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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>Who is pregnant? defining real-world data-based pregnancy episodes in the National COVID Cohort Collaborative (N3C)</strong> -
<div>
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Objective To define pregnancy episodes and estimate gestational aging within electronic health record (EHR) data from the National COVID Cohort Collaborative (N3C). Materials and Methods We developed a comprehensive approach, named Hierarchy and rule-based pregnancy episode Inference integrated with Pregnancy Progression Signatures (HIPPS) and applied it to EHR data in the N3C from 1 January 2018 to 7 April 2022. HIPPS combines: 1) an extension of a previously published pregnancy episode algorithm, 2) a novel algorithm to detect gestational aging-specific signatures of a progressing pregnancy for further episode support, and 3) pregnancy start date inference. Clinicians performed validation of HIPPS on a subset of episodes. We then generated three types of pregnancy cohorts based on the level of precision for gestational aging and pregnancy outcomes for comparison of COVID-19 and other characteristics. Results We identified 628,165 pregnant persons with 816,471 pregnancy episodes, of which 52.3% were live births, 24.4% were other outcomes (stillbirth, ectopic pregnancy, spontaneous abortions), and 23.3% had unknown outcomes. We were able to estimate start dates within one week of precision for 431,173 (52.8%) episodes. 66,019 (8.1%) episodes had incident COVID-19 during pregnancy. Across varying COVID-19 cohorts, patient characteristics were generally similar though pregnancy outcomes differed. Discussion HIPPS provides support for pregnancy-related variables based on EHR data for researchers to define pregnancy cohorts. Our approach performed well based on clinician validation. Conclusion We have developed a novel and robust approach for inferring pregnancy episodes and gestational aging that addresses data inconsistency and missingness in EHR data.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.08.04.22278439v1" target="_blank">Who is pregnant? defining real-world data-based pregnancy episodes in the National COVID Cohort Collaborative (N3C)</a>
</div></li>
<li><strong>Differential immune response induced by two immunization schedules with an inactivated SARS-CoV-2 vaccine in a randomized phase 3 clinical trial</strong> -
<div>
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Background: The development of vaccines to control the COVID-19 pandemic progression is a worldwide priority. CoronaVac<sup>®</sup> is an inactivated SARS-CoV-2 vaccine approved for emergency use with robust efficacy and immunogenicity data reported in trials in China, Brazil, Indonesia, Turkey, and Chile. Methods: This study is a randomized, multicenter, and controlled phase 3 trial in healthy Chilean adults aged ≥18 years. Volunteers received two doses of CoronaVac<sup>®</sup> separated by two (0-14 schedule) or four weeks (0-28 schedule). 2,302 volunteers were enrolled, 440 were part of the immunogenicity arm, and blood samples were obtained at different times. Samples from a single center are reported. Humoral immune responses were evaluated by measuring the neutralizing capacities of circulating antibodies. Cellular immune responses were assessed by ELISPOT and flow cytometry. Correlation matrixes were performed to evaluate correlations in the data measured. Results: Both schedules exhibited robust neutralizing capacities with the response induced by the 0-28 schedule being better. No differences were found in the concentration of antibodies against the virus and different variants of concern between schedules. Stimulation of PBMCs with MPs induced the secretion of IFN-g and the expression of activation induced markers for both schedules. Correlation matrixes showed strong correlations between neutralizing antibodies and IFN-g secretion. Conclusions: Immunization with CoronaVac<sup>®</sup> in Chilean adults promotes robust cellular and humoral immune responses. The 0-28 schedule induced a stronger humoral immune response than the 0-14 schedule. Funding: Ministry of Health, Government of Chile, Confederation of Production and Commerce &amp; Millennium Institute on Immunology and Immunotherapy, Chile. Clinical trial number: NCT04651790.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.08.05.22278464v1" target="_blank">Differential immune response induced by two immunization schedules with an inactivated SARS-CoV-2 vaccine in a randomized phase 3 clinical trial</a>
</div></li>
<li><strong>Two years of COVID-19 Pandemic: Framework of Health Interventions in a Brazilian City</strong> -
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The COVID-19 pandemic and its effects on public health have urgently demanded effective health policies to avoid the spread of COVID-19. Thus, public administrators have implemented non-pharmacological and pharmacological interventions to mitigate the pandemic9s impacts and strengthen health services. The aim of this ecological study is to describe the scenario of COVID-19 pandemic in a Brazilian city, during two years. This ecological study was carried out in Nova Friburgo, a Brazilian city, for 105 weeks (two years), from March 29, 2020 (week 1) to April 02, 2022 (week 105). Data on COVID-19 cases and COVID-19 deaths, occupation of COVID-19 exclusive beds in hospitals, community mobility, vaccination, government regulation on the opening of city establishments and city risk assessment were collected from public datasets. Four waves of COVID-19 cases and deaths were observed during this period. The first case occurred in week 1 and first death in week 3 of this study. The highest peaks of cases and deaths were observed during the third wave with 1,131 cases (week 54) and 47 deaths (week 55) and where the highest occupation of COVID-19 exclusive beds in local hospitals occurred. Interventions from more restrictive to more flexible, were implemented throughout this study, including lockdown and gradual return in economic and social strata levels. Vaccination began on week 43 and at the end of this study 89.91% of the total population was vaccinated with at least one dose, being 83.22% fully vaccinated. A deep description of several interventions used to avoid COVID-19 spread in a Brazilian city during two years of this pandemic can help promote better decision-making in the future while it exposes the challenges of conducting public health policies in a pandemic scenario.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.08.05.22278481v1" target="_blank">Two years of COVID-19 Pandemic: Framework of Health Interventions in a Brazilian City</a>
</div></li>
<li><strong>Heterologous vaccination as a strategy to minimize inequity in COVID-19 vaccine access: A modeling study in Thailand</strong> -
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Background: Vaccinations are the best hope to control the COVID-19 pandemic and save lives. Due to the high demand and failure to share vaccines equitably, there were not enough vaccine supplies to cover the majority of people in low- and middle-income countries during the early stage of vaccination. To cope with this problem, Thailand, an upper-middle-income country, decided to employ a heterologous vaccination strategy as the primary COVID-19 vaccination regimen in the country. The CoronaVac (CV) vaccine was administered as the first dose, followed by the ChAdOx1 nCoV-19 (AZ) vaccine as the second dose. However, there is no study to assess the effectiveness of the heterologous vaccination employed in Thailand compared to the standard homologous vaccination. Methods: We delineated the course and timeline of COVID-19 vaccination in Thailand. An age-structured compartmental model for COVID-19 transmission and vaccination was constructed and employed to assess the effectiveness of the heterologous vaccination strategy. The impact of the vaccine prioritization strategies on COVID-19 mortality and infections was also investigated. Results: We found that the CV+AZ heterologous vaccination strategy outperforms the CV and AZ homologous vaccinations in reducing cumulative cases and deaths when combined with other non-pharmaceutical interventions. Furthermore, the results suggested that prioritizing vaccines for the elderly could be optimal in reducing COVID-19 mortality for a wide range of vaccination rates and transmission dynamics. Conclusions: Our modeling results suggested that to minimize inequity in COVID-19 vaccine access in low- and middle-income countries, those countries may use early accessible but maybe lower-efficacy vaccines as the first dose of heterologous vaccination in combination with higher-efficacy vaccines as the second dose.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.08.05.22278489v1" target="_blank">Heterologous vaccination as a strategy to minimize inequity in COVID-19 vaccine access: A modeling study in Thailand</a>
</div></li>
<li><strong>Evaluation of a process to implement advance care planning conversations in primary care: uptake and patient experience</strong> -
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Objective: Advance care planning (ACP) can support patients in achieving current and future medical care that aligns with their values and goals. In primary care, a lack of standardized processes hinders implementation of ACP conversations. This study reports a quality improvement process to identify and engage patients and clinicians in ACP. Methods: Primary care clinicians received training in conversations based on the Serious Illness Conversation Guide and tools to support ACP. In December 2019, patients 65 years of age and older with chronic obstructive pulmonary disease were systematically identified, mailed ACP resources and telephoned by the clinic to invite them to an ACP appointment. We tracked the attendance of the patients and evaluated patient experience using a survey. Results: Of the 91 patients telephoned, 50 were reached, and 27 attended the appointment. Further efforts were suspended in March 2020 due to the COVID-19 pandemic. Thirteen patients completed the survey. There were statistically significant increases in the patient9s perception of being heard and understood by their physician, feeling hopeful about quality of life and feeling peaceful. Conclusion: This study provides evidence that with training, tools and processes, patients and primary care clinicians can be effectively engaged in ACP conversations.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.08.04.22278435v1" target="_blank">Evaluation of a process to implement advance care planning conversations in primary care: uptake and patient experience</a>
</div></li>
<li><strong>Different interventions for different vaccinations? Effects of psychological factors and health policies on COVID-19 primary and booster vaccine uptake</strong> -
<div>
Mitigation of the COVID-19 pandemic requires continued uptake of SARS-CoV-2 vaccines. Using experimental data collected in Germany in February 2022 (N = 2,701), this study investigated (a) predictors of primary and booster vaccination and (b) potential effects of policies combining vaccination mandates and monetary incentives. Compared to unvaccinated participants, those with primary vaccination were less complacent, more often understood the collective protection afforded by vaccination, and less often endorsed conspiracy-based misinformation. Compared to participants with primary vaccination, boosted individuals were even less complacent, exhibited fewer conspiracy-based beliefs, perceived fewer constraints, and more often favored compliance with official vaccination recommendations. Support for and reactance about vaccination mandates depended on vaccination status rather than policy characteristics, regardless of mandate type or incentives (up to 500 euro). While unvaccinated individuals rejected policy provisions and declined vaccination, boosted individuals indicated mid-level support for mandates and showed high vaccination intention. Among vaccinated individuals, higher incentives of up to 2,000 EUR had a considerable effect on the willingness to get boosted, especially in the absence of a mandate. The results indicate that mandates may be needed to increase primary vaccination numbers while incentives could be an alternative to promote booster uptake. However, combining both measures for the same target group seems inadvisable.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/xsh48/" target="_blank">Different interventions for different vaccinations? Effects of psychological factors and health policies on COVID-19 primary and booster vaccine uptake</a>
</div></li>
<li><strong>Social Pathways to Side-Effects: Personal Contacts and Social Media Predict COVID-19 Vaccine Side-Effect Expectations and Experience</strong> -
<div>
COVID-19 vaccine side-effects remain a substantial barrier to vaccination. Previous studies suggest that the experience of vaccination side-effects is exacerbated by expectations, but the extent to which social communication influences these expectations is currently unclear. A prospective longitudinal study (N=551) assessed whether three different information sources, face-to-face reports from personal acquaintances, social media posts, and news reports predict the development of COVID-19 vaccination side-effects and whether side-effect expectations mediate the relationship between the information sources and side-effect experiences. The number of pre-vaccination social media post views and impressions of severity conveyed from personal acquaintances significantly predicted pre-vaccination side-effect expectations and post-vaccination side-effects. Moreover, pre-vaccination side-effect expectations fully mediated the relationship between both sources of social communication and experienced side-effects. These data illuminate the pathways between social communication and COVID-19 vaccination side-effects and suggest that modifying side-effect expectations can change the COVID-19 vaccination experience.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/e2bfv/" target="_blank">Social Pathways to Side-Effects: Personal Contacts and Social Media Predict COVID-19 Vaccine Side-Effect Expectations and Experience</a>
