Forget the two state solution

The two-state solution is dead. It’s time to look for a new plan

Despite the arguments of the die-hard advocates of the two-state solution from both sides, I cannot perceive how it is still possible…The United States of Israel-Palestine does not answer the basic needs and demands of what this conflict has been about. Jews want their own state where they are sovereign and where they determine their identity, culture, and destiny. So do the Palestinians. The problem is that we have failed to reach agreement on the partition of the Land of Israel/Palestine. 

By GERSHON BASKIN

AUGUST 5, 2020

Reprinted from Jerusalem Post

In 1975, when I wrote my first Op-Ed article in support of the creation of a Palestinian state next to Israel, I did so from a completely Zionist perspective. I believed that if Israel was in fact the democratic nation-state of the Jewish people, then it could not rule over millions of Palestinians, deny them basic human and civil rights, and continue to be both democratic and the Jewish nation-state. There has always been tension between these two pillars of the State of Israel. Israel has always been a challenged democracy, but it appeared to uphold the basic principles of democracy. There has always been discrimination against the Palestinian Arab citizens of Israel. A lot of that is due to the view of Israel that their state aspirations is at war with the other’s people, which makes them suspect.

The Law of Return for Jews only has also been one of Israel’s challenges regarding its democracy. How could Jews from the former Soviet Union, Ethiopia or me, from the United States, receive automatic citizenship while even first-degree relatives of Palestinian citizens of Israel whose families were living in the land for generations before Israel was born cannot become citizens of Israel? My answer to this was that almost all nation-states have immigration laws that give preference to descendants of their own nation living abroad. The Israeli Jewish immigration law does not discriminate between citizens of Israel, it discriminates between those who are not citizens but would like to become citizens. But without there being a Palestinian state next to Israel with its own law of return and Israel’s control over the Palestinians having no end in sight, this become extremely problematic.

Even with all of the holes in my arguments I remained a strong supporter of the two-states solution, because what we Israeli Jews and Palestinian Arabs were willing to fight, to die, and to kill for was a territorial expression of our identities. With that at the roots of the conflict, partition was the answer. We were not fighting for equal rights under a secular democratic state.

The United States of Israel-Palestine does not answer the basic needs and demands of what this conflict has been about. Jews want their own state where they are sovereign and where they determine their identity, culture, and destiny. So do the Palestinians. The problem is that we have failed to reach agreement on the partition of the Land of Israel/Palestine. We tried, but the offers on the table of negotiations never reached the point where both sides could say yes.

With the huge asymmetry of power between the two sides, Israel’s unilateralism has been far more in control of creating facts on the ground. Palestinians have failed to find the way to achieve their goals, which – at least according to the positions they laid down in negotiations over the past 25 years – have been for an independent sovereign state on 22% of the land including the West Bank and Gaza and East Jerusalem as their capital. They agreed to minor border changes and territorial swaps on a one-to-one basis taking into account some of the facts that Israel created on the ground in the form of settlements.

THEY HAVE not agreed to compromise more than that. Since the beginning of the permanent status negotiations in 2000, the Palestinians have been requested to agree to compromises beyond those lines, and they have refused. Since 2009, there have been no serious negotiations at all. Despite the arguments of the die-hard advocates of the two-state solution from both sides, I cannot perceive how it is still possible. For years I said that if solution to the conflict means the end of conflict then the only solution is two states for two peoples.

The real breakthrough towards a two-state solution was in November 1988, when the Palestine National Council – the body representing the Palestinian people in Palestine and around the world – voted in support of Arafat’s Declaration of Independence and the political platform in favor of the partition of Palestine. Admittedly 40 years late, the Palestinian people’s recognition of Israel came along with a remarkable compromise – the creation of the State of Palestine only on the lands conquered by Israel in 1967. They could have said that they recognize the UN Partition resolution plan (UNGA 181 – November 29, 1947) including the attached map granting them almost 50% of the land. The miracle of the Palestinian recognition of Israel was the willingness to accept only 22% of what they believed rightfully belonged to them. They never imagined that when signing the Oslo agreements, they would be negotiating on the 22% that remained.

