Special Report: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics.

Explanation: In Italy, millions are locked down and more than 1,000 people have died from the coronavirus. In South Korea, hit by the disease at about the same time, only a few thousand are quarantined and 67 people have died. As the virus courses through the world, the story of two outbreaks illustrates a coming problem for countries now grappling with an explosion in cases.

It’s impractical to test every potential patient, but unless the authorities can find a way to see how widespread infection is, their best answer is lockdown. Italy started out testing widely, then narrowed the focus so that now, the authorities don’t have to process hundreds of thousands of tests. But there’s a trade-off: They can’t see what’s coming and are trying to curb the movements of the country’s entire population of 60 million people to contain the disease. Even Pope Francis, who has a cold and delivered his Sunday blessing over the internet from inside the Vatican, said he felt “caged in the library.”  Thousands of miles away in South Korea, authorities have a different response to a similar-sized outbreak. They are testing hundreds of thousands of people for infections and tracking potential carriers like detectives, using cell phone and satellite technology. Both countries saw their first cases of the disease called COVID-19 in late January. South Korea has since reported 67 deaths out of nearly 8,000 confirmed cases, after testing more than 222,000 people. In contrast, Italy has had 1,016 deaths and identified more than 15,000 cases after carrying out more than 73,000 tests on an unspecified number of people. Epidemiologists say it is not possible to compare the numbers directly. But some say the dramatically different outcomes point to an important insight: Aggressive and sustained testing is a powerful tool for fighting the virus. Jeremy Konyndyk, a senior policy fellow at the Center for Global Development in Washington, said extensive testing can give countries a better picture of the extent of an outbreak. When testing in a country is limited, he said, the authorities have to take bolder actions to limit movement of people. “I’m uncomfortable with enforced lockdown-type movement restrictions,” he said. “China did that, but China is able to do that. China has a population that will comply with that.”  The democracies of Italy and South Korea are useful case studies for countries such as America, which have had problems setting up testing systems and are weeks behind on the infection curve. So far, in Japan and the United States particularly, the full scale of the problem is not yet visible. Germany has not experienced significant testing constraints, but Chancellor Angela Merkel warned her people on Wednesday that since 60% to 70% of the populace is likely to be infected, the only option is containment. South Korea, which has a slightly smaller population than Italy at about 50 million people, has around 29,000 people in self-quarantine. It has imposed lockdowns on some facilities and at least one apartment complex hit hardest by outbreaks. But so far no entire regions have been cut off. Seoul says it is building on lessons learned from an outbreak of Middle East Respiratory Syndrome (MERS) in 2015 and working to make as much information available as possible to the public. It has embarked on a massive testing program, including people who have very mild illness, or perhaps don’t even have symptoms, but who may be able to infect others. This includes enforcing a law that grants the government wide authority to access data: CCTV footage, GPS tracking data from phones and cars, credit card transactions, immigration entry information, and other personal details of people confirmed to have an infectious disease. The authorities can then make some of this public, so anyone who may have been exposed can get themselves - or their friends and family members - tested. In addition to helping work out who to test, South Korea’s data-driven system helps hospitals manage their pipeline of cases. People found positive are placed in self-quarantine and monitored remotely through a smartphone app, or checked regularly in telephone calls, until a hospital bed becomes available. When a bed is available, an ambulance picks the person up and takes the patient to a hospital with air-sealed isolation rooms. All of this, including hospitalization, is free of charge. South Korea’s response is not perfect. While more than 209,000 people have tested negative there, results are still pending on about 18,000 others - an information gap that means there are likely more cases in the pipeline. The rate of newly confirmed cases has dropped since a peak in mid-February, but the system’s greatest test may still be ahead as authorities try to track and contain new clusters. South Korea does not have enough protective masks - it has started rationing them - and it is trying to hire more trained staff to process tests and map cases. And the approach comes at the cost of some privacy. South Korea’s system is an intrusive mandatory measure that depends on people surrendering what, for many in Europe and America, would be a fundamental right of privacy. Unlike China and the island-state of Singapore, which have used similar methods, South Korea is a large democracy with a population that is quick to protest policies it does not like. “Disclosing information about patients always comes with privacy infringement issues,” said Choi Jaewook, a preventive medicine professor at Korea University and a senior official at the Korean Medical Association. Disclosures “should be strictly limited” to patients’ movements, and “it shouldn’t be about their age, their sex, or their employers.”   Traditional responses such as locking down affected areas and isolating patients can be only modestly effective, and may cause problems in open societies, says South Korea’s Deputy Minister for Health and Welfare Kim Gang-lip. In South Korea’s experience, he told reporters on Monday, lockdowns mean people participate less in tracing contacts they may have had. “Such an approach,” he said, “is close-minded, coercive, and inflexible.”  Italy and South Korea are more than 5,000 miles apart, but there are several similarities when it comes to coronavirus. Both countries’ main outbreaks were initially clustered in smaller cities or towns, rather than in a major metropolis - which meant the disease quickly threatened local health services. And both involved doctors who decided to ignore testing guidelines. Italy’s epidemic kicked off last month. A local man with flu symptoms was diagnosed after he had told medical staff he had not been to China and discharged himself, said Massimo Lombardo, head of local hospital services in Lodi. The diagnosis was only made after the 38-year-old, whose name has only been given as Mattia, returned to the hospital. Testing guidelines at the time said it was not necessary to test people who had no link to China or other affected areas. But an anaesthetist pushed the protocols and decided to go ahead and test for COVID-19 anyway, Lombardo said. Now, some experts in Italy believe Mattia may have been infected through Germany, rather than China. Decisions about testing hinge partly on what can be done with people who test positive, at a time when the healthcare system is already under stress. In Italy at first, regional authorities tested widely and counted all positive results in the published total, even if people did not have symptoms. Then, a few days after the patient known as Mattia was found to have COVID-19, Italy changed tack, only testing and announcing cases of people with symptoms. The authorities said this was the most effective use of resources: The risk of contagion seemed lower from patients with no symptoms, and limited tests help produce reliable results more quickly. The approach carried risks: People with no symptoms still can be infected and spread the virus. On the other hand, the more you test the more you find, so testing in large numbers can put hospital systems under strain, said Massimo Antonelli, director of intensive care at the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome. Testing involves elaborate medical processes and follow-up. “The problem is actively searching for cases,” he said. “It means simply the numbers are big.”   Italy has a generally efficient health system, according to international studies. Its universal healthcare receives funding below the European Union average but is comparable with South Korea’s, at 8.9% of GDP against 7.3% in South Korea, according to the World Health Organization. Now, that system has been knocked off balance. Staff are being brought into accident and emergency departments, holidays have been canceled and doctors say they are delaying non-urgent operations to free up intensive care beds. Pier Luigi Viale, head of the infectious disease unit at Sant’ Orsola-Malpighi hospital in Bologna, is working around the clock - in three jobs. His hospital is handling multiple coronavirus cases. His doctors are shuttling to other hospitals and clinics in the area to lend their expertise and help out with cases. In addition, his doctors also have to deal with patients with other contagious diseases who are struggling to survive. “If it drags on for weeks or months we’ll need more reinforcements,” he told Reuters. Last week, the mayor of Castiglione d’Adda, a town of about 5,000 people in Lombardy’s “red zone” which was the first to be locked down, made an urgent online appeal for help. He said his small town had had to close its hospital and was left with one doctor to treat more than 100 coronavirus patients. Three of the town’s four doctors were sick or in self quarantine. “Doctors and nurses are at the limit,” said a nurse from the hospital where Mattia was taken in. “If you have to manage people under artificial respiration you have to be watching them constantly, you can’t look after the new cases that come in.”     Studies so far suggest that every positive case of coronavirus can infect two other people, so local authorities in Lombardy have warned that the region’s hospitals face a serious crisis if the spread continues - not just for COVID-19 patients but also for others whose treatment has been delayed or disrupted. As the crisis spreads into Italy’s less prosperous south, the problems will be magnified. Intensive care facilities face the most intense pressure. They require specialist staff and expensive equipment and are not set up for mass epidemics. In total, Italy has around 5,000 intensive care beds. In the winter months, some of these are already occupied by patients with respiratory problems. Lombardy and Veneto have just over 1,800 intensive care beds between public and private systems, only some of which can be set aside for COVID-19 patients. The government has asked regional authorities to increase the number of intensive care places by 50% and to double the number of beds for respiratory and contagious diseases, while reorganizing staff rosters to ensure adequate staffing. Some 5,000 respirators have been acquired for intensive care stations, the first of which are due to arrive on Friday, deputy Economy Minister Laura Castelli said. The region has already asked nursing institutes to allow students to bring forward their graduation to get more nurses into the system early. Pools of intensive care specialists and anaesthetists are to be set up, including staff from outside the worst affected regions. To add to the burden, hospitals in Italy depend on medical personnel to try to trace the contacts that people who test positive have had with others. One doctor in Bologna, who asked not to be named, said he had spent a 12-hour day tracing people who had been in contact with just one positive patient, to ensure those who next need testing are found. “You can do that if the number of cases remains two to three,” the doctor said. “But if they grow, something has to give. The system will implode if we continue to test everyone actively and then have to do all this.”  In South Korea as in Italy, an early case of COVID-19 was identified when a medical officer followed their intuition, rather than the official guidelines, on testing. The country’s first case was a 35-year-old Chinese woman who tested positive on Jan. 20. But the largest outbreak was detected after the 31st patient, a 61-year-old woman from South Korea’s southeastern city of Daegu, was diagnosed on Feb. 18. Like the patient named Mattia in Italy, the woman had no known links to Wuhan, the Chinese province where the disease was first identified. And as in Italy, the doctors’ decision to recommend a test went against guidelines at the time to test people who had been to China or been in contact with a confirmed case, said Korea Medical Association’s Choi Jaewook. “Patient 31,” as she became known, was a member of a secretive church which Deputy Minister for Health and Welfare Kim Gang-lip said has since linked to 61% of cases. Infections spread beyond the congregation after the funeral of a relative of the church’s founder was held at a nearby hospital, and there were several other smaller clusters around the country. Once the church cluster was identified, South Korea opened around 50 drive-through testing facilities around the country. In empty parking lots, medical staff in protective clothing lean into cars to check their passengers for fever or breathing difficulties, and if needed, collect samples. The process usually takes about 10 minutes, and people usually receive the results in a text reminding them to wash their hands regularly and wear face masks. A total of 117 institutions in South Korea have equipment to conduct the tests, according to the Korea Centers for Disease Control and Prevention (KCDC). The numbers fluctuate daily, but an average of 12,000 is possible, and maximum capacity is 20,000 tests a day. The government pays for tests of people with symptoms, if referred by a doctor. Otherwise, people who want to be tested can pay up to 170,000 won ($140), said an official at a company called Seegene Inc, which supplies 80% of the country’s kits and says it can test 96 samples at once. There are also 130 quarantine officers like Kim Jeong-hwan, who focus on minute details to track potential patients. The 28-year-old public health doctor spends his whole working days remotely checking up on people who have tested positive for COVID-19, the disease caused by the virus. Kim, who is doing military service, is one of a small army of quarantine officers who track the movements of any potential carriers of the disease by phone, app or the signals sent by cell phones or the black boxes in automobiles. Their goal: To trace all the contacts people may have had, so they too can be tested. “I haven’t seen anyone telling bad lies,” Kim said. “But lots of people generally don’t remember exactly what they did.”   Underlining their determination, quarantine officers told Reuters they located five cases after a worker in a small town caught the virus and went to work in a “coin karaoke,” a bar where a machine lets people sing a few songs for a dollar. At first, the woman, who was showing symptoms, did not tell the officers where she worked, local officials told Reuters. But they put the puzzle together after questioning her acquaintances and obtaining GPS locations on her mobile device. “Now, quarantine officers have maximum power and authority,” said Kim Jun-geun, an official at Changnyeong County who collects information from quarantine officers. South Korea’s government also uses location data to customize mass messages sent to cellphones, notifying every resident when and where a nearby case is confirmed. Lee Hee-young, a preventative medicine expert who is also running the coronavirus response team in South Korea’s Gyeonggi province, said South Korea has gone some of the way after MERS to increase its infrastructure to respond to infectious diseases. But she said only 30% of the changes the country needs have happened. For instance, she said, maintaining a trained workforce and up-to-date infrastructure at smaller hospitals isn’t easy. “Until we fix this,” Lee said, “explosions like this can keep blowing up anywhere.”


