This Remote Patient Monitoring Startup Just Landed A $70 Million Series C

Health Recovery Solutions in action

hen Covid-19 cases began to soar around Ann Arbor in April, the University of Michigan Hospital reached 100% capacity. Like most hospitals, University of Michigan Hospital was not ready for the pandemic surge, but they did have a leg up.

That same month they’d coincidentally implemented Health Recovery Solutions’ remote patient monitoring, a patented technology system that records patient vitals via Bluetooth and connects them with their clinicians through video or instant messaging. This enabled the resource-strapped hospital to care for over 400 patients remotely throughout 2020.

Today, HRS announced it closed a $70 million series C led by LLR Partners with participation from existing investor Edison Partners, bringing the Hoboken, New Jersey-based startup’s total funding to $86 million. The news comes on the heels of a year of massive growth, which saw their head count balloon 258% to 155 employees and revenue grow by 188% to $23.5 million.

“People are choosing the proven remote-monitoring solution right now,” says Jarrett Bauer, HRS’ Forbes 30 Under 30 cofounder and CEO. “That’s one of the reasons why we’re doing so well—people are looking for the company that’s best.”

Bauer, now 34, was inspired to start by HRS by his grandma. Battling a heart condition, Bauer’s grandma was admitted to the hospital three times, resulting in over $14,000 of medical bills. While pursuing his M.B.A. at Johns Hopkins in 2012, Bauer began constructing an at-home hospital alternative that would eventually become HRS. “We didn’t know where to start,” Bauer told Forbes in 2019 when the company raised its $10 million series B. “We just knew it was a problem, and the best companies solve problems.”

With Covid-19, telehealth doctor appointments have become just doctor appointments, increasing 154% from March to October of 2020, according to the Centers for Disease Control. Rather than cut into HRS’ margins, the telehealth boom has helped HRS soar. The healthcare company has deals with over 220 U.S. healthcare systems—74 of which signed on as clients of HRS during the pandemic—with over 20,000 nurses checking HRS logs every day.

“We consider Health Recovery Solutions the Cadillac model,” says Brandy Knudson, Michigan Medicine’s Telehealth Project Manager. “It fills a huge gap for us because we want to reduce readmissions and reduce unnecessary trips to the hospital.”

The company makes money by billing clinical institutions on subscription to integrate their solutions in treatment, coming at no additional cost to patients. HRS recognizes the varying levels of sickness and technological ability of patients, so the company’s products range from a pulse oximeter for the sickest, while near-recovered patients can manually enter symptoms on HRS’ smartphone app.

All of this patient data is stored in a cloud for clinicians, making it easier to recognize prognosis patterns and health trends. By implementing HRS, major healthcare systems like Penn Medicine have reduced 30-day readmission by over 50% for all heart failure patients, while FirstHealth of the Carolinas says the technology has saved patients more than $1.9 million since its implementation in 2016.

“Patients are looking to stay in their homes longer, get care in their homes longer, and there’s an increasing prevalence of chronic conditions,” says Sasank Aleti, a partner at Philadelphia-based private equity firm LLR Partners. “HRS met our criteria of taking costs out of the system, driving better outcomes and a better patient experience.”

For Bauer, the future of HRS lies in universalizing hospital-from-home treatment. With the $70 million round, the company plans to more than double head count in 2021 to 250 employees with the goal of being able to treat over a million patients by adding new healthcare providers and upping their disease module count (they currently treat 90 diseases). “Why aren’t we like Google? Why aren’t we like Apple?” asks Bauer. “We’re playing to win—to be that.”

I’m the Under 30 Editorial Community Lead at Forbes. Previously, I directed marketing at a mobile app startup. I’ve also worked at The New York Times and New York Observer. I attended the University of Pennsylvania where I studied English and creative writing. Follow me on Instagram and Twitter at @iamsternlicht.

Source: This Remote Patient Monitoring Startup Just Landed A $70 Million Series C

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The coronavirus pandemic has overwhelmed hospitals, physicians and the medical community. That’s pushed telemedicine into the hands of providers and patients as the first response for primary care. Telemedicine isn’t new to the medical community, however it hasn’t been embraced due to insurance coverage, mindset and stigma. Here’s how it works and what it means for the future of health care. » Subscribe to CNBC: https://cnb.cx/SubscribeCNBC » Subscribe to CNBC TV: https://cnb.cx/SubscribeCNBCtelevision » Subscribe to CNBC Classic: https://cnb.cx/SubscribeCNBCclassic
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Mammograms Pick Up Swelling Related To The Covid-19 Vaccine Study Says

When she found a lump in her left breast during a routine self-check, Boston primary care physician Dr. Devon Quasha knew exactly what to do. She immediately scheduled a diagnostic mammogram and ultrasound at Massachusetts General Hospital for early January.

Quasha didn’t notice much of a reaction to the vaccine at first, but a couple of days before her appointment her left arm began to hurt.
Tender, swollen lumps developed under her left armpit, along with a large swelling above her collarbone — all areas where there are lymph nodes, the body’s filters for germs.
“You have lymph nodes above and below your collarbone,” Quasha said. “You don’t want to feel those. It was scary when I felt it.”
Lymph nodes contain immune cells that help fight invaders. That’s why it made sense to Quasha that the nodes were reacting to the vaccine, building antibodies as they were designed to do. But she couldn’t be sure.
The swelling was only on the left side where she had gotten the shot — the same side as the worrisome lump. Was it a reaction to the vaccine or another sign of breast cancer?

