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<title>06 December, 2021</title>
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<h1 data-aos="fade-down" id="covid-19-sentry">Covid-19 Sentry</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-preprints">From Preprints</a></li>
<li><a href="#from-clinical-trials">From Clinical Trials</a></li>
<li><a href="#from-pubmed">From PubMed</a></li>
<li><a href="#from-patent-search">From Patent Search</a></li>
</ul>
<h1 data-aos="fade-right" id="from-preprints">From Preprints</h1>
<ul>
<li><strong>Delay in assessing vitamin D supplements and live vaccines for tuberculosis, polio, and measles to protect people from Covid-19</strong> -
<div>
Introduction: In March 2020, less than three months after China reported a cluster of pneumonia cases in Wuhan, the United States (US) government budgeted money to support development of Covid-19 vaccines. By mid-December 2020, two had been developed, tested, and received the US government’s experimental use authorization. Given evidence that vitamin D supplements and live vaccines for tuberculosis, polio, and measles reduce risks for acute respiratory infection, many experts hypothesized they might reduce risks for Covid-19 infection. Expedited randomized controlled trials, as done for Covid-19 vaccines, could have assessed their protection against C19 no later than end-July 2020. Methods: On 21 April 2021, I searched trial registries maintained by the US National Institutes of Medicine and the World Health Organization for trials with ≥400 participants to assess vitamin D or live vaccines to prevent Covid-19 infections (all or symptomatic). On 10-13 November 2021, I searched PubMed and medRxiv for results reported from these trials. Results: In April 2021, I found 32 trials (9 for vitamin D and 23 for live vaccines) proposing to assess the impact of these interventions on rates of new Covid-19 infections (all or symptomatic). Only 10 trials proposed to begin by June 2020, and only one to end in 2020. My search on 10-13 November 2021, almost 11 months after the US approved the first two Covid-19 vaccines, found results reported from only one of the 32 trials (live measles vaccine significantly reduced new symptomatic infections). Conclusions: If health experts had demonstrated similar urgency in assessing vitamin D supplements and live vaccines for tuberculosis, polio, and measles as in developing Covid-19 vaccines, trials could have reported by end-July 2020. Depending on what trials reported, these interventions could have prevented a large percentage of more than 600,000 Covid-19 deaths reported in the US from August 2020 through November 2021. Delay in assessing vitamin D has racial implications as well, since vitamin D deficiency and Covid-19 deaths in the US have been far more common among Blacks and Hispanics compared to Whites. Going forward, depending on what trials report, these interventions could help people live with Covid-19 as an endemic virus.
</div>
<div class="article-link article-html- link">
🖺 Full Text HTML: <a href="https://osf.io/swc7x/" target="_blank">Delay in assessing vitamin D supplements and live vaccines for tuberculosis, polio, and measles to protect people from Covid-19</a>
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<li><strong>Remote learning during COVID-19: Student satisfaction and performance (now updated with data going to November 2020)</strong> -
<div>
The rapid introduction of University remote learning due to COVID19 raised concerns of poorer educational outcomes, especially for at-risk students. Comparing satisfaction (n=33,029) and marks (n=128,823) in the first online unit to the previous three years, multilevel models ascertain the effect of remote learning with comprehensive controls, and test equity and curricula moderators. Results indicate significant small decrements in satisfaction and an increase in marks; effects so small as to be insubstantial. No highly dissatisfied or poorly performing student sub-groups were identified. While not all education aspects are measured, this high-level comparison indicates a successful initial transition to remote learning.
</div>
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🖺 Full Text HTML: <a href="https://edarxiv.org/n2ybd/" target="_blank">Remote learning during COVID-19: Student satisfaction and performance (now updated with data going to November 2020)</a>
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<li><strong>Robust Single-cell Matching and Multi-modalAnalysis Using Shared and Distinct FeaturesReveals Orchestrated Immune Responses</strong> -
<div>
The ability to align individual cellular information from multiple experimental sources, techniques and systems is fundamental for a true systems-level understanding of biological processes. While single-cell transcriptomic studies have transformed our appreciation for the complexities and contributions of diverse cell types to disease, they can be limited in their ability to assess protein-level phenotypic information and beyond. Therefore, matching and integrating single-cell datasets which utilize robust protein measurements across multiple modalities is critical for a deeper understanding of cell states, and signaling pathways particularly within their native tissue context. Current available tools are mainly designed for single-cell transcriptomics matching and integration, and generally rely upon a large number of shared features across datasets for mutual Nearest Neighbor (mNN) matching. This approach is unsuitable when applied to single-cell proteomic datasets, due to the limited number of parameters simultaneously accessed, and lack of shared markers across these experiments. Here, we introduce a novel cell matching algorithm, Matching with pARtIal Overlap (MARIO), that takes into account both shared and distinct features, while consisting of vital filtering steps to avoid sub-optimal matching. MARIO accurately matches and integrates data from different single-cell proteomic and multi-modal methods, including spatial techniques, and has cross-species capabilities. MARIO robustly matched tissue macrophages identified from COVID-19 lung autopsies via CODEX imaging to macrophages recovered from COVID-19 bronchoalveolar lavage fluid via CITE-seq. This cross-platform integrative analysis enabled the identification of unique orchestrated immune responses within the lung of complement expressing macrophages and their impact on the local tissue microenvironment. MARIO thus provides an analytical framework for unified analysis of single-cell data for a comprehensive understanding of the underlying biological system.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2021.12.03.471185v1" target="_blank">Robust Single-cell Matching and Multi-modalAnalysis Using Shared and Distinct FeaturesReveals Orchestrated Immune Responses</a>
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<li><strong>A kinetic model considering the decline of antibody level and vaccination of COVID-19</strong> -
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In order to evaluate the decline in antibody levels and the impact of vaccination on the spread of the epidemic, we establish COVID-19 dynamic models that consider the decline in antibody levels and the effects of vaccination, and retrospectively evaluate the epidemic situation in England. Based on the epidemic data in England from September 1 to October 31, 2020, considering the continuous decline in the antibody level of COVID-19 recovers, an improved SEIR infectious disease dynamics model that considers the reinfection of recovers due to the decline in antibody levels is established. The kinetic parameters of the SEIR model are obtained by fitting. On this basis, a SEIRV infectious disease dynamic model with vaccination is established to study the impact of different vaccination rates and vaccine failure rates on the development of the epidemic in England. We obtain the lower the vaccine failure rate, the fewer new cases. When the vaccination rate is fixed at 0.005 (equivalent to 250000 people vaccinated every day), the peak of the epidemic will decrease with the decrease of vaccine failure rate. The peak value when the failure rate is 0.001 is 81.4% lower than the peak value when the failure rate is 0.01, and the peak value when the failure rate is 0.01 is 89.5% lower than the peak value when the failure rate is 0.02. When the failure rate is less than 0.01, the peak time will advance with the decrease of failure rate; when the failure rate is greater than 0.01, the peak time will be delayed with the decrease of failure rate; when the failure rate is 0.01, the peak time is 528 days later than that when the failure rate is 0.001 and 295 days later than that when the failure rate is 0.05. On the 60th day of vaccination, the vaccine failure rate of 0.002 decreases the number of cases by 5.8% compared with the vaccine failure rate of 0.01; on the 70th day of vaccination, the vaccine failure rate of 0.002 reduces the number of cases by 9.1% compared with the vaccine failure rate of 0.01. Therefore, with the extension of time, the vaccine with low failure rate has a more obvious effect on reducing the number of cases than the vaccine with high failure rate. When the vaccine failure rate is fixed at 0.005, we study the impact of different vaccination rates on the spread of the epidemic in England, the result shows that the peak of epidemic situation decreases with the increase of vaccination rate, and the peak time advance with the increase of vaccination rate, when the vaccination rate is 0.025, the peak decreases by 74.8% and the peak time was 114 days earlier than that when the vaccination rate is 0.005.Therefore, the higher the vaccine efficiency and vaccination rate, the lower the peak of the epidemic. On the basis of improving the effectiveness of vaccines, increasing the vaccination rate is of practical significance for controlling the spread of the epidemic.
</p>
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<div class="article- link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.01.21266680v1" target="_blank">A kinetic model considering the decline of antibody level and vaccination of COVID-19</a>
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<li><strong>Cellular and humoral responses to SARS-CoV-2 vaccination in immunosuppressed patients</strong> -
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Objective: SARS-CoV-2 vaccinations have demonstrated vaccine immunogenicity in healthy volunteers, however, efficacy in immunosuppressed patients is less well characterised. Subsequently, there is an urgent need to address the impact of immunosuppression on vaccine immunogenicity. Methods: Serological, T-cell ELISpot, cytokines and immunophenotyping investigations were used to assess vaccine responses (either BNT162b2 mRNA or ChAdOx1 nCoV-19) in double-vaccinated patients receiving immunosuppression for renal transplants or haematological malignancies (n=13). Immunological responses in immunosuppressed patients (VACC-IS) were compared to immunocompetent vaccinated (VACC-IC, n=12), unvaccinated (UNVACC, n=11) and infection-naive unvaccinated (HC, n=3) cohorts. All participants, except HC, had prior COVID-19 infection. Results: T-cell responses were identical between VACC-IS and VACC-IC (92%) to spike-peptide (S) stimulation. UNVACC had the highest T-cell non-responders (n=3), whereas VACC-IC and VACC-IS both had one T-cell non-responder. No significant differences in humoral responses were observed between VACC-IC and VACC-IS, with 92% (12/13) of VACC-IS patients demonstrating seropositivity. One VACC-IS failed to seroconvert, however had detectable T-cell responses. All VACC-IC participants were seropositive for anti-spike antibodies. Furthermore, both VACC-IS and VACC-IC participants elicited strong Th1 cytokine response with immunodominance towards S-peptide. Differences in T-cell immunophenotyping were seen between VACC-IS and VACC-IC, with lower CD8+ activation and T-effector memory phenotype observed in VACC-IS. Conclusion: SARS-CoV-2 vaccines are immunogenic in patients receiving immunosuppressive therapy, with responses comparable to vaccinated immunocompetent participants. Lower humoral responses were seen in patients treated with B-cell depleting therapeutics, but with preserved T-cell responses. We suggest further work to correlate both protective immunity and longevity of these responses in both healthy and immunosuppressed patients.
</p>
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.03.21267250v1" target="_blank">Cellular and humoral responses to SARS-CoV-2 vaccination in immunosuppressed patients</a>
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<li><strong>Using an electronic frailty index to predict adverse outcomes in geriatric COVID-19 patients: data from the Stockholm GeroCovid study</strong> -
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Background: The Clinical Frailty Scale (CFS) is a strong predictor for worse outcomes in geriatric COVID-19 patients, but it is less clear whether an electronic frailty index (eFI) constructed from routinely collected electronic health records (EHRs) provides similar predictive value. This study aimed to investigate the predictive ability of an eFI in comparison to other frailty and comorbidity measures, using mortality, readmission, and the length of stay as outcomes in geriatric COVID-19 patients. Methods: We conducted a retrospective cohort study using EHRs from nine geriatric clinics in Stockholm, Sweden, comprising 3,405 COVID-19 patients (mean age 81.9 years) between 1/3/2020 and 31/10/2021. Frailty was assessed using a 48-item eFI developed for Swedish geriatric patients, the CFS, and Hospital Frailty Risk Score (HFRS). Comorbidity was measured using the Charlson Comorbidity Index (CCI). We analyzed in-hospital mortality and 30-day readmission using logistic regression and area under receiver operating characteristic curve (AUC). 30-day and 6-month mortality were modelled by Cox regression, and the length of stay by linear regression. Results: Controlling for age and sex, a 10% increase in the eFI was associated with higher risks of in-hospital mortality (odds ratio [OR]=2.84; 95% confidence interval=2.31-3.51), 30-day mortality (hazard ratio [HR]=2.30; 1.99-2.65), 6-month mortality (HR=2.33; 2.07-2.62), 30-day readmission (OR=1.34; 1.06-1.68), and longer length of stay (β=2.28; 1.90-2.66). The CFS, HFRS and CCI similarly predicted these outcomes, but the eFI had the best predictive accuracy for in-hospital mortality (AUC=0.775). Conclusions: An eFI based on routinely collected EHRs can be applied in identifying high-risk geriatric COVID-19 patients.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.03.21267254v1" target="_blank">Using an electronic frailty index to predict adverse outcomes in geriatric COVID-19 patients: data from the Stockholm GeroCovid study</a>
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<li><strong>Healthcare worker risk of COVID-19: A 20-month analysis of protective measures from vaccination and beyond</strong> -
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Background: As the COVID-19 pandemic continues and new variants such as Omicron emerge, we aimed to re-evaluate vaccine effectiveness as well as impacts of rigorously implemented infection control, public health and occupational health measures in protecting healthcare workers (HCWs). Methods: Following a cohort of 21,242 HCWs in Vancouver, British Columbia, Canada, for 20 months since the pandemic started, we used Cox regression and test-negative design to examine differences in SARS-COV-2 infection rates compared to community counterparts, and within the HCW workforce, assessing the role of occupation, testing accessibility, vaccination rates, and vaccine effectiveness over time. Results: Nurses, allied health professionals and medical staff in this jurisdiction had a significantly lower rate of infection compared to their age-group community counterparts, at 47.4, 41.8, and 55.3% reduction respectively; controlling for vaccine-attributable reductions, the protective impact was still substantial, at 33.4, 28.0, and 36.5% respectively. Licensed practical nurses and care aides had the highest risk of infection among HCWs, more than double that of medical staff. However, even considering differences in vaccination rates, no increase in SARS-CoV-2 infection was found compared to community rates, with combined protective measures beyond vaccination associated with a 17.7% reduced SARS-COV-2 rate in the VCH workforce overall. There was also no evidence of waning immunity within at least 200 days after second dose. Conclusion: Rigorously implemented occupational health, public health and infection control measures results in a well-protected healthcare workforce with infection rates at or below rates in community counterparts. Greater accessibility of vaccination worldwide is essential; however, as implementing measures to protect this workforce globally also requires considerable health system strengthening in many jurisdictions, we caution against overly focusing on vaccination to the exclusion of other crucial elements for wider protection of HCWs, especially in facing ongoing mutations which may escape current vaccines.
