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Tag: World Health Organization

  • Infertility affects a ‘staggering’ 1 in 6 people worldwide, WHO says | CNN

    Infertility affects a ‘staggering’ 1 in 6 people worldwide, WHO says | CNN



    CNN
     — 

    An estimated 1 in 6 people globally are affected by infertility, according to a new report from the World Health Organization, which emphasizes that the condition is common.

    Rates of infertility – defined as not being able to conceive after a year of having unprotected sex – are similar across all countries and regions, Monday’s WHO report says.

    “In our analysis, the global prevalence of lifetime infertility was 17.5%, translating into 1 out of every 6 people experiencing it in their lifetime,” Dr. Gitau Mburu, a scientist of fertility research at WHO, said Monday.

    “Lifetime prevalence of infertility does not differ by income classification of countries,” he said. “Lifetime prevalence was 17.8% in high-income countries and 16.5% in low- and middle-income countries, which, again, was not a substantial or significant difference.”

    Yet there are differences in how much people are spending on fertility treatments and how accessible such treatments are, according to the report.

    “People in the poorest countries were found to spend a significantly larger proportion of their income on a single cycle of IVF or on fertility care compared with wealthier countries,” Mburu said, “exemplifying that this is an area with high-level risk of inequality in access to health care.”

    Global public health groups typically call attention to overpopulation as a major public health concern, so the spotlight that the WHO report turns on infertility not only is surprising but is welcome, said Dr. David Keefe, reproductive endocrinologist and infertility specialist at the NYU Langone Fertility Center in New York.

    “That report did not surprise me in terms of the content, because it’s been known for some time that infertility is much more prevalent than anyone wants to think about: Having a child and having a family is kind of a universal dream or aspiration for people from every country, from every region. What surprised me was the World Health Organization coming out in support of it,” said Keefe, who was not involved with the WHO research.

    “It was a welcome acknowledgment of the other foot dropping on the population front,” he said. “The acknowledgment that this is a worldwide problem and that additional attention must be devoted to it in terms of policy and strategy is welcome.”

    The WHO report – described as the “first of its kind in a decade” – includes an analysis of infertility data from 1990 through 2021. The data came from 133 previously published studies on infertility prevalence.

    “The purpose of this analysis was to generate updated data on the global and regional estimates of infertility prevalence by analyzing all available data from different countries, making sure that we take into account different study approaches,” Mburu said.

    Based on that data, the researchers estimate that lifetime prevalence of infertility – representing the proportion of people who have ever experienced infertility in their reproductive life – was 17.5% in 2022.

    The period prevalence of infertility, meaning the proportion of people with infertility at any given point currently or in the past, was found to be 12.6% in 2022.

    Although the data showed some variation in infertility prevalence across regions – with the highest lifetime prevalence at 23.2% in the Western Pacific, compared with the lowest at 10.7% in the Eastern Mediterranean – those regional differences were not either substantial or conclusive based on the data, according to WHO’s report.

    The researchers also did not determine whether global infertility rates have been increasing or decreasing over time.

    “The data which we analyzed for this report was from 1990 to 2021, and during that period, we did not see evidence of increasing rates of infertility. However, the way the data was arranged, it was not really organized to answer that question,” Dr. James Kiarie, head of contraception and fertility care at WHO, said Monday. “We cannot, based on the data we have, say that infertility is increasing or constant – so we must say that probably the jury is still out on that question.”

    Over time, various factors can affect a person’s fertility, and age is one of the most important, said Dr. Emre Seli, chief scientific officer for the maternal and infant health nonprofit March of Dimes. Seli, who is also a professor at Yale School of Medicine and medical director of Yale Fertility Center, was not involved in the new report.

    “Fertility decreases as the age of the female partner increases,” he said.

    “Fertility is really an emotionally taxing issue for those who are affected by it. It is a major source of stress to want to have a child and not be able to,” Seli said. “Most of my patients are women, and they do become affected by this at many levels, and they do suffer from lack of adequate research as well as lack of adequate insurance coverage to undergo the treatments that they need.”

    Infertility, affecting the male or female reproductive system, can be treated with medicine, surgery or assisted reproductive technologies such as in vitro fertilization or IVF, during which an egg and sperm are joined in a lab dish and put into a womb once the fertilized egg becomes an embryo.

    “Infertility is a major and a widespread health issue affecting a staggering 1 in 6 people globally over the duration of their reproductive lives,” Dr. Pascale Allotey, director of the Sexual and Reproductive Health and Research Department at WHO, said Monday.

    Despite that, solutions for the prevention, diagnosis and treatment of infertility remain “underfunded” and “inaccessible” to many patients due to high costs, Allotey said.

    “Infertility is an important public health concern because it can have wide-reaching negative impacts on the lives of the people affected,” she said. “WHO is calling for universal access to affordable high-quality fertility care, improved data to enable infertility to be meaningfully addressed in health policy and programs, and greater efforts to ensure this issue is no longer sidelined in health research and policy.”

    Mburu added that infertility can also have effects on mental health, raising risks of anxiety, depression and intimate partner violence.

    “Our message is that infertility needs to be included as a priority in responding to the needs of populations in different countries,” Mburu said. “This is because people have a right to expect to obtain the highest possible standard of mental, social and physical health as defined by WHO.”

    The new data from WHO reinforces that more people need fertility coverage and access to high-quality care than was previously thought, said Dr. Asima Ahmad, an endocrinologist and fertility expert who serves as chief medical officer and co-founder of Carrot Fertility, a company that helps employers set up fertility benefits. She added that inequities emerge in who has such access to care, such as Black women who tend to experience inequities in access.

    “These inequities, I’m not surprised that they exist on a global level, because we already see the inequities in the United States domestically, with how infertility impacts different populations and how some populations have limited access. And even with the access that they finally get, they, for example, will have a lower rate of success or even a higher rate of miscarriage,” said Ahmad, who was not involved in the new WHO report.

    “A lot of people don’t have access to clinically vetted evidence-based information around what causes infertility, how to recognize it, and then when you do find out that you have it, how to treat it,” she said. “The other, which is one of the biggest barriers that we see, is financial access to fertility. In the United States, a lot of that access comes through the employer providing, for example, fertility benefits, but on a global level, that’s not necessarily the case, and finances tends to be the biggest barrier.”

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  • WHO advisers to consider whether obesity medication should be added to Essential Medicines List | CNN

    WHO advisers to consider whether obesity medication should be added to Essential Medicines List | CNN



    CNN
     — 

    Advisers to the World Health Organization will consider next month whether to add liraglutide, the active ingredient in certain diabetes and obesity medications, to its list of essential medicines.

    The list, which is updated every two years, includes medicines “that satisfy the priority health needs of the population,” WHO says. “They are intended to be available within the context of function health systems at all times, in adequate amounts in the appropriate dosage forms, of assured quality and at prices that individuals and the community can afford.”

    The list is “a guide for the development and updating of national and institutional essential medicine lists to support the procurement and supply of medicines in the public sector, medicines reimbursement schemes, medicine donations, and local medicine production.”

    The WHO Expert Committee on the Selection and Use of Essential Medicines is scheduled to meet April 24-28 to discuss revisions and updates involving dozens of medications. The request to add GLP-1 receptor agonists such as liraglutide came from four researchers at US institutions including Yale University and Brigham and Women’s Hospital.

    These drugs mimic the effects of an appetite-regulating hormone, GLP-1, and stimulate the release of insulin. This helps lower blood sugar and slows the passage of food through the gut. Liraglutide was developed to treat diabetes but approved in the US as a weight-loss treatment in 2014; its more potent cousin, semaglutide, has been approved for diabetes since 2017 and as an obesity treatment in 2021.

    The latter use has become well-known thanks to promotions from celebrities and on social media. It’s sold under the name Ozempic for diabetes and Wegovy for weight loss. Studies suggest that semaglutide may help people lose an average of 10% to 15% of their starting weight – significantly more than with other medications. But because of this high demand, some versions of the medication have been in shortage in the US since the middle of last year.

    The US patent on liraglutide is set to expire this year, and drugmaker Novo Nordisk says generic versions could be available in June 2024.

    The company has not been involved in the application to WHO, it said in a statement, but “we welcome the WHO review and look forward to the readout and decision.”

    “At present, there are no medications included in the [Essential Medicines List] that specifically target weight loss for the global burden of obesity,” the researchers wrote in their request to WHO. “At this time, the EML includes mineral supplements for nutritional deficiencies yet it is also described that most of the population live in ‘countries where overweight and obesity kills more people than underweight.’ “

    WHO’s advisers will make recommendations on which drugs should be included in this year’s list, expected to come in September.

    “This particular drug has a certain history, but the use of it probably has not been long enough to be able to see it on the Essential Medicines List,” Dr. Francesco Blanca, WHO director for nutrition and food safety, said at a briefing Wednesday. “There’s also issues related to the cost of the treatment. At the same time, WHO is looking at the use of drugs to reduce weight excess in the context of a systematic review for guidelines for children and adolescents. So we believe that it is a work in progress, but we’ll see what the Essential Medicines List committee is going to conclude.”

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  • Five dead as Tanzania detects first-ever Marburg virus outbreak

    Five dead as Tanzania detects first-ever Marburg virus outbreak

    Three of the eight confirmed cases are receiving treatment even as 161 contacts are being monitored, according to the WHO.

    Tanzania has confirmed eight cases of Marburg, a high-death viral hemorrhagic fever with symptoms broadly similar to those of Ebola, in its first-ever outbreak, according to the World Health Organization (WHO).

    The WHO said in a late Tuesday statement that the confirmation by Tanzania’s national public laboratory followed the death of five people in the northwest Kagera region who developed symptoms, which include fever, vomiting, bleeding and renal failure.

    Among the dead was a health worker, WHO said. The three who survived were getting treatment, with 161 contacts being monitored.

    “The efforts by Tanzania’s health authorities to establish the cause of the disease is a clear indication of the determination to effectively respond to the outbreak,” said Matshidiso Moeti, WHO regional director for Africa.

    “We are working with the government to rapidly scale up control measures to halt the spread of the virus.”

    With a death rate of as high as 88 percent, Marburg is from the same virus family responsible for Ebola and is transmitted to people from fruit bats. It then spreads through contact with bodily fluids of infected people.

    The symptoms include high fever, severe headache and malaise which typically develop within seven days of infection, according to the WHO.

    Tanzania’s outbreak comes a month after Equatorial Guinea confirmed its first-ever outbreak of Marburg virus disease too. The WHO intensified surveillance in the Central African nation, deploying health emergency experts in epidemiology, case management, infection prevention, laboratory and risk communication to boost the country’s response.

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  • A Major Clue to COVID’s Origins Is Just Out of Reach

    A Major Clue to COVID’s Origins Is Just Out of Reach

    Updated at 2:45 p.m. on March 21, 2023

    Last week, the ongoing debate about COVID-19’s origins acquired a new plot twist. A French evolutionary biologist stumbled across a trove of genetic sequences extracted from swabs collected from surfaces at a wet market in Wuhan, China, shortly after the pandemic began; she and an international team of colleagues downloaded the data in hopes of understanding who—or what—might have ferried the virus into the venue. What they found, as The Atlantic first reported on Thursday, bolsters the case for the pandemic having purely natural roots: The genetic data suggest that live mammals illegally for sale at the Huanan Seafood Wholesale Market—among them, raccoon dogs, a foxlike species known to be susceptible to the virus—may have been carrying the coronavirus at the end of 2019.

    But what might otherwise have been a straightforward story on new evidence has rapidly morphed into a mystery centered on the origins debate’s data gaps. Within a day or so of nabbing the sequences off a database called GISAID, the researchers told me, they reached out to the Chinese scientists who had uploaded the data to share some preliminary results. The next day, public access to the sequences was locked—according to GISAID, at the request of the Chinese researchers, who had previously analyzed the data and drawn distinctly different conclusions about what they contained.

    Yesterday evening, the international team behind the new Huanan-market analysis released a report on its findings—but did not post the underlying data. The write-up confirms that genetic material from raccoon dogs and several other mammals was found in some of the same spots at the wet market, as were bits of SARS-CoV-2’s genome around the time the outbreak began. Some of that animal genetic material, which was collected just days or weeks after the market was shut down, appears to be RNA—a particularly fast-degrading molecule. That strongly suggests that the mammals were present at the market not long before the samples were collected, making them a plausible channel for the virus to travel on its way to us. “I think we’re moving toward more and more evidence that this was an animal spillover at the market,” says Ravindra Gupta, a virologist at the University of Cambridge, who was not involved in the new research. “A year and a half ago, my confidence in the animal origin was 80 percent, something like that. Now it’s 95 percent or above.”

