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On this page IntroductionEach year, Health Canada receives thousands of reports of suspected adverse reactions (side effects) about drugs and natural health products and how to get zithromax without prescription of suspected medical device incidents. These reports, captured through the Canada Vigilance Program, contribute to Health Canadaâs post-market monitoring of health product safety.Manufacturers, importers, hospitals and other mandatory reporters are required to report to Health Canada on adverse reactions and incidents related to marketed health products. Health Canada also encourages health care professionals, patients, caregivers and consumers how to get zithromax without prescription to submit voluntary reports about serious adverse reactions or incidents concerning drugs, natural health products or medical devices. Data from both the Canada Vigilance Program and other sources, like recalls that are reported to Health Canada, provide critical information that helps improve patient safety.Building the Canada Vigilance Program Since the Canada Vigilance Program began, the number of reports submitted to Health Canada has increased every year.

This increase is due to a number of factors, such as. The rise how to get zithromax without prescription in the overall number of marketed health products the implementation of mandatory reporting for all hospitals in Canada the expansion of the Canadian Medical Devices Sentinel Network (CMDSNet), Health Canadaâs proactive surveillance program that encourages program participants to report medical device incidents the implementation of voluntary consumer reporting Health Canadaâs efforts to promote simpler and easier ways to report a changing and aging Canadian population with changing health needs an increase in patient safety programs by industry, which leads to an increase in targeted detection and reporting proactive information gathering efforts by Health Canada, which lead to the discovery of unreported adverse drug reactions and medical device incidents While the number of reports is increasing, we know that adverse drug reactions and medical device incidents continue to be under-reported in Canada and worldwide.Improving the Canada Vigilance ProgramHealth Canada continues to improve the quantity and quality of all incoming Canada Vigilance Program data by. Providing feedback to stakeholders on the quality of reports identifying and flagging duplicate reports in the Canada Vigilance database cleaning the data so it can be analyzed using automated data entry to reduce human error implementing mandatory reporting by hospitals of serious adverse drug reactions and medical device incidents (as of December 2019) About the 2019 dataThis page summarizes data on adverse reaction reports received by Health Canada during 2019 and key trends over the past 10 years. We present data on.

Adverse reactions to drugs and natural health products incidents related to the use of medical devices recalls that occurred after products were approved for sale in CanadaData on adverse drug reactions and medical device incidents are based on reports sent to Health how to get zithromax without prescription Canada through the Canada Vigilance Program. Recall data are based on the work of the Regulatory Operations and Enforcement Branch. The statistics on this page are based only on Canadian reports and how to get zithromax without prescription do not include data from other countries (foreign reports).Adverse reactions to drugs and natural health productsTotal number of reportsIn 2019, Health Canada received 96,559 domestic reports.Over the last 10 years. The number of Canadian reports has increased over 4-fold (from 22,211 reports in 2010 to 96,559 reports in 2019) Health Canada received an average of 8,000 Canadian reports per month in 2019 Source of reportsIn 2019.

90,350 (93.6%) of reports came from mandatory reporters Canada has a strong reporting system in place to ensure that industry is responsible for their products and that they submit reports in a timely manner 3,849 (4.0%) were voluntary reports from health professionals working outside of hospitals 956 (1.0%) were voluntary reports from the general population 1,248 (1.3%) were from hospitals, which, until December 16, 2019, submitted reports to Health Canada on a voluntary basis Going forward, Health Canada anticipates receiving a larger volume of reports from hospitals because of the new mandatory reporting regulations Over the last 10 years. 9 out of 10 reports received at Health Canada were submitted by industryTypes how to get zithromax without prescription of reported productsOne or more drugs or natural health products may be mentioned in a report because the reporter suspects they played a role in the adverse reaction.In 2019. A total of 208,383 drugs or natural health products were mentioned in the 96,559 reports sent to Health Canada pharmaceutical drug products were most often reported, at 68.1% biotechnological products were the second most frequently reported, at 28.1% within these product categories, the specific products most often reported were. immunosuppressants (drugs that aim to reduce the activity of the bodyâs immune system) at 32.5% of all reported suspected products anti-neoplastic agents (drugs used to treat cancer) at 16.4% of all reported suspected products Over the last 10 years.

The most common products reported each year in adverse drug reactions have been immunosuppressants how to get zithromax without prescription and anti-neoplastic agents these numbers reflect the. large number of anti-neoplastic agents approved for use in Canada known risks associated with these products large number of patient reporting programs in place for these products severity of the underlying disease in the population being treated each year, more drugs and natural health products are included in the adverse reactions reported to Health Canada from 25,668 reported products in 2010 to 208,383 reported products in 2019, an 8-fold increase this may be due to improved reporting mechanisms and increased general awareness of the risks involved in using multiple products with the reporting of more drugs and natural health products, we can look at product interactions seen in real-world situations involving Canadians with complex medical needs Adverse reactionsA report may mention more than one adverse reaction. In 2019 how to get zithromax without prescription. 420,120 adverse reactions were mentioned in the reports sent to Health Canada the top 4 reported adverse reactions included.

general disorders and administration site conditions, such as pain or weakness (96,640, or 23.0%) gastrointestinal disorders, such as vomiting or diarrhea (37,892, or 9.0%) investigations that include performing tests and physical examinations (33,651, or 8.0%) musculoskeletal and connective tissue disorders resulting in swelling or joint pain (33,531, or 8.0%) Over the last 10 years. Each year, more adverse reactions are included in the reports sent to Health Canada from 79,249 adverse reactions in 2010 to 420,120 reported reactions in 2019, a 5-fold increase this may be due to improved reporting mechanisms if more reporters report similar details about adverse reactions, this will help to reinforce ongoing issues seen with certain how to get zithromax without prescription products this may signal a potential public health issue for further review OutcomesIn 2019. 7 out of 10 (67,754, or 70.2%) adverse reactions reported to Health Canada were of a serious natureOver the last 10 years. The majority of adverse reaction reports were serious because.

regulated parties are legally obligated to report all serious reactions to Health Canada health professionals and consumers are more likely to report serious reactions that result in harm We make how to get zithromax without prescription it a priority to review the most serious product safety issues affecting Canadians. However, all reports are important. Together, they help to flag how to get zithromax without prescription potential product safety issues .In 2019. 6,119 (6.3%) reports mentioned a suspected link between a death that had occurred and the use of a drug or natural health product 18,852 (19.5%) reports mentioned hospitalization 2,483 (2.6%) reports mentioned the occurrence of a potentially life-threatening condition 193 (0.2%) reports mentioned a congenital anomaly (birth defect) 52,119 (54.0%) reports indicated that, without intervention, the reported adverse reaction could have resulted in a serious outcomeOutcomes are complex and may be the result of multiple factors, including existing medical conditions or the progression of an illness.

A reported outcome may not be directly caused by the use of a drug or natural health product. Increasing the quantity and quality of reports submitted to Health Canada can provide more robust evidence and help to determine if there is how to get zithromax without prescription a link to specific products. This in turn can keep Canadians safer from the harmful effects of certain health products. Medical device incidentsTotal number of incidentsIn 2019, Health Canada received information about 25,235 domestic incidents.Over the last 10 years.

The number of Canadian how to get zithromax without prescription incidents has increased almost 4-fold (from 6,326 incidents in 2010 to 24,726 incidents in 2019) an average of 2,000 Canadian incidents were reported each month in 2019Source of reportsIn 2019. 22,809 (92.2%) incidents were reported by industry Canada has a strong reporting system in place where industry is held accountable for their products and must report incidents in a timely manner to Health Canada as per the Medical Devices Regulations 1,018 (4.1%) incidents were based on voluntary reports from the community Voluntary reports from consumers, health care professionals and others add to the quality and quantity of incoming data and help provide a comprehensive picture of medical device problems or issues 554 (2.2%) incidents were reported by health care institutions participating in CMDSNet CMDSNet is a proactive surveillance program that encourages the reporting of medical device problem reports from participating institutions CMDSNet provides a complementary data source for post-market safety evaluations Over the last 10 years. 9 out of 10 incidents were reported by industryWith the introduction of mandatory reporting for all hospitals in December 2019, we anticipate receiving a larger volume of incident reports from hospitals in the future.Types of reported productsA medical device incident may involve more than one medical device. This means that multiple devices may be described in the reports sent to how to get zithromax without prescription Health Canada.In 2019.

