Day: October 16, 2020

health

A nurse saw a Chesapeake doctor do questionable things for years. She also got gifts totaling hundreds of thousands of dollars.

Margo Stone did a little bit of everything over the nearly three decades that she worked for Dr. Javaid Perwaiz.

Her job titles included nurse, office administrator, and bookkeeper. She assisted Perwaiz in the examining rooms, checked patient’s blood pressure and weight, ordered supplies, paid bills, recorded deposits, and handled the payroll and payroll taxes.

She also had a romantic relationship with the longtime obstetrician-gynecologist now on trial for more than 60 criminal charges in U.S. District Court in Norfolk.

Prosecutors allege that Perwaiz, 70, performed unneeded work on patients for years in order to fund a lavish lifestyle. He’s charged with multiple counts of health care fraud, making false statements related to health care matters and identity theft. His jury trial began Wednesday and could last more than a month.

Stone told jurors she first started working part-time as a nurse for Perwaiz in the early 1990s and later became a full-time employee. Over the years, her responsibilities grew. So, too, did her relationship with the doctor.

He spent lots of time with Stone, her husband and two sons, Stone testified. He became a kind of grandfather figure for the boys, now in their 20s. He paid for the boys’ high school and college tuitions and bought the oldest son a car. The boys eventually started calling him Papa.

Perwaiz hung the boys’ framed portraits on the walls of his office and put their initials on the license plate of one of his cars.

Stone also got lots of gifts from the doctor. She estimated that he gave her about 10 watches, each valued at $2,000. She also got purses, sunglasses, and jewelry. She even shared an American Express card with him that she used to buy things for herself and her sons.

When asked by Assistant U.S. Attorney John Butler to estimate the total value of the gifts that Perwaiz gave her over the years, her response: “Several hundred thousand dollars.”

And while Stone testified that she would have stopped working for the doctor immediately if she ever thought he did anything that would put a patient’s safety in jeopardy, she said she saw him do some things that were questionable.

One day when she was filling in at the main office, she said she saw him examining a patient with an instrument that was broken. She immediately ordered a new part for it.

When staff complained that he wasn’t sterilizing a piece of equipment for the recommended amount of time, she said she confronted him and he agreed to wait in the future. And when she heard patients complain about having to undergo too many surgeries, she confronted him about that, too.

“Sometimes he seemed to listen, sometimes he did not,” she said.

Stone also said she knew that he wasn’t using some instruments properly and occasionally saw him alter information on patients records.

In other testimony Friday, two of Perwaiz’s former patients told jurors how the doctor recommended they get a hysterectomy after they

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COVID-19 numbers are rising in Illinois. How worried should the Chicago area be?

Illinois just announced a record number of new COVID-19 cases. Positivity rates for coronavirus testing are up too. So are hospitalizations and deaths.



a group of people standing on a sidewalk: Wearing masks to protect from transmitting COVID-19, people stand in line for early voting at Truman College in Chicago on Oct. 14, 2020.


© Jose M. Osorio / Chicago Tribune/Chicago Tribune/TNS
Wearing masks to protect from transmitting COVID-19, people stand in line for early voting at Truman College in Chicago on Oct. 14, 2020.

But a deeper look at the data can soften the sense of alarm somewhat — at least for the Chicago area, where many pandemic metrics have remained steady for months until some recent upticks. And the state as a whole is still in better shape than its neighbors on most of those same statistics.

As a pandemic-weary public braces for winter, the latest Illinois figures have prompted researchers and public health officials to offer a mix of warnings and reassurance. They worry a second surge may be starting in Illinois while also noting that the shifting pandemic threatens some areas more than others.

“Chicago is doing a little better than downstate Illinois, Illinois is doing a little better than Wisconsin, etc. But broadly, COVID is not going well,” Chicago’s public health commissioner, Dr. Allison Arwady, said in a Facebook Live session on Thursday.

A day earlier, Gov. J.B. Pritzker told reporters the figures were a reminder of the importance of wearing masks and avoiding close contact with others.

“To date, Illinois has had relative success keeping this virus at bay,” Pritzker said, “and we’re still doing better than many of our neighbors. But we can’t let up.”

