Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.

Q: Paragraph: The mosquito-borne viral infection has spread across the country, with 61 out of 64 districts reporting dengue cases by late Tuesday. The government has confirmed 15,369 dengue cases since Jan. 1. Of those, 9,683 patients were diagnosed between July 1 and July 30. As of Tuesday, about 4,400 patients, including many children, were undergoing hospital treatment. There have been 14 deaths. Officials from Dhaka, the overcrowded capital and the epicenter of the outbreak, have struggled to contain it, drawing criticism and spreading panic among some residents. Dengue is found in tropical areas around the world and is spread by a type of mosquito that mainly lives in urban areas. The virus causes severe flu-like symptoms, and while there is no specific treatment for the illness, medical care to maintain a person’s fluid levels is seen as critical. There are fears that the situation in the countryside will worsen as many residents of the city travel to villages to celebrate Eid-ul-Adha next month. Infected humans can serve as a source of the virus for uninfected mosquitoes. Ayesha Akhter, assistant director at the Directorate General of Health Services under the Ministry of Health, said an outbreak of dengue has accompanied every monsoon since 2000, but this year’s situation is the worst. A DGHS study identified a six-fold increase in the Aedes aegypti mosquito population in four months in Dhaka as the primary cause of the larger-than-average outbreak. Earlier this month, the World Health Organization said the dengue situation in Bangladesh was “alarming but not out of control.” Other countries in Asia are also facing a surge in dengue cases this year, including Thailand, where 53,699 cases and 65 deaths were reported as of July 23. Nevertheless, with dengue cases soaring in recent weeks, Dhaka hospitals have been running out of room and manpower to treat new patients. Prof. Abul Kalam Azad, director general of DGHS, said they had asked the hospitals to increase beds for dengue patients and to open dengue wards. The government also halved the charges for diagnosing dengue and directed public and private hospitals, clinics and diagnostic centers to do the same. Dhaka Medical College Hospital, the largest hospital in the country, opened a special ward for dengue patients, said A.K.M. Nasir Uddin, its director general. Prof. Uttam Kumar Barua, director of Shaheed Suhrawardy Medical College and Hospital, another major public hospital in Dhaka, said they were relying on senior medical students to assist doctors in the face of so many patients. “We don’t have manpower, logistic support and technicians as much as needed. That’s why we are having too much pressure. We have three times more patients than our bed capacity,” Barua said. He said they were admitting every dengue patient who entered the hospital but could not provide beds or even seats for everyone, adding that many had been asked to wait in hospital corridors and verandas. Champa Begum took her 8-month-old to Shaheed hospital on Wednesday. “I have other kids. I go to work leaving this one to another child. I have no way but to work,” she said. “I can’t take care of this child properly. This child is laid down anywhere. My home is above dirty water. That how this one was bitten and got dengue.” On Tuesday, Bangladeshi Prime Minister Sheikh Hasina called for concerted efforts to fight the illness. “The government is working to tackle dengue,” she told an emergency meeting of her ruling Awami League party via teleconference from London, where she was on an official visit. “I urge everyone to keep their houses and surrounding areas clean. That will save us from the disease,” she said. The country’s opposition parties and urban planning experts blamed the central and local government’s lack of preparedness for the rise in dengue cases. People have taken to Facebook to vent their anger about city authorities’ failure to control dengue-carrying mosquitoes. Claim: Bangladesh grapples with country’s worst dengue outbreak.

