After almost two years, Western Australia has lifted the nation’s toughest COVID-19 border controls. Double-vaccinated international and domestic travelers are now allowed in, as the so-called hermit state reconnects with the rest of the world.

For almost 700 days Western Australia was cut off from the rest of the country and the world.

Most international visitors were banned, as Australia’s largest state, which is 10 times the size of the United Kingdom, tried to isolate itself from the pandemic.

The state premier, Mark McGowan, said the tough policy had “avoided needless deaths,” but he acknowledged the pain felt by separated families and businesses.

The tough measures did keep infections low, but they were unable to stop a recent surge in omicron cases.

A total of 1,770 cases were reported Wednesday — a new record for Western Australia — but the number of hospitalizations remains relatively low.

With almost 99% of the eligible population double-vaccinated, authorities have insisted that the time is right to end border restrictions.

Dr. Mark Duncan-Smith, president of the Australian Medical Association (Western Australia), told the Australian Broadcasting Corp. that the tough border strategy appears to have worked.

“What is happening here in WA [Western Australia] right now, with omicron at 1,000 cases a day, is a social experiment that has never been done in the world, and so what we are hoping for is that we will get a very, very soft landing and hopefully our hospitalization numbers will stay very low and that will be testimony to the effectiveness of those borders over the last two years, buying us that time,” he said.

Western Australia’s tough stance on border closures led to it being dubbed a “hermit kingdom.”

McGowan was compared to the North Korean dictator Kim Jong-un by Alan Joyce, the CEO of Australia’s national airline, Qantas, last month. Joyce later apologized for his comments.

Other Australian states and territories imposed internal border closures during the pandemic, but those restrictions ended last year. Australia reopened its international borders to all vaccinated international travelers on Feb. 21, but Western Australia maintained its restrictions.

Passengers on the first flights from Sydney and Melbourne into the Western Australian state capital, Perth, were welcomed with gifts of toy quokkas, a small marsupial said to be the “world’s happiest animal.”

Tourism officials in Western Australia have said the reopening of domestic and international travel into the state would bring “joy” to the industry.

Australia has recorded about 2.9 million coronavirus infections since the pandemic began. More than 5,200 people have died.
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The moon is about to get walloped by nearly 3 metric tons of space junk, a punch that will carve out a crater that could fit several semitrailer trucks.

The leftover chunk of a rocket will smash into the far side of the moon at 9,300 kph (5,800 mph) on Friday, away from telescopes’ prying eyes. It may take weeks, even months, to confirm the impact through satellite images.

It’s been tumbling haphazardly through space, experts believe, since China launched it nearly a decade ago. But Chinese officials are dubious it’s theirs.

No matter whose it is, scientists expect the object to carve out a hole 10 to 20 meters (33 to 66 feet) across and send moon dust flying hundreds of kilometers across the barren, pockmarked surface.

Not hard to follow

Low-orbiting space junk is relatively easy to track. Objects launching deeper into space are unlikely to hit anything, and these far-flung pieces are usually soon forgotten by everyone except a handful of observers who enjoy playing celestial detective on the side.

SpaceX originally took the rap for the upcoming lunar litter after asteroid tracker Bill Gray identified the collision course in January. He corrected himself a month later, saying the “mystery” object was not a SpaceX Falcon rocket upper stage from the 2015 launch of a deep space climate observatory for NASA.

Gray said it was likely the third stage of a Chinese rocket that sent a test sample capsule to the moon and back in 2014. But Chinese ministry officials said the upper stage had reentered Earth’s atmosphere and burned up

But there were two Chinese missions with similar designations — the test flight and 2020’s lunar sample return mission — and U.S. observers believe the two are getting mixed up.

The U.S. Space Command, which tracks lower space junk, confirmed Tuesday that the Chinese upper stage from the 2014 lunar mission never deorbited, as previously indicated in its database. But it could not confirm the country of origin for the object about to strike the moon.

“We focus on objects closer to the Earth,” a spokesperson said in a statement.

Gray, a mathematician and physicist, said he’s confident now that it’s China’s rocket.

“I’ve become a little bit more cautious of such matters,” he said. “But I really just don’t see any way it could be anything else.”