A total of 25,519 suspected medical devices were mentioned in the incidents reported to Health Canada the most frequently reported devices were used in. general and plastic surgery (8,926, or 35.8%) general hospital settings (5,977, or 24.0%) cardiovascular care, like pacemakers, defibrillators and stents (2,478, or 10.0%) Over the how to get zithromax without prescription last 10 years prior to 2019. Devices for general hospital use (such as needles, catheters and syringes) were most often reported these incidents do not mean that these devices have more risk or cause more harm. Rather, they were.

reported more frequently to Health Canada used how to get zithromax without prescription more often more readily available when compared to other medical devices in more specialized categories In 2019. The category of general and plastic surgery (with devices such as electrodes, implants and surgical staplers) was the most reported this was due to the submission of a large number of reports related to breast implants this prompted Health Canada and its partners to. investigate the risks associated with some types of breast implants take some unsafe breast implant products off the market educate Canadians about breast implants Over the last 10 years. Each year, more suspected products are being reported in the medical device incidents sent to Health Canada from 6,544 devices in 2010 to 25,519 devices in 2019, a 4-fold increase this may be due to improved reporting mechanisms and increased general awareness of the importance of reporting how to get zithromax without prescription increased reporting gives us the ability to better understand what happens when people use more than one device at a time Device issuesMore than one issue or problem with a device may be mentioned in a medical device incident.

In 2019. 28,124 issues related to the use of medical devices were experienced material integrity problems (for example, material how to get zithromax without prescription rupture, a burst container or vessel, or breaking) were mentioned 28.1% of the time mechanical problems (especially fluid leaks) were mentioned 21.1% of the time Over the last 10 years. The types of reported issues may vary from year to year more issues with medical devices are being included in the reports sent to Health Canada from 374 issues in 2010 to 28,124 issues in 2019 this is likely due to improved reporting practices, which are capturing more detail, and the increase in the number of incoming reports we are working on improving standardized reporting and categorization of information, which will increase the quality and usability of the dataHealth effectsMore than one health effect may be mentioned in a medical device incident.In 2019. 22,518 health effects were mentioned in incidents reported to Health Canada the top reported health effect was hyperglycemia (high blood sugar), which was reported in 1,896 (8.4%) incidents other reported health effects included.

capsular contracture (when the capsule how to get zithromax without prescription surrounding an implanted device distorts) (1,671, or 7.4%) injury (1,338, or 5.9%) pain (761, or 3.4%) Over the last 10 years. Hyperglycemia has remained a top reported health effect this is not unexpected. Devices that measure blood sugar, such as glucose meters and glucose monitoring systems, are some of the most frequently used medical devices in CanadaOutcomesIn 2019. 7,949 (34.5%) how to get zithromax without prescription medical device incidents reported to Health Canada were of a serious natureOver the last 10 years.

The proportion of medical device incidents that were serious. varied between 10.3% and 19.6% from 2010 to 2018 jumped to over one-third of all incidents in 2019 this was due how to get zithromax without prescription to the submission of a large number of reports related to breast implants While priority is given to reports that are flagged as serious, all reports are important. Taken together, reports of medical device incidents may indicate a potential public health issue. In 2019.

85 (0.4%) of all medical device incidents mentioned a possible link between a death that occurred and the use of a medical device however, the reported death may not have been directly caused by the suspected medical device incident surgery was the most common outcome reported in medical device incidents, with 3,365 incidents involving some form of surgery 1,659 (49.3%) were revision surgeries (to fix an issue) 1,291 (38.4%) were explantations how to get zithromax without prescription (removal of device) 1,274 (76.8%) of the reported revision surgeries and 1,079 (83.6%) of the explantations involved breast implants 3,791 (19.7%) incidents indicated that there was no reported patient involvement or consequences to a patient these incidents did not cause harm, but were reported to Health Canada because they were near misses under different circumstances or without intervention, serious harm may have occurred this information helps us work with industry to take action before an actual harm occurs Marketed health product recallsRecallsA drug or natural health product recall results in the correction of a distributed product or its removal from further sale or use.A medical device recall may result in. Removal of a product from further sale or use an on-site correction of the device an advisement to consumers of problems or potential problems with their device alternative labelling, which may include updates to instructions or manualsIn 2019, Health Canada received reports of. 162 pharmaceutical drug recalls 32 natural health product recalls 822 medical device recallsFor each report, the Department evaluates the recall strategy to ensure the appropriate corrective actions are taken and that the actions are effective. Identified health risksThere how to get zithromax without prescription are 3 types of health hazards.

Type I. Using or being exposed to a product will probably cause serious adverse health effects or death Type II. Using or being exposed to a product may cause temporary adverse health consequences or how to get zithromax without prescription the possibility of serious adverse health effects is remote Type III. Using or being exposed to a product is not likely to cause any adverse health effectsOf the 162 recalls of pharmaceutical drugs (prescription, non-prescription, radiopharmaceutical and active pharmaceutical ingredient).

52 were classified as type I 59 were classified as type II 51 were classified as type how to get zithromax without prescription IIIOf the 32 natural health product recalls. 16 were classified as type I 8 were classified as type II 8 were classified as type IIIOf the 822 medical device recalls. 37 were classified as type I 493 were classified as type II 292 were classified as type IIIRelated linksThe purpose of this notice is to advise stakeholders that Health Canada is proposing to. On this page how to get zithromax without prescription Overview The interim order (IO) introduced on May 23, 2020, provides another pathway to facilitate clinical trials for potential buy antibiotics drugs and medical devices, while upholding strong patient safety requirements and validity of trial data.

The IO expires on May 23, 2021, at which time authorizations for clinical trials issued under the IO will end. In light of the ongoing buy antibiotics zithromax, thereâs a need for sponsors of clinical trials for urgent drugs and devices used to diagnose, treat, mitigate or prevent buy antibiotics to continue their work. Thus, Health Canada proposes to maintain the flexibilities and regulatory oversight provided by the IO until at least the fall of how to get zithromax without prescription 2021. Weâre also proposing to bring forward regulatory amendments that would allow the flexibilities under the IO to continue after the fall of 2021.

Sponsors will be able to continue conducting clinical trials authorized how to get zithromax without prescription under the IO as well as use this other pathway for new or later-phase buy antibiotics clinical trials. The proposed regulatory amendments will also. maintain patient safety while broadening access to these trials support the development of safe and effective therapies, yet through flexible measures will reduce the overall impact on the health care system contribute to ensuring further regulatory predictability to sponsors engaged in these important clinical trials The proposed regulatory amendments will have minimal changes in relation to the IO. The only substantive change is to extend the how to get zithromax without prescription records retention requirement beyond the duration of the IO.

For IO-authorized drug clinical trials, Health Canada is proposing to set most records retention requirements to 15 years. For medical devices, weâre proposing to align records requirements with those outlined in the Medical Devices Regulations. Neither the IO nor these proposed transition regulations would apply to radiopharmaceutical drugs and Class I medical how to get zithromax without prescription devices. Health Canada is also proposing to reduce most 25-year records retention requirements to 15 years for trials authorized through normal regulatory pathways.

This would apply to drugs (excluding radiopharmaceuticals) how to get zithromax without prescription as well as natural health products under the Food and Drug Regulations and Natural Health Products Regulations. Health Canada is considering certain exceptions to this proposal. Next steps Health Canada will consult with interested industry stakeholders, health system partners and other government departments on the proposed regulations. We will be holding a webinar and teleconference in how to get zithromax without prescription each official language in December 2020.

Written comments are also welcome by January 25, 2021. Once stakeholder input is considered, we will publish the transition regulations in the Canada Gazette and revised guidance. Contact us For more information or to provide comments about this notice, please email how to get zithromax without prescription us at hc.policy.bureau.enquiries.sc@canada.ca. For more information on the proposed records retention requirements, please email us at hc.prsd-questionsdspr.sc@canada.ca.

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Latest antibiotics News By Ernie zithromax 1 gram oral packet Mundell HealthDay ReporterTUESDAY, Nov. 24, 2020 zithromax 1 gram oral packet â At least three new buy antibiotics treatment candidates are already in the pipeline, will a roll-out expected early in the new year. But on Monday, experts attending a meeting of an advisory committee to the U.S. Centers for Disease Control and Prevention stressed zithromax 1 gram oral packet that Americans who get a shot shouldn't be surprised if they feel under the weather for a few days afterwards."These are immune responses, so if you feel something after vaccination, you should expect to feel that. And when you do, it's normal that you have some arm soreness or some fatigue or some body aches or even some fever," Patricia Stinchfield of Children's Hospitals and Clinics of Minnesota, told the meeting of the CDC's Advisory Committee on Immunization Practices.

She represents the National Association of Pediatric Nurse Practitioners, and said providers must be ready to explain this to people who line zithromax 1 gram oral packet up to get any buy antibiotics treatment.treatments work to fight disease by producing an immune response within the body. And sometimes that means flu-like symptoms, such as aches, headache and fever.Already, some volunteers in trials of candidate treatments from drug companies Moderna, Pfizer and AstraZeneca have reported flu-like symptoms after immunization. And experts worry that those reports might keep zithromax 1 gram oral packet people away from vaccination, or from required second doses.The CDC's Dr. Sara Oliver told the committee during the five-hour-long meeting that, depending on the survey, anywhere between 40% and 80% of Americans say they'd be willing to get vaccinated.Dr. Paul Hunter, of the city of Milwaukee health department and a voting member of zithromax 1 gram oral packet the committee, said the testimonials of the first batches of people who get a buy antibiotics treatment could be crucial to wider acceptance."The people who highly value getting the treatment soon and fast, early, are going to be really helpful to everyone else.

