Covid-19 News

  • Today we can see that the US governments 20 year venture to establish a democracy in Afghanistan cannot even survive a few days against a group of regressive insurgents.


    In fact I find it odd how the right side of the political spectrum state that they have no confidence in governments because they are inept and inefficient (which has a lot of truth to it). Yet many conspiracies about super complicated government plots seem to come from the right.

    Afghanistan policy is disgraceful but to be fair it is a problem that just can't be solved. Not going in would have left OBL and Al Quaeda there. Going in was never going to work long-term - it never has - the russians could not do it nor anyone else. Pakistan can't control the tribal territories inside their own border. That part of the world is ungovernable in any sane way and rich because of the drugs trade.


    One positive - for all that money and blood we now have a population there of women who expect democratic standards of liberty and education. What will happen to them now is appalling - equivalent for many to sexual slavery trafficking - but done to a whole country at once. However they may be able to change Taliban society from within for the better. There is some hope.


    When criticising govt policy you need a policy that would be better. I would not have gone in - would have put pressure on the Taliban in other ways and been patient. But it is a difficult call. And the appalling treatment of women by Taliban was a big thing.


    Maybe when leaving I would have got China involved but (a) China would not want this much and (b) US China relations were rubbish and (c) that would be politically impossible.


    So democratic governments are inept and inefficient, but autocrats are all of that and bad and you can't change them. Look at most recent US example, that was very nearly autocracy.


    This particular US decision was a case of Biden and Trump having identical policies - though you can argue Biden would have handled the initial timing and diplomacy a bit better, I don't think that would have helped. Biden pulling out now as he has done is pretty close to what Trump would do and can be criticised in the same way. Though you can see why the US needs to do it.

  • some counties in Florida did issue mask mandates, they had higher deaths and hospilitations than the ones that had no mask mandate. Not complex at all!


    Well it means nothing without a lot more data. Generally those with worst infection rates tend to be the ones who get mask mandates. partly political; high pop density => worse and also => democratic =>. pro-mandate. partly, when things are really bad more people think mandates are right thing.


    As always it is difficult because correlation is not causation and we are trying to show what mask mandates cause, not what cases mask mandates which we cannot control.

  • some counties in Florida did issue mask mandates, they had higher deaths and hospilitations than the ones that had no mask mandate. Not complex at all!


    Well it means nothing without a lot more data. Generally those with worst infection rates tend to be the ones who get mask mandates. partly political; high pop density => worse and also => democratic =>. pro-mandate. partly, when things are really bad more people think mandates are right thing.


    As always it is difficult because correlation is not causation and we are trying to show what mask mandates cause, not what cases mask mandates which we cannot control.

    More data is needed and I will point out that in a couple of counties Dade and orange, their is a very large black and Hispanic communities. Both had mandates. Orange county includes Disney so infections could be from outside the county. Both have large populations

  • N2O gets you high (or ‘deaths you out’, as my friend says). NO gets you hard is a signalling molecule and vasodilator.

    :)


    Thanks for that. My chemistry is very rusty. We have N20 (Nitrous oxide - laughing gas) , NO (Nitric oxide), NO2 (Nitrigen dioxide). All those covalent bonds...


    I still want to know - is NO Ok to be snorting regularly - I would not assume it is.

  • When criticising govt policy you need a policy that would be better.

    1. No I don't. As a UK voter I can be critical of the crappy track and trace fiasco. It is not up to me to find a better policy. Politicians create policies.


    2. In any case I was not criticising US government policy as such, just using a current example to illustrate how ineffectual the strategies of even the most powerful governments can turn out to be. This thought cheers me when I think on the way the CCP is bringing "1984 on steriods" to its own people. The CCP is likely not as almighty as they hope they are.

  • Let me add, some counties in Florida did issue mask mandates, they had higher deaths and hospilitations than the ones that had no mask mandate. Not complex at all!

    Does it occur to you that they issued mandates because they had higher deaths? The causality is reversed. Rural districts with low population density in places like upstate New York and Yamaguchi prefecture did not need mandates because they had so few cases. Atlanta must have masking or we will have mass death. I probably encounter more people close up going to the grocery store or the park than my friends in Yamaguchi encounter in a year. Furthermore, just about everyone you meet in rural Yamaguchi lives there. There are no outsiders. They closed down the towns and stopped the tourist trade.


