Climate scientists warn the world is courting disaster if it fails to swiftly do what’s required to limit global warming to 1.5 degrees Celsius.

The International Panel on Climate Change released a report on mitigating climate change. After two previous reports on the physical science behind climate change and on its potential impacts, the United Nation’s top climate body says changes are now causing huge disruptions in the natural world and in human well-being. 

Over the last decade, the report says average annual global greenhouse gas emissions were at their highest levels in human history.    

However, the co-chair of the panel’s third working group, Jim Skea, says the rate of growth has slowed in the last two years along with increasing evidence of many countries taking climate action. 

“Despite this progress, our assessment concludes that unless there are immediate and deep emission reductions across all sectors, limiting warming to 1.5 degrees will be beyond reach,” he said. “Now limiting warming to around two degrees still requires global emissions to peak before 2025 at the latest, and be reduced by a quarter by 2030.” 

The report says the energy sector accounts for a third of all emissions, and major transitions will be required to slow global warming. This, it says, will involve substantial reductions in fossil fuel use, widespread electrification, improved energy efficiency, and the use of alternative fuels. 

The vice-chair of the third working group, Diana Urge-Vorsatz, says the right policies can result in a 40 to 70 percent reduction in greenhouse gas emissions by 2050. She says changes in lifestyle and behavior also can reduce the carbon footprint, as well as improve health and well-being. 

“Of the 60 actions we assessed in this report, on an individual level, the biggest contribution comes from switching to walking and cycling and using electrified transport. Other effective options include reducing air travel and adapting our houses,” Urge-Vorsatz said.  

Scientists on the intergovernmental panel agree business as usual is not an option in meeting the many challenges of climate change. They warn the longer action is put off, the more irreversible it will become. 
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The United Nations’ top climate body says drastic measures, including significant cuts in fossil fuel use, are necessary to contain global warming to 1.5 degrees Celsius above preindustrial temperatures. 

Monday’s report by the Intergovernmental Panel on Climate Change showed that the world is “on a fast track to climate disaster” and that governments and organizations have engaged in “a litany of broken climate promises,” said U.N. Secretary-General Antonio Guterres.

“It is a file of shame, cataloguing the empty pledges that put us firmly on track towards an unlivable world,” he said in a video message released alongside the report.

Guterres said the world’s current trajectory is global warming of more than double the 1.5-degree limit agreed at climate talks in Paris in 2015.

To keep the 1.5-degree limit within reach, he said that the world would need to cut global emissions by 45% this decade. 

The 2,800-page report said only such severe emissions cuts this decade could turn the situation around. Even then, it said such measures would need to be combined with governments planting more trees and developing technologies that could remove some of the carbon dioxide already in the atmosphere.

“It’s now or never,” IPCC report co-chair James Skea said in a statement with the report.

“Without immediate and deep emissions reductions across all sectors, it will be impossible,” he added.

The report said that in the next three years — by 2025 — the world would need to stop greenhouse gas emissions from rising further to be on track to reach the Paris goals. If current policies continue, the report said, the 1.5-degree target will be “beyond reach,” and it will be harder after 2030 to limit warming to 2 degrees Celsius.

Guterres put the blame on governments and businesses but did not single out individual countries.

“Some government and business leaders are saying one thing but doing another.”

“Simply put, they are lying,” he added. “And the results will be catastrophic.”

U.S. Secretary of State Antony Blinken said in a statement that the report “reveals how current global efforts to mitigate the climate crisis fall far short of what is needed” and that this will be a “decisive decade.”

He cited some of the report’s recommendations to halt climate change, from “improving energy efficiency, to halting and reversing global deforestation, to deploying more sustainable transportation and clean energy.” If countries take action now, he added, they can halve global emissions by 2030.

Some information in this report came from The Associated Press, Reuters, and Agence France-Presse.

 
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The World Health Organization reports 13 million people die every year from environmental causes, including more than seven million who are killed each year from exposure to air pollution.

New data released by the World Health Organization confirms that practically the whole world is breathing in unhealthy air. The WHO is calling for urgent action to curb the use of fossil fuels to reduce air pollution levels. This, it says threatens the health of billions of people, leading to the preventable deaths of millions.

Sophie Gumy is technical officer in WHO’s department of environment, climate change and health. She says the data show air quality is poorest notably in the eastern Mediterranean, Southeast Asian, and African regions.

“Most of the seven million deaths, they come from low and middle-income countries, indeed they do,” Gumy said. “That does not mean that the high-income countries are not impacted. You know we are using mortality to calculate the impact of air pollution on health. However, we are very much aware that you should actually count for morbidity — all the disease that it creates…There are a lot of costs associated with air pollution, which are not necessarily captured in the deaths.”

The WHO report says significant harm is being done by even low levels of many air pollutants. It says particulate matter can penetrate deep into the lungs and enter the bloodstream. This can cause cardiovascular disease, stroke, and respiratory impacts. It says nitrogen oxide or NO2 can cause asthma and other respiratory diseases.

The director of WHO’s department of environment, climate change and health, Maria Neira, says particulate matter can affect almost every organ in the body. She calls this a major health issue, one which overlaps with the causes of climate change. As such, she says the causes of air pollution should be tackled in a similar fashion.

“We need to accelerate the transition to clean, modern, sustainable renewable sources of energy,” Neira said. “I think we will all agree that our dependence on fossil fuels for generating our energy, needs to change if we want to protect our health.

WHO recommends measures including building safe and affordable public transport systems, implementing stricter vehicle emissions, investing in energy-efficient housing and power generation, and improving industry and municipal waste management.
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Cameroon observed World Autism Awareness Day Saturday with rights groups advocating for autistic children to be given an education. Supporters say autistic children often can’t go to school because autism is falsely believed to be a result of witchcraft.

The Timely Performance Care Center, a school for disabled children in Cameroon’s capital, Yaounde, organized a campaign for parents and communities to stop the stigma that autistic kids often are subject to.

The center has an enrollment of 70 autistic children.

The school’s manager, Betty Nancy Fonyuy, said autistic children are frequently kept at home because of stigma. She said many communities and parents abuse the rights of autistic children by refusing to educate them or give them the freedom to socialize with other children.

“We want parents to accept the children that God has given them and to be able to educate the society that these children are not a form of divine punishment for witchcraft or a class of any evil thing. These children have a lot to offer to society if given a chance. Give them the chance. The world needs to know what autism is. Accept individuals born and living with autism,” she said.

