YCLOAK

The spread of monkeypox in the U.S. could represent the dawn of a new sexually transmitted disease, though some health officials say the virus that causes pimple-like bumps might yet be contained before it gets firmly established.

Experts don’t agree on the likely path of the disease, with some fearing that it is becoming so widespread that it is on the verge of becoming an entrenched STD — like gonorrhea, herpes and HIV.

But no one’s really sure, and some say testing and vaccines can still stop the outbreak from taking root.

So far, more than 2,400 U.S. cases have been reported as part of an international outbreak that emerged two months ago.

Health officials are not sure how fast the virus has spread. They have only limited information about people who have been diagnosed, and they don’t know how many infected people might be spreading it unknowingly.

They also don’t know how well vaccines and treatments are working. One impediment: Federal health officials do not have the authority to collect and connect data on who has been infected and who has been vaccinated.

With such huge question marks, predictions about how big the U.S. outbreak will get this summer vary widely, from 13,000 to perhaps more than 10 times that number.

Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said the government’s response is growing stronger every day and vaccine supplies will soon surge.

“I think we still have an opportunity to contain this,” Walensky told The Associated Press.

Monkeypox is endemic in parts of Africa, where people have been infected through bites from rodents or small animals. It does not usually spread easily among people.

But this year more than 15,000 cases have been reported in countries that historically don’t see the disease. In the U.S. and Europe, the vast majority of infections have happened in men who have sex with men, though health officials have stressed that anyone can catch the virus.

It spreads mainly through skin-to-skin contact, but it can also be transmitted through linens used by someone with monkeypox. Although it’s been moving through the population like a sexually transmitted disease, officials have been watching for other types of spread that could expand the outbreak.

Symptoms include fever, body aches, chills, fatigue and bumps on parts of the body. The illness has been relatively mild in many men, and no one has died in the U.S. But people can be contagious for weeks, and the lesions can be extremely painful.

When monkeypox emerged, there was reason to believe that public health officials could control it.

The tell-tale bumps should have made infections easy to identify. And because the virus spreads through close personal contact, officials thought they could reliably trace its spread by interviewing infected people and asking who they had been intimate with.

It didn’t turn out to be that easy.

With monkeypox so rare in the U.S., many infected men — and their doctors — may have attributed their rashes to some other cause.

Contact tracing was often stymied by infected men who said they did not know the names of all the people they had sex with. Some reported having multiple sexual interactions with strangers.

It didn’t help that local health departments, already burdened with COVID-19 and scores of other diseases, now had to find the resources to do intensive contact-tracing work on monkeypox, too.

Indeed, some local health officials have given up expecting much from contact tracing.

There was another reason to be optimistic: The U.S. government already had a vaccine. The two-dose regimen called Jynneos was licensed in the U.S. in 2019 and recommended last year as a tool against monkeypox.

When the outbreak was first identified in May, U.S. officials had only about 2,000 doses available. The government distributed them but limited the shots to people who were identified through public health investigations as being recently exposed to the virus.

Late last month, as more doses became available, the CDC began recommending that shots be offered to those who realize on their own that they could have been infected.

Demand has exceeded supply, with clinics in some cities rapidly running out of vaccine doses and health officials across the country saying said they don’t have enough.

That’s changing, Walensky said. As of this week, the government has distributed more than 191,000 doses, and it has 160,000 more ready to send. As many as 780,000 doses will become available as early as next week.

Once current demand is satisfied, the government will look at expanding vaccination efforts.

The CDC believes that 1.5 million U.S. men are considered at high risk for the infection.

Testing has also expanded. More than 70,000 people can be tested each week, far more than current demand, Walensky said. The government has also embarked on a campaign to educate doctors and gay and bisexual men about the disease, she added.

Donal Bisanzio, a researcher at RTI International, believes U.S. health officials will be able to contain the outbreak before it becomes endemic.

But he also said that won’t be the end of it. New bursts of cases will probably emerge as Americans become infected by people in other countries where monkeypox keeps circulating.

Walensky agrees that such a scenario is likely. “If it’s not contained all over the world, we are always at risk of having flare-ups” from travelers, she said.

Shawn Kiernan, of the Fairfax County Health Department in Virginia, said there is reason to be tentatively optimistic because so far the outbreak is concentrated in one group of people — men who have sex with men.

Spread of the virus into heterosexual people would be a “tipping point” that may occur before it’s widely recognized, said Kiernan, chief of the department’s communicable disease section. 

Spillover into heterosexuals is just a matter of time, said Dr. Edward Hook III, emeritus professor of infectious diseases at the University of Alabama at Birmingham. 

If monkeypox becomes an endemic sexually transmitted disease, it will be yet another challenge for health departments and doctors already struggling to keep up with existing STDs. 

Such work has long been underfunded and understaffed, and a lot of it was simply put on hold during the pandemic. Kiernan said HIV and syphilis were prioritized, but work on common infections like chlamydia and gonorrhea amounted to “counting cases and that’s about it.” 

