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European Dermatologists Unhappy With Pandemic Teledermatology

European dermatologists shifted en masse to teledermatology during the first wave of the COVID-19 pandemic, and most of them disliked the videoconferencing experience intensely, according to the findings of a survey presented at the virtual annual congress of the European Academy of Dermatology and Venereology.

“The results of our survey clearly show 7 out of 10 participating dermatologists declared that they were not happy with teledermatology, and most of them declared that they were not at all happy,” according to Mariano Suppa, MD, PhD, of the department of dermatology and venereology, Free University of Brussels.

“It was very interesting: it was not just about the lack of a good quality of consultation, but was also related to some extent to a lack of respect from some patients, and also a lack of empathy. The majority of survey respondents felt [attacked] by their own patients because they were proposing teledermatology. So, yes, we were forced to go to teledermatology, and I think we will be again to some extent, but clearly we’re not happy about it,” he elaborated in response to a question from session chair Brigitte Dreno, MD, professor of dermatology and vice dean of the faculty of medicine at the University of Nantes (France).

The survey, conducted by the EADV communication committee, assessed the pandemic’s impact on European dermatologists’ professional practices and personal lives through 30 brief questions, with space at the end for additional open-ended comments. In the comments section, many dermatologists vented about their income loss, the disorganized response to round one of the pandemic, and most of all about teledermatology. Common complaints were that teledermatology required a huge consumption of energy and constituted a major intrusion upon the physicians’ personal lives. And then there was the common theme of unkind treatment by some patients.

The survey was sent twice in June 2020 to more than 4,800 EADV members. It was completed by 490 dermatologists from 39 countries. Suppa attributed the low response rate to physician weariness of the topic due to saturation news media coverage of the pandemic.

Sixty-nine percent of responding dermatologists were women. Fifty-two percent of participants were over age 50, 81% lived in a city, and 53% worked in a university or public hospital or clinic. Twelve percent lived alone.

Impact on Professional Practice

Many European dermatologists were on the front lines in dealing with the first wave of COVID-19. Twenty-eight percent worked in a COVID-19 unit. Forty-eight percent of dermatologists performed COVID-19 tests, and those who didn’t either had no patient contact or couldn’t get test kits. Thirty-five percent of dermatologists saw patients who presented with skin signs of COVID-19. Four percent of survey respondents became infected.

Seventy percent rescheduled or canceled all or most patient appointments. Clinical care was prioritized: during the peak of the pandemic, 76% of dermatologists saw only urgent cases – mostly potentially serious rashes – and dermato-oncology patients. Seventy-six percent of dermatologists performed teledermatology, although by June 60% of respondents reported seeing at least three-quarters of their

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What European leaders need to get right during second wave of lockdowns

Fearing all of its intensive care beds could be full by mid-November, France implemented nationwide restrictions at the end of October — as did Belgium and Ireland. Germany’s softer, so-called “lockdown light,” restrictions began on Monday, and Austria is following suite on Tuesday.

UK Prime Minister Boris Johnson has called for a second lockdown to begin in England later this week, while daily record increases of coronavirus infections in Italy appear to foreshadow another round of severe restrictions.

As countries attempt to beat back the virus before the Christmas holiday season, experts are calling on European governments to rethink their pandemic approach, fix its blind spots, and prevent another spiraling rise in illness next year, further derailing economies in the process.

“We have gone so far down the track with our very indirect measures like lockdowns and we haven’t even sorted out the two basics: We’re not finding all the cases, and when we do, people are not fully complying with self-isolation and quarantines,” Mark Woolhouse, a professor of infectious disease at the University of Edinburgh, told CNN.

“I do think we’ve jumped several steps ahead of ourselves in solving the immediate problem in the UK and the rest of Europe,” Woolhouse added.

Dr. Margaret Harris, a spokesperson for the World Health Organization (WHO), told the UK’s Guardian newspaper that the “missing link” in Europe’s handling of coronavirus is the management of self-isolation. “That’s not just isolation of people who are sick — it’s isolation of people who have contacts and are first-degree contacts,” she said.

