Sunday 16 October 2016
Tuesday 14 October 2014
ABORTION REPRIEVE -- FOR NOW
The Supreme Court Stops Parts Of Abortion Law.
The U.S. Supreme Court on Tuesday blocked key parts of a 2013 law in Texas that had closed all but eight facilities providing abortions in America's second most-populous state.
In an unsigned order, the justices sided with abortion rights advocates and health care,positive thinking providers in suspending an Oct. 2 ruling by a panel of the New Orleans-based U.S. 5th Circuit Court of Appeals that Texas could immediately apply a rule making abortion clinics statewide spend millions of dollars on hospital-level upgrades.
The court also put on hold a provision of the law only as it applies to clinics in McAllen and El Paso that requires doctors at the facilities to have admitting privileges at nearby hospitals. The admitting privileges rule remains in effect elsewhere in Texas.
Justices Samuel Alito, Antonin Scalia and Clarence Thomas said they would have ruled against the clinics in all respects.
The 5th Circuit is still considering the overall constitutionality of the sweeping measure overwhelmingly passed by the GOP-controlled Texas Legislature and signed into law by Gov. Rick Perry last year.
Even as it weighs the merits of the law, the appeals court had said it could be enforced — opening the door for the emergency appeal to the Supreme Court.
"We're seeing the terrible impact these restrictions have on thousands of Texas women who effectively no longer have access to safe and legal abortion," said Cecile Richards, president of Planned Parenthood Federation of America. "We're relieved that the court stepped in to stop this, and we hope this dangerous law is ultimately overturned completely."
"This does not protect the health and safety of women who are undergoing abortion," said Joe Pojman, executive director of Texas Alliance for Life. ""This is definitely a short-term loss, but not necessarily a long- term loss."
The 5th Circuit decision had blocked an August ruling by Austin-based U.S. District Judge Lee Yeakel, who had found that requiring hospital-style upgrades was less about safety than making access to abortion difficult. Yeakel's ruling temporarily suspended the upgrade rules before they could go into effect Sept. 1 — and the order from the Supreme Court means they are on hold again.
Allowing the rules on hospital-level upgrades to be enforced — including mandatory operating rooms and air filtration systems — shuttered more than a dozen clinics across Texas.
Until the nation's highest court intervened, only abortion facilities in the Houston, Austin, San Antonio and the Dallas-Fort Worth areas remained open. And none was left along the Texas-Mexico border or outside any of the state's largest urban areas.
Some other clinics had closed even earlier amid enforcement of the rule on admitting privileges at nearby hospitals. That portion has already been upheld twice by the appeals court.
The fight over the Texas law is the latest over tough new abortion restrictions that have been enacted across the country. The office of Texas Attorney General Greg Abbott, a Republican who is the favorite in next month's governor's race, is leading the defense of the law.
Democrat Wendy Davis launched her campaign for governor behind the celebrity she achieved through a nearly 13-hour filibuster last summer that temporarily blocked the law's passage. Davis said she was "thankful that women can continue to make their own personal decisions." Abbott's office said he would continue to defend the law.
Attorneys for the state have denied that Texas women would be burdened by fewer abortion facilities, saying nearly 9 in 10 would still live within 150 miles of a provider. The law's opponents note that leaves nearly a million Texas women embarking on drives longer than three hours to get an abortion.
Monday 13 October 2014
NIH HEAD: BUDGET CUTS KILLED EBOLA VACCINE
Ebola Vaccine Would Likely Have Been Found By Now If Not For Budget Cuts: NIH Director.
BETHESDA, Md. -- As the federal government frantically works to combat the Ebola outbreak in West Africa, and as it responds to a second diagnosis of the disease at home, one of the country's top health officials says a vaccine likely would have already been discovered were it not for budget cuts.
Dr. Francis Collins, the head of the National Institutes of Health, said that a decade of stagnant spending has "slowed down" research on all items, including vaccinations for infectious diseases. As a result, he said, the international community has been left playing catch-up on a potentially avoidable humanitarian catastrophe.
