Tag Archives: Coronavirus (COVID-19)

COVID Travel Advisory :: Travelers to New York from all but these 31 countries must be quarantined, Gov. Andrew Cuomo announces | Instant News



NEW YORK (WABC) – Gov. Andrew Cuomo has announced that international travelers from countries considered Level 2 and 3 will be required to self-quarantine and complete a travel form upon arrival in New York. Cuomo has signed the executive order Monday in response. to CDC decision to cancel airport screening measures amid rising COVID-19 cases around the world Health officials say measure is needed for contact tracing purposes . Coronavirus Update: List of States Added to Tri-State Travel Advice Quarantine List “CDC’s decision to end enhanced screening at airports, associated with alarming increase in cases in countries around the world entire, poses an increased threat to New York’s progress in the war against COVID -19, ”Governor Cuomo said. “Today’s decree will require the Department of Health to alert all travelers from any level 2 or 3 country of mandatory quarantine requirements, and will require international travelers to complete the Travel Health Form of DOH to assist the state in its contact tracing efforts and further prevent the spread of COVID-19. “The decree builds on the COVID-19 national travel advisory already in place for states that have a significant degree of community spread of the coronavirus. The 31 countries not subject to the governor’s decree and the mandatory quarantine requirement are listed below: American SamoaAnguillaBonaireBruneiCambodiaCayman IslandsDominiqueFalkland IslandsFijiGuernseyGroenlandGrenadaIsle of ManLaosMacau SARMarshall IslandsMauritiusMicronesiaMontserratNew CaledoniaNew ZealandPalau -Saba -Saba-test-positive on a 10 000-day or more Saint-Kitemy area with an average of 10 000 people arriving from Saint-Saint-Kitemy to a 100-day Saint-Saint-Barthy New Zealand arrives at an average of 10 000 people with a Saint-Saint-Barths test at New Zealand area with a positivity rate of 10 percent or more on a 7-day moving average. ALSO READ | Exclusive: Renters living in a Manhattan hotel alongside homeless men say they ‘feel trapped’ . It overwhelmed the health care sector, put millions of people out of work, drowned social services in an ocean of need and has threatened the food supply Americans have long taken for granted. In the height of the crisis and for the weeks that followed, no part of life, or even what followed, was spared.RELATED: New York, New Jersey, Connecticut Out-of-State Travelers Quarantine List Educational InformationHow the Coronavirus Changed the New York City AreaDo you have symptoms of coronavirus? What is open, what is closed in the tri-state area? COVID-19 Help, Information. Stimulus and Business Updates UPDATES New York CityNew JerseyLong IslandWestchester and Hudson ValleyConnecticut abc7NY Phase Tracker: Copyright © 2020 WABC-TV. All rights reserved. .



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Swiss studies show how important time is in responding to COVID-19 | Instant News


A new study published on preprinted servers medRxiv* in July 2020 revealed the important nature of time as a factor in controlling mortality rates in the current COVID-19 pandemic. The background of this paper is the outbreak in Switzerland, where around 30,000 people were infected with acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and more than 1,800 died from late February to early May 2020. This study shows that the introduction of NPI in March 2020 prevents thousands of virus-related deaths in Switzerland.

Study: Time is crucial: containment of the SARS-CoV-2 epidemic in Switzerland from February to May 2020. Image credit: Roger Gantner / Shutterstock

Plague Course in Switzerland

The first case in this country came from a region adjacent to the area affected by Italy, but the disease quickly spread to the small country. In response to the outbreak, a series of non-pharmaceutical interventions (NPI) were quickly introduced, including the closure of elementary schools, shops selling non-essential items, and restaurants, and limiting the gathering of more than five people on March 20, 2020.

The epidemic showed a decline after the introduction of these measures in March. On May 10, 2020, restrictions were lifted. The paper by researchers at the University of Bern aims to show how the timing of NPI implementation affects the course of the epidemic and its results.

New model number of infections, hospitalized patients, intensive care unit (ICU) occupancy, and deaths during the SARS-CoV-2 epidemic in Switzerland.  Solid lines show the maximum likelihood estimates of the model and shaded area according to the 95% prediction interval.  The model fits the data shown as white circles.  The number of reported infections (gray box) is shown for comparison.  The vertical dashed line shows the strengthening of social distance on March 17, 2020.