‘It was like a wildfire’

After the ultrasound, Quasha’s radiologist was concerned. She told Quasha she considered the lump she had felt in her breast to be of little significance, but the lymph nodes that showed up as white blobs on her mammogram were another matter. In non-pandemic times, that finding would set off alarm bells, requiring the need for further investigation, even an immediate biopsy.
Yet Quasha had just had the vaccine. After talking it over with her, Quasha said her doctor decided not to do a biopsy at that time. Instead she told Quasha to come back for a follow-up ultrasound in six weeks.

“I cannot tell you how many women are showing nodes on mammograms and people thought it was going to be not that common,” said Lehman, who is also a professor of radiology at Harvard Medical School.
Tales of unnecessary biopsies spurred the patient care committee of the Society of Breast Imaging (SBI) to put out an advisory in January: Ask your patients about their Covid-19 status, and record the date and which arm received the vaccine. Consider that before automatically scheduling a biopsy.
“We wanted to advocate that women don’t always need to have a biopsy,” said Dr. Lars Grimm, associate professor of radiology at Duke University School of Medicine and one of the authors of the SBI advisory. “Because oftentimes the default if you see swollen lymph nodes in a patient would actually be to recommend doing a biopsy.”
Mass General’s Lehman agreed. “When you hear hoofbeats, don’t think zebra,” she said. “If a woman had a vaccine in the arm on the same side, and the lymph nodes are swollen, this is a normal biological response. It’s totally expected. It just doesn’t make sense to start imaging.”
That does not mean that women who wish to be sure about their cancer status cannot have a biopsy, Grimm stressed. “You actually have some women who want to biopsy,” he said. “You might tell them, ‘Hey, I think this is due to your Covid vaccine, and I’m sure that it’s going to resolve in a few weeks on its own and you’re going to be fine.’ But that patient tells you, ‘I’m not going to be comfortable waiting, I want to know now.’ “

Focus on screening to save lives

For Quasha, the knowledge that many women were experiencing the same type of reaction to the vaccine was a welcome relief from worry. After a discussion with her doctor, she said she no longer needs the follow-up screening. “I was very reassured,” Quasha said. “The point here is that there are a number of side effects from the vaccine which are not dangerous but can sometimes increase patient anxiety.”
Instead of bringing women back in for an unnecessary ultrasound, radiology centers should be focused on scheduling women who have missed or are overdue on their mammogram, Lehman said.
“We need to take care of the large percentage of women who didn’t get screened because of the shutdowns during Covid,” she said. “At Mass General alone, we failed to screen 15,000 women because of Covid, and we’re still trying to get them back in.
“This isn’t where I need to start doing axillary ultrasounds, because someone had a vaccine and the node swelled. It’s just not being practical or pragmatic or putting our patient’s needs first,” she said. It’s not just breast cancer, Lehman stressed. Lymph nodes in other parts of the body are also reacting to the Covid-19 vaccines, causing people with other forms of cancer to undergo unnecessary procedures.
“There have been some false scares and some unnecessary biopsies because people didn’t think to ask, and they assume that the node was the cancer coming back,” she said.

What to do?

To avoid unnecessary worry, SBI recommends women schedule any routine, annual breast screening before getting the Covid-19 vaccine. If a woman has already had the vaccine, or is soon scheduled to do so, the society suggests waiting at least four to six weeks after the second dose before scheduling your appointment.
At Mass General, Lehman and her team have gone a step further. They are screening all women regardless of vaccine status, but telling those with no history of cancer that any swelling in the lymph nodes that might be connected to a Covid-19 vaccine is benign — meaning not cancerous.
“This follows the American College of Radiology recommendations that if you have a known inflammatory cause you can say it’s benign,” said Lehman, who recently published a paper on the hospital’s procedures.
“If their concern is a swelling or tenderness after the vaccine in their armpit, we suggest that they wait four to six weeks, talk to their doctor, and if it persists, then we have them come in to do an evaluation of it,” she said.
Whatever you do, experts stress, don’t skip getting your breast cancer screening when it is recommended. A study published Tuesday in the journal Radiology that followed over half a million women made the point clearly: Women who skip even one scheduled mammography screening before they are diagnosed with breast cancer have a significantly higher risk of dying. In fact, the risk of having a fatal breast cancer within 10 years of diagnosis was 50% lower for women who had regular breast screenings, the study said.

By: 

Source: Mammograms pick up swelling related to the Covid-19 vaccine, study says – CNN

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Researchers Warn of Heightened Risk of HIV With Certain COVID-19 Vaccines

As the race to approval of a safe and effective vaccine for coronavirus disease 2019 (COVID-19) continues, a group of researchers is warning some of these vaccines could make patients more susceptible to contracting HIV.

Writing in The Lancet, the researchers are urging caution when it comes to the use of adenovirus type-5 (Ad5) vectored vaccines for COVID-19, recalling their research from a decade ago on an Ad5 vectored vaccine in 2 HIV vaccine trials.

“On the basis of these findings, we are concerned that use of an Ad5 vector for immunisation against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could similarly increase the risk of HIV-1 acquisition among men who receive the vaccine,” wrote the researchers. “Both the HIV and COVID-19 pandemics disproportionately affect vulnerable populations globally. Roll-out of an effective SARS-CoV-2 vaccine globally could be given to populations at risk of HIV infection, which could potentially increase their risk of HIV-1 acquisition.”

There are several clinical trials assessing Ad5 vectored vaccine candidates underway, including by China’s CanSino Biologics and California-based ImmunityBio.

The group’s ”cautionary tale” stems from the Step and Phambili phase 2b trials that studied the efficacy of an Ad5 vectored HIV-1 vaccine in preventing HIV infection. Across both international studies, they found that the vaccine actually increased the risk of HIV among the vaccinated men.

