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<title>19 November, 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>Impact of State Telehealth Parity Laws for Private Payers on Hypertension Management before and during the COVID-19 Pandemic</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
BACKGROUND: Telehealth has emerged as an effective tool for managing common chronic conditions such as hypertension, especially during the COVID-19 pandemic. However, the impact of state telehealth payment and coverage parity laws on hypertension management remains uncertain. METHODS: Data from the MerativeTM MarketScan® Commercial Claims and Encounters Database from January 1, 2016 to December 31, 2021 were used to construct the study cohort. The sample included non-pregnant individuals aged 25?64 years with hypertension. We reviewed and coded telehealth parity laws related to hypertension management in all 50 states and the District of Columbia, distinguishing between payment parity laws and coverage parity laws. The primary outcomes were antihypertension medication use, measured by the average medication possession ratio (MPR), medication adherence (MPR ?80%), and average number of days of drug supply. We used a generalized difference-in-difference (DID) design to examine the impact of these laws. Results were presented as marginal effects and 95% confidence intervals (CI). RESULTS: Among 353,220 individuals, states with payment parity laws were significantly linked to increased average MPR by 0.43 percentage point (95% CI: 0.07 - 0.79), and an increase of 0.46 percentage point (95% CI: 0.06 - 0.92) in the probability of medication adherence. Payment parity laws also led to an average increase of 2.14 days (95% CI: 0.11 - 4.17) in antihypertensive drug supply, after controlling for state-fixed effects, year-fixed effects, individual sociodemographic characteristics and state time-varying covariates including unemployment rates, GDP per capita, and poverty rates. In contrast, coverage parity laws were associated with a 2.13-day increase (95% CI: 0.19 - 4.07) in days of drug supply, but did not significantly increase the average MPR or probability of medication adherence. In addition, telehealth payment or coverage parity laws were positively associated with the number of hypertension-related telehealth visits, but this effect did not reach statistical significance. These findings were consistent in sensitivity analyses. CONCLUSIONS: State telehealth payment parity laws were significantly associated with greater medication adherence, whereas coverage parity laws were not. With the increasing adoption of telehealth parity laws across states, these findings may support policymakers in understanding potential implications on management of hypertension.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.16.23298658v1" target="_blank">Impact of State Telehealth Parity Laws for Private Payers on Hypertension Management before and during the COVID-19 Pandemic</a>
</div></li>
<li><strong>Development of a prediction model for 30-day COVID-19 hospitalization and death in a national cohort of Veterans Health Administration patients - March 2022 - April 2023.</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
<b>Objective</b>: Develop models to predict 30-day COVID-19 hospitalization and death in the Omicron era for clinical and research applications. <b>Material and Methods</b>: We used comprehensive electronic health records from a national cohort of patients in the Veterans Health Administration (VHA) who tested positive for SARS-CoV-2 between March 1, 2022, and March 31, 2023. Full models incorporated 84 predictors , including demographics, comorbidities, and receipt of COVID-19 vaccinations and anti-SARS-CoV-2 treatments. Parsimonious models included 19 predictors. We created models for 30-day hospitalization or death, 30-day hospitalization, and 30-day all-cause mortality. We used the Super Learner ensemble machine learning algorithm to model risks. Model performance was assessed with the area under the receiver operating characteristic curve (AUC), Brier scores, and calibration intercepts and slopes in a 20% holdout dataset. <b>Results</b>: Models were trained and tested on 198,174 patients, of whom 8% were hospitalized or died within 30 days of testing positive. AUCs for the full models ranged from 0.80 (hospitalization) to 0.91 (death). Brier scores were close to 0, with the lowest error in the mortality model (Brier score: 0.01). All three models were well calibrated with calibration intercepts &lt;0.23 and slopes &lt;1.05. Parsimonious models performed comparably to full models. <b>Discussion</b>: These models may be used for risk stratification to inform COVID-19 treatment and to identify high-risk patients for inclusion in clinical trials. <b>Conclusions</b>: We developed prediction models that accurately estimate COVID-19 hospitalization and mortality risk following emergence of the Omicron variant and in the setting of COVID-19 vaccinations and antiviral treatments.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.17.23298653v1" target="_blank">Development of a prediction model for 30-day COVID-19 hospitalization and death in a national cohort of Veterans Health Administration patients - March 2022 - April 2023.</a>
</div></li>
<li><strong>Antibody response to symptomatic infection with SARS-CoV-2 Omicron variant viruses, December 2021 to June 2022</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
To describe humoral immune responses to symptomatic SARS-CoV-2 infection, we assessed immunoglobulin G binding antibody levels using a commercial multiplex bead assay against SARS-CoV-2 ancestral spike protein receptor binding domain (RBD) and nucleocapsid protein (N). We measured binding antibody units per mL (BAU/mL) during acute illness within 5 days of illness onset and during convalescence in 105 ambulatory patients with laboratory-confirmed SARS-CoV-2 infection with Omicron variant viruses. Comparing acute- to convalescent phase antibody concentrations, geometric mean anti-N antibody concentrations increased 47-fold from 5.5 to 259 BAU/mL. Anti-RBD antibody concentrations increased 2.5-fold from 1258 to 3189 BAU/mL.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.17.23298700v1" target="_blank">Antibody response to symptomatic infection with SARS-CoV-2 Omicron variant viruses, December 2021 to June 2022</a>
</div></li>
<li><strong>Potential impact of annual vaccination with reformulated COVID-19 vaccines: lessons from the U.S. COVID-19 Scenario Modeling Hub</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Importance: COVID-19 continues to cause significant hospitalizations and deaths in the United States. Its continued burden and the impact of annually reformulated vaccines remain unclear. Objective: To project COVID-19 hospitalizations and deaths from April 2023–April 2025 under two plausible assumptions about immune escape (20% per year and 50% per year) and three possible CDC recommendations for the use of annually reformulated vaccines (no vaccine recommendation, vaccination for those aged 65+, vaccination for all eligible groups). Design: The COVID-19 Scenario Modeling Hub solicited projections of COVID-19 hospitalization and deaths between April 15, 2023–April 15, 2025 under six scenarios representing the intersection of considered levels of immune escape and vaccination. State and national projections from eight modeling teams were ensembled to produce projections for each scenario. Setting: The entire United States. Participants: None. Exposure: Annually reformulated vaccines assumed to be 65% effective against strains circulating on June 15 of each year and to become available on September 1. Age and state specific coverage in recommended groups was assumed to match that seen for the first (fall 2021) COVID-19 booster. Main outcomes and measures: Ensemble estimates of weekly and cumulative COVID-19 hospitalizations and deaths. Expected relative and absolute reductions in hospitalizations and deaths due to vaccination over the projection period. Results: From April 15, 2023–April 15, 2025, COVID-19 is projected to cause annual epidemics peaking November–January. In the most pessimistic scenario (high immune escape, no vaccination recommendation), we project 2.1 million (90% PI: 1,438,000–4,270,000) hospitalizations and 209,000 (90% PI: 139,000–461,000) deaths, exceeding pre-pandemic mortality of influenza and pneumonia. In high immune escape scenarios, vaccination of those aged 65+ results in 230,000 (95% CI: 104,000–355,000) fewer hospitalizations and 33,000 (95% CI: 12,000–54,000) fewer deaths, while vaccination of all eligible individuals results in 431,000 (95% CI: 264,000–598,000) fewer hospitalizations and 49,000 (95% CI: 29,000–69,000) fewer deaths. Conclusion and Relevance: COVID-19 is projected to be a significant public health threat over the coming two years. Broad vaccination has the potential to substantially reduce the burden of this disease.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.26.23297581v2" target="_blank">Potential impact of annual vaccination with reformulated COVID-19 vaccines: lessons from the U.S. COVID-19 Scenario Modeling Hub</a>
</div></li>
<li><strong>Fluoxetine promotes immunometabolic defenses to mediate host-pathogen cooperation during sepsis</strong> -
<div>
Selective serotonin reuptake inhibitors (SSRIs) are some of the most prescribed drugs in the world. While they are used for their ability to increase serotonergic signaling in the brain, SSRIs are also known to have a broad range of effects beyond the brain, including immune and metabolic effects. Recent studies have demonstrated that SSRIs are protective in animal models and humans against several infections, including sepsis and COVID-19, however the mechanisms underlying this protection are largely unknown. Here we mechanistically link two previously described effects of the SSRI fluoxetine in mediating protection against sepsis. We show that fluoxetine-mediated protection is independent of peripheral serotonin, and instead increases levels of circulating IL-10. IL-10 is necessary for protection from sepsis-induced hypertriglyceridemia and cardiac triglyceride accumulation, allowing for metabolic reprogramming of the heart. Our work reveals a beneficial off-target effect of fluoxetine, and reveals a protective immunometabolic defense mechanism with therapeutic potential.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.18.567681v1" target="_blank">Fluoxetine promotes immunometabolic defenses to mediate host-pathogen cooperation during sepsis</a>
</div></li>
<li><strong>Spatially resolved single-cell atlas of the lung in fatal Covid19 in an African population reveals a distinct cellular signature and an interferon gamma dominated response</strong> -
<div>
Postmortem single-cell studies have transformed understanding of lower respiratory tract diseases (LRTD) including Covid19 but there is almost no data from African settings where HIV, malaria and other environmental exposures may affect disease pathobiology and treatment targets. We used histology and high-dimensional imaging to characterise fatal lung disease in Malawian adults with (n=9) and without (n=7) Covid19, and generated single-cell transcriptomics data from lung, blood and nasal cells. Data integration with other cohorts showed a conserved Covid19 histopathological signature, driven by contrasting immune and inflammatory mechanisms: in the Malawi cohort, by response to interferon-gamma in lung-resident alveolar macrophages, in USA, European and Asian cohorts by type I/III interferon responses, particularly in blood-derived monocytes. HIV status had minimal impact on histology or immunopathology. Our study provides data resources and highlights the importance of studying the cellular mechanisms of disease in underrepresented populations, indicating shared and distinct targets for treatment.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.16.566964v1" target="_blank">Spatially resolved single-cell atlas of the lung in fatal Covid19 in an African population reveals a distinct cellular signature and an interferon gamma dominated response</a>
</div></li>
<li><strong>Dynamic label-free analysis of SARS-CoV-2 infection reveals virus-induced subcellular remodeling.</strong> -
<div>
Assessing the impact of SARS-CoV-2 on organelle dynamics allows a better understanding of the mechanisms of viral replication. We combine label-free holo-tomographic microscopy (HTM) with Artificial Intelligence (AI) to visualize and quantify the subcellular changes triggered by SARS-CoV-2 infection. We study the dynamics of shape, position and dry mass of nucleoli, nuclei, lipid droplets (LD) and mitochondria within hundreds of single cells from early infection to syncytia formation and death. SARS-CoV-2 infection enlarges nucleoli, perturbs LD, changes mitochondrial shape and dry mass, and separates LD from mitochondria. We then used Bayesian statistics on organelle dry mass states to define organelle cross-regulation (OCR) networks and report modifications of OCR that are triggered by infection and syncytia formation. Our work highlights the subcellular remodeling induced by SARS-CoV-2 infection and provides a new AI-enhanced, label-free methodology to study in real-time the dynamics of cell populations and their content.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.16.567378v1" target="_blank">Dynamic label-free analysis of SARS-CoV-2 infection reveals virus-induced subcellular remodeling.</a>
</div></li>
<li><strong>Identification of mouse CD4+ T cell epitopes in SARS-CoV-2 BA.1 spike and nucleocapsid for use in peptide:MHCII tetramers</strong> -
<div>
Understanding adaptive immunity against SARS-CoV-2 is a major requisite for the development of effective vaccines and treatments for COVID-19. CD4+ T cells play an integral role in this process primarily by generating antiviral cytokines and providing help to antibody-producing B cells. To empower detailed studies of SARS-CoV-2-specific CD4+ T cell responses in mouse models, we comprehensively mapped I-Ab restricted epitopes for the spike and nucleocapsid proteins of the BA.1 variant of concern via IFN{gamma} ELISpot assay. This was followed by the generation of corresponding peptide:MHCII tetramer reagents to directly stain epitope-specific T cells. Using this rigorous validation strategy, we identified 6 reliably immunogenic epitopes in spike and 3 in nucleocapsid, all of which are conserved in the ancestral Wuhan strain. We also validated a previously identified epitope from Wuhan that is absent in BA.1. These epitopes and tetramers will be invaluable tools for SARS-CoV-2 antigen-specific CD4+ T cell studies in mice.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.16.566918v1" target="_blank">Identification of mouse CD4+ T cell epitopes in SARS-CoV-2 BA.1 spike and nucleocapsid for use in peptide:MHCII tetramers</a>
</div></li>
<li><strong>Human microbiota is a reservoir of SARS-CoV-2 advantageous mutations</strong> -
<div>
