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<title>16 July, 2022</title>
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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>Lasting alterations in monocyte and dendritic cell subsets in individuals after hospitalization for COVID-19</strong> -
<div>
After more than two years the COVID-19 pandemic continues to burden healthcare systems and economies worldwide, and it is evident that long-term effects of the disease can persist for months post-recovery in some individuals. The activity of myeloid cells such as monocytes and dendritic cells (DC) is essential for correct mobilization of the innate and adaptive responses to a pathogen. Impaired levels and responses of monocytes and DC to SARS CoV-2 is likely to be a driving force behind the immune dysregulation that characterizes severe COVID-19. Here, we followed, for 6-7 months, a cohort of COVID-19 patients hospitalized during the early waves of the pandemic. The levels and phenotypes of circulating monocyte and DC subsets were assessed to determine both the early and long-term effects of the SARS-CoV-2 infection. We found increased monocyte levels that persisted for 6-7 months, mostly attributed to elevated levels of classical monocytes. While most DC subsets recovered from an initial decrease, we found elevated levels of cDC2/cDC3 at the 6-7 month timepoint. Analysis of functional markers on monocytes and DC revealed sustained reduction in PD-L1 expression but increased CD86 expression across almost all cell types examined. Finally, viral load and CRP correlated to the appearance of circulating antibodies and levels of circulating DC and monocyte subsets, respectively. By elucidating some of the long-term effects that SARS-CoV-2 infection has on these key innate myeloid cells, we have shed more light on how the immune landscape remains affected in the months following severe COVID-19.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.07.15.500185v1" target="_blank">Lasting alterations in monocyte and dendritic cell subsets in individuals after hospitalization for COVID-19</a>
</div></li>
<li><strong>Understanding public support for COVID-19 pandemic mitigation measures over time: Does it wear out?</strong> -
<div>
COVID-19 mitigation measures intend to protect public health, but their adverse psychological, social, and economic effects weaken popular support. Less favorable trade-offs may especially weaken support for more restrictive measures. Support for mitigation measures may also differ between population subgroups who experience different benefits and costs, and decrease over time, a phenomenon termed ‘pandemic fatigue’. We examined self-reported support for COVID-19 mitigation measures in The Netherlands over 12 consecutives waves of data collection between April 2020 – May 2021 in an open population cohort study. Participants were recruited through community panels of the 25 regional public health services, and through links to the online surveys advertised on social media. The 54,010 unique participants in the cohort study on average participated in 4 waves of data collection. Most participants were female (65%), middle-aged (57% 40-69 years), highly educated (57%), not living alone (84%), residing in an urban area (60%), and born in the Netherlands (95%). COVID-19 mitigation measures implemented in the Netherlands remained generally well-supported over time (all scores &gt;3 on 5-point scale ranging 1 (low) – 5 (high)). During the whole period studied, support was highest for personal hygiene measures, quarantine and wearing face masks, high but somewhat lower for not shaking hands, testing and self-isolation, and restricting social contacts, and lowest for limiting visitors at home, and not traveling abroad. Women and higher educated people were more supportive of some mitigation measures than men and lower educated people. Older people were more supportive of more restrictive measures than younger people, and support for more socially restrictive measures decreased most over time in higher educated people or in younger people. This study found no support for pandemic fatigue in terms of a gradual decline in support for all mitigation measures over time. Rather, findings suggest that support for mitigation measures reflects a balancing of benefits and cost, which may change over time, and differ between measures and population subgroups.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/yq2az/" target="_blank">Understanding public support for COVID-19 pandemic mitigation measures over time: Does it wear out?</a>
</div></li>
<li><strong>Teladentistry and distance learning :Access to oral health state : systematic Reviews</strong> -
<div>
:Covid19 pandemic has changed the vision on how to deal in emergency situations .Advanced technology and spreading growth of internet connection encourage people to use it to obtain helpful advice in critical climate of covid 19 crisis . The aim of this study to through the light on importance of teledentistry in critical emergency situations .
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/p794v/" target="_blank">Teladentistry and distance learning :Access to oral health state : systematic Reviews</a>
</div></li>
<li><strong>Genome-first detection of emerging resistance to novel therapeutic agents for SARS-CoV-2</strong> -
<div>
Some COVID-19 patients are unable to clear their infection or are at risk of severe disease, requiring treatment with neutralising monoclonal antibodies (nmAb) and/or antivirals. The rapid roll-out of novel therapeutics means there is limited understanding of the likely genetic barrier to drug resistance. Unprecedented genomic surveillance of SARS-CoV-2 in the UK has enabled a genome-first approach to the detection of emerging drug resistance. Here we report the accrual of mutations in Delta and Omicron cases treated with casirivimab+imdevimab and sotrovimab respectively. Mutations occur within the epitopes of the respective nmAbs. For casirivimab+imdevimab these are present on contiguous raw reads, simultaneously affecting both components. Using surface plasmon resonance and pseudoviral neutralisation assays we demonstrate these mutations reduce or completely abrogate antibody affinity and neutralising activity, suggesting they are driven by immune evasion. In addition, we show that some mutations also reduce the neutralising activity of vaccine-induced serum.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.07.14.500063v1" target="_blank">Genome-first detection of emerging resistance to novel therapeutic agents for SARS-CoV-2</a>
</div></li>
<li><strong>Pangenome analysis of SARS-CoV2 strains to Identify Potential vaccine targets by Reverse Vaccinology</strong> -
<div>
Background: Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) leads to respiratory failure and obstructive alveolar damage, which may be fatal in immunocompromised individuals. COVID-19 pandemic has badly affected every part of the world, and still, the situation in the world is getting worse with the emergence of novel variants. The aim of our study is to explore the genome of SARS-CoV2 followed by in silico reverse vaccinology analysis. This will help to identify the most putative vaccine candidate against the virus in a robust manner and enables cost-effective development of vaccines compared with traditional strategies. Methods: The genomic sequencing data is retrieved from NCBI (Reference Sequence Number NC_045512.2). The sequences are explored through comparative genomics approaches by GENOMICS to find out the core genome. A comprehensive set of proteins obtained was employed in computational vaccinology approaches (names of tools?) for the prediction of the best possible B and T cell epitopes through ABCpred and IEDB Analysis Resource, respectively. The multi-epitopes were further tested against human toll-like receptors and cloned in an E. coli plasmid vector. Findings: The designed Multiepitope Subunit Vaccine was non-allergenic, antigenic (0.6543), &amp; non-toxic, with significant connections with the human leukocyte antigen (HLA) binding alleles, and collective global population coverage of 84.38%. It has 276 amino acids, consisting of an adjuvant with the aid of an EAAAK linker, AAY linkers used to join the 4 CTL epitopes, and GPGPG linkers used to join the 3 HTL epitopes and KK linkers used to join the 7 B-cell epitopes. MESV docking with human pathogenic toll-like receptors-3 (TLR3) exhibited a stable &amp; high binding affinity. An in-silico codon optimization approach was used in the codon system of E. coli (strain K12) to obtain the GC-Content of Escherichia coli (strain K12): 50.7340272413779 and CAI-Value of the improved sequence: 0.9542834278823386. The multi-epitope vaccine’s optimized gene sequence was cloned in-silico in E. coli plasmid vector pET-30a (+), BamHI, and HindIII restriction sites were added to the N and C-terminals of the sequence, respectively. Conclusion: There is a pressing need to combat Covid-19 and we need quick and reliable approaches to Covid-19. By using In-silico approaches, we acquire an effective vaccine that could trigger adequate immune responses at the cellular and humoral levels. The suggested sequences can be further validated through in vivo and in vitro experimentation. Keywords: Covid-19, SARS Cov-2, Pangenome Analysis, Reverse Vaccinology
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.07.15.500170v1" target="_blank">Pangenome analysis of SARS-CoV2 strains to Identify Potential vaccine targets by Reverse Vaccinology</a>
</div></li>
<li><strong>Exploring the trajectory and correlates of social isolation for veterans across a 6-month period during COVID-19</strong> -
<div>
Social isolation is a relevant problem for veterans who are at risk for disengaging from others as a function of transition stress from military life to civilian life, and given high rates of exposure to trauma and psychological distress. Few researchers have examined social isolation in veterans over time, particularly during COVID-19 that led to significant barriers and restrictions on social interactions. The purpose of this longitudinal study was to assess veterans’ experience of social isolation and its mental health and social functioning correlates during a 6-month period of the COVID-19 pandemic. Participants were 188 United States veterans of the Iraq and Afghanistan wars, who completed a total of four assessments: one every two months for a total duration of six months. Surveys included measures of global mental health and social functioning as indicated by perceived emotional support, quality of marriage, and couple satisfaction. Multilevel modeling was used to assess 1) growth models to determine whether social isolation changed over time and the trajectory of that change (i.e., linear or quadratic); and 2) whether social isolation was related to both concurrent and prospective indicators of mental health and social functioning. All analyses included person mean centered and grand mean centered isolation to assess for within-and between-person effects. Veterans reported a quadratic trajectory in social isolation that decreased slightly and stabilized over time. Findings indicate that higher social isolation, at both the within- and between-person level, was negatively associated with concurrent emotional support, mental health, quality of marriage, and couple satisfaction. However, all prospective effects were nonsignificant at the within-person level. Results suggest although isolation may decrease over time, veterans report worse mental health and social functioning during times when they report higher levels of social isolation compared to themselves and others. Future work is needed to determine if interventions can be applied during those times to prevent or target those negative associations.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/xf3zb/" target="_blank">Exploring the trajectory and correlates of social isolation for veterans across a 6-month period during COVID-19</a>
</div></li>
<li><strong>Vitamin C is an efficient natural product for prevention of SARS-CoV-2 infection by targeting ACE2 in both cell and in vivo mouse models</strong> -
<div>
