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"content": "\u003cp>The first five months of the COVID-19 pandemic in California rank among the deadliest in state history, deadlier than any other consecutive five-month period in at least 20 years.\u003c/p>\n\u003cp>And the grim milestone encompasses thousands of “excess” deaths not accounted for in the state’s official COVID death tally: a loss of life concentrated among Blacks, Asians and Latinos, afflicting people who experts say likely didn’t get preventive medical care amid the far-reaching shutdowns or who were wrongly excluded from the coronavirus death count.\u003c/p>\n\u003cp>\u003ciframe loading=\"lazy\" title=\"Excess Deaths in California, By County\" aria-label=\"Map\" id=\"datawrapper-chart-WmugB\" src=\"https://datawrapper.dwcdn.net/WmugB/8/\" scrolling=\"no\" frameborder=\"0\" style=\"border: none;\" width=\"600\" height=\"814\">\u003c/iframe>\u003c/p>\n\u003cp>About 125,000 Californians died from March through July, up by 14,200, or 13%, from the average for the same five months during the prior three years, according to a review of \u003ca href=\"https://www.cdph.ca.gov/Programs/CHSI/Pages/Statistical-Reports.aspx\">data\u003c/a> from the state Department of Public Health.\u003c/p>\n\u003cp>By the end of July, California had logged about 9,200 deaths officially attributed to COVID-19 in county death records. That left about 5,000 “excess” deaths for those months — meaning deaths above the norm not attributed to COVID-19. Deaths tend to increase from year to year as the population grows, but typically not by that much.\u003c/p>\n\u003cp>A closer look at California’s excess deaths during the period reveals a disturbing racial and ethnic variance: All the excess deaths not officially linked to COVID infection were concentrated in minority communities. Latinos make up the vast majority, accounting for 3,350 of those excess deaths, followed by Asians (1,150), Blacks (860) and other Californians of color (350).\u003c/p>\n\u003cp>[pullquote]All the excess deaths not officially linked to COVID-19 infection were concentrated in minority communities.[/pullquote]The overall number of excess deaths across all races and ethnicities was ultimately tempered because, compared with the three prior years, there were actually 383 fewer deaths among white Californians than would be expected in the absence of COVID-19. In addition, California Healthline adjusted the overall numbers to reflect more than 320 COVID deaths that could not be categorized by race or ethnicity because that information was missing from state records.\u003c/p>\n\u003cp>Several epidemiologists interviewed said they believe a sizable portion of the excess deaths among people of color did, in fact, stem from COVID infections but went undetected for a variety of reasons. Among them: a shortage of coronavirus tests in the early months of the pandemic; an uneven strategy for how and when to administer those tests, which persists; and inadequate access to health care providers in many low-income and immigrant communities.\u003c/p>\n\u003cp>\u003ca href=\"https://profiles.ucsf.edu/kirsten.bibbins-domingo\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Kirsten Bibbins-Domingo\u003c/a>, chair of the Department of Epidemiology and Biostatistics at the UC San Francisco, is among those who suspect the excess deaths reflect a COVID undercount in minority communities. She noted that several chronic health conditions that disproportionately affect Blacks and Latinos — including diabetes, high blood pressure and heart disease — also place them at higher risk for severe complications from COVID-19.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In addition, Bibbins-Domingo said, the prolonged shutdown of medical offices in the early months of the pandemic — and with them non-urgent surgeries and routine medical care — likely accelerated death among people with those chronic conditions.\u003c/p>\n\u003cp>“Shutdowns always come at a cost,” she said. “It is our most marginalized communities that experience the cost of a shutdown.”\u003c/p>\n\u003cp>According to state Department of Public Health data, deaths in California attributed to diabetes rose 12% from March through July when compared with the average for the same period over the past three years. In addition, deaths attributed to Alzheimer’s disease rose 11%.\u003c/p>\n\u003cp>“Dementia is also a disease where we have racial, ethnic minorities already at greater risk,” said \u003ca href=\"https://andreapolonijo.com/about\" target=\"_blank\" rel=\"noopener noreferrer\">Andrea Polonijo\u003c/a>, a medical sociologist at the UC Riverside. “Now that we have the pandemic, they’re more socially isolated. Social isolation we know can cause deeper cognitive decline.”\u003c/p>\n\u003cp>It’s hard to determine whether a death is due to COVID-19 if the victim never sought medical care, said \u003ca href=\"http://www.lchc.org/who-we-are/staff/\" target=\"_blank\" rel=\"noopener noreferrer\">Jeffrey Reynoso\u003c/a>, executive director of the nonprofit Latino Coalition for a Healthy California. Latinos in California are less likely to have health insurance, he said. They may face language barriers if their medical provider — or contact tracer — does not speak Spanish. Latino immigrants working in the U.S. without authorization may hesitate to visit the doctor.\u003c/p>\n\u003cp>“Immigration is definitely a driver in creating a fear and a mistrust of systems, and that includes our health care system,” Reynoso said.\u003c/p>\n\u003cp>Polonijo said the fact that Latinos make up the bulk of the excess deaths correlates with their dominant role in farming, meat processing, manufacturing and food service, jobs all deemed essential during the pandemic.\u003c/p>\n\u003cp>“This population is also more likely to live in more crowded conditions,” she said. “So not only are they exposed at work, but they are bringing disease home and with it the possibility of spreading it to their family, bringing it to the community.”\u003c/p>\n\u003cp>Bibbins-Domingo noted that, while a major portion of COVID deaths overall have occurred among seniors and nursing home residents, a disproportionate number of the state’s excess deaths are of working-age adults.\u003c/p>\n\u003cp>“The excess deaths that we’re seeing in communities of color and in low-income communities are deaths that are occurring at younger ages,” she said. “These are deaths that are occurring in these ages from 20 to 60, generally speaking — the ages when people would be out working.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.apiahf.org/leadership/kathy-ko-chin/\" target=\"_blank\" rel=\"noopener noreferrer\">Kathy Ko Chin\u003c/a>, president of the Oakland-based Asian & Pacific Islander American Health Forum, said Asian Americans also tend to be overrepresented in essential worker occupations, noting that a large proportion of the state’s nurses are Filipino. In addition, she said, government officials have not done enough to translate COVID educational materials into the many languages spoken by California’s Asian Americans. The Trump administration’s rhetoric on immigration during the past four years, she added, has had a “chilling effect” that has kept many foreign-born Asian Americans from visiting a doctor.\u003c/p>\n\u003cp>“People were really, really scared,” Chin said.\u003c/p>\n\u003cp>Counties in Southern California and the largely rural Central Valley — places with a high proportion of Latino residents — tended to have high rates of excess deaths from March to July. Among counties with at least 100,000 people, Kings County, an arid expanse north of Los Angeles that is home to industrial-scale agriculture, had the highest rate of excess deaths per capita.\u003c/p>\n\u003cp>Officials at the Kings County Department of Public Health did not return a message seeking comment.\u003c/p>\n\u003cp>Bibbins-Domingo and others said it is important for state and county health officials to take a hard look at their excess death numbers. Excess deaths matter, she said, because they expose shortcomings in health care delivery. In addition, local and state responses to COVID-19 are grounded in data; if that data is inaccurate, the responses may be misguided.\u003c/p>\n\u003cp>“Deaths are important because they also help us to understand how much severe COVID is there in the community that we have to worry about,” Bibbins-Domingo said. “I think when we undercount that, we both fly blind for the overall pandemic management, and we might fly particularly blind in understanding the impact of the pandemic in particular communities.”\u003c/p>\n\u003cp>\u003cem>Phillip Reese is a data reporting specialist and an assistant professor of journalism at California State University, Sacramento.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://khn.org\">KHN\u003c/a> story first published on \u003ca href=\"http://www.californiahealthline.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Healthline\u003c/a>, a service of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>\u003cimg decoding=\"async\" src=\"https://ssl.google-analytics.com/collect?v=1&t=event&ec=Republish&tid=UA-53070700-2&z=1600720483034&cid=6a21b6bd-c27b-40cb-a4a3-f69c9cb4e27b&ea=https%3A%2F%2Fkhn.org%2Fnews%2Fcalifornias-deadliest-spring-in-20-years-suggests-covid-undercount%2F&el=California%E2%80%99s%20Deadliest%20Spring%20in%2020%20Years%20Suggests%20COVID%20Undercount\">\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The first five months of the COVID-19 pandemic in California rank among the deadliest in state history, deadlier than any other consecutive five-month period in at least 20 years.\u003c/p>\n\u003cp>And the grim milestone encompasses thousands of “excess” deaths not accounted for in the state’s official COVID death tally: a loss of life concentrated among Blacks, Asians and Latinos, afflicting people who experts say likely didn’t get preventive medical care amid the far-reaching shutdowns or who were wrongly excluded from the coronavirus death count.\u003c/p>\n\u003cp>\u003ciframe loading=\"lazy\" title=\"Excess Deaths in California, By County\" aria-label=\"Map\" id=\"datawrapper-chart-WmugB\" src=\"https://datawrapper.dwcdn.net/WmugB/8/\" scrolling=\"no\" frameborder=\"0\" style=\"border: none;\" width=\"600\" height=\"814\">\u003c/iframe>\u003c/p>\n\u003cp>About 125,000 Californians died from March through July, up by 14,200, or 13%, from the average for the same five months during the prior three years, according to a review of \u003ca href=\"https://www.cdph.ca.gov/Programs/CHSI/Pages/Statistical-Reports.aspx\">data\u003c/a> from the state Department of Public Health.\u003c/p>\n\u003cp>By the end of July, California had logged about 9,200 deaths officially attributed to COVID-19 in county death records. That left about 5,000 “excess” deaths for those months — meaning deaths above the norm not attributed to COVID-19. Deaths tend to increase from year to year as the population grows, but typically not by that much.\u003c/p>\n\u003cp>A closer look at California’s excess deaths during the period reveals a disturbing racial and ethnic variance: All the excess deaths not officially linked to COVID infection were concentrated in minority communities. Latinos make up the vast majority, accounting for 3,350 of those excess deaths, followed by Asians (1,150), Blacks (860) and other Californians of color (350).\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The overall number of excess deaths across all races and ethnicities was ultimately tempered because, compared with the three prior years, there were actually 383 fewer deaths among white Californians than would be expected in the absence of COVID-19. In addition, California Healthline adjusted the overall numbers to reflect more than 320 COVID deaths that could not be categorized by race or ethnicity because that information was missing from state records.\u003c/p>\n\u003cp>Several epidemiologists interviewed said they believe a sizable portion of the excess deaths among people of color did, in fact, stem from COVID infections but went undetected for a variety of reasons. Among them: a shortage of coronavirus tests in the early months of the pandemic; an uneven strategy for how and when to administer those tests, which persists; and inadequate access to health care providers in many low-income and immigrant communities.\u003c/p>\n\u003cp>\u003ca href=\"https://profiles.ucsf.edu/kirsten.bibbins-domingo\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Kirsten Bibbins-Domingo\u003c/a>, chair of the Department of Epidemiology and Biostatistics at the UC San Francisco, is among those who suspect the excess deaths reflect a COVID undercount in minority communities. She noted that several chronic health conditions that disproportionately affect Blacks and Latinos — including diabetes, high blood pressure and heart disease — also place them at higher risk for severe complications from COVID-19.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In addition, Bibbins-Domingo said, the prolonged shutdown of medical offices in the early months of the pandemic — and with them non-urgent surgeries and routine medical care — likely accelerated death among people with those chronic conditions.\u003c/p>\n\u003cp>“Shutdowns always come at a cost,” she said. “It is our most marginalized communities that experience the cost of a shutdown.”\u003c/p>\n\u003cp>According to state Department of Public Health data, deaths in California attributed to diabetes rose 12% from March through July when compared with the average for the same period over the past three years. In addition, deaths attributed to Alzheimer’s disease rose 11%.\u003c/p>\n\u003cp>“Dementia is also a disease where we have racial, ethnic minorities already at greater risk,” said \u003ca href=\"https://andreapolonijo.com/about\" target=\"_blank\" rel=\"noopener noreferrer\">Andrea Polonijo\u003c/a>, a medical sociologist at the UC Riverside. “Now that we have the pandemic, they’re more socially isolated. Social isolation we know can cause deeper cognitive decline.”\u003c/p>\n\u003cp>It’s hard to determine whether a death is due to COVID-19 if the victim never sought medical care, said \u003ca href=\"http://www.lchc.org/who-we-are/staff/\" target=\"_blank\" rel=\"noopener noreferrer\">Jeffrey Reynoso\u003c/a>, executive director of the nonprofit Latino Coalition for a Healthy California. Latinos in California are less likely to have health insurance, he said. They may face language barriers if their medical provider — or contact tracer — does not speak Spanish. Latino immigrants working in the U.S. without authorization may hesitate to visit the doctor.\u003c/p>\n\u003cp>“Immigration is definitely a driver in creating a fear and a mistrust of systems, and that includes our health care system,” Reynoso said.\u003c/p>\n\u003cp>Polonijo said the fact that Latinos make up the bulk of the excess deaths correlates with their dominant role in farming, meat processing, manufacturing and food service, jobs all deemed essential during the pandemic.\u003c/p>\n\u003cp>“This population is also more likely to live in more crowded conditions,” she said. “So not only are they exposed at work, but they are bringing disease home and with it the possibility of spreading it to their family, bringing it to the community.”\u003c/p>\n\u003cp>Bibbins-Domingo noted that, while a major portion of COVID deaths overall have occurred among seniors and nursing home residents, a disproportionate number of the state’s excess deaths are of working-age adults.\u003c/p>\n\u003cp>“The excess deaths that we’re seeing in communities of color and in low-income communities are deaths that are occurring at younger ages,” she said. “These are deaths that are occurring in these ages from 20 to 60, generally speaking — the ages when people would be out working.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.apiahf.org/leadership/kathy-ko-chin/\" target=\"_blank\" rel=\"noopener noreferrer\">Kathy Ko Chin\u003c/a>, president of the Oakland-based Asian & Pacific Islander American Health Forum, said Asian Americans also tend to be overrepresented in essential worker occupations, noting that a large proportion of the state’s nurses are Filipino. In addition, she said, government officials have not done enough to translate COVID educational materials into the many languages spoken by California’s Asian Americans. The Trump administration’s rhetoric on immigration during the past four years, she added, has had a “chilling effect” that has kept many foreign-born Asian Americans from visiting a doctor.\u003c/p>\n\u003cp>“People were really, really scared,” Chin said.\u003c/p>\n\u003cp>Counties in Southern California and the largely rural Central Valley — places with a high proportion of Latino residents — tended to have high rates of excess deaths from March to July. Among counties with at least 100,000 people, Kings County, an arid expanse north of Los Angeles that is home to industrial-scale agriculture, had the highest rate of excess deaths per capita.\u003c/p>\n\u003cp>Officials at the Kings County Department of Public Health did not return a message seeking comment.\u003c/p>\n\u003cp>Bibbins-Domingo and others said it is important for state and county health officials to take a hard look at their excess death numbers. Excess deaths matter, she said, because they expose shortcomings in health care delivery. In addition, local and state responses to COVID-19 are grounded in data; if that data is inaccurate, the responses may be misguided.\u003c/p>\n\u003cp>“Deaths are important because they also help us to understand how much severe COVID is there in the community that we have to worry about,” Bibbins-Domingo said. “I think when we undercount that, we both fly blind for the overall pandemic management, and we might fly particularly blind in understanding the impact of the pandemic in particular communities.”\u003c/p>\n\u003cp>\u003cem>Phillip Reese is a data reporting specialist and an assistant professor of journalism at California State University, Sacramento.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://khn.org\">KHN\u003c/a> story first published on \u003ca href=\"http://www.californiahealthline.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Healthline\u003c/a>, a service of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>\u003cimg decoding=\"async\" src=\"https://ssl.google-analytics.com/collect?v=1&t=event&ec=Republish&tid=UA-53070700-2&z=1600720483034&cid=6a21b6bd-c27b-40cb-a4a3-f69c9cb4e27b&ea=https%3A%2F%2Fkhn.org%2Fnews%2Fcalifornias-deadliest-spring-in-20-years-suggests-covid-undercount%2F&el=California%E2%80%99s%20Deadliest%20Spring%20in%2020%20Years%20Suggests%20COVID%20Undercount\">\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "A COVID-19 Vaccine May Be Only 50% Effective. Is That Good Enough?",
"headTitle": "A COVID-19 Vaccine May Be Only 50% Effective. Is That Good Enough? | KQED",
"content": "\u003cp>As we get closer to a COVID-19 vaccine, it’s exciting to imagine a day when the virus is gone. But a vaccine will not be a magic bullet. In fact, it may be only about 50% effective.\u003c/p>\n\u003cp>Dr. Anthony Fauci, chief of the National Institute of Health and Infectious Disease, has\u003ca href=\"https://www.brown.edu/academics/public-health/fauci\"> tried to set realistic expectations\u003c/a> when discussing the importance of a vaccine. “We don’t know yet what the efficacy might be. We don’t know if it will be 50% or 60%,” Fauci said during a Brown University event in August.\u003c/p>\n\u003cp>“I’d like it to be 75% or more,” Fauci said, but he acknowledged that may not be realistic.\u003c/p>\n\u003cp>The Food and Drug Administration has said that once a vaccine is shown to be safe and at least 50% effective, it could be approved for use in the U.S.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>So What Does 50% Efficacy Mean?\u003c/strong>\u003c/p>\n\u003cp>“When we talk ‘vaccine effectiveness,’ what we’re talking about is, ‘How effective was the vaccine at preventing actual disease?’ ” explains scientist\u003ca href=\"https://www.immunize.org/aboutus/litjen_tan_bio.asp\"> L.J. Tan\u003c/a>, chief strategistof the nonprofit Immunization Action Coalition.\u003c/p>\n\u003cp>In other words, Tan says, “If you vaccinate 100 people, 50 people will not get [the] disease.”\u003c/p>\n\u003cp>This may not sound like an impressive rate of infection prevention, but there are other potential benefits to individuals and the community from getting vaccinated.\u003c/p>\n\u003cp>“It’s possible that the [COVID-19] vaccine will reduce the severity of disease” in the other 50% who do get sick, says physician\u003ca href=\"https://cph.osu.edu/people/wmiller\"> Bill Miller\u003c/a> of The Ohio State University College of Public Health. “It may mean that people are less likely to be hospitalized, require ICU care or die.\u003c/p>\n\u003cp>“That’s certainly the case with the influenza vaccine,” Miller adds. “People who get the vaccine may still get the flu, but, for the most part, their disease is milder than if they hadn’t had the vaccine.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=16506\">Michael Ison\u003c/a>, an infectious disease physician at the Northwestern University Feinberg School of Medicine, echoes that sentiment. While it’s true that 50 out of 100 people who get the vaccine could still end up getting infected with the coronavirus, “hopefully, the majority will have milder disease,” Ison says. But he cautions there’s a lot to learn in that regard, given that the studies of COVID-19 vaccine candidates are still very much underway.\u003c/p>\n\u003cp>“We really need to get some information from the trials that are ongoing to best understand what the impact will be,” he says. Ison is a member of the research team at Northwestern that is conducting studies on COVID-19 and on influenza vaccines.\u003c/p>\n\u003cp>And here’s the next reality check: The extent to which any vaccine that emerges will help halt the COVID-19 pandemic depends on how many people get the immunization.\u003c/p>\n\u003cp>In order to put this pandemic in the rearview mirror, a large percentage of the population needs to either be vaccinated or gain immunity via an infection with the virus (a much riskier route that \u003ca href=\"https://www.npr.org/sections/health-shots/2020/07/24/894148860/without-a-vaccine-researchers-say-herd-immunity-may-never-be-achieved\">would include many more deaths\u003c/a>).\u003c/p>\n\u003cp>When a large portion of the population has immunity to the virus because of this sort of \u003ca href=\"https://apic.org/monthly_alerts/herd-immunity/\">“herd immunity,”\u003c/a> it’s unlikely to keep spreading. Even people who haven’t been vaccinated (such as very young babies and those with compromised immune systems) are protected once this level of immunity in a population is achieved, because the illness has little opportunity to spread within the community — most people who run into the virus in this scenario are immune.\u003c/p>\n\u003cp>For the coronavirus, Ison says, “‘herd immunity’ is seen when we have somewhere between 60% to 70% of the population having some degree of protection.”\u003c/p>\n\u003cp>So — here’s a little math — if 20% of the U.S. population ends up getting exposed to the virus and developing an infection before we have a vaccine (as is \u003ca href=\"https://www.nytimes.com/2020/04/23/nyregion/coronavirus-new-york-update.html#:~:text=About%2021%20percent%20of%20people,what%20is%20the%20infection%20rate.\">estimated to be the level of immunity in the New York City metro area right now),\u003c/a> then we would still need an additional 40% of the population to gain protection via a vaccine.\u003c/p>\n\u003cp>And in order to get 40% of a population immune through vaccination — if you have a vaccine with 50% efficacy — “you’re going to have to vaccinate 80% of the population,” says \u003ca href=\"https://vaccines.emory.edu/faculty-evc/primary-faculty/del_rio_carlos.html\">Carlos del Rio\u003c/a>, an infectious disease expert at Emory University. “So it’s not going to happen right away.”\u003c/p>\n\u003cp>For starters, Ison says, there are logistical challenges to getting everyone vaccinated, given the mammoth undertaking of manufacturing and distributing a vaccine.\u003c/p>\n\u003cp>“It’s going to take us months to get the entire population vaccinated if they are willing to get vaccinated,” he says — which is \u003ca href=\"https://www.npr.org/2020/09/09/911188375/how-vaccine-skepticism-may-affect-efforts-to-combat-the-coronavirus-pandemic\">another big “if.”\u003c/a> An NPR/PBS/Marist poll in August found that\u003ca href=\"https://www.npr.org/2020/08/14/902265017/poll-biden-expands-lead-a-third-of-country-says-it-wont-get-vaccinated\"> more than a third of Americans — 35% — say they won’t get vaccinated\u003c/a> when a vaccine comes available.\u003c/p>\n\u003cp>What’s more, most of the candidate vaccines now being tested would require two separate doses to trigger their most effective protection, Ison says. So at a minimum, he notes, you’ve got a full month between the two doses of vaccine and a short period of time after the second dose before someone who was been vaccinated would be protected.\u003c/p>\n\u003cp>It’s also still not known how long the immunity gained through any of the current COVID-19 vaccine candidates will last or to what extent the virus might mutate or change in a way that makes that vaccine less effective.\u003c/p>\n\u003cp>“What we will only know once we have the vaccine [approved and rolled out] is how effective it is, how long lasting the protection is and how much pressure it applies to the virus to change, to escape the pressures of the vaccine,” Ison says.\u003c/p>\n\u003cp>Despite all these remaining unknowns, it is safe to say that any such vaccine against the coronavirus could play a significant role in reducing the spread of the virus.\u003c/p>\n\u003cp>“If a vaccine is 50% effective, that’s still good,” Miller says. That means that you have a good possibility of being protected. He says we should think about its effectiveness the way we do about the benefits of cancer treatments, for example.\u003c/p>\n\u003cp>“In some severe cancers, we’d be pretty happy to get a drug that gets us to 50% effectiveness,” he notes.\u003c/p>\n\u003cp>\u003cstrong>Why Do We Need to Test a Proposed Vaccine in So Many People?\u003c/strong>\u003c/p>\n\u003cp>For now, it’s important to see the experimental trials of each vaccine candidate through to the end, Miller says. The phase 3 trials will tell us a lot about the safety of a vaccine as well as its effectiveness.\u003c/p>\n\u003cp>The large studies now underway are being conducted as double-blind, placebo-controlled trials, which is considered the gold standard in scientific research. This means half the participants get the real vaccine and “half the patients get a placebo — a water shot,” Ison says. And nobody — not the researchers nor the participants — will know until after the study is complete who got the placebo and who got the real vaccine.\u003c/p>\n\u003cp>“What we would like to see is that there’s a difference in the rate of COVID-19 — with a much lower rate in patients who get the vaccine than in the patients who get the placebo,” Ison says. But it takes time and a lot of people to see that sort of effect and to answer questions about safety.\u003c/p>\n\u003cp>The vaccine makers are aiming to enroll about 30,000 people in each trial.