Scientists around the world are working to battle the coronavirus – an effort that extends to a space-travel lab that worked overtime to help sick earthlings. VOA’s Arash Arabasadi has This Week in Space.
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One August day in 2017, a 31-year-old man with a cough boarded a crowded minibus in Madagascar’s capital, Antananarivo.The man was dead before he could reach his destination.That touched off the most lethal outbreak of pneumonic plague in decades. By the end of November, more than 2,400 people had been infected and 209 had died.Basketball teams from around the Indian Ocean region were in Madagascar at the time for a championship tournament. A coach from the Seychelles died and a South African player fell ill. The risk of an international outbreak loomed.To stamp it out, health officials needed to break the chains of transmission: find the people who had come into contact with each infected individual and prevent them from spreading the disease to anyone else.It’s known as contact tracing. It’s the same task that experts now say the United States must dramatically increase as COVID-19 lockdowns loosen. COVID-19 is the disease caused by the coronavirus.COVID-19 infections will inevitably increase in the coming weeks, they say, and a work force must be standing by to stop new patients from rekindling a widespread outbreak. Tiny Madagascar’s experience could provide the U.S. and other countries with valuable lessons and insights.Sorry, but your browser cannot support embedded video of this type, you can
FILE – Red Cross volunteers talk to villagers about the plague outbreak, 30 miles west of Antananarivo, Madagascar, Oct. 16, 2017.So when the volunteers were called upon to become pneumonic plague contact tracers, the community already knew them and listened to them. People were willing to share information about who was at risk.Pneumonic plague is 100% fatal within days if left untreated. The community health volunteers delivered antibiotics that would prevent infection.Occasionally, though, people would not take them.”Fear, I think, was one of the biggest factors,” Yanulis said. People “did not know how to deal with that news” that they might have been exposed to a lethal disease.Health volunteers would “go up the chain” to deal with refusals, he added. They’d call in the head of the local health center, the village watch committee, and even the mayor to “basically talk it through” and “ultimately convince the person that it’s not just for your good, it’s also for the good of the community.”Then the volunteer would go back every day during the one-week course of antibiotics to make sure the person took them.The contact tracers were part of a coordinated effort from local, state and national officials, plus international partners, including the World Health Organization.”In 2½ months, we had a real public health success,” Yanulis said. New cases dropped sharply in October. On December 4, the WHO declared the outbreak contained.The same volunteers are “at the ready” to deal with COVID-19, he added. “In some cases they are already being oriented and trained.”While they are unpaid in Madagascar, community health workers are on government payrolls in Kenya, Ethiopia, Malawi and other countries in Africa and elsewhere, Yanulis said.A medical worker walks past people lined up at Gotham Health East New York, a COVID-19 testing center, April 23, 2020, in the Brooklyn borough of New York.People skillsIn the United States, states, cities and counties are preparing to hire thousands of people to do the same kind of labor intensive, high-touch work that helped Madagascar contain its outbreak.They don’t need much education, Yanulis said. “It’s really about being someone who is comfortable going into the community.”Before COVID-19, much of the contact tracing U.S. health departments did was for sexually transmitted infections, which carry more of a stigma than the coronavirus infection.The process is basically the same, said Tim Heymans, a disease intervention specialist with the Minnesota Department of Health. When he calls a contact, the first question he asks is whether the person can speak privately. “When you show them that you’re trying to protect their privacy, I think that builds trust.”When he delivers the news, “they may be shocked at first or are upset or defensive.” Some get angry and don’t cooperate, but, he said, “most of the time within moments, they’re giving signs that they’re glad that we called and are happy for the advice we’re giving them on where they can go to get help with this.”For the most difficult cases, Heymans said, “we try to appeal to the person’s sense of the greater good and protecting people around them.” ‘Complicated and messy’COVID-19 contacts need to isolate themselves for 14 days, which can be a lot to ask.A person might be taking care of elderly relatives and young children. Staying at home risks spreading the infection to vulnerable family members, said Adriane Casalotti, governmental and public affairs chief at the National Association of County and City Health Officials.But “if they leave,” she asked, “who’s going to help pick up the slack?”Health departments may need to support people in quarantine with housing, food, medicine and even financial help.”People’s lives are complicated and