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Total Cost of Her COVID-19 Treatment: $34,927.43

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When Danni Askini started feeling chest pain, shortness of breath and a migraine all at once on a Saturday in late February, she called the oncologist who had been treating her lymphoma. Her doctor thought she might be reacting poorly to a new medication, so she sent Askini to a Boston-area emergency room. There, doctors told her it was likely pneumonia and sent her home.

Over the next several days, Askini saw her temperature spike and drop dangerously, and she developed a cough that gurgled because of all the liquid in her lungs. After two more trips to the ER that week, Askini was given a final test on the seventh day of her illness, and once doctors helped manage her flu and pneumonia symptoms, they again sent her home to recover. She waited another three days for a lab to process her test, and at last she had a diagnosis: COVID-19.

A few days later, Askini got the bills for her testing and treatment: $34,927.43. “I was pretty sticker-shocked,” she says. “I personally don’t know anybody who has that kind of money.”

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Like 27 million other Americans, Askini was uninsured when she first entered the hospital. She and her husband had been planning to move to Washington, D.C. this month so she could take a new job, but she hadn’t started yet. Now that those plans are on hold, Askini applied for Medicaid and is hoping the program will retroactively cover her bills. If not, she’ll be on the hook.

She’ll be in good company. Public health experts predict that tens of thousands and possibly millions of people across the United States will likely need to be hospitalized for COVID-19 in the foreseeable future. And Congress has yet to address the problem. On March 18, it passed the Families First Coronavirus Response Act, which covers testing costs going forward, but it doesn’t do anything to address the cost of treatment.

While most people infected with COVID-19 will not need to be hospitalized and can recover at home, according to the World Health Organization, those who do need to go to the ICU can likely expect big bills, regardless of what insurance they have. As the U.S. government works on another stimulus package, future relief is likely to help ease some economic problems caused by the coronavirus pandemic, but gaps remain.

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Here is everything you need to know about what getting treated for COVID-19 could cost you.

How much does it cost to be hospitalized for COVID-19?

Because of our fragmented health care system, it depends on what kind of insurance you have, what your plan’s benefits are, and how much of your deductible you’ve already paid down.

A new analysis from the Kaiser Family Foundation estimates that the average cost of COVID-19 treatment for someone with employer insurance—and without complications—would be about $9,763. Someone whose treatment has complications may see bills about double that: $20,292. (The researchers came up with those numbers by examining average costs of hospital admissions for people with pneumonia.)

How much of that do I have to pay?

Most private health insurance plans are likely to cover most services needed to treat coronavirus complications, but that doesn’t include your deductible—the cost you pay out-of-pocket before your insurance kicks in. More than 80% of people with employer health insurance have deductibles, and last year, the average annual deductible for a single person in that category was $1,655. For individual plans, the costs are often higher. The average deductible for an individual bronze plan in 2019 was $5,861, according to Health Pocket.

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In both complicated and uncomplicated cases, patients with employer-based insurance can expect out-of-pocket costs of more than $1,300, the Kaiser researchers found. The costs were similar regardless of complications because many people who are hospitalized reach their deductible and out-of-pocket maximum.

Many health insurance plans also require co-pays or co-insurance, too. Those costs are often 15-20% for an in-network doctor, meaning you would pay that portion of the cost, and can be much more for out-of-network doctors.

Medicare and Medicaid will also likely cover the services needed for coronavirus treatment, but the details on deductibles (for Medicare) and potential co-pays will again depend on your plan, and which state you’re in for Medicaid.

What if I’m uninsured?

It’s not pretty. Some hospitals offer charity care programs and some states are making moves to help residents pay for COVID-19 costs beyond testing. Several states, including Maryland, Massachusetts, Nevada, New York, Rhode Island and Washington, have created “special enrollment periods” to allow more people to sign up for insurance mid-year.

Other states are requiring coverage of future vaccines or changing rules about prescription medication refills to help people stock up on essential medicines. So far, Maine, Maryland, Massachusetts, Nevada, New Mexico, New York and Oregon have required insurers to waive costs for a COVID-19 vaccine once one is ready, and the states that have loosened rules to help people fill prescriptions include Alaska, Colorado, Delaware, Florida, Maine, Maryland, New Hampshire, North Carolina and Washington.

The Commonwealth Fund, a healthcare think tank, has a coronavirus tracker that’s keeping a list of the moves each state has made so far.

There’s no way I could afford to pay out-of-pocket for care. What can I do?

The U.S. health care system doesn’t have a good answer for you, and it’s a problem. But there are a few things to keep in mind that could help minimize costs.

If you think you may have the virus, the first step is to call your doctor or emergency department before showing up, the CDC says. This will let them prepare the office and give you instructions ahead of time, but it could also save you money. Getting treated in a hospital will generally start off more expensive than a visit to a doctor’s office. Another cost comes from the “facilities fee,” which many hospitals charge anytime a patient comes through their doors. For Danni Askini’s first trip to the hospital in Boston on Feb. 29, for example, she was charged $1,804 for her emergency room visit and another $3,841.07 for “hospital services.”

Other costs to watch out for include lab tests, which can be “out-of-network” even if the doctor treating you is in your insurance network. It’s always best to ask for information in writing so that you can appeal the bills if necessary, says Caitlin Donovan of the National Patient Advocate Foundation. And appealing is worth it. Often, providers and insurers have reversed or lowered bills when patients go public or are covered by the media.

These problems aren’t coming out of the blue. Even when we’re not weathering a global pandemic, Americans face uniquely high health care costs, compared to the rest of the world, and millions of us already put off medical care because of concerns about how much it’ll cost. But with COVID-19 sweeping across the country, an old problem becomes increasingly urgent: many Americans could still face massive treatment bills, or seek to prevent those by avoiding testing and treatment—worsening the outbreak further.

“If you’re sick, you need fewer barriers,” Donovan says. “But also, it doesn’t help society to have people still crawling around going to their job and getting other people sick.”

By Abigail Abrams March 19, 2020

Source: Total Cost of Her COVID-19 Treatment: $34,927.43

I shot this video to share my experiences living with the Coronavirus (COVID-19). I discuss the symptoms I’ve experienced, the treatments that have helped with recovery and the process I’ve been enduring to keep my family safe. Thank you for all of your kind words and support during this event. Positive energy, and prayers will get us all through this and let’s hope for the best outcome in the near future. For more information, including my COVID-19 survival guide, read: https://www.audioholics.com/editorial…  Audioholics Recommendations Amazon Shop: https://www.amazon.com/shop/audioholics Audioholics Recommended Cables: 250ft CL2 12AWG Speaker Cable: https://amzn.to/2vwS9QH Locking Banana Plugs: https://amzn.to/2ZQt15x 9ft 4K HDR HDMI Cables: https://amzn.to/2WiIXeD Audioholics Recommended Electronics: Denon AVR-X4600H 9.2CH AV Receiver: https://amzn.to/2ZTbsCe Yamaha RX-A3080 9.2CH AV Receiver: https://amzn.to/2VzA03v Denon AVR-X6400H 11.2CH AV Receiver: https://amzn.to/2LelABB Audioholics Recommended Speakers: SVS Prime 5.1 Speaker / Sub System: https://amzn.to/2GWoFCn Klipsch RP-8000F Tower Speakers: https://amzn.to/2Vd8QQn Pioneer SP-FS52 Speakers: https://amzn.to/2n7SyIJ Sony SSCS5 Speakers: https://amzn.to/2ndEn56 SVS SB-3000 13″ Subwoofer: https://amzn.to/2XYxqBr Follow us on: Patreon: https://www.patreon.com/audioholics FACEBOOK https://www.facebook.com/Audioholics GOOGLE PLUS https://plus.google.com/+Audioholics TWITTER https://twitter.com/AudioholicsLive #coronavirus #covid-19

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Can You Get Coronavirus Twice? How Long Are You Immune After COVID-19?

