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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>Effect of Trait Anxiety and Quarantine on Mood and Decision Making</strong> -
<div>
Our social environment influences our affective states and decisions, which was quite evident during COVID-19 pandemic-imposed quarantine. However, little is understood about recovery from social deprivation, especially for those with high trait anxiety. To understand this, we gathered ~24000 momentary assessments of affect and social interactions over three days of isolation followed by seven days of recovery from 116 young adults returning to a university campus. Quarantine induced a greater desire for social interactions and post-quarantine, individuals attempted to make up for this in different ways. High trait anxious individuals, who experienced more stressful events, higher negative affect, and lower positive affect during and after quarantine, depended more on interaction with people “close” to them. They derived greater emotional benefits from close interactions and experienced greater reductions in negative affect due to such positive events. However, low trait anxious individuals experienced less stress, and post-release, they interacted more with distant companions, which increased their positive affect. We also studied how affective states impacted decision-making through a virtual patch-foraging task played during and after quarantine. Affective states reported in the last 24 hours significantly impacted participants near-optimal strategies to maximize rewards in the task. Participants with high fluctuation in affective states tended to over-harvest, while those with high average negative affect tended to under-harvest. Our results highlight how social deprivation impacts affective states as a function of trait anxiety and social interactions and their effects on reward-based decision-making.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/jt6gz/" target="_blank">Effect of Trait Anxiety and Quarantine on Mood and Decision Making</a>
</div></li>
<li><strong>Factors associated with severe acute respiratory syndrome-related coronavirus 2 infection in unvaccinated children and young adults</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
BACKGROUND: Pediatric COVID-19 cases are often mild or asymptomatic, which has complicated estimations of disease burden using existing testing practices. We aimed to determine the age-specific population seropositivity and risk factors of SARS-CoV-2 seropositivity among children and young adults during the pandemic in British Columbia (BC). METHODS: We conducted two cross-sectional serosurveys: phase 1 enrolled children and adults &lt;25 years between November 2020-May 2021 and phase 2 enrolled children &lt;10 years between June 2021-May 2022 in BC. Participants completed electronic surveys and self-collected finger-prick dried blood spot (DBS) samples. Samples were tested for immunoglobulin G antibodies against ancestral spike protein (S). Descriptive statistics from survey data were reported and two multivariable analyses were conducted to evaluate factors associated with seropositivity. RESULTS: A total of 2864 participants were enrolled, of which 95/2167 (4.4%) participants were S-seropositive in phase 1 across all ages, and 61/697 (8.8%) unvaccinated children aged under ten years were S-seropositive in phase 2. Overall, South Asian participants had a higher seropositivity than other ethnicities (13.5% vs. 5.2%). Of 156 seropositive participants in both phases, 120 had no prior positive SARS-CoV-2 test. Young infants and young adults had the highest reported seropositivity rates (7.0% and 7.2% respectively vs. 3.0-5.6% across other age groups). CONCLUSION: SARS-CoV-2 seropositivity among unvaccinated children and young adults was low in May 2022, and South Asians were disproportionately infected. This work demonstrates the need for improved diagnostics and reporting strategies that account for age-specific differences in pandemic dynamics and acceptability of testing mechanisms.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.13.23294036v2" target="_blank">Factors associated with severe acute respiratory syndrome-related coronavirus 2 infection in unvaccinated children and young adults</a>
</div></li>
<li><strong>A molnupiravir-associated mutational signature in global SARS-CoV-2 genomes</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Molnupiravir, an antiviral medication that has been widely used against SARS-CoV-2, acts by inducing mutations in the virus genome during replication. Most random mutations are likely to be deleterious to the virus, and many will be lethal, and so molnupiravir-induced elevated mutation rates reduce viral load. However, if some patients treated with molnupiravir do not fully clear SARS-CoV-2 infections, there could be the potential for onward transmission of molnupiravir-mutated viruses. Here we show that SARS-CoV-2 sequencing databases contain extensive evidence of molnupiravir mutagenesis. Using a systematic approach, we find that a specific class of long phylogenetic branches, distinguished by a high proportion of G-to-A and C-to-T mutations, appear almost exclusively in sequences from 2022, after the introduction of molnupiravir treatment, and in countries and age-groups with widespread usage of the drug. We identify a mutational spectrum, with preferred nucleotide contexts, from viruses in patients known to have been treated with molnupiravir and show that its signature matches that seen in these long branches, in some cases with onwards transmission of molnupiravir-derived lineages. Finally, we analyse treatment records to confirm a direct association between these high G-to-A branches and the use of molnupiravir.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.01.26.23284998v4" target="_blank">A molnupiravir-associated mutational signature in global SARS-CoV-2 genomes</a>
</div></li>
<li><strong>How reliable are estimates of key parameters in viral dynamic models?</strong> -
<div>
Mathematical models of viral infection have been developed and fit to data to gain insight into disease pathogenesis for a number of agents including HIV, hepatitis C and B virus. However, for acute infections such as influenza and SARS-CoV-2, as well as for infections such as hepatitis C and B that can be acute or progress to being chronic, viral load data are often collected after symptoms develop, usually around or after the peak viral load. Consequently, we frequently lack data in the exponential phase of viral growth, i.e., when most transmission events occur. Missing data may make estimation of the time of infection, the infectious period, and parameters in viral dynamic models, such as the cell infection rate, difficult. Here, we evaluated the reliability of estimates of key model parameters when viral load data prior to the viral load peak is missing. We estimated the time from infection to peak viral load by fitting non-linear mixed models to a dataset with frequent viral RNA measurements, including pre-peak. We quantified the reliability of estimated infection times, key model parameters, and the time to peak viral load. Although estimates of the time of infection are sensitive to the quality and amount of available data, other parameters important in understanding disease pathogenesis, such as the loss rate of infected cells, are less sensitive. We find a lack of data in the exponential growth phase underestimates the time to peak viral load by several days leading to a shorter predicted exponential growth phase. On the other hand, having an idea of the time of infection and fixing it, results in relatively good estimates of dynamical parameters even in the absence of early data.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.08.17.553792v1" target="_blank">How reliable are estimates of key parameters in viral dynamic models?</a>
</div></li>
<li><strong>Purification, crystallization, and preliminary structural analysis of multivalent immunogenic effector protein-anchored SARS-CoV-2 RBD</strong> -
<div>
The continuous spread of highly transmissible variants of concern and the potential diminished effectiveness of existing vaccines necessitate ongoing research and development of new vaccines. Immunogenic molecule-anchored antigen has demonstrated superior efficacy in subunit vaccination, primarily due to enhanced cellular uptake facilitated by the affinity between the surface of Immunogenic molecule and the cell membrane. Based on the Immunogenic recombinase B. malayi RecA (BmRecA), we have overexpressed the construct of BmRecA with SARS-CoV-2 RBD (BmRecA-RBD) that exists as a stable helical filament formation; it was purified and crystallized to obtain X-ray diffraction data at 2.7 Angstrom, belonged to the hexagonal symmetry group P65 in the unit-cell parameters of a=b=122.12, c=75.55 and alpha=beta=90 degree, gamma=120 degree. The Matthews coefficient was estimated to be 3.12 Angstrom3 Da-1, corresponding to solvent contents of 52.65.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.08.17.553661v1" target="_blank">Purification, crystallization, and preliminary structural analysis of multivalent immunogenic effector protein-anchored SARS-CoV-2 RBD</a>
</div></li>
<li><strong>Virological characteristics of the SARS-CoV-2 XBB.1.5 variant</strong> -
<div>
Circulation of SARS-CoV-2 Omicron XBB has resulted in the emergence of XBB.1.5, a new Variant of Interest. Our phylogenetic analysis suggests that XBB.1.5 evolved from XBB.1 by acquiring the F486P spike (S) mutation, subsequent to the acquisition of a nonsense mutation in ORF8. Neutralization assays showed similar abilities of immune escape between XBB.1.5 and XBB.1. We determined the structural basis for the interaction between human ACE2 and the S protein of XBB.1.5, showing similar overall structures between the S proteins of XBB.1 and XBB.1.5. The intrinsic pathogenicity of XBB.1.5 in hamsters is lower than that of XBB.1. Importantly, we found that the ORF8 nonsense mutation of XBB.1.5 resulted in impairment of MHC expression. In vivo experiments using recombinant viruses revealed that the XBB.1.5 mutations are involved with reduced virulence of XBB.1.5. Together, these data suggest that the mutations in ORF8 and S could enhance spreading of XBB.1.5 in humans.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.08.16.553332v1" target="_blank">Virological characteristics of the SARS-CoV-2 XBB.1.5 variant</a>
</div></li>
<li><strong>Assembly of SARS-CoV-2 ribonucleosomes by truncated N* variant of the nucleocapsid protein</strong> -
<div>
The Nucleocapsid (N) protein of SARS-CoV-2 compacts the RNA genome into viral ribonucleoprotein (vRNP) complexes within virions. Assembly of vRNPs is inhibited by phosphorylation of the N protein SR region. Several SARS-CoV-2 variants of concern carry N protein mutations that reduce phosphorylation and enhance the efficiency of viral packaging. Variants of the dominant B.1.1 viral lineage also encode a truncated N protein, termed N* or {Delta}(1-209), that mediates genome packaging despite lacking the N-terminal RNA-binding domain and SR region. Here, we show that {Delta}(1-209) and viral RNA assemble into vRNPs that are remarkably similar in size and shape to those formed with full-length N protein. We show that assembly of {Delta}(1-209) vRNPs requires the leucine-rich helix (LH) of the central disordered region, and that the LH promotes N protein oligomerization. We also find that fusion of a phosphomimetic SR region to {Delta}(1-209) inhibits RNA binding and vRNP assembly. Our results provide new insights into the mechanisms by which RNA binding promotes N protein self-association and vRNP assembly, and how this process is modulated by SR phosphorylation.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.08.16.553581v1" target="_blank">Assembly of SARS-CoV-2 ribonucleosomes by truncated N* variant of the nucleocapsid protein</a>
</div></li>
<li><strong>Molecular evolution and adaptation of SARS-CoV-2 omicron XBB sub-lineage Spike protein under African selection pressure.</strong> -
<div>
The SARS-CoV-2 Omicron variant of concern (VOC) has multiple mutations in the spike (S) protein, which mediates viral infection and immunity. We analysed a sub lineage of Omicron, designated omicron XBB (XBB), that showed structural and functional changes in the S protein in response to the African selection pressures. We used molecular modelling to compare the S protein structures of the original Omicron and XBB found that XBB had a reduced receptor-binding domain (RBD) due to the loss of some {beta}-sheets, which may increase its affinity to the human angiotensin-converting enzyme 2 (hACE2) receptor. We also used Fast Unconstrained Bayesian AppRoximation (FUBAR) and Recombination Detection Program 4 (RDP 4) to perform selection and recombination analysis respectively of the S protein sequences of Omicron and XBB and detected signals of positive selection and recombination in the N terminal domain (NTD) of the S1 subunit, which contains antibody-binding epitopes, and the RBD, which is involved in viral entry. Our results reveal the structural and functional adaptation of the Omicron XBB variant in Africa and its potential implications for viral pathogenesis and immunity.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.08.16.553557v1" target="_blank">Molecular evolution and adaptation of SARS-CoV-2 omicron XBB sub-lineage Spike protein under African selection pressure.</a>
</div></li>
<li><strong>Early estimation of life expectancy using weekly deaths data</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
This paper proposes a simple method to obtain early estimates of life expectancy at any age using data on weekly deaths. Although tailored on weekly deaths data from the Statistical Office of the European Union (Eurostat), the logic of the method is applicable to any timely data on infra-annual deaths counts, would they be quarterly, monthly, or other. When the method is applied to a time period still to complete, it is in substance a nowcasting technique whose reliability increases as new data become available, provided a correct specification of the model. It is also presented an application to 30 European countries for the years 2022 and 2023, returning a provisional estimate of life expectancy at birth much earlier than from official statistics. These early estimates show that in Europe the process of recovery in life expectancy at birth from the COVID-19 pandemic will be practically completed in 2023, unless unexpected mortality crises will occur in the second half of the year.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.11.23293993v2" target="_blank">Early estimation of life expectancy using weekly deaths data</a>
</div></li>
