Switching Away From The Deadly Serious (Ebola) — To Pure Farce — Our 45th President’s Tweet-Storms; And Presidency, More Broadly

May 18, 2017 - Leave a Response

I have decided this morning — as I depart — to close with a farce — of epic proportions. [It is now a farce, primarily because 45 has been caught — hand still in the cookie jar. See below.]

To be certain, there is more than a bit of a serious undertone here: as the revised masthead below above implies — I (albeit privately) found yesterday morning’s Russian/Putin “agitprop” salvo to be. . . just another in a long line of indignities to which Mr. Trump has willingly and fecklessly subjected the once-proud American people, before the world. Y A W N.

On the other hand, I suspect it was the last straw, for most of the elite GOP. In yesterday morning’s story, Mr. Putin offered to produce Russian-sourced but unspecified “transcripts” — ostensibly to exonerate Mr. Trump, in the Russian investigation.

With that, Mr. Putin achieved a master-stroke of Russian propaganda: offering the US Congress HIS Russian government resources, to help Mr. Trump hold on to his office — for at least a little while longer.

Genius, in the sheer audacity of it! In the cold light of the next morning, then, and setting aside Mr. Putin’s nonsense — let us consider what this says about the state of our (now, as of last night, clearly less-imperiled) Republic: the US Congress may at present be (at least marginally effectively). . . trolled, by the Russian President.

Why? Because our 45th President has gone out of his way to sidle up, and play “kissy-face” with him. [And that is the most charitable spin anyone can put upon Mr. Trump’s actions, taken as a whole.]

Our vulnerability to being trolled, or “agit-propped“, is a direct result of the amateurish positions our rank amateur President has taken, and continues to take. [Again, that is with a rosily charitable lens, as to his “on the record” remarks.]

And yesterday, by lunch, many elite Republicans (privately) I suspect — declared what the rest of us long knew. This man — 45 — is unfit.

And so, by dinner time, we had word of a special independent counsel, with criminal charging authority — who served under Bush 43rd, and our 44th President admirably — as FBI Director for 13 years (yep — Mr. Comey’s immediate predecessor). Irony — it’s for me!

We will let the investigation go where it might — but this is a post-Archibald Cox moment, Mr. Trump.

In truth, the warlock has already been “outed“. He’s. . . orange. And yes, I do think this morning marks the beginning of the end, of the Trump Presidency.

It may take eight more months, now. But likely not too much longer than that. Word.

नमस्ते

WHO: First Situation Report, On 2017 DRC Ebola Outbreak

May 17, 2017 - Leave a Response

To be sure, I do hate leaving — for a joyously boisterous long weekend, on a relatively ominous global public health news note — but sometimes. . . . that is just the way it is — and the way it has to be.

So — the first official and comprehensive tallies are up, at WHO: additional cases have been reported — very near the same province that was likely the index location, of the long ago original outbreak of Ebola (or at least the first documented one), back in 1976.

Importantly, no inter-country African travel restrictions are recommended by WHO. That fact should be repeated widely by the MSM. From the full report, then — a few snippets:

. . . .Following this cluster of illness and deaths, the health team carried out outbreak investigation and collected five blood samples that were transported to a laboratory, the Institut National de Recherche Biomédicale (INRB), in Kinshasa. Laboratory results released on 11 May 2017 showed that two of the five samples tested positive for Ebola virus of the Zaire sub-type using a technique call polymerase chain reaction (PCR).

As of 15 May 2017, a total of 19 patients suspected to have Ebola including 3 deaths (death rate of 15.8%) have been reported. The cases reported are from three areas, namely Nambwa (10 cases and 2 deaths), Mouma (3 cases and 1 death) and Ngay (6 cases and no death). A total of 125 close contacts have been identified and are being followed up on a daily basis. . . .

Likati health zone shares borders with two provinces in DRC and with the Central African Republic. The affected areas are remote and hard-to-reach with limited communication and transport networks. . . .

• At this stage, the overall risk is high at national level due to the known impact of Ebola outbreaks, remoteness of the affected area, limited access to health care and suboptimal surveillance.

• Risk at regional level is moderate due to the proximity with international borders and the recent influx of refugees from Central African Republic.

• The risk is low at global level. . . .

Depending on the evolution of the situation, the risk will be reassessed at the three levels. . . .

WHO advises against the application of any travel or trade restrictions on the Democratic Republic of Congo based on the current information available on this Ebola outbreak. WHO continues to monitor reports of measures implemented at points of entry. . . .

Still only a one word passing mention — in a list — of some future vaccinations (on page 4); no concrete plan to vaccinate a ring around these 125 contacts — to reach perhaps 1,000 to 3,000 potential future contacts, of contacts.

