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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>Do Lockdowns Bring about Additional Mortality Benefits or Costs? Evidence based on Death Records from 300 Million Chinese People</strong> -
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Objectives: To estimate the short-term effect of stringent lockdown policies on non-COVID-19 mortality and explore the heterogeneous impacts of lockdowns in China after the COVID-19 outbreak. Design Employing a difference-in-differences method. Setting Using comprehensive death records covering around 300 million Chinese people, we estimate the impacts of city and community lockdowns on non-COVID-19 mortality outside of Wuhan. Participants: 44,548 deaths recorded in 602 counties or districts by the Disease Surveillance Point System of the Chinese Center for Disease Control and Prevention from 1 January 2020 to14 March 2020. Results We find that lockdowns reduced the number of non-COVID-19 deaths by 4.9% (cardiovascular deaths by 6.2%, injuries by 9.2%, and non-COVID-19 pneumonia deaths by 14.3%). A back-of-the-envelope calculation shows that more than 32,000 lives could have been saved from non-COVID-19 diseases/causes during the 40 days of the lockdown on which we focus. Main outcome measures: Weekly numbers of deaths from all causes without COVID-19, cardiovascular diseases, injuries, pneumonia, neoplasms, chronic respiratory diseases, and other causes were used to estimate the associations between lockdown policies and mortality. Conclusions: The results suggest that the rapid and strict virus countermeasures not only effectively controlled the spread of COVID-19 but also brought about unintended short-term public health benefits. The health benefits are likely driven by significant reductions in air pollution, traffic, and human interactions during the lockdown period. These findings can help better inform policymakers around the world about the benefits and costs of lockdowns policies in dealing with the COVID-19 pandemic.
</p>
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2020.08.28.20183699v3" target="_blank">Do Lockdowns Bring about Additional Mortality Benefits or Costs? Evidence based on Death Records from 300 Million Chinese People</a>
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<li><strong>Based Analysis Framework for identifying COVID-19 Incidence and Fatality Determinants at National Level Case study: Africa</strong> -
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Abstract Background: COVID-19 pandemic is an extraordinary threat with significant implications in all aspects of human life, therefore, it represents the most immediate challenges for all countries all over the world. Objectives: This study is intended to develop a GIS-based analysis model to explore, quantify and model the relationships between COVID-19 morbidity and mortality and their potential predictor variables. Method: For this purpose, a model was developed to estimate COVID-19 incidence and fatality rates in Africa up to 16th of August 2020 at the national level. The model involved Ordinary Least Squares (OLS) and Geographically Weighted Regression (GWR) analysis through ArcGIS was applied. Result: Spatial Autocorrelation Analysis revealed that there was positive spatial autocorrelation in COVID-19 incidence (Moran index 0.16. P value &lt;0.1), and fatality (Moran index 0.0.35, P value&lt;0.01) rates within different African countries. At continental level, OLS revealed that COVID-19 incidence rate was found to be positively associated with overcrowding, health expenditure, HIV infections and air pollution and negatively associated with BCG vaccine (β=2.97,1.45, 0.01, 3.29, -47.65 respectively, P&lt; 0.05) At the same time, COVID-19 fatality was found to be positively related to asthma prevalence and tobacco use. Yet, certain level of inconsistency was noted in the case of COVID-19 fatality, which was negatively related to elder population, poverty, and cardiovascular mortality (P&lt;0.05). This model showed convenient level of validity in modeling the relationship between COVID-19 incidence as well as fatality and their key predictors using GWR. In this respect, the model explained about 58% and 55% of the variance in COVID-19 incidence and fatality rates, respectively, as a function of considered predictors. Conclusion: Application of the suggested model can assist in guiding intervention strategies, particularly in case of local and community level whenever the data on COVID-19 cases and predictors variables are available.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.12.21249661v1" target="_blank">Based Analysis Framework for identifying COVID-19 Incidence and Fatality Determinants at National Level Case study: Africa</a>
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<li><strong>The impact of the coronavirus disease 2019 (COVID-19) pandemic on university students' dietary intake, physical activity, and sedentary behaviour</strong> -
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University students are a vulnerable group for poor dietary intake, insufficient physical activity and sedentary behaviour. The purpose of this study was to examine the impact of COVID-19 on university students9 dietary intake, physical activity and sedentary behaviour. Participants were students (n=125) from the Universities of Saskatchewan and Regina. An online questionnaire was administered retrospectively (for pre-pandemic) and prospectively (during the pandemic) to examine students9 dietary intake, physical activity and sedentary behaviour. Overall, nutrient and caloric intakes were significantly reduced (p&lt;0.05) during the pandemic, and alcohol intake increased (p=0.03). Before the pandemic, 16% and 54% of the participants were meeting the Canadian 24-Hour Movement Guidelines for Adults (18-64 years) of 150 minutes of moderate-vigorous physical activity and 8 hours or less of sedentary activity respectively. Only 10% met the guidelines for physical activity while 30% met the guidelines for sedentary behaviour during the pandemic. The minutes per week spent engaging in moderate to vigorous physical activity during the pandemic decreased by approximately 20% (p&lt;0.001). The hours spent in sedentary activities increased by 3 hours per day (p&lt;0.001). Our findings confirm that during the pandemic, students9 inadequate dietary intake, high alcohol consumption, low physical activity and high sedentary behaviour were significantly compounded. Novelty During COVID-19, the nutrient and caloric intakes of university students decreased, and alcohol intake increased significantly. University students9 physical activity levels decreased, and sedentary activity increased significantly during COVID-19. During COVID-19 students did not engage in sufficient physical activity to offset the increased sedentary behaviour.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.12.21249608v1" target="_blank">The impact of the coronavirus disease 2019 (COVID-19) pandemic on university students' dietary intake, physical activity, and sedentary behaviour</a>
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<li><strong>Predictors of COVID-19 Vaccine Hesitancy: Socio-demographics, Co-Morbidity and Past Racial Discrimination</strong> -
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Importance: Immunization programs are only successful when there are high rates of acceptance and coverage. While delivering billions of COVID 19 doses globally addressing vaccine hesitancy will be one of the most significant public health communication efforts ever undertaken. Objective: The goal of this study is to explore predictors of COVID 19 vaccine hesitancy, including sociodemographic factors, comorbidity, risk perception, and experience of discrimination, in a sample of the U.S. population. Design: We used a cross sectional online survey study design. The survey was implemented between Dec 13 and 23, 2020. Setting: The survey was limited to respondents over 18 years of age residing in the USA. Participants: Respondents were individuals belonging to priority groups for vaccine distribution. Main Outcome(s) and Measure(s): Respondents were asked how likely they would be to take a COVID 19 vaccine if offered at no cost within two months. Vaccine hesitancy was measured using a scale ranging from 1 (low hesitancy) to 6 (high hesitancy). Results: Responses were received from 2,650 respondents (response rate 84%) from all 50 states and Puerto Rico, American Samoa, and Guam. The majority were in the age category between 25 and 44 years (66%), male (53%), and working in the healthcare sector (61%). Most were White and non-Hispanic (66%) respondents followed by Black non-Hispanic (14%) and Hispanic (8%) respondents. Experience with racial discrimination was a predictor of vaccine hesitancy. Those reporting racial discrimination having 21% increased odds of being at a higher level of hesitancy compared to those who did not report such experience (OR=1.21, 95% C.I. 1.01-1.45). Conclusions and Relevance: Communication and logistical aspects during the COVID 19 vaccination campaign need to be sensitive to individuals past-experience of discrimination by identifying appropriate channels of communication and sites for vaccine distribution to reach those who may have sentiments of mistrust in the vaccination campaign.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.12.21249152v1" target="_blank">Predictors of COVID-19 Vaccine Hesitancy: Socio-demographics, Co-Morbidity and Past Racial Discrimination</a>
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<li><strong>An open-access database of infectious disease transmission trees to explore superspreader epidemiology</strong> -
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Historically, emerging and re-emerging infectious diseases have caused large, deadly, and expensive multi-national outbreaks. Often outbreak investigations aim to identify who infected whom by reconstructing the outbreak transmission tree, which visualizes transmission between individuals as a network with nodes representing individuals and branches representing transmission from person to person. We compiled a database of 383 published, standardized transmission trees consisting of 16 directly-transmitted diseases ranging in size from 2 to 286 cases. For each tree and disease we calculated several key statistics, such as outbreak size, average number of secondary infections, the dispersion parameter, and the number of superspreaders. We demonstrated the potential utility of the database through short analyses addressing questions about superspreader epidemiology for a variety of diseases, including COVID-19. First, we compared the frequency and contribution of superspreaders to onward transmission across diseases. COVID-19 outbreaks had significantly fewer superspreaders than outbreaks of SARS and MERS and a dispersion parameter between that of SARS and MERS. Across diseases the presence of more superspreaders was associated with greater outbreak size. Second, we further examined how early spread impacts tree size. Generally, trees sparked by a superspreader had larger outbreak sizes than those trees not sparked by a superspreader, and this trend was significant for COVID-19 trees. Third, we investigated patterns in how superspreaders are infected. Across trees with more than one superspreader, we found support for the theory that superspreaders generate other superspreaders, even when controlling for number of secondary infections. In sum, our findings put the role of superspreading to COVID-19 transmission in perspective with that of SARS and MERS and suggest an avenue for further research on the generation of superspreaders. These data have been made openly available to encourage reuse and further scientific inquiry.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.11.21249622v1" target="_blank">An open-access database of infectious disease transmission trees to explore superspreader epidemiology</a>
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<li><strong>Hospital load and increased COVID-19 related mortality - a nationwide study in Israel</strong> -
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The rapid spread of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worldwide and the disease caused by the virus, coronavirus disease 19 (COVID-19), has caused a global pandemic with devastating social and economic consequences. Throughout the pandemic, several health systems were overwhelmed in light of the rapid emergence of new cases within a short period of time. The heavy workload imposed on hospital services might have negatively affected patients9 outcomes and exacerbated mortality rates. Here, we assessed excess in-hospital mortality across the Israeli healthcare system, using a model developed for predicting patient mortality based on data of day-by-day patient disease course. Mortality predictions were made using Monte-Carlo methods based on a multistate survival analysis and a set of Cox regression models, first constructed and validated on a nationwide cohort during the first stages of the pandemic in Israel. We show that during a peak of hospitalizations in September and October 2020, patient deaths significantly exceeded the model9s mortality predictions, while reverting to match the predictions as patient load subsided in October, and showing signs of renewed excess mortality as hospital load is increasing again since late December 2020. Our work emphasizes that even in countries in which the healthcare system did not reach a specific point defined as insufficiency, the increase in hospital workload was associated with higher patient mortality, while ruling out factors related to changes in the hospitalized population. In addition, our study highlights the importance of quantifying excess mortality in order to assess quality of care, and define an appropriate carrying capacity of severe patients in order to guide timely healthcare policies and allocate appropriate resources. Full model code is available for use at https://github.com/JonathanSomer/covid-19-multi-state-model.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.11.21249526v1" target="_blank">Hospital load and increased COVID-19 related mortality - a nationwide study in Israel</a>
