Wells Fargo and Chase are invested in the Dakota Access Pipeline.

Explanation: The pipeline is expected to carry 470,000 barrels of oil per day. Energy Transfer Partners CEO Kelcy Warren has said the company will not reroute the pipeline.

Uncategorized, bank, dapl, standing rock

As the protests against an oil pipeline near the Standing Rock Sioux reservation escalated in November 2016, environmentalist activists began targeting financial institutions backing the Dakota Access Pipeline and urging supporters to boycott them with various memes shared around social media, or petitions calling on the banks to pull their funds out of the project:  Financial documents from Energy Transfer Partners, the pipeline builder, lists a number of large banking institutions that have provided credit for the project, including: Credit Suisse; Royal Bank of Canada; Suntrust Bank; BNP Paribas; HSBC; Citibank; Morgan Stanley; Wells Fargo, Bank of America; and JP Morgan Chase. The Standing Rock Sioux, who fear the pipeline’s route presents a threat to their sacred sites and water supply, have been fighting the project since 2014, but protesters calling themselves “water protectors,” lead by the tribe, have been camping near the site since April 2016 in an effort to stop the project. As of late November 2016, the Army Corps of Engineers, which manages the land, and the governor of North Dakota, have made statements indicating they want the thousands of demonstrators encamped near the project site to leave. But the demonstration and continued opposition by the Standing Rock Sioux have turned an oil pipeline project into an intensifying cause that has drawn international scrutiny, an open letter from BankTrack notes: The debacle has escalated into a national crisis and an international scandal. A member of the UN’s Permanent Forum on Indigenous Issues has been deployed to North Dakota to monitor the situation, while President Obama has intervened to ask the Army Corps of Engineers to examine alternative routes for the pipeline. Meanwhile, the protest at Standing Rock is backed by over a million – and growing – allies worldwide, with numerous solidarity actions springing up across the United States and beyond, including protests at EPFI headquarters and outlets. The world is closely watching how all actors involved will deal with the situation, including the banks that provide financial support to the project. Given the presumed Indigenous rights commitments of EPFIs, it is for us inexplicable that gross violations of Native land titles, threats to water sources and the desecration of burial grounds have not been identified early on as reasons for EPFIs to not provide funding for this project. However, this unfortunately fits into a documented and consistent pattern of disrespect of local communities and Indigenous rights by EPFI-backed projects worldwide. We understand that it is not the role of the EP Association to intervene in specific project situations. Nevertheless, we consider it crucial for the credibility of the Equator Principles as an effective safeguard against violation of Indigenous Peoples’ rights that your meeting calls upon the EPFIs involved in financing DAPL that they take swift action to stop the ongoing violation of the rights of Native Americans. The letter urges the banks to halt further loan payments and raises the concern that the project falls out of line with Equator Principles, a consortium that sets minimum standards to which signing institutions are expected to adhere on matters of community and environmental accountability. According to Energy Transfer Partners, the end project will be a 1,172-mile, 30-inch diameter pipeline: ….that will connect the rapidly expanding Bakken and Three Forks production areas in North Dakota to Patoka, Illinois” enabling the domestic production of light sweet crude oil “to reach major refining markets in a more direct, cost-effective, safer and environmentally responsible manner.


Coca-Cola is an effective contraceptive.

Explanation: The bottom line? The best contraceptive use for a Coke is to use it wash down your daily birth control pills.

Somehow I doubt this is what Coca-Cola meant by ‘the pause that refreshes.’ Here’s a short newspaper summary from 1985 about the first study undertaken to verify claims about Coke’s contraceptive properties:  ‘OLD COKE’ BETTER THAN ‘NEW COKE?’ Common commodities such as honey and sodium bicarbonate, acidic fruit juices and oils have been used through history as spermicides. Three Harvard researchers note that Coca-Cola is said to be favored for this purpose in some developing countries and was touted in American folklore as a contraceptive aid in years gone by. No documentation of the soft drink’s spermicidal capabilities was found, so Dr. Sharee  Umpierre and two colleagues decided to test Coke in some of its various formulations in their lab. They found that Diet Coke was a most effective spermicide and the original formula Coke was also quite effective, five times more so than the reformulated “new” Coke. “Although not recommended for postcoital contraception, partly because sperm can be found in the oviducts within minutes after intercourse, Coca-Cola products do appear to have a spermicidal effect,” the researchers said in a letter to the New England Journal of Medicine. “Furthermore, our data indicate that at least in the area of spermicidal effect, ‘Classic’ Coke is it.”   [T]he researchers said they found marked differences in the ability of four different Coca-Cola formulations to act as a spermicide. At the same time, they warned against the use of soft drinks of any kind as douches after intercourse to prevent pregnancy. While there are differences among soft drinks, all fail as effective contraceptives, the researchers noted. To test the sperm-killing abilities of various Coca-Cola products, the three researchers prepared test tubes containing small samples of carefully preserved sperm and poured in small amounts of Diet Coke, New Coke, caffeine-free New Coke and Classic Coke — carefully repeating the test three times for each soda. All of them killed some sperm, but New Coke turned out to be least effective, with Diet Coke having the most pronounced effect overall and Classic Coke recording a five times greater sperm-killing rate than its upstart rival. “Coca-Cola products do appear to have a spermicidal effect,” the study deadpanned. “Furthermore, our data indicate that, at least in the area of spermicidal effect, ‘Classic Coke’ is it.” Coca-Cola saw little humor in the Harvard project. A spokesman said the company hadn’t seen the new report, but “our position is we do not promote any of our products for any medical use.”1  However, other researchers were unable to verify these results in later experiments. Subsequent trials performed by medical researchers in Taiwan (using several varities of both Coca-Cola and Pepsi-Cola) led them to the opposite conclusion, that “cola has little if any spermicidal effect”:  The inhibitory effect of Old Coke, caffeine-free New Coke, New Coke, Diet Coke and Pepsi-Cola on human sperm motility was studied with a trans-membrane migration method. None of them could decrease sperm motility to less than 70% of control within one hour. A previous study which claimed a marked variation of spermicidal potencies among different formulations of Coca-Cola could not be confirmed. Even if cola has a spermicidal effect, its potency is relatively weak as compared with other well-known spermicidal agents. Testing of various cola formulas on sperm motility using a trans-membrane procedure did not decrease motility to less than 70% control in a 1-hour period. Diet Coca-Cola had the strongest spermicidal effect followed by Classic Coca-Cola, Caffeine-free Coca-Cola and New Coca-Cola. Since there are no known substances in cola that effect cellular membranes, the results of these tests were not unusual. Other tests have been done using higher dilution of cola which could effect sperm motility and give different results for spermicidal potencies. The results show that cola has little if any spermicidal effect. Its use in postcoital douching is ineffective and could cause complications such as infection.2  Whichever set of results one wants to believe, those tempted to grab a six-pack and head down to the beach should keep in mind that spermicides themselves aren’t all that effective at preventing pregnancy. Saying Diet Coke kills sperm is like saying a rubber glove makes a decent balloon — you shouldn’t interpret either as meaning that using them creatively will keep you safe from parenthesis. (That’s when you wind up pregnant and end up writing a book about it.) Coca-Cola may not be promoting its product as a spermicidal douche, but the idea ain’t new. Coke (and Dr Pepper in the southern States) douches have been part of contraceptive lore at least since the 1950s, with the common belief being that the carbonic acid in Coke killed the sperm and the sugar “exploded” the sperm cells, while the carbonation of the drink forced the jet of liquid into the vagina. Back in the 1950s and 1960s, this method of parenthood prevention proved somewhat popular because not only was it cheap and universally available at a time when reliable birth control methods were hard to come by, but it also came in its own handy “shake and shoot” disposable applicator. After intercourse, the girl would uncap a warm Coke, put her thumb over the mouth of the bottle, shake up the beverage, then insert the neck of the bottle in her vagina and move her thumb out of the way. The warm well-shaken Coke became an effervescent spermicidal douche, with the traditional (at that time) six-ounce bottle providing what was deemed to be just the right amount for one application. As stated above, this method wasn’t all that effective at preventing pregnancy. Though Coca-Cola might have been a (slight) step up from plain water, douching with any liquid is far too often a case of attempting to close the barn door after the horse has got loose. By the time the douche is fired off, 100,000 or thereabouts sperm are swimming around in the uterus, already out of reach of any douche, even a fizzy one. Women should be reluctant to turn to soda pop douches for another reason besides their ineffectiveness at preventing Momhood — the sugars in them being let loose in that part of a woman’s anatomy can lead to yeast infections, an annoying, difficult-to-cure condition. Oddly, a 1992 study conducted by Nigerian researchers found that, although Coca-Cola and Pepsi-Cola were ineffective as spermicides, Krest bitter lemon drink fared quite well in this regard, and they recommended additional study to determine whether it might have “great potential as such a contraceptive”:  This study investigated the effects of increase in temperature and in pH of Coca-Cola, Afri-Cola, Pepsi-Cola and Krest bitter lemon drinks (“soft drinks”) produced in Nigeria on the in vitro motility of spermatozoa. Of the drinks, Krest bitter lemon (unadjusted) immobilized all spermatozoa within 1 minute of addition. Conclusion: i) alkalinity decreases the spermicidal action of all drinks except Coca-Cola, and ii) Krest bitter lemon may achieve very high efficacy if used as post-coital douche, especially in the impoverished, densely populated Third World. Other than Krest bitter lemon, the significant decreases in sperm motility were not enough to prevent pregnancy. These findings indicated that researchers should test Krest bitter lemon for effectiveness as a postcoital contraceptive. If indeed it proves effective, it has great potential as such a contraceptive among the poor in the densely population developed countries since it is readily available and inexpensive.3


New Ebola case in Congo, days before outbreak’s expected end.