The findings from the Phambili study, in particular, have important implications for the use of the vaccines in COVID-19, according to the researchers, as findings from this study showed that heterosexual men receiving the Ad5 vectored vaccine faced a consistently increased risk of HIV infection. Notably, this increased risk appeared to be limited to men, with women not having an observed increase of infection in the study.

In the Step trial, the risk of acquiring HIV was particularly high among men who were uncircumcised and Ad5 seropositive men who reported having unprotected anal sex with a partner who was HIV seropositive or who had unknown serostatus as baseline.

Of note, the vaccine in both studies did not have the HIV envelope. Meanwhile, in another study that used a DNA prime and an Ad5 vector, both of which had the HIV envelope, there was no observed increase in HIV infection.

The reason for the observed increase in HIV risk remains uncertain, although several follow-up studies have suggested a potential explanation, according to the researchers.

“The vaccine was highly immunogenic in the induction of HIV-specific CD4 and CD8 T cells; however, there was no difference in the frequency of T-cell responses after vaccination in men who did and did not later become infected with HIV in the Step Study,” they wrote. “These findings suggest that immune responses induced by the HIV-specific vaccine were not the mechanism of increased acquisition.

Participants with high frequencies of preimmunisation Ad5-specific T cells were associated with a decreased magnitude of HIV-specific CD4 responses and recipients of the vaccine had a decreased breadth of HIV-specific CD8 responses, suggesting that pre-existing Ad5 immunity might dampen desired vaccine-induced responses.”

Other exploratory studies have indicated that the vaccine enhances HIV replication in CD4 T cells or that Ad5-specific CD4 T cells could be more susceptible to HIV infection.

Jaime Rosenberg

Reference

Buchbinder SP, McElrath MJ, Dieffenback C, Corey L. Use of adenovirus type-5 vectored vaccines: a cautionary tale. Lancet. Published online October 19, 2020.doi:10.1016/S0140-6736(20)32156-5

Source: http://ajmc.com

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ENewsTrends

A new paper warns the link between COVID-19 vaccines and HIV risk.

Mayo Clinic

Nearly half of people in the U.S. diagnosed with HIV, the virus that causes AIDS, are over 50, according to the Centers for Disease Control and Prevention (CDC). HIV damages the body’s immune system, and interferes with the body’s ability to fight infection and disease. Does that make it more difficult to fight off COVID-19? Dr. Stacey Rizza, an infectious diseases specialist at Mayo Clinic, says, “We know that anybody who has a suppressed immune system may have an altered response to the virus that causes COVID-19. We know that older people whose immune systems are a little weaker, and people who have medical issues or organ diseases, are going to generally do worse with the infection.

If somebody has HIV and their immune system is weaker, meaning they’re not on therapy, or they’re earlier on in their therapy and their CD4 count is still low, they may be at risk of having a worse reaction to the virus. We will learn more about SARS-CoV-2 on people living with HIV over time.” Read more: https://newsnetwork.mayoclinic.org/di… More health and medical news on the Mayo Clinic News Network. https://newsnetwork.mayoclinic.org/ Journalists: Clean and nat sound versions of this pkg available for download at https://newsnetwork.mayoclinic.org/ Register (free) at https://newsnetwork.mayoclinic.org/re…

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4 Reasons Your Practice Needs a Virtual Waiting Room

Technology has accelerated changes in healthcare as a result of the public health crisis, offering patients convenient and safe ways to stay connected to their doctors. Telehealth, for example, allows patients to attend doctor appointments via video technology which ensures a face-to-face interaction while enabling both patients and providers to attend the appointment in the privacy and security of their own environments. Now, in addition to telehealth visits, virtual waiting rooms have emerged as a way to help patients continue to socially distance through the check-in process before attending a visit in person or online.

What is a virtual waiting room?

A virtual waiting room is a remote way for patients to:

  • Check-in for appointments (in-person and virtual visits)
  • Complete necessary paperwork digitally
  • Receive instructions and safety protocols for in-person visits
  • Be notified of when and where to go once their doctor is ready to see them in the exam room

A virtual waiting room can be deployed in just about any kind of medical setting, giving patients the option to check-in for their appointment or a visit to the emergency room while remaining in their car until their provider is ready to see them. This reduces the amount of time patients spend around others inside the office, thereby minimizing the chances that they’ll infect others or be infected by COVID-19. Virtual waiting rooms can also be used for telehealth visits to guide the registration process and notify patients when providers are ready to initiate the visit.

There’s a variety of ways to implement a virtual waiting room solution, from using HIPAA compliant texting and chatbots to other technology that can facilitate the remote check-in process. In many cases, patients can join a virtual waiting room after receiving a link via text message. After completing any necessary digital forms online, patients are placed in a virtual queue and alerted in real-time when the doctor is ready to see them. This offers many benefits for patients seeking care at any kind of specialty clinic, hospital, or primary care office.

Reasons why you need a virtual waiting room.

1. Contactless patient registration improves COVID-19 infection control.

Using a virtual waiting room allows your patients to bypass face-to-face registration which reduces contact with staff and other patients. Because COVID-19 is spread through respiratory droplets passed through the air after a cough, sneeze, or other forceful expressions, the only way to eliminate the risk of spread is to avoid contact altogether with others. By employing a remote patient registration process using digital forms or a chatbot, medical practices can still collect the information they need and offer any support patients need while filling out forms without coming into close contact.

2. Virtual waiting rooms offer a patient-friendly experience in a comfortable environment.

The traditional waiting room experience is often frustrating and inconvenient if you think about it. Whether or not you’re sick, the waiting room is often full of people with runny noses, coughs, and crying children who are also waiting to be seen which means it’s noisy, overwhelming, and a little bit awkward. When doctors fall behind, these noises seem to multiply as every minute waiting feels like a minute lost that could have otherwise been better spent.