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<li><strong>Immunochromatographic SARS-CoV-2 IgG antibody assay: a cross-sectional study conducted at Wakayama Medical University in Japan</strong> -
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Asymptomatic patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection must be quickly identified and isolated to prevent the spread of the virus. The number of asymptomatic healthy people is completely unknown because they remain untested. Detection of specific SARS-CoV-2 antibodies has been widely accepted as a diagnostic test, and an immunochromatographic test, which is simpler and relatively cheaper than other methods, is becoming the gold standard for identifying healthy people who had been infected with SARS-CoV-2 in the past. In this study, 1,528 volunteers who worked at a particular hospital were subjected to an immunochromatographic IgG test for SARS-CoV-2 to determine the ratio of asymptomatic people. Only 12 volunteers (0.79%) were IgG<sup>+</sup>, with no significant background differences in the sex, age, profession, experiences of working at the emergency department or caring for coronavirus disease 2019 patients. If this IgG<sup>+</sup> ratio was to be extrapolated to Wakayama city9s population, 2,780 out of 3,54,063 people may be asymptomatic for SARS-CoV-2. The results imply that anyone may get infected with SARS-CoV-2 but remain asymptomatic.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.10.21249421v1" target="_blank">Immunochromatographic SARS-CoV-2 IgG antibody assay: a cross-sectional study conducted at Wakayama Medical University in Japan</a>
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<li><strong>Modelling the impact of household size distribution on the transmission dynamics of COVID-19</strong> -
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Under the implementation of non-pharmaceutical interventions such as social distancing and lockdowns, household transmission has been shown to be significant for COVID-19, posing challenges for reducing incidence in settings where people are asked to self-isolate at home and to spend increasing amounts of time at home due to distancing measures. Accordingly, characteristics of households in a region have been shown to relate to transmission heterogeneity of the virus. We introduce a stochastic epidemiological model to examine the impact of the household size distribution in a region on the transmission dynamics. We choose parameters to reflect incidence in two health regions of the Greater Vancouver area in British Columbia and simulate the impact of distancing measures on transmission, with household size distribution the only different parameter between simulations for the two regions. Our result suggests that the dissimilarity in household size distribution alone can cause significant differences in incidence of the two regions, and the distributions drive distinct dynamics that match reported cases. Furthermore, our model suggests that offering individuals a place to isolate outside their household can speed the decline in cases, and does so more effectively where there are more larger households.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.12.21249707v1" target="_blank">Modelling the impact of household size distribution on the transmission dynamics of COVID-19</a>
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<li><strong>Impact of COVID-19 on the indigenous population of Brazil: A geo-epidemiological study</strong> -
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This study aimed to analyze the geographical distribution of COVID-19 and to identify high-risk areas for the occurrence of cases and deaths from the disease in the indigenous population of Brazil. This is an ecological study whose units of analysis were the Special Indigenous Sanitary Districts. Cases and deaths by COVID-19 notified by the Special Secretariat for Indigenous Health between March and October 2020 were included. To verify the spatial association, the Getis-Ord General G and Getis-Ord Gi * techniques were used. High spatial risk clusters have been identified by the scan statistics technique. 32,041 cases of COVID-19 and 471 deaths were reported. The incidence and mortality rates were between 758.14 and 18530.56 cases and 5.96 and 265.37 deaths per 100 thousand inhabitants, respectively. The non-randomness of cases (z-score = 5.40; p &lt;0.001) and deaths (z-score = 3.83; p &lt;0.001) was confirmed. Hotspots were evidenced for both events with confidence levels of 90, 95 and 99% concentrated in the North and Midwest regions of the country. Eight high-risk spatial clusters for cases with a relative risk (RR) between 1.08 and 4.11 (p &lt;0.05) and two risk clusters for deaths with RR between 3.08 and 3.97 (p &lt;0.05) were identified. The results indicate critical areas in the indigenous territories of Brazil and contribute to better targeting the control actions of COVID-19 in this population.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.12.21249703v1" target="_blank">Impact of COVID-19 on the indigenous population of Brazil: A geo-epidemiological study</a>
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<li><strong>Detection of SARS-CoV-2 nucleocapsid antigen from serum can aid in timing of COVID-19 infection</strong> -
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SARS-CoV-2 RNA can be detected in respiratory samples for weeks or even months after onset of COVID-19 disease. Therefore, one of the diagnostic challenges of PCR positive cases is differentiating between acute COVID-19 disease and convalescent phase. Recently, the presence of SARS-CoV-2 nucleocapsid antigen in serum samples of COVID-19 patients was published [Le Hingrat et al. Detection of SARS-CoV-2 N-antigen in blood during acute COVID-19 provides a sensitive new marker and new testing alternatives, Clinical Microbiology and Infection, 2020]. Our study aimed to characterize the analytical specificity and sensitivity of an enzyme-linked immunosorbent assay (Salocor SARS-CoV-2 Antigen Quantitative Assay Kit (Salofa Ltd, Salo, Finland)) for the detection of SARS-CoV-2 antigen in serum, and to characterize the kinetics of antigenemia. The evaluation material included a negative serum panel of 155 samples, and 126 serum samples from patients with a PCR-confirmed COVID-19. The specificity of the Salocor SARS-CoV-2 serum N antigen test was 98.0%. In comparison with simultaneous positive PCR from upper respiratory tract (URT) specimens, the test sensitivity was 91.7%. In a serum panel in which the earliest serum sample was collected two days before the collection of positive URT specimen, and the latest 48 days after (median 1 day post URT sample collection), the serum N antigen test sensitivity was 94% within 14 days post onset of symptoms. The antigenemia resolved approximately two weeks after the onset of disease and diagnostic PCR. The combination of simultaneous SARS-CoV-2 antigen and antibody testing appeared to provide useful information for timing of COVID-19. Our results suggest that SARS-CoV-2 N-antigenemia may be used as a diagnostic marker in acute COVID-19.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.08.20248771v1" target="_blank">Detection of SARS-CoV-2 nucleocapsid antigen from serum can aid in timing of COVID-19 infection</a>
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<li><strong>A Scoping Review of the Experience of Implementing Population Testing for SARS-CoV-2</strong> -
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Background: The SARS-CoV-2 pandemic has led to the swift introduction of population testing programmes in many countries across the world, using testing modalities such as drive-through, walk-through, mobile and home visiting programmes. Here, we provide an overview of the literature describing the experience of implementing population testing for SARS-CoV-2. Methods: We conducted a scoping review using Embase, Medline and the Cochrane Library in addition to a grey literature search. We identified indicators relevant to process, quality and resource outcomes related to each testing modality. Results: 2,999 titles were identified from the academic literature and the grey literature search, of which 22 were relevant. Most studies were from the USA and the Republic of Korea. Drive-through testing centres were the most common testing modality evaluated and these provided a rapid method of testing whilst minimising resource use. Conclusions: The evidence base for population testing lacks high quality studies, however, the literature provides evaluations of the advantages and limitations of different testing modalities. There is a need for robust evidence in this area to ensure that testing is deployed in a safe and effective manner in response to the Covid-19 pandemic. Keywords: mass testing, population testing, SARS-CoV-2, Covid-19
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.11.21249571v1" target="_blank">A Scoping Review of the Experience of Implementing Population Testing for SARS-CoV-2</a>
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<li><strong>Model-based cellular kinetic analysis of SARS-CoV-2 infection: different immune response modes and treatment strategies</strong> -
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Increasing number in global COVID-19 cases demands for mathematical model to analyze the interaction between the virus dynamics and the response of innate and adaptive immunity. Here, based on the assumption of a weak and delayed response of the innate and adaptive immunity in SARS-CoV-2 infection, we constructed a mathematical model to describe the dynamic processes of immune system. Integrating theoretical results with clinical COVID-19 patients9 data, we classified the COVID-19 development processes into three typical modes of immune responses, correlated with the clinical classification of mild &amp; moderate, severe and critical patients. We found that the immune efficacy (the ability of host to clear virus and kill infected cells) and the lymphocyte supply (the abundance and pool of naive T and B cell) play important roles in the dynamic process and determine the clinical outcome, especially for the severe and critical patients. Furthermore, we put forward possible treatment strategies for the three typical modes of immune response. We hope our results can help to understand the dynamical mechanism of the immune response against SARS-CoV-2 infection, and to be useful for the treatment strategies and vaccine design.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.11.21249562v1" target="_blank">Model-based cellular kinetic analysis of SARS-CoV-2 infection: different immune response modes and treatment strategies</a>
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<li><strong>Rates and predictors of uptake of formal and informal mental health support during the COVID-19 pandemic: an analysis of 26,740 adults in the UK in lockdown</strong> -
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Purpose: The coronavirus disease 2019 (COVID-19) pandemic has put a great strain on people9s mental health. A growing number of studies have shown worsening mental health measures globally during the pandemic. However, there is a lack of empirical study on how people support their mental health during the COVID-19 pandemic. This study aimed to examine a number of formal and informal mental health supports. Further, it explored factors that might be associated with the use of different types mental health support. Method: Data from 26,740 adults in the UCL COVID -19 Social Study were analysed between 13th April, 2020 and 3rd July, 2020. Data were analysed using logistic and Poisson regression models. Results: About 45% of people reported talking to friends or family members to support their mental health, 43% engaging in self-care activities, 20% taking medication, 9% speaking to mental health professionals, 8% talking to a GP or other health professional, and another 8% using helpline or online services. Gender, education, living status, loneliness, pre-existing mental health conditions, general depression and anxiety, coping and personality were found to be associated with the use of mental health support. Conclusion: While the negative impacts caused by the COVID-19 pandemic are inevitable, people can play an active role in managing their mental health. Understanding the patterns and predictors of various kinds of mental health support during the pandemic is crucial for future service planning and delivery through recognising potential barriers to mental health care faced by certain groups.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.11.21249509v1" target="_blank">Rates and predictors of uptake of formal and informal mental health support during the COVID-19 pandemic: an analysis of 26,740 adults in the UK in lockdown</a>
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<li><strong>Cardiorespiratory Fitness and Neuromuscular Performance in Patients Recovered from COVID-19</strong> -
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Objective: COVID-19 affects cardiorespiratory and muscular systems, causing dysfunctions that may persist after recovery from the acute infection and treatment. The aim of this study was to evaluate cardiorespiratory fitness and neuromuscular performance in these patients. Methods: Patients recovered from mild (n=31) and severe (n=17) COVID-19 were evaluated and compared to healthy subjects (n=15). All volunteers underwent a maximal cardiopulmonary exercise test with simultaneous acquisition of electromyography (EMG). Power output, oxygen uptake (VO2), pulse oxygen (O2Pulse), cardiovascular efficiency (ΔHR/ΔVO2), ventilation (VE), breathing reserve (BR) and ventilatory efficiency (VE/VCO2 slope) were analyzed. From EMG, power output for type Ia and IIa activation as well as total neuromuscular efficiency (Δwatts/Δ%RMS) were determined. Results: Patients with severe COVID-19 presented lower VO2, O2Pulse and VE than mild COVID-19 patients and healthy subjects (p &lt; 0.05 for all comparisons). No differences in ΔHR/ΔVO2, BR or VE/VCO2 slope were observed among the groups (p &gt; 0.05 for all comparisons). Type IIa and IIb fibers were activated at lower power output in severe than in mild COVID-19 patients and healthy subjects (p &lt; 0.05). Δwatts/Δ%RMS was lower in severe than in mild COVID-19 patients and healthy subjects (p &lt; 0.05). Conclusion: Patients recovered from severe COVID-19 present low cardiorespiratory fitness, activate glycolytic fibers at low power outputs, and show low neuromuscular efficiency; while patients recovered from mild COVID-19 do not present these sequels.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.11.20248930v1" target="_blank">Cardiorespiratory Fitness and Neuromuscular Performance in Patients Recovered from COVID-19</a>