<li><strong>Mapping COVID-19 vaccine acceptance and uptake amongst Chinese residents: A systematic review and meta-analysis</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Objective: Controlling the COVID-19 pandemic depends on the widespread acceptance of vaccination. Vaccine hesitancy is a growing area of concern in China. The aim of the study is to map the overall acceptance and uptake rates of COVID-19 vaccines across different groups.  Methods: Five peer-reviewed databases bases were searched (PubMed, EMBASE, Web of Science, EBSCO, and Scopus). Studies that conducted cross-sectional surveys in China to understand the acceptance/willingness to receive COVID-19 vaccines were included.  Results: Among 2420 identified studies, 47 studies with 327,046 participants were eligible for data extraction. Males had a higher uptake of COVID-19 vaccines (OR=1.17; 95% CI:1.08 - 1.27) along with Chinese residents with &gt;= 5000 RMB monthly income (OR=1.08; 95% CI:1.02 - 1.14). Conclusion: COVID-19 vaccination uptake rates in China need to be improved. To inform public health decisions, continuous vaccination uptake monitoring is required.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.09.23293915v1" target="_blank">Mapping COVID-19 vaccine acceptance and uptake amongst Chinese residents: A systematic review and meta-analysis</a>
</div></li>
<li><strong>Effects of the COVID-19 pandemic on the restaurant industry: Comparisons between immigrants and US-born workers</strong> -
<div>
The COVID-19 pandemic reduced employment in the U.S., across many industries. The restaurant industry was particularly hard hit, losing 2.5 million jobs in 2020 alone. Now in the recovery from the pandemic, the restaurant industry is experiencing an unprecedented shortage of workers, forcing many restaurants to raise their offered wages, reduce their hours of service, or close altogether. How have workers been affected by these demand shocks? Understanding the demand for restaurant workers during the pandemic and the recovery has important policy implications because restaurant workers make up the third largest occupation group and have the lowest wages of any occupation group. Foreign-born workers in particular are overrepresented in restaurants and in the back-of-house jobs that are lower paying and more dangerous. Using results from our nationally-representative survey of restaurant owners and hiring managers and our analysis of Community Population Survey data, we found that foreign-born workers fared worse than native-born workers as the restaurant industry shed jobs during the height of the pandemic. Our findings are consistent with previous studies suggesting that foreign-born workers are more vulnerable to negative business cycles than their native-born counterparts. But during the various stages of the recovery, when the restaurant industry experienced worker shortages, we also found that there was very little shifting toward foreign-born workers. These results are at odds with previous studies suggesting that foreign-born workers would be more attractive in these circumstances because they are more adaptable to changing labor demands (including dangerous working conditions like a pandemic) and do not have access to social safety net benefits like unemployment compensation. Part of the explanation for this surprising result may be found in recent, more restrictive immigration policies that have decreased the pool of available foreign-born workers.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/d5bc6/" target="_blank">Effects of the COVID-19 pandemic on the restaurant industry: Comparisons between immigrants and US-born workers</a>
</div></li>
<li><strong>Post-recovery health domain scores among outpatients by SARS-CoV-2 testing status during the pre-Delta period</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Symptoms of COVID-19 including fatigue and dyspnea, may persist for weeks to months after SARS-CoV-2 infection. This study compared self-reported disability among SARS-CoV-2-positive and negative persons with mild to moderate COVID-19-like illness who presented for outpatient care before widespread COVID-19 vaccination. Methods: Unvaccinated adults with COVID-19-like illness enrolled within 10 days of illness onset at three US Flu Vaccine Effectiveness Network sites were tested for SARS-CoV-2 by molecular assay. Enrollees completed an enrollment questionnaire and two follow-up surveys (7-24 days and 2-7 months after illness onset) online or by phone to assess illness characteristics and health status. The second follow-up survey included questions measuring global health, physical function, fatigue, and dyspnea. Scores in the four domains were compared by participants SARS-CoV-2 test results in univariate analysis and multivariable Gamma regression. Results: During September 22, 2020 - February 13, 2021, 2,712 eligible adults were enrolled, 1,541 completed the first follow-up survey, and 650 completed the second follow-up survey. SARS-CoV-2-positive participants were more likely to report fever at acute illness but were otherwise comparable to SARS-CoV-2-negative participants. At first follow-up, SARS-CoV-2-positive participants were less likely to have reported fully or mostly recovered from their illness compared to SARS-CoV-2-negative participants. At second follow-up, no differences by SARS-CoV-2 test results were detected in the four domains in the multivariable model. Conclusion: Self-reported disability was similar among outpatient SARS-CoV-2-positive and -negative adults 2-7 months after illness onset.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.14.23294086v1" target="_blank">Post-recovery health domain scores among outpatients by SARS-CoV-2 testing status during the pre-Delta period</a>
</div></li>
<li><strong>The predictive and prognostic value of peripheral blood antigen-specific memory B cells in phospholipase A2 receptor-associated membranous nephropathy</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background Phospholipase A2 receptor-associated membranous nephropathy (PLA2R-MN) is an anti-PLA2R antibody (PLA2R-Ab) mediated autoimmune kidney disease. Although antibody titer correlates closely with disease activity, whether it can provide longer-term predictions on disease course and progression is unclear. Rituximab, a B-cell depletion therapy, has become the first-line treatment option for PLA2R-MN; however, the response to Rituximab varies among patients. Methods We developed a flow cytometry-based test that detects and quantifies PLA2R antigen-specific memory B cells (PLA2R-MBCs) in peripheral blood, the primary source for PLA2R-Ab production upon disease relapse. We applied the test to 159 blood samples collected from 28 patients with PLA2R-MN (at diagnosis, during and after immunosuppressive treatment, immunological remission, and relapse) to evaluate the relationship between circulating PLA2R-MBC levels and disease activity. Results The level of PLA2R-MBCs in healthy controls (n=56) is less than or equal to 1.5% of the total MBC compartment. High circulating PLA2R-MBC levels were detected in two patients post-Rituximab despite achieving immunologic and proteinuric remission, as well as in two patients with negative serum autoantibody but increasing proteinuria. Elimination of these cells with Rituximab improved clinical outcomes. Moreover, five patients exhibited elevated PLA2R-MBC levels before disease relapse, followed by a rapid decline to baseline when relapse became clinically evident. COVID-19 vaccination or SARS-CoV-2 infection significantly affected the dynamics of circulating PLA2R-MBCs. Conclusions This study suggests that monitoring PLA2R-MBC levels in patients with PLA2R-MN may help refine and individualize immunosuppressive therapy and predict disease course and progression. The technology and findings may also have broader applications in the clinical management of other autoimmune diseases.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.14.23292885v1" target="_blank">The predictive and prognostic value of peripheral blood antigen-specific memory B cells in phospholipase A2 receptor-associated membranous nephropathy</a>
</div></li>
<li><strong>Coronaviruses Spike glycoprotein endodomains: the sequence and structure-based comprehensive study</strong> -
<div>
The flexibility of proteins makes them available to interact with many biomolecules in the cell. Specifically, such interactions in viruses help them to perform more functions despite having a smaller genome. Therefore, these flexible regions can be exciting and essential targets to be explored for their role in pathogenicity and therapeutic developments as they achieve essential interactions. In the continuation with our previous study on disordered analysis of SARS-CoV-2 spike cytoplasmic tail (CTR), or endodomain, here we have explored the disordered potential endodomains of six other coronaviruses using multiple bioinformatics approaches and molecular dynamics simulations. Based on the comprehensive analysis of its sequence and structural composition, we report the varying disorder propensity in endodomains of spike proteins of coronaviruses. The observations of this study may help to understand the importance of spike glycoprotein endodomain and creating therapeutic interventions against them.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.08.16.553512v1" target="_blank">Coronaviruses Spike glycoprotein endodomains: the sequence and structure-based comprehensive study</a>
</div></li>
<li><strong>Predicting host-based, synthetic lethal antiviral targets from omics data</strong> -
<div>
Traditional antiviral therapies often have limited effectiveness due to toxicity and development of drug resistance. Host-based antivirals, while an alternative, may lead to non-specific effects. Recent evidence shows that virus-infected cells can be selectively eliminated by targeting synthetic lethal (SL) partners of proteins disrupted by viral infection. Thus, we hypothesized that genes depleted in CRISPR KO screens of virus-infected cells may be enriched in SL partners of proteins altered by infection. To investigate this, we established a computational pipeline predicting SL drug targets of viral infections. First, we identified SARS-CoV-2-induced changes in gene products via a large compendium of omics data. Second, we identified SL partners for each altered gene product. Last, we screened CRISPR KO data for SL partners required for cell viability in infected cells. Despite differences in virus-induced alterations detected by various omics data, they share many predicted SL targets, with significant enrichment in CRISPR KO-depleted datasets. Comparing data from SARS-CoV-2 and influenza infections, we found possible broad-spectrum, host-based antiviral SL targets. This suggests that CRISPR KO data are replete with common antiviral targets due to their SL relationship with virus-altered states and that such targets can be revealed from analysis of omics datasets and SL predictions.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.08.15.553430v1" target="_blank">Predicting host-based, synthetic lethal antiviral targets from omics data</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>Study of Obeldesivir in Children and Adolescents With COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Drug: Obeldesivir<br/><b>Sponsor</b>:   Gilead Sciences<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>EFFECT OF COGNITIVE BEHAVIORAL THERAPY ON DEPRESSION AND QUALITY OF LIFE IN PATIENTS WITH POST COVID-19</strong> - <b>Condition</b>:   Post-COVID-19 Syndrome<br/><b>Intervention</b>:   Behavioral: rehacom<br/><b>Sponsor</b>:   Cairo University<br/><b>Enrolling by invitation</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Immunogenicity and Safety of AdCLD-CoV19-1 OMI as a Booster: A COVID-19 Preventive Vaccine in Healthy Volunteers</strong> - <b>Conditions</b>:   COVID-19;   Vaccines<br/><b>Interventions</b>:   Biological: AdCLD-CoV19-1 OMI;   Biological: Comirnaty Bivalent 0.1mg/mL (tozinameran and riltozinameran)<br/><b>Sponsor</b>:   Cellid Co., Ltd.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Using Text Messages to Boost COVID-19 Vaccine Booking Rate</strong> - <b>Conditions</b>:   Vaccination Hesitancy;   COVID-19<br/><b>Interventions</b>:   Behavioral: Behavioural science-informed text messages;   Behavioral: Control<br/><b>Sponsors</b>:   The Behavioural Insights Team;   Public Health England;   Department of Health and Social Care;   NHS England and NHS Improvement<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>Ivermectin to Prevent SARS-CoV-2 (COVID-19) Hospitalisation in Subjects Over 50</strong> - <b>Conditions</b>:   COVID-19;   SARS-CoV-2<br/><b>Interventions</b>:   Drug: Ivermectin;   Drug: Placebo<br/><b>Sponsor</b>:   Insud Pharma<br/><b>Terminated</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>Methylprednisolone in Patients With Cognitive Deficits in Post-COVID-19 Syndrome (PCS)</strong> - <b>Condition</b>:   Post-COVID-19 Syndrome<br/><b>Intervention</b>:   Drug: Methylprednisolone<br/><b>Sponsor</b>:   Charite University, Berlin, Germany<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Phase II Trial to Evaluate the Safety and Immunogenicity of BIMERVAX® When Coadministered With Seasonal Influenza Vaccine (SIIV) in Adults Older Than 65 Years of Age Fully Vaccinated Against COVID-19</strong> - <b>Conditions</b>:   SARS CoV 2 Infection;   Influenza, Human<br/><b>Interventions</b>:   Biological: BIMERVAX;   Biological: SIIV<br/><b>Sponsor</b>:   Hipra Scientific, S.L.U<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>Leveraging Community Health Workers to Combat COVID-19 and Mental Health Misinformation in Haiti, Malawi, and Rwanda</strong> - <b>Conditions</b>:   Mental Health;   COVID-19;   Misinformation<br/><b>Interventions</b>:   Behavioral: Card-Sorting Activity (Pre-intervention design);   Behavioral: SMS Crafting (Pre-intervention design);   Behavioral: SMS Messaging<br/><b>Sponsors</b>:   Harvard Medical School (HMS and HSDM);   Partners in Health<br/><b>Active, not recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Study to Learn About New COVD-19 RNA Vaccine Candidates for New Varients in Healthy Individuals</strong> - <b>Conditions</b>:   SARS-CoV-2 Infection;   COVID-19<br/><b>Intervention</b>:   Biological: BNT162b2 (Omi XBB.1.5)<br/><b>Sponsors</b>:   BioNTech SE;   Pfizer<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pulmonary Artery Pressure in COVID-19 Survivors</strong> - <b>Condition</b>:   Pulmonary Hypertension Secondary<br/><b>Intervention</b>:   Diagnostic Test: right heart catheterization (RHC).