On the third anniversary of the COVID-19 pandemic, the virus is still spreading, and the death toll is nearing 7 million worldwide. Yet most people have resumed their normal lives, thanks to a wall of immunity built from infections and vaccines.

The virus appears here to stay, along with the threat of a more dangerous version sweeping the planet.

“New variants emerging anywhere threaten us everywhere,” said virus researcher Thomas Friedrich of the University of Wisconsin-Madison. “Maybe that will help people to understand how connected we are.”

Saturday marks three years since the World Health Organization first called the outbreak a pandemic, March 11, 2020, and the United Nation’s health organization says it’s not yet ready to say the emergency has ended.

The virus endures

With the pandemic still killing 900 to 1,000 people a day worldwide, the stealthy virus behind COVID-19 hasn’t lost its punch. It spreads easily from person to person, riding respiratory droplets in the air, killing some victims but leaving most to bounce back without much harm.

“Whatever the virus is doing today, it’s still working on finding another winning path,” said Dr. Eric Topol, head of Scripps Research Translational Institute in California.

We’ve become numb to the daily death toll, Topol says, but we should view it as too high. Consider that in the United States, daily hospitalizations and deaths, while lower than at the worst peaks, have not yet dropped to the low levels reached during summer 2021 before the delta variant wave.

At any moment, the virus could change to become more transmissible, more able to sidestep the immune system or more deadly. Topol said we’re not ready for that. Trust has eroded in public health agencies, furthering an exodus of public health workers. Resistance to stay-at-home orders and vaccine mandates may be the pandemic’s legacy.

Fighting back

There’s another way to look at it. Humans unlocked the virus’ genetic code and rapidly developed vaccines that work remarkably well. We built mathematical models to get ready for worst-case scenarios. We continue to monitor how the virus is changing by looking for it in wastewater.

“The pandemic really catalyzed some amazing science,” said Friedrich.

The achievements add up to a new normal where COVID-19 “doesn’t need to be at the forefront of people’s minds,” said Natalie Dean, an assistant professor of biostatistics at Emory University. “That, at least, is a victory.”

Dr. Stuart Campbell Ray, an infectious disease expert at Johns Hopkins, said the current omicron variants have about 100 genetic differences from the original coronavirus strain. That means about 1% of the virus’ genome is different from its starting point. Many of those changes have made it more contagious, but the worst is likely over because of population immunity.

Matthew Binnicker, an expert in viral infections at the Mayo Clinic in Rochester, Minnesota, said the world is in “a very different situation today than we were three years ago — where there was, in essence, zero existing immunity to the original virus.”

That extreme vulnerability forced measures aimed at “flattening the curve.” Businesses and schools closed, weddings and funerals were postponed. Masks and “social distancing” later gave way to showing proof of vaccination. Now, such precautions are rare.

“We’re not likely to go back to where we were because there’s so much of the virus that our immune systems can recognize,” Ray said. Our immunity should protect us “from the worst of what we saw before.”

Real-time data lacking

On Friday, Johns Hopkins did its final update to its free coronavirus dashboard and hot-spot map with the death count standing at more than 6.8 million worldwide. Its government sources for real-time tallies had drastically declined. In the U.S., only New York, Arkansas and Puerto Rico still publish case and death counts daily.

“We rely so heavily on public data and it’s just not there,” said Beth Blauer, data lead for the project.

The U.S. Centers for Disease Control and Prevention still collects a variety of information from states, hospitals and testing labs, including cases, hospitalizations, deaths and what strains of the coronavirus are being detected. But for many counts, there’s less data available now and it’s been less timely.

“People have expected to receive data from us that we will no longer be able to produce,” said the CDC’s director, Dr. Rochelle Walensky.

Internationally, the WHO’s tracking of COVID-19 relies on individual countries reporting. Global health officials have been voicing concern that their numbers severely underestimate what’s actually happening and they do not have a true picture of the outbreak.

For more than year, CDC has been moving away from case counts and testing results, partly because of the rise in home tests that aren’t reported. The agency focuses on hospitalizations, which are still reported daily, although that may change. Death reporting continues, though it has become less reliant on daily reports and more on death certificates — which can take days or weeks to come in.

