U.S. regulators on Tuesday authorized another COVID-19 booster for people age 50 and older, a step to offer extra protection for the most vulnerable in case the coronavirus rebounds. The Food and Drug Administration’s decision opens a fourth dose of the Pfizer or Moderna vaccines to those people at least four months after their previous booster. Until now, the FDA had cleared fourth doses only for people 12 and older who have severely weakened immune systems. The agency said this especially fragile group also can get an additional booster, a fifth shot. The latest expansion, regardless of people’s health, allows an extra shot to millions more Americans — and the question is whether everyone who’s eligible should rush out and get it. The Centers for Disease Control and Prevention is expected to weigh in. The move comes at a time of great uncertainty. COVID-19 cases have dropped to low levels after the winter surge of the super-contagious Omicron variant. Two vaccine doses plus a booster still provide strong protection against severe disease and death, CDC data show. But an Omicron sibling is causing causing a worrisome jump in infections in Europe — and spreading in the U.S. — even as vaccination has stalled. About two-thirds of Americans are fully vaccinated, and half of those eligible for a first booster haven’t gotten one. Pfizer had asked the FDA to clear a fourth shot for people 65 and older, while Moderna requested another dose for all adults “to provide flexibility” for the government to decide who really needs one. There’s limited evidence to tell how much benefit another booster could offer right now. FDA made the decision without input from its independent panel of experts that has wrestled with how much data is required to expand shots. “There might be a reason to top off the tanks a little bit” for older people and those with other health conditions, said University of Pennsylvania immunologist E. John Wherry, who wasn’t involved in the government’s decision. But while he encourages older friends and relatives to follow the advice, the 50-year-old Wherry — who is healthy, vaccinated and boosted — doesn’t plan on getting a fourth shot right away. With protection against severe illness still strong, “I’m going to wait until it seems like there’s a need.” None of the COVID-19 vaccines are as strong against the Omicron mutant as they were against earlier versions of the virus. Also, protection against milder infections naturally wanes over time. But the immune system builds multiple layers of defense and the type that prevents severe illness and death is holding up. During the U.S. Omicron wave, two doses were nearly 80% effective against needing a ventilator or death — and a booster pushed that protection to 94%, the CDC recently reported. Vaccine effectiveness was lowest — 74% — in immune-compromised people, the vast majority of whom hadn’t gotten a third dose. U.S. health officials also looked to Israel, which during the Omicron surge opened a fourth dose to people 60 and older at least four months after their last shot. Preliminary data posted online last week suggested some benefit: Israeli researchers counted 92 deaths among more than 328,000 people who got the extra shot, compared to 232 deaths among 234,000 people who skipped the fourth dose. What’s far from clear is how long any extra benefit from another booster would last, and thus when to get it. “The ‘when’ is a really difficult part. Ideally we would time booster doses right before surges but we don’t always know when that’s going to be,” said Dr. William Moss of the Johns Hopkins Bloomberg School of Public Health. Plus, a longer interval between shots helps the immune system mount a stronger, more cross-reactive defense. “If you get a booster too close together, it’s not doing any harm — you’re just not going to get much benefit from it,” said Wherry. The newest booster expansion may not be the last: Next week, the government will hold a public meeting to debate if everyone eventually needs a fourth dose, possibly in the fall, of the original vaccine or an updated shot. As for updating vaccines, studies in people — of Omicron-targeted shots alone or in combination with the original vaccine — are underway. The National Institutes of Health recently tested monkeys and found “no significant advantage” to using a booster that targets just Omicron. from https://ift.tt/MiUlgRG Check out https://takiaisfobia.blogspot.com/
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Two years into a global pandemic whose initial cause remains a subject of debate, Reuters, on March 11, published an especially jarring story: the World Health Organization, according to the news agency, had advised Ukraine to eliminate any high-threat pathogens it had in its biolabs, to reduce (and ideally eliminate) the chances that, were the Russian army to attack those facilities, pathogens would leak out and spread disease to the population. The risk of such a disaster—either through some terrible accident, or by nefarious design—is real, but thankfully, not quite as big of a threat as it might seem. For one thing, Ukraine does not have a single Biosafety Level (BSL) 4 within its borders—these are the highest-security labs, which are authorized to store the most dangerous pathogens (like the world’s last remaining samples of smallpox). Additionally, many pathogens stored in lower BSL labs are vulnerable to heat and sunlight, meaning they are unlikely to spread widely were they to escape those facilities—which have safeguards of their own to prevent that from happening. The risk that the chaos of the war will unleash pathogens from Ukrainian labs is “extremely unlikely. But, yes, in theory, it’s a possibility,” says Filippa Lentzos, the co-director of the Centre for Science and Security Studies at King’s College London. Even in peacetime, accidents at laboratories around the world that cause people to get sick are more common than one would hope; just this December, a lab worker in Taiwan was diagnosed with the Delta variant of SARS-CoV-2, which was traced to a bite from an infected lab mouse. Lab leaks have threatened even more dire consequences; as Gregory Lewis, the acting head of the Biosecurity Research Group at Oxford University’s Future of Humanity Institute, points out, the last known death from smallpox, in 1978, was caused by a lab leak in the United Kingdom. “Globally, we are not good enough. We all need to improve,” says Lewis. In 2020, the head of the Ihor Kuzin, then Ukraine’s chief state sanitary doctor, told the Ukrainian television network TSN the country only had two Biosafety Level 3 laboratories. Such labs, while not the highest security risk, are still designed to contain pathogens that can be transmitted through the air and could potentially cause lethal infections. Wartime conditions, though, could compromise those security measures. And if someone were to be infected, accidentally or otherwise, war time conditions might be harder to treat people who have been exposed and contain the infection, such as compromising access to medications, says Hayley Severance, deputy vice president of global biological policy and programs at the Nuclear Threat Initiative, a security nonprofit that aims to reduce global nuclear and biological threats. However, Severance and Lentzos explain that there are a number of factors that bring down the risk for Ukraine’s bioresearch infrastructure. For instance, in lower-security labs—the majority of labs in Ukraine—scientists typically deactivate pathogens to examine them, Severance says. And in more-secure BSL 3 labs, pathogens face additional obstacles that prevent them from escaping; according to World Health Organization standards, such labs are equipped with various features to keep pathogens secure, including self-closing, interlocked doors; sealed windows, and decontamination equipment such as incinerators. Lentzos says they have layered protections, such that some measures will remain in place if others fail. Additionally, it’s unlikely that the Russian government would steal a pathogen from a lab to infect other people, says Severance. First of all, because Russia has similar ecosystems to Ukraine, its own labs likely will already have any pathogen that could be found in a Ukrainian lab. Indeed, Russia is one of only a handful of countries that has BSL 4 labs. Secondly, biological attacks are uncommon, because pathogens tend to be “difficult to spread” and “very unpredictable,” says Lentzos. Compared to conventional weapons, pathogens are much harder to control—which means it’s hard to prevent them from harming one’s own troops. “It’s easier to make something very nasty in a test tube, but