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Mondays are usually a relatively low day for the number of cases reported, as states are still noting results from testing that took place over the weekend when many facilities are closed. But this Monday, the United States still notched up 127,000 additional confirmed cases of COVID-19. A week earlier, that would have been a record high. It’s also almost 40,000 cases higher than were reported the previous Monday. At the rate cases are soaring, it seems certain the United States will pass 150,000 cases in a single day at some point this week.This latest surge of virus continues to be extremely broad based. Both Illinois and Texas exceeded 10,000 new cases on Monday. Already on Tuesday, Illinois has announced 12,623 new cases, obliterating the state’s past record. It’s actually the highest value that any state has posted since Florida and Texas soared back in July, and higher than any daily number posted by New York in the opening phase of the pandemic (though limited testing at the time meant that cases in New York were badly underreported). An astounding 17 states reported over 3,000 new cases on Monday.- Advertisement – However, Pfizer’s vaccine announcement is genuinely good news. And it’s not just good news for Pfizer’s vaccine, or even just good news for COVID-19.The Pfizer vaccine’s high efficacy is fantastic news, because the vaccine targets the spike protein that COVID-19 uses to attach to human cells. The other “big four” vaccines now in Phase 3: Oxford / AstraZeneca, Moderna, and Johnson & Johnson also target that same protein. That means the world is likely to have a variety of effective vaccines, some of which may be easier to administer and easier to use in areas without extreme refrigeration.Pfizer’s vaccine is the first phase 3 trial of a vaccine using mRNA in a human. If the safety data holds up, the technology could potentially become a new standard in how vaccines can be rapidly developed against other diseases.Moderna’s vaccine is also mRNA based. Unlike Pfizer, they’re a relatively small company that has essentially bet the farm on this trial. They should be reporting their Phase 3 results within the next two weeks.Johnson & Johnson’s vaccine has some advantages in that it’s a single dose and doesn’t need temperatures lower than those provided by normal refrigerators. Their single dose approach means they should move through Phase 3 more quickly. However, they were the last of the major trials to begin, and they’re recruiting a large pool, so don’t expect results for another month or more.And of course, the best news possible is that it won’t be Donald Trump who handles the deployment of these vaccines. This isn’t Biden’s first experience in crisis management. After all, he walked into the White House in 2009 in the midst of the Great Recession and took charge of Obama’s response to that crisis. He’s used to managing large teams in dire circumstances. – Advertisement – Just a few points out of the morass of statistics: Illinois now has 4,742 people in the hospital with COVID-19, with 911 in the ICU, and 399 on ventilators. In North Dakota, 7.4% of the total population has now tested positive for COVID-19. Tennessee had as many cases in the last two days, as it had in the entire pandemic up until mid-June.Over time, the case fatality rate for new patients has decreased. But, so far at least, it’s hard to point at any miracle drug that accounts for this change. Trump’s much promoted hydroxychloroquine was never more than a pipe dream. Remdesivir, which seemed to represent a net positive for patients in mid-disease and gained FDA approval, has turned out to show no real effect in the largest trial to date. The only real advances seem to be in the use of anti-inflammatory steroids with patients who need supplemental oxygen or ventilation. If there’s any good thing at all to come from the pandemic so far, it may be that doctors have acquired a better understanding of how to conduct long period intubation while decreasing damage and lowering the rate of death—for the awful reason that they’ve had so many patients on which to test different procedures.Synthetic monoclonal antibody treatments, such as the Regeneron treatment given to Trump during his bout with the disease, do hold out a lot of hope for effective treatment. On Tuesday, Eli Lilly gained emergency approval for it’s version of a two-antibody cocktail, bamlanivimab. However, at the moment there are very few doses available. The total output of both Eli Lilly and Regeneron to date would not be enough to treat the positive patients of a single day at this point, and since the treatments are most effective when administered early, they’re not really a significant effect on the total national picture—even if they are of powerful net benefit for those patients lucky enough to receive one of these rare treatments. – Advertisement – – Advertisement – Now we just have to survive until vaccines, and Biden, arrive.
