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Not everyone is celebrating Ms. Abrams. Lee Morris, a Republican who serves as county commissioner in Fulton County, home to Atlanta, said he viewed Ms. Abrams, a fiery orator, as “divisive,” drawing a comparison between her and Mr. Trump.“Like President Trump’s allegations of cheating and corruption have fired up the right side, certainly her efforts have fired up the enthusiasm of folks to get out and vote,” Mr. Morris said in an interview Friday. That said, while Mr. Trump’s false claims of rigged elections and widespread cheating are baseless, Georgia has a long and documented history of voter suppression, particularly among voters of color.- Advertisement – – Advertisement – Ms. Abrams has, at times, also run afoul of members of her own party, who criticized her blunt ambition and open desire to be Mr. Biden’s running mate. In the South, where Black politicians are close-knit and traditional, Ms. Abrams has also been a disruptive force. Her political vision can be at odds with the local Democratic establishment, and her shot to national prominence has ruffled feathers.The political payoff of Mr. Biden’s breakthrough in Georgia, however, may put those tensions to rest. The playbook she popularized took root — a combination of winning back metro suburbanites and registering new voters in Black, Latino, and Asian-American communities.Nse Ufot, the current chief executive of New Georgia Project, said electoral campaigns are often too shortsighted to do the long-term work of registering and educating new voters, regardless of party affiliation.- Advertisement – “When you think about the transactional nature of electoral campaigns, I think they prioritize getting people who are already voters to vote for them,” Ms. Ufot said, adding that there was “not enough conversation about 100 million Americans who are eligible to vote who did not vote in 2016.”Astead Herndon contributed reporting.
Mr. Biden campaigned on a promise of an aggressive federal response to Covid-19 — in contrast with Mr. Trump’s leave-it-to-the states approach. His plan includes appointing a “national supply chain commander” and setting up a “pandemic response board” — ideas that draw heavily from President Franklin D. Roosevelt, whose big-government policies helped lift the nation out of the Great Depression. Mr. Biden’s moves were reminiscent of former President Barack Obama’s quick steps after his election in November 2008 to name an economics team as the nation spiraled further into financial crisis. The situation Mr. Biden will inherit will be even more dire: a deadly pandemic wrapped inside a devastating economic downturn, against the backdrop of a deeply divided nation and President Trump’s refusal to accept the election results.Mr. Biden’s new advisory panel offered a not-so-subtle rebuke of Mr. Trump: Its members include Rick Bright, a vaccine expert who blew the whistle on the Trump administration this spring after he was abruptly removed from his job running a federal medical research agency. Dr. Murthy, a son of Indian immigrants who were also physicians, served as surgeon general under Mr. Obama, and briefly under Mr. Trump, who fired Dr. Murthy in April 2017 when he refused to step down. More than 238,000 Americans have died of Covid-19, and if current trends hold, the number of deaths could double by the time Mr. Biden takes office in January. On Sunday, the United States reached a grim milestone: 10 million Americans have now been infected. Mr. Biden himself has repeatedly warned of a “dark winter” — a phrase he invoked again on Monday, saying, “We’re still facing a very dark winter.”Mr. Biden’s appearance in Wilmington underscored a difficult truth for the president-elect: While he has vowed to make fighting the pandemic his No. 1 priority as president, he can do little before he is inaugurated Jan. 20 other than use his bully pulpit.“What he knows is there is almost 10 weeks between now and the inauguration, and those 10 weeks are absolutely critical for the health of this country,” said Kathleen Sebelius, who served as health secretary to Mr. Obama and has advised the Biden team.- Advertisement – The first surgeon general of Indian descent, he has for years made headlines for calling gun violence a public health threat; the National Rifle Association urged the Senate not to confirm him.Dr. Kessler, who led the F.D.A. under Presidents George Bush and Bill Clinton, made his name in Washington in the 1990s fighting Big Tobacco. Updated Nov. 9, 2020, 7:57 p.m. ET WASHINGTON — President-elect Joseph R. Biden Jr. moved on Monday to begin assuming responsibility for the surging coronavirus pandemic, naming a string of high-profile scientists — including a former surgeon general and a former Food and Drug Administration commissioner — to advise him on the pandemic and imploring Americans to wear masks.“A mask is not a political statement, but it’s a good way to start pulling the country together,” Mr. Biden declared in a brief speech from his home city, Wilmington, Del., after meeting with members of his new coronavirus advisory board.- Advertisement – A Harvard-educated pediatrician who also has a law degree from the University of Chicago, he led the F.D.A. in an unsuccessful push to regulate cigarettes, and steered the agency as it sped up drug approvals and enacted regulations requiring food manufacturers to use standardized nutrition labels and expose “stealth fat” in foods.Dr. Nunez-Smith, who was raised in St. Thomas, one of the U.S. Virgin Islands, has devoted her career to ending racial disparities in health — a perspective that will inform her work on the coronavirus pandemic, which has disproportionately affected people of color.At Yale, she is the founding director of a research center devoted to creating health equity for marginalized populations, and is also the founding director of the Pozen-Commonwealth Fund Fellowship in Health Equity Leadership, which trains health care professionals to address disparities in health and medical care.