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Daily Archives: April 10, 2022

Humour: News in Cartoons

Charts: Where Americans Get Their News and Who They Trust for Information

Where do Americans get their news?

Source : YouGovAmerica

Self-Spreading Vaccine Research Could Spin Out of Control, Experts Warn

George Dvorsky wrote . . . . . . . . .

Imagine a future scenario in which a dangerous new virus is detected in chimpanzees. To prevent this virus from spreading to humans, biologists decide to deliberately infect scores of wild chimps with a transmissible vaccine—an infectious, lab-grown virus that immunizes, rather than harms, its host. The chimps, now vaccinated, no longer pose a threat to humans.

That solution sounds too good to be true, which is exactly the problem, as scientists warn in a new Policy Forum published today in Science. Self-spreading vaccines are potentially dangerous and difficult to manage, and are “genetically too unstable to be used safely and predictably outside contained facilities,” write the authors, led by Filippa Lentzos from King’s College London and Guy Reeves from the Max Planck Institute for Evolutionary Biology.

This is not just their opinion, the authors argue. Rather, it’s an “evidence-based norm” that’s been around for decades, but this “norm now seems to be challenged,” they write. The result is an increased potential for “risky research on lab-modified self-spreading viruses,” according to the report. This could lead to a normalization of the concept and eventual real-world use without the proper safeguards, the scientists argue.

“Self-spreading vaccine research continues to proceed despite a lack of new information that would compellingly refute long-standing evidence-based norms in virology, evolutionary biology, vaccine development, international law, public health, risk assessment, and other disciplines,” the biologists write.

Vaccines that spread like a disease are an unquestionably powerful concept. They could be used to protect animals from disease and/or prevent them from harboring viruses dangerous to humans. In 2020, biologists Scott Nuismer and James Bull, both at the University of Idaho, argued for this very approach in a paper titled “Self-disseminating vaccines to suppress zoonoses.” (By self-disseminating virus, scientists mean a virus that has been artificially modified to perform a desired function while retaining its ability to spread between hosts.)

By leveraging the spreading power of viruses, scientists could create biological agents that proliferate quickly through a target population, with the viruses performing specific tasks, such as delivering vaccines or sterilizing invasive species. In the late 1980s, Australian researchers dabbled with lab-modified, contagious viruses, using multiple approaches to exterminate foxes, mice, and rabbits, according to the paper.

More conceptually—and certainly more controversially—this strategy could also be used to spread vaccines among humans.

As the paper points out, interest in this biotechnology has increased significantly over the past several years, with the European Union (through its Horizon 2020 program), the U.S. National Institutes of Health, and the U.S. Defense Advanced Research Projects Agency all currently running programs to explore a wide range of possible applications.

Lentzos, Reeves, and colleagues say it’s time to pump the brakes and consider the consequences of this research and all the moving parts needed to make such a thing work. It’s not immediately clear, they argue, that self-disseminating viruses can be contained or removed from an environment once released, or who would be responsible for the biocontrol agent, should the virus behave unexpectedly or cross national boundaries.

Advocates of the idea say these viruses could be modified to have short lifespans or be made incapable of mutating, but “it remains to be experimentally tested if [manipulations] could simultaneously limit viral replication transmissibility to the extent that they could be perceived as controllable while maintaining sufficient transmissibility to be considered useful as vaccines in continually dynamic environments,” according to the report.

As for using transmissible vaccines to limit the spread of diseases from animals to humans, the scientists say the “the vast majority of virus species that currently exist are undescribed by science,” making it “very difficult to imagine how the considerable effort necessary to develop and test self-spreading vaccines could identify and then prioritize single viral species circulating in wildlife.” That viruses are constantly mutating makes this task all the more onerous, they add.

In terms of what’s needed, the authors call for various safeguards, cost-benefit analyses, and measures such as regulatory oversight. This would involve “a concerted, global governance effort with coherent regional, national, and local implementation.” The essay suggests that national governments update their legislation and guidelines on the matter, while developers and funders of this research “articulate comprehensive and credible regulatory paths through which they believe the safety and efficacy of self-spreading approaches could be established.”