– Advertisement – The rally earlier in the week for stocks dependent on an economic recovery was sparked by an announcement from Pfizer and BioNTech that the companies’ Covid-19 vaccine candidate appeared to be more than 90% effective in its phase three trial.More positive news on the vaccine front could come soon, as Moderna announced on Wednesday evening that its phase-three trial had accrued enough cases of the coronavirus to submit the preliminary results to an independent safety monitoring board.The positive news for vaccines comes amid a worrying rise in Covid-19 cases across the country. The United States has now confirmed more than 10 million cases of the virus and some areas, including New York City and San Francisco, have announced new economic restrictions in an attempt to slow the spread.- Advertisement – U.S. stock futures were mostly flat on Wednesday evening following a strong session for tech stocks.Futures contracts tied to the Dow Jones Industrial Average rose 30 points, or 0.1%, and those for the S&P 500 saw a similar gain. Futures for the Nasdaq 100 were flat.The move in futures after the market bucked its recent trend on Wednesday, with the tech-heavy Nasdaq Composite leading while cyclicals and small caps lagged. The Dow slipped 23 points after adding nearly 1,100 in the two previous sessions.- Advertisement – Investors will also be looking at new data on the economic recovery on Thursday morning. The Labor Department is slated to release jobless claims data for last week before the opening bell, and economists surveyed by Dow Jones expect 740,000 claims. New inflation data will also be released before the markets open in New York. – Advertisement – Traders work the floor of the New York Stock Exchange.NYSE The rally for equities after the Pfizer news followed a strong election week for stocks, which saw the S&P 500 rise more than 7%. Rick Rieder, head of the global allocation team at BlackRock, said on “Closing Bell” that he expected stocks to continue to rise through the end of the year, though he expected trading to be choppy.He also said he expected the economic recovery to continue despite the rise in Covid-19 cases.“The Fed is going to stay in this accommodative mode for a period of time,” Rieder said. “When you put that much stimulus in, you put that much liquidity in, and then you add fiscal stimulus … the economy will actually do pretty well.”
Jul 23, 2008 (CIDRAP News) – Federal health officials today released their official guidance on allocating vaccine during an influenza pandemic, with few changes from a previous draft that put military personnel, critical health and emergency workers, pregnant women, and small children at the head of the line.The 25-page guidance document is intended to help state and local leaders allocate scarce vaccine supplies in a pandemic, especially the early stages. The goals are to blunt the effects of a pandemic on public health and the economy and to limit general social disruption.The new document, issued by the Department of Health and Human Services (HHS) and the Department of Homeland Security (DHS), is a revision of one that was released in October 2007. It was developed by a federal interagency working group, which gathered two rounds of input from the public and various stakeholders, including business and community organizations.In a news release, HHS Secretary Mike Leavitt called the guidance “the result of a deliberative democratic process.””This guidance was developed to ensure that our nation’s critical infrastructure remains up and running and we address the needs of all of our citizens, enabling the country to recover from a pandemic more quickly,” added Dr. Jeffrey Runge, DHS assistant for health affairs and chief medical officer.Once a pandemic emerges, “it could be on the order of 20 weeks before matched vaccine begins to flow,” and production capacity will be limited, said Dr. William Raub, Leavitt’s science advisor, at a press conference today. “So we need a plan to target the successive batches as fairly as we can. These guidelines are the instrument to do that.”Consensus on four objectivesFederal officials said all the public and stakeholder input produced a consensus on four objectives for vaccine allocation:Protect people who are critical to the pandemic response and care for those who are sick with the fluProtect providers of essential community servicesProtect those at high risk for infection because of their jobsProtect childrenThe working group settled on five tiers, or vaccination priority groups. To facilitate the assignment of people to the different tiers, the authors sorted the population into four broad categories: homeland and national security, healthcare and community support services, critical infrastructures, and the general population. They also defined several “target groups” on the basis of occupation, type of service, age-group, or risk level.In making their recommendations, federal officials looked at three levels of pandemic severity: severe, moderate, and less severe. Some occupational and risk groups move to a higher or lower tier depending on pandemic severity, but tier 1 is the same for all levels of severity. The following classifications assume a severe pandemic.In tier 1—those first in line for vaccine—are several “critical occupations”: deployed military forces, critical healthcare workers, emergency medical services workers, fire fighters, and police. Also