“Covid-19 is about a virus, but also inequities in health that pre-existed the pandemic,” said Gregg Gonsalves, an assistant professor at the Yale School of Public Health. “Dr. Nunez-Smith has spent her life and career focused on those left behind, forgotten and hit hard” by the coronavirus.The panel will also include Dr. Eric Goosby, an internationally recognized infectious disease expert who was Mr. Obama’s global AIDS coordinator; Dr. Celine Gounder, a clinical assistant professor at the New York University Grossman School of Medicine; Dr. Julie Morita, the executive vice president of the Robert Wood Johnson Foundation, a philanthropy focused on health; Loyce Pace, the executive director and president of Global Health Council; and Dr. Robert Rodriguez, who like Dr. Goosby teaches at the University of California, San Francisco School of Medicine. “I am grateful for the opportunity to serve my country & rejoin the fight against COVID-19,” Dr. Bright wrote Monday on Twitter. “With the leadership of President-elect Biden & VP-elect Harris, & their trust in Science, I have no doubt we’ll be able to end the pandemic & save lives. And remember, #WearAMask!”- Advertisement – Mr. Biden has also vowed to consult Dr. Anthony S. Fauci, the government’s top infectious disease expert. Dr. Fauci, who tries to stay out of politics, did not respond to a text message on Monday asking if Mr. Biden had reached out to him, and refused to answer a question about it during an interview with Wolf Blitzer of CNN. But he offered praise for the vice president’s advisers.“They’re colleagues of mine, they’re people that I’ve been dealing with for years and years,” he said. “Of course they’re qualified.”Michael D. Shear contributed reporting from Wilmington, Del. – Advertisement – “There’s a need for bold action to fight this pandemic,” Mr. Biden said on Monday. In making his case for wearing masks, he gave a nod to Roosevelt’s wartime stance, saying, “Throughout our history, the history of our nation, we have seen over and over again how small acts add up to enormous achievements.”The 13 members of his task force include well-known figures with Washington experience, some of whom are familiar faces on television: Dr. Vivek H. Murthy, a former surgeon general; Dr. David A. Kessler, a former F.D.A. commissioner; Dr. Ezekiel J. Emanuel, a noted bioethicist and brother of former Mayor Rahm Emanuel of Chicago; and Dr. Atul Gawande, a best-selling author.Mr. Biden reached across parties and across administrations. Dr. Luciana Borio, a vice president at In-Q-Tel, which invests in intelligence technology, was a member of Mr. Trump’s National Security Council until he disbanded the office charged with responding to pandemics and bioterrorism threats. Dr. Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, advised the George W. Bush administration after the 2001 anthrax attacks.None of the task force members appeared with him on Monday, but Ms. Sebelius said Mr. Biden “is signaling that science is back.”The panel will have three co-chairmen: Dr. Murthy and Dr. Kessler, who have been advising the Biden campaign since March, and Dr. Marcella Nunez-Smith, an associate professor at the Yale School of Medicine. All have activist bents.
Uber already offers customers the option to schedule rides, but executives said the new Reserve feature also allows riders to favour specific drivers and provides $50 (roughly Rs. 3,700) in Uber credit should a reserved ride not arrive on time.Scheduled rides have seen a surge in demand since the beginning of the pandemic in March, said Uber Reserve Product Lead Geoff Tam-Scott.“On-demand is still going to continue to be our bread and butter… but a lot of riders have told us the appeal of the Reserve experience is create your trip and then don’t worry about it,” Tam-Scott said.- Advertisement – Uber is seeing only a slow recovery of its US rides business amid the coronavirus pandemic, with trips in the United States and Canada down 59 percent in the third quarter compared to last year.Uber shares on Monday surged on the prospect of a coronavirus vaccine.Company executives said the new Reserve feature was a response to customer surveys and focus groups that showed a need for an option to book rides in advance for appointments, such as doctor visits.- Advertisement – – Advertisement – Uber on Tuesday said it would roll out a new feature in the United States that will allow customers to reserve scheduled rides up to 30 days in advance.The feature marks an expansion of Uber’s traditional on-demand model and adds to previous initiatives that allow passengers to select drivers who accept pets or offer car seats.- Advertisement – Uber said it will release the feature in more than 20 US cities in the coming weeks, including in New York, Chicago, Miami, Houston and Seattle.Riders pay an $8 (roughly Rs. 600) to $12 (roughly Rs. 900) reservation fee, which is included in the upfront price locked in when booking. Reserve initially is limited to Uber’s premium car segments, but will later expand to other price ranges and rural areas.© Thomson Reuters 2020Which is the best TV under Rs. 25,000? We discussed this on Orbital, our weekly technology podcast, which you can subscribe to via Apple Podcasts, Google Podcasts, or RSS, download the episode, or just hit the play button below.
