Daily Kos presidential results live coverage #4

first_imgStick with us as we continue following the presidential results live, and check in with Daily Kos Elections as they follow the downballot races.Resources:- Advertisement – Donald Trump, Joe Biden, elecciones EE. UU. (GDA via AP Images) The Daily Kos Elections guide to every key presidential swing state in 2020.The Daily Kos Elections Nov. 3, 2020 poll closing times map.center_img – Advertisement –last_img

Read More →

Good news on the vaccine, but rough months ahead

first_img– Advertisement – Pfizer and BioNTech on Monday announced that their coronavirus vaccine was more than 90% effective in preventing the disease.“What we’re hearing and what we’re seeing is that this is promising news, but it’s not the end all, be all,” said Dr. Syra Madad, senior director of the systemwide special pathogens program at New York City Health + Hospitals.There’s a timeline for when the vaccine will be available and when it can be administered, she told CNBC’s “Street Signs Asia” on Tuesday. “There’s still some time between now and then, which means that we have some very rough few months ahead of us.”- Advertisement – More than 50.9 million people have been infected with the coronavirus globally, including 10.1 million in the U.S., according to data compiled by Johns Hopkins University. Cases have spiked in recent weeks as the weather turns colder, and medical experts have warned that the situation could get worse.Madad said pharmaceutical companies have said vaccines may be available by the end of 2020 for priority groups such as health-care workers, but the public won’t have access yet.- Advertisement –center_img “We’re not actually going to see the effectiveness of these vaccines played out in the general population until sometime (in) quarter two of next year, so we still have some months to go,” she said.“This is a process that is going to follow a pretty fast timeline, but certainly it is not fast enough, with the coming months and the increased number of cases that we’re seeing around the world.” The next few months will still be difficult as virus cases continue to set new daily records in the U.S., an infectious disease doctor said this week in spite of promising news from vaccine trials.That’s because a vaccine won’t be available in time to stop the flood of cases that is likely to come as winter approaches in the Northern Hemisphere.- Advertisement –last_img read more

Read More →

Woolnut Leather Sleeve for MacBook has a soft wool interior and a slip-in design » Gadget Flow

first_img– Advertisement – The Woolnut Leather Sleeve for MacBook is seriously luxurious. With a leather outer material and a wool interior, its soft design lets you easily slip in your laptop. Plus, the Scandinavian vegetable-tanned full-grain leather develops a beautiful patina over time. And the 100% natural wool felt from Germany is of the highest quality. Made specifically for each MacBook model, this case provides a tight, snug fit around your computer. With a minimal and timeless Swedish design, this leather MacBook sleeve will go with any outfit and blend with all your accessories. Additionally, it lets you conveniently charge your MacBook while it’s safe inside. Finally, when you take out your computer to use it, simply place this leather sleeve underneath it for a supportive pad.last_img read more

