Coronavirus in the US

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https://www.theguardian.com/world/2020/mar/27/jair-bolsonaro-coronavirus-brazil-governors-appalled

Bolsonaro’s anti-science response to coronavirus appals Brazil’s governors
Brazil
The president has contradicted his own health ministry by urging people to return to work and schools – ‘I was gobsmacked,’ said one former Bolsonaro ally

Top Brazilian politicians from across the political spectrum have warned that Jair Bolsonaro is putting thousands of lives at risk with what they called his reckless, paranoid, anti-scientific and belligerent response to the coronavirus.

In a series of scathing interviews – conducted as 26 of Brazil’s 27 state governors convened an emergency meeting to discuss Bolsonaro’s behaviour – regional chiefs told the Guardian they feared the far-right leader was sowing confusion over the need for quarantine and social distancing measures, and wasting precious time setting political bonfires to energize his radical base.

Bolsonaro sparked fury on Tuesday with an extraordinary address to the nation in which he rubbished the quarantine measures and travel restrictions being implemented by many state governors and urged Brazilians to return to work and schools – in contradiction of his own health ministry’s counsel.

The comments stunned state governors – many of whom are now in open revolt against the president.

“I was gobsmacked,” said Ronaldo Caiado, the rightwing governor of Goiás state and a former Bolsonaro ally.

“It’s appalling. You cannot govern a country like this,” added Caiado, who this week severed ties with Bolsonaro. “At a moment like this he should have the humility to leave things to those who understand them.”

Paulo Câmara, governor of the north-eastern state of Pernambuco, said regional chiefs were disappointed that “when every expert, from every country recommends staying at home … [Bolsonaro] goes on national TV and says this is an exaggeration, that distancing isn’t necessary, that the virus isn’t all that deadly, that it’s just ‘a little flu’.

“We’re sorry that right now the central command is more interested in political and electoral questions than the health of the Brazilian people,” added Câmara, whose state has registered 46 cases and three deaths.

Rui Costa, the Workers’ party governor of Bahia, said the country needed mature, professional and calm leadership – not ideology-infused grandstanding. “We cannot treat such a serious question in such a debauched manner,” he said.

In an open letter to Bolsonaro published after their summit on Wednesday, the rebel governors signalled they would ignore his calls to scale back their lockdowns.

“Coronavirus is an adversary that must be defeated with good sense, empathy, balance and unity,” they wrote.

In a second letter, the governors of Brazil’s nine north-eastern states declared: “Attacks and quarrels will not save the country.”

Flávio Dino, the leftwing governor of the north-eastern state of Maranhão, said he believed Bolsonaro’s downplaying of the pandemic stemmed from a conviction that coronavirus was a political plot not a public health emergency.

“Deep down it’s a kind of denialism. He thinks this is a media invention and a Chinese conspiracy which is part of their battle for hegemony with the US. He must have heard this from Trump,” said Dino, from the Brazilian Communist party.

“That explains his resistance to these [lockdown] measures because deep, deep down he believes coronavirus is a communist invention,” added Dino, who said Bolsonaro’s jumbled response was risking lives.

“He wastes so much time with these illusions, these deliriums, these conspiracies, these fantasies, these scuffles – and when you’re facing a serious crisis this is catastrophic,” Dino said.

Câmara said Bolsonaro’s call to relax containment measures contradicted expert scientific consensus and would be disregarded. “As governors it is our duty to enforce these restrictions and follow the guidance of the World Health Organization … and this is what we will do,” he vowed.

“Brazil isn’t ready for an exponential growth [in cases] so we need to buy time … so we can put together the infrastructure to treat as many infected people as possible.”

Eduardo Leite, governor of the southern state of Rio Grande do Sul, which has 162 confirmed cases, said lockdown was crucial so hospitals could prepare for a wave of Covid-19 patients.

“[Bolsonaro] should be the one leading and coordinating this process. But not only is he not doing this, he’s actually sabotaging the plans state governments are putting in place,” added Leite, from the centre-right Brazilian Social Democracy party (PSDB).

Leite said attacks on science and “political radicalism” would not solve the “extreme” crisis.

One of those spearheading the mutiny is São Paulo’s governor, João Doria, a former Bolsonaro ally who many suspect harbours presidential ambitions.