Compliance

The WHO does not advocate for lockdowns as the primary means of controlling the virus. But if lockdowns happen, governments must use the “extra time granted” by the restrictions “to build their capacities to detect, isolate, test and care for all cases; trace and quarantine all contacts; engage, empower and enable populations to drive the societal response and more,” the health organization wrote in October.
After the first round of lockdowns in spring, countries across Europe reopened their economies prematurely, according to experts, without nailing down major safeguards, like contact tracing and quarantines.
By July 1, Spain had fully reopened its borders to all countries and lifted quarantine periods. Over the summer, the UK required travelers from certain high-risk countries to self-isolate, but others were allowed to come and go without checks.
Polling suggests that the majority of Brits say they would comply with self-isolation measures — but the evidence suggests that is just not happening in reality. According to a preprint study between March and August 5, less than 20% of people who reported Covid-19 symptoms in England complied with the country’s self-isolation regulations.
What it's like inside a Hong Kong coronavirus quarantine camp

Harris says reinforcement is key: “So for instance, in a place like Hong Kong, you would be called every day, or the police come to your house,” she told the Guardian.

Countries in the Asia-Pacific region have become the gold-standard on how enforce this. In Australia, which remains closed to most non-Australians, almost all travelers coming into
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VFMCRP and ChemoCentryx announce European Medicines Agency has accepted to review the Marketing Authorization Application for avacopan

Regulatory News:

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20201102005955/en/

Vifor Fresenius Medical Care Renal Pharma (VFMCRP) Ltd. and ChemoCentryx, Inc., today announced that the European Medicines Agency (EMA) accepted to review the Marketing Authorization Application (MAA) for avacopan for the treatment of patients with ANCA-associated vasculitis (granulomatosis with polyangitis (GPA) and microscopic polyangiitis (MPA)), a group of rare and severe autoimmune diseases with high need for targeted therapies.

If approved, avacopan would be the first orally administered selective complement 5a receptor inhibitor, for the treatment of patients with anti-neutrophil cytoplasmic antibody-associated vasculitis. Data from the global pivotal phase-III ADVOCATE trial demonstrated statistical superiority in sustaining remission at 52 weeks in the avacopan group compared to the prednisone group. In the trial, the avacopan group also showed significantly lower glucocorticoid toxicity, greater improvement in kidney function and greater improvement in health-related quality of life measures compared to the prednisone group.

The EMA will review the application under the centralized marketing authorization procedure. If approved avacopan would receive marketing authorization in all member states of the European Union (EU), as well as in Iceland, Liechtenstein and Norway. Approval is expected H2, 2021.

Vifor Pharma Group is a global pharmaceuticals company. It aims to become the global leader in iron deficiency, nephrology and cardio-renal therapies. The company is a partner of choice for pharmaceuticals and innovative patient-focused solutions. Vifor Pharma Group strives to help patients around the world with severe and chronic diseases lead better, healthier lives. The company develops, manufactures and markets pharmaceutical products for precision patient care. Vifor Pharma Group holds a leading position in all its core business activities and consists of the following companies: Vifor Pharma and Vifor Fresenius Medical Care Renal Pharma (a joint company with Fresenius Medical Care). Vifor Pharma Group is headquartered in Switzerland, and listed on the Swiss Stock Exchange (SIX Swiss Exchange, VIFN, ISIN: CH0364749348).

For more information, please visit viforpharma.com

About ChemoCentryx
ChemoCentryx is a biopharmaceutical company developing new medications for inflammatory and autoimmune diseases and cancer. ChemoCentryx targets the chemokine and chemoattractant systems to discover, develop and commercialize orally-administered therapies. ChemoCentryx’s lead drug candidate, avacopan (CCX168), successfully completed a pivotal Phase III trial in ANCA-associated vasculitis.

ChemoCentryx also has early stage drug candidates that target chemoattractant receptors in other inflammatory and autoimmune diseases and in cancer.

