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WHO and the pandemic flu “conspiracies”

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Abstract

Key scientists advising the World Health Organization on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing. These conflicts of interest have never been publicly disclosed by WHO, and WHO has dismissed inquiries into its handling of the A/H1N1 pandemic as “conspiracy theories.” Deborah Cohen and Philip Carter investigate Watch the BMJ/The Bureau of Investigative Journalism's video on WHO and disclosure. This video has also appeared on Al Jazeera and guardian.co.uk. Next week marks the first anniversary of the official declaration of the influenza A/H1N1 pandemic. On 11 June 2009 Dr Margaret Chan, the director general of the World Health Organization, announced to the world’s media: “I have conferred with leading influenza experts, virologists, and public health officials. In line with procedures set out in the International Health Regulations, I have sought guidance and advice from an Emergency Committee established for this purpose. On the basis of available evidence, and these expert assessments of the evidence, the scientific criteria for an influenza pandemic have been met…The world is now at the start of the 2009 influenza pandemic.”It was the culmination of 10 years of pandemic preparedness planning for WHO—years of committee meetings with experts flown in from around the world and reams of draft documents offering guidance to governments. But one year on, governments that took advice from WHO are unwinding their vaccine contracts, and billions of dollars’ worth of stockpiled oseltamivir (Tamiflu) and zanamivir (Relenza)—bought from health budgets already under tight constraints—lie unused in warehouses around the world.A joint investigation by the BMJ and the Bureau of Investigative Journalism has uncovered evidence that raises troubling questions about how WHO managed conflicts of interest among the scientists who advised its pandemic planning, and about the …

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... Considero que el momento culminante de este tipo de críticas contra las vacunas lo constituyó la publicación en la revista The Lancet en 1998 del estudio realizado por el Dr. Andrew Wakefield según el cual la vacuna triple (contra sarampión, paperas y rubéola) produciría un nuevo síndrome que combina síntomas gastrointestinales y autismo, y que fue recordado, a su vez, por los defensores de la vacuna contra la nueva influenza. Fueron trabajos publicados en el British Medical Journal (BMJ) entre 2009 y 2015 los que analizaron y denunciaron con mayor profundidad este fraude (Cohen y Carter, 2010), y cuyos argumentos fueron reproducidos por los medios: ...
... Pese a lo cual la OMS no reveló ninguno de estos conflictos de intereses. El informe cuestionó especialmente el hermetismo sobre el nombre de los expertos que integraron el grupo de emergencia que recomendó a la directora general de la OMS que decidiera el 11 de junio de 2009 convertir en pandemia la emergencia de la influenza A (H1N1) (Cohen y Carter, 2010). ...
... Debido a estas y a otras críticas, el 11 de agosto de 2010 la OMS publicó los nombres de los quince integrantes del comité de emergencia, constatándose que cinco de estos expertos cobraban de la industria, pero la OMS subrayó que en ningún caso se produjeron conflictos de intereses que pudieran afectar a la autonomía de los especialistas (Cohen y Carter, 2010). No obstante, la OMS propuso la constitución de un comité científico con profesionales ajenos a dicha organización, que a finales de marzo del 2011 concluyó que no se hallaron evidencias directas ni indirectas de la influencia de intereses comerciales en las decisiones tomadas por dicho organismo internacional para promover el uso de la nueva vacuna. ...
Chapter
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Este capítulo debruça-se sobre o papel da confiança na gestão da incerteza e do risco relativamente ao uso de medicamentos. Com base numa pesquisa sociológica em Maputo, Moçambique, esta análise procura compreender como diferentes modalidades de confiança, desdobradas analiticamente em três ‘camadas’ ou bases relacionais —confiança nos sistemas médicos, nas organizações e nos provedores de saúde, e nas experiências pessoais e socialmente partilhadas— operam em conjunto dando forma às relações dos indivíduos com os medicamentos, num contexto de crescente pluralismo terapêutico.
... It is a disease caused by the SARS-CoV-2 virus, and the World Health Organization (WHO) declared it a global pandemic on 11 March 2020. Throughout history, humanity has observed several pandemic situations such as the African obesity pandemic [1], the pandemic flu [2], the HIV/AIDS pandemic [3], etc. Humans are currently facing a crucial time to fight with an invisible enemy, namely, coronavirus . Due to this deadly disease, millions of people are infected by COVID-19 worldwide, and many have died. ...
Article
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Recently, the rapid transmission of Coronavirus 2019 (COVID-19) is causing a significant health crisis worldwide. The World Health Organization (WHO) issued several guidelines for protection against the spreading of COVID-19. According to the WHO, the most effective preventive measure against COVID-19 is wearing a mask in public and crowded areas. It is quite difficult to manually monitor and determine people with masks and no masks. In this paper, different deep learning architectures were used for better results evaluations. After extensive experimentation, we selected a custom model having the best performance to identify whether people wear a face mask or not and allowing an easy deployment on a small device such as a Jetson Nano. The experimental evaluation is performed on the custom dataset that is developed from the website (See data collection section) after applying different masks on those images. The proposed model in comparison with other methods produced higher accuracy (99% for training accuracy and 99% for validation accuracy). Moreover, the proposed method can be deployed on resource-constrained devices.
... From membership and recognition issues to funding priorities and intervention programmes, discussions of public health have been caught in moral geographies (for example, AIDS as a "gay disease") and subject to repeated securitisation as territorial nationstates and their expert representatives adjudicate on how far and fast to securitise disease, including imposing emergency measures (Elbe, 2010(Elbe, , 2011. Conspiracy theories complicate further the work of global health initiatives, with some calling into question the intentions of the philanthropic Bill and Melinda Gates Foundation (which pledged US $250 million in May 2020 for COVID-19-related work alone) to use COVID-19 as a way to "microchip" the public and sell more vaccines (on earlier flu conspiracies see Cohen & Carter, 2010; and on the Gates conspiracies see Georgiou, Delfabbro, & Balzan, 2020). Global public health funding, as President Trump reminded the WHO recently, depends on major national donors and subject to disruption in moments of crisis and tension. ...
Article
COVID-19 is highlighting and exposing how public health and geopolitics intersect across spaces, scales, and settings. Existing literature focuses on the geopolitical determinants of health such as the allocation of foreign health-related assistance in postcolonial spaces and the relationship between population health and the health impacts of exploiting resources for economic benefit. How populist nationalism shapes public reactions to disease has also been documented. There is a popular geopolitical dimension to how COVID-19 is portrayed-with expertise questioned, conspiracies circulated, lockdowns contested, and mask-wearing ridiculed. Calls to keep "foreign" pathogens and viruses out of national territory carry with them possibilities for exceptional measures, xenophobic politics, and heightened surveillance on the border and beyond. The place of the World Health Organization (WHO) within global health security remains complicated by the intersection of public health and geopolitical contexts. By using three themes, within and beyond the WHO, we explore how COVID-19 has been productive of three geopolitical narratives: public health as emblematic of great power rivalries, the bordering of the virus, and the (surgical) facemask as power projection. Our paper concludes with an assessment of how important it is to track and trace the relationship between health and geopolitics.
... Key scientists advising the World Health Organization on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing. These conflicts of interest have never been publicly disclosed by WHO, and WHO has dismissed inquiries into its handling of the A/H1N1 pandemic as "conspiracy theories" (Cohen and Carter 2010). ...
Article
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Claiming that someone subscribes to a conspiracy theory can be a potent method of denigration. I observed this process up close: the thesis of one of my PhD students was alleged to endorse a conspiracy theory, therefore discrediting it. Journalists, bloggers, petition signers, Wikipedia editors and scientists endorsed the allegations without assessing whether the thesis actually propounded a conspiracy, without assessing whether evidence was provided for the alleged conspiracy, and without providing any evidence that the allegation discredited the thesis. It seems that few people will question a claim that is endorsed by others, meshes with what they would like to believe, and requires effort to check.
... influenza vaccines and antiviral drugs. 74 From then on, the WHO was much more cautious in its crisis communication, increasingly stressing the role of national risk assessment. ...
Article
The world is increasingly vulnerable to infectious diseases. Although the fundamental reform of the International Health Regulations (IHR) in 2005 was heralded as the beginning of a new era of international health law, the Ebola outbreak 2014 shattered all hopes that the world would now be adequately equipped for epidemic outbreaks of transmissible diseases. The Ebola crisis is perceived as an epic failure on the part of the World Health Organization (WHO). The many dead are a sad testimony to the world's inability to adequately respond to the threat posed by contagions. In reaction to this defeat, policymakers now focus on hands-on initiatives to foster global health instead of reformulating international health law. So far, extensive investments and innovations within the WHO, the United Nations system, and in the private sector have multiplied rapidly. The mushrooming of various health initiatives, however, increases the complexity and reduces the consistency of the current global health landscape. The leadership role of the WHO needs to be restored to provide a coherent response for the next global scale public health emergency. To this end, a fundamental reform of the presently widely neglected international regulatory framework in the field of public law, the IHR, is of vital importance. Keywords: World Health Organization, International Health Regulations, Infectious Diseases, Ebola, Influenza, Public Health, Public Health Emergency
... The eventual mildness of the pandemic also raised questions about the conduct of the WHO, in particular. The WHO emergency committee was singled out for criticism since some of its expert advisers were said to have had compromising links with pharmaceutical companies that benefited from national plans to stockpile antivirals (Cohen and Carter 2010, Flynn 2010, Godlee 2010. It is estimated that, worldwide, billions were spent on preparations for the pandemic. ...
Chapter
The 2009 swine flu pandemic turned out to be milder than it seemed to be in the first few weeks, yet it was serious for those with serious illness or who were pregnant at the time. These features of the pandemic produced communications dilemmas for experts, including a threat to public trust. With reference to the moral tale of the “boy who cried wolf,” this chapter reflects on how people in our research spoke of the eventual mildness of the 2009 pandemic and how this situation was construed as a false alarm, with implications for public trust in science and politics surrounding world-scale problems such as pandemics, population vaccination, superbugs, and health security.
