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Tag: death toll

  • Death toll from floods, landslides on Indonesia’s Sumatra island rises to 164

    The death toll from flash floods and landslides on Indonesia’s Sumatra island rose to 164 on Friday, with 79 people missing, authorities said.Rescuers were hampered by damaged bridges and roads and a lack of heavy equipment.The death toll in North Sumatra province rose to 116, while 25 people died in Aceh. Rescuers also retrieved 23 bodies in West Sumatra, National Disaster Mitigation Agency’s Chief Suharyanto said.A tropical cyclone is expected to continue hitting the Southeast Asian nation for days, Indonesia’s Meteorology, Climatology, and Geophysical Agency reported.THIS IS A BREAKING NEWS UPDATE. AP’s earlier story follows below.Rescuers were hampered by damaged bridges and roads and a lack of heavy equipment Friday after flash floods and landslides on Indonesia’s Sumatra island left 82 people dead and dozens missing.A tropical cyclone is expected to continue hitting the Southeast Asian nation for days, said Indonesia’s Meteorology, Climatology, and Geophysical Agency.Monsoon rains caused rivers to burst their banks in North Sumatra province Tuesday. The deluge tore through mountainside villages, swept away people and submerged more than 3,200 houses and buildings, the National Disaster Management Agency said. About 3,000 displaced families fled to government shelters.Elsewhere in the island’s provinces of Aceh and West Sumatra, thousands of houses were flooded, many up to their roofs, the agency said.The death toll in North Sumatra province rose to 55 as rescue teams struggled to reach affected areas in 12 cities and districts of North Sumatra province, said the National Disaster Mitigation Agency’s spokesperson, Abdul Muhari. He revised the number of people still missing in the province to 41 from the initial report of 88 following a coordination meeting with local authorities Friday.Mudslides that covered much of the area, power blackouts and a lack of telecommunications were hampering the search efforts, said Ferry Wulantukan, spokesperson for North Sumatra regional police.In West Sumatra province, flash floods that struck 15 cities and districts left at least 21 people dead, Muhari said, citing data reported by West Sumatra’s vice governor. The number of people still missing was unclear.West Sumatra’s disaster mitigation agency reported that the flooding submerged more than 17,000 homes, forcing about 23,000 residents to flee to temporary shelters. Rice fields, livestock and public facilities were also destroyed, and bridges and roads cut off by floods and landslides isolated residents.In Aceh province, authorities struggled to bring excavators and other heavy equipment over washed-out roads after torrential rains sent mud and rocks crashing onto the hilly hamlets. At least six people have died and 11 were missing in three villages in Central Aceh district.The extreme weather was driven by Tropical Cyclone Senyar, which formed in the Strait of Malacca, said Achadi Subarkah Raharjo at Indonesia’s Meteorology, Climatology, and Geophysical Agency.He warned that unstable atmospheric conditions mean extreme weather could persist as long as the cyclone system remains active.“We have extended its extreme weather warning due to strong water vapor supply and shifting atmospheric dynamics,” Raharjo said.Senyar intensified rainfall, strong winds, and high waves in Aceh, North Sumatra, West Sumatra, Riau and nearby areas before dissipating. Its prolonged downpours left steep, saturated terrains highly vulnerable to disasters, he said.Seasonal rains frequently cause flooding and landslides in Indonesia, an archipelago of 17,000 islands where millions of people live in mountainous areas or near fertile flood plains.____Karmini reported from Jakarta, Indonesia.

    PADANG, Indonesia —

    The death toll from flash floods and landslides on Indonesia’s Sumatra island rose to 164 on Friday, with 79 people missing, authorities said.

    Rescuers were hampered by damaged bridges and roads and a lack of heavy equipment.

    The death toll in North Sumatra province rose to 116, while 25 people died in Aceh. Rescuers also retrieved 23 bodies in West Sumatra, National Disaster Mitigation Agency’s Chief Suharyanto said.

    A tropical cyclone is expected to continue hitting the Southeast Asian nation for days, Indonesia’s Meteorology, Climatology, and Geophysical Agency reported.

    THIS IS A BREAKING NEWS UPDATE. AP’s earlier story follows below.

    Rescuers were hampered by damaged bridges and roads and a lack of heavy equipment Friday after flash floods and landslides on Indonesia’s Sumatra island left 82 people dead and dozens missing.

    A tropical cyclone is expected to continue hitting the Southeast Asian nation for days, said Indonesia’s Meteorology, Climatology, and Geophysical Agency.

    Monsoon rains caused rivers to burst their banks in North Sumatra province Tuesday. The deluge tore through mountainside villages, swept away people and submerged more than 3,200 houses and buildings, the National Disaster Management Agency said. About 3,000 displaced families fled to government shelters.

    Elsewhere in the island’s provinces of Aceh and West Sumatra, thousands of houses were flooded, many up to their roofs, the agency said.

    The death toll in North Sumatra province rose to 55 as rescue teams struggled to reach affected areas in 12 cities and districts of North Sumatra province, said the National Disaster Mitigation Agency’s spokesperson, Abdul Muhari. He revised the number of people still missing in the province to 41 from the initial report of 88 following a coordination meeting with local authorities Friday.

    Mudslides that covered much of the area, power blackouts and a lack of telecommunications were hampering the search efforts, said Ferry Wulantukan, spokesperson for North Sumatra regional police.