Fonyuy said in January 2021, the center organized a door-to-door campaign to urge parents to send their autistic children to school. She said the response was encouraging, but that many parents still hide their autistic children at home.

To mark World Autism Awareness Day on Saturday, scores of community leaders, parents of autistic children and heads of educational establishments in Cameroon’s economic capital, Douala, emphasized at an event that autistic children, like any other children, need love, care and education.

Among the speakers was Carine Bevina, a psychologist at the University of Douala.

Bevina said parents should enroll their children in school because the parents would find it difficult to train their autistic children on their own. Bevina spoke by a messaging app from Douala.

She said autism level one means that a child needs regular attention and help to surmount difficulties initiating social interactions and maintaining reciprocity in social interactions. She said autism level two means that a child has repetitive behaviors and requires substantial support, and autism level three means the child’s communication skills are regressing.

Ndefri Paul, 45, is the father of an 11-year-old autistic child.

Paul said he came out on World Autism Awareness Day to tell anyone who doubted it that autistic children can compete with other children if well educated. He says in 2021, his autistic son, like many children without autism, wrote and passed the entrance examination to get into secondary school.

The educational talk at the Douala city council courtyard on Saturday was part of activities marking World Autism Awareness Day.

Similar activities were held in towns, including Bafoussam, a western commercial city, Garoua and Maroua on Cameroon’s northern border with Nigeria, and Yaounde.

Officials in Cameroon say there are 750,000 autistic children in the central African state. Sixty-five percent of them are denied education.

Cameroon’s Social Affairs minister, Pauline Irene Nguene, said communities should stop stigmatizing autistic children with the erroneous belief that autism is divine punishment for parents of autistic children. She said communities should denounce parents who hide autistic children at home and schools that refuse to teach children with the disorder.

The U.N. says that autism is genetic and families with one child with autism have an increased risk of having another child with autism. The U.N. says family members of a person with autism also tend to have higher rates of autistic traits.

World Autism Awareness Day celebrates the resilience of people affected by the disorder and supports causes that promote awareness of autism. Children in schools are educated about autism and encouraged to accept it. The U.N. launched World Autism Awareness Day for the first time in 2007.
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Britain is experiencing a record number of COVID-19 cases, with almost 5 million people, or 1 person in every 13 infected, according to official data.

The news of the spike in infections came on the same day that Britain stopped giving free rapid COVID tests to most of its population, as part of Prime Minister Boris Johnson’s “living with COVID” plan.

Under Johnson’s plan, people who do not have conditions that make them vulnerable to COVID-19 must pay for tests to find out if they have been infected.

The uptick is blamed on the highly contagious omicron variant BA.2, which is also causing an increase in hospitalization and death rates. However, the number of infections is expected to start decreasing this month and next month, officials say.

“Any infection that spreads rapidly, peaks quickly and decreases rapidly on the other side,” Paul Hunter, professor of medicine at the University of East Anglia, told The Guardian.

According to an Associated Press report, a University of Oxford biology professor said he believes most people in the country will be infected with the variant this summer.

James Naismith said, “This is literally living with the virus by being infected with it.”

Johns Hopkins Coronavirus Resource Center reported early Sunday that it has recorded more than 490,000 global COVID cases and more than 6 million deaths.  Nearly 11 billion vaccines have been administered, according to Johns Hopkins.
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Irina, her husband and 4-year-old son hid in the cellar of their house in Chernihiv, north of Kyiv, for three weeks as intense fighting, including a tank battle, raged around them.

“At first my son seemed to be coping okay,” she says. “But then with unrelenting stress, shelling and blasts, there was a deterioration — the boy started to become withdrawn. He became nervous. He started to stutter,” she says.

Their escape from Chernihiv wasn’t gentle either.

“We had to drive along a road, which we knew was mined. And we saw a lot of burned-out cars with people, families, scorched inside. We tried to ignore it all and just continue because we had our kid and just wanted to save him,” she says.

She doesn’t know what her son saw, what he took in from the carnage and how it is churning inside him. He was in his booster seat in the back of their car. She hopes he slept through a lot of the dangerous and terrifying journey from Chernihiv.

“I have not tried to raise anything with him about what he saw,” she added. She has heard that drawing is good therapy for traumatized children and has been encouraging him to do so.

So far, he has been drawing repeatedly the yellow and blue Ukrainian colors.

Many Ukrainian evacuees say they have noticed their children have changed and seemed to be displaying signs of trauma and stress, even those who did not witness at first hand horrifying scenes.  Some exhibit rage; others seem withdrawn. Some are bed-wetting.

“It won’t just be combatants, we will have to help after this war,” says the Reverend Mykola Kwich, a Greek-Catholic priest in western Ukraine. Kwich is a trained counselor and has helped rehabilitate soldiers suffering from post-traumatic stress disorder.

 

“Civilians who have gone through bombardments and shelling and have witnessed a lot will need help,” he said. “We are expecting to have to do a huge amount of psychological work. We will have to do this work because it will impact our society and lead to more problems.

 

“Wars are about destruction. In the same way towns and buildings get damaged during war, so with people inside. After war, you can’t be the same person. But there are methods and therapy we can use to help restore people’s mental health and assist them to pursue a normal life, if they are willing. Of course, you won’t return to being the person you were before,” he adds.

 

Refugee reception centers in central and Western Ukraine are trying to offer traumatized adults counseling and play therapy for kids. “We do have specialists and priests coming to visit the evacuees” says Valeriy Dyakiv, director of a reception facility sheltering about 300 evacuees in the central Ukrainian town of Vinnytsia.

 

“Prayers calm people a little bit,” he adds. “And for children there are different types of activities. We had a puppet show the other day, and for some kids it was a huge surprise because they were from small villages and they had never seen puppets before,” he says. The activities for the kids also involve drama and poetry readings.

 The center managed by Dyakiv has the benefit of having as an evacuee a well-known Ukrainian actress, Olena Prystup, who fled her hometown of Kharkiv, the beleaguered eastern Ukraine town. “My favorite role? Prystup ponders when asked. “Ophelia,” she then says.

That seems highly fitting what Prystup is trying to do now — to help traumatized children deal with their stress. William Shakespeare’s Ophelia, from the drama “Hamlet,” is a young Danish noblewoman and potential wife for Prince Hamlet, who, due to Hamlet’s actions, ends up falling into a state of madness that ultimately leads to her drowning herself.