And I think we really are going to need to honor them, because they are going to let us know how it feels," he told the committee. "And I think these people are likely to be health care workers who are likely to be up for that kind of task."Another treatment candidateAmericans were greeted with a possible advance against antibiotics zithromax 1 gram oral packet as Thanksgiving week began. A third treatment candidate shows good results in shielding recipients against the zithromax.Meanwhile, zithromax 1 gram oral packet U.S. antibiotics cases continued to explode. More than 179,000 new cases were recorded on Monday, with more than 12.4 million Americans now known to be infected.Hopes for the roll-out of another effective treatment brightened zithromax 1 gram oral packet on Monday, however.

Drug giant AstraZeneca announcing that late-stage clinical trials of its antibiotics shot showed it to be 70.4% effective, The New York Times reported.The trials were conducted in the United Kingdom and Brazil in collaboration with the University of Oxford. The AstraZeneca treatment becomes the third shot to show good effectiveness, following on the heels of promising data on zithromax 1 gram oral packet treatments from Pfizer and Moderna. Both of the latter two shots had effectiveness around 95%.The AstraZeneca results were based on the results of two dosing regimens for the treatment. One regimen showed an effectiveness of 62%, the company said, while the other showed a 90% effectiveness.The regimen showing a 90% effectiveness involved a first dose given at half strength zithromax 1 gram oral packet and a second dose given at standard strength. No severe cases of buy antibiotics emerged among any recipients, and there was a reduction in asymptomatic s, suggesting that the treatment was reducing transmission of the zithromax, AstraZeneca said.Worsening spreadIn the meantime, the new antibiotics is spreading across America with unprecedented speed, the White House antibiotics Task Force said in its first briefing in four months on Thursday."This is more cases, more rapidly, than what we had seen before," Dr.

Deborah Birx said during the briefing zithromax 1 gram oral packet. "You can see the increase in test positivity to around 10%." That's the number of people tested who get a positive diagnosis. SLIDESHOW Whooping Cough (Pertussis) Symptoms, treatment Facts See Slideshow Birx pointed to a map of the country zithromax 1 gram oral packet that is covered in red, highlighting the number of daily hospitalizations, which now regularly tops 70,000, CNN reported. Birx said she has been crisscrossing the country as she tries to encourage state and local leaders to take measures to stop the spread of the zithromax.Still, task force members spoke out against the idea of nationwide lockdowns or schools, even as New York City returned to remote learning this week, CNN reported."We do know what to do and we are asking every American to do those things today," Birx stressed. That starts with zithromax 1 gram oral packet wearing masks, but also staying apart and limiting gatherings, she said.The zithromax spreads even when people do not show symptoms, Birx noted.

"It is because of this asymptomatic spread that we are asking zithromax 1 gram oral packet people to wear a mask indoors," she said. "Decreasing those friend-and-family gatherings where people come together and unknowingly spread the zithromax," will also help slow the spread, she added.Earlier Thursday, the U.S. Centers for Disease Control and Prevention zithromax 1 gram oral packet asked Americans not to travel for Thanksgiving. More than 187,000 cases were announced nationwide on Thursday, another single-day record, and daily tallies have been rising in 47 states, according to The New York Times.In California, officials reported more than 13,000 new cases, a single-day record, prompting the state to announce a 10 p.m. Curfew for all but essential workers, the Times reported.Even if the current seven-day national average of about 166,000 daily cases plateaued until the end of the year, nearly 7 million more people would still contract buy antibiotics, the Times said.Though talk of two highly effective treatments came this week, they will not be widely zithromax 1 gram oral packet available until spring of 2021."We are in for a rough period through the end of February," Dr.

Jessica Justman, a professor of epidemiology at Columbia University, told the Times. "It looks hard to find a way to break it."A global scourgeBy Tuesday, the zithromax 1 gram oral packet U.S. antibiotics case count passed 12.4 million while the death toll neared 258,000, according to a Times tally. According to the same tally, zithromax 1 gram oral packet the top five states in antibiotics cases as of Tuesday were. Texas with nearly 1.2 million.

California with zithromax 1 gram oral packet just over 1.1 million. Florida with over 944,000. Illinois with nearly 666,000 zithromax 1 gram oral packet. And New York with almost 607,000.Curbing the spread of the antibiotics in the rest of the world remains challenging.Many European countries are zithromax 1 gram oral packet tightening restrictions, the Associated Press reported. France has entered a nationwide lockdown, and Germany and Austria have started partial lockdowns as government officials across the continent scramble to slow a sharp rise in s that threatens to overwhelm their health care systems.England has followed suit, while Italy, Greece and Kosovo also announced new measures, the AP reported.Things are no better in India, where the antibiotics case count has passed 9 million on Tuesday, a Johns Hopkins University tally showed.

More than 134,000 antibiotics patients have died in India, according to the Hopkins tally, but when measured as a proportion of the population, the country has had far fewer zithromax 1 gram oral packet deaths than many others. Doctors say this reflects India's younger and leaner population. Still, the country's public zithromax 1 gram oral packet health system is severely strained, and some sick patients cannot find hospital beds, the Times said. Only the United States has more antibiotics cases.Meanwhile, Brazil passed 6 million cases and had nearly 170,000 deaths as of Tuesday, the Hopkins tally showed.Worldwide, the number of reported s topped 59 million on Tuesday, with nearly 1.4 million deaths recorded, according to the Hopkins tally.More informationThe U.S. Centers for Disease Control zithromax 1 gram oral packet and Prevention has more on the new antibiotics.SOURCES.

CNN. The New zithromax 1 gram oral packet York Times. Associated PressCopyright Â© 2020 HealthDay. All rights zithromax 1 gram oral packet reserved. From Parenting Resources Featured Centers Health Solutions From Our Sponsors.

Latest antibiotics News By Ernie Mundell HealthDay ReporterTUESDAY, Nov how to get zithromax without prescription. 24, 2020 â At least three new buy antibiotics treatment candidates are already in the pipeline, will a roll-out how to get zithromax without prescription expected early in the new year. But on Monday, experts attending a meeting of an advisory committee to the U.S.

Centers for Disease Control and Prevention stressed that Americans who get a shot shouldn't be surprised if they feel under the weather for a few days afterwards."These are immune responses, so if you feel something after vaccination, you should expect how to get zithromax without prescription to feel that. And when you do, it's normal that you have some arm soreness or some fatigue or some body aches or even some fever," Patricia Stinchfield of Children's Hospitals and Clinics of Minnesota, told the meeting of the CDC's Advisory Committee on Immunization Practices. She represents how to get zithromax without prescription the National Association of Pediatric Nurse Practitioners, and said providers must be ready to explain this to people who line up to get any buy antibiotics treatment.treatments work to fight disease by producing an immune response within the body.

And sometimes that means flu-like symptoms, such as aches, headache and fever.Already, some volunteers in trials of candidate treatments from drug companies Moderna, Pfizer and AstraZeneca have reported flu-like symptoms after immunization. And experts worry that those reports might keep people away from vaccination, or from required how to get zithromax without prescription second doses.The CDC's Dr. Sara Oliver told the committee during the five-hour-long meeting that, depending on the survey, anywhere between 40% and 80% of Americans say they'd be willing to get vaccinated.Dr.

Paul Hunter, of the city of Milwaukee health department and how to get zithromax without prescription a voting member of the committee, said the testimonials of the first batches of people who get a buy antibiotics treatment could be crucial to wider acceptance."The people who highly value getting the treatment soon and fast, early, are going to be really helpful to everyone else. And I think we really are going to need to honor them, because they are going to let us know how it feels," he told the committee. "And I think these people are likely how to get zithromax without prescription to be health care workers who are likely to be up for that kind of task."Another treatment candidateAmericans were greeted with a possible advance against antibiotics as Thanksgiving week began.

A third treatment candidate shows how to get zithromax without prescription good results in shielding recipients against the zithromax.Meanwhile, U.S. antibiotics cases continued to explode. More than 179,000 new cases were recorded on Monday, with more than 12.4 million Americans now known to be infected.Hopes for the roll-out of another effective treatment how to get zithromax without prescription brightened on Monday, however.

