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"content": "\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">W\u003c/span>\u003c/span>hen there’s a public health crisis or disaster like the coronavirus pandemic, experts know that the official death tally is going to be an undercount by some extent. Some people who die might never have been tested for the disease, for example, and if people die at home without receiving medical care, they might not make it into the confirmed data.\u003c/p>\n\u003cp>To address that, researchers often look to what are called excess deaths — the number of deaths overall during a particular period of time compared to how many people die during the stretch in a normal year.\u003c/p>\n\u003cp>Now, in the most \u003ca href=\"https://www.cdc.gov/mmwr/volumes/69/wr/mm6942e2.htm?s_cid=mm6942e2_w\" target=\"_blank\" rel=\"noopener noreferrer\">updated count to date\u003c/a>, researchers at the Centers for Disease Control and Prevention have found that nearly 300,000 more people in the United States died from late January to early October this year compared to the average number of people who died in recent years. Just two-thirds of those deaths were counted as COVID-19 fatalities, highlighting how the official U.S. death count — now standing at about 220,000 — is not fully inclusive.\u003c/p>\n\u003cp>To be exact, the researchers reported that 299,028 more people died from Jan. 26 to Oct. 3 this year than on average during the same stretch from 2015 to 2019. Excess deaths also occurred at higher rates among Latinx, Asian, American Indian, and Black people than among white people, mirroring the disparities in official U.S. COVID-19 death counts.\u003c/p>\n\u003cp>Most likely, the excess deaths account for some otherwise untallied COVID-19 deaths — those who may have died without being tested or who died at home and whose deaths were not counted as caused by the coronavirus. But the 300,000 number probably also includes people who died because they were scared to seek out medical care because of the pandemic or had their care interrupted, and because of other causes. One limitation of the study, the researchers noted, was that the U.S. population is growing and getting older, so more deaths might have occurred in 2020 versus recent years without a pandemic, making a direct comparison harder.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Deaths among white people in 2020 were just 11.9% higher than average years, a much lower increase than deaths among Latinx people (53.6% higher than average), Asian people (36.6% higher), Black people (32.9% higher), and American Indians and Alaska Natives (28.9% higher). “These disproportionate increases among certain racial and ethnic groups are consistent with noted disparities in COVID-19 mortality,” the researchers wrote.\u003c/p>\n\u003cp>There were also differences among different age groups, with the largest increase occurring among people age 25 to 44, who saw excess deaths that were 26.5% higher than average. People 45 to 64 had 14.4% more deaths, while those 65 to 74 had 24.1% more deaths. Deaths among people 75 to 84 were 21.5% higher and 14.7% higher for people 85 and above. Deaths this year for people under 25, however, were 2% below average.\u003c/p>\n\u003cp>\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\">W\u003c/span>\u003c/span>hen there’s a public health crisis or disaster like the coronavirus pandemic, experts know that the official death tally is going to be an undercount by some extent. Some people who die might never have been tested for the disease, for example, and if people die at home without receiving medical care, they might not make it into the confirmed data.\u003c/p>\n\u003cp>To address that, researchers often look to what are called excess deaths — the number of deaths overall during a particular period of time compared to how many people die during the stretch in a normal year.\u003c/p>\n\u003cp>Now, in the most \u003ca href=\"https://www.cdc.gov/mmwr/volumes/69/wr/mm6942e2.htm?s_cid=mm6942e2_w\" target=\"_blank\" rel=\"noopener noreferrer\">updated count to date\u003c/a>, researchers at the Centers for Disease Control and Prevention have found that nearly 300,000 more people in the United States died from late January to early October this year compared to the average number of people who died in recent years. Just two-thirds of those deaths were counted as COVID-19 fatalities, highlighting how the official U.S. death count — now standing at about 220,000 — is not fully inclusive.\u003c/p>\n\u003cp>To be exact, the researchers reported that 299,028 more people died from Jan. 26 to Oct. 3 this year than on average during the same stretch from 2015 to 2019. Excess deaths also occurred at higher rates among Latinx, Asian, American Indian, and Black people than among white people, mirroring the disparities in official U.S. COVID-19 death counts.\u003c/p>\n\u003cp>Most likely, the excess deaths account for some otherwise untallied COVID-19 deaths — those who may have died without being tested or who died at home and whose deaths were not counted as caused by the coronavirus. But the 300,000 number probably also includes people who died because they were scared to seek out medical care because of the pandemic or had their care interrupted, and because of other causes. One limitation of the study, the researchers noted, was that the U.S. population is growing and getting older, so more deaths might have occurred in 2020 versus recent years without a pandemic, making a direct comparison harder.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Deaths among white people in 2020 were just 11.9% higher than average years, a much lower increase than deaths among Latinx people (53.6% higher than average), Asian people (36.6% higher), Black people (32.9% higher), and American Indians and Alaska Natives (28.9% higher). “These disproportionate increases among certain racial and ethnic groups are consistent with noted disparities in COVID-19 mortality,” the researchers wrote.\u003c/p>\n\u003cp>There were also differences among different age groups, with the largest increase occurring among people age 25 to 44, who saw excess deaths that were 26.5% higher than average. People 45 to 64 had 14.4% more deaths, while those 65 to 74 had 24.1% more deaths. Deaths among people 75 to 84 were 21.5% higher and 14.7% higher for people 85 and above. Deaths this year for people under 25, however, were 2% below average.\u003c/p>\n\u003cp>\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\u003c/div>\u003c/p>",
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"content": "\u003cp class=\"p1\">We’re in the middle of the worst public health crisis in a century, one in which adherence to public health guidelines makes all the difference between an out-of-control pestilence and a serious but containable emergency.\u003c/p>\n\u003cp class=\"p1\">California, at the beginning of the coronavirus pandemic, slowed what looked to be its inexorable spread with an extraordinary yet simple solution:\u003c/p>\n\u003cp class=\"p1\">Shut it all down. \u003ci>Everything\u003c/i>.\u003c/p>\n\u003cp>[pullquote citation='Dr. John Swartzberg, UC Berkeley School of Public Health']‘To get people to change their behavior, to forbid them to do something, is not usually successful.’[/pullquote]\u003c/p>\n\u003cp class=\"p1\">But aside from the economic consequences of sheltering an entire state in place, public health officials were aware of another reason that asking people to remain totally insulated from the dangers of the coronavirus would have diminishing returns:\u003c/p>\n\u003cp class=\"p1\">From a public health perspective, pasting a proverbial big X over something is frequently a losing bet.\u003c/p>\n\u003cp class=\"p3\">“To get people to change their behavior, to forbid them to do something is not usually successful,” said Dr. John Swartzberg, clinical professor emeritus at the UC Berkeley School of Public Health\u003ci>.\u003c/i>\u003c/p>\n\u003cp class=\"p3\">Swartzberg points to the U.S. ban on alcohol, in effect from 1920 to 1933, as a historical example.\u003c/p>\n\u003cfigure id=\"attachment_1970293\" class=\"wp-caption alignright\" style=\"max-width: 600px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2029/10/pandemic-1918-photos.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1970293 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2029/10/pandemic-1918-photos.jpg\" alt=\"\" width=\"600\" height=\"830\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2029/10/pandemic-1918-photos.jpg 600w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/10/pandemic-1918-photos-160x221.jpg 160w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A streetcar conductor in Seattle won’t allow a passenger aboard without a mask in 1918. \u003ccite>(U.S. National Archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p3\">Prohibition, Swartzberg says, was a “puritanical” approach to eradicating real societal ills associated with drinking. But it was ultimately repealed, and it’s widely viewed as a failure due to unintended consequences that included the rise of organized crime through bootlegging and the deaths of people who consumed toxic illegal alcohol.\u003c/p>\n\u003cp class=\"p3\">Today, governments use a well-established strategy called harm reduction to help \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876518/\">\u003cspan class=\"s1\">mitigate\u003c/span>\u003c/a> the negative effects of not only alcohol but a host of other public health risks, including the spread of COVID-19.\u003c/p>\n\u003cp class=\"p1\">The basic principle behind harm reduction: Don’t tell people they absolutely can’t do something, because it won’t work as well as allowing the behavior, but with added rules to reduce risk.\u003c/p>\n\u003cp class=\"p3\">If Prohibition is a cautionary tale of what happens when harm reduction is left out of the equation, the concept of safer sex is a textbook example of how it can work.\u003c/p>\n\u003cp class=\"p3\">In the earliest days of the HIV crisis, Swartzberg says, health officials promoted an abstinence-only message.\u003c/p>\n\u003cp class=\"p3\">“That clearly didn’t work,” he said, so it was dropped in favor of encouraging people to engage in practices like using condoms and getting tested for the virus.\u003c/p>\n\u003cp class=\"p3\">“We know you’re going to go have sex. But if you’re having sex, here’s what you can do to reduce your risk and your partner’s risk. That was a much more\u003cspan class=\"Apple-converted-space\"> \u003c/span>successful policy. It’s the same thing with what we’re talking about with COVID.”\u003c/p>\n\u003cp class=\"p1\">As scientists continue to work on therapies to address the disease, Bay Area health officials have made one thing clear: Social distancing and masking, ways of reducing risk from the coronavirus, are here to stay for a good while longer. A safe and effective vaccine may be at least several months away; meanwhile all the data has shown that wearing masks and avoiding indoor gatherings are keys to slowing the spread of the disease.\u003c/p>\n\u003cp class=\"p1\">While many months into the crisis people may be suffering mask-wearing and social distancing fatigue, public health experts say the rules are designed to actually allow people more freedom, not less, compared to the constraints of a strict lockdown.\u003c/p>\n\u003cp class=\"p1\">The incremental reopening of different parts of the economy as California counties move through the state’s \u003ca href=\"https://covid19.ca.gov/safer-economy/\">\u003cspan class=\"s1\">risk assessment levels\u003c/span>\u003c/a> is a case in point for how a society can modulate harm reduction in response to changing circumstances. At the highest risk level, the state allows shopping malls to open at 25% capacity; at the next highest, it’s 50%; and at the next, 100%, but with closed common areas and reduced-capacity food courts. In other words, the harm reduction measures ratchet down as the risk subsides.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p1\">\u003cb>Buckling Up\u003c/b>\u003c/p>\n\u003cp class=\"p1\">Passing safety laws and getting people to embrace them can take years or even decades. While it’s standard practice now for us to buckle up before pulling out of the driveway, modern automobile seat belts weren’t invented until the 1950s, a half-century after Ford brought motorcars to the masses with the Model T. The idea for retractable belts in passenger cars is credited to a \u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/302856\">\u003cspan class=\"s1\">neurologist in Pasadena\u003c/span>\u003c/a>, who’d been treating a large number of patients suffering from head traumas sustained in car crashes.\u003c/p>\n\u003cp class=\"p1\">But the U.S. didn’t require car manufacturers to equip vehicles with seat belts until1968. Even then, no law required passengers to wear them. That occurred in the 1980s, when states began mandating people to buckle up or risk a fine.\u003c/p>\n\u003cp class=\"p1\">With COVID-19, Swartzberg says, we can’t afford that long of an adjustment period; people have to embrace harm reduction now to keep the virus from spreading. Most public health officials agree that the lack of consistent messaging from federal leadership about the efficacy of these practices has been a major barrier to fighting the pandemic in the U.S. For example, a \u003cspan class=\"s2\">recently released \u003ca href=\"https://int.nyt.com/data/documenttools/evanega-et-al-coronavirus-misinformation-submitted-07-23-20-1/080839ac0c22bca8/full.pdf\">\u003cspan class=\"s3\">study\u003c/span>\u003c/a> by Cornell University researchers found that President Trump is “likely the \u003ca href=\"https://www.nytimes.com/2020/09/30/us/politics/trump-coronavirus-misinformation.html\">\u003cspan class=\"s3\">largest driver\u003c/span>\u003c/a>” of COVID-19 misinformation. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cb>Secondhand Smoke\u003c/b>\u003c/p>\n\u003cp class=\"p1\">Some health experts say the lessons learned from anti-tobacco campaigns show that certain strategies may be more effective than others at changing people’s behavior.\u003c/p>\n\u003cp class=\"p1\">Dr. Richard Jackson, professor emeritus at the UCLA Fielding School of Public Health and a former state of California public health officer, says getting to the point where bans were enacted on smoking in public spaces like restaurants, planes and parks took years. What eventually tipped the scales for lawmakers and the American public, Jackson says, was not the message that smoking is bad for you, but rather that lighting up can harm other people.\u003c/p>\n\u003cp class=\"p3\">\u003ci>“\u003c/i>It was when we showed that flight attendants were actually getting sick from being in a confined space with a lot of smokers, that was the beginning,” Jackson said. “But eventually, over time, it led to the ban of indoor smoking\u003ci>.”\u003c/i>\u003c/p>\n\u003cp class=\"p3\">It wasn’t until 1995 that California paved the way for smoking bans when it became the first state to outlaw smoking in indoor workplaces.\u003c/p>\n\u003cp class=\"p3\">Behavioral economists have a name for actions that affect not ourselves but other people or the whole of society: externalities.\u003c/p>\n\u003cp class=\"p3\">Mask wearing can reduce the externalities of leaving your house during the COVID-19 pandemic because studies show that it helps prevent virus transmission to other people, who may not even know they’re contagious.\u003c/p>\n\u003cp class=\"p3\">When it comes to choosing not to wear a mask, Jackson says, a person might argue: “It’s my life, I can take that risk.” But helping them understand that flaunting this precaution can endanger a child, a loved one, an innocent bystander — what Jackson calls “sympathetic victims” — may encourage holdouts to think twice about ignoring public health orders.