    In West Sumatra province, flash floods that struck 15 cities and districts left at least 21 people dead, Muhari said, citing data reported by West Sumatra’s vice governor. The number of people still missing was unclear.

    West Sumatra’s disaster mitigation agency reported that the flooding submerged more than 17,000 homes, forcing about 23,000 residents to flee to temporary shelters. Rice fields, livestock and public facilities were also destroyed, and bridges and roads cut off by floods and landslides isolated residents.

    In Aceh province, authorities struggled to bring excavators and other heavy equipment over washed-out roads after torrential rains sent mud and rocks crashing onto the hilly hamlets. At least six people have died and 11 were missing in three villages in Central Aceh district.

    The extreme weather was driven by Tropical Cyclone Senyar, which formed in the Strait of Malacca, said Achadi Subarkah Raharjo at Indonesia’s Meteorology, Climatology, and Geophysical Agency.

    He warned that unstable atmospheric conditions mean extreme weather could persist as long as the cyclone system remains active.

    “We have extended its extreme weather warning due to strong water vapor supply and shifting atmospheric dynamics,” Raharjo said.

    Senyar intensified rainfall, strong winds, and high waves in Aceh, North Sumatra, West Sumatra, Riau and nearby areas before dissipating. Its prolonged downpours left steep, saturated terrains highly vulnerable to disasters, he said.

    Seasonal rains frequently cause flooding and landslides in Indonesia, an archipelago of 17,000 islands where millions of people live in mountainous areas or near fertile flood plains.

    ____

    Karmini reported from Jakarta, Indonesia.


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  • Hong Kong fire: Death toll rises to 94 amid final push to find survivors

    The death toll in the Hong Kong apartment complex fire has risen to 94, with dozens still missing, as firefighters make a final push to find survivors on the third day of the blaze.

    Deputy director of the Hong Kong Fire Services, Derek Armstrong Chan, told the Associated Press that crews were prioritizing apartments in the seven high-rise buildings where they had received multiple calls for help during the fire but hadn’t been able to reach them immediately.

    Why It Matters

    The fire is the deadliest to strike the former British colony in more than 70 years. The death toll is more than double that of the 1996 Kowloon fire, which struck a commercial building, killing 41 people. However, the worst fire in Hong Kong’s history remains the 1918 Happy Valley Fire, which killed over 600 people, and the 1948 warehouse fire that resulted in 176 deaths.

    A special investigation team has now been established to determine the cause of the fire, Chief Executive John Lee said.

    What To Know

    Hundreds of people have now been evacuated from the Wang Fuk Court apartments, in the Tai Po district, located in a suburban area in the New Territories, with around 900 sent to temporary shelters overnight.

    At least 94 have been confirmed dead, with more than 70 people injured, including 11 firefighters. Hong Kong leader John Lee previously said that 279 people were missing early Thursday after authorities lost contact. There have been no updated figures on how many remain missing.

    The final search of the buildings will be completed Friday, at which point crews will officially end the rescue phase.

    “Our firefighting operation is almost complete,” Chan said.

    Chan said that the fire had spread “exceptionally fast” while falling bamboo scaffolding and debris made it difficult for emergency vehicles and firefighters to reach those trapped by the blaze. More than 1,000 firefighters were brought in to tackle the blaze, and even now, the buildings continue to smoke from small flare-ups.

    Three men, between the ages of 52 and 68, have been arrested on suspicion of manslaughter in connection with the fire. They included two directors and an engineering consultant from a construction company, which has not been named.

    “We have reason to believe that those in charge of the construction company were grossly negligent,” said Eileen Chung, a senior superintendent of police.

    Police on Thursday also searched the office of Prestige Construction & Engineering Company—the firm in charge of renovations for the apartment complex—and seized multiple boxes of documents. AP’s calls for comment went unanswered on Thursday.

    Authorities suspected some materials used on the exterior walls did not meet fire safety standards, which may have accelerated the spread of the fire. The building, which was undergoing renovations, was also surrounded by bamboo scaffolding. Hong Kong’s anti-corruption agency has now launched a corruption probe into the renovation project.

    Deadly fire likely to accelerate ending use of iconic bamboo as scaffolding

    The housing complex, built in the 1980s, was undergoing a major renovation and was covered in bamboo scaffolding when it caught fire on Wednesday. Officials said the blaze started on the external scaffolding and quickly spread across the bamboo and construction netting to the inside of the building, before spreading to the other buildings. In all, seven of the eight 32-story towers, which include around 2,000 apartments for about 4,800 residents, went up in flames,

    City officials have already been planning a shift from the 1000-year-old bamboo construction technique to metal scaffolding in public works. The tragic fire, which has already claimed dozens of lives, is only likely to accelerate that shift.

    Eric Chan, the Chief Secretary for Administration, told AP that the traditional bamboo was inferior to metal for fire safety.

    “While we know that bamboo scaffolding has a long history in Hong Kong, its flame retardancy is inferior to that of metal scaffolding. For safety reasons, the government believes that a complete switch to metal scaffolding should be implemented in suitable working environments,” he said.

    Hong Kong authorities have also launched immediate reviews of other housing estates in the city, undergoing renovation work, to ensure the buildings and scaffolding meet safety protocols.

