Mapping Billionaire Wealth: Where The Richest Americans Live Now Vs. Two Decades Ago

Billionaires love sunshine and low taxes — but not always.

By Monica Hunter-Hart, Contributor


“California used to be the Golden State. Now it’s rusted and destroyed,” says energy drinks magnate Russ Weiner. In a way, the state’s flush with gold; California is a treasure trove of extreme wealth. But some of its most affluent residents, including Weiner (worth an estimated $4.8 billion as of the date of publishing), have also been moving away, Forbes finds in a 20-year analysis of the annual Forbes 400 list of the richest Americans.

California has consistently been home to more members of The Forbes 400 than any other state, and now has 87. But that’s six fewer than two decades ago. Plenty of California-based tech tycoons moved on and off the list over the years as their fortunes fluctuated with the stock market, but some disappeared because billionaires just up and left. Over the past 20 years, while gaining new Forbes 400 residents, California lost 19 of them to other states, particularly Texas, Nevada and Florida, where Rockstar Energy drink founder Weiner moved in 2009.

What made him want to skip town? “Crime, homelessness, education, taxes,” he says. Oh, and Democrats.

Weiner is far from the only uber-wealthy entrepreneur who’s been chasing both rays and lower taxes. Florida and Texas, which have neither state income tax nor state capital gains tax, both saw dramatic 20-year upticks in residents who made the 400 list. Texas went from 36 to 45, a 25% jump, while Florida — stunningly — doubled from 23 to 46 members of the list. Most of the increase in Florida came from Forbes 400 members moving there. That includes the likes of hedge fund tycoon Ken Griffin, a former longtime resident of Chicago, who also relocated his firm Citadel to Miami because he said it offered a better corporate environment; Paychex founder Tom Golisano, who said he was escaping New York’s high taxes when he moved to Naples in 2009; Charles B. Johnson, who moved to Palm Beach from California after retiring from money management firm Franklin Resources; and Thomas Peterffy of Interactive Brokers, who left Connecticut around 2015, also for Palm Beach.

An outsized number of the last decade’s Florida transplants came from the northeastern elite enclaves of New York, Connecticut and Illinois, and most made their fortunes in finance and investments. A far smaller amount of the list’s new Floridians created fortunes in the Sunshine State from the start, like Nick Caporella, whose National Beverage makes the popular La Croix bubbly water.

The picture is much dimmer in the Midwest, which has been shedding the extremely wealthy. The number of richest Americans there dropped 42% over the past two decades, from 73 to 42, mostly because Heartland billionaires’ fortunes decreased or didn’t keep pace with the rest of the country. (The cutoff to make the Forbes 400 rose from $600 million in 2003 to $2.9 billion in 2023.) But some just moved to warmer pastures, like movie producer Gigi Pritzker (who changed her permanent address from Chicago to California around 2019) or two heirs to the Walmart fortune (from Missouri to Texas and Nevada).

And about 30% of Midwesterners on the 2003 and 2013 Forbes 400 lists have since dropped off because they passed away. In the last few years, that’s included iconic figures like Berkshire Hathaway’s Walter Scott Jr. (a former Omaha resident who was a close friend of Warren Buffett) and Chicago’s Sam Zell (forefather of the modern real estate investment trust), and a bit before them, William Ford Sr, the last grandchild of Henry Ford, who lived in Michigan. The manufacturing industry saw a particularly high number of drop-offs — paralleling the decades-long manufacturing decline in the Midwest — as did media, real estate and retail.

Minnesota has been hit hardest. It ranked No. 9 among states with the most 400 members in 2003, when there were 11, but has now been completely drained out. A single family had an outsized impact on that decline. The clan behind the world’s biggest agriculture company, Cargill, used to be concentrated in the North Star State, where the business is still based. But Cargill’s old guard has died and the richest family members are now scattered across the country in Montana, Wisconsin, Missouri and California.

This scenario — where a company’s big shareholders live far from the company itself — is actually not unusual. And it may be even more common these days in a place like Minnesota, says the Tax Foundation’s Jared Walczak.

“Minnesota does very well with traditional C corporations,” says Walczak. “It’s high taxes, but those high taxes historically have not fallen very heavily on businesses, so it’s been a very competitive place to operate your Fortune 500 company. But you also have a situation where states like this may be unattractive for the C-suites themselves,” perhaps in part because of those higher individual taxes. And in an increasingly mobile environment, he points out, not even high-level executives need to live where they work.

Although taxes matter, Walczak and other analysts stress that it’s far from the only consideration for billionaires when it comes to planning where to live. It often isn’t even the top factor.

“Many state lawmakers overestimate how sensitive rich people are to a few percentage points’ difference in the state tax rate,” says Carl Davis of the Institute on Taxation and Economic Policy. Richard Auxier of the Tax Policy Center agrees: “If you’re in West Virginia or Michigan and you think the taxes are the only thing that’s different about your state and Florida and Texas, I really need you to think a bit harder.”

Instead, the decision of where to live is hyper-personal, they say, noting that being closer to family is a frequent reason why billionaires move. The uber-wealthy also pursue top education systems, keeping in mind both their kids as well as their company workforces. Urban amenities are a big draw. So are safe neighborhoods, good infrastructure and centers of culture.

The culture is what AriZona Iced Tea founder Don Vultaggio, raised in Brooklyn and worth an estimated $5.6 billion, loves about New York City. (Vultaggio now lives outside the city, in the Long Island enclave of Port Washington.) He remembers a conversation he once had with Andrew Cuomo: “‘Governor, businesses don’t mind paying taxes. We like it here. Museums, theater. It’s great.’” Many must agree, as the number of New Yorkers on the 400 shot up 27% over the past two decades, from 49 to 62.

Extreme wealth has been consolidating in the United States. Back in 2003, the 10 states with the most 400 members had 275 of them; today, they have 297. Exactly 60% of the billionaires who made the list this year live in just four states: California, New York, Florida and Texas — the four states with the largest populations, together home to one third of all Americans. “The growing geographic concentration helps explain our populist politics these days,” says Darrell West, author of the 2014 book Billionaires: Reflections on the Upper Crust. “Much of the country is being left behind in terms of economic activity.”

A handful of states — Maine, Delaware, North Dakota, New Mexico and Alaska — haven’t had a resident make The Forbes 400 list in at least two decades. On the other hand, the picture has been getting much rosier in places like Arizona and Georgia, which joined the top 10 states for the first time in 2014 (when the latter was tied with Maryland and Tennessee at 7 list members) and now ranks No. 6 with 10 Forbes 400 residents. Iowa and Kentucky both had no 400 members in 2003 and now each have one: Harry Stine (worth an estimated $8.8 billion, who joined the list in 2014), and Tamara Gustavson ($7.4 billion, 2011), respectively.

This is also a great year for Mississippi, which made the list for only the second time in two decades. Joining the ranks of the richest are Hattiesburg’s Duff brothers, who are behind the holding company Duff Capital Investors, which owns construction, energy and trucking firms.

“Mississippi is a good place to do business, mainly because of our people, who are hard-working, optimistic and dedicated to providing a better future for their families,” says Thomas Duff, who’s worth an estimated $3 billion. “Keeping a Mississippi-based operation for our companies has helped us stay true to our values.”

Sitting at the very bottom of the Forbes wealth ranking is Alaska, which has never had a resident make the 400 list since it was first published in 1982. That does constitute a loss for the Last Frontier.

“You would love to have billionaires living in your state,” says the Tax Policy Center’s Auxier, explaining that the attraction is not just tax revenue but also the companies the wealthy often start or bring. “Someone just sitting on their money, they’ll take them, they don’t want to lose them — but if you talk to someone in these states, what they really want is a billionaire who is participating in the economy and hopefully has businesses in the state.”

Of course, there’s only so much a state can do to court the rich. With great wealth comes great mobility. The Americans with the deepest pockets will go where they want.

MORE FROM FORBES

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Tech titans’ vision for a new city in Northern California raises concerns

Silicon Valley tech tycoons on Thursday announced their intentions of building a new city in Northern California. The billionaire investors have to date spent over $900 million to acquire more than 50,000 acres of land in Solano County. Local and US officials, however, have raised concerns about what one Congressman calls “a vision”, not “a plan”.

Investing through a company named California Forever, which saw the launch of its official website on Thursday, tech billionaires are laying out the blueprint for a dream city in Northern California.

On its website, California Forever said it has acquired over 50,000 acres (or 202 square kilometres) of land through its subsidiary – Flannery Associates – in eastern Solano County, which is nestled between Sacramento, the Sacramento-San Joaquin River Delta, San Francisco and Napa Valley in Northern California.

Located at the crossroads of major Northern California cities, Solano County is touted by the company as the perfect place to build the dream city from scratch.

While the website did not disclose the amount that has been injected into the project, the New York Times on Tuesday reported investments of over $900 million in land purchases alone over the past five years.

Founded in 2017 by former Goldman Sachs trader Jan Sramek, California Forever is backed by Silicon Valley heavyweights such as Laurene Powell Jobs, Marc Andreessen, Michael Moritz and John Doerr, among others.

A project shrouded in secrecy

Until Thursday, very little was known about California Forever and Flannery Associates. The parent company and its subsidiary have remained extremely discreet regarding their operations in Northern California.

While Flannery managed to keep most of its activities under wraps, local authorities were alerted when the company started acquiring vast expanses of land, and at prices often well above market rates, until it became Solano County’s largest landowner.

The identity of the company and its billionaire investors only came to light following an investigation led by US federal authorities, who raised concerns of national security after Flannery bought land parcels surrounding Travis Air Force Base, a major base located in Solano County’s seat of Fairfield.

According to the Wall Street Journal, the Air Force’s Foreign Investment Risk Review Office launched a probe in late 2022 into Flannery’s purchases of roughly 52,000 acres in Solano County, including around Travis.

Fears that Flannery was representing foreign interests, especially Chinese, were soon dispelled as Silicon Valley tech titans, who unveiled their project of building a dream city, emerged as backers of the company.

City of dreams?

Citing European cities as inspiration, Flannery said it aims to build liveable communities and walkable neighbourhoods while providing “good-paying local jobs” to residents.

Flannery also revealed plans to build tens of thousands of homes, a solar farm, parks and other open spaces in the eastern part of the county.