"NIH has been working on Ebola vaccines since 2001. It's not like we suddenly woke up and thought, 'Oh my gosh, we should have something ready here,'" Collins told The Huffington Post on Friday. "Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would've gone through clinical trials and would have been ready."
It's not just the production of a vaccine that has been hampered by money shortfalls. Collins also said that some therapeutics to fight Ebola "were on a slower track than would've been ideal, or that would have happened if we had been on a stable research support trajectory."
"We would have been a year or two ahead of where we are, which would have made all the difference," he said.
Speaking from NIH's headquarters in Bethesda, Maryland, the typically upbeat Collins was somber when discussing efforts to control the Ebola epidemic. His days are now spent almost exclusively on the disease. But even after months of painstaking work, a breakthrough doesn't seem on the immediate horizon.
Money, or rather the lack of it, is a big part of the problem. NIH's purchasing power is down 23 percent from what it was a decade ago, and its budget has remained almost static. In fiscal year 2004, the agency's budget was $28.03 billion. In FY 2013, it was $29.31 billion -- barely a change, even before adjusting for inflation. The situation is even more pronounced at the National Institute of Allergy and Infectious Diseases, a subdivision of NIH, where the budget has fallen from $4.30 billion in FY 2004 to $4.25 billion in FY 2013. (Story continues below.)
The growing severity of the Ebola crisis in West Africa and the fear of an outbreak in America haven't loosened the purse strings. NIH has not received any additional money. Instead, Collins and others have had to "take dollars that would've gone to something else" -- such as a universal influenza vaccine -- "and redirect them to this."
Collins said he'd like Congress to pass emergency supplemental appropriations to help with the work. But, he added, "nobody seems enthusiastic about that."
Several Democratic lawmakers have in fact introduced legislation that would increase NIH funds by up to $46.2 billion in 2021. But there is no indication that such a bill will move forward any time soon.
Under the existing budget, NIH officials have rushed to find a breakthrough. Though health officials were already "cutting corners" in an effort to produce an Ebola vaccine, Collins said that a best-case scenario would be for a clinical trial to start in December, and it would take until February or March to know if the drug worked.
"If we wait that long to solve this, we will have basically failed with the more traditional measures of contact-tracing to get this epidemic under control," said Collins.
An Ebola vaccine, in short, would be an insurance policy, worth pursuing if other means fail and for possible future epidemics. Currently, NIH is working on a fifth-generation Ebola vaccine that has had positive results. But the tests are being done on monkeys, not people. To set up a clinical trial for humans takes time and resources, and doubly so in a country whose social and political fabric is as frayed as Liberia's. Even so, limited trials have already begun.
A second vaccine is being designed in Canada, just weeks behind NIH's schedule. But recipients have exhibited fever symptoms, which could prove problematic because elevated temperature is also a symptom of Ebola.
Collins says his "dream" is to set up a trial using those two vaccines and involving 30,000 people. But even with the current heightened demand, he cautioned that such a dream couldn't be rushed.
"Sometimes vaccines not only don't work, they make things worse," Collins told HuffPost. "Look at the HIV step trial, where that vaccine not only did not protect HIV, it increased susceptibility because it did something to the immune system that made it more vulnerable. That could happen here too." (The private sector, it should be noted, hasn't developed an Ebola vaccine for a variety of reasons, primarily financial ones.)
Collins was more bullish about the prospects of developing a therapy, as opposed to a vaccine, because it would be possible to conduct a test trial among people already in treatment units, rather than among the uninfected.
So far, much of the focus has been on an experimental cocktail of three monoclonal antibodies known as ZMapp. But the current stockpile is not nearly great enough. Collins, a touch exasperated, said it would be all but impossible to have significant doses available by the end of the calendar year -- with a lack of funding once again playing a disruptive role.
"Had it not been for other shortages, we might very well by now know that it works and have a large stock of it," he said.
There are other potential therapies. Brincidofovir has been used on an Ebola patient brought to Nebraska and on the late Thomas Eric Duncan, who was diagnosed with the disease after traveling to Dallas from his native Liberia. Unlike ZMapp, there is a large stockpile of Brincidofovir available, and the doses required are small. "So you could imagine you have enough drug now to treat 16,000 people," said Collins. But, again, a clinical trial is needed in Liberia.
