YCLOAK

Golden butterflies adorn the walls of the Netherland’s only euthanasia expertise center, put up in remembrance of thousands of patients who have chosen to die with dignity over the past two decades.

Situated in a leafy upmarket suburb of The Hague, the Euthanasia Expertise Center is the only one of its kind, giving information, assisting medical doctors and providing euthanasia as end-of-life care, which was legalized in a world first in the Netherlands on April 1, 2002.

Belgium soon followed later that year and Spain last year became the sixth country to adopt euthanasia — the act of intentionally ending a life to relieve a person’s suffering, for instance through a lethal injection given by a doctor.

The number of people seeking euthanasia is growing in the Netherlands, with some 7,666 last year, up by more than 10 percent from the year before, according to official figures.

The vast majority are aged 60 or over, suffering from cancer or other terminal illnesses.

“Twenty years ago, when the law was passed, it was known, but certainly not used as often as today,” said Sonja Kersten, director of the Euthanasia Expertise Center.

The reasons are many: an ageing Dutch population; the fact that euthanasia is no longer a taboo subject and society has opened up to the issue.

“Dying with dignity is a debate that’s growing within Dutch society, which is quite open to the subject,” Kersten said.

‘Existential question’

Euthanasia is only authorized in a few countries around the world.

In Belgium, which will mark two decades of euthanasia in May, some 40 French citizens also benefitted from the practice last year.

The decision to ask for euthanasia as end-of-life care remains a “difficult and existential question,” Kersten said.

“It’s neither a patient’s right, nor a doctor’s duty,” to have euthanasia, she added.

In the Netherlands, euthanasia can only be carried out under strict conditions set down in Dutch law.

Children aged up to 16 need the permission of their parents and guardians, while parents must be involved in the process for children aged 16 and 17. From 18, any Dutch citizen may ask for assisted death.

In all cases, the patient must have “unbearable suffering with no prospect of improvement” and must have requested to die in a way that is “voluntary, well considered and with full conviction”.

Other criteria apply as well, like the absence of a reasonable alternative to the patient’s situation.

Doctors, too, cannot be forced to perform euthanasia.

‘Die at home’

The Euthanasia Expertise Centre helps doctors through the process by sharing knowledge and providing guidance. At the same time, the center helps patients whose doctors refuse to help them.

The center, established in 2012, is a foundation but patient care is reimbursed by health insurers.

It first positioned itself as the “Levenseindekliniek,” Dutch for “End-of-life clinic,” offering on-site euthanasia.

But even before the start, it became apparent that most patients preferred to die at home, Kersten said.

Today, the center can call upon a network of about 140 doctors and nurses around the country, employed by the Euthanasia Expertise Center.

Most euthanasia requests, however, are handled by the patient’s own physician, with whom they already have a relationship of trust. Last year, this was true for 80 percent of euthanasia procedures performed in the country.

“There are however still doctors in the Netherlands who are opposed to euthanasia,” said Kersten, adding “they have every right.”

The center’s medical team itself provided euthanasia to nearly 900 people in 2020, out of nearly 3,000 requests, with figures on the rise.

About 20 percent had dementia or psychiatric disorders.

The Netherlands’ highest court ruled in 2020 that doctors can euthanize patients with severe dementia without the fear of prosecution.

It concerns patients with advanced dementia who are no longer mentally competent but who previously had a clear request for euthanasia.

The decision followed a landmark case, not related to the Expertise center, in which a doctor was acquitted of providing euthanasia on a woman in 2016 with severe Alzheimer’s disease, who earlier requested the procedure.
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When the end of the COVID-19 pandemic comes, it could create major disruptions for a cumbersome U.S. health care system made more generous, flexible and up-to-date technologically through a raft of temporary emergency measures.

Winding down those policies could begin as early as the summer. That could force an estimated 15 million Medicaid recipients to find new sources of coverage, require congressional action to preserve broad telehealth access for Medicare enrollees, and scramble special COVID-19 rules and payment policies for hospitals, doctors and insurers. There are also questions about how emergency use approvals for COVID-19 treatments will be handled.

The array of issues is tied to the coronavirus public health emergency first declared more than two years ago and periodically renewed since then. It’s set to end April 16 and the expectation is that the Biden administration will extend it through mid-July.

Some would like a longer off-ramp.

Transitions don’t bode well for the complex U.S. health care system, with its mix of private and government insurance and its labyrinth of policies and procedures. Health care chaos, if it breaks out, could create midterm election headaches for Democrats and Republicans alike.