A sequel to a movie that you didn’t want to see in the first place is one thing, like Ghost Rider 2 after Ghost Rider. A sequel to having a COVID-19 infection would be something completely different.

You may think that the one “positive” of testing positive for the COVID-19 causing coronavirus (SARS-CoV2) and surviving would be that you won’t get infected by that virus again. At least not during this pandemic. Ah, but is this assumption really true? Will you indeed be immune to the SARS-CoV2 after you’ve recovered from a COVID-19 infection? Some reports out of Japan and China seem to suggest otherwise.

For example, Daniel Leussink and Rocky Swift reported for Reuters about a female tour bus guide in Japan who tested positive for the virus after recovering from a COVID-19 infection. Here is a UNTV news report on the case:

                               

Does this case actually prove that re-infection with the virus is possible? Or was this just a mistake in the testing? Or did the person have a particularly weak immune system so that she couldn’t generate immunity? After all, one case can be an accident, an aberration, an anomaly, an aardvark in a sea of anemone.

Well, oops something like this happened again, according to a more recent NHK-World Japan report. This time it was a man in his 70’s, who first tested positive for SARS-CoV2 on February 14 while on a Diamond Princess cruise ship. After being transferred to a medical facility in Tokyo, he stayed there until testing negative for the virus. On March 2, he left the facility and traveled home via public transportation. However, the man eventually began feeling sick with a fever, which prompted him to go to a hospital on March 13. The following day he tested positive for the virus again.

Then there’s the February 14 article from Caixin, a Beijing, China-based media group, that was entitled “14% of Recovered Covid-19 Patients in Guangdong Tested Positive Again.” Umm, 14% would seem more like an “ooop” than an “ooops.” This CGTN news warned of such reinfection possibilities:

                           

Remember though, these are news reports and not scientific studies yet. While the reappearance of Nicholas Cage with a flaming skull riding a motorcycle may not call for additional scientific studies, all of these cases certainly do. First, scientists need to confirm whether the test results were indeed accurate. Remember, no test is perfect. If people can screw up a drink order, they can certainly mess up a medical test. Even if a test is performed properly, you could still get a positive result when you don’t actually have an infection. On the flip side, just because you test negative doesn’t necessarily mean that there is no way that you are carrying the virus. That’s why a doctor may test you multiple times to be sure of a result.

Secondly, doctors and other scientists need to double-check or triple-check that each of these patients actually got re-infected with the virus rather than had an infection that simply lasted a long time. What if, for example, the cruise passenger and the tour bus guide each had fairly long infections and just happened to have intervening false negative test results? The tests could have simply been like commercial breaks in the middle of a single long episode of a television show.

Third of all, the amount of immunity that you build up after being exposed to any virus depends on not only virus itself but surprise, surprise your immune system and its response. When your immune system sees a particular virus for the first time, it can essentially get caught with its pants down, not ready to defend your body against this new invader. However, exposure to the virus either through a vaccine or getting infected may train your immune system so that, borrowing the words of former President George W. Bush, “fool me once, shame on — shame on you. Fool me — you can’t get fooled again.” If strong enough, your immune system then may be ready with proper defenses next time the virus comes calling. Could the cases of reinfection then be examples of people who happened to have weaker immune systems?

Or are these cases any indication that our immune systems may not be able to consistently build up enough protection against SARS-CoV2? Well, a review article published in January 2020 in the Journal of Medical Virology summarizes much of what is known about your immune system’s response to various types of coronavirus. As you can see, this involves a complex orchestra of different cells and chemicals. Therefore, the immune response to one virus won’t necessarily be the same as to another virus, even if both viruses were different types of coronaviruses. All of this also depends on how strong your immune system may be and how well your immune system recognizes an invader like SARS-CoV2.

Plus, your immune system has got to remember the virus. Over time, immunity may fade, allowing the virus to reinfect you. It’s like when you get back together with an ex after you have forgotten how terrible you are for each other. The question then is how long can your immune system remember SARS-CoV2?

With SARS-CoV2 having emerged so quickly, there just haven’t been enough studies yet on how your immune system may react specifically to SARS-CoV2 and how this may differ from person to person. Therefore, we have to rely on studies of other coronaviruses for now. The closest approximation is probably the even more evil cousin of SARS-CoV2, the original SARS virus that caused the outbreak of 2002-2003.

In a study published in a 2007 issue of Emerging Infectious Diseases, a research team from the Shanxi Provincial Center for Disease Control and Prevention in Taiyuan, China, followed 176 patients who had had severe acute respiratory syndrome (SARS). On average, SARS-specific antibodies remained at the same level in a patient’s blood for about two years. Then, during the third year after infection, antibody levels tended to drop precipitously. This suggests that immunity to the SARS virus may remain for two to three years with reinfection possible after three years.

Keep in mind though that antibody levels do not always correlate with immunity. They can be like selfies on Instagram, only indirect measures of what’s really going on at a deeper level. Some people may have immunity against a virus without detectable antibody levels, and some people may be very susceptible to infection even though antibodies are present. The only way to have determined if the patients actually had immunity against the SARS virus would have been to have re-exposed them to the virus and checked what happened. And that would have been a horrible experiment to do.

The other question is how many different versions of SARS-CoV2 may be running around, or rather spreading around since viruses don’t have little feet and little sneakers. It’s difficult to answer this question for sure without more thorough and widespread testing. According to a study published in the journal National Science Review, an analysis of samples from 103 COVID-19 cases suggests that at least two different versions of SARS-CoV2 are circulating. This doesn’t necessarily mean that these versions are so different that immunity to one version doesn’t mean immunity to another. Regardless, things may evolve in the near future. Viruses can be like the characters in Game of Thrones or an actor in a Broadway show, changing rapidly. Over time, the new coronavirus could possibly mutate to the point that new versions are no longer as recognizable by your immune system as the original version. After all, mutations are probably what allowed the virus to jump from another animal to humans.

Not knowing exactly how immunity against SARS-CoV2 works and how long it may last throws a gigantic wrench into public health planning. Many trying to predict the course of the pandemic have been assuming that once a high enough proportion of the overall population has been infected and has become immune, the pandemic will subside. Herd immunity is the percentage of the overall population that is immune to a given pathogen. When this percentage gets high enough, the virus will struggle to find more susceptible people to infect, sort of like trying to sell Justin Bieber T-shirts in a crowd when most of the people are already wearing such shirts. The belief is that when around 70% of the population is immune to the virus, SARS-CoV2 will struggle to continue transmitting.