With more than 4,000 people having died from Ebola -- the majority of them in West Africa -- the clock is already ticking fast for the biomedical research community. On Sunday morning, it sped up even more as news broke that a second patient in the United States had tested positive for the disease. The patient, a nurse who had treated Duncan, is the first person to contract the disease on U.S. soil. Officials at the Centers for Disease Control and Prevention (CDC) say they're looking into how it happened. Though the patient, who works at the Texas Health Presbyterian Hospital in Dallas, had been wearing protective gear during her encounters with Duncan, officials indicated that a procedural lapse likely caused the transmission.
Speaking two days before that second diagnosis, Collins urged for calm when contemplating the possibility of an outbreak. Ebola is a disease that is highly lethal. But it is also only transmitted through direct contact with bodily fluids or objects contaminated with the virus.
"Certainly there's been a lot of fear [in the] response from people who are probably at essentially zero risk, that this might somehow take over our country, which is really not going to happen," said Collins. "And despite all the assurances [...] it still hasn't quite sunk in. There's still the cable news people who are whipping this up, and frankly sometimes using it for political purposes to sort of shoot at the government."
Collins didn't downplay the severity of the disease, noting that its rapid spread in Africa, and the humanitarian disaster it has left in its wake, should rattle people. He also agreed with the comparison made by Tom Frieden, head of the CDC, who recently said the current Ebola crisis is the worst epidemic since the outbreak of AIDS. But, Collins added, perspective was still needed.
"More people will die today of AIDS than have died so far in the entire Ebola epidemic," said Collins. "We've somehow gotten used to that, and it doesn't seem to be so threatening or frightening. Certainly in the United States, another 50,000 people will get infected with HIV this year, because that's been sort of the steady number."
"How many more people will get infected with Ebola this year in the U.S.?" he went on. "I would guess you could count among the fingers of two hands, depending on what contacts of the guy in Dallas actually turned out to get infected See More
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Sunday 12 October 2014
SHOCKING NEWS GAY MARRIAGE
Federal Judge Strikes Down Alaska Gay Marriage Ban.
A federal judge struck down Alaska’s ban on same-sex marriage Sunday evening.
The U.S. District Court for the District of Alaska ruled that the state's ban was unconstitutional under the Due Process and Equal Protection Clauses of the U.S. Constitution.
U.S. District Judge Timothy M. Burgess wrote that any relationship between the ban and government interests was "either nonexistent or purely speculative."
"Alaska’s same-sex marriage laws are a prime example of how 'the varying treatment of different groups or persons is so unrelated to the achievement of any combination of legitimate purposes that we can only conclude that the legislature’s actions were irrational,'” Burgess wrote, citing an earlier court ruling.
"Refusing the rights and responsibilities afforded by legal marriage sends the public a government-sponsored message that same-sex couples and their familial relationships do not warrant the status, benefits, and dignity given to couples of the opposite sex," the Alaskan court decision continued.
Alaska Gov. Sean Parnell (R) released a statement on Sunday saying that he would appeal the ruling to the 9th U.S. Circuit Court of Appeals, though that court has already struck down similar bans in Idaho and Nevada.
“As Alaska’s governor, I have a duty to defend and uphold the law and the Alaska Constitution,” Parnell said in the statement. “Although the district court today may have been bound by the recent Ninth Circuit panel opinion, the status of that opinion and the law in general in this area is in flux. I will defend our constitution See More
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CDC BRACES FOR MORE CASES
Texas Health Worker Tests Positive For Ebola.
DALLAS, Texas, Oct 12 (Reuters) - A Texas health worker has contracted Ebola after treating a Liberian who died of the disease at a Dallas hospital last week, raising concern about how U.S. medical guidelines aimed at stopping the spread of the disease were breached.
The infected worker, identified as a woman but not named by authorities as they announced the case on Sunday, is believed to be the first person to contract the disease in the United States.
Health officials said the worker at the Texas Health Presbyterian Hospital had been wearing protective gear during treatment of Thomas Eric Duncan. Duncan was a Liberian who died on Wednesday after being exposed to Ebola in his home country and developing the disease while visiting the United States.