\u003c/p>\n\u003cp>“Side effects of vaccines [can be] very rare, so you need a lot of people to see if the vaccine causes any unexpected problems,” Miller explains. “These side effects must also be monitored carefully post-marketing to ensure that every important problem is identified.”\u003c/p>\n\u003cp>Ison notes that there’s another benefit to a large study — it helps researchers know how strong the immune response to a vaccine needs to be to be protective.\u003c/p>\n\u003cp>\u003cstrong>Will the Vaccine Protect Older People? And What If I’m Heavy?\u003c/strong>\u003c/p>\n\u003cp>With age, the immune system often mounts a lesser response to vaccination; that’s why, for example, adults 65 and older can opt for a high-dose flu shot — that’s thought to help bolster their protection. And scientists also know from prior research that the flu vaccine is \u003ca href=\"https://www.npr.org/sections/health-shots/2019/11/24/782079520/excess-weight-can-weaken-the-flu-shot\">less effective in people who carry a lot of extra weight\u003c/a>. Ison says it’s too soon to know if obesity or age will be a factor in the immune response to the COVID-19 vaccine candidates now being considered for use.\u003c/p>\n\u003cp>In research results so far, he says, “the small, phase 1 data shows that you can generate antibody responses even in older adults, but it’ll be these larger studies that will tell us [whether] we need to use higher doses or more doses of the vaccine in certain cases.” Results from phase 3 trials of safety and effectiveness are expected in the coming months.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2020 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=A+COVID-19+Vaccine+May+Be+Only+50%25+Effective.+Is+That+Good+Enough%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As we get closer to a COVID-19 vaccine, it’s exciting to imagine a day when the virus is gone. But a vaccine will not be a magic bullet. In fact, it may be only about 50% effective.\u003c/p>\n\u003cp>Dr. Anthony Fauci, chief of the National Institute of Health and Infectious Disease, has\u003ca href=\"https://www.brown.edu/academics/public-health/fauci\"> tried to set realistic expectations\u003c/a> when discussing the importance of a vaccine. “We don’t know yet what the efficacy might be. We don’t know if it will be 50% or 60%,” Fauci said during a Brown University event in August.\u003c/p>\n\u003cp>“I’d like it to be 75% or more,” Fauci said, but he acknowledged that may not be realistic.\u003c/p>\n\u003cp>The Food and Drug Administration has said that once a vaccine is shown to be safe and at least 50% effective, it could be approved for use in the U.S.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>So What Does 50% Efficacy Mean?\u003c/strong>\u003c/p>\n\u003cp>“When we talk ‘vaccine effectiveness,’ what we’re talking about is, ‘How effective was the vaccine at preventing actual disease?’ ” explains scientist\u003ca href=\"https://www.immunize.org/aboutus/litjen_tan_bio.asp\"> L.J. Tan\u003c/a>, chief strategistof the nonprofit Immunization Action Coalition.\u003c/p>\n\u003cp>In other words, Tan says, “If you vaccinate 100 people, 50 people will not get [the] disease.”\u003c/p>\n\u003cp>This may not sound like an impressive rate of infection prevention, but there are other potential benefits to individuals and the community from getting vaccinated.\u003c/p>\n\u003cp>“It’s possible that the [COVID-19] vaccine will reduce the severity of disease” in the other 50% who do get sick, says physician\u003ca href=\"https://cph.osu.edu/people/wmiller\"> Bill Miller\u003c/a> of The Ohio State University College of Public Health. “It may mean that people are less likely to be hospitalized, require ICU care or die.\u003c/p>\n\u003cp>“That’s certainly the case with the influenza vaccine,” Miller adds. “People who get the vaccine may still get the flu, but, for the most part, their disease is milder than if they hadn’t had the vaccine.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=16506\">Michael Ison\u003c/a>, an infectious disease physician at the Northwestern University Feinberg School of Medicine, echoes that sentiment. While it’s true that 50 out of 100 people who get the vaccine could still end up getting infected with the coronavirus, “hopefully, the majority will have milder disease,” Ison says. But he cautions there’s a lot to learn in that regard, given that the studies of COVID-19 vaccine candidates are still very much underway.\u003c/p>\n\u003cp>“We really need to get some information from the trials that are ongoing to best understand what the impact will be,” he says. Ison is a member of the research team at Northwestern that is conducting studies on COVID-19 and on influenza vaccines.\u003c/p>\n\u003cp>And here’s the next reality check: The extent to which any vaccine that emerges will help halt the COVID-19 pandemic depends on how many people get the immunization.\u003c/p>\n\u003cp>In order to put this pandemic in the rearview mirror, a large percentage of the population needs to either be vaccinated or gain immunity via an infection with the virus (a much riskier route that \u003ca href=\"https://www.npr.org/sections/health-shots/2020/07/24/894148860/without-a-vaccine-researchers-say-herd-immunity-may-never-be-achieved\">would include many more deaths\u003c/a>).\u003c/p>\n\u003cp>When a large portion of the population has immunity to the virus because of this sort of \u003ca href=\"https://apic.org/monthly_alerts/herd-immunity/\">“herd immunity,”\u003c/a> it’s unlikely to keep spreading. Even people who haven’t been vaccinated (such as very young babies and those with compromised immune systems) are protected once this level of immunity in a population is achieved, because the illness has little opportunity to spread within the community — most people who run into the virus in this scenario are immune.\u003c/p>\n\u003cp>For the coronavirus, Ison says, “‘herd immunity’ is seen when we have somewhere between 60% to 70% of the population having some degree of protection.”\u003c/p>\n\u003cp>So — here’s a little math — if 20% of the U.S. population ends up getting exposed to the virus and developing an infection before we have a vaccine (as is \u003ca href=\"https://www.nytimes.com/2020/04/23/nyregion/coronavirus-new-york-update.html#:~:text=About%2021%20percent%20of%20people,what%20is%20the%20infection%20rate.\">estimated to be the level of immunity in the New York City metro area right now),\u003c/a> then we would still need an additional 40% of the population to gain protection via a vaccine.\u003c/p>\n\u003cp>And in order to get 40% of a population immune through vaccination — if you have a vaccine with 50% efficacy — “you’re going to have to vaccinate 80% of the population,” says \u003ca href=\"https://vaccines.emory.edu/faculty-evc/primary-faculty/del_rio_carlos.html\">Carlos del Rio\u003c/a>, an infectious disease expert at Emory University. “So it’s not going to happen right away.”\u003c/p>\n\u003cp>For starters, Ison says, there are logistical challenges to getting everyone vaccinated, given the mammoth undertaking of manufacturing and distributing a vaccine.\u003c/p>\n\u003cp>“It’s going to take us months to get the entire population vaccinated if they are willing to get vaccinated,” he says — which is \u003ca href=\"https://www.npr.org/2020/09/09/911188375/how-vaccine-skepticism-may-affect-efforts-to-combat-the-coronavirus-pandemic\">another big “if.”\u003c/a> An NPR/PBS/Marist poll in August found that\u003ca href=\"https://www.npr.org/2020/08/14/902265017/poll-biden-expands-lead-a-third-of-country-says-it-wont-get-vaccinated\"> more than a third of Americans — 35% — say they won’t get vaccinated\u003c/a> when a vaccine comes available.\u003c/p>\n\u003cp>What’s more, most of the candidate vaccines now being tested would require two separate doses to trigger their most effective protection, Ison says. So at a minimum, he notes, you’ve got a full month between the two doses of vaccine and a short period of time after the second dose before someone who was been vaccinated would be protected.\u003c/p>\n\u003cp>It’s also still not known how long the immunity gained through any of the current COVID-19 vaccine candidates will last or to what extent the virus might mutate or change in a way that makes that vaccine less effective.\u003c/p>\n\u003cp>“What we will only know once we have the vaccine [approved and rolled out] is how effective it is, how long lasting the protection is and how much pressure it applies to the virus to change, to escape the pressures of the vaccine,” Ison says.\u003c/p>\n\u003cp>Despite all these remaining unknowns, it is safe to say that any such vaccine against the coronavirus could play a significant role in reducing the spread of the virus.\u003c/p>\n\u003cp>“If a vaccine is 50% effective, that’s still good,” Miller says. That means that you have a good possibility of being protected. He says we should think about its effectiveness the way we do about the benefits of cancer treatments, for example.\u003c/p>\n\u003cp>“In some severe cancers, we’d be pretty happy to get a drug that gets us to 50% effectiveness,” he notes.\u003c/p>\n\u003cp>\u003cstrong>Why Do We Need to Test a Proposed Vaccine in So Many People?\u003c/strong>\u003c/p>\n\u003cp>For now, it’s important to see the experimental trials of each vaccine candidate through to the end, Miller says. The phase 3 trials will tell us a lot about the safety of a vaccine as well as its effectiveness.\u003c/p>\n\u003cp>The large studies now underway are being conducted as double-blind, placebo-controlled trials, which is considered the gold standard in scientific research. This means half the participants get the real vaccine and “half the patients get a placebo — a water shot,” Ison says. And nobody — not the researchers nor the participants — will know until after the study is complete who got the placebo and who got the real vaccine.\u003c/p>\n\u003cp>“What we would like to see is that there’s a difference in the rate of COVID-19 — with a much lower rate in patients who get the vaccine than in the patients who get the placebo,” Ison says. But it takes time and a lot of people to see that sort of effect and to answer questions about safety.\u003c/p>\n\u003cp>The vaccine makers are aiming to enroll about 30,000 people in each trial.\u003c/p>\n\u003cp>“Side effects of vaccines [can be] very rare, so you need a lot of people to see if the vaccine causes any unexpected problems,” Miller explains. “These side effects must also be monitored carefully post-marketing to ensure that every important problem is identified.”\u003c/p>\n\u003cp>Ison notes that there’s another benefit to a large study — it helps researchers know how strong the immune response to a vaccine needs to be to be protective.\u003c/p>\n\u003cp>\u003cstrong>Will the Vaccine Protect Older People? And What If I’m Heavy?\u003c/strong>\u003c/p>\n\u003cp>With age, the immune system often mounts a lesser response to vaccination; that’s why, for example, adults 65 and older can opt for a high-dose flu shot — that’s thought to help bolster their protection. And scientists also know from prior research that the flu vaccine is \u003ca href=\"https://www.npr.org/sections/health-shots/2019/11/24/782079520/excess-weight-can-weaken-the-flu-shot\">less effective in people who carry a lot of extra weight\u003c/a>. Ison says it’s too soon to know if obesity or age will be a factor in the immune response to the COVID-19 vaccine candidates now being considered for use.\u003c/p>\n\u003cp>In research results so far, he says, “the small, phase 1 data shows that you can generate antibody responses even in older adults, but it’ll be these larger studies that will tell us [whether] we need to use higher doses or more doses of the vaccine in certain cases.” Results from phase 3 trials of safety and effectiveness are expected in the coming months.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2020 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=A+COVID-19+Vaccine+May+Be+Only+50%25+Effective.+Is+That+Good+Enough%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "The Air Quality's Terrible Out There. So How Can You Keep It Clean Indoors?",
"headTitle": "The Air Quality’s Terrible Out There. So How Can You Keep It Clean Indoors? | KQED",
"content": "\u003cp>As California and the Bay Area braces for what could be another severe fire season, we spoke to several scientists and engineers about how to keep our indoor air clean, both at home and in shared spaces.\u003c/p>\n\u003ch3>\u003cstrong>How to Handle All This Smoke\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>What can we do to clean the air we breath inside our apartments and houses? \u003c/strong>\u003c/p>\n\u003cp>When we have wildfire smoke and the coronavirus, it’s best to keep our windows and doors closed and focus on cleaning the air inside our homes. You can do that with an air purifier that uses what’s called a HEPA filter; it’s a filter that actually cleans the air of both smoke and the particles that carry the coronavirus. These \u003ca href=\"https://www.nytimes.com/wirecutter/lists/get-better-indoor-air-quality/\" target=\"_blank\" rel=\"noopener noreferrer\">portable air purifiers\u003c/a> are good at cleaning the air in smaller spaces or individual rooms, and while these purifiers won’t remove all hazardous particles from the air, they do \u003ca href=\"https://ntrs.nasa.gov/citations/20170005166\" target=\"_blank\" rel=\"noopener noreferrer\">a very good job\u003c/a>.\u003c/p>\n\u003cp>Portable HEPA air purifiers can be purchased online and in stores. They range in price, and while many are very costly, \u003ca href=\"https://www.nytimes.com/wirecutter/reviews/best-air-purifier/\" target=\"_blank\" rel=\"noopener noreferrer\">you don’t have to spring for top price\u003c/a> to get top quality. Alternatively, some people are building \u003ca href=\"https://www.kqed.org/science/1968863/helping-kids-protect-themselves-from-dirty-air-one-diy-filter-at-a-time\" target=\"_blank\" rel=\"noopener noreferrer\">their own air purifiers\u003c/a> out of a box fan, a MERV filter and heavy-duty tape, for a price of roughly $50. University of Colorado Boulder chemistry professor \u003ca href=\"https://cires.colorado.edu/council-fellows/jose-luis-jimenez\" target=\"_blank\" rel=\"noopener noreferrer\">Jose-Luis Jimenez\u003c/a> says they really do work. It’s important not to leave these DIY air purifiers unattended, as it could be a fire hazard if the fan gets too hot, Jimenez says.\u003c/p>\n\u003cp>It’s also important to reduce the amount of indoor air pollution we create, says \u003ca href=\"https://wcec.ucdavis.edu/about/directory/theresa-pistochini/\" target=\"_blank\" rel=\"noopener noreferrer\">Theresa Pistochini\u003c/a>, engineering manager at the UC Davis Energy and Efficiency Institute and Western Cooling Efficiency Center.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Avoid generating other pollutants indoors: temporarily avoid cooking on a gas stove, candles, incense, etc.,” she says. “Shut off kitchen and bathroom exhaust fans to reduce air exchange with outdoors.”\u003c/p>\n\u003cp>\u003cstrong>My school has a good filter, but we bring in outdoor air to make it safer for students, in the pandemic. We can’t do that when there is wildfire smoke. What then? \u003c/strong>\u003c/p>\n\u003cp>Smoke particles range in size hugely, and they can be ultra fine, smaller than the particles that carry the coronavirus. That means buildings with a MERV 13 filter will do a good job of capturing particles that carry the virus, but will only capture some wildfire smoke, says \u003ca href=\"https://www.pdx.edu/engineering/dean\" target=\"_blank\" rel=\"noopener noreferrer\">Richard Corsi\u003c/a>, dean of engineering and computer science at Portland State University. Some buildings have systems that can accommodate a stronger filter, like a MERV 14, 15, 16 or even a HEPA filter, but this is not the case for all buildings. A stronger filter would be more effective at cleaning the air of both hazards.\u003c/p>\n\u003cp>If buildings can’t accommodate stronger filters and therefore cannot increase ventilation due to wildfire smoke, Corsi advises significantly bringing down the number of people using the building, or closing the building for the time being.\u003c/p>\n\u003cp>Pistochini agrees. “We are stuck in an impossible situation,” she says. “The pandemic dictates we go outside, the wildfire dictates we go inside.”\u003c/p>\n\u003cp>“The only widely available technology I’m aware of that tackles both these things at once is filters,” she said. Considering we’re in a pandemic, Pistochini still recommends building operators draw in some air from the outside, especially if a building has at least a MERV13 filter.\u003c/p>\n\u003cp>Then, both Pistochini and Corsi agree, portable air filters will help with smoke and the virus.\u003c/p>\n\u003ch3>\u003cstrong>Turning to the Coronavirus Pandemic\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>As we return to schools and offices, what practices should we be asking our schools and employers to adopt in these shared indoor environments? \u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Wear masks\u003c/strong> — even with physical distancing, says Corsi. To make this an easier pill to swallow, Corsi says give people breaks during the day during which they can go outside, physically distance, and take off their mask: a “mask break.” That is, assuming the air outside isn’t smoke-filled.\u003c/li>\n\u003cli>\u003cstrong>Distance.\u003c/strong> “We’ve done the design of every classroom assuming that people are wearing an inner tube with a three foot radius, so that you’ll always be 6 feet away from anybody,” Corsi says, referring to the setup of spaces at Portland State University.\u003c/li>\n\u003cli>\u003cstrong>Hold certain activities outside.\u003c/strong> Choir, playing wind instruments and group aerobic activities can cause more circulation of the virus because people are exhaling and inhaling at greater rates than they would be otherwise. Corsi suggests empty, above-ground parking structures.\u003c/li>\n\u003cli>\u003cstrong>Schedule creatively.\u003c/strong> Corsi encourages people to stagger their schedules at the office to limit the number of people in an enclosed space. For schools, he says to operate at a lower capacity for each space, and leave ample time between classes to avoid congestion in hallways.\u003c/li>\n\u003cli>\u003cstrong>Follow coronavirus etiquette.\u003c/strong> For shared spaces like elevators, Corsi says he practices “the new elevator etiquette”: mask on, just a few people in the elevator at a time, face away from one another, and no one talks.\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>How about the actual air we are breathing indoors?\u003c/strong>\u003c/p>\n\u003cp>When tackling potential coronavirus transmission indoors, atmospheric chemist at the Scripps Institution of Oceanography, \u003ca href=\"https://kprather.scrippsprofiles.ucsd.edu/\" target=\"_blank\" rel=\"noopener noreferrer\">Kim Prather\u003c/a>, says, “I’m advising people to make sure that the room they’re in is well ventilated.”\u003c/p>\n\u003cp>That means opening windows and doors when possible. When that is not possible, consider what kind of HVAC system the buildings have.\u003c/p>\n\u003cp>Pistochini says we all think of an HVAC system as providing heating and cooling, but, she says, “It should do two other things: it should filter the air and it should provide ventilation.” Ventilation means bringing outdoor air inside and exhausting indoor air.\u003c/p>\n\u003cp>In terms of the coronavirus, filtration can pull particles out of the air that may contain the virus. Ventilation will dilute the concentration of particles in the indoor air.\u003c/p>\n\u003cp>Pistochini says it’s hard to visualize this with the actual virus. so she suggests imagining “your kid went and dropped a gallon full of glitter in your swimming pool.” To remove the glitter (i.e. the virus), “you could pump it through a filter. Or you could change the water. Those two things are basically what HVAC systems do for air,” she says.\u003c/p>\n\u003cp>But you need three things in place for the HVAC system to work, she says: a fan that is actually on and running, a decent filter changed regularly, and for the outdoor air intake to be open.\u003c/p>\n\u003cp>The air filters used in HVAC systems have ratings. For the coronavirus, scientists recommend a MERV 13 filter or greater.\u003c/p>\n\u003cp>Prather says one way people can tell whether there is enough ventilation in their indoor spaces is to actually measure the carbon dioxide in the air with a monitor. Prather says a well ventilated room will have a carbon dioxide level of 800 or less. A room that is not well ventilated will have higher levels of carbon dioxide, which builds as humans exhale. She says she would like to see these monitors, which cost roughly $100, installed in classrooms so teachers have an understanding of their indoor air quality.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>These details are very technical, so it may take a few tries to get the answers to what HVAC system and other safety measures your office or school has. It may be best to ask the facilities department, a building manager, or human resources.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As California and the Bay Area braces for what could be another severe fire season, we spoke to several scientists and engineers about how to keep our indoor air clean, both at home and in shared spaces.\u003c/p>\n\u003ch3>\u003cstrong>How to Handle All This Smoke\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>What can we do to clean the air we breath inside our apartments and houses? \u003c/strong>\u003c/p>\n\u003cp>When we have wildfire smoke and the coronavirus, it’s best to keep our windows and doors closed and focus on cleaning the air inside our homes. You can do that with an air purifier that uses what’s called a HEPA filter; it’s a filter that actually cleans the air of both smoke and the particles that carry the coronavirus. These \u003ca href=\"https://www.nytimes.com/wirecutter/lists/get-better-indoor-air-quality/\" target=\"_blank\" rel=\"noopener noreferrer\">portable air purifiers\u003c/a> are good at cleaning the air in smaller spaces or individual rooms, and while these purifiers won’t remove all hazardous particles from the air, they do \u003ca href=\"https://ntrs.nasa.gov/citations/20170005166\" target=\"_blank\" rel=\"noopener noreferrer\">a very good job\u003c/a>.\u003c/p>\n\u003cp>Portable HEPA air purifiers can be purchased online and in stores. They range in price, and while many are very costly, \u003ca href=\"https://www.nytimes.com/wirecutter/reviews/best-air-purifier/\" target=\"_blank\" rel=\"noopener noreferrer\">you don’t have to spring for top price\u003c/a> to get top quality. Alternatively, some people are building \u003ca href=\"https://www.kqed.org/science/1968863/helping-kids-protect-themselves-from-dirty-air-one-diy-filter-at-a-time\" target=\"_blank\" rel=\"noopener noreferrer\">their own air purifiers\u003c/a> out of a box fan, a MERV filter and heavy-duty tape, for a price of roughly $50. University of Colorado Boulder chemistry professor \u003ca href=\"https://cires.colorado.edu/council-fellows/jose-luis-jimenez\" target=\"_blank\" rel=\"noopener noreferrer\">Jose-Luis Jimenez\u003c/a> says they really do work. It’s important not to leave these DIY air purifiers unattended, as it could be a fire hazard if the fan gets too hot, Jimenez says.\u003c/p>\n\u003cp>It’s also important to reduce the amount of indoor air pollution we create, says \u003ca href=\"https://wcec.ucdavis.edu/about/directory/theresa-pistochini/\" target=\"_blank\" rel=\"noopener noreferrer\">Theresa Pistochini\u003c/a>, engineering manager at the UC Davis Energy and Efficiency Institute and Western Cooling Efficiency Center.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Avoid generating other pollutants indoors: temporarily avoid cooking on a gas stove, candles, incense, etc.,” she says. “Shut off kitchen and bathroom exhaust fans to reduce air exchange with outdoors.”\u003c/p>\n\u003cp>\u003cstrong>My school has a good filter, but we bring in outdoor air to make it safer for students, in the pandemic. We can’t do that when there is wildfire smoke. What then? \u003c/strong>\u003c/p>\n\u003cp>Smoke particles range in size hugely, and they can be ultra fine, smaller than the particles that carry the coronavirus. That means buildings with a MERV 13 filter will do a good job of capturing particles that carry the virus, but will only capture some wildfire smoke, says \u003ca href=\"https://www.pdx.edu/engineering/dean\" target=\"_blank\" rel=\"noopener noreferrer\">Richard Corsi\u003c/a>, dean of engineering and computer science at Portland State University. Some buildings have systems that can accommodate a stronger filter, like a MERV 14, 15, 16 or even a HEPA filter, but this is not the case for all buildings. A stronger filter would be more effective at cleaning the air of both hazards.\u003c/p>\n\u003cp>If buildings can’t accommodate stronger filters and therefore cannot increase ventilation due to wildfire smoke, Corsi advises significantly bringing down the number of people using the building, or closing the building for the time being.\u003c/p>\n\u003cp>Pistochini agrees. “We are stuck in an impossible situation,” she says. “The pandemic dictates we go outside, the wildfire dictates we go inside.”\u003c/p>\n\u003cp>“The only widely available technology I’m aware of that tackles both these things at once is filters,” she said. Considering we’re in a pandemic, Pistochini still recommends building operators draw in some air from the outside, especially if a building has at least a MERV13 filter.\u003c/p>\n\u003cp>Then, both Pistochini and Corsi agree, portable air filters will help with smoke and the virus.\u003c/p>\n\u003ch3>\u003cstrong>Turning to the Coronavirus Pandemic\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>As we return to schools and offices, what practices should we be asking our schools and employers to adopt in these shared indoor environments? \u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Wear masks\u003c/strong> — even with physical distancing, says Corsi. To make this an easier pill to swallow, Corsi says give people breaks during the day during which they can go outside, physically distance, and take off their mask: a “mask break.” That is, assuming the air outside isn’t smoke-filled.\u003c/li>\n\u003cli>\u003cstrong>Distance.\u003c/strong> “We’ve done the design of every classroom assuming that people are wearing an inner tube with a three foot radius, so that you’ll always be 6 feet away from anybody,” Corsi says, referring to the setup of spaces at Portland State University.\u003c/li>\n\u003cli>\u003cstrong>Hold certain activities outside.\u003c/strong> Choir, playing wind instruments and group aerobic activities can cause more circulation of the virus because people are exhaling and inhaling at greater rates than they would be otherwise. Corsi suggests empty, above-ground parking structures.\u003c/li>\n\u003cli>\u003cstrong>Schedule creatively.\u003c/strong> Corsi encourages people to stagger their schedules at the office to limit the number of people in an enclosed space. For schools, he says to operate at a lower capacity for each space, and leave ample time between classes to avoid congestion in hallways.\u003c/li>\n\u003cli>\u003cstrong>Follow coronavirus etiquette.\u003c/strong> For shared spaces like elevators, Corsi says he practices “the new elevator etiquette”: mask on, just a few people in the elevator at a time, face away from one another, and no one talks.\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>How about the actual air we are breathing indoors?\u003c/strong>\u003c/p>\n\u003cp>When tackling potential coronavirus transmission indoors, atmospheric chemist at the Scripps Institution of Oceanography, \u003ca href=\"https://kprather.scrippsprofiles.ucsd.edu/\" target=\"_blank\" rel=\"noopener noreferrer\">Kim Prather\u003c/a>, says, “I’m advising people to make sure that the room they’re in is well ventilated.”\u003c/p>\n\u003cp>That means opening windows and doors when possible. When that is not possible, consider what kind of HVAC system the buildings have.\u003c/p>\n\u003cp>Pistochini says we all think of an HVAC system as providing heating and cooling, but, she says, “It should do two other things: it should filter the air and it should provide ventilation.” Ventilation means bringing outdoor air inside and exhausting indoor air.\u003c/p>\n\u003cp>In terms of the coronavirus, filtration can pull particles out of the air that may contain the virus. Ventilation will dilute the concentration of particles in the indoor air.\u003c/p>\n\u003cp>Pistochini says it’s hard to visualize this with the actual virus. so she suggests imagining “your kid went and dropped a gallon full of glitter in your swimming pool.” To remove the glitter (i.e. the virus), “you could pump it through a filter. Or you could change the water. Those two things are basically what HVAC systems do for air,” she says.\u003c/p>\n\u003cp>But you need three things in place for the HVAC system to work, she says: a fan that is actually on and running, a decent filter changed regularly, and for the outdoor air intake to be open.\u003c/p>\n\u003cp>The air filters used in HVAC systems have ratings. For the coronavirus, scientists recommend a MERV 13 filter or greater.\u003c/p>\n\u003cp>Prather says one way people can tell whether there is enough ventilation in their indoor spaces is to actually measure the carbon dioxide in the air with a monitor. Prather says a well ventilated room will have a carbon dioxide level of 800 or less. A room that is not well ventilated will have higher levels of carbon dioxide, which builds as humans exhale. She says she would like to see these monitors, which cost roughly $100, installed in classrooms so teachers have an understanding of their indoor air quality.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These details are very technical, so it may take a few tries to get the answers to what HVAC system and other safety measures your office or school has. It may be best to ask the facilities department, a building manager, or human resources.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "The West Can't Firefight Its Way Out of Yearly Mega-Fires",
