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"As a result, we've had to cut corners," said Karim, who also directs the Centre for the AIDS Programme of Research in South Africa . "And in the medical world, cutting corners carries a high price." During the pandemic, the medical world has relied heavily on so-called pre-print articles, or scientific papers that haven't been through the rigors of peer review. The ivermectin craze in South Africa was fueled by a paper that was never peer-reviewed and that was eventually found to contain major problems with its data. "It got 150,000 views," said Karim. "It influenced so many people to use ivermectin." The paper was eventually retracted. But by then, doctors in Karim's own medical school had publicly advocated for the use of ivermectin to treat COVID-19. As Karim sees it, the medical fraternity itself had become "complicit" in pushing ivermectin. He says this pandemic has tested science in many ways. Doctors, overwhelmed by sick patients, are confusing clinical observation for scientific rigor.

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To an epidemiologist, a physician, or a virologist, this process of making public-health policy tends to look chaotic, and many outcomes seem not entirely rational. In 2013, Chris Tyler, a science adviser to the British Parliament, memorably offered 20 recommendations to scientists about policy making. Several items on his list are particularly relevant to the COVID-19 pandemic: “There is more to policy than scientific evidence,” “Starting policies from scratch is rarely an option,” and “Policy and science operate on different timescales.” On this last point, Tyler elaborated: “When policy makers say that they need information soon, they mean within days or weeks, not months. This is not a flaw of the system; it is the way it is.” On many issues, fortunately, no gap exists between “following the science” and the everyday practice of public health. Requiring measles vaccination for school entry and restricting smoking in indoor public spaces are evidence-based policies that protect human health with no significant downside. COVID-19, however, has caused many “wicked problems”—a visit these guys phrase coined in 1973 for policy issues that are difficult to solve because the relevant evidence is incomplete or contradictory, because a large number of people or opinions are involved, because any solution would impose a large economic burden, or because any response touches upon a host of other problems. For instance, during the surge in Delta-variant infections, should a community mandate indoor masks, vaccines, both, or neither? The scientific evidence clearly indicates that a person who wears a mask or completes the vaccination series, or both, is at reduced risk of acquiring and transmitting COVID-19. But if businesses are now required to implement either a mask mandate or a vaccine mandate, does the government have enough people to inspect compliance and process violations? [Education]

Health insurance companies had to cover the test with no financial obligation to consumers and pay list price for labs outside the insurers' networks.  But some insurers and are fighting what they consider high-priced tests from labs that charge 10 times or more than Medicare’s rate of $51 per test. The insurers allege in lawsuits that some labs are profiteering, but labs contend insurers are withholding payments for legitimate services desperately needed to protect patients and help public health track the virus. Read more here. Study: Low dose of Pfizer-BioNTechn vaccine is safe, effective for kids 5-11 Pfizer-BioNTech's COVID-19 vaccine  is safe and effective for children ages 5 to 11 at one-third the dose used in adolescents and adults, according to a new study from the companies. The Food and Drug Administration and Centers for Disease Control and Prevention will need to sign off on the vaccine before it becomes available to children, but government officials have promised to quickly review the data. The Pfizer-BioNTech vaccine, called Comirnaty, is fully approved for use in adults and older teens, though still authorized only for emergency use in 12- to 15-year-olds. The adult dose of the Pfizer-BioNTech vaccine is 30 micrograms, while the companies propose a 10 microgram dose in children ages 5 to 11. As in adults, the vaccine would be given to children in two shots, delivered at least three weeks apart.