included are pregnant women, infants, and toddlers. Those groups total an estimated 24 million people.Among the health workers assigned to tier 1 are an estimated 300,000 public health personnel, 3.2 million hospital employees, 2.5 million outpatient and home healthcare providers, and 1.6 million workers in long-term care facilities.Tier 2, totaling an estimated 15 million people, includes the following occupational groups: military support, border protection, the National Guard, intelligence services, other national security, community services, utilities (energy and water), communications, “critical government” workers, and two groups not previously included in this tier: pharmacists and mortuary workers. Also included in tier 2 are two high-risk groups: contacts of infants, and children with certain medical conditions.Tier 3 includes several more occupational groups: other active duty military; other healthcare workers; other critical infrastructure sectors, including banking and finance, chemical, food and agriculture, pharmaceutical, postal and shipping, and transportation workers; and other government workers. Also in tier 3 are healthy children ages 3 to 18 years. Tier 3 is estimated to include 64 million people.Tier 4, an estimated 74 million people, consists of two high-risk populations: adults between the ages of 19 and 64 who have chronic medical conditions that increase their risk of severe flu, and everyone age 65 or older.Tier 5 is defined as all other healthy adults between 19 and 64 years old who don’t fall into one of the other tiers, estimated at 123 million people.The guidance says that all groups within a given tier should be vaccinated at the same time, but “sub-prioritization” may be necessary if the vaccine supply is very short, which may be the case through the first wave of a pandemic. The guidance gives recommendations about how to rank groups within tier 1 in this situation, putting front-line inpatient and hospital-based healthcare workers first.Another case of sub-prioritization is in tier 4, which includes 19- to 64-year-old adults with medical conditions and adults 65 and older. If the vaccine supply is limited, the 19- to 64-year-olds should be vaccinated first, HHS advises. The reason: elderly people have a lower immune response to flu vaccines, so putting high-risk younger adults first makes better use of the available vaccine.Protecting essential workersThe main reason for vaccinating workers in critical infrastructure sectors, the report says, is not to reduce general absenteeism, but rather to protect workers whose absence would slow or stop critical functions and also to protect workers at especially high occupational risk.At the press conference, Dr. Ben Schwartz of the Centers for Disease Control and Prevention responded to a question about why transportation workers were not ranked higher than tier 3.”We certainly recognize the importance of including the transportation system,” he said. “It’s in tier 3 because it’s an infrastructure where it’s likely the overall demand won’t increase in a pandemic and may decrease. Transportation workers are not likely to be highly exposed to ill people, and thereby won’t be at high risk. A truck driver is a pretty solitary worker.”Schwartz also said demand for nonessential commodities may drop during a pandemic, which would allow workers to shift to transporting more essential goods.In other observations, the guidance says that general population groups assume greater priority, relative to occupational groups, in less severe pandemics, ie, those ranking 1 or 2 on HHS’s pandemic severity index.During the 1957 and 1968 pandemics, healthcare and essential services were effectively maintained in the United States, the document says. “Because of this, after tier 1, occupational groups in the health care and community support services and critical infrastructure categories are not specifically prioritized and workers in these groups would be vaccinated based on their age and health status as part of the general population.”Experts welcome the planMany public health experts have praised HHS’ hard work on the pandemic vaccine allocation guidance, particularly that of the interagency working group that spearheaded the project. They have also praised the agency for its leadership role.Jeffrey Levi, PhD, executive director of Trust for America’s Health (TFAH), a nonprofit health advocacy group based in Washington, DC, wrote in an e-mail to CIDRAP News today that the guidance represents a step in the right direction. “HHS is to be commended for the breadth of outreach that was part of developing this guidance,” he said.J. Eline Garrett, JD, assistant director for health policy and public health at the Minnesota Center for Health Care Ethics (MCHCE) in Minneapolis, told CIDRAP News that HHS and other agencies have shown strong leadership. “There’s a whole lot that’s good here. A range of pandemic scenarios and scalability are very important, and we value and agree with the way that multiple tracks and category tiers are used to address the practical and ethical complexities,” she said.The public health community also appreciates federal officials’ recognition that there is a need for vaccine allocation, she said.Some see serious gapsHowever, some experts said the federal guidance still contains some serious gaps and raises a host of questions.Levi said there tier 1 includes a large number of people, which demonstrates