... Otros enfoques alternativos incluyeron la cuestión de si los orígenes del virus estaban relacionados con la agricultura industrializada o si las autoridades sanitarias fueron indebidamente influidas por las compañías farmacéuticas que se beneficiarían de una alarma mundial sobre la pandemia. Este último enfoque creció en importancia a nivel mundial a raíz de la pandemia, y en 2010 el British Medical Journal y la Oficina Británica de Periodismo de Investigación detallaron los "conflictos de intereses" de los asesores de la OMS, que tenían vínculos con las empresas farmacéuticas (Cohen & Carter, 2010). ...
Article
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En este artículo se explora la mediatización de las epidemias como objeto de conocimiento público, mediante un análisis de contenido de las noticias sobre la gripe A (H1N1) de 2009 en Argentina, Estados Unidos y Venezuela. Los resultados indican que los periódicos siguieron los esfuerzos de las autoridades sanitarias de movilizar la atención pública y, simultáneamente, contener la alarma exagerada y los discursos sobre el virus.
... Indeed, WHO's previous pandemic responses, as in the case of COVID-19, have been subject to accusations of politicisation and lack of transparency. For example, Cohen and Carter (2010) argued that scientists advising WHO on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing. The significant point being that the declaration of a pandemic contributes to the political momentum to enact public health measures including, where available, the provision of vaccines (Bijl & Schellekens, 2011). ...
Article
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Disease outbreaks and pandemics have long played a role in societal and economic change. However, the nature of such change is selective, meaning that it is sometimes minimal and, at other times, and change or transformation may be unexpected, potentially even reinforcing contemporary paradigms. A comprehensive overview of pandemics and their effects is provided. This is used to help contextualise the COVID-19 pandemic, its impact on tourism and government, industry and consumer response. Drawing on the available literature, factors that will affect tourism and destination recovery are then identified. Some measures will continue or even expand present growth orientations in tourism while others may contribute to sustainability. It is concluded that that the selective nature of the effects of COVID-19 and the measures to contain it may lead to reorientation of tourism in some cases, but in others will contribute to policies reflecting the selfish nationalismof some countries. However, the response to planetary limits and sustainable tourism requires a global approach. Despite clear evidence of this necessity, the possibility for a comprehensive transformation of the tourism system remains extremely limited without a fundamental transformation of the entire planet.
... According to the WHO roughly 800,000,000 individuals will be infected with the Influenza virus of 6 As of August 1, 2020, COVID-19 already had led to more than 17 ...
Preprint
Full-text available
Fear of the coronavirus disease 2019 (COVID-19) has spread around the world. National borders are closed, the economy is shut down, and self-quarantining of millions of people have become the “new normal.” Early warnings regarding the readiness of large-scale RT-PCR testing in Europe, the existence of contradicting and ambiguous epidemiological data, and the striking similarities to the H1N1-pandemic scandal in 2009 could not prevent this global response to COVID-19. Vague definitions of “fatal COVID-19 cases”, unreliable RT-PCR tests as well as political, financial, and scientific special interests and often times biased news coverage by the mass media are also important factors. In this manuscript we demonstrate that COVID-19 is at most only equally as dangerous or even less dangerous than the seasonal flu of 2017/2018 or that of 2019/2020 in the US. Considering the degree of negligence of the World Health Organization (WHO) and many countries during the swine flu pandemic in 2009 as well as during past and ongoing public health programs in Europe and Africa in the management of quality-control procedures in the approval of diagnostic tests, vaccines, and other pharmacological agents, skepticism has taken an unusually distant back seat to panic. We encourage the use of critical thinking and rational evaluation of information in reaching informed decisions with respect to the upcoming vaccines and future pharmacological treatments for COVID-19. We propose the usage of “Cystus052” as a potential preventive agent in addition to current already existing measurements in place and convalescent plasma infusions (CPI) and the inhibition of the “Papain-Like-Protease” (PLP) as rational approach for future research projects to the treatment of COVID-19.
... This is because in modern society, the production system of healthcare supplies is profit-driven. 2 Decisions regarding the management of disease can no longer be made based solely on scientific grounds. Unless a disease poses a specific risk to a wide population, its mere presence in a localized area or population may not be significant from a business perspective. ...
Article
Full-text available
The COVID-19 pandemic has created huge damage to society and brought panics around the world. Such panics can be ascribed to the seemingly deceptive features of the COVID-19: compared to other deadly viral outspreads, it has medium transmission and mortality rates. As a result, the severity of the causative coronavirus, SARS-CoV-2, was deeply underestimated by the society at the beginning of the COVID-19 outbreak. Based on this, in this review, we define the viruses with features similar to those of SARS-CoV-2 as the Panic Zone viruses. To contain those viruses, accurate and fast diagnosis followed by effective isolation and treatment of patients are pivotal at the early stage of virus breakouts. This is especially true when there is no cure or vaccine available for a transmissible disease, which is the case for current COVID-19 pandemic. As of July 2020, more than one hundred kits for the COVID-19 diagnosis on the market are surveyed in this review, while emerging sensing techniques for the SARS-CoV-2 are also discussed. It is of critical importance to rationally use these kits for the efficient management and control of the Panic Zone viruses. Therefore, we discuss guidelines to select diagnostic kits at different outbreak stages of the Panic Zone viruses, SARS-CoV-2 in particular. While it is of utmost importance to use nucleic-acid based detection kits with low false negativity (high sensitivity) at the early stage of an outbreak, the low false positivity (high specificity) gains its importance at later stages of the outbreak. When the society is set to reopen from the lock-down stage of the COVID-19 pandemic, it becomes critical to have immunoassay based kits with high specificity to identify people who can safely return to the society after their recovery of SARS-CoV-2 infections. Finally, since a massive attack from a viral pandemic requires a massive defense from the whole society, we urge both government and private sectors to research and develop affordable and reliable point-of-care testing (POCT) kits, which can be used massively by the general public (and therefore called as massive POCT) to contain Panic Zone viruses in future.
... Though common perception has been that a pandemic entails widespread illness with substantial overall mortality, many health-related international organizations no longer use severity as a criterion in determining when a particular outbreak should be designated a pandemic. Thus until May 2009, the World Health Organization (WHO) defined pandemics as outbreaks generating "enormous numbers of deaths and illness," but after May 2009, WHO dropped this phrase describing severity (Cohen & Carter, 2010). ...
Conference Paper
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Focusing on COVID-19 as a prime example, this paper reports on a pilot study on the impact of wide-ranging catastrophic events like pandemics on the demand for and the supply of e-government services. Such e-services in general are of great consequence for enduring socioeconomic development but may become especially important in crisis situations. The purpose of the study is to identify the specific issues related to providing necessary e-government services during and in the aftermath of an outbreak and ensuring the continuance of essential public services operations. This research provides a basis for managing and responding to such events in the future and help maintain and perhaps improve the e-government services that are most needed. The pilot study was conducted in a municipal administration in Poland. Based on interviews with city administrators and technical staff involved with providing and maintaining e-government services, the issues faced due to COVID-19 as well as the reactions and responses to these issues are investigated to develop guidelines for future handling of similar crises.
... Aziende farmaceutiche) hanno inabissato la propria credibilità [16][17][18][19]116,119]. ...
Preprint
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La paura della malattia da Coronavirus 2019 (COVID-19) si è diffusa a livello mondiale. Confini nazionali sono stati chiusi, l’economia è stata fermata e la quarantena fiduciaria obbligatoria di milioni di persone è stata definita la ‘nuova normalità’. Avvisaglie precoci circa la disponibilità di massicce campagne di Test RT-PCR in Europa, come pure l’esistenza di dati contraddittori ed ambivalenti e l’impressionante similitudine con lo scandalo pandemico del virus H1N1 degli anni 2009/2010 non hanno assolutamente impedito una reazione di paura e timore a livello mondiale. Definizioni indeterminate dei ‘decessi da COVID-19’, risultati dei test RT-PCR inattendibili come pure comuni interessi politici, economici e scientifici nonché segnalazioni e campagne massmediatiche superficiali e parziali sono stati fattori determinanti. In questo manoscritto faremo emergere come l’infezione da COVID-19 sia ugualmente pericolosa, se non meno pericolosa, del virus influenzale stagionale del 2017/2018 o di quello del 2019/2020 negli Stati Uniti d’America (USA). In considerazione della disattenzione dell’Organizzazione Mondiale della Sanità (OMS) e di molte altre nazioni durante l’influenza suina del 2009/2010, come pure durante i programmi di promozione della salute pubblica promossi sia nel passato che attualmente in corso in Europa come in Africa riguardo ai processi di verifica della qualità dei test diagnostici, delle sostanze di cui si compongono vaccini ed altri prodotti farmaceutici prima della loro approvazione gioca un ruolo sorprendentemente subordinato riguardo la presente Pandemia da COVID-19 negli abituali e sobri discorsi scientifici in materia. Una comprensione profonda ed una valutazione misurata dell’attuale crisi da Coronavirus è possibile esclusivamente in un’ottica multidimensionale. Non solo dati epidemiologici e scoperte mediche, ma anche punti di vista economici, psicologici e sociopsicologici fanno da sfondo, come pure le prassi dell’informazione e comunicazione nei media e nei social-media, le correnti e le pulsioni politiche e sociali, devono essere opportunamente e misuratamente prese in considerazione per una valutazione completa e complessiva di questa complessa crisi. Questo si è cercato di fare nel presente lavoro.
... Pandemics are not immune to conspiracy theories and there a list of them being circulated in the media. Although there were suspicions from academics about the way WHO handled 2009 influenza A/H1N1 pandemic; Cohen and Carter (2010) general population may also show some attraction towards conspiracy theories. For instance, the misguided video posts were reported as far more popular than the posts dispersing accurate public health information about the Zika virus infection (Sharma et al., 2017). ...