"headTitle": "The West Can’t Firefight Its Way Out of Yearly Mega-Fires | KQED",
"content": "\u003cp>It’s become a near-annual occurrence. A massive wildfire forces thousands of people to flee their homes. Exhausted firefighters warn of its speed and intensity. Smoke smothers cities and states hundreds of miles away.\u003c/p>\n\u003cp>\u003ca href=\"https://www.npr.org/2020/08/24/905480961/record-setting-blazes-continue-to-rip-through-northern-california\">The yearly eruption of hundreds\u003c/a> of wildfires across the West is no longer surprising. What’s surprising is “our society’s ability to continue to tolerate” lives lost and billions of dollars in damages and firefighting costs, year after year, says Tom Harbour, the former director of fire and aviation at the U.S. Forest Service.\u003c/p>\n\u003cp>Especially, he says, when we know of ways to reduce the risk.\u003c/p>\n\u003cp>The wave of fires that erupted this week on the West Coast, like previous record-breaking blazes, are further validation of something forest ecologists and fire veterans have been saying for years: that no amount of firefighting resources will avert the next big wildfire. Nine of the top 10 largest wildfires in California history have occurred in the last decade despite \u003ca href=\"https://www.sacbee.com/news/politics-government/the-state-worker/article239166108.html\">massive investments\u003c/a> in \u003ca href=\"https://www.pressdemocrat.com/article/news/california-spends-nearly-300-million-on-helicopters-that-can-drop-water-on/\">new technology\u003c/a> and equipment.\u003c/p>\n\u003cp>“We can’t ‘one more engine, one more hand crew’ our way out of this,” Harbour said. “We’ve got ourselves into a big problem, and it’s taken some time. It’s going to take some time, energy and effort to get our way out.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The nation needs to rethink its relationship with wildfire, ecologists and firefighters say. Instead of treating it as a threat to be swiftly extinguished, communities need to learn to live with fire, as people \u003ca href=\"https://www.npr.org/2020/08/24/899422710/to-manage-wildfire-california-looks-to-what-tribes-have-known-all-along\">have before\u003c/a>.\u003c/p>\n\u003cp>Increasingly, communities and homeowners are realizing that on their own. Flammable roofs are being replaced with more fire-resistant ones. Homeowners are clearing vegetation around their property to create buffers from flames. Prescribed fire is becoming \u003ca href=\"http://calag.ucanr.edu/archive/?article=ca.2018a0044\">more common\u003c/a>.\u003c/p>\n\u003cp>Fire experts warn that billions of dollars in federal, state and local investments will be needed to reduce the risk of wildfire substantially in the West. But the COVID-19 pandemic, coupled with the \u003ca href=\"https://www.nifc.gov/fireInfo/fireInfo_documents/SuppCosts.pdf\">soaring costs\u003c/a> of fire suppression, means that money is in short supply.\u003c/p>\n\u003cp>“Nationally, we’re faced with: What can we do to scale this up so that communities don’t have to struggle with it on their own?” said Jennifer Balch, fire scientist at the University of Colorado Boulder. “Because every homeowner expects firefighters to show up when there’s a fire that threatens their home, but they’re maxed out. There’s just no way they’re going to be able to fight every fire.”\u003c/p>\n\u003cp>\u003cstrong>A Wake-up Call\u003c/strong>\u003c/p>\n\u003cp>The truce between people and fire is being negotiated under challenging conditions. A century of suppression has left Western forests overgrown. Hotter temperatures stoked by climate change are drying out the vegetation and priming it to burn. And millions of people continue to move to forested areas, upping the stakes and putting more strain on already-stressed landscapes.\u003c/p>\n\u003cp>But when a fire sweeps into a community, it can be a wake-up call to reduce future risks. In 2003, the Old Fire burned more than 90,000 acres in Big Bear, a heavily forested town in the Southern California mountains.\u003c/p>\n\u003cp>“There were [300] or 400 houses that were lost,” said Jeff Willis, fire chief with the Big Bear Fire Department. “It was also during that fire that we evacuated the entire community for about a week period. So that was a big moment of recognition is what I would say.”\u003c/p>\n\u003cp>Afterward, the fire department took stock of the region’s vulnerabilities. The surrounding forests were dense and overgrown, potentially providing fuel for bigger fires. Many homes, built decades ago, had wood roofs that could ignite from embers blown far ahead of a fire.\u003c/p>\n\u003cp>The fire department passed a sweeping “\u003ca href=\"https://bigbearfire.com/community-wildfire-protection-plan-cwpp\">community wildfire protection plan\u003c/a>.” It inspected properties and enforced requirements to trim dry brush and trees around homes. It installed evacuation signs around town to guide residents in an emergency.\u003c/p>\n\u003cp>Over almost a decade, more than 1,000 wood roofs were replaced with fire-resistant materials, thanks to a grant program that offset the cost for homeowners. The fire department thinned out forests adjacent to residential areas, working alongside the U.S. Forest Service, which manages national forest land in the region.\u003c/p>\n\u003cp>“That was a heck of an effort,” Willis said. “Gradually over time, though it was initially controversial, I think we made tremendous strides.”\u003c/p>\n\u003cp>Big Bear was one of the first California communities to launch such a comprehensive effort. While it doesn’t guarantee homes and buildings will survive an extreme fire, it boosts their chances. The problem has been maintaining and expanding the safeguards.\u003c/p>\n\u003cp>Vegetation requires annual inspections and trimming. But Willis says the budget hasn’t kept up.\u003c/p>\n\u003cp>“The community risk reduction and fire prevention, all of that takes a second seat to the main mission, which is responding to emergency incidents,” he said. “What I would need, and I know I’m not alone from a fire chief’s perspective, we would need to double our budget.”\u003c/p>\n\u003cp>The Big Bear Fire Department has largely relied on state and federal grants, totaling more than $5 million since its prevention plan began. But with more communities vying for those dollars, they’re harder to get. This year, the department \u003ca href=\"https://www.bigbearfire.org/homepage/press-releases/215-curbside-chipping-program-suspended\">was turned down\u003c/a> for three out of four grants for a curbside vegetation chipping program, which helps homeowners break down the brush on their property.\u003c/p>\n\u003cp>The community also voted down a local tax measure in March that would have provided new funding. Now, the fire department is looking at cutting staff. “Unfortunately, there’s a lot more that we should do,” Willis says. “We are and were and still remain a community at risk.”\u003c/p>\n\u003cp>\u003cstrong>Reducing Risk\u003c/strong>\u003c/p>\n\u003cp>Funding has long been a problem for efforts to reduce wildfire risk.\u003c/p>\n\u003cp>In 2015, \u003ca href=\"https://www.fs.usda.gov/sites/default/files/2015-Fire-Budget-Report.pdf\">a report\u003c/a> published by the Forest Service warned: “As more and more of the agency’s resources are spent each year to provide the firefighters, aircraft, and other assets necessary to protect lives, property, and natural resources from catastrophic wildfires, fewer and fewer funds and resources are available to support other agency work — including the very programs and restoration projects that reduce the fire threat.”\u003c/p>\n\u003cp>Congress took a step to address that in 2018, passing a “\u003ca href=\"https://www.usda.gov/media/press-releases/2018/03/23/secretary-perdue-applauds-fire-funding-fix-omnibus\">fire funding fix\u003c/a>” that allows the Forest Service to tap federal emergency disaster funds when suppression costs exceeded its budget. The “fix” goes into effect this year, but fire veterans and ecologists are skeptical that it alone will address the underlying problems.\u003c/p>\n\u003cp>Nearly half of the agency’s $5.14 billion budget is still earmarked for fire suppression.\u003c/p>\n\u003cp>“There’s definitely not enough economic support,” said Crystal Kolden, a fire scientist at UC Merced. “How we have always addressed natural hazards as a nation is that we have invested in reducing risk with federal tax dollars because natural hazard reduction is a social good.”\u003c/p>\n\u003cp>Last month, Sens. Dianne Feinstein, D-Calif., and Steve Daines, R-Mont., proposed a \u003ca href=\"https://www.daines.senate.gov/imo/media/doc/FINAL%20Section%20by%20Section%20the%20Emergency%20Wildfire%20and%20Public%20Safety%20Act%20of%202020%20(002).pdf\">bipartisan bill\u003c/a> to clear roadblocks for vegetation removal projects. Critics say it would undermine existing environmental protections.\u003c/p>\n\u003cp>Earlier this year, California announced\u003ca href=\"https://www.gov.ca.gov/2020/08/13/california-u-s-forest-service-establish-shared-long-term-strategy-to-manage-forests-and-rangelands/\"> a new state-federal effort\u003c/a> to reduce wildfire risks. The goal is to treat 1 million acres of forest and wildland annually with prescribed fires and forest thinning projects.\u003c/p>\n\u003cp>Both initiatives address overgrown forests. But fire ecologists say it’s going to take a wider range of solutions to protect communities. What works in one place might not in another.\u003c/p>\n\u003cp>“What people tend to look for is a single bullet solution,” Kolden says. “And the reality is that fire is complex. All natural hazards are complex. And there is no single silver bullet solution.”\u003c/p>\n\u003cp>California lawmakers have made several unsuccessful attempts to set aside funding for some other solutions. Earlier this year, $1 billion was canceled for a house retrofit fund due to the state’s pandemic-related budget shortfall. State lawmakers tried last month to pass $3 billion for both emergency fire response and community preparedness, but the legislative session ended.\u003c/p>\n\u003cp>Without action, the drivers of extreme fire are only going to increase with time. People continue to move into forested areas. The climate continues to warm. And, even with adequate funding, community-based solutions will take decades to implement.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“As bad as it is, it’s going to get worse,” Harbour says. “And it’s going to get worse for another decade or two, even with us adopting some of these mitigations.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2020 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=Why+Firefighting+Alone+Won%27t+Stop+Western+Mega-Fires&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s become a near-annual occurrence. A massive wildfire forces thousands of people to flee their homes. Exhausted firefighters warn of its speed and intensity. Smoke smothers cities and states hundreds of miles away.\u003c/p>\n\u003cp>\u003ca href=\"https://www.npr.org/2020/08/24/905480961/record-setting-blazes-continue-to-rip-through-northern-california\">The yearly eruption of hundreds\u003c/a> of wildfires across the West is no longer surprising. What’s surprising is “our society’s ability to continue to tolerate” lives lost and billions of dollars in damages and firefighting costs, year after year, says Tom Harbour, the former director of fire and aviation at the U.S. Forest Service.\u003c/p>\n\u003cp>Especially, he says, when we know of ways to reduce the risk.\u003c/p>\n\u003cp>The wave of fires that erupted this week on the West Coast, like previous record-breaking blazes, are further validation of something forest ecologists and fire veterans have been saying for years: that no amount of firefighting resources will avert the next big wildfire. Nine of the top 10 largest wildfires in California history have occurred in the last decade despite \u003ca href=\"https://www.sacbee.com/news/politics-government/the-state-worker/article239166108.html\">massive investments\u003c/a> in \u003ca href=\"https://www.pressdemocrat.com/article/news/california-spends-nearly-300-million-on-helicopters-that-can-drop-water-on/\">new technology\u003c/a> and equipment.\u003c/p>\n\u003cp>“We can’t ‘one more engine, one more hand crew’ our way out of this,” Harbour said. “We’ve got ourselves into a big problem, and it’s taken some time. It’s going to take some time, energy and effort to get our way out.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The nation needs to rethink its relationship with wildfire, ecologists and firefighters say. Instead of treating it as a threat to be swiftly extinguished, communities need to learn to live with fire, as people \u003ca href=\"https://www.npr.org/2020/08/24/899422710/to-manage-wildfire-california-looks-to-what-tribes-have-known-all-along\">have before\u003c/a>.\u003c/p>\n\u003cp>Increasingly, communities and homeowners are realizing that on their own. Flammable roofs are being replaced with more fire-resistant ones. Homeowners are clearing vegetation around their property to create buffers from flames. Prescribed fire is becoming \u003ca href=\"http://calag.ucanr.edu/archive/?article=ca.2018a0044\">more common\u003c/a>.\u003c/p>\n\u003cp>Fire experts warn that billions of dollars in federal, state and local investments will be needed to reduce the risk of wildfire substantially in the West. But the COVID-19 pandemic, coupled with the \u003ca href=\"https://www.nifc.gov/fireInfo/fireInfo_documents/SuppCosts.pdf\">soaring costs\u003c/a> of fire suppression, means that money is in short supply.\u003c/p>\n\u003cp>“Nationally, we’re faced with: What can we do to scale this up so that communities don’t have to struggle with it on their own?” said Jennifer Balch, fire scientist at the University of Colorado Boulder. “Because every homeowner expects firefighters to show up when there’s a fire that threatens their home, but they’re maxed out. There’s just no way they’re going to be able to fight every fire.”\u003c/p>\n\u003cp>\u003cstrong>A Wake-up Call\u003c/strong>\u003c/p>\n\u003cp>The truce between people and fire is being negotiated under challenging conditions. A century of suppression has left Western forests overgrown. Hotter temperatures stoked by climate change are drying out the vegetation and priming it to burn. And millions of people continue to move to forested areas, upping the stakes and putting more strain on already-stressed landscapes.\u003c/p>\n\u003cp>But when a fire sweeps into a community, it can be a wake-up call to reduce future risks. In 2003, the Old Fire burned more than 90,000 acres in Big Bear, a heavily forested town in the Southern California mountains.\u003c/p>\n\u003cp>“There were [300] or 400 houses that were lost,” said Jeff Willis, fire chief with the Big Bear Fire Department. “It was also during that fire that we evacuated the entire community for about a week period. So that was a big moment of recognition is what I would say.”\u003c/p>\n\u003cp>Afterward, the fire department took stock of the region’s vulnerabilities. The surrounding forests were dense and overgrown, potentially providing fuel for bigger fires. Many homes, built decades ago, had wood roofs that could ignite from embers blown far ahead of a fire.\u003c/p>\n\u003cp>The fire department passed a sweeping “\u003ca href=\"https://bigbearfire.com/community-wildfire-protection-plan-cwpp\">community wildfire protection plan\u003c/a>.” It inspected properties and enforced requirements to trim dry brush and trees around homes. It installed evacuation signs around town to guide residents in an emergency.\u003c/p>\n\u003cp>Over almost a decade, more than 1,000 wood roofs were replaced with fire-resistant materials, thanks to a grant program that offset the cost for homeowners. The fire department thinned out forests adjacent to residential areas, working alongside the U.S. Forest Service, which manages national forest land in the region.\u003c/p>\n\u003cp>“That was a heck of an effort,” Willis said. “Gradually over time, though it was initially controversial, I think we made tremendous strides.”\u003c/p>\n\u003cp>Big Bear was one of the first California communities to launch such a comprehensive effort. While it doesn’t guarantee homes and buildings will survive an extreme fire, it boosts their chances. The problem has been maintaining and expanding the safeguards.\u003c/p>\n\u003cp>Vegetation requires annual inspections and trimming. But Willis says the budget hasn’t kept up.\u003c/p>\n\u003cp>“The community risk reduction and fire prevention, all of that takes a second seat to the main mission, which is responding to emergency incidents,” he said. “What I would need, and I know I’m not alone from a fire chief’s perspective, we would need to double our budget.”\u003c/p>\n\u003cp>The Big Bear Fire Department has largely relied on state and federal grants, totaling more than $5 million since its prevention plan began. But with more communities vying for those dollars, they’re harder to get. This year, the department \u003ca href=\"https://www.bigbearfire.org/homepage/press-releases/215-curbside-chipping-program-suspended\">was turned down\u003c/a> for three out of four grants for a curbside vegetation chipping program, which helps homeowners break down the brush on their property.\u003c/p>\n\u003cp>The community also voted down a local tax measure in March that would have provided new funding. Now, the fire department is looking at cutting staff. “Unfortunately, there’s a lot more that we should do,” Willis says. “We are and were and still remain a community at risk.”\u003c/p>\n\u003cp>\u003cstrong>Reducing Risk\u003c/strong>\u003c/p>\n\u003cp>Funding has long been a problem for efforts to reduce wildfire risk.\u003c/p>\n\u003cp>In 2015, \u003ca href=\"https://www.fs.usda.gov/sites/default/files/2015-Fire-Budget-Report.pdf\">a report\u003c/a> published by the Forest Service warned: “As more and more of the agency’s resources are spent each year to provide the firefighters, aircraft, and other assets necessary to protect lives, property, and natural resources from catastrophic wildfires, fewer and fewer funds and resources are available to support other agency work — including the very programs and restoration projects that reduce the fire threat.”\u003c/p>\n\u003cp>Congress took a step to address that in 2018, passing a “\u003ca href=\"https://www.usda.gov/media/press-releases/2018/03/23/secretary-perdue-applauds-fire-funding-fix-omnibus\">fire funding fix\u003c/a>” that allows the Forest Service to tap federal emergency disaster funds when suppression costs exceeded its budget. The “fix” goes into effect this year, but fire veterans and ecologists are skeptical that it alone will address the underlying problems.\u003c/p>\n\u003cp>Nearly half of the agency’s $5.14 billion budget is still earmarked for fire suppression.\u003c/p>\n\u003cp>“There’s definitely not enough economic support,” said Crystal Kolden, a fire scientist at UC Merced. “How we have always addressed natural hazards as a nation is that we have invested in reducing risk with federal tax dollars because natural hazard reduction is a social good.”\u003c/p>\n\u003cp>Last month, Sens. Dianne Feinstein, D-Calif., and Steve Daines, R-Mont., proposed a \u003ca href=\"https://www.daines.senate.gov/imo/media/doc/FINAL%20Section%20by%20Section%20the%20Emergency%20Wildfire%20and%20Public%20Safety%20Act%20of%202020%20(002).pdf\">bipartisan bill\u003c/a> to clear roadblocks for vegetation removal projects. Critics say it would undermine existing environmental protections.\u003c/p>\n\u003cp>Earlier this year, California announced\u003ca href=\"https://www.gov.ca.gov/2020/08/13/california-u-s-forest-service-establish-shared-long-term-strategy-to-manage-forests-and-rangelands/\"> a new state-federal effort\u003c/a> to reduce wildfire risks. The goal is to treat 1 million acres of forest and wildland annually with prescribed fires and forest thinning projects.\u003c/p>\n\u003cp>Both initiatives address overgrown forests. But fire ecologists say it’s going to take a wider range of solutions to protect communities. What works in one place might not in another.\u003c/p>\n\u003cp>“What people tend to look for is a single bullet solution,” Kolden says. “And the reality is that fire is complex. All natural hazards are complex. And there is no single silver bullet solution.”\u003c/p>\n\u003cp>California lawmakers have made several unsuccessful attempts to set aside funding for some other solutions. Earlier this year, $1 billion was canceled for a house retrofit fund due to the state’s pandemic-related budget shortfall. State lawmakers tried last month to pass $3 billion for both emergency fire response and community preparedness, but the legislative session ended.\u003c/p>\n\u003cp>Without action, the drivers of extreme fire are only going to increase with time. People continue to move into forested areas. The climate continues to warm. And, even with adequate funding, community-based solutions will take decades to implement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“As bad as it is, it’s going to get worse,” Harbour says. “And it’s going to get worse for another decade or two, even with us adopting some of these mitigations.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2020 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=Why+Firefighting+Alone+Won%27t+Stop+Western+Mega-Fires&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"slug": "we-all-want-the-covid-vaccine-to-fix-everything-but",
"title": "Yes, We All Want a COVID Vaccine to Fix Everything. But That's Unlikely",