“The flexibilities granted through the public health emergency have helped people stay covered and get access to care, so moving forward the key question is how to build on what has been a success and not lose ground,” said Juliette Cubanski, a Medicare expert with the nonpartisan Kaiser Family Foundation, who has been researching potential consequences of winding down the pandemic emergency.

Medicaid churn

Medicaid, the state-federal health insurance program for low-income people, is covering about 79 million people, a record partly due to the pandemic.

But the nonpartisan Urban Institute think tank estimates that about 15 million people could lose Medicaid when the public health emergency ends, at a rate of at least 1 million per month.

Congress increased federal Medicaid payments to states because of COVID-19, but it also required states to keep people on the rolls during the health emergency. In normal times states routinely disenroll Medicaid recipients whose incomes rise beyond certain levels, or for other life changes affecting eligibility. That process will switch on again when the emergency ends, and some states are eager to move forward.

Virtually all of those losing Medicaid are expected to be eligible for some other source of coverage, either through employers, the Affordable Care Act or — for kids — the Children’s Health Insurance Program.

But that’s not going to happen automatically, said Matthew Buettgens, lead researcher on the Urban Institute study. Cost and lack of awareness about options could get in the way.

People dropped from Medicaid may not realize they can pick up taxpayer-subsidized ACA coverage. Medicaid is usually free, so people offered workplace insurance could find the premiums too high.

“This is an unprecedented situation,” said Buettgens. “The uncertainty is real.”

The federal Centers for Medicare and Medicaid Services, or CMS, is advising states to take it slow and connect Medicaid recipients who are disenrolled with other potential coverage. The agency will keep an eye on states’ accuracy in making eligibility decisions. Biden officials want coverage shifts, not losses.

“We are focused on making sure we hold on to the gains in coverage we have made under the Biden-Harris administration,” said CMS Administrator Chiquita Brooks-LaSure. “We are at the strongest point in our history and we are going make sure that we hold on to the coverage gains.”

ACA coverage — or “Obamacare” — is an option for many who would lose Medicaid. But it will be less affordable if congressional Democrats fail to extend generous financial assistance called for in President Joe Biden’s social legislation. Democrats stalling the bill would face blame.

Republicans in mostly Southern states that have refused to expand Medicaid are also vulnerable. In those states, it can be very difficult for low-income adults to get coverage and more people could wind up uninsured.

State Medicaid officials don’t want to be the scapegoats. “Medicaid has done its job,” said Matt Salo, head of the National Association of Medicaid Directors. “We have looked out for physical, mental and behavioral health needs. As we come out of this emergency, we are supposed to right-size the program.”

Telehealth static

Millions of Americans discovered telehealth in 2020 when coronavirus shutdowns led to the suspension of routine medical consultations. In-person visits are again the norm, but telehealth has shown its usefulness and gained broader acceptance.

The end of the public health emergency would jeopardize telehealth access for millions enrolled in traditional Medicare. Restrictions predating COVID-19 limit telehealth mainly to rural residents, in part to mitigate health care fraud. Congress has given itself 151 days after the end of the public health emergency to come up with new rules.

“If there are no changes to the law after that, most Medicare beneficiaries will lose access to coverage for telehealth,” the Kaiser Foundation’s Cubanski said.

A major exception applies to enrollees in private Medicare Advantage plans, which generally do cover telehealth. However, nearly 6 in 10 Medicare enrollees are in the traditional fee-for-service program.

Tests, vaccines, treatments, payments & procedures

Widespread access to COVID-19 vaccines, tests and treatments rests on legal authority connected to the public health emergency.

One example is the Biden administration’s requirement for insurers to cover up to eight free at-home COVID-19 tests per month.

An area that’s particularly murky is what happens to tests, treatments and vaccines covered under emergency use authorization from the Food and Drug Administration.

Some experts say emergency use approvals last only through the duration of the public health emergency. Others say it’s not as simple as that, because a different federal emergency statute also applies to vaccines, tests and treatments. There’s no clear direction yet from health officials.

The FDA has granted full approval to Pfizer-BioNTech’s COVID-19 vaccine for those 16 and older and Moderna’s for those 18 and older, so their continued use would not be affected.

But hospitals could take a financial hit. Currently Medicare pays them 20% more for the care of COVID-19 patients. That’s only for the duration of the emergency.

And Medicare enrollees would have more hoops to jump through to be approved for rehab in a nursing home. A suspended Medicare rule requiring a prior three-day hospital stay would come back into effect.