That is both troubling, and disappointing — even allowing for the fact that the affected areas lie a fully-mountainous, forested 220 miles (350 kilometers) away — on a terribly pock-marked (Jeeps only) dirt road — just a path, really — from any city of note.

We may well need a US airlift — and drop-in — operation. That’s my $0.02 — and sleep will certainly find me this evening, now. . . with a twinkling, green-eyed… g’night!

नमस्ते

Pre-Long Weekend Clean-Up: Etugliflozin News Due From Merck/Pfizer 60/40 Venture, In Early June…

May 17, 2017 - Leave a Response

This falls in the diabetes space, for the two companies — which as we reported almost exactly four years ago — involves a 60/40 split, in favor of Kenilworth, on this next gen Phase III candidate.

To be fair, this cooperative effort is running well behind the Lilly offering (in fact, we speculated that the entire “risk sharing” venture was born of Lilly’s clear lead, back in the Spring of 2013). Merck does expect to report news (on this, and a host of other diabetes-focused studies) in early June at the ADA conference in San Diego — so that is potentially good news. Here’s the bit:

. . .Merck announced that 19 scientific presentations from Merck’s diabetes pipeline and portfolio – including Phase 3 data for investigational ertugliflozin, additional analyses of JANUVIA® (sitagliptin), and real-world research – will be presented at the 77th Scientific Sessions of the American Diabetes Association (ADA) in San Diego, June 9-13, 2017. Oral and poster presentations of ertugliflozin, a SGLT-2 inhibitor in development with Pfizer, include new data from two Phase 3 studies and 52-week extension data from three other studies in the VERTIS clinical development program.. . . .

Now you know. Scantly sleeping, once again, as sleep fails to find me. . . oh well.

नमस्ते

More Ignoble, But Ancient, Schering-Plough History Put To Rest… 2001 K-Dur® Antitrust Suit Settles.

May 16, 2017 - Leave a Response

The patent on this tiny coated crystal was first granted in September of 1989. It is, at base, simply a potassium chloride crystal, coated to dissolve slowly in the gut. While I do admire the 1980s era ingenuity it took to create that long-ago drug, nearly 27 years seems more than long enough to recoup the R&D, plus book a massive profit stream.

And so, K-Dur® it seems — in what is actually a smallish settlement for Kenilworth to absorb — has finally met its “pay for delay” end-game. The end comes in the form of a $60 million payment, in a 16 plus year old federal antitrust class action (as a successor to a legacy S-P class action).

Here is Reuters on it all, tonight:

. . . .The settlement, disclosed in papers filed in federal court in Newark, New Jersey on Monday, came in a class action filed in 2001 arising out of a settlement in patent litigation between Upsher-Smith and Schering-Plough Corp, now owned by Merck.

That patent deal, plaintiffs in the antitrust class action said, was an example of a “pay-for-delay” settlement, in which brand-name drug makers pay generic companies to keep their products off the market for a longer period.

Both companies continued to deny wrongdoing as part of the settlement, according to court papers. The settlement is subject to court approval.

Neither Merck nor Upsher-Smith immediately responded to requests for comment on Tuesday. . . .

Now you know. There are some things that I’ve. . . simply stopped doing. I long ago (like late May 2015) stopped caring — stopped looking in. . . on this federal court file. So I learned of yesterday’s settlement — in today’s papers. So it goes. And I am decidedly good with it all. A wide smile. . . with much excitement ahead, this weekend, indeed. So. . . whatever, S-P (and Mr. Prep. H.). . . .

नमस्ते.

Nigeria Returns To 2014 Border Screenings Policy — With Ebola Re-Emerging In The Congo

May 16, 2017 - Leave a Response

This is, in truth, a very difficult time, in central Africa, from a public health policy perspective. Local in-country health ministers do not want to engender panic, but they also must move swiftly, given the severity of the situation. As you may see, at right, Nigeria does not even share a border-line with northern DRC — and the affected Bas-Uele Province, of the DRC. Even so, it is tightening its border entry procedures — in the same way it had, in 2014 — in the last sustained viral event. I suppose that is wise — but if the rest of Africa begins to clamp down, once again, the continent’s economy will shudder — from the effect of the clamp-down — without even one more live Ebola transmission, continent wide.

Moreover, thus far (as CIDRAP notes), the governing body of the World Health Organization has not authorized the use of the Merck vaccine candidate, though it has said if/when it does — it will be in a ring fashion — as it was deployed in the last outbreak (but was not ready until 2016).