Despite the company’s ambitious plans, local authorities have expressed worries regarding the feasibility of the project.

Pointing to Solano County’s dry weather conditions, Fairfield Mayor Catherine Moy said in an interview with abc7news that Flannery’s proposed plans are unrealistic.

“It’s an area that is known for its drought conditions. It makes zero sense. There’s no mass transit. It does not have fresh water. There is some water, but not enough for tens of thousands of homes,” Moy said.

Moy also voiced concerns regarding road infrastructure.

“The roads out there are already dangerous. Highway 12 is the highway that goes through there out to Highway 99 and Highway 5. It’s called Blood Alley for a reason,” Moy said. “There’s no way that tens of thousands of homes could be supported by that.”

While Flannery noted the need to improve local infrastructure on its website, it failed to provide details on how that could be achieved.

Other elected officials have joined Moy in voicing their concerns.

Following a meeting with Flannery representatives on Tuesday, US Representative Mike Thompson said: “They don’t have a plan, they have a vision, an idea,” the San Francisco Chronicle reported.

“To say that this is going to be a long, long road is probably an understatement,” he added.

Meanwhile, US Representative John Garamendi described as “strong-arm mobster tactics” the company’s method of purchasing the land, the Chronicle reported.

Tech follies

But this won’t be the first time that Silicon Valley tycoons have dreamed of pioneering cities without following through.

In 2013, Google cofounder and former CEO Larry Page floated the idea of creating a high-tech utopia with minimal regulation.

California start-up incubator Y Combinator set up a research lab in 2016 to study how to build better cities.

Paypal cofounder Peter Thiel launched a pilot project for floating cities in French Polynesia in 2018, and the New York Times reported the same year that Facebook was negotiating with the city of San Francisco for permits to build a town on the outskirts of Silicon Valley.

None of these proposals have come to fruition to date.

“In the end, it doesn’t even matter that these cities are built,” said University of Glasgow sociology professor Elisabetta Ferrari, who specialises in digital media. For the entrepreneurs and investors, rather, “the most important (thing) is that we talk about it”.

“They want to show that they are not just rich, they are also people with vision and entrepreneurs that are doing something for the people,” she said.

Housing workers

In an article published in April on Tesla CEO Elon Musk’s latest endeavours in Texas, which include building a town called Snailbrook aimed at housing employees, the Guardian compared corporation-built cities to 19th-century US industrial towns.

Offering only basic accommodation and meagre amenities, these towns “were often closer to prison camps than ideal cities”, the Guardian said, and noted that companies “want to minimise overheads and squeeze as much out of their captive townsfolk as they can get away with”.

Flannery aims to provide affordable housing near San Francisco, where many employers have been forced to increase salaries to attract or retain workers who are facing soaring rents in the city.

The number of tech tycoons proposing to build towns and cities in recent years “has a lot to do with the idea of ‘technosolutionism’. A concept that can be boiled down to ‘there is an app for that’,” Ferrari said, adding that it is “the idea that technology provides the best way to address a problem”.

These entrepreneurs and investors “are pitching themselves like they are the best to deal with [the problem], when, they say, political power cannot address efficiently modern urban development challenges”, she said. 

This article has been translated from the original in French.

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Hurricane Hilary weakens but fears of ‘catastrophic flooding’ remain

Forecasters said the storm was still expected to enter the history books as the first tropical storm to hit Southern California in 84 years, bringing flash floods, mudslides, isolated tornadoes, high winds and power outages.

Hurricane Hilary roared toward Mexico’s Baja California peninsula early Sunday as a weakened but still dangerous Category 1 hurricane likely to bring “catastrophic and life-threatening” flooding to the region and cross into the southwestern US as a tropical storm, the National Weather Service said.

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The National Weather Center in Miami said in the most recent advisory at 12 a.m. that the maximum sustained wind speed was 137 kph, down from 145 kph hours earlier. The storm was about 145 kilometres south of Punta Eugenia, Mexico, and 720 kilometres from San Diego, California.

Meteorologists warned that despite weakening, the storm remained treacherous.

One person drowned Saturday in the Mexican town of Santa Rosalia, on the peninsula’s eastern coast, when a vehicle was swept away in an overflowing stream. Rescue workers managed to save four other people, said Edith Aguilar Villavicencio, the mayor of Mulege township.

It was not immediately clear whether officials considered the fatality related to the hurricane, but video posted by local officials showed torrents of water coursing through the town’s streets.

Forecasters said the storm was still expected to enter the history books as the first tropical storm to hit Southern California in 84 years, bringing flash floods, mudslides, isolated tornadoes, high winds and power outages. The forecast prompted authorities to issue an evacuation advisory for Santa Catalina Island, urging residents and beachgoers to leave the tourist destination 37 kilometres off the coast.

Elizabeth Adams, a meteorologist at the National Weather Service San Diego office, said rain could fall up to 37.62 centimetres an hour across Southern California’s mountains and deserts, from late Sunday morning into the afternoon. The intense rainfall during those hours could cause widespread and life-threatening flash floods.

California Governor Gavin Newsom proclaimed a state of emergency, and officials urged people to finish their preparations before sundown Saturday. It would be too late by Sunday, one expert said.

The hurricane is the latest major climate disaster to wreak havoc across the US, Canada and Mexico. Hawaii’s island of Maui is still reeling from last week’s blaze that killed over 100 people and ravaged the historic town of Lahaina, making it the deadliest US wildfire in more than a century. In Canada, firefighters on Saturday continued to battle blazes during the nation’s worst fire season on record.

Hilary brought heavy rain and flooding to Mexico and the southwestern US on Saturday, ahead of the storm’s expected Sunday border crossing. Forecasters warned it could dump up to 25 centimetres — a year’s worth of rain for some areas — in southern California and southern Nevada.

“This does not lessen the threat, especially the flood threat,” Jamie Rhome, the US National Hurricane Center’s deputy director, said during a Saturday briefing to announce the storm’s downgraded status. “Don’t let the weakening trend and the intensity lower your guard.”

Meteorologists also expected the storm to churn up “life-threatening” surf and rip currents, including waves up to 12 metres high, along Mexico’s Pacific coast. Dozens sought refuge at storm shelters in the twin resorts of Los Cabos at the southern tip of the Baja peninsula, and firefighters rescued a family in San Jose del Cabo after the resort was hit by driving rain and wind.

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In Tijuana, fire department head Rafael Carrillo voiced the fear at the back of everyone’s mind in the border city of 1.9 million people, particularly residents who live in homes on steep hillsides.

”If you hear noises or the ground cracking, it is important for you to check it and get out as fast as possible because the ground can weaken and your home could collapse,” Carrillo said.

Tijuana ordered all beaches closed Saturday and set up a half dozen storm shelters at sports complexes and government offices.

Mexico’s navy evacuated 850 people from islands off the Baja coast and deployed almost 3,000 troops for emergency operations. In La Paz, the picturesque capital of Baja California Sur state on the Sea of Cortez, police patrolled closed beaches to keep swimmers out of the whipped-up surf.

The US hurricane centre posted tropical storm and potential flood warnings for Southern California from the Pacific coast to interior mountains and deserts. The San Bernardino County sheriff issued evacuation warnings for several mountain and foothill communities ahead of the storm, while Orange County sent out its own alert for anyone living in a wildfire burn scar in the Santa Ana Mountains’ Silverado and Williams canyons.

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Authorities in Los Angeles scrambled to get the homeless off the streets and into shelters, and officials ordered all state beaches in San Diego and Orange counties closed.

Across the region, municipalities ran out of free sandbags and grocery shelves emptied out as residents stockpiled supplies. The US National Park Service closed California’s Joshua Tree National Park and Mojave National Preserve to keep visitors from becoming stranded amid flooding.

Major League Baseball rescheduled three Sunday games in Southern California, moving them to Saturday as part of split doubleheaders, and SpaceX delayed the launch of a satellite-carrying rocket from a base on California’s central coast until at least Monday.

The White House said President Joe Biden had been briefed on the latest preparedness plans ahead of the hurricane’s turn to the US. “I urge everyone, everyone in the path of this storm, to take precautions and listen to the guidance of state and local officials,” he said.

Hilary on Friday had rapidly grown into an exceedingly dangerous Category 4 major hurricane, with its top sustained winds peaking at 230 kph. Its winds dropped to 185 kph early Saturday as a Category 3 storm, before further weakening to 1161 kph as a Category 2.

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By late afternoon Saturday, it was centred 965 kilometres south-southeast of San Diego, California. Moving north-northwest at 28 kph, the storm was expected to turn more toward the north and pick up forward speed.

The hurricane was expected to brush past Punta Eugenia on the Pacific coast before making a nighttime landfall along a sparsely populated area of the peninsula about 330 kilometres south of the Pacific port city of Ensenada.

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California To Do Socialism On Electric Bills To Spur Clean Power Transition. ‘Yes! YES!’ Say Sickos.

California electric bills are some of the highest in the USA, but in the next few years, as part of the state’s efforts to decarbonize the power sector, California will start charging high-income residents a higher basic rate for electricity while reducing basic charges for lower-income customers. At the same time, the state’s three big for-profit utilities would reduce the metered cost of electricity use, making it more affordable for people to switch from gas heat and stoves to electric, and rewarding energy efficiency and the adoption of rooftop solar.

Rich people aren’t happy, of course, because why should they pay more so non-rich people can have more affordable power? Well, because you can, and spreading out the costs of decarbonization benefits everyone. You’ll benefit (really, you and all future generations on the planet will benefit) from everyone pumping less carbon into the atmosphere. The sooner, the better, for all of us.


A short ‘splainer, via the Guardian:

Electricity bills are made up of fixed costs as well as fees that vary based on the amount of electricity residents use. Last year, the state passed a law giving the California public utilities commission a 1 July 2024 deadline to determine a fixed charge for household electric bills based on people’s income.

The new income-based electricity bills could hit residents’ mailboxes as soon as 2025. Based on proposals currently under consideration, residents who make more than $180,000 a year could pay about $500 more annually on their electricity bills, while Californians who make less than $28,000 annually could save up to $300 a year. The law is part of the state’s answer of how to equitably transition away from carbon as an energy source.

