Immuno-suppressants and COVID-19: Immuno-suppressed people are not more likely to die due to COVID-19, nor are they at a higher risk of ventilation, as compared to those who do not take immunosuppressants, a new Lancet study has found. The study, which was published in The Lancet Rheumatology journal and was accessed by Financial Express Online, said that while previous studies had determined that patients suffering from autoimmune diseases were more like to contract COVID-19 infection, there were not any conclusive studies on the deaths or invasive ventilation reported among such patients. The study, therefore, analysed the health records of a whopping 2.22 lakh adults in the US who were hospitalised between January 2020 and June 2021. Of these, nearly 16,500 had been taking immunosuppressants before they were hospitalised.
The study divided immunosuppressive medications into several classes and found that each of the drug classes was either associated with reduced invasive mechanical ventilation or no effect at all, which means that none of the drug classes were associated with increased invasive ventilation. Meanwhile, the drug class of JAK inhibitors was found to be associated with a significant decrease in cases of in-hospital deaths. On the other hand, Rituximab, when taken for rheumatological conditions or as a cancer therapy, led to an increase in risk of in-hospital deaths. Other than that, no drugs led to a significant association with increase in in-hospital deaths, the study found. “Although not statistically significant, the effect size suggests a potentially elevated risk of death for people with anthracycline prescription,” the paper added.
The paper said that even though the cases related to COVID-19 seem to be on a decline, it is still an ongoing pandemic and therefore, there are some important questions that need to be answered. “In this analysis of more than 2,20,000 adults hospitalised with COVID-19, there was no discernible increased risk of invasive mechanical ventilation or in-hospital death with most of the therapies we examined,” the paper said. These findings are important because these therapies are commonly used among patients across the globe, and there are many questions around how these therapies and the drugs involved can impact their health.
The findings of this study can help doctors figure out treatments for people with comorbidities while keeping in mind the ongoing risk of the coronavirus pandemic. Since these immunosuppressive drugs have not shown to lead to any major increase in the cases of invasive ventilation or, for most drugs, in cases of in-hospital deaths, this information can help doctors ascertain which immunosuppressants they can administer to patients so that they do not lead to adverse effects in case a patients ends up contracting COVID-19 and requires hospitalisation. This also sheds light on the fact that given the current pandemic, patients who have otherwise been taking Rituximab either as a cancer therapy or for rheumatological conditions need to discuss alternatives with their doctors.
However, while the study has looked at hospitalised cases of coronavirus and how it matches with immunosuppressants, there is also a need for in-depth study regarding the link between these drugs and the various COVID-19 vaccines. So far, as per the UK’s NHS, “immunosuppressed patients, due to disease or treatment are an ‘at-risk’ group (previous termed ‘clinically extremely vulnerable’) and should be vaccinated against COVID-19”. It also added that as per the patient group detection reports for various vaccines, “there are no groups of potentially immunosuppressed patients that should be excluded from receiving the vaccine based on their treatment or disease alone. It is, however, noted that some immunosuppressed patients may have a suboptimal response to the vaccine and should therefore continue to avoid exposure unless they are advised otherwise by their doctor”.
This, however, does need to be looked at in-depth in a similar kind of study so that the level of protection for immuno-suppressed patients with COVID-19 can be determined and better alternatives can be looked at or developed for such patients.
Woman passenger from UK tests Covid positive at Hyderabad airport
Hyderabad: A 35-year-old international passenger who reached the Rajiv Gandhi International Airport here on Wednesday has tested positive for Covid-19 after undergoing an RT-PCR test at the airport itself. The woman passenger had traveled from the United Kingdom, which has been categorised as an ‘At Risk Country’.
The passenger has been admitted to the Telangana Institute of Medical Sciences (TIMS) and samples were collected and sent for genetic sequencing. Officials said she did not have any symptoms and that her health condition was being monitored closely.
According to officials, the woman hails from Rangareddy district and was on a visit to UK from Hyderabad. Though her close relatives tested negative, their health condition is also being monitored.
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Revealed: how Sidney Powell could be disbarred for lying in court for Trump | US elections 2020
Sidney Powell, the former lawyer for Donald Trump who filed lawsuits across America for the former president, hoping to overturn the results of the 2020 presidential election, has on several occasions represented to federal courts that people were co-counsel or plaintiffs in her cases without seeking their permission to do so, the Guardian has learned.
