shape
carat
color
clarity

Coronavirus Updates November 2021

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978
Happy November 2nd! I didn't start the November thread yet so here it is. For anyone who wants to share Covid info from the news or personal updates. This is the thread for Covid resources and info.
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978
While thousands of visitors to Shanghai Disneyland were lining up for roller coasters and watching fireworks above the fairytale castle on Sunday, staff sealed the park. People in Hazmat suits streamed in through the gates, testing everyone before they were allowed to leave. It seems an infection was reported nearby. Such dystopian scenes have become seemingly common these past two years. As the world enters the 23rd month of the coronavirus, the number of confirmed dead has now surpassed a once unthinkable number—5 million. And the real number is likely much higher. Here’s the latest on the pandemic.
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978


"
The global death toll from COVID-19 surpassed 5 million, with the U.S. in the unenviable position of first place. (AP)

As of Monday at 8 a.m. EDT, the unofficial U.S. COVID toll reached 45,971,267 cases and 745,836 deaths, increases of 526,488 cases and 9,895 deaths versus this time a week ago.

However, the number of new infections nationally has dropped to less than half of what was seen in August. (Washington Post)



A declassified report suggests U.S. intelligence is unlikely to determine whether the origin of the novel coronavirus occurred naturally or was the result of a lab leak. (AP)

Moderna said the FDA needs more time to review the company's coronavirus vaccine for adolescents ages 12 to 17, in order to further investigate the risk for myocarditis.

Meanwhile, a Maryland man pleaded guilty to running a fake Moderna websitethat charged people $30 a dose. (Washington Post)

Close call? White House Press Secretary Jen Psaki tested positive for COVID-19 on Sunday; she was outside and masked when she last saw President Biden on Tuesday. (CNN)

Russia again set a new record in daily case counts on Saturday; most workers will stay home for a week beginning on Monday to slow the spread. (The Hill)

Maine's Supreme Court blocked an emergency appeal from healthcare workers opposed to the state's vaccine mandate, which went into effect on Friday. (ABC News)



The FDA approved pilocarpine HCl ophthalmic solution 1.25% (Vuity) for adults with age-related blurry near-vision, AbbVie announced.

Democrats are still fighting to include measures that would lower prescription drug prices in President Biden's social spending bill. (Politico)

The U.S. Supreme Court is hearing oral arguments on Monday over Texas's controversial abortion law, which prohibits most abortions in the state. (Kaiser Health News)

Scientists at the NIH identified how two people were able to control HIV for an extended time -- via two different mechanisms -- after halting treatment.

A pharmaceutical executive and father of two, Sree Aravapalli, was shot in his New Jersey home after a suspect followed him 50 miles from a casino. (NBC New York)


Across the world, countries are noticing how diet-related illnesses leave people more vulnerable to COVID-19 and taking measures to encourage healthier behaviors. It's unclear why the U.S. hasn't followed suit. (Politico)



Four physicians who are among the most fierce advocates for aducanumab (Aduhelm), Biogen's controversial Alzheimer's drug, all have strong "at times undisclosed" ties to the drug company. (STAT+)

CNN's Jake Tapper criticized those making death threats against Fox News' Neil Cavuto, after Cavuto urged viewers to get vaccinated. (The Daily Beast)"
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978

CDC: Prior Infection Won't Protect You From COVID Hospitalization​

— Study shows importance of vaccination to prevent severe disease, even among previously infected​


"
In people hospitalized for COVID-like respiratory illnesses, unvaccinated adults who previously had COVID-19 were over five times more likely to test positive for SARS-CoV-2 compared with recipients of Pfizer or Moderna vaccine, researchers found.

Among more than 7,000 people hospitalized for typical COVID-like symptoms, 8.7% of unvaccinated adults with a prior infection at least 3 months before tested positive for SARS-CoV-2 again, as compared to 5.1% of the fully vaccinated patients without a prior history of infection, for an adjusted odds ratio (OR) of 5.49 (95% CI 2.75-10.99) after factoring in local positivity rates, age, and numerous other factors, reported Catherine Bozio, PhD, of the CDC, and colleagues, writing in an early edition of the Morbidity and Mortality Weekly Report.



Proponents of prior infection have traded salvos with those supporting vaccination over the past few months, as dueling reports emerged. First, there was the study in Kentucky in early August that found COVID vaccination doubled protection among previously infected individuals versus those who had not been vaccinated. Then a preprint from Israel at the end of August found prior infection was superior to vaccination against the Delta variant.

Other studies cast doubt on the effectiveness of vaccination, such as the study from late July that found that three-quarters of individuals in a COVID outbreak on Cape Cod were previously vaccinated, though most of the cases were mild.

CDC Director Rochelle Walensky, MD, weighed in on the new evidence on Friday from more than 7,348 people across nine states.

"We now have additional evidence that reaffirms the importance of COVID-19 vaccines, even if you have had prior infection," she said in a statement. "This study adds more to the body of knowledge demonstrating the protection of vaccines against severe disease from COVID-19."

Bozio's team examined data on hospitalizations from January 1 to September 2, 2021 from the VISION Network, a group of 187 hospitals in nine U.S. states. Participants were adults ages 18 and up with COVID-19 molecular testing 14 days to before 72 hours prior to admission with a "COVID-like illness discharge diagnosis," and who had been tested at least once since February 1, 2020.

The researchers noted that adults were considered "unvaccinated" with a previous infection if there was no record of COVID-19 vaccine doses received and the most recent positive test for SARS-CoV-2 occurred more than 90 days before hospitalization. Adults were considered vaccinated if they had received the second Pfizer or Moderna dose at least 14 days before hospitalization. Partially vaccinated patients, those who received Johnson & Johnson vaccine, and those with a positive test result 14-89 days before hospitalization were excluded.


Overall, 201,269 hospitalizations were identified, with 139,655 patients hospitalized after vaccines were eligible for their particular age group. Molecular testing was performed for 94,264 patients with hospitalizations for COVID-like illness.



There were 1,020 hospitalizations among previously infected and unvaccinated adults, and 6,328 hospitalizations among previously vaccinated adults who met the study criteria.

