“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
Canada has banned the export of some prescription medicines in order to prevent a shortage in the country.
The decision is in response to a US plan that would allow for drugs to be imported from Canada to make them cheaper for Americans.
Although prescription drug prices in Canada are higher than some nations, they are cheaper than the US.
A number of Canada’s drug suppliers and residential treatment center had warned that the plan, implemented by President Trump, would cause shortages.
The pandemic has already increased demands for some medicines, according to the AFP news agency.
A statement from Canada’s health ministry said the country sources 68% of its drugs from overseas and therefore it was important to avoid any disruptions to supplies.
“Companies will now also be required to provide information to assess existing or potential shortages when requested, and within 24 hours if there is a serious or imminent health risk,” the statement said.
Mr Trump signed an executive order in July to allow for the legal importation of cheaper drugs from Canada.
A month later, Canadian Prime Minister Justin Trudeau said he was happy to help other nations with their supplies if possible but his priority was protecting the needs of Canadians.
Drugmakers have faced intense criticism from US politicians – including Mr Trump – as well as insurance companies and patients’ groups over the high cost of new medicines and price hikes in some older generic drugs.
President-elect Joe Biden has previously spoken of potentially importing drugs to bring down costs.
This is the hack that proved America’s elections can be stolen using a few lines of computer code. The ‘Hursti Hack’ in this video is an excerpt from the feature length Emmy nominated documentary ‘Hacking Democracy’. The hack of the Diebold voting system in Leon County, Florida, is real. It was verified by computer scientists at UC Berkeley. To watch the full movie, visit http://www.hackingdemocracy.com For updates, visit the official Facebook page at http://www.facebook.com/hackingdemocr… HACKING DEMOCRACY – Directed by Simon Ardizzone and Russell Michaels The disturbingly shocking HBO documentary HACKING DEMOCRACY bravely tangles with our nation’s ills at the heart of democracy. The film the Diebold corporation doesn’t want you to see, this revelatory journey follows tenacious Seattle grandmother Bev Harris and her band of extraordinary citizen-activists as they set out to ask one simple question: How does America count its votes? From Florida and California to Ohio and Washington State, filmmakers Simon Ardizzone, Russell Michaels and Robert Cohen starkly reveal a broken system riddled with secrecy, incompetent election officials, and electronic voting machines that can be programmed to steal elections. Equipped only with a powerful sense of righteous outrage, the activists take on voting machine industry, exposing alarming security holes in America’s trusted voting machines. They even go dumpster diving at a county election official’s office in Florida, uncovering incendiary evidence of miscounted votes. But proving our votes can be stolen without a trace culminates in a duel between Diebold voting machines and a computer hacker from Finland – with America’s democracy at stake. ‘Hacking Democracy’ was nominated for an Emmy award for Outstanding Investigative Journalism. “Disturbing stuff. . . It’s not shocked-shocked you feel watching this; it’s genuine shock.’ – The New York Times “It is hard to imagine a documentary that is more important to the civic life of the nation — let alone one that is so compelling and ultimately moving” – Baltimore Sun After we filmed the ‘Hursti Hack’ California’s Secretary of State ordered an investigation. The best computer scientists at UC Berkeley analysed the Diebold voting machines’ computer source code. The UC Berkeley Report can be found here: https://www.sos.state.tx.us/elections… Page 2 of the report states: “Harri Hursti’s attack does work. Mr. Hursti’s attack on the AV-OS is definitely real. He was indeed able to change the election results by doing nothing more than modifying the contents of a memory card. He needed no passwords, no cryptographic keys, and no access to any other part of the voting system, including the GEMS election management server.” We hope that as many people as possible will vote because the bigger the turnout the harder it is for someone to rig the total national results.
See previous you tubes on Covid 19 we have a national health car crisis with people believing masks are the answer when the truth masks only are the first part of control, second and most importantly are HANDS and direct spread
Science’s COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.
In late June, Sanne de Jong developed nausea, shortness of breath, sore muscles, and a runny nose. At first, she thought it might be lingering effects from her COVID-19 infection in the spring. De Jong, 22, had tested positive on 17 April and suffered mild symptoms for about 2 weeks. She tested negative on 2 May—just in time to say farewell to her dying grandmother—and returned to work as a nursing intern in a hospital in Rotterdam, the Netherlands.
But when her symptoms re-emerged, her doctor suggested she get tested again. “A reinfection this soon would be peculiar, but not impossible,” she told De Jong, who by then had again lost her sense of smell and had abdominal pains and diarrhea.