mercifully somewhat harder to actually use it in combat,” says Lewis. Further, it also isn’t very likely that locals will stumble into labs looking for medical supplies; as Lentzos points out, such labs don’t store medications, and it can be hard to mistake a research lab filled with flasks, test tubes and mysterious liquid solutions for a pharmacy. Additionally, actually taking a disease out of a test tube (accidentally or otherwise) and spreading it to others is harder than you might think, unless you happen to have a biologist on hand. “What the heck will you do with it? Will you infect yourself and then try to infect others? Will you, you know, throw it at people? Will you defrost it?” says Lentzos. All that said, Russia can still turn biolabs into a tool to hurt the Ukrainian public—by turning the possibility that pathogens could be let loose into a weapon of disinformation and public confusion. Indeed, Russia has already begun to spread false information about biological weapons in Ukraine. Earlier this month, for example, the Russian defense ministry claimed that Ukraine was operating a covert bioweapons program allegedly controlled by the U.S. military; soon after, experts—including a number of Russian scientists—responded, saying there isn’t any evidence to support those allegations. Severance says Ukraine has been transparent about the work at its facilities, and has participated in international efforts like the Cooperative Threat Reduction Program, which the U.S. created to assist former Soviet states in dismantling unconventional weapons programs, and collaborates regularly with scientists from other countries. Such propaganda suggests that, were Russia to take over Ukrainian bioresearch labs, it could give Moscow more fuel for further disinformation, which the Putin regime could use in an attempt to justify the war to Russian citizens; to undermine international institutions, such as the United Nations, that investigate claims of biological weapons programs; and generally generate more distrust and uncertainty. Further, by spreading rumors about biological weapons, and thus generating a false narrative to justify Russia’s own use of such tools of destruction, Russian propaganda could undermine the longstanding international consensus that biological weapons are inhumane and unacceptable. Going forward, Severance argues that the world should do more to make it harder to make false claims about biological weapons programs. While Ukraine is a party to the Biological Weapons Convention, the disarmament treaty doesn’t have a verification protocol—which, in theory, would have been able to help prove that Russia’s accusations are baseless. As it stands, Severance says Russian propaganda is “eroding the hard fought and won norms that have been established against biological weapon uses. It just really creates a dangerous environment.” from https://ift.tt/RSogaMh Check out https://takiaisfobia.blogspot.com/ Chimére Smith used to love her job as an English teacher in the Baltimore public school system. But she hasn’t taught since March 2020, when she caught COVID-19 and then developed Long COVID. Two years later, she still experiences symptoms including fatigue, migraines, blurry vision, chronic pain, and dizziness. Smith says she and her school district haven’t agreed upon accommodations that would allow her to return to the classroom, so she currently receives disability benefits—but they will expire in about six months, leaving her to rely on Social Security or potentially forcing her back into the workforce. (A Baltimore City Public Schools spokesperson said in a statement that any employee with a diagnosed health condition that affects their ability to work can request accommodations; the system approved 600 requests during the 2020-2021 school year, most related to COVID-19.) The thought of potentially having to work before she’s ready causes Smith stress to the point of physical pain, she says. “Having to return back to work, knowing that I don’t feel well enough in my body still, is scary,” she says. Stories like Smith’s are common. Many people with Long COVID symptoms are unable to work or must do their jobs through extreme discomfort. Other long-haulers, as people with Long COVID are sometimes known, have been unable to secure disability benefits, in many cases because their symptoms defy easy explanation or documentation, making it difficult to prove they meet the standard for disability. The situation isn’t unique to those with Long COVID. Millions of people in the U.S. have chronic illnesses or physical disabilities, and advocates have been calling for better workplace accommodations and federal disability policies since well before the pandemic. But two big changes in the workforce—an alarming number of newly disabled adults in the U.S. (many of them likely long-haulers) and millions of open jobs that need to be filled—may finally force companies to become more accommodating. Many people with Long COVID have relied on remote work to stay employed. Working from home during the pandemic naturally offered flexibility around schedules, working styles, and dress codes, which made it easier for some long-haulers—and many people who were disabled before the pandemic—to continue doing their jobs. But pandemic precautions are rolling back, and many companies are insisting that employees return to the office. “Employers are trying to push people back into in-person [work], which means that we are going back to ‘normal’—and that ‘normal’ wasn’t working for a lot of people,” says Mia Ives-Rublee, director of the Disability Justice Initiative at the Center for American Progress, a nonpartisan policy institute. Taylor Martin, a 29-year-old lawyer and long-hauler who has done contract work from her home in Minnesota throughout the pandemic, says remote work allows her to manage her unpredictable symptoms, including nerve pain, fatigue, cognitive dysfunction, and temperature regulation issues. “I’ll be fine for a week or a month or a few days,” she says, “and then it’s like [I’m] hit by a bus, and it’s all back.” Martin had irritable bowel syndrome before she developed Long COVID, so she’s never felt totally comfortable working in an office. But now that she also has Long COVID symptoms, she can’t imagine working outside her home without major changes to office life—but she knows she may have to eventually, given the demands of the legal field. Ives-Rublee says employers can offer plenty of accommodations that would make work easier for disabled employees. Simply allowing someone to sit instead of standing at a cash register or reception desk all day could make a major difference, she notes as one example. So could guaranteeing frequent breaks. Martin says an office nap room, or at least a quiet area where she could rest, would help on bad days. A flexible schedule that allows her to work from home during flare-ups is also crucial, she says, as are things like storage areas for her medications and a casual dress code that accommodates her temperature regulation issues. Jack, a 40-year-old from Colorado who asked to go by first name only to speak candidly about his employment issues, seconds the need for flexible schedules. After he caught COVID-19 in January 2021, he never recovered from the resulting fatigue and brain fog and was forced to leave his high-powered job in consulting. Though his company asked if he would like to request accommodations, he saw no way to get back to the grueling pace he kept before he got sick. “The job that I had was 60 hours a week minimum” with frequent travel, he says. “It is quite challenging when perfectly fine.” Jack has received disability benefits while out of work, but they’ll expire soon. He’s considering looking for a part-time job—but he’d need an employer who allows him to work in short chunks and is understanding about days when he can’t work at all. “I’m good for about two or three hours of good work per day,” Jack says. “It’s a tough job to find, especially if I want to get anywhere close to replacing the money I was making.” Even well-meaning employers find certain jobs difficult to modify. Many health care jobs, for instance, have to be done in person and are physically taxing, which complicates Jennifer Laffey’s job coordinating employee health services at New York hospital system Northwell Health. About 35 of Northwell’s 78,000 employees have been diagnosed with Long COVID and enrolled in its program for long-haulers. Laffey’s team works with human resources and other departments to help them get back to work and match them with clinicians in the Northwell system for treatment. In some cases, employees require a temporary shift in