Some of these individuals say that they only found out that Powell had named them once the cases were already filed.
During this same period of time, Powell also named several other lawyers – with their permission in those instances – as co-counsel in her election-related cases, despite the fact that they played virtually no role whatsoever in bringing or litigating those cases.
Both Powell’s naming of other people as plaintiffs or co-counsel without their consent and representing that other attorneys were central to her cases when, in fact, their roles were nominal or nonexistent, constitute serious potential violations of the American Bar Association model rules for professional conduct, top legal ethicists told the Guardian.
Powell’s misrepresentations to the courts in those particular instances often aided fundraising for her nonprofit, Defending the Republic. Powell had told prospective donors that the attorneys were integral members of an “elite strike force” who had played outsized roles in her cases – when in fact they were barely involved if at all.
Powell did not respond to multiple requests for comment via phone, email, and over social media.
The State Bar of Texas is already investigating Powell for making other allegedly false and misleading statements to federal courts by propagating increasingly implausible conspiracy theories to federal courts that Joe Biden’s election as president of the United States was illegitimate.
The Texas bar held its first closed-door hearing regarding the allegations about Powell on 4 November. Investigations by state bar associations are ordinarily conducted behind closed doors and thus largely opaque to the public.
A federal grand jury has also been separately investigating Powell, Defending the Republic, as well as a political action committee that goes by the same name, for fundraising fraud, according to records reviewed by the Guardian.
Among those who have alleged that Powell falsely named them as co-counsel is attorney Linn Wood, who brought and litigated with Powell many of her lawsuits attempting to overturn the results of the election with her, including in the hotly contested state of Michigan.
The Michigan case was a futile attempt by Powell to erase Joe Biden’s victory in that state and name Trump as the winner. On 25 August, federal district court Judge Linda Parker, of Michigan, sanctioned Powell and nine other attorneys who worked with her for having engaged in “a historic and profound abuse of the judicial process” in bringing the case in the first place. Powell’s claims of election fraud, Parker asserted, had no basis in law and were solely based on “speculation, conjecture, and unwarranted suspicion”.
Parker further concluded that the conduct of Powell, Wood, and the eight other attorneys who they worked with, warranted a “referral for investigation and possible suspension or disbarment to the appropriate disciplinary authority for each state … in which each attorney is admitted”.
Wood told the court in the Michigan case that Powell had wrongly named him as one of her co-counsel in the Michigan case. During a hearing in the case to determine whether to sanction Wood, his defense largely rested on his claim that he had not been involved in the case at all. Powell, Wood told the court, had put his name on the lawsuit without her even telling him.
Wood said: “I do not specifically recall being asked about the Michigan complaint … In this case obviously my name was included. My experience or my skills apparently were never needed, so I didn’t have any involvement with it.”
Wood’s attorney, Paul Stablein, was also categorical in asserting that his client had nothing to do with the case, telling the Guardian in an interview: “He didn’t draft the complaint. He didn’t sign it. He did not authorize anyone to put his name on it.”
Powell has denied she would have ever named Wood as a co-counsel without Wood’s permission.
But other people have since come forward to say that Powell has said that they were named as plaintiffs or lawyers in her election-related cases without their permission.
In a Wisconsin voting case, a former Republican candidate for Congress, Derrick Van Orden, said he only learned after the fact that he had been named as a plaintiff in one of Powell’s cases.
“I learned through social media today that my name was included in a lawsuit without my permission,” Van Orden said in a statement he posted on Twitter, “To be clear, I am not involved in the lawsuit seeking to overturn the election in Wisconsin.”
Jason Shepherd, the Republican chairman of Georgia’s Cobb county, was similarly listed as a plaintiff in a Georgia election case without his approval.
In a 26 November 2020 statement, Shepherd said he had been talking to an associate of Powell’s prior to the case’s filing about the “Cobb GOP being a plaintiff” but said he first “needed more information to at least make sure the executive officers were in agreeing to us being a party in the suit”. The Cobb County Republican party later agreed to remain plaintiffs in the case instead of withdrawing.
Leslie Levin, a professor at the University of Connecticut Law School, said in an interview: “Misrepresentations to the court are very serious because lawyers are officers of the court. Bringing a lawsuit in someone’s name when they haven’t consented to being a party is a very serious misrepresentation and one for which a lawyer should expect to face serious discipline.”
