Obamacare Helps Poorer Americans Spot Cancer Earlier: Study

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Obamacare Helps Poorer Americans Spot Cancer Earlier: Study

By Amy Norton
HealthDay Reporter

MONDAY, July 6, 2020 (HealthDay News)

Medicaid expansion under Obamacare may have decreased the number of poorer Americans diagnosed with advanced cancer, a new study suggests.

The study focused on Ohio, which was among the first states to expand its Medicaid program under the Affordable Care Act (ACA) in 2014.

The researchers found that in the three years after expansion, low-income residents saw a 15% drop in their odds of being diagnosed with metastatic cancer.

That refers to cancers that have spread from the original site to other parts of the body. While metastatic cancer can be treated, it is most often incurable, according to the U.S. National Cancer Institute.

Medicaid is the publicly funded insurance program for the poor. The new findings suggest that its expansion helped prevent some of those late diagnoses.

And it’s “quite likely” that better access to cancer screenings was one reason, said senior researcher Dr. Johnie Rose, of Case Western Reserve University School of Medicine in Cleveland.

“There also might have been a ‘hmm’ factor,” he said. That is, if more people were able to see a primary care doctor, that might have caught some red-flag symptoms that led to timelier cancer diagnoses.

Starting in 2014, the ACA allowed U.S. states to expand their Medicaid programs, making more poor residents eligible for coverage. It’s known that those expanded programs reduced the ranks of the uninsured — and, at least in some cases, improved access to health care.

More recently, studies have been linking expansion to clear health benefits — including declines in deaths from heart disease, stroke and opioid overdose.

The new study, published online July 6 in the journal Cancer, points to another benefit.

“I think for policymakers and for voters, this shows there’s a concrete, demonstrable, life-saving benefit from expanding access to care,” said Rose, an assistant professor at the Case Western Reserve Center for Community Health Integration.

For the study, his team analyzed information on nearly 12,800 Ohio residents, aged 30 to 64, who were diagnosed with breast, cervical, lung or colon cancer between 2011 and 2016. All either had Medicaid or were uninsured.

On average, the study found, people diagnosed after Medicaid expansion were 15% less likely to be diagnosed with metastatic cancer, versus those diagnosed before.

That does not prove Medicaid expansion directly led to the reduction. But, Rose said, there was no similar decrease in metastatic cancer among people who remained uninsured.

And to create a “control” group, the researchers did a separate analysis of privately insured people living in higher-income Ohio communities. Again, there was no change in the odds of being diagnosed with metastatic cancer after 2014.

A decline of 15% might not sound large. But in this context, Rose said, it is.

“Bringing it down that much in three years is really remarkable,” he said.

When it comes to catching cancer at earlier stages, “the gaps between the rich and the poor have been so stubborn for so long,” Rose said.

“This is a rare bit of progress,” he said.

It is a “major finding,” agreed Dr. Hala Borno, an oncologist and assistant clinical professor at the University of California, San Francisco.

Borno, who wrote an editorial published with the study, said the results are “compelling.” But she also pointed out that access to Medicaid — or health insurance in general — does not guarantee that people can afford needed care.

Health insurance, including some states’ Medicaid programs, can come with hefty “cost-sharing” — such as monthly premiums, deductibles and co-pays.

According to Borno, Ohio is one of only 21 states where Medicaid does not charge monthly premiums or enrollment fees. She said the current findings are relevant to those states where cost-sharing is not an issue, but that may not be true in other states.

Besides making sure all Americans have access to health care, Borno said, it’s critical to ensure they have comprehensive coverage.

“Coverage for all is when people can actually obtain the health services they need with necessary financial risk protection,” she said.

As of July 1, 38 states (including Washington, D.C.) have expanded their Medicaid programs under the ACA, according to the Kaiser Family Foundation.

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SOURCES: Johnie Rose, MD, PhD, assistant professor, Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, Ohio; Hala Borno, MD, assistant clinical professor, genitourinary oncology program, University of California, San Francisco; Cancer, July 6, 2020, online



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Company Gets $1.6 Billion From U.S. Government for Coronavirus Vaccine

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Company Gets $1.6 Billion From U.S. Government for Coronavirus Vaccine

TUESDAY, July 7, 2020 (HealthDay News) — Vaccine maker Novavax will receive $1.6 billion from the U.S. government to provide 100 million doses of a coronavirus vaccine by early 2021, the Maryland-based company said Monday.

