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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>Stent For Life Initiative in Portugal: progress through years and Covid-19 Impact</strong> -
<div>
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Background: During Stent for Life Initiative in Portugal lifetime, positive changes in ST elevation myocardial infarction treatment were observed, by the increase of Primary Angioplasty numbers and improvements in patients’ behaviour towards myocardial infarction, with an increase in those who called 112 and the lower proportion attending non primary percutaneous coronary intervention centres. Despite public awareness campaigns and system educational programmes, patient and system delay did not change significantly over this period. The aim of this study was to address the public awareness campaign effectiveness on peoples’ behaviour facing STEMI, and how Covid-19 has affected STEMI treatment. Methods: Data from 1381 STEMI patients were collected during a one-month period each year, from 2011 to 2016, and during one and a half month, matching first lockdown in Portugal 2020. Four groups were constituted: Group A (2011); Group B (2012 &amp; 2013); Group C (2015 &amp; 2016) and group D (2020). Results: The proportion of patients who called 112, increased significantly (35.2% Group A; 38.7% Group B; 44.0% Group C and 49.6% Group D, p=0.005); significant reduction was observed in the proportion of patients who attended healthcare centres without PPCI (54.5% group A; 47.6% Group B; 43.2% Group C and 40.9% Group D, p=0.016), but there were no differences on groups comparison. Total ischemic time, measured from symptoms onset to reperfusion increased progressively from group A [250.0 (178.0-430.0)] to D [296.0 (201.0 – 457.5.8)] p=0.012, with statistically significant difference between group C and D (p=0.034). Conclusions: During the term of SFL initiative in Portugal, patients resorted less to primary health centres and called more to 112. These results can be attributed the public awareness campaign. Nevertheless, patient and system delays did not significantly change over this period, mainly in late years of SFL, probably for low efficacy of campaigns and in 2020 due to Covid-19 pandemic.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.25.23288494v1" target="_blank">Stent For Life Initiative in Portugal: progress through years and Covid-19 Impact</a>
</div></li>
<li><strong>Leveraging Machine Learning for Effective Public Health Policies: Lessons from the COVID-19 Pandemic and Future Directions in Global Health</strong> -
<div>
The COVID-19 pandemic has exposed the vulnerabilities of global health systems and highlighted the need for rapid, data-driven decision-making in public health. Machine learning (ML) has the potential to provide valuable insights and contribute to improved health outcomes. In this paper, we aim to explore the role of ML in global health, identify its limitations, and discuss strategies to overcome these challenges while maximizing its benefits. We conduct a comprehensive literature review and analyze case studies from the COVID-19 pandemic. Our findings indicate that ML has played a significant role in the COVID-19 response, particularly in areas such as disease modeling, drug discovery, and resource allocation. However, several limitations, including data quality and accessibility, hinder the full potential of ML in global health. We propose strategies to overcome these limitations, such as promoting data-sharing collaborations, ensuring data privacy, and fostering interdisciplinary research. This paper contributes to the ongoing conversation on the applications and limitations of ML in global health, providing insights and recommendations for researchers, practitioners, and policymakers to effectively leverage ML for improved public health outcomes.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/f64cn/" target="_blank">Leveraging Machine Learning for Effective Public Health Policies: Lessons from the COVID-19 Pandemic and Future Directions in Global Health</a>
</div></li>
<li><strong>The impact of long-term conditions and comorbidity patterns on COVID-19 infection and hospitalisation: a cohort study</strong> -
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Introduction Older adults are usually more vulnerable to COVID-19 infections; however, little is known about which comorbidity patterns are related to a higher probability of COVID-19 infection. This study investigated the role of long-term conditions or comorbidity patterns on COVID-19 infection and related hospitalisations. Methods This study included 4,428 individuals from Waves 8 (2016−2017) and 9 (2018−2019) of the English Longitudinal Study of Ageing (ELSA), who also participated in the ELSA COVID-19 Substudy in 2020. Comorbidity patterns of chronic conditions were identified using an agglomerative hierarchical clustering method. The relationships between comorbidity patterns or long-term conditions and COVID-19 related outcomes were examined using multivariable logistic regression. Results Among a representative sample of community-dwelling older adults in England, those with cardiovascular disease (CVD) and complex comorbidities had an almost double risk of COVID-19 infection (OR=1.87, 95% CI=1.42−2.46) but not of COVID-19 related hospitalisation. A similar pattern was observed for the heterogeneous comorbidities cluster (OR=1.56, 95% CI=1.24−1.96). The individual investigations of long-term conditions with COVID-19 infection highlighted primary associations with CVD (OR=1.46, 95% CI=1.23−1.74), lung diseases (OR=1.40, 95% CI=1.17−1.69), psychiatric conditions (OR=1.40, 95% CI=1.16−1.68), retinopathy/eye diseases (OR=1.39, 95% CI=1.18−1.64), and arthritis (OR=1.27, 95% CI=1.09−1.48). In contrast, metabolic disorders and diagnosed diabetes were not associated with any COVID-19 outcomes. Discussion/Conclusion This study provides novel insights into the comorbidity patterns that are more vulnerable to COVID-19 infections and highlights the importance of CVD and complex comorbidities. These findings facilitate crucial new evidence for appropriate screening measures and tailored interventions for older adults in the ongoing global outbreak.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.25.23289035v1" target="_blank">The impact of long-term conditions and comorbidity patterns on COVID-19 infection and hospitalisation: a cohort study</a>
</div></li>
<li><strong>Potential biomarkers for fatal outcome prognosis in a cohort of hospitalized COVID-19 patients with pre-existing co-morbidities</strong> -
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Background: The difficulty to predict fatal outcomes in COVID-19 patients, impacts in the general morbidity and mortality due to SARSCoV2 infection, as it wears out the hospital services that care for these patients. Unfortunately, in several of the candidates for prognostic biomarkers proposed, the predictive power is compromised when patients have pre-existing co-morbidities. Methods. A cohort of one hundred and forty-seven patients hospitalized for severe COVID19 was included in a descriptive, observational, single-center, and prospective study. Patients were recruited during the first COVID-19 pandemic wave (April-Nov, 2020). Data were collected from the clinical history while immunophenotyping by multiparameter flow cytometry analysis allowed us to assess the expression of surface markers on peripheral leukocytes. Patients were grouped according to the outcome in survivor or decease. The prognostic value of leukocytes, cytokines or HLA-DR, CD39, and CD73 was calculated. Results: Hypertension and chronic renal failure but not obesity and diabetes were conditions more frequent among the decease group. Mixed hypercitokinemia, including inflammatory(IL-6) and anti-inflammatory(IL-10) cytokines, was more evident in deceased patients. In the decease group, lymphopenia with a higher NLR value was present. HLA-DR expression and the percentage of CD39+ cells were higher than non COVID-19 patients, but remain similar despite outcome. ROC analysis and cut-off value of NLR (69.6%, 9.4), pNLR (71.1%, 13.6), IL-6 (79.7%, 135.2 pg/mL). Conclusion: The expression of HLA-DR, CD39, and CD73, as many serum cytokines (other than IL-6) and chemokines levels do not show prognostic potential compared to NLR and pNLR values.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.25.23288937v1" target="_blank">Potential biomarkers for fatal outcome prognosis in a cohort of hospitalized COVID-19 patients with pre-existing co-morbidities</a>
</div></li>
<li><strong>Broadly neutralizing antibodies targeting a conserved silent face of spike RBD resist extreme SARS-CoV-2 antigenic drift</strong> -
<div>
Developing broad coronavirus vaccines requires identifying and understanding the molecular basis of broadly neutralizing antibody (bnAb) spike sites. In our previous work, we identified sarbecovirus spike RBD group 1 and 2 bnAbs. We have now shown that many of these bnAbs can still neutralize highly mutated SARS-CoV-2 variants, including the XBB.1.5. Structural studies revealed that group 1 bnAbs use recurrent germline-encoded CDRH3 features to interact with a conserved RBD region that overlaps with class 4 bnAb site. Group 2 bnAbs recognize a less well-characterized “site V” on the RBD and destabilize spike trimer. The site V has remained largely unchanged in SARS-CoV-2 variants and is highly conserved across diverse sarbecoviruses, making it a promising target for broad coronavirus vaccine development. Our findings suggest that targeted vaccine strategies may be needed to induce effective B cell responses to escape resistant subdominant spike RBD bnAb sites.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.04.26.538488v1" target="_blank">Broadly neutralizing antibodies targeting a conserved silent face of spike RBD resist extreme SARS-CoV-2 antigenic drift</a>
</div></li>
<li><strong>Association between SARS-CoV-2 and metagenomic content of samples from the Huanan Seafood Market</strong> -
<div>
The role of the Huanan Seafood Market in the early SARS-CoV-2 outbreak remains unclear. Recently the Chinese CDC released data from deep sequencing of environmental samples collected from the market after it was closed on January-1-2020 (Liu et al, 2023). Prior to this release, Crits-Christoph et al (2023) analyzed data from a subset of the samples. Both studies concurred that the samples contained genetic material from a variety of species, including some like raccoon dogs that are susceptible to SARS-CoV-2. However, neither study systematically analyzed the relationship between the amount of genetic material from SARS-CoV-2 and different animal species. Here I implement a fully reproducible computational pipeline that jointly analyzes the number of reads mapping to SARS-CoV-2 and the mitochondrial genomes of chordate species across the full set of samples. I validate the presence of genetic material from numerous species, and calculate mammalian mitochondrial compositions similar to those reported by Crits-Christoph et al (2023). However, the number of SARS-CoV-2 reads is not consistently correlated with reads mapping to any non-human susceptible species. For instance, 14 samples have &gt;20% of their chordate mitochondrial material from raccoon dogs, but only one of these samples contains any SARS-CoV-2 reads, and that sample only has 1 of ~200,000,000 reads mapping to SARS-CoV-2. Instead, SARS-CoV-2 reads are most correlated with reads mapping to various fish, such as catfish and largemouth bass. These results suggest that while metagenomic analysis of the environmental samples is useful for identifying animals or animal products sold at the market, co-mingling of animal and viral genetic material is unlikely to reliably indicate whether any animals were infected by SARS-CoV-2.