For years, gonorrhea, chlamydia and syphilis cases have been rising. 

“By and large,” Hook said, doctors “do a crummy job of taking sexual histories, of inquiring about and acknowledging their patients are sexual beings.” 
…

India and Namibia have signed an agreement to bring cheetahs to the forests of the South Asian country, where the large cat became extinct 70 years ago.

According to the agreement signed Wednesday, eight African cheetahs will be transferred from Namibia to India in August for captive breeding at the Kuno National Park (KNP) wildlife sanctuary, in the central Indian state of Madhya Pradesh.

Indian officials said that as part of the “ambitious” project, 12 more African cheetahs from South Africa are expected to be brought to the park, though a formal agreement between the two countries has not yet been signed.

The KNP wildlife sanctuary is the new Indian home for African cheetahs, complying with International Union for Conservation of Nature (IUCN) guidelines, including a specific focus on site quality, abundant prey base and vast swaths of grasslands.

“The main goal of cheetah reintroduction project is to establish viable cheetah metapopulation in India that allows the cheetah to perform its functional role as a top predator,” a statement from the Indian Environment Ministry said.

The arrival of the cheetahs is expected to coincide with India’s 75th Independence Day celebrations on August 15, 2022.

After signing the agreement in New Delhi with Namibia’s Deputy Prime Minister Netumbo Nandi-Ndaitwah, India’s Environment Minister Bhupender Yadav tweeted: “Completing 75 glorious years of Independence with restoring the fastest terrestrial flagship species, the cheetah, in India, will rekindle the ecological dynamics of the landscape.”

In another tweet, he said, “Cheetah reintroduction in India has a larger goal of re-establishing ecological function in Indian grasslands that was lost due to extinction of Asiatic cheetah. This is in conformity with IUCN guidelines on conservation translocations.”

A statement from the Environment Ministry said the KNP can currently host up to 21 cheetahs, but after the restoration of a wider landscape, its capacity will be increased to about 36.

The cheetah, the fastest land animal, has been rapidly heading toward extinction and is classified as a vulnerable species under the IUCN’s red list of threatened species. An estimated 7,000 cheetahs remain in the wild and almost all of them are in Africa.

The plummeting number of cheetahs across the world is blamed mostly on the depletion of habitats and poaching. Hunting, loss of habitat and food scarcity led to the animal’s extinction in India.

It is believed that more than 10,000 Asiatic cheetahs roamed the wilds of India during the 16th century.

The cheetah population in India dwindled during the 19th century, largely because of bounty hunting by local Indian kings and ruling British officials.

The last three Asiatic cheetahs were hunted down in 1948 by an Indian king in central India. In 1952, the cheetah was declared officially extinct in the country.

Just a dozen or so Asiatic cheetahs are left in the wild right now — all in Iran.

In 2010, India initiated an effort to revive the cheetah population at the KNP wildlife sanctuary by bringing in African cheetahs. But in 2012, an Indian court stalled the project, noting it would come in conflict with a then-ongoing plan to introduce lions in the sanctuary.

In 2020, India’s Supreme Court announced African cheetahs could be introduced in a “carefully chosen location” in India on an experimental basis. Since then, India has been making an effort to ship in the African cheetahs.

Indian officials are hopeful that this time, the plan to introduce African cheetahs in India is going to succeed, and the country will be able to revive its cheetah population.
…

Ukrainian therapist Svitlana Kutsenko thought she was making progress with her patients — army veterans recovering from mental trauma suffered during fighting with Russia in 2014. Then, war erupted again.

Now, five months after Russia invaded Ukraine, Kutsenko says the situation looks bleaker than ever. Many of her patients have returned to the front lines, while ordinary citizens scarred by the horrors of life in wartime are now seeking treatment.

“Sometimes it’s bearable, sometimes it’s not,” Kutsenko, who lives in Kyiv, told The Associated Press. “Some people are suffering from huge fear — fear of death, fear of their relatives’ death and some are pretty angry about what’s going on and they want to somehow take this anger under control.”

Kutsenko was among 20 Ukrainian mental health professionals who spent the past two weeks in Israel receiving training on how to treat trauma cases.

Israel, which has gone through several wars with its Arab neighbors and has a large population of Holocaust survivors, has deep experience in treating psychological or mental trauma.

But in Ukraine, awareness for recognizing and treating mental trauma remains relatively low. And despite a conflict with Russia that has been ongoing since 2014, the country is not equipped to deal with the numbers of people affected by the Russian invasion.

Kutsenko said that there is a great difference between treating patients struggling to come to terms with events from the past and helping people who are under fire cope with grief and fear in real time.

“Right now, in Ukraine, it’s not just, you know, shooting and people” being killed by missiles and bombs, Kutsenko said, adding that torture, rape and other terrible acts are also happening.

The course’s instructor, Danny Brom, says treating mental trauma in Israel has taught him how to provide therapy to victims who are both post-trauma and still in immediate danger. These lessons, he said, have helped him relate to mental health professionals from conflict zones across the world and especially Ukraine.