    However, the situation has changed. With the Delta variant, rural districts in south Georgia now suddenly have so many cases, they have to close the schools. It is a defacto lockdown. It is caused by people not getting vaccinated.

  • What I have been saying all along is that governments and their institutions are too inept to ever be able to carry out the kind of Byzantine plots beloved of conspiracy theorists.

    They struggle to get the basics right, especially with their senior bosses and political masters changing so frequently, not to mention policy changes or U turns.

    That is true of governments. They are often incompetent. Also corporations. I have seen many marketing fiascos and bone-headed policies the destroyed corporations such as Sears. That is why I doubt that big pharma and other corporations can conspire for long, or control events for long. Obviously, they have often conspired for a while. Railroads conspired in the late 19th century to keep prices high . . . until the railroad industry overbuilt in response to the artificially high prices, and the industry collapsed. It never really recovered from a business profitability point of view. Hospitals and doctors are conspiring to keep healthcare in the U.S. 2 to 3 times more expensive than anywhere else. Anyone can see that will end badly for them, sooner or later. It is a stupid thing to do. It is short term gain in return for long term oblivion. The U.S. will either have national health care, or people will invent robots and new kinds of hospitals that will put the ones we now have out of business.


    Armies also make terrible mistakes. There are disasters in military history that seem incomprehensible, such as the Battle of the Somme, and the fall of Kabul yesterday. It is also true of churches and religions. See the Catholic church response to the Protestant Reformation. It is also true of physicists. See their response to the discovery of the laser and cold fusion. Aviation is one of the most careful industries in history, but it still has things like the Boeing 737 problems. It is also true of farmers, the fishing industry (which is destroying the stocks of fish and putting itself out of business), bankers, ship captains, programmers, restaurant chains, the mining industry, fine arts, Hollywood, big oil, and . . . you get the picture I think . . . every other human institution. They are all prone to disastrous misjudgements and mistakes. Why? Because that is human nature.

  • Israeli Health Payor Study Reveals Pfizer mRNA Vaccine Effectiveness Wanes Greatly for 60+ at 4.8 Months


    Israeli Health Payor Study Reveals Pfizer mRNA Vaccine Effectiveness Wanes Greatly for 60+ at 4.8 Months
    A recent study led by Leumit Health Services and the Shamir Medical Center Institutional Review Board in Israel led to some concerning results. The study
    trialsitenews.com


    A recent study led by Leumit Health Services and the Shamir Medical Center Institutional Review Board in Israel led to some concerning results. The study authors recently uploaded the manuscript to the preprint server medRxiv. Involving 33,943 fully vaccinated adults administered the Pfizer-BioNTech vaccine, three cohorts based on age were studied, including 1) 60 and up, 2) 40 to 59, and 3) 18 to 29. The study authors found concerning risk of breakthrough infection in those vaccinated at least 146 days (4.8 months) before reinfection—the risk further escalates for people older than 60.


    The Challenge

    A growing number of breakthrough cases now occur with the delta variant of interest. As the variant has a far greater viral surge, this could be why vaccinated individuals succumb to COVID-19 infection. Yahoo News reported that, according to a leaked CDC document, there were approximately 35,000 symptomatic COVID-19 infections per week among the fully vaccinated, but this needs to be confirmed.


    Although most vaccinated cases don’t lead to severe cases, a growing trend in Israel reveals vaccinated people are at ever greater risks. To date, about 50% of America’s population is fully vaccinated based on CDC data. These vaccinations, however, were developed to deal with different strains of the pathogen. What about the highly transmissible and virulent delta variant or lambda?


    The Israeli Study

    Leumit Health Services and the Shamir Medical Center Institutional Review Board in Israel led a study involving 33,943 vaccinated adults who received the Pfizer-BioNTech vaccine known as BNT162b2. Segmenting the patients into the three age cohorts mentioned above, the team found the overall breakthrough infection rate rare at 1.8%; however, they found risk markedly rises with age and duration from the last vaccine dose. In fact, those participants over 60 who had received their last vaccine over five months ago faced treble risks of breakthrough infections.