    What People Are Saying

    Deputy director Chan said, “We will endeavor to force entry into all the units of the seven blocks concerned so as to ensure that there is no other possible casualties.”

    Resident Lawrence Lee, waiting in one of the shelters where evacuated residents gathered overnight, told the Associated Press his wife was trapped in their apartment: “When the fire started, I told her on the phone to es cape. But once she left the flat, the corridor and stairs were all filled with smoke and it was all dark, so she had no choice but to go back to the flat.”

    A spokesman for Hong Kong’s Independent Commission Against Corruption (ICAC) told the South China Morning Post: “In view of the immense public interest involved, the ICAC today set up a task force to launch a full investigation into possible corruption in the grand renovation project of Wang Fuk Court in Tai Po.” 

    What Happens Next

    The death toll is likely to rise. Officials are continuing to investigate the cause of the blaze.

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  • Mexico City propane tanker explosion death toll reaches 15

    MEXICO CITY (AP) — The death toll from the explosion of a tanker truck carrying propane on a major highway in Mexico City last week has risen to 15, authorities said Monday.

    Mexico City health officials announced on X that a 40-year-old man had died from his injuries and then hours later said in a statement that a 15th person had died who had not been identified. Thirty-nine people remained hospitalized.

    Investigators determined that the tank of the overturned trailer ruptured after colliding with something. They continue investigating whether the truck was speeding and whether the driver had sufficient training.

    The resulting fire last Wednesday engulfed more than two dozen vehicles and left dozens of badly burned victims.

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  • An earthquake destroys villages in eastern Afghanistan and kills 800 people, with 2,500 injured

    Desperate Afghans clawed through rubble in the dead of the night in search of missing loved ones after a strong earthquake killed some 800 people and injured more than 2,500 in eastern Afghanistan, according to figures provided Monday by the Taliban government.The 6.0 magnitude quake late Sunday hit towns in the province of Kunar, near the city of Jalalabad in neighboring Nangarhar province, causing extensive damage.The quake at 11:47 p.m. was centered 17 miles east-northeast of Jalalabad, the U.S. Geological Survey said. It was just 5 miles deep. Shallower quakes tend to cause more damage. Several aftershocks followed.Footage showed rescuers taking injured people on stretchers from collapsed buildings and into helicopters as people frantically dug through rubble with their hands.The Taliban government’s chief spokesman, Zabihullah Mujahid, said at a press conference Monday that the death toll had risen to at least 800 with more than 2,500 injured. He said most of the casualties were in Kunar.Buildings in Afghanistan tend to be low-rise constructions, mostly of concrete and brick, with homes in rural and outlying areas made from mud bricks and wood. Many are poorly built.One resident in Nurgal district, one of the worst-affected areas in Kunar, said nearly the entire village was destroyed.“Children are under the rubble. The elderly are under the rubble. Young people are under the rubble,” said the villager, who did not give his name.“We need help here,” he pleaded. “We need people to come here and join us. Let us pull out the people who are buried. There is no one who can come and remove dead bodies from under the rubble.”Homes collapsed and people screamed for helpEastern Afghanistan is mountainous, with remote areas.The quake has worsened communications. Blocked roads are forcing aid workers to walk four or five hours to reach survivors. Dozens of flights have operated in and out of Nangarhar Airport, transporting the injured to hospital.One survivor described seeing homes collapse before his eyes and people screaming for help.Sadiqullah, who lives in the Maza Dara area of Nurgal, said he was woken by a deep boom that sounded like a storm approaching. Like many Afghans, he uses only one name.He ran to where his children were sleeping and rescued three of them. He was about to return to grab the rest of his family when the room fell on top of him.“I was half-buried and unable to get out,” he told The Associated Press by phone from Nangarhar Hospital. “My wife and two sons are dead, and my father is injured and in hospital with me. We were trapped for three to four hours until people from other areas arrived and pulled me out.”It felt like the whole mountain was shaking, he said.Rescue operations were underway and medical teams from Kunar, Nangarhar and the capital Kabul have arrived in the area, said Sharafat Zaman, a health ministry spokesman.Zaman said many areas had not been able to report casualty figures and that “the numbers were expected to change” as deaths and injuries are reported. The chief spokesman, Mujahid, said helicopters had reached some areas but road travel was difficult.“There are some villages where the injured and dead haven’t been recovered from the rubble, so that’s why the numbers may increase,” he told journalists.The tremors were felt in neighboring PakistanFilippo Grandi, the United Nations High Commissioner for Refugees, said the earthquake intensified existing humanitarian challenges in Afghanistan and urged international donors to support relief efforts.“This adds death and destruction to other challenges including drought and the forced return of millions of Afghans from neighbouring countries,” Grandi wrote on the social media platform X. “Hopefully the donor community will not hesitate to support relief efforts.”A magnitude 6.3 earthquake struck Afghanistan on Oct. 7, 2023, followed by strong aftershocks. The Taliban government estimated at least 4,000 people perished in that quake.The U.N. gave a far lower death toll of about 1,500. It was the deadliest natural disaster to strike Afghanistan in recent memory.The latest earthquake was likely to “dwarf the scale of the humanitarian needs” caused by the disaster of 2023, according to the International Rescue Committee.Entire roads and communities have been cut off from accessing nearby towns or hospitals and 2,000 casualties were reported within the first 12 hours, said Sherine Ibrahim, the country director for the aid agency.“Although we have been able to act fast, we are profoundly fearful for the additional strain this will have on the overall humanitarian response in Afghanistan,” said Ibrahim. ” Global funding cuts have dramatically hampered our ability to respond to the ongoing humanitarian crisis.”Sunday night’s quake was felt in parts of Pakistan, including the capital Islamabad. There were no reports of casualties or damage.Pakistani Prime Minister Shehbaz Sharif said he was deeply saddened by events in Afghanistan. “Our hearts go out to the victims and their families. We are ready to extend all possible support in this regard,” he said on the social platform X.Pakistan has expelled tens of thousands of Afghans in the past year, many of them living in the country for decades as refugees.At least 1.2 million Afghans have been forced to return from Iran and Pakistan so far this year, according to a June report by UNHCR.