“They understand that we Israelis know what we are talking about. This … has happened to us in the different wars, so there’s a very special connection between them and us. They really feel that we understand what we are talking about,” said Brom, a clinical psychologist who is director of Metiv, an Israeli nonprofit that trains mental health professionals to treat trauma victims.

The group included 20 psychologists from across Ukraine, including some who have been displaced throughout the war. The course included training in cognitive behavior therapy techniques, or CBT, which are commonly used to treat depression and anxiety.

Larysa Zasiekina is a psychologist from western Ukraine, where internally displaced people have flocked to seek refuge from the fighting.

Before the war, she treated adults, but now she sees mothers and children who have had to suddenly leave everything behind as their husbands and fathers head off to battle.

Zasiekina says the course has given her new methods to cope with this new reality, especially when it comes to working with young people.

“We used a lot of imaginary exercises, and I think these exercises are very good for children because actually they have a lot of imagination,” says Zasiekina. “They want to play.”

Throughout the course, the participants were never far from having to deal with horrific news from back home.

During her time in Jerusalem, Kutseno got word that the building across from her family home in Vinnytsia, where her parents still live, had been bombed. Her parents weren’t harmed in the barrage, which killed 23 people that day, but it was a terrifying reminder.

“Even being here, feeling safe, war is still (in) the background of everything I do here,” Kutseno said.

“It’s not like I will get back to something that will have changed,” she added. “What I will find there is war.” 
…

The White House says President Joe Biden has tested positive for COVID-19 and is experiencing “very mild symptoms.” The president’s diagnosis comes amid another wave of the coronavirus in the United States, driven this time by the BA.5 variant.  VOA’s Senior Diplomatic Correspondent Cindy Saine reports.
…

New cases of COVID-19 have been sweeping across the United States in recent weeks. On Thursday, President Joe Biden tested positive. His symptoms of tiredness, a runny nose and dry cough are considered mild.

The highly infectious and transmittable BA.5 subvariant of the coronavirus’s omicron variant is making up nearly 80% of new cases, according to the latest figures from the U.S. Centers for Disease Control and Prevention (CDC) COVID Data Tracker.

Although the initial vaccinations are effective at preventing hospitalization and death, their immunity weakens over time.

“So, more people, even those who might have protection from past infection or vaccination, have gotten COVID-19,” according to the CDC.

That’s why the CDC is recommending that immunized adults and children 5 years and older follow up with a vaccination booster in five months, and those 50 and older get a second booster shot for renewed protection. But so far, the CDC reports that only about half of adults have gotten a booster and just 28% of those age 50 and older have received a second dose, which provides even further protection from the illness.

This leaves millions of people more vulnerable to the most recent variants of omicron.

 

“It’s very concerning that many individuals who are eligible for boosters are choosing not to get them,” David Grabowski, a professor of health care policy at Harvard Medical School, told VOA. “There’s really strong research suggesting the protective effects of these boosters against COVID.”

The White House issued a warning this week about the spike in BA.5 subvariant cases and urged Americans over the age of 50 to get the booster shots.

“It could save your life,” said Dr. Ashish Jha, the administration’s COVID response coordinator.

Many health advocates are alarmed that public momentum over COVID-19 has waned.

Some people “don’t feel a sense of urgency to get booster shots even though they are available in most parts of the country,” Grabowski said.

Part of the reason may be a lack of communication by public health officials that is confusing to the public, said Dr. William Schaffner, a professor of infectious diseases at Vanderbilt University School of Medicine.

“Public health officials have not communicated clearly when you should get a booster and that it is an important step,” Grabowski told VOA.

Dr. David Aronoff, chair of the Department of Medicine at Indiana University’s School of Medicine, explained that in some instances, “people may have had a booster shot and not have realized they were eligible for another in several months.”

There is also the idea that since the symptoms from BA.5 are usually mild for people who are vaccinated, then why bother getting a booster, said Tina Runyan, a professor of family medicine and community health at the University of Massachusetts Medical School. With a highly contagious strain going around, some people think they will get COVID anyway, so getting a booster won’t protect them that much, she said.

But Dr. Anthony Fauci, the nation’s top infectious disease expert, said that’s not true.

“If you are not vaccinated to the fullest, namely, you have not gotten boosters according to what the recommendations are, then you’re putting yourself at an increased risk that you could mitigate against by getting vaccinated,” he said during a July 12 press briefing with the White House COVID-19 response team and public health officials.

Despite that warning, health experts say COVID-19 fatigue is causing a lack of response.

“People are ready to put COVID behind them and they just want to return to a more normal way of life,” explained Schaffner.

Going back to normal may be fleeting as new subvariants continue to pop up.

“We have to start thinking about the booster as something we might do annually to protect ourselves and others,” said Keri Althoff, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Maryland.

Meanwhile, new vaccines are in the works to target omicron subvariants BA.4 and BA.5.

“Getting vaccinated now will not preclude you from getting a variant-specific vaccine later this fall or winter,” said Jha, the White House COVID response coordinator.