    Company Confirmation

    Yahoo News reports that even Pfizer’s CEO Albert Bourla agrees that vaccine effectiveness wanes with time. For example, he concurred in July that the vaccine efficacy lowers to 84% after four to six months. Yahoo also reported a Pfizer-sponsored study indicating the vaccine was most potent from one week to two months from the second jab. The BNT162b2 product then declines in efficacy on average about 6% every two months.


    That’s why the chatter is now all about booster doses as the Pfizer CEO recently declared on CNBC’s Exchange, “The good news is that we are very, very confident that a third dose, a booster, will take up the immune response to levels that will be enough to protect against the delta variant.”


    That’s why the CDC recently recommended vaccinated people wear masks, even at home if there is an unvaccinated person or someone immunocompromised living there.


    About Leumit Health Services

    An Israeli health insurance and medical services organization founded in 1933, Leumit Health Services was the smallest of the four Kupot Holim (Israel’s state-mandated health funds) with 700,000 members.


    Lead Research/Investigator

    Ariel Israel, MD, Ph.D., Leumit Research Institute & Department of Family Medicines, Leumit Health Services, Israel.


    Call to Action: How much more will the Pfizer-BioNTech vaccine wane in effectiveness? Keep an eye on the studies

  • Vaccination reduces R0 by a factor of 2 (vax -> unvax) and 4 (vax -> vax)

    Pretty bullshit. Children math from basic data that does not match the real situation.

    Vaccinated people are the ideal super spreader as many have no symptoms. Israel says actually vaccines protect 35% from an infections but these folks spread way more ...

    Israel data II :: Vaccines protect 80% from serious illness. But if a vaccinated is infected= PCR+ his serious rate is much higher than that of an unvaccinated person. This needs follow up with involved comorbities and age groups.


    Why is vaccination still good for epidemic progress?

    It's in fact bad as it stops the passive immunization that is 10..80x longer lasting than a vaccination. Live data from Kerala shows vaccine states have problems to reach a high population anti body level.


    Higher severity among vaccinated:

    Of the 5,599 breakthrough cases, 514 people were sick enough to be hospitalized and 57 people died!


    MN's breakthrough infection statistics, including hospitalizations, deaths
    This is how many breakthrough infection cases have been found in Minnesota.
    bringmethenews.com

  • Merck Moves Molnupiravir as Health Canada Agrees to Rolling Submission


    Merck Moves Molnupiravir as Health Canada Agrees to Rolling Submission
    TrialSite just reported that Merck’s Australian unit secured a provisional determination from the drug regulatory body there called Therapeutic Goods
    trialsitenews.com


    TrialSite just reported that Merck’s Australian unit secured a provisional determination from the drug regulatory body there called Therapeutic Goods Administration (TGA), opening the door for imminent provisional approval Down Under. Merck’s making moves to own the early antiviral treatment of COVID-19, a market TrialSite suggests could be worth several billion per annum. Over 90% of COVID-19 cases are either asymptomatic or mild-to-moderate. Front line care doctors have identified early treatment as absolutely essential to managing the pandemic, along with vaccination. They go hand-in-hand. Now Merck Canada announced the initiation of a rolling submission to Health Canada for the antiviral targeting COVID-19 called Molnupiravir. This investigational twice-daily oral antiviral agent is currently in a handful of clinical trials.


    TrialSite follows up with a brief breakdown of this milestone.


    Is there a great need for antiviral-like treatments targeting COVID-19, especially early on?

    Yes. The U.S. government is now subsidizing a few pharmaceutical initiatives and a new repurposing study (ACTIV-6) that includes ivermectin. Ridgeback Biotherapeutics chief executive officer Wendy Holman went on the record recently “There remains a great need for a range of solutions for the pandemic, and we are hopeful that Molnupiravir will play a role in helping patients.”


    What is the rolling submission process?

    Now, thanks to the Minister of Health’s Interim Order, Health Canada can review early safety, quality, and efficacy data while later-stage clinical trials take place. And with existing trials, as material data becomes available, Merck can share such data points with the health regulator.


    When will Health Canada make a decision about the investigational product?

    When all necessary evidence has been submitted and reviewed.


    What were the Phase 2 interim results from the MOVe-OUT clinical trials?

    Recently presented by Merck and partner Ridgeback Biotherapeutics at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID), the data, according to Wendy Holman, “…are promising, and we are pleased to be able to present the Phase 2 interim results for Molnupiravir while we proceed with the Phase 3 portion of MOVe—OUT in non-hospitalized patients.”