Explanation: A new case of the Ebola virus has been confirmed in eastern Congo, just three days before the country expected to declare an end to the outbreak, the World Health Organization said Friday.

Matshidiso Moeti, Health, General News, Public health, Africa, International News, United Nations, Virus Outbreak, Ebola virus

The new case was confirmed in Beni, a community that had been an epicenter of the second-deadliest Ebola outbreak in history. It had been nearly 42 days without a case, and WHO chief Tedros Adhanom Ghebreyesus said Congo’s declaration had been planned for Monday. “We have been preparing for and expecting more cases,” he said, reflecting the caution that mixed with optimism in recent days. “I am sad,” WHO Africa chief Matshidiso Moeti said in a tweet. Health workers in Congo had been awaiting the end of one global public health emergency — Ebola — while bracing for the arrival of another: the coronavirus. Already, two coronavirus cases have been reported in Beni. “We’ll just have to go for another 42 days,” or the required period of time without a case for the Ebola outbreak to be declared over, said Mike Ryan, the emergencies chief for the WHO. “Maybe that’s our lesson for COVID-19: There is no exit strategy until you’re in control of the situation,” Ryan said. “You must always be ready to start again … never be surprised.” The Ebola outbreak has claimed more than 2,260 lives — second to the 2014-2016 outbreak in West Africa. The current outbreak declared in August 2018 has occurred in especially challenging conditions amid deadly rebel attacks, community suspicion and some of the world’s weakest infrastructure in remote areas. Some Ebola responders were attacked and killed. And yet the outbreak has seen the use of experimental Ebola vaccines, a welcome development in fighting one of the world’s most notorious diseases. In Beni on Friday, some residents were crushed. “It’s really a shame,” said Mbusa Kyota, who had just heard the news of the new Ebola case on the radio. “Now doctors, and the population, have to multiply their efforts to defeat this outbreak one more time.” Health workers had already been turning their Ebola messaging and other efforts to fighting the coronavirus. “This is a devastating development for the communities in eastern (Congo) who are also under threat from the coronavirus outbreak, in addition to ongoing conflict and displacement,” Kate Moger, a regional vice president with the International Rescue Committee, said in a statement. ___ Cheng reported from London.


“President Trump has banned welfare for illegal immigrants which will save $57.4 billion a year.”

Explanation: Long before Trump became president, immigrants living in the country illegally were generally ineligible for federal public benefits. A study said first-generation immigrants and their dependents cost state and local governments $57.4 billion a year. That number isn't tied to federal costs or benefits. Most of that cost was for schooling. A Trump administration rule made it more difficult for people to get visas or permanent-residency status if they received public assistance or were likely to need it.

President Donald Trump has been consistent and forceful in his argument that immigration represents a burden on the American taxpayer and the economy. His administration has sought to crack down on illegal immigration and curtail legal immigration, most recently by ordering a 60-day halt on issuance of green cards to people outside the United States. But a Facebook post crediting him with saving billions by denying welfare to "illegal immigrants" is inaccurate. "President Trump has banned welfare for illegal immigrants which will save $57.4 billion a year," said the April 9 Facebook post. "Do you support Trump on this?? I damn sure do!!" The post was flagged as part of Facebook’s efforts to combat  news and misinformation on its News Feed. (Read more about our partnership with Facebook.) There are several wrong premises with the post: Immigrants living in the country illegally and those who arrive on non-immigrant visas (such as students and tourists) are generally not eligible for federal public benefits, even though some pay income taxes and contribute to Social Security. This was the case before Trump became president. The Trump administration issued a rule in August 2019 that broadened the government’s ability to deny visas and permanent-resident status to immigrants who get public benefits or those who may need assistance after their arrival. The rule targets people who are seeking legal admission and those who are here and applying for permanent residency. The Facebook post doesn’t specify where the $57.4 billion figure comes from, but the post mirrors a headline on a Breitbart story. That story, however, was about legal immigration. Here's a more detailed explanation of the inaccuracies. Generally, immigrants living illegally in the United States are ineligible for federal public benefits such as the Supplemental Nutrition Assistance Program (commonly called food stamps), regular Medicaid, Supplemental Security Income and Temporary Assistance for Needy Families. These restrictions are not the result of Trump’s presidency. They may be eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children, Emergency Medicaid to cover emergency medical needs, and other emergency assistance, such as short-term non-cash, in-kind emergency disaster relief (which includes things like crisis counseling, shelter, food and water.) For decades, even immigrants who came to the United States legally have been restricted from public assistance for a period. A 1996 law barred immigrants from federal "means tested" public benefits for five years. (There are some exemptions; this story has more details.) Additionally, public-charge rules say that immigrants can be turned away if they are likely to depend on public-assistance programs; this type of restriction has been in place for more than 100 years. The Trump administration in August 2019 broadened the interpretation of these rules to make them stricter. But that did not ban welfare for immigrants here illegally. Immigration experts told PolitiFact that under the new rule, immigration officials will be able to deny immigrants visas if they are deemed "more likely than not" to use public benefits such as Medicaid, food stamps or housing vouchers. Immigrants who are in the United States legally on temporary visas and have relied on such benefits in the past could also have more difficulty getting a green card. The Facebook post claimed that the purported ban would save Americans $57.4 billion a year. An August 2018 Breitbart headline said, "Trump’s welfare ban for immigrants would be $57.4B tax cut for Americans." The story centered on Trump’s plan for a public-charge rule and immigrants who would "resettle permanently" in the United States. That Breitbart story linked to a 2016 post on its website headlined, "National Academies: Immigrants cost state and local taxpayers $57.4 billion per year." A study from the National Academies of Sciences, Engineering, and Medicine estimated that the annual fiscal cost of first-generation immigrants and their dependents, averaged across 2011-2013, was $57.4 billion. The figure referred to state and local expenses, not federal costs or benefits, and the main cost was education, said Francine D. Blau, a Cornell University economics professor who chaired the panel of researchers studying the economic and fiscal consequences of immigration. "We find that much of this cost is related to the cost of educating both immigrant children and U.S. citizen children of immigrants (we attribute the entire cost of education to the parents of school age children)," Blau said via email. "The cost is smaller if we recognize the public-good aspect of education, that is, the broader social benefits in having a more educated populace." The $57.4 billion also included costs of general public services such as police, fire, parks and recreation. It also did not apply only to immigrants in the country illegally. The study relied on data from the Census Bureau’s Current Population Survey, which did not allow researchers to differentiate between immigrants here legally and illegally, Blau said. A Facebook post said, "President Trump has banned welfare for illegal immigrants which will save $57.4 billion a year." Trump has not done that. Immigrants here illegally were already ineligible for most federal assistance programs. Trump’s administration issued a public-charge rule that would deny legal admission to people who are likely to depend on public benefits and which would make getting lawful permanent residency more difficult for people who are already in the country and used public assistance. The source of the $57.4 billion figure is unclear. A study estimated a $57.4 billion annual cost to state and local governments for first generation immigrants and their dependents. Schooling costs accounted for the bulk of that cost. The post is inaccurate.


Quick brain scan could screen for autism

Explanation: The enthusiasm this story effuses about a new brain scanning technology to diagnose autism may well be warranted. But it fails to give more than the most cursory of cautions about the early stage of this research and the tough road that lies ahead. The story makes it sound like we are a slam dunk away from seeing this test at the local radiology clinic. In reality, much larger studies with a much greater range of patients will be needed to tell whether the scan is effective enough to be widely used. Autism is difficult to diagnose due to its many different causes and symptoms and because it often occurs with other similar neurodevelopmental disorders. A fast and accurate diagnostic brain scan would take much of the uncertainty out of the diagnostic process and would hopefully speed treatment and other support services to patients.

Many of the deficiencies discussed above in the "Evidence" criterion could also be applied to this criterion. Importantly, the story didn’t do enough to call attention to the small and highly selected sample of patients, which likely biases the results towards greater accuracy than what would be observed in a larger and more diverse sample. There was also inadequate acknowledgment of the fact that this was a study of adults whereas the real need is for diagnostic tool for use in children. Yes, it was acknowledged that the childrens’ studies hadn’t been done but the outcome of these not-yet-done studies was almost treated as a fait accompli. Lastly, we would like to have seen some discussion of a somewhat subtle but important issue that wasn’t addressed. That is, whenever we diagnose a condition with new technology, the group of individuals identified as having the condition, in this case autism, will change. Some previously undiagnosed children will be labeled with autism and some previously labeled with autism will be told that this is not the diagnosis. In addition, the severity of the disease may change (a more sensitive test will likely identify milder cases). Anytime the spectrum of disease changes, we have to ask ourselves, Will the treatments produce the same benefits and harms? Since benefits are often smaller for individuals with milder disease but the adverse effects are the same, the risk benefit ratio often increases with the more sensitive test. As discussed above, the story doesn’t attempt to quantify the harm of false-positive or false-negative diagnoses. It also doesn’t explore the potential harm of labeling someone with borderline symptoms as having autism. In addition, it has now become clear that MRI with contrast is associated with kidney damage. Physicians now check kidney function in all patients prior to an MRI and must weigh the need for the images vs the very small (but tangible) risk of kidney damage. Readers would have been better served by more detail and less unbridled optimism in this piece. To wit: we learn that the scan’s accuracy was "so high" that the results were strongly significant despite the study’s small sample size. Instead of  gushing over the test’s accuracy, however, we think the story should have spent more time discussing the limitations of such a small study and the additional research that needs to be conducted to confirm these results. We still don’t know whether the method can differentiate between autism and other neurodevelopmental conditions. And it is unclear whether the results are applicable beyond the small group of high-functioning adult males who were studied. We also think the story failed to provide all of the necessary information about the study’s outcomes. To be effective, diagnostic tests must do more than simply identify individuals with a disease (which is the result this story focused on); they must also rule out those individuals who do not have a disease and do not require treatment. Failure to accomplish the latter will result in an excessively high false-positive rate and could result in much unnecessary treatment of healthy people. We recognize that this is a complex concept to convey in a consumer news story, but the story didn’t even mention the possibility that people without autism could be given an erroneous positive diagnosis. Finally, we should call attention to the story’s speculation about applying the new technology to children. The story quotes one of the study investigators saying there is "no reason" why the test wouldn’t work in children, even though it has never been tested in this population. In fact, there are any number of good reasons why this test might be less effective in the developing brain than in a mature one. Someone involved in this story – the reporter? the editor? somebody, please! – should have known this and injected some skepticism into the discussion. The story didn’t exaggerate the prevalence or impact of autism. One of the sources for this story was not involved in the research and has no obvious conflicts of interest. The story notes that autism is currently diagnosed via interviews and patient observation. Although it is clear that this technology is not yet available to the public, the story predicts the new scan "could be ready for general use in a couple of years." Really? Who says? It seems unlikely that any knowledgeable researcher would make such a wildly optimistic prediction on the basis of a 40-person study. But the story treats this forecast as an established fact requiring no attribution, so we can’t tell where it came from. In any case, we think such pie-in-the-sky guesstimates are usually wrong and should be avoided in health journalism. Researchers have long studied the brains of patients with autism using MRI scans. However, the ability to make a clinical diagnosis of autism using MRI would be noteworthy progress. Since this story included two expert interviews, we can be sure it didn’t rely on a news release


