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"title": "Coronavirus Data Dashboards for Bay Area, California, US, the World — All in One Place",
"headTitle": "Coronavirus Data Dashboards for Bay Area, California, US, the World — All in One Place | KQED",
"content": "\u003cp>\u003cem>Originally posted May 5\u003c/em>\u003c/p>\n\u003cp>County health departments in the Bay Area have issued a joint set of \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/bay-area-health-officer-indicator.aspx?mc_cid=634de84af2&mc_eid=e3e8054959\" target=\"_blank\" rel=\"noopener noreferrer\">criteria\u003c/a> to guide them in deciding when and how much to allow the region to tiptoe out of its current forced hibernation. For those who want to access the kind of COVID-19 data that public health officials are staring at in order to divine the right conditions for loosening restrictions, we’ve curated some of the best resources for tracking the numbers.\u003c/p>\n\u003cp>First up is the California Health and Human Services Agency’s dashboard, which is chock-full of \u003cstrong>\u003ca href=\"https://public.tableau.com/views/COVID-19PublicDashboard/Covid-19Public?:embed=y&:display_count=no&:showVizHome=no\" target=\"_blank\" rel=\"noopener noreferrer\">California case statistics\u003c/a>\u003c/strong> and \u003ca href=\"https://public.tableau.com/views/COVID-19PublicDashboard/Covid-19Hospitals?:embed=y&:display_count=no&:showVizHome=no\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cstrong>hospital data\u003c/strong>\u003c/a>, sorted by every county in the state. We also included data dashboards for the Bay Area, the U.S. and the world.\u003c/p>\n\u003cp>\u003cstrong>More California Data\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.cdph.ca.gov/P\">County Data Monitoring\u003c/a> – Metrics that the California Department of Public Health is tracking, including case rates, testing positivity and available ventilators \u003cspan style=\"color: #0000ff;\">\u003cem>NEW\u003c/em>\u003c/span>\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11809760/how-many-california-coronavirus-cases-see-latest-numbers-by-county\" target=\"_blank\" rel=\"noopener noreferrer\">California Coronavirus Tracker by County\u003c/a> – KQED\u003c/li>\n\u003cli>\u003ca href=\"https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/\" target=\"_blank\" rel=\"noopener noreferrer\">California Coronavirus Tracking\u003c/a> – Comprehensive data on cases, deaths, hospitalizations, demographics and testing, viewable by county and city, from the Los Angeles Times\u003c/li>\n\u003cli>\u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019.aspx#COVID-19%20by%20the%20Numbers\" target=\"_blank\" rel=\"noopener noreferrer\">California COVID-19 by the Numbers\u003c/a> – California Department of Public Health\u003c/li>\n\u003c/ul>\n\u003ch3>Bay Area Data\u003c/h3>\n\u003cp>The nine counties of the Bay Area have released data dashboards where you can monitor daily counts on cases, deaths, hospitalizations, demographics and more.\u003c/p>\n\u003cp>Here is \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Santa Clara County’s data\u003c/a>, for example. Click on the image to be taken to the dashboard. Links to the other counties are directly below.\u003c/p>\n\u003cfigure id=\"attachment_1963598\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1963598 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2013/04/SantaClara.jpg\" alt=\"\" width=\"800\" height=\"532\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2013/04/SantaClara.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2013/04/SantaClara-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2013/04/SantaClara-768x511.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot of Santa Clara dashboad taking April 29, 2020\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Data Dashboards by County\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://ac-hcsa.maps.arcgis.com/apps/opsdashboard/index.html#/1e0ac4385cbe4cc1bffe2cf7f8e7f0d9\" target=\"_blank\" rel=\"noopener noreferrer\">Alameda\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.coronavirus.cchealth.org/dashboard\" target=\"_blank\" rel=\"noopener noreferrer\">Contra Costa\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://coronavirus.marinhhs.org/surveillance\" target=\"_blank\" rel=\"noopener noreferrer\">Marin\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://legacy.livestories.com/s/v2/coronavirus-report-for-napa-county-ca/9065d62d-f5a6-445f-b2a9-b7cf30b846dd/\" target=\"_blank\" rel=\"noopener noreferrer\">Napa\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://data.sfgov.org/stories/s/fjki-2fab\" target=\"_blank\" rel=\"noopener noreferrer\">San Francisco\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.smchealth.org/post/san-mateo-county-covid-19-data-1\" target=\"_blank\" rel=\"noopener noreferrer\">San Mateo\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Santa Clara\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://doitgis.maps.arcgis.com/apps/MapSeries/index.html?appid=055f81e9fe154da5860257e3f2489d67\" target=\"_blank\" rel=\"noopener noreferrer\">Solano\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://sonomacounty.maps.arcgis.com/apps/MapSeries/index.html?appid=21a1653b79ba42039ff22bcb85fa5b19\" target=\"_blank\" rel=\"noopener noreferrer\">Sonoma\u003c/a>\u003c/li>\n\u003c/ul>\n\u003ch3>Projected Peaks in U.S. States and the World\u003c/h3>\n\u003cp>The Institute for Health Metrics and Evaluation, a research center at University of Washington Medicine, \u003ca href=\"https://covid19.healthdata.org/united-states-of-america\" target=\"_blank\" rel=\"noopener noreferrer\">models the projected curve\u003c/a> of the pandemic for each U.S. state and each nation using the latest available data. Though of late the model has come under some \u003ca href=\"https://www.kqed.org/science/1962318/coronavirus-model-used-by-trump-administration-to-guide-reopening-is-flawed-critics-say\" target=\"_blank\" rel=\"noopener noreferrer\">criticism\u003c/a>. Here’s \u003ca href=\"https://www.nytimes.com/interactive/2020/04/22/upshot/coronavirus-models.html\" target=\"_blank\" rel=\"noopener noreferrer\">more about different models\u003c/a> from The New York Times.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://covid19.healthdata.org/united-states-of-america\" height=\"700\" width=\"100%\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cstrong>More U.S. data\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/science/1962884/bay_area_coronavirus_data\" target=\"_blank\" rel=\"noopener noreferrer\">Johns Hopkins Coronavirus Resource Center Map\u003c/a> – Find data for any county in the U.S.\u003c/li>\n\u003cli>\u003ca href=\"https://www.npr.org/sections/health-shots/2020/03/16/816707182/map-tracking-the-spread-of-the-coronavirus-in-the-u-s\" target=\"_blank\" rel=\"noopener noreferrer\">NPR State Tracking\u003c/a> – How quickly is the virus spreading in each state? \u003c/li>\n\u003cli>\u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. Centers for Disease Control and Prevention Data\u003c/a> – \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/covid-data/forecasting-us.html\" target=\"_blank\" rel=\"noopener noreferrer\">forecasts\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html\">New York Times Coronavirus Tracking\u003c/a> – Maps, hot spots, case growth rates\u003c/li>\n\u003cli>\u003ca href=\"https://covidtracking.com/data\" target=\"_blank\" rel=\"noopener noreferrer\">COVID Tracking Project\u003c/a> – Testing data state-by-state\u003c/li>\n\u003c/ul>\n\u003ch3>Across the Globe: Cases, Deaths, Recoveries and More\u003c/h3>\n\u003cp>If you want to find coronavirus data for cities across the globe, the Center for Systems Science and Engineering at Johns Hopkins has created a \u003ca href=\"https://coronavirus.jhu.edu/map.html\" target=\"_blank\" rel=\"noopener noreferrer\">global interactive map\u003c/a> with stats for the number of COVID-19 cases and deaths.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://coronavirus.jhu.edu/map.html\" width=\"100%\" height=\"700\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003ch3>WHO Data Tracks Curves by Region and Country\u003c/h3>\n\u003cp>The World Health Organization (WHO) keeps a \u003ca href=\"https://covid19.who.int/\" target=\"_blank\" rel=\"noopener noreferrer\">Situation Dashboard\u003c/a> showing the number of cases and fatalities by country. Scroll down the page for interactive tools to follow curves for different countries and global region. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Originally posted May 5\u003c/em>\u003c/p>\n\u003cp>County health departments in the Bay Area have issued a joint set of \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/bay-area-health-officer-indicator.aspx?mc_cid=634de84af2&mc_eid=e3e8054959\" target=\"_blank\" rel=\"noopener noreferrer\">criteria\u003c/a> to guide them in deciding when and how much to allow the region to tiptoe out of its current forced hibernation. For those who want to access the kind of COVID-19 data that public health officials are staring at in order to divine the right conditions for loosening restrictions, we’ve curated some of the best resources for tracking the numbers.\u003c/p>\n\u003cp>First up is the California Health and Human Services Agency’s dashboard, which is chock-full of \u003cstrong>\u003ca href=\"https://public.tableau.com/views/COVID-19PublicDashboard/Covid-19Public?:embed=y&:display_count=no&:showVizHome=no\" target=\"_blank\" rel=\"noopener noreferrer\">California case statistics\u003c/a>\u003c/strong> and \u003ca href=\"https://public.tableau.com/views/COVID-19PublicDashboard/Covid-19Hospitals?:embed=y&:display_count=no&:showVizHome=no\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cstrong>hospital data\u003c/strong>\u003c/a>, sorted by every county in the state. We also included data dashboards for the Bay Area, the U.S. and the world.\u003c/p>\n\u003cp>\u003cstrong>More California Data\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.cdph.ca.gov/P\">County Data Monitoring\u003c/a> – Metrics that the California Department of Public Health is tracking, including case rates, testing positivity and available ventilators \u003cspan style=\"color: #0000ff;\">\u003cem>NEW\u003c/em>\u003c/span>\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11809760/how-many-california-coronavirus-cases-see-latest-numbers-by-county\" target=\"_blank\" rel=\"noopener noreferrer\">California Coronavirus Tracker by County\u003c/a> – KQED\u003c/li>\n\u003cli>\u003ca href=\"https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/\" target=\"_blank\" rel=\"noopener noreferrer\">California Coronavirus Tracking\u003c/a> – Comprehensive data on cases, deaths, hospitalizations, demographics and testing, viewable by county and city, from the Los Angeles Times\u003c/li>\n\u003cli>\u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019.aspx#COVID-19%20by%20the%20Numbers\" target=\"_blank\" rel=\"noopener noreferrer\">California COVID-19 by the Numbers\u003c/a> – California Department of Public Health\u003c/li>\n\u003c/ul>\n\u003ch3>Bay Area Data\u003c/h3>\n\u003cp>The nine counties of the Bay Area have released data dashboards where you can monitor daily counts on cases, deaths, hospitalizations, demographics and more.\u003c/p>\n\u003cp>Here is \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Santa Clara County’s data\u003c/a>, for example. Click on the image to be taken to the dashboard. Links to the other counties are directly below.\u003c/p>\n\u003cfigure id=\"attachment_1963598\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1963598 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2013/04/SantaClara.jpg\" alt=\"\" width=\"800\" height=\"532\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2013/04/SantaClara.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2013/04/SantaClara-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2013/04/SantaClara-768x511.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot of Santa Clara dashboad taking April 29, 2020\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Data Dashboards by County\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://ac-hcsa.maps.arcgis.com/apps/opsdashboard/index.html#/1e0ac4385cbe4cc1bffe2cf7f8e7f0d9\" target=\"_blank\" rel=\"noopener noreferrer\">Alameda\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.coronavirus.cchealth.org/dashboard\" target=\"_blank\" rel=\"noopener noreferrer\">Contra Costa\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://coronavirus.marinhhs.org/surveillance\" target=\"_blank\" rel=\"noopener noreferrer\">Marin\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://legacy.livestories.com/s/v2/coronavirus-report-for-napa-county-ca/9065d62d-f5a6-445f-b2a9-b7cf30b846dd/\" target=\"_blank\" rel=\"noopener noreferrer\">Napa\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://data.sfgov.org/stories/s/fjki-2fab\" target=\"_blank\" rel=\"noopener noreferrer\">San Francisco\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.smchealth.org/post/san-mateo-county-covid-19-data-1\" target=\"_blank\" rel=\"noopener noreferrer\">San Mateo\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Santa Clara\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://doitgis.maps.arcgis.com/apps/MapSeries/index.html?appid=055f81e9fe154da5860257e3f2489d67\" target=\"_blank\" rel=\"noopener noreferrer\">Solano\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://sonomacounty.maps.arcgis.com/apps/MapSeries/index.html?appid=21a1653b79ba42039ff22bcb85fa5b19\" target=\"_blank\" rel=\"noopener noreferrer\">Sonoma\u003c/a>\u003c/li>\n\u003c/ul>\n\u003ch3>Projected Peaks in U.S. States and the World\u003c/h3>\n\u003cp>The Institute for Health Metrics and Evaluation, a research center at University of Washington Medicine, \u003ca href=\"https://covid19.healthdata.org/united-states-of-america\" target=\"_blank\" rel=\"noopener noreferrer\">models the projected curve\u003c/a> of the pandemic for each U.S. state and each nation using the latest available data. Though of late the model has come under some \u003ca href=\"https://www.kqed.org/science/1962318/coronavirus-model-used-by-trump-administration-to-guide-reopening-is-flawed-critics-say\" target=\"_blank\" rel=\"noopener noreferrer\">criticism\u003c/a>. Here’s \u003ca href=\"https://www.nytimes.com/interactive/2020/04/22/upshot/coronavirus-models.html\" target=\"_blank\" rel=\"noopener noreferrer\">more about different models\u003c/a> from The New York Times.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://covid19.healthdata.org/united-states-of-america\" height=\"700\" width=\"100%\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cstrong>More U.S. data\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/science/1962884/bay_area_coronavirus_data\" target=\"_blank\" rel=\"noopener noreferrer\">Johns Hopkins Coronavirus Resource Center Map\u003c/a> – Find data for any county in the U.S.\u003c/li>\n\u003cli>\u003ca href=\"https://www.npr.org/sections/health-shots/2020/03/16/816707182/map-tracking-the-spread-of-the-coronavirus-in-the-u-s\" target=\"_blank\" rel=\"noopener noreferrer\">NPR State Tracking\u003c/a> – How quickly is the virus spreading in each state? \u003c/li>\n\u003cli>\u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. Centers for Disease Control and Prevention Data\u003c/a> – \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/covid-data/forecasting-us.html\" target=\"_blank\" rel=\"noopener noreferrer\">forecasts\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html\">New York Times Coronavirus Tracking\u003c/a> – Maps, hot spots, case growth rates\u003c/li>\n\u003cli>\u003ca href=\"https://covidtracking.com/data\" target=\"_blank\" rel=\"noopener noreferrer\">COVID Tracking Project\u003c/a> – Testing data state-by-state\u003c/li>\n\u003c/ul>\n\u003ch3>Across the Globe: Cases, Deaths, Recoveries and More\u003c/h3>\n\u003cp>If you want to find coronavirus data for cities across the globe, the Center for Systems Science and Engineering at Johns Hopkins has created a \u003ca href=\"https://coronavirus.jhu.edu/map.html\" target=\"_blank\" rel=\"noopener noreferrer\">global interactive map\u003c/a> with stats for the number of COVID-19 cases and deaths.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://coronavirus.jhu.edu/map.html\" width=\"100%\" height=\"700\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003ch3>WHO Data Tracks Curves by Region and Country\u003c/h3>\n\u003cp>The World Health Organization (WHO) keeps a \u003ca href=\"https://covid19.who.int/\" target=\"_blank\" rel=\"noopener noreferrer\">Situation Dashboard\u003c/a> showing the number of cases and fatalities by country. Scroll down the page for interactive tools to follow curves for different countries and global region. This includes the number of cases confirmed per day and the change over time.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://covid19.who.int/\" width=\"100%\" height=\"700\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003ch3>Death Rates Per 100,000 Residents\u003cbr>\n\u003ca title=\"Infographic: COVID-19 Deaths Per 100,000 Inhabitants: A Comparison | Statista\" href=\"https://www.statista.com/chart/21170/coronavirus-death-rate-worldwide/\">\u003cimg decoding=\"async\" style=\"width: 100%; height: auto !important; max-width: 960px;\" src=\"https://cdn.statcdn.com/Infographic/images/normal/21170.jpeg\" alt=\"Infographic: COVID-19 Deaths Per 100,000 Inhabitants: A Comparison | Statista\" width=\"100%\" height=\"auto\">\u003c/a> You will find more infographics at \u003ca href=\"https://www.statista.com/chartoftheday/\">Statista\u003c/a>\n\u003c/h3>\u003cp>\u003c/p>\u003c/div>",
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"title": "Major Health Risks From Taking Hydroxychloroquine for COVID-19, Latest Research Finds",
"headTitle": "Major Health Risks From Taking Hydroxychloroquine for COVID-19, Latest Research Finds | KQED",