One regimen showed an effectiveness of 62%, the company said, while the other showed a 90% effectiveness.The regimen showing a 90% effectiveness involved a first dose given at half strength and a second dose given how to get zithromax without prescription at standard strength. No severe cases of buy antibiotics emerged among any recipients, and there was a reduction in asymptomatic s, suggesting that the treatment was reducing transmission of the zithromax, AstraZeneca said.Worsening spreadIn the meantime, the new antibiotics is spreading across America with unprecedented speed, the White House antibiotics Task Force said in its first briefing in four months on Thursday."This is more cases, more rapidly, than what we had seen before," Dr. Deborah Birx said how to get zithromax without prescription during the briefing.

"You can see the increase in test positivity to around 10%." That's the number of people tested who get a positive diagnosis. SLIDESHOW Whooping Cough (Pertussis) Symptoms, treatment Facts See Slideshow Birx pointed to a map of the country how to get zithromax without prescription that is covered in red, highlighting the number of daily hospitalizations, which now regularly tops 70,000, CNN reported. Birx said she has been crisscrossing the country as she tries to encourage state and local leaders to take measures to stop the spread of the zithromax.Still, task force members spoke out against the idea of nationwide lockdowns or schools, even as New York City returned to remote learning this week, CNN reported."We do know what to do and we are asking every American to do those things today," Birx stressed.

That starts with wearing masks, but also staying apart and limiting gatherings, she said.The how to get zithromax without prescription zithromax spreads even when people do not show symptoms, Birx noted. "It is because of this asymptomatic spread that we are asking people to wear a mask indoors," she how to get zithromax without prescription said. "Decreasing those friend-and-family gatherings where people come together and unknowingly spread the zithromax," will also help slow the spread, she added.Earlier Thursday, the U.S.

Centers for Disease Control and Prevention asked how to get zithromax without prescription Americans not to travel for Thanksgiving. More than 187,000 cases were announced nationwide on Thursday, another single-day record, and daily tallies have been rising in 47 states, according to The New York Times.In California, officials reported more than 13,000 new cases, a single-day record, prompting the state to announce a 10 p.m. Curfew for all but essential workers, the Times reported.Even if the current seven-day national average of about 166,000 daily cases plateaued until the end of the year, nearly 7 million more people would still contract buy antibiotics, the Times said.Though talk of two highly effective treatments came this week, they will how to get zithromax without prescription not be widely available until spring of 2021."We are in for a rough period through the end of February," Dr.

Jessica Justman, a professor of epidemiology at Columbia University, told the Times. "It looks hard to find a way to break it."A global how to get zithromax without prescription scourgeBy Tuesday, the U.S. antibiotics case count passed 12.4 million while the death toll neared 258,000, according to a Times tally.

According to the same how to get zithromax without prescription tally, the top five states in antibiotics cases as of Tuesday were. Texas with nearly 1.2 million. California with just over how to get zithromax without prescription 1.1 million.

Florida with over 944,000. Illinois with how to get zithromax without prescription nearly 666,000. And New York with almost 607,000.Curbing the spread of the antibiotics in the rest how to get zithromax without prescription of the world remains challenging.Many European countries are tightening restrictions, the Associated Press reported.

France has entered a nationwide lockdown, and Germany and Austria have started partial lockdowns as government officials across the continent scramble to slow a sharp rise in s that threatens to overwhelm their health care systems.England has followed suit, while Italy, Greece and Kosovo also announced new measures, the AP reported.Things are no better in India, where the antibiotics case count has passed 9 million on Tuesday, a Johns Hopkins University tally showed. More than 134,000 antibiotics patients have died in India, according to the Hopkins tally, but when measured as a proportion of the how to get zithromax without prescription population, the country has had far fewer deaths than many others. Doctors say this reflects India's younger and leaner population.

Still, the country's public health system is severely strained, and some sick patients how to get zithromax without prescription cannot find hospital beds, the Times said. Only the United States has more antibiotics cases.Meanwhile, Brazil passed 6 million cases and had nearly 170,000 deaths as of Tuesday, the Hopkins tally showed.Worldwide, the number of reported s topped 59 million on Tuesday, with nearly 1.4 million deaths recorded, according to the Hopkins tally.More informationThe U.S. Centers for Disease how to get zithromax without prescription Control and Prevention has more on the new antibiotics.SOURCES.

What is Zithromax?

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Clinical decision-support software companies raised more than $1 billion during the first half of 2021âdouble the amount raised does zithromax expire during the same period last year.Investors poured $1.1 billion into companies that sell clinical decision-support toolsâproducts that analyze data and provide recommendations on patient careâduring the first six months of 2021, up from $545 million during the same period in 2020, according to a second-quarter report from market research firm Mercom Capital Group.Clinical decision-support software companies have raised nearly $7 billion since Mercom began tracking digital health funding in 2010.Businesses that sell clinical decision-support tools are part of a broader category of digital health tools designed to assist healthcare providers and practices with managing health data. As a whole, companies does zithromax expire in that health information management subsector raised $3.7 billion during the first half of 2021, up from $2 billion in the same period last year.Such software has been a particular area of focus as the Food and Drug Administration refines its strategy for regulating digital health technologies. Some clinical decision-support products are reviewed by the agency, while others does zithromax expire aren'tâdepending on whether they're deemed low or high risk to patients.The Boston-based company raised a $165 million Series C funding round led by Oakland, California-based Kaiser Permanente and New York investment firm D1 Capital Partners, PathAI reported in May. The company also struck a deal to acquire Poplar, the management service arm of Memphis, Tennessee-based pathology laboratory Poplar Healthcare, last month.WuXi Diagnostic, a Chinese precision medicine company, raised a $150 million Series B funding does zithromax expire round.

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Start Preamble Federal Transit Administration Antabuse street price (FTA), zithromax effectiveness time DOT. Notice of funding opportunity. The antibiotics Disease 2019 (buy antibiotics) public health zithromax effectiveness time emergency Start Printed Page 63654has had a significant impact on transit operations. During a series of FTA listening sessions held over the last three months, transit agencies asked FTA to support research to identify solutions to address the operational challenges that they are facing as a result of buy antibiotics. In response, FTA makes available through this Notice of Funding Opportunity (NOFO) funding to support research demonstration grants to public transit agencies to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the buy antibiotics public health emergency.

Demonstration grants under this NOFO are authorized under FTA's Public Transportation Innovation Program (49 zithromax effectiveness time U.S.C. 5312). Eligible projects will demonstrate innovative solutions to improve the operational efficiencies of transit systems and enhance mobility for their communities in four major areas. (1) Vehicle, zithromax effectiveness time facility, equipment and infrastructure cleaning and dis. (2) exposure mitigation measures.

(3) innovative mobility such as contactless payments. And (4) zithromax effectiveness time measures that strengthen public confidence in transit services. The total funding available for awards under this NOFO is $10,000,000. FTA may supplement this amount zithromax effectiveness time if additional funding becomes available. Applicants must submit completed proposals for funding opportunity FTA-2020-015-TRI through the GRANTS.GOV âAPPLYâ function by 11:59 p.m.

Eastern Time on November 2, 2020. Prospective applicants should register as soon as possible on the GRANTS.GOV website to ensure they zithromax effectiveness time can complete the application process before the submission deadline. Application instructions are available on FTA's website at http://transit.dot.gov/âhowtoapply and in the âFINDâ module of GRANTS.GOV. FTA will not accept mail and fax submissions. Start Further Info Please send any questions zithromax effectiveness time on this notice to Jamel El-Hamri email.

Jamel.El-Hamri@dot.gov phone. 2020-366-8985. A Telecommunication zithromax effectiveness time Device for the Deaf (TDD) is available for individuals who are deaf or hard of hearing at 1-800-877-8339. End Further Info End Preamble Start Supplemental Information Table of Contents A. Program Description zithromax effectiveness time B.

Federal Award Information C. Eligibility Information D. Application and Submission Information E zithromax effectiveness time. Application Review Information F. Federal Award Administration Information G.

Federal Awarding Agency Contact zithromax effectiveness time Information A. Program Description The Public Transportation buy antibiotics Research Demonstration Grant Program is funded through the Public Transportation Innovation Program (49 U.S.C. 5312), with the goal to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the buy antibiotics public health emergency. Eligible projects will propose zithromax effectiveness time to develop and deploy innovative solutions in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis.

(2) exposure zithromax effectiveness time mitigation measures. (3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit. As required zithromax effectiveness time by 49 U.S.C. 5312(e)(4), projects funded under this NOFO must participate in an evaluation by an independent outside entity that will conduct a comprehensive evaluation of the success or failure of the projects funded under this subsection and any plan for broad-based implementation of the innovation promoted by successful projects.

B. Federal Award Information FTA zithromax effectiveness time makes available $10,000,000 in fiscal year (FY) 2020 funds under the Public Transportation Innovation Program (49 U.S.C. 5312) to finance the Public Transportation buy antibiotics Research Demonstration Grant Program. FTA may supplement the total funds available if additional funding becomes available at the time project selections are made. FTA will grant pre-award authority starting on zithromax effectiveness time the date of the project award announcement for selected projects and should be completed within 24 months from the date of award.