At the same time, researchers caution that — even seven months into the pandemic — its trajectory remains hard to predict. Without frequent, random testing to gauge the virus’s true spread, the public is left with a buffet of data options that have various quirks and can be tricky to interpret.

Here are the figures researchers cite most often, how the Chicago area measures vs. other parts of Illinois, and reasons for concern as fall moves into winter:

Case counts are rising, but …

Researchers and public health officials agree there’s reason to be nervous in the greater Chicago region. Look no further than the count of new COVID-19 cases reported each day.

The Chicago region — defined by the state as Cook, DuPage, Kane, Kankakee, Lake, McHenry and Will counties — peaked this spring at roughly 2,350 reported cases per day, based on a seven-day rolling average.

After “bending the curve,” that average fell below 500. Then cases began increasing slowly this summer. That growth eased a bit in September but took a sharper turn higher this month. The latest case figures have averaged more than 1,800 daily.

In other words, we saw a dramatic drop in cases, only to see much of that improvement wiped out.

There are caveats. To start with, assume more people have been infected than these numbers show, as some people never develop symptoms and many don’t get tested. In Chicago, according to Arwady, roughly 3% of residents have officially tested positive

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health

More than 100 more cases identified in Cy-Fair

Hospitalizations for coronavirus are rising across Texas, but a recent poll shows that many Texas voters may not take a coronavirus vaccine if one is developed.

The poll, conducted by the Texas Tribune and the University of Texas, shows that only 42 percent of Texas voters would try to get the vaccine, the Tribune reported, while 36 percent said they would not. This is a drop from a previous poll they had conducted in June, which showed 59 percent of Texas voters would try to get the vaccine.


There is significant skepticism around a potential vaccine as well, the Tribune reported, with polling showing 41 percent think a COVID-19 vaccine would be provided before being proven safe and effective.

While Texas still waits for a vaccine, cases have still been going up around Cy-Fair. Data from Harris County Public Health shows a total of 962 active cases in the area as of 4 p.m. Friday, which is an increase of more than 100 cases since last week.

There were no more deaths from COVID-19 reported this week, however, with the number of deaths remaining stagnant at 91.

Data was compiled from the ZIP codes in the Cypress Creek Mirror’s coverage area: 77040, 77041, 77065, 77070, 77086, 77095, 77429 and 77433. The ZIP code with the highest number of cases, 77040, dropped this week from 242 to 234 active cases, but increases were seen in other ZIP codes like 77070, rising from 125 to 151 cases, and 77086, rising from 138 to 160 active cases.

Testing is being offered at Spring Branch Community in Cypress, 7777 Westgreen Blvd., from 8 a.m. to 3 p.m. Monday through Saturday. Walk-ins are accepted but appointments are preferred. Appointments can be scheduled by calling 832-927-7575 or by going to covidcheck.hctx.net.

paul.wedding@hcnonline.com

Source Article

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health

Trump’s allies claim he’s incapable of gutting Obamacare. He’s already doing it.

These assurances conveniently ignore the basic facts of California v. Texas — in which the plaintiffs argue the entire ACA should be struck down as a result of its individual mandate penalty being brought to zero in 2017 legislation. That lawsuit has the full support of the Trump administration and 18 Republican-led states, and has already received favorable rulings from conservative, lower-court judges — whom these same senators helped install. These assurances also paper over the Senate Republicans’ recent vote rejecting a measure to halt federal support for the lawsuit. All of this fits into a larger pattern: Since he took office, Trump’s budgets have called for not only repealing the Affordable Care Act, but even deeper cuts to the Medicaid program. But when it comes to Trump’s plans for health care, the best thing he and his Republican allies have going for them is skepticism that they can pull them off.

Proposals to do away with the ACA’s protections are deeply unpopular — in the years since its passage in 2010, both the ACA as a whole and its individual components have gained public support. Trump has nonetheless benefited from a common narrative that his attacks on the Affordable Care Act are mere posturing. His bombastic tweets, his confusing insistence that Obamacare is already gone, and his empty promises to protect preexisting conditions have created a misleading impression that Trump has done little to change health-care policy beyond rebranding existing law. But the truth is that Trump’s opposition to the Affordable Care Act is not simply rhetorical — in fact, his policy record reflects a maximally aggressive approach to undoing the law through every legislative, administrative, and judicial channel available.

