Stem cell scientists say they have created “synthetic embryos” without using sperm, eggs or fertilization for the first time, but the prospect of using such a technique to grow human organs for transplantation remains distant.

The breakthrough was hailed as a major step forward, though some experts said the result could not fully be considered to be embryos and warned of future ethical considerations.

In research published in the journal Cell this week, scientists at the Weizmann Institute of Science in Israel said found a way to have mouse stem cells self-assemble into embryo-like structures in the lab.

They started by collecting cells from the skin of mice, then made them return to the state of stem cells.

The stem cells were then placed in a special incubator designed by the researchers, which continuously moved to mimic a mother’s womb.

The vast majority of the cells failed to form anything.

But 50 — 0.5 percent of the 10,000 total — collected themselves into spheres, then embryo-like structures, the researchers said.

After eight days — around a third of the 20-day mouse gestation period — there were early signs of a brain and a beating heart, they added.

They were described as 95% similar to normal mouse embryos.

‘Time will tell’

If human organs could one day be grown in a lab, the technique could provide life-saving transplants for thousands of people every year.

Stem cell scientist Jacob Hanna, who led the research, told AFP, “The big problem for transplantation is that you need to find a matching donor and the DNA is never identical to the patient.”

But using the new technique, one day scientists could take cells from a patient’s liver, for example, use them to make stem cells, grow a synthetic embryo then “transplant them back into the patient,” Hanna said.

“The cell will be made from the patient, so it will be the exact DNA — no need to find donors and there can be no rejection,” he added.

While they were the most advanced synthetic embryo-like structures ever grown, some scientists not involved in the research warned against calling them “embryos.”

“These are not embryos,” French stem cell scientist Laurent David told AFP.

He preferred to call them embryoids, the name for a group of cells that resemble an embryo.

However, David welcomed the “very convincing” research, which he said could allow further experiments to understand exactly how organs form.

Beyond organs, Hanna said the embryoids could also help identify new targets for drugs and potentially help find solutions for a range of issues such as pregnancy loss, infertility, endometriosis and preeclampsia.

“Time will tell,” he said.

Hanna, a Palestinian who led the research at the institute in Israel, said, “Science is my escape from the harsh reality I face while living in my homeland.”

“And I am one of the very ‘lucky’ ones,” he added.

The first author of the Cell study is a PhD student from the Palestinian enclave of Gaza, who needs a special permit regularly renewed to allow him to work at the institute in the Israeli city of Rehovot, Hanna said.

Ethical implications

Hanna has founded a company, Renewal Bio, that he said “will be focusing on testing potential clinical applications of human synthetic embryoids.”

He said they had ethical approval for such testing in Israel and it was legal in many other countries such as the U.S. and U.K.

“We should remember that synthetic embryos are embryoids and not real embryos and do not have the potential to become viable,” he said.

But researchers not involved in the study said it was very early to consider using such a technique for humans.

Alfonso Martinez Arias of Spain’s Pompeu Fabra University said the breakthrough “opens the door to similar studies with human cells, though there are many regulatory hoops to get through first and, from the point of view of the experiments, human systems lag behind mouse systems.”

And aiming to get similar results from human cells is likely to open an ethical can of worms.

“Although the prospect of synthetic human embryos is still distant, it will be crucial to engage in wider discussions about the legal and ethical implications of such research,” James Briscoe of Britain’s Francis Crick Institute said.
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As a sex worker and adult film actor, Roc was relieved when he was among the first Spaniards to get a monkeypox vaccine. He knew of several cases among men who have sex with men, which is the leading demographic for the disease, and feared he could be next. 

“I went home and thought, ‘Phew, my God, I’m saved,’ ” the 29-year-old told The Associated Press. 

But it was already too late. Roc, the name he uses for work, had been infected by a client a few days before. He joined Spain’s steadily increasing count of monkeypox infections that has become the highest in Europe since the disease spread beyond Africa, where it has been endemic for years. 

He began showing symptoms: pustules, fever, conjunctivitis and tiredness. Roc was hospitalized for treatment before getting well enough to be released. 

Spanish health authorities and community groups are struggling to check an outbreak that has killed two young men. They reportedly died of encephalitis, or swelling of the brain, that can be caused by some viruses. Most monkeypox cases cause only mild symptoms. 

Spain has confirmed 4,942 cases in the three months since the start of the outbreak, which has been linked to two raves in Europe, where experts say the virus was likely spread through sex. 

The only country with more infections than Spain is the much larger United States, which has reported 7,100 cases. 

Global count

In all, the global monkeypox outbreak has seen more than 26,000 cases in nearly 90 countries since May. There have been 103 suspected deaths in Africa, mostly in Nigeria and Congo, where a more lethal form of monkeypox is spreading than in the West. 

Health experts stress that this is not technically a sexually transmitted disease, even though it has been mainly spreading via sex among gay and bisexual men, who account for 98% of cases beyond Africa. The virus can be spread to anyone who has close, physical contact with an infected person, their clothing or bed sheets. 

Part of the complexity of fighting monkeypox is striking a balance between not stigmatizing men who have sex with men, while also ensuring that both vaccines and pleas for greater caution reach those currently in the greatest danger. 

Spain has distributed 5,000 shots of the two-shot vaccine to health clinics and expects to receive 7,000 more from the European Union in the coming days, its health ministry said. The EU has bought 160,000 doses and is donating them to member states based on need. The bloc is expecting another 70,000 shots to be available next week. 

To ensure that those shots get administered wisely, community groups and sexual health associations are targeting gay men, bisexuals and transgender women. 

In Barcelona, BCN Checkpoint, which focuses on AIDS/HIV prevention in gay and trans communities, is now contacting at-risk people to offer them one of the precious vaccines. 

Pep Coll, medical director of BCN Checkpoint, said the vaccine rollout is focused on people who are already at risk of contracting HIV and are on preemptive treatment, men with a high number of sexual partners and those who participate in sex with the use of drugs, as well as people with suppressed immune responses. 

But there are many more people who fit those categories than doses, about 15,000 people just in Barcelona, Coll said. 

The lack of vaccines, which is far more severe in Africa than in Europe and the U.S., makes social public health policies key, experts say. 

Contact tracing more difficult

As with the coronavirus pandemic, contact tracing to identify people who could have been infected is critical. But, while COVID-19 could spread to anyone simply through the air, the close bodily contact that serves as the leading vehicle for monkeypox makes some people hesitant to share information. 

“We are having a steady stream of new cases, and it is possible that we will have more deaths. Why? Because contact tracing is very complicated because it can be a very sensitive issue for someone to identify their sexual partners,” said Amós García, epidemiologist and president of the Spanish Association of Vaccinology. 

Spain says that 80% of its cases are among men who have sex with men and only 1.5% are women. But García insisted that will change unless the entire public, regardless of gender or sexual orientation, grasps that having various sexual partners creates greater risk. 

Given the dearth of vaccines and the trouble with contact tracing, more pressure is being put on encouraging prevention. 

From the start, government officials ceded the leading role in the get-out-the-word campaign to community groups. 

Sebastian Meyer, president of the STOP SIDA association dedicated to AIDS/HIV care in Barcelona’s LGBTQ community, said the logic was that his group and others like it would be trusted message-bearers with person-by-person knowledge of how to drive the health warning home. 

Community associations that represent gay and bisexual men have bombarded social media, websites and blogs with information on monkeypox safety. Officials in Catalonia, the region including Barcelona that has over 1,500 cases, are pushing public service announcements on dating apps Tinder and Grindr warning about the disease. 