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<li><strong>Genomic and mobility data reveal mass population movement as a driver of SARS-CoV-2 dissemination and diversity in Bangladesh</strong> -
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Background New data streams are being used to track the pandemic of SARS-CoV-2, including genomic data which provides insights into patterns of importation and spatial spread of the virus, as well as population mobility data obtained from mobile phones. Here, we analyse the emergence and outbreak trajectory of SARS-CoV-2 in Bangladesh using these new data streams, and identify mass population movements as a key early event driving the ongoing epidemic. Methods We sequenced complete genomes of 67 SARS-CoV-2 samples (March-July 2020) and combined this dataset with 324 genomes from Bangladesh. For phylogenetic context, we also used 68,000 GISAID genomes collected globally. We paired this genomic data with population mobility information from Facebook and three mobile phone operators. Findings The majority (85%) of the Bangladeshi sequenced isolates fall into either pangolin lineage B.1.36 (8%), B.1.1 (19%) or B.1.1.25 (58%). Bayesian time-scaled phylogenetic analysis predicted SARS-COV-2 first appeared in mid-February, through international introductions. The first case was reported on March 8th. This pattern of repeated international introduction changed at the end of March when three discrete lineages expanded and spread clonally across Bangladesh. The shifting pattern of viral diversity across Bangladesh is reflected in the mobility data which shows the mass migration of people from cities to rural areas at the end of March, followed by frequent travel between Dhaka and the rest of the country during the following months. Interpretation In Bangladesh, population mobility out of Dhaka as well as frequent travel from urban hotspots to rural areas resulted in rapid country-wide dissemination of SARS-CoV-2. The strains in Bangladesh reflect the local expansion of global lineages introduced early from international travellers to and from major international travel hubs. Importantly, the Bangladeshi context is consistent with epidemiologic and phylogenetic findings globally. Bangladesh is one of the few countries in the world with a rich history of conducting mass vaccination campaigns under complex circumstances. Combining genomics and these new data streams should allow population movements to be modelled and anticipated rendering Bangladesh extremely well prepared to immunize citizens rapidly. Based on our genomics data and the country9s successful immunization history, vaccines becoming available globally will be suitable for implementation in Bangladesh while ongoing genomic surveillance is conducted to monitor for new variants of the virus.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.01.05.21249196v1" target="_blank">Genomic and mobility data reveal mass population movement as a driver of SARS-CoV-2 dissemination and diversity in Bangladesh</a>
</div></li>
</ul>
<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 of ORTD-1 in Patients Hospitalized With COVID-19 Related Pneumonia</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: ORTD-1 low dose;   Drug: ORTD-1 mid dose;   Drug: ORTD-1 high dose;   Other: Vehicle control<br/><b>Sponsor</b>:   Oryn Therapeutics, LLC<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>The Effect of Deep Breathing Exercise on Dyspnea, Anxiety and Quality of Life in Patients Treated for COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Behavioral: Deep Breathing Exercise with Triflo<br/><b>Sponsor</b>:   Ankara University<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Safety and Immunogenicity of Two Different Strengths of the Inactivated COVID-19 Vaccine ERUCOV-VAC</strong> - <b>Condition</b>:   COVID-19 Vaccine<br/><b>Interventions</b>:   Biological: ERUCOV-VAC;   Other: Placebo Vaccine<br/><b>Sponsors</b>:   Health Institutes of Turkey;   TC Erciyes 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>Dendritic Cell Vaccine, AV-COVID-19, to Prevent COVID-19 Infection</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: AV-COVID-19;   Other: GM-CSF<br/><b>Sponsors</b>:   Aivita Biomedical, Inc.;   PT AIVITA Biomedika Indonesia;   Indonesia Ministry of Health;   National Institute of Health Research and Development, Ministry of Health Republic of Indonesia<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 Real World Study of Bamlanivimab in Participants With Mild-to-moderate Coronavirus Disease 2019 (COVID-19)</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Drug: Bamlanivimab<br/><b>Sponsors</b>:   Eli Lilly and Company;   AbCellera Biologics Inc.<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>Dexamethasone for COVID-19</strong> - <b>Condition</b>:   Covid19<br/><b>Intervention</b>:   Drug: Dexamethasone<br/><b>Sponsor</b>:   University of Oklahoma<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>Immunologic Responses to Single and Double Doses of SARS-CoV-2 Vaccines in Egyptians</strong> - <b>Condition</b>:   COVID-19 Vaccines<br/><b>Intervention</b>:   Biological: COVID-19 Vaccines<br/><b>Sponsor</b>:   Assiut University<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>Study of Adalimumab or Placebo in Patients With Mild to Moderate COVID-19</strong> - <b>Condition</b>:   Mild to Moderate COVID-19<br/><b>Interventions</b>:   Drug: Adalimumab;   Drug: Placebo<br/><b>Sponsors</b>:   Ology Bioservices;   Pharm-Olam, LLC;   Chemical, Biological, Radiological, and Nuclear Medical<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>Rapid Diagnosis of COVID-19 by Chemical Analysis of Exhaled Air</strong> - <b>Condition</b>:   Covid19<br/><b>Intervention</b>:   Diagnostic Test: Performance evaluation (sensitivity and specificity) for COVID-19 diagnosis of the Vocus PTR-TOF process<br/><b>Sponsor</b>:   Hospices Civils de Lyon<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>A Study to Evaluate MVC-COV1901 Vaccine Against COVID-19 in Adult</strong> - <b>Condition</b>:   Covid19 Vaccine<br/><b>Interventions</b>:   Biological: MVC-COV1901(S protein with adjuvant);   Biological: MVC-COV1901(Saline)<br/><b>Sponsor</b>:   Medigen Vaccine Biologics Corp.<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>The Safety and Efficacy of Pyronaridine-artesunate (Pyramax® or Artecom®)in COVID-19 Patients</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Drug: Artecom® (pyronaridine-artesunate);   Drug: Placebo<br/><b>Sponsor</b>:   Shin Poong Pharmaceutical Co. Ltd.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study to Evaluate the Safety, Tolerability, and Efficacy of BGE-175 in Participants ≥ 60 Years of Age and Hospitalized With Coronavirus Disease 2019 (COVID-19) That Are Not in Respiratory Failure</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Drug: BGE-175;   Other: Placebo<br/><b>Sponsor</b>:   BioAge Labs, Inc.<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>Efficacy of Ramdicivir and Baricitinib for the Treatment of Severe COVID 19 Patients</strong> - <b>Conditions</b>:   Covid19;   Covid-19 ARDS<br/><b>Interventions</b>:   Drug: Remdesivir;   Drug: Baricitinib;   Drug: Tocilizumab<br/><b>Sponsors</b>:   M Abdur Rahim Medical College and Hospital;   First affiliated Hospital Xi'an Jiaoting 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>Antiseptic Mouth Rinses to Reduce Salivary Viral Load in COVID-19 Patients</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Drug: Betadine© bucal 100 mg/ml;   Drug: Oximen® 3%;   Drug: Clorhexidine Dental PHB©;   Drug: Vitis Xtra Forte©;   Drug: Distilled Water<br/><b>Sponsors</b>:   Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana;   Hospital Universitario Fundación Jiménez Díaz;   Hospital Universitario General de Villalba;   Hospital Universitario Infanta Elena;   Hospital Universitario Virgen de la Arrixaca;   Hospital Clínico Universitario de Valencia;   Dentaid SL<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>RU Anti-SARS-CoV-2 (COVID-19) mAbs in Healthy Volunteers</strong> - <b>Condition</b>:   Covid19<br/><b>Intervention</b>:   Biological: C144-LS and C-135-LS<br/><b>Sponsor</b>:   Rockefeller University<br/><b>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>Biological characteristics and biomarkers of novel SARS-CoV-2 facilitated rapid development and implementation of diagnostic tools and surveillance measures</strong> - Existing coronavirus named as a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has speeded its spread across the globe immediately after emergence in China, Wuhan region, at the end of the year 2019. Different techniques, including genome sequencing, structural feature classification by electron microscopy, and chest imaging using computed tomography, are primarily used to diagnose and screen SARS-CoV-2 suspected individuals. Determination of the viral structure, surface proteins,...</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>Proposed Mechanisms of Targeting COVID-19 by Delivering Mesenchymal Stem Cells and Their Exosomes to Damaged Organs</strong> - With the outbreak of coronavirus disease (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the world has been facing an unprecedented challenge. Considering the lack of appropriate therapy for COVID-19, it is crucial to develop effective treatments instead of supportive approaches. Mesenchymal stem cells (MSCs) as multipotent stromal cells have been shown to possess treating potency through inhibiting or modulating the pathological events in COVID-19. MSCs...</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 certain medicinal plants compounds as new potential inhibitors of novel corona virus (COVID-19) using molecular docking analysis</strong> - SARS-CoV-2 is a new strain of coronavirus that appeared in China in December 2019, in recent years, great progress has been made in developing new antiviral drugs, and natural products, are important sources of potential and new antiviral drugs. The present study aimed to assess some biologically active compounds present in medicinal plants as potential COVID-19 inhibitors, using molecular docking methods. The Docking study was performed by Molecular Operating Environment software (MOE). About...</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>Quantum chemical studies on molecular structure, AIM, ELF, RDG and antiviral activities of hybrid hydroxychloroquine in the treatment of COVID-19: molecular docking and DFT calculations</strong> - Structure-activity relationships for hydroxychloroquine compound and its derivatives resulted in a potent antiviral activity. Where hydroxychloroquine derivatives showed an apparent efficacy against coronavirus related pneumonia. For this reason, the current study is focused on the structural properties of hydroxychloroquine and hydroxychloroquine sulfate. Optimized structures of these molecules have been reported by using DFT method at B3LYP/6-31G* level of theory. Te geometric were determined...</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 trimeric human angiotensin-converting enzyme 2 as an anti-SARS-CoV-2 agent</strong> - Effective intervention strategies are urgently needed to control the COVID-19 pandemic. Human angiotensin-converting enzyme 2 (ACE2) is a membrane-bound carboxypeptidase that forms a dimer and serves as the cellular receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). ACE2 is also a key negative regulator of the renin-angiotensin system that modulates vascular functions. We report here the properties of a trimeric ACE2 ectodomain variant, engineered using a structure-based...</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>Upregulation of DUSP6 impairs infectious bronchitis virus replication by negatively regulating ERK pathway and promoting apoptosis</strong> - Elucidating virus-cell interactions is fundamental to understanding viral replication and identifying targets for therapeutic control of viral infection. The extracellular signal-regulated kinase (ERK) pathway has been shown to regulate pathogenesis during many viral infections, but its role during coronavirus infection is undetermined. Infectious bronchitis virus is the representative strain of Gammacoronavirus, which causes acute and highly contagious diseases in the poultry farm. In this...</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>Repurposing existing drugs: identification of SARS-CoV-2 3C-like protease inhibitors</strong> - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for coronavirus disease 2019 (COVID-19). Since its emergence, the COVID-19 pandemic has not only distressed medical services but also caused economic upheavals, marking urgent the need for effective therapeutics. The experience of combating SARS-CoV and MERS-CoV has shown that inhibiting the 3-chymotrypsin-like protease (3CLpro) blocks the replication of the virus. Given the well-studied properties of FDA-approved drugs,...</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>Experimental Models to Study COVID-19 Effect in Stem Cells</strong> - The new strain of coronavirus (severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2)) emerged in 2019 and hence is often referred to as coronavirus disease 2019 (COVID-19). This disease causes hypoxic respiratory failure and acute respiratory distress syndrome (ARDS), and is considered as the cause of a global pandemic. Very limited reports in addition to ex vivo model systems are available to understand the mechanism of action of this virus, which can be used for testing of any drug...</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>Drug Repurposing: Dipeptidyl Peptidase IV (DPP4) Inhibitors as Potential Agents to Treat SARS-CoV-2 (2019-nCoV) Infection</strong> - The current outbreak of severe acute respiratory distress syndrome (SARS) or nCOVID-19 pandemic, caused by the coronavirus-2 (CoV-2), continues to wreak havoc globally. As novel vaccines are being discovered and developed, small molecule drugs still constitute a viable treatment option for SARS-CoV-2 infections due to their advantages such as superior patient compliance for oral therapies, reduced manufacturing costs and ease of large scale distribution due to better stability and storage...