JUULing, or use of a JUUL e-cigarette, has caused cancer in four students.

Explanation: The best decision is to never start smoking or initiate nicotine-containing products. We stand by our mission to serve as a true alternative to combusted cigarettes for adult smokers. We will continue to respond as necessary to unfounded allegations.

E-cigarettes and vaping have been the focus of a number of social media rumors. In early 2018, one such rumor appeared that using a JUUL brand e-cigarette had caused lung cancer in four students: Vaping and juuling CAN cause cancer. Talk to kids. Did I mention we should talk to kids?https://t.co/dFIpTwVNeW pic.twitter.com/99MkGL0p83 — Deborah Gilboa, MD (@AskDocG) March 5, 2018  honestly I didn’t even know juuling was a thing until it stopped being a thing bc all these kids have lung cancer now yikes :/ — mckenna 🌈✨🦄 (@swiftlydinah) February 14, 2018  Although plenty of news reports warned parents that JUULing was the newest dangerous teen trend, we have been unable to find any that reported diagnoses or death from cancer associated with use of e-cigarettes. This rumor appeared to originate with viral screenshots from an Instagram post of indeterminate origin: the juul wave is ~over~ pic.twitter.com/FcP4pMqNNw — matea cannavino (@mateacannavino) February 7, 2018  According to the screenshots, four students in total have received terminal or otherwise dire diagnoses attributed specifically to their use of JUUL products. Aside from the mention of two universities (USC and LSU), the only available detail was that a 19-year-old man purportedly was “diagnosed with lung cancer” and his “lungs [were] completely black.” This rumor comes with no supporting evidence, incidental or otherwise. Dr. Kien Vuu, professor of medicine at UCLA-David Geffen School of Medicine, addressed the plausibility of specific claims that at least four people had developed lung cancer by JUULing for a relatively short period of their lives: It is unlikely that ‘Juuling’ has a short term carcinogenic effect which would cause cancer so early in these young people. It usually takes a lag time from an exposure of a carcinogen before cancer ensues. Research into the long-term effects of e-cigarette use is ongoing, but David Levy, a professor of oncology at Georgetown Lombardi, said of data published in mid-2017: Our findings are consistent with randomized trials and those observational studies that measure frequency of e-cigarette use. These results support the use of e-cigarettes — especially, consistent use — as an effective smoking cessation aid. Since e-cigarettes are generally estimated to have a small proportion of the mortality risks of cigarettes, this represents an important life-saving intervention that doctors can recommend when other forms of treatment fail. Levy referenced a study (“E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys”) published by BMJ on 26 July 2017. Laws about minimum age for tobacco purchases vary between states. However, JUUL’s self-imposed age restriction is 21, regardless of any state laws: Beginning August 23, 2017, the minimum age to purchase JUUL products on JUULvapor.com will be 21 years or older. For some existing customers, this may mean changes to your account or delivery experience. Warranties will continue to be honored for JUUL devices purchased at retail or online for customers who are of legal age in their state. JUUL posted a statement addressing the rumor: The claim circulating on social media that individuals’ friends “have been diagnosed with cancer as a direct result of the JUUL” is unsubstantiated and reckless. For all our customers, partners and employees that are on our important mission with us to improve public health, know that we will protect the company and our customers and take legal action as appropriate. At JUUL Labs, we care deeply about our customers. Many people in the company and their friends use JUUL as well, so we include ourselves as our customers. We are a mission driven company seeking to eliminate cigarettes by providing a true alternative for adult smokers. JUUL incorporates important technological advances and best practices which include the following; First, JUUL is temperature regulated to minimize the emissions of combustion-related degradation products. Second, we do not add chemicals of concern on key FDA lists such as formaldehyde as ingredients. (Note that nicotine, while on these lists, is included in our product to facilitate switching for adult smokers.) Third, independent third party laboratories have conducted validated analytical tests on the aerosol contents of JUUL and we are excited to present these results within the SRNT scientific forum at the end of this month.


Heart Association's Stroke Guidelines Support Clot-Removing Device If clot-busting drugs don't work, device can be used to pull the blockage out through the artery

Explanation: A Medtronic device used to remove clots during stroke. This brief article explains why a certain subset of people who have strokes may be treated more effectively with a new procedure than with existing alternatives. The new procedure sends a thin wire tube through their blood vessels to the location of a clot in the brain and removes it. The story did an excellent job of listing the complex criteria required to find the patients for whom this procedure is now recommended. It could have provided more specifics about the benefits associated with the procedure and its costs. And one of the experts tapped for commentary is a paid consultant to companies who make the devices used in this procedure, and the story should have alerted readers to that fact. The new guidelines are the result of months of study by a committee of the American Heart Association. Implementation of these guidelines will require much more systematic coordination of stroke care than currently exists. Currently, smaller community hospitals can quickly assess a patient, get an imaging study, and start tPA (clot-busting medication delivered by IV) within an hour or two after symptoms begin. But to assess eligibility for endovascular clot retrieval (the procedure discussed here), and transport patients to centers that provide the highly specialized procedures, could take time. There is good-quality evidence that such coordination of stroke care would produce clinically important benefits, but the logistical and cost challenges that have yet to be addressed are significant.