SARS-CoV-2 mutations are rapidly emerging, in particular advantageous mutations in the spike (S) protein, which either increase transmissibility or lead to immune escape, are posing a major challenge to pandemic prevention and treatment. However, how the virus acquires a high number of advantageous mutations in a short time remains a mystery. Here, we show that the human microbiota may contribute to mutations in variants of concern (VOCs). We identified a mutation and adjacent 6 amino acids (aa) in a viral mutation fragment (VMF) and searched for homologous fragments (HFs) in the National Center for Biotechnology Information (NCBI) database. Among the approximate 8000 HFs obtained, 61 mutations in S and other outer membrane proteins were found in bacteria, accounting for 62% of all mutation sources, which is a 12-fold higher than the natural variable proportion. Approximately 70% of these bacterial species belong to the human microbiota, are primarily distributed in the gut or lung and exhibit a composition pattern similar to that of COVID-19 patients. Importantly, SARS-CoV-2 RNA-dependent RNA polymerase (RdRp) replicates corresponding bacterial mRNAs harboring mutations, producing chimeric RNAs. Collectively, SARS-CoV-2 may acquire mutations from the human microbiota, resulting in alterations in the binding sites or antigenic determinants of the original virus. Our study sheds light on the evolving mutational mechanisms of SARS-CoV-2.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.16.567485v1" target="_blank">Human microbiota is a reservoir of SARS-CoV-2 advantageous mutations</a>
</div></li>
<li><strong>Krisp: A python package for designing CRISPR and amplification-based diagnostic assays from whole genome data</strong> -
<div>
Recent pandemics such as COVID-19 have highlighted the importance of rapidly developing diagnostics to detect and monitor evolving pathogens. CRISPR-Cas technology, combined with isothermal DNA amplification methods, has recently been used to develop diagnostic assays for sequence-specific recognition of DNA or RNA. These assays have similar sensitivity to the gold standard qPCR but can be deployed as easy to use and inexpensive test strips. However, the discovery of diagnostic regions of a genome flanked by conserved regions where primers can be designed requires extensive bioinformatic analyses of genome sequences. We developed the python package krisp to find primers and diagnostic sequences that differentiate groups of samples from each other at any taxonomic scale, using either unaligned genome sequences or a variant call format (VCF) file as input. Krisp has been optimized to handle large datasets by using efficient algorithms that run in near linear time, use minimal RAM, and leverage parallel processing when available. The validity of krisp results has been demonstrated in the laboratory with the successful design of SHERLOCK assays to distinguish the sudden oak death pathogen Phytophthora ramorum from closely related Phytophthora species. Krisp is released open source under a permissive license with all the documentation needed to quickly design CRISPR-Cas diagnostic assays.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.16.567433v1" target="_blank">Krisp: A python package for designing CRISPR and amplification-based diagnostic assays from whole genome data</a>
</div></li>
<li><strong>Unveiling the Emotional Turmoil: How Covid-19 impacted researchers and the pursuit of emotional well-being in academia.</strong> -
<div>
The Covid-19 crisis unprecedentedly required researchers to adapt to significant changes in their work and personal lives. Our study aims to fill this gap analysing the Covid-19 emotional impact and confinement potential disruptions on researchers activity (specifically, those related to working conditions, caring responsibilities, health, balance, and social support) considering the modulating role played by age, gender, and job position. An online survey was distributed during the first lockdown period of the Covid-19 pandemic, and answers from 1301 researchers (ECR %, senior researchers %) working in Sciences (28.1%), Social Sciences (25.9%), Humanities (16.2%), Health (16.2%) and in Engineering and Architecture (13.5%) were collected. The study highlights that the initial lockdown during the Covid-19 pandemic had a significant emotional impact on researchers, exacerbating pre-existing emotional distress and burnout within this group. Factors such as age, health, gender, and difficulties in balancing work and family life were associated with an increased risk of burnout and emotional distress. Lack of social support was identified as a significant risk factor, while the academic culture prioritizing productivity over well-being contributed to the issue. These findings underscore the need for greater support and cultural changes in academia to preserve researchers' mental health and prevent the chronicization of mental health issues in young academics.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.15.567306v1" target="_blank">Unveiling the Emotional Turmoil: How Covid-19 impacted researchers and the pursuit of emotional well-being in academia.</a>
</div></li>
<li><strong>Extending the welcome: a pluralist and coevolutionary analysis of the transformation of induction and transition provision</strong> -
<div>
This paper reflects on an institution-wide transformation of student welcome, induction and transition (WIT) at a large, research-intensive UK university, a change accelerated by the Covid-19 pandemic. The paper examines this process of change, from its origins, through its evolution, and co-evolution, over three academic years since the onset of the Pandemic. To do so, the paper adopts a pluralist approach, utilising theories of change established in higher education literature: Kift’s transition pedagogy and Kotter’s model of organisational change. Crucially, it augments these with a co-evolutionary approach examining interacting populations, learning and qualitative change, which may provide useful insights to other institutions navigating changes to WIT provision.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/edarxiv/emh3c/" target="_blank">Extending the welcome: a pluralist and coevolutionary analysis of the transformation of induction and transition provision</a>
</div></li>
<li><strong>Species and habitat specific changes in bird activity in an urban environment during Covid 19 lockdown</strong> -
<div>
Covid-19 lockdowns provided ecologists with a rare opportunity to examine how animals behave when humans are absent. Indeed many studies reported various effects of lockdowns on animal activity, especially in urban areas and other human-dominated habitats. We explored how Covid-19 lockdowns in Israel have influenced bird activity in an urban environment by using continuous acoustic recordings to monitor three common bird species that differ in their level of adaptation to the urban ecosystem: (1) the hooded crow, an urban exploiter, which depends heavily on anthropogenic resources; (2) the rose-ringed parakeet, an invasive alien species that has adapted to exploit human resources; and (3) the graceful prinia, an urban adapter, which is relatively shy of humans and can be found urban habitats with shrubs and prairies. Acoustic recordings provided continuous monitoring of bird activity without an effect of the observer on the animal. We performed dense sampling of a 1.3 square km area in northern Tel-Aviv by placing 17 recorders for more than a month in different micro-habitats within this region including roads, residential areas and urban parks. We monitored both lockdown and no-lockdown periods. We portray a complex dynamic system where the activity of specific bird species depended on many environmental parameters and decreases or increases in a habitat-dependent manner during lockdown. Specifically, urban exploiter species decreased their activity in most urban habitats during lockdown, while human adapter species increased their activity during lockdown especially in parks where humans were absent. Our results also demonstrate the value of different habitats within urban environments for animal activity, specifically highlighting the importance of urban parks. These species- and habitat-specific changes in activity might explain the contradicting results reported by others who have not performed a habitat specific analysis.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.06.03.543542v3" target="_blank">Species and habitat specific changes in bird activity in an urban environment during Covid 19 lockdown</a>
</div></li>
<li><strong>Unraveling antiviral efficacy of multifunctional immunomodulatory triterpenoids against SARS-COV-2 targeting virus-specific enzymes</strong> -
<div>
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) may be over, but its variants continue to emerge, and patients with mild symptoms having long COVID is still under investigation. SARS-CoV-2 infection leading to elevated cytokine levels and suppressed immune responses set off cytokine storm, fatal systemic inflammation, tissue damage, and multi-organ failure. Thus, drug molecules targeting the SARS-CoV-2 virus-specific proteins or capable of suppressing the host inflammatory responses to viral infection would provide an effective antiviral therapy against emerging variants of concern. Evolutionarily conserved papain-like protease (PLpro) and main protease (Mpro) play an indispensable role in the virus life cycle and immune evasion. Direct-acting antivirals targeting both these viral proteases represent an attractive antiviral strategy that is also expected to reduce viral inflammation. The present study has evaluated the antiviral and anti-inflammatory potential of natural triterpenoids: azadirachtin, withanolide_A, and isoginkgetin. These molecules inhibit the Mpro and PLpro proteolytic activities with half-maximal inhibitory concentrations (IC50) values ranging from 1.42 to 32.7 M. Isothermal titration calorimetry (ITC) analysis validated the binding of these compounds to Mpro and PLpro. As expected, the two compounds, withanolide_A and azadirachtin exhibit potent anti-SARS-CoV-2 activity in cell-based assays, with half-maximum effective concentration (EC50) values of 21.73 M and 31.19 M, respectively. The anti-inflammatory role of azadirachtin and withanolide_A when assessed using HEK293T cells were found to significantly reduce the levels of CXCL10, TNF, IL6, and IL8 cytokines, which are elevated in severe cases of COVID-19. Interestingly, azadirachtin and withanolide_A were also found to rescue the decreased type-I interferon response (IFN-1). The results of this study clearly highlight the role of triterpenoids as effective antiviral molecules that target SARS-CoV-2 specific enzymes and also host immune pathways involved in virus mediated inflammation.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.06.24.546363v2" target="_blank">Unraveling antiviral efficacy of multifunctional immunomodulatory triterpenoids against SARS-COV-2 targeting virus-specific enzymes</a>
</div></li>
<li><strong>DEFEN-CE: Social Dialogue in Defence of Vulnerable Groupsin Post?COVID-19 Labour Markets. Report on Czechia and Slovakia</strong> -
<div>
This report is part of the EC-funded research project DEFEN-CE: Social Dialogue in Defence of Vulnerable Groups in Post-COVID-19 Labour Markets (VS/2021/0196). It scrutinizes how social partners influenced COVID-19-related policy responses towards vulnerable groups in the labour market, and whether this experience created opportunities for strengthening social dialogue in general. The empirical focus is on Czechia and Slovakia as representatives of embedded neoliberal countries. This means liberalizing labour market policies during their economic transition starting in the 1990s, but at the same time, anchoring some institutional mechanisms of policy-making, including social dialogue at the national level. The analysis is based on new empirical data in two dimensions: • primary data on policy measures relevant for the vulnerable groups in the labour market, categorized in a standard database of the most important COVID-19 measures relevant for vulnerable groups. • 19 original semi-structured interviews with employer organizations, trade unions, governments, and NGOs in Czechia and Slovakia, implemented in 2022-2023.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/cvprx/" target="_blank">DEFEN-CE: Social Dialogue in Defence of Vulnerable Groupsin Post?COVID-19 Labour Markets. Report on Czechia and Slovakia</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>Cognitive Rehabilitation in Post-COVID-19 Syndrome</strong> - <b>Conditions</b>: Post-COVID-19 Syndrome <br/><b>Interventions</b>: Behavioral: CO-OP Procedures; Behavioral: Inactive Control Group <br/><b>Sponsors</b>: University of Missouri-Columbia; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) <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>Robotic Assisted Hand Rehabilitation Outcomes in Adults After COVID-19</strong> - <b>Conditions</b>: Robotic Exoskeleton; Post-acute Covid-19 Syndrome; Rehabilitation Outcome; Physical And Rehabilitation Medicine <br/><b>Interventions</b>: Device: Training with a Robotic Hand Exoskeleton <br/><b>Sponsors</b>: University of Valladolid; Centro Hospitalario Padre Benito Menni <br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Safety and Immunogenicity of BNT162b2 Coadministered With SIIV in Adults 18 Through 64 Years of Age</strong> - <b>Conditions</b>: SARS-CoV-2 Infection; COVID-19 <br/><b>Interventions</b>: Biological: BNT162b2; Other: Placebo; Biological: Seasonal Inactivated Influenza Vaccine <br/><b>Sponsors</b>: Pfizer <br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Multicenter, Adaptive, Randomized, doublE-blinded, Placebo-controlled Study in Participants With Long COVID-19: The REVIVE Trial</strong> - <b>Conditions</b>: Long COVID-19 Syndrome; Chronic Fatigue Syndrome <br/><b>Interventions</b>: Drug: Fluvoxamine Maleate 100 MG; Drug: Placebo; Drug: Metformin Extended Release Oral Tablet <br/><b>Sponsors</b>: Cardresearch <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>Clinical Evaluation of the Panbio™ COVID-19/Flu A&amp;B Panel</strong> - <b>Conditions</b>: COVID-19; Influenza A; Influenza B <br/><b>Interventions</b>: Diagnostic Test: Panbio™ <br/><b>Sponsors</b>: Abbott Rapid Dx <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>Connecting Friends and Health Workers to Boost COVID-19 Vaccination in Latino Communities</strong> - <b>Conditions</b>: COVID-19; Vaccine <br/><b>Interventions</b>: Behavioral: REDES; Behavioral: Control <br/><b>Sponsors</b>: Johns Hopkins University; National Institute on Minority Health and Health Disparities (NIMHD); Rutgers 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>The Safety and Tolerability of A8G6 COVID-19 Neutralization Antibody Combined With Nasal Spray</strong> - <b>Conditions</b>: SARS-CoV-2; Prevention <br/><b>Interventions</b>: Biological: A8G6 SARS-CoV-2 Neutralization Antibody combination nasal spray; Other: A8G6 SARS-CoV-2 Neutralization Antibody nasal excipient <br/><b>Sponsors</b>: The Second Affiliated Hospital of Chongqing Medical University <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Influence of Hypoxic, Normobaric and Hypobaric Training on the Immunometabolism of Post-covid-19 Athletes</strong> - <b>Conditions</b>: Normobaric Hypoxia; Hypoventilation; Normoxia <br/><b>Interventions</b>: Other: Repeated sprint <br/><b>Sponsors</b>: Faculdade de Motricidade Humana; University of Sao Paulo; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. <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>Clinical Evaluation of the Panbio™ COVID-19/Flu A&amp;B Panel to Support Home Use</strong> - <b>Conditions</b>: COVID-19; Influenza A; Influenza Type B <br/><b>Interventions</b>: Diagnostic Test: Panbio™ COVID-19/Flu A&amp;B Panel <br/><b>Sponsors</b>: Abbott Rapid Dx <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>Building Engagement Using Financial Incentives Trial - Colorectal Cancer Screening</strong> - <b>Conditions</b>: Health