</p>
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.02.21267190v1" target="_blank">Healthcare worker risk of COVID-19: A 20-month analysis of protective measures from vaccination and beyond</a>
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<li><strong>Comparative magnitude and persistence of SARS-CoV-2 vaccination responses on a population level in Germany</strong> -
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Background While SARS-CoV-2 vaccinations were successful in decreasing COVID-19 caseloads, recent increases in SARS-CoV-2 infections have led to questions about duration and quality of the subsequent immune response. While numerous studies have been published on immune responses triggered by vaccination, these often focused on the initial peak response generated in specific population subgroups (e.g. healthcare workers or immunocompromised individuals) and have often only examined the effects of one or two different immunisation schemes. Methods and Findings We analysed serum samples from participants of a large German seroprevalence study (MuSPAD) who had received all available vaccines and dose schedules (mRNA-1273, BNT162b2, AZD1222, Ad26.CoV2S.2 or a combination of AZD1222 plus either mRNA-1273 or BNT162b2). Antibody titers against various SARS-CoV-2 antigens and ACE2 binding inhibition against SARS-CoV-2 wild-type and the Alpha, Beta, Gamma and Delta variants of concern were analysed using a previously published multiplex immunoassay MULTICOV-AB and an ACE2-RBD competition assay. Among the different vaccines and their dosing regimens, homologous mRNA-based or heterologous prime-boost vaccination produced significantly higher antibody responses than vector-based homologous vaccination. Ad26.CoV2S.2 performance was significantly reduced, even compared to AZD1222, with 91.67% of samples being considered non-responsive forACE2 binding inhibition. mRNA-based vaccination induced a higher ratio of RBD- and S1-targeting antibodies than vector-based vaccination, which resulted in an increased proportion of S2-targeting antibodies. Previously infected individuals had a robust immune response once vaccinated, regardless of which vaccine they received. When examining antibody kinetics post-vaccination after homologous immunisation regimens, both titers and ACE2 binding inhibition peaked approximately 28 days post-vaccination and then decreased as time increased. Conclusions As one of the first and largest population-based studies to examine vaccine responses for all currently available immunisation schemes in Germany, we found that homologous mRNA or heterologous vaccination elicited the highest immune responses. The high percentage of non-responders for Ad26.CoV2.S requires further investigation and suggests that a booster dose with an mRNA-based vaccine may be necessary. The high responses seen in recovered and vaccinated individuals could aid future dose allocation, should shortages arise for certain manufacturers. Given the role of RBD- and S1-specific antibodies in neutralising SARS-CoV-2, their relative over-representation after mRNA vaccination may explain why mRNA vaccines have an increased efficacy compared to vector-based formulations. Further investigation on these differences will be of particular interest for vaccine development and efficacy, especially for the next-generation of vector-based vaccines.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.01.21266960v1" target="_blank">Comparative magnitude and persistence of SARS-CoV-2 vaccination responses on a population level in Germany</a>
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<li><strong>Estimation of heterogeneous instantaneous reproduction numbers with application to characterize SARS-CoV-2 transmission in Massachusetts counties</strong> -
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The reproductive number is an important metric that has been widely used to quantify the infectiousness of communicable diseases. The time-varying instantaneous reproductive number is useful for monitoring the real time dynamics of a disease to inform policy making for disease control. Local estimation of this metric, for instance at a county or city level, allows for more targeted interventions to curb transmission. However, simultaneous estimation of local reproductive numbers must account for potential sources of heterogeneity in these time-varying quantities – a key element of which is human mobility. We develop a statistical method that incorporates human mobility between multiple regions for estimating region-specific instantaneous reproductive numbers. The model also can account for exogenous cases imported from outside of the regions of interest. We propose two approaches to estimate the reproductive numbers, with mobility data used to adjust incidence in the first approach and to inform a formal priori distribution in the second (Bayesian) approach. Through a simulation study, we show that region-specific reproductive numbers can be well estimated if human mobility is reasonably well approximated by available data. We use this approach to estimate the instantaneous reproductive numbers of COVID-19 for 14 counties in Massachusetts using CDC case report data and the human mobility data collected by SafeGraph. We found that, accounting for mobility, our method produces estimates of reproductive numbers that are distinct across counties. In contrast, independent estimation of county-level reproductive numbers tends to produce similar values, as trends in county case-counts for the state are fairly concordant. These approaches can also be used to estimate any heterogeneity in transmission, for instance, age-dependent instantaneous reproductive number estimates. As people are more mobile and interact frequently in ways that permit transmission, it is important to account for this in the estimation of the reproductive number.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.02.21267164v1" target="_blank">Estimation of heterogeneous instantaneous reproduction numbers with application to characterize SARS- CoV-2 transmission in Massachusetts counties</a>
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<li><strong>Post-traumatic Stress Risk among COVID-19 Survivors in Colombia</strong> -
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The study9s objective was to establish the prevalence and variables associated with post-traumatic stress disorder risk (PTSD-R) in a sample of COVID-19 survivors in Santa Marta, Colombia. A cross-sectional study was designed with a non-probabilistic sample of adult COVID-19 survivors. Participants were demographically characterized and completed scales for depression risk, insomnia risk, and PTSD-R. Three hundred and thirty COVID-19 survivors between 18 and 89 years participated; 61.52% were women. The frequency of depression risk was 49.70%; insomnia risk, 60.61%; and PTSD-R, 13.33%. Depression risk (OR = 41.43, 95% CI 5.54 - 311.63), insomnia risk (OR = 5.25, 95% CI 1.77 - 18.71), low income (OR = 3.46, 95% CI 1.38 - 8.67) and being married or free union (OR = 2.65, 95% CI 1.13 - 6.22) were associated with PTSD-R. In conclusion, two out of every fifteen COVID-19 survivors are in PTSD-R. Depression and insomnia risk are strongly associated with PTSD-R in COVID-19 survivors.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.02.21267210v1" target="_blank">Post-traumatic Stress Risk among COVID-19 Survivors in Colombia</a>
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<li><strong>Persistent Symptoms Among Frontline Health Workers Post-acute COVID-19 Infection</strong> -
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Background: Growing evidence shows that a significant number of patients with COVID19 experience prolonged/persistent symptoms, also known as Long COVID. Reports of Long COVID are rising but little is known about prevalence in non-hospitalized patients. Objective: We sought to identify the persistent symptoms of COVID19 in frontline workers at Right to Care (RTC) South Africa who have past the acute phase of illness with a view to establishing rehabilitation programs for its employees and the community at large. Methods: This was a cross-sectional survey. We analysed data from 207 eligible COVID19 positive RTC frontline workers who participated in a post-COVID online self-administered survey. The survey was active for two months. Frequencies and median were calculated for categorical and continuous variables, respectively. Results: The survey response rate was 30% (62 out of 207); of the 62 respondents with a median age of 33.5 years (IQR= 30 to 44 years), 47 (76%) were females. The majority (n=55; 88.7%) self-isolated and 7 (11.3%) were admitted to hospital at time of diagnosis. The most common comorbid condition reported was hypertension particularly among workers aged 45 to 55 years. Headache, body ache, fatigue, loss of smell, dry cough, fever, and loss of appetite were the most common reported symptoms at time of diagnosis. Persistent symptoms were characterized by fatigue, anxiety, difficulty sleeping, chest pain, muscle pain and brain fog, being the six most reported. Conclusion: The impact of persistent/Long COVID-19 on the health of frontline workers could have direct impact in health service delivery. Given the rise in cases of COVID19 in South Africa and the world at large, the prevalence of Long COVID is likely to be substantial and therefore need for rehabilitation programs targeted at each of the persistent (Long) COVID symptoms is critical.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.03.21267225v1" target="_blank">Persistent Symptoms Among Frontline Health Workers Post-acute COVID-19 Infection</a>
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<li><strong>Risk assessment of banknotes as a fomite of SARS-CoV-2 in cash payment transactions</strong> -
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Background The COVID 19 pandemic has triggered concerns and assumptions globally about transmission of the SARS- CoV-2 virus via cash transactions. Objectives Assess the risk of contracting COVID-19 through exposure to SARS-CoV-2 via cash acting as a fomite in payment transactions. Methods A quantitative microbial risk assessment was conducted for a worst-case scenario assuming an infectious person at the onset of symptoms, when virion concentrations in coughed droplets are at their highest. This person then contaminates a banknote by coughing on it and immediately hands it over to another person, who might then be infected by transferring the virions with a finger from the contaminated banknote to a facial mucous membrane. The scenario considered transfer efficiency of virions on the banknote to fingertips when droplets were still wet and after having dried up and subsequently being touched by finger printing or rubbing the object. Results Accounting for the likelihood of the worst-case scenario to occur by considering 1) a local prevalence of 100 COVID-19 cases/100,000 persons, 2) a maximum of about 1/5th of infected persons transmit high virus loads and 3) the numbers of cash transactions/person/day, the risk of contracting COVID-19 via person-to-person cash transactions was estimated to be much lower than once per 39,000 days (107 years) for a single person. In the general populace, there will be a maximum of 2.6 expected cases/100,000 persons/day. The risk for a cashier at an average point of sale was estimated to be much less than once per 430 working days (21 months). Discussion The worst-case scenario is a rare event, therefore, for a single person, the risk of contracting COVID-19 via person-to-person cash transactions is very low. At a point of sale, the risk to the cashier proportionally increases but it is still low.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.03.21267258v1" target="_blank">Risk assessment of banknotes as a fomite of SARS-CoV-2 in cash payment transactions</a>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Epidemiology of myocarditis and pericarditis following mRNA vaccines in Ontario, Canada: by vaccine product, schedule and interval</strong> -
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Structured Abstract Importance: Increased rates of myocarditis/pericarditis following COVID-19 mRNA vaccines have been observed. However, little data are available related to product-specific differences, which have important programmatic impacts. Objective: The objective of this study was to estimate reporting rates of myocarditis/pericarditis following COVID-19 mRNA vaccine by product, age, sex, and dose number, as well inter-dose interval. Design: We conducted a population-based cohort study using passive vaccine safety surveillance data. All individuals in Ontario, Canada who received at least one dose of COVID-19 mRNA vaccine between December 14, 2020 and September 4, 2021 were included. Setting: This study was conducted in Ontario, Canada (population: 14.7 million) using the provincial COVID-19 vaccine registry and provincial adverse events following immunization database. Participants: We included all individuals with a reported episode of myocarditis/pericarditis following COVID-19 vaccine in the study period. We obtained information on all doses administered in the province to calculate reporting rates. Exposure: Receipt of COVID-19 mRNA vaccine (mRNA-1273 [Moderna Spikevax] or BNT162b2 [Pfizer-BioNTech Comirnaty]). Main Outcome(s) and Measure(s): Reported rate of myocarditis/pericarditis meeting level 1-3 of the Brighton Collaboration case definitions. Results: There were 19,740,741 doses of mRNA vaccines administered and 297 reports of myocarditis/pericarditis meeting our inclusion criteria. Among these, 69.7% occurred following the second dose of COVID-19 mRNA vaccine and 76.8% occurred in males. The median age of individuals with a reported event was 24 years. The highest reporting rate of myocarditis/pericarditis was observed in males aged 18-24 years following mRNA-1273 as the second dose; the rate in this age group was 5.1 (95% CI 1.9-15.5) times higher than the rate following BNT162b2 as the second dose. Overall reporting rates were higher when the inter-dose interval was shorter (i.e., ≤30 days) for both vaccine products. Among individuals who received mRNA-1273 for the second dose, rates were higher for those who had a heterologous as opposed to homologous vaccine schedule. Conclusions and Relevance: Our results suggest that vaccine product, inter-dose interval and vaccine schedule combinations may play a role in the risk of myocarditis/pericarditis, in addition to age and sex. Certain programmatic strategies could reduce the risk of myocarditis/pericarditis following mRNA vaccines.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.02.21267156v1" target="_blank">Epidemiology of myocarditis and pericarditis following mRNA vaccines in Ontario, Canada: by vaccine product, schedule and interval</a>
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<li><strong>Prevalence of SARS-CoV-2 infection among COVID-19 RT-PCR laboratory workers in Bangladesh</strong> -
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Background: Health care workers (HCWs) at the frontline are confronting a substantial risk of infection during the coronavirus disease 2019 (COVID-19) pandemic. This emerging virus created specific hazards to researchers and laboratory staff in a clinical setting, underlined by rapid and extensive worldwide transmission. This study aimed to investigate the prevalence of SARS-CoV-2 infection among COVID-19 RT-PCR laboratory health workers in Bangladesh. Materials &amp; Methods: This retrospective study was conducted between October 2 to December 2, 2020. A total of 508 participants, including doctors, scientific officers, medical technologists, and cleaners working in several COVID-19 RT-PCR laboratories, were included in this study. Data were collected from each participant using a semi-structured questionnaire prepared in the format of an anonymous Google form. All participants provided informed consent. The Ethical clearance was obtained from the Institutional Ethics Review Committee of Shaheed Suhrawardy Medical College, Dhaka, Bangladesh. All statistical analyses were performed using SPSS (Statistical Package for the Social Sciences) version 25.0 software (SPSS, Inc). Results: Out of the 508 participants, 295 tested positive for SARS CoV-2 RT-PCR. Among the positive cases, 202 were men, 93 were women, with a median age of 30 years. The most positive cases were medical technologists (53.22%) followed by doctors (28.8%). Out of the 271 symptomatic positive cases, the most typical symptoms were fever (78.5%), fatigue (70%), loss of smell and taste (65%), cough (64%), and others. Hypertension, obesity, and diabetes were found in 8.8%, 8.8%, and 7.1% positive cases. A + blood group was present in 37% of the positive cases, followed by the B+ blood group (27%) and O+ blood group (25%). Inadequate supply of personal protection equipment (PPE), absence of negative pressure ventilation, laboratory contamination, and no training on molecular test methods were found in 13.8%, 67.8%, 44.7%, and 40.6% of positive cases, respectively. Conclusion: Evaluating the infection status of laboratory health workers is crucial for drawing attention from the public, providing practical suggestions for government agencies, and increasing protective measures for laboratory health workers.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.02.21267191v1" target="_blank">Prevalence of SARS-CoV-2 infection among COVID-19 RT-PCR laboratory workers in Bangladesh</a>