"content": "\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">A \u003c/span>\u003c/span>new study underlines safety concerns about using the malaria drugs hydroxychloroquine and chloroquine to treat COVID-19, and heightens questions about whether or not the drugs are effective at all.\u003c/p>\n\u003cp>[pullquote citation=\"Dr. Steven Nissen, Cleveland Clinic\"]‘Based upon these findings and others, no one should take hydroxychloroquine with or without an antibiotic unless they are in a randomized controlled trial. It should not be used in the general population to prevent or to treat COVID-19 infection.’[/pullquote]The study, which was published in \u003ca href=\"https://marlin-prod.literatumonline.com/pb-assets/Lancet/pdfs/S0140673620311806.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">The Lancet\u003c/a>, cannot answer the question of whether or not hydroxychloroquine and chloroquine can help patients fight off COVID-19 or whether the drugs increase or decrease the death rates in those patients. Those answers can only come from large studies in which patients are randomly assigned to either receive the drugs or a placebo. Dozens of such studies are ongoing.\u003c/p>\n\u003cp>The results, however, are a reminder of the risks of deciding to use medicines without clear evidence of their benefits and risks.\u003c/p>\n\u003cp>One of the findings of the current study seems hard to ignore: that the drugs increase the risk of dangerous disturbances in heart rhythms. These are known side effects of both medicines, but the increases in the study are striking. After adjustment for other risk factors, it appears that patients on hydroxychloroquine had double the risk of ventricular arrhythmias, and those on chloroquine had triple. When an antibiotic such as azithromycin was added, as some proponents have advocated, the risk jumped to fivefold.\u003c/p>\n\u003cp>“It’s a very striking finding and it’s convincing to me,” said Steven Nissen, a cardiologist at the Cleveland Clinic. “Based upon these findings and others, no one should take hydroxychloroquine with or without an antibiotic unless they are in a randomized controlled trial. It should not be used in the general population to prevent or to treat COVID-19 infection.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Eric Topol, director and founder of the Scripps Research Translational Institute and a cardiologist, noted the risk \u003ca href=\"https://twitter.com/EricTopol/status/1263811764287725574\" target=\"_blank\" rel=\"noopener noreferrer\">in a series of tweets.\u003c/a> “It’s no longer that hydroxychloroquine has no sign of efficacy,” he wrote, “it is associated with an increase in mortality.”\u003c/p>\n\u003cp>The study is the largest observational study so far on the use of chloroquine and hydroxychloroquine to treat COVID-19; it combined data from 15,000 COVID-19 patients at 671 hospitals on six continents who were treated with the drugs. Those patients were compared to 81,000 patients who had COVID-19 but did not receive the drugs.\u003c/p>\n\u003cp>Other observational studies have made comparisons in smaller populations. A study of 368 U.S. veterans also showed that the drugs might be potentially harmful. But two \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2766117\" target=\"_blank\" rel=\"noopener noreferrer\">different\u003c/a> \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMoa2012410\" target=\"_blank\" rel=\"noopener noreferrer\">studies\u003c/a> each including 1,400 patients treated in New York during the COVID-19 pandemic showed no impact on mortality at all.\u003c/p>\n\u003cp>The difficulty with observational (sometimes called “real-world”) studies is that, often, the patients whom doctors choose to treat with a drug are different — in this case, probably sicker — than those who go untreated.\u003c/p>\n\u003cp>The study in veterans “basically was a paper that showed that sick patients were more likely to get prescribed hydroxychloroquine, and the sick patients die. Now is it that it’s hydroxychloroquine that’s causing the death, or is it the fact that sick patients are the ones that more frequently die of COVID-19?” Amy Abernethy, the principal deputy commissioner at the Food and Drug Administration, told STAT this earlier this week.\u003c/p>\n\u003cp>Adding more patients helps. But the problem is that, while researchers can control for risk factors that they know about, they can’t rule out that patients getting chloroquine and hydroxychloroquine are dying for reasons they don’t understand that have nothing to do with the drugs.\u003c/p>\n\u003cp>Still, the results don’t bode well for the malaria drugs as COVID-19 treatments. After controlling for risks such as weight, heart disease, and lung disease, the mortality rate in the control group was 9%. For those who received hydroxychloroquine, it was 18%; when an antibiotic was added, it was more than 20%. That’s not what would be expected if the drugs were highly effective treatments.\u003c/p>\n\u003cp>The results about heart rhythm issues are harder to discount, because they are known side effects of the drugs. Observational studies are generally seen as useful for picking up side effects.\u003c/p>\n\u003cp>Trying hydroxychloroquine as a COVID-19 treatment was sensible. Just as early laboratory studies showed that remdesivir, the drug developed by Gilead Sciences that the National Institute of Allergy and Infectious Disease found might shorten the time it took patients to recover from Covid-19 in a randomized clinical trial, so too did hydroxychloroquine. And results are conflicting. A \u003ca href=\"https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v3\" target=\"_blank\" rel=\"noopener noreferrer\">62-patient randomized study \u003c/a>in China even seemed to show some benefit from the drug.\u003c/p>\n\u003cp>Even if the results from the new study, led by researchers at the Brigham and Women’s Hospital Center for Advanced Heart Disease/Cardiomyopathy in Boston, hold up, it’s still possible the drug could have some benefit. Researchers are testing it for preventing people who are exposed to the virus from being infected. Again, that can only come from randomized controlled studies.\u003c/p>\n\u003cp>Hydroxychloroquine use spiked dramatically after the drug was embraced by President Trump, who on Monday said that he himself was taking the drug, and commentators on Fox News. Sean Hannity read a letter from a doctor recounting his own experience using the drugs as a treatment on air.\u003c/p>\n\u003cp>Results from some of the first large, randomized studies of hydroxychloroquine are expected soon, including a study being conducted by the French government and one at the University of Minnesota. If they show that the drugs were actually harmful, it will be another giant misstep in the response to the virus. If they show it works, we’ll have another tool — probably a small one — in combating the pandemic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2020/05/22/what-a-big-new-study-on-malaria-drugs-as-covid-19-treatments-tells-us-and-what-it-doesnt/\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The study, which was published in \u003ca href=\"https://marlin-prod.literatumonline.com/pb-assets/Lancet/pdfs/S0140673620311806.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">The Lancet\u003c/a>, cannot answer the question of whether or not hydroxychloroquine and chloroquine can help patients fight off COVID-19 or whether the drugs increase or decrease the death rates in those patients. Those answers can only come from large studies in which patients are randomly assigned to either receive the drugs or a placebo. Dozens of such studies are ongoing.\u003c/p>\n\u003cp>The results, however, are a reminder of the risks of deciding to use medicines without clear evidence of their benefits and risks.\u003c/p>\n\u003cp>One of the findings of the current study seems hard to ignore: that the drugs increase the risk of dangerous disturbances in heart rhythms. These are known side effects of both medicines, but the increases in the study are striking. After adjustment for other risk factors, it appears that patients on hydroxychloroquine had double the risk of ventricular arrhythmias, and those on chloroquine had triple. When an antibiotic such as azithromycin was added, as some proponents have advocated, the risk jumped to fivefold.\u003c/p>\n\u003cp>“It’s a very striking finding and it’s convincing to me,” said Steven Nissen, a cardiologist at the Cleveland Clinic. “Based upon these findings and others, no one should take hydroxychloroquine with or without an antibiotic unless they are in a randomized controlled trial. It should not be used in the general population to prevent or to treat COVID-19 infection.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Eric Topol, director and founder of the Scripps Research Translational Institute and a cardiologist, noted the risk \u003ca href=\"https://twitter.com/EricTopol/status/1263811764287725574\" target=\"_blank\" rel=\"noopener noreferrer\">in a series of tweets.\u003c/a> “It’s no longer that hydroxychloroquine has no sign of efficacy,” he wrote, “it is associated with an increase in mortality.”\u003c/p>\n\u003cp>The study is the largest observational study so far on the use of chloroquine and hydroxychloroquine to treat COVID-19; it combined data from 15,000 COVID-19 patients at 671 hospitals on six continents who were treated with the drugs. Those patients were compared to 81,000 patients who had COVID-19 but did not receive the drugs.\u003c/p>\n\u003cp>Other observational studies have made comparisons in smaller populations. A study of 368 U.S. veterans also showed that the drugs might be potentially harmful. But two \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2766117\" target=\"_blank\" rel=\"noopener noreferrer\">different\u003c/a> \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMoa2012410\" target=\"_blank\" rel=\"noopener noreferrer\">studies\u003c/a> each including 1,400 patients treated in New York during the COVID-19 pandemic showed no impact on mortality at all.\u003c/p>\n\u003cp>The difficulty with observational (sometimes called “real-world”) studies is that, often, the patients whom doctors choose to treat with a drug are different — in this case, probably sicker — than those who go untreated.\u003c/p>\n\u003cp>The study in veterans “basically was a paper that showed that sick patients were more likely to get prescribed hydroxychloroquine, and the sick patients die. Now is it that it’s hydroxychloroquine that’s causing the death, or is it the fact that sick patients are the ones that more frequently die of COVID-19?” Amy Abernethy, the principal deputy commissioner at the Food and Drug Administration, told STAT this earlier this week.\u003c/p>\n\u003cp>Adding more patients helps. But the problem is that, while researchers can control for risk factors that they know about, they can’t rule out that patients getting chloroquine and hydroxychloroquine are dying for reasons they don’t understand that have nothing to do with the drugs.\u003c/p>\n\u003cp>Still, the results don’t bode well for the malaria drugs as COVID-19 treatments. After controlling for risks such as weight, heart disease, and lung disease, the mortality rate in the control group was 9%. For those who received hydroxychloroquine, it was 18%; when an antibiotic was added, it was more than 20%. That’s not what would be expected if the drugs were highly effective treatments.\u003c/p>\n\u003cp>The results about heart rhythm issues are harder to discount, because they are known side effects of the drugs. Observational studies are generally seen as useful for picking up side effects.\u003c/p>\n\u003cp>Trying hydroxychloroquine as a COVID-19 treatment was sensible. Just as early laboratory studies showed that remdesivir, the drug developed by Gilead Sciences that the National Institute of Allergy and Infectious Disease found might shorten the time it took patients to recover from Covid-19 in a randomized clinical trial, so too did hydroxychloroquine. And results are conflicting. A \u003ca href=\"https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v3\" target=\"_blank\" rel=\"noopener noreferrer\">62-patient randomized study \u003c/a>in China even seemed to show some benefit from the drug.\u003c/p>\n\u003cp>Even if the results from the new study, led by researchers at the Brigham and Women’s Hospital Center for Advanced Heart Disease/Cardiomyopathy in Boston, hold up, it’s still possible the drug could have some benefit. Researchers are testing it for preventing people who are exposed to the virus from being infected. Again, that can only come from randomized controlled studies.\u003c/p>\n\u003cp>Hydroxychloroquine use spiked dramatically after the drug was embraced by President Trump, who on Monday said that he himself was taking the drug, and commentators on Fox News. Sean Hannity read a letter from a doctor recounting his own experience using the drugs as a treatment on air.\u003c/p>\n\u003cp>Results from some of the first large, randomized studies of hydroxychloroquine are expected soon, including a study being conducted by the French government and one at the University of Minnesota. If they show that the drugs were actually harmful, it will be another giant misstep in the response to the virus. If they show it works, we’ll have another tool — probably a small one — in combating the pandemic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2020/05/22/what-a-big-new-study-on-malaria-drugs-as-covid-19-treatments-tells-us-and-what-it-doesnt/\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Utah Went All In on Unproven Hydroxychloroquine Before Medical Experts Prevailed",
"headTitle": "Utah Went All In on Unproven Hydroxychloroquine Before Medical Experts Prevailed | KQED",
"content": "\u003cp>\u003cem>Note: On Monday, May 19, after this post was written, President Trump \u003ca href=\"https://www.npr.org/sections/coronavirus-live-updates/2020/05/18/858335915/despite-fdas-caution-trump-says-he-is-taking-hydroxychloroquine-preventatively\" target=\"_blank\" rel=\"noopener noreferrer\">said\u003c/a> he’s taking hydroxychloroquine, prompting \u003ca href=\"https://www.nytimes.com/2020/05/18/us/politics/trump-hydroxychloroquine-covid-coronavirus.html\" target=\"_blank\" rel=\"noopener noreferrer\">immediate criticism\u003c/a> from a range of medical experts who warned it posed a danger to his health and set a bad example.\u003c/em>\u003c/p>\n\u003cp>Even before President Trump started plugging chloroquine and \u003ca href=\"https://www.statnews.com/2020/04/06/trump-hydroxychloroquine-fact-check/\" target=\"_blank\" rel=\"noopener noreferrer\">hydroxychloroquine\u003c/a> as COVID-19 treatments, enthusiasm for the old malaria drugs was swelling in the state of Utah.\u003c/p>\n\u003cp>The “stunning medications” led to “responses that are equivalent to Lazarus” — the biblical figure brought back to life by Jesus — one physician said at an event at the state Capitol. The deputy director of the state health department, even as he acknowledged there was not “FDA-type of evidence” showing the drugs worked, said he was willing to put stock in case reports and “test tube evidence.”\u003c/p>\n\u003cp>Propelled by that hype, as well as mounting fears of the oncoming pandemic, the state pursued a sweeping — and eyebrow-raising — policy that would have let pharmacies dispense the unproven medications to patients with COVID-19 without a prescription. Utah, which took perhaps the most aggressive strategy with the drugs of any state, also put in an order for $800,000 worth of chloroquine and hydroxychloroquine to build a stockpile, and considered buying millions of dollars more.\u003c/p>\n\u003cp>The state did all of that without any rigorous evidence the drugs can help patients recover faster from COVID-19. Clinical trials that will answer that question are ongoing, but recent observational studies have cast doubt on an effect. And in the weeks since Utah’s efforts to promote and procure the drugs, the Food and Drug Administration has \u003ca href=\"https://www.statnews.com/2020/04/24/fda-warns-against-widespread-use-of-hydroxychloroquine-drug-touted-by-trump/\" target=\"_blank\" rel=\"noopener noreferrer\">warned\u003c/a> they should not be taken for COVID-19 outside a hospital or a clinical trial, citing “reports of serious heart rhythm problems.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Utah eventually abandoned its plans to make the drugs available without prescriptions and canceled its order.\u003c/p>\n\u003cp>\u003cstrong>A Drugs’ Rise and Fall\u003c/strong>\u003c/p>\n\u003cp>The saga of the drugs’ rise and fall in Utah, pieced together from documents STAT obtained through a public records request, provides a case study of what happens when hope and excitement about therapies outpace the evidence. It underscores the pressure officials felt to demonstrate they were on top of the response, even as such efforts sowed confusion among the medical community and led them into initiatives they came to regret. And, mirroring the hydroxychloroquine debate in the Trump administration, it shows how experts scrambled to inject restraint and plead for leaders to follow evidence at a time when promises of easy remedies were more enticing.\u003c/p>\n\u003cp>When, for example, the Utah Medical Association issued a bulletin to physicians, since rescinded, that suggested the state was recommending hydroxychloroquine or chloroquine for COVID-19 patients, the state epidemiologist wrote to others in the health department, “I disagree with this approach.” A top infectious disease specialist at the University of Utah was more blunt, sending a message with only “WTF?????”\u003c/p>\n\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">I\u003c/span>\u003c/span>n Utah, the hydroxychloroquine hype reached the public on March 20, at \u003ca href=\"https://www.youtube.com/watch?v=chedMU777bU\" target=\"_blank\" rel=\"noopener noreferrer\">a press conference\u003c/a> at the state Capitol. A group of policymakers and health professionals reassured people that they’d begun working on ways to get patients chloroquine and hydroxychloroquine. They cast their efforts as a reason for hope, while glossing over the concerns experts were raising about the medications as COVID-19 therapies. The drugs, Stuart Adams, the president of the state Senate, said, “may help bend that curve and keep people out of hospitals.”\u003c/p>\n\u003cp>Other speakers at the event carried the same message. Dan Richards, a pharmacist, suggested the drugs contributed to South Korea’s success in stemming its outbreak. Kurt Hegmann, a physician, made the comparison to Lazarus, and Marc Babitz, the deputy director of the state health department, delivered his comments about the quality of evidence. At one point, Babitz cited Trump as a reason for suggesting the drugs might work.\u003c/p>\n\u003cp>“Our president came out and suggested the medications,” Babitz said. “So we’re very confident this could make a significant difference.”\u003c/p>\n\u003cp>One reason why hydroxychloroquine and chloroquine attracted attention was because they were old. New drugs to fight COVID-19 would take months to develop, but these drugs had long been used to treat malaria, as well as lupus and rheumatoid arthritis. That meant that doctors could prescribe them off-label to people with COVID-19 immediately.\u003c/p>\n\u003cp>Driving much of the Utah officials’ interest in the drugs was Richards, the CEO of a local pharmacy chain, Meds in Motion. In a March 12 email to the executive director of the Utah health department, Joseph Miner, he suggested there was already demand for chloroquine.\u003c/p>\n\u003cp>Richards also suggested the state pursue a standing order, essentially a blanket prescription that would allow pharmacies to ship compounded versions of the drugs directly to patients when they tested positive for the coronavirus. He indicated doing so might help patients stay healthy enough they could avoid hospitals, at a time when a major fear of the pandemic was that it would swamp health systems.\u003c/p>\n\u003cp>“Utah needs this to have the potential for an epidemic curve like that for South Korea,” Hegmann, the physician working with Richards, wrote to health department leaders on March 17. (Experts say South Korea’s success in minimizing its outbreak stems not from these drugs, but from strategies like widespread testing, isolating people who are infected, and contact tracing.)\u003c/p>\n\u003cp>Hegmann does not appear to be an infectious disease specialist or critical care physician; his \u003ca href=\"https://healthcare.utah.edu/fad/mddetail.php?physicianID=u0206373\" target=\"_blank\" rel=\"noopener noreferrer\">University of Utah biography\u003c/a> says he is the chief of the division of occupational and environmental health with “expertise in musculoskeletal disorders and the evaluation of commercial drivers.” But the records indicate Hegmann and Richards were part of a public-private initiative backed by some state senators to find ways to expedite the screening of Utahns for COVID-19 and refer them to treatment; Hegmann is president of a company that was helping develop an online screening tool. (The \u003ca href=\"https://www.deseret.com/utah/2020/5/5/21248656/utah-coronavirus-covid-health-department-malaria-drugs-chloroquine-hydroxychloroquine\" target=\"_blank\" rel=\"noopener noreferrer\">Deseret News\u003c/a> and \u003ca href=\"https://www.sltrib.com/news/2020/05/13/start-team-utah-execs/\" target=\"_blank\" rel=\"noopener noreferrer\">Salt Lake Tribune\u003c/a> separately obtained the records and reported on some of their contents earlier this month.)\u003c/p>\n\u003cp>“We are not a state-appointed, organized task force,” \u003ca href=\"https://www.deseret.com/utah/2020/3/23/21191657/coronavirus-covid-19-hydroxychloroquine-chloroquine-malaria-treatment-utah\" target=\"_blank\" rel=\"noopener noreferrer\">Richards told the Deseret News\u003c/a> in March. “We are just a bunch of people who raised our hands and said something had to be done.”\u003c/p>\n\u003cp>But they quickly gained sway with the state. Hegmann, Richards, and the health department’s Miner and Babitz were soon swapping drafts and suggested edits for the standing order. A draft showed that the online screening tool would refer certain people to testing and then, if positive, to treatment with compounded hydroxychloroquine or chloroquine. The drugs, the draft said, have “the potential to help stop the spread of this virus, reduce need for hospitalization, and reduce mortality rates.”\u003c/p>\n\u003cp>The group thought it was a way to speed the drugs to patients, who wouldn’t need to consult with a physician after testing positive. By getting pharmacies to compound the medications, it wouldn’t cause a shortage of the versions used by patients with lupus and rheumatoid arthritis, they argued. The health department officials did not appear to raise questions about whether a pharmacist should be involved in crafting a policy that could benefit pharmacies, the records indicate.\u003c/p>\n\u003cp>Hegmann, Richards, and a spokesman for the state health department did not respond to emails from STAT seeking comment.\u003c/p>\n\u003cp>\u003cstrong>Trump Touts the Unproven Drug\u003c/strong>\u003c/p>\n\u003cp>Around the same time, Trump started talking up the drugs.\u003c/p>\n\u003cp>“Trump is touting chloroquine and hydroxychloroquine at [a] news conference right now,” Miner wrote to the group on March 19.\u003c/p>\n\u003cp>“That should help with community acceptance of this option,” Babitz replied. “I will say privately that I wish we had ‘trumped’ his announcement with this great plan.”\u003c/p>\n\u003cp>Trump’s support for the drugs came as they were being cheered on Fox News and among his political allies. Their arguments relied on results from small and flawed studies that weren’t designed to prove whether the drugs were effective or not. The view was that this was an emergency, and people couldn’t afford to wait for the results of randomized controlled trials, the types of studies that can show whether a drug works.\u003c/p>\n\u003cp>“What do you have to lose?” Trump said, even as federal health officials said they needed to wait on the trials results. Experts also noted that the drugs carried risks to people’s hearts.