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Read Now: Why monkeypox is a repeat of the data mistakes made with Covid-19 – 101 Latest News



Why monkeypox is a repeat of the data mistakes made with Covid-19

#monkeypox #repeat #data #mistakes #Covid19

The US declared monkeypox a public health emergency this month, but the decision may have come too late. Though states are now required to report cases, and commercial labs have an approved test, a testing bottleneck persists, and cases — which passed 10,000 confirmed cases this week — are likely still being underreported. Any effective public health response to an infectious disease is dependent on having accurate data. If the virus spreads to other populations, such as college dorms — where cases have already been reported — the testing bottleneck could ultimately make it impossible to contain the spread. Reliable demographic information is key to making the right choices for allocating limited tests and vaccines.

All of this feels like an uncanny echo of the early mishandling of Covid-19. Limited access to testing, a hobbled federal infrastructure to track cases, and the general lack of communication among different agencies and states complicated the federal government’s ability to make evidence-based public health decisions. Reporting lags on rising cases meant that lockdowns began too late to save tens of thousands of lives. Similarly, certain communities uniquely at risk, like Black and Hispanic people who lacked access to health care, were suffering higher rates of severe illness and death from Covid before policymakers had any way of knowing where to direct public health outreach.

But the roots of this deadly problem long predate monkeypox outbreaks or the Covid-19 pandemic. The US has always had a fragmented health care system, with widely disparate experiences for patients based on state, insurance company, or hospital chain. Without systems to reliably record and share population-level data between decision-makers, health care workers can’t focus on helping the patients who need it most. The consequences are worse for marginalized people — such as Indigenous people, people with disabilities, or youth at risk for teen pregnancy — who were already facing inadequate care before the pandemic.

It doesn’t have to be this way. The US has an opportunity to learn from the tough lessons of the last few years and build on work to improve transparency and data sharing. With monkeypox already a global public health emergency, it’s vital for the data to be available, promptly and accurately, to coordinate an effective public health response. This is how we can get there.

Why does data matter?

Evidence-based medicine — the practice of using observation, studies, and randomized controlled trials to test which treatments work has transformed the medical field over the last century. But for that to work, as Covid showed, you need to have data to inform medical decisions.

The US has mandatory reporting systems for some contagious diseases, along with public health concerns like lead poisoning. This usually means that hospitals, clinics, and laboratories are required to report the location, severity of the illness, and treatment provided for any confirmed case. They also must document demographic information, such as race and ethnicity.

But that reporting is hobbled by the fact that there is no single agency responsible for the US health care system. Data is collected by federal agencies such as the Department of Health and Human Services — which houses the CDC, the Food and Drug Administration, and the Indian Health Service — as well as the Federal Emergency Management Agency (FEMA), which focuses on supplies and infrastructure for disaster preparedness. But communication among these agencies, the state health departments that report to them, and the hospitals and organizations where data is collected is often challenging, thanks to a fractured system made up of hundreds of different organizations.

Data comes in from over 900 health systems, or chains of hospitals under shared management; the largest include about 200 hospitals. But that’s just a fraction of the over 6,000 hospitals across the country. So when, for example, positive test results for Covid-19 or monkeypox, or cases of workplace exposure to pesticides, have to be reported to the state, public health boards in every state must coordinate with hundreds of different organizations and aggregate their data before they can share it with federal agencies. Except during an officially declared public health emergency — which, for monkeypox, is only a week old — the CDC has limited legal power to mandate reporting.

A 3D rendering of the global spread of Covid-19.
Getty Images

Data also isn’t collected the same way everywhere. There is a large number of different electronic health record systems currently in use in the US. They allow medical professionals to document a patient’s diagnosis and treatment, and in theory, share them more efficiently than in the days of paper-based records. But the software systems aren’t designed to be compatible with each other, so they cannot easily exchange data.