This is the largest deal announced by the Trump administration to date as part of its attempts to provide coronavirus vaccines and treatments to Americans as soon as possible, The New York Times reported.

The $1.6 billion is coming from a “collaboration” between the Health and Human Services Department and the Defense Department, according to a Novavax spokeswoman.

In May, the Trump administration said it would give up to $1.2 billion to British drugmaker AstraZeneca, which has said it could have a vaccine available by October. Federal funding has also been given to four other companies — Moderna Therapeutics, Johnson & Johnson, Merck and Sanofi — for their experimental coronavirus vaccines, The Times reported.

Novavax has never brought a product to market, the Times reported.


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AHA News: Months After Infection, Many COVID-19 Patients Can’t Shake Illness

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AHA News: Months After Infection, Many COVID-19 Patients Can’t Shake Illness

MONDAY, July 6, 2020 (American Heart Association News)

It was a Tuesday in late March when Julia Henry first felt the body aches and dry cough that signaled the start of her bout with COVID-19. By that weekend, her husband and three children also were sick. But the kids were fine less than a week later, her husband within two weeks.

“My husband just woke up one day starting to feel back to normal, and I kept waiting for that day when I would have that feeling. But I never did. I never did,” said Henry, a 40-year-old physical therapist from New Hampshire.

“For more than two months, I couldn’t do much of anything,” she said. “Now after three months, I’m finally starting to be able to do some normal, everyday things, like play with my kids or cook dinner for my family.”

As of early July 6, there have been nearly 2.9 million confirmed cases of COVID-19 in the United States, according to Johns Hopkins University’s oft-used tracker. Of those, 906,763 – about 31% – are listed as “recovered.” But recovery isn’t the same for everyone. The World Health Organization reports the median time for recovery is up to two weeks for those with mild cases, while those with more severe cases can take up to six weeks for symptoms to resolve.

Some people, however, say they continue to experience symptoms months after infection. In doctor visits and on social media groups, a growing number of patients report lingering symptoms ranging from mild issues, such as continued loss of taste or smell, to more serious ones, such as heart palpitations, chest pain, shortness of breath, extreme fatigue, cognitive difficulties or recurring fevers. Whether these symptoms eventually resolve or whether they signal permanent damage from the virus remains unknown.

“It has been just six months since the virus was detected in China, so nobody can tell you for sure if these are short-term or long-term complications,” said Dr. Samer Kottiech, a cardiologist in New York City who estimates 90% of his patients who come in after COVID-19 infections experience prolonged symptoms.

Kottiech, who was himself infected in March, said he hasn’t fully recovered either.

“The biggest problem is that my lung capacity is still a little bit decreased,” he said. “I used to be very active. Now I don’t feel like I can exercise like I used to.”

With little data to go on, it is too soon to draw conclusions about what’s happening to those with lingering issues, said Dr. Avindra Nath, head of clinical neurology at the National Institutes of Health’s Institute for Neurological Disorders and Stroke.

He believes several things could be occurring: the patient could have an underlying condition, such as heart disease or diabetes, which they didn’t know was there prior to infection; the virus, or the body’s immune system response to it, could be causing new damage; or, the patient may be experiencing something called post-viral fatigue syndrome, a condition reported in some patients infected with other coronaviruses, such as SARS and MERS.

“What we know from these other viral infections is that they can cause problems that last for years,” Nath said.

Nath is preparing to enroll patients in a study that will investigate what’s going on in the immune systems of people who don’t fully recover from COVID-19.

“There is some abnormality in the immune system that’s doing it,” he said. “We want to find out what those abnormalities are. Once you figure that out, you can potentially treat them.”

Unlike trying to unravel what’s happened to the immune systems of patients who have felt ill for years, Nath said, “we now have an excellent opportunity, because we know what these patients had and exactly when they had it. It is early enough in the course of this illness that we can learn a lot about how and why these symptoms are occurring, which could have broad implications for all people with post-viral syndrome.”

However, people with lingering COVID-19 symptoms shouldn’t assume they’ll stay ill for years, Nath said. “I want to reassure people there is still time for them to get better. Even if they are only gradually improving, if they are getting better at all, they will probably continue to do so.”

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American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved.

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As REM Sleep Declines, Life Span Suffers

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As REM Sleep Declines, Life Span Suffers

By Steven Reinberg
HealthDay Reporter

TUESDAY, July 7, 2020 (HealthDay News) — Deep sleep is essential for good health, and too little of it may shorten your life, a new study suggests.