Health and Human Services Secretary Xavier Becerra recently told The Associated Press that his department is committed to giving “ample notice” when it ends the public health emergency.

“We want to make sure we’re not putting in a detrimental position Americans who still need our help,” Becerra said. “The one that people are really worried about is Medicaid.”
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Laura Purdy is a U.S. doctor on Ukraine’s front lines. In her case, that’s a computer screen in Tennessee.

“Patients that I have talked to from some of the larger cities in Ukraine are fearful of leaving their homes because of air raid sirens or offshore attacks,” said Purdy, a surgeon who, until 2016, served in the U.S. Army’s units that provide health care to civilians worldwide. “They need/want to speak to a physician but are fearful to venture out to do so.”

Purdy now cares for patients in Kyiv and other cities under Russian attack through Starlink, an internet constellation of some 2,000 satellites operated by billionaire Elon Musk’s private firm SpaceX.

Russia invaded Ukraine on February 24, and as of March 30, 1,189 Ukrainians had been killed and 1,901 injured, according to the U.N. Human Rights Office.

U.S. doctors are stepping up to provide much-needed advice via telehealth, a practice honed during the pandemic, to the Ukranian soldiers, civilians and refugees injured in the fighting or attempting to manage chronic diseases amid the chaos.

Purdy is just one of the many physicians who have joined Aimee, a 10-year-old telehealth platform headquartered in Silicon Valley. Having built the telehealth systems for the International Space Station and SpaceX, Aimee is staffed by self-described “nerds who want to make a difference” and are now partnering with Ukraine’s Ministry of Health to provide Ukrainians with free telemedicine visits.

By using the Aimee app, Purdy said, patients can get advice and treatment recommendations from a U.S. physician while they remain in a safe location.

Milton Chen, founder and CEO of VSee, the telehealth company that launched Aimee, said a “couple thousand” physicians and a “couple hundred” translators have joined the platform to provide 24/7 telecare in Ukraine. The doctors provide care for battlefield trauma injuries as well as basics such as prenatal care, chronic disease management and mental health services.

“You could do a remote ultrasound; you could connect to a digital stethoscope to listen to someone’s heart and lung sound. All these medical signals will stream live to the physicians — so other than physically touching the patient — and the physician could get quite a bit of information on the patient,” he said via video.

Through telemedicine, Purdy treated a legally blind man who relies on his family for all his daily needs. Purdy helped him set up a free consultation with an ophthalmologist to interpret tests he underwent in Ukraine.

“This occurred in a city that was actively under attack, and we were able to provide advice and support to the patient while allowing him to stay safely sheltered in place,” she told VOA Mandarin.

The lack of medicine is one of the biggest hurdles for patients in Ukraine, said Purdy, who earned her medical degree at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

“The pharmacies have run out of medication, or they are closed. So, many times we find patients who we can give medical recommendations to, but they may not have access to the pharmaceuticals that they need to treat the condition they are experiencing,” she said.

And while remote doctors can’t solve challenges such as the lack of insulin for patients with diabetes, they can provide much-needed assistance. Dr. Mohamed Aburawi, founder and CEO of Speetar, a telehealth platform founded in 2017 to operate in Libya, told Forbes that “every day a conflict lasts, the situation worsens, and telehealth provides care, relief and stability to communities and people that need it most. Our own experience in protracted conflict highlights how telehealth maintains continuity of care for refugees, migrants and internally displaced populations.”

Telemedicine can also include teaching patients how to stop bleeding from wounds and injuries, a challenge for citizens in war zones, said Patricia Turner, executive director of the American College of Surgeons, which since 2015 has trained people without medical backgrounds through the Stop the Bleed initiative launched by the White House.

“When you bleed … you can actually die in as quickly as five minutes, so stopping the bleeding helps … save a life,” she told VOA Mandarin.

Two doctors who have family ties to Ukraine and work at Brigham and Women’s Hospital in Boston, Massachusetts, turned to telemedicine and developed a training video for Ukrainians.

Dr. Nelya Melnitchouk, a Ukraine native, came up with the idea for the video, and Dr. Eric Goralnick, who is of Ukrainian descent, helped organize the collaboration between the hospital and the Stop the Bleed initiative, according to The Boston Globe.

The training course can be finished in a few hours, Turner said, and can help health care workers and the public learn how to effectively stop bleeding.