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<li><strong>Fusion of Imaging and Non-Imaging Data for Disease Trajectory Prediction for COVID-19 Patients</strong> -
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Purpose: This study investigates whether graph-based fusion of imaging data with non-imaging EHR data can improve the prediction of disease trajectory for COVID-19 patients, beyond the prediction performance of only imaging or non-imaging EHR data. Materials and Methods: We present a novel graph-based framework for fine-grained clinical outcome prediction (discharge, ICU admission, or death) that fuses imaging and non-imaging information using a similarity-based graph structure. Node features are represented by image embedding and edges are encoded with clinical or demographic similarity. Results: Our experiments on data collected from Emory Healthcare network indicate that our fusion modeling scheme performs consistently better than predictive models using only imaging or non-imaging features, with f1-scores of 0.73, 0.77, and 0.66 for discharge from hospital, mortality, and ICU admission, respectively. External validation was performed on data collected from Mayo Clinic. Our scheme highlights known biases in the model prediction such as bias against patients with alcohol abuse history and bias based on insurance status. Conclusion: The study signifies the importance of fusion of multiple data modalities for accurate prediction of clinical trajectory. Proposed graph structure can model relationships between patients based on non-imaging EHR data and graph convolutional networks can fuse this relationship information with imaging data to effectively predict future disease trajectory more effectively than models employing only imaging or non-imaging data. Forecasting clinical events can enable intelligent resource allocation in hospitals. Our graph-based fusion modeling frameworks can be easily extended to other prediction tasks to efficiently combine imaging data with non-imaging clinical data.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.12.02.21267211v1" target="_blank">Fusion of Imaging and Non-Imaging Data for Disease Trajectory Prediction for COVID-19 Patients</a>
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<h1 data-aos="fade-right" id="from-clinical-trials">From Clinical Trials</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>GlowTest COVID-19 Antigen Home Test Kit QRI Use Study</strong> - <b>Condition</b>:   Covid 19<br/><b>Intervention</b>:   Diagnostic Test: GlowTest COVID-19 Antigen Home Test<br/><b>Sponsors</b>:   Arion Bio;   CSSi Life Sciences<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Allogenic UCMSCs as Adjuvant Therapy for Severe COVID-19 Patients</strong> - <b>Condition</b>:   Covid 19<br/><b>Interventions</b>:   Biological: Normoxic Allogenic UCMSC;   Other: Normal saline solution<br/><b>Sponsors</b>:   Kementerian Riset dan Teknologi / Badan Riset dan Inovasi Nasional, Indonesia;   Dr. Moewardi General Hospital, Surakarta, Indonesia;   Dr. Sardjito General Hospital, Yogyakarta, Indonesia;   Dr. Hasan Sadikin General Hospital, Bandung, Indonesia;   PT Bifarma Adiluhung<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Physical Fitness in Young Healthy Adults After COVID-19 Infection</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Other: Physical Activity Level;   Other: Evaluation of knee extension and elbow flexion muscle strength;   Other: Evaluation of functional strength of trunk muscles;   Other: Muscle Endurance;   Other: Flexibility;   Other: Balance;   Other: Fatigue<br/><b>Sponsor</b>:  <br/>
Baskent University<br/><b>Enrolling by invitation</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Using MOST to Optimize an Intervention to Increase COVID-19 Testing for Frontline Essential Workers</strong> - <b>Conditions</b>:   COVID-19;   COVID-19 Testing<br/><b>Interventions</b>:   Behavioral: Motivational interviewing</li>
</ul>
<ol start="1001" type="I">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">counseling;   Behavioral: Text messages (TMs) and quiz questions (QQs);   Behavioral: Peer education;   Behavioral: Access to COVID testing<br/><b>Sponsor</b>:   New York University<br/><b>Not yet recruiting</b></li>
</ol>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Efficacy of Different COVID-19 Vaccine Combinations in Inducing Long-term Humoral Immunity [PRIBIVAC]</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: Homologous mRNA booster vaccine;   Biological: Heterologous mRNA booster vaccine;   Biological: Non-mRNA booster vaccine A;   Biological: Non- mRNA booster vaccine B;   Biological: Non-mRNA booster vaccine C<br/><b>Sponsors</b>:   Tan Tock Seng Hospital;   A*Star;   Duke-NUS Graduate Medical School;   KK Women’s and Children’s Hospital<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Inhaled Recombinant Non-immunogenic Staphylokinase vs Placebo in Patients With COVID-19 - FORRIF Trial</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Recombinant nonimmunogenic staphylokinase;   Drug: Placebo<br/><b>Sponsors</b>:   Supergene, LLC;   Russian Academy of Medical Sciences<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Safety and Immunogenicity of COVID-19 Vaccine, Inactivated in Healthy Population Aged From 3 to 11 Years</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Biological: COVID-19 Vaccine,Inactivated<br/><b>Sponsor</b>:   Sinovac Biotech Co., Ltd<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Nutritional Supplementation of Vitamin D, Quercetin and Curcumin With Standard of Care for Managing Mild Early Symptoms of COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Standard of care;   Dietary Supplement: Investigational treatment<br/><b>Sponsor</b>:   King Edward Medical University<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study of Immunogenicity Equivalence of a Homologous Third Dose of Covid-19 (Recombinante) Vaccine</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Biological: Covid -19 (recombinante) vaccine<br/><b>Sponsor</b>:   The Immunobiological Technology Institute (Bio-Manguinhos) / Oswaldo Cruz Foundation (Fiocruz)<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study to Evaluate the Safety and Efficacy of a Monoclonal Antibody Cocktail for the Prevention of COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: ADM03820;   Other: Placebo<br/><b>Sponsors</b>:  <br/>
Ology Bioservices;   Enabling Biotechnologies (EB)<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Usefulness of DORNASE in COVID-19 on HFNO</strong> - <b>Condition</b>:   COVID-19 Pneumonia<br/><b>Intervention</b>:   Procedure: inhalations<br/><b>Sponsor</b>:  <br/>
University Medical Centre Ljubljana<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Immune Response of Heterologous Boost Third Dose of mRNA and Protein COVID-19 Vaccine: a Single-blind, and Randomized Study</strong> - <b>Conditions</b>:   COVID-19;   Breakthrough Infection<br/><b>Interventions</b>:   Biological: BNT162b2;   Biological: mRNA-1273;   Biological: MCV COVID-19 vaccine<br/><b>Sponsors</b>:   Chang Gung Memorial Hospital;   Medigen Vaccine Biologics Corp.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 VACCINE SAFETY AND EFFECTIVENESS</strong> - <b>Condition</b>:   SARS-CoV-2 Infection<br/><b>Intervention</b>:   Biological: ChAdOx1 nCoV-19 vaccine (AZD1222)<br/><b>Sponsors</b>:   Federal University of Espirito Santo;   Instituto René Rachou/Fiocruz<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Phase Ⅱ and Ⅲ Trial of a SARS-CoV-2 Vaccine LYB001</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: LYB001;   Biological: Placebo<br/><b>Sponsor</b>:   Yantai Patronus Biotech Co., Ltd.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Immune Response of Asymptomatic EHPAD Employees Infected With COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Other: serology<br/><b>Sponsors</b>:  <br/>
Assistance Publique - Hôpitaux de Paris;   Institut Pasteur<br/><b>Not yet recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Quantifying the contribution of pathways of nosocomial acquisition of COVID-19 in English hospitals</strong> - CONCLUSIONS: Current control strategies have successfully reduced the transmission of SARS-CoV-2 between patients and HCWs. In order to reduce the burden of nosocomial COVID-19 infections on health services, stricter measures should be enforced that would inhibit the spread of the virus between bays or wards in the hospital. There should also be a focus on inhibiting the spread of SARS-CoV-2 between HCWs. The findings have important implications for infection-control procedures in hospitals.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Phytotoxicity assessment of biodegradable and non-biodegradable plastics using seed germination and early growth tests</strong> - Global production of plastics remains at the high level despite the SARS-Cov-2 pandemic. These are primarily petroleum- derived plastics but the contribution of bio-based plastics estimated at the level of 1% in the plastic market in 2019 is expected to be increasing. Simultaneously, the significant part of plastic waste is still disposed improperly and pollutes the environment making a threat to all living organisms. In this work three plastic materials, two bio-based biodegradable: polylactide…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The NSP14/NSP10 RNA repair complex as a Pan-coronavirus therapeutic target</strong> - The risk of zoonotic coronavirus spillover into the human population, as highlighted by the SARS-CoV-2 pandemic, demands the development of pan-coronavirus antivirals. The efficacy of existing antiviral ribonucleoside/ribonucleotide analogs, such as remdesivir, is decreased by the viral proofreading exonuclease NSP14-NSP10 complex. Here, using a novel assay and in silico modeling and screening, we identified NSP14-NSP10 inhibitors that increase remdesivir’s potency. A model compound, sofalcone,…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Viral proteases: Structure, mechanism and inhibition</strong> - Viral proteases are diverse in structure, oligomeric state, catalytic mechanism, and substrate specificity. This chapter focuses on proteases from viruses that are relevant to human health: human immunodeficiency virus subtype 1 (HIV-1), hepatitis C (HCV), human T-cell leukemia virus type 1 (HTLV-1), flaviviruses, enteroviruses, and coronaviruses. The proteases of HIV-1 and HCV have been successfully targeted for therapeutics, with picomolar FDA-approved drugs currently used in the clinic. The…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Efficacy and potential mechanisms of Chinese herbal compounds in coronavirus disease 2019: advances of laboratory and clinical studies</strong> - The Coronavirus disease 2019 (COVID-19) pandemic is still spread and has made a severe public health threat around the world. To improve disease progression, emerging Chinese herbal compounds were used in clinical practice and some agents have proven beneficial in treating COVID-19. Here, the relevant literature from basic researches to clinical application were identified and comprehensively assessed. A variety of Chinese herbal compounds have been reported to be effective in improving symptoms…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Relative Ratios of Human Seasonal Coronavirus Antibodies Predict the Efficiency of Cross-Neutralization of SARS- CoV-2 Spike Binding to ACE2</strong> - BACKGROUND: Antibodies raised against human seasonal coronaviruses (sCoVs), which are responsible for the common cold, are known to cross-react with SARS-CoV-2 antigens. This prompts questions about their protective role against SARS-CoV-2 infections and COVID-19 severity. However, the relationship between sCoVs exposure and SARS-CoV-2 correlates of protection are not clearly identified.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Discovery of Di- and Trihaloacetamides as Covalent SARS-CoV-2 Main Protease Inhibitors with High Target Specificity</strong> - The main protease (M^(pro)) is a validated antiviral drug target of SARS-CoV-2. A number of M^(pro) inhibitors have now advanced to animal model study and human clinical trials. However, one issue yet to be addressed is the target selectivity over host proteases such as cathepsin L. In this study we describe the rational design of covalent SARS- CoV-2 M^(pro) inhibitors with novel cysteine reactive warheads including dichloroacetamide, dibromoacetamide, tribromoacetamide,…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A phase I, first-in-human, randomized dose-escalation study of anti-activated factor XII monoclonal antibody garadacimab</strong> - Factor XII (FXII) is the principal initiator of the plasma contact system and has proinflammatory and prothrombotic activities. This single-center, first-in-human phase I study aimed to assess the safety and tolerability of single escalating doses of garadacimab, a monoclonal antibody that specifically inhibits activated FXII (FXIIa), in healthy male volunteers. Volunteers were randomized to eight cohorts, with intravenous (i.v.) doses of 0.1, 0.3, 1, 3, and 10 mg/kg and subcutaneous (s.c.)…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Metformin Suppresses Monocyte Immunometabolic Activation by SARS-CoV-2 Spike Protein Subunit 1</strong> - A hallmark of COVID-19 is a hyperinflammatory state associated with severity. Monocytes undergo metabolic reprogramming and produce inflammatory cytokines when stimulated with SARS-CoV-2. We hypothesized that binding by the viral spike protein mediates this effect, and that drugs which regulate immunometabolism could inhibit the inflammatory response. Monocytes stimulated with recombinant SARS-CoV-2 spike protein subunit 1 showed a dose-dependent increase in glycolytic metabolism associated with…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Nucleic Acid-Based Treatments Against COVID-19: Potential Efficacy of Aptamers and siRNAs</strong> - Despite significant efforts, there are currently no approved treatments for COVID-19. However, biotechnological approaches appear to be promising in the treatment of the disease. Accordingly, nucleic acid-based treatments including aptamers and siRNAs are candidates that might be effective in COVID-19 treatment. Aptamers can hamper entry and replication stages of the SARS-CoV-2 infection, while siRNAs can cleave the viral genomic and subgenomic RNAs to inhibit the viral life cycle and reduce…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Screening of a Small Molecule Compound Library Identifies Toosendanin as an Inhibitor Against Bunyavirus and SARS- CoV-2</strong> - Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging tick-borne virus causing serious infectious disease with a high case-fatality of up to 50% in severe cases. Currently, no effective drug has been approved for the treatment of SFTSV infection. Here, we performed a high-throughput screening of a natural extracts library for compounds with activities against SFTSV infection. Three hit compounds, notoginsenoside Ft1, punicalin, and toosendanin were identified for displaying…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Berry derived constituents in suppressing viral infection: Potential avenues for viral pandemic management</strong> - Berries are acknowledged as a rich source of major dietary antioxidants and the fact that berry phenolics exhibit antioxidant property is widely accepted. Berries are abundant in Vitamin C and polyphenols such as anthocyanins, flavonoids, and phenolic acids. Polyphenols are found to have several therapeutic effects such as anti-inflammatory, antioxidant, and antimicrobial properties. Increasing studies are focusing on natural products and their components for alternative therapeutics against…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Differential Interactions between Human ACE2 and Spike RBD of SARS-CoV-2 Variants of Concern</strong> - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the current coronavirus disease 2019 (COVID-19) pandemic. It is known that the receptor-binding domain (RBD) of the spike protein of SARS-CoV-2 interacts with the human angiotensin-converting enzyme 2 (ACE2) receptor, initiating the entry of SARS-CoV-2. Since its emergence, a number of SARS-CoV-2 variants have been reported, and the variants that show high infectivity are classified as variants of concern…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Direct and Catalytic C-Glycosylation of Arenes: Expeditious Synthesis of the Remdesivir Nucleoside</strong> - Since early 2020, scientists have strived to find an effective solution to fight SARS-CoV-2, especially by developing reliable vaccines that inhibit the spread of the disease and repurposing drugs for combatting its effects on the human body. The antiviral prodrug Remdesivir is still the most widely used therapeutic during the early stage of the infection. However, the current synthetic routes rely on the use of protecting groups, air-sensitive reagents, and cryogenic conditions, impeding the…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Spherical Neutralizing Aptamer Inhibits SARS-CoV-2 Infection and Suppresses Mutational Escape</strong> - New neutralizing agents against SARS-CoV-2 and associated mutant strains are urgently needed for the treatment and prophylaxis of COVID-19. Herein, we develop a spherical cocktail neutralizing aptamer-gold nanoparticle (SNAP) to block the interaction between the receptor-binding domain (RBD) of SARS-CoV-2 and host ACE2. With the multivalent aptamer assembly as well as the steric hindrance effect of the gold scaffold, SNAP exhibits exceptional binding affinity against the RBD with a dissociation…</p></li>
