The signs that the small, scattered coronavirus outbreak in the United States could spiral into a larger-scale problem are growing. A new analysis, first reported by STAT, found there are likely now 500 to 600 (mostly undetected) cases of Covid-19, the disease caused by the coronavirus, in Washington state alone. “January 1 in Wuhan was March 1 in Seattle,” computational biologist Trevor Bedford, who did the analysis, told STAT, referring to the Chinese city where the virus emerged and began rapidly infecting humans.
The decisions federal and local public health officials make this week — to test more people with symptoms, inform the public about the risk, isolate the sick, and institute other measures — will be crucial. So will the speed at which they execute them.
This could be a make-or-break moment where US cases remain relatively low and dispersed, or explode in the coming weeks, like they did in Wuhan in January.
Meanwhile, on Fox News and social media, a dangerous conspiracy theory about the origin of the health crisis won’t die.
There are two main versions of the rumor, and they have one common thread: that the coronavirus, SARS-CoV-2, originated in a level 4 (the highest biosafety level) research laboratory in Wuhan.
In one version of the rumor, the virus was engineered in the lab by humans as a bioweapon. In another version, the virus was being studied in the lab (after being isolated from animals) and then “escaped” or “leaked” because of poor safety protocol.
The Wuhan Institute of Virology is a real place, and the exact origin of the novel coronavirus is still a mystery, with researchers racing since the outbreak began to figure it out. But already, virologists who’ve parsed the genome and infectious disease experts who study coronaviruses have more than enough evidence to show that the virus is brand new and came from nature, not the Wuhan lab. A large group of them, citing genome analyses from multiple countries, recently affirmed in The Lancet that the virus originated in wildlife.
The emergence of the virus in the same city as China’s only level 4 biosafety lab, it turns out, is pure coincidence.
Before we get to debunking, let’s note who is spreading rumors about the origins of the virus.
First, several prominent US conservative pundits and politicians — known to regularly spew nonsense (and bash China) — have been politicizing the bioweapon rumorfor weeks.
“It probably is a ChiCom laboratory experiment that is in the process of being weaponized,” right-wing radio host and Presidential Medal of Freedom recipient Rush Limbaugh said of the virus on February 24. “All superpower nations weaponize bioweapons.”
The Arkansas senator furthered “infodemic” by pushing debunked claim that the novel coronavirus may have been created in a Wuhan laboratory. https://t.co/oJvVzjOyxw
On Monday, former White House strategist Steve Bannon went on Fox News to defend Cotton and imply that the Chinese Communist Party was still hiding something about the origin of Covid-19. “The mainstream media and far left [are] saying, ‘Oh, he’s a conspiracy theorist,”’ Bannon said. ”All he’s saying: It’s incumbent upon the Chinese Communist Party and President Xi [Jinping] to come out and give all information … this is all Cotton’s saying.”
In the New York Post, Steven Mosher, a regular critic of China’s population control measures, has stoked the leakage rumor, using an array of circumstantial clues that Chinese labs’ handling of deadly pathogens can’t be trusted.
Similar rumors have also been running rampant in online forums in China. The South China Morning Post on February 20 debunked yet another rumor of the virus escaping from the lab in China:
More rumours swirled online over the weekend, this time that [Wuhan Institute of Virology] researcher Chen Quanjiao had reported the head of the institute, Wang Yanyi, claiming she had “sold experimental animals” to the live animal and seafood market and “leaked the virus” from the lab.
But Chen denied the claim, saying she was angry that her name had been used to fabricate information. “The recent rumours about the institute have affected the researchers as they try to tackle key problems,” Chen said in a statement.
The scientific evidence disproving these rumors matters because the conspiracy theory could persist and undermine trust in public health authorities at this critical moment. As the Washington Post reported Sunday, the rumor that the virus came from a Chinese lab is one reason residents of one Alabama county are currently unnerved and distrustful of the response to Covid-19 in their state.
“Conspiracy theories about manmade viruses are not new. We saw this with HIV — the rumor that the US made it and introduced it into Africa. But they are really dangerous kinds of things to get spread around,” Gerald Keusch, a professor of medicine and international health and associate director of Boston University’s National Emerging Infectious Diseases Laboratories, told Vox.
So let’s walk through what we know about the virus, and why it’s time to put the lab rumor to rest.
Soon after the Chinese government acknowledged there was an outbreak of a mysterious new virus in late December in Wuhan, scientists raced to sequence its genome. By mid-January, they had it and shared it with the World Health Organization.