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"content": "\u003cp class=\"p2\">With a mounting death toll, declining mental health, mandatory Zoom classrooms, fried parents and mass unemployment, the nation’s hopes have crystallized around the one thing that will make it all go away.\u003c/p>\n\u003cp class=\"p2\">A vaccine.\u003c/p>\n\u003cp class=\"p2\">Perhaps you’re imagining schools once again teeming with kids, stores full of shoppers, people ripping off their masks …\u003c/p>\n\u003cp class=\"p2\">But that’s likely more of a Hollywood ending than what actually lies ahead.\u003c/p>\n\u003cp class=\"p2\">Experts cite potential hurdles in manufacturing and distribution, \u003cspan class=\"s1\">public distrust\u003c/span>, and the sheer scale required of any successful inoculation program as reasons the vaccine will not be a panacea for the current crisis.\u003c/p>\n\u003cp class=\"p3\">“I don’t think we’re going to get a magic bullet,” said Dr. Arthur L. Caplan, professor of bioethics at the NYU Grossman School of Medicine.\u003c/p>\n\u003cp class=\"p2\">While President Donald Trump \u003ca href=\"https://www.reuters.com/article/us-health-coronavirus-trump-vaccine/trump-says-coronavirus-vaccine-possible-before-nov-3-idUSKCN25221Q\">\u003cspan class=\"s1\">said\u003c/span>\u003c/a> last month a vaccine could be available before the election in November, more conservative estimates peg a possible early launch at the beginning of next year. If a drug company manages to successfully manufacture an effective immunization by then, it would be the fastest vaccine rollout in history. The speediest development to date occurred for the mumps vaccine — about four years.\u003c/p>\n\u003cp class=\"p2\">Shortening that timeline is theoretically possible only because the entire scientific establishment, including more than 100 pharmaceutical and biotech companies, are on a quest to prevent the same disease. Yet, even a proven vaccine may only be the beginning of getting back to something approaching normal.\u003c/p>\n\u003cp class=\"p2\">“Even FDA approval is not the green light to say, ‘We’ve got a vaccine and everything’s over,'” said Caplan. “It would be very, very surprising if we got a very highly effective vaccine, first one out of the box for this particular virus.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p3\">\u003cb>Not All Vaccines Are Alike\u003c/b>\u003c/p>\n\u003cp class=\"p3\">Even for those first in line for a shot, protection from the virus won’t be immediate — it takes weeks for the immune system to marshal its biological forces in the form of disease-fighting antibodies. And a vaccine that creates immunity for some people may not protect others. When a vaccine is approved for the general public, it will be the first time it’s administered on higher-risk groups, which are not typically enrolled in safety trials due to the difficulty of determining the cause of adverse reactions in those populations.\u003c/p>\n\u003cp class=\"p3\">“People tend to look for what’s called a clean baseline in a study sample,” Caplan said.\u003c/p>\n\u003cp class=\"p3\">(After a vaccine is released, the Food and Drug Administration closely monitors any negative effects to determine if higher-risk groups are responding poorly.)\u003c/p>\n\u003cp class=\"p3\">In addition, evidence exists that vaccines do not work in some sub-populations. For example, people over 60 do not build much of an immune response to the flu shot. The immune system of people with cancer often prevents a vaccine from working, and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547886/\">\u003cspan class=\"s1\">limited data\u003c/span>\u003c/a> suggests obesity reduces the effectiveness of immunizations.\u003cspan class=\"s2\"> These groups are also the most susceptible to the worst consequences of contracting the coronavirus.\u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s2\">T\u003c/span>he efficacy of vaccines has a wide range. The annual \u003ca href=\"https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm\">\u003cspan class=\"s1\">flu shot\u003c/span>\u003c/a> is at one end of the spectrum, working 40% to 60% of the time. At the other end, the measles \u003ca href=\"https://www.cdc.gov/vaccines/vpd/measles/index.html#:~:text=Two%20doses%20of%20MMR%20vaccine%20are%20about%2097%25%20effective%20at,through%2012%20years%20of%20age.\">\u003cspan class=\"s1\">vaccine\u003c/span>\u003c/a> is about 93% effective with a single shot and 97% with two doses. The National Institutes of Health is aiming for 50% effectiveness for a COVID-19 immunization, though scientists do not know how long that immunity will last.\u003c/p>\n\u003cp class=\"p3\">Vaccinologists say there’s a good chance a coronavirus shot will not give you lifetime immunity.\u003c/p>\n\u003cp class=\"p3\">\u003cb>Logistical Obstacles\u003c/b>\u003c/p>\n\u003cp class=\"p3\">Even once a vaccine exists, a drug company will need to manufacture billions of doses to treat populations around the world. That’s if it’s just one shot. Many vaccines require more than one, spaced at least a month apart to be effective.\u003c/p>\n\u003cp class=\"p3\">“In the history of vaccines, anything like cholera, cervical cancer, anything that’s been a two‐shot vaccine has turned out to be a pain in the neck,” said Caplan. “People don’t comply.”\u003c/p>\n\u003cp class=\"p3\">It’s difficult to make billions of anything safe and reliable. Plants go offline. Parts malfunction. Shortages will likely crop up.\u003c/p>\n\u003cp class=\"p5\">Making sure there is adequate access to syringes, vials, stoppers, gloves and even alcohol swabs is “going to be a challenge,” said Dr. Georges C. Benjamin, executive director of the American Public Health Association.\u003c/p>\n\u003cp class=\"p3\">More bottlenecks can unfold in distribution. Shipping, trucking or flying vaccines around the globe often requires deep refrigeration, at temperatures 112 degrees below zero. Successful transport will require technical expertise and thorough planning, both of which will be a challenge in poorer nations.\u003c/p>\n\u003cp class=\"p3\">The troubled \u003ca href=\"https://www.kqed.org/news/11806695/coronavirus-report-why-did-it-take-so-long-to-get-rapid-test-kits\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">rollout\u003c/span>\u003c/a> of coronavirus tests at the beginning of the pandemic shows just how difficult carrying out a mass vaccination program could be.\u003c/p>\n\u003cp>“Remember that we are going to be vaccinating everyone in the world, so that means, just like testing, there’s going to be supply chain issues that we’ve got to work through early in the process,” Benjamin said.\u003c/p>\n\u003cp class=\"p3\">\u003cb>Vaccine Hesitancy\u003c/b>\u003c/p>\n\u003cp class=\"p3\">Once a truck delivers the vaccine to doctors’ offices, there’s still no guarantee people will get it. A recent NBC News \u003ca href=\"https://www.nbcnews.com/politics/2020-election/poll-less-half-americans-say-they-ll-get-coronavirus-vaccine-n1236971\">\u003cspan class=\"s1\">poll\u003c/span>\u003c/a> found less than half of people in the U.S. would get a government-approved vaccine, with 22% saying they wouldn’t and 32% unsure. In 2019, the World Health Organization called vaccine hesitancy a \u003ca href=\"https://www.who.int/vietnam/news/feature-stories/detail/ten-threats-to-global-health-in-2019\" target=\"_blank\" rel=\"noopener noreferrer\">threat\u003c/a> to global health, and the \u003cspan class=\"s1\">antivaccine movement\u003c/span> has been \u003ca href=\"https://www.nature.com/articles/d41586-020-01423-4\" target=\"_blank\" rel=\"noopener noreferrer\">spreading disinformation\u003c/a> since the beginning of the outbreak.\u003c/p>\n\u003cp class=\"p3\">Some people believe doctors push immunizations because they receive extra government subsidies.\u003c/p>\n\u003cp class=\"p3\">“Most [people] do not seem to understand that vaccines in most practices is at best a break-even proposition,” said Dr. Margot Savoy, professor of family and community medicine at Temple University. “For some practices it is actually a money-losing proposition. People are doing it because of the health of the public, not because they’re making a lot of money on it.”\u003c/p>\n\u003cp class=\"p3\">Savoy says many of her low-income patients worry the vaccine will be pushed on poor\u003ci> \u003c/i>people to test it out.\u003c/p>\n\u003cp class=\"p3\">“Your ongoing experiences with systemic racism that continues to exist in the medical system means that you’re not necessarily going to trust the new vaccine that just came out,” Savoy said.\u003c/p>\n\u003cp class=\"p3\">If some communities are hesitant or if supplies run short, then case counts will rise even after scientists and officials celebrate success — which could give the false impression it doesn’t work.\u003c/p>\n\u003cp class=\"p3\">Early branding of the federal vaccine initiative may not have helped matters. The government called the effort \u003ca href=\"https://www.hhs.gov/about/news/2020/06/16/fact-sheet-explaining-operation-warp-speed.html#:~:text=Operation%20Warp%20Speed%20(OWS)%20aims,(collectively%20known%20as%20countermeasures).\">\u003cspan class=\"s1\">Operation Warp Speed\u003c/span>\u003c/a>.\u003c/p>\n\u003cp class=\"p3\">“I think it has given people an impression that corners will be cut,” said Dr. Walter A. Orenstein, professor of medicine at Emory University. “It has raised concerns that these vaccines are going to get by with a far lower standard than other vaccines.”\u003c/p>\n\u003cp class=\"p3\">The problem is the terminology, he says, not fewer formal safety protocols.\u003c/p>\n\u003cp class=\"p3\">\u003cb>In It Together\u003c/b>\u003c/p>\n\u003cp class=\"p3\">Even a slight reduction in vaccination rates can impede a successful immunization program. Vaccines only work if nearly everyone is on board. A measles outbreak in northeastern New York last year is a case in point: The virus took hold in a highly unvaccinated community of Orthodox Jews, leading to the longest documented \u003ca href=\"https://www.cdc.gov/mmwr/volumes/68/wr/mm6819a4.htm\">\u003cspan class=\"s1\">outbreak\u003c/span>\u003c/a> in the U.S. since 2000.\u003c/p>\n\u003cp class=\"p3\">Doctors estimate about 60% to 70% of the human population will have to become inoculated to stop the coronavirus, which will require sophisticated planning, governmental cohesion, and extensive public health education. When exactly all that will come together is unclear.\u003c/p>\n\u003cp class=\"p2\">“I’d like to firmly come down on, ‘Beats me,’” said Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “I am no longer making guesses about this virus.”\u003c/p>\n\u003cp class=\"p3\">While a lot can go wrong, he hopes a lot will go right, because a vaccine is our best option to develop community immunity.\u003c/p>\n\u003cp class=\"p3\">“If you look at smallpox, polio, measles, you can see the dramatic impact we’ve had in terms of reduction of disease,” said Dr. Julie Morita, executive vice president at the Robert Wood Johnson Foundation. “We have had major successes with vaccines, and that’s why there is so much great hope for this COVID vaccine.”\u003c/p>\n\u003cp class=\"p3\">In the meantime, the pandemic drudgery of masking up, social distancing and quarantining will have to continue if we are to prevent the deadly coronavirus from spiraling out of control … again.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Since the beginning of the pandemic, hopes have hinged on the development of a vaccine. But the reality is the complexities of vaccine manufacturing, distribution and human response and behavior make it unlikely it will be a magic bullet.",
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"title": "Yes, We All Want a COVID Vaccine to Fix Everything. But That's Unlikely | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p2\">With a mounting death toll, declining mental health, mandatory Zoom classrooms, fried parents and mass unemployment, the nation’s hopes have crystallized around the one thing that will make it all go away.\u003c/p>\n\u003cp class=\"p2\">A vaccine.\u003c/p>\n\u003cp class=\"p2\">Perhaps you’re imagining schools once again teeming with kids, stores full of shoppers, people ripping off their masks …\u003c/p>\n\u003cp class=\"p2\">But that’s likely more of a Hollywood ending than what actually lies ahead.\u003c/p>\n\u003cp class=\"p2\">Experts cite potential hurdles in manufacturing and distribution, \u003cspan class=\"s1\">public distrust\u003c/span>, and the sheer scale required of any successful inoculation program as reasons the vaccine will not be a panacea for the current crisis.\u003c/p>\n\u003cp class=\"p3\">“I don’t think we’re going to get a magic bullet,” said Dr. Arthur L. Caplan, professor of bioethics at the NYU Grossman School of Medicine.\u003c/p>\n\u003cp class=\"p2\">While President Donald Trump \u003ca href=\"https://www.reuters.com/article/us-health-coronavirus-trump-vaccine/trump-says-coronavirus-vaccine-possible-before-nov-3-idUSKCN25221Q\">\u003cspan class=\"s1\">said\u003c/span>\u003c/a> last month a vaccine could be available before the election in November, more conservative estimates peg a possible early launch at the beginning of next year. If a drug company manages to successfully manufacture an effective immunization by then, it would be the fastest vaccine rollout in history. The speediest development to date occurred for the mumps vaccine — about four years.\u003c/p>\n\u003cp class=\"p2\">Shortening that timeline is theoretically possible only because the entire scientific establishment, including more than 100 pharmaceutical and biotech companies, are on a quest to prevent the same disease. Yet, even a proven vaccine may only be the beginning of getting back to something approaching normal.\u003c/p>\n\u003cp class=\"p2\">“Even FDA approval is not the green light to say, ‘We’ve got a vaccine and everything’s over,'” said Caplan. “It would be very, very surprising if we got a very highly effective vaccine, first one out of the box for this particular virus.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p3\">\u003cb>Not All Vaccines Are Alike\u003c/b>\u003c/p>\n\u003cp class=\"p3\">Even for those first in line for a shot, protection from the virus won’t be immediate — it takes weeks for the immune system to marshal its biological forces in the form of disease-fighting antibodies. And a vaccine that creates immunity for some people may not protect others. When a vaccine is approved for the general public, it will be the first time it’s administered on higher-risk groups, which are not typically enrolled in safety trials due to the difficulty of determining the cause of adverse reactions in those populations.\u003c/p>\n\u003cp class=\"p3\">“People tend to look for what’s called a clean baseline in a study sample,” Caplan said.\u003c/p>\n\u003cp class=\"p3\">(After a vaccine is released, the Food and Drug Administration closely monitors any negative effects to determine if higher-risk groups are responding poorly.)\u003c/p>\n\u003cp class=\"p3\">In addition, evidence exists that vaccines do not work in some sub-populations. For example, people over 60 do not build much of an immune response to the flu shot. The immune system of people with cancer often prevents a vaccine from working, and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547886/\">\u003cspan class=\"s1\">limited data\u003c/span>\u003c/a> suggests obesity reduces the effectiveness of immunizations.\u003cspan class=\"s2\"> These groups are also the most susceptible to the worst consequences of contracting the coronavirus.\u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s2\">T\u003c/span>he efficacy of vaccines has a wide range. The annual \u003ca href=\"https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm\">\u003cspan class=\"s1\">flu shot\u003c/span>\u003c/a> is at one end of the spectrum, working 40% to 60% of the time. At the other end, the measles \u003ca href=\"https://www.cdc.gov/vaccines/vpd/measles/index.html#:~:text=Two%20doses%20of%20MMR%20vaccine%20are%20about%2097%25%20effective%20at,through%2012%20years%20of%20age.\">\u003cspan class=\"s1\">vaccine\u003c/span>\u003c/a> is about 93% effective with a single shot and 97% with two doses. The National Institutes of Health is aiming for 50% effectiveness for a COVID-19 immunization, though scientists do not know how long that immunity will last.\u003c/p>\n\u003cp class=\"p3\">Vaccinologists say there’s a good chance a coronavirus shot will not give you lifetime immunity.\u003c/p>\n\u003cp class=\"p3\">\u003cb>Logistical Obstacles\u003c/b>\u003c/p>\n\u003cp class=\"p3\">Even once a vaccine exists, a drug company will need to manufacture billions of doses to treat populations around the world. That’s if it’s just one shot. Many vaccines require more than one, spaced at least a month apart to be effective.\u003c/p>\n\u003cp class=\"p3\">“In the history of vaccines, anything like cholera, cervical cancer, anything that’s been a two‐shot vaccine has turned out to be a pain in the neck,” said Caplan. “People don’t comply.”\u003c/p>\n\u003cp class=\"p3\">It’s difficult to make billions of anything safe and reliable. Plants go offline. Parts malfunction. Shortages will likely crop up.\u003c/p>\n\u003cp class=\"p5\">Making sure there is adequate access to syringes, vials, stoppers, gloves and even alcohol swabs is “going to be a challenge,” said Dr. Georges C. Benjamin, executive director of the American Public Health Association.\u003c/p>\n\u003cp class=\"p3\">More bottlenecks can unfold in distribution. Shipping, trucking or flying vaccines around the globe often requires deep refrigeration, at temperatures 112 degrees below zero. Successful transport will require technical expertise and thorough planning, both of which will be a challenge in poorer nations.\u003c/p>\n\u003cp class=\"p3\">The troubled \u003ca href=\"https://www.kqed.org/news/11806695/coronavirus-report-why-did-it-take-so-long-to-get-rapid-test-kits\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">rollout\u003c/span>\u003c/a> of coronavirus tests at the beginning of the pandemic shows just how difficult carrying out a mass vaccination program could be.\u003c/p>\n\u003cp>“Remember that we are going to be vaccinating everyone in the world, so that means, just like testing, there’s going to be supply chain issues that we’ve got to work through early in the process,” Benjamin said.\u003c/p>\n\u003cp class=\"p3\">\u003cb>Vaccine Hesitancy\u003c/b>\u003c/p>\n\u003cp class=\"p3\">Once a truck delivers the vaccine to doctors’ offices, there’s still no guarantee people will get it. A recent NBC News \u003ca href=\"https://www.nbcnews.com/politics/2020-election/poll-less-half-americans-say-they-ll-get-coronavirus-vaccine-n1236971\">\u003cspan class=\"s1\">poll\u003c/span>\u003c/a> found less than half of people in the U.S. would get a government-approved vaccine, with 22% saying they wouldn’t and 32% unsure. In 2019, the World Health Organization called vaccine hesitancy a \u003ca href=\"https://www.who.int/vietnam/news/feature-stories/detail/ten-threats-to-global-health-in-2019\" target=\"_blank\" rel=\"noopener noreferrer\">threat\u003c/a> to global health, and the \u003cspan class=\"s1\">antivaccine movement\u003c/span> has been \u003ca href=\"https://www.nature.com/articles/d41586-020-01423-4\" target=\"_blank\" rel=\"noopener noreferrer\">spreading disinformation\u003c/a> since the beginning of the outbreak.\u003c/p>\n\u003cp class=\"p3\">Some people believe doctors push immunizations because they receive extra government subsidies.\u003c/p>\n\u003cp class=\"p3\">“Most [people] do not seem to understand that vaccines in most practices is at best a break-even proposition,” said Dr. Margot Savoy, professor of family and community medicine at Temple University. “For some practices it is actually a money-losing proposition. People are doing it because of the health of the public, not because they’re making a lot of money on it.”\u003c/p>\n\u003cp class=\"p3\">Savoy says many of her low-income patients worry the vaccine will be pushed on poor\u003ci> \u003c/i>people to test it out.\u003c/p>\n\u003cp class=\"p3\">“Your ongoing experiences with systemic racism that continues to exist in the medical system means that you’re not necessarily going to trust the new vaccine that just came out,” Savoy said.\u003c/p>\n\u003cp class=\"p3\">If some communities are hesitant or if supplies run short, then case counts will rise even after scientists and officials celebrate success — which could give the false impression it doesn’t work.\u003c/p>\n\u003cp class=\"p3\">Early branding of the federal vaccine initiative may not have helped matters. The government called the effort \u003ca href=\"https://www.hhs.gov/about/news/2020/06/16/fact-sheet-explaining-operation-warp-speed.html#:~:text=Operation%20Warp%20Speed%20(OWS)%20aims,(collectively%20known%20as%20countermeasures).\">\u003cspan class=\"s1\">Operation Warp Speed\u003c/span>\u003c/a>.\u003c/p>\n\u003cp class=\"p3\">“I think it has given people an impression that corners will be cut,” said Dr. Walter A. Orenstein, professor of medicine at Emory University. “It has raised concerns that these vaccines are going to get by with a far lower standard than other vaccines.”\u003c/p>\n\u003cp class=\"p3\">The problem is the terminology, he says, not fewer formal safety protocols.\u003c/p>\n\u003cp class=\"p3\">\u003cb>In It Together\u003c/b>\u003c/p>\n\u003cp class=\"p3\">Even a slight reduction in vaccination rates can impede a successful immunization program. Vaccines only work if nearly everyone is on board. A measles outbreak in northeastern New York last year is a case in point: The virus took hold in a highly unvaccinated community of Orthodox Jews, leading to the longest documented \u003ca href=\"https://www.cdc.gov/mmwr/volumes/68/wr/mm6819a4.htm\">\u003cspan class=\"s1\">outbreak\u003c/span>\u003c/a> in the U.S. since 2000.\u003c/p>\n\u003cp class=\"p3\">Doctors estimate about 60% to 70% of the human population will have to become inoculated to stop the coronavirus, which will require sophisticated planning, governmental cohesion, and extensive public health education. When exactly all that will come together is unclear.\u003c/p>\n\u003cp class=\"p2\">“I’d like to firmly come down on, ‘Beats me,’” said Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “I am no longer making guesses about this virus.”\u003c/p>\n\u003cp class=\"p3\">While a lot can go wrong, he hopes a lot will go right, because a vaccine is our best option to develop community immunity.\u003c/p>\n\u003cp class=\"p3\">“If you look at smallpox, polio, measles, you can see the dramatic impact we’ve had in terms of reduction of disease,” said Dr. Julie Morita, executive vice president at the Robert Wood Johnson Foundation. “We have had major successes with vaccines, and that’s why there is so much great hope for this COVID vaccine.”\u003c/p>\n\u003cp class=\"p3\">In the meantime, the pandemic drudgery of masking up, social distancing and quarantining will have to continue if we are to prevent the deadly coronavirus from spiraling out of control … again.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Three new studies strongly support using inexpensive and widely available drugs to treat people who are seriously ill with COVID-19. The drugs are steroids, and the research published Wednesday confirms they are proving to be the most effective treatment found to date.\u003c/p>\n\u003cp>Initially, the use of these drugs in COVID-19 was controversial. Some doctors have long used steroids to treat conditions related to COVID-19, namely \u003ca href=\"https://www.nigms.nih.gov/education/fact-sheets/Pages/sepsis.aspx\">sepsis\u003c/a> and \u003ca href=\"https://www.lung.org/lung-health-diseases/lung-disease-lookup/ards\">acute respiratory distress syndrome\u003c/a>.\u003c/p>\n\u003cp>Steroids help tamp down the immune system’s potentially deadly overreaction to an infection. But some doctors worried that steroids could also prevent the body from fighting off the coronavirus effectively.\u003c/p>\n\u003cp>“Giving steroids to COVID-19 could have been quite scary,” \u003ca href=\"https://mirm-pitt.net/our-people/faculty-staff-bios/derek-c-angus-md-mph-frcp-fccm-fccp/\">says Dr. Derek Angus\u003c/a>, a critical care specialist at the University of Pittsburgh Medical Center.\u003c/p>\n\u003cp>In June, \u003ca href=\"https://www.npr.org/sections/coronavirus-live-updates/2020/06/16/878069587/early-results-show-benefit-of-steroid-for-very-sick-covid-19-patients\">a major study from the U.K\u003c/a>. found that the steroid dexamethasone was a big help. It reduced deaths significantly among the most serious cases of COVID-19 — notably people who needed ventilators or supplemental oxygen.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That advance was great news, but those findings created a conundrum for Angus and other researchers who were running their own studies of steroids in COVID-19 patients. It no longer felt appropriate to be giving some people steroids and others a placebo.\u003c/p>\n\u003cp>“Essentially overnight, because these findings were so striking, there was this sense among clinicians participating in other clinical trials [that] … we have to stop our trials.”\u003c/p>\n\u003cp>So those studies all ended prematurely. Researchers from three research groups have now published the findings they had gathered in the journal \u003cem>JAMA\u003c/em>. One group is \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2770276\">from France\u003c/a>, one is \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2770277\">from Brazil\u003c/a>, and the third is \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2770278\">an international team\u003c/a> that includes the University of Pittsburgh’s Angus.\u003c/p>\n\u003cp>Taken together, the publication of these studies “represents an important step forward in the treatment of patients with COVID-19,” Drs. Hallie Prescott and Todd Rice \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2770275\">wrote in a \u003cem>JAMA\u003c/em> editorial\u003c/a>. The results not only provide further support for the use of dexamethasone, they also back the use of another widely used steroid, hydrocortisone.\u003c/p>\n\u003cp>“I think it’s good news to have a strong, clear signal on what is a widely available, inexpensive class of therapies,” Angus said. He also contrasts these studies with a lot of other research on COVID-19. Many other studies, such as those involving much-hyped anti-malaria drugs, did not randomize their participants or include a comparison group. Such measures — \u003ca href=\"https://himmelfarb.gwu.edu/tutorials/studydesign101/rcts.cfm\">randomized controlled trials\u003c/a> — are the gold standard for medical research.\u003c/p>\n\u003cp>“It is reassuring that we can get randomized trials executed successfully and rapidly in the face of a pandemic,” Angus said, “and it definitely puts us on a surer footing.”\u003c/p>\n\u003cp>Based on these new results and related analysis, the World Health Organization on Wednesday \u003ca href=\"https://www.who.int/publications/i/item/WHO-2019-nCoV-Corticosteroids-2020.1\">updated its guidelines\u003c/a> for steroids. It now recommends them for severely or critically ill COVID-19 patients, such as those on a ventilator, but not for patients with milder disease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>You can contact NPR science correspondent Richard Harris at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\">\u003cem>rharris@npr.org.\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2020 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=Inexpensive+Steroids+Can+Save+Lives+Of+Seriously+Ill+COVID-19+Patients&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Multiple studies now confirm earlier research: Dexamethasone and hydrocortisone, drugs that reduce an immune system's overreaction, can help reduce deaths of hospitalized COVID-19 patients.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Three new studies strongly support using inexpensive and widely available drugs to treat people who are seriously ill with COVID-19. The drugs are steroids, and the research published Wednesday confirms they are proving to be the most effective treatment found to date.\u003c/p>\n\u003cp>Initially, the use of these drugs in COVID-19 was controversial. Some doctors have long used steroids to treat conditions related to COVID-19, namely \u003ca href=\"https://www.nigms.nih.gov/education/fact-sheets/Pages/sepsis.aspx\">sepsis\u003c/a> and \u003ca href=\"https://www.lung.org/lung-health-diseases/lung-disease-lookup/ards\">acute respiratory distress syndrome\u003c/a>.\u003c/p>\n\u003cp>Steroids help tamp down the immune system’s potentially deadly overreaction to an infection. But some doctors worried that steroids could also prevent the body from fighting off the coronavirus effectively.\u003c/p>\n\u003cp>“Giving steroids to COVID-19 could have been quite scary,” \u003ca href=\"https://mirm-pitt.net/our-people/faculty-staff-bios/derek-c-angus-md-mph-frcp-fccm-fccp/\">says Dr. Derek Angus\u003c/a>, a critical care specialist at the University of Pittsburgh Medical Center.\u003c/p>\n\u003cp>In June, \u003ca href=\"https://www.npr.org/sections/coronavirus-live-updates/2020/06/16/878069587/early-results-show-benefit-of-steroid-for-very-sick-covid-19-patients\">a major study from the U.K\u003c/a>. found that the steroid dexamethasone was a big help. It reduced deaths significantly among the most serious cases of COVID-19 — notably people who needed ventilators or supplemental oxygen.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That advance was great news, but those findings created a conundrum for Angus and other researchers who were running their own studies of steroids in COVID-19 patients. It no longer felt appropriate to be giving some people steroids and others a placebo.\u003c/p>\n\u003cp>“Essentially overnight, because these findings were so striking, there was this sense among clinicians participating in other clinical trials [that] … we have to stop our trials.”\u003c/p>\n\u003cp>So those studies all ended prematurely. Researchers from three research groups have now published the findings they had gathered in the journal \u003cem>JAMA\u003c/em>. One group is \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2770276\">from France\u003c/a>, one is \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2770277\">from Brazil\u003c/a>, and the third is \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2770278\">an international team\u003c/a> that includes the University of Pittsburgh’s Angus.\u003c/p>\n\u003cp>Taken together, the publication of these studies “represents an important step forward in the treatment of patients with COVID-19,” Drs. Hallie Prescott and Todd Rice \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2770275\">wrote in a \u003cem>JAMA\u003c/em> editorial\u003c/a>. The results not only provide further support for the use of dexamethasone, they also back the use of another widely used steroid, hydrocortisone.\u003c/p>\n\u003cp>“I think it’s good news to have a strong, clear signal on what is a widely available, inexpensive class of therapies,” Angus said. He also contrasts these studies with a lot of other research on COVID-19. Many other studies, such as those involving much-hyped anti-malaria drugs, did not randomize their participants or include a comparison group. Such measures — \u003ca href=\"https://himmelfarb.gwu.edu/tutorials/studydesign101/rcts.cfm\">randomized controlled trials\u003c/a> — are the gold standard for medical research.\u003c/p>\n\u003cp>“It is reassuring that we can get randomized trials executed successfully and rapidly in the face of a pandemic,” Angus said, “and it definitely puts us on a surer footing.”\u003c/p>\n\u003cp>Based on these new results and related analysis, the World Health Organization on Wednesday \u003ca href=\"https://www.who.int/publications/i/item/WHO-2019-nCoV-Corticosteroids-2020.1\">updated its guidelines\u003c/a> for steroids. It now recommends them for severely or critically ill COVID-19 patients, such as those on a ventilator, but not for patients with milder disease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>You can contact NPR science correspondent Richard Harris at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\">\u003cem>rharris@npr.org.\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2020 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=Inexpensive+Steroids+Can+Save+Lives+Of+Seriously+Ill+COVID-19+Patients&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"title": "Scientists Look to Convalescent Plasma, Antibody Cloning as Possible COVID Cures",
