The Pennsylvania Supreme Court ruled that child protection officials may not order drug tests as part of a child abuse investigation on Tuesday, June 16th. The Justices sided with prosecutor David J. Russo who had recently come under fire from CPS agents.
Greene county received a confidential tip that David Russo was seen publicly intoxicated while caring for five children and that he had been charged with spousal abuse. The Greene County child protective service recused themselves and brought in Fayette county officials to complete an investigation.
The unanimous decision says that the law “does not expressly or implicitly authorize collecting samples of bodily fluids, without consent, for testing”.
David Russo said in a phone interview “I think this a great victory for the people against government intrusion. The Supreme Court of Pennsylvania has sided with the people.”
Fayette county lost a decision in a lower court that would have required Russo to submit to a drug screen and allow investigators to inspect the condition of his home. All five of his children were interviewed at school and the state was unable to substantiate any claims from the confidential tip.
David J. Russo was elected as a Republican to the office of District Attorney for Greene county last November. During his campaign he was also successfully representing himself in this legal dispute which he said “had become routine practice in Greene County”. Greene suggested it was very prevalent for child protective services to drug test both parents in every investigation before the superior court ruled in his favor.
David J. Russo was sworn in as Greene County District Attorney in November 2019. He was engaged in court proceedings regarding the ruling at that time.
The first complaint about Russo came in October 2018. An unidentified source claimed he appeared to be under the influence of drugs or alcohol about two weeks earlier, while he was defending a client before Greene County Children and Youth Services. The second and third reports were in November 2018, alleging he had been “completely out of it” in public and that there was “domestic violence in the home,”.
Russo argued that the order to produce an observed urine drug screen violated his 4th amendment rights and requiring it “will inevitably lead to the forcible extraction of bodily fluids, the incarceration of parents for refusing to comply, or the exile of parents from their children.”
Coronavirus Covid-19 has been dominating headlines and social media posts for several weeks now, and as the cases ramp up in the US it will only get worse. People have 24/7 access to news media and instant updates from Facebook.
With the glut of information most people are starting to feel like an expert on coronavirus and epidemiology, but even some experts are putting out false or misleading information. I am admittedly not an expert on the coronavirus or epidemiology, but when Doctors and healthcare professionals are posting false claims on Facebook and giving interviews with completely false information, I believe anyone with a handle on the facts should address it.
I began following the coronavirus pandemic on about January 10th. As the owner of a commercial business that sources products from China it was relevant to our orders that were in progress and future inventory concerns. I watched as the coronavirus case number grew from a couple hundred to approximately 20,000 as the official Chinese New Year came to a close.
There were some disruptions with our contacts (for example FedEx stopped running temporarily) but the majority of closures and disruption was isolated to the Hubei province. It seemed that our governments were doing a decent job of stopping the spread of the virus to the US public, but I knew it was serious once the CDC issued a briefing that said disruption to daily life might be severe.
The Coronavirus has been spreading in the US for Months
This is completely false without a shred of credibility.
What The Spread Looked Like In China
Coronavirus likely began in late November in Wuhan China which is located in the Hubei province. Covid 19 spread around a local wet market at first, but there were only 54 confirmed cases worldwide on January 3rd 2020. It began to spread quickly and confirmed cases started piling up through the month of January with only a handful of international cases.
Coastal provinces in China are relatively unscathed compared to Hubei which at the time of this writing has roughly half the world’s Coronavirus deaths. The world was able to stave off the spread for a time, but once several European countries became infected it became clear that the US would be unable to prevent the spread to the general public.
Entering The United States
Among the first US citizens infected were residents of the Life Care Center nursing home in Washington state. Roughly 30% of those infected died there, which is a clear indication of a dangerous and unseen virus.