Jan 19, 2006 (CIDRAP News) – A new report in Nature cites more evidence that mutations detected in H5N1 avian influenza viruses recovered from patients in Turkey may better equip the viruses to infect humans.The World Health Organization (WHO) announced a week ago that a mutation in one virus sample could improve the virus’s ability to spread from birds to humans. The mutation is believed to make the virus more likely to bind to human cell receptors and less likely to bind to avian cell receptors, the WHO said.A news article published today by Nature says scientists have detected another mutation in the Turkish samples that may improve the microbe’s ability to jump not only from birds to humans but also from human to human. However, a scientist quoted in the piece said the two mutations, on their own, are not likely to lead to efficient person-to-person transmission.Virus samples from the first two Turkish children to die of avian flu have been analyzed at the National Institute of Medical Research (NIMR) in London. Last week the WHO announced that a sample from one of the patients had an amino acid change in hemagglutinin, the surface protein that enables flu viruses to bind to and enter host cells.The same mutation was seen in two patients in Hong Kong in 2003 and in Vietnam last year, the WHO said. Previous research indicated that the Hong Kong 2003 viruses prefer human cell receptors over bird cell receptors, the agency said. But the WHO stopped short of suggesting that this would help explain the relatively high incidence of human cases in Turkey—at least 20 in about 2 weeks.The Nature report, by Declan Butler, says the virus samples from both Turkish patients have a mutation in the polymerase protein, which serves to replicate the virus’s genetic material. The change is a substitution of lycine for glutamic acid at position 627. The same mutation has been seen before, including in Eurasian poultry recently and in the one person who died in the 2003 outbreak of H7N7 avian flu in the Netherlands.”The polymerase mutation is one of the ten genetic changes that gave rise to the 1918 pandemic flu virus,” the story says. The mutation indicates adaptation to humans, said Alan Hay, director of the WHO flu laboratory at the NIMR, as quoted in the story.The story goes on to say that the Turkish samples are the first in which the polymerase and hemagglutinin mutations have been found together. “They could make it easier for humans to catch the virus from poultry,” it says. “But they might also favor human-to-human transmission.” Together, the two mutations help the virus survive and infect cells in the nose and throat, increasing the chance that coughing would spread it via droplets, the story says.However, Hay said it is hard to predict how the mutations will affect the virus’s behavior and that “just two changes are unlikely to create efficient human-to-human transmission on their own,” according to the report.One other mutation—a change at position 153 of the hemagglutinin protein—also was found in one of the virus samples, the story said. Maria Cheng of the WHO told Nature it was unclear what effect that change has.Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of this Web site, said the findings point up how little is known about exactly what changes would be sufficient to produce a pandemic strain of virus.”We know what changes occurred in the 1918 virus, but is that the example or is that the model?” he said. “In other words, does it have to be exactly like that, or can it be a series of changes somewhat like that? We don’t know if some changes are more important than others or if some changes have to happen together.”While virologists have learned a lot, “there’s more that we don’t know than we do know,” Osterholm added. “The thing I think is concerning about the situation in Turkey is we continue to see the potential for mutations to occur, which in turn leads us to the possibility that all the wrong mutations might occur and result in a 1918-like experience.”See also:Jan 12 WHO statement on analysis of H5N1 virus from Turkish patientshttp://www.who.int/csr/don/2006_01_12/en/index.html
Sep 8, 2006 (CIDRAP News) – A recent report about the use of blood products to treat patients in the Spanish influenza pandemic of 1918 has sparked interest among those concerned about the threat of the next pandemic, but experts say it’s far from clear whether the approach would be practicable in a pandemic today.In a report published last week, US military researchers said blood products obtained from recovering influenza patients apparently helped save the lives of some patients in the 1918 pandemic, and the same approach should be considered today in the face of another pandemic threat.Combing the medical literature from the Spanish flu era, the researchers found six controlled studies in which the use of blood plasma, serum, or whole blood from recovering flu patients reduced mortality in seriously ill patients. The authors hypothesize that antibodies in the blood products blunted the effects of the flu virus.”Patients with Spanish influenza pneumonia who received transfusion with influenza-convalescent human blood products may have experienced a clinically important reduction in the risk for death,” say Thomas C. Luke, of the Navy Bureau of Medicine and Surgery, and colleagues. Their report was published online by Annals of Internal Medicine.Luke and colleagues write that borrowed antibodies in blood products have been used to prevent and treat a number of infectious diseases, including rabies, measles, hepatitis B, cytomegalovirus, and respiratory syncytial virus.Six studies showed benefitThe authors searched eight major medical journals for controlled trials of the use of blood products from recovering flu patients to treat a minimum of 10 severely ill patients. They found eight studies that met their criteria, ranging in size from 43 to 551 patients, with a total of 1,703. None of the trials was blinded or randomized, and the methods were rated as poor by today’s standards. Most of the patients were men between the ages of 17 and 45.Six of the eight studies showed that the treatment improved survival. The overall case-fatality rate for treated patients was 16% (54 of 336), versus 37% among the controls (452 of 1,219). In addition, all eight