Behavior; Colorectal Cancer; Influenza; COVID-19; Vaccine Hesitancy; Vaccine-Preventable Diseases; Healthcare Patient Acceptance <br/><b>Interventions</b>: Behavioral: Financial incentive for colorectal cancer screening; Behavioral: Financial incentive for flu shot; Behavioral: Financial incentive for COVID-19 shot <br/><b>Sponsors</b>: Tulane University; National Heart, Lung, and Blood Institute (NHLBI) <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>Effects of Rehabilitation Combined With a Maintenance Program Compared to Rehabilitation Alone in Post-COVID-19</strong> - <b>Conditions</b>: Post-COVID-19 Syndrome <br/><b>Interventions</b>: Procedure: Rehabilitation combined to a digital maintenance program; Procedure: Rehabilitation without maintenance program <br/><b>Sponsors</b>: Schön Klinik Berchtesgadener Land; Bavarian State Ministry of Health and Care (Funding); Deutsche Rentenversicherung Bund (German pension insurance) (Design); Betriebskrankenkassen Landesverband Bayern (Bavarian health insurance) (Design) <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>Child and Adolescent Mental Health Literacy for Primary Schools Teachers. A Multicomponent Intervention</strong> - <b>Conditions</b>: Child Mental Health <br/><b>Interventions</b>: Behavioral: Child Mental Health Literacy Program <br/><b>Sponsors</b>: Universidad de Valparaiso <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>Brief Digital Intervention to Increase COVID-19 Vaccination Among Individuals With Anxiety or Depression</strong> - <b>Conditions</b>: Misinformation; Vaccine Hesitancy; Anxiety; Depression; COVID-19 <br/><b>Interventions</b>: Behavioral: Attitudinal inoculation; Behavioral: Cognitive-behavioral therapy-informed intervention; Behavioral: Conventional public health messaging <br/><b>Sponsors</b>: City University of New York, School of Public Health; University of North Carolina, Chapel Hill <br/><b>Not yet recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Niclosamide, but not ivermectin, inhibits anoctamin 1 and 6 and attenuates inflammation of the respiratory tract</strong> - Inflammatory airway diseases like cystic fibrosis, asthma and COVID-19 are characterized by high levels of pulmonary cytokines. Two well-established antiparasitic drugs, niclosamide and ivermectin, are intensively discussed for the treatment of viral inflammatory airway infections. Here, we examined these repurposed drugs with respect to their anti-inflammatory effects in airways in vivo and in vitro. Niclosamide reduced mucus content, eosinophilic infiltration and cell death in asthmatic mouse…</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>Identification of synthetically tractable MERS-CoV main protease inhibitors using structure-based virtual screening and molecular dynamics potential of mean force (PMF) calculations</strong> - The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a potentially lethal infection that presents a substantial threat to health, especially in Middle East nations. Given that no FDA-approved specific therapy for MERS infection exists, designing and discovering a potent antiviral therapy for MERS-CoV is crucial. One pivotal strategy for inhibiting MERS replication is to focus on the viral main protease (M^(pro)). In this study, we identify potential novel M^(pro) inhibitors employing…</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>CD97 negatively regulates the innate immune response against RNA viruses by promoting RNF125-mediated RIG-I degradation</strong> - The G protein-coupled receptor ADGRE5 (CD97) binds to various metabolites that play crucial regulatory roles in metabolism. However, its function in the antiviral innate immune response remains to be determined. In this study, we report that CD97 inhibits virus-induced type-I interferon (IFN-I) release and enhances RNA virus replication in cells and mice. CD97 was identified as a new negative regulator of the innate immune receptor RIG-I, and RIG-1 degradation led to the suppression of the IFN-I…</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 3CL protease by the anti-viral chimeric protein RetroMAD1</strong> - COVID-19 results from SARS-CoV-2, which mutates frequently, challenging current treatments. Therefore, it is critical to develop new therapeutic drugs against this disease. This study explores the interaction between SARS-CoV-2 3CL^(pro) and RetroMAD1, a well-characterized coronavirus protein and potential drug target, using in-silico methods. The analysis through the HDOCK server showed stable complex formation with a binding energy of -12.3, the lowest among reference drugs. 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>Targeting SARS-CoV-2 nonstructural protein 3: function, structure, inhibition, and perspective in drug discovery</strong> - As a highly contagious human pathogen, severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) has infected billions of people worldwide with more than 6 million deaths. With several effective vaccines and antiviral drugs now available, the SARS-CoV-2 pandemic been brought under control. However, a new pathogenic coronavirus could emerge in the future, given the zoonotic nature of this virus. Natural evolution and drug-induced mutations of SARS-CoV-2 also require continued…</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>Compounds derived from Humulus lupulus inhibit SARS-CoV-2 papain-like protease and virus replication</strong> - CONCLUSION: In addition to the already known inhibition of M^(pro) by XN, our results show, for the first time, that hop-derived compounds target also SARS-CoV-2 PL^(pro) which is a promising therapeutic target as it contributes to both viral replication and modulation of the immune system. These findings support the possibility to develop new hop-derived antiviral drugs targeting human coronaviruses.</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>Type I interferon signaling induces a delayed antiproliferative response in respiratory epithelial cells during SARS-CoV-2 infection</strong> - The proliferation of respiratory epithelial cells is crucial to host recovery from acute lung injury caused by SARS-CoV-2 and other viral pathogens, but the molecular pathways that govern this process are poorly understood. We performed a high-throughput CRISPR screen that surprisingly revealed a detrimental effect of specific host response, type I interferon (IFN-I) signaling, on the fitness of SARS-CoV-2-infected Calu-3 cells. While IFN-I signaling has been previously associated with several…</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>Luminescent reporter cells enable the identification of broad-spectrum antivirals against emerging viruses</strong> - The emerging viruses SARS-CoV-2 and arenaviruses cause severe respiratory and hemorrhagic diseases, respectively. The production of infectious particles of both viruses and virus spread in tissues requires cleavage of surface glycoproteins (GPs) by host proprotein convertases (PCs). SARS-CoV-2 and arenaviruses rely on GP cleavage by PCs furin and subtilisin kexin isozyme-1/site-1 protease (SKI-1/S1P), respectively. We report improved luciferase-based reporter cell lines, named luminescent…</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>Identification of Ebselen derivatives as novel SARS-CoV-2 main protease inhibitors: Design, synthesis, biological evaluation, and structure-activity relationships exploration</strong> - The main protease (M^(pro)) represents one of the most effective and attractive targets for designing anti-SARS-CoV-2 drugs. In this study, we designed and synthesized a novel series of Ebselen derivatives by incorporating privileged fragments from different pockets of the M^(pro) active site. Among these compounds, 11 compounds showed submicromolar activity in the FRET-based SARS-CoV-2 M^(pro) inhibition assay, with IC(50) values ranging from 233 nM to 550 nM. Notably, compound 3a displayed…</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>Traditional Formulations for Managing COVID-19: A Systematic Review</strong> - Background: The advancing etiopathogenesis, diagnosis, and treatment of the global coronavirus disease 2019 (COVID-19) pandemic have prompted the medical community to consider Ayurveda, Siddha, and Unani as add-on preventive and therapeutic options. Objective: To explore the effect of standalone or integrative Traditional Formulations (TFs) on selected clinical symptoms and biomarkers of COVID-19. Search strategy: Out of 465 articles identified from PubMed, ScienceDirect, and Scopus, 17…</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>Potential drug-drug interactions of frequently prescribed medications in long COVID detected by two electronic databases</strong> - Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leads to a wide range of acute and chronic complications including long COVID, a well-known chronic sequela. Long COVID often necessitates long-term treatment, which may lead to an increased potential for drug-drug interactions (DDIs). The objective of this study was to assess potential DDIs among frequently prescribed medications in long COVID by using two electronic databases. Sixty frequently prescribed agents were…</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>Engineered Nanovesicles Expressing Bispecific Single Chain Variable Fragments to Protect against SARS-CoV-2 Infection</strong> - Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in high morbidity and mortality rates worldwide. Although the epidemic has been controlled in many areas and numerous patients have been successfully treated, the risk of reinfection persists due to the low neutralizing antibody titers and weak immune response. To provide long-term immune protection for infected patients, novel bispecific CB6/dendritic cell (DC)-specific…</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>Molecular Design of Novel Inhibitor by TargetingIL-6Rα using Combined Pharmacophore and Experimentally Verified Plant Products with Scaffold-Hopping Techniques: A Dual Therapeutic Strategy for COVID-19 and Cancer</strong> - The IL-6/IL-6R/gp130 complex serves as a significant indicator of cytokine release syndrome in COVID-19 and chronic inflammation, increasing the risk of cancer. Therefore, we identified IL-6Rα as a potential target to block gp130 interaction. Notably, there has been no reception of approval for an orally available drug to serve this purpose, to date. In this study, we targeted IL-6Rα to inhibit IL-6Rα/gp130 interaction. The selection of the lead candidate L821 involved the amalgamation of three…</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 matrix metalloproteinase ADAM10 supports hepatitis C virus entry and cell-to-cell spread via its sheddase activity</strong> - Hepatitis C virus (HCV) exploits the four entry factors CD81, scavenger receptor class B type I (SR-BI, also known as SCARB1), occludin, and claudin-1 as well as the co-factor epidermal growth factor receptor (EGFR) to infect human hepatocytes. Here, we report that the disintegrin and matrix metalloproteinase 10 (ADAM10) associates with CD81, SR-BI, and EGFR and acts as HCV host factor. Pharmacological inhibition, siRNA-mediated silencing and genetic ablation of ADAM10 reduced HCV 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>Structure-based virtual screening, ADMET analysis, and molecular dynamics simulation of Moroccan natural compounds as candidates for the SARS-CoV-2 inhibitors</strong> - The lack of treatments and vaccines effective against SARS-CoV-2 has forced us to explore natural compounds that could potentially inhibit this virus. Additionally, Morocco is renowned for its rich plant diversity and traditional medicinal uses, which inspires us to leverage our cultural heritage and the abundance of natural resources in our country for therapeutic purposes. In this study, an extensive investigation was conducted to gather a collection of phytoconstituents extracted from…</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>What Kind of Trouble Is Eric Adams In?</strong> - New York City’s mayor has downplayed the federal investigation into his campaign fund-raising, but, by dodging questions and obfuscating, he’s invited even more public scrutiny. - <a href="https://www.newyorker.com/news/daily-comment/what-kind-of-trouble-is-eric-adams-in">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What Comes After Panda Diplomacy?</strong> - Biden meets with President Xi as U.S.-China relations get less warm and fuzzy. - <a href="https://www.newyorker.com/news/daily-comment/what-comes-after-panda-diplomacy">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Journalistic Independence Isn’t a Human-Resources Exercise</strong> - A free and independent press is vital to preserve, but doing so requires the people running media companies to take that idea out of mothballs. - <a href="https://www.newyorker.com/news/our-columnists/journalistic-independence-isnt-a-human-resources-exercise">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>After Forty Years of Democracy, Argentina Faces a Defining Presidential Runoff</strong> - Is the country really so fed up with the status quo that it will elect a right-wing former TV personality? - <a href="https://www.newyorker.com/news/daily-comment/after-forty-years-of-democracy-argentina-faces-a-defining-presidential-runoff">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Mother’s Grief in New Haven</strong> - Laquvia Jones lost both of her sons to shootings. Now she wonders why a city with a deep sense of community—and one of the wealthiest universities in the world—can’t figure out how to address gun violence. - <a href="https://www.newyorker.com/news/the-weekend-essay/a-mothers-grief-in-new-haven">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>How to talk to a loved one about their health</strong> -
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<img alt="A woman and her mother stand together, looking out at a pond in a park. The waves in the pond reveal a large but delicate portrait of the mother." src="https://cdn.vox-cdn.com/thumbor/42-SaowzEuNx8BBByErFWTVgeCA=/480x0:1920x1080/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72739898/Vox_LovedOnes_SN_231002.0.jpg"/>
<figcaption>
Simone Noronha for Vox
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Compassionate ways to let a friend or family member know you’re looking out for them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nTdXM5">
After her father had a transient ischemic attack, also known as a mini-stroke, Lisa McCarty snapped into action. She had taken a prominent role in his life and was knowledgeable about his health, so she offered to make a follow-up appointment with the cardiologist. Her dad, on the other hand, responded with sarcasm, McCarty says, and told his daughter he was capable of making a phone call himself. “I took that sarcasm, which he was known for, as that he wanted to handle it and was declaring his independence and ability to do it on his own,” McCarty, a writer and publicist, says. “He was also setting a boundary in this situation, which I had to respect to some degree, but also keep him safe.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lbv4x7">
McCarty respected her father’s wishes but still remained involved in his care: She checked in to ensure he’d made the appointment, took him to future doctors’ appointments, researched other specialists, compiled a list of questions to address with medical professionals before every appointment, and discussed his health on a daily basis over the phone.