About ADVOCATE and ANCA-Associated Vasculitis
The ADVOCATE trial of avacopan was a global double-blind double-dummied Phase III trial of 331 patients with ANCA-associated vasculitis (ANCA vasculitis) in 20 countries.

ANCA vasculitis is a systemic disease in which over-activation of the complement pathway further activates neutrophils, leading to inflammation and destruction of small blood vessels. This results in organ damage and failure, with the kidney as a major target. Treatment for ANCA vasculitis consists of courses of immuno-suppressants (cyclophosphamide or rituximab), combined with high-dose and often prolonged use of glucocorticoids which can be associated with significant adverse events. ANCA vasculitis is relapsing and remitting long term condition and patients are at

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European Commission approves Roche’s Tecentriq in combination with Avastin for the treatment of people with the most common form of liver cancer

  • Tecentriq in combination with Avastin is the first and only cancer immunotherapy regimen approved in Europe for the treatment of unresectable hepatocellular carcinoma (HCC), the most common form of liver cancer

  • Tecentriq combination improved overall survival and progression-free survival compared with the previous standard of care

Basel, 2 November 2020 – Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced that the European Commission has approved Tecentriq® (atezolizumab) in combination with Avastin® (bevacizumab) for the treatment of adult patients with advanced or unresectable hepatocellular carcinoma (HCC) who have not received prior systemic therapy.

“Tecentriq in combination with Avastin is the first treatment to be approved in over a decade that has improved overall survival for people with previously untreated advanced or unresectable hepatocellular carcinoma,” said Levi Garraway, M.D., Ph.D., Roche’s Chief Medical Officer and Head of Global Product Development. “We’re delighted that people in Europe can now benefit from this combination and we look forward to working with individual countries within the EU to ensure people can access the combination as soon as possible.”

“The results of the IMbrave150 study mark a breakthrough in the treatment of advanced liver cancer, one of the few cancers with a rising death rate and limited options in the first-line setting,” said Dr Arndt Vogel, Professor of Medicine at Hannover Medical School. “After many failures in the last 12 years, the combination of Tecentriq and Avastin shows improvement in overall survival compared to sorafenib and offers patients the opportunity for improved disease control with a high overall response rate.”

The approval is based on results from the Phase III IMbrave150 study, which showed that Tecentriq in combination with Avastin reduced the risk of death (overall survival [OS]) by 42% (hazard ratio [HR]=0.58; 95% CI: 0.42–0.79; p=0.0006) and reduced the risk of disease worsening or death (progression-free survival [PFS]) by 41% (HR=0.59; 95% CI: 0.47–0.76; p<0.0001), compared with sorafenib. IMbrave150 is the first Phase III cancer immunotherapy study to show an improvement in both OS and PFS in people with unresectable HCC compared with sorafenib. Grade 3–4 adverse events occurred in 57% of people receiving Tecentriq and Avastin and 55% of people receiving sorafenib. The most frequent serious adverse reactions for the combination (≥2%) were bleeding in the gastrointestinal tract and fever. These results were published in the New England Journal of Medicine on 14 May 2020.

Today’s approval follows a positive opinion from the European Medicines Agency’s (EMA) Committee for Medicinal Products for Human Use (CHMP) in September 2020. In May 2020, the US Food and Drug Administration approved Tecentriq in combination with Avastin for the treatment of people with unresectable or metastatic HCC who have not received prior systemic therapy. In addition, in October 2020 the China National Medical Products Administration approved the combination for the treatment of people with unresectable HCC who have not received prior systemic therapy. In total, the combination is now approved in 59 countries for people with unresectable HCC. Tecentriq in combination with Avastin was also recently included as

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European Cities Plead for More Flu Shots as Winter Looms, Pandemic Rages | Top News

By Alicja Ptak, Emilio Parodi and Francois Murphy

WARSAW/MILAN/VIENNA (Reuters) – A surge in demand for vaccines to ward off the winter flu has led to shortages in some European cities, raising the risk of a potentially lethal “twindemic” as COVID-19 cases spike.

