"Connecting Communities for COVID19 News" 27th Nov 2020
Coronavirus lockdowns contributing to faster deterioration in dementia patients, research finds
Forced into lockdowns to prevent the spread of coronavirus, families of people with dementia have been left heartbroken that being isolated appears to have contributed to the deterioration of their loved ones. For Verity Jausnik, coronavirus restrictions meant she was unable to spend quality time with her elderly mother, Vivien "Viv" Russell. Ms Russell, 72, has lived with early onset dementia for a decade but an accelerated deterioration of her condition during the lockdown of her aged care home has meant she has lost her ability to remember her family, particularly her grandchildren.
What the biopharma industry is doing to build confidence in Covid-19 vaccines
Over the last few weeks, the United States has surpassed 100,000 Covid-19 cases a day and reached the staggering milestone of 10 million cases. This is both sobering and humbling. While there has been encouraging news about progress in the development of Covid-19 vaccines, making sure that Americans have confidence in these vaccines is crucial to helping bend the curve of infections and getting us back to some semblance of normalcy. According to researchers writing in The Lancet, we will need a majority of Americans to have the confidence to get vaccinated for Covid-19 vaccines to be effective in moving the U.S. toward population-level control of viral spread. As Anthony Fauci has noted, “If you have a vaccine that is highly effective and not enough people get vaccinated, you’re not going to realize the full, important effect of having a vaccine.”
Scientists ask to see evidence behind relaxing UK's Christmas Covid rules
Ministers are facing calls to publish scientific advice on the relaxing of Covid-19 rules over Christmas amid warnings that a single infectious guest could infect a third of those at a household gathering. Under rules revealed by the prime minister on Tuesday, up to three households can form a “bubble” for five days over Christmas. It prompted some scientists to speak out, warning that mixing will inevitably lead to an increase in infections come the new year, leading to deaths. Some said the government should have put greater emphasis on the dangers and potential control measures. Now experts have called for the government to release advice given by the Scientific Advisory Group for Emergencies (Sage).
Rapid COVID-19 tests provide lifeline for London orchestra
Maxine Kwok, a violinist in London’s oldest symphony orchestra, is delighted that rehearsals have resumed thanks to a rapid, lab-free COVID-19 test that gives the musicians the confidence to work together again. “It was so difficult not to play for months,” Kwok, a member of the London Symphony Orchestra (LSO), said after being tested. “But the moment that we were able to have this kind of testing at this regularity, meaning we could just come back to work and feel comfortable and safe, really made a huge difference for us,” Kwok told Reuters. “I was so thrilled. I can’t describe it really,” she added ahead of a rehearsal attended by around 40 musicians, all masked and still observing social distancing rules.
Coronavirus: Limit contacts before Christmas bubbling, executive urges
People should limit their contact with others before Covid-19 restrictions are relaxed at Christmas, Deputy First Minister Michelle O'Neill has said. Across the UK, three households can mix for five days from 23-27 December. However, Ms O'Neill said it was important to reduce Covid-19 transmission "as low as possible". First Minister Arlene Foster said the next two weeks "are crucial... so that we can all have the safest and the happiest Christmas possible".
Antibody testing likely undercounts the number of people who have had COVID-19: More than 25% of infected health care workers had NO signs of it in their blood work 60 days later
CDC researchers found that 6% of more than 3,000 health care workers they tested had antibodies to coronavirus. Within 60 days, when they were retested 28% of the health care workers had antibody levels so low that they could no longer be detected. Researchers warn this suggests that using antibody testing likely undercounts how many people have had COVID-19 and that plasma has a short shelf life
Covid vaccine trials did NOT monitor whether participants took other steps to prevent infection like wearing masks and social distancing
A participant in Pfizer's coronavirus vaccine trials told Business Insider that the firm did not monitor the participants behavior if they didn't feel sick. Moderna also did not specify how to behave or track data on the participants' actions during its trial. It was left up to individuals to wear masks or socially distance - behaviors that are estimated to reduce the risk of spreading or catching COVID-19
Untested, untraced: how three-quarters of Covid contacts slip through cracks
Statistics show how ‘world-beating’ tracing scheme fails to follow up on Covid-19 cases at every step. It was in May that Boris Johnson promised the UK would have a “world-beating” test-and-trace operation in place within weeks. “Our test-and-trace system is as good as, or better than, any other system anywhere in the world,” he doubled down in July. But nearly half a year after the system was established, thousands of Covid-19 cases still go undetected each week, leaving severe lockdown restrictions as the only option to prevent hospitals across the country from collapsing. The Guardian has analysed the latest figures on the performance of test and trace to show how people at risk of spreading the virus go missing at every step of the process.
