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Tag: iab-vaccines

  • Mpox in the United States Fast Facts | CNN

    Mpox in the United States Fast Facts | CNN

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    CNN
     — 

    Here’s a look at mpox, formerly known as monkeypox, in the United States. In 2022, an outbreak was declared a public health emergency of international concern by the World Health Organization (WHO). The virus originated in Africa and is the cousin of the smallpox virus.

    In November 2022, WHO renames the monkeypox virus as mpox after working with International Committee on the Taxonomy of Viruses (ICTV) to rename the the virus using non-stigmatizing, non-offensive social and cultural nomenclature.

    (Source: Centers for Disease Control and Prevention)

    Mpox is a poxvirus. It generally causes pimple- or blister-like lesions and flu-like symptoms such as fever. The disease is rarely fatal.

    Mpox spreads through close contact. This includes direct physical contact with lesions as well as “respiratory secretions” shared through face-to-face interaction and touching objects that have been contaminated by mpox lesions or fluids. The virus may also pass to a fetus through the placenta.

    Anyone can become ill from mpox, but the US Centers for Disease Control and Prevention (CDC) says that more than 99% of mpox cases in the United States in the 2022 outbreak have been among men who have sex with men. However, mpox is not generally considered a sexually transmitted disease.

    Mpox is usually found in West and Central Africa, but additional cases have been seen in Europe, including the United Kingdom, and other parts of the world in recent years. Those cases are typically linked to international travel or imported animals infected with the poxvirus.

    CDC Mpox Map and Case Count

    WHO Situation Reports

    Timeline and 2022 Outbreak

    1958 – Mpox is discovered when monkeys kept for research cause two outbreaks in Copenhagen, Denmark.

    1970 – The first human case is recorded in Zaire (now the Democratic Republic of Congo).

    2003 – An outbreak in the United States is linked to infected pet prairie dogs imported from Ghana and results in more than 80 cases.

    July 16, 2021 – The CDC and local health officials in Dallas announce they are investigating a case of mpox in a traveler from Nigeria. “The individual is a City of Dallas resident who traveled from Nigeria to Dallas, arriving at Love Field airport on July 9, 2021. The person is hospitalized in Dallas and is in stable condition,” the Dallas County Department of Health and Human Services says in a statement.

    May 17, 2022 – The first confirmed US case of mpox in the 2022 outbreak is reported to the CDC in a traveler who returned to Massachusetts from Canada.

    May 19, 2022 – WHO reports that death rates of the outbreak have been between 3% and 6%.

    May 23, 2022 – The CDC announces the release of mpox vaccine doses from the nation’s Strategic National Stockpile for “high-risk people.” In the United States, the two-dose Jynneos vaccine is licensed to prevent smallpox and specifically to prevent mpox.

    May 26, 2022 – CDC Director Dr. Rochelle Walensky announces that the United States is distributing the vaccine to states with reported cases and recommends vaccination for people at highest risk of infection due to direct contact with someone who has mpox.

    June 22, 2022 – The CDC announces a partnership with five commercial laboratories to ramp up testing capacity in the United States.

    June 23, 2022 – New York City launches the first mpox vaccination clinic in the United States.

    June 28, 2022 – The US Department of Health and Human Services (HHS) and the Biden administration announce an enhanced vaccination strategy and report that more than 9,000 doses of vaccine have been distributed to date.

    July 22, 2022 – Two American children contract mpox – a first in the United States. According to the CDC, the two cases are unrelated.

    July 23, 2022 – WHO declares mpox a public health emergency of international concern, “an extraordinary event that may constitute a public health risk to other countries through international spread of disease and may require an international coordinated response.”

    July 27, 2022 – After weeks of mpox vaccines being in limited supply, more than 786,000 additional doses are made available in the United States, according to HHS.

    July 29, 2022 – New York declares a state disaster emergency in response to the mpox outbreak.

    August 1, 2022 – California and Illinois declare states of emergency. California has reported more than 800 cases, while Illinois has had more than 500, according to data from the CDC.

    August 2, 2022 – An mpox response team is created by the Biden administration. President Joe Biden names Robert Fenton from the Federal Emergency Management Agency (FEMA) as the White House national mpox response coordinator.

    August 2, 2022 – A report from Spain’s National Institute for Microbiology indicates two men, ages 31 and 44, who died from mpox in unrelated cases had both developed encephalitis, or swelling of the brain, which can be triggered by viral infections. Encephalitis is a very rare condition known to be associated with mpox. It has been reported in people with mpox in West Africa and in a patient in the United States in 2003 during the small outbreak linked to imported prairie dogs.

    August 4, 2022 – The Biden administration declares the mpox outbreak a national public health emergency.

    August 5, 2022 – A report published by the CDC finds that 94% of cases were among men who had recent sexual or close intimate contact with another man. Further, 54% of cases were among Black Americans and Latinos.

    August 9, 2022 – In an effort to stretch the limited supply of the Jynneos mpox vaccine, federal health officials authorize administering smaller doses using a different method of injection. The new injection strategy allows health-care providers to give shallow injections intradermally, in between layers of the skin, with one-fifth the standard dose size instead of subcutaneously, into the fatty layer below the skin, with the larger dose.

    August 18, 2022 – The White House announces the acceleration of the HHS vaccine distribution timeline, with an additional 1.8 million doses of the Jynneos vaccine being made available. Additional vaccines will be distributed to communities hosting large LGBTQI+ events.

    August 19, 2022 – Washington’s King County, which includes Seattle, declares mpox a public health emergency, with more than 270 recorded cases.

    September 12, 2022 – The first US death due to mpox is confirmed in Los Angeles County, California.

    May 11, 2023 – WHO declares the mpox outbreak is no longer a global health emergency.

    October 26, 2023 – CDC’s Advisory Committee on Immunization Practices, or ACIP, votes unanimously to recommend that certain individuals ages 18 and older who are at high risk for getting mpox continue to get the vaccine as a routine part of their sexual health care.

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  • Why Biden’s orbit isn’t worried about Robert F. Kennedy’s 2024 campaign | CNN Politics

    Why Biden’s orbit isn’t worried about Robert F. Kennedy’s 2024 campaign | CNN Politics

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    CNN
     — 

    President Joe Biden’s campaign didn’t respond to the Robert F. Kennedy Jr. campaign kick-off because, though there is now a major donor summit on the books for next week, there still technically is no Biden campaign.

    What there is instead is an acceptance among most Democratic leaders that they may still have to wait a while for Biden to make it official – and a grudging embrace of that.

    To the confident advisers in the Biden orbit and their wider circle of supporters, the Kennedy challenge only serves to reinforce the president’s strength. Kennedy and spiritual author Marianne Williamson – mocked at a daily White House press briefing after her primary campaign launch – are the extent of the challenge Biden has drawn.

    The Democratic National Committee has made very clear, meanwhile, that the party apparatus is aligned with Biden. No plans for primary debates are underway. A White House aide did not respond when asked for comment about Kennedy’s kick-off.

    The furthest that New Hampshire Democratic Party Chairman Ray Buckley, who has been critical of Biden’s efforts to stop his state from holding its traditional first-in-the-nation primary, would go when asked about Kennedy’s candidacy was to say, “You just never know what catches the fancy of the voters.”

    “I think the president’s done a fantastic job. The amount of accomplishments is simply breathtaking,” Buckley said. “I don’t see a singular issue galvanizing opposition to him.”

    For at least a few hours on Wednesday, though, it looked like a real challenge. Like the bar across Boston Common that has the iconic “Cheers” sign but doesn’t actually look much like the set of the sitcom inside, Kennedy launch event at the Boston Park Plaza – with the “I’m a Kennedy Democrat” signs waving, the security with earpieces buzzing around – could, with a squint, look like any of the many campaigns from his famous family, including two against incumbent Democratic presidents, both of which ended with Republican wins.

    What many attendees were there for, they said, was Kennedy-style truth telling. What many of them cheered most loudly for through his meandering speech – “this is what happens when you censor somebody for 18 years,” he joked with an hour left to go – were the oblique references to his Covid-19 vaccine skepticism. That skepticism has ostracized Kennedy from nearly every scientist, most Democratic leaders and many members of his family.

    Kennedy acknowledged that distance from his family, previously reported by CNN, by naming those family members who did attend the event, as well as others he said had written him “beautiful letters of love” about his launch even though they are opposed to him running.

    Inside the crowded ballroom on Wednesday, Kennedy told hundreds of supporters he knows he’s already being counted out.

    That, he said, was part of the point, and what made him just like his father and namesake, whose 1968 primary campaign took on Lyndon Johnson.

    “He was running against a president in his own party. He was running against a war. He was running at a time of unprecedented polarization in our country,” Kennedy said, calling his father getting into the 1968 race feeling like he had no chance to win.

    “That hopelessness of his campaign,” Kennedy said, “freed him to tell the truth to the American people.”

    Former Ohio Rep. Dennis Kucinich, a two-time presidential candidate from the left, compared Kennedy to Paul Revere in his own introduction of the candidate. Kennedy noted that he’d timed his campaign launch to the anniversary of that ride, even reciting a bit of the famous Henry Longfellow poem, which he noted his grandmother Rose had made all her 29 grandchildren memorize.

    A new American Revolution is coming, he said, calling his campaign a mission to “end the corrupt merger of state and corporate power.”

    But much of Kennedy’s speech returned to themes of how he had been trying to tell people what he thought was right, despite the government working against him – whether in his environmental work or when he called for an end to Covid-19 lockdowns.

    As a corner of Twitter lit up with “Curb Your Enthusiasm” jokes following the introduction of his wife Cheryl Hines (a star in the show), Kennedy plowed through his concerns at length. There were mentions of the CIA. There were mentions of the butterflies he worried his grandchildren would never get to see because of environmental degradation and the songbirds they’d never get to hear. There was an extended critique of the American health care system, which he said has failed in not effectively treating chronic diseases. “If I have not significantly dropped the number of children with chronic disease by the end of my second term, I do not want to get reelected,” he said. There were questions about whether the war in Ukraine is in the national interest.

    Kennedy knows he gets dismissed as a purveyor of misinformation, he said in his speech, but “a lot of the misinformation is just statements that depart from government orthodoxy.”

    More than an hour into his speech, the crowd erupted as he spoke about the rise in autism diagnoses since 1989, arguing that he has never met someone his age with autism.

    “Why aren’t we asking the question – what happened?” Kennedy asked.

    Over two hours – including when a fire alarm briefly interrupted the speech – Kennedy never explicitly said the word “vaccine” once.

    “He’s a truth teller,” said Rich Prunier, a native of Worcester, Massachusetts, who remembered meeting John F. Kennedy during his 1956 Senate campaign and attended Wednesday’s event.

    Asked what he felt Robert F. Kennedy, Jr. tells the truth about, Prunier said, “name a subject.” His wife – wearing a matching “I’m a Kennedy Democrat” 2024 T-shirt – held up her copy of Kennedy’s book about “The Real Anthony Fauci.”

    Prunier, who said he has received other vaccines but none of the Covid-19 shots, said he had voted for Vermont Sen. Bernie Sanders for the Democratic nomination in 2016 and 2020, but abstained in the 2020 general election because he didn’t like Biden or Donald Trump. He said he just peeled his Sanders bumper sticker off and will soon be replacing it with the Kennedy one he just picked up.

    Elsewhere in the crowd, a small group posed for an iPhone photo while saying, “Freedom!”

    Karen Huntley, a 60-year-old bookkeeper who’d come from Connecticut after reading about the launch from a well-known vaccine skeptic, said she wasn’t ready to commit but that Kennedy “sounds like a good candidate” because of his position on vaccines.

    Huntley said she’d voted for Trump twice, but wouldn’t again – because of Operation Warp Speed, the Trump administration effort that helped accelerate development of the Covid-19 vaccine.

    “I consider Trump the father of the vaccine,” she said.

    His opposition to the vaccine, many leading Democrats say, disqualified Kennedy immediately.

    “Being a vaccine denier and causing harm to public health is not progressive,” California Democratic Rep. Robert Garcia, one of the newest progressive leaders elected to Congress, told CNN. “The Democratic Party – and the progressive wing – will be solidly behind President Biden. There is no support or appetite for a challenger.”

    Vaccine skepticism led Kennedy to a meeting at Trump Tower during the 2016 transition, after which he said the then-president-elect asked him to chair a commission on vaccines (the Trump transition later denied this, and the commission never came to be).

    Asked back then what his father or late uncles Ted Kennedy or John F. Kennedy would think of Trump as president, Robert F. Kennedy said, “He’s probably come into office less encumbered by ideology or by obligations than anybody who’s won the presidency since Andrew Jackson. We’ll see what happens.”

    By 2020, he said he had fully turned on Trump.

    “He’s a bully, and I don’t like bullies, and that’s part of American tradition. I think in many ways he’s discredited the American experiment with self-governance,” Kennedy told Yahoo News three years ago.

    While Kennedy says he’s running as a progressive, his first interview after declaring his candidacy was with Fox’s Tucker Carlson, in which he insisted that the American government is lying about the casualty rate in Ukraine.

    Roger Stone, the longtime Trump adviser and proud dirty trickster, wrote up his own thoughts about a campaign he called “intriguing and potentially substantially impactful on the 2024 presidential race.”

    “I believe that if he can pull together a minimally effective campaign, he could garner as much as a third of the Democrat primary vote,” Stone argued about Kennedy.

    Stone predicted that Democratic Party leaders would try to block that from happening, but if he turns out to be wrong, “Given America’s state of peril, if RFK performs better than expected, the former President should consider the drafting of RFK as the Republican vice presidential candidate in a ‘bipartisan’ unity ticket.”

    But though he and Kennedy were in a photo together backstage at an event last July, as part of the far-right Reawaken America tour, Stone said he has nothing to do with this campaign.

