Categories: Letters to the Editor, OpinionNew York, according to one recent study, is the absolute worst place in the country to practice medicine.Yet Albany has passed a “one-sided” bill to drastically increase health care costs by significantly increasing the numbers of lawsuits that could be brought against our profession. Physicians are very concerned with The Gazette’s Dec. 18 editorial, “Extend statute of limitations for cancer lawsuits,” endorsing the legislation.If signed into law, this bill will undoubtedly exacerbate the physician shortages we face here in the Mohawk and Schoharie valleys. A recent study by the Healthcare Association of New York State noted that 86 percent of upstate hospitals indicated that sometimes they transfer patients from their emergency departments because the specialist they need is not available.New York’s designation as the worst state to be a doctor was largely because our medical liability costs far exceed any other state. Many other states such as California, Texas and Florida have exponentially less costs. These states have enacted some reasonable controls on liability awards. But not New York.Regulating medical malpractice lawsuits requires a delicate balance. If there’s a need to expand the time to bring lawsuits, it must be balanced with legislation to address the flaws that cause our excessive costs.Gov. Andrew Cuomo must set the balance by vetoing this bill and push for comprehensive reform that addresses the deficiencies for all parties — patients, lawyers, doctors and hospitals.Joseph Sellers, MDCobleskillThe writer is a family physician.More from The Daily Gazette:EDITORIAL: Thruway tax unfair to working motoristsFoss: Should main downtown branch of the Schenectady County Public Library reopen?EDITORIAL: Urgent: Today is the last day to complete the censusEDITORIAL: Beware of voter intimidationEDITORIAL: Find a way to get family members into nursing homes
LandSecs lands One New Change for over £175m
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DTZ wins Pru contract
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A leisurely road to success
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Loan star
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Points of view
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Indonesia monitors dozens in contact with first two COVID-19 cases in Greater Jakarta
Terawan also detailed the chronology of the younger coronavirus patient’s movement before she and her mother, who was infected by her daughter, were admitted to the isolation ward at Sulianti Saroso Infectious Diseases Hospital (RSPI Sulianti Suroso) in Jakarta.According to the minister’s account, the daughter, who worked as a dance coach, had met with the Japanese woman, a friend, in a club in Jakarta, where the two danced together on Feb. 14.“On Feb. 16, [the patient] coughed a lot, so she went to a hospital and returned home immediately afterward. She then asked on Feb. 26 to be hospitalized because her coughing hadn’t stopped. On Feb. 28, she received a call from her Japanese friend that [the latter] was being hospitalized in Malaysia after having tested positive for coronavirus,” Terawan said in a press conference at the RSPI on Monday afternoon.The 41-year-old Japanese woman was Malaysia’s 24th coronavirus patient, and had tested positive for coronavirus on Feb. 27 after traveling from Japan in January and to Indonesia in early February, according to the Malaysian Health Ministry on Friday.Terawan said the two patients had been admitted to a private hospital where they were “treated as patients under supervision” for coronavirus concerns before the two were admitted to the RSPI and tested for COVID-19 on Sunday.Depok Mayor Mohammad Idris confirmed separately that the two residents had previously been admitted to Mitra Keluarga Hospital on Feb. 27, where they were suspected of suffering from bronchitis. The two left the hospital on Feb. 29 as they were referred to the RSPI.“On [Sunday], we immediately conducted a thorough check-up on the women […] The daughter is now in a good condition, she only coughs occasionally,” Terawan said after visiting the patients, adding that none of the women had complained about any shortness of breath or fever – known symptoms of COVID-19 — while being treated at the hospital.The ministry’s director general for disease control and prevention, Anung Sugihantono, said in the press conference that the ministry had obtained the names of 48 people and had tried to contact them.Anung did not specify the dates of the contacts but he said the ministry collected the data as part of the procedure after the government found positive cases of COVID-19. “The number so far is 48, and they had first-, second- and third-[degree] contact,” he said.First-degree contact means people meet the patients every day, second-degree contact means they meet regularly and third-degree means the people have been in a room or area with the patient, he said.The announcement on Monday added Indonesia to the list of coronavirus-hit countries after the archipelago had claimed zero confirmed cases for almost two months since the virus first emerged from the Chinese city of Wuhan in late December.On Sunday, the Singaporean government announced that three of its newest cases, identified only as cases 101, 103 and 104 had a travel history to Batam.The three cases bring the number of COVID-19 patients who tested positive after visiting Indonesia to seven.The three people, two Singaporeans and a Myanmar citizen, visited Batam together from Feb. 21 to Feb. 23, and were part of a cluster of COVID-19 cases linked to