However, things could change substantially if people can actually get re-infected with the virus or different enough versions of the virus end up circulating. Such possibilities would be yet more reasons to question the “herd immunity” approach to controlling the pandemic that’s currently being discussed in the U.K. and described by Sarah Boseley for The Guardian. Since there is no vaccine available against SARS-CoV2, there is actually talk of allowing those with stronger immune systems to get infected to achieve the 70% or so herd immunity threshold. Huh?

This strategy would make sense except for the fact that it doesn’t. First of all, those who get infected could end up having serious consequences such as death, which is typically a very serious consequence. This would be reminiscent of the saying that “the operation was successful, but the patient died.” Allowing people to become infected by a potentially deadly virus is always a risky proposition, sort of like playing roulette when your lungs are on the betting table. So far, the COVID-19 case-fatality rate seems to be somewhere between 1% and 3.4%. This isn’t as high as the rate for SARS but nonetheless significantly higher than that of a bad flu season.

Secondly, this herd immunity strategy depends on people not getting re-infected with the virus. But with the aforementioned reports from Japan and China, you have to wonder if the strategy is not a “herd immunity” strategy but rather a “herd immunity maybe” strategy to borrow the words of Carly Rae Jepsen. “Maybe” may work to some degree with flirting and dating but not when lives are at stake.

Third of all, this strategy assumes that people will not leave or enter the U.K. That may work only if you want to completely eliminate travel to and from the country.

Finally, such a strategy would run counter to other mitigation strategies such as social distancing as indicated by the following tweet:

                           

Uh, U.K., would this really be O.K.?

All of this is a reminder that scientists do not yet know enough about this new coronavirus. What percentage of people become immune to the virus if exposed? How strong is the immunity? Will it actually prevent reinfection? How long would this immunity last? Is it two years as the SARS study hints at or could it be much shorter than that? How does all of this vary from person to person? How many different versions of the virus may end up circulating? As the Internet meme goes, I and many other scientists have so many questions.

Therefore, if you do get exposed to the virus and recover, don’t view it as a free pass to start hugging strangers, digging your fingers deep into your nose like you are looking for pocket change, and licking door knobs. Keep doing what everyone else should be doing such as social distancing, washing your hands frequently and thoroughly, keeping your filthy fingers from gravitating towards your gigantic face, and actively disinfecting surfaces, objects, and that enormous BTS statue that you have in your living room. Just because you survived the first infection, doesn’t necessarily mean that future exposures and possible infections will end up OK. As you know, sequels don’t always have the same endings.

Follow me on Twitter or LinkedIn. Check out my website.

I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order. Currently, I am a Professor of Health Policy and Management at the City University of New York (CUNY), Executive Director of PHICOR (@PHICORteam), Associate Professor at the Johns Hopkins Carey Business School, and founder and CEO of Symsilico. My previous positions include serving as Executive Director of the Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Associate Professor of International Health at the Johns Hopkins Bloomberg School of Public Health, Associate Professor of Medicine and Biomedical Informatics at the University of Pittsburgh, and Senior Manager at Quintiles Transnational, working in biotechnology equity research at Montgomery Securities, and co-founding a biotechnology/bioinformatics company. My work involves developing computational approaches, models, and tools to help health and healthcare decision makers in all continents (except for Antarctica) and has been supported by a wide variety of sponsors such as the Bill and Melinda Gates Foundation, the NIH, AHRQ, CDC, UNICEF, USAID and the Global Fund. I have authored over 200 scientific publications and three books. Follow me on Twitter (@bruce_y_lee) but don’t ask me if I know martial arts

Source: Can You Get Coronavirus Twice? How Long Are You Immune After COVID-19?

Coronaviruses (CoV) are a family of viruses that cause sicknesses like the common cold, as well as more severe diseases, such as Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome. A novel coronavirus (nCoV) is a new strain – one that hasn’t previously been recognized in humans. Coronaviruses cause diseases in mammals and birds. A zoonotic virus is one that is transmitted between animals and people. When a virus circulating in animal populations infects people, this is termed a “spillover event”. How does CoVID-19 affect the body? The virus is fitted with protein spikes sticking out of the envelope that forms the surface and houses a core of genetic material. Any virus that enters your body looks for cells with compatible receptors – ones that allow it to invade the cell. Once they find the right cell, they enter and use the cell’s replication machinery to create copies of themselves. It is likely that COVID-19 uses the same receptor as SARS – found in both lungs and small intestines. It is thought that CoVID-19 shares many similarities with SARS, which has three phases of attack: viral replication, hyper-reactivity of the immune system, and finally pulmonary destruction. Early on in infection, the coronavirus invades two types of cells in the lungs – mucus and cilia cells. Mucus keeps your lungs from drying out and protects them from pathogens. Cilia beat the mucus towards the exterior of your body, clearing debris – including viruses! – out of your lungs. Cilia cells were the preferred hosts of SARS-CoV, and are likely the preferred hosts of the new coronavirus. When these cells die, they slough off into your airways, filling them with debris and fluid. Symptoms include a fever, cough, and breathing difficulties. Many of those infected get pneumonia in both their lungs. Enter the immune system. Immune cells recognize the virus and flood into the lungs. The lung tissue becomes inflamed. During normal immune function, the inflammatory process is highly regulated and is confined to infected areas. However, sometimes the immune system overreacts, and this results in damage to healthy tissue. More cells die and slough off into the lungs, further clogging them and worsening the pneumonia. As damage to the lungs increases, stage three begins, potentially resulting in respiratory failure. Patients that reach this stage of infection can incur permanent lung damage or even die. We see the same lesions in the lungs of those infected by the novel coronavirus as those with SARS. SARS creates holes in the lungs, so they look honeycomb-like. This is probably due to the aforementioned over-reactive immune response, which affects tissue both infected and healthy and creates scars that stiffen the lungs. As such, some patients may require ventilators to aid breathing. The inflammation also results in more permeable alveoli. This is the location of the thin interface of gas exchange, where your lungs replace carbon dioxide in your blood with fresh oxygen you just inhaled. Increased permeability causes fluid to leak into the lungs. This decreases the lungs’ ability to oxygenate blood, and in severe cases, floods them so that you become unable to breathe. Sometimes, this can be fatal. The immune system’s over-reaction can also cause another kind of damage. Proteins called cytokines are the immune system’s alarm system, recruiting immune cells to the infection site. Over-production of cytokines can result in a cytokine storm, where there is large-scale inflammation in the body. Blood vessels become more permeable and fluid seeps out. This makes it difficult for blood and oxygen to reach the rest of the body and can result in multi-organ failure. This has happened in the most severe cases of CoVid-19. Although there are no specific treatments for coronaviruses, symptoms can be treated through supportive care. Also, vaccines are currently in development. What can you do to protect yourself from CoVid-19? Basic protocol comes down to regular hand washing, avoiding close contact with anyone coughing or sneezing, avoiding unnecessary contact with animals, washing hands after contact with animals, thoroughly cooking meat and eggs prior to consumption, and covering your mouth and nose while coughing or sneezing. Respiratory viruses are typically transmitted via droplets in sneezes or coughs of those infected, so preventing their travel stops the spread of disease. Alveoli model from: https://www.turbosquid.com/3d-models/…

There Is A Drug Already Used In Japan Which May Treat COVID-19, Says New Study

A group of scientists in Germany have identified a drug called camostat mesylate, that they believe may work to combat COVID-19, the disease caused by the SARS-CoV-2 coronavirus.