New model number of infections, hospitalized patients, intensive care unit (ICU) occupancy, and deaths during the SARS-CoV-2 epidemic in Switzerland. Solid lines show the maximum likelihood estimates of the model and shaded area according to the 95% prediction interval. The model fits the data shown as white circles. The number of reported infections (gray box) is shown for comparison. The vertical dashed line shows the strengthening of social distance on March 17, 2020.

Potential Effects of Previous or Next NPI

The researchers used modeling to estimate the effects of various scenarios on the Swiss epidemic. That is, if the NPI has been applied a week before or a week later, how has the incidence of infection, the number of cases treated at the hospital, and mortality, changed?

This study is based on a population-based transmission model and includes a gradual introduction of the NPI. Previous studies have shown that this causes a sharp reduction in the amount of effective reproduction (Re) in Switzerland.

Reduction of effective reproduction number of Re during the SARS-CoV-2 epidemic in Switzerland.  Solid lines show the maximum likelihood estimates of the model and shaded area according to the 95% compatibility interval.  We assume that the introduction of NPI sequentially results in a reduction in sigmoid transmission rates for about 2 weeks.  The vertical dashed line shows the strengthening of social distance on March 17, 2020.

Reduction of effective reproduction number of Re during the SARS-CoV-2 epidemic in Switzerland. Solid lines show the maximum likelihood estimates of the model and shaded area according to the 95% compatibility interval. We assume that the introduction of NPI sequentially results in a reduction in sigmoid transmission rates for about 2 weeks. The vertical dashed line shows the strengthening of social distance on March 17, 2020.

Using public data about the daily number of confirmed cases, hospitalization, admission to the intensive care unit (ICU), and virus-related deaths, the researchers found that initially, infections rose exponentially.

The researchers also estimate that the total number of infections is about ten times the number of cases diagnosed and confirmed initially. Then, the diagnosed cases account for around 20% of the total, but finally, after all the BOP is present, it drops again to around 10% of the total. The total estimate, therefore, amounts to around 264,000 cases.

Using a simulation of the previous NPI introduction, the model shows that around 2,000 deaths will occur if the NPI continues to negatively affect the number of deaths after May 10. If they had been implemented a week before, the model concluded that the peak number of hospitalizations would be much lower, at ~ 440, as would be the peak of ICU occupancy and death, respectively at ~ 88 and 400.

If the NPI is introduced a week later, these numbers will increase substantially, with a peak inpatient number of around 10,200, peak ICU occupancy of 1,900, and deaths of more than 8,000 each.

Doubling Time Triples with NPI

Current studies show that the effective reproduction rate (Re) fell from about 2.6 at the beginning to 0.64, which corresponds to a doubling time of about 3 days and 9 days at the start of the epidemic and post-lockdown phase, respectively. This underlines the urgency of the initial NPI in containing the spread of the virus.

The researchers commented, “One week of exponential increase in new infections during the spread of the initial epidemic requires 3.1 weeks of ‘locking’ to reduce the number of infections to the same level.”

Implications of this Study

This is the first study to analyze the possible effects of counterfactual scenarios regarding changes in the timing of NPI implementation. This finding is partly supported by lower mortality in Austria, which reported its first few cases at the same time as Switzerland, and who also fell victim to the spread from neighboring Lombardy, in Italy. However, the initial and strict introduction of the NPI within one week of the first case led to a reduction in the number of deaths.

In addition, the researchers showed that the high peak ICU occupancy rate of nearly 2,000 that could potentially result from a one-week delay in the NPI might flood the national health system, because the effective capacity of the ICU in Switzerland was only around 1,275 in April 2020.

In summary, this study concludes, “Our study illustrates that time is the most important when it comes to outbreak responses. We point out that while previous implementation of the NPI in Switzerland would result in a much lower number of cases and deaths being treated in hospitals, the steps taken succeeded in preventing the much higher morbidity and mortality burden associated with SARS-CoV-2. “

Because one week of exponential virus spread requires three weeks of locking to bring the number of daily cases back to their original level, the delay not only increases the number of deaths but extends the locking period. Therefore, the adoption of a stringent NPI will reduce the social and economic burden of these measures. Second, there are significant differences in the number of infections in various cantons, and this might indicate that new local outbreaks might be limited to separate areas.

