Laos records 285 new Covid-19 cases

Laos has confirmed 285 new Covid-19 cases over the past 24 hours, bringing the total to 32,314 including 7,005 active cases and 40 deaths, according to the National Taskforce Committee for Covid-19 Prevention and Control.

Of the new confirmed cases, 280 were classified as local infections mostly in Luang Prabang 101, Vientiane 83, Khammuan 24, Vientiane (province) 17, Savannakhet 15, Saravan 14, and Champassak 12.

Luang Namtha reported eight domestic cases as Bokeo did three, and Oudomxay, Xaysomboun and Borikhamxay reported one each.

Five new imported cases were reported with two each in Xayabury and Vientiane, and one in Savannakhet.

Director General of the Department of Communicable Disease Control, Ministry of Health, Dr Rattanaxay Phetsouvanh told a press conference today that the infections were detected among 3,637 people tested for Covid-19 yesterday.

Yesterday also witnessed 517 patients discharged from hospital.

Source: Lao News Agency

Facebook Plans to Hire 10,000 in EU to Build ‘Metaverse’

Facebook says it plans to hire 10,000 workers in the European Union over the next five years to work on a new computing platform.

The company said in a blog post Sunday that those high-skilled workers will help build “the metaverse,” a futuristic notion for connecting people online that encompasses augmented and virtual reality.

Facebook executives have been touting the metaverse as the next big thing after the mobile internet as they also contend with other matters such as antitrust crackdowns, the testimony of a whistleblowing former employee and concerns about how the company handles vaccine-related and political misinformation on its platform.

In a separate blog post Sunday, the company defended its approach to combating hate speech, in response to a Wall Street Journal article that examined the company’s inability to detect and remove hateful and excessively violent posts.

Source: Voice of America

In Quiet Debut, Alzheimer’s Drug Finds Questions, Skepticism

The first new Alzheimer’s treatment in more than 20 years was hailed as a breakthrough when regulators approved it more than four months ago, but its rollout has been slowed by questions about its price and how well it works.

Several major medical centers remain undecided on whether to use Biogen’s Aduhelm, which is recommended for early stages of the disease. Big names like the Cleveland Clinic and Mass General Brigham in Boston say they’ll pass on it for now.

One neurology practice has even banned the company’s sales reps from its offices, citing concerns about the drug and its price, which can climb past $50,000 annually.

Many doctors say they need to learn more about how Aduhelm works and what will be covered before they decide whether to offer it. That might take several months to sort out. Even then, questions may linger.

“The drug won’t be for everybody, even with access,” said Salim Syed, an analyst who covers Biogen for Mizuho Securities USA.

Syed estimates that only around one-tenth of the people diagnosed with early-stage Alzheimer’s may wind up taking Aduhelm chronically, especially if regulators approve similar treatments from Biogen’s competitors.

Biogen, which reports third-quarter financial results Wednesday, is not saying how many people have received the drug since it was approved on June 7. A company executive said last month that Biogen was aware of about 50 sites infusing Aduhelm, far fewer than the 900 the company had said it expected to be ready shortly after regulators approved the drug.

Aduhelm is the first in a line of new drugs that promise to do what no other Alzheimer’s treatment has managed: slow the progress of the fatal brain-destroying disease instead of just managing its symptoms.

“It’s like a breath of fresh air,” said Dr. Stephen Salloway, a Rhode Island neurologist and Biogen consultant who is prescribing the drug. People with Alzheimer’s “know what’s coming, and they want to do whatever they can to stay in the milder stage.”

The U.S. Food and Drug Administration approved Aduhelm despite objections from its own independent advisers, several of whom resigned. The agency later said the drug was appropriate for patients with mild symptoms or early-stage Alzheimer’s.

Aduhelm clears brain plaque thought to play a role in Alzheimer’s disease, and regulators made the call based on study results showing the drug seemed likely to benefit patients.

Biogen, which developed Aduhelm with Japan’s Eisai Co., had halted two studies on the drug due to disappointing results. It later said further analysis showed the treatment was effective at higher doses.

The FDA is requiring Biogen to conduct a follow-up study.