responsibilities. A nurse who typically delivers bedside care, for example, might be able to work in a call center to answer patient inquiries over the phone. Ultimately, though, some positions are difficult to tweak. “It’s very hard to take a surgeon out of an operating room,” Laffey says. For people with specialized roles like these, a leave of absence is sometimes the only option—but it’s not always enough. Some people recover from Long COVID in a few months, but many long-haulers have been sick for longer than a year. It’s not clear if or when there will be therapies that allow them to get back to normal. The Americans with Disabilities Act requires employers to make reasonable accommodations for people with disabilities. But, as Smith and Jack found, that standard doesn’t always translate to a smooth transition back to work, either because employers can’t or won’t make certain adjustments or because people are just too sick to maintain their positions. Some long-haulers struggle to have their disability recognized at all. Overall, well under half of applicants successfully get disability benefits from the Social Security Administration. Long-haulers often have a particularly difficult time because Long COVID is new, little understood, and hard to document. Some people may have normal results on medical or diagnostic tests but remain sick for reasons doctors don’t understand, which makes it hard to capture on paper why they are unable to work. Many long-haulers struggle to get their physicians to take their symptoms seriously, which makes the bar even harder to clear with benefits providers. Smith, the former English teacher, says she was able to get disability benefits because she has chronic migraines—but, she says, that is just one symptom among many. She hopes Long COVID will soon be more readily recognized. “We need to get very clear about calling it, labeling it, diagnosing [Long COVID] for what it is, so more people are able to get the benefits and the resources of that,” she says. There has been some progress on that front. In March, Sen. Tim Kaine of Virginia announced that he has Long COVID and helped introduce a bill that would educate employers about long-haulers’ rights and make it easier for patients to access support services. And as doctors learn more about Long COVID, it will hopefully become easier to diagnose and document. But Ives-Rublee says more needs to be done to protect long-haulers and people with disabilities and chronic illnesses of all kinds. The U.S. Equal Employment Opportunity Commission, which enforces laws that prevent discrimination in the workplace, requires more funding, and the Social Security Administration needs more people to work through the backlog of requests for benefits, she says. Expanding Medicaid would also give more people access to insurance and other necessary benefits, she says. A problem as massive as Long COVID demands systemic solutions. But in the meantime, some companies are working toward improvements. One is Goodpath, a personalized medicine startup that offers its services to businesses as a health benefit for employees. It recently created an app-based program for people recovering from Long COVID. After completing a detailed questionnaire, each user is paired with a health coach and given daily tasks—like breathing exercises, stretches, or smell training—tailored to their symptoms. The program just launched, so it’s too soon to have data on its effectiveness, but Goodpath has begun offering it to U.S. employees of big companies, including Yamaha. Goodpath CEO Bill Gianoukos says the company’s primary goal is to help long-haulers get better, but there’s also a financial incentive for employers to use the program. Many people with Long COVID can’t see top experts or get into specialty clinics, which means they often bounce from doctor to doctor, racking up health care costs without seeing much improvement. Goodpath aims to streamline that process, hopefully leading to better outcomes for less money. Without the wide adoption of programs like these or reliable federal protections, however, some people with Long COVID are forced to acknowledge that their careers may look very different than they did before they got sick. Jack, the former consultant, says he has come to terms with the fact that work may not be a big part of his life unless he makes a dramatic recovery. “If my lot in life is to be more of a family guy and less of the jet-set [career man],” he says, “I think I can be okay with that.” from https://ift.tt/eg5b6Ql Check out https://takiaisfobia.blogspot.com/ For the last two years, the U.S. has been stuck in a cycle of COVID-19 case spikes and lulls. Cases rise dramatically, then drop off—and the process repeats. Several times, these surges have been preceded by rising case rates in Europe—such as before last year’s Delta wave and the start of last winter’s Omicron spike—which is why experts have been carefully monitoring a recent increase in cases there. More than 5.2 million COVID-19 infections were reported across Europe during the week ending March 20, according to World Health Organization data, and countries including the U.K. have also reported rising hospitalization rates. The spike has likely been caused in part by the BA.2 variant, a relative of Omicron that studies suggest is at least 30% more contagious than Omicron. The number of cases reported in Europe was roughly the same during the week ending March 20 compared to the prior week—suggesting a possible plateau—but countries including Germany, the Netherlands, and the U.K. are still reporting high levels of infection. The question now is whether the U.S. will follow in Europe’s footsteps, as it has before. About 35% of COVID-19 cases sequenced in the U.S. from March 13-19 were caused by BA.2, according to U.S. Centers for Disease Control and Prevention (CDC) data. In the CDC monitoring region that includes Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and Connecticut, more than half of cases are now linked to the variant. Wastewater surveillance data also show that viral levels are rising in certain parts of the country, particularly the Northeast. No one knows for sure what will happen next, and some experts are somewhat split in their predictions—but the consensus seems to be one of cautious optimism. Dr. Anthony Fauci, White House chief medical advisor and head of the U.S. National Institute of Allergy and Infectious Diseases, said on March 20 there will likely be an “uptick” in U.S. cases this spring, but “hopefully, we won’t see a surge. I don’t think we will.” Syra Madad, an epidemiologist with Harvard’s Belfer Center for Science and International Affairs, agrees that there will likely be an increase in cases and possibly hospitalizations due to BA.2, but she is hopeful that widespread population immunity—through either vaccination or prior infection with Omicron—will prevent a major spike. Despite his very recent predictions of an impending BA.2 surge in the U.S., Dr. Eric Topol, founder of the Scripps Research Translational Institute, says he is now guardedly hopeful. It could take a few more weeks to see what BA.2 will do in the U.S., so nothing is certain—but if the U.S. were going to follow trends in Europe, Topol says he expects that case counts would have started to rise significantly by now, since BA.2 is already prevalent in the U.S. Instead, the U.S. is currently reporting about 27,000 new infections per day, the lowest average number since summer 2021. “The fact that we’re not seeing anything is surprising,” Topol says. “It’s very gratifying, in my view, because I love to be wrong when I’m trying to predict that something bad could happen.” The monster U.S. winter Omicron surge may be providing some armor against a new wave, says Ali Mokdad, a professor of health metrics sciences at the Institute for Health Metrics and Evaluation. By some estimates, at least 40% of the U.S. population was infected during the Omicron wave, though it’s hard to say for sure since many people used at-home rapid tests that aren’t included in official case counts. Some preliminary research suggests that people infected by the original Omicron variant are unlikely to get sick from BA.2—so high levels of natural immunity, combined with coverage from vaccines, may help stave off a surge, Mokdad says. (Vaccines didn’t hold up as well against Omicron as previous variants, but they do still provide strong protection: while the original Omicron variant was circulating, fully vaccinated people were about 2.5 times less likely to test positive for COVID-19 than unvaccinated people, and mRNA-based shots were still at least 90% effective at preventing death and