<br/><b>Sponsor</b>:   Mansoura University Hospital<br/><b>Enrolling by invitation</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>Preliminary Efficacy of a Technology-based Physical Activity Intervention for Older Korean Adults During the COVID-19 Pandemic</strong> - <b>Conditions</b>:   Cardiovascular Health;   Physical Function<br/><b>Intervention</b>:   Behavioral: Golden Circle<br/><b>Sponsor</b>:   University of Illinois at Urbana-Champaign<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>Supported Employment COVID-19 Rapid Testing for PWID</strong> - <b>Condition</b>:   Health Behavior<br/><b>Intervention</b>:   Behavioral: Supported Employment<br/><b>Sponsor</b>:   University of Oregon<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study of Tixagevimab/Cilgavimab and Regdanvimab Efficacy for Treatment of COVID-19</strong> - <b>Condition</b>:   Coronavirus Infections<br/><b>Interventions</b>:   Drug: tixagevimab/cilgavimab 150+150 mg;   Drug: tixagevimab/cilgavimab 300+300 mg;   Drug: regdanvimab<br/><b>Sponsors</b>:   City Clinical Hospital No.52 of Moscow Healthcare Department;   Gamaleya Research Institute of Epidemiology and Microbiology, Health Ministry of the Russian Federation<br/><b>Active, not recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Playing Games to Learn About Childrens Vaccines Project</strong> - <b>Conditions</b>:   HPV;   COVID-19;   Vaccine-Preventable Diseases<br/><b>Intervention</b>:   Behavioral: vaccination games<br/><b>Sponsor</b>:   Michigan State 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>Cereset Research Long-Term Healthcare Worker Study</strong> - <b>Conditions</b>:   Stress;   Anxiety;   Autonomic Dysregulation;   Acoustic Stimulation;   Hyperarousal;   Health Personnel<br/><b>Intervention</b>:   Device: Cereset Research<br/><b>Sponsors</b>:   Wake Forest University Health Sciences;   Susanne Marcus Collins Foundation, Inc.<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>Cysteamine-mediated blockade of the glycine cleavage system modulates epithelial cell inflammatory and innate immune responses to viral infection</strong> - Transient blockade of glycine decarboxylase (GLDC) can restrict de novo pyrimidine synthesis, which is a well-described strategy for enhancing the host interferon response to viral infection and a target pathway for some licenced anti-inflammatory therapies. The aminothiol, cysteamine, is produced endogenously during the metabolism of coenzyme A, and is currently being investigated in a clinical trial as an intervention in community acquired pneumonia resulting from viral (influenza and…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Bioengineered Neutrophil Extinguisher Targets Cascade Immune Pathways of Macrophages for Alleviating Cytokine Storm in Pneumonia</strong> - Cytokine storm is a common complication of COVID-19 pneumonia and has been proven to contribute to high mortality rates. However, current treatment approaches exhibit limited potential to balance immune response and overproduction of inflammatory cytokines, leading to poor therapeutic outcomes. Herein, a smart bioengineered neutrophil, Extinguisher, composed of live neutrophils encapsulating the liposome formulation of NF-κB suppressor MLN4924 and STING inhibitor H-151 (Lip@MH), is developed for…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Discovery of GS-5245 (Obeldesivir), an Oral Prodrug of Nucleoside GS-441524 That Exhibits Antiviral Efficacy in SARS-CoV-2-Infected African Green Monkeys</strong> - Remdesivir 1 is an phosphoramidate prodrug that releases the monophosphate of nucleoside GS-441524 (2) into lung cells, thereby forming the bioactive triphosphate 2-NTP. 2-NTP, an analog of ATP, inhibits the SARS-CoV-2 RNA-dependent RNA polymerase replication and transcription of viral RNA. Strong clinical results for 1 have prompted interest in oral approaches to generate 2-NTP. Here, we describe the discovery of a 5-isobutyryl ester prodrug of 2 (GS-5245, Obeldesivir, 3) that has low cellular…</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>Novel mono- and multivalent N-acetylneuraminic acid glycoclusters as potential broad-spectrum entry inhibitors for influenza and coronavirus infection</strong> - N-acetylneuraminic acid (Neu5Ac) is a glycan receptor of viruses spread in many eukaryotic cells. The present work aimed to design, synthesis and biological evaluation of a panel of Neu5Ac derivatives based on a cyclodextrin (CD) scaffold for targeting influenza and coronavirus membrane proteins. The multivalent Neu5Ac glycoclusters efficiently inhibited chicken erythrocyte agglutination induced by intact influenza virus in a Neu5Ac density-dependent fashion. Compared with inhibition by Neu5Ac,…</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>Post-COVID-19 syndrome management: Utilizing the potential of dietary polysaccharides</strong> - The COVID-19 pandemic has caused significant global impact, resulting in long-term health effects for many individuals. As more patients recover, there is a growing need to identify effective management strategies for ongoing health concerns, such as post-COVID-19 syndrome, characterized by persistent symptoms or complications beyond several weeks or months from the onset of symptoms. In this review, we explore the potential of dietary polysaccharides as a promising approach to managing…</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>Alkyne as a Latent Warhead to Covalently Target SARS-CoV-2 Main Protease</strong> - There is an urgent need for improved therapy to better control the ongoing COVID-19 pandemic. The main protease M^(pro) plays a pivotal role in SARS-CoV-2 replications, thereby representing an attractive target for antiviral development. We seek to identify novel electrophilic warheads for efficient, covalent inhibition of M^(pro). By comparing the efficacy of a panel of warheads installed on a common scaffold against M^(pro), we discovered that the terminal alkyne could covalently modify…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Discovery and Mechanism Study of SARS-CoV-2 3C-like Protease Inhibitors with a New Reactive Group</strong> - 3CL^(pro) is an attractive target for the treatment of COVID-19. Using the scaffold hopping strategy, we identified a potent inhibitor of 3CL^(pro) (3a) that contains a thiocyanate moiety as a novel warhead that can form a covalent bond with Cys145 of the protein. Tandem mass spectrometry (MS/MS) and X-ray crystallography confirmed the mechanism of covalent formation between 3a and the protein in its catalytic pocket. Moreover, several analogues of compound 3a were designed and synthesized….</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 Suitable Membrane Distance Regulated by the RBD_ACE2 Interaction is Critical for SARS-CoV-2 Spike-Mediated Viral Invasion</strong> - The receptor-binding domain (RBD) of spike recognizing the receptor angiotensin-converting enzyme 2 (ACE2) initiates membrane fusion between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and cell membrane. Although the structure of the RBD_ACE2 complex has been well studied, its functional mechanism in membrane fusion is still not fully understood. Here, using an in vitro cell-vesicle content-mixing assay, it is found that the cleavage at the S2 site by thrombin (Thr) protease…</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>Endotheliopathy of liver sinusoidal endothelial cells in liver disease</strong> - Liver is the largest solid organ in the abdominal cavity, with sinusoid occupying about half of its volume. Under liver disease, hemodynamics in the liver tissue dynamically change, resulting in injury to liver sinusoidal endothelial cells (LSECs). We discuss the injury of LSECs in liver diseases in this article. Generally, in noninflamed tissues, vascular endothelial cells maintain quiescence of circulating leukocytes, and unnecessary blood clotting is inhibited by multiple antithrombotic…</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>Convalescent plasma from Norwegian blood donors to treat COVID-19</strong> - BACKGROUND: At the start of the pandemic, the Norwegian Directorate of Health and Norwegian blood banks initiated the production of COVID-19 convalescent plasma within the framework of clinical studies. In this article we describe the blood donors who participated.</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>De novo design of bioactive phenol and chromone derivatives for inhibitors of Spike glycoprotein of SARS-CoV-2 in silico</strong> - This work presents the synthesis of 12 phenol and chromone derivatives, prepared by the analogs, and the possibility of conducting an in silico study of its derivatives as a therapeutic alternative to combat the SARS-CoV-2, pathogen responsible for COVID-19 pandemic, using its S-glycoprotein as a macromolecular target. After the initial screening for the ranking of the products, it was chosen which structure presented the best energy bond with the target. As a result, derivative 4 was submitted…</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>Endothelial FoxM1 reactivates aging-impaired endothelial regeneration for vascular repair and resolution of inflammatory lung injury</strong> - Aging is a major risk factor of high incidence and increased mortality of acute respiratory distress syndrome (ARDS). Here, we demonstrated that persistent lung injury and high mortality in aged mice after sepsis challenge were attributable to impaired endothelial regeneration and vascular repair. Genetic lineage tracing study showed that endothelial regeneration after sepsis-induced vascular injury was mediated by lung resident endothelial proliferation in young adult mice, whereas this…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Forodesine and Riboprine Exhibit Strong Anti-SARS-CoV-2 Repurposing Potential: <em>In Silico</em> and <em>In Vitro</em> Studies</strong> - Lately, nucleos(t)ide antivirals topped the scene as top options for the treatment of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Targeting the two broadly conserved SARS-CoV-2 enzymes, RNA-dependent RNA polymerase (RdRp) and 3-to-5 exoribonuclease (ExoN), together using only one shot is a very successful new tactic to stop SARS-CoV-2 multiplication irrespective of the SARS-CoV-2 variant type. Herein, the current…</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>Anticancer pan-ErbB inhibitors reduce inflammation and tissue injury and exert broad-spectrum antiviral effects</strong> - Targeting host factors exploited by multiple viruses could offer broad-spectrum solutions for pandemic preparedness. Seventeen candidates targeting diverse functions emerged in a screen of 4,413 compounds for SARS-CoV-2 inhibitors. We demonstrated that lapatinib and other approved inhibitors of the ErbB family receptor tyrosine kinases suppress replication of SARS-CoV-2, Venezuelan equine encephalitis virus (VEEV), and other emerging viruses with a high barrier to resistance. Lapatinib…</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>Pyronaridine tetraphosphate is an efficacious antiviral and anti-inflammatory active against multiple highly pathogenic coronaviruses</strong> - The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), continues to be one of the largest dangers to human health around the world. The need for effective antiviral and anti-inflammatory treatments is still extremely high as newly emerging variants threaten the efficacy of currently used treatment options. Many compounds are effective at inhibiting SARS-CoV-2 infection in vitro but fail to recapitulate that efficacy in vivo….</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>In Vivek Ramaswamy, the Republicans Have Something New</strong> - The thirty-eight-year-old “anti-woke” polemicist and political novice has become one of Trumps main rivals. - <a href="https://www.newyorker.com/news/the-political-scene/in-vivek-ramaswamy-the-republicans-have-something-new">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Ukrainians Forced to Flee to Russia</strong> - Some are brought against their will. Others are encouraged in subtler ways. But the over-all efforts seem aimed at the erasure of the Ukrainian people. - <a href="https://www.newyorker.com/magazine/2023/08/21/the-ukrainians-forced-to-flee-to-russia">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Ron DeSantis Slump</strong> - The Florida governor once looked likely to defeat Donald Trump. Where did his campaign go wrong? - <a href="https://www.newyorker.com/news/the-political-scene/the-ron-desantis-slump">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Fani Williss Indictment of Donald Trump and a Voting-System Breach</strong> - The charges include allegations about a largely overlooked incident in Coffee County, Georgia. - <a href="https://www.newyorker.com/news/daily-comment/fani-williss-indictment-of-donald-trump-and-a-voting-system-breach">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Is Guatemala About to See an Upset Win for Democracy?</strong> - The governments attempts to influence the election have brought an unexpected opportunity for a candidate with a particular connection to the countrys history. - <a href="https://www.newyorker.com/news/daily-comment/is-guatemala-about-to-see-an-upset-win-for-democracy">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>How to handle a scary diagnosis</strong> -
<figure>
<img alt="A drawing of two hands holding each other in front of an abstract painterly background." src="https://cdn.vox-cdn.com/thumbor/vIkd_1mR_Bt5vvoXWw8LaJ47d5w=/240x0:1680x1080/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72560807/ScaryDiagnosis_PaigeVickers_Vox.0.jpg"/>
<figcaption>
Paige Vickers/Vox; Shutterstock
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</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Its tough to know how to talk about a life-threatening illness, whether its your own or someone elses.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ODkSiT">
When Chiara Riga was diagnosed with stage 4 metastatic breast cancer at 27, she was absolutely stunned. As her feelings morphed into a form of acceptance, Riga tried to live her life according to some semblance of normal — aside from the fact that she was undergoing intensive cancer treatment, barely mustering the energy to get through the day, and managing side effects like painful mouth sores. In retrospect, she realizes that attempting to move on as though nothing had changed didnt work at all. In fact, it psychologically backfired.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9FrMRB">
When she was diagnosed, Riga was told she would have another 10 to 15 years if she was lucky and that <a href="https://pubmed.ncbi.nlm.nih.gov/28500107/">only 26 percent of women</a> with her diagnosis live past five years. “The biggest emotional struggle has been watching all of my friends and peers go on with their lives — buy homes, have babies, get married — and I feel like I cant do those things,” says Riga. “Terminal cancer is always going to be something thats separating me from others.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OF2rFH">