Another crater

Jonathan McDowell of the Harvard and Smithsonian Center for Astrophysics supported Gray’s revised assessment, but noted: “The effect will be the same. It’ll leave yet another small crater on the moon.”

The moon already bears countless craters, ranging up to 2,500 kilometers (1,600 miles). With little to no real atmosphere, the moon is defenseless against the constant barrage of meteors and asteroids, and the occasional incoming spacecraft, including a few intentionally crashed for science’s sake. With no weather, there’s no erosion, so impact craters last forever.

China has a lunar lander on the moon’s far side, but it will be too far away to detect Friday’s impact just north of the equator. NASA’s Lunar Reconnaissance Orbiter will also be out of range. It’s unlikely India’s moon-orbiting Chandrayaan-2 will be passing by then, either.

“I had been hoping for something [significant] to hit the moon for a long time. Ideally, it would have hit on the near side of the moon at some point where we could actually see it,” Gray said.

Reexamining the origins

After initially pinning the upcoming strike on Elon Musk’s SpaceX, Gray took another look after an engineer at NASA’s Jet Propulsion Laboratory questioned his claim. Now, he’s “pretty thoroughly persuaded” it’s a Chinese rocket part, based not only on orbital tracking back to its 2014 liftoff, but also data received from its short-lived ham radio experiment.

JPL’s Center for Near-Earth Object Studies endorses Gray’s reassessment. A University of Arizona team also recently identified the Chinese Long March rocket segment from the light reflected off its paint during telescope observations of the careening cylinder.

It’s about 12 meters (40 feet) long and 3 meters (10 feet) in diameter. It does a somersault every two to three minutes.

Gray said SpaceX never contacted him to challenge his original claim. Neither have the Chinese.

“It’s not a SpaceX problem, nor is it a China problem. Nobody is particularly careful about what they do with junk at this sort of orbit,” Gray said.

Tracking deep space mission leftovers like this is hard, according to McDowell. The moon’s gravity can alter an object’s path during flybys, creating uncertainty. And there’s no readily available database, McDowell noted, aside from the ones he, Gray and a couple of others have “cobbled together.”

“We are now in an era where many countries and private companies are putting stuff in deep space, so it’s time to start to keep track of it,” McDowell said. “Right now there’s no one, just a few fans in their spare time.”
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A Texas judge on Wednesday blocked the state from investigating the parents of a transgender teenager over gender-confirmation treatments but stopped short of preventing the state from looking into other reports about children receiving similar care.

District Judge Amy Clark Meachum issued a temporary order halting the investigation by the Department of Family and Protective Services into the parents of the 16-year-old girl. The parents sued over the investigation and Republican Governor Greg Abbott’s order last week that officials look into reports of such treatments as abuse.

Meachum wrote that the parents and the teen “face the imminent and ongoing deprivation of their constitutional rights, the potential loss of necessary medical care, and the stigma attached to being the subject of an unfounded child abuse investigation.”

Meachum set a March 11 hearing on whether to issue a broader temporary order blocking enforcement of Abbott’s directive.

‘Unfathomably cruel’

The lawsuit marked the first report of parents being investigated following Abbott’s directive and an earlier nonbinding legal opinion by Republican Attorney General Ken Paxton labeling certain gender-confirmation treatments as “child abuse.” The American Civil Liberties Union and Lambda Legal sued the state Tuesday on behalf of the teen.

“We appreciate the relief granted to our clients, but this should never have happened and is unfathomably cruel,” Brian Klosterboer, ACLU of Texas attorney, said in a statement. “Families should not have to fear being separated because they are providing the best possible health care for their children.”

Spokespersons for Abbott’s and Paxton’s offices did not immediately respond to requests for comment Wednesday night. A spokesperson for DFPS said there would be “deliberate discussions” about next steps.

The ruling came as President Joe Biden’s administration announced new steps to protect transgender children and their families in response to Abbott’s order. Biden condemned state laws targeting transgender people in his State of the Union address Tuesday.

“Like so many anti-transgender attacks proliferating in states across the country, the governor’s actions callously threaten to harm children and their families just to score political points,” the president said in a statement Wednesday night. “These actions are terrifying many families in Texas and beyond. And they must stop.”

