Public Health Alarms Over Rebound In New Covid-19 Cases As Protests Continue

Largely thanks to the overwhelming profit motive of corporatized media, Americans suffer from an entrenched myopia that has become a major stumbling block to all manner of reform. We could spend hours parsing various theories about the provenance and nature of this endemic short-termism, which permeates everything from the priorities of corporations, the media and the average man on the street.
Whether you believe us or not, scientists and public health officials who have been on the front lines of the pandemic are alarmed by the  resurgence in new coronavirus cases following 2 weeks of protests spanning more than 30 states.
Moreover, many of the same critics who attacked GOP governors and the Trump administration for pushing for a “premature” reopening are now arguing that the coronavirus is no longer a concern.

As US stock benchmarks power higher, it seems investors are choosing to ignore warning signs like Johns Hopkins University data showing a sharp jump in new cases last week, compared with the week before, according to a WSJ analysis of the data.
This attitude seems at odds with the advice from experts including Dr. Fauci and UK Secretary of Health Matt Hancock, who warned that the demonstrations risked sparking a resurgence in new cases. Robert Redfield, director for the Centers for Disease Control and Prevention, joined Gov Cuomo in urging protesters to get tested immediately.
“I do think there is potential, unfortunately, for this to be a seeding event,” Dr. Redfield said.

While New York, New Jersey and a handful of the other most hard-hit states have reported continued success, states like Florida, Tennessee and even Texas have seen a jump in new cases. And while expanded testing capacity is undoubtedly one contributing factor, many fear that increased human interaction is mostly to blame.

Source: NYT
Public health officials in Utah – not exactly a focal point of the unrest spurred by the murder of George Floyd – reported an alarming spike in new cases in the wake of the state’s reopening, which began about a month ago. Officials say it’s unclear how much of that jump is due to expanded testing accessibility, and how much represent the virus’s natural rate of expansion.

The spread of the virus picked up in Utah weeks after reopenings began, said Angela Dunn, state epidemiologist with the Utah Department of Health. She said she is very concerned about the rise in infections and urged residents to use face coverings and maintain social distancing.
“This past week, we’ve had a sharp spike in cases, and it’s not explained easily by a single outbreak or increase in testing,” Dr. Dunn said Wednesday. “This is a statewide trend.”

In Nashville, the rebound was sharp enough to convince officials to delay the next step in its reopening plan.

In Nashville, Tenn., a surge in the number of daily coronavirus cases reported has slowed reopening plans. Alex Jahangir, a surgeon and the head of the city’s Covid-19 task force, said case counts over the last few days had increased the city’s seven-day average. The city will wait to make a decision on when to begin its next reopening phase.
“It is concerning enough for us to slow down and see what’s happening over the next few days,” Dr. Jahangir said Thursday.

LA County blamed last week’s spike on delays in counting new cases, while Arkansas says it is now considering a regional approach following a spike in cases in the northwestern part of the state, while officials continue to ramp up testing.

“The spike in the new cases that we have reflects the dramatic increase in testing that we’re doing,” said Arkansas Gov Asa Hutchinson .

Florida is allowing Disney World to reopen, even as the pace of new cases has continued to accelerate, seeing a 13% spike last week.
What’s more,  tear gas and pepper spray cause people to tear up and cough, aerosolizing the virus and causing it to spread more easily.
At this point, leftists and the MSM have become so trusting of reports confirming their worldview that they’ve been blinded by their own biases, exposing the seams of a shoddily stitched political narrative.
https://www.zerohedge.com/geopolitical/experts-alarmed-rebound-new-coronavirus-cases-protests-expected-continue

Re-home drug manufacturing, but don’t jeopardize US sector leadership

The Latin phrase Primum non nocere meaning “first, do no harm” is part of the Hippocratic oath medical students recite during their symbolic white coat ceremony. Perhaps politicians and government officials proposing massive changes to the critical supply lines of medicines ought to take such an oath as well.
As states begin the herculean task of applying the President’s Guidelines for Opening Up America Again in their localities, policymakers and economists are suggesting varying ways to propel our largely dormant commercial sectors forward, including the need to buy goods from American small businesses, farmers and manufacturers.