The new study published last week in Cell, shows that SARS-CoV-2 binds to human cells in a similar way to the original SARS coronavirus (SARS-CoV) that caused a worldwide outbreak in 2003, with this binding depending on viral proteins called ‘spike’ proteins.

“Spike is so named because that’s what it looks like: a spike on the surface of the virus particle,” said Angela L. Rasmussen, PhD, a virologist in the faculty of the Center for Infection and Immunity at the Columbia Mailman School of Public Health. “In order for a virus to infect a cell, it has to attach itself to a protein on the surface of that cell which we call the receptor. For SARS-CoV-2, this is a protein called ACE2. Spike binds ACE2 and allows SARS-CoV-2 to enter and infect cells,” she added.

As well as this initial process, the spike protein has to be primed by an enzyme called a protease in order for the virus to complete entry into the cell. The study showed that similar to SARS-CoV, SARS-CoV-2 uses a protease called TMPRSS2 to complete this process.

The scientists then looked at whether there were any compounds available that could stop the entry of coronavirus into the cell by stopping the TMPRSS2 protease from working. From previous work on SARS-CoV, they found one potential candidate called camostat mesylate and showed that the drug stopped SARS-CoV-2 from infecting lung cells in a dish.

“We found that SARS-CoV-2, like SARS-CoV, uses the host proteins ACE2 and TMPRSS2 to enter cells. Both viruses should therefore infect similar cells in patients and may cause disease via similar mechanisms,” said Markus Hoffmann, PhD, researcher in the Infection Biology Unit of the German Primate Center, Leibniz Institute for Primate Research, Göttingen, Germany and first author of the paper.

Developing new drugs for infectious diseases or even diseases such as cancer or neurological conditions can take years, even decades. But camostat mesylate has already been tested in people, albeit not for the treatment of COVID-19.

“We knew from our previous work that camostat mesylate was active against other coronaviruses, including SARS-CoV. Therefore, we tested whether it is also active against SARS-CoV-2,” said Stefan Pöhlmann, PhD, Professor in the same institute in Göttingen. “Our study shows that camostat mesylate blocks infection of cells with SARS-CoV-2-like particles and with authentic, patient-derived SARS-CoV-2. Moreover, camostat mesylate inhibited infection of important target cells – human lung epithelial cells,” he added.

The compound is approved in Japan for the treatment of a number of non-infectious conditions in people, such as chronic pancreatitis and postoperative reflux esophagitis and has also had some tests in mice infected with SARS-CoV. However, it has never been tested in humans with COVID-19.

“It does require trials in humans to determine if it’s effective, and I suspect it would also require pre-clinical animal work with SARS-CoV-2 specifically before human trials could start. If it has been shown to be safe for clinical use in other countries, it may be fast-tracked for FDA approval or the FDA may authorize emergency off-label use,” said Rasmussen, indicating that the FDA will have to examine safety data and pre-clinical data before determining which, if any course of action to take with investigating the drug further.

One concern is that TMPRSS2 might not be the only protease that controls spike priming and hence blocking it may be ineffective in people as other proteases may act as backups, still allowing the virus entry into cells. There are also questions to be asked about how the drug would actually alter the ability of the virus to cause disease in people.

“Pathogenesis can’t be studied in cultured cells, so these questions will need to be addressed using animal models and human clinical samples,” said Rasmussen.

Given the similarities between SARS-CoV and the current virus SARS-CoV-2, the researchers also looked at whether people who recovered from SARS had any immunity to the new virus strain. They took serum containing antibodies taken from 3 recovering SARS-CoV patients back around the time of the original outbreak in 2003 and showed that this blocked entry of SARS-CoV-2 into cells. The serum was taken from patients b

“Antibodies from patients who had recovered from SARS blocked the SARS-CoV-2 from infecting cells in culture. This suggests that antibodies against SARS might be useful as a treatment for SARS-CoV-2,” said Rasmussen.

SARS in 2003 was a smaller outbreak compared to the current situation with only 8,098 cases formally recorded and over 7,000 people surviving. It is not known how many of these people are still alive today, but it is possible that they will have some immunity to COVID-19. On a wider scale, studying these people may provide incredibly useful clues about successfully treating COVID-19. So, what are the next steps for the researchers?

“We are currently analyzing whether camostat mesylate-related inhibitors show improved antiviral activity. So far we have not been contacted by others regarding off-label use of camostat mesylate. However, we are contacting physicians to discuss this option,” said Pöhlmann.

There are currently no FDA-approved treatments for COVID-19, but last week, the National Institutes of Health announced that the antiviral drug remdesivir had begun testing in a human clinical trial in the U.S. Remdesivir, marketed by Gilead Sciences has previously shown promise in preventing MERS coronavirus disease in tests on monkeys and is already being used in human trials in Wuhan. The first patient in the U.S. is an American who was evacuated from the Diamond Princess cruise ship, which became a floating incubator for the virus, resulting in over 700 infections and six deaths reported so far.

Follow me on Twitter. Check out my website.

I am a postdoctoral research scientist focusing on childhood cancers and new, targeted cancer therapies. As a survivor of childhood leukemia myself, I am a determined advocate for research into better, less-toxic cancer treatments and how to reduce the long-term side effects of current drugs. I am an award-winning science communicator and have written for The Times, The Guardian and various cancer-focused outlets. I am also a 2017 TED Fellow, having done my TED talk this year on cancer survivorship and I regularly do public talks on topics ranging from ‘Why haven’t we cured cancer yet?’ to ‘Cannabis and cancer; hype or hope?’. I am passionate about using social media to communicate science and frequently share pictures and stories from my own laboratory work in real-time on my Twitter account @vickyyyf, alongside commentary about important research breakthroughs. You can find out more about me and how to get in contact via my website drvickyforster.com. All of my articles reflect my personal views and not those of my employer.

Source: There Is A Drug Already Used In Japan Which May Treat COVID-19, Says New Study

(25 Feb 2020) The University of Nebraska Medical Center in Omaha announced Tuesday it is enrolling adults diagnosed with the Coronavirus for a new clinical drug trial to treat the disease.

Back & Neck Pain: When To See A Doctor

Maybe you’ve had a pain in the neck for a day, or maybe your back’s been killing you for months. No matter how long you’ve suffered, you likely wrestle with the question of whether you should see a doctor.

The fact is that back and neck pain often clears up on its own with rest and, sometimes, at-home heat or ice treatment. But other times, medical attention is necessary.

8 questions to help you know whether to seek medical attention for neck or back pain

If you answer yes to any of these questions, you should consult your doctor for more information.

1. Do you also have a fever?

A fever could be unrelated to your neck or back pain, but it could also be a sign of a serious infection such as meningitis. Untreated infections can become life-threatening, so if you suspect one, call your doctor immediately.

2. Have you had cancer?

Sometimes pain is caused by tumors in your spine or pressing on your organs, nerves, or blood vessels. If you have a history of cancer, call your doctor to see if you should be checked out for tumors.

3. Are you over 50 and overweight?

Some back pain is related to obesity—and since people often get less physical exercise as they age, it can be important to address pain before it becomes debilitating.

A pain-management doctor can work with you on a pain control plan, using a combination of physical therapy, weight management and other relevant treatments.