That started with the administration and its congressional allies using their precious year-one political capital to try to repeal the law through Congress. But for an unexpected, last-minute thumbs-down from Sen. John McCain (R-Ariz.), the Trump White House, the Republican House and 49 Republican senators were ready to proceed with undoing the ACA even though they never agreed on the “replace” part of their “repeal-and-replace” promise. In the wake of that legislative failure, the Trump administration pushed on by taking aggressive actions on its own to limit access to health care. One of the cruelest was urging states to put in place work requirements for Medicaid — measures that have been shown to significantly reduce health coverage without actually increasing employment. (Before a judge stayed work requirements in Arkansas — the first state to put them in effect — 18,000 adults had lost coverage in the first year.)

The Trump administration’s concerted effort to undermine participation in the ACA marketplaces — by rolling back outreach efforts, shortening open enrollment periods, and removing the individual mandate — has, by design, reduced the number of people enrolled. And the administration has taken steps to expand short-term coverage and “association health plans” that are not required to abide by ACA rules protecting people with preexisting conditions or limiting insurance company profits —

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health

White House Opposes Expanded Virus Testing, Complicating Stimulus Talks

“No testing scheme, no test is perfect. There will always be people who go undetected,” said Dr. David Dowdy, an infectious disease epidemiologist at Johns Hopkins University who has researched and written about herd immunity. “The best way to protect the most vulnerable is to reduce the amount of virus that’s in the population that can get through all of those testing schemes and cause destruction.”

Dr. Atlas’s position has been challenged by medical advisers around him who have backgrounds in infectious disease response, revealing a significant rift in the White House over the right approach. Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, has pushed for aggressive, broad testing even among young and healthy people, often clashing with Dr. Atlas in meetings.

“I would always be happy if we had 100 percent of students tested weekly,” Dr. Birx said on Wednesday in an appearance at Penn State University, “because I think testing changes behavior.”

Dr. Atlas at one point influenced the administration’s efforts to install new Centers for Disease Control and Prevention guidance that said it was not necessary to test people without symptoms of Covid-19 even if they had been exposed to the virus, upsetting Dr. Birx and Dr. Robert R. Redfield, the C.D.C. director.

The administration’s efforts to fund federal and state testing have long been fraught. In July, as administration officials and top Senate Republicans clashed over the contours of their initial $1 trillion proposal, the White House initially balked at providing billions of dollars to fund coronavirus testing and help federal health agencies.

Since the early days of the pandemic, Mr. Romer has argued for a wide-scale testing program, costing as much as $100 billion. He had hoped to persuade Dr. Atlas that if officials could quickly identify and isolate people carrying the virus, they would slow its spread and allow normal economic activity to resume more quickly.

In his email, sent to Dr. Atlas’s personal account, Mr. Romer proposed additional testing and isolation efforts that could allow far more Americans to return to work and shopping, generating economic activity that would be 10 or 100 times larger than the cost of the testing program itself.

Source Article

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medicine

Living Health Integrative Medicine Celebrates its 19th Anniversary

Living Health Integrative Medicine, Which Was Founded by Dr. Thomas Chaney and Dr. Stephanie Chaney, Provides a Natural and Effective Integrative Approach to Health

ANNAPOLIS, MD / ACCESSWIRE / October 13, 2020 / Dr. Thomas Chaney and Dr. Stephanie Chaney are pleased to announce that Living Health Integrative Medicine, which they co-founded, is celebrating 19 years in business.

To contact Living Health Integrative Medicine and/or to sign up for their newsletter, please visit https://www.mylivinghealth.com/contact-us/.

As Dr. Thomas Chaney noted, he and Dr. Stephanie Chaney are proud of the way their devotion to integrative medicine has helped Living Health Integrative Medicine to become the leader in holistic wellness throughout Maryland, Washington DC and Northern Virginia.

They also take pride in the fact that they are leaders in functional medicine and physical medicine. They use the most current research and science to help guide the treatments they suggest for their valued patients.

Dr. Thomas Chaney, Dr. Stephanie Chaney and their team of practitioners truly live up to their practice’s name, working as an integrated team to provide everyone with the best possible care and results.

