Saving water can help us deal with the climate crisis. Here’s how to reduce your use | CNN

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CNN
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The reliability of our faucets providing water every time we turn them on can make water seem like a magical, never-ending resource.

But abusing the availability of this finite resource can contribute to water scarcity and harm our capacity to deal with the impact of the climate crisis.

“Four billion people today already live in places that are affected by water scarcity at least part of the year,” said Rick Hogeboom, executive director of the Water Footprint Network, an international knowledge center based in the Netherlands. “Climate change will have a worsening influence on the demand-supply balance,” he said.

“If all people were to conserve water in some way, that would help ease some of the immediate impacts seen from the climate crisis,” said Shanika Whitehurst, associate director of sustainability for Consumer Reports’ research and testing. Consumer Reports is a nonprofit that helps consumers evaluate goods and services.

“Unfortunately, there has been a great toll taken on our surface and groundwater sources, so conservation efforts would more than likely have to be employed long term for there to be a more substantial effect.”

Yes, businesses and governments should play a part in water conservation by, respectively, producing goods “water efficiently” and allocating water in a sustainable, equitable way, Hogeboom said.

But “addressing the multifaceted water crises is a shared responsibility. No one actor can solve it, nor is there a silver bullet,” he added. “We need all actors to play their part.”

Contrary to what you might think, the water used directly in and around the home makes up a minor portion of the total water footprint of a consumer, Hogeboom said.

“The bulk — typically at least 95% — is indirect water use, water use that is hidden in the products we buy, the clothes we wear and the food we eat,” Hogeboom said. “Cotton, for instance, is a very thirsty crop.”

Of the 300-plus gallons of water the average American family uses every day at home, however, roughly 70% of this use occurs indoors, according to the US Environmental Protection Agency — making the home another important place to start cutting your use.

Here are some ways to reduce your water footprint as you move from room to room and outdoors.

Since the kitchen involves dishwashing, cooking and one of the biggest water guzzlers — your diet — it’s a good place to start.

An old kitchen faucet can release 1 to 3 gallons of water per minute when running at full blast, according to Consumer Reports. Instead of rinsing dishes before putting them in the dishwasher, scrape food into your trash or compost bin. Make sure your dishwasher is fully loaded so you only do as many wash cycles as necessary and make the most use of the water.

With some activities you can save water by not only using less but also upgrading the appliances that deliver the water. Dishwashers certified by Energy Star, the government-backed symbol for energy efficiency, are about 15% more water-efficient than standard models, according to Consumer Reports.

If you do wash dishes by hand, plug up the sink or use a wash basin so you can use a limited amount of water instead of letting the tap run.

If you plan on eating frozen foods, thaw them in the fridge overnight instead of running water over them. For drinking, keep a pitcher of water in the fridge instead of running the faucet until the water’s cool — and if you need to do that to get hot water, collect the cold water and use it to water plants.

Cook foods in as little water as possible, which can also retain flavor, according to the University of Toronto Scarborough’s department of physical and environmental sciences.

When it comes to saving water via what you eat, generally animal products are more water-intensive than plant-based alternatives, Hogeboom said.

“Go vegetarian or even better vegan,” he added. “If you insist on meat, replace red meat by pig or chicken, which has a lower water footprint than beef.”

It takes more than 1,800 gallons of water to produce 1 pound of beef, Consumer Reports’ Whitehurst said.

The bathroom is the largest consumer of indoor water, as the toilet alone can use 27% of household water, according to the EPA. You can cut use here by following this adage: “If it’s yellow, let it mellow. If it’s brown, flush it down.”

“Limiting the amount of toilet flushes — as long as it is urine — is not problematic for hygiene,” Whitehurst said. “However, you do have to watch the amount of toilet paper to avoid clogging your pipes. If there is solid waste or feces, then flush the toilet immediately to avoid unsanitary conditions.”

Older toilets use between 3.5 and 7 gallons of water per flush, but WaterSense-labeled toilets use up to 60% less. WaterSense is a partnership program sponsored by the EPA.

“There’s probably more to gain by having dual flush systems so you don’t waste gallons for small flushes,” Hogeboom said.

By turning off the sink tap when you brush your teeth, shave or wash your face, you can save more than 200 gallons of water monthly, according to the EPA.

Cut water use further by limiting showers to five minutes and eliminating baths. Shower with your partner when you can. Save even more water by turning it off when you’re shampooing, shaving or lathering up, Consumer Reports suggests.

Replacing old sink faucets or showerheads with WaterSense models can save hundreds of gallons of water per year.

Laundry rooms account for nearly a fourth of household water use, according to the EPA. Traditional washing machines can use 50 gallons of water or more per load, but newer energy- and water-conserving machines use less than 27 gallons per load.

You can also cut back by doing full loads (but not overstuffing) and choosing the appropriate water level and soil settings. Doing the latter two can help high-efficiency machines use only the water that’s needed. If you have a high-efficiency machine, use HE detergent or measure out regular detergent, which is more sudsy and, if too much is used, can cause the machine to use more water, according to Consumer Reports.

Nationally, outdoor water use accounts for 30% of household use, according to the EPA. This percentage can be much higher in drier parts of the country and in more water-intensive landscapes, particularly in the West.

If you prefer to have a landscape, reduce your outdoor use by planting only plants appropriate for your climate or ones that are low-water and drought-resistant.

“If maintained properly, climate-appropriate landscaping can use less than one-half the water of a traditional landscape,” the EPA says.

The biggest water consumers outside are automatic irrigation systems, according to the EPA. To use only what’s necessary, adjust irrigation controllers at least once per month to account for weather changes. WaterSense irrigation controllers monitor weather and landscape conditions to water plants only when needed.

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Most Americans are uncomfortable with artificial intelligence in health care, survey finds | CNN



CNN
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Most Americans feel “significant discomfort” about the idea of their doctors using artificial intelligence to help manage their health, a new survey finds, but they generally acknowledge AI’s potential to reduce medical mistakes and to eliminate some of the problems doctors may have with racial bias.

Artificial intelligence is the theory and development of computer programs that can solve problems and perform tasks that typically would require human intelligence – machines that can essentially learn like humans can, based on the input they have been given.

You probably already use technology that relies on artificial intelligence every day without even thinking about it.

When you shop on Amazon, for example, it’s artificial intelligence that guides the site to recommend cat toys if you’ve previously shopped for cat food. AI can also help unlock your iPhone, drive your Tesla, answer customer service questions at your bank and recommend the next show to binge on Netflix.

Americans may like these individualized services, but when it comes to AI and their health care, it may be a digital step too far for many.

Sixty percent of Americans who took part in a new survey by the Pew Research Center said that they would be uncomfortable with a health care provider who relied on artificial intelligence to do something like diagnose their disease or recommend a treatment. About 57% said that the use of artificial intelligence would make their relationship with their provider worse.

Only 38% felt that using AI to diagnose disease or recommend treatment would lead to better health outcomes; 33% said it would lead to worse outcomes; and 27% said it wouldn’t make much of a difference.

About 6 in 10 Americans said they would not want AI-driven robots to perform parts of their surgery. Nor do they like the idea of a chatbot working with them on their mental health; 79% said they wouldn’t want AI involved in their mental health care. There’s also concern about security when it comes to AI and health care records.

“Awareness of AI is still developing. So one dynamic here is, the public isn’t deeply familiar with all of these technologies. And so when you consider their use in a context that’s very personal, something that’s kind of high-stakes as your own health, I think that the notion that folks are still getting to know this technology is certainly one dynamic at play,” said Alec Tyson, Pew’s associate director of research.

The findings, released Wednesday, are based on a survey of 11,004 US adults conducted from December 12-18 using the center’s American Trends Panel, an online survey group recruited through random sampling of residential addresses across the country. Pew weights the survey to reflect US demographics including race, gender, ethnicity, education and political party affiliation.

The respondents expressed concern over the speed of the adoption of AI in health and medicine. Americans generally would prefer that health care providers move with caution and carefully consider the consequences of AI adoption, Tyson said.

But they’re not totally anti-AI when it comes to health care. They’re comfortable with using it to detect skin cancer, for instance; 65% thought it could improve the accuracy of a diagnosis. Some dermatologists are already exploring the use of AI technology in skin cancer diagnosis, with some limited success.

Four in 10 Americans think AI could also help providers make fewer mistakes, which are a serious problem in health care. A 2022 study found that medical errors cost about $20 billion a year and result in about 100,000 deaths each year.

Some Americans also think AI may be able to build more equity into the health care system.

