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Impact of COVID-related state of emergency declarations on asthma exacerbations in children

An investigation into the impact of the 2020 state of emergency declarations on exacerbated bronchial asthma (*1) in children has been conducted in Kobe City, Hyogo Prefecture, Japan. The research group included Project Assistant Professor YAMAGUCHI Hiros

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An investigation into the impact of the 2020 state of emergency declarations on exacerbated bronchial asthma (*1) in children has been conducted in Kobe City, Hyogo Prefecture, Japan. The research group included Project Assistant Professor YAMAGUCHI Hiroshi and Professor NOZU Kandai of the Department of Pediatrics at Kobe University’s Graduate School of Medicine, and the Kobe Children’s Primary Emergency Medical Center Director ISHIDA Akihito.

Credit: Modified version of Yamaguchi et al., Int. J. Environ. Res. Public Health 2021, 18, 11407.

An investigation into the impact of the 2020 state of emergency declarations on exacerbated bronchial asthma (*1) in children has been conducted in Kobe City, Hyogo Prefecture, Japan. The research group included Project Assistant Professor YAMAGUCHI Hiroshi and Professor NOZU Kandai of the Department of Pediatrics at Kobe University’s Graduate School of Medicine, and the Kobe Children’s Primary Emergency Medical Center Director ISHIDA Akihito.

The survey covered patient visits to the Kobe Children’s Primary Emergency Medical Center for the period from 2011 to 2020. First of all, the researchers identified yearly spring and fall peaks in the number of asthma patients in the annual data up to 2019. In addition, they also found a significant correlation between children’s asthma attacks and atmospheric temperature increases. Furthermore, they revealed that asthma attacks occurred more easily in children aged 5 and under the higher the level of atmospheric sulfur dioxide (SO2). The average temperature for 2020 was similar to the previous year, however under the state of emergency in spring, the number of patients with bronchial asthma declined as SO2 levels decreased. After the state of emergency was lifted, the regular peak in patient numbers was seen in fall. It can be supposed that this is due to the relationship between the occurrence of asthma attacks and exposure to SO2, as well asthe increase in viral infections resulting from the recommencement of social activities and in-person interactions.

These research results were published online in the ‘International Journal of Environmental Research and Public Health’ on October 29, 2021.

Main Points

  • The researchers conducted a survey on the number of patients who visited Kobe Children’s Primary Emergency Medical Center with bronchial asthma from 2011 to 2020.
  • Clear peaks were observed in spring and fall in the data up until 2019. In addition, there was a significant correlation between the number of children with bronchial asthma across all age groups and the increase in average atmospheric temperature. Furthermore, in children aged 5 and under, there was a significant correlation with increased levels of atmospheric sulfur dioxide (SO2).
  • Due to the state of emergency declarations, there was markedly less atmospheric pollution in Kobe City during 2020 compared to other years, and SO2 levels also significantly declined.
  • No peak was observed in the data for spring 2020, when a state of emergency was in place. However, the regular yearly peak was found in the data for fall 2020, when the state of emergency had been lifted. It is assumed that the spring results were due to the reduced SO2 emissions and the state of emergency measures, which meant that children were exposed to less environmental pollutants and infections. Measures such as social distancing reduced face-to-face interactions, and practices such as handwashing and mask-wearing contributed towards making children’s environments more hygienic. 

Research Background

Studies in numerous countries have reported various environmental factors involved in bronchial asthma, including infections (such as rhinovirus, RS virus and influenza), meteorological factors (such as temperature, pressure and humidity), allergens (eg. pollen, yellow sand) and atmospheric pollutants (such as SO2, nitrogen oxide (NO2) and PM2.5). However, the effects of environmental factors on bronchial asthma in children living in Kobe City was unclear, as no study had been conducted into the seasonal and yearly changes in the numbers of patients. In addition, it was also not known what impact the 2020 state of emergency declarations in response to the novel coronavirus pandemic had on the number of pediatric inpatients with bronchial asthma in Kobe City.

Research Findings
A total of 278, 465 patients under the age of 16 visited the Kobe Children’s Primary Emergency Medical Center in the 2011-2020 period, of which 7,476 were diagnosed with bronchial asthma. This believed to be the largest number of patients with bronchial asthma in a single-institution study.

