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Economist Impact: World Cancer Series – pharmaphorum in attendance, day one (part iii)

Taking a brief look back to pharmaphorum’s coverage of Day One of The Economist’s 8th Annual World Cancer
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Taking a brief look back to pharmaphorum’s coverage of Day One of The Economist’s 8th Annual World Cancer Series congress in Brussels, Belgium, in November – where the foci were “innovation, equity, and excellence”. After a panel on the priorities for innovation and excellence in cancer care within Europe, with the essential aim of the conference “universally excellent cancer control and cancer outcomes across the Continent”, came a presentation on ‘Inequalities in cancer – facts and data’ by Francesca Colombo, head of the Health Division at the Organisation for Economic Co-operation and Development (OECD).

Colombo opened with the impactful statement that 40% of the differences in cancer cases can be attributed to preventable factors, such as lifestyle. Lung cancer is, she said, the most common cause of cancer deaths for men, as smoking is more prevalent among men in Europe, as well as in low-income groups. Indeed, there is a 60% higher likelihood of men smoking across EU countries than women.

Another cause of difference exists within health systems themselves, Colombo stated, with income particularly affecting breast cancer screening uptake in Romania, Bulgaria, and Norway (breast cancer screening is 1.25 times more likely to be taken up by higher-income people). Other factors, however, include the availability or otherwise of cancer drugs. Nonetheless, resources only explain part of the differences in oncological performance, she said. Regularly, only about half of the data needed to inform policy and practice is measured.

Crisis and cancer control

Colombo’s presentation was followed by the panel, ‘The future of European cancer control in a time of crisis’. Moderated by Dr Vivek Muthu of Marivek Healthcare Solutions and Economist Impact, the panellists included: MEP Frances Fitzgerald; CEO of Youth Cancer Europe (YCE) Katie Rizvi; Professor of clinical oncology and radiotherapy and head of the department of oncology and radiotherapy, Medical University of Gdansk, Poland, Dr Jacek Jassem; and Head of Europe and Canada oncology at AstraZeneca, Greg Rossi.

Fitzgerald opened the discussion. A Member of the European Parliament since 2019, she stated that what happens in a crisis is that existing inequalities get exaggerated. In attempting to answer the question of how cancer care can continue to be prioritised on an ongoing basis, many medical voices were heard, she said. But, at the same time, other health priorities were going down the scale and, therefore, the demands on our health services require a catch-up.

Fitzgerald stated that, as a politician, it’s about keeping a voice in a crisis, and anticipating the next problem: pre-planning helps to ensure the voices of specialists and experts are kept at the forefront. Secondly, collaboration is highly important, she said. Also chair of Transforming Breast Cancer Together, collaboration creates a far better chance of needs being met and builds bridges between the various levels.

Katia Rizvi commented that some of the most agile entities are patient organisations, which supply very important intelligence and data. However, it was a ‘hustle’ for patient organisations to be heard during the pandemic, she said. Nonetheless, the more recent and ongoing crisis in Ukraine saw YCE being the first responder in that country.

The Ukrainian situation and therapy across borders

Dr Jacek Jassem noted the challenge that the Ukrainian crisis had been and continues to be. Now [as of 8th November], he said, 7 million Ukrainians have crossed the Polish border, and 2.5 million have settled in Poland. Therapy wasn’t available in Ukraine, for one reason or another, or had been interrupted due to circumstances, he explained. So, it was that Poland had to provide the necessary cancer care and, indeed, soon after the war started, it had been decided that refugees would have the same care as Polish patients – despite the difficulties faced by having no Polish documentation.

In addition to accommodation problems, unemployment, and broken families – mainly women and children, given men haven’t been allowed to leave Ukraine – the management of cancer in refugees is different. There is no screening available for cervical cancer in Ukraine, so the rates are much higher on average than the rest of Europe, Jassem said. As far as children were concerned, they arrived in groups from evacuated hospitals, at one point a group of 30 coming in.

