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<title>29 October, 2023</title>
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<title>Covid-19 Sentry</title><meta content="width=device-width, initial-scale=1.0" name="viewport"/><link href="styles/simple.css" rel="stylesheet"/><link href="../styles/simple.css" rel="stylesheet"/><link href="https://unpkg.com/aos@2.3.1/dist/aos.css" rel="stylesheet"/><script src="https://unpkg.com/aos@2.3.1/dist/aos.js"></script></head>
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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>Streamlined DNA template preparation and co-transcriptional 5’ capped RNA synthesis enabled by solid-phase catalysis</strong> -
<div>
The success of SARS-CoV-2 mRNA vaccines demonstrated that rapid, large-scale manufacturing of synthetic mRNA is necessary for an effective and timely response to a pandemic. Innovations in areas such as template design and manufacturing processes are being implemented to facilitate more simple, cost-effective and scalable mRNA synthesis. In this study, for the first time, we demonstrate that the enzymatic steps in mRNA production (including DNA template linearization, RNA synthesis, 5' capping and methylation) can be carried out using enzymes immobilized to a solid support. Specifically, we demonstrate efficient IVT template DNA linearization using immobilized BspQI, where the linearized template DNA can be directly used in IVT without the need of purification. We also showed that immobilized T7 RNA polymerase, Faustovirus RNA capping enzyme (FCE), vaccinia cap 2'-O-methyltransfease (2'OMTase) and a novel FCE::T7RNAP fusion enable efficient enzymatic synthesis of Cap-1 RNA in a one-pot format. This solid-phase enzymatic platform may enable highly efficient, seamless and continuous mRNA synthesis workflows that minimizes sample loss and units of operation in biopharmaceutical manufacturing.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.28.564520v1" target="_blank">Streamlined DNA template preparation and co-transcriptional 5’ capped RNA synthesis enabled by solid-phase catalysis</a>
</div></li>
<li><strong>Exploring the Accuracy of Differentiation-Based Regressive Models in Disease Forecasting</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Predictive models have been able to foresee outbreaks of mosquito-borne diseases such as malaria and map Ebola outbreaks. This has allowed health organizations to plan the amount of resources and the number of healthcare workers n eeded more effectively, on top of finding out other useful data such as the locations most vulnerable to the disease and the demographics most affected. It can therefore be assumed that predictive analytics can reduce the amount of economic and non-economic burden caused by other epidemics as well, with COVID-19 being an obvious example.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.26.23297654v1" target="_blank">Exploring the Accuracy of Differentiation-Based Regressive Models in Disease Forecasting</a>
</div></li>
<li><strong>Loneliness Online: Social media interaction decreased loneliness in young adults during recommended social isolation.</strong> -
<div>
The recent COVID-19 pandemic and periods of recommended social isolation has led to a rise in questions regarding the role of Social media as a mean of limiting feelings of loneliness. Loneliness is described as a disparity between an individual’s desired social relations and their present relations and while social media supports in building social connections, there is limited understanding of loneliness in relation to social media use, especially in the Middle East. Taking these contexts into consideration, the current study hypothesized that greater social media addiction, increased passive browsing, decreased interaction such as posting and tagging friends, and broadcasting such as status updates and going live would significantly increase loneliness in young adults during the pandemic in the UAE. In order to test this, data was collected online from 177 young adults in the UAE during recommended social isolation, and was analysed using hierarchical regression. Results indicated that only social media interaction significantly decreased feelings of loneliness amongst the participants. Browsing, broadcasting, and addiction however did not significantly impact levels of loneliness in young adults during recommended social isolation, which contradicts the majority of the past findings. The findings show that interactions with others on social media facilitate much needed connections, especially during a health emergency and recommended isolation.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/b549s/" target="_blank">Loneliness Online: Social media interaction decreased loneliness in young adults during recommended social isolation.</a>
</div></li>
<li><strong>Echocardiographic characterisation in severe Covid-19 with respiratory failure - an observational study.</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Objective: We aimed to investigate cardiac effects of severe SARS-CoV-2 and the importance of echocardiography-assessment and biomarkers. Methods: This is an observational study of the first patients admitted to intensive care due to SARS-CoV-2-respiratory failure. Thirty-four underwent echocardiography of which twenty-five were included, compared to forty-four non-echo patients. Exclusion was based on absence of normofrequent sinus rhythm and/or mechanical respiratory support. Biomarkers were analysed on clinical indication. Results: Mortality was higher in the echo- compared to non-echo group (44 % vs. 16%, p&lt;0.05). Right-sided parameters were not under significant strain. Tricuspid valve regurgitation velocity indicated how increased pulmonary pressure was associated with mortality (survivors: 2.51 +/- 0.01 m/s vs. non-survivors: 3.06 +/- 0.11 m/s, p&lt;0.05), before multiple comparison-correction. Setting cut-off for pulmonary hypertension to 2.8 m/s generated p&lt;0.01 using frequency distribution testing. Cardiac markers, high sensitivity cardiac troponin I and N-terminal pro brain natriuretic peptide, and D-dimer were higher in the echocardiography group. (hs-TnI (ng/L): echo : 133 +/- 45 vs. non-echo: 81.3 +/- 45, p&lt;0.01; NT-proBNP (ng/L): echo: 2959 +/- 573 vs. non-echo: 1641 +/- 420, p&lt;0.001; D-dimer (mg/L): echo: 16.1 +/- 3.7 vs. non-echo: 6.1 +/- 1.5, p&lt;0.01) and non-survivor group (hs-TnI (ng/L): survivors: 59.1 +/- 21 vs. non-survivors: 211 +/- 105, p&lt;0.0001; NT-proBNP (ng/L): survivors: 1310 +/- 314 vs. non-survivors: 4065 +/- 740, p&lt;0.0001; D-dimer (mg/L): survivors: 7.2 +/- 1.5 vs. non-survivors: 17.1 +/- 4.8, p&lt;0.01). Tricuspid regurgitation velocity was positively correlated with cardiac troponin I (r=0.93, r2=0.74, p&lt;0.001). Conclusions: These results suggest there is no negative effect on cardiac function in critical SARS-CoV-2. Pulmonary pressure appears higher amongst non-survivors indicating pulmonary disease as the driver of mortality. Echocardiography was more commonly performed in the non-survivor group, and cardiac biomarkers as well as D-dimer was higher in the non-survivor group suggesting they carry negative prognostic values.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.27.23297666v1" target="_blank">Echocardiographic characterisation in severe Covid-19 with respiratory failure - an observational study.</a>
</div></li>
<li><strong>Mental health conditions and COVID-19 vaccine outcomes: a scoping review</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: The COVID-19 pandemic has had a profound impact on the mental health of people worldwide. Mental health also impacts on physical health. In the context of viral illnesses, viral challenge studies have shown that indices of mental health are associated with susceptibility to viral infections, including coronaviruses. Research conducted during the pandemic has shown that people with a history of mental health conditions were at increased risk of infection, hospitalisation, and mortality. However, the relationship between mental health conditions and vaccine outcomes such as vaccine intentions, uptake, and vaccine breakthrough is not yet well-understood. Methods: We conducted a systematic search on the topics of COVID-19 vaccine intentions, vaccine uptake, and vaccine breakthrough, in relation to mental health conditions, in four databases: PubMed, MEDLINE, SCOPUS, and PsychINFO, as well as the publication lists of Clinical Practice Research Datalink (CPRD), The Health Improvement Network (THIN), OpenSAFELY, and QResearch. Inclusion criteria focus on studies reporting either of the aforementioned COVID-19 vaccine outcomes among people with mental health conditions. Results: Thirty-three out of 251 publications met our inclusion criteria for this review. Overall, the evidence is inconclusive regarding the level of intention to accept the COVID-19 vaccine among people with mental health conditions. However, people with mental health conditions were more likely to have lower uptake of the COVID-19 vaccine, compared to people without. Common barriers to COVID-19 vaccine uptake include concerns about the safety, effectiveness, and side effects of the vaccines. Limited evidence also suggests that vaccine breakthrough may be a particular risk for those with substance use disorder. Conclusions: Our findings revealed a possible intention-behaviour gap for receiving the COVID-19 vaccine among people with mental health conditions, yielding interventions to encourage vaccine uptake in this population. There is also the need to enhance our understanding of COVID-19 vaccine breakthrough in people with mental health conditions.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.27.23297663v1" target="_blank">Mental health conditions and COVID-19 vaccine outcomes: a scoping review</a>
</div></li>
<li><strong>ChineseCVD: first-in-world, web-based, Chinese-specific Cardiovascular Risk Calculator incorporating long COVID, COVID-19 vaccination, SGLT2i and PCSK9i treatment effects</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Web-based risk prediction tools for cardiovascular diseases are crucial for providing rapid risk estimates for busy clinicians, but there is none available specifically for Chinese subjects. This study developed ChineseCVD, first-in-world web-based Chinese-specific Cardiovascular Risk Calculator incorporating long COVID, COVID-19 vaccination, SGLT2i and PCSK9i treatment effects. Methods: Adult patients attending government-funded family medicine clinics in Hong Kong between 1st January 2000 and 31st December 2003 were included. The primary outcome was major adverse cardiovascular events (MACE) defined as a composite of myocardial infarction, heart failure, transient ischaemic attacks/ischaemic strokes, and cardiovascular mortality. Results: A total of 155,066 patients were used as the derivation cohort. Over a median follow-up of 16.1 (11.6-17.8) years, 31,061 (20.44%) had MACE. Cox regression identified male gender, age, comorbidities, cardiovascular medications, systolic and diastolic blood pressure, and laboratory test results (neutrophil-lymphocyte ratio, creatinine, ALP, AST, ALT, HbA1c, fasting glucose, triglyceride, LDL and HDL) as significant predictors of the above outcomes. ChineseCVD further incorporates the impact of smoking status, COVID-19 infection, number of COVID-19 vaccination doses, and modifier effects of newest medication classes of PCSK9i and SGLT2i. The calculator enables clinicians to demonstrate to patients how risks vary with different medications. Conclusions: The ChineseCVD risk calculator enables rapid web-based risk assessment for adverse cardiovascular outcomes, thereby facilitating clinical decision-making at the bedside or in the clinic.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.27.23297656v1" target="_blank">ChineseCVD: first-in-world, web-based, Chinese-specific Cardiovascular Risk Calculator incorporating long COVID, COVID-19 vaccination, SGLT2i and PCSK9i treatment effects</a>
</div></li>
<li><strong>Complement dysregulation is a predictive and therapeutically amenable feature of long COVID</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Long COVID encompasses a heterogeneous set of ongoing symptoms that affect many individuals after recovery from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The underlying biological mechanisms nonetheless remain obscure, precluding accurate diagnosis and effective intervention. Complement dysregulation is a hallmark of acute COVID-19 but has not been investigated as a potential determinant of long COVID. Methods: We quantified a series of complement proteins, including markers of activation and regulation, in plasma samples from healthy convalescent individuals with a confirmed history of infection with SARS-CoV-2 and age/ethnicity/gender/infection/vaccine-matched patients with long COVID. Findings: Markers of classical (C1s-C1INH complex), alternative (Ba, iC3b), and terminal pathway (C5a, TCC) activation were significantly elevated in patients with long COVID. These markers in combination had a receiver operating characteristic predictive power of 0.794. Other complement proteins and regulators were also quantitatively different between healthy convalescent individuals and patients with long COVID. Generalized linear modeling further revealed that a clinically tractable combination of just four of these markers, namely the activation fragments iC3b, TCC, Ba, and C5a, had a predictive power of 0.785. Conclusions: These findings suggest that complement biomarkers could facilitate the diagnosis of long COVID and further suggest that currently available inhibitors of complement activation could be used to treat long COVID. Funding: This work was funded by the National Institute for Health Research (COV-LT2-0041), the PolyBio Research Foundation, and the UK Dementia Research Institute.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.26.23297597v1" target="_blank">Complement dysregulation is a predictive and therapeutically amenable feature of long COVID</a>
</div></li>
<li><strong>Immune Epitopes of SARS-CoV-2 Spike Protein and Considerations for Universal Vaccine Development</strong> -
<div>
Despite the success of global vaccination programs in slowing the spread of COVID-19, these efforts have been hindered by the emergence of new SARS-CoV-2 strains capable of evading prior immunity. The mutation and evolution of SARS-CoV-2 have created a demand for persistent efforts in vaccine development. SARS-CoV-2 Spike protein has been the primary target for COVID-19 vaccine development, but it is also the hotspot of mutations directly involved in host susceptibility and immune evasion. Our ability to predict emerging mutants and select conserved epitopes is critical for the development of a broadly neutralizing therapy or a universal vaccine. In this article, we review the general paradigm of immune responses to COVID-19 vaccines, highlighting the immunological epitopes of Spike protein that are likely associated with eliciting protective immunity resulting from vaccination. Specifically, we analyze the structural and evolutionary characteristics of the SARS-CoV-2 Spike protein related to immune activation and function via the toll-like receptors (TLRs), B cells, and T cells. We aim to provide a comprehensive analysis of immune epitopes of Spike protein, thereby contributing to the development of new strategies for broad neutralization or universal vaccination.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.26.564184v1" target="_blank">Immune Epitopes of SARS-CoV-2 Spike Protein and Considerations for Universal Vaccine Development</a>
</div></li>
<li><strong>Impact of Memory T Cells on SARS-COV-2 Vaccine Response in Hematopoietic Stem Cell Transplant</strong> -