disease severe enough to require mechanical ventilation.) Read More: It’s Time to Rethink Your COVID-19 Risk Tolerance Why, then, did BA.2 take off in European countries that also experienced Omicron surges over the fall and winter and have higher vaccination and booster rates than the U.S.? It’s still unclear, but timing may have played a part. BA.2 began spreading in Europe during the winter months, when people are mostly inside and pathogens transmit easily. Many European countries had also recently dropped restrictions such as mask mandates, opening the door to a jump in infections, Mokdad says. Waning immunity from vaccines and prior infections may have also played a part, he says. But—for better or worse—many parts of the U.S. have been living largely without COVID-19 precautions for many months, so Mokdad doesn’t expect BA.2 to cause a big shock to the system here. His models suggest the U.S. will see a sustained decline in cases through the spring and summer, before they pick up again in the winter when people are forced back indoors. If another new variant emerges, however, that could alter the projections. Whether or not there’s a “next” surge, we’re still in one, says Dr. Ebony Hilton-Buchholz, an associate professor anesthesiology and critical care medicine at the University of Virginia. Baseline levels of COVID-19 remain high, with hundreds of people dying each day. “We’ve never left the first wave,” she says. “We need a peak and a trough, and we haven’t reached the trough. We keep creating new peaks.” Hilton-Buchholz says U.S. policymakers should focus less on gaming out the pandemic’s timeline and more on promoting things that are proven to work, such as wearing a high-quality mask, improving indoor ventilation, and encouraging people to get vaccinated—including with boosters, which have so far failed to catch on widely in the U.S. Madad agrees that it’s too soon to let up on infection-prevention measures. “There’s this dangerous narrative that cases don’t matter and it’s all about hospitalizations,” she says, but that ignores complications, such as Long COVID, which can strike people who experience even mild cases. To help prevent infections that could lead to complications, individuals may want to keep wearing masks even if they aren’t mandated, she says. Despite their optimism about BA.2, both Mokdad and Topol agree that the U.S. is letting public-health measures and pandemic funding lapse too soon. Even if BA.2 does not lead to a surge, a totally new variant—one to which people do not have some natural immunity—could emerge at any time, and the U.S. would not be prepared to fight it. Congress did not include additional funding for COVID-19 relief in a March spending bill, which the White House says will endanger ongoing testing, treatment, and vaccination efforts. The Biden Administration has asked for an additional $22.5 billion to pay for those programs and warned that it currently does not have enough money to purchase additional booster doses for all Americans, should they become necessary. Inadequate funding could also make it harder to track the virus through testing, genomic sequencing, and wastewater surveillance, Topol notes, and there’s little hope of preventing surges if you can’t see the virus coming. (Madad suggests ordering more free rapid at-home COVID-19 tests from the government now, while you still can.) “We need to keep our eyes on the ball,” Mokdad says. “We need to make sure we’re doing enough testing in order to understand if we have a new variant, and if we have a surge.” from https://ift.tt/08Tqfax Check out https://takiaisfobia.blogspot.com/ On March 1, President Joe Biden made a big promise to Americans. In his State of the Union speech, he proudly announced he was launching a program that would allow people who test positive for COVID-19 to immediately have access to recently authorized pills to treat the viral infection. “We’re launching the “Test to Treat” initiative so people can get tested at a pharmacy and, if they prove positive, receive the antiviral pills on the spot at no cost,” he said. Biden pledged that supplies of the medications would be increased at pharmacies across the nation, beginning in mid-March, to realize a vision of on-the-spot care for COVID-19. Those drugs have started to reach states, but the next step of getting them to people who might benefit from them the most is proving more challenging. A regulatory change made in September 2021 allows pharmacists to write prescriptions for COVID-19 therapies and to administer the COVID-19 vaccine. But the U.S. Food and Drug Administration (FDA) emergency use authorizations (EUAs) for Paxlovid (Pfizer’s antiviral treatment) and molnupiravir (made by Merck and Ridgeback Therapeutics) specified that they could only be prescribed by physicians, advanced practice nurses, and physician assistants licensed to dispense antivirals. Only a fraction of retail pharmacy chains have such licensed providers on site who can write a prescription for a COVID-19 therapy. In other words, while the Test to Treat program is well-intentioned, it’s not really addressing the true barriers to treatment for many of those who need it the most: those who don’t have a primary care physician or aren’t getting regular checkups at clinics or hospitals and who rely on pharmacies for treating everything from flu to strep throat to, now, COVID-19. If people test positive at a pharmacy that doesn’t have a prescriber on staff, then they still have to either make an appointment with a primary care physician, or go to an urgent care center or clinic to be evaluated. And because the pills need to be taken within a few days of symptoms or diagnosis to be most effective, that delay could make the treatment useless. Read more: How an Online Pharmacy Sold Millions Worth of Dubious COVID-19 Drugs Of Walgreens’ 1,300 locations that currently stock COVID-19 antiviral medications, for example, only 250 have health providers on site who can prescribe them. Walgreens partners with VillageMD, a nationwide network of primary care physicians, which co-locates many of its clinics adjacent to the pharmacy. In such cases, people who test positive and might need a COVID-19 antiviral prescription “wouldn’t have to physically leave the location,” says Dr. Clive Fields, chief medical officer of VillageMD. “They would go to the pharmacist, get tested, then walk 15 steps to the comprehensive primary care office, get evaluated, and if the antiviral is appropriate, get a prescription and literally pick it up without walking out of the location.” That’s the ideal scenario that Biden laid out in the State of the Union, but it’s not possible in most of the nation’s pharmacies. While nine out of 10 Americans live within five miles of a pharmacy, if they can’t be seen by a medical provider and receive a prescription for an antiviral on site, then the Test to Treat program loses much of its disease-curbing power. “The idea of somebody coming into a pharmacy to get tested, then calling a doctor to see if they can make an appointment in three or four days doesn’t make sense,” says Fields. “It’s bad for the patient, bad for the community and bad for everybody the patient comes in contact with.” Some experts say that the program does have the potential, however, to achieve what Biden hopes, and more—if it is linked to the at-home tests that the government is providing to every American household. It’s a matter of using the tools we have to fight the virus in a more coordinated and intentional way. What medications are available to treat COVID-19 and how do they workWith the COVID-19 pandemic showing signs of waning, but not disappearing as new variants and subvariants of the virus are inevitable, protecting people from getting sick is still the highest public health priority. That means continuing to administer vaccines and booster shots—but these aren’t foolproof, so a certain percentage of vaccinated people will still get infected, and some of those will get seriously ill. For them, drug treatments could mean the difference between days battling flu-like symptoms at home, and weeks in the hospital—potentially in the Intensive Care Unit. In October 2020, the FDA approved the first drug treatment for COVID-19, remdesivir, an antiviral that makes it difficult for the SARS-CoV-2 virus to make more copies of itself and infect other healthy cells. However, it is only available in IV form, so patients have to visit an infusion clinic or hospital for the therapy. Studies also show that it’s only moderately effective, reducing serious adverse events associated with COVID-19 by about 30% among those taking it within days of symptoms appearing compared to those