First of all, the researchers investigated trends in patient numbers between 2011 and 2020. From the results, they discovered that for the 2011-2019 period there were clear peaks in the spring and fall of every year. In contrast to this, no peak was observed during the state of emergency in spring 2020, however a similar peak in the number of patients compared to previous years was observed in the data for October 2020 when the state of emergency had been lifted (Figure 1). Next, the researchers looked at what kind of environmental factors in Kobe City were related to pediatric bronchial asthma for the 2011-2019 period in order to determine the factors that caused the 2020 change in the number of patients. The subsequent results revealed a significant correlation between the total number of pediatric patients with respiratory difficulties and the increase in average atmospheric temperature. Furthermore, in children aged 5 and under, there was a significant correlation with increased concentrations of SO2. However, no significant correlations were found with other factors relating to climate, pollutants, the number of patients with respiratory infections (e.g. influenza, RS virus), typhoons, yellow sand nor pollen levels.

Due to the state of emergency declarations, 2020 levels of atmospheric pollution in Kobe City were markedly lower than in other years, with a significant decrease in SO2 levels (Figure 2). It is believed that the peak in bronchial asthma admissions was not observed in spring 2020 due to the decrease in SO2 and other impacts of the state of emergency, such as reduced person-to-person contact due to social distancing, and handwashing and mask-wearing measures that created a more hygienic environment. It is thought that the peak in cases returned in fall 2020 due to infection transmission resulting from increased contact between children, and the increase in environmental pollution due to the recommencement of social activities, which also increased exposure risks.

Further Developments
It is said that bronchial asthma attacks often occur on cold days and before or after a typhoon. However, this research study has shown that in Kobe City, bronchial asthma is more easily triggered on high temperature days, and is also exacerbated by SO2 emissions, particularly during the back-to-school periods. Preventative measures such as taking care not to be outside for long periods during high temperature days, and avoiding places with high levels of car and factory emissions could help, particularly during spring and fall when there is a high number of asthma attacks.

In addition, a relationship was also found between the number of asthma patients and the increase in person-to-person contact and social activities after the state of emergency was lifted. Therefore, measures that create a hygienic environment (such as mask-wearing, handwashing and gargling) are also important for children who have a history of respiratory issues.

Glossary
1. Bronchial Asthma: 
Bronchial asthma is an illness characterized by repetitive instances of breathing difficulties due to the narrowing of the airways. In serious cases the patient may become unable to breathe, resulting in death.
2. Sulfur Dioxide (SO2): This is produced by burning coal and oil. Industrial emissions of SO2, such as those from factories, are known to cause acid rain. In addition, SO2 emissions were also responsible for the Yokkaichi asthma cases that occurred in the city of Yokkaichi (Mie Prefecture, Japan) from the 1960s to the early 1970s. It is a known cause of respiratory illnesses.

Journal Information
Title:

“Impact of the state of emergency during the COVID-19 pandemic in 2020 on asthma exacerbations among children in Kobe city, Japan”
DOI: 10.3390/ijerph182111407

Authors:
Hiroshi Yamaguchi *, Kandai Nozu, Shinya Ishiko, Hiroaki Nagase, Takeshi Ninchoji, China Nagano, Hiroki Takeda, Ai Unzaki, Kazuto Ishibashi, Ichiro Morioka, Kazumoto Iijima, Akihito Ishida
*Corresponding Author

Journal:
International Journal of Environmental Research and Public Health


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Easyjet share price down 3% as pandemic losses hit £2.2 billion

The EasyJet share price shed over 3% today to give up a chunk of…
The post Easyjet share price down 3% as pandemic losses hit £2.2 billion first appeared on Trading and Investment News.

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The EasyJet share price shed over 3% today to give up a chunk of the gains the budget airline had made earlier in the week. The new slide came after it announced a £213 loss for the last quarter of the year covering the Christmas period, taking losses for the Covid-19 pandemic period to £2.2 billion. The airline also told investors it is still burning through £150 million in cash every month as it struggles to build capacity back up.

The short-haul airline that makes most of its income shuttling holidaymakers and business travellers around Europe said it is still only operating at around half of its pre-pandemic capacity. However, it is hopeful that pent-up demand and an end to travel restrictions mean it will return to pre-pandemic levels by summer and enjoy much brisker trade than of late over the Easter and spring period.

easy jet plc

But before then the airline company will again have to absorb deep losses over the current quarter, which is traditionally its weakest of the year. Even a strong summer period, think most analysts, will be insufficient to see the company return to profit this year. EasyJet’s value is still less than half of what it was in February 2020 before the coronavirus-induced market sell-off that hit later that month and saw markets dive into March before starting to recover. The share prices of rival budget airlines Ryanair and WizzAir have recovered much more strongly in comparison to EasyJet’s and are now close to their pre-pandemic levels. There have been concerns around whether EasyJet could survive the pandemic but investors contributed £1.2 billion last autumn to bolster its balance sheet.