REM (rapid eye movement) sleep is when dreams occur and the body repairs itself from the ravages of the day. For every 5% reduction in REM sleep, mortality rates increase 13% to 17% among older and middle-aged adults, researchers report.

“Numerous studies have linked insufficient sleep with significant health consequences. Yet, many people ignore the signs of sleep problems or don’t allow enough time to get adequate sleep,” said lead researcher Eileen Leary. She is a senior manager of clinical research at Stanford University in Palo Alto, Calif.

“In our busy, fast-paced lives, sleep can feel like a time-consuming nuisance. This study found in two independent cohorts that lower levels of REM sleep was associated with higher rates of mortality,” she said.

How REM sleep is associated with risk of death isn’t known, Leary said. Also, this study couldn’t prove that poor REM causes death, only that it’s associated with an increased risk of dying early.

“The function of REM is still not well understood, but knowing that less REM is linked to higher mortality rates adds a piece to the puzzle,” she said.

It’s still too early to make recommendations about improving REM sleep based on this study, Leary said.

“As we learn more about the relationship, we can begin looking at ways to optimize REM. But that is outside the scope of this project,” she said.

For the study, Leary and her colleagues included more than 2,600 men, average age 76, who were followed for a median of 12 years. They also collected data on nearly 1,400 men and women, average age 52, who were part of another study and were followed for a median of 21 years.

Poor REM sleep was tied to early death from any cause as well as death from cardiovascular and other diseases, the researchers found.

REM sleep’s links to mortality were similar in both groups.

“REM sleep appears to be a reliable predictor of mortality and may have other predictive health values,” Leary said. “Strategies to preserve REM may influence clinical therapies and reduce mortality risk, particularly for adults with less than 15% of REM sleep.”

Previous studies have focused on total sleep time and have shown that both not enough total sleep and too much total sleep can be associated with increased risk of dying early, said Dr. Michael Jaffee, an associate professor of neurology at the University of Florida in Gainesville.

“When we sleep, we go through different stages to include REM sleep. REM describes our eye movements during this stage and is also the state associated with when we have dreams,” he said.

This study shows that it is not just total sleep time that may be important, but assuring the right balance of the different stages of sleep, said Jaffee, who co-authored an editorial that accompanied the study.

Neurologists need to look for conditions affecting patients, such as obstructive sleep apnea, that can reduce REM, and doctors should also be aware that certain medications they prescribe can reduce REM, he said.

The study also opens up additional avenues for research to determine if scientists should focus on treatments that affect not just total sleep but target sleep stage balance, Jaffee said.

“This study shows yet another reason for the importance of proper sleep time — recommendations for adults is seven hours — and a good balance of sleep stages by assuring that any possible conditions, such as obstructive sleep apnea, that can cause a reduction in REM be evaluated and managed,” he said.

“Anyone with difficulty with sleeping or with loud snoring can benefit from discussing this with their physician,” Jaffee added.

The report was published online July 6 in JAMA Neurology.

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SOURCES: Eileen Leary, Ph.D., senior manager, clinical research, Stanford University, Palo Alto, Calif.; Michael Jaffee, M.D., associate professor, neurology, University of Florida, Gainesville; JAMA Neurology, July 6, 2020, online



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U.S. Coronavirus Cases Near 3 Million as Sun Belt Hospitals Reach Capacity – MedicineNet Health News

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U.S. Coronavirus Cases Near 3 Million as Sun Belt Hospitals Reach Capacity – MedicineNet Health News

By Robin Foster and E.J. Mundell
HealthDay Reporters

TUESDAY, July 7, 2020

With the number of coronavirus cases in the United States approaching 3 million on Monday, hospitals across the Sun Belt continued to be flooded with COVID-19 patients.

Arizona reached 89 percent capacity for ICU beds, as Alabama, California, Georgia, North Carolina, South Carolina and Texas also reported unprecedented numbers of hospitalizations, the Washington Post reported.

For the 28th day in a row, the country’s rolling seven-day average of daily new cases obliterated previous records, though the number of deaths nationwide has remained relatively stable, the newspaper reported.

Testing centers across the country are now being stretched to their limits, according to the Post. In many cities, a combination of factors are fueling the problem: a shortage of key supplies, backlogs at laboratories that perform the tests, and surging infection counts as cases climb in almost 40 states.

Forget any talk about a second wave of COVID-19 infections, because America is “still knee deep in the first wave,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Monday, the Post reported. Unlike Europe, “we never came down to baseline and now are surging back up,” he explained.