The research Biogen submitted so far doesn’t give doctors as much insight as they would normally have into a drug, said Dr. Brendan Kelley, a neurologist at UT Southwestern Medical Center in Dallas. Its experts are still reviewing Aduhelm.

“Biogen went to the FDA with preliminary data, so it makes it really challenging to know how to navigate,” he said. More complete research would give doctors a better idea for how the drug will work in a broader patient population, Kelley said.

Cost is another concern.

Biogen’s pricing for Aduhelm is “irresponsible and unconscionable,” according to signs posted on office doors for The Neurology Center, a Washington, D.C.-area practice. The signs also refer to Aduhelm as a medication “of dubious effectiveness” and tell Biogen sales reps they are no longer welcomed in the center’s offices.

“As physicians we feel compelled to speak out and protest BIOGEN’s actions,” one of the signs reads.

Neurology Center CEO Wendy Van Fossen said the signs went up in July, but she declined to elaborate on why they were posted.

A Biogen spokeswoman said in an email that it was disappointing that some centers are denying access to the drug.

As for Aduhelm’s effectiveness, company data shows that plaque removal “is reasonably likely to predict a clinical benefit,” said Biogen Chief Medical Officer Dr. Maha Radhakrishnan. She said regulators reviewed data from more than 3,000 patients, counting two late-stage studies and earlier research.

Doctors also are worried about whether patients taking Aduhelm will be able to get the regular brain scans needed to monitor their progress on the drug.

Issues with care access weren’t explored in the clinical research, which also involved patients who were generally younger and healthier than those in the broader population, noted Dr. Zaldy Tan, director of the Cedars-Sinai memory and aging program.

The Los Angeles health system is still evaluating Aduhelm. Its committee of experts is considering things like which doctors will prescribe the drug and how to ensure patients are monitored for problems like dizziness or if headaches develop. Bleeding in the brain is another potential side effect.

“Safety and access are real issues that need to be prioritized,” Tan said.

Aduhelm also requires a deeper level of coordination among doctors than other Alzheimer’s treatments, noted Radhakrishnan.

Prescribing doctors have to work with neurologists, radiologists and nurse practitioners to diagnose patients, confirm the presence of plaque in the brain, get them started on the treatment and then monitor them.

“All of this is work in progress,” Radhakrishnan said.

Uncertainty about insurance coverage is another holdup.

Some insurers have decided not to cover the drug. Others, including the major Medicare Advantage insurer Humana, haven’t made a decision yet but are reviewing claims case by case in the meantime.

The federal Medicare program is expected to make a national coverage determination by next spring that will lay out how it handles the drug.

Biogen executives said recently they think most sites that will offer the drug are waiting for clarity on reimbursement, including that Medicare decision.

Medicare’s determination looms large for the Cedars-Sinai experts. Tan said they know they should reach a decision before the Medicare decision prompts more patient inquiries.

He said doctors also realize they aren’t just evaluating Aduhelm: They’re also thinking about how to handle similar treatments that could get FDA approval.

“We want to make sure we get it right,” Tan said.

Source: Voice of America

Funerals Held for Victims of Afghanistan Mosque Bombing

Funeral services were held Saturday for victims of Friday’s suicide bomb attack on a Shiite mosque in Afghanistan’s southern city of Kandahar that killed at least 47 people and wounded more than 70.

Islamic State’s Amaq news agency said late Friday that two of its members fatally shot security guards at the entrance to the mosque before blowing themselves up inside between two groups of hundreds of worshippers.

IS identified the attackers as Afghan nationals Anas al-Khurasani and Abu Ali al-Baluchi.

Taliban officials vowed to bolster security at Shiite mosques Saturday as hundreds gathered while the victims were buried by their families. Sixty-three graves were prepared, but a provincial Taliban official said the official death toll was 47.

United Nations Secretary-General spokesman Stéphane Dujarric described the attack in a statement Friday as “despicable” and said the attackers “must be brought to justice.”

In a statement Friday, the U.N. Security Council stressed the need to hold everyone involved in “these reprehensible acts of terrorism accountable and bring them to justice.”

