News from Bioethics.com

Teargas, Beatings and Bleach: the Most Extreme Covid-19 Lockdown Controls Around the World

1 day 11 hours

(The Guardian) – As coronavirus lockdowns have been expanded globally, billions of people have found that they are now faced with unprecedented restrictions. Police across the world have been given licence to control behaviour in a way that would normally be extreme even for an authoritarian state. On Tuesday, police in Kenya gave their “sincere condolences” after a 13-year-old boy was shot and killed on his balcony in Nairobi as police moved through the neighbourhood, enforcing a coronavirus curfew.

Are Hospitals Seeing a Surge of Coronavirus Patients? Some Officials Aren’t Saying

1 day 11 hours

(NPR) – Many public health departments, such as New York City’s, are publishing daily updates on the number, age and location of hospitalized patients. Louisiana is reporting the number of patients on ventilators. Still, other hotspots aren’t releasing numbers at all, either because public health officials are overwhelmed by the crisis and are still compiling the numbers or for reasons they declined to explain, even though they are compiling the numbers internally. The San Francisco Bay Area, in particular, is releasing incomplete data despite being an early epicenter of the U.S. outbreak, according to an investigation by NPR and member station KQED.

In Crowded Hospitals, Who Will Get Life-Saving Equipment?

1 day 11 hours

(Wired) – But what would rationing a ventilator actually mean? To Wall, who also researches clinical bioethics at New York University, the answer was opaque. Would he be asked to prioritize by age, turning away the elderly, as some hospitals in Italy did? What if the choice was between an old person and a younger one who was far less healthy and more likely to die, even with a ventilator’s aid? What if that patient was a health care worker who might, in the weeks ahead, get better and save more people? The guidance was unclear.

Genetic Analysis of the Coronavirus Gives Scientists Clues About How It’s Spreading

1 day 11 hours

(The Verge) – As the coronavirus spreads around the globe, it has mutated in tiny, subtle ways. Those mutations aren’t cause for concern, and so far, don’t appear to be making the virus any more or less dangerous. But scientists can use those slight changes to track the virus from person to person, and location to location.  “If we identify a new outbreak cluster in one state, and there’s a question of whether it’s related to a previous cluster or not, the small mutational changes can help you figure out if they’re connected,” says Patrick Boyle, a synthetic biologist at Ginkgo Bioworks.

Playing God: Pandemic Brings Moral Dilemmas to US Hospitals

1 day 12 hours

(Christianity Today) – There are three main ethical concerns that medical professionals are now facing, according to the Center for Bioethics and Human Dignity: protecting the vulnerable by not overwhelming health care systems, allocating insufficient medical supplies, and keeping medical workers safe who lack the proper protective equipment against the virus. The questions are very real: Who should receive medical care when there aren’t enough resources to go around? Two ethicists aiding US medical workers with these dilemmas are Carol L. Powers, a lawyer and the co-founder and chair of the Community Ethics Committee out of Harvard Medical School’s Center for Bioethics in Boston; and David Stevens, a physician and CEO emeritus of the Christian Medical & Dental Associations in Bristol, Tennessee who spent 11 years on the front lines of the HIV/AIDS and malaria epidemics in Africa.

Dutch End-of-Life Debate Flares as Coronavirus Tests Healthcare Limits

2 days 9 hours

(Reuters) – Doctors in the Netherlands have been advising elderly patients to think twice before agreeing to COVID-19 treatment in hospital intensive-care units, drawing criticism that they are attempting to ration scarce ICU beds. The affluent Netherlands is rapidly approaching the capacity of its healthcare system just over a month into the crisis, with efforts underway to double the number of intensive care beds to 2,400 by Sunday.

Unproven Stem Cell Therapy Gets OK for Testing in Coronavirus Patients

2 days 9 hours

(The New York Times) – An experimental stem cell therapy derived from human placentas will begin early testing in patients with the coronavirus, a New Jersey biotech company said Thursday. The treatment, being developed by the company Celularity, has not yet been used on any patients with symptoms of Covid-19, but it has caught the attention of Rudy Giuliani, President Trump’s personal lawyer. Mr. Giuliani recently featured an interview with the company founder on his website and said on Twitter that the product has “real potential,” while also criticizing the Food and Drug Administration for not moving more quickly to approve potential remedies.

For Homeless People, Covid-19 Is Horror on Top of Horror

2 days 10 hours

(Wired) – Homelessness is incompatible with health. Experts like Margot Kushel, a professor of medicine at UC San Francisco who studies homelessness, have been saying so for decades, but, in the midst of the coronavirus pandemic, it’s never been truer. “It’s a calamity. It’s our worst nightmare,” Kushel says. “It’s an enormous crisis superimposed on an existing crisis.” Unhoused people are already among the most sick in society, and now they’re physically incapable of following the Centers of Disease Control and Prevention’s most basic virus-fighting directive: stay home.

