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Southern Indian states have declared a state of emergency

Two southern Indian states have declared a state of emergency, as coronavirus cases spread at a breakneck pace through the country and pressure increases on Prime Minister Narendra Modi’s government to enforce a national shutdown.


Bengaluru, the capital of Karnataka, has the most significant active caseload of any Indian region, with over 300,000 people. However, analysts warn that the worst is yet to come as India’s third-largest city struggles with oxygen scarcity, overcrowded hospitals, and overcrowded crematoriums. The lockout declaration in Tamil Nadu state came after a regular total of over 26,000 cases on Friday.


Since February, infections have risen dramatically in India due to increased viral varieties and government decisions to encourage large crowds to assemble for religious festivals and political rallies.


India recorded 401,078 suspected cases on Saturday, with a record high of 4,187 deaths. In India, there have been over 21.8 million reported infections and almost 240,000 deaths. Also, such drastic tolls, according to experts, are under-counted.
As his hospital strained to find more air, one doctor in Bengaluru said he had to refuse patients “left, right, and center.”


“The issue is that the demand is so high that we require continuous oxygen,” said Dr. Sanjay Gururaj, medical director at Shanti Hospital and Research Center. The hospital sends a vehicle twice a day to oxygen plants on the city’s outskirts to retrieve 12 jumbo oxygen cylinders. “This would have lasted over two weeks; now, it lasts just over a day,” he said.


The state’s oxygen scarcity led the Supreme Court to ask the federal government to raise the amount of liquid medical oxygen sent to Karnataka. The decision came after 24 virus patients died on Monday in a government hospital. It is unknown how many of them perished because of the shortage of oxygen, but an inquiry is underway.


So far, Modi has delegated liability for combating the virus in this latest outbreak to under-resourced state governments, and he has been accused of doing very little. His government has responded that it is doing everything possible in the face of a “once-in-a-century crisis.” Meanwhile, many medical professionals, minority politicians, and even Supreme Court justices are pressing for nationwide bans, claiming that a patchwork of state regulations is inadequate to increase infections.
Experts warn that the surge in Bengaluru is outpacing that of other hard-hit cities such as the capital, New Delhi, and Mumbai. According to Murad Banaji, a mathematician modeling COVID-19 development in India, cases have increased 100-fold since February, citing official numbers. Test positivity has risen to over 30%, showing that the virus is much more severe than reported estimates, he said.
“Disaster was looming by early March when cases rose,” he said. “Bangalore is more than a ticking time bomb — it is amid an explosion.” Bengaluru was classified as Bangalore.


In recent weeks, Northern India, headed by New Delhi, has received much attention, with news channels broadcasting pictures of patients lying on stretchers outside hospitals and mass funeral pyres that flame all night.
The crisis in Karnataka has drawn attention to other southern states dealing with an increase in incidents. In Andhra Pradesh, daily cases have surpassed 20,000 for the past three days, prompting the state to impose new restrictions.

Kerala, which served as a model for dealing with the pandemic last year, went into lockdown on Saturday. With chronic cases exceeding 40,000, the state is increasing money, including turning hundreds of industrial oxygen cylinders into medical oxygen, according to Dr. Amar Fetle, the state’s COVID-19 officer.


“The magnitude of cases from last year to now is different,” he said, noting that rising figures have resulted in further hospitalizations and increased demand on health-care services, with hospitals complete. “It has turned into a race between occupancy and how quickly we can add beds. We are doing everything we can to remain ahead of the virus.”


Infections are on the rise in the southern area, but there has been “less visible outcry” than in the north due to improved health facilities and government programs addressing issues at the neighborhood level, according to Jacob John, professor of community medicine at Christian Medical College, Vellore.


However, as the epidemic has ravaged major cities in waves, smaller towns and communities with tiny links to health services are also at risk.


“These places are becoming affected, which suggests that we may not have seen the worst yet in south India,” he added.


