“Shared expectations lead to predictability.”
131. The conflict continues: science v. politics
Q: Is the CDC still unable to stay focused on the science of communicable disease?
A: The controversial conflicts continue:
- Politics over science: The CDC created a sweeping order in September requiring all passengers and employees to wear masks on all forms of public and commercial transportation in the United States. This included airplanes, buses, subways, taxis, shuttles, tourist conveyances and limousines. This order was supported by Alex Azar, the US Secretary of Health and Human Services. But the White House Coronavirus Task Force led by vice president Mike Pence refused to even discuss this order and blocked it from being released. If it had been released, it would have been one of the toughest federal mandates to date controlling the expanding numbers of COVID-19 cases. An unnamed “task force official” said this kind of requirement should be left up to the individual states to decide. “Local and state officials need to determine the best approach for their response efforts depending on how the coronavirus is impacting their area.” The CDC director, Robert R Redfield, MD, who oversaw the order’s drafting, recently stated he thinks masks are the most powerful weapon we have to confront COVID-19, and we all need to embrace masks and set the example for each other.” But this order was never released.
- Science over politics I: William H, Foege, MD is perhaps one of the leading epidemiologists of our times. In 1976, he devised the global strategy that led to the total eradication of the disfiguring and often fatal infectious disease – smallpox. He served as the director of the CDC between 1977 and 1983. Under his leadership, CDC grew to become a world leader in research and prevention of communicable diseases. On September 23 of this year, Dr. Foege sent a personal letter to Robert Redfield, MD, the current director of CDC. This letter was later released to the public. He opened, “The first thing would be to face the truth. You and I both know that.” “This (pandemic response) will go down as a colossal failure of the public health system of the country. The biggest challenge in a century and we let the country down,” “The public health texts of the future will use this as a lesson on how not to handle an infectious disease pandemic.” “In 6 months, they have caused CDC to go from gold to tarnished brass.” He went on to chide Dr. Redfield for allowing this damage to continue by acquiescing and letting political influence to occur. He challenged Dr. Redfield’s legacy, encouraging him to apologize to the scientists and staff in the agency and to stop allowing politics to intervene. He told him that by telling truth to the people at CDC, he will probably be fired, but he will be able to hold his head high from the bad headlines that will last only for a few weeks.
- Science over politics II: The New England Journal of Medicine, a prestigious peer-reviewed medical journal, became the third scientific journal to editorialize against the way the White House has mismanaged the response to coronavirus-19. Its editorial entitled “Dying in a leadership vacuum” stated, “They have taken a crisis and turned it into a tragedy.” When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent.” The other two scientific journals on record include The Lancet that published an editorial in May asking that a president be elected that “understands that public health should not be guided by partisan politics.” Scientific American published a more direct editorial endorsing Joe Biden for president because of the failures of the Trump administration.
- Scientists study possible coronavirus-19 mutation
Q: Many viral diseases mutate over time. Has this happened to coronavirus-19?
A: In Patagonia, a far-flung region of Chile in South America, a second wave of COVID-19 has broken out that appears to be significantly more contagious than experienced earlier. Marcelo Navarrate, MD, of the University of Magallalanes stated that researchers have detected “structural changes” in the spikes of the coronavirus-19 virus. These changes indicate the virus has mutated. Research is underway to explore this correlation. The Magallanes region in Chile is a remote glacier-strewn wilderness dotted with small towns. Hospitals are nearing capacity with patients being evacuated to the capital, Santiago. This finding corresponds to a preliminary study in Houston, Texas that found that during its second wave, a more contagious strain has dominated. Scientists say the mutations may make the virus more contagious but do not necessarily make it more deadly, nor do they necessarily inhibit the effectiveness of a potential vaccine. More research is underway.
133. Debora Birx MD cites the cause of currently increased COVID infections Q. Dr. Birx of the White House Coronavirus Task Force spoke in Connecticut. What was her message?
A: Deborah Birx, MD, spoke in Hartford last Thursday. She has served on the White House Coronavirus Task Force as its response coordinator. She has been excluded from recent influence in that group’s discussion since president Trump decided to limit the role of science in developing federal policies. Dr. Birx came to this position after working decades to advance research on HIV/AIDS vaccines. She informed her audience, “The kind of spread we’re seeing now is very different from the spread experienced in May and April.” The spread in the Northeast “is not coming from classrooms or workplaces, but rather social gatherings indoors and outdoors when masks and distance protocols are not followed.” She stressed it is important to be “socially engaged but physically distant” when around friends or family who do not live in the same household. Especially with the holiday gatherings being planned now, it has to be recognized that masks should become part of “everyday life.” She said it should be assumed that everyone nearby, even if you have known them for a long time, may now be infected and contagious even it they don’t appear or feel ill. Vin Gupta MD, from the Institute for Health Metrics and Evaluation at the University of Washington stated recently that as many as 80% of the people who are spreading coronavirus-19 and infecting other people look completely healthy. Half of these people spreading the disease are asymptomatic, and the rest are “pre-symptomatic” – shedding the virus during the few days before they become sick.
134. Russia has approved its first COVID-19 medication for sale in pharmacies Q. Is Russia further along in its COVID research than we are?
A: Russia’s pharmaceutical company “R-Pharm” has announced that starting this week, a COVID-19 prescription medication “coronavir” can be picked up at local pharmacies. This is an antiviral drug for outpatient treatment of mild to moderate COVID-19. This is in the same family of Russian drugs as another antiviral drug (“Avifavir”) rolled out last May for use in hospitals. Both medications are based on favipiravir, which was developed in Japan in 2014 for use with the common flu. Coronavir’s Phase III trial was comparatively small, involving only 168 COVID-19 patients. One report stated, “R-Pharm’s announcement is another sign Russia is pushing hard to take a global lead in the race against the virus. It is already exporting its COVID-19 tests and has clinched several international deals for supplies of its Sputnik-V vaccine,”
- Bits and pieces…
Q: What else is new?
Answer:
- Pine-Sol is approved as a disinfectant for coronavirus-19. The Environmental Protection Agency (EPA) has been testing and listing approved disinfecting agents to protect surfaces on which the coronavirus-19 may collect. All the identified products appear in a category they call “List N,” and are identified by their chemical composition. This makes it difficult for homeowners and small groups to find a product by its trade name. Recently, the commonly available product, Pine Sol, was approved, and notices went out by the EPA notifying the public of its use giving its common name as it appears on retail store shelves.
- The pharmaceutical company, Eli Lilly, put out a press release stating it was seeking emergency use authorization (EUA) for its experimental antibody treatment currently undergoing limited trials. This therapeutic works similar to the Regeneron’s REGN-COV2 administered to president Trump after his admission to Waller Reed hospital. In this highly competitive market, some officials have stated this EUA request is too early. The trials have just begun and have involved only 268 people of whom 112 received the drug. Early results show some success, but more data is needed. The Regeneron’s drug is also not approved for an EUA, but it did capture the headlines because it was granted “compassionate use” for Trump.
- A study published last week in the journal Clinical Infectious Diseases, Omar Hasan, MD, from the University of British Columbia reported, “When our body fights the new coronavirus in our lungs, it also starts to fight its own proteins that keep our blood from clotting.” That protein has been identified as phospholipids. Knowing what may be causing the excessive blood clotting in severe COVID-19 patients may help to find ways to prevent this in the future.