    “We are acquaintances,” Stone told CNN about Kennedy. “I met him once. I have no idea who is running his campaign, and therefore no contact with them.”

    In a long tweet last week, Kennedy denied speculation that has circulated in news reports that ties him to former Trump adviser Steve Bannon.

    “Is it a sign of my campaign’s strength that the Elite of DC’s establishment media simultaneously and shamelessly published an orchestrated and baseless lie to smear me, even before I announce my presidential campaign?” Kennedy wrote. “Steve Bannon has nothing to do with my presidential campaign. I have never discussed a presidential run with Mr. Bannon.”

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  • FDA clears the way for additional bivalent boosters for certain vulnerable individuals | CNN

    FDA clears the way for additional bivalent boosters for certain vulnerable individuals | CNN

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    CNN
     — 

    The U.S. Food and Drug Administration amended the terms of its emergency use authorizations for the Pfizer and Moderna bivalent vaccines on Tuesday, allowing people ages 65 and older and certain people with weakened immunity to get additional doses before this fall’s vaccination campaigns.

    The bivalent vaccines made by Pfizer and Moderna carry instructions for fighting both the original strain of the Covid-19 virus as well as Omicron and its spinoffs.

    They have been available in the United States since September under emergency use authorizations, or EUAs, which tightly restrict how the vaccines may be given.

    On Tuesday, the FDA changed the terms of the authorizations for those vaccines so that certain individuals could get an additional dose ahead of most others.

    Namely, adults ages 65 and older who have received a single dose of a bivalent vaccine may receive an additional dose at least four months following their first dose.

    Most individuals with certain degrees of immunocompromise who have received a first dose of a bivalent vaccine can get a second at least 2 months later. Additional doses may be administered at the discretion of their healthcare provider.

    Dr. Peter Hotez, who co-directs the Center for Vaccine Development at Texas Children’s Hospital, has been calling on the FDA to increase access to the bivalent boosters for those who want them. He says for the most part, today’s guidance from the agency makes sense.

    “My only question is why the 65 year age cutoff? What was that based on? Ordinarily I would have preferred that it be brought down to 60 or even 50,” Hotez said in an email to CNN.

    “For those Americans who understand its importance, we should make second bivalent boosters available. Finally, we’ll soon need guidance about another annual fall booster. Presumably that information comes sometime this summer,” he added.

    For immunocompromised children ages 6 months through 4 years, eligibility for additional bivalent doses will depend on the vaccine previously received, the FDA said in a news release.

    Another big change is that most unvaccinated individuals may now receive a single dose of a bivalent vaccine, rather than mutiple doses of the original single-strain vaccines, the agency said. The FDA simplified its recommendation for unvaccinated individuals after recognizing that most Americans now have some immunity against Covid-19, even if its just through past infections.

    “Evidence is now available that most of the U.S. population 5 years of age and older has antibodies to SARS-CoV-2, the virus that causes COVID-19, either from vaccination or infection that can serve as a foundation for the protection provided by the bivalent vaccines. COVID-19 continues to be a very real risk for many people, and we encourage individuals to consider staying current with vaccination, including with a bivalent COVID-19 vaccine. The available data continue to demonstrate that vaccines prevent the most serious outcomes of COVID-19, which are severe illness, hospitalization, and death,” said Dr. Peter Marks, head of FDA’s Center for Biologics Evaluation and Research, in a news release.

    Children ages 6 months through 5 years who have not yet been vaccinated may now receive a two-dose series of the Moderna bivalent vaccine as their primary series, or a three-dose series of the Pfizer-BioNTech bivalent vaccine if they are 6 months through 4 years of age. Children who are age 5 may receive two doses of the Moderna bivalent or a single dose of the Pfizer-BioNTech bivalent vaccine.

    Children ages 6 months through 5 years who got started on their monovalent vaccines, can now get a dose of a bivalent vaccine, but the number of doses they qualify for will depend on the number of doses they’ve already had and what kind of vaccine they got.

    The agency stressed that most people who have gotten one dose of a bivalent vaccine are not currently eligible for a second dose.

    And they encouraged everyone who hasn’t yet gotten their first dose of a bivalent vaccine to do so, and many Americans are still in that bucket.

    Only about 17% of those eligible, less than 1 in 5 Americans, has gotten a recommended dose.

    As time has passed, adults with reduced immune function because of their age or an underlying health problem have been asking doctors whether they need another dose of the bivalent vaccines.

    The United States Center for Disease Control and Prevention has reported early data showing that the effectiveness of the bivalent vaccines, even against emergency room visits and hospitalizations, has already started to wane.

    But the agency has not been free to make what’s known as a “permissive use” recommendation about the boosters, which would allow doctors to offer additional doses to vulnerable patients because of the terms of the EUA.

    The updated terms give the CDC and its Advisory Committee on Immunization Practices (ACIP) greater freedom to recommend additional doses of the bivalent vaccines. The ACIP is holding a meeting on the Covid-19 vaccines Wednesday and is expected to endorse the FDA’s changes.

    For everyone not covered by today’s changes, the FDA says it intends to make decisions about future vaccinations after receiving recommendations on the fall strain composition from its advisory committee in June.

    Both Canada and the United Kingdom have offered another round of bivalent boosters to those at highest risk from Covid-19 this spring.

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  • Robert F. Kennedy Jr. files paperwork to run for president as a Democrat | CNN Politics

    Robert F. Kennedy Jr. files paperwork to run for president as a Democrat | CNN Politics

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    CNN
     — 

    Environmental lawyer and anti-vaccine activist Robert F. Kennedy Jr. has filed paperwork with the Federal Election Commission to run for president in 2024 as a Democrat.

    The filing was confirmed Wednesday by his campaign treasurer, John E. Sullivan.

    The 69-year-old is the son of former New York senator, US attorney general and assassinated 1968 presidential candidate Robert F. Kennedy and the nephew of the late President John F. Kennedy.

    Kennedy Jr. is a longtime vaccine skeptic. He has promoted discredited claims linking vaccines and autism and founded the anti-vaccine organization Children’s Health Defense. He has also railed against the coronavirus vaccine and has criticized the federal government’s handling of the pandemic.

    In 2019, three members of his family – his sister Kathleen Kennedy Townsend, brother Joseph P. Kennedy II and niece Maeve Kennedy McKean – forcefully denounced his anti-vaccine views in a Politico Magazine op-ed, arguing that he was “part of a misinformation campaign that’s having heartbreaking – and deadly – consequences.”

    In 2022, Kennedy Jr. invoked Nazi Germany in an anti-vaccine speech at the Lincoln Memorial in Washington, DC. The previous year, Instagram took down his account “for repeatedly sharing debunked claims about the coronavirus or vaccines.”

    Kennedy had tweeted last month that he was considering a presidential run.

    “If it looks like I can raise the money and mobilize enough people to win, I’ll jump in the race,” he said.

    His tweet also pointed supporters to his website: “Let Bobby know you want to see his leadership in the White House,” the site says while asking for donations.

    As an environmental lawyer, Kennedy worked with a group that led the Hudson River cleanup. He also worked for the Natural Resources Defense Council and co-founded an environmental law firm.

    Should he go through with his presidential bid, Kennedy would be the latest in a long line of family members to enter politics.

    His sister Kathleen served as the lieutenant governor of Maryland from 1995 to 2003. His brother Joseph was a congressman from Massachusetts from 1987 to 1999. And more recently, his brother Chris Kennedy was an unsuccessful candidate for governor of Illinois in 2018.

    The last Kennedy to hold elected office was his nephew former Massachusetts Rep. Joe Kennedy III, who lost a Democratic Senate primary in 2020. (He is now the US special envoy for Northern Ireland.) Caroline Kennedy, the daughter of former President Kennedy, is currently the US ambassador to Australia.

    The 2024 Democratic presidential race is only beginning to take shape, with President Joe Biden expected to announce his bid for a second term. Author Marianne Williamson launched a second long-shot campaign for the Democratic presidential nomination last month.

    On the Republican side, former President Donald Trump jump-started the race for the party nomination, announcing his third bid for the White House last year. Former United Nations Ambassador Nikki Haley, former Arkansas Gov. Asa Hutchinson and entrepreneur Vivek Ramaswamy are also in the race, while other well-known contenders, including Florida Gov. Ron DeSantis and former Vice President Mike Pence, are weighing bids of their own.

    This story has been updated with additional information.

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  • The fatal mauling of 4-year-old forces India to grapple with stray dog problem | CNN

    The fatal mauling of 4-year-old forces India to grapple with stray dog problem | CNN

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    New Delhi
    CNN
     — 

    For nearly a minute, the 4-year-old boy attempts to valiantly escape the hungry pack of stray dogs as they circle around him.

    He tries to run, but one of the animals pulls the boy to the ground. Two more dogs close in, offering the victim little respite.

    The boy, who has not been publicly identified, is dragged by the pack for several feet, writhing in pain as the strays pounce. He strives to wrestle from their grip, but his small and fragile body cannot compete with the aggressors.

    His piercing screams alert his father nearby – but it was too late. The child was declared dead upon arrival at the hospital.

    The brutal attack, captured by a security camera in Hyderabad in February, a sprawling city in the central Indian state of Telangana, has horrified the nation of 1.3 billion and placed focus on an issue that long divided opinion: what to do with India’s vast number of stray dogs?

    The issue is a sensitive one in a country where there is an ingrained cultural respect for animals and an aversion to culling. Most agree stray dogs are an issue, but there is a fierce debate over how best to respond.

    According to the Press Trust of India, there are around 62 million strays in the country, although experts say the real number would be nearly impossible to verify.

    Most of these animals – lovably nicknamed ‘Indie’ dogs – live in harmony with humans. Often, residents of gated communities come together to feed them, some even adopting them as family pets.

    But over the years, bites and killings by stray dogs have put many cities on edge, with politicians, the media, and citizens scrambling to present various solutions.

    Long before the death of the 4-year-old boy in Hyderabad made headlines, local media have run similar tales about India’s “killer dogs” – stories that are then often picked up by international outlets.

    “”Man-eater’ dog terror back in Bihar,” wrote The Telegraph India in a story last month after a series of bites in the northern Indian state.

    It is illegal to kill stray dogs in India. A 2001 law states strays should instead be picked up, neutered, and vaccinated against rabies, before being released.

    But in light of the gruesome attacks, many of which have happened to children, some have attempted to challenge the law.

    In 2016, a campaign to kill stray dogs after a series of bites in the southern state of Kerala gained traction in the local news.

    But animal rights activists were angered, instead urging authorities to offer clemency and find other solutions. The hashtag #BoycottKerala began trending on social media, and the plan was later abolished.

    While the law requires strays to be neutered and vaccinated, experts say there is a lack of strict implementation.

    “Of course we have a stray dog problem,” Anjali Gopalan, managing trustee at the All Creatures Great and Small, a Delhi-based non-profit that cares for animals, said.

    “Not only do we have a stray dog problem, but we also have a problem with rabies in this country. So, steps have to be taken to deal with both.”

    Rabies is a vaccine-preventable disease which can spread to humans if they are bitten or scratched by an infected animal. It is almost always fatal unless a series of jabs can be administered soon after someone is bitten.

    Dogs are the source of the vast majority of human rabies deaths, according to the World Health Organization (WHO) and contribute up to 99% of all rabies transmissions to humans. India is endemic for rabies, the WHO said, accounting for 36% of the world’s rabies deaths.

    A key way to reduce rabies within a stray dog population is to capture and vaccinate as many animals as possible.

    But veterinarian Sarungbam Devi, founder and trustee of Animal India Trust, said India needs to do more.

    “At the time of the sterilization, we vaccinate the dog only once and then they are released. That’s all the vaccination a stray dog gets in his lifetime and that’s not enough,” she said.

    A lack of resources in the country means it is difficult to push government bodies to increase the inoculation of street dogs against the virus, Devi added.

    But when it comes to dog bites, Devi said, education plays the biggest role: “The government hasn’t done anything to increase awareness or educate the masses. We need to educate people, we need to be more vocal and visual about the (anti-bite) programs,” she said.

    “People need to know what to do when a dog bites you, how to you prevent it … I don’t think I have ever seen anything on this anywhere.”

    The Society for the Prevention of Cruelty to Animals (SPCA) recommends avoiding unfamiliar dogs and wild animals, not running when approached by an unknown dog and always supervising children and dogs, among other things, to avoid bites.

    According to the government, more than 6.8 million Indians were bitten by stray dogs in 2020 – and increase from 3.9 million in 2012. And experts say those numbers are likely not the full picture.

    CNN has reached out to the Department of Animal Husbandry and Dairying but has not received a response.

    “The problem is lack of awareness towards how to live around dogs,” Devi said, adding there needs to be an “intense anti-rabies drive and sterilization program everywhere in India.”

    But many Indian cities and states have been successful in bringing down their feral dog population and eradicating rabies.

    In the financial capital Mumbai, as many as 95% of the city’s stray dogs have been sterilized owing to “consistent” implementation of re-vaccination and welfare programs, said Abodh Aras, CEO of the non-profit Welfare of Stray Dogs.

    A robust public health system for post-bite treatment and regular school programs about dog bite and rabies prevention has also contributed, Aras said.

    “There are other places that have success stories. There is Goa that has eliminated rabies, (the state of) Sikkim that has got its state of operations around, and eliminated rabies,” he added. “It needs a combination of government support, will and infrastructure, and animal welfare NGOs working in that area for this model to be successful.”

    But not every city has the resources to implement this model.

    Take for example Noida, a satellite city of more than half a million on the outskirts of Delhi that is a comparatively wealthy place and home to many middle-class families.

    Devi, from the Animal India Trust, said Noida remains “very disorganized,” and her organization is the only non-profit covering the entire city – a colossal and tedious task for a small team, she said.

    Stray dogs caught by authorities in Noida on October 18, 2022.