There were communication and psychology problems, he explained, and documentation was scarce or missing. Theirs is also the issue that therapies can’t be restarted, they have to be continued, and so with no documentation and contacting doctors in Ukraine impossible because either the hospital didn’t exist anymore, or contact was otherwise challenging – Jassem asserted that they could only do their best. As Vivek rightly termed it: ‘heart-breaking’.

Industry’s learning from the pandemic

Regarding industry response in crisis, Greg Rossi returned to the pandemic experience, wherein industry’s role had been threefold: innovation, delivering vaccines, and therapies (for example, in B-Cell malignancies). The industry, he said, had been at its finest, able to move quickly despite the challenges. Being on the cancer side of the business, Rossi has seen huge value and innovation over the past 20 years – and much of that will be eroded because of the pandemic, he noted.

Over a million cancer screening tests were not carried out in 2020, which is a critical situation when the early treatment of patients is crucially important for the potential to cure. So it is, Rossi said, that they’re seeing bulkier, later stage disease and a worse prognosis because of that. Having worked with FBO and ESMP, it’s clear, he said, that patients need to engage with the health system when they’re symptomatic.

Rossi mentioned that biomarker testing is necessary for the right work-up and diagnosis – but it was difficult for a lung cancer patient to get a bronchoscopy during the pandemic. Radiologists were busy, he said, understanding how to treat Covid patients. And what of home support treatments, he asked. There are ways to use telemedicine and toxicity management apps and systems can be flexible in order to accelerate engagement. In short, the current crisis now is “basically a pandemic of cancer in Europe”, Rossi said, where a quarter of cases are.

Equitable cancer care across member states

Rizvi returned to the war in Ukraine’s facilitation of more flexible HP access, but noted that such patient movement flexibility was not being seen as regards the Balkans, for example. A re-evaluation of equity across EU member states should take place, she said.

Fitzgerald believed the present moment is unique, demanding international collaboration. How, she asked, can health be built into the protection directive given to Ukrainians, providing them nearly the rights of citizens in other countries? By a flexible and cooperative approach, she said.

At this juncture, Vivek interjected that crisis is an imperfect storm at the moment, with political instability in member states, but equally, a pan-European approach makes so much sense. Rizvi replied that there aren’t large-scale studies or a crisis analysis plan in Europe for oncology. Jassem added that the rapid development of telemedicine during COVID, and teleological imaging, rapidly developed: meeting online to discuss a patient and implementing home care are solutions. Delivery of medicines and home laboratories (requiring a small device connected to a smartphone) –also could help, he said.

Rossi posited that for equitable and high-quality cancer care, measurables are needed. Without high-quality, integrated data sets, best practices can’t be identified, nor can variables. Integrated data at a regional level is very important, he said, and Europe is falling behind the US in this. To this statement, an audience member said the two couldn’t be compared, as there is no united Europe in health. To this, Rossi clarified that he meant with regard to integrated data sets, not access; looking for the best possible framework for what works in cancer.

Fitzgerald agreed, and Vivek stated that a balance needs to be struck between setting out broad objectives and allowing sovereign states their priorities. Fitzgerald replied that if the European vision is to count for anything, then equality in care between states is fundamental: “what’s in the best interest of citizens, of patients, goes beyond national boundaries,” she said.

Regional considerations and fixing the fault line

Another question from the audience – this time from Parker Moss, chief ecosystems, and partnership officer at Genomics England – noted the call for breaking down national and regional boundaries, and state boundaries in the US. In England, Moss said, genomics systems have been broken down into seven regions, and Australia – although it has much smaller populations – has exactly the same number of regions, and different health practices and outcomes within those. Therefore, does healthcare have a natural tendency to fragment and, if so, is there a way to fix that fault, he asked.