"headTitle": "Scientists Look to Convalescent Plasma, Antibody Cloning as Possible COVID Cures | KQED",
"content": "\u003cp class=\"p1\">Since early in the pandemic, scientists have said antibodies that the immune system makes to fight the coronavirus could be crucial in finding a cure for COVID-19.\u003c/p>\n\u003cfigure id=\"attachment_1969056\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-1969056\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-1020x1360.jpg\" alt=\"\" width=\"640\" height=\"853\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-1020x1360.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-768x1024.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-1152x1536.jpg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-1536x2048.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UCSF expects results from a placebo-controlled trial using COVID-19 convalescent plasma by the end of 2020. \u003ccite>(Dr. Ashok Nambiar/UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">The FDA recently authorized one of these treatments — \u003ca href=\"https://www.kqed.org/science/1968824/qa-is-convalescent-plasma-therapy-safe-and-effective-as-a-covid-19-treatment\">\u003cspan class=\"s1\">convalescent plasma,\u003c/span>\u003c/a> in which the antibody-rich portion of blood donated by recovered COVID-19 patients is given to people hospitalized with the disease. But the \u003ca href=\"https://www.politico.com/news/2020/08/23/plasma-treatment-coronavirus-fda-trump-400390\">\u003cspan class=\"s1\">approval\u003c/span>\u003c/a>, which came soon after President Donald Trump \u003ca href=\"https://www.politico.com/news/2020/08/19/trump-coronavirus-plasma-therapy-398801\">\u003cspan class=\"s1\">accused\u003c/span>\u003c/a> the agency of moving too slowly on the treatment for political reasons, has prompted pushback from some in the scientific community, who say more research is needed to determine if and how plasma can be effective against COVID-19. Meanwhile, research on another therapy, involving antibodies cloned in the lab, is just getting underway in human subjects.\u003c/p>\n\u003cp class=\"p1\">\u003cb>‘Liquid Gold’\u003c/b>\u003c/p>\n\u003cp class=\"p1\">Plasma, sometimes called “liquid gold” by doctors for its yellow hue and potential therapeutic value, is made by spinning blood to separate antibodies and other proteins from red blood cells.\u003c/p>\n\u003cp class=\"p1\">The use of convalescent plasma in medicine dates back \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781783/\">\u003cspan class=\"s1\">more than a hundred years\u003c/span>\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">“We’ve used it in infectious diseases from polio to influenza, ebola, etc.,” said UCSF professor of medicine Dr. Peter Chin-Hong.\u003c/p>\n\u003cp class=\"p1\">Chin-Hong, whose team is running a COVID-19 convalescent plasma trial, says that while the treatment is considered relatively low-risk, the FDA’s authorization is too hasty.\u003c/p>\n\u003cp class=\"p1\">“The main reason why it’s the wrong time is that we just don’t have enough data yet to say if it works,” he said.\u003c/p>\n\u003cp class=\"p3\">Early results from a \u003ca href=\"https://www.medrxiv.org/content/10.1101/2020.07.29.20162917v2\">\u003cspan class=\"s1\">Mayo Clinic study\u003c/span>\u003c/a> suggest convalescent plasma may reduce COVID-19 mortality rates. But the study, which is available as a non-peer-reviewed preprint, wasn’t placebo-controlled, and Chin-Hong says results from rigorous clinical trials with COVID-19 convalescent plasma have yet to be published.\u003c/p>\n\u003cp class=\"p4\">\u003ci>“\u003c/i>I think plasma is a great potential intervention,” he said. “I just don’t know where it works best.\u003ci>”\u003c/i>\u003c/p>\n\u003cp class=\"p3\">The \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-convalescent-plasma-potential-promising-covid-19-treatment\">\u003cspan class=\"s1\">FDA’s authorization\u003c/span>\u003c/a> limits plasma treatment to hospitalized patients, and much of the early application for research purposes has focused on the most severe cases. But Chin-Hong says convelescent plasma may work better early on, before the disease has a chance to progress and patients get seriously ill.\u003c/p>\n\u003cp class=\"p3\">Dr. James Zehnder, director of clinical pathology at Stanford, agrees that the jury is still out on whether plasma can treat the sickest COVID-19 patients. In looking at the natural patterns of how infected patients make antibodies, he says, researchers have seen the most robust antibody response from those who have severe, potentially life-threatening inflammation. In contrast, those who have milder illness tend to have a weaker antibody response.\u003c/p>\n\u003cp class=\"p4\">\u003ci>“\u003c/i>So one question is that if the really sick patients are already making really high levels of antibodies,” Zehnder said, “how does infusing more antibodies help?\u003ci>”\u003c/i>\u003c/p>\n\u003cp class=\"p4\">Results from placebo-controlled trials, Zehnder says, are the gold standard for clinical research, and they will be key in answering questions surrounding COVID-19 convalescent plasma therapy.\u003c/p>\n\u003cp class=\"p1\">Dr. Stuart Cohen, chief of infectious diseases at UC Davis,\u003ci> \u003c/i>worries that a broad rollout of the treatment in the wake of the FDA authorization could jeopardize that research by stifling enrollment.\u003c/p>\n\u003cp class=\"p1\">“If I tell you, you can be on this clinical trial where you could get a placebo and then they say, ‘Well, I saw that this is available already, why don’t you just give it to me?’” Cohen said, “that sort of finishes off any real ability to determine whether this really works or not.”\u003c/p>\n\u003cp class=\"p1\">While he acknowledges doctors are desperate for more tools to try to fight COVID-19, Cohen cautions that the supply of convalescent plasma, which has mostly kept up with the demand for research studies, could be depleted as a result of the FDA authorization.\u003c/p>\n\u003cp class=\"p1\">If doctors all of sudden begin prescribing the drug liberally, Chin-Hong adds, “it may mean that the patients who need it the most may not get it.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p1\">\u003cb>Cloning Antibodies in the Lab\u003c/b>\u003c/p>\n\u003cp class=\"p3\">Convalescent plasma isn’t the only way researchers are using antibodies from the blood of recovered patients to develop COVID-19 treatments. Scientists are also working to manufacture antibodies in the lab.\u003c/p>\n\u003cp class=\"p3\">“What you can do is you can go into that person who’s a survivor and find the most potent antibody in that person, clone it and then give it to millions of people,” said Dr. Phil Pang, chief medical officer at San Francisco-based \u003ca href=\"https://www.vir.bio/\">\u003cspan class=\"s1\">Vir Biotechnology\u003c/span>\u003c/a>.\u003c/p>\n\u003cp class=\"p3\">These “\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284445/\">\u003cspan class=\"s1\">monoclonal antibodies\u003c/span>\u003c/a>,” Pang says, are made by cloning the powerful, neutralizing antibodies that prevent the coronavirus from invading healthy cells.\u003c/p>\n\u003cp class=\"p3\">The FDA first approved this type of treatment in the 1980s. Doctors have used them mainly to help treat cancer patients and people with autoimmune conditions.\u003c/p>\n\u003cp class=\"p3\">Unlike convalescent plasma, Pang says, the supply of monoclonal antibodies isn’t dependent on blood donations and can be scaled up to potentially reach more people. The proteins are typically replicated in the lab using cell lines from hamsters or mice.\u003c/p>\n\u003cp class=\"p3\">“The antibody manufacturing process is now a very well-defined process,” Pang said. “I would say it’s akin to the way in which we can go about manufacturing cars.”\u003c/p>\n\u003cp class=\"p3\">Pang says one of the antibodies Vir has cloned has been shown to neutralize SARS-CoV-2 in a lab. The finding was supported by an \u003ca href=\"https://www.nature.com/articles/s41586-020-2349-y\" target=\"_blank\" rel=\"noopener noreferrer\">article\u003c/a> \u003cspan class=\"s1\">published in \u003ci>Nature\u003c/i>\u003c/span>\u003ci> \u003c/i>in May.\u003cb> \u003c/b>The company recently launched a randomized trial to see if giving a single injection to newly diagnosed COVID-19 patients can help stop the illness from progressing.\u003c/p>\n\u003cp class=\"p3\">The treatment may eventually be able to prevent infection in front-line workers and other at-risk populations exposed to the coronavirus, acting like a short-term vaccine, Pang says.\u003c/p>\n\u003cp class=\"p3\">“A\u003ci> \u003c/i>vaccine works by giving a person to, say, a fragment of a viral protein and hoping that their immune system creates antibodies,” Pang said. “In this case, what we’re saying is let’s just give them the immune response we know or believe will be protective\u003ci>.\u003c/i>”\u003c/p>\n\u003cp class=\"p3\">The \u003ca href=\"https://www.nih.gov/news-events/news-releases/clinical-trials-monoclonal-antibodies-prevent-covid-19-now-enrolling\">\u003cspan class=\"s1\">NIH\u003c/span>\u003c/a> and a host of drug companies, including Regeneron Pharmaceuticals and Eli Lilly, are testing their own COVID-19 monoclonal antibody candidates.\u003c/p>\n\u003cp class=\"p3\">Preliminary results from both Vir’s monoclonal antibody study and UCSF’s convalescent plasma research are expected by the end of 2020.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">Since early in the pandemic, scientists have said antibodies that the immune system makes to fight the coronavirus could be crucial in finding a cure for COVID-19.\u003c/p>\n\u003cfigure id=\"attachment_1969056\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-1969056\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-1020x1360.jpg\" alt=\"\" width=\"640\" height=\"853\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-1020x1360.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-768x1024.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-1152x1536.jpg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288-1536x2048.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/COVID-Plasma2-scaled-e1598660843288.jpg 1920w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UCSF expects results from a placebo-controlled trial using COVID-19 convalescent plasma by the end of 2020. \u003ccite>(Dr. Ashok Nambiar/UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">The FDA recently authorized one of these treatments — \u003ca href=\"https://www.kqed.org/science/1968824/qa-is-convalescent-plasma-therapy-safe-and-effective-as-a-covid-19-treatment\">\u003cspan class=\"s1\">convalescent plasma,\u003c/span>\u003c/a> in which the antibody-rich portion of blood donated by recovered COVID-19 patients is given to people hospitalized with the disease. But the \u003ca href=\"https://www.politico.com/news/2020/08/23/plasma-treatment-coronavirus-fda-trump-400390\">\u003cspan class=\"s1\">approval\u003c/span>\u003c/a>, which came soon after President Donald Trump \u003ca href=\"https://www.politico.com/news/2020/08/19/trump-coronavirus-plasma-therapy-398801\">\u003cspan class=\"s1\">accused\u003c/span>\u003c/a> the agency of moving too slowly on the treatment for political reasons, has prompted pushback from some in the scientific community, who say more research is needed to determine if and how plasma can be effective against COVID-19. Meanwhile, research on another therapy, involving antibodies cloned in the lab, is just getting underway in human subjects.\u003c/p>\n\u003cp class=\"p1\">\u003cb>‘Liquid Gold’\u003c/b>\u003c/p>\n\u003cp class=\"p1\">Plasma, sometimes called “liquid gold” by doctors for its yellow hue and potential therapeutic value, is made by spinning blood to separate antibodies and other proteins from red blood cells.\u003c/p>\n\u003cp class=\"p1\">The use of convalescent plasma in medicine dates back \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781783/\">\u003cspan class=\"s1\">more than a hundred years\u003c/span>\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">“We’ve used it in infectious diseases from polio to influenza, ebola, etc.,” said UCSF professor of medicine Dr. Peter Chin-Hong.\u003c/p>\n\u003cp class=\"p1\">Chin-Hong, whose team is running a COVID-19 convalescent plasma trial, says that while the treatment is considered relatively low-risk, the FDA’s authorization is too hasty.\u003c/p>\n\u003cp class=\"p1\">“The main reason why it’s the wrong time is that we just don’t have enough data yet to say if it works,” he said.\u003c/p>\n\u003cp class=\"p3\">Early results from a \u003ca href=\"https://www.medrxiv.org/content/10.1101/2020.07.29.20162917v2\">\u003cspan class=\"s1\">Mayo Clinic study\u003c/span>\u003c/a> suggest convalescent plasma may reduce COVID-19 mortality rates. But the study, which is available as a non-peer-reviewed preprint, wasn’t placebo-controlled, and Chin-Hong says results from rigorous clinical trials with COVID-19 convalescent plasma have yet to be published.\u003c/p>\n\u003cp class=\"p4\">\u003ci>“\u003c/i>I think plasma is a great potential intervention,” he said. “I just don’t know where it works best.\u003ci>”\u003c/i>\u003c/p>\n\u003cp class=\"p3\">The \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-convalescent-plasma-potential-promising-covid-19-treatment\">\u003cspan class=\"s1\">FDA’s authorization\u003c/span>\u003c/a> limits plasma treatment to hospitalized patients, and much of the early application for research purposes has focused on the most severe cases. But Chin-Hong says convelescent plasma may work better early on, before the disease has a chance to progress and patients get seriously ill.\u003c/p>\n\u003cp class=\"p3\">Dr. James Zehnder, director of clinical pathology at Stanford, agrees that the jury is still out on whether plasma can treat the sickest COVID-19 patients. In looking at the natural patterns of how infected patients make antibodies, he says, researchers have seen the most robust antibody response from those who have severe, potentially life-threatening inflammation. In contrast, those who have milder illness tend to have a weaker antibody response.\u003c/p>\n\u003cp class=\"p4\">\u003ci>“\u003c/i>So one question is that if the really sick patients are already making really high levels of antibodies,” Zehnder said, “how does infusing more antibodies help?\u003ci>”\u003c/i>\u003c/p>\n\u003cp class=\"p4\">Results from placebo-controlled trials, Zehnder says, are the gold standard for clinical research, and they will be key in answering questions surrounding COVID-19 convalescent plasma therapy.\u003c/p>\n\u003cp class=\"p1\">Dr. Stuart Cohen, chief of infectious diseases at UC Davis,\u003ci> \u003c/i>worries that a broad rollout of the treatment in the wake of the FDA authorization could jeopardize that research by stifling enrollment.\u003c/p>\n\u003cp class=\"p1\">“If I tell you, you can be on this clinical trial where you could get a placebo and then they say, ‘Well, I saw that this is available already, why don’t you just give it to me?’” Cohen said, “that sort of finishes off any real ability to determine whether this really works or not.”\u003c/p>\n\u003cp class=\"p1\">While he acknowledges doctors are desperate for more tools to try to fight COVID-19, Cohen cautions that the supply of convalescent plasma, which has mostly kept up with the demand for research studies, could be depleted as a result of the FDA authorization.\u003c/p>\n\u003cp class=\"p1\">If doctors all of sudden begin prescribing the drug liberally, Chin-Hong adds, “it may mean that the patients who need it the most may not get it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cb>Cloning Antibodies in the Lab\u003c/b>\u003c/p>\n\u003cp class=\"p3\">Convalescent plasma isn’t the only way researchers are using antibodies from the blood of recovered patients to develop COVID-19 treatments. Scientists are also working to manufacture antibodies in the lab.\u003c/p>\n\u003cp class=\"p3\">“What you can do is you can go into that person who’s a survivor and find the most potent antibody in that person, clone it and then give it to millions of people,” said Dr. Phil Pang, chief medical officer at San Francisco-based \u003ca href=\"https://www.vir.bio/\">\u003cspan class=\"s1\">Vir Biotechnology\u003c/span>\u003c/a>.\u003c/p>\n\u003cp class=\"p3\">These “\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284445/\">\u003cspan class=\"s1\">monoclonal antibodies\u003c/span>\u003c/a>,” Pang says, are made by cloning the powerful, neutralizing antibodies that prevent the coronavirus from invading healthy cells.\u003c/p>\n\u003cp class=\"p3\">The FDA first approved this type of treatment in the 1980s. Doctors have used them mainly to help treat cancer patients and people with autoimmune conditions.\u003c/p>\n\u003cp class=\"p3\">Unlike convalescent plasma, Pang says, the supply of monoclonal antibodies isn’t dependent on blood donations and can be scaled up to potentially reach more people. The proteins are typically replicated in the lab using cell lines from hamsters or mice.\u003c/p>\n\u003cp class=\"p3\">“The antibody manufacturing process is now a very well-defined process,” Pang said. “I would say it’s akin to the way in which we can go about manufacturing cars.”\u003c/p>\n\u003cp class=\"p3\">Pang says one of the antibodies Vir has cloned has been shown to neutralize SARS-CoV-2 in a lab. The finding was supported by an \u003ca href=\"https://www.nature.com/articles/s41586-020-2349-y\" target=\"_blank\" rel=\"noopener noreferrer\">article\u003c/a> \u003cspan class=\"s1\">published in \u003ci>Nature\u003c/i>\u003c/span>\u003ci> \u003c/i>in May.\u003cb> \u003c/b>The company recently launched a randomized trial to see if giving a single injection to newly diagnosed COVID-19 patients can help stop the illness from progressing.\u003c/p>\n\u003cp class=\"p3\">The treatment may eventually be able to prevent infection in front-line workers and other at-risk populations exposed to the coronavirus, acting like a short-term vaccine, Pang says.\u003c/p>\n\u003cp class=\"p3\">“A\u003ci> \u003c/i>vaccine works by giving a person to, say, a fragment of a viral protein and hoping that their immune system creates antibodies,” Pang said. “In this case, what we’re saying is let’s just give them the immune response we know or believe will be protective\u003ci>.\u003c/i>”\u003c/p>\n\u003cp class=\"p3\">The \u003ca href=\"https://www.nih.gov/news-events/news-releases/clinical-trials-monoclonal-antibodies-prevent-covid-19-now-enrolling\">\u003cspan class=\"s1\">NIH\u003c/span>\u003c/a> and a host of drug companies, including Regeneron Pharmaceuticals and Eli Lilly, are testing their own COVID-19 monoclonal antibody candidates.\u003c/p>\n\u003cp class=\"p3\">Preliminary results from both Vir’s monoclonal antibody study and UCSF’s convalescent plasma research are expected by the end of 2020.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Q&A: Is Convalescent Plasma Therapy Safe and Effective as a COVID-19 Treatment?",
"headTitle": "Q&A: Is Convalescent Plasma Therapy Safe and Effective as a COVID-19 Treatment? | KQED",
"content": "\u003cp>The Food and Drug Administration on Sunday issued an emergency authorization for doctors to treat COVID-19 using blood plasma from patients who’ve recovered from the disease.\u003c/p>\n\u003cfigure id=\"attachment_1968851\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2029/08/convalescent-plasma-therapy.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1968851 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2029/08/convalescent-plasma-therapy-1020x574.jpg\" alt=\"\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy-768x432.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy-1536x864.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy.jpg 1600w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Alex Edelman/AFP via Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Below, STAT answers the major questions surrounding convalescent plasma as a COVID-19 treatment and the science supporting its use.\u003c/p>\n\u003cp>\u003cstrong>What is convalescent plasma, and how does it work?\u003c/strong>\u003c/p>\n\u003cp>When people get sick with COVID-19, their immune systems generate antibodies to fight the disease. Those antibody proteins float in their blood plasma — the liquid component of blood that suspends blood cells.\u003c/p>\n\u003cp>Doctors can harvest the plasma, test it for safety, and then purify it to isolate those antibodies. That “plasma-derived therapy,” or “convalescent plasma,” can be injected into another patient sick with COVID-19, and the antibodies it contains can help fight the virus early in an infection until the patient’s own immune system generates its own antibodies in sufficient quantities to beat back COVID-19.\u003c/p>\n\u003cp>\u003cstrong>Does scientific evidence show that convalescent plasma is a safe and effective treatment for COVID-19?\u003c/strong>\u003c/p>\n\u003cp>The Mayo Clinic released data in June that showed plasma treatment was safe following transfusion in a group of 20,000 patients, which included substantial enrollment from Black and Latino patients.\u003c/p>\n\u003cp>A study released Aug. 13 — but not yet peer-reviewed — suggested that using convalescent plasma to treat patients with severe COVID-19 soon after their diagnosis was associated with a lower likelihood of death. But the study had serious scientific limitations that make interpreting the findings difficult.\u003c/p>\n\u003cp>The Mayo Clinic study, which enrolled more than 35,000 patients, showed that patients who received transfusions within three days of their COVID-19 diagnosis had a seven-day death rate of 8.7%, while patients who received plasma treatment after four or more days had a mortality rate of 11.9%. The difference met the standard for statistical significance.\u003c/p>\n\u003cp>The study didn’t include a placebo group for comparison, however, so it’s unclear exactly how impactful the plasma treatment might be. The study was sponsored by the National Institutes of Health and sought to broaden access to convalescent plasma, part of a so-called “expanded access” program not designed to definitively test how well the treatment works, but instead to quickly get it to patients.\u003c/p>\n\u003cp>More rigorous randomized, placebo-controlled studies of convalescent plasma are ongoing.\u003c/p>\n\u003cp>\u003cstrong>What does an emergency use authorization, or ‘EUA,’ mean?\u003c/strong>\u003c/p>\n\u003cp>The FDA has issued a number of emergency authorizations for COVID-19 treatments: Most notably the Gilead Sciences antiviral remdesivir, and for the antimalarial drug hydroxychloroquine, which the agency has since withdrawn.\u003c/p>\n\u003cp>The authorizations mean, effectively, that the agency believes the treatments in question are promising and largely safe, though there’s not yet definitive data supporting their efficacy.\u003c/p>\n\u003cp>An EUA for convalescent plasma would effectively license doctors across the country to begin treating COVID-19 patients with convalescent plasma, but it’s unclear whether it will result in a meaningful expansion in access to the therapy, in part because the supply is limited by the number of recovered patients who donate plasma.\u003c/p>\n\u003cp>The Mayo Clinic study, which relied on an FDA “expanded access” program, was broad enough that it allowed 35,000 patients access to the treatment despite the lack of a formal authorization for its use. It’s unclear whether an EUA will lead to a major increase in the number of doctors capable of using convalescent plasma to treat COVID-19, and the number of patients who will end up receiving the treatment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Aren’t some patients being treated with convalescent plasma already?\u003c/strong>\u003c/p>\n\u003cp>Yes, through “compassionate use” programs like the Mayo Clinic study, and through more rigorous clinical trials.\u003c/p>\n\u003cp>\u003cstrong>Isn’t the government already advertising convalescent plasma as a COVID-19 treatment?\u003c/strong>\u003c/p>\n\u003cp>Yes. FDA Commissioner Stephen Hahn began encouraging Americans sick with COVID-19 to donate plasma as early as April. The federal government, in fact, has already spent about $8 million on radio and online advertisements encouraging Americans to donate plasma, even though no government agency has formally endorsed its use.\u003c/p>\n\u003cp>President Donald Trump attended a roundtable on donating plasma last month at the American Red Cross national headquarters in Washington, D.C., accompanied by health secretary Alex Azar, Surgeon General Jerome Adams, and Tony Fauci, the director of the National Institute of Allergy and Infectious Diseases.\u003c/p>\n\u003cp>Hahn’s face has even appeared on FDA-branded billboard advertisements that encourage passers-by: “Help us save lives. Donate plasma now.”\u003c/p>\n\u003cp>\u003cstrong>Has there been pushback regarding use of convalescent plasma?