Read More →

Young voters aided Biden win, seek more progressive Democratic Party

first_imgMembers of the Georgia Tech Women’s basketball team hold voting signs outside of McCamish Pavillion which serves as a polling place on Election Day in Atlanta, Ga., on Tuesday, November 3, 2020.Tom Williams | CQ-Roll Call, Inc. | Getty Images Now, youth organizers are pushing the Democratic Party to embrace a more progressive platform.“Progressive voters are the future of this country, progressive policies are the future of politics, and we are going to keep fighting to make sure that Biden’s administration is as progressive as possible,” Weinberg said.Young voters’ electoral impactVoters ages 18-29, particularly young people of color, supported Biden at a greater rate than any other age group, NBC News exit polls show. Between 73% and 87% of Latino, Asian and Black youth supported Biden, compared with 51% of White youth, according to data from the Center for Information and Research on Civic Learning and Engagement, or CIRCLE, at Tufts University.In key swing states such as Arizona, Michigan and Pennsylvania, where NBC News has projected a Biden win, preliminary data shows young people’s support helped push Biden over the margin of victory. Biden made gains in Michigan and Pennsylvania counties with large college student populations. With catchphrases such as “Because a C+ is better than an F,” the campaign focused on mobilizing young people to vote President Donald Trump out of office. After more than 290,000 followers and millions of likes, comments and shares on the account, Settle for Biden has become an advocacy group and its name has proven to be an effective rallying cry for young voters.Other progressive groups have also been organizing young people for political action, including the climate-focused Sunrise Movement, anti-gun violence group March for Our Lives, immigrant advocacy group United We Dream and other movements.Their efforts may have had an impact on Biden’s victory. Turnout among voting-eligible Americans ages 18-29 increased significantly from 2016 to 2020 and a majority of them supported Biden, according to preliminary analysis from Tufts University.- Advertisement – Young Black voters played a crucial role in flipping Georgia, a traditionally Republican stronghold, where Biden currently holds a narrow lead. Voters ages 18-29 made up 21% of the state’s voter share — 5% higher than the youth voter share nationwide. About 90% of young Black voters supported Biden, compared with 34% of White youth and 57% of all youth voters in Georgia.  President-elect Joe Biden was not Sam Weinberg’s first or even second choice for the White House. Like many young progressives, the 19-year-old Illinois native had supported Sens. Bernie Sanders and Elizabeth Warren during the Democratic primaries.But in April, when Biden became the last man standing in the Democratic primary, Weinberg decided to back the centrist candidate.Fearing his peers might not follow suit, he created “Settle for Biden,” an Instagram account using what he describes as “sardonic millennial and Gen Z humor” to convince young people to, well, settle for Biden.- Advertisement –center_img “We won this election for Joe Biden,” said Nikayla Jefferson, a 24-year-old organizer for the Sunrise Movement. “We’re not going to let that go. He definitely owes his administration to us.”The Biden campaign did not immediately respond to CNBC’s request for comment.A divided partyIn April, a coalition of progressive youth groups including the Sunrise Movement, the March for Our Lives Action Fund, United We Dream Action and Justice Democrats penned a letter to Biden asking him to earn the support of young people. The coalition urged Biden to support policies such as “Medicare for All,” canceling student debt, a wealth tax and the Green New Deal commitment to clean energy.“We need you to champion the bold ideas that have galvanized our generation and given us hope in the political process,” the letter read.On Wednesday, the Sunrise Movement and Justice Democrats released a list of recommendations for Biden’s Cabinet, including Warren as Treasury secretary and Sanders as labor secretary.The move comes as tension grows between the Democratic Party’s moderate and liberal factions. As Democrats’ House majority is projected to shrink following the 2020 election, centrist Democrats have blamed progressive policies for costing the party seats, including “Medicare for All” and the Green New Deal.Meanwhile, progressive Democrats have criticized moderate Democrats for catering more to center-right voters than those who consistently vote blue. Prominent figures such as Reps. Alexandria Ocasio-Cortez and Rashida Tlaib are urging the party to “embrace the base.”“It’s important to not ignore who supports you the most,” said Mary-Pat Hector, a 22-year-old youth voting advocate based in Atlanta. “Young people are now officially a huge part of their base, so it’s important to talk to them.”Hector points to Black female leaders who have rallied youth voters in Georgia for years, including Tamieka Atkins, Helen Butler, Nse Ufot, Deborah Scott and 2018 Democratic gubernatorial candidate Stacey Abrams.“We really need to be thinking about how to be in conversation with young people, not just in the two to three months before an election like we’re cramming for a test,” said Abby Kiesa, deputy director of CIRCLE.“If we don’t have politicians in there that seem like they care about young people, then we’re not going to want to get involved,” said 20-year-old Emily Zanieski, co-leader of Students for Ossoff, a youth-led initiative to elect Georgia Democratic Senate candidate Jon Ossoff.‘We are the future of the party’For many young people, Biden’s campaign promise of a return to “normalcy” is not enough.“This sense of uncertainty about the future is something we’ve been feeling for a long time, and that comes down to issues such as health care, education affordability and climate change,” said Royce Mann, 19, legislative director for March for Our Lives’ Georgia chapter.“The party needs to start listening to its progressive wing and start understanding that a progressive platform aligns with folks who I don’t think a centrist could ever reach,” said Isabella Guinigundo, an 18-year-old organizer with Ohio Progressive Asian Women’s Leadership. “Progressive policies are good policies for anyone interested in good paying jobs and a future that is for all of us.”The Democratic Party’s first test? Biden’s Cabinet appointees.In addition to the Sunrise Movement and Justice Democrats, Settle for Biden has also released a slate of recommendations for top government posts. With the fate of the Senate still unknown, youth organizers are urging Biden to use his executive powers in key areas such as the Covid-19 pandemic, climate change and the economy.“The work starts now. We have to hold these people accountable to support the policies that we want to see happen in the future,” said Marcia Lacopo, 21, a North Carolina-based organizer with progressive youth voting initiative NextGen America.After propelling Biden to the White House, young progressives expect the president-elect to deliver on the mandate they’ve given him.“We are the future of the party,” Sunrise Movement’s Jefferson said. “We’ve made it very clear that the party is changing and either they come with us or we kick them out of office.” – Advertisement – – Advertisement –last_img read more