Reference
India’s surge hits southern states, prompts more lockdowns. https://apnews.com/article/india-religion-coronavirus-pandemic-health-18d61c7956cb0bf9f59d975a5f171875

The effectiveness of vaccinations against new variants

The effectiveness of vaccinations against new variants would also dictate when, where, and how often additional shots are needed. According to Pfizer’s latest trial, the two-dose vaccine appears extremely successful for at least six months, and potentially longer. Additionally, six months after receiving the second requisite injection, those that received Moderna’s vaccine retained significant amounts of virus-fighting antibodies. Although the new COVID-19 vaccines are expected to last at least a year, they are unlikely to have lifetime immunity, like measles vaccinations do, according to Dr. Kathleen Neuzil, a vaccine specialist at the University of Maryland. Present vaccinations are targeted against a specific spike protein found in coronaviruses, according to Mehul Suthar of the Emory Vaccine Center. If the virus evolves sufficiently over time, vaccinations may need to be modified to maintain efficacy.The vaccinations tend to be protective against the prominent strains that have arisen, albeit somewhat less so against the one initially discovered in South Africa.

Reference

How long does protection from COVID-19 vaccines last?,https://www.woodtv.com/covid-19-vaccine/how-long-does-protection-from-covid-19-vaccines-last/

Three hundred health initiatives have been introduced

More than three hundred health initiatives have been introduced under the Trump presidency. The little-used statute recognized as the Congressional Review Act helps a new government to oversee the revocation of the regulations. However, Congress has not attempted to use it to date, and the president has not requested it. The legislation extends, with a few variations, to policies concluded between 21 August 2020 and 20 January 2021. It is only valid for the first 60 parliamentary days of the current Congress.

In 2017, Republicans abrogated a family planning policy by the Congressional Review Act. The administration of Biden may well be the one to assess it. Using the act is dangerous, too. No administration will issue an “equivalent” rule under its provisions. Many revisions to Trump’s agenda are part of broader legislation affecting a wide range of topics. The Senate also has a chief for the Management and Budget Bureau to confirm, and the current Secretary for Health and Human Services, Xavier Becerra, was sworn in last week.

Congress could shift to the Act of Congressional Review. The act was not included during the transfer from Obama to Biden. For both the Biden government and the new Congress, the change process was turbulent. It is not too late for Congress to apply the act to a Trump law at the last minute, which allows HHS to revise 18,000 regulations. This might be a cleaner approach to avoid the sunset clause, which asks for a range of laws to be checked.

Reference

How Biden Could Quickly Undo Trump Era Health Policies, https://www.npr.org/sections/health-shots/2021/03/26/981410515/how-biden-could-quickly-undo-trump-era-health-policies

4,400 Modern Doses of Vaccine Not Kept Cool

4,400 Modern Doses of Vaccine Not Kept Cool Enough Might be Unusable. Maine health officials noticed that during transport, several Moderna vaccine shipments were not kept sufficiently cool. According to the CDC, Moderna’s vaccine vials must stay at freezing temperatures between -25°C and -15°C. Whether the doses of the vaccine would have to be tossed away or even be used is uncertain. The vaccine was shipped from the manufacturer’s processing plant in Massachusetts to 50 locations throughout the state, health officials said. Processes are to guarantee that the doses are held cool, the U.S. Centers for Disease Control and Prevention reports.

Resource
4,400 Moderna Vaccine Doses Not Kept Cold Enough May Be Unusable. https://www.npr.org/2021/01/19/958539556/4-400-moderna-vaccine-doses-not-kept-cold-enough-may-be-unusable

One week after obtaining a federal green light from Pfizer and BioNTech’s COVID-19 vaccine

On Friday, only one week after obtaining a federal green light from Pfizer and BioNTech’s COVID-19 vaccine, the Food and Drug Administration officially approved a second emergency vaccine—this one produced by Moderna. The vaccine produced by Moderna, whose headquarters in Cambridge, Mass., has been given an immediate usage permit by federal regulators. The vaccine produced by Moderna, whose headquarters in Cambridge, Mass., has been given an immediate usage permit by federal regulators. FDA Authorizes Moderna COVID-19 Vaccine For Emergency Use: Coronavirus Changes Food and Drug Administration greenlights the U.S. biomedical firm’s emergency vaccine. The step bolsters a massive inoculation campaign already underway.With last week’s Pfizer vaccine permit, health and defense authorities have undertaken a vast campaign to deliver millions of doses throughout the world. Amid the flurry accompanying the rollout of the Pfizer vaccine, Moderna’s alternative made steady headway in its drive toward a permission.