\u003c/strong>\u003c/p>\n\u003cp>Yes. The New York Times reported on Wednesday that Fauci and the director of the National Institutes of Health recently intervened to discourage the FDA from issuing an EUA for convalescent plasma, citing concerns over weak data.\u003c/p>\n\u003cp>It’s not clear whether their reported pushback made a difference. Francis Collins, the NIH director, and Fauci are widely respected scientists, but have no authority over FDA.\u003c/p>\n\u003cp>Scientists outside government have cast the convalescent plasma debate as a case study in pandemic-era science — and how the urgency of treating COVID-19 balances against the need for caution and due diligence in developing new medical treatments.\u003c/p>\n\u003cp>“It raises the question of what strength of evidence is necessary to treat during a pandemic,” Harlan Krumholz, director of the Center for Outcomes Research and Evaluation at Yale New Haven Hospital, told STAT recently. “The problem is we have yet to resolve what is sufficient evidence to change the treatment paradigm.”\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2020/08/23/is-convalescent-plasma-safe-and-effective/\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\" 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>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Food and Drug Administration on Sunday issued an emergency authorization for doctors to treat COVID-19 using blood plasma from patients who’ve recovered from the disease.\u003c/p>\n\u003cfigure id=\"attachment_1968851\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2029/08/convalescent-plasma-therapy.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1968851 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2029/08/convalescent-plasma-therapy-1020x574.jpg\" alt=\"\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy-768x432.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy-1536x864.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/08/convalescent-plasma-therapy.jpg 1600w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Alex Edelman/AFP via Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Below, STAT answers the major questions surrounding convalescent plasma as a COVID-19 treatment and the science supporting its use.\u003c/p>\n\u003cp>\u003cstrong>What is convalescent plasma, and how does it work?\u003c/strong>\u003c/p>\n\u003cp>When people get sick with COVID-19, their immune systems generate antibodies to fight the disease. Those antibody proteins float in their blood plasma — the liquid component of blood that suspends blood cells.\u003c/p>\n\u003cp>Doctors can harvest the plasma, test it for safety, and then purify it to isolate those antibodies. That “plasma-derived therapy,” or “convalescent plasma,” can be injected into another patient sick with COVID-19, and the antibodies it contains can help fight the virus early in an infection until the patient’s own immune system generates its own antibodies in sufficient quantities to beat back COVID-19.\u003c/p>\n\u003cp>\u003cstrong>Does scientific evidence show that convalescent plasma is a safe and effective treatment for COVID-19?\u003c/strong>\u003c/p>\n\u003cp>The Mayo Clinic released data in June that showed plasma treatment was safe following transfusion in a group of 20,000 patients, which included substantial enrollment from Black and Latino patients.\u003c/p>\n\u003cp>A study released Aug. 13 — but not yet peer-reviewed — suggested that using convalescent plasma to treat patients with severe COVID-19 soon after their diagnosis was associated with a lower likelihood of death. But the study had serious scientific limitations that make interpreting the findings difficult.\u003c/p>\n\u003cp>The Mayo Clinic study, which enrolled more than 35,000 patients, showed that patients who received transfusions within three days of their COVID-19 diagnosis had a seven-day death rate of 8.7%, while patients who received plasma treatment after four or more days had a mortality rate of 11.9%. The difference met the standard for statistical significance.\u003c/p>\n\u003cp>The study didn’t include a placebo group for comparison, however, so it’s unclear exactly how impactful the plasma treatment might be. The study was sponsored by the National Institutes of Health and sought to broaden access to convalescent plasma, part of a so-called “expanded access” program not designed to definitively test how well the treatment works, but instead to quickly get it to patients.\u003c/p>\n\u003cp>More rigorous randomized, placebo-controlled studies of convalescent plasma are ongoing.\u003c/p>\n\u003cp>\u003cstrong>What does an emergency use authorization, or ‘EUA,’ mean?\u003c/strong>\u003c/p>\n\u003cp>The FDA has issued a number of emergency authorizations for COVID-19 treatments: Most notably the Gilead Sciences antiviral remdesivir, and for the antimalarial drug hydroxychloroquine, which the agency has since withdrawn.\u003c/p>\n\u003cp>The authorizations mean, effectively, that the agency believes the treatments in question are promising and largely safe, though there’s not yet definitive data supporting their efficacy.\u003c/p>\n\u003cp>An EUA for convalescent plasma would effectively license doctors across the country to begin treating COVID-19 patients with convalescent plasma, but it’s unclear whether it will result in a meaningful expansion in access to the therapy, in part because the supply is limited by the number of recovered patients who donate plasma.\u003c/p>\n\u003cp>The Mayo Clinic study, which relied on an FDA “expanded access” program, was broad enough that it allowed 35,000 patients access to the treatment despite the lack of a formal authorization for its use. It’s unclear whether an EUA will lead to a major increase in the number of doctors capable of using convalescent plasma to treat COVID-19, and the number of patients who will end up receiving the treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Aren’t some patients being treated with convalescent plasma already?\u003c/strong>\u003c/p>\n\u003cp>Yes, through “compassionate use” programs like the Mayo Clinic study, and through more rigorous clinical trials.\u003c/p>\n\u003cp>\u003cstrong>Isn’t the government already advertising convalescent plasma as a COVID-19 treatment?\u003c/strong>\u003c/p>\n\u003cp>Yes. FDA Commissioner Stephen Hahn began encouraging Americans sick with COVID-19 to donate plasma as early as April. The federal government, in fact, has already spent about $8 million on radio and online advertisements encouraging Americans to donate plasma, even though no government agency has formally endorsed its use.\u003c/p>\n\u003cp>President Donald Trump attended a roundtable on donating plasma last month at the American Red Cross national headquarters in Washington, D.C., accompanied by health secretary Alex Azar, Surgeon General Jerome Adams, and Tony Fauci, the director of the National Institute of Allergy and Infectious Diseases.\u003c/p>\n\u003cp>Hahn’s face has even appeared on FDA-branded billboard advertisements that encourage passers-by: “Help us save lives. Donate plasma now.”\u003c/p>\n\u003cp>\u003cstrong>Has there been pushback regarding use of convalescent plasma?\u003c/strong>\u003c/p>\n\u003cp>Yes. The New York Times reported on Wednesday that Fauci and the director of the National Institutes of Health recently intervened to discourage the FDA from issuing an EUA for convalescent plasma, citing concerns over weak data.\u003c/p>\n\u003cp>It’s not clear whether their reported pushback made a difference. Francis Collins, the NIH director, and Fauci are widely respected scientists, but have no authority over FDA.\u003c/p>\n\u003cp>Scientists outside government have cast the convalescent plasma debate as a case study in pandemic-era science — and how the urgency of treating COVID-19 balances against the need for caution and due diligence in developing new medical treatments.\u003c/p>\n\u003cp>“It raises the question of what strength of evidence is necessary to treat during a pandemic,” Harlan Krumholz, director of the Center for Outcomes Research and Evaluation at Yale New Haven Hospital, told STAT recently. “The problem is we have yet to resolve what is sufficient evidence to change the treatment paradigm.”\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2020/08/23/is-convalescent-plasma-safe-and-effective/\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\" 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>\n\u003c/div>\u003c/p>",
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"title": "Bay Area Experiences Worst Air Quality in the World Due to Wildfires",
"headTitle": "Bay Area Experiences Worst Air Quality in the World Due to Wildfires | KQED",
"content": "\u003cp>\u003cem>Updated Aug. 21\u003c/em>\u003c/p>\n\u003cp>After months of following shelter-at-home orders due to the COVID-19 pandemic, Bay Area residents now have another reason to stay inside: dangerously poor air quality from a series of wildfires, which continue to burn out of control.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.kqed.org/science/1930023/map-heres-your-daily-air-quality-report-for-the-bay-area\" target=\"_blank\" rel=\"noopener noreferrer\">Air Quality Index\u003c/a> in the region degenerated to \u003ca href=\"https://waqi.info/#/c/2.436/50.934/1.4z\" target=\"_blank\" rel=\"noopener noreferrer\">worst-in-the-world \u003c/a>status this week, with the unhealthiest conditions south, east and northeast of San Francisco, as smoke spread outward from the LNU, SCU and CZU Lightning Complex fires.\u003c/p>\n\u003cp>Officials are urging people in areas where the air is classified as “unhealthy” — displayed as red on color-coded maps — to stay indoors, particularly those with respiratory conditions such as asthma and COPD, as well as older adults, children and teens. For those who have to go out, the recommendation is to avoid strenuous outdoor activities or to shorten the amount of time outside.\u003c/p>\n\u003cp>The forecast calls for the air to stay unhealthy for sensitive groups, such as those with heart or lung disease, throughout the weekend.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The \u003ca href=\"https://www.lung.org/clean-air/emergencies-and-natural-disasters/wildfires\" target=\"_blank\" rel=\"noopener noreferrer\">American Lung Association in California\u003c/a> offered the following advice for local residents struggling with the simultaneous health risks of smoke, extreme heat and COVID-19:\u003c/p>\n\u003cul>\n\u003cli>Stay inside as much as possible, with doors, windows and fireplace dampers shut — and clean air circulating through air conditioners and/or air cleaners. Residents should use the recirculation setting on their home air conditioners to avoid outdoor air contamination. Using whole house fans is not recommended because they can allow unfiltered outside air into the home.\u003c/li>\n\u003cli>Those with chronic lung disease are encouraged to gather all their medications, delivery devices, prescriptions and insurance cards in one spot so they can quickly be transported in the event of an evacuation.\u003c/li>\n\u003cli>If evacuating, remember to continue to follow guidance around COVID-19 such as practicing social distancing, wearing a cloth face covering and using hand sanitizer.\u003c/li>\n\u003cli>Contact a physician immediately if lung disease symptoms worsen or are not relieved by the usual medicines. Seek medical attention if experiencing wheezing, shortness of breath, difficulty taking a full breath, chest heaviness, lightheadedness, and dizziness.\u003c/li>\n\u003cli>Avoid exercising outdoors, particularly if you smell smoke or experience eye or throat irritation.\u003c/li>\n\u003cli>For those returning to a fire-damaged home, limit exposure to ash by wearing protective clothing, gloves, goggles and a fitted N95 mask, if available. Note that a cloth mask, such as those often used to prevent the spread of COVID-19, will not adequately protect lungs from particles found in wildfire smoke.\u003c/li>\n\u003c/ul>\n\u003cp>Breathing particulate-heavy air could make people more susceptible to the novel coronavirus, says Dr. Madhavi Dandu, professor of medicine at UCSF.\u003c/p>\n\u003cp>“A\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",null]'>ir pollution and all type of particulate matter, but especially the particulate 2.5 that we see in fires, can really impact both lung health as well as just general immune health,” Dandu said. “O\u003c/span>\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",null]'>ne of the things that it does is destroy these little hairs that we call cilia that are in the lungs, which are ways to protect the lungs. They basically wipe off the germs, or spread off the germs, so that they don’t eventually get into the bloodstream.”\u003c/span>\u003c/p>\n\u003cp>Dandu says given the health risks associated with breathing in smoke, “staying out of the polluted air if at all possible is the safest thing to do.”\u003c/p>\n\u003cp>\u003cstrong> ‘A Very Complicated Situation’\u003c/strong>\u003c/p>\n\u003cp id=\"x_docs-internal-guid-f791b892-7fff-1715-bcab-9128ac424c34\" dir=\"ltr\">Considering the array of disasters the region is now facing, Solano County Health Officer Dr. Bela Matyas says, the choices for staying safe are no longer cut and dried, and the confluence of heat and wildfire smoke amid the backdrop of the coronavirus pandemic is making an already difficult situation worse, particularly for people with underlying health conditions.\u003c/p>\n\u003cp dir=\"ltr\">For instance, for the many people in the region without air conditioning, cooled public spaces like movie theaters, malls and libraries are closed due to the pandemic. So some people now face the hard trade-off between opening the windows to get relief from the heat and breathing in the smoke that it allows in.\u003c/p>\n\u003cp dir=\"ltr\">“This is a very complicated situation. There is no perfect solution here, because solutions for one exacerbate the other,” Matyas said. “And so the compromise of trying to protect against all of these multiple things happening at the same time is the best that we can do.”\u003c/p>\n\u003cp dir=\"ltr\">For people with a respiratory illness, breathing in wildfire smoke can be especially dangerous, he says. But those without underlying health concerns might consider opening the windows to cool their living space for a short time before closing them again.\u003c/p>\n\u003cp dir=\"ltr\">For the most vulnerable, the county is operating three combined cooling-evacuation centers, Matyas says.\u003c/p>\n\u003cp dir=\"ltr\">He called it “a little bit tricky, because as people are showing up, we need to screen them [for COVID-19]. But a lot of the symptoms that we screen for are actually created by the smoke. So a person shows up at an evacuation site coughing and short of breath, who’s just come from an evacuated zone within the fire. How do you know that it’s the smoke that did that as opposed to COVID?”\u003c/p>\n\u003cp dir=\"ltr\">As for facial coverings, he distinguished between the less protective masks people are using to slow the spread of the coronavirus with the N95s that filter out harmful smoke particles.\u003c/p>\n\u003cp dir=\"ltr\">“If you’re going to be going to a congregating environment like an evacuation center, by all means, bring your [anticoronavirus] mask so that when you’re indoors, you can maintain social distancing,” he said. “But I don’t think you can rely on masks as one of the elements of the strategy to protect against the smoke.\u003c/p>\n\u003cp dir=\"ltr\">“N95 would be an appropriate type of mask to wear to protect yourself from dust and smoke. But those masks aren’t available” because of a shortage caused by the pandemic.\u003c/p>\n\u003cp dir=\"ltr\">In San Francisco, which spent much of the day engulfed in air classified as “unhealthy,” either for sensitive groups or the general population, Mayor London Breed put the latest crises in the context of a warming globe.\u003c/p>\n\u003cp dir=\"ltr\">“The effects of climate change are already being felt,” she said, “and sadly we know events like these are only going to become more common with drier weather and hotter temperatures.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp dir=\"ltr\">\u003cem>Jon Brooks and Danielle Venton contributed to this post.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated Aug. 21\u003c/em>\u003c/p>\n\u003cp>After months of following shelter-at-home orders due to the COVID-19 pandemic, Bay Area residents now have another reason to stay inside: dangerously poor air quality from a series of wildfires, which continue to burn out of control.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.kqed.org/science/1930023/map-heres-your-daily-air-quality-report-for-the-bay-area\" target=\"_blank\" rel=\"noopener noreferrer\">Air Quality Index\u003c/a> in the region degenerated to \u003ca href=\"https://waqi.info/#/c/2.436/50.934/1.4z\" target=\"_blank\" rel=\"noopener noreferrer\">worst-in-the-world \u003c/a>status this week, with the unhealthiest conditions south, east and northeast of San Francisco, as smoke spread outward from the LNU, SCU and CZU Lightning Complex fires.\u003c/p>\n\u003cp>Officials are urging people in areas where the air is classified as “unhealthy” — displayed as red on color-coded maps — to stay indoors, particularly those with respiratory conditions such as asthma and COPD, as well as older adults, children and teens. For those who have to go out, the recommendation is to avoid strenuous outdoor activities or to shorten the amount of time outside.\u003c/p>\n\u003cp>The forecast calls for the air to stay unhealthy for sensitive groups, such as those with heart or lung disease, throughout the weekend.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"https://www.lung.org/clean-air/emergencies-and-natural-disasters/wildfires\" target=\"_blank\" rel=\"noopener noreferrer\">American Lung Association in California\u003c/a> offered the following advice for local residents struggling with the simultaneous health risks of smoke, extreme heat and COVID-19:\u003c/p>\n\u003cul>\n\u003cli>Stay inside as much as possible, with doors, windows and fireplace dampers shut — and clean air circulating through air conditioners and/or air cleaners. Residents should use the recirculation setting on their home air conditioners to avoid outdoor air contamination. Using whole house fans is not recommended because they can allow unfiltered outside air into the home.\u003c/li>\n\u003cli>Those with chronic lung disease are encouraged to gather all their medications, delivery devices, prescriptions and insurance cards in one spot so they can quickly be transported in the event of an evacuation.\u003c/li>\n\u003cli>If evacuating, remember to continue to follow guidance around COVID-19 such as practicing social distancing, wearing a cloth face covering and using hand sanitizer.\u003c/li>\n\u003cli>Contact a physician immediately if lung disease symptoms worsen or are not relieved by the usual medicines. Seek medical attention if experiencing wheezing, shortness of breath, difficulty taking a full breath, chest heaviness, lightheadedness, and dizziness.\u003c/li>\n\u003cli>Avoid exercising outdoors, particularly if you smell smoke or experience eye or throat irritation.\u003c/li>\n\u003cli>For those returning to a fire-damaged home, limit exposure to ash by wearing protective clothing, gloves, goggles and a fitted N95 mask, if available. Note that a cloth mask, such as those often used to prevent the spread of COVID-19, will not adequately protect lungs from particles found in wildfire smoke.\u003c/li>\n\u003c/ul>\n\u003cp>Breathing particulate-heavy air could make people more susceptible to the novel coronavirus, says Dr. Madhavi Dandu, professor of medicine at UCSF.\u003c/p>\n\u003cp>“A\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",null]'>ir pollution and all type of particulate matter, but especially the particulate 2.5 that we see in fires, can really impact both lung health as well as just general immune health,” Dandu said. “O\u003c/span>\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",null]'>ne of the things that it does is destroy these little hairs that we call cilia that are in the lungs, which are ways to protect the lungs. They basically wipe off the germs, or spread off the germs, so that they don’t eventually get into the bloodstream.”\u003c/span>\u003c/p>\n\u003cp>Dandu says given the health risks associated with breathing in smoke, “staying out of the polluted air if at all possible is the safest thing to do.”\u003c/p>\n\u003cp>\u003cstrong> ‘A Very Complicated Situation’\u003c/strong>\u003c/p>\n\u003cp id=\"x_docs-internal-guid-f791b892-7fff-1715-bcab-9128ac424c34\" dir=\"ltr\">Considering the array of disasters the region is now facing, Solano County Health Officer Dr. Bela Matyas says, the choices for staying safe are no longer cut and dried, and the confluence of heat and wildfire smoke amid the backdrop of the coronavirus pandemic is making an already difficult situation worse, particularly for people with underlying health conditions.\u003c/p>\n\u003cp dir=\"ltr\">For instance, for the many people in the region without air conditioning, cooled public spaces like movie theaters, malls and libraries are closed due to the pandemic. So some people now face the hard trade-off between opening the windows to get relief from the heat and breathing in the smoke that it allows in.\u003c/p>\n\u003cp dir=\"ltr\">“This is a very complicated situation. There is no perfect solution here, because solutions for one exacerbate the other,” Matyas said. “And so the compromise of trying to protect against all of these multiple things happening at the same time is the best that we can do.”\u003c/p>\n\u003cp dir=\"ltr\">For people with a respiratory illness, breathing in wildfire smoke can be especially dangerous, he says. But those without underlying health concerns might consider opening the windows to cool their living space for a short time before closing them again.\u003c/p>\n\u003cp dir=\"ltr\">For the most vulnerable, the county is operating three combined cooling-evacuation centers, Matyas says.\u003c/p>\n\u003cp dir=\"ltr\">He called it “a little bit tricky, because as people are showing up, we need to screen them [for COVID-19]. But a lot of the symptoms that we screen for are actually created by the smoke. So a person shows up at an evacuation site coughing and short of breath, who’s just come from an evacuated zone within the fire. How do you know that it’s the smoke that did that as opposed to COVID?”\u003c/p>\n\u003cp dir=\"ltr\">As for facial coverings, he distinguished between the less protective masks people are using to slow the spread of the coronavirus with the N95s that filter out harmful smoke particles.\u003c/p>\n\u003cp dir=\"ltr\">“If you’re going to be going to a congregating environment like an evacuation center, by all means, bring your [anticoronavirus] mask so that when you’re indoors, you can maintain social distancing,” he said. “But I don’t think you can rely on masks as one of the elements of the strategy to protect against the smoke.\u003c/p>\n\u003cp dir=\"ltr\">“N95 would be an appropriate type of mask to wear to protect yourself from dust and smoke. But those masks aren’t available” because of a shortage caused by the pandemic.\u003c/p>\n\u003cp dir=\"ltr\">In San Francisco, which spent much of the day engulfed in air classified as “unhealthy,” either for sensitive groups or the general population, Mayor London Breed put the latest crises in the context of a warming globe.\u003c/p>\n\u003cp dir=\"ltr\">“The effects of climate change are already being felt,” she said, “and sadly we know events like these are only going to become more common with drier weather and hotter temperatures.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp dir=\"ltr\">\u003cem>Jon Brooks and Danielle Venton contributed to this post.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Doctors and Nurses Are Not Doing Okay",
"headTitle": "Doctors and Nurses Are Not Doing Okay | KQED",