The vaccinated group tended to be far older than the unvaccinated cohort:

  • 65-74 years: 28% vs 20%
  • 75-84 years: 32% vs 17%
  • 85 and up: 18% vs 8%
While more unvaccinated adults were ages 18-49 versus vaccinated adults (31% vs 9%, respectively), Black (10% vs 7%), and Hispanic (19% vs 12%).

"Secondary analyses that did not adjust for time since infection or vaccination or adjusted time since infection or vaccination differently as well as before and during Delta variant predominance produced similar results," the authors wrote.

They concluded that "all eligible persons should be vaccinated against COVID-19 as soon as possible, including unvaccinated persons previously infected with SARS-CoV-2.""
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978

FDA Authorizes First COVID Vaccine for Younger Kids​

— Agency emphasizes immune response, safety data in children ages 5 to 11 years​


"


FDA EUA Pfizer-BioNTech COVID-19 vaccine for children ages 5-11 over a photo of a gloved hand holding the vaccine.

Pfizer-BioNTech's COVID-19 vaccine was authorized for use in children as young as 5 years old, the first in the U.S. to receive emergency use authorization (EUA) in this younger age group, the FDA announced Friday.
The agency amended the existing EUA to include children ages 5 to 11 after the vaccine produced an immune response that was comparable to the response seen in people ages 16 to 25, and showed 91% efficacy in a small descriptive analysis.

Pfizer's vaccine was first authorized in December 2020 for people 16 and older, and in May for adolescents ages 12 to 15.
The vaccine will be given as a two-dose series, 3 weeks apart, at a lower 10-μg dose apiece.
To emphasize the scope of the virus in children, FDA noted that children ages 5 to 11 currently make up 39% of the COVID cases among individuals ages 18 and younger, with 8,300 hospitalizations and 146 deaths.
"As a mother and a physician, I know that parents, caregivers, school staff, and children have been waiting for today's authorization. Vaccinating younger children against COVID-19 will bring us closer to returning to a sense of normalcy," said Acting FDA Commissioner Janet Woodcock, MD, in a statement.
In fact, in a press briefing Friday afternoon, both Woodcock and Peter Marks, MD, PhD, director of FDA's Center for Biologics Evaluation and Research (CBER) said they would both give the vaccine to their children if they were in this age group without hesitation.

"Whenever we're thinking about children, we try to be as careful as we can with products," Marks said.
FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) "overwhelmingly voted in favor" of the EUA, the agency noted in its release. However, reporters cited the back-and-forth debate among the committee about potentially narrowing the scope of the EUA to high-risk children.
Marks said what ultimately swayed them was at least a third of children hospitalized with COVID-19 did not have identifiable risk factors, and "trying to limit to higher-risk groups could create issues."
Woodcock added that children from racial and ethnic minorities are "more frequently hospitalized" and "we want to make sure the entire vulnerable population gets vaccinated," she said.

A reporter asked why a parent should get their child vaccinated if COVID cases are declining, and Woodcock said that increased uptake of vaccination will help to decrease transmission among all age groups.

"If I had young children … I would not want to take the risk that they … would develop long-COVID, multisystem inflammatory syndrome or be hospitalized from the virus," she said.
Marks added that some experts are predicting a winter surge from the Delta variant, especially as people begin to gather indoors.
Supporting data were from the phase II/III study C4591007, which included 3,109 participants who received the vaccine and 1,528 who received placebo.
The vaccine met immunobridging success criteria, with increases in neutralizing antibody geometric mean titers among children ages 5 to 11 comparable to individuals ages 16 to 25. Comparable seroresponse rates were observed among the two groups versus baseline as well.
A descriptive analysis found 90.7% vaccine efficacy (95% CI 67.4-98.3), with three COVID cases in the vaccine group and 16 in the placebo group. None of the cases met the criteria for severe COVID. About 20% who acquired COVID-19 had comorbidities, and most infections occurred from July to August of this year.

Adverse events (AEs) were similar to other populations, with no cases of myocarditis or pericarditis, anaphylaxis, or deaths. The most common AE was fatigue (39%), followed by headache (28%) and muscle pain (12%). Most systemic AEs were mild or moderate, and resolved 1 to 2 days after onset, FDA staff noted.
At the briefing, Marks attempted to assuage fears about safety by noting that FDA will continue to monitor safety data about this vaccine along with CDC after it is authorized, including tracking "very rare side effects."
"When we authorize a vaccine like this, it's not like we're discharging someone from the hospital and saying goodbye," he said.
On Tuesday, November 2, the CDC's Advisory Committee on Immunization Practices will meet to discuss further clinical recommendations, the agency said."
 

Asscherhalo_lover

Ideal_Rock
Premium
Joined
Aug 16, 2007
Messages
5,703
Harry (10 months) participated in the Moderna trial yesterday! He had blood work to confirm he has no previous COVID antibodies and then went back for the blinded trial. He goes back in three weeks for the next injection. The coordinator hopes the trial will be unblinded within 60 days after the second dose, then we'll know if he had the vaccine or just the placebo. No reaction for him so far, totally normal happy Harry. Resized_20211101_120209.jpeg
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978
@Asscherhalo_lover Harry is a gorgeous baby ♥️
Sending bucketloads of good luck vibes his way.
 

MaisOuiMadame

Ideal_Rock
Premium
Joined
Jan 9, 2015
Messages
3,451
Harry (10 months) participated in the Moderna trial yesterday! He had blood work to confirm he has no previous COVID antibodies and then went back for the blinded trial. He goes back in three weeks for the next injection. The coordinator hopes the trial will be unblinded within 60 days after the second dose, then we'll know if he had the vaccine or just the placebo. No reaction for him so far, totally normal happy Harry. Resized_20211101_120209.jpeg

Such a handsome boy ! Thank you Harry and @Assherhalo_lover
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978

Kids 5-11 Can Now Get Pfizer's COVID Vaccine​

— Pfizer vaccine for kids earns a perfect score from CDC panel​

by Molly Walker, Deputy Managing Editor, MedPage Today November 2, 2021


A female physician prepares to vaccinate a little girl, both are wearing protective masks.