“We’re hoping we get new vaccines in the future that will target particular variants as they come up,” Aronoff said, but the currently available vaccines, which include boosters, “are keeping people out of hospitals and from dying from COVID.”
…

An unvaccinated young adult from New York recently contracted polio, the first U.S. case in nearly a decade, health officials said Thursday. 

Officials said the patient, who lives in Rockland County, had developed paralysis. The person developed symptoms a month ago and did not recently travel outside the country, county health officials said. 

It appears the patient had a vaccine-derived strain of the virus, perhaps from someone who got live vaccine — available in other countries, but not the U.S. — and spread it, officials said. 

The person is no longer deemed contagious, but investigators are trying to figure out how the infection occurred and whether other people may have been exposed to the virus. 

Most Americans are vaccinated against polio, but unvaccinated people may be at risk, said Rockland County Health Commissioner Dr. Patricia Schnabel Ruppert. Health officials scheduled vaccination clinics nearby soon and encouraged anyone who has not been vaccinated to get the shots. 

“We want shots in the arms of those who need it,” she said at a Thursday press conference announcing the case. 

Feared disease

Polio was once one of the nation’s most feared diseases, with annual outbreaks causing thousands of cases of paralysis, many of them in children. 

Vaccines became available starting in 1955, and a national vaccination campaign cut the annual number of U.S. cases to fewer than 100 in the 1960s and fewer than 10 in the 1970s, according to the U.S. Centers for Disease Control and Prevention. 

In 1979, polio was declared eliminated in the U.S., meaning there was no longer routine spread. 

Rarely, travelers have brought polio infections into the U.S. The last such case was in 2013, when a 7-month-old who had recently moved to the U.S. from India was diagnosed in San Antonio, Texas, according to federal health officials. That child also had the type of polio found in the live form of vaccine used in other countries. 

There are two types of polio vaccines. The U.S. and many other countries use shots made with an inactivated version of the virus. But some countries where polio has been more of a recent threat use a weakened live virus that is given to children as drops in the mouth. In rare instances, the weakened virus can mutate into a form capable of sparking new outbreaks. 

U.S. children are still routinely vaccinated against polio with the inactivated vaccine. Federal officials recommend four doses: to be given at 2 months of age; 4 months; at 6 to 18 months; and at age 4 through 6 years. Some states require only three doses. 

According to the CDC’s most recent childhood vaccination data, about 93% of 2-year-olds had received at least three doses of polio vaccine. 

How it spreads

Polio spreads mostly from person to person or through contaminated water. It can infect a person’s spinal cord, causing paralysis and possibly permanent disability and death. The disease mostly affects children. 

Polio is endemic in Afghanistan and Pakistan, although numerous countries in Africa, the Middle East and Asia have also reported cases in recent years. 

Rockland County, in New York City’s northern suburbs, has been a center of vaccine resistance in recent years. A 2018-19 measles outbreak there infected 312 people. 

Last month, health officials in Britain warned parents to make sure children have been vaccinated because the polio virus had been found in London sewage samples. No cases of paralysis were reported. 
…

Preparations are underway for the mass rollout of the world’s first malaria vaccine to protect millions of children in Africa.

The rollout is being funded by Gavi, the Vaccine Alliance, for nearly $160 million.

The World Health Organization said Gavi’s multimillion-dollar funding marks a key advance in the fight against one of Africa’s most severe public health threats. It noted that countries in sub-Saharan Africa bear the brunt of the yearly toll of more than 240 million global cases of malaria, including more than 600,000 reported deaths. The main victims are children under age 5.

WHO regional director for Africa Matshidiso Moeti said one child dies every minute in Africa, with catastrophic consequences for families, communities and national development.

The vaccine was introduced in Africa in 2019. Since then, more than 1.3 million children have benefited from the lifesaving inoculations in three pilot countries — Ghana, Kenya and Malawi. Moeti said those countries have reported a 30 percent drop in hospitalizations of children with severe malaria and a 9% reduction in child deaths.

“If delivered at scale, millions of new cases could be averted, and tens of thousands of lives saved every year,” Moeti said. “We were encouraged to see that demand for the vaccine is high, even in the context of COVID-19, with the first dose reaching between 73% to over 90% coverage.”

Thabani Maphosa, managing director of country programs at Gavi, called the vaccine the most effective tool in the fight against malaria, one that will save children’s lives. However, he said, demand for the lifesaving product will outstrip supply.

“Our challenge during this critical phase is to ensure the doses we have available are used as effectively and equitably as possible,” Maphosa said. “With this is mind, Gavi today is opening an application window for malaria support.”

He said the three pilot countries, which already have experience in rolling out the vaccine, will get first crack at applying for and receiving funding. So, practically speaking, Maphosa said, they will require little help in setting up their systems to get the operation underway.