Other public health experts have issued similar warnings.

“We’re right back where we were at the peak of the epidemic during the New York outbreak,” former U.S. Food and Drug Administration commissioner Scott Gottlieb said Sunday on the CBS show, “Face the Nation,” the Post reported. “The difference now is that we really had one epicenter of spread when New York was going through its hardship, now we really have four major epicenters of spread: Los Angeles, cities in Texas, cities in Florida, and Arizona. And Florida looks to be in the worst shape.”

On Monday, new coronavirus cases in that state exceeded 6,300, NBC Miami reported. That is a drop from the 10,000 new cases a day the state has experienced multiple times in recent weeks, the Post reported.

Florida’s total caseload passed 206,400, a grim milestone only reached so far by three other states — New York, California and Texas — the New York Times reported.

Meanwhile, the virus appears to be spreading wildly in Arizona, as hospitals rushed to expand capacity and adopted practices similar to those employed at the height of the outbreak in New York City and Italy, the Post reported. Those measures include doubling up hospital beds in rooms, pausing elective surgeries and bringing in health-care workers from other states.

So far, coronavirus death counts have not matched the spikes in new infections, however.

“What we’re able to do is when people do get hospitalized and get into the ICU, we’re able to save more lives with treatments like remdesivir, with steroids now, which has a big impact on mortality, and innovations in care like using blood thinners on patients and not intubating them as aggressively,” Gottlieb explained.

As cases skyrocket, ‘pooled’ testing strategy tried

Case counts could get even worse.

The nation’s top infectious disease expert warned that daily case counts could soon top 100,000 a day if the spread of COVID-19 isn’t slowed.

“I can’t make an accurate prediction, but it is going to be very disturbing, I will guarantee you that, because when you have an outbreak in one part of the country, even though in other parts of the country they are doing well, they are vulnerable,” Dr. Anthony Fauci said during a Senate committee hearing last week.

“We’ve really got to do something about that, and we need to do it quickly,” Fauci testified during questioning from Sen. Elizabeth Warren (D-Mass.).

One new strategy that U.S. health officials plan to adopt is “pooled” coronavirus testing, the Times reported. The decades-old method would vastly increase the number of virus tests performed in the United States.

Instead of carefully rationing tests to only those with symptoms, pooled testing would allow frequent surveillance of asymptomatic people, the newspaper reported. Mass identification of coronavirus infections could hasten the reopening of schools, offices and factories.

With pooled testing, nasal or saliva swabs are taken from large groups of people. Setting aside part of each individual’s sample, a lab then combines the rest into a batch holding five to 10 samples each. If a pooled sample yields a positive result, the lab would retest the reserved parts of each individual sample that went into the pool, pinpointing the infected person, according to the Times.

“We’re in intensive discussions about how we’re going to do it,” Fauci told the Times. “We hope to get this off the ground as soon as possible.”

A handful of states have actually brought the virus under control after being slammed in the early stages of the pandemic. Determined to keep case counts low, New York, Connecticut and New Jersey have said they will now mandate quarantines for travelers coming from states that are experiencing large spikes in new cases, the Times said.

By Tuesday, the U.S. coronavirus case count neared 3 million as the death toll passed 130,000, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Tuesday were: New York with over 402,000; California with over 277,800; Texas with more than 209, 000; Florida with over 206,000; and New Jersey with more than 175,400.

Vaccines and treatments

There has been some good news in recent weeks, however. Researchers at Oxford University in England announced that dexamethasone, a widely used, low-cost steroid, appears to cut the death rate for ventilated COVID-19 patients by one-third. It also lowered the death rate for patients who require oxygen (but are not yet on a ventilator) by one-fifth, the Times reported.

“Bottom line is, good news,” Fauci, who directs the U.S. National Institute of Allergy and Infectious Diseases, told the Associated Press. “This is a significant improvement in the available therapeutic options that we have.”

But at least three manufacturers of the drug have reported shortages, according to the American Society of Health-System Pharmacists, STAT News reported. Two of the manufacturers cited increased demand as a reason for their shortages.

Meanwhile, the search for an effective vaccine continues.

The federal government will pay Novavax $1.6 billion to speed development of 100 million doses of a coronavirus vaccine by the beginning of next year, the Times reported.

The deal is the largest that the Trump administration has made so far with a company as part of Operation Warp Speed, a federal effort to make coronavirus vaccines and treatments available to the American public as quickly as possible, the Times said.

