studies showing that computers can use voice to detect diseases and even mental health.

Fitbits device doesnt introduce an entirely new data point, instead relying on upgraded sensors to offer more accurate and clinically validated insights about heart health, recovery, and more. A cynic might look at these options, plus other options such as the Whoop band which is an activity and recovery tracker that also requires a subscription as ways to create a recurring revenue model. Because to get the best insights you have to pay a monthly fee.

But I think the long game is to deliver enough data to a digital assistant so it can become the starting point for health care delivery. In other words, letting the wearer know when to make a doctors appointment or providing a historical picture of their health at annual physicals even during emergency events or illness.

COVID-19 and a desire to avoid in-person health care will accelerate demand for this data. But in order to ensure these devices and their algorithms arent just digital snake oil, well need to validate them, get regulators and doctors on board, and convince consumers that the data produced by these devices will be governed by strict privacy laws. Otherwise, its just a device and one that many will be able to do without.

Related

Go here to read the rest:
Welcome to the post-COVID wearables world - Stacey on IoT

Herd immunity the notion that once a high proportion of a population has contracted or been vaccinated against an infectious disease, the likelihood of others in the population being infected is drastically reduced is a coveted yet intangible goal in a world without a COVID-19 vaccine.

Its safety in numbers, in other words. But unless and until theres a widely available vaccine for the SARS-CoV-2 coronavirus, which causes the disease COVID-19, physicians say the reality is far more complex.

Patrick Vallance, the U.K.s chief scientific adviser, said last March that herd immunity was an option the Boris Johnson government was exploring as COVID-19 began taking a toll on the country. His apparent aim, regarded by his critics as idealistic and foolhardy even early on, was to quickly build up herd immunity among those believed to be least likely to suffer tragic consequences and thereby slow the rate of transmission to populations most at risk of death.

The U.K. abandoned the idea. Later blaming poor messaging, U.K. Health Secretary Matt Hancock stated, Herd immunity is not our goal or policy, while other experts said it would be a side effect of the governments overall coronavirus action plan.

A key tenet of the herd-immunity concept is the separation of those at a lower risk of dying from the higher-risk group namely, people over 70 and those with pre-existing conditions. As the lower-risk group contracts the virus, immunity spreads in the so-called herd, ultimately lowering the risk for those in the higher-risk group of coming into contact with a currently contagious person and becoming infected.

Dont miss: No, the summer surge in coronavirus cases in some states isnt part of a second wave

While it was deemed too difficult to achieve in the U.K., a country with a population that hovers near 66.4 million, Sweden stayed on that track. Its gamble: With a population of just over 10 million, it could achieve herd immunity without experiencing too many fatalities.

Swedens prime minister, Stefan Lfven, advocated voluntary social-distancing rules and not closing schools but banning gatherings of more than 50 people. He has steadfastly insisted that his country has taken the right approach, despite criticisms from health advocates.

Now there are quite a few people who think we were right, Lfven said this week. The strategy that we adopted, I believe is right to protect individuals, limit the spread of the infection. Critically, however, the country did not ban visits to nursing homes until the end of March.

The logic: In an ideal world, where people do not come into contact with those who are vulnerable, a country could manage the spread of the virus without overwhelming hospitals with sick people, while also mitigating the full economic impact of closing businesses and introducing travel bans.

How did it turn out? Its still early, given that most Western countries are still grappling with the first wave of coronavirus (and many experts express doubt that the wave metaphor is suited to this virus), but results have been poor relative to other countries.

Sweden has the ninth highest number of COVID-related deaths per capita in the world, at 57.09 per 100,000 people. The U.K. has the fifth highest, at 62.47.

Whats more, the U.K. has a fatality rate of 12.6%, second only to Italys 13.6%. Sweden has a fatality rate of 6.7%. To put those figures in context, the U.S. has had 54.55 COVID-related deaths per 100,000 people and a fatality rate of 3.1%, less than half the rate of Sweden.

So what happened? Sweden resisted a lockdown, while the U.K. took its time to introduce its own shelter-in-place orders and travel ban. The U.K. introduced lockdown measures on March 23, and on March 25, the same day that Britains Prince Charles tested positive for the coronavirus, the U.K. government said police would be given the power to use reasonable force to enforce shelter-in-place rules.