reports said that patients showed clinical improvement after treatment. Moderate to serious transfusion-related adverse events occurred in 4% (9 of 235) of patients in studies that included such data.The timing of treatment made a difference. On the basis of data from four studies, patients treated within 4 days of the onset of pneumonia had an overall case-fatality rate of 19% (28 of 148), whereas those treated later had a fatality rate of 59% (49 of 83).Acknowledged limitations of the analysis include the small size of the studies, the lack of blinding, and the lack of placebo treatment. The authors also say they can’t exclude the possibility that other studies yielded negative findings but went unpublished. Therefore they couldn’t reach a firm conclusion about the effectiveness of the treatment.Nonetheless, they recommend that a committee of experts be set up to consider using plasma treatment for H5N1 patients and to recommend a research strategy.In an editorial accompanying the report, John J. Treanor, MD, an infectious disease expert at the University of Rochester, says the strategy deserves consideration, but he also raises some caveats.Passive immunotherapy for flu viruses, including H5N1, has worked in lab mice, Treanor writes. Such treatment prevents many viral diseases in humans, but little recent evidence supports using this approach to treat sick patients, he says. Also, obtaining and using blood products for treatment in the midst of an outbreak would involve “formidable logistical hurdles.”Proving the concept of “serotherapy” for H5N1 would require running controlled trials in regions where human H5N1 cases are occurring, Treanor asserts. He believes the effort would be worthwhile: “We can, should, and must explore these issues about serotherapy now, in advance of the pandemic.”Serotherapy called impracticalOther experts who were asked about using this approach in the next pandemic expressed views ranging from guarded interest to dismissive skepticism.Michael T. Osterholm, PhD, MPH, didn’t question the scientific plausibility of the idea, but argued that it wouldn’t be practical in a pandemic. Osterholm is director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of the CIDRAP Web site.”We won’t have the capacity to do much plasmapheresis [harvesting of plasma] of recovered patients because the system—healthcare workers and equipment—will collapse,” Osterholm told CIDRAP News. “And with today’s safety regulation, you couldn’t do it like you did in 1918.”He said supplies and equipment needed for blood transfusions and processing are likely to run out. “The entire healthcare system is a just-in-time delivery system for virtually everything. . . . You couldn’t do it if you wanted to, because you just won’t have the equipment. Blood banks don’t have months and months of inventory on hand. The bags, tubing, needles, and reagents are made offshore.””Transfusion medicine is going to be severely challenged during a pandemic,” Osterholm said. “Just transfusing the blood we need [will be difficult], let alone doing this kind of thing.”Blood-bank official sees logistical problemsLouis Katz, MD, chair of an American Association of Blood Banks task force on pandemic flu and the blood supply, acknowledged that supplies are likely to be a problem but said that using plasma from recovered patients could be helpful in a pandemic.The idea “is something we’re trying to think about, but it hasn’t made it into the first edition of our pandemic flu planning guidelines,” said Katz, who is executive vice president of the Mississippi Valley Regional Blood Center in Davenport, Iowa.He said blood banks are likely to run short of both personnel and supplies in a pandemic, but supplies are the bigger worry.”We take delivery twice a month on critical lab reagents and once or twice a month on pheresis kits, so the maximum [inventory on hand] is a month,” Katz said.His center doesn’t have space to store 8 to 12 weeks’ worth of supplies, and even if it did, suppliers might not be able to ramp up deliveries to permit stockpiling, he said. “The just-in-time economy has its advantages in terms of efficiency, but in a crunch there are serious problems,” he added.Further, few recovered flu patients would be available to donate plasma in the early stage of a pandemic, Katz said. “I think there are substantial barriers to providing a lot of it during the first wave.” He predicted the task would be “substantially easier” in the second wave of a pandemic.Katz thinks blood banks could get recovered patients to donate plasma, but not until weeks into the pandemic. “I think they’d come in, but whether we could process enough [blood products] to treat meaningful number of patients, I don’t know,” he said.If the pandemic resembled those in 1957 and 1968, in which “business operations weren’t horribly disrupted, we probably could ramp up and make immune plasma fairly quickly,” Katz said. “It totally depends on what happens.”Another question is whether the Food and Drug Administration (FDA) would approve the use of blood plasma to treat flu patients. “It’s complicated, but it becomes an issue of labeling,” Katz said. “As long as I didn’t label it ‘hyperimmune influenza plasma,’ I think they’d be fairly permissive.” Before allowing such a label, the FDA would require clinical trials and other steps to certify the safety, purity, and potency of the product, he said.Summing up his thoughts on the topic, Katz said, “While theoretically it’s a great idea, the logistics are going to be difficult.”Dr. Jed Gorlin, medical director of Memorial Blood Centers in St. Paul, said the concept of using plasma to treat flu patients has been under discussion in blood-bank circles for a while.Gorlin said blood banks are worried about shortages of blood donors and of staff to collect blood in a pandemic. But he was more optimistic than Katz on the question of supplies and equipment.The 1918 flu pandemic lasted about 2 months in most places, he said, adding, “For things like bags and so on we easily have a month and often 2 months, so that part we’re not particularly concerned about.” On the other hand, other supplies, such as N95 breathing masks, may well run out, he said.”Blood centers are ahead of most hospitals in that we already have lists of critical reagents and equipment,” Gorlin said. “We’re