The EasyJet share price is closing the week at around £6.15 compared to over £15 before the pandemic. However, there is now hope the worst may be behind the airline and it can begin its, potentially long, journey back to health. Chief executive John Lundgren attempted to soften the announcement of another hefty loss with a bullish statement on where things go from here for his company:

“Booking volumes jumped in the UK following the welcome reduction of travel restrictions announced on January 5, which have been sustained and given a further boost from the UK government’s decision this week to remove all testing requirements.”

“We believe testing for travel across our network should soon become a thing of the past. We see a strong summer ahead, with pent-up demand that will see easyJet returning to near-2019 levels of capacity, with UK beach and leisure routes performing particularly well.”

For now, however, forward guidance for the immediate quarter remains cautious with the company admitting it has fallen short of its expectations to be at 80% capacity by this quarter, sitting at just 67%. However, with most analysts confident the company will eventually return to strength, and profit in the 2022-23 financial year, EasyJet shares could offer a good buying opportunity at current levels.

The post Easyjet share price down 3% as pandemic losses hit £2.2 billion first appeared on Trading and Investment News.

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Authoritarian Madness: The Slippery Slope From Lockdowns To Concentration Camps

Authoritarian Madness: The Slippery Slope From Lockdowns To Concentration Camps

Authored by John W. Whitehead & Nisha Whitehead via The Rutherford Institute,

“All the Dachaus must remain standing. The Dachaus, the Belsens, the Buchenwal

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Authoritarian Madness: The Slippery Slope From Lockdowns To Concentration Camps

Authored by John W. Whitehead & Nisha Whitehead via The Rutherford Institute,

“All the Dachaus must remain standing. The Dachaus, the Belsens, the Buchenwald, the Auschwitzes—all of them. They must remain standing because they are a monument to a moment in time when some men decided to turn the Earth into a graveyard. Into it they shoveled all of their reason, their logic, their knowledge, but worst of all, their conscience. And the moment we forget this, the moment we cease to be haunted by its remembrance, then we become the gravediggers.”

- Rod Serling, Deaths-Head Revisited

In the politically charged, polarizing tug-of-war that is the debate over COVID-19, we find ourselves buffeted by fear over a viral pandemic that continues to wreak havoc with lives and the economy, threats of vaccine mandates and financial penalties for noncompliance, and discord over how to legislate the public good without sacrificing individual liberty.

The discord is getting more discordant by the day.

Just recently, for instance, the Salt Lake Tribune Editorial Board suggested that government officials should mandate mass vaccinations and deploy the National Guard “to ensure that people without proof of vaccination would not be allowed, well, anywhere.”

In other words, lock up the unvaccinated and use the military to determine who gets to be “free.”

These tactics have been used before.

This is why significant numbers of people are worried: because this is the slippery slope that starts with well-meaning intentions for the greater good and ends with tyrannical abuses no one should tolerate.

For a glimpse at what the future might look like if such a policy were to be enforced, look beyond America’s borders.

In Italy, the unvaccinated are banned from restaurants, bars and public transportation, and could face suspensions from work and monthly fines. Similarly, France will ban the unvaccinated from most public venues.

In Austria, anyone who has not complied with the vaccine mandate could face fines up to $4100. Police will be authorized to carry out routine checks and demand proof of vaccination, with penalties of as much as $685 for failure to do so.

In China, which has adopted a zero tolerance, “zero COVID” strategy, whole cities—some with populations in the tens of millions—are being forced into home lockdowns for weeks on end, resulting in mass shortages of food and household supplies. Reports have surfaced of residents “trading cigarettes for cabbage, dishwashing liquid for apples and sanitary pads for a small pile of vegetables. One resident traded a Nintendo Switch console for a packet of instant noodles and two steamed buns.”

For those unfortunate enough to contract COVID-19, China has constructed “quarantine camps” throughout the country: massive complexes boasting thousands of small, metal boxes containing little more than a bed and a toilet. Detainees—including children, pregnant women and the elderly— were reportedly ordered to leave their homes in the middle of the night, transported to the quarantine camps in buses and held in isolation.