Children ages 5-11 should be vaccinated against COVID-19 with the Pfizer/BioNTech vaccine, the CDC's Advisory Committee on Immunization Practices (ACIP) said on Tuesday.
ACIP voted 14-0 to recommend vaccinating this population with a two-dose regimen of 10 μg apiece, 21 days apart, citing the favorable benefit-risk association, the idea of restoring normalcy to children, and especially the extensive data presented by FDA and CDC staff.
"Today is a monumental day in the course of this pandemic and one that many of us will be very eager to see," said CDC Director Rochelle Walensky, MD, once again addressing the panel. She added that since the first vaccines were authorized for ages 16 and up, the question has been when protection might be expanded to younger children.

This is a "recommendation likely to have tremendous impact," Walensky said. She said she was eager to see how committee members "interpret what we know and acknowledge areas of uncertainty."
Walensky also said that 745 children have died of COVID during the pandemic, including 94 children ages 5-11, and over 2,300 children in this population have been diagnosed with multi-system inflammatory syndrome (MIS-C).
Many committee members spoke as parents and grandparents and explained how they have vaccinated their children and grandchildren. Consumer representative Veronica McNally, JD, got a bit choked up when talking about how she would vaccinate her child after this recommendation, and would do so to prevent "the 95th death" in a child.
In an unusual move, several liaison representatives from the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), National Association of Pediatric Nurse Practitioners (NAPNAP), and the Pediatric Infectious Diseases Society (PIDS) read statements in support of vaccination for this age group prior to the ACIP vote.

Even normally skeptical ACIP members were on the side of the vaccine. Sarah Long, MD, of Drexel University in Philadelphia, who previously expressed hesitation about risk of vaccine-associated myocarditis in other age groups, said she was "very supportive" of this recommendation, given the large amount of data presented by the FDA and manufacturer, as well as because of the lower dose.
"We have one more vaccine that saves the lives of children and we should be very confident to employ it to the maximum to do what it was meant to do without significant concerns of serious adverse events," she said.
All eyes were on one rare side effect, vaccine-associated myocarditis. CDC staff presented data on vaccine-associated myocarditis showing that it occurs less frequently in younger children, and no cases of myocarditis were observed within the clinical trial.

INFECTIOUS DISEASE​

FDA Authorizes First COVID Vaccine for Younger Kids
INFECTIOUS DISEASE
CDC: Prior Infection Won't Protect You From COVID Hospitalization
INFECTIOUS DISEASE
Florida Sues Biden; Millions of J&J Shots Collecting Dust; Worst Fish in Pregnancy
Matthew Oster, MD, of the CDC, noted the incidence of vaccine-associated myocarditis would be about one in every 10,000 to 20,000 individuals for this age group. McNally asked Oster point-blank if given the information today, in his medical opinion, do the benefits outweigh the risks of vaccination.

"In my opinion, yes," Oster said.
While ACIP members were united in their support for the vaccine, Matthew Daley, MD, of Kaiser Permanente Colorado in Aurora, acknowledged those who are against this recommendation.
"I feel like collectively we're stronger when we hear from dissenting voices," he said. "Of course, you only want what's best for your child. It's understandable that you have questions given" the disinformation campaign against the vaccine, Daley said.
Several ACIP members stressed the importance of talking to pediatricians about the vaccine, and pediatricians recommending the vaccine to their patients.
This interim recommendation will go into effect when Walensky signs it, which she is expected to do later tonight.
We will "end this pandemic with science leading the charge," Walensky said
 

nala

Ideal_Rock
Premium
Joined
Oct 23, 2011
Messages
7,045
Our school district authorized that we remove the plexi glass from student desks. No need to social distance anymore. And we have 100 percent negative Covid testing rate in our scho of 2900. We test weekly using the oral method.
 

MamaBee

Super_Ideal_Rock
Joined
Mar 31, 2018
Messages
14,480
Our school district authorized that we remove the plexi glass from student desks. No need to social distance anymore. And we have 100 percent negative Covid testing rate in our scho of 2900. We test weekly using the oral method.

That’s just wonderful news @nala!
 

MamaBee

Super_Ideal_Rock
Joined
Mar 31, 2018
Messages
14,480
Haha. We are all a bit suspicious, tbh. But it is what it is!

I just looked up the oral testing. It seems very accurate…
I’m suspicious of everyone now. My oldest son just got a PCR test. It was negative so I let him hug me..:lol: I told him that’s it until he gets another test..He knows I’m not kidding either..hahaha
 

dk168

Super_Ideal_Rock
Premium
Joined
Jul 7, 2013
Messages
12,492
My mum called to ask me not to visit her and my brother in Vancouver on 24 October and I was due to fly out there on Sunday 07 November.

Something to do with new restrictions for unvaccinated local residents which means my mum and bro who are both unvaccinated for underlying health issues, would not be able to go out and about with me. There are other more taxing and stressful issues that she has to deal with and I don't envy her having to deal with them so late in her life stage (she is in her early 80s). Hence I can appreciate why I got bumped off.

I still have not received a response let alone a refund for my PCR test package (Fit to Fly and a Day 2 on return) from a company that was recommended to me. I e-mailed them as per their instructions in my purchase confirmation e-mail on the day I cancelled my flight immediately after ending my phone call with my mum, including a copy of my flights cancellation e-mail.

I have submitted a complaint just now, hopefully, they will respond soon, however, I am not holding my breath.

Other news:

Cases are high, mainly in the younger generations and those who have yet to be fully vaccinated in my county and region. However, the number requiring hospitalisation is low and so is the death rate.

I know of at least 2 cases of fully vaccinated individuals having caught the Delta variant, and suffered milder symptoms and have since recovered.

I should be able to book for my booster in mid November, or sooner if the government decides to shorten the time period between second dose and booster from 6 months to 5 months.

I am performing lateral test twice a week, however, I have disabled the NHS Covid App. Still wearing mask in crowded indoor areas and on public transport.

Still being vigilant as Covid-19 is far from over!

DK :))
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978
I just looked up the oral testing. It seems very accurate…
I’m suspicious of everyone now. My oldest son just got a PCR test. It was negative so I let him hug me..:lol: I told him that’s it until he gets another test..He knows I’m not kidding either..hahaha

LOL same. My mom is still incredulous we won't come into the house. Haha so we will hang out in their backyard or on their porch in 40 degree weather. Better than not seeing them at all right?