    KABUL, Afghanistan —

    Desperate Afghans clawed through rubble in the dead of the night in search of missing loved ones after a strong earthquake killed some 800 people and injured more than 2,500 in eastern Afghanistan, according to figures provided Monday by the Taliban government.

    The 6.0 magnitude quake late Sunday hit towns in the province of Kunar, near the city of Jalalabad in neighboring Nangarhar province, causing extensive damage.

    The quake at 11:47 p.m. was centered 17 miles east-northeast of Jalalabad, the U.S. Geological Survey said. It was just 5 miles deep. Shallower quakes tend to cause more damage. Several aftershocks followed.

    Footage showed rescuers taking injured people on stretchers from collapsed buildings and into helicopters as people frantically dug through rubble with their hands.

    The Taliban government’s chief spokesman, Zabihullah Mujahid, said at a press conference Monday that the death toll had risen to at least 800 with more than 2,500 injured. He said most of the casualties were in Kunar.

    Buildings in Afghanistan tend to be low-rise constructions, mostly of concrete and brick, with homes in rural and outlying areas made from mud bricks and wood. Many are poorly built.

    One resident in Nurgal district, one of the worst-affected areas in Kunar, said nearly the entire village was destroyed.

    “Children are under the rubble. The elderly are under the rubble. Young people are under the rubble,” said the villager, who did not give his name.

    “We need help here,” he pleaded. “We need people to come here and join us. Let us pull out the people who are buried. There is no one who can come and remove dead bodies from under the rubble.”

    Homes collapsed and people screamed for help

    Eastern Afghanistan is mountainous, with remote areas.

    The quake has worsened communications. Blocked roads are forcing aid workers to walk four or five hours to reach survivors. Dozens of flights have operated in and out of Nangarhar Airport, transporting the injured to hospital.

    One survivor described seeing homes collapse before his eyes and people screaming for help.

    Sadiqullah, who lives in the Maza Dara area of Nurgal, said he was woken by a deep boom that sounded like a storm approaching. Like many Afghans, he uses only one name.

    He ran to where his children were sleeping and rescued three of them. He was about to return to grab the rest of his family when the room fell on top of him.

    “I was half-buried and unable to get out,” he told The Associated Press by phone from Nangarhar Hospital. “My wife and two sons are dead, and my father is injured and in hospital with me. We were trapped for three to four hours until people from other areas arrived and pulled me out.”

    It felt like the whole mountain was shaking, he said.

    Rescue operations were underway and medical teams from Kunar, Nangarhar and the capital Kabul have arrived in the area, said Sharafat Zaman, a health ministry spokesman.

    Zaman said many areas had not been able to report casualty figures and that “the numbers were expected to change” as deaths and injuries are reported. The chief spokesman, Mujahid, said helicopters had reached some areas but road travel was difficult.

    “There are some villages where the injured and dead haven’t been recovered from the rubble, so that’s why the numbers may increase,” he told journalists.

    The tremors were felt in neighboring Pakistan

    Filippo Grandi, the United Nations High Commissioner for Refugees, said the earthquake intensified existing humanitarian challenges in Afghanistan and urged international donors to support relief efforts.

    “This adds death and destruction to other challenges including drought and the forced return of millions of Afghans from neighbouring countries,” Grandi wrote on the social media platform X. “Hopefully the donor community will not hesitate to support relief efforts.”

    A magnitude 6.3 earthquake struck Afghanistan on Oct. 7, 2023, followed by strong aftershocks. The Taliban government estimated at least 4,000 people perished in that quake.

    The U.N. gave a far lower death toll of about 1,500. It was the deadliest natural disaster to strike Afghanistan in recent memory.

    The latest earthquake was likely to “dwarf the scale of the humanitarian needs” caused by the disaster of 2023, according to the International Rescue Committee.

    Entire roads and communities have been cut off from accessing nearby towns or hospitals and 2,000 casualties were reported within the first 12 hours, said Sherine Ibrahim, the country director for the aid agency.

    “Although we have been able to act fast, we are profoundly fearful for the additional strain this will have on the overall humanitarian response in Afghanistan,” said Ibrahim. ” Global funding cuts have dramatically hampered our ability to respond to the ongoing humanitarian crisis.”

    Sunday night’s quake was felt in parts of Pakistan, including the capital Islamabad. There were no reports of casualties or damage.