    For now, the report is just that: a report, not yet formally reviewed by other scientists or even submitted for publication to the journal—and that will remain the case as long as this team continues to leave space for the researchers who originally collected the market samples, many of them based at the Chinese Center for Disease Control and Prevention, to prepare a paper of their own. And still missing are the raw sequence files that sparked the reanalysis in the first place—before vanishing from the public eye.


    Every researcher I asked emphasized just how important the release of that evidence is to the origins investigation: Without data, there’s no base-level proof—nothing for the broader scientific community to independently scrutinize to confirm or refute the international team’s results. Absent raw data, “some people will say that this isn’t real,” says Gigi Gronvall, a senior scholar at the Johns Hopkins Center for Health Security, who wasn’t involved in the new analysis. Data that flicker on and off publicly accessible parts of the internet also raise questions about other clues on the pandemic’s origins. Still more evidence might be out there, yet undisclosed.

    Transparency is always an essential facet of research, but all the more so when the stakes are so high. SARS-CoV-2 has already killed nearly 7 million people, at least, and saddled countless people with chronic illness; it will kill and debilitate many more in the decades to come. Every investigation into how it began to spread among humans must be “conducted as openly as possible,” says Sarah Cobey, an infectious-disease modeler at the University of Chicago, who wasn’t involved in the new analysis.

    The team behind the reanalysis still has copies of the genetic sequences its members downloaded earlier this month. But they’ve decided that they won’t be the ones to share them, several of them told me. For one, they don’t have sequences from the complete set of samples that the Chinese team collected in early 2020—just the fraction that they spotted and grabbed off GISAID. Even if they did have all of the data, the researchers contend that it’s not their place to post them publicly. That’s up to the China CDC team that originally collected and generated the data.

    Part of the international team’s reasoning is rooted in academic decorum. There isn’t a set-in-stone guidebook among scientists, but adhering to unofficial rules on etiquette smooths successful collaborations across disciplines and international borders—especially during a global crisis such as this one. Releasing someone else’s data, the product of another team’s hard work, is a faux pas. It risks misattribution of credit, and opens the door to the Chinese researchers’ findings getting scooped before they publish a high-profile paper in a prestigious journal. “It isn’t right to share the original authors’ data without their consent,” says Niema Moshiri, a computational biologist at UC San Diego and one of the authors of the new report. “They produced the data, so it’s their data to share with the world.”

    If the international team released what data it has, it could potentially stoke the fracas in other ways. The World Health Organization has publicly indicated that the data should come from the researchers who collected them first: On Friday, at a press briefing, Tedros Adhanom Ghebreyesus, the WHO’s director-general, admonished the Chinese researchers for keeping their data under wraps for so long, and called on them to release the sequences again. “These data could have and should have been shared three years ago,” he said. And the fact that it wasn’t is “disturbing,” given just how much it might have aided investigations early on, says Gregory Koblentz, a biodefense expert at George Mason University, who wasn’t involved in the new analysis.

    Publishing the current report has already gotten the researchers into trouble with GISAID, the database where they found the genetic sequences. During the pandemic, the database has been a crucial hub for researchers sharing viral genome data; founded to provide open access to avian influenza genomes, it is also where researchers from the China CDC published the first whole-genome sequences of SARS-CoV-2, back in January 2020. A few days after the researchers downloaded the sequences, they told me, several of them were contacted by a GISAID administrator who chastised them about not being sufficiently collaborative with the China CDC team and warned them against publishing a paper using the China CDC data. They were in danger, the email said, of violating the site’s terms of use and would risk getting their database access revoked. Distributing the data to any non-GISAID users—including the broader research community—would also be a breach.

    This morning, hours after the researchers released their report online, many of them found that they could no longer log in to GISAID—they received an error message when they input their username and password. “They may indeed be accusing us of having violated their terms,” Moshiri told me, though he can’t be sure. The ban was instated with absolutely no warning. Moshiri and his colleagues maintain that they did act in good faith and haven’t violated any of the database’s terms—that, contrary to GISAID’s accusations, they reached out multiple times with offers to collaborate with the China CDC, which has “thus far declined,” per the international team’s report.

    GISAID didn’t respond when I reached out about the data’s disappearing act, its emails to the international team, and the group-wide ban. But in a statement released shortly after I contacted the database—one that echoes language in the emails sent to researchers—GISAID doubled down on accusing the international team of violating its terms of use by posting “an analysis report in direct contravention of the terms they agreed to as a condition to accessing the data, and despite having knowledge that the data generators are undergoing peer review assessment of their own publication.”

    Maria Van Kerkhove, the WHO’s COVID-19 technical lead, told me that she’s learned that the China CDC researchers recently provided a fuller data set to GISAID—more complete than the one the international team downloaded earlier this month. “It’s ready to go,” she told me. GISAID just needs permission, she said, from the Chinese researchers to make the sequences publicly available. “I reach out to them every day, asking them for a status update,” she added, but she hasn’t yet heard back on a definitive timeline. In its statement, GISAID also “strongly” suggested “that the complete and updated dataset will be made available as soon as possible,” but gave no timeline. I asked Van Kerkhove if there was a hypothetical deadline for the China CDC team to restore access, at which point the international team might be asked to publicize the data instead. “This hypothetical deadline you’re talking about? We’re way past that,” she said, though she didn’t comment specifically on whether the international team would be asked to step in. “Data has been uploaded. It is available. It just needs to be accessible, immediately.”

    Why, exactly, the sequences were first made public only so recently, and why they have yet to reappear publicly, remain unclear. In a recent statement, the WHO said that access to the data was withdrawn “apparently to allow further data updates by China CDC” to its original analysis on the market samples, which went under review for publication at the journal Nature last week. There’s no clarity, however, on what will happen if the paper is not published at all. When I reached out to three of the Chinese researchers—George Gao, William Liu, and Guizhen Wu—to ask about their intentions for the data, I didn’t receive a response.

    “We want the data to come out more than anybody,” says Saskia Popescu, an infectious-disease epidemiologist at George Mason University and one of the authors on the new analysis. Until then, the international team will be fielding accusations, already flooding in, that it falsified its analyses and overstated its conclusions.


    Researchers around the world have been raising questions about these particular genetic sequences for at least a year. In February 2022, the Chinese researchers and their close collaborators released their analysis of the same market samples probed in the new report, as well as other bits of genetic data that haven’t yet been made public. But their interpretations deviate pretty drastically from the international team’s. The Chinese team contended that any shreds of virus found at the market had most likely been brought in by infected humans. “No animal host of SARS-CoV-2 can be deduced,” the researchers asserted at the time. Although the market had perhaps been an “amplifier” of the outbreak, their analysis read, “more work involving international coordination” would be needed to determine the “real origins of SARS-CoV-2.” When reached by Jon Cohen of Science magazine last week, Gao described the sequences that fleetingly appeared on GISAID as “[n]othing new. It had been known there was illegal animal dealing and this is why the market was immediately shut down.”

    There is, then, a clear divergence between the two reports. Gao’s assessment indicates that finding animal genetic material in the market swabs merely confirms that live mammals were being illegally traded at the venue prior to January 2020. The researchers behind the new report insist that the narrative can now go a step further—they suggest not just that the animals were there, but that the animals, several of which are already known to be vulnerable to SARS-CoV-2, were there, in parts of the market where the virus was also found. That proximity, coupled with the virus’s inability to persist without a viable host, points to the possibility of an existing infection among animals, which could spark several more.

    The Chinese researchers used this same logic of location—multiple types of genetic material pulled out of the same swab—to conclude that humans were carrying around the virus at Huanan. The reanalysis confirms that there probably were infected people at the market at some point before it closed. But they were unlikely to be the virus’s only chauffeurs: Across several samples, the amount of raccoon-dog genetic material dwarfs that of humans. At one stall in particular—located in the sector of the market where the most virus-positive swabs were found—the researchers discovered at least one sample that contained SARS-CoV-2 RNA, and was also overflowing with raccoon-dog genetic material, while containing very little DNA or RNA material matching the human genome. That same stall was photographically documented housing raccoon dogs in 2014. The case is not a slam dunk: No one has yet, for instance, identified a viral sample taken from a live animal that was swabbed at the market in 2019 before the venue was closed. Still, JHU’s Gronvall told me, the situation feels clearer than ever. “All of the science is pointed” in the direction of Huanan being the pandemic’s epicenter, she said.

    To further untangle the significance of the sequences will require—you guessed it—the now-vanished genetic data. Some researchers are still withholding their judgment on the significance of the new analysis, because they haven’t gotten their hands on the genetic sequences themselves. “That’s the whole scientific process,” Van Kerkhove told me: data transparency that allows analyses to be “done and redone.”

    Van Kerkhove and others are also wondering whether more data could yet emerge, given how long this particular set went unshared. “This is an indication to me in recent days that there is more data that exists,” she said. Which means that she and her colleagues haven’t yet gotten the fullest picture of the pandemic’s early days that they could—and that they won’t be able to deliver much of a verdict until more information emerges. The new analysis does bolster the case for market animals acting as a conduit for the virus between bats (SARS-CoV-2’s likeliest original host, based on several studies on this coronavirus and others) and people; it doesn’t, however, “tell us that the other hypotheses didn’t happen. We can’t remove any of them,” Van Kerkhove told me.

    More surveillance for the virus needs to be done in wild-animal populations, she said. Having the data from the market swabs could help with that, perhaps leading back to a population of mammals that might have caught the virus from bats or another intermediary in a particular part of China. At the same time, to further investigate the idea that SARS-CoV-2 first emerged out of a laboratory mishap, officials need to conduct intensive audits and investigations of virology laboratories in Wuhan and elsewhere. Last month, the U.S. Department of Energy ruled that such an accident was the likelier catalyst of the coronavirus outbreak than a natural spillover from wild animals to humans. The ruling echoed earlier judgments from the FBI and a Senate minority report. But it contrasted with the views of four other agencies, plus the National Intelligence Council, and it was made with “low confidence” and based on “new” evidence that has yet to be declassified.

    The longer the investigation into the virus’s origins drags on, and the more distant the autumn of 2019 grows in our rearview, “the harder it becomes,” Van Kerkhove told me. Many in the research community were surprised that new information from market samples collected in early 2020 emerged at all, three years later. Settling the squabbles over SARS-CoV-2 will be especially tough because the Huanan market was so swiftly shut down after the outbreak began, and the traded animals at the venue rapidly culled, says Angela Rasmussen, a virologist at the University of Saskatchewan and one of the researchers behind the new analysis. Raccoon dogs, one of the most prominent potential hosts to have emerged from the new analysis, are not even known to have been sampled live at the market. “That evidence is gone now,” if it ever existed, Koblentz, of George Mason University, told me. For months, Chinese officials were even adamant that no mammals were being illegally sold at the region’s wet markets at all.

    So researchers continue to work with what they have: swabs from surfaces that can, at the very least, point to a susceptible animal being in the right place, at the right time, with the virus potentially inside it. “Right now, to the best of my knowledge, this data is the only way that we can actually look,” Rasmussen told me. It may never be enough to fully settle this debate. But right now, the world doesn’t even know the extent of the evidence available—or what could, or should, still emerge.

    Katherine J. Wu

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  • Records may show double billing for some US-supported work done at Chinese research facilities

    Records may show double billing for some US-supported work done at Chinese research facilities

    Records may show double billing for some US-supported work done at Chinese research facilities – CBS News


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    CBS News has reviewed records that may show the U.S. government paid twice for aspects of projects carried out at a research lab in Wuhan and other facilities in China. Now USAID’s internal watchdog has opened a probe after receiving information from Republican Sen. Roger Marshall. Senior investigative correspondent Catherine Herridge reports. Editor’s note: Graphics in the video have been updated and the web version of this report has been updated to include a comment about our report by Peter Daszak of EcoHealth Alliance.

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  • Scientists parse another clue to possible origins of Covid-19 as WHO says all possibilities ‘remain on the table’ | CNN

    Scientists parse another clue to possible origins of Covid-19 as WHO says all possibilities ‘remain on the table’ | CNN



    CNN
     — 

    There’s a tantalizing new clue in the hunt for the origins of the Covid-19 pandemic.

    A new analysis of genetic material collected from January to March 2020 at the Huanan Seafood Market in Wuhan, China, has uncovered animal DNA in samples already known to be positive for SARS-CoV-2, the coronavirus that causes Covid-19. A significant amount of that DNA appears to belong to animals known as raccoon dogs, which were known to be traded at the market, according to officials with the World Health Organization, who addressed the new evidence in a news briefing on Friday.