American Heart Association,Boston Scientific,Medtronic

The article does not mention, even generally, what removing a clot using these devices might cost. In a broader way, we would have welcomed discussion of how much treating strokes costs the entire health system and how risks versus benefits of different strategies may have large effects throughout the health system. For example, if this new intervention prevents disability for more patients, might it save the system those costs? This story is not about a single research study, so it is perhaps understandable that it remains general in its comments about benefits. But we found only statement from an expert that addresses the issue: “All of these studies showed that the device can safely and effectively stop a stroke by removing blood clots.” While stopping a stroke is clearly a benefit, that sentence does not tell us by what percentage of people randomly chosen to receive the new procedure have a better long-term outcome in terms of quality of life, or die less often of later complications, or any other measurable difference. The outcome assessed in the studies, “functional independence after stroke,” is easy to understand. And the benefits were significant: 53-71% of treated patients were functionally independent following the stroke, compared to 29-40% of untreated patients. The article meets the standard by including this sentence: “The major risk of using the device is that it could tear an artery and cause bleeding in the brain, particularly since it will be used on people who have already received very potent blood thinners, Kandzari said.” It also notes, “clinical trials have shown that the risk of brain bleeding for people who received tPA and then went through mechanical clot removal is no greater than for people who just receive the blood thinner.” Some caution about the fact that we don’t know if that risk will be as low when the procedure is rolled out more widely (as opposed to being used in a highly controlled study environment) would have been welcome. This story is about a set of guidelines and not about a single research study. The guidelines are themselves based on six different randomized trials described elsewhere as of high-quality. Guidelines like these are very carefully considered by a committee. The quote from the story is: “The outcomes were uniformly positive in all of the trials,” he said. “It’s really, really good evidence.” The story also notes that the guidelines have been endorsed by other medical societies. In addition, there is discussion of limitations insofar as the story addresses how narrowly one must filter patients in order for them to fit these new guidelines. We think the discussion of evidence is sufficient to convey the quality of the research, but we wouldn’t have minded some additional detail. For example, the related news release issued for the guidelines says: “The evidence backing this new recommendation received the highest rating based on the scientific evidence reviewed, and suggests the benefits substantially outweigh the potential risks in these patients.” and further: “Evidence-based guidelines are based on clinical trials, which tell you that if you have a patient with the same characteristics of those in the trials, on average they will do much better with the treatment than if you treat them another way,” Powers said. There was no disease mongering in this story. The story quotes two experts, one of whom chaired the committee that wrote the guidelines (Powers) and the other (Kandazari) who was apparently independent of the guideline-writing process. The solicitation of an outside expert opinion is commendable, but the story should have notified readers that Dr. Kandazari is a paid consultant for companies, such as Medtronic and Boston Scientific, that make the devices that are used in these procedures. See this Wall Street Journal report and the disclosures on this online CME program. The alternative to endovascular clot retrieval is no procedure, and is made clear in the article. It’s clear from the story that these procedures can only be performed by highly-trained interventionists at specialized stroke treatment centers. The story emphasizes the importance of getting patients to these centers quickly. That’s sufficient for a Satisfactory rating, but it would have been nice to know how many of these stroke centers there are throughout the country. And do most residents in the US live close enough to get to one within the magic short window? We believe the story establishes that the procedure has been under study for some time and that the guidelines issued are new. The story quotes the author of the guidelines, and one other expert who is not an author. It does not rely solely on the news release.


Al Jazeera reporter Kimberly Halkett called White House Press Secretary Kayleigh McEnany a "lying bitch" during a press briefing.

Explanation: Did a Reporter Call Kayleigh McEnany a ‘Lying Bitch’?

An exchange between White House Press Secretary Kayleigh McEnany and a reporter for Al-Jazeera led to allegations that the reporter muttered an epithet.Right-wing social media users accused reporter Kimberly Halkett of calling McEnany a “lying bitch” after a press briefing on July 21 2020. A clip of the end of the exchange between the two posted by the “@Breaking911” Twitter account was shared more than 2,500 times on the platform:WATCH: Reporter appears to call White House @PressSec Kayleigh McEnany a “lying bitch.” pic.twitter.com/BLCISlaAbp— Breaking911 (@Breaking911) July 21, 2020Halkett herself wrote on Twitter that she told McEnany, “OK, you don’t want to engage.” As fellow reporter Andrew Feinberg noted, the official White House transcript of the briefing corroborates Halkett’s claim:If you’re still accusing @KimberlyHalkett of using an obscenity during today’s briefing with @PressSec, even the White House official stenographers say you’re wrong. pic.twitter.com/9T3EPDdBnR— Andrew Feinberg (@AndrewFeinberg) July 21, 2020The exchange and its abrupt end stemmed from a question Halkett posed regarding United States President Donald Trump’s “concerns” about mail-in voting; Trump had recently claimed once again, falsely, that mail-in voting would lead to “the most CORRUPT ELECTION in our Nation’s History.” (As NBC News reported, Facebook added a label to the post urging users to “get official voting info,” without debunking the claim. )Halkett asked:So he’s obviously concerned about the integrity of the U.S. election and certainly internal sabotage. But why are we not hearing from the President about fears about external sabotage?For example, coming out of the UK today, there is a Parliamentary Committee report that says that Russia influenced the Scottish referendum; there are questions about Brexit. But we’ve really not heard the President put the Kremlin on notice with respect to the U.S. election. Will we hear from him today on that?“The President today has put the world on notice that our election systems must be secure,” McEnany responded, according to the transcript. “This is — under this President, in 2018, he articulated the first full cyber strategy for the United States since 2003. In 2019, he extended the National Emergency Declaration on Foreign Election Interference.”As Halkett continued to try to ask McEnany specifically about election interference on the part of Russia, McEnany instead cited a Wall Street Journal editorial claiming that mail-in voting had produced an “absolute catastrophe” in New York City. (A day prior to the editorial’s publication, more than 280 of the newspaper’s editors and reporters signed a letter criticizing the opinion section for a “lack of fact-checking and transparency, and its apparent disregard for evidence.”)“What they found is 19 percent of ballots have been rejected in Queens, 28 percent rejected in Brooklyn,” McEnany said. “There are questions about mail — mass mail-out [sic] voting.”“I’m asking about foreign interference,” Halkett replied.“And I know you don’t want to hear them, which is why you talk over me,” McEnany said. “But I encourage you to read the op-ed.”After that point, the audio becomes unclear as both women talk simultaneously, but the transcript reads:Q: Okay, let me just redirect on the China vaccine research. Russia has interfered —MS. MCENANY: Yes, you’ve gotten two questions, which is more than some of your colleagues.Yes.Q: Okay, you don’t want to engage.In May 2020, the Tampa Bay Times reported that despite claiming that there were “real concerns about mail-in voting,” McEnany herself has voted by mail in Florida, listed as her state of residence, eleven times in the past ten years. To date she has not told the newspaper whether she would support changing the state law to “to restrict voting by mail to those unable to vote in person.”The flap between Halkett and McEnany came just hours after a confirmed account of profanity against Democratic Rep. Alexandria Ocasio-Cortez. As The Hill reported, Republican Rep. Ted Yoho cursed at Ocasio-Cortez after approaching her in the Capitol:In a brief but heated exchange, which was overheard by a reporter, Yoho told Ocasio-Cortez she was “disgusting” for recently suggesting that poverty and unemployment are driving a spike in crime in New York City during the coronavirus pandemic.“You are out of your freaking mind,” Yoho told her.Ocasio-Cortez shot back, telling Yoho he was being “rude.”The two then parted ways. Ocasio-Cortez headed into the building, while Yoho, joined by Rep. Roger Williams (R-Texas), began descending toward the House office buildings. A few steps down, Yoho offered a parting thought to no one in particular.“Fucking bitch,” he said.Ocasio-Cortez later confirmed the encounter, adding: “That kind of confrontation hasn’t ever happened to me — ever. I’ve never had that kind of abrupt, disgusting kind of disrespect levied at me.”Comments


Explanation: While it’s true that a mayor in New York state has introduced a plan to allow heroin users to use the drug under medical supervision, the claim that the city of New York has legalized heroin for recreational use is not true, and originated with a satire news web site.

Junk News, empire news, heroin, legalized

On 15 February 2016, the entertainment web site Empire News published an article claiming that New York state had legalized heroin: The state of New York made history this week, following on the heels of the wave of marijuana legalizations across the country. Recreational use of heroin will become fully legal in the state by the end of this year. […] “By legalizing, monitoring, and taxing heroin, we will not only cut down on inmates and care costs, but also open up a whole new job market,” Cuomo explained. “It’s a good situation all around, especially for taxpayers.” This story is a piece of fiction from Empire News, a fake news web site that clearly labels its content as “satire” in its disclaimer: Empire News is intended for entertainment purposes only. Our website and social media content uses only fictional names, except in cases of public figure and celebrity parody or satirization. Any other use of real names is accidental and coincidental. While Empire News is open about its satirical content, the article was later republished by web sites such as We Are Change, Health Facts Concern, and Top Health Records, which do not clearly identify themselves as purveyors of fake news. In addition to multiple web sites sharing the fake news story, some readers may have been confused by recent stories about Ithaca mayor Svante Myrick’s controversial plan to allow heroin users to use the drug legally (but under medical supervision): An upstate New York mayor’s proposal to consider allowing heroin users to shoot up under medical supervision has divided drug policy experts, with some hailing it as an innovative, science-based approach and others rejecting it as radical and a slippery slope to legalization. Ithaca Mayor Svante Myrick formally announced the idea Wednesday as one of several proposals to address a wave of opioid addiction. The Democratic mayor also wants to create a new office of drug policy, help at-risk teens learn work skills and adopt a strategy implemented in Seattle that has police sending low-level drug offenders to treatment instead of jail.