    Gopalan, from All Creatures Great and Small, points to even more difficult operations in rural India, where electricity is lacking and maintaining cold storage for vaccines is an issue.

    Following the 4-year-old’s death in Hyderabad, officials promised swift action to prevent future tragedies.

    “We have been sterilizing dogs and anti-rabies injections are being given to them,” Greater Hyderabad Municipal Corporation Mayor Vijayalaxmi Gadwal, told local news agency, ANI.

    “So far in Hyderabad we have identified more than 500,000 dogs and sent more than 400,000 dogs for sterilization. We are following every guideline which is being given to us by the Supreme Court. We’re also going to adopt these dogs so that the number of stray dogs will be reduced.”

    That campaign may have an impact locally. But it many fear it is likely only a matter of time before another pack of dogs somewhere in India takes a child’s life.

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  • Federal judge says insurers no longer have to provide some preventive care services, including cancer and heart screenings, at no cost | CNN Politics

    Federal judge says insurers no longer have to provide some preventive care services, including cancer and heart screenings, at no cost | CNN Politics

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    CNN
     — 

    A federal judge in Texas said Thursday that some Affordable Care Act mandates cannot be enforced nationwide, including those that require insurers to cover a wide array of preventive care services at no cost to the patient, including some cancer, heart and STD screenings, and tobacco programs.

    In the new ruling, US District Judge Reed O’Connor struck down the recommendations that have been issued by the US Preventive Services Task Force, which is tasked with determining some of the preventive care treatments that Obamacare requires to be covered.

    The decision applies to task force recommendations issued on or after March 23, 2010 – the day the Affordable Care Act was signed into law. While the group had recommended various preventive services prior to that date, nearly all have since been updated or expanded.

    O’Connor’s ruling comes after the judge had already said that the task force’s recommendations violated the Constitution’s Appointments Clause. The judge also deemed unlawful the ACA requirement that insurers and employers offer plans that cover HIV-prevention measures such as PrEP for free.

    Other preventive care mandates under the ACA remain in effect.

    The full extent of the ruling’s impact and when its effects could be felt are unclear.

    It is likely the case will be appealed, and the Justice Department has the option to ask that O’Connor’s ruling be put on pause while the appeal is litigated.

    The Justice Department did not immediately respond to a CNN request for comment, nor did the US Department of Health and Human Services.

    White House spokesperson Karine Jean-Pierre called the case “yet another attack on the Affordable Care Act” and said that DOJ and HHS were reviewing Thursday’s ruling.

    The decision, in a case brought by employers and individuals in Texas, represents the latest legal affront to the landmark 2010 health care law. It is unclear what immediate practical effect O’Connor’s new ruling will have for those with job-based and Affordable Care Act policies because insurance companies will likely continue no-cost coverage for the remainder of the contracts even though the Obamacare requirements in question have been blocked. Contracts often last one calendar year.

    O’Connor’s Thursday ruling is expected to kick off a new phase of the legal battle over Obamacare’s preventive care measures. The judge rejected other claims that the ACA’s foes brought against the law – including challenges to the entities that determine no-cost coverage mandates for vaccines, an assortment of women’s health preventive care treatments, and services for infants and children. It’s possible that the plaintiffs appeal those aspects of O’Connor’s handling of the case, which could put at risk coverage requirements for additional preventive services at no cost.

    A lawyer for the challengers did not respond to CNN’s inquiry about Thursday’s decision.

    O’Connor is a George W. Bush-appointee who sits in the Northern District of Texas and who has issued anti-Obamacare rulings in major challenges to the law in the past. An appeal of the current case would head to the 5th US Circuit Court of Appeals, perhaps the most conservative federal appeals court in the country.

    While the case does not pose the existential threat to the Affordable Care Act that previous legal challenges did, legal experts say that O’Connor’s ruling nonetheless puts in jeopardy the access some Americans will have to a whole host of preventive treatments.

    “We lose a huge chunk of preventive services because health plans can now impose costs,” said Andrew Twinamatsiko, associate director of the O’Neill Institute for National and Global Health Law at Georgetown University. “People who are sensitive to cost will go without, mostly poor people and marginalized communities.”

    Thursday’s ruling, if left standing, could have significant consequences for Americans nationwide by limiting access to key preventive services aimed at early detection of diseases, including lung and colorectal cancer, depression and hypertension.

    Some of the US Preventive Services Task Force’s recommendations – including lung and skin cancer screenings, the use of statins to prevent cardiovascular disease and the offer of PrEP for those at high risk of HIV – were issued after the ACA’s enactment.

    Certain older recommendations have been updated with new provisions, such as screening adults ages 45 to 49 for colorectal cancer.

    “It would effectively lock in place coverage of evidence-based prevention with no cost sharing from 13 years ago,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation.

    Some of the cost-sharing for these preventive services can be substantial. PrEP, for instance, can cost up to $20,000 a year, plus lab and provider charges, according to Kaiser.

    In an earlier ruling, the judge upheld certain free preventive services for children, such as autism and vision screenings and well-baby visits, and for women, such as mammograms, well-woman visits and breastfeeding support programs.

    O’Connor also upheld the mandate that provides immunizations at no charge for the flu, hepatitis, measles, shingles and chickenpox.

    These services are recommended by the Health Resources and Services Administration and the Advisory Committee on Immunization Practices.

    Insurers will have to continue to cover preventive and wellness services since they are one of the Affordable Care Act’s required essential health benefits. But under O’Connor’s ruling, they could require patients to pick up part of the tab.

    Insurers’ trade associations stressed there would be no immediate disruption to coverage.

    “It is vitally important for patients to know that their care and coverage will not change because of today’s court decision,” said David Merritt, senior vice president of policy and advocacy for the Blue Cross Blue Shield Association. “Blue Cross and Blue Shield companies strongly encourage their members to continue to access these services to promote their continued well-being. We will continue to monitor further developments in the courts.”

    More than 150 million people with private insurance can receive preventive services without cost-sharing under the Affordable Care Act, according to a 2022 report published by HHS.

    Overall, about 60% of the 173 million people enrolled in private health coverage used at least one of the ACA’s no-cost preventive services in 2018 prior to the Covid-19 pandemic, according to a recent Kaiser analysis. These include some services that will continue to be available at no charge under the judge’s ruling.

    The most commonly received preventive care includes vaccinations, not including Covid-19 vaccines, well-woman and well-child visits, and screenings for heart disease, cervical cancer, diabetes and breast cancer, according to Kaiser. The most commonly used preventive services will continue to be covered at no cost.

    Studies have shown the Obamacare mandate prompted an uptake in preventive services and narrowed care disparities in communities of color.

    “There’s plenty of evidence that people responded to this incentive and started using preventive care more often,” said Paul Shafer, assistant professor of health policy at Boston University.

    This story has been updated with additional details.

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  • China approves its first mRNA Covid-19 vaccine | CNN Business

    China approves its first mRNA Covid-19 vaccine | CNN Business

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    Hong Kong
    CNN
     — 

    China has approved its first Covid-19 vaccine based on mRNA technology, months after the country lifted strict pandemic measures.

    The vaccine was developed by CSPC Pharmaceutical Group, a homegrown firm based in the northern Chinese city of Shijiazhuang, it said in a Wednesday statement to the Hong Kong stock exchange. The vaccine targets the Omicron variant and was tested in China with over 5,500 people, it added.

    The approval comes just weeks after China declared a “major and decisive victory” in its handling of the coronavirus outbreak that swept the country in recent months following an abrupt relaxation of its “zero-Covid” policy late last year.

    “This is a positive step because there is strong scientific evidence that mRNA vaccines do much better than non-MRA vaccines,” Jin Dong-yan, a professor in molecular virology at the University of Hong Kong, told CNN.

    “Whether this product … is as good as other products on market is still to be determined.”

    CSPC said in the statement the results had demonstrated the vaccine’s “safety, immunogenicity and efficacy,” but it didn’t offer additional details.

    Until now, China has approved only inactivated vaccines made by Sinovac Biotech and Sinopharm Group, two Beijing-based drugmakers.

    The inactivated vaccines have been found to elicit lower levels of antibody response compared to ones using the newer messenger RNA technology. Biotech firms Pfizer

    (PFE)
    and Moderna

    (MRNA)
    make rRNA vaccines.

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  • World’s number one tennis player Novak Djokovic to miss Miami Open due to vaccination status | CNN

    World’s number one tennis player Novak Djokovic to miss Miami Open due to vaccination status | CNN

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    CNN
     — 

    The world’s top men’s tennis player Novak Djokovic will miss the Miami Open next week, after being denied entry to the United States because he is unvaccinated against Covid-19, tournament director James Blake announced on Friday.

    The United States still requires international visitors to be vaccinated against Covid-19, and the Serbian, who has previously confirmed that he remains unvaccinated, had applied for special permission to enter the country ahead of the tournament.

    “We tried to get Novak Djokovic to be allowed to get an exemption, but that wasn’t able to happen,” Blake said in an interview with the Tennis Channel.

    “Obviously, we’re one of the premier tournaments in the world, we’d like to have the best players that can play. We did all that we could. We tried to talk to the government, but that’s out of our hands.”

    Florida Governor Ron DeSantis said earlier this month he would “run a boat from the Bahamas” for Djokovic to compete in the Miami Open tennis tournament.

    DeSantis called on US President Joe Biden to drop the vaccine requirement for international travelers so the 22-time grand slam champion would be able to compete.

    The 35-year-old Djokovic has missed several other tournaments because of his vaccination status. Earlier this month, Djokovic withdrew from the ongoing BNP Paribas Open at Indian Wells in California due to being denied the exemption. Last year, he missed Indian Wells, the Miami Open and all the tournaments included in the US Open swing.

    The Miami Open’s main draw play starts March 22 and and the tournament ends April 2.

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  • FDA advisers narrowly vote in favor of Pfizer’s RSV vaccine for older adults, despite possible safety concerns | CNN

    FDA advisers narrowly vote in favor of Pfizer’s RSV vaccine for older adults, despite possible safety concerns | CNN

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    CNN
     — 

    Vaccine advisers to the US Food and Drug Administration narrowly voted Tuesday in favor of Pfizer’s RSV vaccine for adults over the age of 60, paving the way for approval of the first nation’s RSV vaccine, despite some safety concerns.

    The committee members voted 7-4, with one abstention, that there is adequate data to support the safety and effectiveness of Pfizer’s vaccine for the prevention of lower respiratory tract disease caused by respiratory syncytial virus among older adults.

    The FDA, which typically follows the independent committee’s recommendations, is scheduled to decide on approval of the vaccines by May, ahead of RSV’s typical winter surge. The US Centers for Disease Control and Prevention must then recommend the shot before it becomes available to the public.

    Pending those steps, Pfizer’s vaccine – along with GSK’s candidate shot, which will be voted on by the FDA advisory committee on Wednesday – would be the first approved RSV vaccines for adults 60 or older.

    RSV is a highly contagious virus that causes flu-like illness in people of all ages that increases in severity with age. It’s is responsible for an estimated 177,000 hospitalizations and 14,000 deaths per year among adults 65 or older, according to the CDC.

    The Pfizer vaccine was 66.7% effective at preventing moderated lower respiratory tract illness with two or more symptoms and 85.7% effective at preventing illness with three or more symptoms, according to an FDA briefing document.

    Although a majority of the committee voted in favor of the vaccine, some members expressed concerns about the vaccine’s “important potential risk: of Guillain-Barre syndrome. Two adults among the 20,000 vaccine recipients in Pfizer’s Phase 3 clinical trial developed symptoms consistent with the rare neurological disorder within nine days of receiving the shot.

    “It seems to me that one case is a red flag. Two cases is very concerning, and it’s concerning to me that Pfizer doesn’t think that there are any safety concerns,” said Dr. Marie Griffin, professor of health policy at Vanderbilt University Medical Center, who voted that the data demonstrated the vaccine was effective but not safe.

    The FDA has recommended that Pfizer conduct a safety study for further evaluation of Guillain-Barre and other immune-mediated demyelinating conditions after potential vaccine approval, and the company has agreed.

    Dr. Daniel Feikin, respiratory disease consultant, who voted that the vaccine was both safe and effective, said that post-marketing safety surveillance will be “critical.”

    Some of the vaccine advisers wanted to see more data on effectiveness against hospitalization or death, especially among high-risk people such as older adults or those with other health conditions.

    “I think the data does support the effectiveness of this vaccine. It’s just the population was underrepresented by people who could most benefit from the vaccine,” Griffin said.

    The available safety and efficacy data from Pfizer’s clinical trial is from the first of two RSV seasons. Some of the experts said that the vote is premature and that they would like to see more data.

    “I’m desperately eager to have a vaccine that works for RSV. This has been a terrible disease my whole career. I would love to see it. No doubt about it,” said Dr. Jay Portnoy, professor of pediatrics at the University of Missouri-Kansas City, who voted that the data demonstrated that the vaccine was safe but not effective.

    Portnoy says that waiting for a second season of data would provide more robust numbers and complete analysis.

    “It’s not an emergency use authorization. We can take the time to finish the studies and get the information we need before licensing this product going forward. So I remain a little bit skeptical, given the data that we have.”

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  • Biden intends to end Covid-19 and public health emergencies on May 11 | CNN Politics

    Biden intends to end Covid-19 and public health emergencies on May 11 | CNN Politics

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    CNN
     — 

    President Joe Biden intends to end the Covid-19 national and public health emergencies on May 11, the White House said Monday.

    The White House, in a statement of administration policy announcing opposition to two Republican measures to end the emergencies, said the national emergency and public health emergency authorities declared in response to the pandemic would each be extended one final time to May 11.

    “This wind down would align with the Administration’s previous commitments to give at least 60 days’ notice prior to termination of the (public health emergency),” the statement said.