One of the reasons California electricity is so expensive is that utilities have higher costs for paying off damage done by wildfires that were caused by their crappy maintenance. (And climate change.) Those costs have been passed on to all utility customers in the form of higher electricity prices based on use, which has made methane gas (you know it as “natural”) stoves, heaters, and water heaters more attractive, especially to lower income ratepayers. High electricity costs may also be a disincentive to adoption of electric vehicles, although even California’s higher electric rates are a huge savings over gassing up an internal combustion vehicle.

(Yes, yes, even better to seize the costs of wildfires directly from PG&E shareholders, at gunpoint maybe, but piracy remains illegal unless you’re a pirate with a PAC.)

As the Washington Post (gift link) explains

That’s where the new law, which passed last summer as part of a larger energy bill, comes in. First proposed by researchers at the University of California at Berkeley and the nonprofit Next 10, the plan would split utility costs into two buckets: Fixed charges, which everyone has to pay just to be connected to the grid, and variable charges, which depend on how much electricity you use. Proponents say that the creation of fixed charges would cover things like wildfire preparedness and grid updates — and would also lower electricity costs based on usage. In theory, that would make it easier to convince Californians to electrify.

Adjusting the monthly fixed charges based on income helps overcome the regressive nature of having all ratepayers pay the same fixed charge, said UC Berkeley economist Meredith Fowlie, one of the proposal’s co-authors. “If you can mimic an income tax, it’s less regressive,” she said.

This is where we make you watch this video from Tabs this morning, which explains why it’s pretty bogus when for-profit utilities claim that home solar increases electricity costs for the poor. That’s only a problem when utilities react to customers adopting solar by imposing the same higher monthly user fees on everyone to “make up” for the revenue they don’t reap from selling power to people who are making their own with home solar.

youtu.be

As video host Matt Ferrell explains, higher monthly fees with lower rates for use can actually leave lower income people paying a proportionally higher amount for electricity while more well-off customers pay less for electricity even if they don’t reduce their usage. While Ferrell doesn’t discuss California’s plan for income-based monthly user fees in the video, it stands to reason that progressive user fees based on income would cover the utility’s fixed costs more equitably, while still helping home solar pay off through reduced use of power. Maybe a little piracy?

UC Berkeley prof Severin Borenstein, another co-author of the Next 10 report, didn’t use the words socialism or redistribution in explaining it to the Guardian, but that was the gist of the plan for shifting costs from rates to progressive user fees.

Everybody can’t put in solar if we’re paying for all of these other costs through per-kilowatt-hour charges. That just gets you into a death spiral where prices go higher and higher. And we know who will be the last people that have solar. It will be poor people.

So hell yes, this sounds like a good idea: Rich people pay a little more, less-wealthy people pay a little less (and can afford an ebike or a down payment on home solar) and while we’re at it let’s do a second climate bill that subsidizes ebikes, funds wider energy efficiency upgrades in low-income housing, and more community solar for low income neighborhoods, too.

Here comes the part where I remind you to stop by Friday for Part 4 of our Wonkette Book Club, where we’re reading Kim Stanley Robinson’s 2020 climate novel The Ministry for the Future. More on the book club and this week’s reading (Chapters 51 through 69, nice) here!

[Guardian / Designing Electricity Rates for an Equitable Transition (Next 10) / WaPo (gift link) / Newser / Undecided with Matt Ferrell on YouTube]

Yr Wonkette is funded entirely by reader donations. If you can, please help with a $5 or $15 monthly donation, so we can continue singing the body politic electric.

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Conjoined Twins Fast Facts | CNN



CNN
 — 

Here’s a look at conjoined twins.

Conjoined twins are physically connected to one another at some point on their bodies.

Conjoined twins occur once every 200,000 live births, according to the University of Minnesota.

About 70% of conjoined twins are female.

Conjoined twins are identical – they are the same sex.

According to the Mayo Clinic, conjoined twins may be joined at any of these areas: chest, abdomen, spine, pelvis, trunk or head.

Scientists believe that conjoined twins develop from a single fertilized egg that fails to separate completely as it divides.

The term “Siamese twins” originated with Eng and Chang Bunker, a set of conjoined twins who were born in Siam (now Thailand) in 1811. They lived to age 63 and appeared in traveling exhibitions. Chang and Eng both married and fathered a total of 21 children between them.

In 1955, neurosurgeon Dr. Harold Voris of Mercy Hospital in Chicago performed the first successful procedure separating conjoined twins.

Lea and Tabea Block
Born August 9, 2003, in Lemgo, Germany, to Peter and Nelly Block. They are joined at the head. On September 16, 2004, the girls are separated. Tabea dies shortly thereafter.

Jade and Erin Buckles
Born February 26, 2004, to Melissa and Kevin Buckles at National Naval Medical Center in Bethesda, Maryland. They share a liver. On June 19, 2004, they are successfully separated.

Tatiana and Anastasia Dogaru
Born January 13, 2004, in Rome to Romanian parents Claudia and Alin Dogaru. They are connected at the head. In August 2007, doctors at University Hospital’s Rainbow Babies & Children’s Hospital in Cleveland announce that they will not perform a separation of the girls because the surgery is too risky.

Abbigail and Isabelle Carlsen
Born November 29, 2005, in Fargo, North Dakota, to Amy and Jesse Carlsen. They are joined at the abdomen and chest. On May 12, 2006, a team of 30 people, including 18 surgeons from various specialties at the Mayo Clinic in Rochester, Minnesota, perform a successful operation to separate the girls.

Regina and Renata Salinas Fierros
Born August 2, 2005, in Los Angeles to Sonia Fierros and Federico Salinas. Born facing each other and joined from the lower chest to the pelvis, they are fused in several places including the liver and genitals, and they share a large intestine. Regina is born with one kidney. On June 14, 2006, the twins are separated during a day-long surgery at Children’s Hospital Los Angeles.

Abygail and Madysen Fitterer
Born August 8, 2006, to Stacy and Suzy Fitterer from Bismarck, North Dakota. They are born joined at the abdomen and share a liver. On January 3, 2007, they are separated in a surgery at the Mayo Clinic.

Preslee Faith and Kylee Hope Wells
Born October 25, 2008, in Oklahoma City to Stevie Stewart and Kylie Wells. They are attached at the chest and are believed to be the first Native American conjoined twins. On January 19, 2009, they are separated at Children’s Hospital at OU Medical Center in Oklahoma City. On February 19, 2011, Preslee Faith dies.

Arthur and Heitor Rocha Brandao
Born April 2009 in Bahia, Brazil, to Eliane and Delson Rocha. They are joined at the hip and share a bladder, intestines, liver and genitals. The twins only have three legs between them. On February 24, 2015, the five-year-old twins undergo a 15-hour separation surgery after months of preparation. Arthur dies three days later after he suffers cardiac arrest.

Angelica and Angelina Sabuco
Born August 2009 in the Philippines to Fidel and Ginady Sabuco. They are joined at the chest and abdomen. On November 1, 2011, they are successfully separated after a 10-hour surgery at Lucile Packard Children’s Hospital in San Jose, California.

Hassan and Hussein Benhaffaf
Born December 2, 2009, in London to Angie and Azzedine Benhaffaf from East Cork, Ireland. They are attached at the chest but share no major organs. On April 8, 2010, they undergo a 14-hour separation surgery at Great Ormond Street Hospital. Both survive.

Maria and Teresa Tapia
Born April 8, 2010, in the Dominican Republic to Lisandra Sanatis and Marino Tapia. They are joined at the lower chest and abdomen and share a liver, pancreatic glands, and part of their small intestine. On November 8, 2011, they are successfully separated following a 20-hour procedure.

Joshua and Jacob Spates
Born January 24, 2011, in Memphis, Tennessee, to Adrienne Spates. They are joined back to back at the pelvis and lower spine, each with separate hearts, heads and limbs. On August 29, 2011, they are successfully separated after a 13-hour surgery. In October 2013, Jacob passes away.

Rital and Ritag Gaboura
Born September 22, 2010, in Khartoum, Sudan, to Abdelmajeed and Enas Gaboura. They are joined at the head. On August 15, 2011, they are successfully separated after a four-stage operation. Two operations took place in May, one in July and the final operation in August.

Allison June and Amelia Lee Tucker
Born March 1, 2012, to Shellie and Greg Tucker. They are attached at the lower chest and abdomen and share their chest wall, diaphragm, pericardium and liver. On November 7, 2012, they are successfully separated after a seven-hour surgery at Children’s Hospital Philadelphia.

A’zhari and A’zhiah Lawrence
Born October 10, 2012, in Virginia to Nachell Jones and Carlos Lawrence. They are joined from the chest to the abdomen and have a conjoined liver. On April 22, 2013, they are successfully separated following 14 hours of surgery. On October 14, 2013, A’zhari passes away.

Emmett and Owen Ezell
Born July 15, 2013, in Dallas to Jenni and Dave Ezell. They are joined at the liver and the intestine. On August 24, 2013, they are successfully separated.

Knatalye Hope and Adeline Faith Mata
Born April 11, 2014, in Houston to Elysse and John Matta. They are joined at the chest, sharing a liver, heart lining, diaphragm, intestines and colon. On February 17, 2015, a team of 12 surgeons separate the twins during a 26-hour procedure.

Erika and Eva Sandoval
Born August 10, 2014, in California to Aida and Arturo Sandoval. They are joined at the lower chest and upper abdomen and share a liver, bladder, two kidneys and three legs. On December 6-7, 2016, they are successfully separated after 17 hours of surgery at Lucile Packard Children’s Hospital Stanford in California.

Acen and Apio Akello
Born September 23, 2014, in Uganda to Ester Akello. They are joined at the hip and pelvis. On September 3, 2015, more than 30 medical specialists help separate the twins’ spinal cord during a 16-hour surgery at Nationwide Children’s Hospital in Ohio. To prepare for the surgery, medical specialists used 3-D printing to create anatomies similar to the girls.

Carter and Conner Mirabal
Born December 12, 2014, in Jacksonville, Florida, to Michelle Brantley and Bryan Mirabal. They are joined at the sternum and abdomen and share a liver and part of their small intestines. On May 7, 2015, the twins are successfully separated after 12 hours of surgery at Wolfson Children’s Hospital in Florida.