<div>
During the COVID-19 pandemic, hematopoietic stem cell transplant (HSCT) recipients faced an elevated mortality rate from SARS-CoV-2 infection, ranging between 10-40%. The SARS-CoV-2 mRNA vaccines are important tools in preventing severe disease, yet their efficacy in the post-transplant setting remains unclear, especially in patients subjected to myeloablative chemotherapy and immunosuppression. We evaluated the humoral and adaptive immune responses to the SARS-CoV-2 mRNA vaccination series in 42 HSCT recipients and 5 healthy controls. Peripheral blood mononuclear nuclear cells and serum were prospectively collected before and after each dose of the SARS-CoV-2 vaccine. Post-vaccination responses were assessed by measuring anti-spike IgG and nucleocapsid titers, and antigen specific T cell activity, before and after vaccination. In order to examine mechanisms behind a lack of response, pre- and post-vaccine samples were selected based on humoral and cellular responses for single-cell RNA sequencing with TCR and BCR sequencing. Our observations revealed that while all participants eventually mounted a humoral response, transplant recipients had defects in memory T cell populations that were associated with an absence of T cell response, some of which could be detected pre-vaccination.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.26.564259v1" target="_blank">Impact of Memory T Cells on SARS-COV-2 Vaccine Response in Hematopoietic Stem Cell Transplant</a>
</div></li>
<li><strong>Overcoming antibody-resistant SARS-CoV-2 variants with bispecific antibodies constructed using non-neutralizing antibodies</strong> -
<div>
A current challenge is the emergence of SARS-CoV-2 variants, such as BQ.1.1 and XBB.1.5, that can evade immune defenses, thereby limiting antibody drug effectiveness. Emergency-use antibody drugs, including the widely effective bebtelovimab, are losing their benefits. One potential approach to address this issue are bispecific antibodies which combine the targeting abilities of two antibodies with distinct epitopes. We engineered neutralizing bispecific antibodies in the IgG-scFv format from two initially non-neutralizing antibodies, CvMab-6 (which binds to the receptor-binding domain [RBD]) and CvMab-62 (targeting a spike protein S2 subunit epitope adjacent to the known anti-S2 antibody epitope). Furthermore, we created a bispecific antibody by incorporating the scFv of bebtelovimab with our anti-S2 antibody, demonstrating significant restoration of effectiveness against bebtelovimab-resistant BQ.1.1 variants. This study highlights the potential of neutralizing bispecific antibodies, which combine existing less effective anti-RBD antibodies with anti-S2 antibodies, to revive the effectiveness of antibody therapeutics compromised by immune-evading variants.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.26.564289v1" target="_blank">Overcoming antibody-resistant SARS-CoV-2 variants with bispecific antibodies constructed using non-neutralizing antibodies</a>
</div></li>
<li><strong>Eviction Moratorium Litigation: What Courts Said, and What Courts Missed</strong> -
<div>
In 2020, federal, state, and local governments imposed eviction moratoriums to prevent mass homelessness and limit the spread of COVID-19. Landlords responded to this unprecedented action by filing lawsuits around the country. This Article analyzes the litigation. It examines the claims of landlords, defenses raised by the government, and how courts dealt with each of them. It also highlights the ways that courts misunderstand the rental market and devalue tenants. The Article shows that, before the Supreme Court intervened in mid-2021, most landlord suits failed, either because courts rejected their claims or governments ran out the clock, demonstrating that mass eviction moratoriums can protect the most vulnerable in times of crisis.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/zumw2/" target="_blank">Eviction Moratorium Litigation: What Courts Said, and What Courts Missed</a>
</div></li>
<li><strong>Peripheral Transcriptomics in Acute and Long-Term Kidney Dysfunction in SARS-CoV2 Infection</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background. Acute kidney injury (AKI) is common in hospitalized patients with SARS-CoV2 infection despite vaccination and leads to long-term kidney dysfunction. However, peripheral blood molecular signatures in AKI from COVID-19 and their association with long-term kidney dysfunction are yet unexplored. Methods. In patients hospitalized with SARS-CoV2, we performed bulk RNA sequencing using peripheral blood mononuclear cells (PBMCs). We applied linear models accounting for technical and biological variability on RNA-Seq data accounting for false discovery rate (FDR) and compared the functional enrichment and pathway results to a historical sepsis-AKI cohort. Finally, we evaluated the association of these signatures with long-term trends in kidney function. Results. Of 283 patients, 106 had AKI. After adjustment for sex, age, mechanical ventilation, and chronic kidney disease (CKD), we identified 2635 significant differential gene expressions at FDR&lt;0.05. Top canonical pathways were EIF2 signaling, oxidative phosphorylation, mTOR signaling, and Th17 signaling, indicating mitochondrial dysfunction and endoplasmic reticulum (ER) stress. Comparison with sepsis associated AKI showed considerable overlap of key pathways (48.14%). Using follow-up estimated glomerular filtration rate (eGFR) measurements from 115 patients, we found that 164/2635 (6.2%) of the significantly differentiated genes were associated with overall decrease in long-term kidney function. The strongest associations were autophagy, renal impairment via fibrosis and cardiac structure/function. Conclusions. We show that AKI in SARS-CoV2 is a multifactorial process with mitochondrial dysfunction driven by ER stress whereas long-term kidney function decline is associated with cardiac structure and function, and immune dysregulation. Functional overlap with sepsis-AKI also highlights common signatures indicating generalizability in therapeutic approaches.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.25.23297469v2" target="_blank">Peripheral Transcriptomics in Acute and Long-Term Kidney Dysfunction in SARS-CoV2 Infection</a>
</div></li>
<li><strong>Comparative Organ Disease Burden and Sequelae of Influenza and SARS-CoV-2 Infection: An Observational Study Using Real-World Data</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Infections with SARS-CoV-2 and influenza are associated with acute and post-acute complications and sequelae of many organ systems (i.e., disease burden). It is important to understand the global disease burden that associates with and follows acute infection in order to establish preventive and therapeutic strategies and to reduce the use of health resources and improve patient health outcomes. To address these questions, we utilized the National Covid Cohort Collaborative, which is an integrated and harmonized data repository of electronic health record data in the USA. From this database, we included in analysis 346,648 eligible SARS-CoV-2-infected patients, 78,086 eligible influenza infected patients, and 146,635 uninfected controls. We describe the disease burden that extends over 2-3 months following infection, and we quantify the reduction of disease burden by treatment. We identify a burden of disease following medically attended influenza that is comparable to that of medically attended SARS-CoV-2 infection. However, in contrast to SARS-CoV-2, influenza acute infection and disease burden are not responsive to antiviral treatment and thus remain as an unmet medical need. Focusing therapeutic strategies solely on the short-term management of acute infection may also underestimate the extended health benefits of antiviral treatment.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.26.23297626v2" target="_blank">Comparative Organ Disease Burden and Sequelae of Influenza and SARS-CoV-2 Infection: An Observational Study Using Real-World Data</a>
</div></li>
<li><strong>Sort-Seq: immune repertoire-based scRNA-Seq systematization</strong> -
<div>
The functional programs chosen by B and T cell clones fundamentally determine the architecture of immune response to distinct challenges. Advances in scRNA-Seq have improved our understanding of the diversity and stability of these programs, but it has proven difficult to link this information with known lymphocyte subsets. Here, we introduce Sort-Seq, an immune repertoire-based method that allows exact positioning of phenotypically defined lymphocyte subsets within scRNA-Seq data. Sort-Seq outperformed CITE-Seq for accurate mapping of the classical CD4+ T helper (Th) cell subsets (Th1, Th1-17, Th17, Th22, Th2a, Th2, and Treg), offering a more powerful approach to the surface phenotype-based scRNA-Seq classification of adaptive lymphocyte subpopulations. Using integrated scRNA-Seq, Sort-Seq, and CITE-Seq data from 122 donors, we provide a comprehensive Th cell scRNA-Seq reference map. Exploration of this dataset revealed the low plasticity and extreme sustainability of the Th17, Th22, Th2, and Th2a cell programs over years. We also develop Cultivation-based Antigen-specific T cell identificatoR in Replicates (CultivAToRR), which identified &gt;80 SARS-CoV-2-specific CD4+ TCR{beta} clonotypes in a single donor across a wide frequency range. We complemented these results with frequency-based capturing of COVID-19-responsive clonotypes and screening against known SARS-CoV-2-specific TCRs. Positioning within the annotated scRNA-Seq map revealed functional subtypes of Th cell clones involved in primary and secondary responses against SARS-CoV-2. The ability to capture low-frequency antigen-specific T cell clones in combination with Sort-Seq-based scRNA-Seq annotation creates an integral pipeline that links challenge-responsive clones with their exact functional subtypes, providing a solid foundation for investigating T cell roles in healthy and pathological immune responses and vaccine development.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.24.563704v1" target="_blank">Sort-Seq: immune repertoire-based scRNA-Seq systematization</a>
</div></li>
<li><strong>Cost-effectiveness analysis of COVID-19 booster doses and oral antivirals in the Indo-Pacific</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Decision-makers in middle-income countries need evidence on the cost-effectiveness of COVID-19 booster doses and oral antivirals to appropriately prioritise these healthcare interventions.   Methods: We used a dynamic transmission model to assess the cost-effectiveness of COVID-19 booster doses and oral antivirals in Fiji, Indonesia, Papua New Guinea, and Timor-Leste. We conducted cost-effectiveness analysis from both healthcare and societal perspectives using 3% discounting for ongoing costs and health benefits. We developed an interactive R Shiny which allows the user to vary key model assumptions, such as the choice of discounting rate, and view how these assumptions affect model results.   Findings: Booster doses were cost saving and therefore cost-effective in all four middle-income settings from both healthcare and societal perspectives using 3% discounting. Providing oral antivirals was cost-effective from a healthcare perspective if procured at a low generic ($25 United States Dollars) or middle-income reference price ($250 United States Dollars); however, their cost-effectiveness was strongly influenced by rates of wastage or misuse, and the ongoing costs of care for patients hospitalised with COVID-19. Interestingly, the cost or wastage of rapid antigen tests did not appear strongly influential over the cost-effectiveness of oral antivirals in any of the four study settings.   Conclusions: Our results support that government funded COVID-19 booster programs continue to be cost-effective in middle-income settings. Oral antivirals demonstrate the potential to be cost-effective if procured at or below a middle-income reference price of $250 USD per schedule. Further research should quantify the rates of wastage or misuse of oral COVID-19 antivirals in middle-income settings.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.26.23297613v1" target="_blank">Cost-effectiveness analysis of COVID-19 booster doses and oral antivirals in the Indo-Pacific</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>Evaluation of Concordance Between Exhaled Air Test (eBAM-CoV) and RT-PCR to Detect SARS-CoV-2</strong> - <b>Conditions</b>: SARS-CoV-2 Infection; COVID-19; Coronavirus <br/><b>Interventions</b>: Device: eBAM Cov Testing <br/><b>Sponsors</b>: Centre Hospitalier Universitaire de Nīmes; University of Nimes; brains’ laboratory sas, FRANCE <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 Safety, Tolerability and Immunogenicity of EG-COVII in Healthy Adult</strong> - <b>Conditions</b>: COVID-19 <br/><b>Interventions</b>: Biological: EG-COVII <br/><b>Sponsors</b>: EyeGene Inc. <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>Pharmacokinetics and Bioequivalence of Aterixen 100 mg Tablets and Aterixen 100 mg Film-coated Tablets in Healthy Volunteers</strong> - <b>Conditions</b>: Viral Infection COVID-19 <br/><b>Interventions</b>: Drug: Aterixen <br/><b>Sponsors</b>: Valenta Pharm JSC <br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Long COVID Brain Fog: Cognitive Rehabilitation Trial</strong> - <b>Conditions</b>: Long COVID; Brain Fog; Cognitive Impairment; Cognitive Dysfunction; Post-Acute COVID-19 Syndrome <br/><b>Interventions</b>: Behavioral: Speed of Processing Training; Behavioral: In-lab Instrumental Activities of Daily Living Training; Behavioral: In-lab Brain Health Training; Behavioral: Transfer Package; Behavioral: Follow Up Phone Calls; Behavioral: Vocational Rehabilitation; Behavioral: Peer Mentoring <br/><b>Sponsors</b>: University of Alabama at Birmingham; National Institute on Disability, Independent Living, and Rehabilitation Research <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>Paradoxical Response to Chest Wall Loading in Mechanically Ventilated Patients</strong> - <b>Conditions</b>: ARDS; COVID-19; Mechanical Ventilation Pressure High; Ventilator-Induced Lung Injury <br/><b>Interventions</b>: Diagnostic Test: Manual loading of the chest wall <br/><b>Sponsors</b>: HealthPartners Institute <br/><b>Withdrawn</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 Practical RCT of TCM in the Treatment of LCOVID and Analysis of Syndrome Types and Medication Characteristics.</strong> - <b>Conditions</b>: Long COVID <br/><b>Interventions</b>: Drug: Traditional Chinese medicine treatment; Drug: Western medicine treatment <br/><b>Sponsors</b>: Chinese University of Hong Kong <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>Immunogenicity of Concomitant Administration of COVID-19 Vaccines With Influenza Vaccines</strong> - <b>Conditions</b>: COVID-19; Influenza; Vaccine Reaction; Contaminant Injected <br/><b>Interventions</b>: Biological: Omicron-containing COVID-19 vaccine; Biological: influenza vaccine <br/><b>Sponsors</b>: Catholic Kwandong University; Korea University Guro Hospital <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Narrative Intervention for Long COVID-19 (NICO)</strong> - <b>Conditions</b>: Long COVID; Long Covid19 <br/><b>Interventions</b>: Behavioral: Narrative Intervention for Long COVID-19 (NICO) <br/><b>Sponsors</b>: University of Colorado, Denver <br/><b>Active, not 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>Home-Based Respiratory Muscle Strength Training Program for Individuals With Post-COVID-19 Persistent Dyspnea</strong> - <b>Conditions</b>: Post-COVID-19 Syndrome; Dyspnea <br/><b>Interventions</b>: Device: Respiratory Muscle Strength Trainers <br/><b>Sponsors</b>: University of South Florida <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>Inspiratory Muscle Strength Training in Post-Covid Syndrome</strong> - <b>Conditions</b>: Cardiovascular Abnormalities; Post-COVID-19 Syndrome; Physical Exercise <br/><b>Interventions</b>: Other: Inspiratory muscle strength training <br/><b>Sponsors</b>: D’Or Institute for Research and Education <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>Inspiratory Muscle Training in People With Long COVID-19- A Pilot Investigation.