A: Bangladesh is facing its worst-ever dengue fever outbreak as hospitals are flooded with patients, putting a severe strain on the country’s already overwhelmed medical system.
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Q: Paragraph: We’ll give the story the benefit of the doubt for again leaning on an independent expert who says the technology is likely prohibitively expensive. While no dollar estimate is given, we think this is good enough for now. As with the harms, the story does quantify the benefits in one way. It says, “It could help avoid up to 98% of these screening procedures, according to the study, which appears in BMJ.” It also says, “The new study included 753 pregnant women who were at high risk for having a child with Down syndrome. Of these, 86 women were determined to be pregnant with a child with Down syndrome.” The story does quantify potential harms in one way by noting, “There were no false-negative results with the new test.” We wish the story also spoke about false positives. False positives are certainly part of the stress and harms from any screening test that need to be considered. In this case, it appears the false positives were low but not negligible. The story adequately describes the study design. The story does avoid disease monitoring, but we wish it had included some of the data from the paper about the frequency of Down syndrome and even some of the other disorders. The LA Times blog piece managed to do this in much less space. The story provides a wealth of outside experts who provide great commentary and context about the study’s findings. We wish more stories about screenings had quotes like these: “In a year or two, this test may be available, but it won’t replace existing technologies, it will nudge its way into our armamentarium of available methodologies,” says Mark I. Evans, MD,  director of Comprehensive Genetics in New York City, and an obstetrician/gynecologist at Mount Sinai School of Medicine, also in New York City. “The bad news is that prenatal diagnosis is not just about Down syndrome…Down syndrome represents about 50% of what we find, and this new test can help with that, but it may also give women a false sense of reassurance.” The story tries to do a good thing by explaining at the very end that the new test is not a diagnostic test, as amniocentesis and chorionic villus sampling are. Rather, it’s a screening test. The distinction – and the significance of that – could have been made more clearly, but we give the story the benefit of the doubt. The story leans on an independent expert to say that the test is “not ready for prime time….in a year or two, this test may be available.” The story does not establish the test’s novelty, and this is largely because it does not provide the proper context. The study itself says, “In the past 20 years maternal age has been combined with ultrasonographic examination of the fetus and biochemical measurement of various proteins or hormones in the maternal circulation to improve identification of high risk pregnancies. This combined approach of screening can now identify more than 90% of affected fetuses, but there is still a need for invasive testing in 3–5% of the population.” This means that as many as 95% of all women would not need invasive testing to begin with, so this test is only potentially a breakthrough for a small minority of women. BMJ actually makes the novelty question easy to answer by breaking it down this way:  What is already known on this topic: Non-invasive prenatal detection of fetal trisomy 21 is achievable by massively parallel sequencing of maternal plasma DNA Its diagnostic performance and practical feasibility in the clinical setting has not been tested on a large scale. What this study adds: Among high risk pregnancies clinically indicated for invasive prenatal diagnosis, non-invasive detection of fetal trisomy 21 can be achieved with the use of multiplexed massively parallel sequencing of maternal plasma DNA at 100% sensitivity and 97.9% specificity, giving a 96.6% positive predictive value and 100% negative predictive value. The sequencing test could be used to rule out trisomy 21 among high risk pregnancies before proceeding to invasive diagnostic testing to reduce the number of cases requiring amniocentesis or chorionic villus sampling.” The story does not rely on a news release. Claim: Progress Toward Blood Test for Down Syndrome

A: This thoroughly reported and carefully written story avoids giving pregnant women false hope of an easier way to detect genetic anomalies while still presenting some compelling information about a new blood test. Pregnancy can be anxiety inducing because of the sheer number of tests already required of women: frequent blood tests, ultrasounds, and amniocentesis in many cases. Add to that the barrage of stories about the way diet and environmental conditions may be affecting in utero development at any given point and one can understand why women might want a simpler solution to find out whether their child might have a genetic disorder. Overall, we think if more stories approached screening the way this story did there would be fewer people demanding the latest over-hyped test from their doctor. This is a “hope for the future” level test that may be inching its way to market. It’s not available now and won’t be in the immediate future – and the story makes that clear.
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Q: Paragraph: America’s opioid epidemic, especially damaging in rural areas where Trump is popular, has been a focus for the Republican president. On Tuesday, the government charged drug distributor Rochester Drug Co-operative Inc and company executives for their role in fueling the epidemic. The company agreed to pay $20 million and enter a deferred prosecution agreement to resolve charges it turned a blind eye to thousands of suspicious orders for opioid pain killers. “We are holding big Pharma accountable,” Trump said at the Rx Drug Abuse and Heroin Summit in Atlanta. Deaths from opioid overdose in the United States jumped 17 percent in 2017 from a year earlier to more than 49,000 according to the Centers for Disease Control and Prevention. Deaths from potent synthetic opioids like fentanyl surged 45 percent in that time, according to the CDC. Hundreds of lawsuits by state and local governments accuse drugmakers such as Purdue Pharma of deceptively marketing opioids, and distributors such as AmerisourceBergen Corp, Cardinal Health Inc and McKesson Corp of ignoring that they were being diverted for improper uses. Trump said he convinced Chinese President Xi Jinping in a December meeting in Argentina to designate fentanyl as a controlled substance. China last month listed all fentanyl-related substances as controlled narcotics after criticism from Trump, though its government blamed U.S. culture for abuse of the drug and said the amount of fentanyl going from China into the United States was “extremely limited.”  “Almost all fentanyl comes from China,” Trump said on Wednesday. “They are going to make it a major crime.”   Little has come of Trump’s earlier calls for executing drug dealers. But the administration has taken some action to address the crisis on other fronts. Trump declared the opioid crisis a public health emergency in October 2017. Last week, U.S. health officials said they will spend $350 million in four states to study ways to best deal with the opioid crisis on the local level, with a goal of reducing opioid-related overdose deaths by 40 percent over three years in selected communities in those states. The Democratic National Committee said in a statement before Trump’s remarks that his proposed Medicaid cuts and efforts to overturn the Affordable Care Act, popularly known as Obamacare, could make the opioid problem worse. Trump has used the crisis to support his call for building a wall on the border with Mexico, saying it would help keep out heroin and other illegal drugs and curb the crisis. Claim: Trump says he is holding big Pharma accountable in opioid fight.

A:
U.S. President Donald Trump touted progress in the fight against opioid abuse on Wednesday and promised to hold drugmakers accountable for their part in the crisis, a day after his administration brought its first related criminal charges against a major drug distributor and company executives.
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