who don’t. It was over a year later, in December 2021, before the FDA issued an EUA for the first COVID-19 antiviral pills, Paxlovid, which also works by blocking SARS-CoV-2 from replicating. The agency authorized the drug based on studies from its maker, Pfizer,that showed the pills can lower risk of hospitalization by more than 90% among those most vulnerable to disease. Just a day after issuing that EUA, the agency authorized molnupiravir, another antiviral that prevents SARS-CoV-2 from making more copies of itself. After encouraging early data, researchers found that molnupiravir wasn’t as effective as they had hoped, lowering the risk of hospitalization and death by only about 30% among those at highest risk of disease. All of these antiviral treatments are, for now, only approved or authorized for those at higher risk of getting severely ill with disease and who are more likely to need hospitalization. They are not meant to prevent infection in the first place, and are only meant to be taken within a few days of when symptoms first appear—the short window when the virus is busy pumping out copies of itself, before it builds up and enters the lungs and other organs. There are, however, other COVID-19 therapies that the FDA authorized to both treat and, in some cases prevent infection. But unlike antiviral treatments,, monoclonal antibodies come in IV, and not pill form, so they aren’t available at pharmacies but only at infusion centers or hospitals. The monoclonal antibodies neutralize any virus floating around by soaking them up so the virus can’t attach to and infect healthy cells. The FDA has so far authorized four such treatments, but they have an Achilles heel: SARS-CoV-2 can easily mutate to get around antibodies. The National Institutes of Health currently advises doctors not to prescribe two of them because they aren’t effective against Omicron. Only Evushield, from AstraZeneca, and GlaxoSmithKline’s Xevudy, (which, interestingly, was developed from the immune cells of an early COVID-19 patient), continues to block Omicron. Where can I get COVID-19 treatments?The U.S. government has purchased drug treatments in bulk and is now distributing them through both the existing Federal Pharmacy Program, in which retail pharmacies can apply for and receive the drugs directly, and the new Test to Treat Program. Under both programs, people who need the drugs will receive them without charge or get reimbursed through their insurers. For now, the Department of Health and Human Services (HHS) has coordinated the bulk of the hundreds of thousands of doses of COVID-19 treatments that have been distributed so far, through its HHS Coordination Operations and Response Element (HCORE). In some cases, HCORE advises states where the supply should go. Indiana, for example, says the government has selected and is now sending drugs directly to certain CVS and Walgreens locations with clinics where health care providers can prescribe them for people who test positive. In other cases, facilities can apply for the drugs: In Minnesota, pharmacies and long-term care facilities that want to dispense the drugs and have relationships with providers who can prescribe them can ask for them directly from the federal government. Read more: Why the U.S. Fumbled Its Early Vaccine Rollout Right now, access is spotty and inequitable, says Dr. Michael Ganio, senior director of pharmacy practice and quality for the American Society of Health System Pharmacists. “A lot of these clinics [to which the government is sending doses] are scattered around metro areas, and don’t include a lot of medically underserved communities or rural areas,” he says, where such one-stop-shopping for testing and treatments could be most powerful. The supply is increasing, but only at a trickle. In Jan., Pfizer said the government was adding to its original order of 10 million doses of its therapy, expected to be filled by June, with another 10 million doses to be delivered by Sept. Last Nov., Merck and Ridgeback, which makes molnupiravir, agreed to provide the US government with more than 3 million courses of its medication. Doctors also expect that as their experience with prescribing the treatments to the most vulnerable people increases, then more otherwise healthy people will also become eligible for them in order to reduce the risk that anyone infected with COVID-19 becomes seriously ill. Still, getting doses to individual pharmacies remains a slow process. And increasing supply still doesn’t allow pharmacists to prescribe the medications. “Supply is not the issue compared to two months ago,” says Rina Shah, group vice president of pharmacy operations and services at Walgreens. “I would say we have dispensed about 10% of the antivirals available to us.” Biden’s Test to Treat program didn’t address the restrictive prescribing requirements in the EUA for COVID-19 antivirals. While the law passed last fall allows pharmacists to administer COVID-19 medications, and expedites people’s access to them, the FDA specifically limited prescribing of Paxlovid and molnupiravir to licensed health care providers because of concerns about drug-drug interactions and side effects. Paxlovid, for example, may cause kidney problems so those with kidney disease need to be monitored closely for changes in kidney function, while pregnant women should not use molnupiravir because of the risk of harm to the developing fetus. The FDA decided that physicians and other licensed providers should be the ones to evaluate people for these risks before prescribing the drugs. But pharmacists argue that evaluating patients for potential drug interactions and side effects is something they are also trained to do. “Assessing and dispensing antivirals are in our wheelhouse,” says Shah. “In every pharmacy, this is what we do every day. We feel there is a really big opportunity in front of us to make a shift in the EUA language to impact hospitalization because we have the technology, talent, and expertise, and the ability to get into every community across the country to increase access to care that much more quickly.” Making the most out of the Test to Treat programIn fact, some public health experts say, the Test to Treat program, combined with the now widely available at-home rapid tests, could become a foundation for shifting the trajectory of COVID-19 by making it possible to treat individual cases without risking spread of the virus in a community. It should theoretically be possible, in fact, to cut out in-person visits entirely. Ideally, people could test themselves at home, then connect via telehealth with a provider who verifies the test result, and can then evaluate that person for whether they need an antiviral by asking about their medical history and current medication use. If the person qualifies, then that provider can write a digital prescription, send it to a pharmacy, and that pharmacy can deliver the antiviral directly to the patient’s home, all without the infectious patient visiting a pharmacy or a health center where they might spread the virus to others. “All of a sudden, you can massively decrease barriers to people getting treated for COVID-19,” says Dr. Michael Mina, formerly of Harvard School of Public Health and now chief science officer at eMed, a health software company that sells at-home rapid COVID-19 tests and provides telehealth experts to help people validate and interpret those results. “We’ve put tests into everyone’s homes. Now let’s link those tests to telemedicine and treatment so people can get a home test, get a lab report based on that home test, and then send that lab result to a physician who can prescribe a treatment,” he says. “Technically the whole process should be that you wake up with symptoms, get tested, and have a prescription delivered to you from your pharmacy all in under an hour.” That, Mina says, should be the ultimate goal of Test to Treat. There’s no reason people who are potentially infectious should have to physically go into a pharmacy to get tested, and then sit around waiting for their prescription to be filled if there is an on-site provider who can prescribe them drugs available—or worse, be sent away if there isn’t. Mina, who contributed to the White House’s National COVID-19 Preparedness Plan released in March 2022, sees the federal government shifting its public health priorities from those oriented towards society as a whole to those that help individual people protect themselves from infection. That makes sense; as the urgent nature of containing a fast-moving virus wanes, it becomes more important to ensure that more people who are infected are treated quickly. That way, there will be fewer people who can spread the virus—to their friends, family, communities, and health care workers. “The more that people get tested because they might want treatment, then that will keep them out of the hospital,” says Mina. “If we can do it right, all of a sudden, COVID-19 becomes a smaller issue for society.” from https://ift.tt/c4LCSzW Check out https://takiaisfobia.blogspot.com/ (NEW YORK) — Former Secretary of State Hillary Clinton said Tuesday she has tested positive for COVID-19 with “mild” symptoms. On social media, the former Democratic presidential candidate said she was “feeling fine” and that former President Bill Clinton had tested negative and was quarantining until their household was fully cleared. A spokesman for the former president posted on Twitter that he would continue to get tested in the days to come.