</strong> - <b>Conditions</b>: Long COVID <br/><b>Interventions</b>: Device: PrO2 <br/><b>Sponsors</b>: University of Bath; Swansea 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>Rural Tailored Communication to Promote SARS-CoV-2 Antibody Testing in Saliva</strong> - <b>Conditions</b>: SARS-CoV2 Infection <br/><b>Interventions</b>: Behavioral: General SARS-CoV-2 Communication; Behavioral: Rural-Targeted SARS-CoV-2 Communication <br/><b>Sponsors</b>: Michigan State University; National Cancer Institute (NCI); Johns Hopkins 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>Cognitive Rehabilitation Therapy for COVID-19</strong> - <b>Conditions</b>: Post-Acute COVID-19 Syndrome <br/><b>Interventions</b>: Behavioral: Compensatory Cognitive Training for COVID-19; Behavioral: Holistic Cognitive Education <br/><b>Sponsors</b>: VA Office of Research and Development <br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID Rehabilitation</strong> - <b>Conditions</b>: Rehabilitation; Post-Acute COVID-19 Syndrome; Post-Infectious Disorders <br/><b>Interventions</b>: Behavioral: One day course; Behavioral: Individual follow-ups <br/><b>Sponsors</b>: University Hospital of North Norway; University of Bergen; Oslo University Hospital; Norwegian University of Science and Technology <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>Food Effects of GST-HG171 Tablets Combined With Ritonavir in Healthy Chinese Participants</strong> - <b>Conditions</b>: COVID-19 Respiratory Infection <br/><b>Interventions</b>: Drug: GST-HG171/ritonavir; Drug: ritonavir <br/><b>Sponsors</b>: Fujian Akeylink Biotechnology Co., Ltd. <br/><b>Active, not 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>IgG antibody levels against the SARS-CoV-2 spike protein in mother-child dyads after COVID-19 vaccination</strong> - CONCLUSIONS: COVID-19 mRNA vaccines induce high anti-SARS-CoV-2 S titers in pregnant women, which can inhibit the binding of ACE2 to protein S and are efficiently transferred to the fetus. However, there was a rapid decrease in antibody levels at 2 to 3 months post-partum, particularly in infants.</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>Neurotoxic effects of chloroquine and its main transformation product formed after chlorination</strong> - Pharmaceutical transformation products (TPs) generated during wastewater treatment have become an environmental concern. However, there is limited understanding regarding the TPs produced from pharmaceuticals during wastewater treatment. In this study, chloroquine (CQ), which was extensively used for treating coronavirus disease-19 (COVID-19) infections during the pandemic, was selected for research. We identified and fractionated the main TP produced from CQ during chlorine disinfection and…</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>Development of Pan-Anti-SARS-CoV-2 Agents through Allosteric Inhibition of nsp14/nsp10 Complex</strong> - SARS-CoV-2 nsp14 functions both as an exoribonuclease (ExoN) together with its critical cofactor nsp10 and as an S-adenosyl methionine-dependent (guanine-N7) methyltransferase (MTase), which makes it an attractive target for the development of pan-anti-SARS-CoV-2 drugs. Herein, we screened a panel of compounds (and drugs) and found that certain compounds, especially Bi(III)-based compounds, could allosterically inhibit both MTase and ExoN activities of nsp14 potently. We further demonstrated…</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>Unraveling bioactive metabolites of mangroves as putative inhibitors of SARS-CoV-2 Mpro and RBD proteins: molecular dynamics and ADMET analysis</strong> - COVID-19 is a deadly pandemic caused by Corona virus leading to millions of deaths worldwide. Till today no medicine was available to cure this disease. This study selected 262 potential bioactive natural products derived from mangroves to inhibit the main protease (Mpro) and receptor-binding domain (RBD) protein of the COVID-19 virus. All the ligands were subjected to Adsorption Digestion Metabolism Excretion and Toxicity (ADMET) predictions and docking studies using AutodockVina. Among all the…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Immunogenicity of Co-Administered Omicron BA.4/BA.5 Bivalent COVID-19 and Quadrivalent Seasonal Influenza Vaccines in Israel during the 2022-2023 Winter Season</strong> - Vaccination against COVID-19 and influenza provides the best defense against morbidity and mortality. Administering both vaccines concurrently may increase vaccination rates and reduce the burden on the healthcare system. This study evaluated the immunogenicity of healthcare workers in Israel who were co-administered with the Omicron BA.4/BA.5 bivalent COVID-19 vaccine and the 2022-2023 quadrivalent influenza vaccine. SARS-CoV-2 neutralizing antibody titers were measured via microneutralization…</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>Longitudinal Analysis of SARS-CoV-2-Specific Cellular and Humoral Immune Responses and Breakthrough Infection following BNT162b2/BNT162b2/BNT162b2 and ChAdOx1/ChAdOx1/BNT162b2 Vaccination: A Prospective Cohort in Naive Healthcare Workers</strong> - Assessing immune responses post-SARS-CoV-2 vaccination is crucial for optimizing vaccine strategies. This prospective study aims to evaluate immune responses and breakthrough infection in 235 infection-naïve healthcare workers up to 13-15 months after initial vaccination in two vaccine groups (108 BNT/BNT/BNT and 127 ChAd/ChAd/BNT). Immune responses were assessed using the interferon-gamma enzyme-linked immunospot (ELISPOT) assay, total immunoglobulin, and neutralizing activity through surrogate…</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>RSL3 Inhibits Porcine Epidemic Diarrhea Virus Replication by Activating Ferroptosis</strong> - Porcine epidemic diarrhea virus (PEDV) is a highly contagious coronavirus that induces diarrhea and death in neonatal piglets, resulting in substantial economic losses to the global swine industry. The mechanisms of PEDV infection and the roles of host factors are still under exploration. In this study, we used the ferroptosis pathway downstream target activator (1S,3R)-RSL3 compound as a starting point, combined with the interactions of N-acetylcysteine and deferoxamine, to elucidate the…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pharmacokinetic and Pharmacodynamic Analysis of the 3CL Protease Inhibitor Ensitrelvir in a SARS-CoV-2 Infection Mouse Model</strong> - The small-molecule antiviral drug ensitrelvir targets the 3C-like protease of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study evaluated its inhibitory effect on viral replication in a delayed-treatment mouse model and investigated the relationship between pharmacokinetic (PK) parameters and pharmacodynamic (PD) effects. SARS-CoV-2 gamma-strain-infected BALB/c mice were orally treated with various doses of ensitrelvir starting 24 h post-infection. Effectiveness 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>Viral Entry Inhibitors Protect against SARS-CoV-2-Induced Neurite Shortening in Differentiated SH-SY5Y Cells</strong> - The utility of human neuroblastoma cell lines as in vitro model to study neuro-invasiveness and neuro-virulence of SARS-CoV-2 has been demonstrated by our laboratory and others. The aim of this report is to further characterize the associated cellular responses caused by a pre-alpha SARS-CoV-2 strain on differentiated SH-SY5Y and to prevent its cytopathic effect by using a set of entry inhibitors. The susceptibility of SH-SY5Y to SARS-CoV-2 was confirmed at high multiplicity-of-infection,…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Ubiquitin-Proteasome System Facilitates Membrane Fusion and Uncoating during Coronavirus Entry</strong> - Although the involvement of the ubiquitin-proteasome system (UPS) in several coronavirus-productive infections has been reported, whether the UPS is required for infectious bronchitis virus (IBV) and porcine epidemic diarrhea virus (PEDV) infections is unclear. In this study, the role of UPS in the IBV and PEDV life cycles was investigated. When the UPS was suppressed by pharmacological inhibition at the early infection stage, IBV and PEDV infectivity were severely impaired. Further study showed…</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>Extracellular Vesicles as a Translational Approach for the Treatment of COVID-19 Disease: An Updated Overview</strong> - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic in the years 2020-2022. With a high prevalence, an easy route of transmission, and a long incubation time, SARS-CoV-2 spread quickly and affected public health and socioeconomic conditions. Several points need to be elucidated about its mechanisms of infection, in particular, its capability to evade the immune system and escape from neutralizing antibodies. Extracellular vesicles (EVs) are phospholipid…</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>Anti-Viral Activity of Bioactive Molecules of Silymarin against COVID-19 via In Silico Studies</strong> - The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection drove the global coronavirus disease 2019 (COVID-19) pandemic, causing a huge loss of human life and a negative impact on economic development. It is an urgent necessity to explore potential drugs against viruses, such as SARS-CoV-2. Silymarin, a mixture of herb-derived polyphenolic flavonoids extracted from the milk thistle, possesses potent antioxidative, anti-apoptotic, and anti-inflammatory properties. Accumulating…</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>Galangal-Cinnamon Spice Mixture Blocks the Coronavirus Infection Pathway through Inhibition of SARS-CoV-2 M<sup>Pro</sup>, Three HCoV-229E Targets; Quantum-Chemical Calculations Support In Vitro Evaluation</strong> - Natural products such as domestic herbal drugs which are easily accessible and cost-effective can be used as a complementary treatment in mild and moderate COVID-19 cases. This study aimed to detect and describe the efficiency of phenolics detected in the galangal-cinnamon mixture in the inhibition of SARS-CoV-2’s different protein targets. The potential antiviral effect of galangal-cinnamon aqueous extract (GCAE) against Low Pathogenic HCoV-229E was assessed using cytopathic effect inhibition…</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>Inhibition of SARS-CoV-2 Infection in Vero Cells by Bovine Lactoferrin under Different Iron-Saturation States</strong> - Despite the rapid mass vaccination against COVID-19, the emergence of new SARS-CoV-2 variants of concern, such as omicron, is still a great distress, and new therapeutic options are needed. Bovine lactoferrin (bLf), a multifunctional iron-binding glycoprotein available in unsaturated (apo-bLf) and saturated (holo-bLf) forms, has been shown to exert broad-spectrum antiviral activity against many viruses. In this study, we evaluated the efficacy of both forms of bLf at 1 mg/mL against infection of…</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>PANoptosis: Mechanism and Role in Pulmonary Diseases</strong> - PANoptosis is a newly defined programmed cell death (PCD) triggered by a series of stimuli, and it engages three well-learned PCD forms (pyroptosis, apoptosis, necroptosis) concomitantly. Normally, cell death is recognized as a strategy to eliminate unnecessary cells, inhibit the proliferation of invaded pathogens and maintain homeostasis; however, vigorous cell death can cause excessive inflammation and tissue damage. Acute lung injury (ALI) and chronic obstructive pulmonary syndrome (COPD)…</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>Some Lasting Lessons from a Dramatic Week at Trump’s Civil Trial</strong> - Among them: the former President is trying to undermine the court system, and prosecutors shouldn’t put too much faith in Michael Cohen. - <a href="https://www.newyorker.com/news/our-columnists/some-lasting-lessons-from-a-dramatic-week-at-trumps-civil-trial">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Speaker Who?: The Rise of a G.O.P. Nobody in Trump’s House</strong> - On the election of Mike Johnson. - <a href="https://www.newyorker.com/news/letter-from-bidens-washington/speaker-who-the-rise-of-a-gop-nobody-in-trumps-house">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Hurricane Otis and the World We Live in Now</strong> - The unexpected Category 5 storm is just the latest in a series of unprecedented climate disasters this year. - <a href="https://www.newyorker.com/news/daily-comment/hurricane-otis-and-the-world-we-live-in-now">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>An International Student on Lockdown During the Shooting in Lewiston, Maine</strong> - “When I saw how my American peers reacted and how I reacted, the contrast just blew my mind,” Alan Wang, a senior at Bates College, said. - <a href="https://www.newyorker.com/news/as-told-to/an-international-student-on-lockdown-during-the-shooting-in-lewiston-maine">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Is There a Path Forward for Gaza and Israel?</strong> - David Remnick hears from two sources about how Israelis and Palestinians feel about the October 7th attacks, and what the future may hold for the region. - <a href="https://www.newyorker.com/podcast/the-new-yorker-radio-hour/is-there-a-path-forward-for-gaza-and-israel">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>Why some Palestinians believe social media companies are suppressing their posts</strong> -
<figure>
<img alt="An illustration of a pair of eyes, hidden beneath a dark shadow, staring out to the left. Surrounding the eyes are white dots of the same size, against a red background." src="https://cdn.vox-cdn.com/thumbor/w99At1BH7-c6BX8QOoRZJR7qPbI=/459x0:1899x1080/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72805823/V1_Shadowbanning_Vox.0.png"/>
<figcaption>
Shadowbanning dates back to the early days of the internet. | Vox; MirageC/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Shadowbanning and the Israel-Hamas war, explained.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="N4Mzb8">
“Algospeak” is an <a href="https://journals.sagepub.com/doi/10.1177/20563051231194586">evasion tactic</a> for automated moderation on social media, where users create new words to use in place of keywords that might get picked up by <a href="https://www.vox.com/2023/4/28/23702644/artificial-intelligence-machine-learning-technology">AI</a>-powered filters. People might refer to dead as “unalive,” or sex as “seggs,” or porn as “corn” (or simply the corn emoji).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XhlMqs">
There’s an <a href="https://www.washingtonpost.com/news/the-intersect/wp/2017/03/20/youtube-is-looking-into-complaints-that-it-unfairly-censors-lgbt-videos/">algospeak</a> term for Palestinians as well: “P*les+in1ans.” Its very existence speaks to a concern among many people posting and sharing pro-Palestine content during the war between <a href="https://www.vox.com/politics/2023/10/10/23911661/hamas-israel-war-gaza-palestine-explainer">Hamas</a> and <a href="https://www.vox.com/israel">Israel</a> that their posts are being unfairly suppressed. Some users believe their accounts, along with certain hashtags, have been “shadowbanned” as a result.