ACE2 is a major receptor for cell entry of SARS-CoV-2. Despite advances in targeting ACE2 to inhibit SARS-CoV-2’s binding, how to efficiently and flexibly control ACE2 levels for prevention of SARS-CoV-2 infection has not been explored. Here, we revealed Vitamin C (VitC) administration as an effective strategy to prevent SARS-CoV-2 infection. VitC reduced ACE2 protein levels in a dose-dependent manner, while partial reduction of ACE2 can greatly restrict SARS-CoV-2 infection. Further studies uncovered that USP50 is a crucial regulator of ACE2 protein levels, and VitC blocks the USP50-ACE2 interaction, thus promoting K48-linked polyubiquitination at Lys788 and degradation of ACE2, without disrupting ACE2 transcriptional expression. Importantly, VitC administration reduced host ACE2 and largely blocked SARS-CoV-2 infection in mice. This study identified an in vivo ACE2 balance controlled by both USP50 and an essential nutrient VitC, and revealed a critical role and application of VitC in daily protection from SARS-CoV-2 infection.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.07.14.499651v1" target="_blank">Vitamin C is an efficient natural product for prevention of SARS-CoV-2 infection by targeting ACE2 in both cell and in vivo mouse models</a>
</div></li>
<li><strong>Neutralization sensitivity of Omicron BA.2.75 to therapeutic monoclonal antibodies</strong> -
<div>
Since the end of 2021, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant outcompeted other variants and took over the world. After the emergence of original Omicron BA.1, Omicron BA.2 subvariant emerged and outcompeted BA.1. As of July 2022, some BA.2 subvariants, including BA.2.12.1, BA.4 and BA.5, emerged in multiple countries and begun outcompeting original BA.2. Moreover, a novel BA.2 subvariant, BA.2.75, was detected in eight countries including India at the end of June 2022, and preliminary investigations suggest that BA.2.75 is more transmissible over the other BA.2 subvariants. On July 7, 2022, the WHO classified BA.2.75 as a variant-of-concern lineage under monitoring. We have recently demonstrated that BA.4/5 is highly resistant to a therapeutic monoclonal antibody, cilgavimab, than BA.2. The resistance of SARS-CoV-2 variants to therapeutic antibodies can be attributed to the mutations in the viral spike protein. Compared to the BA.2 spike, BA.2.12.1 and BA.4/5 respectively bear two and four mutations in their spike proteins. On the other hand, the majority of BA.2.75 spike bears nine substitutions. The fact that the mutation number in the BA.2.75 spike is larger than those in the BA.4/5 spike raises the possibility that the BA.2.75 spike significantly reduces sensitivity towards therapeutic monoclonal antibodies than BA.2 and BA.4/5. In this study, we generated pseudoviruses harboring the spike proteins of BA.2.75, BA.4/5 and BA.2 and evaluated the efficacy of ten therapeutic monoclonal antibodies and three antibody cocktails against BA.2.75.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.07.14.500041v1" target="_blank">Neutralization sensitivity of Omicron BA.2.75 to therapeutic monoclonal antibodies</a>
</div></li>
<li><strong>A zebrafish model of COVID-19-associated cytokine storm syndrome reveals that the Spike protein signals via TLR2</strong> -
<div>
Understanding the mechanism of virulence of SARS-CoV-2 and host innate immune responses are essential to develop novel therapies. One of the most studied defense mechanisms against invading pathogens, including viruses, are Toll-like receptors (TLRs). Among them, TLR3, TLR7, TLR8 and TLR9 detect different forms of viral nucleic acids in endosomal compartments, whereas TLR2 and TLR4 recognize viral structural and nonstructural proteins outside the cell. Although many different TLRs have been shown to be involved in SARS-CoV-2 infection and detection of different structural proteins, most studies have been performed in vitro and the results obtained are rather contradictory. In this study, we report using the unique advantages of the zebrafish model for in vivo imaging and gene editing that the S1 domain of the Spike protein from the Wuhan strain (S1WT) induced hyperinflammation in zebrafish larvae via a Tlr2/Myd88 signaling pathway and independently of interleukin-1{beta} production. In addition, S1WT also triggered emergency myelopoiesis, but in this case through a Tlr2/Myd88-independent signaling pathway. These results shed light on the mechanisms involved in the COVID-19-associated cytokine storm syndrome.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.07.14.500031v1" target="_blank">A zebrafish model of COVID-19-associated cytokine storm syndrome reveals that the Spike protein signals via TLR2</a>
</div></li>
<li><strong>SARS-CoV-2 BA.4 infection triggers more cross-reactive neutralizing antibodies than BA.1</strong> -
<div>
SARS-CoV-2 variants of concern (VOCs) differentially trigger neutralizing antibodies with variable cross-neutralizing capacity. Here we show that unlike SARS-CoV-2 Omicron BA.1, which triggered neutralizing antibodies with limited cross-reactivity, BA.4/5 infection triggers highly cross-reactive neutralizing antibodies. Cross-reactivity was observed both in the absence of prior vaccination and also in breakthrough infections following vaccination. This suggests that next-generation vaccines incorporating BA.4, which is spreading globally, might result in enhanced neutralization breadth.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.07.14.500039v1" target="_blank">SARS-CoV-2 BA.4 infection triggers more cross-reactive neutralizing antibodies than BA.1</a>
</div></li>
<li><strong>Fc effector activity and neutralization against SARS-CoV-2 BA.4 is compromised in convalescent sera, regardless of the infecting variant</strong> -
<div>
The SARS-CoV-2 Omicron BA.1 variant, which exhibits high level neutralization resistance, has since evolved into several sub-lineages including BA.4 and BA.5, which have dominated the fifth wave of infection in South Africa. Here we assessed the sensitivity of BA.4 to neutralization and antibody dependent cellular cytotoxicity (ADCC) in convalescent donors infected with four previous variants of SARS-CoV-2, as well as in post-vaccination breakthrough infections (BTIs) caused by Delta or BA.1. We confirm that BA.4 shows high level resistance to neutralization, regardless of the infecting variant. However, breakthrough infections, which trigger potent neutralization, retained activity against BA.4, albeit at reduced titers. Fold reduction of neutralization in BTIs was lower than that seen in unvaccinated convalescent donors, suggesting maturation of neutralizing responses to become more resilient against VOCs in hybrid immunity. BA.4 sensitivity to ADCC was reduced but remained detectable in both convalescent donors and in BTIs. Overall, the high neutralization resistance of BA.4, even to antibodies from BA.1 infections, provides an immunological mechanism for the rapid spread of BA.4 immediately after a BA.1-dominated wave. Furthermore, although ADCC activity against BA.4 was reduced, residual activity may nonetheless contribute to the protection from disease.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.07.14.500042v1" target="_blank">Fc effector activity and neutralization against SARS-CoV-2 BA.4 is compromised in convalescent sera, regardless of the infecting variant</a>
</div></li>
<li><strong>Ending transmission of SARS-CoV-2: sterilizing immunity using an intranasal subunit vaccine</strong> -
<div>
Immunization programs against SARS-CoV-2 with commercial intramuscular (IM) vaccines prevent disease but not infections. The continued evolution of variants of concern (VOC) like Delta and Omicron has increased infections even in countries with high vaccination coverage. This is due to commercial vaccines being unable to prevent viral infection in the upper airways and exclusively targeting the spike (S) protein that is subject to continuous evolution facilitating immune escape. Here we report a multi-antigen, intranasal vaccine, NanoSTING-NS that yields sterilizing immunity and leads to the rapid and complete elimination of viral loads in both the lungs and the nostrils upon viral challenge with SARS-CoV-2 VOC. We formulated vaccines with the S and nucleocapsid (N) proteins individually to demonstrate that immune responses against S are sufficient to prevent disease whereas combination immune responses against both proteins prevents viral replication in the nasal compartment. Studies with the highly infectious Omicron VOC showed that even in vaccine-naive animals, a single dose of NanoSTING-NS significantly reduced transmission. These observations have two implications: (1) mucosal multi-antigen vaccines present a pathway to preventing transmission and ending the pandemic, and (2) an explanation for why hybrid immunity in humans is superior to vaccine-mediated immunity by current IM vaccines.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.07.14.500068v1" target="_blank">Ending transmission of SARS-CoV-2: sterilizing immunity using an intranasal subunit vaccine</a>
</div></li>
<li><strong>Malinformation – an emergent problem for medical journals and scientific communication</strong> -
<div>
Background: Malinformation is the presentation of curated facts in manner that presents a false narrative and/or creates a misleading impression by leaving out important context. Unlike its better-known relatives, misinformation and disinformation, malinformation depends not on false information, but rather on employing cherry-picked facts and deliberate omissions to mislead. While medical journals are the vanguards of new biomedical research, results and commentary published in them can be misrepresented to produce insidious malinformation, with distortions introduced by third parties interpreting the research, authors themselves, or both. Objective: To investigate the proliferation and interpretation of medical malinformation. Design: An altmetric and sentiment analysis of an article on a COVID-19 vaccine with the highest engagement score ever published in a medical journal. Setting: Worldwide. Participants: Media outlets and social media users worldwide. Measurements: Quantification of the context, spread, adoption, and interpretation of a prominent recent case study of medical malinformation. Results: This analysis suggests the selective and leading presentation made this an especially powerful piece of malinformation, in large part because the imprimatur of a respected medical journal gave it a veneer of legitimacy. Sentiment analysis suggests it has been chiefly amplified by antivaccine activists and conspiracy theorists worldwide, with negative ramifications for vaccine acceptance. The appearance of malinformation in a medical journal can adversely affect public understanding of medical science. Conclusion: To maintain public trust in medical science, authors, editors, and reviewers need be aware of the potential for malinformation and decontextualized misappropriation of bona fide results.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/g4jwr/" target="_blank">Malinformation – an emergent problem for medical journals and scientific communication</a>
</div></li>
<li><strong>Another doubling of excess mortality in the United States relative to its European peers between 2017 and 2021</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A mortality gap has emerged between the United States and other high-income nations before the pandemic and was estimated to account for one in seven US deaths in 2017. International comparisons in Covid-19 mortality suggest both the number and proportion of US deaths that can be attributed to this gap should have increased during the pandemic. Publicly available data on deaths from all causes and 2020-2021 Covid-19 death counts in the United States and five European countries, were combined with population estimates by sex and age group in these European countries to produce sex- and age-specific mortality rates. These rates are averaged and applied to the US population by sex and age-group to compare the resulting and actual US death counts. This counterfactual reveals 892,491 excess deaths in the United States in 2021—deaths that would have been prevented had the United States achieved the average mortality rates of its main West European peers. Excess deaths doubled between 2017 and 2021, with most of the increase occurring during the pandemic (89.1% increase between 2019 and 2021). Population change contributed little to the 2017- 2021 increase in excess deaths (42,317 additional deaths, 9.4% of the increase). Covid-19 mortality alone continue contributed 230,672 excess deaths in 2021 (51.2%), more than 2020, whereas other causes of deaths contributed 177,235 more excess deaths in 2021 than in 2017 (39.4% of the increase). In 2021, excess mortality in the United States relative to its European peers accounted for 25.8% of all deaths (3,426,249), up from 15.7% in 2017. The increase was driven in part by the large share of Covid- 19 deaths that are excess deaths (relative to European Covid-19 mortality rates),a proportion that has hovered around 50% but increased to 63.3% in 2021 as US vaccination rates plateaued at lower levels than in European countries. The overall increase in mortality from other causes during the pandemic increasingly separates the United States from West European countries as well.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.03.21.22272722v2" target="_blank">Another doubling of excess mortality in the United States relative to its European peers between 2017 and 2021</a>