Meachum issued the order hours after attorneys for the state and for the parents appeared before her via Zoom in a brief hearing.

Paul Castillo, Lambda Legal’s senior counsel, told Meachum that allowing the order to be enforced would cause “irreparable” harm to the teen’s parents and other families.

“It is unconscionable for DFPS to still pursue any investigation or inflict more trauma and harm,” Castillo said in a statement after the judge’s ruling.

The groups also represent a clinical psychologist who has said the order will force her to choose between reporting her clients to the state or facing the loss of her license and other penalties.

Ryan Kercher, an attorney with Paxton’s office, told Meachum that the governor’s order and the earlier opinion don’t require the state to investigate every transgender child receiving gender-confirmation care.

Restrictions meet opposition

Abbott’s directive and the attorney general’s opinion go against the nation’s largest medical groups, including the American Medical Association, which have opposed Republican-backed restrictions filed in statehouses nationwide.

The U.S. Department of Health and Human Services on Wednesday encouraged anyone targeted by a child welfare investigation because of Abbott’s order to contact the agency’s civil rights office. The department also released guidance saying that despite the order in Texas, health care providers are not required to disclose private patient information regarding gender confirming care.

Arkansas last year became the first state to pass a law prohibiting gender confirming treatments for minors, and Tennessee approved a similar measure. A judge blocked Arkansas’ law, and the state is appealing.

The Texas lawsuit does not identify the family by name. The suit said the mother works for DFPS on the review of reports of abuse and neglect. The day of Abbott’s order, she asked her supervisor how it would affect the agency’s policy, according to the lawsuit.

The mother was placed on leave because she has a transgender daughter, and the following day, she was informed her family would be investigated in accordance with the governor’s directive, the suit said. The teen has received puberty-delaying medication and hormone therapy.

DFPS said Tuesday that it had received three reports since Abbott’s order and Paxton’s opinion but would not say whether any resulted in investigations.

At Wednesday’s hearing, Castillo said he was aware of at least two other families being investigated. He also said some medical providers have stopped providing prescriptions for gender confirming care because of the governor’s order.
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A leading cybersecurity firm says it has discovered a “highly sophisticated” piece of malware being used by Chinese hacking teams to attack government and critical infrastructure targets.

Symantec, a division of U.S.-based software designer and manufacturer Broadcom, said the earliest known sample of the malware, which has been dubbed Daxin, dates back to 2013, while Microsoft first documented the hacking tool in December 2013.

A report by the company’s Threat Hunter Team says Daxin is “without doubt” the most advanced piece of malware it has seen used “by a China-linked actor.” The unit says Daxin was discovered along with other hacking tools previously used by Chinese cyberattackers.

The hackers have deployed Daxin against “organizations and governments of strategic interest to China.” The malware permits the attackers to communicate directly with infected computers on highly secured networks where direct internet connectivity is not available, allowing them to extract data without raising suspicions.

Vikram Thakur, a technical director with Symantec, told Reuters that Daxin “can be controlled from anywhere in the world once a computer is actually infected.” Thakur said Daxin’s victims included high-level, non-Western government agencies in Asia and Africa, including justice ministries.
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An expert group of 270 climate scientists warns the dire impacts of climate change soon will be irreversible unless governments act decisively to tackle these imminent global threats.

Hoesung Lee, chairman of the Intergovernmental Panel on Climate Change, does not mince words. He said the stakes of our planet have never been higher.

“Human activities have warmed the planet at a rate not seen in at least the past 2,000 years. We are on course to reaching global warming of 1.5 degrees Celsius within the next two decades and temperatures will continue to rise unless the world takes much bolder action,” said Lee.

He said the action governments take today will shape how people will be able to adapt to climate change and how nature will respond to increasing climate risks.

Debra Roberts is co-chair of the IPCC Working Group II, which produced the report. She said the scientific evidence that climate change is a threat to human well-being and the health of the planet is unequivocal.

“Climate change combines with unsustainable use of natural resources. Habitat destruction, deforestation, and growing urbanization as well as inequity and marginalization … 3.3 to 3.6 billion people live in global hotspots of high vulnerability to climate change,” said Roberts.

