Cuomo denies causing 6,500 nursing home deaths

Gov. Andrew Cuomo denied this week that his state Health Department’s controversial March 25 order saying nursing homes could not bar admission or readmission to a resident based on a positive COVID-19 test had anything to do with the over 6,500 deaths in those facilities related to the virus.

“That’s not why they lost a loved one in a nursing home. Your question — the premise of your question is just actually wrong. People were lost in nursing homes, were lost because that’s where the virus preys.

“The virus preys on senior citizens,” insisted Cuomo, reprimanding a Finger Lakes News Radio reporter during a phone conference call with other members of the media on Wednesday.

“There’s a whole report done with data. The way the virus got into nursing homes was from two possible carriers — before we even knew about it,” continued the governor, ignoring the seeming impossibility of infected staffers at one nursing home having any impact on all the others.

“The staff, working staff, at the nursing home brought in the virus, or potentially family members before we stopped family visits brought in the virus and this happened at a time back in February when we didn’t even know the virus was circulating in New York State, that’s how the virus got into the nursing home,” he added.

Cuomo has defensively pointed to an internal report conducted by his own state Health Department and widely criticized by medical experts, politicians and family members who lost loved ones in facilities to the virus.

Experts like Catherine Troisi, an epidemiologist with the University of Texas Health Science Center at Houston, ripped the DOH-issued report released in July, arguing the analysis lacked sufficient information including data on nursing homes that were free of the deadly disease before being forced to admit infected patients.

“Would this get published in an academic journal? No,” Troisi told the Associated Press at the time.

Cuomo however reversed the policy on May 10, announcing hospitals could no longer send patients into nursing homes with a positive coronavirus case following a visit.

At the time, he argued the former policy was put into place to prevent discrimination against sick patients upon admission or readmission by facilities.

Presently, 6,484 nursing home residents have died in facilities since March of suspected or confirmed COVID-19 cases, according to the latest DOH data published Oct. 1. An additional 304 individuals succumbed to the disease in adult care facilities.

“If you’d actually like to understand some facts, I’ll have them send you a full report that was done and then you can help people with the facts,” Cuomo added cheekily to the upstate-based reporter.

“Ignorance doesn’t help grieving people. The rule that the State had which was from the CDC guidance, right? The State didn’t make it up, they were following the CDC guidance. Now you can say, well, State Health Department was stupid to follow the federal guidance and you may have a point there,” he added.

“But the rules said the nursing home can’t discriminate on the basis of COVID. The law also said a nursing home cannot accept a person who they cannot treat effectively while protecting the other residents. That’s the law.”

“We never scrambled for beds and we never needed nursing home beds because we always had hospital beds so it just never happened in New York where we needed to say to a nursing home we need you to take this person even though they’re COVID-positive,” Cuomo added.

“It never happened. We had extra beds. We had extra beds at Javits. We had extra beds at emergency hospitals that we put up all across the state so it just never happened that we needed a nursing home to take a COVID-positive person. It never happened that we needed a nursing home to take a COVID positive person. It never happened.”

Critics have argued however that the state’s order went beyond federal guidance, and that it was not clear that facilities had the choice to send sick patients to other facilities as a plan B if they were unable to cohort infected individuals or provide adequate.

The DOH denied a desperate request from Cobble Hill Health Center in Brownstone Brooklyn CEO Donny Tuchman in April, when he emailed the agency asking if there was “a way for us to send our suspected COVID patients” to the Jacob Javits Center, or the US naval hospital ship USNS Comfort — but the request was denied.

Assemblyman Ron Kim (D-Flushing) — a frequent critic of the governor’s policy and chief sponsor of legislation that would authorize an independent probe into the state’s handling of the crisis in these facilities was not convinced.

“The governor and his administration are stuck trying to figure out which lies they need to defend and how best to gaslight the public to believe that they did everything to save nursing home lives,” he said.

“We need the governor to tell the truth and own up to his mistakes.”

Senior advisor to the governor, Rich Azzopardi, bit back: “Anyone who bothered to read the transcript would know the Governor was crystal clear and was saying what didn’t happen was the crunch on hospital beds that every projection especially the federal government’s projections predicted.