September will mark three years since Riga was diagnosed. “There are a lot of people who were there at the beginning, wearing pink, bringing me pink things, who I now havent heard from in over a year,” she says. “It doesnt end when its no longer [fresh] news because this is going to be my life. It feels like everyone thinks that Ive got it settled because Ive been [navigating] this for so long, when in reality [my life with metastatic cancer] is constantly changing, and still checking in and still making an effort — even however many years in — is still really important.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="P82EQj">
Its common to receive a scary diagnosis. In 2023, <a href="https://seer.cancer.gov/statfacts/html/common.html">roughly 2 million people will be diagnosed with cancer in the US</a> and an estimated 600,000 people will die of the disease. Hundreds of thousands of Americans also face life-threatening diagnoses related to <a href="https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm">advanced lung, heart, kidney, or liver disease, stroke, and other neurological diseases</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FsGUB4">
And yet, talking about these diagnoses in a compassionate, supportive, understanding way often presents challenges for everyone involved — both the people who have been diagnosed and those who love them. While their heart may be in the right place, people learning of a loved ones diagnosis, often due to a feeling of helplessness, offer words that are anything but helpful. “Sometimes Ill hear patients say, My loved one, my partner, or my family member was so well-intended in telling me what they think I should be doing or why I got cancer, but it wasnt helpful to me,’” says <a href="https://www.simmsmanncenter.ucla.edu/profile/valentina-ogaryan/">Valentina Ogaryan</a>, a clinical psychologist at the Simms/Mann Center for Integrative Oncology at the University of California Los Angeles. Meanwhile, people whove received a life-threatening diagnosis are facing a bevy of complex emotions and may not know how to ask for what they need — or even know precisely what they need (or want) just yet.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PmV4NJ">
There are ways to thoughtfully discuss and respond to such a diagnosis, whether youre looking for support from loved ones after receiving news about your own health or you want to be there for someone you care for. Heres some guidance.
</p>
<h3 id="7fgodk">
How to talk about a scary diagnosis with friends and family
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="n3dbX8">
Who you share information about your diagnosis with as well as the best time to bring it up with them will depend on your individual needs and what feels right to you.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VCnbAZ">
“You need to do what you feel comfortable with at your own pace,” says <a href="https://www.mskcc.org/profile/meredith-cammarata">Meredith Cammarata</a>, an oncology social worker at Memorial Sloan Kettering Cancer Center in New York City. “You dont necessarily have to immediately start telling everyone if you dont want to. This is your own life, your own business, your own personal circumstances. Its okay to pick and choose who you want to tell and who you dont want to tell.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dmAn8V">
In doing so, you can create a support team with whom you feel able to be vulnerable. Conversely, you may also feel alone and isolated because you dont have people in your life you feel you can rely on or trust with this poignant news, says Cammarata. If thats the case, it can be helpful to reach out to other people navigating the same diagnosis in your medical community or connect with a mental health professional, she says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hzkIXS">
For example, Riga says the “single most helpful thing” for her mental health was making connections within the cancer community, like meeting a mentor with whom she has become close friends through an organization called <a href="https://abcdbreastcancersupport.org/">After Breast Cancer Diagnosis (ABCD)</a> and working with a psycho-oncologist. She also volunteers and advocates with <a href="https://b-present.org/">b-present</a>, an organization that provides resources for those supporting adolescents and young adults navigating cancer.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XOSLXa">
Amri Kibbler, a 48-year-old from Putnam Valley, New York, who was diagnosed with stage 3 colorectal cancer in December 2020, felt that connecting with people in support groups who were in a similar situation “age- and responsibility-wise” was “priceless.” “Community, as a cancer patient and survivor, really makes you feel less alone and makes you feel less afraid,” she says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4bHK2g">
Once youre clear on the people you can really rely on, you may begin to ask for what you need. Cammarata adds, “Its also normal, however, to feel like you dont know what you need.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6htpZ9">
For this reason, Cammarata says you may find it helpful to say, “Ive been diagnosed with X and Im not exactly sure what I need, but I will reach out to you when I need it,” or, depending on preference, “Id appreciate it if youd check in on me because Im not someone who is comfortable reaching out to someone else for support.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cQjfQQ">
Talk to your doctor and care team about how you can anticipate engaging with your caregivers and loved ones, suggests Cammarata. Questions might include:
</p>
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Will treatment require a ride from a family member or friend?
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What side effects might I experience?
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Am I going to be able to drive?
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Am I going to be able to do the cooking?
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Am I going to be able to take my kids to school or sporting events?
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</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eergWL">
You may be someone who can care for yourself physically and take yourself to and from treatments or procedures but who is seeking emotional connection and would like to discuss the diagnosis with family and friends. Or you may need them to show up to handle logistics and not want to discuss whats going on emotionally. Either way, speaking with your treatment team can help you get clear on which types of support you need most.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kIwVrc">
At times, you might set definitive boundaries. In 2021, Sacramento, California-based nursing student Rachel Thomas, now 32, was diagnosed with <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/gestational-trophoblastic-disease">gestational trophoblastic neoplasia</a>, a disease that occurs in early pregnancy, in which cells that would typically develop into the placenta turn into an abnormal — and in some cases cancerous — mass. She recalls being direct with friends and family from the get-go that she didnt want them to share their hot takes on her diagnosis and treatment.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4ByLKN">
“I was pretty clear that I didnt want opinions,” she recalls. “I said, If you dont have hard data for me, I just dont have faith in it. I think it was a good choice for me, and they respected it.”
</p>
<h3 id="eZuDbr">
What to say — and not say — to a loved one who has received a scary diagnosis
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kkF04s">
While learning that someone you love is facing a life-threatening diagnosis is no doubt frightening, showing support involves managing your own feelings as opposed to expecting them to. “Check in with yourself, and check in with your own emotions,” says Cammarata, who adds that its normal to feel helpless when youre in this position. “Its hard to tolerate feeling helpless, and instinctually, it makes people feel like they need to just do something quickly.” Instead, become aware of your own feelings, pause, shore up empathy, and then see how you might be able to be helpful to your loved one, she suggests.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="muKa7i">
It may be helpful to bear in mind that once patients receive a cancer diagnosis, they can experience an abrupt <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145173/">shift in their sense of self and identity</a>, says Ogaryan. Facing ones mortality and contending with potential existential distress can be overwhelming, and it can have different implications for the various roles in their lives, she notes. You can be helpful by “being a sounding board, a listening ear, responding compassionately, and giving permission for [your] loved one to share any/all of the emotions and feelings that may arise.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KG4Fzk">
By making a concerted effort to tune into and follow your loved ones cues — a valuable step Cammarata recommends taking ongoingly — youll note that there are times in which they want to open up and other moments in which theyd prefer not to discuss their experience at all.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uqXvEg">
“The best thing,” according to Riga, is when her friends ask, “Do you want a solution, or do you just want to vent?” “I think most people want to fix it, but you literally cant,” she says. “Dont try to make me feel better. Just validating that what Im going through sucks is the most important.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nkMTJz">
If sharing about their diagnosis seems like the last thing your loved one wants to do, you might say, “Im here to listen if and when you want to talk,” suggests Cammarata, who adds, “Be mindful that they might not want [their diagnosis] to be a topic of every discussion. They might say, Lets talk about the news or celebrity gossip. They might want to change the topic, and thats okay, too. It might be a nice reprieve.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NUZ9cn">
There will be moments in which you may not know what to say at all. When that happens, it is best to admit that, points out Meredith Diamond, a 30-year-old in California who was diagnosed in April with stage 4 <a href="https://www.lls.org/lymphoma/hodgkin-lymphoma/diagnosis/hodgkin-lymphoma-subtypes">nodular sclerosis Hodgkin lymphoma</a>. “I was grateful when people reached out and said, I dont even know what to say, because that feels more appropriate than when people start saying how sorry they are,” she says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="E23fL5">
That said, some moments call for simply being present in silence, holding space, and reflectively sitting side by side — something Thomas wishes her loved ones would have done more often.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dDdSGy">
“Its helpful to be in the moment with the person,” acknowledges Ogaryan.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1D3O87">
Concrete actions are also appreciated. You might note that youre going to the grocery store and ask if you can pick anything up for your loved one, suggests Cammarata. You might get them a gift card to a store or a restaurant that serves an extensive menu.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8B9Kh7">
Kibbler agrees that useful gifts — such as cute hats, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9276410/#:~:text=A%20randomized%20clinical%20study%20revealed,regimen%20with%20high%20emetogenic%20power.">ginger candies to ease nausea that may result from chemotherapy</a>, a cozy sweatshirt to lounge around in, even links to meditations, sound baths, or personalized playlists and photos of the people who care about them — are valued.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OIrYk1">
However, its possible that your loved one might not be able to eat those baked treats or be able to use certain gifts, so when in doubt, ask them, “How can I support you?” or “What do you need right now?” suggests Thomas. “People often hesitate to put that burden on somebody, to tell them what they need,” she says. “But I personally would have preferred to say, This is what I need today or Thank you so much for offering to buy us dinner. Im really in the mood for In-N-Out.’”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gD8tog">
Continuing to show up and check in over time is also a must. “In the beginning, there tend to be a lot of check-ins, a lot of how can I help, a plethora of support — sometimes so much support, some patients dont know what to do with it all,” says Cammarata. “And then, treatment goes on. Its the third month, its the sixth month, its a year and a half. Patients start to feel isolated because the amount of check-ins slowly starts to decrease.” For that reason, she emphasizes the impact of even a quick text like, “Checking in, how are you doing this week?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="u9bDVg">
Kibbler wishes she had received more texts like these. “I wished that people had reached out more,” she says. “Any little message of support always made a big difference in my day and how I was feeling. Its just a very lonely experience. You see the world going on around you [and] remember being sick. You really appreciate any kind of connection with other people that are taking the time to think of you in any which way.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GGCPfx">
Avoid platitudes such as, “Youre a warrior,” “F*ck cancer, lets win the battle,” or “Believe in the power of positive thinking,” all of which make it seem as though attitude is the sole determinant of the diseases outcome, says Cammarata. And while some people do find strength in these words, they can also exacerbate anxiety and <a href="https://pubmed.ncbi.nlm.nih.gov/35174696/">existential distress</a>, she notes. “When you say Be brave, be strong, think positively, it unintentionally tells someone how they should cope and how they should feel, and it takes away from that persons ability to truly describe their own feelings and their own individual experience. Oftentimes I see it leading to patients feeling invalidated and isolated.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Q8SZw7">
Along the same lines, steer clear of starting a sentence with “at least” (e.g. “at least they caught it when they did,” “at least you dont need chemotherapy,” or “at least you already have children, a thriving career, a partner, have traveled the world,” etc.), which minimizes your loved ones experience.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DB8L1R">
Instead, you might aim to validate that experience, offering words of support that mirror the following examples Thomas wishes she had heard more often from people in her circle:
</p>
<ul>
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“Thank you for sharing with me.”