“More than 100 people are being trained every other day,” she said. “We’re doing it via video so you can watch them on YouTube. We’re also doing them live remotely so that we can answer questions.”
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The U.K. will ban conversion therapy for gay or bisexual people in England and Wales, but not for transgender people, ITV reported Thursday.

Hours earlier, the government had confirmed an ITV report that it would drop a plan to introduce legislation to ban LGBT conversion therapy and would instead review how existing law could be utilized more effectively to prevent it.

That prompted an angry response from LGBT groups and some lawmakers.

“The Prime Minister has changed his mind off the back of the reaction to our report and he WILL now ban conversion therapy after all,” ITV political reporter Paul Brand tweeted.

“Senior Govt source absolutely assures me it’ll be in Queen’s Speech (of planned legislation). But only gay conversion therapy, not trans,” he said.

A Downing Street spokesperson declined to comment.

Prime Minister Boris Johnson’s government has come under increasing pressure on the issue after former leader Theresa May vowed in 2018 to eradicate a procedure that aims to change or suppress someone’s sexual orientation or gender identity.

In May last year, when the government set out its post-pandemic parliamentary agenda, it said measures would be brought forward to prevent these “abhorrent practices which can cause mental and physical harm,” starting with a consultation on how best to protect people and how to eliminate coercive practices.
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Scientists say they have finally assembled the full genetic blueprint for human life, adding the missing pieces to a puzzle nearly completed two decades ago.

An international team described the first-ever sequencing of a complete human genome – the set of instructions to build and sustain a human being – in research published Thursday in the journal Science. The previous effort, celebrated across the world, was incomplete because DNA sequencing technologies of the day weren’t able to read certain parts of it. Even after updates, it was missing about 8% of the genome.

“Some of the genes that make us uniquely human were actually in this ‘dark matter of the genome’ and they were totally missed,” said Evan Eichler, a University of Washington researcher who participated in the current effort and the original Human Genome Project. “It took 20-plus years, but we finally got it done.”

Many — including Eichler’s own students — thought it had been finished already.

“I was teaching them, and they said, ‘Wait a minute. Isn’t this like the sixth time you guys have declared victory? I said, ‘No, this time we really, really did it!” Eichler said.

Scientists said this full picture of the genome will give humanity a greater understanding of our evolution and biology while also opening the door to medical discoveries in areas like aging, neurodegenerative conditions, cancer and heart disease.

“We’re just broadening our opportunities to understand human disease,” said Karen Miga, an author of one of the six studies published Thursday.

The research caps off decades of work. The first draft of the human genome was announced in a White House ceremony in 2000 by leaders of two competing entities: an international publicly funded project led by an agency of the U.S. National Institutes of Health and a private company, Maryland-based Celera Genomics.

The human genome is made up of about 3.1 billion DNA subunits, pairs of chemical bases known by the letters A, C, G and T. Genes are strings of these lettered pairs that contain instructions for making proteins, the building blocks of life. Humans have about 30,000 genes, organized in 23 groups called chromosomes that are found in the nucleus of every cell.

Before now, there were “large and persistent gaps that have been in our map, and these gaps fall in pretty important regions,” Miga said.

Miga, a genomics researcher at the University of California-Santa Cruz, worked with Adam Phillippy of the National Human Genome Research Institute to organize the team of scientists to start from scratch with a new genome with the aim of sequencing all of it, including previously missing pieces. The group, named after the sections at the very ends of chromosomes, called telomeres, is known as the Telomere-to-Telomere, or T2T, consortium.

Their work adds new genetic information to the human genome, corrects previous errors and reveals long stretches of DNA known to play important roles in both evolution and disease. A version of the research was published last year before being reviewed by scientific peers.

“This is a major improvement, I would say, of the Human Genome Project,” doubling its impact, said geneticist Ting Wang of the Washington University School of Medicine in St. Louis, who was not involved in the research.

Eichler said some scientists used to think unknown areas contained “junk.”

“Some of us always believed there was gold in those hills,” he said. Eichler is paid by the Howard Hughes Medical Institute, which also supports The Associated Press’s health and science department.

Turns out that the gold Eichler believed in includes many important genes, he said, such as some integral to making a person’s brain bigger than a chimp’s, with more neurons and connections.

To find such genes, scientists needed new ways to read life’s cryptic genetic language.

Reading genes requires cutting the strands of DNA into pieces hundreds to thousands of letters long. Sequencing machines read the letters in each piece and scientists try to put the pieces in the right order. That’s especially tough in areas where letters repeat.