If this last scenario sounds chillingly familiar, it should.

Eighty years ago, another authoritarian regime established more than 44,000 quarantine camps for those perceived as “enemies of the state”: racially inferior, politically unacceptable or simply noncompliant.

While the majority of those imprisoned in the Nazi concentration camps, forced labor camps, incarceration sites and ghettos were Jews, there were also Polish nationals, gypsies, Russians, political dissidents, resistance fighters, Jehovah’s Witnesses, and homosexuals.

Culturally, we have become so fixated on the mass murders of Jewish prisoners by the Nazis that we overlook the fact that the purpose of these concentration camps were initially intended to “incarcerate and intimidate the leaders of political, social, and cultural movements that the Nazis perceived to be a threat to the survival of the regime.”

As the U.S. Holocaust Memorial Museum explains:

“Most prisoners in the early concentration camps were political prisoners—German Communists, Socialists, Social Democrats—as well as Roma (Gypsies), Jehovah's Witnesses, homosexuals, and persons accused of ‘asocial’ or socially deviant behavior. Many of these sites were called concentration camps. The term concentration camp refers to a camp in which people are detained or confined, usually under harsh conditions and without regard to legal norms of arrest and imprisonment that are acceptable in a constitutional democracy.”

How do you get from there to here, from Auschwitz concentration camps to COVID quarantine centers?

Connect the dots.

You don’t have to be unvaccinated or a conspiracy theorist or even anti-government to be worried about what lies ahead. You just have to recognize the truth in the warning: power corrupts, and absolute power corrupts absolutely.

This is not about COVID-19. Nor is it about politics, populist movements, or any particular country.

This is about what happens when good, generally decent people—distracted by manufactured crises, polarizing politics, and fighting that divides the populace into warring “us vs. them” camps—fail to take note of the looming danger that threatens to wipe freedom from the map and place us all in chains.

It’s about what happens when any government is empowered to adopt a comply-or-suffer-the-consequences mindset that is enforced through mandates, lockdowns, penalties, detention centers, martial law, and a disregard for the rights of the individual.

The slippery slope begins in just this way, with propaganda campaigns about the public good being more important than individual liberty, and it ends with lockdowns and concentration camps.

The danger signs are everywhere.

Claudio Ronco, a 66-year-old Orthodox Jew and a specialist in 18th-century music, recognizes the signs. Because of his decision to remain unvaccinated, Ronco is trapped inside his house, unable to move about in public without a digital vaccination card. He can no longer board a plane, check into a hotel, eat at a restaurant or get a coffee at a bar. He has been ostracized by friends, shut out of public life, and will soon face monthly fines for insisting on his right to bodily integrity and individual freedom.

For all intents and purposes, Ronco has become an undesirable in the eyes of the government, forced into isolation so he doesn’t risk contaminating the rest of the populace.

This is the slippery slope: a government empowered to restrict movements, limit individual liberty, and isolate “undesirables” to prevent the spread of a disease is a government that has the power to lockdown a country, label whole segments of the population a danger to national security, and force those undesirables—a.k.a. extremists, dissidents, troublemakers, etc.—into isolation so they don’t contaminate the rest of the populace.

The world has been down this road before, too.

Others have ignored the warning signs. We cannot afford to do so.

As historian Milton Mayer recounts in his seminal book on Hitler’s rise to power, They Thought They Were Free:

“Most of us did not want to think about fundamental things and never had. There was no need to. Nazism gave us some dreadful, fundamental things to think about—we were decent people‑—and kept us so busy with continuous changes and 'crises' and so fascinated, yes, fascinated, by the machinations of the 'national enemies', without and within, that we had no time to think about these dreadful things that were growing, little by little, all around us.”

The German people chose to ignore the truth and believe the lie.

They were not oblivious to the horrors taking place around them. As historian Robert Gellately points out, “[A]nyone in Nazi Germany who wanted to find out about the Gestapo, the concentration camps, and the campaigns of discrimination and persecutions need only read the newspapers.”

The warning signs were there, blinking incessantly like large neon signs.

“Still,” Gellately writes, “the vast majority voted in favor of Nazism, and in spite of what they could read in the press and hear by word of mouth about the secret police, the concentration camps, official anti-Semitism, and so on. . . . [T]here is no getting away from the fact that at that moment, ‘the vast majority of the German people backed him.’”