already sensitive to our supply chain and in some cases we have alternative suppliers.”Transfusion specialist interestedRobert J. Bowman, MD, a transfusion medicine specialist at the University of Minnesota Medical School in Minneapolis, called the proposal “very interesting,” at least theoretically.”I am unsure of the relative success of immunoglobulin preparations in treating viral illness but given the paucity of treatment options the strategy ought to be tried,” he commented by e-mail.Criteria for acceptance of plasma donors would have to be developed, he said. Plasma could be tested for antibodies and used directly, or many units could be pooled and used to make a standardized intravenous immunoglobulin preparation (IVIG), he suggested.”Not only do I think this is possible, I think the idea should be tried with standardized IVIG preparations,” Bowman wrote. If the treatment worked, its applicability would depend on collection agencies having enough staff and enough money to pay for the IVIG, he added.Bowman predicted that safety and other regulatory issues would be “manageable,” but he acknowledged that supply interruptions could be a problem.He also said he was uncertain how much IVIG would cost or how long it would take to prepare. “We’re not talking about days, we’re talking weeks or months,” he said. “It takes some time to pool it, then you have to fractionate it, and then there’s testing. So it’s a big deal. But all the technology is there.”Luke TC, Kilbane EM, Jackson JL, et al. Meta-analysis: convalescent blood products for Spanish influenza: a future H5N1 treatment? Ann Intern Med 2006 Oct 17;145(8) (early online publication) [Full text]Treanor JJ. Avian influenza: exploring all the avenues. (Editorial) Ann Intern Med 2006 Oct 17; 145(8) (early online publication) [Full text]
Dec 7, 2006 (CIDRAP News) – A new diagnostic tool that involves thousands of fragments of genetic material on a glass slide can identify a vast range of different pathogens, including viruses, bacteria, fungi, and parasites, according to a report from an international team of researchers.The “GreeneChip system” was successfully tested on samples from patients with respiratory disease, hemorrhagic fever, tuberculosis, and urinary tract infections, researchers from Columbia University and several World Health Organization (WHO) reference laboratories reported this week in Emerging Infectious Diseases. The study’s lead author is Gustavo Palacios of Columbia’s Mailman School of Public Health in New York City.The GreeneChip is a slide with more than 29,000 probes, or short strips of genetic material, attached. “When human fluid and tissue samples are applied to the chip, these probes will stick to any closely related genetic material in the samples,” the National Institute of Allergy and Infectious Diseases (NIAID), which supported the research, said in a news release. “This allows the rapid and specific identification of any pathogens therein—even those related to but genetically distinct from the ones represented on the chip.”The test was used to identify malaria as the previously unknown disease that had killed a person during the outbreak of Marburg hemorrhagic fever in Angola in 2004 and 2005, according to the report.The technology can yield a result in as little as 6 hours, Dr. W. Ian Lipkin, senior author of the report, told CIDRAP News. Lipkin, director of the Jerome L. and Dawn Greene Infectious Disease Laboratory at Columbia, said the system is already being made available to major surveillance labs on a collaborative basis. The test can be used on a variety of samples, including respiratory secretions, tissue, blood, urine, and stool.To create a “panmicrobial” genetic database, the researchers gathered viral genetic sequences from the databases of the International Committee on Taxonomy of Viruses and the US National Center for Biotechnology Information (NCBI). They added sequences for fungi, bacteria, and parasites from the Ribosomal Database Project and the NCBI database, according to their report. The sequences “represent all recognized 1,710 vertebrate viral species and 135 bacterial, 73 fungal, and 63 parasite genera.”The team designed their viral probes to represent at least 3 separate genomic target regions for every family or genus of vertebrate virus. A similar process was used to identify probes for bacteria, fungi, and parasites. The resulting “panmicrobial array” contained 29,495 probes. An inkjet system was used to deposit the probes on glass slides, which can accept up to 244,000 of the genetic fragments, the report says.To conduct the test, the team isolated genetic material from patient samples, amplified it with polymerase chain reaction (PCR), tagged it with fluorescent “reporter” molecules, and put it in a solution to which the GreeneChip slides were exposed for several hours. After the sides were dried, they were “read” by a laser scanner.”You look for binding of the material to various probes deposited on the slide,” Lipkin explained. “The presence of a binding event is indicated by a fluorescent signal, and the pattern of fluorescent signals on the slide translates to specific identifiers of microbes of all types.”The system was initially tested on material from cultured cells infected with 49 different viruses, all of which were accurately identified. The team then used the system to test samples collected from patients with various diseases. “In all cases, array analysis detected an agent consistent with the diagnosis obtained by culture or PCR,” the article states. The pathogens identified included human enterovirus A, respiratory syncytial virus, influenza virus, Marburg virus, SARS coronavirus, lactobacillus, mycobacteria, and gammaproteobacteria.The test was also used on a sample from a healthcare worker who had died of fever and liver failure during the Marburg outbreak in Angola. Previous tests for Marburg and several other hemorrhagic fevers had been negative. The GreeneChip result, combined with the patient’s history of lack of malaria prohylaxis, pointed to Plasmodium falciparum malaria.Commenting on the speed of the test, Lipkin said, “We can get an answer as rapidly as 6 hours, but routinely we do this procedure overnight, or 12 to 14 hours.”The authors write that the use of microarrays in disease surveillance “has