“We have two groups of kids,” Prystup says. “The youngsters are learning some poems by heart and then reciting them at short performances. And the older ones, teenagers, are actually working on a play right now. I don’t know how it’s going to shape out. I hope it is going to be okay, and some of them are talented,” she adds.

Professional psychiatrists worry, though, that Ukraine doesn’t have the health care capacity to cope with what is likely to be needed when the war is over. Even before Russia’s invasion, Ukraine suffered a high prevalence of depression, alcoholism and suicide compared to some other European countries.

A report by the World Health Organization in 2020 noted that mental health disorders are the country’s second leading cause of disability and affect about 30 percent of the population. The WHO also noted that many Ukrainians distrust psychiatry because of the Soviet past when psychiatry was used as a tool of repression — dissidents were often accused of being “mentally ill” and incarcerated in hospitals during the Communist era.

It said in a report, “Challenges include a large institutionalized psychiatric system associated with human rights violations, alongside public stigma and low awareness of mental health. Social services for people with mental disorders are limited or absent in the community.”
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The future of abortion rights is in flux in the U.S. as the Supreme Court is expected to weigh in on the issue in June. Since September, Texas has banned abortions after six weeks.

Amy, a spoken-word poet, recently had an abortion. And it was no easy task. The divorced mother of a 3-year-old said she barely had time to think once she realized she was pregnant — because she is in Texas.

“If I would have had a little bit more time, lowered my blood pressure a little bit — maybe I would have made a different decision. We’ll never know,” she said.

In September, the state enacted the most restrictive abortion law in the U.S. Amy, who declined to give her last name, knew she had just days to make her decision, find a place to get an abortion, and then go through with it.

“I don’t even think I had gotten the results from the pregnancy test, and I was already googling where to get an abortion in Texas, just so that I could have the option,” she said.

Amy’s experience in Texas may soon become reality for more women in the U.S.

The Supreme Court is expected to decide on an abortion case in June that could spur a wave of abortion rights restrictions throughout the nation.

Worried abortion rights advocates point to life in Texas under the new law, where abortion is illegal after a fetal heartbeat is detected, which is around six weeks of being pregnant for most women.

The law also carries the ability to sue anyone who helps a woman get an abortion after six weeks.

The reality for most women is the deadline is even shorter. When Amy missed her period, two weeks after having sex, she was considered to be four-and-a-half to five weeks pregnant, since pregnancy is calculated from the first day of a woman’s last period. Amy had less than a week, but after multiple phone calls, she was able to get into a clinic.

“I didn’t even have time to assess my own thoughts, I felt the clock ticking,” she said.

For anti-abortion activists, this time constraint is a big step in the right direction.

“Our goal is to make a society such that no woman would even consider having an abortion because she feels there are no alternatives. We do have vast alternatives,” said Joe Pojman, founder of Texas Alliance for Life.

Instead of seeking an abortion, Pojman wants pregnant women to visit Texas’ nearly 200 crisis pregnancy centers, where he says they can find support.

Brittany Green-Benningfield, who heads the Pflugerville Pregnancy Resource Center, said such groups offer a variety of resources for pregnant women.

“So this is our baby boutique for our moms,” she said while offering a tour of the center. “This is where, when they come and take lessons with us, they get an opportunity to shop. Through classes, they earn points, and then they are able to take what they need. We have a licensed sonographer, and she provides ultrasounds for any of our clients that come in. We are giving our moms a first glimpse to see their baby.”

The centers also help women make doctor’s appointments and offer things like canned goods until the child is 2-and-a-half to 3 years old. Pojman said it’s all a big step in the right direction, but that much more work is needed.

“While the number of abortions has substantially decreased and women are seeking more agencies that provide alternatives to abortions, there are still tens of thousands of abortions in Texas going on,” he said.

In some ways, Amy was a best-case scenario for someone seeking an abortion in Texas. She knew the law, she knew she had to move quickly, and she had resources to get an abortion and possibly travel out of state, if necessary. That’s not the case for poorer women who are being harmed most by the law, say abortion rights advocates.

Sarah Wheat, a spokesperson for Planned Parenthood, said she sees the obstacles women can face.

“Once they find out and are informed that Texas law prevents them from accessing an abortion right here as they’re sitting already in our health center, it’s too much, the barriers are too great, whether that is that they don’t have access to reliable transportation or they can’t get time off of their job or they don’t have somebody to take care of their children. It is totally out of reach,” she said.

In each month between September and December, 1,400 Texas women went out of state for an abortion, according to the University of Texas. That’s more than 4,000 women. Many others who missed the deadline ordered abortion pills online, which come with risks when not taken under medical supervision.

Amy said this makes her worry.

“Women are going to get abortions,” she said. “They’ve done it for centuries, even when they were fully illegal, and that’s how women died from abortions. So if you take away this decision, you’re ultimately just taking away women’s lives.”
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The future of abortion rights is in flux in the U.S. as the Supreme Court is expected to weigh in on the issue in June. Since September, Texas has banned abortions after six weeks. For women seeking an abortion, many are in a race against time. Deana Mitchell has the story. 
Camera: Deana Mitchell Produced by: Deana Mitchell
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As Russia’s invasion of Ukraine enters a second month, social media and television continue to constantly broadcast disturbing images and news about the conflict. That’s raising some concerns about the effect it might be having on children’s mental health. Video: Artyom Kokhan
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Cameroon is struggling to contain a cholera outbreak that has sickened 6,000 people with the bacteria and killed nearly 100 since February. Authorities have dispatched the ministers of health and water to affected areas and have begun quarantining cholera patients to prevent it from spreading.

Cameroon’s Public Health Ministry said the number of cholera patients received in hospitals was growing by the day.  

In the seaside city of Limbe in the past week alone, 200 of 300 patients were treated and discharged from the government hospital. 

Filbert Eko, the highest-ranking official in Cameroon’s Southwest region where Limbe is located, said the region was the worst hit by cholera, with more than 800 cases since February, forcing the the quarantining of patients to prevent the disease from spreading.

“The treatment center will be separated from the hospital and from the public. No outsider will be allowed to have access to the patients,” Eko said. “We don’t want contact between families and the patients. We are taking [efforts] upon ourselves, searching for resources to feed these patients free of charge.”

Cameroon’s Public Health Ministry says many of those sickened by cholera do not go to hospitals, seeking only traditional cures, and end up dying at home, though no official figures are given.  