\u003c/p>\n\u003cp class=\"p3\">\u003cb>Cultural Differences\u003c/b>\u003c/p>\n\u003cp class=\"p3\">The coronavirus pandemic isn’t the first time Americans have been asked to pull masks over their faces, avoid crowds, and subject themselves to a shutdown of parts of the economy to fight a deadly virus.\u003c/p>\n\u003cp class=\"p3\">Doctors prescribed a strikingly similar regimen to fight the 1918 Spanish influenza pandemic, says Dr. Lee Riley, head of the infectious disease and vaccinology division at the UC Berkeley School of Public Health. An estimated 50 million people worldwide and 675,000 in the U.S. died from complications caused by the virus, \u003ca href=\"https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm\">\u003cspan class=\"s1\">according\u003c/span>\u003c/a> to the U.S. Centers for Disease Control and Prevention.\u003c/p>\n\u003cp class=\"p3\">“If you look at some pictures from that period, a lot of people were wearing masks,” Riley said. “They washed their hands, kept social distance, and local governments tried to make sure that people didn’t congregate in large numbers, everything that they’re saying right now.”\u003c/p>\n\u003cp class=\"p3\">Studies suggest public health measures \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1849868/\">\u003cspan class=\"s1\">reduced\u003c/span>\u003c/a> the 1918 flu pandemic \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1849868/\">\u003cspan class=\"s1\">up to 50 \u003c/span>\u003c/a>% in some cities where they were implemented early on.\u003c/p>\n\u003cp class=\"p3\">“That was a big pandemic, almost two years,” Riley said, “And eventually this virus petered out. So the public health measures work.” He added that the pandemic was contained long before the first approved flu vaccine, which was developed in the 1940s.\u003c/p>\n\u003cp class=\"p3\">Riley points out that wearing masks to thwart disease has become the social norm in some countries around the world, particularly in Asia. He grew up in Japan in the 1950s and remembers wearing a mask to elementary school.\u003c/p>\n\u003cp class=\"p3\">Because reliable vaccines to fight influenza or bacterial respiratory diseases didn’t yet exist, wearing a mask was the primary way people kept from getting sick, Riley says. But there was also a cultural incentive.\u003c/p>\n\u003cp class=\"p3\">“There’s a phrase in Japan that was instilled in all little kids: Never cause harm to strangers and your neighbors,” he said. “And so one major driving force why people will wear a mask is not just to protect themselves, but also (to) prevent the transmission.”\u003c/p>\n\u003cp class=\"p3\">Japan, Riley said, is a more socially conscious culture when compared with more individualistic societies in the West. When it comes to fighting the pandemic, he says the U.S. could benefit from this baked-in harm reduction philosophy.\u003c/p>\n\u003cp class=\"p3\">“I think, you know, Americans are not that different from other people when they start really thinking about this.” he said. “And when we have a good leadership model, we can really serve as a model.”\u003c/p>\n\u003cp>\u003cem>Jon Brooks contributed to this report.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"title": "From Condoms to Coronavirus Masks, 'Harm Reduction' Has Worked to Protect Public Health | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">We’re in the middle of the worst public health crisis in a century, one in which adherence to public health guidelines makes all the difference between an out-of-control pestilence and a serious but containable emergency.\u003c/p>\n\u003cp class=\"p1\">California, at the beginning of the coronavirus pandemic, slowed what looked to be its inexorable spread with an extraordinary yet simple solution:\u003c/p>\n\u003cp class=\"p1\">Shut it all down. \u003ci>Everything\u003c/i>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘To get people to change their behavior, to forbid them to do something, is not usually successful.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">But aside from the economic consequences of sheltering an entire state in place, public health officials were aware of another reason that asking people to remain totally insulated from the dangers of the coronavirus would have diminishing returns:\u003c/p>\n\u003cp class=\"p1\">From a public health perspective, pasting a proverbial big X over something is frequently a losing bet.\u003c/p>\n\u003cp class=\"p3\">“To get people to change their behavior, to forbid them to do something is not usually successful,” said Dr. John Swartzberg, clinical professor emeritus at the UC Berkeley School of Public Health\u003ci>.\u003c/i>\u003c/p>\n\u003cp class=\"p3\">Swartzberg points to the U.S. ban on alcohol, in effect from 1920 to 1933, as a historical example.\u003c/p>\n\u003cfigure id=\"attachment_1970293\" class=\"wp-caption alignright\" style=\"max-width: 600px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2029/10/pandemic-1918-photos.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1970293 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2029/10/pandemic-1918-photos.jpg\" alt=\"\" width=\"600\" height=\"830\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2029/10/pandemic-1918-photos.jpg 600w, https://cdn.kqed.org/wp-content/uploads/sites/35/2029/10/pandemic-1918-photos-160x221.jpg 160w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A streetcar conductor in Seattle won’t allow a passenger aboard without a mask in 1918. \u003ccite>(U.S. National Archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p3\">Prohibition, Swartzberg says, was a “puritanical” approach to eradicating real societal ills associated with drinking. But it was ultimately repealed, and it’s widely viewed as a failure due to unintended consequences that included the rise of organized crime through bootlegging and the deaths of people who consumed toxic illegal alcohol.\u003c/p>\n\u003cp class=\"p3\">Today, governments use a well-established strategy called harm reduction to help \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876518/\">\u003cspan class=\"s1\">mitigate\u003c/span>\u003c/a> the negative effects of not only alcohol but a host of other public health risks, including the spread of COVID-19.\u003c/p>\n\u003cp class=\"p1\">The basic principle behind harm reduction: Don’t tell people they absolutely can’t do something, because it won’t work as well as allowing the behavior, but with added rules to reduce risk.\u003c/p>\n\u003cp class=\"p3\">If Prohibition is a cautionary tale of what happens when harm reduction is left out of the equation, the concept of safer sex is a textbook example of how it can work.\u003c/p>\n\u003cp class=\"p3\">In the earliest days of the HIV crisis, Swartzberg says, health officials promoted an abstinence-only message.\u003c/p>\n\u003cp class=\"p3\">“That clearly didn’t work,” he said, so it was dropped in favor of encouraging people to engage in practices like using condoms and getting tested for the virus.\u003c/p>\n\u003cp class=\"p3\">“We know you’re going to go have sex. But if you’re having sex, here’s what you can do to reduce your risk and your partner’s risk. That was a much more\u003cspan class=\"Apple-converted-space\"> \u003c/span>successful policy. It’s the same thing with what we’re talking about with COVID.”\u003c/p>\n\u003cp class=\"p1\">As scientists continue to work on therapies to address the disease, Bay Area health officials have made one thing clear: Social distancing and masking, ways of reducing risk from the coronavirus, are here to stay for a good while longer. A safe and effective vaccine may be at least several months away; meanwhile all the data has shown that wearing masks and avoiding indoor gatherings are keys to slowing the spread of the disease.\u003c/p>\n\u003cp class=\"p1\">While many months into the crisis people may be suffering mask-wearing and social distancing fatigue, public health experts say the rules are designed to actually allow people more freedom, not less, compared to the constraints of a strict lockdown.\u003c/p>\n\u003cp class=\"p1\">The incremental reopening of different parts of the economy as California counties move through the state’s \u003ca href=\"https://covid19.ca.gov/safer-economy/\">\u003cspan class=\"s1\">risk assessment levels\u003c/span>\u003c/a> is a case in point for how a society can modulate harm reduction in response to changing circumstances. At the highest risk level, the state allows shopping malls to open at 25% capacity; at the next highest, it’s 50%; and at the next, 100%, but with closed common areas and reduced-capacity food courts. In other words, the harm reduction measures ratchet down as the risk subsides.\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>Buckling Up\u003c/b>\u003c/p>\n\u003cp class=\"p1\">Passing safety laws and getting people to embrace them can take years or even decades. While it’s standard practice now for us to buckle up before pulling out of the driveway, modern automobile seat belts weren’t invented until the 1950s, a half-century after Ford brought motorcars to the masses with the Model T. The idea for retractable belts in passenger cars is credited to a \u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/302856\">\u003cspan class=\"s1\">neurologist in Pasadena\u003c/span>\u003c/a>, who’d been treating a large number of patients suffering from head traumas sustained in car crashes.\u003c/p>\n\u003cp class=\"p1\">But the U.S. didn’t require car manufacturers to equip vehicles with seat belts until1968. Even then, no law required passengers to wear them. That occurred in the 1980s, when states began mandating people to buckle up or risk a fine.\u003c/p>\n\u003cp class=\"p1\">With COVID-19, Swartzberg says, we can’t afford that long of an adjustment period; people have to embrace harm reduction now to keep the virus from spreading. Most public health officials agree that the lack of consistent messaging from federal leadership about the efficacy of these practices has been a major barrier to fighting the pandemic in the U.S. For example, a \u003cspan class=\"s2\">recently released \u003ca href=\"https://int.nyt.com/data/documenttools/evanega-et-al-coronavirus-misinformation-submitted-07-23-20-1/080839ac0c22bca8/full.pdf\">\u003cspan class=\"s3\">study\u003c/span>\u003c/a> by Cornell University researchers found that President Trump is “likely the \u003ca href=\"https://www.nytimes.com/2020/09/30/us/politics/trump-coronavirus-misinformation.html\">\u003cspan class=\"s3\">largest driver\u003c/span>\u003c/a>” of COVID-19 misinformation. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cb>Secondhand Smoke\u003c/b>\u003c/p>\n\u003cp class=\"p1\">Some health experts say the lessons learned from anti-tobacco campaigns show that certain strategies may be more effective than others at changing people’s behavior.\u003c/p>\n\u003cp class=\"p1\">Dr. Richard Jackson, professor emeritus at the UCLA Fielding School of Public Health and a former state of California public health officer, says getting to the point where bans were enacted on smoking in public spaces like restaurants, planes and parks took years. What eventually tipped the scales for lawmakers and the American public, Jackson says, was not the message that smoking is bad for you, but rather that lighting up can harm other people.\u003c/p>\n\u003cp class=\"p3\">\u003ci>“\u003c/i>It was when we showed that flight attendants were actually getting sick from being in a confined space with a lot of smokers, that was the beginning,” Jackson said. “But eventually, over time, it led to the ban of indoor smoking\u003ci>.”\u003c/i>\u003c/p>\n\u003cp class=\"p3\">It wasn’t until 1995 that California paved the way for smoking bans when it became the first state to outlaw smoking in indoor workplaces.\u003c/p>\n\u003cp class=\"p3\">Behavioral economists have a name for actions that affect not ourselves but other people or the whole of society: externalities.\u003c/p>\n\u003cp class=\"p3\">Mask wearing can reduce the externalities of leaving your house during the COVID-19 pandemic because studies show that it helps prevent virus transmission to other people, who may not even know they’re contagious.\u003c/p>\n\u003cp class=\"p3\">When it comes to choosing not to wear a mask, Jackson says, a person might argue: “It’s my life, I can take that risk.” But helping them understand that flaunting this precaution can endanger a child, a loved one, an innocent bystander — what Jackson calls “sympathetic victims” — may encourage holdouts to think twice about ignoring public health orders.\u003c/p>\n\u003cp class=\"p3\">\u003cb>Cultural Differences\u003c/b>\u003c/p>\n\u003cp class=\"p3\">The coronavirus pandemic isn’t the first time Americans have been asked to pull masks over their faces, avoid crowds, and subject themselves to a shutdown of parts of the economy to fight a deadly virus.\u003c/p>\n\u003cp class=\"p3\">Doctors prescribed a strikingly similar regimen to fight the 1918 Spanish influenza pandemic, says Dr. Lee Riley, head of the infectious disease and vaccinology division at the UC Berkeley School of Public Health. An estimated 50 million people worldwide and 675,000 in the U.S. died from complications caused by the virus, \u003ca href=\"https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm\">\u003cspan class=\"s1\">according\u003c/span>\u003c/a> to the U.S. Centers for Disease Control and Prevention.\u003c/p>\n\u003cp class=\"p3\">“If you look at some pictures from that period, a lot of people were wearing masks,” Riley said. “They washed their hands, kept social distance, and local governments tried to make sure that people didn’t congregate in large numbers, everything that they’re saying right now.”\u003c/p>\n\u003cp class=\"p3\">Studies suggest public health measures \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1849868/\">\u003cspan class=\"s1\">reduced\u003c/span>\u003c/a> the 1918 flu pandemic \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1849868/\">\u003cspan class=\"s1\">up to 50 \u003c/span>\u003c/a>% in some cities where they were implemented early on.\u003c/p>\n\u003cp class=\"p3\">“That was a big pandemic, almost two years,” Riley said, “And eventually this virus petered out. So the public health measures work.” He added that the pandemic was contained long before the first approved flu vaccine, which was developed in the 1940s.\u003c/p>\n\u003cp class=\"p3\">Riley points out that wearing masks to thwart disease has become the social norm in some countries around the world, particularly in Asia. He grew up in Japan in the 1950s and remembers wearing a mask to elementary school.\u003c/p>\n\u003cp class=\"p3\">Because reliable vaccines to fight influenza or bacterial respiratory diseases didn’t yet exist, wearing a mask was the primary way people kept from getting sick, Riley says. But there was also a cultural incentive.\u003c/p>\n\u003cp class=\"p3\">“There’s a phrase in Japan that was instilled in all little kids: Never cause harm to strangers and your neighbors,” he said. “And so one major driving force why people will wear a mask is not just to protect themselves, but also (to) prevent the transmission.”\u003c/p>\n\u003cp class=\"p3\">Japan, Riley said, is a more socially conscious culture when compared with more individualistic societies in the West. When it comes to fighting the pandemic, he says the U.S. could benefit from this baked-in harm reduction philosophy.\u003c/p>\n\u003cp class=\"p3\">“I think, you know, Americans are not that different from other people when they start really thinking about this.” he said. “And when we have a good leadership model, we can really serve as a model.”\u003c/p>\n\u003cp>\u003cem>Jon Brooks contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "FDA Releases Stricter Vaccine Safety Guidelines Despite White House Interference",
