WHO recommends doctors not use Gilead remdesivir to treat COVID

 

• The World Health Organization is recommending against doctors using Gilead Sciences' (NASDAQ:GILD) remdesivir (Veklury) to treat hospitalized COVID-19 patients.
• Gilead shares are down 1.6% after hours.
• “There is currently no evidence that it improves survival or the need for ventilation,” a panel of experts convened by WHO says in The BMJ.
• That comes very shortly after regulators gave the drug a quick approval for treating COVID-19 - and its use in treating President Trump when he was diagnosed with COVID-19 early last month.
• A global WHO-sponsored trial, Solidarity, found that the drug didn't reduce deaths, and the experts reviewed data from three other trials to conclude remdesivir has "no meaningful effect" on time to clinical improvement.
• https://seekingalpha.com/news/3638208-who-recommends-doctors-not-use-remdesivir-to-treat-covidminus-19-gildminus-1_6

Fauci: Public Health Curbs Should Stay Post Vax Distribution

Dr. Anthony Fauci says public health measures should still remain in place following the distribution of the coronavirus vaccine.

''The issue is that you’re not going to be completely protected against a degree of infection that you might not even notice that you might be able to spread to others,'' he said in a virtual discussion with The Hastings Center on Thursday.

''Which is the reason why the message you may have heard me say over the last couple weeks in the media is that getting vaccinated with a highly efficacious vaccine does not mean that you’re going to ababdon completely public health measures."

Pharmaceutical giants Pfizer and Moderna in recent days announced vaccines that are 95% effective in combating COVID-19.

The annual flu vaccine is usually only 60% effective and that is what experts initially expected from COVID-19 vaccines. However, their surprisingly high immunity rate raises hopes around the world that vaccines may help put an end to the pandemic.

Fauci said it was unclear what impact the vaccines may have on transmission.

''We have the same issue with influenza,'' Fauci said, noting that the two coronavirus vaccines are far more effective than the seasonal flu vaccine. ''You can get vaccinated with influenza and you won’t get sick, but it won’t necessarily prevent you from getting infected — although you won’t know you’re infected because you’ll either get mild or no symptoms.''

https://www.newsmax.com/newsfront/vaccines-2020-covid-fauci/2020/11/19/id/997919/

Sun Belt Cities Poised to Recover Fastest From the Pandemic

 Sun Belt areas led by Dallas will reach full employment faster than cities such as New York, which suffered deeper job losses due to COVID-19, a new report showed.

Austin and Phoenix are also expected to make a faster economic recovery from the pandemic than other major U.S. cities, according to a labor-analytics report from software firm, ThinkWhy. Its LaborIQ ranking weighed such factors as working-age population growth, migration and education. Atlanta and Tampa round out the top five.

Those cities “will have some of the strongest population growth the next few years due to the health of their job markets,” said Jay Denton, chief innovation officer at Dallas-based ThinkWhy.

The outlook for recovery is tempered by a surge in coronavirus cases as a latest wave of infections sweeps the nation, sparking new round of tighter restrictions. Texas, the second-most populous state, earlier this month became the first U.S. state to surpass 1 million cases.

Employment in the Sun Belt cities cited in the report have suffered much less than the national average drop of 9.4% as of the second quarter from a year earlier. Among the 10 largest counties, the Bureau of Labor Statistics shows that the New York City area had an employment decline of 18.8%, Cook County in Chicago a 13.1% drop and California’s Orange County and Los Angeles saw decreases of 12.7% and 12.2%, respectively.

By comparison, Maricopa county in Arizona, which includes Phoenix and its suburbs, saw a drop of just 4.6% and sectors such as finance and construction were fully recovered by June.

LaborIQ’s No. 1-ranked Dallas experienced an annual employment decline of 5.8% in June. But with its 2.2 million college graduates along with strong migration and wage growth, the area is set to recover quickly, according to the report.

The Dallas finding is bolstered by data from Kastle Systems which tracks electronic access to office buildings and found that Dallas leads the country with 42.2% of workers returning to offices. That compares with less than 20% returning by Nov. 10 in New York, Chicago and San Francisco.

By 2021, LaborIQ forecasts that all sectors in Dallas will be at least 99% recovered including leisure and hospitality. By contrast, that sector is not expected to recover until 2025 in New York City.

https://www.newsmax.com/finance/streettalk/sun-belt-cities-recover-pandemic/2020/11/19/id/997902/

California imposes overnight curfew to stem coronavirus

  California Gov. Gavin Newsom is imposing an overnight curfew as the most populous state tries to head off a surge in coronavirus cases.

Newsom announced Thursday a limited stay-at-home order in 41 counties that account for nearly the entire state population of just under 40 million people.

Starting Saturday, all non-essential work, movement and gatherings must cease between 10 p.m. to 5 a.m.

The move comes only days after the state imposed restrictions limiting business operations in those 41 counties, which have the most significant increases in virus cases.