Yoga and Stretching Equally Effective for Back Pain

Explanation: An independent expert can point out whether a study is valid and relevant and whether any cautionary notes should accompany its conclusions. The article provided an accurate, bare-bones description of the study and its main conclusions—that yoga and intensive stretching were similarly effective and were both superior to the self-care intervention. But it also missed several key points, as detailed in the scoring below. And since the study in the Archives of Internal Medicine was actually accompanied by an independent commentary that could have been cited, these omissions are all the more telling. So what points might an independent expert have added to the coverage?The most important one is that the subjects in this study were relatively affluent and generally had mild back pain and modest functional limitations. The results of this study may not apply to the large body of patients from less affluent backgrounds with more severe back pain, greater functional impairment, and more complex health problems. Would a roughneck on an oil rig, an auto mechanic, or a hotel maid gain a similar benefit from yoga or intensive stretching as the subjects in this study? No one really knows. The availability of these treatments is also an issue. Similarly structured viniyoga programs may not be available in many communities—and it is not clear that most health insurance plans will cover them. The type of intensive stretching program described in this study would appear to be uncommon in the United States. So most patients wouldn’t have access to this intervention. Lastly, this study did not compare yoga and intensive stretching to “usual care”. So yoga and intensive stretching may be superior to a self-care program, but it is not as clear that they are any better than routine back care as dispensed across the United States. In the United States, back pain is the ninth most expensive medical condition for women, and the 10th for men, in terms of direct medical costs—with chronic back pain accounting for a disproportionate chunk of those expenses. And the costs of work absence and disability claims related to back pain vastly exceed the medical price tag. Though Americans spend almost $35 billion per year on the medical treatment of back pain, the prevalence of chronic back pain appears to be rising—and self-rated spinal health among Americans appears be declining. (See Soni, 2011; Freburger et al., 2008; and Martin et al., 2008). A number of nonsurgical treatments—analgesics, exercise, manual therapies, complementary/alternative therapies, psychological interventions, and multidisciplinary rehabilitation—are modestly effective in the management of chronic back pain. Yet for various reasons, Americans overuse ineffective treatments and underuse effective ones. (See Carey et al., 2009). So the identification of treatments that facilitate recovery and are popular with patients is a key social and medical priority. References for This Review:  Balagué F et al., Non-specific low back pain, Lancet, epub ahead of print, October 7, 2011; DOI:10.1016/S0140- 6736(11)60610-7). Carey TS et al., A long way to go: Practice patterns and evidence in chronic low back pain care, Spine, 2009; 34(7):718–24. Medicine, 2007; 147(7):478– 91. Freburger J et al., The rising prevalence of chronic low back pain, Archives of Internal Medicine, 2009; 169(3):251–8. Martin BI et al. Expenditures and health status among adults with back and neck problems. JAMA 2008; 299:656-664. Soni A, Top ten most costly conditions among men and women, 2008, Agency for Healthcare Quality and Research, Statistical Brief #331, 2011. www.meps.ahrq.gov/mepsweb/data_files/publications/st331/stat331.pdf.

The story did not mention the costs or cost-effectiveness of any of the interventions. These are important issues. Individuals who opt for yoga classes, for instance, may have to bear the costs themselves. The journalist adequately framed and quantified the benefits in terms of both primary and secondary outcome measures. The article did not discuss adverse events in any of the groups, though the study reported on them. This is an important point, as the New York Times article observed that many people with back pain shy away from exercise programs for fear of exacerbating their symptoms. The article adequately described the randomized controlled trial and its results. However, it did not adequately describe the limitations of this trial—which looked primarily at subjects with mild-to-moderate uncomplicated chronic back pain. It is not clear that the study conclusions apply to individuals with more severe back pain. There was no obvious disease mongering in the article. Members of the general public are legitimately concerned about chronic back pain and its consequences. The New York Times article did not offer commentary from an independent source. The evidence on chronic back pain is complex and challenging, as is the evidence on yoga and stretching. So the article would have benefited from additional expert input. The authors of the clinical trial did not disclose any conflicts-of-interest, so there was no need to report on this criterion in the article. The New York Times feature did not mention a full range of alternative treatments for chronic back pain. However, it did mention several other potential therapies, including medications, physical therapy, and strengthening exercises. The writer probably assumed that yoga classes and stretching programs are widely available across the United States. So we’ll award a “satisfactory” here. But it is not actually all that clear that similar “viniyoga” classes and intensive stretching programs are available in most communities—or that physicians and patients can easily find them. And it is not clear to what extent they are covered by health insurance plans. The article did not discuss the novelty of the treatment interventions. The intensive stretching class would appear be a novel intervention developed for the clinical trial—and similar programs aren’t widely available around the country. The “viniyoga” program may be less novel, but is distinctive nonetheless. The article did not rely on a news release. Group Health in Seattle did release a lengthy press release on this study. But the New York Times article did not appear to use it.


Ben Carson Says he "didn’t have an involvement with" nutritional supplement company Mannatech.

National, Candidate Biography, Ben Carson,

Ben Carson said it’s "total propaganda" to suggest he had any connection to Mannatech, a maligned nutritional supplement company. At the Oct. 28 Republican presidential debate, hosted by CNBC in Boulder, Colo., moderator Carl Quintanilla asked Carson about his involvement with the company. "This is a company called Mannatech, a maker of nutritional supplements, with which you had a 10-year relationship," Quintanilla said. "They offered claims they could cure autism, cancer. They paid $7 million to settle a deceptive marketing lawsuit in Texas, and yet your involvement continues. Why?" "Well, that’s easy to answer: I didn’t have an involvement with them," replied Carson, a former pediatric neurosurgeon. "That is total propaganda. And this is what happens in our society -- total propaganda. I did a couple speeches for them. I did speeches for other people. They were paid speeches. It is absolutely absurd to say that I had any kind of relationship with them. Do I take the product? Yes. I think it’s a good product." Mannatech sells nutritional supplement pills made from larch tree bark and aloe, ingredients with disputed health benefits. The company in 2009 settled the lawsuit, which stemmed from claims that the company was deceptively pitching cures and treatments for illnesses such as cancer and even Down Syndrome. For Carson to say he "didn’t have an involvement with" Mannatech is a stretch. While he was not any sort of employee for the company as far as we can tell, it’s hard to see the speeches he’s delivered, as well as other promotional work, as anything but a full-throated endorsement of the product. Further, Mannatech appears to view Carson as a product promoter. First, the speeches. Carson has delivered four to Mannatech, according to the Wall Street Journal. Carson has written these paid remarks off as just several of many diverse speeches the Washington Speakers Bureau have booked for him. But in the speeches, he talks about his personal fondness for the product, which he started taking in conjunction with cancer treatment years ago. For example, Carson delivered remarks to Mannatech sales associates in 2004. In the speech, he talked about his introduction to Mannatech’s supplements and a personal conversation he had with the company’s lead doctor. "I started taking the product, and within about three weeks, my symptoms went away," adding that he toyed with the idea of using only the supplements, rather than undergoing cancer surgery. He said in the remarks that it would be inappropriate for him to be an official spokesman or sales associate, but he does refer people to Mannatech. Since then, he has appeared in Mannatech-produced videos that appear to be promotional materials. In 2011, he answered questions in an interview with Mannatech’s co-CEO and chief science officer. In a 2013 Mannatech video, Carson described his experience with nutritional supplements. "The wonderful thing about a company like Mannatech is that they recognize that when God made us, he gave us the right fuel. And that fuel was the right kind of healthy food," Carson said in the 2013 video. "Basically what the company is doing is trying to find a way to restore natural diet as a medicine or as a mechanism for maintaining health." Carson also talked about his use of nutritional supplements on PBS in 2014, and Mannatech promoted the interview on its homepage. While it’s no longer accessible, the Mannatech website had a specific tag for all articles about Carson. Carson’s campaign requested that Mannatech remove some videos and articles featuring Carson from its website. And since media outlets have started poking around this question, Mannatech has taken down even more, according to reporters at the Wall Street Journal. Our ruling Carson said, "I didn’t have an involvement with" the nutritional supplement company Mannatech. As far as we can tell, Carson was not a paid employee or official endorser of the product. However, his claim suggests he has no ties to Mannatech whatsoever. In reality, he got paid to deliver speeches to Mannatech and appeared in promotional videos, and he consistently delivered glowing reviews of the nutritional supplements. As a world-renowned surgeon, Carson’s opinion on health issues carries weight, and Mannatech has used Carson’s endorsement to its advantage. We rate Carson’s claim .