\u003c/p>\n\u003cp>Soon, Utah’s “great plan” was raising concerns with experts, too.\u003c/p>\n\u003cp>“The use of an unproven therapy in this way could be a grave mistake medically,” Andrew Pavia, the chief of pediatric infectious diseases at the University of Utah, wrote on March 22 to Miner and the lieutenant governor after finding out about the standing order.\u003c/p>\n\u003cp>He stressed that the state should wait for solid evidence before recommending the drugs, particularly to people who weren’t that sick. Hospitalized patients might be treated with hydroxychloroquine — cases where the potential benefits outweighed the risk — but patients shouldn’t take the medications at home without a physician’s oversight, Pavia said. “There is as yet no real evidence of clinical benefit for these drugs,” Pavia wrote. “Wide use of unproven therapies in outpatients and low risk patients exposes them to potential harm with little evidence of benefit.”\u003c/p>\n\u003cp>Within a few days, Gov. Gary Herbert’s office pulled the plug on the standing order, saying that there was enough capacity for people with COVID-19 to first consult with a clinician, who could decide whether or not to prescribe the medications, emails show.\u003c/p>\n\u003cp>But the state was not done with hydroxychloroquine. About a week later, a state purchasing agency — a separate agency from the health department — agreed to buy 20,000 packets of compounded chloroquine and hydroxychloroquine from Meds in Motion, Richards’ pharmacy, for $800,000.\u003c/p>\n\u003cp>[pullquote align='right' citation='Scott Aberegg, University of Utah, in an email']‘This smacks as irresponsible and even reckless.’[/pullquote]\u003c/p>\n\u003cp>State officials’ support for the drugs led to confusion — and backlash.\u003c/p>\n\u003cp>The clearest example: the swift reaction to \u003ca href=\"https://utahmed.org/docs/COVID/Hydroxychloroquine%20Letter%203-27-2020.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">a March 27 email\u003c/a> from the Utah Medical Association to the state’s doctors, which said that Utah’s health department was “recommending that providers use a longstanding medication to treat COVID-19.” Listed were forms of chloroquine and hydroxychloroquine.\u003c/p>\n\u003cp>The email included suggested dosages, and added: “The state has arranged for production of compounded medication, so we do not anticipate this will cause a shortage for patients who need it for other conditions.”\u003c/p>\n\u003cp>Pavia, the infectious disease expert, fired off an email to Angela Dunn, the state epidemiologist who has been helping lead Utah’s COVID-19 response, that only said “WTF?????” Dunn quickly wrote to Babitz and Miner: “Do you know who put out these recommendations from UDOH?” In a follow up, she wrote, “As you know I disagree with this approach.”\u003c/p>\n\u003cp>It was only the beginning. “This smacks as irresponsible and even reckless,” Scott Aberegg of the University of Utah’s division of pulmonary and critical care medicine wrote to state health officials, adding there was “no credible data that support a recommendation for this drug for this indication.” He said that patients should be in monitored clinical trials if they were going to be taking the drugs.\u003c/p>\n\u003cp>Eventually, Babitz clarified. What happened, he said, was that he had supplied the association with recommended doses of the drugs should doctors want to prescribe them to treat COVID-19. It wasn’t meant to suggest that all COVID-19 patients get these drugs, he said.\u003c/p>\n\u003cp>In his explanation, Babitz spelled out a timeline of what had occurred leading up to the medical association’s email. The first bullet point: “President Trump announces to the world that chloroquine and hydroxychloroquine can combat COVID19.” He concluded: “If a healthcare provider, for whatever reason, decides s/he wishes to treat a COVID19 positive patient, our desire was to recommend the safest dosing of these medications.”\u003c/p>\n\u003cp>Miner emailed the head of the medical association asking for a corrected statement. “I admit there was much enthusiasm among some clinicians, pharmacists and political leaders locally and nationally about the prospects of using these medications to see if they would help blunt the severity of this pandemic,” he wrote. He added: “After further consideration we know we must have better scientific research before recommending them.”\u003c/p>\n\u003cp>The following day, the association sent out another email: “The UDOH has withdrawn its guidance on hydroxychloroquine from March 27. They are instead endorsing the launching of the clinical studies and urging patients to participate in the trial to get access to the investigative drugs in a controlled environment with gathering of data.”\u003c/p>\n\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">H\u003c/span>\u003c/span>ydroxychloroquine and chloroquine’s moments in the spotlight did not last very long — at the national level, and in Utah.\u003c/p>\n\u003cp>The drugs \u003ca href=\"https://www.nytimes.com/2020/04/22/business/media/virus-fox-news-hydroxychloroquine.html\" target=\"_blank\" rel=\"noopener noreferrer\">stopped getting\u003c/a> as much attention from Trump and Fox News. Observational studies found no benefits, and the FDA issued its warning about heart rhythm problems. Prescriptions tapered off — a relief to people who take them for autoimmune conditions.\u003c/p>\n\u003cp>In Utah, criticism quickly built once the state’s $800,000 purchase came to light. Some state \u003ca href=\"http://www.utahhousedemocrats.org/news/2020/4/21/house-democrats-concerned-with-state-purchasenbspof-unproven-drug-for-covid-19-patients\" target=\"_blank\" rel=\"noopener noreferrer\">lawmakers questioned\u003c/a> why taxpayer dollars were being spent on unproven drugs. On April 24, Herbert, the governor, said he did not know about the initial purchase and said the health department’s talks to buy another 200,000 treatment courses from Meds in Motion had “ceased.”\u003ca href=\"https://www.sltrib.com/news/2020/04/26/robert-gehrke-not-only/\" target=\"_blank\" rel=\"noopener noreferrer\"> The Salt Lake Tribune reported\u003c/a> the state far overpaid for the drugs compared to other formulations of hydroxychloroquine, and that the state was not experiencing any shortages.\u003c/p>\n\u003cp>“It was never more than a questionable COVID-19 treatment, and Utahns were never at risk of running out of it,” the\u003ca href=\"https://www.sltrib.com/opinion/editorial/2020/04/29/tribune-editorial-bad/\" target=\"_blank\" rel=\"noopener noreferrer\"> Tribune editorial board wrote\u003c/a> on April 29. “But that didn’t stop state officials from making a purchase that far exceeded any known need in the state. … State political leaders have given money and license to shameless promoters of baseless medical claims.”\u003c/p>\n\u003cp>That day, Herbert announced Meds in Motion refunded the state its $800,000. “A state supply of chloroquine/hydroxychloroquine is no longer prudent,” \u003ca href=\"https://governor.utah.gov/2020/04/30/governors-office-statement-on-internal-review-of-compounded-chloroquine-and-hydroxychloroquine-purchase/\" target=\"_blank\" rel=\"noopener noreferrer\">the governor’s office said\u003c/a>.\u003c/p>\n\u003cp>Herbert’s office cited “breakdowns in communication between state agencies,” but there were no ramifications. “All involved acted proactively, preemptively, and prudently during an emergency in an effort to save lives,” a statement said.\u003c/p>\n\u003cp>As for Richards, he said his goal had always been to contribute to the state’s response.\u003c/p>\n\u003cp>“We did it to help the state, and it didn’t work out,” Richards \u003ca href=\"https://kutv.com/news/coronavirus/man-who-refunded-utah-800k-for-malaria-drug-i-got-left-holding-the-bag\" target=\"_blank\" rel=\"noopener noreferrer\">told KUTV\u003c/a>. “And we move on.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2020/05/18/utah-hydroxychloroquine-scramble-course-correct/?utm_source=STAT+Newsletters&utm_campaign=62e8419eda-Daily_Recap&utm_medium=email&utm_term=0_8cab1d7961-62e8419eda-149648249\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Note: On Monday, May 19, after this post was written, President Trump \u003ca href=\"https://www.npr.org/sections/coronavirus-live-updates/2020/05/18/858335915/despite-fdas-caution-trump-says-he-is-taking-hydroxychloroquine-preventatively\" target=\"_blank\" rel=\"noopener noreferrer\">said\u003c/a> he’s taking hydroxychloroquine, prompting \u003ca href=\"https://www.nytimes.com/2020/05/18/us/politics/trump-hydroxychloroquine-covid-coronavirus.html\" target=\"_blank\" rel=\"noopener noreferrer\">immediate criticism\u003c/a> from a range of medical experts who warned it posed a danger to his health and set a bad example.\u003c/em>\u003c/p>\n\u003cp>Even before President Trump started plugging chloroquine and \u003ca href=\"https://www.statnews.com/2020/04/06/trump-hydroxychloroquine-fact-check/\" target=\"_blank\" rel=\"noopener noreferrer\">hydroxychloroquine\u003c/a> as COVID-19 treatments, enthusiasm for the old malaria drugs was swelling in the state of Utah.\u003c/p>\n\u003cp>The “stunning medications” led to “responses that are equivalent to Lazarus” — the biblical figure brought back to life by Jesus — one physician said at an event at the state Capitol. The deputy director of the state health department, even as he acknowledged there was not “FDA-type of evidence” showing the drugs worked, said he was willing to put stock in case reports and “test tube evidence.”\u003c/p>\n\u003cp>Propelled by that hype, as well as mounting fears of the oncoming pandemic, the state pursued a sweeping — and eyebrow-raising — policy that would have let pharmacies dispense the unproven medications to patients with COVID-19 without a prescription. Utah, which took perhaps the most aggressive strategy with the drugs of any state, also put in an order for $800,000 worth of chloroquine and hydroxychloroquine to build a stockpile, and considered buying millions of dollars more.\u003c/p>\n\u003cp>The state did all of that without any rigorous evidence the drugs can help patients recover faster from COVID-19. Clinical trials that will answer that question are ongoing, but recent observational studies have cast doubt on an effect. And in the weeks since Utah’s efforts to promote and procure the drugs, the Food and Drug Administration has \u003ca href=\"https://www.statnews.com/2020/04/24/fda-warns-against-widespread-use-of-hydroxychloroquine-drug-touted-by-trump/\" target=\"_blank\" rel=\"noopener noreferrer\">warned\u003c/a> they should not be taken for COVID-19 outside a hospital or a clinical trial, citing “reports of serious heart rhythm problems.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Utah eventually abandoned its plans to make the drugs available without prescriptions and canceled its order.\u003c/p>\n\u003cp>\u003cstrong>A Drugs’ Rise and Fall\u003c/strong>\u003c/p>\n\u003cp>The saga of the drugs’ rise and fall in Utah, pieced together from documents STAT obtained through a public records request, provides a case study of what happens when hope and excitement about therapies outpace the evidence. It underscores the pressure officials felt to demonstrate they were on top of the response, even as such efforts sowed confusion among the medical community and led them into initiatives they came to regret. And, mirroring the hydroxychloroquine debate in the Trump administration, it shows how experts scrambled to inject restraint and plead for leaders to follow evidence at a time when promises of easy remedies were more enticing.\u003c/p>\n\u003cp>When, for example, the Utah Medical Association issued a bulletin to physicians, since rescinded, that suggested the state was recommending hydroxychloroquine or chloroquine for COVID-19 patients, the state epidemiologist wrote to others in the health department, “I disagree with this approach.” A top infectious disease specialist at the University of Utah was more blunt, sending a message with only “WTF?????”\u003c/p>\n\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">I\u003c/span>\u003c/span>n Utah, the hydroxychloroquine hype reached the public on March 20, at \u003ca href=\"https://www.youtube.com/watch?v=chedMU777bU\" target=\"_blank\" rel=\"noopener noreferrer\">a press conference\u003c/a> at the state Capitol. A group of policymakers and health professionals reassured people that they’d begun working on ways to get patients chloroquine and hydroxychloroquine. They cast their efforts as a reason for hope, while glossing over the concerns experts were raising about the medications as COVID-19 therapies. The drugs, Stuart Adams, the president of the state Senate, said, “may help bend that curve and keep people out of hospitals.”\u003c/p>\n\u003cp>Other speakers at the event carried the same message. Dan Richards, a pharmacist, suggested the drugs contributed to South Korea’s success in stemming its outbreak. Kurt Hegmann, a physician, made the comparison to Lazarus, and Marc Babitz, the deputy director of the state health department, delivered his comments about the quality of evidence. At one point, Babitz cited Trump as a reason for suggesting the drugs might work.\u003c/p>\n\u003cp>“Our president came out and suggested the medications,” Babitz said. “So we’re very confident this could make a significant difference.”\u003c/p>\n\u003cp>One reason why hydroxychloroquine and chloroquine attracted attention was because they were old. New drugs to fight COVID-19 would take months to develop, but these drugs had long been used to treat malaria, as well as lupus and rheumatoid arthritis. That meant that doctors could prescribe them off-label to people with COVID-19 immediately.\u003c/p>\n\u003cp>Driving much of the Utah officials’ interest in the drugs was Richards, the CEO of a local pharmacy chain, Meds in Motion. In a March 12 email to the executive director of the Utah health department, Joseph Miner, he suggested there was already demand for chloroquine.\u003c/p>\n\u003cp>Richards also suggested the state pursue a standing order, essentially a blanket prescription that would allow pharmacies to ship compounded versions of the drugs directly to patients when they tested positive for the coronavirus. He indicated doing so might help patients stay healthy enough they could avoid hospitals, at a time when a major fear of the pandemic was that it would swamp health systems.\u003c/p>\n\u003cp>“Utah needs this to have the potential for an epidemic curve like that for South Korea,” Hegmann, the physician working with Richards, wrote to health department leaders on March 17. (Experts say South Korea’s success in minimizing its outbreak stems not from these drugs, but from strategies like widespread testing, isolating people who are infected, and contact tracing.)\u003c/p>\n\u003cp>Hegmann does not appear to be an infectious disease specialist or critical care physician; his \u003ca href=\"https://healthcare.utah.edu/fad/mddetail.php?physicianID=u0206373\" target=\"_blank\" rel=\"noopener noreferrer\">University of Utah biography\u003c/a> says he is the chief of the division of occupational and environmental health with “expertise in musculoskeletal disorders and the evaluation of commercial drivers.” But the records indicate Hegmann and Richards were part of a public-private initiative backed by some state senators to find ways to expedite the screening of Utahns for COVID-19 and refer them to treatment; Hegmann is president of a company that was helping develop an online screening tool. (The \u003ca href=\"https://www.deseret.com/utah/2020/5/5/21248656/utah-coronavirus-covid-health-department-malaria-drugs-chloroquine-hydroxychloroquine\" target=\"_blank\" rel=\"noopener noreferrer\">Deseret News\u003c/a> and \u003ca href=\"https://www.sltrib.com/news/2020/05/13/start-team-utah-execs/\" target=\"_blank\" rel=\"noopener noreferrer\">Salt Lake Tribune\u003c/a> separately obtained the records and reported on some of their contents earlier this month.)\u003c/p>\n\u003cp>“We are not a state-appointed, organized task force,” \u003ca href=\"https://www.deseret.com/utah/2020/3/23/21191657/coronavirus-covid-19-hydroxychloroquine-chloroquine-malaria-treatment-utah\" target=\"_blank\" rel=\"noopener noreferrer\">Richards told the Deseret News\u003c/a> in March. “We are just a bunch of people who raised our hands and said something had to be done.”\u003c/p>\n\u003cp>But they quickly gained sway with the state. Hegmann, Richards, and the health department’s Miner and Babitz were soon swapping drafts and suggested edits for the standing order. A draft showed that the online screening tool would refer certain people to testing and then, if positive, to treatment with compounded hydroxychloroquine or chloroquine. The drugs, the draft said, have “the potential to help stop the spread of this virus, reduce need for hospitalization, and reduce mortality rates.”\u003c/p>\n\u003cp>The group thought it was a way to speed the drugs to patients, who wouldn’t need to consult with a physician after testing positive. By getting pharmacies to compound the medications, it wouldn’t cause a shortage of the versions used by patients with lupus and rheumatoid arthritis, they argued. The health department officials did not appear to raise questions about whether a pharmacist should be involved in crafting a policy that could benefit pharmacies, the records indicate.\u003c/p>\n\u003cp>Hegmann, Richards, and a spokesman for the state health department did not respond to emails from STAT seeking comment.\u003c/p>\n\u003cp>\u003cstrong>Trump Touts the Unproven Drug\u003c/strong>\u003c/p>\n\u003cp>Around the same time, Trump started talking up the drugs.\u003c/p>\n\u003cp>“Trump is touting chloroquine and hydroxychloroquine at [a] news conference right now,” Miner wrote to the group on March 19.\u003c/p>\n\u003cp>“That should help with community acceptance of this option,” Babitz replied. “I will say privately that I wish we had ‘trumped’ his announcement with this great plan.”\u003c/p>\n\u003cp>Trump’s support for the drugs came as they were being cheered on Fox News and among his political allies. Their arguments relied on results from small and flawed studies that weren’t designed to prove whether the drugs were effective or not. The view was that this was an emergency, and people couldn’t afford to wait for the results of randomized controlled trials, the types of studies that can show whether a drug works.\u003c/p>\n\u003cp>“What do you have to lose?” Trump said, even as federal health officials said they needed to wait on the trials results. Experts also noted that the drugs carried risks to people’s hearts.\u003c/p>\n\u003cp>Soon, Utah’s “great plan” was raising concerns with experts, too.\u003c/p>\n\u003cp>“The use of an unproven therapy in this way could be a grave mistake medically,” Andrew Pavia, the chief of pediatric infectious diseases at the University of Utah, wrote on March 22 to Miner and the lieutenant governor after finding out about the standing order.\u003c/p>\n\u003cp>He stressed that the state should wait for solid evidence before recommending the drugs, particularly to people who weren’t that sick. Hospitalized patients might be treated with hydroxychloroquine — cases where the potential benefits outweighed the risk — but patients shouldn’t take the medications at home without a physician’s oversight, Pavia said. “There is as yet no real evidence of clinical benefit for these drugs,” Pavia wrote. “Wide use of unproven therapies in outpatients and low risk patients exposes them to potential harm with little evidence of benefit.”\u003c/p>\n\u003cp>Within a few days, Gov. Gary Herbert’s office pulled the plug on the standing order, saying that there was enough capacity for people with COVID-19 to first consult with a clinician, who could decide whether or not to prescribe the medications, emails show.\u003c/p>\n\u003cp>But the state was not done with hydroxychloroquine. About a week later, a state purchasing agency — a separate agency from the health department — agreed to buy 20,000 packets of compounded chloroquine and hydroxychloroquine from Meds in Motion, Richards’ pharmacy, for $800,000.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>State officials’ support for the drugs led to confusion — and backlash.\u003c/p>\n\u003cp>The clearest example: the swift reaction to \u003ca href=\"https://utahmed.org/docs/COVID/Hydroxychloroquine%20Letter%203-27-2020.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">a March 27 email\u003c/a> from the Utah Medical Association to the state’s doctors, which said that Utah’s health department was “recommending that providers use a longstanding medication to treat COVID-19.” Listed were forms of chloroquine and hydroxychloroquine.\u003c/p>\n\u003cp>The email included suggested dosages, and added: “The state has arranged for production of compounded medication, so we do not anticipate this will cause a shortage for patients who need it for other conditions.”