But Meyer believes fatigue from the COVID-19 pandemic has played a part. Doctors advise people with monkeypox lesions to isolate until they have fully healed, which can take up to three weeks. 

“When people read that they must self-isolate, they close the webpage and forget what they have read,” Meyer said. “We are just coming out of COVID, when you couldn’t do this or that, and now, here we go again. … People just hate it and put their heads in the sand.”
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Early Europeans drank milk for thousands of years before they evolved the ability to fully digest it as adults, scientists say.

New results published in the journal Nature suggest that being able to digest the lactose in milk wasn’t usually much of an advantage for ancient people in Europe. Instead, the new study suggests that famine and disease made lactose intolerance deadly.

The new discovery challenges the long-standing assumption that dairy farming spread through ancient populations alongside the genetic quirks that prevent adults from losing the ability to digest lactose.

Like other young mammals, human children produce an enzyme called lactase that breaks down lactose. The gene for lactase usually turns off in adulthood because aside from humans, adult mammals don’t drink milk.

Without lactase, lactose from milk ends up feeding gut microbes that produce gas, which can cause uncomfortable digestive problems.

“You’ll get some cramps. You’ll get some diarrhea. Might fart a bit more. It might be unpleasant for you,” said geneticist Mark Thomas of University College London, who led the genetics work for the new study. “It might be embarrassing, but you’re not going to die.”

But when our ancient ancestors suffered through plagues or famines, getting diarrhea from drinking milk was probably more than just uncomfortable, the authors suggest.

“Then we’re talking about a life-threatening condition,” Thomas said.

About one-third of people alive today have a genetic variant that keeps their lactase gene from turning off. This trait has evolved independently multiple times in the ancestors of people now living in parts of Africa, the Middle East, South Asia and Europe.

Scientists long assumed that lactase persistence evolved alongside the spread of dairy farming, which happened over a few thousand years beginning around 7000 BC.

However, earlier studies revealed that lactase persistence was vanishingly rare in Europe until about 3,000 years ago. But after that, it took only a few thousand years for the trait to become widespread — the blink of an eye in evolutionary time.

Why this trait would evolve so quickly was a mystery.

“Lactase persistence has been under enormous amounts of natural selection over the last eight to ten thousand years … more than any other part of the genome in Europeans,” said Thomas. “It was, for a very long period of time, the one trait upon which life and death pivoted more than any other. … It’s insane. It just defies explanation.”

Searching for an explanation, the authors sought to reconstruct the history of milk use in the region over the past 9,000 years. They examined fat residues left on more than 7,000 pottery shards collected at 550 archaeological sites across Europe.

“When people were cooking … fat liquefies and then penetrates into the pores of the pottery,” said organic geochemist and study co-author Mélanie Roffet-Salque of the University of Bristol. “It’s quite stunning, really. But thousands of years later when archaeologists excavate a piece of pottery that had been discarded and then we analyze the pottery, it’s still there.”

The pottery shards showed that milk consumption was widespread across most of Europe for thousands of years before most Europeans became lactose tolerant.

Studying health data on modern Britons, the researchers didn’t find any evidence that drinking milk hurts the health of modern adults who don’t produce lactase.

Surprisingly, using data on ancient population fluctuations to approximate when and where ancient Europeans dealt with famine and disease, the researchers found that sickness and hunger might explain the evolution of lactase persistence better than milk consumption.

Famine could have forced ancient people to drink more milk than usual as other food sources ran out. And both malnutrition and disease could have made lactose-induced diarrhea very dangerous. Severe diarrhea can kill — it is still the second leading cause of death for children under 5 worldwide.

Shevan Wilkin, a biomolecular archaeologist at the University of Zurich who reviewed the new paper, said the research was an important step forward but that she’s not necessarily convinced that famine and disease alone can explain the evolution of lactase persistence.

“The reason I don’t know if I think they’re right, I also don’t know if I think they’re wrong, is before 2,000 years ago, there were absolutely times of famine,” Wilkin said.

Thomas said he’d like to see similar studies done in Africa, where lactase persistence evolved independently three different times. Wilkin agreed, noting that Europe is over-studied, and that future research should focus on other regions, including central Asia, where people drink lots of milk despite lacking a genetic variant that keeps lactase from turning off in adults.

“I think it’d be really interesting to apply this [in] multiple places,” said Wilkin. “It’s just such a cool and ambitious undertaking, and I think it’s really going to spur a ton of new studies.”
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Scientists say that climate change is increasing the likelihood of lightning strikes across the United States, after lightning struck at a square near the White House, leaving three people dead and one more in critical condition. 

The hot, humid conditions in the U.S. capital on Thursday were primed for electricity. Air temperatures topped out at 34 degrees Celsius, 3 C higher than the 30-year normal maximum temperature for August 4, according to the National Weather Service. 

More heat can draw more moisture into the atmosphere, while also encouraging rapid updraft, two key factors for charged particles that lead to lightning. A key study released in 2014 in the journal Science warned that the number of lightning strikes could increase by 50% in this century in the United States, with each 1 C of warming translating into a 12% rise in the number of lightning strikes. 

Fast-warming Alaska has seen a 17% rise in lightning activity since the cooler 1980s. And in typically dry California, a siege of 14,000 lightning strikes during August 2020 sparked some of the state’s biggest wildfires on record. 

Beyond the United States, there is evidence that lightning strikes are also shooting up in India and Brazil. 

Bolts rarely hit people

But even as lightning strikes increase, being hit by one is still extremely rare in the United States, experts say. Roughly 40 million lightning bolts touch down in the country every year, according to the U.S. Centers for Disease Control and Prevention, with the odds of being struck at less than 1 in a million. 

Among those who are hit, about 90% survive the ordeal, the CDC says. The country counted 444 deaths from lightning strikes from 2006 through 2021. 

The two men and two women struck by lightning on Thursday while visiting Washington’s Lafayette Square, just north of the White House, were not so lucky when a bolt hit the ground during a violent afternoon thunderstorm. 

The lightning hit near a tree that stands meters from the fence that surrounds the presidential residence and offices across from the square, which is often crowded with visitors, especially in the summer months. 

All four victims suffered life-threatening injuries and were taken to area hospitals. Two later died: James Mueller, 76, and Donna Mueller, 75, from Janesville, Wisconsin, the Metropolitan Police Department said. 

“We are saddened by the tragic loss of life,” the White House said in a statement on Friday. “Our hearts are with the families who lost loved ones, and we are praying for those still fighting for their lives.” 

Later Friday a third victim, a 29-year-old male, was pronounced dead, the Metropolitan Police Department said. Further details on the victim were being withheld until the person’s family could be notified. 

Because heat and moisture are often needed to make lightning, most strikes happen in the summer. In the United States, the populous, subtropical state of Florida sees the most people killed by lightning. 
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One in eight people who get coronavirus develop at least one symptom of long COVID, one of the most comprehensive studies on the condition to date suggested on Thursday. 

With more than half a billion coronavirus cases recorded worldwide since the start of the pandemic, there has been rising concern about the lasting symptoms seen in people with long COVID. 

However, almost none of the existing research has compared long COVID sufferers with people who have never been infected, making it possible that some of the health problems were not caused by the virus. 

A new study published in The Lancet journal asked more than 76,400 adults in the Netherlands to fill out an online questionnaire on 23 common long COVID symptoms. 

From March 2020 to August 2021, each participant filled out the questionnaire 24 times.  

During that period, more than 4,200 of them, 5.5%, reported catching COVID. 

Of those with COVID, more than 21% had at least one new or severely increased symptom three to five months after becoming infected. 

However nearly 9% of the control group, which did not have COVID, reported a similar increase in some symptoms. 