</ul>
<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>REAL-TIME REST BREAK MANAGEMENT SYSTEM FOR WORKPLACE</strong> - The present invention relates to a real-time rest break management system for workplace that comprises of a work desk, wherein first portion is incorporated with a biometric unit 4 for authenticating first user, and a second portion with a telescopic panel 2 associated with a weight sensor 6 and timer unit 7 calculating weight of head/hand manifesting user presence and their resting time period is mounted with an inflated cushion 5, an interactive primary display unit 1 attached over desk enables user to set first/second threshold time for sleeping/taking break, further linked with a tracking interface keeping track of activities and a vibrating unit crafted inside the cushion 5 which is linked to a secondary display unit 8 of second user, giving them access to actuate vibrating unit generating impulses to wake first user when threshold time period is exceeded by the first user. - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=IN342791215">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>P2P 네트워크를 이용한 내장된 화상회의 시스템</strong> - 본 발명은 P2P 네트워크를 이용한 내장된 화상회의 시스템에 관한 것으로, 상태표시부(1), 영상송출부(2), 제어부(3), 광고부(4), 입력부(5)를 포함한다. - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=KR342781397">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A DOORBELL SYSTEM FOR MONITORING AND RECORDING A PHYSIOLOGICAL DATA OF A PERSON</strong> - AbstractTitle: A doorbell system for monitoring and recording a physiological data of a person The present invention provides a doorbell system 500 for monitoring and recording a physiological data of a person. The doorbell system 500 having a transmitter module 100 and a receiving module 200. The transmitter module 100 is having a TOF sensor module 110, an ultrasound detector 120, and an infrared detector 130. Further, a speech recognition system 150, a facial recognition system 160, and a temperature detector 190 are provided for recognizing speech, face, and temperature of the person by comparing pre-stored data. A controlling module 180 is set with a predefined commands for communicating with the transmitter module 100 and receiving module 200. The collected facial and speech data is compared and matched with the pre-stored data then the temperature detector 190 triggers and the door opens when the captured body temperature of the person is matched within the predefined range of temperature.Figure 1 - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=IN340503637">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A study of contemporary trends in investing patterns, household savings, and economic investment.</strong> - Because household savings and household investments are intertwined and interdependent, they are discussed briefly in this paper. Household savings account for more than half of a country’s capital formation, which fluctuates due to a variety of economic factors such as inflation and interest rates. Households should gradually shift their savings and investments from physical assets to financial assets to avoid a sudden change in wealth. They should also save and invest using a variety of platforms. Trends in investing and saving will be easier to track and measure this way. This year’s domestic saving rate in India is 2.3 percent lower than last year’s and 1.2 percent lower than the year before. Since 2011, general domestic savings have been steadily declining, with the trend continuing into the following year. According to official data, the GDP in 2020 shrank by 23.9%, the least in previous years and the least since the Covid-19 pandemic in previous years. As a result, the information presented in this paper is drawn from and evaluated from other sources - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=IN340502149">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>靶向刺激体液免疫和细胞免疫的新冠病毒mRNA疫苗</strong> - 本发明公开了一种靶向刺激体液免疫和细胞免疫的新冠病毒mRNA疫苗。本申请的第一方面提供一种分离的DNA分子组合，该DNA分子组合包括第一DNA分子和第二DNA分子和第三DNA分子中的至少一种。通过第一DNA分子以及第二DNA分子和/或第三DNA分子的组合，利用第一DNA分子最终合成的mRNA诱导高滴度的交叉中和抗体，利用第二DNA分子和/或第三DNA分子最终合成的mRNA诱导新冠病毒特异性的细胞毒性T淋巴细胞，从而高效地同时激活相对独立的体液免疫应答和细胞免疫应答，应对新冠病毒在流行传播过程中产生的突变毒株所引发的突破性感染。 - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=CN343418093">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>跨膜丝氨酸蛋白酶2抑制剂在制备治疗和/或预防冠状病毒感染药物中的用途</strong> - 本发明公开了跨膜丝氨酸蛋白酶2抑制剂在制备治疗和/或预防冠状病毒感染药物中的用途。本发明通过亲和垂钓及活性导向分离获得3种化合物，证实该类化合物可以直接地与跨膜丝氨酸蛋白酶2结合，KD&lt;13μM，且能够显著抑制跨膜丝氨酸蛋白酶2的催化活性。在细胞水平上可以有效的抑制新型冠状病毒SARS‑CoV‑2假病毒入侵，表明该类化合物对于制备治疗和/或预防病毒感染药物具有非常积极的作用。化合物1 化合物2 化合物3。 - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=CN343418164">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>PROLIPOSOMAL DRY POWDER INHALER OF REMDESIVIR</strong> - The present invention is related to Proliposomal Dry Powder Inhaler of Remdesivir and its method thereof for the treatment of viral infections such Coronaviridae (including COVID-19 infection). - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=IN342291904">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Use of Diminazene Aceturate, Xanthenone, ACE 2 activators or analogs for the Treatment and therapeutic use of COVID-19 on human patients.</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU340325322">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>ACTIVE RIDER SAFETY SYSTEM FOR TWO WHEELERS</strong> - The present invention relates to an active rider safety system for two wheelers comprising, a protective case equipped by a user for riding, where the case is integrated with multiple piezoelectric sensor that determines fastening of the case by user, a processing unit linked to the sensor, where the unit detects absence of case upon fetching data from the sensor below a threshold value and thereby terminates operation of ignition by stopping a coupled motor operated via a radio frequency module, an alcohol detection sensor that detects presence of alcohol and send data to processing unit, a temperature sensor that measures temperature of the user, an accelerometer sensor that activates upon ignition us tuned on to determine presence of a crash and a navigation module that via communication module sends location of user to pre saved users and concerned authorities. - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=IN340503361">link</a></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Medizintechnische Haltevorrichtung und Haltevorrichtungs-Kit jeweils zum Halten von allgemeinmedizinischen, chirurgischen oder diagnostischen Einrichtungen oder Instrumenten sowie deren Verwendung insbesondere zur Datenerfassung</strong> -
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Medizintechnische Haltevorrichtung (10) eingerichtet zum Halten von allgemeinmedizinischen, chirurgischen oder diagnostischen Einrichtungen oder Instrumenten, insbesondere Diagnose-Einrichtungen oder -instrumenten für den Mund-/Rachenraum aus der folgenden Gruppe: Spatel (1), Abstrich-Einrichtung (2), Lichtquelle (3), Kamera (4); wobei die Haltevorrichtung (10) aufweist:</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">einen Kontaktbereich (15) zum manuellen Kontaktieren der Haltevorrichtung (10) durch einen Nutzer;</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">wenigstens eine mit dem Kontaktbereich (15) verbundene Haltekupplung (11, 12, 13) zum reversiblen Kuppeln, insbesondere form- und/oder kraftschlüssigen Kuppeln, der jeweiligen Einrichtung oder des Instruments; dadurch gekennzeichnet, dass der Kontaktbereich (15) eine Mindest-Längserstreckung (x15) von 20cm aufweist, wobei die wenigstens eine Haltekupplung (11, 12) an einem Längs-Ende des Kontaktbereichs (15) angeordnet ist, und wobei der Kontaktbereich</li>
</ul>
<ol start="15" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">zumindest teilweise aus Kupfer besteht oder Kupfer als Oberflächenmaterial/-werkstoff aufweist, wobei die medizintechnische Haltevorrichtung (10) eingerichtet ist zum Kuppeln einer/der Kamera im Kontaktbereich, insbesondere bei Verwendung einer Kamera mit einem Gehäuse mit integrierter Kuppelfunktion.</li>
</ol>
<img alt="embedded image" id="EMI-D00000"/>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"></p>
<ul>
<li><a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=DE343577678">link</a></li>
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<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-new-yorker">From New Yorker</a></li>
<li><a href="#from-vox">From Vox</a></li>
<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
<li><a href="#from-ars-technica">From Ars Technica</a></li>
<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
</ul>
<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Trump’s COVID Coverup</strong> - During the 2020 campaign, the former President tested positive days before debating Joe Biden and kept it secret. - <a href="https://www.newyorker.com/news/daily-comment/trumps-covid-coverup">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Supreme Court Looks Ready to Overturn Roe v. Wade</strong> - Lawyers and Justices on both sides—with the possible exception of John Roberts—appeared to be past pretending that the Mississippi case is about anything less. - <a href="https://www.newyorker.com/news/daily-comment/the-supreme-court-looks-ready-to-overturn-roe">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Uncertainties of the Omicron Variant</strong> - The new coronavirus strain is worrisome—but its effect won’t be the same everywhere. - <a href="https://www.newyorker.com/science/medical-dispatch/the-uncertainties-of-the-omicron-variant">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Will the Omicron Travel Restrictions Work?</strong> - Attempts to slow the pandemic by screening international arrivals have a mixed record of success. - <a href="https://www.newyorker.com/news/annals-of-inquiry/will-the-omicron-travel-restrictions-work">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Chris Cuomo’s Personal Journey</strong> - The self-evaluation will be televised. - <a href="https://www.newyorker.com/cartoons/blitts-kvetchbook/chris-cuomos-personal-journey">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>Biden’s pre-K plan might not be as “universal” as he hopes</strong> -
<figure>
<img alt="" src="https://cdn.vox-
cdn.com/thumbor/zojYKVSKVT7fqPbNQQC_Lk7LHF4=/724x0:7887x5372/1310x983/cdn.vox-
cdn.com/uploads/chorus_image/image/70234044/GettyImages_1231590878.0.jpg"/>
<figcaption>
Preschooler Korey Hill works on an alphabet puzzle at Patterson Elementary School in Washington, DC, in February. | Evelyn Hockstein for The Washington Post via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Democrats want to expand preschool to all 3- and 4-year-olds but risk deepening inequities in the process.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VzGCrh">
Advocates for the universal preschool plan in Democrats’ Build Back Better Act say it could be transformative for families and their 3- and 4-year-olds:<strong> </strong>giving parents flexibility, helping children grow and develop, and offering states a big return on their investment in pre-K expansion, all while boosting the country’s competitiveness on the global stage.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HDjsq1">
The $110 billion proposal<strong> </strong>for free, high-quality pre-K could offer early learning that helps kids throughout their lives. Early childhood education experts who spoke to Vox said the initiative is ambitious.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YoN1CN">
“This is unprecedented on the part of the federal government to get involved in education in quite this way,” says Elizabeth Cascio, a professor of economics at Dartmouth College who researches education and social policy. “Helping to establish another grade in the school system is not something the federal government has ever done.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Xg41en">
President Biden <a href="https://twitter.com/potus/status/1452703454527467524">recently touted</a> that his plan would be <a href="https://twitter.com/POTUS/status/1465727591437017092">free</a> and <a href="https://twitter.com/joebiden/status/1285640182700453888?lang=en">universal</a>: “Studies show that the earlier our children begin to learn in school, the better. That’s why we’re going to make two years of high-quality preschool available to every child,” he wrote on Twitter. But critics warn it could fall short of providing the universal, high- quality early education it promises.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QbN0q9">
First, although universal pre-K has bipartisan support in some states, Republican governors could simply opt out of the federal funds under the Biden plan — some state lawmakers <a href="https://www.washingtonpost.com/business/2021/11/30/biden-universal-prek-gop/">have already suggested</a> they will. States may also balk at the plan’s short-term funding. The program is currently only funded for six years, and federal assistance decreases significantly in the last two yeas.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gpkRmC">
Then there’s the question of how to measure what an effective pre-K program actually is: The proposal doesn’t lay out specifics on how to measure the quality of pre-K programs. This, education experts argue, risks worsening learning and behavioral outcomes for kids, especially those from high-needs communities.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KHpSC2">
The Biden administration’s vision is admirable but doesn’t offer a clear roadmap — one that truly bolsters the inclusion of <em>all</em> 3- and 4-year-olds — experts warn. “There are incredible barriers to Black and Latino families living in segregated disadvantage, which means their children are already disproportionately unable to access pre-K services,” said John Fantuzzo, director of the Penn Child Research Center and professor of human relations at the Penn Graduate School of Education. “If the federal government merely expands what already exists, without rethinking who is in need or what [high] quality is, the deployment of these services won’t move the needle for those who need it most.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="anKxbL">
As the Senate weighs the sweeping social-spending bill, Democrats are confident that federal and state lawmakers will back the preschool proposal. “We know that these programs are good for children. There’s a very strong research base that shows that [pre-K] has a great return on investment,” said Carmel Martin, deputy director of the White House’s Domestic Policy Council for Economic Mobility and an architect of the plan. “And we know that states across the country are interested in expanding access to these programs since so many of them already have state-funded preschool programs. It’s not just something that’s popular with Democratic leaders.”