* Important Notification

medRxiv publishing initial scientific reports that are not reviewed by colleagues and, therefore, should not be considered conclusive, guiding clinical practice / health-related behaviors, or treated as pre-existing information.

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Littler global leadership – Canada – Q2 2020 – syndrome (COVID-19) | Instant News


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Quarterly

The Ontario court of appeal: decision on the assessment of deliverability
provisions about termination

Landmark decisions of judicial or regulatory bodies

Authors: Rhonda B. levy, a lawyer with knowledge management and Monty
Verlint, Partner – Less Canada

On 17 June 2020, the Ontario court of Appeal ruled
the decision regarding the enforcement of termination
in employment contracts, provided that the correct method
determining whether the point of termination in the employment contract
executable is the analysis of the contract as a whole and not
on a gradual basis. If the termination of the provision in the contract
contrary to the requirements of the employment standards act
2000, all notice periods will be considered
invalid, regardless of the existence of separateness
p., which can not be used to sever the offending part
the termination provisions.

The province announce plans to gradually ease COVID-19
Limitations and opening

New rules or the official guide

Authors: Rhonda B. levy, a lawyer with knowledge management and Monty
Verlint, Partner – Less Canada

In Canada, the easing of restrictions in connection with COVID-19
pandemic is determined by each individual province or territory. In
April and may 2020, a number of provincial governments (UK
Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec,
Newfoundland and Labrador, new Brunswick, Prince Edward Island)
announced that they plan to gradually ease restrictions with the aim
in the end, completely renewing their provinces.

New jobs harassment and abuse prevention mode
Is Governed By Federal Law Employers

New rules or the official guide

Authors: Rhonda B. levy, a lawyer with knowledge management and Monty
Verlint, Partner – Less Canada

On 24 June 2020, the Federal government published the workplace
Harassment and violence provisions (regulations), which set out
requirements that Federal regulated employers are
need to meet in order to satisfy its obligations under
Canada Labour code (CLC) for the investigation, recording, reporting, prevention
and provide training on work place harassment and
violence, including sexual harassment and sexual violence. In
Laws support bill C-65, an act to amend the Canada labour
Code (harassment and violence), the parliamentary employment and
The relations act, personnel and Law on the execution of the budget, 2017 No. 1
(Proposition 65), which received Royal assent on October 25, 2018. In June
22, by 2020, the Federal government announced that both bill C-65 and
the decree will enter into force on 1 January 2021.

Ontario: new rules in accordance with the law labor standards
Favorable for employers

New rules or the official guide

Authors: Rhonda B. levy, a lawyer with knowledge management and Monty
Verlint, Partner – Less Canada

29 may 2020, the government of Ontario filed Ontario
228/20 regulation (regulation) in accordance with the labor standards law,
2000 (ESA). The resolution amends the dismissal and constructive dismissal
rules, in accordance with the ESA, and in most cases, eliminates temporary
layoffs and the risk of constructive dismissal
the Statute defined “COVID-19 period”, during which
many employers in Ontario have been forced to close or reduce operations.
These Rules do not apply to workers in Union jobs
who will continue to be subject to the layoff in ESA
rules. A number of canadian jurisdictions was amended
the labor law to extend the period of temporary
layoffs in the result COVID-19 pandemic.

If approved, the proposed bill will be amended CEWS and CERB

The proposed bill or initiative

Authors: Rhonda B. levy, a lawyer with knowledge management and Monty
Verlint, Partner – Less Canada

On June 10, 2020, the Federal government passed bill C-17,
The law relating to additional COVID-19 measures for first reading.
If adopted in its current form, bill C-17, among other things,
to amend Canada ambulance subsidy wage (CEWS), 75%
program wage subsidy to encourage employers to save them
employees during COVID-19 crisis and emergency in Canada
Good answer (CERB), a taxable allowance of $ 2,000 every four
weeks to four months for the employees who lost
their income from COVID-19 crisis. Changes in CEWS would
include the extension of its validity for a further 12 weeks until August
29, 2020, the extension of the right to CEWS into several groups, and
other amendments to ensure that the CEWS continues to fulfill its
goals. Changes in CERB would include all payments,
made in two weeks step of establishing the circumstances under which
employees will not be eligible for CERB, and to subject applicants
sanctions in specific circumstances.