The general public has no immunity to Coronavirus, so even though it is mild when contracted by healthy young adults it still uses the public as a vector to reach communities of elderly people with existing health conditions. If Coronavirus had been spreading through the US unchecked since November we would have a scene that closely resembles Italy or Hubei by now, with entire hospitals overrun and healthcare staff having to turn away the worst patients because they tax the resources to a higher extent.
Flattening the Curve
Since the spread of Coronavirus closely matches the official narrative, the US has had time to prepare and begin limiting contact with crowds which will slow the spread immensely. Our outbreak is more likely to resemble the coastal Chinese provinces than Italy because of these preparations.
Johns Hopkins has been publishing an interactive GIS map showing confirmed cases, deaths and recoveries worldwide since early January.
It took a little over a month for 1 case to ramp up to 50 confirmed. Many more people were carrying and transmitting the virus and as healthcare officials caught up with testing and information distribution there were 2,000-4,000 new cases being reported daily during the second half of January in China.
The demand was so severe in Hubei the government built a new hospital in 10 days. None of this happened in the US; frankly it’s ludicrous to insist that Coronavirus had been spreading under the guise of the Flu in the US for 2 months, died down a little and is now spreading just as the CDC (who says there was less than 100 cases in the US until February) has predicted it would.
The healthcare apparatus in the US has its problems but we are especially equipped for identifying and reporting new diseases. With the level of transparency and existing checks and balances Covid 19 would have quickly been identified and reported up the chain of command in the US.
Holding Your Breath for 10 Seconds is a Way to Diagnose Coronavirus Without a Test
This is one of the more ridiculous claims floating around the Internet. It is included in a long post that claims to be taken from advice given by experts in Taiwan. The Taiwan Fact Check Center has already debunked this claim and many experts have come out calling it ridiculous with zero merit.
Drinking Water Will Wash The Virus Into Your Stomach
The Coronavirus has an elegant design like most viruses it targets and attacks proteins and other cells as a host. You can’t wash away coronavirus no more than you can wash away throat cancer. Staying hydrated does have a positive effect on your immune system, but there is no indication that drinking water does anything other than that in relation to Covid 19.
Coronavirus is No Big Deal, the Flu is Deadlier
Coronavirus has spread across the entire planet in a little over 3 months killing on average 3% of patients with confirmed cases. The Flu has a mortality rate of approximately 0.1%, or 30 times less than Covid 19.
It’s even more startling that in clusters where the infected are elderly the virus has a mortality rate between 15% and 30%.
It’s also more easily transmitted than the Flu. Scientists measure the ease of transmission with the basic reproduction number which indicates how many people a single infected individual will infect on average. The Flu’s value is R1.9, and initial estimates for Coronavirus Covid 19 put its mean value at R3.28.
This graph shows the estimated mortality and ease of transmission or Covid 19 compared to other known diseases.
The Coronavirus has quickly shown that it’s far worse than the flu as a public health crisis; in Italy Coronavirus patients quickly filled hospital beds and caused a paradigm change in the way Italian Doctors prescribe and handle care. Older patients that would use a lot of time and resources and may still die would usually be high priority, but in this new paradigm they are left to die so healthcare workers can distribute care to those most likely to benefit.
Children Cannot Catch Coronavirus or Do not Get Symptoms
I would like to point out that a correlation isn’t always the product of a cause; initial cases were most likely contracted by adults traveling in the public and during the second round their children became infected but did not exhibit severe symptoms and were likely overlooked. The CDC recommends the same measures to stop the spread of Coronavirus in children that they do in adults.
Pets Cannot Catch or Transmit Coronavirus
Although the World Health Organization believes that animals are not a primary driver of transmission, a dog in Hong Kong tested positive twice.
Coronaviruses have a history of spreading between different species, which includes the genesis of Covid 19. Cats and Ferrets were shown to be asymptomatic hosts of SARS capable of infecting other cats in the same cage.
You should assume that your pets are just as susceptible to contracting coronavirus as your children and implement measures to protect them, but there is nothing out there to indicate that you should get rid of your pets. Experts recommend following basic hygiene guidelines and wash your hands before and after touching a pet.