Studies have shown that most providers have some form of implicit bias, with more positive attitudes toward White patients and negative attitudes toward people of color, and that could affect their decision-making.

Among the survey participants who understand that this kind of bias exists, the predominant view was that AI could help when it came to diagnosing a disease or recommending treatments, making those decisions more data-driven.

Tyson said that when people were asked to describe in their own words how they thought AI would help fight bias, one participant cited class bias: They believed that, unlike a human provider, an AI program wouldn’t make assumptions about a person’s health based on the way they dressed for the appointment.

“So this is a sense that AI is more neutral or at least less biased than humans,” Tyson said. However, AI is developed with human input, so experts caution that it may not always be entirely without bias.

Pew’s earlier surveys about artificial intelligence have found a general openness to AI, he said, particularly when it’s used to augment, rather than replace, human decision-making.

“AI as just a piece of the process in helping a human make a judgment, there is a good amount of support for that,” Tyson said. “Less so for AI to be the final decision-maker.”

For years, radiologists have used AI to analyze x-rays and CT scans to look for cancer and improve diagnostic capacity. About 30% of radiologists use AI as a part of their practice, and that number is growing, a survey found – but more than 90% in that survey said they wouldn’t trust these tools for autonomous use.

Dr. Victor Tseng, a pulmonologist and medical director of California-based Ansible Health, said that his practice is one of many that have been exploring the AI program ChatGPT. His group has set up a committee to look into its uses and to discuss the ethics around using it so the practice could set up guardrails before putting it into clinical practice.

Tseng’s group published a study this month that showed that ChatGPT could correctly answer enough practice questions that it would have passed the US Medical Licensing Examination.

Tseng said he doesn’t believe that AI will ever replace doctors, but he thinks technology like ChatGPT could make the medical profession more accessible. For example, a doctor could ask ChatGPT to simplify complicated medical jargon so that someone with a seventh-grade education could understand.

“AI is here. The doors are open,” Tseng said.

The Pew survey findings suggest that attitudes could shift as more Americans become more familiar with artificial intelligence. Survey respondents who were more familiar with a technology were more supportive of it, but they still shared caution that doctors could move too quickly in adopting it.

“Whether you’ve heard a lot about AI, just a little or maybe even nothing at all, all of those segments of the public are really in the same space,” Tyson said. “They echo this sentiment of caution of wanting to move carefully in AI adoption in health care.”

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A childbirth myth is spreading on TikTok. Doctors say the truth is different | CNN



CNN
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Ashley Martinez has four sons and is pregnant with the daughter she’s wanted for years.

Last month, she posted a video online imploring doctors to prioritize her life, not the life of her unborn baby, if complications arise when she is in labor and it comes down to that choice.

The San Antonio, Texas, resident is due in May and is one of a number of pregnant people who have recently posted “living will” videos on TikTok.

Martinez had an emergency C-section during her last pregnancy after her umbilical cord came out before her baby, a rare but dangerous condition known as an umbilical cord prolapse that can deprive a baby of vital blood flow and oxygen.

Martinez described her last delivery as terrifying. Eight months after the Supreme Court reversed Roe v. Wade, ending a constitutional right to abortion, she said she worries about what would happen if she faced similar challenges again.

Since the ruling in June, a number of US states have criminalized abortions, leading to some fears that doctors would prioritize the life of the unborn child during a medical emergency.

Martinez lost her mother to non-Hodgkin’s lymphoma at a young age, and the thought of her children going through a similar tragedy terrifies her.

“Having to go into another delivery where I’m going to have a C-section, it’s scary for me,” said the 29-year-old. “My fourth pregnancy was my only C-section. I’ve always thought about not being here for my kids just because of what I went through growing up without my mom.”

More than a dozen US states have banned or severely restricted access to abortions following the Supreme Court’s decision eight months ago. The abortion bans have led to legal chaos as advocates take the fight to courtrooms.

Even so, several ob/gyns told CNN that a hard choice between saving a mother and baby’s lives at childbirth, like the one outlined in the TikTok videos, is highly unlikely.

This trend on TikTok has sparked a flurry of dueling videos among pregnant women and other people. Some have posted videos telling doctors in such situations to prioritize their unborn babies first, and criticizing those who expressed a different view.

Martinez concedes that her mother, who died at 25, would likely have chosen to save her child first if she could.

“My mother, she didn’t have a choice, you know?” Martinez said. “The message that I want to send is just basically nobody is wrong or right in this situation. In both situations, it is a hard decision to pick your children over your unborn baby.”

In Texas, where Martinez lives, abortions are banned at all stages of pregnancy – unless there’s a life-threatening medical emergency.

Dr. Franziska Haydanek, an ob/gyn in Rochester, New York, who shares medical advice on TikTok, said she’s noticed many “living will” videos in recent months.

In most of the videos, a woman appears alongside a written message saying something like, “If there are complications during childbirth, save me before the baby.” Some people, including Martinez, reference their children in their decision and even show them in the video.

One was posted by Tuscany Gunter, 22, a woman whose baby is due in April. Abortion after 20 weeks of pregnancy is illegal in her home state of North Carolina, and Gunter told CNN she filmed her message in solidarity with others who said they would choose themselves first.

“I wanted to make it known where I stand and to stand up with other women who are getting bashed online for saying they would rather be saved first over their baby,” said Gunter, who lives in Fayetteville.

“As a mother to three young children, I cannot dump the emotional trauma of losing their mother on them as children and expect them to cope. While I would be crushed to lose a baby, I need to think of my other living children as well … And I know the baby that passed would be safe without ever having to experience any pain or sadness.”

Another woman, Leslie Tovar of Portland, Oregon, said that even though her state has no legal restrictions on abortion, she posted her video because she feared doctors would prioritize saving her unborn child to avoid legal ramifications in the post-Roe v. Wade era.

“I have two other kids at home who need mom. I can’t bear the thought of my two young boys ages 6 and 4 without their mom,” she said.

All three women said they’ve had these conversations with their partners, who agreed they should be saved first.

Of her husband, Tovar said, “His exact words were, ‘We could always have another baby later in life but there is never replacing the mother of my boys, I couldn’t do this without you.’”

It’s true that complications occasionally come up during a pregnancy that lead doctors to recommend delivery to save the mother’s life, medical experts said.

If this is done before a fetus is viable – under 24 weeks – the chances of the baby’s survival are low, said Dr. Elizabeth Langen, a maternal-fetal medicine physician at the University of Michigan Von Voigtlander Women’s Hospital.

Roe v. Wade’s reversal did make terminating such pregnancies more complicated, Langen and Haydanek say.

In cases involving a baby that’s not viable, it could mean that even when the baby is unlikely to survive and the mom’s health is at risk, the priority will be on saving the baby due to fear of legal ramifications, Langen said.

But both doctors say these scenarios don’t occur during the birth of a viable baby. In that instance, Roe v. Wade is “less involved,” Haydanek said.

“We do everything in our efforts to save both (mother and baby),” she said. “I can’t think of a time where the medical team has had to make a decision about who to save in a viable laboring patient. It’s just not a real scenario in modern medicine – just one we are seeing played out on TV.”

Hospitals have enough resources – obstetrics and neonatal intensive care unit teams, for example – to meet the needs of both the mother and the baby, Haydanek and Langen said.

“We’re usually doing our best to take care of both the mom and the baby. And there’s very rarely a circumstance where we will do something to harm the mom in order to have the benefit of the baby,” added Langen.

“If mom’s health is deteriorating, ultimately, she’s not going to be able to support baby’s wellbeing,” Langen said. “And so generally, what we encourage folks to do is really support mom’s health, because that’s in the best interest of both mother and baby.”

Abortion rights demonstrators hold signs outside the US Supreme Court in Washington after the court overturned Roe v. Wade in June 2022.

Both doctors said it’s important for patients to talk to their health care providers about their medical concerns and share their “living will” wishes with loved ones in case there are complications during labor that require partners to make medical decisions.

However, those decisions will not involve doctors asking your partner whose life should come first, they said.

“Before getting in a fight with your partner about who they choose to save, know that there isn’t a situation where we will ask them that,” said Haydanek, who has called the TikTok trend “horribly anxiety inducing.”

She said it’s come up so many times in recent months that she made her own TikTok video to reassure expectant parents.

“Please don’t feel like you have to make this choice,” she says in the video. “I know firsthand how much anxiety there can be in pregnancy … but it’s just not a situation that you’re gonna find yourself in.”

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Thousands of people can’t get full treatments of a lifesaving cancer drug | CNN



CNN
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Dino Carlone was frightened when he was diagnosed with bladder cancer three years ago, but his spirits were buoyed when he learned that he could get help from a highly effective drug with a great track record.