Article
Aims: Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. Methods: A large-scale multicenter online survey was completed by the parents (n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers-HCW [18.2%] vs. others), geographical (İstanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. Results: Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p < .001), a mother (odds ratio 1.67, p < .001), and a younger parent (odds ratio 0.98, p = .012); living with an adult with a chronic physical illness (odds ratio 1.38, p < .001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p = .043), positive psychiatric history (odds ratio 1.29, p < .001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p < .001; vs. odds ratio 2.61, p < .001) were independently associated with significant parental distress. Conclusions: Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit. Keywords: COVID 19; children; mental health; pandemic; parent.
... Many health-related international organizations no longer use any measure of severity to define a pandemic. For example, until May 2009, the World Health Organization (WHO) defined pandemics as outbreaks generating "enormous numbers of deaths and illness" but after May 2009, WHO dropped this phrase describing severity (Cohen & Carter, 2010). This ambiguity about when exactly a catastrophic outbreak constitutes a pandemic and the lack of set policies about when authorities may declare a pandemic and impose special rules and restrictions makes the business environment in an outbreak rather unpredictable. ...
Article
Regulatory measures during an outbreak keep many organizations from operating as usual, requiring new practices and policies. Since society has become highly dependent on effective and efficient information systems (IS), understanding how outbreaks may impact IS is critical. By looking at existing literature, problems associated with sustaining reliable IS services, as well as changing needs for IS caused by the new circumstances are explored, and new opportunities for IS after the outbreak are discussed.
... According to the WHO roughly 800,000,000 individuals will be infected with the Influenza virus of 6 As of August 1, 2020, COVID-19 already had led to more than 17 ...
Preprint
Full-text available
Fear of the coronavirus disease (COVID-19) has spread around the world. National borders are closed, the economy is shut down, and self-quarantining of millions of people have become the “new normal.” Early warnings regarding the readiness of large-scale RT-PCR testing in Europe, the existence of contradicting and ambiguous epidemiological data, and the striking similarities to the H1N1-pandemic scandal in 2009 could not prevent this global response to COVID-19. Vague definitions of “fatal COVID-19 cases”, unreliable RT-PCR tests as well as political, financial, and scientific special interests and often times biased news coverage by the mass media are also important factors. In this manuscript we demonstrate that COVID-19 is at most only equally as dangerous or even less dangerous than the seasonal flu of 2017/2018 or that of 2019/2020 in the US. Considering the degree of negligence of the World Health Organization (WHO) and many countries during the swine flu pandemic in 2009 as well as during past and ongoing public health programs in Europe and Africa in the management of quality-control procedures in the approval of diagnostic tests, vaccines, and other pharmacological agents, skepticism has taken an unusually distant back seat to panic. We encourage the use of critical thinking and rational evaluation of information in reaching informed decisions with respect to the upcoming vaccines and future pharmacological treatments for COVID-19. We propose the use of “Cystus052” as a potential preventive agent, convalescent plasma infusions (CPI) as the most promising treatment currently available for severe COVID-19 cases, and the inhibition of the “Papain-Like-Protease” (PLP) as rational approach for future research projects to the treatment of COVID-19.
... However, in the Netherlands, the "Osterhaus Affair" has not raised confidence in vaccination programs, either. In 2009, this Dutch virologist, advised WHO about the handling of an A1H1N! pandemic (Swine Flu, Mexican Flu) that never occurred [35,36]. Twenty of 40 million vaccines doses bought, the Dutch had to throw away. ...
... On the other hand, around a third of participants strongly believed in one or more conspiracy theories related to COVID-19, and that the belief in two of the conspiracy theories (man-made theory and business control theory) were significantly negatively associated with vaccination intent. Conspiracy theories have been reported in previous pandemics, with the possibility of affecting compliance to preventive measures and intention to vaccinate [43][44][45][46][47]. ...
Article
Full-text available
Background The massive, free and unrestricted exchange of information on the social media during the Covid-19 pandemic has set fertile grounds for fear, uncertainty and the rise of fake news related to the virus. This “viral” spread of fake news created an “infodemic” that threatened the compliance with public health guidelines and recommendations. Objective This study aims to describe the trust in social media platforms and the exposure to fake news about COVID-19 in Lebanon and to explore their association with vaccination intent. Methods In this cross-sectional study conducted in Lebanon during July–August, 2020, a random sample of 1052 participants selected from a mobile-phone database responded to an anonymous structured questionnaire after obtaining informed consent (response rate = 40%). The questionnaire was conducted by telephone and measured socio-demographics, sources and trust in sources of information and exposure to fake news, social media activity, perceived threat and vaccination intent. Results Results indicated that the majority of participants (82%) believed that COVID-19 is a threat and 52% had intention to vaccinate. Exposure to fake/ unverified news was high (19.7% were often and 63.8% were sometimes exposed, mainly to fake news shared through Watsapp and Facebook). Trust in certain information sources (WHO, MoPH and TV) increased while trust in others (Watsapp, Facebook) reduced vaccination intent against Covid-19. Believing in the man-made theory and the business control theory significantly reduced the likelihood of vaccination intent (Beta = 0.43; p = 0.01 and Beta = -0.29; p = 0.05) respectively. Conclusion In the context of the infodemic, understanding the role of exposure to fake news and of conspiracy believes in shaping healthy behavior is important for increasing vaccination intent and planning adequate response to tackle the Covid-19 pandemic.
... During health crises such as the H1N1 influenza pandemic in 2009 and the Ebola epidemic in 2013, questions arose about potential conflicts of interest among expert consultants who had financial connections with the pharmaceutical industry and who served on WHO advisory boards and the WHO Emergency Committee. 59,60 While conflicts of interest among experts have been widely discussed in academic forums, in the US Congress and in the press, exposing such conflicts of interest still is problematic. ...
Article
Full-text available
Social media have changed the way citizens participate in and express opinions about government policy. Social media serve organizations in achieving four main goals: interacting with citizens; fostering citizen participation; furthering open government; and analyzing/monitoring public opinion and activities. We contend that despite the importance of social media, international and local health organizations have been slow to adopt to them, primarily due to the discrepancy between intraorganizational discourse modes and the type of discourse suitable for dialogue with the public. In this perspective paper, we recommend strategies for such public dialogue based on understanding the challenges faced by organizations on the road to becoming more "social" in their social media presence and in their health and risk communication. Subsequently, we propose an integrative approach that combines three complementary paths: (1) putting the "social" back into health organizations' culture by inserting more "social" content into the internal organizational discourse through consultation with experts from different fields, including those who diverge from the scientific consensus. (2) Using strategies to enable health organizations to respond to the public on social networks, based on health communications research and studies on emerging infectious disease (EID) communication. (3) Engaging the public on social media based on the participatory approach, which considers the public as a partner that understands science and can work with the organizations to develop an open and innovative pandemic realm by using crowdsourcing to solve complex global health problems. For each path, we define the current challenges, among which are (1) overcoming organizational groupthink and hidden profiles, (2) treating all unofficial information as misleading, and (3) insufficient public engagement in solving complex global problems. We then offer recommendations for dealing with each challenge.
... Most health-related international organizations no longer use any measure of severity to define a Pandemic. For example, until May 2009, the World Health Organization (WHO) defined Pandemic as an outbreak generating 'enormous numbers of deaths and illness, but after May 2009, WHO dropped this phrase describing severity (Cohen & Carter, 2010). In the light of the above criteria, the COVID-19 worldwide outbreak can be described as the COVID-19 Pandemic . ...
Conference Paper
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We explored the Moral Attitudes (MA) and Organizational Ethics (OETH) before and during the COVID-19 Pandemic in relation to the sex of Information Technology (IT) Knowledge Workers (KW) in regional, cross-border enterprises in Poland, a transition economy. Two dimensions of MA and three dimensions of OETH-Ethical Optimism (ETO), Corporate Social Responsibility (CSR), and Top Management Action (TMA)-were investigated. The analysis was carried out on data obtained from a random survey among KW representing mainly small and medium-sized enterprises in the cross-border region of Lower Silesia. Our research findings suggest that KW manifest high enough moral codes that do not correlate too strongly with OETH. Pandemic and sex, in general, affect the relationship between MA and OETH of KW in the transition economy.
... Such conflicts of interest can lead to biased research that harms public health (Resnik, 2014), a flawed approval process of medical treatments (Cohen & Carter, 2010;DeLong, 2012;Ferner, 2005) and an unbalanced allocation of budgets to fight diseases (Nozaki, 2013;Stuckler et al., 2008). They also have a deleterious effect on public trust in science, medical research, and medicine (Cook et al., 2007;Drazen & Koski, 2000;Friedman, 2002). ...
Article
Full-text available
The controversy over vaccines, which has recently intensified following the COVID-19 pandemic, provokes heated debates, with both advocates and opponents raising allegations of bias and fraud in research. Researchers whose work raises doubts about the safety of certain vaccines claim to be victims of discriminatory treatment aimed at suppressing dissent, including the unjustified retraction of their published research. Such practices have previously been discussed in other controversial fields in science (e.g., AIDS, the environment, and water fluoridation) but not in the field of vaccines. The purpose of this study was to analyze, for the first time, the subjective views of researchers whose papers were retracted. Study participants are active researchers, most with international reputations in their respective fields. They perceived retraction as a means of censoring and silencing critical voices with the aim of preserving the pro-vaccination agenda of interested parties. Participants also reported additional measures aimed at harming them personally and professionally. These findings point to the need for a fair, open, and honest discourse about the safety of vaccines for the benefit of public health and the restoration of trust in science and medicine.
... This is because in modern society, the production system of healthcare supplies is profit-driven. 2 Decisions regarding the management of disease can no longer be made based solely on scientific grounds. Unless a disease poses a specific risk to a wide population, its mere presence in a localized area or population may not be significant from a business perspective. ...