messy,” she said. “So the public health response ends up being complicated and messy.”A smartphone app built for the state of Utah displaying coronavirus test sites. The app tracks symptoms and shares location data for contact tracing.Job opportunitiesWith states looking to hire thousands of contact tracers quickly, Johns Hopkins University has developed a five-hour online training course covering the basics of the disease, contact tracing and how it works, and some of the privacy and ethical issues involved.It also covers how to build rapport, “because ultimately, this is a program about connecting with people and helping support them to stop the spread,” said course instructor Emily Gurley at Johns Hopkins.Entry-level contact tracing jobs pay in the mid-$30,000 range, according to NACCHO’s Casalotti. The organization said Congress needs to provide $7.6 billion for health departments to hire at least 100,000 of them, plus another 10,000 supervisors and 1,600 epidemiologists.With tens of millions of people out of work, there’s no shortage of applicants. Massachusetts had 40,000 applicants for 1,000 positions, according to USA Today.Being out of work is just part of the surge of interest, Casalotti said. “I think a lot of people are stuck at home and they’re watching this all happen outside their windows and they want to help.”When the COVID-19 pandemic hit, Casalotti noted, health departments had not recovered from steep budget and staffing cuts made in the wake of the 2008 financial crisis.Given the economic devastation the pandemic is causing to state and local budgets, she is worried that history will repeat itself.”We’re actually really concerned, if this is anything like the 2008 recession, that local departments on the front lines of this response … will end up being in worse financial shape after coronavirus than they were before,” she said.
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Scientists around the world are working to battle the coronavirus – an effort that extends to a space-travel lab that worked overtime to help sick earthlings. VOA’s Arash Arabasadi has This Week in Space.
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Burundi has expelled four officials from the World Health Organization (WHO), declaring them persona non grata and ordering them to leave the country by Friday, a leaked memo from the country’s foreign ministry reveals. The decision comes days before the May 20 presidential elections and amid a global coronavirus pandemic.Bernard Ntahiraja, the foreign affairs assistant minister, did not provide an explanation for the expulsion. The WHO’s Regional Director for Africa, Matshidiso Moeti, said that the organization “remain[s] very willing to…support their [Burundi’s] response to COVID-19.” John Nkengasong, the head of the African Centers for Disease Control and Prevention, said in a statement that he found the decision to hold elections in a time of the COVID-19 crisis irresponsible. “We have to collectively deny the virus any space to transmit,” he said.Opposition candidate Léonce Ngendakumana said the expulsion is “regrettable” and called upon the government to heed recommended health and safety precautions. “The country alone won’t be able to contain the pandemic,” Ngendakmana said. The expelled officials include WHO country head Walter Kazadi Mulombo, field epidemiologist Jean Pierre Mulunda Nkata, health sector coordinator Ruhana Mirindi Bisimwa, and Daniel Tarzy.Burundi has only 27 reported cases of COVID-19, but health officials suspect cases are on the rise due to the lack of testing and lockdown measures, the CDC said.Critics accuse the government of downplaying the virus in order to temper rising civil unrest, fearing a repeat of the violence that occurred after the 2015 election of current president Pierre Nkurunziza.In 2019, Burundi expelled United Nations officials who investigated the violence after the 2015 vote.  The country also left the International Criminal Court after facing charges of state-sponsored crime.
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America faces the “darkest winter in modern history” unless leaders act decisively to prevent a rebound of the coronavirus, says a government whistleblower who alleges he was ousted from his job after warning the Trump administration to prepare for the pandemic.
Immunologist Dr. Rick Bright makes his sobering prediction in testimony prepared for his appearance Thursday before the House Energy and Commerce Committee. Aspects of his complaint about early administration handling of the crisis are expected to be backed up by testimony from an executive of a company that manufactures, respirator masks.
A federal watchdog agency has found “reasonable grounds” that Bright was removed from his post as head of the Biomedical Advanced Research and Development Authority after sounding the alarm at the Department of Health and Human Services. Bright alleged he became a target of criticism when he urged early efforts to invest in vaccine development and stock up on supplies.
“Our window of opportunity is closing,” Bright says in his prepared testimony posted on the House committee website. “If we fail to develop a national coordinated response, based in science, I fear the pandemic will get far worse and be prolonged, causing unprecedented illness and fatalities.”
