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Thoughts about the relationships between transport and the urban area it serves

Posts Tagged ‘#covid19

Promising new approach

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Elsewhere the orange idiot is pushing drugs that have not been proven safe or effective. The following press release arrived in my in box this morning, and may not be noticed by our mainstream media because they are busy cutting staff pay – or even shutting down altogether. The idea that the government – or their readers – should now ride to their rescue seems really strange to me since the reason they have nothing to fall back on is that they have been bleeding the companies dry. I have no sympathy whatever for these vultures.

Queen’s University leading cell therapy clinical trial to help improve outcomes in COVID-19 patients

Researchers at Queen’s University Belfast are leading a UK-wide clinical trial, offering an innovative cell therapy treatment for COVID-19 patients with acute respiratory failure.

This clinical trial, led by Professor Danny McAuley and Professor Cecilia O’Kane, both researchers from the Wellcome-Wolfson Institute for Experimental Medicine at Queen’s, is investigating the use of allogenic Mesenchymal stromal cells (MSCs) in patients with a complication known as Acute Respiratory Distress Syndrome (ARDS) caused by COVID-19.

In the most critically unwell patients with COVID-19, many develop a complication known as ARDS. In ARDS the lungs become inflamed and leaky so they fill with fluid. This causes respiratory failure and patients may require admission to intensive care and a ventilator machine to support their breathing.

A recent statement from the four UK Chief Medical Officers outlined the importance of clinical trials amidst the COVID-19 crisis. Professor Cecilia O’Kane said: “It is only through clinical trials we will be able to determine if new treatments are effective and safe in critically ill patients.”

The trial involves the use of MSCs, a type of cell derived from human tissue such as bone marrow or umbilical cord (which is otherwise discarded after the baby is born), to treat the injury to the lung caused by COVID 19. MSCs are a novel treatment that have been shown in experimental models to reduce inflammation, fight infection and improve the repair of injured tissue.

Patients in this trial, which is known as REALIST COVID 19, will be treated with a purified population of MSCs derived from umbilical cord tissue called ORBCEL-C. The ORBCEL-C therapy has been developed by scientists at Orbsen Therapeutics in Galway, Ireland. The ORBCEL-C therapeutic is manufactured under licence by the UK NHS Blood and Transplant Service for the REALIST COVID-19 trial.

The trial is being introduced as part of an existing programme of research investigating the use of MSCs in patients with ARDS. The first patient has now been recruited with plans to recruit at least 60 patients throughout the COVID-19 pandemic at multiple sites across the UK including Belfast, Birmingham and London.

Professor Ian Young, Clinical Professor at the Centre for Public Health, Queen’s University Belfast, Director of HSC R&D and Chief Scientific Advisor at the Department of Health, said: “The Health and Social Care Research & Development Division has been working with researchers across HSC to address the global problem of Coronavirus.  We have contributed £230K for this vital research which will provide important evidence regarding a potential new treatment for respiratory failure, a leading cause of mortality in COVID-19.  We will continue to support health research and encourage people to participate in research trials and other studies so patients can get the best possible treatment to help tackle the spread of COVID-19.”

The trial has been identified by the National Institute for Health Research (NIHR) as a national urgent public health study. It is one of a number of COVID-19 studies that have been given urgent public health research status by the Chief Medical Officer/ Deputy Chief Medical Officer for England.  The study is funded by the Health and Social Care Research & Development Division and the Wellcome Trust, sponsored by the Belfast Health and Social Care Trust and supported by the NI Clinical Trials Unit, the NIHR Clinical Research Network and the Northern Ireland Clinical Research Network.

Orbsen CSO Steve Elliman noted: “While there are over 100 vaccines and therapies in development targeting the SARS-CoV-2 infection – at present there are no disease modifying therapies approved for ARDS.  We’re delighted the REALIST trial was approved and listed by NIHR as an Urgent Public Health Research Study so we can continue assess the safety of the ORBCEL-C therapy in patients with ARDS.”

Sir Professor Alimuddin Zumla of University College London, a global coronavirus and infectious diseases expert said: “This is an exciting and important trial which targets rectifying the underlying causes of lung damage and has great potential of saving many lives from COVID-19. The team should be congratulated for their leadership of host-directed therapies, a concept which has not yet been explored to its full potential.”

Professor Danny McAuley is also part of an international network of researchers who are taking forward trials of umbilical cord-derived Mesenchymal stromal cells for the treatment of COVID-19: UK: (UCL- Sir Professor Azumla); Portugal (Champualimud Foundation – Professor Markus Maurer; Italy (INMI-Professor Giuseppe Ippolito) and China (Fifth Medical Center- Professor Fu-Sheng Wang.)

-Ends-

  1. Media inquiries to comms.officer@qub.ac.uk  
  2. About NIHR: Please visit  https://www.nihr.ac.uk/covid-19/ to learn about other studies that have been given urgent public health status and the single, national prioritisation process that has been established to prevent duplication of effort and to ensure that the resources and capacity of the health and care system to support COVID-19 research are not exceeded.
  3. About Wellcome: Wellcome exists to improve health by helping great ideas to thrive. We support researchers, we take on big health challenges, we campaign for better science, and we help everyone get involved with science and health research. We are a politically and financially independent foundation. For more information please  visit: http://wellcome.ac.uk/
  4. For further information about HSC Research & Development Division work, please visit: www.research.hscni.net

Written by Stephen Rees

April 7, 2020 at 10:00 am

Posted in good news, Pandemic

Tagged with

Social Distancing

with 2 comments

There was a little bit of ambivalence for me yesterday. The people who work in our hospitals were posting “Stay Home”

But the official line from Bonnie Henry the Provincial Health Officer is that we can – and should – go for a walk as long as we maintain social distancing. Clearly this is easier to achieve in some places than others. The pictures that accompany this post shows what was going on at Locarno Beach and Spanish Banks yesterday. The logs are now being removed to deter gathering in one spot.