Funds are available only for eligible expenses incurred after the announcement of project selections. C. Eligibility Information (1) Eligible zithromax effectiveness time Applicants Eligible applicants include State and local governmental authorities, direct recipients of Urbanized Area (49 U.S.C. 5307) and Rural Area (49 U.S.C. 5311) formula funds, and Indian zithromax effectiveness time tribes.

Eligible applicants are limited to FTA grantees or subrecipients who would be the primary beneficiaries of the innovative products and services that are developedâtypically public transit agencies. Except for projects proposed by Indian tribes, proposals for projects in rural (non-urbanized) areas must be submitted as part of a consolidated State proposal. States and other eligible applicants also may submit consolidated proposals zithromax effectiveness time for projects in urbanized areas. The submission of the Statewide application will not preclude the submission and consideration of any application from other eligible recipients in an urbanized area in a State. Proposals may contain projects to be implemented by the recipient or its subrecipients.

Eligible subrecipients include zithromax effectiveness time public agencies, private nonprofit organizations, and private providers engaged in public transportation. Eligible applicants may submit consolidated proposals for projects. (2) Cost Sharing or Matching The maximum Federal share of project costs is 100 percent. FTA may give additional consideration to applicants that propose a local share and may view these applicants zithromax effectiveness time as more competitive. The applicant must document the source(s) of the local match, if any, in the grant application.

For any applicants proposing match, eligible local zithromax effectiveness time match sources include the following. Cash from non-Government sources other than revenues from providing public transportation services. Revenues derived from the sale of advertising and concessions. Revenues generated from value capture financing zithromax effectiveness time mechanisms. Funds from an undistributed cash surplus.

Replacement or depreciation cash fund or reserve. New capital zithromax effectiveness time. Or in-kind contributions. (3) Eligible Projects Eligible projects will propose innovative solutions to improve operational efficiencies of transit agencies and enhance the mobility of transit users, through projects that demonstrate innovative solutions for. Vehicle, facility, equipment and infrastructure cleaning zithromax effectiveness time and dis.

Exposure mitigation measures such a real-time notification of rail and bus passenger loads. New multi-modal zithromax effectiveness time payment innovative mobility systems such as contactless payments. And measures that strengthen public confidence in transit. Each applicant may only submit one proposal.Start Printed Page 63655 D. Application and Submission Information (1) Address and zithromax effectiveness time Form of Application Submission Applications must be submitted through GRANTS.GOV.

Applicants can find general information for submitting applications through GRANTS.GOV at www.fta.dot.gov/âhowtoapply, along with specific instructions for the forms and attachments required for submission. Mail and fax submissions will not be accepted. (2) Content and Form of Application Submission zithromax effectiveness time a. Proposal Submission A complete proposal submission consists of at least two forms. 1.

The SF-424 Mandatory Form (downloadable from zithromax effectiveness time GRANTS.GOV) and 2. The supplemental form for the FY 2020 buy antibiotics Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA buy antibiotics Demonstration Program). The application must include responses to zithromax effectiveness time all sections of the SF-424 mandatory form and the supplemental form unless a section is indicated as optional. FTA will use the information on the supplemental form to determine applicant and project eligibility for the program and to evaluate the proposal against the selection criteria described in part E of this notice. FTA will accept only one supplemental form per SF-424 submission.

FTA encourages applicants to consider submitting a single supplemental form that includes multiple activities to zithromax effectiveness time be evaluated as a consolidated proposal. Applicants may attach additional supporting information to the SF-424 submission, including but not limited to letters of support, project budgets, or excerpts from relevant planning documents. Supporting documentation must be described and referenced by file name in the appropriate response section of the supplemental form, or it may not be reviewed. Information such as applicant name, Federal amount requested, local match amount, description of areas served, etc., may be requested in varying zithromax effectiveness time degrees of detail on both the SF-424 form and supplemental form. Applicants must fill in all fields unless stated otherwise on the forms.

If applicants copy information into the supplemental form from another source, they should verify that the supplemental form has fully captured pasted text and that it has not truncated the text due to character limits built into the form. Applicants should use both the âCheck Package for Errorsâ and the âValidate Formâ validation zithromax effectiveness time buttons on both forms to check all required fields. Applicants should also ensure that the Federal and local amounts specified are consistent. Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with zithromax effectiveness time the R.O.U.T.E.S.

Initiative, the Department encourages applicants to consider how the project will address the challenges faced by rural areas. B. Application Content The SF-424 Mandatory Form and the supplemental form will prompt applicants for the required information, including. I. Applicant Name ii.

Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number iii. Key contact information (contact name, address, email address, and phone number) iv. Congressional district(s) where project will take place v. Project Information (title, executive summary, and type) vi. A detailed description of the need for the project vii.

A detailed description of how the project will support the Program objectives viii. Evidence that the applicant can provide the local cost shares ix. A description of the technical, legal, and financial capacity of the applicant x. A detailed project budget xi. Details on the local matching funds xii.

A detailed project timeline xiii. Whether the project impacts an Opportunity Zone (3) Unique Entity Identifier and System for Award Management (SAM) Each applicant is required to. (1) Be registered in SAM before submitting an application. (2) provide a valid unique entity identifier in its application. And (3) continue to maintain an active SAM registration with current information at all times during which the applicant has an active Federal award or an application or plan under consideration by FTA.

These requirements do not apply if the applicant. (1) Is excepted from the requirements under 2 CFR 25.110(b) or (c). Or (2) has an exception approved by FTA under 2 CFR 25.110(d). FTA may not make an award until the applicant has complied with all applicable unique entity identifier and SAM requirements. If an applicant has not fully complied with the requirements by the time FTA is ready to make an award, FTA may determine that the applicant is not qualified to receive an award and use that determination as a basis for making a Federal award to another applicant.

All applicants must provide a unique entity identifier provided by SAM. Registration in SAM may take as little as 3-5 business days, but there can be unexpected steps or delays. For example, the applicant may need to obtain an Employer Identification Number. FTA recommends allowing ample time, up to several weeks, to complete all steps. For additional information on obtaining a unique entity identifier, please visit www.sam.gov.

(4) Submission Dates and Times Project proposals must be submitted electronically through GRANTS.GOV by 11:59 p.m. Eastern on November 2, 2020. Mail and fax submissions will not be accepted. FTA urges applicants to submit applications at least 72 hours prior to the due date to allow time to correct any problems that may have caused either GRANTS.GOV or FTA systems to reject the submission. Proposals submitted after the deadline will only be considered under extraordinary circumstances not within the applicant's control.

Deadlines will not be extended due to scheduled website maintenance. GRANTS.GOV scheduled maintenance and outage times are announced on the GRANTS.GOV website. Within 48 hours after submitting an electronic application, the applicant should receive two email messages from GRANTS.GOV. (1) Confirmation of successful transmission to GRANTS.GOV. And (2) confirmation of successful validation by GRANTS.GOV.

If the applicant does not receive confirmation of successful validation or receives a notice of failed validation or incomplete materials, the applicant must address the reason for the failed validation, as described in the email notice, and resubmit before the submission deadline. If making a resubmission for any reason, applicants must include all original attachments regardless of which attachments were updated and check the box on the supplemental form indicating this is a resubmission. Applicants are encouraged to begin the process of registration on the GRANTS.GOV site well in advance of the submission deadline. Registration is Start Printed Page 63656a multi-step process, which may take several weeks to complete before an application can be submitted. Registered applicants may still be required to update their registration before submitting an application.

Registration in SAM is renewed annually and persons making submissions on behalf of the Authorized Organization Representative (AOR) must be authorized in GRANTS.GOV by the AOR to make submissions. (5) Funding Restrictions Funds may be used for post-award expenditures only. Funds under this NOFO cannot be used to reimburse projects for otherwise eligible expenses incurred prior to the date of project award announcements. (6) Other Submission Requirements FTA encourages applicants to identify scaled funding options in case insufficient funding is available to fund a project at the full requested amount. If an applicant indicates that a project is scalable, the applicant must provide an appropriate minimum funding amount that will fund an eligible project that achieves the objectives of the program and meets all relevant program requirements.

The applicant must provide a clear explanation of how a reduced award would affect the project budget and scope. FTA may award a lesser amount whether or not the applicant provides a scalable option. E. Application Review Information (1) Project Evaluation Criteria Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S.

Initiative, the Department will consider how the project will address the challenges faced by rural areas. In addition, the Department will review and consider applications for funding pursuant to this Notice in accordance with the President's September 2, 2020 memorandum, entitled Memorandum on Reviewing Funding to State and Local Government Recipients of Federal Funds that Are Permitting Anarchy, Violence, and Destruction in American Cities, consistent with guidance from the Office of Management and Budget and the Attorney General and with all applicable laws. FTA will evaluate proposals submitted according to the following criteria. (a) Project Innovation and Impact. (b) Project Approach.