Originally published on Littler Mendelson, July
2020

The content of this article is intended to give General
leadership on this issue. Specialist advice should be sought
on your specific circumstances.

Popular articles on: coronavirus (COVID-19) from Canada

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“Winter is coming,” warns UK experts COVID-19 | Instant News


Famous lines of “Game of Thrones“About approaching the dangers of this winter might prove accurate, say, scientists at a new report. The researchers stated that the second wave of infections could hit Britain this winter, and this would be worse than the first wave that claimed as many as 120,000 lives.

The COVID-19 pandemic caused by acute coronavirus 2 (SARS-CoV-2) respiratory syndrome has gripped the world, and now experts warn that it is far from over. To date, the virus has infected 13.28 million people and claimed more than 577,000 lives worldwide.

Novel Coronavirus SARS-CoV-2 This transmission electron microscope image shows SARS-CoV-2 – also known as 2019-nCoV, the virus that causes COVID-19. isolated from a patient in the US, emerging from the surface of cells cultured in the lab. Images were captured and colored at NIAID’s Rocky Mountain Laboratories (RML) in Hamilton, Montana. Credit: NIAID

Current status in the UK

To date, there have been 292,931 cases of SARS-CoV-2 detected in the UK, and the infection has caused 45,053 deaths in the country. Over time the death rate and new cases have declined in the UK, and in July to date, there were 1,100 deaths, the researchers said. However, there may be no room for complacency that they warn.

According to the nation’s scientific advisors from Academy of Medical Sciences, which was asked to predict using modeling analysis, the worst is yet to come.

worst-case scenario that makes sense for the winter COVID-19 epidemic in the UK.  This model assumes that Rt rises to 1.7 from September 2020 to July 2021. (A) daily infections, (B) COVID-19 deaths caused in hospitals (ie excluding care homes and over-deaths in the community), (C ) general beds are occupied and (D) critical care beds are occupied.  Solid lines show medians, dark bands interquartile range, and pale bands at credible intervals of 95% (CrI).

The worst worst case scenario for the winter COVID-19 epidemic in the UK. This model assumes that Rt rises to 1.7 from September 2020 to July 2021. (A) daily infections, (B) COVID-19 deaths caused in hospitals (ie excluding care homes and over-deaths in the community), (C ) general beds are occupied and (D) critical care beds are occupied. Solid lines show medians, dark bands interquartile range, and pale bands at credible intervals of 95% (CrI).

Predictions and warnings

37 researchers in the team say that winter deaths can range between 24,500 and 251,000 in hospitals in the UK. This will be related to coronavirus infection. Deaths can peak between January and February 2021, they speculate.

These figures are predicted in a scenario where there are no locks or drugs available to treat any infection or vaccine to prevent COVID-19. At present, there is no specific drug that can be used to treat COVID-19, and the treatment is mainly supportive and symptomatic.

Around 120 vaccine candidates are currently undergoing clinical trials in various parts of the world, including one promising agent tested by Oxford researchers. However, nothing is available for use in humans.

Lockdown is the total closure of offices, businesses, schools and public transportation to break the transmission chain. The predicted number of deaths does not take into account locking, availability of effective drugs or vaccines during this winter.

Report

This report was requested by the chief British scientific advisor, Sir Patrick Vallance. The researchers write, “Risk … can be reduced if we take action immediately.” The actual status of a pandemic during winter is uncertain. However, what is clear is that the virus can survive better during winter and thus can spread easily among people who are trapped indoors during winter. The report states, “In cold, rainy or windy weather people are reluctant to open windows because they make cold winds and therefore they often have lower ventilation rates in winter. This can be a special challenge in modern airtight buildings that have a high level of infiltration very low for energy efficiency and for low income people who are trying to keep down heating costs. “

Burden on the health system

Thus, COVID-19 has a high level of infectivity but a low risk of complications and death. Only a small proportion of people – especially the elderly and those who suffer from other diseases, are at risk of complications.