Social Distancing sign
Notice that the Parks Board cannot even get the simplest things right.
Below the City gets it right
See the difference?
Social Distancing 1
Social Distancing 2
Social Distancing 3


Then this morning this appeared on Facebook. Everything below this is a quotation.

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A good read. Please share Subject: Eye opening

Very, very important information posted by Jonathan Smith:

Hey everybody, as an infectious disease epidemiologist (although a lowly one), at this point feel morally obligated to provide some information on what we are seeing from a transmission dynamic perspective and how they apply to the social distancing measures. Like any good scientist I have noticed two things that are either not articulated or not present in the “literature” of social media. I am also tagging my much smarter infectious disease epidemiologist friends for peer review of this post. Please correct me if I am wrong (seriously).


Specifically, I want to make two aspects of these measures very clear and unambiguous.


First, we are in the very infancy of this epidemic’s trajectory. That means even with these measures we will see cases and deaths continue to rise globally, nationally, and in our own communities in the coming weeks. Our hospitals will be overwhelmed, and people will die that didn’t have to. This may lead some people to think that the social distancing measures are not working. They are. They may feel futile. They aren’t. You will feel discouraged. You should. This is normal in chaos. But this is also normal epidemic trajectory. This enemy that we are facing is very good at what it does; we are not failing. We need everyone to hold the line as the epidemic inevitably gets worse. This is not my opinion; this is the unforgiving math of epidemics for which I and my colleagues have dedicated our lives to understanding with great nuance, and this disease is no exception. We know what will happen; I want to help the community brace for this impact. Stay strong and with solidarity knowing with absolute certainty that what you are doing is saving lives, even as people begin getting sick and dying. You may feel like giving in. Don’t.

Second, although social distancing measures have been (at least temporarily) well-received, there is an obvious-but-overlooked phenomenon when considering groups (i.e. families) in transmission dynamics. While social distancing decreases contact with members of society, it of course increases your contacts with group (i.e. family) members. This small and obvious fact has surprisingly profound implications on disease transmission dynamics. Study after study demonstrates that even if there is only a little bit of connection between groups (i.e. social dinners, playdates/playgrounds, etc.), the epidemic trajectory isn’t much different than if there was no measure in place. The same underlying fundamentals of disease transmission apply, and the result is that the community is left with all of the social and economic disruption but very little public health benefit. You should perceive your entire family to function as a single individual unit; if one person puts themselves at risk, everyone in the unit is at risk. Seemingly small social chains get large and complex with alarming speed. If your son visits his girlfriend, and you later sneak over for coffee with a neighbor, your neighbor is now connected to the infected office worker that your son’s girlfriend’s mother shook hands with. This sounds silly, it’s not. This is not a joke or a hypothetical. We as epidemiologists see it borne out in the data time and time again and no one listens. Conversely, any break in that chain breaks disease transmission along that chain.


In contrast to hand-washing and other personal measures, social distancing measures are not about individuals, they are about societies working in unison. These measures also take a long time to see the results. It is hard (even for me) to conceptualize how ‘one quick little get together’ can undermine the entire framework of a public health intervention, but it does. I promise you it does. I promise. I promise. I promise. You can’t cheat it. People are already itching to cheat on the social distancing precautions just a “little”- a playdate, a haircut, or picking up a needless item at the store, etc. From a transmission dynamics standpoint, this very quickly recreates a highly connected social network that undermines all of the work the community has done so far.

Until we get a viable vaccine this unprecedented outbreak will not be overcome in grand, sweeping gesture, rather only by the collection of individual choices our community makes in the coming months. This virus is unforgiving to unwise choices. My goal in writing this is to prevent communities from getting ‘sucker-punched’ by what the epidemiological community knows will happen in the coming weeks. It will be easy to be drawn to the idea that what we are doing isn’t working and become paralyzed by fear, or to ‘cheat’ a little bit in the coming weeks. By knowing what to expect, and knowing the importance of maintaining these measures, my hope is to encourage continued community spirit, strategizing, and action to persevere in this time of uncertainty.

UPDATE

It turned out to be difficult to find the source of that piece. One of my readers Barb Meinema was more persistent than I and sent me this email today

Hello!  I reached out to Dr. Bozard, and she was kind enough to respond and too find the original author.  It would be very appreciated if you would please update your post accordingly.  See below.  Thanks so much!


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From Dr. Smith (Posted on my note to Dr. Bozard)
Hi Barb Cox Meinema and Andrea Collisson – I originally wrote the letter to my small community. Since then it is gotten out on the internet. In an effort for version control, I worked with the editors of Medium to make a public version here: 
https://elemental.medium.com/hold-the-line-17231c48ff17

~~~ ~~~ ~~~ ~~~ 

And, for what it’s worth, the new WordPress block editor made this update much harder to do than the old system. And it inserted typos where there were none before.


Written by Stephen Rees

March 22, 2020 at 12:57 pm

Posted in Pandemic

Tagged with