(c) National Applicability. (d) Commercialization and/or Knowledge Transfer. And (e) Technical, Legal and Financial Capacity. FTA encourages each applicant to demonstrate how a project supports all criteria with the most relevant information the applicant can provide, regardless of whether such information has been specifically requested or identified in this notice. A.

Project Innovation and Impact i. Effectiveness of the project in achieving and demonstrating the specific objectives of this program. Ii. Demonstration of benefits in addressing the needs of the transit agency and industry and impacts to infrastructure, equipment, transit workforce, and riders. Iii.

Degree of improvement over current and existing technologies, designs, and/or practices applicable to the transit industry. B. Project Approach i. Quality of the project approach such as existing partnerships, collaboration strategies and level of commitment of the project partners. Ii.

Proposal is realistic in its approach to fulfill the milestones/deliverables, schedule and goals. C. National Applicability i. Degree to which the project could be replicated by other transit agencies regionally or nationally. Ii.

Ability to evaluate technologies, designs and/or practices in a wide variety of conditions and locales. Iii. Degree to which the technology, designs and/or practices can be replicated by other transportation modes. D. Commercialization and/or Knowledge Transfer i.

Demonstrates a realistic plan for moving the results of the project into the transit marketplace (patents, conferences, articles in trade magazines, webinar, site visits, etc.). Ii. How the project team plans to work with the industry on improving best practices, guidance and/or standards, if applicable. Iii. Demonstrate a clear understanding and robust approach to data collection, access and management.

E. Technical, Legal and Financial Capacity Capacity of the applicant and any partners to successfully execute the project effort. There should be no outstanding legal, technical, or financial issues with the applicant that would make this a high-risk project. (2) Review and Selection Process An FTA technical evaluation committee will evaluate proposals based on the published project evaluation criteria. Members of the technical evaluation committee will rate the applications and may seek clarification about any statement in an application.

The FTA Administrator will determine the final selection and amount of funding for each project after consideration of the findings of the technical evaluation committee. Geographic diversity, diversity of the project type, the amount of local match to be provided, and the applicant's receipt and management of other Federal transit funds may be considered in FTA's award decisions. Prior fare payment innovation efforts may receive priority consideration. The FTA Administrator will consider the following key DOT objectives. A.

Utilizing alternative funding sources and innovative financing models to attract non-Federal sources of investment. B. Whether the project is located in or supports public transportation service in a qualified opportunity zone designated pursuant to 26.U.S.C. 1400Z-1. And c.

The extent to which the project addresses challenges specific to the provision of rural public transportation. (3) FAPIIS Review Prior to making a grant award, FTA is required to review and consider any information about the applicant that is in the Federal Awardee Performance and Integrity Information System (FAPIIS) accessible through SAM. An applicant may review and comment on information about itself that a Federal awarding agency previously entered. FTA will consider any comments by the applicant, in addition to the other information in FAPIIS, in making a judgment about the applicant's integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 2 CFR 200.205 Federal Awarding Agency Review of Risk Posed by Applicants. F.

Federal Award Administration Information (1) Federal Award Notices FTA will announce the final project selections on the FTA website. Project recipients should contact their FTA Regional Office for additional information regarding allocations for Start Printed Page 63657projects. At the time project selections are announced, FTA will extend pre-award authority for the selected projects. There is no blanket pre-award authority for these projects before announcement. There is no minimum or maximum grant award amount, but FTA intends to fund as many meritorious projects as possible.

FTA only will consider proposals from eligible recipients for eligible activities. Due to funding limitations, projects selected for funding may receive less than the amount originally requested. In those cases, applicants must be able to demonstrate that the proposed projects are still viable and can be completed with the amount awarded. (2) Administrative and National Policy Requirements a. Pre-Award Authority FTA will issue specific guidance to recipients regarding pre-award authority at the time of selection.

FTA does not provide pre-award authority for competitive funds until projects are selected, and there are Federal requirements that must be met before costs are incurred. For more information about FTA's policy on pre-award authority, see the FY 2020 Apportionments Notice published on June 3, 2020, at https://www.govinfo.gov/âcontent/âpkg/âFR-2020-06-03/âpdf/â2020-11946.pdf. b. Grant Requirements Selected applicants will submit a grant application through FTA's electronic grant management system and adhere to the customary FTA grant requirements for research project (insert Circular name). All competitive grants, regardless of award amount, will be subject to the Congressional notification and release process.

FTA emphasizes that third-party procurement applies to all funding awards, as described in FTA Circular 4220.1F, âThird Party Contracting Guidance.â However, FTA may approve applications that include a specifically identified partnering organization(s) (2 CFR 200.302(f)). When included, the application, budget, and budget narrative should provide a clear understanding of how the selection of these organizations is critical for the project and give sufficient detail about the costs involved. C. Planning FTA encourages applicants to engage the appropriate State Departments of Transportation, Regional Transportation Planning Organizations, or Metropolitan Planning Organizations in areas to be served by the project funds available under this program. D.

Standard Assurances The applicant assures that it will comply with all applicable Federal statutes, regulations, executive orders, FTA circulars, and other Federal administrative requirements in carrying out any project supported by the FTA grant. The applicant acknowledges that it is under a continuing obligation to comply with the terms and conditions of the grant agreement issued for its project with FTA. The applicant understands that Federal laws, regulations, policies, and administrative practices might be modified from time to time and may affect the implementation of the project. The applicant agrees that the most recent Federal requirements will apply to the project unless FTA issues a written determination otherwise. The applicant must submit the Certifications and Assurances before receiving a grant if it does not have current certifications on file.

E. Free Speech and Religious Liberty In connection with any program or activity conducted with or benefiting from funds awarded under this notice, recipients of funds must comply with all applicable requirements of Federal law, including, without limitation, the Constitution of the United States. Statutory, regulatory, and public policy requirements, including without limitation, those protecting free speech, religious liberty, public welfare, the environment, and prohibiting discrimination. The conditions of performance, non-discrimination requirements, and other assurances made applicable to the award of funds in accordance with regulations of the Department of Transportation. And applicable Federal financial assistance and contracting principles promulgated by the Office of Management and Budget.

In complying with these requirements, recipients must ensure that no concession agreements are denied or other contracting decisions made on the basis of speech or other activities protected by the First Amendment. If the Department determines that a recipient has failed to comply with applicable Federal requirements, the Department may terminate the award of funds and disallow previously incurred costs, requiring the recipient to reimburse any expended award funds. (3) Reporting The post-award reporting requirements include submission of the Federal Financial Report (FFR) and Milestone Progress Report in TrAMS. An evaluation of the grant will occur at various points in the demonstration process and at the end of the project. In addition, FTA is responsible for producing an Annual Report to Congress that compiles evaluation of selected projects, including an evaluation of the performance measures identified by the applicants.

All applicants must develop an evaluation plan to measure the success or failure of their projects and describe any plans for broad-based implementation of successful projects. FTA may request data and reports to support the evaluation and Annual Report. A. Independent Evaluation To achieve a comprehensive understanding of the impacts and implications of each proposed buy antibiotics Research Demonstration Program, projects funded under this announcement will require the recipient to conduct a third party independent evaluation of their project. Recipients will be required to contract with a third party independent evaluator to assist in developing an evaluation plan, and collecting, storing and managing data required to fulfill the evaluation requirement.

No more than 10 percent of the Federal share of the project may be used to hire the third-party independent evaluator and the inclusion of a third-party independent evaluation should be described in the grant application. If the project duration is more than two years, an interim evaluation report would need to be submitted to FTA, otherwise the evaluation report should be included as part of the final project report. B. buy antibiotics Research Demonstration Grant Program Evaluation Projects funded under this announcement will be required to establish a set of performance metrics set by the third-party independent evaluator and shared with FTA. G.

Federal Awarding Agency Contacts Information For questions about applying, please contact Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone. 202-366-8985. A TDD is available at 1-800-877-8339 (TDDFIRS). To ensure that applicants receive accurate information about eligibility or the program, applicants are encouraged to contact FTA directly with questions, rather than through intermediaries or third parties.Start Printed Page 63658 FTA staff also may conduct briefings on the competitive grants selection and award process upon request.

Start Signature K. Jane Williams, Deputy Administrator. End Signature End Supplemental Information [FR Doc. 2020-22316 Filed 10-7-20. 8:45 am]BILLING CODE 4910-57-P.

Start Preamble Federal how to get zithromax without prescription Transit Administration (FTA), DOT. Notice of funding opportunity. The antibiotics Disease 2019 (buy antibiotics) public health emergency Start Printed Page 63654has had a significant impact how to get zithromax without prescription on transit operations.