    The connection to raccoon dogs came to light after Chinese researchers shared raw genetic sequences taken from swabbed specimens collected at the market early in the pandemic. The sequences were uploaded in late January 2023, to the data sharing site GISAID, but have recently been removed.

    An international team of researchers noticed them and downloaded them for further study, the WHO officials said Friday.

    The new findings – which have not yet been publicly posted – do not settle the question of how the pandemic started. They do not prove that raccoon dogs were infected with SARS-CoV-2, nor do they prove that raccoon dogs were the animals that first infected people.

    But because viruses don’t survive in the environment outside of their hosts for long, finding so much of the genetic material from the virus intermingled with genetic material from raccoon dogs is highly suggestive that they could have been carriers, according to scientists who worked on the analysis. The analysis was led by Kristian Andersen, an immunologist and microbiologist at Scripps Research; Edward Holmes, a virologist at the University of Sydney; Michael Worobey, an evolutionary biologist at the University of Arizona. These three scientists, who have been digging into the origins of the pandemic, were interviewed by reporters for The Atlantic magazine. CNN has reached out to Andersen, Holmes and Worobey for comment.

    The details of the international analysis were first reported Thursday by The Atlantic.

    The new data is emerging as Republicans in Congress have opened investigations into the pandemic’s origin. Previous studies provided evidence that the virus likely emerged naturally in market, but could not point to a specific origin. Some US agencies, including a recent US Department of Energy assessment, say the pandemic likely resulted from a lab leak in Wuhan.

    In the news briefing on Friday, WHO Director-General Tedros Adhanom Ghebreyesus said the organization was first made aware of the sequences on Sunday.

    “As soon as we became aware of this data, we contacted the Chinese CDC and urged them to share it with WHO and the international scientific community so it can be analyzed,” Tedros said.

    WHO also convened its Scientific Advisory Group for the Origins of the Novel Pathogens, known as SAGO, which has been investigating the roots of the pandemic, to discuss the data on Tuesday. The group heard from Chinese scientists who had originally studied the sequences, as well as the group of international scientists taking a fresh look at them.

    WHO experts said in the Friday briefing that the data are not conclusive. They still can’t say whether the virus leaked from a lab, or if it spilled over naturally from animals to humans.

    “These data do not provide a definitive answer to the question of how the pandemic began, but every piece of data is important in moving us closer to that answer,” Tedros said.

    What the sequences do prove, WHO officials said, is that China has more data that might relate to the origins of the pandemic that it has not yet shared with the rest of the world.

    “This data could have, and should have, been shared three years ago,” Tedros said. “We continue to call on China to be transparent in sharing data and to conduct the necessary investigations and share results.

    “Understanding how the pandemic began remains a moral and scientific imperative.”

    CNN has reached out to the Chinese scientists who first analyzed and shared the data, but has not received a reply.

    The Chinese researchers, who are affiliated with that country’s Center for Disease Control and Prevention, had shared their own analysis of the samples in 2022. In that preprint study posted last year, they concluded that “no animal host of SARS-CoV2 can be deduced.”

    The research looked at 923 environmental samples taken from within the seafood market and 457 samples taken from animals, and found 63 environmental samples that were positive for the virus that causes Covid-19. Most were taken from the western end of the market. None of the animal samples, which were taken from refrigerated and frozen products for sale, and from live, stray animals roaming the market, were positive, the Chinese authors wrote in 2022.

    When they looked at the different species of DNA represented in the environmental samples, the Chinese authors only saw a link to humans, but not other animals.

    When an international team of researchers recently took at fresh look at the genetic material in the samples – which were swabbed in and around the stalls of the market – using an advanced genetic technique called metagenomics, scientists said they were surprised to find a significant amount of DNA belonging to raccoon dogs, a small animal related to foxes. Raccoon dogs can be infected with the virus that causes Covid-19 and have been high on the list of suspected animal hosts for the virus.

    “What they found is molecular evidence that animals were sold at that market. That was suspected, but they found molecular evidence of that. And also that some of the animals that were there were susceptible to SARS-CoV2 infection, and some of those animals include raccoon dogs,” said Maria Van Kerkhove, WHO’s technical lead for Covid-19, in Friday’s briefing.

    “This doesn’t change our approach to studying the origins of Covid-19. It just tells us that more data exists, and that data needs to be shared in full,” she said.

    Van Kerkhove said that until the international scientific community is able to review more evidence, “all hypotheses remain on the table.”

    Some experts found the new evidence persuasive, if not completely convincing, of an origin in the market.

    “The data does point even further to a market origin,” Andersen, the Scripps Research evolutionary biologist who attended the WHO meeting and is one of the scientists analyzing the new data, told the magazine Science.

    The assertions made over the new data quickly sparked debate in the scientific community.

    Francois Balloux, director of the Genetics Institute at University College London, said the fact that the new analysis had not yet been publicly posted for scientists to scrutinize, but had come to light in news reports, warranted caution.

    “Such articles really don’t help as they only polarise the debate further,” Balloux posted in a thread on Twitter. “Those convinced by a zoonotic origin will read it as final proof for their conviction, and those convinced it was a lab leak will interpret the weakness of the evidence as attempts of a cover-up.”

    Other experts, who were not involved in the analysis, said the data could be key to showing the virus had a natural origin.

    Felicia Goodrum is an immunobiologist at the University of Arizona, who recently published a review of all available data for the various theories behind the pandemic’s origin.

    Goodrum says the strongest proof for a natural spillover would be to isolate the virus that causes Covid-19 from an animal that was present in the market in 2019.

    “Clearly, that is impossible, as we cannot go back in time any more than we have through sequencing, and no animals were present at the time sequences could be collected. To me, this is the next best thing,” Goodrum said in an email to CNN.

    In the WHO briefing, Van Kerkhove said that the Chinese CDC researchers had uploaded the sequences to GISAID as they were updating their original research. She said their first paper is in the process of being updated and resubmitted for publication.

    “We have been told by GISAID that the data from China’s CDC is being updated and expanded,” she said.

    Van Kerkhove said on Friday that what WHO would like to be able to do is to find the source of where the animals came from. Were they wild? Were they farmed?

    She said in the course of its investigation into the pandemic’s origins, WHO had repeatedly asked China for studies to trace the animals back to their source farms. She said WHO had also asked for blood tests on people who worked in the market, as well as tests on animals that may have come from the farms.

    “Share the data,” Dr. Mike Ryan, executive director of WHO’s health emergencies program, said Friday, addressing scientists around the world who might have relevant information. “Let science do the work, and we will get the answers.”

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  • US agency assessment backing Covid lab leak theory raises more questions than answers — and backlash from China | CNN

    US agency assessment backing Covid lab leak theory raises more questions than answers — and backlash from China | CNN

    Editor’s Note: A version of this story appeared in CNN’s Meanwhile in China newsletter, a three-times-a-week update exploring what you need to know about the country’s rise and how it impacts the world. Sign up here.


    Hong Kong
    CNN
     — 

    The US Department of Energy’s assessment that Covid-19 most likely emerged due to a laboratory accident in China has reignited fierce debate and attention on the question of how the pandemic began.

    But the “low confidence” determination, made in a newly updated classified report, has raised more questions than answers, as the department has publicly provided no new evidence to back the claim. It’s also generated fierce pushback from China.

    “We urge the US to respect science and facts, stop politicizing this issue, stop its intelligence-led, politics-driven origins-tracing,” a Chinese Foreign Ministry spokesperson said on Wednesday.

    The Department of Energy assessment is part of a broader US effort in which intelligence agencies were asked by President Joe Biden in 2021 to examine the origins of the coronavirus, which was first detected in the Chinese city of Wuhan.

    That overall assessment from the intelligence community was inconclusive, and then, as now, there has yet to be a decisive link established between the virus and a specific animal or other route – as China continues to stonewall international investigations into the origins of the virus.

    Four agencies and the National Intelligence Council assessed with low confidence that the virus likely jumped from animals to humans through natural exposure, while one assessed with moderate confidence that the pandemic was the result of a laboratory-related accident. Three other intelligence community elements were unable to coalesce around either explanation without additional information, according to a declassified version of the 2021 report.

    The majority of agencies remain undecided or lean toward the virus having a natural origin – a hypothesis also widely favored by scientists with expertize in the field. But the change from the US Department of Energy has now deepened the split in the intelligence community, especially as the director of the FBI this week commented publicly for the first time on his agency’s similar determination made with “medium confidence.”

    Intelligence agencies can make assessments with either low, medium or high confidence. A low confidence assessment generally means the information obtained is not reliable enough, or is too fragmented to make a more definitive judgment.

    And while the assessment and new commentary has pulled the theory back into the spotlight, neither agency has released evidence or information backing their determinations. That raises crucial questions about their basis – and shines the spotlight back on gaping, outstanding unknowns and need for further research.

    Hear FBI director remark on Covid lab leak theory

    Scientists largely believe the virus most likely emerged from a natural spillover from an infected animal to people, as many viruses before it, though they widely acknowledge the need for more research of all options. Many have also questioned the lack of data released to substantiate the latest claim.

    Virologist Thea Fischer, who in 2021 traveled to Wuhan as part of a World Health Organization (WHO) origins probe and remains a part of ongoing WHO tracing efforts, said it was “very important” that any new assessments related to the origin of the virus are documented by evidence.

    “(These are) strong accusations against a public research laboratory in China and can’t stand alone without substantial evidence,” said Fischer, a professor at the University of Copenhagen.

    “Hopefully they will share with the WHO soon so the evidence can be known and assessed by international health experts just as all other evidence concerning the pandemic origin.”

    A senior US intelligence official told the Wall Street Journal, which first reported the new Department of Energy assessment, that the update to the assessment was conducted in light of new intelligence, further study of academic literature and in consultation with experts outside government.

    The idea that the virus could have emerged from a lab accident became more prominent as a spotlight was turned on coronavirus research being done at local facilities, such as the Wuhan Institute of Virology. It was further enhanced amid a failure to find a “smoking gun” showing which animal could have passed the virus to people at Wuhan’s Huanan Seafood Wholesale Market – the location linked to a number of early known cases – amid limitations to follow-up research.

    Some experts who have been closely involved in examining existing information, however, are skeptical of the new assessment giving the theory more weight.

    “Given that so much of the data we have points to a spillover event occurring at the Huanan market in late 2019 I doubt there’s anything very significant in it or new information that would change our current understanding,” said David Robertson, a professor in the University of Glasgow’s School of Infection and Immunity, who was involved in recent research with findings that supported the natural origin theory.

    He noted that locations of early human cases centered on the market, positive environmental samples, and confirmation that live animals susceptible to the virus were for sale there are among evidence supporting the natural origins theory – while there’s no data supporting a lab leak.

    “The extent of this evidence continually gets lost (in media discussion) … when in fact we know a lot about what happened, and arguably more than other outbreaks,” he said.

    Security personnel stand guard outside the Wuhan Institute of Virology in Wuhan as members of the World Health Organization (WHO) team investigating the origins of the Covid-19 coronavirus make a visit on February 3, 2021.

    Efforts to understand how the pandemic started have been further complicated by China’s lack of transparency – especially as the origin question spiraled into another point of bitter contention within rising US-China tensions of recent years.

    Beijing has blocked robust, long-term international field investigations and refused to allow a laboratory audit, which could bring clarity, and been reticent to share details and data around domestic research to uncover the cause. However, it repeatedly maintains that it has been transparent and cooperative with the WHO.

    Chinese officials carefully controlled the single WHO-backed investigation it did allow on the ground in 2021, citing disease control measures to restrict visiting experts to their hotel rooms for half their trip and to prevent them from sharing meals with their Chinese counterparts – cutting off an opportunity for more informal information sharing.

    Citing data protection, Beijing has also declined to allow its own investigatory measures, like testing stored blood samples from Wuhan or combing through hospital data for potential “patient zeros,” to be verified by researchers outside the country.

    China has fiercely denied that the virus emerged from a lab accident, and has repeatedly tried to assert it could have arrived in the country for the initial outbreak from elsewhere – including a US laboratory, without offering any evidence supporting the claim.

    But a top WHO official as recently as last month publicly called for “more cooperation and collaboration with our colleagues in China to advance studies that need to take place in China”– including studies of markets and farms that could have been involved.