The two-state solution is dead. Both Israel and Palestine killed it, although Israel bears much greater responsibility for its death than the Palestinians do. Most Palestinians are very prepared to go back to the old plan of one state. Of course, they want that one state to be Palestinian, and most are prepared for there to be a Jewish minority in that one state, even a large Jewish majority. That, of course, is not acceptable to the overwhelming majority of Jews in Israel. Jews who talk about one state see that state as Jewish and even if they are prepared to accept a Palestinian minority, they don’t know how to deal with the millions of Palestinians on the land. Some of them are part of the ongoing policies of making life nearly impossible for the Palestinians, hoping that they will leave. Others live in the dream world that Palestinians will accept living in Bantustan type communities such as those proposed in the Trump plan. Others refuse to confront the problem at all because we have learned to control the Palestinian population and offer them financial relief with jobs in Israel or in settlements.

When they are quiet, we don’t have to deal with them and when they are violent, we won’t deal with them. And so, the “situation” just continues. We know that there are no leaders on either side really willing to negotiate some kind of real deal. And as time goes by, the options for a realistic partition have diminished and as it seems to no longer exist anymore.

The last holdouts for the two-state solution seem to be the international community and the Zionist left who – as did I – see this solution as the Zionist solution: holding onto the dream or perhaps the myth of the Jewish democratic state. I no longer hold on to that dream. I no longer know what the solution to the conflict is.

I know that we have to search for one and that the search must be on both sides of the conflict lines. I think that the Jewish people need to have a land that they call their own. I know that the Palestinian people also need that. Somehow, we need to create a reality in which both sides can think of this place as their home, where they have self-determination, and a territorial expression of their identity. It needs to embody the principles of democracy and equality. It must be a reality where one side does not rule over the other. This solution does not yet exist at the present time, but neither does the two-state solution.

The writer is a political and social entrepreneur who has dedicated his life to the State of Israel and to peace between Israel and her neighbors. His latest book 
In Pursuit of Peace in Israel and Palestine was published by Vanderbilt University Press and is now available in Israel and Palestine. It will soon appear in Arabic in Amman and Beirut.

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maybe the rebels got it right

townhall.com

These ‘Inconvenient’ Data Patterns Destroy the Established Coronavirus Narrative

If lockdowns are the answer, why did Georgia cases rise two months after theirs ended? Why did Sweden never get overwhelmed? If they just work while they’re being implemented, what is to stop the virus when people do come out? If masks work, why is the virus surging in places that implement and strictly enforce their use? Why are places that never masked doing fine?

By Scott Morefield

No matter what position you take on lockdowns, masks, Hydroxychloroquine, or any other COVID-related issue, there’s a doctor or expert out there whose opinion you can easily grab and use to bolster your case. Indeed, most people have formed their opinions on what should be done about the ongoing coronavirus pandemic and consequently have decided which “experts” they want to listen to, follow on social media, and share material from. For better or worse, to a large degree, we’re firmly entrenched in our own echo chambers. So to a degree, appealing to authority is almost a moot point at this point in the game, whether your “authority” is the CDC and WHO, who have consistently been wrong more than they have been right, or that group of doctors who were censored and even dismissed from jobs last week for daring to express an unpopular yet sincerely held medical opinion.

What isn’t a moot point, however, is observable patterns, which exist independently of what any of the “experts” have to say. Now I’m no doctor, and neither are most of you, but I am a functioning, thinking adult with at least half a brain (some of you may dispute this, and you’re certainly entitled to your opinion!). I’m also capable of analyzing statistics, reading charts, and noticing patterns. And the patterns I’m noticing have me scratching my head. As someone who doesn’t sit well with cognitive dissonance, media gaslighting, and especially governmental overreach, if I’m being told I shouldn’t or can’t go out and that I’m not allowed to breathe free air when I do, the evidence on the ground should damn-well comport with the “logic” they are giving us to justify their extreme measures. But they aren’t, not in any observable, logical way.