“Our model of integrative medicine incorporates natural therapies and treatments to address the whole body versus simply treating a symptom temporarily,” Dr. Thomas Chaney said.

“Our goal is to help you achieve your health goals and for you to reach your maximum health potential.”

From people who are dealing with the pain associated with neuropathy, to those who are looking for effective physical therapy, require regenerative medicine treatments and/or wish to lose weight or have been diagnosed with diabetes, Dr. Stephanie Chaney said they focus on practicing integrative medicine, which focuses on identifying the root cause of health issues.

“We combine multiple treatment options, such as chiropractic, physical therapy, functional medicine, nutrition, regenerative medicine, diagnostic testing, dietary supplement therapy, detoxification and custom nutrition plans,” she said.

About Dr. Thomas Chaney, Dr. Stephanie Chaney and Living Health Integrative Medicine:

Dr. Thomas Chaney is a Maryland native and the founder and co-owner of Living Health Integrative Medicine, which takes a holistic approach to healthcare. He is the co-author of the best-selling books “Lose the Gluten, Lose your Gut. Ditch the Grain, Save your Brain” and “Defeat Diabetes.” Dr. Chaney is a respected member of the profession with a national reputation for dedication to helping the public improve their health naturally.

Dr. Stephanie Chaney grew up in Ottawa Canada and is the co-owner of Living Health Integrative Medicine. She is a leader in the integrative health field, sharing her knowledge with practitioners and the public. Dr. Chaney is a renowned speaker on holistic health and regular guest on the morning show, Great Day Washington. She has also been featured as a guest natural health expert on FOX, ABC and NBC. She is the co-author of the best-selling books “Lose the Gluten, Lose your Gut. Ditch the Grain, Save your Brain” and “Defeat Diabetes.”

For more information, please visit https://www.mylivinghealth.com/.

Living Health Integrative Medicine

1833 Forest Drive, Suite A

Annapolis, MD

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health

Prehospital Plasma Boosts Survival in Traumatic Brain Injury

Prehospital plasma, administered soon after injury, appears to improve survival for patients with traumatic brain injury (TBI), results of a new analysis suggest.

Administration of prehospital plasma demonstrated a strong survival benefit and was associated with a 45% lower risk for mortality in TBI patients, Danielle S. Gruen, PhD, and colleagues write in their report, published online October 15 in JAMA Network Open.

The finding is from a post hoc secondary analysis of a prespecified subgroup from the Prehospital Air Medical Plasma (PAMPer) randomized clinical trial, published in 2018 in The New England Journal of Medicine.

PAMPer studied the safety and efficacy of prehospital administration of thawed plasma in injured patients at risk for hemorrhagic shock. It included 501 patients; 230 received prehospital plasma, and 271 received standard-care resuscitation that did not include prehospital plasma administration.

Results showed that mortality at 30 days, the trial’s primary endpoint, was significantly lower in the plasma group than in the standard-care group (23.2% vs 33.0%; P = .03).

The current analysis explored the association between prehospital plasma resuscitation and survival in a subgroup of 166 patients with TBI. Of these, 74 patients received prehospital plasma, and 92 received standard care.



Dr Jason Sperry

“If you give prehospital plasma to injured patients, there is a survival benefit, as PAMPer showed, and the current study demonstrates that the signal is strongest in patients who have traumatic brain injury,” senior author Jason L. Sperry, MD, MPH, professor of surgery and critical care, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, told Medscape Medical News.

“We think that giving plasma as soon as possible improves survival via several mechanisms,” he said. “These include volume expansion to restore perfusion, an alteration in the inflammatory response, a reduction in endothelial injury, and the prevention or mitigation of coagulopathy.”

The median age of the patients with TBI was 43 years (range, 25 – 60 years). Brain injury was shown on CT imaging. Most patients with TBI were men (n = 125, 75.3%), and all had blunt trauma injuries. The median Injury Severity Score was 29 (interquartile range [IQR], 22 – 38).

