image:
A 3D rendering shows one of the isolated antibodies, FluB-393, (blue) binding to the neuraminidase surface glycoprotein (red) of the influenza type B virus to prevent infection.
Credit: Illustration by Elad Binshtein, PhD, and Anthony Czelusniak
Researchers at Vanderbilt University Medical Center have isolated human monoclonal antibodies against influenza B, a significant public health threat that disproportionately affects children, the elderly and other immunocompromised individuals.
Seasonal flu vaccines cover influenza B and the more common influenza A but do not stimulate the broadest possible range of immune responses against both viruses. In addition, people whose immune systems have been weakened by age or illness may not respond effectively to the flu shot.
Small-molecule drugs that block neuraminidase, a major surface glycoprotein of the influenza virus, can help treat early infection, but they provide limited benefit when the infection is more severe, and they are generally less effective in treating influenza B infections. Thus, another way to combat this virus is needed.
Reporting in the journal Immunity, the VUMC researchers describe how, from the bone marrow of an individual previously vaccinated against influenza, they isolated two groups of monoclonal antibodies that bound to distinct parts of the neuraminidase glycoprotein on the surface of influenza B.
One of the antibodies, FluB-400, broadly inhibited virus replication in laboratory cultures of human respiratory epithelial cells. It also protected against influenza B in animal models when given by injection or through the nostrils.
Intranasal antibody administration may be more effective and have fewer systemic side effects than more typical routes intravenous infusion or intramuscular injection in part because intranasal antibodies may trap the virus in the nasal mucus, thereby preventing infection of the underlying epithelial surface, the researchers suggested.
These findings support the development of FluB-400 for the prevention and treatment of influenza B and will help guide efforts to develop a universal influenza vaccine, they said.
Antibodies increasingly have become an interesting medical tool to prevent or treat viral infections, said the papers corresponding author, James Crowe Jr., MD. We set out to find antibodies for the type B influenza virus, which continues to be a medical problem, and we were happy to find such especially powerful molecules in our search.
Crowe, who holds the Ann Scott Carell Chair, is University Distinguished Professor of Pediatrics and director of the Vanderbilt Vaccine Center, which has isolated monoclonal antibodies against a host of viral infections, including COVID-19.
The papers first author, Rachael Wolters, DVM, PhD, is a former graduate student in the Crowe lab. Other VUMC co-authors are Elaine Chen, PhD, Ty Sornberger, Luke Myers, Laura Handal, Taylor Engdahl, Nurgen Kose, Lauren Williamson, PhD, Buddy Creech, MD, and Katherine Gibson-Corley, DVM, PhD.
This study was supported in part by National Institutes of Health grants T32AI112541, K01OD036063 and U01AI150739, NIH-HHS contracts 75N93019C00074 and 75N93019C00073, and the Collaborative Influenza Vaccine Innovation Centers program of the National Institute of Allergy and Infectious Diseases.
Illustration: A 3D rendering shows one of the isolated antibodies, FluB-393, (blue) binding to the neuraminidase surface glycoprotein (red) of the influenza type B virus to prevent infection.
(illustration by Elad Binshtein, PhD, and Anthony Czelusniak)
Article|Online Now PDF Figures Save Share Reprints Request Isolation of human antibodies against influenza B neuraminidase and mechanisms of protection at the airway interface
31-May-2024
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The United States and Europe are taking steps to acquire or manufacture H5N1 bird flu vaccines that could be used to protect at-risk poultry and dairy workers, veterinarians and lab technicians, government officials said, moves influenza experts say could curb the threat of a pandemic.
U.S officials last week said they were moving bulk vaccine from CSL Seqirus that closely matches the current virus into finished shots that could provide 4.8 million doses of vaccine. European health officials told Reuters they were in talks to acquire CSL's prepandemic vaccine.
Canadian health officials said they have met with GSK, maker of Canada's seasonal flu shots, to discuss acquiring and manufacturing a prepandemic bird flu vaccine once its seasonal flu production capacity is freed up.
SECOND AMERICAN CONTRACTS BIRD FLU TIED TO DAIRY COWS AS CDC SAYS RISK OF INFECTION STILL LOW
Other countries, including the UK, are discussing how to proceed on prepandemic vaccines, scientists said.
A dairy farmer is seen herding cows in Ontario, Canada, on March 24, 2020. The U.S. and Europe are taking steps to acquire or manufacture H5N1 bird flu vaccines that could be used to protect at-risk poultry and dairy workers. (REUTERS/Alex Filipe/File Photo)
The actions follow the explosive spread of a new strain of bird flu that emerged in late 2020 and has caused unprecedented numbers of deaths among wild birds and domestic poultry and has begun infecting many mammal species.