“You’re telling yourself, ‘OK, I have cancer, and it’s a very aggressive cancer, but I’ve got great therapy. There’s great numbers,’ ” said Carlone, 65.

Carlone was supposed to receive treatment for several years, but he says he only got it for only a few months because his urologist told him there was a shortage of the drug, called Bacillus Calmette-Guérin, or BCG.

Carlone said he was shocked and angry that in a country as wealthy as the United States, there’s a shortage of an important cancer drug.

A new report estimates that more than 8,300 US patients a year are not receiving full BCG treatments for their bladder cancer. BCG is an older drug – it has been around for more than 40 years – and relatively inexpensive. Pharmaceutical companies aren’t clamoring to make it.

“This is a terrible crisis. We should be doing everything we can to give every single one of these patients the best chance of survival,” said Laura Bray, a board member of the End Drug Shortages Alliance, one of the sponsors of the report. “It’s heartbreaking, and we must do better.”

A spokesperson for Merck, the sole maker worldwide of BCG, wrote in an emailed statement that the company increased production of the drug by 200% between 2012 and 2019 and has been producing it “to the full extent of manufacturing capacity over the past several years.”

Merck is building a facility to expand production of BCG. The company expects the facility to be completed sometime between late 2025 and late 2026, which includes time for necessary regulatory approvals, according to the statement.

“Our company will continue to work to complete this project and meet patient needs in as timely a manner as possible. Our commitment to [BCG] is at the core of Merck’s mission to save and improve lives. We continue to recognize the impact supply shortages can have on patients when they cannot receive the medicines they need,” the statement says.

A number of factors are contributing to the shortage, which began in 2019. BCG is a biologic drug – which uses bacteria – and so is more complicated to make than many other types of drugs and especially prone to quality control issues.

Sanofi, the other company that once made BCG, started having production problems in 2012. In 2016, it announced that it would stop making the drug the next year.

Also, while cases of bladder cancer are slowly increasing, it’s still a relatively small market, and making the drug requires a significant investment.

In a written statement, a spokesperson for the US Food and Drug Administration said that “whenever a shortage occurs, FDA actively works with manufacturers and other U.S. federal agencies to try to address supply issues for the drug product in shortage.”

When BCG became available in 1976, it was considered a breakthrough strategy. First used as a tuberculosis vaccine, it contains a weakened bacteria that triggers the immune system to fight the cancer.

“It’s an absolutely fabulous drug,” said Dr. Benjamin Davies, a spokesperson for the American Urological Association.

Bladder cancer patients receive six rounds of BCG after surgery and then more treatments every few months for a year or two, depending on the person, according to Davies. The treatment is done in the doctor’s office, using a catheter that delivers the drug directly to the bladder.

Carlone, of Vero Beach, Florida, said he was supposed to receive BCG doses over a period of about two years. But he said after receiving doses for a few months in early 2020, his urologist told him he wouldn’t be able to get his remaining doses because of the shortage.

“It’s a very, very frightening circumstance to realize that at that point, what they deem to be an aggressive cancer could in fact come right back,” he said.

Bladder cancer has a 30% to 40% recurrence rate, said Davies, a professor of urology at the University of Pittsburgh Medical Center.

“That’s a very high recurrence rate,” he said. “It’s a nasty disease.”

There are about 82,920 new cases of bladder cancer in the US a year and 16,710 deaths, according to the American Cancer Society.

For the new report, 20 health care systems and physician practices responded to a survey from Vizient, a health care performance improvement company.

All of them said they had to use at least one strategy to deal with the BCG shortage, and four of the centers said they couldn’t give BCG at all, according to the report.

Because of the shortage, the American Urological Association recommends prioritizing doses for higher-risk patients.

Some medical centers in the survey said they are splitting doses. A vial is supposed to be used for one dose for one patient, but instead, they use it for more than one patient. That could lead to waste, though, because the entire vial needs to used within six hours of opening, said Erin Fox, an adjunct professor at the University of Utah College of Pharmacy and specialist in drug shortages.

Other drugs can be used instead of BCG, but they are more expensive and don’t work as well, Davies said.

“So not only can’t we give the right drug because of the shortage, but we have to spend more money,” he said.

BCG is just one of many drugs in shortage, including other cancer drugs for adults and for children.

Carlone wonders why the FDA can’t do more to persuade companies to make drugs that aren’t necessarily very lucrative.

“To me, this is a failure,” he said. “As Americans, you rely on [government] institutions, and the institutions are failing as far as I’m concerned.”

According to the FDA statement, the agency “cannot require a pharmaceutical company to make a drug – or make more of a drug – even if it is medically necessary. In addition, we cannot control how much of a drug is distributed – or which purchasers will be given priority.”

Marta Wosińska, a former senior FDA official, said the federal government could offer financial incentives for pharmaceutical companies to make drugs that are in shortage, similar to the way the government has paid them to make Covid-19 vaccines and treatments.

Wosińska, an economist at the Brookings Institution, said it would be “a little bit of a tall order” to expect pharmaceutical companies to make drugs, or increase production of drugs, that aren’t particularly profitable.

“They have a fiduciary responsibility to their shareholders, so you can only ask them to do so much,” said Wosińska, who worked on drug shortages as director of the economics staff at the FDA’s Center for Drug Evaluation and Research before she left the agency in 2016.

Dr. Yoram Unguru, a member of the core faculty at the Johns Hopkins Berman Institute of Bioethics, said that “pharmaceutical companies can continue to generate profits while ensuring access to essential medicines.”

He added that the government has an obligation to fix these shortages.

“The federal government must take a more hands-on approach and maintain a critical stockpile of essential lifesaving medicines and set prices for medications, akin to existing rate-setting bodies that oversee public utilities,” he said.

The BCG shortage is expected to continue for years.

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After a train derailment, Ohio residents are living the plot of a movie they helped make | CNN



CNN
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When Ben Ratner’s family signed up in 2021 to be extras in the movie “White Noise,” they thought it would be a fun distraction from their day-to-day life in blue-collar East Palestine, Ohio.

Ratner, 37, is in a traffic jam scene, sitting in a line of cars trying to evacuate after a freight train collided with a tanker truck, triggering an explosion that fills the air with dangerous toxins. In another scene, his father wears a trench coat and hat while people walk across an overpass to get out of town. Directors told the group they wanted them to look “forlorn and downtrodden” as they escape the environmental disaster.

The 2022 movie was shot around Ohio and is based on a novel by Don DeLillo. The book was published in 1985, shortly after a chemical disaster in Bhopal, India, that killed nearly 4,000 people. The book and film follow the fictional Gladney family – a couple and their four kids – as they flee an “airborne toxic event” and then return home and try to resume their normal lives.

Ratner tried to rewatch the movie a few days ago and found that he couldn’t finish it.

“All of a sudden, it hit too close to home,” he said.

Ratner and his family – his wife, Lindsay, and their kids, Lilly, Izzy, Simon and Brodie – are living the fiction they helped bring to the screen.

Officials ordered them to evacuate their home last week, a day after a Norfolk Southern train carrying 20 cars of hazardous materials slid off the rails and caught fire, threatening to explode. The National Transportation Safety Board is still investigating the cause of the incident.

“The first half of the movie is all almost exactly what’s going on here,” Ratner said Wednesday, four days into their evacuation.

In a way, the movie has provided a point of grim humor about the situation facing the residents of East Palestine – the joke no one wanted to make.

“Everybody’s been talking about that,” Ratner said of his friends and neighbors who are keeping in close touch through the crisis. “I actually made a meme where I superimposed my face on the poster and sent it to my friends.”

In the 2022 film

Scholars who study DeLillo’s work say they are not surprised by the collision of life and art. His work is often described as prescient, said Jesse Kavadlo, an English professor at Maryville University in St. Louis and president of the Don DeLillo Society.

“The terrible spill now is, of course, a coincidence. But it plays in our minds like life imitating art, which was imitating life, and on and on, because, as DeLillo suggests in ‘White Noise’ as well, we have unfortunately become too acquainted with the mediated language and enactment of disaster,” Kavadlo said.

The night of February 3, Ratner was watching his daughter’s basketball game at the local high school when the crash happened. He didn’t hear it over the noise of the game, but when they walked out of the building, he could see the massive blaze. He shot a few seconds of video on his cell phone.

His family returned to their house, which sits less than a mile from the crash site. Throughout the night, he said, they heard sirens but got little information. “We weren’t sure exactly what the danger was.”

While his family slept, he stayed up, nervously watching the fire and the news.