This suggested that 12.7% of those who had COVID — around 1 in 8 — suffered from long-term symptoms, the study said.  

The research also recorded symptoms before and after COVID infection, allowing the researchers to further pinpoint exactly what was related to the virus. 

It found that common long COVID symptoms include chest pain, breathing difficulties, muscle pain, loss of taste and smell, and general fatigue.

‘Major advance’

One of the study’s authors, Aranka Ballering of the Dutch University of Groningen, said long COVID was “an urgent problem with a mounting human toll.” 

“By looking at symptoms in an uninfected control group and in individuals both before and after SARS-CoV-2 infection, we were able to account for symptoms which may have been a result of non-infectious disease health aspects of the pandemic, such as stress caused by restrictions and uncertainty,” she said. 

The authors of the study said its limitations included that it did not cover later variants, such as delta or omicron, and did not collect information about some symptoms such as brain fog, which have since been considered a common sign of long COVID. 

Another study author, Judith Rosmalen, said “future research should include mental health symptoms” such as depression and anxiety, as well as aspects like brain fog, insomnia and a feeling of malaise after even minor exertion. 

Christopher Brightling and Rachael Evans, experts from Britain’s Leicester University who were not involved in the study, said it was “a major advance” on previous long COVID research because it had an uninfected control group. 

“Encouragingly, emerging data from other studies” suggest there is a lower rate of long COVID in people who have been vaccinated or infected with the omicron variant, they said in a linked Lancet comment. 
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The United States has declared monkeypox a public health emergency, the health secretary said Thursday, a move expected to free up additional funding and tools to fight the disease. 

The declaration came as the tally of cases crossed 6,600 in the United States on Wednesday, almost all of them among men who have sex with men. 

“We’re prepared to take our response to the next level in addressing this virus, and we urge every American to take monkeypox seriously,” Health and Human Services Secretary Xavier Becerra said at a briefing. 

The declaration will also help improve the availability of monkeypox data, U.S. Centers for Disease Control and Prevention Director Rochelle Walensky said, speaking alongside Becerra. 

The World Health Organization also has designated monkeypox a “public health emergency of international concern,” its highest alert level. The WHO declaration last month was designed to trigger a coordinated international response and could unlock funding to collaborate on vaccines and treatments. 

Biden earlier this month appointed two top federal officials to coordinate his administration’s response to monkeypox, following declarations of emergencies by California, Illinois and New York. 

First identified in monkeys in 1958, the disease has mild symptoms including fever, aches and pus-filled skin lesions, and people tend to recover from it within two to four weeks, according to the WHO. It spreads through close physical contact and is rarely fatal. 

Anthony Fauci, Biden’s chief medical adviser, told Reuters on Thursday that it was critical to engage leaders from the gay community as part of efforts to rein in the outbreak, but cautioned against stigmatizing the disease and its victims. 

“Engagement of the community has always proven to be successful,” Fauci said. 

Unlike when COVID-19 emerged, there are vaccines and treatments available for monkeypox, which was first documented in Africa in the 1970s. 

The U.S. government had distributed 156,000 monkeypox vaccine doses nationwide through mid-July. It has ordered an additional 2.5 million doses of Bavarian Nordic’s vaccine. 

The first U.S. case of monkeypox was confirmed in Massachusetts in May, followed by another case in California five days later. 
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NASA discusses its upcoming test flight to the moon. Plus, another look deep into the history of our universe, and we remember a beloved fictional pioneer in spaceflight. VOA’s Arash Arabasadi brings us “The Week in Space.”
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President Joe Biden on Wednesday signed an executive order that the White House said would protect access to abortion care, part of the continuing fallout from a June Supreme Court reversal of its landmark 1973 ruling establishing a right to abortion.

With each of the 50 states now free to write abortion laws as it sees fit, an early test came Tuesday when voters in the Midwestern state of Kansas voted decisively to keep that state’s right to abortion. But several states now outlaw the practice, sometimes even in the case of rape or incest.

“This is just extreme,” Biden said before signing the order, which aims to help people seeking abortions travel to a state where it remains legal. “You know, even the life of the mother is in question in some case — in some states.

“Republicans in Congress and their extreme MAGA ideology are determined to go even further, talking about nationwide bans that would outlaw abortion in every state, under every circumstance, going after the broader right to privacy as well. But as I said before, this fight is not over. And we saw that last night in Kansas.”

This was the second abortion-related executive order that Biden had signed since the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision. The first executive order, last month, aimed to guarantee access to emergency contraception and abortion medication.

Critics said these White House actions were too vague, and too slow.

“What we’re seeing is the federal government figuring out how they can support abortion patients without violating federal law,” said Elizabeth Nash, state policy analyst at the Guttmacher Institute, a research and policy organization that supports abortion rights.

“And so that’s why some of this is so piecemeal,” she said. “And we’re seeing what agencies are going to come up with. And frankly, this is the sort of announcement that we really needed to hear right when Dobbs came down. And so I’m hoping that these agencies can be kick-started into action so that they can catch up. Because we are seeing states ban abortion.”

On Wednesday, White House press secretary Karine Jean-Pierre said the Biden administration is working as fast as it can, but “there’s steps and processes that we have to take in order to take actions as big as these.

“But look, there has been an urgency from this president from day one when — when the Supreme Court made this extreme decision to take away a constitutional right,” she said.

Thirteen states immediately banned abortion right after the Supreme Court ruling. In the coming months, four states — California, Kentucky, Michigan and Vermont — will vote on abortion, as Kansas did.

Kansans on Tuesday voted in large numbers, and nearly 59% voted against a proposal to amend the state constitution to remove abortion protections. In this respect, the conservative state echoed national trends: A recent Pew poll found that 61% of U.S. adults say abortion should be legal in all or most cases.

Anti-abortion groups decried the Kansas vote and Biden’s actions.

“Biden and the Democrats make a serious error in assuming Americans nationwide agree with their radical agenda — using the full weight of the federal government to impose abortion on demand up to the moment of birth, illegally forcing taxpayers to fund it, ‘cracking down’ on nonprofits that provide life-affirming alternatives, and threatening to destroy any guardrails of democracy that stand in their way,” said Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America.

No state allows abortion at birth. Most abortions — about 91% of them — happen before the 13-week mark, said the U.S. Centers for Disease Control and Prevention.

Research from the Kaiser Family Foundation found that abortions at or after 21 weeks of pregnancy represent just 1% of all U.S. abortions. Those cases, it said, are often the result of serious health risks to the fetus or the pregnant person.

Since the ruling, Biden and Vice President Kamala Harris have urged Congress to enshrine abortion access into federal law. Harris has spent the past few weeks crisscrossing the country to speak about the issue with legislators, health care providers, faith leaders and others.

She said the Biden administration’s policy is clear.

“We trust the judgment of the women of America to make decisions based on what they know is in their best interests,” she said.

“We trust the women of America to make those decisions, if she chooses, in consultation with her faith leader, with her physician, with her loved one. But we understand fully the government should not be making that decision for her.”
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Two invasive species — the brown tree snake and the American bullfrog — cost the world more than $16 billion between 1986 and 2020, according to a study. 

Researchers say the already-hefty price tag should be seen as a lower limit on the true cost of invasive reptiles and amphibians, especially in under-studied regions such as Africa and South America. The study results were published in the online journal Scientific Reports. 

Invasive species are animals, plants or other living things that aren’t native to the places where they live and damage their new environments. Humans spread many of the more than 340 invasive reptile and amphibian species — as stowaways in cargo or through the exotic pet trade, for instance. 