These people may need intensive care and ventilation and are more at risk of dying. However, the spread of massive infections can also lead to extraordinary health care systems. This has been seen throughout Europe and in the United States for the past few months.

The NHS, too, is under pressure to meet the needs of thousands of patients. With the reduced number of COVID-19 cases, there has been a revival of flu cases and non-COVID-19 cases, the researchers explained.

The second wave of coronavirus infections can stretch the system to its capacity, they speculate. They say that there is a waiting list of non-coronavirus cases and this could reach 10 million by the end of this year if the situation with COVID-19 continues to worsen.

Expert talk

Prof. Stephen Holgate, a breathing specialist from the University Hospital of Southampton NHS Trust, is the chair of this report. He said in his statement, “This is not a prediction – but it is a possibility. Modeling shows that deaths could be higher with the new wave of COVID-19 this winter. But the risk of this event can be reduced if we take immediate action.”

He said that at this time, the numbers were low, and this could be “a window of critical opportunity to help us prepare for the worst that winter can throw at us.”

Co-author Prof. Dame Anne Johnson, from the Academy of Medical Sciences, said in a statement, “Facing these potential challenges, and after a difficult year, it will be easy to feel hopeless and helpless. But this report shows that we can act now to change things for the better. “He said,” COVID-19 has not disappeared. We need to do everything we can to stay healthy this winter. “

Health Secretary Matt Hancock has assured that the government already plans to handle the second wave this winter. A government statement said, “We remain vigilant, and the government will ensure the resources needed to avoid the second peak that will flood our NHS.”

Recommendations for prevention of the second wave

The report’s authors have made certain recommendations for overcoming problems with the second wave of the pandemic.

  • They urged further testing for infections and intensive tracking of all contacts of infected people to prevent the spread of infection.
  • A broad campaign to get more people vaccinated against seasonal flu to reduce the burden of flu cases this winter
  • Prevent transmission of coronavirus infection to other patients by making the area “corona-free” in the hospital.
  • Availability of adequate personal protective equipment (PPE) for health care workers to prevent infection and spread.

Window to act now

The researchers added that at present, many of these predicted figures are based on a modeling system, and if the parameters are changed slightly, the number of deaths and hospitalization can change significantly.

However, researchers urge the general public and policy makers to prepare for the worst case scenario while hoping for the best. “There’s a lot to do, and we don’t have much time to do it,” Johnson said. “A window to action now.”

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How COVID-19 affects the nervous system | Instant News


A new paper published in the journal JAMA Neurology in May 2020 discussed the presentation and complications of COVID-19 with respect to the nervous system.

The COVID-19 pandemic has caused hundreds of thousands of cases of severe pneumonia and respiratory disorders, in 188 countries and regions in the world. The causative agent, SARS-CoV-2, is a new coronavirus, with well-recognized lung complications. However, evidence is increasing that the virus also affects other organs, such as the nervous system and heart.

The Coronaviruses: A Glimpse

That corona virus is a group of large spread RNA viruses that infect animals and humans. Human infections are known to be caused by 7 coronaviruses, namely human coronavirus (HCoV) –229E, HCoV-NL63, HCoV-HKU1, HCoV-OC43, MERS-CoV, SARS-CoV-1, and SARS-CoV-2.

Among these, the last three are known to cause severe human disease. While HCoV is more associated with respiratory manifestations, three of them are known to infect neurons: HCoV-229E, HCoV-OC43, and SARS-CoV-1.

Current research aims to contribute to the knowledge of the SARS-CoV-2 neurotropism, as well as post-infectious neurological complications. This virus infects humans through ACE2 receptors in various tissues, including airway epithelium, kidney cells, small intestine, proper lung tissue, and endothelial cells.

Because endothelium is found in blood vessels throughout the body, this offers a potential route for CoV to be localized in the brain. In addition, a recent report shows that ACE2 is also found in brain neurons, astrocytes, and oligodendrocytes, especially in areas such as substantia nigra, ventricles, middle temporal gyrus, and olfactory bulb.

Interestingly, ACE2 in neuron tissue is expressed not only on the surface but also in the cytoplasm. This finding could imply that SARS-CoV-2 can infect neuronal and glial cells in all parts of the central nervous system.