Oregon Governor Kate Brown signed a bill into law in August 2017 that allows authorities to confiscate guns from certain individuals without prior notice or hearing.

Explanation: Oregon Governor Signs Gun Confiscation Bill Into Law

It’s true that those who believe a family member is risk to themselves or someone else will be able to petition the court for an “extreme risk protection order” that temporarily strips them of gun rights — but main parts of the so-called Oregon gun confiscation bill have been misrepresented. Oregon Gov. Kate Brown signed Senate Bill 719 into law on August 16, 2017, and the law took effect on August 23. The bill, which is modeled after similar measures in Washington and California, enables ” a family or household member” to petition the court for an extreme risk protection order that can revoke a person’s right to own guns and ammunition for up to a year. The petitioner has to provide evidence that an individual attempted suicide within the last 180 days, or that they had been convicted on offenses like domestic abuse, drunken driving, stalking, and animal abuse, among others. The bill outlines conditions that have to be met for a judge to issue an extreme risk protection order : The court shall issue an extreme risk protection order if the court finds by clear and convincing evidence, based on the petition and supporting documentation and after considering a statement by the respondent, if provided, that the respondent presents a risk in the near future, including an imminent risk, of suicide or of causing physical injury to another person. The court may not include in the findings any mental health diagnosis or any connection between the risk presented by the respondent and mental illness. Once an order is issued and notice is served, the respondent has 30 days to appeal the decision. If an appeal is filed, a hearing has to be scheduled within 21 days for the respondent to make a case. If there’s no appeal, or if the appeal is denied, the order is enforced, and law enforcers have the authority to search and seize weapons and ammunition. Gun rights groups reported on the bill extensively, some calling it the Oregon gun confiscation bill. While many of these reports accurately summarized Senate Bill 719, others misrepresented key parts of it. One site, Silence is Consent, published a report that was shared nearly 150,000 times on social media within days. The report claimed that bill violated 14th Amendment due process rights, a claim that’s false: It’s also a direct violation of the 14th amendment, which gives United States citizens the right to a formal hearing before their property is seized: All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws. Comments


Researchers Develop Simple Paper Test That Quickly Diagnoses Illnesses by Changing Colour

Explanation: Paper diagnostic test strip. Image: McMaster UniversityThis news release reports on the development of paper test strips that amplify DNA or RNA from blood, sweat or urine and determine if the person taking the test has a disease. The strips are made of a polymeric sugar film integrated with the paper device. Once a sample is applied the paper changes color to indicate the presence of a marker for a “specific bacterium, virus, or even cancer,” according to the release. The researchers quoted in the release claim that these test strips can be easily and inexpensively manufactured and, because they are portable, could be used to diagnose or self-diagnose illness (such as Ebola) in remote areas before the subject even knows they are ill. But the release does not make clear how such a test could be used to diagnose and differentiate between the multitudes of different diseases and conditions that afflict humans. Besides skirting other important details such as ballpark cost of the strips and data backing up claimed benefits, the release doesn’t put the paper test in context. While the idea of a “simple” paper test to check for illness may sound novel to the public, paper diagnostic tools have been under development since at least 2007. Some diseases are contagious long before the patient has any symptoms. If a person could be diagnosed as contagious in an asymptomatic stage, then the spread of infection could be slowed or halted. A rapid test allowing patients tested in a clinic to know before they left if they had influenza or a cold, strep or a viral sore throat, would be advantageous because it would allow faster targeted treatments. Because such a diagnostic tools are predicted to be relatively inexpensive, portable, and easy to use, they might also hold enormous potential for helping health professionals in the developing world to quickly and accurately diagnose and treat disease.

Academic medical center news release,Diagnostic tests

While the release says that the test strips would be inexpensive, there is no indication of what exactly that means. Also, the assumed necessity of multiple strips for different diseases means a wide variety of test strips would be necessary. There is no indication of how the strips might compare in cost to common laboratory diagnostic tests. We know that this research is preliminary and that it might be difficult to give an accurate figure. But if it’s not too early to claim these tests “can confirm presence of infections, some cancers, even before patients feel symptoms,” then it’s not too early to give some sense of what the test might cost. The release indicates that it would be good to diagnose these diseases quickly and cheaply, but there are no hard numbers on how accurate the test strips are or how beneficial it is to diagnose a cold early. While the spread of disease might be a consideration, that is not mentioned in the release. The release doesn’t tell readers how sensitive the paper diagnostics are, or whether their sensitivity and accuracy vary from illness to illness or from medium to medium. For example, does sensitivity vary depending on whether they are analyzing blood or urine? As with all diagnostic tests, there is the risk of false or missed diagnosis that this news release doesn’t address. One can envision a scenario where cheaper, easier-to-use diagnostic tests lead to more frequent testing in situations where tests wouldn’t have been used before. The increased volume of testing could lead to more false-positive results with resulting unnecessary anxiety and treatment. There is no mention of any metrics in this news release. No indication of how well the DNA or RNA amplify or how accurately this occurs. There is no indication of false positive or negative results either. In general, the science behind this development is left out of the news release. The release does not engage in disease mongering. The news release lists all the funding sources for the project. All of the authors are McMasters University faculty or staff. The only corporate funder is Pro-Lab Diagnostics. It is unclear if any of the authors have conflicts of interest with this funding source. There is no mention of which alternative or conventional diagnostic tests the paper strips might replace. The news release makes it clear that this technology is not currently available, but says it “could be commercialized quickly.” That seems a bit optimistic to us, but we’ll give the benefit of the doubt here. In assessing the novelty of the test we took into account that paper diagnostic tools are not a new concept. Organizations such as Diagnostics For All have been working in this field since at least 2007, and paper diagnostic tools have also garnered significant news coverage. For example, MIT Technology Review listed paper diagnostics one of their 10 “breakthrough technologies” in 2009. The field is sufficiently active that there have been at least three different review papers over the past couple of years on research into paper diagnostics: here, here and here. Without some context regarding the field, it’s unclear what is novel about these new research findings or how they advance paper diagnostics. We’ll give the release a pass for this criteria even though the release talks about a new diagnostic test that “can change the medical landscape.” However, we already addressed the question of novelty and won’t ding the sponsor twice for making this claim.


A Johns Hopkins scientist issued a "blistering report" on flu vaccine dangers in the British Medical Journal.

Explanation: What's true: A piece published in British Medical Journal argued the potential risks of aggressive vaccination against the flu have not been highlighted sufficiently, and that the benefits of the flu shot are overestimated. What's false: The British Medical Journal piece was neither a "research article" nor a peer-reviewed study, and it was authored by an anthropologist who is neither a "Johns Hopkins scientist" nor a professional in the medical or biological fields.