</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>Neutrophil Extracellular Traps and Their Implications in Cardiovascular and Inflammatory Disease</strong> - Neutrophils are primary effector cells of innate immunity and fight infection by phagocytosis and degranulation. Activated neutrophils also release neutrophil extracellular traps (NETs) in response to a variety of stimuli. These NETs are net-like complexes composed of cell-free DNA, histones and neutrophil granule proteins. Besides the evolutionarily conserved mechanism to capture and eliminate pathogens, NETs are also associated with pathophysiological processes of various diseases. Here, we...</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 in teriflunomide-treated patients with multiple sclerosis: A case report and literature review</strong> - CONCLUSION: Available data suggest that teriflunomide therapy should not be discontinued in MS patients who develop SARS-CoV-2 infection, also in presence of significant comorbidities or clinical conditions requiring hospitalization. Additional studies are necessary to assess if the drug can also have a protective role against SARS-CoV-2.</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 systematic review of experimental evidence for antiviral effects of ivermectin and an in-silico analysis of ivermectin's possible mode of action against SARS-CoV-2</strong> - Viral infections remain a major cause of economic loss with an unmet need for novel therapeutic agents. Ivermectin is a putative antiviral compound; the proposed mechanism is the inhibition of nuclear translocation of viral proteins, facilitated by mammalian host importins, a necessary process for propagation of infections. We systematically reviewed the evidence for the applicability of ivermectin against viral infections including SARS-CoV-2 regarding efficacy, mechanisms and selective...</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>ACE2-derived peptides interact with the RBD domain of SARS-CoV-2 spike glycoprotein, disrupting the interaction with the human ACE2 receptor</strong> - Vaccines could be the solution to the current SARS-CoV-2 outbreak. However, some studies have shown that the immunological memory only lasts three months. Thus, it is imperative to develop pharmacological treatments to cope with COVID-19. Here, the in silico approach by molecular docking, dynamic simulations and quantum biochemistry revealed that ACE2-derived peptides strongly interact with the SARS-CoV-2 RBD domain of spike glycoprotein (S-RBD). ACE2-Dev-PepI, ACE2-Dev-PepII, ACE2-Dev-PepIII...</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>Ifenprodil Stereoisomers: Synthesis, Absolute Configuration, and Correlation with Biological Activity</strong> - Ifenprodil (1) is a potent GluN2B-selective N-methyl-d-aspartate (NMDA) receptor antagonist that is used as a cerebral vasodilator and has been examined in clinical trials for the treatment of drug addiction, idiopathic pulmonary fibrosis, and COVID-19. To correlate biological data with configuration, all four ifenprodil stereoisomers were prepared by diastereoselective reduction and subsequent separation of enantiomers by chiral HPLC. The absolute configuration of ifenprodil stereoisomers was...</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>ACE-2-interacting Domain of SARS-CoV-2 (AIDS) Peptide Suppresses Inflammation to Reduce Fever and Protect Lungs and Heart in Mice: Implications for COVID-19 Therapy</strong> - COVID-19 is an infectious respiratory illness caused by the virus strain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and until now, there is no effective therapy against COVID-19. Since SARS-CoV-2 binds to angiotensin-converting enzyme 2 (ACE2) for entering into host cells, to target COVID-19 from therapeutic angle, we engineered a hexapeptide corresponding to the ACE2-interacting domain of SARS-CoV-2 (AIDS) that inhibits the association between receptor-binding...</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>A Second Trump Impeachment Could Answer More Questions About the Attack on the Capitol</strong> - The message from Democrats is that, even though Trump will soon be out of office, the act of a President inciting an attack on Congress is in a category of its own. - <a href="https://www.newyorker.com/news/daily-comment/a-second-trump-impeachment-could-answer-more-questions-about-the-attack-on-the-capitol">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Trump Can’t Be Allowed to Escape Justice Yet Again</strong> - Despite all the outrage sparked by last week’s riot, the President has grounds for believing that he won’t receive any immediate punishment for openly inciting an insurrection. - <a href="https://www.newyorker.com/news/our-columnists/trump-cant-be-allowed-to-escape-justice-yet-again">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Deciding Who Should Be Vaccinated First</strong> - The immunologist Barry Bloom discusses how to balance the vaccination needs of older Americans and frontline workers. - <a href="https://www.newyorker.com/news/q-and-a/deciding-who-should-be-vaccinated-first">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Learning from the Failure of Reconstruction</strong> - The storming of the Capitol was an expression of the antidemocratic strands in American history. - <a href="https://www.newyorker.com/news/q-and-a/learning-from-the-failure-of-reconstruction">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Life After Lynching in “Ashes to Ashes”</strong> - The artist Winfred Rembert and the activist and physician Shirley Jackson Whitaker reckon with the living legacy of racist violence in America. - <a href="https://www.newyorker.com/culture/the-new-yorker-documentary/life-after-lynching-in-ashes-to-ashes">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Biden can fight climate change, guarantee housing, and halve poverty — without the GOP</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/dyb-Cho9vP0CNNj_fe-GebH053k=/127x0:4092x2974/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/68660251/GettyImages_1230220167.0.jpg"/>
<figcaption>
President-elect Joe Biden announces climate and energy appointments in Wilmington, Delaware, in December. | Joshua Roberts/Getty Images
</figcaption>
</figure></li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Biden’s majority is fragile. But it could also be incredibly powerful.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XfyUMB">
Despite Joe Biden’s defeat of Donald Trump, the November election was a bit of a letdown for Democrats. The party lost House seats, and Senate Republicans did better than expected, dashing progressives’ dreams of a transformational Biden administration.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Me2CRD">
Then January 5 happened. Democrats Jon Ossoff’s and Raphael Warnock’s victories in the Georgia runoff elections mean that the Democratic policy wish list has been disinterred — even if the reality of a 50-50 Senate and slimmer Democratic margin in the House may force the party and the president-elect to temper their ambitions.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oZHvam">
That gives Biden two years to move — two years with a 50-50 Senate when he’ll be constrained by what moderates like Sens. Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) are willing to vote for.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TPV3lt">
Still, Biden and his allies in Congress can accomplish an awful lot through a process called <a href="https://www.vox.com/policy-and-politics/2016/11/23/13709518/budget-reconciliation-explained">budget reconciliation</a>. The Senate filibuster means that a bill typically requires 60 votes to move forward. With only 50 Democratic senators (plus tie-breaker Vice President-elect Kamala Harris), that’s a nearly insurmountable barrier. But the budget reconciliation process exempts certain legislation that primarily affects taxes and spending from the filibuster, meaning the 50 Senate Democrats can pass it on their own.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6S1T0S">
That makes reconciliation the most crucial process for the Biden presidency, through which his legislative agenda will live or die.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="klmemI">
Not everything can pass through budget reconciliation. It likely rules out measures like a <a href="https://www.vox.com/2019/8/16/20807610/raise-the-wage-act-15-minimum-wage-bill">minimum wage increase</a>, or <a href="https://www.vox.com/policy-and-politics/2018/10/26/18024542/dc-puerto-rico-statehood-senate-democracy">DC and Puerto Rico statehood</a>, or updates to the Voting Rights Act, or gerrymandering reform.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="D1oz6D">
Still, it’s plausible that Biden and his allies in Congress can use budget reconciliation to accomplish large swaths of his agenda, including paid parental and sick leave, universal pre-K, a $3,000 child allowance, universal housing vouchers, a massive investment in clean energy, expanded health care coverage, and more.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oGOdJZ">
During the general election, Biden’s team talked about him as the next FDR: a president who could seize a crisis to fundamentally transform the role of government. What he can achieve through reconciliation falls short of those ambitions; he will not turn America into a European social democracy overnight.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1yTtoM">
But what Biden can do — consensus items that most congressional Democrats agree on and have been campaigning on for years or decades — could nonetheless transform American life dramatically. An America where pre-K is universal and child care is affordable for all, with trillions in clean energy investment, free community college, paid maternity leave, a child allowance for parents, and a housing program that nearly eliminates homelessness, is a very different America. And it is in reach for the Biden administration.
</p>
<h3 id="XO78ld">
The potential and limits of a Senate majority
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SG29Ol">
Joe Biden’s agenda is vast and impossible to summarize in a single article, even when confined to what’s possible under budget reconciliation. But to pick out some of its most important aspects, Biden could:
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wworUB">
Approve $2,000 checks, state and local aid, and a boost to vaccine funding
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rRDFUA">
Create a $3,000-per-year child allowance for parents
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ALnZ3y">
Make housing a human right funded through federal vouchers
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3tKH2M">
Guarantee paid maternal/sick leave
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="erE3er">
Achieve universal pre-K for all 3- and 4-year-olds, and massively expand child care access
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GvS6M3">
Spend $2 trillion investing in clean energy and climate R&amp;D
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hRw1ox">
Forgive the first $10,000 in student loans for all debtors
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CAL0Rg">
Make community college free for all
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="P6G5vW">
Reduce Medicare eligibility to age 60 and perhaps create a public option open for all
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RHk555">
Raise taxes on the rich by $4 trillion
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fV0mLp">
Effectively abolish the debt ceiling to prevent future GOP hostage-taking
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KUh8VE">
To understand why this is possible, and much of the rest of his agenda is likely not, you have to know a bit about the filibuster.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YJS5wp">
The filibuster, a Senate practice <a href="https://www.vox.com/21424582/filibuster-joe-biden-2020-senate-democrats-abolish-trump">developed in the mid-19th century</a>, gives senators the power to delay legislation by either speaking indefinitely or (most often) merely threatening to speak indefinitely. Initially, there was no way to end a filibuster as long as the senator in question was committed to delaying; in the 20th century, though, the Senate developed the “cloture” rule, which allows a supermajority of senators, currently 60, to end a filibuster. Under the Obama and Trump presidencies, filibusters became so frequent that there is an understanding that all legislation supported by one party but not the other will need 60 votes to overcome a filibuster and pass the Senate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lRtqfb">
But there is a catch: In the 1970s, the Senate crafted a process called “budget reconciliation” that allows certain legislation to avoid a filibuster. It’s a major advantage that has unsurprisingly been used for lots of major legislation over the years: the 2017 Trump tax cuts and 2001/2003 Bush tax cuts, the 1996 welfare reform act, and the 2010 bill in which Obama and allies nationalized the student loan industry.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XP6CvZ">
It also means that the 50 Democratic senators plus Vice President-elect Kamala Harris will be able to pass some types of legislation, so long as all Democrats are in agreement.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S6oW5G">
However, reconciliation comes with profound limitations. It can usually only be used once per budget resolution, which in theory works out to one reconciliation bill a year. (Since Congress hasn’t yet passed a budget resolution for fiscal year 2021, Democrats could do two bills this year, one for 2021 and one for 2022; the details are a bit complicated, as the <a href="http://www.cbpp.org/research/federal-budget/introduction-to-budget-reconciliation">Center on Budget and Policy Priorities’ David Reich and Richard Kogan explain</a>.)