\u003c/p>\n\u003cp>Pavia, the infectious disease expert, fired off an email to Angela Dunn, the state epidemiologist who has been helping lead Utah’s COVID-19 response, that only said “WTF?????” Dunn quickly wrote to Babitz and Miner: “Do you know who put out these recommendations from UDOH?” In a follow up, she wrote, “As you know I disagree with this approach.”\u003c/p>\n\u003cp>It was only the beginning. “This smacks as irresponsible and even reckless,” Scott Aberegg of the University of Utah’s division of pulmonary and critical care medicine wrote to state health officials, adding there was “no credible data that support a recommendation for this drug for this indication.” He said that patients should be in monitored clinical trials if they were going to be taking the drugs.\u003c/p>\n\u003cp>Eventually, Babitz clarified. What happened, he said, was that he had supplied the association with recommended doses of the drugs should doctors want to prescribe them to treat COVID-19. It wasn’t meant to suggest that all COVID-19 patients get these drugs, he said.\u003c/p>\n\u003cp>In his explanation, Babitz spelled out a timeline of what had occurred leading up to the medical association’s email. The first bullet point: “President Trump announces to the world that chloroquine and hydroxychloroquine can combat COVID19.” He concluded: “If a healthcare provider, for whatever reason, decides s/he wishes to treat a COVID19 positive patient, our desire was to recommend the safest dosing of these medications.”\u003c/p>\n\u003cp>Miner emailed the head of the medical association asking for a corrected statement. “I admit there was much enthusiasm among some clinicians, pharmacists and political leaders locally and nationally about the prospects of using these medications to see if they would help blunt the severity of this pandemic,” he wrote. He added: “After further consideration we know we must have better scientific research before recommending them.”\u003c/p>\n\u003cp>The following day, the association sent out another email: “The UDOH has withdrawn its guidance on hydroxychloroquine from March 27. They are instead endorsing the launching of the clinical studies and urging patients to participate in the trial to get access to the investigative drugs in a controlled environment with gathering of data.”\u003c/p>\n\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">H\u003c/span>\u003c/span>ydroxychloroquine and chloroquine’s moments in the spotlight did not last very long — at the national level, and in Utah.\u003c/p>\n\u003cp>The drugs \u003ca href=\"https://www.nytimes.com/2020/04/22/business/media/virus-fox-news-hydroxychloroquine.html\" target=\"_blank\" rel=\"noopener noreferrer\">stopped getting\u003c/a> as much attention from Trump and Fox News. Observational studies found no benefits, and the FDA issued its warning about heart rhythm problems. Prescriptions tapered off — a relief to people who take them for autoimmune conditions.\u003c/p>\n\u003cp>In Utah, criticism quickly built once the state’s $800,000 purchase came to light. Some state \u003ca href=\"http://www.utahhousedemocrats.org/news/2020/4/21/house-democrats-concerned-with-state-purchasenbspof-unproven-drug-for-covid-19-patients\" target=\"_blank\" rel=\"noopener noreferrer\">lawmakers questioned\u003c/a> why taxpayer dollars were being spent on unproven drugs. On April 24, Herbert, the governor, said he did not know about the initial purchase and said the health department’s talks to buy another 200,000 treatment courses from Meds in Motion had “ceased.”\u003ca href=\"https://www.sltrib.com/news/2020/04/26/robert-gehrke-not-only/\" target=\"_blank\" rel=\"noopener noreferrer\"> The Salt Lake Tribune reported\u003c/a> the state far overpaid for the drugs compared to other formulations of hydroxychloroquine, and that the state was not experiencing any shortages.\u003c/p>\n\u003cp>“It was never more than a questionable COVID-19 treatment, and Utahns were never at risk of running out of it,” the\u003ca href=\"https://www.sltrib.com/opinion/editorial/2020/04/29/tribune-editorial-bad/\" target=\"_blank\" rel=\"noopener noreferrer\"> Tribune editorial board wrote\u003c/a> on April 29. “But that didn’t stop state officials from making a purchase that far exceeded any known need in the state. … State political leaders have given money and license to shameless promoters of baseless medical claims.”\u003c/p>\n\u003cp>That day, Herbert announced Meds in Motion refunded the state its $800,000. “A state supply of chloroquine/hydroxychloroquine is no longer prudent,” \u003ca href=\"https://governor.utah.gov/2020/04/30/governors-office-statement-on-internal-review-of-compounded-chloroquine-and-hydroxychloroquine-purchase/\" target=\"_blank\" rel=\"noopener noreferrer\">the governor’s office said\u003c/a>.\u003c/p>\n\u003cp>Herbert’s office cited “breakdowns in communication between state agencies,” but there were no ramifications. “All involved acted proactively, preemptively, and prudently during an emergency in an effort to save lives,” a statement said.\u003c/p>\n\u003cp>As for Richards, he said his goal had always been to contribute to the state’s response.\u003c/p>\n\u003cp>“We did it to help the state, and it didn’t work out,” Richards \u003ca href=\"https://kutv.com/news/coronavirus/man-who-refunded-utah-800k-for-malaria-drug-i-got-left-holding-the-bag\" target=\"_blank\" rel=\"noopener noreferrer\">told KUTV\u003c/a>. “And we move on.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2020/05/18/utah-hydroxychloroquine-scramble-course-correct/?utm_source=STAT+Newsletters&utm_campaign=62e8419eda-Daily_Recap&utm_medium=email&utm_term=0_8cab1d7961-62e8419eda-149648249\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Health officials are concerned that as California and the Bay Area begin to loosen shelter-at-home rules, there could be a rising number of COVID-19 outbreaks at nursing homes and assisted living facilities.\u003c/p>\n\u003cp>These long-term care homes have become ground zero in the coronavirus crisis: state data show more than 1,400 people have died of COVID-19 in facilities licensed by the California Department of Public Health and the California Department of Social Services. And state public health officials acknowledge that those totals are likely an undercount.\u003c/p>\n\u003cp>\u003ca href=\"#callout\">Click here if you know someone in a nursing home or assisted facility … share your story!\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">KQED’s Ted Goldberg interviewed Science reporter Molly Peterson about the problem. These excerpts have been edited for length and clarity. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Which Bay Area Counties Have Had Serious COVID-19 Outbreaks? \u003c/b>\u003c/p>\n\u003cp>In San Francisco, there was a lot of attention on an early outbreak at Laguna Honda. But other facilities since then, including Central Gardens, have had many more cases.\u003c/p>\n\u003cp>Alameda County had a lot of high-profile nursing home outbreaks, including at Gateway Care and Rehab Center. That’s where the district attorney for Alameda County is investigating at least 13 deaths.\u003c/p>\n\u003cp>There are also problems at assisted living facilities; these are places that aren’t meant to provide health care services, the way that nursing homes do. At one facility in Contra Costa County called The Chateau, there were 74 cases of COVID-19. Meanwhile, in less populated San Mateo County, assisted living facilities have 75 percent more cases of COVID-19 than in Contra Costa.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It’s hard to compile accurate information, in part because the county health department in Santa Clara is the only one in the Bay Area that regularly is sharing data about long-term care outbreaks. Santa Clara had a peak of bad outbreaks in late April and early May; it’s declined since then.\u003c/p>\n\u003cp>\u003cb>Why Does the Virus Spread So Easily in Long-term Care Homes?\u003c/b>\u003c/p>\n\u003cp>There’s more touching, there’s more interaction between nurses and patients at a skilled nursing facility because people are there for medical reasons and they’re more fragile.\u003c/p>\n\u003cp>People who are infected but have no symptoms can spread the coronavirus. And public health officials are concerned about transmission among the staff, especially where workers are taking public transit, or where they may be moving among two or three jobs at different facilities.\u003c/p>\n\u003cp>The concern with loosening the stay-at-home orders is that, with more people out in the world, these workers who are traveling on public transit will then be exposed to a higher level of risk.\u003c/p>\n\u003cp>\u003cb>Who’s In Charge of Assisted Living and Nursing Homes? \u003c/b>\u003c/p>\n\u003cp>Both the California Department of Public Health and the Centers for Medicare and Medicaid Services oversee skilled nursing facilities. Assisted living facilities are not considered health care facilities; the Department of Social Services oversees those.\u003c/p>\n\u003cp>Since skilled nursing facilities are more like hospitals, they have more regulations to follow, and can be written up if they don’t comply. In assisted living facilities, there are very few consequences if staff don’t meet the guidelines. For both facilities, counties don’t play a role in overseeing them.\u003c/p>\n\u003cp>\u003cb>How Did Regulators Prepare for the Pandemic? \u003c/b>\u003c/p>\n\u003cp>At the beginning of this crisis, there was a huge concern among regulators that there would be staff absences and that staff themselves would obviously get sick. So there have been some waivers aimed at making it easier for facilities to hire more staff; regulators waived some training requirements and loosened up some background checks.\u003c/p>\n\u003cp>Right now, nobody’s getting in trouble for things that usually would be deficiencies or violations of standards. The goal, regulators say, is to talk to the facilities that they are not physically visiting. Remember, right now regulators and inspectors are not generally going to these facilities, nor are the local advocates from the ombudsman’s office.\u003c/p>\n\u003cp>\u003cb>Why Isn’t Everyone in Long-Term Care Homes Tested, Regardless of Symptoms?\u003c/b>\u003c/p>\n\u003cp>San Francisco mandates testing. That’s just getting off the ground. Alameda County is recommending testing for workers and patients, whether they have symptoms or not.\u003c/p>\n\u003cp>There are two reasons testing isn’t mandatory. One, widespread testing has not been possible for a long time. And two, as Erica Pan, Alameda County’s acting health officer, told me, you want to make sure the tests are useful if you’re going to put people through that. In other words, they want to know there’s a concrete action they can take in response to a positive test. For example, they could recommend workers stay home if they’re positive or you can put COVID-19 patients together and move them away from negative ones.\u003c/p>\n\u003cp>Last, who pays for the testing? Counties have paid for some of it. County health officers say they try to get care homes to pay for their own tests. Industry associations are advocating for more federal aid and more publicly funded tests.\u003c/p>\n\u003cp> \u003c/p>\n\u003ch3>Help KQED Science report on the pandemic!\u003c/h3>\n\u003cp>[hearken src=\"https://modules.wearehearken.com/kqed/embed/5489.js\"]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Health officials are concerned that as California and the Bay Area begin to loosen shelter-at-home rules, there could be a rising number of COVID-19 outbreaks at nursing homes and assisted living facilities.\u003c/p>\n\u003cp>These long-term care homes have become ground zero in the coronavirus crisis: state data show more than 1,400 people have died of COVID-19 in facilities licensed by the California Department of Public Health and the California Department of Social Services. And state public health officials acknowledge that those totals are likely an undercount.\u003c/p>\n\u003cp>\u003ca href=\"#callout\">Click here if you know someone in a nursing home or assisted facility … share your story!\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">KQED’s Ted Goldberg interviewed Science reporter Molly Peterson about the problem. These excerpts have been edited for length and clarity. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Which Bay Area Counties Have Had Serious COVID-19 Outbreaks? \u003c/b>\u003c/p>\n\u003cp>In San Francisco, there was a lot of attention on an early outbreak at Laguna Honda. But other facilities since then, including Central Gardens, have had many more cases.\u003c/p>\n\u003cp>Alameda County had a lot of high-profile nursing home outbreaks, including at Gateway Care and Rehab Center. That’s where the district attorney for Alameda County is investigating at least 13 deaths.\u003c/p>\n\u003cp>There are also problems at assisted living facilities; these are places that aren’t meant to provide health care services, the way that nursing homes do. At one facility in Contra Costa County called The Chateau, there were 74 cases of COVID-19. Meanwhile, in less populated San Mateo County, assisted living facilities have 75 percent more cases of COVID-19 than in Contra Costa.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It’s hard to compile accurate information, in part because the county health department in Santa Clara is the only one in the Bay Area that regularly is sharing data about long-term care outbreaks. Santa Clara had a peak of bad outbreaks in late April and early May; it’s declined since then.\u003c/p>\n\u003cp>\u003cb>Why Does the Virus Spread So Easily in Long-term Care Homes?\u003c/b>\u003c/p>\n\u003cp>There’s more touching, there’s more interaction between nurses and patients at a skilled nursing facility because people are there for medical reasons and they’re more fragile.\u003c/p>\n\u003cp>People who are infected but have no symptoms can spread the coronavirus. And public health officials are concerned about transmission among the staff, especially where workers are taking public transit, or where they may be moving among two or three jobs at different facilities.\u003c/p>\n\u003cp>The concern with loosening the stay-at-home orders is that, with more people out in the world, these workers who are traveling on public transit will then be exposed to a higher level of risk.\u003c/p>\n\u003cp>\u003cb>Who’s In Charge of Assisted Living and Nursing Homes? \u003c/b>\u003c/p>\n\u003cp>Both the California Department of Public Health and the Centers for Medicare and Medicaid Services oversee skilled nursing facilities. Assisted living facilities are not considered health care facilities; the Department of Social Services oversees those.\u003c/p>\n\u003cp>Since skilled nursing facilities are more like hospitals, they have more regulations to follow, and can be written up if they don’t comply. In assisted living facilities, there are very few consequences if staff don’t meet the guidelines. For both facilities, counties don’t play a role in overseeing them.\u003c/p>\n\u003cp>\u003cb>How Did Regulators Prepare for the Pandemic? \u003c/b>\u003c/p>\n\u003cp>At the beginning of this crisis, there was a huge concern among regulators that there would be staff absences and that staff themselves would obviously get sick. So there have been some waivers aimed at making it easier for facilities to hire more staff; regulators waived some training requirements and loosened up some background checks.\u003c/p>\n\u003cp>Right now, nobody’s getting in trouble for things that usually would be deficiencies or violations of standards. The goal, regulators say, is to talk to the facilities that they are not physically visiting. Remember, right now regulators and inspectors are not generally going to these facilities, nor are the local advocates from the ombudsman’s office.\u003c/p>\n\u003cp>\u003cb>Why Isn’t Everyone in Long-Term Care Homes Tested, Regardless of Symptoms?\u003c/b>\u003c/p>\n\u003cp>San Francisco mandates testing. That’s just getting off the ground. Alameda County is recommending testing for workers and patients, whether they have symptoms or not.\u003c/p>\n\u003cp>There are two reasons testing isn’t mandatory. One, widespread testing has not been possible for a long time. And two, as Erica Pan, Alameda County’s acting health officer, told me, you want to make sure the tests are useful if you’re going to put people through that. In other words, they want to know there’s a concrete action they can take in response to a positive test. For example, they could recommend workers stay home if they’re positive or you can put COVID-19 patients together and move them away from negative ones.\u003c/p>\n\u003cp>Last, who pays for the testing? Counties have paid for some of it. County health officers say they try to get care homes to pay for their own tests. Industry associations are advocating for more federal aid and more publicly funded tests.\u003c/p>\n\u003cp> \u003c/p>\n\u003ch3>Help KQED Science report on the pandemic!\u003c/h3>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>A candidate vaccine for COVID-19 developed by the drugmaker Moderna appears to generate an immune response similar to the response seen in people who have been infected by the virus and recovered, the company said Monday.\u003c/p>\n\u003cp>In a Phase 1 trial, eight patients who received two doses of the vaccine at the lowest and middle doses tested — 25 and 100 micrograms — developed neutralizing antibodies to the virus at levels similar to people who had recovered from infection, the company said in a statement.\u003c/p>\n\u003cp>The data were limited and from only a small number of participants in the trial, led by the National Institute of Allergy and Infectious Diseases. But they are still likely to be seen as encouraging. 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One of the people in the 100-microgram arm developed redness at the injection site that met the criteria for a \u003ca href=\"https://www.fda.gov/media/84954/download\" target=\"_blank\" rel=\"noopener noreferrer\">Grade 3\u003c/a> adverse event. And three volunteers in the highest dose arm — 250 micrograms — developed Grade 3 systemic reactions after receiving the second of two doses. There were no Grade 4 or life-threatening adverse events recorded in the trial.\u003c/p>\n\u003cp>The early readout included arms of the trial involving people age 18 to 55 years old who received either two doses at the 25 microgram or 100 microgram level or one dose at 250 microgram. 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"content": "\u003cp>Last week, Gov. Gavin Newsom announced the easing of California’s unprecedented order confining most people to their homes and shutting down all but essential businesses. Now, across much of California, lower-risk manufacturers and retailers such as bookstores, flower shops, and clothing stores are beginning to reopen, while other businesses like restaurants, malls and salons remain closed, awaiting state approval for the next round.\u003c/p>\n\u003cp>In the Bay Area, six counties — Alameda, Contra Costa, Marin, San Francisco, San Mateo and Santa Clara \u003ci>—\u003c/i> as well as the city of Berkeley, remain under a stricter \u003ca href=\"https://www.kqed.org/news/11816872/while-some-california-covid-19-restrictions-ease-most-bay-area-officials-hold-back\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">regional stay-at-home order\u003c/span>\u003c/a>, while public health officials further build testing and hospital capacity. (San Francisco and Marin are expected to loosen their orders starting May 18 by allowing curbside pickup at retail stores.)\u003c/p>\n\u003cp>County health officials have outlined five “indicators” of progress they are aiming for as they determine when to allow society to reopen further. These include benchmarks for testing, contact tracing and reserves of protective equipment like masks, face shields, gloves and gowns.\u003c/p>\n\u003cp>The Bay Area appears to currently be meeting at least two of the key metrics, one of which calls for the number of new coronavirus cases to flatten or decrease, the other which sets a target of stable or decreasing COVID-19 hospitilizations for 14 consecutive days. COVID-19 is the illness caused by the coronavirus.\u003c/p>\n\u003cp>Here are the number of patients being treated for COVID-19 in Bay Area hospitals from April 24 through May 7. Use the drop-down menu to see the numbers for each Bay Area county.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/CoYe8/15/\" height=\"400\" width=\"100%\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>Here are the newly identified coronavirus cases from April 30 through May 10. Again, use the drop-down menu to see the numbers for each Bay Area county.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/GqdBB/11/\" height=\"400\" width=\"100%\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>On Monday, Grant Colfax, director of the San Francisco Department of Public Health, called out hospitalizations as critical in deciding whether to allow some businesses to reopen on Monday, May 18.