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"title": "Here Are 8 Lingering Questions About the New COVID Pills From Merck and Pfizer",
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"content": "\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">T\u003c/span>\u003c/span>he past two months have brought extremely good news in the fight against COVID-19. Two different oral treatments have proved effective at both preventing people newly diagnosed with COVID-19 from entering the hospital and from dying.\u003c/p>\n\u003cp>“We’re accelerating our path out of this pandemic,” President Biden said after data on the second COVID pill became available. The wide availability of oral drugs could make COVID-19 less lethal, making it less risky for people to return to in-person work and to their normal lives.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2021/10/01/mercks-antiviral-pill-reduces-hospitalization-of-covid-patients-a-possible-game-changer-for-treatment/\" target=\"_blank\" rel=\"noopener noreferrer\">first results\u003c/a>, from Merck and Ridgeback Therapeutics, were released in October and will be considered by an advisory panel to the Food and Drug Administration in December. That could lead to an emergency use authorization in the U.S. by the end of the year. That drug, molnupiravir, reduced hospitalizations by 50% and prevented deaths entirely a large randomized clinical trial when it was given within five days of when symptoms began. The pill is given as a five-day course during which patients take a total of 40 pills.\u003c/p>\n\u003cp>In November, Pfizer announced that its COVID pill, Paxlovid, reduced hospitalizations by 89% and also prevented deaths in its own large randomized study. As with the Merck drug, Paxlovid is given as a five-day course. It must be given with a second medicine, a booster, called ritonavir, which is made by AbbVie, another large drug firm. The Pfizer regimen involves taking 30 pills over a five-day period.\u003c/p>\n\u003cp>Though the topline results are similar, the medicines could have different risks and benefits. The companies have only issued data in press releases, not scientific articles, and doctors need to know a lot more about both. Here is an overview of what we still don’t know about the COVID pills and when we might learn it.\u003c/p>\n\u003ch3>Which one works better?\u003c/h3>\n\u003cp>At the headline level, Pfizer’s pill reduced the risk of hospitalization and death \u003ca href=\"https://www.statnews.com/2021/11/05/experimental-pfizer-pill-prevents-covid-hospitalizations-and-deaths/\" target=\"_blank\" rel=\"noopener noreferrer\">by 89%,\u003c/a> while Merck showed \u003ca href=\"https://www.statnews.com/2021/10/01/mercks-antiviral-pill-reduces-hospitalization-of-covid-patients-a-possible-game-changer-for-treatment/\" target=\"_blank\" rel=\"noopener noreferrer\">a reduction of 50%\u003c/a>. But neither firm has disclosed detailed data from its pivotal studies, and the trials were not identically designed.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The studies enrolled similar populations — unvaccinated people with mild to moderate COVID-19 and at least one risk factor for severe disease — but they had slightly different measures of efficacy. Pfizer’s 89% figure comes from patients who started getting its pill, Paxlovid, within three days of their first COVID-19 symptoms. Merck’s 50% applies to patients who began treatment within five days. In the Paxlovid study, patients who started treatment within five days saw an 85% improvement in hospitalization or death versus placebo. Merck has not shared data on patients who got its drug within three days of symptom onset.\u003c/p>\n\u003cp>What the studies had in common was 100% efficacy against death, regardless of when patients started treatment. Merck’s study counted eight deaths among patients on placebo, and Pfizer’s observed 10.\u003c/p>\n\u003cp>On the safety side, the rate of side effects in both studies was similar between the treatment groups and placebo groups. In each study, fewer patients in the treatment group left the study due to side effects compared to those in the placebo group. Neither company has disclosed detailed data on the type and severity of side effects.\u003c/p>\n\u003cp>Each treatment is administered twice a day for five total days, amounting to 10 doses in total. Pfizer’s drug is co-administered with a common antiviral called ritonavir.\u003c/p>\n\u003ch3>Will the antiviral be available for vaccinated patients with breakthrough infections?\u003c/h3>\n\u003cp>Both companies conducted their studies entirely in patients who were at high risk of complications if they caught COVID and who also had not been vaccinated. That leads to a big question for policymakers: Should those who have been vaccinated, but who develop a breakthrough infection of SARS-CoV-2, be given the pills?\u003c/p>\n\u003cp>Right now that is a question without data. A third antiviral pill, from the biotech firm Atea and the large drug firm Roche, failed to prove it was effective in its own study, and Wall Street analysts suspect the reason is that the companies included vaccinated patients in the research. For those who have received the vaccine, hospitalization and death are much less likely. This means that it is harder for a drug to show efficacy, because there are fewer infections to prevent.\u003c/p>\n\u003cp>So regulators and public health officials will have to make a judgement on the risks and benefits of the COVID pills for people with breakthrough infections — without direct data in these populations.\u003c/p>\n\u003cp>Pfizer is running a clinical trial, with results due next year, that does include vaccinated patients, and the company’s executives have expressed confidence based on the results so far that the treatment should work. Both Merck and Pfizer are also running studies to show that the drugs can prevent people from developing symptoms if they take the antivirals after they are exposed to the virus.\u003c/p>\n\u003ch3>Do the drugs work the same way?\u003c/h3>\n\u003cp>No, not really. While both drugs interfere with the process the coronavirus uses to reproduce itself, each drug interferes at a very different point.\u003c/p>\n\u003cp>Merck’s drug throws a wrench into the works quite early. After someone takes molnupiravir, the drug is transformed into something uncannily similar to one of RNA’s chemical building blocks.\u003c/p>\n\u003cp>The modification is so subtle that not only will the coronavirus use molnupiravir in place of other building blocks when it replicates itself, but coronaviruses’ unusual proofreading mechanism can’t even pick up on the imposter compound. Over time, the drug will encourage the virus to introduce even more mistakes.\u003c/p>\n\u003cp>“Ultimately, this leads to what’s known as error catastrophe. It’s introducing so many different mutations that, eventually, nothing further can happen,” said Katherine Seley-Radtke, a medicinal chemist at the University of Maryland, Baltimore County. “You’ve got this completely mutated RNA.”\u003c/p>\n\u003cp>Pfizer’s drug, Paxlovid, acts at a completely different point in the virus’ reproductive process.\u003c/p>\n\u003cp>“It’s apples and oranges,” said Ronald Swanstrom, a biochemistry professor at the University of North Carolina School of Medicine.\u003c/p>\n\u003cp>Unlike molnupiravir, Paxlovid allows the strings of viral RNA to be assembled correctly. It even allows those strings to be used to create viral proteins, which are initially produced in one big chunk. Like a bolt of fabric before it’s cut to a clothing pattern, this protein needs to be chopped down to size before it can work.\u003c/p>\n\u003cp>That cutting is what Paxlovid prohibits. The drug is designed to bind to a particularly important point in an enzyme called a protease which slices up proteins. Without a functioning protease, the virus can’t create functional copies; no working virus, no problem.\u003c/p>\n\u003cp>Protease inhibitors have been used for decades to create more than a dozen drugs for HIV and hepatitis C; in some cases, they’ve also been used as cancer drugs.\u003c/p>\n\u003cp>“There’s a long history of medicinal chemistry targeting proteases,” said Bryan Dickinson, a chemical biologist at the University of Chicago.\u003c/p>\n\u003cp>Paxlovid is designed with a SARS-CoV-2-specific protease in mind, so it works more specifically on this coronavirus than molnupiravir.\u003c/p>\n\u003cp>But Paxlovid can’t work as well if it’s taken on its own. The body’s defense mechanisms will get rid of anything that it doesn’t recognize — including drugs, which can be digested by enzymes in a person’s liver. Another drug called ritonavir blocks the liver enzyme that would likely chew up Paxlovid, which gives the latter drug the space it needs to work.\u003c/p>\n\u003ch3>How do they compare with monoclonal antibodies?\u003c/h3>\n\u003cp>Regeneron Pharmaceuticals and Eli Lilly have each won FDA authorization for antibody combination therapies that keep recently diagnosed COVID-19 patients from hospitalization and death. In a Phase 3 study enrolling recently diagnosed patients at high risk for severe disease, Regeneron’s treatment reduced the risk of hospitalization or death \u003ca href=\"https://investor.regeneron.com/news-releases/news-release-details/phase-3-trial-shows-regen-covtm-casirivimab-imdevimab-antibody\" target=\"_blank\" rel=\"noopener noreferrer\">by 70%\u003c/a> compared to placebo. In a similar study, Lilly’s therapy showed \u003ca href=\"https://www.prnewswire.com/news-releases/lillys-bamlanivimab-and-etesevimab-together-reduced-hospitalizations-and-death-in-phase-3-trial-for-early-covid-19-301243984.html\" target=\"_blank\" rel=\"noopener noreferrer\">an 87% reduction\u003c/a>.\u003c/p>\n\u003cp>The biggest difference is one of convenience. The antibody treatments are administered intravenously in a one-time, roughly hour-long process (Regeneron’s is authorized for subcutaneous injection when an IV procedure is not feasible). That could make the treatments from Pfizer and Merck, taken orally at home, preferable to patients unable to visit an infusion center.\u003c/p>\n\u003cp>There’s also a difference in cost. Regeneron and Lilly have signed deals with the federal government to sell their treatments at about $1,250 per dose. Merck’s agreement with the U.S. works out to about $700 for a five-day course of molnupiravir. Pfizer is still negotiating contracts but is expected to set a similar price for Paxlovid.\u003c/p>\n\u003ch3>How easy will they be to get?\u003c/h3>\n\u003cp>A pill is a huge leap in terms of logistical ease over infused therapies like monoclonal antibodies. For those treatments, not only did people have to make their way to clinics for their infusions, but hospitals and other facilities had to set up places where people who were actively infectious could come get treated without risking others’ health. (The other antiviral authorized to treat COVID-19, Gilead’s remdesivir, is an infusion and approved only for hospitalized patients, but some data indicate that if it were to be given to patients earlier in their infections, it could have a greater effect. If its approval ever covered outpatients, however, it would still run into the same logistical challenges of an infused therapy.)\u003c/p>\n\u003cp>Still, the COVID pills come with a key challenge of their own. They’re most effective when given early in the infection, so people need to be able to get tested and get their prescription rapidly. And the U.S. testing landscape is still limited. PCR tests can take days to return a result, and though the Biden administration has upped its effort to expand the availability of at-home rapid tests, finding one at a store is still hit or miss — success feels like scoring this holiday season’s hottest gift. Any delay in getting diagnosed undercuts the power of these pills; even a day or two has real implications for a treatment meant to clear out an acute infection like COVID-19.\u003c/p>\n\u003ch3>Will it affect a patient’s DNA?\u003c/h3>\n\u003cp>This is really a question only for Merck’s molnupiravir, since it works by sneaking subtly corrupted parts into the coronavirus’s RNA sequence.\u003c/p>\n\u003cp>Once the virus has mutated too much, it can’t work — mission accomplished. But there’s a theoretical chance that molnupiravir could also influence normal human DNA when it replicates, too. If mutations happen during that process, it could spell real trouble.\u003c/p>\n\u003cp>Merck did some tests during molnupiravir’s development to check this possibility out. In two different types of animal studies using higher and longer doses than are given to humans, Merck’s scientists didn’t see any increased risk of unwanted mutations.\u003c/p>\n\u003cp>“We are very confident in the safety profile of molnupiravir based on our preclinical and clinical data,” executive vice president Dean Li told investors in an October conference call, according to a transcript in the financial database Sentieo.\u003c/p>\n\u003cp>But UNC’s Swanstrom isn’t completely convinced that the tests Merck did were sensitive enough. In August, he and his colleagues \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/33961695/\" target=\"_blank\" rel=\"noopener noreferrer\">published a paper in\u003c/a> the Journal of Infectious Diseases showing that a key metabolite of molnupiravir could mutate DNA in animal cells.\u003c/p>\n\u003cp>Given these results, Swanstrom said he would be particularly interested in seeing a long-term study of people who took molnupiravir to continue to monitor this potential effect over the next 10 or 20 years.\u003c/p>\n\u003cp>“This thing is going to go into thousands of people. And are we just going to ignore the fact that there’s this potential risk?” he said. “The risk could be zero. It could be no worse than going to get a dental X-ray — or it could do something more. But unless we find out, you know, we’re going to learn this lesson the hard way, way later than we should.”\u003c/p>\n\u003ch3>What might the new antivirals mean for cancer patients?\u003c/h3>\n\u003cp>Because the new antiviral Pfizer is developing is a protease inhibitor, infectious disease specialists are familiar with how it works. So we already know: These drugs have the potential to interfere with many therapies used to treat cancer, Tobias Hohl, chief of the infectious diseases service at Memorial Sloan Kettering Cancer Center in New York, told STAT.\u003c/p>\n\u003cp>“They’re going to be very helpful [in our] armamentarium, but they will not substitute for prevention or vaccination efforts because these are not medicines that are completely benign and harmless in terms of their drug-drug interactions and toxicity,” he said. “So we’re going to have to be careful and thoughtful about how we use our protease inhibitors.”\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2020/08/10/winter-is-coming-as-flu-season-nears-americas-window-of-opportunity-to-beat-back-covid-19-is-narrowing/\" target=\"_blank\" rel=\"noopener noreferrer\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Matthew Herper, Damian Garde, Kate Sheridan, Adam Feuerstein, Andrew Joseph, and Elizabeth Cooney contributed reporting.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">T\u003c/span>\u003c/span>he past two months have brought extremely good news in the fight against COVID-19. Two different oral treatments have proved effective at both preventing people newly diagnosed with COVID-19 from entering the hospital and from dying.\u003c/p>\n\u003cp>“We’re accelerating our path out of this pandemic,” President Biden said after data on the second COVID pill became available. The wide availability of oral drugs could make COVID-19 less lethal, making it less risky for people to return to in-person work and to their normal lives.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2021/10/01/mercks-antiviral-pill-reduces-hospitalization-of-covid-patients-a-possible-game-changer-for-treatment/\" target=\"_blank\" rel=\"noopener noreferrer\">first results\u003c/a>, from Merck and Ridgeback Therapeutics, were released in October and will be considered by an advisory panel to the Food and Drug Administration in December. That could lead to an emergency use authorization in the U.S. by the end of the year. That drug, molnupiravir, reduced hospitalizations by 50% and prevented deaths entirely a large randomized clinical trial when it was given within five days of when symptoms began. The pill is given as a five-day course during which patients take a total of 40 pills.\u003c/p>\n\u003cp>In November, Pfizer announced that its COVID pill, Paxlovid, reduced hospitalizations by 89% and also prevented deaths in its own large randomized study. As with the Merck drug, Paxlovid is given as a five-day course. It must be given with a second medicine, a booster, called ritonavir, which is made by AbbVie, another large drug firm. The Pfizer regimen involves taking 30 pills over a five-day period.\u003c/p>\n\u003cp>Though the topline results are similar, the medicines could have different risks and benefits. The companies have only issued data in press releases, not scientific articles, and doctors need to know a lot more about both. Here is an overview of what we still don’t know about the COVID pills and when we might learn it.\u003c/p>\n\u003ch3>Which one works better?\u003c/h3>\n\u003cp>At the headline level, Pfizer’s pill reduced the risk of hospitalization and death \u003ca href=\"https://www.statnews.com/2021/11/05/experimental-pfizer-pill-prevents-covid-hospitalizations-and-deaths/\" target=\"_blank\" rel=\"noopener noreferrer\">by 89%,\u003c/a> while Merck showed \u003ca href=\"https://www.statnews.com/2021/10/01/mercks-antiviral-pill-reduces-hospitalization-of-covid-patients-a-possible-game-changer-for-treatment/\" target=\"_blank\" rel=\"noopener noreferrer\">a reduction of 50%\u003c/a>. But neither firm has disclosed detailed data from its pivotal studies, and the trials were not identically designed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The studies enrolled similar populations — unvaccinated people with mild to moderate COVID-19 and at least one risk factor for severe disease — but they had slightly different measures of efficacy. Pfizer’s 89% figure comes from patients who started getting its pill, Paxlovid, within three days of their first COVID-19 symptoms. Merck’s 50% applies to patients who began treatment within five days. In the Paxlovid study, patients who started treatment within five days saw an 85% improvement in hospitalization or death versus placebo. Merck has not shared data on patients who got its drug within three days of symptom onset.\u003c/p>\n\u003cp>What the studies had in common was 100% efficacy against death, regardless of when patients started treatment. Merck’s study counted eight deaths among patients on placebo, and Pfizer’s observed 10.\u003c/p>\n\u003cp>On the safety side, the rate of side effects in both studies was similar between the treatment groups and placebo groups. In each study, fewer patients in the treatment group left the study due to side effects compared to those in the placebo group. Neither company has disclosed detailed data on the type and severity of side effects.\u003c/p>\n\u003cp>Each treatment is administered twice a day for five total days, amounting to 10 doses in total. Pfizer’s drug is co-administered with a common antiviral called ritonavir.\u003c/p>\n\u003ch3>Will the antiviral be available for vaccinated patients with breakthrough infections?\u003c/h3>\n\u003cp>Both companies conducted their studies entirely in patients who were at high risk of complications if they caught COVID and who also had not been vaccinated. That leads to a big question for policymakers: Should those who have been vaccinated, but who develop a breakthrough infection of SARS-CoV-2, be given the pills?\u003c/p>\n\u003cp>Right now that is a question without data. A third antiviral pill, from the biotech firm Atea and the large drug firm Roche, failed to prove it was effective in its own study, and Wall Street analysts suspect the reason is that the companies included vaccinated patients in the research. For those who have received the vaccine, hospitalization and death are much less likely. This means that it is harder for a drug to show efficacy, because there are fewer infections to prevent.\u003c/p>\n\u003cp>So regulators and public health officials will have to make a judgement on the risks and benefits of the COVID pills for people with breakthrough infections — without direct data in these populations.\u003c/p>\n\u003cp>Pfizer is running a clinical trial, with results due next year, that does include vaccinated patients, and the company’s executives have expressed confidence based on the results so far that the treatment should work. Both Merck and Pfizer are also running studies to show that the drugs can prevent people from developing symptoms if they take the antivirals after they are exposed to the virus.\u003c/p>\n\u003ch3>Do the drugs work the same way?\u003c/h3>\n\u003cp>No, not really. While both drugs interfere with the process the coronavirus uses to reproduce itself, each drug interferes at a very different point.\u003c/p>\n\u003cp>Merck’s drug throws a wrench into the works quite early. After someone takes molnupiravir, the drug is transformed into something uncannily similar to one of RNA’s chemical building blocks.\u003c/p>\n\u003cp>The modification is so subtle that not only will the coronavirus use molnupiravir in place of other building blocks when it replicates itself, but coronaviruses’ unusual proofreading mechanism can’t even pick up on the imposter compound. Over time, the drug will encourage the virus to introduce even more mistakes.\u003c/p>\n\u003cp>“Ultimately, this leads to what’s known as error catastrophe. It’s introducing so many different mutations that, eventually, nothing further can happen,” said Katherine Seley-Radtke, a medicinal chemist at the University of Maryland, Baltimore County. “You’ve got this completely mutated RNA.”\u003c/p>\n\u003cp>Pfizer’s drug, Paxlovid, acts at a completely different point in the virus’ reproductive process.\u003c/p>\n\u003cp>“It’s apples and oranges,” said Ronald Swanstrom, a biochemistry professor at the University of North Carolina School of Medicine.\u003c/p>\n\u003cp>Unlike molnupiravir, Paxlovid allows the strings of viral RNA to be assembled correctly. It even allows those strings to be used to create viral proteins, which are initially produced in one big chunk. Like a bolt of fabric before it’s cut to a clothing pattern, this protein needs to be chopped down to size before it can work.\u003c/p>\n\u003cp>That cutting is what Paxlovid prohibits. The drug is designed to bind to a particularly important point in an enzyme called a protease which slices up proteins. Without a functioning protease, the virus can’t create functional copies; no working virus, no problem.\u003c/p>\n\u003cp>Protease inhibitors have been used for decades to create more than a dozen drugs for HIV and hepatitis C; in some cases, they’ve also been used as cancer drugs.\u003c/p>\n\u003cp>“There’s a long history of medicinal chemistry targeting proteases,” said Bryan Dickinson, a chemical biologist at the University of Chicago.\u003c/p>\n\u003cp>Paxlovid is designed with a SARS-CoV-2-specific protease in mind, so it works more specifically on this coronavirus than molnupiravir.\u003c/p>\n\u003cp>But Paxlovid can’t work as well if it’s taken on its own. The body’s defense mechanisms will get rid of anything that it doesn’t recognize — including drugs, which can be digested by enzymes in a person’s liver. Another drug called ritonavir blocks the liver enzyme that would likely chew up Paxlovid, which gives the latter drug the space it needs to work.\u003c/p>\n\u003ch3>How do they compare with monoclonal antibodies?\u003c/h3>\n\u003cp>Regeneron Pharmaceuticals and Eli Lilly have each won FDA authorization for antibody combination therapies that keep recently diagnosed COVID-19 patients from hospitalization and death. In a Phase 3 study enrolling recently diagnosed patients at high risk for severe disease, Regeneron’s treatment reduced the risk of hospitalization or death \u003ca href=\"https://investor.regeneron.com/news-releases/news-release-details/phase-3-trial-shows-regen-covtm-casirivimab-imdevimab-antibody\" target=\"_blank\" rel=\"noopener noreferrer\">by 70%\u003c/a> compared to placebo. In a similar study, Lilly’s therapy showed \u003ca href=\"https://www.prnewswire.com/news-releases/lillys-bamlanivimab-and-etesevimab-together-reduced-hospitalizations-and-death-in-phase-3-trial-for-early-covid-19-301243984.html\" target=\"_blank\" rel=\"noopener noreferrer\">an 87% reduction\u003c/a>.\u003c/p>\n\u003cp>The biggest difference is one of convenience. The antibody treatments are administered intravenously in a one-time, roughly hour-long process (Regeneron’s is authorized for subcutaneous injection when an IV procedure is not feasible). That could make the treatments from Pfizer and Merck, taken orally at home, preferable to patients unable to visit an infusion center.\u003c/p>\n\u003cp>There’s also a difference in cost. Regeneron and Lilly have signed deals with the federal government to sell their treatments at about $1,250 per dose. Merck’s agreement with the U.S. works out to about $700 for a five-day course of molnupiravir. Pfizer is still negotiating contracts but is expected to set a similar price for Paxlovid.\u003c/p>\n\u003ch3>How easy will they be to get?\u003c/h3>\n\u003cp>A pill is a huge leap in terms of logistical ease over infused therapies like monoclonal antibodies. For those treatments, not only did people have to make their way to clinics for their infusions, but hospitals and other facilities had to set up places where people who were actively infectious could come get treated without risking others’ health. (The other antiviral authorized to treat COVID-19, Gilead’s remdesivir, is an infusion and approved only for hospitalized patients, but some data indicate that if it were to be given to patients earlier in their infections, it could have a greater effect. If its approval ever covered outpatients, however, it would still run into the same logistical challenges of an infused therapy.)\u003c/p>\n\u003cp>Still, the COVID pills come with a key challenge of their own. They’re most effective when given early in the infection, so people need to be able to get tested and get their prescription rapidly. And the U.S. testing landscape is still limited. PCR tests can take days to return a result, and though the Biden administration has upped its effort to expand the availability of at-home rapid tests, finding one at a store is still hit or miss — success feels like scoring this holiday season’s hottest gift. Any delay in getting diagnosed undercuts the power of these pills; even a day or two has real implications for a treatment meant to clear out an acute infection like COVID-19.\u003c/p>\n\u003ch3>Will it affect a patient’s DNA?\u003c/h3>\n\u003cp>This is really a question only for Merck’s molnupiravir, since it works by sneaking subtly corrupted parts into the coronavirus’s RNA sequence.\u003c/p>\n\u003cp>Once the virus has mutated too much, it can’t work — mission accomplished. But there’s a theoretical chance that molnupiravir could also influence normal human DNA when it replicates, too. If mutations happen during that process, it could spell real trouble.\u003c/p>\n\u003cp>Merck did some tests during molnupiravir’s development to check this possibility out. In two different types of animal studies using higher and longer doses than are given to humans, Merck’s scientists didn’t see any increased risk of unwanted mutations.\u003c/p>\n\u003cp>“We are very confident in the safety profile of molnupiravir based on our preclinical and clinical data,” executive vice president Dean Li told investors in an October conference call, according to a transcript in the financial database Sentieo.\u003c/p>\n\u003cp>But UNC’s Swanstrom isn’t completely convinced that the tests Merck did were sensitive enough. In August, he and his colleagues \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/33961695/\" target=\"_blank\" rel=\"noopener noreferrer\">published a paper in\u003c/a> the Journal of Infectious Diseases showing that a key metabolite of molnupiravir could mutate DNA in animal cells.\u003c/p>\n\u003cp>Given these results, Swanstrom said he would be particularly interested in seeing a long-term study of people who took molnupiravir to continue to monitor this potential effect over the next 10 or 20 years.\u003c/p>\n\u003cp>“This thing is going to go into thousands of people. And are we just going to ignore the fact that there’s this potential risk?” he said. “The risk could be zero. It could be no worse than going to get a dental X-ray — or it could do something more. But unless we find out, you know, we’re going to learn this lesson the hard way, way later than we should.”\u003c/p>\n\u003ch3>What might the new antivirals mean for cancer patients?\u003c/h3>\n\u003cp>Because the new antiviral Pfizer is developing is a protease inhibitor, infectious disease specialists are familiar with how it works. So we already know: These drugs have the potential to interfere with many therapies used to treat cancer, Tobias Hohl, chief of the infectious diseases service at Memorial Sloan Kettering Cancer Center in New York, told STAT.\u003c/p>\n\u003cp>“They’re going to be very helpful [in our] armamentarium, but they will not substitute for prevention or vaccination efforts because these are not medicines that are completely benign and harmless in terms of their drug-drug interactions and toxicity,” he said. “So we’re going to have to be careful and thoughtful about how we use our protease inhibitors.”\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2020/08/10/winter-is-coming-as-flu-season-nears-americas-window-of-opportunity-to-beat-back-covid-19-is-narrowing/\" target=\"_blank\" rel=\"noopener noreferrer\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Matthew Herper, Damian Garde, Kate Sheridan, Adam Feuerstein, Andrew Joseph, and Elizabeth Cooney contributed reporting.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Pregnancy and Climate Change: COP26 Looks at What's at Stake for Women",
"headTitle": "Pregnancy and Climate Change: COP26 Looks at What’s at Stake for Women | KQED",
"content": "\u003cp>World leaders turned their focus to gender Tuesday at the U.N. global climate summit in Glasgow, Scotland. Globally, women are more vulnerable to the effects of climate change than men, as they make up a majority of the world’s poor and depend most on natural resources, according to the U.N.’s Intergovernmental Panel on Climate Change. In the United States, one subgroup of women are particularly at risk: pregnant women.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2021/11/ccnow_logo.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/11/ccnow_logo-160x160.jpg\" alt=\"\" width=\"160\" height=\"160\" class=\"alignright size-thumbnail wp-image-1977443\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/11/ccnow_logo-160x160.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/11/ccnow_logo-800x800.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/11/ccnow_logo-1020x1020.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/11/ccnow_logo-768x768.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/11/ccnow_logo.jpg 1069w\" sizes=\"(max-width: 160px) 100vw, 160px\">\u003c/a>As global temperatures and emissions rise, so does the impact of climate change on public health. More pollutants from automobiles, fossil fuel plants and smoke from wildfires degrades air quality. This means at-risk populations, such as pregnant women and developing fetuses, are more likely to suffer from cardiac disease, respiratory disease and stress on mental health.\u003c/p>\n\u003cp>Climate-related exacerbation of air pollution and heat exposure significantly increases the risk to maternal, fetal and infant health, according to a 2020 JAMA Network review that assessed more than 32 million U.S. births.\u003c/p>\n\u003cp>[pullquote size='small' align='left' citation='Kelly Davis\u003cbr>National Birth Equity Collaborative']‘Pregnancy is a natural stress test. So if folks are already stressed through environmental racism, environmental injustice, their stress is only exacerbated during the very fragile time of pregnancy and childbirth.’[/pullquote] For the first time in the U.S., researchers found consistent evidence that pollution in the air, and heat, affect pregnancy outcomes including stillbirth, low birth weight and preterm delivery rates, said Rupa Basu, head of the air and climate epidemiology section of the California Environmental Protection Agency and co-author of the JAMA study.\u003c/p>\n\u003cp>Microscopic air pollutants have the ability to go deep into a mother’s lungs, Basu said, threatening her pulmonary health. Pollutants can cross into the placenta, leading to inflammation that can cause gestational diabetes or preeclampsia. Extreme heat can stress the mother and trigger reactions from dizziness to cardiac arrest.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The review also confirmed that the mothers most threatened are those with asthma and minorities, especially Black women. \u003c/p>\n\u003cp>“Pregnancy is a natural stress test. So if folks are already stressed through environmental racism, environmental injustice, their stress is only exacerbated during the very fragile time of pregnancy and childbirth,” said Kelly Davis, chief of birth equity innovation at the National Birth Equity Collaborative, a reproductive justice non-profit. \u003c/p>\n\u003cp>National and international climate discussions, like the U.N. summit, overlook the immediate needs of marginalized communities, Davis told CBS News. \u003c/p>\n\u003cp>“Oftentimes, climate change [goals are] so lofty and all of these things are important, but they erase the emergency and environmental concerns that Black women and pregnant people are facing every day,” she said. \u003c/p>\n\u003cp>Black and Indigenous women in the U.S. are two to three times more likely to die from pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Climate threats only exacerbate that pre-existing maternal health crisis in the U.S. and yet few people know about the danger, said Skye Wheeler, senior researcher of the Women’s Rights Division at Human Rights Watch. \u003c/p>\n\u003cp>There is more public information about protecting pets from extreme heat than there is about pregnant women, according to the most recent Human Rights Watch review of 105 official heat safety web pages, climate action plans and sustainability initiatives for 18 major US cities, including the 15 most populous, totaling 32 million people. \u003c/p>\n\u003cp>Only two of the reviewed documents — from Chicago and Philadelphia — explicitly addressed the danger heat poses during pregnancy. Since the review was conducted in August 2020, New York City has added the group to a list of vulnerable populations. Concerns about the dangers of heat for pets were found 37 times in the literature.\u003c/p>\n\u003cp>Rising temperatures put extra stress on a mother and fetus. A 2020 Harvard study found a link between gestational diabetes and extreme heat. This summer, the American College of Obstetricians and Gynecologists issued guidance on the link between extreme temperatures and irregular birth outcomes. \u003c/p>\n\u003cp>Even a hurricane can put expectant mothers under enough added stress that the weather can lead to higher rates of preterm births. \u003c/p>\n\u003cp>President Joe Biden’s Build Back Better plan includes legislation to address the link between climate threats and pregnancy. Representative Lauren Underwood, a Democrat from Illinois, has introduced legislation that would help educate medical professionals and patients on climate-change related risks for pregnant people. \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.cbsnews.com/news/pregnancy-women-fetuses-risks-climate-change/\" rel=\"noopener noreferrer\" target=\"_blank\">story\u003c/a> originally appeared on the website of \u003ca href=\"https://www.cbsnews.com/\" rel=\"noopener noreferrer\" target=\"_blank\">CBS News\u003c/a> and is part of Covering Climate Now, a global journalism collaboration strengthening coverage of the climate story.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>World leaders turned their focus to gender Tuesday at the U.N. global climate summit in Glasgow, Scotland. Globally, women are more vulnerable to the effects of climate change than men, as they make up a majority of the world’s poor and depend most on natural resources, according to the U.N.’s Intergovernmental Panel on Climate Change. In the United States, one subgroup of women are particularly at risk: pregnant women.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2021/11/ccnow_logo.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/11/ccnow_logo-160x160.jpg\" alt=\"\" width=\"160\" height=\"160\" class=\"alignright size-thumbnail wp-image-1977443\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/11/ccnow_logo-160x160.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/11/ccnow_logo-800x800.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/11/ccnow_logo-1020x1020.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/11/ccnow_logo-768x768.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/11/ccnow_logo.jpg 1069w\" sizes=\"(max-width: 160px) 100vw, 160px\">\u003c/a>As global temperatures and emissions rise, so does the impact of climate change on public health. More pollutants from automobiles, fossil fuel plants and smoke from wildfires degrades air quality. This means at-risk populations, such as pregnant women and developing fetuses, are more likely to suffer from cardiac disease, respiratory disease and stress on mental health.\u003c/p>\n\u003cp>Climate-related exacerbation of air pollution and heat exposure significantly increases the risk to maternal, fetal and infant health, according to a 2020 JAMA Network review that assessed more than 32 million U.S. births.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> For the first time in the U.S., researchers found consistent evidence that pollution in the air, and heat, affect pregnancy outcomes including stillbirth, low birth weight and preterm delivery rates, said Rupa Basu, head of the air and climate epidemiology section of the California Environmental Protection Agency and co-author of the JAMA study.\u003c/p>\n\u003cp>Microscopic air pollutants have the ability to go deep into a mother’s lungs, Basu said, threatening her pulmonary health. Pollutants can cross into the placenta, leading to inflammation that can cause gestational diabetes or preeclampsia. Extreme heat can stress the mother and trigger reactions from dizziness to cardiac arrest.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The review also confirmed that the mothers most threatened are those with asthma and minorities, especially Black women. \u003c/p>\n\u003cp>“Pregnancy is a natural stress test. So if folks are already stressed through environmental racism, environmental injustice, their stress is only exacerbated during the very fragile time of pregnancy and childbirth,” said Kelly Davis, chief of birth equity innovation at the National Birth Equity Collaborative, a reproductive justice non-profit. \u003c/p>\n\u003cp>National and international climate discussions, like the U.N. summit, overlook the immediate needs of marginalized communities, Davis told CBS News. \u003c/p>\n\u003cp>“Oftentimes, climate change [goals are] so lofty and all of these things are important, but they erase the emergency and environmental concerns that Black women and pregnant people are facing every day,” she said. \u003c/p>\n\u003cp>Black and Indigenous women in the U.S. are two to three times more likely to die from pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Climate threats only exacerbate that pre-existing maternal health crisis in the U.S. and yet few people know about the danger, said Skye Wheeler, senior researcher of the Women’s Rights Division at Human Rights Watch. \u003c/p>\n\u003cp>There is more public information about protecting pets from extreme heat than there is about pregnant women, according to the most recent Human Rights Watch review of 105 official heat safety web pages, climate action plans and sustainability initiatives for 18 major US cities, including the 15 most populous, totaling 32 million people. \u003c/p>\n\u003cp>Only two of the reviewed documents — from Chicago and Philadelphia — explicitly addressed the danger heat poses during pregnancy. Since the review was conducted in August 2020, New York City has added the group to a list of vulnerable populations. Concerns about the dangers of heat for pets were found 37 times in the literature.