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Antibiotic resistance and the global rise in human conflict - STAT
▻https://www.statnews.com/2023/12/28/antimicrobial-antibiotic-resistance-global-conflict-gaza-ukraine

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In recent months, evidence suggests, the war in Ukraine and the ongoing conflict in Gaza have led to spikes of multidrug-resistant bacterial infections. This is to be expected; conflicts often create conditions that are perfect for drug resistance to emerge and spread, with the first evidence of this dating back as far as the 1940s.

#antibiorésistance #guerres

« Il y a une énorme détresse dans la classe ouvrière en Amérique » | Les Echos
▻https://www.lesechos.fr/monde/etats-unis/il-y-a-une-enorme-detresse-dans-la-classe-ouvriere-en-amerique-2028009

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La crise des opioïdes joue un grand rôle. Les laboratoires pharmaceutiques et les distributeurs de médicaments ont ciblé les lieux où ils savaient que les gens souffraient ou étaient en détresse. Ils ont provoqué l’épidémie, avec l’aide des médecins et la complicité des parlementaires, qui ont bloqué les enquêtes de la Drug Enforcement Agency (DEA). Puis les médecins ont fait marche arrière, mais beaucoup de gens étaient déjà devenus dépendants. Le marché illégal s’est développé. L’héroïne est devenue moins chère que l’Oxycontin. Le Fentanyl l’a supplanté et gagne du terrain à l’ouest du Mississippi.
Les morts de désespoir ne touchent pas que les Blancs non hispaniques, en fin de compte ?

Nous avons été critiqués pour ne pas l’avoir vu au début. Mais c’est injuste, car ça ne se voyait pas encore dans les données de 2013 sur lesquelles nous avons travaillé. Les Afro-Américains ont échappé pendant un certain temps à la crise des opioïdes . Je pense que cela tient notamment au fait qu’ils n’ont pas confiance dans le système médical et que leur douleur n’est pas prise au sérieux par les médecins.
Vous montrez d’ailleurs que les morts de désespoir sont plutôt déterminées par le niveau de diplôme que par la race…

Sur les certificats de décès aux Etats-Unis, le niveau d’études est mentionné. En 2015, nous avons vu que la hausse des décès par suicide, par overdose ou par cirrhose ne concernait quasiment que les personnes n’ayant pas un diplôme de niveau Bac+4 (« college degree »). Or il ne s’agit pas d’une petite minorité, mais de deux tiers des Américains. Aux Etats-Unis, un tiers de la population interrompt ses études après le lycée et un autre tiers n’arrive pas à Bac+4. Avoir fait un peu d’études supérieures n’aide pas vraiment.

Covid-19 hasn’t fallen into a seasonal pattern — yet
▻https://www.statnews.com/2023/08/23/covid-19-has-not-yet-fallen-into-a-seasonal-pattern

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To most people on the planet, the #Covid-19 pandemic is over. But for many scientists who have been tracking the largest global infectious disease event in the era of molecular biology, there is still a step that the virus that caused it, #SARS-CoV-2, hasn’t yet taken. It has not fallen into a predictable seasonal pattern of the type most respiratory pathogens follow.

A research team airs the messy truth about #AI in medicine
▻https://www.statnews.com/2023/04/27/hospitals-health-artificial-intelligence-ai

Caregivers complain AI models are unreliable and of limited value. Tools designed to warn of impending illnesses are inconsistent and sometimes difficult to interpret. Even evaluating them for accuracy, and susceptibility to bias, is still an unsettled science.

#IA #médecine

In areas with more Black doctors, Black people live longer - STAT
▻https://www.statnews.com/2023/04/14/black-doctors-primary-care-life-expectancy-mortality

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The study, published Friday in JAMA Network Open, is the first to link a higher prevalence of Black doctors to longer life expectancy and lower mortality in Black populations. Other studies have shown that when Black patients are treated by Black doctors, they are more satisfied with their health care, more likely to have received the preventive care they needed in the past year, and are more likely to agree to recommended preventive care such as blood tests and flu shots. But none of that research has shown an impact on Black life expectancy.