Read More →

Larsa Pippen Says She’s Fighting COVID-19 Amid Kardashian Rift

first_imgLarsa Pippen revealed that she’s been sick with the novel coronavirus after making headlines for her hot takes on the Kardashian family — but she quickly deleted the announcement.“I’ve been battling Covid for a week. It’s no joke I’ve never felt pain like this!” the Real Housewives of Miami alum, 46, wrote on her Instagram Story on Friday, November 13, before removing the post hours later.Larsa Pippen attends the ROC Nation Pre-Grammy Brunc Larsa Pippen Says She Tested Positive for COVID-19 Amid Kardashian DramaLarsa Pippen attends the ROC Nation Pre-Grammy Brunch in Los Angeles on February 9, 2019. Broadimage/Shutterstock- Advertisement – Us Weekly can confirm that the reality TV personality tested positive for COVID-19 as the global health crisis rages on. “She’s been battling it for a week with a hard time breathing,” Pippen’s rep said. “She’s had horrible body aches. We’re hoping she starts feeling better soon.”Pippen’s health revelation comes shortly after she came clean about the state of her current relationship with Kim Kardashian, Kourtney Kardashian and Khloé Kardashian amid rumors that the longtime pals had a falling out. While discussing her history with the famous family, Pippen called out Kanye West for being the reason for her feud with Kim, 40.“If Kanye feels like him and Kim are better without me, then let them be without me. I’m OK with that,” Pippen said on the Monday, November 9, episode of the “Hollywood Raw” podcast, before claiming that the Yeezy designer, 43, had “brainwashed” his wife and her sisters.Kim Kardashian Khloe Kardashian and Kourtney Kardashian in 2014 Larsa Pippen Says She Tested Positive for COVID-19 Amid Kardashian DramaKim Kardashian, Khloe Kardashian and Kourtney Kardashian attend the Grand Opening of DASH Miami Beach on March 12, 2014. Omar Vega/Invision/AP/Shutterstock- Advertisement – Though the details of their friendship’s demise raised eyebrows, the Kardashian family is “unbothered” by Larsa’s comments.“The family thinks Larsa spoke out about this now because she is craving attention,” a source told Us exclusively. “And the only attention she got as of late was from being Kim’s best friend and from being on the show.”Listen to Us Weekly’s Hot Hollywood as each week the editors of Us break down the hottest entertainment news stories! Earlier this year, fans noticed that the Skims founder was no longer following Pippen on Instagram after years of friendship. The Chicago native, who was previously married to Scottie Pippen for 21 years, had frequently appeared on Keeping Up With the Kardashians since falling in with the reality stars and their squad.As social media users wondered whether a feud was brewing, an insider told Us in July that Kim “wanted to reset” her account to focus on “her family and childhood friends.” Larsa, however, continued to accuse West of being the instigator behind the end of her friendship with Kim.“I didn’t feel any type of way. I just felt, like, do what’s best for your family,” she said of the KKW Beauty founder on Monday. “I love you, you and I are best friends, we’ve been through everything together, I would never do anything to jeopardize our relationship, we’re like sisters, we’re family, but if you have to unfollow me to make your home a better place, do it.”- Advertisement – – Advertisement –last_img read more

Read More →

The County With No Coronavirus Cases (and Plenty of Suspicion)