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MCVhhM">
McCarty’s father died from his heart condition and other complications with cancer a few years later. She considers their conversations about his health a success, though, offering support when it was needed and stepping away when it was not. “I respected his independence while also voicing my opinion and speaking up when I was concerned about something,” she says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yG9sGG">
When it comes to the people we love, it’s normal to take an interest in their health and well-being. As parents or other relatives age, their physical and <a href="https://www.vox.com/mental-health">mental health</a> may become a topic of concern. If it’s been a few months since you’ve seen a loved one, the difference in their demeanor may be apparent. For those with whom you’re regularly in touch, they may frequently remark about the same aches and pains, prompting you to speak up.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="b36VwX">
However, many people approach these conversations by making demands of their loved ones. While well-intentioned, a heavy-handed approach “puts people on the defensive,” says <a href="https://profiles.arizona.edu/person/segrin">Chris Segrin</a>, head of the University of Arizona’s department of communication and a behavioral scientist whose speciality is interpersonal relationships. Some people consider putting pressure on a loved one the most effective strategy because “they’re convinced this is the thing to be done,” he says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HovyaT">
People avoid medical care for a variety of reasons. A record high <a href="https://news.gallup.com/poll/468053/record-high-put-off-medical-care-due-cost-2022.aspx">38 percent of Americans say they or a loved one postponed medical treatment due to the cost</a> in 2022, according to a Gallup poll. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351276/">logistics of getting to a doctor </a>— having too little time, a lack of transportation, and inconvenient hours at the doctor’s office — often deter people from seeking care, especially in <a href="https://time.com/6257775/patient-burnout-health-care/">rural areas where access to a doctor can be difficult</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="drfEol">
They may also believe they are generally healthy enough and don’t need preventive care. When people have had a traumatic past medical experience, they may avoid care in the future. “People have bad experiences with doctors and those bad experiences can be both in the form of not getting good health guidance, and also in the form of maybe getting good health guidance, but maybe not being treated well,” says Matt Lundquist, the founder and clinical director of <a href="https://tribecatherapy.com/">Tribeca Therapy</a>, “or not being treated with dignity or experiencing body shaming or someone not being accommodating of a disability or racism or sexual assault.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kNcyWL">
To tactfully broach conversations about a loved one’s physical and mental health, experts recommend affirming their autonomy, validating their hesitancy with the <a href="https://www.vox.com/health-care">health care</a> system, and avoiding shame and blame. While we can’t change others’ behavior, we can encourage — and support — friends and family to take steps toward improving their care.
</p>
<h3 id="4ffP11">
Prepare yourself — and your loved one — for the conversation
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KmGACG">
Rather than launching into a spur-of-the-moment diatribe, carefully plan the points you’d like to outline, says therapist <a href="https://www.israanasir.com/">Israa Nasir</a>. Make an internal list of topics you’d like to address instead of focusing on their health more broadly. Are they always mentioning how they’re having trouble walking up stairs? Have you noticed that they haven’t been to the dentist in a few years? Keep a mental note. If you’re feeling nervous, you can practice the conversation with a partner, friend, or roommate ahead of time or write down exactly what you want to say, Nasir explains.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4t2nR9">
Should you have a strained relationship with the relative you’re looking to speak with, you can outsource the conversation to a third party, Segrin says. This person should be someone your loved one trusts and listens to. Explain to the other person your concerns and why you consider them the best person to have this discussion. You could approach the third party by saying, “We both want Mom to be part of our future, but it seems like she’s not taking her health seriously. Unfortunately, I’m not the one to be able to have this conversation, but maybe you could.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="51fv60">
Give your loved one a heads-up that you want to discuss something important with them in private, Nasir says. This way they can prepare themselves for a serious conversation and avoid feeling ambushed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MCq8lr">
Regardless of who initiates the conversation, these talks should always be one-on-one and in a private place. Do not broach the discussion at the dinner table or encourage other family members to get involved. “I would highly advise against that type of tactic,” Segrin says, “where you line the person up in front of five loved ones who all take turns trying to convince them.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8JbQhJ">
However, if your loved one’s well-being is at risk — they’re experiencing shortness of breath, chest pains, suicidality, or are having adverse effects of alcohol and/or drugs — don’t hesitate in getting them to a hospital immediately or calling 911. You may need to enlist the help of other loved ones in emergency situations, Segrin says.
</p>
<h3 id="s7QIR4">
Approach the discussion with curiosity, not blame
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fpXF5Y">
Once you’ve set the stage for the conversation, begin by asking your loved one about their experience. Rather than exclaiming “You always complain about your back hurting — you need to go to a physical therapist,” start by asking “What’s going on with you? How do you feel about this?” suggests Lundquist. Don’t make assumptions that they’re being purposefully neglectful or unmotivated.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NH0380">
Use “I statements” when framing your discussion. First, tell your loved one how much you value them and their health. Then share your concerns. You could say, “It’s hard for me to see you in pain. I would love to figure out a plan we can do together that would make this easier for you.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0miiUH">
Always be sure to validate their concerns. If they avoid medical care because of the cost or believe health professionals are only out to make money off of patients, acknowledge your loved one’s hesitations, says therapist and <a href="https://podcasts.apple.com/us/podcast/popcorn-therapy/id1648830110">podcast co-host</a> <a href="https://abetterlifetherapy.com/folashade">Shade Adekunle</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mZkJ7H">
You can also use your own experience as an example, Segrin says. If you’re trying to encourage a sibling to see a dentist, tell them about a recent positive visit you had at the dentist. You could say, “I had a really terrible toothache a few weeks ago. The scheduler at the dentist’s office was amazing and got me in right away. I got the cavity filled and the whole procedure was a breeze.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mSHcMq">
“Leading by example is a really good way to get a conversation going,” Segrin says, “because it helps the other person lower their guard and lower their defenses so they’re not feeling attacked.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="b4ZccB">
If you and your loved ones are in a position to <a href="https://www.vox.com/even-better/23378958/end-of-life-planning-elders-parents-grandparents-loved-ones">plan for the future</a>, in the instance of, say, an older relative who values their independence, ask them when they would consider some assistance, Adekunle says. Try asking, “How will we know when it’s time for you to get a bit more support? What do you think that we should be looking for?” They can make decisions about their well-being without being stripped of autonomy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rNQuF7">
Other questions and statements to help begin or continue the conversation with curiosity and empathy include:
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1KJ7cG">
<em>Is your health insurance up to date?</em>
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9WapN4">
<em>How can I best support you right now? </em>
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="600cN9">
<em>I’m worried this could grow into something more serious.</em>
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="I009O6">
<em>I’m remembering how our mother had this condition. She let it go for too long. I’d hate to see that happen to you.</em>
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9e1Mws">
<em>I want you to be a part of my life for as long as possible. Will you please consider looking into this for me?</em>
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uQzg5X">
Statements to avoid include:
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TPhy5y">
<em>You’re not taking care of yourself. </em>
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0KRSfU">
<em>You always complain about your back but you never do anything about it. </em>
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kEaBWu">
<em>You have to do something about your high cholesterol.</em>
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vZV24X">
<em>You need to exercise more/watch what you eat/lose weight/cut down on drinking.</em>
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sg4aSg">
Be prepared for your loved one to potentially get defensive or shut down the conversation. Remind your loved one that you’re coming from a place of concern but don’t press them to talk any more than they’re comfortable. Your goal is to preserve the relationship and, ideally, empower your relative to make decisions for themself. In worst-case scenarios, your relative might keep you in the dark when something serious occurs, like a car accident or a fall, because they’re worried about being blamed or losing their independence, Adekunle says. Keeping the conversation focused on validation and empathy instead of blame and demands can help avoid this.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lU6vob">
If emotions — anger, frustration, fear, sadness — are preventing either of you from having a constructive conversation, step away for a few minutes, get some air and a glass of water, Nasir says. You may need to drop the discussion entirely for the day. However, don’t forget to pick it up again in the future.
</p>
<h3 id="LoHJP9">
Encourage action by offering tangible support
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dTtdrA">
Change doesn’t happen overnight, but if your loved one is receptive to receiving help, make an offer that will slowly move them in the right direction. Maybe that means curating a list of local doctors who take their insurance; maybe that’s offering to drive them to a doctor’s appointment. You might consider a compromise: If your knee pain hasn’t subsided in a week, would you think about reaching out to a doctor? “When do you think that you would be ready to go see someone about this?” Adekunle suggests asking. “Because then that probably means it’s serious.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8dS8kN">
You can also offer to call the office on their behalf, but be sure to get your loved one’s permission before you take any action. “When they realize someone’s making decisions and choices for me, without consulting me,” Segrin says, “that’s very likely to result in what we call a boomerang effect where you get the exact opposite of what you want.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="idzUDb">
You can also offer easy suggestions that encourage a more healthy or balanced lifestyle. If your best friend told you their therapist recommended they get more fresh air to minimize stress, offer to go on a post-work stroll a few times a week if you can. “Let them know you support them in their journey,” Nasir says. “If you’re just there to nag at them and you’re not ready to show up for them, then it’s not your place to have this conversation.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kWvkKy">
Ultimately, your loved one is a person with the right and agency to make choices for themselves. All you can do is tell them how much they mean to you and show up for them when it matters.