</p>
<h3 id="DSwBZr">
What the research says about preschool
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="e1ScE0">
For decades, education reformers and policymakers have searched for ways to close opportunity gaps — unequal access to the resources that children need to be successful in school and in life. As early as kindergarten, students from high-income families are ahead of those from low-income families on reading, math, and social and emotional skills,<strong> </strong>according to the <a href="https://www.epi.org/publication/reducing-and-averting-achievement-gaps/#epi-
toc-10">Economic Policy Institute</a>, a left-leaning think tank.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ndqb7Q">
Expanding high-quality early childhood education, namely pre-K programs, has been offered up as one way to close these gaps.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qWd5B6">
Though <a href="https://www.edworkingpapers.com/sites/default/files/ai19-27.pdf">not all studies</a> of Head Start, the federal program that funds preschool for low-income children, have found <a href="https://scholar.harvard.edu/files/ddeming/files/deming_headstart_aejfinal.pdf">clear long-term benefits</a>, most research on the program has found that kids who participate are <a href="https://www.hamiltonproject.org/papers/the_long_term_impacts_of_head_start">more likely to graduate high school and attend college</a>, with <a href="https://static1.squarespace.com/static/563b95a2e4b0c51a8b87767c/t/59b2e1d259cc681cdd587b22/1504895485410/Barr+%26+Gibbs_Intergenerational_2017.pdf">benefits transferring across generations</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Gi6PKS">
Studies of <a href="https://georgetown.app.box.com/s/kkv3d717lib52clh9w4t3wns50ivcaxs">state-funded</a> <a href="https://www.nber.org/system/files/working_papers/w19735/w19735.pdf">pre-K programs</a> <a href="https://blueprintlabs.mit.edu/research/the-long-term-effects-of-universal-preschool-in-boston/">are similar</a>: Not all have found significant, lasting positive effects, but studies have found improvements in social, emotional, and behavioral skills, graduation rates, SAT-taking rates, and employment rates as well as decreases in juvenile incarceration and teen pregnancy rates for students who participated. Researchers have often found that <a href="https://www.brookings.edu/wp-content/uploads/2017/04/duke_prekstudy_final_4-4-17_hires.pdf">children from low- income families and dual-language learners benefit</a> more than children from middle- or high-income backgrounds and those who are English proficient.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-
cdn.com/thumbor/qhrWS_qi_MANVvmNbeGzc5GkNrc=/800x0/filters:no_upscale()/cdn.vox-
cdn.com/uploads/chorus_asset/file/23035977/AP21268633252836.jpg"/> <cite>Mary Altaffer/AP</cite></figure></li>
</ul>
<figcaption>
Pre-K teacher Vera Csizmadia teaches 3- and 4-year-old students in her classroom at the Dr. Charles Smith Early Childhood Center in Palisades Park, New Jersey, in September.
</figcaption>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IPGyWf">
Proponents also <a href="https://www.vox.com/future-perfect/2018/10/16/17928164/early-childhood-education-doesnt-teach-kids-fund-
it">point to</a> preschool as a boon for parents, particularly low-income parents. The opportunity to leave their children in the care of educators for a full day allows them to enter the workforce full time or pursue higher education. Washington, DC’s universal pre-K <a href="https://www.vox.com/identities/2018/9/26/17902864/preschool-
benefits-working-mothers-parents">program helped lead to a 10 percentage-point increase in labor force participation</a> for women with young children.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FML3oA">
Forty-four states, DC, and Guam already funded some kind of preschool program during the 2019-20 school year, according to the <a href="https://nieer.org/state-preschool-
yearbooks/yearbook2020">National Institute for Early Education Research</a> at Rutgers University. But most American kids under 5 weren’t enrolled in preschool that year:<strong> </strong><a href="https://nieer.org/state-preschool-
yearbooks/yearbook2020">Only 34 percent</a> of 4-year-olds and 6 percent of 3-year-olds were enrolled across the states that offer it. States spent more than $9 billion on preschool programs, spending $5,449 per child on average, that year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qEYqSk">
“It used to be that 5-year-olds were on the margins of school entry — by the mid-1960s, only about half of states funded kindergarten,” Cascio said. “The progress has been much faster with pre-K, but there’s still a long way to go.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AKZtk5">
Democrats’ six-year plan would offer free preschool to all 3- and 4-year-olds by sharing costs between states and the federal government to more than double the current number of preschool seats, offering slots to more than 6 million children. The bill would also require states to increase the salaries of preschool staff, establish new degree requirements for educators, develop new curricula for preschools, and regularly report progress to the Department of Health and Human Services.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZVPySG">
But there are at least three major areas where the plan could fall short of its goal.
</p>
<h3 id="2wDP4E">
<ol type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">Red states might refuse federal funds for universal pre-K
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gKVcv0">
In a January <a href="https://www.ffyf.org/2021-policy-poll-fact-sheet/">poll</a> of American adults from the nonpartisan First Five Years Fund, 73 percent of Republicans and 95 percent of Democrats were in favor of making free preschool more available to all 3- and 4-year-olds whose parents want to send them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XoCnTY">
But the bipartisan support behind pre-K expansion doesn’t mean that all states, particularly red states, will sign up. Preschool programs have thrived in conservative states like Georgia and Oklahoma for years, but there’s no guarantee that Republican governors, who have traditionally left education up to local and state leaders, will want more involvement from the federal government.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fWDtIL">
“It’s the state’s responsibility to fund government education, not the federal government’s. Each community is different,” Sherri Ybarra, Idaho’s superintendent of public instruction, told the <a href="https://www.wsj.com/articles/how-bidens-plan-would-expand-pre-k-to-millions-of-
children-11636713000">Wall Street Journal</a>. “If I had the opportunity to sit down with President Biden, I would say, ‘Let the states focus on where they think their students need the most intervention and the most help.’”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BFE5lm">
Republican lawmakers in multiple states, including Missouri, Minnesota, North Carolina, and New Hampshire, <a href="https://www.washingtonpost.com/business/2021/11/30/biden-universal-prek-gop/">told the Washington Post</a> that they were wary of parts of the program, with some citing federal overreach as a concern.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ImvQnl">
“Republican leaders have supported federal investment in preschool historically. The way the program is set up, it is not the federal government getting inappropriately involved,” says Martin. “We want to partner with states, and the program anticipates that states would be the ones administering and setting standards for the program.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Lq5xqM">
The bill also contains a backup plan that allows the Department of Health and Human Services to partner with the local governments directly should states not opt in, allowing providers, from nonprofit organizations to schools and childcare centers, within the mixed-delivery system to receive funding.
</p>
<h3 id="tirHP4">
<ol start="2" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">The money eventually disappears
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7JEQJr">
From 2022 to 2024, the program would dole out money to the states based on population trends and child poverty rates — priority will be given to programs for children from families with income at or below 200 percent of the poverty line — setting aside $4 billion, $6 billion, and $8 billion for each year, respectively. Then in the next three years, from 2025 to 2027, a phase-down begins with the government picking up about 95 percent of state expenditures, down to about 63 percent in the final year. Year four of the program is the only year that government covers nearly all expected costs.
</p>
<figure class="e-image">
<img alt="Chart: “The Build
Back Better Act won’t cover all of states’ pre-K needs”" src="https://cdn.vox-cdn.com/thumbor/kZB2YB7qErw-
T_rYSF4rNf572n8=/800x0/filters:no_upscale()/cdn.vox-
cdn.com/uploads/chorus_asset/file/23059429/Final_pre_k_BBB_funding.png"/>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="k2Sv9f">
This shrinking pot of funds might turn some states away. As Matt Bruenig at the left-leaning think tank People’s Policy Project <a href="https://www.peoplespolicyproject.org/2021/11/09/the-incredible-shrinking-pre-k-plan/">noted</a>, the size of the program has only decreased with each iteration of the bill. In the first draft, the federal government covered 100 percent of state costs in the first three years and even picked up 60 percent of state costs in 2028.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cV6Ly6">
Whether this shrunken federal contribution would be enough to entice states is left to be seen. One GOP lawmaker from Minnesota <a href="https://www.washingtonpost.com/business/2021/11/30/biden-universal-prek-
gop/">called</a> the plan a “bait and switch,” since the money from the federal government decreases. Plus, the cost of establishing or expanding universal pre-K could vary widely from state to state: Some states may have extra space to house pre-K programs, for example, while others may need to build from scratch.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QKN0aO">
The first three years of the program will focus on pre-K expansion for children from low-income backgrounds, but some<strong> </strong>early education experts worry the targeted approach expires too soon.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YOqx53">
States move to a universal free-for-all entitlement program in year four. But first, they have to ensure that “a majority of children” in high-needs communities have been offered the opportunity to enroll.<strong> </strong>The word “majority” could prove consequential, says Bruce Fuller, a sociologist and professor of education at the University of California Berkeley.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eOMi31">
“If you look at states like the Dakotas or Montana, proportionately, they have huge populations of low-income and lower-middle-income class families who don’t have affordable pre-K,” said Fuller. “And how you fill that void in two to three years is going to be a pressing question.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Y62Sg1">
For many states, expanding pre-K is simply a matter of money. “The lack of funding has been a major impediment,” Cascio said. “States feeling constrained financially has been a major impediment to the expansion of these programs and meeting all children’s needs.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="919ZuV">
And since almost all states already offer some form of free preschool, proponents of the Biden administration’s plan see federal funding as a continuation of state-level plans. “The funds are meant to supplement but not supplant dollars that states are already investing,” said Rasheed Malik, the director of early childhood policy at the Center for American Progress. “With this plan, it’s not possible to hit the pedal and go from zero to 60 right away. There’s sensitivity to the fact that states need to have a plan to make sure they’re not going to disrupt the supply of infant and toddler child care in communities.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="38mVL7">
Federal spending increases in the first three years, with the expectation that it will take time for pre-K to be expanded into all communities in a state. Then in the final three years, the training wheels come off. “If a state government is forward-looking, they have to decide whether they’re going to be ready to ride the bike on their own,” Cascio said. “Are they going to have the state capacity and the fiscal capacity to do it on their own?”
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-
cdn.com/thumbor/KqcS4QseWwXAJY_RIk23HJ0uBw4=/800x0/filters:no_upscale()/cdn.vox-
cdn.com/uploads/chorus_asset/file/23035997/GettyImages_1236123512.jpg"/> <cite>Andrew Caballero-Reynolds/AFP via Getty Images</cite>
<figcaption>
A Build Back Better sign is displayed in a pre-K classroom at East End Elementary School in North Plainfield, New Jersey, on October 25, when President Biden visited the school.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pjguzl">
The six-year time frame also comes with the hope and expectation that the plan will be renewed and extended once leaders and constituents realize the benefits, though it’s clear that the amount of years is a result of political considerations as opposed to research that shows how long it would take to implement the program. It took decades to usher in kindergarten, and it’s still not compulsory across the country. But in states like Georgia and Oklahoma, the pre-K programs experienced dramatic year-on-year increases in pre-K enrollment when they rolled out their programs. “There is evidence to suggest that when a state is interested in doing this they can ramp up fairly quickly,” Cascio said.