Some industries, like agriculture and automotive, will certainly benefit from this sentiment. However, one unique sector where patriotic sentiment in the form of protectionist trade policies doesn’t make sense is for onerous domestic production provisions for critically needed prescription drugs and medical supplies.

In the midst of this chaotic, global public health pandemic, private enterprise and public sector institutions of all sizes have been tested to their limits and have shown the unparalleled value of America’s biopharmaceutical and manufacturing leadership.
Forcing new rules and manipulating our pharmaceutical supply chains, especially while COVID-19 and related lockdowns are still hampering our American way of life, will cause further harm to jobs and our economy, increase prices for consumers and ultimately diminish the quality and speed of care delivered by U.S. health care professionals.

The assertion that all prescription medications and medical devices should be domestically produced and manufactured, as some sort of protection against a global pandemic, is based more on angry emotions than any logical solution.

This pandemic, like all others, made apparent both supply and demand side uncertainty and volatility. As economic history has shown, however, America should not depend on any external supplier for essential products, including ourselves.
Take our nation’s energy renaissance made possible by President Trump. This triumph was not achieved by mandates and government production requirements. Instead  it was secured as a result of regulatory reforms and tax policies that served as critical incentives for domestic production and manufacturing, which in turn made us competitive in the global energy markets.
Carrots, not sticks, prevailed; job and economic growth ensued. The key is creating an environment where American entrepreneurship can flourish.

These are unprecedented times and the pandemic has exposed the vulnerability of the global economy to out-sized systemic shocks. Thankfully, the Trump administration is focused on healthcare resources simultaneously with preparing a quick pathway for economic recovery.
It is crucial that people can get back to work safely and soon. One of the most obvious adjustments needed is planning and preparing for the next global event by investing in and stockpiling shelf-stable medicines, personal protective equipment, and other essential life-saving materials.
President Trump is working to get this done and ensure Americans facing future emergencies are better equipped unlike his predecessors who left a depleted national inventory upon their departure.
However, policymakers should be careful not to make poor reactionary decisions that will put the American people at more risk. For example, the assertion that all prescription medications and medical devices should be domestically produced and manufactured, as some sort of protection against a global pandemic, is based more on angry emotions than any logical solution.
And predictably, with angered emotion comes inflammatory rhetoric and inaccuracies that spread like wildfire during uncertain times. This is the case with respect to the public’s perception that we are dependent on foreign countries like China for our prescription drugs.
Reason’s Eric Boehm unearths the reality behind some of the inflated numbers we’ve been hearing. Bottom line: while parts of many drugs are secured abroad, much more are made in the U.S., along with the European Union and the rest of the world.

Similar to the automotive, aviation, and information technology industries, the global pharmaceutical manufacturing pipeline is incredibly diversified.  At the same time, according to the Food and Drug Administration’s tracking, there are twice as many prescription drug facilities in the U.S. as there are in China.
Add in the EU and rest of the world, and America still leads the world in biopharmaceutical innovation and manufacturing.
Ironically, ill-conceived protectionist mandates, socialist-style price control policies, and other heavy-handed intrusions into the marketplace could knock this hard-earned crown – and its critical economic, employment, and lifesaving benefits – straight off our own heads.         Instead of sure-to-fail protectionist policies, let’s double down on President Trump’s own road map of regulatory reforms, tax cuts, and fair-trade deals like the USMCA to incentivize more domestic production. Much like we’ve seen in the energy and general manufacturing sectors, this will make production and manufacturing of prescription drugs and medical equipment in the U.S. even more attractive while ensuring critical global supply chains lines remain open.
Doing so would cause no harm and do a lot of good for America.Steve Forbes is Chairman and Editor-in-Chief of Forbes Media. 
Kenneth J. Blackwell is the former Treasurer of the State of Ohio and a Board Member of the National Taxpayers Union.
https://www.foxbusiness.com/markets/drug-manufacturing-us-leadership

