Three policy problems: biocreep and the extension of biopolitical administration

This paper critiques recent developments in educational discourse through an analysis of two UK Government White Papers and three specific problems. We argue that the latter herald forms of ‘biocreep'. Echoing the analysis of such phenomena in the work of Michel Foucault, this gradual extension of ‘biopolitics' into the field of education is a tendency which has accelerated with the Coronavirus pandemic and raises many questions for policy analysis. First, we show how the White Papers' approach to life and its related assumptions embody an attempt to further entrench the techniques of biopolitical population management in secondary and further education settings. Second, our analysis of the two Papers shows not just a deepening discursive shift towards ways of instrumentalising educational processes, but also identifies a triple problem of political assemblage: primo, this shift relies on the assemblage of a ‘problematic subject';secondo, it simultaneously assembles the problem of value extraction;and tertio, it obscures the problem of desire or unruliness of the assemblages created. Just as discursive practices of instrumentation, administration and evacuation try to manage these assemblages, they remain unable to contain the three problems they enshrine. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

COVID-19 vaccination uptake in people with epilepsy in wales.

PURPOSE: People with epilepsy (PWE) are at increased risk of severe COVID-19. Assessing COVID-19 vaccine uptake is therefore important. We compared COVID-19 vaccination uptake for PWE in Wales with a matched control cohort. METHODS: We performed a retrospective, population, cohort study using linked, anonymised, Welsh electronic health records within the Secure Anonymised Information Linkage (SAIL) Databank (Welsh population=3.1 million).We identified PWE in Wales between 1st March 2020 and 31st December 2021 and created a control cohort using exact 5:1 matching (sex, age and socioeconomic status). We recorded 1st, 2nd and booster COVID-19 vaccinations. RESULTS: There were 25,404 adults with epilepsy (127,020 controls). 23,454 (92.3%) had a first vaccination, 22,826 (89.9%) a second, and 17,797 (70.1%) a booster. Comparative figures for controls were: 112,334 (87.8%), 109,057 (85.2%) and 79,980 (62.4%).PWE had higher vaccination rates in all age, sex and socioeconomic subgroups apart from booster uptake in older subgroups. Vaccination rates were higher in older subgroups, women and less deprived areas for both cohorts. People with intellectual disability and epilepsy had higher vaccination rates when compared with controls with intellectual disability. CONCLUSIONS: COVID-19 vaccination uptake for PWE in Wales was higher than that for a matched control group.

