New COVID-19 Vaccine Unit Opens at Montefiore and Albert Einstein College of Medicine

The vaccine unit opening comes as global coronavirus infections are rising sharply, with nearly 200,000 cases reported daily in the United States. Montefiore’s goal is to ensure more than half of all trial participants are adults most affected by COVID-19 with a focus on people older than 65. Across the country, older individuals and communities of color have been disproportionately impacted by the pandemic.

“Montefiore and Einstein have a legacy of providing inclusive access to cutting edge care,” said Andrew D. Racine, M.D., Ph.D., system senior vice president and chief medical officer at Montefiore and professor of pediatrics at Einstein. “By ensuring that historically underrepresented patients are included in COVID-19 vaccination research, this effort will help ensure the efficacy and safety of vaccines for these underrepresented patient groups.”

The new vaccine unit builds on Montefiore and Einstein’s leadership conducting COVID-19 trials and providing lifesaving clinical care to thousands of people in the community and has already started enrolling people in the AstraZeneca-Oxford vaccine AZD1222 trial. Dr. Zingman is the principal investigator at Montefiore for the vaccine, which is one of 13 COVID-19 vaccines in phase III trials and the first to be evaluated at Montefiore and Einstein. He was also the principal investigator at Montefiore and Einstein for the ACTT-1 and ACTT-2 National Institutes of Health trials, which evaluated remdesivir (now FDA-approved as a treatment for people hospitalized with COVID-19) and remdesivir plus baricitinib, respectively. 

Since March, physician-scientists at Montefiore and Einstein have studied COVID-19’s impact on almost every major health condition, ranging from asthma to cancer; examined health inequities in local communities; and helped determine which treatments work best against COVID-19.

Among its notable research, Montefiore and Einstein faculty:

–  Published the first major U.S. study on the use of steroids, which confirmed the findings of the large-scale British RECOVERY trial showing that steroids are effective in treating COVID-19; the study also revealed which patients can be harmed by steroids

–  Led the first-ever study comparing the immune responses of adults and children with COVID-19 and detected key differences that may explain why children have milder disease than adults

–  Led the development of a monoclonal antibody therapy to neutralize COVID-19—and potentially other emerging coronaviruses—clinical trials will begin in December

–  Created a blood test for detecting COVID-19 antibodies, used clinically and for research

–  Launched the first randomized, placebo-controlled, double-blind trial of convalescent plasma with NYU Langone Medicine Center, which has expanded to include the University of Miami and the University of Texas-Houston, among other locations across the country

–  Was the first New York City medical center to enroll participants in the ACTT-1 remdesivir trial and the second highest enrolling site worldwide

–  Will offer the first randomized controlled trial of dexamethasone versus baricitinib (NIAID ACTT-4 study) for the hyperinflammatory state in COVID-19

“Words cannot express my appreciation for the many people who worked so hard to establish the new COVID-19 vaccine unit, making sure underrepresented communities will have access to the most promising

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Admissions to cardiac care unit double in Lebanon amid medicine shortages

Admissions to Lebanon’s cardiac care unit doubled in late October as the country struggles from shortages of medicine, an economic crisis, and the ongoing coronavirus pandemic.

Key medicines have been in short supply as people rushed to stockpile them following reports that the Central Bank of Lebanon planned to lift subsidies on medicines because it no longer has enough foreign exchange reserves to maintain its import subsidy scheme.

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Patients have subsequently found themselves at risk as they are unable to access potentially life-saving treatments.

Admissions to the Cardiac Care Unit at Beirut’s Rafic Hariri University Hospital (RHUH) have doubled recently, tweeted the hospital’s CEO Firass Abiad, who said patients with heart failure have been unable to find needed medications including Furosemide, an inexpensive diuretic.

Heart patients suffer from loss of medicine access

In recent weeks, heart patients have reported increasing concerns related to ongoing shortages of the two types of cardiovascular medicines. One of them is a medicine manufactured locally with a license from a French laboratory, the other a multivitamin specially formulated to help lower cholesterol levels for a healthy heart.

“Heart patients in Lebanon are at the front line of this issue and are complaining of the loss of two types of medicines,” Nabil Shasha, Head of Cardiology Divison at RHUH told Al Arabiya English.

“Some of these medications are very crucial in a sense that stopping any of them for few days could subject patients to a wide range of complications that could jeopardize their lives,” he explained. adding that patients with coronary artery disease might sustain acute myocardial infarction or cardiac death if they fail to take anti-platelets.

“Lack of diuretic drugs that excrete fluids through the kidneys and increase urine output. If not taken, the patient’s body starts accumulating fluids leading to volume overload causing lung congestion and shortness of breath and ankle and leg swelling.” Hadi Skouri, Cardiologist at AUBMC told Al Arabiya English.

“The patient starts to feel short of breath at rest and with time it progresses to shortness of breath at rest their oxygen levels start to be reduced and he will be admitted to the emergency room and hospital admission to receive intravenous diuretics,” he added.