Let’s start with Sweden, that quasi-socialist winter wonderland of woke snowflakes that somehow decided to go against the grain on COVID and consequently went seemingly overnight from the world’s darling to the world’s next Khmer Rouge. Not only did Sweden NOT implement draconian lockdowns when this whole thing started, they never even mandated mask-wearing (oh, the horror!). According to nearly all the “experts,” Sweden was supposed to be something like a scene out of the Book of Revelation by now, complete with rivers of blood and bodies piled up to horses’ bridles. Hospitals were going to be overrun. People were going to be dying in the streets. There was going to be carnage unlike nothing anyone had ever seen…

Except, none of that happened. Not even close. Absent an early Cuomo-style failure to adequately protect nursing homes that hurt their numbers early on, that country’s strategy was a tremendous success. Sweden implemented a few sustainable, common-sense measures, bent toward the storm, and rode it through. And now, they are reaping the rewards. Last week, Bloomberg reported on the country’s “‘Promising’ Covid-19 Data as New Cases Plunge.” State epidemiologist Anders Tegnell and the Health Agency of Sweden report declining cases since a late June peak and a death rate that has plunged right along with it. “That Sweden has come down to these levels is very promising,” said Tegnell. “The curves are going down and the curves for the seriously ill are beginning to approach zero.”

Everyone from the lamestream media to President Trump himself disparaged Sweden’s approach, and they were all ridiculously, cartoonishly wrong. Now that Sweden has obtained some degree of herd immunity and is back to some sense of relative normalcy, where do they go to get their apology?

Other inconvenient patterns exist closer to home. Consider South Dakota, where its courageous leader and (hopefully) future presidential candidate, Republican Gov. Kristi Noem, steadfastly refused to shut down her state nor require masks. Aside from a bad outbreak in a meat-packing plant early on, the infection and death rate in that admittedly less population-dense state has remained consistently low.

Want a more populous state? How about Georgia, where Brian Kemp was supposedly conducting an “experiment in human sacrifice” by reopening his state too soon and not mandating masks at the state level. Cases did rise (but haven’t spiked) nearly TWO MONTHS after their lockdown ended, but deaths are still below 4,000 statewide and are nowhere near any sort of drastic spike. Now, it even looks like hospitalizations have peaked and are trending down.

For those who insisted we needed New York-style lockdowns in the Sunbelt states of Arizona, Texas, and Florida to fight those surges, consider this data pattern from former New York Times reporter Alex Berenson: “AZ/FL/TX: 60 million people, no lockdowns (now), 23,000 peak hospitalizations, 500ish (hopefully) peak daily deaths. New York: 20 million people, hard lockdown, 18,000 peak hospitalizations, 1000 peak daily deaths. Let’s lockdown forever!” Indeed.

Other narrative-inconvenient data patterns exist in the places that supposedly did things “right.” Japan and even Hong Kong are seeing small case spikes – but big trend changes – despite militaresque adherence to universal masking the entire duration of the pandemic. And then there’s California, land of fruits and nuts, whose governor implemented a statewide mask mandate on June 18. Two weeks later, cases were three times what they were before the mandate and have continued to roll along at around the 10,000 mark every day since. (Have you noticed that leftists who criticize surging red states for not doing “enough” mysteriously leave California out?) Globally, Brazil, India, and Mexico have all experienced significant spikes in cases case and death rates lately despite early masking requirements on significant portions of their populations. So apparently, those who told us coronavirus would be pretty much eliminated if we would just wear masks for a few weeks were either ignorant or lying or both.

All of the above, along with plenty of other data patterns I didn’t have room to mention, raise the following questions: If lockdowns are the answer, why did Georgia cases rise two months after theirs ended? Why did Sweden never get overwhelmed? If they just work while they’re being implemented, what is to stop the virus when people do come out? If masks work, why is the virus surging in places that implement and strictly enforce their use? Why are places that never masked doing fine?

These data patterns don’t suggest that COVID-19 isn’t dangerous or deadly to some people, but they do suggest that viruses are pretty good at doing what they do and there’s not a lot that humans can do – especially through lockdowns or face coverings – to stop them. Like it or not, the likely only way out is going to be some form of herd immunity. Fortunately, especially with T cells and the fact that many more have had it than the actual case count, we could be much farther along than we think.