Hillary Clinton, 74, said she was “more grateful than ever for the protection vaccines can provide against serious illness” and urged people to get vaccine and booster shots. Former President Barack Obama announced earlier this month that he had tested positive for the coronavirus.
from https://ift.tt/BpiEqJ5 Check out https://takiaisfobia.blogspot.com/ Moderna announced today that its COVID-19 vaccine produces “robust” levels of antibodies among children six months to six years old similar to those generated by adults vaccinated with the shot. The results are part of the company’s KidCOVE study and will be submitted to the Food and Drug Administration (FDA) for emergency use authorization in this youngest, and last group of children to be eligible for COVID-19 vaccination, Moderna said in a statement. In the study, nearly 7,000 children six months to six years old were randomly assigned to receive two doses of Moderna’s mRNA-based COVID-19 vaccine, or two doses of placebo. The dosage for this age group is one-quarter of that currently approved for adults. Children vaccinated with the shot produced antibodies against SARS-CoV-2 at similar levels to those that adults made after being vaccinated at higher doses, likely reflecting children’s more active and efficient immune systems. Those antibodies led to an efficacy of 43.7% in protecting children six months to two years old from getting infected with the Omicron variant of the COVID-19 virus, and 37.5% among those aged two to six. None of the children in the study who became infected experienced severe disease, were hospitalized, or died. Currently, Moderna’s vaccine is only approved for those over 18 years old, while Pfizer-BioNTech’s is approved for adults and has emergency use authorization for those between ages five and 18. But these results could put Moderna ahead of Pfizer-BioNTech in receiving authorization to distribute its vaccine to younger children. In addition to seeking authorization for its vaccine to be used for children between six months and six years of age, Moderna is also asking the FDA to authorize two doses of its mRNA vaccine in children six to 12 years old, based on data provided to the agency the shots are safe and effective in that age group. While Pfizer-BioNTech had submitted a request in February for FDA authorization of its vaccine for the youngest age group, the companies and the agency decided to delay reviewing the application until April, when additional data among children given an additional, third dose of the vaccine will be available. The two-dose regimen didn’t prove as efficacious in protecting the youngest children from infection and disease, especially against the Omicron variant, as health officials had hoped. Children under six are the last group to be vaccinated against COVID-19, and ensuring the shots for them are both safe and effective is critical as the new Omicron subvariant, BA.2, continues to cause more new infections, and virus control measures like mask-wearing are being dropped in schools and other public places throughout the U.S. from https://ift.tt/CevBhN3 Check out https://takiaisfobia.blogspot.com/ The U.S. is taking a crash course in learning to “live with the virus.” Policymakers and health experts agree that we have migrated to a less-disruptive COVID-19 endemic phase. This has produced extensive commentary on what living with the virus, and achieving the “new normal” might look like—liberating some while confusing others. Many people have spent two years avoiding and fearing the virus and are now being advised that it’s safe to unmask and to resume a normal social life. For them, this has not ushered in a comfortable sense of natural transition, but instead has caused a national emotional whiplash. Psychologists call this avoidance conflict. CDC’s new look-up map tool for COVID-19 community risk-level attempts to balance key goals of preventing hospital overload and flattening the curve of serious disease. The agency’s previous map based on level of transmission reflected most counties as high-intensity bright red. The new map is mostly a reassuring low-risk green. Critics of this new approach say that the agency “seems to have moved the goalposts to justify the political imperative to let people get back to their normal lives.” What both the critics and supporters of the CDC’s new tool have missed is that—whether red or green—the tool doesn’t change our prior fundamental relationship to the virus which we have had since the beginning of the pandemic. We are all still advised to warily avoid it until it becomes “safe enough.” This old paradigm will not lead us to a “new normal”. With the new CDC guidance our old paradigm dilemmas remain endless. When do I mask? Do I send my child to school with the sniffles? Can I return to work after cancer chemotherapy? Do I need a fourth shot? When do I use at home rapid tests? Should our family fly to our usual summer vacation spot? In this era of cautious fraught optimism, few have grasped the stark reality that for the country to successfully navigate to a sustainable endemic phase, most of us must transition from avoiding to accepting transmission and infections. Let’s sit with that for a second. This should be the center-point of our endemic-phase policies and practices. This is the seismic shift that will ultimately enable us to live in a sustainable new normal. Here are five guideposts that should help us get there: 1) Accept that we can’t outrun OmicronOmicron is an extraordinarily communicable variant. It is ubiquitous and will eventually infect nearly all susceptible people, whether they try to avoid infection or not. The Institute of Health Metrics and Evaluation estimates that about three-fourths of the country already has “functional immunity” to Omicron, and expects this to continue to “grow through the tail-end of the Omicron wave.” As with many respiratory viruses like the flu, colds and pneumonia, we should expect to see a seasonal pattern with more case (positive test) surges. Further outbreaks of high caseloads should not set off alarms to deviate from a steadfast endemic-phase new paradigm, as long as the vulnerable population—which suffers the brunt of the disease burden—is protected from infection. We have accepted coexistence with many other communicable pathogens with similar characteristics in the past, without undue mental trauma or physical disruption. Now it’s COVID-19’s turn. 2) Identify “vulnerable” and “non-vulnerable” risk sub-groupsThe public has been conditioned by dire whole population numbers (all test-positive cases, hospitalizations, and deaths). This drives risk perceptions, and actions for much of COVID-19 policy. Throughout the pandemic this has resulted in a grossly inaccurate and distorted view of individual risk and has led to excessive mass avoidance behaviors and bad policy. This flawed lens must now be replaced. To enable the “new normal,” Americans can be separated into two discrete risk-based sub-populations: those that if infected have a similar or lower risk of hospitalization and death than that from influenza (called the “non-vulnerables”) and those that have a far higher comparative risk of these outcomes (called the “vulnerables.”) Risk is actually a continuum from very low to very high, but this simplifying binary categorization is intended to offer clear public understanding. The determination of vulnerability is based on three overwhelmingly dominant factors that drive severe outcomes from Omicron infection: age, immunological susceptibility, and underlying conditions. Poverty and ethnic/racial factors also confer risk, but indirectly through social and health-equity disparities. Age is the single greatest predictor of infection outcome. A recent CDC study revealed that compared to people under 30 years of age, those over 65 year olds who are infected are 5-10 times