These include parts of Africa, as well as South Asia, Central and South America, small islands, and the Arctic. The report warns that people living in these hotspots will likely experience severe food shortages, leading to malnutrition, should global temperatures rise by two degrees Celsius by 2050.

Despite these dire predictions, scientists say the report presents a reality check on what has been done to stem global warming and what remains to be done. They say the report offers solutions on how to adapt to climate change and mitigate their worst effects.

Scientists say some challenges can be addressed by creating a more equitable and sustainable world, by moving away from fossil fuels to renewable energy, and by using indigenous knowledge to protect nature.

These steps, along with adaptation and mitigation projects, can help create change, but poorer countries will need wealthier countries to help finance them.
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Kenya has ramped up its efforts to control the twin challenges of the coronavirus and malaria by introducing locally made testing kits for the two diseases. Kenya’s Medical Research Institute (KEMRI) says the kits offer quicker detection and will soon be exported to the region. Brenda Mulinya reports from Nairobi. Videographer and producer: Amos Wangwa
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Archaeologists in Jordan’s southeast desert have discovered a 9,000-year-old ritualistic complex. It’s the earliest known large human-built structure involving Neolithic hunting communities. Experts say it points to civilization in the Middle East much earlier than originally thought.

Jordan’s antiquities ministry recently announced the discovery of huge human stone structures believed to be the oldest known to date from 9,000 years ago in its southeastern desert plateau area of Jabal Khashabiyeh. 

Jordanian archaeologist Wael Abu Aziza told reporters that “they’re the oldest huge human structures known to date.” He said Neolithic hunters living 9,000 years ago used huge stone enclosures to trap wild animals en masse. Also, one structure, thought to be a shrine, contained objects the experts believe to be related to ancient rituals. 

Commenting on the discovery, archeologist Pearce Paul Creasman of the American Center of Research in Amman said it was likely older than other similar structures, also found in Jordan, known as the Ain Ghazal statues.  

“Absolutely, no question that this is a significant find. The Ain Ghazal statues have been traditionally considered some of the oldest and the most significant of human occupation and so this could possibly be pushing that back, a little bit older,” Creasman said.  

A team of international archaeologists—including those from the United States—say the discoveries show how hunting communities in Neolithic times, predating Iraq’s sophisticated Assyrians by several thousand years and who were far less developed, displayed early signs of civilization. At the site were also found children’s toys made by these hunters who etched human faces in stone between hunting trips in the Arabian Desert.  

“This is absolutely evidence of complex activity from a date doing a level organization that we don’t see all over the place at that time and is kind of a predecessor to what we would generally think of as civilization today,” Creasman.   

Archaeologists said this major find could change perceptions of early human civilization in the Middle East.
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Some medical experts have expressed concern that COVID-19 preventative measures, like masking and remote schooling, are potentially weakening children’s immune systems by shielding them from the usual childhood illnesses.

“There’s a lot of reasons to believe that kids need to be exposed to things to keep their immunity complex, so that should they encounter something very dangerous, they have aspects of their immunity that might cross over and help protect them against those things,” says Sara Sawyer, a professor of molecular, cellular and developmental biology at the University of Colorado Boulder.

At birth, vulnerable infants get antibodies from their mother’s breast milk, which helps protect them until they can build their own immunity. It’s no accident that babies start putting things in their mouths as soon as they gain enough dexterity to pick things up.

“They’re doing that because they’re sampling the environment and building their immunity. That’s an evolutionary trait,” Sawyer says. “They’re exposing their body to germs in a certain, level way to build their immunity. So, some people would argue that childhood illnesses, like colds and stomach bugs, build our immunity so that when more dangerous things come along, we’re prepared and we don’t get as sick from those more dangerous things.”

Even before the pandemic, epidemiological evidence suggested that children in more developed countries, where handwashing and the use of sanitizer are more prevalent, might have less-developed immune systems compared to kids in developing nations who are routinely exposed to more bacteria, viruses and allergens. This makes kids in more industrialized countries more vulnerable to developing autoimmune diseases, according to what’s known as the “hygiene hypothesis.”