Follow Scott on Twitter @SKMorefield

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AI used to accurately identify prostate cancer

scitechdaily.com

Artificial Intelligence Identifies Prostate Cancer With Near-Perfect Accuracy

During testing, the AI demonstrated 98% sensitivity and 97% specificity at detecting prostate cancer — significantly higher than previously reported for algorithms working from tissue slides.

University of Pittsburgh

Prostate Biopsy AI Cancer

Prostate biopsy with cancer probability (blue is low, red is high). This case was originally diagnosed as benign but changed to cancer upon further review. The AI accurately detected cancer in this tricky case. Credit: Ibex Medical Analytics

A study published today (July 27, 2020) in The Lancet Digital Health by UPMC and University of Pittsburgh researchers demonstrates the highest accuracy to date in recognizing and characterizing prostate cancer using an artificial intelligence (AI) program.

“Humans are good at recognizing anomalies, but they have their own biases or past experience,” said senior author Rajiv Dhir, M.D., M.B.A., chief pathologist and vice chair of pathology at UPMC Shadyside and professor of biomedical informatics at Pitt. “Machines are detached from the whole story. There’s definitely an element of standardizing care.”

To train the AI to recognize prostate cancer, Dhir and his colleagues provided images from more than a million parts of stained tissue slides taken from patient biopsies. Each image was labeled by expert pathologists to teach the AI how to discriminate between healthy and abnormal tissue. The algorithm was then tested on a separate set of 1,600 slides taken from 100 consecutive patients seen at UPMC for suspected prostate cancer.

During testing, the AI demonstrated 98% sensitivity and 97% specificity at detecting prostate cancer — significantly higher than previously reported for algorithms working from tissue slides.

Also, this is the first algorithm to extend beyond cancer detection, reporting high performance for tumor grading, sizing, and invasion of the surrounding nerves. These all are clinically important features required as part of the pathology report.

AI also flagged six slides that were not noted by the expert pathologists.

But Dhir explained that this doesn’t necessarily mean that the machine is superior to humans. For example, in the course of evaluating these cases, the pathologist could have simply seen enough evidence of malignancy elsewhere in that patient’s samples to recommend treatment. For less experienced pathologists, though, the algorithm could act as a failsafe to catch cases that might otherwise be missed.

“Algorithms like this are especially useful in lesions that are atypical,” Dhir said. “A nonspecialized person may not be able to make the correct assessment. That’s a major advantage of this kind of system.”

While these results are promising, Dhir cautions that new algorithms will have to be trained to detect different types of cancer. The pathology markers aren’t universal across all tissue types. But he didn’t see why that couldn’t be done to adapt this technology to work with breast cancer, for example.

###

Reference: 27 July 2020, The Lancet Digital Health.

Additional authors on the study include Liron Pantanowitz, M.B.B.Ch., of the University of Michigan; Gabriela Quiroga-Garza, M.D., of UPMC; Lilach Bien, Ronen Heled, Daphna Laifenfeld, Ph.D., Chaim Linhart, Judith Sandbank, M.D., Manuela Vecsler, of Ibex Medical Analytics; Anat Albrecht-Shach, M.D., of Shamir Medical Center; Varda Shalev, M.D., M.P.A., of Maccabbi Healthcare Services; and Pamela Michelow, M.S., and Scott Hazelhurst, Ph.D., of the University of the Witwatersrand.

Funding for this study was provided by Ibex, which also created this commercially available algorithm. Pantanowitz, Shalev and Albrecht-Shach report fees paid by Ibex, and Pantanowitz and Shalev serve on the medical advisory board. Bien and Linhart are authors on pending patents US 62/743,559 and US 62/981,925. Ibex had no influence over the design of the study or the interpretation of the results.