</p>
<aside id="u7X1vQ">
<div>
</div>
</aside>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2FDXb7">
Algospeak is just one of the user-developed methods of varying effectiveness that are supposed to dodge suppression on platforms like <a href="https://www.vox.com/tiktok">TikTok</a>, <a href="https://www.vox.com/instagram-news">Instagram</a>, and <a href="https://www.vox.com/facebook">Facebook</a>. People might use unrelated hashtags, screenshot instead of repost, or avoid employing Arabic hashtags to attempt to evade apparent but unclear limitations on content about Palestine. It’s not clear whether these methods really work, but their spread among activists and around the internet speaks to the real fear of having this content hidden from the rest of the world.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WR2yVr">
“Shadowbanning” gets thrown around a lot as an idea, is difficult to prove, and is not always easy to define. Below is a guide to its history, how it manifests, and what you as a social media user can do about it.
</p>
<h3 id="QavH3V">
What is shadowbanning?<strong> </strong>
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="31mIPS">
Shadowbanning is an often covert form of platform moderation that limits who sees a piece of content, rather than banning it altogether. According to a <a href="https://www.vice.com/en/article/a3q744/where-did-shadow-banning-come-from-trump-republicans-shadowbanned">Vice dive into the history of the term</a>, it likely originates as far back as the internet bulletin board systems of the 1980s.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Cc2oDo">
In its earliest iterations, shadowbanning worked kind of like a digital quarantine: Shadowbanned users could still log in and post to the community, but no one else could see their posts. They were present but contained. If someone was shadowbanned by one of the site’s administrators for posting awful things to a message board, they’d essentially be demoted to posting into nothingness, without knowing that was the case.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dcp4sD">
Social media, as it evolved, upended how communities formed and gathered online, and the definition of shadowbanning expanded. People get seen online not just by creating an account and posting to a community’s virtual space, but by understanding how to get engagement through a site’s algorithms and discovery tools, by getting reshares from influential users, by purchasing ads, and by building followings of their own. Moderating became more complicated as users became savvier about getting seen and working around automated filters.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yd9V2v">
At this point, shadowbanning has come to mean any “really opaque method of hiding users from search, from the algorithm, and from other areas where their profiles might show up,” said Jillian York, the director for international freedom of expression for the Electronic Frontier Foundation (EFF). A user might not know they’ve been shadowbanned. Instead, they might notice the effects: a sudden drop in likes or reposts, for instance. Their followers might also have issues seeing or sharing content a shadowbanned account posts.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sw7Jbr">
If you’re from the United States, you might know shadowbanning as a term <a href="https://www.nytimes.com/2018/07/26/us/politics/twitter-shadowbanning.html">thrown around by conservative activists and politicians</a> who believe that social media sites — in particular Facebook and <a href="https://www.vox.com/twitter">Twitter</a> (now X) — have deliberately censored right-wing views. This is part of a years-long campaign that has prompted <a href="https://www.vox.com/2018/9/6/17824652/twitter-dorsey-energy-and-commerce-hearing-shadow-banning">lawsuits and congressional hearings</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0nMMZH">
While the evidence is slim that these platforms were engaging in systemic censorship of conservatives, the idea seems to catch on any time a platform takes action against a prominent right-wing account with a large following. The <a href="https://www.vox.com/scotus">Supreme Court</a> <a href="https://www.nbcnews.com/politics/supreme-court/supreme-court-weigh-republican-backed-social-media-censorship-laws-rcna66522">recently agreed</a> to hear a pair of cases challenging laws in Texas and Florida that restrict how social <a href="https://www.vox.com/media">media companies</a> can moderate their sites.
</p>
<h3 id="m9EIw3">
Why are people concerned about shadowbanning in relation to the Israel-Hamas war?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fTrvr0">
War <a href="https://www.vox.com/technology/2023/10/12/23913472/misinformation-israel-hamas-war-social-media-literacy-palestine">produces</a> a swell of violent imagery, propaganda, and misinformation online, circulating at a rapid pace and triggering intense emotional responses from those who view it. That is inevitable. The concern from activists and digital rights observers is that content about Palestinians is not being treated fairly by the platforms’ moderation systems, leading to, among other things, shadowbanning.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zqdf9i">
Outright account bans are pretty visible to both the account holder and anyone else on the platform. Some moderation tools designed to combat misinformation involve publicly flagging content with information boxes or warnings. Shadowbanning, by comparison, is not publicly labeled, and platforms might not tell a user that their account’s reach is limited, or why. Some users, though, have noticed signs that they might be shadowbanned after posting about Palestine. According to <a href="https://mashable.com/article/instagram-shadowbanning-censor-israel-palestine">Mashable</a>, these include Instagram users who saw their engagement crater after posting with their location set to Gaza in solidarity, sharing links to fundraisers to help people in Palestine, or posting content that is supportive of Palestinians.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7yIeDE">
Some digital rights organizations, including the EFF and <a href="https://7or.7amleh.org/">7amleh-The Arab Center for Social Media Advancement</a>, are actively tracking potential digital rights violations of Palestinians during the conflict, particularly on Instagram, where some Palestinian activists have noticed troubling changes to how their content circulates in recent weeks.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vcYqtB">
“These include banning the use of Arabic names for recent escalations [i.e., the Israel-Hamas war] while allowing the Hebrew name, restricting comments from profiles that are not friends, and…significantly reducing the visibility of posts, Reels, and stories,” Nadim Nashif, the co-founder and director of 7amleh, wrote in an email to Vox.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dLKDES">
In a statement, <a href="https://www.vox.com/meta">Meta</a> said that the post visibility issues impacting some Palestinian users were due to a global “bug” and that some Instagram hashtags were no longer searchable because a <a href="https://about.fb.com/news/2023/10/metas-efforts-regarding-israel-hamas-war/">portion of the content</a> using it violated Meta rules. Meta’s statement does not name specific hashtags that have been limited under this policy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AXkJCR">
Mona Shtaya, a Palestinian digital rights activist, took to Instagram to <a href="https://www.instagram.com/p/CyIdaBMtrXL/">characterize the hashtag shadowbans</a> as a “collective punishment against people who share political thoughts or document human rights violations” that will negatively impact efforts to fact-check and share accurate information about the situation in Gaza.
</p>
<h3 id="XxiQwv">
What’s the difference between shadowbanning and moderation bias?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iZO3Xf">
Shadowbanning is just one aspect of a broader problem that digital rights experts are tracking when it comes to potential bias in the enforcement of a platform’s rules. And this is not a new issue for pro-Palestinian content.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AVc1Ig">
Moderation bias “comes in a lot of different flavors, and it’s not always intentional,” York said. Platforms might underresource or incorrectly resource their language competency for a specific language, something that York said has long been an issue with how US-based platforms such as Meta moderate content in Arabic. “There might be significant numbers of Arabic-language content moderators, but they struggle because Arabic is across a number of different dialects,” she noted.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fy0E3y">
Biases also emerge in how certain terms are classified by moderation algorithms. We know that this specific sort of bias can affect Palestinian content <a href="https://techcrunch.com/2023/10/19/meta-instagram-palestine-israel-shadowban-censorship-moderation-bias/">because it happened before</a>. In 2021, during another escalation in conflict between Hamas and Israel, digital rights groups <a href="https://www.hrw.org/news/2021/10/08/israel/palestine-facebook-censors-discussion-rights-issues">documented</a> hundreds of content removals that seemed to unfairly target pro-Palestine sentiments. Meta <a href="https://www.buzzfeednews.com/article/ryanmac/instagram-facebook-censored-al-aqsa-mosque">eventually</a> acknowledged that its systems were <a href="https://time.com/6050350/palestinian-content-facebook/">blocking references</a> to the al-Aqsa Mosque, a holy site for Muslims that was incorrectly flagged in Meta’s systems as connected to terrorist groups.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="16YWWV">
Meta commissioned an <a href="https://www.bsr.org/en/reports/meta-human-rights-israel-palestine">independent report</a> into its moderation decisions during the 2021 conflict, which documented Meta’s weaknesses in moderating Arabic posts in context. It also found that Meta’s decisions “appear to have had an adverse human rights impact” on the rights of Palestinian users’ “freedom of expression, freedom of assembly, political participation, and non-discrimination.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gl2peS">
In response to the report, <a href="https://about.fb.com/wp-content/uploads/2022/09/Meta-Response_-Israel-and-Palestine-Due-Diligence-Exercise.pdf">Meta promised to review its relevant policies and improve its moderation of Arabic</a>, including by recruiting more moderators with expertise in specific dialects. Meta’s current moderation of Israel-Hamas war content is being led by a centralized group with expertise in Hebrew and Arabic, <a href="https://about.fb.com/news/2023/10/metas-efforts-regarding-israel-hamas-war/">the company said</a>. Some content removals, they added, are going through without account “strikes” to avoid automatically banning accounts that have had content taken down in error.
</p>
<h3 id="11QFTF">
What other content gets shadowbanned?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ug0Y0C">
Claims of shadowbanning are associated with divisive issues. But probably the best-documented cases have to do with how major platforms handle content about nudity and sex. Sex workers have long <a href="https://hackinghustling.org/wp-content/uploads/2020/09/Posting-Into-the-Void.pdf">documented their own shadowbans</a> on mainstream social media platforms, particularly after a pair of bills passed in 2018 aimed at stopping sex trafficking removed protections for online platforms that hosted a <a href="https://www.vox.com/culture/2018/4/13/17172762/fosta-sesta-backpage-230-internet-freedom">wide range of content about sex</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="U8ysaX">
In general, York said, shadowbans become useful moderation tools for platforms when the act of directly restricting certain sorts of content might become a problem for them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HhjQFL">
“They don’t want to be seen as cutting people off entirely,” she said. “But if they’re getting pressure from different sides, whether it’s governments or shareholders or advertisers, it is probably in their interest to try to curtail certain types of speech while also allowing the people to stay on the platform so it becomes less of a controversy.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Cq6TZX">
TikTok content can also get shadowbanned, according to its <a href="https://newsroom.tiktok.com/community-guidelines">community guidelines,</a> which note that the platform “may reduce discoverability, including by redirecting search results, or making videos ineligible for recommendation in the ‘For You’ feed” for violations. Other platforms, like Instagram, <a href="https://www.vox.com/youtube">YouTube</a>, and X, have used tools to downrank or limit the reach of “borderline” or inappropriate content, as defined by their moderation systems.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="L9bq97">
While it’s very difficult — if not impossible — to prove shadowbanning unless a company decides to confirm that it happened, there are some documented cases of the biases inherent within these moderation systems that, while not quite fitting the definition of shadowbanning, might be worth considering while trying to evaluate claims. TikTok <a href="https://www.nbcnews.com/news/us-news/tiktok-algorithm-prevents-user-declaring-support-black-lives-matter-n1273413">had to correct an error in 2021</a> that automatically banned creators from using phrases like “black people” or “black success” in their marketing bios for the platform’s database of creators who are available to create sponsored content for brands. In 2017, <a href="https://www.vox.com/lgbtq">LGBTQ</a> creators <a href="https://www.washingtonpost.com/news/the-intersect/wp/2017/03/20/youtube-is-looking-into-complaints-that-it-unfairly-censors-lgbt-videos/">discovered</a> that YouTube had labeled otherwise innocuous videos that happened to feature LGBTQ people in them as “restricted content,” limiting their viewability.
</p>
<h3 id="6rYEzW">
How can you tell if your account has been shadowbanned?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qXsoio">
This can be difficult! “I do feel like people are often gaslighted by the companies about this,” said York. Many platforms, she continued, “won’t even admit that shadowbanning exists,” even if they use automated moderation tools like keyword filters or account limitations that are capable of creating shadowbans. And some of the telltale signs of shadowbanning — lost followers, a drop in engagement — could be explained by an organic loss of interest in a user’s content or a legitimate software bug.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7ntlnX">
Some platform-specific sites promise to analyze your account and let you know if you’ve been shadowbanned, but those tools are not foolproof. (You should also be careful about giving your account information to a third-party site.) There is one solution, York said: Companies could be more transparent about the content they take down or limit, and explain why.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Y4Wcds">
<a href="https://www.vox.com/technology/23930670/israel-gaza-hospital-explosion-media-new-york-times-twitter-x-tiktok-telegram-peter-kafka-column">Finding good information about a conflict </a>is already difficult. This is especially true for those trying to learn more about the Israel-Hamas war, and in particular, about Gaza. Few journalists have been able to do on-the-ground reporting from Gaza, making it extremely difficult to verify and contextualize the situation there. <a href="https://cpj.org/2023/10/journalist-casualties-in-the-israel-gaza-conflict/">According to the Committee to Protect Journalists</a>, as of this writing, 29 journalists have died since the war began. Adding the specter of shadowbans to this crisis of reliable information threatens yet another avenue for providing and amplifying firsthand accounts to a wider public.