The call from her municipal health service came on 3 July. De Jong had tested positive again. “You’re kidding me!” she recalls saying.
Scientists are keenly interested in cases like hers, which are still rare but on the rise. Reinfections hint that immunity against COVID-19 may be fragile and wane relatively quickly, with implications not just for the risks facing recovered patients, but also for how long future vaccines might protect people. “The question everybody wants to answer is: Is that second one going to be less severe most of the time or not?” says Derek Cummings, who studies infectious disease dynamics at the University of Florida. “And what do reinfections teach us about SARS-CoV-2 immunity in general?”
South Korean scientists reported the first suspected reinfections in April, but it took until 24 August before a case was officially confirmed: a 33-year-old man who was treated at a Hong Kong hospital for a mild case in March and who tested positive again at the Hong Kong airport on 15 August after returning from a trip to Spain. Since then, at least 24 other reinfections have been officially confirmed—but scientists say that is definitely an underestimate.
To count as a case of reinfection, a patient must have had a positive polymerase chain reaction (PCR) test twice with at least one symptom-free month in between. But virologist Chantal Reusken of the Dutch National Institute for Public Health and the Environment (RIVM) explains that a second test can also be positive because the patient has a residue of nonreplicating viral RNA from their original infection in their respiratory tract, because of an infection with two viruses at the same time or because they had suppressed but never fully cleared the virus. So most journals want to see two full virus sequences, from the first and second illnesses, that are sufficiently different, says Paul Moss, a hematologist at the University of Birmingham. “The bar is very high,” Moss says. “In many cases, the genetic material just isn’t there.”
Even if it is, many labs don’t have the time or money to clinch the case. As a result, the number of genetically proven reinfections is orders of magnitude lower than that of suspected reinfections. The Netherlands alone has 50 such cases, Brazil 95, Sweden 150, Mexico 285, and Qatar at least 243.
The Hong Kong patient’s second infection was milder than the first, which is what immunologists would expect, because the first infection typically generates some immunity. That may explain why reinfections are still relatively rare, says Maria Elena Bottazzi, a molecular virologist at Baylor College of Medicine and Texas Children’s Hospital.
They could become more common over the next couple of months if early cases begin to lose their immunity. Reinfections with the four coronaviruses that cause the common cold occur after an average of 12 months, a team led by virologist Lia van der Hoek at Amsterdam University Medical Center recently showed. Van der Hoek thinks COVID-19 may follow that pattern: “I think we’d better prepare for a wave of reinfections over the coming months.” That’s “bad news for those who still believe in herd immunity through natural infections,” she adds, and a worrisome sign for vaccines.
And there are hints that people who have serious COVID-19 mount the strongest responses, just as in the two other serious human diseases caused by coronaviruses, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome. Both trigger high antibody levels that last up to 2 years, and T cell responses to SARS can be detected even longer. Because of these persistent immune defenses, “I expect that most reinfections will be asymptomatic,” says Antonio Bertoletti, an infectious disease specialist at the National University of Singapore. He says being reinfected might even be a good thing, “since you will continue to boost and train your immune system.”
Not all reinfections seen so far are milder. “We see all different combinations,” Reusken says. The second time Luciana Ribeiro, a surgeon in Rio de Janeiro, got sick, it was much worse. She was first infected by a colleague in March, developed mild symptoms, and tested negative afterward. Three months later, Ribeiro had symptoms again—she could no longer smell her breakfast, she says—but she didn’t immediately get a test because she thought she was immune. When she grew more and more tired, she requested a computerized tomography scan. “It showed that half of my lungs were affected,” Ribeiro says. “‘This clearly is COVID,’ the radiologist told me. I didn’t believe it, but I tested positive.”
Ribeiro thinks she was reinfected by a patient in the intensive care unit where she works, and that her second episode may have been worse because virus-laden aerosols produced during a medical procedure entered her lungs. But she has another theory as well: “It could be that the virus has become more virulent in the meantime.”
So far, no proof exists of mutations that would make the virus more pathogenic or that might help the virus evade immunity. But a recent preprint by a team at the Swedish Medical Center in Seattle suggests one may exist. The team describes a person who was infected in March and reinfected 4 months later. The second virus had a mutation common in Europe that causes a slight change in the virus’ spike protein, which helps it break into human cells. Although symptoms were milder the second time, neutralization experiments showed antibodies elicited by the first virus did not work well against the second, the authors note, “which could have important implications for the success of vaccine programs.”