4. Do you have weak legs or bowel or bladder problems?

If you notice your legs getting progressively weaker, or if you are having trouble controlling your bowel or bladder, you should seek medical attention right away. Incontinence and/or progressive weakness in the leg or seat area may be symptoms of a serious condition.

5. Have you recently suffered an injury?

If you’ve had a fall, a car accident or another type of physical trauma, you should be checked out by a doctor. It’s possible that your neck or back pain is the result of a spinal injury.

6. Does pain radiate down one leg?

Pain, numbness or an electrical sensation that travels down one leg is called sciatica. Sciatica can have several causes, ranging from a tight piriformis muscle to an irritation of a spinal root nerve. Frequently, sciatica can be treated by physical therapy and strengthening of the leg and core muscles. Pain or tingling in one leg can also be a symptom of spinal stenosis, or pressure on the spinal root nerve. A doctor will test for this while assessing your sciatica.

7. Does your pain get worse when you bend over?

If bending or flexing makes your pain worse, you may have a disc problem such as a bulging disc, herniated disc or degenerative disc disease.

8. Have you had your pain for longer than three weeks?

Even if you answered no to the above seven questions, you should make an appointment with your doctor if your pain has persisted for nearly a month. At this length, pain is considered chronic and can lead to other negative consequences. A doctor can work with you to develop a pain management program to help alleviate impacts on your lifestyle.

Want to learn more about how spine pain impacts your life?

Health Risk Assessment

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By: Reston Hospital Center – October 14, 2019

Source: Back and neck pain: When to see a doctor

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Pharmacies Don’t Know How to Dispose of Leftover Opioids and Antibiotics

Today (Dec. 30), a team of researchers from the University of California, San Francisco and the Children’s National Hospital in Washington, D.C., published the results of an investigation into whether or not pharmacy workers could provide accurate information on the disposal of two classes of drugs: opioids and antibiotics. The results are frightening:

The researchers enlisted volunteers to place calls to nearly 900 pharmacies in California, posing as parents with leftover antibiotics and opioids from a “child’s” recent surgery. They asked the pharmacy employees on the line—either pharmacists or pharmacy technicians—how to deal with these unused drugs, and then the researchers compared those answers to the guidelines for correct disposal published by the U.S. Food and Drug Administration (FDA).

The found that approximately 43% of pharmacy workers responded accurately on how to deal with antibiotics; just 23% knew what to do with opioids.

Drug disposal is one of those vexing problems where people generally want to do the right thing, but often simply don’t know how. As Hillary Copp, associate professor of urology at UCSF and the senior author of the study noted in a press release, “The FDA has specific instructions on how to dispose of these medications, and the American Pharmacists Association has adopted this as their standard. Yet it’s not being given to the consumer correctly the majority of the time.”

According to the FDA, unused medications should be put (without crushing any pills or capsules) in an “unappealing substance such as dirt, cat litter, or used coffee grounds;” that mixture should then be put into a sealed container like a secure plastic bag before it is thrown out. In addition, all personal information should be scratched out or otherwise destroyed.

Indeed, in 2017, a team of scientists from the U.S. Geological Survey and Environmental Protection Agency published a paper reporting the results of a study of 38 streams across the country. It found 230 human-created drugs and poisons. And there are significant knock-on effects of improper disposable: many of the drugs identified in the 2017 study are known to kill, harm the health of, or change the behavior of fish, insects and other wildlife. This, in turn, can impact the food chain, and eventually harm humans as well.

Antibiotics and opioids, the two drug classes that the Annals of Internal Medicine study looked at, are particularly malevolent when not disposed correctly.

When antibiotics are disseminated widely throughout the environment, it raises the chances of bacteria developing resistance to the drugs. Any bacteria that encounters an antibiotic, whether in the human body, or in a stream or pond, will attempt to survive. Those that do will pass their genes onto future generations of bacteria, fueling a growing global health concern: the World Health Organization has made it clear that antimicrobial resistance in microbes (which includes antibiotic-resistant bacteria), is one of the globes biggest impending public health challenges, given that it could eliminate some of medical science’s most effective tools against disease-causing organisms.

Meanwhile, research into the impacts of opioids on lab animals suggests that they respond to the drugs much like humans: by self-administering over and over, to their detriment. Scientists are still working on understanding how opioids in the waste stream impact animals living in the wild. One thing is for sure: opioids ARE in the global water supply. A 2018 review of the scientific literature found 22 opioids in wastewater and surface water samples from all over the world.

Perhaps the bigger issue with opioids, however, is that those prescribed them tend to keep them around. The results of a survey published in JAMA Internal Medicine in 2016 found that about 60% of Americans prescribed opioids kept their leftover meds for “future use,” and a number of recent studies and investigations have found that these drugs, when either shared with or surreptitiously taken by relatives and acquaintances, can lead to addiction and overdose.

On the flip side, other recent studies have noted that clearer guidance and take-back events can get people to not only get rid of unused opioids, but to do so in a way that’s environmentally sound. Given the ongoing American opioid crisis, any steps to get this class of deadly drugs off the street—and out of medicine cabinets—could be significant. This most recent study suggests that one place to start might be at the point-of-sale: the pharmacy.

By Elijah Wolfson December 30, 2019

Source: Pharmacies Don’t Know How to Dispose of Leftover Opioids and Antibiotics

369K subscribers
According to the Substance Abuse and Mental Health Services Administration, addiction to prescription opioid painkillers is real. Of the 21.5 million Americans 12 or older who had a substance use disorder in 2014, 1.9 million had a substance use disorder involving prescription pain pills. Addicts aren’t just the stereotypical shady figures hiding in dark alleys to get a fix. They are average people turning to health care providers for medication that is highly addictive. Mayo Clinic experts agree that an opioid epidemic exists in the U.S. In this Mayo Clinic Minute, reporter Vivien Williams talks to pain medicine specialist Dr. Mike Hooten about the changing face of addiction. More health and medical news on the Mayo Clinic News Network http://newsnetwork.mayoclinic.org/

 

CBD Oil for Parkinson’s Disease

Every year in the United States, approximately 60,000 individuals are newly diagnosed with Parkinson’s disease according to the Parkinson’s Foundation (PF).[1]

The PF adds that, by the year 2020, the number of people living with this medical condition is expected to near one million in total, making it more prevalent than multiple sclerosis, muscular dystrophy, and Lou Gehrig’s disease combined.

What is Parkinson’s disease?

The American Parkinson Disease Association (APDA) defines Parkinson’s as “a type of movement disorder that can affect the ability to perform common, daily activities.”[2]

Unlike other movement disorders, Parkinson’s disease is characterized by a loss of brain cells, specifically those in the substantia nigra region. This lowers dopamine levels which causes issues related to movement regulation, thus impacting the patients’ quality of life.

Parkinson’s disease is both chronic and progressive, making this movement disorder one that is long-lasting, while also worsening as time progresses.

Also, though it typically appears after the age of 50, roughly one in ten Parkinson’s disease patients are diagnosed at a younger age. This is called Early Onset Parkinson’s.

Symptoms of Parkinson’s tend to vary from person to person and fall into one of two categories: motor symptoms and non-motor symptoms.