"content": "\u003cp class=\"p1\">After five months working shifts at an emergency department in Oakland, Douglas Frey says he’s mentally and physically spent. \u003cspan class=\"s1\">Most days the\u003c/span> tall, athletic-looking 47-year-old nurse\u003cspan class=\"s1\"> ends his shift depleted by what he calls an “undercurrent” of “tension.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">Every day Frey worries he’ll make a mistake — picking up a contaminated mask, perhaps — and bring the virus home to his two boys and wife, who is immunocompromised. He’s worried about his hospital’s ability to source enough masks and protective gear for him to do his job safely.\u003c/p>\n\u003cfigure id=\"attachment_1968315\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1968315 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/08/IMG_3506-e1597182085426-800x885.jpg\" alt=\"After working many consecutive months both as an ER nurse in Oakland Douglas Frey is emotionally and physically exhausted.\" width=\"800\" height=\"885\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426-800x885.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426-1020x1129.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426-160x177.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426-768x850.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426-1388x1536.jpg 1388w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426.jpg 1574w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">After working many consecutive months as an ER nurse in Oakland, Douglas Frey is emotionally and physically exhausted. \u003ccite>(Courtesy of Douglas Frey)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p3\">Frey is not alone among medical staff when it comes to pandemic burnout.\u003c/p>\n\u003cp class=\"p3\">The unflappable health care heroes of the current crisis are beginning to crack under the strain. Doctors, nurses and other professionals are not only fighting an intractable virus day after day, they’re also coping with isolation, shifting official guidelines and limited ways to recharge.\u003c/p>\n\u003cp class=\"p1\">A\u003ca href=\"https://onlinelibrary.wiley.com/doi/10.1111/acem.14065\"> \u003cspan class=\"s2\">study\u003c/span>\u003c/a> published in June by researchers from UCSF and other universities showed emergency medicine physicians reporting a median 60% increase in emotional exhaustion and burnout over prepandemic levels.\u003c/p>\n\u003cp class=\"p1\">These workers cited the unavailability of protective gear, inadequate testing and the risk of spreading the virus by discharged patients as their primary concerns. Physicians noted their stress levels have decreased their affection with family members.\u003c/p>\n\u003cp class=\"p1\">The gowns in one recent shipment to Frey’s hospital were so thin that managers encouraged workers to double up when they wore them, he says. But, “Even with two, they’d come off in shreds by the time you got them off.”\u003c/p>\n\u003cp class=\"p1\">Now, he has the opposite problem. The gowns in the current stock are made of thick, impermeable vinyl. He often leaves the hospital soaked in sweat.\u003c/p>\n\u003cp class=\"p1\">Frey’s work frustrations are compounded by the drumbeat of bad news and what he considers to be a lack of cohesive response on the part of political leaders. “I’m exhausted by the fact that every family, store, business, organization, school, city, county and state is having to duplicate efforts to try and figure out what to do,” he said.\u003c/p>\n\u003cp class=\"p1\">And now he’s bracing for a potentially overwhelming wave of patients this fall when COVID-19 collides with cold and flu season.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p1\">\u003cb>Recipe for More Burnout\u003c/b>\u003c/p>\n\u003cp class=\"p1\">Before the pandemic hit, 42% of more than 15,000 physicians responding to an online survey by the medical news website Medscape \u003ca href=\"https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460?faf=1\" target=\"_blank\" rel=\"noopener noreferrer\">reported\u003c/a> being burned out. High rates of depression and suicide in the medical profession have long been a \u003ca href=\"https://www.npr.org/sections/health-shots/2018/07/31/634217947/to-prevent-doctor-suicides-medical-industry-rethinks-how-doctors-work\" target=\"_blank\" rel=\"noopener noreferrer\">problem\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">Experts fear the coronavirus crisis will only make those numbers go up.\u003c/p>\n\u003cp class=\"p1\">“When the stress of hospitals gets unbelievably high, it ceases to be a place where we get sustenance, or feel like we’re being helpful,” said Bradley Dreifuss, an emergency medicine physician and public health specialist at the University of Arizona in Tucson. “Instead we feel helpless.”\u003c/p>\n\u003cp class=\"p1\">Dreifuss penned a \u003ci>New York Times\u003c/i>\u003ca href=\"https://www.nytimes.com/2020/06/26/opinion/coronavirus-arizona-hospitals.html\"> \u003cspan class=\"s2\">editorial\u003c/span>\u003c/a> in June to draw attention to health care fatigue. He wrote the article from an Airbnb after nine consecutive shifts. For months he has lived there alone to protect his wife and 10-year-old daughter.\u003c/p>\n\u003cp class=\"p1\">He says many of his colleagues are starting to withdraw emotionally and show increasing levels of cynicism, which inspired him to add mental health services to an initiative he started called\u003ca href=\"https://hcwhosted.org/\"> \u003cspan class=\"s2\">HCW Hosted.\u003c/span>\u003c/a> At first, the online platform connected health care workers with temporary housing, but now doctors and nurses can access mental health support as well.\u003c/p>\n\u003cp class=\"p1\">Dreifuss called the current situation “very, very challenging.”\u003c/p>\n\u003cp class=\"p1\">“COVID patients are much sicker than our typical patients physiologically,” he said. “When you’re working with constrained resources and uncertainty, it makes it a lot worse.”\u003c/p>\n\u003cp class=\"p1\">\u003cb>Extra Burden on Latino Doctors\u003c/b>\u003c/p>\n\u003cp class=\"p1\">The days began to blur together for Dinora Chinchilla, a pulmonologist specializing in critical care in Los Angeles County, where the virus has killed nearly\u003ca href=\"https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/los-angeles-county/\"> \u003cspan class=\"s2\">5,000 \u003c/span>\u003c/a>people.\u003c/p>\n\u003cfigure id=\"attachment_1968316\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1968316 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/08/IMG_9630-800x1067.jpg\" alt=\"Dr. Dinora Chinchilla is finally taking a month after seven consecutive months treating patients in an ICU in Los Angeles county.\" width=\"800\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-1020x1360.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-768x1024.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-1152x1536.jpg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-1536x2048.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-scaled.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Dinora Chinchilla is finally taking a month off after working seven consecutive months. \u003ccite>(Nicole Cataldi)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">“All I saw was COVID, COVID, COVID,” she said. “I didn’t know Monday from a Saturday. I felt like every day was on repeat.”\u003c/p>\n\u003cp class=\"p1\">She is finally taking a few weeks off to refuel. Many days, when the 39-year-old looked around the intensive care unit, every single patient was connected to a ventilator. Most were older, overweight, diabetic and Latino.\u003c/p>\n\u003cp class=\"p1\">“Seeing how disproportionately COVID has affected the Latino community and being able to be that person for them now is what I always wanted,” said Chinchilla. “But that comes with a big burden.”\u003c/p>\n\u003cp class=\"p1\">As a kid growing up in East L.A., she dreamed of treating low-income families like hers. Bridging that barrier inspires her to work longer shifts than many of her colleagues, she says. Current COVID-19 protocols do not allow visitors inside the hospital, so she has insisted on personally calling the families of Latino patients, because she believes it’s kinder to deliver what is often devastating news directly\u003ci> \u003c/i>rather than through a translator.\u003c/p>\n\u003cp class=\"p1\">“It was just so emotional,” Chinchilla said, fingering the inside of a large silver hoop earring. “I can’t say that I didn’t cry often.”\u003c/p>\n\u003cp class=\"p1\">The heartache didn’t end at work. When Chinchilla unlocked the door to her house, her two young children would run toward her. But she had to head in the opposite direction.\u003c/p>\n\u003cp class=\"p1\">“How sad is that?” she said. “Not being able to hug your child when she’s so happy that you’re home because you’ve been gone for 14 hours.”\u003c/p>\n\u003cp class=\"p1\">Chinchilla didn’t embrace her kids until she scrubbed herself raw in a scalding shower. And, now, even though she’s enjoying slower days at home recovering, her mind won’t relax.\u003c/p>\n\u003cp class=\"p1\">“I feel that sense of duty,” she said. “This is my specialty. This is what I signed up for. I have to be there.”\u003c/p>\n\u003cfigure id=\"attachment_1968318\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1968318\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-800x1067.jpeg\" alt=\"The emergency room where Dr. Victor Cisneros works is running out of beds for patients, many from Latino families like his.\" width=\"800\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-800x1067.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-1020x1360.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-160x213.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-768x1024.jpeg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-1152x1536.jpeg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-1536x2048.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907.jpeg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The emergency department in Orange County where Dr. Victor Cisneros works is running out of beds for patients, many from Latino families like his. \u003ccite>(Victor Cisneros)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">Victor Cisneros, a 39-year-old emergency department physician, can relate. He treats patients in Orange County. His hospital is running out of beds for patients, many from families just like his.\u003cspan class=\"Apple-converted-space\"> \u003c/span>\u003c/p>\n\u003cp class=\"p1\">“I grew up very underserved,” said Cisneros, smiling. “I come from a very humble family. I’m the first physician, the first person to graduate college.”\u003c/p>\n\u003cp class=\"p1\">He’s originally from Mexico, but now much of his family lives in Los Angeles. Even though they live near each other, social distancing has made it hard for them to feel close. For Cisneros, the lack of physical contact is exacerbated because he lives alone.\u003c/p>\n\u003cp class=\"p1\">“You just feel trapped,” he said. “Because you’re in the ER for 10 hours, which is intense, exhausting. It smells. People are vomiting. There’s blood.”\u003c/p>\n\u003cp class=\"p1\">He used to disconnect from work by working out or going to dinner with friends. But now, his gym is closed and many of his friends don’t want to hang out, knowing he’s around sick people all day.\u003c/p>\n\u003cp class=\"p1\">“So, I’m on a couch in front of a screen by myself. It’s almost like you’re in jail.”\u003c/p>\n\u003cp class=\"p1\">He fears the current situation is not sustainable, especially for physicians who were already burned out. “This is probably the tipping edge for them,” he said.\u003c/p>\n\u003cp class=\"p1\">Doctors aren’t known for seeking help, said Dr. Deborah Marin, a professor of psychiatry at Mount Sinai’s Icahn School of Medicine. “Suffering is kind of part of the profession to some degree,” she said. “But people shouldn’t be suffering.”\u003c/p>\n\u003cp class=\"p1\">Marin directs a new program called the\u003ca href=\"https://icahn.mssm.edu/about/departments/psychiatry/clinical/stress-resilience-personal-growth-center\"> \u003cspan class=\"s2\">Mount Sinai Center for Stress, Resilience, and Personal Growth\u003c/span>\u003c/a>, designed to address mental health issues like depression, anxiety and post-traumatic stress disorder in health care workers.\u003c/p>\n\u003cp class=\"p1\">“The idea is to shore up people’s resilience and be supportive of them,” Marin said. “They need to feel like they’re not in this alone.”\u003c/p>\n\u003cp class=\"p1\">The program includes a hotline, a wellness app and workshops designed to help connect nurses and doctors. She says the most important step is to ask for help, which could mean starting a conversation with a supervisor, friend or a therapist.\u003c/p>\n\u003cp class=\"p1\">Which could be good advice for not just doctors, but all of us.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">After five months working shifts at an emergency department in Oakland, Douglas Frey says he’s mentally and physically spent. \u003cspan class=\"s1\">Most days the\u003c/span> tall, athletic-looking 47-year-old nurse\u003cspan class=\"s1\"> ends his shift depleted by what he calls an “undercurrent” of “tension.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">Every day Frey worries he’ll make a mistake — picking up a contaminated mask, perhaps — and bring the virus home to his two boys and wife, who is immunocompromised. He’s worried about his hospital’s ability to source enough masks and protective gear for him to do his job safely.\u003c/p>\n\u003cfigure id=\"attachment_1968315\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1968315 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/08/IMG_3506-e1597182085426-800x885.jpg\" alt=\"After working many consecutive months both as an ER nurse in Oakland Douglas Frey is emotionally and physically exhausted.\" width=\"800\" height=\"885\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426-800x885.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426-1020x1129.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426-160x177.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426-768x850.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426-1388x1536.jpg 1388w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_3506-e1597182085426.jpg 1574w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">After working many consecutive months as an ER nurse in Oakland, Douglas Frey is emotionally and physically exhausted. \u003ccite>(Courtesy of Douglas Frey)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p3\">Frey is not alone among medical staff when it comes to pandemic burnout.\u003c/p>\n\u003cp class=\"p3\">The unflappable health care heroes of the current crisis are beginning to crack under the strain. Doctors, nurses and other professionals are not only fighting an intractable virus day after day, they’re also coping with isolation, shifting official guidelines and limited ways to recharge.\u003c/p>\n\u003cp class=\"p1\">A\u003ca href=\"https://onlinelibrary.wiley.com/doi/10.1111/acem.14065\"> \u003cspan class=\"s2\">study\u003c/span>\u003c/a> published in June by researchers from UCSF and other universities showed emergency medicine physicians reporting a median 60% increase in emotional exhaustion and burnout over prepandemic levels.\u003c/p>\n\u003cp class=\"p1\">These workers cited the unavailability of protective gear, inadequate testing and the risk of spreading the virus by discharged patients as their primary concerns. Physicians noted their stress levels have decreased their affection with family members.\u003c/p>\n\u003cp class=\"p1\">The gowns in one recent shipment to Frey’s hospital were so thin that managers encouraged workers to double up when they wore them, he says. But, “Even with two, they’d come off in shreds by the time you got them off.”\u003c/p>\n\u003cp class=\"p1\">Now, he has the opposite problem. The gowns in the current stock are made of thick, impermeable vinyl. He often leaves the hospital soaked in sweat.\u003c/p>\n\u003cp class=\"p1\">Frey’s work frustrations are compounded by the drumbeat of bad news and what he considers to be a lack of cohesive response on the part of political leaders. “I’m exhausted by the fact that every family, store, business, organization, school, city, county and state is having to duplicate efforts to try and figure out what to do,” he said.\u003c/p>\n\u003cp class=\"p1\">And now he’s bracing for a potentially overwhelming wave of patients this fall when COVID-19 collides with cold and flu season.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cb>Recipe for More Burnout\u003c/b>\u003c/p>\n\u003cp class=\"p1\">Before the pandemic hit, 42% of more than 15,000 physicians responding to an online survey by the medical news website Medscape \u003ca href=\"https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460?faf=1\" target=\"_blank\" rel=\"noopener noreferrer\">reported\u003c/a> being burned out. High rates of depression and suicide in the medical profession have long been a \u003ca href=\"https://www.npr.org/sections/health-shots/2018/07/31/634217947/to-prevent-doctor-suicides-medical-industry-rethinks-how-doctors-work\" target=\"_blank\" rel=\"noopener noreferrer\">problem\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">Experts fear the coronavirus crisis will only make those numbers go up.\u003c/p>\n\u003cp class=\"p1\">“When the stress of hospitals gets unbelievably high, it ceases to be a place where we get sustenance, or feel like we’re being helpful,” said Bradley Dreifuss, an emergency medicine physician and public health specialist at the University of Arizona in Tucson. “Instead we feel helpless.”\u003c/p>\n\u003cp class=\"p1\">Dreifuss penned a \u003ci>New York Times\u003c/i>\u003ca href=\"https://www.nytimes.com/2020/06/26/opinion/coronavirus-arizona-hospitals.html\"> \u003cspan class=\"s2\">editorial\u003c/span>\u003c/a> in June to draw attention to health care fatigue. He wrote the article from an Airbnb after nine consecutive shifts. For months he has lived there alone to protect his wife and 10-year-old daughter.\u003c/p>\n\u003cp class=\"p1\">He says many of his colleagues are starting to withdraw emotionally and show increasing levels of cynicism, which inspired him to add mental health services to an initiative he started called\u003ca href=\"https://hcwhosted.org/\"> \u003cspan class=\"s2\">HCW Hosted.\u003c/span>\u003c/a> At first, the online platform connected health care workers with temporary housing, but now doctors and nurses can access mental health support as well.\u003c/p>\n\u003cp class=\"p1\">Dreifuss called the current situation “very, very challenging.”\u003c/p>\n\u003cp class=\"p1\">“COVID patients are much sicker than our typical patients physiologically,” he said. “When you’re working with constrained resources and uncertainty, it makes it a lot worse.”\u003c/p>\n\u003cp class=\"p1\">\u003cb>Extra Burden on Latino Doctors\u003c/b>\u003c/p>\n\u003cp class=\"p1\">The days began to blur together for Dinora Chinchilla, a pulmonologist specializing in critical care in Los Angeles County, where the virus has killed nearly\u003ca href=\"https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/los-angeles-county/\"> \u003cspan class=\"s2\">5,000 \u003c/span>\u003c/a>people.\u003c/p>\n\u003cfigure id=\"attachment_1968316\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1968316 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/08/IMG_9630-800x1067.jpg\" alt=\"Dr. Dinora Chinchilla is finally taking a month after seven consecutive months treating patients in an ICU in Los Angeles county.\" width=\"800\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-1020x1360.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-768x1024.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-1152x1536.jpg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-1536x2048.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_9630-scaled.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Dinora Chinchilla is finally taking a month off after working seven consecutive months. \u003ccite>(Nicole Cataldi)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">“All I saw was COVID, COVID, COVID,” she said. “I didn’t know Monday from a Saturday. I felt like every day was on repeat.”\u003c/p>\n\u003cp class=\"p1\">She is finally taking a few weeks off to refuel. Many days, when the 39-year-old looked around the intensive care unit, every single patient was connected to a ventilator. Most were older, overweight, diabetic and Latino.\u003c/p>\n\u003cp class=\"p1\">“Seeing how disproportionately COVID has affected the Latino community and being able to be that person for them now is what I always wanted,” said Chinchilla. “But that comes with a big burden.”\u003c/p>\n\u003cp class=\"p1\">As a kid growing up in East L.A., she dreamed of treating low-income families like hers. Bridging that barrier inspires her to work longer shifts than many of her colleagues, she says. Current COVID-19 protocols do not allow visitors inside the hospital, so she has insisted on personally calling the families of Latino patients, because she believes it’s kinder to deliver what is often devastating news directly\u003ci> \u003c/i>rather than through a translator.\u003c/p>\n\u003cp class=\"p1\">“It was just so emotional,” Chinchilla said, fingering the inside of a large silver hoop earring. “I can’t say that I didn’t cry often.”\u003c/p>\n\u003cp class=\"p1\">The heartache didn’t end at work. When Chinchilla unlocked the door to her house, her two young children would run toward her. But she had to head in the opposite direction.\u003c/p>\n\u003cp class=\"p1\">“How sad is that?” she said. “Not being able to hug your child when she’s so happy that you’re home because you’ve been gone for 14 hours.”\u003c/p>\n\u003cp class=\"p1\">Chinchilla didn’t embrace her kids until she scrubbed herself raw in a scalding shower. And, now, even though she’s enjoying slower days at home recovering, her mind won’t relax.\u003c/p>\n\u003cp class=\"p1\">“I feel that sense of duty,” she said. “This is my specialty. This is what I signed up for. I have to be there.”\u003c/p>\n\u003cfigure id=\"attachment_1968318\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1968318\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-800x1067.jpeg\" alt=\"The emergency room where Dr. Victor Cisneros works is running out of beds for patients, many from Latino families like his.\" width=\"800\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-800x1067.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-1020x1360.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-160x213.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-768x1024.jpeg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-1152x1536.jpeg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907-1536x2048.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/08/IMG_7918-scaled-e1597180915907.jpeg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The emergency department in Orange County where Dr. Victor Cisneros works is running out of beds for patients, many from Latino families like his. \u003ccite>(Victor Cisneros)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">Victor Cisneros, a 39-year-old emergency department physician, can relate. He treats patients in Orange County. His hospital is running out of beds for patients, many from families just like his.\u003cspan class=\"Apple-converted-space\"> \u003c/span>\u003c/p>\n\u003cp class=\"p1\">“I grew up very underserved,” said Cisneros, smiling. “I come from a very humble family. I’m the first physician, the first person to graduate college.”\u003c/p>\n\u003cp class=\"p1\">He’s originally from Mexico, but now much of his family lives in Los Angeles. Even though they live near each other, social distancing has made it hard for them to feel close. For Cisneros, the lack of physical contact is exacerbated because he lives alone.\u003c/p>\n\u003cp class=\"p1\">“You just feel trapped,” he said. “Because you’re in the ER for 10 hours, which is intense, exhausting. It smells. People are vomiting. There’s blood.”\u003c/p>\n\u003cp class=\"p1\">He used to disconnect from work by working out or going to dinner with friends. But now, his gym is closed and many of his friends don’t want to hang out, knowing he’s around sick people all day.\u003c/p>\n\u003cp class=\"p1\">“So, I’m on a couch in front of a screen by myself. It’s almost like you’re in jail.”\u003c/p>\n\u003cp class=\"p1\">He fears the current situation is not sustainable, especially for physicians who were already burned out. “This is probably the tipping edge for them,” he said.\u003c/p>\n\u003cp class=\"p1\">Doctors aren’t known for seeking help, said Dr. Deborah Marin, a professor of psychiatry at Mount Sinai’s Icahn School of Medicine. “Suffering is kind of part of the profession to some degree,” she said. “But people shouldn’t be suffering.”\u003c/p>\n\u003cp class=\"p1\">Marin directs a new program called the\u003ca href=\"https://icahn.mssm.edu/about/departments/psychiatry/clinical/stress-resilience-personal-growth-center\"> \u003cspan class=\"s2\">Mount Sinai Center for Stress, Resilience, and Personal Growth\u003c/span>\u003c/a>, designed to address mental health issues like depression, anxiety and post-traumatic stress disorder in health care workers.\u003c/p>\n\u003cp class=\"p1\">“The idea is to shore up people’s resilience and be supportive of them,” Marin said. “They need to feel like they’re not in this alone.”\u003c/p>\n\u003cp class=\"p1\">The program includes a hotline, a wellness app and workshops designed to help connect nurses and doctors. She says the most important step is to ask for help, which could mean starting a conversation with a supervisor, friend or a therapist.\u003c/p>\n\u003cp class=\"p1\">Which could be good advice for not just doctors, but all of us.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "The US Has a Dwindling Number of Months to Contain COVID-19 Before a Winter Surge",
"headTitle": "The US Has a Dwindling Number of Months to Contain COVID-19 Before a Winter Surge | KQED",
"content": "\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">T\u003c/span>\u003c/span>he good news: The United States has a window of opportunity to beat back COVID-19 before things get much, much worse.\u003c/p>\n\u003cp>The bad news: That window is rapidly closing. And the country seems unwilling or unable to seize the moment.\u003c/p>\n\u003cp>Winter is coming. Winter means cold and flu season, which is all but sure to complicate the task of figuring out who is sick with COVID-19 and who is suffering from a less threatening respiratory tract infection. It also means that cherished outdoor freedoms that link us to pre-COVID life — pop-up restaurant patios, picnics in parks, trips to the beach — will soon be out of reach, at least in northern parts of the country.\u003c/p>\n\u003cp>Unless Americans use the dwindling weeks between now and the onset of “indoor weather” to tamp down transmission in the country, this winter could be Dickensianly bleak, public health experts warn.\u003c/p>\n\u003cp>“I think November, December, January, February are going to be tough months in this country without a vaccine,” said Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It is possible, of course, that some vaccines could be approved by then, thanks to \u003ca href=\"https://www.statnews.com/2020/07/30/a-huge-experiment-how-the-world-made-so-much-progress-on-a-covid-19-vaccine-so-fast/\" target=\"_blank\" rel=\"noopener noreferrer\">historically rapid scientific work\u003c/a>. But there is little prospect that vast numbers of Americans will be vaccinated in time to forestall the grim winter Osterholm and others foresee.\u003c/p>\n\u003cp>Human coronaviruses, the distant cold-causing cousins of the virus that causes COVID-19, circulate year-round. Now is typically the low season for transmission. But in this summer of America’s failed COVID-19 response, the SARS-CoV-2 virus is widespread across the country, and pandemic-weary Americans seem more interested in resuming pre-COVID lifestyles than in suppressing the virus to the point where schools can be reopened, and stay open, and restaurants, movie theaters, and gyms can function with some restrictions.\u003c/p>\n\u003cp>“We should be aiming for no transmission before we open the schools and we put kids in harm’s way — kids and teachers and their caregivers. And so, if that means no gym, no movie theaters, so be it,” said Caroline Buckee, associate director of the Center for Communicable Disease Dynamics at Harvard’s T.H. Chan School of Public Health.\u003c/p>\n\u003cp>“We seem to be choosing leisure activities now over children’s safety in a month’s time. And I cannot understand that trade-off.”\u003c/p>\n\u003cp>While many countries managed to suppress the spread of SARS-CoV-2, the United States has failed miserably. Countries in Europe and Asia are worrying about a second wave. Here, the first wave rages on, engulfing rural as well as urban parts of the country. Though there’s been a slight decline in cases in the past couple of weeks, more than 50,000 Americans a day are being diagnosed with COVID-19. And those are just the confirmed cases.\u003c/p>\n\u003cp>To put that in perspective, at this rate the U.S. is racking up more cases in a week than Britain has accumulated since the start of the pandemic.\u003c/p>\n\u003cp>Public health officials had hoped transmission of the virus would abate with the warm temperatures of summer and the tendency — heightened this year — of people to take their recreational activities outdoors. Experts do believe people are less likely to transmit the virus outside, especially if they are wearing face coverings and keeping a safe distance apart.\u003c/p>\n\u003cp>But in some places, people have been throwing COVID cautions to the wind, flouting public health orders in the process. Kristen Ehresmann, director of infectious disease epidemiology, prevention, and control for the Minnesota Department of Health, points to a \u003ca href=\"http://www.citypages.com/news/minnesota-sues-rodeo-for-flouting-coronavirus-rules/571995611\" target=\"_blank\" rel=\"noopener noreferrer\">large, three-day rodeo\u003c/a> that was held recently in her state. Organizers knew they were supposed to limit the number of attendees to 250 but refused; thousands attended. In Sturgis, South Dakota, an estimated quarter of a million motorcyclists were expected to descend on the city this past weekend for an annual rally that spans 10 days.