#ศาสตร์เกษตรดินปุ๋ย : ขอบคุณแหล่งข้อมูล : หนังสือพิมพ์ The Nation.

Pandemic likely to ‘get worse before it gets better,’ Trump says in somber return to coronavirus briefing

Health & BeautyJul 22. 2020President Donald Trump speaks during a coronavirus briefing at the White House on Tuesday, July 21, 2020. CREDIT: Washington Post photo by Jabin Botsford

By The Washington Post · Toluse Olorunnipa · NATIONAL, HEALTH, POLITICS 

WASHINGTON – President Donald Trump walked to the lectern in the White House briefing room alone Tuesday, attempting to single-handedly hit the reset button on the public blame he is facing for not controlling the novel coronavirus pandemic.

Three months after he abandoned the daily virus briefings and attempted to turn the country’s attention to what he described as the “great American comeback,” Trump’s low-key reappearance before reporters seemed to be a tacit admission that his previous strategy had not worked. 

Six months after the first coronavirus case was confirmed in the United States – and with almost 4 million confirmed infections – Trump’s attempt to re-engage with the crisis and embrace public health guidelines marked a notable departure from his recent approach to the pandemic.

“We are in the process of developing a strategy that’s going to be very, very powerful,” Trump said Tuesday, reading from prepared remarks that did not include details of what the strategy would entail.

While Trump continued to showcase his trademark boosterism with repeated praise of his administration, he also appeared to acknowledge that the virus he once said would soon disappear continues to pose a serious threat to the country, as well as to his reelection chances.

“It will probably, unfortunately, get worse before it gets better,” he said during the 30-minute briefing in which he spoke in subdued tones. “Something I don’t like saying about things, but that’s the way it is.”

That somber approach harked back to late March, when Trump warned of a “great national trial unlike any it has ever faced before” and predicted a “very painful two weeks” for the country. 

That soberness did not last long; Trump spent much of April and May attacking governors who did not reopen their economies and resisting calls for the federal government to play a more central role in managing the crisis. 

Public health experts blame much of the country’s current predicament on that lack of leadership in those months – specifically pointing to Trump’s unwillingness to push face coverings and social distancing as he traveled the country holding rallies and mocking people who wore masks. Trump’s approval among the general public has also plummeted in recent months, with Americans giving him low marks for his leadership in crisis.

On the same day that his Democratic rival Joe Biden slammed him by saying “he’s quit on this country,” Trump attempted to use the revived daily briefing to prove otherwise.

Trump used part of his time in the briefing room to push a public health message that many lawmakers and medical experts have been requesting for months. He praised health-care workers for saving lives, largely avoided attacks on Democrats, and urged Americans to wear masks and stay away from crowded bars.

While he avoided some of the gaffes from his previous briefings and spent less time airing personal grievances, Trump still used the televised platform to break away from White House talking points and stir controversy. He contradicted press secretary Kayleigh McEnany’s claims that he gets tested multiple times a day for the virus, and he sent well wishes to a woman who has been accused of grooming Jeffrey Epstein’s underage victims and recruiting them to be sexually abused over several years.

“I just wish her well,” Trump said when asked about Ghislaine Maxwell, Epstein’s longtime companion who prosecutors say was an accomplice in his predation.

Trump’s decision to appear at the briefing without members of the coronavirus task force was itself a matter of controversy in the hours before the event. Fearing that the president might become distracted and unfocused without public health officials in the room, several Republicans – and some White House officials – have called for the briefings to feature less Trump and more doctors. 

But several top health officials in the administration did not know as of Tuesday morning whether they would be participating in the briefing alongside the president. 

Appearing Tuesday on CBS News’s “This Morning,” U.S. Surgeon General Jerome Adams did not directly answer a question about whether high-profile members of the coronavirus task force would appear.

Asked by co-host Gayle King whether he, White House coronavirus response coordinator Deborah Birx or National Institute of Allergy and Infectious Diseases Director Anthony Fauci would be in attendance, Adams said: “They’re still figuring that out.”

Shortly before the briefing, Fauci told CNN that he had not been invited.