@dk168 I am sorry you cannot visit your family yet. Sending you gentle hugs. Hopefully soon you will be able to safely visit them.
 

Arcadian

Ideal_Rock
Premium
Joined
Sep 17, 2008
Messages
9,086
@Asscherhalo_lover thats awesome! Thank you for his participation!

I go for my booster Nov 8. They've said that we will be in there for about an hour. Of course they want blood, seems like every time I go they take buckets...lol After this, unless something really bad happens, I won't have to go into the research center until September 2022 (which would be the end of the study for me).

I haven't gotten flu shot yet, but will few weeks after this one.
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978
The U.K.'s drug regulator cleared Merck and Ridgeback Biotherapeutics antiviral oral drug for COVID-19, the first nation to do so. (CNBC)

Moderna's COVID-19 vaccine was more effective at preventing Delta variant infections among clinical trial participants vaccinated more recently, pointing to waning protection. (New England Journal of Medicine)

The World Health Organization announced that Covaxin, India's homemade COVID vaccine, has been cleared for emergency use.



In San Francisco, kids ages 5 and up will soon need to show proof of COVID vaccination for certain indoor activities. (Politico)

The Mu variant of SARS-CoV-2 was found to be 10.6 times more resistant to vaccine serum neutralization than its parental B.1 virus, and 1.5 times more resistant than Beta -- previously considered the most resistant variant. (New England Journal of Medicine)

As of Thursday at 8 a.m. EDT, the unofficial U.S. COVID toll reached 46,253,681 cases and 750,431 deaths, increases of 81,369 and 1,801, respectively, from this time a day ago.

That means that more people have died of COVID-19 in the U.S. than live in either Wyoming, Vermont, Alaska, or Washington, D.C. (Washington Post)

In France, cases have shot up to their highest levels in 2 months and masks will be required in some schools starting next week. (Reuters)

Meanwhile, Russia's latest COVID surge has shown no signs of letting up, as new cases and deaths remain at record highs and restrictions are extended. (AP)



Unsure if you need a COVID test after that recent indoor gathering? When to Test may be able to help, according to the NIH.

CVS pharmacy said it plans to add physicians to its workforce. (Wall Street Journal)

The American Psychological Association's (APA) council of representatives adopted a resolution that apologizes for APA's role in perpetuating systemic racism and for the field's role in harming people of color. (NPR)

Incyte's launch of its ruxolitinib (Opzelura) for atopic dermatitis has been delayedafter complaints of "texture problems" in the topical JAK inhibitor solution. (FiercePharma)

The pharmaceutical industry has spent nearly $263 million on lobbying efforts this year alone to fight drug-pricing reform. (CBS News)

In other coronavirus news, herbs and mushrooms are finally being tested in the fight against COVID-19. (JAMA)

New York City's mayor-elect Eric Adams said he would "revisit" the city's vaccine mandate for municipal workers. (New York Post)

Green Bay Packers quarterback Aaron Rodgers tested positive for COVID-19; the reigning MVP has been considered unvaccinated by the NFL despite taking an unnamed "alternate treatment" he had hoped would qualify him as being vaccinated. (ESPN)
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978

Biden Admin Sets Date for Vaccine Mandates​

— Rules for facilities taking Medicare/Medicaid dollars, large employers take effect Jan. 4, 2022​

by Shannon Firth, Washington Correspondent, MedPage Today November 4, 2021


President Joe Biden speaks at Eisenhower Executive Office Building in Washington, DC

On Thursday, the Biden administration issued two rules it argues will boost COVID-19 vaccination rates among workers -- including healthcare workers -- save lives, and strengthen the economy in the process.
The first rule, issued by Centers for Medicare & Medicaid Services (CMS), mandates that all healthcare workers whose organizations receive funding from Medicare or Medicaid be fully vaccinated against COVID-19 by Jan. 4, 2022. The second rule, issued by the Occupational Safety and Health Administration (OSHA), calls on business owners with 100 or more employees to require their workers to either get vaccinated or submit to weekly testing by this date.

"Ensuring patient safety and protection from COVID-19 has been the focus of our efforts in combatting the pandemic and the constantly evolving challenges we're seeing," CMS Administrator Chiquita Brooks-LaSure, said in a statement. "Today's action addresses the risk of unvaccinated healthcare staff to patient safety and provides stability and uniformity across the nation's healthcare system to strengthen the health of people and the providers who care for them."
Also, in an attempt to simplify the implementation process for employers, officials said the administration has also pushed back the deadline for a previously announced vaccine requirements for federal employees and contractors to the Jan. 4, 2022 date as well.
Under the new Emergency Temporary Standard (ETS), as the rule from OSHA is known, employers must write, implement, and enforce either a mandatory COVID-19 vaccination policy or a policy that lets employees choose between vaccination and weekly COVID-testing plus masking. Healthcare workers will not have the option to submit to weekly testing in lieu of a vaccine.

"We have a higher bar for healthcare workers, given their critical role in ensuring the health and safety of their patients," a senior administration official stated during a background phone call with reporters on Wednesday evening.
The two rules combined, in addition to previous regulations, will extend vaccination requirements to roughly two-thirds of all employees nationwide, including 17 million healthcare workers and 84 million employees, officials said. (Business groups had previously urged the administration to delay a vaccine mandate until after the holidays out of concern that it could worsen supply chain problems and labor shortages.)
The ETS will also call for employers to offer paid time off to allow employees to receive their shots and paid leave to recover from any side effects.

OSHA will also support employers to build their vaccine or testing requirements program by providing "robust compliance assistance" including sample plans, fact sheets, and frequently asked questions, noted officials on the press call.

The penalty for a single citation is approximately $14,000, they noted. For "willful penalties," employers can be fined ten times that amount, roughly $140,000.
As for the agency's legal authority to implement an ETS, a senior administration official said that 745,000 American deaths does indeed meet the criteria for a standard of "grave danger," and the standard is also "necessary" to protect workers.
Experts clashed over whether the standard was indeed necessary, during a congressional hearing last week, and legal challenges are anticipated.
David Zaas, MD, CEO for MUSC Health's Charleston division, who spoke about healthcare workforce issues during a virtual panel discussion hosted by the American Hospital Association on Tuesday, said the vaccine requirements MUSC implemented have helped to alleviate patients' worries, but also served as a recruitment tool.
"I think people were choosing to work at places where they knew their co-workers were vaccinated," Zaas said.