</p></li>
<li><strong>Most of Israel’s weapons imports come from the US. Now Biden is rushing even more arms.</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/DW_ayOizDZWykDhAiUtl0Nz2bqc=/626x0:5635x3757/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72878785/1763009023.0.jpg"/>
<figcaption>
Activists protest against war in Gaza as Secretary of State Antony Blinken and Defense Secretary Lloyd Austin testify during a Senate Appropriations Committee hearing about the United States sending aid to Israel and Ukraine on Capitol Hill on October 31, 2023, in Washington, DC. | Jabin Botsford/Washington Post via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
What the US sending Israel weapons “at the speed of war” looks like.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8GjaLm">
One area where the Biden administration has set itself apart is in sending weapons to partner countries, and now we’re getting a more complete picture of what the US is sending Israel in the weeks since October 7.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SFQyTh">
Since Russia invaded Ukraine in February 2022, the US has ramped up its previously minimal military aid to the country to an unparalleled <a href="https://crsreports.congress.gov/product/pdf/IF/IF12040#:~:text=From%202014%2C%20when%20Russia%20first,according%20to%20the%20State%20Department.">$46.7 billion</a>. Ukraine <a href="https://www.cfr.org/article/how-much-aid-has-us-sent-ukraine-here-are-six-charts">towers</a> over the other major recipients in bar charts of US security assistance for 2022 and ’23. The US is sending so many munitions there that it has apparently strained American factories and led to a whole-of-government <a href="https://www.whitehouse.gov/briefing-room/speeches-remarks/2022/02/15/fact-sheet-department-of-defense-releases-new-report-on-safeguarding-our-national-security-by-promoting-competition-in-the-defense-industrial-base/">effort</a> to revive military supply chains.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RdBd6v">
The US is also accelerating arms transfers to Israel in response to Hamas’s October 7 attacks that killed <a href="https://www.reuters.com/world/middle-east/israel-revises-death-toll-oct-7-hamas-attack-around-1200-2023-11-10/">1,200 people</a> and resulted in the kidnapping of more than 200. Last month, President Joe Biden announced from the <a href="https://www.whitehouse.gov/briefing-room/speeches-remarks/2023/10/18/remarks-by-president-biden-on-the-october-7th-terrorist-attacks-and-the-resilience-of-the-state-of-israel-and-its-people-tel-aviv-israel/https://www.whitehouse.gov/briefing-room/speeches-remarks/2023/10/18/remarks-by-president-biden-on-the-october-7th-terrorist-attacks-and-the-resilience-of-the-state-of-israel-and-its-people-tel-aviv-israel/">Oval Office</a> that he would seek “an unprecedented support package for Israel’s defense” of $14.3 billion. “We’re surging additional military assistance,” he added.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DSS7Hx">
But while Ukraine has never been a traditional recipient of heavy military aid, the US’s most recent support of the Israeli military builds on a long bipartisan American practice. Israel has received about $3 billion annually, adjusted for inflation, for <a href="https://www.axios.com/2023/11/04/us-israel-aid-military-funding-chart">the last 50 years</a>, and is the <a href="https://www.stimson.org/2023/in-shadow-of-war-a-snapshot-of-u-s-military-assistance-to-israel/">largest historical recipient</a> of US security aid. The Obama administration in 2016 announced the <a href="https://www.nytimes.com/2016/09/14/world/middleeast/israel-benjamin-netanyahu-military-aid.html">biggest security assistance package</a> to the country ever, pledging <a href="https://obamawhitehouse.archives.gov/the-press-office/2016/09/14/fact-sheet-memorandum-understanding-reached-israel">$38 billion</a> for Israel over the next decade. US support has ensured that Israel maintains its <a href="https://sgp.fas.org/crs/mideast/RL33222.pdf">qualitative military edge</a> over neighboring Arab countries by having more advanced weapons systems, something Congress wrote into law in 2008.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qoJAbb">
Israel would not be able to conduct this war without the US, which over time has provided Israel with about 80 percent of the country’s weapons imports. Israel is using them as part of its large-scale military operation that has so far killed over <a href="https://www.ochaopt.org/">11,000 Palestinians</a> and destroyed hospitals and civilian infrastructure. While it is the Israeli Defense Forces doing the killing, the extent of US aid has raised serious questions about American culpability. “Providing weapons that knowingly and significantly would contribute to unlawful attacks can make those providing them complicit in war crimes,” Human Rights Watch <a href="https://www.hrw.org/news/2023/11/06/suspend-arms-israel-palestinian-armed-groups">said</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="28kqb6">
Which weapons, exactly, the US is sending to fill Israel’s requests since October 7 has been hitherto kept secret — in contrast to how the US publicizes the weapons it delivers to Ukraine. But <a href="https://www.bloomberg.com/news/articles/2023-11-14/pentagon-is-quietly-sending-israel-ammunition-laser-guided-missiles?embedded-checkout=true&amp;sref=j0yibzu3#xj4y7vzkg">Bloomberg</a> this week published a leaked Pentagon document that showed the US has delivered 2,000 Hellfire missiles that can be launched from Apache helicopters, as well as an array of other mortars and ammo, including “36,000 rounds of 30mm cannon ammunition, 1,800 of the requested M141 bunker-buster munitions and at least 3,500 night-vision devices.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Xk5T89">
This year, military budgets around the world hit <a href="https://www.sipri.org/media/press-release/2023/world-military-expenditure-reaches-new-record-high-european-spending-surges">all-time highs</a>. Israel in recent years has been <a href="https://www.timesofisrael.com/israeli-arms-sales-doubled-in-a-decade-hit-new-record-of-12-5-billion-in-2022/">growing its arms export business</a>. It also imports significant weapons from the UK, Italy, Canada, and Germany, but 92 percent of what Israel gets comes <a href="https://www.timesofisrael.com/israel-ranked-worlds-10th-largest-weapons-exporter-in-past-five-years/">from the United States</a>. As researcher William Hartung wrote recently in <a href="https://www.thenation.com/article/politics/us-aid-israel-gaza/">The Nation</a>, “Israel’s arsenal, and its arms industry, are by and large made in, and financed by, the USA.”
</p>
<h3 id="G0QQPn">
Why Biden’s team is so effective at getting weapons to Israel
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rvcw5d">
The Biden administration has a robust understanding of weapons systems and the business behind them. While any mainstream US administration, Republican or Democrat, would likely be rushing weapons orders to Israel, this administration is uniquely qualified to do so, bringing to bear their successes on Ukraine arms transfer and experience advising weapons-makers. In the second year of his presidency, <a href="https://stephensemler.substack.com/p/comparing-arms-sales-under-trump">Biden’s arms sales</a> overtook President Donald Trump’s, who himself had already overseen a big increase.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SziMWz">
The House <a href="https://www.npr.org/2023/11/03/1210386678/house-approves-military-aid-israel">voted</a> in favor of new military assistance to Israel but cut out the Ukraine aid component, so the Senate will likely not pass it. In the meantime, the Biden administration has been efficient and quiet about transfers, using creative tools to jump-start deliveries to Israel that include <a href="https://www.defense.gov/News/Transcripts/Transcript/Article/3566388/senior-defense-official-senior-military-official-hold-a-background-briefing-on/">direct commercial sales</a> from arms-makers (meaning the US isn’t financing the purchases but does allow American weapons manufacturers to sell to Israel), governmental financing vehicles that don’t require congressional approval, and hurrying up orders that were placed before October. Stockpiles meant for US use are also being diverted to Israel. As a senior Pentagon official put it, “<a href="https://www.defense.gov/News/Transcripts/Transcript/Article/3566388/senior-defense-official-senior-military-official-hold-a-background-briefing-on/">expediting security assistance</a>” to Israel has been task number one.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nkrxFH">
Secretary of Defense Lloyd Austin is a former board member of Raytheon, the major military contractor that <a href="https://breakingdefense.com/2023/10/raytheon-rafael-officially-pick-arkansas-site-for-iron-dome-missile-production/">co-produces</a> Iron Dome receptors with the Israeli company Rafael Advanced Defense Systems. RTX, as Raytheon has been renamed, is one of the most significant providers to Israel. Austin and many other senior appointees to the Pentagon bring a depth of experience working for the arms industry. Even if they aren’t directly involved in the day-to-day — Austin has had to <a href="https://www.warren.senate.gov/newsroom/press-releases/in-response-to-senator-warrens-questions-secretary-of-defense-nominee-general-lloyd-austin-commits-to-recusing-himself-from-raytheon-decisions-for-four-years">recuse himself</a> from the Department of Defense’s dealings with Raytheon — the heft these appointments bring shows the seriousness with which the Biden administration takes the defense industrial base.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SV2udx">
As Austin <a href="https://www.appropriations.senate.gov/imo/media/doc/download_testimony8.pdf">told</a> the Senate, “We are flowing security assistance to Israel at the speed of war.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cdsTXC">
Secretary of State Antony Blinken co-founded WestExec Advisors in 2017, which has worked for military contractors, new military-tech startups, and Israeli companies. Blinken, for his part, advised the defense contractor <a href="https://prospect.org/power/meet-the-consulting-firm-staffing-biden-administration-westexec/">Boeing</a>, according to his financial disclosure. Last month, Boeing rushed the transfer of <a href="https://www.wsj.com/world/middle-east/u-s-plans-320-million-weapons-transfer-to-israel-as-gaza-toll-mounts-7c50afd9">1,000 smart bombs</a> and <a href="https://www.bloomberg.com/news/articles/2023-10-18/boeing-accelerates-delivery-of-up-to-1-800-gps-guidance-bomb-kits-to-israel#xj4y7vzkg">1,800 GPS-guidance bomb kits</a> to Israel.
</p>
<figure class="e-image">
<img alt="Shiny silver artillery shells stand in racks waiting to be painted." src="https://cdn.vox-cdn.com/thumbor/TeWaLZTuubCHIo8lG0y5Dy1EYxU=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25093447/1251797885.jpg"/> <cite>Aimee Dilger/SOPA Images/LightRocket via Getty Images</cite>
<figcaption>
Unfinished shells wait to be prepared for painting. The Scranton Army Ammunition Plant held a media day to show what they make. The plant makes a 155mm artillery shell.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="N5U2xG">
Much of the team that worked to get Israel the $38 billion Obama package over 10 years is leading the way. Other key State Department officials include Daniel Shapiro, who also <a href="https://prospect.org/power/biden-advisers-ride-on-pegasus-nso-spyware/">worked for the Israel spyware maker NSO Group</a> when he was out of government. Intelligence leaders, too, bring vast experience. Avril Haines, the director of the Office of National Intelligence, has worked as an adviser to the data-processing powerhouse Palantir, which has been a <a href="https://www.palantir.com/q3-2023-letter/en/">staunch supporter of Israel</a> and apparently provides advanced tech to the Israeli military.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="c69tjA">
The <a href="https://www.timesofisrael.com/israeli-arms-sales-doubled-in-a-decade-hit-new-record-of-12-5-billion-in-2022/">foundation of relationships between the defense industries</a> in the US, Israel, and its other partners in the region also helps. When the world’s biggest aerospace and defense companies gathered at the Dubai Airshow this week, for example, Israeli defense firms and officials <a href="https://en.globes.co.il/en/article-defense-ministry-bans-israelis-from-attending-dubai-airshow-1001462608">kept a low profile</a> — but the big deals continued. Take the US-Israel-UAE triangle, which benefits each country. Boeing, an American company, signed a <a href="https://apnews.com/article/dubai-air-show-israel-hamas-russia-ukraine-d2ca068f0c88592c60eb9f11737baa46">$52 billion</a> airliner contract with a UAE carrier. On the sidelines of the fair, business people discussed “the impact of the demand for equipment stemming from the conflicts in Gaza” and “Close U.S.-U.A.E. alignment on the Israel-Gaza conflict,” according to the <a href="https://mailchi.mp/usuaebusiness.org/us-officials-talk-defense-equipment-release-and-sales-policy-ahead-of-dubai-airshow-2023?e=7906d1715b">US-UAE Business Council</a>. At the same time, Elbit Systems’ Emirati subsidiary is selling <a href="https://www.ainonline.com/aviation-news/aerospace/2023-11-15/amid-conflict-israel-projects-minimal-presence-dubai">$53 million of military tech</a> to the UAE.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XKNND5">
The US has promoted the <a href="https://www.state.gov/u-s-security-cooperation-with-ukraine/">long lists</a> of weapons it is sending to Ukraine, publishing one-pagers and tallies that go into great detail. But as <a href="https://theintercept.com/2023/11/07/israel-us-weapons-secret/">the Intercept’s Ken Klippenstein</a> noted, the Biden administration has kept the list of weapons it’s sending to Israel secret. The administration has also “sought permission to unilaterally blanket-approve the future sale of military equipment and weapons — like ballistic missiles and artillery ammunition  —  to Israel without notifying Congress,” according to the watchdog group <a href="https://inthesetimes.com/article/white-house-request-waiver-arms-sales-gaza-israel">Women for Weapons Trade Transparency</a>. That would remove a key mechanism for oversight from lawmakers — and scrutiny from the public.