Bright’s testimony follows this week’s warning by Dr. Anthony Fauci, the government’s top infectious disease expert, that a rushed lifting of store-closing and stay-at-home restrictions could “turn back the clock,” seeding more suffering and death and complicating efforts to get the economy rolling again.  
President Donald Trump has dismissed Bright as “a disgruntled guy,” and some of the president’s political allies have urged that Fauci be fired, although that seems unlikely.
More than 83,000 people have died in the U.S., representing more than one-fourth of global deaths and the world’s highest toll. On the planet more than 4.3 million have been infected and about 295,000 have died.
Eager to restart the economy, Trump has been urging states to lift restrictions, and many governors are doing so gradually, though consumers remain leery of going back to restaurants, social events and sporting competitions.
In his prepared testimony, Bright said, “The undeniable fact is there will be a resurgence of (COVID-19) this fall, greatly compounding the challenges of seasonal influenza and putting an unprecedented strain on our health care system.”  
“Without clear planning and implementation of the steps that I and other experts have outlined, 2020 will be darkest winter in modern history,” Bright wrote.
Bright, who has a doctoral degree in immunology, outlined a path forward that would be based on science, even as researchers work to develop better treatments and an effective vaccine. The steps include:
— Establishing a national testing strategy. The White House has urged states to take the lead on testing, even as the federal government pushes to make more tests and better ones widely available. Trump says the U.S. has “prevailed” on testing through this strategy, but in Congress Democrats are demanding a federal framework to encompass the whole nation.
— Doubling down on educating the public about basic safety measures such as frequent hand-washing and wearing masks in public places as guidelines indicate. “Frankly, our leaders must lead by modeling the behavior,” said Bright, in a not-too-subtle reference to a president who conspicuously goes maskless.
— Ramping up production of essential equipment and supplies, from cotton swabs for testing to protective gear for health care workers and essential workers.
— Setting up a system to fairly distribute equipment and supplies that are scarce and highly sought. Eliminating state vs. state competition would increase efficiency and reduce costs, he wrote.
As part of his whistleblower complaint, Bright is seeking to be reinstated in his old job. HHS, his employer, says it strongly disagrees with his allegations and that it reassigned him to a high-profile position helping to lead the development of new coronavirus tests at the National Institutes of Health.  
BARDA, the agency Bright worked at for 10 years, was created to help the government respond to bioterrorism, infectious diseases, and radiological attacks. It focuses on developing and procuring counter-measures such as vaccines and treatments. Prior to his reassignment Bright had received an “outstanding” performance review.  
He says friction with HHS leaders escalated after he opposed widespread use of hydroxycholoroquine, a malaria drug that Trump touted without proof as a “game-changer” for treating COVID-19 patients. Subsequent studies have indicated the drug may do more harm than good. Bright was summarily removed in late April.
One aspect of Bright’s complaint is expected to get backing at Thursday’s hearing from an executive of a Texas company that manufactures N95 respirator masks. Michael Bowen, executive vice president of Prestige Ameritech, emailed with Bright repeatedly starting in late January. Bowen offered to crank up production lines that were sitting idle, while warning that the world supply of masks was being snapped up by other countries. Bright said in his complaint that it took five weeks to move the federal bureaucracy.
In written testimony to the committee, Bowen said Bright and other BARDA directors he’d worked with previously all wanted to address a chronic problem of not enough masks in the government stockpile, “but in my opinion didn’t have enough authority.”
After the terrorist attacks of Sept. 11, 2001, America was told that restrictive “governmental ‘silos’ had been torn down … so that different federal agencies could work together for national security,” Bowen added. “But I didn’t see evidence of that.”
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The European Medicines Agency predicted that there could be licensed drugs to treat the new coronavirus in the next few months and that a vaccine might even be approved in early 2021, in a “best-case scenario.”
Dr. Marco Cavaleri, who heads the European regulator’s vaccines department, told a media briefing on Thursday that approving medicines to treat COVID-19 might be possible “before the summer,” citing ongoing clinical trials. Recent early results for the drug remdesivir suggested it could help patients recover from the coronavirus faster, although longer-term data is still needed to confirm any benefit.  
Although it typically takes years to develop a vaccine, Cavaleri said that if some of the shots already being tested prove to be effective, they could be licensed as early as the beginning of next year.  