    The statement added, “To be clear, continuation of these emergency declarations until May 11 does not impose any restriction at all on individual conduct with regard to COVID-19. They do not impose mask mandates or vaccine mandates. They do not restrict school or business operations. They do not require the use of any medicines or tests in response to cases of COVID-19.”

    The statement came in response to a pair of measures before the House that would end the public health emergency and the Covid-19 national emergency.

    The White House weighed in because House Democrats were concerned about voting against the Republican legislation to end the public health emergency that is coming to the floor this week without a plan from the Biden administration, a senior Democratic aide told CNN.

    “Democrats were concerned about the optics of voting against Republicans winding down the public health emergency, absent an understanding of whether and how we intended to do so from the White House,” the aide said. “As soon as we saw this bill, it obviously concerns the White House. So, it was important for them to weigh in.”

    The administration argues that the bills are unnecessary because it intends to end the emergencies anyway. The White House also noted the passage of the measures ahead of May 11 would have unintended consequences, such as disrupting the administration’s plans for ending certain policies that are authorized by the emergencies.

    The White House said it would extend the Covid-19 emergencies one final time in order to ensure an orderly wind-down of key authorities that states, health care providers and patients have relied on throughout the pandemic.

    A White House official pointed to a successful vaccination campaign and reductions in Covid cases, hospitalizations and deaths as a rationale for lifting the emergency declarations. The official said a final extension will allow for a smooth transition for health care providers and patients and noted that health care facilities have already begun preparing for that transition.

    The administration is actively reviewing flexible policies that were authorized under the public health emergency to determine which can remain in place after it is lifted on May 11.

    The aide told CNN that it will be up to every member to decide what is best for their district and how they will vote on the legislation this week. Declaring an end to the public health emergency will also end the border restriction known as Title 42, which will also likely set up a showdown on Capitol Hill.

    The public health emergency has enabled the government to provide many Americans with Covid-19 tests, treatments and vaccines at no charge, as well as offer enhanced social safety net benefits, to help the nation cope with the pandemic and minimize its impact.

    “People will have to start paying some money for things they didn’t have to pay for during the emergency,” said Jen Kates, senior vice president at the Kaiser Family Foundation. “That’s the main thing people will start to notice.”

    Most Americans covered by Medicare, Medicaid and private insurance plans have been able to obtain Covid-19 tests and vaccines at no cost during the pandemic. Those covered by Medicare and private insurance have been able to get up to eight at-home tests per month from retailers at no charge. Medicaid also picks up the cost of at-home tests, though coverage can vary by state.

    Those covered by Medicare and Medicaid have also had certain therapeutic treatments, such as monoclonal antibodies, fully covered.

    Once the emergency ends, Medicare beneficiaries generally will face out-of-pocket costs for at-home testing and all treatment. However, vaccines will continue to be covered at no cost, as will testing ordered by a health care provider.

    State Medicaid programs will have to continue covering Covid-19 tests ordered by a physician and vaccines at no charge. But enrollees may face out-of-pocket costs for treatments.

    Those with private insurance could face charges for lab tests, even if they are ordered by a provider. Vaccinations will continue to be free for those with private insurance who go to in-network providers, but going to an out-of-network providers could incur charges.

    Covid-19 vaccinations will be free for those with insurance even when the public health emergency ends because of various federal laws, including the Affordable Care Act and pandemic-era measures, the Inflation Reduction Act and a 2020 relief package.

    Americans with private insurance have not been charged for monoclonal antibody treatment since they were prepaid by the federal government, though patients may be charged for the office visit or administration of the treatment. But that is not tied to the public health emergency, and the free treatments will be available until the federal supply is exhausted. The government has already run out of some of the treatments so those with private insurance may already be picking up some of the cost.

    The uninsured had been able to access no-cost testing, treatments and vaccines through a different pandemic relief program. However, the federal funding ran out in the spring of 2022, making it more difficult for those without coverage to obtain free services.

    The federal government has been preparing to shift Covid-19 care to the commercial market since last year, in part because Congress has not authorized additional funding to purchase additional vaccines, treatments and tests.

    Pfizer and Moderna have already announced that the commercial prices of their Covid-19 vaccines will likely be between $82 and $130 per dose – about three to four times what the federal government has paid, according to Kaiser.

    The public health emergency has also meant additional funds for hospitals, which have been receiving a 20% increase in Medicare’s payment rate for treating Covid-19 patients.

    Also, Medicare Advantage plans have been required to bill enrollees affected by the emergency and receiving care at out-of-network facilities the same as if they were at in-network facilities.

    This will end once the public health emergency expires.

    But several of the most meaningful enhancements to public assistance programs are no longer tied to the public health emergency. Congress severed the connection in December as part of its fiscal year 2023 government funding package.

    Most notably, states will now be able to start processing Medicaid redeterminations and disenrolling residents who no longer qualify, starting April 1. They have 14 months to review the eligibility of their beneficiaries.

    As part of a Covid-19 relief package passed in March 2020, states were barred from kicking people off Medicaid during the public health emergency in exchange for additional federal matching funds. Medicaid enrollment has skyrocketed to a record 90 million people since then, and millions are expected to lose coverage once states began culling the rolls.

    A total of roughly 15 million people could be dropped from Medicaid when the continuous enrollment requirement ends, according to an analysis the Department of Health and Human Services released in August. About 8.2 million folks would no longer qualify, but 6.8 million people would be terminated even though they are still eligible, the department estimated.

    Many who are disenrolled from Medicaid, however could qualify for other coverage.

    Food stamp recipients had been receiving a boost during the public health emergency. Congress increased food stamp benefits to the maximum for their family size in a 2020 pandemic relief package.

    The Biden administration expanded the boost in the spring of 2021 so that households already receiving the maximum amount and those who received only a small monthly benefit get a supplement of at least $95 a month.

    This extra assistance will end as of March, though several states have already stopped providing it.

    Congress, however, extended one set of pandemic flexibilities as part of the government funding package.

    More Medicare enrollees are able to get care via telehealth during the public health emergency. The service is no longer limited just to those living in rural areas. They can conduct the telehealth visit at home, rather than having to travel to a health care facility. Plus, beneficiaries can use smartphones and receive a wider array of services via telehealth.

    These will now continue through 2024.

    This story has been updated with additional details.

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  • Fact check: Biden makes false and misleading claims in economic speech | CNN Politics

    Fact check: Biden makes false and misleading claims in economic speech | CNN Politics

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    Washington
    CNN
     — 

    President Joe Biden delivered a Thursday speech to hail economic progress during his administration and to attack congressional Republicans for their proposals on the economy and the social safety net.

    Some of Biden’s claims in the speech were false, misleading or lacking critical context, though others were correct. Here’s a breakdown of the 14 claims CNN fact-checked.

    Touting the bipartisan infrastructure law he signed in 2021, Biden said, “Last year, we funded 700,000 major construction projects – 700,000 all across America. From highways to airports to bridges to tunnels to broadband.”

    Facts First: Biden’s “700,000” figure is wildly inaccurate; it adds an extra two zeros to the correct figure Biden used in a speech last week and the White House has also used before: 7,000 projects. The White House acknowledged his misstatement later on Thursday by correcting the official transcript to say 7,000 rather than 700,000.

    Biden said, “Well, here’s the deal: I put a – we put a cap, and it’s now in effect – now in effect, as of January 1 – of $2,000 a year on prescription drug costs for seniors.”

    Facts First: Biden’s claims that this cap is now in effect and that it came into effect on January 1 are false. The $2,000 annual cap contained in the Inflation Reduction Act that Biden signed last year – on Medicare Part D enrollees’ out-of-pocket spending on covered prescription drugs – takes effect in 2025. The maximum may be higher than $2,000 in subsequent years, since it is tied to Medicare Part D’s per capita costs.

    Asked for comment, a White House official noted that other Inflation Reduction Act health care provisions that will save Americans money did indeed come into effect on January 1, 2023.

    – CNN’s Tami Luhby contributed to this item.

    Criticizing former President Donald Trump over his handling of the Covid-19 pandemic, Biden said, “Back then, only 3.5 million people had been – even had their first vaccination, because the other guy and the other team didn’t think it mattered a whole lot.”

    Facts First: Biden is free to criticize Trump’s vaccine rollout, but his “only 3.5 million” figure is misleading at best. As of the day Trump left office in January 2021, about 19 million people had received a first shot of a Covid-19 vaccine, according to figures published by the Centers for Disease Control and Prevention. The “3.5 million” figure Biden cited is, in reality, the number of people at the time who had received two shots to complete their primary vaccination series.

    Someone could perhaps try to argue that completing a primary series is what Biden meant by “had their first vaccination” – but he used a different term, “fully vaccinated,” to refer to the roughly 230 million people in that very same group today. His contrasting language made it sound like there are 230 million people with at least two shots today versus 3.5 million people with just one shot when he took office. That isn’t true.

    Biden said Republicans want to cut taxes for billionaires, “who pay virtually only 3% of their income now – 3%, they pay.”

    Facts First: Biden’s “3%” claim is incorrect. For the second time in less than a week, Biden inaccurately described a 2021 finding from economists in his administration that the wealthiest 400 billionaire families paid an average of 8.2% of their income in federal individual income taxes between 2010 and 2018; after CNN inquired about Biden’s “3%” claim on Thursday, the White House published a corrected official transcript that uses “8%” instead. Also, it’s important to note that even that 8% number is contested, since it is an alternative calculation that includes unrealized capital gains that are not treated as taxable income under federal law.

    “Biden’s numbers are way too low,” said Howard Gleckman, senior fellow at the Urban-Brookings Tax Policy Center at the Urban Institute think tank, though Gleckman also said we don’t know precisely what tax rates billionaires do pay. Gleckman wrote in an email: “In 2019, Berkeley economists Emmanuel Saez and Gabe Zucman estimated the top 400 households paid an average effective tax rate of about 23 percent in 2018. They got a lot of attention at the time because that rate was lower than the average rate of 24 percent for the bottom half of the income distribution. But it still was way more than 2 or 3, or even 8 percent.”

    Biden has cited the 8% statistic in various other speeches, but unlike the administration economists who came up with it, he tends not to explain that it doesn’t describe tax rates in a conventional way. And regardless, he said “3%” in this speech and “2%” in a speech last week.

    Biden cited a 2021 report from the Institute on Taxation and Economic Policy think tank that found that 55 of the country’s largest corporations had made $40 billion in profit in their previous fiscal year but not paid any federal corporate income taxes. Before touting the 15% alternative corporate minimum tax he signed into law in last year’s Inflation Reduction Act, Biden said, “The days are over when corporations are paying zero in federal taxes.”

    Facts First: Biden exaggerated. The new minimum tax will reduce the number of companies that don’t pay any federal taxes, but it’s not true that the days of companies paying zero are “over.” That’s because the minimum tax, on the “book income” companies report to investors, only applies to companies with at least $1 billion in average annual income. According to the Institute on Taxation and Economic Policy, only 14 of the companies on its 2021 list of 55 non-payers reported having US pre-tax income of at least $1 billion.

    In other words, there will clearly still be some large and profitable corporations paying no federal income tax even after the minimum tax takes effect this year. The exact number is not yet known.

    Matthew Gardner, a senior fellow at the Institute on Taxation and Economic Policy, told CNN in the fall that the new tax is “an important step forward from the status quo” and that it will raise substantial revenue, but he also said: “I wouldn’t want to assert that the minimum tax will end the phenomenon of zero-tax profitable corporations. A more accurate phrasing would be to say that the minimum tax will *help* ensure that *the most profitable* corporations pay at least some federal income tax.”

    There are lots of nuances to the tax; you can read more specifics here. Asked for comment on Thursday, a White House official told CNN: “The Inflation Reduction Act ensures the wealthiest corporations pay a 15% minimum tax, precisely the corporations the President focused on during the campaign and in office. The President’s full Made in America tax plan would ensure all corporations pay a 15% minimum tax, and the President has called on Congress to pass that plan.”

    Noting the big increase in the federal debt under Trump, Biden said that his administration has taken a “different path” and boasted: “As a result, the last two years – my administration – we cut the deficit by $1.7 trillion, the largest reduction in debt in American history.”

    Facts First: Biden’s boast leaves out important context. It is true that the federal deficit fell by a total of $1.7 trillion under Biden in the 2021 and 2022 fiscal years, including a record $1.4 trillion drop in 2022 – but it is highly questionable how much credit Biden deserves for this reduction. Biden did not mention that the primary reason the deficit fell so substantially was that it had skyrocketed to a record high under Trump in 2020 because of bipartisan emergency pandemic relief spending, then fell as expected as the spending expired as planned. Independent analysts say Biden’s own actions, including his laws and executive orders, have had the overall effect of adding to current and projected future deficits, not reducing those deficits.

    Dan White, senior director of economic research at Moody’s Analytics – an economics firm whose assessments Biden has repeatedly cited during his presidency – told CNN’s Matt Egan in October: “On net, the policies of the administration have increased the deficit, not reduced it.” The Committee for a Responsible Federal Budget, an advocacy group, wrote in September that Biden’s actions will add more than $4.8 trillion to deficits from 2021 through 2031, or $2.5 trillion if you don’t count the American Rescue Plan pandemic relief bill of 2021.

    National Economic Council director Brian Deese wrote on the White House website last week that the American Rescue Plan pandemic relief bill “facilitated a strong economic recovery and enabled the responsible wind-down of emergency spending programs,” thereby reducing the deficit; David Kelly, chief global strategist at J.P. Morgan Funds, told Egan in October that the Biden administration does deserve credit for the recovery that has pushed the deficit downward. And Deese correctly noted that Biden’s signature legislation, last year’s Inflation Reduction Act, is expected to bring down deficits by more than $200 billion over the next decade.

    Still, the deficit-reducing impact of that one bill is expected to be swamped by the deficit-increasing impact of various additional bills and policies Biden has approved.