This week, Doria clashed with Bolsonaro, accusing him of dividing Brazil at a time of national crisis. Brazil’s president hit back, bellowing “Your Excellency is an example to no one,” during a video conference.

In turn, Doria warned that Bolsonaro’s behaviour could cost lives. “Lead your country. Lead your people,” he said.

Coronavirus has set Brazilian politics alight, with Bolsonaro drawing heavy fire for dismissing the pandemic as media “hysteria”. On Thursday health officials said the number of cases had risen to 2,915 with 77 deaths.

Renato Casagrande, the governor of Espírito Santo, which has 40 cases, said Bolsonaro’s address had stunned him.

“I felt afraid. I couldn’t believe the words the president was saying. The health ministry has been guiding our response. The World Health Organization has been guiding our response. We are trying to convince people of the need right now for a greater confinement to stop the virus. And then the president comes out with completely different advice and even accuses other leaders of exterminating jobs and the economy. It was unbelievable.”

Even Carlos Moisés da Silva, the rightwing governor of the heavily pro-Bolsonaro southern state of Santa Catarina, told reporters Bolsonaro’s declarations had “flabbergasted” him.

Bolsonaro rejects such criticism as the work of political rivals jostling to succeed him in 2022. This week he claimed governors and mayors forcing businesses to close were committing “a crime” and risked mass unemployment. “They’re destroying Brazil,” Bolsonaro claimed.

Dino, who has ordered the closure of shops, restaurants and schools, defended drastic measures.

“Paradoxically, they are the fastest and least painful way for you to come out of the crisis because you contain the spread of the virus.”

Caiado urged Bolsonaro to change tack and empower Brazil’s health minister, Luiz Henrique Mandetta.

Speaking to reporters on Wednesday Caiado also suggested that, as he faced up to coronavirus Bolsonaro should look not to his political idol, Donald Trump, but to his predecessor.

“Nobody put it better than Obama. In politics and in life, ignorance is not a virtue,” he said.

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As Brazil’s far-right president Jair Bolsonaro calls on people to return to work despite the advice of medical experts, his government is rolling out a propaganda video with the hashtag Brazil Can’t Stop (#OBrasilNãoPodePara).

The clip, which shows beaming Brazilian workers and professionals, has been shared on Bolsonarista WhatsApp and the president’s son, senator Flávio Bolsonaro, posted it on his Facebook.

Bolsonaro has been widely condemned for his response to the crisis, which he has dismissed as a fantasy and a “media trick”. In a Facebook Live broadcast on Thursday night, Bolsonaro pointed to rising unemployment in the United States – which has overtaken China as the country with most cases of coronavirus – as the reason Brazil needed to get back to work.

“This problem has already started here,” he said, comparing lockdown measures to “that chemotherapy equipment” treatment for cancer.

“They are killing the patient to combat the virus,” he said. “Without money I am dying of hunger, man, dying of hunger. Suicide. Violence comes next.” Bolsonaro also shared a video on Facebook of a parade of cars demonstrating for a return to work in Balneário Camboriú in Santa Catarina state, southern Brazil.

Santa Catarina state will allow restaurants, bars, gyms, shopping centres and shops to open from 1 April, the Estado de S.Paulo newspaper . Mato Grosso and Rondônia states – also run by rightwing governors – have announced similar measures.

But Brazilian coronavirus cases continued to rise – to 2,991 cases and 77 deaths. And a researcher for the government research institute Fiocruz said hospitalisations for respiratory problems had exploded since the first coronavirus case was confirmed, the Folha de S.Paulo newspaper . There were 2,250 cases from March 15-21, nearly 10 times the norm.

Guardian

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@fretfulmother

I hadn’t heard they don’t work. Can you post a link to that info. It’s news to me and sad to hear that.

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I won’t touch the “NY grabbed ventilators” statement, but since I live in NY and listen every morning to Cuomo’s press conferences, I will clarify that he was thanking the National Guard and health care workers for showing up, in the face of danger.

I cannot speak for other areas, but my part of NY is shut down and people are staying home, 100%.

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Just saw the briefing by Virginia 's Governor Northam ( who is also a physician). He said he and his staff may seem to be dressing more casually these days but that is because they are not wearing ties. He said ties have been shown to harbor “infectious pathogens” so they are not wearing ties right now!

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Thanks for sharing the information about Brazil, @doschicos . Two of my younger child’s three roommates are from Brazil, and at least one has expressed concern to my child about what her own family is doing during the pandemic.