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rQMQcm">
“Thank you for trusting me with your story.”
</li>
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“I hear you.”
</li>
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“That sounds hard.”
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sGqpgL">
Diamond says youll also do well to avoid “over-dramatic” statements, such as, “Why does this have to happen to you?” or “This isnt fair,” “This is the worst thing that could happen.” She explains that these statements feel like people are just trying to say what they think she wants to hear, when in fact all they do is ignite additional anxiety.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="F3PqzK">
Steer clear of telling stories about other people who have dealt with a similar diagnosis, adds Diamond. To her, this has felt overwhelming and as though people want to share their own stories, which only served to further complicate or even minimize her own. “Everyone has their own experience,” she says. “And sometimes, [it] felt like they were telling me how they thought my journey [should] be.” Peppering in other traumatic stories (even when the outcome is a positive one) typically only results in increasing anxiety rather than alleviating it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mUFHqZ">
Talking about a life-threatening diagnosis presents challenges for everyone involved — especially the person diagnosed. Thoughtfulness is key. Riga recalls casually telling a friend that she had a scan scheduled weeks in advance. “Just before, I got a text [that said] Hey, Im thinking of you. Dont feel like you have to share the results, but I just want you to know that Im wishing [you] the best. Its so simple. Its the little things, remembering, showing that you care.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uL6ju1">
<a href="https://drjessicazucker.com/"><em>Jessica Zucker</em></a><em> is a Los Angeles-based psychologist specializing in reproductive health and the author of </em><a href="https://bookshop.org/p/books/i-had-a-miscarriage-a-memoir-a-movement-jessica-zucker/14208928?ean=9781558612884"><em>I HAD A MISCARRIAGE: A Memoir, a Movement</em></a><em>. Her writing has appeared in the New York Times, the Washington Post, the Guardian, New York magazine, and Vogue, among others. Jessicas second book is due out next year.</em>
</p></li>
<li><strong>The case for optimism about the Supreme Court</strong> -
<figure>
<img alt="Brett Kavanaugh, Neil Gorsuch, Elena Kagen, and Samuel Alito sitting in a row, laughing." src="https://cdn.vox-cdn.com/thumbor/nr-e_zg8rry4R1NF_jfF9ZPJHTk=/205x0:4206x3001/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72560782/1062431280.0.jpg"/>
<figcaption>
Four justices laugh during a ceremony at the Trump White House. | Andrew Harrer/Bloomberg via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
There are some terrible things that even this Supreme Court isnt willing to do.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="whjlOz">
When you cover this <a href="https://www.vox.com/scotus">Supreme Court</a> for a living, it is tempting to fall into despair.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="y3c08b">
The Court has spent the last few years <a href="https://www.vox.com/scotus/2023/7/8/23784320/supreme-court-2022-term-affirmative-action-religion-voting-rights-abortion">relitigating long-settled fights</a> over abortion and <a href="https://www.vox.com/2023/6/14/23761092/supreme-court-affirmative-action-college-admissions-race">affirmative action</a>. It consistently rules that the rights of LGBTQ Americans, women using birth control, and even people who dont want to catch a deadly disease must <a href="https://www.vox.com/22889417/supreme-court-religious-liberty-christian-right-revolution-amy-coney-barrett">give way to the whims of the Christian Right</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kyVySh">
Under its three-year-old Republican supermajority, the Court took a <a href="https://www.vox.com/23180634/supreme-court-rule-of-law-abortion-voting-rights-guns-epa">decidedly post-legal turn</a>. It routinely relies on fabricated legal rules, such as the so-called <a href="https://www.vox.com/scotus/23791610/supreme-court-major-questions-doctrine-nebraska-biden-student-loans-gorsuch-barrett">major questions doctrine</a>, to veto liberal policies like <a href="https://www.vox.com/joe-biden">President Joe Biden</a>s <a href="https://www.vox.com/student-loan-debt">student loan</a> forgiveness program or <a href="https://www.vox.com/2022/6/30/23189610/supreme-court-epa-west-virginia-clean-power-plan-major-questions-john-roberts">to undermine environmental protections</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sU472P">
Its guns decision in <a href="https://www.vox.com/2022/6/23/23180205/supreme-court-new-york-rifle-pistol-clarence-thomas-second-amendment-guns"><em>New York State Rifle v. Bruen</em></a><em> </em>(2022) is an <a href="https://www.vox.com/2022/6/23/23180205/supreme-court-new-york-rifle-pistol-clarence-thomas-second-amendment-guns">incompetent train wreck</a>, which has <a href="https://www.washingtonpost.com/opinions/2023/07/07/originalism-supreme-court-second-amendment-reeves/">baffled lower court judges</a> and <a href="https://www.vox.com/policy-and-politics/2023/2/2/23583377/supreme-court-guns-domestic-abuse-fifth-circuit-second-amendment-rahimi-united-states">produced appalling results</a> — including an appeals court decision holding that a law prohibiting individuals from “possessing a firearm while under a domestic violence restraining order” is unconstitutional.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="M149aD">
And yet, despite all of this, I am far more optimistic about the future of the United States than I was a year ago, and a big reason why is the Supreme Courts behavior over the last several months.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Cg31Ai">
When the Court opened its latest term last October, <a href="https://www.vox.com/policy-and-politics/2022/9/26/23343192/supreme-court-voting-rights-abortion-affirmative-action-race-medicaid-clean-water">my level of alarm was about a 13 out of 10</a>. The GOP-appointed justices had just completed an <a href="https://www.vox.com/23180634/supreme-court-rule-of-law-abortion-voting-rights-guns-epa">orgy of conservative grudge settling</a>, including its decision overruling <a href="https://www.vox.com/2022/5/3/23055125/roe-v-wade-abortion-rights-supreme-court-dobbs-v-jackson"><em>Roe v. Wade</em></a>. Worse, the Court planned to hear new cases that could <a href="https://www.vox.com/2022/2/1/22910909/supreme-court-racial-gerrymander-alabama-merrill-singleton-milligan">legalize racial gerrymandering</a>, <a href="https://www.vox.com/policy-and-politics/2022/11/3/23435346/supreme-court-medicaid-health-hospital-corporation-indiana-talevski">gut Medicaid</a>, and potentially even <a href="https://www.vox.com/policy-and-politics/2022/12/4/23481063/supreme-court-moore-harper-independent-state-legislature-doctrine-elections">destroy US democracy altogether</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZVM8Ra">
A little less than a year later, my level of alarm is down to a nine. The Courts last term gave anyone to the left of Brett Kavanaugh <a href="https://www.vox.com/scotus/2023/7/8/23784320/supreme-court-2022-term-affirmative-action-religion-voting-rights-abortion">no shortage of outrages</a>, but it <a href="https://www.vox.com/scotus/2023/6/8/23754267/supreme-court-ketanji-brown-jackson-medicaid-health-hospital-talevski">left Medicaid intact</a>. It shut down an argument that many of <a href="https://www.vox.com/scotus/2023/6/23/23771310/supreme-court-united-states-texas-ice-immigration-drew-tipton-brett-kavanaugh">Donald Trumps nativist appointees to the lower courts used</a> to seize control of federal <a href="https://www.vox.com/immigration">immigration policy</a>. And, on the crucial issue of <a href="https://www.vox.com/voting-rights">voting rights</a>, the Court handed down <a href="https://www.vox.com/scotus/2023/6/8/23753932/supreme-court-john-roberts-milligan-allen-voting-rights-act-alabama-racial-gerrymandering">two decisions</a> <a href="https://www.vox.com/scotus/2023/6/27/23775378/supreme-court-moore-harper-john-roberts-independent-state-legislature-north-carolina-bush-gore">that give real hope</a> that, no matter how else these justices might interfere with federal policymaking, they will preserve the peoples right to elect officials that the justices themselves do not want to see in office.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eckR1U">
I want to be precise about the argument that Im making. If you are angry at the Supreme Court, you are right to be angry. Many of this Courts decisions are completely lawless — such as the Courts recent decision in <a href="https://www.supremecourt.gov/opinions/22pdf/22-506_nmip.pdf"><em>Biden v. Nebraska</em></a> (2023), which ignored a federal law that <a href="https://www.vox.com/scotus/2023/6/30/23779903/supreme-court-student-loan-biden-nebraska-john-roberts">unambiguously authorized Bidens student loan forgiveness program</a>. They demand anger. And <a href="https://www.vox.com/scotus/2023/7/8/23784320/supreme-court-2022-term-affirmative-action-religion-voting-rights-abortion">that anger isnt just righteous, it is useful</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="esQY4D">
But I also want to counsel against despair — that is, I want to counsel against the absence of hope.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tIt0pk">
The Courts GOP-appointed majority is starting to draw some fences around the conservative legal project. The Court appears <a href="https://www.vox.com/scotus/2023/6/8/23754267/supreme-court-ketanji-brown-jackson-medicaid-health-hospital-talevski">unwilling to attack entrenched parts of the American welfare state</a>. It smacked down a Trump judge who <a href="https://www.vox.com/politics/2023/4/21/23686788/supreme-court-abortion-pill-ruling-mifepristone-fda-alliance-hippocratic-medicine">attempted to ban the abortion drug mifepristone</a>. It has rejected legal arguments that would <a href="https://www.vox.com/2021/6/24/22547545/supreme-court-collins-yellen-124-billion-housing-unitary-executive-samuel-alito-neil-gorsuch">devastate the US economy</a> or <a href="https://www.vox.com/22996799/supreme-court-biden-navy-seal-vaccine-austin-covid">threaten its national security</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fBi8V9">
And, most importantly, the Court is now signaling that it may preserve <a href="https://www.vox.com/scotus/2023/6/27/23775378/supreme-court-moore-harper-john-roberts-independent-state-legislature-north-carolina-bush-gore">Americas ability to hold free and fair elections</a> (or, at least, to hold elections that are as free and fair as possible in a nation with an <a href="https://www.vox.com/policy-and-politics/2020/1/30/20997046/constitution-electoral-college-senate-popular-vote-trump">Electoral College and a malapportioned Senate</a>).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="L9000Y">
If it holds to that, theres a very real chance that liberals and centrists can defeat this <a href="https://www.vox.com/scotus/2023/7/8/23784320/supreme-court-2022-term-affirmative-action-religion-voting-rights-abortion">increasingly unpopular Court</a> the old-fashioned way — by consistently electing presidents and senators who will fill the Court with justices who will relegate the works of Samuel Alito <a href="https://www.vox.com/23180634/supreme-court-rule-of-law-abortion-voting-rights-guns-epa">to the anti-canon</a>.