    Pakistani Prime Minister Shehbaz Sharif said he was deeply saddened by events in Afghanistan. “Our hearts go out to the victims and their families. We are ready to extend all possible support in this regard,” he said on the social platform X.

    Pakistan has expelled tens of thousands of Afghans in the past year, many of them living in the country for decades as refugees.

    At least 1.2 million Afghans have been forced to return from Iran and Pakistan so far this year, according to a June report by UNHCR.

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  • Only the Emergency Has Ended

    Only the Emergency Has Ended

    Emergency responses—being, well, emergency responses—aren’t designed to last forever, and this morning, the World Health Organization declared the one that’s been in place for the COVID-19 pandemic since January 2020 officially done. “This virus is here to stay. It is still killing, and it’s still changing,” Tedros Adhanom Ghebreyesus, the director general of the WHO, said at a press conference; although the coronavirus will continue to pose a threat, the time had simply come, he and his colleagues said, for countries to move away from treating it as a global crisis.

    And, really, they already have: The United States, for instance, ended its national emergency last month and will sunset its public-health emergency next week; countries around the world have long since shelved testing programs, lifted lockdowns, dispensed with masking mandates, and even stopped recommending frequent COVID shots to healthy people in certain age groups. In some ways, the WHO was already a straggler. Had it waited much longer, the power of its designation of COVID as a “public health emergency of international concern,” or PHEIC, “would have been undermined,” says Salim Abdool Karim, the director of the Centre for the AIDS Program of Research in South Africa.

    There’s no disputing that the virus’s threat has ebbed since the pandemic’s worst days. By and large, “we are in our recovery phase now”—not perfectly stabilized, but no longer in chaotic flux, says René Najera, the director of public health at the College of Physicians of Philadelphia. Still, ending the emergency doesn’t mean that the world has fully addressed the problems that made this an emergency. Global vaccine distribution remains wildly inequitable, leaving many people susceptible to the virus’s worst effects; deaths are still concentrated among those most vulnerable; the virus’s evolutionary and transmission patterns are far from predictable or seasonal. Now, ending the emergency is less an epidemiological decision than a political one: Our tolerance for these dangers has grown to the extent that most people are doing their best to look away from the remaining risk, and will continue to until the virus forces us to turn back.

    The end to the PHEIC, to be clear, isn’t a declaration that COVID is over—or even that the pandemic is. Both a PHEIC and a pandemic tend to involve the rapid and international spread of a dangerous disease, and the two typically do go hand in hand. But no set-in-stone rules delineate when either starts or ends. Plenty of diseases have met pandemic criteria—noted by many epidemiologists as an epidemic that’s rapidly spread to several continents—without ever being granted a PHEIC, as is the case with HIV. And several PHEICs, including two of the Ebola outbreaks of the past decade and the Zika epidemic that began in 2015, did not consistently earn the pan- prefix among experts. With COVID, the WHO called a PHEIC more than a month before it publicly labeled the outbreak a pandemic on March 11. Now the organization has bookended its declaration with a similar mismatch: one crisis designation on and the other off. That once again leaves the world in a bizarre risk limbo, with the threat everywhere but our concern for it on the wane.

    For other diseases with pandemic potential, understanding the start and end of crisis has been simpler. After a new strain of H1N1 influenza sparked a global outbreak in 2009, disrupting the disease’s normal seasonal ebb and flow, scientists simply waited until the virus’s annual transmission patterns went back to their pre-outbreak baseline, then declared that particular pandemic done. But “we don’t really have a baseline” to return to for SARS-CoV-2, says Sam Scarpino, an infectious-disease modeler at Northeastern University. This has left officials floundering for an end-of-pandemic threshold to meet. Once, envisioning that coda seemed more possible: In February 2021, when the COVID shots were still new, Alexis Madrigal wrote in The Atlantic that, in the U.S. at least, pandemic restrictions might end once the country reached some relatively high rate of vaccination, or drove daily deaths below 100—approximating the low-ish end of the flu’s annual toll.

    Those criteria aren’t perfect. Given how the virus has evolved, even, say, an 85 percent vaccination rate probably wouldn’t have squelched the virus in a way public-health experts were envisioning in 2021 (and wouldn’t have absolved us of booster maintenance). And even if the death toll slipped below 100 deaths a day, the virus’s chronic effects would still pose an immense threat. But thresholds such as those, flawed though they were, were never even set. “I’m not sure we ever set any goals at all” to designate when we’d have the virus beat, Céline Gounder, an infectious-disease physician at NYU and an editor-at-large for public health at KFF Health News, told me. And if they had been, we probably still would not have met them: Two years out, we certainly have not.

    Instead, efforts to mitigate the virus have only gotten laxer. Most individuals are no longer masking, testing, or staying up to date on their shots; on community scales, the public goods that once seemed essential—ventilation, sick leave, equitable access to insurance and health care—have already faded from most discourse. That COVID has been more muted in recent months feels “more like luck” than a product of concerted muffling from us, Scarpino told me. Should another SARS-CoV-2 variant sweep the world or develop resistance to Paxlovid, “we don’t have much in the way of a plan,” he said.