And some scientists worry about another scenario that could make the second episode worse: enhanced disease, in which a misfiring immune response to the first infection exacerbates the second one. In dengue fever, for example, antibodies to an initial infection can actually help dengue viruses of another serotype enter cells, leading to a more severe and sometimes fatal second infection. In some other diseases, the first infection triggers ineffective, nonneutralizing antibodies and T cells, hampering a more effective response the second time around.
A recent preprint published by Chinese researchers suggested patients whose first COVID-19 infection is very severe may have ineffective antibodies, which might make them more prone to severe reinfections. But so far there’s no evidence from reinfected patients to suggest enhanced disease is at work in COVID-19—although scientists haven’t ruled it out either. Vaccination against some diseases can also trigger enhancement later—a known or suspected complication of vaccines against dengue and respiratory syncytial virus in humans and a coronavirus disease in cats. But there is no evidence that candidate COVID-19 vaccines do so, Cummings says. “Having worked with dengue I can say the empirical basis for enhanced disease is just not there, while it was very strong in dengue.”
De Jong’s virus samples were both sequenced in Reusken’s lab, with a surprising outcome: The sequences were not identical, but showed so much similarity that RIVM virologist Harry Vennema says she probably did not clear the virus in April and that it started to replicate again in June. “I did have a lot of stress after that first episode because my grandmother died,” De Jong says. “Maybe that had an impact on my immune system.”
That makes her case different from a true reinfection—although Vennema says perhaps they should be considered similar, because in both cases the immune system failed to mount a protective response. His lab has found at least one similar case, he says, suggesting some unconfirmed reinfections might actually be a resurgence of the original virus.
Other coronaviruses can also cause persistent infections, says Stanley Perlman of the University of Iowa. In 2009, his team showed that an encephalitis-causing mouse coronavirus can linger in the body and continuously trigger immune responses, even if it doesn’t replicate. And in a preprint posted on 5 November, a team of U.S. scientists shows SARS-CoV-2 can persist for months inside the gut. Persistent infections, they suggest, may help explain the extraordinarily long-lasting symptoms that afflict some COVID-19 survivors.
De Jong is experiencing some of those symptoms. Although she tested negative in September and has high levels of neutralizing antibodies, suggesting she is protected for at least a couple of months, she still suffers from gastrointestinal complaints, fatigue, and cognitive impairment. De Jong says her story is a warning to people who had the virus and think they’re now invulnerable: “Please be cautious. You can get it again.”
This chart is suppose to be from the CDC. It indicates that only 9.2% of opiate OD’s are from pharma opiates, BUT – the title on the graph says “ILLICIT DRUGS”… so none of the OD’s from a pharma opiate alone the person DID NOT HAVE A RX FOR THE PHARMA OPIATE IN THEIR TOXICOLOGY ? There are ten columns and six columns indicated that illegal Fentanyl was found in toxicology – either the sole reason for the OD or in combination with other substances. Those percentages add up to at least 50% of all OD’s from this group of OD’s.
Two important years to note in this graph. 2012, reportedly the year that opiate Rxing peaked and 2016 the start of the CDC guidelines.
All the lines – except the > 65 y/o shows a sharp upturn.
From 2012 to 2017 all the values more than doubled.
Does this suggest that those >65/yo continued to get at least a moderate amount of pain medication ?
What we still don’t know – either because the CDC doesn’t have the data or doesn’t share the data, if these OD’s were accidental overdoses or SUICIDES ?
Does this also suggest that illegal Fentanyl started showing up on the street as “Heroin” or the street dealers were mixing in illegal Fentanyl to increase the available supply. Heroin has to be grown whereas illegal Fentanyl is chemical reactions and the only limits to the quantity that can be produced/obtained is obtaining the basic chemicals and space to “mix the chemicals and package the final product”.
It was claimed that Illegal Fentanyl was less expensive than Heroin and mg to mg it was at least TWELVE TIMES the potency.
Newton’s Third Law of Motion. It states, “For every action, there is an equal and opposite reaction”… so it would appear that for every action by the Federal/State bureaucracies to stop addiction and OD’s … DID JUST THE OPPOSITE
Robert Safian, MD, wrote system’s board about toxic culture, pursuit of profit over people
In ongoing drama at Michigan’s Beaumont Health system, one of its long-time cardiologists has sent two letters to its board calling for executives to be fired.
“The longer corporate leadership remains, the greater our decline,” Robert Safian, MD, wrote in one of the letters, which was obtained by local news site Deadline Detroit.
The letters come after healthcare workers and local leaders fought off a proposed merger between eight-hospital Beaumont and 26-hospital Advocate-Aurora. Executives called off the deal in early October, after many physicians opposed it and expressed a lack of confidence in corporate leadership via an internal survey.