Patients with TBI were more severely injured than those without TBI, and the incidence of prehospital intubation was higher for those patients. In addition, they were more likely to receive in-hospital vasopressors, the length of stay in the intensive care unit was longer, they spent more days on mechanical ventilation, and 24-hour mortality rates (P = .001) and 30-day mortality rates (P = < .001) were higher.

Except for the plasma intervention, there were no significant differences in fluid administration during transport to the hospital. However, in-hospital transfusion requirements differed between the two groups. Patients with TBI who were treated with prehospital plasma received less crystalloid fluid, vasopressors, and packed red blood cells in the first 24 hours.

In addition, for patients with TBI who received prehospital plasma, international normalized ratios were lower (median, 1.20 [IQR, 1.10 – 1.40] vs 1.40 [IQR 1.20 – 1.80]).

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Coronavirus Live Updates : NPR

President Trump announced a partnership with two national pharmacy chains to administer coronavirus vaccines to nursing homes at an event in Fort Myers, Fla.

Brendan Smialowski/AFP via Getty Images


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Brendan Smialowski/AFP via Getty Images

President Trump announced a partnership with two national pharmacy chains to administer coronavirus vaccines to nursing homes at an event in Fort Myers, Fla.

Brendan Smialowski/AFP via Getty Images

The Trump administration announced a new partnership with two major national pharmacy chains to facilitate the distribution of a future coronavirus vaccine to nursing homes on Friday.

“Today, I’m thrilled to announce that we have just finalized a partnership with CVS and Walgreens,” President Trump told a group in Fort Myers, Fla., at an event centered on seniors. He said the plan was for the pharmacies to “deliver the vaccine directly to nursing homes at no cost to our seniors.”

The Pharmacy Partnership for Long Term Care Program is part of the Trump administration’s Operation Warp Speed effort. No coronavirus vaccines have yet been authorized by the government, though several vaccine candidates are in the final stages of clinical trials.

“Early in the COVID-19 vaccination program, there may be a limited supply of vaccine and our planning efforts need to focus on those at highest risk for developing severe illness from COVID-19,” Dr. Jay Butler, deputy director for infectious diseases at the Centers for Disease Control and Prevention told reporters on a press call.

That includes people older than 65, who are much more likely to get severely ill and die from the coronavirus than other age groups. The details of which would be the first groups to get a vaccine once one is authorized is still in flux, but seniors would likely be among the first to be eligible.

The pharmacy program “provides end-to-end management of the COVID-19 vaccination process,” Butler explained. That includes scheduling on site clinic dates with each facility, ordering supplies like syringes, and ensuring cold-chain management of the vaccine. Once the vaccine is on site, pharmacy staff will administer it to residents and staff and report it to the required public health department.

The program will be free for facilities, but optional. “This is voluntary. They have to opt-in,” Paul Mango, deputy chief of staff for policy at the Department of Health and Human Services told reporters. “This will be something that will be available to every nursing home and senior living facility in the country.”

“This is really significant,” Claire Hannan, Executive Director of the Association of Immunization Managers wrote to NPR. “We’ve never really had coordinated partnership between pharmacies and public health across all states.”

Friday was the deadline for states to deliver a vaccine distribution plan to CDC, which will be evaluating the plans and providing feedback over the next two weeks, according to federal health officials.

One of the leading vaccine candidates, made by Pfizer, requires ultra-cold storage, which “could pose a major challenge to getting nursing home and long term care residents vaccinated,”

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Pickleball Courts Now Available To Reserve At Greenwich Park

GREENWICH, CT — Two official pickleball courts are now available to reserve at Christiano Park after years of requests from residents.

Patricia Troiano, the town’s recreation supervisor, said interest in the sport among residents has steadily increased over the past few years, particularly this year as residents look for more safe outdoor activities to enjoy due to the coronavirus.

“[Residents] feel safer outdoors,” Troiano said. “They also want the ability, when they’re distant from others, to be able to have some moveable activity and not have to keep a mask on the entire time. That’s something people have told us.”

According to Troiano, pickleball allows residents to play outdoors while safely distanced across a net from an opponent. (To sign up for Greenwich breaking news alerts and more, click here.)

Previously, residents could play pickleball on tennis courts, which use higher and longer nets, at the Chrisiano and Loughlin Avenue parks.