The new study found that Black residents in counties with more Black physicians — whether or not they actually see those doctors — had lower mortality from all causes, and showed that these counties had lower disparities in mortality rates between Black and white residents. The finding of longer life expectancy persisted even in counties with a single Black physician.

How infectious disease experts respond to Covid nearly 3 years in
▻https://www.statnews.com/2022/11/21/how-infectious-disease-experts-are-responding-to-covid-nearly-three-years-

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[…] we wondered if people who work in the infectious diseases sphere are still taking steps to try to avoid catching the virus, and if so, which ones. We also wondered whether — maybe even hoped — they are feeling less stressed about Covid and are starting to lower their guard.

The short answer: Some appear to be, a little. But most are still using multiple measures to try to avoid Covid.

Researchers’ tests of lab-made version of Covid virus draw scrutiny
▻https://www.statnews.com/2022/10/17/boston-university-researchers-testing-of-lab-made-version-of-covid-virus-d

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“I’m very tired of people suggesting that virologists and NIAID are reckless or don’t care about biosafety,” said Rasmussen, a coronavirus expert at the University of Saskatchewan’s Vaccine and Infectious Disease Organization. “The problem isn’t that. The problem is that the guidelines and expectations aren’t clear for many experiments and the process isn’t transparent.”

How the splintering of Omicron could shape Covid’s next phase - STAT
▻https://www.statnews.com/2022/10/06/bq11-omicron-variants-splintering-covid-next-phase

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The immunity people have built up from vaccinations and infections will likely continue to offer strong protection against severe outcomes for most, particularly if they’ve stayed up-to-date with boosters.)

But the concern about these newest sublineages is not just that they could drive up cases once more. Already, some monoclonal antibody treatments were rendered useless and had to be abandoned as the virus evolved. And in some lab experiments, the remaining antibody therapies — bebtelovimab, as well as Evusheld — can’t stand up to some of the new variants. (Just on Monday, the Food and Drug Administration warned that Evusheld, which is given to immunocompromised people to bolster their protection as a pre-exposure therapy, can’t neutralize certain SARS-2 variants.) That could leave people at high risk for severe Covid even more vulnerable.

Peacock added one note: While it’s possible that the future #SARS-2 strains we’ll be dealing with will continue to be descended from Omicron, another Omicron-like event could occur. That is, a variant from a distant part of SARS-2’s family tree could appear suddenly and outcompete everything else in the landscape, just as the original Omicron did last year around Thanksgiving.

Aux Etats-Unis on commence ces jours-ci l’injection de boosters visant BA.4/BA.5, malgré l’absence de données humaines. En Europe l’autorisation viendra peut-être plus tard, pour l’instant on autorise les boosters visant BA.1, qui eux bénéficient d’essais humains.

First adapted COVID-19 booster vaccines recommended for approval in the EU
▻https://www.ema.europa.eu/en/news/first-adapted-covid-19-booster-vaccines-recommended-approval-eu

EMA’s human medicines committee (CHMP) has recommended authorising two vaccines adapted to provide broader protection against COVID-19. Comirnaty [#Pfizer/BioNTech] Original/Omicron BA.1 and Spikevax [#Moderna] bivalent Original/Omicron BA.1 are for use in people aged 12 years and above who have received at least primary vaccination against COVID-19.

[...] Other adapted vaccines incorporating different variants, such as the Omicron subvariants BA.4 and BA.5, are currently under review by EMA or will be submitted soon, and, if authorised, will further extend the arsenal of available vaccines. The clinical data generated with the original/BA.1 bivalent vaccines recommended today will support the evaluation and authorisation of further adapted vaccines.

CDC recommends updated Covid-19 boosters
▻https://www.statnews.com/2022/09/01/cdc-advisory-panel-backs-updated-covid-19-boosters

The updated vaccine is designed to teach the immune system to recognize a broader array of SARS-2 strains by including a second target, the Omicron subvariants BA.4 and BA.5. (The spike protein on viruses from those two subvariants is identical.) BA.5 is currently the dominant virus circulating in the United States.