</div>
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🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.04.25.538336v1" target="_blank">Association between SARS-CoV-2 and metagenomic content of samples from the Huanan Seafood Market</a>
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<li><strong>A systematic review of the prevalence of persistent gastrointestinal symptoms and incidence of new gastrointestinal illness after acute SARS-CoV-2 infection</strong> -
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It is known that SARS-CoV-2 infection can result in gastrointestinal symptoms. For some, these symptoms may persist beyond acute infection, in what is known as post-COVID syndrome. We conducted a systematic review to examine the prevalence of persistent gastrointestinal symptoms and the incidence of new gastrointestinal illness following acute SARS-CoV-2 infection. We searched scientific literature using MedLine, SCOPUS, Embase, Europe PubMed Central, medRxiv and Google Scholar from December 2019 to October 2022. Two reviewers independently identified 28 eligible articles which followed participants for various gastrointestinal outcomes after acute SARS-CoV-2 infection. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. The weighted pooled prevalence for persistent gastrointestinal symptom of any nature and duration was 10.7%, compared to 4.9% in healthy controls. For six studies at a low risk of methodological bias, the symptom prevalence ranged from 0.2% to 24.1% with a median follow-up time of 13 weeks. We also identified the presence of functional gastrointestinal disorders in historically SARS-CoV-2 exposed individuals. Our review has shown that, from a limited pool of mostly low-quality studies, previous SARS-CoV-2 exposure may be associated with ongoing gastrointestinal symptoms and the development of functional gastrointestinal illness. Furthermore, we show the need for high-quality research to better understand the SARS-CoV-2 association with gastrointestinal symptoms, particularly as population exposure to enteric infections returns to pre-COVID-19-restriction levels.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.26.23289142v1" target="_blank">A systematic review of the prevalence of persistent gastrointestinal symptoms and incidence of new gastrointestinal illness after acute SARS-CoV-2 infection</a>
</div></li>
<li><strong>Comparative Cohort Study of Post-Acute Covid-19 Infection with a Nested, Randomized Controlled Trial of Ivabradine for Those With Postural Orthostatic Tachycardia Syndrome (The COVIVA Study)</strong> -
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Background: Significant clinical similarities have been observed between the recently described Long-Haul COVID-19 (LHC) syndrome, Postural Orthostatic Tachycardia Syndrome (POTS) and Inappropriate Sinus Tachycardia (IST). Shared symptoms include light-headedness, palpitations, tremulousness, generalized weakness, blurred vision, chest pain, dyspnea, brain-fog, and fatigue. Ivabradine is a selective sinoatrial node blocker FDA-approved for management of tachycardia associated with stable angina and heart failure not fully managed by beta blockers. In our study we aim to identify risk factors underlying LHC, as well as the effectiveness of ivabradine in controlling heart rate dysregulations and POTS/IST related symptoms. Methods/Design: A detailed prospective phenotypic evaluation combined with multi-omic analysis of 200 LHC volunteers will be conducted to identify risk factors for autonomic dysfunction. A comparator group of 50 volunteers with documented COVID-19 but without LHC will be enrolled to better understand the risk factors for LHC and autonomic dysfunction. Those in the cohort who meet diagnostic criteria for POTS or IST will be included in a nested prospective, randomized, placebo-controlled trial to assess the impact of ivabradine on symptoms and heart rate, assessed non-invasively based on physiologic response and ambulatory electrocardiogram. Additionally, studies on catecholamine production, mast cell and basophil degranulation, inflammatory biomarkers, and indicators of metabolic dysfunction will be measured to potentially provide molecular classification and mechanistic insights. Discussion: Optimal therapies for dysautonomia, particularly associated with LHC, have yet to be defined. In the present study, ivabradine, one of numerous proposed interventions, will be systematically evaluated for therapeutic potential in LHC-associated POTS and IST. Additionally, this study will further refine the characteristics of the LHC-associated POTS/IST phenotype, genotype and transcriptional profile, including immunologic and multi-omic analysis of persistent immune activation and dysregulation. The study will also explore and identify potential endotheliopathy and abnormalities of the clotting cascade.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.25.23289110v1" target="_blank">Comparative Cohort Study of Post-Acute Covid-19 Infection with a Nested, Randomized Controlled Trial of Ivabradine for Those With Postural Orthostatic Tachycardia Syndrome (The COVIVA Study)</a>
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<li><strong>Surveillance of Vermont wildlife in 2021-2022 reveals no detected SARS-CoV-2 viral RNA</strong> -
<div>
Previous studies have documented natural infections of SARS-CoV-2 in various domestic and wild animals. More recently, studies have been published noting the susceptibility of members of the Cervidae family, and infections in both wild and captive cervid populations. In this study, we investigated the presence of SARS-CoV-2 in mammalian wildlife within the state of Vermont. 739 nasal or throat samples were collected from wildlife throughout the state during the 2021 and 2022 harvest season. Data was collected from red and gray foxes (Vulpes vulples and Urocyon cineroargentus, respectively), fishers (Martes pennati), river otters (Lutra canadensis), coyotes (Canis lantrans), bobcats (Lynx rufus rufus), black bears (Ursus americanus), and white-tailed deer (Odocoileus virginianus). Samples were tested for the presence of SARS-CoV-2 via quantitative RT-qPCR using the CDC N1/N2 primer set and/or the WHO-E gene primer set. Our results indicate that no sampled wildlife were positive for SARS-CoV-2. This finding is surprising, given that most published North America studies have found SARS-CoV-2 within their deer populations. The absence of SARS-CoV-2 RNA in populations sampled here may provide insights in to the various environmental and anthropogenic factors that reduce spillover and spread in North American’s wildlife populations.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.04.25.538264v1" target="_blank">Surveillance of Vermont wildlife in 2021-2022 reveals no detected SARS-CoV-2 viral RNA</a>
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<li><strong>Intranasal VLP-RBD vaccine adjuvanted with BECC470 confers immunity against Delta SARS-CoV-2 challenge in K18-hACE2-mice</strong> -
<div>
As the COVID-19 pandemic transitions to endemic, seasonal boosters are a plausible reality across the globe. We hypothesize that intranasal vaccines can provide better protection against asymptomatic infections and more transmissible variants of SARS-CoV-2. To formulate a protective intranasal vaccine, we utilized a VLP-based platform. Hepatitis B surface antigen-based virus like particles (VLP) linked with receptor binding domain (RBD) antigen were paired with the TLR4-based agonist adjuvant, BECC 470. K18-hACE2 mice were primed and boosted at four-week intervals with either VLP-RBD-BECC or mRNA-1273. Both VLP-RBD-BECC and mRNA-1273 vaccination resulted in production of RBD-specific IgA antibodies in serum. RBD-specific IgA was also detected in the nasal wash and lung supernatants and were highest in VLP-RBD-BECC vaccinated mice. Interestingly, VLP-RBD-BECC vaccinated mice showed slightly lower levels of pre-challenge IgG responses, decreased RBD-ACE2 binding inhibition, and lower neutralizing activity in vitro than mRNA-1273 vaccinated mice. Both VLP-RBD-BECC and mRNA-1273 vaccinated mice were protected against challenge with a lethal dose of Delta variant SARS-CoV-2. Both vaccines limited viral replication and viral RNA burden in the lungs of mice. CXCL10 is a biomarker of severe SARS-CoV-2 infection and we observed both vaccines limited expression of serum and lung CXCL10. Strikingly, VLP-RBD-BECC when administered intranasally, limited lung inflammation at early timepoints that mRNA-1273 vaccination did not. VLP-RBD-BECC immunization elicited antibodies that do recognize SARS-CoV-2 Omicron variant. However, VLP-RBD-BECC immunized mice were protected from Omicron challenge with low viral burden. Conversely, mRNA-1273 immunized mice had low to no detectable virus in the lungs at day 2. Together, these data suggest that VLP-based vaccines paired with BECC adjuvant can be used to induce protective mucosal and systemic responses against SARS-CoV-2.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.04.25.538294v1" target="_blank">Intranasal VLP-RBD vaccine adjuvanted with BECC470 confers immunity against Delta SARS-CoV-2 challenge in K18-hACE2-mice</a>
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<li><strong>Remote Aerosol SARS-CoV-2 Transmission from Clinical COVID Patients to Rodent Sentinels</strong> -
<div>
We performed studies investigating the feasibility of human to animal (H2A) model system to test whether patient generated respiratory bioaerosols hold infective capacity when traversing long distance airborne transport within the built environment. South African patients, clinically confirmed by facemask sampling to be exhaling SARS-CoV-2 genomic sequence, were recruited and housed for multiple days in a clinical ward with a uniquely designed building ventilation system continuously channeling exhaust airflow to individual microisolator animal caging units located proximal but segregated from clinic space (University of Pretoria AIR facility).
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🖺 Full Text HTML: <a href="https://osf.io/cre2w/" target="_blank">Remote Aerosol SARS-CoV-2 Transmission from Clinical COVID Patients to Rodent Sentinels</a>
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<li><strong>Conventional and Bayesian workflows for clinical prediction modelling of severe Covid-19 outcomes based on clinical biomarker test results: LabMarCS: Laboratory Markers of COVID-19 Severity - Bristol Cohort</strong> -
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We describe several regression models to predict severe outcomes in COVID-19 and challenges present in complex observational medical data. We demonstrate best practices for data curation, cross-validated statistical modelling, and variable selection emphasizing recent Bayesian methods. The study follows a retrospective observational cohort design using multicentre records across National Health Service (NHS) trusts in southwest England, UK. Participants included hospitalised adult patients positive for SARS-CoV 2 during March to October 2020, totalling 843 patients (mean age 71, 45% female, 32% died or needed ICU stay), split into training (n=590) and validation groups (n=253). Models were fit to predict severe outcomes (ICU admission or death within 28-days of admission to hospital for COVID-19, or a positive PCR result if already admitted) using demographic data and initial results from 30 biomarker tests collected within 3 days of admission or testing positive if already admitted. Cross-validation results showed standard logistic regression had an internal validation median AUC of 0.74 (95% Interval [0.62,0.83]), and external validation AUC of 0.68 [0.61, 0.71]; a Bayesian logistic regression (with horseshoe prior) internal AUC of 0.79 [0.71, 0.87], and external AUC of 0.70 [0.68, 0.71]. Variable selection performed using Bayesian predictive projection determined a four variable model using Age, Urea, Prothrombin time and Neutrophil-Lymphocyte ratio, with a median internal AUC of 0.79 [0.78, 0.80], and external AUC of 0.67 [0.65, 0.69]. We illustrate best-practices protocol for conventional and Bayesian prediction modelling on complex clinical data and reiterate the predictive value of previously identified biomarkers for COVID-19 severity assessment.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.09.16.22279985v4" target="_blank">Conventional and Bayesian workflows for clinical prediction modelling of severe Covid-19 outcomes based on clinical biomarker test results: LabMarCS: Laboratory Markers of COVID-19 Severity - Bristol Cohort</a>
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<li><strong>Genomic epidemiology reveals the dominance of Hennepin County in transmission of SARS-CoV-2 in Minnesota from 2020-2022</strong> -
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SARS-CoV-2 has had an unprecedented impact on human health and highlights the need for genomic epidemiology studies to increase our understanding of virus evolution and spread, and to inform policy decisions. We sequenced viral genomes from over 22,000 patient samples tested at Mayo Clinic Laboratories between 2020-2022 and use Bayesian phylodynamics to describe county and regional spread in Minnesota. The earliest introduction into Minnesota was to Hennepin County from a domestic source around January 22, 2020; six weeks before the first confirmed case in the state. This led to the virus spreading to Northern Minnesota, and eventually, the rest of the state. International introductions were most abundant in Hennepin (home to the Minneapolis/St. Paul International (MSP) airport) totaling 45 (out of 107) over the two-year period. Southern Minnesota counties were most common for domestic introductions with 19 (out of 64), potentially driven by bordering states such as Iowa and Wisconsin as well as Illinois which is nearby. Hennepin also was, by far, the most dominant source of in-state transmissions to other Minnesota locations (n=772) over the two-year period. We also analyzed the diversity of the location source of SARS-CoV-2 viruses in each county and noted the timing of state-wide policies as well as trends in clinical cases. Neither the number of clinical cases or major policy decisions, such as the end of the lockdown period in 2020 or the end of all restrictions in 2021, appeared to have impact on virus diversity across each individual county.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.07.24.22277978v3" target="_blank">Genomic epidemiology reveals the dominance of Hennepin County in transmission of SARS-CoV-2 in Minnesota from 2020-2022</a>
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<li><strong>Variability in excess deaths across countries with different vulnerability during 2020-2023</strong> -