Nora Freeman Engstrom, a law professor at Stanford University, says that Powell’s actions appear to violate Rule 3.3 of the ABA’s model rules of professional misconduct which hold that “a lawyer shall not knowingly … make a false statement of fact of law to a tribunal”.
Since election day last year, federal and state courts have dismissed more than 60 lawsuits alleging electoral fraud and irregularities by Powell, and other Trump allies.
Shortly after the election, Trump named Powell as a senior member of an “elite strike force” who would prove that Joe Biden only won the 2020 presidential race because the election was stolen from him. But Trump refused to pay her for her services. To remedy this, Powell set up a new nonprofit called Defending the Republic; its stated purpose is to “protect the integrity of elections in the United States”.
As a nonprofit, the group is allowed to raise unlimited amounts of “dark money” and donors are legally protected from the ordinary requirements to disclose their identities to the public. Powell warned supporters that for her to succeed, “millions of dollars must be raised”.
Echoing Trump’s rhetoric, Powell told prospective donors that Defending the Republic had a vast team of experienced litigators.
Among the attorneys who Powell said made up this “taskforce” were Emily Newman, who had served Trump as the White House liaison to the Department of Health and Human Services and as a senior official with the Department of Homeland Security. Newman had been a founding board member of Defending the Republic.
But facing sanctions in the Michigan case, some of the attorneys attempted to distance themselves from having played much of a meaningful role in her litigation.
Newman’s attorney told Parker, the judge, that Newman had “not played a role in the drafting of the complaint … My client was a contract lawyer working from home who spent maybe five hours on this matter. She really wasn’t involved … Her role was de minimis.”
To have standing to file her Michigan case, Powell was initially unable to find a local attorney to be co-counsel on her case but eventually attorney Gregory Rohl agreed to help out.
But when Rohl was sanctioned by Parker and referred to the Michigan attorney disciplinary board for further investigation, his defense was that he, too, was barely involved in the case. He claimed that he only received a copy of “the already prepared” 830-page initial complaint at the last minute, reviewed it for “well over an hour”, while then “making no additions, decisions or corrections” to the original.
As with Newman, Parker, found that Rohl violated ethics rules by making little, if any, effort to verify the facts of the claims in Powell’s filings.
In sanctioning Rohl, the judge wrote that “the court finds it exceedingly difficult to believe that Rohl read an 830-page complaint in just ‘well over an hour’ on the day he filed it. So, Rohl’s argument in and of itself reveals sanctionable conduct.”
Govt to introduce important Bill, Covid situation likely to be discussed
The government on Thursday will table ‘The National Institute of Pharmaceutical Education and Research (Amendment) Bill 2021’ in the Lok Sabha. A discussion on Coronavirus (Covid-19) pandemic and its various related aspects is also likely to take place in the lower House.
Health Minister Mansukh Mandaviya will move the ‘The National Institute of Pharmaceutical Education and Research (Amendment) Bill’ in the Lok Sabha to amend the National Institute of Pharmaceutical Education and Research Act, 1998.
Under rule 193, a discussion on Covid-19 pandemic and various aspects related to it will likely take place. According to sources, the members may also raise their concern and ask for the government’s preparedness for the new Omicron variant. Under Rule 193, members can seek details about the new Covid variant. “Short duration discussion is likely to be held in the Lok Sabha on the Covid and its various aspects, including new Omicron variant,” sources said.
Union Minister Gajendra Singh Shekhawat, Prahlad Singh Patel, General V.K. Singh, Krishan Pal, Bhanu Pratap Verma, Rameshwar Teli and Kaushal Kishore will lay papers on the table. Reports and action reports of different standing committees will also be laid in the day.
The Lok Sabha on Wednesday passed the Assisted Reproductive Technology (Amendment) Bill 2021 (ART) by voice vote as the amendments moved by the DMK MP N.K. Prem Chandran, Trinamool Congress MP Saugata Roy and Shiv Sena MP Vinayak Raut were negated. The ART Bill seeks to regulate fertility clinics. All such clinics will have to be registered under the National Registry of Banks and Clinics of India.
The opposition is likely to continue to raise its voices on price rise, unemployment and extended jurisdiction of the Border Security Force (BSF) in some states. The opposition parties are also demanding a law guaranteeing the minimum support price (MSP).
(Only the headline and picture of this report may have been reworked by the Business Standard staff; the rest of the content is auto-generated from a syndicated feed.)
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