</div></li>
<li><strong>Practical application of CO2 as an indicator regarding the risk of infection</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The air quality of enclosed spaces has attracted great attention due to the ongoing Covid-19 pandemic. The infection risk in these spaces can be estimated for various scenarios with different methods so the important parameters and effective infection prevention measures can be compared. Previous studies showed that indoor CO 2 concentration could be considered a surrogate for infection risk. In this regard, a generic relation can be established between the CO 2 levels and infection probability. Based on this consideration, some practical evaluations between CO 2 concentration and infection risk are conducted in this study. The effect of mask efficiency, viral emission rate, and duration of exposure are also included in the assessments. It is shown that continuous CO 2 monitoring can be helpful in the evaluation of possible preventive measures. Findings are expected to contribute to the understanding of the simple parameters related to the infection risk.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.07.14.22277631v1" target="_blank">Practical application of CO2 as an indicator regarding the risk of infection</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>Bank of Human Leukocytes From COVID-19 Convalescent Donors With an Anti-SARS-CoV-2 Cellular Immunity</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Other: Generation of a biobank allowing the cryopreservation of leucocytes from COVID19 convalescent donors<br/><b>Sponsor</b>:   Central Hospital, Nancy, France<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Generation of SARS-CoV-2-specific T Lymphocytes From Recovered Donors and Administration to High-risk COVID-19 Patients</strong> - <b>Condition</b>:   Severe COVID-19<br/><b>Interventions</b>:   Biological: Coronavirus-2-specific T cells;   Other: standard of care (SOC)<br/><b>Sponsors</b>:   George Papanicolaou Hospital;   General Hospital Of Thessaloniki Ippokratio<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Randomised, Multi-centre, Double-blind, Phase 3 Study to Observe the Effectiveness, Safety and Tolerability of Molnupiravir Compared to Placebo Administered Orally to High-risk Adult Outpatients With Mild COVID-19 Receiving Local Standard of Care in South Africa</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Drug: Molnupiravir 200 mg<br/><b>Sponsors</b>:   University of Witwatersrand, South Africa;   Bill and Melinda Gates Foundation<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>Evaluate the Efficacy and Safety of FB2001 in Hospitalized Patients With Moderate to Severe COVID-19 (BRIGHT Study)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: FB2001;   Drug: FB2001 placebo<br/><b>Sponsor</b>:   Frontier Biotechnologies Inc.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Engaging Staff to Improve COVID-19 Vaccination Response at Long-Term Care Facilities</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Behavioral: Full Intervention;   Other: Enhanced Usual Care<br/><b>Sponsors</b>:   Kaiser Permanente;   Patient-Centered Outcomes Research Institute;   Global Alliance to Prevent Prematurity and Stillbirth (GAPPS)<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Study to Evaluate the Efficacy of PanCytoVir™ for the Treatment of Non-Hospitalized Patients With COVID-19 Infection</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: PanCytoVir™ (probenecid);   Drug: Placebo<br/><b>Sponsor</b>:   TrippBio, Inc.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Value of Montelukast as a Potential Treatment of Post COVID-19 Persistent Cough</strong> - <b>Condition</b>:   Post COVID-19<br/><b>Intervention</b>:   Drug: Montelukast Sodium Tablets<br/><b>Sponsor</b>:   Assiut University<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>Topical Antibacterial Agents for Prevention of COVID-19</strong> - <b>Conditions</b>:   COVID-19;   SARS-CoV2 Infection<br/><b>Interventions</b>:   Drug: Neosporin;   Other: Vaseline<br/><b>Sponsors</b>:   Yale University;   Bill and Melinda Gates Foundation<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">**NanoMn®_COVID-19 A Prospective, Multicenter, Randomized, Placebo-controlled, Parallel-group, Double-blind Trial to Evaluate the Clinical Efficacy of NanoManganese® on Top of Standard of Care, in Adult Patients With Moderate to Severe Coronavirus Disease 2019 (COVID-19)** - <b>Condition</b>:   COVID-19 Pandemic<br/><b>Interventions</b>:   Drug: Placebo;   Drug: Experimental drug<br/><b>Sponsor</b>:   Medesis Pharma SA<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>Plasma Exchange Therapy for Post- COVID-19 Condition: A Pilot, Randomized Double-Blind Study</strong> - <b>Condition</b>:   Post-COVID19 Condition<br/><b>Interventions</b>:   Combination Product: Plasma Exchange Procedure;   Other: Sham Plasma Exchange Procedure<br/><b>Sponsors</b>:   Fundación FLS de Lucha Contra el Sida, las Enfermedades Infecciosas y la Promoción de la Salud y la Ciencia;   IrsiCaixa;   Banc de Sang i Teixits<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of Effectiveness of Proprietary Rehabilitation Program in Patients After COVID-19 Infection</strong> - <b>Conditions</b>:   COVID-19;   Rehabilitation<br/><b>Interventions</b>:   Other: Respiratory training with the use of resistance set on respiratory muscle trainer;   Other: Respiratory training without resistance set on respiratory muscle trainer<br/><b>Sponsor</b>:   Medical University of Bialystok<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>Developing an Integrative, Recovery-Based, Post-Acute COVID-19 Syndrome (PACS) Psychotherapeutic Intervention</strong> - <b>Condition</b>:   Post-acute COVID-19 Syndrome<br/><b>Intervention</b>:   Behavioral: PACS Coping and Recovery (PACS-CR) Intervention<br/><b>Sponsor</b>:   VA Office of Research and Development<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Mineralocorticoid Use in COVID-19 Patients</strong> - <b>Conditions</b>:   COVID-19;   ARDS<br/><b>Intervention</b>:   Drug: Fludrocortisone Acetate 0.1 MG<br/><b>Sponsor</b>:   Ain Shams University<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Dose Escalation Phase 1 Study Evaluating the Safety and Pharmacokinetics of an Inhaled COVID-19 Inhibitor Delcetravir in Healthy Subjects</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Combination Product: Delcetravir dry powder inhaler<br/><b>Sponsor</b>:   Esfam Biotech Pty 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>A Study to Evaluate the Safety and Immunogenicity of Ad5-vector Based Vaccine Against Coronavirus Variants in Adults (≥18 Years) Immunized With 2 Doses of mRNA Vaccines Plus One Dose of Booster AZD1222 Vaccine</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: Bivalent Recombinant COVID-19 Vaccine (Adenovirus Type 5 Vector);   Biological: Bivalent Recombinant COVID-19 Vaccine (Adenovirus Type 5 Vector) for Inhalation;   Biological: mRNA-based COVID-19 vaccine<br/><b>Sponsor</b>:   CanSino Biologics 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>Inhibition of the lectin pathway of complement ameliorates hypocomplementemia and restores serum bactericidal activity in patients with severe COVID-19</strong> - No abstract</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluating the Effects of Curcumin on the Cytokine Storm in COVID-19 Using a Chip-Based Multiplex Analysis</strong> - SARS-CoV-2 can stimulate the expression of various inflammatory cytokines and induce the cytokine storm in COVID-19 patients leading to multiple organ failure and death. Curcumin as a polyphenolic compound has been shown to have anti-inflammatory properties and inhibit the release of numerous pro-inflammatory cytokines. We present multiplex analysis using the Evidence Investigator biochip system to determine the effect of curcumin on serum level of cytokines which are typically elevated in…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Immune dynamics in SARS-CoV-2 experienced immunosuppressed rheumatoid arthritis or multiple sclerosis patients vaccinated with mRNA-1273</strong> - Background: Patients affected by different types of autoimmune diseases, including common conditions such as Multiple Sclerosis (MS) and Rheumatoid Arthritis (RA), are often treated with immunosuppressants to suppress disease activity. It is not fully understood how the SARS-CoV-2 specific humoral and cellular immunity induced by infection and/or upon vaccination is affected by immunosuppressants.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Analysis of the molecular mechanism of Huangqi herb treating COVID-19 with myocardial injury by pharmacological tools, programming software and molecular docking</strong> - CONCLUSIONS: Huangqi may play a therapeutic role in treating COVID-19 with myocardial injury by the effects of resisting virus and protecting myocardium concurrently.</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>Prolonged NHE Activation may be Both Cause and Outcome of Cytokine Release Syndrome in COVID-19</strong> - The release of cytokines and chemokines such as IL-1β, IL-2, IL-6, IL-7, IL-10, TNF-α, IFN-γ, CCL2, CCL3, and CXCL10 is increased in critically ill patients with COVID-19. Excessive cytokine release during COVID-19 is related to increased morbidity and mortality. Several mechanisms are put forward for cytokine release syndrome during COVID-19. Here we would mention a novel pathways. SARS-CoV-2 increases angiotensin II levels by rendering ACE2 nonfunctional. Angiotensin II causes cytokine release…</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>Beneficial effect of polyphenols in COVID-19 and the ectopic F<sub>1</sub> F<sub>O</sub> -ATP synthase: Is there a link?</strong> - COVID-19 has been proposed to be an endothelial disease, as endothelial damage and oxidative stress contribute to its systemic inflammatory and thrombotic events. Polyphenols, natural antioxidant compounds appear as promising agents to prevent and treat COVID-19. Polyphenols bind and inhibit the F(1) F(o) -ATP synthase rotary catalysis. An early target of polyphenols may be the ectopic F(1) F(o) -ATP synthase expressed on the endothelial plasma membrane. Among the pleiotropic beneficial action…</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>Surface Display of Peptides Corresponding to the Heptad Repeat 2 Domain of the Feline Enteric Coronavirus Spike Protein on <em>Bacillus subtilis</em> Spores Elicits Protective Immune Responses Against Homologous Infection in a Feline Aminopeptidase-N-Transduced Mouse Model</strong> - Although feline coronavirus (FCoV) infection is extremely common in cats, there are currently few effective treatments. A peptide derived from the heptad repeat 2 (HR2) domain of the coronavirus (CoV) spike protein has shown effective for inhibition of various human and animal CoVs in vitro, but further use of FCoV-HR2 in vivo has been limited by lack of practical delivery vectors and small animal infection model. To overcome these technical challenges, we first constructed a recombinant…</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>Corona versus Dengue: Distinct Mechanisms for Inhibition of Polyprotein Processing by Antiviral Drugs</strong> - Inhibitors interfering with processing of the viral polyprotein are used successfully for the control of extremely important viral pathogens, such as HIV and most recently SARS-CoV-2. This Viewpoint provides a mechanistic evaluation of a promising antiviral lead compound against dengue virus, JNJ-A07, 4-(3-((1-(4-chlorophenyl)-2-oxo-2-(6-(trifluoromethoxy)indolin-1-yl)ethyl)amino)-5-methoxyphenoxy)butanoic acid. The antiviral effect of JNJ-A07 appears, in our opinion, to be connected to an…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Impact on COVID-19 by Intravenous Bevacizumab Used for Hereditary Hemorrhagic Telangiectasia: A Case Report</strong> - Coronavirus disease 2019 (COVID-19) continues as an infectious pandemic. With emphasis on mitigating its impact globally, strategies have been emphasized on prevention to treatment in severe cases. As for pharmacotherapies, many have been researched, with a few being recommended for patients with COVID-19 depending upon their severity. Bevacizumab, a recombinant monoclonal antibody often used for oncological disease and rare genetic disorders, has gained attention in combatting COVID-19 due to…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of Clove Phytochemicals as Potential Antiviral Drug Candidates Targeting SARS-CoV-2 Main Protease: Computational Docking, Molecular Dynamics Simulation, and Pharmacokinetic Profiling</strong> - The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus can cause a sudden respiratory disease spreading with a high mortality rate arising with unknown mechanisms. Still, there is no proper treatment available to overcome the disease, which urges the research community and pharmaceutical industries to screen a novel therapeutic intervention to combat the current pandemic. This current study exploits the natural phytochemicals obtained from clove, a traditional natural therapeutic…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Potential inhibitors for blocking the interaction of the coronavirus SARS-CoV-2 spike protein and its host cell receptor ACE2</strong> - CONCLUSION: This platform is a rapid, sensitive, specific, and high throughput system, and available for screening large compound libraries. TS-984 is a potent blocker of the interaction between the S-protein and ACE2, which might have the potential to be developed into an effective anti-coronavirus drug.