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Coronavirus Is Bad but US Flu's New Numbers Still Far Worse – Medscape

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After falling slightly around the winter holidays, influenza activity has now risen for 2 consecutive weeks, according to a January 31 report from the US Centers for Disease Control and Prevention (CDC).

At a time when many are rightly concerned about the novel coronavirus (2019nCoV) — of which there are 11 confirmed cases in the United States as of Monday — the CDC is also warning citizens not to drop their guard about influenza, which has caused at least 19 million illnesses, 180,000 hospitalizations, and 10,000 deaths so far this season.

Nationwide, during the week ending January 25 (week 4), 5.7% of outpatient visits for influenza-like illness activity were reported, up from 5.1% the week before and above the national baseline of 2.4%. Regionally, this percentage ranged from 4.1% to 7.7% and visits were above region-specific baselines in all regions.

Activity was high in the District of Columbia, New York City, Puerto Rico, and 41 states — an increase from 35 the week before. Activity was moderate in seven states. There were insufficient data to calculate activity from the US Virgin Islands and two states (Delaware and Idaho).

Geographically, influenza activity was widespread in Puerto Rico and 49 states, regional in Hawaii, local in the District of Columbia, and sporadic in the US Virgin Islands. Guam did not report on activity.

Between Oct. 1, 2019 and Jan. 25, 2020, 8633 laboratory-confirmed influenza-associated hospitalizations were reported. Of those, 5173 (59.9%) were linked to influenza A virus, 3401 (39.4%) to influenza B virus, 27 (0.3%) to influenza A and influenza B virus co-infection, and 32 (0.4%) to influenza virus for which type was undetermined.

Among viruses for which influenza A virus subtype was available, 1080 (91.1%) were A(H1N1)pdm09 virus and 106 (8.9%) were A(H3N2).

Overall, the cumulative hospitalization rate was 29.7 per 100,000 population, “similar to what has been seen during recent previous influenza seasons at this time of year,” the CDC says in the report. However, the CDC says rates in children and young adults are higher than those seen at this time during recent seasons.

The highest hospitalization rate is among adults aged 65 years and older (71.3 per 100,000 population), followed by children younger than 5 years (48.8) and adults aged 50 to 64 years (36.7).

The percentage of deaths that resulted from pneumonia and influenza was 6.7% — below the epidemic threshold of 7.2% for week 3.

During week 4, CDC received reports of 14 influenza-associated pediatric deaths that occurred between the weeks ending Nov. 9, 2019 and Jan. 25, 2020. Eight were linked to influenza B viruses, one of which underwent lineage determination and was a B/Victoria virus. Six were related to influenza A viruses; three of those were subtyped and found to be A(H1N1)pdm09 viruses.

There have been 68 influenza-related pediatric deaths so far during the 2019-2020 influenza season. Of those, 45 were linked to influenza B viruses; all eight that had lineage determined were B/Victoria viruses. Approximately one third (23) were related to influenza A viruses, of which 13 were subtyped and found to be A(H1N1)pdm09 viruses.

The vast majority (91.5%) of the 1108 hospitalized adults who had information on underlying conditions had one or more underlying medical conditions. The most common of these were cardiovascular disease, metabolic disorder, obesity, and chronic lung disease.

Among hospitalized children with information on underlying conditions, about half (46.5%) had one or more underlying conditions, the most common of which was asthma. Approximately one fourth (26.4%) of hospitalized women of childbearing age with pregnancy status recorded were pregnant.

Estimates of influenza vaccine effectiveness are not yet available for this season; however, the CDC emphasizes that vaccination is the best way to prevent influenza and its complications.

“Antiviral medications are an important adjunct to flu vaccine in the control of influenza. Almost all (>99%) of the influenza viruses tested this season are susceptible to the four FDA-approved influenza antiviral medications recommended for use in the US this season,” the CDC writes in the report.

CDC FluView. Published online January 31, 2020. Full text

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WHO resumes hydroxychloroquine trial on Covid-19 patients – ITIJ

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On May 25, WHO suspended the trial of the drug, which is usually used to treat malaria patients, after a study published in medical journal The Lancet found that Covid-19 hospitalised patients treated with hydroxychloroquine had a higher risk of death, as well as an increased frequency of irregular heartbeats, than those who weren’t treated with it. 

However, WHO officials have since asserted that there is no evidence that the drug reduces the mortality in these patients, and the study has since been retracted over data concerns. 

“The executive group received this recommendation and endorsed the continuation of all arms of solidarity trial including hydroxychloroquine,” said WHO Director-General Tedros Adhanom Ghebreyesus during a press conference 3 June, adding that WHO planned to continue to monitor the safety of the therapeutics being tested in trials involving over 3,500 patients spanning over 35 countries. 

“WHO is committed to accelerating the development of effective therapeutics, vaccines and diagnostics as part of our commitment to serving the world with science, solutions and solidarity,” Ghebreyesus said. 