The next morning, activity around the site had picked up. “There was a lot of commotion, helicopters and people hightailing it out of town, and it was it was a little intense,” he said.

His wife and kids headed to stay with his wife’s parents, who live about 2 miles from the crash site. Ratner went to work running the coffee shop he and his wife own, LiB’s Market, in nearby Salem.

By that afternoon, an official alert warned that people needed to move even farther, beyond a 2-mile radius. Roughly half of the town’s 4,800 residents had to evacuate.

A friend offered to let them stay in their pool house. They later moved to another friend’s house next to their café.

School was canceled for the week. They got their dog out of the house, but they had to leave the pet turtle behind.

For now, they’re keeping their distance. But even after they go back, they have to decide whether they’ll stay.

East Palestine is in an economically depressed area, Ratner said, but it had been on a rebound. He and his wife had been considering opening another café there, but now they’re worried that plan is in jeopardy.

“That’s where we’ve been raising our kids, finishing college, buying a business, and that’s been our place,” he said. “In the future, are we going to have to sell the house? Is it worth any money at this point?”

Five of the tankers on the train that overturned last week were carrying liquid vinyl chloride, which is extremely combustible. Last Sunday, they became unstable and threatened to explode. First responders and emergency workers had to vent the tankers, spill the vinyl chloride into a trench, and then burn it off before it turned the train into a bomb. Authorities feared that an explosion could send shrapnel up to a mile away.

But that didn’t happen. The controlled burn worked and the evacuation order for East Palestine residents was officially lifted Wednesday after real-time air and water monitoring did not find any contaminant levels above screening limits.

“All of the readings we’ve been recording in the community have been at normal concentrations, normal backgrounds, which you find in almost any community,” James Justice, a representative of the US Environmental Protection Agency, said at a briefing Wednesday.

Support team members prepared to assess remaining hazards in East Palestine, Ohio, on February 7.

Although authorities have assured the residents that any immediate danger has passed, some residents have yet to return home. Ratner said they’re worried about longer-term risks that environmental officials are only beginning to assess.

Real-time air readings, which use handheld instruments to broadly screen for classes of contaminants like volatile organic compounds, showed that the air quality near the site was within normal limits.

The decision to lift the evacuation order was based on analysis of air monitoring data, according to Charles Rodriguez, community involvement coordinator for the EPA’s Region 5 office.

Up to this point, officials have been looking for large immediate threats: explosions or chemical levels that could make someone acutely ill.

“Under this phase, it’s been the emergency response,” Kurt Kohler of the Ohio EPA’s Office of Emergency Response said Wednesday. “As you see the emergency services go back home, off-site, Ohio EPA is going to remain involved through our other divisions that oversee the long-term cleanup of these kinds of spills.”

The cleanup and monitoring of the site, he said, could take years.

Although the explosion risk is past, Ratner said, people who live in East Palestine want to know about the chemical threats that might linger.

Fish and frogs have died in local streams. People have reported dead chickens and shared photos of dead dogs and foxes on social media. They say they smell chemical odors around town.

When asked at Wednesday’s briefing about exactly what spilled, representatives from Norfolk Southern listed butyl acrylate, vinyl chloride and a small amount of non-hazardous lube oil.

“Butyl acrylate is a lot of what we’re gathering information on,” said Scott Deutsch, a regional manager of hazardous materials at Norfolk Southern.

Butyl acrylate is a clear, colorless liquid with a strong, fruity odor that’s used to make plastics and paint. It’s possible to inhale it, ingest it or absorb it through the skin. It irritates the eyes, skin and lungs and may cause shortness of breath, according to the National Institute of Occupational Safety and Health. Repeated exposure can lead to lung damage.

Vinyl chloride, which is used to make PVC pipes, can cause dizziness, sleepiness and headaches. It has also been linked to an increased risk of cancer in the liver, brain, lungs and blood.

Although butyl acrylate easily mixes with water and will move quickly through the environment, it isn’t especially toxic to humans, said Richard Peltier, an associate professor of environmental health sciences at the University of Massachusetts at Amherst.

“Vinyl chloride, however, has a specific and important risk in that is contains a bunch of chlorine molecules, which can form some really awful combustion byproducts,” Peltier said. “These are often very toxic and often very persistent in the environment.”

Portions of a Norfolk Southern freight train that derailed February 3 were still on fire the next day.

A spokesperson for Norfolk Southern acknowledged but did not respond to CNN’s request for more information on how much of these chemicals spilled into the soil and water.

The Ohio EPA says it’s not sure yet, either.

“Initially, with most environmental spills, it is difficult to determine the exact amount of material that has been released into the air, water, and soil. The assessment phase that will occur after the emergency is over will help to determine that information,” James Lee, media relations manager for the Ohio EPA, wrote in an email to CNN.

Lee said that after his agency has assessed the site, it will work on a remediation plan.

Vinyl chloride is unstable and boils and evaporates at room temperature, giving it a very short lifespan in the environment, said Dana Barr, a professor of environmental health at Emory University’s Rollins School of Public Health.

“If you had a very small amount of vinyl chloride that was present in an area, it would evaporate within minutes to hours at the longest,” she said.

“But the problem they’re facing here is that it’s not just a small amount, and so if they can’t contain what gets into the water or what gets into the soil, they may have this continuous off-gassing of vinyl chloride that has gotten into these areas,” Barr said.

“I probably would be more concerned about the chemicals in the air over the course of the next month.”

State officials said they would continue to monitor the site for exactly that reason. They are also continuing to try to dig and remove contaminated soil.

“Right now, we have a system set up. As the data comes, it is distributed to a network of people to look at both on an immediate-phase – ‘Hey, is there anything really alarming to look at’ – and those smaller numbers that really matter to long-term health,” Kohler said at Wednesday’s briefing.

He said the local health department would test residents’ wells to make sure their drinking water is safe. Officials are also offering to test the air in residents’ homes before they come back.

Norfolk Southern is funding a phone line for residents to speak to a toxicologist with the Center for Toxicology and Environmental Health, an environmental consulting firm.

No one is quite sure whether to trust the help, though, since it’s coming mostly from the company behind the spill. Some residents have already filed a class-action lawsuit against Norfolk Southern.

“We’re definitely signing up for the air testing of the home before we get in there,” Ratner said.

The first trains to pass since the accident started rolling through again midweek, Ratner said. The roar of the trains, a sound he used to tune out, is now jarring.

Even the sounds of loud trucks are “off-putting,” he said.

Don Cheadle, left, and Adam Driver star in

Ratner said it was fun to be part of a disaster movie – a stylized, darkly comedic Netflix streamer starring Adam Driver, Greta Gerwig and Don Cheadle.

In real life, the situation has been gutting.

“Those are great actors, but it was hard to see it as a put-on,” Ratner said.

He shares the sentiments of Lenny Glavan, a local tattoo artist, who wrote a letter to Norfolk Southern CEO Alan Shaw on Tuesday to express the town’s anger and frustration over the accident.

“You just ripped from us our small-town motto ‘A place you want to be,’ ” Glavan wrote.

“It may not be beach-front property, it may not even have the highest paying jobs, or much else to offer, but in my experiences in life, the place I and most people want to be is when you need a helping hand, a shoulder to cry on, a friend to pray with, or a place to call home East Palestine has always been that place to want to be,” he said in his note, which was publicly posted on Facebook.

“With the events in which have occurred, the railroad that gave this small town life has now taken the life, the heartbeat, the unity and that security that families or individuals long for in this wild world away … possibly indefinitely.”

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Paging Dr. AI? What ChatGPT and artificial intelligence could mean for the future of medicine | CNN



CNN
— 

Without cracking a single textbook, without spending a day in medical school, the co-author of a preprint study correctly answered enough practice questions that it would have passed the real US Medical Licensing Examination.

But the test-taker wasn’t a member of Mensa or a medical savant; it was the artificial intelligence ChatGPT.

The tool, which was created to answer user questions in a conversational manner, has generated so much buzz that doctors and scientists are trying to determine what its limitations are – and what it could do for health and medicine.

ChatGPT, or Chat Generative Pre-trained Transformer, is a natural language-processing tool driven by artificial intelligence.

The technology, created by San Francisco-based OpenAI and launched in November, is not like a well-spoken search engine. It isn’t even connected to the internet. Rather, a human programmer feeds it a vast amount of online data that’s kept on a server.

It can answer questions even if it has never seen a particular sequence of words before, because ChatGPT’s algorithm is trained to predict what word will come up in a sentence based on the context of what comes before it. It draws on knowledge stored on its server to generate its response.