    Has Merck received public subsidy indirectly from U.S. taxpayers?

    Yes, at least a $356 million payment by the government in December 2020 and recently under the Biden administration in $1.2 billion committed contracts should the drug be authorized under emergency use or approved.


    Moving Forward

    Merck must still complete a global clinical trial with 1800+ patients for this pill taken twice daily upon early diagnosis of COVID-19. In Australia, TrialSite has heard reports from various news sources that thus far, their product looks promising with what is reported as only mild side effects.


    The company sponsors a few studies involving the antiviral drug. In one Phase 2/3 study (NCT04575584), the sponsor evaluates the safety, tolerability, and efficacy of Molnupiravir (MK-4482) compared to placebo. The primary study hypothesis here is that the study drug is superior to placebo as assessed by the rate of sustained recovery through Day 29. This study should be wrapping up soon. In another global Phase 3 study (NCT04575597), the sponsor investigates the drug in a larger study involving 1,850 participants.


    And another major Phase 3 study (NCT04939428) runs through April 2022 and involves prophylaxis attributes for household contacts; this is a larger, multicenter, randomized, double-blind, placebo-controlled study seeking to determine the efficacy, safety, and tolerability of Molnupiravir in adults who reside with a person infected with COVID-19. Thus the drug is being used as a prophylaxis for household contacts—another huge potential market.


    The endpoint: Molnupiravir will be superior to placebo in preventing laboratory-confirmed COVID-19 infection through Day 14 in participants who do not have confirmed or suspected COVID-19 at the time of screening and randomization.


    Molnupiravir is also one of the study drugs in a multi-drug study called AGILE based out of the University of Liverpool.


    Call to Action: TrialSite continues to monitor this clinical program and invites readers to look for updates as they become

  • It is also true of farmers, the fishing industry (which is destroying the stocks of fish and putting itself out of business), bankers, ship captains, programmers, restaurant chains, the mining industry, fine arts, Hollywood, big oil, and . . . you get the picture I think . . . every other human institution. They are all prone to disastrous misjudgements and mistakes. Why? Because that is human nature.

    Some institutions tend to be more incompetent than others. I do not know whether governments on average are more incompetent than corporations. It is hard to judge. However, government incompetence often causes more harm and has larger consequences. Because governments have more power than corporations, and there is only one Federal government. It has a monopoly on power. When Sears goes out of business that leaves plenty of other retailers. It leaves Amazon, which is what pushed Sears to its doom. If something goes wrong with Amazon, there are plenty of others.


    Because governments are monopolies and their incompetence causes more harm, we pay more attention to problems in government. This may give us a false impression they are more incompetent than corporations. (Or, perhaps, the impression is correct . . . I don't know.) You may not have noticed that Sears has been spiraling down, gradually going out of business. But you probably did know that the U.S. policy in Afghanistan has been headed for disaster for nearly 20 years. Anyone not blinded by ideology can see that the Trump administration's COVID policies killed 500,000 people unnecessarily. That's way more consequential than Sears going bankrupt.


    People often claim that because governments are monopolies, their service agencies are unresponsive. Or slow. It is a cliche to say that a local government Department of Motor Vehicles (DMV) (where you get a driver's license) will be understaffed with surly people and long lines. In fact, here in Atlanta, the DMV is a model of efficiency. The sign-in, waiting line, photos and so on are as modern as they can be. The people are polite and efficient. It seldom takes more than 10 minutes. Whereas the telephone company and cable TV service is a nightmare. They are infuriating, even though there are multiple TV vendors, so there is competition. The simple model of competition = competence and good service does not apply. I do not know why. But, I do know why the DMV is good. It used to be slower and low tech. Atlanta became something of a high tech mecca, similar to Boston or San Francisco. The voters here wised up and demanded modernization and 21st century standards of service. The politicians responded by improving the DMV, because they are afraid of angry voters, and every voter has to deal with the DMV sooner or later. That is the mechanism. As I said, I have no idea why some similar mechanism does not work with the cable TV companies.