Health officials are urging traditional healers to direct their cholera patients to the closest hospital. 

Linda Esso, director of epidemics and pandemics at Cameroon’s Public Health Ministry, said cholera has spread to more than 40% of major towns, including the capital, Yaounde, the economic capital, Douala, and western commercial towns like Buea, Limbe and Bafoussam.  Esso said scores of villages have reported cholera cases and the entire country is threatened by the outbreak. She said the public should be very careful and protect itselves because contaminated persons may be spreading the disease without knowing it.

Cameroon’s president, Paul Biya, dispatched the ministers of health and water this week to cholera-affected areas to assess the situation.  

The two ministers blamed a shortage of clean drinking water in towns and villages, brought on by the long dry season, for rising cholera infections. 

They said medical staff were increased in the areas and about 30 new public toilets have been constructed in Limbe, Buea, and Douala to improve public hygiene. The ministers called on the public to stop defecating in the open and in streams.  

Cameroon’s minister of water, Gaston Eloundou Essomba, said officials are also providing clean water to villages and towns hit by the outbreak. He said he has asked the Cameroon Water Distribution Company (CAMWATER) to make sure trucks transport water regularly and free of charge to towns and villages that lack piped water.  He said the water distribution company should immediately treat water in all community and family wells to ensure the public has quality drinking water.

Cameroon’s public health minister, Manaouda Malachie, says Douala’s New Bell Prison has become an epicenter of cholera.  

He said hygiene had been improved at the prison but would not say how many of the more than 6,000 inmates were infected or died from the bacteria.  

Cameroon suffers from frequent cholera outbreaks.  One of the worst, in 2011, infected more than 23,000 people and killed more than 800.
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Golden butterflies adorn the walls of the Netherland’s only euthanasia expertise center, put up in remembrance of thousands of patients who have chosen to die with dignity over the past two decades.

Situated in a leafy upmarket suburb of The Hague, the Euthanasia Expertise Center is the only one of its kind, giving information, assisting medical doctors and providing euthanasia as end-of-life care, which was legalized in a world first in the Netherlands on April 1, 2002.

Belgium soon followed later that year and Spain last year became the sixth country to adopt euthanasia — the act of intentionally ending a life to relieve a person’s suffering, for instance through a lethal injection given by a doctor.

The number of people seeking euthanasia is growing in the Netherlands, with some 7,666 last year, up by more than 10 percent from the year before, according to official figures.

The vast majority are aged 60 or over, suffering from cancer or other terminal illnesses.

“Twenty years ago, when the law was passed, it was known, but certainly not used as often as today,” said Sonja Kersten, director of the Euthanasia Expertise Center.

The reasons are many: an ageing Dutch population; the fact that euthanasia is no longer a taboo subject and society has opened up to the issue.

“Dying with dignity is a debate that’s growing within Dutch society, which is quite open to the subject,” Kersten said.

‘Existential question’

Euthanasia is only authorized in a few countries around the world.

In Belgium, which will mark two decades of euthanasia in May, some 40 French citizens also benefitted from the practice last year.

The decision to ask for euthanasia as end-of-life care remains a “difficult and existential question,” Kersten said.

“It’s neither a patient’s right, nor a doctor’s duty,” to have euthanasia, she added.

In the Netherlands, euthanasia can only be carried out under strict conditions set down in Dutch law.

Children aged up to 16 need the permission of their parents and guardians, while parents must be involved in the process for children aged 16 and 17. From 18, any Dutch citizen may ask for assisted death.

In all cases, the patient must have “unbearable suffering with no prospect of improvement” and must have requested to die in a way that is “voluntary, well considered and with full conviction”.

Other criteria apply as well, like the absence of a reasonable alternative to the patient’s situation.

Doctors, too, cannot be forced to perform euthanasia.

‘Die at home’

The Euthanasia Expertise Centre helps doctors through the process by sharing knowledge and providing guidance. At the same time, the center helps patients whose doctors refuse to help them.

The center, established in 2012, is a foundation but patient care is reimbursed by health insurers.

It first positioned itself as the “Levenseindekliniek,” Dutch for “End-of-life clinic,” offering on-site euthanasia.

But even before the start, it became apparent that most patients preferred to die at home, Kersten said.

Today, the center can call upon a network of about 140 doctors and nurses around the country, employed by the Euthanasia Expertise Center.

Most euthanasia requests, however, are handled by the patient’s own physician, with whom they already have a relationship of trust. Last year, this was true for 80 percent of euthanasia procedures performed in the country.

“There are however still doctors in the Netherlands who are opposed to euthanasia,” said Kersten, adding “they have every right.”

The center’s medical team itself provided euthanasia to nearly 900 people in 2020, out of nearly 3,000 requests, with figures on the rise.

About 20 percent had dementia or psychiatric disorders.

The Netherlands’ highest court ruled in 2020 that doctors can euthanize patients with severe dementia without the fear of prosecution.

It concerns patients with advanced dementia who are no longer mentally competent but who previously had a clear request for euthanasia.

The decision followed a landmark case, not related to the Expertise center, in which a doctor was acquitted of providing euthanasia on a woman in 2016 with severe Alzheimer’s disease, who earlier requested the procedure.
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When the end of the COVID-19 pandemic comes, it could create major disruptions for a cumbersome U.S. health care system made more generous, flexible and up-to-date technologically through a raft of temporary emergency measures.

Winding down those policies could begin as early as the summer. That could force an estimated 15 million Medicaid recipients to find new sources of coverage, require congressional action to preserve broad telehealth access for Medicare enrollees, and scramble special COVID-19 rules and payment policies for hospitals, doctors and insurers. There are also questions about how emergency use approvals for COVID-19 treatments will be handled.

The array of issues is tied to the coronavirus public health emergency first declared more than two years ago and periodically renewed since then. It’s set to end April 16 and the expectation is that the Biden administration will extend it through mid-July.

Some would like a longer off-ramp.

Transitions don’t bode well for the complex U.S. health care system, with its mix of private and government insurance and its labyrinth of policies and procedures. Health care chaos, if it breaks out, could create midterm election headaches for Democrats and Republicans alike.

“The flexibilities granted through the public health emergency have helped people stay covered and get access to care, so moving forward the key question is how to build on what has been a success and not lose ground,” said Juliette Cubanski, a Medicare expert with the nonpartisan Kaiser Family Foundation, who has been researching potential consequences of winding down the pandemic emergency.