first_imgSome residents said they knew about cases of the coronavirus in the county, but because they were limited to visiting workers, the county still considers itself to be virus free — if on a technicality. Mr. Galan, from Eagle Pass near Texas’ border with Mexico, said he usually spent about 12 days working and then got four days off. He counted himself lucky to be only five hours away from his family. Some workers come from much further, like Utah or Louisiana.While in Loving County, Mr. Galan lived in a man camp on his company’s property, sharing a small living space with another worker. He said the workers there practiced social distancing. “On our yard, nobody’s gotten sick from Covid,” he said.But, he added, no one was being tested unless they had symptoms. “They don’t test you just to test you,” Mr. Galan said. For that, workers must travel to larger cities like Odessa or Midland. Though never included in the county’s official reports, at least one positive test for the coronavirus was recorded over the summer at a local health clinic in Mentone, the county’s only town, according to a worker at the clinic. It is something that people in the county are proud of. They talk about it. They live by it.“You can take that off!” Chuck Flushe told a visitor in a face mask at the window of his food truck as a pair of barefaced oil field workers milled about. “We don’t have the virus here.”If only it were true.- Advertisement – There were rattlesnakes in the yard of their first home, she remembered, and a toilet out back. They had five children, moved to a bigger house, accumulated acre upon acre of land and never left.Mr. Jones, known to all by his childhood nickname, went from the oil fields to become sheriff for nearly three decades. “He was known as the only sheriff in Texas you could call Punk and get away with it,” Mrs. Jones said.Their children went to the local schoolhouse until the sixth grade. But it ran short of students, and then closed. Children now ride a bus at 6 a.m. to the next county east. Those who live in Loving County full-time — the U.S. mainland’s smallest population, with no more than 169 people stretched across 669 square miles of sand, mesquite and greasewood — credit their relative antiviral success to the landscape and the sparseness of the population. They joke that they were socially distant before it was cool.“It’s a desert town. That’s what it is,” said Steve Simonsen, the county attorney. “We don’t speak in terms of running how many cows per acre, it’s how many cows per section. A section is 640 acres.”But despite the wide-open space, the county is busy. The census counts 10 times the number of workers in the county as residents. Trucks hauling equipment for the oil fields or big boxes of sand for fracking groan through town in a constant, noisy stream. Plastic trash and bits of blown truck tire litter the roadside.When one drives through the county at night, lights from the oil and gas operations flicker brightly across the landscape, creating the mirage of a distant city that can never quite be reached. “You top that hill and it looks like you’re driving into Dallas or Fort Worth,” Mr. Simonsen said.Men — and it is mostly men who work in Loving County — shuffle in and out of the only shop for miles, a relatively new convenience store where the line for beer and single-serving meals can stretch to the rear refrigerators during the 5 p.m. rush.“Restrooms Coming Soon,” boasts an all-caps banner hanging outside. On a recent weekday evening, one shopper wore a cowboy hat. More had on mesh trucker caps. None were in masks. Neither were the clerks. The county is exempt from a statewide mandate. Now even rural areas, which escaped the brunt of the pandemic early on, have become serious centers of new infections. In recent months, a diminishing number of small, remote counties, including Loving County, remained the only places in the continental United States with no positive cases.One by one, each has begun to record infections. The last besides Loving County to officially fall was Esmeralda County in Nevada, which reported its first case last week. (Kalawao County in Hawaii, which has even fewer people than Loving County, also has reported no known cases.) Most tests conducted in the county have involved oil and gas field workers, according to Mr. Luk, at the local clinic. And those would be recorded in the employees’ county of residence, not in Loving County, said Lara Anton, a state Health Department spokeswoman.Were any permanent residents infected? Officially, that is still a no.But Loving County residents concede that their perfect record is probably no longer perfect.“To say that we’re the only place in the United States that’s never had a Covid case, I don’t think that’s true,” Mr. Simonsen said. “It’s a nice little bit of hype, but certainly it’s been here.” A private health clinic offers coronavirus tests and performs around 20 per week, according to Anthony Luk, 28, a paramedic there. Mr. Luk, like most workers in the county, lives in a trailer — his is attached to the clinic — and stays for two-week stints between periods of rest at home in Lubbock.During his time there, he said, the clinic has had two positive tests for the coronavirus: in August, involving the man camp near the center of Mentone, and another taken at a job site outside of Loving County.The August case raised alarm at the county courthouse because clerks and other county workers often go to the camp for free lunch on workdays.“We’re made very known when something like that happens here,” said Angela Medlin, 31, a deputy county clerk who moved with her husband and four children to Mentone last year. “I know of at least one guy who was sick, but they took him back to where he’s from,” she said, recalling the situation over the summer.In town, residents draw a bright line between themselves and the visiting workers. Those who live in the county full-time treat one another like members of an extended family bubble.At the courthouse, a square brick building from 1935, the doors are now locked to outsiders and the county employees do not wear masks. When someone comes to visit, like a landman looking into new oil or gas leases, the person must have an appointment and wear a mask.A Halloween party for the children in town attracted about 60 people and included temperature checks at the door. People felt comfortable not wearing masks. MENTONE, Texas — Zoom in on the glowing red map of ever-escalating coronavirus cases in the continental United States and you will find one county that has been spared. Only one, from coast to coast.Like a lone house standing after a tornado has leveled a town, Loving County, in the shadeless dun plains of oil-rich West Texas, has yet to record a single positive case of the coronavirus.- Advertisement – But there are few such gatherings in Mentone, where the county’s history of oil booms and busts can be read in hollow rusting storage tanks, empty corrugated homes and the cracked plaster of the only schoolhouse, unused for decades.“When we got here, I said, ‘Punk, how long are we going to live in this godforsaken place?’” recalled Mary Belle Jones, 89, who moved to Loving County in 1953 with her husband, Elgin Jones. But even if the virus is not front of mind in Loving County, it has changed life here.The pandemic caused a downturn as oil prices dropped, reducing the number of workers in town. The man camps were less full. Hotel rooms that just months ago cost $350 a night in Pecos, the nearest large town, were now going for a third of the price.“With the pandemic, a lot of stuff shut down,” said Ricardo Galan, 38, who works for a supply company that he said had dropped from 50 employees to 12. The man lived at what everyone in this part of Texas calls a “man camp” — temporary housing for transient oil and gas field workers — near the center of town when he became sick. But since he was not a permanent resident, and was quickly shuttled home, Loving County never reported the case. Its record remained intact.Ten months after the first infection was recorded in the United States, the coronavirus has made its way into every corner of the country. More than 11 million people have tested positive for the virus, which causes Covid-19, with more than 164,000 new cases emerging on Monday alone.- Advertisement – Several members of the Jones family stayed in Loving County. One son, Skeet Jones, is the top county executive. His sister is the county clerk. Mr. Simonsen, the county attorney, married into the family.“She was spending more time here than she was at home so we decided to make the move,” Mr. Simonsen, a lawyer who last lived in Houston, said of his wife. “I knew there wasn’t a lawyer here in town, so.”For Leroy Medlin, 33, moving to Loving County was the fulfillment of a dream. Not so for Angela, his wife, who had to be convinced.“She was throwing a fit at just the idea of it,” he said, seated in a wicker recliner on his porch at the far edge of town, a cowboy hat on a table at his side.Mr. Medlin, who was fired from his job as a San Antonio police detective for lying to justify car pursuits and later lost his job in town as a deputy sheriff, works as a cowboy on the Jones family ranch.“I kind of like to go back in time. That’s why I’m out here,” he said. – Advertisement –last_img read more