On 17 October 2014, a natural news blog posted an article (which had initially been published over a year earlier by a different alternative health news site) reporting that a “Johns Hopkins scientist … issued a blistering report on influenza vaccines in the British Medical Journal (BMJ).” The article, timed to the start of flu season, spread rapidly on social media sites and sparked renewed interest in the subject of flu vaccines. The article referenced a 16 May 2013 feature by Peter Doshi that was published in the British Medical Journal. However, the importance of that BMJ feature was greatly exaggerated by the natural news sites that used it as the basis for their own articles. Despite BMJ’s authoritative reputation in the medical world, items published by that journal as “features” are not medical studies but rather pieces run under a “News & Views” heading. Readers unfamiliar with the BMJ can easily confuse claims made in feature articles for peer-reviewed research findings. Moreover, Johns Hopkins University had nothing to do with the so-called “blistering report” about flu vaccinations touted in natural news articles Peter Doshi is neither a virologist nor a epidemiologist, but rather an anthropologist who completed a fellowship in comparative effectiveness research at Johns Hopkins. He conducted no research into influenza or vaccines at Johns Hopkins, nor does he speak for the university on that subject. In Peter Doshi’s British Medical Journal feature, he that argued the potential risks of aggressive vaccination against the flu have not been highlighted sufficiently, and that the benefits of the flu shot are overestimated: Today around 135 million doses of influenza vaccine annually enter the US market, with vaccinations administered in drug stores, supermarkets — even some drive-throughs. This enormous growth has not been fueled by popular demand but instead by a public health campaign that delivers a straightforward, who-in-their-right-mind-could-possibly-disagree message: influenza is a serious disease, we are all at risk of complications from influenza, the flu shot is virtually risk free, and vaccination saves lives. Through this lens, the lack of influenza vaccine availability for all 315 million US citizens seems to border on the unethical. Yet across the country, mandatory influenza vaccination policies have cropped up, particularly in healthcare facilities, precisely because not everyone wants the vaccination, and compulsion appears the only way to achieve high vaccination rates. Closer examination of influenza vaccine policies shows that although proponents employ the rhetoric of science, the studies underlying the policy are often of low quality, and do not substantiate officials’ claims. The vaccine might be less beneficial and less safe than has been claimed, and the threat of influenza appears overstated. Doshi strongly suggested, without ever actually saying so, that the flu vaccine may not be beneficial at all. But he never came close to proving that point — instead, he continually harped about the notion that the effectiveness of the vaccine (and studies thereof) didn’t apply equally to everyone (an obvious point) and repeatedly picked nits about whether the precise percentages reported in published studies on the vaccine are accurate. As Forbes noted of his claims:  Doshi’s argument against the flu vaccine boils down to this: the vaccine is much less than 100% effective, and it doesn’t work for everyone. This is undeniably true, and the research community makes no secret of it. Meanwhile, though, the annual flu vaccine is usually effective: a recent study showed, for example, that it reduced children’s risk of ending up in a pediatric intensive care unit by 74%. So get your flu shot (or snort) now, before flu season hits, because it takes a couple of weeks for your body to develop immunity. By getting immunized, you’ll not only increase your chances of getting through the winter flu-free, but (because you won’t spread the flu to others) you might also save someone whose immune system would be overwhelmed by influenza. The natural news blog post referencing Doshi’s 2013 BMJ feature also quoted Dr. Russell Blaylock: For most people, says Dr. Blaylock, flu vaccines don’t prevent the flu but actually increase the odds of getting it. The mercury contained in vaccines is such a strong immune depressant that a flu shot suppresses immunity for several weeks. “This makes people highly susceptible to catching the flu,” he says. “They may even think the vaccine gave them the flu, but that’s not true — it depressed their immune system and then they caught the flu.” Blaylock, a former neurosurgeon, has a history of issuing dubious, conspiracy-based warnings about a number of suspected dangers in both science-based medicine and the environment at large, including aspartame, chemtrails, cookware, and dental amalgams. A 2009 profile in a Canadian newspaper quoted Blaylock on his belief that the Affordable Healthcare Act (or Obamacare) was in actuality a depopulation effort: “Knowing they cannot easily pass a euthanasia law or just have them rounded up and exterminated, they (the proponents of socialized medicine) use the medical care system to speed them along to their deaths.” Totalitarianism is coming and, “as the economy worsens, which they can engineer with their Federal Reserve friends, people will be more accepting of such things as euthanasia on the elderly and terminally ill, the insane, the feeble-minded and the chronically ill.” Vaccines are also one of Blaylock’s many targets. He insinuates that the H1N1 virus may be the product of some pharmaceutical research project gone awry, or that it may even be a man-made virus purposely released by someone with the “Illuminati Depopulation Agenda.” Blaylock appears regularly on right-wing radio programs such as the Alex Jones Show, where the popular topics are climate-change fraud and the supposed erosion of civil liberties under Obama. The claims made by Doshi and echoed by Blaylock hinge on a flawed, two-pronged premise: flu vaccines are a large moneymaker for pharmaceutical companies, and the vaccines aren’t really beneficial because the flu isn’t that bad and healthy people don’t die from it. First, the flu shot is not nearly as profitable to pharmaceutical companies as many imagine, generating less than one percent of global pharmaceutical company revenues. By contrast, an actual flu epidemic would likely generate far larger profits for those companies: Worldwide sales of flu vaccines in 2013 was around $3.1 billion, according to estimates of a healthcare market research firm. But let’s put this in context of the worldwide sales of all pharmaceutical products in 2013 — nearly $1 trillion. In other words, various flu vaccines make up less than 0.3% of worldwide sales of Big Pharma, so from a strategic point of view, it’s not that interesting. Just for context, cholesterol lowering drugs, like statins, sold more than $33 billion two years ago. If I were a Big Pharma executive, I’d be telling my R&D and Marketing divisions to invest in new statins, because the potential return on investment could be 10X higher. Vaccines in general have a lower net profit than other pharmaceuticals. There are many reasons for the lower profit for vaccines, but it’s mostly due to shipping and spoilage loss. For flu vaccines, it’s actually much worse. Flu vaccines are only useful for one flu season, so anything unsold at the end of the flu season is destroyed. Thus, if you look at flu vaccine as a profit center for Big Pharma, there really are better strategic and tactical choices for pharmaceutical companies. Moreover, according to data from the Centers for Disease Control (CDC), tens of thousands of people (many otherwise healthy) die each year of the flu. The agency reported in 2013 that 90 percent of juvenile patients who died of the flu in that season had not been vaccinated: Pediatric deaths are defined as flu-associated deaths that occur in people younger than 18 years. An early look at this season’s reports indicates that about 90 percent occurred in children who had not received a flu vaccination this season. This review also indicated that 60 percent of deaths occurred in children who were at high risk of developing serious flu-related complications, but 40 percent of these children had no recognized chronic health problems. The proportions of pediatric deaths occurring in children who were unvaccinated and those who had high-risk conditions are consistent with what has been seen in previous seasons. Finally, much of the objection to flu vaccine marketing makes mention of the varying strains of influenza that circulate each year. A 2013 study indicated the flu shot can “provide cross protection against non-matching circulating strains” even if they are not exactly matched.


Lawsuit filed against county mental health agency.

Explanation: A former adult foster home licenser at Clatsop Behavioral Healthcare has filed a $550,000 lawsuit against the agency alleging gender discrimination and retaliation.

Mental health, Health, Discrimination, Lawsuits, Astoria, Gender discrimination, General News

The Astorian reports Carole Purtle claims she was subjected to sexual harassment from a co-worker and that her complaints were ignored by her supervisor. She also claims she was retaliated against, and ultimately fired, after making the reports to the state about Medicaid. Mental health agency spokesman Michael Shipley said while Clatsop Behavioral Healthcare cannot comment on any pending matters, the agency believes all employees should be treated fairly, and they remain committed to providing a positive environment. Purtle was an adult foster home licenser in the agency’s intellectual and developmental disabilities program. Purtle first took her claims to the state Bureau of Labor and Industries. The state dismissed her complaint in June for insufficient evidence. ___ Information from: The Daily Astorian, http://www.dailyastorian.com


U.S. doctors on coronavirus frontline seek protection from malpractice suits.

Explanation: U.S. medical professionals on the front line of the coronavirus pandemic are lobbying policymakers for protection from potential malpractice lawsuits as hospitals triage care and physicians take on roles outside their specialties.

State chapters of the powerful American Medical Association and other groups representing healthcare providers have been pressing governors for legal cover for decisions made in crisis-stricken emergency rooms. More than half a dozen emergency room doctors and nurses told Reuters they are concerned about liability as they anticipate rationing care or performing unfamiliar jobs due to staff and equipment shortages caused by the outbreak. Governors in New York, New Jersey and Michigan have responded with orders that raised the standard for injuries or deaths while working in support of the state’s response to COVID-19 from negligence to gross negligence, or an egregious deviation from standard care. Physicians, who have long blamed malpractice lawsuits for driving up healthcare costs, hope other states will follow. “There are too many variables here. We are going to be second-guessed,” said Jeremy Faust, an emergency physician at Brigham and Women’s Hospital (BWH) in Boston. “We need better protection, if only to guard against unreasonable claims.”     On Monday, U.S. Senator Ben Sasse, a Republican from Nebraska, introduced legislation that would protect U.S. doctors who practice outside their area of specialty or who use a modified medical device. Doctors would also be protected for providing treatment outside standard healthcare facilities. Plaintiffs firms that specialize in malpractice are keeping an eye on how healthcare providers are responding to the crisis. The Doan Law Firm, which has offices nationwide, said on its website that some providers are adopting “untested treatment plans or use hastily-designed and manufactured patient care equipment” that could “lead to medical malpractice.”  Jimmy Doan, the firm’s founder, did not respond to a request for comment. President Donald Trump warned on Tuesday that the outbreak could kill up to 240,000 in the United States and said that the impact would intensify in coming weeks, potentially overwhelming hospitals. Doctors and nurses said they worried about the lack of equipment and obligations to resuscitate patients without the ventilators needed to do it. In an example of how healthcare professionals could be exposed to malpractice lawsuits, several doctors said the increasing demand for hospital beds meant they weren’t able to be as cautious as they normally might be with non-coronavirus patients. Doctors routinely order extensive testing and overnight observation for patients with mild heart conditions or strokes, even if their symptoms have disappeared once they get to the hospital, for example. Now, they are sending these individuals home to make room for COVID-19 patients. Malpractice lawsuits can be very costly. A Baltimore jury last year awarded $229 million for brain damage suffered by a girl born at Johns Hopkins Bayview Medical Center, for example. Insurance premiums can top $100,000 a year for some specialists in states without caps on damages. An image was posted on Twitter last week of a malpractice law firm’s website which featured a blog post titled “What you should know about medical negligence during the COVID-19 crisis.”  “It truly disgusts me to see what badness comes out during a crisis like this,” wrote Eugene Yang, a professor of medicine at the University of Washington who tweeted the post, which drew dozens of comments, many from healthcare professionals, sharing his rage. The website of the law firm, Mannarino & Brasfield, has been taken offline and a recorded message on the firm’s answering system said the post was published by an outside contractor. The firm’s phone message apologized and said the post did not reflect the firm’s values. Joe Belluck, a New York lawyer who brings medical malpractice cases, said he’s concerned the coronavirus crisis could be used to enact a wish list of changes sought by doctors, hospitals and the medical industry to curb unrelated lawsuits. “I just hope these things are done in a way that is tailored to the crisis taking place,” he said. Lawyers who represent patients said the law already protects medical professionals. To make their case, patients must show a medical provider negligently deviated from the reasonable standard of care for the particular circumstances. An emergency room doctor operating in the peak chaos of the coronavirus outbreak wouldn’t be judged against the standard of care provided in a physician’s private office, they said. “The question I would ask is, why aren’t the ordinary liability rules already sufficient to address the issues?” said Chip Becker of the Kline & Specter law firm in Philadelphia. Kimberly Chernoby, an emergency room doctor in Indiana who works with BWH’s Faust on brief19.com, a website that reviews COVID-19 research and policy, said she’s not reassured. “We’re in a once-in-a-lifetime experience. Who knows what’s reasonable?” she said.