Reference
Moderna’s COVID-19 Vaccine Becomes 2nd To Earn FDA Authorization.https://www.npr.org/sections/coronavirus-live-updates/2020/12/18/947948227/modernas-covid-19-vaccine-becomes-2nd-to-earn-fda-authorization?refresh=true

Pfizer will only be able to deliver 2.9 million doses in the first few days

It is expected that Pfizer will only be able to deliver 2.9 million doses in the first few days and only up to 6.4 million doses by 19 December, according to Operation Warp Speed, the government’s vaccine effort.

“As part of the discussion on who should qualify for phase 1b access to the vaccine, ACIP has so far discussed individuals with high-risk medical conditions such as cancer, chronic kidney disease, chronic obstructive pulmonary disease (COPD), immunocompromised organ transplant status, obesity, severe heart disease, sickle cell disease, and type 2 diabetes,” said the Muscular Dystrophy Association.

For example, last month, the head of the Hawaii Healthcare Association told CNN that not a single hospital in Hawaii had a freezer that could remain cold enough to store Pfizer’s coronavirus vaccine and that the state may not have enough access to dry ice to make proper use of the company’s distribution boxes.

They resolve quickly, but CDC and other officials are worried that they might scare some people away from getting a second dose of vaccine and are preparing educational materials to let people know the symptoms are a sign that the vaccine is working to reactivate the body’s immune response and is harmless.

Vaccine counselors have already broken down priority groups into subgroups, and only the first people to receive vaccines have been identified.

Operation Warp Speed Chief Counselor Moncef Slaoui has projected that Pfizer and Moderna can make and deliver between 60 million and 70 million vaccines in January and hopes that two other vaccine makers, AstraZeneca, and Johnson & Johnson, will join the vaccine mix in the coming months.

Moderna and Pfizer each claim that they can take up to a billion doses by the end of 2021, but Moderna say that it could be half that—a product that has never been sold before—and Pfizer has already severely adjusted its timeline for delivery of vaccines after unspecified manufacturing problems.

Slaoui said that up to 15% of Pfizer and Moderna vaccine participants had quite noticeable side effects,” including nausea, body aches, headaches, and chills.

Pfizer’s vaccine had its first scare in the US with a health worker in Juneau, Alaska, suffering from an allergic reaction.

“Around one in every million people who get a vaccine can have a severe allergic reaction to the vaccine,” Dr.

And what about the essential workers? ACIP’s expert bodies, including Johns Hopkins University and the National Academies of Science, Engineering, and Medicine, suggest it will be prudent to vaccinate those who work in food processing, emergency responders, and service workers before the general public.

The US Food and Drug Administration granted emergency use authorization for Pfizer and BioNTech’s vaccine on Friday, and it is widely expected that EUA will give a similar vaccine to Moderna next week.

Reference

Trump says he is ‘not scheduled’ to take Covid-19 vaccine …. https://www.rt.com/usa/509567-trump-white-house-vaccine-later/

Public health authorities and drug manufacturers need to be open regarding the side effects of coronavirus vaccine

Public health authorities and drug manufacturers need to be open regarding the side effects of coronavirus vaccines, doctors say. Doctors met with CDC advisers as states plan to administer doses as early as next month. Both Pfizer and Moderna vaccines need two doses at different intervals. Participants in the trials registered high fever, body aches, extreme headaches, day-long fatigue after the shots. “We need to make patients aware that this will not be a walk in the park,” says Dr. Sandra Fryhofer. Nurse practitioners recommend that drug manufacturers should use terms such as “response” instead of “adverse reaction” to explain side effects. “If this proves to work, people are going to toughen up,” says the nurse practitioner.

“These are immune responses,” says Stinchfield, a former member of the committee who voted. “If you feel something after vaccination, expect to feel that” Pfizer and its partner BioNTech applied for an emergency license for their coronavirus vac.