Invasive reptiles and amphibians can damage crops, destroy infrastructure, spread disease and upset ecosystems. The damage is costly, but scientists still don’t fully understand the extent of the economic impact wrought by invasive species. 

For the study, biologist and study author Ismael Soto of the University of South Bohemia, and Ceske Budejovice in the Czech Republic, and his colleagues, estimated the global cost of invasive reptiles and amphibians using a database called InvaCost. The database collects the results of thousands of studies, reports and other documents produced by scientists, governments and non-governmental organizations. 

The data revealed that invasive reptiles and amphibians have cost at least $17 billion worldwide between 1986 and 2020.  

“But this cost mostly focused on two species — the brown tree snake [and] the American bullfrog,” Soto told VOA in an interview via Zoom. “But there are almost 300 invasive species of reptiles [and] amphibians. So, this means that our cost is really underestimated.”  

The two species have received a disproportionate amount of attention from researchers, said economist Shana McDermott of Trinity University, who was not involved in the study. 

“When you talk about invasives, people immediately will probably say, ‘Oh, the brown tree snake,’ just because its impacts are so wide-ranging,” she said via Zoom. “It’s got ecosystem biodiversity impacts. It’s got impacts to human health — it sends people to the hospital every year with bites. It takes down energy infrastructure. … And so, of course, people are like, ‘Oh God! That’s an incredibly dangerous invasive! Let’s understand it better.'”  

The research bias toward a few well-known species also skews the distribution of costs worldwide. For instance, 99.6% of the $10.4 billion in costs from reptile invasions were in Oceania and the Pacific Islands, largely reflecting damage dealt by the brown tree snake in Hawaii, Guam and Northern Mariana Islands. Likewise, most damage from amphibians was in Europe.  

But that doesn’t mean invasive reptiles and amphibians aren’t problematic elsewhere. Soto said there are many invasive amphibians in Africa, but their costs probably haven’t been quantified.  

“There’s not enough research in these countries [to] detect the economic costs,” he said. 

Soto also noted that the current cost estimate only includes costs that are easily quantified. Destroyed crops or property are easier to count than reduced quality of life or indirect damage to human health and assigning dollar values to ecological damage is trickier still, McDermott said. 

“We’re still in this very early stage of trying to understand the economic costs, and trying to understand how invasive species impact ecosystems, how they impact people’s quality of life,” she said, adding that she wants to include the price of biodiversity losses in future cost estimates. 

Soto and McDermott agreed that future studies should not only quantify the costs of more species in more regions but also project how the costs will evolve with time, especially as climate change continues to facilitate the spread of more invasive species. 

“There is a lot still left to be determined. … I do think that quantifying it is the first step, though,” said McDermott. “Unless you can put a dollar value on it, unfortunately, you don’t get [policymakers’] attention for policy. So, this is an incredibly important topic. … We really shouldn’t be waiting on more studies to act.” 

 
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A bill enhancing health care and disability benefits for millions of veterans exposed to toxic burn pits won final approval in the Senate on Tuesday, ending a brief stalemate over the measure that had infuriated advocates and inspired some to camp outside the Capitol.

The Senate approved the bill by a vote of 86-11. It now goes to President Joe Biden’s desk to be signed into law. Biden described the legislation as the biggest expansion of benefits for service-connected health issues in 30 years and the largest single bill ever to comprehensively address exposure to burn pits.

“I look forward to signing this bill, so that veterans and their families and caregivers impacted by toxic exposures finally get the benefits and comprehensive health care they earned and deserve,” Biden said.

The Senate had overwhelming approved the legislation back in June, but a do-over was required to make a technical fix. That process derailed when Republicans made a late attempt to change another aspect of the bill last week and blocked it from advancing.

The abrupt delay outraged veterans groups and advocates, including comedian Jon Stewart. It also placed GOP senators in the uncomfortable position of delaying the top legislative priority of service organizations this session of Congress.

A group of veterans and their families have been camping out at the Capitol since that vote. They had endured thunderstorms and Washington’s notorious summer humidity, but they were in the galleries as senators cast their votes.

“You can go home knowing the good and great thing you have done and accomplished for the United States of America,” Senate Majority Leader Chuck Schumer told them.

The legislation expands access to health care through the Department of Veterans Affairs for millions who served near burn pits. It also directs the VA to presume that certain respiratory illnesses and cancers were related to burn pit exposure, allowing veterans to obtain disability payments to compensate for their injury without having to prove the illness was a result of their service.

Roughly 70% of disability claims related to burn pit exposure are denied by the VA due to lack of evidence, scientific data and information from the Defense Department.

The military used burn pits to dispose of such things as chemicals, cans, tires, plastics and medical and human waste.

Hundreds of thousands of Vietnam War era veterans and survivors also stand to benefit from the legislation. The bill adds hypertension, or high blood pressure, as a presumptive disease associated with Agent Orange exposure.

The Congressional Budget Office projected that about 600,000 of 1.6 million living Vietnam vets would be eligible for increased compensation, though only about half would have severe enough diagnoses to warrant more compensation.

Also, veterans who served in Thailand, Cambodia, Laos, Guam, American Samoa and Johnston Atoll will be presumed to have been exposed to Agent Orange. That’s another 50,000 veterans and survivors of deceased veterans who would get compensation for illnesses presumed to have been caused by their exposure to the herbicide, the CBO projected.

The bill is projected to increase federal deficits by about $277 billion over 10 years.

The bill has been a years-long effort begun by veterans and their families after they had returned from the fighting in Iraq and Afghanistan and experienced maladies that they suspected were caused by their close proximity to burn pits. It was named after Sgt. First Class Heath Robinson from Ohio, who died in 2020 from cancer he attributed to prolonged exposure to burn pits. His widow, Danielle Robinson, was first lady Jill Biden’s guest at the president’s State of the Union address earlier this year.

Stewart, the former host of Comedy Central’s The Daily Show, also brought increased exposure to the burn pit maladies veterans were facing. He also was in the gallery watching the vote Tuesday. He wept and held his head in his hand as the final vote began.

“I’m not sure I’ve ever seen a situation where people who have already given so much had to fight so hard to get so little,” he said after the vote. “And I hope we learn a lesson.”

The House was the first to act on the burn pits legislation. An earlier version the House approved in March was expected to increase spending by more than $320 billion over 10 years, but senators trimmed some of the costs early on by phasing in certain benefit enhancements. They also added funds for staffing to help the VA keep up with the expected increase in demand for health care and an increase in disability claims.

Some GOP senators are still concerned that the bill will increase delays at the VA because of an increased demand for veterans seeking care or disability compensation.

“What we have learned is that the VA cannot deliver what is promised because it does not have the capacity to handle the increase,” said Sen. Marsha Blackburn, R-Tenn.

Sens. Jon Tester, D-Mont., and Jerry Moran, R-Kan., led the effort to get the bill passed in the Senate. After passage, Tester told reporters he received a call from Biden, thanking him for “taking a big weight” off his shoulder.

Moran said that when the bill failed to pass last week, he was disappointed but remembered the strength of the protesters who had sat outside in the scorching heat for days.

“Thanks to the United States Senate for demonstrating when there’s something good and a good cause, this place still works,” Moran said. 
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The United States sued Idaho on Tuesday over a state law that it says imposes a “near-absolute ban” on abortion and also sought to block the Western state from prosecuting or disciplining doctors, according to a court filing.

The lawsuit, filed in U.S. District Court for Idaho, seeks a preliminary and permanent injunction against the state prohibiting enforcement of the law and asked the court to rule that the state law violates federal statutes.