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Israeli study associates low Vitamin D with COVID infection

medicalxpress.com

Low plasma 25(OH) vitamin D level associated with increased risk of COVID-19 infection

“The main finding of our study was the significant association of low plasma vitamin D level with the likelihood of COVID-19 infection among patients who were tested for COVID-19, even after adjustment for age, gender, socio-economic status and chronic, mental and physical disorders,” said Dr. Eugene Merzon, Head of the Department of Managed Care and leading researcher of the LHS group.

by Bar-Ilan University

Low plasma 25(OH) vitamin D level associated with increased risk of COVID-19 infection
Dr. Milana Frenkel-Morgenstern, Azrieli Faculty of Medicine. Credit: Bar-Ilan University

Vitamin D is recognized as an important co-factor in several physiological processes linked with bone and calcium metabolism, and also in diverse non-skeletal outcomes, including autoimmune diseases, cardiovascular diseases, type 2 diabetes, obesity and cognitive decline, and infections. In particular, the pronounced impact of vitamin D metabolites on the immune system response, and on the development of COVID-19 infection by the novel SARS CoV-2 virus, has been previously described in a few studies worldwide.

The collaborative group of scientists from the Leumit Health Services (LHS) and the Azrieli Faculty of Medicine of Bar-Ilan University aimed to determine associations of low plasma 25(OH)D with the risk of COVID-19 infection and hospitalization. Using the real-world data and Israeli cohort of 782 COVID-19 positive patients and 7,025 COVID-19 negative patients, the groups identified that low plasma vitamin D level appears to be an for COVID-19 infection and hospitalization. The research was just published in The FEBS Journal.

“The main finding of our study was the significant association of low plasma vitamin D level with the likelihood of COVID-19 infection among patients who were tested for COVID-19, even after adjustment for age, gender, socio-economic status and chronic, mental and physical disorders,” said Dr. Eugene Merzon, Head of the Department of Managed Care and leading researcher of the LHS group. “Furthermore, low vitamin D level was associated with the risk of hospitalization due to COVID-19 infection, although this association wasn’t significant after adjustment for other confounders,” he added. “Our finding is in agreement with the results of previous studies in the field. Reduced risk of acute respiratory tract infection following vitamin D supplementation has been reported,” said Dr. Ilan Green, Head of the LHS Research Institute.

“According to our analysis, persons that were COVID-19 positive were older than non-infected persons. Interestingly, the two-peak distributions for age groups were demonstrated to confer increased risk for COVID-19: around ages 25 and 50 years old,” said Dr. Milana Frenkel-Morgenstern, the leader of the Azrieli Faculty of Medicine research group. “The first peak may be explained by high social gathering habits at the young age. The peak at age 50 years may be explained by continued social habits, in conjunction with various chronic diseases,” Dr. Frenkel-Morgenstern continued.

“Surprisingly, , like dementia, cardiovascular disease, and chronic lung disease that were considered to be very risky in previous studies, were not found as increasing the rate of infection in our study,” noted Prof. Shlomo Vinker, LHS Chief Medical Officer. “However, this finding is highly biased by the severe social contacts restrictions that were imposed on all the population during the COVID-19 outbreak. Therefore, we assume that following the Israeli Ministry of Health instructions, patients with chronic medical conditions significantly reduced their social contacts. This might indeed minimize the risk of COVID-19 infection in that group of patients,” explained Prof. Vinker.

Dr. Dmitry Tworowski and Dr. Alessandro Gorohovski. from the Frenkel-Morgenstern laboratory at Bar-Ilan University’s Azrieli Faculty of Medicine, suggest that the study will have a very significant impact. “The main strength of our study is its being large, real-world, and population-based,” they explained. Now researchers are planning to evaluate factors associated with mortality due to COVID-19 in Israel. “We are willing to find associations to the COVID-19 clinical outcomes (for example, pre-infection glycemic control of COVID-19 patients) to make the assessment of mortality risk due to COVID-19 in Israel,” said Dr. Eugene Merzon.



More information: Eugene Merzon et al, Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study, The FEBS Journal (2020). DOI: 10.1111/febs.15495

Citation: Low plasma 25(OH) vitamin D level associated with increased risk of COVID-19 infection (2020, July 27) retrieved 28 July 2020 from https://medicalxpress.com/news/2020-07-plasma-25oh-vitamin-d-covid-.html

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

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Israelis copy American anarchists

Corona Dissonance and Primal Rage

Progressive and radical organizations in cahoots with radical politicians are using an orchestrated and coordinated political campaign supplemented with the blind support of the broadcasted leftist media to create the illusion of a government in chaos, mismanagement, and corruption.