Wizlearn Technologies Pte Ltd, a Singaporean software company, the Singaporean government reported.In response, the Indonesian government is monitoring as many as 15 people in Batam, including a driver and a domestic worker, who were in close contact with the three patients while they were in the island.Topics : President Joko “Jokowi” Widodo has announced that two Indonesians living in Greater Jakarta have tested positive for the novel coronavirus disease (COVID-19), the first two confirmed cases of the disease in the country.The Health Ministry has tracked the movements of the patients, both residents of Depok, West Java, and found at least 48 people who were in various level of contact with them. The Depok administration has also sent a circular to about 70 medical workers in a private hospital in Depok, who were in contact with one of the patients, to limit their movements and avoid crowded areas.The news caused some people in Greater Jakarta to rush to buy surgical masks and hand sanitizer, currently in a short supply in both conventional shops or sold at inflated prices on online platforms. Jokowi said the two infected people, a 64-year-old woman and her 31-year-old daughter, had been in contact with a Japanese citizen who tested positive on Feb. 27 in Malaysia after visiting Indonesia in early February.“When we received information [about the Japanese citizen] a team in Indonesia immediately traced who the Japanese citizen had met with,” Jokowi told reporters at the State Palace on Monday. “We checked [the two people] and this morning I received a report from the health minister that they tested positive for the coronavirus.”He said the government was well-prepared to handle COVID-19 cases.Later, in another press conference, Health Minister Terawan Agus Putranto corrected the information, saying that the government had been notified about the possibility of the community transmission only after the younger patient had reported to a hospital in her home town of Depok, to inform staff that she had close contact with a COVID-19 patient who was being treated in Malaysia. Apparently, the Japanese woman had called her to inform her that she had been declared positive for the COVID-19.
As Jokowi promises millions of chloroquine doses for COVID-19, experts warn against self-medication
Chloroquine is used as a second-line drug, the experts say, meaning that it would only be used when initial medicines, common ones used to treat COVID-19 patients’ clinical symptoms, such as fever, do not produce any satisfying results. Even then, experts are still split over its use in treating the disease.There are currently no vaccines or antiviral drugs approved for the disease but the World Health Organization is launching a multinational trial to search for potential treatments for the virus, which include chloroquine. Other drugs in its trial are the experimental antiviral remdesivir initially developed to treat the Ebola virus, an HIV drug combination consisting of the lopinavir/ritonavir and the lopinavir/ritonavir plus interferon.Maksum of UI said that chloroquine was still used in Indonesia, although not as commonly as other antimalarial drugs considering its side effects.The Post has discovered the drug is being sold on e-commerce platforms in the country.In Papua, where malaria remains a problem, chloroquine used to be easy to find and purchase, a resident who refused to be named told the Post on Wednesday. Recently the drug had gotten more difficult to obtain, she added, attributing its scarcity to the drug being named a possible treatment for COVID-19.When reports said that the drug could be used to treat COVID-19 patients, the 55-year-old woman said she consumed the drug every day until she learned about its side effects and that its effectiveness was still being studied.”No one wants to be infected by the virus,” she said.The woman said that the government had not been distributing essential information for residents in her area to prevent the spread of the virus, prompting her to relay information about the new virus strain that she learned from the media to her neighbors.Papua has recorded three confirmed COVID-19 cases as of Wednesday, as nationwide cases reach 790 with 58 deaths.Jokowi said on Monday that the millions of chloroquine doses were produced in the country by state-owned pharmaceutical company PT Kimia Farma and would only be used on COVID-19 patients if doctors deemed it necessary. The company was not available for immediate comment.”Chloroquine is not a first-line treatment, but a second-line treatment […] The drug is not an over-the-counter drug, so the consumption must be on doctor’s orders,” Jokowi said, adding to his earlier statements about the drug, which many consider misleading.Read also: Indonesia produces chloroquine, anti-malaria drug tested as possible treatment for COVID-19The government’s spokesperson for COVID-19 affairs, Achmad Yurianto, has also warned the public that chloroquine was not for prevention purposes and hence must not be consumed at home.”We ask people, once again, not to purchase, store and consume the drug without a doctor’s prescription,” Yurianto said.If Indonesia was to use the drug on its COVID-19 patients, Maksum of UI said the government should participate in the WHO-led clinical trials to study potential COVID-19 treatments so that the results could be part of the WHO’s global data.He cited experts suggesting that chloroquine could disrupt the virus’ ability to infiltrate living cells and replicate itself, although emphasizing the need for further studies to prove these early assumptions.Drug discovery commonly would take