Preprint
The COVID-19 pandemic has created huge damage to society and brought panics around the world. Such panics can be ascribed to the seemingly deceptive features of the COVID-19: compared to other deadly viral outspreads, it has medium transmission and mortality rates. As a result, the severity of the causative coronavirus, SARS-CoV-2, was deeply underestimated by the society at the beginning of the COVID-19 outbreak. Based on this, in this review, we define the viruses with features similar to those of SARS-CoV-2 as the Panic Zone viruses. To contain those viruses, accurate and fast diagnosis followed by effective isolation and treatment of patients are pivotal at the early stage of virus breakouts. This is especially true when there is no cure or vaccine available for a transmissible disease, which is the case for current COVID-19 pandemic. As of January 2021, more than two hundred kits for the COVID-19 diagnosis on the market are surveyed in this review, while emerging sensing techniques for SARS-CoV-2 are also discussed. It is of critical importance to rationally use these kits for the efficient management and control of the Panic Zone viruses. Therefore, we discuss guidelines to select diagnostic kits at different outbreak stages of the Panic Zone viruses, SARS-CoV-2 in particular. While it is of utmost importance to use nucleic acid-based detection kits with low false negativity (high sensitivity) at the early stage of an outbreak, the low false positivity (high specificity) gains its importance at later stages of the outbreak. When a society is set to reopen from the lock-down stage of the COVID-19 pandemic, it becomes critical to have antibody based immunoassay kits with high specificity to identify people who can safely return to the society after their recovery of SARS-CoV-2 infections. Given that the emergence of mutant viruses at the beginning of 2021 has complicated current battle against the COVID-19, we also discussed approaches and guidelines to detect viral mutants in the middle of the second wave of the pandemic that started at the end of 2020. Finally, since a massive attack from a viral pandemic requires a massive defense from the whole society, we urge both government and private sectors to research and develop more affordable and reliable point-of-care testing (POCT) kits, which can be used massively by the general public (and therefore called as massive POCT) to contain Panic Zone viruses in future.
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This article aims at understanding the challenges of tackling complex policy problems in multilevel governance. In order to better grasp the multilevel regulation of complex policy problems, it is needed to understand how uncertainty and scientific expertise are dealt with. We investigate this via the regulation of pandemics by the EU and the WHO, with the H1N1 pandemic of 2009 as critical case. The analysis of the multilevel practice reveals that the attitude toward uncertainty fundamentally differed between the global (WHO) and the European level. At the global level a classic speaking truth to power approach involved the denial of uncertainty, while at the EU level the assigned role of providing scientific expertise was interpreted as a necessity to openly communicate about uncertainty. While the global approach was heavily criticized, the uncertainty communication at the European level was much appreciated. © 2019 The Authors. European Policy Analysis published by Wiley Periodicals, Inc. on behalf of Policy Studies Organization.
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We are at this moment in the middle of the Corona COVID-19 (SARS-CoV-2) pandemic facing a global disaster, which seemingly is caused by a new deadly virus the whole world is trying to cope with after warning from the World Health Organization (WHO) about a mortality of 3.4%. Three leading experts in infectious diseases, Wolfgang Wodarg, Sucharit Bhakdi and John PA Ioannidis on the other hand hold the position that we are misinterpreting the statistics and instead facing a misinformation campaign, not a dangerous new virus. The WHO is counting the death-numbers wrongly, ignoring large dark numbers of infected, and ignoring both all we know about the Corona virus already, and all the statistics on the common cold and flu we have access to, and the statistics on mortality in the population we also have access to, thus creating an image of a mortal pandemic. Unfortunately, the politicians of the world have reacted to the WHO campaign as if it was true, creating massive fear in the population, which now has come to believe that we are facing a deathly new infection. Massive fear boosts the symptoms of Corona patients strongly in susceptible individual for psychosomatic reasons: If you believe you have a mortal infection, and everybody, including your own doctor and the hospital affirms you in this belief, it is only natural that you feel miserable. If you feel bad at the hospital, you will be treated. Hospitalization, ventilators, and drugs can give hospital infections, side effects, and increase mortality. In this way, the world has affirmed itself in the illusion of a mortal pandemic, which simply does not exist to begin with. COVID-19 has a mortality of around 0.01%, in accordance with the death statistics from many countries.
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When trusted international organisations like the World Health Organisation (WHO) get co-opted, the onus falls on national governments to dispassionately evaluate vaccines for their people. The state cannot abdicate this responsibility. In this context the role of international philanthropic organisations influencing the functioning of national technical advisory groups on behalf of vaccine lobbies is deprecated.
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In the “global war on terror,” civilians have been harmed by US and other governments’ airstrikes, such as unmanned aerial vehicle (UAV) attacks. This has led to public demand for more transparency into the harm inflicted upon civilian populations. Non-state actors have utilized UAVs for over a decade, and some have armed their UAVs, into kamikaze-style UAVs, or with grenade-dropping capability. This paper compares how UAV attacks by the United States and non-state actors harm civilian populations and how this might influence local or regional support for non-state actors. This study utilized data from 258 UAV attacks by non-state actors. Data on US UAV attacks were obtained from the Bureau of Investigative Journalism. The mean number of casualties and injuries from non-state actors’ UAV attacks were 0.17 and 0.43 per attack, respectively, as opposed to 0.42 and 0.14 from US UAV attacks. If non-state actors aim to gain support from local populations, taking their fight to the skies might not be the best strategy. Contrary, civilian harm from non-state actors’ attacks might strengthen security forces and create a stronger population-supported counterterrorism effort.
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Niet-deskundige politici, artsen met belangenverstrengelingen en een falend overheidsbeleid domineren de discussie over influenzavaccinatie. Het is verontrustend hoezeer de adviezen van de huidige deskundigen en politici getuigen van een groot gebrek aan wetenschappelijk en helder denkvermogen. Er zijn immers nog steeds geen wetenschappelijke bewijzen voor de werkzaamheid van de griepprik.
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We are at this moment in the middle of the Corona COVID-19 (SARS-CoV-2) pandemic facing a global disaster, which seemingly is caused by a new deadly virus the whole world is trying to cope with after warning from the World Health Organization (WHO) about a mortality of 3.4%. Three leading experts in infectious diseases, Wolfgang Wodarg, Sucharit Bhakdi and John PA Ioannidis on the other hand hold the position that we are misinterpreting the statistics and instead facing a misinformation campaign, not a dangerous new virus. The WHO is counting the death-numbers wrongly, ignoring large dark numbers of infected, and ignoring both all we know about the Corona virus already, and all the statistics on the common cold and flu we have access to, and the statistics on mortality in the population we also have access to, thus creating an image of a mortal pandemic. Unfortunately, the politicians of the world have reacted to the WHO campaign as if it was true, creating massive fear in the population, which now has come to believe that we are facing a deathly new infection. Massive fear boosts the symptoms of Corona patients strongly in susceptible individual for psychosomatic reasons: If you believe you have a mortal infection, and everybody, including your own doctor and the hospital affirms you in this belief, it is only natural that you feel miserable. If you feel bad at the hospital, you will be treated. Hospitalization, ventilators, and drugs can give hospital infections, side effects, and increase mortality. In this way, the world has affirmed itself in the illusion of a mortal pandemic, which simply does not exist to begin with. COVID-19 has a mortality of around 0.01%, in accordance with the death statistics from many countries.
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The media are strongly and uncritically reflecting the belief that Corona virus COVID-19 is a deadly virus, that causes high mortality in NYC. The belief is coming from the World Health Organization WHO, who has estimated the infection mortality rate (IMR) to be 3.4%, but scientist all over the world is now based on mortality statistics and autopsy studies documenting that the IMR of COVID-19 is less than 0.01%. The stories in the media seem convincing, with pictures of mass-graves and mobile morgues in New York City, and terrible statistics of death in NYC presented in New York Times. There is an obvious mismatch between the information that comes from the independent scientist and the WHO, and many people take the media stories from NYC as a proof of COVID-19 being a fatal new virus. We have therefore looked into the media stories about the effect of the 2020 Corona pandemic on New York City and have been able to document for each story we have analyzed that the story comes from an interpretation of reality that is based on the preconceived idea that NYC is under attack of a deadly new virus. This means that when we look at the data presented in the story, we come to the opposite conclusion: there is nothing in the data behind the media stories that justifies the conclusion that a deadly pandemic is happening in NYC. The data is in line with the IMR of 0.01% found by the independent experts while the stories are in line with the IMR of 3.4% estimated by WHO. We warn the world that WHO most likely is following the interests of the pharmaceutical industry that funds WHO, and encourage the media to be much more critical and thorough in their research, so the media stories about COVID-19 can be less biased in the future. Keywords: pandemic, corona, industry, virus, graves
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Oversat fra “Ventegodt S, Merrick J. A tribute to the Corona virus COVID-19 (SARS-CoV-2) whistle-blowers. J Altern Med Res 2020;12(2):In Press”Open Access. Teksten kan bruges frit med denne reference. Vi er i dette øjeblik midt i Corona COVID-19 (SARS-CoV-2) pandemien, hvor vi står over for en global katastrofe, som efter sigende er forårsaget af en ny dødbringende virus, med en dø-delighed på omkring 3,4 %, som hele verden prøver at håndte-re, efter advarsel fra Verdenssundhedsorganisationen (WHO) Tre førende eksperter i infektionssygdomme, Wolfgang Wod-arg, Sucharit Bhakdi og John PA Ioannidis, mener, at vi fortol-ker statistikken fejlagtigt og at vi ikke står over for en ny og farlig virus men overfor en misinformationskampagne. WHO tæller dødstallene forkert, ignorerer store mængder raske smit-tede, og ignorerer både alt det vi allerede ved om Corona-virus-sen, og alle statistikker om almindelig forkølelse og influenza, som fx de statistiske oplysninger om dødelighed i befolkningen som vi har adgang til, og skaber derved et billede af en pandemi med et dødeligt Corona virus. Desværre har verdens politikere reageret på WHO-kampagnen, som om den var sand, hvilket skaber massiv frygt; befolkningen har af sundhedsmyndighe-derne fået at vide, at vi står over for en ny dødbringende infek-tion. Massiv frygt øger symptomerne på Corona infektionen. Dette ses især hos mennesker som er særligt sårbare af indivi-duelle psykosomatiske årsager. Hvis du mener, du har en døde-lig infektion, og alle, herunder din egen læge og hospitalet be-kræfter dig i opfattelsen, er det kun naturligt, at du føler dig dårligt tilpas. Og hvis du har det dårligt på hospitalet, ja, så bliver du behandlet. Både indlæggelse, medicin og respiratorer kan give infektioner, bivirkninger og øge dødeligheden. På den måde har verden bekræftet sig selv i illusionen om en dødelig pandemi, der til at begynde med simpelt hen ikke eksisterer. COVID-19 har en dødelighed på omkring 0,01 % ifølge stati-stikkerne fra mange lande.