been limited because of low sensitivity and unwieldy analytical programs.” They say the GreeneChip system offers improved sensitivity and more user-friendly software.”The advent of validated highly multiplexed microbiologic assays will afford unprecedented opportunities for unbiased pathogen surveillance and discovery and reduction of illness and death caused by infectious diseases,” the report concludes.Lipkin said his lab is already making the GreeneChip available to people involved in global surveillance networks, such as the Centers for Disease Control and Prevention (CDC), WHO reference labs, and state laboratories.”Typically what we do is if people have samples, they fly here” and have them tested, he said. “It’s still relatively new and there are not a lot of people trained on it.”But Agilent Technologies, which makes the laser scanner, has installed the machine at the CDC and in a New York state lab, and Lipkin’s lab will provide training in use of the system, with support from the NIAID, he said.He said he hopes the system eventually can be used in clinical labs, but he couldn’t predict how long that might take. “There are a lot of things that must be done between here and there. The first thing is moving through the appropriate regulatory agencies. . . . But for broad-based surveillance operations, this is likely to be implemented in the very short term. Given that we’re already putting it in state and national labs, you could say it’s already deployed.”As for cost, Lipkin said the GreeneChip slides cost about $100 in materials, but he was unsure of the cost of the laser scanner. He also said his team searches genetic databases regularly in order to keep the probe sets used in the system up to date.”I’m convinced it’s critical that we develop multiplex diagnostic systems, because testing of agents one at a time is too costly in terms of time, effort, and samples,” Lipkin said. “There’s no way you could possibly cover as many pathogen targets as you can with this approach.”Palacio G, Quan P-L, Jabado OJ, et al. Panmicrobial oligonucleotide array for diagnosis of infectious diseases. Emerg Infect Dis 2007 Jan;13(1) (Early online publication) [Full text]See also:Nov 15, 2006, CIDRAP News story “‘Gene chip’ test could speed H5N1 diagnosis”
Apr 16, 2007 (CIDRAP News) – Bangladesh’s livestock ministry said today that H5N1 avian influenza has spread to two more farms, and Cambodian officials have reported poultry outbreaks near where a 13-year-old girl recently died of the disease, according to news services.The outbreak areas in Bangladesh include a farm in the western Jessore district near the Indian border, while the other is in Savar district near the capital, Dhaka, a livestock ministry spokesperson told Reuters.The new outbreaks were reported 2 days after a team of investigators from the United Nations Food and Agricultural Organization (FAO) arrived in Dhaka to collect information on recent outbreaks and suggest containment measures, according to another Reuters report today.FAO representative Ad Spigkers told Reuters that a 10-member FAO team would spend 2 weeks in Bangladesh visiting affected farms and laboratories and interviewing farmers and government specialists.”The government is wondering how and why it came here. We are trying to get our finger on it,” Spigkers told Reuters. “There is a lot of work [to be done], every country has its special conditions. It’s a densely populated country, many chickens, many ducks.”In mid March, Bangladesh reported its first H5N1 outbreak, which struck layer chickens at a three farms near Dhaka, according to a Mar 30 report from the World Organization for Animal Health (OIE). The source of the infection was unknown. Since then, 79,000 chickens have been culled on 32 farms in eight districts, Reuters reported.Myanmar, on Bangladesh’s eastern border, reported outbreaks at several poultry farms in early April.On Apr 14, agriculture officials in Cambodia said an outbreak had been discovered earlier in the week in backyard poultry in Kampong Cham province, prompting the culling of 100 birds, Agence France-Presse (AFP) reported today. The outbreak area was in the same district where a 13-year-girl recently died from an H5N1 infection.Cambodia reported its first poultry outbreak of 2007 to the OIE on Apr 12. The outbreak involved backyard poultry at five households in one village in Kampong Cham province, about 77 miles east of Phnom Penh. The disease killed 302 of 1,086 susceptible birds; the rest were destroyed. The source of the infection was not determined. It was not clear whether the outbreak referred to in the AFP report was separate from the one Cambodia reported to the OIE.Cambodia’s last poultry outbreak occurred in March 2006.See also:OIE reports on 2007 outbreaks in Cambodia and Bangladesh
The preliminary reports clearly articulate the nonmedical criteria that will help public officials fairly distribute scarce pandemic resources, Magnan said, adding, “This does provide a roadmap for negotiating the difficult landscape, but doesn’t tell us how to drive the car.” If community engagement sessions show broad support for age-based rationing decisions, Minnesota officials should ensure that their actions comply with federal and state age discrimination laws, the authors advise. Enough antivirals to treat, with a standard regimen, 21% of the state’s residents during the first wave of the pandemic Equitable access to resources A vital next step is to gather public feedback to ensure that the final reports reflect the shared values of Minnesotans, she said, adding that transparency and trust may help community members understand the decisions health officials may someday have to make. Today MCHCE and UMCB launched a Web portal to gather public feedback on the draft documents. Magnan told reporters that over the coming months the groups will also host town hall meetings in two Minnesota cities and convene six focus groups to review the recommendations. J. Eline Garrett, JD, assistant director for health policy and public health at the MCHCE, said few states have conducted detailed pandemic planning and that even fewer have drafted ethical guidelines. Her collaborator, Debra DeBruin, PhD, associate director of the UMCB, said what sets Minnesota’s process apart is a focus on how to carry out the ethical