</p></li>
<li><strong>Your health care open enrollment questions, answered</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/bO4ogV9vvr7wslO1-MRC-TfuxJg=/279x0:4656x3283/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72805737/GettyImages_455114267.0.jpg"/>
<figcaption>
Getty Images
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
From the politics of US health care to assistance for selecting a Medicare Advantage plan.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QUjJxd">
Health care <a href="https://www.vox.com/23914351/health-insurance-plans-open-enrollment-guide-obamacare-medicare-dental">open enrollment</a> is here and we’re here to help guide you through it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BZmokJ">
During this baffling annual ritual, Americans encounter our health care system’s most confounding questions. Why am I <a href="https://www.vox.com/23890764/healthcare-insurance-marketplace-open-enrollment-employer-sponsored-united-blue-cross-shield-aetna">stuck with my employer’s health plan</a>? Who thought <a href="https://www.vox.com/policy/23892823/healthcare-flexible-spending-account-fsa-hsa-wageworks">flexible spending accounts were a good idea</a>? Why do I have to make <a href="https://www.vox.com/policy/2023/3/17/23639685/medicare-medicaid-plans-health-insurance-open-enrollment-privatization">so many choices when enrolling in Medicare</a>? Is my dental insurance <a href="https://www.vox.com/23901293/dentist-delta-dental-insurance-cigna-aspen-metlife-aetna">a scam</a>?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rxkXSB">
Those were <a href="https://www.vox.com/23914351/health-insurance-plans-open-enrollment-guide-obamacare-medicare-dental">the questions we had here at Vox going into this open enrollment season</a>. But we were curious to know what questions our audience had too. Last week, Vox supporters had an opportunity to ask and have answered their questions about open enrollment. If I were to identify a common theme, it was less about specific benefits and more big picture: Why is it so hard to make things simpler? Why is our health care discourse so contentious?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rop2vY">
In the spirit of Vox’s commitment to keeping our journalism free to all, we wanted to share some of those questions and answers with all of our readers. So here they are, lightly edited for clarity and length.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0A1vpe">
<strong>Why does Medicare For All or some universal health care for everybody seem like such a monumental task to accomplish in the USA as opposed to other countries around the world? Is it simply that we as Americans are focused on ourselves instead of helping others around us or is it more complicated than that?</strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4S81xO">
I think the problem boils down to two distinct but related issues.
</p>
<ol>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hsCP98">
The health care industry is very influential in Congress and willing to spend a lot of money to preserve the status quo.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="b2arXw">
The American public may have reservations about our current health care system, but they are apprehensive about change.
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</ol>
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<div id="FlwKRB">
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="if586V">
The first issue speaks for itself: Going back to the Truman era, the industry has marshaled immense resources to oppose proposals that would lead to more government involvement in health care. The Clinton health plan, opposed by <a href="https://www.youtube.com/watch?v=CwOX2P4s-Iw">the insurance industry’s Harry &amp; Louise ads</a>, is the best example of the effectiveness of its tactics. The Obama administration cut deals with the industry to get the Affordable Care Act (ACA) passed but, as a result, the law largely worked under the infrastructure that was already in place. There are some signs of the industry’s influence waning, such as Congress’s success in <a href="https://www.vox.com/policy/2023/8/30/23850979/medicare-drug-price-negotiations-10-prescription-list">authorizing Medicare drug negotiations</a>, but its ability to sway Republicans and moderate Democrats will always be the most important vote-counting hurdle to any major restructuring getting passed.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2gHSCN">
The political headwinds are also strengthened by the second issue: the voters. I have sat in on <a href="https://www.vox.com/policy-and-politics/2018/2/8/16655796/democrats-medicare-for-all-clinton-voters-trump">focus groups about Medicare-for-all</a> with middle-of-the-road-ish voters who are in theory open to change. They may not love what they have now, but many of them like the idea of having choices and they are worried that they will somehow end up worse off if there is a big overhaul. I do think people find some of the theoretical benefits of Medicare-for-all appealing, but they can be swayed by arguments pointing out the potential downsides. And the truth is, for all its problems, there is a critical mass of people who are <a href="https://www.vox.com/policy/2023/10/16/23894085/health-insurance-open-enrollment-medical-dental-medicare-obamacare">just satisfied enough with the status quo</a>. Polling consistently finds Americans think poorly of the system as a whole but they are more positive about their own health coverage. That’s the paradox Medicare-for-all supporters have to solve.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wx5jfL">
So I think as long as those two factors hold true, it’s hard to imagine big changes happening. It’s certainly possible that things will deteriorate enough that the political environment will change. But who knows if we’ll ever reach that point.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="h6Wd6m">
<strong>Why is health care so political in the US?</strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6eCd11">
I don’t think the US is unique in having health care be a contentious issue. I traveled to other countries for <a href="https://www.vox.com/2020/1/13/21055327/everybody-covered">our Everybody Covered series</a> a few years ago and each of the places I visited had been through spirited health care debates. Protesters marched through the halls of the Taiwanese capital when <a href="https://www.vox.com/health-care/2020/1/13/21028702/medicare-for-all-taiwan-health-insurance">Taiwan</a> was considering its single-payer plan. <a href="https://vox.com/2020/1/15/21030568/australia-health-insurance-medicare?_ga=2.50113638.11709235.1698328032-533221487.1631628316&amp;_gl=1*1lx35us*_ga*NTMzMjIxNDg3LjE2MzE2MjgzMTY.*_ga_C3QZPB4GVE*MTY5ODMyNzk2Mi4zMjcuMS4xNjk4MzMwMTI3LjU1LjAuMA..">Australia</a> has seen its health care system swing wildly between the public and private sectors depending on which party was in power, before settling into a hybrid model. Doctors in <a href="https://vox.com/policy-and-politics/2020/1/17/21046874/netherlands-universal-health-insurance-private?_ga=2.50113638.11709235.1698328032-533221487.1631628316&amp;_gl=1*1lx35us*_ga*NTMzMjIxNDg3LjE2MzE2MjgzMTY.*_ga_C3QZPB4GVE*MTY5ODMyNzk2Mi4zMjcuMS4xNjk4MzMwMTI3LjU1LjAuMA..">the Netherlands</a> protested over working conditions in the early 2000s, leading to reforms to their sector.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Lu8oaI">
But I think the US health care discourse is distinct for one big reason. While those countries have difficult debates about health care and have seen big changes, they have reached a social consensus that universal health care is the goal. It’s just a question of how to achieve it. The US has never reached that kind of consensus. Even today, the two parties have very different views on that question. I think that’s why our health care debate can seem so divisive: because it’s over fundamental questions about what the government should be doing and its obligations to its citizens.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JQjMuD">
On top of that, you have a lot of money behind any health care debate. Health care is one of our economy’s biggest sectors and the various companies involved with it are willing to spend a lot of money whenever their interests are at stake.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="v55Ihz">
<strong>Something I’ve been wondering about is how much more accessible care for mental health has gotten, even though there’s a long way to go. When did mental health become more recognized/a more important part of health insurance?</strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4sNt64">
You’re right: We do still have a long way to go. A recent survey <a href="https://www.mhtari.org/Survey_Conducted_by_NORC.pdf">found</a> that 40 percent of patients who sought in-network mental health care had to make four or more calls to find a provider who would see them — compared to just 14 percent for physical health care. More than half of patients said they had had an insurance claim for mental health care denied three or more times, compared to about one-third who said they had the same experience with physical services.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uRVwNq">
But, to your point, that doesn’t mean we haven’t made progress. Insurers used to have no obligation to cover mental health care at all. The first mental health parity law was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950754/">passed in the late 1990s</a> as a kind of bipartisan consolation prize after Bill Clinton’s health care reform plan fizzled out. It was largely symbolic because the health insurance market was mostly unregulated at the time. Sometimes health insurers didn’t cover mental health care at all. On the individual market, health insurers would disqualify people from coverage if they had mental health needs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="n1CFYV">
In 2008, Congress took another pass at improving coverage for mental health services, attaching a bill to the must-pass financial bailout and establishing the rules that exist today. (The ACA then extended these requirements to insurance sold on the law’s insurance marketplaces.) The 2008 law said insurers couldn’t place unfair limits on mental health care. You couldn’t be limited to two mental health visits but permitted six doctor visits, for example. Patients couldn’t face higher out-of-pocket costs for mental health services.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8yzf8n">
In practice, though, it has been hard to enforce. Mental health providers may be in an insurance network, but that doesn’t mean they have availability to see new patients, to name one common problem. The Biden administration is taking new steps, 15 years after the law first passed, to<a href="https://www.vox.com/2023/8/4/23815827/mental-health-therapy-services-health-insurance"> try to force more compliance</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9tt6dm">
<strong>On behalf of my mother, I’d like to ask how best to determine if a Medicare Advantage plan serves her better than traditional Medicare. I know that the Advantage plans generally cover medical, prescription and some dental and that traditional Medicare does not cover prescriptions or dental and that she’d have to enroll in a Part D plan for prescriptions. Other seniors I know have told us to steer clear of Advantage plans due to losing benefits under medical.</strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tGcUge">
It’s funny you should ask. After our series published, I was sent a new online tool for Medicare plan shopping, by a Berkeley professor who sits on the company’s board. I can’t formally endorse it, of course, but I did mess around with it a bit as a hypothetical shopper and it seemed designed to help people compare different options. Healthpilot might be worth checking out: <a href="http://healthpilot.com/">http://healthpilot.com/</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zNLqUx">
The AARP has other resources that might be useful to <a href="https://www.aarp.org/health/medicare-insurance/info-2022/help-enrolling.html#:~:text=Medicare%20Rights%20Center,at%20800%2D333%2D4114.">people in this situation</a>. As Allie Volpe wrote for our series, in <a href="https://www.vox.com/even-better/23905148/health-insurance-obamacare-ppo-epo-premium-deductible-copay-cobra-explainer">a guide to picking your health plan</a>, there’s a lot of free assistance available to help people make open enrollment decisions.
</p></li>
<li><strong>Israeli troops are in Gaza: 7 big questions about the war, answered</strong> -
<figure>
<img alt="Smoke rises over buildings in Gaza City on October 9." src="https://cdn.vox-cdn.com/thumbor/uO5w5Wy00ykWEs11gvp6j3OdYTc=/289x0:4912x3467/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72741287/1715810722.0.jpg"/>
<figcaption>
Israel declared war on Hamas, one day after the Palestinian militant group conducted a brutal attack. Israel has already launched what it describes as one of its largest aerial bombardments ever on the Gaza Strip. | Sameh Rahmi/NurPhoto via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
What will “full” war between Israel and Hamas mean? And 6 other questions about the conflict.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0yuDmd">
<a href="https://www.vox.com/israel">Israel</a> has launched what appears to be a ground invasion of Gaza, after the<strong> </strong>worst outbreak of violence between it and Hamas in decades. The weeks-old conflict has already claimed over 9,000 lives as of Saturday, and likely will claim many more.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TUzqep">
“We moved to a new phase in the war,” <a href="https://www.cnn.com/middleeast/live-news/israel-hamas-war-gaza-news-10-28-23/h_3fc60f39fd2697cf54af4dc4179b3585">Israeli Defense Minister Yoav Gallant said in a statement in Hebrew on Saturday</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HEhnwE">
Over the previous 24 hours, Israel had expanded its air, sea, and ground assault on Gaza, amid a near-total internet and phone blackout in the territory. Israel has not yet explicitly called this an invasion, and the effort appears more limited than the full-scale one some experts expected. But Israel repeatedly signaled Friday and Saturday that this is a significant ground operation.<strong> </strong>Now, after heavy bombardment of the Palestinian territory, Israeli troops are actively fighting in Gaza.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3IaTMk">
It has been, according to one Palestinian who was able to post online, “<a href="https://www.nytimes.com/live/2023/10/28/world/israel-gaza-war-hamas-news/a50fd990-8933-5511-b5b7-a9f79d4becb8?smid=url-share">the worst night in the history of Gaza</a>.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5jpC5k">
This flare-up of the conflict began on October 7, when the armed wing of the Palestinian group Hamas launched a massive, complex, and well-coordinated attack on <a href="https://www.vox.com/israel">Israel</a> early on October 7 from the territory it controls in Gaza. Militants killed more than 1,400 people, including <a href="https://www.barrons.com/news/foreign-victims-of-deadly-hamas-attack-3ab899d7">at least 31 US citizens</a>; <a href="https://abcnews.go.com/International/timeline-surprise-rocket-attack-hamas-israel/story?id=103816006">wounded 4,500</a>; kidnapped over 220 people, <a href="https://www.cnn.com/2023/10/11/politics/american-hostages-israel-gaza-hamas/index.html">including US citizens</a> and many civilians; and fired rockets on Israeli civilians.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fJg6MT">
It was the most devastating and brutal assault Israel had suffered in decades; <a href="https://twitter.com/IDF/status/1711027540536471994">Israeli officials described it as their country’s 9/11</a>. The <a href="https://www.nytimes.com/2023/10/10/world/middleeast/israel-gaza-war-hamas-deaths-killings.html">horror of the attack</a> only became clearer in the days after, as reports of some — if not all — of the worst atrocities <a href="https://www.jpost.com/israel-news/defense-news/2023-10-12/live-updates-767856">were confirmed</a>. In recent days, the Israeli military shared videos and information with a select group of journalists about the extent of Hamas’s violence. It included <a href="https://www.theatlantic.com/ideas/archive/2023/10/why-israeli-officials-screened-footage-hamas-attack/675735/">grueling stories and imagery about families and children being targeted</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DjN4IJ">
In response to the October 7 attack, Israel <a href="https://apnews.com/live/israel-hamas-war-live-updates">officially declared war</a> against Hamas one day later. In the weeks since, the country has launched over 8,000 missiles on Gaza, declared a “full siege” of the territory it has blockaded for 16 years, and told Palestinians in the north of Gaza — where approximately 1.1 million people live — that they should relocate to the south. Only after US and international pressure did Israel allow <a href="https://www.ochaopt.org/content/hostilities-gaza-strip-and-israel-flash-update-21">a trickle of trucks with humanitarian aid to enter the country</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rCEBoc">
Thus far, over 7,700 Palestinians in Gaza have been killed and over 18,000 injured, <a href="https://www.nytimes.com/live/2023/10/28/world/israel-gaza-war-hamas-news/5212de6e-f785-590d-bf50-447a27bd9cf5?smid=url-share">according to the Gaza Health Ministry</a>. An <a href="https://www.ochaopt.org/content/hostilities-gaza-strip-and-israel-flash-update-21">estimated 1.4 million people are displaced</a>, with about half of them sheltering in United Nations-run facilities. Protests around the <a href="https://twitter.com/AhmedB100/status/1718237176192708936">world</a> calling for a ceasefire <a href="https://twitter.com/IfNotNowOrg/status/1718025990142624100">intensified Friday night</a>, and world leaders like UN <a href="https://x.com/antonioguterres/status/1718272688228290938?s=20">Secretary-General António Guterres</a> and the <a href="https://x.com/JosepBorrellF/status/1718268606843072981?s=20">EU’s top diplomat</a> made similar calls on Saturday.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fEArm7">
“Without a fundamental change, the people of Gaza will face an unprecedented avalanche of human suffering,” Guterres’s office said in online statement Friday.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AustyN">
Several countries, including <a href="https://www.nytimes.com/live/2023/10/08/world/israel-gaza-attack-hamas-news/egypt-and-jordan-are-trying-to-calm-the-conflict?smid=url-share">Egypt and Jordan</a>, have volunteered to try to defuse the situation diplomatically, and <a href="https://www.theguardian.com/world/2023/oct/28/qatars-peacemaking-ambitions-face-ultimate-test-in-crucible-of-israel-hamas-war">Qatar has been helping</a> <a href="https://twitter.com/alihashem_tv/status/1717887371612483830?s=20">lead negotiations</a> to secure the release of Hamas-held hostages and potentially deliver a temporary ceasefire.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TN4bFo">
The Biden administration stood immediately behind Israel after Hamas’s terrorist attack, promising <a href="https://apnews.com/live/israel-hamas-war-live-updates#0000018b-0fb5-d540-af9b-0ff50b270000">additional military support</a>, sending <a href="https://www.defense.gov/News/Releases/Release/Article/3551716/statement-from-secretary-lloyd-j-austin-iii-on-us-force-posture-changes-in-the/">several US warships</a> and aircraft squadrons into the Eastern Mediterranean, speaking vociferously on Israel’s behalf, and repeatedly visiting the country. The US has also <a href="https://www.washingtonpost.com/politics/2023/10/27/us-urging-israel-rethinkg-gaza-ground-invasion/">reportedly pushed Israel in private to consider avoiding a full-scale ground invasion</a> that would lead to high casualties and could draw in other regional actors.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0ifFdt">
Given the near-total communications blackout — and the Israeli military’s circumspection about its operations — it’s hard to know the extent of what’s currently happening in Gaza. A few reporters, <a href="https://aje.io/nw7juv?update=2444332">like those for Al Jazeera</a>, are occasionally able to provide updates via satellite.