    “These studies need to be conducted in China and we need cooperation from our colleagues there to advance our understandings,” WHO technical lead for Covid-19 Maria Van Kerkhove said at a media briefing.

    When asked about the Department of Energy assessment by CNN, a WHO representative said the organization and its origins tracing advisory body “will keep examining all available scientific evidence that would help us advance the knowledge on the origin of SARS CoV 2 and we call on China and the scientific community to undertake necessary studies in that direction.”

    “Until we have more evidence all hypotheses are still on the table,” the representative said.

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  • We Have a Mink Problem

    We Have a Mink Problem

    Bird flu, at this point, is somewhat of a misnomer. The virus, which primarily infects birds, is circulating uncontrolled around much of the world, devastating not just birds but wide swaths of the animal kingdom. Foxes, bobcats, and pigs have fallen ill. Grizzly bears have gone blind. Sea creatures, including seals and sea lions, have died in great numbers.

    But none of the sickened animals has raised as much concern as mink. In October, a bird-flu outbreak erupted at a Spanish mink farm, killing thousands of the animals before the rest were culled. It later became clear that the virus had spread between the animals, picking up a mutation that helped it thrive in mammals. It was likely the first time that mammal-to-mammal spread drove a huge outbreak of bird flu. Because mink are known to spread certain viruses to humans, the fear was that the disease could jump from mink to people. No humans got sick from the outbreak in Spain, but other infections have spread from mink to humans before: In 2020, COVID outbreaks on Danish mink farms led to new mink-related variants that spread to a small number of humans.

    As mammals ourselves, we have good reason to be concerned. Outbreaks on crowded mink farms are an ideal scenario for bird flu to mutate. If, in doing so, it picks up the ability to spread between humans, it could potentially start another global pandemic. “There are many reasons to be concerned about mink,” Tom Peacock, a flu researcher at Imperial College London, told me. Right now, mink are a problem we can’t afford to ignore.

    For two animals with very different body types, mink and humans have some unusual similarities. Research suggests that we share similar receptors for COVID, bird flu, and human flu, through which these viruses can gain entry into our bodies. The numerous COVID outbreaks on mink farms during the early pandemic, and the bird-flu outbreak in Spain, gravely illustrate this point. It’s “not surprising” that mink can get these respiratory diseases, James Lowe, a veterinary-medicine professor at the University of Illinois at Urbana-Champaign, told me. Mink are closely related to ferrets, which are so well known for their susceptibility to human flu that they’re the go-to model for flu research.

    Mink wouldn’t get sick as often, and wouldn’t be as big an issue for humans, if we didn’t keep farming them for fur in the perfect conditions for outbreaks. Many barns used to raise mink are partially open-air, making it easy for infected wild birds to come in contact with the animals, sharing not only air but potentially food. Mink farms are also notoriously cramped: The Spanish farm, for example, kept tens of thousands of mink in about 30 barns. Viral transmission would be all but guaranteed in those conditions, but the animals are especially vulnerable. Because mink are normally solitary creatures, they face significant stress in packed barns, which may further predispose them to disease, Angela Bosco-Lauth, a biomedical-sciences professor at Colorado State University, told me. And because they’re often inbred so their coats look alike, an entire population may share a similar genetic susceptibility to disease. The frequency of outbreaks among mink, Bosco-Lauth said, “may actually have less to do with the animals and more to do with the fact that we raise them in the same way … we would an intensive cattle farm or chickens.”

    So far, there’s no evidence that mink from the Spanish farm spread bird flu to humans: None of the workers tested positive for the virus, and since then, no other mink farms have reported outbreaks. “We’re just not very susceptible” to bird flu, Lowe said. Our bird-flu receptors are tucked deep in our lungs, but when we’re exposed, most of the virus gets caught in the nose, throat, and other parts of the upper respiratory tract. This is why bird-flu infection is less common in people but is often pneumonia-level severe when it does happen. Indeed, a few humans have gotten sick and died from bird flu in the 27 years that the current strain of bird flu, known as H5N1, has circulated. This month, a girl in Cambodia died from the virus after potentially encountering a sick bird. The more virus circulating in an environment, the higher the chances a person will get infected. “It’s a dose thing,” Lowe said.

    But our susceptibility to bird flu could change. Another mink outbreak would give the virus more opportunities to keep mutating. The worry is that this could create a new variant that’s better at binding to the human flu receptors in our upper respiratory tract, Stephanie Seifert, a professor at Washington State University who studies zoonotic pathogens, told me. If the virus gains the ability to infect the nose and throat, Peacock, at Imperial College London, said, it would be better at spreading. Those mutations “would worry us the most.” Fortunately, the mutations that arose on the Spanish mink farm “were not as bad as many of us worried about,” he added, “but that doesn’t mean that the next time this happens, this will also be the case.”

    Because mink carry the receptors for both bird flu and human flu, they could serve as “mixing vessels” for the viruses to combine, researchers wrote in 2021. (Ferrets, pigs, and humans share this quality too.) Through a process called reassortment, flu viruses can swap segments of their genome, resulting in a kind of Frankenstein pathogen. Although viruses remixed in this way aren’t necessarily more dangerous, they could be, and that’s not a risk worth taking. “The previous three influenza pandemics all arose due to mixing between avian and human influenza viruses,” Peacock said.

    While there are good reasons to be concerned about mink, it is hard to gauge just how concerned we should be—especially given what we still don’t know about this changing virus. After the death of the young girl in Cambodia, the World Health Organization called the global bird flu situation “worrying,” while the CDC maintains that the risk to the public is low. Lowe said “it’s certainly not very risky” that bird flu will spill over into humans, but is worth keeping an eye on. H5N1 bird flu is not new, he added, and it hasn’t affected people en masse yet. But the virus has already changed in ways that make it better at infecting wild birds, and as it spreads in the wild, it may continue to change to better infect mammals, including humans. “We don’t understand enough to make strong predictions of public-health risk,” Jonathan Runstadler, an infectious-diseases professor at Tufts University, told me.

    As bird flu continues to spread among birds and in domestic and wild animal populations, it will only become harder to control. The virus, formally seasonal, is already present year-round in parts of Europe and Asia, and it is poised to do the same in the Americas. Breaking the chain of transmission is vital to preventing another pandemic. An important step is to avoid situations where humans, mink, or any other animal could be infected with both human and bird flu at the same time.

    Since the COVID outbreaks, mink farms have generally beefed up their biosecurity: Farm workers are often required to wear masks and protective gear, such as disposable overalls. To limit the risk to mink—and other susceptible hosts—farms need to reduce their size and density, reduce contact between mink and wild birds, and monitor the virus, Runstadler said. Some nations, including Mexico, Ecuador, have recently embraced bird-flu vaccines for poultry in light of the outbreaks. H5N1 vaccines are also available for humans, though they aren’t readily available.  Still, one of the most obvious options is to shut mink farms down. “We probably should have done that after SARS-CoV-2,” Bosco-Lauth, at Colorado State, said. Doing so is controversial, however, because the global mink industry is valuable, with a huge market in China. Denmark, which produces up to 40 percent of the world’s mink pelts, temporarily banned mink breeding in 2020 after a spate of COVID outbreaks, but the ban expired last month, and farms are returning, albeit in a limited capacity.

    But mink  are far from the only animal that poses a bird-flu risk to humans. “Frankly, with what we’re seeing with other wildlife species, there really aren’t any mammals that I would discount at this point in time,” Bosco-Lauth said. Any mammal species repeatedly infected by the virus is a potential risk, including marine mammals, such as seals. But we should be most concerned about the ones humans frequently come into close contact with, especially animals that are raised in high density, such as pigs, Runstadler said. This doesn’t pose just a human public-health concern, he said, but the potential for “ecological disruption.” Bird flu can be a devastating disease for wildlife, killing animals swiftly and without mercy.

    Whether bird flu makes the jump into humans, it isn’t the last virus that will threaten us—or mink. The era we live in has become known as the “Pandemicene,” as my colleague Ed Yong has called it, one defined by the regular spillover of viruses into humans, caused by our disruption of the normal trajectories of viral movement in nature. Mink may never pass bird flu to us. But that doesn’t mean they won’t be a risk the next time a novel influenza or coronavirus comes around. Doing nothing about mink essentially means choosing luck as a public-health strategy. Sooner or later, it will run out.

    Yasmin Tayag

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  • The Lab Leak Will Haunt Us Forever

    The Lab Leak Will Haunt Us Forever

    The lab-leak theory lives! Or better put: It never dies. In response to new but unspecified intelligence, the U.S. Department of Energy has changed its assessment of COVID-19’s origins: The agency, which had previously been undecided on the matter, now rates a laboratory mishap ahead of a natural spillover event as the suspected starting point. That conclusion, first reported over the weekend by The Wall Street Journal, matches up with findings from the FBI, and also a Senate Minority report out last fall that called the pandemic, “more likely than not, the result of a research-related incident.”

    Then again, the new assessment does not match up with findings from elsewhere in the federal government. In mid-2021, when President Biden asked the U.S. intelligence community for a 90-day review of the pandemic’s origins, the response came back divided: Four agencies, plus the National Intelligence Council, guessed that COVID started (as nearly all pandemics do) with a natural exposure to an infected animal; three agencies couldn’t decide on an answer; and one blamed a laboratory accident. DOE’s revision, revealed this week, means that a single undecided vote has flipped into the lab-leak camp. If you’re keeping count—and, really, what else can one do?—the matter still appears to be decided in favor of a zoonotic origin, by an updated score of 5 to 2. The lab-leak theory remains the outlier position.

    Are we done? No, we aren’t done. None of these assessments carries much conviction: Only one, from the FBI, was made with “moderate” confidence; the rest are rated “low,” as in, hmm we’re not so sure. This lack of confidence—as compared with the overbearing certainty of the scientists and journalists who rejected the possibility of a lab leak in 2020—will now be fodder for what could be months of Congressional hearings, as House Republicans pursue evidence of a possible “cover-up.” But for all the Sturm und Drang that’s sure to come, the fundamental state of knowledge on COVID’s origins remains more or less unchanged from where it was a year ago. The story of a market origin matches up with recent history and an array of well-established facts. But the lab-leak theory also fits in certain ways, and—at least for now—it cannot be ruled out. Putting all of this another way: ¯_(ツ)_/¯.

    That’s not to say that it’s a toss-up. All of the agencies agree, for instance, that SARS-CoV-2 was not devised on purpose, as a weapon. And several bits of evidence have come to light since Biden ordered his review—most notably, a careful plot of early cases from Wuhan, China, that stamps the city’s Huanan market complex as the outbreak’s epicenter. Many scientists with relevant knowledge believe that COVID started in that market—but their certainty can waver. In that sense, the consensus on COVID’s origins feels somewhat different from the one on humans’ role in global warming, though the two have been pointedly compared. Climate experts almost all agree, and they also feel quite sure of their position.

    The central ambiguity, such as it is, of COVID’s origin remains intact and perched atop a pair of improbable-seeming coincidences: One concerns the Huanan market, and the other has to do with the Wuhan Institute of Virology, where Chinese researchers have specialized in the study of bat coronaviruses. If COVID really started in the lab, one position holds, then it would have to be a pretty amazing coincidence that so many of the earliest infections happened to emerge in and around a venue for the sale of live, wild animals … which happens to be the exact sort of place where the first SARS-coronavirus pandemic may have started 20 years ago. But also: If COVID really started in a live-animal market, then it would have to be a similarly amazing coincidence that the market in question happened to be across the river from the laboratory of the world’s leading bat-coronavirus researcher … who happened to be running experiments that could, in theory, make coronaviruses more dangerous.

    One might argue over which of these coincidences is really more surprising; indeed, that’s been the major substance of this debate since 2020, and the source of endless rancor. In theory, further studies and investigations would help resolve some of this uncertainty—but these may never end up happening. A formal inquiry into the pandemic’s origin, set up by the World Health Organization, had intended to revisit its claim from early 2021 that a laboratory source was “extremely unlikely.” Now that project has been shelved in the face of Chinese opposition, and the Wuhan Institute of Virology has long since stopped responding to requests for information from its U.S.-based research partners and the NIH, according to an inspector general’s report from the Department of Health and Human Services.

    In the meantime, the smattering of facts that have been introduced into the lab-leak debates over the past two years, have been, at times, maddeningly opaque—like the unnamed, “new intelligence” that swayed the Department of Energy. (For the record, The New York Times reports that each of the agencies investigating the pandemic’s origin had access to this same intelligence; only DOE changed its assessment to favor the lab-leak explanation as a result.) We’re only told that certain fresh and classified information has changed the minds of some (but only some) unnamed analysts who now believe (with limited assurance) that a laboratory origin is most likely. Well, great, I guess that settles it.