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<li><strong>‘All together now’: Facilitators and barriers to mutual aid during the first UK COVID-19 lockdown, and implications for community resilience</strong> -
<div>
Despite undeniable hardship, the onset of the COVID-19 pandemic also saw an outpour of community solidarity and mutual aid towards those in need. This study explored why people participated in mutual aid, as well as the factors that contributed to continued involvement and/or its decline. We conducted remote interviews with 18 people in South-east England who had been involved in volunteering and local community support groups during the first UK lockdown from March to May 2020. Using thematic approaches to data analysis, we identified two broad themes: 1) Shared social identities and mutual support, and 2) Enduring connections and barriers to continued participation. Participants often reported an emergent shared identity, preferring the localised nature of these groups and the associated mutual nature of support. They also reported intentions to continue providing such support, should the need arise again, and any barriers to continued involvement in mutual aid were better explained by structural and systemic issues, rather than individual, motivational factors. Implications for pandemic response are discussed and future research suggested.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/8gsr2/" target="_blank">‘All together now’: Facilitators and barriers to mutual aid during the first UK COVID-19 lockdown, and implications for community resilience</a>
</div></li>
<li><strong>An Effective mRNA-LNP Vaccine Against the Lethal Plague Bacterium</strong> -
<div>
Plague is a rapidly deteriorating contagious disease that has killed millions of people during the history of mankind and is caused by the gram-negative bacterium Yersinia pestis. Currently, the disease is treated effectively with antibiotics. However, in the case of an outbreak caused by a multiple-antibiotic-resistant strain, alternative countermeasures are required. Despite the many efforts to develop a safe vaccine against the disease, there is still no vaccine approved for use in western countries. mRNA Lipid Nanoparticle (mRNA-LNP) vaccines have been demonstrated during the Covid-19 pandemic to be a versatile, clinically relevant, and rapidly manufactured vaccine platform. However, harnessing this platform for bacterial pathogens remains a formidable challenge. Here, we describe the design of several mRNA-LNP vaccine versions against Y. pestis, based on the F1 capsular antigen. We demonstrate that mRNA-LNP vaccines encoding the F1 antigen with either no signal sequences or conjugated to human Fc, provide substantial cellular and humoral responses. Most importantly, these vaccine candidates fully protect animals against Y. pestis infection. The results of this study suggest that mRNA-LNPs can be effective as anti-bacterial vaccines, and further developed to combat other bacterial pathogens, which are urgently needed, given the looming threat of antibiotic resistance.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.08.07.503096v1" target="_blank">An Effective mRNA-LNP Vaccine Against the Lethal Plague Bacterium</a>
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<li><strong>Interpretable RNA Foundation Model from Unannotated Data for Highly Accurate RNA Structure and Function Predictions</strong> -
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Non-coding RNA structure and function are essential to understanding various biological processes, such as cell signaling, gene expression, and post-transcriptional regulations. These are all among the core problems in the RNA field. With the rapid growth of sequencing technology, we have accumulated a massive amount of unannotated RNA sequences. On the other hand, expensive experimental observatory results in only limited numbers of annotated data and 3D structures. Hence, it is still challenging to design computational methods for predicting their structures and functions. The lack of annotated data and systematic study causes inferior performance. To resolve the issue, we propose a novel RNA foundation model (RNA-FM) to take advantage of all the 23 million non-coding RNA sequences through self-supervised learning. Within this approach, we discover that the pre-trained RNA-FM could infer sequential and evolutionary information of non-coding RNAs without using any labels. Furthermore, we demonstrate RNA-FM’s effectiveness by applying it to the downstream secondary/3D structure prediction, SARS-CoV-2 genome structure and evolution prediction, protein-RNA binding preference modeling, and gene expression regulation modeling. The comprehensive experiments show that the proposed method improves the RNA structural and functional modelling results significantly and consistently. Despite only being trained with unlabelled data, RNA-FM can serve as the foundational model for the field.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.08.06.503062v1" target="_blank">Interpretable RNA Foundation Model from Unannotated Data for Highly Accurate RNA Structure and Function Predictions</a>
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<li><strong>Slovak parents’ mental health and socioeconomic changes during the COVID-19 pandemic</strong> -
<div>
Studying changes in people’s mental health has become one of the hot topics during the current COVID-19 pandemic. Parents were said to be among the most vulnerable groups, considering the nature of the imposed anti-pandemic measures. The present paper analyzes trends in mental health indicators in a sample of Slovak parents (N = 363) who participated in four waves of data collection across a year and a half of the COVID-19 pandemic. Mental health indicators were represented by general levels of depression and anxiety and the COVID-related stress and anxiety. Only minor changes in depression and anxiety were observed, however, the dynamic in COVID-related stress and especially anxiety was more noteworthy. Besides some exceptions, the results hold even after controlling for the socioeconomic situation. Gender differences in the mental health trends were mostly negligible. These results indicate that, in general, parents have successfully adapted to the pandemic situation.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/86m3y/" target="_blank">Slovak parents’ mental health and socioeconomic changes during the COVID-19 pandemic</a>
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<li><strong>Early Side Effects after Administration of the 1st Dose of Oxford-AstraZeneca Vaccine</strong> -
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Vaccines have played a central role in minimizing new infections, the rate of hospitalizations, and the overall burden on the health sector. Fear of side effects is the biggest and commonest reason for avoiding getting vaccinated. It is, therefore, essential to maintain the clarity and consistency of message, to support and encourage people to get vaccinated. This study aims to contribute in that regard, by registering and quantifying the early side-effects of the Oxford-AstraZeneca COVID-19 vaccine in Pakistan. This study employs a non-random cross-sectional design. Data collected from 477 participants using a structured questionnaire was used to investigate the relationship between socio-demographic characteristics and side effect profiles of the participants. Binomial Logistic Regression was used to analyze the data. Odds Ratio (OR) gives the likelihood of having a side effect versus the reference group. Significance level (α) for the probability value (p-value) is set at 0.05. Fever (30.19%) was the most commonly experienced side effect, followed closely by fatigue (22.01%). 71.11% of those with fever experienced low grade fever (99-100F) while 62.69% of body aches experienced were moderate in intensity (Grades 4-6). In general, younger people are significantly more likely (p=0.023) to experience side effects (OR -1 = 1.023: interpreted as 1.023 times increase per unit decrease in age). Similarly, they are more likely (p= 0.029) to have a headache (OR -1 =1.039). Also, they are more likely (p= 0.007) to have a body ache (OR -1 =1.038). The Oxford-AstraZeneca COVID-19 vaccine side-effects seem to be more prevalent among younger age groups, which points to increased vaccine safety among older individuals that are usually more susceptible to severe COVID-19 infection. In addition, we found a substantially reduced number of side-effects, as compared to the clinical trials, which is an encouraging indicator for vaccine safety.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.08.04.22278415v1" target="_blank">Early Side Effects after Administration of the 1st Dose of Oxford-AstraZeneca Vaccine</a>
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<li><strong>Optimization of Ventilation Therapy Prioritization Strategies among Patients with COVID-19: Lessons Learned from Real-World Data of nearly 600,000 Hospitalized Patients</strong> -
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Objective To investigate the benefit of ventilation therapy among various patient groups with COVID-19 admitted to hospitals, based on the real-world data of hospitalized adult patients. Methods Data used in the longitudinal study included 599,340 records of hospitalized patients. All participants were categorized based on demographics and their date of hospitalization. Two models were used in this study: firstly, participants were assessed by their probability of receiving ventilation therapy during hospitalization using mixed-effects logistic regression. Secondly, the clinical benefit of receiving ventilation therapy among various patient groups was quantified while considering the probability of receiving ventilation therapy during hospital admission, as estimated in the first model. Findings Among participants, 60,113 (10.0%) received ventilation therapy, 85,158 (14.2%) passed away due to COVID-19, and 514,182 (85.8%) recovered. Among all groups with sufficient data for analysis, patients aged 40-64 years who had chronic respiratory diseases (CRD) and malignancy benefitted the most from ventilation therapy; followed by patients aged 65+ years who had malignancy, cardiovascular diseases, and diabetes; and patients aged 18-39 years who had malignancy. Patients aged 65+ who had CRD and cardiovascular disease gained the least benefit from ventilation therapy. Conclusion This study promotes a new aspect of treating patients for ventilators: it could be suggested that rather than focusing on the scarcity of ventilators, guidelines focus on decision-making algorithms to also take the usefulness of the intervention into account, whose beneficial effect is dependent on the selection of the right time in the right patient.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.08.04.22278438v1" target="_blank">Optimization of Ventilation Therapy Prioritization Strategies among Patients with COVID-19: Lessons Learned from Real-World Data of nearly 600,000 Hospitalized Patients</a>
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<li><strong>Determining population-level allocation strategies for COVID-19 treatments in the United States using a quantitative framework, a case study using nirmatrelvir/ritonavir</strong> -
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Background: New COVID-19 medications force decision makers to weigh limited evidence of efficacy and cost in determining which patient populations to target for treatment. A case in point is nirmatrelvir/ritonavir, a drug that has been recommended for elderly, high-risk individuals, regardless of vaccination status, even though clinical trials have only evaluated it in unvaccinated patients. A simple optimization framework might inform a more reasoned approach to the tradeoffs implicit in the treatment allocation decision. Methods: We used a mathematical model to analyze the cost-effectiveness of four nirmatrelvir/ritonavir allocation strategies, stratified by vaccination status and risk for severe disease. We considered treatment effectiveness at preventing hospitalization ranging from 21% to 89%. Sensitivity analyses were performed on major parameters of interest. A web-based tool was developed to permit decision-makers to tailor the analysis to their settings and priorities. Results: Providing nirmatrelvir/ritonavir to unvaccinated patients at high-risk for severe disease was cost-saving when effectiveness against hospitalization exceeded 33% and cost-effective under all other data scenarios we considered. The cost-effectiveness of other allocation strategies, including those for vaccinated adults and those at lower-risk for severe disease, depended on willingness-to-pay thresholds, treatment cost and effectiveness, and the likelihood of severe disease. Conclusions: Priority for nirmatrelvir/ritonavir treatment should be given to unvaccinated persons at high-risk of severe disease from COVID-19. Further priority may be assigned by weighing treatment effectiveness, disease severity, drug cost, and willingness to pay for deaths averted.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.08.04.22278431v1" target="_blank">Determining population-level allocation strategies for COVID-19 treatments in the United States using a quantitative framework, a case study using nirmatrelvir/ritonavir</a>