The new shots can only be used as a booster for people who have had a primary series of vaccines. It is not authorized for use as a primary series.

With the authorization of these boosters, the FDA suspended the authorizations for the previous boosters produced by Pfizer and Moderna. Those monovalent (one strain) boosters can no longer be given in this country, except in children who are too young to receive one of the bivalent boosters.

#vaccin_bivalent

The #FDA stands by as the vaping industry flouts its orders - STAT
▻https://www.statnews.com/2022/08/24/the-fda-stands-by-as-the-vaping-industry-flouts-its-orders

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The agency has sweeping legal authorities to crack down on vape companies that ignore its bans, ranging from levying seven-figure fines to physically pulling products off shelves. But the FDA has never used those powers, according to its own data. In several cases, it’s even dropped cases against companies that it knows are still selling illegal products.

#cigarette_électronique #e_cigarette #vape

Je ne vois pas d’autre explication que la #corruption

FDA appears to hold off on crackdown on synthetic nicotine products
▻https://www.statnews.com/2022/07/08/fda-appears-to-hold-off-on-crackdown-on-synthetic-nicotine-products-despit

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Il ne suffit pas de faire des lois, il faut aussi des forces pour les faire appliquer dans les délais. Des humains pour bosser dessus et empêcher d’autres humains de traîner les pieds pour renforcer les entreprises contre la santé publique.
Cette affaire en est un bel exemple... malheureusement pas isolé.

WASHINGTON — Congress gave the Food and Drug Administration a clear directive to crack down on vape companies skirting the agency’s rules. But there are growing signs the agency is not ready to do as instructed.

Now, advocates are apoplectic.

This March, Congress acted remarkably swiftly to give the FDA the power to regulate so-called synthetic nicotine products — vaping products, often sold in fruity flavors like ”watermelon berry,” “banana ice,” and “rainbow cloudz,” that were only on the market because of a loophole in the agency’s tobacco regulation. That loophole allowed companies to sell their products so long as they made them using nicotine produced in a lab, rather than extracting it from a tobacco plant.

Federal data show that youth have increasingly switched to these products because they still provide the fruity flavors that previously popular companies, like Juul, have discontinued. An annual survey conducted by the FDA and Centers for Disease Control and Prevention found that one synthetic vaping brand, Puff Bar, was the most popular e-cigarette among current youth tobacco users.

When Congress gave the FDA power to regulate these products, it also gave the agency clear deadlines: The law says synthetic tobacco companies had to have submitted so-called premarket applications by May 14, 2022, and that any company that didn’t submit an application by that date would be considered illegal. Congress also said that any product not authorized by the FDA as of July 13 — next Wednesday — would also be considered illegal.

But an FDA spokesperson told STAT Friday that the agency has not taken action to date against any company selling synthetic nicotine that hasn’t submitted an application.

#Tabac #Cigarette_electronique #Bureaucratie

FDA recommends vaccine makers update Covid-19 shots to target Omicron
▻https://www.statnews.com/2022/06/30/fda-recommends-vaccine-makers-update-covid-19-shots-to-target-omicron

The Food and Drug Administration is advising vaccine makers to reformulate their Covid-19 shots to target the BA.4 and BA.5 Omicron subvariants as well as the original strain of the virus, the agency announced Thursday, as it seeks to provide people with broader protection against the evolving coronavirus.

[...] The FDA had to provide its recommendation this summer so that vaccine makers have enough time to adapt their formulas and manufacture shots should a fall and winter booster campaign be necessary.

[...] The newer forms of the shots will only be offered as boosters, Marks said. The primary series of shots will continue to use the original vaccines

Cette proposition en suit une autre de l’OMS faite 2 semaines plus tôt.

the WHO’s position is that the goal of updating the vaccines isn’t to try to keep up with the evolving virus — an approach that is used with flu vaccines — but rather to expose the immune system to another very different version of SARS-2 to teach it to better recognize and respond to both current and hopefully future strains of the virus.