The U.S. Department of Health and Human Services (HHS) had already said that it would provide up to $1.2 billion to the drug company AstraZeneca to develop a potential coronavirus vaccine from Oxford University, in England.

That research agreement funds a clinical trial of the potential vaccine in the United States this summer with about 30,000 volunteers, the Times reported.

The goal? To make at least 300 million doses that could be available as early as October, the HHS said in a statement.

The United States has already agreed to provide up to $483 million to the biotech company Moderna and $500 million to Johnson & Johnson for their vaccine efforts. It is also providing $30 million to a virus vaccine effort led by the French company Sanofi, the Times reported. Moderna said a large clinical trial of its vaccine candidate could begin in July.

Nations grapple with pandemic

Elsewhere in the world, the situation remains challenging.

Even as the pandemic is easing in Europe and some parts of Asia, it is worsening in India. As officials in New Delhi worked to test all of the city’s 29 million residents, the number of coronavirus cases passed 719,600 on Tuesday, making it the country with the third-highest number of COVID-19 cases and pushing many hospitals to their breaking point, the Times reported.

Brazil has also become a hotspot in the coronavirus pandemic, with well over 1.6 million confirmed infections by Tuesday, according to the Hopkins tally. It has the second-highest number of cases, behind only the United States.

Cases are also spiking wildly in Russia: As of Tuesday, that country reported the world’s fourth-highest number of COVID-19 cases, at nearly 693,000, the Hopkins tally showed.

Worldwide, the number of reported infections passed 11.4 million on Tuesday, with nearly 538,000 deaths, according to the Hopkins tally.

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Working Off Your Quarantine Weight Gain

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Working Off Your Quarantine Weight Gain

Latest Diet & Weight Management News

TUESDAY, July 7, 2020 (HealthDay News)

Life in lockdown has led many to overeat and gain weight, a phenomenon referred to as the “COVID-15.”

But some small changes can get you back into shape, a weight management specialist suggests.

“COVID-19 changed how we eat, what we eat and how we spend our day,” said Dr. Peter Jian, an assistant professor of family and community medicine at the Baylor College of Medicine in Houston.

“Unfortunately, for some of us that meant less healthy choices,” Jian added in a Baylor news release.

Jian offered these tips for working off the excess pounds and returning to a healthy lifestyle:

  • Learn how to cook. Or start other new hobbies to keep active. “Use this time as an opportunity to focus on the things that we can do in order to improve our health,” Jian said.
  • Stay physically active. If you’re afraid to go to the gym, try biking, hiking and walking outside. You can also join an online fitness program.
  • Eat a healthy diet. Buy nutritious foods with curbside pickup or delivery. If you shop in person, choose foods placed at the front and side aisles, where the fresh and organic produce is available. Avoid prepackaged and processed foods.
  • To lose weight, start small. Gradually introduce new eating and exercise habits. This makes changes easier to adjust to.
  • Stay clear of fad diets. Many of these programs aren’t backed by science and could be harmful. If you have difficulty losing weight, see your doctor.

“It’s a very challenging time. But I think the best we can do is focus on the positives and focus on the things that we can control, and the things that we can do positively influence our own health,” Jian said.

— Steven Reinberg

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SOURCE: Baylor College of Medicine, news release, July 1, 2020



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Humans will have to ‘wait decades’ to see the effects of emissions cuts

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Humans will have to ‘wait decades’ to see the effects of emissions cuts


Britain has been trying to curb emissions and has not used coal-fired plants for the whole of May 2020 (Picture: Rex)

Humans may need to ‘wait for decades’ to see the results of large emission cuts on global surface temperatures, scientists have said.

Researchers in Norway used computer simulations to analyse various scenarios that looked at the effects of rapid reductions in several types of greenhouse gas emissions, such as carbon dioxide (CO2), methane and black carbon.

They found that although large-scale emission cuts are needed to achieve the global climate goals, it may take decades before the effects of the reductions on temperatures can be measured.

The researchers estimated that even for the most optimistic scenarios, it will take at least 15 years to establish the impact of emission cuts on global warming.

Bjorn H Samset, of the Centre for International Climate and Environmental Research (Cicero) in Oslo, who is one of the authors of the study published in the journal Nature Communications, said: ‘Human-induced climate change can be compared with a tank ship at high speed and in big waves.

‘If you want the ship to slow down, you will put the engine in reverse, but it will take some time before you start noticing that the ship is moving more slowly.