Scientists said some areas were illegible before improvements in gene sequencing machines that now allow them to, for example, accurately read a million letters of DNA at a time. That allows scientists to see genes with repeated areas as longer strings instead of snippets that they had to later piece together.

Researchers also had to overcome another challenge: Most cells contain genomes from both mother and father, confusing attempts to assemble the pieces correctly. T2T researchers got around this by using a cell line from one “complete hydatidiform mole,” an abnormal fertilized egg containing no fetal tissue that has two copies of the father’s DNA and none of the mother’s.

The next step? Mapping more genomes, including ones that include collections of genes from both parents. This effort did not map one of the 23 chromosomes that is found in males, called the Y chromosome, because the mole contained only an X.

Wang said he’s working with the T2T group on the Human Pangenome Reference Consortium, which is trying to generate reference, or template, genomes for 350 people representing the breadth of human diversity.

“Now we’ve gotten one genome right and we have to do many, many more,” Eichler said. “This is the beginning of something really fantastic for the field of human genetics.”
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A microgravity ceremony ushers in a new commander of the International Space Station. An old space telescope finds something new in the cosmos. And a futuristic helmet to study astronauts’ brain waves. VOA’s Arash Arabasadi brings us The Week in Space.
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After spending two years being socially distanced in his home country of South Korea, Kim Hoe-jun booked a last-minute flight to Hawaii, where he had enjoyed his honeymoon six years ago, giving in to his craving for overseas travel.

“I bought the ticket just a week ago, but it was rather a no-brainer. It felt like I was making up for those two years not being able to go abroad often as I used to before COVID,” he said, before boarding the plane from Incheon International Airport on Friday.

Vaccinated and boosted, Kim and his wife are among South Koreans joining in a rush for “revenge travel” — a term that has been trending on social media as people scramble to book overseas trips that were delayed by coronavirus restrictions.

The boom started after March 21 when South Korea lifted a seven-day mandatory quarantine for fully vaccinated travelers arriving from most countries. The restriction had been eased last year but was reimposed in December as the highly infectious Omicron variant spread.

The country has largely scrapped its once-aggressive tracing and containment efforts despite a record COVID-19 wave, joining a growing list of Asian countries that have eased quarantine rules, including Singapore, Japan, Australia and New Zealand.

Koreans now appear more ready to travel. Polls showed people are less worried about the implications of catching the virus, and increasingly see its prevention as out of their hands.

Sales of overseas flight tickets on 11st, an e-commerce unit of SK Telecom, South Korea’s top mobile carrier, rose more than eight-fold compared with a year before between March 11, when the lifting of quarantine was announced, and March 27, the company said.

Kim Na-yeon, 27, was excited to return to Hawaii, where she used to live.

“I couldn’t dare to travel even in Korea because of COVID,” she said. “But now I feel a bit freer with the exemption, so I’ve decided to go meet old friends and do some sightseeing.”

Exploding demand

Airlines and travel agencies have reported exploding demand for routes to Hawaii, Saipan and Guam, as well as some destinations in Europe and Southeast Asia where tourists submitting a vaccination certificate or negative test result are exempted from quarantine.

Saipan and Guam, both of which have travel bubble pacts with South Korea, also offer free COVID testing and pay for quarantine expenses if a traveler tests positive. Each South Korean national visiting Saipan receives $100 in “travel bucks” to spend at businesses there.

The tour arm of online retail giant Interpark reported a 324% growth in flight bookings for Oceania between March 11-22 from the same period of 2021, a 268% increase for Southeast Asia and 262% more bookings for Europe.

On Sunday, the company sold a record 5,200 Hawaii tour packages within 70 minutes. CJ Corp’s home shopping unit said it received about 2,800 orders for a Spain and Italy trip in one hour on Sunday, totaling 15 billion won ($12.41 million), days after garnering 9 billion won ($7.4 million) from its sales of a Hawaii package.

“The surge reflects growing customer sentiment that an end of COVID travel curbs might be in the offing after the mandatory quarantine was lifted,” said Lee Jeong-pil, general manager of CJ’s home shopping unit.

Lee Tae-woo, a 36-year-old frequent traveler to Japan, said he has changed some money into yen, taking advantage of the currency’s sharp decline and hoping to jump on the revenge travel bandwagon soon.

Though Japan has yet to allow tourists back in, it has reduced the quarantine period for arrivals for business and other purposes to three days from seven this month and signaled further easing of travel curbs.