Cavaleri cautioned, however, that many experimental vaccines never make it to the end and that there are often delays.  
“But we can see the possibility that if everything goes as planned, vaccines could be approved a year from now,” he said.  Sorry, but your browser cannot support embedded video of this type, you can
download this video to view it offline. Embed” />CopyMore than 140 heads of states and health experts, including South African President Cyril Ramaphosa, Pakistani Prime Minister Imran Khan and Nobel laureate Joseph Stiglitz issued an appeal Thursday calling on all countries to unite behind a “people’s vaccine” against COVID-19, to ensure any effective treatments and vaccines be available globally to anyone who needs them, for free.
At the moment, there are about a dozen vaccine candidates being tested in China, Britain, Germany and the U.S. The World Health Organization has estimated it could take about 12 to 18 months for an effective vaccine to be found.  
While some experts have proposed dropping the requirement for large-scale advanced clinical trials altogether, Cavaleri said that wasn’t currently being considered.  
“Our current thinking is all vaccines under development should undergo large phase 3 trials to establish what is the level of protection,” he said.  
But he acknowledged that could change if the situation worsened.  
“Things may evolve as the pandemic will evolve and we will see if we need to do something else,” Cavaleri said.
Some officials have warned that a vaccine might never be found; previous attempts to develop a vaccine against related coronaviruses like SARS and MERS have all failed. But Cavleri was optimistic an immunization against COVID-19 would eventually be discovered, as there are various technologies being tried globally.  
“I think it’s a bit early to say, but we have good reason to be sufficiently optimistic that at the end of the day, some vaccines will make it,” he said.
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Cancer deaths have dropped more in states that expanded Medicaid coverage under the Affordable Care Act than in states that did not, new research reveals. The report Wednesday is the first evidence tying cancer survival to the health care change, which began in 2014 after the law known as “Obamacare” took full effect, said one study leader, Dr. Anna Lee of Memorial Sloan Kettering Cancer Center in New York. “For a policy to have this amount of impact in a short amount of years” is remarkable, because cancer often takes a long time to develop and prove fatal, she said. Lee discussed the results in an American Society of Clinical Oncology news conference as part of its annual meeting later this month. The law let states expand Medicaid eligibility and offer subsidies to help people buy health insurance. Twenty-seven states and Washington, D.C., did that, and 20 million Americans gained coverage that way. The other 23 states did not expand benefits. Researchers used national health statistics on cancer deaths to track trends before and after the law. They looked only at deaths in people younger than 65, who stood to benefit from the change because those older already were covered by Medicare. About 30% of U.S. cancer deaths are in people younger than 65.  The cancer death rate fell throughout the United States from 1999 to 2017 in that age group, but more in states that expanded Medicaid — 29% versus 25% in states that did not. Researchers specifically compared death rates from 2011 to 2013, before the health care change, to 2015 to 2017, after it. In states that expanded coverage, the change meant 785 fewer cancer deaths in 2017. Another 589 deaths could have been prevented that year if all states had expanded Medicaid, researchers estimated. Having health insurance allows quicker treatment after diagnosis and access to more treatment options so patients can get the best care available, which can improve survival odds, Lee said. Insured people also may have more opportunities for screening to detect cancers at a stage when they’re most treatable.  The new work builds on research from last year’s conference that suggested more patients, blacks in particular, were able to quickly start on treatment after a diagnosis of advanced cancer in states that expanded Medicaid, said Dr. Howard Burris. He is president of the oncology society and heads the Sarah Cannon Research Institute, a cancer center in Nashville, Tennessee.  “There was so much excitement” when federal statistics showed a big drop in cancer deaths over the last decade, and the new study shows “it was an even better improvement in expansion states,” said Burris, who had no role in the study. The picture is murky for specific racial groups. States that expanded Medicaid generally had fewer blacks and more Hispanics than states that did not expand. Blacks have had worse cancer death rates than other groups, but that also has been improving at a greater rate than for whites. Expansion of Medicaid seemed to make no difference in cancer mortality rates for blacks but did seem to improve the situation for Hispanics. To date, 36 states and Washington, D.C., have expanded Medicaid and 14 have not. 