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Importance: Excess deaths provide estimates of total impact of major crises, such as the COVID-19 pandemic. Objective: To evaluate excess deaths trajectories during 2020-2023 across countries with accurate death registration and population age structure data; and to assess how excess death patterns and trajectories correlate with economic indicators of vulnerability overall and in different age strata. Methods: Data were used from the Human Mortality Database on 34 countries. Excess deaths were calculated for 2020-2023 (to 2/26/2023) using 2017-2019 as baseline reference, with weekly expected death calculations and adjustment for 5 age strata. Countries were divided into less and more vulnerable; the latter had per capita nominal GDT&lt;$30,000, Gini&gt;0.35 for income inequality and/or at least 2.5% of their population living in poverty. Results: Excess deaths (as proportion of expected deaths, p% ) were strongly inversely correlated with per capita GDP (r=-0.61), strongly correlated with proportion living in poverty (r=0.65) and modestly correlated with income inequality (r=0.42). The 17 less vulnerable countries had 201,471 excess deaths versus 2,005,380 among the 17 more vulnerable countries. The USA would have had 1.50 million fewer deaths if it had the performance of Sweden, 1.13 million fewer deaths if it had the performance of Finland, and 0.93 million fewer deaths if it had the performance of France. Excess deaths started deviating in the two groups after the first wave when correlational patterns with the 3 economic indicators also started to emerge. Between-country heterogeneity diminished over time within each of the two groups. Less vulnerable countries had mean p%=-0.4% and 0.9% in 0-64 and &gt;65 year-old strata while more vulnerable countries had mean p%=8.3% and 9.0%, respectively. Certain countries performed substantially worse (USA, Canada, Chile, UK) or better (France, Poland, Slovenia) in the non-elderly than in the elderly. Usually lower death rates were seen in children 0-14 years old during 2020-2023 versus pre-pandemic years. Conclusion: While the pandemic hit some countries earlier than others, country vulnerability dominated eventually the cumulative impact. Half of the analyzed countries witnessed no substantial excess deaths versus pre-pandemic levels, while the other half suffered major death tolls.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.24.23289066v1" target="_blank">Variability in excess deaths across countries with different vulnerability during 2020-2023</a>
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<li><strong>Estimation of Near-kink Reproduction Numbers During the Emergent Variants of the COVID-19 Pandemic: Log-quadratic and Forward-imputation Approach</strong> -
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Background: Sketching the major portraits of the COVID-19 epidemic when variants of the pathogen emerge is critical to inform the dynamics of disease transmission, reproduction (i.e., the average counts of individuals of secondary infections generated by an index individual infected by the virus) strength of the pathogen, and countermeasure strategies. Multiple approaches, including log-linear, EpiEstim (an R package generally utilized to estimate the evolution traits of epidemics), and near-log-linear techniques, have been exploited to evaluate the principal parameters such as basic and effective reproduction numbers of an epidemic outbreak. Objective: This study focuses on the kink corner (i.e., sharp alternation of direction of the transmission curve) presenting differentiated log-quadratic traits where more infectious variants of viruses emerge at the diminishing transmission phase of an infectious disease. Methods: A novel log-quadratic trending framework was proposed to project potentially unidentified cases (i.e., forward imputing approximately one week ahead) of COVID-19 around the kink, where the transmission of the pandemic initially lowered and accelerated subsequently, and exercised with the updated framework of classic EpiEstim and Log-linear model. I first compared the performance near the kink using the proposed technique versus the two traditional models taking into account a variety of levels of transmissibility, data distribution (Weibull, Gamma, and Lognormal distributions), and reporting rates (0.2, 0.4, 0.6, 0.8 and 1.0 respectively). Thereafter I utilized the revised framework on the outbreak data of four settings including Bulgaria, Japan, Poland, and South Korea from June to August 2022. Results: The proposed framework reduced the estimation bias versus traditional EpiEstim and log-linear methods near the kink. The coverage estimates of 95% confidence intervals improved. The proposed forward-imputation method implied generally a consistent ascending trend of effective reproduction number estimation applying to a precipitous transition from diminishing to diverging scenarios versus the irregular zigzagging outcomes in classic methods when more contagious variants of the virus were present in the absence of effective vaccines. Conclusions: The log-quadratic correction accounting for transmissibility, data distribution, reporting rates, sliding windows, and generation intervals improved the basic and effective reproduction numbers estimation at the kink corner versus the classic EpiEstim and log-linear models by refined amendment of curve fitting. This is of concern when essentially the fundamental transmission traits of a pandemic alter expeditiously and countermeasures are needed at the earlier variant phases of the transiting climax with the advancement of the pandemic.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.24.23289029v1" target="_blank">Estimation of Near-kink Reproduction Numbers During the Emergent Variants of the COVID-19 Pandemic: Log-quadratic and Forward-imputation Approach</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>Efficacy and Safety of Nirmatrelvir/Ritonavir for Treating Omicron Variant of COVID-19</strong> - <b>Condition</b>:   Omicron Variant of COVID-19<br/><b>Intervention</b>:   Drug: Nirmatrelvir/Ritonavir<br/><b>Sponsor</b>:   Xiangao Jiang<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 Study of mRNA-1283.222 Injection Compared With mRNA-1273.222 Injection in Participants ≥12 Years of Age to Prevent COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: mRNA-1283.222;   Biological: mRNA-1273.222<br/><b>Sponsor</b>:   ModernaTX, Inc.<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of the RD-X19 Treatment Device in Individuals With Mild COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Device: RD-X19;   Device: Sham<br/><b>Sponsor</b>:   EmitBio Inc.<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Postoperative Sugammadex After COVID-19</strong> - <b>Conditions</b>:   General Anesthesia;   COVID-19<br/><b>Interventions</b>:   Drug: Sugammadex Sodium;   Drug: neostigmine 50µg/kg + glycopyrollate 0.01mg/kg<br/><b>Sponsor</b>:   Korea University Ansan Hospital<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 Randomized, Double-Blind, Placebo-Controlled Phase 2/3 Study to Determine the Safety and Effectiveness of Azeliragon in the Treatment of Patients Hospitalized for Coronavirus Disease 2019 (COVID-19)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Azeliragon;   Drug: Placebo<br/><b>Sponsor</b>:   Salim S. Hayek<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>To Evaluate the Safety and Efficacy of Meplazumab in Treatment of Post-COVID-19</strong> - <b>Condition</b>:   Post-COVID-19<br/><b>Interventions</b>:   Biological: Meplazumab for injection;   Other: Normal saline<br/><b>Sponsor</b>:   Jiangsu Pacific Meinuoke Bio Pharmaceutical Co Ltd<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Cognitive-behavioral Therapy for Mental Disorder in COVID-19 Survivors</strong> - <b>Condition</b>:   Post Acute COVID-19 Syndrome<br/><b>Intervention</b>:   Behavioral: mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT)<br/><b>Sponsor</b>:   Azienda Socio Sanitaria Territoriale di Lecco<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>Efficacy of Lactobacillus Paracasei PS23 for Patients With Post-COVID-19 Syndrome</strong> - <b>Condition</b>:   Post-COVID-19 Syndrome<br/><b>Intervention</b>:   Dietary Supplement: PS23 heat-treated<br/><b>Sponsors</b>:   Mackay Memorial Hospital;   Bened Biomedical Co., Ltd.<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 Coping and Resilience Intervention for Adolescents</strong> - <b>Condition</b>:   COVID-19 Pandemic<br/><b>Interventions</b>:   Behavioral: Coping and Resilience Intervention for Adolescents;   Other: Printing materials of Coping and Resilience Intervention for Adolescents<br/><b>Sponsor</b>:   Taipei Medical University<br/><b>Enrolling by invitation</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Effectiveness of Modified Diaphragmatic Training for Gastroesophageal Reflux Disease Post Covid-19</strong> - <b>Conditions</b>:   GERD;   Post COVID-19 Condition;   Diaphragm Issues<br/><b>Intervention</b>:   Other: Diaphragmatic Training<br/><b>Sponsor</b>:   Indonesia 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>Effect of Telerehabilitation Practice in Long COVID-19 Patients</strong> - <b>Conditions</b>:   Long COVID-19;   Long COVID;   Post COVID-19 Condition;   Post-COVID-19 Syndrome;   Post-COVID Syndrome<br/><b>Interventions</b>:   Behavioral: Telerehabilitation;   Behavioral: Standard rehabilitation care<br/><b>Sponsor</b>:   Indonesia University<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Safety, Tolerability and Pharmacokinetics Study of RAY1216 in Healthy Adult Participants</strong> - <b>Condition</b>:   COVID-19 (Coronavirus Disease 2019)<br/><b>Interventions</b>:   Drug: RAY1216 dose 1;   Drug: RAY1216 dose 2;   Drug: RAY1216 dose 3;   Drug: RAY1216 dose 4 &amp;ritonavir   Drug: RAY1216 dose 5;   Drug: RAY1216 dose 6;   Drug: RAY1216 dose 7;   Drug: RAY1216 dose 8;   Drug: RAY1216 dose 9;   Drug: RAY1216 dose 10<br/><b>Sponsor</b>:   Guangdong Raynovent Biotech Co., Ltd<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>Computerized Training of Attention and Working Memory in Post COVID-19 Patients With Cognitive Complaints</strong> - <b>Conditions</b>:   COVID-19;   Cognitive Impairment;   Cognition Disorder;   Memory Disorders;   Attention Deficit;   Memory Impairment;   Memory Loss;   Attention Impaired<br/><b>Intervention</b>:   Device: RehaCom<br/><b>Sponsor</b>:   Erasmus Medical Center<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>Strategies and Treatments for Respiratory Infections &amp;Amp; Viral Emergencies (STRIVE): Immune Modulation Strategy Trial</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: abatacept infusion;   Drug: Placebo group<br/><b>Sponsor</b>:   University of Minnesota<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 of Silmitasertib (CX-4945) in Healthy Subject</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Drug: CX-4945<br/><b>Sponsor</b>:   Senhwa Biosciences, Inc.<br/><b>Active, not recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Regulatory approval pathway for COVID-19 vaccine in USA, Europe and India</strong> - The coronavirus disease-2019 (COVID-19) outbreak has confused everyone, including healthcare experts, physicians and frontline workers. Monoclonal antibodies, anticoagulants and immunomodulatory therapy were initially used to treat COVID-19. However, they can only inhibit the virus from replicating, which is not enough to provide a lasting cure. As each month passes, a growing number of companies are working on vaccinations that will aid in the development of resistance against the corona virus….</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Discovery of Highly Potent Small Molecule Pan-Coronavirus Fusion Inhibitors</strong> - The unprecedented pandemic of COVID-19, caused by a novel coronavirus, SARS-CoV-2, and its highly transmissible variants, led to massive human suffering, death, and economic devastation worldwide. Recently, antibody-evasive SARS-CoV-2 subvariants, BQ and XBB, have been reported. Therefore, the continued development of novel drugs with pan-coronavirus inhibition is critical to treat and prevent infection of COVID-19 and any new pandemics that may emerge. We report the discovery of several highly…</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 Flavonoid Cyanidin Shows Immunomodulatory and Broad-Spectrum Antiviral Properties, Including SARS-CoV-2</strong> - New antiviral treatments are needed to deal with the unpredictable emergence of viruses. Furthermore, vaccines and antivirals are only available for just a few viral infections, and antiviral drug resistance is an increasing concern. Cyanidin (a natural product also called A18), a key flavonoid that is present in red berries and other fruits, attenuates the development of several diseases, through its anti-inflammatory effects. Regarding its mechanism of action, A18 was identified as an IL-17A…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Efficacy of Plant-Made Human Recombinant ACE2 against COVID-19 in a Golden Syrian Hamster Model</strong> - Coronavirus disease 2019 (COVID-19) is a novel infectious respiratory disease caused by SARS-CoV-2. We evaluated the efficacy of a plant-based human recombinant angiotensin-converting enzyme 2 (hrACE2) and hrACE2-foldon (hrACE2-Fd) protein against COVID-19. In addition, we analyzed the antiviral activity of hrACE2 and hrACE2-Fd against SARS-CoV-2 using real-time reverse-transcription PCR and plaque assays. The therapeutic efficacy was detected using the Golden Syrian hamster model infected with…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Inhibition of Rab1B Impairs Trafficking and Maturation of SARS-CoV-2 Spike Protein</strong> - Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) utilizes cellular trafficking pathways to process its structural proteins and move them to the site of assembly. Nevertheless, the exact process of assembly and subcellular trafficking of SARS-CoV-2 proteins remains largely unknown. Here, we have identified and characterized Rab1B as an important host factor for the trafficking and maturation of the spike protein (S) after synthesis at the endoplasmic reticulum (ER). Using confocal…</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>Perspectives Associated with Human Papillomavirus Vaccination in Adults: A Qualitative Study</strong> - CONCLUSION: Both intrinsic and extrinsic factors play a role in influencing HPV vaccine uptake, and such considerations can guide efforts to improve the odds of HPV vaccination in working-age adults.</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>An Oral Galectin Inhibitor in COVID-19-A Phase II Randomized Controlled Trial</strong> - CONCLUSION: PL-M is safe and effective for clinical use in reducing viral loads and promoting rapid viral clearance in COVID-19 patients by inhibiting SARS-CoV-2 entry into cells through the inhibition of Gal-3.