the need for more vaccine production capacity and the need to more seriously explore vaccine stockpiles.Garrett said that despite the revisions that followed extensive input from stakeholders, the MCHCE still has a number of concerns about the federal guidance. “This is to be expected. This work is difficult and important,” she said.One of the group’s concerns is that the federal guidance doesn’t explicitly and consistently address vaccine efficacy among the different population groups.In some instances, the guidance lacks rationales for the placement of groups on the priority spectrum, which makes it seem less transparent and more difficult for public health officials to grasp, Garrett said. For example, a high priority is placed on vaccinating children, but prioritization decisions might change if the pandemic virus that emerges threatens a different group.Prioritization of workers in homeland security, healthcare, and community support acknowledges exposure levels, but it doesn’t address the risk of death or serious complications, Garrett said. Allocating vaccine to critical workers who are not at risk could shortchange members of the general population who are at risk, she added.Garrett acknowledged that it’s difficult to balance flexibility with uniformity and equity.Federal officials recommend that states uniformly apply the prioritization guidance, but she said a lack of flexibility might be impractical for some areas and in some situations. For example, authorities plan to distribute vaccine in proportion to each state’s population. However, some critical jobs might not be distributed equally among states.Also, some locations might opt to keep schools open during a pandemic and will need to factor teachers into the vaccination scheme, Garrett said.”These questions haven’t been asked or answered, but they should at least be addressed,” she said.Ignoring economic realities?Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, which publishes CIDRAP News, said the current federal guidance falls far short of what’s needed to address critical infrastructure and economic realities.During a pandemic, failure to adequately protect workers in sectors such as power, water, food, transportation, and pharmaceuticals could cause collateral damage that could rival deaths from the virus, he said.For example, Osterholm said the transportation sector is incompletely addressed in the vaccine prioritization plan and that coal workers aren’t listed as a priority, even though half of the electricity in the United States is generated by coal.Also, he pointed out that several lifesaving drugs in the United States are generics that are made offshore. Written stakeholder comments that Osterholm and some of his colleagues submitted to HHS suggested that the federal plan should prioritize some offshore workers who help produce goods, such as generic drugs, that are critical to the United States.See also: Jul 23 HHS news releasehttp://www.hhs.gov/news/press/2008pres/07/20080723a.htmlHHS guidance document on allocating vaccinehttp://www.flu.gov/individualfamily/vaccination/allocationguidance.pdfDec 12, 2207, CIDRAP News story on public response to draft HHS planOct 24, 2007, CIDRAP News story on draft HHS guidance
Apr 16, 2009 (CIDRAP News) – As polio eradication efforts lost ground in 2008, 15 African countries bore the brunt of the spread of the disease with multiple importations of wild poliovirus, the US Centers for Disease Control and Prevention (CDC) and its global health partners reported today.Though the disease’s spread raises concerns about reaching the global goal of eradication, the CDC also reports some positive developments, such as quicker detection and response patterns that might have limited the size of the outbreaks when compared with a polio resurgence that occurred between 2002 and 2005. The findings appear in today’s issue of Morbidity and Mortality Weekly Report (MMWR) and follow on the heels of an Apr 3 CDC report that described last year’s 26% spike in polio cases.The new report describes 32 importations of wild poliovirus (WPV) 1 and 3 into 15 African countries, which led to 96 polio cases from January 2008 to March 2009. The importations have struck three regions of Africa: West Central, the Horn, and South Central. Nigeria was the direct or indirect source of 29 of the importations, which accounted for 68 cases. India was the source for three WPV importations, all of them affecting Angola, which resulted in 28 cases.In its assessment of polio detection trends in Africa, the CDC reports that the median interval between onset of paralysis in the first identified case to laboratory polio confirmation was 31.5 days, compared with a median of 51 days during the 2002-2005 increase in polio cases.Response time also decreased, the report says. The median interval from laboratory confirmation to the first large-scale vaccination effort was 27.5 days, compared with 37 days during the 2002-2005 polio resurgence.Five countries that were previously polio-free experienced WPV importation before 2008 and have seen the virus persist into 2009: Angola, Chad, the Democratic Republic of Congo, Niger, and Sudan. Indicators of routine and supplemental immunization activities suggest lower immunization rates in children in these five countries, compared to the other African countries that had polio reimportation—64% versus 75%. Efforts are under way to strengthen acute flaccid paralysis