Even for a popular software platform like Epic, which covers about a third of hospital systems in the US, categories like a patient’s diagnosis — or even something as simple as their height or weight — are often customized for a particular hospital or chain. This makes for a more efficient workflow for the medical professionals on the ground, but it means that every hospital or chain is collecting slightly different information and organizing it differently. In order to piece the information together into a national picture that policymakers can actually use, each individual dataset has to be mapped onto a standardized format, a massive administrative burden that adds to delays.

For example, when I worked as a nurse in Canada, different hospitals in the same city used different recordkeeping software. Rather than digitally transferring data, other hospitals would fax a paper copy of their records, which had to be entered manually, leading to delay and data entry mistakes — and this was assuming that we knew the patient had been hospitalized there before. Getting the records of a patient’s medical history from primary care providers or clinics was even more challenging. It wasn’t uncommon for a single patient to end up with two or three duplicate charts, sometimes due to minor spelling errors in their name.

With hundreds of different organizations involved, it’s no wonder the US faces greater challenges in maintaining a complete and accurate national-level database than a country like the UK, with a centralized single-payer health care system. The sheer size and varied demographics of the US population add further challenges.

“The United States is incredibly diverse in many ways,” is how epidemiologist Katelyn Jetelina puts it. “You know, race, ethnicity, age, health status, state-level policies, rural, urban. There are so many [of what we call] confounders in epidemiology, so many important factors that will influence health and disease. What we see in New York City isn’t necessarily going to be generalizable or translatable to, for example, rural Texas.”

Until the US started using commercial labs to ramp up testing capacity for monkeypox in late June, samples could only be processed at state public health labs, with a cumbersome process. Hot spots like New York were overstretched, while other states’ labs sat idle. The delays and poor coordination between clinics and city health departments meant that contact tracing happened too late to contain the spread. If the spread had been caught earlier, patients would have been more likely to minimize their risk and seek out testing and treatment if they were exposed, and there would have been more advance warning on ordering a vaccine supply.

Undertesting doesn’t just affect the case numbers reported, but hurts patients’ access to treatment. Tecovirimat, or TPOXX, an antiviral drug that is most effective for treating monkeypox if started early, can’t be prescribed until a test comes back positive, and since it’s not officially approved by the FDA for monkeypox treatment, doctors need to jump through bureaucratic hoops to prescribe it. This leaves many patients suffering from untreated painful lesions for days or weeks.

As Jetelina pointed out in a Substack post, monkeypox doesn’t need to go the same way that Covid did; it’s a known disease, with a vaccine already developed, and spreads via close contact rather than being airborne. But the slow initial response, disorganized due to lack of information, means that the window of opportunity to contain monkeypox is closing.

Where do we go from here?

However difficult the growing pains, there has been real progress made on data collection since the first US Covid-19 cases in early 2020.

The National Covid Cohort Collaborative, a project run by the National Institutes of Health which gathers clinical data on Covid-19, was stood up during the pandemic. Joni Rutter, the collaborative’s acting director, describes the challenges they faced when combining hundreds of disparate data sources around the pandemic: “Even when you’re talking about height, one site will send us data in inches. One site will send it in centimeters.”

For more complicated questions, the process is even more fraught. Long Covid, for example, is linked to more than 200 distinct symptoms of varying severity, but screening tools generally include only some of these, their definitions vary between different hospitals and clinics, and doctors often won’t document every symptom a patient experiences. As a result, estimates on the risk of long Covid vary from as much as one in two Covid-19 cases to one in 20. It’s also particularly important for the Collaborative’s dataset to accurately reflect the diversity of the US population, a challenge their team has worked hard on. “It really helps us to get access to rural communities and more minority communities,” Rutter says.

The NIH’s efforts to build the Collaborative database in the right way were a major step forward, one that should be more widely adopted. More than 2,000 scientists are using the group’s centralized database system to ask critical questions about Covid, like rates of reinfection, characteristics of long Covid, and differences in outcomes between urban and rural patients. Meanwhile, the National Patient Safety Board, an advocacy group calling for a health care equivalent of the National Transportation Safety Board, hopes to improve tracking of medical errors and use machine learning to find underlying causes.