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<li><strong>Intra-pulmonary and intra-cardiac shunts in adult COVID-19 versus non-COVID ARDS ICU patients using echocardiography and contrast bubble studies (COVID-Shunt Study): a prospective, observational cohort study</strong> -
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Importance: Studies have suggested intra-pulmonary shunts may contribute to hypoxemia in COVID-19 ARDS and may be associated with worse outcomes. Objective: To evaluate the presence of right-to-left (R-L) shunts in COVID-19 and non-COVID ARDS patients using a comprehensive hypoxemia work-up for shunt etiology and associations with mortality. Design, Setting, Participants: We conducted a multi-centre (4 Canadian hospitals), prospective, observational cohort study of adult critically ill, mechanically ventilated, ICU patients admitted for ARDS from both COVID-19 or non-COVID (November 16, 2020-September 1, 2021). Intervention: Contrast-enhanced agitated-saline bubble studies with transthoracic echocardiography/transcranial Doppler (TTE/TCD) ± transesophageal echocardiography (TEE) assessed for the presence of R-L shunts. Main Outcomes and Measures: Primary outcomes were shunt incidence and association with hospital mortality. Logistic regression analysis was used to determine association of shunt presence/absence with covariables. Results: The study enrolled 226 patients (182 COVID-19 vs. 42 non-COVID). Median age was 58 years (interquartile range [IQR]: 47-67) and APACHE II scores of 30 (IQR: 21-36). In COVID-19 patients, the incidence of R-L shunt was 31/182 patients (17.0%; intra-pulmonary: 61.3%; intra-cardiac: 38.7%) versus 10/44 (22.7%) non-COVID patients. No evidence of difference was detected between the COVID-19 and non-COVID-19 shunt rates (risk difference [RD]: -5.7%, 95% CI: -18.4-7.0, p=0.38). In the COVID-19 group, hospital mortality was higher for those with R-L shunt compared to those without (54.8% vs 35.8%, RD: 19.0%, 95% CI 0.1-37.9, p=0.05). But this did not persist at 90-day mortality, nor after regression adjustments for age and illness severity. Conclusions: There was no evidence of increased R-L shunt rates in COVID-19 compared to non-COVID controls. Right-to-left shunt was associated with increased in-hospital mortality for COVID-19 patients, but this did not persist at 90-day mortality or after adjusting using logistic regression.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.08.04.22278445v1" target="_blank">Intra-pulmonary and intra-cardiac shunts in adult COVID-19 versus non-COVID ARDS ICU patients using echocardiography and contrast bubble studies (COVID-Shunt Study): a prospective, observational cohort study</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>A Study to Learn About a New COVID-19 RNA Vaccine Candidate as a Booster Dose in COVID-19 Vaccine-Experienced Healthy Adults</strong> - <b>Conditions</b>:   SARS-CoV-2 Infection;   COVID-19<br/><b>Interventions</b>:   Biological: BNT162b5 Bivalent (WT/OMI BA.2);   Biological: BNT162b2 Bivalent (WT/OMI BA.1)<br/><b>Sponsors</b>:   BioNTech SE;   Pfizer<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>Monitoring the Efficacy of a Probiotic Dietary Supplement SmartProbio C in Patients With Severe COVID-19 Infection</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Dietary Supplement: SmartProbio C;   Dietary Supplement: Placebo<br/><b>Sponsors</b>:   Medi Pharma Vision;   Veterinary Research Institute;   Brno University Hospital<br/><b>Completed</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>Cardiovascular Function and Physical Activity in COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Behavioral: Active-at-home-HF<br/><b>Sponsor</b>:   Coventry 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>A Study to Measure the Amount of Study Medicine in Blood in Adult Participants With COVID-19 and Severe Kidney Disease</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Drug: PF-07321332 (nirmatrelvir)/ritonavir<br/><b>Sponsor</b>:   Pfizer<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>Long-term Effects of SARS-CoV-2 on the Central Nervous System and One-year Follow-up of “Long COVID-19” Patients</strong> - <b>Condition</b>:   Long Covid19<br/><b>Intervention</b>:   Diagnostic Test: Perfusion brain scintigraphy imaging<br/><b>Sponsor</b>:   Brugmann University 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>Effect of Pulmonary Rehabilitation Program on Post Hospitalization Severe COVID- 19 Patients</strong> - <b>Condition</b>:   Post COVID-19 Condition<br/><b>Intervention</b>:   Combination Product: respiratory exercises - incentive spirometer - walking<br/><b>Sponsor</b>:   Fayoum University Hospital<br/><b>Completed</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>Physiotherapy in Post COVID-19 Syndrome Patients</strong> - <b>Condition</b>:   Post-COVID-19 Syndrome<br/><b>Interventions</b>:   Other: Cognitive behavioral principles-based treatment program;   Other: Control intervention<br/><b>Sponsor</b>:   Universidad de Granada<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>Rehabilitation for People With Post COVID-19 Syndrome</strong> - <b>Condition</b>:   Post-COVID-19 Syndrome<br/><b>Interventions</b>:   Other: Multidimensional intervention;   Other: Control intervention<br/><b>Sponsor</b>:   Universidad de Granada<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>Active Cycle Of Breathing Technique Verses Breathing Exercises In Post ICU COVID-19 Patients</strong> - <b>Condition</b>:   Post Covid-19 Patients<br/><b>Interventions</b>:   Other: Chest physiotherapy with breathing exercises and ACBT;   Other: Chest physiotherapy with breathing exercises<br/><b>Sponsor</b>:   Riphah International 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>Addressing Vaccine Hesitancy and Increasing COVID-19 Vaccine Uptake Among African American Young Adults in the South</strong> - <b>Conditions</b>:   COVID-19;   Vaccine Uptake<br/><b>Intervention</b>:   Behavioral: Tough Talks COVID<br/><b>Sponsors</b>:   University of North Carolina, Chapel Hill;   University of Alabama at Birmingham;   National Institute on Minority Health and Health Disparities (NIMHD)<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>rSIFN-co Among Healthy Subjects and Subjects With Mild or Asymptomatic COVID-19</strong> - <b>Conditions</b>:   COVID-19;   SARS-CoV-2<br/><b>Interventions</b>:   Drug: rSIFN-co Nasal Spray;   Drug: Placebo Nasal Spray<br/><b>Sponsor</b>:   Sichuan Huiyang Life Science and Technology Corporation<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>A CHW Intervention to Identify and Decrease Barriers to COVID 19 Testing &amp; Vaccination</strong> - <b>Conditions</b>:   Vaccine Hesitancy;   COVID-19 Testing;   Community Health Workers<br/><b>Intervention</b>:   Behavioral: Community Health Worker led curriculum<br/><b>Sponsors</b>:   Charles Drew University of Medicine and Science;   Los Angeles County Department of Public Health;   National Library of Medicine (NLM)<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>Lollipop COVID-19 Testing Study</strong> - <b>Conditions</b>:   COVID-19;   SARS CoV 2 Infection;   COVID-19 Pandemic<br/><b>Intervention</b>:   Diagnostic Test: Lollipop Swab<br/><b>Sponsor</b>:   University of Wisconsin, Madison<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>Evaluation of Safety and Immunogenicity of the Recombinant ZR202-CoV and ZR202a-CoV Vaccines in Adults.</strong> - <b>Conditions</b>:   SARS-CoV-2 Infection;   COVID-19<br/><b>Interventions</b>:   Biological: ZR202-CoV;   Biological: ZR202a-CoV;   Biological: Comirnaty®<br/><b>Sponsor</b>:   Shanghai Zerun Biotechnology Co.,Ltd<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>Immunogenicity and Safety of BBIBP-Corv Coadministered With PPV23 and IIV4 in Hemodialysis Population</strong> - <b>Conditions</b>:   Hemolysis;   COVID-19<br/><b>Interventions</b>:   Biological: coadministration;   Biological: COVID-19 vaccine;   Biological: IIV4+PPV23<br/><b>Sponsors</b>:   China National Biotec Group Company Limited;   Hunan Provincial Center for Disease Control and Prevention;   Sichuan Center for Disease Control and Prevention;   Guizhou Center for Disease Control and Prevention;   Xiangya Hospital of Central South University;   Beijing Institute of Biological Products Co Ltd.;   Chengdu Institute of Biological Products Co.,Ltd.;   Shanghai Institute Of Biological Products<br/><b>Not yet recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</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>Interleukin 6: A biomarker for COVID-19 progression</strong> - COVID-19 was discovered in China for the first time in December 2019 and was declared a pandemic by the World Health Organization on March 11, 2020. Due to its rapid geographic expansion over the last three years, it has now become a global health issue. The infection is caused by SARS-CoV-2, which is obtained from a zoonotic source and transmitted directly or through contact. Following exposure, the immune system becomes hyperactive resulting in the production of pro-inflammatory cytokines,…</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>Exploring the Potential of Chemical Inhibitors for Targeting Post-translational Glycosylation of Coronavirus (SARS-CoV-2)</strong> - The Spike (S) protein of SARS-CoV-2 expressed on the viral cell surface is of particular importance as it facilitates viral entry into the host cells. The S protein is heavily glycosylated with 22 N-glycosylation sites and a few N-glycosylation sites. During the viral surface protein synthesis via the host ribosomal machinery, glycosylation is an essential step in post-translational modifications (PTMs) and consequently vital for its life cycle, structure, immune evasion, and cell infection….</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 impact of social support and stress on academic burnout among medical students in online learning: The mediating role of resilience</strong> - CONCLUSION: The results of this study can provide a reference for the future development of appropriate educational strategies and coping measures to ameliorate the academic burnout of medical students.</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 effect of information-driven resource allocation on the propagation of epidemic with incubation period</strong> - In the pandemic of COVID-19, there are exposed individuals who are infected but lack distinct clinical symptoms. In addition, the diffusion of related information drives aware individuals to spontaneously seek resources for protection. The special spreading characteristic and coevolution of different processes may induce unexpected spreading phenomena. Thus we construct a three-layered network framework to explore how information-driven resource allocation affects SEIS…</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>Role of the mucin-like glycoprotein FCGBP in mucosal immunity and cancer</strong> - IgGFc-binding protein (FCGBP) is a mucin first detected in the intestinal epithelium. It plays an important role in innate mucosal epithelial defense, tumor metastasis, and tumor immunity. FCGBP forms disulfide-linked heterodimers with mucin-2 and members of the trefoil factor family. These formed complexes inhibit bacterial attachment to mucosal surfaces, affect the motility of pathogens, and support their clearance. Altered FCGBP expression levels may be important in the pathologic processes…</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>Methylene blue, Mycophenolic acid, Posaconazole, and Niclosamide inhibit SARS-CoV-2 Omicron variant BA.1 infection of human airway epithelial organoids</strong> - Sublineages of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) Omicron variants continue to amass mutations in the spike (S) glycoprotein, which leads to immune evasion and rapid spread of the virus across the human population. Here we demonstrate the susceptibility of the Omicron variant BA.1 (B.1.1.529.1) to four repurposable drugs, Methylene blue (MB), Mycophenolic acid (MPA), Posaconazole (POS), and Niclosamide (Niclo) in post-exposure treatments of primary human airway cell…</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>SARS-CoV-2 Spike Protein Vaccine-Induced Immune Imprinting Reduces Nucleocapsid Protein Antibody Response in SARS-CoV-2 Infection</strong> - Immune imprinting or original antigenic sin (OAS) is the process by which the humoral memory response to an antigen can inhibit the response to new epitopes of that antigen originating from a second encounter with the pathogen. Given the situation of the COVID-19 pandemic, multiple vaccines have been developed against SARS-CoV-2 infection. These vaccines are directed to the spike protein (S protein) of the original variant of Wuhan D614G. Vaccine memory immune response against S protein in…</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>Synthesis and Evaluation of Diterpenic Mannich Bases as Antiviral Agents against Influenza A and SARS-CoV-2</strong> - A chemical library was constructed based on the resin acids (abietic, dehydroabietic, and 12-formylabietic) and its diene adducts (maleopimaric and quinopimaric acid derivatives). The one-pot three-component CuCl-catalyzed aminomethylation of the abietane diterpenoid propargyl derivatives was carried out by formaldehyde and secondary amines (diethylamine, pyrrolidine, morpholine, and homopiperazine). All compounds were tested for cytotoxicity and antiviral activity against influenza virus…</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>Targeting Emerging RNA Viruses by Engineered Human Superantibody to Hepatitis C Virus RNA-Dependent RNA Polymerase</strong> - RNA-dependent RNA polymerase (RdRp) is a unique and highly conserved enzyme across all members of the RNA virus superfamilies. Besides, humans do not have a homolog of this protein. Therefore, the RdRp is an attractive target for a broadly effective therapeutic agent against RNA viruses. In this study, a formerly generated cell-penetrating human single-chain antibody variable fragment (superantibody) to a conformational epitope of hepatitis C virus (HCV) RdRp, which inhibited the polymerase…</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>Medical students’ perspectives on how COVID-19 has impacted their otolaryngology educational experience: A nationwide survey study</strong> - CONCLUSIONS: According to students, COVID-19 negatively impacted a broad array of otolaryngology educational experiences including research, faculty interaction, and interest group involvement. Students also indicated several well-received adaptations, such as virtual mentorship programs, curated video materials, remote research opportunities, and online question banks. This feedback helps contextualize selection committee decisions and, importantly, assists clerkship directors and undergraduate…</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>Phytoncides could potentially inhibit the spike protein of SARS-CoV-2 variants</strong> - No abstract</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>Analysis of mechanisms of Shenhuang Granule in treating severe COVID-19 based on network pharmacology and molecular docking</strong> - CONCLUSION: Multiple components of SHG regulated multiple targets to inhibit virus invasion and cytokine storm through several signaling pathways; this provides a scientific basis for clinical applications and further experiments.