</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>Electrosprayed Mesenchymal Stromal Cell Extracellular Matrix Nanoparticles Accelerate Cellular Wound Healing and Reduce Gram-Negative Bacterial Growth</strong> - Treatments for acute respiratory distress syndrome are still unavailable, and the prevalence of the disease has only increased due to the COVID-19 pandemic. Mechanical ventilation regimens are still utilized to support declining lung function but also contribute to lung damage and increase the risk for bacterial infection. The anti-inflammatory and pro-regenerative abilities of mesenchymal stromal cells (MSCs) have shown to be a promising therapy for ARDS. We propose to utilize the regenerative…</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>Establishment of an Antiplasmodial Vaccine Based on PfRH5-Encoding RNA Replicons Stabilized by Cationic Liposomes</strong> - CONCLUSION: Intradermal delivery of cationic lipid-encapsulated samRNA constructs is a feasible approach for developing future malaria vaccines.</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>Autochthonous Peruvian Natural Plants as Potential SARS-CoV-2 M<sup>pro</sup> Main Protease Inhibitors</strong> - Over 750 million cases of COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), have been reported since the onset of the global outbreak. The need for effective treatments has spurred intensive research for therapeutic agents based on pharmaceutical repositioning or natural products. In light of prior studies asserting the bioactivity of natural compounds of the autochthonous Peruvian flora, the present study focuses on the identification SARS-CoV-2 M^(pro) main…</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>Heparin, Low Molecular Weight Heparin, and Non-Anticoagulant Derivatives for the Treatment of Inflammatory Lung Disease</strong> - Unfractionated heparin has multiple pharmacological activities beyond anticoagulation. These anti-inflammatory, anti-microbial, and mucoactive activities are shared in part by low molecular weight and non-anticoagulant heparin derivatives. Anti-inflammatory activities include inhibition of chemokine activity and cytokine synthesis, inhibitory effects on the mechanisms of adhesion and diapedesis involved in neutrophil recruitment, inhibition of heparanase activity, inhibition of the proteases of…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Recent Advances in Anti-Tuberculosis Drug Discovery Based on Hydrazide-Hydrazone and Thiadiazole Derivatives Targeting InhA</strong> - Tuberculosis is an extremely serious problem of global public health. Its incidence is worsened by the presence of multidrug-resistant (MDR) strains of Mycobacterium tuberculosis. More serious forms of drug resistance have been observed in recent years. Therefore, the discovery and/or synthesis of new potent and less toxic anti-tubercular compounds is very critical, especially having in mind the consequences and the delays in treatment caused by the COVID-19 pandemic. Enoyl-acyl carrier protein…</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>Current Update on Role of Hesperidin in Inflammatory Lung Diseases: Chemistry, Pharmacology, and Drug Delivery Approaches</strong> - Inflammation is a common feature of many respiratory diseases, such as pneumonia, asthma, pulmonary fibrosis, chronic obstructive pulmonary disease (COPD), lung cancer, acute lung injury, and COVID-19. Flavonoids have demonstrated their anti-inflammatory and antioxidant effects by influencing inflammation at different stages and majorly impacting several respiratory diseases’ onset and development. According to current studies, hesperidin, one of the most abundant polyphenols, can inhibit…</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>Azido-Ceramides, a Tool to Analyse SARS-CoV-2 Replication and Inhibition-SARS-CoV-2 Is Inhibited by Ceramides</strong> - Recently, we have shown that C6-ceramides efficiently suppress viral replication by trapping the virus in lysosomes. Here, we use antiviral assays to evaluate a synthetic ceramide derivative α-NH2-ω-N3-C6-ceramide (AKS461) and to confirm the biological activity of C6-ceramides inhibiting SARS-CoV-2. Click-labeling with a fluorophore demonstrated that AKS461 accumulates in lysosomes. Previously, it has been shown that suppression of SARS-CoV-2 replication can be cell-type specific. Thus, AKS461…</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>Mycolactone: A Broad Spectrum Multitarget Antiviral Active in the Picomolar Range for COVID-19 Prevention and Cure</strong> - We have previously shown computationally that Mycolactone (MLN), a toxin produced by Mycobacterium ulcerans, strongly binds to Munc18b and other proteins, presumably blocking degranulation and exocytosis of blood platelets and mast cells. We investigated the effect of MLN on endocytosis using similar approaches, and it bound strongly to the N-terminal of the clathrin protein and a novel SARS-CoV-2 fusion protein. Experimentally, we found 100% inhibition up to 60 nM and 84% average inhibition at…</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 Climate Crisis Gives Sailing Ships a Second Wind</strong> - Cargo vessels are some of the dirtiest vehicles in existence. Can a centuries-old technology help to clean them up? - <a href="https://www.newyorker.com/news/annals-of-a-warming-planet/the-climate-crisis-gives-sailing-ships-a-second-wind">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Is It Sexist to Want Dianne Feinstein to Retire?</strong> - Debbie Stabenow, a Democratic colleague in the Senate, sees a double standard at work. - <a href="https://www.newyorker.com/news/q-and-a/is-it-sexist-to-want-dianne-feinstein-to-retire">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What’s Going On with Samuel Alito?</strong> - The Justice’s objection to the Supreme Court’s recent ruling in an abortion-pill case is another catalogue of his resentments. - <a href="https://www.newyorker.com/news/daily-comment/whats-going-on-with-samuel-alito">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Security Camera for the Planet</strong> - A new satellite, funded by a nonprofit, aims to pinpoint emissions of methane—a gas that plays a major role in global warming. - <a href="https://www.newyorker.com/news/annals-of-climate-action/a-security-camera-for-the-planet">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Week the Biden-Trump Rematch Got Real</strong> - One difference from 2020: the Republican attacks on the President’s even more unpopular Veep. - <a href="https://www.newyorker.com/news/letter-from-bidens-washington/the-week-the-biden-trump-rematch-got-real">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>The thorny ethical issues of the Pentagon partnering with the private sector</strong> -
<figure>
<img alt="The Pentagon building seen through an airplane window in the sky above it." src="https://cdn.vox-cdn.com/thumbor/6cKzmpIoEOY4uBwkxQjZ7EuBgCw=/404x0:3885x2611/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72226917/1252170321.0.jpg"/>
<figcaption>
The US Pentagon building in Arlington, Virginia, on April 21, 2023. | Tom Brenner/Bloomberg via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
How it’s legal to work as a corporate consultant and a Pentagon adviser at the same time.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4zmcoc">
An array of new federal intelligence and military offices have been launched in recent years with one overriding goal: to connect the slow-moving federal bureaucracy to private, venture capital-backed companies doing cutting-edge work.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Qc78JH">
Several military services and intelligence agencies have launched venture capital offices, and the <a href="https://www.vox.com/recode/2022/7/27/23277664/chips-act-solve-chip-shortage-biden-manufacturing">CHIPS Act</a> that President Joe Biden’s team is implementing is premised on public-private partnerships to advance the US’s high-tech manufacturing sector.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xk8N5C">
All these efforts can pose a set of ethical quandaries given the blurry line between the public interest and corporate interests. And a recent career move illustrates those stakes.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="V7Ox1j">
This week, lawyer Linda Lourie announced that she was joining the Pentagon’s newly established Office of Strategic Capital, which is designed to connect military-tech companies with private investors, as a part-time consultant. She posted on <a href="https://www.linkedin.com/posts/linda-lourie_nationalsecurity-emergingtech-activity-7056353589799079936-KUAk?utm_source=share&amp;utm_medium=member_desktop">LinkedIn</a> how excited she was to “attract and scale private capital for emerging and frontier technologies in support of national security.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CVcGfv">
What stood out, however, is that she would maintain her private-sector job at <a href="https://theintercept.com/2021/07/06/westexec-biden-administration/">WestExec Advisors</a>, the ultra-connected Washington consultancy that works with tech and defense companies. The work of the Office of Strategic Capital is remarkably similar to the services that WestExec provides. Now, she would be working in the private and public sectors at the same time.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nTd0ZH">
The career shift for Lourie appears messy, but it is not illegal. “Outsourcing defense to a corporate adviser doesn’t seem like an ideal way to put the public’s interests first,” Walter Shaub, a top ethics official in the Obama administration, told me.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wwVPi8">
“My work for the different organizations cover different issues, and although I don’t expect any conflicts of interest, I will be very cautious to ensure that it doesn’t occur,” Lourie <a href="https://www.linkedin.com/feed/update/urn:li:activity:7056422957564243968/">posted</a> in response to Shaub’s reply on LinkedIn. (Requests for comment from Lourie and WestExec Advisors were not returned.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rHTizT">
The Pentagon reiterated that principle and said Lourie wouldn’t be working on specific investment decisions.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JtbP29">
“These employees are hired to contribute to broad policy discussions that relate to DoD’s role of informing and encouraging private sector investment in our nation’s critical technologies,” a Pentagon spokesperson said in a statement. “DOD ethics officials provide special government employees with clear guidelines on the ethics rules and specifically how to avoid conflicts of interest.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HRDYhE">
But government ethics experts say it will be hard to verify no conflicts arose in those policy discussions: Hiring people as “special government employees,” as Lourie is, requires fewer disclosures for the public. More broadly, the gray area in which she’s operating connects to the larger questions of what it means to marry private corporations to government, and whether it’s the American people or the corporations that benefit.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7ERCd0">
The core question is whether Lourie’s dual-hatted roles are unique or representative of how the government works today. While OSC says there is only one other employee hired as a special government employee, the increase of these appointees in substantive roles across the government could pose similar issues.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0HI5t9">
As more and more government offices are established to grease connections to the private sector, and as former policymakers continue to use the <a href="https://prospect.org/power/biden-adviser-jake-sullivan-think-tanker-scholar-consultant/">revolving door into corporate consulting</a> when they leave government, this issue is likely to keep occurring.
</p>
<h3 id="0e4pWN">
When the government seeks the private sector’s help
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fycUEd">
In December, the Department of Defense <a href="https://media.defense.gov/2022/Dec/01/2003123982/-1/-1/1/ESTABLISHMENT-OF-THE-OFFICE-OF-STRATEGIC-CAPITAL.PDF">launched</a> the Office of Strategic Capital to broaden private investment in technologies critical to national security.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ecRud0">
The biggest consumers of many new military technologies are, of course, often the government. But since Pentagon contracts can take years, it means that startups often struggle to break into the federal bureaucracy. That’s been called the “<a href="https://federalnewsnetwork.com/defense-main/2022/06/dod-confronting-valley-of-death-other-innovation-bottlenecks/">valley of death</a>,” and over the last two decades,<strong> </strong>a variety of new divisions have been designed to overcome the hurdles startups face in getting into the Pentagon. This has also been a key policy area that Michèle Flournoy, an Obama Pentagon official who co-founded WestExec Advisors with Antony Blinken in 2017, has researched extensively.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tiLj3q">
In 2019, Flournoy co-authored an <a href="https://foreignpolicy.com/2019/02/25/heres-how-the-united-states-can-keep-its-technological-edge-trump/">article</a> about how the US could maintain its tech superiority. One suggestion: “The government could also help connect critical technology and resource suppliers to private sector capital.” That seems similar to what the Office of Strategic Capital has set out to do.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="R4rzR1">
In the 2024 Pentagon budget, the Biden administration has sought <a href="https://www.wsj.com/articles/pentagon-woos-silicon-valley-to-join-ranks-of-arms-makers-38b1d4c0">$115 million</a> to fund the office, which will ultimately use <a href="https://www.wsj.com/articles/pentagon-office-to-support-tech-investment-critical-for-national-security-11669918443">financial tools like loans and loan guarantees</a> to boost startups of interest. Its first year will largely consist of research. Only a handful of staffers are currently listed as being a part of the office, according to Linkedin. As it seeks new authorities to deploy investment tools, the office has <a href="https://breakingdefense.com/2023/03/pentagon-teams-with-sba-to-make-key-tech-investments-dod-cant-legally-do-itself/">partnered</a> with the Small Business Administration’s investment program.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sIrSr4">
The idea behind the office isn’t new. It builds on investment efforts in the Army and Air Force and the Defense Innovation Unit (DIU), an incubator launched in 2015. Among the emerging startups that the DIU has backed to multibillion-dollar success is the military-tech company <a href="https://www.defensenews.com/pentagon/2022/09/08/pentagon-must-rethink-incentives-outgoing-diu-chief-says/">Anduril</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0KCtk7">
When <a href="https://www.vox.com/technology/23634433/silicon-valley-bank-collapse-silvergate-first-republic-fdic">Silicon Valley Bank crashed</a> at the end of March, many military-tech startups were exposed to economic stress. The Office of Strategic Capital was “actively collaborating with our DoD and other government colleagues to advocate for our national security community” and “constantly monitoring national security-related impacts to the crisis,” <a href="https://techinquiry.org/?article=osc-svb">according</a> to a press release.