    If and when the virus troubles us again, our lack of preparedness will be a reflection of America’s classically reactive approach to public health. Even amid a years-long emergency declaration that spanned national and international scales, we squandered the opportunity “to make the system more resilient to the next crisis,” Gounder said. There is little foresight for what might come next. And individuals are still largely being asked to fend for themselves—which means that as this emergency declaration ends, we are setting ourselves up for another to inevitably come, and hit us just as hard.

    As the final roadblocks to declaring normalcy disappear, we’re unlikely to patch those gaps. The PHEIC, at this point, was more symbolic than practical—but that didn’t make it inconsequential. Experts worry that its end will sap what remaining incentive there was for some countries to sustain a COVID-focused response—one that would, say, keep vaccines, treatments, and tests in the hands of those who need them most. “Public interest is very binary—it’s either an emergency or it’s not,” says Saskia Popescu, an infection-prevention expert at George Mason University. With the PHEIC now gone, the world has officially toggled itself to “not.” But there’s no going back to 2019. Between that and the height of the pandemic is middle-ground maintenance, a level of concern and response that the world has still not managed to properly calibrate.

    Katherine J. Wu

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  • Do Overdoses Look Different Now?

    Do Overdoses Look Different Now?

    Most likely, the person’s skin color will change. An ashy tone might creep in, or they could turn a shade of blue. If too much fluid pools in their mouth or lungs and mixes with air, foam will appear at their lips. There might be a sound, too—that of light snoring. These are some of the main symptoms of an overdose. Although the drug causing the reaction might be different, the symptoms look the same. “An overdose is an overdose,” Soma Snakeoil, a co-founder of the Sidewalk Project, a harm-reduction organization, told me.

    But although overdose symptoms have not shifted, the ability to treat it has, most notably because of the availability of naloxone, the medication that can quickly reverse an overdose and that was approved in late March to be sold over the counter, as Narcan. This move happened at least in part because in the past few decades, the entire context of an overdose in the United States has changed. The U.S. has entered its fourth wave of the opioid crisis, and the death toll is different now: Overdoses have been steadily increasing for many years, but this wave, also known as the “era of overdoses,” has seen the highest number of fatal overdoses yet. “I think what makes this current crisis so unique is the volume” of overdoses, John Pamplin II, an epidemiologist at Columbia’s school of public health, told me. And that is happening because the drugs have changed too. “It’s not necessarily that more people are using drugs,” Emilie Bruzelius, an epidemiology researcher at Columbia’s school of public health, told me. “The opioids that people are using now are incredibly strong, and they’re more likely to cause an overdose.”

    The result is that any person using drugs has a higher chance of overdosing than ever before. “There’s no population segment that is insulated,” Bruzelius said. “It’s really affecting everybody now.”

    The origins of the opioid crisis can be traced back to 1999. As doctors prescribed opioids more and more—OxyContin prescriptions for non-cancer-related pain alone increased from about 670,000 in 1997 to 6.2 million in 2002—related deaths rose swiftly. In that same period, the number of deaths increased almost 30 percent, to nearly 9,000. This first wave largely affected white people: By 2010, the opioid mortality rate was more than two times higher for white people than Black people.

    That year, a second wave began, in which overdose deaths involving heroin grew most dramatically. By 2015, heroin overdose deaths surpassed the number of deaths attributable to opioid pills. This time, the total opioid mortality rate grew for both Black and white populations; death rates increased by an average of at least 30 percent a year beginning in 2010, and accelerated even faster after 2013. In this same period, illicitly manufactured fentanyl—a synthetic opioid approved for pain relief—was being slipped into heroin, counterfeit pills, cocaine, and other drugs. Many of the people taking these drugs did not realize that they were taking fentanyl at all, leading to a third wave of overdoses. Mortality skyrocketed. In 2017, synthetic opioids were responsible for more than 28,000 deaths, while opioid-pill and heroin overdose deaths had leveled off at about 15,000. The demographics of the crisis continued to shift too, and in 2020, the fastest increases in death rates was experienced by Black and Indigenous Americans, surpassing the death rate of white Americans, Pamplin told me.

    Read: What those in power are missing about the opioid epidemic

    The new, fourth wave is characterized by more mixing of different drugs. “People are overdosing from cocaine and fentanyl or methamphetamines and fentanyl or methamphetamines and fentanyl and heroin,” Bruzelius told me. Recently, xylazine—a non-opiate sedative also known as “tranq”—has infiltrated the fentanyl supply, resulting in what the DEA has deemed the deadliest threat yet.

    This is the context in which the FDA approved Narcan to be sold over the counter. Narcan packages naloxone as a nasal spray, and the FDA argued that its approval could “help improve access to naloxone, increase the number of locations where it’s available, and help reduce overdose deaths throughout the country.” By binding to opioid receptors, naloxone blocks the effects of opiates in the system. This reverses the impact of an overdose, restoring normal breathing.

    But drug policies in America tend to swing, pendulum-like, from one extreme to the other, David Courtwright, a historian at the University of North Florida, told me: A response focused on care for drug users might give way to a more punitive policy. Already, some critics of Narcan’s availability have pushed to restrict its use on the grounds that an effective overdose treatment could encourage drug use—even though there’s “just no kind of scientific or empirical backing” for those arguments, Bruzelius said. Here, the simplest logic holds: If overdoses are affecting every community in America, better to have an accessible treatment everywhere.

    Zoya Qureshi

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  • How Many COVID Deaths Will Chinese Protesters Accept?