In the letters, Safian requested the board terminate CEO John Fox as well as the system’s chief operating officer and chief medical officer. Safian said more than 100 “physician-leaders” at Beaumont’s Royal Oak hospital alone will make major changes to their practices this year, including relocating, “as a result of the toxic culture” at Beaumont.
“When hospital leadership cuts costs by cutting essential services, forcing physician leaders out of the institution, failing to support unique programs, bartering physician and nursing services to the lowest bidder, severely reducing supplies, mandating use of equipment against the will of physicians, and instituting any other ‘cost-saving’ strategies that are anti-patient, then leadership has crossed the line into fiscal irresponsibility (malfeasance?),” wrote Safian, who has been with Beaumont since 1991.
Noting executives and administrators accepted bonuses in March — including $2.6 million for Fox — Safian added: “And to use financial hardship as a justification for cuts, and then to receive financial incentives to make such cuts, is ethically and morally reprehensible.”
This year Beaumont has accepted a combined $866.9 million in CARES Act funds, including $363.1 million in grants that do not have to be paid back, according to Good Jobs First. Sources and reports say Beaumont also sits on more than $2 billion in reserves. (Beaumont did not list reserves in its most recent federal Form 990 tax filing, from 2018, and system representatives did not answer MedPage Today’s questions about them.)
Brian Berman, MD, Beaumont’s former pediatrics chief, was fired after he objected to Royal Oak emergency center cutbacks, according to Deadline Detroit. He was escorted out of the hospital in front of his staff.
Safian writes that an internal medicine and emergency room physician were also terminated for raising concerns. Kelly Levasseur, DO, who directed the pediatric ED, resigned because she lacked “confidence in corporate leadership.”
“Corporate leadership has created a culture of fear and intimidation, and many Beaumont workers, including physicians, have been ‘forced out’ after disagreeing with corporate decisions. This toxic culture has been progressively worsening over the last few years,” he wrote.
The urology department chair, 25 orthopedic surgeons, and a cardiology practice have sent letters to board chair John Lewis, a former Comerica executive, complaining about Beaumont executives.
Safian also asserted that more than 200 Beaumont nurse anesthetists were coerced into signing contracts with NorthStar, which Beaumont hired this year to replace its longtime independent anesthesia services provider. Meanwhile, dozens of anesthesiologists are leaving the system, he said.
The NorthStar decision “has upset the personal and professional careers of hundreds of Beaumont anesthesiologists and [nurse anesthetists], and has created a situation in which the quality of our specialty anesthesiology services in 2021 will be much lower than what we have experienced for the last 3 decades,” he wrote.
Safian could not be reached for comment this week, but he emailed MedPage Today when the Advocate-Aurora deal fell through on Oct. 2: “Merger is relatively minor in terms of imminent threat to the system.”
In calling for Beaumont executives to be removed, Safian echoed the sentiments expressed in a letter written by Mark Shaevsky, JD, a prominent local attorney and former board member, in August. “There’s been a lack of respect for professionals in the organization,” Shaevsky told MedPage Today then, with Fox aiming primarily to achieve a 4% operating margin despite Beaumont’s nonprofit status.
Fox’s employment contract with Beaumont was extended by two years beyond this year, he said during an August interview with a local publisher.
Beaumont is planning a time to discuss Safian’s first letter, according to a statement it provided to Becker’s Hospital Review last week, saying that the letter contains several errors.
A Beaumont spokesperson did not respond to MedPage Today’s request for comment on Tuesday.
I do not support nor encourage someone committing suicide …BUT…. before COVID-19 we had about 50,000/yr suicides and ONE MILLION ATTEMPTS and many claim that suicides have increased since COVID-19 came around in Feb/March.
I know that I am walking out on very far on a ethical limb… but read this entire post and see if you don’t agree with the logic behind it. Recently I made the post below and the title is linked back to the post
Out of those 50,000 suicides and one million attempts is there a suicide note left behind … which contains a statement as to who is to blame for this person for exercising the “final solution ” to get themselves out their unrelenting pain ?
Look at the chart on the above post of the adverse effects to the human body of under/untreated pain and look at the very last line “INCREASED THOUGHTS OF SUICIDE”.
Following the path that is outlined in the attached post to put those on notice that is involved in reducing/stopping a pt’s pain meds… doesn’t make any difference if it is a prescriber, insurance/PBM company, chain pharmacy if the pt suffers a stroke, heart attack, death or suicide… suicide in particular, could whoever is behind the decision to cut the pt pain meds.. could them be charged with assisting suicide, involuntary manslaughter or some similar charge… Insurance/PBM companies have medical directors and one would think that is where such policies of reducing pt’s pain meds would originate… and thus would they be the one who could be personally held responsible ?