</p>
<h3 id="zXUANd">
What’s off about working for government and the private sector at once
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="L15mop">
For all their successes, these public-private partnerships can create ethical issues.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dEEeNK">
Conflicts of interest are the main concern. That’s why government employees disclose their employers, investments, clients, and assets in filings, and then they work with ethics officers and their managers to avoid favoritism and guard against working on aspects of a project that could affect their own financial interests.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kml6lR">
Roles that have close ties to the private sector and that hire government contractors pose particular issues. The director of the Defense Innovation Unit from 2018 to 2022, Michael Brown, allegedly engaged in <a href="https://fedscoop.com/mike-brown-diu-ig-investiation-unethical-contracting-former-cfo-says/">unethical hiring and contracting</a>, according to the unit’s CFO. Those complaints could not be substantiated by the <a href="https://media.defense.gov/2023/Jan/05/2003140631/-1/-1/1/20201102-067934-CASE-01.PDF">DoD Inspector General</a>, which cleared Brown last year. But the ordeal led him to <a href="https://www.bloomberg.com/news/articles/2021-07-14/biden-s-choice-for-pentagon-s-weapons-chief-is-withdrawing">withdraw</a> his nomination for a senior Pentagon appointment.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UTW6h4">
Part-time employees, like Linda Lourie, create a distinct set of potential landmines.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ppVt2R">
Lourie worked in the Biden White House’s <a href="https://www.politico.com/news/2022/03/28/google-billionaire-joe-biden-science-office-00020712">Office of Science and Technology Policy</a>. When she left and joined WestExec in 2022, the firm <a href="https://www.westexec.com/westexec-advisors-welcomes-linda-lourie-and-richard-stengel/">said</a> it was, “leveraging Linda’s robust knowledge-base to help our clients capitalize on strategic opportunities.” WestExec Advisors has <a href="https://theintercept.com/2021/07/06/westexec-biden-administration/">worked</a> for clients including Big Tech companies, prominent banks, prime military contractors, and new defense-tech startups. The firm has specialized in <a href="https://web.archive.org/web/20180314072217/https://www.westexec.com/">linking</a> “private equity and multinational corporations to emerging technology.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="issIsL">
Lourie’s designation as a <a href="https://www.oge.gov/Web/278eGuide.nsf/Content/Definitions~Special+Government+Employee+(SGE)">special government employee</a> (SGE) would allow her to work simultaneously in government and at WestExec, without publicly revealing her clients.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3dE3Au">
An SGE is just anyone who is expected to work no more than 130 days in a 365-day period. Its use may have been legitimate during the early days of Covid, when bureaucracy was moving slowly amid pandemic restrictions. And when technocratic knowledge is needed for a specific issue, it’s a helpful classification. “One of the great benefits of the SGE option is you can attract talent for a limited time that you might not otherwise get,” says Don Fox, who worked as acting director of the Office of Government Ethics from 2011 to 2013.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="U05ihq">
But this particular SGE role comes with less transparency than other roles a private sector adviser might normally fill, such as working as a government contractor or<strong> </strong>serving on federal advisory boards. The latter is different because there are “more ethical safeguards” and more “transparency, like open meetings requirements,” says Kathleen Clark, a law professor at Washington University in St. Louis. “None of this applies to this kind of SGE.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tVAHQV">
The Pentagon spokesperson said, “Employees designated as special government employees are limited to broad policy discussions, and are not included in discussions that relate to specific investments.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Utg7kp">
But Jeff Hauser of the watchdog Revolving Door Project worries that the role is still prone to exploitation. “It would take Herculean firewalls in one’s brain — that human beings are not capable of — to ignore the fact that you continue to be employed at an entity that has ongoing interest in certain outcomes on decisions you’re working on in government,” he told me.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gEeojQ">
About <a href="https://extapps2.oge.gov/annualquestionnaire/aq2021.nsf/7559f4f5ef67aaa485257e4b0043f87e/CAAEB758061B7211852588700062E7D4?OpenDocument">1,600</a> special government employees worked in the Office of the Secretary of Defense in 2021, the most recently available calendar year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uGC1gG">
Experts say the overuse of them for high-profile hires can undermine trust in government ethics enforcement. The most prominent Biden appointee to use the designation has been <a href="https://www.washingtonpost.com/politics/2022/03/28/anita-dunn-biden-skdk/">Anita Dunn</a>, who revolved in and out of the White House as a senior adviser to the president on short stints that allowed her to avoid publicly disclosing her clients and financial interests. Matt Miller, the incoming State Department spokesperson, appears to have been a special government employee when he worked as a <a href="https://www.reuters.com/world/us/former-nsc-official-matthew-miller-named-us-state-dept-spokesperson-2023-04-11/">White House comms official</a> at the beginning of Russia’s invasion of Ukraine.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fHEzlU">
This trend was perhaps more prevalent in the Trump administration, with such high-profile appointees as State Department Ukraine envoy <a href="https://www.politico.com/story/2019/09/28/trump-ukraine-kurt-volker-1517874">Kurt Volker</a>. White House lawyer Emmet Flood <a href="https://www.law.com/nationallawjournal/2018/08/06/trump-lawyer-emmet-floods-financial-disclosure-shows-3-3m-partner-share/">started</a> out as an SGE and was converted to full time. <a href="https://www.politico.com/news/2020/08/28/mick-mulvaney-hedge-fund-404643">Mick Mulvaney</a>, in his job as Ireland envoy, worked under this designation. But the Trump administration’s brazen and unprecedented ethical malfeasance shouldn’t obscure troubling dynamics in the Biden administration.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LAJs2z">
Shaub, who ran the Office of Government Ethics from 2013 to 2017, notes that Lourie could take proactive transparency measures to mitigate potential conflicts. The main concern is that WestExec, which already has <a href="https://prospect.org/world/how-biden-foreign-policy-team-got-rich/">numerous ties to the Biden administration</a>, might appear to have an advantage given one of its senior members working in a government office doing work relevant to the firm.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QhV6s0">
“She could choose to disclose her clients and disclose her work for the government. That would be a voluntary disclosure, of course, but the optics are terrible and the government owes the public concrete assurances,” Shaub, who is now at the Project on Government Oversight, told me.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="apZKuC">
Lourie is not the only one in the office simultaneously in the public and private sectors. Kirsten Bartok Touw, an aerospace and defense investor at New Vista Capital, also <a href="https://www.linkedin.com/in/kirsten-bartok-touw-a2b2/">works as an adviser</a> to the Office of Strategic Capital.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gojFY4">
Since the Pentagon’s Office of Strategic Capital is new, the responsibilities of the job might not be clear. “I would want to be updated on [the role] periodically, because with a brand new function or office, this could be iterative,” Fox, who previously served as deputy general counsel of the Air Force, told me. The scope of the work may evolve.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="odXR45">
Many of the current ethics laws and major reforms came out of the post-Watergate moment, and the Trump administration tested their limits and enforcement. As Fox put it, “Public perception is, in some ways, everything.”
</p></li>
<li><strong>A new Senate bill would curb Trump’s worst judges</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/IyroLhYdht1xDs_eBdsVRYW-Chc=/199x0:1379x885/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72226847/temp.0.png"/>
<figcaption>
Matthew Kacsmaryk, a Trump-appointed federal judge who has largely acted as a rubber stamp for right-wing causes. | Courtesy of Senate Judiciary Committee
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
There is a solution to America’s Matthew Kacsmaryk problem.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2AYl64">
The United States has a <a href="https://www.vox.com/policy-and-politics/2022/12/17/23512766/supreme-court-matthew-kacsmaryk-judge-trump-abortion-immigration-birth-control">Matthew Kacsmaryk problem</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="O1BsHS">
A longtime activist for the Christian right, Kacsmaryk is the Trump-appointed judge who <a href="https://www.vox.com/politics/2023/3/16/23642927/supreme-court-abortion-matthew-kacsmaryk-mifepristone-texas-trump">tried earlier this month to ban mifepristone</a>, a drug used in more than half of all abortions in the US, before his decision was <a href="https://www.vox.com/politics/2023/4/21/23686788/supreme-court-abortion-pill-ruling-mifepristone-fda-alliance-hippocratic-medicine">blocked by the Supreme Court</a>. Kacsmaryk’s mifepristone decision followed an array of others, on issues ranging from <a href="https://www.vox.com/policy-and-politics/2022/12/13/23505459/supreme-court-birth-control-contraception-constitution-matthew-kacsmaryk-deanda-becerra">birth control</a> to <a href="https://storage.courtlistener.com/recap/gov.uscourts.txnd.330752/gov.uscourts.txnd.330752.63.0_2.pdf">LGBTQ discrimination</a> to <a href="https://www.vox.com/2022/6/30/23189965/supreme-court-biden-texas-remain-in-mexico-john-roberts">immigration</a>, where he sought to impose his will on the entire nation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5wqQ8X">
And really, the problem is even larger. Since the start of the Biden administration, right-wing litigants started <a href="https://www.reuters.com/legal/government/democratic-bill-would-combat-judge-shopping-keep-national-cases-dc-2023-04-26/">funneling their lawsuits</a> seeking nationwide rulings to judges they believe will reliably do the bidding of the most extreme elements of the Republican Party, regardless of what the law actually says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BZ282U">
On Wednesday, Sen. Mazie Hirono (D-HI) introduced legislation that seeks to prevent litigants from doing just that. It’s not a perfect bill, and it likely would need to be strengthened before it could stop all far-right litigants from funneling their cases to partisans like Kacsmaryk. It’s also utterly unlikely to be enacted by this Congress. But this bill is a hopeful sign that Democrats may get serious about stopping the worst judges in the country from setting federal policy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7o3cmn">
“Judge shopping” isn’t exactly new — Chief Justice John Roberts warned in his <a href="https://www.supremecourt.gov/publicinfo/year-end/2021year-endreport.pdf">2021 report on the federal judiciary</a> about judge shopping by patent lawyers, many of whom tried to <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4185189">shunt their cases to a particular judge in Waco, Texas</a> — but it is an especially serious problem when litigants use it to bypass the entire political process to change federal policy on a nationwide basis.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="E20Vyj">
Kacsmaryk, and judges like him, are able to shape federal policy so often because of the unusual way Texas’s federal courts assign cases to trial judges. Every federal civil case filed in Amarillo, Texas, is <a href="https://www.vox.com/policy-and-politics/2023/2/14/23597741/supreme-court-matthew-kascmaryk-judge-shopping-texas-utah-walsh-justice-department">automatically assigned to Kacsmaryk</a>, so Republican litigants who want to all but guarantee a trial court victory simply need to file their complaint in Kacsmaryk’s Amarillo courthouse. Similarly, virtually any lawsuit filed in Victoria, Texas, is <a href="https://www.vox.com/policy-and-politics/2023/2/14/23597741/supreme-court-matthew-kascmaryk-judge-shopping-texas-utah-walsh-justice-department">assigned to Drew Tipton</a>, another Trump judge whose record is similar to Kacsmaryk’s.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vePLrd">
Worse, nearly all decisions handed down by a federal trial judge in Texas appeal to the United States Court of Appeals for the Fifth Circuit, a <a href="https://www.vox.com/policy-and-politics/2022/12/27/23496264/supreme-court-fifth-circuit-trump-court-immigration-housing-sexual-harrassment">deeply reactionary court</a> with a history of <a href="https://www.vox.com/policy-and-politics/2022/10/20/23414311/cfpb-unconstitutional-fifth-circuit-supreme-court-trump-community-financial">declaring entire federal agencies unconstitutional</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wPEtBR">
Hirono’s proposed legislation, the “<a href="https://fingfx.thomsonreuters.com/gfx/legaldocs/znpnbnnxopl/SIL23441.pdf">Stop Judge Shopping Act</a>,” is only two pages long, but it seeks to end some federal courts’ practice of allowing litigants to shop around for reliably partisan judges. If enacted, it would require any lawsuit seeking a nationwide order blocking a federal policy, or seeking an order blocking a federal policy that “extends beyond the parties to the civil action,” to be filed in a federal court in the District of Columbia.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="526E2e">
In fairness, the short-term impact of this bill would be to move these lawsuits into a court that currently favors Democrats. At the moment, most of the seats on the United States District Court for the District of Columbia are held by Democratic appointees. And, while Trump did appoint four judges to this court, none have shown the same consistent disregard for the rule of law displayed by Kacsmaryk. This court’s decisions also appeal to the DC Circuit, a center-left court dominated by Obama and Biden appointees.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tvB1IG">
But the DC federal courts already hear an unusually large number of cases challenging federal policies. As Justice Ketanji Brown Jackson, who served as both a trial and an appellate judge in the DC federal courts, once said, the dockets in these courts are “largely comprised of legal disputes <a href="https://www.judiciary.senate.gov/imo/media/doc/Brown%20Jackson%20Responses1.pdf">concerning the scope and application of the federal government’s power</a>.” So shifting cases targeting federal policies to DC would also mean that these cases would be heard by judges who have an unusual amount of expertise on the kinds of questions that arise in such cases.