Maphosa said a second round of funding will take place at the end of the year. At that time, he said other countries with moderate to high cases of severe malaria can submit applications for support.
…

A new study shines a light on the health risks, challenges, and barriers faced daily by millions of refugees and migrants who suffer from poor health because they lack access to the health care available to others in their host countries.

The World Health Organization has just published its first world report on the health of refugees and migrants. WHO Director-General Tedros Adhanom Ghebreyesus called it a landmark report and an alarm bell.

He said the report reveals the wide disparities between the health of refugees and migrants and the wider populations in their host countries.  

“For example, many migrant workers are engaged in the so-called 3-D jobs—dirty, dangerous, and demanding—without adequate social and health protection or sufficient occupational health measures,” he said. “Refugees and migrants are virtually absent from global surveys and health data, making these vulnerable groups almost invisible in the design of health systems and services.”   

Tedros noted that one billion people or one in every eight people on Earth is a refugee or migrant. He said the numbers were growing. Tedros added that more and more people will be on the move in response to burgeoning conflicts, climate change, rising inequality, and global emergencies, such as the COVID-19 pandemic.

He said the health needs of refugees and migrants often are neglected or unaddressed in the countries they pass through or settle in.

“They face multiple barriers, including out of pocket costs, discrimination and fear of detention and deportation,” Tedros said. “Many countries do have health policies that include health services for refugees and migrants. But too many are either ineffective or are yet to be implemented effectively.”

Waheed Arian, an Afghan refugee and a medical doctor in Britain, recalls the conditions under which he and his family lived in a refugee camp in Pakistan during the late 1980s. He said they were exposed to many diseases, including malaria and tuberculosis. 

“The conditions that we see in refugee camps now in various parts of the world – they are not too dissimilar to the conditions that I experienced firsthand,” he said. “Although we were safe from bombs, we were not physically safe. We were not socially safe, and we were not mentally safe.”   

WHO chief Tedros is calling on governments and organizations that work with refugees and migrants to come together to protect and promote the health of people on the move. He said the report sets forth strategies for achieving more equitable, inclusive health systems that prioritize the well-being of all people.
…

Drought can slightly increase developing world children’s risk of diarrheal disease, researchers have found, adding that wetter regions seem to be affected differently than drier ones. 

Diarrhea is the second-leading cause of death among children worldwide, and climate change is making droughts longer, more frequent and more severe, the new study published in the journal Nature Communications found. 

The study, based on data from 51 low- and middle-income countries, found that children were more likely to recently have had diarrhea following six months to two years of drought conditions, although the effect of drought differed across dry, temperate and tropical climate zones. 

Previous studies found links between diarrheal disease and rainfall, flooding and seasonality, but little was known before about the effects of drought. 

The new study “fills that void of understanding the impacts associated with drought specifically, as opposed to flooding, extreme rains and seasonality,” said epidemiologist Joseph Eisenberg of the University of Michigan, who was not involved in the study. 

“Water plays an essential role both in helping address the problem as well as increasing the risk of being exposed,” he said. 

Water essential  for good hygiene

Water is central to the spread and prevention of diarrheal disease. Germs that cause diarrhea survive and spread in water, but water is also important for hygienic practices, such as hand-washing, that prevent infections. 

Study author Pin Wang, an environmental epidemiologist at Yale University, and his colleagues thought drought could force families to prioritize scarce water for drinking rather than washing, leaving children more vulnerable to diarrhea. 

“Drought can directly impact the WASH (Water, Sanitation, and Hygiene) practices,” Wang said. “Because of the insufficient water supply, people might prioritize the water for other necessary uses, such as drinking, but not for washing hands and also flushing [the] toilet.” 

Wang and his colleagues combined weather records with data on diarrhea in over 1.3 million children under the age of 5 from the Demographic and Health Surveys Program, which surveys representative families to collect data on health and demographics in the developing world. The Demographic and Health Surveys data also included information on each child, household wealth and WASH practices. 

Using this data, the researchers then determined whether the children in the dataset had experienced drought, how long the drought had lasted, and how severe it had been relative to normal conditions. 

Correcting for differences among households and individual children, the researchers found that exposure to a six-month drought slightly increased the risk of diarrhea in children under age 5. Risk was 5% higher after mild drought and 8% higher after severe drought, though the strength of drought’s effect on diarrhea depended on other factors, such as local climate, hygiene and water access. 

In dry regions, droughts lasting six months did not affect diarrhea rates significantly, but droughts lasting two years did. 

The authors speculate that it may be because these dry regions are already prepared for short periods of water scarcity but can’t cope with very long droughts. On the other hand, tropical and temperate regions saw worse effects in six-month droughts than in longer ones, perhaps because they are less prepared for water shortages in the short term but have more water available in general to help adapt in the long term. 

The researchers found that families in a drought washed their hands and performed other WASH practices less often than those who were not experiencing drought. That accounted for about 10% of the increase in diarrhea rates in mild drought and about 20% in severe conditions. 

Children whose families need to walk more than 30 minutes to collect water also had a higher risk of diarrhea associated with severe drought than those whose families had water nearby. 