\u003c/p>\n\u003cp>“We will be keeping a close eye on the data,” he said. “Specifically, we will be looking at hospitalizations of COVID-positive patients as our metric of whether to move forward with expanded curbside pickup and takeout next week. This is a key metric.”\u003c/p>\n\u003cp>He said hospitalizations for COVID-19 in the city have been flat, in the 70-94 range.\u003c/p>\n\u003cp>“If we can keep within the range for the next week, we anticipate allowing the next group of businesses to reopen,” he said. “If we have a sustained increase in hospitalizations, we will evaluate where the new cases are coming from and shift our focus there.”\u003c/p>\n\u003cp>A spike in the number of people entering the hospital system would indicate that the virus gained strength two weeks prior, and that people who are sick with COVID-19 are requiring intensive care.\u003c/p>\n\u003cp>To see updated case counts for all California counties, check out KQED’s \u003ca href=\"https://www.kqed.org/news/11809760/how-many-california-coronavirus-cases-see-latest-numbers-by-county\" target=\"_blank\" rel=\"noopener noreferrer\">California COVID-19 tracker\u003c/a>.\u003c/p>\n\u003cdiv>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://laist.com/projects/2020/coronavirus-tracker/app/california/index.html\" width=\"1000\" height=\"2300\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Last week, Gov. Gavin Newsom announced the easing of California’s unprecedented order confining most people to their homes and shutting down all but essential businesses. Now, across much of California, lower-risk manufacturers and retailers such as bookstores, flower shops, and clothing stores are beginning to reopen, while other businesses like restaurants, malls and salons remain closed, awaiting state approval for the next round.\u003c/p>\n\u003cp>In the Bay Area, six counties — Alameda, Contra Costa, Marin, San Francisco, San Mateo and Santa Clara \u003ci>—\u003c/i> as well as the city of Berkeley, remain under a stricter \u003ca href=\"https://www.kqed.org/news/11816872/while-some-california-covid-19-restrictions-ease-most-bay-area-officials-hold-back\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">regional stay-at-home order\u003c/span>\u003c/a>, while public health officials further build testing and hospital capacity. (San Francisco and Marin are expected to loosen their orders starting May 18 by allowing curbside pickup at retail stores.)\u003c/p>\n\u003cp>County health officials have outlined five “indicators” of progress they are aiming for as they determine when to allow society to reopen further. These include benchmarks for testing, contact tracing and reserves of protective equipment like masks, face shields, gloves and gowns.\u003c/p>\n\u003cp>The Bay Area appears to currently be meeting at least two of the key metrics, one of which calls for the number of new coronavirus cases to flatten or decrease, the other which sets a target of stable or decreasing COVID-19 hospitilizations for 14 consecutive days. COVID-19 is the illness caused by the coronavirus.\u003c/p>\n\u003cp>Here are the number of patients being treated for COVID-19 in Bay Area hospitals from April 24 through May 7. Use the drop-down menu to see the numbers for each Bay Area county.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/CoYe8/15/\" height=\"400\" width=\"100%\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>Here are the newly identified coronavirus cases from April 30 through May 10. Again, use the drop-down menu to see the numbers for each Bay Area county.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/GqdBB/11/\" height=\"400\" width=\"100%\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>On Monday, Grant Colfax, director of the San Francisco Department of Public Health, called out hospitalizations as critical in deciding whether to allow some businesses to reopen on Monday, May 18.\u003c/p>\n\u003cp>“We will be keeping a close eye on the data,” he said. “Specifically, we will be looking at hospitalizations of COVID-positive patients as our metric of whether to move forward with expanded curbside pickup and takeout next week. This is a key metric.”\u003c/p>\n\u003cp>He said hospitalizations for COVID-19 in the city have been flat, in the 70-94 range.\u003c/p>\n\u003cp>“If we can keep within the range for the next week, we anticipate allowing the next group of businesses to reopen,” he said. “If we have a sustained increase in hospitalizations, we will evaluate where the new cases are coming from and shift our focus there.”\u003c/p>\n\u003cp>A spike in the number of people entering the hospital system would indicate that the virus gained strength two weeks prior, and that people who are sick with COVID-19 are requiring intensive care.\u003c/p>\n\u003cp>To see updated case counts for all California counties, check out KQED’s \u003ca href=\"https://www.kqed.org/news/11809760/how-many-california-coronavirus-cases-see-latest-numbers-by-county\" target=\"_blank\" rel=\"noopener noreferrer\">California COVID-19 tracker\u003c/a>.\u003c/p>\n\u003cdiv>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://laist.com/projects/2020/coronavirus-tracker/app/california/index.html\" width=\"1000\" height=\"2300\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "'First My Sister, Then Her Husband, Then My Niece': Latinos Hit Hard by COVID-19",
"headTitle": "‘First My Sister, Then Her Husband, Then My Niece’: Latinos Hit Hard by COVID-19 | KQED",
"content": "\u003cp>\u003ca href=\"https://www.kqed.org/science/1964618/primero-mi-hermana-luego-su-esposo-luego-mi-sobrina-la-comunidad-latina-es-la-mas-afectada-por-covid-19\" rel=\"noopener noreferrer\" target=\"_blank\">\u003cstrong>Leer en español\u003c/strong>\u003c/a>\u003c/p>\n\u003cp class=\"p1\">As the coronavirus pandemic spreads, it’s exposing class and racial inequities across the U.S.\u003c/p>\n\u003cp class=\"p1\">In California, the virus is hitting Latinos disproportionately hard. The group makes up 39% of the state’s population but 51% of confirmed \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Race-Ethnicity.aspx\">cases\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">The skewed numbers are even greater in the Bay Area. In San Francisco, Latinos are about \u003ca href=\"https://data.census.gov/cedsci/table?q=San%20Francisco%20County%20%20DP05&g=0500000US06085&tid=ACSDP5Y2018.DP05\">\u003cspan class=\"s1\">15% of the population\u003c/span>\u003c/a> but \u003ca href=\"https://data.sfgov.org/stories/s/w6za-6st8\">\u003cspan class=\"s1\">40% of confirmed COVID-19 cases\u003c/span>\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">Doctors and volunteers recently \u003ca href=\"https://www.ucsf.edu/news/2020/05/417356/initial-results-mission-district-covid-19-testing-announced\">\u003cspan class=\"s1\">tested\u003c/span>\u003c/a> nearly 3,000 people in San Francisco’s dense Mission District for the coronavirus. Three- quarters of the positive cases were men, and 95% were Latino\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">“Zero were white,” says Jon Jacobo, \u003cspan style=\"font-weight: 400;\">chair of the Latino Task Force on COVID-19, a volunteer-run effort operating in conjunction with UCSF\u003c/span>. “Ninety percent of those tested positive said that they did not have the ability to work from home.”\u003c/p>\n\u003cp class=\"p1\">More than half of the positive cases in the Mission were asymptomatic, which means as many as 1 in 50 people living and working in the Mission could be unknowingly spreading the illness to co-workers and family members. \u003cb>\u003c/b>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/XELmo/6/\" height=\"420\" width=\"100%\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp class=\"p1\">\u003cb>Can’t Afford to Shelter In Place\u003c/b>\u003c/p>\n\u003cp class=\"p1\">Two months ago Socorro Diaz stopped cleaning houses in Santa Rosa. She has adhered to the stay-at-home order religiously. But the 39-year-old mother of three can’t afford to shelter any longer.\u003c/p>\n\u003cp class=\"p1\">“I honestly don’t want to work,” said Diaz. “I’m scared to catch the virus. But the bills are piling up. I have to go back to work.”\u003c/p>\n\u003cp class=\"p1\">Each time Diaz leaves the house she’s haunted by what happened to her extended family in Santa Clara County, where the virus spread quickly in a cramped apartment.\u003c/p>\n\u003cp class=\"p1\">A few days after her sister came home from work at an electronics factory, where mask supplies ran short, family members started coughing.\u003c/p>\n\u003cp class=\"p1\">“First my sister, then her husband, then my niece, her husband, her daughter,” says Diaz. “Eventually the whole family.”\u003c/p>\n\u003cp class=\"p1\">All eight family members soon lay in bed with fever, chills and body aches. COVID-19 struck Diaz’s older brother the hardest. Doctors connected him to a ventilator two weeks ago, and they expect he will be in the intensive care unit for at least another two weeks.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/n4jj3/5/\" height=\"275\" width=\"100%\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Underlying Health Conditions\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">At San Francisco General Hospital, more than \u003ca href=\"https://sfmayor.org/article/san-francisco-releases-map-coronavirus-impact-zip-code\" target=\"_blank\" rel=\"noopener noreferrer\">80%\u003c/a> of hospitalized coronavirus patients are Latino, who usually make up only about 30% of the patient population in total.\u003c/p>\n\u003cp class=\"p3\">“I think we’re looking primarily at a situation of high-density living conditions and people unfortunately having to be at some higher risk due to jobs, having to move outside the home and having a harder time distancing from others,” says Vivek Jain, an infectious disease specialist at the hospital.\u003c/p>\n\u003cp class=\"p1\">He says many of his Latino patients struggle with underlying health conditions like obesity, asthma, hypertension and diabetes, all of which are risk factors for COVID-19.\u003c/p>\n\u003cp class=\"p1\">Adriana Villatoro Ortez struggles with both asthma and diabetes. During the lockdown, she didn’t venture out of the house except to go to the grocery store. Last month, a few days after shopping for food in San Francisco’s Outer Sunset neighborhood, she started to feel sick. The 62-year-old fought nausea, body aches and a burning pain in her ribs for three days before she eventually rushed to the hospital with a high fever. X-rays and a CT scan revealed inflammation in her lungs and back.\u003c/p>\n\u003cp class=\"p1\">“They gave me a slew of medication,” Ortez said. “Something to regulate my blood pressure, to settle my stomach and something to reduce pain.”\u003c/p>\n\u003cp class=\"p1\">She says overwhelming nausea prevented her from eating or drinking. On the fourth day in the hospital she received a positive COVID-19 test. That same day her blood oxygen levels dropped.\u003c/p>\n\u003cp class=\"p1\">“I thought the virus was going to progress, and I might not make it,” Ortez said.\u003c/p>\n\u003cp class=\"p1\">After nine painful days in the hospital, doctors released her. She’s now slowly recovering at home. Ortez says her stomach still burns from taking numerous medications.\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Lacking Data\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">In Santa Clara County, Latinos account for about \u003ca href=\"https://data.census.gov/cedsci/table?q=Santa%20Clara%20County%20%20DP05&g=0500000US06085&tid=ACSDP5Y2018.DP05\">\u003cspan class=\"s1\">26% of the population\u003c/span>\u003c/a>, and \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx\">\u003cspan class=\"s1\">38% of confirmed cases.\u003c/span>\u003c/a> In Alameda County, it’s \u003ca href=\"https://data.census.gov/cedsci/table?q=Alameda%20County&g=0500000US06001&tid=ACSDP1Y2018.DP05\">\u003cspan class=\"s1\">22.5% of the population\u003c/span>\u003c/a> and \u003ca href=\"https://ac-hcsa.maps.arcgis.com/apps/opsdashboard/index.html#/1e0ac4385cbe4cc1bffe2cf7f8e7f0d9\">\u003cspan class=\"s1\">38% of cases.\u003c/span>\u003c/a> Along with San Francisco, these three counties have some of the highest numbers and rates of confirmed COVID-19 cases in the Bay Area.\u003c/p>\n\u003cp class=\"p1\">Many health departments in California are not reporting racial demographic information. And when there is data, there are often a lot of unknowns. In San Francisco, Alameda and Santa Clara counties, the ethnicity is unknown for 16% to 20% of coronavirus cases.\u003c/p>\n\u003cp class=\"p3\">“We need a lot more data than we’re getting,” said Dr. Richard Besser, former acting director of the Centers for Disease Control and Prevention, and the director of the Robert Wood Johnson Foundation. “And we need to ensure that in every community we’re not just getting total number of cases, and total number of hospitalizations and deaths, but we’re getting data that’s broken down by race, ethnicity, gender and disability.”\u003c/p>\n\u003cp class=\"p1\">Besser says accurate numbers are necessary for draft policies that protect the most vulnerable populations. He’s urging public officials to ensure protocols are in place like Spanish health messages, masks for returning workers, and diversity among decision-makers.\u003c/p>\n\u003cp class=\"p1\">“My biggest fear is that as we open up the economy, the same groups that have been devastated by this so far are going to continue to be plagued,” stresses Besser. “In America today, your income and the color of your skin are determining how you do in this epidemic and that just shouldn’t be.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/science/1964618/primero-mi-hermana-luego-su-esposo-luego-mi-sobrina-la-comunidad-latina-es-la-mas-afectada-por-covid-19\" rel=\"noopener noreferrer\" target=\"_blank\">\u003cstrong>Leer en español\u003c/strong>\u003c/a>\u003c/p>\n\u003cp class=\"p1\">As the coronavirus pandemic spreads, it’s exposing class and racial inequities across the U.S.\u003c/p>\n\u003cp class=\"p1\">In California, the virus is hitting Latinos disproportionately hard. The group makes up 39% of the state’s population but 51% of confirmed \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Race-Ethnicity.aspx\">cases\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">The skewed numbers are even greater in the Bay Area. In San Francisco, Latinos are about \u003ca href=\"https://data.census.gov/cedsci/table?q=San%20Francisco%20County%20%20DP05&g=0500000US06085&tid=ACSDP5Y2018.DP05\">\u003cspan class=\"s1\">15% of the population\u003c/span>\u003c/a> but \u003ca href=\"https://data.sfgov.org/stories/s/w6za-6st8\">\u003cspan class=\"s1\">40% of confirmed COVID-19 cases\u003c/span>\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">Doctors and volunteers recently \u003ca href=\"https://www.ucsf.edu/news/2020/05/417356/initial-results-mission-district-covid-19-testing-announced\">\u003cspan class=\"s1\">tested\u003c/span>\u003c/a> nearly 3,000 people in San Francisco’s dense Mission District for the coronavirus. Three- quarters of the positive cases were men, and 95% were Latino\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">“Zero were white,” says Jon Jacobo, \u003cspan style=\"font-weight: 400;\">chair of the Latino Task Force on COVID-19, a volunteer-run effort operating in conjunction with UCSF\u003c/span>. “Ninety percent of those tested positive said that they did not have the ability to work from home.”\u003c/p>\n\u003cp class=\"p1\">More than half of the positive cases in the Mission were asymptomatic, which means as many as 1 in 50 people living and working in the Mission could be unknowingly spreading the illness to co-workers and family members. \u003cb>\u003c/b>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/XELmo/6/\" height=\"420\" width=\"100%\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp class=\"p1\">\u003cb>Can’t Afford to Shelter In Place\u003c/b>\u003c/p>\n\u003cp class=\"p1\">Two months ago Socorro Diaz stopped cleaning houses in Santa Rosa. She has adhered to the stay-at-home order religiously. But the 39-year-old mother of three can’t afford to shelter any longer.\u003c/p>\n\u003cp class=\"p1\">“I honestly don’t want to work,” said Diaz. “I’m scared to catch the virus. But the bills are piling up. I have to go back to work.”\u003c/p>\n\u003cp class=\"p1\">Each time Diaz leaves the house she’s haunted by what happened to her extended family in Santa Clara County, where the virus spread quickly in a cramped apartment.\u003c/p>\n\u003cp class=\"p1\">A few days after her sister came home from work at an electronics factory, where mask supplies ran short, family members started coughing.\u003c/p>\n\u003cp class=\"p1\">“First my sister, then her husband, then my niece, her husband, her daughter,” says Diaz. “Eventually the whole family.”\u003c/p>\n\u003cp class=\"p1\">All eight family members soon lay in bed with fever, chills and body aches. COVID-19 struck Diaz’s older brother the hardest. Doctors connected him to a ventilator two weeks ago, and they expect he will be in the intensive care unit for at least another two weeks.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/n4jj3/5/\" height=\"275\" width=\"100%\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Underlying Health Conditions\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">At San Francisco General Hospital, more than \u003ca href=\"https://sfmayor.org/article/san-francisco-releases-map-coronavirus-impact-zip-code\" target=\"_blank\" rel=\"noopener noreferrer\">80%\u003c/a> of hospitalized coronavirus patients are Latino, who usually make up only about 30% of the patient population in total.\u003c/p>\n\u003cp class=\"p3\">“I think we’re looking primarily at a situation of high-density living conditions and people unfortunately having to be at some higher risk due to jobs, having to move outside the home and having a harder time distancing from others,” says Vivek Jain, an infectious disease specialist at the hospital.\u003c/p>\n\u003cp class=\"p1\">He says many of his Latino patients struggle with underlying health conditions like obesity, asthma, hypertension and diabetes, all of which are risk factors for COVID-19.\u003c/p>\n\u003cp class=\"p1\">Adriana Villatoro Ortez struggles with both asthma and diabetes. During the lockdown, she didn’t venture out of the house except to go to the grocery store. Last month, a few days after shopping for food in San Francisco’s Outer Sunset neighborhood, she started to feel sick. The 62-year-old fought nausea, body aches and a burning pain in her ribs for three days before she eventually rushed to the hospital with a high fever. X-rays and a CT scan revealed inflammation in her lungs and back.\u003c/p>\n\u003cp class=\"p1\">“They gave me a slew of medication,” Ortez said. “Something to regulate my blood pressure, to settle my stomach and something to reduce pain.”\u003c/p>\n\u003cp class=\"p1\">She says overwhelming nausea prevented her from eating or drinking. On the fourth day in the hospital she received a positive COVID-19 test. That same day her blood oxygen levels dropped.\u003c/p>\n\u003cp class=\"p1\">“I thought the virus was going to progress, and I might not make it,” Ortez said.\u003c/p>\n\u003cp class=\"p1\">After nine painful days in the hospital, doctors released her. She’s now slowly recovering at home. Ortez says her stomach still burns from taking numerous medications.\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Lacking Data\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">In Santa Clara County, Latinos account for about \u003ca href=\"https://data.census.gov/cedsci/table?q=Santa%20Clara%20County%20%20DP05&g=0500000US06085&tid=ACSDP5Y2018.DP05\">\u003cspan class=\"s1\">26% of the population\u003c/span>\u003c/a>, and \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx\">\u003cspan class=\"s1\">38% of confirmed cases.\u003c/span>\u003c/a> In Alameda County, it’s \u003ca href=\"https://data.census.gov/cedsci/table?q=Alameda%20County&g=0500000US06001&tid=ACSDP1Y2018.DP05\">\u003cspan class=\"s1\">22.5% of the population\u003c/span>\u003c/a> and \u003ca href=\"https://ac-hcsa.maps.arcgis.com/apps/opsdashboard/index.html#/1e0ac4385cbe4cc1bffe2cf7f8e7f0d9\">\u003cspan class=\"s1\">38% of cases.\u003c/span>\u003c/a> Along with San Francisco, these three counties have some of the highest numbers and rates of confirmed COVID-19 cases in the Bay Area.\u003c/p>\n\u003cp class=\"p1\">Many health departments in California are not reporting racial demographic information. And when there is data, there are often a lot of unknowns. In San Francisco, Alameda and Santa Clara counties, the ethnicity is unknown for 16% to 20% of coronavirus cases.\u003c/p>\n\u003cp class=\"p3\">“We need a lot more data than we’re getting,” said Dr. Richard Besser, former acting director of the Centers for Disease Control and Prevention, and the director of the Robert Wood Johnson Foundation. “And we need to ensure that in every community we’re not just getting total number of cases, and total number of hospitalizations and deaths, but we’re getting data that’s broken down by race, ethnicity, gender and disability.”\u003c/p>\n\u003cp class=\"p1\">Besser says accurate numbers are necessary for draft policies that protect the most vulnerable populations. He’s urging public officials to ensure protocols are in place like Spanish health messages, masks for returning workers, and diversity among decision-makers.\u003c/p>\n\u003cp class=\"p1\">“My biggest fear is that as we open up the economy, the same groups that have been devastated by this so far are going to continue to be plagued,” stresses Besser. “In America today, your income and the color of your skin are determining how you do in this epidemic and that just shouldn’t be.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "COVID-19 Testing Supply Shortages Have Been Resolved, Bay Area Health Officers Say",