more likely to be hospitalized and 65-340 times more likely to die. The absolute numbers are staggering. Over age 65s comprise 13 percent of the population and in January produced 80 percent of total deaths from Omicron. Those over 75 are 6 percent of the population and produced about half of the daily average 2600 deaths during the January surge. Individual and population susceptibility is reduced through either infection or full vaccination. Either are about 80-90 percent protective against serious disease and death, with effectiveness significantly waning with age and over time. The level of susceptibility is an ever-changing dynamic equilibrium between waxing and waning forces. It should increase slowly in coming months as Omicron declines. With the expected increase in transmission and further booster uptake later in the year, we should again expect higher population immunity. The CDC has listed over twenty underlying medical conditions with conclusive evidence of higher risk for severe COVID-19 outcomes: obesity, advanced diabetes, mental disorders have the highest association with death. Additionally there are the estimated ten million immunocompromised Americans, who have autoimmune disease, cancer, chemotherapy regimens or other reasons for immunosuppression. In this new paradigm about 20-25 percent of the American population has a current risk of serious illness from Omicron significantly greater than that of the seasonal flu. These vulnerable people are anyone over 65, and increasing exponentially with advanced age, immunological susceptibility, and significant comorbidities. The immunocompromised of any age are also included. This group must avoid infection, which is their key prevention metric. The remaining 75-80 percent of Americans are “non-vulnerable” as defined by having a similar or lower chance of serious outcomes from Omicron than from the seasonal flu. This group does not need to avoid infection. Their important metric is serious disease and deaths, not cases. 3) Prioritize protection of the high-risk vulnerable populationThis binary scheme now produces much simpler, targeted and effective disease-mitigating framework: the non-vulnerable new normal can be similar to the old normal when interacting with other non-vulnerables. However, when non-vulnerables directly intersect with the welfare of the “vulnerable” population, specific accommodations should be required. In practice this means universal masking on public transport, vaccination, boosting and masking for health care workers and in congregate facilities, such as nursing homes. As a country we have precedents for balancing “freedom to” with “freedom from”—for example in establishing smoke-free public spaces. For those in the vulnerable group, there is unfortunately no dramatic new normal. This is not a societal but a viral imposition. COVID-19 and its variants have taken an unimaginable and inequitable toll in the vulnerable population. Vaccines and boosters have slowed but have not stemmed this tide. Society will need to intensively work through protective public accommodations, and each vulnerable individual and household will need a viable plan. 4) Plan for the most likely scenarioMany are rightfully apprehensive about important “known unknowns” relating to COVID-19 infection. This includes the emergence of new variants, the dangers of Long Covid, the lack of an approved vaccine for infants and young children, and other possible adverse developments. These are all legitimate concerns, however the positive risk-benefit calculus for most individuals and society favors the resumption of our normal lives. Strategic decisions in war are usually focused on “most likely case” assumptions while also preparing for a “worst case.” As new information develops we must maintain the capacity to pivot quickly if things change for the worse. 5) Unite the country through minimizing restrictionsThis “new normal” can perhaps take us from the rancor of partisan politics and ideology to focusing on what works for the country in saving and restoring lives. The primary issue becomes protecting the vulnerable, not masking and other interventions. Obligatory protections should focus only on the areas of intersection with the vulnerable. And hopefully many or even most Americans, no matter their political outlook, can agree on this priority. Pulling together as a society is likely to be most effective when it is the collective embodiment of individual expression. This would not only produce public health dividends, but also boost the economy and help restore America’s full productivity and dynamism at a particularly challenging time in our history. Adopting these guideposts will accelerate our progress to the new normal. It will take time, tenacity, and societal consensus to reach our goal. But the pandemic off-ramp is clearly in view. from https://ift.tt/eabRImF Check out https://takiaisfobia.blogspot.com/ The U.S. could soon see Covid-19 cases rise again and vulnerable people are likely to need a fourth vaccine dose, one of President Joe Biden’s top health advisers warned as the White House calls for more money to fight the pandemic. Anthony Fauci, the longtime head of the National Institute of Allergy and Infectious Diseases and a Biden adviser, said U.K. officials are already warning him of an increase there driven by the BA.2 sub-variant, easing restrictions and waning protection from vaccines, and that the U.S. tends to be a few weeks behind case curves in the U.K. [time-brightcove not-tgx=”true”] “We have all three of those factors right now in this country,” Fauci said in an interview Thursday. “I would predict that we are going to see a bit of an increase, or at least a flattening out and plateauing of the diminution of cases. And the question is how do we deal with that.” U.S. cases have steadily fallen since records set in January, prompting restrictions to be eased and Biden to encourage Americans to resume a more normal life. But the administration is also calling on Congress to approve new funding to head off a fresh crisis, continue certain programs and buy new vaccines and treatments. The funding is also crucial to continue clinical trials of booster shots and work on developing pan-coronavirus vaccines, Fauci said. The White House has sought $22.5 billion in funding, warning that it will soon have to wind down programs and can’t buy more therapeutic treatments. Without new funding, “a lot of things are going to stop. It really will be a very serious situation,” Fauci said. “It just is almost unconscionable.” ‘A Transition Stage’Fauci spoke Thursday to House Democrats during the weekly Democratic Whip meeting, at the invitation of Whip Jim Clyburn, outlining the administration’s needs. The U.S. has not ordered enough shots to give all Americans a fourth dose if needed, officials said earlier this week. Fauci said that the data aren’t entirely clear, but that protection against hospitalization appears to wane after four or five months after a third shot, and would be expected to fall further. “I would project that sooner or later, we will need a fourth,” though perhaps only for the elderly and those with underlying medical conditions, at least at first, Fauci said. Both the cash crunch and Fauci’s warnings come as Biden’s White House Covid team prepares for a change in leadership. Response coordinator Jeff Zients and his deputy, Natalie Quillian, will leave their roles next month and be replaced by Ashish Jha, dean of the Brown School of Public Health. Fauci praised all of them, while cautioning the fall in cases is a good sign, but is not sure to last. “It’s really in a transition stage. We are obviously going in the right direction,” Fauci said. “We have to be really careful and not declare total victory prematurely. I do believe we will be able to settle into a degree of normality.” Jha, in tweets Thursday, also predicted that cases could rise again and new variants could emerge. “We are very likely to see more surges of infections,” he said. The U.S. will need to be flexible, including potentially returning to recommending the use of masks in certain settings, Fauci said. “We’d better be careful, because history has taught us that what’s gone on in the U.K. generally happens to us three or four weeks later,” he said. from https://ift.tt/FIGjCsT Check out https://takiaisfobia.blogspot.com/ During a lull between air raid warnings earlier this month, Iryna Nikolaieva sat in a stairwell of a Kyiv bomb shelter where she had been living for three days and called engineers at two chemical plants near the front lines in the country’s east. Nikolaiva worked as an expert on hazardous waste, and she worried that fighting