Acute Leukemia and COVID-19: The Johns Hopkins Experience

Introduction: At the beginning of the COVID-19 pandemic in the United States, some states combated viral spread via lockdowns. In Maryland, where Johns Hopkins Hospital (JHH) is located, the closures began with public schools (March 12, 2020;3/12/20);followed by bars, restaurants, movie theaters, gyms and gatherings of >50 people (3/16/20) with 250 Maryland State Police troopers being activated to aid in enforcement. All non-essential businesses were closed on 3/23/20, with a statewide “stay-at-home order” announced on 3/30/20. At this time, we anecdotally noted a decline in the number of adult patients presenting to JHH with new diagnoses of acute leukemia (AL). In this retrospective study, we quantified changes in new AL diagnoses over this period. Methods: The study was approved by the JHH IRB. All patients with new presentations of AL undergo diagnostic flow cytometry (FC) analysis at our institution on peripheral blood and/or bone marrow samples. The FC database was searched for new diagnoses of adult (≥ 18 years) and pediatric (<18 years) AL during the following timeframes: [1] 3/13-6/10/20 (90 days after the first announced restriction) and [2] 2/11-3/12/20 (30 days prior to the first restriction). The database was searched for the same time periods in 2019 (3/13-6/10/19 and 2/10-3/12/19). A diagnosis of AL was considered new if the patient had not previously been diagnosed with AL or evolved to AL from an underlying myeloid neoplasm. Clinical data were collected from the electronic medical record. We used a Fisher's exact test to compare the distribution of new patients in the 30 days prior and 90 days following the announced COVID-19 restrictions in Maryland in 2020 to that of new patients in the corresponding time periods for 2019. The Cochran-Armitage test was used to compare trends in new patients with AL in the 30 days prior and 90 days following COVID-19 restrictions, as compared to the same time period in 2019. Statistical significance was defined as a p-value <0.05. Results: Between 3/13- 6/10/20, there were 25 new diagnoses of AL (11 women/14 men) with a median age of 51 years (range: 2.6 - 89 years;10 pediatric/15 adult). During the same 90 day period in 2019, there were 32 new diagnoses of AL (18 women/14 men) with a median age of 63 years (range: 8 - 93 years;2 pediatric/30 adult). Figure 1 shows the distribution of new AL diagnoses in adult patients by date of presentation. This decrease was most pronounced in the first 30 days, in which only one new adult patient with AL presented to JHH. The distribution of adult patients diagnosed in the 30 days prior and 90 days following the March 2020 restrictions was significantly different from the corresponding time period in 2019 (p=0.03);however, the overall trend of new adult AL diagnoses in the 30 days prior and the 90 days following the March 2020 restrictions was not significantly different from the corresponding time period in 2019 (p= 0.77). Of note, many patients with AL reported symptoms that overlapped with those of COVID-19 including fatigue (40%), dyspnea (35%) and fever (22%). 35.1% of patients diagnosed with AL after restrictions had no characteristic symptoms of COVID-19, as compared to 12.5% of patients diagnosed with AL during this period in 2019 (Table 1). Discussion: These data suggest that new presentations of adult AL were delayed by COVID-19-related restrictions. Given the acuity of AL, this delay may have affected clinical outcomes. Interestingly, pediatric new AL cases did not decrease during this time period. The reasons are unclear, though parents appear to have remained willing to seek care for their children even during the uncertain days at the beginning of the pandemic, perhaps due to the media reporting that COVID-19 infection was less aggressive in young people. Given the possibility of additional lockdowns due to COVID-19 variants or new pandemics, these data highlight the importance of encouraging patients to seek care in the event of illness, screening patients for both infectious and non-infectious diseas , and ensuring that routine medical care remains accessible. [Formula presented] Disclosures: Brown: Kura: Membership on an entity's Board of Directors or advisory committees;Amgen: Membership on an entity's Board of Directors or advisory committees;Takeda: Membership on an entity's Board of Directors or advisory committees;Novartis: Membership on an entity's Board of Directors or advisory committees;KIte: Membership on an entity's Board of Directors or advisory committees. Webster: AmGen: Consultancy;Pfizer: Consultancy.

Comparative analysis of three laboratory based serological assays for SARS-CoV-2 in an Australian cohort.

Many unanswered questions remain regarding the role of SARS-CoV-2 serological assays in this unfolding COVID-19 pandemic. These include their utility for the diagnosis of acute SARS-CoV-2 infection, past infection or exposure, correlation with immunity and the effective duration of immunity. This study examined the performance of three laboratory based serological assays, EUROIMMUN Anti-SARS-CoV-2 IgA/IgG, MAGLUMI 2000 Plus 2019-nCov IgM/IgG and EDI Novel Coronavirus (COVID-19) IgM/IgG immunoassays. We evaluated 138 samples from a reference non-infected population and 71 samples from a cohort of 37 patients with SARS-CoV-2 confirmed positive by RT-PCR. The samples were collected at various intervals of 0-45 days post symptoms onset (PSO). Specificity and sensitivity of these assays was 60.9%/71.4% (IgA) and 94.2%/63.3% (IgG) for EUROIMMUN; 98.5%/18.4% (IgM) and 97.8%/53.1% (IgG) for MAGLUMI; and 94.9%/22.5% (IgM) and 93.5%/57.1% (IgG) for EDI, respectively. When samples collected ≥14 days PSO were considered, the sensitivities were 100.0 and 100.0%; 31.0 and 82.8%; 34.5 and 57.1%, respectively. Using estimated population prevalence of 0.1, 1, and 10%, the positive predictive value of all assays remained low. The EUROIMMUN Anti-SARS-CoV-2 IgA lacked specificity for acute diagnosis and all IgM assays offered poor diagnostic utility. Seroconversion can be delayed although all patients had seroconverted at 28 days in our cohort with the EUROIMMUN Anti-SARS-CoV-2 IgG. Despite this, with specificity of only 94% this assay would not be satisfactory for seroprevalence studies in the general Australian population given this is likely to be currently <1%.