    Biden said, “Wages are up, and they’re growing faster than inflation. Over the past six months, inflation has gone down every month and, God willing, will continue to do that.”

    Facts First: Biden’s claim that wages are up and growing faster than inflation is true if you start the calculation seven months ago; “real” wages, which take inflation into account, started rising in mid-2022 as inflation slowed. (Biden is right that inflation has declined, on an annual basis, every month for the last six months.) However, real wages are lower today than they were both a full year ago and at the beginning of Biden’s presidency in January 2021. That’s because inflation was so high in 2021 and the beginning of 2022.

    There are various ways to measure real wages. Real average hourly earnings declined 1.7% between December 2021 and December 2022, while real average weekly earnings (which factors in the number of hours people worked) declined 3.1% over that period.

    Biden said he was disappointed that the first bill passed by the new Republican majority in the House of Representatives “added $114 billion to the deficit.”

    Facts First: Biden is correct about how the bill would affect the deficit if it became law. He accurately cited an estimate from the government’s nonpartisan Congressional Budget Office.

    The bill would eliminate more than $71 billion of the $80 billion in additional funding for the Internal Revenue Service (IRS) that Biden signed into law in the Inflation Reduction Act. The Congressional Budget Office found that taking away this funding – some of which the Biden administration said will go toward increased audits of high-income individuals and large corporations – would result in a loss of nearly $186 billion in government revenue between 2023 and 2032, for a net increase to the deficit of about $114 billion.

    The Republican bill has no chance of becoming law under Biden, who has vowed to veto it in the highly unlikely event it got through the Democratic-controlled Senate.

    Biden said that “MAGA Republicans” in the House “want to impose a 30 percent national sales tax on everything from food, clothing, school supplies, housing, cars – a whole deal.” He said they want to do that because “they want to eliminate the income tax system.”

    Facts First: This is a fair description of the Republicans’ “FairTax” bill. The bill would eliminate federal income taxes, plus the payroll tax, capital gains tax and estate tax, and replace it with a national sales tax. The bill describes a rate of 23% on the “gross payments” on a product or service, but when the tax rate is described in the way consumers are used to sales taxes being described, it’s actually right around 30%, as a pro-FairTax website acknowledges.

    It is not clear how much support the bill currently has among the House Republican caucus. Notably, House Speaker Kevin McCarthy told CNN’s Manu Raju this week that he opposes the bill – though, while seeking right-wing votes for his bid for speaker in early January, he promised its supporters that it would be considered in committee. Biden wryly said in his speech, “The Republican speaker says he’s not so sure he’s for it.”

    Biden claimed the unemployment rate “is the lowest it’s been in 50 years.”

    Facts First: This is true. The unemployment rate was just below 3.5% in December, the lowest figure since 1969.

    The headline monthly rate, which is rounded to a single decimal place, was reported as 3.5% in December and also reported as 3.5% in three months of President Donald Trump’s tenure, in late 2019 and in early 2020. But if you look at more precise figures, December was indeed the lowest since 1969 – 3.47% – just below the figures for February 2020, January 2020 and September 2019.

    Biden said that the unemployment rates for Black and Hispanic Americans are “near record lows” and that the unemployment rate for people with disabilities is “the lowest ever recorded” and the “lowest ever in history.”

    Facts First: Biden’s claims are accurate, though it’s worth noting that the unemployment rate for people with disabilities has only been released by the government since 2008.

    The Black or African American unemployment rate was 5.7% in December, not far from the record low of 5.3% that was set in August 2019. (This data series goes back to 1972.) The rate was 9.2% in January 2021, the month Biden became president. The Hispanic or Latino unemployment rate was 4.1% in December, just above the record low of 4.0% that was set in September 2019. (This data series goes back to 1973.) The rate was 8.5% in January 2021.

    The unemployment rate for people with disabilities was 5.0% in December, the lowest since the beginning of the data series in 2008. The rate was 12.0% in January 2021.

    Biden said that fewer families are facing foreclosure than before the pandemic.

    Facts First: Biden is correct. According to a report published by the Federal Reserve Bank of New York, about 28,500 people had new foreclosure notations on their credit reports in the third quarter of 2022, the most recent quarter for which data is available; that was down from about 71,420 people with new foreclosure notations in the fourth quarter of 2019 and 74,860 people in the first quarter of 2020.

    Foreclosures plummeted in the second quarter of 2020 because of government moratoriums put in place because of the Covid-19 pandemic. Foreclosures spiked in 2022, relative to 2020-2021 levels, after the expiry of these moratoriums, but they remained very low by historical standards.

    Biden said, “More American families have health insurance today than any time in American history.”

    Facts First: Biden’s claim is accurate. An analysis provided to CNN by the Kaiser Family Foundation, which studies US health care, found that about 295 million US residents had health insurance in 2021, the highest on record – and Jennifer Tolbert, the foundation’s director for state health reform, told CNN this week that “I expect the number of people with insurance continued to increase in 2022.”

    Tolbert noted that the number of insured residents generally rises over time because of population growth, but she added that “it is not a given” that there will be an increase in the number of insured residents every year – the number declined slightly under Trump from 2018 to 2019, for example – and that “policy changes as well as economic factors also affect these numbers.”

    As CNN’s Tami Luhby has reported, sign-ups on the federal insurance exchange created by the Affordable Care Act, also known as Obamacare, have spiked nearly 50% under Biden. Biden’s 2021 American Rescue Plan pandemic relief law and then the 2022 Inflation Reduction Act temporarily boosted federal premium subsidies for exchange enrollees, and the Biden administration has also taken various other steps to get people to sign up on the exchanges. In addition, enrollment in Medicaid health insurance has increased significantly during the Covid-19 pandemic, in part because of a bipartisan 2020 law that temporarily prevented people from being disenrolled from the program.

    The percentage of residents without health insurance fell to an all-time low of 8.0% in the first quarter of 2022, according to an analysis published last summer by the federal government’s Department of Health and Human Services. That meant there were 26.4 million people without health insurance, down from 48.3 million in 2010, the year Obamacare was signed into law.

    Biden said, “And over the last two years, more than 10 million people have applied to start a small business. That’s more than any two years in all of recorded American history.”

    Facts First: This is true. There were about 5.4 million business applications in 2021, the highest since 2005 (the first year for which the federal government released this data for a full year), and about 5.1 million business applications in 2022. Not every application turns into a real business, but the number of “high-propensity” business applications – those deemed to have a high likelihood of turning into a business with a payroll – also hit a record in 2021 and saw its second-highest total in 2022.

    Trump’s last full year in office, 2020, also set a then-record for total and high-propensity applications. There are various reasons for the pandemic-era boom in entrepreneurship, which began after millions of Americans lost their jobs in early 2020. Among them: some newly unemployed workers seized the moment to start their own enterprises; Americans had extra money from stimulus bills signed by Trump and Biden; interest rates were particularly low until a series of rate hikes that began in the spring of 2022.

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  • FDA vaccine advisers vote to harmonize Covid-19 vaccines in the United States | CNN

    FDA vaccine advisers vote to harmonize Covid-19 vaccines in the United States | CNN

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    CNN
     — 

    A panel of independent experts that advises the US Food and Drug Administration on its vaccine decisions voted unanimously Thursday to update all Covid-19 vaccines so they contain the same ingredients as the two-strain shots that are now used as booster doses.

    The vote means young children and others who haven’t been vaccinated may soon be eligible to receive two-strain vaccines that more closely match the circulating viruses as their primary series.

    The FDA must sign off on the committee’s recommendation, which it is likely to do, before it goes into effect.

    Currently, the US offers two types of Covid-19 vaccines. The first shots people get – also called the primary series – contain a single set of instructions that teach the immune system to fight off the original version of the virus, which emerged in 2019.

    This index strain is no longer circulating. It was overrun months ago by an ever-evolving parade of new variants.

    Last year, in consultation with its advisers, the FDA decided that it was time to update the vaccines. These two-strain, or bivalent, shots contain two sets of instructions; one set reminds the immune system about the original version of the coronavirus, and the second set teaches the immune system to recognize and fight off Omicron’s BA.4 and BA.5 subvariants, which emerged in the US last year.

    People who have had their primary series – nearly 70% of all Americans – were advised to get the new two-strain booster late last year in an effort to upgrade their protection against the latest variants.

    The advisory committee heard testimony and data suggesting that the complexity of having two types of Covid-19 vaccines and schedules for different age groups may be one of the reasons for low vaccine uptake in the US.

    Currently, only about two-thirds of Americans have had the full primary series of shots. Only 15% of the population has gotten an updated bivalent booster.

    Data presented to the committee shows that Covid-19 hospitalizations have been rising for children under the age of 2 over the past year, as Omicron and its many subvariants have circulated. Only 5% of this age group, which is eligible for Covid-19 vaccination at 6 months of age, has been fully vaccinated. Ninety percent of children under the age of 4 are still unvaccinated.

    “The most concerning data point that I saw this whole day was that extremely low vaccination coverage in 6 months to 2 years of age and also 2 years to 4 years of age,” said Dr. Amanda Cohn, director of the US Centers for Disease Control and Prevention’s Division of Birth Defects and Infant Disorders. “We have to do much, much better.”

    Cohn says that having a single vaccine against Covid-19 in the US for both primary and booster doses would go a long way toward making the process less complicated and would help get more children vaccinated.

    Others feel that convenience is important but also stressed that data supported the switch.

    “This isn’t only a convenience thing, to increase the number of people who are vaccinated, which I agree with my colleagues is extremely important for all the evidence that was related, but I also think moving towards the strains that are circulating is very important, so I would also say the science supports this move,” said Dr. Hayley Gans, a pediatric infectious disease specialist at Stanford University.

    Many others on the committee were similarly satisfied after seeing new data on the vaccine effectiveness of the bivalent boosters, which are cutting the risk of getting sick, being hospitalized or dying from a Covid-19 infection.

    “I’m totally convinced that the bivalent vaccine is beneficial as a primary series and as a booster series. Furthermore, the updated vaccine safety data are really encouraging so far,” said Dr. David Kim, director of the the US Department of Health and Human Services’ National Vaccine Program, in public discussion after the vote.

    Thursday’s vote is part of a larger plan by the FDA to simplify and improve the way Covid-19 vaccines are given in the US.

    The agency has proposed a plan to convene its vaccine advisers – called the Vaccines and Related Biological Products Advisory Committee, or VRBPAC – each year in May or June to assess whether the instructions in the Covid-19 vaccines should be changed to more closely match circulating strains of the virus.

    The time frame was chosen to give manufacturers about three months to redesign their shots and get new doses to pharmacies in time for fall.

    “The object, of course – before anyone says anything – is not to chase variants. None of us think that’s realistic,” said Jerry Weir, director of the Division of Viral Products in the FDA’s Office of Vaccines Research and Review.

    “But I think our experience so far, with the bivalent vaccines that we have, does indicate that we can continue to make improvements to the vaccine, and that would be the goal of these meetings,” Weir said.

    In discussions after the vote, committee members were supportive of this plan but pointed out many of the things we still don’t understand about Covid-19 and vaccination that are likely to complicate the task of updating the vaccines.

    For example, we now seem to have Covid-19 surges in the summer as well as the winter, noted Dr. Michael Nelson, an allergist and immunologist at the University of Virginia. Are the surges related? And if so, is fall the best time to being a vaccination campaign?

    The CDC’s Dr. Jefferson Jones said that with only three years of experience with the virus, it’s really too early to understand its seasonality.

    Other important questions related to the durability of the mRNA vaccines and whether other platforms might offer longer protection.

    “We can’t keep doing what we’re doing,” said Dr. Bruce Gellin, chief of global public health strategy at the Rockefeller Foundation. “It’s been articulated in every one of these meetings despite how good these vaccines are. We need better vaccines.”

    The committee also encouraged both government and industry scientists to provide a fuller picture of how vaccination and infection affect immunity.

    One of the main ways researchers measure the effectiveness of the vaccines is by looking at how much they increase front-line defenders called neutralizing antibodies.

    Neutralizing antibodies are like firefighters that rush to the scene of an infection to contain it and put it out. They’re great in a crisis, but they tend to diminish in numbers over time if they’re not needed. Other components of the immune system like B-cells and T-cells hang on to the memory of a virus and stand ready to respond if the body encounters it again.

    Scientists don’t understand much about how well Covid-19 vaccination boosts these responses and how long that protection lasts.

    Another puzzle will be how to pick the strains that are in the vaccines.

    The process of selecting strains for influenza vaccines is a global effort that relies on surveillance data from other countries. This works because influenza strains tend to become dominant and sweep around the world. But Covid-19 strains haven’t worked in quite the same way. Some that have driven large waves in other countries have barely made it into the US variant mix.

    “Going forward, it is still challenging. Variants don’t sweep across the world quite as uniform, like they seem to with influenza,” the FDA’s Weir said. “But our primary responsibility is what’s best for the US market, and that’s where our focus will be.”

    Eventually, the FDA hopes that Americans would be able to get an updated Covid-19 shot once a year, the same way they do for the flu. People who are unlikely to have an adequate response to a single dose of the vaccine – such as the elderly or those with a weakened immune system – may need more doses, as would people who are getting Covid-19 vaccines for the first time.

    At Thursday’s meeting, the advisory committee also heard more about a safety signal flagged by a government surveillance system called the Vaccine Safety Datalink.

    The CDC and the FDA reported January 13 that this system, which relies on health records from a network of large hospital systems in the US, had detected a potential safety issue with Pfizer’s bivalent boosters.

    In this database, people 65 and older who got a Pfizer bivalent booster were slightly more likely to have a stroke caused by a blood clot within three weeks of their vaccination than people who had gotten a bivalent booster but were 22 to 42 days after their shot.