The city of Lake Worth Beach, Florida cut power and water services to some residents in the middle of the COVID-19 pandemic.

Explanation: Did a Florida City Cut Residents’ Power During the COVID-19 Pandemic?

A confrontation between officials in Lake Worth Beach, Florida drew attention after a member of the local city commission criticized his colleagues of not taking the COVID-19 pandemic seriously.“This is a banana republic, is what you’re turning this place into with your so-called leadership,” Commissioner Omari Hardy told Mayor Pam Triolo during the commission’s March 17 2020 meeting. “We cut people’s utilities this week and made them pay — with what could have been their last check — to turn their lights off in a global health pandemic. But you don’t care about that.”Footage of the argument was covered by news outlets in the area, and was also shared on several social media platforms.The argument erupted after the conclusion of the meeting, during which Triolo granted City Manager Michael Bornstein emergency powers during the outbreak. Hardy criticized the mayor and Bornstein after she cut debate on the matter. He also accused Triolo and the rest of the commission of ignoring his request to hold an emergency meeting on the disease (a novel coronavirus strain known as COVID-19) a week earlier.Hardy also told a local news station, WPBF-TV, that electricity and water were cut off for 52 customers who had fallen behind on their payments. An additional 53 customers, he said, were slated to suffer the same penalty the day after the contentious meeting.Bornstein confirmed the inital rash of service cuts and added that the process was carried out automatically for customers who had failed to pay their bill for 72 days. But those customers, he said, would be allowed to resume service without cost. He also promised that no service would be cut while the pandemic is unfolding, though late payments would be due in full after the crisis passes.“We don’t want people stressing during this period,” Bornstein told WPBF. “It’s stressful enough. We’re actually trying to find ways to make people calm down.”In a Facebook post published three days after his argument with Triolo, Hardy said he did not regret confronting her.“We could have directed the city manager to stop shutoffs last week, when I requested an emergency meeting for exactly that purpose,” he said. “Only Commissioner Robinson wanted to meet. The rest said it was unnecessary. So this week, dozens of families had their lights shut off, and my colleagues didn’t want to have any discussion about it, and I lost my cool.”


US regulators OK updated version of decades-old antibiotic.

Explanation: U.S. regulators on Tuesday approved a modernized version of a decades-old antibiotic used to treat a number of infections.

Health, Business, North America, Pneumonia, Antibiotics

Paratek Pharmaceuticals’ Nuzyra was designed to overcome the problem of resistance to tetracycline, an antibiotic widely used until recent years. The company said the Food and Drug Administration approved Nuzyra for treating bacterial pneumonia and severe skin infections. Paratek plans to launch the antibiotic early next year, initially for use in hospitals. It hasn’t disclosed the price. Boston-based Paratek estimates its drug could eventually treat nearly 900,000 hospitalized U.S. patients annually About 2 million Americans get infections from antibiotic-resistant bacteria each year and 23,000 die, according to the Centers for Disease Control and Prevention. Paratek tested Nuzyra against several types of bacteria that cause pneumonia and skin infections. The drug was more effective than two standard antibiotics given to patients in comparison groups, company testing showed. Many antibiotics no longer work well, if at all, against some bacterial infections, due to their overuse in medicine and livestock production. Paratek’s drug, also known as omadacycline, is the first in a new class of antibiotics. It’s an updated version of tetracycline, a 65-year-old antibiotic that was a workhorse against skin, respiratory and other infections until increasing resistance limited its use. Paratek created its drug by tweaking tetracycline to block two common ways bacteria use to resist it. The FDA approved both an IV version and a daily pill that patients can switch to when they leave the hospital, the company said. It will eventually market the drug for patients treated at doctors’ offices and clinics. Last week, the U.S. Health and Human Services Department announced at the United Nations General Assembly a new global effort to fight antibiotic resistance and develop new treatments. The 106 initial participants included drugmakers, government agencies, medical groups and animal food producers. ___ Follow Linda A. Johnson on Twitter: @LindaJ_onPharma ___ The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.


New Therapy for Enlarged Prostate May Bypass Unpleasant Side Effects

Explanation: Strong points:  there were several clear caveats, mostly from independent experts interviewed. Weaker points:  failure to evaluate the evidence, failure to put into appropriate context of other alternative treatments for which there is FAR more data and experience. Experimental outcomes need to be presented in a framework that avoids generating unrealistic expectations. There are many men who are affected with benign prostatic hyperplasia, so the information presented needs to do a better job of providing them with accurate, balanced, complete information that can facilitate a truly informed shared decision-making encounter with their doctors.

There was no discussion of costs. Why not? You can let a researcher say it’s ready to be used in certain patients, yet you can’t estimate a cost? While reporting that 66 out 67 patients in the study experienced ‘improvement’ in symptoms, it was not clear to readers what exactly was improved, the extent to which it was improved, and what the satisfaction level with the improvement was. There was not an adequate presentation about the benefits from this procedure. The story did not report on any harms observed in the 67 men who took part in the study reported on. The last line of the story indicated that the findings should be considered ‘preliminary’ and an early paragraph indicated that the study had not yet even been presented at the meeting. And, while the story did note that 9 months was insufficient time to measure outcomes, it did not explicity address the limitations of a small case-series (with no comparison group). A story like this must do a better job of helping readers understand why not all studies are equal, why when a researcher says this is “ready to be used” that needs to be backed up by data, and how there is a far greater evidence base for many other approaches to BPH, including other so-called minimally invasive procedures, and including a watch-and-wait approach that many men are happy with – which was never mentioned. The story did not engage in overt disease-mongering. It would have been helpful to know that BPH rarely causes problems that require medical attention, though it can result in symptoms that are bothersome for some men. Clinicians with expertise in treating benign prostatic hyperplasia and without apparent ties to the study reported on were quoted in this story. The story provided some insight about how this new minimally invasive treatment for benign prostatic hyperplasia compared with TURP. However it neglected to mention that there are number of surgical techniques and minimally invasive techniques available for which there is comparable effectiveness and fewer complications than TURP. And while the study authors claim the new procedure has value because it didn’t have the higher risk for the need for re-operation, the 9-month follow-up was too short to actually be able to lay claim to this benefit. The oddest part of the story was the line that other minimally invasive treatments “are less effective and have a greater risk of a need for reoperation according to background materials that accompanied the study. (emphasis added)  Does that mean according to marketing materials provided? What was that source of that material? What a silly, unsubstantiated, unsourced thing to include! The story allowed the lead researcher to boast that prostatic artery emoblization was ‘ready to be used in certain patients’. But then it quickly countered that with “but other experts aren’t so sure.” The story could have stated much more emphatically that it is a stretch to think that PAE would be utilized in this new population on the basis of a single, small scale study, presented as an oral presentation at a meeting. Given that the procedure is still experimental at this point, it is unlikely to be widely available. And although the story noted that few physicians are ‘trained to perform the procedure’ it should have been explicit that this is currently not an option for most men. Nonetheless, we’ll give the story a BARELY satisfactory on this criterion. The story seemed to suggest that the procedure reported on was novel; it should have mentioned (as the competing WebMD story did) that it is already in use to treat other non-cancerous, hyperplastic conditions. Does not appear to rely solely on a news release.


Hate daylight saving time? You may have a point, researchers say.

Explanation: For most Americans, daylight saving time means only one thing: losing an hour’s sleep. So what is the point?

This is actually a reasonable question, according to a growing body of scientific research. Daylight saving time is the practice of moving clocks forward by one hour during summer months so that daylight lasts longer into evening. Most of North America and Europe follows the custom, while the majority of countries elsewhere do not. When clocks in almost all of the United States spring forward by an hour at 2 a.m. on Sunday, it will likely prompt an increase in heart attacks and strokes, cause more car accidents and reduce worker productivity, according to studies. It will also fail to cut the nation’s energy bill, contrary to what the experts once believed. In December, a psychology journal published results showing that federal judges handed out sentences that were on average 5 percent longer the day after daylight saving time began than those given out one week before or after. Disruptions, even minor ones, to human beings’ sleep patterns can have outsized effects, according to researchers. “Our study suggests that sudden, even small changes in sleep could have detrimental effects,” Amneet Sandhu of the University of Colorado told Reuters in 2014 after his study of Michigan hospital data showed a 25 percent jump in heart attacks on the Monday after daylight saving time began. Daylight saving time, which runs until the fall, was widely adopted during World War Two as an energy-saving measure. The rationale was that a later sunset meant people would spend fewer hours using lights inside their homes in the evening. But studies have generally failed to show significant energy savings associated with the shift. Plenty of people expressed frustration on social media on Saturday, as the prospect of losing an hour’s sleep loomed large. “Daylight Savings Time seems like a communist plot to get us all confused and tired and thinking the government wants to help us,” wrote Twitter user Michael Farris Jr. Abolishing daylight saving time – or conversely, extending it year-round – would require a law passed by U.S. Congress. States are allowed to opt out of daylight saving time, but all states are required to follow standard time from November to March. Legislators in some states have tried unsuccessfully to pass laws abandoning daylight saving time, but Arizona and Hawaii are the only states that do not reset their clocks twice a year. For everyone else, Sunday morning will come just a little bit earlier than usual.