Soon after that, scientists saw that the virus closely resembled viruses that circulate in bats. “If you look at the genetic sequence of the virus, it’s closely related to a bat virus, about 96 percent the same,” Jim LeDuc, head of the Galveston National Laboratory, a level 4 biosafety lab in Texas, told Vox. “There’s been talk about a pangolin intermediate host; that’s probably not true.”
Chinese officials also reported that several of the first cluster of cases had ties to a live animal market where both seafood and other wildlife were sold as food. (The market has since been closed.) The market soon became the leading hypothesis for how the virus made the leap into humans, where it’s been able to spread efficiently ever since.
The genetic evidence and epidemiological information, according to three esteemed infectious disease researchers writing in the New England Journal of Medicine, “implicates a bat-origin virus infecting unidentified animal species sold in China’s live-animal markets.”
According to a genome analysis by Tanja Stadler from the Department of Biosystems Science and Engineering at ETH Zurich in Basel, the virus first began transmitting in humans in China as early as the first half of November 2019.
“The widespread hypothesis that the first person was infected at an animal market in November is still plausible,” Stadler said in a statement. “Our data effectively rule out the scenario that the virus circulated in humans for a long time before that.”
LeDuc agrees with the hypothesis that the animal market played a role in the virus jumping to humans. “The linkage back to the market is pretty realistic, and consistent with what we saw with SARS,” said LeDuc. “It’s a perfectly plausible and logical explanation: The virus exists in nature and, jumping hosts, finds that it like humans just fine, thank you.“
What researchers have to figure out now is how exactly the coronavirus jumped to humans: perhaps through a human eating an infected animal, or through humans being exposed to infected feces or urine. “All we know [is] its likely distant source was bats, but we don’t know who was between bats and people,” said Vincent Racaniello, a professor of microbiology and immunology at Columbia and host of the This Week in Virology podcast. “It could be a direct infection [between bats and humans] as well.”
In a recent podcast episode, Racaniello discussed with two other researchers a fascinating preprint paper (that’s currently under peer review, according to the authors) about the virus origin. The key finding: that SARS-CoV-2 is “not a laboratory construct nor a purposefully manipulated virus.”
The paper, which was uploaded onto Virological.org in February, is written by several leading microbiologists who closely examined the SARS-CoV-2 genome.
Specifically, they found theunusual biochemical features of the virus could only have come about two ways after the virus jumped from animal to humans, or what’s called zoonotic transfer. The ways, they write, are: “1) natural selection in a non-human animal host prior to zoonotic transfer, and 2) natural selection in humans following zoonotic transfer.”
In other words, nature came up with these weird characteristics in the genome, either in an intermediary animal between bats and people or in humans after the virus infected one. As Racaniello put it on his podcast: “Humans could never have dreamed this up.”
What’s more, he noted, no known lab anywhere in the world was working on a coronavirus like this one, and its closest relative is a bat virus found in a cave in 2013 in Yunnan, China, 1,000 miles from Wuhan.“Presumably there’s a common ancestor, most likely from a bat or an intermediary animal that was contaminated by that bat,” Racaniello says.
Several experts told me the theory that the virus was meant to be a bioweapon doesn’t make sense, either. One big reason: Covid-19 isn’t all that deadly or transmissible, compared to other potential pathogens out there.
“To make it as a bioweapon, if that’s what you wanted to do, there are scarier and more virulent pathogens to work with,” said Keusch of Boston University.
For instance, Ebola and the West African Lassa virus are deadly threats that can only be studied in biosafety level 4 labs, like Wuhan. Crimean-Congo hemorrhagic fever is a tick-borne disease that has a death rate of 30 to 50 percent. The global death rate for Covid-19, meanwhile, is around 3 percent at the moment, but it’s expected to come down dramatically as more cases are discovered in the coming weeks. And even now, it varies widely by country and region.
Simply put, if you wanted to release a bioweapon to kill a lot of people, there are much deadlier pathogens you could use.
In his article in the New York Post, Mosher suggests that we shouldn’t trust the officials who ran the Wuhan lab. “It sure sounds like China has a problem keeping dangerous pathogens in test tubes where they belong, doesn’t it?” he says.
I asked LeDuc, who runs the Galveston biocontainment lab, if he has any experience with the Wuhan lab. Turns out he has a lot. He and his colleagues have worked for six years with the Chinese team there, both in advising them on building their lab and keeping it safe, and on scientific collaboration. “I can tell you that lab in Wuhan is equivalent to any lab here in the US and Europe,” he said.
