With more than 3.0 million page views and more than 5,000 items, this blog provides news and commentary on public policy, business and economic issues related to the $3 billion California stem cell agency. David Jensen, a retired California newsman, has published this blog since January 2005. His email address is djensen@californiastemcellreport.com.
Thursday, June 04, 2020
California's $5.5 Billion Stem Cell Countdown: Sixty Percent on the Way to the Ballot
The measure is an effort to financially rescue the California stem cell agency, which is running out of money. It will begin shutting down this fall without substantial financial assistance.
Today's report from state election officials showed 411,839 verified signatures out of a raw total of 924,189. Backers of the measure are hoping for 685,534 valid signatures to avoid going to a "full check," signature-by-signature count. Such an effort in 58 counties could be so prolonged that the measure would miss the deadline for being placed on the ballot.
The current count is a combination of a hand count and random sampling.
State election officials have set a deadline of June 24 for counties to submit figures. The state's own deadline to complete its work is June 25.
Today's tally is 60 percent of the needed 685,534. It is 110 percent of the legally required figure of 623,212.
So far about 78 percent of the raw signatures have been verified as coming from legally registered voters.
Still missing from the total of verified signatures are San Diego, Riverside and Orange counties, which have a total of 200,546 raw signatures.
Look for an update on the tally tomorrow evening or early Saturday morning right here on the California Stem Cell Report, your source for the last 15 years for all things dealing with the stem cell agency, officially known as California Institute for Regenerative Medicine(CIRM).
Wednesday, June 03, 2020
California's $5.5 Billion Stem Cell Countdown: Two Pathways to the Ballot But Maybe One Not So Good
The agency, known formally as the California Institute for Regenerative Medicine (CIRM), is running out of money -- the $3 billion that voters gave it in 2004. It needs the initiative to qualify for the ballot and voters to approve it or CIRM will begin closing its doors next fall.
As of this evening, the multibillion dollar rescue proposal was nominally 63 percent along the road to qualifying. The measure had 394,237 valid signatures of registered voters, according to election officials. It needs 623,212.
But the campaign says it really wants substantially more. A campaign official today said that its desired figure is 685,534, 110 percent of 623,212. Reaching 110 percent would avoid a "full check," which is a prolonged verification of each signature. That process might not be finished until after the deadline of June 24 for counties to get their figures to state election officials. The state schedules its verification on June 25.
A goal of reaching 685,534, however, means that the backers of the measure have only 58 percent of the signatures needed.
"If the result of the (now ongoing) random sample indicates that the number of valid signatures represents between 95% and 110% of the required number of signatures to qualify the initiative or referendum measure for the ballot, the secretary of state directs the county elections officials to verify every signature on the petition," according to the state's ballot initiative web site.
Critical to the process is the percentage of qualified signatures out of the 924,189 that were turned in May 12 by the measure's backers. That percentage is holding relatively steady at about 78 and has varied little as the count has progressed over several weeks. As long as validity rate stays above about 74 percent, the initiative will be sent to voters.
"We’ve been very pleased with the validity rate so far and believe we have more than enough valid signatures to qualify," said Sarah Melbostad, a campaign spokeswoman.
The measure's validity rate is also closely aligned with five other initiatives that have qualified or nearly qualified in recent months for the fall ballot. Those initiatives have run or are running at rates that range from 73 percent to 78 percent. That is significant because the signatures are largely gathered by firms that specialize in that sort of work.
It is reasonable to surmise that the firms, which compete for business, are more than likely to produce similar results. (For the other initiatives, see here and also here. The five initiatives mentioned had to labor under the restrictions of the Covid crisis.)
Officials have not yet verified signatures in some larger counties including San Diego, Orange and Riverside.
Look for the latest figures tomorrow evening or early Friday on the California Stem Cell Report.
Advisory: Update on Ballot Count for California Stem Cell Measure
Advisory on Ballot Initiative Count, Fresh Figures Not Forthcoming
Monday, June 01, 2020
California's $5.5 Billion Stem Cell Countdown: Sixty-two Percent Along the Road to the November Ballot
Saturday, May 30, 2020
California's $5.5 Billion Stem Cell Countdown: Snail-like Progress Towards the Ballot
Friday, May 29, 2020
California's Stem Cell Agency Backs More Covid Research in its $5 Million Round
"“These three projects highlight three very different approaches to combatting the acute devastating health manifestations of Covid-19 as well as the debilitating sequelae that impact the ability to recover from the acute illness. Through this Covid funding opportunity, CIRM is enabling researchers to re-direct work they have already done, often with CIRM support, to quickly develop new approaches to Covid-19."
