Lack

fitness

Vehicle fitness: lack of testing pollutes Punjab


LAHORE:

Fitness checking and certification of vehicles running in Punjab could not be done for the last eight months.

A foreign company responsible for vehicle inspection in the province could not open after the coronavirus lockdown imposed in March this year.

As per details available with The Express Tribune, The Vehicle Inspection and Certification System (VICS) had been closed since the first lockdown was enforced in March due to the coronavirus pandemic in Punjab.

The Punjab Transport Department had extended the fitness certificates of thousands of vehicles without checking for six months. Due to inactivity of fitness checking centres, vehicles had become a major source of smog by emitting smoke on the roads.

The Punjab government had abolished the system of Motor Vehicle Examiner in 2015 and contracted a Swedish firm for fitness and inspection of vehicles which was supposed to set up VICS centres for vehicle inspection across the province. As per the agreement, the company’s commercial vehicles were to be inspected and certificates were to be issued to them for which data was provided to the company by the government.

In case of inspection and certification of less than 50% of the provided vehicles, Punjab government will pay compensation to the company. Under the agreement, the company must first complete its network of centres across the province for which the government land was to be provided on lease to the company.

However, the company failed to complete its network even after five years since the abolishment of motor vehicle examiner system. The foreign company’s system had not been able to achieve significant success in vehicle inspection and certification in the province. The company had now closed its centres since March 2020 which had stopped the work of inspection and certification of vehicles.

In such a situation, there was no system for fitness and inspection of vehicles in the province for eight months. In such a situation, Punjab Transport Department had adopted a unique formula of extending the fitness certificates of the vehicles for six months without inspecting them. Under this formula, the officials of said department were looking at the old certificates of the vehicles and affixing a sixmonth extension stamp on them.

The vehicles were not being inspected but an affidavit was being taken from the owner of the vehicle that they were responsible for the fitness of their vehicle. The provincial transport department officials stated in addition to the inspection fee ranging from Rs1,300 to Rs4,000, a fine of Rs6 per day was being received from vehicle owners and their fitness certificates were being extended for six months.

Due to this, the smoke-emitting vehicles across the province were openly circulating because they had an extended fitness certificate from the transport department which was causing a terrible increase in environmental pollution. Thus, there was practically no system of vehicle inspection and fitness in Punjab for the last eight months. In this regard, Punjab Transport Minister Jahanzeb Khan Khichi said the purpose of establishing VICS was to make

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dentist

Reality bites: Lack of cash stops many Bathurst people seeing dentist | Western Advocate

news, local-news, news

A NEW study released this month has found up to 25 per cent of people aged 15 and over in Bathurst have delayed seeing a dental professional in the last 12 months due to concerns over the cost. The study, released by the NSW Council of Social Service, maps economic disadvantage across NSW. Australian Dental Association NSW president Dr Kathleen Matthew said delaying dental health treatments put people’s overall health at risk. Dr Matthew said it was “clearly concerning” one in four people are delaying dental treatment because they can’t afford it. “I think that’s a very important conversation to have with the population.” She said the flow on effects from not getting treatment include pain and dental stress which only gets worse, costs more money and requires higher intervention in the end. Dr Matthew also said the lower end of social economic scale are more vulnerable to dental disease with dental disease the most chronic disease there is in the community, worldwide. ALSO MAKING NEWS: “It’s (dental) the missing part of the health system … if you visit the GP it’s subsidised by the government if you get a script filled subsidised by the PBS.” Complicating the matter are the extensive wait lists for public dental services. “The waiting list for the public system is a two door system…. if you have dental pain or infection there is a triage system in place but that’s just to sort out that issue,” she explained. “If you have multiple issues, you’re on the waiting list which has a bench mark of six months, in Bathurst there are 7000 people waiting,” she said. Dr Matthews said the time had come to discuss the health system and ask does it actually work. “The mouth is part of the body but there is form of subsidy under Medicare (for dental treatment). “If you’ve got a diseased wisdom tooth and the competing priory is getting good on the table for your family, then that’s going to be the higher priority,” she said. “Dentists get criticised about their costs, but the reality is we are running a health business without government support,” she said. “The Government needs to sit down come up with a plan to treat those vulnerable to dental disease more effectively and efficiently.” Dr Matthews said there is child dental benefit scheme for low income families, who receive $1000 in dental treatment per child, but said more needs to be done. She said the government needs to look at the staged implementation of a universal scheme for basic dental care.

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HAVE YOUR SAY

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health

States say they lack federal funds to distribute coronavirus vaccines as CDC tells them to be ready by Nov. 15

State officials have been planning in earnest in recent weeks to get shots into arms even though no one knows which vaccine will be authorized by the Food and Drug Administration, what special storage and handling may be required and how many doses each state will receive.

Despite those uncertainties, the Centers for Disease Control and Prevention is asking states to be prepared to “preposition” doses in key locations throughout the country. Officials want to move quickly once the FDA authorizes a vaccine and a CDC advisory panel issues recommendations on which populations should be vaccinated, according to a letter the CDC sent Monday to state preparedness and immunization officials.

