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Hydroxy hysteria: When saving lives collides with politics and bureaucracy | TheHill – The Hill

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Field reports from physicians around the world suggest that hydroxychloroquine, a relatively inexpensive drug used to treat malaria for more than 60 years, may be useful in fighting COVID-19. Based on this emerging data, President TrumpDonald John TrumpSanders says he wouldn’t ‘drop dead’ if Trump decided on universal healthcare Overnight Health Care: Trump officials lay groundwork for May reopening | Democrats ramp up talks with Mnuchin on next relief deal | Fauci says death toll could be around 60,000 Hillicon Valley: State officials push for more election funds | Coronavirus surveillance concerns ramp up pressure for privacy bill | Senators warned not to use Zoom | Agencies ask FCC to revoke China Telecom’s license MORE has suggested that doctors consider the “off-label” use of hydroxychloroquine in this global emergency.

So why is President Trump being ridiculed or condemned for at least spreading a ray of hope against a disease so new it would be impossible for the Food and Drug Administration (FDA) to have its own officially approved treatment yet? Is the president promoting quackery, or worse?

Nothing of the sort.

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To start, hydroxychloroquine is not being used without any safeguards. The standard clinical trials proving its value against this disease have not been conducted — but hydroxychloroquine was tested and approved six decades ago, and it has an established record of efficacy and side effects that physicians can review. More importantly, no doctor is (or should be) prescribing it without following standard protocols observed for any drug or any patient.

While hydroxychloroquine may not be the best or ultimate cure against COVID-19, and while its use may be more experimental than proven at this stage, the fact is that this is not a normal situation. We face a new, dangerously infectious virus, and abnormal times can require abnormal measures. Hydroxychloroquine has shown promise in treating symptomatic cases of COVID-19, which is why many doctors are using it. And a recent survey of some 1,200 U.S. doctors found that 65 percent said they would prescribe it to treat or prevent COVID-19 in a family member.

Indeed, medical authorities have explained for years that off-label drug use — prescribing a medication for a health condition other than its normal, approved purpose — can be an innovative way to broaden therapeutic tools in challenging medical situations. Here is what the FDA itself tells us:

Once the FDA approves a drug, health care providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient. You may be asking yourself why your health care provider would want to prescribe a drug to treat a disease or medical condition that the drug is not approved for. One reason is that there might not be an approved drug to treat your disease or medical condition. Another is that you may have tried all approved treatments without seeing any benefits. In situations like these, you and your health care provider may talk about using an approved drug for an unapproved use to treat your disease or medical condition.

And here is what the National Library of Medicine said — well before COVID-19 appeared on the scene — about using hydroxychloraquine against diseases for which the drug had never been officially approved: “It is also used to treat discoid or systemic lupus erythematosus and rheumatoid arthritis in patients whose symptoms have not improved with other treatments. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.”

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What, then, is really going on with this debate? Sad to say, it appears that at least some of the president’s critics are being influenced by what might otherwise be rational disagreements with him on other issues, a legitimate rivalry between political parties, or even a purely personal dislike for Trump. This, despite the potential for needless deaths of thousands of Americans who contract COVID-19, long before the FDA can finish the typical multi-year process of approving a drug for any one disease.

If any example shows us that partisan politics generally has gotten out of hand, it would be this. But it is more than this, too. In truth, President Trump has a different view of “expertise” than most liberals, progressives, academics or Washington insiders. He has shown a willingness to listen to the results of scientific research, but he does not automatically “defer to the experts” on the policy implications of that research. As his record of regulatory reform has demonstrated, he is willing to cut bureaucratic red tape in order to get results.

There is not an FDA-approved treatment for COVID-19 yet — it is simply too early. But that does not mean it is an “insult against science” to conclude that governmental action should be taken in the midst of an emergency based on the best facts available. Indeed, even outside of an emergency, it is no disrespect to science to say some medical treatments that some physicians deem prudent for their patients should be allowed — and, yes, promoted — even if those have not been the subject of someone’s peer-reviewed Ph.D. thesis or years of regulatory process. Even when the experts have the time to spend years studying a problem, they often can be wrong. Doctors in the field who are treating patients have valuable information to contribute in this crisis, too.