‘It will also rock back and forth because of the waves.’

The Earth’s surface temperature has, on average, risen by 0.2C every 10 years over the last five decades.


The Earth's surface temperature has, on average, risen by 0.2C every 10 years over the last five decades. (Nasa)
The Earth’s surface temperature has, on average, risen by 0.2C every 10 years over the last five decades. (Nasa)

Climate experts have attributed this rise in temperatures to human-induced emissions of greenhouse gases.

Mr Samset said: ‘If we are to reach the Paris Agreement ambition of limiting global warming to no more than 2C – or less – the first step will be to slow down the warming process.’

Looking at various hypothetical emission reduction scenarios, the researchers found CO2 and methane to have the biggest impact on global warming.

Study author Jan S Fuglestvedt, also of Cicero, said: ‘If these emissions are reduced very strongly, we will see the effect quickly.

‘But if reductions follow more realistic pathways, it will unfortunately take longer.’

The team also analysed what would happen if air pollutant emissions such as sulphur dioxide (SO2) were reduced significantly and found that unlike soot, methane and CO2, cutting SO2 emissions would in fact speed up global warming.


Smoke billows from a large steel plant as a Chinese labourer works at an unauthorized steel factory in Inner Mongolia. (Photo by Kevin Frayer/Getty Images)
Smoke billows from a large steel plant as a Chinese labourer works at an unauthorized steel factory in Inner Mongolia. (Photo by Kevin Frayer/Getty Images)

Cicero’s Marianne T Lund, who is also one of the authors on the study, said: ‘SO2 turns into sulphate particles in the atmosphere, and they have a cooling effect because they reflect sunlight.’

Commenting on the research, Tim Palmer, Royal Society research professor at the University of Oxford, who was not involved in the study, said: ‘Fundamentally, these are not new results: just as we knew that it takes some time for the climate-change signal to emerge from the noise on the way up, we knew that it will take some time for a reduced climate change signal to emerge from the noise on the way down.

‘However, the authors have done an extensive investigation of this effect and, thus, we have a better quantification of the effect than we previously had.’



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Secretary Railways reveals 70 percent of the rail system outdated

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Secretary Railways reveals 70 percent of the rail system outdated

ISLAMABAD               -          The Secretary of the Ministry of Railways Habib ur Rehman Gillani on Tuesday informed the sub-committee of the Public Accounts Committee that 70 percent of railways system was outdated, and has been since 20 years.

While briefing the members of the sub-committee of PAC, which was chaired by PTI-MNA Riaz Fatyana, the Secretary of Railways said that due to the lack of forward planning the railways, which is one of the important departments of the country. has failed to make any visible progress.

He further informed the sub-committee that in order to improve the current situation of railways, the Prime Minister Imran Khan following their request has approved many important posts including; a Business planning expert and a Technical expert which will help them pull the railways out of such a crisis.

He also said that the track condition of Pakistan Railways was very bad as despite the fact that almost 30 thousands workers have been working on repairing it, the condition still is not good. The reason for it was that the track was getting less than 10 percent of the budget for repairing.

Secretary Railways further informed the committee that the maintenance of the railway track was the responsibility of the government and due to the frequent negligence the track will soon be of no use.

Meanwhile, the convener of the committee, MNA Riaz Fatyana, directed the railways officials to start work on the downsizing within the Railways which will help to release the financial burden from the department.

He further directed the railways officials to form a strategy to improve the track of the railways for the locomotives as this sector of the department has been greatly neglected since decades.

He maintained that the department should also focus on the branch lines rather than to waste all the energy of the single route from Karachi to Peshawar.

He further said that railways was one of the departments that has more land assets than any other; suggesting that the railway should have a plan of planting trees around the track which will help the railway department to increase its revenue after some years.

On the occasion the ruling party MNA Munaza Hassan raised a question about whether there was a schedule department in the railways for maintaining a check and balance on the movements of the locomotives or not.

In his reply to the question Secretary Railways said that they were going to formulate a plan to introduce a digital system in the railway department which will help them to keep an eye on the movement of the locomotives and also will help them to get information about the numbers of the passengers in train.

He further elaborated that due to the lack of digital systems in the railway department they have not been able to get the feedback of the passengers regarding the services of the railway department.

At the end the official of the Audit department raised reservations over the performance of the railways and said that the railways in all the three main sectors including HR assets, Financial assets, and Physical assets has so far no planning which was of the reasons of its current crisis.