In contrast, virtual waiting rooms allow patients who are waiting to see their doctor in person remain in their own vehicle where they can control the temperature and noise. As they wait, they can do what they’d like with the time they have whether that’s reading a book, working on their laptop, or FaceTiming a friend. And, a virtual queue keeps them updated on how much longer they have to wait so they’re never left wondering.

For patients using telehealth visits, your staff can still capture the required information and payment virtually using waiting room solutions. Meanwhile, patients register and wait for their appointment in the comfort of their own home where they’re relaxed, socially distanced, and maybe even surrounded by a supportive family. And, patients can spend their time how they wish in a “virtual parking lot” until their provider is ready to initiate the video visit.

3. It’s easier to maintain privacy and security.

If you think back to the traditional waiting room set-up, it can be challenging to maintain a sense of privacy, especially if you’re filling out paper registration forms with nearby patients looking over your shoulder. Waiting solutions eliminate this problem while collecting private health data using HIPAA compliant technology that helps providers understand the patient’s health condition without compromising security. And, patients don’t need to remember patient portal passwords or clunky app logins to “show-up” in the waiting room. Instead, they simply confirm their identity using two-step authentication via a direct link to their phone number.

4. The entire process can be automated, saving you practice precious resources.

The best part about remote check-in is that your practice can establish automated workflows from appointment reminders to patient check-in. This frees up your staff to focus on the tasks in front of them. Text messages can be created using customizable templates that pull relevant patient data, such as their appointment date and time, while repurposing language that guides patients through the process. You can still establish ways for patients to seek extra support, such as by texting “HELP” back to the office to solicit a phone call from the staff. But, the simple step of automation can greatly speed up the registration process while capturing and syncing patient information digitally into their medical record without the manual effort.

Do you need help launching a virtual waiting room at your practice? Contact us today for a free demo.

By: ProviderTech

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LifeLink

Virtualizing the waiting room experience will be key as healthcare providers get back to business.

UK Trials Antibody Cocktail That Could Halt Covid Outbreaks In Care Homes & On Cruise Ships

An antibody cocktail that gives immediate protection against coronavirus and could bring outbreaks on cruise ships and in care homes to a halt is being trialled in Britain.

The treatment has been developed by pharmaceutical giant AstraZeneca from Covid-fighting antibodies found in the blood of a patient who survived the virus.

With a vaccine, the body takes around six weeks to develop immunity after an injection. With the cocktail, it is thought that the antibodies are able to fight off the virus immediately and may last for a year before needing to be replenished. 

The Government hopes the treatment could protect hundreds of thousands of people who cannot be vaccinated because their immune systems are compromised.

It could also be used to prevent vulnerable patients from catching Covid in hospitals and care homes, or be issued quickly to cruise ship passengers and crew should a traveller be diagnosed with the virus.

The first trial participant is due to be given the drug at North Manchester General Hospital on Saturday, and results are expected in the spring.

Describing how the drug could be used, Sir Mene Pangalos, an executive vice president at AstraZeneca, said: “So imagine a cruise ship that has an outbreak where half the people have been vaccinated and half haven’t because of access to the vaccine. You’d be able to go and immunize the whole cruise ship with this antibody and everyone will be protected straight away.

“Or where there has been a case confirmed in a care home, you will go and immunize everybody in the care home to protect them from progressing on with the disease, or in a hospital or a school. Or someone comes to the doctor or hospital with confirmed Covid disease and symptoms, and we treat them with the antibody and then they go home and we hopefully stop them getting sicker. 

“There’s also going to be a significant number of people, even in a world where vaccines are highly effective, who will not respond to vaccines, or will not take vaccines, and so having potential therapeutics I think it is important.”

Kate Bingham, who chairs the Government’s Vaccine Taskforce, said the antibody cocktail could also be used to give front line workers immediate protection, adding: “It will work instantly, so there may be examples of the military or healthcare workers or people that need immediate protection, and you could use this antibody cocktail, as opposed to waiting. This is part of the portfolio to protect the whole UK.”

The team at AstraZeneca screened thousands of antibodies to find the most effective at fighting coronavirus, and eventually used two types from a Covid survivor who had an extremely potent immune response.

However, the antibody cocktail will not be rolled out to a large proportion of the population because it is far more expensive and difficult to make than vaccines. While a vaccine costs just a few pounds, a dose of antibodies can cost hundreds of pounds.

But there are around 350,000 people in Britain who are unable to be vaccinated so, if successful, they are likely to be offered the treatment.

Phase Three trials on 1,000 volunteers are taking place at nine sites across Britain, but the team is planning to recruit a further 4,000 participants globally, and researchers are urgently calling on more people to volunteer. 

Sir Mene also said the Oxford vaccine team was still “on track” to have final results before Christmas, adding: “We’re still hoping we might be able to dose, if we show the vaccine is safe and effective, towards the end of the year.

“We’re not going to be able to vaccinate the whole population of the UK immediately. There is a large group of people who will have to wait a while to receive the vaccination.”

By Sarah Knapton

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LiveScience

The new COVID-19 drug called REGN-COV2 contains two antibodies shown to help neutralize the virus. Read about the possible #COVID-19 treatment: https://www.livescience.com/antibody-… Science News • Videos • Explainers SUBSCRIBE to the Live Science YouTube channel → http://www.shorturl.at/fzCV5 Twitter→ https://twitter.com/LiveScience Facebook→ https://www.facebook.com/livescience Instagram→ https://www.instagram.com/live_science/ For the science geek in everyone, LiveScience.com breaks down the stories behind the most interesting news and photos on the Internet, while also digging up fascinating discoveries that hit on a broad range of fields, from dinosaurs and archaeology to wacky physics and astronomy to health and human history. If you want to learn something interesting every day, #LiveScience is the place for you.