During the briefings Trump headlined in March and April, the president regularly undercut or muddled the messaging from public health officials. Trump, who rarely attended the coronavirus task force meetings, would often show up for the televised briefings with a different set of talking points.

The president regularly pitched the anti-malarial drug hydroxychloroquine as a “game changer” even as Fauci and others cautioned that it was untested and might not serve as an effective treatment. The Food and Drug Administration has since pulled its emergency use authorization for the drug after some studies showed that it could lead to a higher risk of death.

Trump also used previous briefings to contradict health experts on face coverings, telling reporters in April that he did not plan to use one. Several administration officials, including Fauci, Birx and Adams, have pleaded with Americans to use masks when in public – a message ensnared in partisan politics as Trump has vacillated on whether face coverings are a vital public health measure or a political statement.

The president appeared to reverse course on his mask skepticism on Monday, tweeting a picture of himself wearing a mask and writing that “many people say that it is Patriotic” to use a face covering when social distancing is not possible. 

Given Trump’s long history of criticizing mask use – he told The Wall Street Journal in June that some Americans wore masks as a protest of him personally – some medical experts said they wished the president would model good public health by walking into the briefing room with his face covered.

“I genuinely hope the President wears a mask to the press briefing as a signal to the several million people watching on TV that wearing a mask is simple and important,” tweeted Rob Davidson, an emergency physician and executive director of the Committee to Protect Medicare, a national network of doctors that has lobbied against Trump. “At a minimum I hope he encourages all Americans to #maskup. A national mandate would be better.”

Trump did not wear a mask to the briefing, but he pulled one out of his pocket and – in a rare departure – did not equivocate as he called on Americans to use them. 

“We’re asking everybody that when you are not able to socially distance, wear a mask, get a mask,” Trump said. “Whether you like the mask or not, they have an impact.”

Trump has long viewed the briefings as an opportunity to tout his handling of the pandemic and put a positive spin on the virus’s devastating toll. Even as daily deaths were spiking in March and April, Trump told reporters that his actions had actually saved millions of lives. He repeated the claim Tuesday.

Trump favorably compared the United States to other countries during the briefing, saying “we’ve done much better than most.”

In reality, the United States has performed far worse than most of the industrialized world in containing the spread of the virus. Cases in the United States have continued to spike in recent weeks, reaching records even as countries in Europe and elsewhere began to bring their outbreaks under control.

While Americans make up less than 5% of the global population, the United States accounts for almost a quarter of all deaths from the coronavirus.

Before the news conference, several previous White House press secretaries gave Trump public advice about how he should approach the briefing room.

Trump “should come out and present the update on what the government is doing in terms of fighting #COVID19 and getting economy open then walk off and allow other officials to provide additional updates and answer questions,” Sean Spicer, the first press secretary in the Trump White House, wrote Tuesday on Twitter. 

He quoted a post from Ari Fleischer, press secretary in the George W. Bush White House, which called the briefings a “mistake” before going on to offer guidance.

“Be specific about what the Fed government is doing” and “Get out of the room within 30 minutes,” he wrote.

Sarah Sanders, who succeeded Spicer, told Fox News on Monday that Trump should remind people that he is doing everything he can to protect them from the virus. 

“Do it in a way that’s compassionate – talk about how he cares about the people and remind them of that being the core of who he is,” she said. 

Trump did take a brief moment during his prepared remarks to acknowledge the more than 139,000 Americans who have died from the virus – though he stopped short of taking any responsibility for their deaths.

“We mourn every precious life that’s been lost,” Trump said. “I pledge in their honor that we will develop a vaccine.”

#ศาสตร์เกษตรดินปุ๋ย : ขอบคุณแหล่งข้อมูล : หนังสือพิมพ์ The Nation.

Oxford coronavirus vaccine safe and promising according to Phase 1 results published in the Lancet

Health & BeautyJul 21. 2020Photo credit:freepik

By Washington Post · William Booth, Carolyn Y. Johnson · NATIONAL, WORLD, HEALTH 

LONDON — An Oxford University group and the British-Swedish pharmaceutical company AstraZeneca reported Monday that their coronavirus vaccine candidate, on which the U.S. and European governments have placed substantial bets, was shown in early-stage human trials to be safe and to stimulate an immune response. 