Many governments boosted vaccine orders this year and launched campaigns to encourage citizens to get shots.

The aim was to inoculate earlier than usual and cover a bigger portion of the continent’s 450 million population to reduce the burden on health services.

Top manufacturers such as GlaxoSmithKline

, Sanofi

, Abbott

and Seqirus have boosted supplies to the region by an average of 30% in anticipation of higher demand. But they are operating at full capacity and cannot meet all the late extra demand, Vaccines Europe, which represents the producers, said in a statement on Wednesday.

Interviews with at least 10 city and government officials, as well as medical experts, also show systems in major cities such as Warsaw are struggling with the strong early demand, causing delays and temporary shortages.

“This year, patients come all the time and ask about vaccines, more than 10 people every day,” said Grazyna Lenkowska-Mielniczuk, manager at Apteka Non Stop pharmacy in Warsaw’s Wola district.

“The wholesalers tell us the same thing as we tell patients: that there are no vaccines and we have to wait.”

Europe’s flu season begins in October and infections typically pick up between mid-November and the start of December, according to data from the European Centre for Disease Prevention and Control.

Seasonal flu viruses cause between 4 and 50 million infections each year and up to 70,000 Europeans die each year of causes linked to flu, particularly among older adults and at-risk groups.

Precautionary measures to curb COVID-19 transmission such as social distancing, mask wearing and hand washing may help curb infections this season.

There was “very limited” flu transmission in the southern hemisphere this year for that reason, Sylvie Briand, director of Global Infectious Hazard Preparedness at the World Health Organization said in a briefing last week.

Even so, surging coronavirus infections across the continent prompted EU Health Commissioner Stella Kyriakides to warn last month of the risk of a “twindemic of COVID-19 and the flu”.

Medical experts are urging more people get inoculated to prevent a deeper crisis.

“There is a need to prevent a double wave of influenza plus COVID-19,” said Clemens Wendtner, chief physician of infectiology and tropical medicine at the Munich Schwabing Clinic, who recommends people younger than 60 get the jab this year.

Poland’s Ministry of Health said it bought 3 million doses this year and will buy more if needed – as of Tuesday it had received 1.6 million shots.

But Mylan’s Influvac Tetra and Sanofi’s Vaxigrip Tetra vaccines are available in only 1% of pharmacies in Poland, according to gdziepolek.pl, a Polish website that helps patients find the nearest pharmacy with a drug they are seeking.

GSK’s Fluarix Tetra is not available and AstraZeneca’s

Fluenz Tetra is available

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Several European countries report daily record highs in coronavirus cases

Multiple European countries experienced record daily highs in new coronavirus cases this week as the pandemic surges again around the world.

France reported 30,000 new confirmed coronavirus cases Thursday, the highest single-day increase since the pandemic hit, and nearly 200 cases per 100,000 people over the past week, according to the The Associated Press.

Cases began to rapidly increase in September, and have spiked in recent weeks.

Italy, an initial hotpot when the pandemic began, saw a new record daily high of 7,332 new cases of COVID-19 Wednesday. The previous record was set on March 21, when 6,557 cases were recorded over a 24-hour period, according to CNN.

Italy has seen a consecutive increase in cases for the past 10 weeks.

In Germany, 6,638 new cases were reported in the past 24 hours, surpassing a previous record of 6,294 new cases recorded on March 28, The Robert Koch Institute confirmed Thursday morning.

The Czech Republic reported a record-high of new daily cases on Friday of 9,721, according to the country’s health ministry, as cases have seen a non-stop upward trend over the past two months.

Several affected countries are enforcing stricter lockdown measures in the wake of Europe’s COVID-19 surge, hoping to prevent future spikes.

The cases come as Europe and the U.S. head into the fall and winter seasons, which public health experts have warned could cause an increase in coronavirus cases as people move inside to get away from colder weather. Experts have also warned that this winter could be particularly deadly due to both the impending flu season and the coronavirus pandemic. 

Source Article

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