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In Numbers: Impact of New Immigration Guidelines on Nearly 11 lakh International Students Enrolled In US

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In Numbers: Impact of New Immigration Guidelines on Nearly 11 lakh International Students Enrolled In US

Students walk near the Widener Library in Harvard Yard at Harvard University in Cambridge. The Ivy League school announced Monday, July 6, 2020, that as the coronavirus pandemic continues its freshman class will be invited to live on campus this fall, while most other undergraduates will be required learn remotely from home. (AP Photo/Charles Krupa, File)

Students already in the US who are enrolled in such programs must depart the country or take other measures, such as transferring to a school with in-person instruction to remain in lawful status.

With uncertainties looming large over how the upcoming academic year will pan out amid the pandemic, the United States on Monday announced that international students would have to leave the country or transfer to another school/college if their schools were to offer only online classes this fall.

“The US Department of State will not issue visas to students enrolled in schools and/or programs that are fully online for the fall semester nor will U.S. Customs and Border Protection permit these students to enter the United States,” the Department of Immigration and Customs Enforcement (ICE) said.

Students already in the US who are enrolled in such programs must depart the country or take other measures, such as transferring to a school with in-person instruction to remain in lawful status. If not, they may face immigration consequences including, but not limited to, the initiation of removal proceedings, it added.

Meanwhile, the fresh guidelines stated that students who are enrolled in schools holding normal in-person classes are allowed to stay but they can only take a maximum of one class or three credit hours online.

Nearly 11 lakh international students are in the US as of 2018-19 – making up for roughly 5.5 per cent of the total enrollment in higher education institutes across the country- the Open Doors report 2019.

Of these, 8,72,214 international students were enrolled in universities while the remaining were on Optional Practical Training (OPT). Status of international students currently in the US on OPT would remain unaffected only ‘if they make normal progress’.

China and India account for 52.1 per cent of all the international students in the US. India is the second-highest source of foreign students in the US after China and had over 2 lakh students in the country as of 2018-19. India students in the US account for over 18 per cent of the total.

Of these, over 1.17 lakh Indian students were enrolled in US universities while the remaining were on OPT. Though the figure may have increased this year, the difference may not be too wide given the annual trend on enrollments.

Any of these students currently enrolled in programs that are likely to be taught online this fall will have to return home unless they transfer to a school ‘with in-person instruction to remain in lawful status.’

Meanwhile, the students who are enrolled in schools planning to operate under a hybrid system (a mix of in-person and online classes) in the fall, will be allowed to remain in the country and take more than one class or three credit hours online provided that their school certifies- “the program is not entirely online and the student is taking the minimum number of online classes required to make normal progress in their degree program.”

These exemptions won’t apply to F-1 students in English language training programs or M-1 students, who are not permitted to enrol in any online courses.

However, if a school changes its operational stance mid-semester, and as a result, a non-immigrant student switches to only online classes or changes their course selections, ending up in an online course load, the foreign student will have to leave the country as per the protocol. These guidelines will affect the newly admitted students as well who are supposed to begin programs this fall.

Nearly 2.7 lakh students had enrolled in the US in 2018-19. This figure has remained over 2 lakh since 2008-09 and even touched 3 lakh in 2015-16.

Even as US embassies and consulates remain shut in most countries, international students enrolled in programs which will only be instructed online in the fall and will not get a visa even when the embassies return to normal operations.

And even if a student gets a visa and arrives on campus for a hybrid program, they will have to leave the country if their program becomes entirely online in the middle of the semester.


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Sunak to unveil ‘kickstart jobs scheme’ for 16-24s

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Sunak to unveil ‘kickstart jobs scheme’ for 16-24s

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The chancellor will present the plans to Parliament on Wednesday

Chancellor Rishi Sunak will announce a £2bn “kickstart scheme” later to create more jobs for young people.

The fund will subsidise six-month work placements for people on Universal Credit aged between 16 and 24, who are at risk of long-term unemployment.

Labour welcomed the move, but said the government had failed to “rise to the scale of the unemployment crisis”.

Mr Sunak is also expected to announce a temporary stamp duty holiday to stimulate the property market.

This would exempt the first £500,000 of all property sales from the tax.

BBC Newsnight’s political editor Nicholas Watt said the chancellor may also introduce a temporary VAT cut to help the hospitality sector, which has been hit hard in the pandemic.

The chancellor’s statement is expected at 12:30 BST (11:30 GMT), after Boris Johnson faces Sir Keir Starmer at Prime Minister’s Questions.