Scarlett and Ximena Torres
Born May 16, 2015, in Corpus Christi, Texas, to Silvia Hernandez and Raul Torres. Scarlett and Ximena are connected below the waist, sharing a colon and a bladder. On April 12, 2016, the twins are separated during a 12-hour procedure at the Driscoll Children’s Hospital in Texas.

Anias and Jadon McDonald
Born on September 9, 2015, in Chicago to Nicole and Christian McDonald. They are joined at the head. On October 13-14, 2016, Anias and Jadon are successfully separated after 27 hours of surgery at the Children’s Hospital at Montefiore Medical Center in New York.

Dawa and Nima Pelden
Born on July 13, 2017, in Bhutan to Bhumchu Zangmo. They are joined at the abdomen. On November 9, 2018, Dawa and Nima are successfully separated after a six-hour surgery at Melbourne Royal Children’s Hospital in Australia.

Safa and Marwa Ullah
Born January 7, 2017, in Pakistan to Zainab Bibi. They are joined at the head. On February 11, 2019, Safa and Marwa are successfully separated after 50 hours of surgery, that took place over a four month period, at London’s Great Ormond Street Hospital.

Ervina and Prefina Bangalo
Born June 29, 2018, in the Central African Republic to Ermine Nzutto. They share a skull and a majority of blood vessels. On June 5, 2020, the twins are successfully separated during an operation in Vatican City lasting 18 hours and involving 30 doctors and nurses.

Abigail and Micaela Bachinskiy
Born December 30, 2019, in Sacramento, California. The twins are joined at the head. On October 23-24, 2020, the twins are successfully separated during a 24-hour operation at UC Davis Children’s Hospital in Sacramento, California.

Siphosethu and Amahle Tyhalisi
Born January 30, 2021, in South Africa to Ntombikayise Tyhalisi. They are joined at the head. On February 24, 2021, the twins are successfully separated during an operation at Red Cross War Memorial Children’s Hospital in Cape Town.

Hassana and Hasina
Born in January 12, 2022 in Kaduna, Nigeria to Omar Rayano. They share an abdomen, pelvis, liver, intestines, urinary and reproductive system, and pelvic bones. On May 18, 2023 the twins are successfully separated during an operation at King Abdullah Specialized Children’s Hospital in Riyadh, Saudi Arabia.

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Covid-19 Pandemic Timeline Fast Facts | CNN



CNN
 — 

Here’s a look at the coronavirus outbreak, declared a worldwide pandemic by the World Health Organization. The coronavirus, called Covid-19 by WHO, originated in China and is the cousin of the SARS virus.

Coronaviruses are a large group of viruses that are common among animals. The viruses can make people sick, usually with a mild to moderate upper respiratory tract illness, similar to a common cold. Coronavirus symptoms include a runny nose, cough, sore throat, possibly a headache and maybe a fever, which can last for a couple of days.

WHO Situation Reports

Coronavirus Map

CNN’s early reporting on the coronavirus

December 31, 2019 – Cases of pneumonia detected in Wuhan, China, are first reported to WHO. During this reported period, the virus is unknown. The cases occur between December 12 and December 29, according to Wuhan Municipal Health.

January 1, 2020 – Chinese health authorities close the Huanan Seafood Wholesale Market after it is discovered that wild animals sold there may be the source of the virus.

January 5, 2020 – China announces that the unknown pneumonia cases in Wuhan are not SARS or MERS. In a statement, the Wuhan Municipal Health Commission says a retrospective probe into the outbreak has been initiated.

January 7, 2020 – Chinese authorities confirm that they have identified the virus as a novel coronavirus, initially named 2019-nCoV by WHO.

January 11, 2020 – The Wuhan Municipal Health Commission announces the first death caused by the coronavirus. A 61-year-old man, exposed to the virus at the seafood market, died on January 9 after respiratory failure caused by severe pneumonia.

January 17, 2020 – Chinese health officials confirm that a second person has died in China. The United States responds to the outbreak by implementing screenings for symptoms at airports in San Francisco, New York and Los Angeles.

January 20, 2020 – China reports 139 new cases of the sickness, including a third death. On the same day, WHO’s first situation report confirms cases in Japan, South Korea and Thailand.

January 20, 2020 – The National Institutes of Health announces that it is working on a vaccine against the coronavirus. “The NIH is in the process of taking the first steps towards the development of a vaccine,” says Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases.

January 21, 2020 – Officials in Washington state confirm the first case on US soil.

January 23, 2020 – At an emergency committee, WHO says that the coronavirus does not yet constitute a public health emergency of international concern.

January 23, 2020 – The Beijing Culture and Tourism Bureau cancels all large-scale Lunar New Year celebrations in an effort to contain the growing spread of coronavirus. On the same day, Chinese authorities enforce a partial lockdown of transport in and out of Wuhan. Authorities in the nearby cities of Huanggang and Ezhou Huanggang announce a series of similar measures.

January 28, 2020 – Chinese President Xi Jinping meets with WHO Director General Tedros Adhanom in Beijing. At the meeting, Xi and WHO agree to send a team of international experts, including US Centers for Disease Control and Prevention staff, to China to investigate the coronavirus outbreak.

January 29, 2020 – The White House announces the formation of a new task force that will help monitor and contain the spread of the virus, and ensure Americans have accurate and up-to-date health and travel information, it says.

January 30, 2020 – The United States reports its first confirmed case of person-to-person transmission of the coronavirus. On the same day, WHO determines that the outbreak constitutes a Public Health Emergency of International Concern (PHEIC).

January 31, 2020 – The Donald Trump administration announces it will deny entry to foreign nationals who have traveled in China in the last 14 days.

February 2, 2020 – A man in the Philippines dies from the coronavirus – the first time a death has been reported outside mainland China since the outbreak began.

February 3, 2020 – China’s Foreign Ministry accuses the US government of inappropriately reacting to the outbreak and spreading fear by enforcing travel restrictions.

February 4, 2020 – The Japanese Health Ministry announces that ten people aboard the Diamond Princess cruise ship moored in Yokohama Bay are confirmed to have the coronavirus. The ship, which is carrying more than 3,700 people, is placed under quarantine scheduled to end on February 19.

February 6, 2020 – First Covid-19 death in the United States: A person in California’s Santa Clara County dies of coronavirus, but the link is not confirmed until April 21.

February 7, 2020 – Li Wenliang, a Wuhan doctor who was targeted by police for trying to sound the alarm on a “SARS-like” virus in December, dies of the coronavirus. Following news of Li’s death, the topics “Wuhan government owes Dr. Li Wenliang an apology,” and “We want freedom of speech,” trend on China’s Twitter-like platform, Weibo, before disappearing from the heavily censored platform.

February 8, 2020 – The US Embassy in Beijing confirms that a 60-year-old US national died in Wuhan on February 6, marking the first confirmed death of a foreigner.

February 10, 2020 – Xi inspects efforts to contain the coronavirus in Beijing, the first time he has appeared on the front lines of the fight against the outbreak. On the same day, a team of international experts from WHO arrive in China to assist with containing the coronavirus outbreak.

February 10, 2020 – The Anthem of the Seas, a Royal Caribbean cruise ship, sets sail from Bayonne, New Jersey, after a coronavirus scare had kept it docked and its passengers waiting for days.

February 11, 2020 – WHO names the coronavirus Covid-19.

February 13, 2020 – China’s state-run Xinhua News Agency announces that Shanghai mayor Ying Yong will be replacing Jiang Chaoliang amid the outbreak. Wuhan Communist Party chief Ma Guoqiang has also been replaced by Wang Zhonglin, party chief of Jinan city in Shandong province, according to Xinhua.

February 14, 2020 – A Chinese tourist who tested positive for the virus dies in France, becoming the first person to die in the outbreak in Europe. On the same day, Egypt announces its first case of coronavirus, marking the first case in Africa.

February 15, 2020 – The official Communist Party journal Qiushi publishes the transcript of a speech made on February 3 by Xi in which he “issued requirements for the prevention and control of the new coronavirus” on January 7, revealing Xi knew about and was directing the response to the virus on almost two weeks before he commented on it publicly.

February 17, 2020 – A second person in California’s Santa Clara County dies of coronavirus, but the link is not confirmed until April 21.

February 18, 2020 – Xi says in a phone call with British Prime Minister Boris Johnson that China’s measures to prevent and control the epidemic “are achieving visible progress,” according to state news Xinhua.

February 21, 2020 – The CDC changes criteria for counting confirmed cases of novel coronavirus in the United States and begins tracking two separate and distinct groups: those repatriated by the US Department of State and those identified by the US public health network.

February 25, 2020 – The NIH announces that a clinical trial to evaluate the safety and effectiveness of the antiviral drug remdesivir in adults diagnosed with coronavirus has started at the University of Nebraska Medical Center in Omaha. The first participant is an American who was evacuated from the Diamond Princess cruise ship docked in Japan.

February 25, 2020 – In an effort to contain the largest outbreak in Europe, Italy’s Lombardy region press office issues a list of towns and villages that are in complete lockdown. Around 100,000 people are affected by the travel restrictions.

February 26, 2020 – CDC officials say that a California patient being treated for novel coronavirus is the first US case of unknown origin. The patient, who didn’t have any relevant travel history nor exposure to another known patient, is the first possible US case of “community spread.”

February 26, 2020 – Trump places Vice President Mike Pence in charge of the US government response to the novel coronavirus, amid growing criticism of the White House’s handling of the outbreak.

February 29, 2020 – A patient dies of coronavirus in Washington state. For almost two months, this is considered the first death due to the virus in the United States, until autopsy results announced April 21 reveal two earlier deaths in California.

March 3, 2020 – The Federal Reserve slashes interest rates by half a percentage point in an attempt to give the US economy a jolt in the face of concerns about the coronavirus outbreak. It is the first unscheduled, emergency rate cut since 2008, and it also marks the biggest one-time cut since then.

March 3, 2020 – Officials announce that Iran will temporarily release 54,000 people from prisons and deploy hundreds of thousands of health workers as officials announced a slew of measures to contain the world’s deadliest coronavirus outbreak outside China. It is also announced that 23 members of Iran’s parliament tested positive for the virus.