</p>
<div>
<figure class="e-image">
<pre><code> &lt;img alt=" " src="https://cdn.vox-cdn.com/thumbor/aOeA0tK09NGeLDL4Q8atTfREhh0=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22222494/GettyImages_1292321546.jpg" /&gt;
&lt;cite&gt;Tasos Katopodis/Getty Images&lt;/cite&gt;
&lt;figcaption&gt;House Speaker Nancy Pelosi and Senate Minority Leader Chuck Schumer speak on Capitol Hill in December.&lt;/figcaption&gt;</code></pre>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eLLxRK">
Then there are the limits on what a bill passed under reconciliation can do<em>, </em>imposed by the “<a href="https://fas.org/sgp/crs/misc/RL30862.pdf">Byrd Rule</a>,” which offers a way for senators to raise an objection against “extraneous” provisions in bills being considered under reconciliation. If the Senate presiding officer (who has historically always acted on the advice of the nonpartisan Senate parliamentarian) agrees, the provision is struck.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lapAG7">
The basics of the Byrd Rule are that reconciliation bills cannot change Social Security, or have merely “incidental” effects on spending/revenue, or increase deficits after 10 years. There are a couple of other limitations as well, but those are the major ones. In other words, reconciliation can be used for spending<em> </em>and taxing, but usually not for pure regulation or legal changes. If the main effect is not budgetary, it’s not reconcilable.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QufXwY">
The purpose of budget reconciliation is to reconcile tax and mandatory spending laws to the budget, and it’s <a href="https://www.cbpp.org/research/federal-budget/introduction-to-budget-reconciliation">never been used to alter discretionary<em> </em>spending</a>, which sustains the military, most domestic government agencies, and some social programs like Head Start, although an ambitious vice president willing to lean on the Senate parliamentarian might be able to force through at least some changes.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="j2lpeY">
Those strictures set some pretty stiff limits on Democrats’ legislative ambitions. Some examples of legislation that probably wouldn’t survive a “Byrd bath” (the Capitol Hill term of art for how the Senate strikes Byrd-violating provisions from reconciliation bills) include:
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hlFmun">
Statehood for DC and Puerto Rico
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hDnFpM">
A minimum wage increase to $15 an hour
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0GlOQh">
Comprehensive immigration reform
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DXa1Jf">
Redistricting and/or campaign finance reform
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5hq8sU">
Revival of the Voting Rights Act
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iVE0cH">
A nationwide mask-wearing mandate
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mpMHf2">
A nationwide ban or limit on indoor dining or other Covid-19 spreading activities
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uyYN17">
Labor law reforms to make it easier to join a union
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CZvNgq">
A minimum wage increase, for example, might indirectly affect the federal budget by leading to higher income and payroll tax revenues and less expenditure on food stamps. But that’s exactly the kind of “incidental” effect the Byrd Rule doesn’t allow legislation to use as an excuse.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="84vQNe">
But even with those constraints, there is still plenty that Democrats can do. Any spending or tax measure that is deficit-neutral or expires within 10 years and doesn’t touch Social Security is fair game. If the legislation requires accompanying regulation, the situation could get more difficult, but as long as those needs are minimal, reconciliation is a doable option.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GuKpPs">
So let’s go through Biden’s agenda and highlight some key measures that likely can be included in reconciliation.
</p>
<h3 id="h714GW">
Biden’s reconcilable agenda
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VjS5Z1">
Biden laid out an extensive <a href="https://www.vox.com/policy-and-politics/21340746/joe-biden-covid-19-coronavirus-recession-harris">legislative platform</a> during his campaign. It starts with his preferred response to the Covid-19 pandemic and accompanying economic crisis. But it goes well beyond that, too. His “Build Back Better” plan spans clean energy, caregiving/universal pre-K, subsidies for US manufacturing, and measures to remedy the racial wealth gap.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JKeg3I">
The measures detailed below are all pulled from the platform that Biden (and in one case Harris) laid out during the campaign. They are not maximalist measures from the left wing of the congressional Democratic caucus; they are measures with buy-in from the executive branch.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fOHllv">
That does not mean that all of these will pass under Biden. What Biden and Harris are willing to support and what Sens. Manchin and Sinema, the likely swing voters in the Democratic Senate caucus, are willing to support are two categories that only sometimes overlap. Fitting all these measures into just a few reconciliation bills would also pose daunting timing and logistical hurdles.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bM3BHg">
But these measures nonetheless give a sense of what Democrats could do if Manchin and Sinema get in line — and, tellingly, this list does not include cultural hot-button issues like gun control, new restrictions on coal energy, or expanded immigration, which could mean that there’s more for Manchin and Sinema to like here than it might seem.
</p>
<h4 id="xNAhpL">
Covid-19
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kjb7Zb">
The first and arguably most important thing Biden and his allies can do with reconciliation is invest in <a href="https://web.archive.org/web/20201114142351/https://joebiden.com/covid19/">his Covid-19 response agenda</a>. Some of these items can be implemented with the president’s authority alone (like using the Defense Production Act to ramp up production of masks and other personal protective equipment), and some require formal legislation (like nationwide mask mandates, though Biden’s plan suggests he would implement mandates by leaning on governors rather than passing a bill).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3ovhAh">
But some of it is mostly about increasing federal spending on certain programs, and so long as the spending is structured as a mandatory program, it will likely make it through reconciliation. <a href="https://web.archive.org/web/20201114142351/https://joebiden.com/covid19/">For instance</a>, Biden has called for a Public Health Jobs Corps comprising over 100,000 employees to work on contact tracing and other pandemic response; a $25 billion investment in vaccine manufacturing and distribution; and a “restart package” for small businesses to help them operate safely during the pandemic. All of those are measures that could likely survive reconciliation.
</p>
<h4 id="PNML4O">
Stimulus
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oEey40">
Biden has consistently called for additional relief measures, beyond those passed in December. He has <a href="https://www.vox.com/22216028/georgia-senate-results-ossoff-loeffler-perdue-warnock">embraced calls</a> for $2,000 stimulus checks (on top or instead of the $600-per-adult checks approved in December), additional relief to states and localities (specifically <a href="https://web.archive.org/web/20201114142351/https://joebiden.com/covid19/">calling</a> for a “renewable fund for state and local governments” and “an emergency package to ensure schools have the additional resources they need to adapt”), and <a href="https://joebiden.com/the-biden-plan-to-scale-up-employment-insurance-by-reforming-short-time-compensation-programs/">nationwide “work sharing”</a> to deter layoffs during recessions.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DAv5yr">
Biden has also endorsed the <a href="https://www.vox.com/2020/5/12/21254397/next-coronavirus-stimulus-package-democrats-heroes-act">HEROES Act,</a> the House-passed $3 trillion stimulus measure that would have extended the $600-per-week bonus unemployment insurance in effect last summer, rather than the $300-per-week bonus passed in December. It’s not clear whether he would push to increase the bonus to $600 in the coming months, or for retroactive UI benefits for August through December, when there were no bonus benefits. Biden has, however, <a href="https://web.archive.org/web/20201101001350/https://joebiden.com/plans-to-support-women-duringcovid19/">said</a> that the $600 bonus payments should last “for however long this crisis lasts,” which would suggest retroactive payments and a boost to $600 going forward.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VRtkAv">
All of the above could be passed through reconciliation. Biden could also, if he wanted, use reconciliation to pass measures creating “triggers” so emergency provisions like extra UI are triggered automatically in future crises. This is a common feature of reform proposals like <a href="https://www.vox.com/future-perfect/2020/3/24/21188470/coronavirus-unemployment-benefits-senate-stimulus">Democratic Sen. Michael Bennet’s</a>, and Senate Finance Chair Ron Wyden has said <a href="https://twitter.com/JStein_WaPo/status/1347634944152137729">he wants “automatic stabilizer” provisions</a> like these included in an economic relief bill. This measure would likely have to expire in 2031, to avoid increasing the deficit outside of the 10-year “window,” but it could make the response to future recessions much faster and more robust.
</p>
<h4 id="8wBQL2">
Anti-poverty measures
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OwwNsb">
Biden and Harris have embraced an extensive anti-poverty agenda, almost all of which is passable through the reconciliation process — though unless paid for by tax increases, it would have to expire after 10 years. Harris co-sponsored the <a href="https://www.vox.com/future-perfect/2019/3/6/18249290/child-poverty-american-family-act-sherrod-brown-michael-bennet">American Family Act</a>, which would offer non-wealthy Americans at least $250 in cash per month, per child, to support struggling families with children. That measure would lift at least 4 million children out of poverty, and <a href="https://www.vox.com/future-perfect/2020/9/18/21444103/child-tax-credit-2020-joe-bden">Biden has endorsed it in at least temporary form</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AbXGYB">
Biden has also <a href="https://www.vox.com/2020/7/9/21316912/joe-biden-housing-plan-section-8">endorsed making Section 8</a>, the federal program offering housing vouchers to low-income families, an entitlement. Currently, only about one-quarter of families eligible for Section 8 benefits get them due to funding shortfalls. Biden’s proposal would make basic housing a universal benefit, cutting poverty substantially and homelessness dramatically, with <a href="https://www.tandfonline.com/doi/abs/10.1080/10511482.2008.9521639">one study suggesting vouchers could cause a 75 percent reduction</a> in homelessness.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rJAYwa">
While Biden has not endorsed it, Harris has called for dramatically expanding the earned income tax credit (EITC) by <a href="https://www.vox.com/future-perfect/2018/10/19/17995374/kamala-harris-lift-act-basic-income-cash-eitc">creating a new $3,000-per-worker credit</a> that phases in, dollar for dollar, with income. A full-time worker at the minimum wage earning $14,500 a year would get an additional $3,000 in benefits. While that’s on the more dramatic end of what congressional Democrats are likely to support, almost all Democrats have endorsed a plan called the <a href="https://www.vox.com/future-perfect/2019/4/10/18302183/tax-cut-democrats-earned-income-tax-credit-child-allowance">Working Families Tax Relief Act</a> that includes a more modest bump in the EITC. Put together, these plans <a href="https://www.vox.com/future-perfect/21456242/joe-biden-poverty-checks-kamala-harris">could cut poverty in the United States by as much as half</a>.