The lawsuit also alleges the state law interferes with the United States’ pre-existing agreements with hospitals under Medicare, referring to the federal health care program for seniors.

“Today, the Justice Department’s message is clear … if a patient comes into the emergency room with a medical emergency jeopardizing the patient’s life or health, the hospital must provide the treatment necessary to stabilize that patient,” U.S. Attorney General Merrick Garland said at a news conference in Washington announcing the filing.

“This includes abortion, when that is the necessary treatment,” Garland added.

Tuesday’s lawsuit marks the Justice Department’s first legal battle over reproductive rights since the Supreme Court in June overturned the landmark 1973 Roe v. Wade ruling that recognized women’s constitutional right to abortion.

Idaho in March became the first state to enact a six-week abortion ban modeled on a Texas law that empowers private citizens to sue abortion providers. The law bans abortion before many women know they are pregnant.
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India is accelerating action against the monkeypox virus after reporting its first death due to monkeypox in the southern state of Kerala, that of a 22-year-old man who had recently returned from the United Arab Emirates.

The death of the young man is the first due to monkeypox in Asia, where several countries have reported outbreaks of the viral infection that has been declared a global public health emergency by the World Health Organization.

Kerala health authorities announced the death on Monday after it was confirmed that the man had monkeypox. He had died in a hospital on Saturday, about a week after returning from the UAE, where his family said he had tested positive for the infection. By the time doctors were informed, he was already critical.

Samples from the man that were tested in India also detected the virus, according to Kerala Health Minister, Veena George.

This is the fourth monkeypox death reported globally outside Africa. So far there have been two monkeypox related fatalities in Spain and one in Brazil.

Kerala health authorities said that about 20 persons, who had been in contact with the 22-year-old, are being monitored. Passengers who were on the flight with him from UAE to Kerala have also been contacted and authorities have urged people with symptoms to inform doctors.

After the death was reported in Kerala, the federal government said it is setting up a task force to monitor the outbreak in the country.

Fifteen laboratories have been designated to diagnose monkeypox while some states, including the capital, New Delhi, have set up isolation wards.

India has so far detected six cases of the viral disease – four in Kerala and two in New Delhi.

Meanwhile the government has invited domestic vaccine makers to consider making shots against monkeypox after the country reported some cases of infection.

The Indian Council of Medical Research, the federal medical research organization, said last week that it is willing to share the monkeypox virus strain it has isolated to aid the process of developing a vaccine. India is a major vaccine producer.

Vaccines already exist for monkeypox, including those used to eradicate smallpox. Experts have said that unlike COVID 19, mass vaccinations against monkey pox will not be necessary.

Monkeypox, which was first discovered in a monkey, is related to the smallpox virus, which was eradicated in 1980, but is far less severe.

The disease has been found in more than 70 countries where it is not endemic. According to The U.S. Centers for Disease Control and Prevention more than 23,000 monkeypox cases have been detected since January in these countries.

In a statement last week, the World Health Organization’s regional director in South East Asia, Poonam K. Singh, said the risk of a monkeypox outbreak in the region was “moderate but the potential of its further international spread is real.” She said that “We need to stay alert and be prepared to roll out an intense response to curtail the spread of monkeypox.”
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The public health response to the outbreak of monkeypox in the United States has so far failed to prevent significant community spread of the disease, leading to a call for a reassessment of the strategy for containing it.

Since the first reported U.S. case of the outbreak on May 17, the number of infections has soared to more than 5,000, with the majority found among men who have sex with men.

Although reporting of case numbers is scattered across different agencies, the U.S. appears to account for more than 25% of global cases identified during the current outbreak, which the World Health Organization has identified as a “public health emergency of international concern.”

‘You have to act fast’

Infectious disease experts have been dismayed by what they saw as a lack of urgency on the part of U.S. public health agencies in the early weeks of the outbreak.

“What I expected to see would have been a more vigorous kind of a response based on lessons that we’ve learned from … COVID-19, as well as lessons we’ve learned from the HIV response,” Dr. Wafaa El-Sadr, founder and director of ICAP at Columbia University Mailman School of Public Health, told VOA.

“When you have an outbreak, the most important thing is you have to act fast, you have to mobilize, and … you have to rally all your assets to work together really quickly to be able to do what’s needed,” El-Sadr said.

Facing criticism at the end of June, the White House announced what it called the “first phase” of a national monkeypox vaccine strategy designed to “help immediately address the spread of the virus by providing vaccines across the country to individuals at high risk.” The administration said that it would “rapidly deploy vaccines in the most affected communities and mitigate the spread of the disease.”

Similar to smallpox

The monkeypox virus comes from the same family as the deadly smallpox virus, but infections with the disease tend to be far less severe and are rarely fatal.

The disease typically presents with a fever and body aches, followed by the eruption of skin lesions, which can occur all over the body but which are often found on the face and hands.

Though the disease is rarely fatal, the skin lesions can cause severe pain lingering over several weeks.

International scope

According to data collected by the World Health Organization, diagnosed new cases of monkeypox have been concentrated in Europe and North America during the latest outbreak, with more than 14,000 reported in the WHO’s European Region and nearly 6,800 in North America.

By contrast, there are far fewer cases in other regions tracked by WHO. The agency’s African Region has reported only 328 cases, and numbers are far lower in the Western Pacific Region (65), the Eastern Mediterranean Region (26) and the South-East Asia Region (6.)

It should be noted that case numbers are affected by countries’ capacity to test and report active cases of monkeypox, meaning that in some developing countries, the numbers reported to the WHO may represent an undercount.

More manageable than COVID

Monkeypox is the sort of disease that the U.S. public health infrastructure ought to be able to combat effectively.

First, because it spreads primarily through close skin-to-skin contact, it is far less contagious than the virus that causes COVID-19, which can be transmitted through the air.

In addition, effective tests to diagnose the disease are available, as is a vaccine to prevent infection. There is also a highly effective treatment available for infected people.

However, the public health response in the U.S. has so far failed to take full advantage of the opportunity to counter monkeypox.

In a July 15 letter to senior public health officials, including Secretary of Health and Human Services Xavier Beccera and CDC Director Rochelle Walensky, a group of physicians and activists complained, “Multiple unnecessary regulatory barriers to treatments, diagnostics, and vaccines have prevented people in the United States from accessing medical countermeasures necessary to protecting their health, allowing the continued spread of monkeypox virus.”

Delays and confusion

While tests exist that can reliably identify cases of monkeypox, in the early weeks of the outbreak only labs affiliated with the Centers for Disease Control were authorized to administer them, creating significant backlogs in testing. They have since been made available to several large commercial laboratory chains, but the initial delay may have contributed to the early spread of the disease.

Even though there is an effective vaccine against monkeypox, U.S. officials failed to order new doses to add to the country’s limited stockpile until June, the month after the disease began spreading. In addition, U.S. regulators did not approve the use of a facility in Denmark, where the vaccine is manufactured, until the middle of July.

While the medication tecovirimat is known to be highly effective against smallpox and has shown success against monkeypox as well, at the beginning of the outbreak, the CDC required doctors to go through an onerous application process for each patient, greatly slowing the distribution of the medication.

‘Public health failure’

In a blistering op-ed published in the New York Times on Saturday, former Food and Drug Administration commissioner Dr. Scott Gottlieb wrote, “Our country’s response to monkeypox has been plagued by the same shortcomings we had with Covid-19. Now if monkeypox gains a permanent foothold in the United States and becomes an endemic virus that joins our circulating repertoire of pathogens, it will be one of the worst public health failures in modern times not only because of the pain and peril of the disease but also because it was so avoidable.”