March 4, 2020 – The CDC formally removes earlier restrictions that limited coronavirus testing of the general public to people in the hospital, unless they had close contact with confirmed coronavirus cases. According to the CDC, clinicians should now “use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested.”

March 8, 2020 – Italian Prime Minister Giuseppe Conte signs a decree placing travel restrictions on the entire Lombardy region and 14 other provinces, restricting the movements of more than 10 million people in the northern part of the country.

March 9, 2020 – Conte announces that the whole country of Italy is on lockdown.

March 11, 2020 – WHO declares the novel coronavirus outbreak to be a pandemic. WHO says the outbreak is the first pandemic caused by a coronavirus. In an Oval Office address, Trump announces that he is restricting travel from Europe to the United States for 30 days in an attempt to slow the spread of coronavirus. The ban, which applies to the 26 countries in the Schengen Area, applies only to foreign nationals and not American citizens and permanent residents who’d be screened before entering the country.

March 13, 2020 – Trump declares a national emergency to free up $50 billion in federal resources to combat coronavirus.

March 18, 2020 – Trump signs into law a coronavirus relief package that includes provisions for free testing for Covid-19 and paid emergency leave.

March 19, 2020 – At a news conference, officials from China’s National Health Commission report no new locally transmitted coronavirus cases for the first time since the pandemic began.

March 23, 2020 – United Nations Secretary-General António Guterres calls for an immediate global ceasefire amid the pandemic to fight “the common enemy.”

March 24, 2020 – Japan’s Prime Minister Shinzo Abe and International Olympic Committee (IOC) president Thomas Bach agree to postpone the Olympics until 2021 amid the outbreak.

March 25, 2020 – The White House and Senate leaders reach an agreement on a $2 trillion stimulus deal to offset the economic damage of coronavirus, producing one of the most expensive and far-reaching measures in the history of Congress.

March 27, 2020 – Trump signs the stimulus package into law.

April 2, 2020 – According to the Department of Labor, 6.6 million US workers file for their first week of unemployment benefits in the week ending March 28, the highest number of initial claims in history. Globally, the total number of coronavirus cases surpasses 1 million, according to Johns Hopkins University’s tally.

April 3, 2020 – Trump says his administration is now recommending Americans wear “non-medical cloth” face coverings, a reversal of previous guidance that suggested masks were unnecessary for people who weren’t sick.

April 8, 2020 – China reopens Wuhan after a 76-day lockdown.

April 14, 2020 – Trump announces he is halting funding to WHO while a review is conducted, saying the review will cover WHO’s “role in severely mismanaging and covering up the spread of coronavirus.”

April 20, 2020 – Chilean health officials announce that Chile will begin issuing the world’s first digital immunity cards to people who have recovered from coronavirus, saying the cards will help identify individuals who no longer pose a health risk to others.

April 21, 2020 – California’s Santa Clara County announces autopsy results that show two Californians died of novel coronavirus in early and mid-February – up to three weeks before the previously known first US death from the virus.

April 28, 2020 – The United States passes one million confirmed cases of the virus, according to Johns Hopkins.

May 1, 2020 – The US Food and Drug Administration issues an emergency-use authorization for remdesivir in hospitalized patients with severe Covid-19. FDA Commissioner Stephen Hahn says remdesivir is the first authorized therapy drug for Covid-19.

May 4, 2020 – During a virtual pledging conference co-hosted by the European Union, world leaders pledge a total of $8 billion for the development and deployment of diagnostics, treatments and vaccines against the novel coronavirus.

May 11, 2020 – Trump and his administration announce that the federal government is sending $11 billion to states to expand coronavirus testing capabilities. The relief package signed on April 24 includes $25 billion for testing, with $11 billion for states, localities, territories and tribes.

May 13, 2020 – Dr. Mike Ryan, executive director of WHO’s health emergencies program, warns that the coronavirus may never go away and may just join the mix of viruses that kill people around the world every year.

May 19, 2020 – WHO agrees to hold an inquiry into the global response to the coronavirus pandemic. WHO member states adopt the proposal with no objections during the World Health Assembly meeting, after the European Union and Australia led calls for an investigation.

May 23, 2020 – China reports no new symptomatic coronavirus cases, the first time since the beginning of the outbreak in December.

May 27, 2020 – Data collected by Johns Hopkins University reports that the coronavirus has killed more than 100,000 people across the US, meaning that an average of almost 900 Americans died each day since the first known coronavirus-related death was reported nearly four months earlier.

June 2, 2020 – Wuhan’s Health Commission announces that it has completed coronavirus tests on 9.9 million of its residents with no new confirmed cases found.

June 8, 2020 – New Zealand Prime Minister Jacinda Ardern announces that almost all coronavirus restrictions in New Zealand will be lifted after the country reported no active cases.

June 11, 2020 – The United States passes 2 million confirmed cases of the virus, according to Johns Hopkins.

June 16, 2020 – University of Oxford scientists leading the Recovery Trial, a large UK-based trial investigating potential Covid-19 treatments, announce that a low-dose regimen of dexamethasone for 10 days was found to reduce the risk of death by a third among hospitalized patients requiring ventilation in the trial.

June 20, 2020 – The NIH announces that it has halted a clinical trial evaluating the safety and effectiveness of drug hydroxychloroquine as a treatment for the coronavirus. “A data and safety monitoring board met late Friday and determined that while there was no harm, the study drug was very unlikely to be beneficial to hospitalized patients with Covid-19,” the NIH says in a statement.

June 26, 2020 – During a virtual media briefing, WHO announces that it plans to deliver about 2 billion doses of a coronavirus vaccine to people across the globe. One billion of those doses will be purchased for low- and middle-income countries, according to WHO.

July 1, 2020 – The European Union announces it will allow travelers from 14 countries outside the bloc to visit EU countries, months after it shut its external borders in response to the pandemic. The list does not include the US, which doesn’t meet the criteria set by the EU for it to be considered a “safe country.”

July 6, 2020 – In an open letter published in the journal Clinical Infectious Diseases, 239 scientists from around the world urge WHO and other health agencies to be more forthright in explaining the potential airborne transmission of coronavirus. In the letter, scientists write that studies “have demonstrated beyond any reasonable doubt that viruses are released during exhalation, talking, and coughing in microdroplets small enough to remain aloft in air and pose a risk of exposure at distances beyond 1 to 2 meters (yards) from an infected individual.”

July 7, 2020 – The Trump administration notifies Congress and the United Nations that the United States is formally withdrawing from WHO. The withdrawal goes into effect on July 6, 2021.

July 21, 2020 – European leaders agree to create a €750 billion ($858 billion) recovery fund to rebuild EU economies ravaged by the coronavirus.

July 27, 2020 – A vaccine being developed by the Vaccine Research Center at the National Institutes of Health’s National Institute of Allergy and Infectious Diseases, in partnership with the biotechnology company Moderna, enters Phase 3 testing. The trial is expected to enroll about 30,000 adult volunteers and evaluates the safety of the vaccine and whether it can prevent symptomatic Covid-19 after two doses, among other outcomes.

August 11, 2020 – In a live teleconference, Russian President Vladimir Putin announces that Russia has approved a coronavirus vaccine for public use before completion of Phase 3 trials, which usually precedes approval. The vaccine, which is named Sputnik-V, is developed by the Moscow-based Gamaleya Institute with funding from the Russian Direct Investment Fund (RDIF).

August 15, 2020 – Russia begins production on Sputnik-V, according to Russian state news agency TASS.

August 23, 2020 – The FDA issues an emergency use authorization for the use of convalescent plasma to treat Covid-19. It is made using the blood of people who have recovered from coronavirus infections.

August 27, 2020 – The CDC notifies public health officials around the United States to prepare to distribute a potential coronavirus vaccine as soon as late October. In the documents, posted by The New York Times, the CDC provides planning scenarios to help states prepare and advises on who should get vaccinated first – healthcare professionals, essential workers, national security “populations” and long-term care facility residents and staff.

September 4, 2020 – The first peer-reviewed results of Phase 1 and Phase 2 clinical trials of Russia’s Covid-19 vaccine are published in the medical journal The Lancet. The results “have a good safety profile” and the vaccine induced antibody responses in all participants, The Lancet says.

October 2, 2020 – Trump announces that he and first lady Melania Trump have tested positive for Covid-19. He spends three nights at Walter Reed National Military Medical Center receiving treatment before returning to the White House.

October 12, 2020 – Drugmaker Johnson & Johnson announces it has paused the advanced clinical trial of its experimental coronavirus vaccine because of an unexplained illness in one of the volunteers.”Following our guidelines, the participant’s illness is being reviewed and evaluated by the ENSEMBLE independent Data Safety Monitoring Board (DSMB) as well as our internal clinical and safety physicians,” the company said in a statement. ENSEMBLE is the name of the study. The trial resumes later in the month.

December 10, 2020 – Vaccine advisers to the FDA vote to recommend the agency grant emergency use authorization to Pfizer and BioNTech’s coronavirus vaccine.

December 14, 2020 – US officials announce the first doses of the FDA authorized Pfizer vaccine have been delivered to all 50 states, the District of Columbia and Puerto Rico.

December 18, 2020 – The FDA authorizes a second coronavirus vaccine made by Moderna for emergency use. “The emergency use authorization allows the vaccine to be distributed in the U.S. for use in individuals 18 years and older,” the FDA said in a tweet.

January 14, 2021 – The WHO team tasked with investigating the origins of the outbreak in Wuhan arrive in China.

January 20, 2021 – Newly elected US President Joe Biden halts the United States’ withdrawal from WHO.

February 22, 2021 – The death toll from Covid-19 exceeds 500,000 in the United States.

February 27, 2021 – The FDA grants emergency use authorization to Johnson & Johnson’s Covid-19 vaccine, the first single dose Covid-19 vaccine available in the US.

March 30, 2021 – According to a 120-page report from WHO, the novel coronavirus that causes Covid-19 probably spread to people through an animal, and probably started spreading among humans no more than a month or two before it was noticed in December of 2019. The report says a scenario where it spread via an intermediate animal host, possibly a wild animal captured and then raised on a farm, is “very likely.”

April 17, 2021 – The global tally of deaths from Covid-19 surpasses 3 million, according to data compiled by Johns Hopkins.