Medicaid churn

Medicaid, the state-federal health insurance program for low-income people, is covering about 79 million people, a record partly due to the pandemic.

But the nonpartisan Urban Institute think tank estimates that about 15 million people could lose Medicaid when the public health emergency ends, at a rate of at least 1 million per month.

Congress increased federal Medicaid payments to states because of COVID-19, but it also required states to keep people on the rolls during the health emergency. In normal times states routinely disenroll Medicaid recipients whose incomes rise beyond certain levels, or for other life changes affecting eligibility. That process will switch on again when the emergency ends, and some states are eager to move forward.

Virtually all of those losing Medicaid are expected to be eligible for some other source of coverage, either through employers, the Affordable Care Act or — for kids — the Children’s Health Insurance Program.

But that’s not going to happen automatically, said Matthew Buettgens, lead researcher on the Urban Institute study. Cost and lack of awareness about options could get in the way.

People dropped from Medicaid may not realize they can pick up taxpayer-subsidized ACA coverage. Medicaid is usually free, so people offered workplace insurance could find the premiums too high.

“This is an unprecedented situation,” said Buettgens. “The uncertainty is real.”

The federal Centers for Medicare and Medicaid Services, or CMS, is advising states to take it slow and connect Medicaid recipients who are disenrolled with other potential coverage. The agency will keep an eye on states’ accuracy in making eligibility decisions. Biden officials want coverage shifts, not losses.

“We are focused on making sure we hold on to the gains in coverage we have made under the Biden-Harris administration,” said CMS Administrator Chiquita Brooks-LaSure. “We are at the strongest point in our history and we are going make sure that we hold on to the coverage gains.”

ACA coverage — or “Obamacare” — is an option for many who would lose Medicaid. But it will be less affordable if congressional Democrats fail to extend generous financial assistance called for in President Joe Biden’s social legislation. Democrats stalling the bill would face blame.

Republicans in mostly Southern states that have refused to expand Medicaid are also vulnerable. In those states, it can be very difficult for low-income adults to get coverage and more people could wind up uninsured.

State Medicaid officials don’t want to be the scapegoats. “Medicaid has done its job,” said Matt Salo, head of the National Association of Medicaid Directors. “We have looked out for physical, mental and behavioral health needs. As we come out of this emergency, we are supposed to right-size the program.”

Telehealth static

Millions of Americans discovered telehealth in 2020 when coronavirus shutdowns led to the suspension of routine medical consultations. In-person visits are again the norm, but telehealth has shown its usefulness and gained broader acceptance.

The end of the public health emergency would jeopardize telehealth access for millions enrolled in traditional Medicare. Restrictions predating COVID-19 limit telehealth mainly to rural residents, in part to mitigate health care fraud. Congress has given itself 151 days after the end of the public health emergency to come up with new rules.

“If there are no changes to the law after that, most Medicare beneficiaries will lose access to coverage for telehealth,” the Kaiser Foundation’s Cubanski said.

A major exception applies to enrollees in private Medicare Advantage plans, which generally do cover telehealth. However, nearly 6 in 10 Medicare enrollees are in the traditional fee-for-service program.

Tests, vaccines, treatments, payments & procedures

Widespread access to COVID-19 vaccines, tests and treatments rests on legal authority connected to the public health emergency.

One example is the Biden administration’s requirement for insurers to cover up to eight free at-home COVID-19 tests per month.

An area that’s particularly murky is what happens to tests, treatments and vaccines covered under emergency use authorization from the Food and Drug Administration.

Some experts say emergency use approvals last only through the duration of the public health emergency. Others say it’s not as simple as that, because a different federal emergency statute also applies to vaccines, tests and treatments. There’s no clear direction yet from health officials.

The FDA has granted full approval to Pfizer-BioNTech’s COVID-19 vaccine for those 16 and older and Moderna’s for those 18 and older, so their continued use would not be affected.

But hospitals could take a financial hit. Currently Medicare pays them 20% more for the care of COVID-19 patients. That’s only for the duration of the emergency.

And Medicare enrollees would have more hoops to jump through to be approved for rehab in a nursing home. A suspended Medicare rule requiring a prior three-day hospital stay would come back into effect.

Health and Human Services Secretary Xavier Becerra recently told The Associated Press that his department is committed to giving “ample notice” when it ends the public health emergency.

“We want to make sure we’re not putting in a detrimental position Americans who still need our help,” Becerra said. “The one that people are really worried about is Medicaid.”
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Laura Purdy is a U.S. doctor on Ukraine’s front lines. In her case, that’s a computer screen in Tennessee.

“Patients that I have talked to from some of the larger cities in Ukraine are fearful of leaving their homes because of air raid sirens or offshore attacks,” said Purdy, a surgeon who, until 2016, served in the U.S. Army’s units that provide health care to civilians worldwide. “They need/want to speak to a physician but are fearful to venture out to do so.”

Purdy now cares for patients in Kyiv and other cities under Russian attack through Starlink, an internet constellation of some 2,000 satellites operated by billionaire Elon Musk’s private firm SpaceX.

Russia invaded Ukraine on February 24, and as of March 30, 1,189 Ukrainians had been killed and 1,901 injured, according to the U.N. Human Rights Office.

U.S. doctors are stepping up to provide much-needed advice via telehealth, a practice honed during the pandemic, to the Ukranian soldiers, civilians and refugees injured in the fighting or attempting to manage chronic diseases amid the chaos.

Purdy is just one of the many physicians who have joined Aimee, a 10-year-old telehealth platform headquartered in Silicon Valley. Having built the telehealth systems for the International Space Station and SpaceX, Aimee is staffed by self-described “nerds who want to make a difference” and are now partnering with Ukraine’s Ministry of Health to provide Ukrainians with free telemedicine visits.

By using the Aimee app, Purdy said, patients can get advice and treatment recommendations from a U.S. physician while they remain in a safe location.

Milton Chen, founder and CEO of VSee, the telehealth company that launched Aimee, said a “couple thousand” physicians and a “couple hundred” translators have joined the platform to provide 24/7 telecare in Ukraine. The doctors provide care for battlefield trauma injuries as well as basics such as prenatal care, chronic disease management and mental health services.

“You could do a remote ultrasound; you could connect to a digital stethoscope to listen to someone’s heart and lung sound. All these medical signals will stream live to the physicians — so other than physically touching the patient — and the physician could get quite a bit of information on the patient,” he said via video.