The APDA shares that it is the motor symptoms of Parkinson’s that typically make these typical daily movements more difficult, some of which include experiencing tremors, having stiff or rigid muscles, walking difficulties, slowness of movement (also known as bradykinesia), and postural instability.

Another motor symptom Parkinson’s disease patients tend to notice is a change in their voice. Changes in volume are common in the early stages, whereas speaking fast, crowding words, and stuttering are more prevalent in advanced stages of this disease.

Parkinson’s symptoms that don’t involve movement and are therefore sometimes missed, include:

  • Reduced sensitivity to smells
  • Trouble staying asleep
  • Increased depression and anxiety
  • Psychotic symptoms such as hallucinations and delusions
  • Fatigue
  • Weight loss
  • Excessive sweating
  • Difficulty multi-tasking
  • Harder time with organization
  • Constipation
  • Increase in urinary frequency and urgency
  • Lightheadedness
  • Reduced libido
  • Slower blinking and dry eyes

Currently, there is no cure for Parkinson’s. However, patients do have a few treatment options that can help manage this particular medical condition.

One is taking a medication to help better manage motor function. Two well-known options include Levodopa and Carbidopa, both of which can be prescribed in varying strengths and formulations.

Another common Parkinson’s treatment is therapy. For instance, physical therapy may be pursued to aid in walking and occupational therapy can help enhance fine motor skills. Speech therapy may also be required to assist with vocal issues.

Deep brain stimulation is an option as well. Approved by the U.S. Food and Drug Administration (FDA) several years ago, this treatment method is a form of surgical therapy in which an electrode is implanted in the brain, then stimulated via a device that is placed in the chest area under the skin.

The APDA further indicates that complementary medicine such as yoga and massage can also provide relief from symptoms of PD as well. Research is also finding that CBD oil can potentially help too.

CBD is short for cannabidiol, a chemical compound found within the cannabis plant that binds to cannabinoid receptors located in the body’s endocannabinoid system.[3]

CBD is different than other cannabinoids found in the marijuana plant that are known for producing the high commonly associated with medical marijuana use. This includes tetrahydrocannabinol (THC) and a similar cannabinoid, tetrahydrocannabivarin (THCV). Both THC and THCV can produce this high effect, whereas CBD does not.[4]

Additionally, our bodies do produce some cannabinoids on its own. These are called endogenous cannabinoids because they are so similar to cannabis plant compounds. CBD works by mimicking and augmenting these natural cannabinoids, providing a more therapeutic effect.

Admittedly, information in this field is still emerging, primarily because the endocannabinoid system is a relatively new finding due to the first endocannabinoid not being discovered until 1992.[5]

After the second one was identified three years later, researchers began to realize that the human body has an entire endocannabinoid system that offers positive effects related to bone density and diabetes prevention.

Since that time, research has also connected CBD with providing benefits for Parkinson’s disease.

For instance, one 2018 study published by Frontiers in Pharmacology shares that CBD helps by increasing levels of the endocannabinoid anandamide, an agonist of cannabinoid receptors.[6] It is also thought to aid in other processes found helpful for Parkinson’s patients, such as those related to serotonin receptors like 5-HT1A, peroxisome proliferator-activated receptors, and more.

Other studies shared by the National Institute of Health (NIH) have found similar results. Specifically, they indicate that the study of CBD in relation to Parkinson’s disease is especially interesting because of the direct relationship between endocannabinoids, cannabinoid receptors, and the neurons associated with this neurodegenerative disease that impacts the central nervous system.[7]

Another piece of research, this one published in the journal Cannabis and Cannabinoid Research, indicates that many clinical trials have been conducted in this area. [8] Though some have been inconclusive or controversial, others have found that CBD has positive effects on some of Parkinson’s motor symptoms.

One such study looked at 22 patients who engaged in the medical use of cannabis, which contains CBD.[9] In this case, improvements were noted in regard to tremor, rigidity, and bradykinesia 30 minutes after using medical marijuana.

Other pieces of Parkinson’s research have found that CBD can also help relieve non-motor symptoms. For instance, an open-label study—meaning that there is no placebo group, so the subjects know that they’re receiving active treatment—found that, after being taken for four weeks, CBD helped reduce psychotic symptoms.[10]

Another double-blind trial involved 119 Parkinson’s patients who were treated with either 75 mg of CBD per day, 300 mg CBD daily, or a placebo. Although researchers could not establish a statistically significant difference in motor and general symptoms scores, there were significantly different means in relation to their well-being and quality of life.[11]

The Michael J. Fox Foundation for Parkinson’s Research adds that research in this area is somewhat limited due to governmental regulations, with interpretation of results also impacted due to no standardization of CBD doses or use of products containing CBD and THC combined.[12] Therefore, it can be difficult to determine the specific effect CBD can provide to Parkinson’s patients.

Healthline reports that CBD oil has a number of scientifically-proven benefits that extend beyond those related to Parkinson’s.[13] Among them are:

One of the major concerns patients have with the use of CBD oil is whether or not it is legal. Psychology Today stresses that, while many people think that the passing of the 2018 Farm Bill legalized CBD federally, this isn’t exactly the case.[14]

Instead, the Farm Bill only legalized hemp, which is the fibrous stalk of the marijuana plant. Technically, all other parts of the plant are still illegal under the Controlled Substances Act.

What confuses the issue even more is that each state has set its own statutes regarding hemp, medical marijuana, and CBD. For instance, in New York, patients can smoke cannabis, but they aren’t banned from accessing it as a dried flower. However, if you live in Colorado, not only can individuals use medical cannabis, but children can even legally possess it on school campuses if they have status as a medical cannabis patient.[15]

Because of these variations, it is always recommended that Parkinson’s patients check the legality of cannabis use or CBD oil in their individual states before utilizing this option for treatment purposes.

[1] “Statistics.” Parkinson’s Foundation. https://parkinson.org/Understanding-Parkinsons/Statistics

[2] “What is Parkinson’s Disease?” American Parkinson Disease Association. https://www.apdaparkinson.org/what-is-parkinsons/

[3] “What is CBD?” Project CBD. https://www.projectcbd.org/about/what-is-cbd

[4] Rahn, B. “What is THCV and What Are the Benefits of This Cannabinoid?” Leafly. Feb 03, 2015. https://www.leafly.com/news/cannabis-101/what-is-thcv-and-what-are-the-benefits-of-this-cannabinoid

[5] “A History of Endocannabinoids and Cannabis.” UTT BioPharma. https://www.uttbio.com/a-history-of-endocannabinoids-and-cannabis/

[6] Peres, F.F. et al. “Cannabidiol as a Promising Strategy to Treat and Prevent Movement Disorders?” Frontiers in Pharmacology. May 2018; 9:482. Doi:10.3389/fphar.2018.00482. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958190/

[7] Fernandez-Ruiz, J et al. “Endocannabinoids and Basal Ganglia Functionality.” Prostaglandins, Leukotrienes and Essential Fatty Acids. Feb-Mar 2002; 66(2-3):257-67. https://www.ncbi.nlm.nih.gov/pubmed/12052041

[8] Stampanoni Bassi, M et al. “Cannabinoids in Parkinson’s Disease.” Cannabis and Cannabinoid Research. Feb 2017; 2(1):21-29. Doi: 10.1089/can.2017.0002. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436333/