As part of that effort, the CDC is asking states to provide by Tuesday critical information, including a list of each jurisdiction’s top five sites capable of receiving and administering a vaccine that must be stored at ultracold temperatures of minus-70 Celsius (minus-94 Fahrenheit). The letter refers to the vaccine only as Vaccine A, but industry and health officials have identified it as Pfizer’s candidate.

Pfizer chief executive Albert Bourla said Tuesday that “hundreds of thousands” of doses had already been produced and that a first look at the data would occur soon. Pfizer will not apply for any authorization of its vaccine sooner than the third week of November, when it will have sufficient safety data.

“We acknowledge that you are being asked to do unprecedented work,” wrote Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, which is leading the CDC’s role in vaccine distribution. She added: “This is a new planning ask.”

State officials say they have been trying to raise the issue with federal officials but have received little response.

“It is absolutely ridiculous that the administration, after spending $10 billion for a Warp Speed effort to develop a vaccine, has no interest in a similar investment in a Warp Speed campaign to get the vaccine to every American as quickly as possible after it is approved,” said Michael Fraser, executive director of the Association of State and Territorial Health Officials.

Operation Warp Speed is the federal initiative, funded by more than $10 billion of taxpayer money, to fast-track development of coronavirus countermeasures.

“The now accelerated timeline underscores the need to address the issue of funding for state and territorial health agencies to make this all work,” Fraser said. “There are many other costs that have no clear way to be paid for at this point.”

Local officials still need to recruit thousands of people to staff vaccine clinics and enroll and train providers. They also have to ramp up information technology and data systems to track vaccine inventory and ordering to ensure people get the correct doses at the right times — most vaccines will require two shots — and to monitor for adverse events. They will need to develop locally tailored vaccination communications campaigns, too.

“States have received some funding, but it’s not nearly enough” to support the scale, scope and

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health

Trial of Antibody Drug for COVID-19 Stopped for Lack of Effectiveness | Health News

By Robin Foster and E.J. Mundell
HealthDay Reporters

(HealthDay)

TUESDAY, Oct. 27, 2020 (HealthDay News) — Testing of Eli Lilly’s antibody drug for hospitalized COVID-19 patients has been halted because the treatment doesn’t help them recover from their infection.

Two weeks ago, enrollment in the study was paused because of a possible safety issue, the Associated Press reported. But the U.S. National Institute of Allergy and Infectious Diseases, which sponsored the Lilly study, pulled the plug on the trial Monday — not because of any safety problem, but because there was only a slight chance that the drug would be effective, the AP said.

Although it is a setback for one of the most promising treatment approaches for COVID-19, Lilly said in a statement that the government is continuing a separate study testing the antibody drug in mild to moderately ill patients, to try to prevent hospitalization and severe illness.

A similar, two-antibody cocktail from Regeneron Pharmaceuticals Inc. was given to President Donald Trump on an emergency basis when he was sickened with the coronavirus. Earlier this month, former New Jersey Gov. Chris Christie said he had received Lilly’s experimental treatment shortly after he was diagnosed with COVID-19, The New York Times reported.

Dr. Eric Topol, a clinical trial expert at the Scripps Research Institute who has been following the treatment’s development, told the Times that the news “tells us they stopped the trial due to futility, as suspected,” and that it “suggests that the timing of monoclonal antibody administration — early [in the illness] — will be important.”

Antibodies are proteins the body makes when an infection invades the body ; they attach to a virus and help eliminate it. The experimental drugs are concentrated versions of one or two specific antibodies that worked best against the coronavirus in lab and animal tests, the AP reported.

Lilly and Regeneron have both asked for emergency use authorization from the U.S. Food and Drug Administration while late-stage studies continue. Lilly said Monday that its request is based on other results suggesting that the drug helps patients who are not hospitalized, and that it will continue to seek the FDA’s permission for emergency use.

Hospitals feel the strain of surging COVID case counts

As the United States has witnessed record-breaking daily coronavirus case counts, public health experts have warned that hospitals may soon reach a breaking point.

More than 41,000 COVID-19 patients are hospitalized across the country, a 40 percent rise in the past month, Times reported.

But in sharp contrast to the early days of the pandemic, more of these patients are being cared for in sparsely populated parts of the country, where the medical infrastructure isn’t as strong as it is in metropolitan areas, the Times reported.

In Utah, hospital administrators have warned Gov. Gary Herbert that they would soon have to ration access to intensive care units, and requested state approval for criteria to decide which patients should get priority, The Salt Lake Tribune reported.

“We told him, ‘It

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health

No Australian should be a hospital ‘frequent flyer’ because of lack of home support

When my firstborn went straight from birth to the special care nursery, I had time to meet another mother of a premature baby. We were tired but never complained because our eyes didn’t miss the fact that in the far corner were the really sick babies clinging to life or, as forlorn faces disclosed, those who had succumbed to the vicissitudes of extreme prematurity.



a sign in front of a tree: Photograph: Paul Braven/AAP


© Provided by The Guardian
Photograph: Paul Braven/AAP



a sign in front of a tree: ‘According to one Australian study, one in seven patients has an unplanned admission to hospital within one month and one in ten10 patients returns within a day.’