\u003c/p>\n\u003cp>Even on smaller scales, public health authorities know some people are letting down their guard. Others have never embraced the need to try to prevent the spread of the virus. Ehresmann’s father was recently invited to visit some friends; he went, she said, but wore his mask, elbow bumping instead of shaking proffered hands. “And the people kind of acted like … ‘Oh, you drank that Kool-Aid,’ rather than, ‘We all need to be doing this.’”\u003c/p>\n\u003cp>Ehresmann and others in public health are flummoxed by the phenomenon of people refusing to acknowledge the risk the virus poses.\u003c/p>\n\u003cp>“Just this idea of, ‘I just don’t want to believe it so therefore it’s not going to be true’ — honestly, I have not really dealt with that as it relates to disease before,” she said.\u003c/p>\n\u003cp>Buckee, the Harvard expert, wonders if the \u003ca href=\"https://www.statnews.com/2020/04/20/the-months-of-magical-thinking-as-the-coronavirus-swept-over-china-some-experts-were-in-denial-about-what-was-to-come/\" target=\"_blank\" rel=\"noopener noreferrer\">magical thinking\u003c/a> that seems to have infected swaths of the country is due to the fact many of the people who have died were elderly. For many Americans, she said, the disease has not yet touched their lives — but the movement restrictions and other response measures have.\u003c/p>\n\u003cp>“I think if children were dying, this would be … a different situation, quite honestly,” she said.\u003c/p>\n\u003cp>Epidemiologist Michael Mina despairs that an important chance to wrestle the virus under control is being lost, as Americans ignore the realities of the pandemic in favor of trying to resume pre-COVID life.\u003c/p>\n\u003cp>“We just continue to squander every bit of opportunity we get with this epidemic to get it under control,’’ said Mina, an assistant professor at Harvard’s T.H. Chan School of Public Health and associate medical director of clinical microbiology at Boston’s Brigham and Women’s Hospital.\u003c/p>\n\u003cp>“The best time to squash a pandemic is when the environmental characteristics slow transmission. It’s your one opportunity in the year, really, to leverage that extra assistance and get transmission under control,” he said, his frustration audible.\u003c/p>\n\u003cp>Driving back transmission would require people to continue to make sacrifices, to accept the fact that life post-COVID cannot proceed as normal, not while so many people remain vulnerable to the virus. Instead, people are giddily throwing off the shackles of coronavirus suppression efforts, seemingly convinced that a few weeks of sacrifice during the spring was a one-time solution.\u003c/p>\n\u003cp>Osterholm has for months warned that people were being misled about how long the restrictions on daily life would need to be in place. He now thinks the time has come for \u003ca href=\"https://www.nytimes.com/2020/08/07/opinion/coronavirus-lockdown-unemployment-death.html?searchResultPosition=1\" target=\"_blank\" rel=\"noopener noreferrer\">another lockdown\u003c/a>. “What we did before and more,” he said.\u003c/p>\n\u003cp>The country has fallen into a dangerous pattern, Osterholm said, where a spike in cases in a location leads to some temporary restraint from people who eventually become alarmed enough to start to take precautions. But as soon as cases start to plateau or decline a little, victory over the virus is declared and people think it’s safe to resume normal life.\u003c/p>\n\u003cp>“It’s like an all or nothing phenomenon, right?” said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases. “You all locked down or you get so discouraged with being lockdown that you decide you’re going to be in crowded bars … you can have indoor parties with no masks. You can do all the things that are going to get you in trouble.”\u003c/p>\n\u003cp>Osterholm said with the K-12 school year resuming in some parts of the country or set to start — along with universities — in a few weeks, transmission will take off and cases will start to climb again. He predicted the next peaks will “exceed by far the peak we have just experienced. Winter is only going to reinforce that. Indoor air,” he said.\u003c/p>\n\u003cp>Buckee thinks that if the country doesn’t alter the trajectory it is on, more shutdowns are inevitable. “I can’t see a way that we’re going to have restaurants and bars open in the winter, frankly. We’ll have resurgence. Everything will get shut down again.”\u003c/p>\n\u003cp>Fauci favors a reset of the reopening measures, with a strong messaging component aimed at explaining to people why driving down transmission now will pay off later. Young people in particular need to understand that even if they are less likely to die from COVID-19, statistically speaking, transmission among 20-somethings will eventually lead to infections among their parents and grandparents, where the risk of severe infections and fatal outcomes is higher. (Young people can also develop long-term health problems as a result of the virus.)\u003c/p>\n\u003cp>“It’s not them alone in a vacuum,” Fauci said. “They are spreading it to the people who are going to wind up in the hospital.”\u003c/p>\n\u003cp>Everyone has to work together to get cases down to more manageable levels, if the country hopes to avoid “a disastrous winter,” he said.\u003c/p>\n\u003cp>“I think we can get it under much better control, between now and the mid-to-late fall when we get influenza or we get whatever it is we get in the fall and the winter. I’m not giving up,” Fauci said.\u003c/p>\n\u003cp>But without an all-in effort “the cases are not going to come down,” he warned. “They’re not. They’re just not.”\u003c/p>\n\u003cp>[ad floatright]\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\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 good news: The United States has a window of opportunity to beat back COVID-19 before things get much, much worse.\u003c/p>\n\u003cp>The bad news: That window is rapidly closing. And the country seems unwilling or unable to seize the moment.\u003c/p>\n\u003cp>Winter is coming. Winter means cold and flu season, which is all but sure to complicate the task of figuring out who is sick with COVID-19 and who is suffering from a less threatening respiratory tract infection. It also means that cherished outdoor freedoms that link us to pre-COVID life — pop-up restaurant patios, picnics in parks, trips to the beach — will soon be out of reach, at least in northern parts of the country.\u003c/p>\n\u003cp>Unless Americans use the dwindling weeks between now and the onset of “indoor weather” to tamp down transmission in the country, this winter could be Dickensianly bleak, public health experts warn.\u003c/p>\n\u003cp>“I think November, December, January, February are going to be tough months in this country without a vaccine,” said Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It is possible, of course, that some vaccines could be approved by then, thanks to \u003ca href=\"https://www.statnews.com/2020/07/30/a-huge-experiment-how-the-world-made-so-much-progress-on-a-covid-19-vaccine-so-fast/\" target=\"_blank\" rel=\"noopener noreferrer\">historically rapid scientific work\u003c/a>. But there is little prospect that vast numbers of Americans will be vaccinated in time to forestall the grim winter Osterholm and others foresee.\u003c/p>\n\u003cp>Human coronaviruses, the distant cold-causing cousins of the virus that causes COVID-19, circulate year-round. Now is typically the low season for transmission. But in this summer of America’s failed COVID-19 response, the SARS-CoV-2 virus is widespread across the country, and pandemic-weary Americans seem more interested in resuming pre-COVID lifestyles than in suppressing the virus to the point where schools can be reopened, and stay open, and restaurants, movie theaters, and gyms can function with some restrictions.\u003c/p>\n\u003cp>“We should be aiming for no transmission before we open the schools and we put kids in harm’s way — kids and teachers and their caregivers. And so, if that means no gym, no movie theaters, so be it,” said Caroline Buckee, associate director of the Center for Communicable Disease Dynamics at Harvard’s T.H. Chan School of Public Health.\u003c/p>\n\u003cp>“We seem to be choosing leisure activities now over children’s safety in a month’s time. And I cannot understand that trade-off.”\u003c/p>\n\u003cp>While many countries managed to suppress the spread of SARS-CoV-2, the United States has failed miserably. Countries in Europe and Asia are worrying about a second wave. Here, the first wave rages on, engulfing rural as well as urban parts of the country. Though there’s been a slight decline in cases in the past couple of weeks, more than 50,000 Americans a day are being diagnosed with COVID-19. And those are just the confirmed cases.\u003c/p>\n\u003cp>To put that in perspective, at this rate the U.S. is racking up more cases in a week than Britain has accumulated since the start of the pandemic.\u003c/p>\n\u003cp>Public health officials had hoped transmission of the virus would abate with the warm temperatures of summer and the tendency — heightened this year — of people to take their recreational activities outdoors. Experts do believe people are less likely to transmit the virus outside, especially if they are wearing face coverings and keeping a safe distance apart.\u003c/p>\n\u003cp>But in some places, people have been throwing COVID cautions to the wind, flouting public health orders in the process. Kristen Ehresmann, director of infectious disease epidemiology, prevention, and control for the Minnesota Department of Health, points to a \u003ca href=\"http://www.citypages.com/news/minnesota-sues-rodeo-for-flouting-coronavirus-rules/571995611\" target=\"_blank\" rel=\"noopener noreferrer\">large, three-day rodeo\u003c/a> that was held recently in her state. Organizers knew they were supposed to limit the number of attendees to 250 but refused; thousands attended. In Sturgis, South Dakota, an estimated quarter of a million motorcyclists were expected to descend on the city this past weekend for an annual rally that spans 10 days.\u003c/p>\n\u003cp>Even on smaller scales, public health authorities know some people are letting down their guard. Others have never embraced the need to try to prevent the spread of the virus. Ehresmann’s father was recently invited to visit some friends; he went, she said, but wore his mask, elbow bumping instead of shaking proffered hands. “And the people kind of acted like … ‘Oh, you drank that Kool-Aid,’ rather than, ‘We all need to be doing this.’”\u003c/p>\n\u003cp>Ehresmann and others in public health are flummoxed by the phenomenon of people refusing to acknowledge the risk the virus poses.\u003c/p>\n\u003cp>“Just this idea of, ‘I just don’t want to believe it so therefore it’s not going to be true’ — honestly, I have not really dealt with that as it relates to disease before,” she said.\u003c/p>\n\u003cp>Buckee, the Harvard expert, wonders if the \u003ca href=\"https://www.statnews.com/2020/04/20/the-months-of-magical-thinking-as-the-coronavirus-swept-over-china-some-experts-were-in-denial-about-what-was-to-come/\" target=\"_blank\" rel=\"noopener noreferrer\">magical thinking\u003c/a> that seems to have infected swaths of the country is due to the fact many of the people who have died were elderly. For many Americans, she said, the disease has not yet touched their lives — but the movement restrictions and other response measures have.\u003c/p>\n\u003cp>“I think if children were dying, this would be … a different situation, quite honestly,” she said.\u003c/p>\n\u003cp>Epidemiologist Michael Mina despairs that an important chance to wrestle the virus under control is being lost, as Americans ignore the realities of the pandemic in favor of trying to resume pre-COVID life.\u003c/p>\n\u003cp>“We just continue to squander every bit of opportunity we get with this epidemic to get it under control,’’ said Mina, an assistant professor at Harvard’s T.H. Chan School of Public Health and associate medical director of clinical microbiology at Boston’s Brigham and Women’s Hospital.\u003c/p>\n\u003cp>“The best time to squash a pandemic is when the environmental characteristics slow transmission. It’s your one opportunity in the year, really, to leverage that extra assistance and get transmission under control,” he said, his frustration audible.\u003c/p>\n\u003cp>Driving back transmission would require people to continue to make sacrifices, to accept the fact that life post-COVID cannot proceed as normal, not while so many people remain vulnerable to the virus. Instead, people are giddily throwing off the shackles of coronavirus suppression efforts, seemingly convinced that a few weeks of sacrifice during the spring was a one-time solution.\u003c/p>\n\u003cp>Osterholm has for months warned that people were being misled about how long the restrictions on daily life would need to be in place. He now thinks the time has come for \u003ca href=\"https://www.nytimes.com/2020/08/07/opinion/coronavirus-lockdown-unemployment-death.html?searchResultPosition=1\" target=\"_blank\" rel=\"noopener noreferrer\">another lockdown\u003c/a>. “What we did before and more,” he said.\u003c/p>\n\u003cp>The country has fallen into a dangerous pattern, Osterholm said, where a spike in cases in a location leads to some temporary restraint from people who eventually become alarmed enough to start to take precautions. But as soon as cases start to plateau or decline a little, victory over the virus is declared and people think it’s safe to resume normal life.\u003c/p>\n\u003cp>“It’s like an all or nothing phenomenon, right?” said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases. “You all locked down or you get so discouraged with being lockdown that you decide you’re going to be in crowded bars … you can have indoor parties with no masks. You can do all the things that are going to get you in trouble.”\u003c/p>\n\u003cp>Osterholm said with the K-12 school year resuming in some parts of the country or set to start — along with universities — in a few weeks, transmission will take off and cases will start to climb again. He predicted the next peaks will “exceed by far the peak we have just experienced. Winter is only going to reinforce that. Indoor air,” he said.\u003c/p>\n\u003cp>Buckee thinks that if the country doesn’t alter the trajectory it is on, more shutdowns are inevitable. “I can’t see a way that we’re going to have restaurants and bars open in the winter, frankly. We’ll have resurgence. Everything will get shut down again.”\u003c/p>\n\u003cp>Fauci favors a reset of the reopening measures, with a strong messaging component aimed at explaining to people why driving down transmission now will pay off later. Young people in particular need to understand that even if they are less likely to die from COVID-19, statistically speaking, transmission among 20-somethings will eventually lead to infections among their parents and grandparents, where the risk of severe infections and fatal outcomes is higher. (Young people can also develop long-term health problems as a result of the virus.)\u003c/p>\n\u003cp>“It’s not them alone in a vacuum,” Fauci said. “They are spreading it to the people who are going to wind up in the hospital.”\u003c/p>\n\u003cp>Everyone has to work together to get cases down to more manageable levels, if the country hopes to avoid “a disastrous winter,” he said.\u003c/p>\n\u003cp>“I think we can get it under much better control, between now and the mid-to-late fall when we get influenza or we get whatever it is we get in the fall and the winter. I’m not giving up,” Fauci said.\u003c/p>\n\u003cp>But without an all-in effort “the cases are not going to come down,” he warned. “They’re not. They’re just not.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Doctors say the antiviral drug remdesivir is one of the few treatments that benefits patients hospitalized with COVID-19. But the drug, made by Gilead Sciences, can cost more than $3,000 for the full course of treatment, and some hospitals — including several in the Bay Area — say it’s in short supply.\u003c/p>\n\u003cp>\u003ca href=\"https://www.gilead.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Foster City-based Gilead\u003c/a> is currently the only company making remdesivir, and \u003ca href=\"https://www.amerisourcebergen.com/\" target=\"_blank\" rel=\"noopener noreferrer\">AmerisourceBergen\u003c/a> is the sole distributor.\u003c/p>\n\u003cp>On Tuesday, California Attorney General Xavier Becerra \u003ca href=\"https://www.oag.ca.gov/system/files/attachments/press-docs/Remdesivir%20Letter%2020200804.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">sent a letter\u003c/a> to federal health officials, urging them to allow other companies to manufacture and distribute the drug.\u003c/p>\n\u003cp>The letter, which was addressed to top officials at the U.S. Department of Health and Human Services, the National Institutes of Health, and the federal Food and Drug Administration, was endorsed by a bipartisan coalition of 34 state attorneys general.\u003c/p>\n\u003cp>Gilead has \u003ca href=\"https://www.gilead.com/purpose/advancing-global-health/covid-19/working-to-supply-remdesivir-for-covid-19\" target=\"_blank\" rel=\"noopener noreferrer\">announced plans\u003c/a> to make 2 million courses of remdesivir, which can be either six or 10 vials, by the end of the year. Becerra’s letter calls that amount “dangerously low” to handle current or future coronavirus outbreaks.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>He says now is the time to produce more of the drug.\u003c/p>\n\u003cp>“If Gilead is not prepared to do it,” he said, “We have the right to say we’re going to try to do whatever we can, go wherever we must, to ramp up the supply.”\u003c/p>\n\u003cp>\u003cstrong>No ‘Secret Sauce’\u003c/strong>\u003c/p>\n\u003cp>Because the development of remdesivir was supported in part by federal tax dollars, including a $30 million NIH-funded clinical trial, Becerra says there are legal grounds for Washington to intervene.\u003c/p>\n\u003cp>“It’s not as if there’s a secret sauce here,” Becerra told KQED. “Folks know how to make this drug and the taxpayers helped make that drug possible. Let’s get it out there to folks.”\u003c/p>\n\u003cp>Under the \u003ca href=\"https://www.govinfo.gov/content/pkg/STATUTE-94/pdf/STATUTE-94-Pg3015.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Bayh-Dole Act\u003c/a>, the letter says, the federal government could make Gilead license its remdesivir patent to third party manufacturers.\u003c/p>\n\u003cp>An HHS spokesperson wrote in an email that because remdesivir wasn’t, “as a whole,” funded by the federal government, it doesn’t believe the Bayh-Dole Act applies in this case.\u003c/p>\n\u003cp>Gilead said in a statement it was “deeply disappointed” by the letter, and that it misrepresented the overall need for its drug:\u003c/p>\n\u003cblockquote>\u003cp>“One significant factual error is the assertion that all 3.5 million current COVID-19 patients should be treated with remdesivir. This assertion ignores the fact that not all COVID-19 patients are eligible to be treated with remdesivir and, thankfully, many will recover prior to hospitalization and never need the drug.”\u003c/p>\u003c/blockquote>\n\u003cp>Remdesivir was shown in one \u003ca href=\"https://www.kqed.org/science/1963229/government-study-shows-patients-responding-to-coronavirus-treatment-drugmaker-gilead-says\" target=\"_blank\" rel=\"noopener noreferrer\">controlled clinical trial\u003c/a> to reduce median COVID-19 hospital stays by about four days.\u003c/p>\n\u003cp>\u003cstrong>Desperate Hospitals\u003c/strong>\u003c/p>\n\u003cp>Dr. Peter Chin-Hong, an infectious disease specialist at UCSF, says that on Tuesday the hospital was down to two vials of remdesivir, with another shipment expected, but not guaranteed, to arrive soon.\u003c/p>\n\u003cp>Chin-Hong says local hospitals have sent each other vials of remdesivir, when able, so that their COVID-19 patients can get the treatment.\u003c/p>\n\u003cp>“We’re definitely desperate for the drug,” said Chin-Hong. “At the clinical end, health care providers currently in 2020 spend a disproportionate amount of time bartering [the] drug, sourcing the drug, trying to play remdesivir Tetris where we’re constantly figuring out, do we have enough?”\u003c/p>\n\u003cp>With the expectation of another coronavirus surge this winter, Chin-Hong says suppliers need to come together to make more remdesivir.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The timing of the attorney general’s letter is actually perfect,” he said, “because if we decide to do something now, we could have an impact on that winter surge.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors say the antiviral drug remdesivir is one of the few treatments that benefits patients hospitalized with COVID-19. But the drug, made by Gilead Sciences, can cost more than $3,000 for the full course of treatment, and some hospitals — including several in the Bay Area — say it’s in short supply.\u003c/p>\n\u003cp>\u003ca href=\"https://www.gilead.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Foster City-based Gilead\u003c/a> is currently the only company making remdesivir, and \u003ca href=\"https://www.amerisourcebergen.com/\" target=\"_blank\" rel=\"noopener noreferrer\">AmerisourceBergen\u003c/a> is the sole distributor.\u003c/p>\n\u003cp>On Tuesday, California Attorney General Xavier Becerra \u003ca href=\"https://www.oag.ca.gov/system/files/attachments/press-docs/Remdesivir%20Letter%2020200804.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">sent a letter\u003c/a> to federal health officials, urging them to allow other companies to manufacture and distribute the drug.\u003c/p>\n\u003cp>The letter, which was addressed to top officials at the U.S. Department of Health and Human Services, the National Institutes of Health, and the federal Food and Drug Administration, was endorsed by a bipartisan coalition of 34 state attorneys general.\u003c/p>\n\u003cp>Gilead has \u003ca href=\"https://www.gilead.com/purpose/advancing-global-health/covid-19/working-to-supply-remdesivir-for-covid-19\" target=\"_blank\" rel=\"noopener noreferrer\">announced plans\u003c/a> to make 2 million courses of remdesivir, which can be either six or 10 vials, by the end of the year. Becerra’s letter calls that amount “dangerously low” to handle current or future coronavirus outbreaks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>He says now is the time to produce more of the drug.\u003c/p>\n\u003cp>“If Gilead is not prepared to do it,” he said, “We have the right to say we’re going to try to do whatever we can, go wherever we must, to ramp up the supply.”\u003c/p>\n\u003cp>\u003cstrong>No ‘Secret Sauce’\u003c/strong>\u003c/p>\n\u003cp>Because the development of remdesivir was supported in part by federal tax dollars, including a $30 million NIH-funded clinical trial, Becerra says there are legal grounds for Washington to intervene.\u003c/p>\n\u003cp>“It’s not as if there’s a secret sauce here,” Becerra told KQED. “Folks know how to make this drug and the taxpayers helped make that drug possible. Let’s get it out there to folks.”\u003c/p>\n\u003cp>Under the \u003ca href=\"https://www.govinfo.gov/content/pkg/STATUTE-94/pdf/STATUTE-94-Pg3015.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Bayh-Dole Act\u003c/a>, the letter says, the federal government could make Gilead license its remdesivir patent to third party manufacturers.\u003c/p>\n\u003cp>An HHS spokesperson wrote in an email that because remdesivir wasn’t, “as a whole,” funded by the federal government, it doesn’t believe the Bayh-Dole Act applies in this case.\u003c/p>\n\u003cp>Gilead said in a statement it was “deeply disappointed” by the letter, and that it misrepresented the overall need for its drug:\u003c/p>\n\u003cblockquote>\u003cp>“One significant factual error is the assertion that all 3.5 million current COVID-19 patients should be treated with remdesivir. This assertion ignores the fact that not all COVID-19 patients are eligible to be treated with remdesivir and, thankfully, many will recover prior to hospitalization and never need the drug.”\u003c/p>\u003c/blockquote>\n\u003cp>Remdesivir was shown in one \u003ca href=\"https://www.kqed.org/science/1963229/government-study-shows-patients-responding-to-coronavirus-treatment-drugmaker-gilead-says\" target=\"_blank\" rel=\"noopener noreferrer\">controlled clinical trial\u003c/a> to reduce median COVID-19 hospital stays by about four days.\u003c/p>\n\u003cp>\u003cstrong>Desperate Hospitals\u003c/strong>\u003c/p>\n\u003cp>Dr. Peter Chin-Hong, an infectious disease specialist at UCSF, says that on Tuesday the hospital was down to two vials of remdesivir, with another shipment expected, but not guaranteed, to arrive soon.\u003c/p>\n\u003cp>Chin-Hong says local hospitals have sent each other vials of remdesivir, when able, so that their COVID-19 patients can get the treatment.\u003c/p>\n\u003cp>“We’re definitely desperate for the drug,” said Chin-Hong. “At the clinical end, health care providers currently in 2020 spend a disproportionate amount of time bartering [the] drug, sourcing the drug, trying to play remdesivir Tetris where we’re constantly figuring out, do we have enough?”\u003c/p>\n\u003cp>With the expectation of another coronavirus surge this winter, Chin-Hong says suppliers need to come together to make more remdesivir.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The timing of the attorney general’s letter is actually perfect,” he said, “because if we decide to do something now, we could have an impact on that winter surge.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
"meta": {
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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}
},
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"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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}
},
"city-arts": {
"id": "city-arts",
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"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2",
"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"meta": {
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"rss": "https://feeds.megaphone.fm/KQINC2275451163"
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"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.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"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>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"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.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"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?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"spotify": "https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"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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"info": "One of public radio's most dynamic voices, Sam Sanders helped launch The NPR Politics Podcast and hosted NPR's hit show It's Been A Minute. Now, the award-winning host returns with something brand new, The Sam Sanders Show. Every week, Sam Sanders and friends dig into the culture that shapes our lives: what's driving the biggest trends, how artists really think, and even the memes you can't stop scrolling past. Sam is beloved for his way of unpacking the world and bringing you up close to fresh currents and engaging conversations. The Sam Sanders Show is smart, funny and always a good time.",
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