ChatGPT can also answer followup questions, admit mistakes and reject inappropriate questions, the company says. It’s free to try while its makers are testing it.

Artificial intelligence programs have been around for a while, but this one generated so much interest that medical practices, professional associations and medical journals have created task forces to see how it might be useful and to understand what limitations and ethical concerns it may bring.

Dr. Victor Tseng’s practice, Ansible Health, has set up a task force on the issue. The pulmonologist is a medical director of the California-based group and a co-author of the study in which ChatGPT demonstrated that it could probably pass the medical licensing exam.

Tseng said his colleagues started playing around with ChatGPT last year and were intrigued when it accurately diagnosed pretend patients in hypothetical scenarios.

“We were just so impressed and truly flabbergasted by the eloquence and sort of fluidity of its response that we decided that we should actually bring this into our formal evaluation process and start testing it against the benchmark for medical knowledge,” he said.

That benchmark was the three-part test that US med school graduates have to pass to be licensed to practice medicine. It’s generally considered one of the toughest of any profession because it doesn’t ask straightforward questions with answers that can easily found on the internet.

The exam tests basic science and medical knowledge and case management, but it also assesses clinical reasoning, ethics, critical thinking and problem-solving skills.

The study team used 305 publicly available test questions from the June 2022 sample exam. None of the answers or related context was indexed on Google before January 1, 2022, so they would not be a part of the information on which ChatGPT trained. The study authors removed sample questions that had visuals and graphs, and they started a new chat session for each question they asked.

Students often spend hundreds of hours preparing, and medical schools typically give them time away from class just for that purpose. ChatGPT had to do none of that prep work.

The AI performed at or near passing for all the parts of the exam without any specialized training, showing “a high level of concordance and insight in its explanations,” the study says.

Tseng was impressed.

“There’s a lot of red herrings,” he said. “Googling or trying to even intuitively figure out with an open-book approach is very difficult. It might take hours to answer one question that way. But ChatGPT was able to give an accurate answer about 60% of the time with cogent explanations within five seconds.”

Dr. Alex Mechaber, vice president of the US Medical Licensing Examination at the National Board of Medical Examiners, said ChatGPT’s passing results didn’t surprise him.

“The input material is really largely representative of medical knowledge and the type of multiple-choice questions which AI is most likely to be successful with,” he said.

Mechaber said the board is also testing ChatGPT with the exam. The members are especially interested in the answers the technology got wrong, and they want to understand why.

“I think this technology is really exciting,” he said. “We were also pretty aware and vigilant about the risks that large language models bring in terms of the potential for misinformation, and also potentially having harmful stereotypes and bias.”

He believes that there is potential with the technology.

“I think it’s going to get better and better, and we are excited and want to figure out how do we embrace it and use it in the right ways,” he said.

Already, ChatGPT has entered the discussion around research and publishing.

The results of the medical licensing exam study were even written up with the help of ChatGPT. The technology was originally listed as a co-author of the draft, but Tseng says that when the study is published, ChatGPT will not be listed as an author because it would be a distraction.

Last month, the journal Nature created guidelines that said no such program could be credited as an author because “any attribution of authorship carries with it accountability for the work, and AI tools cannot take such responsibility.”

But an article published Thursday in the journal Radiology was written almost entirely by ChatGPT. It was asked whether it could replace a human medical writer, and the program listed many of its possible uses, including writing study reports, creating documents that patients will read and translating medical information into a variety of languages.

Still, it does have some limitations.

“I think it definitely is going to help, but everything in AI needs guardrails,” said Dr. Linda Moy, the editor of Radiology and a professor of radiology at the NYU Grossman School of Medicine.

She said ChatGPT’s article was pretty accurate, but it made up some references.

One of Moy’s other concerns is that the AI could fabricate data. It’s only as good as the information it’s fed, and with so much inaccurate information available online about things like Covid-19 vaccines, it could use that to generate inaccurate results.

Moy’s colleague Artie Shen, a graduating Ph.D. candidate at NYU’s Center for Data Science, is exploring ChatGPT’s potential as a kind of translator for other AI programs for medical imaging analysis. For years, scientists have studied AI programs from startups and larger operations, like Google, that can recognize complex patterns in imaging data. The hope is that these could provide quantitative assessments that could potentially uncover diseases, possibly more effectively than the human eye.

“AI can give you a very accurate diagnosis, but they will never tell you how they reach this diagnosis,” Shen said. He believes that ChatGPT could work with the other programs to capture its rationale and observations.

“If they can talk, it has the potential to enable those systems to convey their knowledge in the same way as an experienced radiologist,” he said.

Tseng said he ultimately thinks ChatGPT can enhance medical practice in much the same way online medical information has both empowered patients and forced doctors to become better communicators, because they now have to provide insight around what patients read online.

ChatGPT won’t replace doctors. Tseng’s group will continue to test it to learn why it creates certain errors and what other ethical parameters need to be put in place before using it for real. But Tseng thinks it could make the medical profession more accessible. For example, a doctor could ask ChatGPT to simplify complicated medical jargon into language that someone with a seventh-grade education could understand.

“AI is here. The doors are open,” Tseng said. “My fundamental hope is, it will actually make me and make us as physicians and providers better.”

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I’m a parent with an active social media brand: Here’s what you need to check on your child’s social media right now | CNN

Editor’s Note: Sign up for CNN’s Stress, But Less newsletter. Our six-part mindfulness guide will inform and inspire you to reduce stress while learning how to harness it.



CNN
— 

If you follow me on Twitter or Instagram, you’ll know I wear a lot of hats: romance author, parent of funny tweenagers, part-time teacher, amateur homesteader, grumbling celiac and the wife of a seriously outdoorsy guy.

Because I’m an author with a major publisher in today’s competitive market, I’ve been tasked with stepping up my social media brand: participation, creation and all. The more transparent and likable I am online, the better my books sell. Therefore, to social media I go.

It’s rare to find someone with no social media presence these days, but there’s a marked difference between posting a few pictures for family and friends and actively creating social media content as part of your daily life.

With a whopping 95% of teens polled having access to smartphones (and 98% of teens over 15), according to an August Pew Research Center survey on teens, social media and technology, it doesn’t look like social media platforms are going away anytime soon.

Not only are they key social tools, but they also allow teens to feel more a part of things in their communities. Many teens like being online, according to a November Pew Research Center survey on teen life on social media. Eighty percent of the teens surveyed felt more connected to what is happening in their friends’ lives, while 71% felt social media allows them to showcase their creativity.

So, while posting online is work for me, it’s a way of life for the tweens and teens I see creating and publishing content online. As a parent of two middle schoolers, I know how important social media is to them, and I also know what’s out there. I see the good, the bad and the viral, and I’ve have put together some guidelines, based on what I’ve seen, for my fellow parents to watch for.

Here are eight questions to ask yourself as you check out your children’s social media accounts.

If you don’t, it’s time to start. It’s like when I had to look up the term “situationship,” I saw that ignorance is not bliss in this case. Or really any case when it comes to your children. Both of my children have smartphones, but even if your children don’t have smartphones, if they have any sort of device — phone, tablet, school laptop — it’s likely they have some sort of social media account out there. Every app our children wish to add to their smart devices comes through my husband’s and my phone notifications for approval. Before I approve any apps, I’ll read the reviews, run an internet search and text my mom friends for their experience.

Most tweens and teens use social media for socializing with local friends.

If I’m still uncertain about an app, I’ll hold off on approving it until I can sit down with my children and ask them why they want it. Sometimes just waiting and forcing a short discussion is enough to convince them they no longer want it. In our household, I avoid any apps that run social surveys, allow anonymous feedback or require the individual to use location services.

If you don’t have your family phone plan all hooked together with parental controls, I’d advise setting that up ASAP. Because different devices and apps have different ways to monitor and set up parental controls, it’s impossible to link all the options here. However, a quick search will give you exactly the coverage you are comfortable with, including apps that track your child’s text messages and changing the settings on your child’s phone to lock down at a certain time every night.

The top social media platforms teens use today are YouTube (95% of teens polled), TikTok (67%), Instagram (62%) and Snapchat (59%), according to the Pew Research Center survey on teens and social media tech. Other social media platforms teens use less frequently are Twitter, Reddit, WhatsApp and Facebook. Most notably, Facebook is seeing a significant downturn in teen users. This list isn’t exhaustive, however. I would check out your children’s devices for group chat apps (such as Slack or Discord) and also scroll through their sport or activity apps where group chat capabilities exist.