Leonard Hernandez, president and CEO for the Susan B. Allen Memorial Hospital in El Dorado, Kansas, said during the panel discussion that his organization would wait for the government to take action, before implementing any sort of mandate.
At least five or six nurses at his rural hospital have said they do not want to get vaccinated, he noted. "That's a big part of our ... nursing staff," he said. "We will prolong ... a decision until CMS says you have to do it."
Vaccination rates have jumped to "well over 90%" among organizations that have implemented requirements voluntarily, an official said on the call.
Soon after the rules were announced on Thursday, the Alliance Defending Freedom and the Dhillon Law Group introduced a challenge to the Biden administration's rules on behalf of the Daily Wire. In addition, attorneys for the conservative news website said they plan to file an emergency motion in order to stay the mandate.
Twenty-four state attorneys general previously threatened to file lawsuits if the Biden administration moved forward with vaccine-or-test rules for private businesses.
Last Updated November 04, 2021
 

Arkteia

Ideal_Rock
Premium
Joined
Nov 3, 2009
Messages
7,589
God, I need to vent somewhere. Two people I know died from Covid. Both unvaccinated. One, a 30+ year-old woman, left several kids. It makes no sense to say, "we all told her", because the tragedy. The second one I knew much better, and spoke with him. He was a blue-collar worker, and I felt that he did not understand why he should be vaccinated. I did spend a lot of time talking to him. And later he called me, said he was ill, going to the ICU and asked to pray for him. I felt it would be too late (((. He asked his family to get vaccinated, from the deathbed, and they did...
I mourn the losses.
How can I even persuade people? I think they are deceived by some conspirologists, and maybe, pay for growing up in areas with bad schools? That didn't teach them to weigh the information critically?
I really spend the time with them. And I am known to speak well with blue-collar workers, they usually listen to me.
What am I missing?
 

mellowyellowgirl

Ideal_Rock
Premium
Joined
May 17, 2014
Messages
6,176
Double dose rates even higher than Israel!!!!! Wooooohoooooo


In my suburb it's like 95% double dose!!!

And we're offering boosters already. Finally Australia has learnt from the failed Covid zero strategy and is not cruising on our high vaccine rates.
 
  • Like
Reactions: DAF

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978
Today's top Covid Stories FYI.

Pfizer said its Covid-19 pill reduced hospitalizations and deaths in high-risk patients by 89%, a result with the potential to upend how the disease caused by the coronavirus is treated. The company plans to seek U.S. authorization this month. Its shares surged as news of the game-changing pill spread. Meanwhile, Republican-controlled states sued to block the White House vaccination mandate. Here’s the latest on the pandemic.

Another coronavirus treatment drug is getting high marks in a clinical trial. The antiviral pill from Pfizer, called Paxlovid, reduced the risk of hospitalization and death by 89 percent among high-risk patients, the pharmaceutical giant said Friday. The data hasn’t been published or peer-reviewed. But if these encouraging results continue to bear out, the pill could be a powerful addition to the tool kit for managing the disease, my colleague Carolyn Johnson reports. President Biden on Friday said the United States has already secured millions of doses, calling the treatment “promising.”

The good news about Pfizer's drug came a day after British regulators on Thursday granted the world’s first approval of an oral covid-19 treatment. The pill molnupiravir, made by Merck, cut hospitalizations and deaths by nearly half among higher-risk patients with mild to moderate illness, according to a global clinical trial. Britain’s health secretary hailed it as a “game changer for the most vulnerable.” Merck is seeking authorization for the pill in the United States, and Pfizer said it will submit data on its own pill to U.S. regulators by Thanksgiving.

After weeks hammering out the details, the Biden administration formally released its workplace vaccine requirements. The 490-page federal rule gives companies with 100 or more workers until the first week of January to either mandate employee vaccinations or require regular testing and mask-wearing. The policy will cover an estimated 84 million employees, a huge portion of the American workforce. A group of attorneys general from Republican-led states filed a lawsuit on Friday to challenge the rule.

The federal government has cut ties with Emergent BioSolution, a vaccine manufacturer at the heart of the Trump administration’s immunization campaign whose plant ruined millions of vaccine doses earlier this year. The company revealed Thursday that U.S. officials had scrapped a deal worth $628 million. Emergent shut down its manufacturing sites in Baltimore for months after a massive batch of Johnson & Johnson doses were found to be contaminated.

Daily coronavirus deaths are falling in the United States. But every day we get a stark reminder of the pandemic’s human toll. On Wednesday, the medical journal BMJ published a study showing more than 28 million extra years of human life were lost in 2020, a year marked by the explosive spread of the virus. Male life expectancy in the U.S. was especially hard hit, with men losing 2.27 extra years, and women 1.61 years. But there was hope in the research, too: In six countries that mounted a strong public health response, life expectancy either increased or didn't change.

Other important news​

Infections are soaring in poorly vaccinated Ukraine. Desperate officials are now trying to scare people into getting the shots.

New York City cut a deal with city-worker unions fighting vaccine requirements. It could ease tensions between officials and vaccine holdouts.

University of Oxford scientists have found a gene common among South Asians that could make covid-19 more deadly. They said the higher risk "should be cancelled out" by the vaccine.
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978

Country by Country, Scientists Eye Beginning of an End to the COVID-19 Pandemic​

By Julie Steenhuysen
November 04, 2021
logo-reutersprofessional.gif





CHICAGO (Reuters) - As the devastating Delta variant surge eases in many regions of the world, scientists are charting when, and where, COVID-19 will transition to an endemic disease in 2022 and beyond, according to Reuters interviews with over a dozen leading disease experts.
They expect that the first countries to emerge from the pandemic will have had some combination of high rates of vaccination and natural immunity among people who were infected with the coronavirus, such as the United States, the UK, Portugal and India. But they warn that SARS-CoV-2 remains an unpredictable virus that is mutating as it spreads through unvaccinated populations.
None would completely rule out what some called a "doomsday scenario," in which the virus mutates to the point that it evades hard-won immunity. Yet they expressed increasing confidence that many countries will have put the worst of the pandemic behind them in the coming year.
"We think between now and the end of 2022, this is the point where we get control over this virus ... where we can significantly reduce severe disease and death," Maria Van Kerkhove, an epidemiologist leading the World Health Organization's (WHO) COVID-19 response, told Reuters.