“Separately the law has always been that nursing homes could only accept residents that they could adequately care for. None of that has changed. Those who continue politicize this issue in a shoddy attempt to deflect from the federal government’s incompetent and disastrous pandemic response should be ashamed of themselves and every media organization should hold them accountable for what they are trying to do.”

Meanwhile, good government group the Empire Center for Public Policy filed a lawsuit arguing the DOH is illegally withholding information about the number of nursing home residents who died of COVID-19 in hospitals so it can intentionally undercount deaths.

And even CNN fact checked the governor’s claims.

“Cuomo’s assertion that ‘it never happened’ is false,” the fact-check read. “According to a report from the New York State Department of Health, ‘6,326 COVID-positive residents were admitted to [nursing home] facilities’ following Cuomo’s mandate that nursing homes accept the readmission of Covid-positive patients from hospitals. Whether or not this was ‘needed,’ it did in fact happen.”

That fact-check was shared by CNN anchor Jake Tapper.

https://nypost.com/2020/10/02/it-never-happened-gov-cuomo-denies-causing-nursing-home-deaths/

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Pain Relief Caused by SARS-CoV-2 Infection May Help Explain COVID-19 Spread

SARS-CoV-2, the virus that causes COVID-19, can relieve pain, according to a new study by University of Arizona Health Sciences researchers.

The finding may explain why nearly half of all people who get COVID-19 experience few or no symptoms, even though they are able to spread the disease, according to the study’s corresponding author Rajesh Khanna, PhD, a professor in the UArizona College of Medicine – Tucson’s Department of Pharmacology.

“It made a lot of sense to me that perhaps the reason for the unrelenting spread of COVID-19 is that in the early stages, you're walking around all fine as if nothing is wrong because your pain has been suppressed,” said Dr. Khanna. “You have the virus, but you don't feel bad because your pain is gone. If we can prove that this pain relief is what is causing COVID-19 to spread further, that's of enormous value.”

The paper, “SARS-CoV-2 Spike protein co-opts VEGF-A/Neuropilin-1 receptor signaling to induce analgesia,” was published today in PAIN, the journal of the International Association for the Study of Pain.

View an animated video of how SARS-CoV-2 reduces pain, and a video of Dr. Rajesh Khanna explaining how his team identified the phenomenon.

The U.S. Centers for Disease Control and Prevention released updated data Sept. 10 estimating that 50% of COVID-19 transmission occurs prior to the onset of symptoms and 40% of COVID-19 infections are asymptomatic.

“This research raises the possibility that pain, as an early symptom of COVID-19, may be reduced by the SARS-CoV-2 spike protein as it silences the body’s pain signaling pathways,” said UArizona Health Sciences Senior Vice President Michael D. Dake, MD. “University of Arizona Health Sciences researchers at the Comprehensive Pain and Addiction Center are leveraging this unique finding to explore a novel class of therapeutics for pain as we continue to seek new ways to address the opioid epidemic.”

Viruses infect host cells through protein receptors on cell membranes. Early in the pandemic, scientists established that the SARS-CoV-2 spike protein uses the angiotensin-converting enzyme 2 (ACE2) receptor to enter the body. But in June, two papers posted on the preprint server bioRxiv pointed to neuropilin-1 as a second receptor for SARS-CoV-2.

“That caught our eye because for the last 15 years my lab has been studying a complex of proteins and pathways that relate to pain processing that are downstream of neuropilin,” said Dr. Khanna, who is affiliated with the UArizona Health Sciences Comprehensive Pain and Addiction Center and a member of the UArizona BIO5 Institute. “So we stepped back and realized this could mean that maybe the spike protein is involved in some sort of pain processing.”

Many biological pathways signal the body to feel pain. One is through a protein named vascular endothelial growth factor-A (VEGF-A), which plays an essential role in blood vessel growth but also has been linked to diseases such as cancer, rheumatoid arthritis and, most recently, COVID-19.