By Ron Jager

www.ronjager.com, July 26, 2020

The coronavirus is invisible and undetectable as we go about our daily routine, but seemingly is everywhere. Despite the coronavirus requiring close contact to spread and infect, it has reached around the globe faster than any pandemic in history. With the race on to stop the corona pandemic, nations throughout the world are investing billions in research and hundreds of private companies and research laboratories are working on the development of a corona vaccine, yet despite this massive effort, we remain largely in an ongoing stage of uncertainty, where trial and error is still the dominant path towards an effective vaccine. With economies in a nosedive, and massive unemployment everywhere, the challenge for most political leaders has been to remain credible and believable as misinformation and disinformation outpace efforts to govern efficiently.

The broadcasted media and social networks have ignored the objective narrative above which would have allowed Israel’s democratically elected government to enlist the public’s support to contain the spreading infection of the coronavirus. Instead, progressive and radical organizations in cahoots with radical politicians are using an orchestrated and coordinated political campaign supplemented with the blind support of the broadcasted leftist media to create the illusion of a government in chaos, mismanagement, and corruption. Leading surveys show that many no longer think authorities can deal with the corona crisis leading to public resistance to lockdown measures even as record number of new infections are recorded daily. Many demonstrations with hundreds and thousands of participants have become corona mega-infection events, and the broadcasted media does everything in its power to ignore the clear and immediate danger to the participants and to the general public who will be infected by the demonstrators as they spread the disease.

In the streets of Jerusalem and other cities, thousands of radical leftists, anarchists, and paid protesters have been violently demonstrating over the past few weeks against the Prime Minister of Israel Benjamin Netanyahu obsessively reported with the help of the enlisted media to spread a false and make believe narrative of mismanagement and gross negligence of the corona virus pandemic. Many in the general public watching at home as this progressive perversion of truth is broadcasted around the clock are simply being scared into silence. A decent and honest debate about what’s best for the public is effectively ruled out.  A general sense of fear and intimidation has overtaken the public discourse. Businesses, jobs, promotions are all prisoners of social media destroying honesty and the ability to question the progressive and radical narrative portrayed by the sympathetic media to the detriment of the general public. As the public is forced to accept the closing of schools, wedding halls, places of worship, restaurants; they are inundated with media reports showing thousands of demonstrators ignoring governmental and health restrictions demonstrating without wearing masks, without keeping social distance and in general defiance of what they have been led to believe is the proper behavior code to stop the spread of the corona virus. The contradictory message between what the general public is expected to refrain from and the freedom to resist these restrictions by demonstrators is creating emotional confusion and a growing sense of dissonance.

This immense gap between the objective reality and the broadcasted and false interpretation of reality has created a sense of dissonance against the false prophets that promote the progressive political agenda. Dissonance is the discomfort we feel when we are forced to accept conflicting beliefs, or behaviors that don’t match our values. Our natural instinct is to resolve the dissonance by either justifying, downplaying or changing an inconsistent belief or behavior. We have an internal drive that motivates us to reduce psychological discomfort and create consistency among our beliefs. Ordinary people and the public at home aren’t frightened of Netanyahu. They are terrified of the mayhem and violence let loose in their streets. The use of residential streets in Jerusalem surrounding the Prime Minister’s residence as public bathrooms with demonstrators urinating and defecating where they please. Ordinary people are appalled at the mega-infection demonstrations, the random vandalism, and they want someone to do something about it. .Ordinary people understand that we can’t put the government on the front lines of the coronavirus war and then question its authority at the same time. They understand that we cannot hold the government responsible while invalidating its decisions. This is the confusion created by the radicals and anarchists, and the resulting dissonance will force ordinary people to choose.

The radical left and anarchists have convinced themselves to over-react to anything Netanyahu does. The never ending refusal to accept the will of the electoral public has resulted in demonstrations becoming more hysterical, more violent, more extreme, and a copy-paste of the “cancel culture” sweeping across America. Radical demonstrators have called for Netanyahu to resign, unrelated to his government’s management of the coronavirus crisis and everything to do with their inability to accept the public will and the democratic process. The rioters hope that the spiraling street violence will make Netanyahu look bad. In fact, it will most likely get him re-elected with even a larger electoral majority for the right wing parties. So what’s left for these radical demonstrators is nothing more than deep primal hate filling our TV screens night after night.