An American Vaccine Disaster 65 Years Ago: Lessons for Today
"If anything is known for sure about the scientific battle against the novel coronavirus, it’s that the quest for a vaccine has been unprecedentedly intense, with rapid development and speedy production the paramount goals."
"The so-called Cutter incident was 'one of the worst biological disasters in American history, exploded the myth of the invulnerability of science and destroyed faith in the vaccine enterprise,' observed Paul Offit, a vaccine expert at the University of Pennsylvania whose 2005 book is the definitive account of the episode."
"Public confidence in the vaccine was shattered. 'The summer of 1955 came and went with few children getting their shots,' historian David Oshinsky, a co-author of the JAMA article, recounted in his 2005 history of the epidemic. Major outbreaks occurred in Boston and Chicago. 'It seemed like old times, with beaches and movie theaters once again deserted and people fleeing the cities to escape the evil germs.'"
"Clinical trials won’t be the final hurdle in bringing vaccines to the world. Managing the public’s expectations will be crucial, since no vaccine for anything is 100% effective. So will ensuring that the manufacturing process is airtight."With anti-vaxxers and conspiracy theorists already spreading wild stories about the coronavirus, it would be a shame to give them more ammunition."'In this world, where there’s so much vaccine hesitancy and doubt,' Caplan said, 'you better get it right, out of the box. You can’t afford a failure. Even knowing that we’re in desperate need of a vaccine and the deaths are happening, I worry that if we don’t do it right, it’s going to be worse.'"
Thursday, May 28, 2020
California's $5.5 Billion Stem Cell Countdown: Still Creeping Up Little by Little
Rogue Stem Cell Clinics and Covid: California Moves 'Sedately' on Regulation
The marketing surge by the clinics has drawn increased attention nationally, including in prestigious scientific journals such as Cell Stem Cell whose usual fare deals with such things as "Stem Cell Hierarchy in Colorectal Cancer."
But one article published earlier this month was titled:
"In the midst of a global public health emergency, some businesses are taking advantage of widespread fears by marketing purported stem cell treatments for Covid-19.
"Such businesses target prospective clients with misleading claims, expose patients to potentially risky stem cell-based products, and undermine efforts to develop evidence-based treatments for Covid-19."Nearly two years ago, California's State Medical Board said it was going to tackle the problem of the rogue clinics. But to this date little has occurred. State legislation to develop regulations was also sidelined.
The California Stem Cell Report queried the medical board earlier this month concerning the status of its effort and whether regulations had been drafted and when a draft would be ready. In response, the board last week released the following statement:
"The board is continuing to work toward the goal of providing recommendations on stem cell and regenerative therapies and developing some guidelines that California physicians and patients can follow that will include a sample informed consent document and educational materials for the public to present to the board for review and final approval.
"In the meantime, pursuant to Business and Professions Code section 684, healthcare practitioners providing stem cell therapy not approved by the Food and Drug Administration (FDA) and who have not obtained approval or clearance for an investigational new drug or device exemption from the FDA for the use of human cells, tissues, or cellular or tissue-based products, must provide notice to their patients indicating the lack of FDA approval, and encouraging their patients to consult with their primary care physician before treatment. Individuals concerned about a physician’s stem cell practice should file a complaint with the Board for review and appropriate action."
"The proliferation of stem cell clinics selling untested and unlicensed therapies has been a public health crisis for years. The Covid-19 pandemic will only deepen the crisis as clinics add the coronavirus to their menu of treatment claims."The California stem cell agency has also pushed for tighter regulation and partnered to help pass the law for disclosure notices concerning lack of FDA approval. For patients considering stem cell treatments, the agency has posted as rundown on issues concerning the treatments or clinical trials.
"If you go online you can find lots of stem cells clinics, all over the US, that claim they can use stem cells to help people with Parkinson’s. Should I go to them?
("In a word, no! These clinics offer a wide variety of therapies using different kinds of cells or tissues (including the patient’s own blood or fat cells) but they have one thing in common; none of these therapies have been tested in a clinical trial to show they are even safe, let alone effective. These clinics also charge thousands, sometimes tens of thousands of dollars these therapies, and because it’s not covered by insurance this all comes out of the patient’s pocket.
("These predatory clinics are peddling hope, but are unable to back it up with any proof it will work. They frequently have slick, well-designed websites, and 'testimonials' from satisfied customers. But if they really had a treatment for Parkinson’s they wouldn’t be running clinics out of shopping malls, they’d be operating huge medical centers because the worldwide need for an effective therapy is so great.
("Here’s a link to the page on our website that can help you decide if a clinical trial or “therapy” is right for you.")