surveillance and supplemental immunization in these countries, the CDC reports.The agency says that four countries—Angola, Chad, Nigeria, and Sudan—have been the source of repeated WPV importation into other countries on the African continent since January 2009. The CDC notes that all four countries have weak health infrastructures, low routine vaccine coverage in certain areas, and gaps in supplemental immunization that are due to poor planning and implementation.Civil war in Angola, Chad, and Sudan in past years may have hurt polio eradication efforts in those countries, the CDC says, adding that Chad and Sudan continue to have civil unrest.Health officials have not determined the mode of WPV transmission from India to Angola, but the CDC said that studies are underway to identify contributing travel patterns, the report says.Supplemental immunization activities in affected and neighboring countries will continue in 2009, and the CDC urges all countries that are polio-free to keep their guard up. “Globalized transportation and international migration pose a risk for WPV reintroduction for all countries,” the agency states.CDC. Wild poliovirus type 1 and type 3 importations—15 countries, Africa, 2008-2009. MMWR 2009 Apr 16;58(14):357-62 [Full text]See also:Apr 2 CIDRAP News story “Polio eradication efforts lost ground in 2008”
Editor’s note: Includes two new sections, on phase change considerations and on possible impact.Apr 27, 2009 (CIDRAP News) – The World Health Organization (WHO) today raised its official pandemic alert level from the current phase 3 to phase 4 on its 6-phase scale, saying the newly identified swine influenza virus has made a pandemic more likely but not inevitable.”We think we have taken a step in that [pandemic] direction, but a pandemic is not considered inevitable at this time,” said Dr. Keiji Fukuda, the WHO’s assistant director-general for health security and environment, at a press conference from Geneva.By the WHO’s definition, phase 4 means that a novel flu virus has become sufficiently transmissible to cause sustained community outbreaks. Phase 3 signals that a new virus is causing sporadic illness cases or small clusters of cases but is not spreading enough to cause larger outbreaks.WHO Director-General Margaret Chan decided to raise the alert phase on the recommendation of the agency’s Emergency Committee, which met today.Fukuda said it was clear to the committee that person-to-person transmission of the swine flu virus is going on. Confirmed swine flu cases have been reported in Mexico, the United States, Canada, and Spain (one case).”Given the widespread presence of the virus, the director-general considered that containment of the outbreak is not feasible,” the WHO said in a statement. “The current focus should be on mitigation measures.”The WHO also recommended today that governments not close borders or restrict travel, saying those steps would likely cause major disruptions while doing little to keep the virus from spreading. However, the agency said it is prudent for sick people to delay international travel and for those who get sick after travel to seek medical attention.In addition, the WHO advised that production of seasonal flu vaccine should not be interrupted in favor of making a swine flu vaccine at this point. The recommendation comes as flu season in the southern hemisphere is getting under way.At the same time, Fukuda said the Emergency Committee advised the WHO “to take all steps to facilitate development of a vaccine that could protect people against this new virus.” He estimated it will take 4 to 6 months to develop and begin producing such a vaccine, and several more months to make it in large quantities.The WHO move came the same day the US swine flu count doubled to 40 cases with the addition of 20 more cases associated with a school in New York City and as federal health officials advised against nonessential travel to Mexico, the epicenter of the outbreaks.Phase change considerationsIn raising the alert phase, the WHO committee “felt that, given the rapidly evolving situation, it was important to send a strong signal to countries that now is a good time to strengthen preparedness for pandemic influenza if it continues to evolve in that direction,” said Fukuda.Although the WHO’s official guidance on pandemic phases and related actions suggests that containment of a new virus may still be possible in phase 4, the agency made clear today that it does not believe it’s still possible to contain the virus to a small geographic area. This agrees with what US health officials have been saying.”The committee discussed the situation in depth and decided that . . . really this virus is too widespread to make containment a feasible consideration,” Fukuda said.The WHO ventured no predictions about how long the pandemic alert will remain at phase 4. “As further information becomes available, WHO may decide to either revert to phase 3 or raise the level of alert to another phase,” the agency statement said.When Fukuda was asked why the WHO didn’t move the alert to phase 5, he indicated the committee had some doubts about the extent of community outbreaks. Phase 5 is defined as a situation involving sustained community outbreaks in two or more countries within one WHO region. Phase 6 means sustained community outbreaks in more than one WHO region.In carefully reviewing the epidemiologic data, including the confirmed and suspected