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A new comet that was discovered in April using data from an orbiting observatory may be visible to the naked eye in the coming weeks. The comet was first spotted by amateur astronomer Michael Mattiazzo, who used data gathered by an instrument onboard the European Space Agency (ESA) and NASA’s Solar and Heliospheric Observatory (SOHO) satellite. The instrument, known as the Solar Wind Anisotropies, or SWAN, maps the constantly outflowing solar wind in interplanetary space by focusing on a wavelength of ultraviolet light emitted by hydrogen atoms.  The new comet was picked up by the instrument because it is releasing huge amounts of water, about 1.3 tons per second. Though its official name is C/2020 F8, the comet has become known as Comet SWAN for the instrument that aided in its discovery. It is making its closest pass by Earth on Wednesday — about 85 million kilometers — and can be seen best by those in the Southern Hemisphere or the southern parts of the Northern Hemisphere. Astronomers say residents of the Northern Hemisphere may be able to get a better view of the comet later this month when it makes its closet pass by the sun. But scientists caution the visibility of comets can be difficult to predict, especially as they get closer to the sun. Astronomer Tony Philips told The New York Times it depends on how the comet reacts to solar heating as it approaches the sun in the next few weeks.  Comets start to disintegrate as they approach the sun, and that disintegrating material may or may not form a “tail” that helps make the object more visible. 
 
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Climate scientists expect above-normal temperatures over the next three months, despite the absence of an El Nino, a natural phenomenon that tends to boost global temperatures.   In past years, record heat has occurred in El Nino years. But that is changing according to the global seasonal climate update from the World Meteorological Organization. The WMO said that April 2020, a non-El Nino period, is tied as the warmest month on record with April 2016, when there was a strong El Nino, as well as climate change. WMO spokeswoman Claire Nullis said all the years subsequent to 2016 have been very warm without El Nino, including 2019, which was the second warmest year on record.  She notes the trend has continues into this year.  “Global temperatures in January, February and March were also the warmest or second warmest year on record, according to international data bases,” Nullis said.  “So, we are seeing now that the human influence on our climate is actually stronger. It is more powerful than natural sources of nature, such as El Nino.”  Heat waves increasingThe WMO said most extreme weather events are happening against a backdrop of climate change. It said heat waves are increasing due to climate change, and that is having a major impact on extreme events such as tropical cyclones and heavy rainfall.  East Africa, for example, is experiencing record rainfall and flooding.   Nullis told VOA that preparing for and managing the impact of extreme weather events is becoming more difficult due to COVID-19. She explains that nations are not paying enough attention to early warning systems because of the pandemic. “We really do need strong multi-hazard early warning systems against hurricanes, against heat waves, because these things are all interlinked,” Nullis said. “They have a cascading effect, and COVID now is one of those hazards.”    WMO scientists said the COVID-19 pandemic more than ever before increases the need for reliable weather forecasts and longer-term climate outlooks.  They said temperatures and precipitation have a major impact on key economic and public health systems, noting that many have been brought to the brink of collapse by the pandemic.  
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Since the COVID-19 pandemic first erupted in China this winter, hopes have lingered that the outbreak would die down with the change of seasons.  “A lot of people think that goes away in April with the heat,” U.S. Stalls are shuttered at Hong Lim Hawker Centre in Singapore, May 10, 2020, amid the coronavirus outbreak. COVID-19 cases in Singapore recently spiked to 700 to 800 per day.”We can see that this virus has spread all over the world, with many different temperatures,” said Universidad Católica de Valencia bioengineering professor Angel Serrano Aroca. “I believe that there is an effect of weather conditions, but I think that this virus is so contagious that there are other factors that are much more important.” Population density, social-distancing measures and public health tools such as testing and contact tracing likely have more of an impact than weather, experts said.  For Murray and colleagues at the University of Washington, “mobility is the most important (factor) and then testing per capita,” he said. When his group more than doubled their estimated COVID-19 death toll in the United States, from 60,000 in mid-April to 135,000 last week, it was largely because states were loosening social distancing and individuals were moving around more even in supposedly locked-down areas. Temperature is probably “important, yet minimal,” he said.  Scientists still have a lot to learn about the virus, however. “As some places warm up,” Murray added, “we may get a stronger signal to understand better what the actual full temperature or seasonality effect will be.” 
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