</p>
<h3 id="36w688">
The Supreme Court still appears to have some commitment to democracy
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rsgtLV">
A year ago, the Supreme Court appeared to be <a href="https://www.vox.com/22575435/voting-rights-supreme-court-john-roberts-shelby-county-constitution-brnovich-elena-kagan">waging a war on the Voting Rights Act</a>, the landmark law that banned race discrimination in elections, and at least four justices seemed eager to give state lawmakers <a href="https://www.vox.com/policy-and-politics/2022/12/4/23481063/supreme-court-moore-harper-independent-state-legislature-doctrine-elections">unprecedented new authority to rig elections</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="F3ERPV">
Today, the picture is different. The Court surprised pretty much everyone who pays attention to voting rights litigation when, in <a href="https://www.supremecourt.gov/opinions/22pdf/21-1086_1co6.pdf"><em>Allen v. Milligan</em></a> (2023), it <a href="https://www.vox.com/scotus/2023/6/8/23753932/supreme-court-john-roberts-milligan-allen-voting-rights-act-alabama-racial-gerrymandering">struck down a racial gerrymander that benefits Republicans</a> in the state of Alabama. Even more significantly, <em>Milligan</em> relied on a provision of the Voting Rights Act, known as the “results test,” which Chief Justice John Roberts has crusaded against for nearly his entire career.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dCwUbT">
This provision, which provides a state election law that “results in a denial or abridgement of the right of any citizen of the United States to vote on account of race or color” is invalid, even if the law was not enacted with racist intent, was signed into law by President Ronald Reagan in 1982. Reagan did so, moreover, over the objection of a conservative faction within his own Justice Department — and one of the most important players in this faction was a young John Roberts.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6TaNux">
As voting rights journalist Ari Berman <a href="https://www.politico.com/magazine/story/2015/08/john-roberts-voting-rights-act-121222/">has written</a>, “Roberts wrote upwards of 25 memos opposing an effects test.” He “drafted talking points, speeches and op-eds for” senior Justice Department officials opposing the amendment, and “prepared administration officials for their testimony before the Senate; attended weekly strategy sessions; and worked closely with like-minded senators on Capitol Hill.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KrVPMW">
So, when Roberts wrote the Courts 5-4 decision in <em>Milligan</em>, he didnt simply hand down a surprising victory for voting rights after years of Supreme Court decisions that seemed <a href="https://www.vox.com/22575435/voting-rights-supreme-court-john-roberts-shelby-county-constitution-brnovich-elena-kagan">intended to dismantle the Voting Rights Act</a>. He also abandoned a 40-year-old grudge against laws that protect racial minorities from discrimination that might be unintentional — a grudge that he still held onto <a href="https://www.oyez.org/cases/2014/13-1371">as recently as a 2015 oral argument</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Chz8X3">
If Roberts intended to send a message to liberals that he is willing to call a truce on voting rights, in other words, he picked an unusually powerful way to make that statement.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YJ7SmR">
Similar things can be said about <a href="https://www.supremecourt.gov/opinions/22pdf/21-1271_3f14.pdf"><em>Moore v. Harper</em></a> (2023), in which the Supreme Court rejected a legal argument, known as the “independent state legislature doctrine” (ISLD), that could have <a href="https://www.vox.com/scotus/2023/6/27/23775378/supreme-court-moore-harper-john-roberts-independent-state-legislature-north-carolina-bush-gore">fundamentally destroyed the United States ability to hold competitive elections</a> for the presidency and for control of Congress.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kU8CdG">
Under the strongest version of the ISLD, each states legislative body has virtually unlimited power to make laws governing federal elections. No state governor may veto such a law, and no state court may strike such a law down. Wisconsins gerrymandered legislature could pass a law giving all of that states electoral votes to Donald Trump, and there would be no recourse.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2Bgsvf">
Meanwhile, weaker versions of this theory would strip state courts of their ability to strike down such laws or otherwise enforce provisions in their state constitutions that preserve voting rights and that protect against gerrymandering.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8YyGMp">
One might think that merely describing this argument would be enough to refute it. But, before <em>Moore</em> reached the Court, five sitting justices had all endorsed some version of the ISLD — although, in fairness, Chief Justice Roberts <a href="https://utexas.app.box.com/s/pd70m6vmah3xf3h7je69pgmnunwuscbm">repudiated that support in 2020</a>. And Barrett, the Courts newest Republican appointee, had not expressed a view on the ISLD. So it appeared that the fate of American democracy would turn on whether Barrett was willing to break with her party.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="t9BjMM">
Instead, the Court handed down a <a href="https://www.vox.com/scotus/2023/6/27/23775378/supreme-court-moore-harper-john-roberts-independent-state-legislature-north-carolina-bush-gore">surprisingly fulsome rejection of the ISLD</a> that reaffirmed previous decisions repudiating this theory, and which concluded that the US Constitution “does not insulate state legislatures from the ordinary exercise of state judicial review.” This decision was joined by Roberts, Kavanaugh, and Barrett.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DgTugF">
<em>Milligan</em> and <em>Moore</em> are only two data points suggesting that this Court will respect democracy (a third is the Courts decision not to overthrow the <a href="https://www.vox.com/2020-presidential-election">2020 election</a> and award a second term to Trump). But they are significant not just because they rejected attacks on voting rights, but because several key justices seemed to retreat from more hardline positions that they have staked out in the past.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ysfQkT">
It remains to be seen, in other words, whether the Court will hold to the line that it seemed to draw in <em>Milligan</em> and <em>Moore</em>. But both cases are hopeful signs that the justices will respect free elections.
</p>
<h3 id="JM9r4w">
The Court is leaving entrenched parts of the American welfare state intact
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oTOvdU">
One of the most alarming Supreme Court decisions from before Republicans gained a supermajority on the Court was <a href="https://www.law.cornell.edu/supremecourt/text/11-393#writing-11-393_OPINION_3"><em>NFIB v. Sebelius</em></a> (2012), where the Court allowed Republican states to opt out of the <a href="https://www.vox.com/obamacare">Affordable Care Act</a>s Medicaid expansion, and four GOP-appointed justices tried to repeal Obamacare in its entirety.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CC54gb">
Since <em>NFIB</em>, however, there have been two other attempts to nuke Obamacare that made it to the Supreme Court — <a href="https://supreme.justia.com/cases/federal/us/576/14-114/"><em>King v. Burwell</em></a> (2015) and <a href="https://www.supremecourt.gov/opinions/20pdf/19-840_6jfm.pdf"><em>California v. Texas</em></a> (2021). And, with each new lawsuit, fewer and fewer justices voted against the law, even though the Court moved sharply to the right between <em>NFIB</em> and <em>Texas</em>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="j4QBHb">
One important thing that changed between <em>NFIB</em> and <em>King</em> is that the Affordable Care Act became fully operational. Although Obamacare became law in 2010, most of its important provisions — including the Medicaid expansion and the provisions providing subsidized health insurance to middle-income earners — <a href="https://www.vox.com/obamacare/2014/9/26/18080566/obamacare-enrollment">did not take effect until 2014</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UKPU6X">
That means that, when the Court nearly repealed the law in 2012, it was targeting a largely hypothetical new policy that few Americans actually benefited from. By the time <em>King</em> and <em>Texas</em> arrived on the Courts docket, by contrast, the justices were being asked to take health coverage away from millions of Americans who already had it. Even some of the justices who dissented in <em>NFIB</em> werent willing to do that.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aqoTJJ">
Something similar happened in <a href="https://www.supremecourt.gov/opinions/22pdf/21-806_2dp3.pdf"><em>Health and Hospital Corporation v. Talevski</em></a> (2023), a June Supreme Court decision that could have eviscerated the entire Medicaid program. Instead, a 7-2 Court voted to leave Medicaid intact.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cIuraN">
Medicaid is a “<a href="https://www.vox.com/scotus/2023/6/8/23754267/supreme-court-ketanji-brown-jackson-medicaid-health-hospital-talevski">conditional grant</a>” program, meaning that the federal government offers each state a significant chunk of money to fund health coverage for low-income patients, but the states must agree to a long list of rules governing how this money should be spent.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3jQGDg">
All 50 states voluntarily accept at least some Medicaid funds, so all 50 states must comply with the conditions attached to those funds. Those conditions range from broad requirements that state Medicaid programs must <a href="https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-435/subpart-B">cover certain individuals</a>, such as low-income pregnant patients and children, to granular rules governing how Medicaid-funded facilities must operate. In <em>Talevski</em>, for example, the plaintiffs accused a Medicaid-funded nursing home of violating a law forbidding it from <a href="https://www.vox.com/policy-and-politics/2022/11/3/23435346/supreme-court-medicaid-health-hospital-corporation-indiana-talevski">using psychotropic drugs</a> “for purposes of discipline or convenience and not required to treat the residents medical symptoms.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kvhE6l">
Many of these conditions, moreover, are enforced almost entirely through private lawsuits. In 2015, however, three current members of the Court (Roberts, Justice Clarence Thomas, and Alito) <a href="https://casetext.com/case/armstrong-v-exceptional-child-ctr-inc-1">signed onto an opinion by the late Justice Antonin Scalia</a>, which argued that “the modern jurisprudence permitting intended beneficiaries [of federal programs] to sue does not generally apply” to conditional grant programs like Medicaid.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TKdyJZ">
Had Scalias position prevailed in <em>Talevski</em>, it would have gutted the entire Medicaid program, leaving Medicaid beneficiaries almost entirely helpless if a state denied them legally mandated coverage.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QbfIu2">
Yet, when confronted with a case that could destroy a program that millions of Americans already depend upon for health care, even most of the Courts Republican appointees blinked. Again, the decision in <em>Talevski</em>, which <a href="https://www.supremecourt.gov/opinions/22pdf/21-806_2dp3.pdf">rejected Scalias argument and left the status quo in place</a>, was 7-2 — with only Thomas and Alito in dissent.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jgdom8">
Compare that decision with <em>Nebraska</em>, the case striking down Bidens student loan forgiveness program. Although the Education Department announced that program in August of 2022, it never took effect because <a href="https://www.supremecourt.gov/opinions/22pdf/22-535_i3kn.pdf">Biden-skeptical judges raced to enjoin it</a>. And the Courts GOP-appointed majority had no problem with halting a government program that did not yet have any beneficiaries.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aliXEj">
Once welfare state programs take full effect, however, several key justices appear much more reluctant to disturb them.