How Long Will Protective Measures Last?
Some good news seems to be on the Horizon. China has declared victory over the Coronavirus and for the most part travel restrictions there are being lifted.
During the first 20 days of February I watched as the number of confirmed cases rose by 2,000-4,000 each day. Toward the end of February that number started to slow, and now new cases are around 100-200 each day. The number of cases in the US now roughly correlates to the number that China had at the end of January when the virus really started to spread. This could indicate that within 6-8 weeks we will have seen the worst of it and Coronavirus will be on the way out.
President Trump has addressed the nation daily regarding the Coronavirus Pandemic. Proposed measures range from travel restrictions to a full on 6 week mandatory quarantine for the entire country.
Of course a major goal in slowing the spread is to not overwhelm healthcare resources. We could see a protracted situation nationally that spreads out to 3-4 months. It’s also likely that summer weather will have a positive effect on transmission rates.
Either way I expect the US to return to business as usual somewhere between the end of April and the beginning of June.
Since the beginning of the Coronavirus Covid-19 Pandemic people have been worried about whether they can catch the virus from packages they received from China.
Can I catch Coronavirus from a Package That Originates in China?
The short answer is no. The conventional understanding was that Coronaviruses across the board could not live outside the body for more than a couple hours. A recent federal study that was contributed to by a number of organizations found that Covid 19 specifically could remain viable on a stainless steel surface for 72 hours and on cardboard for 24 hours. Most packages come shipped in cardboard. The average shipping time for a package from China is 3 months total. During that time a full month is spent on a freight ship over the open ocean. The virus has no chance of surviving the trip.
Can I catch Coronavirus from the Mailman?
However now that Coronavirus Covid 19 has been spreading person to person within the United States, the surface of your packages could become contaminated by the carrier or the sender prior to shipment. If the shipment is longer than 24 hours it would have to be infected during the final day of transportation on the ground in your city. There is a real concern about mail carriers and other shipping company employees becoming sick and passing the disease onto others, but all major companies are adjusting their procedures to help protect both their employees and customers. For instance Drug Test City is only having one employee handle outgoing orders and they are screened for fever and symptoms daily. We are also treating packages with Lysol before they leave the warehouse.
Coronavirus is named for the corona around the cell which acts as tentacles to attach each cell to target proteins.
You are far more likely to catch Coronavirus Covid-19 from a person you have made close contact with than from a package arriving in the mail, but if the package is sealed you can practically eliminate that risk by wearing gloves and treating your packages with spray Lysol and washing your hands. Wait 3-5 minutes after spraying before opening the package or handling without gloves and dispose of the gloves immediately.
I would suggest being cautious, but with proper sanitation and a simple disinfecting protocol you have nothing to worry about when it comes to the mail; you’re more likely to be infected by the mailman himself.
Tips for Dealing With Coronavirus Covid-19
Wash your hands with antibacterial soap and hot water.
Hard non-porous surfaces such as stainless steel transmit over 70% of pathogens. Clean them often.
Avoid touching your face.
Maintain a distance of 3 meters or 9 feet from other people when possible.
Disinfect packages at the door. Lysol spray is effective against Coronavirus.
Hand sanitizer needs to contain more than 60% alcohol to be effective.
The mortality rate is much higher amongst the elderly with existing health problems.
All of the measures in place are as much to slow the spread and ease the burden on the healthcare system as they are to try and stop the spread.
It is believed Covid 19 will slow dramatically during the summer like Influenza. Scientists have already developed vaccines. This should be over in a year or two.
Just like most diabetics, I have checked my blood glucose levels twice in a short period of time out of curiosity to find that my glucose meter gives different readings. At first I thought I may have had a faulty meter, but for me and my personal needs a 10% margin of error is not a big deal. Since then I have learned a lot about how different meters work, improvements in the technology used in home testing supplies, government controlled standards for accuracy and the general needs of different kinds of diabetic patients through my work and community engagement.