Rossi responded by saying that one of the challenges is findings the unmet needs and asking whether treatment needs to be intensified or de-intensified, getting the biological detail into the databases and reinterpreting at a useful level.

Fitzgerald said it had to be a combined approach. Given the inequalities across Europe, there’s no defence to not engage on the macro level. Evidently, cancer care can’t be delivered purely nationally, she said. Jassem interjected that solidarity is critical in a crisis, and Rizvi added preparedness, also.

The post Economist Impact: World Cancer Series – pharmaphorum in attendance, day one (part iii) appeared first on .

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Survey Shows Declining Concerns Among Americans About COVID-19

Survey Shows Declining Concerns Among Americans About COVID-19

A new survey reveals that only 20% of Americans view covid-19 as "a major threat"…

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Survey Shows Declining Concerns Among Americans About COVID-19

A new survey reveals that only 20% of Americans view covid-19 as "a major threat" to the health of the US population - a sharp decline from a high of 67% in July 2020.

(SARMDY/Shutterstock)

What's more, the Pew Research Center survey conducted from Feb. 7 to Feb. 11 showed that just 10% of Americans are concerned that they will  catch the disease and require hospitalization.

"This data represents a low ebb of public concern about the virus that reached its height in the summer and fall of 2020, when as many as two-thirds of Americans viewed COVID-19 as a major threat to public health," reads the report, which was published March 7.

According to the survey, half of the participants understand the significance of researchers and healthcare providers in understanding and treating long COVID - however 27% of participants consider this issue less important, while 22% of Americans are unaware of long COVID.

What's more, while Democrats were far more worried than Republicans in the past, that gap has narrowed significantly.

"In the pandemic’s first year, Democrats were routinely about 40 points more likely than Republicans to view the coronavirus as a major threat to the health of the U.S. population. This gap has waned as overall levels of concern have fallen," reads the report.

More via the Epoch Times;

The survey found that three in ten Democrats under 50 have received an updated COVID-19 vaccine, compared with 66 percent of Democrats ages 65 and older.

Moreover, 66 percent of Democrats ages 65 and older have received the updated COVID-19 vaccine, while only 24 percent of Republicans ages 65 and older have done so.

“This 42-point partisan gap is much wider now than at other points since the start of the outbreak. For instance, in August 2021, 93 percent of older Democrats and 78 percent of older Republicans said they had received all the shots needed to be fully vaccinated (a 15-point gap),” it noted.

COVID-19 No Longer an Emergency

The U.S. Centers for Disease Control and Prevention (CDC) recently issued its updated recommendations for the virus, which no longer require people to stay home for five days after testing positive for COVID-19.

The updated guidance recommends that people who contracted a respiratory virus stay home, and they can resume normal activities when their symptoms improve overall and their fever subsides for 24 hours without medication.

“We still must use the commonsense solutions we know work to protect ourselves and others from serious illness from respiratory viruses, this includes vaccination, treatment, and staying home when we get sick,” CDC director Dr. Mandy Cohen said in a statement.

The CDC said that while the virus remains a threat, it is now less likely to cause severe illness because of widespread immunity and improved tools to prevent and treat the disease.

Importantly, states and countries that have already adjusted recommended isolation times have not seen increased hospitalizations or deaths related to COVID-19,” it stated.

The federal government suspended its free at-home COVID-19 test program on March 8, according to a website set up by the government, following a decrease in COVID-19-related hospitalizations.

According to the CDC, hospitalization rates for COVID-19 and influenza diseases remain “elevated” but are decreasing in some parts of the United States.

Tyler Durden Sun, 03/10/2024 - 22:45

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Rand Paul Teases Senate GOP Leader Run – Musk Says “I Would Support”

Rand Paul Teases Senate GOP Leader Run – Musk Says "I Would Support"

Republican Kentucky Senator Rand Paul on Friday hinted that he may jump…

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Rand Paul Teases Senate GOP Leader Run - Musk Says "I Would Support"

Republican Kentucky Senator Rand Paul on Friday hinted that he may jump into the race to become the next Senate GOP leader, and Elon Musk was quick to support the idea. Republicans must find a successor for periodically malfunctioning Mitch McConnell, who recently announced he'll step down in November, though intending to keep his Senate seat until his term ends in January 2027, when he'd be within weeks of turning 86. 