"headTitle": "FDA Releases Stricter Vaccine Safety Guidelines Despite White House Interference | KQED",
"content": "\u003cp>The Food and Drug Administration released updated safety standards Tuesday for makers of COVID-19 vaccines despite efforts by the White House to block them, clearing the way for requirements that are widely expected to prevent the introduction of a vaccine before Election Day.\u003c/p>\n\u003cp>In the new guidelines posted on its website, the FDA said vaccine makers should follow trial participants for at least two months to rule out any major side effects before seeking emergency approval. That standard had been a sticking point between the FDA and White House officials, who said it could unreasonably delay the availability of COVID-19 vaccines.\u003c/p>\n\u003cp>President Donald Trump has repeatedly insisted a vaccine could be authorized before Nov. 3, even though top government scientists working on the effort have said that timeline is very unlikely. On Monday Trump said vaccines are coming “momentarily,” in a video recorded after he returned to the White House.\u003c/p>\n\u003cp>Former FDA officials have warned that public perception that a vaccine was being rushed out for political reasons could derail efforts to vaccinate millions of Americans.\u003c/p>\n\u003cp>A senior administration official confirmed Monday that the White House had blocked FDA’s plans to formally publish the safety guidelines based on the two-month data requirement, arguing there was “no clinical or medical reason” for it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But on Tuesday, the FDA posted the guidance on its website, making clear that regulators plan to impose the safety standards for any vaccine seeking an expedited path to market.\u003c/p>\n\u003cp>FDA Commissioner Stephen Hahn said in a statement that he hoped the guidelines would help “the public understand our science-based decision-making process that assures vaccine quality, safety and efficacy.”\u003c/p>\n\u003cp>The requirements are aimed at companies seeking rapid approval through the FDA’s emergency authorization pathway. That accelerated process, reserved for health emergencies, allows medical products onto the market based on a lower bar than traditional FDA approval. But FDA has made clear only vaccines that are shown to be safe and effective will be authorized for coronavirus.\u003c/p>\n\u003cp>Former FDA acting commissioner Dr. Stephen Ostroff said the requirements seem reasonable given the agency is in largely “uncharted territory” in terms of considering emergency use of a vaccine. The agency has only previously cleared one vaccine through the method — a decades-old shot that was authorized to prevent anthrax poisoning in 2005.\u003c/p>\n\u003cp>“There really is no margin for error here,” Ostroff said. “Even when you’re talking about limited use of a vaccine there has to be some level of assurance that there isn’t a risk here that would far outweigh the benefit.”\u003c/p>\n\u003cp>Dr. Peter Marks, the head of FDA’s vaccine division, said Tuesday that the two-month follow-up requirement was chosen to be “something reasonably aggressive, but not too conservative — right in the middle.” He spoke at a symposium organized by Johns Hopkins University.\u003c/p>\n\u003cp>Initial doses of vaccines for emergency use would likely be reserved for medical workers and people with health conditions that make them particularly vulnerable to coronavirus. Full FDA approval for the general population will require significantly more data and is not expected until mid-2021.\u003c/p>\n\u003cp>The White House attempt to block the guidance followed a string of instances in which the Trump administration has undercut its own medical experts working to combat the pandemic. FDA’s Hahn has been attempting to shore up public confidence in the vaccine review process for weeks, vowing that career scientists, not politicians, will decide if the shots are safe and effective.\u003c/p>\n\u003cp>Pfizer CEO Albert Bourla has stoked excitement by saying that he expects data on whether the company’s candidate works to be ready in late October. But a number of variables would still have to align for the company to submit, and the FDA to review and greenlight, a vaccine application before Nov. 3. Pfizer’s competitors Moderna, AstraZeneca and Johnson & Johnson are working on longer research timelines.\u003c/p>\n\u003cp>Vaccine development typically takes years, but the U.S. government has invested billions in efforts to accelerate the process and help multiple drugmakers prepare multiple candidates. All the doses will be purchased by the federal government for use vaccinating the U.S. population.\u003c/p>\n\u003cp>Beyond exposing the rift between the White House and FDA, the delay in releasing the guidelines may have had limited practical effect.\u003c/p>\n\u003cp>FDA scientists have been discussing the guidelines publicly for weeks and have made clear that the recommendations have already been shared with each of the vaccine developers.\u003c/p>\n\u003cp>Former FDA Commissioner Scott Gottlieb said Tuesday that drugmakers depend on the FDA’s science-based endorsement to vouch for the safety and effectiveness of their products.\u003c/p>\n\u003cp>“I can’t imagine a circumstance where a sponsor would challenge or seek to undermine the FDA’s role here,” Gottlieb said at the COVID-19 symposium. “This is precisely the moment when we need an objective, neutral arbiter.”\u003c/p>\n\u003cp>Last week, Gottlieb and six other former FDA commissioners blasted the Trump administration for “undermining the credibility” of the agency in a op-ed calling for the release of the then-stalled vaccine guidelines.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Scientists should make decisions based on data, unfettered by political pressure or the intrusions of ideology or vested interests,” the officials wrote.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Food and Drug Administration released updated safety standards Tuesday for makers of COVID-19 vaccines despite efforts by the White House to block them, clearing the way for requirements that are widely expected to prevent the introduction of a vaccine before Election Day.\u003c/p>\n\u003cp>In the new guidelines posted on its website, the FDA said vaccine makers should follow trial participants for at least two months to rule out any major side effects before seeking emergency approval. That standard had been a sticking point between the FDA and White House officials, who said it could unreasonably delay the availability of COVID-19 vaccines.\u003c/p>\n\u003cp>President Donald Trump has repeatedly insisted a vaccine could be authorized before Nov. 3, even though top government scientists working on the effort have said that timeline is very unlikely. On Monday Trump said vaccines are coming “momentarily,” in a video recorded after he returned to the White House.\u003c/p>\n\u003cp>Former FDA officials have warned that public perception that a vaccine was being rushed out for political reasons could derail efforts to vaccinate millions of Americans.\u003c/p>\n\u003cp>A senior administration official confirmed Monday that the White House had blocked FDA’s plans to formally publish the safety guidelines based on the two-month data requirement, arguing there was “no clinical or medical reason” for it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But on Tuesday, the FDA posted the guidance on its website, making clear that regulators plan to impose the safety standards for any vaccine seeking an expedited path to market.\u003c/p>\n\u003cp>FDA Commissioner Stephen Hahn said in a statement that he hoped the guidelines would help “the public understand our science-based decision-making process that assures vaccine quality, safety and efficacy.”\u003c/p>\n\u003cp>The requirements are aimed at companies seeking rapid approval through the FDA’s emergency authorization pathway. That accelerated process, reserved for health emergencies, allows medical products onto the market based on a lower bar than traditional FDA approval. But FDA has made clear only vaccines that are shown to be safe and effective will be authorized for coronavirus.\u003c/p>\n\u003cp>Former FDA acting commissioner Dr. Stephen Ostroff said the requirements seem reasonable given the agency is in largely “uncharted territory” in terms of considering emergency use of a vaccine. The agency has only previously cleared one vaccine through the method — a decades-old shot that was authorized to prevent anthrax poisoning in 2005.\u003c/p>\n\u003cp>“There really is no margin for error here,” Ostroff said. “Even when you’re talking about limited use of a vaccine there has to be some level of assurance that there isn’t a risk here that would far outweigh the benefit.”\u003c/p>\n\u003cp>Dr. Peter Marks, the head of FDA’s vaccine division, said Tuesday that the two-month follow-up requirement was chosen to be “something reasonably aggressive, but not too conservative — right in the middle.” He spoke at a symposium organized by Johns Hopkins University.\u003c/p>\n\u003cp>Initial doses of vaccines for emergency use would likely be reserved for medical workers and people with health conditions that make them particularly vulnerable to coronavirus. Full FDA approval for the general population will require significantly more data and is not expected until mid-2021.\u003c/p>\n\u003cp>The White House attempt to block the guidance followed a string of instances in which the Trump administration has undercut its own medical experts working to combat the pandemic. FDA’s Hahn has been attempting to shore up public confidence in the vaccine review process for weeks, vowing that career scientists, not politicians, will decide if the shots are safe and effective.\u003c/p>\n\u003cp>Pfizer CEO Albert Bourla has stoked excitement by saying that he expects data on whether the company’s candidate works to be ready in late October. But a number of variables would still have to align for the company to submit, and the FDA to review and greenlight, a vaccine application before Nov. 3. Pfizer’s competitors Moderna, AstraZeneca and Johnson & Johnson are working on longer research timelines.\u003c/p>\n\u003cp>Vaccine development typically takes years, but the U.S. government has invested billions in efforts to accelerate the process and help multiple drugmakers prepare multiple candidates. All the doses will be purchased by the federal government for use vaccinating the U.S. population.\u003c/p>\n\u003cp>Beyond exposing the rift between the White House and FDA, the delay in releasing the guidelines may have had limited practical effect.\u003c/p>\n\u003cp>FDA scientists have been discussing the guidelines publicly for weeks and have made clear that the recommendations have already been shared with each of the vaccine developers.\u003c/p>\n\u003cp>Former FDA Commissioner Scott Gottlieb said Tuesday that drugmakers depend on the FDA’s science-based endorsement to vouch for the safety and effectiveness of their products.\u003c/p>\n\u003cp>“I can’t imagine a circumstance where a sponsor would challenge or seek to undermine the FDA’s role here,” Gottlieb said at the COVID-19 symposium. “This is precisely the moment when we need an objective, neutral arbiter.”\u003c/p>\n\u003cp>Last week, Gottlieb and six other former FDA commissioners blasted the Trump administration for “undermining the credibility” of the agency in a op-ed calling for the release of the then-stalled vaccine guidelines.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Scientists should make decisions based on data, unfettered by political pressure or the intrusions of ideology or vested interests,” the officials wrote.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>After dismissing the threat of the COVID-19 pandemic for months, President Trump announced \u003ca href=\"https://twitter.com/realDonaldTrump/status/1311892190680014849\" target=\"_blank\" rel=\"noopener noreferrer\">on Twitter\u003c/a> late Thursday night that he and his wife, Melania, had tested positive for the coronavirus that causes the disease. The White House on Friday said Trump is experiencing “mild” symptoms and that he will \u003ca href=\"https://www.npr.org/2020/10/02/919697784/trump-makes-unannounced-visit-to-walter-reed-following-coronavirus-diagnosis\" target=\"_blank\" rel=\"noopener noreferrer\">work \u003c/a>from Walter Reed hospital “for the next few days.”\u003c/p>\n\u003cp>On KQED’s \u003ca href=\"https://www.kqed.org/forum/2010101880055/president-trump-tests-positive-for-coronavirus\" target=\"_blank\" rel=\"noopener noreferrer\">Forum\u003c/a> radio program Friday, \u003cstrong>Dr. Bob Wachter\u003c/strong>, chair of the Department of Medicine at UCSF, spoke with host Michael Krasny about the prognosis for Trump, what therapeutics may be available to him, and an assessment of the president’s response to the pandemic from a public health perspective.\u003c/p>\n\u003cp>The following has been edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>What is the prognosis for someone of President Trump’s age, height and weight, and other characteristics?\u003c/strong>\u003c/p>\n\u003cp>\u003cem>Bob Wachter\u003c/em>: As we go through the checkboxes of what would give you a worse prognosis, he checks off many if not all of them. Older is worse than younger, and once you get up to 74 years old, your chance of dying is somewhere around 100 times greater than if you got it in your 20s. But his chances of survival are quite good; from what we know from public information, his chances of dying are about 1 in 20, though that’s probably about 10 times greater than the average person who gets COVID.\u003c/p>\n\u003cp>[pullquote citation=\"Dr. Bob Wachter, UCSF\"]‘As we go through the checkboxes of what would give you a worse prognosis, he checks off many if not all of them. But his chances of survival are quite good.’[/pullquote]Men do almost twice as poorly as women for reasons that aren’t fully understood. He also meets the clinical definition of obesity in terms of his body mass index. That makes his prognosis three times worse than if he wasn’t obese.\u003c/p>\n\u003cp>Whatever other illnesses he has, and they have not been forthcoming about his medical record, that can only add to the negative prognostic signs. He already comes into this with a fair number of points against him.\u003c/p>\n\u003cp>That doesn’t mean he’s likely to do poorly, but the fact that he has symptoms means that he already is not in the best category: About 40% of people who get the coronavirus are asymptomatic through the entire course of the illness; maybe a little bit less than that because some are presymptomatic.\u003c/p>\n\u003cp>You might say, “the symptoms are mild.” Is that reassuring? I would say not at all. Because he gets tested every day, we know he only got it a couple of days ago. So he’s very early in his course. It would be highly surprising for him to be worse than just mildly symptomatic now. And his period of greatest risk will come in the next seven to 10 days or so.\u003c/p>\n\u003cp>\u003cstrong>What therapeutics is President Trump eligible for? Which ones do you think would help?\u003c/strong>\u003c/p>\n\u003cp>There is no proven treatment for early COVID in terms of preventing the illness from getting worse and leading to a shortness of breath or hospitalization or ultimately respiratory failure.\u003c/p>\n\u003cp>[pullquote]‘It would be highly surprising for him to be worse than just mildly symptomatic [at this stage]. His period of greatest risk will come in the next seven to 10 days or so.’