    After a thorough review of other vaccine safety data in the US and in other countries that use Pfizer bivalent boosters, the agencies concluded that the stroke risk was probably a statistical fluke and said no changes to vaccination schedules were recommended.

    At Thursday’s meeting, Dr. Nicola Klein, a senior research scientist with Kaiser Permanente of Northern California, explained how they found the signal.

    The researchers compared people who’d gotten a vaccine within the past three weeks against people who were 22 to 42 days away from their shots because this helps eliminate bias in the data.

    When they looked to see how many people had strokes around the time of their vaccination, they found an imbalance in the data.

    Of 550,000 people over 65 who’d received a Pfizer bivalent booster, 130 had a stroke caused by a blood clot within three weeks of vaccination, compared with 92 people in the group farther out from their shots.

    The researchers spotted the signal the week of November 27, and it continued for about seven weeks. The signal has diminished over time, falling from an almost two-fold risk in November to a 47% risk in early January, Klein said. In the past few days, it hasn’t been showing up at all.

    Klein said they didn’t see the signal in any of the other age groups or with the group that got Moderna boosters. They also didn’t see a difference when they compared Pfizer-boosted seniors with those who were eligible for a bivalent booster but hadn’t gotten one.

    Further analyses have suggested that the signal might be happening not because people who are within three weeks of a Pfizer booster are having more strokes, but because people who are within 22 to 42 days of their Pfizer boosters are actually having fewer strokes.

    Overall, Klein said, they were seeing fewer strokes than expected in this population over that period of time, suggesting a statistical fluke.

    Another interesting thing that popped out of this data, however, was a possible association between strokes and high-dose flu vaccination. Seniors who got both shots on the same day and were within three weeks of those shots had twice the rate of stroke compared with those who were 22 to 42 days away from their shots.

    What’s more, Klein said, the researchers didn’t see the same association between stroke and time since vaccination in people who didn’t get their flu vaccine on the same day.

    The total number of strokes in the population of people who got flu shots and Covid-19 boosters on the same day is small, however, which makes the association a shaky one.

    “I don’t think that the evidence are sufficient to conclude that there’s an association there,” said Dr. Tom Shimabukuro, director of the CDC’s Immunization Safety Office.

    Nonetheless, Richard Forshee, deputy director of the FDA’s Office of Biostatistics and Pharmacovigilance, said the FDA is planning to look at these safety questions further using data collected by Medicare.

    The FDA confirmed that the agency is taking a closer look.

    “The purpose of the study is 1) to evaluate the preliminary ischemic stroke signal reported by CDC using an independent data set and more robust epidemiological methods; and 2) to evaluate whether there is an elevated risk of ischemic stroke with the COVID-19 bivalent vaccine if it is given on the same day as a high-dose or adjuvanted seasonal influenza vaccine,” a spokesperson said in a statement.

    The FDA did not give a time frame for when these studies might have results.

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  • Opinion: Women don’t have to die from cervical cancer | CNN

    Opinion: Women don’t have to die from cervical cancer | CNN

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    Editor’s Note: Dr. Eloise Chapman-Davis is director of gynecologic oncology at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. Dr. Denise Howard is chief of obstetrics and gynecology at NewYork-Presbyterian Brooklyn Methodist Hospital and a vice chair of obstetrics and gynecology at Weill Cornell Medicine. The views expressed in this commentary are their own. Read more opinion on CNN.



    CNN
     — 

    As doctors who specialize in women’s reproductive health, we are on the front lines of a preventable crisis. Imagine treating a woman with advanced cancer who has a five-year survival rate of 17%, knowing that she should have never developed the deadly disease in the first place.

    This is what we are facing with cervical cancer. Yet we have the clinical tools not only to lower but also eliminate nearly all the roughly 14,000 new cases and 4,300 deaths from cervical cancer each year.

    Denise Howard

    We have effective screenings: the traditional Pap smear and the HPV test. If these screening tests are abnormal, additional tests can determine who needs further treatment to prevent the development of cancer. Importantly, we have the HPV vaccine, which protects against high-risk human papillomavirus (HPV) types that cause the majority of cervical cancer cases and is nearly 100% effective, according to the National Cancer Institute.

    A report published earlier this month shows the vaccine’s tremendous impact. The US saw a 65% drop in cervical cancer rates from 2012 through 2019 among women ages 20-24, the first to have received the vaccine. The vaccine, combined with screening, could wipe out cervical cancer and make it a disease of the past.

    But the percentage of women overdue for their cervical cancer screening is growing, and, alarmingly, late-stage cases are on the rise.

    We have had the heartbreaking experience of seeing mothers in the prime of life die from this avoidable disease, leaving small children behind — even women who had an abnormal screening but never received follow-up care. It’s devastating to see an otherwise healthy person slowly die from a preventable cancer.

    Simply put, cervical cancer should never occur. This Cervical Cancer Awareness Month, we should commit to making that a reality. Here is what needs to happen.

    Eliminating cervical cancer requires commitment at multiple levels, from public awareness campaigns with culturally appropriate messaging that broadcasts the power of the vaccine and screenings to prevent cancer to resources that ensure all women have easy access to routine health exams.

    Timely screening reminders and systems to prioritize follow-up care are essential. Too many women with abnormal screenings don’t receive their results, reminders or follow-up instructions they understand and, therefore don’t receive the proper treatment. Barriers also include logistical challenges like transportation and language issues. Studies suggest that 13% to 40% of cervical cancer diagnoses result from lack of follow-up among women with an abnormal screening test.

    Gynecology and primary care practices should be vigilant about reaching and monitoring patients with suspicious test findings. Large health systems can leverage the power of the electronic health record to track abnormal tests and ensure these women receive the proper follow-up.

    Pediatricians should encourage parents of children 9 and older to get the HPV vaccine and stress its safety. About 60% of teenagers are up to date on their HPV vaccines, according to the US Centers for Disease Control and Prevention. Physicians not recommending the vaccine and parents’ rising concerns about its safety, despite more than 15 years of evidence that it is safe and effective, have been cited as top reasons why more children aren’t receiving this lifesaving vaccine.

    College campuses should do large-scale, catch-up vaccination outreach. These students are at high risk for contracting HPV, yet only half report having received the full HPV vaccine series. This service should be provided at no cost to students.

    Stark racial disparities also must be addressed. As Black women physicians, we are frustrated that Black women continue to be more likely to die from the disease than any other race, according to the American Cancer Society. The system failures contributing to this tragedy range from Black women receiving less aggressive treatment to barriers around access to affordable routine health care and the high-quality, specialized treatment needed to treat cancer. Everyone deserves access to quality care.

    Older patients should be told that approval of the HPV vaccine has been extended up to age 45 and to discuss with their doctor whether it’s right for them. Insurance providers should cover the cost of the vaccine for these older ages.

    Women should see a gynecologist on a regular basis well into their older years. We see patients with cervical cancer in their 60s and 70s who haven’t been screened in 20 years. Many people stop seeing a gynecologist after childbearing or menopause, but this shouldn’t be the case. Getting quality gynecological exams throughout a woman’s life is critical to preserving it.

    We also need to empower women to be their own advocates through health education. Women should receive their screening result with an explanation of what it means and any next steps clearly delineated. No news after a screening is not good news. In an ideal world, women would see their HPV status as essential information with the power to save their lives.

    Education makes a difference. At NewYork-Presbyterian and Weill Cornell Medicine, we produced a series of easy-to-understand, publicly available videos on cervical cancer and the HPV vaccine. We showed several of the vaccine videos to more than 100 parents in one of our pediatric practices that serves mostly low-income families as part of a pilot study. Their knowledge scores on a questionnaire about the vaccine and HPV that they completed before and after watching the videos increased nearly 80%, and roughly 40% of the unvaccinated children received the HPV vaccine within one month. We aim to expand this effort.

    We have the tools to prevent cervical cancer but fail to use them effectively. It’s unacceptable, and we can no longer ignore the problem. It’s time for a full-scale offensive focused on all fronts to make cervical cancer a disease of the past.

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  • White House Covid-19 Response Team’s chief science officer to retire | CNN Politics

    White House Covid-19 Response Team’s chief science officer to retire | CNN Politics

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    CNN
     — 

    Dr. David Kessler, chief science officer for the White House Covid-19 Response Team, is retiring, according to a statement from the US Department of Health and Human Services.

    “For decades, Dr. Kessler has worked tirelessly to address our nation’s most challenging public health issues, and his work during the COVID-19 pandemic has been no different,” HHS Secretary Xavier Becerra said in the statement Friday.

    “Whether he was leading our effort to develop and distribute safe and effective COVID-19 vaccines and treatments, or sharing his perspective during daily strategy sessions and data deliberations, Dr. Kessler’s contributions to our COVID-19 response have helped save lives. I am grateful for the wisdom he has shared with us and wish him the best in his future endeavors,” Becerra continued.

    Kessler’s government career began when President George H.W. Bush appointed him to lead the US Food and Drug Administration in 1990; he oversaw the rollout of the agency’s iconic Nutrition Facts label on packaged foods and helped streamline its drug approval process. After stepping down from the FDA in 1997, he became dean of the Yale School of Medicine and then joined the University of California, San Francisco.

    President Joe Biden chose Kessler for the Covid-19 response team in 2021. He was also co-chair of the Biden transition’s coronavirus task force and that administration’s head of Operation Warp Speed, the group formed under President Donald Trump to speed vaccine development and distribution.

    “Every day for two years, David has been laser focused on ensuring we had enough vaccines and treatments for the American people,” Dr. Ashish Jha, the response team coordinator, said Friday on Twitter. “An extraordinary public servant. We will miss him.”

    Ron Klain, the White House chief of staff, tweeted, “There has been no more valued and trusted wise advisor to the @POTUS on scientific and medical matters than Dr. Kessler. He will be GREATLY missed.”

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  • How much should people worry about Covid’s newly-dominant XBB.1.5 variant? Our medical analyst explains | CNN

    How much should people worry about Covid’s newly-dominant XBB.1.5 variant? Our medical analyst explains | CNN

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    CNN
     — 

    A new Covid-19 variant, XBB.1.5, is spreading rapidly throughout the United States. In December 2022, the proportion of new Covid-19 infections due to this Omicron offshoot have increased from 4% to 18%, according to a January 6 release from the US Centers for Disease Control and Prevention, and is projected to rise further still. In some parts of the country, it constitutes more than half of all new infections. According to the World Health Organization, XBB.1.5 is the most transmissible form of Omicron yet.

    What should people know about XBB.1.5? Do vaccines and treatments work against it? Can tests pick it up? Will hospitals become overwhelmed again? Should kids wear masks to school again? And could there be even more worrisome variants that emerge in the future?

    To guide us through these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician, public health expert and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.”

    CNN: What should people know about the latest Covid-19 variant, XBB.1.5?

    Dr. Leana Wen: People should not be surprised that there is a new variant. The more viruses replicate, the more they mutate. Most mutations do not confer evolutionary advantage and won’t spread further, but some do.

    There are three key questions to ask about new variants. First, is it more contagious? Second, does it cause more serious disease? And third, is it more immune-evasive, meaning it undercuts the protection of existing vaccines and treatments?

    The mutations XBB.1.5 has acquired have made it more contagious. A more transmissible strain has the evolutionary advantage that it will spread faster than others, and therefore could displace other strains. This is a trend seen throughout the coronavirus pandemic — new, even more transmissible strains replacing their predecessors and becoming dominant.

    The good news is that, thus far, this strain does not appear to cause more severe disease. Like other Omicron descendants, it probably causes milder illness compared with the Delta variants that predated Omicron.

    There are some studies that suggest XBB.1.5 is more immune-evasive compared with previously dominant Omicron strains. Further research is underway to identify the degree of immune protection afforded by existing vaccines; the White House’s Covid-19 response coordinator Dr. Ashish Jha said that “data suggests that if you’ve been vaccinated, if you’ve gotten that updated bivalent booster, you’re still going to have a good amount of protection,” during an interview Friday with CNN’s Kate Bolduan.

    But even if it turns out these vaccines don’t hold up as well against infection with XBB.1.5, they will probably protect well against severe illness — which underscores the need for people to receive the updated booster if they are eligible.

    CNN: Can tests pick up this new variant?

    Wen: PCR tests definitely can, and there’s no reason to think that this variant won’t be picked up by rapid home antigen tests. If you have symptoms or are exposed to someone with the coronavirus, you should certainly get tested. The tests won’t show you which strain you picked up, but they should detect circulating variants.

    CNN: Do existing treatments work against XBB.1.5?

    Wen: Antiviral treatments like Paxlovid should work against XBB.1.5. Unfortunately, monoclonal antibody treatments probably don’t. In November, the US. Food and Drug Administration withdrew their authorization of the last remaining monoclonal antibody because of its lack of efficacy against new variants. And on January 6, the agency issued a statement that the preventive antibody Evusheld may be ineffective against XBB.1.5.

    On a policy level, it’s critical there are urgent investments into better treatments. There are many people vulnerable to severe outcomes due to Covid-19, and we need to have a wider range of effective treatments available for them.

    CNN: Could hospitals become overwhelmed again?

    Wen: Covid-19 infections could rise in the coming weeks due to a combination of this new variant and the fact that many people will have traveled and gathered over the holidays. I don’t think the surge will be nearly as bad as the initial Omicron wave in early 2022, though, because of the large proportion of Americans who have by this point already contracted Covid-19 and have some baseline immunity to it.

    If you have symptoms or are exposed to someone with the coronavirus, you should certainly get tested, says Dr. Leana Wen.

    Increasing booster rates, particularly among the elderly, will help blunt the rise in hospitalizations. It’s a major problem that only about a third of Americans ages 65 and older have received the updated bivalent booster, which has been shown in a recent study to reduce hospitalization by 73% in this age group.

    CNN: How much should people worry about XBB.1.5?