</p>
<figure class="e-image">
<pre><code> &lt;img alt=" " src="https://cdn.vox-cdn.com/thumbor/qPySu5XnbI4sydN6Puhp7pcTZOA=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22222512/GettyImages_632190472__1_.jpg" /&gt;
&lt;cite&gt;Alex Wong/Getty Images&lt;/cite&gt;
&lt;figcaption&gt;President Barack Obama, Sen. Chuck Schumer (middle left), Rep. Nancy Pelosi (center), and Vice President Joe Biden (right) at Donald Trump’s inauguration in 2017 in Washington, DC.&lt;/figcaption&gt;</code></pre>
</figure>
<h4 id="3p9CVk">
Pre-K and caregiving
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pBpTvp">
Biden has an <a href="https://web.archive.org/web/20201101010402/http://joebiden.com/caregiving/">extensive caregiving agenda</a>, which got a central role in his “Build Back Better” program outlined last summer. It includes a subsidy and tax credit package to states to guarantee universal pre-K access for 3- and 4-year-olds, increased funding for Medicaid’s long-term care services and support, a refundable child care tax credit of up to $8,000 per child under age 13, and a state partnership offering a sliding-scale child care subsidy based on the <a href="https://www.help.senate.gov/imo/media/doc/CCFWFA%20Fact%20Sheet%20116th%20Congress%20FINAL.pdf">Child Care for Working Families Act</a> sponsored by Sen. Patty Murray (D-WA) and Rep. Bobby Scott (D-VA).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ae5gn8">
He has also <a href="https://joebiden.com/womens-agenda/">endorsed paid family and medical leave</a> along the lines of Sen. Kirsten Gillibrand’s (D-NY) <a href="https://web.archive.org/web/20201103070902/https://joebiden.com/womens-agenda/">FAMILY Act</a>, though Biden would pay for it with tax increases on the wealthy rather than Gillibrand’s proposed mild payroll tax increase.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mA2EsI">
All of those spending measures can be passed through reconciliation. But Seth Hanlon of the Center for American Progress flags that Biden’s plan to give caretakers a wage credit for Social Security, effectively raising retirement benefits for stay-at-home parents and full-time elderly/disabled family caregivers, could not run through reconciliation because the process bars changes to Social Security.
</p>
<figure class="e-image">
<pre><code> &lt;img alt=" " src="https://cdn.vox-cdn.com/thumbor/0yVyjqDF9W4IzeOJEgUQdxDQg1k=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22222524/GettyImages_1229592523.jpg" /&gt;
&lt;cite&gt;Nicholas Kamm/AFP/Getty Images&lt;/cite&gt;
&lt;figcaption&gt;House Speaker Nancy Pelosi and Senate Minority Leader Chuck Schumer on Capitol Hill in November.&lt;/figcaption&gt;</code></pre>
</figure>
<h4 id="xHFJPC">
Education
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QXidd8">
Beyond pre-K and caregiving, Biden has also proposed <a href="https://web.archive.org/web/20201101012124/https://joebiden.com/beyondhs/">free community college</a> and forgiving the first $10,000 in student loans held by all debtors. While raising committee issues, both those policies are easily doable through reconciliation. Indeed, the modern student loan program was created in 2010 through a reconciliation bill.
</p>
<h4 id="qEPwgM">
Climate change
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Z16Tdk">
As <a href="https://www.vox.com/energy-and-environment/2019/5/28/18636759/climate-change-budget-reconciliation-democrats">David Roberts has explained for Vox</a>, budget reconciliation is probably the best way to pass climate legislation under a Democratic administration. Some of <a href="https://web.archive.org/web/20201101002352/https://joebiden.com/climate-plan">Biden’s agenda</a>, like a binding 100 percent clean energy requirement by 2050, is likely off limits to reconciliation as it’s closer to regulation than taxation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="E4RGkg">
But Biden also <a href="https://web.archive.org/web/20201028150037/https://joebiden.com/clean-energy/">pledged $2 trillion in climate spending</a>, which can be passed through reconciliation. Of that $2 trillion, $400 billion will go to federal purchases of clean energy tech like batteries and electric vehicles to help boost those industries. Other components include infrastructure projects like electricity grid upgrades and universal broadband; expanded public transportation; and massively expanded R&amp;D spending on clean energy and carbon removal.
</p>
<h4 id="ciKshT">
Health care
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VkIIAI">
Biden’s <a href="https://web.archive.org/web/20201101010407/https://joebiden.com/HealthCare/">health care plan</a> calls for reducing the Medicare eligibility age from 65 to 60, offering a public option open to individuals and employers (including individuals getting private insurance through their employer), boosting the Affordable Care Act’s subsidies for health insurance, and making Medicaid expansion available to the 14 states that have not embraced it through the new public option.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lPPjqo">
My colleague <a href="https://www.vox.com/policy-and-politics/22216716/georgia-senate-election-results-obamacare-vote">Dylan Scott has more details here</a>, predicting that while subsidy expansion is likely, a public option will be a much harder lift for Democrats. There is some ambiguity about whether a public option is passable through budget reconciliation, as Scott notes, but <a href="https://www.bennet.senate.gov/public/index.cfm/2010/2/bennet-leads-push-to-include-public-option-in-health-insurance-reform-reconciliation-package">many</a> <a href="https://talkingpointsmemo.com/dc/reid-speaks-on-the-push-to-pass-public-option-via-reconciliation">Democrats</a> believed it was in 2010 during the Obamacare fight. A Medicare age change is almost certainly passable.
</p>
<figure class="e-image">
<pre><code> &lt;img alt=" " src="https://cdn.vox-cdn.com/thumbor/RxtbQfPdG4PoFqlcI_Pf8kS4_Rk=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22222531/GettyImages_1271930740.jpg" /&gt;
&lt;cite&gt;Chip Somodevilla/Getty Images&lt;/cite&gt;
&lt;figcaption&gt;Senate Minority Leader Chuck Schumer (left) fist bumps then-presidential nominee Joe Biden as he arrives for a remembrance ceremony of the 9/11 attacks on September 11, 2020, in New York City.&lt;/figcaption&gt;</code></pre>
</figure>
<h4 id="0ZGeaX">
Tax increases
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3FMsjr">
This is a somewhat odd time to be raising taxes, given the still-nascent economic recovery and rock-bottom interest rates that make it cheaper to pay off federal debt in five to 10 years than to prevent incurring the debt now. But Biden has promised not to raise taxes on people making under $400,000 and to <a href="https://web.archive.org/web/20201101004003/http://joebiden.com/two-tax-policies/">substantially increase taxes above that mark</a> to the tune of <a href="https://www.taxpolicycenter.org/publications/analysis-former-vice-president-bidens-tax-proposals/full">$4 trillion</a> over 10 years, and all of that could be done in reconciliation — and used to pay for some other items on his agenda outlined here.
</p>
<h4 id="xESAPQ">
Debt ceiling
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EkHKRO">
One of the biggest thorns in the side of the Obama administration was Congress’s statutory limit on the amount of debt the United States could have outstanding, a limit that gave House Speaker John Boehner incredible leverage, most notably in the summer of 2011, to threaten to force a default on the US’s debts if his legislative demands were not met.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="N9Kid8">
Abolishing the debt ceiling entirely may not be possible through reconciliation, but it can certainly be rendered impotent by raising it to, say $999 quadrillion.
</p>
<h3 id="9z8xaU">
The Biden legacy
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="D5CZiD">
Fitting all of those measures into two or three reconciliation bills from 2021 to 2023 would be challenging. It would require herculean efforts of vote-wrangling in the Senate, and likely some unsavory deals akin to the <a href="https://omaha.com/livewellnebraska/obamacare/what-was-the-cornhusker-kickback-the-deal-that-led-to-nelson-s-crucial-aca-vote/article_a2eb3a1d-df14-513b-a141-c8695f6c258e.html">“Cornhusker Kickback” subsidy</a> to Nebraska that got Sen. Ben Nelson (D-NE) on board with Obamacare in 2009. Biden and his administration will need to prioritize carefully, and perhaps drop some measures they consider too difficult to get Democratic consensus on.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ljlThk">
There’s also a chance that the sheer cost of some of these measures will bring back the austerity politics that dominated much of Obama’s presidency. <a href="https://www.nbcnews.com/politics/white-house/joe-biden-wants-set-aside-deficit-concerns-invest-ailing-u-n1253638">Biden has been talking a good game about the necessity of increased deficit spending</a>, especially on temporary investments like green energy. But moderates like Manchin and Sinema may balk at a $4-5 trillion combined price tag for his agenda.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xvrJAH">
The list above also does not resolve some of the Democratic Party’s longer-term problems, like its geographic disadvantage in the US Senate and the challenge of state-level gerrymandering. Admitting DC and Puerto Rico as states would alleviate the former a bit (<a href="https://twitter.com/davidshor/status/1277794239536074753?lang=en">though not enough</a>), and <a href="https://www.brennancenter.org/our-work/analysis-opinion/five-ways-hr-1-would-transform-redistricting">mandating independent redistricting commissions</a> would alleviate the latter — but those are likely not doable through reconciliation. With Democrats unlikely to get a 60-vote majority anytime soon, that could mean the party’s structural problems will just keep getting worse.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5KMaw8">
But enough caveats; the agenda above is enormous. It would make the US no longer the <a href="https://www.politifact.com/factchecks/2016/jul/25/kirsten-gillibrand/yes-us-only-industrialized-nation-without-paid-fam/">only industrialized country without paid family leave</a>. It would dramatically reduce homelessness and evictions by ensuring all low-income families have a right to housing. It would slash child and adult poverty and greatly accelerate America’s (and the world’s) transition away from fossil fuels.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bW7mAN">
It’s easy to be cynical about American politics, especially if you have been fighting for the above goals for decades to little avail. But you should allow yourself to feel a little hope in this moment, too. We’re about to embark on a rare two-year period where big changes are possible. That’s worth getting excited about.