Boris Johnson, the prime minister who himself was hospitalized with coronavirus and ultimately recovered, was late to issue those orders and introduce a travel ban. One study released in June estimated that 34% of detected U.K. transmissions arrived from Spain, France, Italy and elsewhere abroad.

That same study concluded that one-third of cases in the U.K. occurred in March, while others said the U.K., along with other countries, underestimated the number of asymptomatic people who were spreading the virus without realizing it.

Whats more, like the U.S., the U.K. did not introduce an early large-scale testing and contact-tracing strategy. All of these factors led to the U.K. placing among the global top ranks, alongside Sweden, for coronavirus-related deaths per capita.

Sweden, meanwhile, failed to protect its elderly population, who make up the majority of those who died from COVID-19 there. This was a major misstep in its herd-immunity strategy, which speaks to the difficulty of applying an idealistic, laboratory model of separating the infected from the most vulnerable to the real world: Sweden only banned care-home visits at the end of March.

It kept most of its schools open, despite children being among the most likely to contract the virus and transmit without displaying symptoms. The country reported its highest death tally in 150 years in the first half of this year.

Despite these efforts, and its relatively small size compared to the U.K. and the U.S., the country is not even close to achieving herd immunity. In an interview with the Observer newspaper in London this month, Anders Tegnell, an epidemiologist involved in managing Swedens pandemic response, claimed that up to 30% of the countrys population could be immune.

But others say that even accounting for those who are asymptomatic, that is a wildly optimistic estimate, and, as Tegnell himself acknowledged, its very difficult to draw a good sample from the population, because, obviously, the level of immunity differs enormously between different age groups between different parts of Stockholm and so on.

Its likely even that 30% level is a long way off from achieving the goal. This month, the Journal of the Royal Society of Medicine published a paper titled Swedens prized herd immunity is nowhere in sight. Epidemiologists estimate that at least 70% of the population attaining immunity is necessary to achieve herd immunity.

And would a vaccine help a country like Sweden that appears to be slouching toward the goal of herd immunity? Not necessarily. A study published last month suggested a vaccine would have to be at least 80% effective to achieve a complete return to normal. The study, published in the American Journal of Preventive Medicine, said a vaccine does necessarily permit a return to normal life.

If 75% of the population gets vaccinated, the vaccine has to have an efficacy of at least 70% to prevent an epidemic and at least 80% to extinguish an ongoing epidemic, the researchers said. If only 60% of the population gets vaccinated, the thresholds are even higher.

What matters is not just that a product is available, but also how effective it is, said lead investigator Bruce Lee, a professor of health policy and management at the City University of New York.

One not insignificant caveat: A recent survey by Yahoo News and YouGov found that the public embrace of a potential vaccine has hit a new low. Only 42% of Americans said they planned to get vaccinated if and when a vaccine becomes available, which is down from 55% in late May, and 46% in early July.

And combining the percentage of those who would not get vaccinated with those who are unsure? That alone adds up to more than 75%. There was a correlation between education level and income with a willingness to get a coronavirus vaccine: 78% of those who had obtained at least bachelors degree said they planned to get vaccinated, compared to 58% of those who didnt finish high school.

While 67% of Caucasians, 71% of Hispanics and 77% of Asian Americans said they were likely to get the future vaccine, barely half of Black respondents (52%) agreed.

A plethora of companies are currently working on coronavirus vaccines. Among them are AstraZeneca AZN, -0.74% ; BioNTech SE BNTX, -2.42% and its partner, Pfizer PFE, +0.13% ; GlaxoSmithKline GSK, -0.37% ; Johnson & Johnson JNJ, +0.43% ; Merck & Co. MERK, ; Moderna MRNA, -0.79% ; and Sanofi SAN, +4.03%.

Key Words:Infectious-disease expert says were thinking too much about a second wave of COVID-19 when its really more like a forest fire

In the meantime, asymptomatic transmission remains the Achilles heel of COVID-19 pandemic control through the public-health strategies we have currently deployed, according to a May 28 editorial in the New England Journal of Medicine.

Symptom-based case detection and subsequent testing to determine isolation and quarantine procedures were justified by the many similarities between SARS-CoV-1 (the virus that caused SARS) and SARS-CoV-2 (the virus that causes COVID-19), they wrote.

Despite the deployment of similar control interventions, the trajectories of the two epidemics have veered in dramatically different directions, they added. Within eight months, SARS was controlled after SARS-CoV-1 had infected approximately 8,100 persons in limited geographic areas.