"headTitle": "COVID-19 Testing Supply Shortages Have Been Resolved, Bay Area Health Officers Say | KQED",
"content": "\u003cp>With the state of California beginning to loosen restrictions put in place to stop the spread of the coronavirus, six Bay Area counties have adhered to their own relatively stricter stay-at-home order. The counties are monitoring a specific set of \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/bay-area-health-officer-indicator.aspx?mc_cid=634de84af2&mc_eid=e3e8054959\" target=\"_blank\" rel=\"noopener noreferrer\">metrics\u003c/a> they say will inform the timing of allowing more businesses to open up.\u003c/p>\n\u003cp>Among the key benchmarks health officials are aiming for is widespread testing for the coronavirus that causes COVID-19. The counties say they want to do 200 tests a day per every 100,000 residents.\u003c/p>\n\u003cp>As testing is ramped up in order to meet the goal, some Bay Area health officials say problems with the supply chain that have notoriously limited testing capacity not only in the Bay Area, but around the country, have been largely resolved.\u003c/p>\n\u003cp>This has allowed a number of counties to announce new testing sites in the past week and expand the number of people who qualify for tests. Contra Costa County, for example, has now \u003ca href=\"https://cchealth.org/press-releases/2020/0507-COVID-19-Testing-for-all-County-Residents.php\" target=\"_blank\" rel=\"noopener noreferrer\">opened testing\u003c/a> to all county residents.\u003c/p>\n\u003cp>Last week we asked three Bay Area health officers about the COVID-19 testing supply chain and the status of testing in their jurisdictions. Here’s what they said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Dr. Matt Willis, Marin County Public Health Officer:\u003c/strong>\u003c/p>\n\u003cp>Willis says the county has had to overcome several testing supply chain barriers since the start of the pandemic.\u003c/p>\n\u003cp>“One week it was swabs. The next week would be vials. The next week it might be the reagents,” Willis said. “Every week, we’ve had to solve for one issue or another.”\u003c/p>\n\u003cp>He says maintaining enough swabs was the biggest challenge, but that has recently changed.\u003c/p>\n\u003cp>“The supply issues have gotten a lot better just in the last couple weeks,” Willis said. “We did have a period where we had more capacity to test than we had patients to test.\u003c/p>\n\u003cp>“Now that we actually have sufficient supplies, we are fixing the next issue, which is just acquiring the staffing and building the operations to scale up. And that’s the work of the next couple of weeks.”\u003c/p>\n\u003cp>\u003cstrong>Dr. Erica Pan, Alameda County Interim Health Officer:\u003c/strong>\u003c/p>\n\u003cp>Pan says Alameda County has also seen improvement on the testing supply front.\u003c/p>\n\u003cp>“A lot of the resources, things like swabs, are getting to where they need to expand testing within the health care system,” she said. “Then we’re also setting up new test sites. So this is continuing to increase rapidly every week.”\u003c/p>\n\u003cp>Supply chain shortages have limited the number of people who could receive COVID-19 tests, but Pan says having more tests means the criteria for who qualifies for a test can be more inclusive.\u003c/p>\n\u003cp>“Because there weren’t enough testing supplies, people were trying to prioritize [those] at the highest risk for severe disease or highest risk of spreading disease or highest risk of exposure to disease,” she said. “So now that there’s more testing resources, we can offer testing to people who have clinical symptoms that we’re concerned about.”\u003c/p>\n\u003cp>Pan says Alameda County is also focused on expanding testing to reach underserved communities\u003c/p>\n\u003cp>“We certainly want to make sure we’re targeting locations where there hasn’t been much testing,” she said. “Communities where we are concerned there’s higher disease because of health inequities or socioeconomic inequities. We know we’re seeing more Latino cases in our case count. So we want to make sure we’re able to test communities of color.”\u003c/p>\n\u003cp>This week, the county announced four new testing sites to help bridge the gap.\u003c/p>\n\u003cp>\u003cstrong>Dr. Chris Farnitano, Contra Costa County Health Officer:\u003c/strong>\u003c/p>\n\u003cp>Farnitano said shortages of many of the elements required for expanded testing have been cleared up.\u003c/p>\n\u003cp>“Essentially every one of those has gotten much, much better. We have really sufficient PPE, swabs, reagents and machines to run as many tests as we’re able to.”\u003c/p>\n\u003cp>Farnitano says supplies recently increased to the point where some testing sites were seeing a surplus of unused tests.\u003c/p>\n\u003cp>“Right now, both the county and the private partners have test sites that could handle more business than they’re getting,” Farnitano said. “So that’s part of our reason we felt we could open up the testing to anyone who wants testing.”\u003c/p>\n\u003cp>Farnitano says the county health department has seen a spike in the demand for COVID-19 tests since the announcement was made last week.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Our phones are struggling to keep up with all the calls,” he said. “But we’re adding more people to the phones, and once they get through, they are able to schedule appointments the same day or the next day if they want to get a test.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>With the state of California beginning to loosen restrictions put in place to stop the spread of the coronavirus, six Bay Area counties have adhered to their own relatively stricter stay-at-home order. The counties are monitoring a specific set of \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/bay-area-health-officer-indicator.aspx?mc_cid=634de84af2&mc_eid=e3e8054959\" target=\"_blank\" rel=\"noopener noreferrer\">metrics\u003c/a> they say will inform the timing of allowing more businesses to open up.\u003c/p>\n\u003cp>Among the key benchmarks health officials are aiming for is widespread testing for the coronavirus that causes COVID-19. The counties say they want to do 200 tests a day per every 100,000 residents.\u003c/p>\n\u003cp>As testing is ramped up in order to meet the goal, some Bay Area health officials say problems with the supply chain that have notoriously limited testing capacity not only in the Bay Area, but around the country, have been largely resolved.\u003c/p>\n\u003cp>This has allowed a number of counties to announce new testing sites in the past week and expand the number of people who qualify for tests. Contra Costa County, for example, has now \u003ca href=\"https://cchealth.org/press-releases/2020/0507-COVID-19-Testing-for-all-County-Residents.php\" target=\"_blank\" rel=\"noopener noreferrer\">opened testing\u003c/a> to all county residents.\u003c/p>\n\u003cp>Last week we asked three Bay Area health officers about the COVID-19 testing supply chain and the status of testing in their jurisdictions. Here’s what they said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Dr. Matt Willis, Marin County Public Health Officer:\u003c/strong>\u003c/p>\n\u003cp>Willis says the county has had to overcome several testing supply chain barriers since the start of the pandemic.\u003c/p>\n\u003cp>“One week it was swabs. The next week would be vials. The next week it might be the reagents,” Willis said. “Every week, we’ve had to solve for one issue or another.”\u003c/p>\n\u003cp>He says maintaining enough swabs was the biggest challenge, but that has recently changed.\u003c/p>\n\u003cp>“The supply issues have gotten a lot better just in the last couple weeks,” Willis said. “We did have a period where we had more capacity to test than we had patients to test.\u003c/p>\n\u003cp>“Now that we actually have sufficient supplies, we are fixing the next issue, which is just acquiring the staffing and building the operations to scale up. And that’s the work of the next couple of weeks.”\u003c/p>\n\u003cp>\u003cstrong>Dr. Erica Pan, Alameda County Interim Health Officer:\u003c/strong>\u003c/p>\n\u003cp>Pan says Alameda County has also seen improvement on the testing supply front.\u003c/p>\n\u003cp>“A lot of the resources, things like swabs, are getting to where they need to expand testing within the health care system,” she said. “Then we’re also setting up new test sites. So this is continuing to increase rapidly every week.”\u003c/p>\n\u003cp>Supply chain shortages have limited the number of people who could receive COVID-19 tests, but Pan says having more tests means the criteria for who qualifies for a test can be more inclusive.\u003c/p>\n\u003cp>“Because there weren’t enough testing supplies, people were trying to prioritize [those] at the highest risk for severe disease or highest risk of spreading disease or highest risk of exposure to disease,” she said. “So now that there’s more testing resources, we can offer testing to people who have clinical symptoms that we’re concerned about.”\u003c/p>\n\u003cp>Pan says Alameda County is also focused on expanding testing to reach underserved communities\u003c/p>\n\u003cp>“We certainly want to make sure we’re targeting locations where there hasn’t been much testing,” she said. “Communities where we are concerned there’s higher disease because of health inequities or socioeconomic inequities. We know we’re seeing more Latino cases in our case count. So we want to make sure we’re able to test communities of color.”\u003c/p>\n\u003cp>This week, the county announced four new testing sites to help bridge the gap.\u003c/p>\n\u003cp>\u003cstrong>Dr. Chris Farnitano, Contra Costa County Health Officer:\u003c/strong>\u003c/p>\n\u003cp>Farnitano said shortages of many of the elements required for expanded testing have been cleared up.\u003c/p>\n\u003cp>“Essentially every one of those has gotten much, much better. We have really sufficient PPE, swabs, reagents and machines to run as many tests as we’re able to.”\u003c/p>\n\u003cp>Farnitano says supplies recently increased to the point where some testing sites were seeing a surplus of unused tests.\u003c/p>\n\u003cp>“Right now, both the county and the private partners have test sites that could handle more business than they’re getting,” Farnitano said. “So that’s part of our reason we felt we could open up the testing to anyone who wants testing.”\u003c/p>\n\u003cp>Farnitano says the county health department has seen a spike in the demand for COVID-19 tests since the announcement was made last week.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Our phones are struggling to keep up with all the calls,” he said. “But we’re adding more people to the phones, and once they get through, they are able to schedule appointments the same day or the next day if they want to get a test.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Big Push: Probing Virus Genomes for Clues to Contain COVID-19 Outbreaks",
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"content": "\u003cp>As California cities and counties begin a gradual loosening of restrictions on daily life, researchers around the state and nation are ramping up efforts to track the coronavirus’ evolution. Monitoring changes in its genetic code will help contain the virus on two fronts: pointing toward areas for therapeutic drugs or vaccines to target and aiding the work of disease tracers, as they work to prevent the spread of new outbreaks.\u003c/p>\n\u003cp>At the beginning of this month the Centers for Disease Control and Prevention announced the \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/spheres.html\" target=\"_blank\" rel=\"noopener noreferrer\">formation of a consortium\u003c/a> to expand sequencing of the COVID-19 virus. In California, one federal lab, five campuses in the UC system, along with several biotech companies and nonprofit laboratories are participating in the effort.\u003c/p>\n\u003cp>\u003cstrong>Expanding Early Efforts\u003c/strong>\u003c/p>\n\u003cp>The first \u003ca href=\"https://www.statnews.com/2020/01/24/dna-sleuths-read-coronavirus-genome-tracing-origins-and-mutations/\" target=\"_blank\" rel=\"noopener noreferrer\">readout of the genome\u003c/a> was released on Jan. 10 by scientists in China, just one month after the first report of pneumonia caused by an unknown virus. In the following weeks dozens — and in the following months thousands — of additional genome sequences were added. Online public repositories, such as \u003ca href=\"https://www.gisaid.org/epiflu-applications/next-hcov-19-app/\" target=\"_blank\" rel=\"noopener noreferrer\">GISAID\u003c/a>, illustrate the virus’ spread around the globe (if messily).\u003c/p>\n\u003cp>As viruses spread from person to person, they randomly accumulate mutations. Some scientists informally call these “typos,” as they reflect letters that change in the RNA sequence. Usually it starts with a single typo, but as these are passed on during viral transmission, and new typos accumulate, the virus branches into lineages.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[aside postID='science_1963899' label='The Coronavirus Is Mutating. That's Normal. Does That Mean It's More Dangerous?']\u003c/p>\n\u003cp>Genomic sequences suggest that the virus was introduced in the United States via \u003ca href=\"https://www.nytimes.com/interactive/2020/04/30/science/coronavirus-mutations.html\" target=\"_blank\" rel=\"noopener noreferrer\">multiple routes\u003c/a>. Both Washington and California had early outbreaks. But some early California cases do not share the distinctive mutations of those in Washington, and likely arrived in the U.S. separately from China. In New York City, one of the nation’s worst-hit regions, the majority of cases are \u003ca href=\"https://www.nytimes.com/2020/04/08/science/new-york-coronavirus-cases-europe-genomes.html\" target=\"_blank\" rel=\"noopener noreferrer\">most similar\u003c/a> to viruses circulating in Europe.\u003c/p>\n\u003cp>\u003cstrong>Tracking Outbreaks\u003c/strong>\u003c/p>\n\u003cp>As people relax their distancing, new outbreaks are all but assured. This nationwide sequencing effort, participants hope, will help with tracking and point toward undetected pockets of infection.\u003c/p>\n\u003cp>“A lockdown can never be perfect and there will be some pocket somewhere,” warns Peter Forster, a geneticist at University of Cambridge, who has \u003ca href=\"https://www.pnas.org/content/117/17/9241\" target=\"_blank\" rel=\"noopener noreferrer\">published\u003c/a> an analysis looking at genomes of the coronavirus in Europe and around the world.\u003c/p>\n\u003cp>As an example of how this tracing could work, imagine feeling sick and testing positive for the COVID-19 virus. You, or the public health department, alert all of your closest contacts. But to have the best chance of quashing the outbreak, health officials need to know where you got the infection. Here is where genomic sequencing can help.\u003c/p>\n\u003cp>Is your virus most similar to those circulating in New York? If so, perhaps you should tell your cousin who visited from Brooklyn that they should also quarantine for two weeks. Or does your virus have mutations most similar to those seen in Washington state? If so, it may be a different acquaintance, friend, co-worker or family member who should isolate themselves.\u003c/p>\n\u003cp>\u003cstrong>Spotting New Mutations, Guiding New Treatments\u003c/strong>\u003c/p>\n\u003cp>Stacia Wyman is a scientist participating in the CDC consortium at the Innovative Genomics Institute on the UC Berkeley campus, where they are analyzing patient samples for results. For every positive result the lab will try to sequence the genome of the virus in that patient. (In some cases, where the viral load is especially low, the genome cannot be accurately sequenced.) The information will illustrate which areas of the virus mutate quickly and which are slower to change. The slow-changing areas are ripe for attack.\u003c/p>\n\u003cp>“It is typical that in viruses or in genomes in general, even in humans, locations that have a very important function tend to evolve very slowly,” Wyman said.\u003c/p>\n\u003cp>In those certain locations, she says, if a mutation occurs it tends to cause disease or disrupt the function of the organism. (Viruses don’t quite qualify as organisms, but they do have genetic material and if they mutate in the wrong spot, they may not be able to replicate.) Those slow-changing areas are useful for scientists to identify, as they search for effective drugs or vaccines.\u003c/p>\n\u003cp>Drugs operate by taking aim at specific proteins and either interrupt the job they were going to do or mimic their effect. Proteins are the workhorses of the cell, carrying out the tasks of construction, destruction and replication. A gene codes for (in effect, writes the recipe for) a protein. If the gene sequence changes through a mutation, the shape of the resulting protein may also change. A drug targeting that protein may no longer work.\u003c/p>\n\u003cp>“And so when you have a therapy, it’s going to target a specific protein or region of a protein that’s going to target a specific locus [on the genome],” said Wyman. “And you want that to be very steady so that when you are coming up with a therapeutic, it is going to be effective for all individuals.”\u003c/p>\n\u003cp>Despite the steady accumulation of mutations in the genomes of the COVID-19 virus, initial signs are that the virus does \u003ca href=\"https://www.npr.org/2020/03/26/822107691/the-coronavirus-is-mutating-relatively-slowly-which-may-be-good-news\" target=\"_blank\" rel=\"noopener noreferrer\">not mutate too quickly\u003c/a> to be addressed by a vaccine or therapeutic drug.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That’s good news for all of us.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As California cities and counties begin a gradual loosening of restrictions on daily life, researchers around the state and nation are ramping up efforts to track the coronavirus’ evolution. Monitoring changes in its genetic code will help contain the virus on two fronts: pointing toward areas for therapeutic drugs or vaccines to target and aiding the work of disease tracers, as they work to prevent the spread of new outbreaks.\u003c/p>\n\u003cp>At the beginning of this month the Centers for Disease Control and Prevention announced the \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/spheres.html\" target=\"_blank\" rel=\"noopener noreferrer\">formation of a consortium\u003c/a> to expand sequencing of the COVID-19 virus. In California, one federal lab, five campuses in the UC system, along with several biotech companies and nonprofit laboratories are participating in the effort.\u003c/p>\n\u003cp>\u003cstrong>Expanding Early Efforts\u003c/strong>\u003c/p>\n\u003cp>The first \u003ca href=\"https://www.statnews.com/2020/01/24/dna-sleuths-read-coronavirus-genome-tracing-origins-and-mutations/\" target=\"_blank\" rel=\"noopener noreferrer\">readout of the genome\u003c/a> was released on Jan. 10 by scientists in China, just one month after the first report of pneumonia caused by an unknown virus. In the following weeks dozens — and in the following months thousands — of additional genome sequences were added. Online public repositories, such as \u003ca href=\"https://www.gisaid.org/epiflu-applications/next-hcov-19-app/\" target=\"_blank\" rel=\"noopener noreferrer\">GISAID\u003c/a>, illustrate the virus’ spread around the globe (if messily).\u003c/p>\n\u003cp>As viruses spread from person to person, they randomly accumulate mutations. Some scientists informally call these “typos,” as they reflect letters that change in the RNA sequence. Usually it starts with a single typo, but as these are passed on during viral transmission, and new typos accumulate, the virus branches into lineages.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Genomic sequences suggest that the virus was introduced in the United States via \u003ca href=\"https://www.nytimes.com/interactive/2020/04/30/science/coronavirus-mutations.html\" target=\"_blank\" rel=\"noopener noreferrer\">multiple routes\u003c/a>. Both Washington and California had early outbreaks. But some early California cases do not share the distinctive mutations of those in Washington, and likely arrived in the U.S. separately from China. In New York City, one of the nation’s worst-hit regions, the majority of cases are \u003ca href=\"https://www.nytimes.com/2020/04/08/science/new-york-coronavirus-cases-europe-genomes.html\" target=\"_blank\" rel=\"noopener noreferrer\">most similar\u003c/a> to viruses circulating in Europe.