I’ve seen preteens and teens using their real names, birthdate, home address, pets’ names, locker numbers or their school baseball team. Any of that information could be used to identify your child and location in real life or using a quick Google search. All of that is an absolute “no” in our house.

I also tell my kids not to answer the fun surveys and quizzes that invite children to share their unique information and repost it for others to see. These can be useful tools for predators and people trying to steal your children’s identity.

What I do: I made the choice a long ago to withhold the names of my children and partner. It’s not an exact science, and I know some clever digging could find them. For my husband, it’s for the sake of his privacy and also the protection of his professionalism. Just because he’s married to a romance author doesn’t mean he should have to answer for my online antics, whatever they may be. For my children, I want to avoid anything embarrassing that could be traced back to them during their college application season.

Even if your children keep their social media profiles private (more on that later), their biographical information, screen name and avatar or profile picture are public information.

Do an internet search of your child’s name to see what’s out there and scroll through images to make sure there isn’t anything you wouldn’t want to be made public. In our household, I’ve asked my children to use generic items or illustrated avatars in their social media bios.

What I do: Parents who do have active social media accounts may want to do a search of their own names. When my first book was published in 2019, I did a search of my name and images and found many photos of my children that came directly from my social media pages. I hadn’t posted pictures of them, but I did use a family photo as my profile photo and those are public record. Once I deleted them, the photos disappeared.

Another “no” in our household is posting videos or photos of our home or bedrooms. Something that feels innocent and innocuous to your middle schooler may not feel that way to an adult seeking out inappropriate content.

I learned this from one of my children’s Pinterest accounts. My kid loves to create themed videos using her own photos and stock pictures, and she’s gained over 500 followers in a short period of time. She has completely followed our rules and I know, because I check and follow her myself — but it hasn’t stopped the influx of adult men following her content.

What we do: Over the holidays, I sat with her and went through each follower one by one and blocked anyone we decided was there for the wrong reasons. In the end, we blocked close to 30 adult men on her account. (I also know that some predators cleverly disguise themselves as children or teens, and we may not catch them all, but this is still a worthy exercise.)

We also talk to our children about how to protect themselves. They wouldn’t want those strangers standing in their bedroom; therefore, they don’t want to post videos of their bedroom or bathroom or classroom for strangers to view.

This is a tricky one for lots of reasons. For content creators to build their following, they need to remain public on social media. If your child is an entrepreneur or artist hoping to grab attention, locking down their account will prevent that from happening.

That said, a way around this is to have two accounts. First, a private one, locked down and only used for family and close friends, and second, a public one that lacks identifiers but showcases whatever branding the child is hoping to grow. I’ve come across some well-managed public accounts for children who have giant followings and noticed they are usually run by parents, who state that right in the profile. I like this. If your children want public profiles because they are hoping to catch the attention of a talent scout, having the accounts monitored by a responsible adult who has their best interest in mind is a healthy compromise.

This is the exception, however. Most tweens and teens today use their social media for socializing with local friends. The benefit of keeping their account as private (or as private as can be) is threefold. It allows them to screen who follows their content, thus preventing our Pinterest fiasco. It prevents strangers from accessing their content and making it viral without their permission. And it protects them from unsolicited contact with strangers.

Not all social media platforms have the option to make your account “private.” For example, YouTube has parental controls that can be adjusted at any time. TikTok and Instagram can be made private (which means users must approve followers) by making the change in the account settings. Once the account is private, a little padlock will show next to the username.

Snapchat allows users to approve followers on a case-by-case basis as well as turn off features that disclose a user’s location. Notably, Snapchat also informs users when another user takes a screenshot of their story, which is a feature other social media platforms don’t have yet.

Most group chat apps don’t have the ability to go private so much as they ask users to approve of follower requests. Take time to discuss with your children who they allow to follow them and what personal information they allow those followers to know. It’s also a great time to teach them the art of “blocking” those individuals who are unsafe or unkind.

My suggestion is to log in, scroll around and even ask your children to teach you about the platforms they use. Then, when they roll their eyes at you, go ahead and tell them about your first Hotmail email address and the way you picked the perfect emo playlist on your Myspace page … and when they’re bent over laughing, sneak a peek at their follower list. Trust me, it’ll be worth it.

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FDA vaccine advisers vote to harmonize Covid-19 vaccines in the United States | CNN



CNN
— 

A panel of independent experts that advises the US Food and Drug Administration on its vaccine decisions voted unanimously Thursday to update all Covid-19 vaccines so they contain the same ingredients as the two-strain shots that are now used as booster doses.

The vote means young children and others who haven’t been vaccinated may soon be eligible to receive two-strain vaccines that more closely match the circulating viruses as their primary series.

The FDA must sign off on the committee’s recommendation, which it is likely to do, before it goes into effect.

Currently, the US offers two types of Covid-19 vaccines. The first shots people get – also called the primary series – contain a single set of instructions that teach the immune system to fight off the original version of the virus, which emerged in 2019.

This index strain is no longer circulating. It was overrun months ago by an ever-evolving parade of new variants.

Last year, in consultation with its advisers, the FDA decided that it was time to update the vaccines. These two-strain, or bivalent, shots contain two sets of instructions; one set reminds the immune system about the original version of the coronavirus, and the second set teaches the immune system to recognize and fight off Omicron’s BA.4 and BA.5 subvariants, which emerged in the US last year.

People who have had their primary series – nearly 70% of all Americans – were advised to get the new two-strain booster late last year in an effort to upgrade their protection against the latest variants.

The advisory committee heard testimony and data suggesting that the complexity of having two types of Covid-19 vaccines and schedules for different age groups may be one of the reasons for low vaccine uptake in the US.

Currently, only about two-thirds of Americans have had the full primary series of shots. Only 15% of the population has gotten an updated bivalent booster.

Data presented to the committee shows that Covid-19 hospitalizations have been rising for children under the age of 2 over the past year, as Omicron and its many subvariants have circulated. Only 5% of this age group, which is eligible for Covid-19 vaccination at 6 months of age, has been fully vaccinated. Ninety percent of children under the age of 4 are still unvaccinated.

“The most concerning data point that I saw this whole day was that extremely low vaccination coverage in 6 months to 2 years of age and also 2 years to 4 years of age,” said Dr. Amanda Cohn, director of the US Centers for Disease Control and Prevention’s Division of Birth Defects and Infant Disorders. “We have to do much, much better.”

Cohn says that having a single vaccine against Covid-19 in the US for both primary and booster doses would go a long way toward making the process less complicated and would help get more children vaccinated.

Others feel that convenience is important but also stressed that data supported the switch.

“This isn’t only a convenience thing, to increase the number of people who are vaccinated, which I agree with my colleagues is extremely important for all the evidence that was related, but I also think moving towards the strains that are circulating is very important, so I would also say the science supports this move,” said Dr. Hayley Gans, a pediatric infectious disease specialist at Stanford University.

Many others on the committee were similarly satisfied after seeing new data on the vaccine effectiveness of the bivalent boosters, which are cutting the risk of getting sick, being hospitalized or dying from a Covid-19 infection.

“I’m totally convinced that the bivalent vaccine is beneficial as a primary series and as a booster series. Furthermore, the updated vaccine safety data are really encouraging so far,” said Dr. David Kim, director of the the US Department of Health and Human Services’ National Vaccine Program, in public discussion after the vote.

Thursday’s vote is part of a larger plan by the FDA to simplify and improve the way Covid-19 vaccines are given in the US.

The agency has proposed a plan to convene its vaccine advisers – called the Vaccines and Related Biological Products Advisory Committee, or VRBPAC – each year in May or June to assess whether the instructions in the Covid-19 vaccines should be changed to more closely match circulating strains of the virus.

The time frame was chosen to give manufacturers about three months to redesign their shots and get new doses to pharmacies in time for fall.

“The object, of course – before anyone says anything – is not to chase variants. None of us think that’s realistic,” said Jerry Weir, director of the Division of Viral Products in the FDA’s Office of Vaccines Research and Review.

“But I think our experience so far, with the bivalent vaccines that we have, does indicate that we can continue to make improvements to the vaccine, and that would be the goal of these meetings,” Weir said.

In discussions after the vote, committee members were supportive of this plan but pointed out many of the things we still don’t understand about Covid-19 and vaccination that are likely to complicate the task of updating the vaccines.

For example, we now seem to have Covid-19 surges in the summer as well as the winter, noted Dr. Michael Nelson, an allergist and immunologist at the University of Virginia. Are the surges related? And if so, is fall the best time to being a vaccination campaign?

The CDC’s Dr. Jefferson Jones said that with only three years of experience with the virus, it’s really too early to understand its seasonality.