</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>Complement activation in COVID-19 and targeted therapeutic options: A scoping review</strong> - Increasing evidence suggests that activation of the complement system plays a key role in the pathogenesis and disease severity of Coronavirus disease 2019 (COVID-19). We used a systematic approach to create an overview of complement activation in COVID-19 based on histopathological, preclinical, multiomics, observational and clinical interventional studies. A total of 1801 articles from PubMed, EMBASE and Cochrane was screened of which 157 articles were included in this scoping review….</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>Prevalence of symptoms, comorbidities, fibrin amyloid microclots and platelet pathology in individuals with Long COVID/Post-Acute Sequelae of COVID-19 (PASC)</strong> - CONCLUSIONS: Fibrin amyloid microclots that block capillaries and inhibit the transport of O(2) to tissues, accompanied by platelet hyperactivation, provide a ready explanation for the symptoms of Long COVID/PASC. Removal and reversal of these underlying endotheliopathies provide an important treatment option that urgently warrants controlled clinical studies to determine efficacy in patients with a diversity of comorbidities impacting on SARS-CoV-2 infection and COVID-19 severity. We suggest…</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 Potential Utility of Lead Compound, E18, in Inhibiting Docking of SARS-CoV-2 by inhibiting ACE2-B<sup>0</sup>AT1 Complex</strong> - Null.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
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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>The Kyrsten Sinema Watch Party</strong> - With Democrats poised to pass the Inflation Reduction Act, their signature legislation on health care and climate change, all eyes were on the senior senator from Arizona. - <a href="https://www.newyorker.com/news/the-political-scene/the-kyrsten-sinema-watch-party">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Kansas Abortion Referendum Has a Message for Democrats</strong> - In the run-up to November’s midterm elections, the Party has an opportunity to seize the mantle as the defender of long-established individual rights. - <a href="https://www.newyorker.com/news/our-columnists/the-kansas-abortion-referendum-has-a-message-for-democrats">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Provocative Politics of Nancy Pelosi’s Trip to Taiwan</strong> - What is the House Speaker’s high-profile visit really about? - <a href="https://www.newyorker.com/news/q-and-a/the-provocative-politics-of-nancy-pelosis-trip-to-taiwan">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Sana Krasikov Reads “The Muddle”</strong> - The author reads her story from the August 15, 2022, issue of the magazine. - <a href="https://www.newyorker.com/podcast/the-writers-voice/sana-krasikov-reads-the-muddle">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How Hurricanes Get Their Names</strong> - In an age of more intense storms, forecasters explain their aims. - <a href="https://www.newyorker.com/news/daily-comment/how-hurricanes-get-their-names">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>The biggest wildlife bill since the Endangered Species Act is <em>this close</em> to becoming law</strong> -
<figure>
<img alt="A black-footed ferret, standing on a scrubby path and looking at the camera." src="https://cdn.vox-cdn.com/thumbor/8crJ5F0RNeHAXPsBkuWrKy56yBI=/217x0:2281x1548/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71219952/GettyImages_186801916.0.jpg"/>
<figcaption>
The black-footed ferret, an endangered species, is one of many animals and plants in the US that would benefit from the $1.4 billion Recovering America’s Wildlife Act. | Kathryn Scott Osler/Denver Post via Getty Image
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Recovering America’s Wildlife Act would funnel millions of dollars into saving overlooked species.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rLKfph">
The Biden administration is on the cusp of enacting the <a href="https://www.vox.com/policy-and-politics/2022/7/28/23281757/whats-in-climate-bill-inflation-reduction-act">biggest piece of climate legislation</a> ever, after the Senate passed the <a href="https://www.vox.com/policy-and-politics/2022/7/28/23282217/climate-bill-health-care-drugs-inflation-reduction-act">Inflation Reduction Act</a> Sunday with a vote straight down party lines. But there’s actually another huge piece of environmental legislation that could soon become law — and it has bipartisan support.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eXVNCf">
Known by the acronym RAWA, <a href="https://www.congress.gov/bill/117th-congress/senate-bill/2372/text">Recovering America’s Wildlife Act</a> would provide close to $1.4 billion a year for restoring wildlife populations across the country. At its core, RAWA addresses a big problem: More than <a href="https://www.nature.org/en-us/about-us/who-we-are/how-we-work/policy/recovering-americas-wildlife/">a third</a> of the nation’s plants and animals are threatened with extinction, from the <a href="https://www.vox.com/down-to-earth/22823993/monarch-butterflies-mexico-milkweed">monarch butterfly</a> to the Florida panther, putting outdoor recreation and ecosystems that Americans depend on at risk.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WI8Ekz">
The bill isn’t just some animal-lover’s fantasy: It passed the House in June on a <a href="https://naturalresources.house.gov/media/press-releases/chair-grijalva-celebrates-bipartisan-house-passage-of-recovering-americas-wildlife-act-">bipartisan vote</a>, and it’s poised to clear the Senate, where it has <a href="https://www.congress.gov/bill/117th-congress/senate-bill/2372/cosponsors">16 Republican co-sponsors</a>, as soon as this fall.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="70P4kO">
Unlike climate-focused legislation, RAWA has a broad base of support, in part because it appeals to hunters and fishers, many of whom tilt conservative. It also gives power to states to decide how to spend the money. Plus, wildlife-related recreation is a <a href="https://www.nature.org/en-us/about-us/who-we-are/how-we-work/policy/recovering-americas-wildlife/">$140 billion</a> industry, so protecting plants and animals comes with a strong economic incentive.
</p>
<div class="c-float-left">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/3bkQtTRcv974hiSd24IkhjdadN8=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/23920454/GettyImages_1241572273.jpg"/> <cite>Creative Touch Imaging Ltd./NurPhoto via Getty Images</cite>
<figcaption>
A monarch butterfly caterpillar on a milkweed plant in Markham, Ontario, Canada.
</figcaption>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="R7PKg5">
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CK6bi9">
To put this bill in perspective: RAWA would be the biggest piece of legislation for wildlife since the Endangered Species Act of 1973, which is credited with saving grizzly bears, gray wolves, and dozens of other beloved American animals from extinction, said Sen. Martin Heinrich, a Democrat from New Mexico.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4E4kCI">
“It would be a real shame if we didn’t take advantage of this,” said Sen. Heinrich, who introduced the bill to the Senate last summer, along with Republican Sen. Roy Blunt of Missouri.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jp60VG">
By funneling money into wildlife conservation, RAWA would protect thousands of plants and animals before<em> </em>they’re at imminent risk of extinction, according to Heinrich and environmental experts. Ultimately, that could save taxpayers money.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iTXcU5">
Here’s how it would work — and why RAWA is an acronym worth knowing.
</p>
<h3 id="iMR4u8">
Why the US has struggled to prevent wildlife declines
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QXzQ3T">
Much of the work to protect animals falls on state wildlife agencies. They have a range of programs to monitor and manage plant and animal populations that include <a href="https://www.vox.com/down-to-earth/23180428/river-otters-iowa-restoration">reintroducing locally extinct species</a> and setting regulations for hunting and fishing. Yet these agencies have only been able to help a small sliver of the nation’s imperiled animals — more than <a href="https://www.fishwildlife.org/afwa-informs/state-wildlife-action-plans">12,000 species</a> in the US are still in need of protection, according to state wildlife agencies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0s0vJI">
The first problem is money. Roughly <a href="https://www.nwf.org/-/media/Documents/PDFs/Wildlife-Conservation/RAWA-fact-sheet.ashx?la=en&amp;hash=1543E31E4F682902B1B7C7D35374709E35894710">80 percent</a> of funding for state-led conservation comes from selling hunting and fishing licenses, in addition to federal excise taxes on related gear, such as guns and ammo. But these activities aren’t as popular as they once were. In the early 1980s, for example, hunters made up 7.2 percent of the US population; by 2020, that proportion had fallen to 4.2 percent, according to the environmental advocacy group <a href="https://wildlifeforall.us/resources/decline-of-hunting-and-fishing/#:~:text=In%20relative%20numbers%2C%20the%20percentage,percent%20of%20the%20U.S.%20population.">Wildlife for All</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1ClQyH">
State conservation is funded through a customer-based model, said Andrew Rypel, a professor of biology at the University of California Davis. And in the last few decades, “the customer base has been declining,” he said. “That results in less conservation work getting done.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="q829qO">
Another problem is how state agencies spend those dwindling funds. Virtually all of the money for conservation is funneled into animals that people like to hunt or fish, such as elk and trout, said Daniel Rohlf, a law professor at Lewis &amp; Clark Law School. That leaves out countless other species, many of which are threatened with extinction. “At the state level, there’s been almost zero focus on non-game fish and wildlife,” Rohlf said.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/9MJ9WFCoeCdd1A-KBD4m-YlEy4k=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/23920452/GettyImages_1241976286.jpg"/> <cite>Jessica Rinaldi/The Boston Globe via Getty Images</cite>
<figcaption>
A fisherman holds a small brown trout that he caught along a river in Vermont.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="X7778d">
Fish that have no commercial value are a good example, Rypel said. “There’s this whole group of fish species that nobody cares about, which people call rough fish,” he said. These are species like the <a href="https://www.nps.gov/miss/learn/nature/freshwater-drum-sheepshead-aplodinotus-grunniens.htm">freshwater drum</a> and <a href="https://fieldguide.mt.gov/speciesDetail.aspx?elcode=AFCJC02280">largescale sucker</a> that have no commercial value yet typically serve <a href="https://afspubs.onlinelibrary.wiley.com/doi/full/10.1002/fsh.10660">a vital role</a> in the ecosystem. “Many of them have been declining over time and they never get worked on because they don’t fall into this customer-driven model,” he said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="I9ruy3">
That’s why researchers like Rypel are so excited about RAWA: The bill seeks to solve both of these problems by providing funding to protect all at-risk plants and animals.