During a series of FTA listening sessions held over the last three months, transit agencies asked FTA to support research to identify solutions to address the operational challenges that they are facing as a result of buy antibiotics. In response, FTA makes available through this Notice of Funding Opportunity (NOFO) funding to support research demonstration grants to public transit agencies to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the buy antibiotics public health emergency. Demonstration grants under how to get zithromax without prescription this NOFO are authorized under FTA's Public Transportation Innovation Program (49 U.S.C.

5312). Eligible projects will demonstrate innovative solutions to improve the operational efficiencies of transit systems and enhance mobility for their communities in four major areas. (1) Vehicle, how to get zithromax without prescription facility, equipment and infrastructure cleaning and dis.

(2) exposure mitigation measures. (3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in how to get zithromax without prescription transit services.

The total funding available for awards under this NOFO is $10,000,000. FTA may supplement this amount if additional funding becomes available how to get zithromax without prescription. Applicants must submit completed proposals for funding opportunity FTA-2020-015-TRI through the GRANTS.GOV âAPPLYâ function by 11:59 p.m.

Eastern Time on November 2, 2020. Prospective applicants should register as soon as possible on the GRANTS.GOV website to ensure how to get zithromax without prescription they can complete the application process before the submission deadline. Application instructions are available on FTA's website at http://transit.dot.gov/âhowtoapply and in the âFINDâ module of GRANTS.GOV.

FTA will not accept mail and fax submissions. Start Further how to get zithromax without prescription Info Please send any questions on this notice to Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone.

2020-366-8985. A Telecommunication Device for the Deaf (TDD) is available for individuals who are deaf or how to get zithromax without prescription hard of hearing at 1-800-877-8339. End Further Info End Preamble Start Supplemental Information Table of Contents A.

Program Description B how to get zithromax without prescription. Federal Award Information C. Eligibility Information D.

Application and how to get zithromax without prescription Submission Information E. Application Review Information F. Federal Award Administration Information G.

Federal Awarding how to get zithromax without prescription Agency Contact Information A. Program Description The Public Transportation buy antibiotics Research Demonstration Grant Program is funded through the Public Transportation Innovation Program (49 U.S.C. 5312), with the goal to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the buy antibiotics public health emergency.

Eligible projects will propose to develop and deploy how to get zithromax without prescription innovative solutions in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis. (2) exposure mitigation how to get zithromax without prescription measures.

(3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit. As required how to get zithromax without prescription by 49 U.S.C.

5312(e)(4), projects funded under this NOFO must participate in an evaluation by an independent outside entity that will conduct a comprehensive evaluation of the success or failure of the projects funded under this subsection and any plan for broad-based implementation of the innovation promoted by successful projects. B. Federal Award Information FTA makes available $10,000,000 in fiscal year (FY) 2020 funds under the how to get zithromax without prescription Public Transportation Innovation Program (49 U.S.C.

5312) to finance the Public Transportation buy antibiotics Research Demonstration Grant Program. FTA may supplement the total funds available if additional funding becomes available at the time project selections are made. FTA will grant pre-award authority starting on the date of the project award announcement for selected how to get zithromax without prescription projects and should be completed within 24 months from the date of award.

Funds are available only for eligible expenses incurred after the announcement of project selections. C. Eligibility Information how to get zithromax without prescription (1) Eligible Applicants Eligible applicants include State and local governmental authorities, direct recipients of Urbanized Area (49 U.S.C.

5307) and Rural Area (49 U.S.C. 5311) formula funds, and Indian tribes how to get zithromax without prescription. Eligible applicants are limited to FTA grantees or subrecipients who would be the primary beneficiaries of the innovative products and services that are developedâtypically public transit agencies.

Except for projects proposed by Indian tribes, proposals for projects in rural (non-urbanized) areas must be submitted as part of a consolidated State proposal. States and other eligible applicants also may submit how to get zithromax without prescription consolidated proposals for projects in urbanized areas. The submission of the Statewide application will not preclude the submission and consideration of any application from other eligible recipients in an urbanized area in a State.

Proposals may contain projects to be implemented by the recipient or its subrecipients. Eligible subrecipients how to get zithromax without prescription include public agencies, private nonprofit organizations, and private providers engaged in public transportation. Eligible applicants may submit consolidated proposals for projects.

(2) Cost Sharing or Matching The maximum Federal share of project costs is 100 percent. FTA may give additional consideration to applicants that propose a local share and may how to get zithromax without prescription view these applicants as more competitive. The applicant must document the source(s) of the local match, if any, in the grant application.

For any applicants proposing match, eligible local match sources include how to get zithromax without prescription the following. Cash from non-Government sources other than revenues from providing public transportation services. Revenues derived from the sale of advertising and concessions.

Revenues generated from value capture financing how to get zithromax without prescription mechanisms. Funds from an undistributed cash surplus. Replacement or depreciation cash fund or reserve.

New capital how to get zithromax without prescription. Or in-kind contributions. (3) Eligible Projects Eligible projects will propose innovative solutions to improve operational efficiencies of transit agencies and enhance the mobility of transit users, through projects that demonstrate innovative solutions for.

Vehicle, facility, equipment and how to get zithromax without prescription infrastructure cleaning and dis. Exposure mitigation measures such a real-time notification of rail and bus passenger loads. New multi-modal payment how to get zithromax without prescription innovative mobility systems such as contactless payments.

And measures that strengthen public confidence in transit. Each applicant may only submit one proposal.Start Printed Page 63655 D. Application and Submission Information (1) Address and Form of Application how to get zithromax without prescription Submission Applications must be submitted through GRANTS.GOV.

Applicants can find general information for submitting applications through GRANTS.GOV at www.fta.dot.gov/âhowtoapply, along with specific instructions for the forms and attachments required for submission. Mail and fax submissions will not be accepted. (2) Content and Form of Application how to get zithromax without prescription Submission a.

Proposal Submission A complete proposal submission consists of at least two forms. 1. The SF-424 Mandatory Form (downloadable from GRANTS.GOV) and how to get zithromax without prescription 2.

The supplemental form for the FY 2020 buy antibiotics Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA buy antibiotics Demonstration Program). The application must include responses to how to get zithromax without prescription all sections of the SF-424 mandatory form and the supplemental form unless a section is indicated as optional. FTA will use the information on the supplemental form to determine applicant and project eligibility for the program and to evaluate the proposal against the selection criteria described in part E of this notice.

FTA will accept only one supplemental form per SF-424 submission. FTA encourages applicants to how to get zithromax without prescription consider submitting a single supplemental form that includes multiple activities to be evaluated as a consolidated proposal. Applicants may attach additional supporting information to the SF-424 submission, including but not limited to letters of support, project budgets, or excerpts from relevant planning documents.

Supporting documentation must be described and referenced by file name in the appropriate response section of the supplemental form, or it may not be reviewed. Information such as applicant name, Federal amount requested, local match amount, description of areas served, etc., may be requested in varying degrees of how to get zithromax without prescription detail on both the SF-424 form and supplemental form. Applicants must fill in all fields unless stated otherwise on the forms.

Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with how to get zithromax without prescription the R.O.U.T.E.S. Initiative, the Department encourages applicants to consider how the project will address the challenges faced by rural areas.

B. Application Content The SF-424 Mandatory Form and the supplemental form will prompt applicants for the required information, including. I.

Applicant Name ii. Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number iii. Key contact information (contact name, address, email address, and phone number) iv.

Congressional district(s) where project will take place v. Project Information (title, executive summary, and type) vi. A detailed description of the need for the project vii.

A detailed project budget xi. Details on the local matching funds xii. A detailed project timeline xiii.

Whether the project impacts an Opportunity Zone (3) Unique Entity Identifier and System for Award Management (SAM) Each applicant is required to. (1) Be registered in SAM before submitting an application. (2) provide a valid unique entity identifier in its application.

And (3) continue to maintain an active SAM registration with current information at all times during which the applicant has an active Federal award or an application or plan under consideration by FTA. These requirements do not apply if the applicant. (1) Is excepted from the requirements under 2 CFR 25.110(b) or (c).

Or (2) has an exception approved by FTA under 2 CFR 25.110(d). FTA may not make an award until the applicant has complied with all applicable unique entity identifier and SAM requirements. If an applicant has not fully complied with the requirements by the time FTA is ready to make an award, FTA may determine that the applicant is not qualified to receive an award and use that determination as a basis for making a Federal award to another applicant.

FTA recommends allowing ample time, up to several weeks, to complete all steps. For additional information on obtaining a unique entity identifier, please visit www.sam.gov. (4) Submission Dates and Times Project proposals must be submitted electronically through GRANTS.GOV by 11:59 p.m.