It is the second consecutive week an attack occurred at a Shiite mosque and was claimed by IS. Forty-six people were killed in an October 9 attack on a mosque in northern Afghanistan.

The attacks are fueling concerns that IS, an adversary of the Taliban and the West, is enlarging its base in Afghanistan since the withdrawal of U.S. and allied troops from the country in August.

Source: Voice of America

Unhappy With Prices, US Ranchers Look to Build Own Meat Plants

Like other ranchers across the country, Rusty Kemp for years grumbled about rock-bottom prices paid for the cattle he raised in central Nebraska, even as the cost of beef at grocery stores kept climbing.

He and his neighbors blamed it on consolidation in the beef industry stretching back to the 1970s that resulted in four companies slaughtering more than 80% of the nation’s cattle, giving the processors more power to set prices while ranchers struggled to make a living. Federal data show that for every dollar spent on food, the share that went to ranchers and farmers dropped from 35 cents in the 1970s to 14 cents recently.

It led Kemp to launch an audacious plan: Raise more than $300 million from ranchers to build a plant themselves, putting their future in their own hands.

“We’ve been complaining about it for 30 years,” Kemp said. “It’s probably time somebody does something about it.”

Crews will start work this fall building the Sustainable Beef plant on nearly 400 acres near North Platte, Nebraska, and other groups are making similar surprising moves in Iowa, Idaho and Wisconsin. The enterprises will test whether it’s really possible to compete financially against an industry trend that has swept through American agriculture and that played a role in meat shortages during the coronavirus pandemic.

The move is well timed, as the U.S. Department of Agriculture is now taking a number of steps to encourage a more diverse supply in the beef industry.

Still, it’s hard to overstate the challenge, going up against huge, well-financed competitors that run highly efficient plants and can sell beef at prices that smaller operators will struggle to match.

‘They’re ready to take a risk’

The question is whether smaller plants can pay ranchers more and still make a profit themselves. An average 620-kilogram steer is worth about $1,630, but that value must be divided between the slaughterhouse, feed lot and the rancher, who typically bears the largest expense of raising the animal for more than a year.

David Briggs, the CEO of Sustainable Beef, acknowledged the difficulty but said his company’s investors remain confident.

“Cattle people are risk takers and they’re ready to take a risk,” Briggs said.

Consolidation of meatpacking started in the mid-1970s, with buyouts of smaller companies, mergers and a shift to much larger plants. Census data cited by the USDA shows that the number of livestock slaughter plants declined from 2,590 in 1977 to 1,387 in 1992. And big processors gradually dominated, going from handling only 12% of cattle in 1977 to 65% by 1997.

Currently four companies — Cargill, JBS, Tyson Foods and National Beef Packing — control more than 80% of the U.S. beef market thanks to cattle slaughtered at 24 plants. That concentration became problematic when the coronavirus infected workers, slowing and even closing some of the massive plants, and a cyberattack last summer briefly forced a shutdown of JBS plants until the company paid an $11 million ransom.

The Biden administration has largely blamed declining competition for a 14% increase in beef prices from December 2020 to August. Since 2016, the wholesale value of beef and profits to the largest processors has steadily increased while prices paid to ranchers have barely budged.

Trying to retain workers with higher pay

The backers of the planned new plants have no intention of replacing the giant slaughterhouses, such as a JBS plant in Grand Island, Nebraska, that processes about 6,000 cattle daily — four times what the proposed North Platte plant would handle.

However, they say they will have important advantages, including more modern equipment and, they hope, less employee turnover thanks to slightly higher pay of more than $50,000 annually plus benefits along with more favorable work schedules. The new Midwest plants are also counting on closer relationships with ranchers, encouraging them to invest in the plants, to share in the profits.

The companies would market their beef both domestically and internationally as being of higher quality than meat processed at larger plants.

Chad Tentinger, who is leading efforts to build a Cattlemen’s Heritage plant near Council Bluffs, Iowa, said he thinks smaller plants were profitable even back to the 1970s but that owners shifted to bigger plants in hopes of increasing profits.

Now, he said, “We want to revolutionize the plant and make it an attractive place to work.”