Why Scientists & Public Health Officials Need To Address Vaccine Mistrust Instead of Dismissing it

Recent polls indicate that more than a third of the country has concerns about a vaccine that in all likelihood will be the only reliable way to end to the COVID-19 pandemic.

These results reflect a similar public sentiment in the U.S. in the 1950s when a polio vaccine was introduced. There are likely multiple reasons for this suspicion, including safety concerns, lack of transparency from the scientific community, lack of trust in the government and the desire to wait until a longer track record of safety can be established.

We are experts in media literacy, health and political communication and biostatistics and biomedical research for future health care providers, from Washington State University’s Edward R. Murrow Center for Media & Health Promotion Research and the Elson S. Floyd College of Medicine. We also live in the communities we hope to serve with our science.

Based on our research, we believe that officials need to use this testing period to build trust, not to create reasons for diminishing it. Respect and forthrightness can turn the tone from adversarial to collaborative, and from a provider-directed practice to a shared decision-making process. Scientists and public health officials must anticipate and address people’s concerns and not brush aside concerns, a process that has become commonplace across other areas of the provider-patient relationship, but vaccine decisions remain a notable exception.

Vaccines and complications

Vaccines are among the safest, most transformative drugs on Earth, with adverse events so low that very nearly universal vaccination is a reasonable expectation. With such a safety record, and with so much at risk with diseases like COVID-19, measles and influenza, vaccine advocates have good reason to stress the overwhelmingly positive safety record.

History has included some vaccines of questionable quality as well as vaccination tactics of even more concern. Certain minority groups have been targeted with egregious coercion. This included cases of forced vaccination for smallpox of African Americans at gunpoint in the southern United States in the early 1900s. At a tenement house in Manhattan’s Little Italy, over 200 men in 1901 in essence performed a smallpox vaccination raid in the middle of the night, trying to vaccinate as many people as they could.

When the miracle vaccine for polio was widely distributed in 1955, speed took precedent over safety, and many doses were distributed that contained live polio virus. As a result, 70,000 children developed muscle weakness, 164 were paralyzed permanently and 10 children died. This led to direct government intervention that has led to thousands of required tests in order to ensure safety and effectiveness.

Why can’t vaccines bounce back from mistakes?

As medical and public health researchers, we have found it interesting that corporations that have been lax and dishonest have bounced back without lasting damage to their reputations. For example, Volkswagen was caught in 2014 for outright lying to the public about their emissions. By 2019, the company topped its prescandal sales record of 2014.

We accept these occasionally fatal flaws and ethical missteps because cars are essential to our lives. The documented safety record of vaccines is staggering, not unlike the impressive safety record boasted by most automobiles on the road today.

Why do vaccines get special scrutiny? Have scientists and health care providers engaged in scientific snobbery by assuming people should do what we advise, without question or any decision-making process? Can scientists and health care providers communicate the good and positive (and bad) background of vaccines better? Has social media sown doubt in an authority that can be perceived to be overconfident? Personal health care decisions have a lasting impact on our kids and our families, so let’s rise to the occasion and utilize this unique opportunity to reframe the conversation about vaccines.

Embrace shared decision-making

The existence of a little-known but critical government office both acknowledges past problems with some vaccines and also provides a method of recourse for those injured by vaccines. The National Vaccine Injury Compensation Program, launched in the 1980s, is a powerful tool for transparency and accountability that should help shape this important, shared decision-making process. For example, between 2006 and 2018 over 3.7 billion doses of covered vaccines were distributed in the U.S. During this same period, 5,233 filed petitions to this office were compensated out of a total of 7,482 petitions. This means that for every 1 million vaccine doses distributed, one individual received compensation.

Rather than brushing off concerns among parents and others who are concerned about safety, experts should listen. When they do talk, they should explain safety issues and should use metaphors such as the safety of vehicles and other medical breakthroughs (e.g., insulin, heart valve surgery) so often relied upon in an effort to work toward the same goal together as a country, and as health care provider and patient.

Experts should acknowledge that the practice of medicine and public health research is a relatively new field of science to drive public health, medical practice advancement and policies when compared to other, far more established scientific disciplines such as physics or chemistry. Building public support requires more than citing solid evidence in the peer-reviewed scientific literature. Owning up to setbacks in vaccine development that the current administration may be on the brink of repeating – and then making the necessary repairs to move forward again, as the auto manufacturers do – also builds confidence. AstraZeneca’s public announcement about a serious adverse event in one of their trials, which led to a pause of participant enrollment, was a great first step.

Let’s begin by acknowledging that all parties want to achieve the same end goal of a healthy, safe return to daily life. Despite the explosion of misinformation about COVID-19, a clear, consistent and respectful approach can reset the vaccine conversation.

[Deep knowledge, daily. Sign up for The Conversation’s newsletter.]

Next, let’s acknowledge that vaccines are not now and have not been 100% perfect (nor is any medicine or car). We should also note that the same science that produces vaccines also produces myriad breakthroughs in specialties such as cardiology and oncology, along with over-the-counter medications such as ibuprofen that mitigate minor ailments but also have limitations and warning labels.

Finally, invite skeptics to a conversation and acknowledge up front that, like any other scientific advancement of things that now work, there was a time when they didn’t work as well, or at all.