“The hygiene hypothesis is actually quite controversial because it’s thought that our exposure to microbes isn’t the only factor,” says Cody Warren, a virologist and immunologist who is a postdoctoral fellow at the University of Colorado Boulder. “A lot of this could also be dictated by genetics, diet, and the environment that we live in. That also shapes our immune system… it’s a real multifactorial thing that we can’t fully account for just by wearing masks. There are other things that go into that equation.”

Warren, the father of three young children, says spending lots of time outdoors is one way to balance the negatives of isolation.

“Just exploring microbes in the environment also is benefiting [and] training our immune system,” Warren says. “Our immune systems get trained through the foods that we eat, which also have microorganisms on them. And so, despite the fact that we’ve kind of been hunkered down a little bit, I do feel that our immune systems will catch up.”

There are other things parents can do, he says, to boost their children’s immune systems during pandemic times.

“One of the most important things you can do is just to stay up to date on vaccines. That’s one of the best ways that we have to train our immune systems,” Warren says. “But also, equally important is making sure our children have a good diet and they regulate stress. It’s been well documented that both of those — having a good diet, a less stressful environment — can have a positive impact on our immune system.”

Once public health officials say masks are no longer necessary, Sawyer thinks pointing out the positives of putting our masks away could reassure hesitant parents who worry about their children getting sick.

“Maybe we should have a public conversation about the possible reasons to take that mask off, if they are in school, and get back to the normal repertoire of relatively safe childhood illnesses,” she says. “The plus side of childhood illnesses is that they can build up that hornet’s nest of immunity that could protect kids against new things that then come along.”
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Hong Kong’s fifth wave of coronavirus could see thousands of deaths, a new study said.

Slammed by the city’s fifth wave of COVID-19, Hong Kong is facing its worst health period since the pandemic began two years ago. It has forced the city’s government to implement strict measures, including compulsory tests for all Hong Kong residents.

February has seen thousands of new cases, mostly from the omicron variant. A new daily high of 10,010 infections was recorded Friday.

A study by the University of Hong Kong considered the potential outcomes from the current wave of coronavirus cases. One of the worst scenarios outlined that if the hospitals were to be overburdened, Hong Kong could see 7,000 COVID-19-related deaths by the end of June.

“The infection fatality risk may increase by 50% when the health care system becomes overburdened, in which case the cumulative number of deaths could further increase to 4,231 – 6,993,” the study said.

But it also said deaths could be half that number, about 3,200 by mid-May, if health measures remained.

‘Zero-COVID’ plan

Hong Kong had adopted a “zero-COVID” strategy, aligned with Beijing’s effort to control the pandemic across China. It had some success, with authorities quickly clamping down on rare outbreaks by contact tracing, social restrictions, mass testing and quarantine.

Fan Hung-ling, chairman of the Hong Kong Hospital Authority, told the Chinese state’s Global Times that the strategy was “our country’s basic policy” and “won’t change.”

Earlier this month, Chinese President Xi Jinping ordered the city’s authorities to get the fifth wave under control. Xi is due to visit Hong Kong July 1, marking the 25th anniversary of the city’s return to China from Britain.

Last week, Hong Kong Chief Executive Carrie Lam unveiled new measures for the city, including a requirement that residents have proof of vaccination against COVID-19 to enter various premises.

On Wednesday, Lam also announced compulsory testing for all residents by March, with a goal of boosting the city’s vaccination rate to 90%.

Dr. David Owens, an honorary assistant clinical professor at Hong Kong University, had hoped for a different plan of action.

“I would have preferred we would have shifted all of our energies that would effectively [be focused on] things that would save lives,” Owens told VOA. “That would be mitigation, to roll out vaccinations to the elderly and vulnerable. I have also argued we should move to rapid testing so we can break the transmission chains quickly.”

Need for home isolation

Dr. Karen Grepin, associate professor at the University of Hong Kong’s School of Public Health, responded to the mass strategy campaign.

“It is likely it will happen at a time very close to the peak of the outbreak and thus it will likely identify literally hundreds of thousands of cases, including likely many who are no longer infectious. It is unlikely that we will be able to isolate even a fraction of these cases, so unless it is coupled with a comprehensive home isolation strategy, it will have little impact on transmission,” Grepin told VOA.

According to data from the Hong Kong Hospital Authority, public hospitals are averaging an occupancy rate of 89%.