</p>
<h3 id="vAketj">
Each state will get millions of dollars more to spend on conservation
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="O6s4KY">
The bill would disperse a total of more than $1.3 billion each year among state wildlife agencies, based on the state’s size, human population, and the number of federally threatened species. California, for example, could get more than $50 million a year, whereas Vermont or New Hampshire — where fewer animals are at risk — could receive closer to $10 million.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gRbldO">
The idea is that these funds would pay for 75 percent of each state’s <a href="https://www.fishwildlife.org/afwa-informs/state-wildlife-action-plans">Wildlife Action Plan</a>. These are formal blueprints, drafted by each state in 2005, that detail which species are vulnerable and how the agency plans to keep them off the federal endangered species list.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="F3BZFj">
New York state’s <a href="https://www.dec.ny.gov/docs/wildlife_pdf/swapfinaldraft2015.pdf">plan</a>, for example, includes 366 species in need of protection, such as the <a href="https://nationalzoo.si.edu/animals/timber-rattlesnake">timber rattlesnake</a> and the <a href="https://www.allaboutbirds.org/guide/Saltmarsh_Sparrow/overview">saltmarsh sparrow,</a> and a wide range of actions to protect them. Those include things like minimizing pollution and protecting forests, wetlands, and other habitats.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hUMKf5">
Historically these action<strong> </strong>plans have been vastly underfunded: States can only pay for about 5 percent or less of them. RAWA seeks to fix that. The bill will also require states to contribute 25 percent in matching funds from other sources, such as license plate sales (so a state that receives $10 million from the government would kick in an additional $2.5 million).
</p>
<div class="c-float-right">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/RTC4nfIlYSuS0nnW3eJQVko05Us=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/23920467/GettyImages_143379282.jpg"/> <cite>Michael Pearce/Wichita Eagle/Tribune News Service via Getty Images</cite>
<figcaption>
Two male lesser prairie chickens, a vulnerable species, fight for territory in a grassland in Kansas.
</figcaption>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fKoz1s">
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uHE7Sz">
One feature of RAWA that makes it so important, experts say, is that it requires states to protect animals that are imperiled, whether or not they’re targeted by hunters and fishers. “That’s funding that doesn’t exist right now,” Rohlf said. The money could provide a lifeline for endangered salamanders, songbirds, and countless other non-game animals that are, as the <a href="https://www.congress.gov/bill/117th-congress/senate-bill/2372/text">bill</a> states, “of greatest conservation need.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rZzIbc">
RAWA also aims to restore wildlife populations before they’re at risk of extinction, to avoid having to list animals as threatened under the Endangered Species Act, which comes with all kinds of regulatory burdens and <a href="https://www.pbs.org/newshour/economy/what-is-an-endangered-species-worth-trump-rule-sparks-debate">costs</a>. “It’s often more expensive to take action once a species is imperiled than it is to take action when it’s doing okay,” said Brent Keith, a senior policy adviser at the Nature Conservancy, a nonprofit organization that has been promoting the new legislation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1XAsvB">
The act could help New York protect habitat for the vulnerable saltmarsh sparrow, for example, according to Amanda Rodewald, senior director of the Center for Avian Population Studies at the Cornell Lab of Ornithology. That could ensure the bird, which is in decline, isn’t listed as endangered, and it could also benefit coastal communities that rely on salt marshes to help dampen flooding during storms.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="L0ZGoJ">
“There are so many shared threats or stressors that are facing wildlife and human communities,” she said. “We just can’t separate out our needs.”
</p>
<aside id="AxdCvK">
<div>
</div>
</aside>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JuNhvL">
That’s another reason why RAWA has drawn bipartisan support. It would help states avoid having the federal government step in to manage species, which conservative legislators tend to oppose.
</p>
<h3 id="PNHSGy">
A “game changer” for tribes
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gRHIj4">
RAWA also includes nearly $100 million for the nation’s Native American tribes, which own or help manage nearly <a href="https://www.nafws.org/news/doing-more-with-less-inequities-in-tribal-fish-wildlife-funding/">140 million acres</a> of land in the US (equal to about 7 percent of the continental US).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MAQQZV">
“It truly is a game changer,” said Julie Thorstenson, executive director of the Native American Fish and Wildlife Society and a member of the Cheyenne River Sioux Tribe.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="N7JxrT">
The nation’s <a href="https://www.bia.gov/about-us#:~:text=There%20are%20574%20federally%20recognized,Villages%20in%20the%20United%20States.">574 tribes</a> manage hundreds of threatened species, and some of their citizens depend closely on wildlife for food. Yet they don’t receive federal money for conservation from excise taxes, like states do, even though Native Americans pay those taxes themselves when they buy guns and other hunting gear, Thorstenson said.
</p>
<figure class="e-image">
<img alt="Don Reiter holds a small bear cub." src="https://cdn.vox-cdn.com/thumbor/4_96CLKfp3UC34xzKQqjKSndEaE=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/23921378/IMG_2929.JPG"/> <cite>Courtesy of the Native American Fish and Wildlife Society</cite>
<figcaption>
Wildlife biologist Don Reiter, a member of the Menominee Indian Tribe of Wisconsin, has studied the ecology of black bears for decades.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pKTDOH">
“There’s no base funding for tribes,” she told Vox, referring to money for conservation. Instead, tribal governments have to cobble together funding from a variety of different sources and compete with each other for small federal grants. “The inequities of funding for tribal fish and wildlife is one of the most important and least-known issues in conservation,” Thorstenson said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cFheaf">
Though RAWA’s $100 million provides tribes with far less money than states, it would chip away at those inequities. “It’s not enough,” Thorstenson said, but “it’s a start.”
</p>
<h3 id="Y9deKB">
How likely is it that RAWA will pass?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FgJE41">
The biggest hurdle ahead is finding a way to offset RAWA’s large price tag. It would cost the government roughly $14 billion over the next decade, and the bill would make the funding permanent.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ztc6ui">
In past negotiations, legislators proposed paying for RAWA by closing loopholes in charitable tax breaks for people who conserve undeveloped land, which some wealthy individuals have exploited. (ProPublica’s Peter Elkind has <a href="https://www.propublica.org/article/syndicated-conservation-easement-irs-tax-scam#:~:text=The%20government%20is%20targeting%20a,encourage%20preservation%20of%20open%20land.">written a lot</a> about what he calls “the tax scam that won’t die.”)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VJdPom">
But that strategy likely won’t generate enough money, Keith said. Sen. Heinrich, meanwhile, declined to share details about a potential pay-for. “We’re still in active conversations with both the Finance Committee and also leadership in the Senate,” he told Vox. “I don’t think that [the pay-for] will be an impediment to get this done.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hCrgGi">
Should legislators find a way to offset RAWA’s cost, it could come to a vote as soon as September. Environmental experts are confident that the bill will pass; with more than a dozen Republican co-sponsors in the Senate, it will likely have well over 60 votes.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VvAP3N">
That’s something to celebrate, Rypel said. “You just don’t hear about a lot of bipartisan bills anymore,” he said. “It could be a very good thing for our country to have a functional and powerful piece of legislation pass in today’s polarized time.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hXQvwM">
</p></li>
<li><strong>An end-of-life doula’s advice on how to make the most of your time on earth</strong> -
<figure>
<img alt="Cartoon of an older woman happily swinging on a swing." src="https://cdn.vox-cdn.com/thumbor/nAmjCCpm4Ek0Hb-lCuGzblUVXiY=/119x0:2004x1414/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71219858/GettyImages_1362749729.0.jpg"/>
<figcaption>
Denis Novikov/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Life is short. Here’s how to cherish every day of it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xJ44GD">
“I want a party in the woods with an all-night campfire. I’ll be off to the side in a sleeping bag, nice and cozy. There will be s’mores and cocktails. My friends can come and go, saying goodbye however they want, or just sitting quietly with me and holding my hand. Nobody should touch my feet, though. I <em>hate</em> having my feet touched. A playlist of my favorite songs should be on repeat. I’d like to die as the fire burns out at dawn. Lights out and lights <em>out</em>, you know?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="h6oiHj">
I’m on Zoom and a chaplain from Iowa is describing her ideal final hours of life. We’re training to become <a href="https://inelda.org/about-doulas/what-is-a-doula/">end-of-life doulas</a>, and this morning’s assignment is to help each other talk through a final hours ritual. It’s one of many exercises designed to confront us with our own mortality, so we can leave our own feelings about death at the door before we step across someone else’s threshold to help with theirs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="q4QljT">
End-of-life (EOL) doulas are at the opposite end of the life cycle spectrum from <a href="https://www.dona.org/what-is-a-doula/">birth doulas</a>. They provide non-clinical care (emotional, logistical, and physical) and help with <a href="https://www.goingwithgracecourses.com/courses/end-of-life-planning-made-simple">planning</a>; engage with <a href="https://www.endoflifedoulaalliance.com/life-review">life reviews</a> and <a href="https://www.beyondmorning.org/">legacy work</a>; and provide <a href="https://learn.uvm.edu/program/end-of-life-doula-at-uvm/end-of-life-doula-certificate/">support</a> for family and friends so caretakers can bring their best, rested selves to support their dying loved one.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="P4fmQY">
I knew training to become a doula would change my relationship to death, but I didn’t anticipate how it would transform my day-to-day life. Like others, my smartphone use skyrocketed during the isolation of the pandemic. Even after those panic-inducing first months in NYC, I still found myself using my phone as a constant distraction — lurking on Instagram, clicking every New York Times alert, obsessively refreshing my email like it was a Vegas slot machine.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cSwZHp">
I didn’t become an end-of-life doula to fix my fragmented focus. I did it because Covid-19 made death suddenly feel very real and very present. But I found that a deep dive into death work profoundly clarified my priorities, and has helped me spend time in ways more aligned with those priorities thanks to the soul-shaking understanding that our time here is truly limited.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="m9h63E">
Here are three components of EOL doula training that have been useful in my never-ending quest to live a more present and focused life in this Age of Endless Distractions. Think of it as a looking-back-from-your-imagined-deathbed approach to living — which sounds morbid in theory but is empowering and enriching in reality.
