News from Bioethics.com

What Other Coronaviruses Tell Us About SARS-CoV-2

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(Quanta Magazine) – COVID-19 and the virus that causes it, SARS-CoV-2, have focused the public’s attention on coronaviruses like never before. But medical researchers have more than half a century of experience with this family of viruses — by the time they identified the first human version in 1965, multiple animal coronaviruses were already known to exist. Since then, dozens of additional coronaviruses have been discovered in wildlife, livestock and humans. We now know of four that cause the common cold: HCoV-OC43, HCoV-229E, HCoV-NL63 and HCoV-HKU1. (HCoV stands for “human coronavirus.” A number of other human strains were also reported in the 1960s, but they were lost and not studied in detail.) Since 2003, we have identified more serious human coronaviruses, which have caused severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and now COVID-19.

Twitter Opens Up Data for Researchers to Study COVID-19 Tweets

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(Reuters) – Twitter Inc will grant researchers and software developers access to a real-time data stream of tens of millions of daily public tweets about COVID-19, which they can use to study the spread of the disease or track misinformation, the company said in a blog post on Wednesday.  Twitter said that this access could also be used by approved applicants working on crisis management, emergency response or communication within communities, as well as those developing machine learning and data tools to help the scientific community understand COVID-19.

Yemen Records Multiple Coronavirus Cases for First Time; U.N. Fears More

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(Reuters) – Yemeni authorities reported multiple coronavirus infections for the first time on Wednesday after the United Nations said it feared the disease could be spreading undetected in a country where millions face famine and lack medical care.  The five new COVID-19 cases were detected in Aden, a southern port which is interim headquarters of a government ousted from the capital Sanaa more than five years ago by the Iran-aligned Houthi group in a war that has created the world’s largest humanitarian crisis. 

FDA Might Grant Emergency Approval of Remdesivir for COVID-19

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(UPI) – The U.S. Food and Drug Administration might grant emergency approval for the antiviral drug remdesivir as a treatment for COVID-19 following new clinical trial results that suggest the drug could help some patients. The New York Times and CNBC on Wednesday reported the FDA was working with manufacturer Gilead Sciences to make remdesivir available to patients who have COVID-19, the disease caused by the novel coronavirus SARS-CoV-2.

Critical Study of Gilead’s Covid-19 Drug Shows Patients Are Responding to Treatment, NIH Says

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(STAT News) – A government-run study of Gilead’s remdesivir, perhaps the most closely watched experimental drug to treat the novel coronavirus, showed that the medicine is effective against Covid-19, the disease caused by the virus. In a statement on Wednesday, the National Institute of Allergy and Infectious Diseases, which is conducting the study, said preliminary data show patients who received remdesivir recovered faster than similar patients who received placebo.

Pandemic Causing Shortage of Contraceptives and Will Impact Women’s Reproductive Health, Says U.N.

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(TIME) – New data released by UNFPA, the UN’s sexual and reproductive health agency, predicts that over 47 million women could lose access to contraception, resulting in 7 million unplanned pregnancies if the lockdown continues for six months. As a result of the COVID-19 pandemic, health facilities are becoming overrun by patients with the virus, resulting in fewer resources or time available for women seeking out medical attention for their sexual or reproductive health. Disruptions in global supply chains are also causing a shortage of contraceptives, particularly in the lowest-income countries, according to the report.

More People on Antidepressants, Antianxiety Medications During Pandemic

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(Medical Xpress) – A report released this month by Express Scripts, a pharmacy benefit management program, found that the use of prescription drugs to treat mental health conditions increased more than 20% between mid-February and mid-March, peaking the week of March 15, when the World Health Organization declared COVID-19 a pandemic. During that same time frame, prescriptions for antianxiety medications rose 34%, while prescriptions for antidepressants increased by 18%. Of the prescriptions filled during that time, more than three-quarters were new prescriptions.

The False Hope of Antibody Testing

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(The Atlantic) – A pair of controversial surveys in the Bay Area and Los Angeles County found antibodies in 2.5 to 4 percent of the population—and even those numbers may be overestimates due to methodological flaws. In New York City, the country’s COVID-19 epicenter, 24.7 percent of people tested positive for antibodies. (The statewide number is 14.9 percent.) These rates do translate to many times more cases than officially documented, to be clear, but they are still a far cry from the 70 percent scientists believe is necessary to reach herd immunity and stop disease transmission. And if only a small fraction of the population can return to work without fear of getting the coronavirus, a return to something resembling normal is still a long way off.