In an email, Bull, co-author of the 2020 paper advocating for research into this biotechnology, said the authors of the new report “raise several valid points,” and he agrees that “informed regulatory oversight is essential,” adding that “public acceptance is also essential.”

“Until we undertake preliminary studies of transmissible vaccines (in contained environments), we will have little evidence on which to base estimated risks and benefits,” Bull told Gizmodo. “It is to be expected that early papers on transmissible vaccines explore the theoretical possibilities, many of which will never be practical or, as further work may show, never be safe.”

In an effort to move ahead cautiously, Bull recommended conservative approaches, such as creating a vaccine from a benign virus that already exists in a target population, as opposed to modifying an otherwise harmful virus. Work into gene drives, a related technology in which modified organisms engineer an entire species, could also help. “Just as gene drive developers have responded to regulatory concerns and have invented new designs with limited potential for spread, it is expected that investment in laboratory studies of transmissible vaccines will also lead to methods that mitigate risks,” Bull argued.

The idea of transmissible vaccines might die on the vine, whether on account of technical issues, safety concerns, or lack of public acceptance. But, clearly, dedicated research attention is needed, since the potential benefits—and risks—are immense.

Source : GIZMODO

Read also at Bulletin of the Atomic Scientists

Scientists are working on vaccines that spread like a disease. What could possibly go wrong? . . . . .

America Is Staring Down Its First So What? COVID-19 Wave

Katherine J. Wu wrote . . . . . . . . .

If the United States has been riding a COVID-19 ’coaster for the past two-plus years, New York and a flush of states in the Northeast have consistently been seated in the train’s front car. And right now, in those parts of the country, coronavirus cases are, once again, going up. The rest of America may soon follow, now that BA.2—the more annoying, faster-spreading sister of the original Omicron variant, BA.1—has overtaken its sibling to become the nation’s dominant version of SARS-CoV-2.

Technologically and immunologically speaking, Americans should be well prepared to duel a new iteration of SARS-CoV-2, with two years of vaccines, testing, treatment, masking, ventilation, and distancing know-how in hand. Our immunity from BA.1 is also relatively fresh, and the weather’s rapidly warming. In theory, the nation could be poised to stem BA.2’s inbound tide, and make this variant’s cameo our least devastating to date.

But theory, at this point, seems unlikely to translate into practice. As national concern for COVID withers, the country’s capacity to track the coronavirus is on a decided downswing. Community test sites are closing, and even the enthusiasm for at-home tests, whose results usually aren’t reported, seems to be on a serious wane; even though Senate Majority Leader Chuck Schumer announced a new deal on domestic pandemic funding, those patterns could stick. Testing and case reporting are now so “abysmal” that we’re losing sight of essential transmission trends, says Jessica Malaty Rivera, a research fellow at Boston Children’s Hospital. “It’s so bad that I could never look at the data and make any informed choice.” Testing is how individuals, communities, and experts stay on top of where the virus is and whom it’s affecting; it’s also one of the main bases of the CDC’s new guidance on when to mask up again. Without it, the nation’s ability to forecast whatever wave might come around next is bound to be clouded.

We can’t react to a wave we don’t see coming. “I keep thinking back to this idea of If we don’t measure it, it won’t happen,” says Shweta Bansal, an infectious-disease modeler at Georgetown University. (As President Donald Trump once put it, “If we stop testing, we’d have fewer cases.”) In reality, “it’s very well happening, and we just don’t see it yet.” There is still no guarantee that the next wave is nigh—but if it is, the U.S. is poorly positioned to meet it. Americans’ motivational tanks are near empty; the country’s stance has, for months, been pretty much whatevs. The next wave may be less a BA.2 wave, and more a so what? wave—one many Americans care little to see, because, after two years of crisis, they care so little to respond.