Like a key in a lock, when VEGF-A binds to the receptor neuropilin, it initiates a cascade of events resulting in the hyperexcitability of neurons, which leads to pain. Dr. Khanna and his research team found that the SARS-CoV-2 spike protein binds to neuropilin in exactly the same location as VEGF-A.

With that knowledge, they performed a series of experiments in the laboratory and in rodent models to test their hypothesis that the SARS-CoV-2 spike protein acts on the VEGF-A/neuropilin pain pathway. They used VEGF-A as a trigger to induce neuron excitability, which creates pain, then added the SARS-CoV-2 spike protein.

“The spike protein completely reversed the VEGF-induced pain signaling,” Dr. Khanna said. “It didn’t matter if we used very high doses of spike or extremely low doses – it reversed the pain completely.”

Dr. Khanna is teaming up with UArizona Health Sciences immunologists and virologists to continue research into the role of neuropilin in the spread of COVID-19.

In his lab, he will be examining neuropilin as a new target for non-opioid pain relief. During the study, Dr. Khanna tested existing small molecule neuropilin inhibitors developed to suppress tumor growth in certain cancers and found they provided the same pain relief as the SARS-CoV-2 spike protein when binding to neuropilin.

“We are moving forward with designing small molecules against neuropilin, particularly natural compounds, that could be important for pain relief,” Dr. Khanna said. “We have a pandemic, and we have an opioid epidemic. They’re colliding. Our findings have massive implications for both. SARS-CoV-2 is teaching us about viral spread, but COVID-19 has us also looking at neuropilin as a new non-opioid method to fight the opioid epidemic.”

Co-authors on the paper from the Department of Pharmacology are: Aubin Moutal, PhD; Lisa Boinon; Kimberly Gomez, PhD; Dongzhi Ran, PhD; Yuan Zhou; Harrison Stratton, PhD; Song Cai, PhD; Shizhen Luo; Kerry Beth Gonzalez; and Samantha Perez-Miller, PhD. Co-authors from the Department of Anesthesiology, with additional affiliations with the Comprehensive Pain and Addiction Center, are Amol Patwardhan, MD, PhD, and Mohab Ibrahim, MD, PhD.

This research was funded by the National Institute of Neurological Disorders and Stroke, a unit of the National Institutes of Health (NIH), under Award No. NS098772; and the National Institute on Drug Abuse, also an NIH unit, under Award No. DA042852.

https://uahs.arizona.edu/news/pain-relief-caused-sars-cov-2-infection-may-help-explain-covid-19-spread

Canada to keep, ease some U.S. border curbs until pandemic wanes

Canada will maintain restrictions on non-essential travel with the United States until the coronavirus outbreak in both nations is much less serious, a senior government official said on Friday.

The comments by Canadian Public Safety Minister Bill Blair suggest that the ban on non-essential travel could stay for months to come, given spiking cases of COVID-19.

The measures, first imposed in March, are due to expire on Oct 21. They do not affect trade.

Blair told reporters that Canada would keep the restrictions in place “until the conditions on both sides of the border ... change very substantively, until we can be assured based on the advice we receive from our public health officials” that the measures could be lifted safely.

The United States on Friday reported 7,260,465 cases of the new coronavirus, up 47,046 from the previous count. A second wave is sweeping Canada, where health officials are reporting almost 2,000 new cases a day compared to just 300 in July.

Canadian officials earlier announced they would ease some restrictions next Thursday to allow for more family reunifications, and plans to allow some new international students to attend learning institutions.

When the measures were first introduced they prompted protests from people separated from family members.

“We recognize that travel restrictions should not keep loved ones apart. In these challenging times, we know those challenges are best met with the strength and support of those we love by our side,” Immigration Minister Marco Mendicino told reporters.

As of Oct. 8, Canada will allow the entry of certain extended family members of Canadian citizens and permanent residents, including those in an exclusive dating relationship of at least one year.

https://www.reuters.com/article/us-health-coronavirus-canada-border/canada-to-ease-some-border-restrictions-to-allow-for-more-family-reunification-idUSKBN26N37T