More studies needed

Eisenberg said that the study was a good first step, but that more studies would be needed to confirm the results. 

“I think the biggest implication … as a hypothesis-generating result is that it will promote and motivate people to conduct some more sophisticated studies to sort of back up the findings,” he said. 

Wang also said that future studies would be needed to back up his findings. And as climate change is expected to shake up rainfall patterns around the world, he said he hopes his result will translate into policy that would protect children from diarrheal disease brought on by drought. 

“We obviously think that with climate change, there will be higher incidence of drought events in the future, particularly … in the places where it’s already having less rainfall right now,” Wang said. “We need to reduce the greenhouse gas emissions, that’s the first thing. The second is that the WASH variables should be emphasized or prioritized — particularly in these low- and middle-income countries. People need better WASH practices to reduce their diarrhea risks.”
…

The world is bracing for more intense heat waves fueled by climate change this summer, and urban centers across the world are unprepared to face these brutal natural disasters.
…

Overdose deaths increased 44% for Blacks and 39% for Native Americans in 2020 compared with 2019, as the COVID-19 pandemic disrupted access to care and exacerbated racial inequality, an official report showed Tuesday.

“Racism, a root cause of health disparities, continues to be a serious public health threat that directly affects the well-being of millions of Americans,” U.S. Centers for Disease Control and Prevention (CDC) acting Principal Deputy Director Debra Houry said in a briefing.

“The disproportionate increase in overdose death rates among Black and American Indian/Alaskan Native people may partly be due to health inequities, like unequal access to substance use treatment and treatment biases.”

Recent increases in deaths were largely driven by illegally manufactured fentanyl and fentanyl analogs, according to the report from the CDC.

Before the pandemic, the overdose death rate was similar for Black, Native and white people, at 27, 26 and 25 per 100,000 people in 2019.

But that changed dramatically in 2020, when the respective figures were 39, 36 and 31 per 100,000 people.

Though the increase among white people was not as great as for Blacks and Native Americans, the new rate is still a historic high.

Among key findings: The overdose death rate among Black males 65 years and older was nearly seven times that of their white counterparts.

Black people 15-24 years old experienced the largest rate increase, 86%, compared with changes seen in other groups.

“There was a substantially lower percentage of people in racial and ethnic minority groups showing evidence of ever receiving treatment for substance use, compared to white people,” CDC health scientist Mbabazi Kariisa said during the briefing.

In fact, most people who died by overdose had no evidence of getting prior substance use treatment before their death.

Areas with a wider income gap between rich and poor had the highest death rates.

Being impoverished “can lead to lack of stable housing, reliable transportation and health insurance, making it even more difficult for people to access treatment and other support services,” Kariisa said.

In terms of recommendations, Houry said it was vital to raise awareness about the lethality of the illicit drug supply, particularly fentanyl, and encourage people to carry the life-saving treatment Naloxone.

Improving access to treatment and offering structural support, such as transport assistance and child care, can improve care access.

“Combining culturally appropriate traditional practices, spirituality and religion with evidence-based substance use disorder treatment also helps raise awareness and reduce stigma,” she said.

“While we have made so much progress in treating substance use disorders as chronic conditions, rather than moral failings, there is still so much more work to do, including making sure that all people who need these services can get them,” Houry concluded.
…

Elon Musk lost a fight to delay Twitter’s lawsuit against him as a Delaware judge on Tuesday set an October trial, citing the “cloud of uncertainty” over the social media company after the billionaire backed out of a deal to buy it.

“Delay threatens irreparable harm,” said Chancellor Kathaleen St. Jude McCormick, the head judge of Delaware’s Court of Chancery, which handles many high-profile business disputes. “The longer the delay, the greater the risk.”

Twitter had asked for an expedited trial in September, while Musk’s team called for waiting until early next year because of the complexity of the case. McCormick said Musk’s team underestimated the Delaware court’s ability to “quickly process complex litigation.”

Twitter is trying to force the billionaire to make good on his April promise to buy the social media giant for $44 billion — and the company wants it to happen quickly because it says the ongoing dispute is harming its business.

Musk, the world’s richest man, pledged to pay $54.20 a share for Twitter, but now wants to back out of the agreement.

“It’s attempted sabotage. He’s doing his best to run Twitter down,” said attorney William Savitt, representing Twitter in Delaware’s Court of Chancery before the court’s Chancellor Kathaleen St. Jude McCormick. The hearing was held virtually after McCormick said she tested positive for COVID-19.

Musk has claimed the company has failed to provide adequate information about the number of fake, or “spam bot,” Twitter accounts, and that it has breached its obligations under the deal by firing top managers and laying off a significant number of employees.

But the idea the Tesla CEO is trying to damage Twitter is “preposterous. He has no interest in damaging the company,” said Musk’s attorney Andrew Rossman, noting he is Twitter’s second largest shareholder with a far larger stake than the entire board.

Savitt emphasized the importance of an expedited trial starting in September for Twitter to be able to make important business decisions affecting everything from employee retention to relationships with suppliers and customers.