In March, U.S. officials reported the first outbreak of the virus in dairy cattle, which has infected dozens of herds in nine states and two dairy workers. The U.S. Food and Drug Administration has estimated that 20% of the U.S. milk supply shows signs of the virus, indicating a wider spread is likely.
Human exposures to the virus in poultry and dairy operations could increase the risk that the virus will mutate and gain the ability to spread easily in people.
DESPITE GROWING CONCERNS OVER BIRD FLU, MANY US DAIRY WORKERS HAVE NOT RECEIVED PROTECTIVE EQUIPMENT
"All of our efforts need to be focused on preventing those events from happening," said Matthew Miller, co-director of the Canadian Pandemic Preparedness Hub at McMaster University. "Once we have widespread infections of humans, we're in big trouble."
Dr. Angela Rasmussen, a virologist at the University of Saskatchewan, said she has been in discussions with U.S. and Canadian officials about using vaccines to protect workers following the virus' spread into new mammal species.
Dawn O'Connell of the U.S. Administration for Strategic Preparedness and Response said the government is "looking closely" at the possibility of vaccinating farm workers and others in close contact with the virus.
The U.S. has contracts with CSL and GSK to test prepandemic vaccines that more closely match the circulating virus than older H5N1 vaccines in the stockpile. The U.S. is moving forward with the CSL vaccine, a Department of Health and Human Services official confirmed.
Discussions about prepandemic vaccine use are going on at government levels and among scientists in a number of places, including in the UK, said Wendy Barclay, chair in influenza virology at University College London, who also researches avian flu for the UK Health Security Agency.
If deployed strategically to dairy farmers, healthcare workers and those in close contact with infected animals, "it would put a pin in the virus," she said, although she said it was not clear if this step was necessary yet.
The UK government did not comment but said it is monitoring the situation in the U.S.
In Europe, the European Commission's Health Emergency Preparedness and Response Authority is working on a joint procurement of CSL Seqirus's vaccine to "potentially prevent a pandemic" sparked by individuals exposed to infected birds and animals, spokesman Stefan De Keersmaecker told Reuters.
A spokeswoman for CSL, which has contracts for pandemic influenza vaccines with 30 governments, said the company has been in talks with several governments about procuring vaccines since 2022. Those requests have accelerated with the U.S. outbreak, she said.
PREPANDEMIC STOCKPILE
The U.S. maintains a stockpile of prepandemic vaccine candidates and bulk vaccine against an array of influenza strains and conducts clinical trials to support an Emergency Use Authorization or FDA license in the event of pandemic.
Seasonal flu vaccine makers, including Sanofi, could also be asked to shift to producing pandemic flu vaccines.
The U.S. is in talks with mRNA vaccine makers Pfizer and Moderna about potential pandemic vaccines.
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Dr. Richard Webby, a St. Jude Children's Research Hospital virologist who studies flu in animals and birds for the World Health Organization, said the situation in dairy cattle merits vaccine use.
"If we look at the exposure levels that some of these farmers are getting, it's high," Webby said.
The decision on how and when to use the vaccine will hinge on evidence of increased transmission, severity of disease, cases in people with no link to a dairy farm and mutations in the virus, U.S. Centers for Disease Control and Prevention Principal Deputy Director Nirav Shah said.
Dutch flu virologist Ron Fouchier of the Erasmus MC in Rotterdam, who has conducted experiments mapping the changes necessary for bird flu to spark a pandemic, said Europe's plan is to procure the CSL vaccine for people occupationally exposed to the virus.
His lab could well be eligible if a vaccine becomes available, he said, adding, "I would certainly take it."
The bird flu outbreak in U.S. dairy cows is prompting development of new, next-generation mRNA vaccines akin to COVID-19 shots that are being tested in both animals and people.
This month, the U.S. Agriculture Department is to begin testing a vaccine developed by University of Pennsylvania researchers by giving it to calves. The idea: If vaccinating cows protects dairy workers, that could mean fewer chances for the virus to jump into people and mutate in ways that could spur human-to-human spread.
Meanwhile, the U.S. Department of Health and Human Services has been talking to manufacturers about possible mRNA flu vaccines for people that, if needed, could supplement millions of bird flu vaccine doses already in government hands.
If theres a pandemic, theres going to be a huge demand for vaccine, said Richard Webby, a flu researcher at St. Jude Childrens Research Hospital in Memphis. The more different (vaccine manufacturing) platforms that can respond to that, the better.
The bird flu virus has been spreading among more animal species in scores of countries since 2020. It was detected in U.S. dairy herds in March, although investigators think it may have been in cows since December. This week, the USDA announced it had been found in alpacas for the first time.