Public-health officials have advised people to keep a distance of six feet from one another and wear face coverings in public settings. Face masks are designed to prevent the wearer, who may be infected with COVID-19 but have mild or no symptoms, from spreading invisible droplets to another person and thereby infecting them, too.

Sweden, for its part, chose not to impose a strict face-mask wearing strategy.

Ultimately, that Achilles hell in COVID-19 of asymptomatic spreading also complicates any herd-immunity strategy where infected people are kept separate from the more vulnerable. The latter group, in reality, cannot remain house bound and without contact with anyone who is not considered vulnerable for months possibly years or however long it takes to reach the critical herd-immunity level.

The World Health Organization currently estimates that 16% of people with COVID-19 are asymptomatic and can transmit the coronavirus, while other data show that 40% of coronavirus transmission is due to carriers not displaying symptoms of the illness.

As of Saturday, more than five months after the World Health Organization declared the COVID-19 outbreak a pandemic, more than 24 million people had been infected with the virus worldwide, and at least 837,879 had died.

In the U.K., there have been 333,806 confirmed cases and 41,573 deaths due to COVID-19. In Sweden, there have been at least 83,958 confirmed cases and 5,821 deaths. These numbers, for the most part, do not include asymptomatic carriers.

Herd immunity remains a distant hope. The success is premised on the ability to keep those two groups separated, but I dont know if you can, Amesh Adalja, a senior scholar at the John Hopkins Center for Health Security and a spokesman for the Infectious Diseases Society of America, told MarketWatch.

Its a challenging approach, Adalja added. Its going to be daunting. Its not as if those two demographics never interact. None of these intervention options is cost-free.

Theres an advantage to coming down with a virus that has been around for hundreds, if not thousands, of years, such as the flu. COVID-19 is new, and scientists are still learning about the viruss ability to mutate and affect the cardiovascular system as well as the respiratory system.

Coronavirus immunity differs from that to other diseases. Immunizations against smallpox, measles or Hepatitis B should last a lifetime, doctors say, but coronaviruses, first identified in the 1960s, interact with our immune system in unique and different ways, Adalja added.

How do other coronaviruses compare to SARS-CoV-2? People infected by SARS-CoV, an outbreak that centered in southern China and Hong Kong from 2002 to 2004, had immunity for roughly two years; studies suggest the antibodies disappear six years after the infection.

For MERS-CoV, a coronavirus first identified in 2012 that has infected hundreds in the Middle East, research indicates people retain immunity for approximately 18 months although the long-term response to being exposed may depend on the severity of the original infection. There are no vaccines for MERS-CoV or SARS-CoV.

Herd immunity is not a preventative measure, says Gideon Meyerowitz-Katz, an epidemiologist working in chronic disease in Sydney, Australia.

If 70% of your population is infected with a disease, it is by definition not prevention. How can it be? Most of the people in your country are sick! And the hopeful nonsense that you can reach that 70% by just infecting young people is simply absurd. If only young people are immune, youd have clusters of older people with no immunity at all, making it incredibly risky for anyone over a certain age to leave their house lest they get infected, forever, he wrote in ScienceAlert.

Its also worth thinking about the repercussions of this disastrous scenario the best estimates put COVID-19 infection fatality rate at around 0.5-1%, Meyerowitz-Katz added. If 70% of an entire population gets sick, that means that between 0.35% to 0.7% of everyone in a country could die, which is a catastrophic outcome.

With something like 10% of all infections needing to be hospitalized, youd also see an enormous number of people very sick, which has huge implications for the country as well, he said. The sad fact is that herd immunity just isnt a solution to our pandemic woes.

The alternative: After a slow start where people were allowed to travel and news of the original outbreak was quashed, telling people to stay home and keep their distance from each other appeared to work for China, as did the travel ban and locking down more than a dozen cities to help lower the rate of new cases and slow the spread of the virus, experts say.

It is the good part of what China did, Adalja said.

Read more here:
Sweden embraced herd immunity, while the U.K. abandoned the idea so why do they BOTH have high COVID-19 fatality rates? - MarketWatch

By John Vandermosten

TSX:PMN.TO | OTC:ARFXF

READ THE FULL PMN.TO RESEARCH REPORT

Current Events

ProMIS (TSX:PMN.TO) (OTC:ARFXF) has a number of recent and upcoming milestones related to development of its pipeline which we summarize below.