He continued, “Our lapses extend beyond political decision making to the agencies tasked with protecting us from these threats. We don’t have a federal infrastructure capable of dealing with these emergencies.”

CDC Director Rochelle Walensky has challenged criticisms from Gottlieb in the past. Earlier in July, she said in a statement to CNN, “It is true that we have work to do — here and internationally — and are likely to see more monkeypox cases in the near term, but it is possible to significantly decrease the number of cases and contain the current monkeypox outbreak through education and increased testing and access to vaccines – all priorities we’ve made dramatic progress on.”

The CDC has launched an effort to support case identification and contact tracing nationwide, as well as support for testing and “case confirmation.” In addition, the agency has expanded outreach to medical professionals to help them identify cases of monkeypox and has expanded its efforts to communicate information about the disease to the public, particularly to the populations most at risk.

CDC researchers are also investigating the nature of the disease, including precisely how it is transmitted and what course the illness typically takes once a person is infected.

At a global level, the CDC reports that it is sharing information with other countries to help coordinate a global response to the virus. This includes close cooperation with the government of Nigeria in an effort to sequence the DNA of the virus, in order to better understand its evolution.

Window is closing

El-Sadr, of Columbia University, told VOA that while she is concerned about the response to the disease this far, she believes there is still an opportunity to bring it under control.

“We have enough tools already,” she said. “If we could just mobilize and communicate and utilize those tools, I think we have a shot at stopping this outbreak. But the window of opportunity closes very fast when it comes to outbreaks and that’s the reason why there’s a profound need for urgency.”

Failure, she said, could leave the U.S. facing the prospect of monkeypox becoming endemic in the country, meaning that it would persist at a fixed level in the country even if no additional infected people arrive from other countries.
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New York City Mayor Eric Adams declared a state of emergency Monday over the spread of monkeypox.

“This order will bolster our existing efforts to educate, vaccinate, test, and treat as many New Yorkers as possible and ensure a whole-of-government response to this outbreak,” Adams said in a statement released with the executive order.

The order allows Adams to suspend local laws and temporarily impose new rules to control the spread of the outbreak.

Similarly, Gov. Kathy Hochul declared a state disaster emergency last Friday. She previously announced that over the next four to six weeks, the federal government would distribute 110,000 vaccine doses to the state in addition to the 60,000 already distributed.

As of Monday, New York City has reported 1,472 cases, according to monkeypox data on the NYC Health website. Most cases worldwide have affected men who have sex with men.

In an announcement Saturday declaring a public health emergency in the city, Adams and Health Commissioner Ashwin Vasan estimated that about 150,000 New Yorkers may be at risk of monkeypox infection.

Cases are continuing to rise across the country. New York currently has the highest number of recorded monkeypox cases among the 50 states, followed by California with 799 cases as of Friday, the CDC reports. San Francisco Mayor London Breed declared a state of emergency on Thursday.

Though California has distributed more than 25,000 vaccine doses, Gov. Gavin Newsom said in a KTVU-TV interview last week that the state is “not even close to where we need to be.”

The rapid spread of monkeypox worldwide has sparked alarm over the past few months. Since May, more than 22,000 cases have been reported in 80 countries, despite the virus naturally occurring only in Central and West Africa.

The World Health Organization declared a global health emergency over monkeypox on July 23.
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Whether it’s abstinence, avoiding nightclubs, limiting sexual partners or pushing for a swift vaccine rollout, Spain’s gay community is on the front line of the monkeypox virus and is taking action. 

“With this monkey thing, I prefer to be careful. … I don’t have sex anymore, I don’t go to parties anymore, and that’s until I’m vaccinated and have some immunity,” said Antonio, a 35-year-old from Madrid who declined to give his last name. 

Antonio, who often went to nightclubs and sometimes to sex parties, decided to act as cases continued to increase. 

Spain on Saturday reported its second monkeypox-related death. 

Outside of Africa, the only other such death has been in Brazil. 

More than 18,000 cases have been detected throughout the world outside of Africa since the beginning of May, according to the World Health Organization (WHO). 

Spain is one of the world’s worst-hit countries. The health ministry’s emergency and alert coordination center put the number of infected people at 4,298. 

As cases increase globally, the WHO has called on the group currently most affected by the virus, men who have sex with men, to limit their sexual partners. 

Lack of vaccines 

“This is not like Covid, the vaccine already exists, there’s no need to invent it. If it wasn’t a queer disease, we would have acted more — and faster,” said Antonio. 

Like other members of the gay community, he believes the authorities have not done enough. 

NGOs have denounced a lack of prevention, a shortage of vaccines and stigmatization linked to the virus.  

This is despite the WHO declaring the monkeypox outbreak a global health emergency. 

Early signs of the disease include a high fever, swollen lymph glands and a chickenpox-like rash. 

The disease usually heals by itself after two to three weeks, sometimes taking a month. 

A smallpox vaccine from Danish drug maker Bavarian Nordic, marketed under the name Jynneos in the United States and Imvanex in Europe, has been found to protect against monkeypox. 

It took Antonio three weeks to get an appointment to be vaccinated, after logging on to the official website every day at midnight. 

Appointments “are going as fast as tickets to the next Beyonce concert,” another said. 

So far, Spain has only received 5,300 doses, which arrived in late June. 

The Spanish health ministry declined to comment when contacted by AFP. 

‘Anyone can catch it’ 

Nahum Cabrera of the FELGTBI+ NGO, an umbrella group of more than 50 LGBTQ organizations from all over Spain, insists there is an urgent need to vaccinate those most at risk. 

That means not just gay men, but anyone who has “regular sex with multiple partners, as well as those who frequent swingers’ clubs, LGTBI saunas, etc.,” he said. 

“It risks creating a false sense of security among the general population, and they relax into thinking that they are safe and that it only happens to men who have sex with men,” he said. 

The target age group for vaccination is those ages 18 and 46, he added. 

Older people are vaccinated against smallpox which was eradicated in Europe in the early 1970s. 

“We are facing a health emergency… that affects the LGBTI community, so people think it is insignificant, that it is not serious,” said Ivan Zaro, of the Imagina MAS (Imagine More) NGO. “This is exactly what happened 40 years ago with HIV.” 

Image director Javier spent three days in hospital in early July after becoming infected.   

The 32-year-old, who is in a monogamous relationship, said he still did not know how he had caught it. 

“I warn everyone,” he said. “It’s an infectious disease, anyone can catch it.” 
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New York has declared a public health emergency due to a monkeypox outbreak.  Mayor Eric Adams and Department of Health and Mental Hygiene Commissioner Dr. Ashwin Vasan made the announcement Saturday.

The two officials said in a joint statement that “New York City is currently the epicenter of the outbreak, and we estimate that approximately 150,000 New Yorkers may currently be at risk for monkeypox exposure.”

“Over the past few weeks, we have moved as quickly as possible to expand outreach and access to vaccines and treatment to keep people safe,” the officials said.  “We will continue to work with our federal partners to secure more doses as soon as they become available. This outbreak must be met with urgency, action, and resources, both nationally and globally, and this declaration of a public health emergency reflects the seriousness of the moment.”

On Friday, New York state Governor Kathy Hochul issued an executive order declaring a state disaster emergency because of the monkeypox outbreak. In her executive order, Hochul said that “More than one in four monkeypox cases in this country are in New York State.”  Her declaration also expanded the number of health care individuals who can administer the monkeypox vaccines.

The World Health Organization has declared the global monkeypox outbreak a public health emergency of international concern.

