News from Bioethics.com

Thousands of Coronavirus Tests Are Going Unused in US Labs

3 months 21 hours

(Nature) – As the United States struggles to test people for COVID-19, academic laboratories that are ready and able to run diagnostics are not operating at full capacity. A Nature investigation of several university labs certified to test for the virus finds that they have been held up by regulatory, logistic and administrative obstacles, and stymied by the fragmented US health-care system. Even as testing backlogs mounted for hospitals in California, for example, clinics were turning away offers of testing from certified academic labs because they didn’t use compatible health-record software, or didn’t have existing contracts with the hospital.

More Coronavirus Vaccines and Treatments Move Toward Human Trials

3 months 21 hours

(The New York Times) – As the coronavirus pandemic spreads at unprecedented rates, invading the lungs of people of all ages, ethnicities and medical histories, companies are ratcheting up their efforts to fight the disease with accelerated schedules for creating new vaccines, and beginning clinical trials for potential treatments. On Wednesday, Novavax, a Maryland-based biotech company, said it would begin human trials in Australia in mid-May for its vaccine candidate. Novavax is one of more than two dozen companies that have announced promising vaccine programs that are speeding through the early stages of testing unlike ever before.

How Does COVID-19 Kill? Uncertainty Is Hampering Doctor’s Ability to Choose Treatments

3 months 1 day

(Nature) – How does COVID-19 kill? Uncertainty over whether it is the virus itself — or the response by a person’s immune system — that ultimately overwhelms a patient’s organs, is making it difficult for doctors to determine the best way to treat patients who are critically ill with the coronavirus. Clinical data suggest that the immune system plays a part in the decline and death of people infected with the new coronavirus, and this has spurred a push for treatments such as steroids that rein in that immune response. But some of these treatments act broadly to suppress the immune system, stoking fears that they could actually hamper the body’s ability to keep the viral infection in check.

In Uganda, Mothers in Labor Die Amidst Coronavirus Lockdown

3 months 1 day

(Reuters) – Fearful that the viral pandemic could overwhelm already overburdened hospitals, authorities have banned private transport without special authorisation. But in a poor country with few ambulances, the travel ban can be deadly for some. A human rights group in the East African country says seven women in labour and two babies have died because they were forced to walk to hospital to give birth. The Ministry of Health said it was investigating the reports and could not comment yet.

International Trial Uses AI to Rapidly Identify Optimal Covid-19 Treatments

3 months 1 day

(STAT News) – A randomized controlled trial ramping up in dozens of hospitals around the world proposes a third way — fusing those two approaches together by using artificial intelligence to home in on the most effective treatments on the fly. The REMAP-CAP study seeks to turn frenetic attempts to save lives on the front lines into a running international experiment, with the goal of quickly identifying optimal treatments for desperately ill patients. By analyzing data on outcomes from more than 50 hospitals, organizers hope to supply fast answers to pressing questions, such as whether the antimalarial drug hydroxychloroquine is an effective therapy and, if so, for which types of patients. The trial will also allow the researchers to test multiple therapies at once.

Prisons and Jails Across the US Are Turning into ‘Petri Dishes’ for Coronavirus. Staffers Are Falling Ill, Too.

3 months 1 day

(CNN) – In the US, the largest known concentration of coronavirus cases outside of hospitals isn’t on a cruise ship or in a nursing home. It’s at a jail in Chicago. At least 251 detainees and 150 staff members at Cook County Jail have tested positive for coronavirus, the county sheriff’s office said Wednesday. At least 22 of the detainees are hospitalized. Across the country, prisons and jails have become hotbeds for coronavirus. Close confinement is likely fueling the spread.

NIH Begins Trial to Test Hydroxychloroquine for Treating COVID-19

3 months 1 day

(Reuters) – The National Institutes of Health (NIH) said on Thursday it was testing anti-malaria drug hydroxychloroquine for treating COVID-19, days after several U.S. doctors said they were using the drug on infected patients without evidence that it worked. The use of the decades-old drug, which has been touted by President Donald Trump as a potential weapon against COVID-19, has soared as the United States has quickly become the epicenter of the pandemic.

“Human Challenge Trials,” Where Healthy Volunteers Would Be Exposed to Covid-19, Explained

3 months 1 day

(Vox) – Now, a bioethicist and two epidemiologists are proposing a bolder option: You can volunteer to get infected yourself. In a recent article published in the Journal of Infectious Diseases, bioethicist Nir Eyal and epidemiologists Marc Lipsitch and Peter G. Smith called for “human challenge studies” to test the effectiveness of coronavirus vaccines as they’re developed. These studies would involve testing the vaccines on a group of volunteers who have been knowingly exposed to the novel coronavirus that causes Covid-19. The hope is that it will allow researchers to ascertain more quickly and conclusively the effectiveness of the proposed vaccine.