Other important questions related to the durability of the mRNA vaccines and whether other platforms might offer longer protection.

“We can’t keep doing what we’re doing,” said Dr. Bruce Gellin, chief of global public health strategy at the Rockefeller Foundation. “It’s been articulated in every one of these meetings despite how good these vaccines are. We need better vaccines.”

The committee also encouraged both government and industry scientists to provide a fuller picture of how vaccination and infection affect immunity.

One of the main ways researchers measure the effectiveness of the vaccines is by looking at how much they increase front-line defenders called neutralizing antibodies.

Neutralizing antibodies are like firefighters that rush to the scene of an infection to contain it and put it out. They’re great in a crisis, but they tend to diminish in numbers over time if they’re not needed. Other components of the immune system like B-cells and T-cells hang on to the memory of a virus and stand ready to respond if the body encounters it again.

Scientists don’t understand much about how well Covid-19 vaccination boosts these responses and how long that protection lasts.

Another puzzle will be how to pick the strains that are in the vaccines.

The process of selecting strains for influenza vaccines is a global effort that relies on surveillance data from other countries. This works because influenza strains tend to become dominant and sweep around the world. But Covid-19 strains haven’t worked in quite the same way. Some that have driven large waves in other countries have barely made it into the US variant mix.

“Going forward, it is still challenging. Variants don’t sweep across the world quite as uniform, like they seem to with influenza,” the FDA’s Weir said. “But our primary responsibility is what’s best for the US market, and that’s where our focus will be.”

Eventually, the FDA hopes that Americans would be able to get an updated Covid-19 shot once a year, the same way they do for the flu. People who are unlikely to have an adequate response to a single dose of the vaccine – such as the elderly or those with a weakened immune system – may need more doses, as would people who are getting Covid-19 vaccines for the first time.

At Thursday’s meeting, the advisory committee also heard more about a safety signal flagged by a government surveillance system called the Vaccine Safety Datalink.

The CDC and the FDA reported January 13 that this system, which relies on health records from a network of large hospital systems in the US, had detected a potential safety issue with Pfizer’s bivalent boosters.

In this database, people 65 and older who got a Pfizer bivalent booster were slightly more likely to have a stroke caused by a blood clot within three weeks of their vaccination than people who had gotten a bivalent booster but were 22 to 42 days after their shot.

After a thorough review of other vaccine safety data in the US and in other countries that use Pfizer bivalent boosters, the agencies concluded that the stroke risk was probably a statistical fluke and said no changes to vaccination schedules were recommended.

At Thursday’s meeting, Dr. Nicola Klein, a senior research scientist with Kaiser Permanente of Northern California, explained how they found the signal.

The researchers compared people who’d gotten a vaccine within the past three weeks against people who were 22 to 42 days away from their shots because this helps eliminate bias in the data.

When they looked to see how many people had strokes around the time of their vaccination, they found an imbalance in the data.

Of 550,000 people over 65 who’d received a Pfizer bivalent booster, 130 had a stroke caused by a blood clot within three weeks of vaccination, compared with 92 people in the group farther out from their shots.

The researchers spotted the signal the week of November 27, and it continued for about seven weeks. The signal has diminished over time, falling from an almost two-fold risk in November to a 47% risk in early January, Klein said. In the past few days, it hasn’t been showing up at all.

Klein said they didn’t see the signal in any of the other age groups or with the group that got Moderna boosters. They also didn’t see a difference when they compared Pfizer-boosted seniors with those who were eligible for a bivalent booster but hadn’t gotten one.

Further analyses have suggested that the signal might be happening not because people who are within three weeks of a Pfizer booster are having more strokes, but because people who are within 22 to 42 days of their Pfizer boosters are actually having fewer strokes.

Overall, Klein said, they were seeing fewer strokes than expected in this population over that period of time, suggesting a statistical fluke.

Another interesting thing that popped out of this data, however, was a possible association between strokes and high-dose flu vaccination. Seniors who got both shots on the same day and were within three weeks of those shots had twice the rate of stroke compared with those who were 22 to 42 days away from their shots.

What’s more, Klein said, the researchers didn’t see the same association between stroke and time since vaccination in people who didn’t get their flu vaccine on the same day.

The total number of strokes in the population of people who got flu shots and Covid-19 boosters on the same day is small, however, which makes the association a shaky one.

“I don’t think that the evidence are sufficient to conclude that there’s an association there,” said Dr. Tom Shimabukuro, director of the CDC’s Immunization Safety Office.

Nonetheless, Richard Forshee, deputy director of the FDA’s Office of Biostatistics and Pharmacovigilance, said the FDA is planning to look at these safety questions further using data collected by Medicare.

The FDA confirmed that the agency is taking a closer look.

“The purpose of the study is 1) to evaluate the preliminary ischemic stroke signal reported by CDC using an independent data set and more robust epidemiological methods; and 2) to evaluate whether there is an elevated risk of ischemic stroke with the COVID-19 bivalent vaccine if it is given on the same day as a high-dose or adjuvanted seasonal influenza vaccine,” a spokesperson said in a statement.

The FDA did not give a time frame for when these studies might have results.

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A plan for competitive, green and resilient industries

We, Renew Europe, want our Union to fulfil its promise of prosperity and opportunities for our fellow Europeans. We have championed initiatives to make our continent freer, fairer and greener, but much more remains to be done.

We are convinced that Europe has what it takes to become the global industrial leader, especially in green and digital technologies. Yet it is faced with higher energy prices and lower levels of investment, which creates a double risk of internal and external fragmentation.

The Russian aggression against Ukraine has shown us that our European way of life cannot be taken for granted. While we stand unwaveringly at the side of our Ukrainian friends and commit to the rebuilding of their homeland, we also need to protect our freedom and prosperity.

That is why Europe needs an urgent and ambitious plan for a competitive, productive and innovative industry ‘made in Europe’. Our proposals below would translate into many more jobs, a faster green transition and increased geopolitical influence.

We must improve the conditions for companies, big and small, to innovate, to grow and to thrive globally.

1. Reforms to kick start the European economy: A European Clean Tech, Competitiveness and Innovation Act

While the EU can be proud of its single market, we must improve the conditions for companies, big and small, to innovate, to grow and to thrive globally.

  • In addition to the acceleration of the deployment of sustainable energy, we call on the Commission to propose a European Clean Tech, Competitiveness and Innovation Act, which would:
  • While the EU can be proud of its single market, we must improve the conditions for companies, big and small, to innovate, to grow and to thrive globally.
  • In addition to the acceleration of the deployment of sustainable energy, we call on the Commission to propose a European Clean Tech, Competitiveness and Innovation Act, which would:
  • Cut red tape and administrative burden, focusing on delivering solutions to our companies, particularly for SMEs and startups.
  • Adapt state aid rules for companies producing clean technologies and energies.
  • Introduce fast-track permitting for clean and renewable energies and for industrial projects of general European interest.
  • Streamline the process for important Projects of Common European Interest, with adequate administrative resources.
  • Guarantee EU-wide access to affordable energy for our industries.
  • Strengthen the existing instruments for a just transition of carbon-intensive industries, as they are key to fighting climate change.
  • Facilitate private financing by completing the Capital Markets Union to allow our SMEs and startups to scale up.
  • Set the right conditions to increase Europe’s global share of research and development spending and reach our own target at 3 percent of our GDP.
  • Build up the European Innovation Council to develop breakthrough technologies.
  • Deliver a highly skilled workforce for our industry.
  • Deepen the single market by fully enforcing existing legislation and further harmonization of standards in the EU as well as with third countries.

We need to reduce more rapidly our economic dependencies from third countries, which make our companies and our economies vulnerable.

2. Investments supporting our industry to thrive: A European Sovereignty Fund and Reform Act

While the EU addresses, with unity, all the consequences of the war in Ukraine, we need to reduce more rapidly our economic dependencies from third countries, which make our companies and our economies vulnerable.

In addition to the new framework for raw materials, we call on the Commission to:

  • Create a European Sovereignty Fund, by revising the MFF and mobilizing private investments, to increase European strategic investments across the Union, such as the production on our soil of critical inputs, technologies and goods, which are key to the green and digital transitions.
  • Carry out a sovereignty test to screen European legislation and funds, both existing and upcoming, to demonstrate that they neither harm the EU’s capacity to act autonomously, nor create new dependencies.
  • Modernize the Stability and Growth Pact to incentivize structural reforms and national investments with real added value for our open strategic autonomy, in areas like infrastructure, resources and technologies.