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You are correct. Cuomo will be throwing much of his state under the bus, as his sole focus is on NYC. There are two parts of New York, really – NYC (with the inclusion of the NYC suburbs) and everywhere else. I’m sure other parts of NYS (like where you live) are doing what they are supposed to do,.

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Some commentary on the subject from a physician context:

https://www.kevinmd.com/blog/2020/03/how-to-avoid-covid-19-infection-at-work-tips-from-an-infectious-disease-physician.html
https://www.kevinmd.com/blog/2013/03/doctors-shed-white-coat-tie.html

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Yes. The ARMY CORPS SHOWED UP. Context! Listen to the speech. Read the entire articles. Do NOT quote out of context

I can reassure you. All of my friends are at home. Most of them won’t even get out to get groceries. You know who is out? My friend’s husband - a doctor in one of the NYC hospitals. A friend of mine who works in a pharmacy.

I won’t go into ventilators, either. Waste of my time.

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Biggest daily rise in UK coronavirus deaths

The UK has recorded its biggest daily rise in coronavirus deaths for the second day running. In the last 24 hours, 181 have died after testing positive for Covid-19. It comes after 115 deaths were recorded the day before. The death toll in the UK stands at 759, with 14,579 confirmed cases

Of the 181 new UK deaths, a further 168 people in England who tested positive for Covid-19 have died. According to NHS England, the patients were aged between 29 and 98 years old and all but four – aged between 82 and 91 – had underlying health conditions.

In Indonesia – the world’s fourth most populous country – the government has performed a policy U-turn and pledged to impose lockdowns to control the coronavirus after the biggest one-day surge in confirmed cases.

After previously restricting tougher restrictions, Indonesia’s chief security minister Mahfud MD said on Friday the national government would allow regional authorities to impose lockdowns to stem the spread of Covid-19.

According to Reuters, the security chief also said the government was mulling a plan to ban “mudik” – the practice that sees millions of Indonesians leave towns and cities for their native villages at the end of the Muslim fasting month of Ramadan in May.

It comes after the country announced on Friday its biggest one-day surge in coronavirus cases, up 153 to 1,046. The country, which has a population of 260 million, has conducted just 4,336 tests. One model by infectious disease experts suggests there are as many as 50,000 cases.

Indonesia’s government has previously been reluctant to embrace the stricter containment strategies of other nations, and President Joko Widodo’s policy has been to encourage social distancing while not imposing tighter restrictions on movement.

But on Thursday, its eastern province of Papua defied Jakarta by closing its airports, sea ports and land borders for 14 days in an attempt to prevent the disease spreading.

After the central government initially sought to over-rule Papua’s moves, Mahfud said on Friday that Jakarta would now issue a regulation allowing regional governments to impose a strict quarantine on their territory.

In a later statement obtained by Reuters, Mahfud said the government was approving a “regional quarantine”, not a lockdown.

Guardian

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Amazon will donate more than $3 million to support coronavirus response in France
From Fanny Bobille in Paris, CNN

Amazon has announced that it will donate 3.5 million euros (approximately $3.8 million) to support those most affected by the coronavirus outbreak in France.

“Amazon is now committing 3.5 million euros to support those who are most affected by the Covid-19 crisis in France. This donation includes a donation of 2.5 million euros in favor of the French Red Cross, and 1 million euros to support organizations that carry out actions across the territory and, in particular, near our employees,” Amazon said Friday.

In Amazon’s statement, the French Red Cross commended the move and thanked the company for its support.

“It is more important than ever to mobilize everyone to help those who need it most, and we thank Amazon for this exceptional gift,” said director general of the French Red Cross, Jean-Christophe Combe. “We are working hard with all of our volunteers and employees in the fight against COVID-19, and the support of companies like Amazon is a very important element in supporting us in these efforts.”

According to Amazon, a new “donation call button” will also be included on all of its sites across Europe to add to the company’s contribution.

“This gift is in addition to the constant work that Amazon and its employees have done in France and around the world,” the statement added.

Michigan reports more than 800 new cases
CNN

Michigan is reporting 801 new cases of novel coronavirus and 32 new deaths on Friday.

The total number of cases in Michigan is now at 3,657 and the total number of deaths is 92, according to the state’s website.