\u003c/p>\n\u003cp>Rising temperatures put extra stress on a mother and fetus. A 2020 Harvard study found a link between gestational diabetes and extreme heat. This summer, the American College of Obstetricians and Gynecologists issued guidance on the link between extreme temperatures and irregular birth outcomes. \u003c/p>\n\u003cp>Even a hurricane can put expectant mothers under enough added stress that the weather can lead to higher rates of preterm births. \u003c/p>\n\u003cp>President Joe Biden’s Build Back Better plan includes legislation to address the link between climate threats and pregnancy. Representative Lauren Underwood, a Democrat from Illinois, has introduced legislation that would help educate medical professionals and patients on climate-change related risks for pregnant people. \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.cbsnews.com/news/pregnancy-women-fetuses-risks-climate-change/\" rel=\"noopener noreferrer\" target=\"_blank\">story\u003c/a> originally appeared on the website of \u003ca href=\"https://www.cbsnews.com/\" rel=\"noopener noreferrer\" target=\"_blank\">CBS News\u003c/a> and is part of Covering Climate Now, a global journalism collaboration strengthening coverage of the climate story.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>[dl_subscribe]\u003cem>A kissing bug gorges on your blood. Then it poops on you. And that poop might contain the parasite that causes Chagas disease, which can be deadly. Without knowing it, millions of people have gotten the parasite in Latin America, where these insects live in many rural homes. As if that wasn’t bad enough, the saliva of some kissing bugs in the U.S. can give you a dangerous allergic reaction.\u003c/em>\u003c/p>\n\u003ch3>\u003cstrong>TRANSCRIPT\u003c/strong>\u003c/h3>\n\u003cp>This kissing bug isn’t going to give you a loving peck when it sticks you with that tucked-away proboscis.\u003c/p>\n\u003cp>It could actually make you really sick, even kill you.\u003c/p>\n\u003cp>It makes its move at night, while you’re sleeping. It likes your warm body.\u003c/p>\n\u003cp>Kissing bugs get their name because they often bite near the lips or eyes, but they’ll dig in anywhere you’ve left uncovered. A little anesthetic guarantees you won’t wake up while they feed on you for 10, 20, even 30 minutes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Every kissing bug needs several huge meals during the year or two it lives.\u003c/p>\n\u003cp>As it gulps, its exoskeleton stretches like a balloon, to fit up to 12 times its weight in blood. This pliability is called plasticization. How it started. How it’s going.\u003c/p>\n\u003cp>All that hot liquid could stress an insect’s body and stunt its growth. So the kissing bug cools it down – inside its head. Your warm blood flows in. The cool insect blood, called hemolymph, absorbs the heat and releases it through the top of the bug’s long head.\u003c/p>\n\u003cp>In this infrared video, you can see the blood cool down by more than 10 degrees Fahrenheit before it reaches the bug’s abdomen.\u003c/p>\n\u003cp>So the bug is safe. You, on the other hand, are not.\u003c/p>\n\u003cp>It injects saliva as it sucks your blood.\u003c/p>\n\u003cp>Here’s a scientist squeezing some out. The saliva has proteins that can give people a deadly allergic reaction called anaphylaxis.\u003c/p>\n\u003cp>And it gets much, much worse.\u003c/p>\n\u003cp>OK. This is super gross. After eating – sometimes while it’s eating – the bug poops. And that poop – and urine – might contain the parasite that causes Chagas disease. If the bug’s victim rubs these feces and urine into the bite wound or their eyes, the parasite can infect them. Years later, as many as one third of the people who got the parasite develop heart disease that can kill them, sometimes suddenly. Pregnant women can even pass the parasite onto their babies.\u003c/p>\n\u003cp>Few contract the parasite in the U.S., even though kissing bugs live here.\u003c/p>\n\u003cp>But in Latin America, millions of people have become infected. There, kissing bugs are known by many different names: chinche besucona … chinche … pito … vinchuca … barbeiro. In rural areas, these kissing bug species live in people’s homes, in the cracks of the walls. And in animal coops. Spraying has helped bring down infections. But hundreds of thousands of people have left their home countries for the U.S., not knowing the bug gave them the parasite. A simple blood test can find it and medications can often kill it.\u003c/p>\n\u003cp>In the American Southwest, the bugs live in the nests of wild animals, like this pack rat den in Arizona, where biologists Anita and Chuck Kristensen collect them.\u003c/p>\n\u003cp>Chuck Kristensen (off camera): Kissing bug, kissing bug! Genuine kissing bug.\u003c/p>\n\u003cp>For the most part, they feed on the pack rats. But in late spring and summer, the bugs sometimes travel from these nests into someone’s home.\u003c/p>\n\u003cp>So sealing off your house, with screens on your windows – and even vents – is one way to keep out these stealthy bloodsuckers.\u003c/p>\n\u003ch3>\u003cstrong>ADDITIONAL RESOURCES\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>Kissing bugs in the US\u003c/strong>\u003c/p>\n\u003cp>In California, kissing bugs – also known as conenose bugs – are most prevalent in the foothill areas surrounding the Central Valley and in the foothills and desert areas of Southern California. Find out \u003ca href=\"http://ipm.ucanr.edu/PMG/PESTNOTES/pn7455.html\">how you can keep kissing bugs out of your house\u003c/a> from the UC Integrated Pest Management Program.\u003c/p>\n\u003cp>Entomologists at Texas A&M University have put together a website with photos of kissing bugs and a \u003ca href=\"https://kissingbug.tamu.edu/\">map showing where they live in the U.S.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Testing for Chagas disease\u003c/strong>\u003c/p>\n\u003cp>Most people with Chagas became infected with the parasite in rural areas of Mexico, Central America and South America. The disease is regularly transmitted in \u003ca href=\"http://www.infochagas.org/en/en-que-paises-hay-chagas\">21 countries\u003c/a>, among them Guatemala, El Salvador, Honduras, Nicaragua, Colombia, Venezuela, Bolivia, Argentina, Paraguay and Brazil. Transmission doesn’t occur in the Caribbean.\u003c/p>\n\u003cp>In the U.S., where kissing bugs very rarely transmit Chagas, researchers estimate that some 350,000 Latin American immigrants contracted the parasite in their home countries.\u003c/p>\n\u003cp>A blood test can find the parasite and two medications, nifurtimox and benznidazole, can often kill it.\u003c/p>\n\u003cp>“Any immigrants from Latin America should probably be tested at least once,” said Dr. Caryn Bern, who studies Chagas at UCSF. She said that any health care provider can order a screening test through their usual lab system.\u003c/p>\n\u003cp>Since pregnant women can pass the parasite onto their babies, women from Latin America or whose own mothers grew up there should get tested. Bern recommended that women test before they become pregnant because these medications can’t be taken during pregnancy.\u003c/p>\n\u003cp>Starting in 2007, nearly all blood banks in the U.S. started \u003ca href=\"https://www.cdc.gov/parasites/chagas/gen_info/screening.html\">screening blood donations\u003c/a> for the parasite.\u003c/p>\n\u003cp>The \u003ca href=\"https://chagasus.org/\">Center of Excellence for Chagas Disease at the Olive View-UCLA Medical Center\u003c/a> in Sylmar, near Los Angeles, has additional guidelines on \u003ca href=\"https://chagasus.org/do-i-have-chagas/\">who should be tested for the parasite\u003c/a> and offers care.\u003c/p>\n\u003cp>The Pan American Health Organization has information on \u003ca href=\"https://www.paho.org/en/topics/chagas-disease\">the disease in Latin America\u003c/a>.\u003c/p>\n\u003cp>The U.S. Centers for Disease Control and Prevention (CDC) has information on \u003ca href=\"https://www.cdc.gov/parasites/chagas/index.html\">Chagas disease in the U.S. \u003c/a>\u003c/p>\n\u003cp>Here’s a list of \u003ca href=\"https://uschagasnetwork.org/providers\">doctors around the U.S. who have experience treating Chagas.\u003c/a>\u003c/p>\n\u003cp>And \u003cstrong>for health care providers\u003c/strong> – and anyone else – who would like to learn more, the CDC offers \u003ca href=\"https://www.cdc.gov/parasites/cme/chagas/course1.html\">an online course.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Health care providers with questions\u003c/strong> can contact the CDC for consultation on all aspects of Chagas disease: Division of Parasitic Diseases Public Inquiries line, 404-718-4745; for emergencies after business hours, 770-488-7100; email parasites@cdc.gov.\u003c/p>\n\u003cp>\u003cstrong>Mal de Chagas\u003c/strong>\u003c/p>\n\u003cp>La Organización Panamericana de la Salud creó un video de dos minutos en español sobre \u003ca href=\"https://youtu.be/KmKoQFMICoU\">cómo se propaga el mal de Chagas en Latinoamérica\u003c/a>. Y también tiene \u003ca href=\"https://www.paho.org/es/temas/enfermedad-chagas\">información sobre la enfermedad. \u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Kissing bug bites can cause anaphylaxis\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>A recent University of Arizona study in Tucson and Bisbee, where kissing bugs commonly enter homes in the summer, found that \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/31295438/\">10% of people who had been bitten by the bugs had developed anaphylaxis\u003c/a>, a severe allergic reaction brought on by proteins in the bugs’ saliva. Symptoms include difficulty breathing, which can cause death if the patient isn’t treated right away with medication.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Every kissing bug needs several huge meals during the year or two it lives.\u003c/p>\n\u003cp>As it gulps, its exoskeleton stretches like a balloon, to fit up to 12 times its weight in blood. This pliability is called plasticization. How it started. How it’s going.\u003c/p>\n\u003cp>All that hot liquid could stress an insect’s body and stunt its growth. So the kissing bug cools it down – inside its head. Your warm blood flows in. The cool insect blood, called hemolymph, absorbs the heat and releases it through the top of the bug’s long head.\u003c/p>\n\u003cp>In this infrared video, you can see the blood cool down by more than 10 degrees Fahrenheit before it reaches the bug’s abdomen.\u003c/p>\n\u003cp>So the bug is safe. You, on the other hand, are not.\u003c/p>\n\u003cp>It injects saliva as it sucks your blood.\u003c/p>\n\u003cp>Here’s a scientist squeezing some out. The saliva has proteins that can give people a deadly allergic reaction called anaphylaxis.\u003c/p>\n\u003cp>And it gets much, much worse.\u003c/p>\n\u003cp>OK. This is super gross. After eating – sometimes while it’s eating – the bug poops. And that poop – and urine – might contain the parasite that causes Chagas disease. If the bug’s victim rubs these feces and urine into the bite wound or their eyes, the parasite can infect them. Years later, as many as one third of the people who got the parasite develop heart disease that can kill them, sometimes suddenly. Pregnant women can even pass the parasite onto their babies.\u003c/p>\n\u003cp>Few contract the parasite in the U.S., even though kissing bugs live here.\u003c/p>\n\u003cp>But in Latin America, millions of people have become infected. There, kissing bugs are known by many different names: chinche besucona … chinche … pito … vinchuca … barbeiro. In rural areas, these kissing bug species live in people’s homes, in the cracks of the walls. And in animal coops. Spraying has helped bring down infections. But hundreds of thousands of people have left their home countries for the U.S., not knowing the bug gave them the parasite. A simple blood test can find it and medications can often kill it.\u003c/p>\n\u003cp>In the American Southwest, the bugs live in the nests of wild animals, like this pack rat den in Arizona, where biologists Anita and Chuck Kristensen collect them.\u003c/p>\n\u003cp>Chuck Kristensen (off camera): Kissing bug, kissing bug! Genuine kissing bug.\u003c/p>\n\u003cp>For the most part, they feed on the pack rats. But in late spring and summer, the bugs sometimes travel from these nests into someone’s home.\u003c/p>\n\u003cp>So sealing off your house, with screens on your windows – and even vents – is one way to keep out these stealthy bloodsuckers.\u003c/p>\n\u003ch3>\u003cstrong>ADDITIONAL RESOURCES\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>Kissing bugs in the US\u003c/strong>\u003c/p>\n\u003cp>In California, kissing bugs – also known as conenose bugs – are most prevalent in the foothill areas surrounding the Central Valley and in the foothills and desert areas of Southern California. Find out \u003ca href=\"http://ipm.ucanr.edu/PMG/PESTNOTES/pn7455.html\">how you can keep kissing bugs out of your house\u003c/a> from the UC Integrated Pest Management Program.\u003c/p>\n\u003cp>Entomologists at Texas A&M University have put together a website with photos of kissing bugs and a \u003ca href=\"https://kissingbug.tamu.edu/\">map showing where they live in the U.S.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Testing for Chagas disease\u003c/strong>\u003c/p>\n\u003cp>Most people with Chagas became infected with the parasite in rural areas of Mexico, Central America and South America. The disease is regularly transmitted in \u003ca href=\"http://www.infochagas.org/en/en-que-paises-hay-chagas\">21 countries\u003c/a>, among them Guatemala, El Salvador, Honduras, Nicaragua, Colombia, Venezuela, Bolivia, Argentina, Paraguay and Brazil. Transmission doesn’t occur in the Caribbean.\u003c/p>\n\u003cp>In the U.S., where kissing bugs very rarely transmit Chagas, researchers estimate that some 350,000 Latin American immigrants contracted the parasite in their home countries.\u003c/p>\n\u003cp>A blood test can find the parasite and two medications, nifurtimox and benznidazole, can often kill it.\u003c/p>\n\u003cp>“Any immigrants from Latin America should probably be tested at least once,” said Dr. Caryn Bern, who studies Chagas at UCSF. She said that any health care provider can order a screening test through their usual lab system.\u003c/p>\n\u003cp>Since pregnant women can pass the parasite onto their babies, women from Latin America or whose own mothers grew up there should get tested. Bern recommended that women test before they become pregnant because these medications can’t be taken during pregnancy.\u003c/p>\n\u003cp>Starting in 2007, nearly all blood banks in the U.S. started \u003ca href=\"https://www.cdc.gov/parasites/chagas/gen_info/screening.html\">screening blood donations\u003c/a> for the parasite.\u003c/p>\n\u003cp>The \u003ca href=\"https://chagasus.org/\">Center of Excellence for Chagas Disease at the Olive View-UCLA Medical Center\u003c/a> in Sylmar, near Los Angeles, has additional guidelines on \u003ca href=\"https://chagasus.org/do-i-have-chagas/\">who should be tested for the parasite\u003c/a> and offers care.\u003c/p>\n\u003cp>The Pan American Health Organization has information on \u003ca href=\"https://www.paho.org/en/topics/chagas-disease\">the disease in Latin America\u003c/a>.\u003c/p>\n\u003cp>The U.S. Centers for Disease Control and Prevention (CDC) has information on \u003ca href=\"https://www.cdc.gov/parasites/chagas/index.html\">Chagas disease in the U.S. \u003c/a>\u003c/p>\n\u003cp>Here’s a list of \u003ca href=\"https://uschagasnetwork.org/providers\">doctors around the U.S. who have experience treating Chagas.\u003c/a>\u003c/p>\n\u003cp>And \u003cstrong>for health care providers\u003c/strong> – and anyone else – who would like to learn more, the CDC offers \u003ca href=\"https://www.cdc.gov/parasites/cme/chagas/course1.html\">an online course.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Health care providers with questions\u003c/strong> can contact the CDC for consultation on all aspects of Chagas disease: Division of Parasitic Diseases Public Inquiries line, 404-718-4745; for emergencies after business hours, 770-488-7100; email parasites@cdc.gov.\u003c/p>\n\u003cp>\u003cstrong>Mal de Chagas\u003c/strong>\u003c/p>\n\u003cp>La Organización Panamericana de la Salud creó un video de dos minutos en español sobre \u003ca href=\"https://youtu.be/KmKoQFMICoU\">cómo se propaga el mal de Chagas en Latinoamérica\u003c/a>. Y también tiene \u003ca href=\"https://www.paho.org/es/temas/enfermedad-chagas\">información sobre la enfermedad. \u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Kissing bug bites can cause anaphylaxis\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"headTitle": "Climate Change Is Here. It’s Bad. Here’s What You Can Do | KQED",
"content": "\u003cp>\u003cstrong>\u003cem>Submit a Bay Area climate change question for KQED’s science reporters at the \u003ca href=\"#question\">bottom of this post\u003c/a>. \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>It’s getting hotter. It’s getting smokier. It’s getting scarier.\u003c/p>\n\u003cp>California’s extreme droughts, heat waves and wildfires \u003ca href=\"https://www.ipcc.ch/report/ar6/wg1/downloads/factsheets/IPCC_AR6_WGI_Regional_Fact_Sheet_North_and_Central_America.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">will likely worsen\u003c/a> in the coming decades and longer if we don’t get our act together.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.nytimes.com/2021/06/07/climate/climate-change-emissions.html\" target=\"_blank\" rel=\"noopener noreferrer\">concentration of carbon dioxide in the atmosphere\u003c/a> is greater than any time in at least the past \u003ca href=\"https://www.science.org/doi/10.1126/sciadv.aav7337\" target=\"_blank\" rel=\"noopener noreferrer\">three million years\u003c/a>, and the world has already warmed 2 degrees Fahrenheit (1.1 degrees Celsius) since the 1800s.\u003c/p>\n\u003cfigure id=\"attachment_1977323\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977323 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-1020x574.jpg\" alt=\"A graph shows a red line steadily increasing from the year 1880 to 2019, from around 290 parts per million of carbon dioxide to 410. A jagged black line goes up and down but follows the overall trend of the red line, showing an increase in temperature of about 1.1 degree Celsius.\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-768x432.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-1536x864.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">As carbon dioxide concentrations increase in the atmosphere, the temperature does as well. \u003ccite>(Image courtesy Climate Central)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>People of color are and will be \u003ca href=\"https://www.epa.gov/newsreleases/epa-report-shows-disproportionate-impacts-climate-change-socially-vulnerable\" target=\"_blank\" rel=\"noopener noreferrer\">disproportionately affected by the health and environmental impacts of climate change\u003c/a>, according to the U.S. Environmental Protection Agency.\u003c/p>\n\u003cp>Taking all this in is overwhelming. But here’s something that makes it easier: there is still time to act.\u003c/p>\n\u003cp>Rapid, bold emissions reductions, starting now, \u003ca href=\"https://www.ipcc.ch/2021/08/09/ar6-wg1-20210809-pr/\" target=\"_blank\" rel=\"noopener noreferrer\">would limit climate change \u003c/a>and its effects.\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-1977324 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-1020x574.jpg\" alt=\"A graph shows temperature warming from 1950 to today, with two diverging lines after that. An orange line depicts temperature rise if there are no cuts to current emissions, showing an average increase in temperature of 4 degrees Celsius. A blue line shows what would happen with substantial cuts in emissions, demonstrating warming would level off around 1.5 degrees Celsius.\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-768x432.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-1536x864.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003c/p>\n\u003cp>We decide what future we get. The one that will be recognizable to us, with limited warming, would require coordination across communities, states and countries.\u003c/p>\n\u003cp>While limiting warming to 2.7 degrees Fahrenheit (1.5 degrees Celsius) would be “very difficult, requiring immediate, top-level government attention and effort,” said Michael Oppenheimer, a Princeton environmental scientist and editor of the Intergovernmental Panel on Climate Change review, it’s “not impossible.”\u003c/p>\n\u003cp>Even if we don’t meet those goals, Oppenheimer said, “there’s no end-of-the-world point where you give up.” Every tenth of a degree matters.\u003c/p>\n\u003cp>That’s where you come in. Climate scientists made it crystal clear in the U.N.’s \u003ca href=\"https://www.ipcc.ch/2021/08/09/ar6-wg1-20210809-pr/\" target=\"_blank\" rel=\"noopener noreferrer\">most recent report\u003c/a> that warming is a “code red for humanity,” according to U.N. Secretary-General António Guterres.\u003c/p>\n\u003cp>This piece is for those who want to respond, but don’t know where to begin.\u003c/p>\n\u003ch3>\u003cstrong>All of us\u003c/strong>\u003c/h3>\n\u003cp>Maybe you think we’re in two camps here in California: those who believe in climate change and those who don’t. But researchers define us with more nuance.\u003c/p>\n\u003cp>The \u003ca href=\"https://climatecommunication.yale.edu/about/projects/global-warmings-six-americas/\" target=\"_blank\" rel=\"noopener noreferrer\">Yale Program on Climate Change Communication\u003c/a> divides Americans into six groups: from those deeply concerned about global warming and supportive of policies (“Alarmed”), to those who view it as a hoax (“Dismissive”).\u003c/p>\n\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_1977322\" class=\"wp-caption aligncenter\" style=\"max-width: 644px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977322 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/6-Americas-Cartoons-Slide-1-e1459619373734.png\" alt=\"\" width=\"644\" height=\"401\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/6-Americas-Cartoons-Slide-1-e1459619373734.png 644w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/6-Americas-Cartoons-Slide-1-e1459619373734-160x100.png 160w\" sizes=\"(max-width: 644px) 100vw, 644px\" />\u003cfigcaption class=\"wp-caption-text\">The Yale Program on Climate Change Communication divides Americans into six groups in terms of their perceptions of global warming. \u003ccite>(Artwork by Michael Sloan)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"https://climatecommunication.yale.edu/about/projects/global-warmings-six-americas/\" target=\"_blank\" rel=\"noopener noreferrer\">More than half of people in the U.S.\u003c/a> fall into the “Alarmed” or “Concerned” categories. This means they’re engaged in this issue and ready to act.\u003c/p>\n\u003cp>Most of these folks don’t know what to do with that worry, though, or how to take meaningful action on climate.\u003c/p>\n\u003ch3>\u003cstrong>Let’s feel some feelings\u003c/strong>\u003c/h3>\n\u003cp>Longtime Bay Area residents will recall a time when the weather didn’t \u003ca href=\"https://www.kqed.org/news/11893922/california-still-deep-in-drought-despite-stormy-weather-capped-by-atmospheric-river\" target=\"_blank\" rel=\"noopener noreferrer\">whiplash from bone dry to flooded streets\u003c/a>, when skies choked with wildfire smoke were anomalous and average fall temperatures were cooler (\u003ca href=\"https://www.climatecentral.org/graphic/fastest-warming-seasons-2022?location=San%20Francisco&graphicSet=Seasonal+Warming\" target=\"_blank\" rel=\"noopener noreferrer\">by 3 degrees Fahrenheit in San Francisco\u003c/a>, to be precise). If you’re a recent Bay Area transplant, I imagine you can think of similar changes wherever you hail from.\u003c/p>\n\u003cp>Facing the climate crisis means grieving the version of the planet we grew up with. That means sitting with painful emotions.\u003c/p>\n\u003cp>The sadness, despair, anger and powerlessness are normal, healthy responses to a serious risk.\u003c/p>\n\u003cp>“We are biologically wired to respond with anxiety to real threats,” said Robin Cooper, a San Francisco-based therapist and founder of the \u003ca href=\"https://www.climatepsychiatry.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Climate Psychiatry Alliance.\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_1977352\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977352 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-1020x674.jpg\" alt=\"\" width=\"640\" height=\"423\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-1020x674.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-800x528.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-768x507.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-1536x1014.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">A woman sits among a group of dead trees at an installation by artist Maya Lin, titled “Ghost Forest,” in Madison Square Park, New York, on May 14, 2021. Maya Lin installed 49 dead Atlantic white cedar trees in a park in New York City to warn of climate change. \u003ccite>(TIMOTHY A. CLARY/AFP)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Resisting these feelings is normal too — it’s a means of protecting ourselves. But burying our heads in the sand ultimately leads to the same outcomes as denying the crisis. Take breaks, but face what is happening. At some point it becomes easier to look at the issue than hide from it.\u003c/p>\n\u003cp>Finally, let yourself feel things. There are losses we cannot reverse. There will be more.\u003c/p>\n\u003cp>Feeling the hard emotions lets you move through them and forward. That doesn’t mean you’re free of them — you aren’t, but pushing them down won’t help you move into action.\u003c/p>\n\u003cp>Here are some ways to process your emotions, since a lot of us are out of practice:\u003c/p>\n\u003col>\n\u003cli>\u003cb>Connect with people. \u003c/b>Talk informally with family or friends, or more formally with a therapist (there are growing networks of \u003ca href=\"https://www.climatepsychiatry.org/climate-aware-therapist\" target=\"_blank\" rel=\"noopener noreferrer\">psychiatrists\u003c/a> and \u003ca href=\"https://www.climatepsychology.us/climate-therapists\" target=\"_blank\" rel=\"noopener noreferrer\">psychologists\u003c/a> with specific training on climate change), or \u003ca href=\"https://www.goodgriefnetwork.org/\">grief\u003c/a> \u003ca href=\"https://www.goodgriefnetwork.org/\">groups\u003c/a>.\u003c/li>\n\u003cli>\u003cstrong>Connect with your body \u003c/strong>through walking, running, yoga, or any exercise you enjoy.\u003c/li>\n\u003cli>\u003cstrong>Connect with nature. \u003c/strong>Environmental psychologist Renee Lertzman said getting out in nature is both calming and “reminds me of why we’re doing this. I’m continually amazed by how incredible life is.”\u003c/li>\n\u003c/ol>\n\u003cp>There are plenty of other \u003ca href=\"https://www.npr.org/sections/health-shots/2020/04/22/808853706/this-earth-day-is-like-no-other-heres-how-to-grieve-and-stay-engaged\" target=\"_blank\" rel=\"noopener noreferrer\">articles\u003c/a>, books, and \u003ca href=\"https://www.kqed.org/forum/2010101885372/climate-anxiety-and-how-it-can-lead-to-hopefulness\" target=\"_blank\" rel=\"noopener noreferrer\">podcasts\u003c/a> about processing these heavy emotions, too.\u003c/p>\n\u003ch3>\u003cstrong>Imagine the future you want\u003c/strong>\u003c/h3>\n\u003cp>It’s inspiring to envision a Bay Area less dependent on fossil fuels, with cleaner air, more predictable weather cycles, and a booming green jobs industry.\u003c/p>\n\u003cp>Air pollution from fossil fuels affects low-income communities and communities of color far more than others, in places close to freeways and industry, like East and West Oakland.\u003c/p>\n\u003cp>Studies from Oxfam show the poorest 50% of Americans are responsible for far less carbon pollution \u003ca class=\"c-link\" href=\"https://policy-practice.oxfam.org/resources/extreme-carbon-inequality-why-the-paris-climate-deal-must-put-the-poorest-lowes-582545/\" target=\"_blank\" rel=\"noopener noreferrer\" data-stringify-link=\"https://policy-practice.oxfam.org/resources/extreme-carbon-inequality-why-the-paris-climate-deal-must-put-the-poorest-lowes-582545/\" data-sk=\"tooltip_parent\">than the average American — about half.\u003c/a> Cleaning up our climate is an act of equity.\u003c/p>\n\u003cp>Cutting down fossil fuels would save lives. California’s air regulator estimated that \u003ca href=\"https://ww2.arb.ca.gov/resources/health-air-pollution\" target=\"_blank\" rel=\"noopener noreferrer\">we see 7,200 premature deaths each year from air pollution\u003c/a>, particularly from pollution related to diesel exhaust.\u003c/p>\n\u003cp>Globally, air pollution from burning fossil fuels is \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0013935121000487\" target=\"_blank\" rel=\"noopener noreferrer\">responsible for 8.7 million deaths annually,\u003c/a> shaking out to more than a tenth of U.S. deaths (deaths from COVID-19 stand at \u003ca href=\"https://coronavirus.jhu.edu/map.html\" target=\"_blank\" rel=\"noopener noreferrer\">nearly 5 million people\u003c/a> globally since the start of the pandemic).\u003c/p>\n\u003cp>The average life expectancy would increase by \u003ca href=\"https://academic.oup.com/cardiovascres/article/116/11/1910/5770885#207231589\" target=\"_blank\" rel=\"noopener noreferrer\">more than a year\u003c/a> across a world without fossil fuel emissions.\u003c/p>\n\u003cp>Switching out gas appliances like stoves for electric ones significantly \u003ca href=\"https://www.vox.com/energy-and-environment/2020/5/7/21247602/gas-stove-cooking-indoor-air-pollution-health-risks\" target=\"_blank\" rel=\"noopener noreferrer\">improves indoor air quality\u003c/a>, which could lead to lower risk for cardiovascular disease in adults and asthma in children.\u003c/p>\n\u003cp>As many of us experienced during the pandemic, converting streets into places for communities to gather brought a lot of joy, with “slow streets” and increased outdoor dining. San Francisco voters decided\u003ca href=\"https://www.sfchronicle.com/election/article/JFK-Drive-will-remain-car-free-after-S-F-voters-17570182.php\" target=\"_blank\" rel=\"noopener\"> to make some of these car-free streets permanent\u003c/a>. Should our cities build out a more walkable and bikeable infrastructure, this could be our norm.\u003c/p>\n\u003cfigure id=\"attachment_1977345\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977345 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">A man walks with his two kids along a street during the San Francisco Bike & Roll to School Day in 2018. \u003ccite>(San Francisco Bicycle Coalition)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Climate action could be a boon for green jobs, like those installing solar panels and restoring wetlands.\u003c/p>\n\u003cp>And climate progress could significantly impact our mental health. That’s because the antidote to climate anxiety is action.\u003c/p>\n\u003ch3>Act\u003c/h3>\n\u003cp>You do not need to become anything you are not to take action on climate change. The issue is big, and the good part about that is there are endless ways to plug in.\u003c/p>\n\u003cp>Climate scientist Kim Nicholas says consider where you spend most of your time and where you get the most energy right now. Start there. Ask yourself, “how is it that we as a family, as a business, [or] as a neighborhood, are impacting the climate? What is it that we can do?”\u003c/p>\n\u003cp>While climate activists debate whether to push people to organize for systemic change or focus on individual actuals, they tend to agree that both are needed. Systems need transforming and the largest reductions in emissions will be found there. But individual changes — especially in rich countries like the U.S. — are important, too.\u003c/p>\n\u003ch3>Action at the systems level\u003c/h3>\n\u003cp>\u003cstrong>Find a group that works for you:\u003c/strong> Climate journalist and organizer Bill McKibben says the most powerful thing an individual can do is \u003ca href=\"https://climate-xchange.org/2020/09/16/be-a-little-less-of-an-individual-author-and-activist-bill-mckibben/\" target=\"_blank\" rel=\"noopener noreferrer\">be less of an individual.\u003c/a> Your voice will be more powerful with others, and it’s more fun and hopeful to tackle this challenge together. There’s no shortage of groups of people concerned about the climate and taking meaningful action.\u003c/p>\n\u003cp>There are groups for \u003ca href=\"https://protectourwinters.org/\" target=\"_blank\" rel=\"noopener noreferrer\">skiers\u003c/a>, \u003ca href=\"https://envirn.org/\" target=\"_blank\" rel=\"noopener noreferrer\">nurses\u003c/a>, \u003ca href=\"https://artistsandclimatechange.com/\" target=\"_blank\" rel=\"noopener noreferrer\">artists\u003c/a>, \u003ca href=\"https://republicen.org/\" target=\"_blank\" rel=\"noopener noreferrer\">political conservatives\u003c/a>, \u003ca href=\"https://www.eldersclimateaction.org/\" target=\"_blank\" rel=\"noopener noreferrer\">grandmothers\u003c/a>, \u003ca href=\"https://www.conservationhawks.org/\" target=\"_blank\" rel=\"noopener noreferrer\">hunters\u003c/a>, and \u003ca href=\"https://climateandsecurity.org/\" target=\"_blank\" rel=\"noopener noreferrer\">people concerned with national security\u003c/a>. See the range? Groups such as these can help guide you to advocate for more change at the systems level.\u003c/p>\n\u003cfigure id=\"attachment_1977351\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977351 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-1020x647.jpg\" alt=\"\" width=\"640\" height=\"406\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-1020x647.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-800x507.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-160x101.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-768x487.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-1536x974.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">Children paint waves on paper as they take part in an event to make art for the youth climate strike on September 20, 2019. \u003ccite>(JOHANNES EISELE/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Vote for climate candidates: \u003c/strong>The rapid policy reform needed to address the climate crisis requires politicians to enact bolder, faster changes.\u003c/p>\n\u003cp>\u003ca href=\"https://onlinelibrary.wiley.com/doi/10.1111/socf.12422\" target=\"_blank\" rel=\"noopener noreferrer\">Research\u003c/a> shows electing representatives that ranked high on the \u003ca href=\"https://scorecard.lcv.org/\" target=\"_blank\" rel=\"noopener noreferrer\">League of Conservation Voters National Environmental Scorecard\u003c/a> significantly reduced a state’s carbon dioxide emissions.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0176268017304500\" target=\"_blank\" rel=\"noopener noreferrer\">Voting female politicians into office\u003c/a> is linked with stronger climate policies and lower emissions, and could be an underutilized tool.\u003c/p>\n\u003cp>\u003cstrong>Contact your representatives: \u003c/strong>Call your local, state or federal representative to share your concerns. Sure, there are other ways to get in touch too, like email and snail mail, but activists and lawmakers say the best way to grab a staffer’s attention is to call and not email, \u003ca href=\"https://www.nytimes.com/2016/11/22/us/politics/heres-why-you-should-call-not-email-your-legislators.html\" target=\"_blank\" rel=\"noopener noreferrer\">The New York Times reports\u003c/a>.\u003c/p>\n\u003cp>If your representatives already share your beliefs, thank them for their efforts and ask them to move further or faster.\u003c/p>\n\u003ch3>Action at the individual level\u003c/h3>\n\u003cp>While the numbers show that minimizing your carbon footprint won’t get us where we need to go on greenhouse gas reductions alone, “If you live in a rich country, and especially the richer you are, your individual actions really matter,” sustainability scientist Kimberly Nicholas writes in her book “\u003ca href=\"https://www.penguinrandomhouse.com/books/665274/under-the-sky-we-make-by-kimberly-nicholas-phd/\" target=\"_blank\" rel=\"noopener noreferrer\">Under the Sky We Make.”\u003c/a>\u003c/p>\n\u003cp>Personal climate actions like skipping drives and flights matter in both reducing carbon, and in changing the perception of a wealthy American ideal — using excessive carbon — that’s quickly getting exported.\u003c/p>\n\u003cp>When changes become a social norm, it becomes more attractive for politicians and companies to take action. Research shows\u003ca href=\"https://www.science.org/doi/abs/10.1126/science.aas8827\" target=\"_blank\" rel=\"noopener noreferrer\"> just 25% of a population is needed to create a norm change\u003c/a>.\u003c/p>\n\u003cp>Our suggestions reflect actions shown to have the biggest impact, so you can spend your limited time and brain capacity judiciously, though there are plenty of other worthwhile things to do.\u003c/p>\n\u003cp>\u003cstrong>Talk about climate change:\u003c/strong> While the majority of Americans are worried about climate change, most people don’t talk about it, even if they’d like to, says Anthony Leiserowitz, director of Yale’s climate communication program. He says by avoiding talking about the topic, we fail to signal how much it matters to us.\u003c/p>\n\u003cp>Climate scientist Katharine Hayhoe has had thousands of conversations about climate change. She recommends a helpful formula for your discussion: start with what you both care about (like your kids, the beach, birds, etc.), connect that passion with climate change (climate change affects everything, so luckily that’s not hard), and then discuss what’s at stake for what you love, and some solutions that are at work locally.\u003c/p>\n\u003cp>You can also talk about what you’re doing about climate change (no self-righteousness please though, that won’t help your cause). Lots of folks are changing their behavior based on the climate crisis, and sharing that could contribute to societal shifts. There are \u003ca href=\"https://brightaction.app/\" target=\"_blank\" rel=\"noopener noreferrer\">tools to help\u003c/a> your community, company, or place of worship collaborate, or even compete with one another.\u003c/p>\n\u003cp>Yale’s climate change communication program has tips on \u003ca href=\"https://climatecommunication.yale.edu/news-events/attaining-meaningful-outcomes-from-conversations-on-climate/\" target=\"_blank\" rel=\"noopener noreferrer\">how to achieve meaningful conversation outcomes\u003c/a>, and you can hear how conversations between a son and his Republican U.S. representative father converted the latter into a \u003ca href=\"https://gimletmedia.com/shows/howtosaveaplanet/j4hk928/trying-to-talk-to-family-about-climate\" target=\"_blank\" rel=\"noopener noreferrer\">conservative climate champion\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Drive less: \u003c/strong>The majority of California’s greenhouse gas emissions \u003ca href=\"https://ww3.arb.ca.gov/cc/inventory/pubs/reports/2000_2019/ghg_inventory_trends_00-19.