</p>
<h3 id="5q1WNX">
Imagine you have three months to live
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bd33BV">
I’m not going to lie to you: This exercise isn’t going to feel great! Please do it only if you feel equipped to engage with feelings of grief and loss. I recommend having someone you trust read it to you, someone who also has the emotional bandwidth and who is not currently grieving. You’ll need a pen and paper. Choose a time when you’re not going to feel rushed and are in a comfortable space. Take some deep breaths. Settle in. Here we go.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mZdpLm">
Write down your five most-prized possessions, your five favorite activities, your top five values, and the five people you love the most.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pQByem">
Close your eyes. Imagine you’re at a doctor’s office. You’ve just been given a terminal diagnosis and told you have approximately three months to live. Sit with that news. Breathe. Open your eyes. Cross any four items off your list.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GwO8Fm">
Close your eyes. You’re back home with your spouse or friends or children or pet. You have to find a way to tell those you love: “I’m dying.” Breathe. Open your eyes. Cross another four items off your list.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yarECN">
Close your eyes. You’ve started feeling the effects of your illness. You can’t get around as easily. Your sleep is restless. You’re nauseated from the medications you’re taking. Breathe. Open your eyes. Cross four more items off your list.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5CbUMt">
Close your eyes. You’re mostly confined to your bed now. Your loved ones have gathered because they know they will soon have to say goodbye. They drift in and out of your bedroom, or wherever you have chosen to spend your final days, holding your hand, perhaps playing music you like or reading aloud your favorite book. Breathe. Open your eyes. Cross four more items off your list.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nX7jmV">
Close your eyes. You’re in bed, eyes closed, unable to move much or to speak at all. You sense that you’re going to die soon, and you wonder what will happen when you go. What are you thinking about in these final moments? Breathe. Open your eyes. Cross the remaining four items off your list.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oPvb5Q">
Whew. You did it. Make sure to give yourself as much time as you need to regroup before you reenter the “real world.” Sit still. Focus on your breath. Drink lots of water.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kHuCNb">
When I did a version of this exercise, I was amazed at how real loss and grief felt as I crossed items off my list. (There is nothing quite like imagining your kid’s life without you to bring on The Sobs.) I don’t want to overstate the impact of imagining loss versus actually experiencing it, nor minimize our individual, multi-faceted responses to real grief, but <a href="https://taylorlab.psych.ucla.edu/wp-content/uploads/sites/5/2014/11/2000_From-Vulnerability-to-Growth_Positive-and-Negative-Effects-of-Stressful-Life-Events.pdf">research</a> has shown that stressful life events can change us, and that includes clarifying our values and priorities. Maybe you, like me, tapped into some of that clarity during this exercise.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4s3Kcr">
A few days after I tried this exercise, I rewrote my Top 20 list on a notecard. I keep that notecard by my laptop and look at it often. It has been an unexpectedly powerful reminder of what and who I love, of who I am and want to be. Each day I think about how to fit in as much as I can from this list, even if I only have a few free minutes to myself. It has become the framework that informs my daily to-dos and balance of <a href="https://todoist.com/productivity-methods/eisenhower-matrix">urgent/important</a> tasks.
</p>
<h3 id="zRuT7i">
Practice deep, active listening
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Nn80Zf">
A good deal of EOL doula work is <a href="https://www.indiebound.org/book/9781451667257">listening work</a>. The deep, active listening doulas are trained for involves <a href="https://inelda.org/learning-what-not-to-say/">holding back</a> our own stories, comments, and feelings. Doulas don’t tell a dying person what to do. They don’t try to fix the situation. They ask open-ended questions and understand that how people move through the dying process is up to them. This kind of listening requires empathy and restraint. It insists on being free from distractions, external (cellphone notifications, I’m looking at you) and internal (like that voice inside your head that wants to judge or give advice).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Q8mV2K">
As the person at a party who makes approximately 30 seconds of obligatory small talk before diving into deeply personal conversations with strangers, I assumed I was custom-built for this part of being a doula. But it can be difficult to stick to open-ended questions, to sit comfortably in silence, or to resist giving well-meaning but unsolicited advice.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PvNM6p">
So, I’ve been practicing. A lot. This kind of listening has altered what I can only think to call the texture of my time. It has made me more present, empathetic, and curious in conversations and relationships.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hvPuhd">
The next time you’re having a conversation with someone who is sharing important information or struggling in some way, you might try it. Ask open-ended questions. “How are you feeling about X?” “Do you want to talk more about Y?” Give their answers space and silence to settle.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VduABn">
Reflect back what you think you’ve heard. Be open to being wrong about what you think you’ve heard. Be supportive, but don’t try to fix the situation with advice or talk them out of what they are feeling. Avoid platitudes like “give it time” or “it wasn’t meant to be.” Even “I know how you feel,” well-intentioned though it is, often misses the mark because we mostly don’t<em> </em>know exactly how someone else feels or entirely understand their specific situation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rS6rnv">
Of course, not all our conversations require this therapist-like level of restraint, but challenge yourself to consider that <a href="https://www.psychologytoday.com/us/blog/the-empowerment-diary/201708/deep-listening-in-personal-relationships">plenty of them could benefit</a> from a touch more deep listening.
</p>
<h3 id="Kw7YUk">
Legacy projects in the here and now
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aTN7YW">
Doulas often help with legacy projects: autobiographies, letters to loved ones, art projects, and more. These projects memorialize a person’s passions and creativity, values and contributions, and — spoiler alert! — you don’t have to wait until you or someone you love is dying to work on one.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Bf4Kpw">
Say you’re an amateur musician. You might already know who you want to leave your beloved instruments to. However, another kind of legacy could be recording a few minutes of playing each week and saving that audio in a digital folder to be passed on down the road.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S2g8d7">
To start thinking about a legacy project ask yourself questions like what life lessons have I learned so far? What brings me joy? How do I want to be remembered? What do I love to do outside of my paid work? Consider what form best fits your legacy project and spend a little time each week or month on it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YerlaA">
Researchers have found that “<a href="https://theconversation.com/why-being-aware-of-your-mortality-can-be-good-for-you-83181">mortality legacy awareness</a>” can be a “highly creative force,” and that “focusing on what you would like to leave behind could help you turn something terrifying into a positive motivational tool.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JkGk7Q">
I’m encouraged by recent shifts in our societal approaches to dying, like the <a href="https://www.orderofthegooddeath.com/">death positive movement</a>, empowering trends in <a href="https://hospicenews.com/2021/11/05/psychedelics-could-be-new-frontier-in-end-of-life-care/">end-of-life care</a>, opportunities for <a href="https://www.npr.org/2013/03/08/173808940/death-cafes-breathe-life-into-conversations-about-dying">exploration and discussion</a>, a transition away from hospitals and back to <a href="https://www.washingtonpost.com/health/many-americans-say-they-want-to-die-at-home-its-not-always-easy-to-make-that-happen/2020/02/14/4196fa0a-325a-11ea-9313-6cba89b1b9fb_story.html">dying at home</a> when possible, and the increasing number of <a href="https://www.phillydeathdoulas.com/">end-of-life doulas</a> as a community resource. Still, proactively thinking about our own death isn’t always (ever?) easy. We live in a country that <a href="https://medicalxpress.com/news/2022-01-experts-overmedicalization-death-rethink-society.html">tends to overmedicalize</a> death. We are currently facing unfathomable individual and collective grief over<strong> </strong>deaths from Covid-19, ever-increasing gun violence, a lack of accessible health care, and a horrifying real-time erosion of human rights. All this in a culture desperately in need of more space for individuals to rest and to mourn.
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It’s easier in the short term to distance ourselves from thinking about death. But engaging with our mortality when we have the bandwidth to do so can offer clarity that in the long term infuses our lives with more joy and meaning. You’ll be living life knowing what you want to have accomplished at the end of it. And that, I swear, is the ultimate productivity hack.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="h4kfYJ">
<em>Thanks to </em><a href="https://inelda.org/"><em>INELDA</em></a><em> for their fantastic end-of-life doula training. The 20 favorites exercise is my abbreviated version of the loss exercise found </em><a href="https://homecareinformation.net/handouts/hen/1537_Supplement.pdf"><em>here</em></a><em>.</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lPWwnv">
<em>Rachel Friedman is the author of</em> <a href="https://www.indiebound.org/book/9780143132127">And Then We Grew Up: On Creativity, Potential, and the Imperfect Art of Adulthood</a><em> and </em><a href="https://www.indiebound.org/book/9780385343374">The Good Girl’s Guide to Getting Lost</a><em>. Find her on Twitter </em><a href="https://twitter.com/RachelFriedman"><span class="citation" data-cites="RachelFriedman">@RachelFriedman</span></a><em>.</em>
</p></li>
<li><strong>Why K-12 schools aren’t requiring students to get Covid-19 vaccines</strong> -
<figure>
<img alt="A high school student wearing a black mask cleans out a blue locker, alone in a long hallway of lockers. She’s kneeling on the floor and putting folders and books in a pair of yellow tote bags." src="https://cdn.vox-cdn.com/thumbor/qpaGYUT1bHKgmoszg6olpALQwhM=/0x0:3200x2400/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71219782/1211427663.0.jpg"/>
<figcaption>
Most US school districts are going mask-optional this coming school year. | Brian van der Brug/Los Angeles Times via Getty Images
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</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Mass indifference is one big factor.
</p>
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For the third summer<strong> </strong>in a row, school leaders are facing the question of what — if anything — they’re going to do to stop the spread of Covid-19 when students return to classrooms.
</p>
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One thing is clear: Almost none of them will be requiring vaccines.
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Just <a href="https://www.washingtonpost.com/graphics/2020/health/covid-vaccine-states-distribution-doses/?itid=lk_inline_manual_16">31 percent</a> of children between 5 and 11 in the US have been fully vaccinated, and <a href="https://www.washingtonpost.com/graphics/2020/health/covid-vaccine-states-distribution-doses/?itid=lk_inline_manual_16">61 percent</a> of 12- to 17-year-olds have been. (Only about <a href="https://www.kff.org/coronavirus-covid-19/issue-brief/covid-19-vaccination-rates-among-children-under-5-have-peaked-and-are-decreasing-just-weeks-into-their-eligibility/">3 percent</a> of children under 5 had received a first dose by July 20.)
</p>
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Still, no state<strong> </strong>in the country is planning to require student vaccinations, a marked turnaround from where things seemed to be headed last winter, when multiple states and school districts suggested vaccine mandates were coming soon. Only Washington, DC, has announced a mandatory school vaccine policy this fall, <a href="https://abcnews.go.com/US/dc-require-students-12-older-vaccinated-covid-19/story?id=87130087">for students 12 and older</a>.
</p>
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Other mitigation measures — from masks to ventilation — may also be on their way out. The Centers for Disease Control and Prevention will likely soon recommend easing school testing, quarantine, and social distancing requirements, CNN <a href="https://www.cnn.com/2022/08/03/health/cdc-covid-guidance/index.html?utm_medium=social&amp;utm_source=twCNN&amp;utm_content=2022-08-03T19%3A37%3A56&amp;utm_term=link">reported</a> last week. (Many schools often disregarded CDC guidelines, but the update is a sign of how expectations have shifted.)