One health worker at Hong Kong’s United Christian Hospital, who chose to remain anonymous, admitted she was “afraid” of the pending testing program.

“Patients were crying,” she said. “A male patient said he had not eaten for 12 hours. And another patient said he wanted to commit suicide. And I started to cry. I cannot offer any more for them.

“I am so afraid of the universal testing program. We don’t have enough manpower for that. The government is so keen on a zero-COVID strategy. To me, it is a zero-medical staff strategy. The morale is worsened every day in the frontline.”

She described her job’s current conditions as like “working in a market.”

“It was so difficult to pass through the waiting hall,” she said. “We have to shout out to search the patients.”

Patients in beds outdoors

Last week, Hong Kong’s Caritas Hospital saw dozens of patients lying in hospital beds outside in cold weather, waiting to be admitted. But occupancy is was at 102%, the Hospital Authority said.

A nurse working at the hospital, who also chose to remain anonymous, said elderly patients “have nowhere to turn.”

“Patients are not severely sick from my ward, but [have a] lack of self-care ability. The virus is widely breaking out in elderly care homes and homes for disabilities. They cannot do self-isolation, as they are from the same care center. The staff [are] probably infected. Therefore, the patients literally have nowhere to go even if they turn negative,” she told VOA.

Hong Kong residents have also spoken to VOA about pandemic fatigue, venting their frustrations at the government’s new health measures.

And some expatriates are also looking to leave the city altogether. A Facebook group aimed at helping expatriates leave Hong Kong has already gained over 3,000 members, only days after being created.

Singapore for some

British citizen Niall Trimble, a job recruitment director at Ethos BeathChapman, an executive recruitment firm in Hong Kong, has decided to move elsewhere in Asia.

“I would say the reason for leaving is the lack of flexibility compared to other places on the COVID situation,” he told VOA. “As a recruiter across technology and financial services I am already seeing a huge influx of candidates looking to move to Singapore and also clients looking to move operations to Singapore.”

Hong Kong’s economy fell into a two-year recession in 2019 and 2020. But last year the city saw growth of 6.4% as coronavirus cases remained low.

But Hong Kong has now recorded at least 84,000 cases, with 2022 alone seeing more infections than the last two years combined.

Hong Kong’s finance chief unveiled a budget of over $20 billion to cope with the outbreak, which will include an electronic spending voucher for each resident.

Hong Kong authorities are set to loosen the strategy on rapid testing and allow home isolation for positive cases, the South China Morning Post reported Friday.
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Most Americans live in places where healthy people, including students in schools, can safely take a break from wearing masks under new U.S. guidelines released Friday. 

The Centers for Disease Control and Prevention outlined the new set of measures for communities where COVID-19 is easing its grip, with less of a focus on positive test results and more on what’s happening at hospitals. 

The new system greatly changes the look of the CDC’s risk map and puts more than 70% of the U.S. population in counties where the coronavirus is posing a low or medium threat to hospitals. Those are the people who can stop wearing masks, the agency said. 

The agency is still advising that people, including schoolchildren, wear masks where the risk of COVID-19 is high. That’s the situation in about 37% of U.S. counties, where about 28% of Americans reside.  

The new recommendations do not change the requirement to wear masks on public transportation and indoors in airports, train stations and bus stations.  

The CDC guidelines for other indoor spaces aren’t binding, meaning cities and institutions even in areas of low risk may set their own rules. And the agency says people with COVID-19 symptoms or who test positive should wear masks.

Risk is generally lower 

But with protection from immunity rising — both from vaccination and infection — the overall risk of severe disease is now generally lower, the CDC said. 

“Anybody is certainly welcome to wear a mask at any time if they feel safer wearing a mask,” CDC Director Dr. Rochelle Walensky said in a news briefing. “We want to make sure our hospitals are OK and people are not coming in with severe disease. … Anyone can go to the CDC website, find out the volume of disease in their community and make that decision.” 

Since July, CDC’s transmission-prevention guidance to communities has focused on two measures: the rate of new COVID-19 cases and the percentage of positive test results over the previous week.  

Based on those measures, agency officials advised people to wear masks indoors in counties where the spread of the virus was deemed substantial or high. This week, more than 3,000 of the nation’s more than 3,200 counties — greater than 95% — were listed as having substantial or high transmission.  