The deep primal hatred of Netanyahu, the democratically elected Prime Minister of the State of Israel in the last three elections and holding office as Prime Minister for close to two consecutive decades has no bounds. The broadcasted media, and social media have in unison permeated the public discourse trampling on every accepted norm of the basic concept of fairness. This deep primal hatred of Netanyahu empowers the anarchists and radicals to perpetuate the idea that everything is really much more simple if only Netanyahu would either go away on his own or if necessary by force.

While Netanyahu has clearly chosen managing the corona pandemic over politics, hospitals may reach a point where they have to choose between who lives and who dies. We can thank, the radicals, the anarchists, the empathetic media for the coming weeks in which the House of God will not be a local synagogue but a local hospital.

About the Author:

Ron grew up in the South Bronx of New York, making Aliyah in 1980. Served for 25 years in the IDF as a Mental Health Field Officer in operational units. Prior to retiring was Commander of the Central Psychiatric Clinic for Reserve Solders at Tel-Hashomer. Since retiring has been involved in strategic consultancy to NGO’s and communities in the Gaza Envelope on resiliency projects to assist first responders and communities. Ron has written numerous articles for outlets in Israel and abroad focusing on Israel and the Jewish world.

To contact: medconf@gmail.com                       Website: www.ronjager.com

 

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Beat the virus with vitamin D

unitedwithisrael.org

Israeli Study: Vitamin D May be the Key to Beating Coronavirus

Using the real-world data and Israeli cohort of 782 COVID-19 positive patients and 7,807 COVID-19 negative patients, the groups identified that low plasma vitamin D level appears to be an independent risk factor for COVID-19 infection and hospitalization.


Drs. Dmitry Tworowski and Alessandro Gorohovski from Bar-Ilan University’s Azrieli Faculty of Medicine suggest that the study could have a very significant impact in minimizing the risk of Coronavirus.

Low plasma 25(OH) vitamin D level is associated with an increased risk of Coronavirus (COVID-19) infections, an Israeli population-based study has found.

Vitamin D is recognized as an important co-factor in several physiological processes linked with bone and calcium metabolism, and also in diverse non-skeletal outcomes, including autoimmune diseases, cardiovascular diseases, type 2 diabetes, obesity and cognitive decline, and infections.

In particular, the pronounced impact of vitamin D metabolites on the immune system response and on the development of COVID-19 infection by the novel SARS CoV-2 virus has been described in a few studies worldwide.

The collaborative group of scientists from the Leumit Health Services (LHS) and the Azrieli Faculty of Medicine of Bar-Ilan University aimed to determine associations of low plasma 25(OH)D with the risk of COVID-19 infection and hospitalization.

Using the real-world data and Israeli cohort of 782 COVID-19 positive patients and 7,807 COVID-19 negative patients, the groups identified that low plasma vitamin D level appears to be an independent risk factor for COVID-19 infection and hospitalization.

“The main finding of our study was the significant association of low plasma vitamin D level with the likelihood of COVID-19 infection among patients who were tested for COVID-19, even after adjustment for age, gender, socio-economic status and chronic, mental and physical disorders,” said Dr. Eugene Merzon, Head of the Department of Managed Care and a leading researcher of the LHS group.

“Our finding is in agreement with the results of previous studies in the field. Reduced risk of acute respiratory tract infection following vitamin D supplementation has been reported,” said Dr. Ilan Green, Head of the LHS Research Institute.

Dr.s Dmitry Tworowski and Alessandro Gorohovski from Bar-Ilan University’s  Azrieli Faculty of Medicine suggest that the study could have a very significant impact.

“The main strength of our study is it’s being large, real-world, and population-based,” they explained.

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Effective therapeutic for COVID-19

newsweek.com

The key to defeating COVID-19 already exists. We need to start using it

Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations.

By Harvey A. Risch, MD, PhD

As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use.