Colloquially, epidemiologically, a wave is a pretty squishy term, a “know it when you see it” notion that gets subjective, fast. “There is no technical definition,” says C. Brandon Ogbunu, a mathematical modeler studying infectious-disease dynamics at Yale. And with COVID-19, there’s no consensus among experts on exactly when waves begin or end, or how sharp or tall one must be to count.

A reasonable delineation for a wave might involve an unexpected deviation from a baseline low—a sudden and sustained uptick in cases that eventually trends back down. That concept might seem intuitive, and yet it’s rife with assumptions: Unexpected, baseline, sudden, sustained—all of these require prior intel on how a disease typically behaves, says Justin Lessler, an infectious-disease modeler at the University of North Carolina at Chapel Hill. Researchers have spent decades building those knowledge bases for diseases like the flu. But “we don’t know what ‘normal’ conditions for COVID-19 are going to look like yet,” he told me.

That makes the start of a wave tough to identify even when testing data abound; no single inflection point guarantees a shift from not a wave to definitely a wave. Technically, the BA.1 wave that reached its zenith in mid-January may not have even ended yet, because experts haven’t decided what threshold it would need to reach to do so. Lessler proposed that last summer’s pre-Delta nadir might serve as a tentative benchmark. “If we were sustained there, it wouldn’t be the worst thing ever,” he told me. But despite the relief much of the nation has been feeling the past couple of months, “most places haven’t even gotten there.”

Still, new waves can begin before their predecessors conclude. The experts I spoke with said that an increase in SARS-CoV-2 cases that ratcheted up counts by more than a couple percentage points a week, lasted at least 14ish days, and impacted a large swath of the country, would definitely trip alarm bells. On the whole, the United States does not seem to be at alarm-bell level quite yet, Ogbunu told me. Maybe, if cases don’t rise sharply enough, or to a high enough amplitude, the country won’t get there with BA.2 at all. But it’s too soon to tell. The latest estimates put BA.2 at the root of about 70 percent of sequenced infections in the United States. That’s right past the proportion at which BA.2 started putting a serious squeeze on other countries, says Sam Scarpino, the managing director of pathogen surveillance at the Rockefeller Foundation. “Once you get into the 50 to 60 percent BA.2 range is when you see cases going up,” he told me. Experts can’t yet know if the U.S. will be more resilient, or less.

Watching only the national curve can also be misleading. Country-wide data show only a gargantuan average; these numbers smooth and conceal the case rises that have already been erupting in isolated patchworks. That sort of variability is a product of where humans have carried this new subvariant; of the immune landscape that vaccinations and past versions of the virus have left behind; and of the local defenses, such as masking (or not), that people are leveraging against BA.2, says Bansal, who’s been leading efforts to map how different communities will be impacted by future variants. And patchiness is to be expected. And these more regional waves still matter, even if they seem at first easier to ignore.

They will, in many cases, mark the places least prepared to weather another surge in infections. Tests, while more abundant, have remained inaccessible to many of those who need them; without tests, treatments, too, will drift out of reach. And Malaty Rivera worries that, even now, we don’t know which parts of the country are being hardest hit, thanks to underdiagnosis and underreporting. Some places that appear to be coasting on plateaus or trending down may not be as well positioned as they first seem. Wastewater surveillance, which homes in on virus particles extruded in waste, could help—but these monitoring sites aren’t distributed evenly, either. As things stand, the national map of where the virus is moving is full of blank spots and dark patches. Even unmeasured waves, if they grow big enough, have ways of breaking over us. At worst, the virus could eventually surprise us with a rash of hospitalizations—a sign that the initial bump of cases, one we should have responded to, is already in our rearview mirror.

Not all case rises have to spell disaster. Since November, when Omicron was first identified, more Americans have been vaccinated for the first time, or boosted, or infected; rapid tests have become more available; and the oral antiviral Paxlovid has hit far more pharmacy shelves. All these factors, plus a springtime flocking into the outdoors, especially in the northern U.S., could help blunt a potential wave’s peak; some may even help uncouple a rise in infections from a secondary surge in hospitalizations and deaths. “Those are the numbers I’m more interested in,” says David S. Jones, a historian of science at Harvard University. If cases go up, but the most severe outcomes stay trim, Jones told me, he’ll feel far less concerned; this wave won’t have to feel like the one the country just weathered, by any stretch.