Then and now

“I wish we could go back to before COVID,” said Kelly Forrester, 52, of Shakopee, Minnesota, who lost her father to the disease in May 2020, survived her own bout in December and blames misinformation for ruining a longtime friendship. “I hate it. I actually hate it.”

The disease feels random to her. “You don’t know who will survive, who will have long COVID or a mild cold. And then other people, they’ll end up in the hospital dying.”

Forrester’s father, 80-year-old Virgil Michlitsch, a retired meat packer, deliveryman and elementary school custodian, died in a nursing home with his wife, daughters and granddaughters keeping vigil outside the building in lawn chairs.

Not being at his bedside “was the hardest thing,” Forrester said.
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A requirement that travelers to the U.S. from China present a negative COVID-19 test before boarding their flights expired Friday after more than two months as cases in China have fallen.

The restrictions were put in place December 28 and took effect January 5 amid a surge in infections in China after the nation sharply eased pandemic restrictions and as U.S. health officials expressed concerns that their Chinese counterparts were not being truthful to the world about the true number of infections and deaths. The requirement from the U.S. Centers for Disease Control and Prevention expired for flights leaving after 3 p.m. Eastern time Friday.

When the restriction was imposed, U.S. officials also said it was necessary to protect U.S. citizens and communities because there was a lack of transparency from the Chinese government about the size of the surge or the variants that were circulating within China.

The rules imposed in January require travelers to the U.S. from China, Hong Kong and Macau to take a COVID-19 test no more than two days before travel and provide a negative test before boarding their flight. The testing applies to anyone 2 years and older, including U.S. citizens.

China saw infections and deaths surge after it eased back from its “zero COVID” strategy in early December after rare public protests of the policy that confined millions of people to their homes and sparked demands for President Xi Jinping to resign.

But as China eased its strict rules, infections and deaths surged, and parts of the country for weeks saw their hospitals overwhelmed by infected patients looking for help. Still, the Chinese government has been slow to release data on the number of deaths and infections.

The U.S. decision to lift restrictions comes at a moment when U.S.-China relations are strained. U.S. President Joe Biden ordered a Chinese spy balloon shot down last month after it traversed the continental United States. The Biden administration has also publicized U.S. intelligence findings that raise concern Beijing is considering providing Russia weaponry for its ongoing war on Ukraine.
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As the world waits for NASA to announce the first crews in its Artemis missions to the moon, VOA’s Kane Farabaugh talks with several astronauts hoping to make the cut as the space agency promotes diversity in its ranks. Camera: Adam Greenbaum
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After three nasty years, the La Nina weather phenomenon that increases Atlantic hurricane activity and worsens Western drought is gone, the National Oceanic and Atmospheric Administration (NOAA) said Thursday.

That’s usually good news for the United States and other parts of the world, including drought-stricken northeast Africa, scientists said.

The globe is now in what’s considered a “neutral” condition and probably trending to an El Nino in late summer or fall, said climate scientist Michelle L’Heureux, head of NOAA’s El Nino/La Nina forecast office.

“It’s over,” said research scientist Azhar Ehsan, who heads Columbia University’s El Nino/La Nina forecasting. “Mother Nature thought to get rid of this one because it’s enough.”

Global impact

La Nina is a natural and temporary cooling of parts of the Pacific Ocean that changes weather worldwide. In the United States, because La Nina is connected to more Atlantic storms and deeper droughts and wildfires in the West, La Ninas often are more damaging and expensive than their more famous flip side, El Nino, experts said, and studies show.

Generally, American agriculture is more damaged by La Nina than El Nino. If the globe jumps into El Nino, it means more rain for the Midwestern corn belt and grains in general and could be beneficial, said Michael Ferrari, chief scientific officer of Climate Alpha, a firm that advises investors on financial decisions based on climate.

When there’s a La Nina, there are more storms in the Atlantic during hurricane season because it removes conditions that suppress storm formation. Neutral or El Nino conditions make it harder for storms to get going, but not impossible, scientists said.

Over the last three years, the U.S. has been hit by 14 hurricanes and tropical storms that each caused $1 billion or more in damage, totaling $252 billion in costs, according to NOAA economist and meteorologist Adam Smith. La Nina and people building in harm’s way were factors, he said.