Volunteers discuss side-effects after receiving Moderna and Pfizer Covid-19 vaccines
Volunteers who received two of the potential coronavirus vaccines in the US have spoken out about the side-effects they experienced following their jabs. This month, Moderna and Pfizer announced their vaccine candidates had been tested to 94.5 per cent and 95 per cent efficacy respectively. Jennifer Haller, who was injected on 16 March with Moderna’s experimental vaccine in Seattle, told WVPI-TV she only experienced mild side-effects as a result. "I had two doses of the vaccine four weeks apart,” she told the broadcaster. “Each time my arm was pretty sore the next day but besides that I personally didn't experience any other side effects." Ms Haller was the first person to receive a shot of Moderna’s candidate at the Kaiser Permanente Washington Health Research Institute as part of the first human trial of a vaccine to prevent the virus.
Here's how to tackle the Covid-19 anti-vaxxers
If we are talking to someone who’s uncertain about the vaccine we should try to be empathetic, actively listen, and focus on the benefits of taking it. And rather than contradicting them, we should suggest places where they can find out additional information. If people feel respected and trusted they are more likely to listen; and if they can find out on their own, then they will have time to process and engage with it without feeling defensive. And there are broader behavioural science tactics that the government can use to improve the uptake of vaccines, including making it seem like the default and showing it to be a social norm. This means using language that inherently assumes everyone will take the vaccines, making people feel they are actively opting out, rather than opting in.
This Lockdown, England’s Theaters Know What to Do Online
The first coronavirus shutdown caught playhouses unawares, but they learned lessons that stood them in good stead when the shutters came down again. What a difference a lockdown makes. By way of proof, consider the terrific lineup of actresses brought together for “Little Wars,” an imaginative if overly arch play by the American writer Stephen Carl McCasland that is streaming online through Dec. 3. Its run finishes the day after England’s second coronavirus shutdown is scheduled to be lifted, at which point theaters in most regions will, with luck, be open again. Whereas streaming prospects during the first lockdown relied largely on recordings from theaters’ archives, the preference now is for material fashioned for the strange era in which we find ourselves. The digital premiere of “Little Wars” testifies to the abundance of talented performers who can be drawn upon during the pandemic, and to their desire to practice their craft against difficult odds. I’m not sure McCasland’s conceit would amount to as much as it does without the collectively hefty presence of such actresses as Linda Bassett, Juliet Stevenson and Sophie Thompson, all established theatrical names here.
India Coronavirus: How do you vaccinate a billion people?
When it comes to vaccine making, India is a powerhouse. It runs a massive immunisation programme, makes 60% of the world's vaccines and is home to half a dozen major manufacturers, including Serum Institute of India - the largest in the world. Not surprisingly, there's no lack of ambition when it comes to vaccinating a billion people against Covid-19. India plans to receive and utilise some 500 million doses of vaccines against the disease and immunise up to 250 million people by July next year.
As France eases lockdown, ski resorts left out in the cold
Megeve, in the foothills of Mont Blanc, was gearing up to welcome back skiers before Christmas after a COVID-19 lockdown was eased. But France’s government - while allowing cinemas, museums and theatres to reopen from Dec. 15 - says its ski slopes must stay off limits until 2021, leaving those who make their living in the Alpine village frustrated and, in some cases, perplexed.
Never mind what antivaxxers say — just watch what they do
Antivax talk is worrying. However, it is only talk. Social media has made this the wordiest era in history. Sharing conspiracy theories online is excitingly subversive, making people feel they have taken the “red pill” and seen the truth. More telling, though, is their behaviour. In real life, when things get serious, almost everyone chooses vaccination. “If Covid-19 vaccines are found to be efficacious and safe and widely available, my guess is that a very large proportion of people will ultimately take them,” says Vish Viswanath of Harvard’s School of Public Health. Even French behaviour is reassuring. Vaccination rates here have been rising: 98.6 per cent of babies born in early 2018 received the “hexavalent” vaccine that protects against six illnesses, including hepatitis B and tetanus. True, it’s compulsory, but parents still have to bring in their kids. Even in the US, where parents can more easily refuse vaccinations, only about 7 per cent or fewer adamantly oppose them, depending on the vaccine, says Viswanath. He adds: “This small group gets a disproportionate share of attention.”