    When more specific information does crop up, it tends to vary in the telling over time; or else it’s promptly pulverized by its partisan opponents. The Journal’s reporting, for instance, mentions a finding by U.S. intelligence that three researchers at the Wuhan Institute of Virology became ill in November 2019, in what could have been the initial cluster of infection. But how much is really known about those sickened scientists? The specifics vary with the source. In one telling, a researcher’s wife was sickened, too, and died from the infection. Another adds the seemingly important fact that the researchers were “connected with gain-of-function research on coronaviruses.” But the unnamed current and former U.S. officials who pass along this sort of information can’t even seem to settle on its credibility.

    Or consider the reporting, published last October by ProPublica and Vanity Fair, on a flurry of Chinese Community Party communications from the fall of 2019. These were interpreted by Senate researcher Toy Reid to mean that the Wuhan Institute of Virology had undergone a major biosafety crisis that November—just when the COVID outbreak would have been emerging. Critics ridiculed the story, calling it a “train wreck” premised on a bad translation. In response ProPublica asked three more translators to verify Reid’s reading, and claimed they “all agreed that his version was a plausible way to represent the passage,” and that the wording was ambiguous.

    Maybe this is just what happens when you’re trapped inside an information vacuum: Any scrap of data that happens to float by will push you off in new directions.

    Daniel Engber

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  • Department of Energy finds COVID Wuhan lab leak theory

    Department of Energy finds COVID Wuhan lab leak theory

    Department of Energy finds COVID Wuhan lab leak theory “plausible” but with “low confidence” – CBS News


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    A new classified report by the U.S. Energy Department has concluded with “low confidence” that it is plausible the COVID-19 pandemic originated from a laboratory leak. The World Health Organization recently shuttered it’s COVID-19 probe because of the Chinese government’s lack of cooperation, making it even harder to determine the origin or how to prevent a future pandemic. Catherine Herridge reports.

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  • US energy dept says COVID probably came from a lab leak

    US energy dept says COVID probably came from a lab leak

    Investigations into the origins of a virus that has now killed nearly 7 million people have been hampered by politics and a lack of access and transparency.

    COVID-19 was probably the result of a leak from a laboratory, according to a newly updated classified report from the United States Department of Energy obtained by the Wall Street Journal newspaper.

    The new coronavirus — SARS-CoV-2 — first emerged in the central Chinese city of Wuhan in late 2019 and quickly spread around the world, so far killing nearly 7 million people. It also created turmoil in the global economy as countries closed borders and ordered lockdowns to try and curb the spread of a virus against which there were, initially, no effective vaccines.

    The judgement for the latest classified report arose out of new intelligence and was made with “low confidence”, the Journal reported on Sunday. The energy department oversees a network of US laboratories, including some that undertake advanced biological research.

    The latest findings suggest a change in the view of the US energy department, which said previously it was undecided on how the virus emerged. The officials declined to elaborate on the intelligence that had prompted the department to change its position. It now joins the Federal Bureau of Investigation (FBI) in saying the virus probably spread after a mishap at a laboratory, a conclusion the FBI reached in 2021 with “moderate confidence”.

    Four US intelligence agencies believe with “low confidence” that COVID-19 took place through natural transmission, while two others remain undecided, the Journal added.

    Despite the agencies’ differing analyses, the update reaffirmed an existing consensus that COVID-19 was not the result of a Chinese biological weapons programme, the people who had read the classified report told the newspaper.

    The report, extending to five pages, was prepared for the White House and members of Congress, the Journal said.

    White House National Security Adviser Jake Sullivan said there were still a “variety of views” on the issue.

    Speaking on CNN on Sunday, he stressed US President Joe Biden had repeatedly asked the intelligence community to invest in trying to find out as much as possible about how the pandemic started.

    “President Biden specifically requested that the national labs, which are part of the Energy Department, be brought into this assessment because he wants to put every tool at use to be able to figure out what happened here,” Sullivan said.

    In mid-February, the World Health Organisation (WHO) promised to do everything possible “until we get the answer” on the origins of the virus, denying a report that suggested the agency had abandoned its investigation.

    After much delay, a WHO team travelled to Wuhan, China, in early 2021 to visit the Huanan market where the first cluster of cases emerged and which was closed and cleaned soon after the virus began to spread. Working alongside Chinese scientists, they also visited the Wuhan Institute of Virology, a biosecurity lab where researchers had been working on bats.

    The investigation faced criticism for lacking transparency and access, and for not sufficiently evaluating the lab-leak theory, which it deemed “extremely unlikely”. It said the most likely explanation was that the virus originated in a bat before crossing to an intermediary animal and making the jump to humans.

    China has accused the US of politicising the investigation and for ‘scapegoating’ the country after former US President Donald Trump dubbed SARS-CoV-2 virus, which causes COVID-19, the “Chinese virus”.

    Finding the origins of the SARS-CoV-2 virus is seen as crucial in order to better fight or even prevent another pandemic.

    WHO chief Tedros Adhanom Ghebreyesus has insisted that all hypotheses remain on the table and called on China to provide further access to investigate.

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  • Turkey rescuers say voices are still being heard under the rubble | CNN

    Turkey rescuers say voices are still being heard under the rubble | CNN



    CNN
     — 

    Rescue teams in southern Turkey say they are still hearing voices from under the rubble more than a week after a devastating 7.8 magnitude earthquake, offering a glimmer of hope of finding more survivors.

    Live images broadcast on CNN affiliate CNN Turk showed rescuers working in two areas of the Kahramanmaras region, where they were trying to save three sisters believed to be buried under the debris.

    In the same region, emergency workers saved a 35-year-old woman who was believed to have been buried for around 205 hours, according to state broadcaster TRT Haber.

    Two brothers – 17-year-old Muhammed Enes Yeninar and 21-year-old brother Abdulbaki Yennir – were also pulled from collapsed buildings on Tuesday, the broadcaster also reported. Further east, in the city of Adiyaman, rescuers pulled an 18-year-old boy and a man alive from the rubble, while Ukraine’s rescue team pulled a woman alive out of the rubble in the southern province of Hatay, according to CNN Turk.

    Eight days after the tremor and its violent aftershocks, more than 41,200 people have been confirmed dead across Turkey and Syria, and survival stories are becoming few and far between.

    UNICEF said it fears that even without verified numbers, it is “tragically clear” that the number of children killed following the quake “will continue to grow.”

    James Elder, a spokesman for the United Nations children’s agency, said 4.6 million children live in the 10 Turkish provinces hit by the disaster, while in Syria, 2.5 million children have been affected.

    A woman sits on the rubble of her destroyed house on Tuesday in Kahramanmaras, Turkey.

    Earthquake victims injured in Kahramanmaras arrive at Ataturk Airport by military cargo plane of Turkish Armed Forces for further medical treatment in Istanbul, Turkey on February 14, 2023.

    As rescue operations start to shift to recovery efforts, UN workers are racing to funnel aid to survivors in Syria through two new border crossings approved by the government in Damascus.

    The United Nations welcomed Syrian President Bashar al-Assad’s decision on Monday to open “the two crossing points of Bab Al-Salam and Al Ra’ee” between Turkey and northwest Syria “for an initial period of three months to allow for the timely delivery of humanitarian aid.”

    Eleven trucks with UN aid crossed into northwest Syria via the Bab Al-Salam passage on Tuesday, UN aid chief Martin Griffiths tweeted, adding that 26 more trucks passed into the region via the Bab Al-Hawa crossing.

    The news came after UN Secretary-General Antonio Guterres said Tuesday the two new border crossings that will take aid inside Syria from Turkey “are open and goods are flowing.”

    Guterres emphasized that human suffering from this natural disaster should not be made worse by manmade obstacles such as access, funding and supplies.

    The UN is launching a $397 million humanitarian appeal for victims of the earthquake in Syria for three months and finalizing a similar appeal for survivors in Turkey, Guterres announced.

    International aid has been slow to arrive in rebel-held areas in northern and northwestern Syria. The situation has been complicated by years of conflict and an already existing humanitarian crisis that has led to further difficulties for survivors who lack food, shelter and medicine as they battle freezing winter conditions.

    Syrian Foreign Minister Faisal Mekdad said last week that any aid the country receives must go through the capital Damascus. But many Western nations have been reluctant to lift sanctions despite requests from Assad, as the measures were placed on his regime after it led a brutal campaign in which hundreds of thousands of civilians have been killed during the years-long civil war.

    Also on Tuesday, a Saudi Arabian plane carrying 35 tons of food, medical aid and shelter landed at Aleppo International Airport, in what is the first shipment of aid from the kingdom to government-held territory since the February 6 earthquake, Syrian state media reported.

    Two more planes of aid are scheduled to arrive in Syria on Wednesday and Thursday, according to Faleh al-Subei, the head of the aid department at the King Salman Humanitarian Aid and Relief Center.

    Meanwhile, Turkey’s Vice President Fuat Oktay has denied reports of food and aid shortages. There were “no problems with feeding the public” and “millions of blankets are being sent to all areas,” he said on live television.

    Turkey’s Foreign Ministry said more than 9,200 foreign personnel are taking part in the country’s search and rescue operations, while 100 countries have offered help so far.

    Syrians pictured in the northwestern province of Idlib on Monday dig graves for their relatives who died as a result of last week's deadly disaster.

    People displaced by the earthquake take refuge in shelters and temporary camps on the outskirts of Jenderes, northwest Syria, on Monday.

    On Monday, UN aid chief Griffiths said the rescue phase of the response was “coming to a close” during a visit to the northern Syrian city of Aleppo.

    “And now the humanitarian phase, the urgency of providing shelter, psychosocial care, food, schooling, and a sense of the future for these people, that’s our obligation now,” he said.

    After announcing an end to their search and rescue operation last week, the “White Helmets” group, officially known as Syria Civil Defense, on Monday declared a seven-day mourning period in rebel-controlled areas in the north of the country.

    The World Health Organization (WHO) stressed the need to “focus on trauma rehabilitation” when treating populations stricken by the devastating disaster.

    The WHO’s Turkey Representative Batyr Berdyklychev highlighted the “growing problem” of a “traumatized population,” forecasting the need for psychological and mental health services in the affected regions.

    “People only now start realizing what happened to them after this shock period,” Berdyklychev said while speaking at a media briefing from the Turkish city of Adana on Tuesday.

    The WHO is negotiating with Turkish authorities to make sure quake survivors can access mental health services, Berdyklychev added, noting that many people displaced by the quake to other areas of Turkey “will also need to be reached.”

    WHO Regional Director for Europe, Hans Kluge told the briefing that the “immediate priority” for the 22 emergency medical teams deployed by the WHO to Turkey is “working particularly to deal with the high number of trauma patients and catastrophic injuries.”

    CORRECTION: This story has been updated to clarify where the 18-year-old boy and a man were rescued, which was in the city of Adiyaman.

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  • The Future of Long COVID

    The Future of Long COVID

    In the early spring of 2020, the condition we now call long COVID didn’t have a name, much less a large community of patient advocates. For the most part, clinicians dismissed its symptoms, and researchers focused on SARS-CoV-2 infections’ short-term effects. Now, as the pandemic approaches the end of its third winter in the Northern Hemisphere, the chronic toll of the coronavirus is much more familiar. Long COVID has been acknowledged by prominent experts, national leaders, and the World Health Organization; the National Institutes of Health has set up a billion-dollar research program to understand how and in whom its symptoms unfurl. Hundreds of long-COVID clinics now freckle the American landscape, offering services in nearly every state; and recent data hint that well-vetted drugs to treat or prevent long COVID may someday be widespread. Long COVID and the people battling it are commanding more respect, says Hannah Davis, a co-founder of the Patient-Led Research Collaborative, who has had long COVID for nearly three years: Finally, many people “seem willing to understand.”

    But for all the ground that’s been gained, the road ahead is arduous. Long COVID still lacks a universal clinical definition and a standard diagnosis protocol; there’s no consensus on its prevalence, or even what symptoms fall under its purview. Although experts now agree that long COVID does not refer to a single illness, but rather is an umbrella term, like cancer, they disagree on the number of subtypes that fall within it and how, exactly, each might manifest. Some risk factors—among them, a COVID hospitalization, female sex, and certain preexisting medical conditions—have been identified, but researchers are still trying to identify others amid fluctuating population immunity and the endless slog of viral variants. And for people who have long COVID now, or might develop it soon, the interventions are still scant. To this day, “when someone asks me, ‘How can I not get long COVID?’ I can still only say, ‘Don’t get COVID,’” says David Putrino, a neuroscientist and physical therapist who leads a long-COVID rehabilitation clinic at Mount Sinai’s Icahn School of Medicine.