Oklahoma governor suspends abortions during pandemic
From CNN’s Hollie Silverman

Oklahoma Gov. Kevin Stitt suspended elective surgeries on Tuesday in an executive order.

On Friday, Stitt’s office issued a clarification that classifies abortion services as elective if they are not deemed a medical emergency.

Abortions will only be deemed a medical emergency if they pose serious health risks to the mother, the statement from the governor’s office said.

“We must ensure that our health care professionals, first responders and medical facilities have all of the resources they need to combat Covid-19,” Stitt said in the statement. “I am committed to doing whatever necessary to protect those who are on the front lines fighting against this virus.”

51 Italian doctors who contracted coronavirus have died since the start of the pandemic
From Sharon Braithwaite in London, CNN

Since the beginning of the coronavirus crisis in Italy, 51 doctors who tested positive for the disease have died, the Italian Association of Doctors said Friday.

The news of the death toll comes after an urgent call for medical protective equipment from the president of the association, Filippo Anelli, on Thursday.

By the numbers: Since the beginning of the epidemic, 6,414 health workers have been infected by coronavirus as of Thursday, according to the Italian National Institute of Health.

Out of the 51 deceased doctors, 32 were working in Lombardy, the Italian region worst-hit by coronavirus.

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Social care is an area of huge concern at the best of times but, all over the world, the Covid-19 pandemic has brought it into sharp focus. In northern Portugal, the plight of elderly residents in a care home – where most have tested positive for the coronavirus and others are awaiting results – has prompted the government to send in the army to avert what desperate staff fear could be a disaster in the making.

“We want help. We want to test people,” one worker at the Nossa Senhora das Dores care home in Vila Real shouted from the window on Tuesday, according to Reuters.

City mayor Rui Santos said he had appealed for urgent government support in evacuating the home. As soon as everyone is out, soldiers will disinfect the facility, Santos added.

Portugal has reported 4,268 confirmed cases of the virus so far, with 76 deaths. At least eight care homes across the country have already had many residents and workers affected and several deaths, mainly in the north.

Meanwhile, in neighbouring Spain, workers fear a similar situation. “Our homes were underresourced and understaffed before all this happened,” Rui Fontes, president of an association training care home workers, told Reuters. “I bet you we’ll find bodies in homes soon ourselves as well.”

Flags will be flown at half-mast in cities across Italy to commemorate the victims of coronavirus as the disease continues to devastate the country. “On Tuesday 31 March, at 12pm, flags at half-staff and a minute of silence to be observed by Italian mayors with the tricolor sash in front of their city hall,” the president of municipalities association ANCI Antonio Decaro announced on Twitter.

The Higher Health Institute (ISS) said on Friday that the peak of the coronavirus epidemic in Italy is approaching. “We have seen an apparent reduction in the infection curve since March 20 but we are not yet in a downward phase,” said Silvio Brusaferro, the ISS president.

In India, the second biggest nation on the planet with a population of 1.3 billion people, testing rates have been abysmally low compared with western nations. As of today, Indian authorities have confirmed 691 positive cases among 26,798 people tested, according to the Indian Council of Medical Research.

Now health authorities are setting up coronavirus call centres across the country in a bid to stop people overwhelming hospitals demanding immediate tests for Covid-19.

According to Reuters, doctors and medical students have been recruited to run virtual diagnostic facilities and prescribe preventive care in more than 30 languages to ensure hospitals are seeing just the most severe cases rather than everyone worrying about possible infection.

It follows Narendra Modi telling the population to self-isolate indoors for three weeks as part of a massive lockdown.

There are reports of dramatic conditions at hospitals in the Alsace region, the epicentre of the Covid-19 epidemic in France.

According to a report by the German Institute for Disaster Medicine, compiled following a visit to the University Clinic in Strasbourg and seen by German news agency dpa, medics in the hard-hit region were no longer ventilating patients aged over 80 but were merely offering “terminal care” with opiates and barbiturates.

The report said the hospital in Strasbourg was facing a mass influx of new patients at an hourly rate and that medics were continuing to offer care even after they themselves had been infected with the virus.

The Strasbourg clinic on Friday rejected some of the details in the report, saying the overall condition of patients was crucial for prioritising access to ventilators, not age, and that the hospital had acquired new ventilators.

Brigitte Klinkert, the president of the French departement Haut-Rhin, confirmed that Alsace hospitals were forced to triage care, meaning some patients were prioritised because of a limited number of ventilators.