© Photograph: Paul Braven/AAP
‘According to one Australian study, one in seven patients has an unplanned admission to hospital within one month and one in ten10 patients returns within a day.’

When the time came to go home, I was relieved because our case had been simple. She, however, had turned pale. Her baby had a congenital cardiac abnormality requiring multi-stage surgery, but not yet. In the meantime, there was nothing to do but wait, and monitor the baby’s heart rate, oxygen levels, and ability to feed.

Related: There is a poverty of body language in telehealth appointments – but there is tenderness too | Ranjana Srivastava

When the doctor left, she whispered, “I am worried.”

“Why?”

“What if he stops breathing?”

‘The oximeter will beep if his saturations drop.”

“And what will I do then?”

“They’ll tell you.”

“How will I sleep knowing something could happen?”

“He will have lots of monitors.”

The passage of many years has done nothing to dim my memory of that cringeworthy conversation; it was not just unhelpful but focused on all the wrong things. My attempt at medical problem-solving left no room to explore her fears. She was probably experiencing guilt, fear and fatigue – I didn’t ask so I didn’t know.

I often recall our exchange when my own adult patients deemed safe for discharge return to hospital. A “failed discharge” variously refers to someone who returns within a month, a week, or even within a day of being sent home. The collective noun for such patients is “frequent flyers” but unlike airline passengers, there are no perks, only greater complications.

All patients are encouraged to return, but what’s striking is how many patients return for non-medical reasons. In other words, the infection is receding, or the wound is healing but people aren’t close to their previous level of function, physical or emotional.

Among my most elderly patients, post-discharge consternation is normal. How much fatigue is OK? Can they skip the fluid restriction on a special occasion? Where did the five new pills come from and what happened to the old ones? What if the bathroom is too far to reach?

Related: ‘Utterly unacceptable’: deaths of four babies at Adelaide hospital prompt call for inquiry

Modern medicine is capable of answering all these questions ahead of time and no patient should have to return to hospital for a script, a walking aid, or care coordination, but in fact it happens regularly when patients feel poorly supported at home or cannot get an appointment with their local doctor. According to one

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health

Analysis: Lack of Antidotes Adds to Ethical Dilemmas for UK COVID-19 Challenge Trials | Top News

LONDON (Reuters) – UK scientists seeking approval to deliberately infect healthy people with COVID-19 in trials must first convince ethics specialists that, among other things, they have potential “rescue therapies” or antidotes to halt the disease.

The problem is that, for the novel coronavirus, there is still no effective treatment or cure.

That means, for now, that the best scientists planning the so-called human challenge studies can offer is Gilead’s remdesivir – an antiviral drug that was found in a large trial to have no impact on COVID-19 death rates.

Chris Chiu, a scientist at Imperial College London co-leading the COVID-19 challenge experiments, said the plan was to give remdesivir to infected volunteers based on a “strong belief” it will be effective if given in the very earliest stages of disease.

Some ethics and medicine experts said that posed problems.

“As an effective rescue therapy does not yet exist for SARS-CoV2, there is a serious ethical dilemma … to address here,” said Stephen Griffin, an associate professor in the school of medicine at Britain’s Leeds University.

Other specialists said the lack of antidotes or rescue therapies was only one of several risks the research team would have to minimise, and trial volunteers would have to accept, if the studies are to gain ethical approval.

Plans to reduce those risks include picking the most robust, healthy, young volunteers to be infected, and using the bare minimum amount of the coronavirus to infect them with COVID-19.

Dominic Wilkinson, a professor of medical ethics at Oxford university, said that, while desirable, having an effective treatment at the ready after deliberately infecting volunteers was “not essential for the ethics of such a trial”.

“The ethical necessity of these trials, and of any trial, is that you assess the risks, you minimise the risks, and you communicate the risks,” he told Reuters. “It’s not the case that you have a situation where there are no risks.”

Human challenge trials are not new. Scientists have used them for decades to learn more detail about – and develop treatments and vaccines against – several other diseases such as malaria, flu, typhoid and cholera.

“Generally with such trials in the past, they were done when you had a specific treatment,” said Margaret Harris, a spokeswoman for the World Health Organization (WHO), when asked about the planned UK trials using the novel coronavirus.

“You must ensure that everybody involved understands exactly what is at stake … and ensure informed consent is rigorous – that they really do understand all the risks,” she said.

Ohid Yaqub, a science policy expert at Britain’s University of Sussex, pointed to WHO guidelines on the issue, which among other things say human challenge trials “might be considered when the disease an organism causes has an acute onset, can be readily and objectively detected, and existing efficacious treatments … can be administered … to prevent significant morbidity, and eliminate mortality.”

Yaqub warned of a risk to public trust in science and medicine if these criteria

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