WHO chief Dr. Tedros Adhanom Ghebreyesus said recently that while 98% of global monkeypox cases “are among men who have sex with men, anyone exposed can get monkeypox, which is why WHO recommends that countries take action to reduce the risk of transmission to other vulnerable groups, including children, pregnant women and those who are immunosuppressed.”

Tedros said, “In addition to transmission through sexual contact, monkeypox can be spread in households through close contact between people, such as hugging and kissing, and on contaminated towels or bedding.” 
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The bedsheets are big. Some are light pink, others hot pink or purple, connected and stretched taut by people holding wooden poles. Together, the sheets form a barrier across the parking lot. The activists, who are supporting a woman’s right to an abortion, wear bright pink vests with PRO-CHOICE in black emblazoned on the front.

This is the front line of protection for pregnant women who drive to this women’s center for an abortion. The sheeting forms a tunnel for them to leave their cars and enter the center, unseen by anti-abortion protesters trying to stop them.

‘There’s very little conversation’

This is the daily scene at the Bristol Regional Women’s Center.   The abortion-rights activists stay inside the center parking lot; the anti-abortion protesters stand on the sidewalk. They walk next to a busy street with posters reading “Love Your Baby and Yourself” or “Babies are Murdered Here” next to competing pink signs that read, “Honk Twice for Choice.”

A local church organizes the anti-abortion protesters. Natalie, who asked to use only her first name for safety reasons, is 24. She has been coming here weekly for seven years, saying, “This is what the Lord has called us to do.” She says  no patient has ever approached her for help.

Another young protester, Haven, says he’s handed out a few pamphlets but it is difficult to approach the women because of the sheeting. He has not spoken to the doctors or the abortion-rights protesters, adding, “There’s very little conversation that can happen.”

The abortion-rights protesters chose not to speak to VOA about their views and asked us to leave. One shone a flashlight into the lens of our video camera.

Inside the clinic, women are given an ultrasound on the first visit. If no fetal heartbeat is detected, they return for a second ultrasound in 48 hours. Again, if no cardiac activity is heard, they are given counseling before a medical abortion.

That is not the case in the adjacent state.

Legal and illegal separated by a street

Bristol, Tennessee, is a border town.

The state line is marked by numerous 20-centimeter-long brass plaques that run down the center of State Street, separating Tennessee from Virginia and its different laws.

As soon as the U.S. Supreme Court in June struck down abortion as a constitutional right, some states instituted “trigger laws” outlawing some or all abortions.

Tennessee’s trigger law outlawed surgical abortions and allowed medical abortions, which use medication to end a pregnancy, during the first six weeks of a pregnancy or until a heartbeat can be recognized, which typically occurs near that time limit.

That means abortions remain legal in Virginia but across State Street, they are restricted in Tennessee.

Olivia, who prefers to use only her first name for safety reasons, is a medical assistant at a women’s clinic in Bristol, Tennessee. She says in the past month, her clinic has had to turn away women in tears, some who had driven many hours to reach the clinic, because an ultrasound found fetal heart activity. The office refers them to Virginia offices if they live nearby. But some drive from eastern Tennessee, and a delay of an extra day to reach another state that’s closer than Virginia can affect the legality of an abortion.

“It becomes a bigger issue,” Olivia says, giving as an example, “North Carolina, [where] you have two separate visits with a 72-hour waiting period.”

Star Eans is a makeup artist on TikTok. The U.S. Supreme Court decision motivated her to become a abortion-rights activist. Eans had a medical abortion less than a year ago when she lived in Tennessee, and complications required a surgical abortion.

“It just makes me angry thinking that, like, if that had happened this year, I would have just died,” Eans says. “If I was still living in Tennessee, and I had to have this baby that I didn’t want, I was very much on the verge of ending myself.”

Doctor looks to move across the border

On Aug. 25, another Tennessee law will prohibit all abortions, surgical and medical.

Because of that, the doctor who runs the Bristol women’s center is considering a satellite office less than a mile away where abortions are legal in Bristol, Virginia.  A GoFundMe page has raised more than $100,000 for the new clinic, and an update on July 29 said it had opened.

But anti-abortion protesters held a rally earlier in July at the Virginia clinic and alerted residents, including Emmitt Russell, whose house is next door. He objects to the anti-abortion protesters and the clinic and says a Virginia ban would motivate him to the polls.

“I didn’t vote in the last two presidential elections … but I would vote against abortions in Virginia, yes,” he said.

No trigger laws exist in Virginia. But Republican Governor Glenn Youngkin is supporting making abortions illegal after 15 weeks. Republicans hold a majority in the state House and could support a ban, but experts think it would be defeated in the Democrat-controlled Senate.  
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Two of the hardest-hit U.S. regions have raised the alert level over the monkeypox outbreak.

San Francisco declared a public health emergency Thursday. The city accounts for 281 of California’s nearly 800 cases. The declaration gives health officials access to additional resources to deal with the outbreak.

New York, with nearly 1,400 cases statewide, made a similar declaration Thursday.

Worldwide, more than 21,000 cases have been reported in 78 countries, nearly all of them outside West and Central Africa, where the virus is endemic. The World Health Organization (WHO) raised the threat level to its highest ranking last weekend.

The U.S. case count is nearing 5,000, according to the U.S. Centers for Disease Control and Prevention (CDC).

The federal government has not declared an emergency but announced plans Thursday to distribute nearly 800,000 additional doses of monkeypox vaccine.

U.S. health officials said they had already distributed 340,000 doses, but many jurisdictions have reported that they have had to turn away patients because of short supplies.

Here are some answers to frequently asked questions.

Who gets monkeypox, and how?

The outbreak has been concentrated among men who have sex with men, though anyone can get monkeypox.

The virus spreads through contact with the rash that infected patients develop. It can also pass through bodily fluids, respiratory droplets after prolonged face-to-face contact or contaminated clothing, bedding or towels.

Men who have sex with men should have fewer sex partners in order to curb the spread, WHO chief Tedros Adhanom Ghebreyesus said Wednesday.

“This is an outbreak that can be stopped,” Tedros said. “The best way to do that is to reduce the risk of exposure.”

However, he added, intolerance of homosexuality would not help.

“Stigma and discrimination can be as dangerous as any virus, and can fuel the outbreak,” Tedros said.

What are the symptoms? Is it fatal?

The disease causes fever, headache, muscle pain, fatigue and swollen lymph nodes, followed by a rash, usually on the face, palms and soles of the feet. About a third of cases also develop a rash on the genitals.

The strain of monkeypox responsible for the global outbreak is rarely fatal but can be extremely painful, according to the CDC. About 10% of cases have been hospitalized “to manage the pain caused by the disease,” Tedros said.

Five deaths have been reported — three in Nigeria and two in the Central African Republic.

What about vaccines and treatments?

About 16 million doses of vaccine are available worldwide, but most will take several months to be packaged and distributed, according to the WHO, which is recommending vaccination only for people at high risk, including people exposed to an infected person, health workers and people with multiple sex partners.

People vaccinated against smallpox likely have some protection against monkeypox, which is a related virus. Smallpox vaccination ended after the disease was declared eradicated in 1980.

Several antiviral medications have been approved.

How unusual is this outbreak?

The current outbreak is the first time this many cases have occurred in such widely dispersed areas outside the endemic countries in West and Central Africa.

Europe accounts for two-thirds of the cases. Nearly one-fifth are in the United States.

WHO’s advisory committee did not agree on the magnitude of the threat at its meeting last Saturday, but Tedros made the decision to declare a “public health emergency of international concern,” the agency’s highest threat assessment.
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U.S. regulators said Friday they are no longer considering authorizing a second COVID-19 booster shot for all adults under 50 this summer, focusing instead on revamped vaccines for the fall that will target the newest viral subvariants.