August 3, 2021 – According to figures published by the CDC, the more contagious Delta variant accounts for an estimated 93.4% of coronavirus circulating in the United States during the last two weeks of July. The figures show a rapid increase over the past two months, up from around 3% in the two weeks ending May 22.

August 12, 2021 – The FDA authorizes an additional Covid-19 vaccine dose for certain immunocompromised people.

August 23, 2021 – The FDA grants full approval to the Pfizer/BioNTech Covid-19 vaccine for people age 16 and older, making it the first coronavirus vaccine approved by the FDA.

September 24, 2021 CDC Director Dr. Rochelle Walensky diverges from the agency’s independent vaccine advisers to recommend boosters for a broader group of people – those ages 18 to 64 who are at increased risk of Covid-19 because of their workplaces or institutional settings – in addition to older adults, long-term care facility residents and some people with underlying health conditions.

November 2, 2021 – Walensky says she is endorsing a recommendation to vaccinate children ages 5-11 against Covid-19, clearing the way for immediate vaccination of the youngest age group yet in the US.

November 19, 2021 – The FDA authorizes boosters of the Pfizer/BioNTech and Moderna Covid-19 vaccines for all adults. The same day, the CDC also endorses boosters for all adults.

December 16, 2021 – The CDC changes its recommendations for Covid-19 vaccines to make clear that shots made by Moderna and Pfizer/BioNTech are preferred over Johnson & Johnson’s vaccine.

December 22, 2021 – The FDA authorizes Pfizer’s antiviral pill, Paxlovid, to treat Covid-19, the first antiviral Covid-19 pill authorized in the United States for ill people to take at home, before they get sick enough to be hospitalized. The following day, the FDA authorizes Merck’s antiviral pill, molnupiravir.

December 27, 2021 The CDC shortens the recommended times that people should isolate when they’ve tested positive for Covid-19 from 10 days to five days if they don’t have symptoms – and if they wear a mask around others for at least five more days. The CDC also shortens the recommended time for people to quarantine if they are exposed to the virus to a similar five days if they are vaccinated.

January 31, 2022 – The FDA grants full approval to Moderna’s Covid-19 vaccine for those ages 18 and older. This is the second coronavirus vaccine given full approval by the FDA.

March 29, 2022 – The FDA authorizes a second booster of the Pfizer/BioNTech and Moderna Covid-19 vaccines for adults 50 and older. That same day, the CDC also endorses a second booster for the same age group.

April 25, 2022 – The FDA expands approval of the drug remdesivir to treat patients as young as 28 days and weighing about seven pounds.

May 17, 2022 – The FDA authorizes a booster dose of Pfizer/BioNTech’s Covid-19 vaccine for children ages 5 to 11 at least five months after completion of the primary vaccine series. On May 19, the CDC also endorses a booster dose for the same age group.

June 18, 2022 – The CDC recommends Covid-19 vaccines for children as young as 6 months.

August 31, 2022 – The FDA authorizes updated Covid-19 vaccine booster shots from Moderna and Pfizer. Both are bivalent vaccines that combine the companies’ original vaccine with one that targets the BA.4 and BA.5 Omicron sublineages. The CDC signs off on the updated booster shots the following day.

May 5, 2023 – The WHO says Covid-19 is no longer a global health emergency.



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Con demanda buscan revocar ley de muerte asistida en California, Estados Unidos

Defensores de los derechos de las personas con discapacidades presentaron esta semana una demanda federal para revocar la ley de muerte médica asistida de California, argumentando que cambios recientes facilitan que las personas con enfermedades terminales cuyas muertes no son inminentes se suiciden con medicamentos recetados.

La ley original de California, que permite a los adultos con enfermedades terminales obtener recetas para medicamentos que pongan fin a su vida, se aprobó en 2016. Los defensores dicen que la versión revisada que entró en vigencia el año pasado elimina salvaguardas cruciales y viola la Constitución de Estados Unidos y la ley conocida en inglés como American with Disabilities Act.

Los demandantes argumentan que es más probable que las personas con discapacidades, y las minorías raciales y étnicas usen las drogas mortales porque es menos probable que esos grupos reciban la atención médica y de salud mental adecuada. 

Los defensores temen que las personas vulnerables puedan ser presionadas para quitarse la vida por parte de familiares o cuidadores, o que ellos mismos se sientan presionados porque no quieran ser una carga.

La demanda sostiene que el enfoque de California, conocido como End of Life Option Act, se remonta a la práctica desacreditada de la eugenesia, que alguna vez buscó evitar que las personas con discapacidades y otros grupos minoritarios se reprodujeran.

El sistema “aleja a las personas con discapacidades terminales de la atención de salud mental, la atención médica y los apoyos necesarios para la discapacidad, y los acerca a la muerte por suicidio bajo el pretexto de la ‘misericordia’ y la ‘dignidad’ al morir“, argumenta la demanda. La enfermedad terminal requerida para la asistencia es, por definición, una discapacidad según el American with Disabilities Act, dice.

Los defensores de la ley rechazaron esas afirmaciones. “Haremos todo lo posible para garantizar que la ley siga vigente”, dijo Kevin Díaz, director de defensa legal de Compassion & Choices, un grupo que respaldó las leyes de California, en un comunicado. 

Díaz agregó que hubo un amplio apoyo público a la “ayuda médica para morir de adultos con enfermedades terminales, que están destinados a morir y solo quieren la opción de morir en paz, en lugar de sufrir innecesariamente”.

Sean Crowley, portavoz del grupo, señaló un estudio de 2007 sobre la práctica en Oregón y los Países Bajos que no encontró “ninguna evidencia de mayor riesgo” para los grupos vulnerables.
Michael Bien, abogado de los demandantes, dijo que la ley viola las garantías constitucionales de igualdad de protección y debido proceso, diseñadas para proteger a las personas de la discriminación y la exclusión. 

Bien es uno de los abogados que presentó la demanda en nombre de United Spinal Association, que tiene al menos 60.000 miembros con lesiones de la médula espinal o que usan sillas de ruedas, incluidos 5.000 en California; Not Dead Yet, que se opone a la muerte asistida por un médico; el Institute for Patient’s Rights, que aboga por las personas que están al final de la vida y que enfrentan disparidades en la atención médica, y Communities Actively Living Independent & Free, un centro de vida independiente en el condado de Los Ángeles.

Bien señaló las estadísticas que muestran las desigualdades en la mortalidad infantil y materna, y las muertes por la covid-19.

“Así es como funciona nuestro sistema, y la atención al final de la vida tiene exactamente los mismos problemas”, dijo Bien.

Es posible que las personas que eligen usar medicamentos suministrados por un médico para terminar con su vida no se den cuenta de que, en cambio, podrían recibir ayuda para controlar el dolor, lo que podría incluir sedación que puede dejarlos inconscientes, dijo Ingrid Tischer, una de las dos demandantes individuales en la demanda.

“Realmente crea dos clases de personas” en función de si se percibe que tienen una enfermedad terminal, dijo el residente de Berkeley de 57 años. “Un lado obtiene la prevención (del suicidio), el otro lado recibe una receta (para acabar con la vida). Y eso es discriminatorio”.

Tischer nació con un tipo de distrofia muscular, una enfermedad progresiva que ahora le dificulta respirar: debe usar un andador o una silla de ruedas.

“Quiero que la atención que reciben las personas al final de la vida, incluida la mía, sea mucho mejor”, dijo. “Y no quiero que el suicidio asistido se convierta en la nueva forma de muerte estadounidense”.

California es uno de los 10 estados que tienen las llamadas leyes de ayuda para morir. Los otros son Colorado, Hawái, Maine, Montana, Nueva Jersey, Nuevo México, Oregón, Vermont y Washington.

Bien dijo que sus clientes estaban buscando una manera de desafiar las leyes y se decidieron por el estatuto de California de 2022 porque eliminaba las salvaguardas de la ley original.

Estas revisiones redujeron el período de espera mínimo requerido entre el momento en que los pacientes deben realizar dos solicitudes orales de medicamentos de 15 días a 48 horas. La demanda señala que, por el contrario, California tiene un período de reflexión de 10 días entre la compra de un arma y su posesión. También eliminó el requisito de que los pacientes hicieran un certificado por escrito dentro de las 48 horas antes de tomar medicamentos para poner fin a sus vidas.

Los defensores de la ley revisada dijeron que esas salvaguardas se habían convertido en barreras innecesarias y que consumían mucho tiempo, y que otras protecciones se mantuvieron en el estatuto. Compassion & Choices, que aboga por las leyes de muerte asistida, citó un estudio de 2017 que encontró que el 21 % de las personas murieron o se enfermaron demasiado para seguir los pasos. Los partidarios de la ley dijeron que no estaban al tanto de ningún abuso o coerción.

La demanda argumenta que los solicitantes podrían vivir indefinidamente con la atención médica adecuada pueden ser consideradas personas con enfermedades terminales y, por lo tanto, elegibles para los medicamentos si es probable que mueran dentro de los seis meses sin esa atención. Dice que eso podría incluir pacientes con diabetes que rechazan la insulina o personas con trastornos renales que rechazan la diálisis.

Bien citó a una doctora en Colorado que escribió en una revista médica que había aconsejado a dos pacientes con anorexia que tomaran medicamentos recetados para acabar con su vida. Compassion & Choices dijo que eso viola la ley.

Según la ley de California, incluso los médicos que no están dispuestos a ayudar a los pacientes a terminar con sus vidas están obligados a documentar la solicitud del paciente, que aún cuenta como la primera de dos solicitudes orales requeridas. Christian Medical & Dental Association demandó por ese requisito y un juez federal bloqueó esa parte de la ley en septiembre. El estado está apelando el fallo.

La Oficina del Fiscal General de California no hizo comentarios inmediatos sobre la demanda, y la autora de la ley, la senadora estatal demócrata Susan Talamantes Eggman, no respondió de inmediatamente a las solicitudes de comentarios. 

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Covid-sniffing dogs can help detect infections in K-12 schools, new study suggests | CNN



CNN
 — 

Elementary students lined up behind a white curtain in the middle of a grand gymnasium at their school in northern California. They stood still as a dog handler walked a yellow Labrador along the other side of the curtain.