Barbados draws hundreds of Americans with remote work program during pandemic
More Americans want to work from paradise during the pandemic. A Barbados travel program giving people the option to relocate to work from the Caribbean island and its white-sand beaches during the pandemic has garnered 675 applications from U.S. citizens, MarketWatch reported.
53% in India willing to switch jobs to avail remote work: Survey
More than half of the office-goers in India are willing to switch jobs if it meant they could work remotely, said a new survey on Thursday. There has been a heightened interest in online learning since Covid-19 with 83 per cent of survey participants from India saying they are more interested in online learning/training, according to the research by Cloud software firm Salesforce.
Working from the beach, holidaying while we work: are we getting the worst of both worlds?
These are paradoxical times for digital nomads. After tripping around the world for years with laptops, carry-on luggage and memberships to co-working spaces, they’ve been grounded by the pandemic. Covid has put the “no” in nomad - closing borders, making movement harder, and grounding flights. But while this class of restless workers stays put, more and more of us have adopted a sort of digital nomad-lite model. Since Covid shutdowns, almost half of all Australians are working remotely. The results, for some, are holidays that look like work and work that looks like a holiday.
What have we learnt about mass remote working?
With this in mind, it seems like a good time to take a step back and reflect on what the last twelve months have taught us about ourselves, our working styles and our ability to adapt. Not only that, but it is also a good time to explore what learnings we can take forward and what can be improved to ensure we continue to thrive both in and out of the home office.
Hands-on virtual labs? U of T Engineering profs get creative with remote learning
A camera and a bottle of Gatorade were the key pieces of equipment for a recent virtual lab in Jennifer Farmer’s applied chemistry course. “We told students that they’d have to determine the amount of food dye in the drink,” explains Farmer, an assistant professor, teaching stream, in the University of Toronto’s department of chemical engineering and applied chemistry in the Faculty of Applied Science & Engineering. Any other year, students would learn to operate a spectrometer to find the answer. “Well, we don’t have spectrometers at home – or do we?” During the COVID-19 pandemic, instructors and teaching assistants (TAs) across U of T Engineering have been forced to create new, engaging and equitable ways to conduct labs – a traditionally hands-on and collaborative in-person learning experience – without using on-campus equipment, software or space.
Virtual learning may keep your child up at night
As students settle into the routine of virtual school, excessive screen time for kids has become common. You've probably heard the old wives' tale about how sitting too close to the TV screen can hurt your eyes but Dr. Katherine Duncan says sitting in front of a laptop likely isn't bad for your vision. Dr. Duncan is a general pediatrician at Beverly Knight Olson Children's Hospital at Navicent Health. When first learning of schools moving from in the classroom to online, she had concerns because excessive screen time can affect children's health.
Virtual Learning: Here's how you can find your center during Covid-19
We have heard this time and again that children grow up to be the adults they experience around them. This is not only true for skills and behaviours they develop but also for certain deeper faculties of the mind such as the ability to pay attention, building resilience, discernment and so on. In times of a pandemic when there is a sense of uncertainty and everyone is operating from a space of anxiety and fear, it is even more critical that we as parents and educators intentionally take time out to center ourselves and find out tools, methods and practices to consciously tune inwards each day.
Stanford University study finds Illinois students years behind in math, reading during online learning
New research suggests remote learning is putting students behind in reading and math. Researchers at Stanford University estimated the virtual classroom has put many kids behind in their studies. In Illinois they found on average, students have lost more than a year in reading progress. Illinois students are about a year and a half behind in math as well. Like most kids, 6-year-old Persephone and 4-year-old Ezekiel are active and love to play. Sitting in front of a computer screen for school has been tough for them.