Massachusetts’ ban on vaping product sales allowed to stand.

Explanation: A state judge on Monday allowed Massachusetts’ four-month ban on the sale of all vaping products to remain in effect but said Gov. Charlie Baker had failed to follow required procedures in enacting the measure.

Health, General News, Charlie Baker, Massachusetts, Vaping

Immediately lifting the ban as requested by the vaping industry “would contravene the public interest,” Suffolk Superior Court Judge Douglas Wilkins wrote in his decision. But he said unless the state goes through the proper procedure for the adoption of an emergency regulation, which requires a public hearing, the ban will end next Monday. “Input from affected industries and members of the public is a potent safeguard against executive abuse of discretion,” Wilkins wrote. The Republican governor last month announced a statewide ban on the sale of vaping products in response to lung illnesses and deaths attributed to the use of e-cigarette products. “We always said that we knew the courts were probably going to be part of this process,” Baker said in response to Monday’s decision. “But for us the public health issues associated with this outweighed the negative consequences, which are real, and we understand that associated with the ban in the first place.” A spokeswoman for the governor says the administration will work with the state attorney general’s office on the next steps. After the governor enacted the ban, several vape shops as well as an industry group challenged it in court, saying it was destroying their business. Baker’s ban “reflects executive overreach, which violates state constitutional separation-of-powers principles” and is “arbitrary and capricious,” the plaintiffs said. Tony Abboud, the executive director of the Vapor Technology Association, said in a statement he was pleased the judge recognized that the organization is likely to prevail in court. “We regret, however, the court’s decision to allow this improper ban to stay in place for a week while the state considers other regulatory alternatives,” he said. Massachusetts public health officials say there have been 29 confirmed or probable vaping-related lung illnesses and one death in the state. Nationwide, the number of vaping-related lung injury cases has surpassed 1,400, and with 33 deaths, according to the U.S. Centre for Disease Control and Prevention.


Afghan capital’s air pollution may be even deadlier than war.

Explanation: Yousuf fled with his family from his home in eastern Afghanistan eight years ago to escape the war, but he couldn’t escape tragedy. In the capital, Kabul, five of his children died, not from violence or bombings, but from air pollution, worsened by bitter cold and poverty.

Afghanistan, AP Top News, International News, General News, Air pollution, Kabul, Health, Science, Asia Pacific, Pollution

At the camp for displaced people they live in, they and other families keep warm and cook by burning the garbage that surrounds them. One by one over the years, each of the children got chest infections and other maladies from the pollution and never made it to age seven, he told The Associated Press. The 60-year-old has nine surviving children. “We didn’t have enough money for the doctor and medicine ... I can barely feed my children,” said Yousuf, who works as a porter in a vegetable market earning barely a dollar a day. Like many Afghans he uses only one name. Afghanistan’s pollution may be even deadlier than its war, now 18 years long. There are no official statistics on how many Afghans die of pollution-related illnesses, but the research group State of Global Air said more than 26,000 deaths could be attributed to it in 2017. In contrast, 3,483 civilians were killed that year in the Afghan war, according to the United Nations. Kabul, a city of some 6 million, has become one of the most polluted cities in the world — ranking in the top of the list among other polluted capitals such as India’s New Delhi or China’s Beijing. Decades of war have wrecked the city’s infrastructure and caused waves of displaced people. On most days, a pall of smog and smoke lies over the city. Old vehicles pump toxins into the air, as do electrical generators using poor quality fuel. Coal, garbage, plastic and rubber are burned by poor people at home, as well as at the many brick kilns, public baths and bakeries. Many apartment buildings have no proper sanitation system, and garbage is piled on roadsides and sidewalks. The large majority of victims are poisoned by the air in their own homes, as families burn whatever they can to keep warm in Kabul’s winters, with frequent sub-zero temperatures and snow. Children and elderly are particularly vulnerable. At least 19,400 of the 2017 deaths were attributable to household pollution, which also contributed to a loss of two years and two months of life expectancy at birth, according to the State of Global Air survey. Yousuf’s camp, home to more than a hundred families, has no proper water or sanitation system and is surrounded by garbage dumps. His and other families’ children search through the garbage for paper, cloth, sticks or plastic, anything that can be burned for fuel. “We are so poor, and we have lots of problems, we don’t have enough money for medicine, wood or coal for heating, so this is our life, my children collect garbage from dump yards and we use it for cooking and heating to keep the kids warm,” he added. Decades of war have worsened the damage to Afghanistan’s environment and have made it a huge challenge to address them. Environmental issues are far down the list of priorities for a government struggling with basic security issues, rampant corruption and a plunging economy. Three or four decades ago, “it was a wish for people to come to Kabul and breath this air,” said Ezatullah Sediqi, deputy director for the National Environmental Protection Agency. But in the wars since, “we lost all our urban infrastructure for water, electricity, public transportation, green areas, all these things,” he said. Kabul’s environmental department has launched a new program to control old vehicles, one significant source of pollution. “Fighting pollution is an important as fighting terrorism,” said Mohammad Kazim Humayoun, the department’s director. Authorities warn that this winter is expected to be colder than usual and fear that will only increase the use of pollution-creating fuels to keep warm. The Kabul municipality has also called on residents to stop burning garbage for heat and instead use fuel. “If everyone follows the instructions laid out by Kabul Municipality, the pollution could be controlled,” the municipality’s spokeswoman, Nargis Mohmand, said. But if not, “then we might live with this untreatable wound for years to come.” But fuel is either too expensive or not available for many in Kabul. Electrical heaters are too pricey for most, and power outages are frequent. Doctors at Kabul’s Indira Gandhi Children’s Hospital say they’ve seen the numbers of patients with pollution-related illnesses increase, though they could not give exact figures. In the winter, hundreds of children a day sometimes come in, suffering from respiratory illnesses, according to hospital officials. Dr. Saifullah Abassin, a specialist trainer at the hospital, said his ward has a capacity of 10 patients but often has three times that number. The government has launched an environmental awareness campaign. Ads on TV, programs at schools and universities and sermons at mosques talk about pollution’s harm to society and tell listeners about steps to reduce it. But there are steps the state needs to take, like encouraging the planting of trees and creating green spaces, as well as implementing a city master plan to stop unplanned development around the capital, often a source of pollution because of their lack of services. Sediqi, of the NEPA, said that ever since the first post-Taliban government was created in 2001, there was no planning on urban infrastructure, which left individuals to build on their own. “Unfortunately, that led to unplanned development,” he said. “So now we have numerous urban problems and challenges and organizational challenges, which is causing the environmental pollution.”


Reports out of Texas that voting machines are automatically switching votes for Donald Trump to votes for Hillary Clinton have fueled speculation that the election is rigged.

Explanation: Texas Vote Switching Fuels Speculation About Rigged Election

Local officials say that scattered reports of vote switching in Texas are a result of voter error, and we couldn’t find any evidence of widespread election fraud going on. Rumors that voting machines in Texas were automatically switching votes for Donald Trump to votes for Hillary Clinton started when early voting opened in Texas on October 24th. A handful of posts popped up on social media about vote switching or vote flipping in the Arlington and Dallas areas. Typically, these posts stated that the voter cast a straight Republican ballot only to find that the Clinton/Kaine box had also been highlighted:    Officials at the Randall County Elections Office told local radio station KISS FM 969 that they were aware of the reports but had chalked them up to user error, “They said that there are several voters each year who report that their ballots are mis-marked, but they are usually caused by the voter accidentally selecting a different party.” And Potter County Judge Nancy Tanner issued a statement on October 25th saying that, “There is not wrong with any of the machines we use for voting. They do not flip your vote. They do not flip parties. Humans do that.” Tanner went on to describe “one incident in Randall County” where a voter voted straight ticket and when they hit the vote button, it flipped parties: They reported it to the election official and they cancelled that ballot and allowed the voter to vote again on another machine. The machine was then checked and nothing was wrong with the machine. I urge the voters to take the opportunity to review their ballots before they hit the vote button. As everyone knows, our fingers don’t always do what their brain tells them. Texas Secretary of State Carlos Cascos, a Republican, also pushed back against claims of widespread voter fraud in the state, the San Antonio Express-News reports: Reacting to GOP presidential candidate Donald Trump’s persistent claims that the election is “rigged,” Cascos, a Republican, said that’s “highly unlikely, very improbable” in this state because each of Texas’ 254 counties has its own voting system, many of them with analog equipment. “I am not concerned about a nationwide vote-rigging epidemic. I certainly don’t believe that it’s going to happen in Texas,” Cascos said. “There’s just too many protocols … at local offices where votes get counted. You’d have to be somebody ingenious, a massive conspiracy with a whole bunch of people involved to try to penetrate every single election office,” Cascos said. On the subject of voter fraud, which Trump also asserts is rampant, Cascos said it happens, but he’s uncertain how often and how significant it is. “I don’t think that anybody has a good handle on it,” he said. In conclusion, there were a few reports of vote flipping in Texas,  but local officials chalked them up to voter error, not rigged voting machines. Aside from a handful of social media posts, there doesn’t appear to be any proof that a vote flipping or vote switching is going on in Texas. That’s why we’re calling this one “unproven.”