cases, the WHO committee was convinced that person-to-person transmission is going on, said Fukuda. “But there’s a recognition that we’d really like more information on the sustainability of the virus, and one of the signs would be widespread community outbreaks. If you look at the case reported in Spain, this was a case in a traveler returning from Mexico, and we don’t really have any evidence of community spread of infections occurring within a country.”Commenting on the recommendation against travel restrictions, he said, “At this point, with the virus widespread . . . closing borders or restricting travel really has very little effect if any effect at stopping the movement of this virus; however it would cause a great deal of disruption of countries.” He said modeling studies have indicated it would take “very, very draconian restrictions on travel” to slow the virus’s spread.Possible impact of WHO movePeter M. Sandman, PhD, a risk-communication expert and business consultant, welcomed the WHO’s phase change as a step that may increase preparedness efforts by many countries and companies and should increase preparations by individuals.Although the WHO has been criticized for not raising the alert level sooner, the system has worked much as expected, given that the agency had to get a consensus, Sandman commented by e-mail.”It matters a lot that the WHO caught up this evening,” he said. “US government officials have been saying for two days now that they’re responding to conditions on the ground, not to any ‘label’ the WHO might decide to apply or not apply. That may be true for the CDC and other US agencies. But it’s not true for health officials in countries without any confirmed cases so far, many of which have written pandemic plans that specify a different response to phase 4 than to phase 3. And it’s not true for companies, especially multinational companies, many of which have their own pandemic plans keyed to the WHO stages. Ditto for cities and states with pandemic plans but no local cases; the WHO phase shift may trigger a response from them as well.”And a lot of smaller companies and smaller communities without pandemic plans have been waiting for a signal to start taking precautionary action. This may be the signal they have been waiting for.”Sandman said that in their messages to the public, US health officials so far have recommended only hygiene practices, not more concrete preparedness steps such as stockpiling supplies. He said he hopes that the shift to phase 4 will inspire the public to do much more.”We are losing precious preparedness time—time to go out and buy supplies before there’s a real emergency, while the shelves are still full and the stores can still replenish; and time to think through what life might be like in a week or two if all schools are closed, most businesses are closed, and many people are very, very sick,” Sandman said.”The trick is to do all that preparing while bearing in mind that this swine flu outbreak may very well fizzle. In other words, we must prepare for the worst without committing ourselves to expecting the worst,” he added.Sandman concluded, “Here’s the secret of preparedness that fearful government leaders tend to forget: It’s a calming experience to prepare. People who have been working hard not to worry about the pandemic that might be looming, people who have spent today holding back that gathering knot in their guts, will feel more in control after they have taken some concrete steps to get themselves and their family ready. I hope they read tonight’s WHO decision as advice to do that tomorrow.”See also: Apr 27 WHO statementhttp://www.who.int/mediacentre/news/statements/2009/h1n1_20090427/en/index.htmlWHO press briefing pagehttp://www.who.int/mediacentre/multimedia/swineflupressbriefings/en/index.html
May 14, 2009 (CIDRAP News) – An international group of experts has examined and rejected the idea proposed recently by an Australian scientist that the novel H1N1 influenza (swine flu) virus is the product of a laboratory accident, the World Health Organization (WHO) reported today.”The group of scientists feels that this hypothesis does not really stand up to scrutiny, that the evidence suggests that this is a naturally derived virus, and not a laboratory-derived virus,” said Dr. Keiji Fukuda, WHO assistant director-general for health security and environment, at a press briefing today.Adrian Gibbs, 75, a veteran flu researcher, said recently that he had concluded from his analysis of the virus’s genetic sequence that it might have evolved in eggs used by scientists to grow viruses and by drug companies to make flu vaccines. Gibbs said he intended to publish a scientific paper describing his hypothesis, according to a May 13 Bloomberg News report.Fukuda said Gibbs contacted the WHO May 9 to communicate his idea, which he had arrived at by studying genetic data deposited in public databases, not from studying the virus directly.”Because of the nature of the hypothesis and the credible nature of the scientist, we took this seriously,” Fukuda said. The Bloomberg story said Gibbs was involved in research that led to the development of oseltamivir (Tamiflu).After hearing Gibbs’ idea, the WHO asked five of its collaborating centers to evaluate it, Fukuda said. A day later the agency asked the United Nations Food and Agriculture Organization (FAO) and the World Organization for Animal Health (OIE) to do the same. WHO