</p>
<h3 id="887DaD">
Who’s concerned about arms to Israel?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ApkupI">
Many of these weapons are now being used in Gaza, with catastrophic humanitarian results. That has led the United Nations, French President Emmanuel Macron, and a number of international organizations to urge an <a href="https://www.vox.com/world-politics/2023/11/4/23945628/israel-hamas-war-gaza-ceasefire-history-explained">immediate ceasefire</a>. Human Rights Watch has <a href="https://www.hrw.org/news/2023/11/14/gaza-unlawful-israeli-hospital-strikes-worsen-health-crisis">called for war crimes investigations</a> into the Israeli bombardment of the health care system.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RzMvO6">
“The emphasis is on damage and not on accuracy,” Israeli military spokesperson Rear Admiral Daniel Hagari <a href="https://www.theguardian.com/world/2023/oct/10/right-now-it-is-one-day-at-a-time-life-on-israels-frontline-with-gaza">said</a> last month. That heavy bombardment and death toll prompted the <a href="https://www.theguardian.com/world/video/2023/nov/16/un-commissioner-says-killing-of-gaza-civilians-cannot-be-dismissed-as-collateral-damage-video">UN’s high commissioner for human rights</a> to say Thursday that “the killing of so many civilians cannot be dismissed as collateral damage.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eQkmF5">
Given this, some activists are protesting US military aid to Israel and are calling for a <a href="https://www.vox.com/world-politics/2023/11/9/23953714/biden-campaign-alumni-want-gaza-ceasefire-state-department-dissent-memo">ceasefire</a>. One group called <a href="https://www.opendemocracy.net/en/palestine-action-elbit-eight-activists-trial-israel-palestine-gaza-weapons-arms/">Palestine Action</a> has been staging actions in the US and the United Kingdom at the facilities of Elbit Systems, an Israeli military contractor. About 150 protesters <a href="https://news.yahoo.com/pro-palestinian-protesters-target-raytheon-192145731.html">picketed</a> Raytheon Technologies in El Segundo, California, for its arms trade with Israel.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ugdwnP">
Josh Paul, a former senior State Department official overseeing arms sales who resigned in protest last month, has been straightforward in saying that Israel is in violation of international law. “It is my opinion that Israel is committing war crimes in its actions in Gaza right now,” he <a href="https://www.al-monitor.com/originals/2023/11/us-ignores-israeli-war-crimes-domestic-politics-ex-official#ixzz8JGjuhTzZ">said</a>. “And it’s not just my opinion. I’ve actually heard from officials across government, including elected officials at a very senior level, who share that opinion but aren’t willing to say it in public.”
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/M_ylTTOEkIh8TlOkizJjtFV8l3Q=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25093445/1723576026.jpg"/> <cite>Yuri Cortez/AFP via Getty Images</cite>
<figcaption>
A shipment of 155mm artillery shells used by the Israeli army is transported on a truck along a highway between Jerusalem and Beersheba in southern Israel on October 14, 2023.
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This may be setting up Israel for a collision with the Biden administration.
</p>
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In February 2022, Biden strengthened the human rights component of US arms transfers. The administration put a new emphasis on human rights in the <a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2023/02/23/memorandum-on-united-states-conventional-arms-transfer-policy/">Conventional Arms Transfer</a> policy that added safeguards for “elevating the importance of protecting civilians.” The policy specifically restricted the transfer of weapons that are “more likely than not” to be used in atrocities, including violations of the Geneva Convention or of international humanitarian law.
</p>
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The Biden administration may be “violating its own conventional arms transfer policy” by sending arms to Israel, as Seth Binder of the Project on Middle East Democracy <a href="https://jacobin.com/2023/11/biden-administration-israel-gaza-military-aid-conventional-arms-transfer-policy">recently told Jacobin</a>.
</p>
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But senior Biden officials insist the administration is upholding its commitments. “All of our arms transfers, including arms transfers to Israel, are rooted in the basic proposition that they will be used consistent with [the] law of armed conflict,” Jake Sullivan, the national security adviser, <a href="https://www.whitehouse.gov/briefing-room/press-briefings/2023/10/20/on-the-record-press-call-with-omb-director-shalanda-young-and-national-security-advisor-jake-sullivan-on-the-supplemental-request-for-critical-national-security-funding-needs/">said</a> last month. “There is no exception here and no difference here from any of our other arms transfers.” The administration regularly conveys to Israel the importance of humanitarian laws, that “innocent civilians must be taken [in]to account for any operation,” <a href="https://www.defense.gov/News/Transcripts/Transcript/Article/3591847/deputy-pentagon-press-secretary-ms-sabrina-singh-holds-a-press-briefing/">according</a> to Pentagon spokesperson Sabrina Singh.
</p>
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Some of the concerns relate specifically to the kinds of weapons the US delivers. The document that Bloomberg obtained showed that the US is sending Israel 57,000 of the 155mm shells that are used in artillery guns. A group of humanitarian aid groups and security experts had sent a <a href="https://reliefweb.int/report/occupied-palestinian-territory/joint-open-letter-transfer-155mm-artillery-shells-israel">letter to the secretary of defense</a> earlier in the week urging the Biden administration not to send these shells to Israel, saying they are “inherently indiscriminate” and “have a high error radius, often landing 25 meters away from the intended target,” which would be particularly destructive in a place as densely populated as Gaza.
</p>
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As arms trade accelerates and scrutiny on Israel’s operations heightens, the reason for the strengthening of the arms transfer policy’s human rights component seems more relevant than ever. “It is not in the US national interest to engage in arms transfers where we assess that they are likely to be used in human rights violations,” Christopher Le Mon, a senior State Department official, <a href="https://www.youtube.com/watch?v=ULFfEvf3Mxs&amp;t=1s">said</a> in March. “It does not advance our national interests, it does not advance our national security.”
</p></li>
<li><strong>Formula 1 grew too fast. Now its new fans are tuning out.</strong> -
<figure>
<img alt="Several young men shout and hold their thumbs down in front of them in the stands of a racetrack." src="https://cdn.vox-cdn.com/thumbor/83YTbBlYVR6WT3we0l3QKhyTZFQ=/140x0:5011x3653/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72878706/1798343525.0.jpg"/>
<figcaption>
Spectators give a thumbs-down about leaving the track ahead of the F1 Grand Prix of Las Vegas on November 16. | Kym Illman/Getty Images
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</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The Las Vegas Grand Prix proves F1 needs more than glitz and glamour.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8jWbgn">
Thanks to a little show called <a href="https://www.vox.com/22652554/drive-to-survive-f1-racing-netflix"><em>Drive to Survive</em></a>, as well as fresh ownership by way of <a href="https://www.forbes.com/sites/csylt/2017/08/15/revealed-how-liberty-media-bought-formula-one-for-301-million/?sh=346d41d7f2a1">Liberty Media</a>, Formula 1 has never been more popular.<strong> </strong>This weekend, they’ll send the fastest cars in the world zooming down the Las Vegas Strip for <a href="https://theathletic.com/5047927/2023/11/10/f1-las-vegas-grand-prix-failure/">the first time in almost 40 years</a>. But if you’re a local looking to catch the race live — or any other American hoping to catch a glimpse of the cars roaring past — good luck.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JpgGE7">
A revitalized pop culture engine has taken over the sport: <a href="https://www.tiktok.com/t/ZT8URS4Vy/">Driver fancams on TikTok</a>, <a href="https://www.newyorker.com/magazine/2022/10/31/toto-wolff-the-compulsive-perfectionist-behind-mercedes-formula-1-team">erudite magazine features</a>, and <a href="https://www.youtube.com/watch?v=_PJvpq8uOZM&amp;ab_channel=BadBunny">braggadocious trap tracks</a> proliferate with each passing day. American audiences, traditionally accustomed to Nascar, have bought into F1, and brought with them a whole new world of moneymaking ploys, not all of which are so fan-friendly.
</p>
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Ask anyone who has spent time at the Miami Grand Prix, which was added to the race calendar just last year: Liberty Media is all about making F1 into an experience, <a href="https://www.thrillist.com/travel/nation/formula-1-races-us-travel-destination">the racing equivalent of Coachella</a> for <a href="https://www.vox.com/celebrities">celebrities</a>, <a href="https://www.vox.com/influencers">influencers</a>, and uber-wealthy tastemakers. All the while, the company pumped up the showiness with <a href="https://www.autoweek.com/racing/formula-1/a43829636/over-the-top-driver-intros-at-f1-miami-grand-prix-divided-drivers/">lavish, cheesy ceremonies</a>. “I guess it’s the American way of doing things, doing sport,” Mercedes driver George Russell said about the Miami race back in May. (At races in Italy, Canada, and Japan, the ceremonies pale in comparison.)
</p>
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If Miami’s extravaganza is any indication, there’s trouble brewing for Las Vegas, especially when it comes to understanding the various audiences in America. Miami’s three-day event put spectacle above sport in every way. And it seems like this weekend on the Strip will have the same excessive vibe — at the cost of everyday fans, locals, and even the Formula 1 teams themselves.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8R7Ypp">
Not only has the hasty construction for a temporary street race track caused <a href="https://www.nevadacurrent.com/2023/10/18/formula-1-officials-say-efforts-to-resolve-traffic-issues-still-a-work-in-progress/">months of havoc</a>, going to the race is out of the question unless you make serious bank. The average “get-in” price began at <a href="https://www.cnn.com/2023/11/15/business/f1-race-las-vegas-ticket-prices/index.html">about $1,600</a> when tickets went on sale a year ago, unless you want to <a href="https://f1destinations.com/tickets-f1-las-vegas-grand-prix-2023/">stand by the Sphere for a cool $500</a>. That’s not including airfare, lodging, food and drink, or any bougie hospitality package (those range from thousands to <a href="https://www.caesars.com/events/f1/nobu-emperor-package">millions of dollars</a>, FYI).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="R0q1yC">
While F1 officials claim that the event will generate <a href="https://www.ktnv.com/news/f1-las-vegas-grand-prix-set-to-boost-valley-economy-by-1-3-billion">more than $1 billion</a> in economic activity for locals, the logistics and fizzled hype around the race tell a different story. <a href="https://am.ticketmaster.com/lvgp/buy">Official tickets are still available</a> when they’re typically sold out, and <a href="https://www.forbes.com/sites/brianbushard/2023/11/14/prices-plummet-for-las-vegas-f1-grand-prix-heres-why/?utm_campaign=socialflowForbesMainTwitter&amp;utm_medium=social&amp;utm_source=ForbesMainTwitter&amp;sh=5d2a19cbd2a0">resale tickets have plummeted by hundreds of dollars</a>. (Don’t mistake a price drop for affordability, though — it’s still ridiculously expensive.) Reasons for such a decline include: an inconvenient start time (10 pm local time, or an absurd 1 am if you’re on the East Coast), a lack of <a href="https://www.espn.com/f1/story/_/id/38831559/max-verstappen-2023-officially-most-dominant-f1-season-ever">stakes</a> — as driver Max Verstappen has dominated the competition this season — and the fact that it’s <a href="https://www.autosport.com/f1/news/las-vegas-grand-prix-weather-forecast-how-cold-will-it-be-for-the-f1-race/10546744/">quite chilly</a> to watch cars vroom vroom in late November.