</p>
<h3 id="6E0Cjx">
Hirono’s bill should be stronger
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tZ2kqo">
At least for the moment, the Stop Judge Shopping Act is an aspirational idea that has virtually no chance of becoming law in the current Congress. The GOP-controlled House is unlikely to pass a bill that diminishes the power of Republican partisans on the federal bench. And even if the bill somehow passed the House, it would still need to clear a 60-vote threshold to pass the Senate, <a href="https://www.vox.com/21424582/filibuster-joe-biden-2020-senate-democrats-abolish-trump">given the filibuster</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oqWkUd">
But if it were to ever be seriously considered, Congress should tighten down its language to ensure that judges like Kacsmaryk and Tipton do not issue decisions that will still impact millions of Americans.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZLU5xr">
Currently, <a href="https://fingfx.thomsonreuters.com/gfx/legaldocs/znpnbnnxopl/SIL23441.pdf">the bill</a> applies to lawsuits seeking to block a federal law, regulation, or executive order. It requires all lawsuits that seek a “nationwide injunction” — that is, an order which applies throughout the entire country — or that seek a court order that “extends beyond the parties to the civil act” to be filed in the DC district court.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oGdDsV">
In theory, this bill should prevent most of the kind of sweeping policymaking that Kacsmaryk and similar judges now engage in fairly regularly. For example, the plaintiffs in <em>Alliance for Hippocratic Medicine v. FDA</em>, the mifepristone case, were doctors who oppose abortions and nonprofit organizations that also oppose abortion. If Hirono’s bill had been law when this case was filed, then Kacsmaryk’s mifepristone ban would have only applied to these plaintiffs, and not to the nation as a whole — effectively rendering the ban toothless because who cares if doctors with strong moral objections to abortion are not allowed to prescribe an abortion drug? It’s not like they were going to write such a prescription in the first place.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5aWN20">
But many lawsuits seeking to block a federal policy are filed by state attorneys general, who have the power to bring lawsuits on behalf of their entire state. Indeed, there is a simply astounding array of lawsuits with names like <a href="https://www.vox.com/policy-and-politics/2022/8/10/23296841/supreme-court-biden-judiciary-republicans-texas-judge-shopping-immigration-obamacare"><em>Texas v. Biden</em></a> or <a href="https://www.supremecourt.gov/DocketPDF/22/22A17/229661/20220708124141045_U.S.%20v.%20Texas%20-%20Appendix.pdf"><em>Texas v. United States</em></a>, where multiple red states join together to ask judges like Kacsmaryk or Tipton to block a federal policy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MWtjXg">
As currently written, Hirono’s bill could potentially allow a large bloc of red state attorneys general to file a lawsuit in Kacsmaryk’s courtroom seeking a court order that blocks a federal policy, but only in their states. Hirono’s bill would not allow Kacsmaryk to issue a nationwide injunction against this policy, but he might potentially issue an order that applies in half of the country.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3oRrF4">
This problem is easy to fix. Hirono’s bill could be changed to also require lawsuits seeking to block a federal policy within one or more states to be filed in the District of Columbia.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jfbqEH">
And, with that change, the bill could very well shut down the Texas injunction pipeline that gives a simply astonishing amount of power to the most shamelessly ideological judges in America.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="B0MHTz">
Congress, though, would have to be willing to act.
</p></li>
<li><strong>Can a 50-year-old treaty still keep the world safe from the changing threat of bioweapons?</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/cBdzM2SGlTKhULiE8U0Je1-Nx8I=/240x0:1680x1080/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72226786/BioWeapons_LiviaGiorginaCarpineto.0.jpg"/>
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Livia Giorgina Carpineto for Vox
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How geopolitics and technological advances are making this a riskier world for bioweapons.
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<strong>GENEVA</strong> — Venomous Agent X is a <a href="https://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750005.html">deadly nerve agent</a>, though you likely know it by another name: VX. It’s an amber, oil-like liquid that targets the body’s nervous system. A<a href="https://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750005.html"> single drop on the skin</a> can kill within minutes. In 2017, North Korea is believed to have used VX to assassinate Kim Jong Un’s estranged half-brother in a Malaysian airport. <a href="https://www.npr.org/sections/thetwo-way/2017/02/26/517340990/banned-nerve-agent-killed-kim-jong-nam-within-20-minutes-malaysia-says#:~:text=The%20hospital's%20autopsy%20result%20revealed,time%2C%20would%20have%20saved%20Kim.">Kim Jong Nam suffered severe paralysis</a>, dead in about 20 minutes from a weapon of mass destruction.
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Sean Ekins and his team thought of the toxin for a possible experiment, one he needed to meet a last-minute deadline for a <a href="https://www.opcw.org/media-centre/news/2022/07/swiss-course-prepares-responders-chemical-incidents">presentation</a> at the Spiez Laboratory in Switzerland, at a conference examining how developments in science and technology might affect chemical and biological weapons regimes. Ekins is a scientist and CEO of Collaborations Pharmaceuticals, a lab that uses machine learning platforms to seek therapeutic treatments for rare and neglected diseases. He and his colleague Fabio Urbina wanted to test and see if they could flip their AI software, MegaSyn. Instead of steering the software away from toxicity, they wanted to see if they could guide the model toward it.
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The scientists trained the software with some 2 million molecules <a href="https://www.ebi.ac.uk/chembl/">from a public database</a>, and then modeled for specific, toxic traits.
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In <a href="https://www.scientificamerican.com/article/ai-drug-discovery-systems-might-be-repurposed-to-make-chemical-weapons-researchers-warn/">just six hours</a>, the AI generated some 40,000 molecules that met the scientists’ criteria, meaning that, based on their molecular structure, they all looked quite a lot like toxic chemical agents. The AI designed VX. It designed other known toxic agents. It even designed entirely new molecules that the scientists hadn’t programmed for, creating a sketch for potentially lethal and novel chemical compounds.
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The experiment was computational — a digital recipe for molecules like VX, not a physical creation of it or any other substance. But Ekins and his team used open source, publicly available data. The AI they used was also largely open source as well; they just tweaked the models a little bit.
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Ekins was horrified. What he and his colleague had thought was a banal experiment ended up creating a cookbook for chemical agents. “If we could do this,” Ekins said, “what’s to stop anyone else doing it?”
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<a href="https://www.vox.com/science-and-health/2017/2/24/14730464/vx-kim-jong-nam-poison-assassinated">VX, after all, is a banned substance</a> under the Chemical Weapons Convention. A lab can’t just produce or go out and order up VX; countries face inspections to make sure they don’t have the stuff, or something like it, hanging around. VX doesn’t exist in nature, and it has no dual uses; that is, it has no therapeutic value or positive benefit. The only reason to have VX is to kill.
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That isn’t the case for many things found in nature, like a virus or, well, your own DNA. Which is why this experiment got so much attention, not just among chemical warfare experts but among those who worry, specifically, about biological weapons. It showed just how simple it might be to apply it to the things that exist all around us, that can’t be tightly controlled, and that very likely have dual uses. Machine learning could be used to find ways to tweak a virus to make it less virulent, or more treatable. Or it could be used to make that virus more difficult to detect, or more deadly. And, if you or a nation-state are so inclined, wield it as a biological weapon.
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Biological weapons, of course, are outlawed, too. The <a href="https://www.un.org/disarmament/biological-weapons/">Biological Weapons Convention (BWC) </a>prohibits the production, use, development, stockpiling, or transfer of biological toxins or disease-causing organisms against humans, animals, or plants. More than 180 countries are party to the pact, which came into force in 1975 as the first multilateral treaty to ban an entire class of weapon. And in the years since, the taboo against state use of biological weapons has largely held.
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Yet a volatile geopolitical environment, combined with the rapid advance and increased access in the ability to edit and engineer pathogens, is straining and testing the nearly 50-year-old BWC as never before.
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“It’s like a race between the technology being developed really quickly and the biosecurity committee racing to put the safeguards around it,” said Jaime Yassif, vice president of global biological policy and programs at the Nuclear Threat Initiative.
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No treaty is perfect, but from the BWC’s beginnings, critics have said it lacked vital elements, like a verification mechanism to make sure everyone is following it. Global tensions, scientific advances, and the ever-expanding repertoire of what is possible with both biology and chemistry are making those flaws and cracks ever more visible.
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Late last year, at the Ninth Annual Review Conference for the Biological Weapons Convention at United Nations Headquarters in Geneva, Switzerland, countries broadly agreed that they needed to find ways to strengthen the pact, to make it fit for purpose in a more chaotic, unpredictable world.
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As is often the case in arms control, agreement is one thing, action another. The same forces buffeting the treaty are also making it nearly impossible to update it for a different age, or even agree on what it means now. The longer the BWC stands still, the faster barriers against a deliberate biological attack begin to fall away. That makes the world more vulnerable than ever to a threat the international community tried to eradicate 50 years ago.
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<h3 id="004kxS">
Illness, weaponized
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Biological weapons are the “poor man’s atom bomb,” said Yong-Bee Lim, the deputy director of the Converging Risks Lab and Biosecurity Projects Manager at the Council on Strategic Risks. They are weapons that can often be built on the cheap, using materials found in nature. Even before the world understood what caused disease, countries used things against their enemies they knew carried contagion: <a href="https://www.britannica.com/technology/biological-weapon/Biological-weapons-in-history">catapulting plague-infested corpses over fortified walls</a>, or giving or selling clothes or blankets from <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1326439/">smallpox </a>patients.
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But biological weapons were always held in a separate category in warfare. They are inherently risky: Contagions are hard to control and contain, and the same pathogens that can infect your target can also sicken you and your population. This is also why they tend to be used as a stealth agent of war; humanity has a general repugnance toward disease and poison that doesn’t extend to other armaments. “It has always been seen as an ungentlemanly weapon,” said Filippa Lentzos, a biosecurity expert and associate professor at King’s College London. “It’s never an element of your arsenal that you are proud to display. It’s always an underhand thing.”
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<img alt="A sign reading United States Army Fort Detrick Veterans Gate. " src="https://cdn.vox-cdn.com/thumbor/T-GanjjcZ3XgCKeT-tBuV71H9pk=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24615070/GettyImages_82148656.jpg"/> <cite>Mark Wilson/Getty Images</cite>
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A sign at the Veterans Gate at Fort Detrick Army Medical Research Institute of Infectious Diseases is shown August 1, 2008, in Frederick, Maryland
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Those factors helped bolster a taboo against biological weapons, which the international community first tried to prohibit with the 1925 Geneva Protocol against chemical and biological methods of warfare. That pact didn’t stop many countries from building biological weapons programs through World War II, with germs used <a href="https://nuke.fas.org/guide/japan/bw/">most notoriously by Japan in China</a>. Well into the Cold War,<a href="https://thebulletin.org/2023/03/biological-weapons-convention/?utm_source=Newsletter&amp;utm_medium=Email&amp;utm_campaign=MondayNewsletter03062023&amp;utm_content=DisruptiveTechnologiesBio_BWC_03062023"> the United States had a program of its own housed outside Washington, DC, at Fort Detrick</a>, along with a chemical and biological weapons <a href="https://historytogo.utah.gov/chemical-weapons-testing/">testing base in Utah.</a>
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The US wasn’t alone. The Soviet Union also had an offensive biological weapons project, as the two superpowers raced to match each other in armaments. But in the late 1960s, <a href="https://wmdcenter.ndu.edu/Portals/97/Documents/Publications/Case%20Studies/cswmd_cs1.pdf">some high-profile mishaps</a> linked to the US chemical and biological weapons programs — <a href="https://wmdcenter.ndu.edu/Portals/97/Documents/Publications/Case%20Studies/cswmd_cs1.pdf">including a toxic cloud from a test of VX that killed or injured 6,000 sheep </a>— along with public anger over the use of herbicides <a href="https://www.aspeninstitute.org/programs/agent-orange-in-vietnam-program/what-is-agent-orange/">like Agent Orange </a>during the Vietnam War, prompted Congress to pressure the Nixon administration to review the biological and chemical weapons programs. “Biological weapons have massive, unpredictable and potentially uncontrollable consequences,” President Richard Nixon <a href="https://2001-2009.state.gov/r/pa/ho/frus/nixon/e2/83597.htm">said</a> in 1969 after the release of the review, which essentially concluded that these kinds of offensive programs weren’t worth the risks.
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The US would ultimately renounce the use of biological warfare, instead focusing its research on defense and safety measures. The American decision, which <a href="https://www.tandfonline.com/doi/full/10.1080/10736700.2020.1823621">came after other allies turned away from their biological weapons programs</a>, seeded the conditions for the creation of the BWC.
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States have not engaged in known biological weapons attacks since — which is not the same thing as saying the treaty hasn’t been violated. The Soviet Union continued to build a big and sophisticated biological weapons program in the decades after it signed the BWC. That became clear<a href="https://www.nonproliferation.org/wp-content/uploads/npr/alibek63.pdf"> after the fall of the USSR in 1991</a>. Other signatories have been suspected <a href="https://www.armscontrol.org/factsheets/bwc">of maintaining offensive weapons programs</a> at different points post-1975, including <a href="https://www.nti.org/analysis/articles/south-africa-biological/#:~:text=South%20Africa%20is%20a%20party,apartheid%2Dera%20biological%20weapons%20program">South Africa</a> and <a href="https://www.worldscientific.com/doi/10.1142/9781783269488_0007#:~:text=The%20Iraqis%20considered%20biological%20weapons,1991%20with%20Operation%20Desert%20Storm.">Iraq</a>. Today, US intelligence <a href="https://www.state.gov/wp-content/uploads/2022/04/2022-Adherence-to-and-Compliance-with-Arms-Control-Nonproliferation-and-Disarmament-Agreements-and-Commitments-1.pdf">assesses that Russia and North Korea </a>maintain active offensive programs, both in violation of the BWC.