Through telemedicine, Purdy treated a legally blind man who relies on his family for all his daily needs. Purdy helped him set up a free consultation with an ophthalmologist to interpret tests he underwent in Ukraine.

“This occurred in a city that was actively under attack, and we were able to provide advice and support to the patient while allowing him to stay safely sheltered in place,” she told VOA Mandarin.

The lack of medicine is one of the biggest hurdles for patients in Ukraine, said Purdy, who earned her medical degree at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

“The pharmacies have run out of medication, or they are closed. So, many times we find patients who we can give medical recommendations to, but they may not have access to the pharmaceuticals that they need to treat the condition they are experiencing,” she said.

And while remote doctors can’t solve challenges such as the lack of insulin for patients with diabetes, they can provide much-needed assistance. Dr. Mohamed Aburawi, founder and CEO of Speetar, a telehealth platform founded in 2017 to operate in Libya, told Forbes that “every day a conflict lasts, the situation worsens, and telehealth provides care, relief and stability to communities and people that need it most. Our own experience in protracted conflict highlights how telehealth maintains continuity of care for refugees, migrants and internally displaced populations.”

Telemedicine can also include teaching patients how to stop bleeding from wounds and injuries, a challenge for citizens in war zones, said Patricia Turner, executive director of the American College of Surgeons, which since 2015 has trained people without medical backgrounds through the Stop the Bleed initiative launched by the White House.

“When you bleed … you can actually die in as quickly as five minutes, so stopping the bleeding helps … save a life,” she told VOA Mandarin.

Two doctors who have family ties to Ukraine and work at Brigham and Women’s Hospital in Boston, Massachusetts, turned to telemedicine and developed a training video for Ukrainians.

Dr. Nelya Melnitchouk, a Ukraine native, came up with the idea for the video, and Dr. Eric Goralnick, who is of Ukrainian descent, helped organize the collaboration between the hospital and the Stop the Bleed initiative, according to The Boston Globe.

The training course can be finished in a few hours, Turner said, and can help health care workers and the public learn how to effectively stop bleeding.

“More than 100 people are being trained every other day,” she said. “We’re doing it via video so you can watch them on YouTube. We’re also doing them live remotely so that we can answer questions.”
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The U.K. will ban conversion therapy for gay or bisexual people in England and Wales, but not for transgender people, ITV reported Thursday.

Hours earlier, the government had confirmed an ITV report that it would drop a plan to introduce legislation to ban LGBT conversion therapy and would instead review how existing law could be utilized more effectively to prevent it.

That prompted an angry response from LGBT groups and some lawmakers.

“The Prime Minister has changed his mind off the back of the reaction to our report and he WILL now ban conversion therapy after all,” ITV political reporter Paul Brand tweeted.

“Senior Govt source absolutely assures me it’ll be in Queen’s Speech (of planned legislation). But only gay conversion therapy, not trans,” he said.

A Downing Street spokesperson declined to comment.

Prime Minister Boris Johnson’s government has come under increasing pressure on the issue after former leader Theresa May vowed in 2018 to eradicate a procedure that aims to change or suppress someone’s sexual orientation or gender identity.

In May last year, when the government set out its post-pandemic parliamentary agenda, it said measures would be brought forward to prevent these “abhorrent practices which can cause mental and physical harm,” starting with a consultation on how best to protect people and how to eliminate coercive practices.
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Scientists say they have finally assembled the full genetic blueprint for human life, adding the missing pieces to a puzzle nearly completed two decades ago.

An international team described the first-ever sequencing of a complete human genome – the set of instructions to build and sustain a human being – in research published Thursday in the journal Science. The previous effort, celebrated across the world, was incomplete because DNA sequencing technologies of the day weren’t able to read certain parts of it. Even after updates, it was missing about 8% of the genome.

“Some of the genes that make us uniquely human were actually in this ‘dark matter of the genome’ and they were totally missed,” said Evan Eichler, a University of Washington researcher who participated in the current effort and the original Human Genome Project. “It took 20-plus years, but we finally got it done.”

Many — including Eichler’s own students — thought it had been finished already.

“I was teaching them, and they said, ‘Wait a minute. Isn’t this like the sixth time you guys have declared victory? I said, ‘No, this time we really, really did it!” Eichler said.

Scientists said this full picture of the genome will give humanity a greater understanding of our evolution and biology while also opening the door to medical discoveries in areas like aging, neurodegenerative conditions, cancer and heart disease.

“We’re just broadening our opportunities to understand human disease,” said Karen Miga, an author of one of the six studies published Thursday.

The research caps off decades of work. The first draft of the human genome was announced in a White House ceremony in 2000 by leaders of two competing entities: an international publicly funded project led by an agency of the U.S. National Institutes of Health and a private company, Maryland-based Celera Genomics.

The human genome is made up of about 3.1 billion DNA subunits, pairs of chemical bases known by the letters A, C, G and T. Genes are strings of these lettered pairs that contain instructions for making proteins, the building blocks of life. Humans have about 30,000 genes, organized in 23 groups called chromosomes that are found in the nucleus of every cell.

Before now, there were “large and persistent gaps that have been in our map, and these gaps fall in pretty important regions,” Miga said.

Miga, a genomics researcher at the University of California-Santa Cruz, worked with Adam Phillippy of the National Human Genome Research Institute to organize the team of scientists to start from scratch with a new genome with the aim of sequencing all of it, including previously missing pieces. The group, named after the sections at the very ends of chromosomes, called telomeres, is known as the Telomere-to-Telomere, or T2T, consortium.

Their work adds new genetic information to the human genome, corrects previous errors and reveals long stretches of DNA known to play important roles in both evolution and disease. A version of the research was published last year before being reviewed by scientific peers.

“This is a major improvement, I would say, of the Human Genome Project,” doubling its impact, said geneticist Ting Wang of the Washington University School of Medicine in St. Louis, who was not involved in the research.

Eichler said some scientists used to think unknown areas contained “junk.”

“Some of us always believed there was gold in those hills,” he said. Eichler is paid by the Howard Hughes Medical Institute, which also supports The Associated Press’s health and science department.

Turns out that the gold Eichler believed in includes many important genes, he said, such as some integral to making a person’s brain bigger than a chimp’s, with more neurons and connections.

To find such genes, scientists needed new ways to read life’s cryptic genetic language.