[9] Lotan, I et al. “Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study.” Clinical Neuropharmacology. Mar-Apr 2014; 37(2):41-4. Doi: 10.1097.WNF.0000000000000016. https://www.ncbi.nlm.nih.gov/pubmed/24614667

[10] Zuardi A.W. et al. “Cannabidiol for the Treatment of Psychosis in Parkinson’s Disease.” Journal of Psychopharmacology. Nov 2009; 23(8):979-83. Doi: 10.1177/0269881108096519. https://www.ncbi.nlm.nih.gov/pubmed/18801821

[11] Chagas M.H. et al. “Effects of Cannabidiol in the Treatment of Patients with Parkinson’s Disease: An Exploratory Double-Blind Trial.” Journal of Psychopharmacology. Nov 2014; 28(11):1088-98. Doi: 10.1177/0269881114550355. https://www.ncbi.nlm.nih.gov/pubmed/25237116

[12] Dolhun, R. “Ask the MD: Medical Marijuana and Parkinson’s Disease.” The Michael J. Fox Foundation for Parkinson’s Research. May 02, 2018. https://www.michaeljfox.org/foundation/news-detail.php?ask-the-md-medical-marijuana-and-parkinson-disease-a

[13] Kubala, J. “7 Benefits and Uses of CBD Oil (Plus Side Effects).” Healthline. Feb 26, 2018. https://www.healthline.com/nutrition/cbd-oil-benefits

[14] Pierre, J. “Now that Hemp is Legal, Is Cannabidiol (CBD) Legal Too?” Psychology Today. Jan 02, 2019. https://www.psychologytoday.com/us/blog/psych-unseen/201901/now-hemp-is-legal-is-cannabidiol-cbd-legal-too

[15] “Legal Information By State & Federal Law.” Americans for Safe Access. https://www.safeaccessnow.org/state_and_federal_law

Dr. Andrew Colucci

By: Dr. Andrew Colucci

Doctor of Medicine (M.D. cum laude) from Boston University School of Medicine in 2012 – Dr. Colucci is currently a radiologist in MA

Source: CBD Oil for Parkinson’s Disease

19.5K subscribers
Does medical marijuana help Parkinson’s symptoms? Rachel Dolhun, MD, movement disorder specialist and vice president of medical communications at The Michael J. Fox Foundation, answers this and other common questions about medical marijuana and Parkinson’s disease. The “Ask the MD” series is intended as an educational resource for people with Parkinson’s and their loved ones. Please consult with your personal healthcare provider to address individual medical questions. The Michael J. Fox Foundation for Parkinson’s Research is dedicated to finding a cure for Parkinson’s disease through an aggressively funded research agenda and to ensuring the development of improved therapies for those living with Parkinson’s today. https://www.michaeljfox.org We gratefully acknowledge the Steering Committee members of our Patient Disease Education Consortium in conjunction with The Albert B. Glickman Parkinson’s Disease Education Program and Charles B. Moss Jr. and family, whose sponsorship allows us to create and distribute materials, while preserving our track record of efficiency in stewarding donor-raised contributions for maximum impact on Parkinson’s drug development. Sponsorship support does not influence MJFF’s content perspective or panelist selection. Note: Tap cc in the lower right corner of the player to enable auto-generated captions for the video.

Why Cardiac Arrest Is More Likely To Kill Women Than Men, And What We’re Going To Do About It

Image result for Cardiac Arrest

If you were walking down the street and a man fell to the pavement clutching his chest, would you know what to do? According to a recent study, of 19,331 out-of-hospital cardiac arrests, there’s a 45 percent chance that someone would rush forward to give the man the CPR he needs.

Important follow-up question: if you were walking down the street and a woman fell to the pavement clutching her chest, would you know what to do? The same study showed that a woman is 27 percent less likely than a man to get CPR from a bystander in public. While there isn’t enough research on the intersecting factors of gender and race, studies looking at race and gender separately suggest that women of color are even less likely to receive bystander CPR.

As half a million Americans will die from cardiac arrest annually, timely CPR is an incredibly important matter. Even as major health organizations train tens of millions of people in resuscitation techniques each year, women still lack equal access to the lifesaving compressions of CPR.

It’s important to look at why bystanders are so much less likely to intervene to save a woman in cardiac arrest. The first barrier is a wildly inaccurate myth that women don’t even experience cardiac arrest. Though many people think heart issues are a “men’s problem,” heart disease actually affects more women than men, killing roughly one woman every minute. Even when bystanders accurately identify that a woman needs CPR, they may be afraid to touch her breasts, confused about where to put their hands, or apprehensive about pushing down hard and fast on a woman’s body.

So, how do we address this laundry list of misconceptions that are literally killing women? The same way we popularized the resuscitation techniques that remarkably double or triple cardiac arrest victims’ chances of survival: through education.

Imagine a CPR manikin (the medical term for the dummies used in training courses), that expressionless, universal human form meant to represent everybody and anybody who could suffer cardiac arrest. See something missing from the manikin’s body? Or rather, two things?

Noticing this shocking oversight, an equal parts pissed-off and inspired team at JOAN Creative had an idea—the WoManikin. The WoManikin is a universal attachment that can easily be slipped over the common flat-chested manikin to add breasts. The WoManikin teaches people how to perform CPR on a torso with breasts during training, so they’ll know what to do when they see a woman or person with breasts in cardiac arrest.

By putting the sleeve design on WoManikin.org as an open source pattern and starting a fund to create more attachments, JOAN hopes to get a WoManikin in every CPR training program in the country by 2020. JOAN developed the WoManikin in collaboration with CPR experts, cardiologists, and organizations that care about closing the gender gap in CPR. So, in that way, the WoManikin doesn’t just provide a way to challenge biased CPR training—it shows what happens when women collaborate and apply creativity to tackle the inequities around them.

To learn more and join the fight to end gender disparities in CPR, visit WoManikin.org.

Hannah Lewman Hannah Lewman Brand Contributor

Hannah Lewman is a Strategist for JOAN Creative.

Source: Why Cardiac Arrest Is More Likely To Kill Women Than Men, And What We’re Going To Do About It

Walmart Joins Pharmaceutical-Tracking Blockchain Consortium MediLedger

Big-box retail giant Walmart has joined MediLedger, a consortium building a blockchain for tracking the provenance of pharmaceuticals.

A spokeswoman for the Bentonville, Arkansas-based company confirmed Walmart’s participation to CoinDesk but had no further comment.

The move represents a deepening of Walmart’s involvement with blockchain technology. Separately, the retailer is a key participant in IBM’s Food Trust, a system for tracking fresh produce through the supply chain that’s built on the Hyperledger Fabric platform.

Walmart has insisted that its suppliers of leafy greens integrate the IBM blockchain, and it should bring similar supply-chain clout to MediLedger, whose members already include pharmaceutical manufacturers such as Pfizer and the three largest pharmaceutical wholesalers, McKesson, AmerisourceBergen, and Cardinal Health. 

“Health and wellness,” a category that includes pharmacy and over-the-counter drugs, accounted for $35 billion of Walmart’s U.S. sales in the fiscal year ended Jan. 31, or 10% of the total, according to the company’s annual report.

Unlike Food Trust, MediLedger uses an enterprise version of the ethereum blockchain, built with a modified version of the Parity client and a consensus mechanism called proof of authority. The consortium is spearheaded by San Francisco-based blockchain firm Chronicled, which closed a $16 million funding round earlier this year.