[/pullquote]The only treatments that have been approved are ones that we know work for sure, and they’re only given for patients who are sick and are in the hospital. One is an antiviral drug called remdesivir, \u003cb>\u003c/b>generally only available to people who are already sick and in the hospital. The other is an anti-inflammatory medicine called dexamethasone, which is a form of steroid.\u003c/p>\n\u003cp>There’s a set of therapeutics, which have shown promise in early studies, called monoclonal antibodies. They’re essentially an artificial form of antibodies. It’s very expensive, so it won’t be widely used, but giving it to people before they’re sick enough to need to be hospitalized — and it’s too early to be sure about this — lowers the rate of hospitalization and sickness. My guess is that they will figure out a way to get the president one of those drugs, even though it’s not generally available to the public.\u003c/p>\n\u003cp>There was a lot of discussion on Twitter last night about how even though he’s got these negative prognostic signs — his age, his obesity and being male — he’ll also get the best care in the world.\u003c/p>\n\u003cp>[pullquote]‘As people have mapped out what a pandemic would look like over the last 20, 30, 40 years, there was no scenario in which the federal government would have become part of the problem.’[/pullquote]That might make a difference if it turns out these drugs work and he has access to them, whereas the rest of us wouldn’t. But I can tell you that in my experience and in the literature, there’s no great evidence that VIPs do better. And actually, sometimes they do worse because as you remember from \u003ca href=\"https://www.kqed.org/news/42207/steve-jobs-think-different-philosophy-included-approach-to-cancer-treatment\" target=\"_blank\" rel=\"noopener noreferrer\">Steve Jobs\u003c/a>, sometimes they dictate their own care and it’s not evidence-based. Sometimes the care is somewhat chaotic because everybody is falling over themselves to take care of the patient. And so in terms of the VIP stuff, I wouldn’t think that his odds are any better than the average patient coming into the emergency room at UCSF today.\u003c/p>\n\u003cp>\u003cstrong>Can you talk about the rapid tests they use at the White House?\u003c/strong>\u003c/p>\n\u003cp>They are getting better. A new one has just come out, but I don’t think it’s being used yet at the White House. They do have false negatives.\u003c/p>\n\u003cp>It’s unusual, but there have been false positives with that test as well. It happened with Gov. [Mike] DeWine of Ohio. And so the first positive test that came back from the president last night might’ve been the rapid one. But by now, though they’re really not being transparent at all about this, because we could use a lot more information about the test, I assume he’s had the better, PCR test, and that both tests were positive. I don’t think they would have come out publicly unless they confirmed both tests.\u003c/p>\n\u003cp>I think part of the theme here is that in the environment of the White House, where people were being tested every day, they took that, I believe, as reassurance that nobody around the president could have COVID, and it’s OK, therefore, not to follow the public health guidelines. And that clearly was a mistake.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Joe Biden’s test came back negative. Could it be too early, though, for the test to be definitive?\u003c/strong>\u003c/p>\n\u003cp>The answer is yes. So it will be important that he has follow-up tests. It takes a few days of incubation period for the virus to replicate enough in order to have a positive test. So if the vice president’s exposure was through the debate, having a negative test today is certainly more reassuring than a positive test, but he would not be out of the woods. You’d want to see tests for another several days.\u003c/p>\n\u003cp>Biden’s risk should be extremely low. First of all, he’s been extraordinarily careful for the entire time. In terms of the debate itself, I didn’t see a measurement, but it looked like he was standing 15 to 20 feet away, which is generally, although not 100%, a safe distance.\u003c/p>\n\u003cp>\u003cstrong>What effect do you think this will have on the next planned debates? The next one, conducted in a town hall format, is scheduled for Oct. 15.\u003c/strong>\u003c/p>\n\u003cp>I think they’ll pay more attention to the risk of the virus in any kind of public gathering, so I imagine the rules will be somewhat different in terms of additional spacing. And certainly everybody in the audience will wear masks.\u003c/p>\n\u003cp>You know, it’s a little bit hard to say in terms of future presidential debates, because the president has symptoms now. In general, we say that two weeks after the onset of symptoms, you are no longer infectious, even if you are continuing to test positive.\u003c/p>\n\u003cp>In the beginning, we saw people with persistently positive viral tests for weeks and weeks and wondered if they were still infectious. And the evidence is really quite clear that a couple of weeks out, you’re no longer infectious, even though you may still test positive because you have the virus.\u003c/p>\n\u003cp>But certainly for the next two weeks, the president needs to be in absolutely strict quarantine. It would be public health malpractice to do an in-person debate within a couple of weeks of someone developing the coronavirus.\u003c/p>\n\u003cp>\u003cstrong>In a \u003ca href=\"https://int.nyt.com/data/documenttools/evanega-et-al-coronavirus-misinformation-submitted-07-23-20-1/080839ac0c22bca8/full.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> released this week, Cornell University researchers found that President Trump is “likely the \u003ca href=\"https://www.nytimes.com/2020/09/30/us/politics/trump-coronavirus-misinformation.html\" target=\"_blank\" rel=\"noopener noreferrer\">largest driver\u003c/a>” of COVID-19 misinformation. What has been the president’s effect on public health? \u003c/strong>\u003c/p>\n\u003cp>We can feel sympathy for the person and still feel like this pandemic has been mishandled at a national level. And the source of much of that is the president; there’s just no two ways about it.\u003c/p>\n\u003cp>It’s very hard to look at his responses all the way through and see anything good about them. Really, under any estimate that I can come up, with that has cost tens of thousands of lives.\u003c/p>\n\u003cp>We look at San Francisco, which just had its 100th death last week from COVID. If the entire country had our death rate, we would have had 165,000 fewer deaths. In San Francisco, our bodies are exactly the same, and the virus is exactly the same. But in an area where there was good political leadership and where the people wore masks and paid attention to the science, that is the kind of difference that could have been made.\u003c/p>\n\u003cp>I believe that had there been presidential leadership, as I think we would have expected — coming out early saying this is serious, here’s what you need to do, the kind of thing that he obviously knew about according to his \u003ca href=\"https://www.cnn.com/2020/09/09/politics/bob-woodward-rage-book-trump-coronavirus/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">discussions\u003c/a> with Bob Woodward — I believe that we would have had tens of thousands if not 100,000 or more fewer deaths.\u003c/p>\n\u003cp>I try to be fair and say this would have been bad under anyone’s watch. It would’ve been a major challenge to the system, and people would have died. But it didn’t have to be like this and doesn’t have to be like this.\u003c/p>\n\u003cp>You know, as people have mapped out and gamed out what a pandemic would look like over the last 20, 30, 40 years, there was no scenario in which the federal government would have become part of the problem, would have been the source of misinformation, would have shackled the main agency responsible for prevention and educating people about what to do. That was not on the list of things that we needed to worry about.\u003c/p>\n\u003cp>\u003cstrong>What effect do you think President Trump’s contracting the virus will have on public health going forward? \u003c/strong>\u003c/p>\n\u003cp>\u003cb>\u003c/b>If there’s any good that comes out of this, it will be that people who did not take this seriously will take it more seriously. You know, if the president can get it, anybody can get it.\u003c/p>\n\u003cp>There sometimes is this feeling that we’re out of the woods. It’s just clearly not true. The virus hasn’t changed in a material way over the course of eight or nine months, and neither have we. We are all susceptible.\u003c/p>\n\u003cp>What’s remarkable is we know the things that one needs to do to lower your chance of contracting the coronavirus. And unfortunately, the president has doubled down on not doing those things. Obviously we wish him well. But there was a lot of foolish behavior that went into this.\u003c/p>\n\u003cp>A lot will hinge on how he does. If he has a mild case, he may feel a little bit crummy for a few days or a week or so and be back to normal. And you wonder what will come out of the politics of that if he recovers. There is also a decent chance that he will do poorly.\u003c/p>\n\u003cp>\u003cstrong>Can we say that this finally puts to rest the idea that hydroxychloroquine can indeed be a prophylactic? The president took it for weeks and swore by it. \u003c/strong>\u003c/p>\n\u003cp>What puts that idea to rest is the fact that there have been more than a dozen studies on that question. But no, I think it’s hazardous to use single-case patient examples. That’s part of what gets the president in trouble: He sees a case where the patient miraculously got better. And the next thing you know, he’s touting it as a cure. That’s why we need science. The fact that he may have been taking hydroxychloroquine and he still got sick is interesting, but to me not persuasive. What’s persuasive is that it has been massively studied, and the evidence is quite clear that it does not work.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After dismissing the threat of the COVID-19 pandemic for months, President Trump announced \u003ca href=\"https://twitter.com/realDonaldTrump/status/1311892190680014849\" target=\"_blank\" rel=\"noopener noreferrer\">on Twitter\u003c/a> late Thursday night that he and his wife, Melania, had tested positive for the coronavirus that causes the disease. The White House on Friday said Trump is experiencing “mild” symptoms and that he will \u003ca href=\"https://www.npr.org/2020/10/02/919697784/trump-makes-unannounced-visit-to-walter-reed-following-coronavirus-diagnosis\" target=\"_blank\" rel=\"noopener noreferrer\">work \u003c/a>from Walter Reed hospital “for the next few days.”\u003c/p>\n\u003cp>On KQED’s \u003ca href=\"https://www.kqed.org/forum/2010101880055/president-trump-tests-positive-for-coronavirus\" target=\"_blank\" rel=\"noopener noreferrer\">Forum\u003c/a> radio program Friday, \u003cstrong>Dr. Bob Wachter\u003c/strong>, chair of the Department of Medicine at UCSF, spoke with host Michael Krasny about the prognosis for Trump, what therapeutics may be available to him, and an assessment of the president’s response to the pandemic from a public health perspective.\u003c/p>\n\u003cp>The following has been edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>What is the prognosis for someone of President Trump’s age, height and weight, and other characteristics?\u003c/strong>\u003c/p>\n\u003cp>\u003cem>Bob Wachter\u003c/em>: As we go through the checkboxes of what would give you a worse prognosis, he checks off many if not all of them. Older is worse than younger, and once you get up to 74 years old, your chance of dying is somewhere around 100 times greater than if you got it in your 20s. But his chances of survival are quite good; from what we know from public information, his chances of dying are about 1 in 20, though that’s probably about 10 times greater than the average person who gets COVID.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘As we go through the checkboxes of what would give you a worse prognosis, he checks off many if not all of them. But his chances of survival are quite good.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Men do almost twice as poorly as women for reasons that aren’t fully understood. He also meets the clinical definition of obesity in terms of his body mass index. That makes his prognosis three times worse than if he wasn’t obese.\u003c/p>\n\u003cp>Whatever other illnesses he has, and they have not been forthcoming about his medical record, that can only add to the negative prognostic signs. He already comes into this with a fair number of points against him.\u003c/p>\n\u003cp>That doesn’t mean he’s likely to do poorly, but the fact that he has symptoms means that he already is not in the best category: About 40% of people who get the coronavirus are asymptomatic through the entire course of the illness; maybe a little bit less than that because some are presymptomatic.\u003c/p>\n\u003cp>You might say, “the symptoms are mild.” Is that reassuring? I would say not at all. Because he gets tested every day, we know he only got it a couple of days ago. So he’s very early in his course. It would be highly surprising for him to be worse than just mildly symptomatic now. And his period of greatest risk will come in the next seven to 10 days or so.\u003c/p>\n\u003cp>\u003cstrong>What therapeutics is President Trump eligible for? Which ones do you think would help?\u003c/strong>\u003c/p>\n\u003cp>There is no proven treatment for early COVID in terms of preventing the illness from getting worse and leading to a shortness of breath or hospitalization or ultimately respiratory failure.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘It would be highly surprising for him to be worse than just mildly symptomatic [at this stage]. His period of greatest risk will come in the next seven to 10 days or so.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The only treatments that have been approved are ones that we know work for sure, and they’re only given for patients who are sick and are in the hospital. One is an antiviral drug called remdesivir, \u003cb>\u003c/b>generally only available to people who are already sick and in the hospital. The other is an anti-inflammatory medicine called dexamethasone, which is a form of steroid.\u003c/p>\n\u003cp>There’s a set of therapeutics, which have shown promise in early studies, called monoclonal antibodies. They’re essentially an artificial form of antibodies. It’s very expensive, so it won’t be widely used, but giving it to people before they’re sick enough to need to be hospitalized — and it’s too early to be sure about this — lowers the rate of hospitalization and sickness. My guess is that they will figure out a way to get the president one of those drugs, even though it’s not generally available to the public.\u003c/p>\n\u003cp>There was a lot of discussion on Twitter last night about how even though he’s got these negative prognostic signs — his age, his obesity and being male — he’ll also get the best care in the world.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘As people have mapped out what a pandemic would look like over the last 20, 30, 40 years, there was no scenario in which the federal government would have become part of the problem.