officials discussed the hypothesis with a large group of experts in both human and animal influenza 2 days ago, he said. They concluded that Gibb’s proposition didn’t fit the evidence.Fukuda added that the WHO will need to review Gibbs’s research article when it is published, but he indicated that it is unlikely to change the experts’ conclusions.He cited the episode as a positive example of rapid, open scientific communication and debate on medical issues, facilitated by putting genetic data in public repositories.”We live in an age when it’s really not possible to hide things,” he said. “It’s all for the better as far as I’m concerned. Maybe it means a little more work, but you can also address it in a way which is convincing to people.””This is much better than dealing with rumors in which the basis for the rumor is not clear and then dealing with answers in which the basis of the answer is not clear,” he added.In response to a question, Fukuda said Gibbs suggested that the novel virus seems to have an increase in lysine (an amino acid) residues and that it sits out on a “long branch” of the influenza phylogenetic tree in comparison with other swine flu viruses. He said it is known that growing flu viruses in eggs can lead to an increase in lysine residues.However, human, avian, and swine flu viruses differ somewhat in this respect, Fukuda said, adding, “After discussion and looking at older swine influenza viruses, it was concluded that the amount of lysine being seen was in fact very consistent with the natural increase in lysine being seen in swine flu viruses.”Also, the experts who evaluated the hypothesis said that because of historical gaps in swine flu genetic data, many swine flu viruses are somewhat isolated on the phylogenetic tree, so Gibbs’ observation on this point was nothing unusual, according to Fukuda.In other comments at today’s briefing, WHO spokesman Gregory Hartl announced that the agency’s daily briefings would be suspended for about a week because of upcoming WHO meetings.A WHO-hosted intergovernmental meeting on virus sharing will begin tomorrow, Hartl said. That will be followed by the World Health Assembly, the annual meeting of WHO member countries, which runs all of next week.The intergovernmental meeting will deal with the sharing of viral isolates and access to vaccines and other products derived from them, an issue pursued by Indonesia in relation to H5N1 avian flu in recent years.In other comments at today’s briefing:Fukuda said experts who met today to discuss whether to recommend mass production of a vaccine for the novel H1N1 virus will probably need to meet several more times before they can come to a conclusion.He said the WHO has not seen any evidence that the novel virus is resistant to the antiviral drugs in use (oseltamivir and zanamivir), and the agency is not making any changes in its recommendations on antiviral use.The WHO continues to be concerned about the fact that most of the people infected with the H1N1 virus have been young, he said. About half of those who died were healthy and had no predisposing conditions. “It’s highly unusual for young, healthy people to die from influenza,” he said. “So this is a pattern which is different than what we see with normal influenza,” though it has been seen in previous pandemics.
Aug 25, 2009Full H1N1 immunity may not come till ThanksgivingHealth and Human Services Secretary Kathleen Sebelius said yesterday it will probably be Thanksgiving before many Americans are fully immunized against the novel H1N1 flu virus, the Associated Press (AP) reported. Sebelius, speaking to reporters in Atlanta, said immunization will probably require two doses 3 weeks apart, and full immunity won’t develop until a week or two after the second dose. The first doses are expected to become available in mid-October.http://www3.whdh.com/news/articles/national/BO122639/Aug 25 AP reportAs demand drops, UK closes 2 pandemic flu call centersBecause of declining demand, Britain’s National Pandemic Flu Service will close two of its telephone call centers this week, the Guardian newspaper reported. The story said infection rates have dropped and calls to the help lines have fallen since late July. The centers prescribe antiviral drugs over the phone to people with flu-like illnesses, a practice that has stirred controversy. More than 500,000 packs of oseltamivir were prescribed in the first 2 weeks after the centers opened.http://www.guardian.co.uk/world/2009/aug/25/swine-flu-call-centres-closeAug 25 Guardian storySmokers may be susceptible to severe H1N1 illnessA Hong Kong health official said smokers may be prone to suffering life-threatening complications from novel H1N1 flu, Bloomberg News reported yesterday. At a medical meeting, Thomas Tsang of Hong Kong’s Centre for Health Protection said 12 of 27 patients who suffered pneumonia and other serous complications were current or former smokers, and some had no other known risk factors. About 1 in 200 people in Hong Kong who tested positive for H1N1 experienced severe disease, the story said.http://www.bloomberg.com/apps/news?pid=20601202&sid=aSs9.rvfo7g8Aug 24 Bloomberg News storyAsia predicted to fall far short on H1N1 vaccineAsian countries will far markedly short of novel H1N1 vaccine this fall, a spokesman for the World Health Organization (WHO) said, according to a Reuters story today. Australia and China are scheduled to start vaccine production in September, but