    How Many COVID Deaths Will Chinese Protesters Accept?

    Anti-lockdown protests erupted across China following a deadly apartment fire in Xinjiang last week. The country’s zero-COVID policy may have been to blame, as first responders were apparently restricted from accessing the scene. Heavy-handed quarantines and endless testing are causing many harms, including food shortages and widespread unemployment. But they’re also keeping China’s COVID death toll very, very low: A study out in May from Nature Medicine, led by Shanghai researchers, estimated that without these strict measures in place, a massive wave of new Omicron infections could overwhelm critical-care units and leave 1.55 million people dead. As protesters call on the government to loosen up, how do they make sense of this potential trade-off?

    Few, if any, of the people in the street are asking for a total rollback of the country’s COVID measures. Global public-health experts and China scholars who have been following the protests either from the ground in China or through contacts overseas told me that the movement lacks a precise set of demands. In general, however, the protesters have expressed a wish for easing restrictions, rather than a to-hell-with-it approach. They may not be opposed to post-exposure quarantine, for example, but they’d like to do it in their homes rather than inside government facilities. And footage of the demonstrations shows that many of the protesters are wearing masks (presumably to protect themselves from the coronavirus) even as they agitate for less aggressive testing programs and greater freedom of movement.

    Read: China’s zero tolerance for Xi’s COVID restrictions

    It’s not that people don’t understand the seriousness of COVID, especially in a nation where only two-thirds of those over the age of 80 are fully vaccinated. “People are very much aware of COVID infection, and to some extent, they may even overestimate some of the immediate health risks,” Jeremiah Jenne, a historian and writer based in Beijing, told me. Propaganda circulated by the government has painted other countries as being overrun with deaths from the disease, and China as the only place where people can be safe. But a growing number of citizens, particularly in urban areas and among those who are more internationally aware, are adjusting how they weigh the risks of COVID against the economic hardships and other costs of permanent, draconian restrictions.

    The World Cup has helped fuel this change in attitude, China scholars told me. David Moser, a professor at Beijing Capital Normal University who’s been in China for 35 years, pointed to the broadcasts of the matches, which showed crowds of unmasked people in the stands, leading undisturbed lives. Chinese observers “got a sense that other countries are handling this by self-quarantining, by allowing a certain amount of infections, and letting people make their own medical decisions,” he said. Protesters may not expect to venture into stadiums without a mask anytime soon, or travel without restrictions, but they would like to see some steps in that direction. “They’re asking for a plan that provides an effective way to deal with the pandemic and keep people safe,” Jenne said, “not to go to Paris in March.”

    Read: No exit from Zero COVID for Xi Jinping

    Xi Chen, a health-policy professor at the Yale School of Public Health, told me that many young people protesting think the risks are much smaller than the ones described in the study from last May, which predicted 1.55 million deaths. “I was circulating the number from that Nature paper to younger friends in my network earlier this year, [and] they don’t buy this idea.” They know that easing off the zero-COVID policy will lead to people dying, but they don’t imagine it would reach that scale. According to Chen, some protesters are asking that public resources be prioritized for helping older adults and other vulnerable people in an attempt to mitigate the harm. The Nature study, for what it’s worth, estimated that if the Chinese government could fill the gaps in vaccination and provide shots for every eligible senior, the death toll from a rampant COVID outbreak would be roughly 600,000, while adding widespread use of antiviral therapies would drive it down much further. (The numbers from that model might not be exactly right, says Albert Ko, an infectious-disease epidemiologist and physician at the Yale School of Public Health, but they’re within the realm of possibility. “Whether it’s 1 million or 1.5 million or 2 million, that’s a huge burden.”)

    Whatever the costs, the protesters are convinced that the zero-COVID policy is unsustainable. Public-health experts agree. “The government should address these concerns, because without jobs, people cannot pay for food and medications,” Chen said. In the end, China will need to navigate reopening while attempting to mitigate loss, Ko told me. “This should have been done much earlier.”

    Zoya Qureshi

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  • The ‘End’ of COVID Is Still Far Worse Than We Imagined

    The ‘End’ of COVID Is Still Far Worse Than We Imagined

    When is the pandemic “over”? In the early days of 2020, we envisioned it ending with the novel coronavirus going away entirely. When this became impossible, we hoped instead for elimination: If enough people got vaccinated, herd immunity might largely stop the virus from spreading. When this too became impossible, we accepted that the virus would still circulate but imagined that it could become, optimistically, like one of the four coronaviruses that cause common colds or, pessimistically, like something more severe, akin to the flu.

    Instead, COVID has settled into something far worse than the flu. When President Joe Biden declared this week, “The pandemic is over. If you notice, no one’s wearing masks,” the country was still recording more than 400 COVID deaths a day—more than triple the average number from flu.

    This shifting of goal posts is, in part, a reckoning with the biological reality of COVID. The virus that came out of Wuhan, China, in 2019 was already so good at spreading—including from people without symptoms—that eradication probably never stood a chance once COVID took off internationally. “I don’t think that was ever really practically possible,” says Stephen Morse, an epidemiologist at Columbia. In time, it also became clear that immunity to COVID is simply not durable enough for elimination through herd immunity. The virus evolves too rapidly, and our own immunity to COVID infection fades too quickly—as it does with other respiratory viruses—even as immunity against severe disease tends to persist. (The elderly who mount weaker immune responses remain the most vulnerable: 88 percent of COVID deaths so far in September have been in people over 65.) With a public weary of pandemic measures and a government reluctant to push them, the situation seems unlikely to improve anytime soon. Trevor Bedford, a virologist at the Fred Hutchinson Cancer Center, estimates that COVID will continue to exact a death toll of 100,000 Americans a year in the near future. This too is approximately three times that of a typical flu year.