Hologic’s financial outlook improves thanks to coronavirus tests

Hologic Inc. HOLX, +1.33% shares rose more than 2% in the extended session Monday after the maker of medical devices said its fiscal third-quarter’s financial outlook has improved, mainly because one of its units is seeing more revenue related to COVID-19 tests. Its surgical business has started to recover faster than the company expected, and its diagnostics business has outperformed “significantly” thanks to “strong” sales of the company’s COVID-19 tests, Hologic said. The company said it expects revenue from the diagnostics business to grow between 20% and 25% in the quarter. Due to ongoing uncertainty related to the pandemic, however, it would not quantify longer-term financial effects. Hologic ended the regular trading day up 1.3%.
https://www.marketwatch.com/story/hologics-financial-outlook-improves-thanks-to-coronavirus-tests-2020-06-08

Gripping Theory Offers Clue to Predicting Cognitive Decline

Low or asymmetrical handgrip strength may be an indicator of cognitive decline in seniors, new research suggests.
Investigators analyzed handgrip strength in over 17,000 adults aged 50 years and older and found that those with both asymmetry and weakness had a twofold increase risk of accelerated cognitive decline.
In particular, those with the greatest odds for lower cognitive functioning had considerably more strength in their nondominant than their dominant hand.
“Having weakness, as measured by maximal handgrip strength, and/or wide strength differences between hands, could be a clue for low cognitive functioning,” lead author Ryan McGrath, PhD, assistant professor in the Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, told Medscape Medical News.
“If a person has weakness and/or handgrip strength asymmetry, a more comprehensive cognitive evaluation may want to be considered — or even evaluations of other age-related health conditions such as frailty,” McGrath said.
The study was published online May 30 in the Journal of the American Geriatric Society.

Indicator of Neural System Deficits

“There is an accumulating amount of evidence that physical measures, such as handgrip strength, are associated with cognitive impairment,” McGrath said.
Previous studies focusing on cognition indicate that imbalances in muscle strength “could be linked to the neural system deficits that drive low cognitive functioning.”
The researchers therefore “wanted to enhance handgrip strength protocols by also evaluating handgrip strength asymmetry because we are usually only interested in maximal handgrip strength,” said McGrath.
To investigate, the researchers analyzed a sample of 17,163 individuals (median age, 65 years [SD, 10.1 years]; 42.2% male; 68.1% non-Hispanic white; 17.7% non-Hispanic black), drawn from the 2006 to 2016 waves of the Health and Retirement Study, a longitudinal study that monitors a variety of factors in aging Americans.
Most participants rated their health as “very good” or “good” (31.2% and 31.8%, respectively).
The researchers assessed cognitive function at each wave of the study using the Telephone Interview for Cognitive Status with “lower” status defined as ≤ 11 for participants ages 50‐64 years and ≤ 10 for those aged ≥ 65 years.
Handgrip strength of both dominant and nondominant hands was measured using a handgrip dynamometer, with “weakness” defined as handgrip strength < 26 kg in men or < 16 kg in women.
Participants with handgrip strength > 10% stronger on either hand were considered as having “any [handgrip strength] asymmetry,” and participants with handgrip strength > 10% stronger on their dominant or nondominant hand were considered as having “dominant” or “nondominant” handgrip strength asymmetry, respectively.

Quick, Feasible Screen

Of the 17,163 study participants, 48% had symmetric handgrip strength, 43% had dominant handgrip strength asymmetry, and 9% had nondominant handgrip strength asymmetry.
Compared with participants with symmetric handgrip strength and no weakness, those with any handgrip strength asymmetry alone had 15% greater odds for lower cognitive functioning, participants with weakness alone had 64% greater odds for lower cognitive functioning, and those with both handgrip strength asymmetry and weakness had 95% greater odds for lower cognitive functioning.