Rossman said more time is needed because it is “one of the largest take-private deals in history” involving a “company that has a massive amount of data that has to be analyzed. Billions of actions on their platform have to be analyzed.”
…

The James Webb telescope is giving the world the clearest ever images of our universe. For VOA News Antoni Belchi has the story.

 
…

The U.S. Supreme Court’s overturning the right to abortion has raised concerns among activists about a domino effect in developing countries, including in Africa. In Kenya, anti-abortion groups have welcomed the ruling while abortion rights supporters fear it could further restrict the reproductive health of girls and women. Juma Majanga reports from Nairobi. Camera: Jimmy Makhulo  
…

The Indian government’s COVID-19 vaccinations hit 2 billion on Sunday, with booster doses underway for all adults, as daily infections hit four-month high, official data showed.

Prime Minister Narendra Modi extolled the vaccination milestone, celebrating the world’s largest and longest-running inoculation campaign, which began last year. 

“India creates history again!” Modi said in a tweet. The prime minister has faced allegations from the opposition of mishandling the pandemic that experts claim killed millions. The government rejects the claims.

Health ministry data shows the COVID death toll at 525,709, with 49 deaths recorded overnight.

New cases rose 20,528 over the past 24 hours, the highest since Feb. 20, according to data compiled by Reuters.

The country of 1.35 billion people has lifted most COVID-related restrictions, and international travel has recovered robustly.

Some 80% of the inoculations have been the AstraZeneca AZN.L vaccine made domestically, called Covishield. Others include domestically developed Covaxin and Corbevax, and Russia’s Sputnik V.

The federal government has been accelerating its booster campaign to avert the spread of infections, edging higher in the eastern states of Assam, West Bengal and Karnataka in the south.
…

Macao’s government will extend a lockdown of casinos and other businesses until Friday, as authorities work to stop the spread of COVID-19 in the world’s biggest gambling hub, according to a statement on its website.

The lockdown in the Chinese special administrative region had been set to end  Monday.

Macao imposed the shutdown last Monday, shuttering the city’s economic engine — its casinos — and forbidding residents from leaving their apartments, except for essential activities such as grocery shopping.

Macao has recorded around 1,700 coronavirus infections since mid-June. More than 20,000 people are in mandatory quarantine as the government adheres to China’s zero-COVID policy, which aims to stamp out all outbreaks, running counter to a global trend of trying to coexist with the virus.

More than 90% of Macao’s 600,000 residents are fully vaccinated against COVID but this is the first time the city has had to grapple with the fast-spreading omicron variant.

The former Portuguese colony has only one public hospital for its more than 600,000 residents, and its medical system was stretched before the coronavirus outbreak.

Authorities have set up a makeshift hospital in a sports dome near the city’s Las Vegas-style Cotai strip and have about 600 medical workers from the mainland assisting them.

In neighboring Hong Kong, authorities are starting to loosen draconian coronavirus restrictions even as daily cases top 3,000, in a push to reboot the financial hub and its economy.
…

Chinese astronauts, known as taikonauts, and a ground crew are working to finish their country’s first permanent orbiting space station and the world’s second by year’s end, official media outlets say.

That milestone will boost China’s national pride and provide it with new channels for economic development and a possible new tool for military use on the ground, analysts say.

The space program advances China’s goal of being “strong and prosperous” by 2049, said Dexter Roberts, a senior fellow at the Atlantic Council’s Asia Security Initiative and author of “The Myth of Chinese Capitalism.” That year marks the 100th anniversary of Communist Party rule in China.

“Developing the economy, becoming wealthier and raising national prestige globally and becoming stronger geopolitically are all very, very clear goals of the party,” he said. 

A crew aboard the Shenzhou-14 spacecraft last month kicked off six months of work on the Tiangong space station, the official Xinhua News Agency reported. 

Personnel in space and on the ground will finish building the space station, expanding it from a single-module structure to triple-module national space laboratory, Xinhua said. 

The U.S. space agency, NASA, bars China from using the International Space Station on military security grounds, prompting China to embark on its own 10 years ago. China launched its broader space program in the 1960s. 

Pride and power projection 

China’s space station has been designed to be a “versatile space lab” that can hold 25 “cabinets” for experiments such as comparing the biological growth mechanism in varying at different gravitational levels, Xinhua said.

As conducted at the space station and on other space platforms, research into biology, life systems, medicine and materials is expected “to expand humanity’s understanding of basic science,” the State Council Information Office said in a January outlook for the program.

Other countries have already used China’s satellite services, including the BeiDou satellite navigation system, which was made available two years ago to Pakistan. Those systems can survey the aftermath of disasters and help launch satellites. 

Officials in Beijing have not said whether the space station will help the People’s Liberation Army. 

Space programs, including BeiDou, have a military and security side, said Yun Sun, director of the China program at the Stimson Center in Washington.  

“The Chinese will argue that while using (the) BeiDou system, you can navigate the weather, you can forecast the natural disasters, and you can also use the satellites to investigate and explore the terrains,” she said.  