At least three people all workers at farms with infected cows have been diagnosed with bird flu, although the illnesses were considered mild.
But earlier versions of the same H5N1 flu virus have been highly lethal to humans in other parts of the world. Officials are taking steps to be prepared if the virus mutates in a way to make it more deadly or enables it to spread more easily from person to person.
Traditionally, most flu vaccines are made via an egg-based manufacturing process thats been used for more than 70 years. It involves injecting a candidate virus into fertilized chicken eggs, which are incubated for several days to allow the viruses to grow. Fluid is harvested from the eggs and is used as the basis for vaccines, with killed or weakened virus priming the bodys immune system.
Rather than eggs also vulnerable to bird flu-caused supply constraints some flu vaccine is made in giant vats of cells.
Officials say they already have two candidate vaccines for people that appear to be well-matched to the bird flu virus in U.S. dairy herds. The U.S. Centers for Disease Control and Prevention used the circulating bird flu virus as the seed strain for them.
The government has hundreds of thousands of vaccine doses in pre-filled syringes and vials that likely could go out in a matter of weeks, if needed, federal health officials say.
They also say they have bulk antigen that could generate nearly 10 million more doses that could be filled, finished and distributed in a matter of a few months. CSL Seqirus, which manufactures cell-based flu vaccine, this week announced that the government hired it to fill and finish about 4.8 million of those doses. The work could be done by late summer, U.S. health officials said this week.
But the production lines for flu vaccines are already working on this falls seasonal shots work that would have to be interrupted to produce millions more doses of bird flu vaccine. So the government has been pursuing another, quicker approach: the mRNA technology used to produce the primary vaccines deployed against COVID-19.
These messenger RNA vaccines are made using a small section of genetic material from the virus. The genetic blueprint is designed to teach the body how to make a protein used to build immunity.
The pharmaceutical company Moderna already has a bird flu mRNA vaccine in very early-stage human testing. In a statement, Moderna confirmed that we are in discussions with the U.S. government on advancing our pandemic flu candidate.
Similar work has been going on at Pfizer. Company researchers in December gave human volunteers an mRNA vaccine against a bird flu strain thats similar to but not exactly the same as the one in cows. Since then, researchers have performed a lab experiment exposing blood samples from those volunteers to the strain seen in dairy farms, and saw a notable increases in antibody responses, Pfizer said in a statement.
As for the vaccine for cows, Penn immunologist Scott Hensley worked with mRNA pioneer and Nobel laureate Drew Weissman to produce the experimental doses. Hensley said that vaccine is similar to the Moderna one for people.
In first-step testing, mice and ferrets produced high levels of bird flu virus-fighting antibodies after vaccination.
In another experiment, researchers vaccinated one group of ferrets and deliberately infected them, and then compared what happened to ferrets that hadnt been vaccinated. All the vaccinated animals survived and the unvaccinated did not, Hensley said.
The vaccine was really successful, said Webby, whose lab did that work last year in collaboration with Hensley.
The cow study will be akin to the first-step testing initially done in smaller animals. The plan is for initially about 10 calves to be vaccinated, half with one dose and half with another. Then their blood will be drawn and examined to look for how much bird flu-fighting antibodies were produced.
The USDA study first will have to determine the right dose for such a large animal, Hensley said, before testing if it protects them like it did smaller animals.
What scares me the most is the amount of interaction between cattle and humans, Hensley said.
Were not talking about an animal that lives on a mountain top, he said. If this was a bobcat outbreak Id feel bad for the bobcats, but thats not a big human risk.
If a vaccine reduces the amount of virus in the cow, then ultimately we reduce the chance that a mutant virus that spreads in humans is going to emerge, he said.
As cases of the disease caused by the mpox virus increase around the country and in Massachusetts, health experts are encouraging at-risk people to get vaccinated.
The first documented case of the virus in the United States was found in Massachusetts in May of 2022, and by the end of that year nearly 500 cases had been documented in the state.
Last year, things seemed to be more under control as mpox was found in just six people in Massachusetts. Already this year, there have been 16 mpox cases in the state.
Were concerned that the 16 that we have here can explode into hundreds of cases, said Dr. Cassandra Pierre, an infectious disease physician who is the associate hospital epidemiologist and medical director of public health programs at Boston Medical Center.
Mpox is not a sexually transmitted disease, but it is associated with sexual activity, Pierre said. The majority of individuals who weve seen infected with mpox are gay, bisexual and other men who have sex with men. Over 90% of the cases have been reported in that population.
The virus can cause painful skin lesions and other symptoms, which can last for several weeks. (While the virus itself is still commonly called monkeypox, the WHO recently changed the name of the disease it causes to mpox.)