Read More →

Republic of Ireland: No new cases of coronavirus after Matt Doherty withdrawal | Football News

first_img – Advertisement – Wednesday 18th November 7:30pm Saturday 21st November 5:00pm Kick off 5:30pm Seamus Coleman and Enda Stevens are also missing through injury, while James McCarthy had already withdrawn from the squad for family reasons.Kenny’s resources were depleted further at the Cardiff City Stadium by Jeff Hendrick’s red card and the booking that will see fellow midfielder Jayson Molumby join him on the suspension list against Bulgaria.Shamrock Rovers pair Graham Burke and Aaron McEneff have been called up along with Millwall striker Troy Parrott and Peterborough’s Jack Taylor.Doherty, meanwhile, cannot come out of his confinement until Wednesday, November 25 – the day before Spurs face Ludogorets in the Europa League – having not trained with his team-mates, making him a doubt for that match.Stoke’s McClean also returned a positive test while on international duty so cannot play in their next two games against Huddersfield and Norwich on Saturday and next Tuesday respectively. Kick off 7:45pm “The round of testing took place yesterday on arrival back into Dublin ahead of the fixture on Wednesday, November 18 at the Aviva Stadium.”Ireland have suffered a spate of positive coronavirus tests in recent months, with Aaron Connolly and Adam Idah both missing last month’s Euro 2020 play-off semi-final defeat in Slovakia for what ultimately turned out to be false-positives.The following day, John Egan, Callum Robinson, Callum O’Dowda and Alan Browne were withdrawn from the squad to face Wales at the Aviva Stadium after another positive test within the camp, and Kenny has since lost Robinson and Browne to Covid-19 positives this month. It means Doherty will miss Tottenham’s Premier League clash with Manchester City on Saturday – live on Sky Sports – but the Republic of Ireland say they there are no new cases ahead of Wednesday’s Nations League game at home to Bulgaria. The Republic of Ireland have confirmed all players and staff have tested negative for coronavirus after Matt Doherty left the camp due to a positive result.The Spurs right-back returned a positive test taken after the Nations League defeat to Wales, along with international team-mate James McClean, and the duo are now under a 10-day isolation period in line with UK government rules.- Advertisement – Republic of Ireland defender Matt DohertyImage:The Republic of Ireland have lost Matt Doherty for the Bulgaria clash The news will come as a relief to boss Stephen Kenny, whose side need to get a point to avoid relegation, and potentially dropping out of the second pot of seeds for the forthcoming 2022 World Cup qualification draw.“The Football Association of Ireland can confirm that all players and staff tested negative for COVID-19 ahead of the UEFA Nations League match against Bulgaria,” read a statement ahead of the game, also live on Sky Sports. – Advertisement – – Advertisement –last_img read more