Confidential discussions with potential partners for platform programs - Ongoing

Capital raise or partnership to fund entry into clinic 2020

Prepare IND and Phase I trial for PMN310 2020

Pursue a vectorization deal - 2020

Generate Phase I biomarker data with Toronto Memory Program 2020

Launch Phase I trial in PMN310 - 2021

Second Quarter 2020 Operational and Financial Results

As the coronavirus dominated the global environment, ProMIS reoriented its efforts towards the virus and forged a relationship with BC Neuroimmunology (BCNI) to develop antibody detection tests for COVID-19. The relationship expanded to include development of assays to screen and diagnose Alzheimers Disease (AD). ProMIS and BCNI later codified their agreement with a Joint Venture business arrangement to offer additional testing. Another effort to combat COVID-19 emerged with a pending $400,000 grant from the Canadian government to predict mutations in the coronavirus. Industry news was punctuated by the FDAs acceptance of Biogens Biologics License Application (BLA) for aducanumab, bringing AD back into focus.

Financial results for second quarter 2020 were published in a press release and SEDAR filings released on August 13, 2020. Minimal revenues were recognized in the second quarter. Research and development efforts consumed $899,0001 in 2Q:20 compared with $1.0 million in the prior year quarter, a 14% drop. Lower spending on external contract research organization (CRO) costs, less share-based compensation were partially offset by higher patent expenditures. General and administrative expenses were $0.8 million, compared with the prior years $0.8 million. The 7% contraction in spend was primarily attributed to reduction in consulting and professional fees offset by increased foreign exchange losses.

As of June 30, 2020, cash stood at $1.3 million, down from the prior year-end level of $1.7 million and essentially flat with the prior quarters level. Cash burn for 2Q:20 was ($1.2) million offset by a net $1.2 million in cash from financing. In March 2020, ProMIS secured approval from the Toronto Stock Exchange to temporarily reduce the exercise price on 44 million options to $0.13 per share in a modification that expires on May 22. During this period which spanned two quarters, ProMIS raised total proceeds of $1.24 million.

Partnerships

ProMIS has developed multiple relationships with BCNI over the last several months, which is led by ProMIS board member Dr. Hans Frykman. On April 15, ProMIS announced a collaboration with BCNI to develop a high-throughput, highly specific serological asay to detect SARS-CoV-2 antibodies. About a month later, the partnership was expanded to include the development of a diagnostic assay for screening and diagnosis of AD. The diagnostic approach will use surface plasmon resonance (SPR)2 technology, a highly accurate approach to detecting specific antibodies.

The serology test that the two companies are developing is able to achieve a 99.9% sensitivity and 99.5% specificity for SARS-CoV-2, levels comprable to industry leading tests. Efforts to develop the diagnostic will also be able to determine whether or not the antibodies detected in the assay are able to neutralize the virus by using ProMIS proprietary peptide antigens. It is important to identify if the antibodies can neutralize the virus as this would indicate that they can confer immunity to COVID-19. 18 antibody targets have been identified that are unique to the spke protein on the virus and the ProMIS BCNI team will next test the binding affinity of the peptide antigents to the antibodies using SPR.

The success of early stage development between ProMIS and BCNI led to the creation of a revenue-sharing joint venture to develop highly accurate tests for AD. The tests would detect, assist in diagnosis and monitor the progression of AD. To joint venture will use SPR technology to generate results, which is favored due to its greater accuracy, flexibility and adaptability compared to enzyme-linked immunosorbent assay (ELISA) immunochemical tests. The JV will measure two brain-protein biomarkers: neurofilament light chain (NfL) and phosphorylated tau181 (P-tau181) which both show precise measurements of amyloid, tau and neurodegeneration. Since measurable AD neuropathology precedes cognitive decline by 15 to 20 years, the wide availability of this test will allow candidates for early stage treatment to be identified when preventative drugs can be most effective. As the 50/50 JV relationship matures between ProMIS and BCNI, additional tests are expected to be developed.

Additional collaborative efforts addressing COVID-19 include the receipt of a Supercluster Award to predict the evolution of the virus. The award of CAD$1.8 million will supprt the effort to identify likely mutations of SARS-CoV-2 in order to develop effective tests, therapies and vaccines against it. The Government of Canada, which provided the award, anticipates that dangerous new strans may emerge and is incentivizing activity to get ahead of the virus evolution. ProMIS is joined by five other commercial and academic collaborators to launch the project. The partners include Terramera, D-Wave, Menten AI, Microsoft Corp, ProMIS and the University of British Columbia. ProMIS will lend its epitope-identifying discovery engine to identify unique sites displayed on complex protein structures to assist in the effort.