</p>
<figure class="e-image">
<img alt="A red Ferrari racecar is frozen in a still photo on a black racetrack, with lights and walls a blur around it." src="https://cdn.vox-cdn.com/thumbor/-1aWMP__k6-kVq35WEJ0_DiKwKQ=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25092753/1798474936.jpg"/> <cite>Mark Thompson/Getty Images</cite>
<figcaption>
Carlos Sainz of Spain driving a Ferrari SF-23 during practice ahead of the F1 Grand Prix of Las Vegas, on November 17.
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</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="N8RDIq">
Sure, Formula 1 has always been a glitzy sport, celebrated on Monaco’s champagne-laden yachts and marked by the opulence of Abu Dhabi’s day-to-night race. But the aggressive pursuit of even more glamour as its audience grows (and transforms) is a deep misunderstanding of why people like F1 to begin with. Fans brought in by Netflix’s <em>Drive to Survive</em> appreciate <a href="https://www.autosport.com/f1/news/how-does-a-formula-1-car-work-wings-diffusers-and-more-explained-4982275/4982275/">the sheer engineering fortitude</a> of cars that make 200 miles per hour look easy, the Bravo-worthy <a href="https://brobible.com/sports/article/fernando-alonso-ghosted-alpine-greek-isles/">interpersonal drama</a>, and the ease of only having to keep up with 20 drivers, rather than hundreds of athletes.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vLoUrs">
The Las Vegas Grand Prix looks to be proof of a hunch many have had for a while. Formula 1’s strategy for explosive growth was never about courting a diverse American audience of fervent fangirls, dorky dads, or motorsport maniacs. It’s about selling the pastiche of American sports to the wealthy, and giving European racing Super Bowl-levels of revenue and cultural soft power.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nDCtQ4">
Formula 1’s missteps in America reflect a fascinating microcosm of what Liberty Media believes drives Americans. But despite Formula 1’s popularity explosion, these recent changes ignore what everyone really wants: competitive, accessible racing. Unless the sport can provide that, new American fans will tune out.
</p>
<h3 id="rwL631">
How Formula 1 became so damn big in the US
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rDw99R">
At the risk of severely oversimplifying F1 to the chagrin of nerds everywhere, the cool thing about Formula 1 is that it’s a physical and technological feat every race. Drivers are going so fast that their bodies are actively fighting against <a href="https://onestopracing.com/g-force-in-f1-explained/">five times the G-force</a> of a normal car. That’s the equivalent of feeling your body becoming five times heavier than it actually is. And in order to make cars go faster and also keep drivers safe, suites of engineers tirelessly research improvements.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QLRS6x">
It’s different from Nascar in a few ways: Drivers race on winding tracks with hard turns rather than circular tracks, the gulfs in performance between the best and worst machines are massive, and, thanks to <a href="https://www.dive-bomb.com/post/the-importance-of-neck-training-for-formula-1-drivers">literally breakneck speeds</a> made to push bodies to their limits, the stakes are higher.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fS5ryd">
There are 10 teams in F1, with two drivers each. There’s a driver championship, where individual racers compete against each other (even teammates), and the constructor’s championship to reward the team as a whole. <a href="https://www.si.com/fannation/racing/f1briefings/track-guides/whats-the-difference-between-f1-constructor-standings-and-driver-standings">Winning in either category</a> nets you more money to build better cars, and better cars mean more wins.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6piuwF">
For a long time, the complexity of F1 alienated potential fans, much the way baseball’s stats-oriented ethos does. US-based company Liberty Media, which owns SiriusXM, <a href="https://www.forbes.com/sites/csylt/2017/08/15/revealed-how-liberty-media-bought-formula-one-for-301-million/?sh=7022c0877f2a">bought Formula 1 in 2017</a>, and updated the branding of the sport to be sexier and more watchable in order to get younger crowds at races. But it was <em>Drive to Survive</em> that changed F1’s longstanding reputation, matching feats of science with drama on the track.
</p>
<figure class="e-image">
<img alt="A huge Texas flag flies over a long, twisting racetrack and huge stands full of people, while cars race along the track." src="https://cdn.vox-cdn.com/thumbor/OaNnzA3TP2VKMyRVXJJffFeCWqY=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25092760/1244207318.jpg"/> <cite>Gongora/NurPhoto via Getty Images</cite>
<figcaption>
The grandstands were full of spectators during the F1 Grand Prix USA in October 2022 in Austin, Texas.
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</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MXK0MT">
The show first aired in 2019, right before the pandemic, and while growth started slow, it has become exponential. 2021 was the first season where audiences could come back to the track, and it couldn’t have been a better time to be an F1 fan. Upstart Verstappen and veteran Mercedes driver Lewis Hamilton — who was battling for his potentially <a href="https://news.sky.com/story/formula-1-lewis-hamilton-misses-out-on-record-eighth-f1-world-title-after-drama-at-abu-dhabi-grand-prix-12491965">record-breaking eighth world champion title</a> — were neck and neck all season, with Verstappen ultimately coming out on top.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rfjdVV">
Total attendance globally for the 2022 season was 5.7 million, up 36 percent compared to 2019, <a href="https://www.libertymedia.com/news/detail/485/liberty-media-corporation-reports-fourth-quarter-and-year">according to Liberty Media’s public financial reports</a>. 2021 and 2022 saw <a href="http://www.sportspromedia.com/news/f1-united-states-grand-prix-2022-record-attendance-cota-new-york-race/?zephr_sso_ott=RfVDpz#:~:text=Formula%20One's%20recent%20race,at%20the%20venue%20in%20Austin.">back-to-back record-breaking attendance</a> at the Austin Grand Prix, with 400,000 and 440,000 attendees, respectively. The average attendance in 2019 per race globally was <a href="https://www.eurosport.com/formula-1/motor-racing-silverstone-on-top-as-f1-reports-bigger-crowds-in-2019_sto7583046/story.shtml">around 200,000 viewers</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SlkSfr">
With that huge growth came the desire to do more in the US — where a lot of change stemmed from. Formula 1 added the Miami Grand Prix in <a href="https://www.sportsbusinessjournal.com/SB-Blogs/SBJ-Unpacks/2023/05/05.aspx?hl=formula+1&amp;sc=0">2022</a>, with the expectation of a <a href="https://www.reuters.com/lifestyle/sports/miami-make-f1-debut-2022-under-10-year-deal-2021-04-18/">10-year contract</a>. The Las Vegas race was announced shortly after, with the debut aiming for 2023.
</p>
<h3 id="ZxolWw">
The growing pains of finding new audiences
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bGPzeC">
The crucial issue with Formula 1 and Liberty Media is their assumption of who is attending these races. The additions of Miami and Las Vegas suggest that F1 is only really after a good party. It makes sense: These are cities that offer a lot of nightlife, <a href="https://vegas.eater.com/2023/11/14/23959505/watch-formua-one-f1-race-dine-celebrities-expensive-las-vegas-strip">food</a>, and culture for those who might only attend a race because it’s the cool thing to do.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rhxNKG">
Roaming around the Miami paddock and the Mercedes party at the Ritz-Carlton on South Beach back in May, I asked folks whether they were fans of a certain team or racer. One answered while sipping a sake martini that she was here for a PR trip; another answered that she lives in Miami and that F1 creates an opportunity to mingle with celebrities and influencers. One half of electronic duo Disclosure played some oontz-oontz tracks, and for a moment, brought Mercedes reserve driver Mick Schumacher, <a href="https://www.crash.net/f1/news/1019743/1/impressive-f1-records-michael-schumacher-still-holds-2023">the son of decorated F1 racer</a> Michael Schumacher, to the stage. Only a handful of people recognized him.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SCJMWH">
In some ways, Liberty Media is right. The guest who is there for the vibe needs to be catered to — they’re the ones who have full wallets. At the same time, longtime fans and even new fans who care about the actual sport bristle at this dynamic. Tickets are becoming more expensive when theoretically these races should be more accessible. Austin’s general admission for the whole race weekend in 2021 was around $200-$300. This year, <a href="https://www.statesman.com/story/sports/college/longhorns/football/2023/10/17/what-to-know-about-f1-u-s-grand-prix-at-cota-2023-the-killers-queen-adam-lambert-tiesto/71204748007/">they went for $475</a>. Las Vegas’s <a href="https://www.f1lasvegasgp.com/inventory?type=General%20Admission">standing room only admission starts at $500</a>, but the hospitality options exceed the price of Miami’s.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zlc5rC">
Currently, some longtimers are miffed at the <a href="https://www.thecut.com/2023/03/formula-1-racing-fangirls.html">fangirl culture shift,</a> blaming them for the changes in F1. The lines between fangirl and clout-chaser are seemingly thin for those who can’t tell the difference. But really, it’s not the new female devotees who are at fault, it’s corporate greed. Those same enthusiasts are certainly the ones asking hard questions: Where are the <a href="https://www.sportingnews.com/us/formula-1/news/f1-academy-explained-new-all-female-driver-series-2023/szkphkthjfkuhmjj36kx1vxn">female drivers</a>? Why did F1 seem so <a href="https://www.cnn.com/2020/07/05/motorsport/f1-austrian-grand-prix-drivers-kneel-and-stand-hamilton-bottas-spt-intl/index.html">pro-“End Racism”</a> in 2020 only to muzzle drivers years later? Why was an <a href="https://www.newsweek.com/formula-one-groping-driver-1557049">alleged abuser</a> and son of a <a href="https://www.espn.com/f1/story/_/id/33681873/inside-haas-how-f1-american-team-cut-ties-nikita-mazepin-oligarch-father">Russian oligarch </a>racing for so long? That can be a tough pill to swallow when so much of the sport has for years been just about statistics. But questioning the status quo can only strengthen the sport — it’s leaving fans out that poses the real problem.
</p>
<h3 id="uyZ3cs">
What’s going on with the Las Vegas Grand Prix?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3sy4DQ">
Lovingly put, Formula 1 severely overestimated the Venn diagram of who loves to watch racing and who can afford a laughably decadent experience. F1 has turned into a spectacle, riding on the coattails of its <a href="https://www.formula1.com/en/latest/article.how-hamilton-and-verstappens-battle-evolved-over-the-2021-season.733vQgLMqampix5fLefN62.html">most exhilarating season in 2021,</a> and the <a href="https://www.si.com/fannation/racing/f1briefings/news/f1-news-charles-leclerc-speaks-candidly-about-hard-to-accept-failures-in-2022-jd22">gut-wrenching rise and fall of Ferrari’s attempt to win the driver’s championship in 2022</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ROLp4E">
But this season’s stakes are just … not there. It’s a total snooze for a new fan who may have become accustomed to the edge-of-your-seat dynamics of the last two years. Verstappen took the championship already with a <a href="https://www.espn.com/f1/story/_/id/38831559/max-verstappen-2023-officially-most-dominant-f1-season-ever">record-breaking 17 wins out</a> of 23 races this year. He could start in the very back of the pack and still take pole position. With the driver’s and constructor’s championship more or less decided, the season is remarkably uninteresting. <a href="https://www.sportsmediawatch.com/2023/11/nba-viewership-back-up-after-big-increase-f1-off-pace-iowa-womens-ratings-nhl/">According to ESPN</a>, Formula 1 is averaging 1.11 million viewers across its networks — down 8 percent from last year.