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">come from transportation\u003c/a>, and for the average U.S. household, gasoline for personal cars \u003ca href=\"https://pubs.acs.org/doi/10.1021/es102221h\" target=\"_blank\" rel=\"noopener noreferrer\">is the the biggest source of emissions\u003c/a>.\u003c/p>\n\u003cp>Most emissions come from long car trips.\u003c/p>\n\u003cfigure id=\"attachment_1977321\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977321 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-1020x573.png\" alt=\"The largest sector is transportation, followed by industrial, electricity, commercial & residential, agriculture, high GWP, and recycling & waste\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-1020x573.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-800x450.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-160x90.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-768x432.png 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-1536x863.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-2048x1151.png 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-1920x1079.png 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">2019 greenhouse gas emissions in California, broken down into sector and subsector. \u003ccite>(Courtesy California Air Resources Board)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Reducing travel in gas cars is one of the biggest things you can do, but can be challenging depending where you live. (This is one place where changing the system comes into play — working for better bus, train, biking and walking routes would make our cities and towns more friendly to ditching cars.)\u003c/p>\n\u003cp>Regardless, reductions in emissions from car trips help, whether that means having no car, taking public transit more, or switching to an electric or hybrid vehicle.\u003c/p>\n\u003cp>Plus, there are plenty of physical and mental benefits to other, familiar options like walking and biking.\u003c/p>\n\u003cp>\u003cstrong>Fly less: \u003c/strong>Only 1% of people cause \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0959378020307779\" target=\"_blank\" rel=\"noopener noreferrer\">half of the emissions from air travel\u003c/a>. While carbon dioxide emissions from flights are roughly \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S1352231020305689\" target=\"_blank\" rel=\"noopener noreferrer\">2.4% of total greenhouse gas emissions globally\u003c/a>, if you’re in that select group of people flying, and flying a lot, cutting down on flights will have an outsized impact on reducing carbon emissions.\u003c/p>\n\u003cp>Eliminate flights that aren’t essential, and if you’re a frequent flyer, set a goal to cut flights in half, or down to a few per year.\u003c/p>\n\u003cp>The shift away from air travel during the COVID-19 pandemic modeled what less flying can look like.\u003c/p>\n\u003cp>\u003cstrong> \u003c/strong>\u003cstrong>Eat a plant-based diet: \u003c/strong>Growing food for us and food to feed animals (that become food for us), plus deforestation (primarily to grow food) accounts for roughly \u003ca href=\"https://www.epa.gov/ghgemissions/global-greenhouse-gas-emissions-data\" target=\"_blank\" rel=\"noopener noreferrer\">24% of global emissions\u003c/a>. Methane comes from cow, sheep, and goat burps and their manure, and nitrous oxide from using fertilizers. Some carbon dioxide is also released from plowing and razing forests. Globally, deforestation is also \u003ca href=\"https://ipbes.net/sites/default/files/2020-02/ipbes_global_assessment_report_summary_for_policymakers_en.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">the main driver of the biodiversity crisis.\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_1977346\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977346 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/RS52166_2543-qut-1020x681.jpg\" alt=\"Four men smile and inspect lettuce in a greenhouse\" width=\"640\" height=\"427\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">A team of veterans inspects organic produce on their farm in San Jose. The Farmer Veteran Coalition is a national nonprofit non-governmental organization in the United States that mobilizes veterans to feed America and transition from military service to a career in agriculture. \u003ccite>(Meg Haywood Sullivan/Climate Visuals Countdown)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Beef is more resource intensive than other foods. Producing it requires\u003ca href=\"https://josephpoore.com/Science%20360%206392%20987%20-%20Accepted%20Manuscript.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"> 22 times more land and emits 62 times more greenhouse gases\u003c/a> per gram of protein than plant proteins like beans.\u003c/p>\n\u003cp>For meat eaters worldwide, cutting back to 1.5 burgers a week would nearly eliminate the need for agricultural expansion, \u003ca href=\"https://www.wri.org/insights/how-sustainably-feed-10-billion-people-2050-21-charts\" target=\"_blank\" rel=\"noopener noreferrer\">even with a global population of 10 billion.\u003c/a>\u003c/p>\n\u003cp>The average American \u003ca href=\"https://www.wri.org/insights/how-sustainably-feed-10-billion-people-2050-21-charts\" target=\"_blank\" rel=\"noopener noreferrer\">eats three burgers a week.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Green your home: \u003c/strong>Energy we use in our homes is the \u003ca href=\"https://pubs.acs.org/doi/10.1021/es102221h\" target=\"_blank\" rel=\"noopener noreferrer\">second-biggest source of emissions for the average American\u003c/a>. You can change that by installing solar panels and efficient windows, and improving insulation. And when some of the biggest home energy hogs need replacement, choose a more efficient alternative: swap your natural gas furnace and water heater for electric heat pumps, replace your gas stove with an induction one.\u003c/p>\n\u003cp>Many of these changes aren’t achievable as a renter, but you can \u003ca href=\"https://www.energy.gov/energysaver/tips-renters-and-rental-property-owners\" target=\"_blank\" rel=\"noopener noreferrer\">bring this up with your property owner\u003c/a>, and depending on where you are, there are \u003ca href=\"https://www.csd.ca.gov/Pages/Low-Income-Weatherization-Program.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">programs\u003c/a> that help with incentives.\u003c/p>\n\u003cp>\u003cstrong>Your climate Venn diagram: \u003c/strong>In the podcast “How to Save a Planet,” host and marine biologist \u003ca href=\"https://www.ayanaelizabeth.com/bio\" target=\"_blank\" rel=\"noopener noreferrer\">Ayana Elizabeth Johnson\u003c/a> suggests one way to find your space in climate action: a Venn diagram.\u003c/p>\n\u003cp>Get out your paper.\u003c/p>\n\u003cfigure id=\"attachment_1977319\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977319 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/Square-1020x1020.png\" alt=\"A Venn diagram with three circles: one says "what brings you joy?", another says "What are you good at?" and the third says "What is the work that needs doing?" The convergence of the circles reads "What you should do."\" width=\"640\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-1020x1020.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-800x800.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-160x160.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-768x768.png 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-1536x1536.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-2048x2048.png 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-1920x1920.png 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">Marine biologist Ayana Elizabeth Johnson has created this Venn diagram to help people find their place in climate action. \u003ccite>(Courtesy The All We Can Save Project)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>What are you good at? “What skills, resources, networks, reach, influence are you bringing to the table?” she asked.\u003c/p>\n\u003cp>What work needs doing? The crisis is so huge that there are many options.\u003c/p>\n\u003cp>What brings you joy? “What gets you out of bed in the morning? Because this is the work of our lifetime,” Johnson said.\u003c/p>\n\u003cp>Your job is to move forward on what you identify at the center of those circles.\u003c/p>\n\u003cp>\u003cstrong>Active hope: \u003c/strong>Hope for the climate is not about crossing your fingers and going about your daily routine.\u003c/p>\n\u003cp>It’s a practice, say climate activist Joanna Macy and psychologist Dr. Chris Johnstone in their book “Active Hope.” This kind of hope involves taking stock of our painful reality, identifying what changes you want to see, and beginning to make them.\u003c/p>\n\u003cp>Doing these things brings us closer to others doing the same. The hope and action beget more of the same.\u003c/p>\n\u003cp>Yes, climate change is here. Yes, it’s bad.\u003c/p>\n\u003cp>And there’s hope — contingent on all of us, acting.\u003cbr />\n\u003ca id=\"question\">\u003c/a>\u003c/p>\n\u003cp>[hearken src=\"https://modules.wearehearken.com/kqed/embed/8818.js\"]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>\u003cem>Submit a Bay Area climate change question for KQED’s science reporters at the \u003ca href=\"#question\">bottom of this post\u003c/a>. \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>It’s getting hotter. It’s getting smokier. It’s getting scarier.\u003c/p>\n\u003cp>California’s extreme droughts, heat waves and wildfires \u003ca href=\"https://www.ipcc.ch/report/ar6/wg1/downloads/factsheets/IPCC_AR6_WGI_Regional_Fact_Sheet_North_and_Central_America.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">will likely worsen\u003c/a> in the coming decades and longer if we don’t get our act together.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.nytimes.com/2021/06/07/climate/climate-change-emissions.html\" target=\"_blank\" rel=\"noopener noreferrer\">concentration of carbon dioxide in the atmosphere\u003c/a> is greater than any time in at least the past \u003ca href=\"https://www.science.org/doi/10.1126/sciadv.aav7337\" target=\"_blank\" rel=\"noopener noreferrer\">three million years\u003c/a>, and the world has already warmed 2 degrees Fahrenheit (1.1 degrees Celsius) since the 1800s.\u003c/p>\n\u003cfigure id=\"attachment_1977323\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977323 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-1020x574.jpg\" alt=\"A graph shows a red line steadily increasing from the year 1880 to 2019, from around 290 parts per million of carbon dioxide to 410. A jagged black line goes up and down but follows the overall trend of the red line, showing an increase in temperature of about 1.1 degree Celsius.\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-768x432.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1-1536x864.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2020Drawdown_TempCO2_en_title_lg-1.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">As carbon dioxide concentrations increase in the atmosphere, the temperature does as well. \u003ccite>(Image courtesy Climate Central)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>People of color are and will be \u003ca href=\"https://www.epa.gov/newsreleases/epa-report-shows-disproportionate-impacts-climate-change-socially-vulnerable\" target=\"_blank\" rel=\"noopener noreferrer\">disproportionately affected by the health and environmental impacts of climate change\u003c/a>, according to the U.S. Environmental Protection Agency.\u003c/p>\n\u003cp>Taking all this in is overwhelming. But here’s something that makes it easier: there is still time to act.\u003c/p>\n\u003cp>Rapid, bold emissions reductions, starting now, \u003ca href=\"https://www.ipcc.ch/2021/08/09/ar6-wg1-20210809-pr/\" target=\"_blank\" rel=\"noopener noreferrer\">would limit climate change \u003c/a>and its effects.\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-1977324 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-1020x574.jpg\" alt=\"A graph shows temperature warming from 1950 to today, with two diverging lines after that. An orange line depicts temperature rise if there are no cuts to current emissions, showing an average increase in temperature of 4 degrees Celsius. A blue line shows what would happen with substantial cuts in emissions, demonstrating warming would level off around 1.5 degrees Celsius.\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-768x432.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1-1536x864.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/2021IPCC_TempPathways_en_title_lg-1.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003c/p>\n\u003cp>We decide what future we get. The one that will be recognizable to us, with limited warming, would require coordination across communities, states and countries.\u003c/p>\n\u003cp>While limiting warming to 2.7 degrees Fahrenheit (1.5 degrees Celsius) would be “very difficult, requiring immediate, top-level government attention and effort,” said Michael Oppenheimer, a Princeton environmental scientist and editor of the Intergovernmental Panel on Climate Change review, it’s “not impossible.”\u003c/p>\n\u003cp>Even if we don’t meet those goals, Oppenheimer said, “there’s no end-of-the-world point where you give up.” Every tenth of a degree matters.\u003c/p>\n\u003cp>That’s where you come in. Climate scientists made it crystal clear in the U.N.’s \u003ca href=\"https://www.ipcc.ch/2021/08/09/ar6-wg1-20210809-pr/\" target=\"_blank\" rel=\"noopener noreferrer\">most recent report\u003c/a> that warming is a “code red for humanity,” according to U.N. Secretary-General António Guterres.\u003c/p>\n\u003cp>This piece is for those who want to respond, but don’t know where to begin.\u003c/p>\n\u003ch3>\u003cstrong>All of us\u003c/strong>\u003c/h3>\n\u003cp>Maybe you think we’re in two camps here in California: those who believe in climate change and those who don’t. But researchers define us with more nuance.\u003c/p>\n\u003cp>The \u003ca href=\"https://climatecommunication.yale.edu/about/projects/global-warmings-six-americas/\" target=\"_blank\" rel=\"noopener noreferrer\">Yale Program on Climate Change Communication\u003c/a> divides Americans into six groups: from those deeply concerned about global warming and supportive of policies (“Alarmed”), to those who view it as a hoax (“Dismissive”).\u003c/p>\n\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_1977322\" class=\"wp-caption aligncenter\" style=\"max-width: 644px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977322 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/6-Americas-Cartoons-Slide-1-e1459619373734.png\" alt=\"\" width=\"644\" height=\"401\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/6-Americas-Cartoons-Slide-1-e1459619373734.png 644w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/6-Americas-Cartoons-Slide-1-e1459619373734-160x100.png 160w\" sizes=\"(max-width: 644px) 100vw, 644px\" />\u003cfigcaption class=\"wp-caption-text\">The Yale Program on Climate Change Communication divides Americans into six groups in terms of their perceptions of global warming. \u003ccite>(Artwork by Michael Sloan)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"https://climatecommunication.yale.edu/about/projects/global-warmings-six-americas/\" target=\"_blank\" rel=\"noopener noreferrer\">More than half of people in the U.S.\u003c/a> fall into the “Alarmed” or “Concerned” categories. This means they’re engaged in this issue and ready to act.\u003c/p>\n\u003cp>Most of these folks don’t know what to do with that worry, though, or how to take meaningful action on climate.\u003c/p>\n\u003ch3>\u003cstrong>Let’s feel some feelings\u003c/strong>\u003c/h3>\n\u003cp>Longtime Bay Area residents will recall a time when the weather didn’t \u003ca href=\"https://www.kqed.org/news/11893922/california-still-deep-in-drought-despite-stormy-weather-capped-by-atmospheric-river\" target=\"_blank\" rel=\"noopener noreferrer\">whiplash from bone dry to flooded streets\u003c/a>, when skies choked with wildfire smoke were anomalous and average fall temperatures were cooler (\u003ca href=\"https://www.climatecentral.org/graphic/fastest-warming-seasons-2022?location=San%20Francisco&graphicSet=Seasonal+Warming\" target=\"_blank\" rel=\"noopener noreferrer\">by 3 degrees Fahrenheit in San Francisco\u003c/a>, to be precise). If you’re a recent Bay Area transplant, I imagine you can think of similar changes wherever you hail from.\u003c/p>\n\u003cp>Facing the climate crisis means grieving the version of the planet we grew up with. That means sitting with painful emotions.\u003c/p>\n\u003cp>The sadness, despair, anger and powerlessness are normal, healthy responses to a serious risk.\u003c/p>\n\u003cp>“We are biologically wired to respond with anxiety to real threats,” said Robin Cooper, a San Francisco-based therapist and founder of the \u003ca href=\"https://www.climatepsychiatry.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Climate Psychiatry Alliance.\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_1977352\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977352 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-1020x674.jpg\" alt=\"\" width=\"640\" height=\"423\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-1020x674.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-800x528.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-768x507.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut-1536x1014.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52176_GettyImages-1232894145-qut.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">A woman sits among a group of dead trees at an installation by artist Maya Lin, titled “Ghost Forest,” in Madison Square Park, New York, on May 14, 2021. Maya Lin installed 49 dead Atlantic white cedar trees in a park in New York City to warn of climate change. \u003ccite>(TIMOTHY A. CLARY/AFP)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Resisting these feelings is normal too — it’s a means of protecting ourselves. But burying our heads in the sand ultimately leads to the same outcomes as denying the crisis. Take breaks, but face what is happening. At some point it becomes easier to look at the issue than hide from it.\u003c/p>\n\u003cp>Finally, let yourself feel things. There are losses we cannot reverse. There will be more.\u003c/p>\n\u003cp>Feeling the hard emotions lets you move through them and forward. That doesn’t mean you’re free of them — you aren’t, but pushing them down won’t help you move into action.\u003c/p>\n\u003cp>Here are some ways to process your emotions, since a lot of us are out of practice:\u003c/p>\n\u003col>\n\u003cli>\u003cb>Connect with people. \u003c/b>Talk informally with family or friends, or more formally with a therapist (there are growing networks of \u003ca href=\"https://www.climatepsychiatry.org/climate-aware-therapist\" target=\"_blank\" rel=\"noopener noreferrer\">psychiatrists\u003c/a> and \u003ca href=\"https://www.climatepsychology.us/climate-therapists\" target=\"_blank\" rel=\"noopener noreferrer\">psychologists\u003c/a> with specific training on climate change), or \u003ca href=\"https://www.goodgriefnetwork.org/\">grief\u003c/a> \u003ca href=\"https://www.goodgriefnetwork.org/\">groups\u003c/a>.\u003c/li>\n\u003cli>\u003cstrong>Connect with your body \u003c/strong>through walking, running, yoga, or any exercise you enjoy.\u003c/li>\n\u003cli>\u003cstrong>Connect with nature. \u003c/strong>Environmental psychologist Renee Lertzman said getting out in nature is both calming and “reminds me of why we’re doing this. I’m continually amazed by how incredible life is.”\u003c/li>\n\u003c/ol>\n\u003cp>There are plenty of other \u003ca href=\"https://www.npr.org/sections/health-shots/2020/04/22/808853706/this-earth-day-is-like-no-other-heres-how-to-grieve-and-stay-engaged\" target=\"_blank\" rel=\"noopener noreferrer\">articles\u003c/a>, books, and \u003ca href=\"https://www.kqed.org/forum/2010101885372/climate-anxiety-and-how-it-can-lead-to-hopefulness\" target=\"_blank\" rel=\"noopener noreferrer\">podcasts\u003c/a> about processing these heavy emotions, too.\u003c/p>\n\u003ch3>\u003cstrong>Imagine the future you want\u003c/strong>\u003c/h3>\n\u003cp>It’s inspiring to envision a Bay Area less dependent on fossil fuels, with cleaner air, more predictable weather cycles, and a booming green jobs industry.\u003c/p>\n\u003cp>Air pollution from fossil fuels affects low-income communities and communities of color far more than others, in places close to freeways and industry, like East and West Oakland.\u003c/p>\n\u003cp>Studies from Oxfam show the poorest 50% of Americans are responsible for far less carbon pollution \u003ca class=\"c-link\" href=\"https://policy-practice.oxfam.org/resources/extreme-carbon-inequality-why-the-paris-climate-deal-must-put-the-poorest-lowes-582545/\" target=\"_blank\" rel=\"noopener noreferrer\" data-stringify-link=\"https://policy-practice.oxfam.org/resources/extreme-carbon-inequality-why-the-paris-climate-deal-must-put-the-poorest-lowes-582545/\" data-sk=\"tooltip_parent\">than the average American — about half.\u003c/a> Cleaning up our climate is an act of equity.\u003c/p>\n\u003cp>Cutting down fossil fuels would save lives. California’s air regulator estimated that \u003ca href=\"https://ww2.arb.ca.gov/resources/health-air-pollution\" target=\"_blank\" rel=\"noopener noreferrer\">we see 7,200 premature deaths each year from air pollution\u003c/a>, particularly from pollution related to diesel exhaust.\u003c/p>\n\u003cp>Globally, air pollution from burning fossil fuels is \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0013935121000487\" target=\"_blank\" rel=\"noopener noreferrer\">responsible for 8.7 million deaths annually,\u003c/a> shaking out to more than a tenth of U.S. deaths (deaths from COVID-19 stand at \u003ca href=\"https://coronavirus.jhu.edu/map.html\" target=\"_blank\" rel=\"noopener noreferrer\">nearly 5 million people\u003c/a> globally since the start of the pandemic).\u003c/p>\n\u003cp>The average life expectancy would increase by \u003ca href=\"https://academic.oup.com/cardiovascres/article/116/11/1910/5770885#207231589\" target=\"_blank\" rel=\"noopener noreferrer\">more than a year\u003c/a> across a world without fossil fuel emissions.\u003c/p>\n\u003cp>Switching out gas appliances like stoves for electric ones significantly \u003ca href=\"https://www.vox.com/energy-and-environment/2020/5/7/21247602/gas-stove-cooking-indoor-air-pollution-health-risks\" target=\"_blank\" rel=\"noopener noreferrer\">improves indoor air quality\u003c/a>, which could lead to lower risk for cardiovascular disease in adults and asthma in children.\u003c/p>\n\u003cp>As many of us experienced during the pandemic, converting streets into places for communities to gather brought a lot of joy, with “slow streets” and increased outdoor dining. San Francisco voters decided\u003ca href=\"https://www.sfchronicle.com/election/article/JFK-Drive-will-remain-car-free-after-S-F-voters-17570182.php\" target=\"_blank\" rel=\"noopener\"> to make some of these car-free streets permanent\u003c/a>. Should our cities build out a more walkable and bikeable infrastructure, this could be our norm.\u003c/p>\n\u003cfigure id=\"attachment_1977345\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977345 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52164_41586088481_efaa2a3126_o-qut.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">A man walks with his two kids along a street during the San Francisco Bike & Roll to School Day in 2018. \u003ccite>(San Francisco Bicycle Coalition)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Climate action could be a boon for green jobs, like those installing solar panels and restoring wetlands.\u003c/p>\n\u003cp>And climate progress could significantly impact our mental health. That’s because the antidote to climate anxiety is action.\u003c/p>\n\u003ch3>Act\u003c/h3>\n\u003cp>You do not need to become anything you are not to take action on climate change. The issue is big, and the good part about that is there are endless ways to plug in.\u003c/p>\n\u003cp>Climate scientist Kim Nicholas says consider where you spend most of your time and where you get the most energy right now. Start there. Ask yourself, “how is it that we as a family, as a business, [or] as a neighborhood, are impacting the climate? What is it that we can do?”\u003c/p>\n\u003cp>While climate activists debate whether to push people to organize for systemic change or focus on individual actuals, they tend to agree that both are needed. Systems need transforming and the largest reductions in emissions will be found there. But individual changes — especially in rich countries like the U.S. — are important, too.\u003c/p>\n\u003ch3>Action at the systems level\u003c/h3>\n\u003cp>\u003cstrong>Find a group that works for you:\u003c/strong> Climate journalist and organizer Bill McKibben says the most powerful thing an individual can do is \u003ca href=\"https://climate-xchange.org/2020/09/16/be-a-little-less-of-an-individual-author-and-activist-bill-mckibben/\" target=\"_blank\" rel=\"noopener noreferrer\">be less of an individual.\u003c/a> Your voice will be more powerful with others, and it’s more fun and hopeful to tackle this challenge together. There’s no shortage of groups of people concerned about the climate and taking meaningful action.\u003c/p>\n\u003cp>There are groups for \u003ca href=\"https://protectourwinters.org/\" target=\"_blank\" rel=\"noopener noreferrer\">skiers\u003c/a>, \u003ca href=\"https://envirn.org/\" target=\"_blank\" rel=\"noopener noreferrer\">nurses\u003c/a>, \u003ca href=\"https://artistsandclimatechange.com/\" target=\"_blank\" rel=\"noopener noreferrer\">artists\u003c/a>, \u003ca href=\"https://republicen.org/\" target=\"_blank\" rel=\"noopener noreferrer\">political conservatives\u003c/a>, \u003ca href=\"https://www.eldersclimateaction.org/\" target=\"_blank\" rel=\"noopener noreferrer\">grandmothers\u003c/a>, \u003ca href=\"https://www.conservationhawks.org/\" target=\"_blank\" rel=\"noopener noreferrer\">hunters\u003c/a>, and \u003ca href=\"https://climateandsecurity.org/\" target=\"_blank\" rel=\"noopener noreferrer\">people concerned with national security\u003c/a>. See the range? Groups such as these can help guide you to advocate for more change at the systems level.\u003c/p>\n\u003cfigure id=\"attachment_1977351\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977351 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-1020x647.jpg\" alt=\"\" width=\"640\" height=\"406\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-1020x647.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-800x507.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-160x101.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-768x487.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut-1536x974.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52175_GettyImages-1168690967-qut.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">Children paint waves on paper as they take part in an event to make art for the youth climate strike on September 20, 2019. \u003ccite>(JOHANNES EISELE/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Vote for climate candidates: \u003c/strong>The rapid policy reform needed to address the climate crisis requires politicians to enact bolder, faster changes.\u003c/p>\n\u003cp>\u003ca href=\"https://onlinelibrary.wiley.com/doi/10.1111/socf.12422\" target=\"_blank\" rel=\"noopener noreferrer\">Research\u003c/a> shows electing representatives that ranked high on the \u003ca href=\"https://scorecard.lcv.org/\" target=\"_blank\" rel=\"noopener noreferrer\">League of Conservation Voters National Environmental Scorecard\u003c/a> significantly reduced a state’s carbon dioxide emissions.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0176268017304500\" target=\"_blank\" rel=\"noopener noreferrer\">Voting female politicians into office\u003c/a> is linked with stronger climate policies and lower emissions, and could be an underutilized tool.\u003c/p>\n\u003cp>\u003cstrong>Contact your representatives: \u003c/strong>Call your local, state or federal representative to share your concerns. Sure, there are other ways to get in touch too, like email and snail mail, but activists and lawmakers say the best way to grab a staffer’s attention is to call and not email, \u003ca href=\"https://www.nytimes.com/2016/11/22/us/politics/heres-why-you-should-call-not-email-your-legislators.html\" target=\"_blank\" rel=\"noopener noreferrer\">The New York Times reports\u003c/a>.\u003c/p>\n\u003cp>If your representatives already share your beliefs, thank them for their efforts and ask them to move further or faster.\u003c/p>\n\u003ch3>Action at the individual level\u003c/h3>\n\u003cp>While the numbers show that minimizing your carbon footprint won’t get us where we need to go on greenhouse gas reductions alone, “If you live in a rich country, and especially the richer you are, your individual actions really matter,” sustainability scientist Kimberly Nicholas writes in her book “\u003ca href=\"https://www.penguinrandomhouse.com/books/665274/under-the-sky-we-make-by-kimberly-nicholas-phd/\" target=\"_blank\" rel=\"noopener noreferrer\">Under the Sky We Make.”\u003c/a>\u003c/p>\n\u003cp>Personal climate actions like skipping drives and flights matter in both reducing carbon, and in changing the perception of a wealthy American ideal — using excessive carbon — that’s quickly getting exported.\u003c/p>\n\u003cp>When changes become a social norm, it becomes more attractive for politicians and companies to take action. Research shows\u003ca href=\"https://www.science.org/doi/abs/10.1126/science.aas8827\" target=\"_blank\" rel=\"noopener noreferrer\"> just 25% of a population is needed to create a norm change\u003c/a>.\u003c/p>\n\u003cp>Our suggestions reflect actions shown to have the biggest impact, so you can spend your limited time and brain capacity judiciously, though there are plenty of other worthwhile things to do.\u003c/p>\n\u003cp>\u003cstrong>Talk about climate change:\u003c/strong> While the majority of Americans are worried about climate change, most people don’t talk about it, even if they’d like to, says Anthony Leiserowitz, director of Yale’s climate communication program. He says by avoiding talking about the topic, we fail to signal how much it matters to us.\u003c/p>\n\u003cp>Climate scientist Katharine Hayhoe has had thousands of conversations about climate change. She recommends a helpful formula for your discussion: start with what you both care about (like your kids, the beach, birds, etc.), connect that passion with climate change (climate change affects everything, so luckily that’s not hard), and then discuss what’s at stake for what you love, and some solutions that are at work locally.\u003c/p>\n\u003cp>You can also talk about what you’re doing about climate change (no self-righteousness please though, that won’t help your cause). Lots of folks are changing their behavior based on the climate crisis, and sharing that could contribute to societal shifts. There are \u003ca href=\"https://brightaction.app/\" target=\"_blank\" rel=\"noopener noreferrer\">tools to help\u003c/a> your community, company, or place of worship collaborate, or even compete with one another.\u003c/p>\n\u003cp>Yale’s climate change communication program has tips on \u003ca href=\"https://climatecommunication.yale.edu/news-events/attaining-meaningful-outcomes-from-conversations-on-climate/\" target=\"_blank\" rel=\"noopener noreferrer\">how to achieve meaningful conversation outcomes\u003c/a>, and you can hear how conversations between a son and his Republican U.S. representative father converted the latter into a \u003ca href=\"https://gimletmedia.com/shows/howtosaveaplanet/j4hk928/trying-to-talk-to-family-about-climate\" target=\"_blank\" rel=\"noopener noreferrer\">conservative climate champion\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Drive less: \u003c/strong>The majority of California’s greenhouse gas emissions \u003ca href=\"https://ww3.arb.ca.gov/cc/inventory/pubs/reports/2000_2019/ghg_inventory_trends_00-19.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">come from transportation\u003c/a>, and for the average U.S. household, gasoline for personal cars \u003ca href=\"https://pubs.acs.org/doi/10.1021/es102221h\" target=\"_blank\" rel=\"noopener noreferrer\">is the the biggest source of emissions\u003c/a>.\u003c/p>\n\u003cp>Most emissions come from long car trips.\u003c/p>\n\u003cfigure id=\"attachment_1977321\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977321 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-1020x573.png\" alt=\"The largest sector is transportation, followed by industrial, electricity, commercial & residential, agriculture, high GWP, and recycling & waste\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-1020x573.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-800x450.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-160x90.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-768x432.png 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-1536x863.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-2048x1151.png 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/figure_4_GHG_emissions_by_scoping_plan_subsector-1-1920x1079.png 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">2019 greenhouse gas emissions in California, broken down into sector and subsector. \u003ccite>(Courtesy California Air Resources Board)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Reducing travel in gas cars is one of the biggest things you can do, but can be challenging depending where you live. (This is one place where changing the system comes into play — working for better bus, train, biking and walking routes would make our cities and towns more friendly to ditching cars.)\u003c/p>\n\u003cp>Regardless, reductions in emissions from car trips help, whether that means having no car, taking public transit more, or switching to an electric or hybrid vehicle.\u003c/p>\n\u003cp>Plus, there are plenty of physical and mental benefits to other, familiar options like walking and biking.\u003c/p>\n\u003cp>\u003cstrong>Fly less: \u003c/strong>Only 1% of people cause \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0959378020307779\" target=\"_blank\" rel=\"noopener noreferrer\">half of the emissions from air travel\u003c/a>. While carbon dioxide emissions from flights are roughly \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S1352231020305689\" target=\"_blank\" rel=\"noopener noreferrer\">2.4% of total greenhouse gas emissions globally\u003c/a>, if you’re in that select group of people flying, and flying a lot, cutting down on flights will have an outsized impact on reducing carbon emissions.\u003c/p>\n\u003cp>Eliminate flights that aren’t essential, and if you’re a frequent flyer, set a goal to cut flights in half, or down to a few per year.\u003c/p>\n\u003cp>The shift away from air travel during the COVID-19 pandemic modeled what less flying can look like.\u003c/p>\n\u003cp>\u003cstrong> \u003c/strong>\u003cstrong>Eat a plant-based diet: \u003c/strong>Growing food for us and food to feed animals (that become food for us), plus deforestation (primarily to grow food) accounts for roughly \u003ca href=\"https://www.epa.gov/ghgemissions/global-greenhouse-gas-emissions-data\" target=\"_blank\" rel=\"noopener noreferrer\">24% of global emissions\u003c/a>. Methane comes from cow, sheep, and goat burps and their manure, and nitrous oxide from using fertilizers. Some carbon dioxide is also released from plowing and razing forests. Globally, deforestation is also \u003ca href=\"https://ipbes.net/sites/default/files/2020-02/ipbes_global_assessment_report_summary_for_policymakers_en.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">the main driver of the biodiversity crisis.\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_1977346\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977346 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/RS52166_2543-qut-1020x681.jpg\" alt=\"Four men smile and inspect lettuce in a greenhouse\" width=\"640\" height=\"427\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/RS52166_2543-qut.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">A team of veterans inspects organic produce on their farm in San Jose. The Farmer Veteran Coalition is a national nonprofit non-governmental organization in the United States that mobilizes veterans to feed America and transition from military service to a career in agriculture. \u003ccite>(Meg Haywood Sullivan/Climate Visuals Countdown)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Beef is more resource intensive than other foods. Producing it requires\u003ca href=\"https://josephpoore.com/Science%20360%206392%20987%20-%20Accepted%20Manuscript.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"> 22 times more land and emits 62 times more greenhouse gases\u003c/a> per gram of protein than plant proteins like beans.\u003c/p>\n\u003cp>For meat eaters worldwide, cutting back to 1.5 burgers a week would nearly eliminate the need for agricultural expansion, \u003ca href=\"https://www.wri.org/insights/how-sustainably-feed-10-billion-people-2050-21-charts\" target=\"_blank\" rel=\"noopener noreferrer\">even with a global population of 10 billion.\u003c/a>\u003c/p>\n\u003cp>The average American \u003ca href=\"https://www.wri.org/insights/how-sustainably-feed-10-billion-people-2050-21-charts\" target=\"_blank\" rel=\"noopener noreferrer\">eats three burgers a week.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Green your home: \u003c/strong>Energy we use in our homes is the \u003ca href=\"https://pubs.acs.org/doi/10.1021/es102221h\" target=\"_blank\" rel=\"noopener noreferrer\">second-biggest source of emissions for the average American\u003c/a>. You can change that by installing solar panels and efficient windows, and improving insulation. And when some of the biggest home energy hogs need replacement, choose a more efficient alternative: swap your natural gas furnace and water heater for electric heat pumps, replace your gas stove with an induction one.\u003c/p>\n\u003cp>Many of these changes aren’t achievable as a renter, but you can \u003ca href=\"https://www.energy.gov/energysaver/tips-renters-and-rental-property-owners\" target=\"_blank\" rel=\"noopener noreferrer\">bring this up with your property owner\u003c/a>, and depending on where you are, there are \u003ca href=\"https://www.csd.ca.gov/Pages/Low-Income-Weatherization-Program.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">programs\u003c/a> that help with incentives.\u003c/p>\n\u003cp>\u003cstrong>Your climate Venn diagram: \u003c/strong>In the podcast “How to Save a Planet,” host and marine biologist \u003ca href=\"https://www.ayanaelizabeth.com/bio\" target=\"_blank\" rel=\"noopener noreferrer\">Ayana Elizabeth Johnson\u003c/a> suggests one way to find your space in climate action: a Venn diagram.\u003c/p>\n\u003cp>Get out your paper.\u003c/p>\n\u003cfigure id=\"attachment_1977319\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1977319 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/10/Square-1020x1020.png\" alt=\"A Venn diagram with three circles: one says "what brings you joy?", another says "What are you good at?" and the third says "What is the work that needs doing?" The convergence of the circles reads "What you should do."\" width=\"640\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-1020x1020.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-800x800.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-160x160.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-768x768.png 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-1536x1536.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-2048x2048.png 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/10/Square-1920x1920.png 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\" />\u003cfigcaption class=\"wp-caption-text\">Marine biologist Ayana Elizabeth Johnson has created this Venn diagram to help people find their place in climate action. \u003ccite>(Courtesy The All We Can Save Project)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>What are you good at? “What skills, resources, networks, reach, influence are you bringing to the table?” she asked.\u003c/p>\n\u003cp>What work needs doing? The crisis is so huge that there are many options.\u003c/p>\n\u003cp>What brings you joy? “What gets you out of bed in the morning? Because this is the work of our lifetime,” Johnson said.\u003c/p>\n\u003cp>Your job is to move forward on what you identify at the center of those circles.\u003c/p>\n\u003cp>\u003cstrong>Active hope: \u003c/strong>Hope for the climate is not about crossing your fingers and going about your daily routine.\u003c/p>\n\u003cp>It’s a practice, say climate activist Joanna Macy and psychologist Dr. Chris Johnstone in their book “Active Hope.” This kind of hope involves taking stock of our painful reality, identifying what changes you want to see, and beginning to make them.\u003c/p>\n\u003cp>Doing these things brings us closer to others doing the same. The hope and action beget more of the same.\u003c/p>\n\u003cp>Yes, climate change is here. Yes, it’s bad.\u003c/p>\n\u003cp>And there’s hope — contingent on all of us, acting.\u003cbr />\n\u003ca id=\"question\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "California to Swap New Gas-Powered Landscaping Equipment for Zero Emissions Tools",
