News from Bioethics.com

Researchers Report “Unprecedented Cluster” of Inflammatory Problems in Children Amid Pandemic

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(CNN) – Researchers in the UK said Wednesday they have seen an “unprecedented cluster” of eight children with rare inflammatory problems amid the coronavirus pandemic. The cases, they said, resemble a severe form of Kawasaki disease — a rare condition that causes inflammation in the walls of the arteries and can limit blood flow to the heart. Separately on Wednesday, the New York State Department of Health reported 64 suspected cases of a similar syndrome, which they called “Pediatric Multi-System Inflammatory Syndrome Associated with COVID-19.”

Using Human Brain Tissue in Lab Dishes, Researchers Show Herpes Link to Alzheimer’s

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(STAT News) – A small 3D version of the human brain develops key features of Alzheimer’s disease when it is infected with a virus that causes cold sores, scientists reported on Wednesday, adding to the evidence that this most common form of dementia can be caused by a common microbe. The new research, published in Science Advances, is the first to directly show in a lab model (rather than through circumstantial evidence from human studies) that the herpes simplex virus HSV-1 might cause Alzheimer’s: Human brain-like tissue infected with the virus became riddled with amyloid plaque-like formations — the hallmark of Alzheimer’s. It also developed neuroinflammation and became less effective at conducting electrical signals, all of which happen in Alzheimer’s disease.

Doctors Lambaste Federal Process for Distributing Covid-19 Drug Remdesivir

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(STAT News) – Hospitals and physicians around the country are sharply criticizing the federal government for the uneven and opaque way it is distributing its supply of the Covid-19 drug remdesivir. The experimental drug received an emergency use authorization from the Food and Drug Administration last week, after preliminary data from a clinical trial showed that it reduced how long it took hospitalized Covid-19 patients to recover. Now, as the drug’s producer, Gilead Sciences, tries to ramp up production, the U.S. government is starting to distribute the limited number of  vials that aren’t needed for ongoing research, so that patients can start to see the benefit outside of clinical trials.

A Cancer Patient Reconsiders Her End-of-Life Wishes, as Covid-19 Brings Mortality into Sharper Focus

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(STAT News) – The creators of the policies said that they were being as fair and objective as possible, and that their algorithm would take every individual’s current prognosis into account. Cancer patient coalitions retorted that no one had consulted them; regardless of their prospects on paper, they said, their lives were worth saving, and they were protected under the Americans with Disabilities Act. If their medical records contained what’s known as a DNR — a “do not resuscitate” order — and there were, for instance, a shortage of ventilators, then they wouldn’t even be in the running for whatever equipment remained. So some patients began calling and texting their oncologists, to remove the DNR from their files. Some took to social media, encouraging others to do the same.

Coronavirus Drug Trial on Volunteer Military Personnel Resumes Following Ethics Concerns

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(Australian Broadcasting Co) – A COVID-19 drug trial involving Australian military personnel and frontline health workers has resumed following complaints by some ethics committee members, who were initially sidelined from the trial’s approval process. The Australian Defence Force [ADF] Malaria and Infectious Diseases Institute has been conducting a study to see whether anti-malaria drug chloroquine is effective in stopping people from contracting coronavirus.

Patients Dying Fast, and Far from Family, Challenge Practice of Palliative Care

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(NPR) – Owens, like other palliative care specialists in COVID-19 hot spots around the country, has seen his professional duties transformed by the deadly virus. Patients and their families face abrupt decisions about the kind of care they want, and time for sensitive deliberation is scarce. Conversations once held in-person are now over the phone, with all the nuances of nonverbal communication lost. The comfort of family at the bedside of the dying is all but gone. This is the new reality for those who practice palliative medicine — a speciality focused on relieving pain and symptoms, improving quality of life, and providing support to patients and families during severe, chronic or fatal illness.

The Problem with Stories About Dangerous Coronavirus Mutations

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(The Atlantic) – As if the pandemic weren’t bad enough, on April 30, a team led by scientists at Los Alamos National Laboratory released a paper that purportedly described “the emergence of a more transmissible form” of the new coronavirus, SARS-CoV-2. This new form, the team wrote, “began spreading in Europe in early February.” Whenever it appeared in a new place, including the U.S., it rapidly rose to dominance. Its success, the team suggested, is likely due to a single mutation, which is now “of urgent concern.” The paper has not yet been formally published or reviewed by other scientists. But on May 5, the Los Angeles Times wrote about it, claiming that “a now-dominant strain of the coronavirus could be more contagious than [the] original.” That story quickly went … well … viral. But “the conclusions are overblown,” says Lisa Gralinski of the University of North Carolina, who is one of the few scientists in the world who specializes in coronaviruses. 