Other organizations are working on cleaning up the data at its source. The Advanced Research Projects Agency for Health, officially authorized in March 2022, is another NIH program based on the Defense Department’s famous research center DARPA, with the goal of promoting innovation and new technology in health care. Its initial work may include revamping electronic health records and letting hospitals migrate their data over to new and improved systems. In its 2022 National Covid-19 Preparedness Plan, the White House committed to improving data infrastructure by scaling up electronic case reporting systems to cover all states, in order to better track case counts and hospitalizations and link these to vaccination rates.

That isn’t enough, though. According to Karen Feinstein, spokesperson for the National Patient Safety Board, the entire approach to health care needs to change. One example to emulate could be the aviation industry; thanks to decades of recommendations from their safety board, which has scrupulously tracked airline data since 1967, accident and fatality rates in air travel have fallen drastically.

“We have all kinds of technology to keep our pilots and passengers safe on airlines and our astronauts safe as they go to and from the space station,” she said. “We know that the answer is to build a better airplane or to build a better spaceship, and to have the pilots and astronauts do the things for which they are trained and prepared. The problem we have in health care is that we haven’t yet built a better airplane.”

And building a “better airplane” for health care will involve reforming the current decentralized and fragmented recordkeeping. As Rutter sees it, “electronic health records need to evolve, and that’s going to be one of those things that I think we as a community, as consumers, need to help ensure does happen.” In the meantime, the National Covid Cohort Collaborative will continue with its current strategy of cleaning and combining the existing records, and is about to launch a section on monkeypox within its open-access database.

Jetelina believes that the federal agencies involved in public health responses need to be granted stronger legal authority to mandate standard reporting from states and hospital systems so they can come closer to the kind of constant surveillance the UK managed early on with Covid-19 and with monkeypox. She thinks the key is to “take out a lot of this red tape and bureaucratic paperwork, at least during a public health emergency, [and] respond much, much quicker.”

With monkeypox, the US can lean on the systems and infrastructure built during the Covid-19 pandemic, but some programs, like those that reimburse providers for treating uninsured patients or provide free Covid-19 tests, vaccines, and antiviral drugs to community health centers, were already scaled down after funding was decreased. In order to pull together a national response, the US needs straightforward, transparent data reporting that can be compared and combined on a national level.

The final difficulty will be in keeping this momentum going. The declaration of a new public health emergency for monkeypox will help keep federal funding flowing toward projects like the OpenData portal, but the need for better health care infrastructure won’t end when the emergency does. In a chronically underfunded public health system, short-term efforts may not be enough.

As Feinstein puts it, “the challenge we always have is something new that distracts the efforts toward reform, because we’ve gotten close to this in the past.” But with the lessons learned during the pandemic and new threats potentially on the horizon, she believes that “now is the time.”


Read Now: Extra Bonus Quote of the Day – 101 Latest News



Quote of the Day

#Extra #Bonus #Quote #Day

“We are not interested in whether the allegations against Vice President Biden are accurate or not.”

— Sen. Chuck Grassley (R-IA), on Fox News.

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Read Now: Sen. Tommy Tuberville's brother rebukes his racist sibling on social media – 101 Latest News



Sen. Tommy Tuberville's brother rebukes his racist sibling on social media

#Sen #Tommy #Tuberville039s #brother #rebukes #racist #sibling #social #media

They say the apple doesn’t fall far from the tree, but apples do often roll in radically different directions: some end up in a rich and piquant Bavarian torte and others land in a McDonald’s pie that tastes like moist cardboard and appears destined for the quaggy, cankerous bowels of Donald John Trump. 

Similarly, siblings are often at opposite poles politically—and in numerous other ways. And these differences appear particularly stark when one sibling is a U.S. senator who continues to burnish his racist bona fides under the klieg lights of media scrutiny and the other is, well, not.