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"content": "\u003cp>Those ubiquitous, noisy leaf blowers, lawn mowers, and weed whackers are producing something more than a high-pitched whirring: pollution that’s harmful to human health.\u003c/p>\n\u003cp>In an effort to curb this air pollution and reduce the emission of greenhouse gases, California will phase out the new manufacture of common gas-powered versions of landscaping equipment as early as 2024.\u003c/p>\n\u003cp>Gov. Gavin Newsom signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB1346\" target=\"_blank\" rel=\"noopener noreferrer\">Assembly Bill 1346\u003c/a> into law this month, effectively banning what the state describes as “small off-road engines,” including common landscaping tools, chain saws and even golf carts.\u003c/p>\n\u003cp>The law also requires new portable, gas-powered generators to be zero emission as soon as 2028.\u003c/p>\n\u003cp>Mostly, these tools are used by people to tidy home lawns and gardens, although commercial landscapers, construction crews and farmers use them, too, at a smaller percentage, \u003ca href=\"https://www.arb.ca.gov/msprog/offroad/sm_en_fs.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">according to the California Air Resources Board\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>People can still use the gas-powered equipment they already own, and stores can still sell their older stock.\u003c/p>\n\u003cp>Christopher Dilbeck works at the air board and helped design the emissions regulations. “[These tools] actually have more smog-forming emissions than light duty passenger cars in California,” Dilbeck said.\u003c/p>\n\u003cp>One hour spent clearing a yard with a leaf blower emits the \u003ca href=\"https://www.arb.ca.gov/msprog/offroad/sm_en_fs.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">same amount of smog-forming gases\u003c/a> as driving 1,100 miles in a standard passenger car, according to the air regulator. That would be like driving from Los Angeles to Denver.\u003c/p>\n\u003cp>Specifically, the gas-powered engines produce particulate matter and ozone. These machines are not major emitters of planet warming gases, although they do produce some carbon dioxide and other greenhouse gases.\u003c/p>\n\u003cp>Multiple environmental and health organizations supported the bill, while a handful of groups opposed it, including those representing landscapers and equipment manufacturers.\u003c/p>\n\u003cp>Assemblyman Marc Berman, D-Menlo Park, co-authored the legislation and said it will particularly benefit workers “who face disproportionate health risks from air pollution.” Those risks include \u003ca href=\"https://www.epa.gov/ground-level-ozone-pollution/health-effects-ozone-pollution\" target=\"_blank\" rel=\"noopener noreferrer\">exacerbating asthma\u003c/a> and \u003ca href=\"https://www.epa.gov/pm-pollution/health-and-environmental-effects-particulate-matter-pm\" target=\"_blank\" rel=\"noopener noreferrer\">heart disease, and causing premature death\u003c/a>.\u003c/p>\n\u003cp>Santa Cruz landscaper Brett Graf owns Habitat Gardens. He says he’s already experienced multiple upsides from using zero-emission tools.\u003c/p>\n\u003cp>“They’re easier to use. They smell better, they’re not as loud, you’re not breathing in these fumes,” Graf said.\u003c/p>\n\u003cp>Graf’s tools are plug-ins or battery powered, and he said his clients are open to him charging his batteries from their outlets while he works.\u003c/p>\n\u003cp>California’s new law is coupled with $30 million in incentives for people to buy zero-emission equipment, meant to aid an equitable transition.\u003c/p>\n\u003cp>But some landscape professionals fear that the transition won’t be equitable or smooth.\u003c/p>\n\u003cp>Daniel Martinez Quiróz owns Martinez Landscape, a three-person outfit in the East Bay.\u003c/p>\n\u003cp>“This quick transition is a huge change for us and it’s catching us by surprise,” Martinez Quiróz said.\u003c/p>\n\u003cp>“It’s going to be a bit more difficult for us to compete, because we have to buy new equipment and that will bring our costs up,” he added. “It’s going to have a big impact on contractors, as well as on clients.”\u003c/p>\n\u003cp>Sandra Giarde is the executive director of the \u003ca href=\"https://www.clca.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Landscape Contractors Association\u003c/a>. She says the group surveyed its members and found that the landscapers who most often use electric equipment service wealthier communities.\u003c/p>\n\u003cp>“How is this [law] going to impact the rest of the communities?” Giarde asked.\u003c/p>\n\u003cp>State regulators point to the availability of battery-powered and plug-in alternatives for commonly used landscaping tools.\u003c/p>\n\u003cp>Those tools will work fine for personal and residential use, Giarde says, but the equipment isn’t up to the job required by commercial landscapers: slogging from site to site for six to eight hours each day.\u003c/p>\n\u003cp>“We want to use this equipment,” Giarde said. “It’s not there yet.”\u003c/p>\n\u003cp>Jason Barbose of the \u003ca href=\"https://www.ucsusa.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Union of Concerned Scientists\u003c/a> said that may be true “but that’s sort of the whole point of the regulation.”\u003c/p>\n\u003cp>“We’re going to put standards out there,” he said. “It may not be achievable today, but that the state determines they can be met.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He says the law is an important step for California as it moves away from fossil fuels.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Those ubiquitous, noisy leaf blowers, lawn mowers, and weed whackers are producing something more than a high-pitched whirring: pollution that’s harmful to human health.\u003c/p>\n\u003cp>In an effort to curb this air pollution and reduce the emission of greenhouse gases, California will phase out the new manufacture of common gas-powered versions of landscaping equipment as early as 2024.\u003c/p>\n\u003cp>Gov. Gavin Newsom signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB1346\" target=\"_blank\" rel=\"noopener noreferrer\">Assembly Bill 1346\u003c/a> into law this month, effectively banning what the state describes as “small off-road engines,” including common landscaping tools, chain saws and even golf carts.\u003c/p>\n\u003cp>The law also requires new portable, gas-powered generators to be zero emission as soon as 2028.\u003c/p>\n\u003cp>Mostly, these tools are used by people to tidy home lawns and gardens, although commercial landscapers, construction crews and farmers use them, too, at a smaller percentage, \u003ca href=\"https://www.arb.ca.gov/msprog/offroad/sm_en_fs.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">according to the California Air Resources Board\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>People can still use the gas-powered equipment they already own, and stores can still sell their older stock.\u003c/p>\n\u003cp>Christopher Dilbeck works at the air board and helped design the emissions regulations. “[These tools] actually have more smog-forming emissions than light duty passenger cars in California,” Dilbeck said.\u003c/p>\n\u003cp>One hour spent clearing a yard with a leaf blower emits the \u003ca href=\"https://www.arb.ca.gov/msprog/offroad/sm_en_fs.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">same amount of smog-forming gases\u003c/a> as driving 1,100 miles in a standard passenger car, according to the air regulator. That would be like driving from Los Angeles to Denver.\u003c/p>\n\u003cp>Specifically, the gas-powered engines produce particulate matter and ozone. These machines are not major emitters of planet warming gases, although they do produce some carbon dioxide and other greenhouse gases.\u003c/p>\n\u003cp>Multiple environmental and health organizations supported the bill, while a handful of groups opposed it, including those representing landscapers and equipment manufacturers.\u003c/p>\n\u003cp>Assemblyman Marc Berman, D-Menlo Park, co-authored the legislation and said it will particularly benefit workers “who face disproportionate health risks from air pollution.” Those risks include \u003ca href=\"https://www.epa.gov/ground-level-ozone-pollution/health-effects-ozone-pollution\" target=\"_blank\" rel=\"noopener noreferrer\">exacerbating asthma\u003c/a> and \u003ca href=\"https://www.epa.gov/pm-pollution/health-and-environmental-effects-particulate-matter-pm\" target=\"_blank\" rel=\"noopener noreferrer\">heart disease, and causing premature death\u003c/a>.\u003c/p>\n\u003cp>Santa Cruz landscaper Brett Graf owns Habitat Gardens. He says he’s already experienced multiple upsides from using zero-emission tools.\u003c/p>\n\u003cp>“They’re easier to use. They smell better, they’re not as loud, you’re not breathing in these fumes,” Graf said.\u003c/p>\n\u003cp>Graf’s tools are plug-ins or battery powered, and he said his clients are open to him charging his batteries from their outlets while he works.\u003c/p>\n\u003cp>California’s new law is coupled with $30 million in incentives for people to buy zero-emission equipment, meant to aid an equitable transition.\u003c/p>\n\u003cp>But some landscape professionals fear that the transition won’t be equitable or smooth.\u003c/p>\n\u003cp>Daniel Martinez Quiróz owns Martinez Landscape, a three-person outfit in the East Bay.\u003c/p>\n\u003cp>“This quick transition is a huge change for us and it’s catching us by surprise,” Martinez Quiróz said.\u003c/p>\n\u003cp>“It’s going to be a bit more difficult for us to compete, because we have to buy new equipment and that will bring our costs up,” he added. “It’s going to have a big impact on contractors, as well as on clients.”\u003c/p>\n\u003cp>Sandra Giarde is the executive director of the \u003ca href=\"https://www.clca.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Landscape Contractors Association\u003c/a>. She says the group surveyed its members and found that the landscapers who most often use electric equipment service wealthier communities.\u003c/p>\n\u003cp>“How is this [law] going to impact the rest of the communities?” Giarde asked.\u003c/p>\n\u003cp>State regulators point to the availability of battery-powered and plug-in alternatives for commonly used landscaping tools.\u003c/p>\n\u003cp>Those tools will work fine for personal and residential use, Giarde says, but the equipment isn’t up to the job required by commercial landscapers: slogging from site to site for six to eight hours each day.\u003c/p>\n\u003cp>“We want to use this equipment,” Giarde said. “It’s not there yet.”\u003c/p>\n\u003cp>Jason Barbose of the \u003ca href=\"https://www.ucsusa.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Union of Concerned Scientists\u003c/a> said that may be true “but that’s sort of the whole point of the regulation.”\u003c/p>\n\u003cp>“We’re going to put standards out there,” he said. “It may not be achievable today, but that the state determines they can be met.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He says the law is an important step for California as it moves away from fossil fuels.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Mixing and Matching COVID Vaccines: What We Know",
"headTitle": "Mixing and Matching COVID Vaccines: What We Know | KQED",
"content": "\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">L\u003c/span>\u003c/span>ater this week an expert committee that advises the Centers for Disease Control and Prevention will hear about the results of a clinical trial that could influence how COVID-19 vaccines are used in this country at some point in the future. The trial, conducted by the National Institute of Allergy and Infectious Diseases, is a so-called mix-and-match trial, testing the vaccines authorized in the U.S. in combinations with each other.\u003c/p>\n\u003cp>The goal of the trial was to see whether using a different vaccine as a booster shot improves protection. So does getting a dose of Pfizer vaccine after getting a single dose of Johnson & Johnson’s vaccine trigger production of more antibodies than a second dose of the J&J would? Are the messenger RNA vaccines made by Pfizer and Moderna virtually interchangeable, or does switching produce a broader set of immune responses?\u003c/p>\n\u003cp>This isn’t theoretical. The booster shot most vaccinated Americans are in the process of getting or booking may not be the last needed. Figuring out how to optimize use of the current generation of COVID-19 vaccines is critical, a number of experts have told STAT.\u003c/p>\n\u003cp>Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy, said we need to realize that many questions remain to be answered about use of these vaccines. We don’t know the optimal dose. We don’t know the most effective interval between doses. We don’t know how many doses we’re going to need and we don’t know whether we would get more durable protection if we mix up the vaccines each person receives, he said.\u003c/p>\n\u003cp>In terms of how we use COVID-19 vaccines, we’re in the very early days, Osterholm said, adding that now that we have effective vaccines, we need to start figuring out how best to use them. “We have to start adopting a public health mindset for decision making,” he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>What follows is a primer on what we know about mixing COVID-19 vaccines.\u003c/p>\n\u003ch3>Let’s start with the terminology\u003c/h3>\n\u003cp>If you get a booster jab that is of the same brand as your previous jab or jabs, you are getting a \u003cem>homologous \u003c/em>booster. In the United States, most people who have been vaccinated have had homologous vaccine series and homologous boosters.\u003c/p>\n\u003cp>There may be some exceptions. Earlier in the vaccine rollout, when supplies were scarce, the CDC advised that people could be given a second shot of whatever vaccine was on hand if they were due for their second shot of vaccine and no supplies of the brand they were due to get were available.\u003c/p>\n\u003cp>If your original series of vaccines or the booster were from different manufacturers, you have what’s called a \u003cem>heterologous\u003c/em> vaccine series or a heterologous boost.\u003c/p>\n\u003cp>A few vaccines are actually designed to capture the benefits of heterologous boosting. For instance, Johnson & Johnson’s Ebola vaccine uses two different types of vaccines — one of which is made using a similar design to the company’s COVID-19 vaccine. Likewise, the Sputnik V vaccine is made up of two doses of similar but not identical vaccines, each made using a different adenovirus that has been modified to carry genetic material from the SARS-CoV-2 virus. In both cases, the goal was to ensure that the immune response the first dose generated didn’t prevent the second shot from taking effect.\u003c/p>\n\u003ch3>Necessity is the mother of invention\u003c/h3>\n\u003cp>As mentioned above, most immunized people in the United States were vaccinated with a homologous series of vaccines. But elsewhere heterologous regimens were used for a couple of different reasons.\u003c/p>\n\u003cp>In the early days of the vaccine rollout, some countries opted to use heterologous boosts because they didn’t have adequate supply to be able to give people a matching shot when they were due for their second dose. And after the AstraZeneca vaccine was seen to cause serious clotting problems in some people who received it (a problem later seen with the J&J vaccine too), some countries stopped using it or limited its use to older adults, for whom the risk of a clotting event after vaccination appeared to be lower. Younger adults were offered one of the mRNA vaccines as their second dose instead.\u003c/p>\n\u003cp>Kathryn Edwards, a vaccines researcher at Vanderbilt University, suggested the United States should probably look at whether specific brands of booster doses should be targeted at certain populations — or more specifically, if certain people should be steered away from certain vaccines when it comes time for them to get boosters. With concerns about myocarditis in young males associated with mRNA vaccines and clotting problems reported mainly with younger women who got one of the viral vectored vaccines, such as the J&J, maybe it’s time to think about who gets which type of COVID-19 vaccine, Edwards said.\u003c/p>\n\u003ch3>A natural experiment turns into a border barrier\u003c/h3>\n\u003cp>Countries like the United Kingdom, Canada, France, and Germany that used heterologous vaccine approaches have created a travel conundrum for their citizens.\u003c/p>\n\u003cp>A number of countries — the United States among them — do not consider people who received two different brands of vaccines fully vaccinated, even if the person’s home country does. This means someone who got an mRNA vaccine as a second dose after receiving an AstraZeneca shot as a priming dose is not deemed fully vaccinated and is not eligible to travel to the U.S. or other countries with the same rule.\u003c/p>\n\u003cp>Canada has roughly 4 million people who were vaccinated on a heterologous schedule. The U.S. and its northern neighbor share the world’s longest border and in pre-Covid times, travel across it was brisk. Now many Canadians are in limbo, unsure if or when they will be allowed to cross into the U.S.\u003c/p>\n\u003cp>Figuring out how to deal with a range of vaccines used in a variety of ways around the world is going to be a challenge that the Biden administration and other governments will have to grapple with as international travel increases.\u003c/p>\n\u003ch3>All combos may not be created equal\u003c/h3>\n\u003cp>Is it possible that any combination of vaccine types or brands will work as well — or better — than if the shots were all of a single brand? That’s not yet clear, but it’s possible — even likely — that the combinations and the order in which the vaccines are given will matter.\u003c/p>\n\u003cp>“A followed by B may not be the same as B followed by A,” explained Bruce Gellin, chief of global public health strategy for the Rockefeller Foundation’s pandemic prevention institute.\u003c/p>\n\u003cp>A number of small studies done in Europe have shown that following up AstraZeneca’s adenovirus-vectored vaccine with a Pfizer or a \u003ca href=\"https://www.nejm.org/doi/10.1056/NEJMc2110716\" target=\"_blank\" rel=\"noopener noreferrer\">Moderna\u003c/a> mRNA booster elicits a greater immune response than what is seen from two doses of the AstraZeneca alone. But an ongoing research effort at Britain’s University of Oxford comparing COVID-19 vaccine combinations called the Com-CoV trials suggests that the inverse may not be true.\u003c/p>\n\u003cp>Scientists conducting the original \u003ca href=\"https://www.thelancet.com/action/showPdf?pii=S0140-6736%2821%2901694-9\" target=\"_blank\" rel=\"noopener noreferrer\">Com-CoV trial\u003c/a> gave volunteers two doses apiece of either AstraZeneca or Pfizer, comparing the antibody levels those regimens elicited to AstraZeneca followed by Pfizer or Pfizer followed by AstraZeneca. Pfizer after AstraZeneca generated higher antibody levels than two doses of AstraZeneca alone; but AstraZeneca after Pfizer was not better than two doses of Pfizer.\u003c/p>\n\u003cp>“The priming event is really important,” said \u003ca href=\"https://www.statnews.com/2021/09/13/barney-graham-leaves-nih-vaccine-research-center/\">Barney Graham\u003c/a>, who was deputy director of the National Institutes of Health’s Vaccine Research Center until the end of August and who played a critical role in the design of the Moderna and other vaccine prototypes.\u003c/p>\n\u003cp>Graham explained that the kind of immune response one gets from COVID-19 vaccines is determined by the first dose. “And so it kind of locks you into a repertoire and a pattern of antibody, T-cell balances that carry on through subsequent boosters,” he said.\u003c/p>\n\u003cp>Much remains to be learned about how to effectively mix COVID-19 vaccines — and it will take time to answer these questions, Graham said. “Those are the kind of things that happen over a 12-year development program. We didn’t do that this time.”\u003c/p>\n\u003ch3>Mixed vaccines carry a punch\u003c/h3>\n\u003cp>In general, COVID-19 vaccines are what’s known as reactogenic; they can carry a wallop. Fevers, sore arms, fatigue, and malaise — a lot of people report feeling kind of crappy in the hours or even day or two after getting a shot.\u003c/p>\n\u003cp>Complaints about reactogenicity were even greater among people who got mixed vaccine brands, the \u003ca href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01115-6/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">Com-CoV trial\u003c/a> reported. So, potentially more post-vaccination side effects, but nothing unmanageable. “It is reassuring that all reactogenicity symptoms were short lived,” the Com-CoV researchers said in a short study published in late May in The Lancet.\u003c/p>\n\u003ch3>The challenge ahead\u003c/h3>\n\u003cp>If evidence continues to amass suggesting that mixing vaccine brands would be of benefit, how do those data get translated into public policy? That won’t be easy, experts warn.\u003c/p>\n\u003cp>Typically, regulators like the Food and Drug Administration act on requests from companies. They review data provided by a manufacturer and decide yes, this vaccine or drug can be given to these people or no, it should not be.\u003c/p>\n\u003cp>But when you are talking about a plan that involves combining products from two different companies, things become much more complex. None of these companies have asked to have a rival’s vaccine used as a booster for their COVID-19 shot — and they’re not likely to.\u003c/p>\n\u003cp>“Normally the manufacturer puts in an application to do something,” said Glen Nowak, director of the Center for Health and Risk Communication at Grady College of Journalism and Mass Communication. “Who then has that responsibility to bring forward a recommendation to mix and match? I think it’s a very good question.”\u003c/p>\n\u003cp>The CDC could address the issue, said Norman Baylor, president and CEO of Biologics Consulting and a former head of the FDA’s Office of Vaccines. Its advisory panel, ACIP, could evaluate the data and, if it supports using heterologous boosts, recommend that this is the way the vaccines could be used. Such advice could take the form of what is known as preferential recommendations — effectively not saying that vaccine B must be used after vaccine A, but noting it would be advisable to do so.\u003c/p>\n\u003cp>Could that happen? Possibly. But if it does happen, it will likely affect the way COVID-19 vaccines are used in the future — in people who haven’t yet started to be vaccinated, or if and when people in the country need a fourth dose of vaccine. Because by the time there are enough data to move forward with this type of policy, most Americans who are currently due for a booster jab will likely have had one.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci data-stringify-type=\"italic\">This story was originally published by \u003c/i>\u003ci data-stringify-type=\"italic\">\u003ca class=\"c-link\" href=\"https://www.statnews.com/2021/10/12/a-primer-on-what-we-know-about-mixing-and-matching-covid-vaccines/?utm_content=bufferd53a2&utm_medium=social&utm_source=facebook&utm_campaign=facebook_organic\" target=\"_blank\" rel=\"noopener noreferrer\" data-stringify-link=\"https://www.statnews.com/2020/08/10/winter-is-coming-as-flu-season-nears-americas-window-of-opportunity-to-beat-back-covid-19-is-narrowing/\" data-sk=\"tooltip_parent\" data-remove-tab-index=\"true\">STAT\u003c/a>\u003c/i>\u003ci data-stringify-type=\"italic\">, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/i>\u003c/p>\n\n",
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"description": "Later this week an expert committee that advises the Centers for Disease Control and Prevention will hear about the results of a clinical trial that could influence how Covid vaccines are used in this country at some point in the future. The trial, conducted by the National Institute of Allergy and Infectious Diseases, is a so-called mix-and-match trial, testing the Covid vaccines authorized in the U.S. in combinations with each other.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">L\u003c/span>\u003c/span>ater this week an expert committee that advises the Centers for Disease Control and Prevention will hear about the results of a clinical trial that could influence how COVID-19 vaccines are used in this country at some point in the future. The trial, conducted by the National Institute of Allergy and Infectious Diseases, is a so-called mix-and-match trial, testing the vaccines authorized in the U.S. in combinations with each other.\u003c/p>\n\u003cp>The goal of the trial was to see whether using a different vaccine as a booster shot improves protection. So does getting a dose of Pfizer vaccine after getting a single dose of Johnson & Johnson’s vaccine trigger production of more antibodies than a second dose of the J&J would? Are the messenger RNA vaccines made by Pfizer and Moderna virtually interchangeable, or does switching produce a broader set of immune responses?\u003c/p>\n\u003cp>This isn’t theoretical. The booster shot most vaccinated Americans are in the process of getting or booking may not be the last needed. Figuring out how to optimize use of the current generation of COVID-19 vaccines is critical, a number of experts have told STAT.\u003c/p>\n\u003cp>Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy, said we need to realize that many questions remain to be answered about use of these vaccines. We don’t know the optimal dose. We don’t know the most effective interval between doses. We don’t know how many doses we’re going to need and we don’t know whether we would get more durable protection if we mix up the vaccines each person receives, he said.\u003c/p>\n\u003cp>In terms of how we use COVID-19 vaccines, we’re in the very early days, Osterholm said, adding that now that we have effective vaccines, we need to start figuring out how best to use them. “We have to start adopting a public health mindset for decision making,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>What follows is a primer on what we know about mixing COVID-19 vaccines.\u003c/p>\n\u003ch3>Let’s start with the terminology\u003c/h3>\n\u003cp>If you get a booster jab that is of the same brand as your previous jab or jabs, you are getting a \u003cem>homologous \u003c/em>booster. In the United States, most people who have been vaccinated have had homologous vaccine series and homologous boosters.\u003c/p>\n\u003cp>There may be some exceptions. Earlier in the vaccine rollout, when supplies were scarce, the CDC advised that people could be given a second shot of whatever vaccine was on hand if they were due for their second shot of vaccine and no supplies of the brand they were due to get were available.\u003c/p>\n\u003cp>If your original series of vaccines or the booster were from different manufacturers, you have what’s called a \u003cem>heterologous\u003c/em> vaccine series or a heterologous boost.\u003c/p>\n\u003cp>A few vaccines are actually designed to capture the benefits of heterologous boosting. For instance, Johnson & Johnson’s Ebola vaccine uses two different types of vaccines — one of which is made using a similar design to the company’s COVID-19 vaccine. Likewise, the Sputnik V vaccine is made up of two doses of similar but not identical vaccines, each made using a different adenovirus that has been modified to carry genetic material from the SARS-CoV-2 virus. In both cases, the goal was to ensure that the immune response the first dose generated didn’t prevent the second shot from taking effect.\u003c/p>\n\u003ch3>Necessity is the mother of invention\u003c/h3>\n\u003cp>As mentioned above, most immunized people in the United States were vaccinated with a homologous series of vaccines. But elsewhere heterologous regimens were used for a couple of different reasons.\u003c/p>\n\u003cp>In the early days of the vaccine rollout, some countries opted to use heterologous boosts because they didn’t have adequate supply to be able to give people a matching shot when they were due for their second dose. And after the AstraZeneca vaccine was seen to cause serious clotting problems in some people who received it (a problem later seen with the J&J vaccine too), some countries stopped using it or limited its use to older adults, for whom the risk of a clotting event after vaccination appeared to be lower. Younger adults were offered one of the mRNA vaccines as their second dose instead.\u003c/p>\n\u003cp>Kathryn Edwards, a vaccines researcher at Vanderbilt University, suggested the United States should probably look at whether specific brands of booster doses should be targeted at certain populations — or more specifically, if certain people should be steered away from certain vaccines when it comes time for them to get boosters. With concerns about myocarditis in young males associated with mRNA vaccines and clotting problems reported mainly with younger women who got one of the viral vectored vaccines, such as the J&J, maybe it’s time to think about who gets which type of COVID-19 vaccine, Edwards said.\u003c/p>\n\u003ch3>A natural experiment turns into a border barrier\u003c/h3>\n\u003cp>Countries like the United Kingdom, Canada, France, and Germany that used heterologous vaccine approaches have created a travel conundrum for their citizens.\u003c/p>\n\u003cp>A number of countries — the United States among them — do not consider people who received two different brands of vaccines fully vaccinated, even if the person’s home country does. This means someone who got an mRNA vaccine as a second dose after receiving an AstraZeneca shot as a priming dose is not deemed fully vaccinated and is not eligible to travel to the U.S. or other countries with the same rule.\u003c/p>\n\u003cp>Canada has roughly 4 million people who were vaccinated on a heterologous schedule. The U.S. and its northern neighbor share the world’s longest border and in pre-Covid times, travel across it was brisk. Now many Canadians are in limbo, unsure if or when they will be allowed to cross into the U.S.\u003c/p>\n\u003cp>Figuring out how to deal with a range of vaccines used in a variety of ways around the world is going to be a challenge that the Biden administration and other governments will have to grapple with as international travel increases.\u003c/p>\n\u003ch3>All combos may not be created equal\u003c/h3>\n\u003cp>Is it possible that any combination of vaccine types or brands will work as well — or better — than if the shots were all of a single brand? That’s not yet clear, but it’s possible — even likely — that the combinations and the order in which the vaccines are given will matter.\u003c/p>\n\u003cp>“A followed by B may not be the same as B followed by A,” explained Bruce Gellin, chief of global public health strategy for the Rockefeller Foundation’s pandemic prevention institute.\u003c/p>\n\u003cp>A number of small studies done in Europe have shown that following up AstraZeneca’s adenovirus-vectored vaccine with a Pfizer or a \u003ca href=\"https://www.nejm.org/doi/10.1056/NEJMc2110716\" target=\"_blank\" rel=\"noopener noreferrer\">Moderna\u003c/a> mRNA booster elicits a greater immune response than what is seen from two doses of the AstraZeneca alone. But an ongoing research effort at Britain’s University of Oxford comparing COVID-19 vaccine combinations called the Com-CoV trials suggests that the inverse may not be true.\u003c/p>\n\u003cp>Scientists conducting the original \u003ca href=\"https://www.thelancet.com/action/showPdf?pii=S0140-6736%2821%2901694-9\" target=\"_blank\" rel=\"noopener noreferrer\">Com-CoV trial\u003c/a> gave volunteers two doses apiece of either AstraZeneca or Pfizer, comparing the antibody levels those regimens elicited to AstraZeneca followed by Pfizer or Pfizer followed by AstraZeneca. Pfizer after AstraZeneca generated higher antibody levels than two doses of AstraZeneca alone; but AstraZeneca after Pfizer was not better than two doses of Pfizer.\u003c/p>\n\u003cp>“The priming event is really important,” said \u003ca href=\"https://www.statnews.com/2021/09/13/barney-graham-leaves-nih-vaccine-research-center/\">Barney Graham\u003c/a>, who was deputy director of the National Institutes of Health’s Vaccine Research Center until the end of August and who played a critical role in the design of the Moderna and other vaccine prototypes.\u003c/p>\n\u003cp>Graham explained that the kind of immune response one gets from COVID-19 vaccines is determined by the first dose. “And so it kind of locks you into a repertoire and a pattern of antibody, T-cell balances that carry on through subsequent boosters,” he said.\u003c/p>\n\u003cp>Much remains to be learned about how to effectively mix COVID-19 vaccines — and it will take time to answer these questions, Graham said. “Those are the kind of things that happen over a 12-year development program. We didn’t do that this time.”\u003c/p>\n\u003ch3>Mixed vaccines carry a punch\u003c/h3>\n\u003cp>In general, COVID-19 vaccines are what’s known as reactogenic; they can carry a wallop. Fevers, sore arms, fatigue, and malaise — a lot of people report feeling kind of crappy in the hours or even day or two after getting a shot.\u003c/p>\n\u003cp>Complaints about reactogenicity were even greater among people who got mixed vaccine brands, the \u003ca href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01115-6/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">Com-CoV trial\u003c/a> reported. So, potentially more post-vaccination side effects, but nothing unmanageable. “It is reassuring that all reactogenicity symptoms were short lived,” the Com-CoV researchers said in a short study published in late May in The Lancet.\u003c/p>\n\u003ch3>The challenge ahead\u003c/h3>\n\u003cp>If evidence continues to amass suggesting that mixing vaccine brands would be of benefit, how do those data get translated into public policy? That won’t be easy, experts warn.\u003c/p>\n\u003cp>Typically, regulators like the Food and Drug Administration act on requests from companies. They review data provided by a manufacturer and decide yes, this vaccine or drug can be given to these people or no, it should not be.\u003c/p>\n\u003cp>But when you are talking about a plan that involves combining products from two different companies, things become much more complex. None of these companies have asked to have a rival’s vaccine used as a booster for their COVID-19 shot — and they’re not likely to.\u003c/p>\n\u003cp>“Normally the manufacturer puts in an application to do something,” said Glen Nowak, director of the Center for Health and Risk Communication at Grady College of Journalism and Mass Communication. “Who then has that responsibility to bring forward a recommendation to mix and match? I think it’s a very good question.”\u003c/p>\n\u003cp>The CDC could address the issue, said Norman Baylor, president and CEO of Biologics Consulting and a former head of the FDA’s Office of Vaccines. Its advisory panel, ACIP, could evaluate the data and, if it supports using heterologous boosts, recommend that this is the way the vaccines could be used. Such advice could take the form of what is known as preferential recommendations — effectively not saying that vaccine B must be used after vaccine A, but noting it would be advisable to do so.\u003c/p>\n\u003cp>Could that happen? Possibly. But if it does happen, it will likely affect the way COVID-19 vaccines are used in the future — in people who haven’t yet started to be vaccinated, or if and when people in the country need a fourth dose of vaccine. Because by the time there are enough data to move forward with this type of policy, most Americans who are currently due for a booster jab will likely have had one.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "COVID Vaccine Safe and Effective for Kids 5 to 11, Pfizer Says",