    As the world turns its gaze away from the coronavirus pandemic, with country after country declaring the virus “endemic” and allowing crisis-caliber interventions to lapse, long-COVID researchers, patients, and activists worry that even past progress could be undone. The momentum of the past three years now feels bittersweet, they told me, in that it represents what the community might lose. Experts can’t yet say whether the number of long-haulers will continue to increase, or offer a definitive prognosis for those who have been battling the condition for months or years. All that’s clear right now is that, despite America’s current stance on the coronavirus, long COVID is far from being beaten.


    Despite an influx of resources into long-COVID research in recent months, data on the condition’s current reach remain a mess—and scientists still can’t fully quantify its risks.

    Recent evidence from two long-term surveys have hinted that the pool of long-haulers might be shrinking, even as new infection rates remain sky-high: Earlier this month, the United Kingdom’s Office for National Statistics released data showing that 2 million people self-reported lingering symptoms at the very start of 2023, down from 2.3 million in August 2022. The U.S. CDC’s Household Pulse Survey, another study based on self-reporting, also recorded a small drop in long-COVID prevalence in the same time frame, from about 7.5 percent of all American adults to roughly 6. Against the massive number of infections that have continued to slam both countries in the pandemic’s third year and beyond, these surveys might seem to imply that long-haulers are leaving the pool faster than newcomers are arriving.

    Experts cautioned, however, that there are plenty of reasons to treat these patterns carefully—and to not assume that the trends will be sustained. It’s certainly better that these data aren’t showing a sustained, dramatic uptick in long-COVID cases. But that doesn’t mean the situation is improving. Throughout the pandemic, the size of the long-COVID pool has contracted or expanded for only two reasons: a change in the rate at which people enter, or at which they exit. Both figures are likely to be in constant flux, as surges of infections come and go, masking habits change, and vaccine and antiviral uptake fluctuates. Davis pointed out that the slight downward tick in both studies captured just a half-year stretch, so the downward slope could be one small portion of an undulating wave. A few hours spent at the beach while the tide is going out wouldn’t be enough to prove that the ocean is drying up.

    Recent counts of new long-COVID cases might also be undercounts, as testing slows and people encounter more challenges getting diagnosed. That said, it’s still possible that, on a case-by-case basis, the likelihood of any individual developing long COVID after a SARS-CoV-2 infection may have fallen since the pandemic’s start, says Deepti Gurdasani, a clinical epidemiologist at Queen Mary University of London and the University of New South Wales. Population immunity—especially acquired via vaccination—has, over the past three years, better steeled people’s bodies against the virus, and strong evidence supports the notion that vaccines can moderately reduce the risk of developing long COVID. Treatments and behavioral interventions that have become more commonplace may have chipped away at incidence as well. Antivirals can now help to corral the virus early in infection; ventilation, distancing, and masks—when they’re used—can trim the amount of virus that infiltrates the body. And if overall exposure to the virus can influence the likelihood of developing long COVID, that could help explain why so many debilitating cases arose at the very start of the pandemic, when interventions were few and far between, says Steven Deeks, a physician researcher at UC San Francisco.

    There’s not much comfort to derive from those individual-level stats, though, when considering what’s happening on broader scales. Even if immunity makes the average infected person less likely to fall into the long-COVID pool, so many people have been catching the virus that the inbound rate still feels like a flood. “The level of infection in many countries has gone up substantially since 2021,” Gurdasani told me. The majority of long-COVID cases arise after mild infections, the sort for which our immune defenses fade most rapidly. Now that masking and physical distancing have fallen by the wayside, people may be getting exposed to higher viral doses than they were a year or two ago. In absolute terms, then, the number of people entering the long-COVID pool may not really be decreasing. Even if the pool were getting slightly smaller, its size would still be staggering, an ocean of patients with titanic needs. “Anecdotally, we still have an enormous waitlist to get into our clinic,” Putrino told me.

    Deeks told me that he’s seen another possible reason for optimism: People with newer cases of long COVID might be experiencing less debilitating or faster-improving disease, based on what he’s seen. “The worst cases we’ve seen come from the first wave in 2020,” he said. But Putrino isn’t so sure. “If you put an Omicron long-COVID patient in front of me, versus one from the first wave, I wouldn’t be able to tell you who was who,” he said. The two cases would also be difficult to compare, because they’re separated by so much time. Long COVID’s symptoms can wax, wane, and qualitatively change; a couple of years into the future, some long-haulers who’ve just developed the condition may be in a spot that’s similar to where many veterans with the condition are now.

    Experts’ understanding of how often people depart the long-COVID pool is also meager. Some long-haulers have undoubtedly seen improvement—but without clear lines distinguishing short COVID from medium and long COVID, entry and exit into these various groups is easy to over- or underestimate. What few data exist on the likelihood of recovery or remission is inconsistent, and not always rosy: Investigators of RECOVER, a large national study of long COVID, have calculated that about two-thirds of the long-haulers in their cohort do not return to baseline health. Putrino, who has worked with hundreds of long-haulers since the pandemic began, estimates that although most of his patients experience at least some benefit from a few months of rehabilitation, only about one-fifth to one-quarter of them eventually reach the point of feeling about as well as they did before catching the virus, while the majority hit a middling plateau. A small minority of the people he has treated, he told me, never seem to improve at all.

    Letícia Soares, a long-hauler in Brazil who caught the virus near the start of the pandemic, falls into that final category. Once a disease ecologist who studied parasite transmission in birds, she is now mostly housebound, working when she is able as a researcher for the Patient-Led Research Collaborative. Her days revolve around medications and behavioral modifications she uses for her fatigue, sleeplessness, and chronic pain. Soares no longer has the capacity to cook or frequently venture outside. And she has resigned herself to this status quo until the treatment landscape changes drastically. It is not the life she pictured for herself, Soares told me. “Sometimes I think the person I used to be died in April of 2020.”

    Even long-haulers who have noticed an improvement in their symptoms are wary of overconfidence. Some absolutely do experience what could be called recovery—but for others, the term has gotten loaded, almost a jinx. “If the question is, ‘Are you doing the things you were doing in 2019?’ the answer is largely no,” says JD Davids, a chronic-illness advocate based in New York. For some, he told me, “getting better” has been more defined by a resetting of expectations than a return to good health. Relapses are also not uncommon, especially after repeat encounters with the virus. Lisa McCorkell, a long-hauler and a co-founder of the Patient-Led Research Collaborative, has felt her symptoms partly abate since she first fell ill in the spring of 2020. But, she told me, she suspects that her condition is more likely to deteriorate than further improve—partly because of “how easy it is to get reinfected now.”


    Last week, in his State of the Union address, President Joe Biden told the American public that “we have broken COVID’s grip on us.” Highlighting the declines in the rates of COVID deaths, the millions of lives saved, and the importance of remembering the more than 1 million lost, Biden reminded the nation of what was to come: “Soon we’ll end the public-health emergency.”

    When the U.S.’s state of emergency was declared nearly three years ago, as hospitals were overrun and morgues overflowed, the focus was on severe, short-term disease. Perhaps in that sense, the emergency is close to being over, Deeks told me. But long COVID, though slower to command attention, has since become its own emergency, never formally declared; for the millions of Americans who have been affected by the condition, their relationship with the virus does not yet seem to be in a better place.

    Even with many more health-care providers clued into long COVID’s ills, the waiting lists for rehabilitation and treatment remain untenable, Hannah Davis told me. “I consider myself someone who gets exceptional care compared to other people,” she said. “And still, I hear from my doctor every nine or 10 months.” Calling a wrap on COVID’s “emergency” phase could worsen that already skewed supply-demand ratio. Changes to the nation’s funding tactics could strip resources—among them, access to telehealth; Medicaid coverage; and affordable antivirals, tests, and vaccines—from vulnerable populations, including people of color, that aren’t getting their needs met even as things stand, McCorkell told me. And as clinicians internalize the message that the coronavirus has largely been addressed, attention to its chronic impacts may dwindle. At least one of the country’s long-COVID clinics has, in recent months, announced plans to close, and Davis worries that more could follow soon.

    Scientists researching long COVID are also expecting new challenges. Reduced access to testing will complicate efforts to figure out how many people are developing the condition, and who’s most at risk. Should researchers turn their scientific focus away from studying causes and cures for long COVID when the emergency declaration lifts, Davids and others worry that there will be ripple effects on the scientific community’s interest in other, neglected chronic illnesses, such as ME/CFS (myalgic encephalomyelitis or chronic fatigue syndrome), a diagnosis that many long-haulers have also received.

    The end of the U.S.’s official crisis mode on COVID could stymie research in other ways as well. At Johns Hopkins University, the infectious-disease epidemiologists Priya Duggal, Shruti Mehta, and Bryan Lau have been running a large study to better understand the conditions and circumstances that lead to long COVID, and how symptoms evolve over time. In the past two years, they have gathered online survey data from thousands of people who both have and haven’t been infected, and who have and haven’t seen their symptoms rapidly resolve. But as of late, they’ve been struggling to recruit enough people who caught the virus and didn’t feel their symptoms linger. “I think that the people who are suffering from long COVID will always do their best to participate,” Duggal told me. That may not be the case for individuals whose experiences with the virus were brief. A lot of them “are completely over it,” Duggal said. “Their life has moved on.”

    Kate Porter, a Massachusetts-based marketing director, told me that she worries about her family’s future, should long COVID fade from the national discourse. She and her teenage daughter both caught the virus in the spring of 2020, and went on to develop chronic symptoms; their experience with the disease isn’t yet over. “Just because the emergency declaration is expiring, that doesn’t mean that suddenly people are magically going to get better and this issue is going to go away,” Porter told me. After months of relative improvement, her daughter is now fighting prolonged bouts of fatigue that are affecting her school life—and Porter isn’t sure how receptive people will be to her explanations, should their illnesses persist for years to come. “Two years from now, how am I going to explain, ‘Well, this is from COVID, five years ago’?” she said.

    A condition that was once mired in skepticism, scorn, and gaslighting, long COVID now has recognition—but empathy for long-haulers could yet experience a backslide. Nisreen Alwan, a public-health researcher at the University of Southampton, in the U.K., and her colleagues have found that many long-haulers still worry about disclosing their condition, fearing that it could jeopardize their employment, social interactions, and more. Long COVID could soon be slated to become just one of many neglected chronic diseases, poorly understood and rarely discussed.

    Davis doesn’t think that marginalization is inevitable. Her reasoning is grim: Other chronic illnesses have been easier to push to the sidelines, she said, on account of their smaller clinical footprint, but the pool of long-haulers is enormous—comprising millions of people in the U.S. alone. “I think it’s going to be impossible to ignore,” she told me. One way or another, the world will have no choice but to look.

    Katherine J. Wu

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  • Worst-ever cholera outbreak in Malawi kills more than 1,200, with

    Worst-ever cholera outbreak in Malawi kills more than 1,200, with

    Malawi Cholera Deaths
    A cholera patient is seen inside an isolation ward at the Bwaila Hospital in Lilongwe central Malawi, Jan. 11, 2023.

    Thoko Chikondi/AP


    Brazzaville — The deadliest cholera outbreak in Malawi‘s history has killed at least 1,210 people, while vaccines remain scarce and several other African nations report outbreaks, the World Health Organization said Thursday. The southern African nation has been battling its worst cholera outbreak on record, with nearly 37,000 cases reported since March 2022.

    Confirmed cases have already been reported across the border in Mozambique, while the WHO said it assessed the current risk of spread inside Malawi and to other neighboring countries as “very high.”

    The WHO said in a statement that active transmission was now ongoing in 27 out of Malawi’s 29 districts, with the country seeing a 143-percent increase in the number of cases last month compared to December.

    “With a sharp increase of cases seen over the last month, fears are that the outbreak will continue to worsen without strong interventions,” WHO warned in a statement.

    But the UN health agency pointed out that the crisis in Malawi is occurring against a backdrop of surging cholera outbreaks worldwide, which have “constrained the availability of vaccines, tests and treatments.”

    Malawi Cholera
    Health workers treat cholera patients at the Bwaila Hospital in Lilongwe central Malawi on Jan. 11, 2023. 

    Thoko Chikondi / AP


    Some 80,000 cases were recorded on the African continent over the whole of 2022.