Read More →

DHS-CDC deal to share travelers’ data draws fire

first_imgApr 27, 2006 (CIDRAP News) – An agreement between US security and health agencies to share more data about travelers in order to keep infectious diseases out of the country has drawn criticism.The memorandum of understanding, signed in October 2005, provides for increased cooperation between the Department of Health and Human Services (HHS) and the Department of Homeland Security (DHS). The document was posted Apr 25 on the Web site of the American Civil Liberties Union (ACLU), which has spoken out against the agreement, as has at least one noted infectious disease expert.Under the agreement, more DHS data would be shared with the Centers for Disease Control and Prevention (CDC), an HHS agency.The CDC already had access to paper customs declarations forms, said Ram Koppaka, MD, PhD, chief of the Quarantine and Border Health Services branch in the CDC Division of Global Migration and Quarantine. The agreement formalizes an existing practice of sharing DHS’ customs declarations, and it expands the information sharing to include two other kinds of information: Advance Passenger Information System (APIS) data and Passenger Name Record (PNR) data. DHS would provide the data to CDC only in response to a request and in compliance with existing agreements with other entities, such as the European Union, the agreement states.The DHS agencies involved in the information-sharing agreement are Customs and Border Patrol (CBP), the Coast Guard, and Immigration and Customs Enforcement (ICE), according to the memorandum. Diseases currently classified as “quarantinable” are cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, severe acute respiratory syndrome (SARS), and novel or re-emerging influenza strains with pandemic potential.The CDC may in turn disclose necessary information to state and local health departments, the agreement says. The memorandum also calls for DHS to assist with passive and active surveillance of travelers if there are outbreaks of quarantinable diseases or other serious communicable diseases. In particular, the document says the CDC will give DHS a list of signs of H5N1 avian influenza so personnel can watch for them in passengers.The pact also calls for CBP and other DHS agencies to detain travelers at the behest of the CDC because of possible infection with a quarantinable disease. The pact notes that the CDC has legal authority to detain, isolate, or quarantine travelers in such situations, and that CBP, ICE, and the Coast Guard have legal authority to assist such steps.The agreement allows the CDC to carry out what Koppaka called “very fundamental public health activities” of contact investigation, quarantine, and isolation. Contact investigation is used more frequently, although quarantine and isolation issues have generated media attention.”The current mumps outbreak is a great illustration of how inability to efficiently identify and notify those who have been exposed is hampering our ability to mount an effective response,” Koppaka told CIDRAP News. He was referring to an ongoing outbreak involving more than 1,100 people, most of them in Iowa. Two potentially infectious people traveled on nine different commercial airline flights in the course of the outbreak.Koppaka also said the SARS outbreak of 2003 showed the need for better data on travelers. In regard to tracking down potentially exposed passengers on multiple planes, he said, “We were not able, not even in a single case, to ensure a person was notified within the 10- to 14-day incubation period for SARS. We feel that is a critical gap in our ability to respond.”The agreement follows a parallel track to another CDC initiative, which would require airlines and ship operators to report passengers who have certain signs of illness and to keep lists of passengers for at least 60 days after arrival. The 3-month comment period on those proposed rules ended Mar 1, and CDC is reviewing comments, Koppaka said.The ACLU has charged that the agreement between DHS and HHS threatens Americans’ privacy rights and violates a US agreement with the European Union.The pact “is continuing evidence that the American government, and especially its security establishment, does not take privacy and data protection seriously,” said Barry Steinhardt, ACLU Technology and Liberty Project director, in an Apr 25 news release.”Steinhardt said the European Union agreed in 2003 to share PNR data with the United States in return for a DHS pledge not to use the data for anything other than to prevent terrorism or other serious crimes. “It is now clear that DHS did not abide by that agreement,” he charged.But Koppaka, referring to the ACLU, said, “I’m not sure they’re aware that DHS closely reviewed this agreement to make sure it complies with their agreement with the EU. HHS’s understanding is that DHS did the analysis and signed off after determining it was compliant.”The ACLU learned of the DHS-HHS agreement in comments by the Air Transport Association on the CDC’s proposed requirement that airlines report sick passengers, according to an Apr 21 ACLU release. On Apr 20 the organization filed a Freedom of Information Act (FOIA) request with the federal government for a copy of the agreement and related information, according to the release. By Apr 25 the group had obtained and posted a copy of the agreement on its Web site.The ACLU labeled the pact a “secret agreement” and said it embodies policies that should have been debated in public.But HHS spokeswoman Christina Pearson denied that the agreement was secret, according to an Apr 21 Reuters report. “We have had this agreement in place and it’s to help CDC when there is a report of communicable diseases on an airplane,” she said. The agreement will help the agency locate passengers who may have been exposed and give them information, she added.Another critic of the agreement, according to an Apr 21 Reuters report, was Donald A. Henderson, MD, MPH, an infectious disease physician and distinguished scholar at the Baltimore-based Center for Biosecurity of the University of Pittsburgh Medical Center.Referring to the provision calling for CBP to detain travelers on behalf of the CDC, Henderson told Reuters, “I was absolutely astonished when I saw that proposed federal regulation. It’s so silly.”Henderson questioned whether there is any evidence that such a system would effectively prevent diseases from spreading, and told Reuters that people can spread influenza and other diseases before they have symptoms.Koppaka emphasized that influenza is not the only disease for which this information sharing might be useful and that the information wouldn’t just be used for quarantine and isolation but also for contact tracing and outbreak investigations.See alsoCopy of the agreement as posted on the ACLU web sitehttp://www.aclu.org/pdfs/privacy/hhs_dhs_mou.pdfApr 25 ACLU news releasehttp://www.aclu.org/privacy/spying/25335prs20060425.htmlApr 21 ACLU news releasehttp://www.aclu.org/privacy/spying/25246prs20060421.htmlNov 22, 2005, CIDRAP News story on CDC updating rules affecting travelershttp://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/nov2205travelers.htmlApr 19 CIDRAP News story on mumps outbreakhttp://www.cidrap.umn.edu/cidrap/content/other/news/april1906mumps.htmllast_img read more