Walmart joins as MediLedger prepares to kick off a pilot project with the U.S. Food and Drug Administration (FDA) in early June. The agency is testing various approaches to creating an interoperable, digitized system for tracking and verifying prescription drugs, something Congress has mandated it deliver by 2023. 

Eric Garvin, co-lead of MediLedger, told CoinDesk:

“The pilots only really make sense if you are working with a group of collaborators.”

MediLedger initially focused on the verification of drugs that are returned to be resold – a sliver of the pharma market, but one that’s still worth over $6 billion. Legislation to help prevent fraudulent products being resold comes into effect in November of this year.

Now the expanded group will start work on the more broad-ranging tracking of all pharma products which involves interoperable data and packaging serialization.

Why blockchain?

It could be argued that in places like the U.K. where the healthcare system is largely run by the government, a digitized system like the one FDA has been mandated to create might be implemented more easily using a centralized system.  

But the U.S. is the largest privatized healthcare system in the world (with the highest prices), which makes for a sprawling fragmentation of siloed databases, supporting the case for a decentralized solution.

The Congressionally mandated 10-year roadmap to a standardized form of serialization on all drug packaging began with the very largest firms complying with electronic tracking of lot shipments, i.e. 100 boxes of some medicine at a time. The next goal was more granular serialization at the level of pillbox or bottle

The third plank of the legislation was that the data being gathered had to be technically interoperable.

That last requirement made some people in the industry think “blockchain is the perfect solution,” said Maria Palombini, director of communities and initiatives development for emerging technology at the IEEE Standards Association.

Palombini stressed that the FDA does not advocate one technology over another and its only prescription is the use of recognized standards within each pilot’s tech stacks.

However, making data (and metadata) interoperable presents the industry with a challenge, she said:

“I think some companies will try and embrace this, and some others will try and stay away from blockchain. Because there is one word that scares them – transparency.”

Garvin said nodes are distributed and operated by industry participants and technology providers, but that data privacy is being addressed with zero-knowledge proofs, a cryptographic method that allows someone to prove something is true about a set of data without exposing the data itself.

This data transparency question is especially pointed at the ends of the supply chain with large pharma dispensers like Walmart, who are unaccustomed to potentially sharing their sales data with competitors.

“They have to try and figure out a way to share this data give far more visibility into the inventory, but also now the retailers are going to have to give data back which they have never really been required to do so,” said Palombini. “That’s going to be a really hard part here.”

Walmart Pharmacy image via Shuttersto

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Source: Pivot – Blockchain Community

How Will The Failure Of Biogen’s Alzheimer’s Drug, Aducanumab, Impact R&D?

uncaptioned image

Photographer: Scott Eisen/Bloomberg

© 2016 Bloomberg Finance LP

The landscape of experimental Alzheimer’s disease (AD) drugs is strewn with failures, so much so that it has been referred to as “an unrelenting disaster zone”. Recognizing the greatly increasing number of patients with this disease, many biopharma companies have invested a lot of resources in attacking this problem, only to be turned away in late stage studies as happened to Merck with its BACE inhibitor, verubecestat, and Lilly with its beta-amyloid antibody, solanezumab.

Now add Biogen to the list of companies that have failed in this arena. Its drug, aducanumab, partnered with Eisai, was believed to be better in removing beta-amyloid from the brain than any agent previously tested. Many have hypothesized that beta-amyloid causes the formation of damaging clumps of debris in the brain leading to AD. Unfortunately, Biogen halted a major clinical trial with aducanumab due to a futility analysis showing that the drug doesn’t work.

This is a terrible result for Alzheimer’s patients who had hoped that this was the drug that would finally succeed in treating AD. But the demise of aducanumab is also disastrous for Biogen which had expended an enormous amount of resources into this program, likely at the expense of other opportunities. It was a risky bet and one for which Wall Street has delivered a punishing blow. Biogen’s stock dropped by nearly 30% shortly after announcing the disappointing aducanumab results.

How is Biogen going to respond? As John Carroll has reported, many industry analysts believe that there aren’t many gems in the Biogen pipeline that can make up for the loss of this potential blockbuster. In predicting Biogen’s next steps, perhaps there are some learnings from another such pipeline failure – that of Pfizer’s torcetrapib.

Torcetrapib was the first of a class of compounds known as CETP inhibitors, drugs that both raised HDL-cholesterol and lowered LDL-cholesterol. A CETP inhibitor had the potential to remodel a heart patient’s lipid profile thereby greatly reducing his risk of a heart attack or stroke. There was tremendous excitement generated in this potential breakthrough treatment, not just in Pfizer but also among cardiologists and heart patients. In fact, internal commercial analyses predicted annual sales in excess of $15 billion. However, as happened with aducanumab, on December 4th, 2006, Pfizer announced that torcetrapib failed its long-term clinical study. The drug was dead. The Wall Street reaction was swift, albeit not as dramatic as Biogen’s experience. Pfizer stock dropped 10% as a result of this news.

Internally, the Pfizer reaction was intense. Torcetrapib was supposed to be the blockbuster that would drive growth into the next decade. Its loss created an enormous hole. Pfizer CEO Jeff Kindler responded in a couple of ways. First, he decided to “right size” R&D in relation to lower expected future revenues. In effect, hundreds of millions of dollars needed to be cut from R&D. Pfizer’s R&D budget had already undergone major portfolio adjustments and reorganizations over the previous five years due to the acquisition of Warner-Lambert Parke-Davis in 2000 followed by the acquisition of Pharmacia in 2004. Meeting the new R&D budget targets weren’t going to be achieved by simple cuts; rather, major research sites had to be closed and jobs had to be eliminated. Gone were R&D sites around the world including those in France, Japan and, most significantly, the iconic laboratory in Ann Arbor, Michigan.

But budget cuts weren’t going to be enough for Pfizer to meet its desired goals. The company began assessing major M&A opportunities and in 2009 it acquired Wyeth for $68 billion leading to yet another round of reorganizations and portfolio reshuffling. The ripple effect of the torcetrapib demise was felt by the entire company and lasted for a number of years.

So, how will Biogen respond? Undoubtedly, there will be budget cuts. In addition, perhaps Biogen will look at its R&D portfolio and give a higher priority to those programs that have the potential to deliver revenues in the short term. There might also be a push to drop programs deemed to be very risky or where the proof-of-concept requires long, expensive clinical trials. Finally, it wouldn’t be surprising to see Biogen become aggressive in their M&A activities. But make no mistake. The death of an important drug like aducanumab will have both a short and a long term effect on Biogen as a company and especially on R&D.

I was the president of Pfizer Global Research and Development in 2007 where I managed more than 13,000 scientists and professionals in the United States, Europe, and Asi…

Source: How Will The Failure Of Biogen’s Alzheimer’s Drug, Aducanumab, Impact R&D?

Blood Type: Microbiome and Diet — CFS Remission

One of my favorite sources for information on the microbiome is run by Dr. Peter J. D’Adamo. For many years he has advocated eating for your blood type. In this week’s issue of New Scientist. an article “Your gut bacteria may match your blood group – but we don’t know why“ The difference between many […]

via Blood Type: Microbiome and Diet — CFS Remission

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