Tracking Fevers Across the Country Shows How Social Distancing Works

2 days 10 hours

(Dallas Morning News) – Social distancing works. Now we have empirical evidence to prove it. A San Francisco-based company called Kinsa Health makes internet-connected thermometers and uses the data to track the rate of fever. With more than one million thermometers in circulation, Kinsa gets as many as 162,000 daily temperature readings. That data shows drops in the number of fevers that coincide with the implementation of social distancing measures.

‘There’s Nothing about It That Will Feel Right’: Hospitals Are Gearing Up to Choose Which Patients to Save If They Run Low on Crucial Equipment

2 days 10 hours

(Business Insider) – Hospitals are preparing to make difficult decisions about which patients to save and how to ration care should they be overwhelmed by the novel coronavirus.  Experts caution that hospitals in the US are at risk of running out of workers, beds, and protective equipment. By one estimate, the US could require up to 400,000 more ventilators in the next month or two — but it has no more than 20,000 left in the national stockpile. Earlier this week, New York Gov. Andrew Cuomo said states were competing to buy ventilators in bidding wars.

Don’t Believe the COVID-19 Models

2 days 10 hours

(The Atlantic) – Here’s the tricky part: When an epidemiological model is believed and acted on, it can look like it was false. These models are not snapshots of the future. They always describe a range of possibilities—and those possibilities are highly sensitive to our actions. A few days after the U.K. changed its policies, Neil Ferguson, the scientist who led the Imperial College team, testified before Parliament that he expected deaths in the U.K. to top out at about 20,000.

An Ethicist on How to Make Impossible Decisions

3 days 4 hours

(The Atlantic) – The question of who gets a ventilator and who does not, when two people are both in real need, is a question of justice of the sort doctors are not trained to adjudicate. But others are, and this is the moment they’ve been training for. On this episode of the Social Distance podcast, Katherine Wells, the executive producer of Atlantic podcasts, and I talk with medical ethicist Arthur Caplan, head of the division of Medical Ethics at the NYU Grossman School of Medicine. What follows is a transcript of our conversation, edited and condensed for clarity. You can also listen to the full episode of Social Distance here.

Coronavirus ‘Could Devastate’ Indigenous Communities

3 days 4 hours

(SciDevNet) – Indigenous communities around the globe are closing borders in an effort to avoid a potentially devastating coronavirus outbreak in their territories. Without medical services, many indigenous communities in remote areas have already taken steps to isolate themselves. But this brings fears that food insecurity could be exacerbated in vulnerable communities who maintain immune system health through diet.

FDA Orders Zantac Removed from Market Due to NDMA Contamination

3 days 5 hours

(UPI) – The U.S. Food and Drug Administration on Wednesday ordered drugmakers to remove all prescription and over-the-counter products containing the agent ranitidine from the market immediately as the agency continues to investigate possible contamination. Ranitidine is the key ingredient in a number of prescription and over-the-counter drugs used to treat heartburn and acid reflux. The popular product Zantac is one of many that uses ranitidine, the FDA noted. 

Federal Inmates to Be Locked in Cells for 14 Days Amid Virus

3 days 5 hours

(ABC News) – The federal Bureau of Prisons is locking all its 146,000 inmates in their cells for the next two weeks in an unparalleled effort to slow the spread of the coronavirus, as the focus shifts to a Louisiana compound, where two inmates have died and nearly 20 others remain hospitalized.  The compound, known as FCC Oakdale, has emerged as ground zero in the federal prison system’s struggle to contain coronavirus behind bars. The situation there is so dire that the local health department told the federal government there was no need to test inmates anymore for the coronavirus. Those showing symptoms should be presumed to have it.

Some Coronavirus Patients Show Signs of Brain Ailments

3 days 5 hours

(The New York Times) – Neurologists around the world say that a small subset of patients with Covid-19 are developing serious impairments of the brain. Although fever, cough and difficulty breathing are the typical hallmarks of infection with the new coronavirus, some patients exhibit altered mental status, or encephalopathy, a catchall term for brain disease or dysfunction that can have many underlying causes, as well as other serious conditions. These neurological syndromes join other unusual symptoms, such as diminished sense of smell and taste as well as heart ailments.