years and involve at least three stages, but in cases like COVID-19 that had been declared a global pandemic, conforming to such lengthy steps was impossible, Maksum said.Experts globally have cautioned people not to resort to self-medication since a man in Arizona, the United States, died after he ingested chloroquine phosphate — an aquarium cleaning product similar to the drug that had also been named by US President Donald Trump as a potential treatment for COVID-19, Reuters reported.Trump tweeted about the combination of hydroxychloroquine and azithromycin, saying it had “a real chance to be one of the biggest game changers in the history of medicine” — a claim played down by America’s top infectious disease expert, Anthony Fauci, who said that the therapy must be tested to assure its safety and efficacy. Topics : Experts are warning the public against panic-buying chloroquine phosphate, an antimalarial drug thought to be a possible treatment for COVID-19, citing the dangerous side effects of the medicine.Reports have surfaced that people had started to purchase the drug without doctors’ prescription after President Joko “Jokowi” Widodo announced last Friday that the government was preparing medicines, including three million doses of chloroquine, which he described as “having been proven to cure COVID-19 in other countries”.Read also: Indonesia starts rapid tests, imports medicines to ‘cure’ COVID-19, Jokowi says Maksum Radji, a clinical microbiologist at the University of Indonesia’s (UI) School of Pharmacy, said the government must be careful in distributing information about the drug as clinical trials were still underway to measure its effectiveness in treating COVID-19. Even then, any consumption of the drug must be done under a doctors’ supervision, he said.”It’s wrong to purchase and consume the drug to prevent catching the virus that causes COVID-19. Chloroquine is a strong drug […] given its side effects,” Maksum told The Jakarta Post on Tuesday.He listed the common side effects of chloroquine consumption, including nausea, vomiting, diarrhea, breathing difficulties, blurred eyesight, stomach cramps, swollen ankles, tinnitus, weakened muscles and mental disorders.Nafrialdi from the Clinical Research Support Unit at the UI’s School of Medicine said that even doctors would be very cautious when prescribing chloroquine, which would only be used on severe cases, as the side effects could lead to burst blood vessels and heart attacks in extreme instances.
Global lockdown tightens as virus deaths mount
Harsh lockdowns aimed at halting the march of the coronavirus pandemic extended worldwide Monday as the death toll soared past 37,600 amid new waves of US outbreaks.Despite slivers of hope in stricken Italy and Spain, the tough measures that have confined some two-fifths of the globe’s population to their homes were broadened.Moscow and Lagos joined the roll call of cities around the globe with eerily empty streets, while Virginia and Maryland became the latest US states to announce emergency stay-at-home orders, followed quickly by the capital city Washington. ‘Nothing to eat’ Britain and Italy both warned recently that measures to prevent disease spread would be in place for months to come.In Britain, COVID-19 has hit high profile figures including Prime Minister Boris Johnson and Prince Charles, who was out of virus isolation, according to royal officials.In Israel, meanwhile, Prime Minister Benjamin Netanyahu became the latest world leader to enter isolation, while German Chancellor Angela Merkel’s third coronavirus test came back negative.The lockdowns are causing hardship across the world but particularly in impoverished cities in Africa and Asia.Africa’s biggest city, Lagos, joined the global stay-at-home from Monday, with Nigerian President Muhammadu Buhari ordering a two-week lockdown for its 20 million people. The measures also apply to the capital Abuja.”Two weeks is too long. I don’t know how we will cope,” said student Abdul Rahim, 25, as he helped his sister sell food from a market stall.Impoverished Zimbabwe also began enforcing a three-week lockdown.”They need to be fed, but there is nothing to eat,” vegetable vendor Irene Ruwisi said in the township of Mbare, pointing at her four grandchildren. “How do they expect us to survive?”The shutdown has already put millions out of work and forced governments to rush through huge stimulus plans.Experts in Germany, Europe’s economic powerhouse, said the virus would shrink output there this year by up to 5.4 percent.In the US, more than two thirds of the population were under lockdown orders.”We are nowhere near over the hump,” warned Louisiana Governor John Bel Edwards. “We still have an awful lot of work to do to flatten the curve.” “We’re sort of putting it all on the line,” Trump said, likening the efforts against coronavirus as a “war.”The number of confirmed COVID-19 cases around the world rose above 784,000, with 413,000 of those in Europe, while most of the confirmed deaths are also from the continent, according to an AFP tally.World leaders — several of whom have been stricken or forced into isolation — are still grappling for ways to deal with a crisis that will have economic and social shockwaves unseen since World War II.Trump and Russian President Vladimir Putin discussed “closer cooperation” and addressed plunging oil prices in a Monday call, the Kremlin said. ‘Good for morale’ The US Navy’s USNS Comfort, which has space for 1,000 beds and a dozen operating rooms, docked one day after Trump extended US social-distancing measures until the end of April. “It will be good for morale,” said New York