Instances like these undoubtedly fuel people’s concerns. Such occurrences should give us all pause, scientist or not, to do better next time and strive to never repeat such notable grievances.

By: Sterling M. McPherson/ Associate Professor, Director and Assistant Dean for Research, Washington State University

Erica Weintraub Austin/ Professor and Director, Edward R. Murrow Center for Media & Health Promotion Research, Washington State University

Porismita Borah/Associate Professor, health communication, Washington State University

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CBC News: The National

Misinformation about vaccines have public health officials in Canada looking for guidance on how to combat medical mistrust. As CBC’s Katie Nicholson reports, the answers they are looking for might be half a world away. »»» Subscribe to The National to watch more videos here: https://www.youtube.com/user/CBCTheNa… Voice Your Opinion & Connect With Us Online: The National Updates on Facebook: https://www.facebook.com/thenational The National Updates on Twitter: https://twitter.com/CBCTheNational »»» »»» »»» »»» »»» The National is CBC Television’s flagship news program. Airing six days a week, the show delivers news, feature documentaries and analysis from some of Canada’s leading journalists.

FDA Approves Remdesivir For Covid-19 Treatment

The Food and Drug Administration on Thursday approved remdesivir as a treatment for hospitalized coronavirus patients, Gilead Sciences said, making it the first FDA-approved drug for Covid-19.

Key Facts

The drug was previously granted an emergency use authorization in May, which allowed healthcare providers to administer the treatment even though it wasn’t formally approved by the FDA.

Remdesivir, which is sold under the brand name Veklury, “should only be administered in a hospital or in a healthcare setting capable of providing acute care comparable to inpatient hospital care,” Gilead said.

The drug is approved for adults and children 12 and older weighing at least 88 lbs. for coronavirus treatment requiring hospitalization.

Clinical trial data has been mixed: A randomized trial from the National Institute of Allergy and Infectious Diseases found remdesivir improved recovery time, but a study from the World Health Organization, which has not yet been peer reviewed, found last week the drug did not increase the chances of survival or result in faster recovery.

Gilead shares jumped 3.8% in after hours trading following the announcement. 

Crucial Quote

“It is incredible to be in the position today, less than one year since the earliest case reports of the disease now known as COVID-19, of having an FDA-approved treatment in the U.S. that is available for all appropriate patients in need,” said Gilead CEO Daniel O’Day in a statement.

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Key Background

President Donald Trump took remdesivir when being treated for the coronavirus earlier this month. Follow me on Twitter. Send me a secure tipRachel SandlerI’m a San Francisco-based reporter covering breaking news at Forbes. I’ve previously reported for USA Today, Business Insider, The San Francisco Business Times and San Jose Inside. I studied journalism at Syracuse University’s S.I. Newhouse School of Public Communications and was an editor at The Daily Orange, the university’s independent student newspaper. Follow me on Twitter @rachsandl or shoot me an email rsandler@forbes.com.

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Remdesivir is a prodrug of an adenosine triphosphate (ATP) analog, with potential antiviral activity against a variety of RNA viruses. Upon administration, remdesivir, being a prodrug, is metabolized into its active form GS-441524. As an ATP analog, GS-441524 competes with ATP for incorporation into RNA and inhibits the action of viral RNA-dependent RNA polymerase. This results in the termination of RNA transcription and decreases viral RNA production.

Remdesivir has an FDA Emergency Use Authorization for use in adults and children with suspected or confirmed COVID-19 in hospital with an SpO2 ≤94%.[L13239] This is not the same as an FDA approval.[L12609] The FDA Emergency Use Authorization suggests a loading dose of 200mg once daily in patients ≥ 40 kg or 5 mg/kg once daily in patients 3.5 kg to less than 40 kg, followed by a maintenance dose of 100mg once daily in patients ≥ 40 kg or 2.5 mg/kg once daily in patients 3.5 kg to less than 40 kg.[L13239] Patients not needing invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO) should be treated for 5 days (including the loading dose on day 1), up to 10 days if they do not show improvement.[L13239] Patients requiring invasive mechanical ventilation or ECMO should be treated for 10 days.[L13239]

Clinical trials used a regimen of 200mg once daily on the first day, followed by 100mg once daily for another 9 days.[A191931,L12174,L12177] Early data suggests that some patients may benefit from only 5 days of treatment.[A198810] Remdesivir was originally investigated as a treatment for Ebola virus, but has potential to treat a variety of RNA viruses.[A191379] Its activity against the coronavirus (CoV) family of viruses, such as SARS-CoV and MERS-CoV, was described in 2017,[A191382] and it is also being investigated as a potential treatment for SARS-CoV-2 infections.[A191427,A193254]

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CNBC Television 1M subscribers The FDA has approved Gilead’s Remdesivir as a Covid-19 treatment. Previously, the drug was approved only for emergency authorization. Gilead stock was up 4 percent after the news. Meg Tirrell joins ‘Closing Bell’ to discuss. For access to live and exclusive video from CNBC subscribe to CNBC PRO: https://cnb.cx/2NGeIvi » Subscribe to CNBC TV: https://cnb.cx/SubscribeCNBCtelevision » Subscribe to CNBC: https://cnb.cx/SubscribeCNBC » Subscribe to CNBC Classic: https://cnb.cx/SubscribeCNBCclassic Turn to CNBC TV for the latest stock market news and analysis. From market futures to live price updates CNBC is the leader in business news worldwide. The News with Shepard Smith is CNBC’s daily news podcast providing deep, non-partisan coverage and perspective on the day’s most important stories. Available to listen by 8:30pm ET / 5:30pm PT daily beginning September 30: https://www.cnbc.com/2020/09/29/the-n… Connect with CNBC News Online Get the latest news: http://www.cnbc.com/ Follow CNBC on LinkedIn: https://cnb.cx/LinkedInCNBC Follow CNBC News on Facebook: https://cnb.cx/LikeCNBC Follow CNBC News on Twitter: https://cnb.cx/FollowCNBC Follow CNBC News on Instagram: https://cnb.cx/InstagramCNBChttps://www.cnbc.com/select/best-cred…#CNBC

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Is Melatonin Safe to Take Every Night

Americans aren’t sleeping well. Roughly 80% of U.S. adults say they struggle to fall asleep at least one night a week, according to a recent Consumer Reports survey. And research has found that sleep problems are also on the rise among adolescents.