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The House just passed a resolution calling on Mike Pence to invoke the 25th Amendment</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/iXOLc0TeoxmcxaSBTqox11Q6dIU=/68x0:2735x2000/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/68659510/AP_21012563883031.0.jpg"/>
<figcaption>
Shattered glass from the January 6, 2021, attack on Congress by a pro-Trump mob is seen on the doors leading to the Capitol Rotunda. | J. Scott Applewhite/AP
</figcaption>
</figure></li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Pence has already said he won’t be invoking the 25th Amendment to remove Trump — but Tuesday’s vote picked up bipartisan support.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cZfcV7">
A House vote on Tuesday revealed strong support for President Donald Trump’s removal in the wake of the violent January 6 attack on the Capitol.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BxiTsm">
House lawmakers on Tuesday voted 223-205 to approve a resolution from Rep. Jamie Raskin (D-MD) that <a href="https://www.speaker.gov/sites/speaker.house.gov/files/1.10.21_25thAmendmentResolution%5BFOR%20INTRO%5D.pdf">urges Vice President Mike Pence</a> to use the process outlined in the 25th Amendment <a href="https://www.vox.com/2021/1/6/22217641/25th-amendment-section-4-pence-trump-cabinet">to force Trump</a> to step down. One Republican — Rep. Adam Kinzinger (R-IL) — voted in favor of the resolution alongside Democrats.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CxF8jO">
While the resolution isn’t binding — <a href="https://twitter.com/SimonMarksFSN/status/1349156521771479042">and Pence has already said he won’t be invoking the 25th Amendment</a> — the vote captured the House backing in favor of Trump’s removal from office. <a href="https://www.vox.com/2021/1/12/22227838/impeachment-liz-cheney-mcconnell-trump-katko">Multiple Republicans including</a> Reps. Liz Cheney (R-WY), John Katko (R-NY) and Kinzinger (R-IL) had also announced earlier in the day that they plan to support Trump’s impeachment, which will get a vote on Wednesday.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Mi6B59">
Notably, House Republicans are not planning to whip the impeachment vote, <a href="https://edition.cnn.com/politics/live-news/trump-impeachment-news-01-12-21/h_669d3f840b4f4d0ca76394feb4a8d705">CNN</a> and <a href="https://www.politico.com/newsletters/huddle/2021/01/12/tk-491372">Politico</a> reported. In other words, while most GOP members of the House are expected to vote against impeaching the president, party leaders won’t try to convince the small group of lawmakers planning to defect from doing otherwise.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="InM4Hj">
Calls for Trump’s resignation or removal have increased since January 6, when the president urged his followers to march toward the Capitol and express their concerns about the certification of the election results. The 25th Amendment — which enables the vice president and a majority of the Cabinet to declare a president “unable to discharge the powers and duties of his office” and force them<strong> </strong>to step down — has been viewed as the fastest way to remove Trump, though Pence has already said he won’t be taking this route.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4hzS3N">
The House on Wednesday will weigh one article of impeachment, charging Trump with inciting an insurrection. Given the overwhelming majority of Democrats who are on board, Trump is poised to become the first US president in history to be impeached twice.
</p>
<h3 id="FSUFEB">
House Democrats’ next steps on impeachment, briefly explained
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FRG0fV">
Tuesday’s 25th Amendment resolution is the first of two votes the House will take in its attempt to remove Trump from office.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="v44Ixx">
The House will introduce an article of impeachment Wednesday morning, setting up a vote on it for later in the day. Democrats had 217 cosponsors for the resolution as of Tuesday afternoon, <a href="https://twitter.com/davidcicilline/status/1349060508461244422">per Rep. David Cicilline</a>, one of the authors.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bHa8Z6">
The House will vote on the single impeachment article, charging Trump with “incitement of insurrection” for his role in encouraging a mob of his supporters who later stormed the Capitol. Trump spoke to a crowd at a “Save America Rally” prior to the riot, during which he repeatedly said the election was “stolen” and asked them to march to the Capitol “to see whether or not we have great and courageous leaders or whether or not we have leaders that should be ashamed of themselves throughout history, throughout eternity.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pvEwll">
In their impeachment article, Democrats also mention Trump’s <a href="https://www.washingtonpost.com/politics/trump-raffensperger-call-transcript-georgia-vote/2021/01/03/2768e0cc-4ddd-11eb-83e3-322644d82356_story.html">recent phone call</a> with Georgia Secretary of State Brad Raffensperger in which he encouraged Raffensperger to “find” more than 11,000 votes to overturn the election. It also references Trump’s rhetoric about the November election being “fraudulent,” a lie he has repeated since his loss.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kW3GDG">
But the biggest thing Democrats are focused on is how Trump’s continued lies resulted in violence and death in DC, marking the first time Capitol Hill was breached since the British invasion of 1812 — and the first time by American citizens.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Z7Ptd5">
If the House does pass the article of impeachment, Pelosi will then transmit it over to the Senate. By then, Democrats could be staring down a lengthy trial with just days left in Trump’s term. Some, including Sen. Joe Manchin (D-WV) are worried that could hurt Biden’s ability to get his Cabinet nominees approved and critical pieces of his agenda passed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3WySKe">
“We have to put our government together quickly — that’s the most important thing we should do,” Manchin <a href="https://www.washingtonpost.com/powerpost/impeachment-trump-congress/2021/01/08/2a0d83ca-51c3-11eb-b96e-0e54447b23a1_story.html">told the Post</a><strong> </strong>last week. “We don’t need any more political theater.”
</p>
<h3 id="gvYQOR">
An impeachment trial could coincide with the early days of Biden’s administration
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uPSUHP">
According to a <a href="https://www.vox.com/2021/1/9/22179004/mitch-mcconnell-memo-second-trump-impeachment-senate-trial">memo from Senate Majority Leader Mitch McConnell</a>, the Senate will not convene for regular business until January 19 unless lawmakers agree to do so earlier by unanimous consent. Given the likely Republican opposition to an earlier start, the Senate probably won’t be in full session for another week.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KMW7yY">
That timing means the start of an impeachment trial would coincide with that of the Biden administration, which officially begins after Biden and Vice President-elect Kamala Harris are sworn in on January 20. To get a trial started sooner, incoming Senate Majority Leader Chuck Schumer has urged McConnell to reconvene the upper chamber by using emergency powers established under a 2004 law.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HuEQqR">
According to the law, Senate majority and minority leaders are able to reconvene the Senate in times of emergency — essentially bypassing unanimous consent to do so — if both lawmakers agree to it. Speaking on Tuesday, <a href="https://www.cnn.com/politics/live-news/trump-impeachment-news-01-12-21/h_6a1c10e2ff253793169def40f4ee1d0f">Schumer said</a>, “This is a time of emergency.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NSwJKb">
“The bottom line is that Leader McConnell has the ability to call us back into session. And we can then move to convict Donald Trump in the impeachment trial and try him,” he added. “That’s what we hope McConnell will do.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Unu8MW">
McConnell has yet to comment on whether he’d agree to this arrangement, but it’s unlikely he will. As a result, starting in late January the Senate is set to juggle both an impeachment trial, its own legislative agenda, and confirmations for Biden’s Cabinet nominees.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iuRgTp">
<a href="https://www.nbcnews.com/politics/donald-trump/clyburn-says-trump-impeachment-trial-could-be-delayed-until-after-n1253660">House Majority Whip Jim Clyburn</a> previously suggested the House could hold off on sending the articles of impeachment in order to delay a potential trial, but some Democrats — including Majority Leader Steny Hoyer — argue that sooner is better. As the rules go, once the House sends articles of impeachment to the Senate, the upper chamber must begin the trial shortly thereafter.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jGnnBC">
What exactly this will look like in practice isn’t yet clear: Biden has suggested the Senate could split its time by tackling legislation and nominations in the morning and conducting the impeachment trial later in the day. “Can we go half day on dealing with impeachment, and half day getting my people nominated and confirmed in the Senate as well as moving on the package?” <a href="https://www.politico.com/newsletters/transition-playbook/2021/01/11/biden-wants-the-senate-to-walk-and-chew-gum-792704">Biden seemed to suggest</a> on Monday.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pDyHkK">
Time in the Senate was also split between impeachment and other legislative business during Trump’s 2020 trial, <a href="https://www.politico.com/newsletters/transition-playbook/2021/01/11/biden-wants-the-senate-to-walk-and-chew-gum-792704">Politico reported</a>. In an <a href="https://buffalonews.com/news/local/schumer-impeachment-wont-stand-in-the-way-of-stimulus-infrastructure-plans/article_118f472a-541b-11eb-8974-47cb4d3fca4f.html">interview with Buffalo News</a>, Schumer signaled the upper chamber was likely to take this approach.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ASCRPp">
“We’re going to have to do several things at once but we got to move the agenda as well. Yes, we’ve got to do both,” he said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="J3CVAG">
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Supreme Court hands down its first anti-abortion decision of the Amy Coney Barrett era</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/ld01JFaBsmnNMd-fGsBggC8FQAA=/80x0:3145x2299/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/68658792/1282403922.0.jpg"/>
<figcaption>
Judge Amy Coney Barrett talks with Supreme Court Associate Justice Clarence Thomas during her ceremonial swearing-in ceremony to be a US Supreme Court Associate Justice. | Tasos Katopodis/Getty Images
</figcaption>
</figure></li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The Court’s decision may be the beginning of the end of Roe v. Wade.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gL3LhJ">
On the surface, the Supreme Court’s decision in <a href="https://www.supremecourt.gov/opinions/20pdf/20a34_3f14.pdf"><em>FDA v. American College of Obstetricians and Gynecologists</em></a>, which was handed down Tuesday evening, is fairly minor.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oZ336v">
The case involves a Food and Drug Administration requirement that a pill used in medication abortions must be distributed to patients directly by health providers and not by retail or mail-order pharmacies. A lower court temporarily suspended this requirement during the pandemic; the Supreme Court’s decision effectively reinstates the requirement.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Vn3XV9">
The Court released no majority opinion, which means that the decision in <em>American College</em> does not explicitly change existing legal doctrine. And the case concerns a policy that the Biden administration could likely reverse after President-elect Joe Biden takes office.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jg3mCI">
Read between the lines, however, and <em>American College</em> warns of a dark future for abortion rights.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VxHUF3">
The premise of pro-abortion rights decisions like <a href="https://www.law.cornell.edu/supremecourt/text/410/113"><em>Roe v. Wade</em></a><em> </em>(1973) is that the Constitution provides special protection to the right to an abortion that it doesn’t provide to other elective medical procedures. Yet, as Justice Sonia Sotomayor explains in dissent, <em>American College</em> effectively rules that a commonly used abortion drug may be regulated more harshly than any other legal medication.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3rKl5l">
Although Chief Justice John Roberts wrote an opinion explaining that he would decide the case on very narrow grounds — holding that courts should defer to public health agencies during the pandemic — no other justice in the majority joined this opinion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eZ0rT9">
For many years, Justice Anthony Kennedy — who typically voted to uphold abortion restrictions but sometimes voted to strike down particularly aggressive attacks on reproductive freedom — held the balance of power between four justices who support abortion rights and four who oppose them. But <a href="https://www.vox.com/policy-and-politics/2018/6/27/17510896/anthony-kennedy-retirement-abortion-rights-roe-v-wade-john-roberts">Kennedy’s retirement in 2018</a> and the death of pro-choice Justice Ruth Bader Ginsburg in 2020 — both Kennedy and Ginsburg were replaced by staunchly conservative Donald Trump appointees — makes it exceedingly likely that the Supreme Court will permit laws that effectively ban abortion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IYP9Rt">
<em>American College</em> does not go that far, but it is an ominous sign for anyone who cares about the right to terminate a pregnancy.