Nurses and Doctors Speaking Out on Safety Now Risk Their Job

3 months 1 day

(New York Times) – As the coronavirus crisis has escalated, workers as varied as grocery cashiers, customer-service representatives and flight attendants have clashed with the employers they accuse of failing to protect and properly value them. Amazon drew attention when it fired a worker who had led a protest over health concerns at a Staten Island warehouse. But perhaps the most curious and persistent management-labor tension has arisen between health care providers like doctors and nurses, who are at the forefront of the virus battle, and the administrators they report to.

Methadone Clinic Lines and Packed Waiting Rooms Leave Clients Vulnerable to Coronavirus

3 months 1 day

(STAT News) – Aimed at reducing the spread of the novel coronavirus, the new rules allow people considered “stable” to take home up to a 28-day supply of methadone under a blanket exception, and people considered “less than stable” to take home up to a 14-day supply. But advocates for people recovering from addiction say compliance with the new guidelines has been inconsistent.

Are Mesenchymal Stem Cells a Promising Treatment for COVID-19?

3 months 1 day

(The Scientist) – A recent pilot study in China in which seven COVID-19 patients received intravenous infusions of donor mesenchymal stem cells—multipotent cells thought to have immunomodulatory capacities—indicates that the intervention was safe, and that the approach may improve patient outcomes. While all seven patients recovered, scientists are mixed in their opinions on the logic behind the approach and how well it truly performed. On Sunday (April 5) the US Food and Drug Administraton approved mesenchymal stem cell (MSC) treatments for use in the very sickest COVID-19 patients under what’s known as expanded access compassionate use.

With Ventilators Running Out, Doctors Say the Machines Are Overused for Covid-19

3 months 3 days

(STAT News) – Even as hospitals and governors raise the alarm about a shortage of ventilators, some critical care physicians are questioning the widespread use of the breathing machines for Covid-19 patients, saying that large numbers of patients could instead be treated with less intensive respiratory support. If the iconoclasts are right, putting coronavirus patients on ventilators could be of little benefit to many and even harmful to some. What’s driving this reassessment is a baffling observation about Covid-19: Many patients have blood oxygen levels so low they should be dead. But they’re not gasping for air, their hearts aren’t racing, and their brains show no signs of blinking off from lack of oxygen.

Data for Gilead’s Potential Coronavirus Therapy Are Coming Soon. Here’s What You Need to Know.

3 months 3 days

(STAT News) – This month, the world should get the first results from a clinical trial testing the drug remdesivir against Covid-19. They will get a lot of attention. Remdesivir, made by the California biotech Gilead Sciences, is one of the potential Covid-19 therapies that is furthest along in the development process. The results, from studies in China, could signal whether the drug can effectively combat the infection — and under which circumstances. So far, there is no proven treatment for the coronavirus. But just how much can be gleaned from these announcements? Will they be the final word on remdesivir? And how can the company supply the drug to patients around the world who might need it?

Africa’s Debt Crisis Hampers Its Fight Against Covid-19

3 months 3 days

(The Economist) – ECONOMIC CRISIS and covid-19 are forcing hard choices on most of the world. But the dilemma facing indebted poor countries is particularly acute. They can either pay foreign creditors or allow more of their citizens to die, say experts. This dilemma is not new. In 2016 Angola spent nearly six times as much servicing its external debt as it did on public health care. Fifteen countries in sub-Saharan Africa spent more money paying creditors abroad than they did on doctors and clinics at home. But now, faced with a slump in revenues and skyrocketing borrowing costs as investors seek relative safety, many African governments are struggling to find the money to fight the pandemic and shore up their economies. Whereas rich countries are borrowing to spend about 8% of GDP on stimulus measures, African ones are spending just 0.8% of GDP.

U.S. Coronavirus Death Projection Lowered, New York Fears Undercount

3 months 3 days

(Reuters) – U.S. officials warned Americans to expect alarming numbers of coronavirus deaths this week, even as an influential university model on Wednesday scaled back its projected U.S. pandemic death toll by 26% to 60,000. The downward revision in the death toll in the University of Washington model – often cited by U.S. and state policymakers – coincides with comments by some political leaders that caseloads may have reached a plateau in certain areas. 

‘PTSD Waiting to Happen’: Bioethicist Ezekiel Emanuel on the Realities of Coronavirus Triage

3 months 3 days

(New York Magazine) – In “Fair Allocation of Scarce Medical Resources in the Time of COVID-19,” the authors present a general front for reducing “years of life lost” by prioritizing care for front-line health-care workers who are essential to pandemic response. Behind the workers that keep medical infrastructure intact, resources should then be catered toward “either to the sickest or to younger people who will have lived the shortest lives if they die untreated.” There are some unassailable rules: “Consensus exists that an individual person’s wealth should not determine who lives or dies.” There are also some unexpected recommendations for those outside the medical community, as the authors suggest that a first-come, first-served mentality — which governs most nonemergency situations — actually introduces more bias into the system.