Novartis's new treatment for hives outperforms Xolair in trials.

Explanation: Novartis said on Tuesday it was taking its experimental medicine ligelizumab to late-stage trials after the drug showed signs of outperforming existing product Xolair in treating severe urticaria, also known as hives.

Xolair is sold by both Novartis and Roche, but has lost patent protection in Europe and the United States, leaving it exposed to rivals who are developing copies of the biological drug. None are yet on the market. Novartis said it now plans two Phase III studies for ligelizumab with more than 2,000 patients who suffer from chronic spontaneous urticaria (CSU), an autoimmune disease that causes persistent itchy reddish welts on the skin. “Despite existing treatment options, too many people continue to struggle with the debilitating and potentially painful symptoms of CSU,” Marcus Maurer, a professor of dermatology and allergy at the Allergie-Centrum-Charite in Berlin, Germany, said in a statement from Novartis. Roche is also developing a new drug, fenebrutinib, to fight CSU and has a Phase II trial, with an expected filing date of after 2021, according to its website. Both companies are looking to develop a more advanced drug than Xolair as India’s Glenmark Pharmaceuticals has a biosimilar copy in the works. Xolair brought in 1.74 billion Swiss francs ($1.75 billion) for Roche last year and $920 million for Novartis. ($1 = 0.9960 Swiss francs)


Although Georgia Gov. Brian Kemp "opened" the state, his mansion remained closed for tours during the COVID-19 pandemic.

Explanation: Is the Georgia Governor’s Mansion Closed Due to COVID-19, Despite Its Governor ‘Opening’ the State for Business?

As Georgia Gov. Brian Kemp (R) made the controversial decision to “reopen” the state in the throes of the COVID-19 pandemic, a Facebook post shared in late April 2020 urged readers to contact the governor’s mansion to request a tour — which were ostensibly canceled until further notice over coronavirus concerns:On April 27 2020, the post shown above was not available — but copies of it were spread throughout social media in different, popular iterations. The text described how the original poster decided to request a tour of the Georgia governor’s mansion as a response to Kemp’s assertion that others in the state — such as hairstylists and bowling alley employees — could safely return to work:Soooooo.. I did a thing.Since Georgia is open now I called the Governor’s Mansion in Atlanta and asked when it will be open for a tour. I would like to schedule one. A very irate staffer told me that there will be NO tours until further notice…Hummmm.. I asked “and why is that??? Surely if nail salons and gyms are open today the mansion would. I find it very unamerican that my rights to visit my Government’s mansion would be infringed upon. Who is your boss?”The irate woman replies.”There is a a nation wide pandemic and the Mansion is being closed for safety purposes.”“Oh really??? You don’t say??? I  still would like to schedule my tour please. The Governor himself said it was safe to come out.”The irate lady hungup in my faceI have time today to play404.261.1776. In case anyone else feels [like] having this question answered.In the copies linked above, some sharers of the post altered the wording slightly and presented the post as if they themselves had written it:So…I did something. Since the State of Georgia is now open, I called the Governor’s Mansion in Atlanta and asked when it would be open for tours as I would like to schedule one. A very annoyed staffer advised that NO tours would be held until further notice. I then asked. “Why is that? Surely if nail salons, gyms and restaurants are now open with social distancing requirements, the Mansion should be open to the public. I find this very ‘Unamerican’ and an infrigement on my rights to visit my state’s Governor’s Mansion.” I also asked her who her supervisor was. The irate woman then replied, “There is currently a nationwide pandemic and the Mansion is closed for safety reasons.” “Really, you don’t say!”, I replied. “I still would like to schedule my tour, please. Governor Kemp advised in a recent public briefing that it’s safe to go out with proper social distancing.” The staffer hung up abruptly! Well, I have time on my hands. If you want to find out why the mansion remains closed, call 404-261-1776!”On April 27 2020, Facebook user Professa Cross said that they were the ones who had written the original post (and subsequently changed its privacy settings); the second post is archived here:Alright everyone. A couple things. If you came here looking for the Governor’s tour post.1. YES I am the original person who made the Governor tour post. I am gonna assume there have been people imitating, perpetrating etc. and someone even said China is spreading my post🤷🏾♂🤷🏾♂🤷🏾♂..lol.2. Some of you were starting to go overboard and get a little crazy so I changed the privacy for that post back to friends only. When you accidentally go viral you gotta stop the flood gate at some point.3. Yall, remember to check your voter status and make yourself heard. You may not be happy w the federal choices but there is always good that can be done in your own local government and community.4. Stay safe everyone and enjoy your day. Wash your hands.Overall, the claims are as follows:Of course, we called 404.261.1776. We were told by a recording that people who were “calling about tours to the mansion” should be advised it was “closed to the public until further notice,” and advised us to visit gov.georgia.gov/governors-mansion/tour-mansion. We did, and a message on the page not only confirmed that we were calling the correct number, it also reiterated that the governor’s mansion was closed “to ensure the health and safety of Georgia families”:Tour the Mansion Public Tours **PUBLIC TOURS CANCELED UNTIL FURTHER NOTICE: Out of an abundance of caution, we are temporarily canceling public tours until further notice to ensure the health and safety of Georgia families. https://gov.georgia.gov/news **Archived versions of the page from April 21 and April 9 2020 featured the same message, indicating that the mansion had closed previously and had not re-opened. On March 30 2020, the page was again identical — the message was added at some point between March 9 2020 and that date.The most recent pre-pandemic page read:Tour the Mansion Public Tours Please make reservations for groups of 10 or more by contacting the Mansion.In short, Professa Cross referenced the fact Kemp had notably “reopened” the state of Georgia (true), adding the claim that they had called the governor’s mansion (which you can call yourself at (404) 261-1776) in order ask about tours as the state was “opened for business.” That number did go to a line with a message confirming the second part of their claim — despite Georgia’s reopening of business, the mansion remained closed to public tours “for the health and safety of Georgia families.”Comments


O’Rourke offers blue vision for red Texas during Nelson show.

Explanation: Democratic Texas Senate candidate Beto O’Rouke rallied thousands with Willie Nelson on Saturday night, offering an openly liberal vision for the country’s largest conservative state and vowing that his campaign that has shunned outside political support can topple Republican Ted Cruz in November.

Willie Nelson, Ted Cruz, Entertainment, Universal health care, Politics, Music, North America, Austin, Texas, Donald Trump

Taking an open-air stage in Texas’ progressive-minded capital city, O’Rourke said he wanted to appeal to voters from both parties and independents but called for universal health care and gay rights, warned of the ills of climate change and switched to his fluent Spanish to denounce President Donald Trump’s calls to wall off the U.S.-Mexico border. He also decried the federal government’s war on drugs, saying it disproportionately targets minorities and the poor. “People of the future are counting on us while we can still get this right,” O’Rourke said of changing the direction of Texas, where a Democrat hasn’t won statewide office since 1994. Despite refusing donations from political action committees, O’Rourke has enjoyed monster fundraising that has outpaced Cruz. He said that’s allowed him to focus on “people and that’s how we win this election.” After Nelson took the stage, O’Rourke sang backup to the iconic hit “On the Road Again” while the crowd cheered, many wearing T-shirts or waving signs bearing the candidate’s name. A three-term congressman from El Paso, O’Rourke’s openly moving to the left contrasts to some other Democrats competing in tight, red-state Senate races around the country. Those include Phil Bredesen, a former Democratic governor of Tennessee who has openly embraced the mantra of a moderate and distanced himself from his own party as he tries to win an open seat in a state Trump won two years ago by 26 points, which was nearly three times his 9-point margin of victory in Texas. Arizona Democratic Rep. Kyrsten Sinema is also running for Senate as a centrist, despite her early career as a Green Party activist. O’Rourke has kept support of his national party at arm’s length, too, but done so in keeping with his more liberal views, not to tamp them down. He’s also previously suggested that he’s open to abolishing the U.S. Immigration and Customs Enforcement agency and impeaching Trump. Cruz and O’Rourke’s second debate had been set for Sunday night at the University of Houston but was postponed. During their first one last week in Dallas, both candidates largely stuck to red meat issues that excite their bases while doing little to attract moderates. O’Rourke said the Nelson event wasn’t about wooing swing voters, either. “It’s a Texas event and it doesn’t get much more Texas than Willie Nelson,” O’Rourke spokesman Chris Evans said. O’Rourke also took the stage during Nelson’s July Fourth Picnic event in Austin to play guitar for the late-night finales of “Will the Circle Be Unbroken” and “I’ll Fly Away.” But with the Nov. 6 election now looming, the stakes are higher this time. His strategy breaks from those of Texas Democrats who have tried to run as moderates only to fail miserably. When Wendy Davis used a Texas Senate filibuster defending abortion rights to briefly rocket to national notoriety and launch a gubernatorial bid in 2014, she endorsed the open carry of handguns statewide and didn’t hide her past support for the death penalty. It didn’t help, as Republican Greg Abbott beat her by 20-plus points. Paul Sadler, an underfunded former state representative whom Cruz defeated by nearly 16 points in 2012, said the idea that only conservative Democrats have any hope of flipping a state like Texas is changing when it comes to social issues including medical marijuana, which is now legal in 31 states. He said Beto “reflects the more modern, young thinking within the Democratic Party.” “I’m not sure if we really call those issues liberal as opposed to merely reflecting the people we’re supposed to represent,” Sadler said. At 85, Nelson isn’t young, of course. But he’s a longtime advocate for marijuana legalization who founded his own cannabis company for places where it is legal, not including Texas, which only allows low-THC cannabis oil that can’t get a user high to be prescribed to patients with intractable epilepsy. Some detractors have posted online comments chiding Nelson for backing a “socialist” and calling for boycotts, but Nelson has shrugged those off. “I love flack,” he said on ABC’s “The View.” ″We’re not happy ’til they’re not happy.” His cannabis company, Willie’s Reserve, responded to conservatives’ calls to burn Nelson records by deadpanning on Twitter: “If you’re going to burn something, burn Willie’s Reserve.” ___ Follow Will Weissert on Twitter: https://twitter.com/apwillweissert ___ Sign up for “Politics in Focus,” a weekly newsletter showcasing the AP’s best political reporting from around the country leading up to the midterm elections: https://bit.ly/2ICEr3D


Sid Miller Says a poll showed 70 percent to 75 percent of people want to see Confederate statues "remain up and not taken down.