Even when the experts are correct, there often are many assumptions and policy biases hidden in the way they articulate their conclusions and recommendations. And organizations like the FDA have their own inherent institutional biases. The more involved and sophisticated the FDA can make the process of investigating drug “efficacy,” the more the process tends to help the biggest drug companies and deter smaller competitors. If you are part of that process — a lobbyist, a drug company executive, or even an FDA scientist committed to applying the most rigorous possible standards — you may see an emergency order moving an experimental drug or process to the top of the list as a challenge to the established way of doing business.

In this crisis, the president rightly has become deeply involved in the details of public policy and is working closely with members of his White House coronavirus task force. You may disagree with his views or his style, but the establishment needs to be shaken up: The normal order of business will not be enough to defeat COVID-19. And even if you think we were unprepared for COVID-19, it was not simply the fault of one man. It is part of the problem with our national approach to solving challenges: too much regulation, too much cronyism, too much corruption.

This crisis is a wake-up call. We need to set aside the old ways of doing things in Washington, innovate together, put on our masks, and get our country back to work. 

Ramin Oskoui, MD, is CEO of Foxhall Cardiology in Washington and has met with President Trump and White House advisers on the coronavirus pandemic.

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‘Disgraceful:’ N.S. Tory leader slams school’s request that military remove uniform

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HALIFAX – Nova Scotia Premier Tim Houston says it’s “disgraceful and demeaning” that a Halifax-area school would request that service members not wear military uniforms to its Remembrance Day ceremony.

Houston’s comments were part of a chorus of criticism levelled at the school — Sackville Heights Elementary — whose administration decided to back away from the plan after the outcry.

A November newsletter from the school in Middle Sackville, N.S., invited Armed Forces members to attend its ceremony but asked that all attendees arrive in civilian attire to “maintain a welcoming environment for all.”

Houston, who is currently running for re-election, accused the school’s leaders of “disgracing themselves while demeaning the people who protect our country” in a post on the social media platform X Thursday night.

“If the people behind this decision had a shred of the courage that our veterans have, this cowardly and insulting idea would have been rejected immediately,” Houston’s post read. There were also several calls for resignations within the school’s administration attached to Houston’s post.

In an email to families Thursday night, the school’s principal, Rachael Webster, apologized and welcomed military family members to attend “in the attire that makes them most comfortable.”

“I recognize this request has caused harm and I am deeply sorry,” Webster’s email read, adding later that the school has the “utmost respect for what the uniform represents.”

Webster said the initial request was out of concern for some students who come from countries experiencing conflict and who she said expressed discomfort with images of war, including military uniforms.

Her email said any students who have concerns about seeing Armed Forces members in uniform can be accommodated in a way that makes them feel safe, but she provided no further details in the message.

Webster did not immediately respond to a request for comment.

At a news conference Friday, Houston said he’s glad the initial request was reversed but said he is still concerned.

“I can’t actually fathom how a decision like that was made,” Houston told reporters Friday, adding that he grew up moving between military bases around the country while his father was in the Armed Forces.

“My story of growing up in a military family is not unique in our province. The tradition of service is something so many of us share,” he said.

“Saying ‘lest we forget’ is a solemn promise to the fallen. It’s our commitment to those that continue to serve and our commitment that we will pass on our respects to the next generation.”

Liberal Leader Zach Churchill also said he’s happy with the school’s decision to allow uniformed Armed Forces members to attend the ceremony, but he said he didn’t think it was fair to question the intentions of those behind the original decision.

“We need to have them (uniforms) on display at Remembrance Day,” he said. “Not only are we celebrating (veterans) … we’re also commemorating our dead who gave the greatest sacrifice for our country and for the freedoms we have.”

NDP Leader Claudia Chender said that while Remembrance Day is an important occasion to honour veterans and current service members’ sacrifices, she said she hopes Houston wasn’t taking advantage of the decision to “play politics with this solemn occasion for his own political gain.”

“I hope Tim Houston reached out to the principal of the school before making a public statement,” she said in a statement.

This report by The Canadian Press was first published Nov. 8, 2024.

The Canadian Press. All rights reserved.

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Saskatchewan NDP’s Beck holds first caucus meeting after election, outlines plans

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REGINA – Saskatchewan Opposition NDP Leader Carla Beck says she wants to prove to residents her party is the government in waiting as she heads into the incoming legislative session.

Beck held her first caucus meeting with 27 members, nearly double than what she had before the Oct. 28 election but short of the 31 required to form a majority in the 61-seat legislature.

She says her priorities will be health care and cost-of-living issues.

Beck says people need affordability help right now and will press Premier Scott Moe’s Saskatchewan Party government to cut the gas tax and the provincial sales tax on children’s clothing and some grocery items.