“We have already been practising triage for two weeks,” Klinkert told German newspaper Die Welt. “You can’t say it often enough, because it isn’t just the German neighbours but also the French outside Alsace who still aren’t taking the situation seriously.”

Researchers in Germany, where the number of confirmed infections is at over 47,400 and 286 deaths by lunchtime, have proposed a mass study into how many people are immune to the Covid-19 virus, in an effort to allow those for whom it is safe to do so, to return to leading a normal life.

According to Spiegel magazine, which has seen the preparations for the study, which is awaiting the approval of authorities, researchers hope to be able to test the blood of more than 100,000 volunteers for Covid-19 antibodies from mid-April.

The test would be repeated on the same volunteers and expanded to use different groups, at regular intervals, in order to oversee how the pandemic is progressing. The scientists – a team compiled from various bodies, including the government’s leading public health body, the Robert Koch Institute, the German Centre for Infection Research, blood donation services, and the Institute for Virology at the Charite hospital in Berlin - hope to discover the extent to which Covid-19, or Sarvs-CoV-2 has already spread, and how many infected people it really kills.

The results of the study would make it easier to decide for instance, when schools should reopen, and large-scale events be allowed to take place, the authors say. If everything goes to plan, the first results would be available by the end of April.

“Those who are immune could be issued with a sort of ‘immune pass’ that would allow people to be excluded from the restrictive measures currently in place” Gérard Krause, an epidemologist from the Helmholtz Centre for Infection Research in Braunschweig, told Der Spiegel.

Guardian

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Yes, I think you did misinterpret.

If you were not posting that you and your DH hoped/expected that the treatment/preventative would fail, then the post about using energy to discredit it and hoping it would fail was not referring to you or your DH. If your DH is writing methods for a study that might lead to Plaquenil as a preventive measure, he is probably not hoping to find that it doesn’t work for that.

Yes, we know that hope doesn’t cure or prevent disease. But really, I don’t think I’ve ever heard of the government or any private enterprise launching a drug study in the hope that the drug is ineffective for the investigated use. If you didn’t hope and expect that there was a good possibility of it working you wouldn’t do the study.

You have to be disciplined enough to follow the results even if they do not validate your hopes, but I decline to believe that the people doing the tests on Plaquenil are hoping for it to fail.

There are people who like to prove the current president wrong about anything or everything, and the comment you misinterpreted may have been referring to them.

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I think he should have had a stronger initial border closing and very strong testing, quarantine, contact tracing, and further quarantining of exposed contacts. Those things combined would work and we would be dealing with a fraction of cases now. The impact on the economy would be much less. 2 months after their lockdown, China is slowly getting back to work. They had a slow start, which is unfortunate, but strong measures worked. We can skip the human rights abuses but otherwise they did a lot of things we could see working a long time ago now.

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Deleted.

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I think it is more that not very long from now we are going to see how stupid and dangerous it was for our country to not put out the raging forest fire in NY so it doesn’t spread everywhere and endanger the rest of the country. That seems very obviously fundamental to me.

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A short while ago, Associated Press filed this troubling report from Tehran, the Iranian capital where people are drinking toxic methanol in the mistaken belief it will combat the coronavirus.

Standing over the still body of an intubated 5-year-old boy wearing nothing but a plastic diaper, an Iranian health care worker in a hazmat suit and mask begged the public for just one thing: Stop drinking industrial alcohol over fears about the new coronavirus.

The boy, now blind after his parents gave him toxic methanol in the mistaken belief it protects against the virus, is just one of hundreds of victims of an epidemic inside the pandemic now gripping Iran.

Iranian media reports nearly 300 people have been killed and more than 1,000 sickened so far by ingesting methanol across the Islamic Republic, where drinking alcohol is banned and where those who do rely on bootleggers. It comes as fake remedies spread across social media in Iran, where people remain deeply suspicious of the government after it downplayed the crisis for days before it overwhelmed the country.

“The virus is spreading and people are just dying off, and I think they are even less aware of the fact that there are other dangers around,” said Dr. Knut Erik Hovda, a clinical toxicologist in Oslo who studies methanol poisoning and fears Iran’s outbreak could be even worse than reported. “When they keep drinking this, there’s going to be more people poisoned.”