History, Polls and Public Opinion, Texas, Sid Miller,

Sid Miller objected to the recent in-the-night removals of four statues of people with Confederate ties from pedestals at the University of Texas. The big-hatted Republican serving as Texas agriculture commissioner further said most Americans agree that such statues should be left in place. In an August 2017 interview with Karina Kling of Spectrum Cable’s Capital Tonight, Miller disputed the notion that statues venerating Confederate figures touch off controversy. "I don’t believe they do cause controversy," Miller said. "I saw a poll, I think (on) NPR, 70 or 75 percent of the people would like to see those statues remain up and not taken down." We decided to check Miller’s poll claim. A caution: Any comparison of poll results is limited by the amount of information available about how and when each poll was taken, what’s asked (there are invariably variations) and the demographic and partisan mix of each poll’s respondents. So, we recognized that fact-checking Miller’s reference to precise results might prove knotty. Huffington Post round-up A Huffington Post news story published the day Miller was interviewed rolled out the results of a HuffPost/YouGov poll of 1,000 adult U.S. citizens who were surveyed over the web Aug. 15-16, 2017--specifically, 353 Democrats, 397 independents and 246 Republicans, the organization reported. Its poll question:"Do you favor or oppose removing statues and memorials of Confederate leaders?" Thirty-three percent favored removals, 48 percent were opposed, 18 percent were unsure. The poll also had a margin of error of plus or minus 4.2 percent so you could speculate that 52 percent of the respondents wanted such statues to stay put. That’s considerably shy of 70-plus percent. But the story noted six other polls taken Aug. 15, 2017, to Aug. 22, 2017, each one asking about Confederate statues three days or more after confrontations between white supremacists and protesters in Charlottesville, Va., crumbled after a driver drove into pedestrians, killing one. Here’s the Huffington Post’s summary of recent statue polls:               SOURCE: Graphic, "Polls Find Little Support For Confederate Statue Removal — But How You Ask Matters," the Huffington Post, Aug. 23, 2017 (accessed Aug. 25, 2017) The Marist Poll We noticed the post-Charlottesville poll showing the largest share of respondents opposed to removing statues was the Marist Poll taken Aug. 14-15, 2017, by mobile and landline phones of 1,125 U.S adults. After the poll interviews, the pollster said, the regionally balanced samples were combined and balanced to reflect the 2013 U.S. Census Bureau’s American Community Survey one-year estimates for age, gender, income, race, and region. Marist said that of the 859 registered voters included in the poll, 37 percent were independents, 36 percent were Democrats and 26 percent were Republicans. The poll, taken in collaboration with NPR and the PBS NewsHour, asked: "Do you think statues honoring leaders of the Confederacy should remain as a historical symbol/be removed because they are offensive to some people?" Sixty-two percent of the surveyed adults said the statues should remain, 27 percent said they should be removed, 11 percent were unsure. The poll’s margin of error was plus or minus 2.9 percentage points meaning you could say close to 65 percent, or as few as 59 percent, of the polled preferred leaving such statues in place. Miller notes a deeper break-out By phone to our inquiry, a Miller campaign spokesman, Todd Smith, said Miller reached his 70 percent or 75 percent figure as an estimate of where Texans stand based on the Marist poll’s detailed results showing 67 percent of moderates and 81 percent of conservative or very conservative respondents said such statues should remain. "He was trying to extrapolate Texas numbers out of that," Smith said. "I don’t think Commissioner Miller was trying to give an exact number." The results also were broken down regionally. Sixty-six percent of respondents in the South favored statues to remain, 23 percent backed removals. Other polls identified by Ariel Edwards-Levy, the Huffington Post’s polling director, suggested 49 percent to 54 percent of respondents oppose statue removals (though it’s again worth stressing it matters how each question was posed and who was polled and how results were weighted). An outlier Only a poll by North Carolina-based Public Policy Polling, which showcases Democratic clients, delivered contrary results, perhaps because of how its question was framed and worded. The company’s general summary of its poll taken Aug. 18-21, 2017, says: "Voters have nuanced views when it comes to Confederate monuments. Overall 39% say they support monuments honoring the Confederacy to 34% who say they oppose them. That's basically unchanged from the 42/35 spread we found on this question when we polled it in June." Even though voters narrowly support the monuments, the summary says, 58 percent of respondents said "they support relocating them from government property and moving them to museums or other historic sites where they can be viewed in proper historical context. There's bipartisan support for that approach with Democrats (72/14), independents (52/27), and Republicans (46/42) all in favor of it." Public Policy Polling says it surveyed 887 registered voters. Eighty percent of participants, selected through a list based sample, responded by phone with the remaining 20 percent participating on the web. Forty-one percent of respondents self-identified as Democrats, 31 percent as Republicans, 29 percent as independents. After a question about supporting or opposing monuments honoring the Confederacy, the poll asked: "Do you support or oppose relocating monuments honoring the Confederacy from government property and moving them to museums or other historic sites where they can be viewed in proper historical context?" Fifty-eight percent supported relocation, 26 percent were opposed, 16 percent were unsure. The poll’s margin of error was plus or minus 3.3 percent so you could speculate that as much as 61 percent of respondents supported relocation. Our ruling Miller said a poll showed 70 percent to 75 percent of people oppose the removal of Confederate statues. All but one of the latest national polls, we confirmed, show more Americans in opposition to tumbling such statues than in favor. But most polls show a little more than 50 percent to 54 percent of respondents opposed with only the Marist poll, which Miller mentioned, indicating more than 60 percent in opposition. The statement is partially accurate but leaves out important details or takes things out of context.


Cannabis Derivative Cannabidiol Reduces Seizures in Severe Epilepsy Disorder

Explanation: This release from the NYU Langone Medical Center describes a randomized placebo controlled clinical trial of children and adolescents with Dravet syndome, an extreme form of epilepsy, who often don’t respond to other drugs. The release provides a very good description of the benefits and the side effects that were reported from the trial. It adds cautions and nuance that are missing from many news releases. But not included were the cost of the new drug (projected to be quite steep) and we think the release could have emphasized more that the children in the trial were already on seizure medications. When the cannabidiol (or a placebo) was added to the maintenance drug it alleviated seizures but also introduced a high degree of side effects. A CNN story on the study, which we also reviewed, had many of the same strengths as the news release (overall depth and detail on benefits), but it similarly skipped cost information. Dravet syndrome is a rare form of epilepsy that generally begins in a child’s first year but is a life-long condition, according to the Epilepsy Foundation. Currently, treatments for this condition are marginal and new therapies addressing its symptoms would be welcome. The trial showed reduced seizures in this difficult-to-treat type of epilepsy compared to patients given a placebo. The lead researcher stressed that the study only tested cannabidiol in patients “with especially severe forms who have not responded to numerous medications”  and that the drug is not a panacea for other forms of epilepsy.

cannabidiol,epilepsy seizures,NYU Langone Medical Center

There was no mention of the cost of the drug but the NYT reported last year that Epidiolex could cost from $2,500 to $5,000 per month. Since the drug isn’t FDA approved, it’s too soon to know whether its cost will be covered by health insurance. The release describes benefits in clear terms, and provides numbers to add context. It states: “Specifically, seizure frequency dropped in the CBD-treated group by 39 percent from a median of nearly 12 convulsive seizures per month before the study to about six; three patients’ seizures stopped entirely. In the placebo group, there was a 13 percent reduction in seizures from about 15 monthly seizures to fourteen.” It also notes that the difference in the degree of seizure reduction between the CBD group and the placebo group was “both statistically significant and clinically consistent.” The release is clear in mentioning the side effects of the use of this drug in the study: “Side effects – experienced by 93.4 percent of patients in the CBD group and 74.6 percent of those treated with placebo – were generally reported as mild or moderate in severity. The most common side effects in the CBD group were vomiting, fatigue and fever. Eight participants from the CBD group withdrew from the trial due to side effects compared to one participant in the placebo group.” The study was a randomized, placebo controlled trial which is considered the highest standard of evidence. While the release didn’t specifically address limitations of this trial, it did recap that this study sought to address some of the limitations present in an earlier open-label study (meaning it wasn’t randomized or compared with a placebo). It states: “The new study confirms results from a December 2015 open-label expanded access program led by Dr. Devinsky that reported reductions in seizure frequency. In that program, both the researchers and patient’s families knew they were receiving CBD, which may have introduced a bias into the results. This new, randomized, controlled clinical study eliminated those concerns as participants and their physicians did not know if they were on CBD or placebo, say the study authors.” The release did say that larger, future trials will look at whether the benefits of cannabidiol can be achieved at lower, and perhaps less toxic doses. No evidence of disease mongering here. The release would have been better if it had provided some additional context about Dravet syndrome or on how researchers believe cannabidiol works to reduce seizures. The release mentions that the trial was funded by GW Pharmaceuticals, the manufacturer of Epidiolex. In the trial, patients in the experimental group had Epidiolex “added to their existing treatment over a 14-week period,” so it is obvious that other treatments are available. But these standard medications are not alternatives to cannabidiol. Instead, cannabidiol is an add-on treatment, not an alternative to existing drugs. The release could have named those standard medications and noted that other cannabidiol compounds are being studied in people with epilepsy. The release states that Epidiolex “has not been approved by the U.S. Food and Drug Administration” yet, so readers can assume that it is not yet available to the public. The FDA does, however, consider cannabidiol an investigational product for treating children with epilepsy and has “expanded access provisions” that allow its use. This would have been useful information to include in the release. The release states that this was “the first large-scale randomized clinical trial for the compound,” adding that the results were both statistically and clinically significant. The release is timed with the publication of the trial results in the New England Journal of Medicine. Much of what is found in the release was reported in the New York Times on March 14, 2016, but that story noted that full study data was not yet available. The release doesn’t rely on unjustifiable language. It inserts needed nuance in several places. For example, it states: “Cannabidiol should not be viewed as a panacea for epilepsy, but for patients with especially severe forms who have not responded to numerous medications, these results provide hope that we may soon have another treatment option,” according to the lead researcher.