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Early administration of remdesivir plus convalescent plasma therapy is effective to treat COVID-19 pneumonia in B-cell depleted patients with hematological malignancies</strong> - Patients with hematological malignancies (HMs) are at a higher risk of developing severe form and protracted course of COVID-19 disease. We investigated whether the combination of viral replication inhibition with remdesivir and administration of anti-SARS-CoV-2 immunoglobulins with convalescent plasma (CP) therapy might be sufficient to treat B-cell-depleted patients with COVID-19. We enrolled 20 consecutive patients with various HMs with profound B-cell lymphopenia and COVID-19 pneumonia…</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>Multi-target mechanisms against coronaviruses of constituents from Chinese Dagang Tea revealed by experimental and docking studies</strong> - CONCLUSION: This study proposes E. chinensis and its triterpenoids and flavonoids as promising potential treatments for coronaviruses.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Allosteric inhibitors of the main protease of SARS-CoV-2</strong> - SARS-CoV-2 has raised the alarm to search for effective therapy for this virus. To date several vaccines have been approved but few available drugs reported recently still need approval from FDA. Remdesivir was approved for emergency use only. In this report, the SARS-CoV-2 3CLpro was expressed and purified. By using a FRET-based enzymatic assay, we have screened a library consisting of more than 300 different niclosamide derivatives and identified three molecules JMX0286, JMX0301, and JMX0941…</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>Crystal structure of the Rubella virus protease reveals a unique papain-like protease fold</strong> - Rubella, a viral disease characterized by a red skin rash, is well-controlled due to an effective vaccine, but outbreaks are still occurring in the absence of available antiviral treatments. The rubella virus (RUBV) papain-like protease (RubPro) is crucial for RUBV replication, cleaving the non-structural polyprotein p200 into two multi-functional proteins, p150 and p90. This protease could represent a potential drug target, but structural and mechanistic details important for the inhibition of…</p></li>
</ul>
<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
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<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-new-yorker">From New Yorker</a></li>
<li><a href="#from-vox">From Vox</a></li>
<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
<li><a href="#from-ars-technica">From Ars Technica</a></li>
<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
</ul>
<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Psychologists Treating Rape Victims in Ukraine</strong> - A grassroots effort is offering mental-health care to Ukrainians who’ve faced sexual violence at the hands of the Russian invasion force. - <a href="https://www.newyorker.com/news/dispatch/the-psychologists-treating-rape-victims-in-ukraine">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Kids Who Lost Parents to COVID</strong> - On two teens bound by grief, and the estimated two hundred thousand American children like them. - <a href="https://www.newyorker.com/news/dispatch/the-kids-who-lost-parents-to-covid">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Last Abortion Clinic in North Dakota Gets Ready to Leave</strong> - The Red River Women’s Clinic has thirty days to close on one side of the border with Minnesota, before reopening on the other. - <a href="https://www.newyorker.com/news/us-journal/the-last-abortion-clinic-in-north-dakota-gets-ready-to-leave">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What’s at Stake in the Fight Against Monkeypox</strong> - There’s still time for a forceful global response to shape the future of the disease. - <a href="https://www.newyorker.com/science/medical-dispatch/whats-at-stake-in-the-fight-against-monkeypox">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Joe Manchin Plays the Role of Wrecker, Again</strong> - The senator from West Virginia delivered a crippling blow to what was left of Joe Biden’s climate-change agenda. - <a href="https://www.newyorker.com/news/our-columnists/joe-manchin-plays-the-role-of-wrecker-again">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>Sri Lanka’s protests are just the beginning of global instability</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/0Dk7kHdDd1CvU1ReWQieo08NopA=/0x0:4892x3669/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71130584/GettyImages_1241898185.0.jpg"/>
<figcaption>
Protesters in Sri Lanka gather at the Presidential Secretariat, the president’s offices, on July 14, 2022. | Arun Sankar/AFP via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Why rising costs of food and other essentials are leading to protests around the world.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nntY8W">
Sri Lanka’s <a href="https://www.nytimes.com/2022/07/14/world/asia/sri-lanka-president-rajapaksa-resigns-protests.html">president</a> finally resigned. Protesters celebrated, and they had reason to: Their mass demonstrations — including a <a href="https://www.hindustantimes.com/world-news/sri-lankan-crisis-protesters-cook-food-play-carrom-inside-lankan-pm-s-ranil-wickremesinghe-residence-video-gotabaya-rajapaksa-101657462911207.html">takeover of the presidential mansion</a> — drove President Gotabaya Rajapaksa from office.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kCwbDR">
Sri Lanka’s economy is in free fall. The country doesn’t have enough money to buy essentials: food, medicine, and especially fuel. <a href="https://www.reuters.com/world/asia-pacific/crisis-hit-sri-lanka-shuts-schools-urges-work-home-save-fuel-2022-06-27/">Buses can’t run, schools can’t open</a>. The economic crisis was years in the making because of <a href="https://www.reuters.com/world/asia-pacific/how-sri-lanka-spiralled-into-crisis-2022-07-13/">mismanagement</a>, but <a href="https://www.state.gov/reports/country-reports-on-terrorism-2019/sri-lanka/">terror attacks</a> in 2019, and later the Covid-19 pandemic, which shriveled Sri Lanka’s tourist economy, pushed it to the brink.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2xffua">
But the domestic political turmoil unfolding in Sri Lanka also links back to the instability across the globe, including the war in Ukraine and all of its consequences.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="owsb4c">
It may seem strange to link street protests against the Sri Lankan government to a war in Europe, but food and oil markets are global. A shock in one place ripples everywhere. The Ukraine war compounded supply chain pressure in the wake of Covid-19, and Moscow’s war in Ukraine and <a href="https://www.vox.com/23049187/russia-sanctions-ukraine-ruble">Western sanctions against Russia</a> have squeezed agricultural exports — critical supplies like grain and sunflower oil — from the entire <a href="https://www.vox.com/23171151/ukraine-grain-wheat-russia-black-sea-odesa-food-crisis">Black Sea region</a>. These products can be replaced on the global market, but at a cost. Fuel prices are also up, and if it costs more to buy diesel for a tractor or to transport cargo, food becomes more expensive still. Food becomes all that much <a href="https://www.vox.com/future-perfect/23140267/countries-are-limiting-food-exports-it-may-make-global-hunger-worse">harder to afford for poor countries</a>, and for poor people in rich countries.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Oi4aJc">
The <a href="https://www.vox.com/2022/7/13/23206038/inflation-cpi-economy-prices">United States</a> and <a href="https://www.cnbc.com/2022/07/14/eu-hikes-inflation-forecast-to-7point6percent-as-russia-ukraine-war-fuels-price-increases.html">Europe</a> are seeing these price shocks. So are people in <a href="https://www.bloomberg.com/news/articles/2022-07-13/ghana-inflation-surges-to-19-year-high-on-transport-costs#xj4y7vzkg">Ghana</a> and <a href="https://www.bloomberg.com/news/articles/2022-07-08/protests-build-across-africa-over-surging-fuel-prices-shortages#xj4y7vzkg">Mozambique</a> and <a href="https://www.imf.org/en/News/Articles/2022/04/15/cf-latin-america-hit-by-one-inflationary-shock-on-top-of-another">Mexico</a> and <a href="https://foreignpolicy.com/2022/07/01/ecuador-protests-indigenous-conaie-lasso-fuel-subsidies-inflation-latin-america/">Ecuador</a> and <a href="https://www.rferl.org/a/central-asia-food-prices/31902419.html">Uzbekistan</a> and <a href="https://www.vox.com/23161802/afghanistan-earthquake-humanitarian-economic-crisis-taliban-united-states">Afghanistan</a>. Food, fuel, and other essentials are getting more expensive, everywhere. Many of these governments want to intervene, but their economies were already pummeled by the Covid-19 pandemic, and so they don’t have the funds to respond to these crises.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jXi9Sr">
That means standards of living will fall in many countries, and that more people will slip into poverty. The United Nation’s World Food Program has <a href="https://www.wfp.org/hunger-catastrophe#:~:text=2022%3A%20a%20year%20of%20unprecedented,on%20the%20edge%20of%20famine.">warned</a> that the number of food-<a href="https://www.npr.org/2022/07/07/1110219180/record-number-of-people-worldwide-are-moving-toward-starvation-u-n-warns#:~:text=David%20Beasley%2C%20head%20of%20the,invaded%20Ukraine%20on%20Feb.%2024.">insecure people has risen to 345 million</a>; nearly 50 million people in more than 45 countries are at risk of falling into famine conditions.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1ZkFDp">
But the global instability that causes prices to rise also creates more instability. Food prices, for example, are rarely the only reason that a government falls, but they can help crystallize simmering discontent in a country.<strong> </strong>“If you can point to rising food prices, it is a sign that something is failing in the implicit contract between the government and the governed,” said <a href="https://korbel.du.edu/about/directory/cullen-hendrix">Cullen Hendrix</a>, a nonresident senior fellow at the Peterson Institute for International Economics and professor at the Josef Korbel School of International Studies at the University of Denver.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PzcW3j">
Vox spoke to Hendrix about why food costs can coincide with political unrest, and where and when that happens — and why Sri Lanka likely represents just the beginning of the volatility about to envelop the globe.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qZsbDL">
This conversation has been edited and condensed for clarity.
</p>
<hr class="p-entry-hr" id="1fvb7F"/>
<h4 id="YZGCzY">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LyA5QJ">
This is a big question, but what is happening, broadly, around rising prices around food and fuel, and political unrest?