“It’s been a long wait, and I’m ready to go back as soon as they finally open up again and visit my favorite coffee roastery and enjoy the night view from Shibuya station,” Lee said, referring to Tokyo’s bustling central district.
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Federal health officials are dropping the warning they have attached to cruising since the beginning of the pandemic, leaving it up to vacationers to decide whether they feel safe getting on a ship.

Cruise-ship operators welcomed Wednesday’s announcement, which came as many people thought about summer vacation plans.

An industry trade group said the move by the Centers for Disease Control and Prevention validated measures that ship owners have taken, including requiring crew members and most passengers to be vaccinated against the virus.

The CDC removed the COVID-19 “cruise ship travel health notice” that was first imposed in March 2020, after virus outbreaks on several ships around the world.

However, the agency expressed reservations about cruising.

“While cruising will always pose some risk of COVID-19 transmission, travelers will make their own risk assessment when choosing to travel on a cruise ship, much like they do in all other travel settings,” CDC spokesperson Dave Daigle said in an email.

Daigle said the CDC’s decision was based on “the current state of the pandemic and decreases in COVID-19 cases onboard cruise ships over the past several weeks.”

COVID-19 cases in the United States have been falling since mid-January, although the decline has slowed in recent weeks, and the current seven-day rolling average for daily new cases in the U.S. is roughly unchanged from two weeks ago, according to figures from Johns Hopkins University. States have rolled back mask mandates, putting pressure on federal officials to ease virus-related restrictions.

Outbreaks continue to be reported on cruise ships, which conduct random testing before the end of voyages.

On Sunday, a Princess Cruises ship returning from the Panama Canal had “multiple” passengers who had tested positive for the virus. Princess Cruises said all the affected passengers showed mild symptoms or none at all, and that all crew members and passengers had been vaccinated. About a dozen passengers tested positive before the same boat docked in San Francisco in January.

Operators are required to tell the CDC about virus cases on board ships. The agency has a colored-coded system to classify ships based on the percentage of passengers who test positive. The CDC said that system remains in place.

Cruise-ship operators have complained since the start of the pandemic that their industry has been singled out for a shutdown and then tighter COVID-19 restrictions than others, including airlines.

The Cruise Lines International Association said in a statement that the CDC’s decision to remove its health warning “recognizes the effective public health measures in place on cruise ships and begins to level the playing field between cruise and similarly situated venues on land.”

Colleen McDaniel, editor in chief of Cruise Critic, a site that publishes review of trips, called the CDC decision big news.

“Symbolically it’s a notice of winds of change when it comes to cruising,” she said. “I do think it can convince some of the doubters. What the CDC says does matter to cruisers.”
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A batch of dome-shaped ice volcanoes that look unlike anything else known in our solar system and may still be active have been identified on Pluto using data from NASA’s New Horizons spacecraft, showing that this remote frigid world is more dynamic than previously known.

Scientists said that these cryovolcanoes — numbering perhaps 10 or more — stand anywhere from 1 kilometer (six-tenths of a mile) to 7 kilometers (4-1/2 miles) tall. Unlike Earth volcanoes that spew gases and molten rock, this dwarf planet’s cryovolcanoes extrude large amounts of ice — apparently frozen water rather than some other frozen material — that may have the consistency of toothpaste, they said.

Features on the asteroid belt dwarf planet Ceres, Saturn’s moons Enceladus and Titan, Jupiter’s moon Europa and Neptune’s moon Triton also have been pegged as cryovolcanoes. But those all differ from Pluto’s, the researchers said, owing to different surface conditions such as temperature and atmospheric pressure, as well as different mixes of icy materials.

“Finding these features does indicate that Pluto is more active, or geologically alive, than we previously thought it would be,” said planetary scientist Kelsi Singer of the Southwest Research Institute in Boulder, Colorado, lead author of the study published this week in the journal Nature Communications.

“The combination of these features being geologically recent, covering a vast area and most likely being made of water ice is surprising because it requires more internal heat than we thought Pluto would have at this stage of its history,” Singer added.

Pluto, which is smaller than Earth’s moon and has a diameter of about 2,380 kilometers (1,400 miles), orbits about 5.8 billion kilometers (3.6 billion miles) away from the sun, roughly 40 times farther than Earth’s orbit. Its surface features plains, mountains, craters and valleys.

Images and data analyzed in the new study, obtained in 2015 by New Horizons, validated previous hypotheses about cryovolcanism on Pluto.

The study found not only extensive evidence for cryovolcanism but also that it has been long-lived, not a single episode, said Southwest Research Institute planetary scientist Alan Stern, the New Horizons principal investigator and study co-author.