Anti-abortion groups are claiming every sperm cell is "a life.

Explanation: We are a Las Vegas based “news” outlet that will keep you informed of trending topics in your world. We only post the most “accurate” and timely information. You can always count on us to bring you the “facts” surrounding everyday events.

Junk News, anti-abortion, fake news, straight stoned

On 6 May 2016, the web site Straight Stoned published an article reporting that anti-abortion groups decided that masturbation was murder, because of the waste of sperm cells involved: The pro-life movement in the United States has long advocated their stance that human life begins at conception and that the human fetus is a person and therefore has a right to live. However, a new argument has taken flight over the last month that is taking the abortion debate to the next level. The variety in opinion on the issue of abortion is reflected in the diverse views of religious groups, but now pro-lifers are declaring “ejaculation is murder” and they want strict laws against the practice. “Life begins BEFORE conception. This is why the Catholics do not believe in birth control,” said Rachel Stratt, pro-life activist. “God made men’s semen for a purpose, and you can just “waste” that purpose by gratifying yourself whenever you want to. Every time you do, you are literally killing thousands of babies! Ejaculation is murder and every sperm cell is a life!” Stratt and her group of protesters are calling for a law that will make ejaculating for self gratification illegal in every state across the country. “Millions upon millions of innocent lives are wasted every day while men have lustful thoughts or watch those sick p*rnos on P*rnHub. We have got to put a stop to this as a human race. Save the sperm, save the children!” The image attached to the story featured a group of women protesting, one of whom was holding a sign that read “Ejaculation is Murder.” However, the image dated to 2014, and the original was subjected to some fairly obvious manipulation: Unlike many fake news sites, Straight Stoned included a tongue-in-cheek disclaimer heavily insinuating its content was not meant to be taken seriously: Your #1 Source For So Called “News”


Biogen multiple sclerosis drug Tecfidera wins European approval.

Explanation: Biogen Idec Inc’s high profile new multiple sclerosis drug Tecfidera won European approval, the company said on Monday, opening the door for its launch in one of the world’s largest markets for MS treatments.

The approval was widely expected after the European Medicines Agency endorsed the drug in November. European health regulators typically follow EMA recommendations within a couple of months. Tecfidera will be the third oral MS drug available in Europe. However, if its impressive early performance in the United States is any indication, the Biogen drug is likely to surpass sales of Novartis’ Gilenya and Aubagio from Sanofi. Tecfidera has consistently shattered Wall Street sales forecasts and is well on the way to racking up more than $1 billion in sales in its first year on the market. Biogen reported Tecfidera sales of $398 million for the fourth quarter of 2013, only the medicine’s third full quarter since winning U.S. approval. It is also approved for sale in Canada and Australia. The introduction in Europe will start in the coming weeks, although its full roll-out will take place over the course of this year and next as Biogen must negotiate reimbursement for the treatment on a country by country basis. First up will be Germany, “where you can get pricing reimbursement rather quickly,” Tony Kingsley, Biogen’s head of global commercial operations, said in a telephone interview. “We’re ready to go,” said Kingsley, adding that Biogen’s Germany sales force for the new drug has been in place for months. Tecfidera’s prospects in Europe had been in doubt at one stage because of uncertainty about protection against generic copies. This issue was resolved in November when Biogen won 10 years of regulatory exclusivity. There are an estimated 400,000 people in Europe with multiple sclerosis. Biogen declined to comment on what type of market share Tecfidera was likely to seize in Europe. “We’re very encouraged by our U.S. experience,” Kingsley said. Robert W Baird analyst Christopher Raymond forecast 2014 Tecfidera sales outside the United States of $291 million. Looking further ahead, analysts on average forecast annual worldwide sales of the drug reaching some $6 billion by 2019, with more than a third of that coming from Europe and other non-U.S. markets, according to consensus forecasts compiled by Thomson Reuters Pharma.


Blogger Says the Vatican reports that Pope Francis tested negative for the coronavirus before a second test came back positive.

Explanation: A California jury on Monday awarded more than $2 billion to a couple who claimed Bayer AG’s glyphosate-based Roundup weed killer caused their cancer, in the largest U.S. jury verdict to date against the company in litigation over the chemical.

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The large punitive damages award is likely to be reduced due to U.S. Supreme Court rulings that limit the ratio of punitive to compensatory damages to 9:1. The jury awarded a total of $2 billion in punitive damages and $55 million in compensatory damages. It was the third consecutive U.S. jury verdict against the company in litigation over the chemical, which Bayer acquired as part of its $63 billion purchase of Monsanto last year. Both other jury verdicts also came in California, one in state court and one in federal court. The jury in Alameda County Superior Court in Oakland on Monday said the company was liable for plaintiffs Alva and Alberta Pilliod’s contracting non-Hodgkin’s lymphoma, a spokeswoman for the couple said. It awarded $18 million in compensatory and $1 billion in punitive damages to Alva Pilliod, and $37 million in compensatory and $1 billion in punitive damages to his wife, Alberta Pilliod. The jury found Roundup had been defectively designed, that the company failed to warn of the herbicide’s cancer risk and that the company acted negligently. The German chemicals giant faces more than 13,400 U.S. lawsuits over the herbicide’s alleged cancer risk. The next jury trial in the glyphosate litigation is scheduled for August in Missouri state court, the first time a jury outside of California will hear a Roundup case. The trial will take place in St. Louis County, where Monsanto’s former headquarters are located. Bayer in a statement on Monday said it was disappointed with the verdict and will appeal. A spokesman called the jury’s decision “excessive and unjustifiable.”   The company said both Alva and Alberta Pilliod had long histories of illnesses known to be substantial risk factors for non-Hodgkin’s lymphoma. “The contrast between today’s verdict and (U.S. Environmental Protection Agency’s) conclusion that there are ‘no risks to public health from the current registered uses of glyphosate’ could not be more stark,” Bayer said. Bayer says that decades of studies by the company and independent scientists have shown glyphosate and Roundup to be safe for human use. Bayer also points to several regulators around the world that found that glyphosate was not carcinogenic to humans. Brent Wisner, a lawyer for the Pilliods, at a news conference following the verdict said Bayer had to take responsibility for its product. “Monsanto keeps denying that it causes cancer and these two fine people here are casualties of that deception,” Wisner said, standing next to the California couple, who are in their 70s. Alberta Pilliod called on Bayer to add a warning label to Roundup, saying she and her husband would not have used the product had it alerted them to a cancer risk. “We’ve been fighting cancer for more than nine years now and we can’t do any of the things we wanted to do. We really resent Monsanto for that,” Pilliod said. The prior two jury verdicts against Bayer in U.S. Roundup trials triggered steep declines in Bayer shares. A San Francisco state court jury in August 2018 awarded $289 million to a California groundskeeper, finding Monsanto’s glyphosate-based weed killers caused his cancer. That award was later reduced to $78 million and is on appeal. In March, a federal jury in San Francisco awarded $80 million to another California man after finding Roundup caused his cancer. The company also said it would appeal that decision. Adam Zimmerman, a law professor at Loyola Law School in Los Angeles, on Monday said it was too early to speculate about a potential settlement of the litigation by Bayer. “The legal questions on appeal in the previous two cases will ultimately inform how this litigation proceeds,” Zimmerman said. It also remains to be seen how juries in other part of the country react to the evidence in upcoming trials, he said. Shareholders have rebuked the company’s top management over its handling of the Monsanto acquisition and the litigation it inherited, which has wiped around 30 billion euros ($33.68 billion) from Bayer’s market value since the first jury verdict. The Pilliods allege the regular use of Roundup on their property between 1975 and 2011 caused them to develop cancers of the lymph system. They filed their lawsuit in 2017 after being diagnosed with cancer in 2011 and 2015, respectively. Both of them are currently in remission, but their trial had been expedited due to the risk of a relapse and potentially short life expectancy. Plaintiffs in the litigation allege that Monsanto had known about the herbicide’s cancer risk for decades, but failed to warn consumers and instead attempted to influence scientists and regulators to receive favorable assessments of its products. Bayer denies those allegations. Lawsuits are largely based on a 2015 conclusion by the World Health Organization’s cancer arm, which classified glyphosate as “probably carcinogenic to humans.”  A 2017 Reuters investigatihere found that the World Health Organization's International Agency for Research on Cancer had dismissed and edited out "non-carcinogenic" findings that were at odds with its final conclusion that the chemical probably causes cancer. The U.S. EPA, the European Chemicals Agency and other regulators have found that glyphosate is not likely carcinogenic to humans.