</p>
<h3 id="uVcmlV">
<ol start="3" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">The guarantees on quality aren’t tough enough
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="H46gpJ">
Experts say that children from low-income families are best buoyed by high-quality pre-K, and <a href="https://files.eric.ed.gov/fulltext/ED579818.pdf">studies</a> <a href="https://www.nber.org/papers/w14474">show</a> that low-quality pre-K could actually <a href="https://www.vox.com/2015/9/24/9391625/quebec-daycare-study">worsen outcomes</a> for children of all circumstances.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pxbNNS">
But what “high quality” means is, in part, left to state governments to determine. To qualify for funding, if they do opt in, states will have to submit plans to the Department of Health and Human Services that estimate how much money they need to create and expand programs. States will also have certain requirements to receive the funding, like meeting quality thresholds<strong> </strong>that the states will define themselves, as long as the programs are not lower quality than Head Start.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="g6M6Zx">
But, some early education experts say, giving so much leeway to states could leave communities out.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2OPVGT">
“Who is defining need, and who is defining quality?” said Fantuzzo. “Do states have the capacity to understand where their preschool deserts are, and then will they have the time to get their act together to provide resources to those with the greatest need?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SMyVza">
The Biden administration says it wants to give states the room to develop and implement systems that work best for their population’s unique challenges and needs, and that all states will have to follow expansion strategies that are backed by research.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WTiyfh">
“The core of the approach to quality is that it gives flexibility for states to define the standards but requires them to do it based on evidence,” says Martin. “We have a fair amount of research that helps us understand what quality looks like. So states have to ensure that it’s being implemented.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TtYUWS">
The proposal plans to press these quality provisions on states, but there’s no guarantee that states would reach high quality or distribute quality progressively, Fuller says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VVhwYA">
Fuller’s <a href="https://gse.berkeley.edu/sites/default/files/nyc_pre-k_study_-
_july_2020_update.pdf">examination</a> of New York City’s pre-K expansion found that preschools mirrored the racial segregation of K-12 schools: Preschools serving mostly white or Asian families offered higher-quality environments than programs in the city’s Black and Latino neighborhoods since city leaders lost track of the distribution of quality.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Q4bADv">
A <a href="https://s3-us-east-2.amazonaws.com/edtrustmain/wp-content/uploads/2014/09/05162154/Young-
Learners-Missed-Opportunities.pdf">2019 Education Trust study</a> of 26 states and their preschool programs found that just 1 percent of Latino children and only 4 percent of Black children in those states were enrolled in high-quality preschool. Ultimately, Fuller fears that Biden’s blanket entitlement approach — extending free pre-K to well-off families — will cement an uneven playing field. (There’s some disagreement among experts here: Research Cascio <a href="https://www.nber.org/system/files/working_papers/w19735/w19735.pdf">conducted on Georgia and Oklahoma’s universal pre-K programs</a> suggested that the presence of higher-income children may help to attract better teachers and<strong> </strong>improve quality for low-income children too.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vg8xbY">
“States are not going to invent systems that meet the needs of the underserved. They’re just going to use what everyone else has already used, so they’re going to get the same results as before,” Fantuzzo said.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/Laegcsc6XB__UbgQoL6Zy4gWs2M=/800x0/filters:no_upscale()/cdn.vox-
cdn.com/uploads/chorus_asset/file/23036022/GettyImages_1232619181.jpg"/> <cite>Matt Roth for the Washington Post via Getty Images</cite>
<figcaption>
Children play together at Little Flowers Early Childhood and Development Center in Baltimore, Maryland, in January.
</figcaption>
</figure>
<h3 id="bKmU2Z">
The program is better than the status quo, experts agree
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yEuKwi">
Taken together with the child care investments proposed in the bill, most experts agree that the Build Back Better bill’s goals are a boon for children and families and beneficial for society at large.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="abRrxb">
“It’s important for folks to understand how inaccessible and inequitable the system is currently,” Malik said. “It is determined by a family’s income right now. Current childcare dollars that do go to preschools and care for younger kids and Head Start combined really can’t even serve 1/10th of the number of low-income kids who really need it.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WpWWxE">
Over the decades, as the public has come to embrace the benefits of early childhood education, higher-income families have spent more money on private programs, only increasing opportunities gaps in education. Martin told Vox that universal pre-K would have big returns for state economies and is one of the best investments states can make for the country’s competitiveness, for children’s futures, and for parent choice.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aTPzGr">
“Once we get to the end of the six years we are going to get a lot closer to universality than we are now, and it will be really popular and remain a really high priority for legislators who have always shown a commitment to this issue in the abstract,” Malik said. “We’ll look back at this as a major turning point in early childhood education.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LysH1J">
Others aren’t as optimistic as Malik but share in his hope. “Pre-K too often inadvertently hardens inequities in children’s futures,” said Fuller. “We have a chance now to build a pre-K system that’s more progressive than the public schools, but it’s going be a massive experiment.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="enjWOL">
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cvG9SU">
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4hmfBA">
</p>
<ul>
<li><strong>Who the pandemic’s next phase will hurt the most</strong> -
<figure>
<img alt="" src="https://cdn.vox-
cdn.com/thumbor/3MWrtXq5h57YSxmDrlFCARjsMqo=/153x0:5700x4160/1310x983/cdn.vox-
cdn.com/uploads/chorus_image/image/70233984/GettyImages_1349260360.0.jpg"/>
<figcaption>
Pedestrians walk past a Covid-19 pop-up testing site in New York City in October. Many health experts and epidemiologists believe that the city, and much of the world, will be living with Covid-19 long into the future. | Spencer Platt/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The US health system’s racial inequities will still be felt after Covid-19 becomes endemic.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="z57Itu">
Most public health experts believe <a href="https://www.vox.com/2021/10/22/22737328/covid-19-pandemic-endemic">Covid-19 will never be eradicated</a>. But the risks have become more tolerable: Six in 10 Americans are now fully vaccinated, and <a href="https://www.vox.com/22704265/merck-covid-19-antiviral-pill-molnupiravir-treatment-drug">new antivirals</a> are coming that reduce the chances of a person ending up in the hospital because of the virus.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="y7750g">
The next stage of the pandemic is still taking shape. It’s too soon to say whether the omicron variant that has caused so much recent concern will drive a new wave of infections around the world. But, whether or not omicron becomes dominant, some Americans will be more at risk from Covid than others going forward. And in any version of endemic Covid — where, for many, Covid-19 can be akin to the flu, <a href="https://www.vox.com/future-perfect/22651046/covid-19-delta-vaccines-
social-distancing-masking-lockdowns">undesirable but manageable</a> — some people, especially the elderly and immunocompromised, will face a higher risk by default.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6cpQ1j">
The lifesaving promise offered by <a href="https://www.vox.com/covid-19-coronavirus-treatment-prevention-cure-vaccines">vaccinations</a> and effective treatments can only be realized if people actually have access to them — and only if they are treated fairly and equitably when they do see a doctor.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="C45XrW">
Unfortunately, Americans do not have equitable access to medical care. Across 25 different measures of health status, including life expectancy, infant mortality and prevalence of chronic illnesses, Black Americans fare worse than white Americans on 19 of them, according to <a href="https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health-care-5-key-
question-and-answers/">a May 2021 Kaiser Family Foundation report</a>. American Indians and Alaskan Natives fare worse on 17; Hispanic Americans see poorer outcomes on 14 of the metrics.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="K14487">
The experience of the past two years has only served to underline how fundamentally unfair the US health system is.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ds0Qz5">
Vaccination is still the most effective way to protect everyone against Covid-19, and the vaccines are free, regardless of insurance, immigration status. But, after months of public health campaigning, 30 percent of the US is still unvaccinated. Vaccination rates among Black adults (65 percent) are slightly lower than among white adults (70 percent); Hispanic adults (61 percent) have an even bigger gap. People who are uninsured, who are also disproportionately Black and Hispanic, are the least likely to be vaccinated. All of these trends reflect existing inequities in the US health system, where historically underserved groups have less access to health care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fyxpzP">
In addition to the major determinants of <a href="https://www.kff.org/policy-watch/covid-19-deaths-among-older-adults-during-the-delta-
surge-were-higher-in-states-with-lower-vaccination-rates/">age</a>, <a href="https://www.nytimes.com/2021/11/02/health/immunocompromised-covid-vaccine.html">health</a>, and <a href="https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-status">vaccination status</a>, at least three other factors will determine how much risk Americans face from Covid-19.
</p>
<h3 id="nALaop">
Risk factor No. 1: Insurance coverage
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QBhYXW">
The first risk factor is lack of insurance coverage, which is already the variable that appears most strongly correlated with whether someone received the vaccine. About 10 percent of people living in America, 27 million people, do not have health insurance — the most fundamental inequity in the US health system.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hVBZnW">
The Covid-19 vaccines are a prime example of how powerful insurance status is in determining whether or not a person receives necessary medical care. Only about 44 percent of uninsured Americans under 65 have received at least one dose of the vaccine, compared to 65 percent of the insured under 65. Of all the subcategories polled in July by the Kaiser Family Foundation for <a href="https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-
monitor-july-2021/">its Covid-19 vaccine monitor</a> — from race to age group to political party — the uninsured had the lowest vaccination rate, even though the Covid-19 vaccines are actually free to everybody regardless of insurance.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/8JaabLRjmgYoXBKgEFl-
YQM6l7k=/800x0/filters:no_upscale()/cdn.vox-
cdn.com/uploads/chorus_asset/file/23034435/republicans_rural_residents_younger_adults_and_uninsured_lag_in_vaccine_uptake.png"/> <cite>Kaiser Family Foundation</cite>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IfpPj8">
That puts the uninsured at a higher risk out of the gate, given how much vaccination reduces the risk of developing a serious case of Covid-19 or getting infected in the first place.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="K9hI9B">
If a person does get infected, timely treatment is the best way to head off severe symptoms. The new Covid-19 antivirals from Merck (which reduces the risk of hospitalization by about 30 percent, <a href="https://www.nytimes.com/2021/11/26/science/merck-molnupiravir-antiviral-covid-pill.html">according to the latest data</a>) and Pfizer (which <a href="https://www.vox.com/future-perfect/22772612/early-treatment-for-covid-fluvoxamine-
molnupiravir-paxlovid">reduced</a> hospitalization rates by as much as 90 percent in clinical trials) are most effective when people have mild or moderate symptoms.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CRkAzA">
But uninsured Americans delay seeking care because of the perceived costs of doing so. More than 30 percent of uninsured Americans said in <a href="https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-july-2021/">a 2019 KFF survey</a> that they’d either delayed care or went without it because of the cost, versus less than 10 percent of people with insurance. Even small out-of-pocket costs, <a href="https://www.vox.com/policy-and-politics/22276166/us-health-
insurance-out-of-pocket-costs-research">as little as $10</a>, have been shown to prevent people from taking medication as prescribed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ja6jk3">
And the slow uptake of the Covid-19 vaccines suggests that, even when care is free, the presumption that it will still be costly to somebody who is uninsured can keep those people away from the doctor or pharmacy.
</p>
<h3 id="RqmcGW">
Risk factor No. 2: Access to medical care
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Jtij26">
The second risk factor is a person’s ability to access health care; the new antivirals appear most effective at earlier stages of the disease, which means patients need to be able to be seen by a doctor in a timely manner in order to head off more severe symptoms.
</p></li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QFQm99">
Geography and socioeconomic characteristics are linked with whether people can actually find a doctor. Roughly 80 percent of rural America was considered to be medically underserved in <a href="https://khn.org/morning-
breakout/health-care-deserts-nearly-80-percent-of-rural-u-s-designated-as-medically-underserved/">a 2019 government analysis</a>. People who live in urban centers also receive worse quality of care than people who live on the fringes of metro areas (i.e., suburbs), per <a href="https://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2019qdr-final-es-cs061721.pdf">a federal Agency for Healthcare Research and Quality report</a>. Low-income Americans are less likely to have ready access to a primary care doctor than their wealthier peers.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XYLfAn">
The number of Americans with an established primary care doctor has been <a href="https://www.reuters.com/article/us-health-pcp-trends/declining-numbers-of-americans-have-
a-primary-care-provider-idUSKBN1YK1Z4">declining</a> in recent years. At the same time, studies <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380899/">have found</a> that people who do not have that kind of relationship with a physician develop more serious symptoms before they do seek care, which tends to lead to <a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2010.0025">worse health outcomes</a>. Their health problems are also more likely to persist if they don’t have a primary care doctor to follow up with after an acute emergency.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6EiUG5">
We have seen the importance of these established patient-physician relationships in the vaccination drive as well. Unvaccinated Americans have <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2106137">said in surveys</a> that they are most likely to be persuaded by their personal doctor.