The outbreak in West Africa, the worst outbreak on record of Ebola, has killed more than 4,000 people, mostly in Liberia, Sierra Leone and Guinea.
The new case in Texas indicated a professional lapse that may have caused other health workers at the hospital to also be infected, said the director of the Centers for Disease Control and Prevention (CDC).
"We don't know what occurred in the care of the index patient, the original patient, in Dallas, but at some point there was a breach in protocol, and that breach in protocol resulted in this infection," CDC director Dr. Thomas Frieden told a news conference.
"We are evaluating other potential healthcare worker exposures because if this individual was exposed, which they were, it is possible that other individuals were exposed," he said.
The worker was in close contact with Duncan and initial testing shows that the level of virus in her system is low. The CDC will conduct a secondary test to confirm the results from a lab in Austin that showed Ebola infection, he said.
"Unfortunately it is possible in the coming days that we will see additional cases of Ebola," he said.
Frieden said there was one person who may have had contact with the infected health worker when she could possible transmit the disease and that person is being monitored.
Frieden said the intubation of Duncan and use of a dialysis machine - measures taken while trying to save his life - posed high risk for transmission of the virus.
Duncan died in an isolation ward on Oct. 8, 11 days after being admitted. More than 50 people attended to his care. The hospital said it was decontaminating its isolation unit while health officials said Duncan's body had been cremated.
Dan Varga, the hospital's chief clinical officer told a news conference that the infected worker "was following full CDC precautions ... so gown, glove, mask and shield."
The hospital has already faced criticism for at first turning away Duncan when he first showed up there on Sept. 25, saying he had been in Liberia and had a fever. About two days after he was discharged, he grew much sicker and was taken back by ambulance and put in an isolation unit.
None of the 10 people who had close contact with him or 38 people who had contact with that group have shown any symptoms, state health officials said.
Texas officials did not identify the health worker or give any details about the person, but CNN said it was a woman nurse.
The Texas case is not the first outside badly hit West Africa in which a health care worker contracted the disease after contact with a patient.
In Spain, a nurse who contracted Ebola after caring for two infected priests repatriated to Spain remained seriously ill but is showing signs of improvement. Teresa Romero, 44, is so far the only person who has tested positive for Ebola through a transmission in the country.
Fifteen people were being monitored in a Madrid hospital for signs of Ebola on Sunday, as the Spanish government tries to contain recriminations over how it has handled the case. None have so far shown any symptoms.
In Dallas, there was a yellow hazardous material drum on the lawn of the brick apartment where the Texas health worker lived and information pamphlets about the Ebola virus were stuffed in the doors in the surrounding blocks of the apartment.
Neighbor Cliff Lawson, 57, said he was woken at 6:00 a.m. by two Dallas police officers who told him "don't panic."
"I went back to bed after that. There's nothing you can do about it. You can't wrap your house in bubble wrap," Lawson said.
A team is decontaminating the patient's apartment and car, Dallas Mayor Mike Rawlings said.
The hospital said in a statement that the new patient, who had not been working for two days, had been taking her own temperature twice a day. The worker informed the hospital of a fever and was isolated immediately upon arrival there.
A union for registered nurses said the Ebola case in Dallas shows that not enough is being done to educate health workers on how to manage patients who show signs of infection.
"Handing out a piece of paper with a link to the Centers for Disease Control, or telling nurses just to look at the CDC website - as we have heard some hospitals are doing - is not preparedness," said Bonnie Castillo, a registered nurse and senior official with National Nurses United.
News of the second patient in Dallas came as U.S. authorities step up efforts to stop the spread of the virus. New York's John F. Kennedy Airport on Saturday began the screening of travelers from the three hardest hit West African countries.
Liberia is the country worst affected by the virus with 2,316 victims, followed by 930 in Sierra Leone, 778 in Guinea, eight in Nigeria and one in the United States, the World Health Organization said on Friday. Some 4,033 people are known to have died in seven countries from the outbreak, it said.
Ebola is spread through contact with fluids of an affected person or contamination from objects such as needles. People are not contagious before symptoms such as fever develop See More
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THIS HOW?