The short answer regarding meter accuracy is that the technology currently used in home diabetes testing supplies are only capable of testing within a 10-20% +/- margin of error. The FDA mandates minimum accuracy standards for testing supplies in the US, currently following the ISO 15197:2013 standard of 95% of tests must be within +/- 20% for results above 75 mg/dl and +/-15% for results below 75 mg/dl. This standard was issued in 2013, and the majority of manufacturers have redesigned their meters for better accuracy, increased consistency and ease of use since then.
The On Call Express line of products performed much better than FDA standards, and performed better than 90% of meters on the market.
Even though a 15% margin of error might seem large on the surface, Robert Ratner, MD, FACP, the American Diabetes Association’s chief scientific and medical officer says “[This level of] accuracy is sufficient for reliable clinical decision making and therapy”. In most cases results taken from an at home blood glucose meter would suggest similar treatment decisions as a result someone would get using laboratory equipment.
How Does a Glucose Meter Work?
To understand why a meter could give differing readings, you first have to understand how they work. The testing strip contains an enzyme that interacts with the glucose in your blood. The mixture generates electrons, which are then converted to an electrical current. The current is transferred from the strip to the meter, which is programmed to read the electrical current as the final numeric value.
A close up view of the design of the On Call Express Test Strip. Notice the reservoir on one end and the contact area on the other.
The variables involved from the manufacture of the enzyme to the actual testing procedure and the test subject are immense. In earlier generations meters had to be coded, or the manufacturer sent a coding chip with each box of strips to alter the formula to match the slight variations in each batch of strips. Today most strips are coded so the end user is unaware that their meter is calibrating itself to each new batch of strips used.
Hospital labs achieve a higher degree of accuracy by controlling variables more closely. Their equipment is kept in an environment with consistent temperature and humidity, and is programmed for those variables. Nurses and technicians are professionally trained to limit variations in testing. The equipment is built with more costly, and more consistent components. Most importantly, blood samples are separated and only the blood plasma is tested (all home testing kits test whole blood). Finally, laboratory machines test a much larger sample for over a minute; at home testing devices are designed to use the smallest sample possible and deliver the fastest results. Even with all those differences laboratory tests generally still have a +/-4% margin of error. Some lab equipment exhibits a +/-5% to +/-8% margin of error.
The most important thing about blood glucose meter accuracy is that you can use the results to make competent and confident decisions regarding your care. If you feel like your meter is inaccurate enough to cause problems with your dosing or treatment, take it with you during your next doctor visit and test simultaneously with the blood sample being drawn for lab testing (be sure to find out if your meter results are converted to Plasma levels or if they’re being reported as whole blood levels). If your reading would have specified a noticeable difference in your treatment, it might be something to worry about. Millions of people use home testing glucose meters every year however, and the FDA receives between 25,000 and 30,000 reports about malfunctions and user errors relating to glucose meters annually. Their standards take real world scenarios and the data associated with those reports into consideration.
Why is Your Diabetes Meter Inaccurate?
Starting with the strip, the chemical process involved relies on an exact amount of blood entering the reservoir in a prescribed amount of time, at a pre-determined temperature and an educated guess assigned to the composition of the blood itself. Not only will one person’s blood differ from another’s in chemical makeup and red blood cell count, contagions on your skin AND the presence of water or alcohol after cleaning can affect the results.
For the strip to have a chance at giving a perfect result you need to use the same amount of blood and fill the strip in the same time frame every time; your blood and the enzyme in the strip needs to be at consistent temperatures. If you think that using two drops of blood from the same lancing site should be more accurate, you’d actually be wrong. The first drop of blood will have more extracellular fluid content than proceeding drops.