Pfizer and Moderna expect to have updated versions of their shots available as early as September, the Food and Drug Administration said in a statement. That would set the stage for a fall booster campaign to strengthen protection against the latest versions of omicron.

The announcement means the U.S. won’t pursue a summer round of boosters using the current vaccines for adults under 50, as some Biden administration officials and outside experts previously suggested. They had argued that another round of shots now could help head off rising cases and hospitalizations caused by the highly transmissible omicron strains.

Currently, all Americans ages 5 and over are eligible for a booster shot five months after their initial primary series. Fourth doses of the Pfizer or Moderna shots — a second booster — are recommended for Americans 50 and older and for younger people with serious health issues that make them more vulnerable to COVID-19.

The FDA urged eligible adults who haven’t been boosted to get their extra shot now: “You can still benefit from existing booster options and leave time to receive an updated booster in the fall,” the agency said in a statement.

The White House has also emphasized that getting a fourth dose now won’t impact anyone’s ability to get omicron-targeted shots once they’re made available — although how long it’s been since their last dose will play a role in how soon they’re eligible.

Two omicron subvariants, BA.4 and BA.5, are even more contagious than their predecessors and have pushed new daily cases above 125,000 and hospitalizations to 6,300. Those are the highest levels since February, though deaths have remained low at about 360 per day, thanks to widespread immunity and improved treatments against the virus.

The subvariants are offshoots of the strain responsible for nearly all of the virus spread in the U.S. this year.

All the COVID-19 vaccines given in the U.S. until now have been based on the original version of the virus that began spreading across the country in early 2020.

In June, the FDA told the vaccine makers that any boosters for the fall would have to combine protection against omicron BA.4 and BA.5 and the original coronavirus strain. Both manufacturers have been speeding their production and data gathering to have those so-called bivalent vaccines ready for the fall.

The FDA and the Centers for Disease Control and Prevention would have to sign off on revamped shots before their launch.

The U.S. has a contract to buy 105 million doses of the Pfizer combination shots once they’re ready, and 66 million of Moderna’s version. But how soon large amounts would become available isn’t clear. The government contracts include options to purchase 300 million doses each but reaching that total will require more funding from Congress, the Biden administration said.

As for timing, getting a booster too soon after the previous dose means missing out on its full benefit — something policymakers will have to take into consideration when rolling out revamped shots.

The White House has at times been frustrated by the pace of decision-making at the FDA and CDC, most notably last summer, when the regulators took weeks to decide whether to authorize the first booster dose for U.S. adults. Privately, West Wing officials believe the delay cost lives, preventing optimum protection amid the delta and omicron surges, and also fed into doubts about vaccine and booster effectiveness that affected their uptake.

In recent weeks, some of those frustrations have bubbled up again, as regulators considered whether to recommend a fourth shot for all adults, not just those at highest risk from the virus. Some in the White House believe that the additional dose would have helped somewhat with the rapidly spreading BA.5 subvariant, and also lift the confidence of anyone worried that their protection had waned.

Still, officials across the government have acknowledged the risks of vaccine fatigue among Americans, including tens of millions who still haven’t received their first booster. Government figures show less than half of those eligible for a booster have gotten that third shot.
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Scientists say wildfires in the American West are bigger, hotter and more destructive than in the past.
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Human-caused climate change made last week’s deadly heat wave in England and Wales at least 10 times more likely and added a few degrees to how brutally hot it got, a study said.

A team of international scientists found that the heat wave that set a new national record high at 40.3 degrees Celsius was made stronger and more likely by the buildup of heat-trapping gases from the burning of coal, oil and natural gas. They said Thursday that temperatures were 2 to 4 degrees Celsius warmer in the heat wave than they would have been without climate change, depending on which method scientists used.

The study has not been published in a peer-reviewed scientific journal yet but follows scientifically accepted techniques, and past such studies have been published months later.

“We would not have seen temperatures above 40 degrees in the U.K. without climate change,” study senior author Friederike Otto, a climate scientist at Imperial College of London, said in an interview. “The fingerprint is super strong.”

World Weather Attribution, a collection of scientists across the globe who do real-time studies of extreme weather to see whether climate change played a role in an extreme weather event and if so how much of one, looked at two-day average temperatures for July 18 and 19 in much of England and Wales and the highest temperature reached in that time.

The daily highest temperatures were the most unusual, a one-in-1,000-year event in the current warmer world, but “almost impossible in a world without climate change,” the study said. Last week’s heat smashed the old national record by 1.6 degrees Celsius. The average over two hot days and nights is a once a century event now but is “nearly impossible” without climate change.

When the scientists used the long history of temperatures in England to determine the impact of global warming, they saw a stronger climate change influence than when they used simulations from climate models. For some reason that scientists aren’t quite certain about, climate models have long underestimated extreme weather signals in the summer in Western Europe, Otto said.

With climate models, the scientists simulate a world without the 1.2 degrees Celsius of warming since pre-industrial times and see how likely this heat would have been in that cooler world without fossil fuel-charged warming. With observations they look at history and calculate the chances of such a heat wave that way.

“The methodology seems sound, but candidly, I didn’t need a study to tell me this was climate change,” said University of Georgia meteorology professor Marshall Shepherd, who wasn’t on this study team but was on a U.S. National Academy of Sciences panel that said these types of studies are scientifically valid. “This new era of heat is particularly dangerous because most homes are not equipped for it there.”

The World Weather Attribution study refers to another analysis that estimates a heat wave like this would kill at least 800 people in England and Wales, where there is less air conditioning than in warmer climates.

Otto, who had to sleep and work in the basement because of the heat, said as the world warms, these record-smashing heat waves will continue to come more frequently and be hotter.

In addition to spurring people to cut greenhouse gas emissions, study co-author Gabe Vecchi said, “this heat wave and heat waves like it should be a reminder that we have to adapt to a warmer world. We are not living in our parents’ world anymore.”
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Los Angeles County dropped a plan to impose a universal indoor mask mandate this week as COVID-19 infections and rates of hospitalizations have stabilized, a top health official said Thursday. 

Health director Barbara Ferrer said two weeks ago that the nation’s most populous county could again require face coverings if trends in hospital admissions continued under criteria set by the U.S. Centers for Disease Control and Prevention. 

On Thursday, she said the county had dodged imposition of the broad mask rule. The county remains at the “high” CDC level of community transmission, but it could drop to “medium” in coming weeks. 

Ferrer made the announcement during a briefing at which she displayed flat and declining data graphs. She said transmission had dropped steadily since July 23, “potentially signaling the beginning of a downward trend in cases.” Hospitalizations are also down. 

“We’re on a decline right now, and it’s hard for us to imagine reinstating universal indoor masking when we’re on this significant of a decline,” Ferrer said. But she added that health officials would reassess things should case rates and hospital admissions spike again. 

While masks won’t be required in most indoor spaces, Ferrer reminded residents that face coverings remain an effective tool to reduce the spread of the coronavirus. 

As it has for most of the pandemic, L.A. County will still require masks in some indoor spaces, including health care facilities, mass transit vehicles, airports, jails and homeless shelters. 

The new mandate, which would have gone into effect Friday, would have expanded the requirement to all indoor public spaces, including shared offices, manufacturing facilities, warehouses, retail stores, restaurants and bars, theaters and schools. 

Nationwide, the latest COVID-19 surge is driven by the highly transmissible BA.5 variant, which now accounts for a majority of cases. It has shown a remarkable ability to get around the protection offered by vaccination.
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