</p>
<h4 id="O2YAHL">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eSWJOB">
We need to decompose that into thinking about food prices and thinking about fuel prices.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="a9i5jJ">
Up until about 2000, the two of those weren’t really correlated. You had periods where you had very high food prices and very low oil prices, or very high oil prices coinciding with low food prices.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iimPkn">
The 2000s are when those two things start to trend much more together. In some ways, the current crisis looks the most like <a href="https://ec.europa.eu/environment/integration/research/newsalert/pdf/225na1_en.pdf">the 2007-2008 food price crisis</a>, because we have simultaneous crises in both food markets and oil markets in terms of elevated prices as a response to, in this case, <a href="https://www.vox.com/russia-invasion-ukraine">instability caused by the Russian invasion of Ukraine</a>. In 2007 and 2008, <a href="https://www.theguardian.com/environment/2007/nov/03/food.climatechange">it had more to do with climatic shocks</a>, and then the ways that many producer countries — countries that normally export food — decided to institute export bans.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sJKyjf">
So, having kind of decomposed those two things, we probably need to take food and fuel prices separately.
</p>
<h4 id="xje00B">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AimdA0">
Okay, so how do they work?
</p>
<h4 id="09M9mp">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RiCPdM">
Generally speaking, there is a positive relationship between higher prices for food in international markets and protest activity. This relationship is particularly evident in democratic and semi-democratic countries. Protest dynamics tend to be less responsive to global food prices in more authoritarian countries.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nwlSFy">
With respect to oil prices as separate from food prices, the research on this topic is a bit more mixed. It’s certainly the case that higher fuel prices can erode real incomes. They can eat into purchasing power, and they can generate significant grievances with incumbent regimes, who are being asked to do something about these higher prices. But it turns out that these higher oil prices are also a source of revenue that many governments that export oil can capture, and they can use that to reinvest back into price supports and mechanisms of ensuring social stability.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HupK9F">
A good way of thinking about this is to look back at the <a href="https://podcasts.apple.com/us/podcast/the-arab-spring-10-years-later/id1346207297?i=1000507772983">Arab Spring</a>, and the places where the Arab Spring protests got the most traction, like <a href="https://www.npr.org/2011/12/17/143897126/the-arab-spring-a-year-of-revolution">Tunisia</a> and <a href="https://www.dw.com/en/egypts-arab-spring-the-bleak-reality-10-years-after-the-uprising/a-56336238">Egypt</a>, are small oil exporters, if they export oil at all. Whereas countries like <a href="https://www.bbc.com/news/world-19401680">Kuwait</a> were able to weather the storm because although they were paying a higher bill for their food imports, they were also reaping these windfall profits associated with higher commodity prices for their main export, being oil. They were able to invest in lavish public spending at a time when, in the wider region, many governments were having to go on austerity diets and slash social spending at precisely the time when doing so was most likely to enrage the populace.
</p>
<h4 id="aYCj2m">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="l8RwhD">
So people are frustrated with inflation in places like the United States and Europe, but as yet, we haven’t seen a mass wave of protests over, say, gas prices. That may happen, but I’m also wondering if this is more likely to happen in countries with less-developed economies, and where the government may have limited ability or capacity to respond.
</p>
<h4 id="map1qA">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cSAlH6">
We know less about the ability of the government to respond, but your point about average incomes is definitely well taken. If you’re in a developing country, and you’re spending 50 percent of your take-home income on food, and much of that food is unprocessed — you’re actually buying bulk wheat, or maybe wheat flour — the increase in food prices hits you much harder than it does, say, for you and me, where we spend a much smaller proportion of our income on food. It’s not as significant a source of hardship. And a lot more of the money that we spend on food, actually, is money spent on packaging and marketing and the like, as opposed to people who are living maybe half a step removed from the underlying bulk commodity.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0mGI5o">
So higher-income countries see less of this kind of protest. We have seen things like the antecedents of what you’re talking about. If you remember back to the <a href="https://www.vox.com/2018/12/3/18123906/france-protest-macron-paris-riots-yellow-vest-arc">yellow vest protests in France</a> and <a href="https://www.france24.com/en/20181209-belgium-yellow-vest-protest-brussels-tax-living-cost">Belgium</a>, those were protests in response to reductions in the subsidies for diesel fuel.
</p>
<h4 id="88VMUO">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gyVoWA">
One of the things I sometimes struggle with in covering protests is that food and fuel prices can factor among them, or be the “spark,” but they ultimately lead to a longer list of grievances against a government. It can be hard to disentangle, and I am wondering, how do you make sense of exactly what role food and fuel prices play in protest movements?
</p>
<h4 id="qAw70A">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="n7XzEC">
At any sufficiently large protest, people are going to be there for a variety of reasons. Food and fuel prices may be significant for some participants, but they may not be particularly significant for others.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cBADCt">
It’s not typically the most food-insecure people that wind up participating in these protests. It’s not the truly hungry. It’s that if you can point to rising food prices, it is a sign that something is failing in the implicit contract between the government and the governed, in terms of being able to secure people’s ability to have plentiful and appropriate food at a bearable price. If you think about that as being the bedrock of the social contract in these regimes going all the way back to Roman times — that’s where the concept of “bread and circuses” comes in — then, yes, they’re kind of a canary in the coal mine for the broader inability of the government to address the grievances and the needs of the populace.
</p>
<h4 id="adDdub">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uWwSoN">
And so I think part of the challenge now, and correct me if I’m wrong, but for countries like Sri Lanka, where you have that fundamental breakdown of the contract, because of what’s happening around the globe — specifically, the war in Ukraine — it is much harder for those countries to figure out an adequate response because they have less tools at their disposal?
</p>
<h4 id="HnTm2X">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AW8s9S">
One hundred percent. The issue in a place like Sri Lanka — and if you look through the list of other places that are experiencing these kinds of inflation protests, like <a href="https://abcnews.go.com/International/wireStory/albania-thousands-join-opposition-protest-price-hikes-86397392">Albania</a>, <a href="https://www.eltiempo.com/mundo/latinoamerica/argentina-protestas-por-inflacion-amenazan-al-presidente-686182">Argentina</a>, <a href="https://www.vozdeamerica.com/a/inflacion-y-protestas-que-ocurre-en-panama-/6655136.html">Panama</a>, <a href="https://www.theeastafrican.co.ke/tea/oped/editorial/brace-for-impact-some-of-east-african-woes-are-self-inflicted-3873950">Kenya</a>, <a href="https://www.aljazeera.com/news/2022/7/13/ghana-inflation-scales-new-peak-at-29-8-in-june">Ghana</a> — these are not places with a ton of what economists would call fiscal space. They do not have the ability to offset these price increases with ramped-up government spending and targeted transfers and subsidies to offset the pain. These are cash-strapped governments; they went into the crisis cash-strapped, many of them because of the ongoing effects of the Covid pandemic.
</p>
<h4 id="DSuz2g">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="d6ps7I">
You mentioned the food crisis in 2007 and 2008. But what are some historical precedents for when higher global food prices created political instability?
</p>
<h4 id="uwDbNq">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ypzJ9t">
I was getting ready to say — I hate to bang on Russia, but I don’t hate to bang on Russia, as this has been their fault before. If you go back to 2010-2011 and the Arab uprisings, the food price spike occurred because Russia decided unilaterally to <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/aepp.13168">impose an export ban</a> on wheat, barley, a bunch of other kinds of grains, in response to <a href="https://www.dw.com/en/russia-begins-ban-on-grain-exports-after-fires-devastate-crops/a-5912105">heat waves and wildfires</a> that were projected to decimate their harvest. In order to maintain domestic food supplies and lower prices, they decided to not export.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mrPhDF">
The problem was that many of the countries that were counting on those exports — the same way as it is now, the countries that are <a href="https://www.vox.com/23171151/ukraine-grain-wheat-russia-black-sea-odesa-food-crisis">counting on Black Sea exports</a>, both from Russia and Ukraine — were the countries in the Middle East and North Africa, which are deeply food import-dependent. Then, <a href="https://www.vox.com/23022693/war-ukraine-shipping-food-hunger">as now</a>, they’re basically thrust back into international markets at much higher prices to try and satisfy their need for food imports.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LYjKIs">
There were obviously elements to the Arab uprisings that had nothing to do with food prices, but it is important to understand the contributing factor that food prices can play.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cARNW5">
The Arab Spring protests were largely coordinated and organized by people who had lots of anti-regime sentiment and had been organizing around it. But what brings otherwise apolitical people out into the streets to participate in these mass movements often are these kinds of political issues that are much more picayune, as opposed to the broader dissatisfaction with the regime, or indeed, the regime type.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Jf8VtD">
Over time, a lot of those protests that were related to food and fuel prices metastasize into protest movements around the form of government, like, “Why don’t we get to elect our government? Why are we run by these corrupt authoritarians?” But there was a significant part of it that began with the food and fuel price spikes.
</p>
<h4 id="Cn5ZEo">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yOmpcG">
Is there something of a tipping point when it comes to food price spikes — like when they reach certain levels, the likelihood of instability increases?
</p>
<h4 id="LaY6rp">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pTNxXx">
I’m hesitant to say that there is a tipping point where I can say, “Once food gets above X price, then it’s on.” I don’t think there’s sufficient evidence for that.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JioBwH">
I will say that the prices we’re currently seeing are, if not historic, near historic. The last time we saw food prices <a href="https://www.foreignaffairs.com/articles/1974-04-01/year-economics-world-food-prices-and-poor">this high in international markets was in 1974</a>. Back then, global food trade was a much smaller share of actual food consumption. Higher global prices mattered less for people’s ability the world over to feed their families.
</p>
<h4 id="2pPZsV">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ro4J4k">
What are the places you’re paying attention to when it comes to political unrest as a result of rising food prices?
</p>
<h4 id="sRH3bu">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Qmf6yT">
I would keep an eye on West Africa, particularly Ghana and Nigeria. I think that there is potential for maybe <a href="https://www.bloomberg.com/news/articles/2022-06-01/pakistan-inflation-climbs-to-13-8-in-may-on-costlier-food-fuel#xj4y7vzkg">Pakistan</a>. The non-oil-rich Middle East and North African countries, and maybe Central America. I think that’s a significant issue, because it’s <a href="https://reliefweb.int/report/guatemala/climate-extremes-food-insecurity-and-migration-central-america-complicated-nexus">co-occurring with droughts</a>. But it’s also the case that these countries, because of rapid rates of urbanization, are becoming increasingly dependent on global markets, and these are countries with fragile governance systems to begin with.
</p>
<h4 id="6ZU5Zp">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UM79u3">
Basically sounds like the whole world.