The agency's view is based on work with disease experts who are mapping out the probable course of the pandemic over the next 18 months. By the end of 2022, the WHO aims for 70% of the world's population to be vaccinated.

"If we reach that target, we will be in a very, very different situation epidemiologically," Van Kerkhove said.
In the meantime, she worries about countries lifting COVID precautions prematurely. "It's amazing to me to be seeing, you know, people out on the streets, as if everything is over."
COVID-19 cases and deaths have been declining since August in nearly all regions of the world, according to the WHO's report on Oct. 26.
Europe has been an exception, with Delta wreaking new havoc in countries with low vaccination coverage such as Russia and Romania, as well as places that have lifted mask-wearing requirements. The variant has also contributed to rising infections in countries such as Singapore and China, which have high rates of vaccination but little natural immunity due to much stricter lockdown measures.
"The transition is going to be different in each place because it's going to be driven by the amount of immunity in the population from natural infection and of course, vaccine distribution, which is variable ... from county by county to country by country," said Marc Lipsitch, an epidemiologist at Harvard T.H. Chan School of Public Health.




Several experts said they expect the U.S. Delta wave will wrap up this month, and represent the last major COVID-19 surge.

"We're transitioning from the pandemic phase to the more endemic phase of this virus, where this virus just becomes a persistent menace here in the United States," former Food and Drug Administration Commissioner Scott Gottlieb said.


Chris Murray, a leading disease forecaster at the University of Washington, likewise sees the U.S. Delta surge ending in November.


"We'll go into a very modest winter increase" in COVID-19 cases, he said. "If there's no major new variants, then COVID starts to really wind down in April."


Even where cases are spiking as countries drop pandemic restrictions, as in the UK, vaccines appear to be keeping people out of the hospital.


Epidemiologist Neil Ferguson of Imperial College London said that for the UK, the "bulk of the pandemic as an emergency is behind us."


'A GRADUAL EVOLUTION'


COVID-19 is still expected to remain a major contributor to illness and death for years to come, much like other endemic illnesses such as malaria.


"Endemic does not mean benign," Van Kerkhove said.


Some experts say the virus will eventually behave more like measles, which still causes outbreaks in populations where vaccination coverage is low.


Others see COVID-19 becoming more a seasonal respiratory disease such as influenza. Or, the virus could become less of a killer, affecting mostly children, but that could take decades, some said.


Imperial College's Ferguson expects above-average deaths in the UK from respiratory disease due to COVID-19 for the next two-to-five years, but said it is unlikely to overwhelm health systems or require social distancing be reimposed.


"It's going to be a gradual evolution," Ferguson said. "We're going to be dealing with this as a more persistent virus."


Trevor Bedford, a computational virologist at Fred Hutchinson Cancer Center who has been tracking the evolution of SARS-CoV-2, sees a milder winter wave in the United States followed by a transition to endemic disease in 2022-2023. He is projecting 50,000 to 100,000 U.S. COVID-19 deaths a year, on top of an estimated 30,000 annual deaths from flu.


The virus will likely continue to mutate, requiring annual booster shots tailored to the latest circulating variants, Bedford said.


If a seasonal COVID scenario plays out, in which the virus circulates in tandem with the flu, both Gottlieb and Murray expect it to have a significant impact on healthcare systems.


"It'll be an issue for hospital planners, like how do you deal with the COVID and flu surges in winter," Murray said. "But the era of ... massive public intervention in people's lives through mandates, that part I believe will be done after this winter surge."


Richard Hatchett, chief executive of the Coalition for Epidemic Preparedness Innovations, said with some countries well protected by vaccines while others have virtually none, the world remains vulnerable.


"What keeps me up at night about COVID is the concern that we could have a variant emerge that evades our vaccines and evades immunity from prior infection," Hatchett said. "That would be like a new COVID pandemic emerging even while we're still in the old one."
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978
FYI those who have AI issues...I thought might be interested in this piece. Hope everyone is doing well.

COVID Vaccination Not Associated With Risk of Severe RA Flares​

By Linda Carroll
November 04, 2021




NEW YORK (Reuters Health) - Patients with rheumatoid arthritis did not experience flares after receiving a two-dose COVID-19 vaccination, a new study from Hong Kong shows.
An analysis of data from nearly 5,500 RA patients revealed that full vaccination with an mRNA vaccine or an inactivated-virus vaccine was not associated with arthritis flares, researchers report in Annals of the Rheumatic Diseases.
"Findings from this study provide real-world evidence of COVID-19 vaccine safety and could potentially overcome vaccine hesitancy among patients with RA," Dr. Ian Chi Kei Wong of The University of Hong Kong and colleagues write.
To explore whether vaccination against COVID-19 might lead to arthritis flares in RA patients, the researchers turned to electronic medical records (EMRs) from the Hospital Authority with linked vaccination records from the Department of Health of the Hong Kong Government.

The researchers obtained records from nearly 4 million patients with confirmed vaccination status. Their analysis focused on 5,493 patients with RA, 1,324 of whom had been vaccinated with either the Pfizer-BioNTech vaccine or the CoronaVac vaccine Compared with non-vaccinated patients, vaccine recipients were younger and less likely to have pre-existing chronic diseases.

During a median follow-up of 32 days, 35 of those who received the Pfizer-BioNTech vaccine had RA or reactive arthritis-related hospitalization. During a median follow up of 30 days, 41 of those who received the CoronaVac vaccine had RA or reactive arthritis-related hospitalization.
Based on propensity-score-weighted Poisson regression, there was no significant association between arthritis flare and vaccination (Pfizer-BioNTech: adjusted incidence rate ratio, 0.86, 95% confidence interval, 0.73 to 1.01; CoronaVac: aIRR, 0.87; 95% CI, 0.74 to 1.02).
The per-patient prescription and distribution of the four rheumatoid drug categories also showed no significant differences between patients who received one of the vaccines and those who were unvaccinated.