</p>
<h3 id="cQaJHw">
The Court is unlikely to let judges ban abortion outright
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="epzYBl">
In <a href="https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf"><em>Dobbs v. Jackson Womens Health Organization</em></a> (2022), the decision overruling <em>Roe</em>, the five Republican appointees in the majority pledged to stay out of national abortion policy. “It is time to heed the Constitution and return the issue of abortion to the peoples elected representatives,” Alito wrote, promising that henceforth, the question of whether abortions would remain legal would rest with elected legislatures.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="x1ClBM">
This was obviously a terrible blow to abortion rights. In <em>Dobbs</em>, the Supreme Court abandoned its historical posture of protecting those rights, and instead adopted a new position of neutrality to abortion. Henceforth, there would be no constitutional safeguards if lawmakers chose to ban the procedure. This has had <a href="https://time.com/6303701/a-rape-in-mississippi/">disastrous</a> <a href="https://www.washingtonpost.com/health/interactive/2023/florida-abortion-law-deborah-dorbert/">consequences</a> <a href="https://www.dallasobserver.com/news/texas-abortion-ban-2-years-later-more-births-and-higher-infant-deaths-17238105">for</a> <a href="https://www.propublica.org/article/legal-medical-impact-abortion-legislation-qa">pregnant people</a> in states where lawmakers did just that.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KAAA3A">
But there is a third posture that the courts could take toward abortion: It could be banned nationally by judicial decree. Last April, Judge Matthew Kacsmaryk, a longtime Christian Right activist who Trump put on the federal bench, <a href="https://www.vox.com/politics/2023/3/16/23642927/supreme-court-abortion-matthew-kacsmaryk-mifepristone-texas-trump">tried to take the courts down this third path</a>. In a decision that took <a href="https://www.vox.com/policy-and-politics/2023/1/22/23539363/abortion-medication-mifepristone-supreme-court-pills-comstock-matthew-kacsmaryk">extraordinary liberties with the law</a>, Kacsmaryk attempted to ban mifepristone, a medication used in about half of all abortions in the United States. Mifepristone has been legal in the US since 2000.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oiqFYk">
In any event, the Supreme Court stepped in fairly quickly, in <a href="https://www.supremecourt.gov/opinions/22pdf/22a901_3d9g.pdf"><em>Danco Laboratories v. Alliance for Hippocratic Medicine</em></a>, to block Kacsmaryks decision before it could take effect. Only two justices — again, Thomas and Alito — publicly dissented from the Courts decision to keep mifepristone legal.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="us9U05">
This case will need to go up to the justices again. On Wednesday, a far-right panel of the United States Court of Appeals for the Fifth Circuit <a href="https://www.vox.com/scotus/2023/8/16/23834926/supreme-court-abortion-mifepristone-fifth-circuit-alliance-hippocratic-medicine-fda">handed down its own decision attempting to significantly restrict mifepristone</a>. But the <em>Danco Laboratories </em>decision is a hopeful sign that the justices will not allow rogue judges to ban abortion outright, or to ban medications and other items used in abortions.
</p>
<h3 id="M33cTC">
The Supreme Court is not controlled by people who want to harm the United States
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jcVQ0L">
In 2008, as a collapsing US housing market threatened to <a href="https://www.vox.com/22106497/supreme-court-collins-mnuchin-124-billion-fannie-mae-freddie-mac-unitary-executive-housing">throw the globe into a second Great Depression</a>, Congress created an agency, the Federal Housing Finance Agency (FHFA), which <a href="https://www.vox.com/2021/6/24/22547545/supreme-court-collins-yellen-124-billion-housing-unitary-executive-samuel-alito-neil-gorsuch">oversaw hundreds of billions of dollars worth of transactions</a> intended to stabilize the housing market and prevent the terrible 2008 recession from becoming something much worse.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7hdLvs">
In <a href="https://www.supremecourt.gov/opinions/20pdf/19-422_k537.pdf"><em>Collins v. Yellen</em></a><em> </em>(2021), several investors made a <a href="https://www.vox.com/22106497/supreme-court-collins-mnuchin-124-billion-fannie-mae-freddie-mac-unitary-executive-housing">nauseatingly complex</a>, but audacious legal argument. They asked the Court to cancel about $124 billion worth of these transactions. And they raised legal arguments that, if taken seriously, would have <a href="https://www.vox.com/2021/6/24/22547545/supreme-court-collins-yellen-124-billion-housing-unitary-executive-samuel-alito-neil-gorsuch">invalidated every single action taken by the FHFA in its 13 years of existence</a>. It is far from clear how on earth a court is supposed to unravel hundreds of billions of dollars worth of transactions that have already taken place, and the turmoil caused by any attempt to do so could itself have triggered an economic depression.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HlXM0R">
But that didnt happen. <em>Collins</em> rejected its plaintiffs call for a $124 billion bonfire. Only Justice Neil Gorsuch <a href="https://www.vox.com/22431044/neil-gorsuch-nihilism-supreme-court-voting-rights-lgbt-housing-obamacare-constitution">agreed with the plaintiffs</a> and the lower court judges whod sided with them, and flirted with an economic depression.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MiUYBJ">
And there are other signs (including the <em>Talevski </em>decision) that the current Court, for all of its willingness to bend the law to implement Republican Party policies, is not willing to endanger important American institutions.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3zy6Ol">
In <a href="https://www.supremecourt.gov/opinions/21pdf/21a477_1bo2.pdf"><em>Austin v. US Navy SEALs 1-26</em></a>, for example, a small group of judges (in the Fifth Circuit, naturally) determined that religious conservatives serving in the US Navy could defy an order to take the Covid vaccine — and could even be deployed against the judgment of military commanders. The implications of these lower court decisions were breathtaking, as they implied that servicemembers who claimed certain religious beliefs did not need to follow orders.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dxOJiL">
As Justice Kavanaugh wrote in a brief opinion explaining why these judges erred, the lower court that countermanded the militarys orders to its own personnel “in effect inserted itself into the Navys chain of command, overriding military commanders professional military judgments.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7htheo">
One of the major narratives that is likely to emerge from the Supreme Courts upcoming term, which will begin in October, is that the justices appear poised to reverse several more Fifth Circuit decisions that threaten the stability of the United States and its government. Among other things, the Supreme Court will review a Fifth Circuit decision that <a href="https://www.vox.com/policy-and-politics/2022/10/20/23414311/cfpb-unconstitutional-fifth-circuit-supreme-court-trump-community-financial">declared an entire agency — the Consumer Financial Protection Bureau — unconstitutional</a>. It will also review a Fifth Circuit decision <a href="https://www.vox.com/2022/5/19/23130569/jarkesy-fifth-circuit-sec">gutting the federal governments power to enforce securities law</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ljU9Ta">
In both these and <a href="https://www.vox.com/policy-and-politics/2023/2/2/23583377/supreme-court-guns-domestic-abuse-fifth-circuit-second-amendment-rahimi-united-states">other cases arising out of the ultra-reactionary Fifth Circuit</a>, the justices are likely to reverse. If nothing else, the Courts upcoming term will test (and, most likely, confirm) the thesis that the Supreme Court is not dominated by nihilists who wish to sow chaos for its own sake.
</p>
<h3 id="KA8axT">
So what does all of this mean?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="A9BeyL">
Again, I want to be clear that no one should be Pollyannaish about this Court. I began this piece by saying that my level of alarm surrounding the Court has moved from a 13 out of 10 to a nine. A nine is still very bad.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="904uCG">
The Supreme Courts descent into partisanship, moreover, is just one symptom of a much larger cancer within American democracy. A former president, the same president who appointed a third of the Supreme Court, has now been <a href="https://www.vox.com/politics/2023/4/4/23664866/donald-trump-indictment-alvin-bragg-jack-smith-stormy-daniels-new-york-georgia">indicted twice for attempting to overthrow an election</a>. Many of that former presidents supporters <a href="https://www.vox.com/policy-and-politics/23513019/january-6-committee-report-trump-2020-election-insurrection">violently attacked the US Capitol</a> in a failed effort to extend his time in office.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Y1tvyz">
But, despite all of these signs that US democracy faces greater challenges today than it has faced since 1965, when the passage of the Voting Rights Act transformed the United States from something more like an apartheid regime into a liberal democracy, the United States is still in the phase in its democratic decline when that decline can be reversed at the ballot box.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fgdK2V">
This is why <em>Moore</em> and <em>Milligan</em> are such hopeful signs. They suggest that the Courts GOP-appointed majority is not attempting to consolidate power by shutting down the franchise. And they tell us that the best reaction to this Court is not despair over what it has done, but <a href="https://www.vox.com/scotus/2023/7/8/23784320/supreme-court-2022-term-affirmative-action-religion-voting-rights-abortion">sustained outrage and political organizing</a> — until the rest of the government overflows with officials who will do everything in their power to undermine this Courts worst decisions.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QP44Pn">
Meanwhile, the Courts decisions in cases like <em>Talevski, Collins, Texas</em>, and <em>SEALs</em> all suggest that this Supreme Court will not do so much damage to US institutions that this damage cannot be reversed by a better Supreme Court, or by a Congress that rejects this Courts values. <em>Roe</em> may be dead, but a Congress with solid Democratic majorities can <a href="https://www.vox.com/20930358/codify-roe-wade-womens-health-protection-act-supreme-court-nancy-pelosi-democrats">pass the Womens Health Protection Act</a> and give back what this Supreme Court has taken from American women.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5bGEqg">
There are also early signs that the Courts partisan behavior is triggering a democratic backlash. The Courts <a href="https://www.vox.com/scotus/2023/8/15/23831338/supreme-court-donald-trump-indictments-federal-judiciary-partisan-trust">more unpopular than it has ever been</a> since several pollsters started measuring approval of the justices. Pro-abortion ballot initiatives consistently prevail, <a href="https://www.vox.com/2023/8/8/23817989/issue-1-ohio-special-election-2023-results-abortion-rights">even in red states</a>. Republicans had a <a href="https://www.vox.com/policy-and-politics/23448972/midterms-results-democrats-senate-red-wave">surprisingly weak election performance in 2022</a>, something that can likely be attributed, at least in part, to the Courts decision in <em>Dobbs</em>.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/98MB3e-2jYFJE3Mnfhyifn9-URg=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24858812/temp.png"/>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VwuXvs">
The strongest case for optimism about the Supreme Court, in other words, boils down to eight words: We can beat them at the ballot box.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KEqh1h">
And then we will replace them.
</p></li>
<li><strong>Why Hurricane Hilary is so strange — and how it could impact California</strong> -
<figure>
<img alt="MEXICO-WEATHER-HURRICANE-HILARY" src="https://cdn.vox-cdn.com/thumbor/bOpxqyov1g_5ckVTq5AvnT6t3_g=/439x0:7463x5268/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72559701/1610413262.0.jpg"/>
<figcaption>
Alfredo Estrella/AFP via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The storm should hit Mexico Sunday and could cause historic rainfall in the Southwest.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="a4QOVC">
In a summer of extreme weather events, Hurricane Hilary is yet another atypical occurrence — a tropical storm headed for the West Coast of the United States.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="u4Ubay">
What it will likely mean for Southern California and the southwest is potential heavy flooding — and even flash flooding — with up to seven inches of rain forecast in some areas and tropical storm force<strong> </strong>winds up to 73 mph as it moves over land.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JINhvA">
Though California has had hurricanes before, its extremely rare because cold water flows from Alaska typically make the Pacific coast an unsuitable environment for them, which rely on water surface temperatures higher than 26 Celsius to form and grow powerful. Hilary, a <a href="https://www.vox.com/2021/8/29/22647117/hurricane-ida-categories-explained">Category 4 storm</a> as of <a href="https://www.nbcnews.com/news/us-news/live-blog/hurricane-hilary-live-updates-california-mexico-flooding-winds-weather-rcna100752">Saturday afternoon</a>, is expected to make landfall on Sunday morning, likely in northern Mexico around Baja California, <a href="https://www.nhc.noaa.gov/refresh/graphics_ep4+shtml/150034.shtml?cone">according to the National Hurricane Center</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wYE2oF">
While people on the <a href="https://www.vox.com/climate/23816029/hurricane-2023-season-forecast-tropical-storm-ian-florida">southeastern coast</a> — particularly in Florida up through the Carolinas, and along the coast of the Gulf of Mexico — are likely well-versed in hurricane preparation, and live in states with storm-hardened infrastructure, thats not so for Southern California and parts of the southwest where the hurricane is expected to hit. Though Hilary is expected to weaken as it heads northward and makes landfall, it could still bring several inches of rain — as many as ten inches are forecast in some parts — and heavy winds.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6PnoY5">
<a href="https://www.gov.ca.gov/2023/08/18/california-mobilizes-ahead-of-hurricane-hilary-urges-people-in-southern-california-to-prepare/">California Gov. Gavin Newsom</a> issued a press release Friday outlining the governments preparation for the storm and urging Southern Californians to prepare themselves for “the wettest tropical cyclone in state history and the first-ever Tropical Storm Watch issued for California.” <a href="https://www.axios.com/2023/08/19/hurricane-hilary-california-catastrophic-flood-nevada-arizona">According to Axios</a>, 43 million people in California and Mexico are under tropical storm warnings, and 27 million under flash flood warnings, in an area stretching all the way to Idaho.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KLx9Wc">
California has already had an extremely wet year, though thats unrelated to Hilarys development and unusual path. <a href="https://www.latimes.com/california/story/2023-04-11/californias-wild-winter-of-atmospheric-rivers">Thirty-one atmospheric rivers</a> hit California last winter and this spring, many of them quite strong. Californias atmospheric rivers provide much of the states precipitation, both as rain and as snowfall, which accumulates in high elevations as snowpack and melts in the warmer months.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rUwO03">
But this years atmospheric rivers were severe in both intensity and duration, <a href="https://www.nytimes.com/interactive/2023/climate/california-drought.html">erasing some drought restrictions</a>, but also causing devastating flooding and record-breaking snowfall.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ctceye">
They were also concentrated in <a href="https://www.nytimes.com/2023/07/10/us/california-flood-relief-central-valley.html">Californias Central Coast</a> and in Southern California, where Hilary is expected to hit, too. “Thats where were really seeing a lot of our larger anomalies in terms of overall precipitation,” Chad Hecht, a research and operations meteorologist at the <a href="https://cw3e.ucsd.edu/">Center for Western Weather and Water Extremes</a> at UC San Diegos Scripps Institution of Oceanography, <a href="https://www.latimes.com/california/story/2023-04-11/californias-wild-winter-of-atmospheric-rivers">told the LA Times in April</a>. “This year, the Central Coast saw four strong atmospheric rivers, where it typically averages less than two.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LbB7nn">
Though Hilary wont have the power of many hurricanes on the East and Gulf Coasts like <a href="https://www.vox.com/22648189/hurricane-ida-new-orleans-louisiana-flood-climate-change-covid">Ida in 2021</a> and <a href="https://www.vox.com/science-and-health/2022/9/28/23376761/hurricane-ian-rapid-intensification-climate-change">Ian in 2022</a>, it still has destructive potential. The amount of rainfall in typically arid locations will likely cause flash flooding, mudslides, and landslides — which could be especially dangerous with the addition of debris from recent forest fire seasons, <a href="https://www.axios.com/2023/08/19/hurricane-hilary-california-catastrophic-flood-nevada-arizona">Axios reports</a>.