</p>
<div class="c-float-right">
<div id="5xbTP2">
<div>
</div>
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TAyoqK">
We do know there were factors that likely contributed more immediately to this outbreak of violence — months of <a href="https://www.nytimes.com/live/2023/10/07/world/israel-gaza-attack/palestinians-israelis-recent-violence?smid=url-share">simmering conflict in Jerusalem and the West Bank over increased Israeli settlements</a>, a far-right Israeli government that has been conducting a <a href="https://foreignpolicy.com/2023/06/08/israel-palestine-west-bank-annexation-netanyahu-smotrich-far-right/">de facto annexation of the West Bank</a>, and <a href="https://www.vox.com/world-politics/2023/8/3/23817467/biden-israel-saudi-arabia-normalization-middle-east-policy">Arab states normalizing relations with Israel (including a new potential deal with Saudi Arabia)</a> — but also that it is a war decades in the making.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VuERN7">
Most Gazans are either refugees from the <a href="https://www.vox.com/videos/2023/5/15/23723947/palestine-nakba-may-15-protests-israel">1948 Nakba</a>, when mass numbers of Palestinians were displaced during the Arab-Israeli War, or descendants of those refugees, said Zaha Hassan, a human rights lawyer and fellow at the Carnegie Endowment for International Peace. They’ve lived under a strict blockade by Israel and Egypt since Hamas assumed control of the Gaza Strip in 2007, relying on foreign aid to access basic necessities. About one-third of Gazans live in extreme poverty, according to the <a href="https://www.pcbs.gov.ps/post.aspx?lang=en&amp;ItemID=3568">Palestinian Central Bureau of Statistics</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VlRGRm">
The international community has largely abandoned efforts to find a political solution to this crisis. Now there is likely to be a long, bloody battle causing significant deaths on both sides, with Palestinians set to bear the brunt of the casualties and destruction going forward.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cVmAeR">
Here’s what else you need to know.
</p>
<div id="sHsHhn">
</div>
<h3 id="66rNfy">
</h3>
<h3 id="HUDYll">
<ol type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">Where does the conflict currently stand?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CQDenh">
After a couple of days of fighting to secure its borders after the Hamas attack, and then weeks of heavy bombardment of Gaza, Israel recently ramped up its military operations against Hamas. First, it conducted <a href="https://www.vox.com/world-politics/2023/10/26/23933939/israel-gaza-hamas-limited-raid-ground-invasion-preparations">small, hours-long raids into Gaza</a> with tanks, and then on Friday night began its largest ground assault since October 7.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ruOwFU">
Troops and tanks entered Gaza; they remain actively fighting there today.<strong> </strong>Palestinian journalist <a href="https://www.youtube.com/watch?v=_nLTe_78D04&amp;t=2s">Hind Khoudary told <em>Tahrir Podcast</em></a><em> </em>that bombardment was continuous throughout the night.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="T50viX">
“Our forces are currently operating on the ground in the Gaza Strip,” <a href="https://twitter.com/IDF/status/1718293784725762312">Lt. Gen. Herzi Halevi said in a video posted Saturday afternoon to X</a>, the website formerly known as Twitter. “These activities are being supported by precise and heavy fire.” Hamas also confirmed that fighting was taking place in <a href="https://www.nytimes.com/live/2023/10/28/world/israel-gaza-war-hamas-news/d3c5d8eb-b922-5620-a708-589eb4b9bced?smid=url-share">at least two areas in northern Gaza</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6PeYPs">
These operations have turned Gaza into a “ball of fire,” Ashraf al-Qudra, a Gaza health ministry spokesperson, <a href="https://von.gov.ng/israeli-bombing-turns-gaza-into-a-ball-of-fire/">told reporters</a>. Over 300 people have been killed in designated safe zones, he added, and destruction is widespread. Already, Gaza was suffering <a href="https://press.un.org/en/2023/sc15462.doc.htm">a humanitarian crisis</a> because of the siege; hospitals were on the brink of collapse and people were drinking saline groundwater, <a href="https://press.un.org/en/2023/sc15462.doc.htm">according to a UN update</a>. The suffering is likely only to get worse.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SjnJ36">
Around the same time Israel launched its assault, landline, cellular, and internet communications out of Gaza went largely dark. While a few people with Israeli or international SIM cards, or those with satellite connections, were able to communicate or post online, most were not. That caused not just extreme anxiety for Palestinians inside Gaza weathering the bombardment and <a href="https://www.washingtonpost.com/world/2023/10/27/israel-war-hamas-gaza-news-palestine/#link-G6UFZRKYHNHXFI5H4P57YLLLH4">those outside trying unsuccessfully to confirm the safety of their family members</a>, but also undermined emergency and humanitarian efforts. Groups like the <a href="https://www.washingtonpost.com/world/2023/10/27/israel-war-hamas-gaza-news-palestine/#link-5UFFHYCYNZEBHAA6W6YOJA7MUU">International Committee of the Red Cross and the World Health Organization</a> said they had lost contact with teams on the ground. The WHO <a href="https://twitter.com/DrTedros/status/1718160325323735365?s=20">said on X, </a>the site formerly known as Twitter, that lack of telecommunications was “making it impossible for ambulances to reach the injured.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pxPCPZ">
Experts previously told Vox that the weeks’ small raids were likely intended to gather intelligence about Hamas and disrupt its command communications, in addition to taking out targets as the IDF claimed on social media — all in preparation for a much larger incursion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6MLkN6">
<s></s>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cp3nFG">
Israel has not explicitly framed this as a full-scale ground invasion, nor is it clear whether the IDF is attempting to seize and control territory or not.<strong> </strong>Such an operation would be highly fraught for the Israel Defense Forces, which will have to contend with chaotic fighting on Gaza’s dense streets. Prime Minister Benjamin Netanyahu has been reluctant to put boots on the ground in Gaza since Israel formally withdrew troops in 2005 after 38 years of occupation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KT9Snt">
But there are<strong> </strong>indications that the weekend’s offensive might not be the extent of things. Halevi’s video Saturday said that “the objectives of this war require a ground operation.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lMl3t1">
“This is a war with multiple stages; today we move on to the next one,” he said. He described the IDF’s objectives as “dismantling Hamas, securing our borders, and the supreme effort to return the hostages home.”
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/6QLUBhU50JeExqpa1C2Sp2p1NCU=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24992992/1716395855.jpg"/> <cite>Jack Guez/AFP via Getty Images</cite>
<figcaption>
As part of Hamas’s initial attack, it launched rockets into Israel on October 7. A man is seen here walking next to a car destroyed by one of those rockets in the southern Israeli city of Ashkelon.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aAzQqr">
To those ends, Saturday, <a href="https://twitter.com/IDF/status/1718240244129059167">the IDF posted a video on X</a> urging “all residents of northern Gaza and Gaza City to relocate south immediately” to avoid “intense hostilities” — a message in English to an Arabic-speaking population it seemed unlikely they’d be able to even receive, given the extremely limited telecommunications.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="my9rGS">
It’s unclear what this means for the fate of the over 200 Israeli civilian and military hostages that Hamas and Palestinian Islamic Jihad militants are holding. There had been <a href="https://www.cnn.com/2023/10/27/middleeast/hostages-qatar-negotiations-intl/index.html">hope earlier Friday that the Qatari-led negotiations were progressing well</a>, and some analysts argue that Israel’s current operation could be designed to put pressure on Hamas to make concessions in those negotiations. But much remains in flux.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qr9h1u">
<em>—Ellen Ioanes</em>
</p>
<h3 id="H4185C">
<ol start="2" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">What do I need to understand about Gaza and Israel’s relationship to understand today?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qZw6gB">
Palestinians living in Gaza and Israelis have always been deeply connected.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UqKQ5W">
With Israel’s victory in the 1967 War, it conquered Gaza and became an occupying power overseeing the Palestinians living there. (Egypt had controlled the territory from 1948 to 1967.) Israel had not always so severely fenced off Gaza from the rest of the world or blockaded flows in and out of it. For several decades, Palestinians from Gaza <a href="https://www.palestine-studies.org/en/node/41127">worked in the Israeli economy</a>. Starting in 1970, Israel <a href="https://conquer-and-divide.btselem.org/map-en.html">established settlements</a> in the territory and military installations. Israel <a href="https://www.btselem.org/gaza-strip/gaza-strip-background#:~:text=In%20September%202005%2C%20Israel%20completed,the%20army%20from%20the%20Strip.">restricted most Palestinians’ movement</a> in and out of Gaza from the onset of the Second Intifada, or uprising, in 2000.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6eKMQe">
Israel <a href="https://www.reuters.com/world/middle-east/conflict-between-israel-palestinians-gaza-2023-10-07/">withdrew</a> its <a href="https://features.gisha.org/ten-years-later/">security forces and settlements</a> from Gaza in 2005, but the territory nevertheless has remained effectively under Israeli occupation. Hamas won legislative elections in 2006, and amid a violent split with the Fatah-run Palestinian Authority in the occupied West Bank, the Islamist movement assumed control of the territory the next year. Israel has <a href="https://www.ochaopt.org/content/movement-and-out-gaza-update-covering-august-2023">blockaded</a> the territory since. The more than 2 million people in Gaza live in what human rights groups have called an “<a href="https://www.hrw.org/news/2022/06/14/gaza-israels-open-air-prison-15">open-air prison</a>.” The territory’s airspace, borders, and sea are under Israeli control, and neighboring Egypt to the south has also imposed severe restrictions on movement.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6HfeN9">
<a href="https://www.ochaopt.org/page/gaza-strip-critical-humanitarian-indicators">The United Nations</a> describes the occupied territory as a “chronic humanitarian crisis.”