Known Variables to Interfere with Test results
Meter not calibrated regularly
Storage and handling of test strips
Not properly cleansing the test site
Testing site damp from alcohol prep or water
Not enough blood applied to test strip
Altitude, temperature, and humidity
Change of Test Site
Inconsistent Red Blood Cell levels due to dehydration, anemia or polycythemia
Interfering substances (Vitamin C, acetaminophen, and uric acid)
Diabetic testing supplies are by design not extremely accurate, but quality control during manufacturing and transport can further affect accuracy. Proper storage by the retailer and finally the patient in a climate controlled environment and keeping an eye on the expiration date will help you limit additional inconsistencies.
4 Tips to Maximize The Accuracy of Your Glucose Meter
Properly Store and Handle Strips– There are two components on your strips that are very sensitive, the chemical that reacts with your blood and the conductor that transmits the reading to your meter.
Keep your strips away from sunlight and moisture
Testing has shown that cooler temperatures help keep the strips longer
Make sure to seal your vial after you take a strip out
Avoid getting the oil on your fingers on the chip/ connection point, it can affect the electrical current
Wash your hands– Try to limit contamination by washing your hands, and drying them thoroughly before testing. I would recommend waiting five minutes afterward and then testing to give your hands a chance to dry completely.
Be consistent– Try and use the same amount of blood and get the blood from the same part of your finger. Aim to get as many tests in the same room of your home at the same times of day ( this will control temperature and also make your benchmarks and trends more meaningful). Only use results from the same meter for intense comparison.
Repeat your tests– When an engineer requires a greater degree of accuracy than their equipment is capable, they will often repeat the test a number of times and use the average. This will also allow you to identify outliers or faulty strips.
Some Things to Consider Regarding Glucose Meter Accuracy
For most readings the current accuracy standards are more than acceptable for making treatment decisions – the guidelines require a higher degree of accuracy in the range where a smaller deviation in treatment could lead to serious consequences. Some patients will also be more susceptible to treatment variations due to inaccuracy, particularly children or adults with a lower body weight. If you are concerned with your meter’s accuracy, I would recommend running a test scenario for various levels of tolerance to find out what levels of inaccuracy your treatment can withstand. It’s important to understand the relationship between your test results and your self administered treatment.
Even though manufacturers have been successful at introducing incrementally better products, it will take a holistic re design and breakthrough to make a substantial increase in accuracy. While some meters are slightly more accurate in testing (The Accu-Chek and FreeStyle meters consistently maintain high accuracy scores in testing), we ultimately decided that the On Call Express meter offered the best return on investment, with comparable accuracy testing results of even the highest rated meters – and better results than some of the most popular (and most expensive) alternatives at a substantial savings.
According to the test results we accumulated from manufacturers and 3rd parties prior to selecting the meters we would sell; At the lower threshold where accuracy is most important, only 3 brands had meters that achieved 100% of results within a 10% margin, and those were Accu-Chek, FreeStyle and On Call Express. 71% of the On Call Express results were within 5% (As compared to the One Touch Verio Pro which only had 53% of tests within the 10% margin [Vs. 100% for the On Call Express], and only 21% within the 5% margin). Overall the relatively high accuracy and incredibly good value of the On Call Express won us over.
An Arjay resident, Julie Miller, was arrested on Monday December 30th for attempting to deceive a urine drug screen by substituting her pet dog’s urine for her own. Pineville KY Officer Michael Smith was called to the scene by Miller’s Parole Officer who had caught her sneaking in a sample of urine. During questioning on scene Miller admitted to Officer Smith that the urine sample was not hers, that is was in fact her dog’s urine and that she had attempted to sneak it in because she knew she would fail the drug screen for Methamphetamine and Suboxone.
Julie Miller, age 40, was arrested for tampering with physical evidence and lodged in the Bell County Detention Center.
She was later served a probation violation at the detention center by probation and parole and a short time afterward, a trafficking in controlled substance warrant by the Bell County Sheriff’s Department.
Pineville Police Department posted the press release to their Facebook page, which quickly gained momentum online.