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"content": "\u003cp>The first results from the highly anticipated trial studying the effectiveness and safety of the Pfizer and BioNTech COVID-19 vaccine for children ages 5 to 11 showed promising results.\u003c/p>\n\u003cp>The pharmaceutical companies said early results of their trial indicate the vaccine is safe for children and establishes a strong antibody response against the virus.\u003c/p>\n\u003cp>Giving a two-dose regimen of 10 μg (micrograms) administered 21 days apart for children between 5 and 11 years old was well tolerated, according to Pfizer and BioNTech. Side effects were also generally comparable to those of people between the ages of 16 and 25 years old who received the vaccine.\u003c/p>\n\u003cp>This trial used a smaller vaccine dosage, 10 micrograms, rather than the 30 microgram dose used for people 12 and older. The dosage was selected as the preferred dose for safety and effectiveness in young children.\u003c/p>\n\u003cp>News of the results come as pediatric cases of COVID-19 are increasing amid a nationwide surge of infections.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Since July, pediatric cases of COVID-19 have risen by about 240 percent in the U.S. — underscoring the public health need for vaccination. These trial results provide a strong foundation for seeking authorization of our vaccine for children 5 to 11 years old, and we plan to submit them to the FDA and other regulators with urgency,” said Albert Bourla, the chairman and CEO for Pfizer.\u003c/p>\n\u003cp>“Over the past nine months, hundreds of millions of people ages 12 and older from around the world have received our COVID-19 vaccine. We are eager to extend the protection afforded by the vaccine to this younger population, subject to regulatory authorization, especially as we track the spread of the Delta variant and the substantial threat it poses to children,” Bourla said in a statement.\u003c/p>\n\u003cp>Despite the strong results, it will be some time before the general public can see an official rollout of vaccines for children ages 5 to 11. Once analysis of the trial is completed, Pfizer and BioNTech will submit the results “in the near term” to the Food and Drug Administration for review and possible emergency use authorization.\u003c/p>\n\u003cp>And even if the FDA grants that authorization, Dr. Francis Collins, director of the National Institutes of Health, recently told NPR that parents and caregivers will likely have to wait until the end of 2021 before a COVID-19 vaccine is fully approved for young children ages 5 to 11.\u003c/p>\n\u003cp>Trial results for children under 5 years of age could come later this year, the pharmaceutical companies said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Already in March 2021, we have started the study to evaluate the immunization of younger children. Our objective was to generate and submit the data for schoolkids to regulatory authorities around the world before the winter season begins,” BioNTech CEO and co-founder Ugur Sahin said.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=COVID+Vaccine+For+Kids+Ages+5+To+11+Is+Safe+And+Effective%2C+Pfizer+Says&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The first results from the highly anticipated trial studying the effectiveness and safety of the Pfizer and BioNTech COVID-19 vaccine for children ages 5 to 11 showed promising results.\u003c/p>\n\u003cp>The pharmaceutical companies said early results of their trial indicate the vaccine is safe for children and establishes a strong antibody response against the virus.\u003c/p>\n\u003cp>Giving a two-dose regimen of 10 μg (micrograms) administered 21 days apart for children between 5 and 11 years old was well tolerated, according to Pfizer and BioNTech. Side effects were also generally comparable to those of people between the ages of 16 and 25 years old who received the vaccine.\u003c/p>\n\u003cp>This trial used a smaller vaccine dosage, 10 micrograms, rather than the 30 microgram dose used for people 12 and older. The dosage was selected as the preferred dose for safety and effectiveness in young children.\u003c/p>\n\u003cp>News of the results come as pediatric cases of COVID-19 are increasing amid a nationwide surge of infections.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Since July, pediatric cases of COVID-19 have risen by about 240 percent in the U.S. — underscoring the public health need for vaccination. These trial results provide a strong foundation for seeking authorization of our vaccine for children 5 to 11 years old, and we plan to submit them to the FDA and other regulators with urgency,” said Albert Bourla, the chairman and CEO for Pfizer.\u003c/p>\n\u003cp>“Over the past nine months, hundreds of millions of people ages 12 and older from around the world have received our COVID-19 vaccine. We are eager to extend the protection afforded by the vaccine to this younger population, subject to regulatory authorization, especially as we track the spread of the Delta variant and the substantial threat it poses to children,” Bourla said in a statement.\u003c/p>\n\u003cp>Despite the strong results, it will be some time before the general public can see an official rollout of vaccines for children ages 5 to 11. Once analysis of the trial is completed, Pfizer and BioNTech will submit the results “in the near term” to the Food and Drug Administration for review and possible emergency use authorization.\u003c/p>\n\u003cp>And even if the FDA grants that authorization, Dr. Francis Collins, director of the National Institutes of Health, recently told NPR that parents and caregivers will likely have to wait until the end of 2021 before a COVID-19 vaccine is fully approved for young children ages 5 to 11.\u003c/p>\n\u003cp>Trial results for children under 5 years of age could come later this year, the pharmaceutical companies said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Already in March 2021, we have started the study to evaluate the immunization of younger children. Our objective was to generate and submit the data for schoolkids to regulatory authorities around the world before the winter season begins,” BioNTech CEO and co-founder Ugur Sahin said.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=COVID+Vaccine+For+Kids+Ages+5+To+11+Is+Safe+And+Effective%2C+Pfizer+Says&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"title": "Long COVID and Breakthrough Infections: What We Know Now",
"headTitle": "Long COVID and Breakthrough Infections: What We Know Now | KQED",
"content": "\u003cp>Like millions of others, Kathleen Hipps thought she was safe from COVID-19 after she got two shots of the Moderna vaccine last spring. So she figured she just had a summer cold when she got the sniffles in July. But then she opened some Vicks VapoRub.\u003c/p>\n\u003cp>“Anyone who’s ever smelled Vicks VapoRub knows how pungent of a smell it is. And I couldn’t smell it. And that’s how I knew I had COVID,” says Hipps, 40, a Los Angeles lawyer who has two young sons.\u003c/p>\n\u003cp>And sure enough, Hipps tested positive. “I got very sick. I was very tired, very congested — could barely get out of bed. I couldn’t work at all. I had to find colleagues to cover my work for me. And I just spent the next week basically in bed, completely isolated from my family,” she says.\u003c/p>\n\u003cp>Hipps never ran a fever, though, and did not have bad headaches or body aches. She started feeling better after about a week, tested negative and went back to working from home and caring for her family. She thought she was fully recovered.\u003c/p>\n\u003cp>“And I was in my mom’s new car and all of a sudden I felt burning. And I thought there was something wrong with her car,” she says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Wherever she moved her foot, she could still feel the burning sensation. And then her other foot started burning, too. It felt like she was walking on hot coals, she says.\u003c/p>\n\u003cp>“I’ve learned that this is neuropathy, and this a common symptom of long COVID,” Hipps says.\u003c/p>\n\u003ch3>Some patients’ symptoms last for weeks or months\u003c/h3>\n\u003cp>\u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html\" target=\"_blank\" rel=\"noopener noreferrer\">Long COVID\u003c/a> is a poorly defined, poorly understood condition that occurs when COVID-19 patients’ symptoms won’t go away\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992371/\" target=\"_blank\" rel=\"noopener noreferrer\"> for weeks or months,\u003c/a> or new ones emerge just when they think they’re all better.\u003c/p>\n\u003cp>More than six weeks after it started, Hipps still experiences the burning sensation every day, as well as tingling and numbness in her hands.\u003c/p>\n\u003cp>Sometimes the numbness is so bad she can’t push her baby’s stroller. Her periods are really heavy. And work tires her out so fast now that she has to take lots of breaks.\u003c/p>\n\u003cp>“I’m really scared. I mean I’m really scared that there are things that are going on with me that I’m going to have to deal with for the rest of my life,” Hipps says.\u003c/p>\n\u003cp>Now it’s really important to stress that the COVID-19 vaccines are still highly effective at protecting people from getting really sick or dying, and are still quite good at keeping most people from even catching the virus or getting mildly ill.\u003c/p>\n\u003cp>But breakthrough infections can happen, especially with the delta variant. And it’s becoming increasingly clear that unvaccinated people can develop long COVID symptoms, even from mild cases.\u003c/p>\n\u003cp>“We’ve seen that with the infection itself in the unvaccinated individuals about 30% of those individuals continue to have these long-haul COVID symptoms,” says Dr.\u003ca href=\"https://irp.nih.gov/pi/avindra-nath\" target=\"_blank\" rel=\"noopener noreferrer\"> Avindra Nath\u003c/a>, who is studying long COVID at the National Institutes of Health.\u003c/p>\n\u003cp>So the concern is whether vaccinated people who get infected may be at risk for long COVID too, Nath says.\u003c/p>\n\u003cp>“I think that’s a good question,” he says.\u003c/p>\n\u003ch3>Studies look for answers about long COVID\u003c/h3>\n\u003cp>A small\u003ca href=\"https://www.npr.org/transcripts/1021888033\" target=\"_blank\" rel=\"noopener noreferrer\"> Israeli study\u003c/a> recently provided the first evidence that breakthrough infections could lead to long COVID symptoms, although the numbers are small. Out of about 1,500 vaccinated health care workers, 39 got infected, and seven reported symptoms that lasted more than six weeks.\u003c/p>\n\u003cp>And a \u003ca href=\"http://www.thelancet-press.com/embargo/vaxeffectiveness.pdf\">large British study\u003c/a> subsequently found about 5% of people who got infected — even though they were fully vaccinated — experienced persistent symptoms, although the study also found that the odds of having symptoms for 28 days or more were halved by having two vaccine doses.\u003c/p>\n\u003cp>“I think it’s a reasonable concern. But it’s too early. I think we need to follow these patients. It’s quite recent that they’ve been recognized. So at the moment we don’t have that answer,” Nath says, adding that if there is a risk, he suspects it’s probably very low.\u003c/p>\n\u003ch3>But the experts don’t all agree\u003c/h3>\n\u003cp>Some infectious disease experts remain highly skeptical that long COVID from breakthrough infections is a big problem.\u003c/p>\n\u003cp>“Pathophysiologically, it’s quite unlikely to get long COVID from a breakthrough infection,” says Dr.\u003ca href=\"https://profiles.ucsf.edu/monica.gandhi\" target=\"_blank\" rel=\"noopener noreferrer\"> Monica Gandhi\u003c/a>, an infectious disease researcher at UCSF.\u003c/p>\n\u003cp>That’s because the immune response generated by the vaccine would prevent the virus from taking hold in the body or triggering a harmful overreaction by the immune system, Gandhi says.\u003c/p>\n\u003cp>“I think it is absolutely not impossible, but pathophysiologically it is less likely,” she says.\u003c/p>\n\u003cp>Other researchers are convinced the problem is real.\u003c/p>\n\u003cp>“Categorically I can say that we have already seen a handful of cases of long COVID from breakthrough infection,” says\u003ca href=\"https://www.putrinolab.net/\"> David Putrino\u003c/a>, who studies long COVID at Mount Sinai.\u003c/p>\n\u003cp>“We need to behave as though there is the same chance as always of developing long COVID from a mild-to-asymptomatic infection because once you have it you can’t unring that bell and you’re looking at months to years of illness,” Putrino says. Putrino is working with\u003ca href=\"https://medicine.yale.edu/profile/akiko_iwasaki/\"> Akiko Iwasaki\u003c/a>, an immunologist at Yale University, to try to understand how breakthrough infections can lead to persistent symptoms.\u003c/p>\n\u003cp>Iwasaki says some people may experience long COVID because the virus is still hiding in the body. In others, it may be that their immune systems overreact to the virus — a so-called autoimmune response.\u003c/p>\n\u003cp>“We know that the vaccine induces a robust immune response to quickly clear the virus during breakthrough infections,” Iwasaki says. “And that suggests to me that autoimmunity may be the culprit there.”\u003c/p>\n\u003cp>Even if breakthrough infections can lead to long COVID, others say there are also plenty of other reasons vaccinated people should continue to keep being careful to avoid catching the virus.\u003c/p>\n\u003cp>“At the end of the day, my biggest concern honestly is not that I’m going to get long COVID,” says Dr.\u003ca href=\"https://vaccines.emory.edu/faculty-evc/primary-faculty/delrio_carlos.html\" target=\"_blank\" rel=\"noopener noreferrer\"> Carlos del Rio\u003c/a>, an infectious disease researcher at Emory University. “It’s that I’m going to bring COVID and give it to someone else. I mean, I have a young granddaughter. If I get infected, I could give it to her. I’m more concerned that people who are vaccinated can get infected and transmit to others.”\u003c/p>\n\u003cp>For her part, Hipps hopes her symptoms don’t plague her for months or even years.\u003c/p>\n\u003cp>“It’s scary because there’s obviously a lot of things we don’t know about this virus and I’m scared about these long-term implications on my body.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Still, she is glad she got the vaccine. She knows it probably kept her out of the hospital and kept her alive.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=What+We+Know+About+Breakthrough+Infections+And+Long+COVID&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Like millions of others, Kathleen Hipps thought she was safe from COVID-19 after she got two shots of the Moderna vaccine last spring. So she figured she just had a summer cold when she got the sniffles in July. But then she opened some Vicks VapoRub.\u003c/p>\n\u003cp>“Anyone who’s ever smelled Vicks VapoRub knows how pungent of a smell it is. And I couldn’t smell it. And that’s how I knew I had COVID,” says Hipps, 40, a Los Angeles lawyer who has two young sons.\u003c/p>\n\u003cp>And sure enough, Hipps tested positive. “I got very sick. I was very tired, very congested — could barely get out of bed. I couldn’t work at all. I had to find colleagues to cover my work for me. And I just spent the next week basically in bed, completely isolated from my family,” she says.\u003c/p>\n\u003cp>Hipps never ran a fever, though, and did not have bad headaches or body aches. She started feeling better after about a week, tested negative and went back to working from home and caring for her family. She thought she was fully recovered.\u003c/p>\n\u003cp>“And I was in my mom’s new car and all of a sudden I felt burning. And I thought there was something wrong with her car,” she says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Wherever she moved her foot, she could still feel the burning sensation. And then her other foot started burning, too. It felt like she was walking on hot coals, she says.\u003c/p>\n\u003cp>“I’ve learned that this is neuropathy, and this a common symptom of long COVID,” Hipps says.\u003c/p>\n\u003ch3>Some patients’ symptoms last for weeks or months\u003c/h3>\n\u003cp>\u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html\" target=\"_blank\" rel=\"noopener noreferrer\">Long COVID\u003c/a> is a poorly defined, poorly understood condition that occurs when COVID-19 patients’ symptoms won’t go away\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992371/\" target=\"_blank\" rel=\"noopener noreferrer\"> for weeks or months,\u003c/a> or new ones emerge just when they think they’re all better.\u003c/p>\n\u003cp>More than six weeks after it started, Hipps still experiences the burning sensation every day, as well as tingling and numbness in her hands.\u003c/p>\n\u003cp>Sometimes the numbness is so bad she can’t push her baby’s stroller. Her periods are really heavy. And work tires her out so fast now that she has to take lots of breaks.\u003c/p>\n\u003cp>“I’m really scared. I mean I’m really scared that there are things that are going on with me that I’m going to have to deal with for the rest of my life,” Hipps says.\u003c/p>\n\u003cp>Now it’s really important to stress that the COVID-19 vaccines are still highly effective at protecting people from getting really sick or dying, and are still quite good at keeping most people from even catching the virus or getting mildly ill.\u003c/p>\n\u003cp>But breakthrough infections can happen, especially with the delta variant. And it’s becoming increasingly clear that unvaccinated people can develop long COVID symptoms, even from mild cases.\u003c/p>\n\u003cp>“We’ve seen that with the infection itself in the unvaccinated individuals about 30% of those individuals continue to have these long-haul COVID symptoms,” says Dr.\u003ca href=\"https://irp.nih.gov/pi/avindra-nath\" target=\"_blank\" rel=\"noopener noreferrer\"> Avindra Nath\u003c/a>, who is studying long COVID at the National Institutes of Health.\u003c/p>\n\u003cp>So the concern is whether vaccinated people who get infected may be at risk for long COVID too, Nath says.\u003c/p>\n\u003cp>“I think that’s a good question,” he says.\u003c/p>\n\u003ch3>Studies look for answers about long COVID\u003c/h3>\n\u003cp>A small\u003ca href=\"https://www.npr.org/transcripts/1021888033\" target=\"_blank\" rel=\"noopener noreferrer\"> Israeli study\u003c/a> recently provided the first evidence that breakthrough infections could lead to long COVID symptoms, although the numbers are small. Out of about 1,500 vaccinated health care workers, 39 got infected, and seven reported symptoms that lasted more than six weeks.\u003c/p>\n\u003cp>And a \u003ca href=\"http://www.thelancet-press.com/embargo/vaxeffectiveness.pdf\">large British study\u003c/a> subsequently found about 5% of people who got infected — even though they were fully vaccinated — experienced persistent symptoms, although the study also found that the odds of having symptoms for 28 days or more were halved by having two vaccine doses.\u003c/p>\n\u003cp>“I think it’s a reasonable concern. But it’s too early. I think we need to follow these patients. It’s quite recent that they’ve been recognized. So at the moment we don’t have that answer,” Nath says, adding that if there is a risk, he suspects it’s probably very low.\u003c/p>\n\u003ch3>But the experts don’t all agree\u003c/h3>\n\u003cp>Some infectious disease experts remain highly skeptical that long COVID from breakthrough infections is a big problem.\u003c/p>\n\u003cp>“Pathophysiologically, it’s quite unlikely to get long COVID from a breakthrough infection,” says Dr.\u003ca href=\"https://profiles.ucsf.edu/monica.gandhi\" target=\"_blank\" rel=\"noopener noreferrer\"> Monica Gandhi\u003c/a>, an infectious disease researcher at UCSF.\u003c/p>\n\u003cp>That’s because the immune response generated by the vaccine would prevent the virus from taking hold in the body or triggering a harmful overreaction by the immune system, Gandhi says.\u003c/p>\n\u003cp>“I think it is absolutely not impossible, but pathophysiologically it is less likely,” she says.\u003c/p>\n\u003cp>Other researchers are convinced the problem is real.\u003c/p>\n\u003cp>“Categorically I can say that we have already seen a handful of cases of long COVID from breakthrough infection,” says\u003ca href=\"https://www.putrinolab.net/\"> David Putrino\u003c/a>, who studies long COVID at Mount Sinai.\u003c/p>\n\u003cp>“We need to behave as though there is the same chance as always of developing long COVID from a mild-to-asymptomatic infection because once you have it you can’t unring that bell and you’re looking at months to years of illness,” Putrino says. Putrino is working with\u003ca href=\"https://medicine.yale.edu/profile/akiko_iwasaki/\"> Akiko Iwasaki\u003c/a>, an immunologist at Yale University, to try to understand how breakthrough infections can lead to persistent symptoms.\u003c/p>\n\u003cp>Iwasaki says some people may experience long COVID because the virus is still hiding in the body. In others, it may be that their immune systems overreact to the virus — a so-called autoimmune response.\u003c/p>\n\u003cp>“We know that the vaccine induces a robust immune response to quickly clear the virus during breakthrough infections,” Iwasaki says. “And that suggests to me that autoimmunity may be the culprit there.”\u003c/p>\n\u003cp>Even if breakthrough infections can lead to long COVID, others say there are also plenty of other reasons vaccinated people should continue to keep being careful to avoid catching the virus.\u003c/p>\n\u003cp>“At the end of the day, my biggest concern honestly is not that I’m going to get long COVID,” says Dr.\u003ca href=\"https://vaccines.emory.edu/faculty-evc/primary-faculty/delrio_carlos.html\" target=\"_blank\" rel=\"noopener noreferrer\"> Carlos del Rio\u003c/a>, an infectious disease researcher at Emory University. “It’s that I’m going to bring COVID and give it to someone else. I mean, I have a young granddaughter. If I get infected, I could give it to her. I’m more concerned that people who are vaccinated can get infected and transmit to others.”\u003c/p>\n\u003cp>For her part, Hipps hopes her symptoms don’t plague her for months or even years.\u003c/p>\n\u003cp>“It’s scary because there’s obviously a lot of things we don’t know about this virus and I’m scared about these long-term implications on my body.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Still, she is glad she got the vaccine. She knows it probably kept her out of the hospital and kept her alive.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=What+We+Know+About+Breakthrough+Infections+And+Long+COVID&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"title": "What I Learned From My 'Mild' Breakthrough Case of COVID",
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"content": "\u003cp>The test results that hot day in early August shouldn’t have surprised me — all the symptoms were there. A few days earlier, fatigue had enveloped me like a weighted blanket. I chalked it up to my weekend of travel. Next, a headache clamped down on the back of my skull. Then my eyeballs started to ache. And soon enough, everything tasted like nothing.\u003c/p>\n\u003cp>As a reporter who’s covered the coronavirus since the first confirmed U.S. case landed in Seattle, where I live, I should have known what was coming, but there was some part of me that couldn’t quite believe it. I had a breakthrough case of COVID-19 — despite my two shots of the Pfizer vaccine, the second one in April.\u003c/p>\n\u003cp>I was just one more example of our country’s tug and pull between fantasies of a post-COVID-19 summer and the realities of our still-raging pandemic, where even the vaccinated can get sick.\u003c/p>\n\u003cp>Not only was I sick, but I’d brought the virus home and exposed my 67-year-old father and extended family during my first trip back to the East Coast since the start of the pandemic. It was just the scenario I had tried to avoid for a year and a half. And it definitely was not the summer vacation I had anticipated.\u003c/p>\n\u003cp>Where did I get it? Who knows. Like so many Americans, I had loosened up with wearing masks and social distancing after getting fully vaccinated. We had flown across the country, seen friends, stayed at a hotel, eaten indoors and, yes, even went to a long-delayed wedding with other vaccinated people.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>I ended up in quarantine at my father’s house. \u003ca href=\"https://www.npr.org/2021/09/04/1034281124/more-people-are-relying-on-covid-19-tests-but-experts-say-theyre-not-foolproof\" target=\"_blank\" rel=\"noopener noreferrer\">Two rapid antigen tests \u003c/a>(taken a day apart) came back negative, but I could tell I was starting to feel sick. After my second negative test, the nurse leveled with me. “Don’t hang your hat on this,” she said of the results. Sure enough, a few days later the results of a PCR test for the coronavirus (this one sent to a lab) confirmed what had become obvious by then.\u003c/p>\n\u003cp>It was a miserable five days. My legs and arms ached, my fever crept up to 103 and every few hours of sleep would leave my sheets drenched in sweat. I’d drop into bed exhausted after a quick trip down to the kitchen. To sum it up, I’d put my breakthrough case of COVID-19 right up there with my worst bouts of flu. Even after my fever cleared up, I spent the next few weeks feeling low.\u003c/p>\n\u003cp>Of course, I am very lucky. I didn’t go up against the virus with a naive immune system, like millions of Americans did until vaccines were widely available. And, in much of the world, vaccines are \u003cem>still \u003c/em>a distant promise.\u003c/p>\n\u003cp>“You probably would have gotten much sicker if you had not been vaccinated,” \u003ca href=\"https://providers.ucsd.edu/details/11556/infectious-diseases-hiv/aids\">Francesca Torriani\u003c/a>, an infectious disease physician at the University of California, San Diego, explained to me recently.\u003c/p>\n\u003cp>As I shuffled around my room checking my fever, it was also reassuring to know that my chances of ending up in the hospital were slim, even with the delta variant. And now, about a month later, I’ve made a full recovery.\u003c/p>\n\u003cp>The reality is breakthrough cases are becoming more common. Here’s what you should know about getting a breakthrough case — and what I wish I’d known when those first symptoms laid me low:\u003c/p>\n\u003ch3>Is it time for a reality check about what the vaccines can — and can’t do?\u003c/h3>\n\u003cp>The vaccines aren’t a force field that ward off all things COVID-19. They were given the greenlight because they greatly lower your chance of getting seriously ill or dying.\u003c/p>\n\u003cp>But it was easy for me — and I’m not the only one — to grab onto the idea that, after so many months of trying not to get COVID-19, that the vaccine was, more or less, the finish line. And that made getting sick from the virus unnerving.\u003c/p>\n\u003cp>After all, there were reassuring findings\u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7013e3.htm\"> earlier this year\u003c/a> that the vaccine was remarkably good at stopping any infection, even mild ones. This was a kind of bonus, we were told. And then in May the Centers for Disease Control and Prevention said go ahead and shed your mask if you’re vaccinated.\u003c/p>\n\u003cp>“There was so much initial euphoria about how well these vaccines work,” says \u003ca href=\"https://kingcounty.gov/depts/health/about-us/health-officer.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Jeff Duchin\u003c/a>, an infectious disease physician and the public health officer for Seattle and King County. “I think we — in the public health community, in the medical community — facilitated the impression that these vaccines are bulletproof.”\u003c/p>\n\u003cp>It’s hard to keep dialing up and down your risk calculations. So if you’d hoped to avoid getting sick at all, even slightly, it may be time for a “reset,” Duchin says. This isn’t to be alarmist but to clear away expectations that COVID-19 is out of your life, and keep up your vigilance about common-sense precautions.\u003c/p>\n\u003cp>With more people vaccinated, the total number of breakthrough infections will rise, and that’s not unexpected, he says. “I don’t think our goal should be to achieve zero risk, because that’s unrealistic.”\u003c/p>\n\u003ch3>How high are my chances of getting a breakthrough case these days?\u003c/h3>\n\u003cp>It used to be quite rare, but the rise of delta has changed the odds.\u003c/p>\n\u003cp>“It’s a totally different ballgame with this delta phase,” says \u003ca href=\"https://www.scripps.edu/faculty/topol/\">Dr. Eric Topol\u003c/a>, a professor of molecular medicine at the Scripps Research Translational Institute in La Jolla, Calif. “I think the chance of having a symptomatic infection has gone up substantially.”\u003c/p>\n\u003cp>But he adds, “Quantifying that in the U.S. is very challenging” because our “data is so shoddy.”\u003c/p>\n\u003cp>The vaccinated still have a considerably lower chance of getting infected than those who aren’t protected that way. Look at data collected from Los Angeles County over the summer as the delta variant started to surge in Southern California: Unvaccinated people were \u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e5.htm\">five times more likely to test positive\u003c/a> than those who were vaccinated.\u003c/p>\n\u003cp>Recent research has tried to pin down how well the vaccines are working against preventing any breakthrough cases during the delta surge, but much of that comes from other countries and estimates vary significantly.\u003c/p>\n\u003cp>In the U.S., a study published recently in \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMc2112981\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cem>The New England Journal of Medicine\u003c/em>\u003c/a> concluded that vaccine effectiveness “against any symptomatic disease is considerably lower against the delta variant,” dropping from over 90% earlier in the year before delta was the predominant strain to only about 65% in July. Research on breakthrough infections over the summer in New York found the vaccines were still overall \u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e1.htm\" target=\"_blank\" rel=\"noopener noreferrer\">about 80% effective against any infection\u003c/a>. Each study has its limits.\u003c/p>\n\u003cp>It’s hard to disentangle what’s most responsible for the rise in breakthrough infections this summer — whether it’s the delta variant itself, waning immunity in some people or that much of the U.S. dropped public health precautions such as masking.\u003c/p>\n\u003cp>“We don’t have good evidence of what’s the cause, but we do know all of these things coming together are associated with more breakthroughs,” says\u003ca href=\"https://www.hsph.harvard.edu/community-safety/people/rachael-piltch-loeb-phd/\"> Rachael Piltch-Loeb\u003c/a>, a public health researcher at the Harvard T.H. Chan School of Public Health.\u003c/p>\n\u003ch3>How careful do I need to be if I want to avoid a breakthrough?\u003c/h3>\n\u003cp>Looking back, I wish I’d taken some more precautions.\u003c/p>\n\u003cp>And my advice is different now when friends and family tell me they want to avoid having a breakthrough case such as mine: Don’t leave it all up to the vaccine. Wear masks, stay away from big gatherings with unvaccinated people, cut down on travel, at least until things calm down.\u003c/p>\n\u003cp>The U.S. \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html\">is averaging more than 130,000\u003c/a> coronavirus infections a day (about twice what it was when I fell sick), hospitals are being crushed and the White House has proposed booster shots. Scientists are still making sense of what’s happening with breakthrough cases.\u003c/p>\n\u003cp>What’s clear is that in many parts of the U.S., we’re all more likely to run into the virus than we were in the spring. “Your risk is going to be different if you are in a place that’s very highly vaccinated, with very low level of community spread,” says \u003ca href=\"https://www.uofmhealth.org/profile/922/preeti-n-malani-md\">Preeti Malani\u003c/a>, an infectious disease specialist at the University of Michigan. “The piece that’s important is what’s happening in your community.”\u003c/p>\n\u003cp>Even with delta, the goal is not to go back to a lockdown mindset though, Malani says. “My hope is that people who are fully vaccinated should really feel like this risk is manageable.”\u003c/p>\n\u003cp>She says, “Feel good about spending time with your friends or having a small dinner party, but make sure everyone is vaccinated.”\u003c/p>\n\u003ch3>What does a “mild” case of COVID-19 feel like?\u003c/h3>\n\u003cp>In my case, it was worse than expected, but in the parlance of public health, it was “mild,” meaning I didn’t end up in the hospital or require oxygen.\u003c/p>\n\u003cp>This mild category is essentially a catchall, says \u003ca href=\"https://profiles.ucsf.edu/robert.wachter\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Bob Wachter\u003c/a>, who chairs the Department of Medicine at the UCSF. “Mild” can be “a day of feeling crummy to being completely laid up in bed for a week, all of your bones hurt and your brain isn’t working well.”\u003c/p>\n\u003cp>“So even if we call them mild cases, as you’ve seen, sometimes these are ones you really don’t want to have if you can avoid it,” he says.\u003c/p>\n\u003cp>There’s not great data on the details of these mild breakthrough infections, but so far it appears that “you do way better than those who are not vaccinated,” says\u003ca href=\"https://healthcare.utah.edu/fad/mddetail.php?physicianID=u1074771&name=sarang-k-yoon\"> Dr. Sarang Yoon\u003c/a>, an occupational medicine specialist at the University of Utah Rocky Mountain Center for Occupational Environmental Health who was part of a nationwide CDC study on breakthrough infections. “In general, in terms of symptom duration, it’s much shorter.”\u003c/p>\n\u003cp>Yoon’s study, published in June with data collected before the delta surge, offers some reassurance: The presence of fever was cut in half, and the days spent in bed reduced by 60% among people with breakthrough infections, compared with unvaccinated people who got sick. “These are meaningful decreases,” says \u003ca href=\"https://medicine.utah.edu/faculty/mddetail.php?facultyID=u0067419\">Matt Thiese\u003c/a>, an epidemiologist and colleague of Yoon’s who worked on the study. “It can be the difference between having a fever for almost nine days and having a fever for just under three days.”\u003c/p>\n\u003cp>A recent study from the U.K. also shows that if you’re sick because of a breakthrough case, it’s generally not as bad, and people have fewer symptoms. In fact, the \u003ca href=\"https://covid.joinzoe.com/post/new-top-5-covid-symptoms\" target=\"_blank\" rel=\"noopener noreferrer\">top five symptoms\u003c/a> for people with a breakthrough infection were headache, sneezing, runny nose, sore throat and loss of smell. Notably absent: fever and persistent cough, which are in the top five for unvaccinated people, according to the data compiled by the U.K. researchers.\u003c/p>\n\u003ch3>If I get a breakthrough infection, how sick could I get?\u003c/h3>\n\u003cp>Even with delta, the chance of getting a case of COVID-19 that’s bad enough to send you to the hospital is still rare.\u003c/p>\n\u003cp>If you’re vaccinated, the\u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7037e2.htm?s_cid=mm7037e2_w\" target=\"_blank\" rel=\"noopener noreferrer\"> risk of being hospitalized is 10 times lower\u003c/a> than if you weren’t vaccinated, according to the latest data from the CDC. Those who get severely and critically ill with a breakthrough case tend to be older — in one study done before delta, \u003ca href=\"https://news.yale.edu/2021/09/07/study-examines-severe-breakthrough-cases-covid-19\">the median age was 80\u003c/a> — with underlying medical conditions such as cardiovascular disease.\u003c/p>\n\u003cp>When I was sick, one thing was in the back of my mind as I monitored my symptoms: Would I have problems catching my breath?\u003c/p>\n\u003cp>Thankfully, when you get exposed, the vaccine has already set you up with antibodies, a first line of defense, that will neutralize parts of the virus that attach to the mucosal surfaces of your upper respiratory tract, says Torriani at UC San Diego.\u003c/p>\n\u003cp>“That initial moment when our body is attacked by the virus, that \u003cem>can\u003c/em> lead to some disease,” she says. It’s a bit of a race.\u003c/p>\n\u003cp>The virus may cause you to get a cold, but, in most people, your immune system will “get its act together and thwart that infection from going down into your lungs,” Wachter says.\u003c/p>\n\u003cp>That later stage of COVID-19 also seems to trigger the immune system to get “overly exuberant” and attack your own body, causing severe respiratory problems such as shortness of breath and destructive inflammation. “So if you can prevent that sort of second stage from happening,” Wachter says, “you can prevent a lot of the severe illness from COVID.” Other parts of your immune system, such as T-cells, are also ready to kick into action if you get sick.\u003c/p>\n\u003cp>If you’re concerned, you can keep an eye on your oxygen levels with a pulse oximeter. That’s much more important than your temperature or symptoms, he says.\u003c/p>\n\u003ch3>Can I spread it to others, and do I need to isolate?\u003c/h3>\n\u003cp>Unfortunately, you still have COVID-19 and need to act like it.\u003c/p>\n\u003cp>Even though my first two tests were negative, I started wearing a mask at my house and keeping my distance from my vaccinated family members. I’m glad I did: No one else got sick.\u003c/p>\n\u003cp>The delta variant is more than two times as contagious as the original strain of the virus and can build up quickly in your upper respiratory tract, as was shown in \u003ca href=\"https://www.npr.org/sections/health-shots/2021/08/06/1025553638/how-a-gay-community-helped-the-cdc-spot-a-covid-outbreak-and-learn-more-about-de\" target=\"_blank\" rel=\"noopener noreferrer\">a cluster of breakthrough infections linked to Provincetown, Mass\u003c/a>., over the summer.\u003c/p>\n\u003cp>“Even in fully vaccinated, asymptomatic individuals, they can have enough virus to transmit it,” says \u003ca href=\"https://www.rockefeller.edu/our-scientists/heads-of-laboratories/952-robert-b-darnell/\">Robert Darnell\u003c/a>, a physician scientist at the Rockefeller University. “Delta is very good at replicating, attaching and inserting itself into cells.”\u003c/p>\n\u003cp>The science isn’t settled about just how likely vaccinated people are to spread the virus, and it does appear that \u003ca href=\"https://www.nature.com/articles/s41591-021-01316-7\" target=\"_blank\" rel=\"noopener noreferrer\">the amount of virus in the nose decreases\u003c/a> faster in people who are vaccinated.\u003c/p>\n\u003cp>Even so, wearing masks and staying isolated from others if you test positive or have symptoms is absolutely critical, Darnell says. He also advises getting tested if you are exposed to someone who has COVID-19, even if you’ve been vaccinated, “because you could very well get infected or ill, and you want to protect those around you, including all the children who aren’t vaccinated.”\u003c/p>\n\u003ch3>Could I get long COVID-19 after a breakthrough infection?\u003c/h3>\n\u003cp>The chance I \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html\">might go on to develop long COVID-19\u003c/a> was front and center in my mind when I had a breakthrough case.\u003c/p>\n\u003cp>While there’s not a lot of data yet, research does show that breakthrough infections can lead to the kind of persistent symptoms that characterize long COVID-19, including brain fog, fatigue and headaches. “Hopefully that number is low. Hopefully it doesn’t last as long and it’s not as severe, but it’s just too early to know these things,” Topol says.\u003c/p>\n\u003cp>Recent research from the U.K. \u003ca href=\"https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00460-6/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">suggests that vaccinated people\u003c/a> are about 50% less likely to develop long COVID-19 than those who are unvaccinated. The underlying cause of long COVID-19 is still not yet known, so it complicates the picture for researchers even more, but this early evidence offers some reassurance.\u003c/p>\n\u003cp>“There may be some symptoms like fatigue [that linger], but studies appear to show that vaccination might also decrease the chances of getting long COVID symptoms,” Torriani says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>This is not true for everyone, and it’s a compelling reason to avoid getting infected altogether, Wachter says. “Some of those mild cases will go on to be long COVID, so you have to factor that in,” he says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=I+Got+A+%27Mild%27+Breakthrough+Case.+Here%27s+What+I+Wish+I%27d+Known&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The test results that hot day in early August shouldn’t have surprised me — all the symptoms were there. A few days earlier, fatigue had enveloped me like a weighted blanket. I chalked it up to my weekend of travel. Next, a headache clamped down on the back of my skull. Then my eyeballs started to ache. And soon enough, everything tasted like nothing.\u003c/p>\n\u003cp>As a reporter who’s covered the coronavirus since the first confirmed U.S. case landed in Seattle, where I live, I should have known what was coming, but there was some part of me that couldn’t quite believe it. I had a breakthrough case of COVID-19 — despite my two shots of the Pfizer vaccine, the second one in April.\u003c/p>\n\u003cp>I was just one more example of our country’s tug and pull between fantasies of a post-COVID-19 summer and the realities of our still-raging pandemic, where even the vaccinated can get sick.\u003c/p>\n\u003cp>Not only was I sick, but I’d brought the virus home and exposed my 67-year-old father and extended family during my first trip back to the East Coast since the start of the pandemic. It was just the scenario I had tried to avoid for a year and a half. And it definitely was not the summer vacation I had anticipated.