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>That might make a difference if it turns out these drugs work and he has access to them, whereas the rest of us wouldn’t. But I can tell you that in my experience and in the literature, there’s no great evidence that VIPs do better. And actually, sometimes they do worse because as you remember from \u003ca href=\"https://www.kqed.org/news/42207/steve-jobs-think-different-philosophy-included-approach-to-cancer-treatment\" target=\"_blank\" rel=\"noopener noreferrer\">Steve Jobs\u003c/a>, sometimes they dictate their own care and it’s not evidence-based. Sometimes the care is somewhat chaotic because everybody is falling over themselves to take care of the patient. And so in terms of the VIP stuff, I wouldn’t think that his odds are any better than the average patient coming into the emergency room at UCSF today.\u003c/p>\n\u003cp>\u003cstrong>Can you talk about the rapid tests they use at the White House?\u003c/strong>\u003c/p>\n\u003cp>They are getting better. A new one has just come out, but I don’t think it’s being used yet at the White House. They do have false negatives.\u003c/p>\n\u003cp>It’s unusual, but there have been false positives with that test as well. It happened with Gov. [Mike] DeWine of Ohio. And so the first positive test that came back from the president last night might’ve been the rapid one. But by now, though they’re really not being transparent at all about this, because we could use a lot more information about the test, I assume he’s had the better, PCR test, and that both tests were positive. I don’t think they would have come out publicly unless they confirmed both tests.\u003c/p>\n\u003cp>I think part of the theme here is that in the environment of the White House, where people were being tested every day, they took that, I believe, as reassurance that nobody around the president could have COVID, and it’s OK, therefore, not to follow the public health guidelines. And that clearly was a mistake.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Joe Biden’s test came back negative. Could it be too early, though, for the test to be definitive?\u003c/strong>\u003c/p>\n\u003cp>The answer is yes. So it will be important that he has follow-up tests. It takes a few days of incubation period for the virus to replicate enough in order to have a positive test. So if the vice president’s exposure was through the debate, having a negative test today is certainly more reassuring than a positive test, but he would not be out of the woods. You’d want to see tests for another several days.\u003c/p>\n\u003cp>Biden’s risk should be extremely low. First of all, he’s been extraordinarily careful for the entire time. In terms of the debate itself, I didn’t see a measurement, but it looked like he was standing 15 to 20 feet away, which is generally, although not 100%, a safe distance.\u003c/p>\n\u003cp>\u003cstrong>What effect do you think this will have on the next planned debates? The next one, conducted in a town hall format, is scheduled for Oct. 15.\u003c/strong>\u003c/p>\n\u003cp>I think they’ll pay more attention to the risk of the virus in any kind of public gathering, so I imagine the rules will be somewhat different in terms of additional spacing. And certainly everybody in the audience will wear masks.\u003c/p>\n\u003cp>You know, it’s a little bit hard to say in terms of future presidential debates, because the president has symptoms now. In general, we say that two weeks after the onset of symptoms, you are no longer infectious, even if you are continuing to test positive.\u003c/p>\n\u003cp>In the beginning, we saw people with persistently positive viral tests for weeks and weeks and wondered if they were still infectious. And the evidence is really quite clear that a couple of weeks out, you’re no longer infectious, even though you may still test positive because you have the virus.\u003c/p>\n\u003cp>But certainly for the next two weeks, the president needs to be in absolutely strict quarantine. It would be public health malpractice to do an in-person debate within a couple of weeks of someone developing the coronavirus.\u003c/p>\n\u003cp>\u003cstrong>In a \u003ca href=\"https://int.nyt.com/data/documenttools/evanega-et-al-coronavirus-misinformation-submitted-07-23-20-1/080839ac0c22bca8/full.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> released this week, Cornell University researchers found that President Trump is “likely the \u003ca href=\"https://www.nytimes.com/2020/09/30/us/politics/trump-coronavirus-misinformation.html\" target=\"_blank\" rel=\"noopener noreferrer\">largest driver\u003c/a>” of COVID-19 misinformation. What has been the president’s effect on public health? \u003c/strong>\u003c/p>\n\u003cp>We can feel sympathy for the person and still feel like this pandemic has been mishandled at a national level. And the source of much of that is the president; there’s just no two ways about it.\u003c/p>\n\u003cp>It’s very hard to look at his responses all the way through and see anything good about them. Really, under any estimate that I can come up, with that has cost tens of thousands of lives.\u003c/p>\n\u003cp>We look at San Francisco, which just had its 100th death last week from COVID. If the entire country had our death rate, we would have had 165,000 fewer deaths. In San Francisco, our bodies are exactly the same, and the virus is exactly the same. But in an area where there was good political leadership and where the people wore masks and paid attention to the science, that is the kind of difference that could have been made.\u003c/p>\n\u003cp>I believe that had there been presidential leadership, as I think we would have expected — coming out early saying this is serious, here’s what you need to do, the kind of thing that he obviously knew about according to his \u003ca href=\"https://www.cnn.com/2020/09/09/politics/bob-woodward-rage-book-trump-coronavirus/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">discussions\u003c/a> with Bob Woodward — I believe that we would have had tens of thousands if not 100,000 or more fewer deaths.\u003c/p>\n\u003cp>I try to be fair and say this would have been bad under anyone’s watch. It would’ve been a major challenge to the system, and people would have died. But it didn’t have to be like this and doesn’t have to be like this.\u003c/p>\n\u003cp>You know, as people have mapped out and gamed out what a pandemic would look like over the last 20, 30, 40 years, there was no scenario in which the federal government would have become part of the problem, would have been the source of misinformation, would have shackled the main agency responsible for prevention and educating people about what to do. That was not on the list of things that we needed to worry about.\u003c/p>\n\u003cp>\u003cstrong>What effect do you think President Trump’s contracting the virus will have on public health going forward? \u003c/strong>\u003c/p>\n\u003cp>\u003cb>\u003c/b>If there’s any good that comes out of this, it will be that people who did not take this seriously will take it more seriously. You know, if the president can get it, anybody can get it.\u003c/p>\n\u003cp>There sometimes is this feeling that we’re out of the woods. It’s just clearly not true. The virus hasn’t changed in a material way over the course of eight or nine months, and neither have we. We are all susceptible.\u003c/p>\n\u003cp>What’s remarkable is we know the things that one needs to do to lower your chance of contracting the coronavirus. And unfortunately, the president has doubled down on not doing those things. Obviously we wish him well. But there was a lot of foolish behavior that went into this.\u003c/p>\n\u003cp>A lot will hinge on how he does. If he has a mild case, he may feel a little bit crummy for a few days or a week or so and be back to normal. And you wonder what will come out of the politics of that if he recovers. There is also a decent chance that he will do poorly.\u003c/p>\n\u003cp>\u003cstrong>Can we say that this finally puts to rest the idea that hydroxychloroquine can indeed be a prophylactic? The president took it for weeks and swore by it. \u003c/strong>\u003c/p>\n\u003cp>What puts that idea to rest is the fact that there have been more than a dozen studies on that question. But no, I think it’s hazardous to use single-case patient examples. That’s part of what gets the president in trouble: He sees a case where the patient miraculously got better. And the next thing you know, he’s touting it as a cure. That’s why we need science. The fact that he may have been taking hydroxychloroquine and he still got sick is interesting, but to me not persuasive. What’s persuasive is that it has been massively studied, and the evidence is quite clear that it does not work.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Jury Duty During a Pandemic: How Safe Is It?",
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"content": "\u003cp>When I recently received a jury summons in the mail, it brought with it more than the usual onset of angst. It included a flyer titled “Attention Prospective Jurors,” outlining COVID protections the courts had put in place.\u003c/p>\n\u003cp>Some of the bullet points didn’t offer a lot of solace. “With current social distancing rules,” the flyer read, “the assembly room will only seat a maximum of 40 to 50 prospective jurors.” Given the current guidelines of social pods not exceeding 12 people, this made me nervous. So, I decided to explore COVID protections put in place by Superior Courts around the Bay Area. I reached out to courts in\u003ca href=\"https://www.sfsuperiorcourt.org/\"> San Francisco\u003c/a>,\u003ca href=\"https://www.sanmateocourt.org/\"> San Mateo\u003c/a>,\u003ca href=\"http://www.alameda.courts.ca.gov/\"> Alameda, \u003c/a>\u003ca href=\"https://www.scscourt.org/\"> Santa Clara\u003c/a> and \u003ca href=\"https://www.marincourt.org/juror_services_overview.htm\">Marin\u003c/a> counties.\u003c/p>\n\u003cp>When the coronavirus hit and lockdowns began in mid-March, jury trials\u003ca href=\"https://www.cc-courts.org/general/docs/StatewideOrderByTheChiefJustice-COVID19Order-03-23-2020.pdf\"> paused\u003c/a>. The Judicial Council of California, the court system’s policymaking body, created a pandemic working group. In June, it issued a 75-page\u003ca href=\"https://live-jcc-newsroom.pantheonsite.io/sites/default/files/newsroom/2020-09/Pandemic%20Working%20Group%20Resource%20Guide.pdf\"> resource guide,\u003c/a> a set of best practices or recommendations. According to a spokesperson for the JCC, the working group used information from state, local and national health officials — including the federal Occupational Safety and Health Administration, Centers for Disease Control and Prevention, and the National Center for State Courts. The council also consulted an industrial hygienist regarding physical layout and social distancing guidelines. The guide is a working document, and the spokesperson said version 2.0 is expected sometime this fall.\u003c/p>\n\u003cp>Nonetheless, I wanted to visit a courthouse and see the coronavirus protections for myself. So, I called up Ken Garcia, the San Francisco Superior Court’s communications director, who agreed to show me around the Hall of Justice at 850 Bryant St. I’d been in a jury pool in this building before, and was familiar with the scene, pre-pandemic.\u003c/p>\n\u003cfigure id=\"attachment_1969958\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2020/09/IMG_9532.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1969958 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/09/IMG_9532-800x600.jpg\" alt=\"Photo: empty corridor at SF Hall of Justice\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-768x576.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532.jpg 2000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The normally crowded corridors at San Francisco’s Hall of Justice stand eerily deserted. \u003ccite>(Polly Stryker/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>The Courthouse\u003c/b>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Courthouses are normally \u003ci>really\u003c/i> busy places, Garcia said, hallways filled “with lawyers, police officers, sheriff’s deputies, the public, jurors, people coming to court to do business.”\u003c/p>\n\u003cp>But on the day I visited, the halls were strangely empty and echoed with the occasional chamber door closing, even though an electronic calendar indicated dozens of hearings, most of them done in-person, while other cases are being conducted online.\u003c/p>\n\u003cp>“We are setting up a remote operation, essentially,” explained Garcia, who said that’s presented some IT challenges. “This building is so old, it’s not wired properly for any kind of new technology.” Nonetheless, the court at 850 Bryant has adapted to hearings via Zoom or YouTube channel.\u003cbr>\n[pullquote size='large' align='right' citation='Ken Garcia, San Francisco Superior Court']‘Justice doesn’t stop. All the cases that were going to go to court at the beginning of March are still going to go to court.’[/pullquote]\u003c/p>\n\u003cp>We peeked inside a couple of courtrooms. The witness stand had plexiglass around it on three sides, separating the judge and anyone in front of the stand from the witness. The jury box and the entire gallery had laminated numbers taped to some of the chairs. The jury had taken over the gallery, socially distanced among the rows. “So, no more than 23 people can be in the courtroom during a trial. And that’s based on the spacing that’s been measured,” Garcia told me, at least 6 feet. Everyone has to wear masks in the courthouse, over their noses, and bottles of hand sanitizer dot the courtrooms. If the public wants to see a criminal trial, he told me, the court can set up a livestream feed.\u003c/p>\n\u003cp>Counties have taken various approaches to vetting their prospective jury pools. San Mateo County screens people in tents outside the courthouse. Alameda County screens people online for hardship, but then does a COVID health screening and a check-in inside the courthouse. San Francisco Superior Court sends out an online survey, with questions to help screen people for vulnerability to the coronavirus, with questions about health concerns\u003ci>, \u003c/i>age, employment — if you’re an essential employee. Garcia said the pandemic has created a case backlog but, “Justice doesn’t stop. It’s just there’s been a lag time. All the cases that were going to go to court at the beginning of March are still going to go to court.” He did add that more litigants are choosing to settle out of court.\u003c/p>\n\u003cp>\u003cb>The Juror\u003c/b>\u003c/p>\n\u003cp>I wanted to hear from someone who had served on a jury since the pandemic began, and I found Kyle Barlow. The 32 year-old computational biologist recently served on a monthlong criminal trial in San Francisco.\u003c/p>\n\u003cp>Given the long exposure involved, he decided to take extra precautions. “I made the personal decision just to shave the facial hair I had. I could wear a KN95 [mask] and just maybe have a little bit more protection for myself during the trial.”\u003cbr>\n[pullquote size='large' align='right' citation='Dr. John Swartzberg']‘People have to understand that it’s [risk] mitigation and it’s not elimination.’[/pullquote]\u003c/p>\n\u003cp>Barlow says some interesting moments occurred when witnesses wore masks with clear plastic over their mouths, so the jury could see their expressions. He said they were “moderately effective, but they tended to fog up when people were talking.”\u003c/p>\n\u003cp>Would he serve again? “Yeah,” says Barlow.\u003ci>“\u003c/i>I think even in these strange times, I definitely would do it again. And I kind of came away with that feeling like enough precautions had been taken, and that it was worth it just to make sure that our justice system is still working.”\u003c/p>\n\u003cp>\u003cb>The Experts\u003c/b>\u003c/p>\n\u003cp>Even with all the precautions in place, jury duty doesn’t come with a guarantee against COVID-19.