“I think that’s one example of how Chinese space technology is having a real impact over countries on Earth,” Yun said. But, she said, “we all know that’s just one narrative.”

The People’s Liberation Army could technically dock military equipment systems in space or use satellites to survey the ground, experts have told VOA. China has the world’s third-strongest armed forces, a source of alarm for the West and smaller Asian countries.

Chinese President Xi Jinping will probably note the space station as an achievement during the national party congress expected before year’s end, Yun said. Experts say Xi is likely to seek appointment at the congress to a third five-year term as party general secretary.

 

“National prestige and security” are top concerns for Chinese leaders as they finish their space station, said the Roberts, of the Atlantic Council. 

The Chinese government is probably pushing the commercial side of its space program because it wants to catch up to the scale of NASA, he said. 

Chinese leaders may hope to develop their own aerospace technology through the space station, said Yan Liang, professor and chair of economics at Willamette University in the U.S. state of Oregon. Some of today’s components could be imports, she said.

“Definitely I do think that with the communication aspect that is about big data and all these other high-tech industries, it’s definitely in the interest for China to be able to do that and maybe later to export to other countries,” Liang said. 

Tiangong’s first module was christened last year. It operates 340 miles above the Earth’s surface, farther away than the International Space Station. 

After a Chinese Shenzhou-14 crew reaches gets to the space station, it will begin research projects and perform spacewalks from the lab module, Xinhua reported.
…

The world was sadder and more stressed out in 2021 than ever before, according to a recent Gallup poll, which found that four in 10 adults worldwide said they experienced a lot of worry or stress.

Experts say the most obvious culprit, the pandemic — and the isolation and uncertainty that came with it — is a factor but not entirely to blame.

Carol Graham, a Gallup senior scientist, says the culprit for declining mental health includes the economic uncertainty faced by low-skilled workers.

“There are some structural negative changes that make some people in particular more vulnerable. And in the end, mental health just reflects that,” says Graham, who is also a senior fellow at the Brookings Institution and a professor of public policy at the University of Maryland.

“For young people who do not have good higher levels of education, what they’re going to do in the future is very unknown. What their stability will be like, what their workforce participation will be like. … Rising levels of inequality between skilled and unskilled workers is another part of it, having to do with technology-driven growth.”

Gallup spoke to adults in 122 countries and areas for its latest Global Emotions Report. Afghanistan is the unhappiest country, with Afghans leading the world when it comes to negative experiences.

Overall, the survey results were not surprising to psychologist Josh Briley, a fellow at The American Institute of Stress.

“Things are moving faster. There’s so much information being thrown at us all the time,” he says. “And of course, media thrives on the bad stuff. So, we are constantly being bombarded with crisis after crisis in the news, on social media, on the radio and on our podcasts. And all that is drowning out the good things that are happening.”

Psychologist Mary Karapetian Alvord says being more connected online means people in one country can feel profoundly affected by what happens in another country, which wasn’t always the case in the past. For her U.S. clients, uncertainty is the biggest stressor.

“Uncertainty of life and how it’s going to impact them on a daily basis. Prices going up and gas going up. And then the supply chain issues that are impacting people in their daily lives,” Alvord says. “But I think the bigger issue is that uncertainty and so much suffering. Of course, the shootings have come up. A lot of people are really stressed out and feeling like, ‘Where is it safe?’”

There have been more than 300 shootings involving multiple victims in the United States so far in 2022.

Happiness worldwide has been trending downward for a decade, according to Gallup. All three psychologists who spoke with VOA point to social media and the flood of unfiltered information as contributors to declining mental health and happiness.

“We’ve seen this explosion worldwide, and I think that’s a big sort of tectonic shift in how humans interact and experience emotions and all sorts of things. And we’re seeing that there’s some real downsides to it,” Graham says.

Briley says part of the problem is that although people are more connected online, they’re often less connected in real life.

“The connection that we have with people, the physical connection has changed. We’re more connected than ever before with people all the way around the world, but we may not know our neighbors’ names anymore,” he says. “So, we don’t necessarily have that person where if my car breaks down, who do I call for a ride to work?”

More optimism, despite frowns

On the upside, the survey found that the percentage of people who reported laughing or smiling a lot was up two points in 2021, while the number of people who say they learned something interesting increased one point. Alvord says looking beyond the negative is critical to maintaining mental health.

“It’s important for people to also find moments of, if not joy, at least satisfaction in life,” she says. “I think sometimes we reach for happiness and that’s just not attainable … and so, our expectations need to be realistic.”

Minorities in the United States might already be doing that. The survey found that people from marginalized groups are among the most resilient.

“Their anxiety may have increased but their optimism, particularly for low-income African Americans, remains very high,” Graham says. “It was a finding I’ve seen for many years, but it surprised me that even during COVID, it held. I think that’s more due to the kind of community ties and other ties that minority communities have built, almost informal safety nets, that have been very protective many, many times in history.”
…