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Burbio, a company that specializes in aggregating school calendars, reported that so far, the vast majority of school districts it tracks nationwide <a href="https://about.burbio.com/school-mask-policy-tracker">will not be requiring masks</a> this fall. And a June <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7123e2.htm?s_cid=mm7123e2_w">CDC study</a> found just under 40 percent of American public schools had replaced or upgraded their HVAC systems to provide improved ventilation.
</p>
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For the last three years, school requirements — closed or open? masks on or off? — have been a battleground in the culture war over Covid-19. Fear of wading back into the polarized fights over vaccination is one reason school leaders have backed away from requiring the shots. So is the fact that vaccines for children under 12 are not yet fully approved by the FDA.
</p>
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But an even bigger factor might be mass indifference: American adults are more hesitant to vaccinate their kids, especially younger kids, than they were to get shots themselves. And no influential health group or federal agency is pushing states to require them to do so.
</p>
<h3 id="1UmB2t">
How California backtracked on vaccine mandates
</h3>
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In October 2021, California’s Democratic Gov. Gavin Newsom <a href="https://www.gov.ca.gov/2021/10/01/california-becomes-first-state-in-nation-to-announce-covid-19-vaccine-requirements-for-schools/">was the first in the nation</a> to announce a planned Covid-19 vaccine mandate for K-12 students once the FDA had fully approved the shots. He said at the time that it could take effect <a href="https://www.reuters.com/world/us/california-require-covid-19-vaccines-schoolchildren-governor-says-2021-10-01/">as early as January</a>.
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Some school districts in the state tried to impose vaccine mandates that would take effect even earlier. Los Angeles Unified School District, the second largest in the nation, announced in September 2021 that students 12 and older must be fully vaccinated by December 19, or switch to online schooling. In Oakland, California, the school board passed a similar vaccine requirement in late September for eligible students, with <a href="https://abc7news.com/oakland-unified-school-district-vaccination-ousd-student-vaccine-mandate-board-schools-deadline/11176364/">a deadline</a> of January 1. The Pfizer vaccine for 16- and 17-year-olds <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-first-covid-19-vaccine">had been fully approved</a> in August, while the shots for 12- to 15-year-olds were still under FDA’s emergency use authorization.
</p>
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By December 2021, facing both political and legal pressure, school leaders pushed back the vaccine mandates to the start of the 2022-23 school year.<strong> </strong>LAUSD board president Kelly Gonez <a href="https://www.politico.com/states/california/story/2021/12/24/la-schools-tried-to-mandate-vaccines-then-it-faced-the-reality-of-sending-30-000-students-home-1402804">has said</a> their decision was “not about conceding to a vocal minority of anti-vaxxers,” although those who oppose mandatory Covid vaccines hailed the delay as a victory.
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But as 2022 continued, pressure for youth Covid-19 vaccines declined. A state lawmaker in California <a href="https://calmatters.org/health/coronavirus/2022/03/california-vaccine-laws/">who had introduced a bill</a> to require Covid-19 vaccines for K-12 students <a href="https://calmatters.org/health/coronavirus/2022/04/kids-covid-vaccine-mandate-california/">withdrew it in April</a>, saying that focus needed to be on ensuring access to the vaccine. The same week, the California Department of Public Health <a href="https://www.cdph.ca.gov/Programs/OPA/Pages/NR22-073.aspx">announced</a> it would no longer add the Covid-19 vaccine to its list of mandated childhood vaccines for public schools because they had not all yet received full FDA approval. The earliest the requirement would take effect, they said, was July 2023. Individual school districts like <a href="https://abc7.com/lausd-covid-vaccine-mandate-recommendation-state-of-california-los-angeles-unified-school-district/11801540/">Los Angeles</a> followed suit.
</p>
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A California health department spokesperson told Vox that the state was waiting “to ensure sufficient time for successful implementation of new vaccine requirements.” As of last month, the vaccines <a href="https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-grants-full-approval-pfizer-covid-vaccine-ages-12-15-2022-07-08/">are now fully approved</a> for ages 12 and up, but not yet for younger children. The California health agency also <a href="https://www.cdph.ca.gov/Programs/OPA/Pages/NR22-073.aspx#:~:text=To%20ensure%20sufficient%20time%20for,no%20sooner%20than%20July%201%2C">said</a> even after all the shots receive full approval, officials would still take into consideration other health group recommendations before issuing a new mandate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mx79YE">
Louisiana, likewise, <a href="https://www.wrkf.org/2022-05-18/covid-vaccine-will-no-longer-be-required-for-2022-23-school-year-in-louisiana-officials-say">retreated</a> on a student vaccine mandate Democratic Gov. John Bel Edwards announced last November. New Orleans Public Schools is the only district in the state to require students to be vaccinated against Covid-19, though policy enforcement <a href="https://www.wwno.org/education/2022-02-18/how-many-new-orleans-public-school-students-are-vaccinated-officials-still-dont-know">has been mixed</a>. New York City Mayor Eric Adams, who<strong> </strong>said in January he was considering <a href="https://transcripts.cnn.com/show/sotu/date/2022-01-09/segment/01">a student vaccine mandate</a> for the fall, quietly dropped the idea, scaling it back to a requirement for students participating in certain sports and other “high-risk” extracurriculars like choir.
</p>
<h3 id="p4Ob7i">
Why districts have been loath to require Covid vaccines for students
</h3>
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The California situation illustrates the several factors at play in schools’ reluctance to require vaccines.
</p>
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One issue is the lack of full FDA approval for vaccines for younger children. The US Supreme Court has endorsed states’ authority to require student vaccines, but many policymakers were wary of testing that legal authority for Covid-19 shots that had only received emergency use authorization. (The Justice Department <a href="https://www.natlawreview.com/article/doj-memo-food-drug-and-cosmetic-act-does-not-prohibit-entities-requiring-vaccines">issued a memo</a> last summer saying schools could legally do this, but the threat of defending those decisions in court was both real and unappealing.)
</p>
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As a result, even once youth vaccines became available, leaders hesitated to require them without full FDA approval. But now the FDA <a href="https://www.aha.org/news/headline/2022-07-08-fda-grants-full-approval-pfizers-covid-19-vaccine-12-15-age-group">has fully approved</a> vaccines for teens and adolescents, and that still hasn’t led states or districts to require the shots for older kids.
</p>
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Policymakers are also wrestling with the fact that the virus is much less deadly for children compared to adults. (Approximately <a href="https://data.cdc.gov/widgets/9bhg-hcku?mobile_redirect=true">1,180 of the more than 1 million Americans</a> who have died of the virus were 17 or younger, though health experts stress vaccination can still help protect against these rare outcomes.) Kids can also catch the virus in school and spread it back at home to their more vulnerable parents and grandparents, but that risk became easier to tolerate once adult vaccines were approved.
</p>
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Most school districts were wary of igniting another public school culture war battle at a time when students were still struggling to regain academic and social skills lost during the pandemic. On the eve of the anniversary of the January 6 riot, former President Donald Trump <a href="https://www.independent.co.uk/news/world/americas/us-politics/january-6-anniversary-trump-maga-b1987695.html">blasted</a> President Joe Biden for supposed “talk” that his administration might enforce a vaccine mandate for school children and urged “MAGA nation” to rise up against any such requirements. (The Biden administration has not publicly discussed any student vaccine mandate.)
</p>
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Conservative law firms were also helping <a href="https://thomasmoresociety.org/wp-content/uploads/2021/10/Dkt.-1_Complaint-1.pdf">to mount legal challenges</a> against proposed Covid-19 vaccine requirements, and groups <a href="https://www.letthembreathe.net/">fighting mask and vaccine mandates</a> have insisted there is no reason to vaccinate kids to protect more vulnerable populations.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7tO7ce">
Polling<strong> </strong><a href="https://www.kff.org/coronavirus-covid-19/press-release/most-parents-dont-want-their-schools-to-require-covid-19-vaccination-but-most-favor-requiring-masks-for-unvaccinated-children-and-staff/">also indicated</a> that many parents were not eager to have their kids get the shots, and administrators felt hesitant to impose any rules that could keep vulnerable students — particularly Black and Latino students — out of in-person learning for even longer than they already endured.
</p>
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<a href="https://www.kff.org/coronavirus-covid-19/dashboard/kff-covid-19-vaccine-monitor-dashboard/">The Covid-19 Vaccine Monitor</a>, run by the Kaiser Family Foundation, reported recently that parents’ intentions to vaccinate their older children have remained relatively steady since the start of the year: About <a href="https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-july-2022/">six in 10</a> parents of those aged 12-17 say their child has been vaccinated (57 percent); about 30 percent say they will definitely not get their teen vaccinated. Eight percent said they will only vaccinate their child if required.
</p>
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Covid vaccination uptake is even lower among children ages 5-11, and nearly half of parents of that age group either say they will only get them vaccinated if required to do so (10 percent) or say they definitely won’t (37 percent).
</p>
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While all demographic groups in the KFF study expressed concerns about long-term effects and side effects, Black and Hispanic parents also voiced more concerns over the logistics of getting their kids vaccinated.
</p>
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Jeremy Singer, an education policy researcher who has been studying <a href="https://edworkingpapers.com/sites/default/files/ai22-617.pdf">Covid-19 school reopenings</a>, said it’s notable that resistance to youth Covid-19 vaccine requirements is present in nearly all school districts. One reason why, he said, may be what school districts are hearing from parents and community members.
</p>
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“District leaders may still be feeling risk-averse, but at this point the ‘riskier’ thing for them could be to impose an unpopular mandate,” he said.
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In January 2022, Singer and his colleagues<strong> </strong>surveyed Detroit parents on whether they supported or opposed various health measures. “Parents expressed overwhelming support for almost every measure … except vaccine mandates for staff and especially students, for which there was a lot more ambivalence,” he said of their findings, which are not yet published.
</p>
<h3 id="vcnTBT">
National groups and federal agencies aren’t pushing for vaccine mandates
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bSPZUc">
Back in February, Education Secretary Miguel Cardona <a href="https://www2.ed.gov/documents/coronavirus/20220225-letter-to-stakeholders.pdf">wrote in a letter</a> to schools, “The #1 tool we have available right now to make sure our schools remain safe and open for all students is vaccination,” and encouraged schools to provide information and host clinics. But the department has stopped short of encouraging schools to require the shots. Elaine Quesinberry, a spokesperson for the Education Department, referred Vox’s questions about student Covid-19 vaccines to the CDC, and the CDC did not return a request for comment.
</p>
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The CDC’s last <a href="https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-childcare-guidance.html">updated schools guidance</a>, posted in late May, does not recommend schools require the shot, though encourages schools doing targeted outreach to promote it. A White House spokesperson <a href="https://theintercept.com/2022/02/06/covid-vaccine-mandate-students-schools/">declined earlier this year to say</a> if Biden would support schools requiring Covid-19 vaccines for students if the vaccines had received full FDA approval.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="D4fpXV">
Susan Martin, a spokesperson for the American Academy of Pediatrics, referred Vox to their policy statement <a href="https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2022-058700/188297/COVID-19-Vaccines-in-Infants-Children-and?autologincheck=redirected">recommending</a> Covid-19 vaccines for all eligible children, and <a href="https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/">their interim guidance</a> on safe schools, which says Covid vaccination and boosters should be encouraged.