    Privately owned hospitals in Atlanta and everywhere else in the U.S. are a nightmare. They are incredibly inefficient. Compared to other countries, they are filthy, causing a large number of nosocomial infections. Service is abominable. They once made me wait for an hour when I was in pain with a swollen arm from an accident. In Japan or Europe a nurse would have given me an ice pack right away. They charge 2 to 3 times more than hospitals elsewhere, yet they seem to lose money. There are several large hospitals in competition in Atlanta, yet they are no more competitive than the cable TV companies. It seems obvious to me why this is. They are colluding. They are violating antitrust laws. Patients do not shop around or demand low prices because their lives are at stake! Or they do not shop around because the insurance pays. In other words, hospitals are not subject to free market competitive mechanisms. They have the worst elements of capitalism and communism, the way railroads did in 1880.


    See:


    How American Healthcare Killed my Father


    How American Health Care Killed My Father
    After the needless death of his father, the author, a business executive, began a personal exploration of a health-care industry that for years has delivered…
    www.theatlantic.com


    BItter Pill. Why Medical Bills are Killing Us


    Bitter Pill: Why Medical Bills Are Killing Us
    Corrections Appended: February 26 and March 12, 2013 1. Routine Care, Unforgettable Bills When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last…
    time.com

  • The vaccine terror state Kerala of India still is in deep shit:


    Already 40'000 breakthrough cases.


    Ha, you’re such a fool Wyttenbach. Endlessly jerked around by media scare stories, designed for the sole purpose of increasing advertising revenue*.


    3.1 million Keralites double-vaccinated, and 5,000 ‘breakthrough’ infections…. 0.16%


    Big WOW.


    (Or 0.9% if we adjust for uncounted cases using the ICMR serosurvey results method, that you have previously proven unable to comprehend. Hint: you multiply by the ‘Undercounting Factor’ ;) ).



    * it also appears that you didn’t even bother to read the whole article, before rushing to propagate the clickbait. Headline says 40,000, yet the numbers in the article only add up to 20,000. Doh!

  • The vaccine terror state Kerala of India still is in deep shit:

    Kerala removed Ivermectin on august 6 after discouraging it for months

    some say it was due to rampant mucomycosis. but retained Remdesivir...

    ..delta has much less fun in Uttar Pradesh

    double vac%... Kerala 19%... U.P. 4%

    Kerala revises COVID-19 treatment guidelines
    New protocol stresses also on critical care guidelines for treating pregnant women
    www.thehindu.com

  • Groundhog day - but to be fair I don't think RB and W actually read anything I post.


    Q. What is the difference between Kerala and Uttar Pradesh?

    A. Kerala is the oldest of the Indian provinces, median age 31.9, Uttar Pradesh is the 2nd youngest, average age 21.5



    Q So what?

    A. In India age correlates to development. Farmers working in fields have large families, and low median age. People living in cities have small families, high median age. You can also see this from the recorded figures for Human Development index Kerala is highest in India at 0.782. UP is second lowest at 0.596.


    Q. I'm not getting it. Why do HDI and median age affect COVID statistics?

    A. Age is simple, fewer old people => less serious COVID, less death. Going by median age we expect Kerala case, hospitalisation and death rates to be 3X or more higher per capita. HDI has several additional effects, which are even larger than this:

    Subsistence farmers in villages don't get tested

    Subsistence farmers in villages dying of COVID are not counted as COVID deaths


    These two effects means that comparing UP vs Kerala is impossible, and on all metrics UP will look better just because it is younger and less developed


    Q. Anything else?

    A. Yes there is, actually. Kerala has been doing great, and looks bad because it is doing great...


    Covid-19: The mystery of rising infections in India's Kerala
    Covid-19 cases continue to rise in Kerala despite the waning of the second wave elsewhere in India.
    www.bbc.co.uk

    Kerala, they say, is testing a lot more people - more than double the people per million compared to the rest of the country. It has kept infection levels in control.

    The state is capturing one out of every two infections compared to other states which are catching one out of 30-odd infections. "Kerala is testing more, and testing smarter. By tracing contacts to find out real cases, testing is also better targeted," says Dr Gagandeep Kang, one of India's top virologists.

    The latest antibody tests survey reveals that only 43% people above the age of six in Kerala have been exposed to the infection, compared to 68% nationwide.

    This, many believe, proves that Kerala has done an admirable job in controlling the spread of coronavirus unlike the rest of India.