The study, published in the British medical journal the Lancet and involving 1,077 volunteers, was described as promising. A second report in the same medical journal on a Chinese vaccine showed what researchers not involved in the study described as modest, positive results.

The two vaccines are among 23 candidates now being tested in human trials, according to a running tally kept by the World Health Organization. More than 130 others are in preclinical trials. None has yet proven itself to protect people from infection or illness. Scientists caution that no one yet knows what level of immune response will be protective against the virus in the real world through a cross section of humanity – young to old, healthy to those with preexisting conditions. 

But with hopes soaring that a number of vaccines will soon emerge to quiet the global pandemic, governments are making massive investments and pharmaceutical companies are readying production.

The U.S. government has pledged up to $1.2 billion toward the Oxford effort and secured a promise of 300 million doses by October. A European alliance has claimed another 400 million doses, while the British government has dibs on 100 million doses, alongside another possible candidate being developed by Imperial College London. 

China approved the use of its vaccine within its military in late June. 

British Prime Minister Boris Johnson was enthusiastic about the Oxford early-stage results.

“This is very positive news. A huge well done to our brilliant, world-leading scientists and researchers,” Johnson tweeted Monday. “There are no guarantees, we’re not there yet & further trials will be necessary – but this is an important step in the right direction.”

The record-breaking pace of vaccine developers has heartened many who want to see the virus tamed in the new year and life return to normal.

But much about the virus remains unknown. Just last week, British researchers reported that people infected with the virus may see defensive antibodies against it quickly fade, within months, raising the possibility that long-term protection may be elusive. 

Still, researchers at Oxford and elsewhere are optimistic they can stimulate a permanent praetorian guard against infection.

“We hope this means the immune system will remember the virus, so that our vaccine will protect people for an extended period,” Andrew Pollard, one of the leaders of the Oxford study, said in a statement. “However, we need more research before we can confirm the vaccine effectively protects against SARS-CoV-2 infection, and for how long any protection lasts.” 

Large-scale, real-world trials of the Oxford vaccine are underway in Britain, Brazil and South Africa. The United States plans to test it later this summer, along with a handful of other candidates, in clinical trials each with about 30,000 volunteers. 

The Oxford vaccine is named ChAdOx1 nCoV-19 and was made from a weakened and nonreplicating version of a common cold virus, an adenovirus. The vaccine has been engineered to express a bit of the coronavirus that produces the spike protein that the virus uses to enter and infect human cells.

Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia said it’s still unclear how protective the immune memory in T cells will be against coronavirus, in part because immune memory is typically more valuable against pathogens that have a longer incubation period than the coronavirus. 

His biggest concern about the Oxford study was that while the vaccine triggered the immune system best when given with a second shot, that two-dose regimen was only tested in 10 patients.

“I’d want to see in a phase two trial: two doses consistently inducing a neutralizing antibody response – and that it’s relatively long lived, not months, not a few weeks,” Offit said.

Infectious-disease experts caution that vaccines must be widely administered to protect the general population, and in an era of widespread skepticism, and even overt hostility toward research and scientists, any vaccine that underperforms or causes serious side effects will set back the effort. 

An editorial in the Lancet warned, “The race for a vaccine moves fast, as the need for a solution is evident, but we cannot forget that safety is of the highest importance.”

In a reflection of how widely anticipated even very early vaccine results have become during the pandemic, results from the Oxford trial were leaked to news outlets in the days before publication, and the hype continued to build over the weekend.

“To me, the message is: it looks like it warrants further study. There’s no showstopper here,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine. “The bottom line is there’s maybe some promise, but definitely you cannot declare victory by any means on these two vaccines. There’s nothing here that would cause me to say we can now release this to the public.”

The Chinese candidate was tested in 500 people and shown to be relatively safe, causing side effects such as pain at the injection site, fevers and headache. It induced an immune response in most participants. However, the vaccine’s early performance has been disappointing to some scientists, and there have been worries that there may already be a reason it won’t work on many people. There is substantial immunity in the human population to the technology at the core of the vaccine – a harmless virus that is used to ferry in a gene that triggers the immune response to the coronavirus.