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Nous sommes actuellement au milieu de la pandémie du Corona COVID-19 (SARS-CoV-2) que répresent une catastrophe mondiale, qui est apparemment causée par un nouveau virus mortel que le monde entier essaie d’affronter après un avertissement de l’Organisation Mondiale de la Santé (OMS), que selon cette organisation a une mortalité de 3,4%. D’autre part, trois grands experts des maladies infectieuses, Wolfgang Wodarg, Sucharit Bhakdi et John PA Ioannidis soutiennent que nous interprétons mal les statistiques et que par contre,nous faisons face à une campagne de désinformation et non à un nouveau virus dangereux. L’OMS compte des nombres de décès de façon incorrecte, ignore un grand et obscure nombre de personnes infectées et ignore tout ce que nous savons sur le coronavirus, toutes les statistiques sur le rhume et la grippe communs auxquelles nous avons accès, en plus des statistiques sur la mortalité dans la population. Nous avons également accès à la création d’une image d’une pandémie mortelle. Malheureusement, les politiciens du monde entier ont réagi à la campagne de l’OMS comme si elle était vraie, créant une peur massive de la population, qui en vient à croire que nous luttons contre une nouvelle infection mortelle. La peur généralisée augmente fortement les symptômes des patients Corona chez l’individu sensible pour des raisons psychosomatiques: si vous pensez que vous avez une infection mortelle et que tout le monde, y compris votre propre médecin et l’hôpital, réaffirment cette croyance, c’est naturel que vous vous sentiez mal. Si vous vous sentez mal à l’hôpital, vous recevrez un traitement. L’hospitalisation et les médicaments peuvent provoquer des infections hospitalières, des effets secondaires et augmenter la mortalité en soi. De cette façon, le monde s’est affirmé dans l’illusion d’une pandémie meurtrière, qui en premier lieu n’existe même pas. Le COVID-19 a une mortalité d’environ 0,01%, selon les statistiques de décès dans nombreux pays.
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Atualmente, estamos no meio da pandemia do Corona COVID- 19 (SARS-CoV-2) diante de um desastre global, aparentemente causado por um novo vírus mortal com o qual o mundo inteiro está a tentar de lidar após um aviso da Organização Mundial da Saúde (OMS), com uma mortalidade de 3,4%. Por outro lado, três dos principais especialistas em doenças infecciosas, Wolfgang Wodarg, Sucharit Bhakdi e John PA Ioannidis, mantêm a posição de que estamos a interpretar mal as estatísticas, e em contrapartida, nós estamos a enfrentar uma campanha de desinformação e não um novo vírus perigoso. A OMS está a contar os números de mortes impropriamente, e a ignorar um grande e obscuro número de pessoas infectadas e a ignorar tudo o que sabemos sobre o Coronavírus, todas as estatísticas do resfriado e gripe comuns às quais temos acesso, além das estatísticas sobre a mortalidade na população. Também temos acesso para deste modo criar uma imagem de uma pandemia mortal. Lamentavelmente, os políticos do mundo reagiram à campanha da OMS como se fosse verdade, e está a criar um medo enorme na população, que agora acredita que estamos a lutar contra uma nova infecção mortal. O medo generalizado aumenta fortemente os sintomas dos pacientes Corona no indivíduo suscetível por razões psicossomáticas: se você acredita ter uma infecção fatal, e todos, está a incluir seu próprio médico e o hospital, afirmam essa crença, é natural que você se sinta mal. Se você se sentir mal no hospital, receberá tratamento, a Hospitalização e medicamentos podem causar infecções hospitalares, efeitos colaterais e aumentar a mortalidade em si. Dessa maneira, o mundo se afirmou na ilusão de uma pandemia mortal, que em primeiro lugar nem mesmo existe. O COVID-19 tem uma mortalidade em torno de 0,01%, de acordo com as estatísticas de mortes em muitos países.
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Vi befinner oss i mitten av Corona COVID-19 (SARS-CoV-2) -pandemin inför en global katastrof, som till synes orsakats av ett nytt dödligt virus som hela världen försöker hantera efter varning från Världshälsoorganisationen (WHO) om en dödlighet på 3,4%. Tre ledande experter på infektionssjukdomar, Wolfgang Wodarg, Sucharit Bhakdi och John PA Ioannidis, anser, å andra sidan, att vi misstolkar statistiken och istället står inför en felaktig informationskampanj, inte ett farligt nytt virus. WHO felräknar dödssiffran, ignorerar stora mörka antal smittade, och ignorerar både allt det vi redan vet om det Corona virus, och all statistik om vanlig förkylning och influensa vi har tillgång till och statistik om dödlighet i befolkningen vi också har tillgång till och därmed skapar vi en bild av ett dödligt epidemiskt coronavirus. Tyvärr har världens politiker reagerat på WHO-kampanjen som om det var sant och skapat massiv rädsla i befolkningen, som nu har kommit att tro att vi står inför en dödlig ny infektion. Massiv rädsla ökar symptomen av Corona patienter kraftigt i mottagliga individer för psykosomatiska orsaker: Om du tror att du har en dödlig infektion, och alla, inklusive din egen läkare och sjukhus bekräftar dig i detta, är det bara naturligt att du bör känna dig dålig. Om du mår dåligt på sjukhuset, kommer du att behandlas. Hospitalisering och läkemedel kan ge sjukhusinfektioner, biverkningar och öka dödligheten av sig själv. På detta sätt har världen bekräftat sig i illusionen av en dödlig epidemi, som helt enkelt inte existerar till att börja med. COVID-19 har en dödlighet på cirka 0,01%, i enlighet med dödsstatistiken från många länder.
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Estamos en este momento en medio de la pandemia Corona COVID-19 (SARS-CoV-2) que enfrenta un desastre global, que aparentemente es causado por un nuevo virus mortal que el mundo entero está tratando de enfrentar después de una advertencia de la Organización Mundial de la Salud (OMS) con una mortalidad del 3,4%. Por otro lado, tres expertos líderes en enfermedades infecciosas, Wolfgang Wodarg , Sucharit Bhakdi y John PA Ioannidis sostienen la posición de que estamos malinterpretando las estadísticas y, en cambio, enfrentamos una campaña de desinformación y no un nuevo virus peligroso. La OMS está contando los números de muertes incorrectamente, ignorando grandes números oscuros de infectados e ignorando todo lo que sabemos sobre el Coronavirus, todas las estadísticas sobre el resfriado común y la gripe a las que tenemos acceso, además de las estadísticas sobre mortalidad en la población. Tenemos también acceso a crear así una imagen de una pandemia mortal. Desafortunadamente, los políticos del mundo han reaccionado a la campaña de la OMS como si fuera cierto, creando un miedo masivo en la población, que ahora ha llegado a creer que estamos combatiendo una nueva infección mortal. El miedo generalizado aumenta los síntomas de los pacientes de Corona fuertemente en el individuo susceptible por razones psicosomáticas: Si usted cree que tiene una infección mortal, y todo el mundo, incluyendo a su propio médico y el hospital le afirman esta creencia , es natural que usted se sienta mal. Si se siente mal en el hospital, recibirá tratamiento. La hospitalización y los medicamentos pueden provocar infecciones hospitalarias, efectos secundarios y aumentar la mortalidad de por sí. De esta manera, el mundo se ha afirmado en la ilusión de una pandemia mortal , que en primer lugar, no existe siquiera. El COVID-19 tiene una mortalidad de alrededor del 0.01%, de acuerdo con las estadísticas de muertes de muchos países.
Chapter
The WHO has identified the development of mental health laws and legal expertise as critical to supporting new global sustainable development and mental health goals. Understanding international standard-setting instruments can also be invaluable for mental health advocates seeking to implement or reform domestic mental health legislation. This chapter will examine some of the WHO’s contributions to global health law and practice including the Framework Convention on Tobacco Control (FCTC), the International Health Regulations, and a number of soft law instruments as models for future mental health law. This chapter also proposes areas for expanded ethical inquiry as the field of global mental health law evolves.
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La crainte de la maladie à coronavirus 2019 (COVID-19) s’est propagée de par le monde. Les frontières nationales sont fermées, l’économie est mise à l’arrêt et la mise en quarantaine de millions de personnes est devenue la « nouvelle normalité ». Les avertissements précoces concernant la disponibilité de tests RT-PCR à grande échelle en Europe, l’existence de données épidémiologiques contradictoires et ambiguës ainsi que les ressemblances frappantes avec le scandale de la pandémie de H1N1 en 2009 n’ont pas permis d’éviter cette réponse mondiale à la COVID-19. De vagues définitions de « cas mortels de COVID-19 », des tests RT-PCR peu fiables, des intérêts spéciaux à la fois politiques, économiques et scientifiques ainsi que la couverture médiatique souvent tendancieuse représentent également des facteurs importants. Dans cette étude, nous montrerons que la COVID-19 est au pire aussi dangereux, sinon moins, que la grippe saisonnière de 2017/18 ou que celle de 2019/20 aux États-Unis. Si l’on considère le degré de négligence de l’Organisation Mondiale de la Santé (OMS) et de nombreux pays dans la pandémie de grippe porcine de 2009 ainsi qu’au cours des programmes de santé publique passés et actuels en Europe et en Afrique dans le cadre de la gestion des procédures de contrôle-qualité et de l’homologation des tests de diagnostic, des vaccins et des agents pharmacologiques, on peut affirmer que le scepticisme a fait place à un sentiment de panique. Nous sommes en faveur du jugement critique et de l’évaluation rationnelle des informations lors de la prise de décisions concernant les futurs vaccins et traitements pharmacologiques de la COVID-19. Nous proposons l’utilisation du « Cystus 052 » comme agent préventif potentiel, la transfusion de plasma de convalescents (CPI) comme le traitement le plus prometteur actuellement disponible pour les cas graves de COVID-19 ainsi que l’inhibition de papaïne comme approche rationnelle dans le cadre de futurs projets de recherche de traitement à la COVID-19.