It’s certainly a reasonable future to hope for, but not an outcome that can be taken for granted. Even now, less than half of Americans are boosted, and health-care systems and their workers are reeling from the most recent surge. And although the Senate has reached a deal on an additional $10 billion of emergency funds for pandemic prevention efforts, that sum is less than half of the original $22.5 billion the Biden administration originally asked for. Without more money to keep mitigation tools flowing freely into the community, Bansal also worries about the implications of focusing too hard on hospitalizations. Taking a so-what approach until a substantial number of severe cases show up, as CDC guidance advises Americans do, is “just too late,” she told me. “The story’s already been written for those individuals who have been infected.” Nor are hospitalizations and deaths the only outcomes that matter, as millions of people in the United States alone continue to grapple with the debilitating symptoms of long COVID, which vaccines only partly diminish.

Outbreaks are dialogues; rises in cases can be driven by a new version of the virus, but also by us. Nearly two years ago, Jones and Stefan Helmreich, an anthropologist at MIT, warned that speaking of epidemics as waves casts them “as natural phenomena”—disasters that blow through us, in ways beyond our control. But the trajectory of an epidemic is actually “deeply shaped by human action, both before such disasters hit and as they are managed,” they wrote. Waves don’t just happen to us. They are also, unlike the ocean swells they evoke, shaped by us. Scientifically, calling whatever’s coming a “BA.2 wave” is fair, because BA.2 is ousting its competitors. Still, its peculiarities—or the peculiarity of any next wave—might be less about the quirks of the variants involved and more about how readily we respond. (Certainly, if it’s not BA.2 that troubles us imminently, it’ll be another SARS-CoV-2 offshoot.)

Human actions can slow rises in cases. They can also accelerate them. And when infections take off, it’s not always easy to tell who holds the steering wheel—pathogen or host. “Every outbreak since the beginning of humankind has a behavioral component, an immunological component, and a viral component,” Yale’s Ogbunu told me. “Where one ends and another begins is never completely clear.” But Americans are too far along in this pandemic, and too familiar with the tools we need to manage it, to shirk culpability entirely. Pre-vaccine variants pummeled us when we were poorly defended. The antibody-dodging BA.1 circumvented some of our immune shields. BA.2 isn’t a perfect match for our shots, either. And yet, fresh off of its sibling’s winter crush, we would be remiss to be twice fooled.

Source : The Atlantic

Heart Disease and Sleepless Nights Often Go Together

Insomnia is widespread in heart disease patients and significantly boosts the risk of heart attack, stroke or other major heart event, a new study says.

The findings show the need to check for and treat sleep problems in heart disease patients, according to researchers.

“Our study indicates that insomnia is common in heart disease patients and is linked with subsequent cardiovascular problems regardless of risk factors, coexisting health conditions and symptoms of mental health,” said lead author Lars Frojd, a medical student at the University of Oslo in Norway.

The new study included more than 1,000 heart disease patients (average age: 62). They participated for an average 16 months after a heart attack and/or a procedure to open blocked arteries — either bypass surgery or stent implantation.

At the start, 45% said they had insomnia and 24% said had used sleep medication in the previous week.

During an average 4.2-year follow-up, 225 patients had 364 major heart events. They included hospitalization for heart attack, restoring blocked blood flow, stroke, heart failure and cardiovascular death.

Insomnia accounted for 16% of repeat heart events, ranking it third in importance after smoking (27%) and inactivity (21%), according to findings presented Thursday at a virtual meeting of the European Society of Cardiology. The study was also published in the journal Sleep Advances.

“This means that 16% of recurrent major adverse cardiovascular events might have been avoided if none of the participants had insomnia,” Frojd said in a meeting news release.

He noted more research is needed to learn whether insomnia treatments such as cognitive behavioral therapy and digital applications would help heart patients.

Source: HealthDay