Wednesday, May 27, 2020
California's $5.5 Billion Stem Cell Countdown: No Big Jump Today
Correction
California's $5.5 Billion Stem Cell Countdown: Nearly 15 Percent Along the Path Towards a Rescue
Tuesday, May 26, 2020
Correction
California Stem Cell Agency Backs Away from Covid Vaccine Plan; Concerns Raised About Mission Creep
"We should be realistic about how that may look good on our website...but the reality is that this whole project (is) not going to have major, short-term impact barring some wonderful serendipity."And, and to come back to the original trust of the voters of California in CIRM, I really do think that we are deviating from our mission and ought not dilute our impact, which is so necessary and so vital."
"As an agency we're taking a much broader and much more sophisticated view of what our mission is. It's morphed. If we were being true to our original mission, we would only be doing embryonic stem cell research....(T)hat's what we the voters asked us to do in 2004."
"To sum up, I'm not really sure what the board is trying to accomplish with its Covid program. I'm not sure that the board has a clear, coherent view of the scope of CIRM's research. And I am not sure the board has a clear idea of what the scientific mission of CIRM should be in the event that new funding comes from the voters."
Text of Sheehy's comments re Covid-19, CIRM, Its Mission and Other Matters
The discussion at the May 23, 2020, meeting of the governing board of the California stem cell agency ranged from Covid-19 and the agency's strapped financial condition to its mission and priorities. One of the directors, Jeff Sheehy, elaborated on the matters and more when he responded to an inquiry following the meeting from the California Stem Cell Report.
The California Stem Cell Report has a policy of running verbatim comments from stem cell agency board members and other interested parties. If other readers would like to submit their comments on this subject or other stem cell matters, please direct them to djensen@californiastemcellreport.com.
Below is the verbatim text of Sheehy's comments.
"First, I felt a great deal of uncertainty around CIRM proposing a COVID program. Having worked towards stem cell therapies for HIV since I came onto the board in 2004, I felt some skepticism around stem cell approaches targeting infectious diseases (ID). Infectious disease has not been a particularly major focus of regenerative medicine efforts and many of the approaches we have tried have struggled. I think there could be a role, but we have a long way to go.
"I thought, in general, a focus on ID is a bit overdue, but I was very concerned about taking funds from sickle cell, where I think there is a strong case for believing we are on track for a cure using stem cell technology, and there are well constructed clinical trials such as the one we just funded.
"Given that CIRM is using its last of its funding, I was also concerned about the funding needed. One of the most telling moments in Friday's meeting was the descriptions by (CIRM Director) Dr. (Keith) Yamamoto (vice chancellor for science policy at UCSF) of the ready and ample availability of Covid funding from the NIH and other federal sources, not just in new funds but also the ability to repurpose existing grants towards Covid.
"Btw, I am not alone in my skepticism around stem cells for Covid-19. I offer first the tweet from Dr. Sean Morrison, former head of ISSCR on March 29:
"'There is no stem cell therapy for Covid19. We would not expect stem cells to have any therapeutic value for people with Covid19.
@ISSCR'"
"Then a couple of weeks ago, Dr. Paul Knoepfler on his blog, the NICHE, offered this:
"'The idea of testing stem cells for Covid-19 may be music to the ears of some folks as an opportunity, but to me from the beginning it sounded mostly like a spaghetti on the wall road to trouble.
"'There is buzz out there that some kind of stem cells or other cells will help with COVID-19. The reality is that that’s probably not going to happen.
"'Even so, a whole range of people and firms are somewhat exaggerating and in a few cases outright hyping the odds of success. That is harming patients and the cell medicine field.'"
"I offer these two comments in support of my doubts. But, I also feel the urgency surrounding Covid. This is my second pandemic, having lived through HIV/AIDS and lost and continue to lose countless people that I care deeply about and living with the disease myself, having endured enormous stigma and outright hatred along with indifference from a president, seeing marginalized communities suffering death and disease disproportionately and indifference because people don't recognize the humanity of the populations most impacted, feeling triggered and re-traumatized by this second pandemic and the enormous stupidity from all points in trying to make a disease fit their self described perceptions of reality in the face of what is real and undeniable.
"I voted to support the COVID program despite my doubts due to urgency, but we know what tools work against infectious diseases -- antivirals and vaccines, and I became an enthusiastic and vocal supporter of the vital research opportunity for convalescent plasma. Convalescent plasma is about as far removed from CIRM as a project could be--a technology at least 100 years old with zero barriers to receiving funding from any source. But, in the absence of a vaccine or antivirals, it represented to me the best and most rational chance to make a difference in patients now. Plus, Zaia et al at City of Hope have the cell handling and manufacturing ability to address some of the factors limiting use and evaluation of convalescent plasma, e.g. potency and consistency of product to name a couple.