▻https://www.statnews.com/2022/06/27/fda-panel-to-advise-on-whether-and-how-covid-vaccines-should-be-updated
#covid-19 #vaccin_bivalent

FDA authorizes Pfizer and Moderna Covid vaccines for infants, toddlers, and preschoolers
▻https://www.statnews.com/2022/06/17/fda-approves-pfizer-and-moderna-covid-vaccines-for-infants-toddlers-and-pr

The Food and Drug Administration on Friday authorized the #Pfizer-BioNTech and #Moderna #Covid #vaccines for use in children as young as 6 months of age, setting the stage for a government push to make the shots available for the youngest children

U.S. death rates show how politics are affecting public health - STAT
▻https://www.statnews.com/2022/06/07/us-death-rates-politicization-public-health

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[…] many Republican states have resisted Medicaid expansion, and decisions like this and a general underinvestment in public health by Republican governors might be the reason behind the growing Democratic-Republican mortality gap.

[…]

As a researcher, I often ask myself “What’s next?” after publishing a study. But I must confess to feeling a little nihilistic this time around: Will this study change minds, or will it become just another projectile in the broader partisan slugfest this country is trapped in? Odds are that most politicians and their most passionate supporters are so locked into their tribes that no amount of data will make them reconsider their positions, even if those very positions are proving to be self-destructive.

#états-unis

Genetic data indicate at least two monkeypox outbreaks underway
▻https://www.statnews.com/2022/06/03/genetic-data-indicate-at-least-two-separate-monkeypox-outbreaks-underway-s

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The Centers for Disease Control and Prevention said Friday that new genetic sequencing data indicate there are at least two distinct monkeypox outbreaks underway outside Africa — a surprise finding that one official said suggests international spread is wider, and has been occurring for longer than has been previously realized.

Here’s how coronavirus may actually be getting more like flu - STAT
▻https://www.statnews.com/2022/05/03/more-uniformly-infectious-more-treatable-more-genetically-predictable-how-

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Lidia Morawska at Queensland University of Technology found that the Delta variant is less reliant on superspreading events, with a k of 0.49. Her team hasn’t yet repeated the work for #Omicron, but she expects that its preference for the upper respiratory tract, where it replicates at astonishing rates, probably results not just in more transmission, but more uniformity in who transmits to others.

“Even a very short time is sufficient to inhale enough of this virus to be infected,” Morawska said. “Short enough that #ventilation may not have had a chance to remove the virus from the #air.”

That’s why she and others are now pushing for the use of germicidal #ultraviolet light, which can zap infectious viral particles in the air, killing them in an instant. This technology could have prevented the Gridiron superspreader event last month in Washington, University of Maryland aerobiologist Don Milton argued in a recent New York Times op-ed. Disinfecting UV light “should become the norm for large indoor gatherings where meals are served and masks cannot be worn,” he wrote.

But the virus is just one component of what makes for a superspreading event. The other is the host network where it lands — which is a function of the current levels of population immunity and how many contacts people are making.

“Based on everything we’ve seen throughout the pandemic, the underlying population susceptibility seems to be the primary driver of spread,” said Emily Gurley, an epidemiologist at Johns Hopkins University. “I think that’s more important than changes in the virus itself.”

That means that even as #SARS-CoV-2 has evolved to be more contagious, it is encountering a small and ever-shrinking proportion of the population whose bodies have never seen some version of it before. Most people, through prior infection, vaccination, or a combination of the two now have immune systems capable of fending off the deadliest outcomes of contracting SARS-CoV-2. And that’s starting to look a lot like what happened when pandemic flu transitioned to seasonal flu.

« Docteur, ai-je besoin d’une 4e dose ? »
▻https://www.vidal.fr/actualites/28999-docteur-ai-je-besoin-d-une-4e-dose.html

Le 7 avril 2022, Olivier Véran, ministre des Solidarités et de la Santé, a annoncé que toutes les personnes de plus de 60 ans qui le souhaitent peuvent désormais recevoir un second rappel de #vaccination au moins 6 mois après le premier rappel.