FDA Bans Products That Help Teens Hide Vaping

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(UPI) – With more American teens taking up e-cigarettes, there’s a flood of products designed to allow them to vape without getting caught by parents or teachers — and federal officials want to put a stop to it. On Monday, the U.S. Food and Drug Administration announced it was sending warning letters to 10 manufacturers to stop making these products targeting youth.

As Lockdowns Lift, New Hazards Lurk in the Water

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(Nature) – The longer a building sits unused, the more potential there is for harm. That’s because the length of time between water treatment and use is one of the key factors determining bacterial regrowth, says Joan Rose, an environmental microbiologist at Michigan State University in East Lansing. One of the main concerns is Legionella, a genus of bacterium that causes Legionnaires’ disease.

Widely Used Surgical Masks Are Putting Health Care Workers at Serious Risk

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(Scientific American) – The Centers for Disease Control and Prevention recently said lower-grade surgical masks are “an acceptable alternative” to N95 masks unless workers are performing an intubation or another procedure on a COVID patient that could unleash a high volume of virus particles. But scholars, nonprofit leaders and former regulators in the specialized field of occupational safety say relying on surgical masks—which are considerably less protective than N95 respirators—is almost certainly fueling illness among front-line health workers, who likely make up about 11% of all known COVID-19 cases.

Consumer Beware: Coronavirus Antibody Tests Are Still a Work in Progress

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(Kaiser Health News) – Such high hopes, however, are running smack into the roadblocks of reality. Infectious disease experts are raising pointed questions about the reliability of the early tests and the studies that hinge on their results. And they warn that state and local governments — as well as individuals — should be wary of shaping policy or changing behavior based on any single report.

Coronavirus Alert: Rare Syndrome Seen in UK Children

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(BBC) – NHS doctors have been warned to look out for a rare but dangerous reaction in children that may be linked to coronavirus infection. An urgent alert sent out to GPs said that intensive care departments in London and other parts of the UK have been treating severely sick children with unusual symptoms. This includes “multi-system inflammation” with flu-like symptoms. Some, but not all, tested positive for coronavirus.

Artificial Intelligence Won’t Save Us from Coronavirus

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(Wired) – As the world confronts the outbreak of coronavirus, many have lauded AI as our omniscient secret weapon. Although corporate press releases and some media coverage sing its praises, AI will play only a marginal role in our fight against Covid-19. While there are undoubtedly ways in which it will be helpful—and even more so in future pandemics—at the current moment, technologies like data reporting, telemedicine, and conventional diagnostic tools are far more impactful. So how can you avoid falling for the AI hype? In a recent Brookings Institution report, I identified the necessary heuristics for a healthy skepticism of AI claims around Covid-19.

Silicon Valley Needs a New Approach to Studying Ethics Now More Than Ever

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(TechCrunch) – Next month, Apple and Google will unveil features to enable contact tracing on iOS and Android to identify people who have had contact with someone who tests positive for the novel coronavirus. Security experts have been quick to point out the possible dangers, including privacy risks like revealing identities of COVID-19-positive users, helping advertisers track them or falling prey to false positives from trolls.These are fresh concerns in familiar debates about tech’s ethics. How should technologists think about the trade-off between the immediate need for public health surveillance and individual privacy? And misformation and free speech?

Dutch Court Allows Euthanasia in Advanced Dementia Cases

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(CNN) – Doctors in the Netherlands may legally euthanize patients with severe dementia who previously provided a written request for the procedure, the country’s highest court ruled Tuesday. In the landmark decision, the court said that a physician may respond to a written request for euthanasia made before someone develops advanced dementia, provided certain legal requirements are met — even if the patient’s condition means they become unable to confirm that request.

Favouring Young Over Old in Covid-19 Treatment Justifiable, Says Ethicist

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(The Guardian) – Older people should be denied treatment for the coronavirus if a younger, healthy person needs help, according to Prof Arthur Caplan, a prominent US medical ethicist. Age, he said, was a “valid criterion” to use when making the “terrible choice” of who should receive scarce resources during the pandemic. “To the extent to which data supports the risk of failure or the odds of success, age can justifiably be used to ration care if maximisation of lives saved is the overarching goal,” said Caplan – who is ethics adviser to the US government – in remarks in a debate published on Wednesday in the British Medical Journal.