Aducanumab Regulatory Submission

After months of suspense, Biogen (BIIB) published a press release on August 7th announcing aducanumabs BLA had been accepted by the FDA and granted priority review generating a target action date of March 7, 2021. Due to the unmet need in AD, the agency plans expedited action on the submission to review the first disease modifying therapy to reduce the clinical decline of AD. When Biogen announced in March 2019 that it had halted the trials evaluating the drug, the AD community and stakeholders had a loss of faith in the amyloid beta approach, given the string of failures capped by this announcement. However, on further examination, it appeared that at high doses the drug did work and a reanalysis demonstrated sufficient efficacy for the FDA to accept the BLA. This is a positive for others in the amyloid beta camp as it shows the approach can work. PMN310 offers several features that suggest it can perform even better than aducanumab due to its more specific targeting of misfolded proteins and lack of off-target Amyloid Related Imaging Abnormality Edema (ARIA-E) brain swelling.

Exhibit I ProMIS Neurodegenerative Candidate Portfolio3

Additions to the Team

In January 2020, Dr. Jos Luis Molinuevo ascended to the Scientific Advisory Board (SAB) bringing his experience as a neurologist, researcher, professor, principal investigator and clinician to the post. Dr. Molinuevo has focused on AD and other related diseases such as PD. He is the Scientific Director of the Alzheimer Prevention Program at the BarcelonaBeta Brain Research Center (BBRC) in Barcelona, Spain, which focuses on Alzheimers disease prevention from a clinical, cognitive, genetic, and biomarker perspective. Dr. Molinuevo is also an associate professor at the University Pompeu Fabra. His experience and knowledge of biomarkers and relationships throughout Europe are valuable assets that should provide support for later stage clinical trials in ProMIS portfolio candidates.

In conjunction with the announcement that ProMIS was collaborating in the development of a serological test for the coronavirus, the company also welcomed Dr. Hans Frykman to the SAB in April. Dr. Frykman is the CEO and medical director of BC Neuroimmunology lab and Neurocode Labs. For decades, the BC Neuroimmunology lab has provided clinical neuroimmunology testing in North America. Dr. Frykman is also a clinical assistant professor of medicine at the University of British Columbia.

RACK1

ProMIS identified a new antagonist against the Receptor for Activated protein C Kinase 1 (RACK1). RACK1 has been implicated in neurodegenerative diseases including amyotrophic lateral sclerosis (ALS). The RACK1 antagonists are designed to prevent this protein from forming aggregates that impair proper neuronal functioning. RACK1 is an attractive target because it interacts with other proteins including TAR DNA-binding protein 43 (TDP43) and Fused in Sarcoma (FUS). TDP43 and FUS can assemble and prevent neurological machinery from functioning properly by impairing synthesis of cell proteins. The RACK1 antagonist is another example of the broad functionality of ProMIS discovery algorithms.

Summary

ProMIS has continued to advance its preclinical programs and enter into diagnosting testing collaborations to detect both coronavirus and Alzheimers Disease. Parallel with these endeavors is the continued interaction with the scientific, investment and corporate community to garner KOL support, financing and partnerships. Management has refined its message highlighting the need to focus on the toxic forms of misfolded proteins that are the root cause of neurodegenerative disease and the importance of biomarkers that can rapidly and inexpensively demonstrate efficacy. We continue to be impressed with ProMIS discovery platforms and their ability to identify unique features of toxic misfolded proteins and their ability to be repurposed to identify targets for the coronavirus. We believe that a pharmaceutical partner deal or large investment will allow the company to advance its candidates into the clinic.

ProMIS represents an attractive opportunity to gain exposure to a disorder with no other approved disease modifying therapies. There are almost six million people in the US and over 30 million people outside of the US suffering from AD. Additionally, there is a larger population with mild cognitive impairment (MCI) and pre-Alzheimers which may benefit even more from toxic oligomer sequestering therapy. The path forward is relatively clear with other assets setting the precedent for trial design and potentially accelerated approaches using biomarkers suggested by regulatory agencies. There is also substantial opportunity for drug development in PD, MSA and ALS.