\u003c/p>\n\u003cp>Where did I get it? Who knows. Like so many Americans, I had loosened up with wearing masks and social distancing after getting fully vaccinated. We had flown across the country, seen friends, stayed at a hotel, eaten indoors and, yes, even went to a long-delayed wedding with other vaccinated people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>I ended up in quarantine at my father’s house. \u003ca href=\"https://www.npr.org/2021/09/04/1034281124/more-people-are-relying-on-covid-19-tests-but-experts-say-theyre-not-foolproof\" target=\"_blank\" rel=\"noopener noreferrer\">Two rapid antigen tests \u003c/a>(taken a day apart) came back negative, but I could tell I was starting to feel sick. After my second negative test, the nurse leveled with me. “Don’t hang your hat on this,” she said of the results. Sure enough, a few days later the results of a PCR test for the coronavirus (this one sent to a lab) confirmed what had become obvious by then.\u003c/p>\n\u003cp>It was a miserable five days. My legs and arms ached, my fever crept up to 103 and every few hours of sleep would leave my sheets drenched in sweat. I’d drop into bed exhausted after a quick trip down to the kitchen. To sum it up, I’d put my breakthrough case of COVID-19 right up there with my worst bouts of flu. Even after my fever cleared up, I spent the next few weeks feeling low.\u003c/p>\n\u003cp>Of course, I am very lucky. I didn’t go up against the virus with a naive immune system, like millions of Americans did until vaccines were widely available. And, in much of the world, vaccines are \u003cem>still \u003c/em>a distant promise.\u003c/p>\n\u003cp>“You probably would have gotten much sicker if you had not been vaccinated,” \u003ca href=\"https://providers.ucsd.edu/details/11556/infectious-diseases-hiv/aids\">Francesca Torriani\u003c/a>, an infectious disease physician at the University of California, San Diego, explained to me recently.\u003c/p>\n\u003cp>As I shuffled around my room checking my fever, it was also reassuring to know that my chances of ending up in the hospital were slim, even with the delta variant. And now, about a month later, I’ve made a full recovery.\u003c/p>\n\u003cp>The reality is breakthrough cases are becoming more common. Here’s what you should know about getting a breakthrough case — and what I wish I’d known when those first symptoms laid me low:\u003c/p>\n\u003ch3>Is it time for a reality check about what the vaccines can — and can’t do?\u003c/h3>\n\u003cp>The vaccines aren’t a force field that ward off all things COVID-19. They were given the greenlight because they greatly lower your chance of getting seriously ill or dying.\u003c/p>\n\u003cp>But it was easy for me — and I’m not the only one — to grab onto the idea that, after so many months of trying not to get COVID-19, that the vaccine was, more or less, the finish line. And that made getting sick from the virus unnerving.\u003c/p>\n\u003cp>After all, there were reassuring findings\u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7013e3.htm\"> earlier this year\u003c/a> that the vaccine was remarkably good at stopping any infection, even mild ones. This was a kind of bonus, we were told. And then in May the Centers for Disease Control and Prevention said go ahead and shed your mask if you’re vaccinated.\u003c/p>\n\u003cp>“There was so much initial euphoria about how well these vaccines work,” says \u003ca href=\"https://kingcounty.gov/depts/health/about-us/health-officer.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Jeff Duchin\u003c/a>, an infectious disease physician and the public health officer for Seattle and King County. “I think we — in the public health community, in the medical community — facilitated the impression that these vaccines are bulletproof.”\u003c/p>\n\u003cp>It’s hard to keep dialing up and down your risk calculations. So if you’d hoped to avoid getting sick at all, even slightly, it may be time for a “reset,” Duchin says. This isn’t to be alarmist but to clear away expectations that COVID-19 is out of your life, and keep up your vigilance about common-sense precautions.\u003c/p>\n\u003cp>With more people vaccinated, the total number of breakthrough infections will rise, and that’s not unexpected, he says. “I don’t think our goal should be to achieve zero risk, because that’s unrealistic.”\u003c/p>\n\u003ch3>How high are my chances of getting a breakthrough case these days?\u003c/h3>\n\u003cp>It used to be quite rare, but the rise of delta has changed the odds.\u003c/p>\n\u003cp>“It’s a totally different ballgame with this delta phase,” says \u003ca href=\"https://www.scripps.edu/faculty/topol/\">Dr. Eric Topol\u003c/a>, a professor of molecular medicine at the Scripps Research Translational Institute in La Jolla, Calif. “I think the chance of having a symptomatic infection has gone up substantially.”\u003c/p>\n\u003cp>But he adds, “Quantifying that in the U.S. is very challenging” because our “data is so shoddy.”\u003c/p>\n\u003cp>The vaccinated still have a considerably lower chance of getting infected than those who aren’t protected that way. Look at data collected from Los Angeles County over the summer as the delta variant started to surge in Southern California: Unvaccinated people were \u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e5.htm\">five times more likely to test positive\u003c/a> than those who were vaccinated.\u003c/p>\n\u003cp>Recent research has tried to pin down how well the vaccines are working against preventing any breakthrough cases during the delta surge, but much of that comes from other countries and estimates vary significantly.\u003c/p>\n\u003cp>In the U.S., a study published recently in \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMc2112981\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cem>The New England Journal of Medicine\u003c/em>\u003c/a> concluded that vaccine effectiveness “against any symptomatic disease is considerably lower against the delta variant,” dropping from over 90% earlier in the year before delta was the predominant strain to only about 65% in July. Research on breakthrough infections over the summer in New York found the vaccines were still overall \u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e1.htm\" target=\"_blank\" rel=\"noopener noreferrer\">about 80% effective against any infection\u003c/a>. Each study has its limits.\u003c/p>\n\u003cp>It’s hard to disentangle what’s most responsible for the rise in breakthrough infections this summer — whether it’s the delta variant itself, waning immunity in some people or that much of the U.S. dropped public health precautions such as masking.\u003c/p>\n\u003cp>“We don’t have good evidence of what’s the cause, but we do know all of these things coming together are associated with more breakthroughs,” says\u003ca href=\"https://www.hsph.harvard.edu/community-safety/people/rachael-piltch-loeb-phd/\"> Rachael Piltch-Loeb\u003c/a>, a public health researcher at the Harvard T.H. Chan School of Public Health.\u003c/p>\n\u003ch3>How careful do I need to be if I want to avoid a breakthrough?\u003c/h3>\n\u003cp>Looking back, I wish I’d taken some more precautions.\u003c/p>\n\u003cp>And my advice is different now when friends and family tell me they want to avoid having a breakthrough case such as mine: Don’t leave it all up to the vaccine. Wear masks, stay away from big gatherings with unvaccinated people, cut down on travel, at least until things calm down.\u003c/p>\n\u003cp>The U.S. \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html\">is averaging more than 130,000\u003c/a> coronavirus infections a day (about twice what it was when I fell sick), hospitals are being crushed and the White House has proposed booster shots. Scientists are still making sense of what’s happening with breakthrough cases.\u003c/p>\n\u003cp>What’s clear is that in many parts of the U.S., we’re all more likely to run into the virus than we were in the spring. “Your risk is going to be different if you are in a place that’s very highly vaccinated, with very low level of community spread,” says \u003ca href=\"https://www.uofmhealth.org/profile/922/preeti-n-malani-md\">Preeti Malani\u003c/a>, an infectious disease specialist at the University of Michigan. “The piece that’s important is what’s happening in your community.”\u003c/p>\n\u003cp>Even with delta, the goal is not to go back to a lockdown mindset though, Malani says. “My hope is that people who are fully vaccinated should really feel like this risk is manageable.”\u003c/p>\n\u003cp>She says, “Feel good about spending time with your friends or having a small dinner party, but make sure everyone is vaccinated.”\u003c/p>\n\u003ch3>What does a “mild” case of COVID-19 feel like?\u003c/h3>\n\u003cp>In my case, it was worse than expected, but in the parlance of public health, it was “mild,” meaning I didn’t end up in the hospital or require oxygen.\u003c/p>\n\u003cp>This mild category is essentially a catchall, says \u003ca href=\"https://profiles.ucsf.edu/robert.wachter\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Bob Wachter\u003c/a>, who chairs the Department of Medicine at the UCSF. “Mild” can be “a day of feeling crummy to being completely laid up in bed for a week, all of your bones hurt and your brain isn’t working well.”\u003c/p>\n\u003cp>“So even if we call them mild cases, as you’ve seen, sometimes these are ones you really don’t want to have if you can avoid it,” he says.\u003c/p>\n\u003cp>There’s not great data on the details of these mild breakthrough infections, but so far it appears that “you do way better than those who are not vaccinated,” says\u003ca href=\"https://healthcare.utah.edu/fad/mddetail.php?physicianID=u1074771&name=sarang-k-yoon\"> Dr. Sarang Yoon\u003c/a>, an occupational medicine specialist at the University of Utah Rocky Mountain Center for Occupational Environmental Health who was part of a nationwide CDC study on breakthrough infections. “In general, in terms of symptom duration, it’s much shorter.”\u003c/p>\n\u003cp>Yoon’s study, published in June with data collected before the delta surge, offers some reassurance: The presence of fever was cut in half, and the days spent in bed reduced by 60% among people with breakthrough infections, compared with unvaccinated people who got sick. “These are meaningful decreases,” says \u003ca href=\"https://medicine.utah.edu/faculty/mddetail.php?facultyID=u0067419\">Matt Thiese\u003c/a>, an epidemiologist and colleague of Yoon’s who worked on the study. “It can be the difference between having a fever for almost nine days and having a fever for just under three days.”\u003c/p>\n\u003cp>A recent study from the U.K. also shows that if you’re sick because of a breakthrough case, it’s generally not as bad, and people have fewer symptoms. In fact, the \u003ca href=\"https://covid.joinzoe.com/post/new-top-5-covid-symptoms\" target=\"_blank\" rel=\"noopener noreferrer\">top five symptoms\u003c/a> for people with a breakthrough infection were headache, sneezing, runny nose, sore throat and loss of smell. Notably absent: fever and persistent cough, which are in the top five for unvaccinated people, according to the data compiled by the U.K. researchers.\u003c/p>\n\u003ch3>If I get a breakthrough infection, how sick could I get?\u003c/h3>\n\u003cp>Even with delta, the chance of getting a case of COVID-19 that’s bad enough to send you to the hospital is still rare.\u003c/p>\n\u003cp>If you’re vaccinated, the\u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7037e2.htm?s_cid=mm7037e2_w\" target=\"_blank\" rel=\"noopener noreferrer\"> risk of being hospitalized is 10 times lower\u003c/a> than if you weren’t vaccinated, according to the latest data from the CDC. Those who get severely and critically ill with a breakthrough case tend to be older — in one study done before delta, \u003ca href=\"https://news.yale.edu/2021/09/07/study-examines-severe-breakthrough-cases-covid-19\">the median age was 80\u003c/a> — with underlying medical conditions such as cardiovascular disease.\u003c/p>\n\u003cp>When I was sick, one thing was in the back of my mind as I monitored my symptoms: Would I have problems catching my breath?\u003c/p>\n\u003cp>Thankfully, when you get exposed, the vaccine has already set you up with antibodies, a first line of defense, that will neutralize parts of the virus that attach to the mucosal surfaces of your upper respiratory tract, says Torriani at UC San Diego.\u003c/p>\n\u003cp>“That initial moment when our body is attacked by the virus, that \u003cem>can\u003c/em> lead to some disease,” she says. It’s a bit of a race.\u003c/p>\n\u003cp>The virus may cause you to get a cold, but, in most people, your immune system will “get its act together and thwart that infection from going down into your lungs,” Wachter says.\u003c/p>\n\u003cp>That later stage of COVID-19 also seems to trigger the immune system to get “overly exuberant” and attack your own body, causing severe respiratory problems such as shortness of breath and destructive inflammation. “So if you can prevent that sort of second stage from happening,” Wachter says, “you can prevent a lot of the severe illness from COVID.” Other parts of your immune system, such as T-cells, are also ready to kick into action if you get sick.\u003c/p>\n\u003cp>If you’re concerned, you can keep an eye on your oxygen levels with a pulse oximeter. That’s much more important than your temperature or symptoms, he says.\u003c/p>\n\u003ch3>Can I spread it to others, and do I need to isolate?\u003c/h3>\n\u003cp>Unfortunately, you still have COVID-19 and need to act like it.\u003c/p>\n\u003cp>Even though my first two tests were negative, I started wearing a mask at my house and keeping my distance from my vaccinated family members. I’m glad I did: No one else got sick.\u003c/p>\n\u003cp>The delta variant is more than two times as contagious as the original strain of the virus and can build up quickly in your upper respiratory tract, as was shown in \u003ca href=\"https://www.npr.org/sections/health-shots/2021/08/06/1025553638/how-a-gay-community-helped-the-cdc-spot-a-covid-outbreak-and-learn-more-about-de\" target=\"_blank\" rel=\"noopener noreferrer\">a cluster of breakthrough infections linked to Provincetown, Mass\u003c/a>., over the summer.\u003c/p>\n\u003cp>“Even in fully vaccinated, asymptomatic individuals, they can have enough virus to transmit it,” says \u003ca href=\"https://www.rockefeller.edu/our-scientists/heads-of-laboratories/952-robert-b-darnell/\">Robert Darnell\u003c/a>, a physician scientist at the Rockefeller University. “Delta is very good at replicating, attaching and inserting itself into cells.”\u003c/p>\n\u003cp>The science isn’t settled about just how likely vaccinated people are to spread the virus, and it does appear that \u003ca href=\"https://www.nature.com/articles/s41591-021-01316-7\" target=\"_blank\" rel=\"noopener noreferrer\">the amount of virus in the nose decreases\u003c/a> faster in people who are vaccinated.\u003c/p>\n\u003cp>Even so, wearing masks and staying isolated from others if you test positive or have symptoms is absolutely critical, Darnell says. He also advises getting tested if you are exposed to someone who has COVID-19, even if you’ve been vaccinated, “because you could very well get infected or ill, and you want to protect those around you, including all the children who aren’t vaccinated.”\u003c/p>\n\u003ch3>Could I get long COVID-19 after a breakthrough infection?\u003c/h3>\n\u003cp>The chance I \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html\">might go on to develop long COVID-19\u003c/a> was front and center in my mind when I had a breakthrough case.\u003c/p>\n\u003cp>While there’s not a lot of data yet, research does show that breakthrough infections can lead to the kind of persistent symptoms that characterize long COVID-19, including brain fog, fatigue and headaches. “Hopefully that number is low. Hopefully it doesn’t last as long and it’s not as severe, but it’s just too early to know these things,” Topol says.\u003c/p>\n\u003cp>Recent research from the U.K. \u003ca href=\"https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00460-6/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">suggests that vaccinated people\u003c/a> are about 50% less likely to develop long COVID-19 than those who are unvaccinated. The underlying cause of long COVID-19 is still not yet known, so it complicates the picture for researchers even more, but this early evidence offers some reassurance.\u003c/p>\n\u003cp>“There may be some symptoms like fatigue [that linger], but studies appear to show that vaccination might also decrease the chances of getting long COVID symptoms,” Torriani says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This is not true for everyone, and it’s a compelling reason to avoid getting infected altogether, Wachter says. “Some of those mild cases will go on to be long COVID, so you have to factor that in,” he says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=I+Got+A+%27Mild%27+Breakthrough+Case.+Here%27s+What+I+Wish+I%27d+Known&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"title": "Evaluating the New Mu Variant in California",
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"content": "\u003cp>The delta variant pretty much ruined summer by setting back the pandemic recovery by months. So if the public is feeling wary of any new coronavirus variants, it’s understandable.\u003c/p>\n\u003cp>The latest new strain, called mu, after the Greek letter, is now present in California, with 348 cases having been identified.\u003c/p>\n\u003cp>\u003cstrong>Dr. Peter Chin-Hong\u003c/strong>, an infectious disease specialist at UCSF, joined KQED’s Raquel Maria Dillon this week to discuss this new variant and how much of a risk it is to prolonging the pandemic.\u003c/p>\n\u003cp>The following has been edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>Why are epidemiologists watching mu so closely?\u003c/strong>\u003c/p>\n\u003cp>\u003cem>Chin-Hong:\u003c/em> It kind of took over the landscape of viruses in Colombia. In the last month or so, it accounted for up to 40% of cases there and also surrounding countries like Ecuador. And now it may be even higher in Colombia; some estimates are above 90%. Nevertheless, it hasn’t really taken off around the world, making up less than 1% of cases around the world. In fact, in the United States, it’s 0.1-0.2% of the cases sequenced last month.\u003c/p>\n\u003cp>\u003cstrong>When should we start to worry about a new variant?\u003c/strong>\u003c/p>\n\u003cp>I think about three questions that I ask myself every time there’s a new variant. Is it more transmissible? Is it more vaccine-evading or vaccine resistant? And does it make you sicker compared to the regular COVID? Personally, what I look at is tempo. If you remember with delta, it took us by surprise. It was found to be so transmissible in taking over the landscape at a tempo that was breathtaking. In May, it was 5% of cases in California. The next month, it started to go to 25%, then 50%. We are not really seeing that with mu outside of Colombia at this moment.\u003c/p>\n\u003cp>\u003cstrong>What’s your personal assessment of mu? And is it here in the Bay Area?\u003c/strong>\u003c/p>\n\u003cp>Mu is definitely here. It’s in 45 countries and in all of the states in the U.S. It’s here because there’s a lot of travel back and forth between the northern part of South America, where it’s dominant, and California.\u003c/p>\n\u003cp>I’m not dispensing with it; it’s something to watch. I’m also not losing sleep over it. These variants may look scary in the lab. But when they come on to the boxing ring that is life, they all play off against each other. And so far, delta is very, very dominant. It’s bullyish. It’s keeping all these other variants in subjugation.\u003c/p>\n\u003cp>\u003cstrong>Are we going to have to be on guard against new variants forever and ever?\u003c/strong>\u003c/p>\n\u003cp>Yes, unfortunately, until more of us get vaccinated. SARS-CoV-2, the virus itself, isn’t very precise; it’s like it’s using a cheap photocopy machine to make copies of itself. Every time it makes a copy, there’s a little bit of an error in it, like a smudge. And that smudge may confer new superpowers — that’s a new variant being created. Every time it makes a copy, there’s that possibility of mutation. In fact, scientists believe every two weeks there’s a new variant somewhere in the world being created, but only a few rise to the rogues gallery of fame, like delta, like mu, like lamda.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>We’ve heard that viruses generally evolve to be less deadly and more contagious. Is that going to be true with COVID-19?\u003c/strong>\u003c/p>\n\u003cp>The virus has to survive in some way; it doesn’t want to die off completely. So some of these superpowers the variants have are probably going to attenuate. These powers of the new variants have been selected for the variants to be prevalent in the community, but not necessarily to be super lethal and kill off all the hosts. So it gets to the point that we want to probably live with COVID, learn to manage it rather than to fear it.\u003c/p>\n\u003cp>\u003cstrong>Should we jump every time a variant gets an official letter, or should we just chill out?\u003c/strong>\u003c/p>\n\u003cp>I definitely think we have to pay attention to each one of them. I think we have to anticipate, be prepared. It’s exhausting, but we have to be in this state of readiness. It reminds us that we’re living with this virus and we need to engage in conversations with folks who haven’t been vaccinated. Really, vaccination is a powerful ally as we battle mu, iota, delta, lambda, the future variants that don’t even have Greek letters yet.\u003c/p>\n\u003cp>\u003cstrong>I like your superpower metaphor, but what I really want is for the vaccines to grant me superpowers …\u003c/strong>\u003c/p>\n\u003cp>I know, but the vaccines \u003cem>are\u003c/em> giving us superpowers. So I think we just have to believe in them more as a country overall.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The delta variant pretty much ruined summer by setting back the pandemic recovery by months. So if the public is feeling wary of any new coronavirus variants, it’s understandable.\u003c/p>\n\u003cp>The latest new strain, called mu, after the Greek letter, is now present in California, with 348 cases having been identified.\u003c/p>\n\u003cp>\u003cstrong>Dr. Peter Chin-Hong\u003c/strong>, an infectious disease specialist at UCSF, joined KQED’s Raquel Maria Dillon this week to discuss this new variant and how much of a risk it is to prolonging the pandemic.\u003c/p>\n\u003cp>The following has been edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>Why are epidemiologists watching mu so closely?\u003c/strong>\u003c/p>\n\u003cp>\u003cem>Chin-Hong:\u003c/em> It kind of took over the landscape of viruses in Colombia. In the last month or so, it accounted for up to 40% of cases there and also surrounding countries like Ecuador. And now it may be even higher in Colombia; some estimates are above 90%. Nevertheless, it hasn’t really taken off around the world, making up less than 1% of cases around the world. In fact, in the United States, it’s 0.1-0.2% of the cases sequenced last month.\u003c/p>\n\u003cp>\u003cstrong>When should we start to worry about a new variant?\u003c/strong>\u003c/p>\n\u003cp>I think about three questions that I ask myself every time there’s a new variant. Is it more transmissible? Is it more vaccine-evading or vaccine resistant? And does it make you sicker compared to the regular COVID? Personally, what I look at is tempo. If you remember with delta, it took us by surprise. It was found to be so transmissible in taking over the landscape at a tempo that was breathtaking. In May, it was 5% of cases in California. The next month, it started to go to 25%, then 50%. We are not really seeing that with mu outside of Colombia at this moment.\u003c/p>\n\u003cp>\u003cstrong>What’s your personal assessment of mu? And is it here in the Bay Area?\u003c/strong>\u003c/p>\n\u003cp>Mu is definitely here. It’s in 45 countries and in all of the states in the U.S. It’s here because there’s a lot of travel back and forth between the northern part of South America, where it’s dominant, and California.\u003c/p>\n\u003cp>I’m not dispensing with it; it’s something to watch. I’m also not losing sleep over it. These variants may look scary in the lab. But when they come on to the boxing ring that is life, they all play off against each other. And so far, delta is very, very dominant. It’s bullyish. It’s keeping all these other variants in subjugation.\u003c/p>\n\u003cp>\u003cstrong>Are we going to have to be on guard against new variants forever and ever?\u003c/strong>\u003c/p>\n\u003cp>Yes, unfortunately, until more of us get vaccinated. SARS-CoV-2, the virus itself, isn’t very precise; it’s like it’s using a cheap photocopy machine to make copies of itself. Every time it makes a copy, there’s a little bit of an error in it, like a smudge. And that smudge may confer new superpowers — that’s a new variant being created. Every time it makes a copy, there’s that possibility of mutation. In fact, scientists believe every two weeks there’s a new variant somewhere in the world being created, but only a few rise to the rogues gallery of fame, like delta, like mu, like lamda.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>We’ve heard that viruses generally evolve to be less deadly and more contagious. Is that going to be true with COVID-19?\u003c/strong>\u003c/p>\n\u003cp>The virus has to survive in some way; it doesn’t want to die off completely. So some of these superpowers the variants have are probably going to attenuate. These powers of the new variants have been selected for the variants to be prevalent in the community, but not necessarily to be super lethal and kill off all the hosts. So it gets to the point that we want to probably live with COVID, learn to manage it rather than to fear it.\u003c/p>\n\u003cp>\u003cstrong>Should we jump every time a variant gets an official letter, or should we just chill out?\u003c/strong>\u003c/p>\n\u003cp>I definitely think we have to pay attention to each one of them. I think we have to anticipate, be prepared. It’s exhausting, but we have to be in this state of readiness. It reminds us that we’re living with this virus and we need to engage in conversations with folks who haven’t been vaccinated. Really, vaccination is a powerful ally as we battle mu, iota, delta, lambda, the future variants that don’t even have Greek letters yet.\u003c/p>\n\u003cp>\u003cstrong>I like your superpower metaphor, but what I really want is for the vaccines to grant me superpowers …\u003c/strong>\u003c/p>\n\u003cp>I know, but the vaccines \u003cem>are\u003c/em> giving us superpowers. So I think we just have to believe in them more as a country overall.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "Pfizer's COVID Vaccine Gets Full Approval From The FDA",
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"content": "\u003cdiv class=\"fullattribution\">\n\u003cp>The Food and Drug Administration has formally approved Pfizer’s COVID-19 vaccine. The widely anticipated decision replaces the emergency use authorization granted by the agency last December.\u003c/p>\n\u003cp>This is the first COVID-19 vaccine to be subject to a full review by the U.S. regulator and to get an approval that puts the vaccine on par with other marketed vaccines.\u003c/p>\n\u003cp>The full approval could make it easier for employers, the military and universities to mandate vaccination and may reassure some people who are hesitant about the vaccine.\u003c/p>\n\u003cp>“While this and other vaccines have met the FDA’s rigorous, scientific standards for emergency use authorization, as the first FDA-approved COVID-19 vaccine, the public can be very confident that this vaccine meets the high standards for safety, effectiveness, and manufacturing quality the FDA requires of an approved product,” \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-covid-19-vaccine\">acting FDA Commissioner Janet Woodcock said in a statement\u003c/a>.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">California Gov. Gavin Newsom was quick to issue supportive words Monday morning in a statement emailed to reporters, saying he encourages “all Californians to trust the science and protect themselves and their community by getting vaccinated.”\u003c/span>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003cspan style=\"font-weight: 400\"> Tomás Aragón, California’s public health officer, said the agency’s official approval of the vaccine “underscores the safety and efficacy of the COVID-19 vaccine and comes at a critical juncture as many of our communities are grappling with increasing cases fueled by the faster spreading Delta variant.”\u003c/span>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003cspan style=\"font-weight: 400\">“For weeks we have watched cases go up at an alarming pace among individuals who are not vaccinated while the vaccinated are largely protected, especially against severe and long-term illness,” he said in a statement. “We know the vaccines work. We know vaccines are safe. We know they save lives. If you are not vaccinated, let this be the milestone that gets you there. Get vaccinated to protect yourself and help put an end to this deadly pandemic.”\u003c/span>\u003c/p>\n\u003ch3 class=\"edTag\">Approval could lead to more vaccinations\u003c/h3>\n\u003cp>A \u003ca href=\"https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-june-2021/\">June poll\u003c/a> from the Kaiser Family Foundation found that 31% of unvaccinated people said they would be more likely to get a COVID-19 vaccine once one receives full approval from the FDA.\u003c/p>\n\u003cp>“While millions of people have already safely received COVID-19 vaccines, we recognize that for some, the FDA approval of a vaccine may now instill additional confidence to get vaccinated,” Woodcock said. “Today’s milestone puts us one step closer to altering the course of this pandemic in the U.S.”\u003c/p>\n\u003cp>The FDA’s full approval applies to people 16 and older. Those between ages 12 and 15 can still receive the vaccine under the existing emergency use authorization.\u003c/p>\n\u003ch3 class=\"edTag\">There is no timeline for children under 12\u003c/h3>\n\u003cp>That authorization does not extend to children under the age of 12. FDA officials have acknowledged the interest in vaccination for children in that age group, but were unable Monday to provide a timeline for a decision on use of the vaccine for those under 12.\u003c/p>\n\u003cp>“Currently there are still trials ongoing here,” Dr. Peter Marks, director of FDA’s Center for Biologics Evaluation and Research, told reporters. “The agency has to wait for the companies to submit. … Obviously, we will move swiftly, but first the trials have to be finished … and the data need to be submitted to us.”\u003c/p>\n\u003cp>The FDA acted Monday without convening a customary public meeting of expert advisers to vet information about the vaccine and make recommendations to the regulator.\u003c/p>\n\u003cp>As of Sunday, 73%\u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#vaccinations\"> of adults have had at least one dose\u003c/a> of the Pfizer, Moderna or Johnson & Johnson vaccine. Pfizer’s vaccine is most commonly administered, accounting for about 56% of the doses administered overall, according to data from the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Moderna’s COVID-19 vaccine remains under the FDA’s review, but its approval is expected to follow in the near future.\u003c/p>\n\u003cp>\u003cem>KQED’s Kevin Stark contributed to this report. \u003c/em>\u003c/p>\n\u003cp>Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003c/p>\n\u003cp>\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Pfizer%27s+COVID+Vaccine+Gets+Full+Approval+From+The+FDA&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/p>\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cdiv class=\"fullattribution\">\n\u003cp>The Food and Drug Administration has formally approved Pfizer’s COVID-19 vaccine. The widely anticipated decision replaces the emergency use authorization granted by the agency last December.\u003c/p>\n\u003cp>This is the first COVID-19 vaccine to be subject to a full review by the U.S. regulator and to get an approval that puts the vaccine on par with other marketed vaccines.\u003c/p>\n\u003cp>The full approval could make it easier for employers, the military and universities to mandate vaccination and may reassure some people who are hesitant about the vaccine.\u003c/p>\n\u003cp>“While this and other vaccines have met the FDA’s rigorous, scientific standards for emergency use authorization, as the first FDA-approved COVID-19 vaccine, the public can be very confident that this vaccine meets the high standards for safety, effectiveness, and manufacturing quality the FDA requires of an approved product,” \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-covid-19-vaccine\">acting FDA Commissioner Janet Woodcock said in a statement\u003c/a>.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">California Gov. Gavin Newsom was quick to issue supportive words Monday morning in a statement emailed to reporters, saying he encourages “all Californians to trust the science and protect themselves and their community by getting vaccinated.”\u003c/span>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003cspan style=\"font-weight: 400\"> Tomás Aragón, California’s public health officer, said the agency’s official approval of the vaccine “underscores the safety and efficacy of the COVID-19 vaccine and comes at a critical juncture as many of our communities are grappling with increasing cases fueled by the faster spreading Delta variant.”\u003c/span>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003cspan style=\"font-weight: 400\">“For weeks we have watched cases go up at an alarming pace among individuals who are not vaccinated while the vaccinated are largely protected, especially against severe and long-term illness,” he said in a statement. “We know the vaccines work. We know vaccines are safe. We know they save lives. If you are not vaccinated, let this be the milestone that gets you there. Get vaccinated to protect yourself and help put an end to this deadly pandemic.”\u003c/span>\u003c/p>\n\u003ch3 class=\"edTag\">Approval could lead to more vaccinations\u003c/h3>\n\u003cp>A \u003ca href=\"https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-june-2021/\">June poll\u003c/a> from the Kaiser Family Foundation found that 31% of unvaccinated people said they would be more likely to get a COVID-19 vaccine once one receives full approval from the FDA.\u003c/p>\n\u003cp>“While millions of people have already safely received COVID-19 vaccines, we recognize that for some, the FDA approval of a vaccine may now instill additional confidence to get vaccinated,” Woodcock said. “Today’s milestone puts us one step closer to altering the course of this pandemic in the U.S.”\u003c/p>\n\u003cp>The FDA’s full approval applies to people 16 and older. Those between ages 12 and 15 can still receive the vaccine under the existing emergency use authorization.\u003c/p>\n\u003ch3 class=\"edTag\">There is no timeline for children under 12\u003c/h3>\n\u003cp>That authorization does not extend to children under the age of 12. FDA officials have acknowledged the interest in vaccination for children in that age group, but were unable Monday to provide a timeline for a decision on use of the vaccine for those under 12.\u003c/p>\n\u003cp>“Currently there are still trials ongoing here,” Dr. Peter Marks, director of FDA’s Center for Biologics Evaluation and Research, told reporters. “The agency has to wait for the companies to submit. … Obviously, we will move swiftly, but first the trials have to be finished … and the data need to be submitted to us.”\u003c/p>\n\u003cp>The FDA acted Monday without convening a customary public meeting of expert advisers to vet information about the vaccine and make recommendations to the regulator.\u003c/p>\n\u003cp>As of Sunday, 73%\u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#vaccinations\"> of adults have had at least one dose\u003c/a> of the Pfizer, Moderna or Johnson & Johnson vaccine. Pfizer’s vaccine is most commonly administered, accounting for about 56% of the doses administered overall, according to data from the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Moderna’s COVID-19 vaccine remains under the FDA’s review, but its approval is expected to follow in the near future.\u003c/p>\n\u003cp>\u003cem>KQED’s Kevin Stark contributed to this report. \u003c/em>\u003c/p>\n\u003cp>Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003c/p>\n\u003cp>\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Pfizer%27s+COVID+Vaccine+Gets+Full+Approval+From+The+FDA&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/p>\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Calls Intensify For Stronger Worker Protections As Heat Deaths Rise In Calif. and U.S.",
"headTitle": "Calls Intensify For Stronger Worker Protections As Heat Deaths Rise In Calif. and U.S. | KQED",