    “If the current fast-rising trend continues, it could surpass the number of cases recorded in 2021, the worst year for cholera in Africa in nearly a decade,” the WHO said.

    Since the outbreak began, Malawi has carried out two large vaccination campaigns, but due to limited supplies, has offered just one of the usually recommended two oral cholera vaccine doses.

    In November, it received the second batch of almost three million doses from the UN, and last month a health ministry spokesman told AFP all the doses had been used.

    The WHO said Thursday that 96.8 percent of the population “residing in communities with high risk and burden of cholera” had been reached.

    Beyond vaccination, the WHO said efforts were under way to improve sanitation and access to clean water, with house-to-house chlorination ongoing in affected communities and districts, among other interventions.

    Cholera, which causes diarrhea and vomiting, is contracted from a bacterium that is generally transmitted through contaminated food or water.

    WHO said there was a continued risk of further increases in the number of cases in the Malawi outbreak, and said there could also be more international spread.

    Malawi’s neighbor Zambia has also reported cases, according to the WHO. As have Burundi, Cameroon, the Democratic Republic of Congo, Ethiopia, Kenya, Nigeria and Somalia.

    The WHO said the current cholera outbreaks in Africa are occurring as the continent faces extreme weather events, conflicts, and as well as overstretched health services.

    Late last month, the UN health agency also warned that the risk from the global cholera outbreak was “very high” due to ongoing multiple outbreaks in many WHO regions.

    WHO chief Tedros Adhanom Ghebreyesus told reporters Wednesday that there were currently 23 countries in the world experiencing cholera outbreaks, with a further 20 countries that share land borders with them at risk.

    “In total, more than one billion people around the world are directly at risk of cholera,” he warned.

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  • The Case for Kraken

    The Case for Kraken

    A new subvariant of SARS-CoV-2 is rapidly taking over in the U.S.—the most transmissible that has ever been detected. It’s called XBB.1.5, in reference to its status as a hybrid of two prior strains of Omicron, BA.2.10.1 and BA.2.75. It’s also called “Kraken.”

    Not by everyone, though. The nickname Kraken was ginned up by an informal group of scientists on Twitter and has caught on at some—but only some—major news outlets. As one evolutionary virologist told The Atlantic earlier this week, the name—at first glance, a reference to a folkloric sea monster—“seems obviously intended to scare the shit out of people” and serves no substantive purpose for communicating science.

    Yes, Kraken is klickbait. It’s arbitrary, unofficial, and untethered to specific facts of evolution or epidemiology—a desperate play to get attention. And mazel tov for that. We should all rejoice at this stupid name’s arrival. Long live the Kraken! May XBB.1.5 sink into the sea.

    Since Omicron spread around the world in the fall of 2021, we’ve been subject to a stultifying slew of jargon from the health authorities: Miniature waves of new infections keep lapping at our shores, while the names of the Omicron subvariants that produce them slop together in a cryptic muck: XBB.1.5 has overtaken BA.5 in recent weeks, and also BF.7, as well as BQ.1 and BQ.1.1; in China, BA.5.2 is quickly spreading too. One might ask, without a shred of undue panic, how worried we should be—but the naming scheme itself precludes an answer. You don’t even need to ask, it says. You’ll never fully understand.

    This isn’t subtext; it’s explicit. A spokesperson for the World Health Organization told my colleague Jacob Stern that people should be grateful for the arcane pronouncements of our leading international consortia. “The public doesn’t need to distinguish between these Omicron subvariants in order to better understand their risk or the measures they need to take to protect themselves,” he said. “If there is a new variant that requires public communication and discourse, it would be designated a new variant of concern and assigned a new label.” In other words: None of what we’re seeing now is bad enough to merit much attention. You don’t need to make any brand-new precautions, so we don’t need to talk about it.

    The public may not need to draw distinctions. But do those distinctions really need to be obscured? A different set of names, one that isn’t precision-engineered to harpoon people’s interest, wouldn’t have to fool us into feeling false alarm. It’s not as though our habit of assigning common names to storms leads to widespread panic starting every summer. When Hurricane Earl appeared last September, no one rushed into a bunker just because they knew what it was called. Then Ian came a few weeks later, and millions evacuated.

    Granted, Kraken sounds a bit more ominous than Earl. (Of all the labels that could be given to the latest version of a deadly virus, it’s not the best.) But the name is more befuddling than terrifying: a nitwitted reference, somehow, to ferocity, absurdity, and conspiratorial delusion all at once. Even so, a silly name still has the virtue of being a name, while a string of numbers and letters is just an entry in a database. Kraken doesn’t care if you’re afraid of COVID, and it doesn’t mind if you’re indifferent. It only wishes to be understood.

    Isn’t that important? A proper name eases conversation (wherever that might lead), and makes it possible to talk about what matters (and what doesn’t). Just try telling the public that Hurricane Earl will be no big deal but Ian is a mortal threat, if instead of “Earl” and “Ian” you had to say “BA.2.12.1” and “B.1.1.529.” The committee that names our storms is chasing clouds instead of clout; it knows that branding efforts make it easier for everyone to stay informed. We might have done the same for SARS-CoV-2, and handed out simple, easy-to-remember names for all the leading Omicron subvariants. (Through 2021, we used Greek letters to describe each major variant.) If Kraken seems alarmist now, that’s because we’re living in a different, dumber timeline, where public legibility has been forbidden. Why give this subvariant a name, the global health officials ask, when it isn’t really that much worse than any other? But that’s a problem of their own creation. If Kraken seems too gaudy, that’s because every other recent name has been too drab.

    Having useful, catchy names doesn’t mean avoiding all abstraction. Florida residents were glad to know, last fall, which hurricanes were Category 2 and which were Category 5; and it may be just as useful to remind yourself that Kraken is not now, of its own accord, a “variant of concern,” let alone a “variant of high consequence.” Our trust in those distinctions is a product of their formality: A special group of experts has decided which public threats are the most important. The Kraken name, if it continues to spread, could undermine this useful sense of deference—and leave us in an awkward free-for-all where anyone could give a name to any variant at any time.

    For the moment, though, our only recourse is to the numbing nomenclature that is now in place, and to the creaking bureaucracy that delivers it. Any other name for XBB.1.5—any better one than Kraken—would have to come from the WHO, an organization that recently spent five months rebranding monkeypox as “mpox” and that has warned that disease names like “paralytic shellfish poisoning” are unduly stigmatizing to shellfish. Kraken has the crucial benefit of being right in front of us. It’s a stupid name, but it’s a name—and names are good.

    Daniel Engber

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  • Children’s deaths prompt WHO warning against Indian-made cough syrup

    Children’s deaths prompt WHO warning against Indian-made cough syrup

    INDIA-UZBEKISTAN-DRUGS-DEATH
    A man walks past the office enterance of Marion Biotech, a pharmaceutical company in Noida on the outskirts of New Delhi, India, December 29, 2022.

    AFP/Getty


    New Delhi — The World Health Organization has issued an alert warning against the use of two Indian cough syrups blamed for the deaths of at least 20 children in Uzbekistan. The WHO said the products, manufactured by India’s Marion Biotech, were “substandard” and that the firm had failed to provide guarantees about their “safety and quality.”

    The alert issued on Wednesday came after Uzbekistan authorities said last month that at least 20 children died after consuming a syrup made by the company under the brand name Doc-1 Max.

    India’s health ministry subsequently suspended production at the company and Uzbekistan banned the import and sale of Doc-1 Max.

    The WHO alert said an analysis of the syrup samples by the quality control laboratories of Uzbekistan found “unacceptable amounts of diethylene glycol and /or ethylene glycol as contaminants.”

    Diethylene glycol and ethylene are toxic to humans when consumed and can prove fatal.

    “Both of these products may have marketing authorizations in other countries in the region. They may also have been distributed, through informal markets, to other countries or regions,” WHO said.

    The products were “unsafe and their use, especially in children, may result in serious injury or death,” it said.

    Marion Biotech officials could not be reached immediately for comment.

    It is the second Indian drugmaker to face a probe by regulators since October, when the WHO linked another firm’s medicines to a spate of child deaths in Gambia.

    Maiden Pharmaceuticals was accused of manufacturing several toxic cough and cold remedies that led to the deaths of at least 66 children in the African country.

    The victims, mostly between five months and four years old, died of acute renal failure.

    India launched a probe into Maiden Pharmaceuticals but later said the investigation had found the suspect drugs were of “standard quality.”


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  • Satellite images capture crowding at China’s crematoriums and funeral homes as Covid surge continues | CNN

    Satellite images capture crowding at China’s crematoriums and funeral homes as Covid surge continues | CNN



    CNN
     — 

    Satellite images taken over a number of Chinese cities have captured crowding at crematoriums and funeral homes, as the country continues its battle with an unprecedented wave of Covid-19 infections following its dismantling of severe pandemic restrictions.

    The images – taken by Maxar in late December and early January and reviewed by CNN – show a funeral home on the outskirts of Beijing, which appears to have constructed a brand-new parking area, as well as lines of vehicles waiting outside of funeral homes in Kunming, Nanjing, Chengdu, Tangshan and Huzhou.

    The scene at the same home last week, showing more cars parked along streets near the entrance.

    China recently moved away from its strict zero-Covid approach to the virus, which had sparked mass unrest after more than two years of tight controls on citizens’ personal lives.

    China’s strict policy shielded its population from the kind of mass deaths seen in Western nations – a contrast repeatedly driven home by the Communist Party to illustrate the supposed superiority of its restrictions.

    Since those rules were lifted, people have regained freedom to travel around their country

    The satellite pictures are consistent with CNN’s reporting and witness accounts shared to social media concerning overcrowding in funeral homes and crematoriums.

    CNN has reported first-hand in Beijing on the makeshift facilities being used to store the deceased, as overworked staff try to keep up with the volume of crates containing yellow body bags, and families report waiting for days to bury or cremate their loved ones.

    A Tangshan City funeral home in January 2020, before the pandemic swept the country.

    The same home last week, where many more vehicles are parked.

    Meanwhile, China’s official Covid-19 death toll since it eased restrictions remains strikingly low – with only 37 deaths recorded since December 7.

    As reports of overwhelmed hospitals and funeral homes roll in, China is facing accusations from the World Health Organization (WHO) and US that it is under-representing the severity of its current outbreak, as top global health officials urge Beijing to share more data about the explosive spread.

    “We continue to ask China for more rapid, regular, reliable data on hospitalizations and deaths, as well as more comprehensive, real-time viral sequencing,” WHO director-general Tedros Adhanom Ghebreyesus said at a news briefing in Geneva Wednesday.

    “WHO is concerned about the risk to life in China and has reiterated the importance of vaccination, including booster doses, to protect against hospitalization, severe disease, and death,” he said.

    Speaking in more detail, WHO executive director for health emergencies Mike Ryan said the numbers released by China “under-represent the true impact of the disease” in terms of hospital and ICU admissions, as well as deaths.

    He acknowledged that many countries have seen lags in reporting hospital data, but pointed to China’s “narrow” definition of a Covid death as part of the issue.

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  • The Coronavirus-Naming Free-for-All

    The Coronavirus-Naming Free-for-All

    These days, it’s a real headache to keep tabs on the coronavirus’s ever-shifting subvariants. BA.2, BA.4, and BA.5, three Omicron permutations that rose to prominence last year, were confusing enough. Now, in addition to those, we have to deal with BQ.1.1, BF.7, B.5.2.6, and XBB.1.5, the version of Omicron currently featuring in concerned headlines. Recently, things have also gotten considerably stranger. Alongside the strings of letters and numbers, several nicknames for these subvariants have started to gain traction online. Where once we had Alpha and Delta and Omicron, we now have Basilisk, Minotaur, and Hippogryph. Some people have been referring to XBB.1.5 simply as “the Kraken.” A list compiled on Twitter reads less like an inventory of variants than like the directory of a mythological zoo.

    The nicknames are not official. They were coined not by the World Health Organization but by an informal group of scientists on Twitter who believe Omicron’s many rotating varieties deserve more widespread conversation. The names have, to an extent, caught on: Kraken has already made its way from Twitter to a number of major news sites, including Bloomberg and The New York Times. Unofficial epithets have come and gone throughout the pandemic—remember “stealth Omicron” and the “Frankenstein variant”?—but these new ones are on another level of weirdness. And not everyone’s a fan.