Influence of climate change

Climate change is a major factor in worsening extreme weather, alongside La Nina, scientists said and numerous studies and reports show. Human-caused warming is like an escalator going up – It makes temperatures increase and extremes worse – while La Nina and El Nino are like jumping up and down on the escalator, according to Northern Illinois University atmospheric sciences professor Victor Gensini.

La Nina has also slightly dampened global average temperatures, keeping warming from breaking annual temperature records, while El Nino slightly turbocharges those temperatures, often setting records, scientists said.

La Nina tends to make western Africa wet, but eastern Africa, around Somalia, dry. The opposite happens in El Nino, with drought-struck Somalia likely to get steady “short rains,” Ehsan said. La Nina has wetter conditions for Indonesia, parts of Australia and the Amazon, but those areas are drier in El Nino, according to NOAA.

El Nino means more heat waves for India and Pakistan and other parts of South Asia and weaker monsoons there, Ehsan said.

Signs that La Nina’s leaving

This particular La Nina, which started in September 2020 but is considered three years old because it affected three different winters, was unusual and one of the longest on record. It took a brief break in 2021 but came roaring back with record intensity.

“I’m sick of this La Nina,” Ehsan said. L’Heureux agreed, saying she’s ready to talk about something else.

The few other times that there’s been a triple-dip La Nina have come after strong El Ninos, and there’s clear physics on why that happens. But that’s not what happened with this La Nina, L’Heureux said. This one didn’t have a strong El Nino before it.

Even though this La Nina has confounded scientists in the past, they say the signs that it’s leaving are clear: Water in the key part of the central Pacific warmed to a bit more than the threshold for a La Nina in February, the atmosphere showed some changes, and along the eastern Pacific near Peru there’s already El Nino-like warming brewing on the coast, L’Heureux said.

Think of a La Nina or El Nino as something that pushes the weather system from the Pacific with ripple effects worldwide, L’Heureux said. When there are neutral conditions like now, there’s less push from the Pacific. That means other climatic factors, including the long-term warming trend, have more influence in day-to-day weather, she said.

Without an El Nino or La Nina, forecasters have a harder time predicting seasonal weather trends for summer or fall because the Pacific Ocean has such a big footprint in weeks-long forecasts.

El Nino forecasts made in the spring are generally less reliable than ones made at other times of year, so scientists are less sure about what will happen next, L’Heureux said. But NOAA’s forecast said there’s a 60% chance that El Nino will take charge come fall.

There’s also a 5% chance that La Nina will return for an unprecedented fourth dip. L’Heureux said she really doesn’t want that but the scientist in her would find that interesting.
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All U.S. women getting mammograms will soon receive information about their breast density, which can sometimes make cancer harder to spot.

The new requirements, finalized Thursday by the Food and Drug Administration, are aimed at standardizing the information given to millions of women following scans to detect breast cancer. Regulators first proposed the changes in 2019; health care providers will have 18 months to comply with the policy.

Some states already require that women receive information on breast density.

About half of women over age 40 have dense breasts, with less fatty tissue and more connective and glandular tissue. That tissue appears white on X-rays, the same color as growths in the breast, making mammograms harder to read. Dense breast tissue is one of the factors that can increase a woman’s chances of developing cancer.

Under the new rules, women with dense breasts will receive a written memo alerting them that their status “makes it harder to find breast cancer.” Those patients will also be directed to speak with their doctor about their results.

Professional guidelines don’t specify next steps for women identified with dense breasts, but some physicians may recommend additional forms of scanning, including ultrasound or MRI.
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Sodium is essential for the smooth functioning of muscles and nerves and maintaining the proper balance of water and minerals. But too much sodium in the diet can kill.

“Almost 2 million deaths each year are associated with excessive sodium intake,” said Tedros Adhanom Ghebreyesus, director-general of the World Health Organization.

“Too much sodium can lead to high blood pressure and increase the risk of cardiovascular diseases,” he said. “And yet globally, average sodium intake is more than double the WHO recommendation for adults of less than 2,000 milligrams per day, or 5 grams of salt.”

That is equivalent to one teaspoon of salt a day.

A WHO report launched Thursday explores for the first time the progress countries have made in implementing sodium intake reduction policies. A survey of WHO’s 194 member states showed “the world is off track to achieve its global target of reducing sodium intake by 30% by 2025.”

The report finds that only 5% of WHO member states “are protected by mandatory and comprehensive sodium reduction policies,” and 73% of WHO member states “lack full range of implementation of such policies.”