The odds of lower cognitive function were even greater when examining hand dominance specifically. Those with dominant handgrip strength symmetry alone, nondominant handgrip strength asymmetry alone, weakness alone, dominant handgrip strength asymmetry and weakness, and nondominant handgrip strength asymmetry and weakness had 12%, 27%, 64%, 89%, and 110% greater odds for lower cognitive functioning, respectively.
“The associations for low cognitive function [and handgrip asymmetry] were exacerbated when those with handgrip strength asymmetry also had weakness,” said McGrath.
“We recommend that measures of handgrip strength asymmetry be used alongside assessment of weakness to improve the prognostic value of handgrip dynamometers,” he added.
He noted that the “feasibility for completing handgrip strength measurements are high [and] opportunities for measuring handgrip strength at home are emerging.”

Simple Tool

Commenting on the study for Medscape Medical News, Keith Fargo, PhD, director of scientific engagement for the Alzheimer’s Association, said the finding is “intriguing” but added that it “needs to be replicated in larger and more diverse study groups.”
Fargo, who was not involved with the study, said that it is “important to note that handgrip strength is not a tool used to assess current or future cognitive function, and that this topic may be worth further investigation, since it is relatively simple to administer and measure.”

For example, “it could be a simple screening tool that could indicate the need for a more comprehensive cognitive evaluation [but] we simply don’t know at this point,” Fargo stated.
McGrath noted that some healthcare providers use measures of handgrip strength to primarily assess muscle function, “but overall the use of handgrip strength in routine geriatric health assessments is generally absent.”
He encourages healthcare providers “to use measure of handgrip strength, given the robust health information it provides and procedural ease.”
However, he cautioned, handgrip strength “methodologies are continually evolving and the associations of handgrip strength with clinically relevant outcomes are wide-ranging, thus healthcare providers should understand how to administer handgrip strength protocols and what handgrip strength is assessing.”
No source of study funding was reported. The authors and Fargo report no relevant financial relationships.
J Am Geriatr Soc. Published online May 30, 2020. Abstract
https://www.medscape.com/viewarticle/931979#vp_1

‘Anxiety Screening Recommended for All Women’ – ACOG-Linked Group

Young women ages 13 and up, including those who are pregnant or have just given birth, should be screened for anxiety at routine visits, according to a Women’s Preventive Services Initiative (WPSI) recommendation released Monday.
In the 10 systematic reviews used to form the evidence base of this recommendation, there was sufficient evidence supporting the accuracy of screening tools and the efficacy of available anxiety treatments, including cognitive behavioral therapy and pharmacologic therapies, reported Heidi Nelson, MD, MPH, and other colleagues at WPSI.

However, no studies looked at the overall effectiveness and harms of anxiety screening, they wrote in the new guideline published in the Annals of Internal Medicine.
“Even though we estimate 40% of women experience anxiety throughout their lifetime, only 20% of men and women actually seek care,” Nelson told MedPage Today. “There is really a gap between the experience of screening and the treatment of anxiety.”
Led by the American College of Obstetricians and Gynecologists, the WPSI is a national program in partnership with the federal Health Resources and Services Administration and involvement from other medical groups. It develops recommendations on clinical issues that have not been addressed by groups like the U.S. Preventive Services Task Force (USPSTF).
The USPSTF currently recommends screening all adults and adolescents ages 12-18 for depression, but similar recommendations do not exist for anxiety.
Although anxiety is also diagnosed in about 20% of men, the WPSI determined that women have unique needs because they experience anxiety triggers such as sexual harassment or eating disorders at higher rates, Nelson said.