</p>
<h3 id="6bB8Uy">
Hilary is unusual, but it doesnt necessarily portend things to come
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="f3Zf86">
Although Hurricane Hilarys path is strange, its not unprecedented, as Paul Miller, an assistant professor in Louisiana State Universitys Department of Oceanography and Coastal Sciences told Vox in an interview.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="agUNtK">
“Its certainly unusual,” Miller said. “There is historical precedent for it, though — its the kind of thing that has happened before. We can cite examples from our lifetime, but it is certainly unusual.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5otBbf">
<a href="https://www.wpc.ncep.noaa.gov/tropical/rain/nora1997.html">Hurricane Nora</a> impacted the American southwest from the Pacific Ocean in 1997, and <a href="https://www.wpc.ncep.noaa.gov/tropical/rain/lester1992.html">Lester in 1992 before that</a>. Still, Miller points out, “Were looking at 25 years since the last time we can point to a similar case.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3398Lq">
Though many unusual or extreme climate events are linked to <a href="https://www.vox.com/climate">climate change</a>, there isnt much to directly connect Hilarys growth and path to the phenomenon. Higher water surface temperatures could account for some of the storms strength, but “Theres nothing about whats happening right now to make me think that climate change is so dramatic that Southern California is now in the crosshairs of tropical systems,” Miller said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fqoYaf">
The Eastern Pacific has its own hurricane season.I<a href="https://www.nhc.noaa.gov/refresh.shtml?epac">ts longer than the Atlantic hurricane season</a>, starting on March 15 and ending on November 30. As the New York Times reported Saturday, its been an active season in the Eastern Pacific, though none of the storms have come as far west as Hilary has. “We typically dont talk about storms in the Eastern Pacific as much because they tend to be less impactful to land,” though thats not always the case, Miller said. Storms like Hurricane Dora, for example, have tracked much further west, <a href="https://www.nytimes.com/2023/08/15/us/hawaii-maui-lahaina-fire.html?name=styln-hawaii-wildfires&amp;region=TOP_BANNER&amp;block=storyline_menu_recirc&amp;action=click&amp;pgtype=Article&amp;variant=undefined">adding to the heavy winds which helped the deadly fire in Maui spread</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="s74wup">
Hilarys path has to do with two specific weather factors, Miller told Vox, including a heat dome over the central US. Though the warm temperatures and the heat dome Miller described didnt cause Hilary to form — that happened thousands of miles away in the Eastern Pacific — it is helping determine Hilarys path.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gTjtg9">
High-pressure air moves clockwise, Miller explained, acting like a conveyor belt bringing Hilary up the West Coast and in toward California and Nevada. A trough in a jet stream over California is also “grabbing Hilary and pulling it northward,” he said, as well as helping cause the storms precipitation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DIvBIH">
Strong winds are another concern for those in and around the hurricanes path. “Generally speaking, the strongest winds will cling to the right side of the hurricane,” Miller said. “So if this same storm was hitting [North Carolinas] Outer Banks or something, the strongest winds would be over ocean,” instead of a populated area like San Diego.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XwHVJ0">
As of Saturday afternoon, Hilary had yet to make landfall and was weakening as it headed northward — much as experts expected. But as with any major weather event, there are still unknowns, Miller said. “The biggest question from this point forward is going to be where it makes landfall.”
</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>Spain wins its first Womens World Cup title, beating England 1-0 in the final</strong> - Spain has won the Womens World Cup for the first time with Olga Carmonas first-half strike giving La Roja a 1-0 victory over England</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>Need just one perfect day with favourable weather to touch 90 m mark: Neeraj Chopra</strong> - Neeraj Chopra ended the countrys long wait of 19 years for a medal at the championships with a silver in the mens javelin event last year</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>Alcaraz and Djokovic meet Sunday in a rematch of the Wimbledon final; Gauff plays for womens title</strong> - Coco Gauff will play for the womens title Sunday after upsetting top-ranked Iga Swiatek 7-6 (2), 3-6, 6-4.</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>Four-year dope ban | Dutee Chand requests Centre, State Government to help</strong> - Ace sprinter Dutee Chand said she will challenge the four-year ban imposed on her by NADA</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>UAE thrashes New Zealand to level T20 series 1-1</strong> - New Zealands top order was strangled by the left-arm spin of Aaayan Afzal Khan</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>Man held with sea horse skeletons</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ethnic blood should not flow in Naga areas: NSCN (I-M)</strong> - Extremist group cautions Kuki and Meitei groups to not bring their fight to Naga-inhabited areas</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>New MCH facility for maternal and infant healthcare</strong> - This multi-speciality hospital is within the premises of Gandhi Hospital.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>BJP flays CM Mann for neglecting people of Punjab in need of hour</strong> - “Punjab needs a Chief Minister and not a campaign Minister,” says BJPs national spokesperson Jaiveer Shergill</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>Amit Shah releases report card of Madhya Pradesh BJP Government</strong> - Home Minister says it removed BIMARU tag from State and put it on path of development.</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>Russias Luna-25 spacecraft crashes into Moon</strong> - The unmanned craft span out control before its planned landing on the Moons south pole.</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: Russia says drone injures five at Kursk railway station</strong> - Kyiv is accused of attacking the transport hub in Kursk - and also the Rostov and Moscow regions.</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 among 7 dead in missile strike on Ukrainian theatre</strong> - A Russian missile strike hits the heart of the northern city of Chernihiv, Ukraine says.</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: US allows transfer of Danish and Dutch F-16 war planes to Kyiv</strong> - US-made jets in Denmark and the Netherlands can be sent to Ukraine when its pilots are fully trained.</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>Cat and dog influencers help Ukrainians cope with war</strong> - How animals accounts have been bringing Ukrainians hope and even practical advice at a time of war.</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>Is Luna 25 alive? Russia says an “emergency situation” has occurred</strong> - “The management team is currently analyzing the situation.” - <a href="https://arstechnica.com/?p=1961927">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I try synthetic salmon and enter the “uncanny valley” of taste</strong> - Synthetic fish isnt quite there yet—and may not be worth the effort. - <a href="https://arstechnica.com/?p=1961837">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Google announces new algorithm that makes FIDO encryption safe from quantum computers</strong> - New approach combines ECDSA with post-quantum algorithm called Dilithium. - <a href="https://arstechnica.com/?p=1961906">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>SanDisk Extreme SSDs are “worthless,” multiple lawsuits against WD say</strong> - Ars cited in two SanDisk SSD failure lawsuits filed yesterday. - <a href="https://arstechnica.com/?p=1961790">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>X suspends pro-Nazi account after two brands halt advertising</strong> - X will soon allow brands to block ads from appearing next to specific profiles. - <a href="https://arstechnica.com/?p=1961835">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>I got 50 dollars from my mom…</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She told me to take my brother to the movies, but not to bring him home before 6, so they had time to prepare his surprise birthday party.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Thats the day I realized he was the favorite twin.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/helpamonkpls"> /u/helpamonkpls </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/15w7cgn/i_got_50_dollars_from_my_mom/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/15w7cgn/i_got_50_dollars_from_my_mom/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Two older couples decide to go out for dinner.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The two husbands sit in the front seat, and the two wives in the rear. The driver asks “Where should we go”? The other gentleman says “We had some great fish the other day”. “Where was that?” comes the reply. The passenger gets a confused look on his face. He thinks for a bit and says “Give me the name of a flower”.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“A lily?” “No, thats not it”.<br/> “A daisy?” “No, not that either”.<br/> “A rose?” The passenger snaps his fingers and pivots around in his seat:
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Rose! Whats the name of that restaurant we went to with the good fish?”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Waldron1943"> /u/Waldron1943 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/15vzdub/two_older_couples_decide_to_go_out_for_dinner/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/15vzdub/two_older_couples_decide_to_go_out_for_dinner/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A German man walks into a McDonalds in the United States…</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
After waiting in line, he finally gets to the counter, and he orders a pint of beer, because you can get beer at McDonalds in Germany.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
An American customer overhears the mans order, and he approaches the German man and says, “How could you be so stupid? you cannot order beer here.” while laughing at the German man right to his face.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The German man thinks for a second and then he starts laughing uncontrollably. Not just any laugh. This is a laugh so intense that he is struggling not to fall over.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The American customer is no longer laughing. He now has a puzzled look on his face. He asks the German man, “whats so funny?” The German man says, “I just realized that you came here for the food.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/MusicCityJayhawk"> /u/MusicCityJayhawk </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/15vho2t/a_german_man_walks_into_a_mcdonalds_in_the_united/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/15vho2t/a_german_man_walks_into_a_mcdonalds_in_the_united/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A man is walking down a street when he reads a graffiti…</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
…saying “The person reading this is an idiot”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
This angers him very much, knowing he has been made a fool. So he picks up a stone and starts writing below it:
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“The person who wrote this is an idiot”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Up_Vootinator"> /u/Up_Vootinator </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/15w6u91/a_man_is_walking_down_a_street_when_he_reads_a/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/15w6u91/a_man_is_walking_down_a_street_when_he_reads_a/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Someone pees “Brezhnev is stupid” into the snow</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Someone pees “Brezhnev is stupid” into the snow on the Red Square.<br/> The KGB immediately starts an investigation, the results are in the next day:<br/> - Comrade Brezhnev, be strong. Our doctors confirmed the urine belongs to comrade Gromiko.<br/> Brezhnev defeatedly leans back in his chair.<br/> - Leonid Ilyich, be strong. There is worse. Our graphologists identified that the handwriting belongs to your wife.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/crufter"> /u/crufter </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/15w5k0x/someone_pees_brezhnev_is_stupid_into_the_snow/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/15w5k0x/someone_pees_brezhnev_is_stupid_into_the_snow/">[comments]</a></span></p></li>
</ul>
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