Francesco Branca, director of WHO’s Department of Nutrition for Health and Development, noted that reducing sodium intake is one of the most cost-effective ways to improve health and reduce the burden of non-communicable diseases “as it can avert a large number of cardiovascular events and deaths at very low program costs.”

Cardiovascular diseases are the leading cause of death globally, claiming an estimated 17.9 million lives. WHO reports that more than four out of five of these deaths are due to heart attacks and strokes, with one-third occurring prematurely in people under age 70.

9 nations succeed

The report finds that only nine countries — Brazil, Chile, Czech Republic, Lithuania, Malaysia, Mexico, Saudi Arabia, Spain and Uruguay — have fully enacted WHO’s recommended policies to reduce sodium intake.

Tom Frieden, CEO of Resolve to Save Lives, cites Chile as a leader in the implementation of lifesaving sodium-reduction policies.

Speaking in a webinar among fellow experts that followed the report’s launch, Frieden said Chile had “passed the law of food labeling and advertising that simultaneously required mandatory front-of pack warning labels, including on sodium; restricted marketing of products that have those warning labels; and banned the procurement of the sale of those products in schools.”

He noted that Argentina, Brazil, Mexico and Uruguay had all passed similar policies, following Chile’s lead.

Branca noted that a significant proportion of sodium in the diet comes from processed and highly processed foods sold in many high-income countries and increasingly in low- and middle-income countries.

“Government-led mandatory maximum limits for sodium-processed foods promote industrywide reformulations,” he said. “They create a marketplace that restricts the less healthy food options regardless of where people shop, or how much they understand or have access to information on labels.”

Frieden said self-regulation by the food manufacturing industry has repeatedly proven to be ineffective and “voluntary policies are often ignored.”

“In fact, a mandatory approach creates a level playing field,” because it can keep companies that take positive steps from feeling as though they must conduct business at a competitive disadvantage.

In addition to the existing proven strategies to reduce sodium, Frieden said, countries can consider new, innovative measures, such as increasing the availability and use of sodium and salt substitutes.

“Recent studies show that these substitutes significantly decrease not only blood pressure, and not only heart attack and strokes, but even death from cardiovascular events,” he said.

“Imagine that changing the brand of salt that you use could reduce the risk of death by 10% or 15%.”
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WeightWatchers, the 60-year-old diet firm, announced this week it would acquire a telehealth company whose providers prescribe anti-obesity drugs for growing numbers of eager online subscribers.

The $132 million deal with Sequence is just the latest commercial push into the red-hot market for prescription drugs that promises significant weight loss. For months, the diabetes drug Ozempic has been touted on social media by celebrities, even though it’s not approved for weight loss. The demand for it sparked shortages.

WeightWatchers will be introducing its roughly 3.5 million subscribers to a new generation of medications that go beyond behavioral changes like gym workouts and diet tracking. Obesity experts say the drugs may revolutionize treatment of the disease that affects 42% of American adults.

Here’s a look at the promise of these new medications and cautions about their use.

What are these new diet drugs?

The drugs that have generated most buzz are from a class of medications called GLP-1 agonists. Two of the most popular, Ozempic and Wegovy, are different doses of the same drug, semaglutide.

Ozempic has been used for six years to treat Type 2 diabetes and is not approved for weight loss. Wegovy was approved in 2021 to treat obesity in adults, and late last year to treat kids and teens 12 and older.

Doctors prescribe the medications to people with diabetes alone, or to people who are obese or who are overweight with additional health problems. Most of these types of drugs are delivered through weekly injections.

Supply problems and soaring demand last year led to a shortage of the drugs, but manufacturer Novo Nordisk said those have been replenished.

How do the drugs work?

They mimic the action of a gut hormone that kicks in after people eat, boosting the release of insulin, blocking sugar production in the liver and suppressing appetite.

A newer drug called tirzepatide mimics the action of two hormones for even greater effect. The Eli Lilly and Company drug, sold under the brand name Mounjaro, is now approved to treat diabetes. But the FDA granted fast-track status to review it to treat obesity. A decision is expected this spring.

With lower appetite and a greater feeling of fullness, people using these drugs eat less and lose weight.

How effective are the drugs?