Drug companies rationing medicines

Pharmaceutical companies in Lebanon have been rationing the distribution of drugs among pharmacies after Lebanon’s Central Bank Governor Riad Salameh said subsidies would have to stop once the threshold for obligatory foreign exchange reserves was reached, without suggesting a timeframe.

According to a Lebanese official quoted by Reuters in early October, the country has only around $1.8 billion of its foreign exchange reserves remaining available for subsidizing key food and other imports.


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Sheriff’s Unit To Tackle Mental Health Repercussions Of Pandemic

HILLSBOROUGH COUNTY, FL — The coronavirus didn’t simply introduce a new pathogen into society. It brought along a host of new problems and exacerbated existing ones that the country will be left to deal with long after the coronavirus symptoms have passed.

They might not be visible under a microscope, but accompanying the pandemic are a host of mental health issues. Isolation, job loss, financial hardships, learning difficulties, drug abuse and domestic violence go hand in hand with an increase in anxiety, fear, panic attacks, physical outbursts, depression, anger and hopelessness caused by the pandemic.

For the deputies at the Hillsborough County Sheriff’s Office, these problems aren’t new. Deputies have long been dealing with drug abusers committing crimes of desperation, jobless families members taking out their frustrations on their spouses, and lonely, unstable people threatening to kill themselves or others.

But with the coronavirus pandemic, deputies trained to keep order and investigate crimes have also taken on the roles of social worker, family mediator and peacekeeper, said Master Deputy Tobias Smith, who’s spent 24 years dealing with mental health calls for the sheriff’s office.

In a typical year, the Hillsborough County Sheriff’s Office receives 1.6 million calls from the public and other agencies. Of those, 540,000 calls come through the sheriff’s 911 emergency lines.

Deputies have no way of knowing which 911 call will lead to a volatile situation that could turn deadly.

But now the Hillsborough County Sheriff’s Office will fight fire with sympathy and understanding thanks to the newly formed Behavioral Resources Unit.

Sheriff Chad Chronister announced the formation of the new Behavioral Resources Unit at a news conference Monday.

The unit, made up of deputies, licensed mental health counselors and licensed clinical social workers, will focus on identifying people who repeatedly come into contact with law enforcement due to mental health issues or homelessness.

The Behavioral Resources Unit will work one on one with these people, connect them with the services they need before crisis in the hopes of keeping them out of the criminal justice system.

Smith said it’s not unusual for deputies to get a call about a person acting strangely due to a mental health problem. But, until now, the sheriff’s office’s only resource was to use the Baker Act to involuntarily hold the person in a psychiatric facility. A few days later, the deputy would see the person back on the streets.

The Florida Mental Health Act of 1971 (Florida Statute 394), commonly known as the “Baker Act,” allows the involuntary institutionalization and examination of a mentally ill person who is behaving erratically or presenting a danger to themselves or others.

Oftentimes, the behavior is caused by their refusal to take or refill prescribed medication, or follow up with mandatory counseling sessions. Since many are homeless or transient, there’s no way for social services to follow up with the person.

“Some have been Baker Acted 20 to 30 times,” Smith said. “If we can get them into some more effective treatment,

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Indigenous mobile health unit combines traditional and modern medicine for treatment

A mobile health unit in Toronto is combining traditional Indigenous treatments and modern medicine to help care for the city’s homeless and most vulnerable people.

Anishnawbe Health Toronto developed its mobile health unit after witnessing a rise in homelessness and overdoses brought on by the COVID-19 pandemic. The nurses, doctors and social workers tour the city’s homeless encampments and other areas to test and treat people in need of medical attention.

“We are providing COVID testing and for people that are homeless, transient and living rough, and also primary health care,” Jane Harrison with the Anishnawbe Health Toronto Mobile Unit told CTV News.

The system allows the health unit to track and care for the people who are experiencing homelessness and may have contracted COVID-19, while also affording them the ability to travel to where they’re needed most.

Now, the mobile health unit typically sees about 100 people per day.

“You can find 50 (to) 60 tents in some of these parks,” said Harvey Manning, director of Programs and Services at Anishnawbe Health Toronto. “What has happened is a lot of drop-in’s have closed. There’s fewer places for people to eat.”

Anishnawbe Health Toronto began in 1984 after its founder, Joe Sylvester, realized a “more comprehensive approach to health care” was needed among the Indigenous community in Toronto.

The health unit promotes traditional forms of Indigenous medicine and practices and offers its patients access to traditional healers, elders and medicine people, along with dentists, chiropractors and massage therapists. The health unit also helps people looking to “escape homelessness.”

“Anishnawbe Health has saved my life,” said Bonnie Gegwetch, a client of the organization.

For Gegwetch, having access to Anishnawbe Health Toronto has helped her to connect with her roots.

“I’m part of the 60s scoop,” she said. “This is my culture, this is where I found it.”

“Anishnawbe health has done an awesome job.”

The health unit is currently fundraising to put all of its services in one new building in downtown Toronto. Construction on the new facility is set to begin later this year.

Wiith files from CTV National News and Indigenous Circle reporter Donna Sound

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