Half a century later, the wife of a prominent German historian, neither of whom were members of the Nazi party, opined: “[O]n the whole, everyone felt well. . . . And there were certainly eighty percent who lived productively and positively throughout the time. . . . We also had good years. We had wonderful years.”

In other words, as long as their creature comforts remained undiminished, as long as their bank accounts remained flush, as long as they weren’t being locked up, locked down, discriminated against, persecuted, starved, beaten, shot, stripped, jailed or killed, life was good.

Life is good in America, too, as long as you’re able to keep cocooning yourself in political fantasies that depict a world in which your party is always right and everyone else is wrong, while distracting yourself with bread-and-circus entertainment that bears no resemblance to reality.

Indeed, life in America may be good for the privileged few who aren’t being locked up, locked down, discriminated against, persecuted, starved, beaten, shot, stripped, jailed or killed, but it’s getting worse by the day for the rest of us.

Which brings me back to the present crisis: COVID-19 is not the Holocaust, and those who advocate vaccine mandates, lockdowns and quarantine camps are not Hitler, but this still has the makings of a slippery slope.

The means do not justify the ends: we must find other ways of fighting a pandemic without resorting to mandates and lockdowns and concentration camps. To do otherwise is to lay the groundwork for another authoritarian monster to rise up and wreak havoc.

If we do not want to repeat the past, then we must learn from past mistakes.

January 27 marks Remembrance Day, the anniversary of the liberation of Auschwitz-Birkenau, a day for remembering those who died at the hands of Hitler’s henchmen and those who survived the horrors of the Nazi concentration camps.

Yet remembering is not enough. We can do better. We must do better.

As I make clear in my book Battlefield America: The War on the American People and in its fictional counterpart The Erik Blair Diaries, the world is teetering on the edge of authoritarian madness.

All it will take is one solid push for tyranny to prevail.

Tyler Durden Fri, 01/28/2022 - 23:40

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Eli Lilly says FDA could deny expanded use of arthritis drug for eczema

Eli Lilly said on Jan. 28 the company expects the U.S. Food and Drug Administration to decline the approval of expanded use of the rheumatoid arthritis drug Olumiant as a treatment for adults with moderate-to-severe eczema.

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Eli Lilly says FDA could deny expanded use of arthritis drug for eczema

(Reuters) – Eli Lilly and Co (LLY.N) said on Friday it expects the U.S. Food and Drug Administration to decline the approval of expanded use of its rheumatoid arthritis drug as a treatment for adults with moderate-to-severe eczema.

“At this point, the company does not have alignment with the FDA on the indicated population,” the drugmaker said.

Olumiant, discovered by Incyte Corp (INCY.O) and licensed to Lilly, belongs to a class of drugs called JAK inhibitors, which came under regulatory scrutiny after Pfizer’s (PFE.N) arthritis drug Xeljanz showed an increased risk of serious heart-related problems and cancer in a February trial. read more

The path to approval for the drug has been arduous, with the FDA extending its review timeline repeatedly.

AbbVie’s (ABBV.N) rival eczema drug, Rinvoq, also faced similar regulatory hurdles before being finally approved by the FDA earlier this month, as well as Pfizer’s Cibinqo. read more

“While not specified by the company, we wonder if the FDA may be looking to limit the use of the product (Olumiant) to an even smaller subset of patients than what Rinvoq and Cibinqo were approved for,” Mizuho analyst Vamil Divan said in a client note.

An Eli Lilly and Company pharmaceutical manufacturing plant is pictured at 50 ImClone Drive in Branchburg, New Jersey, March 5, 2021. REUTERS/Mike Segar/File Photo

Lilly also said it has decided to discontinue its program for testing use of Olumiant in autoimmune disease lupus, based on early results from two late-stage trials.

The decision would adversely affect Lilly which continues to bet on upcoming regulatory decisions on the drug for treating COVID-19 for certain hospitalized patients and severe alopecia areata, a type of hair loss.

In the United States, the drug is already authorized for emergency use in hospitalized adults with COVID-19 and children aged two or older requiring supplemental oxygen or mechanical ventilation. Lilly awaits Olumiant’s full approval in certain hospitalized COVID-19 patients, with an anticipated regulatory action in the second quarter.

Reporting by Manojna Maddipatla in Bengaluru; Editing by Krishna Chandra Eluri and Shinjini Ganguli

Our Standards: The Thomson Reuters Trust Principles.

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