For instance, many labs now use radio waves to track and inventory vials containing dangerous pathogens.
Keusch agrees. “I don’t think there’s any likelihood that the lab is less prepared in terms of protocol and capability than any lab in the US. It’s really good, though nothing is perfect,” he said.
The rumors have also reportedly hurt the lab’s ability to do its work.
“The rumours … have caused severe damage to our researchers who have been dedicated to working on the front line, and seriously interrupted the emergency research we are doing during the epidemic,” the lab said in a statement, according to the South China Morning Post.
According to Bruce Aylward, an epidemiologist who led the World Health Organization’s recent mission to China to assess its Covid-19 response, the investigation into where and how the virus jumped to people is ongoing. The focus remains on the (now closed) Huanan Wholesale Seafood Market, the wildlife market inside it, and other area markets.
“Ever since SARS, the market authorities now have to record which animals are sold by whom and where they come from in these markets. So now there’s a list of 10 vendors from seven provinces,” he told my colleague Julia Belluz in a recent interview. “Then China’s CDC can do a case control study based on where in the market these animals were.”
The focus in the past month has been on saving lives, he said, but as new cases and deaths decline, the investigators will eventually be able to turn back to getting animal info from the market vendors and testing the animals.
Racaniello says it’s critical that the source is identified to eliminate the chance that the virus is introduced into people again.
For LeDuc, China’s experience with the coronavirus should be a clear message of the great public health threat live animal markets post.
“The reason we’re seeing [coronaviruses like SARS and SARS-CoV-2 emerge] in China is they have these live animal markets, where they bring in animals alive and co-house them, one cage on top of another, where there’s an opportunity for transmission between atypical hosts,” says LeDuc.
We’ll need to be patient for Chinese investigators to get to the bottom of how the virus made the jump from animals to humans. In the meantime, remember that in a public health crisis, conspiracy theories are a distraction. Rather, it’s our collective responsibility to stay focused on keeping each other safe.
Correction: An earlier version of this story misidentified Tom Cotton’s position in Congress. He is a US senator.
The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.
New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.
The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.
Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.
Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.
“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.
“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”
McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.
But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.
The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.
He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.
“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.
“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.
McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”
McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.
He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.
“Early identification of reading difficulty can truly change the trajectory of a child’s life.”
This report by The Canadian Press was first published Oct. 23, 2024.
LONDON (AP) — Britain’s drug regulator approved the Alzheimer’s drug Kisunla on Wednesday, but the government won’t be paying for it after an independent watchdog agency said the treatment isn’t worth the cost to taxpayers.
It is the second Alzheimer’s drug to receive such a mixed reception within months. In August, the U.K. regulator authorized Leqembi while the same watchdog agency issued draft guidance recommending against its purchase for the National Health Service.
In a statement on Wednesday, Britain’s Medicines and Healthcare regulatory Agency said Kisunla “showed some evidence of efficacy in slowing (Alzheimer’s) progression” and approved its use to treat people in the early stages of the brain-robbing disease. Kisunla, also known as donanemab, works by removing a sticky protein from the brain believed to cause Alzheimer’s disease.
Meanwhile, the National Institute for Health and Care Excellence, or NICE, said more evidence was needed to prove Kisunla’s worth — the drug’s maker, Eli Lilly, says a year’s worth of treatment is $32,000. The U.S. Food and Drug Administration authorized Kisunla in July. The roll-out of its competitor drug Leqembi has been slowed in the U.S. by spotty insurance coverage, logistical hurdles and financial worries.
NICE said that the cost of administering Kisunla, which requires regular intravenous infusions and rigorous monitoring for potentially severe side effects including brain swelling or bleeding, “means it cannot currently be considered good value for the taxpayer.”
Experts at NICE said they “recognized the importance of new treatment options” for Alzheimer’s and asked Eli Lilly and the National Health Service “to provide additional information to address areas of uncertainty in the evidence.”
Under Britain’s health care system, most people receive free health care paid for by the government, but they could get Kisunla if they were to pay for it privately.
“People living with dementia and their loved ones will undoubtedly be disappointed by the decision not to fund this new treatment,” said Tara Spires-Jones, director of the Centre for Discovery Brain Sciences at the University of Edinburgh. “The good news that new treatments can slow disease even a small amount is helpful,” she said in a statement, adding that new research would ultimately bring safer and more effective treatments.
Fiona Carragher, chief policy and research officer at the Alzheimer’s Society, said the decision by NICE was “disheartening,” but noted there were about 20 Alzheimer’s drugs being tested in advanced studies, predicting that more drugs would be submitted for approval within years.