Immunotherapy Drug Becomes First Therapy Approved by FDA for Rare Skin Cancer

Explanation: A new drug approval offers an opportunity to review the evidence with readers. This news release from the Fred Hutchinson Cancer Research Center about a newly approved drug for Merkel cell carcinoma (MCC), a rare type of skin cancer, missed that chance. We understand the need to get the news out there and even to highlight a patient story, but there is enough evidence on benefits and risks associated with immunotherapy, not to mention costs, that news releases should give readers a fuller picture. Without that important information, the dramatic experience of the cancer patient in the release provides an overly optimistic picture of patient outcomes for everyone who may be diagnosed with this particular type of cancer. MCC is a rare, often aggressive type of skin cancer, with about 1,500 new cases diagnosed in the U.S. each year. The 5-year survival rate for MCC is estimated at around 60 percent, according to MayoClinic.org. This is the first drug approved for treating MCC — but not the only recognized treatment for the disease. Some of the media interest in the approval relates to the rapidity with which the FDA approved it while awarding the drug several special designations — accelerated approval, priority review, breakthrough therapy and orphan drug status, the latter of which “provides incentives to assist and encourage the development of drugs for rare diseases,” according to the FDA’s news release on the approval. Readers should keep in mind that the evidence for the drug is limited and based on a small study of short duration.

Independent research center news release

There is no mention of costs in this piece. Even though it calls out the drug avelumab (marketed as Bavencio) by name, the release does not talk about what a typical regimen of that drug or any other would be. Bloomberg reports that avelumab will be priced at $13,000 a month, or $156,000 for a year of treatment. The release alludes to a study in the Lancet Oncology but it does not provide any of the measurable benefits found in that study, namely that out of 88 patients who received at least one dose of the drug avelumab, 28 achieved an “objective response” within an average of about 10 months. That means that less than a third of the patients who took the drug saw something positive happen as a result. The release might make you think that, in fact, the majority of patients who take the drug see their tumors shrink. But even when a 90% reduction in tumor mass occurred (as was the case of the patient profiled), it would not automatically translate into longer survival for all patients. The release states that almost a third of patients in the trial “with no hope at all of surviving” benefited from the drug. What does no hope at all mean? Were all of the patients in the trial at stage 4 of the disease? The release doesn’t tell us. The same study named in the release shows that multiple patients had side effects from the drugs. These are not mentioned in the release. The side effects occurred in two patients who developed lymphopenia (abnormally low white blood cells), one who had an increase in blood creatine phosphokinase which could indicate muscle inflammation or damage, and other disorders. There were also “serious treatment-related adverse events” in five patients, including enterocolitis [inflammation of the small intestine and the colon], infusion-related reaction, aminotransferases [enzymes related to the liver] increased, chondrocalcinosis [calcium deposits in cartilage], synovitis [joint inflammation], and interstitial nephritis [inflammation of the kidneys]. We think that patient stories should be used judiciously and balanced with a full representation of the evidence. In this case, the story of one patient is used as a stand-in for all patient experiences in the absence of any measurements of benefits or risks. We don’t think that it is a fair representation of the two-thirds of patients who may see no benefit from the drug, including the fraction who may actually have a serious adverse reaction. While the news release notes that this is the first treatment approved by the FDA for MCC, it does not highlight that this is only a phase II study so there’s no direct evidence that the new treatment is better than the existing treatments. Beyond linking to a Lancet Oncology article, the release doesn’t tell us anything about the study upon which the approval was based. At minimum we’d like news releases to tell us how many patients were enrolled in the study and for how long. According to the published study, 88 patients were enrolled in the trial and received at least one dose of avelumab over the course of the 14-month trial period. Most patients were followed up at 10.4 months. Among the 88 patients, 28 (31.8%) had an “objective response,” 8 had an “incomplete response” and 20 had “partial responses” by the end of the study. We aren’t provided with data on the average survival for the disease following treatment, but that may be because the 10+-month follow up was of insufficient duration to meaningfully assess the new drug. As mentioned under harms, there were numerous serious side effects. Presenting absolute risks and mortality data would have provided important context to the study. There is no overt disease mongering in the release. It provides some context on MCC and how often it occurs in relation to melanoma, the most common form of skin cancer. However, the comment that MCC is “35 times less common than melanoma, but on average, it is about three times more likely to be deadly,” is difficult to interpret. The release appropriately explains that the clinical trial in question was for a drug made by Merck and that the lead scientist in the clinical trial receives ongoing funding from other companies. (We should note, too, that one of the reviewers on this news release, Bill Heisel, works at the University of Washington where some of the researchers on the clinical trial work as faculty.) The release makes no mentions of, or comparisons to, other therapies. Standard therapies include surgery, radiation and chemotherapy. The release makes it clear that this is the first therapy approved by the FDA for this particular type of cancer once it has spread. The release focuses on the fact that “Avelumab is the first FDA-approved treatment for metastatic MCC and the first disease that the drug has ever been approved to treat.” Immunotherapy is an emerging area of research, and the release appropriately explains why this particular approval is important. The release doesn’t use sensational or unjustified language.


Landmark clinical trial shows gene-targeted drug can treat prostate cancer

Explanation: This small phase ll study looked at responses to the drug olarparib, and its action on a particular type of prostate tumor mutation. While the news release indicates that this is pioneering work in the field of personalized prostate cancer treatment, there is still much to be skeptical about the practice of isolating cancer-related genes with new targeted drugs. The key point not made in the news release is that the study did not demonstrate any mortality or survival benefit in the act of identifying and targeting men with mutated prostate tumors and giving them olarparib. The news release comes across somewhat as a promotional vehicle for genetic testing and yet comparing it with the test for BRAC (breast cancer susceptibility gene) mutation would tend to give it a gloss it might not deserve. Without results with this form of  “precision medicine,” hyping genetic testing around this type of metastatic prostate cancer feels a little irresponsible. The final line: “Understanding the link between prostate cancer and DNA repair mutations is incredibly important for patients and their families” seems to be putting the cart way before the horse and is likely to confuse and build unreasonable expectations among prostate cancer sufferers. Many men still die from prostate cancer and if there were an easy genetic test that could pinpoint which prostate cancer sufferers were most likely to benefit from a targeted drug therapy this could be a huge advance. The news release presents hype and hope yet one has to refer to the published study to find any real information, where the researchers report: “We cannot yet determine whether olaparib improves overall survival among patients with metastatic, castration-resistant prostate cancer and DNA-repair defects.”

Academic medical center news release,Prostate cancer

The release provides no cost information on the drug and the additional testing and additional radiographic work that would be part of this treatment. The release lacks information on key outcomes such as months of disease-free survival or death rates. This is the closest we get to any quantification of benefits: “We showed that a subset of men whose tumours had mutations in their DNA repair machinery responded particularly well to treatment with olaparib.” No harms are mentioned. Summaries of studies need qualifiers. The trial was a controlled clinical trial (not observational) in that the researchers selected the subjects and decided what to treat them with. But it wasn’t randomized or blinded which made it ripe for potential biases. The subset of men in this study were dying of prostate cancer. There was no disease mongering about their condition. We recognize that it can be challenging to sort out and explain complex partnerships in a brief news release but it is better to point out that potential conflicts exist. Although the release mentions a pharmaceutical backer of the study (AstraZeneca) and lists other funders, the vast majority of investigators had multiple, complex ties to pharmaceutical makers including some who have patents and other commercial interests in the success of these treatments. These are mostly highly financially conflicted researchers whose conflicts are never mentioned in the news release, even though we know that such financial entanglement will mean that any news release will put the best possible face on the outcome of their research. This criteria doesn’t apply since all the gene-specified patients were given the same treatment. The release implies that the study enrolled patients whose alternative treatments had failed, but it doesn’t say what those treatments were. We’ll rate this Not Applicable. The story nods to the availability of the drug used in the study in the UK when it says it “was licensed last year for women with ovarian cancer and inherited BRCA mutations, but so far has not been approved for use on the NHS by NICE or the Cancer Drugs Fund.” However, we aren’t left with any idea if the gene testing carried out here is widely available. That’s a critical point that should have been addressed. The release states that this is the “First trial to show benefit of ‘precision medicine’ in prostate cancer.” We suspect that this kind of prostate cancer mutation-specific targeting is novel for prostate cancer. It isn’t in the field of oncology in general, however. There is some unjustified language here that is inappropriate including the phrases: “pioneering drug,” “a milestone in cancer treatment,” ” a significant step forward” and “cutting-edge genomic sequencing, and “highly effective at treating men with DNA repair defects.” Let’s recall that the drug hasn’t been shown to help anyone live longer.