Reference

Doctors say CDC should warn people the side effects from Covid vaccine shots won’t be ‘a walk in the park’. https://www.cnbc.com/2020/11/23/covid-vaccine-cdc-should-warn-people-the-side-effects-from-shots-wont-be-walk-in-the-park-.html

Interleukin-1 has been involved as a mediator of chronic pericarditis

Interleukin-1 has been involved as a mediator of chronic pericarditis. A phase 3 trial of rilonacept was performed in patients with acute symptoms and systemic inflammation. During the run-in period, the median time for pain resolution or near-resolution was 5 days, and the median time for normalization of CRP was 7 days. Injection site reactions and upper respiratory tract infections were the most common adverse events. Among patients with chronic periecarditis, treatment resulted in rapid resolution and a slightly lower risk of recurrence than placebo. The most common side effects were injection site reactions and upper respiratory tract infections.

Reference

Phase 3 Trial of Interleukin-1 Trap Rilonacept in Recurrent Pericarditis. https://www.nejm.org/doi/full/10.1056/NEJMoa2027892

Regeneron Pharmaceuticals has paused critically ill COVID-19 patients’ enrollment

Regeneron Pharmaceuticals has paused critically ill COVID-19 patients’ enrollment with its trial studying the antibody cocktail treatment, which was fond of President Trump earlier this month. The choice is because of potential safety concerns.
The drugmaker on Friday said it was suspending the enrollment of hospitalized #COVID-19 patients requiring high-flow oxygen or mechanical ventilation after an unbiased monitoring committee observed “a potential safety signal and an unfavorable risk/benefit profile at the moment.”

The enrollment of individuals in this category should be on hold, pending the collection and evaluation of additional data.

Trials continue to test the antibody cocktail in hospitalized patients necessitating little if any extra oxygen. Other trials involving mild or moderately ill patients also can move ahead.

The drug has revealed encouraging outcomes. Regeneron on Wednesday said early data confirmed the therapy lowered COVID-19 related medical visits by 57 percent.

Regeneron earlier this month asked the foodstuff and Drug Administration for emergency approval and said it could make doses accessible to the American people free of charge. The drugmaker said it might have sufficient doses for 300,000 people when looking at the coming months.

Reference

Regeneron stops enrolling critically ill COVID-19 patients …. https://news.immitate.com/2020/10/30/regeneron-stops-enrolling-critically-ill-covid-19-patients-for-antibody-drug-trial-thehill-the-hill/.

It is a mystery that increased dementia risk linked to drugs commonly used to treat intestinal, respiratory and mood disorders

Anticholinergic drugs are utilized to produce a panoply of factors—for depression and psychosis, bladder and gastrointestinal conditions, allergies and symptoms of Parkinson’s disease.


Yet, within the study published Monday in Journal of the American Medical Association’s Internal Medicine, patients over age 55 who used strong anticholinergic medication daily for more than four years had a 50 percent increased danger of developing dementia.

“This research provides further evidence that doctor should be cautious when prescribing particular drugs that have anticholinergic properties,” Tom Dening, perhaps one of the authors and head of one’s Center for Dementia for the University of Nottingham, said within a press release. “However, it’s important that individuals taking medications along these lines just not only stop them unexpectedly as this can be a great deal more harmful. If patients have concerns, they would have to discuss them along with their doctor to think about what you should know about the treatment they are actually receiving.”

Researchers assessed medical data on nearly 59,000 people with dementia, which they collected between January 2004 and January 2016. Of given records they analyzed, the average age of patients was 82 and about 63 percent of them were women.

Approximately 57 percent considering the patients in the study received a prescription for a minimum of at least one strong anticholinergic drug, one to 11 years before being diagnosed with dementia. Though the link found between the drugs and creating of dementia appears strong, the scientists noted that their findings are associations and do not demonstrate that drugs cause dementia.

Doctors prescribe anticholinergic drugs as a treatment for conditions like chronic obstructive pulmonary disease, bladder conditions, allergies, gastrointestinal disorders and warning signs of Parkinson’s disease.

The investigation was mighty at some limitations—for example, some patients will possibly not have obtained their drugs as directed, so anticholinergic exposure levels could have been misclassified.
“Further research is essential to make sure that regardless of the association between these drugs and the chance of dementia is causal. These drugs are prescribed for a range of medical conditions and all of the concerns patients might have to stop them appearing should be discussed using their doctors,” Professor Martin Rossor, NIHR National Director of Dementia Research, said.

These health conditions may be as acute as seizures or psychosis, so weighing the pros and cons of taking clonazepam along with a physician is critical professionals say.