The order will last one month, until Dec. 21, but could be extended if infection rates and disease trends don’t improve.

“The virus is spreading at a pace we haven’t seen since the start of this pandemic and the next several days and weeks will be critical to stop the surge. We are sounding the alarm,” Newsom said in a statement.

While nonessential businesses must close by 10 p.m., restaurants will be permitted to offer takeout food. Residents will still be able to get medical care, pick up prescriptions and take care of other essential needs.

https://apnews.com/article/us-news-gavin-newsom-california-coronavirus-pandemic-47ec9b65c376bf64ccd8460978b9f6fb

Scientists Failed to Use Common Sense Early in the Pandemic

 As a scientist and historian of science, I get asked a lot by friends and family to comment on scientific questions. Are vaccines safe? Is red meat bad for you? How much time do we have left to fix climate change? Many of these matters are not nearly as complicated as they have sometimes been made out to be. Vaccination is broadly safe for most people; eating large amounts of red meat is associated with higher rates of death from a number of cancers; and scientists think we have about a decade left to get greenhouse gas emissions under control and avoid the worst consequences.

Lately nearly all the questions involve COVID-19—particularly the matter of masks. The argument for wearing them is pretty straightforward: viruses are spread in droplets, which are expelled when an infected person talks, shouts, sings or just breathes. A properly constructed and fitted mask can prevent the spread of those droplets and therefore the spread of the virus. That is why surgeons have been routinely wearing medical-grade masks since the 1960s (and many doctors and nurses wore cloth masks long before then). It is also why in many parts of Asia, people routinely wear masks in public. A flimsy or poorly fitting face covering may not be much use, but—barring the risk of generating a false sense of security—it is unlikely to do harm. So it stands to reason that, when in public, most people should wear masks. The U.S. Centers for Disease Control and Prevention summarizes: “Masks are recommended as a simple barrier to help prevent respiratory droplets from traveling into the air.... This is called source control.”

So why are people confused? One reason is that we have been getting conflicting messages. In April the World Health Organization told the general public not to mask, while the CDC told us we should. In June the WHO adjusted its guidance to say that the general public should wear nonmedical masks where there was widespread community transmission and physical distancing was difficult. Meanwhile CDC director Robert R. Redfield declared that “cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus—particularly when used universally.” Today government guidance around the globe varies from masks only for sick people to masks mandatory for all.

Why the contradictory messaging? In particular, why did the WHO say in April not to wear masks? At the time, there was a severe shortage of personal protective equipment; the WHO evidently feared that ordinary people would rush out to buy masks, denying them to medical personnel. According to one report, officials were also concerned that widespread masking would lead to a false sense of security, leading people to ignore other safety measures, such as handwashing and self-isolation.

If the WHO had simply said this, there would have been a lot less confusion. But apparently there was another problem. At the time, no direct evidence existed regarding community spread of this particular virus, and most previous studies were done in clinical settings. The WHO put it this way: “There is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19.”

This is a common pattern in science: conflating the absence of evidence with evidence of absence. It arises from the scientific norm of assuming a default hypothesis of no effect and placing burden of proof of those asserting an affirmative claim. Usually this makes sense: we do not want to overturn established science on the basis of an assertion or speculation. But when public health and safety are at stake, this standard becomes priggish. If we have evidence that something may help—and is unlikely to do harm—there is little excuse for not recommending it. And when there is a mechanistic reason to think it might help, the lack of clinical trials should not be a barrier to acting on mechanistic knowledge. One epidemiologist offered some common sense: “Randomized trials don't support a big effect of face masks, but there is the mechanistic plausibility for face masks to work.... So why not consider it?”

In nearly all areas of science, our evidence is imperfect or incomplete, but this is no excuse not to act on what we know.

https://www.scientificamerican.com/article/scientists-failed-to-use-common-sense-early-in-the-pandemic/

Baker Joins NE Govs, Asks Colleges To COVID Test Students Pre-Thanksgiving

 Governor Charlie Baker joined governors in the northeast to encourage colleges to administer a COVID-19 test to students going home for Thanksgiving before they leave campus.

Students who test positive for the coronavirus would be encouraged to stay on campus. Students who are already quarantining on campus must remain in place until they have completed their quarantine.

"The region is experiencing a surge in COVID cases and a surge in the serious health impacts this disease brings with it. Working together on travel and higher education policies like these, states can have a bigger impact on COVID spread as students travel for the holidays,” said Governor Charlie Baker. “Gathering with friends and family significantly increases the risk of spreading the virus and while testing and isolation guidelines can help slow the spread, it is up to everyone to wear a mask and avoid gathering indoors with people outside of your household.”

The move is sparked by rising COVID cases across the country – including the Northeast – and the possibility of increased transmission at Thanksgiving gatherings. On Wednesday, the seven-day weighted average of positive tests in Massachusetts was 3.31%,

The governors are also asking that colleges expand remove instruction for the weeks between Thanksgiving and winter break to reduce students’ travel. Students that do return to college campuses after Thanksgiving should receive a COVID-19 test and follow state quarantine protocols.