    Wen: It depends on the individual. There are many people who are not concerned about contracting Covid-19. They may be young and healthy and unlikely to become severely ill due to the coronavirus. Maybe they have just recovered from a previous infection and are protected against serious illness for several months. Or maybe the downside of continuing precautions is significant to them. I don’t think it’s wrong for people to proceed with their pre-pandemic routines, considering that XBB.1.5 is not likely to be the last variant of concern we see — and that it doesn’t appear to cause more severe disease.

    On the other hand, there are many people who are worried about becoming severely ill from Covid-19. People who are elderly or who have underlying health conditions should speak with their physician about their risk of severe illness due to Covid-19. If they are at high risk even after getting the bivalent booster, they should consider additional precautions to avoid infection while this highly transmissible variant is circulating. That includes asking others to take a rapid test prior to socializing and wearing a high-quality N95 or equivalent mask while in crowded indoor places.

    CNN: Some school districts are bringing back mask mandates. Should kids wear masks to schools again?

    Wen: This will depend on the family. If everyone is generally healthy, the parents or caregivers are going to work without a mask and all members are socializing freely with others outside of school, then it wouldn’t add much more protection to mask in the classroom.

    On the other hand, families that are still taking many precautions because of, for example, a severely immunocompromised household member might decide to all mask while in in crowded indoor spaces.

    My children have not been masking in school since the beginning of this school year, and I don’t currently plan for this to change. We would reconsider if a new variant emerges that causes much more severe disease, but that does not appear to be the case with XBB.1.5.

    CNN: Could there be even more worrisome variants that emerge in the future?

    Wen: Yes. This is the reason why genomic surveillance is so important. We need to identify and study new variants as they emerge. This is part of our “new normal”— there will be new variants that, from time to time, lead to surges of infections. The key is to make sure people are still protected against severe disease and to keep hospitals from becoming overwhelmed. And we must make sure everyone makes use of the tools we have available, including vaccines.

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  • Novak Djokovic back in Australia following high-profile visa ban | CNN

    Novak Djokovic back in Australia following high-profile visa ban | CNN

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    CNN
     — 

    Novak Djokovic is back in Australia, according to a spokesperson with Tennis Australia, nearly a year after his high-profile visa ban from the country over his stance on the Covid-19 vaccination.

    The 21-time grand slam champion is slated to open his 2023 tennis season next week in Adelaide for the Adelaide International 1. It comes more than a month after Australian officials said that Djokovic’s three-year ban from entering the country would be overturned.

    The Serbian was deported from Australia in January after former immigration minister Alex Hawke found the tennis star posed a risk to public health and order because, as a celebrity sportsman who had previously expressed opposition to people being compelled to get the Covid-19 vaccine, he could be seen as an “icon” for anti-vaxxers.

    The minister’s decision to deport the former world No. 1 men’s player meant he was initially banned from reentry for three years.

    On Monday, Tennis Australia CEO Craig Tiley said, “We will welcome him back to Australia.”

    As for the reception Djokovic should expect to receive from Aussies, Tiley said, “I have a great deal of confidence in the Australian public. I think we have a very well-educated sporting public particularly those that come for tennis. They love their tennis. They love seeing greatness. They love seeing great athleticism, great matches.

    “I have a lot of confidence that the fans will react like we hope they would react and have respect for that,” he added.

    CNN has reached out to the tennis star for comment.

    Djokovic has won nine men’s singles titles at the Australian Open, more than anyone else in history. He is entered to play in the 2023 edition next month.

    Djokovic’s high-profile visa saga overshadowed the Australian Open earlier this year, pitting one of tennis’ biggest stars against the Australian government and dividing opinion in the country, which had enacted tough pandemic border restrictions.

    The government revoked the Serbian’s visa shortly after his arrival in Melbourne on January 5 because he was not vaccinated against Covid-19.

    Djokovic said he was under the impression he could enter the country because two independent panels associated with Tennis Australia and the Victorian state government had granted him an exemption on the grounds he had been infected with the virus a few weeks prior to his arrival.

    But the federal government argued that was not a valid reason for an exemption under its rules.

    A judge later ruled that border officers had been “unreasonable” when they canceled Djokovic’s visa and ordered his release from an immigration detention center.

    But his visa was then revoked for a second time and after losing his bid to challenge the decision, the tennis star left Australia.

    Despite his return to action in selected tournaments following the ordeal, the player’s Covid-19 vaccination stance restricted his participation in others.

    In July, Djokovic won his 21st grand slam title, beating Nick Kyrgios in the final at Wimbledon.

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  • Biden signs vital $858 billion defense bill into law, nixing military’s Covid-19 vaccine mandate | CNN Politics

    Biden signs vital $858 billion defense bill into law, nixing military’s Covid-19 vaccine mandate | CNN Politics

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    CNN
     — 

    President Joe Biden on Friday signed the National Defense Authorization Act into law, a massive defense spending bill with provisions that will give service members a pay raise, fund support for Ukraine and Taiwan and rescind the US military’s Covid-19 vaccine mandate.

    In a statement following the signing of the NDAA, Biden said the act “provides vital benefits and enhances access to justice for military personnel and their families, and includes critical authorities to support our country’s national defense, foreign affairs, and homeland security.”

    The Senate voted last week to pass the massive NDAA with bipartisan support. It follows the House’s bipartisan approval of the legislation the week prior.

    The defense bill outlines the policy agenda for the Department of Defense and the US military and authorizes spending in line with the Pentagon’s priorities. But it does not appropriate the funding itself. The legislation, which authorizes $817 billion specifically for the Department of Defense, will provide $45 billion more than Biden’s budget request earlier this year.

    The increase for fiscal year 2023 is intended to address the effects of inflation and accelerate the implementation of the national defense strategy, according to the Senate Armed Services Committee. It authorizes $12.6 billion for the inflation impact on purchases, $3.8 billion for the impact on military construction projects and $2.5 billion for the impact on fuel purchases, according to a bill summary from the committee.

    The NDAA includes provisions to strengthen air power and land warfare defense capabilities, as well as cybersecurity. And it shows Congress’ continued support for helping Ukraine repel Russia’s invasion, even though several Republican lawmakers have raised questions about the ongoing US aid. Additionally, the NDAA establishes a specific defense modernization program for Taiwan to deter aggression by China.

    Among a series of provisions to support service members and their families, the funding will provide a 4.6% increase in military basic pay for service members – the largest in 20 years. The Department of Defense’s civilian workforce will get the same raise. It also bumps up service members’ housing allowance.

    In addressing service member suicides, the act requires the Secretary of Defense to compile a report on suicide rates within the ranks.

    The act also ends the requirement that troops receive the Covid-19 vaccine. However, it will not reinstate members of the military who were discharged for refusing to get vaccinated.

    White House press secretary Karine Jean-Pierre previously said the White House had viewed the removal of the vaccine mandate as “a mistake,” but she declined to say whether Biden would sign a bill that ends the requirement, noting that the president would “judge the bill in its entirety.”

    Biden said in his statement on Friday that while he’s pleased the funding bill supports several critical objectives, “certain provisions of the Act raise concerns.”

    He repeated past concerns about barring funds to transfer Guantanamo Bay detainees into the custody of certain foreign nations and several “constitutional concerns or questions of construction” over other provisions – including concerns about the transmission of highly sensitive information to Congress.

    Biden also called a portion of the NDAA requiring that documents, including presidential communications, be shared unconstitutional.

    “I will commit to complying with its disclosure requirements only in such cases where a committee has a need for such Presidential communications that outweighs the potential harm to the confidentiality interests underlying the Presidential communications privilege,” the president’s statement said.

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  • Democracy has its flaws, but it has emerged from the pandemic in much ruder health than the alternative | CNN

    Democracy has its flaws, but it has emerged from the pandemic in much ruder health than the alternative | CNN

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    CNN
     — 

    For nearly half a decade, you could be forgiven for thinking just about everything in Western democracy seemed a bit broken. The social-media yelling in 140 characters. The wild populism, and dog-whistle racism. The clumsy coronavirus lockdowns and their attendant conspiracy theories. The tolerance of absolute, constant falsehoods. The questioning and beleaguering of the electoral process.

    Some began to behave as if it were smoother on the other side of the fence, in autocracies where things are just ordered to happen, and criticism is swallowed whole.

    Yet, as we stagger past the third anniversary of Covid-19’s emergence, the fallacy that autocracies are a superior social contract is crumbling. At the end of 2022, the world is a place where consent matters, and debate might actually save your hide.

    The Trump era created a safe space for autocracies to flex on the global stage, while American tried to put itself First, and its commander-in-chief was happy to receive “lovely” letters from North Korea, or get very close to the Kremlin. But it took the pandemic to expose the utter mess one man in charge can create.

    The most glaring and unimaginably stark example is Russia. President Vladimir Putin bumbled his way through the pandemic with snap lockdowns, a poorly performing vaccine, and a general disregard for how useful accurate data can be in defeating a complex foe like Nature. But it was his personal choices that led to a disconnect which has proved fatal to tens of thousands of innocent Ukrainians, and perhaps even more Russian soldiers.

    The persistent warnings from Western intelligence in January that an invasion of Ukraine was imminent seemed far-fetched to many analysts, including me. Those analysts overlooked the enormity of the task, and the assumption the Kremlin remained a rational actor. Those calming caveats were swiftly whisked away when – in the days leading up to the war – Putin summoned his security henchmen and dressed them down, at a safe distance of well over 20 feet, and then delivered a 57-minute televised speech showing he had spent the pandemic reading all the wrong parts of the internet.

    His spoken dissertation even reminded Russians how mean Bill Clinton had been 20 years ago, shunning Putin’s stated desire to join NATO. Putin’s isolation had compounded not just his historical grievances. There were now fewer subordinates in contact with him, and fewer opinions voiced to counter the absurd assumption Russia’s invasion would be welcomed by Ukrainians and last about three days.

    A RUSI report recently noted that seized Russian orders showed units expected to be “cleaning up” within 10 days, and that no effective “red team” assessment of the plan – challenging its assumptions – had happened.

    And so, the largest land war in Europe for 75 years began, and with it a likely military defeat for Russia that may rewrite the established norms of European security and see Moscow’s place as a global superpower evaporate. Putin’s insecurities over NATO and the practical task of connecting the occupied Crimean Peninsula to the Russian mainland fueled his catastrophic decision. But the Kremlin head’s isolation – along with his echo chamber of paranoid nonsense – cemented it.

    But even now, in this late stage in the Russian military demise, when its readiest form of resupply is forced conscripts to the frontline, Moscow must be mindful of consent. The “partial mobilization” announced in September has sent 77,000 Russian men to Ukraine, Putin recently said. But it has also unleashed a wave of protests perhaps not seen in Russia since the 1990s.

    Tightening the screws on dissent is a sign opposition is growing, not ebbing. The nastier Russia gets, the more acutely aware the Kremlin is of its unpopularity. Invading Ukraine was the worst decision a Russian leader has made since the Soviets invaded Afghanistan. We know how that misadventure ended.

    Police officers detain demonstrators in St. Petersburg on September 21, 2022, following calls to protest against partial military mobilisation announced by President Vladimir Putin.

    The pandemic caused economic and emotional stress in every society, leaving citizens less tolerant of poor managers and outdated dogma. Even the United Kingdom swiftly ejected two prime ministers over issues of conduct and incompetence, not long after their ruling Conservative Party had won a landslide victory at the last election.

    The economic fallout from the pandemic is also the backdrop for another dazzling failure of autocracy, in Iran. But the focal point of recent protests has been the brutal treatment of teenagers for protesting mandatory headscarves. Killing a young woman for not wanting to dress more conservatively than her grandmother perhaps did (Iran was – as recently as the 1970s – secular) is grotesque in any society.

    Iranians protest the death of 22-year-old Mahsa Amini after she was detained by the morality police, in Tehran, Iran, on October 1, 2022.

    But it lit the touch paper in communities ravaged by years of sanctions, the pandemic, and persistent inflation of perhaps as much as 50%. Permit salaries and savings to diminish that much annually, and any elected government could expect to be ousted fast. In Iran’s cities, the violence around this dogma did not distract from the economic fury, but amplify it.

    Well over half of Iran’s population was born in the 1990s, when the Islamic Revolution was already a decade old. A system born in the era of the landline is telling youth born into the world of fax machines how to behave in the era of quantum computing.

    The pandemic hit Iran hard, and I witnessed in 2020 how poorly resourced Tehran’s hospitals were. When your parent is dying and you can’t get a ventilator for them, you don’t have time for a lengthy discourse blaming US sanctions imposed because of Iran’s confrontation of the American hegemony in the region. An emergency like Covid can damage what remains of the contract between ruling conservatives and citizens: If you cannot protect us from a disease at our time of need, then what is the purpose of the corruption, repression and rules on women’s dress?

    Medical workers transport a patient with Covid-19 at Rasoul Akram Hospital in Tehran on October 20, 2020.

    The recent public confusion over whether the country’s morality police would be disbanded – a statement made by the prosecutor general which was later mauled – is a sign of government reform perhaps, but also an indication of how state power is not a tidy behemoth in Iran. There is debate, too, and here it clearly, with hundreds of corpses already underfoot, considered bending to popular will.

    This stark and deadly repression does not at this time herald the demise of the Iranian regime. But it is perhaps a moment of irreversible acceptance that the people cannot just be Ctrl-Alt-Deleted when they don’t suit the state program. It is a recognition that even the best-resourced, most controlling and efficient of repressive regimes – China – has had to deal with.

    Iranians protest the death of 22-year-old Mahsa Amini after she was detained by the morality police, in Tehran on October 27, 2022.

    The pandemic led Beijing to resort to mass control on a whole new level. Its solution to the disease ravaging the planet was to be the harshest of all – in limiting movement. The authorities’ favored tool – used to its limits – was the one almost every other society realized would not work indefinitely.