"content": "\u003cp>As the temperature in Grand Island, Nebraska, soared to 91 degrees that July day in 2018, two dozen farmworkers tunneled for nine hours into a thicket of cornstalks, snapping off tassels while they crossed a sunbaked field that spanned 206 acres — the equivalent of 156 football fields.\u003c/p>\n\u003cp>When they emerged at the end of the day to board a bus that would transport them to a nearby motel to sleep, one of the workers, Cruz Urias Beltran, didn’t make it back. Searchers found the 52-year-old farmworker’s body 20 hours later amid the cornhusks, “as if he’d simply collapsed,” recalled a funeral home employee. An empty water bottle was stuffed in his jeans pocket. An autopsy report confirmed that Beltran died from heatstroke. It was his third day on the job.\u003c/p>\n\u003cp>Beltran is one of at least 384 workers who died from environmental heat exposure in the U.S. in the last decade, according to an investigation by NPR and Columbia Journalism Investigations, the investigative reporting unit of the Columbia Journalism School. The count includes people toiling in essential, yet often, invisible jobs in 37 states across the country: farm laborers in California, construction and trash-collection workers in Texas and tree trimmers in North Carolina and Virginia. An analysis of federal data from the Bureau of Labor Statistics shows the three-year average of worker heat deaths has doubled since the early 1990s.\u003c/p>\n\u003cfigure id=\"attachment_1976348\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1976348\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/cruz_in_the_1990s-edit-d66a1ab99079af2d799ed3c53e9aa916dbe96937-3-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_in_the_1990s-edit-d66a1ab99079af2d799ed3c53e9aa916dbe96937-3-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_in_the_1990s-edit-d66a1ab99079af2d799ed3c53e9aa916dbe96937-3-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_in_the_1990s-edit-d66a1ab99079af2d799ed3c53e9aa916dbe96937-3-768x576.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_in_the_1990s-edit-d66a1ab99079af2d799ed3c53e9aa916dbe96937-3.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A family photo of Cruz Urias Beltran taken during the 1990s. \u003ccite>(Paty Espinoza)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>CJI and NPR reviewed hundreds of pages of documents, including workplace inspection reports, death investigation files, depositions, court records and police reports, and interviewed victims’ families, former and current officials from the Occupational Safety and Health Administration, workers, employers, workers’ advocates, lawyers and experts.\u003c/p>\n\u003cp>CJI and NPR also analyzed two federal data sets on worker heat deaths: one from the Occupational Safety and Health Administration, the other from the Bureau of Labor Statistics. Both are divisions within the U.S. Labor Department.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Among the findings:\u003c/p>\n\u003cul>\n\u003cli>The Occupational Safety and Health Administration (OSHA), whose primary responsibility is to protect workers from hazards, has failed to adopt a national heat standard to safeguard workers against rapidly rising temperatures, resulting in an enforcement system rife with problems.\u003c/li>\n\u003cli>For at least a dozen companies, it wasn’t the first time their workers succumbed to heat. One worker collapsed and died after repeatedly complaining about the heat; another died after hauling 20 tons of trash for nearly 10 hours. In some instances, employees died after not having ample water and scheduled shade breaks. Many died within their first week on the job.\u003c/li>\n\u003cli>OSHA officials often decide not to penalize companies for worker deaths. When they do, they routinely negotiate with business owners and reduce violations and fines.\u003c/li>\n\u003cli>In some cases, OSHA doesn’t follow up after a worker’s death from heat exposure to ensure that the company is complying with the measures the agency imposed to prevent future fatalities.\u003c/li>\n\u003cli>Workers of color have borne the brunt: Since 2010, Hispanics have accounted for a third of all heat fatalities, yet they represent a fraction — 17% — of the U.S. workforce. Health and safety experts attribute this unequal toll to Hispanics’ overrepresentation in industries vulnerable to dangerous heat, such as construction and agriculture.\u003c/li>\n\u003cli>OSHA’s record-keeping on heat fatalities is so poor that there’s no way to know exactly how many workers have died from heat.\u003c/li>\n\u003c/ul>\n\u003cp>Current and former OSHA officials acknowledge that the known death tally is a vast undercount. The agency mostly relies on companies to report worker fatalities after they occur, but not all do so.\u003c/p>\n\u003cp>CJI and NPR reporters analyzed worker heat deaths recorded by OSHA between 2010 and 2020 and compared each incident day’s high temperature with historical averages over 40 years. Most of the deaths happened on days that were unusually hot for that date. More than two-thirds occurred on days when the temperature reached at least 90 degrees.\u003c/p>\n\u003cp>Yet no worker should die from heat, said Ronda McCarthy, an occupational health specialist who directs medical services at the health care provider Concentra, in Waco, Texas. McCarthy spent seven years educating her home state’s municipal workers about heat, which reduced cases of worker heat exhaustion and similar conditions there.\u003c/p>\n\u003cp>“Heat illness should be considered a preventable illness,” she said.\u003c/p>\n\u003ch3>No federal heat standard\u003c/h3>\n\u003cp>OSHA has known about the dangers of heat — and how to prevent deaths — for decades. In 1972, the National Institute for Occupational Safety and Health (NIOSH), part of the U.S. Centers for Disease Control and Prevention, studied the effects of heat stress on workers in the U.S. and recommended criteria for an OSHA heat standard. Under the proposal, employers would have had to give employees one break every hour and offer ready access to water. New workers would have received extra breaks so they could acclimate to strenuous activity in the heat.\u003c/p>\n\u003cp>NIOSH has refined these safety measures — first in 1986 and, again, in 2016 — but OSHA has not acted on them because of other regulatory priorities. This year, for the first time, OSHA is officially considering a heat standard by putting it on its regulatory agenda. James Frederick, OSHA’s acting director, said it’s a “priority” for the Biden administration.\u003c/p>\n\u003cp>“Occupational exposure to heat remains a very important topic,” Frederick said in an interview with CJI and NPR. “We’re focused on improving our efforts to protect workers moving forward.”\u003c/p>\n\u003cfigure id=\"attachment_1976349\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976349 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-1920x1279.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2.jpg 2000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Jim Frederick, acting assistant secretary of labor for the Occupational Safety and Health Administration, stands in the national office of OSHA in Washington, D.C., on July 26, 2021. \u003ccite>(Ian Morton/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Absent a heat standard, OSHA must rely on a 50-year-old regulation guaranteeing workers a “hazard-free workplace.” OSHA does require companies to provide adequate water, but not other heat-safety measures.\u003c/p>\n\u003cp>OSHA’s own research shows relying on this general rule hasn’t worked. A 2016 study by agency scientists found that some employers whose workers got sick or died from heat hadn’t met basic water provisions. Most companies never offered rest breaks. Only one out of 84 total employers had a plan for building up its workers’ tolerance for laboring in heat.\u003c/p>\n\u003cp>In 2011, four labor and public interest organizations, including Public Citizen, a consumer rights advocacy group, petitioned OSHA to issue a heat standard. They asked the agency for an emergency temporary standard because a new rule, the petition stated, “could potentially take many years before it’s finalized and implemented.”\u003c/p>\n\u003cp>David Michaels, then the assistant secretary of labor for Occupational Safety and Health, who oversaw OSHA, denied the petition, arguing in a January 2012 letter to petitioners that workers weren’t dying from heat at a rate that would justify a legal standard. Recognizing extreme heat’s threat, he said most workers can “recover fairly quickly when the appropriate measures are taken.”\u003c/p>\n\u003cp>Instead, Michaels launched a voluntary awareness campaign distributing posters and flyers that instructed employees on how to protect themselves. OSHA incorporated these precautions into a free bilingual phone app featuring government-issued heat alerts and advisories. The agency continued this campaign through 2013. Its principle message remains on \u003ca href=\"https://www.osha.gov/heat\">OSHA’s website today\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_1976351\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976351 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">David Michaels, the assistant secretary of labor for the Occupational Safety and Health Administration, attends a full committee hearing on Capitol Hill in Washington, D.C., on June 23, 2010. The hearing was on “Worker Health and Safety from the Oil Rig to the Shoreline,” focusing on how worker health and safety is regulated and enforced by various parties, from oil rig workers to post-accident cleanup operations. \u003ccite>(Astrid Riecken/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Michaels touted the campaign as a success at the time. The numbers are less clear. The number of workers who succumbed to heat topped 61 cases during the campaign’s inaugural year, in 2011 — an all-time high. An additional 65 workers would die from heat exposure in the ensuing two years, closer to the annual average for the decade, while the campaign remained an agency priority.\u003c/p>\n\u003cp>Six years after his petition denial letter, and after leaving OSHA’s top post, Michaels changed his approach. In 2018, he joined Public Citizen and 131 additional groups in a second petition asking the agency to enact a heat standard. This time, petitioners cited NIOSH’s updated guidelines and warned that “this warming trend will not only continue but accelerate.”\u003c/p>\n\u003cp>In a recent interview, Michaels, now a public health professor at George Washington University in Washington, D.C., said the agencywide consensus was that climate change would worsen the problem. But the rule-making process at OSHA is “so difficult” and the industry opposition so formidable that adopting a heat standard “became a bridge too far,” he said. He has come to believe a standard is essential.\u003c/p>\n\u003cp>“We know that heat kills,” Michaels said. “And if we don’t have requirements, heat will kill more workers.”\u003c/p>\n\u003ch3>Search and rescue\u003c/h3>\n\u003cp>A standard that included water, rest, shade and acclimatization could have saved Beltran, an experienced farmworker who traveled more than 1,300 miles from San Luis, Arizona, to the heart of America’s Corn Belt to pull tassels off corn plants for Rivera Agri Inc.\u003c/p>\n\u003cp>The day he went missing in the fields on the outskirts of Grand Island, the temperature — with humidity — felt like 100 degrees. Joseph Rivera, the company’s owner, placed an emergency call to authorities shortly after 5 p.m. Beltran was in the field but didn’t come out with the other workers, he told the 911 operator.\u003c/p>\n\u003cfigure id=\"attachment_1976374\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976374 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-800x640.jpg\" alt=\"\" width=\"800\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-800x640.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-1020x816.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-160x128.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-768x614.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-1536x1229.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-2048x1638.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-1920x1536.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The cornfield where Cruz Urias Beltran’s body was found near Cairo, Neb., on July 28, 2021. \u003ccite>(Walker Pickering/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The call set off an elaborate search-and-rescue mission in the central Nebraska city of 51,000. One volunteer flew a Piper Cub airplane low and slow, on the lookout for the orange safety hat atop Beltran’s salt-and-pepper hair. Another manned a helicopter circling the sea of stalks until the chopper ran low on fuel. At sunset, a Nebraska State Patrol plane with thermal-imaging equipment scanned for a sign of Beltran’s body temperature, but since the plants and soil also were emanating heat, he went undetected.\u003c/p>\n\u003cp>The following morning, as the temperature hovered in the 90s, the Red Cross opened a temporary cooling station with air conditioning for the 100 volunteers who joined the search. Shortly after noon, someone spotted Beltran’s body, facedown in the husks.\u003c/p>\n\u003cp>Two months after Beltran’s body was shipped to his family’s home in Mexico’s Sonora state, an OSHA inspector visited Rivera Agri as part of the agency’s investigation into the death. OSHA inspection records show the company didn’t deploy the kind of preventive measures that a heat standard would have required. Rivera Agri did not ensure that employees took enough rest breaks in the shade, drank sufficient amounts of water and adapted to their grueling work, the records show.\u003c/p>\n\u003cfigure id=\"attachment_1976357\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1976357\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/cruz_urias_beltran_hugging_his_son_jesus_adrian_urias_machado-edit-40cf5ef60a1dc6e3723a63d2c216ceb3af5f9477-1-800x600.png\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_urias_beltran_hugging_his_son_jesus_adrian_urias_machado-edit-40cf5ef60a1dc6e3723a63d2c216ceb3af5f9477-1-800x600.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_urias_beltran_hugging_his_son_jesus_adrian_urias_machado-edit-40cf5ef60a1dc6e3723a63d2c216ceb3af5f9477-1-160x120.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_urias_beltran_hugging_his_son_jesus_adrian_urias_machado-edit-40cf5ef60a1dc6e3723a63d2c216ceb3af5f9477-1-768x576.png 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_urias_beltran_hugging_his_son_jesus_adrian_urias_machado-edit-40cf5ef60a1dc6e3723a63d2c216ceb3af5f9477-1.png 952w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Beltran hugs his son, Jesus Adrian Urias Machado. Beltran was an experienced farmworker and traveled from Arizona to work in Nebraska. \u003ccite>(Paty Espinoza)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“These actions were left to the employees to manage themselves,” the inspector wrote in a nine-page citation.\u003c/p>\n\u003cp>OSHA found that the “moderate lifting and bending” and “pushing and pulling” that Beltran had performed in the heat had contributed to his death. It cited Rivera Agri for a violation and proposed fines totaling $11,641. The agency also ordered the company to train employees on the symptoms of heat illness, among other safety measures. Rivera Agri agreed to OSHA’s conditions, and the fines were reduced to $9,500, records show.\u003c/p>\n\u003cp>Angela Rivera, who runs the farm labor contracting business with her father, Joseph, said the company has worked to fulfill the agreement. Today, it contracts with a farmworker-rights group to educate employees on how to respond to heat emergencies. Near the cornfield, it sets up extra water stations and has canopies for emergency shade.\u003c/p>\n\u003cp>“We’ve been in this business for a long time,” said Angela Rivera, who calls Beltran’s death “an unfortunate thing.”\u003c/p>\n\u003cp>“Every year we try to step it up,” she said.\u003c/p>\n\u003cp>Joseph Rivera said supervisors now monitor the heat on their cellphones and pull detasselers from the cornfields whenever it gets too hot — part of a heat-stress plan the Riveras created after Beltran’s death. They hand out brochures explaining the new policy to every farmworker on their bus.\u003c/p>\n\u003ch3>Not the first death\u003c/h3>\n\u003cp>Beltran was not Rivera Agri’s first heat-related fatality. In July 1997, a 39-year-old detasseler died of heatstroke under similar circumstances. Like Beltran, it was his third day on the job, and the temperature had spiked to 95 degrees. When he collapsed, the crew found him within two hours. But his core body temperature was 108 degrees — hot enough for the brain, liver and kidneys to shut down.\u003c/p>\n\u003cp>OSHA investigated his death but didn’t impose penalties because then-OSHA Area Director Ben Bare determined there was no applicable standard. The lack of a standard leaves individual OSHA officials to decide whether a general violation applies to each death, creating a pattern of uneven enforcement in worker heat-death cases, records show.\u003c/p>\n\u003cp>CJI and NPR’s analysis of worker heat deaths shows that, like Rivera Agri, 11 other companies have lost more than one employee. In five of the cases, OSHA investigated the first fatality and issued citations, only for another employee to die from heat. One of those cited was Texas-based Hellas Construction, which builds publicly and privately funded stadiums and other sports infrastructure projects across the country.\u003c/p>\n\u003cp>In July 2018, the week before Beltran died in a Nebraska cornfield, Karl Simmons signed on as a laborer for Hellas. At 30, with long braided hair and a shoulder tattoo bearing his mother’s name, Simmons arrived at the sprawling Gateway Park in Fort Worth, Texas, ready to install turf.\u003c/p>\n\u003cp>On his second day on the job, Simmons, who had served in the U.S. Navy, took a lunch break and fielded a call from his wife, Precious. “It’s just hot,” he complained, according to a deposition she gave in a lawsuit filed by the family against Hellas. The five-person crew had already drunk all the water. Simmons returned to preparing the mixture to attach to the turf, shoveling gravel and adhesive chemicals into a mixer.\u003c/p>\n\u003cp>That afternoon — as the temperature topped 96 degrees — Simmons told his supervisor he felt hot, according to OSHA records. He complained about the heat two more times that day. Each time, he said he felt sick. At one point, he sought shade under a tree while his supervisor drove to a store to get water.\u003c/p>\n\u003cp>A passerby eventually spotted Simmons sprawled on the ground, facedown, and alerted the crew. His brother-in-law, Michael Spriggins, who worked alongside Simmons as a Hellas laborer, sprinted to his aid. He found Simmons gasping for breath, bleeding from his nose and mouth.\u003c/p>\n\u003cfigure id=\"attachment_1976359\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976359 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Karl Simmons was installing turf at Gateway Park in Fort Worth, Texas, when he felt ill. Later, he was pronounced dead at a local hospital. The official cause of death was heatstroke. \u003ccite>(JerSean Golatt/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It was a sight I ain’t going to never forget,” Spriggins said in an interview with CJI and NPR.\u003c/p>\n\u003cp>He called 911 and then placed a cool towel under Simmons’ neck at the dispatcher’s instructions. Simmons opened his eyes.\u003c/p>\n\u003cp>“It looked like he’s gonna pull through this,” Spriggins recalled.\u003c/p>\n\u003cp>Two hours later, Simmons was pronounced dead at a local hospital. Heatstroke, the autopsy report confirmed. He was one of at least 53 workers who have been fatally stricken by heat in Texas since 2010, CJI and NPR’s analysis shows.\u003c/p>\n\u003cp>The next day, Jason Davidson, Hellas’ chief safety officer, emailed more than 340 company employees, addressing the perils of laboring in extreme heat. It was at least the fourth written warning he sent in the summer of 2018, when 11 additional Hellas employees were diagnosed with heat-related illnesses requiring medical attention.\u003c/p>\n\u003cp>Dean Wingo, who oversaw the OSHA regional office that includes Texas from 2007 to 2012, said Hellas’ hospitalization numbers suggest a worrying pattern. Serious heat-related illness involves everything from a heat rash to uncontrolled bleeding, according to medical experts. In its most severe form, heatstroke can cause multisystem organ failure that has lasting adverse effects. Wingo said he believes Hellas’ record on workplace heat safety shows “poor” company management.\u003c/p>\n\u003cfigure id=\"attachment_1976360\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1976360\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dean Wingo, who formerly oversaw the OSHA regional office that includes Texas, says he believes Hellas Construction’s record on workplace heat safety shows “poor” company management. \u003ccite>(Michael Cirlos III/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hellas officials declined a dozen interview requests for this story and didn’t respond to a list of 20 written questions from CJI and NPR. In its response to a wrongful-death lawsuit filed in July 2019 by Simmons’ wife, the company denied that its conduct “rose to a level of gross neglect” or that it failed to provide a safe workplace.\u003c/p>\n\u003cp>But in December 2018, OSHA found that Hellas hadn’t provided Simmons a workplace “free from recognized hazards” and cited the company for two violations, including failing to record Simmons’ death in OSHA logs, records show. OSHA proposed a fine of $14,782 against Hellas for Simmons’ death. The company earned more than $150 million in revenue that year.\u003c/p>\n\u003cp>As part of a settlement, Hellas agreed to implement “a more robust/detailed training program … to prevent heat exhaustion and heat stress injuries.” OSHA lowered the fine by nearly $2,000, to $12,934. That’s higher than the national average fine of $7,314 for employers in such cases, according to a CJI and NPR analysis.\u003c/p>\n\u003cp>Hellas executives did not carry out the safety measures, records show. And OSHA never showed up at a work site to see whether the company was following the terms of the settlement agreement.\u003c/p>\n\u003cp>OSHA’s regional office in Dallas, which investigated Simmons’ death, declined to discuss the case.\u003c/p>\n\u003cp>OSHA data shows the agency reduced heat-related sanctions nationally by 31%, on average, after settlements. It cut the penalties in more than half of the 246 heat-death cases in which OSHA had proposed them.\u003c/p>\n\u003cp>Wingo said the only way OSHA can ensure that companies like Hellas keep their promises is to conduct follow-up inspections in person.\u003c/p>\n\u003cp>“I don’t think it’s excusable,” he said. “When you’ve had a fatality, you go back.”\u003c/p>\n\u003cp>On July 19, 2019, a year after Simmons’ death, a second Hellas worker succumbed to heat — this time in Hondo, Texas, 42 miles west of San Antonio. At 6 a.m. that day, forecasters were promising a scorcher. The temperature would soar to 99 degrees, 3 degrees hotter than the 40-year average, the CJI and NPR data analysis shows.\u003c/p>\n\u003cp>Pedro Martinez Sr., 49, had been employed by Hellas for more than a year when he arrived for work at McDowell Middle School with his 22-year-old namesake. The father had gotten the son a summer job. At the time, Pedro Jr., also known as “Bruno,” was between semesters at a college in his home state of Zacatecas, Mexico.\u003c/p>\n\u003cp>On the third day, the pair did cement work on the school’s athletic field. They pulled out vertical rebar stakes using a device called a JackJaw, pumping a handle to wrench the stakes from the ground. As in the Simmons case, an OSHA inspection would later confirm that the area had little shade. Records show that the younger Martinez toiled for 10 hours before taking a lunch break at 4 p.m.\u003c/p>\n\u003cp>Nearly two hours later, he was working beside his father when he became overheated and ran off, hit a fence and collapsed. The father rushed his son to a local hospital’s emergency room, where nurses placed ice packs around his body. But his core temperature was already 108 degrees, according to a police report. The official cause of death was heatstroke.\u003c/p>\n\u003cfigure id=\"attachment_1976365\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976365 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The former construction site where Pedro Martinez Jr., died of heatstroke. The athletic field and track is adjacent to McDowell Middle School in Hondo, Texas. \u003ccite>(Michael Cirlos III/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In December 2019, OSHA cited Hellas for a willful violation, the most serious category. The citation would have placed Hellas on a public list of “severe violators,” reserved for repeat offenders. The agency proposed a penalty of $132,598 — the maximum amount OSHA could levy at the time.\u003c/p>\n\u003cp>One month later, Hellas challenged the citation, arguing it should be dismissed because OSHA didn’t prove “the necessary elements of its claims.” The Labor Department settled with Hellas in April 2020, cutting the fine in half and reclassifying the willful violation as five “serious” ones. This kept Hellas off the severe violators list. A revised settlement agreement required the company to create a heat-illness prevention plan, among other things. It’s unclear whether Hellas followed through.\u003c/p>\n\u003cp>By May of last year, Hellas had paid the fine, and OSHA resolved the case. The agency’s regional office in San Antonio, which investigated Martinez’s death, declined two requests to discuss the case.\u003c/p>\n\u003ch3>A state standard falls short\u003c/h3>\n\u003cp>Besides Texas, the states of California, Florida and Arkansas have each recorded at least 14 worker heat deaths since 2010, according to CJI and NPR’s analysis. Unlike most states, however, California has its own heat standard. Passed in 2005, the standard was later named after a 17-year-old pregnant farmworker, Maria Jimenez, who died from heat exposure while pruning grapes. The standard was the first to uphold the pillars of heat safety: water, rest, shade and acclimatization.\u003c/p>\n\u003cp>In 2015, after the United Farm Workers sued California’s state version of OSHA, the agency tightened its standard. Cal/OSHA lowered the heat safety limit from 85 to 80 degrees and required companies to prepare for extreme heat threats on days hotter than 95 degrees. It also allocated more money and staff to enforcement.\u003c/p>\n\u003cp>Today, California’s rule is widely viewed as the gold standard. The Labor Department should emulate it, said John Newquist, who served as assistant administrator in OSHA Region 5 in the Upper Midwest from 2005 to 2012.\u003c/p>\n\u003cp>“It’s easy with California already adopting this thing for years,” he said. “If you follow these guidelines, that works.”\u003c/p>\n\u003cp>But OSHA data on worker heat deaths suggests the state’s standard can fall short. The rule has led to a rise in heat-related enforcement actions by the state’s Division of Occupational Safety and Health, known as Cal/OSHA, every year but 2010, 2014, 2016, 2018 and 2020, when the coronavirus pandemic affected such activities across the board. In 2019, for instance, the agency conducted more than 4,000 heat inspections and cited workplaces in nearly half of them. Still, the CJI and NPR analysis shows that California’s yearly tally of worker heat deaths has remained steady over the past decade.\u003c/p>\n\u003cp>Some critics say the agency has yet to curb worker heat illnesses and deaths because of lax and uneven enforcement.\u003c/p>\n\u003cp>Garrett Brown, a Cal/OSHA inspector from 1994 to 2014, has investigated dozens of heat deaths and worked as a special adviser for a former Cal/OSHA secretary and as a part-time inspector until this year. He believes the agency can’t “do what it needs to do” to protect the state’s workers because of its chronic understaffing. Brown has documented staffing levels for years, charting the data on his blog, \u003ca href=\"https://insidecalosha.org/\">\u003cem>Inside Cal/OSHA\u003c/em>\u003c/a>. The figures reveal a tiny workforce — about 190 inspectors for 1 million employers responsible for 18 million workers. That’s one inspector for roughly every 5,200 companies.\u003c/p>\n\u003cp>Brown said mismanagement and the state’s inability to fill inspector positions have exacerbated the problem. As of July 31, at least 25% of nearly 250 Cal/OSHA inspector positions remained vacant. And that can make for dire consequences on the ground.\u003c/p>\n\u003ch3>A firefighter’s death\u003c/h3>\n\u003cp>In California, where fires have been raging, the victims of heat-related deaths are sometimes firefighters.\u003c/p>\n\u003cp>In April 2015, just two months before California’s standard was tightened, Raymond Araujo, one of 4,000 inmates who then served as firefighters for the state’s Department of Forestry and Fire Protection — known as Cal Fire — was on a 2-mile hike in Banning, California, about 30 miles from Palm Springs. Winding through steep, often shadeless hills, the trail was part of the department’s required cardiovascular training. On that day, the temperature climbed to 81 degrees, 10 degrees hotter than the 40-year average.\u003c/p>\n\u003cfigure id=\"attachment_1976372\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976372 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A fire station warning sign is shown down the road from Cal Fire’s De Luz Fire Station 16 in Fallbrook, Calif., where firefighter Yaroslav “Yaro” Katkovwas was assigned. \u003ccite>(Ariana Drehsler/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As the 12-member group neared the end of the exercise, Araujo stumbled and fell to his knees. His supervisor told his colleagues to help Araujo stand up and remove his fire gear so he could finish the hike. He walked 30 feet more and eventually collapsed.\u003c/p>\n\u003cp>The fire captain called for medical assistance, and a helicopter transported Araujo back to a nearby base camp, where he was pronounced dead, the records show.\u003c/p>\n\u003cp>While the Cal/OSHA inspection report named heat as a contributing factor in Araujo’s death, the cause was “hypertensive cardiovascular disease,” according to the autopsy report. As a result, Cal/OSHA deemed his death an accident.\u003c/p>\n\u003cp>Brown, the former Cal/OSHA inspector, reviewed the agency’s report and said it was impossible for him to know why officials declined to investigate. He said the incident resembled many cases he had investigated — where workers suffered heart attacks because of the heat. Were he leading the charge, Brown said, he would have wanted to talk to eyewitnesses because the incident had all the hallmarks of a heat illness violation.\u003c/p>\n\u003cp>“One way to invalidate a fatality report is to decide that it’s natural causes,” he said, explaining that Cal/OSHA managers can look for ways to lessen understaffed inspectors’ workloads.\u003c/p>\n\u003cp>Cal/OSHA declined CJI and NPR’s requests to interview key officials for this story. But an agency spokesman defended Cal/OSHA’s handling of Araujo’s death, noting that the agency followed the Cal/OSHA medical unit’s assessment in determining a cause of death.\u003c/p>\n\u003cp>Asked about the effectiveness of the heat standard, the agency said it regularly looks to enhance enforcement activities.\u003c/p>\n\u003cp>“We continue to evaluate the effectiveness of our programs and consult with various subject matter experts to determine what changes, if any, are necessary to improve health and safety,” spokesman Frank Polizzi said in an email.\u003c/p>\n\u003ch3>‘It pays not to comply’\u003c/h3>\n\u003cp>Just before 8 a.m. on July 28, 2019, Cal Fire firefighter Yaroslav “Yaro” Katkov set out with a fellow employee and a fire captain on a hike similar to the one that Araujo had made. The 28-year-old Ukrainian immigrant, who lived in Murrieta, California, a bedroom community near San Diego, had served as a reserve firefighter before being hired by Cal Fire in a seasonal role a year earlier.\u003c/p>\n\u003cfigure id=\"attachment_1976371\" class=\"wp-caption alignright\" style=\"max-width: 395px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1976371\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/yaro3-c6336f214f435a3aeeca34908eac8a5749d38604-2.jpe\" alt=\"\" width=\"395\" height=\"296\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/yaro3-c6336f214f435a3aeeca34908eac8a5749d38604-2.jpe 395w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/yaro3-c6336f214f435a3aeeca34908eac8a5749d38604-2-160x120.jpe 160w\" sizes=\"(max-width: 395px) 100vw, 395px\">\u003cfigcaption class=\"wp-caption-text\">Cal Fire firefighter Yaroslav “Yaro” Katkov was on a routine training exercise when he stumbled and felt exhausted shortly before he collapsed. \u003ccite>(Ashley Vallario)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On a standard training exercise, Katkov was asked to complete a 1.45-mile loop at Cal Fire’s rural Station 16 in Fallbrook, a remote mountainous area halfway between Los Angeles and San Diego. As they traversed the loop, the captain and the co-worker noticed Katkov lagging behind the required 30-minute deadline to finish the hike. The two stopped on several occasions to allow Katkov to catch up, delaying their end time by 10 minutes. The temperature would climb to 88 degrees that day — 5 degrees hotter than the 40-year average.\u003c/p>\n\u003cp>The captain, Joe Ekblad, recognized that Katkov hadn’t given his body enough of a rest yet, but ordered the firefighters to repeat the exercise, according to the Cal/OSHA records. On the way up the steepest incline of the loop, Katkov stumbled and told his supervisor he felt exhausted — two telltale signs of heat stress. He collapsed on the hilltop, was airlifted to a hospital nearly two hours later and died of heat illness the next day.\u003c/p>\n\u003cp>“He loved the idea of being like a wildland firefighter,” said Ashley Vallario, Katkov’s fiancée. “It made him happy.”\u003c/p>\n\u003cp>This time, Cal/OSHA investigated Katkov’s death, interviewing eyewitnesses. The inspector detailed extensive failures by the captain, which led to his demotion. The agency found that Cal Fire had failed to stop the hike and seek emergency medical treatment even after Katkov had exhibited heat-related symptoms. Regulators levied a fine of $80,000 — almost five times the average Cal/OSHA fine of $17,000 in these cases.\u003c/p>\n\u003cp>Neither Cal Fire nor Ekblad responded to requests for comment.\u003c/p>\n\u003cfigure id=\"attachment_1976401\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976401 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Yaroslav “Yaro” Katkov was asked to complete a 1.45-mile loop at Cal Fire’s rural Station 16 in Fallbrook, a remote mountainous area halfway between Los Angeles and San Diego. \u003ccite>(Ariana Drehsler for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Such a large penalty shows what a fully enforceable heat standard can do, some experts say. But Cal/OSHA records suggest the regulators’ stick has not come soon enough. Since 2012, at least four other firefighters have died during Cal Fire training hikes. All the firefighters but Katkov were inmates. No other case yielded sanctions.\u003c/p>\n\u003cp>Cal Fire’s training processes, meanwhile, continue to put firefighters at risk. In 2020, almost a year after Katkov’s death, another department firefighter was sickened by heat during a hike. That firefighter was rushed to the hospital and survived.\u003c/p>\n\u003cp>Ellen Widess, head of Cal/OSHA from 2011 to 2013, said she sees an unsettling pattern: Employers can brush off the cost of an agency fine. In many cases, she said, penalties have no effect.\u003c/p>\n\u003cp>“We’ve seen that the costs of [non]compliance are so cheap,” Widess said. “It pays not to comply.”\u003c/p>\n\u003ch3>‘It’s going to be like this every year’\u003c/h3>\n\u003cp>In the three years since Public Citizen renewed its petition for an OSHA heat standard, political pressure for such action has grown. In March, Rep. Judy Chu, D-Calif., authored legislation that would require OSHA to create a national heat standard based on NIOSH criteria and mandate employer training “to prevent and respond” to heat illnesses. The bill, co-sponsored by at least 57 House Democrats, is pending in committee. It marks the second attempt by federal lawmakers to establish a rule since 2019.\u003c/p>\n\u003cp>OSHA, meanwhile, said it will take the first step toward issuing a rule this fall. In October, the agency plans to publish a request for information from employers, occupational health specialists, climate scientists and workers on the viability of a standard. Frederick, OSHA’s acting director, said the input could help the agency develop a regulation that applies to any industry in the United States.\u003c/p>\n\u003cp>“Heat hazards exist in many, many industries,” he said. “We know that we have work to do with almost every industry to understand … what the effect of heat hazards in their workplace is and how best they are putting in practices and controls to mitigate those hazards.”\u003c/p>\n\u003cp>Already, former OSHA officials are anticipating industry pushback, particularly from construction groups.\u003c/p>\n\u003cfigure id=\"attachment_1976404\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976404 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-800x640.jpg\" alt=\"\" width=\"800\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-800x640.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-1020x816.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-160x128.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-768x614.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-1536x1229.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-2048x1638.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-1920x1536.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The body of farmworker Cruz Urias Beltran was found in this cornfield near Cairo, Neb. \u003ccite>(Walker Pickering/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Every time OSHA proposes a standard, [the] industry accuses OSHA of killing jobs and destroying whatever industry is going to be regulated,” said Jordan Barab, a former deputy assistant labor secretary who helped shepherd two chemical-exposure standards through protracted rule-making processes. “That would probably follow with a heat standard.”\u003c/p>\n\u003cp>Some states have decided not to wait. In June, as an unprecedented heat wave blanketed the Pacific Northwest, Sebastian Francisco Perez moved irrigation pipes at a nursery in Willamette Valley, Oregon. Perez was found dead at the end of his shift. Preliminary information suggests the incident was heat related, but Oregon Occupational Safety and Health (Oregon OSHA) has yet to make a determination, according to Aaron Corvin, a spokesman for Oregon OSHA. Ten days later, the state enacted an emergency heat standard.\u003c/p>\n\u003cp>Back in Grand Island, Nebraska, where the average high temperature has increased 2 degrees since the 1990s, the intensifying heat is not lost on Joseph Rivera. As a younger man in the fields, he remembers there were hot and humid days. But now the heat is so extreme, he said, “you get these hot days that just come up over you.”\u003c/p>\n\u003cp>“With climate change, you hit 112 in Nebraska the other day,” Rivera said, explaining why he’s amenable to a federal heat standard. “It’s going to be like this every year.”\u003c/p>\n\u003chr>\n\u003cp>\u003cem>Christina Stella, a reporter with Nebraska Public Media; Jacob Margolis, a reporter with KPCC in Los Angeles; Allison Mollenkamp, an intern on NPR’s investigative team; and The Texas Newsroom contributed to this story. Julia Shipley, Brian Edwards and David Nickerson reported this story as fellows for Columbia Journalism Investigations, an investigative reporting unit at the Columbia Journalism School in New York. Cascade Tuholske, a climate impact scientist at Columbia University’s Earth Institute, contributed to the data analysis. Public Health Watch, an independent investigative nonprofit, helped edit this story.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was supported by the Fund for Investigative Journalism.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Heat+Is+Killing+Workers+In+The+U.S.+%E2%80%94+And+There+Are+No+Federal+Rules+To+Protect+Them&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Heat has killed hundreds of workers in the U.S., many in construction or agriculture, an investigation by NPR and Columbia Journalism Investigations found. Federal standards might have prevented them.",