Why Does Covid-19 Make Some People So Sick? Ask Their DNA

3 months 3 days

(Wired) – On Monday, 23andMe launched a new study intended to illuminate any genetic differences that might help explain why people who’ve contracted Covid-19 have such varying responses to the infection. The consumer genomics company joins a number of emerging academic projects aimed at answering the same question. Prior research indicates that some gene variants can put people at higher risk for certain infectious diseases.

New Research Examines Wastewater to Detect Community Spread of Covid-19

3 months 3 days

(STAT News) – A series of crucial setbacks in Covid-19 testing has made it difficult to keep up with the virus’ rapid spread, and has inspired some researchers to look to wastewater to help fill in the gap of measuring how prevalent SARS-CoV-2 is in a given community. In a paper posted Tuesday to the preprint server medRxiv, researchers collected samples in late March from a wastewater treatment plant serving a large metropolitan area in Massachusetts and found that the amount of SARS-CoV-2 particles in the sewage samples indicated a far higher number of people likely infected with Covid-19 than the reported cases in that area.

China’s Virus Pandemic Epicenter Wuhan Ends 76-Day Lockdown

3 months 3 days

(Medical Xpress) – As of just after midnight Wednesday, the city’s 11 million residents are now permitted to leave without special authorization as long as a mandatory smartphone application powered by a mix of data-tracking and government surveillance shows they are healthy and have not been in recent contact with anyone confirmed to have the virus.

Venezuela Elderly Feel ‘Sentenced to Euthanasia’ under Coronavirus Quarantine

3 months 3 days

(Reuters) – The coronavirus outbreak has sparked concern around the world for the elderly, who are much more vulnerable to the COVID-19 respiratory disease caused by the virus. But the plight of senior citizens was already acute in Venezuela following six years of brutal economic crisis and chronic problems with power and water services. Blanco and Rodriguez, like 3 million other Venezuelan retirees, struggle to live on state pensions of 250,000 bolivars a month – the equivalent of about $3 – which can at best buy a few pounds of chicken or several kilos of corn flour.

Coronavirus: Africa Will Not Be a Testing Ground for Vaccine, Says WHO

3 months 4 days

(BBC) – The head of the World Health Organization (WHO) has condemned as “racist” the comments by two French doctors who suggested a vaccine for the coronavirus could be tested in Africa. “Africa can’t and won’t be a testing ground for any vaccine,” said Director General Dr Tedros Adhanom Ghebreyesus. The doctors’ remarks during a TV debate sparked outrage, and they were accused of treating Africans like “human guinea pigs”. One of them later issued an apology.

Cancer Surgeries and Organ Transplants Are Being Put Off for Coronavirus. Can They Wait?

3 months 4 days

(ProPublica) – Elective surgery is, by definition, any surgery that is scheduled. That means cancer surgery, organ transplants and other lifesaving procedures, all of which are now put on hold — in some cases indefinitely. Since making its initial recommendation, the American College of Surgeons has been issuing increasingly urgent bulletins, with its March 24 missive detailing triage guidelines for cancer, cardiac and pediatric surgeries. It now finds itself in the grim position of recommending that removal of cancerous colon polyps be deferred for three months and breast cancer surgery be delayed if the disease responds to hormone therapy. In hospitals with heavy COVID-19 caseloads — those with no spare ventilators or ICU capacity — it urges that all surgical procedures be avoided unless the patient is likely to die within the next few hours or days.

A Fast-Moving Virus Pits Treating Patients Against Finding a Cure

3 months 4 days

(Bloomberg) – Pharmaceutical-research experts are raising concerns that attempts to offer desperate coronavirus patients some form of treatment may hobble crucial studies of which drugs actually work and which ones don’t. More than 100 off-the-shelf and experimental therapies are being tested either formally or informally for the coronavirus disease, including hydroxychloroquine, the antimalarial touted as a treatment by President Donald Trump, and remdesivir, an experimental drug from biotechnology company Gilead Sciences Inc. There are so many even coronavirus experts can barely keep track.

Virus Crisis Shines Light on Troubled North Africa Health Care

3 months 4 days

(Medical Xpress) – The coronavirus pandemic has put the spotlight on shortcomings in health care in several North African countries, even as governments moved quickly to announce restrictions to limit the spread of the virus. “Our fate is in the hands of a health system that we have neglected for years”, a doctor in the Moroccan city of Marrakesh said in a video widely shared on social media. COVID-19 patients in Morocco have denounced the conditions in public hospitals, reigniting nagging controversy over the underfunded health sector.

New York State, Long a Holdout Against Legalizing Surrogacy, Overturns Ban

3 months 4 days

(NBC News) – New York state is overturning its long-held ban on paid surrogacy, “a bright spot for New York families in these difficult times,” said the co-sponsor of the bill. The legislation was approved Thursday and was one of many non-fiscal measures included in the state budget passed amid the coronavirus pandemic, which has hit New York harder than any state in the United States. The budget included a grim prediction for the effects of the coronavirus, with state tax revenues estimated to fall by at least $10 billion.

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