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'Truly sorry': Scientists pull panned Lancet study of Trump-touted drug – National Post

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NEW YORK/LONDON — An influential study that found hydroxychloroquine increased the risk of death in COVID-19 patients has been withdrawn a week after it led to major trials being halted, adding to confusion about a malaria drug championed by U.S. President Donald Trump.

The Lancet medical journal pulled the study after three of its authors retracted it, citing concerns about the quality and veracity of data in it. The World Health Organization (WHO) will resume its hydroxychloroquine trials after pausing them in the wake of the study. Dozens of other trials have resumed or are in process.

The three authors said Surgisphere, the company that provided the data, would not transfer the dataset for an independent review and they “can no longer vouch for the veracity of the primary data sources.”

The fourth author of the study, Dr. Sapan Desai, chief executive of Surgisphere, declined to comment on the retraction.

The Lancet said it “takes issues of scientific integrity extremely seriously” adding: “There are many outstanding questions about Surgisphere and the data that were allegedly included in this study.”

Another study in the New England Journal of Medicine (NEJM) that used Surgisphere data and shared the same lead author, Harvard Medical School Professor Mandeep Mehra, was retracted for the same reason.

The Lancet said reviews of Surgisphere’s research collaborations were urgently needed.

The race to understand and treat the new coronavirus causing the COVID-19 pandemic has accelerated the pace of research and peer-reviewed scientific journals are go-to sources of information for doctors, policymakers and lay people alike.

Chris Chambers, a professor of psychology and an expert at the UK Center for Open Science, said The Lancet and the NEJM – which he described as “ostensibly two of the world’s most prestigious medical journals” – should investigate how the studies got through peer review and editorial checks.

“The failure to resolve such basic concerns about the data” raises “serious questions about the standard of editing” and about the process of peer review, he said.

The Lancet did not immediately respond to a Reuters request for comment. The NEJM could not immediately be reached for comment.

UNANSWERED QUESTIONS

The observational study published in The Lancet on May 22 said it looked at 96,000 hospitalized COVID-19 patients, some treated with the decades-old malaria drug. It claimed that those treated with hydroxychloroquine or the related chloroquine had higher risk of death and heart rhythm problems than patients who were not given the medicines.

“I did not do enough to ensure that the data source was appropriate for this use,” the study’s lead author, Professor Mehra, said in a statement. “For that, and for all the disruptions – both directly and indirectly – I am truly sorry.”

Many scientists voiced concern about the study, which had already been corrected last week because some location data was wrong. Nearly 150 doctors signed an open letter to The Lancet calling the article’s conclusions into question and asking to make public the peer review comments that preceded publication.

Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine said the retraction decision was “correct” but still left unanswered the question about whether hydroxychloroquine is effective in COVID-19.

“It remains the case that the results from randomized trials are necessary to draw reliable conclusions,” he said. (Reporting by Michael Erman, Peter Henderson, Kate Kelland and Josephine Mason Editing by Leslie Adler, Tom Brown, Giles Elgood and Carmel Crimmins)

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Possible link between more overdoses and pandemic isolation: Guelph health officials – CTV News

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GUELPH —
The number of suspect overdose deaths in Guelph since the outbreak of COVID-19 has already surpassed the number of deaths in all of 2019.

Health officials say isolation could be a contributing factor, as staff at the consumption treatment centre have seen about half of the regular users during the time of the pandemic.

“From mid March until just the end of May we’ve seen eight deaths,” said Raechelle Devereaux, executive director of the Guelph Community Health Centre.

In 2018, there were seven overdose deaths in Guelph.

Jade McAfee uses the CTS site and say she’s lost a lot of friends to overdoses.

“It is scary,” she said. “I myself have overdosed 13 times.”

While officials say a toxic supply is to blame for overdoses, the COVID-19 pandemic has added a hurdle when it comes to prevention.

“The same things that are keeping people safe during the pandemic like isolating and staying home are some things that work against us,” said Devereaux.

Registered nurse Danielle Castledine supervises injections and says they would normally see 30 people a day before the pandemic.

“Before we had an intermediate space where people could be before and after,” she said. “So even if they were waiting they were waiting with peer workers and nurses and social workers.”

To help with better spacing, they’ve opened a new booth to decrease wait times and encourage more people to use the services.

“[Before the crisis] you didn’t have to have a mask, get stopped, have your temperature taken when you could blow in and out easily,” said Eric Cunningham, a user of the CTS site.

Staff say the lack of foot traffic at the CTS is a bad sign and worry the alternative is using in isolation, which decreases the likelihood of potentially life-saving intervention.

“It’s better for anybody to not do it alone,” said McAfee.

The health centre says between March 17 and May 30 there were 63 overdoses.

In the same time period last year there were 74, but only one overdose death.

The Guelph Community Health Centre says the team is door knocking at vulnerable apartment and shelters to give more information on harm reduction to help those potential using alone.

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