I admit to being puzzled, about that. There are 300,000 doses at the ready. At least 10,000 of those should (in my view) already be on their way, inside the tertiary rings of contact, in Bas-Uele Province — even if reaching the rugged forested terrain in the far northern Congo is more than a bit of a challenge.

Refrigeration-equipped trucks (even if flown in by US military assistance) ought to already be rolling north, loaded with vaccine stock. [Under 44, they would already be. I cannot resist saying so — and noting that Mr. Trump will likely never say anything about this topic.] But back to the main topic — it seems to me that the moderate risk of some side effects is outweighed by the need to avoid another multi-year epidemic. I am hopeful the WHO Director General will say so, even later this week.

In any event, here is the Nigeria Tribune on it all, overnight:

. . . .Speaking during his visit to the Nnamdi Azikiwe International Airport, Abuja, on Monday, Minister of Health, Professor Isaac Adewole, asked Nigerians not to panic, adding that the Federal Government remained committed to ensuring that the virus was not imported to the country. . . .

As part of the measures being put in place, the minister was at the airport to inspect thermal screening machines located at the port health stand. . . .

Onward, on a suddenly very warm and humid Spring morning. Be well, one and all. [Late last night, Cassini made a fourth ring plunge — around Saturn — drawing ever closer. . . to her twisting demise.]

नमस्ते

[U] Ninth Circuit Oral Argument: Live Blogging, This Morning…

May 15, 2017 - Leave a Response

Mr. Trump: Time’s Up. You. Are. A. Fraud.

Your “movement” is morally bankrupt — and now largely non-existent — gutted by your endless duplicity.

Watch it on CSPAN, or. . . Look for my live coverage, in the blue pull quotes below (or if I am constrained by day-gig duties, look for the coverage initially in comments to this post — as it is easier to post comments by phone, than edit the main post that way). Order here.

. . . .We are underway: the jurists are already probing Mr. Wall, over whether Mandel is the right standard. Exactly as it started in the Fourth Circuit.

It is clear that Mr. Trump will lose, unless Mandel is the standard. . . . Any other standard — any first amendment case standard — will be a death knell for Mr. Trump’s putative order. . . .

Now on to questions of standing, and the panel is trying to understand how the Administration could even credibly claim the lower courts (all of them) were in error. Not likely. . . .

Now Mr. Wall has foundered, unable to explain away the fact that the 1965 Amendments to the NIA (signed by President Johnson, in the shadow of the Statue of Liberty) have not been repealed — and that the “nationality” discrimination prohibition must be read consistently with subsequent amendments. Congress knows exactly how to repeal a prior law — and it did not do so. Mr. Wall cannot clear that hurdle — forgetting the constitutional violations. . . .

Now he is unable to explain Mr. Trump’s campaign promises. . . .

[Oops! A work interruption here; back by 12:30 CDT. Ugh. Plaintiffs now underway. . . . Going well!]

Update: argument has concluded. On to the Supremes — but I predict both the Fourth and Ninth Circuits will hold against Mr. Trump’s Muslim Ban 2.0. . .

[Graphic at right (and in today’s masthead) derived from a legendary Reddit user, and all around great artist — with courteous fair use claimed. Be well. Be wise. Actively — but peaceably — resist the pumpkin-hued narcissist. Out.

नमस्ते

Current Congo Ebola Outbreak: An Estimated 125 “Contacts” — Of The Three Known Fatalities

May 14, 2017 - Leave a Response

More difficult news, tonight, from Bas Uele Province. We will endeavor to keep a near real-time series of updated items near the top, on this current outbreak.

CNN has the latest:

. . . .Bas-Uele province, with a population of 900,000 in 2007, is mostly inhabited by the Boa tribe, which subsists through farming and hunting and conducts some trade by way of the Uele River. . . .

Health officials are investigating 17 other suspected cases, Dr. Ernest Dabire, WHO’s health cluster coordinator, said Sunday in Kinshasa. He further estimated that 125 people had been linked to the confirmed Ebola cases and urged the public to be vigilant and visit their doctor if they experience fever or other symptoms. . . .

As you fall asleep safe and sound — whole and healthy, tonight, count yourself blessed — we should all reflect upon just how lucky we are — by purely unearned random chance, of variant viral biology — and of. . . again, random geography, by birth. That alone should be. . . decidedly humbling.

नमस्ते

Now Eleven Confirmed Ebola Cases… In Congo’s 2017 Outbreak.

May 13, 2017 - Leave a Response

It is with some deep concern that I report this update — as it signals a fully blossomed outbreak — a new one — but it seems that WHO health authorities are on-scene, very near in time to the discovery of the first case — or the index case, as its called.