Due to the uncertain environment regarding to aducanumab, the investment community is waiting to invest new money in A programs. We expect to see a response by the FDA to Biogens drug by March of next year, which may bring attention back to the A space. We continue to believe in the potential of PMN310 and the other candidates in development and the tremendous opportunity in AD and other neurodegenerative diseases due to the lack of effective therapies and the magnitude of the need.

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1. Currency is denominated in Canadian Dollars

2. SPR is an approach that employs covalently attached ligands which interact with an analyte. Light is refracted on an underlying sensor chip, the angle of which can determine the mass of a bound protein. See here for a detailed explanation.

3. Source: ProMIS Corporate Presentation January 2020.

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PMN.TO: Serology Testing JV in AD and COVID - Zacks Small Cap Research

Masks as medicine

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

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

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

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

Kate Haug

Sebastopol

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cyndi Williams, CEO and founder at Quin, discusses why the digital and healthcare industries need to combine forcesto harness the full potential health apps have to offer.

There are more than 300,000 health-related apps available from leading app stores worldwide a number which has more than doubled in the past five years. In line with this astonishing growth, the number of digital health apps has also doubled since 2015, and is expected to be worth over $100 billion by 2023.

Whereas the traditional medical R&D process is incredibly expensive and time-consuming, app development offers an exciting alternative. Although the smartphone may never supersede medical devices, it is nonetheless an invaluable repository of lifestyle and behavioural data with immense promise for improving insights, outcomes and patient quality of life.

However, the exponential rise of mobile health apps (mHealth apps) now faces several significant obstacles from the rising cost of development to institutional reluctance and limitations to integration and interoperability.

Its time for a paradigm shift

As the populations of developed countries continue to skew older, chronic conditions become increasingly common and the shortage of healthcare workers continues, the requirement for further innovation in the industry also increases. The medical industry is built upon innovations that improve life expectancy, quality of life, and offer diagnostic and treatment options. mHealth apps offer the potential to not only assist with these, but also aid in improving healthcare costs and efficiency.

Medical health apps augment existing systems to enable earlier interventions, greater patient autonomy and significant improvements to quality of life. In the long term, this represents a paradigm shift from crisis intervention to patient-led preventative medicine.

Consumer interest is already here

While there is some resistance to this movement in the medical industry, healthcare consumers overwhelmingly support the increased use of digital technology. In a recent survey in the US, 75% of consumers reported that technology already played an important role in managing their health, while the number of healthcare consumers using mHealth apps jumped by 32% between 2014 and 2018, according to Accenture.

Accentures research also found that the 88% were comfortable sharing data gathered by wearable health devices with a medical professional, offering an early example of the beneficial interplay between digital monitoring and conventional medicine.

Changing life for people with diabetes

Diabetes is one such condition where mHealth apps can be hugely beneficial to an individuals lifestyle management. People with diabetes constantly make decisions that directly affect their physical health and attempt to balance dozens of interconnected factors that determine the appropriate insulin dose. For this reason, the mHealth App Economics 2017 study listed diabetes among the top three areas with the greatest market potential for digital health solutions, but market penetration has been limited. There is still a lot of potential for innovators who are willing to dig deep and understand more about how mHealth apps can positively influence the lives of people with diabetes.

For instance, many people with diabetes use continuous glucose monitors (CGMs) which already sync data to their phone. Combining this data with the other data that smartphones often collect sleep, steps, exercise, and even diet, weight and menstruation, if the person uses other apps to track these could produce significantly smarter and more personal dosage diagnosis for insulin.

The upcoming app Quin is an example of the next generation of intelligent, smartphone-based medical health apps. The app synthesises the users data to help them make informed, independent decisions on insulin dosing and lifestyle management based on previous experiences and day-to-day habits.

An exciting road ahead if we choose to take it

The proliferation of medical health apps represents truly personalised medicine, as patients phones passively log data in real-time and use their computational power to turn that raw information into actionable insights. From diagnosis to prevention and treatment, these affordable, scalable and ever-improving mobile health apps represent a revolution in medicine that will improve the quality of all our lives.

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The collision of fast-paced digital industry with healthcare - Med-Tech Innovation

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

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

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

We expect interim results within the next two weeks.

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

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

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

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

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

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

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

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

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

Editing by Michael Shields and Andrew Cawthorne

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