\u003c/p>\n\u003cp>“People have to understand that it’s mitigation and it’s not elimination,” says infectious diseases specialist Dr. John Swartzberg, who served as a scientific adviser for the American Board of Trial Advocates’ guide to conducting civil trials during the pandemic\u003cb>. \u003c/b>He said the courts are challenged by a lack of funds, but “from everything I can tell, I think they’ve done a good job with what they have.”\u003c/p>\n\u003cp>Would Swartzberg feel comfortable serving on a jury if called? He says he would serve, but since he is older, he would still feel a bit nervous. He’d want to make sure he had at least 6 feet distance from others, that everyone wore masks, used sanitizer, and one more thing: air exchange. He’d want to know how long it takes to filter and fully refresh all the air in the courtroom. “A lot of the older buildings have like two air exchanges per hour. Whereas in a hospital room, you’d be held to a standard anywhere between eight and 12 exchanges an hour.”\u003c/p>\n\u003cp>Dr. Dean Winslow, professor of medicine and specialist in infectious diseases at Stanford, agrees. He says it takes a very efficient HVAC system to filter out small particle aerosols that can remain suspended “for up to several hours.” For him, “the most important thing would be limiting even large rooms to no more than about 25 people, even in a fairly large room and requiring, very, very strictly that people wear face masks or appropriate face coverings during that time.\u003ci>” \u003c/i>And, he, too, would want to see a high rate of air exchange. \u003ci> \u003c/i>\u003c/p>\n\u003cp>Although the courthouses are mostly older buildings, a quick survey reveals that some (but not all) have upgraded filtration systems, and officials at several of the courthouses in Bay Area counties told me they have been running their air filtration system intakes at 100%.\u003c/p>\n\u003cp>A spokesman for the Marin County Superior Court said the air exchange rate in the county Superior Court rooms is three-four times per hour. However, the recent fires complicated opening filtration system dampers for maximum air intake, so the courts brought in “air scrubbers,” loud, industrial machines, to clean the inside air.\u003c/p>\n\u003cp>\u003cb>The Judge\u003c/b>\u003c/p>\n\u003cp>Moving some trial elements online has had some benefits, according to Judge Tara Desautels, presiding judge for the Alameda County Superior Court. With some witnesses testifying via Zoom or other remote means, she says,\u003ci> “\u003c/i>Jurors have, in fact, said that they enjoy that opportunity because it enables them to be really upfront and close to the witness as compared to in a pre-COVID jury setting where you would have the 12 jurors on the side of the room in the jury box, depending on where your seat is and your vision abilities.” She says, in addition to the standard mask requirements and distancing, each juror now has their own separate table in deliberation, with personal copies of jury instructions and evidence.\u003c/p>\n\u003cp>I asked Desautels if fewer people were showing up to serve on juries, or if more were trying to get out of serving. “One of the reasons why we have had to create overflow rooms is because we have had more than our normal, normally expected turnout rate,” she said. “We were very afraid that we would receive no jurors, that no one would be willing to come to our courthouses when we began our jury selection, and we have been very pleasantly surprised.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Okay, back to one of the doctors. I had to ask: what about going to the bathroom in a shared facility with strangers? Is that a problem? “There have been no outbreaks that I’m aware of related to public restrooms or flushing toilets,” Winslow said. “It’s more of a theoretical risk.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When I recently received a jury summons in the mail, it brought with it more than the usual onset of angst. It included a flyer titled “Attention Prospective Jurors,” outlining COVID protections the courts had put in place.\u003c/p>\n\u003cp>Some of the bullet points didn’t offer a lot of solace. “With current social distancing rules,” the flyer read, “the assembly room will only seat a maximum of 40 to 50 prospective jurors.” Given the current guidelines of social pods not exceeding 12 people, this made me nervous. So, I decided to explore COVID protections put in place by Superior Courts around the Bay Area. I reached out to courts in\u003ca href=\"https://www.sfsuperiorcourt.org/\"> San Francisco\u003c/a>,\u003ca href=\"https://www.sanmateocourt.org/\"> San Mateo\u003c/a>,\u003ca href=\"http://www.alameda.courts.ca.gov/\"> Alameda, \u003c/a>\u003ca href=\"https://www.scscourt.org/\"> Santa Clara\u003c/a> and \u003ca href=\"https://www.marincourt.org/juror_services_overview.htm\">Marin\u003c/a> counties.\u003c/p>\n\u003cp>When the coronavirus hit and lockdowns began in mid-March, jury trials\u003ca href=\"https://www.cc-courts.org/general/docs/StatewideOrderByTheChiefJustice-COVID19Order-03-23-2020.pdf\"> paused\u003c/a>. The Judicial Council of California, the court system’s policymaking body, created a pandemic working group. In June, it issued a 75-page\u003ca href=\"https://live-jcc-newsroom.pantheonsite.io/sites/default/files/newsroom/2020-09/Pandemic%20Working%20Group%20Resource%20Guide.pdf\"> resource guide,\u003c/a> a set of best practices or recommendations. According to a spokesperson for the JCC, the working group used information from state, local and national health officials — including the federal Occupational Safety and Health Administration, Centers for Disease Control and Prevention, and the National Center for State Courts. The council also consulted an industrial hygienist regarding physical layout and social distancing guidelines. The guide is a working document, and the spokesperson said version 2.0 is expected sometime this fall.\u003c/p>\n\u003cp>Nonetheless, I wanted to visit a courthouse and see the coronavirus protections for myself. So, I called up Ken Garcia, the San Francisco Superior Court’s communications director, who agreed to show me around the Hall of Justice at 850 Bryant St. I’d been in a jury pool in this building before, and was familiar with the scene, pre-pandemic.\u003c/p>\n\u003cfigure id=\"attachment_1969958\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2020/09/IMG_9532.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1969958 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/09/IMG_9532-800x600.jpg\" alt=\"Photo: empty corridor at SF Hall of Justice\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-768x576.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/09/IMG_9532.jpg 2000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The normally crowded corridors at San Francisco’s Hall of Justice stand eerily deserted. \u003ccite>(Polly Stryker/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>The Courthouse\u003c/b>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Courthouses are normally \u003ci>really\u003c/i> busy places, Garcia said, hallways filled “with lawyers, police officers, sheriff’s deputies, the public, jurors, people coming to court to do business.”\u003c/p>\n\u003cp>But on the day I visited, the halls were strangely empty and echoed with the occasional chamber door closing, even though an electronic calendar indicated dozens of hearings, most of them done in-person, while other cases are being conducted online.\u003c/p>\n\u003cp>“We are setting up a remote operation, essentially,” explained Garcia, who said that’s presented some IT challenges. “This building is so old, it’s not wired properly for any kind of new technology.” Nonetheless, the court at 850 Bryant has adapted to hearings via Zoom or YouTube channel.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "‘Justice doesn’t stop. All the cases that were going to go to court at the beginning of March are still going to go to court.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>We peeked inside a couple of courtrooms. The witness stand had plexiglass around it on three sides, separating the judge and anyone in front of the stand from the witness. The jury box and the entire gallery had laminated numbers taped to some of the chairs. The jury had taken over the gallery, socially distanced among the rows. “So, no more than 23 people can be in the courtroom during a trial. And that’s based on the spacing that’s been measured,” Garcia told me, at least 6 feet. Everyone has to wear masks in the courthouse, over their noses, and bottles of hand sanitizer dot the courtrooms. If the public wants to see a criminal trial, he told me, the court can set up a livestream feed.\u003c/p>\n\u003cp>Counties have taken various approaches to vetting their prospective jury pools. San Mateo County screens people in tents outside the courthouse. Alameda County screens people online for hardship, but then does a COVID health screening and a check-in inside the courthouse. San Francisco Superior Court sends out an online survey, with questions to help screen people for vulnerability to the coronavirus, with questions about health concerns\u003ci>, \u003c/i>age, employment — if you’re an essential employee. Garcia said the pandemic has created a case backlog but, “Justice doesn’t stop. It’s just there’s been a lag time. All the cases that were going to go to court at the beginning of March are still going to go to court.” He did add that more litigants are choosing to settle out of court.\u003c/p>\n\u003cp>\u003cb>The Juror\u003c/b>\u003c/p>\n\u003cp>I wanted to hear from someone who had served on a jury since the pandemic began, and I found Kyle Barlow. The 32 year-old computational biologist recently served on a monthlong criminal trial in San Francisco.\u003c/p>\n\u003cp>Given the long exposure involved, he decided to take extra precautions. “I made the personal decision just to shave the facial hair I had. I could wear a KN95 [mask] and just maybe have a little bit more protection for myself during the trial.”\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "‘People have to understand that it’s [risk] mitigation and it’s not elimination.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Barlow says some interesting moments occurred when witnesses wore masks with clear plastic over their mouths, so the jury could see their expressions. He said they were “moderately effective, but they tended to fog up when people were talking.”\u003c/p>\n\u003cp>Would he serve again? “Yeah,” says Barlow.\u003ci>“\u003c/i>I think even in these strange times, I definitely would do it again. And I kind of came away with that feeling like enough precautions had been taken, and that it was worth it just to make sure that our justice system is still working.”\u003c/p>\n\u003cp>\u003cb>The Experts\u003c/b>\u003c/p>\n\u003cp>Even with all the precautions in place, jury duty doesn’t come with a guarantee against COVID-19.\u003c/p>\n\u003cp>“People have to understand that it’s mitigation and it’s not elimination,” says infectious diseases specialist Dr. John Swartzberg, who served as a scientific adviser for the American Board of Trial Advocates’ guide to conducting civil trials during the pandemic\u003cb>. \u003c/b>He said the courts are challenged by a lack of funds, but “from everything I can tell, I think they’ve done a good job with what they have.”\u003c/p>\n\u003cp>Would Swartzberg feel comfortable serving on a jury if called? He says he would serve, but since he is older, he would still feel a bit nervous. He’d want to make sure he had at least 6 feet distance from others, that everyone wore masks, used sanitizer, and one more thing: air exchange. He’d want to know how long it takes to filter and fully refresh all the air in the courtroom. “A lot of the older buildings have like two air exchanges per hour. Whereas in a hospital room, you’d be held to a standard anywhere between eight and 12 exchanges an hour.”\u003c/p>\n\u003cp>Dr. Dean Winslow, professor of medicine and specialist in infectious diseases at Stanford, agrees. He says it takes a very efficient HVAC system to filter out small particle aerosols that can remain suspended “for up to several hours.” For him, “the most important thing would be limiting even large rooms to no more than about 25 people, even in a fairly large room and requiring, very, very strictly that people wear face masks or appropriate face coverings during that time.\u003ci>” \u003c/i>And, he, too, would want to see a high rate of air exchange. \u003ci> \u003c/i>\u003c/p>\n\u003cp>Although the courthouses are mostly older buildings, a quick survey reveals that some (but not all) have upgraded filtration systems, and officials at several of the courthouses in Bay Area counties told me they have been running their air filtration system intakes at 100%.\u003c/p>\n\u003cp>A spokesman for the Marin County Superior Court said the air exchange rate in the county Superior Court rooms is three-four times per hour. However, the recent fires complicated opening filtration system dampers for maximum air intake, so the courts brought in “air scrubbers,” loud, industrial machines, to clean the inside air.\u003c/p>\n\u003cp>\u003cb>The Judge\u003c/b>\u003c/p>\n\u003cp>Moving some trial elements online has had some benefits, according to Judge Tara Desautels, presiding judge for the Alameda County Superior Court. With some witnesses testifying via Zoom or other remote means, she says,\u003ci> “\u003c/i>Jurors have, in fact, said that they enjoy that opportunity because it enables them to be really upfront and close to the witness as compared to in a pre-COVID jury setting where you would have the 12 jurors on the side of the room in the jury box, depending on where your seat is and your vision abilities.” She says, in addition to the standard mask requirements and distancing, each juror now has their own separate table in deliberation, with personal copies of jury instructions and evidence.\u003c/p>\n\u003cp>I asked Desautels if fewer people were showing up to serve on juries, or if more were trying to get out of serving. “One of the reasons why we have had to create overflow rooms is because we have had more than our normal, normally expected turnout rate,” she said. “We were very afraid that we would receive no jurors, that no one would be willing to come to our courthouses when we began our jury selection, and we have been very pleasantly surprised.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Okay, back to one of the doctors. I had to ask: what about going to the bathroom in a shared facility with strangers? Is that a problem? “There have been no outbreaks that I’m aware of related to public restrooms or flushing toilets,” Winslow said. “It’s more of a theoretical risk.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The Centers for Disease Control and Prevention posted guidance last Friday evening saying that aerosol transmission might be one of the “most common” ways the coronavirus is spreading — and then took the guidance down on Monday.\u003c/p>\n\u003cp>The now-deleted updates were notable because so far the CDC has stopped short of saying that the virus is airborne.\u003c/p>\n\u003cp>The agency says the guidance was a draft version of proposed changes that was posted in error to its website. The CDC says that it is updating its recommendations regarding airborne transmission of the virus that causes COVID-19 and that it will post updated language once that process is complete.\u003c/p>\n\u003cp>Over the weekend, the CDC page “\u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html\">How COVID-19 Spreads\u003c/a>” included among the most common modes of transmission “respiratory droplets or small particles, such as those in aerosols, produced when an infected person coughs, sneezes, sings, talks, or breathes.”