While the EU has to resist protectionist measures, we will always want to promote an open economy with fair competition.

3. Initiatives creating a global level playing field:

A New Generation of Partnerships in the World Act

While the EU has to resist protectionist measures, we will always want to promote an open economy with fair competition.

  • In addition to all the existing reforms made during this mandate, notably on public procurement and foreign subsidies, we call on the Commission to:
  • Make full use of the EU’s economic and political power regarding current trade partners to ensure we get the most for our industry exports and imports, while promoting our values and standards, not least human rights and the Green Deal.
  • Promote new economic partnerships with democratic countries so we can face climate change and all the consequences of the Russian aggression together.
  • Ensure the diversification of supply chains to Europe, particularly regarding critical technologies and raw materials, based on a detailed assessment of current dependencies and alternative sources.
  • Use all our trade policy instruments to promote our prosperity and preserve the single market from distortions from third countries.
  • Take recourse to dispute settlement mechanisms available at WTO level whenever necessary to promote rules-based trade.
  • Adopt a plan to increase our continent’s attractiveness for business projects.
  • Create a truly European screening of the most sensitive foreign investments.
  • We, Renew Europe, believe that taken together these initiatives will foster the development of a competitive and innovative European industry fit for the 21st century. It will pave the way for a better future for Europeans that is more prosperous and more sustainable.



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LeBron James and Billie Jean King lead tributes to American journalist Grant Wahl | CNN



CNN
— 

The death of prominent journalist Grant Wahl at the World Cup in Qatar has led to an outpouring of shock and grief across the sports world, with NBA star LeBron James and tennis great Billie Jean King leading the tributes to the American.

Prominent American journalist Grant Wahl has died in Qatar after collapsing while covering the World Cup, sparking an outpouring of shock and grief across the sports world. He was 49.

King said Wahl’s death was “heartbreaking.”

“A talented journalist, Grant was an advocate for the LGBTQ community & a prominent voice for women’s soccer,” King tweeted Saturday. “He used his platform to elevate those whose stories needed telling. Prayers for his family.”

On Friday in Philadelphia, basketball star James said he had been “very fond of Grant.” While Wahl was at Sports Illustrated, he did a cover story on James when James was in high school.

“I’ve always kind of watched from a distance even when I moved up in ranks and became a professional, and he went to a different sport,” said James, speaking at a postgame press conference. “Any time his name would come up I’ll always think back to me as a teenager and having Grant in our building … It’s a tragic loss.”

Tyler Adams, the captain of the US men’s national soccer team, which was knocked out of the World Cup by the Netherlands in the last 16, sent his “deepest sympathy” to Wahl’s wife, Celine Gounder, and to those who knew him.

“As players we have a tremendous amount of respect for the work of journalists, & Grant’s was a giant voice in soccer that has tragically fallen silent,” Adams wrote on Twitter.

Qatar’s World Cup organizers said on Saturday that Wahl “fell ill” in the press area, where he received “immediate medical treatment on site.”

He was then transferred to Hamad General Hospital, said a spokesperson for the Supreme Court Committee for Delivery and Legacy, the body responsible for planning the tournament.

Wahl was treated in the stadium “for about 20-25 minutes” before he was moved to the hospital, Keir Radnedge, a columnist at World Soccer Magazine, told CNN Saturday.

“This was towards the end of extra time in the match. Suddenly, colleagues up to my left started shouting for medical assistance. Obviously, someone had collapsed. Because the chairs are freestanding, people were able to move the chairs, so it’s possible to create a little bit of space around him,” Radnedge said.

He added that the medical team were there “pretty quickly and were able to, as best they could, give treatment.”

White House Press Secretary Karine Jean-Pierre reacted to Wahl’s death on Saturday, adding that senior State Department officials were in touch with Qatari officials and Grant’s family.

“Grant Wahl was an inspiration to many. Our thoughts are with his wife Dr. Céline Gounder and all those who loved him. State Department officials are in touch with Grant’s family and with senior officials in the government of Qatar to ensure his family gets the support they need,” Jean-Pierre wrote on Twitter.

“Only some days ago, Grant was recognized by FIFA and AIPS (the International Sports Press Association) for his contribution to reporting on eight consecutive FIFA World Cups,” said FIFA President Gianni Infantino in a statement.

Infantino and FIFA media director Bryan Swanson were at the hospital on Saturday to offer any kind of support needed for the family, friends, and the journalists who were also his housemates in Qatar.

The co-editors in chief of Sports Illustrated, the publication where Wahl spent the majority of his career, said in a joint statement they were “shocked and devastated at the news of Grant’s passing.”

“We were proud to call him a colleague and friend for two decades – no writer in the history of (Sports Illustrated) has been more passionate about the sport he loved and the stories he wanted to tell,” said the statement.

It added that Wahl had first joined the publication in November 1996. He had volunteered to cover the sport as a junior reporter – back before it reached the heights of global popularity it now enjoys – eventually becoming “one of the most respected soccer authorities in the world,” it said.

The statement said that Wahl also worked with other media outlets including Fox Sports. After leaving Sports Illustrated in 2020, he began publishing his podcast and newsletter.

Other current and former US soccer players, including Ali Krieger and Tony Meola, shared their condolences, as did sporting bodies such as Major League Soccer and the National Women’s Soccer League.

Wittyngham, Wahl’s podcast co-host, told CNN on Saturday the news of his death had been hard to fathom.

“For Americans, Grant Wahl is the first person you read covering soccer. He was kind of the only person for a while … Grant was the first person who really paid genuine attention to this sport in a meaningful way,” Wittyngham said.

Several journalists shared stories of reporting alongside Wahl, and having encountered him at multiple World Cups over the years.

“Before he became the best covering soccer he did hoops and was so kind to me,” wrote famed broadcaster Dick Vitale.

Timmy T. Davis, the US Ambassador to Qatar, tweeted that Wahl was “a well known and greatly respected reporter who focused on the beautiful game.”

“The entire US Soccer family is heartbroken to learn that we have lost Grant Wahl,” US Soccer said in a statement on its official Twitter account.

“Grant made soccer his life’s work, and we are devastated that he and his brilliant writing will no longer be with us.”

US Soccer praised Wahl’s passion and “belief in the power of the game to advance human rights,” and shared its condolences with Wahl’s wife, Celine Gounder, and his loved ones.

Gounder also posted the US Soccer statement on Twitter.

“I am so thankful for the support of my husband Grant Wahl’s soccer family and of so many friends who’ve reached out tonight. I’m in complete shock,” wrote Gounder, a former CNN contributor who served on the Biden-Harris transition Covid-19 advisory board.

US State Department spokesperson Ned Price said the department was in “close communication” with Wahl’s family. The World Cup organizers also said they were in touch with the US embassy “to ensure the process of repatriating the body is in accordance with the family’s wishes.”

Wahl wearing a rainbow-colored t-shirt while working at Qatar 2022.

Wahl had covered soccer for more than two decades, including 11 World Cups — six men’s, five women’s – and authored several books on the sport, according to his website.

He had just celebrated his birthday earlier this week with “a great group of media friends at the World Cup,” according to a post on his official Twitter account, which added: “Very thankful for everyone.”

In an episode of the podcast Futbol with Grant Wahl, published days before his death on December 6, he had complained of feeling unwell.

“It had gotten pretty bad in terms of like the tightness in my chest, tightness, pressure. Feeling pretty hairy, bad,” Wahl told co-host Chris Wittyngham in the episode. He added that he sought help at the medical clinic at the World Cup media center, believing he had bronchitis.

He was given cough syrup and ibuprofen, and felt better shortly afterward, he said.

Wahl also said he experienced an “involuntary capitulation by my body and mind” after the US-Netherlands game on December 3.

“This isn’t my first rodeo. I’ve done eight of these on the men’s side,” he said at the time. “And so like, I’ve gotten sick to some extent at every tournament, and it’s just about trying to find a way to like get your work done.”

He further described the incident in a recent newsletter published on December 5, writing that his body had “broke down” after he had little sleep, high stress and a heavy workload. He’d had a cold for 10 days, which “turned into something more severe,” he wrote, adding that he felt better after receiving antibiotics and catching up on sleep.

Wahl had made headlines in November by reporting that he was detained and briefly refused entry to a World Cup match because he was wearing a rainbow t-shirt in support of LGBTQ rights.

He said security staff had told him to change his shirt because “it’s not allowed,” and had taken his phone. Wahl said he was released 25 minutes after being detained and received apologies from a FIFA representative and a senior member of the security team at the stadium.

Afterward, Wahl told CNN he “probably will” wear the shirt again.



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