Read More →

New evidence of cytokine storm in avian flu cases

first_imgJun 14, 2006 (CIDRAP News) – Scientists in Hong Kong have reported new experimental evidence that avian influenza infections in human cells are more likely to trigger a destructive immune-system overreaction, or “cytokine storm,” than human flu viruses are.Writing in the July 1 Journal of Infectious Diseases, the researchers report that two avian flu viruses, a 1997 strain of H5N1 and a 1997 H9N2 strain, caused immune system cells in lab cultures to produce much greater levels of certain chemokines (a class of cytokine, or messenger protein) than such cells did when infected with an ordinary human flu virus.”In general, the chemokines and chemokine-receptor responses of MDMs [monocyte-derived macrophages, a type of immune cell] to avian influenza viruses were much stronger than those to human virus, which may account for the high pathogenicity of avian viruses,” the report states.In addition, the H5N1 strain caused immune cells from adults to produce higher levels of certain cytokines than similar cells from newborn babies did. The authors say that finding may help explain why Hong Kong’s human H5N1 outbreak in 1997 killed 5 of 9 infected adults (older than 12) but only 1 of 9 infected children. That sharp difference in adult and child mortality rates has not been seen in the current wave of H5N1 cases dating to late 2003.Scientists have suggested that the cytokine storm played a role in the high death rate in the 1918 Spanish flu pandemic and is playing a similar role in human cases of H5N1 infection today. Autopsies of H5N1 avian flu victims in Vietnam and elsewhere have revealed lungs choked with debris from excessive inflammation triggered by the virus. Similar severe lung damage was frequently reported in victims of the 1918 pandemic, which disproportionately killed people with the strongest immune systems—young, healthy adults.The new study was conducted by a University of Hong Kong team that has previously reported experimental evidence of a cytokine storm in H5N1 avian flu. The team includes J. S. Malik Peiris and, as first author, Jianfang Zhou.In view of the severe lung damage caused by H5N1 in humans, the team decided to measure the expression of four chemokines and two chemokine receptors induced in MDM cells by avian and human flu viruses. They also sought to compare the chemokine production induced by these viruses in adult-derived MDMs and in neonatal MDMs derived from umbilical cord blood.Three viruses were used: a strain from the 1997 human outbreak in Hong Kong, a 1997 strain of H9N2 from quail, and a 1998 strain of H1N1 human flu from Hong Kong. The H9N2 virus is a precursor of the H5N1 virus, with which it shares six internal proteins, the report says. Because of the safety risks involved in working with H5N1 viruses, the team first did the experiment with the H9N2 virus and then repeated it with the H5N1 virus in a biosafety level 3 facility.The investigators found that all three viruses replicated at similar rates in both adult and neonatal MDMs, as indicated by similar numbers of viral matrix gene copies in the cells. That suggested that differences in chemokine production are not due to greater growth of the avian viruses.The MDMs generally showed much greater chemokine responses to the avian flu viruses than to the human flu virus, and the differences were often greater for the adult MDMs than the neonatal MDMs, the report says.For example, the adult MDM responses to the H5N1 strain were roughly 20-fold greater than their responses to the H1N1 virus. For one particular chemokine, called CCL3, the increase for adult MDMs was about 25-fold, but for neonatal MDMs, it was significantly lower—less than 10-fold, as shown on a graph in the report. For the other three measured chemokines, the responses of adult MDMs to H5N1 also exceeded those of the neonatal MDMs, but the differences were smaller.Also, compared with the H1N1 virus, the H5N1 virus caused adult MDMs to express 6- to7-fold greater levels of the two chemokine receptors (CCR1 and CCR5). But the H5N1 strain induced no significant increase in expression of chemokine receptors by the neonatal MDMs.”We have demonstrated that human MDMs have differential responses to human influenza virus H1N1/98 and avian viruses H9N2/G1 and H5N1/97, in spite of their similar infectivity and viral replication,” the authors write. “Moreover, stronger chemokine and chemokine-receptor responses to avian influenza viruses were detected in adult MDMs than in neonatal MDMs.”They add that the higher CCL3 response to H5N1 by adult MDMs, as compared with neonatal MDMs, may be “one of the important factors” in the higher adult mortality rate in Hong Kong’s 1997 outbreak. They note that higher levels of CCL3, along with several other chemokines, have been found in plasma from people who died of H5N1 disease than in people who survived it.Overall, the authors conclude, “These data suggest that host factors may influence the disease process or outcome.”The latest findings parallel evidence that Peiris and colleagues reported last November concerning the cytokine storm hypothesis. In that study, lung cells growing in a lab culture reacted much more intensely to two strains of H5N1 virus than to an ordinary human flu virus (see link below).Zhou J, Law HKW, Cheung CY, et al. Differential expression of chemokines and their receptors in adult and neonatal macrophages infected with human or avian influenza viruses. J Infect Dis 2006 Jul 1;194:61-70 [Abstract]See also:Nov 16, 2005, CIDRAP News story “Lab study supports idea of ‘cytokine storm’ in H5N1 flu”last_img read more