</p>
<h3 id="ikK0vi">
Risk factor No. 3: Equitable treatment
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NX93Vg">
But having an insurance card and physically walking into a doctor’s office are only the first two steps to receiving effective treatment. Once there, a patient needs to be treated fairly by their doctor — the third risk, if they don’t receive that equitable treatment.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="14REEk">
And, unfortunately, there is a growing body of evidence that, separate from insurance status and other variables, Black and Hispanic patients in America do not receive the same quality of care as their white counterparts. Health care providers are less likely to view their symptoms as serious and less likely to prescribe necessary medications to treat their illness. Already, Black and Hispanic Americans have experienced higher rates of death and hospitalization during the pandemic than their white peers.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WQ62F1">
“Given that people of color are less likely to have health coverage, are more likely to face barriers to accessing care, and receive poorer quality of care, they are likely to face disparities in obtaining care and treatment for Covid-19,” Samantha Artiga, director of the Racial Equity and Health Policy Program at the Kaiser Family Foundation, told me.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DWduxf">
There is a racial component to the first two risk factors. Black and Hispanic Americans are more likely to be uninsured than white Americans. They are also less likely to have reliable access to medical care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="y6k4qr">
But race alone can determine whether or not an American receives appropriate medical care. Black and Hispanic Americans are <a href="https://www.kff.org/report-section/kff-the-undefeated-survey-on-
race-and-health-main-findings/">more likely to say</a> they’ve had negative experiences with a health care provider than white people, with higher shares reporting that their doctor did not believe them or that they were refused a test or treatment they thought they needed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5eTgL9">
“Race is a factor, and I would say that it’s distinct from other barriers because it erodes care quality for patients of color directly and indirectly,” Kumi Smith, a University of Minnesota epidemiologist, told me. “Directly through implicit or explicit racial biases held by providers, indirectly through the racially disparate ways that societal resources and benefits are distributed across society. So in a way, patients of color, especially Black patients, suffer the consequences of racism twice over.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kLvE9i">
According to multiple studies that have tried to look at the problem empirically, the discrimination that people of color describe in those surveys is real. Studies have shown that Black people are less likely than white people to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/">prescribed pain medications</a> and are <a href="https://pubmed.ncbi.nlm.nih.gov/26454472/">subjected to longer wait times in the emergency department</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="v21Pvy">
New research looked at prescriptions for heart medications — the kind of routine care for serious but treatable illness that we hope Covid-19 antivirals will become — and once again found the same racial disparities, even when controlling for other factors such as insurance status.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yXWtbl">
The study, led by Utibe Essien at the University of Pittsburgh, examined patients with atrial fibrillation who were treated at the local Veterans Affairs hospital system. It found that Black and Hispanic patients were less likely to start taking medication for their condition. These patients were being treated at an integrated hospital system (eliminating the access issue) and the researchers focused on a subgroup of patients who enrolled in Medicare Part D to cover the cost of their care (eliminating the problem of uninsurance).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fs15O9">
Yet disparities persisted in the treatment received by Black and Hispanic patients. Essien has written on this issue of <a href="https://jamanetwork.com/journals/jama/article-
abstract/2785584">“pharmacoequity,”</a> which attempts to capture the full extent of the disadvantages that people of color face in receiving necessary medical care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dZoG5c">
“Race is not just foundational to the challenges of underinsurance and access but access to treatments, from monoclonal antibodies to antiviral therapies,” he told me.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="D8Rtrq">
These inequities have been with us for a long time. They will continue to be with us in the future. And so long as Covid-19 continues to circulate, many Americans of color will face a higher risk from the virus as a result.
</p>
<ul>
<li><strong>What Peng Shuai’s rape accusation says about China</strong> -
<figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><img alt="Peng Shuai prepares to serve the ball in a first-round match at the 2020 Australian Open on
January 21, 2020, in Melbourne, Australia." src="https://cdn.vox-cdn.com/thumbor/O6bgv_zxuS-
GxSqAwauToQsGZU0=/398x0:3589x2393/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/70232421/1194977504.0.jpg"/></p>
<figcaption>
Peng Shuai plays in the 2020 Australian Open in Melbourne, Australia. | Fred Lee/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The tennis star’s disappearance is part of a larger pattern of censorship and misogyny.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KmkeZ6">
The safety and freedom of <a href="https://www.thecut.com/2021/12/the-disappearance-of-
peng-shuai-what-we-know.html">Chinese tennis star Peng Shuai</a> have been in serious doubt since the beginning of November, when she accused a powerful former Chinese Communist Party<strong> </strong>official of sexual assault. But while her case has garnered international attention, it’s far from an isolated incident — and it speaks volumes about the purpose of political disappearances in China, as well as the country’s treatment of sexual assault.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fADdqk">
In a <a href="https://www.thetimes.co.uk/article/e6f897bc-550b-11ec-9b65-68b0858e7bd3?shareToken=23a5bd241940258d9e47d02f9b1593a4">November 2 post on Chinese social media app Weibo</a>, Peng accused former vice premier Zhang Gaoli of sexual assault. Within minutes, the post disappeared; shortly thereafter, all mentions of Peng on social media did too. Although she has since reappeared in videos released by Chinese state media, it’s still unclear whether she is safe and able to speak freely, and her case has drawn support from tennis stars like <a href="https://twitter.com/naomiosaka/status/1460723353174433793?s=20">Naomi Osaka</a>, <a href="https://twitter.com/serenawilliams/status/1461408866697105413?s=20">Serena Williams</a>, and <a href="https://twitter.com/Reuters/status/1466499913521369088?s=20">Novak Djokovic</a>, as well as the Women’s Tennis Association.
</p>
<div id="RMVmCx">
<blockquote class="twitter-tweet">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" dir="ltr" lang="en">
I am devastated and shocked to hear about the news of my peer, Peng Shuai. I hope she is safe and found as soon as possible. This must be investigated and we must not stay silent. Sending love to her and her family during this incredibly difficult time. <a href="https://twitter.com/hashtag/whereispengshuai?src=hash&amp;ref_src=twsrc%5Etfw">#whereispengshuai</a> <a href="https://t.co/GZG3zLTSC6">pic.twitter.com/GZG3zLTSC6</a>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">— Serena Williams (<span class="citation" data-cites="serenawilliams">@serenawilliams</span>) <a href="https://twitter.com/serenawilliams/status/1461408866697105413?ref_src=twsrc%5Etfw">November 18, 2021</a></p></blockquote></div></li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ggmyUX">
In the weeks since Peng’s initial disappearance, China’s response to the international outcry over her whereabouts and ability to speak freely has been alarmingly opaque. Among other steps, Chinese state media released a <a href="https://twitter.com/CGTNOfficial/status/1461025491842916358">screenshot of an email</a> supposedly written by Peng to Women’s Tennis Association President Steve Simon, which was meant to assure worried spectators that Peng was “fine” and “resting at home,” but did the opposite. Several dubious <a href="https://www.nytimes.com/2021/11/20/sports/tennis/peng-shuai-video.html">videos released by Chinese state media</a> also failed to assure most of the international community that all was well.
</p>
<div id="3v1o5y">
<blockquote class="twitter-tweet">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" dir="ltr" lang="en">
Chinese tennis star Peng Shuai has sent an email to Steve Simon, the WTA Chairman &amp; CEO, CGTN has learned. The email reads: <a href="https://t.co/uLi6Zd2jDI">pic.twitter.com/uLi6Zd2jDI</a>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">— CGTN (<span class="citation" data-cites="CGTNOfficial">@CGTNOfficial</span>) <a href="https://twitter.com/CGTNOfficial/status/1461025491842916358?ref_src=twsrc%5Etfw">November 17, 2021</a></p>
</blockquote>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SKkFt6">
“These photos and videos can only prove that Peng Shuai is alive, but nothing else. They cannot prove that Peng Shuai is free,” Teng Biao, a prominent Chinese civil rights lawyer, told <a href="https://www.nytimes.com/2021/11/22/world/asia/china-peng-shuai-metoo.html?name=styln-peng-
shuai%C2%AEion=TOP_BANNER&amp;block=storyline_menu_recirc&amp;action=click&amp;pgtype=Article&amp;variant=0_Control&amp;is_new=false">the New York Times</a> last month.
</p>
<h3 id="6ytXYY">
High-profile figures have disappeared in China before
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jeRgdP">
Although Peng’s disappearance sparked an international outcry, it’s far from the first time China has disappeared public figures. <a href="https://www.nytimes.com/2019/08/02/world/asia/fan-bingbing-comeback-
scandal.html">Fan Bingbing</a>, one of China’s most famous actresses; <a href="https://www.hollywoodreporter.com/news/general-news/zhao-wei-france-1235004948/">Zhao Wei</a>, a billionaire and actress; and <a href="https://www.theguardian.com/business/2021/jan/23/the-strange-case-of-alibabas-jack-ma-and-his-
three-month-vanishing-act">Jack Ma</a>, once China’s richest man and the head of massive e-commerce site Alibaba, have all disappeared for periods in recent years, only to reappear with little explanation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VjUf98">
Fan, a massive star who commanded China’s film industry and attracted international attention, was held under house arrest for four months in 2018 on charges of tax evasion — a fairly typical practice in China, as the <a href="https://www.nytimes.com/2019/08/02/world/asia/fan-bingbing-comeback-scandal.htmlq">New York Times</a> reported the following year in a profile of the actress. She reappeared, cowed and praising “the [Communist] party and the state’s good policies.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8YywbL">
The disappearances of prominent people who the Chinese Communist Party, and President Xi Jinping in particular, perceive as fundamentally inimical to communist values — either through their outspokenness, as in the cases of Peng, <a href="https://www.theguardian.com/artanddesign/2020/mar/22/ai-weiwei-an-artist-must-be-an-
activist">artist Ai Weiwei</a>, and actress Zhao; or their public image, like Ma and Fan — serves as a warning to Chinese citizens. In particular, <a href="https://apnews.com/article/coronavirus-pandemic-sports-entertainment-health-
beijing-d9aeeb571e4c1d4cb8f4efb469e9faa2">criticizing the state</a>, its policies, or prominent party members can be dangerous, as in the case of real estate tycoon Ren Zhiqiang, <a href="https://www.nytimes.com/2020/03/31/business/china-ren-zhiqiang-censorship.html">who disappeared last year</a> and was later <a href="https://www.bbc.com/news/world-asia-china-54245327">sentenced to 18 years in prison</a> on corruption charges after criticizing Xi’s response to the Covid-19 pandemic.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tHYpKc">
Given that context, Peng’s disappearance and peculiar reappearance isn’t exactly a surprise; <a href="https://www.nytimes.com/2021/11/03/world/asia/china-metoo-peng-shuai-zhang-gaoli.html">she is the first known person</a> to publicly accuse a member of the Politburo Standing Committee — Zhang was once the vice premier under Xi, making him part of the highest rungs of power — of sexual assault. According to Lü Pin, a longtime Chinese feminist activist, the disappearance wasn’t so much a warning, but a panic response.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qDyj6p">
“Somehow, the Chinese government doesn’t know how to deal with her case,” Lü said. “They don’t have any language to talk about her case, so they have to block messages, they have to block everything because they don’t know how to deal with it in any other ways.”
</p>
<h3 id="F1Ve31">
The government censors China’s #MeToo movement
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RfwuCf">
Even though Peng is an international figure, with two Grand Slam doubles titles under her belt and the adulation of the Chinese state because of her successful career, accusing a powerful party member of assault was a massive risk on her part — and seen as an unforgivable transgression against the state.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QaPBbW">
Her initial message on Weibo, which was quickly taken down, makes it clear she knew the danger of her decision to speak up: “It doesn’t matter if I’m hitting a rock with an egg, or being a moth that flies towards the flame,” <a href="https://www.theatlantic.com/international/archive/2021/11/what-peng-shuai-scandal-reveals-about-chinese-
power/620834/">she wrote</a>. “I am telling the truth about what happened between us.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="w4RSTW">
According to a recent piece in Australian outlet <a href="https://theconversation.com/what-the-peng-shuai-saga-tells-us-about-
beijings-grip-on-power-and-desire-to-crush-a-metoo-moment-172375">The Conversation</a>, “[Peng’s] story directly contradicted the Communist Party’s <a href="https://www.newyorker.com/news/q-and-a/reconsidering-the-history-of-the-
chinese-communist-party">official narrative</a> of harmonious relations between people and Party. In particular, her allegations contradict the narrative that women, who purportedly ‘<a href="https://www.marxists.org/history/erol/ncm-1/ol-women.htm">hold up half the sky in China</a>,’ enjoy <a href="https://inews.co.uk/news/world/feminist-activism-china-social-death-amid-clampdown-women-speaking-
out-1307000">gender equality under this government</a>.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6Jdqqs">
That narrative, however, isn’t the reality in China. As Leta Hong Fincher, author of<em> Betraying Big Brother: The Feminist Awakening in China, </em>argued in a <a href="https://www.washingtonpost.com/news/global-opinions/wp/2018/03/01/xi-jinpings-authoritarian-rise-in-china-has-
been-powered-by-sexism/?noredirect=on">Washington Post</a> piece in 2018, far from guaranteeing gender equality, Xi’s authoritarian regime in fact depends on enforcing patriarchal norms and depicts him as the head of the “family” that is the nation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zYsBNF">
That’s only gotten worse as China’s economic boom of the past several decades slows. According to Hong Fincher, “Chinese propaganda under Xi’s leadership has revived sexist elements of Confucianism, in particular trying to push the notion that a traditional family (based on marriage between a man and a virtuous, obedient woman) is the foundation of a stable government.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uvuMI6">
Given that framework, Peng’s decision to speak publicly against the state, pierces the illusion of a harmonious “family” headed by “Xi Dada” — <a href="https://www.washingtonpost.com/news/global-opinions/wp/2018/03/01/xi-jinpings-authoritarian-rise-in-china-has-
been-powered-by-sexism/?noredirect=on">Big Daddy Xi</a> — and exposes devastating family secrets.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BA0671">
“Peng Shuai’s disclosure of being sexually abused by Zhang Gaoli, the former Vice Premiere of the People’s Republic of China, is crucial,” <a href="https://pinerpiner.medium.com/a-feminist-comment-on-pengshuais-
case-408a50018711">Lü</a> wrote in a November blog post. “Though only the tip of the iceberg, it exposes the real life of Chinese highest cadres, on how their power masked their hypocrisy, and how they are excessively corrupted.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jFkXTq">
“Every day, there are victims trying to get attention, but most of them cannot get any attention, and they were censored before people can see them,” Lü said in a phone call with Vox. “That’s sad, but only very few people’s voices could be heard in China, could go beyond the censorship.”