The vaccine triggered the production of neutralizing antibodies that can block the virus in only about half the test subjects – 59% of those given a high dose and 47% given a lower dose. Older people tended to respond less favorably.

The ultimate proof of whether any vaccine works will be large-scale clinical trials that use a flip of the coin to randomly decide whether thousands of people receive the experimental vaccine or a placebo shot – and then wait to see if the vaccinated group is protected against infection or severe disease.

The immune system uses a multipronged approach to defeat any pathogen, and it’s not yet known exactly what protects against a coronavirus infection.

Much public attention has focused on antibodies that block and neutralize the virus. Other experimental coronavirus vaccines from biotechnology company Moderna and pharma giant Pfizer have been shown to trigger antibodies at similar or greater levels than people who are naturally recovering from coronavirus infections, a benchmark that many scientists consider a hopeful sign.

But there are other forms of immune memory, including T cells, that are an area of increasing interest as evidence accumulates that antibody levels can drop off quickly in people naturally recovering from an infection. The Oxford study, like studies from Moderna and Pfizer, measured some T cell responses. 

One type of T cell, helper T cells, can be compared to “the football coach, where the coach calls the play,” said Angela Rasmussen, a virologist at Columbia University. “They’re coordinating the immune response of all the other cells in the immune system – those are really important.” The helper T cells can instruct the immune system to produce virus-fighting antibodies.

There are also “killer,” or cytotoxic, T cells, which are capable of destroying infected cells.

“It is unclear the role that cytotoxic T cells play in amelioration of covid-19 disease,” Offit said in an email. “It is, in a sense, a second line of defense.”

#ศาสตร์เกษตรดินปุ๋ย : ขอบคุณแหล่งข้อมูล : หนังสือพิมพ์ The Nation.

Maryland jurisdictions want to roll back reopening

Health & BeautyJul 21. 2020A pedestrian passes by the main gate of the National Zoo in March 2020, shortly after the zoo closed because of the coronavirus pandemic. MUST CREDIT: Washington Post photo by Bill O’Leary

By The Washington Post · Ovetta Wiggins, Rachel Chason, Dana Hedgpeth, Julie Zauzmer · NATIONAL, HEALTH

The top health officers in Maryland’s most-populous jurisdictions – including Montgomery and Prince George’s counties – asked the state on Monday to reconsider what activities it permits amid the novel coronavirus pandemic as experts across the Washington region urged caution while watching virus cases rise in recent weeks.

The health officers said their respective jurisdictions are weighing “a range of revisions,” including restrictions on gathering sizes, mandating face coverings for indoor and outdoor activities, and stopping indoor service at restaurants and bars. 

The email was sent to Deputy Secretary of Health Fran Phillips and signed by the health officers in Anne Arundel, Baltimore, Howard, Montgomery and Prince George’s counties and Baltimore City. 

“Our jurisdictions are prepared to act quickly to address these concerns but would prefer for the state to take action to create a unified, standardized approach to address this resurgence of cases,” they wrote. 

Mike Ricci, a spokesman for Maryland Gov. Larry Hogan, a Republican, said in a statement that the state looks “closely at the data every day with public health experts” and will continue to emphasize caution. 

“We have stressed to local health officers the importance of enforcing the public health orders currently in place, particularly at bars and restaurants,” Ricci said. “We cannot allow a small segment of bad actors to squander the sacrifices that Marylanders have made. But as the governor has said, if necessary, he is prepared to take action.”

The seven-day average of coronavirus cases in the greater Washington region has nearly doubled in the past month. It stood at 1,760 on Monday after climbing steadily from a low of 907 cases. 

On Sunday, Maryland reported 925 new cases, the highest number since late May, when there were more than 1,000 new cases reported daily. Virus-related hospitalizations have also started showing slight upticks. 

The state’s six largest jurisdictions have all seen a rebound in new infections in recent days, with Howard and Anne Arundel showing the most dramatic increases. In Howard, the seven-day average in new cases has jumped from five in mid-June to about 40, rivaling the figures that were reported at the peak of the crisis in May and June. In Anne Arundel, the seven-day average has jumped from just above 20 in late June to more than 60 this weekend.