    Until recently, Chinese citizens were still being welded into their homes in quarantine, and even burning to death in one tragic instance when they perhaps could have been rescued from a domestic fire. It’s perhaps the most damning indictment of China’s one-person rule this century.

    Workers in  protective clothes walk past barriers placed to close off streets in areas locked down after the detection of cases of Covid-19 in Shanghai on March 15, 2022.

    The world has been on a steep learning curve, where social distancing, economic subsidies, vaccines, agonizing deaths and limited global travel have led most societies to now accept the Covid-esque persistent cough as part of what happens in winter. Yet China’s initial decision – stifle the disease – has barely evolved. Its vaccine program has faltered, yet its original tool of mass surveillance has not.

    What is more remarkable is not protests breaking out under such an authoritarian yoke, but that President Xi Jinping did not presume they would.

    Beijing appeared to have been taken by surprise, but also believed it could repress its way out of the unrest. The recent removal of significant parts of the quarantine and testing systems does not solve China’s Covid problems. It was simply their authorities’ only choice. And it is a badly timed one. China is not adequately vaccinated to cope with a massive rise in cases, particularly its elderly population, many experts argue. Even if 1% catch it badly, that is 14 million people in need of medical care – roughly the population of Zimbabwe.

    A demonstrator holds a blank sign and chants slogans during a protest in Beijing, China, on Monday, November 28, 2022.

    Huge challenges require decision-makers of enormous ability. Xi has unparalleled power, evidenced when he sat by as his predecessor Hu Jintao was inexplicably led out during the highly choreographed closing moments of the recent National Congress. But it is pretty clear that Xi got the big decisions around Covid wrong. And that the country where SARS-Cov-2 first emerged is enduring the longest impact of the virus because of poor decisions by its leaders.

    It is a problem for Xi. The singular selling point of autocratic power is that it is absolute: that you can get things done without the delay of debate and compromise that democratic systems endure.

    The point is to be strong, implement decisions fast, and consider dissent the cost of tough, good decisions; not to appear strong, implement fast, and then change your mind publicly after months pursuing a bad idea. For Xi, it is also dangerous for a population to learn they can only truly communicate with their government through disobedience and protest.

    It’s important to feel discomfort when extolling the virtues of modern democracy. It doesn’t really work. It is slow and encourages ego and half-measures. It keeps changing its mind and wasting endless resources while stumbling for the solution.

    But it provides space for dissent and, more importantly, other, competing ideas. And, if you are forcing taxi drivers to fight in a war of choice you are losing, or shooting teenagers for taking off headscarves, or imprisoning people in their apartments to suppress a virus the rest of the world is living calmly with, alternative ideas are important.

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  • India on alert for new variants as Covid wave sweeps China | CNN

    India on alert for new variants as Covid wave sweeps China | CNN

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    New Delhi
    CNN
     — 

    India’s health minister has advised the public to take precautions against Covid-19, including getting vaccinated and wearing masks, as the country remains on alert for potential new variants that could emerge from the wave of infections sweeping neighboring China.

    Health Minister Mansukh Mandaviya on Thursday told Parliament that India would begin randomly testing 2% of international travelers arriving at the country’s airports, after he asked regional authorities to send positive samples to laboratories monitoring for new Covid strains.

    “States have been told to make people aware of (the need to) wear masks, use hand sanitizers, maintain respiratory hygiene and social distancing,” Mandaviya said, as he encouraged Indians to receive vaccines or booster shots.

    Speaking Wednesday at a meeting to review the Covid situation in the country amid rising cases in several Asian nations, Mandaviya said: “Covid is not over yet. I have directed all concerned to be on the alert, and strengthen surveillance.”

    India, a country of 1.3 billion, relaxed its Covid restrictions earlier this year after a drop in infections, and people have mostly stopped wearing masks outside.

    The warnings from the Indian minister come as China braces for infections to spread from its biggest cities to its vast rural areas following its hurried and under-prepared exit from the zero-Covid strategy earlier this month.

    On Wednesday, World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus expressed concern over rising cases in China, emphasizing he was worried about “increasing reports of severe disease.”

    “In order to make a comprehensive risk assessment of the situation on the ground, WHO needs more detailed information on disease severity, hospital admissions and requirements for ICU support,” Tedros told a news conference.

    The surge could lead to nearly 1 million deaths in China, according to a study released last week, which added it was also likely to overload many local health systems in the country.

    Meanwhile, Chinese experts have warned that the worst may be yet to come. Wu Zunyou, chief epidemiologist at the Chinese Center for Disease Control and Prevention (CDC), said last week that China is being hit by the first of three expected waves of infections this winter.

    Last year, India was devastated by a second wave of Covid-19, which killed tens of thousands and overwhelmed the country’s health system.

    Since then, India has administered more than 2 billion Covid vaccines and nearly 75% of its population has received at least one dose, according to data from Johns’ Hopkins University.

    According to the Health Ministry, India had seen a “steady decline” in cases, with an average of about 150 infections a day nationwide as of December 19.

    “We are prepared to manage any situation,” Health Minister Mandaviya said in a Twitter post Wednesday.

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  • Opinion: After their pandemic debut, mRNA vaccines are just getting started | CNN

    Opinion: After their pandemic debut, mRNA vaccines are just getting started | CNN

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    CNN
     — 

    Many think the now-famous mRNA vaccines came into existence in the blink of an eye, at warp speed, in the throes of a deadly pandemic. But for Drew Weissman, who, along with his research partner Katalin Karikó, is credited with developing the platform that made the life-saving mRNA vaccines possible, RNA technology was a long time coming.

    Weissman, 63, grew up in Lexington, Massachusetts, before attending Brandeis University, and then receiving both a doctorate and a medical degree from Boston University. He eventually landed a fellowship in Dr. Anthony Fauci’s lab at the National Institute of Allergy and Infectious Disease, where he spent the better part of the ’90s researching dendritic cells, a key biological player in starting the body’s immune response. So, when he found himself at the University of Pennsylvania in 1997, the question of how to bolster the human immune system was already burning in his mind.

    Then, serendipity stepped in. Weissman bumped into Karikó, a biochemist at the university, while waiting at the Xerox machine for articles to be photocopied. They began talking about their shared research interest. Karikó, a native of Hungary, had spent decades researching messenger RNA – the biological instruction manual for the production of proteins in human cells – and was convinced of the potential it held for human therapeutics.

    Just like that, a scientific dream team was formed.

    Their research, however, was an uphill battle. For years, Weissman and Karikó’s experiments with RNA ended in failure. The key problem: The RNA was provoking an immune response that made their lab mice sick. But in 2005, with little support left from the scientific community, the pair had a breakthrough. They realized that by modifying the RNA, it would subvert detection by immune cells, and the proteins that the body synthesized from the RNA would train the immune system to recognize a specific foreign invader. With this modified RNA, the mice no longer got sick and showed the immunity Weissman and Karikó had hoped for.

    So, when the Covid-19 pandemic hit, it didn’t take long – just the amount of time to sequence the genome of the SARS-CoV-2 virus, create the mRNA based on that sequence and send the final product through the regulatory process – for a safe and effective Covid-19 mRNA vaccine to be approved for use.

    Since then, millions of lives have been saved by the vaccines. Covid-19 is still a threat, but vaccinated and boosted Americans have largely been able to return to a normal cadence of life.

    Across the globe, however, life has looked very different. China has resisted the use of Western mRNA vaccines, instead relying on its zero-Covid policy of strict lockdowns and Covid controls to try to keep the virus from spreading within its borders. This policy recently sparked unprecedented demonstrations among Chinese citizens and, as a result, on Wednesday, the Chinese government released extensive revisions to its restrictive, and ultimately unsuccessful, zero-Covid policy.

    Protests against Covid restrictions spread across China in late November as citizens took to the streets to vent their anger.

    The easing of China’s policy may be heralded as a victory, but it’s one that could come with a steep cost. As of late November, 90% of China’s population had completed two doses of a Covid-19 vaccine, while only about 66% of people over 80 had received two doses, according to Chinese officials. What’s more, the vaccines available to Chinese citizens use an inactivated SARS-CoV-2 virus, and pale in comparison to their mRNA counterparts that are approved in the US, says Weissman.

    But now, it seems, China is recognizing the promise of mRNA vaccines; it’s reportedly close to having one, made in its own country, approved for use. If that approval comes soon, it could deliver the nation from its pandemic turmoil.

    This interview has been edited for length and clarity:

    CNN: Can you explain how an mRNA vaccine works? What happens in the body after someone gets an mRNA shot?

    Weissman: In an mRNA vaccine, the mRNA acts as a kind of middleman. In our cells, DNA contains all the codes for the proteins we need to live. The messenger RNA makes a copy of one of those codes and brings it to a machine called a ribosome that reads the mRNA code and produces a protein from it.

    An mRNA Covid-19 vaccine supplies the codes for part of the SARS-CoV-2 virus called the spike protein. The ribosomes read the mRNA vaccine code and create the virus’ spike protein from it — and the body’s immune system starts recognizing it and creating antibodies to respond to it. Then, if the real virus is ever introduced into the system, the body will recognize its spike protein and will have already built up the antibodies needed to fight it off.

    CNN: What were the biggest challenges to developing the mRNA vaccine platform?

    Weissman: The roadblocks started 25 years before the pandemic hit. Back then, everybody took the attitude that mRNA wasn’t a good therapeutic and that it was a waste of resources to do the research. Support and funding were the biggest roadblocks we hit. We finally got funding, but even after that, it was years before people started to think, “Oh, wait a minute, RNA might actually be useful!”

    CNN: When the scientific community was skeptical of investing in RNA research, what was it that kept you from giving up on it?

    Weissman: The reason I kept at it was the potential I thought RNA had. When you have to make a new vaccine for a new disease using live viruses, it’s a huge amount of work. But RNA is simple. It’s plug and play. You take any protein you want to make an immune response against, you make RNA from it, you stick it in lipids, and you’re done. It was a simple platform that could be used emergently if a new virus suddenly appeared. We were thinking that it would be used against a flu pandemic, but when Covid hit, the vaccine was ready to go.

    I also thought that in addition to vaccines, we might be able to deliver therapeutic proteins and gene edit with RNA. There was so much potential that we felt that the drawbacks needed to be addressed and figured out. And that’s why we stuck with it for so many years.

    CNN: Do you see a future in which we turn to RNA therapeutics to treat or prevent things like the flu, cancers or autoimmune diseases?

    Weissman: We’re now turning to RNA for more than just vaccines. There are therapeutics in the works for a variety of diseases, including HIV, influenza, malaria and others. And there are ongoing clinical trials using RNA to treat cancer. We’ll likely also see clinical trials for RNA therapeutics for autoimmune diseases, too. So, it’s hit the mainstream, and people are looking at it as a potential new therapy.

    I’m also speaking with institutions that treat genetic diseases that afflict only 200 people. There is such a small population affected that no pharmaceutical company, and very few academics, are interested in researching them. But there is potential for RNA to be the key to treatment of these diseases because instead of having to reinvent the gene therapy for each disease, we can use the RNA platform we’ve already developed and easily plug in different diseases. We don’t have to spend $100 million in research to make a new treatment.

    CNN: What does the world need to do to better utilize RNA technologies to fight diseases in the future?

    Weissman: We need to develop the infrastructure to make new medicines, new vaccines, new therapies available to the world. I’ve been working with a lot of low- and middle-income countries to help them develop RNA therapeutics. Take Thailand: Through support from its government and charitable donations, Thailand was able to fund the development of an mRNA vaccine, which is currently in clinical trials, and could be distributed through Southeast Asia.

    And it’s not just Covid vaccines. If countries have the infrastructure to produce RNA therapeutics, they could potentially protect their people from some of the biggest infectious diseases. So, the most important thing is building the infrastructure where it’s needed.

    CNN: What are your thoughts on China’s zero Covid approach? Do you think China did its citizens a disservice by not making mRNA vaccines available to them?

    China has relied on a policy of strict lockdowns and Covid controls to try and keep the virus from spreading within its borders.

    Weissman: Initially, I think China took the right approach, which was to lock down to avoid transmitting Covid-19. And that worked in the beginning. The problem is that, once vaccines became available, China then only gave their citizens vaccines that were made in its own country. And, honestly, the vaccines that they made were lousy.

    Now they find themselves in a situation where the virus can be transmitted very easily when people are out in public. Had they purchased mRNA vaccines and immunized their population, they wouldn’t be in this situation. The bottom line is that China’s zero-Covid policy will never work, because Covid is everywhere. You can’t keep it out.

    CNN: The Covid-19 vaccines use messenger RNA, or mRNA. Is mRNA the only type of RNA that is being studied for use in therapeutics?

    Weissman: No, there’s a new institute at the University of Pennsylvania that does all kinds of RNA research. There are some diseases, particularly muscular diseases, that are caused by incorrect splicing of our RNA. So, we’re looking at new therapies to correct that splicing problem, which use different types of RNA.

    CNN: What are the biggest problems that face RNA therapeutics and vaccines moving forward?

    Weissman: The biggest problem is social media distortion of what RNA is and what it can do. Misinformation scares a lot of people away from taking RNA therapies. I can’t tell you how many times a week I hear people say, “Oh, I won’t take the vaccine, it’ll make me sterile, it’ll give me cancer, it’ll change my genes.” All of that is absolute nonsense, and I think it’s important for scientists to let people know that it’s nonsense – that RNA is safe.

    But there are a lot of ways to address that problem. Scientists aren’t vocal enough about science. There are large groups of people who think scientists are all frauds and who don’t believe in science, and they’re being cultured by some of our far right-wing politicians, religious leaders and community leaders. We need to get to those leaders and tell them to stop creating this unwarranted fear. We need to tell them that science isn’t the enemy.

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