their vaccine is unlikely to benefit the rest of the region. “There is going to be massive underproduction of vaccines as compared to the needs and demand,” said Manila-based WHO spokesman Peter Cordingley.Sweden targets entire population for vaccineSweden has set aside $142 million to pay for the vaccination of its entire population against pandemic flu, an official said yesterday, according to an Agence France-Press (AFP) story today. The country has signed an agreement with British vaccine maker GlaxoSmithKline for 18 million vaccine doses enough to cover its population of about 9.3 million with two doses each. Sweden’s vaccination program will be voluntary.http://www.swedishwire.com/politics/811-sweden-to-fund-mass-swine-flu-vaccinationAug 25 AFP storyAll Maryland hospitals e-linked for flu trackingMaryland officials announced Monday that all of the state’s hospitals will be linked via computer to better track pandemic influenza this fall and winter, according to a Baltimore Sun report. Maryland is the first state to enroll all its hospitals in the surveillance program, which also can be used to combat bioterror. Forty-six hospitals will share data on patients admitted, diagnoses, and treatments. In addition, state drugstores will log sales of flu and cold medications.http://www.baltimoresun.com/health/bal-md.flu25aug25,0,2493626.storyAug 25 Baltimore Sun report
Yifei Chai, an innovation architect, advises Disney, Adidas and 20th Century Fox how to stimulate human emotion in an innovative way in the digital world, and as we know that in truism everything revolves around emotions and experiences, then the tourism sector can certainly learn a lot from the main lecturer at the Communications Days. Yifei Chai Interestingly, he will hold as many as two lectures at this year’s festival in Rovinj and thus become the first person so far at the Days of Communications to succeed. The lecture will answer the question: How to create the best emotional experience with your customers through creative thinking and innovation? For more information on Communication Days, visit the official website of the festival www.danikomunikacija.com. Clients describe his approach as emotional alchemy. Innovation, concept and strategy, art and creative direction, design and craftsmanship – areas where Yifei Chai is an undisputed authority – help advertisers and brands to design unforgettable, touching and surprising experiences to increase a sense of deeper connection with the audience. Communication Days will be held from March 28 to 31, 2019. From year to year, the Days of Communication record an increasing number of visitors. The organizers are announcing interesting and diverse content and invite all advertisers, agencies, public relations experts, media representatives, students and other professionals from the communications industry to the festival, which last year broke all attendance records. Artificial intelligence in tourism is more and more pronounced, because today when we collect and have large databases, we must know how to understand and apply them. Also, artificial intelligence in a large “scheme” of data can show us some patterns that we do not see, and which we can use wisely later in communication and promotion to the target group. In Japan, on the other hand, a couple of hotels have been opened where there are no staff, whose role has been taken over by robots. One such hotel was recently even closed. How all this affects or will affect the current development of the tourism sector, we can find out from experts on this topic. His second lecture “Human Survival Guide in the Age of AI – How to Coexist with the Coolest and Baddest of AI” is ideal for fans of artificial intelligence (AI). Chai envisioned the lecture as comparing fictional AIs (like Terminator or Ex-Machine) with real AIs like IBM Watson or search engines like Google that Hollywood has long portrayed as the ultimate heroes or extreme villains. Chai regularly emphasizes that we already live in the future and unquestioningly follow the instructions of artificial intelligence. Lecturer Yifei Chai, if we could, we would like to announce twice “, says the director of the Communication Day program, Dunja Ivana Ballon. Forget understanding digital, make digital understand you – the starting point of his first lecture is “Digital Empathy” which will address issues such as how we can become more humane when subjected to artificial platforms that do not speak human language and how we can create experiences that will enable us not to forget our human nature in interaction with the machine.
ALL INSPECTIONS IN TOURISM ARE UNITED. FROM NOW ON, TOURIST INSPECTORS WILL BE ABLE TO ENTER UNREGISTERED FACILITIES BUSINESS CONDITIONS SUPERVISED BY THE TOURIST INSPECTION AND THE PRINCIPLE OF OPPORTUNITY RELATED NEWS: – N 77.11 – Renting and leasing of cars and light motor vehicles i – I 55.10 – Hotels and similar accommodation ( hotels, hotel resorts, apartment hotels, motels) Supervisory activities will include taxpayers who perform the activity: – C 10.7 – Manufacture of bakery and confectionery products, Tax and Customs Administration in the period from 23 to 29.5.2019 May XNUMX. will carry out fiscalization inspections on the entire territory of the Republic of Croatia with the aim of preventing the gray economy and protecting the State Budget and taxpayers who duly fulfill their tax obligations. THE STATE INSPECTORATE STARTED WORKING