near the facilities could damage earthen dams holding back hundreds of thousands of tons of chemical sludge, setting off a catastrophic accident. A manager at one site picked up and said that the situation was under control. The chief engineer of the other—a chemical processing facility with waste facilities less than two miles from the front line near the town of Toresk—said he had no idea how the storage sites were holding up. “They said they could not get there because of active hostilities,” says Nikolaieva, speaking from Warsaw, where she fled after nine days living in the bomb shelter with her son, his girlfriend, and hundreds of other Kyiv residents. “It’s not safe for people to go there to check.” Vladimir Putin’s unprovoked attack on Ukraine has already caused unimaginable suffering, with millions of civilians forced to flee their homes, and thousands of others trapped under Russian shelling in cities like Mariupol. The fighting is also creating new environmental hazards, which threaten to add to the war’s human cost. Some of those environmental risks, like a release of radiation from one of Ukraine’s nuclear power plants, could have immediate and devastating consequences. Others, like carcinogenic dust from bombed buildings, are long term threats, with effects likely to reverberate for years and decades after fighting stops. “Civilians depend on their immediate surroundings and the environment,” says Richard Pearshouse, the director of the environment and human rights division of Human Rights Watch. “It’s no longer sufficient to think of the environment as an afterthought to conflict.” Read more: Ukraine Must Be the Last War of the Age of Impunity All wars create devastating environmental threats for civilians, but the fighting in Ukraine could lead to particularly disastrous environmental consequences because the country is so heavily industrialized, particularly in the east, considered to be Ukraine’s industrial heartland. Much of that infrastructure—steel plants in the eastern Donets Basin, chemical facilities near cities like Kyiv and Korosten, and weapons factories, including facilities to produce intercontinental ballistic missiles—was developed in the Soviet era, with some having fallen into disrepair or mismanagement in recent years. Warfare also changes the risks posed by such facilities immensely. Some hazards might be relatively well-contained under normal circumstances, but could kill or sicken thousands if they are damaged by bombs or shelling. Hydropower dams could fail, for instance, and flood entire towns and villages. One of the most dangerous threats is the possibility of a toxic waste spill from one of Ukraine’s chemical facilities, such as the plant near Toresk. That facility in particular could be extremely susceptible to damage, and an accident could have catastrophic consequences. The Toresk facility has two huge man-made toxic waste ponds, each emitting sickly-sweet phenol fumes, along with gaseous naphthalene and formaldehyde (even standing nearby is enough to cause nausea and dizziness, and to irritate visitors’ throats and eyes). Nikolaieva conducted a government-sponsored audit at the facility in 2019, and found that one of the dams holding back more than a quarter million tons of chemical sludge had “obvious” signs of instability. She concluded that fighting with Russia-backed rebels risked setting off a chain reaction disaster—shelling could breach one of the storage ponds and send thousands of tons of waste racing downhill, flooding an even larger 8 million ton, man-made lake filled with chemical byproducts below. Within 10 minutes, such a surge could breach levees around that site and send millions of tons of toxic sludge pouring into the Zalizna river, with a tidal wave of chemical ooze knocking out bridges and electrical equipment downstream, and contaminating drinking water for the entire region. “People will die if it’s the only water that they can drink,” Nikolaieva says. “Maybe for one week [they will be] okay, and then your organs will be poisoned; the liver first.” Notably, much of that poison would flow downstream to the Seversky Donets river and into Russia. “I would like to inform Russians and say we will have our chemicals in the water taps,” Nikolaieva says. The war in Ukraine will likely also have less obvious effects on local environments and the health of people living in them. Even if fighting steers clear of industrial facilities, it can still create new hazards, like spilled fuel that can contaminate groundwater, or chemicals and heavy metals left behind from spent arms. Many of the effects of environmental damage may only become apparent in the years after fighting ends—like carcinogenic dust and debris that could cause cancers (like those affecting 9/11 first responders) in survivors of shelling attacks. And if a major disaster does occur, the war will only make it worse by preventing containment efforts or adequate warnings to affected populations. Read more: Will China Try to Stop Russia’s War in Ukraine? Nuclear facilities are a prime example, particularly after Russian forces attacked the irradiated Chernobyl exclusion zone early in the fighting, and fought over the Zaporizhzhia nuclear power plant in the county’s southeast earlier this month, sparking a fire at the facility. A major accident at either site could have enormous repercussions for Ukraine, the broader region, or even the entire hemisphere, say Olena Pareniuk and Kateryna Shavanova, two Ukrainian radiobiologists with extensive experience working at Chernobyl, who jointly corresponded with TIME (Shavanova is in Kyiv while Pareniuk is near Chernivtsi, Ukraine). If the massive arc-shaped steel shelter built to confine the remains of Chernobyl’s No. 4 reactor is damaged, it could spread radioactive dust across the region. And an accident at Zaporizhzhia, which houses an amount of nuclear material equivalent to 20 Chernobyls, could be even more disastrous than the 1986 Chernobyl meltdown, since the ongoing war could make it all but impossible to mount an effective cleanup response (it took about 500,000 “liquidators” recruited from around the USSR to contain the Chernobyl disaster). “No one with common sense would enter the territory of a nuclear plant with artillery weapons,” Pareniuk and Shavanova write over email. “For us…such behavior does not even fit into our understanding of the world. It’s as if the river flowed up in the sky by itself or the sky turned orange.” Ukraine’s environmental protection ministry has made attempts to catalog the environmental damage caused by Russian attacks. And some NGOs have worked remotely to try and map potential environmental hazards, both to warn civilians, and aid in cleanup efforts when the war finally ends. For now, in the midst of the fighting, it’s hard to see the real extent of environmental contamination—though numerous reports of bombed industrial plants aren’t a good sign. “We don’t even know what number of square kilometers [of land] have been destroyed,” says Tetiana Omelianenko, a waste management consultant based in Kyiv. Ukrainian environmental experts have created online pages where local residents and companies can report environmental incidents during the conflict that might later require remediation, like spilled gasoline from destroyed fuel storage facilities, or the destruction of an industrial plant. “After the end of the war, it will be evaluated and published,” Omelianenko says. “Only after that can we do some estimations [of environmental damage].” But until fighting stops, Ukraine’s environmental experts can only do so much. Since getting to Poland, Nikolaieva has worked for the Ukrainian government without pay, preparing information on Ukraine’s toxic waste sites to present to intergovernmental groups. Omelianenko, who has remained in Kyiv despite ongoing attacks, has divided her time between volunteering and continuing her environmental consulting work (“More or less, I have a strong nervous system,” she says). She is surveying Ukrainian waste management companies to try and predict what will happen if the fighting shuts down their operations, and she’s planning to help revise a green action plan for the city of Kyiv after the fighting ends, changing cost estimates to account for damage from Russian artillery, with the idea of keeping the city on track for its climate goals. She’s also sprouting plant seeds in her apartment—another effort to prepare for a future without bombs and shelling. “When the war ends,” Omelianenko says, “I’ll need to grow flowers in my garden.” from https://ift.tt/1bHUJL7 Check out https://takiaisfobia.blogspot.com/ |
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