</p>
<div class="c-float-right">
<figure class="e-image">
<img alt="Map showing the Gaza strip, Israel, and the West Bank." src="https://cdn.vox-cdn.com/thumbor/vQD4Sqd6yF7G8l-zqEoXXrZROIg=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24992959/gX1cC_the_gaza_strip_final_10_10__1_.png"/>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FCEXCy">
“This pressure being put on Palestinians — it just assumes that they’re insignificant and they will tolerate any degree of humiliation, and that’s just not true,” said Rashid Khalidi, the Columbia University historian.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sCXnsz">
Israel has launched intense military operations on the densely populated territory <a href="https://www.aljazeera.com/news/2022/8/7/timeline-israels-attacks-on-gaza-since-2005">many times</a> over the past decade and a half in response to rocket attacks from Palestinian militants. The Israeli military has called it “<a href="https://www.washingtonpost.com/world/2021/05/14/israel-gaza-history/">mowing the grass</a>”: a tactic of conducting semi-regular attacks on alleged terrorist cells to take out leaders and new militant groups, which also kill noncombatants and destroy civilian infrastructure in the process. But <a href="https://www.lrb.co.uk/the-paper/v36/n15/mouin-rabbani/israel-mows-the-lawn">mowing the lawn</a> almost by definition does not address the root causes of terrorism but only reduces the level of Hamas’s violence temporarily and perpetuates an escalating cycle of violence. Experts say that there is no military solution to the political problem posed by Hamas.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lAqzWa">
Hamas’s wanton violence does not by any means represent the views of all Palestinians. A survey of Palestinians from this summer showed that if legislative elections were held for the first time since 2006, about 44 percent of Gazan voters would <a href="https://www.pcpsr.org/sites/default/files/Poll%2088%20English%20full%20text%20June%202023.pdf">choose</a> Hamas. But there has been no opportunity for elections, and so in addition to Israeli military action, Palestinians living in Gaza must endure an unrepresentative government that imposes some Islamic tenets, implements <a href="https://www.palestine-studies.org/en/node/232088">repressive policies</a> against <a href="https://www.vox.com/lgbtq">LGBTQ</a> people, and uses <a href="https://www.hrw.org/news/2022/06/30/palestine-impunity-arbitrary-arrests-torture">abusive policies</a> against detainees.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sUJVAz">
Even as the situation for Palestinians living in Gaza has gotten worse in the past 15 years, less and less attention from world leaders and US administrations has been paid to it. Yet the cause of Palestine — to secure an independent, sovereign, and viable state — continues to galvanize grassroots support in the<strong> </strong>Arab Middle East and the Muslim world.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PLWHi6">
<em>—Jonathan Guyer</em>
</p>
<h3 id="0lOyzB">
<ol start="3" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">But why did Hamas launch such a huge attack on October 7?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vuXV4K">
According to Hamas itself, the attack was provoked by recent events surrounding the Temple Mount, a site in Jerusalem holy to Jews and Muslims alike. <a href="https://www.aljazeera.com/news/2023/10/4/israeli-settlers-storm-al-aqsa-mosque-complex-on-fifth-day-of-sukkot">Earlier this month</a>,<strong> </strong>Israeli settlers had been entering the al-Aqsa Mosque atop the mount and praying, which Hamas termed “<a href="https://www.timesofisrael.com/hamas-commander-says-attacks-are-in-defense-of-al-aqsa-claims-5000-missiles-fired/">desecration</a>” in a statement on their offensive (which they’ve named Operation Al-Aqsa Storm).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Dl7Alg">
It’s implausible, to put it mildly, that Hamas was simply outraged by these events and is acting accordingly. This kind of complex operation had to be months in the making; Hamas sources have <a href="https://twitter.com/elgindy_/status/1710840246965858520?s=46&amp;t=Q0DWAgZoZiCSO36rUfhY6A">confirmed as much to Reuters</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RU9zhw">
But at the same time, Hamas’s choice of casus belli does tell us something important.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mWoOqS">
Palestinian politics is defined, in large part, by how its leadership responds to Israel’s continued occupation — both its physical presence in the West Bank and its economically devastating blockade of the Gaza Strip. Hamas’s strategy to outcompete its rivals, including the Fatah faction currently in charge of the West Bank, is to channel Palestinian rage at their suffering: to be the authentic voice of resistance to Israel and the occupation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IBVEk3">
And the past few months have seen plenty of outrages, ones even more significant than events in Jerusalem. Israel’s current hard-right government, dominated by factions that oppose a peace agreement with the Palestinians, has been conducting a <a href="https://foreignpolicy.com/2023/06/08/israel-palestine-west-bank-annexation-netanyahu-smotrich-far-right/">de facto annexation of the West Bank</a>. It has ignored settler violence against West Bank civilians, including <a href="https://www.cnn.com/2023/06/15/middleeast/huwara-west-bank-settler-attack-cmd-intl/index.html">a February rampage in the town of Huwara</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ulLAIV">
Israel’s focus on the West Bank may also have created an operational opportunity for Hamas. According to <a href="https://twitter.com/GONENB1/status/1710568015396270226">Uzi Ben Yitzhak</a>, a retired Israeli general, the Israeli government had deployed most of the regular IDF forces to the West Bank to manage the situation there — leaving only a skeleton force at the Gaza border and creating conditions where a Hamas surprise attack could succeed.
</p>
<div id="hdN4ao">
<div class="volume-video" id="volume-placement-884">
</div></div></li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Q51RzL">
There are also geopolitical concerns at work, with <a href="https://twitter.com/elgindy_/status/1710840246965858520?s=46&amp;t=Q0DWAgZoZiCSO36rUfhY6A">some experts arguing</a> this was intended to fundamentally shift how the world approaches Israeli-Palestinian<strong> </strong>relations.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EEk9Pz">
Israel is currently in the midst of a US-brokered negotiation <a href="https://www.vox.com/world-politics/2023/8/3/23817467/biden-israel-saudi-arabia-normalization-middle-east-policy">to normalize relations with Saudi Arabia</a>, a major follow-up to the <a href="https://www.vox.com/2021/5/13/22434142/israel-gaza-hamas-war-trump-biden-abraham-accords">Abraham Accord agreements</a> struck with several Arab countries during the <a href="https://www.vox.com/trump-administration">Trump administration</a>. Normalization is widely seen among Palestinians as the Arab world giving up on them, agreeing to treat Israel like a normal country even as the occupation deepens. Hamas could well be trying to torpedo the Saudi deal and even trying to undo the existing Abraham Accords. Indeed, a Hamas spokesperson said that the attack was “<a href="https://twitter.com/amberinzaman/status/1710583193466790254">a message</a>” to Arab countries, calling on them to cut ties with Israel. (It’s worth noting that planning for an attack this complex very likely began well before the Saudi negotiations heated up.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XUdRTJ">
Together, these are all conditions in which it makes more strategic sense for Hamas to take such a huge risk.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MGLw4v">
To be clear: Saying it makes <em>strategic </em>sense for Hamas to engage in atrocities is not to justify their killing of civilians. There is a difference between explanation and justification: The reasoning behind Hamas’s attack may be explicable even as it is morally indefensible.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XyvKNt">
We’ll find out more in the coming weeks and months about which, if any, of these conditions proved decisive in Hamas’s calculus. But they’re the necessary background context to even try to begin making sense of this week’s horrific events.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5aKujt">
<em>—Zack Beauchamp</em>
</p>
<h3 id="eLJYwe">
<ol start="4" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">How did this become an outright war, worse than we’ve seen in decades?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nFwTXS">
Hamas’s attack was well-coordinated, massive in scale, included an unprecedented incursion into Israeli territory, and managed to evade the Israeli security apparatus, which is why it was so surprising — and able to inflict so much carnage.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lHwoJi">
“The Israelis pride themselves on having world-class intelligence, with the Mossad, with Shin Bet, with Israeli military intelligence,” Colin Clarke, director of research at the Soufan Group, a global intelligence and security consultancy, told Vox. “They do — from the most exquisite human sources to the most capable technical intelligence gathering capabilities [including] cyber and signals intelligence.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nkRUrB">
As explained above, there are both longstanding and immediate reasons a conflict of some sort was likely.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cm4YzP">
“The message has been clear to Palestinians,” Hassan said. “They can’t wait on some Arab savior and they can’t wait on the US government to act as peace broker — that they’re going to have to take matters into their own hands, whatever that looks like.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lHHt4p">
But the sheer brutality and devastation has been a shock to Israeli society. Rhetoric from Netanyahu and the IDF has reflected the “vengeance,” as Natan Sachs, director of the Center for Middle East Policy at the Brookings Institution, characterized it, that Israeli society is feeling in the wake of the devastating attack.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Sdd5AG">
“In a way, this is our 9/11,” IDF spokesperson Lt. Col. Richard Hecht <a href="https://twitter.com/IDF/status/1711027540536471994">said in a video statement posted to the social network X</a> on October 8. Videos have circulated showing dead Israelis, as well as Israeli civilians being captured by Hamas militants, presumably to be held in Gaza. Israel’s briefing to journalists earlier this week included videos that showed what <a href="https://www.theatlantic.com/ideas/archive/2023/10/why-israeli-officials-screened-footage-hamas-attack/675735/">the Atlantic’s Graeme Wood described</a> as “an eagerness to kill nearly matched by eagerness to disfigure the bodies of the victims.” Though Israeli towns near the Gaza border are now under IDF control, the <a href="https://www.nytimes.com/2023/10/10/world/middleeast/israel-gaza-war-hamas-deaths-killings.html">full understanding of the horror of the Hamas attack</a> continues to grow, with all but a few of the hostages remaining in captivity and <a href="https://twitter.com/IDF/status/1710784783381393515">some presumed dead</a>. Hamas had previously threatened to execute captive Israelis if IDF operations strike civilian targets in Gaza without warning, <a href="https://apnews.com/article/israel-palestinians-gaza-hamas-airstrikes-hostages-4377e096f62bf535bebcdff38cf16049">the Associated Press reported</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FnieMm">
Netanyahu <a href="https://www.cnn.com/2023/10/08/middleeast/israel-gaza-attack-hostages-response-intl-hnk/index.html">formally declared war on Hamas</a> one day after the attack. That <a href="https://www.nytimes.com/live/2023/10/11/world/israel-news-hamas-war/israels-new-unity-government-brings-in-opposition-figures-with-military-know-how?smid=url-share">war effort will be governed by a small “war management cabinet</a>” composed of Netanyahu, Defense Minister Yoav Gallant, and Benny Gantz, the leader of the opposition National Unity party who joined Netanyahu in an <a href="https://www.wsj.com/world/middle-east/israels-netanyahu-forms-unity-government-to-direct-war-2cbf4c3d">emergency unity government Wednesday</a>. Gadi Eizenkot, another former army chief, <a href="https://www.nytimes.com/live/2023/10/11/world/israel-news-hamas-war">will join the broader security cabinet</a>, potentially instilling more trust in a government that has widely been seen to have failed at its most important task: to keep Israelis safe.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sD5iPC">
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9mNdQY">
<em>—EI</em>
</p>
<h3 id="nn3wTn">
<ol start="5" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">What will declared war mean?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="60EQ9y">
No one knows how this war will play out. But given Israel’s highly advanced military, its response to Hamas’s attack will be massive and devastating in turn.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UalGzP">
That’s what Israel has been indicating since the beginning: On October 9, Netanyahu vowed to <a href="https://www.cnn.com/2023/10/09/middleeast/israel-gaza-hamas-fighting-monday-intl-hnk/index.html">attack Hamas with a force “like never before”</a> and has <a href="https://www.indiablooms.com/world-details/F/40601/israeli-pm-netanyahu-vows-to-decimate-every-hamas-member.html">vowed</a> to kill every member of the group. The same day, Israel said it would place Gaza under a “complete siege,” and announced it called up <a href="https://www.reuters.com/world/middle-east/israel-drafts-300000-reservists-it-goes-offensive-2023-10-09/#:~:text=Hagari%20said%20300%2C000%20reservists%20have,are%20going%20on%20the%20offensive.%22">300,000 military reservists</a>, a number that’s now grown by 60,000.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8BvU1u">
“I ordered a complete siege on Gaza. We are fighting human animals, and we act accordingly,” Gallant said. “As of now, no electricity, no food, no fuel for Gaza.”