[...] il n’existe à ce jour aucune donnée suggérant un bénéfice d’un 2e rappel chez les personnes de moins de 60 ans (à l’exception des personnels soignants dans une optique de réduction de la probabilité qu’ils puissent infecter leurs patients).

Concernant les personnes de plus de 60 ans, les données de la Drees, comme celles des Centers for Disease Control and Prevention (CDC) américains ou de la Health and Security Agency au Royaume-Uni, montrent que la protection accordée par le 1er rappel tend, dans cette population, à diminuer dès 3 mois après l’injection. Associées aux données israéliennes, elles plaident pour l’administration, chez les personnes âgées les plus à risque, d’un 2e rappel au moins 4 mois après le premier.

Experts fear U.S. may default to annual Covid boosters without sufficient data
▻https://www.statnews.com/2022/04/26/experts-fear-us-may-default-to-annual-covid-boosters-without-sufficient-da

Last week Wherry and several dozens of experts signed a letter urging the FDA to put more emphasis on assessing additional parts of the immune response to Covid vaccines, arguing that measuring T cells is critical to fleshing out our understanding of how long-lasting vaccine protection is. They asked the FDA to revise its guidance to vaccine manufacturers to ask them to make a greater effort to measure T cell responses.

[...] “If we had a better sort of overall understanding of #Tcell responses and their durability, we might be able to A) make some more rational decisions about when to boost based on what we expect the boost to do — that is, protect from all disease or protect from hospitalization and severe disease? — and B) create public messaging that creates the right expectations,” Wherry said.

#covid-19

#Covid-19 cases that return after #Paxlovid antiviral treatment puzzle doctors - CNN
▻https://www.cnn.com/2022/04/27/health/paxlovid-covid-rebound/index.html

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Des rechutes après une cure de paxlovid, clinique et biologique (PCR de nouveau positif quelques jours après sa négativation) sans qu’il ne s’agisse de réinfection (résultat séquençage inchangé)

The FDA noted these rebound cases in its own analysis of the data from the clinical trials. The phenomenon was found in a small percentage of cases, roughly 10 to 14 days after starting Paxlovid. It’s not clear how common these may be. A clinical trial of the medication is still ongoing.

WHO says 12 countries have reported unusual cases of hepatitis in kids
▻https://www.statnews.com/2022/04/23/who-says-12-countries-have-reported-unusual-cases-of-hepatitis-in-kids

Severe #hepatitis in previously healthy children isn’t common. What makes these cases of serious liver inflammation more unusual is that they haven’t been caused by the typical culprits — the hepatitis viruses labeled A through E that are the most common causes of the condition.

Instead, suspicion has centered on an unexpected suspect — an adenovirus, specifically adenovirus type 41. At least 74 of the affected children have tested positive for adenovirus infection and molecular testing has turned up evidence of adenovirus 41 in 18 of those children.

[...] Another theory stems from the fact that these cases are being reported roughly two years into the Covid pandemic. Many of the affected children will have had fewer colds and other infections over the past couple of years, because of social distancing and mask wearing. That may have left them more susceptible to developing severe illness when they encountered germs. Scientists from Hong Kong reported last year that children there were ending up in hospital with rhinovirus infections — common colds — when schools reopened after months of closure.

The possibility that #Covid-19 may be playing some role in this is also still on the table, Pebody said.

Pfizer is expected to ask the F.D.A. to authorize its #Covid vaccine for children under 5.
▻https://www.nytimes.com/2022/01/31/us/politics/children-covid-vaccine.html

#Pfizer and its partner BioNTech are expected as soon as Tuesday to ask the Food and Drug Administration to authorize a coronavirus #vaccine for children under 5 years old as a two-dose regimen while they continue to research how well three doses work.

Federal regulators are eager to review the data in hopes of authorizing shots for young children on an emergency basis as early as the end of February, according to multiple people familiar with the discussions, who were not authorized to speak publicly. If Pfizer waited for data on a three-dose regimen, the data would not be submitted until late March and the vaccine might not be authorized for that age group until late spring.