</p>
<h4 id="cKhlbA">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5ckWnl">
I mean, the outlook isn’t great. These markets are being reined in a little bit. The higher oil prices that are a function of these kinds of political instability tend to be relatively short-lived. They’re persisting longer now, just because of how large an exporter Russia is and the scale of instability. Typically, in the past, other big exporters have increased exports to offset the effects of this kind of destabilization. But I wish I had better news for you.
</p>
<h4 id="wZ4Dig">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KAX97c">
What are some possible interventions that the United States or other wealthier governments might be able to do to ameliorate some of these brewing crises in poorer parts of the world?
</p>
<h4 id="Ymdxkc">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GTvfj6">
The <a href="https://reliefweb.int/report/world/g7-statement-global-food-security-elmau-28-june-2022">G-7</a> and then the <a href="https://www.reuters.com/article/us-health-coronavirus-g20/g20-ministers-agree-to-keep-markets-open-tackle-pandemic-supply-disruptions-idUSKBN21H0HT">G-20</a> both attempted to push through agreements not to use export bans. <a href="https://www.aljazeera.com/news/2022/5/14/india-bans-wheat-exports-cites-food-security-and-soaring-prices">India gets a carve-out</a> because India is, you know, a developing country, and I think it’s more political theater than it is actual constraint on food supply and food exports.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dxKUjZ">
In terms of longer-term — and this is where we get really speculative — ultimately, we need to reform the global food producing system in ways that increase resilience, not just to climate change, but also to these kinds of geopolitical shocks, because I don’t think this is going anywhere. If you look at the projections of the kinds of countries that are going to be seeing increasing yields and potentially larger harvests moving forward, it is places like Russia, Kazakhstan, the United States, and Canada.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="x34OzQ">
That said — and this is the thing that I think is potentially more controversial — I’m of the opinion that we probably need to see more subsidization of agriculture in developed countries, as opposed to less. I wish it were the case that we could convince voters in Iowa to subsidize food production in places like Thailand or Kenya; unfortunately, electoral politics don’t work that way. But the subsidies that are paid by taxpayers in developed countries are actually subsidizing consumption at the global level.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Kavlmf">
That’s not necessarily a super popular opinion, especially among folks who are fairly wedded to agricultural development in developing countries as a mechanism for growth. But I do think that’s something we need to be getting serious about, because I don’t think, in the near term, we’re going to be able to offset these kinds of volatility that can be created by these countries with very large market shares having their supply just go offline. There’s not enough slack in the global food system to make up for that.
</p>
<h4 id="pRSsDZ">
Jen Kirby
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="13BJVc">
If I’m understanding you correctly, the global food market basically works the way it works. But having a place like the United States or Canada, which does have the capacity to supply more people, they could make up for some of the pressure when Russia or another major area is taken offline or creates major disruptions?
</p>
<h4 id="oGBm4z">
Cullen Hendrix
</h4>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wdwJr6">
I tend to believe in markets, but I will say that markets for basic necessities like food, these are not markets you want to operate according to cold economic logic. The market for food is not a market where you want to wind up at the end of the sale with no available supply. We can’t have that because we need to have buffers in the system precisely because of events like the ones we’ve seen. And so if that’s physical grain reserves, [or] if it’s governments willing to use what they call virtual reserves, which are basically governments, in a coordinated fashion, intervening in markets to short these futures contracts to drive prices back down.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="I71f82">
There are things that can be done. It’s just going to take an investment of resources and, I think, broader awareness of the enlightened self-interest that it does not make the United States any safer and more prosperous to exist in the world where many of our trading partners and many of our strategic partners around the world are facing instability because they can’t feed their populations.
</p></li>
<li><strong>Democrats’ latest attempt at resurrecting Build Back Better, explained</strong> -
<figure>
<img alt="Senators Meet On New Infrastructure Plan After Talks With President Biden Collapse" src="https://cdn.vox-cdn.com/thumbor/mfF8oxXYH8d4D9ZS4K2CuZT9Byc=/0x0:5919x4439/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71054621/1322576691.0.jpg"/>
<figcaption>
Sen. Joe Manchin (D-WV) walks to a meeting in 2021, in Washington, DC. | Kevin Dietsch/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Lawmakers are scrambling to get a deal done before August.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ScuRjZ">
<a href="https://www.vox.com/2022/3/16/22955410/build-back-better-scenarios">Democrats are</a> struggling to resurrect parts of the <a href="https://www.vox.com/2021/12/13/22799436/build-back-better-senate-manchin-parliamentarian">Build Back Better Act</a> after the broader <a href="https://www.vox.com/2021/12/19/22845122/manchin-build-back-better-psaki">package imploded last year</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ukObTF">
They’d hoped to put together a trimmed version of the original $2 trillion package, narrowly focused on health care, climate, and tax reforms. <a href="https://www.washingtonpost.com/us-policy/2022/07/14/manchin-climate-tax-bbb/">Sen. Joe Manchin (D-WV), however, has expressed opposition</a> to additional climate and tax policies, and it now seems the party will have to settle for a smaller bill than leaders wanted, one that centers on <a href="https://www.finance.senate.gov/imo/media/doc/070622%20Prescription%20Drug%20Pricing%20Reform%20Leg%20Text.pdf">lowering prescription drug costs</a> and extending health insurance subsidies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cZ5AsY">
<a href="https://www.washingtonpost.com/us-policy/2022/07/14/manchin-climate-tax-bbb/">The Washington Post</a> reported July 14 that Manchin told Democratic leaders he doesn’t want to proceed on climate spending or tax hikes due to concerns about inflation. He is still reportedly open to supporting Democrats’ prescription drugs package as well as an extension to Affordable Care Act subsidies, which are due to sunset at the end of this year. And he has said he may be willing to <a href="https://www.bloomberg.com/news/articles/2022-07-15/manchin-says-he-ll-reconsider-tax-climate-plan-in-september">negotiate again on taxes and climate in September</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LrB1Me">
If Democrats stay united on these aspects of the bill, they could still pass a substantial piece of legislation that would enable Medicare to negotiate drug prices and help reduce health care costs for millions of people.<strong> </strong>That said, this version of Build Back Better would fall far short of the transformative climate and social spending package that many lawmakers and activists have been pushing for for months.
</p>
<h3 id="lpj2kf">
What Democrats have agreed on
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Es0082">
Thus far, Democrats are aligned on their prescription drugs plan as well as an extension of ACA subsidies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VMDNbu">
The drug provisions could be significant, though they are narrower than what Democratic lawmakers were considering last year — the plan doesn’t include proposals some in the party were fighting for, like a $35 per month cap on insulin costs.<strong> </strong>
</p>
<h3 id="Ps224J">
Here are the provisions that Democrats agree on so far:
</h3>
<h4 id="ZeinSI">
Prescription drugs plan
</h4>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pFLH5k">
<strong>Allowing Medicare to negotiate drug prices: </strong>Medicare has historically been barred from negotiating on most prescription drug prices, meaning it pays drug prices set by manufacturers. This bill would change that. In doing so, it could mean drastic price reductions on specific drugs for people covered by Medicare, since the government has huge buying and negotiating power.
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="htuIkv">
The savings would not apply to people covered by private insurance, however, <a href="https://www.reuters.com/world/us/us-senate-democrats-reach-deal-lower-drug-prices-2022-07-06/">Reuters reports</a>. The legislation guarantees that Medicare can begin negotiations in 2023, starting with 10 drugs, which will be chosen by the Department of Health and Human Services.
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SeR3Tk">
<strong>Capping out-of-pocket drug costs for Medicare recipients: </strong>The legislation would cap annual out-of-pocket drug costs for Medicare recipients at $2,000. After that, Medicare would pay for additional expenses. It would be a major change since there is currently no cap, meaning people sometimes spend thousands more for a single drug.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="t4W67l">
<strong>Requiring rebates for price hikes:</strong> If pharmaceutical companies raise the costs of a drug at a rate faster than the rate of inflation, they would be forced to refund the difference to people paying for the drug. This tenet is intended to check companies that try to make exorbitant annual increases on a drug.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZqInWr">
<strong>Expanding prescription drug subsidies for low-income seniors: </strong>Currently, seniors who are at or below 150 percent of the federal poverty line are able to receive a partial subsidy for their prescription drugs. The legislation would enable them to receive a larger subsidy for these expenses.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uLzyLp">
<strong>Making vaccines free for seniors: </strong>The legislation would make all vaccines free for seniors, a notable change in coverage. Currently, Medicare covers some vaccines, like the flu shot, but not all immunizations are included.<strong> </strong>
</li>
</ul>
<h4 id="tO5ojp">
ACA subsidy extensions
</h4>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jPa4pc">
<strong>ACA subsidies:</strong> As part of the American Rescue Plan, Congress expanded the subsidies available for health insurance coverage under the Affordable Care Act, including reducing premium costs for those who fall between 100 percent and 400 percent of the federal poverty level. These subsidies, however, are due to sunset at the end of the year if Congress does not renew them; Manchin has said he’s willing to consider a two-year extension.