Read More →

Authors defend study of nondrug measures in 1918 pandemic

first_imgJan 25, 2008 (CIDRAP News) – The authors of a 2007 study of nonpharmaceutical measures used in the 1918 influenza pandemic, responding to a critique from historian John M. Barry, argued last week that there is strong evidence that New York City used isolation and quarantine to battle the Spanish flu.In a study published in August, Dr. Howard Markel and colleagues said their analysis of historical records from 43 US cities indicated that the early use of nonpharmaceutical interventions (NPIs), such as isolating the sick and banning public gatherings, saved lives in the 1918-19 pandemic.Their study, which appeared in the Aug 8 Journal of the American Medical Association, had a major influence on the Centers for Disease Control and Prevention’s (CDC’s) recommendations early in 2007 for the early, targeted use of NPIs in a flu pandemic. Two of the authors, including senior author Dr. Martin Cetron, work at the CDC Division of Global Migration and Quarantine.In a letter published in JAMA in November, John M. Barry, author of the 2004 book The Great Influenza, rejected the finding of Markel et al that New York City used isolation and quarantine to combat the epidemic. He argued that the evidence about events in New York City does not support the authors’ view that NPIs were effective n 1918. Markel and colleagues responded with a letter in the same issue of JAMA.Subsequently, Barry presented his critique in much more detail in a commentary published by CIDRAP News on Nov 27 (see link below). He questioned Markel’s findings concerning not only New York City but also Chicago.Last week, with no fanfare, the CDC’s Division of Global Migration and Quarantine published a detailed online response to Barry’s critique. The response’s authors are not listed, but the presentation and referencing indicate it was written by the JAMA article authors. The response does not specifically mention Barry, referring only to “assertions made on the Internet.”Barry’s argumentThe response by Markel et al is best understood in the context of Barry’s critique. His main points were as follows:None of the New York City Department of Health’s official records, including board meeting minutes, from the pandemic period mention the use of quarantine.In looking for evidence of isolation and quarantine in New York City, Markel et al relied heavily on statements by City Health Commissioner Royal Copeland. Copeland was a homeopath, not a medical doctor, and was appointed by the city’s Democratic political machine, Tammany Hall, which had a record of putting unqualified loyalists in city jobs.In separate speeches to private physicians that were reprinted in the New York Medical Journal in October 1918, Copeland and his deputy, Louis Harris, head of the city’s Bureau of Preventable Diseases, gave a long list of actions taken to battle the flu epidemic (and some not taken), but neither mentioned isolation and quarantine. Copeland said that even were it possible “to confine every person to his or her home, it is doubtful whether the epidemic could be measurably diminished.”In statements to the New York Times, Copeland might have talked about a New York quarantine just to make the city look better in the face of reports that Jersey City was using quarantine.Concerning NPIs in Chicago, the JAMA study said the city took its first action on day minus-2, ie, 2 days before the mortality rate exceeded double the baseline rate. But (Barry wrote) at that point the city only banned public funerals, and it didn’t use any major NPIs until 21 days later (day plus-19), when it banned public gatherings in general.Quarantine orders taken seriously In their response, Markel et al write that in 1918, quarantine was a complex concept with several meanings. “There is, unfortunately, no way to quantify with exact precision the level of public compliance with any of the NPI in any of the 43 cities in our study,” they state. “When studying the broader context of epidemics of this era, however, the historical record suggests that when such public health orders were enacted, they were taken rather seriously, albeit not universally.”They go on to list various pieces of evidence that isolation and quarantine were practiced in New York City during the pandemic.As their principal evidence, the authors point to the weekly minutes of the board of the city health department for Sep 17, 1918, when the group declared influenza (along with lobar and bronchial pneumonia) a reportable disease, the same as cholera, smallpox, and plague. The city’s health code required the isolation and quarantine of those ill with the disease or suspected of having it.The day after this declaration, the city notified all resident physicians of it by letter and reminded them of their responsibility to isolate and quarantine cases, the authors write.Subsequently, “numerous articles in virtually every New York newspaper” reported the use of isolation and quarantine in the city, the authors continue. A footnote cites articles in the New York Herald, the Evening Journal, the Times, and the World.Further, the CDC article says that directors of health department hospitals were worried about running out of beds in their isolation wards because of the influx of flu patients. As evidence for this, the authors cite a Sep 24, 1918, New York Times story in which Copeland said that if the epidemic grew any further, health department hospitals would run out of space and would have to call on general hospitals for help.Also, the authors write that some private physicians in the city took the isolation and quarantine order so seriously that they placed homemade quarantine placards on the homes of flu patients. An endnote says that Copeland, in another statement to the New York Times, said that placarding by private physicians was not necessary, given that the city code required isolation or quarantine of patients.Concerning the lack of mention of quarantine in the health department’s annual report and other documents and in the speeches by Copeland and Harris, Markel et al assert that this “absence of evidence” does not equal “evidence of absence.”Interpreting Copeland’s commentsThe authors also reject the suggestion that Copeland spoke of a New York quarantine only because Jersey City had implemented a quarantine policy. They say this suggestion seems to have been inaccurately derived from a New York Times article that happened to report on the Jersey City quarantine immediately after mentioning New York’s.Further, the study authors say that in his comment about the futility of trying to fight the epidemic by confining every person at home, Copeland meant what he actually said, and was not talking only about isolation of patients and quarantine of contacts.In an endnote, the authors discuss Copeland’s political affiliation and training. They assert that his Tammany affiliation does not necessarily mean he was incompetent and that despite being a homeopathic physician, he was trained in and had a deep appreciation for allopathic medicine.The study authors also reject Barry’s suggestion that a possible reason for New York’s and Chicago’s relatively mild experiences in the 1918 pandemic was that many residents might have developed some immunity during the first wave of flu in the spring of 1918. Their study revealed no statistical associations between flu-related excess mortality rates in each city during the four successive waves of influenza from spring 1918 through the winter of 1920.Regarding the Chicago experience, the authors said they reran their analysis using different dates for the initiation of NPIs and got essentially the same results. They changed the date marking the first NPI from Sep 26, when public funerals for flu patients were banned, to Oct 1, when isolation of flu patients was ordered. They also changed the date for the general ban on public gatherings to Oct 17. With these dates, the correlations of public health actions with excess death rates and total excess deaths remained about the same.See also: Commentary by the JAMA authors, published on the CDC Division of Global Migration and Quarantine sitehttp://www.cdc.gov/ncidod/dq/1918_commentary.htmCommentary by author John M. Barry, published Nov 27, 2007, by CIDRAP Newshttp://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/nov2707barry.htmlAbstract of Aug 8, 2007, JAMA report by Markel and colleagues: “Nonpharmaceutical interventions implemented by US cities during the 1981-1919 influenza pandemic”Aug 13, 2007, CIDRAP News story “Study says nondrug measures helped in 1918 flu pandemic”last_img read more

Read More →