Texas Health Worker Tests Positive For Ebola.
DALLAS (AP) — A Texas health care worker tested positive for Ebola even though she wore full protective gear while caring for a hospitalized patient who later died from the virus, health officials said Sunday. If the preliminary diagnosis is confirmed, it would be the first known case of the disease being contracted or transmitted in the U.S.
Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, said the diagnosis shows there was a clear breach of safety protocol and all those who treated Thomas Eric Duncan are now considered potentially exposed.
The worker wore a gown, gloves, mask and shield while she cared for Duncan during his second visit to Texas Health Presbyterian Hospital, said Dr. Daniel Varga of Texas Health Resources, which runs the hospital. Frieden said the worker has not been able to identify a specific breach of protocol that might have led to her being infected.
Duncan, who arrived in the U.S. from Liberia to visit family on Sept. 20, first sought medical care for fever and abdominal pain on Sept. 25. He told a nurse he had traveled from Africa, but he was sent home. He returned Sept. 28 and was placed in isolation because of suspected Ebola. He died Wednesday.
Liberia is one of the three West African countries most affected by the ongoing Ebola epidemic, which has killed more than 4,000 people, according to World Health Organization figures published Friday. The others are Sierra Leone and Guinea.
Texas health officials have been closely monitoring nearly 50 people who had or may have had close contact with Duncan in the days after he started showing symptoms.
The health care worker reported a fever Friday night as part of a self-monitoring regimen required by the CDC, Varga said. He said another person is in isolation, and the hospital has stopped accepting new emergency room patients.
"We knew a second case could be a reality, and we've been preparing for this possibility," said Dr. David Lakey, commissioner of the Texas Department of State Health Services. "We are broadening our team in Dallas and working with extreme diligence to prevent further spread."
Dallas officials knocked on doors, made automated phone calls and passed out fliers to notify people within a four-block radius of the health care worker's apartment complex about the situation, though they said there was no reason for neighbors to be concerned.
Dallas police officers stood guard outside the complex Sunday and told people not to go inside. One said an industrial barrel outside contained hazardous waste taken from inside the building. Nearby residents periodically came out of their homes to ask about the commotion.
Kara Lutley, who lives a half-block from the complex, said she never received a call or other emergency notice and first heard about it on the news. She said the infected worker seemed to have taken all necessary precautions.
"I'm not overly concerned that I'll get Ebola," she said.
Officials said they also received information that there may be a pet in the health care worker's apartment, and they have a plan in place to care for the animal. They do not believe the pet has signs of having contracted Ebola.
Frieden on Sunday raised concerns about the possible breach of safety protocol and told CBS' "Face the Nation" that among the things CDC will investigate is how the workers took off protective gear, because removing it incorrectly can lead to contamination. Investigators will also look at dialysis and intubation, procedures with the potential for spreading infectious material.
Health care workers treating Ebola patients are among the most vulnerable, even if wearing protective gear. A Spanish nurse assistant recently became the first health care worker infected outside West Africa during the ongoing outbreak. She helped care for a missionary priest who was brought to a Madrid hospital. More than 370 health care workers in west Africa have fallen ill or died in west Africa since epidemic began earlier this year.
Ebola spreads through close contact with a symptomatic person's bodily fluids, such as blood, sweat, vomit, feces, urine, saliva or semen. Those fluids must have an entry point, like a cut or scrape or someone touching the nose, mouth or eyes with contaminated hands, or being splashed. The World Health Organization says blood, feces and vomit are the most infectious fluids, while the virus is found in saliva mostly once patients are severely ill. The whole live virus has never been culled from sweat.
Duncan, the first person in the U.S. diagnosed with Ebola, came to Dallas to attend the high school graduation of his son, who was born in a refugee camp in Ivory Coast and brought to the U.S. as a toddler when his mother successfully applied for resettlement.
The trip was the culmination of decades of effort, friends and family members said. But when Duncan arrived in Dallas, though he showed no symptoms, he had already been exposed to Ebola. His neighbors in Liberia believe Duncan become infected when he helped a pregnant neighbor who later died from it. It was unclear if he knew about her diagnosis before traveling See More
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