\u003c/p>\n\u003cp>It continued: “These particles can be inhaled into the nose, mouth, airways, and lungs and cause infection. This is thought to be the main way the virus spreads.” The guidance also stated that these particles might travel farther than 6 feet.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For a few days, researchers who have suspected aerosol transmission for months \u003ca href=\"https://twitter.com/jljcolorado/status/1307787446948511744\">cheered \u003c/a>the update as a long-overdue acknowledgment of accumulating evidence for how the virus transmits, particularly in indoor spaces.\u003c/p>\n\u003cp>Now the page has reverted to what it said before — that the virus spreads between people in close contact through respiratory droplets. The page makes no mention of aerosol transmission.\u003c/p>\n\u003cp>In July, the World Health Organization updated its guidance on aerosols after \u003ca href=\"https://www.npr.org/2020/07/06/887925721/scientists-urge-who-to-update-guidance-on-airborne-transmission-of-the-coronavir\">more than 200 scientists urged it\u003c/a> to do so. WHO’s guidance now \u003ca href=\"https://www.who.int/news-room/q-a-detail/q-a-how-is-covid-19-transmitted\">states\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>“There have been reported outbreaks of COVID-19 in some closed settings, such as restaurants, nightclubs, places of worship or places of work where people may be shouting, talking, or singing. In these outbreaks, aerosol transmission, particularly in these indoor locations where there are crowded and inadequately ventilated spaces where infected persons spend long periods of time with others, cannot be ruled out. More studies are urgently needed to investigate such instances and assess their significance for transmission of COVID-19.”\u003c/p>\u003c/blockquote>\n\u003cp>What’s the difference between respiratory droplets and aerosol particles?\u003c/p>\n\u003cp>Respiratory droplets are larger and fall to the ground quickly — hence the 6-feet rule that’s generally considered safe for social distancing amid the pandemic. Aerosol particles are smaller and can linger in the air, moving with air currents from which they can be inhaled.\u003c/p>\n\u003cp>An airborne virus is considered to be a virus that spreads in exhaled particles that are small enough to linger in the air and move with air currents, from which they can be breathed in by passersby who then get sick.\u003c/p>\n\u003cp>Linsey Marr is a professor of civil and environmental engineering who researches airborne transmission at Virginia Tech. She was excited to see the CDC’s changes on Friday, though she was also surprised at how strongly the new guidance was written — particularly in that it stated plainly that SARS-CoV-2 is an \u003cem>airborne virus\u003c/em>.\u003c/p>\n\u003cp>Such a classification could require additional precautions in health care settings, she says.\u003c/p>\n\u003cp>Marr says that the changes mistakenly posted by the CDC could be significant if they are implemented.\u003c/p>\n\u003cp>“It means that nationally we need to do something about [transmission] beyond 6 feet, which means masks and ventilation and filtration,” she says. “And if we do that, I think we can get a better control on the spread of the virus.”\u003c/p>\n\u003cp>The posted and withdrawn transmission guidelines are just the latest in public reversals and controversy at the CDC.\u003c/p>\n\u003cp>On Friday, the agency \u003ca href=\"https://www.npr.org/2020/09/18/914519545/cdc-reverses-controversial-guidelines-regarding-coronavirus-testing\">reversed its new guidance on testing\u003c/a>, published in August, that suggested people who have possibly been exposed to the coronavirus don’t necessarily need to get tested for infection.\u003c/p>\n\u003cp>Also last week, Michael Caputo, the top spokesperson for the U.S. Department of Health and Human Services, announced he was \u003ca href=\"https://www.npr.org/2020/09/16/913684013/hhs-spokesperson-takes-leave-of-absence-after-disparaging-government-scientists\">taking a leave of absence\u003c/a> after a social media tirade in which he falsely accused government scientists of engaging in “sedition.” He had also come under criticism after reports that he and scientific adviser Paul Alexander sought to edit and delay public health reports from the CDC. Alexander is leaving the agency permanently.\u003c/p>\n\u003cp>These episodes, among others, have raised questions about the agency’s consistency and credibility during the coronavirus pandemic.\u003c/p>\n\u003cp>Dr. Howard Koh is a professor at the Harvard T.H. Chan School of Public Health who served as assistant secretary for health during the Obama administration.\u003c/p>\n\u003cp>“The consistent inconsistency in this administration’s guidance on COVID-19 has severely compromised the nation’s trust in our public health agencies,” Koh said in a statement Monday.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“During the greatest public health emergency in a century, trust in public health is essential — without it, this pandemic could go on indefinitely. To rectify the latest challenge, the CDC must acknowledge that growing scientific evidence indicates the importance of airborne transmission through aerosols, making mask wearing even more critical as we head into the difficult fall and winter season.”\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=CDC+Publishes+%E2%80%94+Then+Withdraws+%E2%80%94+Guidance+On+Aerosol+Spread+Of+Coronavirus&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Centers for Disease Control and Prevention posted guidance last Friday evening saying that aerosol transmission might be one of the “most common” ways the coronavirus is spreading — and then took the guidance down on Monday.\u003c/p>\n\u003cp>The now-deleted updates were notable because so far the CDC has stopped short of saying that the virus is airborne.\u003c/p>\n\u003cp>The agency says the guidance was a draft version of proposed changes that was posted in error to its website. The CDC says that it is updating its recommendations regarding airborne transmission of the virus that causes COVID-19 and that it will post updated language once that process is complete.\u003c/p>\n\u003cp>Over the weekend, the CDC page “\u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html\">How COVID-19 Spreads\u003c/a>” included among the most common modes of transmission “respiratory droplets or small particles, such as those in aerosols, produced when an infected person coughs, sneezes, sings, talks, or breathes.”\u003c/p>\n\u003cp>It continued: “These particles can be inhaled into the nose, mouth, airways, and lungs and cause infection. This is thought to be the main way the virus spreads.” The guidance also stated that these particles might travel farther than 6 feet.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For a few days, researchers who have suspected aerosol transmission for months \u003ca href=\"https://twitter.com/jljcolorado/status/1307787446948511744\">cheered \u003c/a>the update as a long-overdue acknowledgment of accumulating evidence for how the virus transmits, particularly in indoor spaces.\u003c/p>\n\u003cp>Now the page has reverted to what it said before — that the virus spreads between people in close contact through respiratory droplets. The page makes no mention of aerosol transmission.\u003c/p>\n\u003cp>In July, the World Health Organization updated its guidance on aerosols after \u003ca href=\"https://www.npr.org/2020/07/06/887925721/scientists-urge-who-to-update-guidance-on-airborne-transmission-of-the-coronavir\">more than 200 scientists urged it\u003c/a> to do so. WHO’s guidance now \u003ca href=\"https://www.who.int/news-room/q-a-detail/q-a-how-is-covid-19-transmitted\">states\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>“There have been reported outbreaks of COVID-19 in some closed settings, such as restaurants, nightclubs, places of worship or places of work where people may be shouting, talking, or singing. In these outbreaks, aerosol transmission, particularly in these indoor locations where there are crowded and inadequately ventilated spaces where infected persons spend long periods of time with others, cannot be ruled out. More studies are urgently needed to investigate such instances and assess their significance for transmission of COVID-19.”\u003c/p>\u003c/blockquote>\n\u003cp>What’s the difference between respiratory droplets and aerosol particles?\u003c/p>\n\u003cp>Respiratory droplets are larger and fall to the ground quickly — hence the 6-feet rule that’s generally considered safe for social distancing amid the pandemic. Aerosol particles are smaller and can linger in the air, moving with air currents from which they can be inhaled.\u003c/p>\n\u003cp>An airborne virus is considered to be a virus that spreads in exhaled particles that are small enough to linger in the air and move with air currents, from which they can be breathed in by passersby who then get sick.\u003c/p>\n\u003cp>Linsey Marr is a professor of civil and environmental engineering who researches airborne transmission at Virginia Tech. She was excited to see the CDC’s changes on Friday, though she was also surprised at how strongly the new guidance was written — particularly in that it stated plainly that SARS-CoV-2 is an \u003cem>airborne virus\u003c/em>.\u003c/p>\n\u003cp>Such a classification could require additional precautions in health care settings, she says.\u003c/p>\n\u003cp>Marr says that the changes mistakenly posted by the CDC could be significant if they are implemented.\u003c/p>\n\u003cp>“It means that nationally we need to do something about [transmission] beyond 6 feet, which means masks and ventilation and filtration,” she says. “And if we do that, I think we can get a better control on the spread of the virus.”\u003c/p>\n\u003cp>The posted and withdrawn transmission guidelines are just the latest in public reversals and controversy at the CDC.\u003c/p>\n\u003cp>On Friday, the agency \u003ca href=\"https://www.npr.org/2020/09/18/914519545/cdc-reverses-controversial-guidelines-regarding-coronavirus-testing\">reversed its new guidance on testing\u003c/a>, published in August, that suggested people who have possibly been exposed to the coronavirus don’t necessarily need to get tested for infection.\u003c/p>\n\u003cp>Also last week, Michael Caputo, the top spokesperson for the U.S. Department of Health and Human Services, announced he was \u003ca href=\"https://www.npr.org/2020/09/16/913684013/hhs-spokesperson-takes-leave-of-absence-after-disparaging-government-scientists\">taking a leave of absence\u003c/a> after a social media tirade in which he falsely accused government scientists of engaging in “sedition.” He had also come under criticism after reports that he and scientific adviser Paul Alexander sought to edit and delay public health reports from the CDC. Alexander is leaving the agency permanently.\u003c/p>\n\u003cp>These episodes, among others, have raised questions about the agency’s consistency and credibility during the coronavirus pandemic.\u003c/p>\n\u003cp>Dr. Howard Koh is a professor at the Harvard T.H. Chan School of Public Health who served as assistant secretary for health during the Obama administration.\u003c/p>\n\u003cp>“The consistent inconsistency in this administration’s guidance on COVID-19 has severely compromised the nation’s trust in our public health agencies,” Koh said in a statement Monday.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“During the greatest public health emergency in a century, trust in public health is essential — without it, this pandemic could go on indefinitely. To rectify the latest challenge, the CDC must acknowledge that growing scientific evidence indicates the importance of airborne transmission through aerosols, making mask wearing even more critical as we head into the difficult fall and winter season.”\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=CDC+Publishes+%E2%80%94+Then+Withdraws+%E2%80%94+Guidance+On+Aerosol+Spread+Of+Coronavirus&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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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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"content": "\u003cp>At the beginning of the coronavirus pandemic, there were lots of stories about scrappy manufacturers promising to revamp their factories to start making personal protective equipment in the U.S.\u003c/p>\n\u003cp>Back in the spring, fuel-cell maker Adaptive Energy retooled part of its factory in Ann Arbor, Michigan, to make plastic face shields. Now, 100,000 finished shields are piling up in cardboard boxes on the factory floor — unsold.\u003c/p>\n\u003cp>“We jumped in head first,” said Ranvir Gujral, the company’s principal owner. He added ruefully: “We weren’t the only ones with a brilliant idea of getting our folks back to work and trying to help and manufacture PPE.”\u003c/p>\n\u003cp>Since the coronavirus pandemic began, President Trump and industry officials have talked a lot about the need to ramp up domestic manufacturing of critical protective gear. But six months on, \u003ca href=\"https://www.npr.org/2020/08/19/903612006/yep-masks-and-protective-gear-are-still-hard-get-especially-for-small-buyers\">there are still shortages of all kinds of PPE,\u003c/a> like N95 respirator masks, while face shields are easy to find.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Lack of a Coherent National Plan\u003c/strong>\u003c/p>\n\u003cp>The disconnect can be traced, in part, to the lack of a coherent national plan.\u003c/p>\n\u003cp>When Gujral and other domestic manufacturers saw an opportunity to help protect front-line workers — and to keep their own employees working, many of them shifted gears to make face shields and hand sanitizer, which are relatively simple to produce.\u003c/p>\n\u003cp>But fewer shifted to making N95 masks, which are far more complicated, and they’re in short supply. Nurses and doctors are reusing masks over and over again. Some small medical practices can’t even find supplies they can afford.\u003c/p>\n\u003cp>Still, Trump consistently ignores that reality.\u003c/p>\n\u003cp>“We’ve opened up factories. We’ve had tremendous success with face masks and with shields,” Trump said during a press briefing at the White House last week.\u003c/p>\n\u003cp>The market is, in fact, glutted with face shields. But the U.S. is still far short of the 3.5 billion masks that public health officials say are needed this year.\u003c/p>\n\u003cp>The White House narrative is that the pandemic revealed the danger of relying too much on Chinese suppliers, and that the U.S. has ramped up domestic production significantly, making those early shortages a thing of the past.\u003c/p>\n\u003cp>“We are taking our business out of China. We are bringing it home. We want our business to come home,” Trump said at the Republican National Convention.\u003c/p>\n\u003cp>But in reality, U.S. manufacturers worry the administration is fumbling a chance to bring the PPE industry back home.\u003c/p>\n\u003cp>“We’re not seeing that happen. In fact, we’re behind in manufacturing jobs. We’re importing more PPEs than ever,” said Scott Paul, president of the Alliance for American Manufacturing.\u003c/p>\n\u003cp>\u003cstrong>‘This Administration Has Really Had a Big Firm Focus’\u003c/strong>\u003c/p>\n\u003cp>The White House worked with some big companies, including 3M and Honeywell, to ramp up domestic production of respirator masks. But that was relatively easy for them:\u003c/p>\n\u003cp>3M developed the first N95 mask, so it already has factories and established customers.