Mayor Bill de Blasio of the arrival of the Comfort, which will help people requiring intensive care unrelated to coronavirus, easing the burden on hospitals.In Russia, Putin urged residents of Moscow to “very seriously” respect a lockdown that has closed all non-essential shops, including restaurants.Moscow’s famed Red Square was deserted, and surrounding streets were quiet.Anna, a 36-year-old web designer, said the lockdown would be hard for her and her five-year-old daughter. “But I don’t want Arina to get sick,” she told AFP on her way to buy bread. “So of course we will observe the quarantine.”Fears of spiking cases drove Moscow to follow Italy, Spain and France in imposing full lockdowns, and Europe remains the epicenter of the pandemic with the death toll there passing 26,500 on Monday, according to an AFP tally. Topics : ‘Work continues’ After weeks of life spent under a national lockdown in Italy, signs were emerging that drastic action could slow the outbreak’s spread.Even though the country’s death toll grew by 812 in 24 hours to 11,591, figures from the civil protection service showed the rate of new COVID-19 infections hitting a new low of just 4.1 percent and the number of people who had recovered reached a new high.”The data are better but our work continues,” said Giulio Gallera, the chief medical officer of Lombardy, Italy’s worst-hit region. Spain, which announced another 812 virus deaths in 24 hours, joined the United States and Italy in surpassing the number of cases in China, where the disease first emerged in December. France reported its highest daily number of deaths since the outbreak began, saying 418 more people had succumbed in hospital.Even as the US health system was stretched to the limit, Trump said he was ordering some excess medical equipment be sent to Italy, France and Spain. In a symbol of the scale of the challenge facing humanity, a US military medical ship sailed into New York to relieve the pressure on overwhelmed hospitals bracing for the peak of the pandemic.The US death toll passed 3,000, while the number of confirmed US infections topped 163,000, a global high.President Donald Trump sought to reassure Americans that authorities were ramping up distribution of desperately needed equipment like ventilators and personal protective gear.He also offered a stark warning, saying “challenging times are ahead for the next 30 days” as he acknowledged mulling a potential nationwide stay-at-home order. 
Bengkulu sees first COVID-19 death as number of confirmed cases rises
Bengkulu recorded its first COVID-19 death on Tuesday after a 50-year-old resident of South Lampung regency in Lampung, identified only as NS, died at Muhammad Yunus Regional General Hospital in Bengkulu.NS was admitted to the hospital on March 24 after showing COVID-19 symptoms. He was being monitored for the coronavirus prior to his death.“The hospital obtained on Monday evening the patient’s test results of his sample, which showed that the patient tested positive for COVID-19. NS died at 7:30 a.m. [on Tuesday],” Bengkulu Governor Rohidin Mersyah said during a press briefing on Tuesday. “I want to break the chain of COVID-19 transmissions. I’m asking all regencies and cities to track all congregation members in their respective regions as most parts of Sumatra Island have become COVID-19 red zones,” the governor said.The Bengkulu city administration has allocated Rp 200 billion (US$12 million) of its budget for COVID-19-related matters. It also took several measures to curb the spread of the disease, including closing schools until April 12 and ordering pregnant and breastfeeding civil servants to work from home.The administration also instructed the city-owned tap water company not to charge low-income households.The government reported 1,528 confirmed cases nationwide, with 136 deaths and 81 recovered cases as of Tuesday. The virus has spread to 32 of the country’s 34 provinces, leaving Gorontalo and East Nusa Tenggara as the only regions with no confirmed COVID-19 cases.Bengkulu’s neighbor, Jambi, had two confirmed COVID-19 patients on Tuesday. Jambi’s COVID-19 task force spokesperson, Johansyah, said two patients who were being monitored tested positive and were receiving treatment at M. Thalib Hospital in Kerinci regency, Jambi.Read also: Turf war undermines COVID-19 fight in IndonesiaJambi health authorities were monitoring 1,000 for COVID-19 as of Tuesday.In Surakarta, Central Java, three people being treated at Moewardi General Hospital tested negative for COVID-19.“These people are still required to be in self-quarantine in their homes for 14 days to make sure that they are fully healthy,” Surakarta Mayor FX Hadi Rudyatmo said on Monday, urging residents not to discriminate against them.Surakarta’s COVID-19 task force chief, Ahyani, said at least three Surakarta citizens had tested positive for COVID-19 as of Monday. Two of them died of the disease, while one recovered. (aly)Topics : NS was part of a congregation holding an Islamic mass gathering in Gowa, South Sulawesi, from March 19 to 22. He returned to Bengkulu on March 20 and stayed in At-Taqwa Grand Mosque in the city.“Starting today [Tuesday], we declare a state of emergency in Bengkulu,” the governor said.Rohidin urged the Bengkulu mayor, as well as the police and military, to isolate congregation members staying at At-Taqwa Mosque and restrict people from entering the mosque. He also ordered Bengkulu city’s COVID-19 task force to track down and test all people suspected of having had direct contact with the patient.Read also: COVID-19: Major roads closed as regions brace for large-scale social restrictions