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<h3 id="Z6aP3P">
The good and the bad of the BWC
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The BWC calls the deliberate use of biological weapons “repugnant to the conscience of mankind.” The <a href="http://bwc1972.org/wp-content/uploads/2016/10/English.pdf">document itself is short</a>, just 15 articles, with the first explicitly banning the development, production, stockpile, and transfer of microbial or biological agents or toxins, “whatever their origin or method of production.”
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It is broad and not particularly specific, but given the dual-purpose and rapidly changing nature of biological research, that is also its strength: “It does make the convention quite future-proof,” said Daniel Feakes, chief of the BWC Implementation Support Unit (ISU), the main body overseeing the convention.
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The BWC is designed to be adaptable, but that also comes with a problem: It makes it difficult to ensure everyone who says they are following the BWC really is. Or, in arms control treaty-speak: It has no legally binding verification regime.
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The Chemical Weapons Convention is arguably narrower, banning specific agents. It also has an enforcement body that carries out inspections. Nuclear treaties between the US and Russia, <a href="https://www.vox.com/world-politics/2023/2/25/23610797/ukraine-war-putin-nuclear-new-start-treaty-suspension">though they’re almost all but officially dead</a>, included robust data-sharing and inspection. “Verification is a pretty standard element of most disarmament conventions, and that’s why people keep on coming back to the issue in the BWC,” Feakes said.
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The BWC has none of that. Some of it has to do with the unique nature of biological weapons, which <em>are</em> distinct from things like chemical agents or nukes. But that has left the BWC with a huge gap since its inception.
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<img alt="From left to right, Nikolai Lunkov, the Russian ambassador, David Ennals, the British Minister for Foreign and Commonwealth Affairs, and Ronald I. Spiers, Minister at the American Embassy, sign the certificates of deposit for the Biological Weapons Convention at Lancaster House in London, 26th March 1975." src="https://cdn.vox-cdn.com/thumbor/GolzzMEW85CDcwJk7xXAkkP7C20=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24615081/GettyImages_825515054.jpg"/> <cite>Frank Barrett/Keystone/Hulton Archive/Getty Images</cite>
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From left, Nikolai Lunkov, the Russian ambassador; David Ennals, the British minister for foreign and Commonwealth Affairs; and Ronald I. Spiers, minister at the American Embassy, signing the certificates of deposit for the Biological Weapons Convention at Lancaster House in London on March 26, 1975.
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“The holy grail that we’ve struggled with with the Biological Weapons Convention is how do you verify that the countries that have signed up to the treaty are not making biological weapons?” said Kenneth Ward, US special representative to the Biological Weapons Convention.
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The closest thing that BWC has to a verification are Confidence Building Measures (CBMs), essentially a book report on a country’s bio activities. Not every country participates, or makes the documents public, and there is no way to fact-check what any country says.
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And even if there were, the BWC is currently ill-equipped for such a task. The annual budget for the BWC <a href="https://www.armscontrol.org/act/2023-01/arms-control-today/bwc-review-conference-dispatch-cliffhanger-conference-seeks">is currently<strong> </strong>about $1.8 million</a>, which in the past has come out to less than most McDonald’s franchise restaurants, <a href="https://twitter.com/CSERCambridge/status/1231693809442074624">according to one estimate in a 2020 book</a>. About two-thirds of countries <a href="https://www.armscontrol.org/act/2023-01/arms-control-today/bwc-review-conference-dispatch-cliffhanger-conference-seeks">pay less than $1,000 into the BWC, including about 50 that pay around $100</a>. That is considerably less than the Organization for the Prohibition of Chemical Weapons (OPCW), which has an<a href="https://www.opcw.org/sites/default/files/documents/2022/09/ec101dg01r1%28e%29.pdf"> estimated 2023 budget of more than $80 million</a> to implement the Chemical Weapons Convention.
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The Implementation Support Unit (ISU) that oversees the BWC just had its staff grow by a quarter — from three to four people. Compare that, again, to the OPCW, <a href="https://www.opcw.org/about/technical-secretariat">which has about 500 staff members</a>. According to Feakes, what resources the ICU has mostly end up going toward the organizing and managing big meetings, like the Ninth Annual Review Conference. Even then, it’s barely enough: By the Friday morning session of the first week of the Review Conference in Geneva last year, <a href="https://www.bwpp.org/documents/Dailyreports/RC22-05.pdf">the UN Web TV broadcast of the BWC negotiations had to be cut off because of cost concerns</a>. If you can’t keep the live feed running, good luck preventing the potential proliferation of biological weapons.
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That means the actual implementation of the BWC looks something akin to matchmaking, where a state may ask for technical or assistance or training, and the ISU seeks out another country or partner that might have the ability to actually do it, because the ISU definitely doesn’t.
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But trying to fit BWC into the mold of other disarmament treaties is a lot trickier than you might think, largely because of the dual-use nature of biology. A nuclear warhead or VX gas has one purpose: warfare. But something like anthrax can and has been used as a biological weapon, and a legitimate lab may need to have anthrax on hand to make a vaccine. The same equipment you might use to try to find a cure to a virus or disease is much the same equipment you’d need to replicate or manipulate a virus for a biological attack. Germs are self-replicating which means countries don’t have to keep huge stockpiles of dangerous viruses.
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Life science itself is far more decentralized than nuclear research, for example. Labs are spread out, and with materials fairly accessible. <a href="https://dna.macrogen.com/">You can buy DNA online</a>, and with <a href="https://fas.org/blogs/sciencepolicy/safeguarding-benchtop-dna-synthesis/">technologies like benchtop DNA synthesis</a>, you can print DNA in your lab with a tool that’s about the size of a microwave. There are far more people with expertise in the biological sciences, from geneticists to lab techs, around the world than there are nuclear scientists. A terror group getting ahold of weapons of mass destruction is always a risk, but the diffusion of biology means it’s probably easier to weaponize a virus — and certainly harder to detect — than it is to make a nuke. And, of course, the BWC only deals with nation-states anyway.
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“You don’t want to create false confidence in a verification regime,” Ward, of the US State Department, said. “You have to be clear: What can we verify? What can we not verify? And we’re never going to be able to verify on a daily basis, is every biological facility in the world doing good things instead of bad things? It’s impossible to know.”
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It’s also not like anyone hasn’t tried, either. Across decades, countries have attempted to figure out some way to create a verification mechanism. Perhaps the closest the BWC came was in 2001, but US opposition effectively sidelined efforts to create a more formal and transparent mechanism for verification for 20 years.
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A lot has happened in those 20 years, including dramatic advances in life sciences — the mapping of the human genome, CRISPR gene-editing technology, mRNA vaccines, and more — which means the nature of biological threats is changing, too. Some verification is better than nothing, and almost certainly better than an absolute free-for-all — as the pandemic itself showed.
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What is a bioweapon today — and tomorrow?
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In a city, in one corner of the world, people start showing up to the hospital. They have some sort of respiratory illness, but it’s not clear what. The cases range in their severity: It is often fatal in older or immunocompromised people; for others, a mild to severe illness. Others still are asymptomatic, a virus in their bodies, spreading without any outward sign.
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<img alt="A person wearing a hazmat suit and a protective mask and goggles. " src="https://cdn.vox-cdn.com/thumbor/CQ44OW0hCCaLyEx4imrCpaSFx6Y=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24615088/GettyImages_57635955.jpg"/> <cite>Jim Watson/AFP via Getty Images</cite>
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A Pentagon Force Protection Agency (PFPA) member looks on after washing down a Red Cross Volunteer who simulated being infected with the anthrax virus during exercise “Gallant Fox 06” outside the Pentagon in Washington, DC, May 17, 2006.
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From there, the virus spreads, and spreads, and spreads. It shuts down economies, upends politics. <a href="https://covid19.who.int/">Millions die; millions more get sick</a>. A vaccine is developed quickly, so are treatments, but none are a perfect shield, especially as the virus, now out in the world, changes.
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This is not a bioweapon but the Covid-19 pandemic. (Which, it’s worth emphasizing, is <a href="https://www.dw.com/en/us-intelligence-says-covid-not-developed-as-biological-weapon/a-59669443">not a bioweapon</a>, even if debates on its origins continue.) But what Covid-19 did do was show just how disruptive an entirely unintentional biological event can be. A deliberate one, or even the accidental release of a virus from a legitimate lab, could be far worse. (A <a href="https://www.washingtonpost.com/opinions/our-lack-of-pandemic-preparedness-could-prove-deadly/2018/09/19/0d7b235c-b13e-11e8-a20b-5f4f84429666_story.html">2018 pandemic tabletop exercise</a> by the Johns Hopkins Center for Health and Security modeled for a release of an engineered bioweapon and <a href="https://www.newyorker.com/science/elements/the-terrifying-lessons-of-a-pandemic-simulation">ended with 150 million people dead</a>.) It’s still not easy to create such a deadly bioweapon, “but barriers are coming down, and risks are increasing,” Lentzos said.
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Barriers are coming down because of the expansion and advancement in the life sciences. There is gene editing, which has been made easier and more powerful<a href="https://www.science.org/content/article/crispr-weapon-mass-destruction"> with tools like CRISPR</a>. A bad actor could use it to make a virus more transmissible, or more fatal, or more resistant to treatment. There is synthetic biology, which enables scientists to manipulate or even design entirely new organisms — <a href="https://www.usni.org/magazines/proceedings/2021/june/synthetic-bioweapons-are-coming#:~:text=Unlike%20traditional%20bioweapons%2C%20which%20most,effects%2C%20mechanisms%2C%20or%20processes.">maybe tailor-made to infect livestock, or a country’s wheat supply, or even a specific person</a>. Then there are the computational tools, like the artificial intelligence used by Ekins where huge databases and the power of computing <a href="https://www.lawfareblog.com/artificial-intelligence-and-chemical-and-biological-weapons">let scientists rapidly sift through potential pathogens much faster</a>, or find new combinations of molecules to create entirely novel viruses.
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Scientists also better understand how the body works; what regulates our hormones, immune systems, and neurotransmitters. Many experts I spoke to talked about bioregulators — systems that regulate our normal bodily functions — as a possible tool of manipulation. This knowledge has plenty of benign applications, and potentially revolutionary ones, but could also be <a href="https://www.theatlantic.com/magazine/archive/2012/11/hacking-the-presidents-dna/309147/">applied for military or political manipulation</a>: speeding up someone’s heart rate, or causing organ failure, or even altering moods, so all of a sudden an even-keeled president is an erratic one.
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There isn’t really a question as to whether such an attack would fit under the BWC. Even though we were decades away from decoding the human genome when the convention was signed, its Article 1 prohibition against any deliberate use of biological material or a toxin fits under the definition.
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But the larger question is whether the spread and development of these technologies incentivizes their malign use. That depends a lot on the political environment — on why a country would take the risk of breaking international law and norms. In a world where other disarmament treaties are falling away, great power competition is rising, and hybrid threats from cyber to information warfare offer the plausible deniability some governments seek, countries may start to see it as a risk worth taking.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JxycJj">
Russia’s war in Ukraine is an example of how these dynamics are playing out. <a href="https://www.wilsoncenter.org/blog-post/moscow-bioweapons-and-ukraine-cold-war-active-measures-putins-war-propaganda">Moscow has very deliberately spread misinformation</a> — amplified by everyone from <a href="https://apnews.com/article/russia-ukraine-covid-health-biological-weapons-china-39eeee023efdf7ea59c4a20b7e018169">the Chinese government</a> to <a href="https://www.nytimes.com/2022/03/11/us/politics/us-bioweapons-ukraine-misinformation.html">right-wingers in the US</a> — alleging that the US has been funding bioweapons labs in Ukraine, including claiming that Washington and Kyiv have collaborated on an infection that is targeting certain groups, delivered by bats and birds. The claims have been disproven, and <a href="https://press.un.org/en/2022/15095.doc.htm">rejected by the United Nations Security Council</a>, but some experts and officials fear it could serve as the basis for a false flag attack.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ecWsPt">
Biological attacks can also be difficult to verify because pathogens are naturally occurring, and even if scientists detect a new one, it’s difficult — if not impossible — to know if it’s something that has been deliberately created or something that emerged accidentally from nature or a lab. And given what Covid-19 demonstrated about the cracks in our defense against biological threats — and how little has been done to fix them over the past few years — a future bioweapon might “prey upon those existing vulnerabilities that haven’t been addressed,” said Saskia Popescu, a biodefense expert at George Washington University.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AnhsMk">
Decentralization further complicates matters, especially as the bioeconomy and biomanufacturing expands. The BWC is focused on nation-states, but this diffusion and access — again, you can buy DNA online and have it shipped to your lab — opens up opportunities for bad actors. “It’s easier for more and more people with less and less skills coming in the door to either make a pathogen from scratch or tinker with it to make it more dangerous,” said Yassif. “And that’s not contained within a few high-level labs, in a world-class lab with lots of resources. It’s increasingly democratized and distributed.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4OcO3D">
Together, this creates a dangerous dynamic: The international bioweapons regime is basically standing still, as technology and geopolitics race ahead of it.