"After having participated in reviews, our two clinical projects are the convalescent plasma one and an ongoing $14 million trial for mesenchymal stem cells for ARDS, the lung complication suffered by critical COVID patients necessitating ventilator support. That UCSF/UC Davis trial is already treating COVID patients at SF General and in Houston to name a couple of sites, and it was supportable because we were availing more patients of access to that therapy like we are doing with convalescent plasma. But both approaches are well supported outside of CIRM and the $750K we gave each project.
"The $150K Discovery projects we funded are interesting, but they are very early in development and given the time and money it takes to move from discovery into translation into clinical trials, these antiviral products could likely be superseded by the host of antiviral products in trials around the world.
In that context, we did see a couple of interesting vaccine proposals that were very far afield and did not score in the fundable range. I had a feeling -- having looked at the vaccine trials underway (and I'm not an expert btw) -- that they seemed very much based in the most part on proven tech that a far-out, left field approach might be useful to explore. HIV has been stubbornly resistant to vaccine development, so I'm very cautious about that field. I was heartened to hear (CIRM Director) Dr. (Kristiina) Vuori from Sanford Burnham opine that she thought that current vaccine approaches were, to paraphrase, following usual pathways, and I thought I heard a suggestion that opening up CIRM to vaccine work might elicit something novel.
"However, the board thought otherwise and I defer to their wisdom.
"I would note that I was intrigued by the discussion around CIRM's mission. As Dr. (Gil) Sambrano (CIRM vice president for portfolio development) noted, stem cells are ubiquitous in the body, and I took that to mean that one could either be elastic or inelastic in accepting products. A vaccine, for instance, would almost necessarily impact T memory stem cells, which are a crucial part of the adaptive immune response to disease (and a vaccine). We have begun to recognize the limits of stem cell centric therapies through our VRO for gene therapy.
"I then asked myself, does CIRM hews to its original mission per Prop. 71? I looked up the original funding mission for the Grants Working Group :
"'(C) In order to ensure that institute funding does not duplicate or supplant existing funding, a high priority shall be placed on funding pluripotent stem cell and progenitor cell research that cannot, or is unlikely to, receive timely or sufficient federal funding, unencumbered by limitations that would impede the research. In this regard, other research categories funded by the National Institutes of Health shall not be funded by the institute....Notwithstanding subparagraph (C), other scientific and medical research and technologies may be funded by the institute if at least two-thirds of a quorum of the members of the Scientific and Medical Research Funding Working Group recommend to the ICOC that such a research proposal is a vital research opportunity.'
"With the federal ban ended, all of CIRM's research is really a vital research opportunity by default at this point. Per COVID and ample federal funding, any funding in that arena is about as far afield as one could get.
"Even with fetal tissue research, which, btw, has fallen off the radar in the media and with some in Congress and the Administration, I can guarantee no one is talking about banning that. You simple cannot develop vaccines or antivirals without mice with humanized immune systems created by using fetal tissue.
"To sum up, I'm not really sure what the board is trying to accomplish with its COVID program. I'm not sure that the board has a clear, coherent view of the scope of CIRM's research. And I am not sure the board has a clear idea of what the scientific mission of CIRM should be in the event that new funding comes from the voters.
"I would note as an aside that CIRM has never submitted its scientific program, including all grants made and their impact, to a rigorous, independent scientific review.
"In short, I don't think we really know at CIRM where we've been and where we want to go. We have anecdotes...."
(Sheehy’s own ellipses in the last paragraph)
Saturday, May 23, 2020
The $5.5 Billion California Stem Cell Countdown: One-Thirteenth Along the Way
Friday, May 22, 2020
$5.5 Billion California Stem Cell Countdown: Total Raw Signatures Now in With 924,213
Parkinson's and the Unseen Offspring of California's Stem Cell Agency
"All of my CIRM awards contributed to (Aspen). We used those funds to develop our genomics tools and databases and to develop improved methods for handling the cells."
"If you go online you can find lots of stem cells clinics, all over the US, that claim they can use stem cells to help people with Parkinson’s. Should I go to them?
("In a word, no! These clinics offer a wide variety of therapies using different kinds of cells or tissues (including the patient’s own blood or fat cells) but they have one thing in common; none of these therapies have been tested in a clinical trial to show they are even safe, let alone effective. These clinics also charge thousands, sometimes tens of thousands of dollars these therapies, and because it’s not covered by insurance this all comes out of the patient’s pocket.
("These predatory clinics are peddling hope, but are unable to back it up with any proof it will work. They frequently have slick, well-designed websites, and 'testimonials' from satisfied customers. But if they really had a treatment for Parkinson’s they wouldn’t be running clinics out of shopping malls, they’d be operating huge medical centers because the worldwide need for an effective therapy is so great.
("Here’s a link to the page on our website that can help you decide if a clinical trial or “therapy” is right for you.")