</p>
<div id="QDmcMo">
<div style="width: 100%; height:
152px;">
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lG18ov">
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MSnswJ">
Despite a handful of <a href="https://edition.cnn.com/2021/08/11/china/sexual-assault-mic-intl-hnk/index.html">high-profile punishments</a> for sexual assault, there is a limit to how far the Communist Party will go in allowing a <a href="https://edition.cnn.com/2018/03/23/asia/china-sexual-assault-metoo-intl/index.html">Western-style #MeToo movement</a> to take hold; previously, China has censored the #MeToo hashtag on social media and <a href="https://www.amnesty.org/en/latest/news/2021/11/china-metoo-journalist-and-labour-activist-facing-subversion-
charge-must-be-released/">detained</a> journalist Sophia Huang Xueqin, who has been deeply involved with the #MeToo movement in China, on a charge of “inciting subversion of state power.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5yvOkV">
In China, according to <a href="https://edition.cnn.com/2021/08/11/china/sexual-assault-mic-intl-hnk/index.html">CNN</a>, state outlets publish articles saying sexual assault isn’t a problem, despite evidence to the contrary. Only about 43,000 cases of “crimes against women’s rights” were prosecuted between 2013 and 2017, in a nation of 1.4 billion. And Peng’s censorship indicates that, like many Chinese women without her star power, she’ll be unable to tell her story and the accused won’t face justice.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pidfmi">
“I doubt that the Chinese government will investigate her accusations,” Lü told Vox over the phone. But, she said, Peng’s case shows the world “the reality of [Chinese] politics”: Though some politicians have been punished by the state for having “affairs,” Lü said, “they never expose the women’s name, and what’s the real experience for them. Were those women raped? Nobody knows.”
</p>
<h3 id="5sFXUv">
The world responds to China’s continuing clampdown
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="a9UPgd">
Peng’s accusation came just as Xi <a href="https://hongkongfp.com/2021/11/12/china-
ruling-party-leaders-pass-historic-xi-resolution/">tightens his grip on power</a>; a resolution on the “correct view” of the Communist Party’s history, passed last month, calls on “the entire party, the entire army and people of all ethnic groups to unite more closely around the Party Central Committee with Comrade Xi Jinping as the core,” <a href="https://hongkongfp.com/2021/11/12/china-ruling-party-leaders-pass-historic-xi-resolution/">according to Agence France-Presse</a>, quoting Chinese state media outlet Xinhua.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RwTUUF">
The new resolution centers Xi as the ultimate arbiter of Chinese political culture, the state, and the history of China’s Communist Party — <a href="https://www.washingtonpost.com/world/chinas-leader-elevated-to-the-level-of-mao-in-communist-
pantheon/2017/10/24/ddd911e0-b832-11e7-9b93-b97043e57a22_story.html?utm_term=.83e8494dba79&amp;itid=lk_inline_manual_8">elevating him</a> to the level of previous Chinese leaders Mao Zedong and Deng Xiaoping — and attempts to justify his crackdowns on pro-democracy activists, Uyghur minorities, and other perceived adversaries.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="d3juK5">
In addition to Xi’s own power play, the February Beijing Winter Olympics will give China an opportunity to show its power and wealth on a global stage, portraying the Communist Party as a viable alternative to American democracy, Atlantic Council fellow <a href="https://www.theatlantic.com/international/archive/2021/11/what-peng-shuai-scandal-reveals-about-chinese-
power/620834/">Michael Schuman writes in the Atlantic</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RTckaH">
But Peng’s case throws a wrench in that plan.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="reJVPj">
While the Olympics will probably go off as planned despite a potential US <a href="https://www.nytimes.com/2021/11/18/us/politics/beijing-olympics-boycott.html">diplomatic boycott</a> over China’s human rights atrocities, the International Olympic Committee’s <a href="https://www.cnn.com/2021/12/01/tennis/peng-
shuai-pound-intl-
spt/index.html?utm_term=link&amp;utm_medium=social&amp;utm_source=twCNN&amp;utm_content=2021-12-01T13%3A45%3A04">response</a> to Peng’s disappearance has heightened scrutiny of the Games and the IOC itself.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Cb4buy">
In a statement this month from <a href="https://www.hrw.org/news/2021/12/01/olympics-protect-peng-shuai">Human Rights Watch</a>, Andrea Florence, the acting director of the Sport &amp; Rights Alliance, criticized “the IOC’s eagerness to ignore the voice of an Olympian who may be in danger and to support claims of state-sponsored media in China.” In a recently introduced <a href="https://wexton.house.gov/uploadedfiles/wexton_ioc_peng_shuai_resolution.pdf">congressional resolution</a>, two US lawmakers have also accused the IOC of “<a href="https://www.scmp.com/news/china/article/3158432/us-congressional-
resolution-says-ioc-aided-beijings-disappearance-peng">collaborating</a> with the Communist Party” in covering up Peng’s accusations and disappearance.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="p34iaM">
“The IOC has demonstrated yet again it cares more about appeasing the Chinese Communist Party and the Olympics’ corporate sponsors rather than the wellbeing of Olympic tennis star Peng Shuai who accused a top CCP official of sexual assault,” Rep. Michael Waltz (R-FL) said in a <a href="https://wexton.house.gov/news/documentsingle.aspx?DocumentID=617">statement</a> announcing the resolution condemning the IOC’s actions.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="295tle">
The IOC’s response stands in stark contrast to that of the WTA, which <a href="https://www.wtatennis.com/news/2384758/steve-simon-announces-wta-s-decision-to-suspend-tournaments-in-
china">unequivocally suspended</a> a lucrative, decade-long contract to hold professional tournaments in China earlier this month.
</p>
<div id="QM9TWk">
<blockquote class="twitter-tweet">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" dir="ltr" lang="en">
BREAKING: WTA announces decision to suspend its tournaments in China due to the ongoing Peng Shuai situation.<br/><br/>From Steve Simon: <a href="https://t.co/dKpGZYPbzh">pic.twitter.com/dKpGZYPbzh</a>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">— Ben Rothenberg (<span class="citation" data-cites="BenRothenberg">@BenRothenberg</span>) <a href="https://twitter.com/BenRothenberg/status/1466122011546116101?ref_src=twsrc%5Etfw">December 1, 2021</a></p>
</blockquote>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="or876J">
“While we now know where Peng is, I have serious doubts that she is free, safe and not subject to censorship, coercion, and intimidation,” Steve Simon, the WTA president, wrote in <a href="https://www.wtatennis.com/news/2384758/steve-simon-announces-wta-s-decision-to-suspend-tournaments-in-china">a statement</a> announcing the suspension. “If powerful people can suppress the voices of women and sweep allegations of sexual assault under the rug, then the basis on which the WTA was founded — equality for women — would suffer an immense setback.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="k360Gd">
With such sustained attention on the problem, it’s unclear <a href="https://www.nytimes.com/2021/12/02/opinion/peng-shuai-china-leaders.html">how long China can keep up the ruse that Peng is fine</a> and able to speak without censorship.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="t6tJ5u">
But while Peng’s case highlights a multitude of serious problems in Chinese politics and culture, Lü told Vox, it likely won’t change the political structure.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8t3T26">
“It’s extremely hard. Our government is very much powerful; nobody really creates real crisis to them,” she said. ”I think that’s the truth, we should admit that. Even Biden cannot do anything.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CtIPbZ">
But expecting a case like Peng Shuai’s, explosive as it is, to create systemic change in China, Lü said, is missing the point of the feminist movement. “Our vision is not to overturn the rule of the Chinese government,” she said. “Our goal is to just make women not suffer so much.”
</p>
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Former England player Darren Gough appointed director of cricket at Yorkshire</strong> - The county recently got rid of its entire coaching staff amid a racism scandal</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ind vs NZ second Test | Technique won’t guarantee runs all the time, but will to fight is key, says Mayank Agarwal</strong> - Mayank Agarwal was adjudged man of the match in the second Test</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>India return to top of ICC Test rankings</strong> - On the WTC table, India are third with 42 points and win percentage of 58.33</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Cricket Australia confirm Perth Ashes Test relocation</strong> - The governing body said attempts to negotiate conditions for the Jan. 14-18 match at Perth Stadium that would suit all parties had proved impossible and that discussions had begun over a replacement venue.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>India beats New Zealand by 372 runs in second Test, win series 1-0</strong> - New Zealand folded up for 167 in the second innings after India set them a mammoth 540-run target.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Khanapur MLA plans padayatra to highlight neglect of constituency</strong> - Anjali Nimbalkar will walk to the Suvarna Soudha</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Panel backed by KPCC president K. Sudhakaran wins board election to Indira Gandhi Cooperative Hospital in Kannur</strong> - A long-standing dispute with K. Sudhakaran had later resulted in the expulsion of Mambaram Divakaran from the Congress party</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Sidhu’s comments irk Congress leaders</strong> - Pritpal Singh Baliawal, AICC national coordinator and spokesperson of Punjab Congress, has resigned from his positions</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>MLC election: ‘Siddaramaiah not welcome in Badami anymore’</strong> - B.B. Chimmanakatti had made way for the former CM in the Assembly constituency</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Schemes for learning beyond textbook: Minister</strong> - Ten new series to begin telecast on the KITE Victers educational channel</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Eric Zemmour: Far-right French presidential candidate grabbed at rally</strong> - A man grabs Eric Zemmour by the neck at the far-right presidential candidate’s first rally.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Biden and Putin to talk amid Ukraine invasion fears</strong> - On Tuesday the US and Russian leaders will speak amid mounting concerns of Russia invading Ukraine.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pope condemns treatment of migrants in Europe</strong> - Visiting a camp in Greece, Francis calls the neglect of migrants the “shipwreck of civilisation”.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why France faces so much anger in West Africa</strong> - Despite engaging better with the African continent recently, the ex-colonial power faces a backlash.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Afghanistan: Macron reveals plans for joint European mission</strong> - The French president says a number of European nations are working on a joint diplomatic mission.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>At least 2 hominin species lived at Laetoli site 3.6 million years ago</strong> - Ancient hominin Lucy may have walked alongside yet another bipedal hominin species. - <a href="https://arstechnica.com/?p=1818035">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How a carbon tax can fight inequality and climate change</strong> - Carbon taxes don’t need to come at the expense of lower-income people: research - <a href="https://arstechnica.com/?p=1818028">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Review: Halo Infinite’s campaign finishes the fight—but arrives in tatters</strong> - Great balance between classic and new ideas marred by serious technical issues. - <a href="https://arstechnica.com/?p=1817954">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Quantum processor swapped in for a neural network</strong> - Quantum processor used to model weather based on sparse data. - <a href="https://arstechnica.com/?p=1818085">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>ESA head says Europe needs to stop facilitating Elon Musk’s ambitions in space</strong> - Musk’s thousands of satellites risk crowding others out of low Earth orbits. - <a href="https://arstechnica.com/?p=1818165">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><strong>What’s the difference between an atheist and an evangelical Christian?</strong> - <!-- SC_OFF -->
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The atheist is honest about not following the teachings of Christ.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Mahote"> /u/Mahote </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/r9kf3d/whats_the_difference_between_an_atheist_and_an/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/r9kf3d/whats_the_difference_between_an_atheist_and_an/">[comments]</a></span></p></li>
<li><strong>Winter is nearly here…</strong> - <!-- SC_OFF -->
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Winter is nearly here &amp; our native birds will soon be finding food scarce. Please go to the pet shop &amp; buy a bag of nuts for our feathered friends. There’s no finer sight on a winters morning then a pair of tits around your nut sack. Just remember however its a bit late in the year to expect a swallow!!!
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/UrbanExpressions"> /u/UrbanExpressions </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/r9v64l/winter_is_nearly_here/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/r9v64l/winter_is_nearly_here/">[comments]</a></span></p></li>
<li><strong>What’s the difference between me and Jimmy Fallon?</strong> - <!-- SC_OFF -->
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I can get through one of his jokes without laughing.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/CoolMentorK"> /u/CoolMentorK </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/r9zdz9/whats_the_difference_between_me_and_jimmy_fallon/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/r9zdz9/whats_the_difference_between_me_and_jimmy_fallon/">[comments]</a></span></p></li>
<li><strong>I told my daughter, “Go to bed, the cows are sleeping in the field.” Puzzled, she asked, “What’s that got to do with anything?” I chuckled, “Well, that means…”</strong> - <!-- SC_OFF -->
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“It’s pasture bedtime!”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/808gecko808"> /u/808gecko808 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/ra3xz3/i_told_my_daughter_go_to_bed_the_cows_are/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/ra3xz3/i_told_my_daughter_go_to_bed_the_cows_are/">[comments]</a></span></p></li>
<li><strong>What’s the difference between a police officer and a bullet?</strong> - <!-- SC_OFF -->
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When a bullet kills someone else, you know it’s been fired
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/HPCTRTW"> /u/HPCTRTW </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/r9jae3/whats_the_difference_between_a_police_officer_and/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/r9jae3/whats_the_difference_between_a_police_officer_and/">[comments]</a></span></p></li>
</ul>
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