The letter from the Maryland health officials came on the same day the District of Columbia’s top health official released data showing that the city is nowhere near putting a lid on community transmission of a virus that has increased its rate of spread across the region. 

The D.C. Health Department published a key metric for the first time Monday and revealed that the number is dismal: The percentage of new coronavirus cases linked to already known cases is 2.8%.

The city’s goal is 60%, which would indicate that the nation’s capital is capable of tracking the spread of the virus and that cases are closely linked. For now, the tiny percentage indicates that the virus is still spreading widely in the community without contact tracers being able to tell enough close contacts of sick people to quarantine as they are exposed.

The small number means most people contracting the virus are not aware of contacts with someone who had it.

LaQuandra Nesbitt, the city’s health director, said D.C. will consider bringing back some restrictions on business or social activities to try to reduce the community spread. She chastised residents for socializing too much in private homes and going to the grocery store daily instead of occasionally.

“It’s not good,” Luisa Franzini, a professor and chairwoman of the Health Services Administration department at the University of Maryland’s school of public health, said of the rising caseloads. “As we reopen and people go out and about more and meet other people and do things without being careful in wearing masks, avoiding being indoors and social distancing, we expected the cases would go up, and that’s what we’re seeing.”

She said leaders in the Washington region should consider prohibiting indoor seating at restaurants again, as well as reclosing gyms, nail salons, barbershops and other places where people are in close contact indoors. Much of the spread is linked to human behavior, she said. 

Leana Wen, an emergency physician and public health professor at George Washington University, said creating a safe environment for schools to reopen in the fall should take precedence over allowing bars to remain open.

“Maybe we should determine that these types of settings should not be open in the meantime in order to keep the level of infection relatively low so that school can open,” said Wen, who previously was Baltimore City’s health commissioner. “If we as a society say our priority is, say, reopening schools in August, then we need to be reimposing some of these measures.”

As health officials urged caution, the region was moving ahead with a gradual reopening likely to bring more people into contact with one another. 

The Smithsonian announced Monday that the National Zoo and the National Air and Space Museum’s Steven F. Udvar-Hazy Center in Virginia will welcome visitors Friday, marking the first time the public can visit the world’s largest museum complex since it closed March 14. Other Smithsonian sites remain shuttered, with reopening dates not yet announced.

The Smithsonian is releasing 5,000 daily passes for the zoo and 1,500 for Udvar-Hazy, which can be reserved by phone or visiting the Smithsonian’s website. 

Metro announced that it will increase transit service significantly next month, from historic lows to at least 70% of what service had been before the pandemic. 

While some organizations took steps toward normalcy, others said the pandemic forced them into the opposite direction. 

Organizers canceled the Marine Corps Marathon for the first time in its 45-year history. Race director Rick Nealis said the decision was made Friday by Marine Corps Commandant David Berger after it became clear that key logistics could not be nailed down until uncomfortably close to race day, Oct. 25. 

D.C. officials in a Monday news conference discussed the lengthening time it is taking some residents to receive coronavirus test results. They said that hospitalized patients are getting results within a day and that nursing home residents with tests processed by the city’s public health lab are learning results within two days. 

Commercial labs are taking much longer, in some cases seven to 10 days.

“It speaks to the need for national leadership. We can collect samples. We’ve pretty much gotten that down. But we need the labs to complete the test,” said Mayor Muriel Bowser, a Democrat. “We can’t have our national leadership throwing up their hands.”

Nesbitt said that if the testing backlog gets much worse, the city might have to return to encouraging testing only for high-priority populations. “At this point, we have the capacity to provide a test for anyone who needs a test,” she said.

The city closed its public testing sites Monday because of the heat – the sites are outdoors – and will operate with shortened hours on Tuesday and Wednesday. Nesbitt said that while the city will undoubtedly test fewer people on these days (public testing sites account for 40% of D.C.’s daily tests) and she has “some concerns” about the virus’s spread with fewer tests, private doctors’ offices could do more tests and absorb some of the demand.