Healthcare corporations have gotten away with cutting/stopping meds because they have no fear of retribution from pts. Putting these healthcare corporations ON NOTICE with a single certified letter from the pt’s attorney could start the ball rolling. If someone has committed suicide and left behind a suicide note who they blame..then the pt’s relatives should be able to go to the local prosecutor or state AG and have charges/arrest warrant on the individual who the pt claim was the reason behind the pt’s actions.
This path, the pt’s relatives will not need an attorney, nor have money to hire an attorney, This involves a CRIME… the state’s bureaucracy would do the “heavy lifting”
Has anyone noticed how much “whining” that Joe Biden has been doing because he is not being included in the COVID-19 vaccination process ?
By the time if/when he is swore into office there is probably going to be millions of doses of vaccine distributed and administered to the most vulnerable people. The WHOLE SYSTEM will be in place and functioning… WITHOUT HIS INPUT and what will he be left to TAKE CREDIT FOR… telling people to wear their masks, wash their hands and stay 6′ apart. According to this doctor, our country could to be four months away from NATIONAL HERD IMMUNITY by Jan 20th, 2021.
Joe is watching his opportunity to take credit for our society and economy getting back on its feet because Trump was finishing his “warp speed project” that he started and not letting Biden get into the middle of the project and try to tinker around with what appears to be a very successful program.
Operation Warp Speed projects 70% herd immunity, potential return to normalcy May 2021
Dr. Moncef Slaoui expects vaccines to start being distributed by mid-December
America might reach herd immunity from the coronavirus sometime around May, according to a timeline laid out by Operation Warp Speed‘s top science adviser.
Dr. Moncef Slaoui spoke with Jake Tapper during Sunday’s “State of the Union,” addressing the timeline for delivering vaccines developed by Moderna and Pfizer – each of which is pending approval.
An advisory panel is meeting Dec. 10 to determine whether or not to approve the vaccines. Should the panel grant approval, Slaoui said that the government will move fast to deliver the vaccines across the country.
Dr. Moncef Slaoui, chief adviser to Operation Warp Speed, speaks in the Rose Garden of the White House, Friday, Nov. 13, 2020, in Washington. (AP Photo/Evan Vucci)
“Our plan is to be able to ship vaccines to the immunization sites within 24 hours from the approval, so I would expect maybe on day two after approval, on the 11th or 12th of December,” Slaoui said.
When asked how long it may take to reach herd immunity, which would potentially allow for a return to normalcy, Slaoui confirmed that Operation Warp Speed determined it could distribute up to 20 million immunizations a month starting in December.
“Normally, with the level of efficacy we have – 95% – then 70% or so of the population being immunized would allow true herd immunity to take place,” Slaoui said. “That is likely to happen somewhere in the month of May, something like that, based on our plans.”
Operation Warp Speed will take its cues from state health departments to determine where the vaccines should go and who will receive the immunizations first.
Slaoui said the Center for Disease Control and Advisory Committee on Immunization Practice would meet to issue guidance as to who states should prioritize for vaccinations, but the final decision would be up to each state.
“But clearly the highest-risk people, front-line workers, essential workers should be among the first,” Slaoui said.
The key, though, will be to shift public perceptions about the safety and effectiveness of the vaccines. A recent Gallup poll found that only about 58% of people trust the vaccine enough to take it.
“I really hope and look forward to seeing the level of negative perception people have about the vaccine decrease and positive perception increase,” Slaoui said. “Most people need to be immunized before we can return to a normal life.”
In subsequent Sunday morning show appearance, Slaoui answered questions regarding the handoff between the Trump administration and the incoming Biden administration, with President-elect Joe Biden set to announce key cabinet appointments this coming week.
On ABC’s “This Week,” Slaoui confirmed that Operation Warp Speed has had no contact yet with anyone on the Biden transition team.
Talking with Chuck Todd on “Meet the Press,” Slaoui stressed that Operation Warp Speed has been separate from “the political environment,” and hopes that there is no disruption during the transition.
“My personal role, as you know, is that I have volunteered for this on a limited basis,” Slaoui said. “My personal agenda is that when we have two vaccines approved, and two medicines approved, and the rest of the portfolio we have in good hands, I’ll probably move back to my private life.”
“As you know, I’ve been highly supportive of the program, and if it means I’ll work with the new administration, I’ll be very happy to.”