Britain asks regulator to assess Oxford/AstraZeneca COVID-19 vaccine
Britain on Friday asked its medicine regulator to assess Oxford University and AstraZeneca’s COVID-19 vaccine candidate for temporary supply, a step towards beginning a roll-out before the end of the year. AstraZeneca expects 4 million doses to be available in Britain by the end of next month, and health minister Hancock is targeting the roll-out to begin before Christmas. “We have formally asked the regulator to assess the Oxford/AstraZeneca vaccine, to understand the data and determine whether it meets rigorous safety standards,” Hancock said in a statement. “This letter is an important step towards deploying a vaccine as quickly as safely possible.”
Covid tiers: large parts of England in tier 3 restrictions after lockdown
Significant sections of England including much of the north and Midlands have been placed in the top tier of new coronavirus restrictions, the government has announced, potentially putting ministers on a collision course with Conservative MPs. Only three areas – Cornwall, the Isle of Wight and Isles of Scilly – are in the lowest level of the new rules, which come into force when the England-wide lockdown ends on 2 December and are intended to stay in force to the spring. This means that, by population, almost 99% of England will be in the top two tiers.
Pandemic weakening more in France than elsewhere in Europe, says PM
France has done a better job of flattening a second wave of COVID-19 infections that some of its European neighbours but it would be premature to talk about an end to the lockdown, Prime Minister Jean Castex said on Thursday. Castex said the 'R' rate that measures the spread was now at 0.65 countrywide, the same level France reached at the end of a three-month confinement in the spring, but that citizens must not lower their guard over the festive holidays.
French PM details plan to lift coronavirus lockdown
France aims to lift a nationwide lockdown on December 15, Prime Minister Castex said, with shops authorised to reopen as early as Saturday after weeks of closure.
No lockdown on weekends or border sealing: Minister
In Uttar Pradesh, State health minister Jai Pratap Singh ruled out night and weekend lockdowns or sealing of border areas in the state. Target and random sampling, he added, will continue in vulnerable areas. “There is no question of a night or weekend lockdown, or any steps towards sealing of borders. All rules of unlock will continue to apply. We will, however, continue with target sampling in designated areas, such as urban slums, jails, sweet shops, malls and (other) high-risk areas. Random testing at the borders will also continue,” Singh said.
Greece extends nationwide coronavirus lockdown by a week
Greece will extend its nationwide lockdown by a week until Dec. 7 as COVID-19 cases continue to surge across the country, a government spokesman said on Thursday. An increase in infections since October has forced the government to impose Greece’s second national shutdown since the pandemic began. The country has registered a total of 97,288 COVID-19 cases and 1,902 deaths during the pandemic, with northern Greece hardest hit and hospitals operating at almost full capacity.
Manchester, Birmingham and Bristol in 'very high' tier 3
Greater Manchester, Birmingham and Bristol will fall under “very high” Tier 3 restrictions when England’s national lockdown ends in six days’ time, the government has announced. It follows Boris Johnson’s announcement earlier this week that while nationwide restrictions will expire on 2 December, a tougher version of the regional tiered system will be re-introduced. Other areas that will be placed under the highest levels of coronavirus restrictions are vast areas of the north-east, including Middlesbrough, Darlington, Newcastle upon Tyne and County Durham.
Angela Merkel extends Germany’s Covid lockdown through Christmas
Germany’s national shutdown is likely to extend into New Year to dampen the coronavirus pandemic, Chancellor Angela Merkel has said. "Given the high number of infections, we assume that the restrictions which are in place before Christmas will continue to be valid until the start of January, certainly for most parts of Germany," Ms Merkel told parliament on Thursday. She added the increase in coronavirus cases was still much too high and the number of deaths a reason for concern. The country embarked on a so-called "wave-breaker" shutdown on November 2 - shutting restaurants, bars and, leisure facilities, but schools, hair salons and shops remained open.
Most of England to enter two toughest tiers when lockdown is lifted
The majority of England will enter the two toughest tiers of Covid restrictions from next week, ministers are set to announce, amid signs of a growing parliamentary rebellion and fears that the measures could remain unchanged until spring. On Thursday Matt Hancock, the health secretary, is expected to say that most of the country will be placed into tiers 2 or 3, which imply significant restrictions on hospitality, after the national lockdown ends on 2 December. As ministers grappled with the backlash, a further 696 coronavirus deaths were announced on Wednesday – the highest UK daily total since 5 May. Lockdown-sceptic Tory MPs have seized on a newly published forecast from the independent Office for Budget Responsibility (OBR), which assumes months more of struggle to get to grips with the virus.