Test may help predict colon cancer recurrence risk

Explanation: Whether to give chemotherapy after surgery for localized colon cancer is controversial. Chemotherapy has significant side effects and the survival benefit is small. As is currently done for breast cancer, to be able to predict whether the tumor is likely to return after surgery would help guide treatment decisions about chemotherapy. This story reports on new results on a gene test for colon cancer tumors to be presented at the American Society of Clinical Oncology meeting. Unfortunately the new test was only modestly able to predict colon cancer recurrence and failed to predict response to chemotherapy. Future research is clearly needed. This story adequately represents the novelty and availability of the test. It does not engage in disease mongering and is clear on the target of the test – colon cancers that are large but have not spread beyond the colon. It quotes multiples sources and is clear to point out who is invested in the development of the test. The story could have been improved by describing what is currently done to determine need for chemotherapy (i.e. pathology and/or imaging tests), by providing the baseline average risk of recurrence as a comparison to the predicted risk from the  test, and by describing potential harms of the test. Finally, the story doesn’t really give any details on the current study or the overall strength of the evidence to support the use of the test. Although the story points out that the results will be presented at a meeting, it should have made the point that these studies are not rigorously peer-reviewed and evaluated prior to presentation, which makes it more difficult to evaluate the study at this time.

The story describes the cost of a similar existing test for breast cancer but is clear to point out that exact costs are not yet available. The story also mentions several times that the high cost of the test may not be worth the expense. The story does provide a range of percentage risk of having a recurrence. The story could have provided the baseline average risk by way of comparison and could have described what the expected benefit in terms of improved survival could potentially be. The story does not describe any harms of the test. Because the test does not predict whether an individual would actually benefit from chemotherapy, some people could decide to undergo chemotherapy based on the results of the test without realizing any benefit. The story didn’t explicitly state that potential harm and we think it should have. The story doesn’t really give any details on the current study or the overall strength of the evidence to support the use of the test. Although the story points out that the results will be presented at a meeting, it should have made the point that these studies are not rigorously peer-reviewed and evaluated prior to presentation, which makes it more difficult to evaluate the study at this time. The story does not exagerrate the seriousness or prevalence of colon cancer. The story is also clear to describe the target of the test – colon cancers that are large but have not spread beyond the colon. The story quotes multiple experts. Clearly not having the test is the alternative. The story did not need to spell that out, but it could have described what is currently done to determine need for chemotherapy, i.e. pathology and/or imaging tests. The story clearly states that the test is not yet available but that it may be in the near future. The story adequately describes the novelty of the test. Because the story quotes multiple experts, it is reasonable to assume that the story does not rely on a press release as the sole source of information. But it does also appear clear that the news release from the American Society of Clinical Oncology meeting is driving the story. Otherwise why not wait until the actual presentation of results – or publication of a peer-reviewed paper?


Indonesian doctor's death exposes heartbreaking risks of coronavirus battle.

Explanation: When Indonesian doctor Ratih Purwarini was buried at dusk in a Jakarta cemetery, only her son Firos saw her plastic-wrapped coffin used for coronavirus victims lowered into the grave.

The rest of the family, instructed to keep a safe distance, watched the proceedings from afar: Firos standing alone by a mound of fresh earth wailing the Islamic call to prayer through his mask. Two weeks before the healthy 46-year-old mother of two was laughing at a family outing in Bandung, a West Javan city by strawberry fields and volcanoes. Now she is a number on a growing list, one of 26 Indonesian doctors killed by COVID-19, the respiratory disease caused by the new coronavirus. “I regret asking her to go to medical school,” said Bambang Purnomo, her devastated 72-year-old father. “I honestly still cry whenever I think of her.”  A month after recording its first case, Indonesia, with 3,293 infections and 280 deaths, has the highest death toll in Asia after China, where the virus emerged late last year, although health experts fear it could be much higher. The deaths of 26 doctors, and nine nurses, battling the pandemic in Indonesia, a sprawling developing nation of 260 million people, has fanned anxiety about a healthcare system ill-prepared to tackle it. In Italy, where the tally of infections is nearing 140,000, 96 doctors have died. But there have been none among the 4,119 cases in Indonesia’s southeast Asian neighbour of Malaysia. “Indonesia was not well prepared at the beginning, and we also didn’t have much personal protective equipment (PPE),” said Prijo Sidipratomo of the Indonesian medical association. “That is why so many doctors have died.”   Indonesia’s health ministry and coronavirus taskforce declined to comment on the doctors’ deaths. President Joko Widodo offered condolences and praised the dedication of the doctors who died. He announced financial incentives for medical professionals and payouts for the families of workers killed by the disease. But Widodo has resisted strict lockdowns, instead urging Indonesians to adopt social distancing measures and stay home. “The country was already exposed to the virus, but no one realised until March,” Sidipratomo added. “The president was not aggressive and the health minister was saying it was going to be okay.”   Now the world’s fourth-most populous nation is racing against time to contain the spread. Hospitals across the archipelago are chronically ill-equipped, lacking beds, medical staff and intensive care facilities, forcing some doctors to fashion makeshift gear, using raincoats and their own masks. “The government has asked all industries to make PPE in Indonesia, but now we are competing with the virus itself,” said Sidipratomo. “The virus is faster than us. So I guess we are in trouble.”  The government needs to act fast, especially outside the capital, said Adib Khumaidi, the deputy chief of the Indonesian doctors’ association. “Jakarta has a lot of doctors, but what if this happens in Sulawesi, Ambon, Maluku and Papua?” he added, naming some of Indonesia’s far-flung regions. “It will be a big problem.”   The first doctor in her family, Purwarini was head of human resources at a North Jakarta hospital, but she started treating patients when the outbreak hit. After a worrying X-ray, Purwarini checked herself into hospital, said her father, a retired civil servant. As her condition worsened, she was moved to a different hospital that provided a ventilator, but succumbed within a week. The deaths of the doctors and nurses have turned the virus response into a sore point for Indonesian medical professionals. “Together, we talk and we think there is no other thing to do than a lockdown,” said Sidipratomo. After his daughter’s death, Purnomo is also grappling with the realities of the pandemic. “I have cars and a house,” he said, clinging to a framed photograph of his firstborn, “But that has no meaning if my daughter has passed away.”  (Interactive graphic tracking global spread of coronavirus: here)  (This story corrects byline.)


A three-cents-per-ounce soda tax in Philadelphia "would result in the loss of 2,000 family-sustaining Teamster Union jobs and countless other jobs in the beverage industry.