So far, the announced field consists of two quintessential establishment types: John Cornyn of Texas and John Thune of South Dakota. While John Barrasso's name had been thrown around as one of "The Three Johns" considered top contenders, the Wyoming senator on Tuesday said he'll instead seek the number two slot as party whip. 

Paul used X to tease his potential bid for the position which -- if the GOP takes back the upper chamber in November -- could graduate from Minority Leader to Majority Leader. He started by telling his 5.1 million followers he'd had lots of people asking him about his interest in running...

...then followed up with a poll in which he predictably annihilated Cornyn and Thune, taking a 96% share as of Friday night, with the other two below 2% each. 

Elon Musk was quick to back the idea of Paul as GOP leader, while daring Cornyn and Thune to follow Paul's lead by throwing their names out for consideration by the Twitter-verse X-verse. 

Paul has been a stalwart opponent of security-state mass surveillance, foreign interventionism -- to include shoveling billions of dollars into the proxy war in Ukraine -- and out-of-control spending in general. He demonstrated the latter passion on the Senate floor this week as he ridiculed the latest kick-the-can spending package:   

In February, Paul used Senate rules to force his colleagues into a grueling Super Bowl weekend of votes, as he worked to derail a $95 billion foreign aid bill. "I think we should stay here as long as it takes,” said Paul. “If it takes a week or a month, I’ll force them to stay here to discuss why they think the border of Ukraine is more important than the US border.”

Don't expect a Majority Leader Paul to ditch the filibuster -- he's been a hardy user of the legislative delay tactic. In 2013, he spoke for 13 hours to fight the nomination of John Brennan as CIA director. In 2015, he orated for 10-and-a-half-hours to oppose extension of the Patriot Act

Rand Paul amid his 10 1/2 hour filibuster in 2015

Among the general public, Paul is probably best known as Capitol Hill's chief tormentor of Dr. Anthony Fauci, who was director of the National Institute of Allergy and Infectious Disease during the Covid-19 pandemic. Paul says the evidence indicates the virus emerged from China's Wuhan Institute of Virology. He's accused Fauci and other members of the US government public health apparatus of evading questions about their funding of the Chinese lab's "gain of function" research, which takes natural viruses and morphs them into something more dangerous. Paul has pointedly said that Fauci committed perjury in congressional hearings and that he belongs in jail "without question."   

Musk is neither the only nor the first noteworthy figure to back Paul for party leader. Just hours after McConnell announced his upcoming step-down from leadership, independent 2024 presidential candidate Robert F. Kennedy, Jr voiced his support: 

In a testament to the extent to which the establishment recoils at the libertarian-minded Paul, mainstream media outlets -- which have been quick to report on other developments in the majority leader race -- pretended not to notice that Paul had signaled his interest in the job. More than 24 hours after Paul's test-the-waters tweet-fest began, not a single major outlet had brought it to the attention of their audience. 

That may be his strongest endorsement yet. 

Tyler Durden Sun, 03/10/2024 - 20:25

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The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While “Waiting” For Deporation, Asylum

The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While "Waiting" For Deporation, Asylum

Over the past several…

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The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While "Waiting" For Deporation, Asylum

Over the past several months we've pointed out that there has  been zero job creation for native-born workers since the summer of 2018...

... and that since Joe Biden was sworn into office, most of the post-pandemic job gains the administration continuously brags about have gone foreign-born (read immigrants, mostly illegal ones) workers.

And while the left might find this data almost as verboten as FBI crime statistics - as it directly supports the so-called "great replacement theory" we're not supposed to discuss - it also coincides with record numbers of illegal crossings into the United States under Biden.