decisions in a pandemic setting. “We don’t want to leave unanswered how the decisions can be practically implemented,” she said. Ethical rationing guidanceIn the 75-page preliminary report on making ethical rationing decisions in a pandemic, the groups assumed, for example: Two of the rationing criteria recommended in the first report, key workers and age, raised several issues when implementing the plan was considered. The authors point out that some volunteers will play such important roles that some should be prioritized as key workers. They also recommend that state officials and workplaces identify key workers in advance of a pandemic to ease their access to resources. Magnan said the reports predict that in a pandemic as bad as the one in 1918, more than 30,000 Minnesotans will die. “And there will not be enough of anything we need to treat the ill,” she added. The estimated supply of N95 respirators for protecting healthcare workers will last less than 3 weeks Eligibility for resources Jan 30, 2009 (CIDRAP News) Minnesota health groups today unveiled two preliminary guidance reports designed to help the state make and implement difficult decisions about allocating scare resources such as antivirals, respirators, ventilators, and vaccines during a severe influenza pandemic. Jan 30 preliminary report on ethically rationing Minnesota health resources in a severe influenza pandemic For most of the pandemic resources, the groups recommend a two-tier prioritization approach that addresses two groups: key workers in critical health and infrastructure jobs, and the general public. However, they recommend a one-tier system for prioritizing ventilators: the general public, including all types of workers. The groups will then consider revising the preliminary reports and present the final version to state officials for implementation, the MDH said. The authors recommend that public officials consider a host of fairness characteristicssuch as high risk of death from the flu or good response to a particular treatmentbefore using random methods to ration scarce pandemic resources. They predict that one of their recommended characteristics, age-based rationing that favors the young, will be particularly controversial and should receive broad public consideration. At some point during a severe pandemic, public officials might be forced to allocate resources among people who have equal priority, the groups acknowledged. In those instances, they advise against using a first-come, first-served approach because it would probably heighten existing healthcare access inequity. “A more random technique, such as flipping a coin or a lottery, should be used instead,” they wrote. Public comment portal for pandemic ethics and implementation reports The pandemic vaccine will be available to only 6% of the state’s residents over the first 12 weeks, and to about 24% over a year (assuming two 15-mcg doses) Standards of care The groups advise public health officials to adjust the use of a range of resources and strategies to best protect as many Minnesotans as possible. For example, though elderly people may not be early candidates to receive vaccines, coordinated rationing of other measures, such as antivirals or N95 respirators, may provide an adequate degree of protection for the elderly Ethics consultation See also: Palliative and hospice care In accepting the groups’ reports today at a press conference, Sanne Magnan, MD, PhD, commissioner of the Minnesota Department of Health (MDH), said the avian influenza virus was a hot topic in 2007 when the MDH hired the Minnesota Center for Health Care Ethics (MCHCE) and the University of Minnesota Center for Bioethics (UMCB) to study the issue and start writing guidance documents. Though bird flu news has waned in the public’s consciousness, “the strain that triggered the concern is still making people ill in Asia and Africa,” she said. Although healthcare workers may run into difficulties accessing patient records to make rationing decisions during a pandemic, the group felt strongly that privacy protections should be enforced. “Patients’ self-reports should be accepted as guiding rationing decisions where possible,” they wrote. A W-shaped mortality curve in which those aged 15 to 40 will join the very young and the elderly in having a high risk of death from influenza infection The groups recommend that the MDH gather an expert working group to discuss complex issues surrounding pandemic standards of care and liability issues. They recommend that any standard-of-care decisions give providers a degree of flexibility, based on their work settings, and avoid giving providers full immunity to liability. “There must be safeguards and protections for patients, as well,” they wrote. Oct 31, 2006, CIDRAP News story “Pandemic vaccine rationing proposal favors the young” A roadmap for implementing rationing In the accompanying 94-page report on implementing resource rationing decisions in a pandemic, the groups focuses on eight main issues: Discussions of rationing need to account for palliative and hospice care for patients who are terminally ill, the groups emphasize. They advise Minnesota officials to bring together a work group to plan for meeting the needs of dying patients by steps such as stockpiling palliative care resources, developing symptom-management algorithms, establishing caregiver educational programs for the community, and creating a process for ongoing community engagement. Protecting the public To protect the public and build trust during a pandemic, the authors recommend that healthcare institutions create systems to routinely review their performance and provide a limited, streamlined process for real-time review of rationing decisions. “This process provides a safeguard for individuals or their families to question the procedural and substantive propriety of decisions at the time they are made,” they wrote. Emergency powers Implementing rationing criteria Acute care centers have about 1,200 ventilators, of which 85% are currently in use Next stepsAfter the groups complete all of their community engagement activities, they will issue a summary of the public’s comments and reaction, the MDH said in a press release today. The MDH said it will make that report public when it receives it by the end of the year.