Most of organized labor -- nearly all -- is just fine with Jim Kenney’s proposed sugary drinks tax. But the Teamsters have a big problem with it. They’re arguing they’ll lose jobs. Opponents to the tax argue higher prices will lead to decreased sales that will eventually trickle down and cause the soda bottling and delivery industry in Philadelphia to collapse. In fact, the loudest voice against the tax (outside lobbyists for the nation’s largest beverage companies) come from the Teamsters. Literally: They organized a ring of 18-wheelers that circled City Hall, horns blaring, to protest the measure. The first-year mayor wants to tax sugary drinks at three cents per ounce -- an unprecedented tax in America -- and use the revenue to fund pre-K, community schools and the city’s ailing pension fund. In a statement, Teamsters Local 830 secretary Daniel Grace wrote that the implementation of a three-cents-per-ounce sugary drinks tax "would result in the loss of 2,000 family-sustaining Teamster Union jobs and countless other jobs in the beverage industry." But there are about 2,000 people working in the beverage industry in Philadelphia in total. So we decided to look a little deeper into this claim. The American Beverage Association has claimed a soda tax in Philadelphia would result in job loss, but didn’t offer an estimate to PolitiFact and referred us to a local firm handling communications for those opposed to the tax. That firm also didn’t have an estimate on job loss and referred us to Grace, the Teamsters head in Philadelphia who didn’t respond to requests for more information. Instead, his spokesman Frank Keel emailed: "The Kenney administration has no idea about the Teamsters’ various roles in the beverage industry and no right to question the very real job losses we'll suffer if this regressive three-cents-an-ounce sugary drinks tax is passed into law." He again reiterated that "we stand to lose as many as 2,000 regional jobs in the beverage industry." Keel didn’t clarify what was meant by "regional," other than to say "there are several Teamsters locals in the Philadelphia regional jurisdiction." The Kenney administration disputes the figures as a "doomsday scenario" and said any job loss suffered due to the implementation of a soda tax will be offset by jobs created by the programming the tax would fund. "If sugary drink prices go up, then consumers will choose tax-exempt beverages like bottled water and diet drinks instead," Kenney’s spokeswoman Lauren Hitt said. "Small businesses will avoid job loss and maintain their profit margins by selling more tax-exempt drinks; and, accordingly, truck drivers will also be fine because they’ll be delivering more bottled water and diet soda." Without their clarification, it’s hard to discern how the Teamsters arrived at their job loss estimate. But economists and studies suggest it’s an overshoot. Robert P. Inman, a professor of business economics and public policy at the University of Pennsylvania’s Wharton school, called the estimate of 2,000 job losses "off the bounds of realistic." About 2,000 jobs would represent nearly the entire soda bottling and delivering industry in Philadelphia, and Inman said it’s inaccurate to assume that a three-cents-per-ounce tax on soda would cause the entire industry to crumble. He said his studies show the city could see a reduction in sales in the $150 million to $200 million range. But Inman said people won’t stop buying bottled drinks. They’ll either switch to bottled beverages like water that’s also bottled and delivered by large beverage companies, or they’ll switch to smaller sized bottles that also still need to be bottled and delivered in the city. "Wherever they’re getting the number from," he said, "it is so far above anything that strikes me as plausible." The Teamsters say they don’t buy the idea that the sale of water, diet sodas and the like will increase enough to cover the loss suffered as a result of the soda tax. In Grace’s statement, he wrote: "Consumers simply don't react that way." A 2014 study published in the American Journal of Public Health found a 20 percent tax on sugar-sweetened beverages (which correlates with about a two-cents-per-ounce tax) would result in small job gains. The study isn’t neutral -- it was funded by The Robert Wood Johnson Foundation’s Healthy Eating Research program. But it found that jobs lost as a result of the tax were offset by jobs created due to consumers switching to untaxed drinks like bottled water. A study published this year by Mexico’s Center for Health Systems Research found that after the country instituted a soda tax, there was a bump: Overall sales increased, largely due to higher amounts of bottled water being purchased. But then, after a year, sales fell to where they were before the tax was passed. The estimate is also higher than any other made before. When city officials floated a soda tax in 2011, the soda companies themselves predicted a job loss of 1,200 people. Al Taubenberger, a current city councilman and the former head of the Greater Northeast Philadelphia Chamber of Commerce, said at the time it would cost the city 1,000 jobs. After Baltimore instituted a two-cents tax on beverage containers last year, about 75 people lost their jobs. But Inman said any job loss estimate when it comes to a soda tax is dubious. Without statistical data -- as no other place in America has instituted a three-cents-per-ounce soda tax -- it’s nearly impossible to accurately calculate predicted job loss. "There’s been no soda tax, so you don’t have any experience who has actually seen what the effects are," he said. "So you end up trying to guess, and you get into this game of ‘your guess is as good as mine.’" Our Rating The Teamsters claim they stand to lose as many as 2,000 jobs in the region and "countless" others if Philadelphia implements a soda tax. This estimate is higher than any estimate floated before and tops what studies show the impact would be. And, at the end of the day, it’s nearly impossible to predict exact job loss as the result of a tax that hasn’t been implemented anywhere else in this way before. Is it within the realm of possibility that 2,000 beverage industry employees would lose their jobs due to the soda tax? Maybe. Is it likely? Not at all.


FDA approves new drug that prevents migraines without side effects

Explanation: This NBC News story takes a look at a newly approved migraine drug. We liked how the story included the cost of the drug, and discussed the lack of effective options for many patients. But the story could leave readers thinking the drug works better than it really does, because it only quotes the drug company’s rosy summary, and not what the FDA reported. Millions of Americans suffer from migraine attacks that greatly diminish their quality of life. There is currently no preventive medication with no side effects approved for patients who suffer from chronic or episodic migraines. This new drug has been hyped by Novartis’ and Amgen’s PR machines since clinical trials for them first began. It is important that people with migraines and their family members and friends (who often forward on anything and everything written about products that claim to reduce migraine attacks) are given accurate information about who a new drug is for and the extent to which it can actually improve people’s lives.

The story accurately reports that the list price for the self-injection will be $575 per month or $6,900 annually. Even so, it’s disconcerting that the story includes this language from a news release: “The price of Aimovig reflects the value it brings to patients and society, including the financial impact on sufferers, caregivers and employers, while also factoring in critical issues such as patient affordability, and fair and timely access.” The article does note that Amgen said this in a statement. However, the claims go unchallenged by any individual or organization who might not agree that the drug’s price reflects its value. The article, using text adapted from the Amgen/Novartis news release, makes the reduction in headache days sound very impressive, explaining it “reduced the average number of monthly migraine headaches by more than 50 percent for nearly half of study participants. After three months, patients treated with the human antibody were nearly three times more likely to have reduced their migraine days by 50 percent or more than those treated with placebo.” This is followed by “Participants of the study also had a greater average reduction in the number of days with headaches and the number of days they needed to take drugs to stop the migraines.” The FDA news release makes the benefits seem less rosy when describing the findings from the three studies that led to the drug’s approval. It explains that in one study, “over the course of six months, Aimovig-treated patients experienced, on average, one to two fewer monthly migraine days than those on placebo.” The release also notes that in a second study, also in patents with episodic migraine, the patients on Aimovig had, on average, one fewer migraine day per month than those on placebo” while the third study, which enrolled patients with chronic migraine (15 migraine days or more per month) found patients had, on average, 2 1/2 fewer monthly migraine days than those on placebo. We noted a similar problem in a Reuters article about the drug published in April. The headline shouts “no side effects.” Yet, the FDA press release says the most common side effects were injection site reactions and constipation. To date, there is virtually no long-term data on the drug and that needed to be emphasized. One study that led to the drug’s approval reported on patients who had taken the drug for six months. The two other studies reported on patients who had taken the drug for three months. The patient quoted in the article has been on the drug for four years, without side effects. But that is an anecdote. There is no data on long-term use. The story states: “No patients taking erenumab stopped treatment due to adverse side effects, but the scientists noted that more research will needed to investigate if the benefits continue.” The story also states that drug is “formulated as an injection to provide long-lasting protection.” It is given by injection because it was designed as a monoclonal antibody. These drugs are given only by injection, and they are known to cause side effects. The story does not contain enough information about the evidence. For example, did patients in the placebo groups also receive an injection? The story did not disease-monger; there are millions of people who get migraines. That is not in question. Which of the people who get migraines who may potentially be candidates for this drug is less clear. The drug’s marketing materials released along with press release announcing FDA approval say “preventive medication may be an option for approximately 10 million Americans with migraine.” The article notes that the Migraine Research Foundation estimates that more than 39 million Americans suffer from migraine attacks. However, it then goes on to confuse definitions and statistics for chronic and episodic migraine, stating that of that 38 million, “about 4 million have chronic migraine and suffer headache for 10 to 14 days per month. In the medical field, a person with 15 or more migraine days a month is considered chronic;  a person with 14 or fewer migraine days has episodic migraine. The story quotes the study’s lead researcher, Dr. Peter Goadsby, a professor of neurology at Kings College London and the University of California, San Francisco. It does not include the information that Dr. Goadsby is an advisor or consultant for, among others, Amgen and Novartis. He also received grants for clinical research from Amgen–a clear potential conflict of interest. A second source in the story is Dr. Dario Zagar. CMS Open Payment reveals he has received payments from Amgen and numerous other drug companies. This information should have been disclosed. The story quotes one patient who has been on the drug, and who says she now never has migraines. It does not quote anyone who was in the study who did not benefit from the new drug. The story explains that there are other treatments that migraine patients can use to prevent or abort migraines. It also notes that these alternatives do not work for everyone. The story tells readers that the drug has received FDA approval and “should also be paid for by health insurance.” As STAT News points out in this article, it is not yet known whether private insurers or Medicaid or Medicare will cover the medication. Even if private insurers do cover it, patients may be responsible for a co-pay or coinsurance that puts the drug out of their reach financially. The article also does not tell readers that Amgen and Novartis have a patient assistance program called Aimovig Ally that can help them learn about their insurance coverage or possibly get the drug for a reduced cost. The story states that this is a new class of drug for migraines. Sources are quoted who were not included in the news release put out by Amgen and Novartis.


Thailand closes more public facilities as coronavirus cases top 1,100.

Explanation: The Thai government on Friday ordered the closing down of more public facilities and businesses in a bid to curb the spread of coronavirus, and extended existing closures until the end of April.

Thailand reported 91 new coronavirus cases and one fatality on Friday, bringing the total to 1,136 cases and five deaths, a health official said on Friday. So far, 97 patients have recovered and gone home. The latest death was of a 50-year-old man in Narathiwat province, bordering Malaysia, who apparently contracted the disease from attending a religious gathering at a mosque in Kuala Lumpur last month, a Thai health official said. The death has led to the lockdown of the southern province by its governor, preventing traffic in and out except for ambulances, trucks carrying essential supplies and official vehicles. The government’s new Centre for COVID-19 Situation Administration (CCSA) in Bangkok says provincial governors now have the authority to implement strict regulations to contain the outbreak. “Now is not a normal situation, but its an emergency and people’s movements may be difficult, so everyone should stay home,” said Taweesin Wisanuyothin, a spokesman for CCSA. Authorities in Bangkok, the city with most of the coronavirus cases, have ordered the further shutdown until April 30 of facilities including libraries, museums, playgrounds, sporting grounds, meeting halls, childcare centres and beauty clinics. The government has also extend the closure of shopping malls, eat-in restaurants and other businesses that were shut down earlier this week to April 30 as well. Essential businesses such as supermarkets, grocery stores and pharmacies will remain open in Bangkok, while the government has reopened phone shops, food courts in hospitals and flower shops in markets in the capital. Several provinces have also issued orders to restrict the opening and closing times of 24-hour convenience stores to reduce the time when people are out in public places.