Weve had conversations with the DPH already earlier this year about this issue as we started to see more people who were infected and unvaccinated for mpox, Pierre said, referring to the Massachusetts Department of Public Health.
Mpox vaccines are now widely available, said Dr. Kevin Ard, director of the sexual health clinic at Massachusetts General Hospital.
There is a DPH website that can show people where they can get vaccines, and we provide the vaccine at no cost right now, Ard said. So, theres really no supply limitation like there was very early, when the outbreak first began.
Nationally, Ard said, low vaccination rates are contributing to an increased risk of another outbreak.
The vaccine rates in Massachusetts are higher than the national average, so I think our risk for an outbreak is probably lower, he said. But still in Massachusetts, there are many people who are eligible for the vaccine who havent had it.
The number of cases in the 2022 outbreak spiked in the summer, Pierre said, raising concern that a similar surge could be seen again.
We are concerned that, going into the summer, there remain a large population of at-risk individuals who are unvaccinated and therefore at risk, Pierre said.
It takes two doses of the vaccine for people to be considered fully vaccinated, Ard said.
People can protect themselves by getting vaccinated if theyve not had any vaccines, Ard said. And if theyve only had one vaccine, they should go ahead and get the second vaccine because we think that that provides the highest protection.
Mass General Hospital plans to offer free vaccinations at Boston Pride events over the next month, Ard said.
Both Pierre and Ard also expressed concerns that a more dangerous variant could be on its way.
In a report, the CDC issued a warning earlier this month about clade I.
The type of virus thats been circulating in the United States so far is known as clade II, but another variant, known as clade I is currently having an outbreak in the Democratic Republic of Congo. That variant causes more severe illness and is associated with higher rates of mortality. No cases have been detected in the United States.
We are concerned about the threat that clade I poses to the population at risk, Pierre said. Especially higher risk people who are unvaccinated.
With summer approaching and Pride celebrations nearing, San Francisco public health officials are again encouraging residents to be fully vaccinated against mpox, known also as monkeypox.
The San Francisco Department of Public Health said Tuesday that while there is not currently a rise in mpox cases in the city, the virus still circulates in the U.S. The agency also noted the Centers for Disease Control and Prevention is monitoring an outbreak of a different strain of the mpox virus that causes more severe disease and is currently spreading in the Democratic Republic of the Congo.
"With summer celebrations such as Pride approaching, now is a great time to protect yourself against mpox by getting vaccinated. The mpox vaccine is available through health systems and at clinics," San Francisco Health Officer Dr. Susan Philip said in a statement. "Even if you are fully vaccinated, it is still important to remain diligent since no vaccine is 100% effective. If you are experiencing symptoms of mpox such as a rash that looks like pimples or blisters, talk to your health care provider about getting tested, and talk to your partners so they can be informed and prevent the spread of infection."
To be fully vaccinated against mpox, health officials say it takes two doses of vaccine.
"Individuals can receive their second dose of the mpox vaccine if it has been at least 28 days since their first dose. There is no need to restart the two-dose series if it has been over 28 days since the first dose. Booster doses are not recommended at this time for those who have completed the two-dose series. In addition, mpox vaccination is not recommended at this time for those who have previously been infected," the SFDPH said.
The health department also recommends and encourages two-dose vaccination for all people living with HIV, anyone taking or eligible to take HIV PrEP, and all men, trans people, and nonbinary people who have sex with men, trans people, or nonbinary people.
Queensland has recorded 10 locally acquired cases of mpox this month in the state's biggest cluster of the virus.
All cases of the disease, formerly known as monkeypox, are linked and contact tracing is underway to potentially locate more people with the infection.
Public health physician Olivia Williams said the current risk to the public is low.
"It is not easily transmitted from person to person without prolonged close or intimate contact," Dr Williams said.
She said no connection had been found to an mpox outbreak in Victoria where 16 confirmed cases have been reported since April 18, 13 of them locally acquired.
"We're still investigating but there is no evidence of a link to Victoria at the moment," Dr Williams said.
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She said the virus was spread by close physical contact with an infected person, through both bodily secretions and skin-to-skin contact.
"There is some evidence that contaminated objects particularly things like clothing, sheets, towels that have been in contact with an infected person, particularly skin lesions or body secretions, can transmit the infection as well," Dr Williams said.
Most Australian mpox cases have been in men who have sex with men.
Dr Williams of Queensland Health's communicable diseases branch said high risk groups, including sex workers, were eligible for free vaccines through sexual health clinics and general practitioners.
In addition to reducing the risk of infection and severe disease, she said vaccination also slashed the chances of the illness spreading.
Free vaccination may also be considered for laboratory scientists who analyse mpox samples and healthcare workers exposed to the illness in patients.