Pfizer Begins Human Testing for Experimental Coronavirus Vaccine in the US

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(CNBC) – Pfizer said Tuesday it has begun testing an experimental vaccine to combat the coronavirus in the United States. The U.S.-based pharmaceutical giant, which is working alongside German drugmaker BioNTech, said the first human participants in the United States have been dosed with the potential vaccine, BNT162. They began human trials of the experimental vaccine late last month in Germany.

‘ICU Delirium’ Is Leaving COVID-19 Patients Scared and Confused

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(The Atlantic) – Spending time in the ICU, especially for anyone with COVID-19, is a dangerous, physically taxing experience: Only the most seriously ill patients land in intensive care, where many undergo a number of complex medical treatments at once, making them even more vulnerable to life-threatening complications. Ten to 30 percent of the sickest, oldest patients who enter don’t make it out. But for survivors, the mental toll can be even more severe than the physical one. About one in three patients who spends more than five days in the ICU will experience some kind of psychotic reaction, which often takes the shape of delirium—an intense confusion that the patient can’t snap out of.

Three Russian Doctors Fall from Hospital Windows, Raising Questions Amid Coronavirus Pandemic

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(CNN) – Three frontline health care workers have mysteriously fallen out of hospital windows in Russia over the past two weeks, heightening public attention to the working conditions for doctors and medical professionals amid the coronavirus pandemic.  Two of those health care workers are dead, and one remains hospitalized. All three incidents, which are being investigated by Russian law enforcement authorities, have prompted intense discussion in the Russian press and on social media.

The Fight Over Facial Recognition Technology Gets Fiercer During the Covid-19 Pandemic

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(STAT News) – The long-simmering debate over facial recognition technology is taking on new urgency during the pandemic, as companies rush to pitch face-scanning systems to track the movements of Covid-19 patients. That’s playing out in California, where state legislators on Tuesday will debate legislation that would regulate the use of the technology. Its most controversial element: It would permit companies and public agencies to feed people’s facial data into a recognition system without their consent if there is probable cause to believe they’ve engaged in criminal activity. The bill isn’t specifically meant for the coronavirus response, but if enacted, could shape the way that people with Covid-19 and their contacts are tracked and traced in the coming months.

New Studies Add to Evidence That Children May Transmit the Coronavirus

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(New York Times) – Among the most important unanswered questions about Covid-19 is this: What role do children play in keeping the pandemic going? Fewer children seem to get infected by the coronavirus than adults, and most of those who do have mild symptoms, if any. But do they pass the virus on to adults and continue the chain of transmission?

Coronavirus: Do Not Use Untested Remedies, WHO Africa Warns

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(BBC) – The World Health Organization (WHO) has issued a warning against people using untested remedies for coronavirus. Africans deserve access to medicines that have gone through proper trials even if they are derived from traditional treatments, it said. Its statement comes as Madagascar’s president is promoting a herbal tonic for treating Covid-19 patients. The African Union (AU) said it wanted to see the scientific data on the “safety and efficacy” of the product.

Doctors Without Patients: ‘Our Waiting Rooms Are Like Ghost Towns’

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(New York Times) – While there are no hard numbers, there are signs that many small groups are barely hanging on. Across the country, only half of primary care doctor practices say they have enough cash to stay open for the next four weeks, according to one study, and many are already laying off or furloughing workers.

With First CRISPR Trials, Gene Editing Moves Toward the Clinic

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(JAMA) – In March, a patient with an inherited form of blindness called Leber congenital amaurosis became the first person to undergo gene editing inside the body using clustered regularly interspaced short palindromic repeats (CRISPR) and associated protein 9 (Cas9). The procedure, part of a phase 1 and 2 trial that’s expected to enroll about 18 patients, comes less than a decade after scientists first demonstrated how CRISPR-Cas9, a bacterial defense system, could be programmed to edit the human genome. Compared with older gene-editing technologies, the technique can be readily and cheaply designed to target almost any genome sequence, and at multiple sites at the same time, with exceptional efficiency. This has opened up the potential to safely and affordably correct an array of disease-causing genetic alterations.

Facing Fraud, U.S. FDA Resets Coronavirus Antibody Test Market Rules

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(Reuters) – The U.S. Food and Drug Administration on Monday said it would require antibody tests for the new coronavirus to undergo an agency review, reversing an earlier policy that had allowed fraudulent products to be marketed. The agency’s previous policy required only that companies attest that their product was valid and labeled as unapproved, attracting 170 companies to the antibody test market including unscrupulous vendors making false claims, Reuters reported last week.