While the causes of America’s sleep woes are up for debate, there’s little disagreement about America’s favorite remedy: Melatonin, by far the country’s most-used sleep aid.

What is Melatonin?

Melatonin is a hormone that plants and animals, including humans, produce naturally. The melatonin sold in over-the-counter pills is synthetic, but chemically it’s the same as the stuff the human body makes. It can, if used properly, help certain problem sleepers get to bed at night. Melatonin hormone secreted by pineal gland (red) at night, regulates body’s daily biological rhythm depending on luminosity as light regulates its secretion via a path involving the suprachiasmatic nucleus (green), the paraventricular nucleus (yellow) and the preganglionic sympathetic neurons. BSIP/Universal Images Group via Getty

Research has also shown it can help combat inflammation, promote weight loss, and maybe even help children with neurodevelopmental disorders. That’s a lot to claim, though there are some studies to back up the various benefits. One 2011 review found evidence that, in children with autism, melatonin supplementation led to improved sleep and better daytime behavior. A small 2017 study from Poland found that obese adults who took a daily 10 mg melatonin supplement for 30 days while eating a reduced-calorie diet lost almost twice as much weight as a placebo group. The underlying cause might be connected to the fact that blood measures of oxidative damage and inflammation were much lower in the people who took melatonin.

“Some of the emerging science is showing that in people with higher levels of inflammation—which could be because they’re obese, or because they’re in the [intensive care unit] for a transplant—melatonin in the range of 6 mg to 10 mg may decrease markers of inflammation,” says Helen Burgess, a professor of psychiatry and co-director of the Sleep and Circadian Research Laboratory at the University of Michigan. If someone is healthy, it’s not clear that high-dose melatonin has a similar anti-inflammation effect, she adds. But it’s possible.

Burgess is one of the country’s foremost melatonin researchers. She says that the traditional view of melatonin is that it plays a role in regulating the body’s internal day-night clocks, which is why it can help people sleep. “But there’s a theory that melatonin’s original purpose was as an antioxidant, which is what it does in plants,” she says. This alternative theory holds that it was only later in human evolution that melatonin took on a secondary role as a biological clock-setter.

Inflammation, like poor sleep, is implicated in the development or progression of an array of diseases, from heart disease and diabetes to depression and dementia. If melatonin could safely promote both better sleep and lower rates of inflammation, it could be a potent preventative for a lot of those ills. And melatonin appears to be safe—though there isn’t much research on the long-term effects of taking it in heavy doses.

What is a safe melatonin dose?

According to Michael Grandner, director of the Sleep and Health Research Program at the University of Arizona, “melatonin is very safe if taken in normal doses,” which is anything between 0.5 mg and 5 mg.

A 0.5 mg dose may be all that’s needed for sleep-cycle regulation, and should be taken three to five hours before bed, he says. For people who want to take melatonin just before bed, a 5 mg dose is appropriate. “Some people report headaches or stomach problems at higher doses, but those side-effects are uncommon,” he says.

Still, there are other concerns. “Melatonin has an incredible safety record, no doubt about it,” says Dr. Mark Moyad, the Jenkins/Pomkempner director of preventive and alternative medicine at the University of Michigan. “But it’s a hormone, and you don’t want to mess around with hormones until you know what they’re doing.”

People with existing medical problems should discuss melatonin with their doctor before using it. While some research has found that melatonin may help treat hyperglycemia in people with diabetes, for example, other studies have shown that, in diabetes patients who carry certain genetic traits, melatonin may interfere with glucose regulation. It’s these sorts of contradictory findings that give experts pause when it comes to issuing melatonin a full-throated endorsement.

“My advice is always to treat supplements like drugs, meaning don’t take a pill unless you need a pill,” Moyad says. He urges restraint with melatonin not because there’s evidence it’s dangerous, but because of the lack of evidence showing it’s safe in high doses over long periods. Especially for parents who are giving melatonin to healthy children, Moyad says caution is warranted. Melatonin appears to be safe, and it could provide a range of health benefits. But there are a lot of unknowns.

By Markham Heid

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Watch more, Matthew Walker Busts Sleep Myths: https://www.youtube.com/watch?v=oDRrR… Why We Sleep is out now: https://amzn.to/2JugGKV Sleep is one of the most important aspects of our life, health and longevity and yet it is increasingly neglected in twenty-first-century society, with devastating consequences: every major disease in the developed world – Alzheimer’s, cancer, obesity, diabetes – has very strong causal links to deficient sleep. In this book, the first of its kind written by a scientific expert, Professor Matthew Walker explores twenty years of cutting-edge research to solve the mystery of why sleep matters. Looking at creatures from across the animal kingdom as well as major human studies, Why We Sleep delves into everything from what really happens during REM sleep to how caffeine and alcohol affect sleep and why our sleep patterns change across a lifetime, transforming our appreciation of the extraordinary phenomenon that safeguards our existence. Find out more: https://www.penguin.co.uk/articles/20… Watch a full interview with Dr Rangan Chatterjee on the Feel Better, Live More podcast: https://youtu.be/_N8zlEs6XVk ————————————————————————- Subscribe to the Penguin channel: http://po.st/SubscribePenguinYouTube Follow us here: Twitter | http://www.twitter.com/penguinukbooks Website | http://www.penguin.co.uk Instagram | http://www.instagram.com/penguinukbooks Facebook | http://www.facebook.com/penguinbooks

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U.S. Won’t Join Global Coronavirus Vaccine Effort Because It’s Led By The WHO

The U.S. announced Tuesday that it would not join an international coalition to find and distribute a Covid-19 vaccine worldwide due to the group’s association with the World Health Organization, the latest sign of the Trump administration withdrawing the country from the international health community’s response to the pandemic over political concerns.