    I keep returning to the flu because, back in early 2021, with vaccine excitement still fresh in the air, several experts told my colleague Alexis Madrigal that a reasonable threshold for lifting COVID restrictions was 100 deaths a day, roughly on par with flu. We largely tolerate, the thinking went, the risk of flu without major disruptions to our lives. Since then, widespread immunity, better treatments, and the less virulent Omicron variant have together pushed the risk of COVID to individuals down to a flu-like level. But across the whole population, COVID is still killing many times more people than influenza is, because it is still sickening so many more people.

    Bedford told me he estimates that Omicron has infected 80 percent of Americans. Going forward, COVID might continue to infect 50 percent of the population every year, even without another Omicron-like leap in evolution. In contrast, flu sickens an estimated 10 to 20 percent of Americans a year. These are estimates, because lack of testing hampers accurate case counts for both diseases, but COVID’s higher death toll is a function of higher transmission. The tens of thousands of recorded cases—likely hundreds of thousands of actual cases every day—also add to the burden of long COVID.

    The challenge of driving down COVID transmission has also become clearer with time. In early 2021, the initially spectacular vaccine-efficacy data bolstered optimism that vaccination could significantly dampen transmission. Breakthrough cases were downplayed as very rare. And they were—at first. But immunity to infection is not durable against common respiratory viruses. Flu, the four common-cold coronaviruses, respiratory syncytial virus (RSV), and others all reinfect us over and over again. The same proved true with COVID. “Right at the beginning, we should have made that very clear. When you saw 95 percent against mild disease, with the trials done in December 2020, we should have said right then this is not going to last,” says Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia. Even vaccinating the whole world would not eliminate COVID transmission.

    This coronavirus has also proved a wilier opponent than expected. Despite a relatively slow rate of mutation at the beginning of the pandemic, it soon evolved into variants that are more inherently contagious and better at evading immunity. With each major wave, “the virus has only gotten more transmissible,” says Ruth Karron, a vaccine researcher at Johns Hopkins. The coronavirus cannot keep becoming more transmissible forever, but it can keep changing to evade our immunity essentially forever. Its rate of evolution is much higher than that of other common-cold coronaviruses. It’s higher than that of even H3N2 flu—the most troublesome and fastest-evolving of the influenza viruses. Omicron, according to Bedford, is the equivalent of five years of H3N2 evolution, and its subvariants are still outpacing H3N2’s usual rate. We don’t know how often Omicron-like events will happen. COVID’s rate of change may eventually slow down when the virus is no longer novel in humans, or it may surprise us again.

    In the past, flu pandemics “ended” after the virus swept through so much of the population that it could no longer cause huge waves. But the pandemic virus did not disappear; it became the new seasonal-flu virus. The 1968 H3N2 pandemic, for example, seeded the H3N2 flu that still sickens people today. “I suspect it’s probably caused even more morbidity and mortality in all those years since 1968,” Morse says. The pandemic ended, but the virus continued killing people.

    Ironically, H3N2 did go away during the coronavirus pandemic. Measures such as social distancing and masking managed to almost entirely eliminate the flu. (It has not disappeared entirely, though, and may be back in full force this winter.) Cases of other respiratory viruses, such as RSV, also plummeted. Experts hoped that this would show Americans a new normal, where we don’t simply tolerate the flu and other respiratory illnesses every winter. Instead, the country is moving toward a new normal where COVID is also something we tolerate every year.

    In the same breath that President Biden said, “The pandemic is over,” he went on to say, “We still have a problem with COVID. We’re still doing a lot of work on it.” You might see this as a contradiction, or you might see it as how we deal with every other disease—an attempt at normalizing COVID, if you will. The government doesn’t treat flu, cancer, heart disease, tuberculosis, hepatitis C, etc., as national emergencies that disrupt everyday life, even as the work continues on preventing and treating them. The U.S.’s COVID strategy certainly seems to be going in that direction. Broad restrictions such as mask mandates are out of the question. Interventions targeted at those most vulnerable to severe disease exist, but they aren’t getting much fanfare. This fall’s COVID-booster campaign has been muted. Treatments such as bebtelovimab and Evusheld remain on shelves, underpublicized and underused.

    At the same time, hundreds of Americans are still dying of COVID every day and will likely continue to die of COVID every day. A cumulative annual toll of 100,000 deaths a year would still make COVID a top-10 cause of death, ahead of any other infectious disease. When the first 100,000 Americans died of COVID, in spring 2020, newspapers memorialized the grim milestone. The New York Times devoted its entire front page to chronicling the lives lost to COVID. It might have been hard to imagine, back in 2020, that the U.S. would come to accept 100,000 people dying of COVID every year. Whether or not that means the pandemic is over, the second part of the president’s statement is harder to argue with: COVID is and will remain a problem.

    Sarah Zhang

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