Online Coronavirus Tests Are Just the Latest Iffy Products Marketed to Anxious Consumers

3 days 5 hours

(Kaiser Health News) – The kits were touted as a way for consumers to manage this difficult situation themselves. No struggle to see the doctor. No calls to the health department. No waiting in line at a drive-thru test site. Instead, consumers could collect their own samples, by either swabbing the throat or cheek or spitting into a cup. The samples would then be mailed back to the companies’ partner laboratories, which would test for the coronavirus. Prices ranged from $135 to $181. But criticism was swift. At-home tests could be skimming the resources needed for lab-based tests. There is also the possibility of people collecting their samples incorrectly and questions about follow-up care.

The Grim Ethical Dilemma of Rationing Medical Care, Explained

3 days 5 hours

(Vox) – With medical experts and politicians now predicting that coronavirus cases will dramatically exceed the capacities of hospitals across America, doctors and nurses face the prospect of picking which patients to prioritize for treatment. Though the term “triage” may conjure images of rough battlefield medicine and crude estimates of patients’ survival odds, excruciating decisions on whom to treat already confront doctors in some places and will likely soon be necessary in America.

With Surgeries Delayed, Patients Wait with Anxiety–Some in Pain–as Hospitals Make Way for Coroanvirus Cases

4 days 4 hours

(Medical Xpress) – “I actually burst into tears and started crying,” Rayburn said. “I really wanted that cancer out … I felt like I was being sacrificed … for the good of the people.” Rayburn is one of many Americans whose surgical procedures, tests and examinations have been canceled as part of the broader response to the rapidly unfolding crisis. These disruptions represent a huge but largely hidden toll of the pandemic, which has slashed services available to patients and inflicted a major economic blow on hospitals and health care workers, one intended to be softened with $100 billion from the stimulus package approved by Congress last week.

A New Covid-19 Problem: Shortages of Medicines Needed for Placing Patients on Ventilators

4 days 4 hours

(STAT News) – On top of the overwhelming shortages of medical equipment required to combat Covid-19, there are now signs that medicines needed for patients who are placed on ventilators are also in short supply. The medicines include more than a dozen sedatives, anesthetics, painkillers, and muscle relaxants, and the shortages raise the possibility that it could become more difficult for health care providers to place these patients on ventilators. This is because the drugs are used to help manage patient pain and comfort levels so they can benefit from mechanical ventilation.

America’s Other Heroes

4 days 4 hours

(The Atlantic) – They flew in on short notice. They left their homes all across America; rushed to Lackland Air Force Base, in Texas, and other military installations; and got to work. They are not elite commandos or rapid-response troops, or at least not the kind you might imagine serving in our military. They are the civilian medical personnel of the National Disaster Medical System and the officers of the U.S. Public Health Service—doctors, nurses, medical technicians. And they always respond, parachuting into hot spots of disease and suffering in the wake of every kind of human trauma imaginable.

Coronavirus: US Navy Captain Pleads for Help Over Outbreak

4 days 4 hours

(BBC) – The captain of a US aircraft carrier carrying more than 4,000 crew has called for urgent help to halt a coronavirus outbreak on his ship. Scores of people on board the Theodore Roosevelt have tested positive for the infection. The carrier is currently docked in Guam. “We are not at war. Sailors do not need to die,” Captain Brett Crozier wrote in a letter to the Pentagon.

U.S. Records 700 Coronavirus Deaths in a Single Day for First Time

4 days 5 hours

(Reuters) – The U.S. government raced to build hundreds of makeshift hospitals to ease the strain on overwhelmed healthcare systems as the United States marked 700 deaths in a single day from COVID-19 for the first time on Tuesday.  That is the equivalent of a person dying every two minutes.

Relaxation of UK Abortion Rules Welcomed by Experts

4 days 5 hours

(The Guardian) – Leading UK healthcare providers have welcomed the government’s decision to allow women to take abortion pills at home without travelling to a clinic. A spokesperson for the Department of Health and Social Care confirmed the government was updating its guidance to help women who need an abortion, but cannot access a clinic because of measures put in place to stem the spread of coronavirus. The move will be made on a temporary basis, limited for two years or until the coronavirus crisis is over, and applies for medical abortions up to the tenth week of pregnancy.

Halting COVID-19: The Benefits and Risks of Digital Contact Tracing

5 days 5 hours

(IEEE Spectrum) – As COVID-19 sweeps through the planet, a number of researchers have advocated the use of digital contact tracing to reduce the spread of the disease. The controversial technique can be effective, but can have disastrous consequences if not implemented with proper privacy checks and encryption. Ramesh Raskar, an associate professor at MIT Media Lab, and his team have developed an app called Private Kit: Safe Paths that they say can do the job while protecting privacy. The software could get integrated into a new, official WHO app touted as the “Waze  for COVID-19.” IEEE Spectrum spoke with Raskar to better understand the risks and benefits of digital contact tracing.

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