\u003c/p>\n\u003cp>\u003cstrong>Tracking Outbreaks\u003c/strong>\u003c/p>\n\u003cp>As people relax their distancing, new outbreaks are all but assured. This nationwide sequencing effort, participants hope, will help with tracking and point toward undetected pockets of infection.\u003c/p>\n\u003cp>“A lockdown can never be perfect and there will be some pocket somewhere,” warns Peter Forster, a geneticist at University of Cambridge, who has \u003ca href=\"https://www.pnas.org/content/117/17/9241\" target=\"_blank\" rel=\"noopener noreferrer\">published\u003c/a> an analysis looking at genomes of the coronavirus in Europe and around the world.\u003c/p>\n\u003cp>As an example of how this tracing could work, imagine feeling sick and testing positive for the COVID-19 virus. You, or the public health department, alert all of your closest contacts. But to have the best chance of quashing the outbreak, health officials need to know where you got the infection. Here is where genomic sequencing can help.\u003c/p>\n\u003cp>Is your virus most similar to those circulating in New York? If so, perhaps you should tell your cousin who visited from Brooklyn that they should also quarantine for two weeks. Or does your virus have mutations most similar to those seen in Washington state? If so, it may be a different acquaintance, friend, co-worker or family member who should isolate themselves.\u003c/p>\n\u003cp>\u003cstrong>Spotting New Mutations, Guiding New Treatments\u003c/strong>\u003c/p>\n\u003cp>Stacia Wyman is a scientist participating in the CDC consortium at the Innovative Genomics Institute on the UC Berkeley campus, where they are analyzing patient samples for results. For every positive result the lab will try to sequence the genome of the virus in that patient. (In some cases, where the viral load is especially low, the genome cannot be accurately sequenced.) The information will illustrate which areas of the virus mutate quickly and which are slower to change. The slow-changing areas are ripe for attack.\u003c/p>\n\u003cp>“It is typical that in viruses or in genomes in general, even in humans, locations that have a very important function tend to evolve very slowly,” Wyman said.\u003c/p>\n\u003cp>In those certain locations, she says, if a mutation occurs it tends to cause disease or disrupt the function of the organism. (Viruses don’t quite qualify as organisms, but they do have genetic material and if they mutate in the wrong spot, they may not be able to replicate.) Those slow-changing areas are useful for scientists to identify, as they search for effective drugs or vaccines.\u003c/p>\n\u003cp>Drugs operate by taking aim at specific proteins and either interrupt the job they were going to do or mimic their effect. Proteins are the workhorses of the cell, carrying out the tasks of construction, destruction and replication. A gene codes for (in effect, writes the recipe for) a protein. If the gene sequence changes through a mutation, the shape of the resulting protein may also change. A drug targeting that protein may no longer work.\u003c/p>\n\u003cp>“And so when you have a therapy, it’s going to target a specific protein or region of a protein that’s going to target a specific locus [on the genome],” said Wyman. “And you want that to be very steady so that when you are coming up with a therapeutic, it is going to be effective for all individuals.”\u003c/p>\n\u003cp>Despite the steady accumulation of mutations in the genomes of the COVID-19 virus, initial signs are that the virus does \u003ca href=\"https://www.npr.org/2020/03/26/822107691/the-coronavirus-is-mutating-relatively-slowly-which-may-be-good-news\" target=\"_blank\" rel=\"noopener noreferrer\">not mutate too quickly\u003c/a> to be addressed by a vaccine or therapeutic drug.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That’s good news for all of us.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Remdesivir: Behind the Controversial Decision to End a Pivotal Drug Study",
"headTitle": "Remdesivir: Behind the Controversial Decision to End a Pivotal Drug Study | KQED",
"content": "\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">T\u003c/span>\u003c/span>he Bay Area drug maker Gilead Sciences released a bombshell two weeks ago: A study conducted by a U.S. government agency had found that the company’s experimental drug, \u003ca href=\"https://www.statnews.com/2020/05/05/remdesivir-gilead-strategic-crossroads-reputation-far-more-at-stake/\" target=\"_blank\" rel=\"noopener noreferrer\">remdesivir\u003c/a>, was the first treatment \u003ca href=\"https://www.statnews.com/2020/04/29/gilead-says-critical-study-of-covid-19-drug-shows-patients-are-responding-to-treatment/\" target=\"_blank\" rel=\"noopener noreferrer\">shown to have even a small effect\u003c/a> against COVID-19.\u003c/p>\n\u003cp>Behind that ray of hope, though, was one of the toughest quandaries in medicine: how to balance the need to rigorously test a new medicine for safety and effectiveness with the moral imperative to get patients an effective treatment as quickly as possible. At the heart of the decision about when to end the trial was a process that was — as is often in the case in clinical trials — by turns secretive and bureaucratic.\u003c/p>\n\u003cp>The National Institute of Allergy and Infectious Diseases has described to STAT in new detail how it made its fateful decision: to start giving remdesivir to patients who had been assigned to receive a placebo in the study, essentially limiting researchers’ ability to collect more data about whether the drug saves lives — something the study, called ACTT-1, suggests but does not prove. In the trial, 8% of the participants given remdesivir died, compared with 11.6% of the placebo group, a difference that was not statistically significant.\u003c/p>\n\u003cp>\u003cstrong>A ‘Lost Opportunity’\u003c/strong>\u003c/p>\n\u003cp>A top NIAID official said he had no regrets about the decision.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There certainly was unanimity within the institute that this was the right thing to do,” said H. Clifford Lane, NIAID’s clinical director. “While I think there might’ve been some discussion, [because] everyone always tries to play devil’s advocate in these discussions, I think there was a pretty uniform opinion that this was what we should do.”\u003c/p>\n\u003cp>From the standpoint of the agency, he said, the study had answered the question it was designed to answer: The median time that hospitalized COVID-19 patients on remdesivir took to stop needing oxygen or exit the hospital was, at 11 days, four days shorter than those who were on placebo. “How many patients would we want to put at risk of dying,” he asked, for that last little bit of proof? Remdesivir, he noted, was not a home run, but is probably better than nothing.\u003c/p>\n\u003cp>Steven Nissen, a veteran trialist and cardiologist at the Cleveland Clinic, disagreed that giving placebo patients remdesivir was the right call. “I believe it is in society’s best interest to determine whether remdesivir can reduce mortality, and with the release of this information doing a placebo-controlled trial to determine if there is a mortality benefit will be very difficult,” he said. “The question is: Was there a route, or is there a route, to determine if the drug can prevent death?” The decision is “a lost opportunity,” he said.\u003c/p>\n\u003cp>Peter Bach, the director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, agreed with Nissen. “The core understanding of clinical research participation and clinical research conduct is we run the trial rigorously to provide the most accurate information about the right treatment,” he said. And that answer, he argued, should ideally have determined whether remdesivir saves lives.\u003c/p>\n\u003cp>The reason we have shut our whole society down, Bach said, is not to prevent COVID-19 patients from spending a few more days in the hospital. It is to prevent patients from dying. “Mortality is the right endpoint,” he said.\u003c/p>\n\u003cp>\u003cstrong>Tough Call\u003c/strong>\u003c/p>\n\u003cp>Most experts contacted by STAT expressed opinions that fell between Nissen and Lane, believing that the decision was a difficult case, with several defending the NIAID.\u003c/p>\n\u003cp>“I think it was a really tough call,” said Janet Wittes, a prominent statistician and the president of Statistics Collaborative.\u003c/p>\n\u003cp>When the remdesivir results were announced, the NIH said the data came from an “interim” analysis. This means that a study was stopped early because a drug’s benefit was so undeniable that it would be unethical to continue the study. But Lane said this was incorrect. The data come from a preliminary final analysis, a point at which the study would normally end.\u003c/p>\n\u003cp>The ACTT study (short for Adaptive COVID-19 Treatment Trial) began in late February. The first patient dosed in the study was an American repatriated from the Diamond Princess, a British cruise ship where there was an outbreak of more than 800 COVID-19 cases. By the terms of the study, hospitalized patients were randomly assigned to receive either intravenous remdesivir or a placebo. On day 15, the study would score patients on a scale from 1 (dead) to 8 (not hospitalized, with no restrictions on activities).\u003c/p>\n\u003cp>As results from other COVID-19 studies conducted in China started to trickle in, Lane and his team began to worry that looking at the outcome on only the 15th day could lead the study to fail even if the drug was effective. On March 22, with only 77 patients enrolled in the study, members of the NIAID team had a conference call on which they decided to change the measure that would be used. Instead of measuring patients on an eight-point scale on one day, the study would measure the time until the patients scored one of the best three outcomes on the scale. This decision was finalized on April 2; it was posted to clinicaltrials.gov, a government registry of clinical trials, on April 16.\u003c/p>\n\u003cp>Ironically, Lane said, the study would still have been positive if the change had not been made. But the change in the study’s main goal also changed the way the study would be analyzed. Now, the NIAID decided, the analysis would be calculated when 400 patients out of the 1,063 patients the study enrolled had recovered. If remdesivir turned out to be much more effective than expected, “interim” analyses would be conducted at a third and two-thirds that number.\u003c/p>\n\u003cp>\u003cstrong>First, Do No Harm\u003c/strong>\u003c/p>\n\u003cp>The job of reviewing these analyses would fall to a committee of outside experts on what is known as an independent data and safety monitoring board, or DSMB. Though they generally go unseen, DSMBs are among the most important and powerful forces in medical research. They are allowed to analyze the data from a trial while it’s ongoing, even as drug companies, doctors, and patients are kept from knowing who is getting the medicine and who is getting placebo. These boards have two jobs: to make sure that patients aren’t being harmed by the experimental drug, and to ensure that it’s not already clear beyond a doubt that a medicine is effective.\u003c/p>\n\u003cp>Those decisions bring moments of triumph, despair, and, occasionally, confusion.\u003c/p>\n\u003cp>When Merck decided to withdraw the painkiller Vioxx in 2004, it was because a DSMB had recommended stopping a study of the drug when it became clear the medicine increased the risk of heart attacks and strokes. In 2014, when a study of the cancer immunotherapy Opdivo first proved that drug extended survival in melanoma, it was because a DSMB had found the result incontrovertible and recommended stopping the study.\u003c/p>\n\u003cp>But the DSMB for the remdesivir study did not ever meet for an interim efficacy analysis, Lane said. All patients had been enrolled by April 20. The data for a DSMB meeting was cut off on April 22. The DSMB met and, on April 27, it made a recommendation to the NIAID.\u003c/p>\n\u003cp>That recommendation was not about whether the patients on placebo should receive remdesivir. Instead, the DSMB recommended that in the next phase of the study, testing Eli Lilly’s arthritis drug Olumiant against remdesivir, there was no need for a placebo-only group.\u003c/p>\n\u003cp>That decision, Lane said, led the NIAID to conclude that patients who had been given placebo should be offered remdesivir, something that started happening after April 28.\u003c/p>\n\u003cp>This is where Nissen and Bach disagree. There were 1,063 patients in the study, but only 480 had recovered at the time of the analysis. Researchers could have collected more data, they argue, and perhaps have learned if remdesivir saves lives. They were already close, both note. Results are considered “significant” if a measure called a p-value is less than 0.05; the value for mortality in the preliminary analysis was 0.059. “How many patients would we want to put at risk of dying to get that 0.01 on the p-value,” Lane retorted.\u003c/p>\n\u003cp>Marc Pfeffer, a cardiologist at the Brigham and Women’s Hospital in Boston, said he believes NIAID made the right call. He said that he was “very sympathetic” to the fact that researchers were getting this study done during a pandemic. “If you make the decision that remdesivir should be part of everybody’s therapy in the next phase, then those volunteers taking the risks in the current trial should be switched to the active therapy now considered effective,” he said.\u003c/p>\n\u003cp>Should this decision have been left to the DSMB, not the NIAID? DSMBs are technically only advisory panels, said Richard Chaisson, a professor at the Johns Hopkins Bloomberg School of Public Health.\u003c/p>\n\u003cp>Chaisson remembers running an NIH-funded study of a preventative treatment for tuberculosis. The DSMB recommended continuing the trial, but he decided not to, because it was putting patients at too much risk. “The NIH had no problem with me not following the DSMB’s advice, and were even relieved I made the decision I did,” he said.\u003c/p>\n\u003cp>Wittes, of Statistics Collaborative, said she is glad she wasn’t on this DSMB, adding, “I don’t know where I would have come out.” And she said that when full results of the study are available, she would be “shocked” if the NIAID had not done things properly.\u003c/p>\n\u003cp>“I think there are groups of people who you’d really respect who would not have stopped a study like this without a mortality benefit,” Wittes said. “And I think you can argue that both ways.”\u003c/p>\n\u003cp>But she also worried that the evidence might not be strong enough to make the decision society is now making: that every new COVID-19 treatment must be given with or compared to remdesivir.\u003c/p>\n\u003cp>\u003cstrong>Not for Everybody?\u003c/strong>\u003c/p>\n\u003cp>“The danger is now it’s the treatment for everybody,” she said. “Now this is the base drug and everything is going to be that plus something or the control. I think we don’t know if it’s strong enough for it to be the standard of care. I don’t think we know who should be treated.”\u003c/p>\n\u003cp>Steven Joffe, an ethics expert at the University of Pennsylvania, said he believes the NIAID likely took the right steps in making its decision to give remdesivir to the placebo patients. But he worries about deciding to use time to improvement, not death, as the measure of success, in the first place.\u003c/p>\n\u003cp>“I don’t find this endpoint very compelling, and to me the real issue is the decision to design the trial around the endpoint of time to recovery defined in the way they defined recovery,” Joffe said. “To me, the decisions that are this weighty ought to be based on clinically important endpoints.”\u003c/p>\n\u003cp>All of this would normally wait until the full results were published, at which point the roster of the DSMB may be revealed. (Lane would not share their names.) But what is unusual in this case is that, before the data are even fully analyzed, the FDA has \u003ca href=\"https://www.statnews.com/2020/05/01/fda-to-allow-emergency-use-of-gileads-covid-19-drug/\" target=\"_blank\" rel=\"noopener noreferrer\">authorized remdesivir’s use\u003c/a>. A Chinese study, meanwhile, \u003ca href=\"https://www.statnews.com/2020/04/23/data-on-gileads-remdesivir-released-by-accident-show-no-benefit-for-coronavirus-patients/\" target=\"_blank\" rel=\"noopener noreferrer\">failed to show\u003c/a> remdesivir had a benefit. Several more studies of the drug expected to read out soon.\u003c/p>\n\u003cp>Ethan Weiss, a cardiologist at the University of California, San Francisco, who traveled to New York two weeks ago \u003ca href=\"https://www.statnews.com/2020/05/07/podcast-covid-19-gilead-pricing-dilemma/\" target=\"_blank\" rel=\"noopener noreferrer\">to treat COVID-19 patients\u003c/a>, said that he does worry that we have missed “a fleeting opportunity” to understand how well remdesivir works. “It is sad to me that we’re not going to get a complete answer about it.” But he said he also thinks the issue is “inside baseball.” Remdesivir, as several experts have pointed out, is not a game changer.\u003c/p>\n\u003cp>The real problem, Weiss said, is not the handling of this particular study but that there aren’t more like it. He said he wished the U.S. had built the infrastructure needed to do more studies like this when the pandemic in New York was at its height. He wished there were more studies, with more DSMBs.\u003c/p>\n\u003cp>“We’ve squandered an incredible opportunity to do good science,” Weiss said. “If we could ever go back and do something all over, it would be the infrastructure to actually learn something. Because we’re not learning enough.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2020/05/11/inside-the-nihs-controversial-decision-to-stop-its-big-remdesivir-study/\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">T\u003c/span>\u003c/span>he Bay Area drug maker Gilead Sciences released a bombshell two weeks ago: A study conducted by a U.S. government agency had found that the company’s experimental drug, \u003ca href=\"https://www.statnews.com/2020/05/05/remdesivir-gilead-strategic-crossroads-reputation-far-more-at-stake/\" target=\"_blank\" rel=\"noopener noreferrer\">remdesivir\u003c/a>, was the first treatment \u003ca href=\"https://www.statnews.com/2020/04/29/gilead-says-critical-study-of-covid-19-drug-shows-patients-are-responding-to-treatment/\" target=\"_blank\" rel=\"noopener noreferrer\">shown to have even a small effect\u003c/a> against COVID-19.\u003c/p>\n\u003cp>Behind that ray of hope, though, was one of the toughest quandaries in medicine: how to balance the need to rigorously test a new medicine for safety and effectiveness with the moral imperative to get patients an effective treatment as quickly as possible. At the heart of the decision about when to end the trial was a process that was — as is often in the case in clinical trials — by turns secretive and bureaucratic.\u003c/p>\n\u003cp>The National Institute of Allergy and Infectious Diseases has described to STAT in new detail how it made its fateful decision: to start giving remdesivir to patients who had been assigned to receive a placebo in the study, essentially limiting researchers’ ability to collect more data about whether the drug saves lives — something the study, called ACTT-1, suggests but does not prove. In the trial, 8% of the participants given remdesivir died, compared with 11.6% of the placebo group, a difference that was not statistically significant.\u003c/p>\n\u003cp>\u003cstrong>A ‘Lost Opportunity’\u003c/strong>\u003c/p>\n\u003cp>A top NIAID official said he had no regrets about the decision.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There certainly was unanimity within the institute that this was the right thing to do,” said H. Clifford Lane, NIAID’s clinical director. “While I think there might’ve been some discussion, [because] everyone always tries to play devil’s advocate in these discussions, I think there was a pretty uniform opinion that this was what we should do.”\u003c/p>\n\u003cp>From the standpoint of the agency, he said, the study had answered the question it was designed to answer: The median time that hospitalized COVID-19 patients on remdesivir took to stop needing oxygen or exit the hospital was, at 11 days, four days shorter than those who were on placebo. “How many patients would we want to put at risk of dying,” he asked, for that last little bit of proof? Remdesivir, he noted, was not a home run, but is probably better than nothing.