\u003c/p>\n\u003cp>Even so, 3M and Honeywell haven’t been able to make enough masks as the pandemic wore on and demand only increased.\u003c/p>\n\u003cp>“We’re not tens of millions of masks short. We’re hundreds of millions of masks short of where we need to be,” Paul said. “It would make complete sense to want to scale up some small and midsized manufacturers to help fill in this massive gap.”\u003c/p>\n\u003cp>But the federal government has no plan to help small- and midsized manufacturers move into PPE.\u003c/p>\n\u003cp>“This administration has really had a big firm focus,” said Gary Gereffi, a professor at Duke University and the founding director of the Duke Global Value Chains Center.\u003c/p>\n\u003cp>“We’ve never really fully dealt with the ongoing demand for the basic items — the face masks and the gloves and the gowns,” Gereffi said, partly because the administration has been more focused on discovering a vaccine that could bring the coronavirus outbreak under control.\u003c/p>\n\u003cp>As a result, Gereffi said: “We didn’t have any agency in the government that knew which companies were producing these different products.”\u003c/p>\n\u003cp>That leaves manufacturers like Ranvir Gujral, the factory owner in Michigan, to figure it out on their own. Gujral still wants to help in the pandemic. He’s thinking about retooling his factory in Michigan again, this time to make N95 masks.\u003c/p>\n\u003cp>“We have the machines lined up. We have the raw materials lined up. We have the capital lined up,” Gujral said.\u003c/p>\n\u003cp>What he’s missing is some certainty that his investment will pay off. Gujral’s factory wouldn’t be ready to start cranking out masks until the spring.\u003c/p>\n\u003cp>“Are we going to still have demand? Are these customers still going to come to us?,” he asked. “We don’t want to be left holding the bag.”\u003c/p>\n\u003cp>Gujral says he can’t risk repeating his face shield experience with N95 masks.\u003c/p>\n\u003cp>“This is a big enough move to put us out of business if it doesn’t go well,” he said. “It’s a bet-the-company move.”\u003c/p>\n\u003cp>It’s the same conundrum facing all sorts of industries. Things are made more cheaply overseas, especially in China. So are customers willing to pay a little more for masks that are made in the USA? Or other scarce items, like protective gloves or gowns?\u003c/p>\n\u003cp>“I hear that from across my industry,” said Kimberly Glas, the president of the National Council of Textile Organizations, an industry trade association in Washington. “People aren’t going to make an investment realizing that there’s not a customer at the other end.”\u003c/p>\n\u003cp>Even as the Trump administration downplays the PPE shortages, it has taken steps to try to shore up U.S. manufacturing of drugs and medical supplies. The president signed an executive order last month requiring federal agencies to buy American-made when possible.\u003c/p>\n\u003cp>It’s a good step, said Glas, who worked at the U.S. Commerce Department during the Obama administration. But she says it will take more than that — a real strategic federal plan, or tax incentives — to convince domestic manufacturers to invest.\u003c/p>\n\u003cp>“My fear is a year from now, we will see these supply chains that were heavily dominated in China go back to China fully,” Glas said.\u003c/p>\n\u003cp>And the U.S. will have squandered a chance to bring jobs back onshore, and make America self-sufficient when it comes to protecting against the coronavirus.\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+Can%27t+America+Make+Enough+N95+Masks%3F+6+Months+Into+Pandemic%2C+Shortages+Persist&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "There's just not enough PPE to satisfy demand. Medics are re-using masks and small practices can't even find supplies they can afford. Some domestic manufacturers could help, but it's a risky move.",
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"description": "There's just not enough PPE to satisfy demand. Medics are re-using masks and small practices can't even find supplies they can afford. Some domestic manufacturers could help, but it's a risky move.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>At the beginning of the coronavirus pandemic, there were lots of stories about scrappy manufacturers promising to revamp their factories to start making personal protective equipment in the U.S.\u003c/p>\n\u003cp>Back in the spring, fuel-cell maker Adaptive Energy retooled part of its factory in Ann Arbor, Michigan, to make plastic face shields. Now, 100,000 finished shields are piling up in cardboard boxes on the factory floor — unsold.\u003c/p>\n\u003cp>“We jumped in head first,” said Ranvir Gujral, the company’s principal owner. He added ruefully: “We weren’t the only ones with a brilliant idea of getting our folks back to work and trying to help and manufacture PPE.”\u003c/p>\n\u003cp>Since the coronavirus pandemic began, President Trump and industry officials have talked a lot about the need to ramp up domestic manufacturing of critical protective gear. But six months on, \u003ca href=\"https://www.npr.org/2020/08/19/903612006/yep-masks-and-protective-gear-are-still-hard-get-especially-for-small-buyers\">there are still shortages of all kinds of PPE,\u003c/a> like N95 respirator masks, while face shields are easy to find.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Lack of a Coherent National Plan\u003c/strong>\u003c/p>\n\u003cp>The disconnect can be traced, in part, to the lack of a coherent national plan.\u003c/p>\n\u003cp>When Gujral and other domestic manufacturers saw an opportunity to help protect front-line workers — and to keep their own employees working, many of them shifted gears to make face shields and hand sanitizer, which are relatively simple to produce.\u003c/p>\n\u003cp>But fewer shifted to making N95 masks, which are far more complicated, and they’re in short supply. Nurses and doctors are reusing masks over and over again. Some small medical practices can’t even find supplies they can afford.\u003c/p>\n\u003cp>Still, Trump consistently ignores that reality.\u003c/p>\n\u003cp>“We’ve opened up factories. We’ve had tremendous success with face masks and with shields,” Trump said during a press briefing at the White House last week.\u003c/p>\n\u003cp>The market is, in fact, glutted with face shields. But the U.S. is still far short of the 3.5 billion masks that public health officials say are needed this year.\u003c/p>\n\u003cp>The White House narrative is that the pandemic revealed the danger of relying too much on Chinese suppliers, and that the U.S. has ramped up domestic production significantly, making those early shortages a thing of the past.\u003c/p>\n\u003cp>“We are taking our business out of China. We are bringing it home. We want our business to come home,” Trump said at the Republican National Convention.\u003c/p>\n\u003cp>But in reality, U.S. manufacturers worry the administration is fumbling a chance to bring the PPE industry back home.\u003c/p>\n\u003cp>“We’re not seeing that happen. In fact, we’re behind in manufacturing jobs. We’re importing more PPEs than ever,” said Scott Paul, president of the Alliance for American Manufacturing.\u003c/p>\n\u003cp>\u003cstrong>‘This Administration Has Really Had a Big Firm Focus’\u003c/strong>\u003c/p>\n\u003cp>The White House worked with some big companies, including 3M and Honeywell, to ramp up domestic production of respirator masks. But that was relatively easy for them:\u003c/p>\n\u003cp>3M developed the first N95 mask, so it already has factories and established customers.\u003c/p>\n\u003cp>Even so, 3M and Honeywell haven’t been able to make enough masks as the pandemic wore on and demand only increased.\u003c/p>\n\u003cp>“We’re not tens of millions of masks short. We’re hundreds of millions of masks short of where we need to be,” Paul said. “It would make complete sense to want to scale up some small and midsized manufacturers to help fill in this massive gap.”\u003c/p>\n\u003cp>But the federal government has no plan to help small- and midsized manufacturers move into PPE.\u003c/p>\n\u003cp>“This administration has really had a big firm focus,” said Gary Gereffi, a professor at Duke University and the founding director of the Duke Global Value Chains Center.\u003c/p>\n\u003cp>“We’ve never really fully dealt with the ongoing demand for the basic items — the face masks and the gloves and the gowns,” Gereffi said, partly because the administration has been more focused on discovering a vaccine that could bring the coronavirus outbreak under control.\u003c/p>\n\u003cp>As a result, Gereffi said: “We didn’t have any agency in the government that knew which companies were producing these different products.”\u003c/p>\n\u003cp>That leaves manufacturers like Ranvir Gujral, the factory owner in Michigan, to figure it out on their own. Gujral still wants to help in the pandemic. He’s thinking about retooling his factory in Michigan again, this time to make N95 masks.\u003c/p>\n\u003cp>“We have the machines lined up. We have the raw materials lined up. We have the capital lined up,” Gujral said.\u003c/p>\n\u003cp>What he’s missing is some certainty that his investment will pay off. Gujral’s factory wouldn’t be ready to start cranking out masks until the spring.\u003c/p>\n\u003cp>“Are we going to still have demand? Are these customers still going to come to us?,” he asked. “We don’t want to be left holding the bag.”\u003c/p>\n\u003cp>Gujral says he can’t risk repeating his face shield experience with N95 masks.\u003c/p>\n\u003cp>“This is a big enough move to put us out of business if it doesn’t go well,” he said. “It’s a bet-the-company move.”\u003c/p>\n\u003cp>It’s the same conundrum facing all sorts of industries. Things are made more cheaply overseas, especially in China. So are customers willing to pay a little more for masks that are made in the USA? Or other scarce items, like protective gloves or gowns?\u003c/p>\n\u003cp>“I hear that from across my industry,” said Kimberly Glas, the president of the National Council of Textile Organizations, an industry trade association in Washington. “People aren’t going to make an investment realizing that there’s not a customer at the other end.”\u003c/p>\n\u003cp>Even as the Trump administration downplays the PPE shortages, it has taken steps to try to shore up U.S. manufacturing of drugs and medical supplies. The president signed an executive order last month requiring federal agencies to buy American-made when possible.\u003c/p>\n\u003cp>It’s a good step, said Glas, who worked at the U.S. Commerce Department during the Obama administration. But she says it will take more than that — a real strategic federal plan, or tax incentives — to convince domestic manufacturers to invest.\u003c/p>\n\u003cp>“My fear is a year from now, we will see these supply chains that were heavily dominated in China go back to China fully,” Glas said.\u003c/p>\n\u003cp>And the U.S. will have squandered a chance to bring jobs back onshore, and make America self-sufficient when it comes to protecting against the coronavirus.\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+Can%27t+America+Make+Enough+N95+Masks%3F+6+Months+Into+Pandemic%2C+Shortages+Persist&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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"excerpt": "With the coronavirus, it's safer to be outside. With wildfire smoke, it's safer to be inside. We got some tips from the experts.",
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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": "\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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"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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"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. 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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. 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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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},
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"info": "The day's top stories from BBC News compiled twice daily in the week, once at weekends.",
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},
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},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
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"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",
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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},
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"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.",
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"order": 10
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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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",
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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},
"closealltabs": {
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"order": 1
},
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"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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"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.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"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.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
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"freakonomics-radio": {
"id": "freakonomics-radio",
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"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
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"id": "fresh-air",
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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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"hidden-brain": {
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"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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"meta": {
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"source": "NPR"
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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.",
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"airtime": "SUN 7:30pm-8pm",
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"link": "/radio/program/how-i-built-this",
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"hyphenacion": {
"id": "hyphenacion",
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"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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"order": 15
},
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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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"order": 18
},
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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/",
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},
"link": "/radio/program/latino-usa",
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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": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"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"
},
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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",
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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": {
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"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
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