</p>
<figure class="e-image">
<img alt="A man stands in the left side of the frame in front of a building that has a crater in the upper left side of it. There is rubble everywhere." src="https://cdn.vox-cdn.com/thumbor/YuznyvN02UqJqrTYwPjbtts_ayw=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24993035/1728019875.jpg"/> <cite>Ahmad Hasaballah/Getty Images</cite>
<figcaption>
Buildings damaged and destroyed by Israeli airstrikes on October 10, 2023, in Gaza City.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GzlLBp">
But Gaza has been described as effectively living under siege since 2007, as documented by <a href="https://news.un.org/en/story/2020/11/1078532">United Nations experts</a>, journalists, and human rights researchers.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="otZsO8">
What will change is the scale of violence: It has already exceeded the most recent severe conflict<strong> </strong>between Israel and Hamas in 2021, and is likely to get much worse.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EvXX6v">
Already, Israel has launched what it describes as <a href="https://www.aljazeera.com/news/liveblog/2023/10/9/israel-hamas-war-live-news-israel-orders-complete-siege-of-gaza-strip">one of its largest aerial bombardments ever</a> on Gaza. Now, we are beginning to see ground operations, which will likely lead to many more deaths, including fighters on each side. Hamas <a href="https://www.nytimes.com/2023/10/28/us/politics/gazas-tunnels-israel-ground-war.html">has an extensive tunnel network</a> that will complicate any Israeli ground effort.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QtYRNP">
The largest number of casualties, though, will likely be Palestinian civilians. Thousands more could die, according to a warning from the UN human rights chief.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BmA7D6">
In 2014, after Hamas conducted a major rocket offensive into Israel, the country responded with a 19-day ground invasion before a ceasefire was reached. During that time, 2,251 Palestinians — including 1,462 civilians — and 73 Israelis were killed in the fighting, according to the <a href="https://www.ochaopt.org/content/key-figures-2014-hostilities">UN Office for the Coordination of Humanitarian Affairs</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MsqH70">
Relations between Israel and Palestinians have always been asymmetrical: Israel, an undeclared nuclear power, has received tens of billions of dollars of US military aid. On October 7, Hamas ruptured Israeli society with wanton violence and mass killing. But it is the Israeli state that retains the capacity to perpetuate an all-out war on the Gaza Strip. Israel has often responded <a href="https://www.alhaq.org/advocacy/20394.html">disproportionately</a> to suicide bombings and rocket attacks from Hamas, partially as a deterrent strategy. The result, however, is an intensity of violence in an occupied territory where residents have nowhere to run, and where civilians are regularly killed in Israel’s assaults on Hamas targets.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6kl1sF">
<em>—JG</em>
</p>
<h3 id="v8R4Dr">
<ol start="6" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">How is the US responding?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ALlxnA">
Biden and Netanyahu’s relationship had grown strained <a href="https://www.politico.com/news/2023/10/07/why-biden-has-no-alternative-to-netanyahu-00120494">over the Israeli leader’s rightward drift and recent judicial overhaul</a> — but after the attack, the US is standing firmly behind its closest ally in the Middle East.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TDikQv">
“In this moment of tragedy, I want to say to them and to the world and to terrorists everywhere that the United States stands with Israel,” Biden said the day of the attack. Several days later, after his third phone call with Netanyahu, he again denounced the “pure, unadulterated evil” of Hamas’s attack on civilians; he and several high-ranking officials also visited Israel and promised America’s support.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7cCQCK">
The US pledged to <a href="https://www.politico.com/news/2023/10/08/biden-major-weapons-transfer-israel-00120520">send additional military materiel</a>, “including munitions,” according to <a href="https://www.defense.gov/News/Releases/Release/Article/3551716/statement-from-secretary-lloyd-j-austin-iii-on-us-force-posture-changes-in-the/">a news release from the Department of Defense</a>, with the first tranche of security assistance already landed in Israel.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8PpbDI">
In addition to the materiel support, <a href="https://www.defense.gov/News/Releases/Release/Article/3557560/statement-from-secretary-of-defense-lloyd-j-austin-iii-on-deployment-of-uss-eis/">two carrier strike groups</a>, each consisting of an aircraft carrier and multiple guided missile destroyers, along with numerous fighter aircraft squadrons have been deployed to the Eastern Mediterranean to deter other actors like <a href="https://www.vox.com/iran">Iran</a> or Hezbollah. However, National Security Council spokesperson John Kirby said in a briefing on October 10, “There’s no intention to put US boots on the ground.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="b0PkBq">
Some human rights and Middle East experts have <a href="https://twitter.com/elgindy_/status/1711080657206563026">criticized US officials for not also prioritizing de-escalation in their public statements,</a> or for not emphasizing the need to avoid further civilian casualties, particularly given the massive civilian casualties Palestinians have endured during previous rounds of violence.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S5cQxF">
In recent weeks, the US’s comments on this have <a href="https://www.vox.com/2023/10/18/23923313/biden-visits-israel-netanyahu-palestine-state-gaza-diplomacy-ceasefire">started to modulate just a little</a>; in Israel Biden said clearly that “we mourn the loss of innocent Palestinian lives” and pledged some humanitarian aid.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="s6I2i8">
In private, US officials have also pushed the Israeli government to slow its planning — particularly to consider its long-term goals and the risks of potential occupation of Gaza. Those efforts reportedly <a href="https://www.washingtonpost.com/politics/2023/10/27/us-urging-israel-rethinkg-gaza-ground-invasion/">even included advocating for a narrower, targeted offensive</a>, rather than a full-scale ground invasion. It’s not clear how much that has affected Israeli officials. On Friday, US National Security Council spokesperson John Kirby attempted to implicitly distance the US from Israel’s operations, saying that while the US is offering military advice, Israel is in the lead.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="axbd5V">
“They have to drive the strategy that they have developed, operationally and then tactically,” <a href="https://www.washingtonpost.com/world/2023/10/27/israel-war-hamas-gaza-news-palestine/#link-NUQHWIHXZJB7ZE4X7TWCQLHO3I">he said</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="biOV1B">
<em>—EI</em>
</p>
<h3 id="jxjqJu">
<ol start="7" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">What does this mean for the region — and world?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Myfwqe">
One of the largest questions going forward is whether this outbreak of violence draws in other countries or groups.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mZ2gDz">
The US defense posture, for instance, seems to anticipate escalation from Iran and Hezbollah, the Shia militant group based in southern Lebanon. US statements have explicitly warned other countries from “looking at this as a chance to take advantage” of Israel’s vulnerability, Kirby said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jBCreL">
Though there is speculation about Iranian and Hezbollah involvement in the operation, there are no concrete details linking them yet. Generally, “Iran has played a major role in helping Hamas with its rocket and missile programs, and mortar programs,” Daniel Byman, a senior fellow at the Center for Strategic and International Studies, told Vox. And Iran and Hezbollah also provide funding, training, and intelligence to Hamas fighters, all of which could have contributed to last week’s attack, both Byman and Clarke said. The <a href="https://www.wsj.com/world/middle-east/hamas-fighters-trained-in-iran-before-oct-7-attacks-e2a8dbb9">Wall Street Journal</a> reported earlier this week that Hamas fighters trained in Iran in September.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BH5TeK">
But so far, there is minimal to no corroborated evidence linking Iran to the planning of this attack. The country is walking a delicate line around the conflict — <a href="https://www.reuters.com/world/middle-east/irans-quandary-how-stay-out-israels-war-hamas-2023-10-22/">Reuters reported</a> its leaders are trying to support Hamas and Hezbollah and condemn Israel’s actions, while avoiding being drawn into outright conflict itself.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BEDo57">
Hezbollah initially started firing rockets and guided missiles into Shebaa Farms, <a href="https://www.reuters.com/world/middle-east/hezbollah-says-it-attacked-five-israeli-outposts-disputed-shebaa-farms-area-2023-10-14/">territory Israel captured from Lebanon during the 1967 War</a>; the militant group and Israel have continued to exchange heavy rocket fire throughout the month. “Our history, our guns, and our rockets are with you,” Hashem Safieddine, a senior Hezbollah official, said at an event outside of Beirut earlier this month, describing Hezbollah as “in solidarity” with the Palestinian people, <a href="https://www.reuters.com/world/middle-east/israel-strikes-lebanon-after-hezbollah-hits-shebaa-farms-2023-10-08/">Reuters reported</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5K3nxc">
Though there is little indication of a bigger regional conflagration as of yet, it remains a possibility that other Arab nations could become involved — or that efforts to normalize relations between those nations, particularly Saudi Arabia, and Israel could be derailed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jhx3t7">
On Friday, October 27, the United Nations General Assembly overwhelmingly passed a resolution calling for “<a href="https://www.youtube.com/watch?v=W9wAZVTlAZM">an immediate, durable and sustained humanitarian truce</a>.” While 120 countries voted in favor of it, only the US, Israel, and a dozen other countries actively dissented (45 countries abstained). Though UNGA resolutions hold important political weight, they carry no real enforcement mechanisms.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="g0IcEE">
As the conflict looks set to continue, there is only one sure thing: The suffering will continue without significant international effort behind a political solution.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jxt3nU">
<em>—EI</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6AtH2V">
<em><strong>Update, October 28, 1:55 pm ET: </strong></em><em>This story, originally published October 10, has been updated three times, most recently with information about Israel’s ground incursion.</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gUSr1o">
</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>Women’s Asian Champions Trophy 2023 | Table toppers India to take on Asian Games champions China on October 30</strong> - India will have a chance to reassert its status as the top-ranked side in the competition</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>IND vs ENG | England win toss, elect to bowl</strong> - India is playing the same 11 that played the match against New Zealand; England too did not make any changes from the eleven that they fielded against Sri Lanka</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Cricket World Cup 2023, IND vs ENG | India sitting pretty with all departments working in sync</strong> - Their party has not just taken off with New Zealand beating them handsomely in the first game of the tournament and then Afghanistan and Sri Lanka also pouring cold water on their dreams of advancing to the knockouts</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>Shakib admits 2023 is Bangladesh’s ’worst ever’ World Cup campaign</strong> - Chasing a small target of 230 runs against Netherlands on October 28, Bangladesh folded inside 43 overs, managing a mere 142 to see their World Cup campaign as good as over</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>Travis Head waited years to open for Australia, wants to make the most of it</strong> - Head, who started opening six years after his 2016 One Day International (ODI) debut, set the tone for the highest-scoring match in World Cup history by hitting 109 off 67 balls</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>Lorry carrying limestone gutted in Chittoor district of Andhra Pradesh</strong> - An electric short-circuit led to flames which engulfed the vehicle at Moghili ghat on the Chittoor-Bengaluru National Highway in the early hours of October 29</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>Tejashwi urges Bihari diaspora in Japan to promote State’s tourism</strong> - A new tourism policy is being planned along with a new IT policy to facilitate the development of the IT sector in Bihar, the Deputy CM said on a visit to the Japan Tourism Expo</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>Kalamssery bomb blast probe takes a startling turn with a former evangelist claiming responsibility</strong> - It seemed that one aspect of the police probe had pivoted towards the inner workings of the almost cult-like religious organisation with a significant presence in Kerala</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>Clean air during Durga Puja, but Kolkata AQI backslides as winter approaches</strong> - The analysis of AQI during the festive season shows the effectiveness of traffic regulations and promoting public transport in improving air quality</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>‘More organised’ BJP eyes entry in Mizoram government</strong> - The BJP has not ruled out the regional Zoram People’s Movement as a possible ally if no party attains a majority in the 40-member Assembly</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>Princess Leonor of Spain’s royal profile rises as she turns 18</strong> - Princess Leonor of Spain’s birthday is on Tuesday, prompting talk of what sort of royal she will be.</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>Moment Czech president knocks soldier’s hat off by striking him with flagpole</strong> - The officer later received an apology from President Petr Pavel who “simply underestimated the weight.”</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>Searching for our grandfathers’ skulls in a German museum</strong> - Descendants of 19 men hanged 123 years ago have spent decades searching for their remains.</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>Spanish Church sexual abuse affected 200,000 children, commission finds</strong> - The country’s first in-depth public inquiry into abuse linked to the Catholic Church presents its findings.</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 hikes interest rates to 15% as inflation soars</strong> - The Bank of Russia raises rates more than expected to try to lower inflation and boost the rouble.</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>Android 14 review: There’s always next year</strong> - Android 14 offers a lightly customizable lock screen and not much else. - <a href="https://arstechnica.com/?p=1954547">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Where the heck did all those structures inside complex cells come from?</strong> - There are competing theories about the origin of the nucleus and endoplasmic reticulum. - <a href="https://arstechnica.com/?p=1979428">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The UK’s problematic Online Safety Act is now law</strong> - The government says it will protect kids online; critics say it’s a threat to privacy. - <a href="https://arstechnica.com/?p=1979426">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Jeff Bezos shows off new Moon lander design for NASA</strong> - “We’re building our landers to enable global landing capability on the Moon, day or night.” - <a href="https://arstechnica.com/?p=1979493">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>This is how we could possibly build paved roads on the Moon</strong> - Lasers melt a regolith-like material into pavers that could be used for lunar roads. - <a href="https://arstechnica.com/?p=1979398">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The priest angrily asks the altar boy standing two meters away,</strong> - <!-- SC_OFF --></p>
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“Are you secretly drinking the holy wine?”
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The altar boy remains silent. The priest’s anger grows.
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“I’m asking you! Can’t you hear me?”
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“No, I can’t hear anything from here, Father.”
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“What do you mean? You’re just two steps away and you can’t hear me?”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The altar boy smirks,
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Why don’t we switch places and you’ll see…”
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They swap places. Now the altar boy asks,
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Who’s embezzling the church donations?”
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The priest mutters,
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“You know what? You’re right! You really can’t hear anything from here.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/MisterrNo"> /u/MisterrNo </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17iuhyt/the_priest_angrily_asks_the_altar_boy_standing/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17iuhyt/the_priest_angrily_asks_the_altar_boy_standing/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Turk, a Frenchman, and an Englishman are traveling on a train.</strong> - <!-- SC_OFF --></p>
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The compartment gets warm, so the Frenchman opens the window and a fly buzzes in. Wanting to show off, the Frenchman swiftly draws his sword and with one strike, the fly is split in half. As the others look on in amazement, the Frenchman hands out his business card, which reads: “France’s Best Swordsman.”
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Seeing this, the Englishman opens the window and lets another fly in. He quickly pulls out an arrow, shoots, and the fly sticks to the wall, dead. He then gives out his business card, which proclaims him as “England’s Best Archer.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Not wanting to be outdone, the Turk opens the window and lets in another fly. He takes out a small knife and throws it at the fly. The fly falls, but after a few seconds, it gets up and flies away. The Englishman and Frenchman burst into laughter. Unfazed, the Turk hands them his business card. It reads: “Remzi, Professional Circumciser.”
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/MisterrNo"> /u/MisterrNo </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17iub9t/a_turk_a_frenchman_and_an_englishman_are/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17iub9t/a_turk_a_frenchman_and_an_englishman_are/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>An economics professor was walking with a student</strong> - <!-- SC_OFF --></p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
when the student looked down and said, “Look! A $50 bill!” The professor explained, “That can’t be true. If it were a $50 bill someone would have already picked it up.”
</p>
</div>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Mekroval"> /u/Mekroval </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17ipsb2/an_economics_professor_was_walking_with_a_student/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17ipsb2/an_economics_professor_was_walking_with_a_student/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A blonde rents a stadium and hosts a event to prove that blondes aren’t dumb</strong> - <!-- SC_OFF --></p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
80,000 blondes show up in the crowd at the lead blonde invites one of the blondes to the stage and asks her a math question. “What’s 2x20?” The lead blonde asks. After thinking for a bit the blonde responds “11?”. The entire crowd starts chanting “give her another chance!”. The lead blonde asked another a question, what’s 4x5?. After thinking for a bit the blonde responded “65?”. The entire crowd changed again “give her another chance. The lead blonde gave her a easy one this time, “whats 2 plus 2?” After thinking the blonde responded “4?”. The crowd chanted “give her another chance!”
</p>
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<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/BuffTF2"> /u/BuffTF2 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17j0oyk/a_blonde_rents_a_stadium_and_hosts_a_event_to/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17j0oyk/a_blonde_rents_a_stadium_and_hosts_a_event_to/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What’s the only thing vegans are allowed to kill?</strong> - <!-- SC_OFF --></p>
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The conversation,
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/MoBhollix"> /u/MoBhollix </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17ijrhh/whats_the_only_thing_vegans_are_allowed_to_kill/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17ijrhh/whats_the_only_thing_vegans_are_allowed_to_kill/">[comments]</a></span></p></li>
</ul>
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