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Die Angst vor der Coronavirus-Erkrankung 2019 (COVID-19) hat sich weltweit verbreitet. Landesgrenzen wurden geschlossen, die Wirtschaft wurde stillgelegt und die Selbstquarantäne von Millionen von Menschen sind zur sogenannten „neuen Normalität“ erklärt worden. Frühzeitige Vorwarnungen in Bezug auf die Bereitschaft zu groß angelegten RT-PCR-Testungen in Europa, die Existenz von widersprüchlichen und ambivalenten epidemiologischen Daten sowie die frappierende Ähnlichkeit zum H1N1-Pandemieskandal 2009/2010 vermochte nicht diese erdumspannende angstgetriebene Reaktion auf die COVID-19 Pandemie zu verhindern. Undifferenzierte Definitionen zur Feststellung von „COVID-19-Todesfällen“, unzuverlässige RT-PCR-Tests sowie politische, finanzielle und wissenschaftliche Interessengemeinschaften und eine oft voreingenommene Berichterstattung der Massenmedien sind ebenfalls wichtige Einflussfaktoren. In diesem Manuskript zeigen wir, dass die Erkrankung COVID-19 genauso gefährlich, wenn nicht sogar weniger gefährlich ist als die saisonale Grippe von 2017/2018 oder die von 2019/2020 in den Vereinigten Staaten von Amerika (USA). Angesichts der Nachlässigkeit der Weltgesundheitsorganisation (WHO) und vieler anderer Nationen während der Schweinegrippe-Pandemie 2009/2010 sowie während vergangener und laufender öffentlicher Gesundheitsförderprogramme in Europa und Afrika bezüglich des Umgangs mit Qualitätskontrollverfahren für die Zulassung von diagnostischen Tests, Impfstoffen und anderen pharmakologischen Wirkstoffen, spielt der für gewöhnlich geführte nüchterne wissenschaftliche Diskurs in solchen Fragen für die COVID-19 Pandemie eine ungewöhnlich untergeordnete Rolle. Ein tieferes Verständnis und eine angemessene Bewertung der derzeitigen Corona-Krise ist nur durch eine multidimensionale Betrachtung möglich. Nicht nur epidemiologische Daten und medizinische Erkenntnisse, sondern auch ökonomische Gesichtspunkte, psychologische und sozialpsychologische Hintergründe, sowie die Informations- und Kommunikationspraxis in den Massenmedien und sozialen Netzwerken sowie soziale und politische Strömungen und Bestrebungen müssen bei einer ganzheitlichen, der Komplexität der Krise angemessenen Betrachtung, mit heran gezogen werden. Das wurde in der vorliegenden Arbeit versucht.
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Researchers and doctors all over the world agrees that the COVID-19 virus is not more dangerous than the normal influenza, yet the World Health Organisation (WHO) and the govenments of the world react to it as if it was a new threat to mankind. This book analyses what is happening and why.
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Strah od bolesti koronavirusa (COVID-19) proširio se širom sveta. Državne granice su zatvorene, ekonomije su u stanju nazadovanja, a samoizolacija miliona ljudi postaje „nova norma“. Rana upozorenja u vezi sa spremnošću za veliko RT-PCR testiranje u Evropi, postojanje kontradiktornih i dvosmislenih epidemioloških podataka i zapanjujuće sličnosti sa skandalom H1N1-pandemije 2009. godine nisu mogli sprečiti ovakvu globalnu reakciju na COVID-19. Nejasne definicije „fatalnih slučajeva COVID-19“, nepouzdani RT-PCR testovi, kao i politički, finansijski i naučni interesi i često pristrasna obaveštavanja od strane masovnih medija takođe su važni faktori. U ovom tekstu prikazaćemo da je COVID-19 u nahjgorem slučaju podjednako opasan ili čak manje opasan od sezonskog gripa 2017/2018 ili 2019/2020 u SAD-u. Uzimajući u obzir stepen nemarnosti Svetske zdravstvene organizacije (WHO – World Health Organization; u daljem tekstu SZO) i mnogih zemalja tokom pandemije svinjskog gripa 2009. godine, kao i tokom prošlih i tekućih programa javnog zdravstva u Evropi i Africi u vezi sa postupcima kontrole kvaliteta za odobravanje dijagnostičkih testova, vakcina i drugih farmakoloških sredstava, skepticizam je zauzeo svoje mesto i ide ruku pod ruku sa panikom. Podstičemo upotrebu kritičkog mišljenja i racionalne procene sadržaja u donošenju informisanih odluka u vezi s predstojećim vakcinama i budućim farmakološkim tretmanima za COVID-19. Predlažemo upotrebu „Cystus052“ kao potencijalnog preventivnog sredstva, infuzije rekonvalescentne plazme (CPI - convalescent plasma infusions; u daljem tekstu IRP) kao lečenje koje najviše obećava i koje je trenutno dostupno za teške slučajeve COVID-19, suzbijanje „Papain-Like-Protease“ (PLP) kao i CPI koje su se pokazale kao racionalan pristup za buduće istraživačke projekte lečenja COVID-19.
Chapter
Surveillance began with counting the numbers of people in the population. At various times in history, numbers have been used to assess the overall strength of the population, to identify the march of dangerous contagion, or to determine needs for food or labor. But even simple counting of population numbers, vital statistics, or reports of disease has been controversial. Information is power and the most rudimentary surveillance can be used both for good and for harm. This chapter sets ethical questions about these basic surveillance methods in historical and epistemological context. It gives examples of uses of data about population numbers, vital statistics, or outbreaks that have been clearly beneficial, as well as examples that have bordered on the genocidal. Counting numbers, as a rudimentary epidemiological method, also presents the opportunity to explore ethical problems raised by epidemiology as a science, such as incomplete data, biased data, or false negatives or positives. Today, with increasing understanding of disease and availability of prevention or treatment, the advantages of outbreak detection may be shared far more widely and more equally. Nonetheless, outbreak detection can generate fear and hostility if patterns of disease track otherwise disfavored groups. COVID-19 has revealed the importance of demographic data about the distribution of disease burdens—data that may either generate mistrust as people see their disadvantage starkly, or that may foster trust if the result is increased attention to disparities in treatment and in health.
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El miedo a la enfermedad de coronavirus 2019 (COVID-19) se ha expandido por el mundo. Las fronteras nacionales están cerradas, la economía está detenida y la cuarentena de millones de personas se ha convertido en la “nueva normalidad”. Los avisos tempranos sobre la preparación de pruebas RT-PCR a gran escala en Europa, la existencia de datos epidemiológicos contradictorios y ambiguos y las sorprendentes similitudes con el escándalo de la pandemia de gripe H1N1 en 2009 no pudieron prevenir esta respuesta mundial al COVID-19. Definiciones vagas de “casos fatales de COVID-19”, pruebas RT-PCR poco confiables, así como intereses políticos, financieros y científicos especiales y, a menudo, la cobertura de noticias influenciadas por parte de los medios de comunicación también son factores importantes. En este manuscrito demostramos que el COVID-19 es, como mucho, solo igual de peligroso o hasta menos peligroso que la gripe estacional del 2017/2018 o la del 2019/2020 en EE. UU. Considerando el nivel de negligencia de la Organización Mundial de la Salud (OMS) y de muchos países durante la pandemia de gripe porcina en 2009, así como durante programas de salud pasados y actuales en Europa y África en la administración de procedimientos de control de calidad para la aprobación de pruebas diagnósticas, vacunas y otros agentes farmacológicos, el escepticismo ha quedado en un asiento trasero inusualmente distante al pánico. Nosotros alentamos el uso de pensamiento crítico y evaluación racional de información para tomar decisiones informadas con respecto a las próximas vacunas y los futuros tratamientos farmacológicos para COVID-19. Nosotros alentamos el uso de “Cystus052” como un potencial agente preventivo, infusiones de plasma convaleciente (CPI) como el tratamiento de “uso compasivo” más prometedor disponible al momento para casos graves de COVID-19 y la inhibición de la "proteasa similar a la papaína" (PLP), así como las CPI como enfoque racional para futuros proyectos de investigación para el tratamiento de COVID-19.
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Social media companies have resorted to censorship to suppress misinformation about the COVID-19 pandemic. This is not the most prudent solution though given the uncertainties about the disease.