Israel’s military has said it will send about 500 soldiers to join police officers in enforcing a nationwide lockdown, writes the Guardian’s Oliver Holmes in Jerusalem.

The armed troops will patrol the streets from Sunday, the military said in a statement, to assist police in “isolating and securing certain areas, blocking routes and additional similar assignments”.

On Wednesday, the Israel government instructed people to stay within 100 metres of their homes for a week or face a fine or even jail. It further reduced public transport and required employers to check workers for fever. Shopping for essential items and food delivery remained permitted.

Spanish government withdraws coronavirus testing kits
Sam Jones
The Spanish government has withdrawn 9,000 Chinese-made coronavirus testing kits from use after it emerged that they had an accurate detection rate of just 30%, reports Sam Jones in Madrid.

Like other countries struggling to diagnose and treat the virus, Spain has looked to China for rapid testing kits equipment and much-needed supplies, and announced this week that it would spend €432m (£387m) on tests, masks, gloves and other personal protective equipment.

However, a batch of Chinese-made kits bought by Spanish health authorities a few weeks ago has been pulled after they were discovered to be unreliable and the Chinese government said that they had been made by a company that did not appear on its list of authorised manufacturers.

In a statement on Thursday, Spain’s health ministry said it would be returning the kits, but stressed that they had not be bought directly from the Chinese manufacturer but from a supply company in Spain that had purchased them in China and had provided the necessary accompanying paperwork.

“The first tests on the rapid testing kits were carried out simultaneously by a hospital in Madrid and by the Carlos III Health Institute, and as soon as their low sensitivity was discovered, they were withdrawn,” said the ministry. “The supplier has been contacted and replacement tests will be provided.”

Certificates shared by the ministry included an EC declaration of conformity for the products, which, according to the documentation, were made by the Shenzen Bioeasy Biotechnology Company Limited in Guandong province.

“Spain follows EU regulation, which means that if a product is certified to conform to European standards, it can be bought and sold throughout the union area,” said the statement.

The ministry said the deficient kits were not part of the new, €432m Chinese order, and had been bought before the Chinese authorities has issued its list of approved manufacturers. In recent days, Spanish health authorities have been urgently distributing almost 650,000 rapid testing kits to frontline medial staff and residence homes for older people.

Spain, which is the European country most affected by coronavirus after Italy, has so far recorded more than 56,000 cases of the disease and more than 4,000 deaths.

Health workers, who account for about 14% of the country’s coronavirus victims, have complained of a lack of basic protective equipment such as face masks and gowns.

[ @privatebanker I am tagging you here because this tells a different story than the Fox News article you had posted previously. ]

Guardian

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Then NYC will grab up all the supplies, including all of the ventilators. And the hot spots in the rest of the country will suffer huge losses of life, because all resources are concentrated in NYC. New Yorkers are fleeing, and they won’t stop fleeing, spreading the virus everywhere.

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Good video of interview with former CDC Director Tom Frieden. He is like Dr. Fauci but he doesn’t have to worry about offending anyone and can speak freely.

https://www.usatoday.com/story/news/health/2020/03/24/coronavirus-response-us-cdc-tom-frieden-usa-today/2910582001/

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@privatebanker A small pilot study released March 6 had disappointing results for hydroxychloroquine. It involved 30 people who’d been just diagnosed with COVID-19, so none of them had progressed to severe disease at the beginning of the trial.

[quote]
One patient in HCQ[treatment] group developed to severe during the treatment. On day 7, COVID-19 nucleic acid of throat swabs was negative in 13 (86.7%) cases in the HCQ group and 14 (93.3%) cases in the control group b**. The median duration from hospitalization to virus nucleic acid negative conservation was 4 (1-9) days in HCQ group, which is comparable to that in the control group[2 (1-4) days, (U=83.5, P>0.05)]. /quote

So, one of the patients in the treatment group, and no patient in the control group, developed to severe disease during the study. After seven days, 86.7% of the treatment group and 93.3% of the treatment group tested negative (or at least I think that’s what “COVID-19 nucleic acid of throat swabs was negative” means); this was not a statistically significant result.

This is a small study, and certainly a bigger study might show more results. But if hydroxychloroquine were a wonder drug, we’d expect to see some wonders, and we saw none of them here. The treatment group did slightly (but statistically insignificantly) worse than the control group.

http://www.zjujournals.com/med/EN/10.3785/j.issn.1008-9292.2020.03.03