That guidance has increasingly been ignored, however, with states, cities, counties and school districts across the U.S. announcing plans to drop mask mandates amid declining COVID-19 cases, hospitalizations and deaths. 

With many Americans already taking off their masks, the CDC’s shift won’t make much practical difference for now, said Andrew Noymer, a public health professor at the University of California-Irvine. But it will help when the next wave of infection — a likelihood in the fall or winter — starts threatening hospital capacity again, he said. 

“There will be more waves of COVID. And so I think it makes sense to give people a break from masking,” Noymer said. “If we have continual masking orders, they might become a total joke by the time we really need them again.” 

Color-coded information

The CDC is also offering a color-coded map — with counties designated as orange, yellow or green — to help guide local officials and residents. In green counties, local officials can drop any indoor masking rules. Yellow means people at high risk for severe disease should be cautious. Orange designates places where the CDC suggests masking should be universal. 

How a county comes to be designated green, yellow or orange will depend on its rate of new COVID-19 hospital admissions, the share of staffed hospital beds occupied by COVID-19 patients and the rate of new cases in the community. 

Mask requirements have ended in most of the U.S. in recent weeks. Los Angeles on Friday began allowing people to remove their masks while indoors if they are vaccinated, and indoor mask mandates in Washington state and Oregon will be lifted in March. 

State health officials are generally pleased with the new guidance and “excited with how this is being rolled out,” said Dr. Marcus Plescia of the Association of State and Territorial Health Officials. 

“This is the way we need to go. I think this is taking us forward with a new direction going on in the pandemic,” Plescia said. “But we’re still focusing on safety. We’re still focusing on preventing death and illness.” 

The CDC said the new system will be useful in predicting future surges and urged communities with wastewater surveillance systems to use that data, too.
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Drugmaker Johnson & Johnson and three major distributors finalized nationwide settlements over their role in the opioid addiction crisis Friday, an announcement that clears the way for $26 billion to flow to nearly every state and local government in the U.S.

Taken together, the settlements are the largest to date among the many opioid-related cases that have been playing out across the country. They’re expected to provide a significant boost to efforts aimed at reversing the crisis in places that have been devastated by it, including many parts of rural America.

Johnson & Johnson, AmerisourceBergen, Cardinal Health and McKesson announced the settlement plan last year, but the deal was contingent on getting participation from a critical mass of state and local governments.

Friday was the deadline for the companies to announce whether they felt enough governments had committed to participate in the settlement and relinquish the right to sue. The four companies notified lawyers for the governments in the case that their thresholds were met, meaning money could start flowing to communities by April.

“We’re never going to have enough money to immediately cure this problem,” said Joe Rice, one of the lead lawyers who represented local governments in the litigation that led to the settlement. “What we’re trying to do is give a lot of small communities a chance to try to change some of their problems.”

While none of the settlement money will go directly to victims of opioid addiction or their survivors, the vast majority of it is required to be used to deal with the epidemic. The need for the funding runs deep.

Kathleen Noonan, CEO of the Camden Coalition of Healthcare Providers, said a portion of the settlement money should be used to provide housing to people with addictions who are homeless.

“We have clients who have a hard time staying clean to make it in a shelter,” she said. “We would like to stabilize them so we can help them recover.”

Dan Keashen, a spokesman for Camden County government, said officials are thinking about using settlement money for a public education campaign to warn about the dangers of fentanyl. They also want to send more drug counselors into the streets, put additional social workers in municipal courts and pay for anti-addiction medications in the county jail.

Officials across the country are considering pumping the money into similar priorities.

California Gov. Gavin Newsom’s proposed budget calls for using $50 million of the state’s expected $86 million share this year for youth opioid education and to train treatment providers, improve data collection and distribute naloxone, a drug that reverses overdoses.

In Florida’s Broward County, home to Fort Lauderdale, the number of beds in a county-run detoxification facility could be expanded from 50 to 70 or 75, said Danielle Wang French, a lawyer for the county.

“It’s not enough, but it’s a good start,” she said of the settlement.