Two vaccine shots are required for optimal effectiveness, 28 days apart.
"Queensland has good supply of mpox vaccine," Dr Williams said.
She said mpox vaccine is also routinely offered to close contacts of newly-diagnosed cases.
Mpox was first reported in Australia in May 2022, with Queensland recording two cases in 2023 and six in 2022.
Dr Williams said mpox infections were generally "fairly mild" and managed at home.
However, some people could become very ill and require admission to hospital.
"If you think you have mpox, seek medical advice and get tested," she said.
Most of the state's new cases have been recorded across five hospital and health services Metro North, Metro South, West Moreton, Darling Downs, and Sunshine Coast.
The disease causes a distinctive rash and lesions that turn into pimples, blisters or sores, and may lead to ulcers and scabs. Lesions can vary in size and number.
Other symptoms can include swollen lymph nodes, fever, sore throat, headache, muscle aches, joint pain, back pain, chills, rectal pain, and exhaustion.
Symptoms begin from five to 21 days after exposure to the virus.
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Study also shows that patients hospitalized within 30 days after infection face 29% higher death risk in 3rd year compared with those not infected
New findings on long COVID by Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system reveal that COVID-19 patients who were hospitalized within the first 30 days after infection face a 29% higher risk of death in the third year post-infection compared with people who have not had the virus. However, the three-year death risk marks a significant decline compared with such risk at previous time points post-infection. The study also shows that even people with mild COVID-19 still experienced new health problems related to the infection three years later.
New findings on long COVID long-term effects on health experienced by many who have had COVID-19 present a good-news, bad-news situation, according to a study at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system.
The bad news: COVID-19 patients who were hospitalized within the first 30 days after infection face a 29% higher risk of death in the third year compared with people who have not had the virus. However, the three-year death risk still marks a significant decline compared with such risk at the one- and two-year marks post-infection. The findings also show that even people with mild COVID-19 were still experiencing new health problems related to the infection three years later.
The good news: The increased risk of death diminishes significantly one year after a SARS-CoV-2 infection among people who were not hospitalized for the virus. This demographic accounts for most people who have had COVID-19.
The new research, published May 30 in Nature Medicine, tracked the viruss health effects in people three years after being infected with the original strain of COVID-19 in 2020. That year, about 20 million people tested positive for the virus in the U.S. The new study assessed the risk of death and 80 adverse health conditions in people three years after being diagnosed with COVID-19.
We arent sure why the viruss effects linger for so long, said senior author Ziyad Al-Aly, MD, a Washington University clinical epidemiologist and a global leader in long COVID research. Possibly it has to do with viral persistence, chronic inflammation, immune dysfunction or all the above. We tend to think of infections as mostly short-term illnesses with health effects that manifest around the time of infection. Our data challenges this notion. I feel COVID-19 continues to teach us and this is an important new lesson that a brief, seemingly innocuous or benign encounter with the virus can still lead to health problems years later.
Up to 10% of people infected with the virus experience long COVID, according to federal data.
Al-Alys prior research has documented COVID-19s damage to nearly every human organ, contributing to diseases and conditions affecting the lungs, heart, brain, and the bodys blood, musculoskeletal and gastrointestinal (GI) systems.
Such studies with longer follow-up are limited, said Al-Aly, a nephrologist who treats patients at the Washington University-affiliated John J. Cochran Veterans Hospital in midtown St. Louis. Addressing this knowledge gap is critical to enhance our understanding of long COVID and will help inform care for people suffering from long COVID.
Al-Aly and his team analyzed millions of de-identified medical records in a database maintained by the U.S. Department of Veterans Affairs, the nations largest integrated health-care system. The study included more than 114,000 veterans with mild COVID-19 who did not require hospitalization; more than 20,000 hospitalized COVID-19 patients; and 5.2 million veterans with no COVID-19 diagnosis. Patients were enrolled in the study from March 1, 2020, to Dec. 31, 2020, and followed for at least three years, until Dec. 31, 2023. Patients included people of diverse ages, races and sexes; statistical modeling ensured parity in representation.
In the third year after infection, COVID-19 patients who had been hospitalized experienced a 34% elevated health risk across all organ systems compared with people who did not have COVID. That number is down from a 182% increased risk one year after a COVID infection and a 57% risk two years after.
Among nonhospitalized patients, researchers found a 5% increased risk in suffering from long COVID in the third year after infection. This translates into 41 more health problems per 1,000 persons a small but not trivial burden. The long-term health effects in the third year primarily affected the GI, pulmonary and neurological systems. By comparison, the risk was increased by 23% one year after infection and increased by 16% two years after.