Hidden from the children’s view, the 2-year-old female pup sniffed each child’s shoes from beneath that curtain barrier. After each sniff, the dog looked back up at the handler. Then the handler brought the dog to the next tiny pair of feet beneath the curtain, and the dog curiously brought her snout close to those toes, then a young girl’s lavender tennis shoes and then another child’s white high-tops.

The dog was smelling for what are called volatile organic compounds that are known to be associated with Covid-19 infections.

While watching the Covid-sniffing dog in action, Dr. Carol Glaser saw her vision come to life.

Months prior, Glaser and her team were implementing the school’s Covid-19 testing program, using antigen nasal swab tests. Around that same time, Glaser heard about reports of dogs being used to screen for Covid-19 infections in sports venues, airports and other public settings.

That’s when Glaser had her “aha” moment – incorporating canines into Covid-19 testing programs at schools, nursing homes or other public facilities could help save time, personnel, possibly even costs, and “would be a lot more fun,” she said.

“I thought if we had dogs in schools to screen the students it would be so much faster and less burdensome for schools,” said Glaser, assistant deputy director in Central Laboratory Services and medical officer for infectious disease laboratories at the California Department of Public Health.

“Remember when an antigen test is done at school, as opposed to home, there’s a whole bunch of rules and regulations that run under that. It’s not as simple as just handing those things out at school and having the kids do them,” said Glaser, who oversaw antigen testing programs at some California public schools.

For now, Glaser and her colleagues described in a new study the lessons they learned from the Covid-19 dog screening pilot program that they launched in some California K-12 public schools.

In their research, published Monday in the journal JAMA Pediatrics, they wrote that the goal was to use dogs for screening and only use antigen tests on people whom the dogs screened as positive – ultimately reducing the volume of antigen tests performed by about 85%.

They wrote that their study supports the “use of dogs for efficient and noninvasive” Covid-19 screening and “could be used for other pathogens.”

The dogs used in the pilot program – two yellow Labradors named Rizzo and Scarlett – trained for a couple of months in a laboratory, sniffing donated socks that were worn by people who either had Covid-19 or didn’t. The dogs alerted their handlers when they detected socks that had traces of the disease – and received a reward of either Cheerios or liver treats.

“The one thing we do know for sure is when you’re collecting a sample off of a human being, you want to go where the most scent is produced. That is the head, the pits, the groin and the feet. Given those options, I went with feet,” said Carol Edwards, an author of the study and executive director of the nonprofit Early Alert Canines, which trains medical alert service dogs, including Rizzo and Scarlett.

“We collected some socks from people willing to donate socks, and we taught the dogs, by smelling the socks, which ones were the Covid socks and they picked it up very quickly,” Edwards said. “Then we moved into the schools and started sniffing the kids at the ankles.”

Last year, from April to May, the dogs visited 27 schools across California to screen for Covid-19 in the real world. They completed more than 3,500 screenings.

Rizzo acted as an energized worker, performing tasks with eagerness, Edwards said, while Scarlett tended to have more of a mellow and easygoing personality.

The screening process involves people – who voluntarily opted in to participate – standing 6 feet apart while the dogs, led by handlers, sniff each person’s ankles and feet. The dogs are trained to sit as a way of alerting their handlers that they detect a potential Covid-19 infection.

To protect each person’s privacy, sometimes the people face away from the dogs and toward a wall or behind a curtain, so that they can’t see the dogs or when a dog sits. If the dog sits in between two people, the handler will verbally ask the dog, “Show me?” And the dog will move its snout to point toward the correct person.

“Our dogs can come in, they can screen 100 kids in a half hour, and then only the ones the dog alerts on have to actually do a test,” Edwards said. “There’s no invasive nasal swab unless the dog happens to indicate on you.”

The researchers found that the dogs accurately alerted their handlers to 85 infections and ruled out 3,411 infections, resulting in an overall accuracy of 90%.

However, the dogs inaccurately alerted their handlers to infections in 383 instances and missed 18 infections, which means the dogs demonstrated 83% sensitivity and 90% specificity when it came to detecting Covid-19 infections in the study.

“Once we stepped into the schools, we saw a drop in their specificity and sensitivity due to the change,” Edwards said, referring to the distractions that children in a school setting can bring. However, Edward said, accuracy improved as the dogs spent more times in schools.

In comparison, Covid-19 BinaxNOW antigen tests have been shown in one real-world study to demonstrate 93.3% sensitivity and 99.9% specificity. That study was conducted in San Francisco and published in 2021 in The Journal of Infectious Diseases.

“We never said the dogs will replace the antigen. This was a time for us to learn how they compared,” Glaser said. “We will always plan on doing some amount of backup testing, but the idea would be that the actual antigen testing would be a fraction of what it would currently be because of the dogs.”

“To run these antigen testing programs at school, it’s taking a lot of school personnel resources, test cards as well as biohazard waste. So, I have no doubt in the long-run once it can be perfected, dogs will be cheaper, but I don’t have a great cost comparison,” she said.

This isn’t the first time that dogs’ abilities to detect traces of Covid-19 infections in real-time have been studied in the scientific literature.

“What we have learned in this work is that the dogs in general are capable of discriminating samples from individuals testing,” said Dr. Cindy Otto, professor and director of the Penn Vet Working Dog Center at the University of Pennsylvania, who was not involved in the new study.

Regarding the new research, Otto said, “On the surface their results are encouraging and with the appropriate selection of dogs, rigorous training and impeccable quality control, there is the potential for dogs to be incorporated in threat monitoring.”

Now that Glaser and her colleagues have published research about their Covid-19 dog screening pilot program, she is eager to implement the approach in nursing home settings.

“Honestly, schools aren’t that interested in testing anymore. The outbreaks just aren’t what they used to be, but what we have done is we’ve transitioned to nursing homes, because there is a tremendous need in nursing homes,” Glaser said, adding that many residents may prefer to undergo screening with a dog than with uncomfortable nasal swabs. “What would you rather have: A swab in your nose or something that just maybe tickles your ankle at most for testing?”

Covid-sniffing dogs Scarlett and Rizzo at a skilled nursing home in California.

In skilled nursing homes, the dogs visit each resident’s room to sniff their feet, calmly smelling for Covid-19 volatile organic compounds as the resident lies in bed or sits in a chair.

“Thinking about where dogs would be deployed, I do really think nursing homes and residential care facilities and even schools – if they were ever to have a big outbreak – would be the natural next fit for this,” Glaser said.

“We think we’ll probably end up primarily using them in nursing homes,” she said. “But we’re still doing a little bit of both – there was a school that asked us to come back last week.”

The pilot program within California public schools also has left Edwards with hope for future opportunities in which canines can help detect disease in humans.

“I really do think it’s the tip of the iceberg. This is the door swinging wide open, and now we need to collaborate with those in the science world and figure out where we can take this,” Edwards said.

“There’s been a lot of chatter, even in the very beginning of this project, talking about what other diseases they could do. We’ve talked about TB, we’ve talked about flu A and B, possibly for this next flu season, seeing if we can get the dogs to alert on that,” she said, as volatile organic compounds are also produced by people with influenza. “It’s just a matter of being able to figure out how to collect samples, how to train the dogs, and then to be safe and effective around those diseases too.”

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A quarter of Americans live with polluted air, with people of color and those in Western states disproportionately affected, report says | CNN



CNN
 — 

About 1 in 4 people in the United States – more than 119 million residents – live with air pollution that can hurt their health and shorten their lives, according to a new report from the American Lung Association. People of color are disproportionately affected, as are residents of Western cities.

Since President Richard Nixon signed the Clean Air Act in 1970, emissions of outdoor air pollutants have fallen 78%, according to the US Environmental Protection Agency. But Wednesday’s 2023 State of the Air report, which focuses on ozone and particle pollution, shows that millions put their health on the line every time they step outside.

To capture pollution levels at the county level, researchers analyzed data collected by the EPA’s Air Quality System, a repository of ambient air quality data from more than 10,000 monitors. They characterized the hourly average ozone concentration and the 24-hour average particle pollution concentration for 2019-21 at each monitoring site and factored in year-round pollution information from the EPA.

There were significant improvements in some areas. Generally, 17.6 million fewer people were breathing unhealthy air than in last year’s report, due largely to falling levels of ozone in some regions.

Ozone pollution is the main ingredient in smog. It comes from cars, power plants and refineries. Exposure to ozone can immediately exacerbate asthma symptoms, and people with long-term exposure to higher levels face a significantly higher risk of death from respiratory diseases than those who live with cleaner air.

Around 25% more counties got an A grade in the report for lower levels of ozone pollution. Some of that improvement can be attributed to the Clean Air Act, according to Katherine Pruitt, author of the report and the American Lung Association’s national senior director for policy.

Emission controls have helped, she said, as has the country’s continuing move away from its reliance on coal for its energy needs. Even something simple as the increase in the number of people who work from home has played a role.

“The Biden administration has set themselves a good, strong to do list of things that will help with environmental justice and climate protection,” Pruitt said. “They’re moving kind of slow, though. So we’d like them to pick up the pace.”

Despite the progress, not everyone was lucky enough to live in a county with good ozone levels. More than 100 million people live in counties that get an F for ozone smog, the report says.

Western and Southwestern cities are the most ozone-polluted, with 10 of the 25 most-polluted cities in California. New York, Chicago and Hartford, Connecticut, were the only three on that list east of the Mississippi River.

The five metropolitan areas with the worst ozone pollution are Los Angeles-Long Beach, California; Visalia, California; Bakersfield, California; Fresno-Madera-Hanford, California; and Phoenix-Mesa, Arizona.

Particle pollution, the other form of pollution tracked in the report, still seems to be a significant issue for the US.

Often hard to see, particle pollution is a mix of solid and liquid droplets that may come in the form of dirt, dust, soot or smoke. Coal- and natural gas-fired power plants create it, as do cars, agriculture, unpaved roads, construction sites and wildfires.

Particle pollution is so tiny – 1/20th of a width of a human hair – that it can travel past your body’s usual defenses.

Instead of being carried out when you exhale, it can get stuck in your lungs or go into your bloodstream. The particles cause irritation and inflammation and may lead to respiratory problems. Exposure can cause cancer, stroke or heart attack; it could also aggravate asthma, and it has even been associated with a higher risk of depression and anxiety, studies show.