</p>
<h3 id="9SrsqV">
<em>American College</em> concerns access to abortion during the pandemic
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hRar9T">
The specific issue in <em>American College</em> involves <a href="https://www.vox.com/2020/12/17/22178362/supreme-court-abortion-amy-coney-barrett-fda-american-college-obstetricians-gynecologists">mifepristone</a>, part of a two-drug regime that is used to induce abortions. Mifepristone causes tissue within the uterus to break down and separate from the uterus itself. A day or two after taking mifepristone, the patient takes a drug called misoprostol, which makes the uterus contract and expel its contents.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dEGNFC">
While mifepristone is often taken at home, the Food and Drug Administration only allows the drug to be dispensed at hospitals, clinics, or other medical offices. It is not available at retail or mail-order pharmacies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S3nqQ2">
This limit on who can dispense mifepristone has been in effect for more than 20 years, and it’s ordinarily a fairly minor limit on abortion rights. During the Covid-19 pandemic, however, it is potentially a significant burden on patients’ ability to terminate their pregnancies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1gjlDd">
In the midst of a deadly pandemic, any trip outside of the home — including a trip to an abortion clinic — can potentially expose individuals to the coronavirus. Moreover, as Justice Sotomayor explains in her dissent, “three-quarters of abortion patients have low incomes, making them more likely to rely on public transportation to get to a clinic to pick up their medication.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aUCdMU">
That means that these patients “must bear further risk of exposure while they travel, sometimes for several hours each way, to clinics often located far from their homes.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9B4rRy">
Indeed, in no small part due to concerns that patients who need to travel in order to pick up medications could become infected with Covid-19, the FDA has eased many restrictions on prescription drugs for as long as the pandemic rages.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Mm0mRn">
The federal government, Sotomayor notes, “has urged healthcare providers and patients to take advantage of telemedicine.” It has “waived many in-person drug distribution requirements because they could ‘put patients and others at risk for transmission of the coronavirus,’” and it has also waived certain mandatory tests that ordinarily must be conducted before certain drugs can be prescribed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kysTEP">
And yet, under the Trump administration, the FDA has refused to relax restrictions on mifepristone. It even appears to have singled mifepristone out for particularly restrictive treatment. As Sotomayor writes, “of the over 20,000 FDA-approved drugs, mifepristone is the only one that the FDA requires to be picked up in person for patients to take at home.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0Wixnr">
This is why <em>American College</em> is such a significant decision, even if it does not make any explicit changes to the Supreme Court’s legal doctrines governing abortions. Instead of holding that abortion is a constitutional right entitled to special protection by the courts, the decision in <em>American College</em> suggests that the government may treat abortion-related treatments more harshly than any other medical treatment.
</p>
<h3 id="ovXC98">
Most of the conservative justices did not explain their decision
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QQElIN">
Sotomayor’s dissenting opinion was joined only by herself and Justice Elena Kagan — although Justice Stephen Breyer, the Court’s third liberal justice, indicated that he would have left in place a lower court decision which suspended the FDA’s restriction on who can dispense mifepristone.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wC3caq">
Of the six conservative justices, only Chief Justice John Roberts explained why he voted the way he did, and Roberts’s opinion, for what it’s worth, disclaims any suggestion that <em>American College</em> is a broad attack on abortion rights.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7F7kz2">
“The question before us is not whether the requirements for dispensing mifepristone impose an undue burden on a woman’s right to an abortion as a general matter.” Rather, Roberts writes, he believes that “courts owe significant deference to the politically accountable entities with the ‘background, competence, and expertise to assess public health’” when deciding how the government should respond to the pandemic.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WxjiEt">
But Roberts is the <a href="https://www.vox.com/2020/6/29/21306895/supreme-court-abortion-chief-justice-john-roberts-stephen-breyer-june-medical-russo">most moderate member</a> of the Court’s Republican majority. And his views matter far less than they used to, now that a majority of the Court is more conservative than he is. The five most conservative justices — a bloc of judges that is large enough to hand down binding decisions with or without Roberts — did not join Roberts’s opinion or otherwise explain their votes.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fjrnC9">
Every one of those five most conservative justices, though, has signaled a desire to <a href="https://www.vox.com/2020/12/17/22178362/supreme-court-abortion-amy-coney-barrett-fda-american-college-obstetricians-gynecologists">roll back</a> <a href="https://www.supremecourt.gov/opinions/19pdf/18-1323_c07d.pdf">abortion rights</a> — or even to overturn <em>Roe</em> outright.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8KzLEV">
<em>American College</em>, in other words, is unlikely to be the last decision from this Supreme Court restricting reproductive choice.
</p>
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Aus vs Ind | Injury-ravaged Indian team trains in Brisbane</strong> - Bumrah was not in his training outfit as he got involved in a discussion with bowling coach Bharat Arun.</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>Chennai Equitation Centre wins big at the Junior National Equestrian Championship</strong> - Young riders from the Chennai Equitation Centre clinched gold and silver medals at the Junior National Equestrian Championship held in Delhi recently</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>Mohammed Siraj has set new standard for calling out racist abuse, feels Nathan Lyon</strong> - Indian pacer Mohammed Siraj has set a new standard for calling out poor crowd behaviour, Australia's top off-spinner Nathan Lyon said on Wednesday, d</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>Aus vs. Ind | Justin Langer blames IPL for injuries on both sides</strong> - ‘IPL this time wasn’t ideal timing for anyone, impacted injuries we’re seeing’</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>Night Hunt primed for a repeat</strong> - Night Hunt, who maintains form, may repeat in the Kumarrajah M.A.M. Muthiah Memorial Cup (1,400m), the chief event of the races to be held here on We</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>ECIL to scale up its operations</strong> - Ministers ask management to pay compensation to laid-off employees</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>Cinemas reopen to good audience response</strong> - Theatres come alive with Vijay’s Master</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>Joint session of Legislature from Jan. 28</strong> - A joint session of the State Legislature has been convened from January 28. According to Law Minister J.C. Madhuswamy, the session will be on till Feb</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>BJP MP Pragya Thakur refers to Godse as ‘nationalist’</strong> - She alleged that the Congress has always abused patriots.</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>Property tax set to go up in municipal areas</strong> - Cabinet decides to levy tax on vacant sites too</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>Italy 'Ndrangheta group: Biggest mafia trial in decades opens</strong> - Hundreds of people will face a judge following a major inquiry into the 'Ndrangheta criminal group.</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>Russia Navalny: Poisoned opposition leader says he will fly home</strong> - Alexei Navalny says he will fly back on 17 January, months after he was sent to Germany for treatment.</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>Irish government to apologise over mother-and-baby homes</strong> - The scandal is a "dark and shameful chapter" of Irish history, says Taoiseach Micheál Martin.</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>Investigation after 'Nazi monkey' appears in Russian circus</strong> - Images appear to show a monkey wearing a Nazi uniform performing at a state circus last week.</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>Diary Sow: Talented Senegal student disappears in France</strong> - An investigation is opened into the disappearance of Diary Sow who has not been seen since 4 January.</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>Seeed launches BeagleV, a $150 RISC-V computer designed to run Linux</strong> - BeagleV is an affordable way to get your feet wet with RISC-V Linux computing. - <a href="https://arstechnica.com/?p=1734466">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Owen Wilson must choose between real and fantasy worlds in Bliss trailer</strong> - Director Mike Cahill also made award-winning 2011 sci-fi film <em>Another Earth</em>. - <a href="https://arstechnica.com/?p=1734682">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>N95 masks, gamer style: Razer’s crazy face-mask prototype revealed</strong> - CES prototype may be vaporware, but high-end features have us intrigued. - <a href="https://arstechnica.com/?p=1734718">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Trump admin. adopts Biden’s vaccine plan, threatens to punish slow states</strong> - Changing plans was always the plan, but it's unclear what will change before Jan. 20. - <a href="https://arstechnica.com/?p=1734656">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Facebook and Twitter could be sued for “censorship” under proposed state law</strong> - North Dakota bill would let users sue social-media sites for blocking posts. - <a href="https://arstechnica.com/?p=1734648">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><strong>A woman tries getting on a bus but realizes her skirt is too tight.</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
As the bus stopped and it was her turn to get on, she became aware that her skirt was too tight to allow her leg to come up to the height of the first step of the bus.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Slightly embarrassed and with a quick smile to the driver, she reached behind to unzip her skirt a little, thinking this would give her enough slack to raise her leg.<br/> She tries to take the step, but only to discover that she could not.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
With a little smile to the driver, she again reaches behind to unzip a little more and again was unable to take the step.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
After becoming quite frustrated and embarrassed, she once again attempted to unzip her skirt more in order to allow more legroom to get on the first step of the bus.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
About this time, a large Texan who was standing behind her, picked her up easily by the waist and placed her gently on the step of the bus.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She went ballistic and turned to the would-be Samaritan and yelled, "How dare you touch my body! ! I don't even know who you are!"
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The Texan smiled and drawled, "Well ma'am, normally I would agree with you but after you unzipped my fly three times I kinda figured we were friends."
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/HumNasheen"> /u/HumNasheen </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/kw1cfv/a_woman_tries_getting_on_a_bus_but_realizes_her/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/kw1cfv/a_woman_tries_getting_on_a_bus_but_realizes_her/">[comments]</a></span></p></li>
<li><strong>A worker at a cucumber factory had this strange urge...</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He wanted to stick his dick into the cucumber cutter. The urge was growing and growing until he decided to visit a psychiatrist.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The psychiatrist found that the only way to heal the urge was to actually go ahead and do it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The next day the worker came home early, his wife asked why. Ashamed, he admitted he had this urge to stick his dick into the cucumber cutter, went to the psychiatrist, who told him to do it so he went ahead and did it. So he got fired immediately.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
His wife in shock checked whether everything was ok with his "belongings". Everything was fine... so she asked: "What happend to the cucumber cutter?"
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Worker: " I think she got fired, too!"
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Gregib"> /u/Gregib </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/kwbkim/a_worker_at_a_cucumber_factory_had_this_strange/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/kwbkim/a_worker_at_a_cucumber_factory_had_this_strange/">[comments]</a></span></p></li>
<li><strong>Do you want to know why the republicans won't impeach Trump?</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Because they believe in carrying a baby to full term.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/IdeaCafe"> /u/IdeaCafe </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/kwbtq6/do_you_want_to_know_why_the_republicans_wont/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/kwbtq6/do_you_want_to_know_why_the_republicans_wont/">[comments]</a></span></p></li>
<li><strong>How do you get 20 Canadians out of a pool on a hot summer day?</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Blow a whistle and say, "Everyone out of the pool, please!” How do you get 20 Americans out of a pool on a hot summer day? Blow a whistle and say, "For your own good and the safety of others, stay in the fucking pool!”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/ThaanksIHateIt"> /u/ThaanksIHateIt </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/kw3z90/how_do_you_get_20_canadians_out_of_a_pool_on_a/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/kw3z90/how_do_you_get_20_canadians_out_of_a_pool_on_a/">[comments]</a></span></p></li>
<li><strong>A blonde accidentally kills a cop and calls the police:</strong> - <!-- SC_OFF -->
<div class="md">
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Hello, is this 911?
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Yes, what is your emergency?
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I called to inform you that you're 910 now.
</li>
</ul>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/MiclosEdi"> /u/MiclosEdi </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/kw9ul8/a_blonde_accidentally_kills_a_cop_and_calls_the/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/kw9ul8/a_blonde_accidentally_kills_a_cop_and_calls_the/">[comments]</a></span></p></li>
</ul>
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