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Wir befinden uns derzeitig mitten in der Corona COVID-19 (SARS-CoV-2) Pandemie und im Angesicht eines globalen Disasters. Scheinbar ausgelöst durch ein neues tödliches Virus, versucht die ganze Welt, nach Warnungen der WHO vor eine Sterblichkeitsrate von 3,4%, mit der Pandemie umzugehen. Auf der anderen Seite, vertreten drei leitende Experten im Bereich ansteckender Krankheiten: Wolfgang Wodag, Sucharit Bhakdi und John PA Ioannidis die Position, dass wir die Statistiken fehlinterpretieren und wir vielmehr mit einer fehlerhaften Berichterstattung, nicht mit einem gefährlichen neuen Virus, konfrontiert sind. Die WHO zählt die Todesfälle inkorrekt und ignoriert hohe dunkel Ziffern von Infizierten. Es wird nicht nur alles, was wir bereits über das Corona-Virus wissen ignoriert, sondern auch die Statistiken über Erkältungen, Grippe und Sterblichkeitsraten der Bevölkerung, zu denen wir bereits Zugang haben. Dadurch kommt das Bild einer tödlichen Pandemie zustande. Bedauerlicher Weise haben Politiker aus der ganzen Welt der Kampagne der WHO Glauben geschenkt, so das nun massive Furcht in der Bevölkerung herrscht, basierend auf der Annahme, dass wir einer neuen tödlichen Infektion gegenüberstehen. Aus psychosomatischen Gründen, verstärkt massive Angst die Symptome der Corona-Patienten in empfindlichen Individuen erheblich: Wenn eine Person in dem Glauben ist, eine tödliche Infektion zu haben, und alle in ihrem Umkreis, einschließlich der behandelnde Arzt und das Krankenhaus, diesen Glauben bestätigen, dann ist es nur natürlich, dass es dieser Person schlecht geht. Wenn Sie im Krankenhaus sind und es Ihnen schlecht geht, werden Sie behandelt. Hospitalisierung und Medikamente allein können zu Krankenhausinfektionen, Nebenwirkungen und erhöhter Sterblichkeit führen. Auf dieser Weise bestätigt sich die Welt selbst in der Illusion, dass es sich um eine tödliche Pandemie handelt – welche jedoch von Beginn an gar nicht erst existiert. COVID-19 zeigt übereinstimmend mit den Sterblichkeitsstatistiken vieler Ländern eine Sterblichkeitsrate von ca. 0.01% auf. Schlüsselwörter: Corona-Virus, COVID-19, SARS-CoV-2 , Pandemie , psychosomatische Theorie, Sterblichkeitsrate, Fallsterblichkeitsrate, Weltgesundheitsorganisation, Korruption, Fehlinformationen, Politik, Wirtschaft Korrespondenz: Søren Ventegodt , MD, MMedSci , EU-MSc-CAM, Forschungszentrum für Lebensqualität, Schlegels Allé 4, 5tv, 1807 Frb C, Kopenhagen, Dänemark. E-Mail: ventegodt@livskvalitet.org
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Issues of financial and intellectual conflict of interest in clinical practice guidelines have raised increasing concern. Professional organizations have responded by more rigorous regulation of conflict of interest. Nevertheless, tension remains between the competing goals of optimizing guideline quality by using the experience and insight of experts and ensuring that financial and intellectual conflicts of interest do not influence recommendations. The executive committee of the American College of Chest Physicians' Antithrombotic Guidelines has developed a strategy comprising 3 innovative aspects to address this tension: First, place equal emphasis on intellectual and financial conflicts and provide explicit criteria for both; second, a methodologist without important conflicts of interest should have primary responsibility for each chapter; and third, experts with important financial or intellectual conflicts of interest can collect and interpret evidence, but only panel members without important conflicts can be involved in developing the recommendation for a specific question. These strategies may help to achieve the benefits of expert input without conflicts of interest influencing recommendations.
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To update a 2005 Cochrane review that assessed the effects of neuraminidase inhibitors in preventing or ameliorating the symptoms of influenza, the transmission of influenza, and complications from influenza in healthy adults, and to estimate the frequency of adverse effects. Search strategy An updated search of the Cochrane central register of controlled trials (Cochrane Library 2009, issue 2), which contains the Acute Respiratory Infections Group's specialised register, Medline (1950-Aug 2009), Embase (1980-Aug 2009), and post-marketing pharmacovigilance data and comparative safety cohorts. Selection criteria Randomised placebo controlled studies of neuraminidase inhibitors in otherwise healthy adults exposed to naturally occurring influenza. Duration and incidence of symptoms; incidence of lower respiratory tract infections, or their proxies; and adverse events. Two reviewers applied inclusion criteria, assessed trial quality, and extracted data. Data analysis Comparisons were structured into prophylaxis, treatment, and adverse events, with further subdivision by outcome and dose. 20 trials were included: four on prophylaxis, 12 on treatment, and four on postexposure prophylaxis. For prophylaxis, neuraminidase inhibitors had no effect against influenza-like illness or asymptomatic influenza. The efficacy of oral oseltamivir against symptomatic laboratory confirmed influenza was 61% (risk ratio 0.39, 95% confidence interval 0.18 to 0.85) at 75 mg daily and 73% (0.27, 0.11 to 0.67) at 150 mg daily. Inhaled zanamivir 10 mg daily was 62% efficacious (0.38, 0.17 to 0.85). Oseltamivir for postexposure prophylaxis had an efficacy of 58% (95% confidence interval 15% to 79%) and 84% (49% to 95%) in two trials of households. Zanamivir performed similarly. The hazard ratios for time to alleviation of influenza-like illness symptoms were in favour of treatment: 1.20 (95% confidence interval 1.06 to 1.35) for oseltamivir and 1.24 (1.13 to 1.36) for zanamivir. Eight unpublished studies on complications were ineligible and therefore excluded. The remaining evidence suggests oseltamivir did not reduce influenza related lower respiratory tract complications (risk ratio 0.55, 95% confidence interval 0.22 to 1.35). From trial evidence, oseltamivir induced nausea (odds ratio 1.79, 95% confidence interval 1.10 to 2.93). Evidence of rarer adverse events from pharmacovigilance was of poor quality or possibly under-reported. Neuraminidase inhibitors have modest effectiveness against the symptoms of influenza in otherwise healthy adults. The drugs are effective postexposure against laboratory confirmed influenza, but this is a small component of influenza-like illness, so for this outcome neuraminidase inhibitors are not effective. Neuraminidase inhibitors might be regarded as optional for reducing the symptoms of seasonal influenza. Paucity of good data has undermined previous findings for oseltamivir's prevention of complications from influenza. Independent randomised trials to resolve these uncertainties are needed.
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New antiviral drugs are available for the treatment of influenza type A and type B infections. In clinical practice, antiviral use has rarely been guided by antecedent laboratory diagnosis. Defined clinical predictors of an influenza infection can help guide timely therapy and avoid unnecessary antibiotic use. To examine which clinical signs and symptoms are most predictive of influenza infection in patients with influenza-like illness using a large data set derived from clinical trials of zanamivir. This analysis is a retrospective, pooled analysis of baseline signs and symptoms from phase 2 and 3 clinical trial participants. It was conducted in mainly unvaccinated (mean age, 35 years) adults and adolescents who had influenza-like illness, defined as having fever or feverishness plus at least 2 of the following influenza-like symptoms: headache, myalgia, cough, or sore throat who underwent laboratory testing for influenza. Clinical signs and symptoms were evaluated in statistical models to identify those best predicting laboratory confirmation of influenza. Of 3744 subjects enrolled with baseline influenza-like symptoms, and included in this analysis, 2470 (66%) were confirmed to have influenza. Individuals with influenza were more likely to have cough (93% vs 80%), fever (68% vs 40%), cough and fever together (64% vs 33%), and/or nasal congestion (91% vs 81%) than those without influenza. The best multivariate predictors of influenza infections were cough and fever with a positive predictive value of 79% (P<. 001). The positive predictive value rose with the increase in the temperature at the time of recruitment. When influenza is circulating within the community, patients with an influenza-like illness who have both cough and fever within 48 hours of symptom onset are likely to have influenza and the administration of influenza antiviral therapy may be appropriate to consider. Arch Intern Med. 2000;160:3243-3247.
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A double-blind, randomized study of inhaled zanamivir for the prevention of influenza in families was conducted. Once a person with a suspected case of influenza was identified (index patient), treatment of all other household members (contacts) ⩾5 years old was initiated. Contacts received either 10 mg zanamivir or placebo inhaled once daily for 10 days. Index patients received relief medication only. In total, 487 households (242 placebo and 245 zanamivir) were enrolled, with 1291 contacts randomly assigned to receive prophylaxis. Four percent of zanamivir versus 19% of placebo households (P<.001) had at least 1 contact who developed symptomatic, laboratory-confirmed influenza, representing 81% protective efficacy (95% confidence interval, 64%–90%). Protective efficacy was similarly high for individuals (82%) and against both influenza types A and B (78% and 85%, respectively, for households). Zanamivir was well tolerated and was effective in preventing influenza types A and B within households where the index patient was not treated
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To review the clinical effectiveness of oseltamivir and zanamivir for the treatment and prevention of influenza A and B. Systematic review and meta-analyses of randomised controlled trials. Published studies were retrieved from electronic bibliographic databases; supplementary data were obtained from the manufacturers. Randomised controlled, double blind trials that were published in English, had data available before 31 December 2001, evaluated treatment or prevention of naturally occurring influenza with zanamivir or oseltamivir (if given using the formulation and dosage licensed for clinical use), and reported at least one end point of relevance. The main outcome measures were the median time to the alleviation of symptoms (for treatment trials) and number of flu episodes avoided (for prevention trials). Three population groups were defined: children aged 12 years and under; otherwise healthy individuals aged 12 to 65 years; and "high risk" individuals (those with certain chronic medical conditions or aged 65 years and older). Seventeen treatment trials and seven prevention trials identified met the inclusion criteria. All trials included compared one of the drugs against placebo or standard care. Treatment of children, otherwise healthy individuals, and high risk populations with zanamivir reduced the median duration of symptoms in days respectively by 1.0 (95% confidence interval 0.5 to 1.5), 0.8 (0.3 to 1.3), and 0.9 (-0.1 to 1.9) for the intention to treat population. The corresponding results, in days, for oseltamivir were 0.9 (0.3 to 1.5), 0.9 (0.3 to 1.4), and 0.4 (-0.7 to 1.4). The effect of giving zanamivir and oseltamivir prophylactically resulted in a relative reduction of 70-90% in the odds of developing flu, depending on the strategy adopted and the population studied. Evidence from randomised controlled trials consistently supports the view that both oseltamivir and zanamivir are clinically effective for treating and preventing flu. However, evidence is limited for the treatment of certain populations and for all prevention strategies.