</p>
<figure class="e-image">
<img alt="A racecar curves around a turn on a track with the lights of Las Vegas and a massive LED screen sphere in the background." src="https://cdn.vox-cdn.com/thumbor/Ye8CRnZmS7l-USyRRq4UjuoQORQ=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25092764/1798410777.jpg"/> <cite>Mark Thompson/Getty Images</cite>
<figcaption>
Max Verstappen driving the Oracle Red Bull Racing RB19 during practice ahead of the F1 Grand Prix in Las Vegas on November 17.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xQ9t1U">
Unlike what <em>Drive to Survive</em> depicts, the drama just isn’t there. The seemingly predetermined nature of these races is turning America off. (Longtime fans may remember a time when Michael Schumacher won five years in a row, so it’s not like the dominance is necessarily new, but it’s just not what drew in bright-eyed American fans.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="APKGh0">
So it’s not that much of a shocker that people don’t want to spend their hard-earned money on a race that doesn’t really matter all that much, especially when said race is the most expensive on the calendar. If Las Vegas apes Miami’s overpriced, underwhelming hospitality — one attendee in May <a href="https://twitter.com/PeterMcCormack/status/1655300145024491521">tweeted</a> “Fyre festival vibes,” after reportedly paying $42 for a “wagyu” sandwich that had what looked like a few slices of ham — it could mean even more tension between certain types of fans.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LzCW4a">
Then there’s the issue of how unwelcome Formula 1 is in Las Vegas. Unlike Miami and Austin, where the races are held temporarily within a stadium or on a dedicated circuit far away from downtown areas, the Las Vegas Grand Prix is at the heart of the city, on roads locals use every day. Street races have their place on the calendar (like in Singapore, my personal favorite to watch), but the key difference is local governments have a sustained relationship with F1 and Liberty Media. What’s going on in Vegas is a haphazard, bureaucratic mess.
</p>
<div id="3vy26o">
<div style="width: 100%; height: 152px;">
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xT6ykR">
As Elizabeth Blackstock reported for <a href="https://jalopnik.com/i-hope-it-bankrupts-them-las-vegas-residents-enraged-a-1851009102">Jalopnik,</a> locals and laborers alike have immense scorn for the <a href="https://www.washingtonpost.com/travel/2023/11/16/las-vegas-f1-race-track/">infrastructural disaster the sport has wreaked on the city</a> for the last nine months, in addition to chopping down trees, pricing out tourists, and more. “I’ll leave you with this,” an anonymous front-of-the-house hotel worker told Blackstock. “I often hear the sentiment, joking or not, that folks wish the mob still ran Las Vegas instead of these vultures and leeches.”
</p>
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Liberty Media CEO Greg Maffei <a href="https://www.theguardian.com/sport/2023/nov/14/f1-apology-las-vegas-greg-maffei-disruption-night-race-complaints">recently issued an apology</a> for the disruption, but padded it with the so-called economic benefit of the race. “I want to apologize to all the Las Vegas residents and we appreciate that they have their forbearance and their willingness to tolerate us,” he said. “We’re going to bring something like $1.7 billion of revenue to the area.”
</p>
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The drivers themselves are a bit more measured. Negative connotations aren’t good for the sport. “I’ve heard there’s been a lot of complaints about the event being here from the locals,” Hamilton <a href="https://www.espn.com/f1/story/_/id/38910392/lewis-hamilton-f1-circus-respect-las-vegas-locals">told reporters</a>. “We’ve got to make sure people are taken care of. We can’t be a circus that shows up that’s all glitz and glamour and people are affected negatively by it, in my opinion.”
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The big question Formula 1 will have to ask itself after this weekend is: Was it worth it? A <a href="https://twitter.com/ESPNF1/status/1725383633094287724">poorly installed drain cover</a> shredded the bottom of Ferrari driver Carlos Sainz’s car during practice, leading to a <a href="https://us.motorsport.com/f1/news/vasseur-f1-vegas-manhole-issues-that-wrecked-sainzs-ferrari-unacceptable/10547502/">pricey repair worth a “fortune,”</a> penalties for Sainz, and a 90-minute delay, pushing the second practice to 2:30 am. Fans were <a href="https://racingnews365.com/police-eject-fans-minutes-before-las-vegas-fp2">ejected from the grandstands</a> moments before practice resumed. What’s the point of spending all that money if you only got to see 10 minutes of car racing?
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The impression is that the US is full of fans with money, and that’s true to some extent. But it’s hard to build something solid and lasting on razzle-dazzle and upcharged extras. Nothing can be cool forever, and drawing comparisons to doomed music festivals doesn’t bode well for the long term. Even if people are dropping the equivalent of a house down payment to have a good time, the growing pains are here. For some fans, the hurt will be too much.
</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>ICC World Cup | Spectator invades field of play during India-Australia final to meet Virat Kohli</strong> - In a massive security breach, a Palestinian supporter invaded the field and hugged Virat Kohli during the 14th over of India’s innings</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>ICC ban a betrayal of the nation: Sri Lanka Sports Minister Roshan Ranasinghe</strong> - The case on the suspension of the interim committee is to be taken up on November 20 in the Court of Appeal.</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>ICC World Cup finals | Narendra Modi stadium turns sea of blue to watch India in red hot form</strong> - Many fans were getting their faces painted in the three colours of the flag from children who were charging ₹50 each.</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>Indian Air Force’s Surya Kiran team puts up spectacular show ahead of World Cup final</strong> - A total of nine Hawk Mk-132 SKAT aircrafts of the IAF created history as it is for the first time that they produced an aerial show ahead of any cricket match in India</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>Las Vegas Grand Prix | Max Verstappen battles through to win a thriller</strong> - Ferrari’s Charles Leclerc overtook Red Bull’s Sergio Perez on the last lap to grab second place</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>Talking Politics with Nistula Hebbar | Vijayendra as new party chief | Will this move consolidate BJP’s position in Karnataka?</strong> - The appointment of Mr. Vijayendra, considered B.S Yeddyurappa’s political heir, is aimed at providing some salve to the Lingayat community’s alienation.</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>Legal aid defense counsels asked to gain knowledge of digital technology</strong> - Justice B.V.L.N. Chakravarthy of Andhra Pradesh High Court participates in the State-wide orientation programme for Legal Aid Defense Counsels organised APSLSA and NLSA</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>Self-regulation provisions in draft broadcasting Bill draw diverse views</strong> - Legal experts point to potential drawbacks in personal data protection of evaluation committee members, overlap in the powers of the regulatory authorities, grey areas with respect to OTT platforms, and concerns over artistic freedom</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>Entrepreneurs are returning from Europe-U.S. to be part of India’s growth story</strong> - Mr. Srivastava said he wants to see the Indian economy growing at double-digit though it is stable at the current 6.5% growth.</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>Police catch security guard flaunting pistol and bullet strap on moving train in Karnataka</strong> -</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>Ukraine war: The Russians snitching on colleagues and strangers</strong> - In Soviet Russia it was common for people to report others to the authorities - now the practice is back.</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>‘Waves’ of Russian drones attack Kyiv for second night in a row</strong> - The latest raids have revived fears Moscow is targeting Ukraine’s energy infrastructure as winter begins.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ukraine war: Marines gain riverbank foothold but front lines barely move</strong> - Marines talk of progress on “several bridgeheads” but soldiers talk of fatigue at the front.</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 seeks extremist label for LGBT movement</strong> - The measure could leave any LGBT activist in the country vulnerable to criminal prosecution.</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>French senator Joël Guerriau questioned on suspicion of drugging MP</strong> - Joël Guerriau was detained after the MP complained of feeling unwell after a drink.</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>Cities: Skylines 2’s troubled launch, and why simulation games are freaking hard</strong> - Elaborate parking booths, Q4 financials, game engines, and the nature of sims. - <a href="https://arstechnica.com/?p=1984342">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Sensible power output makes the DBA Mini eMastered a huge amount of fun</strong> - Think of it as an alternative to a supercar. - <a href="https://arstechnica.com/?p=1984688">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>OpenAI board attempts to hit “Ctrl-Z” in talks with Altman to return as CEO</strong> - Cleared of malfeasance, Altman’s unpopular firing may be undone—if he’s interested. - <a href="https://arstechnica.com/?p=1985272">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Starship brought the thunder as it climbed into space for the first time</strong> - Starship reached a speed of 15,000 mph, then self-destructed over the Gulf of Mexico. - <a href="https://arstechnica.com/?p=1985247">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The FCC says new rules will curb SIM swapping. I’m pessimistic</strong> - SIM swaps and port-out scams are a fact of life. New rules aren’t likely to change that. - <a href="https://arstechnica.com/?p=1985061">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>A priest, a minister, and a rabbi want to see who’s best at his job. So they each go into the woods, find a bear, and attempt to convert it.</strong> - <!-- SC_OFF --></p>
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Later they get together. The priest begins: “When I found the bear, I read to him from the Catechism and sprinkled him with holy water. Next week is his First Communion.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“I found a bear by the stream,” says the minister, “and preached God’s holy word. The bear was so mesmerized that he let me baptize him.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
They both look down at the rabbi, who is lying on a gurney in a body cast. “Looking back,” he says, “maybe I shouldn’t have started with the circumcision.”
</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/TheQuietKid22"> /u/TheQuietKid22 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17yrr2a/a_priest_a_minister_and_a_rabbi_want_to_see_whos/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17yrr2a/a_priest_a_minister_and_a_rabbi_want_to_see_whos/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What did your husband get YOU?</strong> - <!-- SC_OFF --></p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Three southern belles stood together gossiping. The topic of discussion were gifts from their husbands. Here’s how it went.
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Pointing at a house on top of a hill, the first southern belle boasts, “Y’all ain’t never seen a house like that. My husband built me that there house!” The second southern belle’s jaw drops and begins to say, “My, I wish my husband would do me that!” The third southern belle squints her eyes and says, “That’s nice. That’s real nice.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Feeling small, the second southern belle begins to take off her coat to reveal jewelry all over her person. She brags, “MY husband keeps me bright as a diamond! The jewelry on my body could simply buy a damn house.” The first southern belle turns red as her body was bare of any jewelry. She says with defeat and admiration, “How beautiful of a gift from your husband.. I wish my husband would do me that!” And the third southern belle said softly, “That’s nice. That’s real nice.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The third southern belle stood quiet. The first and second belle look at eachother, then the third… look at eachother, then the third…. Growing impatient, the first one exclaims, “And what did your husband get YOU?”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Gracefully, the third southern belle says, “Well… my husband paid for my etiquette classes, so instead of saying, ‘I DONT GIVE A FUCK….. I say, ’That’s nice. That’s real nice.’”
</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/sweetmaja"> /u/sweetmaja </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17yiw1n/what_did_your_husband_get_you/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17yiw1n/what_did_your_husband_get_you/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I went to McDonald’s today. I smiled at the bloke and said “Can I have a small shake please?”</strong> - <!-- SC_OFF --></p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He told me to “Fuck off” and walked out of the men’s toilets.
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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/Wallygonk"> /u/Wallygonk </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17ytnat/i_went_to_mcdonalds_today_i_smiled_at_the_bloke/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17ytnat/i_went_to_mcdonalds_today_i_smiled_at_the_bloke/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A well known fighter was drinking at a bar</strong> - <!-- SC_OFF --></p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
When an old man walks in, taps him on the shoulder and says “I just fucked your mother! Whatcha gonna do about it, big man?”. The music stops, the patrons turn to look, but the fighter says nothing and keeps drinking. The old man gets frustrated and leaves in a huff.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Later, the old man comes back and jabs the fighter in the shoulder again. “I just got back from fucking your mom again! Whatcha gonna do about it, big boy?” The fighter just shruggs it off and keeps to his drink so the old drunkard leaves again frustrated.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Another 2 hours go by, and the old man shows back up. He stumbles over to the fighter and yells “I’m just gonna keep fucking your mother! Whatcha gonna do about that?!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The fighter finally puts his drink down, lightly grabs the man by his shoulders, and says, “Dad, you’re drunk, go home.”
</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/headexpl0dy"> /u/headexpl0dy </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17yfto9/a_well_known_fighter_was_drinking_at_a_bar/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17yfto9/a_well_known_fighter_was_drinking_at_a_bar/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I think think my best friend is having an affair with my wife.</strong> - <!-- SC_OFF --></p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He’s been miserable lately.
</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/KarmicComic12334"> /u/KarmicComic12334 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17ycegj/i_think_think_my_best_friend_is_having_an_affair/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17ycegj/i_think_think_my_best_friend_is_having_an_affair/">[comments]</a></span></p></li>
</ul>
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