“What’s most fascinating about Pluto is that it’s so complex – as complex as the Earth or Mars despite its smaller size and high distance from the sun,” Stern said. “This was a real surprise from the New Horizons flyby, and the new result about cryovolcanism re-emphasizes this in a dramatic way.”

The researchers analyzed an area southwest of Sputnik Planitia, Pluto’s large heart-shaped basin filled with nitrogen ice. They found large domes 30-100 kilometers (18-60 miles) across, sometimes combining to form more complexly shaped structures.

An elevation called Wright Mons, one of the tallest, may have formed from several volcanic domes merging, yielding a shape unlike any Earth volcanoes. Although shaped differently, it is similar in size to Hawaii’s large volcano Mauna Loa.

Like Earth and our solar system’s other planets, Pluto formed about 4.5 billion years ago. Based on an absence of impact craters that normally would accumulate over time, it appears its cryovolcanoes are relatively recent — formed in the past few hundred million years.

“That is young on a geologic timescale. Because there are almost no impact craters, it is possible these processes are ongoing even in the present day,” Singer said.

Pluto has lots of active geology, including flowing nitrogen ice glaciers and a cycle in which nitrogen ice vaporizes during the day and condenses back to ice at night — a process constantly changing the planetary surface.

“Pluto is a geological wonderland,” Singer said. “Many areas of Pluto are completely different from each other. If you just had a few pieces of a puzzle of Pluto you would have no idea what the other areas looked like.” 
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Scientists in Kenya are testing a project using solar panels to shade crops while generating clean energy. It’s called agrivoltaics. Successful trials have shown that this technology reduces water loss and results in higher yields. Juma Majanga reports from Kajiado, Kenya.
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U.S. President Joe Biden on Wednesday introduced his administration’s new website, COVID.gov, designed to be a clearinghouse for the latest pandemic information, as well as a means of providing access to vaccines, tests, treatments and masks on a single site.

Speaking to reporters at the White House, Biden also asked Congress to approve an additional $22 billion in emergency funding to help continue the fight against the COVID-19 pandemic.

Biden said the nation was entering a new moment in the pandemic. He stressed that though the pandemic no longer controlled our lives, it was not over, noting an uptick of new cases in recent weeks — as expected, he said.

Biden added that the U.S. now had the tools to protect all people.

The president said COVID.gov provides access to all the tools available to address COVID-19, including a list of all 90,000 vaccination sites in the United States, links to obtaining masks and tests, and where to obtain COVID-19 treatments. The site also has a search function, which can be used to find the latest information on the status of the pandemic in any region in the country.

‘Test-to-treat’ sites

The website also features a so-called “test-to-treat” locator, designed to allow access to U.S. pharmacies and community health centers where anyone can get tested for COVID-19 and, if required, receive appropriate treatment.

The White House said the administration had launched more than 2,000 such sites across the country, as well as 240 in Veterans Affairs and Department of Defense facilities to serve veterans, military personnel and their families.

The president also urged Congress to approve additional funding to fight the pandemic. He said without it, the U.S. would not be able to sustain its testing capacity beyond June, and vaccines could run out as early as September, leaving the nation vulnerable should another wave of the virus that causes COVID-19 hit.

Biden also noted that the U.S. Food and Drug administration on Tuesday approved a second COVID-19 booster — a fourth shot overall for those receiving the Pfizer or Moderna vaccines — for all people over age 50 and people with compromised immune systems.

He urged all eligible people to get their boosters. To prove his point, following his remarks at the White House, he received his fourth vaccination as reporters watched.
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Malaysia’s health ministry is proposing a major initiative to prevent young people from smoking. It’s a bold plan but critics say it has flaws. Dave Grunebaum has the story.
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The World Health Organization reported a 43 percent spike in deaths from COVID-19 globally last week, while the number of cases continued to fall worldwide.

In its weekly epidemiological report, the WHO said 45,000 deaths attributed to COVID-19 were reported in the week ending March 27, up from 33,000 the week before. That spike follows a week in which deaths declined by 23 percent.

The agency said the increase in deaths is likely driven by changes in the definition of COVID-19 deaths in nations in the Americas such as Chile and the United States, and by retrospective adjustments reported from India in Southeast Asia.

As an example, Chile had the highest number of new deaths, reporting 11,858, a leap of 1,710 percent from the previous week. The United States saw a smaller but still significant increase of 5,367 new deaths, an increase of 8 percent.