‘They’re extremely efficient’

Besides paying ranchers more and providing dividends to those who own shares, the hope is that their success will spur more plants to open, and the new competitors will add openness to cattle markets.

Derrell Peel, an agricultural economist at Oklahoma State University, said he hopes they’re right, but noted that research shows even a 30% reduction in a plant’s size will make it far less efficient, meaning higher costs to slaughter each animal.

Unless smaller plants can keep expenses down, they will need to find customers who will pay more for their beef, or manage with a lower profit margin than the big companies.

“We have these very large plants because they’re extremely efficient,” Peel said.

According to the North American Meat Institute, a trade group that includes large and mid-size plants, the biggest challenge will be the shortage of workers in the industry.

It’s unfair to blame the big companies and consolidation for the industry’s problems, said Tyson Fresh Meats group President Shane Miller.

“Many processors, including Tyson, are not able to run their facilities at capacity in spite of ample cattle supply,” Miller told a U.S. Senate committee in July. “This is not by choice: Despite our average wage and benefits of $22 per hour, there are simply not enough workers to fill our plants.”

The proposed new plants come as the USDA is trying to increase the supply chain. The agency has dedicated $650 million toward funding mid-size and small meat and poultry plants and $100 million in loan guarantees for such plants. Also planned are new rules to label meat as a U.S. product to differentiate it from meat raised in other countries.

“We’re trying to support new investment and policies that are going to diversify and address that underlying problem of concentration,” said Andy Green, a USDA senior adviser for fair and competitive markets.

Source: Voice of America

Canada Sees Benefits from Delaying Second COVID Vaccine Dose

Recent studies indicate Canada’s decision to extend the interval between the first and second doses of COVID-19 vaccines can actually lead to increased resistance to the virus. It also finds mixing the brand and type of doses gives better protection.

The decision by Canadian authorities to immunize as many people as possible with any available dose of COVID-19 vaccine, then extending the time until administering the second dose, appears to be paying off.

Recent data compiled by the British Columbia Centre for Disease Control and the Quebec National Institute of Public Health also show the strategy of using the first available vaccine for a second dose, even if not the same brand as the first, actually increased effectiveness and saved lives.

Pfizer, Moderna and AstraZeneca all recommend 21-28 days between the two shots. Canada’s experience suggests protection is even stronger after a six-week interval.

For the Pfizer vaccine, this effectiveness went from 82% after a three- to four-week interval, to 93% when the booster, or secondary dose was given after four months.

The study also finds two doses of the AstraZeneca vaccine gave less protection than the mRNA vaccines of Pfizer and Moderna. However, those who received an mRNA as a booster dose have the same protection as if they had two of the same, even if their first dose was AstraZeneca.

All three vaccines were found to be more than 90% effective in keeping recipients out of the hospital for COVID-19.

Throughout the pandemic, Dr. Bonnie Henry, the provincial health officer for the Canadian province of British Columbia, has encouraged first doses to be administered as quickly as possible — and not to worry whether the second dose is from a different vaccine.

Overall, she said, Canada’s experience could provide insights for the rest of the world.

“We don’t want countries to have to hold doses back or wait for manufacturers to be able to give people the full protection they need when they’re seeing outbreaks in other countries — and we saw this in India, for example,” she said. So it is really important globally that we’re able to use whatever vaccines are available to support people to have good protection.”

Joan Robinson, a pediatric infectious disease doctor and professor at the University of Alberta and Stollery Children’s Hospital in Edmonton, said increasing the time between the doses can be good for the long term in areas with stable or low coronavirus levels.

However, Robinson said, there is one downside for the short term, especially in areas where there are high concentrations of COVID-19 cases.

“So the delay between the doses during the time between your first and second dose, you’re much more likely to get COVID than if you had got this second dose earlier,” she said. “Certainly with the delta variant, one gets the impression that one dose may be less effective.”

The findings of researchers in British Columbia and Quebec, which are thousands of kilometers apart, are almost identical.

This most recent Canadian data have not been widely published or peer reviewed, but researchers released the information early to make it available globally as soon as possible.

Source: Voice of America