The new report says the number of people living in counties with failing grades for daily spikes of particle pollution was the highest it has been in a decade. Nearly 64 million live with these kind of unhealthy spikes in counties that get failing grades.

One driver of the high amounts of particle pollution are the wildfires that have consumed hundreds of thousands of acres. In 2021 alone, there were 14,407 fires, many in the West, according to the National Interagency Fire Center. There used to be a wildfire season, experts say, but now they happen year-round.

Those fires are why the regions with the highest concentrations of air pollution are largely in the West.

When the American Lung Association started producing its report in 2004, 106 counties in 30 states got failing grades for daily spikes in particle pollution. Fewer than half were in eight states west of the Rocky Mountains. Today, 111 counties in 19 states got Fs for spikes in particle pollution, and all but eight counties are in the West, the report says.

Urban centers in the Rust Belt and the industrialized East had gotten the most failing grades in the early 2000s, but many have cleaned up and now get passing grades.

Bakersfield, California, displaced Fresno as the metropolitan area with the worst short-term particle pollution, but Fresno did not suddenly develop cleaner air. That city still had the most-polluted label for year-round particle pollution, tied with Visalia, in the agricultural San Joaquin Valley.

Los Angeles is still the city with the worst ozone pollution, according to the report, as it has been for all but one of the years included in the report.

California has some of the more progressive environmental legislation in the country, but the climate crisis has not been kind to the state, said Tarik Benmarhnia, an air pollution and wildfire researcher at the University of California, San Diego, who did not work on the new report.

“All these cities like Bakersfield and Visalia are in a valley near the forests that are seeing big fires. There’s also intense agricultural and industrial work there, so they unfortunately have all the worst conditions for air pollution,” Benmarhnia said.

There are some newcomers to the list of the 25 areas with the most particle pollution, including Denver and Fargo, North Dakota. Reno, Nevada; Yakima and Spokane, Washington; and Boise, Idaho; all made the worst list this year.

San Luis Obispo, California; Portland, Oregon; and Seattle and Bellingham, Washington; all moved off the list of worst 25 cities.

Residents in the cities ranked worst for particle pollution are living with more of it, the report says. In the top 25 cities with the worst air, the average number of days residents were exposed to high levels of fine particle pollution increased to a weighted average of 18.3, up from 16.5 in last year’s report.

East of the Mississippi, Pittsburgh and Lancaster, Pennsylvania, were the two worst metropolitan areas in the country, posting more days high in fine particle pollution in this year’s report.

Not everyone experiences pollution the same way in the US. Regardless of the region, communities of color bear the brunt of the problem.

Specifically, although people of color make up 41% of the overall US population, they are 54% of the nearly 120 million people living in counties with at least one failing grade for unhealthy air. And in the counties with the worst air quality, 72% of the 18 million residents are people of color, the report said.

Other research has also shown this trend. On maps that lay out areas with high levels of air pollution and where communities were redlined – areas where Black people were forced to live – they line up perfectly, Pruitt said.

“Then, the other aspect is, when you have a community of color that is a voluntary community, people aren’t forced to live there, those are communities that tend to have less of a voice, so decision makers place polluting sources in those communities because there’s not as much howling by people with power when they do. So those communities get the highways; they get the landfills; they get the fence lines,” she said.

There’s a myth that only poor communities live with disproportionate pollution levels, says Chris Tessum, a professor in the Civil and Environmental Engineering Department of the University of Illinois. Tessum, who was not involved in the new report, says race really is the determining factor.

“The thinking is that people with more money will buy better property, which has lower air pollution and that’s just the way of the world or whatever, but that’s just kind of emphatically not, not true,” he said.

Communities need to play a key role in making decisions to help clean air, Tessum said.

“People that have the power will use that power to benefit themselves and not the people that have been historically overburdened,” he said.

The new report says government and residents can make a difference. One suggestion is to leverage Inflation Reduction Act funding to help reduce emissions at ports and to invest in zero-emission heavy-duty vehicles and in infrastructure that would improve air quality monitoring.

States can also use the Clean Air Act authority to adopt the California zero-emissions standards for cars and trucks, the report says.

At the federal level, agencies must finalize stronger limits on air pollution to truly protect public health and advance environmental justice, the report says, including standards to move the country toward zero-emissions vehicles. The EPA also has to set stronger national standards for particle pollution and ozone, the researchers say.

Pruitt said she knows firsthand how better policies can work. She said growing up before the Clean Air Act, pollution was so high that she could see it every time she stepped outside. Today, the pollution is not nearly as visible.

“I’m in my mid-60s, and of course, air pollution was very tangible when I was young, but these days, thank goodness it isn’t. Most people don’t see it,” she said. Unless a person has a lung condition, they may not even feel it.

But just because you can’t see it or feel it doesn’t mean it’s not there. Pruitt encourages people to remember that no level of pollution is safe. The World Health Organization estimates that the combined effects of ambient air pollution and household air pollution are associated with 6.7 million premature deaths annually.

“People don’t really recognize that what they’re breathing is impacting their health,” Pruitt said.

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Concerned about the courts, some states and universities are stockpiling abortion drugs | CNN



CNN
 — 

With an eye on the courts, a growing number of Democratic-led states are stockpiling the pills that can be used for a medication abortion, the most common form of the procedure in the US.

The officials want to be prepared, in case US District Judge Matthew Kacsmaryk’s decision to suspend the US Food and Drug Administration’s approval of mifepristone goes through, so medication abortions would still be available in their states for some period of time. But they’re taking different approaches to the idea.

New York Gov. Kathy Hochul announced Tuesday that her state’s Department of Health would buy 150,000 doses of misoprostol, the other of the two drugs typically used in a medication abortion.

Misoprostol can be used off-label for an abortion, without mifepristone, but patients often have to use more of it. It would not be covered by the court case, and if Kacsmaryk’s decision stands, the New York City’s Health Department tweeted, it will change to using this medication only.

“Medication abortion continues to be available at our Sexual Health Clinics and NYC Health + Hospitals locations. Should mifepristone become unavailable, we will continue to make medication abortion accessible to all in NYC by shifting to a misoprostol-only treatment regimen,” the tweet said.

The state says the 150,000 doses should represent a five-year supply of pills.

“Anti-choice extremists have shown that they are not stopping at overturning Roe, and they are working to entirely dismantle our country’s reproductive health care system, including medication abortion and contraception,” Hochul said. “New York will always be a safe harbor for abortion care, and I am taking action to protect abortion access in our State and continue to lead the nation in defending the right to reproductive autonomy.”

California is also stocking up on misoprostol.

“While California still believes Mifepristone is central to the preferred regimen for medication abortion, the State negotiated and purchased an emergency stockpile of Misoprostol in anticipation of Friday’s ruling by far-right federal judge Matthew Kacsmaryk to ensure that California remains a safe haven for safe, affordable, and accessible reproductive care,” Gov. Gavin Newsom’s office said in a release Monday.

California plans to purchase up to 2 million pills through CalRx, a state initiative set up to make drugs more affordable.

The governor’s office said the state now has more than 250,000 pills on hand, which it purchased for about $100,000.

California said it shared the terms of its purchase agreement with other members of the Reproductive Freedom Alliance, a nonpartisan coalition of 21 governors who are committed to protecting reproductive rights, and who might also be interested in taking such action.

Another member of that alliance, Washington Gov. Jay Inslee, announced last week that his state bought a three year-supply of mifepristone, the drug at the center of Kacsmaryk’s ruling.

Inslee directed the state Department of Corrections – which has a pharmacy license and is legally able to buy medications – to buy the drug last month, he said, and the shipment was delivered March 31. The University of Washington also purchased 10,000 doses.

Lawmakers are introducing a bill to authorize officials to distribute or sell the medication to licensed providers throughout the state.

“This Texas lawsuit is a clear and present danger to patients and providers all across the country. Washington will not sit by idly and risk the devastating consequences of inaction,” Inslee said. “Washington is a pro-choice state, and no Texas judge will order us otherwise.”

In the meantime, its attorney general, Bob Ferguson, is helping lead a multistate lawsuit to protect access to mifepristone.

On Friday, the same day Kacsmaryk’s ruling came down, a federal judge in Washington ordered the US not to make any changes that would restrict access to mifepristone in the territories that brought the lawsuit: 17 states and the District of Columbia.

On Monday, Massachusetts Gov. Maura T. Healey announced that at her request, the University of Massachusetts and health care providers have also taken action to stockpile doses of mifepristone.

The governor’s office said last week that the university bought about 15,000 doses of mifepristone, enough to cover the commonwealth for about a year, and the pills are expected to arrive this week. Local health care providers have agreed to buy more, and the government agreed to set aside $1 million to pay for those doses.

The Massachusetts governor also signed an executive order confirming protections for medication abortion under existing law.

“Here in Massachusetts, we are not going to let one extremist judge in Texas turn back the clock on this proven medication and restrict access to care in our state,” Healey said. “The action we are taking today protects access to mifepristone in Massachusetts and protects patients and providers from liability. In Massachusetts, we stand for civil rights and freedom. We will always protect access to reproductive health care, including medication abortion.”

Danco Laboratories, the manufacturer of the brand-name version of mifepristone, says that orders for the drug have increased substantially in recent months and are significantly higher than they were at this time last year.

Demand for mifepristone is up across all types of customers, including clinics, pharmacies and individual providers, said Abby Long, Danco’s director of public affairs. But Massachusetts is the only state that has requested an especially large number of pills from the company.

Maine Gov. Janet Mills, who called the Texas decision “reckless” and a “fundamental assault on women’s rights,” said Monday that her administration is evaluating its options, “including procuring mifepristone if needed, to protect access to medication abortion for Maine women.”

The Connecticut governor’s office said Wednesday that it is also monitoring the situation.

Oregon Gov. Tina Kotek’s office said in an email Wednesday that she has directed the Oregon Health Authority to “explore all available avenues for ensuring Oregon is prepared should Mifepristone become less available. That includes evaluating the supply of Mifepristone and Misoprostol and consulting with providers to better understand the potential impact on the provision of abortion and reproductive health care and what additional support might be necessary.”



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