In the analysis, researchers also measured and compared the number of healthy life-years lost due to COVID-19. They found that among the nonhospitalized, at three years after infection, COVID-19 had contributed to 10 lost years of healthy life per 1,000 persons. By comparison, three years post-infection, those hospitalized for COVID-19 had experienced 90 lost years of healthy life per 1,000 persons.
For context, in the U.S., heart disease and cancer each cause about 50 lost years of healthy life per 1,000 persons, while stroke contributes to 10 lost years of healthy life per 1,000 persons.
That a mild SARS-CoV-2 infection can lead to new health problems three years down the road is a sobering finding, said Al-Aly, who is also director of the Clinical Epidemiology Center at the VA St. Louis Health Care System, and head of the research and development service. The problem is even worse for people with severe SARS-CoV-2 infection. It is very concerning that the burden of disease among hospitalized individuals is astronomically higher.
COVID-19 is a serious threat to the long-term health and well-being of people and it should not be trivialized, he said.
The extended trajectory for long COVID may change as researchers incorporate data from years beyond 2020. At that time, vaccines and antivirals had not been developed. Similarly, Al-Alys analysis does not consider subsequent variants such as omicron or delta.
Even three years out, you might have forgotten about COVID-19, but COVID hasnt forgotten about you, Al-Aly said. People might think theyre out of the woods, because they had the virus and did not experience health problems. But three years after infection, the virus could still be wreaking havoc and causing disease or illness in the gut, lungs or brain.
Cai M, Xie Y, Topol E, Al-Aly Z. Three-year outcomes of post-acute sequelae of COVID-19. Nature Medicine. May 30, 2024. DOI: https://doi.org/10.1038/s41591-024-02987-8.
This research was funded by the U.S. Department of Veterans Affairs.
About Washington University School of Medicine
WashU Medicine is a global leader in academic medicine, including biomedical research, patient care and educational programs with 2,900 faculty. Its National Institutes of Health (NIH) research funding portfolio is the second largest among U.S. medical schools and has grown 56% in the last seven years. Together with institutional investment, WashU Medicine commits well over $1 billion annually to basic and clinical research innovation and training. Its faculty practice is consistently within the top five in the country, with more than 1,900 faculty physicians practicing at 130 locations and who are also the medical staffs of Barnes-Jewish and St. Louis Childrens hospitals of BJC HealthCare. WashU Medicine has a storied history in MD/PhD training, recently dedicated $100 million to scholarships and curriculum renewal for its medical students, and is home to top-notch training programs in every medical subspecialty as well as physical therapy, occupational therapy, and audiology and communications sciences.
In Congress next month, Republicans will question former Gov. Andrew Cuomo and other officials on how New Yorks leaders responded to the COVID-19 pandemic. The result will likely be a display of grandstanding and exaggeration, as political opportunists use the hearing to push their own agendas.
Yet here in New York, we have yet to conduct our own, truly independent accounting of how the state handled COVID. Democrats should be the party of accountability, honesty, and science yet even D.C. extremists are ahead of us in reviewing New Yorks COVID response.
Instead of allowing this Washington politicized circus to posture as an assessment of the pandemic response, New Yorks leaders should create a truly independent, external commission to provide an unbiased, apolitical assessment of the states COVID response.
As elected officials representing districts in the epicenter of the pandemic, we worked tirelessly to help provide for our communities throughout COVID-19, and to support those who tragically lost family members and loved ones, as well as survivors who are now chronically ill and disabled. Now, four years later, we owe it to those same communities to keep fighting for them to deliver accountability and transparency around what transpired in those weeks and months after COVID-19 hit New York.
Allowing the past to go unexamined has resulted in legitimate questions from the public about what the state is hiding. Are Democrats unwilling to examine actions by members of their own party? Are public hearings and commissions only used when politically expedient and denied when they could turn up uncomfortable truths?
Creating a truly independent commission would underscore a commitment to accountability that transcends politics sending a clear message that we put the wellbeing of New Yorkers above all else.
When any natural disaster or statewide emergency leads to tens of thousands of deaths, we have a responsibility to our constituents to review what happened, identify potential missteps, and learn from these errors. In the case of COVID-19, numerous questions were raised around the states decision to require nursing homes to accept COVID-positive patients and the high rate of nursing home deaths that ensued.
Rather than sweep this recent history under the rug, the government has a duty to provide an honest, independent accounting of the events and decisions that led to these deaths. To date, however, the only review ordered by state leaders is a study conducted by a consulting firm without the authority to subpoena witnesses or review documents. This study may contribute to our understanding of the COVID aftermath, but it is far from sufficient on its own.