Top US court blocks NY coronavirus limits on houses of worship
As coronavirus cases surge again nationwide, the United States Supreme Court has barred New York from enforcing certain limits on attendance at churches and synagogues in areas designated as hard hit by the virus. The justices split 5-4 for Wednesday’s vote, with new Justice Amy Coney Barrett in the majority. It was the conservative’s first publicly discernible vote as a justice. The court’s three liberal justices and Chief Justice John Roberts dissented.
Midwestern Governors Seek More Federal Covid-19 Aid for Businesses
A growing number of governors are calling for another round of coronavirus-relief legislation from Washington, saying they are unable to provide additional funds to small businesses amid budget shortfalls. The issue is gaining urgency as money from federal relief passed earlier this year runs out ahead of a year-end deadline to spend it. States have funneled hundreds of millions of dollars in federal aid into everything from personal-protective equipment and hazard pay for front-line health-care workers to schools and food banks.
Covid-19: Preparation for NI vaccination programme in December
Plans are under way to allow Northern Ireland's vaccination programme to begin next month, according to the Health Minister Robin Swann. Without regulatory approval any plans at this stage are provisional. According to the Department of Health, the vaccination programme will be on a phased basis, and will run well into 2021. Plans include a public information campaign to encourage take up among the public.
Lockdown tiers will mean hospitality ‘never recovers’
The hospitality industry has responded with fierce criticism of the new tier system, warning that it will wipe out billions of pounds of trading and lead to huge numbers of job losses.The new tier
Students may be compensated for lost teaching during UK lockdown
Students could be awarded financial compensation for lost teaching time during the Covid-19 lockdown after the higher education complaints watchdog told an institution to pay £1,000 to an international student. However, the National Union of Students (NUS) described the process for dealing with complaints about university disruption during the pandemic as “farcical” and “inadequate” as the Office of the Independent Adjudicator published details of a handful of individual cases. About 200 complaints have been submitted to the ombudsman so far. Many more are expected, as students can only take their case to the OIA if they have exhausted the internal complaints procedure at their own university. The NUS says the system must be simplified to speed up redress.
Germany Extends Strict Lockdown Measures With Eye Towards Reopening Ski Slopes
Germany is extending its current coronavirus lockdown measures through mid-December, Chancellor Angela Merkel announced this week. The country will remain under measures introduced in early November that include limits on private gatherings and it will keep bars, restaurants, and museums closed. Residents will be given some leeway around the Christmas holiday. Members of one household can meet up with 10 people between Dec. 23 to Jan. 1. Children under 14 are exempt. The overall restrictions are set to continue until Dec. 20, but it's expected, with the continued surge in infections, that these rules will stay in place until early January, Merkel said.
In Italy’s South, War Zone Doctors Are Called to the Rescue Amid Covid-19 Upsurge
Italy’s troubled south, which was largely spared earlier on in the pandemic, is now struggling to cope—so much so that the government is turning for help to a medical charity used to working in war zones. The Milan-based nongovernmental organization Emergency is best known for assisting war victims in countries such as Afghanistan, or Ebola patients in Sierra Leone. It has now agreed to help confront the crisis in Italy’s poorest region of Calabria, where the dysfunctional health care system is ill-equipped to deal with a viral outbreak.
London pubs to reopen if they serve food as capital placed in tier 2
Pubs in London will be allowed to open next week if they serve food, after the capital was placed in tier 2 of the new restrictions. The move will delight MPs and businesses in London – but is likely to kick off a political row as most cities in the North and Midlands face the harshest tier 3 curbs. Success in curbing Covid-19 infections in Liverpool means it will drop into tier 2, but Manchester faces the toughest restrictions after lockdown ends on 2 December – shutting pubs and restaurants except for takeaways.
UK pub operators report losses, job cuts as lockdown pain builds
British pub operators Mitchells & Butlers and Fuller, Smith & Turner said on Thursday they had cut around 1,650 jobs and suffered millions in financial losses as the hospitality industry reels from new lockdowns. The British Beer & Pub Association (BBPA) has warned of thousands, if not tens of thousands, of job losses if the government does not give pubs more freedom or grants to help them cover fixed costs in order to survive winter. M&B, which owns All Bar One, Harvester and Browns, said it had cut 1,300 jobs. Smaller rival Fuller’s said its total number of employees had been reduced by 20% following about 350 job cuts, the sale of its pizza chain The Stable and through natural attrition. The companies said they have enough resources to operate in the foreseeable future, but the downside scenarios cast doubts about their ability to continue as going concerns.