My original article in the AJE is available free online, and I encourage readers—especially physicians, nurses, physician assistants and associates, and respiratory therapists—to search the title and read it. My follow-up letter is linked there to the original paper.

Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

Hydroxychloroquine tablets
Hydroxychloroquine tablets      GEORGE FREY/AFP via Getty Images

A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients.

Why has hydroxychloroquine been disregarded?

First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points. For the sake of high-risk patients, for the sake of our parents and grandparents, for the sake of the unemployed, for our economy and for our polity, especially those disproportionally affected, we must start treating immediately.

Harvey A. Risch, MD, PhD, is professor of epidemiology at Yale School of Public Health.

The views expressd in this article are the writer’s own.

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Common drug may reduce severity of COVID-19

timesofisrael.com

Existing drug may downgrade COVID threat to common cold level — Jerusalem study

“If our findings are borne out by clinical studies, this course of treatment could potentially downgrade COVID-19’s severity into nothing worse than a common cold,” Nahmias said.

By Nathan Jeffay

An existing medicine can “downgrade” the danger-level of coronavirus to that of a common cold, a Jerusalem researcher is claiming, after testing it on infected human tissue.

Prof. Yaakov Nahmias says that his research shows that the novel coronavirus is so vicious because it causes lipids to be deposited in the lungs, and that there is a solution to undo the damage: a widely-used anti cholesterol drug called fenofibrate.

“If our findings are borne out by clinical studies, this course of treatment could potentially downgrade COVID-19’s severity into nothing worse than a common cold,” Nahmias said.

Unlike remdesivir, which is being lauded for its effect on coronavirus patients, fenofibrate, sometimes sold under the brand name Tricor, is already accredited by America’s Food and Drug Administration and is in plentiful supply. Remdesivir is in short supply and is also still pending full approval by regulators like the FDA.

Prof. Yaakov Nahmias of the Hebrew University of Jerusalem (right) (courtesy of the Hebrew University of Jerusalem)

Nahmias, director of Hebrew University’s Grass Center for Bioengineering, reached his conclusion in joint research with Dr. Benjamin tenOever at New York’s Mount Sinai Medical Center. Their paper has gone live on an online portal run by Cell Press, publishers of biomedical journals, for research that hasn’t yet been peer reviewed.

Nahmias and tenOever performed lab tests on human lung cells infected with SARS-CoV-2.

Nahmias said they arrived at the idea that a cholesterol drug could help after studying the way in which the novel coronavirus “hijacks” the human body.

He told The Times of Israel: “The question is why this new coronavirus is so different from its close relatives that just cause a common cold. What we see is that this virus really changes lipid metabolism in the human lungs. The new coronavirus causes tiny lipid droplets to accumulate in the lungs, something you don’t normally see in the lungs in any significant quantity.”

The chemical composition of the fenofibrate cholesterol-lowering drug. Atoms are represented as spheres with conventional color coding: hydrogen (white), carbon (grey), oxygen (red), chlorine (green) (iStock)

Similar processes, hinging on the virus depositing fats, seem to take place in other parts of the body too, such as the liver, said Nahmias.

He believes that the virus does this in order to perpetuate itself in the host, and that if this process can be stopped, it will halt the onset of problems with organs — normally the lungs — that cause the virus to badly affect patients.

He said the virus interferes with the ability of the body to break down fat, and fenofibrate jump-starts this process. “The interesting thing about our study is that fenofibrate actually binds and activates the very site on the DNA that the virus shuts down — a part of our DNA that allows our cells to burn fat,” he stated.

“Virus infection causes the lung cells to start building up fat, and fenofibrate allows the cells to burn it.”

The restart of the process is swift, he said, comparing it to “when the plug is removed from the bath tub.”

Nahmias said that the high danger level from coronavirus isn’t caused by its infectiousness or the body’s general ability to rid itself of the virus, but rather by the unique symptoms it causes. “Your body can easily deal with the virus, all we need to do is deal with the symptoms,” he said.

“We need to give the body time to clear the virus without going into respiratory failure. And it’s by doing this that I think we can transform it into something far less serious, something like the common cold.”

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