Eastern on November 2, 2020. Mail and fax submissions will not be accepted. FTA urges applicants to submit applications at least 72 hours prior to the due date to allow time to correct any problems that may have caused either GRANTS.GOV or FTA systems to reject the submission.

Proposals submitted after the deadline will only be considered under extraordinary circumstances not within the applicant's control. Deadlines will not be extended due to scheduled website maintenance. GRANTS.GOV scheduled maintenance and outage times are announced on the GRANTS.GOV website.

Within 48 hours after submitting an electronic application, the applicant should receive two email messages from GRANTS.GOV. (1) Confirmation of successful transmission to GRANTS.GOV. And (2) confirmation of successful validation by GRANTS.GOV.

Registration is Start Printed Page 63656a multi-step process, which may take several weeks to complete before an application can be submitted. Registered applicants may still be required to update their registration before submitting an application. Registration in SAM is renewed annually and persons making submissions on behalf of the Authorized Organization Representative (AOR) must be authorized in GRANTS.GOV by the AOR to make submissions.

(5) Funding Restrictions Funds may be used for post-award expenditures only. Funds under this NOFO cannot be used to reimburse projects for otherwise eligible expenses incurred prior to the date of project award announcements. (6) Other Submission Requirements FTA encourages applicants to identify scaled funding options in case insufficient funding is available to fund a project at the full requested amount.

If an applicant indicates that a project is scalable, the applicant must provide an appropriate minimum funding amount that will fund an eligible project that achieves the objectives of the program and meets all relevant program requirements. The applicant must provide a clear explanation of how a reduced award would affect the project budget and scope. FTA may award a lesser amount whether or not the applicant provides a scalable option.

E. Application Review Information (1) Project Evaluation Criteria Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S.

(a) Project Innovation and Impact. (b) Project Approach. (c) National Applicability.

(d) Commercialization and/or Knowledge Transfer. And (e) Technical, Legal and Financial Capacity. FTA encourages each applicant to demonstrate how a project supports all criteria with the most relevant information the applicant can provide, regardless of whether such information has been specifically requested or identified in this notice.

A. Project Innovation and Impact i. Effectiveness of the project in achieving and demonstrating the specific objectives of this program.

Ii. Demonstration of benefits in addressing the needs of the transit agency and industry and impacts to infrastructure, equipment, transit workforce, and riders. Iii.

Degree of improvement over current and existing technologies, designs, and/or practices applicable to the transit industry. B. Project Approach i.

Quality of the project approach such as existing partnerships, collaboration strategies and level of commitment of the project partners. Ii. Proposal is realistic in its approach to fulfill the milestones/deliverables, schedule and goals.

C. National Applicability i. Degree to which the project could be replicated by other transit agencies regionally or nationally.

Ii. Ability to evaluate technologies, designs and/or practices in a wide variety of conditions and locales. Iii.

Degree to which the technology, designs and/or practices can be replicated by other transportation modes. D. Commercialization and/or Knowledge Transfer i.

Iii. Demonstrate a clear understanding and robust approach to data collection, access and management. E.

Technical, Legal and Financial Capacity Capacity of the applicant and any partners to successfully execute the project effort. There should be no outstanding legal, technical, or financial issues with the applicant that would make this a high-risk project. (2) Review and Selection Process An FTA technical evaluation committee will evaluate proposals based on the published project evaluation criteria.

Members of the technical evaluation committee will rate the applications and may seek clarification about any statement in an application. The FTA Administrator will determine the final selection and amount of funding for each project after consideration of the findings of the technical evaluation committee. Geographic diversity, diversity of the project type, the amount of local match to be provided, and the applicant's receipt and management of other Federal transit funds may be considered in FTA's award decisions.

Prior fare payment innovation efforts may receive priority consideration. The FTA Administrator will consider the following key DOT objectives. A.

1400Z-1. And c. The extent to which the project addresses challenges specific to the provision of rural public transportation.

(3) FAPIIS Review Prior to making a grant award, FTA is required to review and consider any information about the applicant that is in the Federal Awardee Performance and Integrity Information System (FAPIIS) accessible through SAM. An applicant may review and comment on information about itself that a Federal awarding agency previously entered. FTA will consider any comments by the applicant, in addition to the other information in FAPIIS, in making a judgment about the applicant's integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 2 CFR 200.205 Federal Awarding Agency Review of Risk Posed by Applicants.

F. Federal Award Administration Information (1) Federal Award Notices FTA will announce the final project selections on the FTA website. Project recipients should contact their FTA Regional Office for additional information regarding allocations for Start Printed Page 63657projects.

At the time project selections are announced, FTA will extend pre-award authority for the selected projects. There is no blanket pre-award authority for these projects before announcement. There is no minimum or maximum grant award amount, but FTA intends to fund as many meritorious projects as possible.

(2) Administrative and National Policy Requirements a. Pre-Award Authority FTA will issue specific guidance to recipients regarding pre-award authority at the time of selection. FTA does not provide pre-award authority for competitive funds until projects are selected, and there are Federal requirements that must be met before costs are incurred.

For more information about FTA's policy on pre-award authority, see the FY 2020 Apportionments Notice published on June 3, 2020, at https://www.govinfo.gov/âcontent/âpkg/âFR-2020-06-03/âpdf/â2020-11946.pdf. b. Grant Requirements Selected applicants will submit a grant application through FTA's electronic grant management system and adhere to the customary FTA grant requirements for research project (insert Circular name).

All competitive grants, regardless of award amount, will be subject to the Congressional notification and release process. FTA emphasizes that third-party procurement applies to all funding awards, as described in FTA Circular 4220.1F, âThird Party Contracting Guidance.â However, FTA may approve applications that include a specifically identified partnering organization(s) (2 CFR 200.302(f)). When included, the application, budget, and budget narrative should provide a clear understanding of how the selection of these organizations is critical for the project and give sufficient detail about the costs involved.

C. Planning FTA encourages applicants to engage the appropriate State Departments of Transportation, Regional Transportation Planning Organizations, or Metropolitan Planning Organizations in areas to be served by the project funds available under this program. D.

The applicant agrees that the most recent Federal requirements will apply to the project unless FTA issues a written determination otherwise. The applicant must submit the Certifications and Assurances before receiving a grant if it does not have current certifications on file. E.

Free Speech and Religious Liberty In connection with any program or activity conducted with or benefiting from funds awarded under this notice, recipients of funds must comply with all applicable requirements of Federal law, including, without limitation, the Constitution of the United States. Statutory, regulatory, and public policy requirements, including without limitation, those protecting free speech, religious liberty, public welfare, the environment, and prohibiting discrimination. The conditions of performance, non-discrimination requirements, and other assurances made applicable to the award of funds in accordance with regulations of the Department of Transportation.

And applicable Federal financial assistance and contracting principles promulgated by the Office of Management and Budget. In complying with these requirements, recipients must ensure that no concession agreements are denied or other contracting decisions made on the basis of speech or other activities protected by the First Amendment. If the Department determines that a recipient has failed to comply with applicable Federal requirements, the Department may terminate the award of funds and disallow previously incurred costs, requiring the recipient to reimburse any expended award funds.

(3) Reporting The post-award reporting requirements include submission of the Federal Financial Report (FFR) and Milestone Progress Report in TrAMS. An evaluation of the grant will occur at various points in the demonstration process and at the end of the project. In addition, FTA is responsible for producing an Annual Report to Congress that compiles evaluation of selected projects, including an evaluation of the performance measures identified by the applicants.

Independent Evaluation To achieve a comprehensive understanding of the impacts and implications of each proposed buy antibiotics Research Demonstration Program, projects funded under this announcement will require the recipient to conduct a third party independent evaluation of their project. Recipients will be required to contract with a third party independent evaluator to assist in developing an evaluation plan, and collecting, storing and managing data required to fulfill the evaluation requirement. No more than 10 percent of the Federal share of the project may be used to hire the third-party independent evaluator and the inclusion of a third-party independent evaluation should be described in the grant application.

If the project duration is more than two years, an interim evaluation report would need to be submitted to FTA, otherwise the evaluation report should be included as part of the final project report. B. buy antibiotics Research Demonstration Grant Program Evaluation Projects funded under this announcement will be required to establish a set of performance metrics set by the third-party independent evaluator and shared with FTA.

G. Federal Awarding Agency Contacts Information For questions about applying, please contact Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone.

202-366-8985. A TDD is available at 1-800-877-8339 (TDDFIRS). To ensure that applicants receive accurate information about eligibility or the program, applicants are encouraged to contact FTA directly with questions, rather than through intermediaries or third parties.Start Printed Page 63658 FTA staff also may conduct briefings on the competitive grants selection and award process upon request.

Start Signature K. Jane Williams, Deputy Administrator. End Signature End Supplemental Information [FR Doc.

2020-22316 Filed 10-7-20. 8:45 am]BILLING CODE 4910-57-P.