</p>
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Even teacher unions — which were influential in shaping school reopening decisions in the 2020-21 school year — have not staked out youth vaccination as a dealbreaker for safe in-person learning. An NEA spokesperson said, “Our position on vaccines have not been changed or updated at this point” and referred Vox to <a href="https://www.nea.org/resource-library/nea-position-covid-19-vaccines">a position statement</a> published in December 2020,<strong> </strong>which said<strong> </strong>parents should follow vaccine guidelines from the CDC and the American Academy of Pediatrics.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BKOGmt">
Back in October 2021, the last time the American Federation of Teachers <a href="https://www.aft.org/press-release/aft-president-weingarten-welcomes-news-fda-approval-pfizer-vaccine-children">released a formal statement</a> on youth vaccines, president Randi Weingarten said “vaccine approval will be critical to keeping our kids safe and healthy, and making sure our schools stay open and remain safe and welcoming for all.” In a statement to Vox, Weingarten said the group is awaiting “full authorization by the FDA to inform requirements for kids — but in the meantime we must ensure the other guardrails, including revamped ventilation, are in place.”
</p>
<h3 id="KAa4AO">
Washington, DC, is moving forward with its student vaccine requirement
</h3>
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The big exception is in the nation’s capital. In late December, Washington, DC, councilmembers voted overwhelmingly in favor of <a href="https://lims.dccouncil.us/Legislation/B24-0423">legislation</a> requiring all eligible students to get vaccinated against Covid-19.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="98P8gO">
The bill set a vaccination deadline for March 1, 2022, though <a href="https://mayor.dc.gov/sites/default/files/dc/sites/coronavirus/page_content/attachments/Situational-Update-Presentation-12-22-2021.pdf">enforcement was delayed</a> until the start of the 2022-23 school year, a concession to help keep students in school. At the time, just over <a href="https://mayor.dc.gov/sites/default/files/dc/sites/coronavirus/page_content/attachments/Situational-Update-Presentation-12-22-2021.pdf">60 percent</a> of DC young people ages 12-17 had received their two shots.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="H0xFsR">
Last month the city <a href="https://www.washingtonpost.com/education/2022/07/31/dc-schools-covid-vaccine-mandate/">announced</a> it would move forward with its back-to-school vaccination policy, requiring Covid-19 vaccines for all students ages 12 and older within the first 20 school days. DC <a href="https://www.washingtonpost.com/education/2022/06/06/dc-students-routine-vaccinations-covid/">is also ramping up outreach and enforcement</a> for its other required youth vaccinations — like measles and mumps — which the city didn’t enforce strictly last year, and students fell behind on.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AfrbIh">
“I think one thing that is important to know in terms of how DC is moving forward is we’re not just talking about the Covid vaccination, we are having a conversation about routine child immunization, and the Covid vaccine just happens to be a part of the series where kids need to get caught up,” said Christina Henderson, a DC councilmember and the lead sponsor of the bill requiring Covid-19 vaccines for students.
</p>
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Henderson said their effort this year involves more concerted help from pediatricians, school leaders, and public health officials, to stress the importance of vaccination and to relay the evidence that millions of young people by now have safely received the shots.
</p>
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Henderson pointed to the recent case of <a href="https://www.bloomberg.com/news/articles/2022-08-04/polio-found-in-two-samples-of-sewage-water-outside-new-york-city">an unvaccinated 20-year-old with polio</a>, and stressed that this is not the time to waver on the importance of pediatric vaccination. “We also know mandates work,” she added, noting that while many teen athletes were initially ambivalent about getting vaccinated, following DC Mayor Muriel Bowser’s vaccination requirement to participate in sports last September, <a href="https://www.washingtonpost.com/sports/2021/10/23/coolidge-football-now-almost-fully-vaccinated-wins-third-straight-blowout/">even hesitant students got their shots</a>.
</p>
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The Washington Post <a href="https://www.washingtonpost.com/education/2022/07/31/dc-schools-covid-vaccine-mandate/">reported</a> in late July that about 85 percent of DC students ages 12-15 have been vaccinated against Covid-19, but just 60 percent of Black children in that age range have been.
</p>
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“If one school has a high unvaccinated rate of students, then we will bring a mobile vaccine clinic there,” Henderson said. “We are not going to assume that parents are purposely saying ‘I don’t want to get my child covered.’ It might just be they were away all summer and didn’t know about it, or didn’t have time.”
</p>
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Kathryn Lynch-Morin, a spokesperson for DC’s Office of the State Superintendent of Education, told Vox that city agencies have been coordinating closely with schools to support them with technical assistance, guidance, and outreach to families.
</p>
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“Our children belong in school with their friends and teachers who care about them,” she said. “But, we know if an outbreak of one of these serious or deadly diseases were to occur, it could have a harmful impact on our children, families, and staff. We also know that vaccinations save lives.”
</p></li>
</ul>
<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>Lagos obliges in Mica Emperor Plate</strong> -</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>CWG 2022: Sharath Kamal extends dominance, wins gold in men’s singles TT</strong> - With this sensational gold, Sharath has taken his overall medal tally to 13 at the CWG, since making his Games debut in 2006.</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>Commonwealth Games 2022: G. Sathiyan wins bronze in TT Men’s singles</strong> - Sathiyan avenged his men’s doubles final loss against Drinkhall and triumphed 11-9 11-3 11-5 8-11 9-11 10-12 and 11-9.</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 sweeps Commonwealth Games badminton singles as Sindhu, Sen clinch maiden golds</strong> - P. V. Sindhu and Lakshya Sen lived up to the billing by grabbing gold medals as India swept the singles badminton competition at the Commonwealth Games for the first time</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>Dragoness and Golden Lioness impress</strong> -</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>Don't know who is real CM in Maharashtra, says Aaditya Thackeray; reiterates Shinde government will fall soon</strong> - Shiv Sena leader Aaditya Thackeray also said the State had a “temporary” Chief Minister as the Shinde government was bound to fall soon.</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>‘Sudden fondness’ of RSS, BJP for Indian flag amusing, says Alagiri</strong> - The two outfits, which had no role in the freedom struggle, are trying to appropriate the flag, he claims</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>Parliament adjourned sine die four days ahead of schedule</strong> - The session was scheduled to be held from July 18 to August 12.</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>Muharram symbolises spirit of sacrifice: Governor</strong> - ‘It reminds us to embrace peace and spread the message of brotherhood’</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>Jaishankar, Ukrainian Foreign Minister discuss Ukraine-Russia war, its global repercussions</strong> - External Affairs Minister S. Jaishankar also assured that the next consignment of Indian humanitarian assistance will reach Ukraine very soon.</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>Extreme drought: Dried-up Italian river reveals unexploded WWII bomb</strong> - Extreme drought and historic heat have caused the River Po’s water levels to drop dramatically.</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>France whale: Hopes fading for lost mammal stuck in River Seine</strong> - The visibly malnourished all-white beluga has been stuck 70km north of Paris since at least Tuesday.</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>Ukraine war: Four more grain ships leave Ukraine as hopes grow for export stability</strong> - Four vessels leave Ukrainian ports via a safe maritime corridor set up under a deal with Russia.</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>Croatia bus crash: Twelve Polish pilgrims killed and 32 injured</strong> - All 32 surviving passengers are injured, 19 of them seriously, officials say.</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>Zaporizhzhia: Russian rockets damaged part of nuclear plant, Ukraine says</strong> - Ukraine says Russian rockets hit part of a giant nuclear plant - but Russia blames Ukraine for it.</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>Rumors, delays, and early testing suggest Intel’s Arc GPUs are on shaky ground</strong> - Possible outcomes run the gamut from “more delays” to outright cancellation. - <a href="https://arstechnica.com/?p=1871511">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The weekend’s best deals: Amazon Kindle Paperwhite, 8BitDo gamepads, and more</strong> - Dealmaster also has discounts on the Apple Pencil, PS5 games, and Beats earbuds. - <a href="https://arstechnica.com/?p=1871786">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Microsoft trackers run afoul of DuckDuckGo, get added to blocklist</strong> - Search privacy company still needs Bing, but won’t allow Microsoft’s trackers. - <a href="https://arstechnica.com/?p=1871913">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Cyberattack on Albanian government suggests new Iranian aggression</strong> - Tehran-linked hack of a NATO member is a significant escalation. - <a href="https://arstechnica.com/?p=1871914">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Fecal fountains: CDC warns of diarrheal outbreaks linked to poopy splash pads</strong> - Whatever you do, don’t get the water in your mouth. - <a href="https://arstechnica.com/?p=1871935">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><strong>If you take the first two letters of the title of each the 7 Harry Potter books, it spells out a secret message</strong> - <!-- SC_OFF -->
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
HAHAHAHAHAHAHA
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/edgar314"> /u/edgar314 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/wiuymg/if_you_take_the_first_two_letters_of_the_title_of/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/wiuymg/if_you_take_the_first_two_letters_of_the_title_of/">[comments]</a></span></p></li>
<li><strong>I can’t remember the name of that Italian dessert where you pour espresso over ice cream.</strong> - <!-- SC_OFF -->
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I asked my Italian friend, but he couldn’t remember either.
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Gil-Gandel"> /u/Gil-Gandel </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/winneg/i_cant_remember_the_name_of_that_italian_dessert/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/winneg/i_cant_remember_the_name_of_that_italian_dessert/">[comments]</a></span></p></li>
<li><strong>Breaking News Trump’s personal library just burned down</strong> - <!-- SC_OFF -->
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The fire consumed both books and he hasn’t even finished coloring the second one
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/soveranol"> /u/soveranol </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/wj6c74/breaking_news_trumps_personal_library_just_burned/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/wj6c74/breaking_news_trumps_personal_library_just_burned/">[comments]</a></span></p></li>
<li><strong>Misunderstanding</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
An old man with hearing problems crashed his car into a very expensive automobile. The owner of the expensive automobile jumps out and confronts the old man and says “Give me $10,000 cash or I will beat you to a pulp!” The old man replies, “Woah wait buddy, I don’t have that much money but let me call my son, he trains dolphins.” The old man dials his son as as he is about to speak the owner of the expensive car yanks the phone out of his hand and says “So you train dolphins, well your old man just hit and damaged my car, you bring me $10,000 or I’m gonna beat the heck outta him!” The son answers “Okay, give me 15 minutes and I’ll be there.” In exactly 15 minutes the son pulls up in a Jeep, Ten men jump out and beat the hell out of the expensive car owner. Meanwhile the son walks over to his father and says “Dad I train Navy Seals not dolphins.
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/gary6043"> /u/gary6043 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/wid404/misunderstanding/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/wid404/misunderstanding/">[comments]</a></span></p></li>
<li><strong>what do you call a pedophile-pirate?</strong> - <!-- SC_OFF -->
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
ARRRRRRHH-Kelly
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Life-Yogurtcloset-98"> /u/Life-Yogurtcloset-98 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/wici6h/what_do_you_call_a_pedophilepirate/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/wici6h/what_do_you_call_a_pedophilepirate/">[comments]</a></span></p></li>
</ul>
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