“There were only two tennis courts at Christiano Park,” Troiano said. “The second tennis court was converted into two pickleball courts on either side of the tennis net.”

The other tennis court, which has colored lines indicating the correct boundaries for a pickleball game, remained untouched, Troiano said. Prior to the two new courts at Christiano, the town had six unofficial pickleball courts residents could use.

“This is the first time we’ve had official [pickleball] courts,”Troiano said, “where players can reserve it, just like they would to play tennis, and just show up with the pickleball and the racket.”

Troiano said the town has talked about putting in official courts for over three years, however the actual planning and work to have one established at Christiano took a little over a year.

“The community has been driving this even prior to COVID-19,” Troiano said. “We have had requests for the last two or three years to get official courts in.”

The town turned its attention to the courts at Christiano first due to the foundation already being in place, Troiano said.

“It was already a tennis court,” Troiano said, “we just had to repaint it and put in new in-bounds and lines, then install the two posts for the two courts and the nets. That was a lot easier to do at Christiano for the first set of official courts.”

Troiano said the estimated cost of establishing the two official courts was originally about $11,000, however she was unsure what the final cost turned out to be.

She also noted the recreation department was already planning to add three more official courts at the Moretti Athletic Field in Cos Cob.

For now, residents who wish to use the courts at Christiano can reserve them through the town website until Nov. 16. After that, the courts can be used on a first-come, first-served basis until the reservation system starts up again in the spring.

“We’re really happy that we finally got this done,” Troiano said, “and if there’s any time to finally add these courts, it’s now. We

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medicine

Antibody Treatment Becomes First FDA-Approved Medicine Against Ebola

The Food and Drug Administration (FDA) has approved the first treatment for Zaire ebolavirus (Ebola virus). The antibody medicine, called Inmazeb, is a cocktail of anti-viral antibodies made by Regeneron Pharmaceuticals to tackle the deadly disease, which continues to ravage the Democratic Republic of Congo (DRC).  

The novel treatment helps stave off the Zaire ebolavirus infection in both adult and young patients, and has been approved for widespread use after a large 2019 trial deemed it safe and effective at reducing mortality in infected patients. The medication, called REGN-EB3 (commercially Inmazeb), is most effective when administered early on during Ebola infection.

It will now be used alongside Merck’s Ervebo, the first FDA-approved vaccine for Ebola, as a two-pronged defense against the outbreaks seen across Africa.

“We are incredibly proud that the FDA has approved Inmazeb, which is also known as REGN-EB3. This is the first time the FDA has approved a treatment specifically for Ebola, which has caused a number of deadly outbreaks,” said George D. Yancopoulos, president and chief scientific officer of Regeneron, in a statement.

On June 1, 2020, the DRC announced its 11th outbreak of Ebola virus, which is still ongoing. As of September 2, the outbreak had taken the lives of 47 people. The 10th outbreak was the second largest on record and took the lives of 2,299 people within the DRC.

Inmazeb contains antibodies that bind directly to the Zaire ebolavirus and blocks the molecules that allow the virus particles to attach to the human cells. These molecules, called glycoproteins, bind to human cell receptors and provide a pathway for the virus to enter the cell, where it replicates and wages war on the immune system. Instead, the cocktail of antibodies contained in Inmazeb attach to the virus glycoprotein, blocking the binding site (epitope). By blocking this method of entry, the antibodies can prevent the virus from spreading and doing damage to host cells.

The medicine does have notable side effects, including fever, chills, tachycardia (fast heart rate), tachypnea (fast breathing), and vomiting. While these symptoms were related to Inmazeb, they are also symptoms of the Ebola virus and could have been directly related to the infection instead of the medicine.

Now, Regeneron hopes to provide the life-saving medication for free to people living under the current Ebola outbreak in the DRC, as part of the Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) protocol for compassionate use. The USA has also ordered Inmazeb in preparation for any potential public health emergencies in the future.

However, Inmazeb is not the only project Regeneron has been working on. You may recognize the name from a different antibody medicine (REGN-COV2) taken by US President Donald Trump during his battle with Covid-19. The company is still actively working toward a safe and effective Covid-19 treatment, and whilst the REGN-COV2 looks promising, it is still in the experimental phase.

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