While India saw 4,525 of new deaths; it represented an increase of 619 percent. The WHO said those deaths included numbers from Maharashtra state, which initially were not included in last week’s COVID-19 death toll.

While the number of new cases overall fell globally, three European countries — Germany, Italy and France — all saw an increase in new cases from the previous week. While Germany and Italy reported increases of two and six percent respectively, France reported 845,119 new cases – a increase of 45 percent.

The WHO has said repeatedly that COVID-19 case counts are likely a vast underestimate of the coronavirus’ prevalence. The agency also expressed concern that many countries in recent weeks announced plans to drop their comprehensive testing programs and other surveillance measures. They said doing so will cripple efforts to accurately track the spread of the virus.

Some information for this report was provided by the Associated Press.
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Botswana has become the first country in Africa to approve the use of the Texas-made COVID-19 vaccine Corbevax. Botswana’s president and California biotech company NantWorks made the announcement Monday as they began construction of a plant to produce COVID-vaccines and drugs to fight cancer.

CEO of biotech firm NantWorks Patrick Soon-Shiong announced on Monday that Botswana’s Medicines Regulatory Authority (BOMRA) had approved the Corbevax jab.

He made the announcement at a groundbreaking ceremony for a vaccine and cancer drug production facility, along with Botswana’s President Mokgweetsi Masisi.

“I am pleased to announce, Mr. President, with the incredibly hard work of both the Ministry of Health and BOMRA, today we announce Africa’s first approved vaccine for Africa by Botswana,” Soon-Shiong said.

Corbevax is a patent-free COVID vaccine developed by the Baylor College of Medicine and Texas Children’s Hospital in the United States. It has been used in Bangladesh, India, and Indonesia.

Soon-Shiong said the first consignment would be delivered to Botswana for distribution across Africa.

“This vaccine has been tested and shown to be active in every variant including omicron. I got a commitment this morning that Botswana, effective immediately, will have access to 100 million of these vaccines that you can distribute,” Soon-Shiong said.

The plant, which is expected to be operational by 2026, plans to produce vaccines for COVID and other diseases, as well as cancer treatment drugs.

Masisi said the plant heralds a new dawn for the production of pharmaceuticals on the continent.

“This is particularly noteworthy in the Africa region, which bears a disproportionate disease burden exacerbated limitation of resources and capabilities to address these health challenges. We are determined to dictate a new legacy associated with access to medicines, vaccines and other health technologies,” he said.

Masisi said the facility would help address vaccine inequality in Africa, where less than 20% of the population is fully vaccinated against COVID – two years into the pandemic.

“Disparities in the distribution of vaccines across the world resulted in a lopsided vaccination drive that seriously hampered efforts to effectively contain the COVID-19 worldwide. This problem has been aptly defined as vaccine nationalism. It is therefore our intent, our conviction that the opening of this vaccine manufacturing facility, will go a long way in changing this narrative,” Masisi said.

Botswana’s Health Minister Edwin Dikoloti says the project would also help treat chronic diseases.

“This day marks a new level in our scientific development and advancement. It signifies a new technological breakthrough which will see us as not just a consumer but also a manufacturer of vaccines and other medication that will come out of this magnificent project,” Dikoloti said.

Botswana’s vaccine manufacturing facility will be the second in Africa being built by Soon-Shiong.

In January, the South African-born U.S. billionaire opened a similar facility in Cape Town.
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The U.S. Food and Drug Administration has authorized a fourth dose of the Pfizer and Moderna COVID-19 vaccines for people 50 and over.

Previously a fourth dose was only authorized for people 12 and up, who are badly immunocompromised.

The U.S. Centers for Disease Prevention and Control will not weigh in on how to implement the FDA’s authorization.

People wanting the fourth shot should only do so at least four months after the previous booster, the FDA said Tuesday.

The FDA’s authorization comes as COVID-19 cases in the U.S. are falling after a winter surge of the omicron variant. 

However, a new subvariant, BA.2, is spreading in Europe and the U.S.

Roughly two-thirds of Americans are fully vaccinated, meaning they’ve had two doses of Pfizer or Moderna or one dose of Johnson & Johnson vaccine. Only half of those eligible have gotten a first booster.

While the vaccines did not stop omicron from circulating widely, health officials say they did help those infected avoid serious illness or death.

The government is also considering authorizing a fourth dose for everyone in the Fall when cases could surge again.

Some information in this report comes from The Associated Press.
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