In a clinical trial, adults who took Wegovy saw a mean weight loss of nearly 35 pounds, or about 15% of their initial body weight. Adolescents lost about 16% of their body weight.

A clinical trial of Mounjaro, which is still being studied, saw mean weight loss of 15% to 21% of body weight depending on the dose, compared with a weight loss of about 3% for people taking a placebo, or a dummy drug.

Why not just diet and exercise?

In a typical weight-loss program where participants rely only on diet and exercise, about a third of people enrolled will lose 5% or more of their body weight, noted Dr. Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine.

Most people find it difficult to lose weight because of the body’s biological reactions to eating less, he said. There are several hormones that respond to reduced calorie intake to increase hunger and maintain body mass.

“There is a real physical phenomenon,” he said. “There is a resistance mechanism that is a coordinated effort by the body to prevent you from losing weight.”

What are the side effects of the drugs?

The most common side effects are short-lived gastrointestinal issues such as nausea, vomiting, diarrhea, stomach pain and constipation.

Other possible side effects include thyroid tumors, cancer, inflammation of the pancreas, kidney and gallbladder and eye problems. People with a family history of certain thyroid cancers or a rare, genetic endocrine disorder should avoid the drugs.

What should consumers watch out for?

These new medications could be an effective part of a multifaceted approach to weight loss, said Dr. Amy Rothberg, a University of Michigan endocrinologist who directs a virtual weight management and diabetes program called Rewind.

But she worries that programs like WeightWatchers are primarily interested in boosting enrollment — and profits.

“My hope is that they do their due diligence and have real monitoring of the patients taking the drugs,” she said.

It’s important to make sure that patients are taking the drugs for the intended purpose, to make sure there’s no reason they shouldn’t take the drugs and that they’re monitored for side effects, she said.
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Plastics entering the world’s oceans have surged by an unprecedented amount since 2005 and could nearly triple by 2040 if no further action is taken, according to research published on Wednesday.

An estimated 171 trillion plastic particles were afloat in the oceans by 2019, according to peer-reviewed research led by the 5 Gyres Institute, a U.S. organization that campaigns to reduce plastic pollution.

Marine plastic pollution could rise 2.6-fold by 2040 if legally binding global policies are not introduced, it predicted.

The study looked at surface-level plastic pollution data from 11,777 ocean stations in six major marine regions covering the period from 1979 to 2019.

“We’ve found an alarming trend of exponential growth in microplastics in the global ocean since the millennium,” Marcus Eriksen, co-founder of the 5 Gyres Group said in a statement.

“We need a strong legally binding U.N. global treaty on plastic pollution that stops the problem at the source,” he added.

Microplastics are particularly hazardous to the oceans, not only contaminating water but also damaging the internal organs of marine animals, which mistake plastic for food.

Experts said the study showed that the level of marine plastic pollution in the oceans has been underestimated.

“The numbers in this new research are staggeringly phenomenal and almost beyond comprehension,” said Paul Harvey, a scientist and plastics expert with Environmental Science Solutions, an Australian consultancy focused on pollution reduction.

The United Nations kicked off negotiations on an agreement to tackle plastic pollution in Uruguay in November, with the aim of drawing up a legally binding treaty by the end of next year.

Environmental group Greenpeace said that without a strong global treaty, plastic production could double within the next 10 to 15 years, and triple by 2050.

A separate international treaty was agreed on Sunday to help protect biodiversity in the world’s high seas.
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France has reported an outbreak of highly pathogenic H5N1 bird flu among red foxes northeast of Paris, the World Organization for Animal Health (WOAH) said on Tuesday, as the spread of the virus to mammals raised global concerns.

After three foxes were found dead in a nature reserve in Meaux near where gulls had died, one of the foxes was collected and tested, WOAH said in a report, citing French authorities.

The World Health Organization last month described the bird flu situation as “worrying” due to the recent rise in cases in birds and mammals and that it was reviewing its global risk assessment in light of recent developments including cases of human transmission in Cambodia.

Avian influenza, commonly called bird flu, has been spreading around the world in the past year, killing more than 200 million birds, sending egg prices rocketing and raising concern among governments about human transmission.

The virus infected a cat in France in late December.

It has also been detected in minks in Spain, foxes and otters in Britain, sea lions in Peru and grizzly bears in the United States.
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