“In other diseases like cancer, treatments have become more effective, safer and cheaper over time,” she said. “ We hope to see similar progress in dementia.”
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
Women living in states with abortion bans obtained the procedure in the second half of 2023 at about the same rate as before the U.S. Supreme Court overturned Roe v. Wade, according to a report released Tuesday.
Women did so by traveling out of state or by having prescription abortion pills mailed to them, according to the #WeCount report from the Society of Family Planning, which advocates for abortion access. They increasingly used telehealth, the report found, as medical providers in states with laws intended to protection them from prosecution in other states used online appointments to prescribe abortion pills.
“The abortion bans are not eliminating the need for abortion,” said Ushma Upadhyay, a University of California, San Francisco public health social scientist and a co-chair of the #WeCount survey. “People are jumping over these hurdles because they have to.”
Abortion patterns have shifted
The #WeCount report began surveying abortion providers across the country monthly just before Roe was overturned, creating a snapshot of abortion trends. In some states, a portion of the data is estimated. The effort makes data public with less than a six-month lag, giving a picture of trends far faster than the U.S. Centers for Disease Control and Prevention, whose most recent annual report covers abortion in 2021.
The report has chronicled quick shifts since the Supreme Court’s Dobbs v. Jackson Women’s Health Organization ruling that ended the national right to abortion and opened the door to enforcement of state bans.
The number of abortions in states with bans at all stages of pregnancy fell to near zero. It also plummeted in states where bans kick in around six weeks of pregnancy, which is before many women know they’re pregnant.
But the nationwide total has been about the same or above the level from before the ruling. The study estimates 99,000 abortions occurred each month in the first half of 2024, up from the 81,000 monthly from April through December 2022 and 88,000 in 2023.
One reason is telehealth, which got a boost when some Democratic-controlled states last year began implementing laws to protect prescribers. In April 2022, about 1 in 25 abortions were from pills prescribed via telehealth, the report found. In June 2024, it was 1 in 5.
The newest report is the first time #WeCount has broken down state-by-state numbers for abortion pill prescriptions. About half the telehealth abortion pill prescriptions now go to patients in states with abortion bans or restrictions on telehealth abortion prescriptions.
In the second half of last year, the pills were sent to about 2,800 women each month in Texas, more than 1,500 in Mississippi and nearly 800 in Missouri, for instance.
Travel is still the main means of access for women in states with bans
Data from another group, the Guttmacher Institute, shows that women in states with bans still rely mostly on travel to get abortions.
By combining results of the two surveys and comparing them with Guttmacher’s counts of in-person abortions from 2020, #WeCount found women in states with bans throughout pregnancy were getting abortions in similar numbers as they were in 2020. The numbers do not account for pills obtained from outside the medical system in the earlier period, when those prescriptions most often came from abroad. They also do not tally people who received pills but did not use them.
West Virginia women, for example, obtained nearly 220 abortions monthly in the second half of 2023, mostly by traveling — more than in 2020, when they received about 140 a month. For Louisiana residents, the monthly abortion numbers were about the same, with just under 700 from July through December 2023, mostly through shield laws, and 635 in 2020. However, Oklahoma residents obtained fewer abortions in 2023, with the monthly number falling to under 470 from about 690 in 2020.
Telehealth providers emerged quickly
One of the major providers of the telehealth pills is the Massachusetts Abortion Access Project. Cofounder Angel Foster said the group prescribed to about 500 patients a month, mostly in states with bans, from its September 2023 launch through last month.
The group charged $250 per person while allowing people to pay less if they couldn’t afford that. Starting this month, with the help of grant funding that pays operating costs, it’s trying a different approach: Setting the price at $5 but letting patients know they’d appreciate more for those who can pay it. Foster said the group is on track to provide 1,500 to 2,000 abortions monthly with the new model.
Foster called the Supreme Court’s 2020 decision “a human rights and social justice catastrophe” while also saying that “there’s an irony in what’s happened in the post-Dobbs landscape.”
“In some places abortion care is more accessible and affordable than it was,” she said.
There have no major legal challenges of shield laws so far, but abortion opponents have tried to get one of the main pills removed from the market. Earlier this year, the U.S. Supreme Court unanimously preserved access to the drug, mifepristone, while finding that a group of anti-abortion doctors and organizations did not have the legal right to challenge the 2000 federal approval of the drug.
This month, three states asked a judge for permission to file a lawsuit aimed at rolling back federal decisions that allowed easier access to the pill — including through telehealth.