In short, the Biden administration opened the floodgates, 10 million illegal immigrants poured into the country, and most of the post-pandemic "jobs recovery" went to foreign-born workers, of which illegal immigrants represent the largest chunk.

Asylum seekers from Venezuela await work permits on June 28, 2023 (via the Chicago Tribune)

'But Tyler, illegal immigrants can't possibly work in the United States whilst awaiting their asylum hearings,' one might hear from the peanut gallery. On the contrary: ever since Biden reversed a key aspect of Trump's labor policies, all illegal immigrants - even those awaiting deportation proceedings - have been given carte blanche to work while awaiting said proceedings for up to five years...

... something which even Elon Musk was shocked to learn.

Which leads us to another question: recall that the primary concern for the Biden admin for much of 2022 and 2023 was soaring prices, i.e., relentless inflation in general, and rising wages in particular, which in turn prompted even Goldman to admit two years ago that the diabolical wage-price spiral had been unleashed in the US (diabolical, because nothing absent a major economic shock, read recession or depression, can short-circuit it once it is in place).

Well, there is one other thing that can break the wage-price spiral loop: a flood of ultra-cheap illegal immigrant workers. But don't take our word for it: here is Fed Chair Jerome Powell himself during his February 60 Minutes interview:

PELLEY: Why was immigration important?

POWELL: Because, you know, immigrants come in, and they tend to work at a rate that is at or above that for non-immigrants. Immigrants who come to the country tend to be in the workforce at a slightly higher level than native Americans do. But that's largely because of the age difference. They tend to skew younger.

PELLEY: Why is immigration so important to the economy?

POWELL: Well, first of all, immigration policy is not the Fed's job. The immigration policy of the United States is really important and really much under discussion right now, and that's none of our business. We don't set immigration policy. We don't comment on it.

I will say, over time, though, the U.S. economy has benefited from immigration. And, frankly, just in the last, year a big part of the story of the labor market coming back into better balance is immigration returning to levels that were more typical of the pre-pandemic era.

PELLEY: The country needed the workers.

POWELL: It did. And so, that's what's been happening.

Translation: Immigrants work hard, and Americans are lazy. But much more importantly, since illegal immigrants will work for any pay, and since Biden's Department of Homeland Security, via its Citizenship and Immigration Services Agency, has made it so illegal immigrants can work in the US perfectly legally for up to 5 years (if not more), one can argue that the flood of illegals through the southern border has been the primary reason why inflation - or rather mostly wage inflation, that all too critical component of the wage-price spiral  - has moderated in in the past year, when the US labor market suddenly found itself flooded with millions of perfectly eligible workers, who just also happen to be illegal immigrants and thus have zero wage bargaining options.

None of this is to suggest that the relentless flood of immigrants into the US is not also driven by voting and census concerns - something Elon Musk has been pounding the table on in recent weeks, and has gone so far to call it "the biggest corruption of American democracy in the 21st century", but in retrospect, one can also argue that the only modest success the Biden admin has had in the past year - namely bringing inflation down from a torrid 9% annual rate to "only" 3% - has also been due to the millions of illegals he's imported into the country.

We would be remiss if we didn't also note that this so often carries catastrophic short-term consequences for the social fabric of the country (the Laken Riley fiasco being only the latest example), not to mention the far more dire long-term consequences for the future of the US - chief among them the trillions of dollars in debt the US will need to incur to pay for all those new illegal immigrants Democrat voters and low-paid workers. This is on top of the labor revolution that will kick in once AI leads to mass layoffs among high-paying, white-collar jobs, after which all those newly laid off native-born workers hoping to trade down to lower paying (if available) jobs will discover that hardened criminals from Honduras or Guatemala have already taken them, all thanks to Joe Biden.

Tyler Durden Sun, 03/10/2024 - 19:15

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