Covax is co-led by the World Health Organization, the Coalition for Epidemic Preparedness Innovations and Gavi, which aims to purchase 2 billion doses of potential Covid-19 shots from several vaccine makers by the end of 2021 and distribute them worldwide.

The WHO announced last week that Covax plans to work with vaccine manufacturers to provide countries worldwide equitable access to safe and effective vaccines, once they are licensed and approved, and that 172 countries are engaged in discussions to potentially participate.

On Monday, the European Commission confirmed it would contribute 400 million euros ($478 million) to the initiative, and the WHO said Germany had joined the pact as well.

“The United States will continue to engage our international partners to ensure we defeat this virus, but we will not be constrained by multilateral organizations influenced by the corrupt World Health Organization and China,” said Judd Deere, a spokesman for the White House.

According to the Washington Post, Health and Human Services Secretary Alex Azar had “interest in exploring some type of role in Covax… but there was resistance in some corners of the government and a belief that the U.S. has enough coronavirus vaccine candidates in advanced clinical trials that it can go it alone.”

The World Health Organization has warned against “vaccine nationalism,” with WHO chief Tedros Adhanom Ghebreyesus stating, “for the world to recover faster, it has to recover together, because it’s a globalized world: the economies are intertwined.”

Key Background:

After initially praising both China and the WHO at the pandemic’s outset, President Donald Trump sharply reversed course. In early April, Trump blasted the World Health Organization, saying they “called it wrong” on the virus, that the WHO was “very China-centric” in its approach, and froze U.S. funding to the organization. “They should have known and they probably did know,” Trump said of World Health Organization officials, suggesting the group had gone along with China’s efforts to downplay the severity of the outbreak.

In July, the administration sent a letter signaling its intent to withdraw from the WHO. “When the U.S. says it is not going to participate in any sort of multilateral effort to secure vaccines, it’s a real blow,” said Suerie Moon, co-director of the Global Health Center at the Graduate Institute of International and Development Studies in Geneva. “The behavior of countries when it comes to vaccines in this pandemic will have political repercussions beyond public health.” 

Crucial Quote:

“Equal access to a COVID-19 vaccine is the key to beating the virus and paving the way for recovery from the pandemic,” said Stefan Löfven, the prime minister of Sweden. “This cannot be a race with a few winners, and the COVAX Facility is an important part of the solution – making sure all countries can benefit from access to the world’s largest portfolio of candidates and fair and equitable distribution of vaccine doses.”

Further Reading:

U.S. says it won’t join WHO-linked effort to develop, distribute coronavirus vaccine (WaPo) 

EU offers 400 million euros to WHO-led COVID-19 vaccine initiative (Reuters) 

Global report: WHO warns against dangers of ‘vaccine nationalism’ (The Guardian)

Tommy Beer

 Tommy Beer

I’m a New York-based news desk reporter for Forbes covering sports, politics and business. Please feel free to contact me via email (tsbeer7 [@] gmail.com) or Twitter (@TommyBeer).

Bayer Agrees To Buy Personalized Vitamin Company Care/of At $225 Million Valuation

Pharmaceutical company Bayer AG has agreed to buy a majority stake in online personalized vitamin and supplement startup Care/of, Bayer confirmed to Bloomberg.

Bayer is acquiring 70% of the four-year-old company in a transaction that values Care/of at $225 million and gives Bayer the option to buy the rest by 2022, a source familiar with the matter told Bloomberg.

Bayer spokesman Dan Childs told Bloomberg it is an “important milestone” for both companies, but declined to disclose the financials. 

Bayer believes Care/of’s business model and product can be expanded to traditional retail channels as the company hopes to reach new customers, Childs said.

Bayer and Care/of plan to grow across new channels and new categories, though right now Care/of is direct-to-consumer. 

The subscription-based company was valued at $156 million in 2018 after raising funds from investors including Goldman Sachs’ venture capital unit.

Craig Elbert and Akash Shah cofounded Care/of in 2016; Care/of and Bayer did not immediately respond to Forbes request to comment.

key background

Care/of, HUM Nutrition, Ritual and other millennial-favored vitamin companies have worked with influencers and grown their own large social media followings. (A key color on Care/of’s Instagram page is “millennial pink.”

$18.3 billion. Online vitamin and supplement sales in the U.S. increased by 15% in 2020 to that amount, according to data from the market research firm IBISWorld. 

further reading

Bayer to Buy Vitamin Company Care/Of at $225 Million Valuation (Bloomberg)

Goldman Puts Money Behind Vitamin Startup Valued Close to GNC  Check out some of my other work here. Send me a secure tip

Elana Lyn Gross

Elana Lyn Gross

I’m a reporter at Forbes and the author of What Next?: Your Five-Year Plan for Life After College published by the Simon & Schuster imprint Adams Media. I have a master’s degree in journalism from Columbia University. 

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