In our districts, families lost parents, grandparents and loved ones and these families deserve accountability. Beyond immediate accountability, we have a responsibility to ensure this outcome does not happen again. Our state will inevitably face health emergencies in the years to come. Preventing future tragedies requires looking backward and assessing the states response with clear-eyed realism, rather than ignoring the past and hoping for the best.
In Albany, we introduced legislation to establish the COVID-19 Pandemic Response Study Commission a fully independent commission of issue experts with the support, funding and tools they need, including subpoena power to speak with any relevant witnesses and review all materials and documents.
This commission would hold public hearings so New Yorkers themselves could hear directly from experts about what transpired in March 2020. It would produce a thorough study that includes a full accounting of the actions taken during the pandemic, determines what errors were made, and most importantly identify solutions to prevent and mitigate potential harm from future tragedies particularly for communities and businesses that were disproportionately impacted by COVID-19.
Only a truly independent commission will ensure the assessment is objective and fact-based; only full subpoena power will ensure the findings are comprehensive and complete.
As elected officials, our constituents empowered us with the authority and responsibility to protect our communities and this includes protection from public health crises. If we allow the recent history of COVID-19 to go unexamined, we have failed to take every step possible to protect New Yorkers from similar tragedies in the future.
New Yorkers deserve more than politicized Washington interviews and a toothless consulting firm review they deserve for Albany to take every step possible to learn from the past so we can fully prepare for the future.
Salazar represents parts of Brooklyn in the state Senate. Gonzalez-Rojas represents parts of Queens in the Assembly.
London
Life expectancy in Europe has returned to the level it reached before the 2020 coronavirus pandemic, while the U.S. is still trying to regain lost ground. Overall, new numbers show life expectancy has increased in most parts of the world, with eastern sub-Saharan Africa showing the biggest gains over the past three decades.
European Union figures released this month show the average life expectancy across the bloc in 2023 was 81.5 years, representing almost a year's gain over 2022, as the coronavirus pandemic was coming to an end.
However, there are marked variations between European countries, noted Jennifer Beam Dowd, a professor of demography and population health and deputy director of the Leverhulme Center for Demographic Science at the University of Oxford.
Within Europe, we're seeing really high life expectancy in countries like Spain and Italy, Sweden, Norway, but some countries are falling behind their peers and that includes the U.K., she said. And then Eastern Europe has made a lot of progress since the post-Soviet mortality crisis of the 1990s, but they're still lagging behind a bit.
In higher income countries, we've seen continued rapid drops in deaths due to cardiovascular disease that has probably made the biggest impact on those numbers over the last 30 years or so. The leaders right now really are some East Asian countries, especially Japan, Hong Kong and Taiwan and South Korea, are doing really well, Dowd told VOA.
A recent study published in the Lancet journal showed that globally, life expectancy increased by 6.2 years between 1990 and 2021, with eastern sub-Saharan Africa experiencing the largest increase of some 10.7 years. This is attributed to progress in tackling the major causes of death among children, such as diarrhea.
I think that's really good news and reflects a lot of continued progress all over the world in falls and infectious disease and infant and child mortality, which makes a big difference to life expectancy because you're saving a lot of years of life if you save lives at young ages, said Dowd.
Figures released in March showed average life expectancy in the United States in 2022, the most recent data available, was 77.5 years still more than a year lower than life expectancy before the coronavirus pandemic, which began in 2020. U.S. life expectancy figures for 2023 have not yet been released.
The Lancet study estimated that almost 16 million deaths were caused by COVID-19 in 2020 and 2021, at the height of the pandemic.
The United States and Britain have struggled to regain lost ground compared to other developed countries, said Dowd.
A lot of countries have bounced back close to pre-pandemic life expectancy, but some countries such as the U.S. have not returned yet to the levels they were at in 2019, she said.
Another thing that's having a big impact, we think right now, is the obesity epidemic, which started taking off, especially in the U.S., in the early 1980s. And in fact, we are seeing major slowdowns in improvements from cardiovascular disease that are driving a lot of the stalling life expectancy in high-income countries.
The U.S. was on the leading edge of that epidemic which also means that people reaching old age now in the U.S. have perhaps been suffering from obesity for many decades and that could be contributing to these trends in cardiovascular disease. But there's also differences across these countries in health care regimes that protect health, especially at older ages, and other social safety nets that we think are health-promoting, Dowd added.
The European principality of Monaco, a favorite home for the super-rich, had the worlds highest life expectancy in 2023, at almost 90 years.
(CNN) Memorial Day is here, and soon summer will arrive. The threat of some diseases, such as Covid-19 is receding, though there arenew coronavirus variantsto keep an eye on, anda secondhuman case of the bird fluhas just been detected in the United States.