</p>
<h3 id="6hWnlO">
Can the BWC keep up?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QTSKRE">
All of this tumult spilled over at the Palais des Nations, United Nations headquarters in Geneva, this past December. There, states-parties to the Biological Weapons Convention gathered for the Ninth Annual Review Conference, or “RevCon,” as it’s known. These happen every five years, although the Covid-19 pandemic had delayed the scheduled meeting. It would ultimately complicate this one as well, as diplomats and delegates started testing positive. By week’s end, the officials presiding over the conference did so in KN95 masks — an outcome that felt a little too on-the-nose for a conference designed to shore up protections against biological threats.
</p>
<figure class="e-image">
<img alt="Nurses in protective gear tend to a patient in a hospital bed, surrounded by medical equipment. " src="https://cdn.vox-cdn.com/thumbor/ONl_LB99ps7ZTkmH5YZaPV4isAE=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24615105/GettyImages_1223666272.jpg"/> <cite>Mario Tama/Getty Images</cite>
<figcaption>
Nurses Albert Legayada (L) and Fred Bueno care for a Covid-19 patient in the ICU at Sharp Grossmont Hospital amid the coronavirus pandemic on May 6, 2020, in La Mesa, California
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UaIDHs">
In the Palais des Nations, a strange combination existed of low expectations and high hopes. The low expectations were mainly a hangover from the ghosts of BWC RevCon past, where states struggled to reach consensus. The war in Ukraine had also increased tensions, with Russia, in particular, playing spoiler because no one would give credence to their Ukraine bioweapons claims.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZcGCak">
Yet many officials and experts hoped the disruptive power of Covid-19 would focus minds, providing a reminder of the threat of any kind of biological risks. New initiatives buzzed about, including <a href="https://www.interacademies.org/sites/default/files/2021-07/Tianjin-Biosecurity-Guidelines-Codes-Conduct.pdf">ethical guidelines for scientists</a> working in technologies that could be manipulated or misused. The Tianjin Biosecurity Guidelines for Codes of Conduct for Scientists included 10 principles for those practicing in the life sciences, an effort to raise awareness and accountability to mitigate biorisks. China, in particular, <a href="https://www.scmp.com/news/china/diplomacy/article/3147911/china-proposes-global-code-conduct-biosecurity-amid-covid-19">had championed these guidelines</a>, which lots of other countries supported, too, including the United States. There were also discussions about creating a scientific or technical body, one that could review and advise on the latest biological and life science developments.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qH7Ft2">
And, at long last, the United States cracked open the door to verification discussions. Ward said it was partly an acknowledgment from the Biden administration of the disruptive nature of Covid-19, but it was also an effort to move past two decades of ill will.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8GoeEW">
But that is always a tough task within international forums. The reality within the Palais was both slightly more boring and slightly more complicated. Politics played a big role in this. Russia, and some other familiar faces, including Iran used the forum to air their particular grievances — Moscow on Ukraine, Tehran on sanctions. The BWC is built on consensus — all the states-parties have to agree — so just one country can spoil the mood, and the progress.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ghijDR">
Most of the intense discussions happened behind closed doors; out in the brightly lit conference room, the delegations discussed, line by line, exactly what should be in the RevCon text, in the most passive-aggressive public edit of all time. Countries went back and forth on word selection, striking this or seeking to add that — respectively, of course — until slowly all the add-ons and enhancements to the BWC fell away.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LE1N66">
But, in the end, there was some progress, or as the line went: “<a href="https://unidir.org/commentary/whats-next-ninth-biological-weapons-review-conference-and-beyond">modest success</a>.” The hopes for adopting those ethical guidelines for scientists or even bare-bones verification measures failed. But the states-parties at the BWC agreed to establish a working group — meeting once a year, for about two weeks or so — to examine a long list of priorities, like advances in science and technology, and a possible road map for bioweapons verification.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dVkoZv">
“Issues like verification, it’s now formally in the agenda or the work plan of the intersessional program, the first time in two decades,” said Izumi Nakamitsu, the United Nations high representative for disarmament affairs.<strong> </strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="N2IXf5">
This is what counts for progress in the world of bioweapons governance: no substantive changes yet, but at least everyone is talking. The group will meet this August for the first time, after setting its agenda last month, with the goal of transforming the BWC by the time of the next RevCon about five years from now. Which is better than nothing when it comes to weapons of mass destruction.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bIEaGY">
In the meantime, the threats to the BWC are accelerating. The world is a more dangerous and tense place. Disinformation around bioweapons is also eroding the taboo against the use. This includes Russia’s playbook of continued accusations about bioweapons in Ukraine and elsewhere. But a top Republican recently claimed, with zero evidence, that the Chinese spy balloon shot down over the Atlantic Ocean in February <a href="https://www.thedailybeast.com/cnn-forces-rep-james-comer-to-admit-theres-no-evidence-spy-balloon-had-bioweapons">was equipped with bioweapons</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S1pdV9">
And maybe it doesn’t sound so crazy, as science speeds ahead. ChatGPT has amplified concerns around artificial intelligence and what it is capable of. Ekins’s software designed VX and thousands of other molecules in six hours, after all. “We’re just a small piece of the pie,” Ekins said, of the VX experiment. “But what else is happening out there?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="d4JgNH">
<em>This reporting was made possible by a grant from </em><a href="https://founderspledge.com/"><em>Founders Pledge</em></a><em>.</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sAeNdp">
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JaKNL4">
</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>A fascinating battle between Knight Riders and Titans on the cards at the Eden</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>Filing of FIR against Brij Bhushan is first step towards victory: Wrestlers</strong> - The wrestlers, who have accused WFI chief of sexual harassment and intimidation, have been demanding that an FIR be filed since they resumed their agitation on April 23.</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>Sri Lanka beats Ireland again, wins Test series 2-0</strong> - Sri Lanka cruised to an innings and 10-run win over Ireland to seal the series 2-0</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>Dhoni fan Jurel relishing his role as finisher for Rajasthan Royals</strong> - ‘I have practised for this spot, I have practised enough to hit every ball for six’</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>Will file FIR in wrestlers sexual harassment case, Delhi Police informs SC</strong> - A Bench of Chief Justice of India D.Y. Chandrachud and P.S. Narasimha directed the Delhi Police to file an affidavit by the next date of hearing, May 5, detailing the steps taken to protect the petitioners</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>Buzz about demolition of old Zenana Hospital triggers alarm</strong> - A multi-level car parking structure is set to come up for vehicles of HC staff, lawyers and judges</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>Lalu back in Patna after nearly seven months, buzz on role in Opposition unity moves</strong> - Speculations are rife that Lalu Prasad, who has relished the role of a “kingmaker” whether in or out of jail, will be helping Bihar CM Nitish Kumar in organising a get-together of Opposition leaders</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>Here are the big stories from Karnataka today</strong> - Welcome to the Karnataka Today newsletter, your guide from The Hindu on the major news stories to follow today. Curated and written by The Hindu Bureau</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>Register FIRs against hate speech even in absence of complaints, SC directs States</strong> - A Bench of Justices K.M. Joseph and B.V. Nagarathna said the court’s order would apply to all hate-speech makers irrespective of their religion</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>‘Pachuvum Athbuthavilakkum’ movie review: Fahadh Faasil’s drama works on the strength of its characters</strong> - All of the characters in Akhil Sathyan’s film, and the way their portraits unhurriedly emerge, somehow justify the run-time, although there was still scope for removing a considerable chunk of the flab</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ukraine war: Nineteen dead as Russian missiles hit cities</strong> - Among those killed were a mother and her three-year-old daughter in the city of Dnipro, officials 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>Pope on Hungary visit dominated by Ukraine war</strong> - Pope Francis disagrees with Hungary’s stance on Russia’s invasion of Ukraine and its refugee policies.</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>Sudan crisis: Turkish evacuation plane fired on</strong> - Paramilitary fighters deny involvement, saying they are committed to the extended truce.</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>Eva Green: Actress wins High Court dispute over $1m film fee</strong> - The French star argued she was owed her payment for a sci-fi film that never got made.</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>Climate change: Spain breaks record temperature for April</strong> - Temperatures reach 38.8C in southern Spain today as heat from Africa brings summer early.</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>Rocket Report: Feds assess Starship fallout; Sweden accidentally bombs Norway</strong> - “It is crucial that those responsible immediately inform the relevant Norwegian authorities.” - <a href="https://arstechnica.com/?p=1934874">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>OLED is great, but where are all the Mini LED laptops?</strong> - We dig into the research and interview companies about the potential of Mini LED. - <a href="https://arstechnica.com/?p=1931553">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>WebOps platform Pantheon defends hosting “hate groups” as developers quit</strong> - Developers quit Pantheon over its stance on hosting SPLC-designated hate groups. - <a href="https://arstechnica.com/?p=1935089">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Raw milk from farm with no electricity sparks outbreak that nearly killed baby</strong> - Raw milk is dangerous for everyone, but especially younger children. - <a href="https://arstechnica.com/?p=1935091">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Judge slams Tesla for claiming Musk quotes captured on video may be deepfakes</strong> - Court will likely require Musk deposition in Tesla Autopilot wrongful death case. - <a href="https://arstechnica.com/?p=1935023">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I uninstalled Facebook as I got depressed seeing my friends post their relationship and marriage.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I uninstalled LinkedIn as I got depressed seeing my colleague post their job change and promotion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I uninstalled instagram as I got depressed seeing my friends travel and enjoy their lives.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
But I’ll never uninstall reddit because you guys are more miserable than me .
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/ES_FTrader"> /u/ES_FTrader </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/131ajwu/i_uninstalled_facebook_as_i_got_depressed_seeing/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/131ajwu/i_uninstalled_facebook_as_i_got_depressed_seeing/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Two bored male casino dealers are waiting at the craps table. A very attractive blond woman arrives and bets $20,000 on a single roll of the dice</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She says, “I hope you don’t mind, but I feel much luckier when I’m completely nude.” With that, she strips down, rolls the dice, and yells, “Come on, baby, Mama needs new clothes!” As the dice come to a stop she jumps up and down and squeals, “YES! YES! I WON, I WON!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She hugs each of the dealers, picks up her winnings and her clothes, and quickly departs. The dealers stare at each other dumbfounded. Finally, one of them asks, “What did she roll?” The other answers, “I don’t know—I thought you were watching.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/quaninter"> /u/quaninter </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/130z2ky/two_bored_male_casino_dealers_are_waiting_at_the/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/130z2ky/two_bored_male_casino_dealers_are_waiting_at_the/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>My Asian waiter just handed my food to the wrong customer because he’s racist and thinks all white people look the same.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Wait, nevermind. That wasn’t my waiter.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/PR0CR45T184T0R"> /u/PR0CR45T184T0R </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/131j85d/my_asian_waiter_just_handed_my_food_to_the_wrong/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/131j85d/my_asian_waiter_just_handed_my_food_to_the_wrong/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>It’s called a threesome because there‘s you and two other people.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A foursome is called that because its you and three other people.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I guess now we know why your mom calls you “handsome”.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/mindk214"> /u/mindk214 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/131fz1s/its_called_a_threesome_because_theres_you_and_two/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/131fz1s/its_called_a_threesome_because_theres_you_and_two/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What do the movies Titanic and The Sixth Sense have in common?</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Icy dead people.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Different-Tie-1085"> /u/Different-Tie-1085 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/1311q2d/what_do_the_movies_titanic_and_the_sixth_sense/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/1311q2d/what_do_the_movies_titanic_and_the_sixth_sense/">[comments]</a></span></p></li>
</ul>
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