</li>
</ul>
<h3 id="wSCQsx">
Democrats are trying to do what they can before the midterms
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MBLYGI">
Although Democrats’ electoral chances in the Senate are looking better than they are in the House, it’s possible the party loses control of one or both chambers of Congress following the November midterms. With the elections fast approaching, Democrats are rushing to capitalize on their existing majorities in case they are no longer able to pass legislation next year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="35FPTT">
That’s likely to mean passing whatever version of Build Back Better the Senate Democratic caucus can agree on.<strong> </strong>This reconciliation bill could be the party’s last major chance to approve new prescription drug policy if Republicans retake just one chamber of Congress. If they are able to make quick progress in the coming weeks, it’s possible that Democrats could hold a vote on the reconciliation by the end of July, <a href="https://twitter.com/mkraju/status/1546530650550935552">though Manchin has</a> expressed uncertainty about this timeline.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oi9HTM">
Republicans have pushed back on these efforts: Senate Minority Leader Mitch McConnell <a href="https://thehill.com/homenews/administration/3543392-mcconnell-threatens-semiconductor-bill-prompting-white-house-rebuke/">threatened</a> to pull support on the US Innovation and Competition Act, a bipartisan bill aimed at investing in the US’s supply chain, unless Democrats abandon reconciliation. Democrats have responded by claiming McConnell is trying to deter the reconciliation bill in order to protect pharmaceutical companies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nbXv9R">
To successfully pass a reconciliation bill, Senate Democrats will need all 50 members of their caucus on board with the legislation, as well as approval from the parliamentarian — who can advise against including provisions if they aren’t seen as sufficiently related to taxing and spending. It seems they now have the former for part of their bill. House Democrats, many of whom have pushed for a more ambitious bill in the past, will need to vote in favor as well.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="P0uI5J">
<em><strong>Update, July 15, 6 pm ET: </strong></em><em>This story has been updated to include new information on Manchin’s statements about climate and tax policy. </em>
</p></li>
<li><strong>Why BA.5 is cause for concern, but not alarm. Yet.</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/kZTLnsHixI5ofdSJBmk47NUyr8k=/10x0:3121x2333/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71122164/GettyImages_1407189718a.0.jpg"/>
<figcaption>
A mix of masked and unmasked people wait in line in New York’s Times Square on June 6. The BA.5 subvariant of SARS-CoV-2 is believed to be fueling a new wave of cases in New York City. | John Smith/VIEWpress/Corbis via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The rise of the latest subvariant, explained.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Lao7DE">
In a <a href="https://erictopol.substack.com/p/the-ba5-story">recent edition</a> of his newsletter, the Scripps Research Institute physician and researcher Eric Topol called the BA.5 subvariant of SARS-CoV-2 “the worst version of the virus that we’ve seen.” The Washington Post used the same language in an <a href="https://www.washingtonpost.com/opinions/2022/07/07/worst-virus-variant-just-arrived-pandemic-is-not-over/">editorial</a> that soon followed, and earlier this week, the White House announced a <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2022/07/12/fact-sheet-biden-administration-outlines-strategy-to-manage-ba-5/#:~:text=Today%2C%20the%20White%20House%20COVID,against%20and%20treat%20COVID%2D19.">strategy for managing BA.5</a>, which stressed the subvariant’s potential to make cases rise in the coming weeks.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SDo4nS">
Why are experts so concerned about this subvariant?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="61f0J4">
For one, hospital admissions are <a href="https://www.ft.com/content/f4794ae3-70ec-436d-bf76-d89c114e93af">now rising</a> concurrently with BA.5, after several months of stable hospitalization rates. Additionally, early evidence suggests the BA.5 subvariant has features that make it better at escaping immune systems, even vaccinated ones, than its ancestors.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nqiwLW">
Also concerning: pandemic complacency has been rising alongside BA.5. Vaccine booster uptake has been <a href="https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-additional-dose-totalpop">modest</a> in the US, and more than one-fifth of the population <a href="https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-by-race-ethnicity/">has not been vaccinated at all</a>. Many fear that a variant better able to evade immune systems will have a better chance of reaching and harming those who remain unvaccinated.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MGynlO">
The good news is we already have the tools to cope with a subvariant like BA.5. “It doesn’t really shake up any of our established countermeasures,” said Anne Hahn, a Yale medical school immunologist who specializes in viral evolution. That means masking and vaccines still work to prevent BA.5’s worst effects. Although, to prevent the subvariant from wreaking major havoc, people need to be willing to reengage with these preventive efforts.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RFx28U">
Americans’ willingness to dial up preventive behaviors will determine — and, perhaps, be shaped by — the path BA.5 takes as it rises to dominance.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iY2m21">
Is this really the worst form of the virus so far? For now, a lot remains unclear: While BA.5 has some things in common with earlier variants — the symptoms it causes seem the same, for example — scientists see a few signals that it has the potential to cause bigger problems if we don’t take some action.
</p>
<h3 id="voRviD">
The early evidence giving scientists the heebie-jeebies about BA.5
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="h9OSLH">
As of July 9, estimates from the Centers for Disease Control and Prevention (CDC) indicate that all the SARS-CoV-2 virus currently circulating in the US is the omicron variant and its subvariants. About <a href="https://covid.cdc.gov/covid-data-tracker/#variant-proportions">65 percent</a> of the subvariants in circulation are of the BA.5 lineage, and the proportion is rising quickly. If BA.5’s rapid expansion continues, it will likely account for nearly all US infections within a month. In <a href="https://www.nature.com/articles/s41591-022-01911-2">South Africa</a>, which had a combined BA.4/BA.5 wave between April and June of this year, case rates grew more quickly than did case rates of the omicron variant that preceded it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Uc8VuV">
Over the course of the pandemic, new variants have eclipsed old ones many times over — among omicron subvariants alone, BA.5 is the <a href="https://covariants.org/per-country?region=United+States">fifth</a> one to rise to prominence in the US. But the first omicron wave created a massive surge in new cases and hospitalizations, while the subsequent ones did not.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sWXU23">
BA.5’s pattern is different, and concerning: As the BA.4 and BA.5 subvariants have become a larger share of the virus in circulation, case and hospitalization numbers have also begun to rise in the US.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/OW208nhNYl50k8eZFzb1J-nn0SU=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/23835080/Screen_Shot_2022_07_14_at_12.03.34_PM.png"/> <cite><a class="ql-link" href="https://covid.cdc.gov/covid-data-tracker" target="_blank">Centers for Disease Control and Prevention</a></cite>
<figcaption>
CDC’s model estimates the recent proportions of circulating variants, with BA.5 currently accounting for about 65 percent of US cases.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DvHZ38">
This trend suggests BA.5 has biological advantages that previous omicron subvariants didn’t have — and laboratory data has begun to clarify what those advantages are.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XOdN9K">
A recent publication from researchers at Columbia University suggests BA.5’s genome is genetically <a href="https://www.nature.com/articles/s41586-022-05053-w_reference.pdf?origin=ppub">pretty different</a> from earlier omicron subvariants, including the one that <a href="https://www.cidrap.umn.edu/news-perspective/2021/12/surge-omicron-cases-upends-christmas-weekend">stole Christmas</a> last year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bVGEj5">
Some of the differences are in the virus’s spike protein, a key target for Covid-19 vaccines. Scientists are worried that the more the spike protein changes, the less likely our current vaccines will elicit antibodies that can neutralize it. It’s possible this subvariant could lead to more infections than its predecessors, even among vaccinated people.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8xVbXR">
Epidemiological data to support this is in its <a href="https://www.nbcnews.com/health/health-news/covid-hospitalizations-double-may-driven-ba5-rcna37679">early</a> <a href="https://www.health.state.mn.us/diseases/coronavirus/stats/vbt.html">stages</a>, but it’s highly plausible, based on some lab studies. An early-July report in the <em>New England Journal of Medicine</em> suggested that in vaccine-boosted people, levels of protective antibodies were <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2206576">three times less active</a> against BA.5 than against the first omicron subvariants. While these antibodies are not the only way the immune system protects the body from severe SARS-CoV-2 infections (we’re looking at <a href="https://www.nih.gov/news-events/nih-research-matters/t-cells-protect-against-covid-19-absence-antibody-response#:~:text=T%20cells%20coordinate%20the%20immune,research%20team%20led%20by%20Dr.">you, T-cells</a>), this finding suggests vaccines could be less protective against BA.5 infection than against earlier strains.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3rtj6c">
Although Covid-19 infection has also been thought to boost protective antibody levels against new variants, omicron has changed the game. <a href="https://www.science.org/doi/10.1126/science.abq1841">Research</a> suggests omicron infections don’t help the immune system effectively recognize and protect against subsequent omicron infections. That makes reinfection after having an omicron variant infection more likely than reinfections that occurred after exposure to previous forms of the virus.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ao7vva">
<a href="https://www.nature.com/articles/s41591-022-01911-2">Real-world data from South Africa</a> shows how this may play out in humans. BA.5 case rates in that country grew more quickly than did case rates of the omicron variant that preceded it. BA.5’s improved ability to infect people protected by vaccination and previous infection could explain its more efficient spread.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LvYbr9">
Hahn noted vaccines and, to some degree, prior infections still appear to offer good protection against severe disease due to BA.5. But there are other unknowns: <a href="https://www.medrxiv.org/content/10.1101/2022.07.07.22277128v1">several</a> <a href="https://onlinelibrary.wiley.com/doi/10.1002/jmv.27908">analyses</a> have raised questions about test sensitivity for omicron subvariants, meaning some diagnostic tests might yield false negatives. There are also open questions about whether monoclonal antibodies, so far an effective treatment for previous Covid-19 variants, will be as effective against BA.5.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WlPuBs">
Overall, it appears BA.5 has clear differences to the variants that came before it. And while those differences will likely drive case increases, it’s not yet clear how deadly the wave will be.
</p>
<h3 id="BnRkGm">
Hospitalizations are up — but severity is not
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XPHmdU">
Charts showing Covid-19 hospital admissions usually display this figure as a single line, but that line belies a lot of complexity.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GfDdPR">
For starters, most patients admitted to the hospital are screened for Covid-19, and if they test positive, they’re counted as a Covid admission — even if they’re admitted with a broken hip and are totally asymptomatic for Covid-19.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gbLOeN">
US data still does not make a distinction between so-called incidental — like the broken hip — and non-incidental Covid-19 admissions. Because of that, it’s hard to determine if the rise in hospitalizations is due to the virus growing more virulent, or if it just means it’s spreading widely in a community. During the first omicron wave — which led to asymptomatic or mild infections in many vaccinated people — some argued that hospitalization figures alone <a href="https://www.washingtonpost.com/outlook/2022/01/07/hospitalization-covid-statistics-incidental/">obscured a meaningful number of incidental<em> </em>Covid-19 admissions</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RashXw">
Experts sometimes use intensive care admissions and ventilator use trends in combination with local test positivity data to help understand local Covid-19 trends. Several doctors told me that judging by those criteria, they have not yet seen signs of a severe illness wave — even though US Covid hospitalizations have <a href="https://covid.cdc.gov/covid-data-tracker/#new-hospital-admissions">risen 50 percent</a> since May.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="L1NoIG">
Aaron Glatt, an infectious disease physician who is also the hospital epidemiologist at Mount Sinai South Nassau in New York, was clear: “We have not seen a surge in critical care admissions,” he said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uISupH">
Although Covid-19 hospitalizations have been slowly creeping up <a href="https://coronavirus.health.ny.gov/daily-hospitalization-summary">across his region</a>, intensive care unit admissions have stayed relatively low and stable. With incidence so high in the community, those critical care admissions and deaths are better predictors of what is really going on in some ways, Glatt said, “and those have not changed.” Glatt also said he had not noticed any new or unusual symptoms in admitted patients with Covid-19.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/brtfaiRby_lnwoWNpPYiHEzobA0=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/23843858/GettyImages_1392347004.jpg"/> <cite>Paul Bersebach/MediaNews Group/Orange County Register via Getty Images</cite>
<figcaption>
A nurse assistant puts on protective gear before entering the room of a Covid-19 patient in California, on April 14.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vLhYeE">
Susan Kline, an infectious disease doctor and hospital epidemiologist at the University of Minnesota Medical Center in Minneapolis, said her hospital has seen Covid-19 admissions jump about 50 percent from their recent low point, and about a third of those admissions have had three or more doses of a vaccine.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fe4fjr">
However, she said, a “fairly high percentage” of people hospitalized with Covid-19 infections were admitted for reasons completely unrelated: they were only counted as Covid-19 patients because a screening test on admission was positive. In other words, she senses a large proportion of those “Covid admissions” were admitted <em>with, </em>but not <em>for, </em>Covid-19 infection.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Hn2rcx">
What’s more, the patients don’t seem to be as sick as in previous waves. “In general, the patients are not showing as severe a disease as we saw early on when we were first admitting patients with Covid-19,” she said.