\u003c/p>\n\u003cp>Steven Nissen, a veteran trialist and cardiologist at the Cleveland Clinic, disagreed that giving placebo patients remdesivir was the right call. “I believe it is in society’s best interest to determine whether remdesivir can reduce mortality, and with the release of this information doing a placebo-controlled trial to determine if there is a mortality benefit will be very difficult,” he said. “The question is: Was there a route, or is there a route, to determine if the drug can prevent death?” The decision is “a lost opportunity,” he said.\u003c/p>\n\u003cp>Peter Bach, the director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, agreed with Nissen. “The core understanding of clinical research participation and clinical research conduct is we run the trial rigorously to provide the most accurate information about the right treatment,” he said. And that answer, he argued, should ideally have determined whether remdesivir saves lives.\u003c/p>\n\u003cp>The reason we have shut our whole society down, Bach said, is not to prevent COVID-19 patients from spending a few more days in the hospital. It is to prevent patients from dying. “Mortality is the right endpoint,” he said.\u003c/p>\n\u003cp>\u003cstrong>Tough Call\u003c/strong>\u003c/p>\n\u003cp>Most experts contacted by STAT expressed opinions that fell between Nissen and Lane, believing that the decision was a difficult case, with several defending the NIAID.\u003c/p>\n\u003cp>“I think it was a really tough call,” said Janet Wittes, a prominent statistician and the president of Statistics Collaborative.\u003c/p>\n\u003cp>When the remdesivir results were announced, the NIH said the data came from an “interim” analysis. This means that a study was stopped early because a drug’s benefit was so undeniable that it would be unethical to continue the study. But Lane said this was incorrect. The data come from a preliminary final analysis, a point at which the study would normally end.\u003c/p>\n\u003cp>The ACTT study (short for Adaptive COVID-19 Treatment Trial) began in late February. The first patient dosed in the study was an American repatriated from the Diamond Princess, a British cruise ship where there was an outbreak of more than 800 COVID-19 cases. By the terms of the study, hospitalized patients were randomly assigned to receive either intravenous remdesivir or a placebo. On day 15, the study would score patients on a scale from 1 (dead) to 8 (not hospitalized, with no restrictions on activities).\u003c/p>\n\u003cp>As results from other COVID-19 studies conducted in China started to trickle in, Lane and his team began to worry that looking at the outcome on only the 15th day could lead the study to fail even if the drug was effective. On March 22, with only 77 patients enrolled in the study, members of the NIAID team had a conference call on which they decided to change the measure that would be used. Instead of measuring patients on an eight-point scale on one day, the study would measure the time until the patients scored one of the best three outcomes on the scale. This decision was finalized on April 2; it was posted to clinicaltrials.gov, a government registry of clinical trials, on April 16.\u003c/p>\n\u003cp>Ironically, Lane said, the study would still have been positive if the change had not been made. But the change in the study’s main goal also changed the way the study would be analyzed. Now, the NIAID decided, the analysis would be calculated when 400 patients out of the 1,063 patients the study enrolled had recovered. If remdesivir turned out to be much more effective than expected, “interim” analyses would be conducted at a third and two-thirds that number.\u003c/p>\n\u003cp>\u003cstrong>First, Do No Harm\u003c/strong>\u003c/p>\n\u003cp>The job of reviewing these analyses would fall to a committee of outside experts on what is known as an independent data and safety monitoring board, or DSMB. Though they generally go unseen, DSMBs are among the most important and powerful forces in medical research. They are allowed to analyze the data from a trial while it’s ongoing, even as drug companies, doctors, and patients are kept from knowing who is getting the medicine and who is getting placebo. These boards have two jobs: to make sure that patients aren’t being harmed by the experimental drug, and to ensure that it’s not already clear beyond a doubt that a medicine is effective.\u003c/p>\n\u003cp>Those decisions bring moments of triumph, despair, and, occasionally, confusion.\u003c/p>\n\u003cp>When Merck decided to withdraw the painkiller Vioxx in 2004, it was because a DSMB had recommended stopping a study of the drug when it became clear the medicine increased the risk of heart attacks and strokes. In 2014, when a study of the cancer immunotherapy Opdivo first proved that drug extended survival in melanoma, it was because a DSMB had found the result incontrovertible and recommended stopping the study.\u003c/p>\n\u003cp>But the DSMB for the remdesivir study did not ever meet for an interim efficacy analysis, Lane said. All patients had been enrolled by April 20. The data for a DSMB meeting was cut off on April 22. The DSMB met and, on April 27, it made a recommendation to the NIAID.\u003c/p>\n\u003cp>That recommendation was not about whether the patients on placebo should receive remdesivir. Instead, the DSMB recommended that in the next phase of the study, testing Eli Lilly’s arthritis drug Olumiant against remdesivir, there was no need for a placebo-only group.\u003c/p>\n\u003cp>That decision, Lane said, led the NIAID to conclude that patients who had been given placebo should be offered remdesivir, something that started happening after April 28.\u003c/p>\n\u003cp>This is where Nissen and Bach disagree. There were 1,063 patients in the study, but only 480 had recovered at the time of the analysis. Researchers could have collected more data, they argue, and perhaps have learned if remdesivir saves lives. They were already close, both note. Results are considered “significant” if a measure called a p-value is less than 0.05; the value for mortality in the preliminary analysis was 0.059. “How many patients would we want to put at risk of dying to get that 0.01 on the p-value,” Lane retorted.\u003c/p>\n\u003cp>Marc Pfeffer, a cardiologist at the Brigham and Women’s Hospital in Boston, said he believes NIAID made the right call. He said that he was “very sympathetic” to the fact that researchers were getting this study done during a pandemic. “If you make the decision that remdesivir should be part of everybody’s therapy in the next phase, then those volunteers taking the risks in the current trial should be switched to the active therapy now considered effective,” he said.\u003c/p>\n\u003cp>Should this decision have been left to the DSMB, not the NIAID? DSMBs are technically only advisory panels, said Richard Chaisson, a professor at the Johns Hopkins Bloomberg School of Public Health.\u003c/p>\n\u003cp>Chaisson remembers running an NIH-funded study of a preventative treatment for tuberculosis. The DSMB recommended continuing the trial, but he decided not to, because it was putting patients at too much risk. “The NIH had no problem with me not following the DSMB’s advice, and were even relieved I made the decision I did,” he said.\u003c/p>\n\u003cp>Wittes, of Statistics Collaborative, said she is glad she wasn’t on this DSMB, adding, “I don’t know where I would have come out.” And she said that when full results of the study are available, she would be “shocked” if the NIAID had not done things properly.\u003c/p>\n\u003cp>“I think there are groups of people who you’d really respect who would not have stopped a study like this without a mortality benefit,” Wittes said. “And I think you can argue that both ways.”\u003c/p>\n\u003cp>But she also worried that the evidence might not be strong enough to make the decision society is now making: that every new COVID-19 treatment must be given with or compared to remdesivir.\u003c/p>\n\u003cp>\u003cstrong>Not for Everybody?\u003c/strong>\u003c/p>\n\u003cp>“The danger is now it’s the treatment for everybody,” she said. “Now this is the base drug and everything is going to be that plus something or the control. I think we don’t know if it’s strong enough for it to be the standard of care. I don’t think we know who should be treated.”\u003c/p>\n\u003cp>Steven Joffe, an ethics expert at the University of Pennsylvania, said he believes the NIAID likely took the right steps in making its decision to give remdesivir to the placebo patients. But he worries about deciding to use time to improvement, not death, as the measure of success, in the first place.\u003c/p>\n\u003cp>“I don’t find this endpoint very compelling, and to me the real issue is the decision to design the trial around the endpoint of time to recovery defined in the way they defined recovery,” Joffe said. “To me, the decisions that are this weighty ought to be based on clinically important endpoints.”\u003c/p>\n\u003cp>All of this would normally wait until the full results were published, at which point the roster of the DSMB may be revealed. (Lane would not share their names.) But what is unusual in this case is that, before the data are even fully analyzed, the FDA has \u003ca href=\"https://www.statnews.com/2020/05/01/fda-to-allow-emergency-use-of-gileads-covid-19-drug/\" target=\"_blank\" rel=\"noopener noreferrer\">authorized remdesivir’s use\u003c/a>. A Chinese study, meanwhile, \u003ca href=\"https://www.statnews.com/2020/04/23/data-on-gileads-remdesivir-released-by-accident-show-no-benefit-for-coronavirus-patients/\" target=\"_blank\" rel=\"noopener noreferrer\">failed to show\u003c/a> remdesivir had a benefit. Several more studies of the drug expected to read out soon.\u003c/p>\n\u003cp>Ethan Weiss, a cardiologist at the University of California, San Francisco, who traveled to New York two weeks ago \u003ca href=\"https://www.statnews.com/2020/05/07/podcast-covid-19-gilead-pricing-dilemma/\" target=\"_blank\" rel=\"noopener noreferrer\">to treat COVID-19 patients\u003c/a>, said that he does worry that we have missed “a fleeting opportunity” to understand how well remdesivir works. “It is sad to me that we’re not going to get a complete answer about it.” But he said he also thinks the issue is “inside baseball.” Remdesivir, as several experts have pointed out, is not a game changer.\u003c/p>\n\u003cp>The real problem, Weiss said, is not the handling of this particular study but that there aren’t more like it. He said he wished the U.S. had built the infrastructure needed to do more studies like this when the pandemic in New York was at its height. He wished there were more studies, with more DSMBs.\u003c/p>\n\u003cp>“We’ve squandered an incredible opportunity to do good science,” Weiss said. “If we could ever go back and do something all over, it would be the infrastructure to actually learn something. Because we’re not learning enough.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Flattening the Curve Bought California Time to Prepare for Future Surge",
"headTitle": "Flattening the Curve Bought California Time to Prepare for Future Surge | KQED",
"content": "\u003cp>\u003cspan style=\"font-weight: 400\">In March, David Entwistle, the CEO of Stanford Health Care, braced for the worst. “We literally thought we would have hundreds of patients.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Models suggested he needed 1,000 hospital beds. At the time he had 600. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Gov. Gavin \u003c/span>\u003cspan style=\"font-weight: 400\">Newsom warned more than 25 million Californians could contract coronavirus. \u003c/span>\u003cspan style=\"font-weight: 400\">But an overwhelming surge never hit. \u003c/span>\u003cspan style=\"font-weight: 400\">To date, about \u003ca href=\"https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/\" target=\"_blank\" rel=\"noopener noreferrer\">65,000\u003c/a> people have tested positive. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">While preparing for the tsunami of patients that didn’t arrive, Stanford, like all California hospitals, canceled elective surgeries. Everything from tummy tucks to brain surgery was put on hold. The move freed up beds and staff, and it conserved precious resources like masks. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“When the first indication that there may be a surge came out, we shut down,” says Dr. Philip Theodosopoulos, a UCSF neurosurgeon. “We shut down the O.R. almost lock, stock and barrel.”\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Health care providers across the state also began to rely on telemedicine at unprecedented levels. Doctors at UCSF went from seeing 160 patients virtually a day to more than 2,000. In mid-March, physicians at \u003c/span>\u003cspan style=\"font-weight: 400\">Sutter Health’s 24 hospitals were seeing about 20-30 patients a day online; today that number is up to 6,000.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Medical leaders around the Bay Area jumped on Zoom calls discussing contingency plans for potential patient overflows. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It was incredibly complicated and incredibly time-consuming,” said Dr. Adrienne Green, the chief medical officer at UCSF. “We have mostly done this as our day job since the beginning of February, when we had our first couple of patients here.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Hospitals erected pop-up tents outside of main entrances to triage COVID-19 patients as they arrived, new mobile respiratory clinics came online to treat less serious coronavirus cases, and decommissioned floors at numerous facilities were reopened. Even bankrupt hospitals that were scheduled to close, like Seton Medical Center in Daly City, got a reprieve to care for patients. In San Diego, hospitals converted college dormitories to alternative care sites. In Los Angeles, a navy ship hospital anchored off the coast, and 3D printing was used to manufacture ventilator parts. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Currently the number of California COVID-19 patients requiring hospitalization continues to fall, and the number of patients in intensive care units has flattened.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But medical leaders say all the planning will pay off. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We have now built in the muscle memory to be able to surge when needed,” says Dr. Stephen Lockhart, the chief medical officer for Sutter Health. UCSF’s Adrienne Green agrees. “We’re now ready and we have all the building blocks to be prepared for a resurgence if it happens.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">That includes not only a spike in coronavirus cases, but also California’s next devastating disaster like a deadly wildfire or an earthquake. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Hospital surge capacity is one of the six indicators Gov. Newsom is using to assess when and how to relax stay-at-home orders. The state has prepared 14 facilities with 2,072 beds statewide to accept patients. There are also more than 10,000 ventilators on hand that are not currently in use. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">A \u003c/span>\u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2020/05/5.4-Report-Card-on-California-Resilience-Roadmap.pdf?campaign_id=49&emc=edit_ca_20200505&instance_id=18234&nl=california-today®i_id=78131845&segment_id=26636&te=1&user_id=3fb78e873af3312f34d0bc1d60a07c7f\">\u003cspan style=\"font-weight: 400\">report card\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> the state issued recently also laid out progress made on procuring personal protective equipment and hospital beds for any surge. The state eased some restrictions last week instituted under its March stay-at-home order, allowing lower-risk nonessential businesses to open for the first time in nearly two months. Most Bay Area counties, however, are sticking with stricter guidelines for now. San Francisco and Marin county are considering opening some stores May 18.\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">In March, David Entwistle, the CEO of Stanford Health Care, braced for the worst. “We literally thought we would have hundreds of patients.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Models suggested he needed 1,000 hospital beds. At the time he had 600. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Gov. Gavin \u003c/span>\u003cspan style=\"font-weight: 400\">Newsom warned more than 25 million Californians could contract coronavirus. \u003c/span>\u003cspan style=\"font-weight: 400\">But an overwhelming surge never hit. \u003c/span>\u003cspan style=\"font-weight: 400\">To date, about \u003ca href=\"https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/\" target=\"_blank\" rel=\"noopener noreferrer\">65,000\u003c/a> people have tested positive. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">While preparing for the tsunami of patients that didn’t arrive, Stanford, like all California hospitals, canceled elective surgeries. Everything from tummy tucks to brain surgery was put on hold. The move freed up beds and staff, and it conserved precious resources like masks. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“When the first indication that there may be a surge came out, we shut down,” says Dr. Philip Theodosopoulos, a UCSF neurosurgeon. “We shut down the O.R. almost lock, stock and barrel.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Health care providers across the state also began to rely on telemedicine at unprecedented levels. Doctors at UCSF went from seeing 160 patients virtually a day to more than 2,000. In mid-March, physicians at \u003c/span>\u003cspan style=\"font-weight: 400\">Sutter Health’s 24 hospitals were seeing about 20-30 patients a day online; today that number is up to 6,000.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Medical leaders around the Bay Area jumped on Zoom calls discussing contingency plans for potential patient overflows. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It was incredibly complicated and incredibly time-consuming,” said Dr. Adrienne Green, the chief medical officer at UCSF. “We have mostly done this as our day job since the beginning of February, when we had our first couple of patients here.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Hospitals erected pop-up tents outside of main entrances to triage COVID-19 patients as they arrived, new mobile respiratory clinics came online to treat less serious coronavirus cases, and decommissioned floors at numerous facilities were reopened. Even bankrupt hospitals that were scheduled to close, like Seton Medical Center in Daly City, got a reprieve to care for patients. In San Diego, hospitals converted college dormitories to alternative care sites. In Los Angeles, a navy ship hospital anchored off the coast, and 3D printing was used to manufacture ventilator parts. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Currently the number of California COVID-19 patients requiring hospitalization continues to fall, and the number of patients in intensive care units has flattened.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But medical leaders say all the planning will pay off. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We have now built in the muscle memory to be able to surge when needed,” says Dr. Stephen Lockhart, the chief medical officer for Sutter Health. UCSF’s Adrienne Green agrees. “We’re now ready and we have all the building blocks to be prepared for a resurgence if it happens.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">That includes not only a spike in coronavirus cases, but also California’s next devastating disaster like a deadly wildfire or an earthquake. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Hospital surge capacity is one of the six indicators Gov. Newsom is using to assess when and how to relax stay-at-home orders. The state has prepared 14 facilities with 2,072 beds statewide to accept patients. There are also more than 10,000 ventilators on hand that are not currently in use. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">A \u003c/span>\u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2020/05/5.4-Report-Card-on-California-Resilience-Roadmap.pdf?campaign_id=49&emc=edit_ca_20200505&instance_id=18234&nl=california-today®i_id=78131845&segment_id=26636&te=1&user_id=3fb78e873af3312f34d0bc1d60a07c7f\">\u003cspan style=\"font-weight: 400\">report card\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> the state issued recently also laid out progress made on procuring personal protective equipment and hospital beds for any surge. The state eased some restrictions last week instituted under its March stay-at-home order, allowing lower-risk nonessential businesses to open for the first time in nearly two months. Most Bay Area counties, however, are sticking with stricter guidelines for now. San Francisco and Marin county are considering opening some stores May 18.\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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},
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"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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