Such is the case with Alabama Sen. Tommy Tuberville and his brother Charles. Charles Tuberville, a Tulsa, Oklahoma-based singer, songwriter, and guitarist who’s played with notables such as B.B. King and Delbert McClinton, has taken note of Tommy’s frequent racist dog-whistling/vituperative vuvuzela-ing and is calling him out over his pig-ignorant comments.

RELATED STORY: Sen. Tuberville makes openly racist remarks on Don Jr.’s web show

The brother of U.S. Senator Tommy Tuberville is speaking out on social media, saying he is “compelled to distance” himself from some of the lawmaker’s recent statements.

“Due to recent statements by him promoting racial stereotypes, white nationalism and other various controversial topics, I feel compelled to distance myself from his ignorant, hateful rants,” Charles Tuberville stated in a Facebook post.

“What I’m trying to say is that, I DO NOT agree with any of the vile rhetoric coming out of his mouth. Please don’t confuse my brother with me. Thanks, Charles Tuberville.”

Okay, so brothers often fight. That’s typical—and not really a big deal. And how bad can Sen. Tuberville’s public comments really be, huh? Well, we’ve researched this, and we now have an answer—and that answer is, “pretty fucking bad.”

For instance, in an interview last week on Donald Trump Jr.’s streaming show “Triggered,” Tuberville wondered aloud if teachers in the inner cities can even read. Because, you know, some sitting U.S. senators can barely read, and look how much they get paid for doing essentially nothing.

“The COVID really brought it out about how bad our schools are and how bad our teachers are, in the inner city. Most of them in the inner city, I don’t know how they got degrees,” Tuberville said. “I don’t know whether they can read and write. … And they want a raise. They want less time to work, less time in school. It’s just, we’ve ruined work ethic in this country. We don’t work at it anymore. We push an easy life.”

Yeah, imagine a country where a football coach who doesn’t know what the three branches of government are can just plop his ignorant ass into a U.S. Senate seat because he was endorsed by a shitty reality show host who spends the bulk of his morning tweeting obscenities on the toilet. That’s an education crisis of Brobdingnagian proportions. Also, if you’re trying to make a point about pervasive failures in our education system, maybe don’t start sentences with “The COVID.”

Of course, this isn’t the first time Tuberville has worn his racism on his sleeve. For instance, earlier this month, when asked if white nationalists should be allowed to serve in the military, he said, in reference to the Biden administration, “They call them that. I call them Americans.”

He then went on to elaborate, because why stop when you’re on a roll? “We are losing in the military so fast. Our readiness in terms of recruitment. And why? I’ll tell you why, because the Democrats are attacking our military, saying we need to get out the white extremists, the white nationalists, people that don’t believe in our agenda, as Joe Biden’s agenda. They’re destroying it.”

Yeah, I don’t know about you, but I really doubt that white nationalism makes our military stronger. How’s Vladimir Putin’s anti-woke army doing these days? 

And last October, in the run-up to the midterm elections, Tuberville had this to say of slavery reparations: “They’re not soft on crime,” Tuberville said in reference to Democrats. “They’re pro-crime. They want crime. They want crime because they want to take over what you got. They want to control what you have. They want reparation because they think the people that do the crime are owed that.”

Whoopsie. Looks like Tommy forgot his racist dogwhistle and was forced to trot out his Aryan airhorn. 

Many of us can sympathize with Charles, of course. Too many of us struggle to cope when family members—ignoring a coup attempt, bushels full of racism, overt mafia tactics, and literal calls to suspend the Constitution—go gaga each year over the return of their pumpkin-spiced Gotti

But imagine if your name were dragged through the mud on a daily basis like Charles’ is. You’d want to speak up, too. Thanks for letting us know what a shitheel your brother is, Charles. We get it. Oh, do we ever. But it’s nice to know not everyone in the Tuberville clan is quite as Klannish as Tommy.

Check out Aldous J. Pennyfarthing’s four-volume Trump-trashing compendium, including the finale, Goodbye, Asshat: 101 Farewell Letters to Donald Trump, at this link. Or, if you prefer a test drive, you can download the epilogue to Goodbye, Asshat for the low, low price of FREE.   