Rates of anxiety are rising nationally amid the COVID-19 pandemic, amplifying the need for increased screening and treatment, Nelson added.
“What’s nice about these types of instruments is that they can be done online with a remote appointment,” Nelson said. “Asking a few extra questions … and opening that door reveals many other things that can help people cope with the situation we are under now.”
In the evidence review of studies conducted in community, primary care, and obstetrics clinics, most screening tools showed moderate to high accuracy in good or fair quality studies, Nelson and co-authors reported, noting that for some tools, the short version fared equally well as longer versions, including the Generalized Anxiety Disorder 2-item questionnaire versus the 7-item questionnaire (GAD-2 vs GAD-7).
Moreover, some tools worked just as well in children and adults, including the GAD-7 and the Hospital Anxiety and Depression Scale, researchers reported.

“Use of the most brief and universal, yet effective, instruments could facilitate integration of anxiety screening into routine clinical practice,” Nelson and co-authors wrote.
However, the jury is still out on whether anxiety screening can be effectively implemented, commented Kim Smolderen, PhD, and Matthew Burg, PhD, both of Yale University in New Haven, Connecticut, in an accompanying Annals editorial.
A total of 27 screening tools were identified in the review, and “clearer directives for how to approach screening could promote uptake of the guidelines in real-world clinical settings,” Smolderen and Burg noted.
Also, “when promoting screening, it is important to reflect on what happens when anxiety is detected,” they wrote.
Namely, women may experience long-term side effects of pharmacologic agents commonly used to treat anxiety, which not only include benzodiazepines but also SSRI/SNRI antidepressants. Medications need to be monitored particularly closely in pregnant or postpartum women, the editorialists noted.

In the evidence review, adverse events were not documented with CBT, but they were common in drug trials. For example, in one high-quality trial, 63% of adults on SSRIs and SNRIs reported at least one adverse event, including sexual dysfunction, weight gain, nausea, and fatigue, researchers reported.
Patients who screen positive for anxiety may also have trouble accessing affordable CBT, wrote Smolderen and Burg, adding that women of color, sexual minorities, and women residing in rural areas disproportionately face obstacles in obtaining mental health care.
“Implementation of mental health screening is most likely to be effective within a collaborative care context, in which well-organized paths are in place to care for those identified with a condition,” they wrote. “Without such a collaborative care context, it is not apparent that the act of screening in itself would provide benefit.
https://www.medpagetoday.com/psychiatry/anxietystress/86950

FDA grants orphan drug designation to Agios’s mitapivat for thalassemia

Agios Pharmaceuticals (NASDAQ:AGIO) +4.4% AH as the company receives FDA orphan drug designation to its pyruvate kinase-R (“PKR”) activator mitapivat for thalassemia.

Mitapivat was previously granted orphan drug designation by the FDA and EMA for pyruvate kinase (“PK”) deficiency, a rare, debilitating, hemolytic anemia.

https://seekingalpha.com/news/3581331-fda-grants-orphan-drug-designation-to-agioss-mitapivat-for-thalassemia

Google Maps to alert users about COVID-19-related travel restrictions

Google is adding features on its Maps service to alert users about COVID-19-related travel restrictions to help them plan their trips better, the Alphabet Inc unit said on Monday.
The update would allow users to check how crowded a train station might be at a particular time, or if buses on a certain route are running on a limited schedule, Google said.
The transit alerts would be rolled out in Argentina, France, India, Netherlands, the United States and United Kingdom among other countries, the company said here in a blog post.
The new features would also include details on COVID-19 checkpoints and restrictions on crossing national borders, starting with Canada, Mexico and the United States.

In recent months, the company has analyzed location data from billions of Google users’ phones in 131 countries to examine mobility under lockdowns and help health authorities assess if people were abiding with social-distancing and other orders issued to rein in the virus.
Google has invested billions of dollars from its search ads business to digitally map the world, drawing 1 billion users on average every month to its free navigation app.
https://www.reuters.com/article/us-health-coronavirus-google/google-maps-to-alert-users-about-covid-19-related-travel-restrictions-idUSKBN23F26N