Reading genes requires cutting the strands of DNA into pieces hundreds to thousands of letters long. Sequencing machines read the letters in each piece and scientists try to put the pieces in the right order. That’s especially tough in areas where letters repeat.

Scientists said some areas were illegible before improvements in gene sequencing machines that now allow them to, for example, accurately read a million letters of DNA at a time. That allows scientists to see genes with repeated areas as longer strings instead of snippets that they had to later piece together.

Researchers also had to overcome another challenge: Most cells contain genomes from both mother and father, confusing attempts to assemble the pieces correctly. T2T researchers got around this by using a cell line from one “complete hydatidiform mole,” an abnormal fertilized egg containing no fetal tissue that has two copies of the father’s DNA and none of the mother’s.

The next step? Mapping more genomes, including ones that include collections of genes from both parents. This effort did not map one of the 23 chromosomes that is found in males, called the Y chromosome, because the mole contained only an X.

Wang said he’s working with the T2T group on the Human Pangenome Reference Consortium, which is trying to generate reference, or template, genomes for 350 people representing the breadth of human diversity.

“Now we’ve gotten one genome right and we have to do many, many more,” Eichler said. “This is the beginning of something really fantastic for the field of human genetics.”
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A microgravity ceremony ushers in a new commander of the International Space Station. An old space telescope finds something new in the cosmos. And a futuristic helmet to study astronauts’ brain waves. VOA’s Arash Arabasadi brings us The Week in Space.
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After spending two years being socially distanced in his home country of South Korea, Kim Hoe-jun booked a last-minute flight to Hawaii, where he had enjoyed his honeymoon six years ago, giving in to his craving for overseas travel.

“I bought the ticket just a week ago, but it was rather a no-brainer. It felt like I was making up for those two years not being able to go abroad often as I used to before COVID,” he said, before boarding the plane from Incheon International Airport on Friday.

Vaccinated and boosted, Kim and his wife are among South Koreans joining in a rush for “revenge travel” — a term that has been trending on social media as people scramble to book overseas trips that were delayed by coronavirus restrictions.

The boom started after March 21 when South Korea lifted a seven-day mandatory quarantine for fully vaccinated travelers arriving from most countries. The restriction had been eased last year but was reimposed in December as the highly infectious Omicron variant spread.

The country has largely scrapped its once-aggressive tracing and containment efforts despite a record COVID-19 wave, joining a growing list of Asian countries that have eased quarantine rules, including Singapore, Japan, Australia and New Zealand.

Koreans now appear more ready to travel. Polls showed people are less worried about the implications of catching the virus, and increasingly see its prevention as out of their hands.

Sales of overseas flight tickets on 11st, an e-commerce unit of SK Telecom, South Korea’s top mobile carrier, rose more than eight-fold compared with a year before between March 11, when the lifting of quarantine was announced, and March 27, the company said.

Kim Na-yeon, 27, was excited to return to Hawaii, where she used to live.

“I couldn’t dare to travel even in Korea because of COVID,” she said. “But now I feel a bit freer with the exemption, so I’ve decided to go meet old friends and do some sightseeing.”

Exploding demand

Airlines and travel agencies have reported exploding demand for routes to Hawaii, Saipan and Guam, as well as some destinations in Europe and Southeast Asia where tourists submitting a vaccination certificate or negative test result are exempted from quarantine.

Saipan and Guam, both of which have travel bubble pacts with South Korea, also offer free COVID testing and pay for quarantine expenses if a traveler tests positive. Each South Korean national visiting Saipan receives $100 in “travel bucks” to spend at businesses there.

The tour arm of online retail giant Interpark reported a 324% growth in flight bookings for Oceania between March 11-22 from the same period of 2021, a 268% increase for Southeast Asia and 262% more bookings for Europe.

On Sunday, the company sold a record 5,200 Hawaii tour packages within 70 minutes. CJ Corp’s home shopping unit said it received about 2,800 orders for a Spain and Italy trip in one hour on Sunday, totaling 15 billion won ($12.41 million), days after garnering 9 billion won ($7.4 million) from its sales of a Hawaii package.

“The surge reflects growing customer sentiment that an end of COVID travel curbs might be in the offing after the mandatory quarantine was lifted,” said Lee Jeong-pil, general manager of CJ’s home shopping unit.

Lee Tae-woo, a 36-year-old frequent traveler to Japan, said he has changed some money into yen, taking advantage of the currency’s sharp decline and hoping to jump on the revenge travel bandwagon soon.

Though Japan has yet to allow tourists back in, it has reduced the quarantine period for arrivals for business and other purposes to three days from seven this month and signaled further easing of travel curbs.

“It’s been a long wait, and I’m ready to go back as soon as they finally open up again and visit my favorite coffee roastery and enjoy the night view from Shibuya station,” Lee said, referring to Tokyo’s bustling central district.
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Federal health officials are dropping the warning they have attached to cruising since the beginning of the pandemic, leaving it up to vacationers to decide whether they feel safe getting on a ship.

Cruise-ship operators welcomed Wednesday’s announcement, which came as many people thought about summer vacation plans.

An industry trade group said the move by the Centers for Disease Control and Prevention validated measures that ship owners have taken, including requiring crew members and most passengers to be vaccinated against the virus.

The CDC removed the COVID-19 “cruise ship travel health notice” that was first imposed in March 2020, after virus outbreaks on several ships around the world.

However, the agency expressed reservations about cruising.

“While cruising will always pose some risk of COVID-19 transmission, travelers will make their own risk assessment when choosing to travel on a cruise ship, much like they do in all other travel settings,” CDC spokesperson Dave Daigle said in an email.

Daigle said the CDC’s decision was based on “the current state of the pandemic and decreases in COVID-19 cases onboard cruise ships over the past several weeks.”

COVID-19 cases in the United States have been falling since mid-January, although the decline has slowed in recent weeks, and the current seven-day rolling average for daily new cases in the U.S. is roughly unchanged from two weeks ago, according to figures from Johns Hopkins University. States have rolled back mask mandates, putting pressure on federal officials to ease virus-related restrictions.

Outbreaks continue to be reported on cruise ships, which conduct random testing before the end of voyages.

On Sunday, a Princess Cruises ship returning from the Panama Canal had “multiple” passengers who had tested positive for the virus. Princess Cruises said all the affected passengers showed mild symptoms or none at all, and that all crew members and passengers had been vaccinated. About a dozen passengers tested positive before the same boat docked in San Francisco in January.