IS Militants ‘Dumped Bodies in Syria Gorge’, HRW Says

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(BBC) – The jihadist group Islamic State used a gorge in north-eastern Syria to dump the bodies of people it had abducted or detained, Human Rights Watch says. Researchers began an investigation after being sent a video in 2014 showing militants throwing corpses into the 50m (164ft) deep al-Hota gorge. HRW also believes bodies continued to be dumped there following IS rule. It wants local authorities to secure the site, remove human remains, and preserve evidence for prosecutions.

A Bioethicist on Why Reopening State Will Kill More Black People

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(Vox) – As of April 28, the United States surpassed 1 million confirmed coronavirus cases. But this hasn’t stopped more than half of US states from partially reopening or making plans to reopen soon. Prematurely restarting businesses means that new virus cases will arise, health officials say, especially in the face of insufficient testing. This puts the country’s most vulnerable populations — black, Latinx, poor, elderly, disabled — at greater risk of infection and death For the black community, the decision to reopen — despite the alarming data that shows they are disproportionately suffering from the disease (black people make up 30 percent of coronavirus cases, according to the CDC, even though they represent just 13 percent of the US population) — fuels the community’s distrust of government and health leadership.

The Morally Complex Mix of Euthanasia and Organ Donation

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(Scientific American) – Gillis had not been a fan of the euthanasia law, but when he learned he could combine MAID with a plan to donate organs, “he was ecstatic,” Gregoire says. “His attitude was, ‘ALS, you can’t take this away. We’re going to give life to other people.’” Combining euthanasia with organ donation may sound logical, but it is ethically fraught and not widely done. In 2017 the Netherlands became the first country to publish clinical guidelines for the practice.

Explainer: What Does New Data Say About Gilead’s Experimental Coronavirus Drug?

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(Reuters) – New clinical data on Gilead Sciences Inc’s experimental antiviral drug remdesivir has raised hopes it might be an effective treatment for the novel coronavirus that has infected more than 3 million people and killed over 225,000 worldwide. On Wednesday, partial data from three different trials of the drug were released, creating both excitement and confusion.Much analysis and more studies are needed to understand which COVID-19 patients are most likely to benefit from the drug if it is deemed effective, under what circumstance it should be given, and whether it has any impact on the death rate. The following is what we do know about the latest three studies.

Scores of Coronavirus Vaccines Are in Competition–How Will Scientists Choose the Best?

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(Nature) – Less than five months after the world first learnt about the new coronavirus causing fatal pneumonia in Wuhan, China, there are more than 90 vaccines for the virus at various stages of development, with more announced each week. At least six are already being tested for safety in people. Now, developers, funders and other stakeholders are laying the groundwork for their biggest challenge yet: determining which vaccines actually work.

Coronavirus Was ‘Not Manmade or Genetically Modified’: U.S. Spy Agency

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(Reuters) – The top U.S. spy agency said for the first time on Thursday the American intelligence community believes the COVID-19 virus that originated in China was not manmade or genetically modified. 

Doctors Anticipate Patient Requests for Experimental Remdesivir Before All the Evidence Comes In

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(STAT News) – Before Wednesday’s hopeful news about the experimental antiviral remdesivir broke, doctors treating patients hospitalized for Covid-19 were already hearing from a few families desperate to get the drug for their loved ones. Now they expect to hear more pleas in the days to come, even though the data are preliminary, results are not available for clinicians to evaluate, and the drug is not yet approved for emergency use.

Nearly a Dozen Approved Drugs Could Be Effective Against COVID-19: Study

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(Reuters) – At least 10 different drug compounds ranging from cancer therapies to antipsychotics and antihistamines may be effective at preventing the new coronavirus from multiplying in the body, according to a multidisciplinary study conducted by a team of scientists in the United States and France. The researchers mapped the human proteins the virus interacts with inside the body when it infects cells and makes copies of itself, then looked for compounds that could block the virus from using those proteins.

Why the Coronavirus Is So Confusing

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(The Atlantic) – But much else about the pandemic is still maddeningly unclear. Why do some people get really sick, but others do not? Are the models too optimistic or too pessimistic? Exactly how transmissible and deadly is the virus? How many people have actually been infected? How long must social restrictions go on for? Why are so many questions still unanswered? The confusion partly arises from the pandemic’s scale and pace. Worldwide, at least 3.1 million people have been infected in less than four months. Economies have nose-dived. Societies have paused. In most people’s living memory, no crisis has caused so much upheaval so broadly and so quickly. 

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