Beck’s NDP is Saskatchewan’s largest Opposition in nearly two decades after sweeping Regina and winning all but one seat in Saskatoon.

The Saskatchewan Party won 34 seats, retaining its hold on all of the rural ridings and smaller cities.

This report by The Canadian Press was first published Nov. 8, 2024.

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Nova Scotia election: Liberals say province’s immigration levels are too high

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HALIFAX – Nova Scotia‘s growing population was the subject of debate on Day 12 of the provincial election campaign, with Liberal Leader Zach Churchill arguing immigration levels must be reduced until the province can provide enough housing and health-care services.

Churchill said Thursday a plan by the incumbent Progressive Conservatives to double the province’s population to two million people by the year 2060 is unrealistic and unsustainable.

“That’s a big leap and it’s making life harder for people who live here, (including ) young people looking for a place to live and seniors looking to downsize,” he told a news conference at his campaign headquarters in Halifax.

Anticipating that his call for less immigration might provoke protests from the immigrant community, Churchill was careful to note that he is among the third generation of a family that moved to Nova Scotia from Lebanon.

“I know the value of immigration, the importance of it to our province. We have been built on the backs of an immigrant population. But we just need to do it in a responsible way.”

The Liberal leader said Tim Houston’s Tories, who are seeking a second term in office, have made a mistake by exceeding immigration targets set by the province’s Department of Labour and Immigration. Churchill said a Liberal government would abide by the department’s targets.

In the most recent fiscal year, the government welcomed almost 12,000 immigrants through its nominee program, exceeding the department’s limit by more than 4,000, he said. The numbers aren’t huge, but the increase won’t help ease the province’s shortages in housing and doctors, and the increased strain on its infrastructure, including roads, schools and cellphone networks, Churchill said.

“(The Immigration Department) has done the hard work on this,” he said. “They know where the labour gaps are, and they know what growth is sustainable.”

In response, Houston said his commitment to double the population was a “stretch goal.” And he said the province had long struggled with a declining population before that trend was recently reversed.

“The only immigration that can come into this province at this time is if they are a skilled trade worker or a health-care worker,” Houston said. “The population has grown by two per cent a year, actually quite similar growth to what we experienced under the Liberal government before us.”

Still, Houston said he’s heard Nova Scotians’ concerns about population growth, and he then pivoted to criticize Prime Minister Justin Trudeau for trying to send 6,000 asylum seekers to Nova Scotia, an assertion the federal government has denied.

Churchill said Houston’s claim about asylum seekers was shameful.

“It’s smoke and mirrors,” the Liberal leader said. “He is overshooting his own department’s numbers for sustainable population growth and yet he is trying to blame this on asylum seekers … who aren’t even here.”

In September, federal Immigration Minister Marc Miller said there is no plan to send any asylum seekers to the province without compensation or the consent of the premier. He said the 6,000 number was an “aspirational” figure based on models that reflect each province’s population.

In Halifax, NDP Leader Claudia Chender said it’s clear Nova Scotia needs more doctors, nurses and skilled trades people.

“Immigration has been and always will be a part of the Nova Scotia story, but we need to build as we grow,” Chender said. “This is why we have been pushing the Houston government to build more affordable housing.”

Chender was in a Halifax cafe on Thursday when she promised her party would remove the province’s portion of the harmonized sales tax from all grocery, cellphone and internet bills if elected to govern on Nov. 26. The tax would also be removed from the sale and installation of heat pumps.

“Our focus is on helping people to afford their lives,” Chender told reporters. “We know there are certain things that you can’t live without: food, internet and a phone …. So we know this will have the single biggest impact.”

The party estimates the measure would save the average Nova Scotia family about $1,300 a year.

“That’s a lot more than a one or two per cent HST cut,” Chender said, referring to the Progressive Conservative pledge to reduce the tax by one percentage point and the Liberal promise to trim it by two percentage points.

Elsewhere on the campaign trail, Houston announced that a Progressive Conservative government would make parking free at all Nova Scotia hospitals and health-care centres. The promise was also made by the Liberals in their election platform released Monday.

“Free parking may not seem like a big deal to some, but … the parking, especially for people working at the facilities, can add up to hundreds of dollars,” the premier told a news conference at his campaign headquarters in Halifax.

This report by The Canadian Press was first published Nov. 7, 2024.

— With files from Keith Doucette in Halifax

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