Operators are required to tell the CDC about virus cases on board ships. The agency has a colored-coded system to classify ships based on the percentage of passengers who test positive. The CDC said that system remains in place.

Cruise-ship operators have complained since the start of the pandemic that their industry has been singled out for a shutdown and then tighter COVID-19 restrictions than others, including airlines.

The Cruise Lines International Association said in a statement that the CDC’s decision to remove its health warning “recognizes the effective public health measures in place on cruise ships and begins to level the playing field between cruise and similarly situated venues on land.”

Colleen McDaniel, editor in chief of Cruise Critic, a site that publishes review of trips, called the CDC decision big news.

“Symbolically it’s a notice of winds of change when it comes to cruising,” she said. “I do think it can convince some of the doubters. What the CDC says does matter to cruisers.”
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A batch of dome-shaped ice volcanoes that look unlike anything else known in our solar system and may still be active have been identified on Pluto using data from NASA’s New Horizons spacecraft, showing that this remote frigid world is more dynamic than previously known.

Scientists said that these cryovolcanoes — numbering perhaps 10 or more — stand anywhere from 1 kilometer (six-tenths of a mile) to 7 kilometers (4-1/2 miles) tall. Unlike Earth volcanoes that spew gases and molten rock, this dwarf planet’s cryovolcanoes extrude large amounts of ice — apparently frozen water rather than some other frozen material — that may have the consistency of toothpaste, they said.

Features on the asteroid belt dwarf planet Ceres, Saturn’s moons Enceladus and Titan, Jupiter’s moon Europa and Neptune’s moon Triton also have been pegged as cryovolcanoes. But those all differ from Pluto’s, the researchers said, owing to different surface conditions such as temperature and atmospheric pressure, as well as different mixes of icy materials.

“Finding these features does indicate that Pluto is more active, or geologically alive, than we previously thought it would be,” said planetary scientist Kelsi Singer of the Southwest Research Institute in Boulder, Colorado, lead author of the study published this week in the journal Nature Communications.

“The combination of these features being geologically recent, covering a vast area and most likely being made of water ice is surprising because it requires more internal heat than we thought Pluto would have at this stage of its history,” Singer added.

Pluto, which is smaller than Earth’s moon and has a diameter of about 2,380 kilometers (1,400 miles), orbits about 5.8 billion kilometers (3.6 billion miles) away from the sun, roughly 40 times farther than Earth’s orbit. Its surface features plains, mountains, craters and valleys.

Images and data analyzed in the new study, obtained in 2015 by New Horizons, validated previous hypotheses about cryovolcanism on Pluto.

The study found not only extensive evidence for cryovolcanism but also that it has been long-lived, not a single episode, said Southwest Research Institute planetary scientist Alan Stern, the New Horizons principal investigator and study co-author.

“What’s most fascinating about Pluto is that it’s so complex – as complex as the Earth or Mars despite its smaller size and high distance from the sun,” Stern said. “This was a real surprise from the New Horizons flyby, and the new result about cryovolcanism re-emphasizes this in a dramatic way.”

The researchers analyzed an area southwest of Sputnik Planitia, Pluto’s large heart-shaped basin filled with nitrogen ice. They found large domes 30-100 kilometers (18-60 miles) across, sometimes combining to form more complexly shaped structures.

An elevation called Wright Mons, one of the tallest, may have formed from several volcanic domes merging, yielding a shape unlike any Earth volcanoes. Although shaped differently, it is similar in size to Hawaii’s large volcano Mauna Loa.

Like Earth and our solar system’s other planets, Pluto formed about 4.5 billion years ago. Based on an absence of impact craters that normally would accumulate over time, it appears its cryovolcanoes are relatively recent — formed in the past few hundred million years.

“That is young on a geologic timescale. Because there are almost no impact craters, it is possible these processes are ongoing even in the present day,” Singer said.

Pluto has lots of active geology, including flowing nitrogen ice glaciers and a cycle in which nitrogen ice vaporizes during the day and condenses back to ice at night — a process constantly changing the planetary surface.

“Pluto is a geological wonderland,” Singer said. “Many areas of Pluto are completely different from each other. If you just had a few pieces of a puzzle of Pluto you would have no idea what the other areas looked like.” 
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Scientists in Kenya are testing a project using solar panels to shade crops while generating clean energy. It’s called agrivoltaics. Successful trials have shown that this technology reduces water loss and results in higher yields. Juma Majanga reports from Kajiado, Kenya.
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U.S. President Joe Biden on Wednesday introduced his administration’s new website, COVID.gov, designed to be a clearinghouse for the latest pandemic information, as well as a means of providing access to vaccines, tests, treatments and masks on a single site.

Speaking to reporters at the White House, Biden also asked Congress to approve an additional $22 billion in emergency funding to help continue the fight against the COVID-19 pandemic.

Biden said the nation was entering a new moment in the pandemic. He stressed that though the pandemic no longer controlled our lives, it was not over, noting an uptick of new cases in recent weeks — as expected, he said.

Biden added that the U.S. now had the tools to protect all people.

The president said COVID.gov provides access to all the tools available to address COVID-19, including a list of all 90,000 vaccination sites in the United States, links to obtaining masks and tests, and where to obtain COVID-19 treatments. The site also has a search function, which can be used to find the latest information on the status of the pandemic in any region in the country.

‘Test-to-treat’ sites

The website also features a so-called “test-to-treat” locator, designed to allow access to U.S. pharmacies and community health centers where anyone can get tested for COVID-19 and, if required, receive appropriate treatment.

The White House said the administration had launched more than 2,000 such sites across the country, as well as 240 in Veterans Affairs and Department of Defense facilities to serve veterans, military personnel and their families.

The president also urged Congress to approve additional funding to fight the pandemic. He said without it, the U.S. would not be able to sustain its testing capacity beyond June, and vaccines could run out as early as September, leaving the nation vulnerable should another wave of the virus that causes COVID-19 hit.

Biden also noted that the U.S. Food and Drug administration on Tuesday approved a second COVID-19 booster — a fourth shot overall for those receiving the Pfizer or Moderna vaccines — for all people over age 50 and people with compromised immune systems.

He urged all eligible people to get their boosters. To prove his point, following his remarks at the White House, he received his fourth vaccination as reporters watched.
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Malaysia’s health ministry is proposing a major initiative to prevent young people from smoking. It’s a bold plan but critics say it has flaws. Dave Grunebaum has the story.
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