Besides Baker, the Regional Coalition of Northeast Governors includes New York Governor Andrew M. Cuomo, New Jersey Governor Phil Murphy, Connecticut Governor Ned Lamont, Delaware Governor John Carney, Pennsylvania Governor Tom Wolf, and Rhode Island Governor Gina Raimondo.

https://boston.cbslocal.com/2020/11/18/covid-charlie-baker-college-students-northeast-governors/

Coronavirus vaccines to arrive in Florida within weeks: DeSantis

 Florida is preparing to receive two coronavirus vaccines that could arrive in the state as soon as three weeks from now, Gov. Ron DeSantis announced Thursday on Twitter.

He said the state has identified five Florida hospitals, including Tampa General, that have the ability to store and distribute millions of doses manufactured by pharmaceutical companies Pfizer and Moderna, possibly by the end of December.

Both companies have reported 95 percent effectiveness of their COVID-19 vaccines. DeSantis said they’ll be shipped across the country within 24 hours of approval by the Federal Drug Administration, which he expects to happen in three to six weeks.

Florida is ready with millions of syringes, needles and alcohol swabs to be used to distribute the medicines, the governor said. The state also is working to get vaccines shipped to CVS and Walgreens pharmacies, which will work with about 2,000 long-term care facilities to distribute the drugs to residents.

DeSantis also announced a new antibody treatment available to coronavirus patients with mild to moderate symptoms. The first dose was administered Wednesday at Tampa General, the hospital said. It’s had great success in clinical trials, reducing the rate of hospitalization for those patients by 70 percent, the governor said.

During the treatment, patients are intravenously given proteins called monoclonal antibodies that neutralize the virus and stop it from spreading. They block a protein in the virus before it can enter human cells and cause illness, according to Tampa General.

Speaking about the vaccines, DeSantis made a point of saying no one would be forced to take them. But he added: “I do, though, believe that these breakthroughs represent probably the greatest rays of hope that we have seen since the pandemic began. They offer the prospect of saving thousands and thousands of lives, and could potentially bring this pandemic to an end.”

Florida on Thursday reported more than 9,000 new cases and 81 additional deaths from the coronavirus, part of a weeks-long surge in infections across the nation, including in the Tampa Bay region.

Along with Tampa General, four other hospitals will receive vaccines: AdventHealth Orlando, UF Health Jacksonville, Memorial Regional Hospital in Hollywood and Jackson Memorial Hospital in Miami.

Tampa General released a recorded internal interview with Dr. Seetha Lakshmi, an infectious disease attending physician and associate epidemiologist at the hospital, and a professor at the University South Florida medical school.

She said vaccines are expected to arrive at Tampa General in the next few weeks, though she doesn’t know exactly when or how many there will be. Lakshmi and others from the hospital had a call with Florida Surgeon General Scott Rivkees late Thursday afternoon, but the state did not offer details on either of those points, said hospital spokesperson Philip Buck.

Frontline health care workers who are “at risk for contracting COVID-19 because of their job” will be the first to receive the vaccine, Lakshmi said. She did not say which groups it would be available to next.

Similarly, AdventHealth Orlando said in a statement that “many details will be worked out in the weeks and months ahead.”

During a morning briefing presented online, Dr. Tim Hendrix, medical director for AdventHealth’s urgent care services, said much is still unknown, including who will receive the vaccine first. He did say, however, that it will be “several weeks to months” before immunization is available to the general public.

“This is exciting,” Hendrix said. “But it is also a lot of work. ... There are a lot of unknowns, but we are preparing for those unknowns.”

DeSantis stressed that while news of the vaccine has most of the spotlight, the antibody treatment created by pharmaceutical company Eli Lilly is just as significant.

The single-dose, infusion-based treatment is provided on an outpatient basis and provides protection to COVID-19 patients who have mild or moderate symptoms to prevent their condition from worsening. It marks a “dramatic shift” in coronavirus care, Tampa General said in a news release.

Lakshmi explained it like this: The antibodies are like bullets, shooting down the virus so that “soldier” or immune cells can defeat it.

The state surveyed all its hospitals to determine demand for the treatment, which takes about two hours to undergo. It passed that information to the federal government, which determined how much of the drug to send to each hospital.

About 3,000 doses have arrived in Florida in the last few days, DeSantis said, and hospitals are beginning to administer them. A similar amount will arrive every week for the foreseeable future, he said.

DeSantis said a similar treatment is being developed by Regeneron, another pharmaceutical company. It’s pending emergency use authorization by the FDA, which the governor said should come in the “relatively near future.”

https://www.tampabay.com/news/health/2020/11/19/tampa-general-one-of-floridas-first-hospitals-to-receive-coronavirus-vaccine/