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Read Now: Karen Ocasio-Cortez: AOC Fumes Over Parody Account, Is Immediately Mocked – 101 Latest News



Karen Ocasio-Cortez: AOC Fumes Over Parody Account, Is Immediately Mocked

#Karen #OcasioCortez #AOC #Fumes #Parody #Account #Immediately #Mocked

Representative Alexandria Ocasio-Cortez (AOC) felt the need to have a meltdown over a Twitter feed serving as a parody account of the congresswoman. Despite the fact that it is clearly labeled “parody,” the far-left socialist demanded action be taken.

She tweeted about the account on Tuesday, advising her followers that the policy statements released by the parody account are “false” and that she and her crack staff of cybersleuths are “assessing” how to move forward.

“FYI there’s a fake account on here impersonating me and going viral. The Twitter CEO has engaged it, boosting visibility,” she claimed. “It is releasing false policy statements and gaining spread.”

“I am assessing with my team how to move forward. In the meantime, be careful of what you see.”

The only thing missing from AOC’s statement is the word ‘Ackchyually’ and an admission that her real name is Karen. It’s also worth noting that the only reason she’d feel compelled to tell followers about a parody account they probably hadn’t heard of prior to this is because the parody looks an awful lot like reality.

RELATED: AOC Exposed: TPI’s Rusty Weiss Cracks Open Her False Claims After She Smack Talks Elon Musk

AOC Mocked For Calling Out Parody Account

The parody account operating in such stealth that AOC felt the need to warn her followers has the following handle: “Alexandria Ocasio-Cortez Press Release (parody).”

The account also has a short bio: “Saying the quiet part out loud. (parody).”

It has a blue check which indicates they are a subscriber, while AOC’s actual Twitter profile has a gray checkmark which indicates it is a verified government account.

Aside from labeling itself a “parody” twice and having different checkmarks, how is the average Ocasio-Cortez fan supposed to tell the difference? It’s a mystery …

AOC was mocked mercilessly by Twitter users who posted their own version of her tweet calling out the parody account.

Others pointed out that, being clearly labeled a ‘parody’ account, the AOC imposter is not violating Twitter’s terms of service and there isn’t much the devout socialist can do about it.

And others noted that maybe the problem isn’t the parody account itself, maybe it’s the congresswoman who constantly sounds like a parody.

But perhaps the best digs came from the parody account itself, as they continued to pummel her with comical tweets.

“I can’t believe people would think these parody tweets are from our office when they are clearly fake,” they wrote. “Come on y’all you know I would never say something as stupid as that.”

“FYI … I have no problem with parody accounts – just the ones that make fun of me,” they also tweeted.

RELATED: Elon Musk Nukes AOC for Complaining About Having to Pay $8/Month for ‘Blue Check’ Status

Elon Musk Engaged

AOC’s rage over Elon Musk engaging with the parody account stems from a tweet on Monday in which they parodied the fake romance between her and the Twitter chief.

This might be the wine talking, but I’ve got a crush on @elonmusk,” they wrote.

Musk replied with a fire emoji.

That fire emoji tweet from Musk earned 1.8 million views. AOC calling out the parody account thus far has 29.6 million views.

Ironically, she did more to amplify the account than Musk did. By far. It’s the Streisand Effect.

Elon Musk and Ocasio-Cortez have been engaged in a Twitter spat for some time. It’s been a classic story of a cat and mouse romance – she, an impressionable former bartender with the intellectual heft of a pre-teen, he a shy billionaire.

AOC even sent a playful public message to Musk suggesting he had censored her on Twitter, all while dining on some lip-smacking good chicken nuggets.

Oh, that sultry vixen.

Musk has been ever the gentleman, even suggesting the couple go Dutch on their social media dates.

The parody account added another tweet which was semi-believable making it quite an effective piece of work.

“After brainstorming with my staff – I’m going to push Congress to make it illegal to joke, laugh, or make fun of me,” they wrote. “Parody should be illegal.”

Sounds real, doesn’t it?

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