It will include the jobs pledge alongside a £3bn “green” fund and boosts for apprenticeships.

In the wake of the prime minister’s “new deal” to build after the coronavirus outbreak unveiled last week, Mr Sunak promised he would deliver the economic update to tackle increasing fears of mass unemployment, particularly among young people.

The Treasury said the “kickstart scheme” would be part of a “three-point plan for jobs… to help Britain bounce back from coronavirus”.

Hundreds of thousands of “new, high-quality” subsidised jobs will be created, the government said.

The CBI praised the scheme as “a much-needed down payment in young people’s futures” and unions said it was “a good first step”.

The chancellor has already outlined a number of other measures in the build-up to his statement, including:

For each “kickstarter” job, the government will cover the cost of 25 hours’ work a week at the National Minimum Wage – £4.55 for under 18s, £6.45 for 18 to 20-year-olds, and £8.20 for 21 to 24-year-olds.

Employers will be able to top up that payment if they wish.

The government said it would allow young people “the opportunity to build their skills in the workplace, and to gain experience that will improve their chances of going on to find long-term sustainable work”.

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Industries employing many young people, such as hospitality, have been hit hard during the pandemic

The scheme will open for applications in August, with the first jobs expected to start in the autumn, and run until December 2021 – with the option of being extended.

It will cover England, Scotland and Wales, and the government said it would provide additional funding to Northern Ireland for a similar scheme.

But Scotland, Wales and Northern Ireland are also calling for fiscal rules to be relaxed to allow them to borrow more and spend unused capital funding to address the “monumental challenges” of the economy.

‘The focus will be on jobs, jobs, jobs’

The government is looking now to the second phase of the crisis, when the worst stage of the health aspect has passed and they hope the economic recovery can begin.

But job losses have begun, with barely a day going by without an announcement from a household name they are shedding staff.

The reality is many of those who have been paid by the Treasury will find their job doesn’t return.

The focus of the chancellor’s statement, therefore, will be “jobs, jobs, jobs”, insiders say.

There will certainly be a long list of proposals from the Treasury.

It’s not a small matter to do something like cut stamp duty, cut VAT in some sectors, accelerate infrastructure spending, or provide £2bn to subsidise jobs for young people.

But they are certainly much more orthodox actions than the kind of drastic steps the Treasury took at the start of this crisis.

Read more analysis from Laura Kuenssberg here.

The chancellor has previously acknowledged young people could be the worst-affected by the crisis when it comes to employment, as they are the age group most likely to be on the government’s furlough scheme – which is set to end in October.

Already, between the start of lockdown in March and May, the number of people aged 24 and under claiming Universal Credit rose by 250,000 to almost 500,000.

In the Commons on Wednesday, Mr Sunak is expected to say: “We also know that youth unemployment has a long-term impact on jobs and wages and we don’t want to see that happen to this generation.”

Labour’s shadow chancellor, Anneliese Dodds, said the scheme “should help many young people to access work” but said the government had not yet done enough to address the threat of mass unemployment.

She called on it to extend the furlough and self-employed schemes, and create “tailored support” for older people or those living in hard-hit areas.

The acting Liberal Democrat leader Sir Ed Davey told BBC Radio 4’s Today programme that the chancellor was right to be helping young people but the “scale of support is just not good enough”.

The director-general of the CBI, Dame Carolyn Fairbairn, said the announcement could see the government “lessening the potential scarring impact of the pandemic for the next generation”.

But she said businesses and the government needed to “work to deliver the kickstarter scheme simply and at speed”, adding: “There can be no time lost in preparing young people who are entering one of the toughest jobs markets we’ve seen in decades.”

Need ‘proper training’

Paul Johnson, director of the Institute for Fiscal Studies, said the scheme would “encourage employers to take on those most at risk” during this crisis but it could result in “creating jobs which aren’t really jobs” or push other people out of work.

Frances O’Grady, general secretary of the Trades Union Congress, welcomed the support for young people but said unions would be “checking the small print to ensure every job provides proper training and a bridge to steady employment”.

The national chairman of the Federation of Small Businesses, Mike Cherry, appealed to the government to ensure smaller firms could benefit from the scheme, adding: “Small businesses must not be left waiting in line behind big corporates when they could get people to work now.”

Are you aged between 16-24 and on Universal Credit? Do you think this placement scheme would help you? Email your thoughts to.

Please include a contact number if you are willing to speak to a BBC journalist.



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