The study has a couple of limitations, said Dr. Medha Barbhaiya, an assistant professor of medicine and healthcare policy and research at Weill Cornell Medical College and an assistant attending physician at the Hospital for Special Surgery.
First, a common limitation for electronic health records that is particularly relevant is the defined outcomes, Dr. Barbhaiya said. The researchers are not able to use standard disease measures or patient-reported outcomes, she added.
"Using hospitalization or consultation with a specialist to define the outcome of a flare," Dr. Barbhaiya told Reuters Health by phone, "essentially means they are assessing more severe flares, ones that led to hospitalization or medical consultation."
"Second, very few patients at the time of the study cohort entry were on corticosteroids," Dr. Barbhaiya said. "That probably means most patients likely had stable disease and very few had active rheumatoid arthritis. Since the ones with active rheumatoid arthritis may be more likely to flare, the generalizability of these findings to patients with RA overall, or at least those with more active disease, is unclear."

"Taking these study limitations into consideration, this study provides complementary information to other studies that have looked at this issue and can offer some reassurance to patients with rheumatoid arthritis," Dr. Barbhaiya said.

"While further studies are needed, the lack of association of Pfizer or CoronaVac vaccination with severe flares in this study population, can help in vaccine decision making for both rheumatologists and patients with rheumatoid arthritis," she said.

The study did not have commercial funding. Several authors report financial ties to Pfizer.
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978

Good morning. The partisan gap in Covid deaths has grown larger.​

As 2020 wound down, there were good reasons to believe that the death toll during the pandemic’s first year might have been worse in red America. There were also good reasons to think it might have been worse in blue America.​
Conservative areas tend to be older, less prosperous and more hostile to mask wearing, all of which can exacerbate the spread or severity of Covid-19. Liberal areas, for their part, are home both to more busy international airports and more Americans who suffer the health consequences of racial discrimination.​
But it turned out that these differences largely offset each other in 2020 — or maybe they didn’t matter as much as some people assumed. Either way, the per capita death toll in blue America and red America was similar by the final weeks of 2020.​
It was only a few percentage points higher in counties where Donald Trump had won at least 60 percent of the vote than in counties where Joe Biden crossed that threshold. In counties where neither candidate won 60 percent, the death toll was higher than in either Trump or Biden counties. There simply was not a strong partisan pattern to Covid during the first year that it was circulating in the U.S.​
Then the vaccines arrived.​
They proved so powerful, and the partisan attitudes toward them so different, that a gap in Covid’s death toll quickly emerged. I have covered that gap in two newsletters — one this summer, one last month — and today’s newsletter offers an update.​
The brief version: The gap in Covid’s death toll between red and blue America has grown faster over the past month than at any previous point.​
In October, 25 out of every 100,000 residents of heavily Trump counties died from Covid, more than three times higher than the rate in heavily Biden counties (7.8 per 100,000). October was the fifth consecutive month that the percentage gap between the death rates in Trump counties and Biden counties widened.​
mail
Data unavailable for Alaska and Washington, D.C.Source: New York Times database, Edison Research​
Some conservative writers have tried to claim that the gap may stem from regional differences in weather or age, but those arguments fall apart under scrutiny. (If weather or age were a major reason, the pattern would have begun to appear last year.) The true explanation is straightforward: The vaccines are remarkably effective at preventing severe Covid, and almost 40 percent of Republican adults remain unvaccinated, compared with about 10 percent of Democratic adults.​
Charles Gaba, a Democratic health care analyst, has pointed out that the gap is also evident at finer gradations of political analysis: Counties where Trump received at least 70 percent of the vote have an even higher average Covid death toll than counties where Trump won at least 60 percent.​
As a result, Covid deaths have been concentrated in counties outside of major metropolitan areas. Many of these are in red states, while others are in red parts of blue or purple states, like Arizona, Michigan, Nevada, New Mexico, Pennsylvania, Oregon, Virginia and even California.​
mail
Data as of Nov. 3.Source: New York Times database​
This situation is a tragedy, in which irrational fears about vaccine side effects have overwhelmed rational fears about a deadly virus. It stems from disinformation — promoted by right-wing media, like Rupert Murdoch’s Fox News, the Sinclair Broadcast Group and online sources — that preys on the distrust that results from stagnant living standards.​

A peak?​

The future of Covid is uncertain, but I do think it’s possible that the partisan gap in Covid deaths reached its peak last month. There are two main reasons to expect the gap may soon shrink.​
One, the new antiviral treatments from Pfizer and Merck seem likely to reduce Covid deaths everywhere, and especially in the places where they are most common. These treatments, along with the vaccines, may eventually turn this coronavirus into just another manageable virus.​
Two, red America has probably built up more natural immunity to Covid — from prior infections — than blue America, because the hostility to vaccination and social distancing has caused the virus to spread more widely. A buildup in natural immunity may be one reason that the partisan gap in new Covid cases has shrunk recently.​
mail
Data unavailable for Alaska and Washington D.C.Source: New York Times database, Edison Research​
Death trends tend to lag case trends by a few weeks, which suggests the gap in deaths will shrink in November.​
Still, nobody knows what will happen next. Much of the recent decline in caseloads is mysterious, which means it may not last. And the immunity from vaccination appears to be much stronger than the immunity from infection, which means that conservative Americans will probably continue to suffer an outsized amount of unnecessary illness and death.​
 

missy

Super_Ideal_Rock
Premium
Joined
Jun 8, 2008
Messages
53,978
Good morning. Is it time to start moving back to normalcy?​
mail
Cable car riders in San Francisco.Jim Wilson/The New York Times​