Specifically, it would seem that the index case patient was likely transported by cab to a health care facility, where he died. Then his cab driver succumbed, just a few days later. Now a third person, who cared for the likely index case, has died. Overall, in the far northern border province of the Congo, there are eleven confirmed cases — just since April 23:

. . . .11 cases; 4 deaths. . .

Personal Protective Equipment (PPE) for health care workers has been shipped on 12 May 2017 to Kisangani. Additional kits are currently being prepared and will be shipped as soon as available. . . .

The bulk-packed vaccine stock cannot arrive soon enough — and the vaccinations cannot begin soon enough. Please keep the people of the Congo, and Bas-Uele province in particular, in your meditations, on Mother’s Day.

नमस्ते

Hard Ebola News, Concerning The Former Zaire — The Democratic Republic Of The Congo…

May 12, 2017 - Leave a Response

We knew this day would come — as life always finds a way — even (especially, perhaps) parasitic, destructive life. . . it adapts — it evolves. . . it lays dormant, in the bush. . . for years. . . decades, even. Then it rises, anew. This is — unfortunately — one of those times.

The good news, however, is that the world now has what it believes will be a 100 per cent effective vaccine — and 300,000 doses at the ready, all manufactured by Merck. [Back story, here.] Even a robust “ring vaccination” program throughout the Bas-Uele province, in the northern part of the DRC (the affected country) will do nothing for those (dozens, potentially, already) who have contracted the full-on virus.

But we should be encouraged that a large epidemic in 2017 is now only a rather remote possibility — assuming the vaccine still inactivates the virus, and that ebola itself hasn’t stealthily-mutated — to avoid the vaccine’s killing instinct. I do think we have very good reason to be hopeful. From this evening’s New York Times, then — a bit:

. . . .Of the five blood samples taken from the newest suspected cases and analyzed by the Congolese National Institute of Biomedical Research, one tested positive for Ebola, according to the Health Ministry. Since April 22, the ministry has recorded nine suspected cases and three deaths.


Dr. Armand Sprecher, a public health specialist and Ebola expert who works with Doctors Without Borders — widely known by its French name, Médecins Sans Frontières, said by telephone from Brussels that unless a full investigation were conducted, it would be hard to know how severe the new outbreak could be. . . .

Do go do what ever it is you do — this Sunday (or Saturday, or tonight), in meditation, communion, prayer or worship — to ask for some biological favors — to befall all the good people of the DRC. And in all of north central Africa, truth told. That’s all I’ve got at the moment, as it has been quite a week for disturbing news, on many fronts. . . . sleep well all — I’m out.

नमस्ते

Time “To Stand, And Deliver” — Please Do Forgive The Politics.

May 12, 2017 - Leave a Response

So many of 45’s tweets are inane, wrong-headed or ignorant — of basic constitutional precepts — it would be impossible to challenge each one. That would be a 24 by 7 job; “no thanks“. . . .

But this one, from just this morning — see image at right; click to enlarge it — stands out, among all, in recent months. It is jaw-slacking, in its unhinged. . . lunacy — from the so-called leader of the free world.

It must be challenged. Forget for a moment that the President is here threatening the former head of the FBI — for exercising what would be his first amendment rights — as he would obviously not violate his duties as a lawyer, and former US employee. He still has a wide swath of first amendment rights, now that he is a private citizen. But as I say, forget that. That’s typical Agent Orange non-sense blather. James Comey is more than up to resisting such penny-ante tactics.

No — I write to note that — under local DC law (i.e., wherever the “conversations” occurred) — and more importantly, under applicable federal law [18 U.S. Code § 2511(1)(e)], unless Mr. Comey consented to any taping, Mr. Trump is admitting to a felony. It is called wire-tapping — and it carries a five year prison term [at §§ (4)(a)]. Now, it is possible (I suppose), that Mr. Trump is referring to a formal investigative interview — one that Mr. Comey might have conducted (of Mr. Trump), as head of the FBI — and of course, that interview would properly be record-able — and recorded. But I am aware of no such formal interview.

. . . .James Comey better hope there are no “tapes” of our conversations, before he starts leaking to the press!. . . .

We shall see — but this staggering display of ignorance is. . . almost laughable. Almost. But not. . . quite.

I suspect Mr. Trump thinks that because Mr. Nixon wire-tapped many people in his office, and over the phone — that this is a good idea. The federal wire-tap laws were amended specifically to respond to Mr. Nixon’s un-American activities. 45’s hubris and ignorance know no bounds.

But he IS, day by fateful, odious day, making a reasonably good case for his own impeachment — from his own tweets. So do hold forth, on Twitter, Mr. President. I await (with relish) your entirely self-inflicted undoing.

नमस्ते