The Coronavirus Pandemic Is Forcing U.S. Doctors to Ration Care for All Patients

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(TIME) – Soon after public health officials identified SARS-CoV-2 virus as the cause of a previously unknown illness in the Hubei province of China, doctors realized that the novel coronavirus seemed to zero in on certain demographics: older people, as well as those with existing chronic diseases and weakened immune systems like Kraemer, 43. “From very early on, I felt vulnerable and scared,” she says. “People were saying ‘everybody don’t worry, this will only affect the sick people.’ I felt vulnerable and expendable.”

The Hunt for a Coronavirus Vaccine–a Perilous and Uncertain Path

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(The Guardian) – The stakes could hardly be higher; the prize still tantalisingly out of reach. It is no exaggeration to say that the fate of many millions of people rests on the discovery of a vaccine for Covid-19 – the only sure escape route from the pandemic. Yet the optimism that accompanied the launch of Oxford University’s human trials this week has to be put in context, and the hurdles facing the scientists need to be understood. The vaccine hunters are trying to outwit an invisible enemy so small that a million viral particles could fit inside a human cell, but whose biological ingenuity has brought everyday life to a standstill. So what is the path to success?

Hospitals Are Using AI to Predict the Decline of Covid-19 Patients–Before Knowing It Works

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(STAT News) – Dozens of hospitals across the country are using an artificial intelligence system created by Epic, the big electronic health record vendor, to predict which Covid-19 patients will become critically ill, even as many are struggling to validate the tool’s effectiveness on those with the new disease. The rapid uptake of Epic’s deterioration index is a sign of the challenges imposed by the pandemic: Normally hospitals would take time to test the tool on hundreds of patients, refine the algorithm underlying it, and then adjust care practices to implement it in their clinics.

Do You Want to Die in an I.C.U.? Pandemic Makes Question All Too Real

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(New York Times) – To date, there’s no clear evidence that older people are more apt to contract the new coronavirus, said Dr. Douglas White, a critical care specialist and the director of the Program on Ethics and Decision Making at the University of Pittsburgh School of Medicine. “What we do know is that older individuals are more likely to experience very severe disease if they do become infected,” he said. “The data are sobering.”

World Must Ensure Equal Access for All to COVID-19 Vaccines, Drugs: WHO

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(Reuters) – All new vaccines, diagnostics and treatments against the new coronavirus must be made equally available to everyone worldwide, the World Health Organization said on Friday as it outlined a plan to accelerate work to fight COVID-19. Launching what he called a “landmark collaboration” to speed the development of effective drugs, tests and vaccines to prevent and treat COVID-19, WHO Director General Tedros Adhanom Ghebreyesus said the lung disease was a “common threat which we can only defeat with a common approach”.

Polio, Measles Outbreaks ‘Inevitable’, Say Vaccine Experts

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(SciDevNet) – Interruptions to vaccination programmes caused by the COVID-19 pandemic could result in new waves of measles or polio outbreaks, health experts warn. A growing number of one-off immunisation campaigns and national routine vaccine introductions are being delayed amid social distancing and other measures to curb the spread of SARS-CoV-2, leaving millions unprotected.

Shortcuts in COVID-19 Drug Research Could Do Long-Term Harm, Bioethicists Worry

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(Scientific American) – Does a widespread medical emergency justify speedier, and sometimes less rigorous, ways to test treatments and evaluate results? Doctors and patients urgently need to get their hands on drugs for the COVID-19 pandemic. But bioethicists Jonathan Kimmelman of McGill University and Alex John London of Carnegie Mellon University argue in an April 23 Science article that hurried trials and tests can do more harm than good. They highlight hastily published case reports that, they contend, can lead doctors to believe some drugs offer more of a benefit than has been proved.

FDA Issues Warning on Side Effects of Malaria Drug for Covid-19

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(UPI) – The U.S. Food and Drug Administration on Friday issued a warning about serious and potentially life-threatening side effects of chloroquine and it’s sister drug hydroxychloroquine, including heart rhythm problems that have been seen in clinical trials. The drugs, which were granted an emergency use authorization by the FDA on March 28, have been shown to cause serious heart problems in patients with severe COVID-19, as evidenced by a new analysis published Friday in the journal JAMA Network Open.

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