    Also, despite the rising number of cases, hospitals have not been overwhelmed. Kerala's case fatality rate is a third of India's national estimate; half of the Covid-19 beds in hospitals are free; and under-reporting of Covid-19 deaths is possibly the lowest in the state, according to a report.

  • Kerala removed Ivermectin on august 6 after discouraging it for months

    some say it was due to rampant mucomycosis. but retained Remdesivir...

    ..delta has much less fun in Uttar Pradesh

    double vac%... Kerala 19%... U.P. 4%

    RB - you know that difference in double vax rate has an insignificant affect on the figures: 96% vs 81% unvax? Right?


    And you remember from my post on topic a few days ago what are the key differences between Kerala and UP. Or maybe you don't - have a look at my post just above. where I repeat the points with detailed figures.


    In addition to everything above - high density urban pop => high R, low density farming pop => low R. And also, Kerala had fewer infections per population earlier on pandemic (from serology) 44%, UP more (71%). That gives Kerala a 56/29 = 1.93 X higher R based on immunity.


    So many factors combine to make kerala look bad, UP look good. But it ain't what it seems.


    One way to look at it. If you just do nothing with COVID, and do not report cases or deaths, you look great. Also, you have a very large short and sharp epidemic surge, after which natural immunity is on your side - till the next variant comes along.


    UP can do this because it is blessed having a very young subsistence farming population.


    But it looks like UP might be gifting the world delta plus variant. Let us hope not.

    Fresh cases of Delta plus, Kappa variants surface in Gorakhpur region
    LUCKNOW Even as fresh Covid cases continued to decline in Uttar Pradesh, the detection of fresh cases of Delta plus and Kappa variants of Covid in Gorakhpur…
    www.hindustantimes.com


    LUCKNOW Even as fresh Covid cases continued to decline in Uttar Pradesh, the detection of fresh cases of Delta plus and Kappa variants of Covid in Gorakhpur region came as a cause of worry for the state health department.

    The Regional Medical Research Centre (RMRC), Gorakhpur had sent 90 samples to the National Institute of Virology (NIV), Pune, for genome sequencing in May. The centre received the report of 38 samples from the institute, confirming eight samples positive for the Delta plus variant, 27 for the Delta variant and three for Kappa variant. The report of 52 samples was awaited, said Dr Ashok Kumar Pandey, senior scientist at RMRC.


    THH

  • RB - what is now your considered opinion of these comparisons between Kerala and UP? There are so many differences other than ivermectin, don't you think? Do you have a detailed study of all India provinces, which use ivermectin when, and epidemic course? That might make your case which at the moment has zero evidence stronger? or maybe weaker... :)

  • Chairman of Tokyo Metropolitan Medical Association Declares During Surge, Time for Ivermectin is Now


    Chairman of Tokyo Metropolitan Medical Association Declares During Surge, Time for Ivermectin is Now
    The chairman of the Tokyo Metropolitan Medical Association recently led an emergency press conference on August 13, declaring the urgent status of the
    trialsitenews.com


    The chairman of the Tokyo Metropolitan Medical Association recently led an emergency press conference on August 13, declaring the urgent status of the pandemic as Japan is now in its worst surge of the COVID-19 pandemic since the onset of the crisis. Most recently, a record number of new cases were reported at 20,140 on August 14. Deaths aren’t as high as successive waves of the pandemic from February 2021 to the end of May, but nerves are frayed with record numbers of infections. Haruo Ozaki shared that 18,000 new infections are reported daily, indicating “it will be ranked high in the world”. However, he acknowledged the death count has eased as compared to previous surges.


    Greenlight for Ivermectin

    In Dr. Ozaki’s recent speech, he declared that ivermectin has demonstrated significant benefits in reducing infections and deaths where the regimen is prophylactically administered for another indication. The head of the Metropolitan Medical Association declared that while clinical trials were important, it was time to greenlight doctors to prescribe ivermectin in association with giving the patient informed consent.


    The Tokyo Metropolitan Medical Association was established back in 1947, and since then, the association has evolved with the growth of this megacity of 14 million.


    Much like what was successfully accomplished in Uttar Pradesh, India, parts of Bangladesh, and places like Argentina and Mexico, Chairman Ozaki calls for the immediate use of ivermectin as cases surge here.


    Lead Research/Investigator

    Haruo Ozaki, Chairman, Tokyo Metropolitan Medical Association

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