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We attempted to develop in vivo resistance of influenza virus to amantadine and to zanamivir, by use of the ferret model of influenza virus infection. Resistance of influenza virus A/LosAngeles/1/87 (H3N2) to amantadine was generated within 6 days, during a single course of treatment, and mutations in the M2 gene that are characteristic of human infections were observed. In contrast, during an identical single course of treatment with zanamivir, no evidence of reduced susceptibility was demonstrated. Pooled virus shed by zanamivir-treated ferrets was used to infect another group of ferrets. Twenty virus clones grew in plaque assays containing zanamivir, indicating possible reduced susceptibility; however, none exhibited reduced susceptibility to zanamivir in neuraminidase (NA) inhibition assays. Sequencing of the NA gene of these clones revealed only a noncoding nucleotide mutation at position 685. Sequencing of the hemagglutinin gene revealed mutations at positions 53, 106, 138, 145, 166, and 186. Similar to the situation in humans, amantadine use in ferrets rapidly produces antiviral resistance, but zanamivir use does not, although nucleotide changes were observed
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Viral respiratory tract infection (VRTI) is the most common illness in humans. Despite the high incidence, the economic impact of non-influenza-related VRTI has not been rigorously explored. Our objectives were to obtain an updated incidence of non-influenza-related VRTI in the United States and to quantify the health care resource use (direct costs) and productivity losses (indirect costs) associated with these infections. A nationwide telephone survey of US households (N = 4051) was conducted between November 3, 2000, and February 12, 2001 to obtain a representative estimate of the self-reported incidence of non-influenza-related VRTI and related treatment patterns. Direct treatment costs measured included outpatient clinician encounters, use of over-the-counter and prescription drugs, and associated infectious complications of non-influenza-related VRTI. Absenteeism estimates for infected individuals and parents of infected children were extrapolated from National Health Interview Survey data. Of survey respondents, 72% reported a non-influenza-related VRTI within the past year. Respondents who experienced a self-reported non-influenza-related VRTI averaged 2.5 episodes annually. When these rates are extrapolated to the entire US population, approximately 500 million non-influenza-related VRTI episodes occur per year. Similarly, if the treatment patterns reported by the respondents are extended to the population, the total economic impact of non-influenza-related VRTI approaches $40 billion annually (direct costs, $17 billion per year; and indirect costs, $22.5 billion per year). Largely because of the high attack rate, non-influenza-related VRTI imposes a greater economic burden than many other clinical conditions. The pending availability of effective antiviral therapies warrants increased attention be paid to this common and expensive illness.
Article
This week’s BMJ is dominated by a cluster of articles on oseltamivir (Tamiflu) (doi:10.1136/bmj.b5351, doi:10.1136/bmj.b5387, doi:10.1136/bmj.b5106, doi:10.1136/bmj.b5164, doi:10.1136/bmj.b5248, doi:10.1136/bmj.b5364). Between them the articles conclude that the evidence that oseltamivir reduces complications in otherwise healthy people with pandemic influenza is now uncertain and that we need a radical change in the rules on access to trial data.Briefly, in updating their Cochrane review, published this week (doi:10.1136/bmj.b5106), Tom Jefferson and colleagues failed to verify claims, based on an analysis of 10 drug company trials, that oseltamivir reduced the risk of complications in healthy adults with influenza. These claims have formed a key part of decisions to stockpile the drug and make it widely available.Only after questions were put by the BMJ and Channel 4 News has the manufacturer Roche committed to making “full study reports” available on a password protected site. Some questions remain about who did what in the Roche trials, how patients were recruited, and why some neuropsychiatric adverse events were not reported. A response from Roche is published in our letters pages (doi:10.1136/bmj.b5364) and their full point by point response is published online (doi:10.1136/bmj.b5374).Should the BMJ be publishing the Cochrane review given that a more complete analysis of the evidence may be possible in the next few months? Yes, because Cochrane reviews are by their nature interim rather than definitive. They exist in the present tense, always to be superseded by the next update. They are based on the best information available to the reviewers at the time they complete their review. The Cochrane reviewers have told the BMJ that they will update their review to incorporate eight unpublished Roche trials when they are provided with individual patient data.Where does this leave oseltamivir, on which governments around the world have spent billions of pounds? The papers in this week’s journal relate only to its use in healthy adults with influenza. But they say nothing about its use in patients judged to be at high risk of complications—pregnant women, children under 5, and those with underlying medical conditions; and uncertainty over its role in reducing complications in healthy adults still leaves it as a useful drug for reducing the duration of symptoms. However, as Peter Doshi points out (doi:10.1136/bmj.b5164), on this outcome it has yet to be compared in head to head trials with non-steroidal inflammatory drugs or paracetamol. And given the drug’s known side effects, the risk-benefit profile shifts considerably if we are talking only in terms of symptom relief.We don’t know yet whether this episode will turn out to be a decisive battle or merely a skirmish in the fight for greater transparency in drug evaluation. But it is a legitimate scientific concern that data used to support important health policy strategies are held only by a commercial organisation and have not been subject to full external scrutiny and review. It can’t be right that the public should have to rely on detective work by academics and journalists to patch together the evidence for such a widely prescribed drug. Individual patient data from all trials of drugs should be readily available for scientific scrutiny.NotesCite this as: BMJ 2009;339:b5405
Article
A Cochrane group’s attempt to reproduce an analysis underpinning the use of oseltamivir in pandemic influenza hit a brick wall. Deborah Cohen retraces its steps
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WHO has revised its definition of pandemic flu in response to current experience with A/H1N1. Peter Doshi argues that our plans for pandemics need to take into account more than the worst case scenarios
Article
WHO says it has three main functions: to set normative standards; to provide technical advice and assistance on medical matters; and to advocate changes in health policy. During its 46 year history the first two functions have been a constant and uncontroversial backbone through which WHO has earned its reputation for scientific excellence. The third function, advocacy, came to the fore with the launch of Health for All in 1977, after which WHO took a key role in influencing international health policy. WHO's friends and critics alike now say that the organisation is losing its influence and retreating into its technical and biomedical shell. This article maps the changes in WHO's approach over the past 46 years and considers whether fears about its loss of influence are justified.
Article
Use of some antiviral drugs for influenza infection is limited by potential rapid emergence of resistance. We studied the efficacy and safety of oseltamivir, the oral prodrug of the neuraminidase inhibitor GS4071, in adults with naturally acquired laboratory-confirmed influenza. We did a randomised controlled trial of 726 previously healthy non-immunised adults with febrile influenza-like illness of up to 36 h duration. Patients were assigned oral oseltamivir 75 mg (n=243), oseltamivir 150 mg (n=245), or placebo (n=238) twice daily for 5 days. We assessed recovery by questionnaire and temperature recordings. The primary endpoint was time to resolution of illness in influenza-infected patients. 475 (66%) patients had confirmed infection. Duration of illness was significantly shorter by 29 h (25% reduction, median duration 87.4 h [95% CI 73.3-104.7], p=0.02) with oseltamivir 75 mg and by 35 h (30%, 81.8 h [68.2-100.0], p=0.01) with oseltamivir 150 mg than with placebo (116.5 h [101.5-137.8]). The effect of oseltamivir was apparent within 24 h of the start of treatment. In patients treated within 24 h of symptom onset, symptoms were alleviated 43 h (37% reduction) and 47 h (40%) earlier with oseltamivir 75 mg and 150 mg, respectively, compared with placebo (75 mg 74.5 h [68.2-98.0], p=0.02; 150 mg 70.7 h [54.0-89.4], p=0.01; placebo 117.5 h [103.0-143.8]). Oseltamivir was associated with lower [corrected] symptom scores, less viral shedding, and improved health, activity, and sleep quality, and was well tolerated. Oseltamivir was effective and well tolerated in the treatment of natural influenza infection in adults. The efficacy, tolerability, and ease of administration warrant further investigation in children, elderly patients, and at-risk patients.
Article
Five years ago I wrote a critique of the World Health Organization in the BMJ .1 One of my sources was a report by an American economist, Richard Tollison, which tore apart the WHO's budgetary priorities. Tollison's main claim was that too little of the WHO's money was spent on improving health in the developing world.2 One statement quoted in the BMJ ran, “The poorest nations in WHO are interested in basic public health, and not in the more exotic forays of WHO into the public health issues of the modern industrialised West.”3 What I and the BMJ and its readers didn't know, because the report didn't say, was that Tollison was in the pay of British American Tobacco. Nor did we know that such covert funding of “independent” commentators was just one part of an elaborate campaign by the tobacco industry to discredit the WHO and divert money and attention away from tobacco control activities. The WHO has been concerned for some time about the poor success of its anti-tobacco initiatives. The forced disclosure last year of 35 million pages of confidential tobacco industry documents alerted the WHO to the possibility of direct interference and led its director general, Dr Gro Harlem Brundtland, to set …
Article
Influenza outbreaks continue to occur in nursing homes despite high vaccination coverage among residents. Recommendations for outbreak control in institutions such as nursing homes advises use of antiviral drugs to reduce influenza transmission. Influenza surveillance was performed among elderly residents of nursing homes in Michigan during 2 influenza seasons. The antiviral drug oseltamivir was used for outbreak control at the discretion of nursing home staff once influenza transmission was confirmed by virus isolation or rapid antigen detection. During 2000-2001, influenza was not confirmed in any of the 28 participating homes, despite transmission of types A (H1N1) and B in the community. During 2001-2002, influenza type A (H3N2) transmission was confirmed in 8 (26%) of 31 participating homes; influenza vaccine coverage among residents was 57%- 98% in outbreak-associated homes. Oseltamivir was used in all homes with influenza transmission; outbreak control varied according to the rapidity of outbreak recognition and the extent of antiviral use. Reported adverse events were primarily gastrointestinal reactions and rashes. Analysis of the usefulness of rapid antigen detection tests for outbreak recognition indicated a sensitivity of only 77% (specificity, 92%). Oseltamivir was reasonably well tolerated, and its use, along with continued promotion of vaccination coverage among nursing home residents and staff, should be a valuable addition to institutional outbreak-control strategies.
Article
Three type A influenza viruses, each of which has a distinct neuraminidase-gene mutation and is resistant to the neuraminidase inhibitor oseltamivir, have been isolated. Previously, in the ferret model, an R292K mutant of a type A (H3N2) virus was not transmitted under conditions in which the wild-type virus was transmitted. This model was used to investigate whether the E119V mutant of a type A (H3N2) virus and the H274Y mutant of a type A (H1N1) virus would be transmitted under similar circumstances. Both mutant viruses were transmitted, although the H274Y mutant required a 100-fold-higher dose for infection of donor ferrets and was transmitted more slowly than was the wild type. Both the mutant and the wild-type viruses retained their genotypic characteristics.
Tamiflu launch media campaign
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