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"title": "Calls Intensify For Stronger Worker Protections As Heat Deaths Rise In Calif. and U.S. | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As the temperature in Grand Island, Nebraska, soared to 91 degrees that July day in 2018, two dozen farmworkers tunneled for nine hours into a thicket of cornstalks, snapping off tassels while they crossed a sunbaked field that spanned 206 acres — the equivalent of 156 football fields.\u003c/p>\n\u003cp>When they emerged at the end of the day to board a bus that would transport them to a nearby motel to sleep, one of the workers, Cruz Urias Beltran, didn’t make it back. Searchers found the 52-year-old farmworker’s body 20 hours later amid the cornhusks, “as if he’d simply collapsed,” recalled a funeral home employee. An empty water bottle was stuffed in his jeans pocket. An autopsy report confirmed that Beltran died from heatstroke. It was his third day on the job.\u003c/p>\n\u003cp>Beltran is one of at least 384 workers who died from environmental heat exposure in the U.S. in the last decade, according to an investigation by NPR and Columbia Journalism Investigations, the investigative reporting unit of the Columbia Journalism School. The count includes people toiling in essential, yet often, invisible jobs in 37 states across the country: farm laborers in California, construction and trash-collection workers in Texas and tree trimmers in North Carolina and Virginia. An analysis of federal data from the Bureau of Labor Statistics shows the three-year average of worker heat deaths has doubled since the early 1990s.\u003c/p>\n\u003cfigure id=\"attachment_1976348\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1976348\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/cruz_in_the_1990s-edit-d66a1ab99079af2d799ed3c53e9aa916dbe96937-3-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_in_the_1990s-edit-d66a1ab99079af2d799ed3c53e9aa916dbe96937-3-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_in_the_1990s-edit-d66a1ab99079af2d799ed3c53e9aa916dbe96937-3-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_in_the_1990s-edit-d66a1ab99079af2d799ed3c53e9aa916dbe96937-3-768x576.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_in_the_1990s-edit-d66a1ab99079af2d799ed3c53e9aa916dbe96937-3.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A family photo of Cruz Urias Beltran taken during the 1990s. \u003ccite>(Paty Espinoza)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>CJI and NPR reviewed hundreds of pages of documents, including workplace inspection reports, death investigation files, depositions, court records and police reports, and interviewed victims’ families, former and current officials from the Occupational Safety and Health Administration, workers, employers, workers’ advocates, lawyers and experts.\u003c/p>\n\u003cp>CJI and NPR also analyzed two federal data sets on worker heat deaths: one from the Occupational Safety and Health Administration, the other from the Bureau of Labor Statistics. Both are divisions within the U.S. Labor Department.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Among the findings:\u003c/p>\n\u003cul>\n\u003cli>The Occupational Safety and Health Administration (OSHA), whose primary responsibility is to protect workers from hazards, has failed to adopt a national heat standard to safeguard workers against rapidly rising temperatures, resulting in an enforcement system rife with problems.\u003c/li>\n\u003cli>For at least a dozen companies, it wasn’t the first time their workers succumbed to heat. One worker collapsed and died after repeatedly complaining about the heat; another died after hauling 20 tons of trash for nearly 10 hours. In some instances, employees died after not having ample water and scheduled shade breaks. Many died within their first week on the job.\u003c/li>\n\u003cli>OSHA officials often decide not to penalize companies for worker deaths. When they do, they routinely negotiate with business owners and reduce violations and fines.\u003c/li>\n\u003cli>In some cases, OSHA doesn’t follow up after a worker’s death from heat exposure to ensure that the company is complying with the measures the agency imposed to prevent future fatalities.\u003c/li>\n\u003cli>Workers of color have borne the brunt: Since 2010, Hispanics have accounted for a third of all heat fatalities, yet they represent a fraction — 17% — of the U.S. workforce. Health and safety experts attribute this unequal toll to Hispanics’ overrepresentation in industries vulnerable to dangerous heat, such as construction and agriculture.\u003c/li>\n\u003cli>OSHA’s record-keeping on heat fatalities is so poor that there’s no way to know exactly how many workers have died from heat.\u003c/li>\n\u003c/ul>\n\u003cp>Current and former OSHA officials acknowledge that the known death tally is a vast undercount. The agency mostly relies on companies to report worker fatalities after they occur, but not all do so.\u003c/p>\n\u003cp>CJI and NPR reporters analyzed worker heat deaths recorded by OSHA between 2010 and 2020 and compared each incident day’s high temperature with historical averages over 40 years. Most of the deaths happened on days that were unusually hot for that date. More than two-thirds occurred on days when the temperature reached at least 90 degrees.\u003c/p>\n\u003cp>Yet no worker should die from heat, said Ronda McCarthy, an occupational health specialist who directs medical services at the health care provider Concentra, in Waco, Texas. McCarthy spent seven years educating her home state’s municipal workers about heat, which reduced cases of worker heat exhaustion and similar conditions there.\u003c/p>\n\u003cp>“Heat illness should be considered a preventable illness,” she said.\u003c/p>\n\u003ch3>No federal heat standard\u003c/h3>\n\u003cp>OSHA has known about the dangers of heat — and how to prevent deaths — for decades. In 1972, the National Institute for Occupational Safety and Health (NIOSH), part of the U.S. Centers for Disease Control and Prevention, studied the effects of heat stress on workers in the U.S. and recommended criteria for an OSHA heat standard. Under the proposal, employers would have had to give employees one break every hour and offer ready access to water. New workers would have received extra breaks so they could acclimate to strenuous activity in the heat.\u003c/p>\n\u003cp>NIOSH has refined these safety measures — first in 1986 and, again, in 2016 — but OSHA has not acted on them because of other regulatory priorities. This year, for the first time, OSHA is officially considering a heat standard by putting it on its regulatory agenda. James Frederick, OSHA’s acting director, said it’s a “priority” for the Biden administration.\u003c/p>\n\u003cp>“Occupational exposure to heat remains a very important topic,” Frederick said in an interview with CJI and NPR. “We’re focused on improving our efforts to protect workers moving forward.”\u003c/p>\n\u003cfigure id=\"attachment_1976349\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976349 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2-1920x1279.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/morton_jfrederick_osha_210716_06-edit_custom-4b483ec03879252f9584a0f9d955dc119e38b782-2.jpg 2000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Jim Frederick, acting assistant secretary of labor for the Occupational Safety and Health Administration, stands in the national office of OSHA in Washington, D.C., on July 26, 2021. \u003ccite>(Ian Morton/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Absent a heat standard, OSHA must rely on a 50-year-old regulation guaranteeing workers a “hazard-free workplace.” OSHA does require companies to provide adequate water, but not other heat-safety measures.\u003c/p>\n\u003cp>OSHA’s own research shows relying on this general rule hasn’t worked. A 2016 study by agency scientists found that some employers whose workers got sick or died from heat hadn’t met basic water provisions. Most companies never offered rest breaks. Only one out of 84 total employers had a plan for building up its workers’ tolerance for laboring in heat.\u003c/p>\n\u003cp>In 2011, four labor and public interest organizations, including Public Citizen, a consumer rights advocacy group, petitioned OSHA to issue a heat standard. They asked the agency for an emergency temporary standard because a new rule, the petition stated, “could potentially take many years before it’s finalized and implemented.”\u003c/p>\n\u003cp>David Michaels, then the assistant secretary of labor for Occupational Safety and Health, who oversaw OSHA, denied the petition, arguing in a January 2012 letter to petitioners that workers weren’t dying from heat at a rate that would justify a legal standard. Recognizing extreme heat’s threat, he said most workers can “recover fairly quickly when the appropriate measures are taken.”\u003c/p>\n\u003cp>Instead, Michaels launched a voluntary awareness campaign distributing posters and flyers that instructed employees on how to protect themselves. OSHA incorporated these precautions into a free bilingual phone app featuring government-issued heat alerts and advisories. The agency continued this campaign through 2013. Its principle message remains on \u003ca href=\"https://www.osha.gov/heat\">OSHA’s website today\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_1976351\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976351 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/gettyimages-102342163_custom-6b6018a90245a086253584a9f5b3992a88d2faa1-1-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">David Michaels, the assistant secretary of labor for the Occupational Safety and Health Administration, attends a full committee hearing on Capitol Hill in Washington, D.C., on June 23, 2010. The hearing was on “Worker Health and Safety from the Oil Rig to the Shoreline,” focusing on how worker health and safety is regulated and enforced by various parties, from oil rig workers to post-accident cleanup operations. \u003ccite>(Astrid Riecken/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Michaels touted the campaign as a success at the time. The numbers are less clear. The number of workers who succumbed to heat topped 61 cases during the campaign’s inaugural year, in 2011 — an all-time high. An additional 65 workers would die from heat exposure in the ensuing two years, closer to the annual average for the decade, while the campaign remained an agency priority.\u003c/p>\n\u003cp>Six years after his petition denial letter, and after leaving OSHA’s top post, Michaels changed his approach. In 2018, he joined Public Citizen and 131 additional groups in a second petition asking the agency to enact a heat standard. This time, petitioners cited NIOSH’s updated guidelines and warned that “this warming trend will not only continue but accelerate.”\u003c/p>\n\u003cp>In a recent interview, Michaels, now a public health professor at George Washington University in Washington, D.C., said the agencywide consensus was that climate change would worsen the problem. But the rule-making process at OSHA is “so difficult” and the industry opposition so formidable that adopting a heat standard “became a bridge too far,” he said. He has come to believe a standard is essential.\u003c/p>\n\u003cp>“We know that heat kills,” Michaels said. “And if we don’t have requirements, heat will kill more workers.”\u003c/p>\n\u003ch3>Search and rescue\u003c/h3>\n\u003cp>A standard that included water, rest, shade and acclimatization could have saved Beltran, an experienced farmworker who traveled more than 1,300 miles from San Luis, Arizona, to the heart of America’s Corn Belt to pull tassels off corn plants for Rivera Agri Inc.\u003c/p>\n\u003cp>The day he went missing in the fields on the outskirts of Grand Island, the temperature — with humidity — felt like 100 degrees. Joseph Rivera, the company’s owner, placed an emergency call to authorities shortly after 5 p.m. Beltran was in the field but didn’t come out with the other workers, he told the 911 operator.\u003c/p>\n\u003cfigure id=\"attachment_1976374\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976374 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-800x640.jpg\" alt=\"\" width=\"800\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-800x640.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-1020x816.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-160x128.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-768x614.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-1536x1229.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-2048x1638.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/nw-2021-07-28-wpick-4376_custom-7e2b8be8b7126e888b7cf0cca98ee3cad4e4cb2c-1-1920x1536.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The cornfield where Cruz Urias Beltran’s body was found near Cairo, Neb., on July 28, 2021. \u003ccite>(Walker Pickering/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The call set off an elaborate search-and-rescue mission in the central Nebraska city of 51,000. One volunteer flew a Piper Cub airplane low and slow, on the lookout for the orange safety hat atop Beltran’s salt-and-pepper hair. Another manned a helicopter circling the sea of stalks until the chopper ran low on fuel. At sunset, a Nebraska State Patrol plane with thermal-imaging equipment scanned for a sign of Beltran’s body temperature, but since the plants and soil also were emanating heat, he went undetected.\u003c/p>\n\u003cp>The following morning, as the temperature hovered in the 90s, the Red Cross opened a temporary cooling station with air conditioning for the 100 volunteers who joined the search. Shortly after noon, someone spotted Beltran’s body, facedown in the husks.\u003c/p>\n\u003cp>Two months after Beltran’s body was shipped to his family’s home in Mexico’s Sonora state, an OSHA inspector visited Rivera Agri as part of the agency’s investigation into the death. OSHA inspection records show the company didn’t deploy the kind of preventive measures that a heat standard would have required. Rivera Agri did not ensure that employees took enough rest breaks in the shade, drank sufficient amounts of water and adapted to their grueling work, the records show.\u003c/p>\n\u003cfigure id=\"attachment_1976357\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1976357\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/cruz_urias_beltran_hugging_his_son_jesus_adrian_urias_machado-edit-40cf5ef60a1dc6e3723a63d2c216ceb3af5f9477-1-800x600.png\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_urias_beltran_hugging_his_son_jesus_adrian_urias_machado-edit-40cf5ef60a1dc6e3723a63d2c216ceb3af5f9477-1-800x600.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_urias_beltran_hugging_his_son_jesus_adrian_urias_machado-edit-40cf5ef60a1dc6e3723a63d2c216ceb3af5f9477-1-160x120.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_urias_beltran_hugging_his_son_jesus_adrian_urias_machado-edit-40cf5ef60a1dc6e3723a63d2c216ceb3af5f9477-1-768x576.png 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/cruz_urias_beltran_hugging_his_son_jesus_adrian_urias_machado-edit-40cf5ef60a1dc6e3723a63d2c216ceb3af5f9477-1.png 952w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Beltran hugs his son, Jesus Adrian Urias Machado. Beltran was an experienced farmworker and traveled from Arizona to work in Nebraska. \u003ccite>(Paty Espinoza)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“These actions were left to the employees to manage themselves,” the inspector wrote in a nine-page citation.\u003c/p>\n\u003cp>OSHA found that the “moderate lifting and bending” and “pushing and pulling” that Beltran had performed in the heat had contributed to his death. It cited Rivera Agri for a violation and proposed fines totaling $11,641. The agency also ordered the company to train employees on the symptoms of heat illness, among other safety measures. Rivera Agri agreed to OSHA’s conditions, and the fines were reduced to $9,500, records show.\u003c/p>\n\u003cp>Angela Rivera, who runs the farm labor contracting business with her father, Joseph, said the company has worked to fulfill the agreement. Today, it contracts with a farmworker-rights group to educate employees on how to respond to heat emergencies. Near the cornfield, it sets up extra water stations and has canopies for emergency shade.\u003c/p>\n\u003cp>“We’ve been in this business for a long time,” said Angela Rivera, who calls Beltran’s death “an unfortunate thing.”\u003c/p>\n\u003cp>“Every year we try to step it up,” she said.\u003c/p>\n\u003cp>Joseph Rivera said supervisors now monitor the heat on their cellphones and pull detasselers from the cornfields whenever it gets too hot — part of a heat-stress plan the Riveras created after Beltran’s death. They hand out brochures explaining the new policy to every farmworker on their bus.\u003c/p>\n\u003ch3>Not the first death\u003c/h3>\n\u003cp>Beltran was not Rivera Agri’s first heat-related fatality. In July 1997, a 39-year-old detasseler died of heatstroke under similar circumstances. Like Beltran, it was his third day on the job, and the temperature had spiked to 95 degrees. When he collapsed, the crew found him within two hours. But his core body temperature was 108 degrees — hot enough for the brain, liver and kidneys to shut down.\u003c/p>\n\u003cp>OSHA investigated his death but didn’t impose penalties because then-OSHA Area Director Ben Bare determined there was no applicable standard. The lack of a standard leaves individual OSHA officials to decide whether a general violation applies to each death, creating a pattern of uneven enforcement in worker heat-death cases, records show.\u003c/p>\n\u003cp>CJI and NPR’s analysis of worker heat deaths shows that, like Rivera Agri, 11 other companies have lost more than one employee. In five of the cases, OSHA investigated the first fatality and issued citations, only for another employee to die from heat. One of those cited was Texas-based Hellas Construction, which builds publicly and privately funded stadiums and other sports infrastructure projects across the country.\u003c/p>\n\u003cp>In July 2018, the week before Beltran died in a Nebraska cornfield, Karl Simmons signed on as a laborer for Hellas. At 30, with long braided hair and a shoulder tattoo bearing his mother’s name, Simmons arrived at the sprawling Gateway Park in Fort Worth, Texas, ready to install turf.\u003c/p>\n\u003cp>On his second day on the job, Simmons, who had served in the U.S. Navy, took a lunch break and fielded a call from his wife, Precious. “It’s just hot,” he complained, according to a deposition she gave in a lawsuit filed by the family against Hellas. The five-person crew had already drunk all the water. Simmons returned to preparing the mixture to attach to the turf, shoveling gravel and adhesive chemicals into a mixer.\u003c/p>\n\u003cp>That afternoon — as the temperature topped 96 degrees — Simmons told his supervisor he felt hot, according to OSHA records. He complained about the heat two more times that day. Each time, he said he felt sick. At one point, he sought shade under a tree while his supervisor drove to a store to get water.\u003c/p>\n\u003cp>A passerby eventually spotted Simmons sprawled on the ground, facedown, and alerted the crew. His brother-in-law, Michael Spriggins, who worked alongside Simmons as a Hellas laborer, sprinted to his aid. He found Simmons gasping for breath, bleeding from his nose and mouth.\u003c/p>\n\u003cfigure id=\"attachment_1976359\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976359 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/npr-jul-31-2021-1_custom-884b15aa0b305a577c37107e8a1a8d8cbe1f2a62-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Karl Simmons was installing turf at Gateway Park in Fort Worth, Texas, when he felt ill. Later, he was pronounced dead at a local hospital. The official cause of death was heatstroke. \u003ccite>(JerSean Golatt/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It was a sight I ain’t going to never forget,” Spriggins said in an interview with CJI and NPR.\u003c/p>\n\u003cp>He called 911 and then placed a cool towel under Simmons’ neck at the dispatcher’s instructions. Simmons opened his eyes.\u003c/p>\n\u003cp>“It looked like he’s gonna pull through this,” Spriggins recalled.\u003c/p>\n\u003cp>Two hours later, Simmons was pronounced dead at a local hospital. Heatstroke, the autopsy report confirmed. He was one of at least 53 workers who have been fatally stricken by heat in Texas since 2010, CJI and NPR’s analysis shows.\u003c/p>\n\u003cp>The next day, Jason Davidson, Hellas’ chief safety officer, emailed more than 340 company employees, addressing the perils of laboring in extreme heat. It was at least the fourth written warning he sent in the summer of 2018, when 11 additional Hellas employees were diagnosed with heat-related illnesses requiring medical attention.\u003c/p>\n\u003cp>Dean Wingo, who oversaw the OSHA regional office that includes Texas from 2007 to 2012, said Hellas’ hospitalization numbers suggest a worrying pattern. Serious heat-related illness involves everything from a heat rash to uncontrolled bleeding, according to medical experts. In its most severe form, heatstroke can cause multisystem organ failure that has lasting adverse effects. Wingo said he believes Hellas’ record on workplace heat safety shows “poor” company management.\u003c/p>\n\u003cfigure id=\"attachment_1976360\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1976360\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/a13i9995-edit_custom-17545930d6db6e5937a8834fbcc78ea9b70c6442-1-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dean Wingo, who formerly oversaw the OSHA regional office that includes Texas, says he believes Hellas Construction’s record on workplace heat safety shows “poor” company management. \u003ccite>(Michael Cirlos III/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hellas officials declined a dozen interview requests for this story and didn’t respond to a list of 20 written questions from CJI and NPR. In its response to a wrongful-death lawsuit filed in July 2019 by Simmons’ wife, the company denied that its conduct “rose to a level of gross neglect” or that it failed to provide a safe workplace.\u003c/p>\n\u003cp>But in December 2018, OSHA found that Hellas hadn’t provided Simmons a workplace “free from recognized hazards” and cited the company for two violations, including failing to record Simmons’ death in OSHA logs, records show. OSHA proposed a fine of $14,782 against Hellas for Simmons’ death. The company earned more than $150 million in revenue that year.\u003c/p>\n\u003cp>As part of a settlement, Hellas agreed to implement “a more robust/detailed training program … to prevent heat exhaustion and heat stress injuries.” OSHA lowered the fine by nearly $2,000, to $12,934. That’s higher than the national average fine of $7,314 for employers in such cases, according to a CJI and NPR analysis.\u003c/p>\n\u003cp>Hellas executives did not carry out the safety measures, records show. And OSHA never showed up at a work site to see whether the company was following the terms of the settlement agreement.\u003c/p>\n\u003cp>OSHA’s regional office in Dallas, which investigated Simmons’ death, declined to discuss the case.\u003c/p>\n\u003cp>OSHA data shows the agency reduced heat-related sanctions nationally by 31%, on average, after settlements. It cut the penalties in more than half of the 246 heat-death cases in which OSHA had proposed them.\u003c/p>\n\u003cp>Wingo said the only way OSHA can ensure that companies like Hellas keep their promises is to conduct follow-up inspections in person.\u003c/p>\n\u003cp>“I don’t think it’s excusable,” he said. “When you’ve had a fatality, you go back.”\u003c/p>\n\u003cp>On July 19, 2019, a year after Simmons’ death, a second Hellas worker succumbed to heat — this time in Hondo, Texas, 42 miles west of San Antonio. At 6 a.m. that day, forecasters were promising a scorcher. The temperature would soar to 99 degrees, 3 degrees hotter than the 40-year average, the CJI and NPR data analysis shows.\u003c/p>\n\u003cp>Pedro Martinez Sr., 49, had been employed by Hellas for more than a year when he arrived for work at McDowell Middle School with his 22-year-old namesake. The father had gotten the son a summer job. At the time, Pedro Jr., also known as “Bruno,” was between semesters at a college in his home state of Zacatecas, Mexico.\u003c/p>\n\u003cp>On the third day, the pair did cement work on the school’s athletic field. They pulled out vertical rebar stakes using a device called a JackJaw, pumping a handle to wrench the stakes from the ground. As in the Simmons case, an OSHA inspection would later confirm that the area had little shade. Records show that the younger Martinez toiled for 10 hours before taking a lunch break at 4 p.m.\u003c/p>\n\u003cp>Nearly two hours later, he was working beside his father when he became overheated and ran off, hit a fence and collapsed. The father rushed his son to a local hospital’s emergency room, where nurses placed ice packs around his body. But his core temperature was already 108 degrees, according to a police report. The official cause of death was heatstroke.\u003c/p>\n\u003cfigure id=\"attachment_1976365\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976365 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/dji_0790-edit_custom-a75e19bdefb32b549549a243ec99508e6fadab64-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The former construction site where Pedro Martinez Jr., died of heatstroke. The athletic field and track is adjacent to McDowell Middle School in Hondo, Texas. \u003ccite>(Michael Cirlos III/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In December 2019, OSHA cited Hellas for a willful violation, the most serious category. The citation would have placed Hellas on a public list of “severe violators,” reserved for repeat offenders. The agency proposed a penalty of $132,598 — the maximum amount OSHA could levy at the time.\u003c/p>\n\u003cp>One month later, Hellas challenged the citation, arguing it should be dismissed because OSHA didn’t prove “the necessary elements of its claims.” The Labor Department settled with Hellas in April 2020, cutting the fine in half and reclassifying the willful violation as five “serious” ones. This kept Hellas off the severe violators list. A revised settlement agreement required the company to create a heat-illness prevention plan, among other things. It’s unclear whether Hellas followed through.\u003c/p>\n\u003cp>By May of last year, Hellas had paid the fine, and OSHA resolved the case. The agency’s regional office in San Antonio, which investigated Martinez’s death, declined two requests to discuss the case.\u003c/p>\n\u003ch3>A state standard falls short\u003c/h3>\n\u003cp>Besides Texas, the states of California, Florida and Arkansas have each recorded at least 14 worker heat deaths since 2010, according to CJI and NPR’s analysis. Unlike most states, however, California has its own heat standard. Passed in 2005, the standard was later named after a 17-year-old pregnant farmworker, Maria Jimenez, who died from heat exposure while pruning grapes. The standard was the first to uphold the pillars of heat safety: water, rest, shade and acclimatization.\u003c/p>\n\u003cp>In 2015, after the United Farm Workers sued California’s state version of OSHA, the agency tightened its standard. Cal/OSHA lowered the heat safety limit from 85 to 80 degrees and required companies to prepare for extreme heat threats on days hotter than 95 degrees. It also allocated more money and staff to enforcement.\u003c/p>\n\u003cp>Today, California’s rule is widely viewed as the gold standard. The Labor Department should emulate it, said John Newquist, who served as assistant administrator in OSHA Region 5 in the Upper Midwest from 2005 to 2012.\u003c/p>\n\u003cp>“It’s easy with California already adopting this thing for years,” he said. “If you follow these guidelines, that works.”\u003c/p>\n\u003cp>But OSHA data on worker heat deaths suggests the state’s standard can fall short. The rule has led to a rise in heat-related enforcement actions by the state’s Division of Occupational Safety and Health, known as Cal/OSHA, every year but 2010, 2014, 2016, 2018 and 2020, when the coronavirus pandemic affected such activities across the board. In 2019, for instance, the agency conducted more than 4,000 heat inspections and cited workplaces in nearly half of them. Still, the CJI and NPR analysis shows that California’s yearly tally of worker heat deaths has remained steady over the past decade.\u003c/p>\n\u003cp>Some critics say the agency has yet to curb worker heat illnesses and deaths because of lax and uneven enforcement.\u003c/p>\n\u003cp>Garrett Brown, a Cal/OSHA inspector from 1994 to 2014, has investigated dozens of heat deaths and worked as a special adviser for a former Cal/OSHA secretary and as a part-time inspector until this year. He believes the agency can’t “do what it needs to do” to protect the state’s workers because of its chronic understaffing. Brown has documented staffing levels for years, charting the data on his blog, \u003ca href=\"https://insidecalosha.org/\">\u003cem>Inside Cal/OSHA\u003c/em>\u003c/a>. The figures reveal a tiny workforce — about 190 inspectors for 1 million employers responsible for 18 million workers. That’s one inspector for roughly every 5,200 companies.\u003c/p>\n\u003cp>Brown said mismanagement and the state’s inability to fill inspector positions have exacerbated the problem. As of July 31, at least 25% of nearly 250 Cal/OSHA inspector positions remained vacant. And that can make for dire consequences on the ground.\u003c/p>\n\u003ch3>A firefighter’s death\u003c/h3>\n\u003cp>In California, where fires have been raging, the victims of heat-related deaths are sometimes firefighters.\u003c/p>\n\u003cp>In April 2015, just two months before California’s standard was tightened, Raymond Araujo, one of 4,000 inmates who then served as firefighters for the state’s Department of Forestry and Fire Protection — known as Cal Fire — was on a 2-mile hike in Banning, California, about 30 miles from Palm Springs. Winding through steep, often shadeless hills, the trail was part of the department’s required cardiovascular training. On that day, the temperature climbed to 81 degrees, 10 degrees hotter than the 40-year average.\u003c/p>\n\u003cfigure id=\"attachment_1976372\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976372 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0005-edit1_custom-38f23e78cad4ff96eef14fea9e92015d4c26beaa-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A fire station warning sign is shown down the road from Cal Fire’s De Luz Fire Station 16 in Fallbrook, Calif., where firefighter Yaroslav “Yaro” Katkovwas was assigned. \u003ccite>(Ariana Drehsler/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As the 12-member group neared the end of the exercise, Araujo stumbled and fell to his knees. His supervisor told his colleagues to help Araujo stand up and remove his fire gear so he could finish the hike. He walked 30 feet more and eventually collapsed.\u003c/p>\n\u003cp>The fire captain called for medical assistance, and a helicopter transported Araujo back to a nearby base camp, where he was pronounced dead, the records show.\u003c/p>\n\u003cp>While the Cal/OSHA inspection report named heat as a contributing factor in Araujo’s death, the cause was “hypertensive cardiovascular disease,” according to the autopsy report. As a result, Cal/OSHA deemed his death an accident.\u003c/p>\n\u003cp>Brown, the former Cal/OSHA inspector, reviewed the agency’s report and said it was impossible for him to know why officials declined to investigate. He said the incident resembled many cases he had investigated — where workers suffered heart attacks because of the heat. Were he leading the charge, Brown said, he would have wanted to talk to eyewitnesses because the incident had all the hallmarks of a heat illness violation.\u003c/p>\n\u003cp>“One way to invalidate a fatality report is to decide that it’s natural causes,” he said, explaining that Cal/OSHA managers can look for ways to lessen understaffed inspectors’ workloads.\u003c/p>\n\u003cp>Cal/OSHA declined CJI and NPR’s requests to interview key officials for this story. But an agency spokesman defended Cal/OSHA’s handling of Araujo’s death, noting that the agency followed the Cal/OSHA medical unit’s assessment in determining a cause of death.\u003c/p>\n\u003cp>Asked about the effectiveness of the heat standard, the agency said it regularly looks to enhance enforcement activities.\u003c/p>\n\u003cp>“We continue to evaluate the effectiveness of our programs and consult with various subject matter experts to determine what changes, if any, are necessary to improve health and safety,” spokesman Frank Polizzi said in an email.\u003c/p>\n\u003ch3>‘It pays not to comply’\u003c/h3>\n\u003cp>Just before 8 a.m. on July 28, 2019, Cal Fire firefighter Yaroslav “Yaro” Katkov set out with a fellow employee and a fire captain on a hike similar to the one that Araujo had made. The 28-year-old Ukrainian immigrant, who lived in Murrieta, California, a bedroom community near San Diego, had served as a reserve firefighter before being hired by Cal Fire in a seasonal role a year earlier.\u003c/p>\n\u003cfigure id=\"attachment_1976371\" class=\"wp-caption alignright\" style=\"max-width: 395px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1976371\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/yaro3-c6336f214f435a3aeeca34908eac8a5749d38604-2.jpe\" alt=\"\" width=\"395\" height=\"296\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/yaro3-c6336f214f435a3aeeca34908eac8a5749d38604-2.jpe 395w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/yaro3-c6336f214f435a3aeeca34908eac8a5749d38604-2-160x120.jpe 160w\" sizes=\"(max-width: 395px) 100vw, 395px\">\u003cfigcaption class=\"wp-caption-text\">Cal Fire firefighter Yaroslav “Yaro” Katkov was on a routine training exercise when he stumbled and felt exhausted shortly before he collapsed. \u003ccite>(Ashley Vallario)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On a standard training exercise, Katkov was asked to complete a 1.45-mile loop at Cal Fire’s rural Station 16 in Fallbrook, a remote mountainous area halfway between Los Angeles and San Diego. As they traversed the loop, the captain and the co-worker noticed Katkov lagging behind the required 30-minute deadline to finish the hike. The two stopped on several occasions to allow Katkov to catch up, delaying their end time by 10 minutes. The temperature would climb to 88 degrees that day — 5 degrees hotter than the 40-year average.\u003c/p>\n\u003cp>The captain, Joe Ekblad, recognized that Katkov hadn’t given his body enough of a rest yet, but ordered the firefighters to repeat the exercise, according to the Cal/OSHA records. On the way up the steepest incline of the loop, Katkov stumbled and told his supervisor he felt exhausted — two telltale signs of heat stress. He collapsed on the hilltop, was airlifted to a hospital nearly two hours later and died of heat illness the next day.\u003c/p>\n\u003cp>“He loved the idea of being like a wildland firefighter,” said Ashley Vallario, Katkov’s fiancée. “It made him happy.”\u003c/p>\n\u003cp>This time, Cal/OSHA investigated Katkov’s death, interviewing eyewitnesses. The inspector detailed extensive failures by the captain, which led to his demotion. The agency found that Cal Fire had failed to stop the hike and seek emergency medical treatment even after Katkov had exhibited heat-related symptoms. Regulators levied a fine of $80,000 — almost five times the average Cal/OSHA fine of $17,000 in these cases.\u003c/p>\n\u003cp>Neither Cal Fire nor Ekblad responded to requests for comment.\u003c/p>\n\u003cfigure id=\"attachment_1976401\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976401 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-2048x1364.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/0017-edit1_custom-f7526141e0da5514521d7a2ee20044bccb4c63d7-2-1920x1279.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Yaroslav “Yaro” Katkov was asked to complete a 1.45-mile loop at Cal Fire’s rural Station 16 in Fallbrook, a remote mountainous area halfway between Los Angeles and San Diego. \u003ccite>(Ariana Drehsler for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Such a large penalty shows what a fully enforceable heat standard can do, some experts say. But Cal/OSHA records suggest the regulators’ stick has not come soon enough. Since 2012, at least four other firefighters have died during Cal Fire training hikes. All the firefighters but Katkov were inmates. No other case yielded sanctions.\u003c/p>\n\u003cp>Cal Fire’s training processes, meanwhile, continue to put firefighters at risk. In 2020, almost a year after Katkov’s death, another department firefighter was sickened by heat during a hike. That firefighter was rushed to the hospital and survived.\u003c/p>\n\u003cp>Ellen Widess, head of Cal/OSHA from 2011 to 2013, said she sees an unsettling pattern: Employers can brush off the cost of an agency fine. In many cases, she said, penalties have no effect.\u003c/p>\n\u003cp>“We’ve seen that the costs of [non]compliance are so cheap,” Widess said. “It pays not to comply.”\u003c/p>\n\u003ch3>‘It’s going to be like this every year’\u003c/h3>\n\u003cp>In the three years since Public Citizen renewed its petition for an OSHA heat standard, political pressure for such action has grown. In March, Rep. Judy Chu, D-Calif., authored legislation that would require OSHA to create a national heat standard based on NIOSH criteria and mandate employer training “to prevent and respond” to heat illnesses. The bill, co-sponsored by at least 57 House Democrats, is pending in committee. It marks the second attempt by federal lawmakers to establish a rule since 2019.\u003c/p>\n\u003cp>OSHA, meanwhile, said it will take the first step toward issuing a rule this fall. In October, the agency plans to publish a request for information from employers, occupational health specialists, climate scientists and workers on the viability of a standard. Frederick, OSHA’s acting director, said the input could help the agency develop a regulation that applies to any industry in the United States.\u003c/p>\n\u003cp>“Heat hazards exist in many, many industries,” he said. “We know that we have work to do with almost every industry to understand … what the effect of heat hazards in their workplace is and how best they are putting in practices and controls to mitigate those hazards.”\u003c/p>\n\u003cp>Already, former OSHA officials are anticipating industry pushback, particularly from construction groups.\u003c/p>\n\u003cfigure id=\"attachment_1976404\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1976404 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-800x640.jpg\" alt=\"\" width=\"800\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-800x640.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-1020x816.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-160x128.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-768x614.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-1536x1229.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-2048x1638.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2021/08/se-2021-07-28-wpick-4427-edit_custom-c315a8531fef94c182a9d3c09fb7398ee7c3f664-2-1920x1536.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The body of farmworker Cruz Urias Beltran was found in this cornfield near Cairo, Neb. \u003ccite>(Walker Pickering/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Every time OSHA proposes a standard, [the] industry accuses OSHA of killing jobs and destroying whatever industry is going to be regulated,” said Jordan Barab, a former deputy assistant labor secretary who helped shepherd two chemical-exposure standards through protracted rule-making processes. “That would probably follow with a heat standard.”\u003c/p>\n\u003cp>Some states have decided not to wait. In June, as an unprecedented heat wave blanketed the Pacific Northwest, Sebastian Francisco Perez moved irrigation pipes at a nursery in Willamette Valley, Oregon. Perez was found dead at the end of his shift. Preliminary information suggests the incident was heat related, but Oregon Occupational Safety and Health (Oregon OSHA) has yet to make a determination, according to Aaron Corvin, a spokesman for Oregon OSHA. Ten days later, the state enacted an emergency heat standard.\u003c/p>\n\u003cp>Back in Grand Island, Nebraska, where the average high temperature has increased 2 degrees since the 1990s, the intensifying heat is not lost on Joseph Rivera. As a younger man in the fields, he remembers there were hot and humid days. But now the heat is so extreme, he said, “you get these hot days that just come up over you.”\u003c/p>\n\u003cp>“With climate change, you hit 112 in Nebraska the other day,” Rivera said, explaining why he’s amenable to a federal heat standard. “It’s going to be like this every year.”\u003c/p>\n\u003chr>\n\u003cp>\u003cem>Christina Stella, a reporter with Nebraska Public Media; Jacob Margolis, a reporter with KPCC in Los Angeles; Allison Mollenkamp, an intern on NPR’s investigative team; and The Texas Newsroom contributed to this story. Julia Shipley, Brian Edwards and David Nickerson reported this story as fellows for Columbia Journalism Investigations, an investigative reporting unit at the Columbia Journalism School in New York. Cascade Tuholske, a climate impact scientist at Columbia University’s Earth Institute, contributed to the data analysis. Public Health Watch, an independent investigative nonprofit, helped edit this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"perspectives": {
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
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},
"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
"airtime": "SUN 12am-1am, SAT 2pm-3pm",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/reveal300px.png",
"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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"source": "npr"
},
"link": "/radio/program/reveal",
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"rss": "http://feeds.revealradio.org/revealpodcast"
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"source": "kqed",
"order": 16
},
"link": "/podcasts/rightnowish",
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