The record-breaking results achieved in the peak season in the Split-Dalmatia County continue with excellent results in the post-season period.According to the eVisitor system, during the month of October, 138.374 arrivals and 499.818 overnight stays were realized in commercial accommodation in the Split-Dalmatia County, which is an increase of 17 percent in arrivals and 8 percent in overnight stays. With a share of 19,76 percent in total overnight stays in Croatia in October, the Split-Dalmatia County achieved the highest volume of tourist traffic in relation to all tourist regions. This result of arrivals and overnight stays in the first ten months firmly positioned the Split-Dalmatia County as the second most important tourist region of Croatia immediately after Istria, and ahead of Kvarner.The tourist revival of Split is finally accompanied by a large investment cycle, especially in expanding the offer of hotel accommodation.The first health hotel in Dalmatia was opened, more precisely in Split – Hotel Marvie. It is the first hotel in Dalmatia specializing in ‘health & wellness’, ie health tourism, located in the Zenta district of Split, next to the hospital and close to all city beaches and only a 15-minute walk to the center of Split. Hotel Marvie covers tens of thousands of square meters, with three underground and seven above-ground floors, and in addition to 74 rooms and two luxury suites, guests will have access to a range of specialized medical wellness services in an area of 1.200 square meters, with spa and fitness area. .The name Marvie is a combination of the Latin word “mare”, which means sea, and the French word “vie”, which means life: in other words, the hotel gives its guests a taste of living by the sea. It gives an insight into the Mediterranean way of life, providing peace, relaxation and health, the hotel states.In addition to facilities for rest and relaxation, there are surgeries for physical medicine and rehabilitation, as well as a dermatological clinic for aesthetic medicine. On the roof terrace there is a large outdoor pool with a beautiful view. The gastronomic offer is based on modern cuisine with Mediterranean ingredients, with a large selection of gluten-free dishes, and guests can use the services of a nutritionist at all times.Strong momentum of hotel construction in SplitAfter the Hotel Park was renovated and extended, the construction of a nearby four-star hotel according to the project of architects Damir Raka and Maja Tedeschi is nearing completion. In Bačvice, the construction of new accommodation capacities follows, so the company “Špinut” received a building permit for the hotel “Vila Harmony Bačvice”, with six above-ground floors on a plot located east of the road-pedestrian bridge. The company “Tommy” plans to reconstruct the former Villa Rosina and build a hotel with 80 rooms. The large annex of the Radisson Hotel is nearing completion, and the ‘Westgate B’ tower is under construction, which will house a large international hotel chain.In the spring of 2019, Split will get the currently largest hotel in the city, which will be able to accommodate more than 500 guests in Žnjan, where the company “Blue Sapphire” is building the hotel “Amfora Resort” **** with 207 rooms and residential apartments. , with a total value of about 27 million euros. In less than two years, a hotel will be built in an extremely busy location between Matejuška and the West Coast, where a boutique hotel will be built instead of the old Hotel Ambasador. The new four-plus-star hotel will have 101 accommodation units (rooms and suites), a swimming pool with a beautiful view of the city port, a meeting room, a spa, a gym and 59 garage spaces. German businessman Klaus Alex Birkenstock, heir to the family shoe empire “Birkenstock”, is the new owner of the hotel in which he will invest 17 million euros.Split was the biggest winner of this year’s tourist awards: it was named the best city break destination and tourist destination of the year – the champion of tourism, and with new investments it is boldly moving forward. Of course, there is always a great danger and “obsession” with new investments that are positive, but there must always be only one question, whether the tourist destination is developing strategically and sustainably, because it is the only real and long-term path.