</p>
<h3 id="owIdmu">
Even if cases aren’t very severe, a new potential big Covid wave is concerning
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LXNZaF">
Even a variant that’s merely more transmissible — but not more severe — is concerning. The more people the virus infects, the greater chances it has to find the people most vulnerable to it. “The people that were at the highest risk of previously being hospitalized are going to still be at the highest risk of getting hospitalized with variants,” Glatt explained. “[Novak] Djokovic can beat me even if he’s not feeling very well,” and with any new variant, he says, “the people who are sickest, even if they’re in their best condition possible, are still going to do worse.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tCBTG3">
Also, hospitalization and death are not the only outcome people want to avoid.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HDQeuP">
Some people with a personal “Covid-zero” policy may be motivated by concerns about long Covid — and mounting data suggests those concerns are not unfounded. A recent publication in <em>The Lancet</em> suggested that about <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00941-2/fulltext">5 percent</a> of vaccinated people infected with omicron variants developed long Covid symptoms, compared with 11 percent of those infected with the delta variant, which predominated in mid- to late 2021.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yaBuG5">
While a one in 20 chance of long Covid represents lower odds of the syndrome than in earlier analyses, the risk is still more than enough to make many want to avoid any Covid-19 infection — even one that doesn’t land them in the hospital.
</p>
<h3 id="gA4B6c">
Lessons from countries where BA.5 has come and gone are mixed
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pDtQRI">
If there’s any reason for optimism, it can be found in countries where cases due to BA.5 have already peaked.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nQEcZz">
One of those countries is South Africa, where BA.5 began to rise in late March and now comprises about half of all Covid variants in the country (the remainder are mostly BA.4). During this wave, neither cases nor hospitalizations rose anywhere near as high as they were during the country’s first omicron surge last winter.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Gm8F5E">
A group of South African investigators recently <a href="https://www.medrxiv.org/content/10.1101/2022.06.28.22276983v1">compared outcomes</a> between people infected during the uptick of BA.5’s rise and those infected during earlier waves, going all the way back to the first wave in 2020.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nyoJPr">
In a <a href="https://www.medrxiv.org/content/10.1101/2022.06.28.22276983v1">publication</a> that has not yet been peer-reviewed, the authors explained that the risk of severe illness during the more recent surge was no higher than the risk during the first omicron surge involving BA.1. They also noted that higher levels of community immunity now than at the time of the first omicron wave were likely protective against severe disease.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wNSiAO">
But the experience of other countries muddies the picture. Portugal also had a surge of cases accompanying a <a href="https://www.ecdc.europa.eu/en/news-events/implications-emergence-spread-sars-cov-2-variants-concern-ba4-and-ba5">rising proportion of BA.5</a> beginning in early May, but had a different experience than South Africa’s: Hospitalizations in Portugal came much closer to the levels they reached during the nation’s first omicron wave, and its death rate has been three to 10 times higher than South Africa’s over the last few months.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/YvUqdgAv6DPi9ETFnOTbiP7IOCM=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/23843342/coronavirus_data_explorer.png"/>
</figure>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/SQA_6yLp6HWOoLYyXtt867f6O1w=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/23843343/coronavirus_data_explorer__1_.png"/>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FklczA">
Hahn said the difference between the two countries’ outcomes may be related to the difference in <a href="https://www.cia.gov/the-world-factbook/field/median-age/country-comparison">ages of their residents</a>: the median age of Portugal’s population is 45, while that of South Africa’s is 28.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kVStzR">
Additionally, Portugal had a high level of booster uptake, making their first omicron wave less severe than South Africa’s. But by the time BA.5 came on the scene, a large part of that immunity may have waned, making Portugal’s population less collectively immune than South Africa’s by the time BA.5 arrived.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="94cwMn">
The US also had a severe first omicron surge, which may mean Americans have some level of protection against a flood of severe outcomes due to BA.5. But that doesn’t mean we should welcome wave after wave of variants to keep building up immunity. “The costs are too high to really see it as a benefit,” said Hahn. “I wouldn’t say that it’s beneficial for society when people continually get sick, have work absence, and maybe even long-term implications from long Covid.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qmNRKn">
Instead, Hahn said, we’d do well to take a little more caution when we’re faced with more immune-evasive subvariants like BA.5.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jcvaH3">
That means wearing masks when in crowded public places and getting vaccinated. And for eligible people unsure whether to get a booster dose now or wait for the <a href="https://www.scientificamerican.com/article/omicron-specific-covid-boosters-are-coming/">omicron-specific shot</a> expected to arrive this fall, she advises getting the additional protection sooner, even if it’s not as finely tuned. “The booster you can get now is more helpful now than the one you can get in a few weeks time,” she said.
</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>Chelsea signs Senegal defender Koulibaly from Napoli</strong> - Koulibaly played eight seasons with the Italian club, making 317 appearances and scoring 14 goals.</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>Count Of Savoy, Flaming Fire and Petronia please</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>Siege Perilous, The Sensation, Devil’s Magic, Angel Bliss and Sonata please</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>Watch | What is Pickleball?</strong> - A video on pickleball, a sport that has gained a lot of popularity in India.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Eng vs Ind, 3rd ODI | India need to change batting approach in series decider</strong> - The ODI series between England and India is currently tied at 1-1 with a match to go in Manchester</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>Amendments will be tabled to allow special investment zones: Bommai</strong> - Chief Minister Basavaraj Bommai has said that required amendments for facilitating establishment of special investment zones at Dharwad and Tumakuru will be tabled in the coming Legislature session</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.P. complains against Telangana’s hydel generation at Srisailam</strong> - KRMB writes again to two Telugu States to handover projects</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>ITBP jawan shoots three colleagues before killing self at camp in J&amp;K</strong> - The incident took place around 3:30 pm at the Devika Ghat community centre in the district.</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>Renaming of Aurangabad | Eknath Shinde goverment wants to prolong process, says Shiv Sena MLC Ambadas Danve</strong> - While the Maha Vikas Aghadi government under Uddhav Thackeray had decided to rename the city as Sambhajinagar, the new dispensation passed a fresh proposal that will see the city being called ‘Chhatrapati Sambhajinagar’.</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>This veteran athlete from Andhra Pradesh is a role model</strong> - Divakar, 78,is going strong by competing in atheletic events</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>Europe heatwave: Deadly wildfires spread in Mediterranean</strong> - A firefighting pilot dies in Portugal and a big fire spreads near Spain’s Costa del Sol.</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>Missile strike on Ukraine space plant in Dnipro kills three</strong> - Russian cruise missiles hit a space rocket plant in Dnipro and the city of Nikopol is also hit.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ukraine war: Four-year-old Liza killed by Russian attack on Vinnytsia</strong> - Liza was one of three children killed in the attack on Vinnytsia, far from the front line.</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: British man Paul Urey held by separatists dies</strong> - British man Paul Urey, captured by Russian-backed separatists, has died in detention, reports say.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>French Bastille Day firework blast kills boy and sister</strong> - A seven-year-old boy and his elder sister were hit by a firework that blew up in a crowd in France.</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>Hackers are targeting industrial systems with malware</strong> - An entire ecosystem of sketchy software is targeting potentially critical infrastructure. - <a href="https://arstechnica.com/?p=1867297">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>US monkeypox cases hit 1,470; CDC says more coming, and we’re short on vaccines</strong> - Though feds are making more vaccine available, it’s not enough to keep up with demand. - <a href="https://arstechnica.com/?p=1867291">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Thanks to subscriptions, iPhone apps finally made more money than games</strong> - The subscription model for mobile apps is paying off big time for some. - <a href="https://arstechnica.com/?p=1867141">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Amid global hellscape, Bill Gates to tank his wealth ranking, gives away $20B</strong> - He’ll still support his family, but swears the rest will go to philanthropy. - <a href="https://arstechnica.com/?p=1867152">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why can’t Intel’s 12th-gen CPUs pass the bar exam? Blame the E-cores</strong> - Older PC games have had similar issues with Alder Lake’s hybrid architecture. - <a href="https://arstechnica.com/?p=1867055">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><strong>my wife left me because i’m obssesed with africa</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
kenya believe it?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
and we have two kids together, this divorce is ghana be so hard on them
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/cute-mudkip"> /u/cute-mudkip </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/w0cs40/my_wife_left_me_because_im_obssesed_with_africa/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/w0cs40/my_wife_left_me_because_im_obssesed_with_africa/">[comments]</a></span></p></li>
<li><strong>My wife FINALLY agreed to a Star Wars role play in the bedroom</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The only catch was I had to be Obi Wan, because she always had a thing for Ewan McGregor.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Of course!” I said, and got to work putting together the sexiest Obi Wan costume I could. I even managed to find Glow in the Dark condoms so I could impress her with my “lightsaber”.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The night finally came. Dressed in my Jedi robe I slowly opened the bedroom door. The room was dark. I could only barely make out my wife’s pale naked body, posed sensually on the bed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I slowly remove my robe, revealing the faint blue glow of my ‘lightsaber’
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
‘Hello there,’ I say, in my best sexy Obi Wan accent
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
‘General Kenobi,’ she replied, as four other ‘Lightsabers’ appeared behind her
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/nikan69"> /u/nikan69 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/vzw37v/my_wife_finally_agreed_to_a_star_wars_role_play/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/vzw37v/my_wife_finally_agreed_to_a_star_wars_role_play/">[comments]</a></span></p></li>
<li><strong>I don’t know what HD is,</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
But my doctor just told me I got 80 of them
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/AjRedditz"> /u/AjRedditz </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/w0axdw/i_dont_know_what_hd_is/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/w0axdw/i_dont_know_what_hd_is/">[comments]</a></span></p></li>
<li><strong>When I was a kid, my parents would always say “Excuse my French” after a swear word…</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
…I’ll never forget that day at school when the teacher asked if we knew any French.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/watwat-656"> /u/watwat-656 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/vzvy58/when_i_was_a_kid_my_parents_would_always_say/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/vzvy58/when_i_was_a_kid_my_parents_would_always_say/">[comments]</a></span></p></li>
<li><strong>A woman in her 90s calls her doctor and asks:</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Doctor, where is the heart?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
To which the doctor replies: “it is at the height of your left nipple”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The elderly woman thanks the man and ends the call.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A new day arrives and the doctor reads the headline of his newspaper
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Elderly woman wants to commit suicide, shoots herself in the knee”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/slibetah"> /u/slibetah </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/vztqz7/a_woman_in_her_90s_calls_her_doctor_and_asks/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/vztqz7/a_woman_in_her_90s_calls_her_doctor_and_asks/">[comments]</a></span></p></li>
</ul>
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