With Memorial Day gatherings getting underway in the US, how worried should people be about the coronavirus and bird flu? Knowing that there are outbreaks of bird flu among poultry and cows, is it safe to keep drinking milk and eating eggs? Are there any special precautions to take while preparing hamburgers? What are other major health issues to consider over the holidays and leading into the summer, such as keeping cool to avoid heatstroke?
To help us through these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and clinical associate professor at George Washington University, and she previously was Baltimores health commissioner.
CNN: Given the spread of avian flu and new coronavirus variants, is there anything we should do?
Dr. Leana Wen:Though there arenew coronavirus variants, the level of coronavirus activity in the United States is quite low. People shouldassess their riskof severe illness if they were to contract Covid-19. Those at high risk, such as those who are elderly or with chronic medical conditions, should be sure that they are up to date with vaccines and have a plan for accessing antiviral treatment. They should test if they experience symptoms, and so should others with whom they have close contact.
Those who want to reduce their risk of contracting the coronavirus and other respiratory viruses further should try to attend outdoor rather than indoor gatherings when possible. When traveling in crowded airports and train stations, they could consider wearing well-fitting N95 or equivalent masks.
Regarding bird flu, theUS Centers for Disease Control and Preventioncontinues to advise that the risk to Americans is low at this time. Thats because there have only beentwo human casesthis year, and both have been in farmworkers with direct exposure to infected cattle. Both individuals had mild symptoms, and there have been no cases of human-to-human transmission during this outbreak.
People who work in the poultry and dairy industry and who otherwise come into regular contact with wild birds, backyard flocks and cows should heed theCDCs guidanceand wear personal protective equipment when working with animals. Health care providers should be on the lookout for farmworkers with possible flulike symptoms. Other people do not need to change their behaviors at this time, and they certainly should not worry about infection with avian flu during Memorial Day or early summer gatherings.
CNN: Does that mean its still safe to keep drinking milk and eating eggs and meat?
Wen:Yes. The US Food and Drug Administrationhasissued guidancethat pasteurized milk is safe to drink.Viral fragments have been in found in the commercial milk supply; however, these were not live viruses that could cause infections. Pasteurization kills viruses, including the influenza virus.
Similarly, testing by the US Department of Agriculture foundno live virusin hamburgers cooked to 145 degrees Fahrenheit. The agency advises thatcooked eggs and poultryare also safe to eat.
This, of course, does not mean that people should consume raw or undercooked meat. These meats harbor a whole variety of pathogens, including bacteria like E. coli and salmonella. In addition, raw milk is not safe to drink. This, too, can harbor bacteria. Moreover, one hypothesis for how avian flu is being transmitted is throughraw milk. People should not consume unpasteurized milk or products made from raw milk.
CNN: How does this translate to gatherings? Is it OK to eat hamburgers and hot dogs, and enjoy barbecues and buffets?
Wen:Yes! Make sure to followgeneral precautionsaround preventing foodborne illnesses. Cook meat to therecommended internal temperatures. Be aware of what containers or utensils come into contact with raw meat and keep clean utensils separate from dirty ones. Refrigerate meat until ready to cook. If you use a cooler, make sure to have an insulated one with lots of ice. And wash your hands often and well.
CNN: Weve talked a lot about infections. Whatare other major health issues to consider over the holidays and leading into the summer, such as keeping cool to prevent heatstroke?
Wen:When the weather gets hot outside, we have to watch out for theeffects of high temperatures on health. Heatstroke occurs when someone has a body temperature above 103 degrees Fahrenheit and can no longer effectively cool themselves. This is a medical emergency and can quickly become fatal.
People should be aware of the symptoms of heat exhaustion, which can progress to heatstroke. They should watch out for those most vulnerable to heat-related illnesses. That includes children and the elderly and other individuals with medical conditions that reduce their ability to regulate their body temperatures.
When high temperatures are forecast, everyone especially the most vulnerable should try to stay inside in air-conditioned spaces or under the shade if they are outdoors. They should keep hydrated and immediately seek shelter in a cool place if they develop symptoms such as headaches, dizziness, muscle aches and tiredness.
CNN: And we cant forget skin protection, right?
Wen:Absolutely.Skin canceris the most common cancer in the United States. One of the key risk factors is exposure to ultraviolet (UV) rays. Everyone should take steps to reduce their UV exposure. These include staying in the shade, wearing a hat and usingbroad-spectrum sunscreenwith a sun protection factor (SPF) of at least 30.
Speaking of prevention, summers are often a period of the year when people have more time on their hands. I advise everyone to take this chance and follow up with their physician on all their health concerns. Now is the time to make sure they are up to date oncancer screeningsand to get chronic medical concerns, like high blood pressure and diabetes, under good control.