    The names associated with the coronavirus have been a fraught conversation since the pandemic’s earliest days, as scientists and public-health figures have tried to use terms that are comprehensible and hold people’s attention but that also avoid pitfalls of inaccuracy, fear-mongering, or xenophobia and racism (see: Donald Trump referring to the coronavirus as “the Chinese virus” and “kung flu”). The official names for variants and subvariants—names such as SARS-CoV-2 B.1.1.7—come from the Pango naming system, which was fashioned by evolutionary biologists in the early months of the pandemic to standardize variant-naming practices. As baffling as they can seem, they follow a clear logic: Under the system, B refers to a particular COVID lineage, B.1 refers to the sublineage of B lineage, B.1.1 refers to the first sublineage of the B.1 sublineage, and so on. When the names get too long, a letter replaces a string of numbers—B.1.1.529.1, for example, becomes BA.1.

    These official names do not exactly roll off the tongue or stick in the memory, which became a problem when new variants of concern started to arise and the world began groping for ways to talk about them. In May 2021, the WHO instituted its now-familiar Greek-letter naming system to stamp out the geographic associations that were gaining prominence at the time. B.1.1.7, B.1.351, and B.1.617—which were being referred to respectively as the U.K. variant, the South African variant, and the Indian variant—became Alpha, Beta, and Delta. But then, alas, came Omicron. Rather than giving way to yet another new Greek-letter variant, Omicron has spent more than a year branching into sublineages, and sublineages of sublineages. As a result, the nomenclature has devolved back into alphanumeric incomprehensibility. Seven different Omicron sublineages now account for at least 2 percent of all infections, and none accounts for more than about 40 percent (though XBB.1.5 is threatening to overwhelm its competitors).

    It’s great news that the ways in which the coronavirus has been mutating recently haven’t been significant enough to produce a whole new, widespread, and possibly far more worrisome version of itself that the world has to contend with. But it also makes talking about the virus much more annoying. Enter T. Ryan Gregory, an evolutionary biologist at Canada’s University of Guelph who is one of the leaders of a small, informal group of scientists that have taken it upon themselves to name the many subvariants that the WHO does not deem worthy of a new Greek letter. The names—Hydra, Cerberus, Centaurus—originated on Twitter, where Gregory compiled them into a list.

    Their value, Gregory told me, is that they fill the space in between the Greek and Pango systems, allowing people to discuss the many current Omicron variants that do not justify a new Greek letter but are still, perhaps, of interest. You can think of it in the same way we do animal taxonomy, he said. Calling a variant Omicron, like calling an animal a mammal, is not particularly descriptive. Calling a variant by its Pango name, like calling an animal by its Latinate species designation, is highly descriptive but a bit unwieldy in common parlance. When we speak of farm animals that moo and produce milk, we speak not of mammals or of Bos taurus but of cows. And so BA.2.3.20 became Basilisk.

    To decide whether a new lineage deserves its own name, Gregory told me, he and his colleagues consider both evolutionary factors (how different is this lineage from its predecessors, and how concerning are its mutations?) and epidemiological factors (how much havoc is this lineage wreaking in the population?). They’re trying to make the process more formal, but Gregory would prefer that the WHO take over and standardize the process.

    That, however, is unlikely to happen. When I asked about this, Tarik Jasarevic, a WHO spokesperson, told me that the organization is aware of the unofficial names but that, for the moment, they’re not necessary. “Virologists and other scientists are monitoring these variants, but the public doesn’t need to distinguish between these Omicron subvariants in order to better understand their risk or the measures they need to take to protect themselves,” he said. The WHO’s position, in other words, is that the differences between one Omicron subvariant and another simply haven’t mattered much in any practical sense, because they shouldn’t have any effect on our behavior. No matter the sublineage, vaccines and boosters still offer the best protection available. Masks still work. Guidance on testing and isolation, too, is the same across the board. “If there is a new variant that requires public communication and discourse,” Jasarevic told me, “it would be designated a new variant of concern and assigned a new label.”

    The WHO isn’t alone in objecting. For Stephen Goldstein, an evolutionary virologist at the University of Utah, the new names are not just unnecessary but potentially harmful. “It’s absolutely crazy that we’re having random people on Twitter name variants,” he told me. For Goldstein, dressing up each new subvariant with an ominous monster name overplays the differences between the mutations and feeds into the panic that comes every time the coronavirus shifts form. In this view, distinguishing one Omicron sublineage from another is less like distinguishing a wolf from a cow and more like distinguishing a white-footed mouse from a deer mouse: important to a rodentologist but not really to anyone else. To go as far as naming lineages after terrifying mythical beasts, he said, “seems obviously intended to scare the shit out of people … It’s hard to understand what broader goal there is here other than this very self-serving clout chasing.”

    Gregory told me that fear and attention are not his group’s aim. He also said, though, that his group is thinking of switching from mythological creatures to something more neutral, such as constellations, in part to address concerns of whipping up unnecessary panic. When it comes to XBB.1.5, some of that panic certainly already exists, whipped up by less-than-nuanced headlines and Twitter personalities who feast on moments like these. Whether or not the name Kraken has contributed, the fear is that XBB.1.5 might be a variant so immune-evasive that it infects everyone all over again or so virulent that it amps up the risk of any given infection. So far, that does not seem to be the case.

    As my colleague Katherine Wu reported in November, we are likely (though by no means definitely) stuck for the foreseeable future in this Omicron purgatory, with its more gradual, more piecemeal pattern of viral evolution. This is certainly preferable to the sudden and unexpected emergence of a dangerous, drastically different variant. But it does mean that we’re likely going to be arguing about whether and how and with what names to discuss Omicron subvariants for some time to come.

    Whichever side you come down on, the state of variant-naming pretty well encapsulates the state of the pandemic as a whole. Hardly anything about the pandemic has been a matter of universal agreement, but the present nomenclatural free-for-all seems to have taken us somewhere even more splintered, even more anarchic. We’re not just arguing about the pandemic; we’re arguing about how to argue about the pandemic. And there’s no end in sight.

    Jacob Stern

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  • China’s COVID-19 surge raises odds of new coronavirus mutant

    China’s COVID-19 surge raises odds of new coronavirus mutant

    Could the COVID-19 surge in China unleash a new coronavirus mutant on the world?

    Scientists don’t know but worry that might happen. It could be similar to omicron variants circulating there now. It could be a combination of strains. Or something entirely different, they say.

    “China has a population that is very large and there’s limited immunity. And that seems to be the setting in which we may see an explosion of a new variant,” said Dr. Stuart Campbell Ray, an infectious disease expert at Johns Hopkins University.

    Every new infection offers a chance for the coronavirus to mutate, and the virus is spreading rapidly in China. The country of 1.4 billion has largely abandoned its “zero COVID” policy. Though overall reported vaccination rates are high, booster levels are lower, especially among older people. Domestic vaccines have proven less effective against serious infection than Western-made messenger RNA versions. Many were given more than a year ago, meaning immunity has waned.

    The result? Fertile ground for the virus to change.

    “When we’ve seen big waves of infection, it’s often followed by new variants being generated,” Ray said.

    About three years ago, the original version of the coronavirus spread from China to the rest of the world and was eventually replaced by the delta variant, then omicron and its descendants, which continue plaguing the world today.

    Dr. Shan-Lu Liu, who studies viruses at Ohio State University, said many existing omicron variants have been detected in China, including BF.7, which is extremely adept at evading immunity and is believed to be driving the current surge.

    Experts said a partially immune population like China’s puts particular pressure on the virus to change. Ray compared the virus to a boxer that “learns to evade the skills that you have and adapt to get around those.”

    One big unknown is whether a new variant will cause more severe disease. Experts say there’s no inherent biological reason the virus has to become milder over time.

    “Much of the mildness we’ve experienced over the past six to 12 months in many parts of the world has been due to accumulated immunity either through vaccination or infection, not because the virus has changed” in severity, Ray said.

    In China, most people have never been exposed to the coronavirus. China’s vaccines rely on an older technology producing fewer antibodies than messenger RNA vaccines.

    Given those realities, Dr. Gagandeep Kang, who studies viruses at the Christian Medical College in Vellore, India, said it remains to be seen if the virus will follow the same pattern of evolution in China as it has in the rest of the world after vaccines came out. “Or,” she asked, “will the pattern of evolution be completely different?”

    Recently, the World Health Organization expressed concern about reports of severe disease in China. Around the cities of Baoding and Langfang outside Beijing, hospitals have run out of intensive care beds and staff as severe cases surge.

    China’s plan to track the virus centers around three city hospitals in each province, where samples will be collected from walk-in patients who are very sick and all those who die every week, Xu Wenbo of the Chinese Center for Disease Control and Prevention said at a briefing Tuesday.

    He said 50 of the 130 omicron versions detected in China had resulted in outbreaks. The country is creating a national genetic database “to monitor in real time” how different strains were evolving and the potential implications for public health, he said.

    At this point, however, there’s limited information about genetic viral sequencing coming out of China, said Jeremy Luban, a virologist at the University of Massachusetts Medical School.

    “We don’t know all of what’s going on,” Luban said. But clearly, “the pandemic is not over.”

    ———

    AP video producer Olivia Zhang and reporter Dake Kang in Beijing contributed to this report.

    ———

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • Health agencies renaming

    Health agencies renaming

    The Biden administration plans to officially switch how it refers to the disease once dubbed “monkeypox” to use the new name “mpox” instead, adopting a long-awaited renaming recommendation announced earlier on Monday by the World Health Organization.

    As cases in the current outbreak swelled earlier this year, the WHO began the process of renaming the disease and its virus variants. Multiple advocates and countries had raised concerns over racist and stigmatizing use of the older name, which was first given to the disease after a 1958 outbreak among Danish laboratory monkeys.

    It is actually wild rodents — not monkeys — that have been mostly spotted harboring the virus in the wild, and are suspected to be the culprit behind many “spillover” infections of humans from animals. Imported pet prairie dogs were blamed for the last significant U.S. outbreak in 2003.

    The Department of Health and Human Services praised the WHO’s decision to switch to the name mpox.

    “We welcome the change by the World Health Organization. We must do all we can to break down barriers to public health, and reducing stigma associated with disease is one critical step in our work to end mpox,” said Health and Human Services Secretary Xavier Becerra in a statement.

    Often a years-long process, the WHO says it accelerated this name change to next year’s edition of the International Classification of Diseases over the past few months. Recommendations were vetted at a meeting late last month.

    “Considerations for the recommendations included rationale, scientific appropriateness, extent of current usage, pronounceability, usability in different languages, absence of geographical or zoological references, and the ease of retrieval of historical scientific information,” the WHO said in a statement.

    Mpox will be the new “preferred term,” though the WHO said both names will be used over the next year as the old name “monkeypox” is phased out.

    Similar to how the name COVID-19 technically only refers to the disease that is caused by the virus SARS-CoV-2, rather than the virus itself, the new mpox disease name leaves unchanged the name of the pathogen that causes it: monkeypox virus. Any change to that moniker would fall to another body called the International Committee on Taxonomy of Viruses.

    The WHO and U.S. change comes as some federal health officials had already taken to calling the disease informally as “mpox” over recent weeks in meetings and presentations, even as their slide decks and websites continued to list the then-official “monkeypox” name.

    Other alternative names like “MPX” or “MPV” had been adopted by some state and local health departments, though the latter could also be confused with a respiratory disease known as metapneumovirus. CDC publications had adopted the abbreviation “MPXV” to refer to the virus behind the disease. 

    A change to local mpox outbreaks

    The name change comes as the pace of the current outbreak around the country has fallen sharply over the last few months. The U.S. is now averaging less than 15 new reported infections per day. 

    Since the outbreak began in May, nearly 30,000 Americans have been reported infected by the virus and 14 have died. Around 81,000 cases have been tallied globally.

    An analysis published by the CDC earlier this month predicted the U.S. would see further slowing of infections in most parts of the country. However, the agency cited a handful of factors — including a stalled second dose vaccination campaign — that raise concerns of a resurgence in the future. 

    At a meeting to the CDC’s outside advisers on emergency response and preparedness earlier this month, officials said they were shifting to a targeted effort to try to extinguish the outbreak. 

    Only a handful of counties are still reporting more than 15 cases per week. However, authorities acknowledge the virus could continue to pose a threat for the foreseeable future.

    “We will need to ensconce mpox into the public health framework, and the natural space for a lot of that will be the STI programs in the public health departments, clinics, and then HIV clinics,” said Dr. Jonathan Mermin, the CDC’s monkeypox response incident manager. 

    “That’s the space where the longer term effort with the population who appears in the current outbreak is at highest risk will be most effective,” added Mermin, who is also the director of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention within the agency. 

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