If not now …​


Among the Covid experts I regularly talk with, Dr. Robert Wachter is one of the more cautious. He worries about “long Covid,” and he believes that many people should receive booster shots. He says that he may wear a mask in supermarkets and on airplanes for the rest of his life.​
Yet Wachter — the chair of the medicine department at the University of California, San Francisco — also worries about the downsides of organizing our lives around Covid. In recent weeks, he has begun to think about when most of life’s rhythms should start returning to normal. Increasingly, he believes the answer is: Now.​
This belief stems from the fact that the virus is unlikely to go away, ever. Like most viruses, it will probably keep circulating, with cases rising sometimes and falling other times. But we have the tools — vaccines, along with an emerging group of treatments — to turn it into a manageable virus, similar to the seasonal flu.​
Given this reality, Wachter, who’s 64, has decided to resume more of his old activities and accept the additional risk that comes with them, much as we accept the risk of crashes when riding in vehicles.​
mail
Dr. Robert M. Wachter.Stephen Lam/San Francisco Chronicle​
He has begun eating in indoor restaurants again and playing poker, unmasked, with vaccinated friends. He has taken airplanes to visit relatives. He hosted a medical conference in downtown San Francisco with a few hundred masked and vaccinated attendees.​
“I’m still going to be thoughtful and careful,” Wachter told The San Francisco Chronicle. But “if I’m not going to do it now, I’m probably saying that I’m not going to do it for the next couple of years, and I might be saying I’m not doing it forever.”​
The hospitalization statistics in highly vaccinated communities help explain Wachter’s attitude. In Seattle (which publishes detailed data), the daily Covid hospitalization rate for vaccinated people has been slightly above one in one million. By comparison, the flu hospitalization rate in a typical year in the U.S. is more than twice as high. For most vaccinated people in a place like Seattle or San Francisco, Covid already resembles just another virus.​
The risks are also low for unvaccinated children because Covid tends to be mild for them. (Plus, any child 5 or older can now be vaccinated.) For young children, Covid looks like a normal flu, if not a mild one:​
mail
Source: Centers for Disease Control and Prevention​
As for long Covid, it is real but rare. It’s also not unique. The flu and other viruses also cause mysterious, lasting problems for a small share of people, studies show.​
The bottom line is that Covid now presents the sort of risk to most vaccinated people that we unthinkingly accept in other parts of life. And there is not going to be a day when we wake up to headlines proclaiming that Covid is defeated. In many ways, the future of the virus has arrived.​
All of which raises the question of which precautions should end — now or soon — and which should become permanent.​
Should offices remain mostly empty? Should schools require children and teachers to wear masks? Should classrooms go remote again when they identify a new Covid case? (In Boston, a K-8 school closed for 10 days starting Wednesday because of an outbreak.) For how long should individuals organize their own lives around a fear of Covid?​
Most of these questions are tricky, and a few factors can guide the decision-making, epidemiologists say.​

1. Local spread​

The lower the rate of Covid spread in a community, the less risk to everyone. The C.D.C. defines a low rate of transmission as, among other things, fewer than 10 new daily cases per 100,000 people. Most of the country is well above that threshold, but parts of the San Francisco, Atlanta, Dallas, Houston, Los Angeles, Miami, New York and Washington areas are below it. (You can look up your county here.)​
Nevada has taken an approach that experts like Julia Raifman of Boston University have praised: The state will remove mask mandates after cases have fallen below a certain level. Joseph Allen of Harvard, criticizing the different approach in many other places, has said, “We’re sleepwalking into policy because we’re not setting goals.”​
One complication: Nationally, new cases have risen modestly in recent weeks, though they are still far below the levels of late summer. If new cases accelerate as the weather gets colder and more activity moves indoors, it may call for caution.​

2. Illness, not cases​

Still, with vaccines widely available and treatments increasingly so, caseloads are not as important a metric as they once were. They “are becoming less and less useful,” as The Atlantic’s Sarah Zhang has written. More telling measures are hospitalizations and deaths.​
The treatments for people who contract Covid are especially important here. Pfizer’s pill regimen, which seems especially effective, reduces the risk of hospitalization by more than 80 percent. These treatments are another step toward turning Covid into a normal virus rather than one that dominates life.​

3. Vulnerability​

Different people face different levels of Covid risk. For most vaccinated people and children, the risks are extremely low. But for some immunocompromised people — like those who have received organ transplants — the risks are higher. The same is true among people in their 80s and 90s.​
Greater precautions make sense for vulnerable people. They will also particularly benefit if rapid Covid testing ever becomes widely available in the U.S., allowing them to socialize more confidently.​
There is a flip side to this point: The aggregate statistics on Covid deaths and hospitalizations exaggerate the risk to most Americans, because a disproportionate share of severe illness occurs among people with specific medical vulnerabilities.​

4. Cost vs. benefit​

Wachter told me that he might always wear a mask while grocery shopping or flying on a plane because the costs of having a covered face and a muzzled voice in those settings are virtually zero. He isn’t usually trying to have a conversation with somebody. And a mask can help protect him from all sorts of respiratory viruses.​
Unfortunately, the costs of most Covid interventions are higher. Masks inhibit communication, especially for young children and the hard of hearing. (Wachter also says he expects conferences eventually to be maskless.) Remote school has been a failure. Remote office work hampers collaboration. Social isolation causes mental-health problems.​
When The Washington Post recently asked Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, when the pandemic would end, she replied: “It doesn’t end. We just stop caring. Or we care a lot less.” She added, “I think for most people, it just fades into the background of their lives.”​
I realize that answer may sound jarring, but the alternative — a society permanently dominated by Covid — is jarring, too. Eventually, the costs of organizing our lives around the virus will exceed the benefits. In some cases, we may have already reached that point.​
 

dk168

Super_Ideal_Rock
Premium
Joined
Jul 7, 2013
Messages
12,492
Got full refund for my Covid Test package for my now-cancelled Canadian trip, after I rang them to enquire when I received a second e-mail reminder a day before the fit to fly test. Apparently payment via PayPal was more complicated to cancel/refund. :roll2:

Booster booked for next Wednesday at a town about 17 miles away that I frequent. I have planned to have a meal and some grocery shopping for Asian ingredients while I am there to make the trip worthwhile.

I read a newspaper article claiming our local regulatory agency had approved Sinopharm's vaccine for use on UK's residents. However, I could not find this on the official government's website.

DK :))
 

wildcat03

Brilliant_Rock
Joined
Apr 11, 2011
Messages
904
Covaxin appears to be safe and efficacious.

Hopefully this can get approved (along with NovaVax) in the US. I sense that a lot of the vaccine hesitant folks might be more willing to get one of those since they are a more familiar type of vaccine!

 
Be a part of the community Get 3 HCA Results
Top