EasyJet says domestic bookings rise as England lockdown ends
British airline easyJet said domestic bookings for December had risen significantly this week compared to last week after news that some COVID-19 restrictions in its home market would be eased. England’s current lockdown bans most international travel, but when it ends on Dec. 2 people will be free to go abroad. Over Christmas, COVID-19 restrictions across the UK will be relaxed to allow families to mix for five days.
Cleaning up: COVID-19 vaccine will not derail disinfectants market, industry exec says
Vaccines against COVID-19 will take some steam out of the market for hygiene products, but demand will remain above pre-pandemic levels as frequent hand-cleaning is here to stay, an executive at Ecolab, a leading firm in the sector, said on Thursday.
CureVac ties up Wacker to churn out more than 100M doses of mRNA coronavirus vaccine
Riding a wave of interest in mRNA-based vaccines, Germany's CureVac is looking to rapidly drive manufacturing of its own shot candidate. After announcing a plan to bring more partners on board, CureVac has knotted the first of those deals to the tune of 100 million doses. CureVac has tagged German chemical company Wacker to churn out drug substance for its mRNA-based COVID-19 vaccine with the goal of adding 100 million doses per year to the biotech's stockpile, the partners said this week. Wacker will produce those doses at its Amsterdam facility starting in the first half of 2021, the companies said. The firm plans to "ramp up" its manufacturing capacity to meet that demand and is prepared to expand in the future to add more doses.
AstraZeneca will likely re-test its COVID-19 vaccine, CEO says after admitting an error in the first trial that led to skewed results
The UK pharmaceutical company AstraZeneca is likely to run a second global trial to assess its COVID-19 vaccine's efficacy, its CEO told Bloomberg News on Thursday. AstraZeneca and the University of Oxford announced Monday that preliminary results indicated their two-dose vaccine could be up to 90% effective at preventing COVID-19. But the team later said an error in the trial left some participants with half-doses instead of full doses. Experts said that error cast doubt on the validity of the efficacy rate and warranted further study.
Feds on COVID-19 mRNA vaccine distribution: Pfizer's dry runs predict a 'very doable process'
What will it take to distribute the first 6.4 million doses of Pfizer’s COVID-19 mRNA vaccine, if all goes according to plan and they ship in mid-December? Alex Azar, secretary of health and human services, acknowledged during a press conference Tuesday that the logistics—which include the need for ultra-cold storage—will be far from easy. But Azar and two other top officials running the government’s Operation Warp Speed effort to speed COVID-19 vaccine distribution did their best to boost the public’s confidence. The FDA has scheduled a meeting to review Pfizer’s vaccine on December 10, and if it’s authorized as expected, it could start shipping within 24 hours, Azar said. In addition to speeding the vaccine to healthcare workers, “CVS Health has said they expect to be vaccinating residents of nursing homes, one of the top priority groups, within 48 hours of FDA authorization,” he said.
Less than 10% of Americans had COVID by September, study finds
Large-scale seroprevalence studies conducted over the summer show that, through September, less than 1 in 10 of Americans had evidence of previous coronavirus infection, researchers from the Centers for Disease Control and Prevention (CDC) reported yesterday in JAMA Internal Medicine. In the nationwide seroprevalence survey, researchers from the CDC's COVID-19 Response Team tested blood serum samples from people in 50 states, the District of Columbia, and Puerto Rico during four periods from July through September, looking for the presence of detectable antibodies for SARS-CoV-2, (the virus that causes COVID-19.
Studies find no COVID benefit for preventive hydroxychloroquine or for convalescent plasma
Two studies published yesterday in the New England Journal of Medicine found that two once-promising but largely discredited COVID-19 treatments —hydroxychloroquine and convalescent plasma—didn't prevent infection or lead to clinical improvement. 'No compelling data' - The first study, an open-label trial led by researchers at Hospital Germans Trias i Pujol in Barcelona, Spain, involved randomly assigning clusters of healthy adults with high-risk, close-contact exposure to a COVID-19 patient to either 800 milligrams (mg) of hydroxychloroquine followed by 6 days of 400-mg doses or usual care.