How does neuroinvasion occur with SARS-CoV-2?

Current knowledge indicates the possibility of nerve cell virus invasion by several mechanisms. These include the transfer of viruses across synapses of infected cells, entering the brain through the olfactory nerve, infection of endothelial blood vessels, and migration of infected white blood cells across the blood-brain barrier (BBB).

The corona virus has been shown to spread back along the nerves from the edge of the peripheral nerves, across synapses, and thus into the brain, in several small animal studies. This is facilitated by a pathway for endocytosis or exocytosis between motor cortex neurons, and other secretory vesicular pathways between neurons and satellite cells.

Axonal transport occurs rapidly using axonal microtubules, which allow the virus to reach the body of neuron cells with a retrograde version of this mechanism.

The possibility of spreading the olfactory route is marked by the occurrence of isolated anosmia and age. In such cases, the virus can pass through the latticed plate to enter the central nervous system (CNS) of the nose. However, more recent unpublished research shows that olfactory neurons lack ACE2, whereas cells in the olfactory epithelium do so. This could mean that a viral injury to the olfactory epithelium, and not the olfactory neuron, is responsible for anosmia, but further studies will be needed to confirm this.

Cross the BBB

This virus can also pass through the BBB through two separate mechanisms. In the first case, infected vascular endothelial cells can move the virus across blood vessels to neurons. Once there, the virus can start to bud and infect more cells.

The second mechanism is through infected white blood cells that pass through the BBB – a mechanism called Trojan horse, which is famous for its role in HIV. Inflamed BBB allows the entry of immune cells and cytokines, and even, possibly, viral particles into the brain. T-lymphocytes, however, do not allow viruses to replicate even though they can be infected.

Neurological features of COVID-19

From limited data on neurological manifestations related to COVID-19, it is clear that headaches, anosmia, and age are among the most common symptoms. However, other findings include stroke and an abnormal state of consciousness.

While headaches occur in up to one third of confirmed cases, anosmia or age shows a much more varied prevalence. In Italy, about one fifth of cases show this symptom, while almost 90% of patients in Germany have such symptoms.

The researchers said, “Given the reports of anosmia that appear as early symptoms of COVID-19, specific testing for anosmia can offer the potential for early detection of COVID-19 infection.”

Impaired consciousness can occur in up to 37% of patients, due to various mechanisms such as infection and direct brain injury, metabolic-toxic encephalopathy, and demyelinating disease. Encephalitis has not been documented as a result of COVID-19.

Toxic-metabolic encephalopathy can occur due to a number of disorders of metabolic and endocrine function. These include electrolyte and mineral imbalances, kidney disorders, and cytokine storms, hypo or hyperglycemia, and liver dysfunction. Patients who are elderly, ill, or already have symptoms of dementia, or are malnourished, are at higher risk for this condition.

Less common neurological complications include Guillain-Barre syndrome, which is a post-viral acute inflammatory demyelinating disease, and cerebrovascular events, including stroke.

Is COVID-19 Therapy Related to Neurological Manifestations?

Nowadays, many different drugs are used to treat this condition.

Chloroquine and hydroxychloroquine, for example, can cause psychosis, peripheral neuropathy, and the latter can worsen the symptoms of myasthenia gravis. Tocilizumab, an IL-6 blocker, is intended to reduce excessive cytokine release that occurs in severe inflammation. Although admission to CNS is limited, it can sometimes cause headaches and dizziness.

Precautions for COVID-19 Patients with Neurological Conditions

If a patient already has a neurological condition that requires special treatment, they tend to be at higher risk for COVID-19, due to existing lung, heart, or liver conditions, having kidney disease (dialysis), if they are overweight, or at immunosuppressive drugs. Also, it is likely that they may be in nursing homes, where many countries have reported severe outbreaks.

This study concludes: “Doctors must continue to monitor patients closely for neurological diseases. Early detection of neurological deficits can lead to improved clinical outcomes and better treatment algorithms. “

Journal reference:

  • Zubair, A. S. et al. (2020). Neuropathogenesis and Neurological Manifestations of Coronavirus in the Coronavirus Era 2019: Overview. JAMA Neurology. doi: 10.1001 / jamaneurol.2020.2065.

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