With fatal overdoses continuing to rage across the U.S., largely because of the spread of fentanyl and other illicitly produced synthetic opioids, public health experts are urging governments to use the money to ensure access to drug treatment for people with addictions. They also emphasize the need to fund programs that are proven to work, collect data on their efforts and launch prevention efforts aimed at young people, all while focusing on racial equity.

“It shouldn’t be: ready, set spend,” said Joshua Sharfstein, a former secretary of the Maryland Department of Health who is now a vice dean of public health at Johns Hopkins University. “It should be: think, strategize, spend.”

In a separate deal that also is included in the $26 billion, the four companies reached a $590 million settlement with the nation’s federally recognized Native American tribes. About $2 billion is being set aside for fees and expenses for the lawyers who have spent years working on the case.

New Brunswick, New Jersey-based Johnson & Johnson has nine years to pay its $5 billion share. The distributors — Conshohocken, Pennsylvania-based AmerisourceBergen; Columbus, Ohio-based Cardinal Health; and Irving, Texas-based McKesson — agreed to pay their combined $21 billion over 18 years. To reach the maximum amounts, states have to get local governments to sign on.

The settlements go beyond money. J&J, which has stopped selling prescription opioids, agrees not to resume. The distributors agree to send data to a clearinghouse intended to help flag when prescription drugs are diverted to the black market.

The companies are not admitting wrongdoing and are continuing to defend themselves against claims that they helped cause the opioid crisis that were brought by entities that are not involved in the settlements.

In a joint statement, the distributors called the implementation of the settlement “a key milestone toward achieving broad resolution of governmental opioid claims and delivering meaningful relief to communities across the United States.”

The requirement that most of the money be used to address the opioid crisis contrasts with a series of public health settlements in the 1990s with tobacco companies. In those cases, states used big chunks of the settlement money to fill budget gaps and fund other priorities.

The amount sent to each state under the opioid settlement depends on a formula that takes into account the severity of the crisis and the population. County and local governments also get shares of the money. A handful of states — Alabama, New Hampshire, Oklahoma, Washington and West Virginia — have not joined all or part of the settlement, mostly because they have their own deals or are preparing for trial.

In Camden, Lisa Davey, a recovery specialist for Maryville Addiction treatment Center, was at a needle exchange this week handing out naloxone, a drug that reverses overdoses, and asking people if they wanted to start treatment.

Davey said she wants to see detoxification and treatment programs receive more funding to keep people in them for longer. As it is, she said, users can detox and be back out on the streets in search of drugs within days.

“They need more time to work their recovery,” she said.

A man picking up clean needles who asked to be identified only as Anthony P. said he was 46 and had struggled with addiction since he was a teenager. He said he’d like to see an effort to cut off fentanyl and related synthetic opioids that are driving overdose death rates from the drug supply.

“Fentanyl’s got to go,” he said.

Martha Chavis, president and CEO of Camden Area Health Education Center, which runs the needle exchange, said one need is offering services like hers in more places. Now, users from far-flung suburbs travel into Camden to get clean needles and kits to test their drugs for fentanyl.

The settlement with J&J and the three distributors marks a major step toward resolving the vast constellation of lawsuits in the U.S. over liability for an epidemic that has been linked to the deaths of more than 500,000 Americans over the past two decades.

Other companies, including business consultant McKinsey and drugmakers Endo, Mallinckrodt and Teva, have reached national settlements or a series of local ones. OxyContin maker Purdue Pharma and a group of states are in mediation through U.S. Bankruptcy Court to try to reach a nationwide settlement.

The crisis has deepened during the coronavirus pandemic, with U.S. opioid-related deaths reaching a high of more than 76,000 in the 12 months that ended in April 2021, largely because of the spread of fentanyl and other lab-made drugs. A recent report from a commission by The Lancet medical journal projected that 1.2 million Americans could die of opioid overdose between 2020 and 2029 without policy changes.

John F. Kelly, a professor of psychiatry in addiction medicine at Harvard Medical School, said he wants to see money from the settlements go not just for treatment, recovery and support efforts but also to build systems designed to prevent this sort of epidemic from happening again.

“Some kind of national board or organization could be set up … to prevent this kind of lack of oversight from happening again — where industry is allowed to create a public health hazard,” he said.
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