Daily U.S. COVID-19 deaths again top 3,000 as officials scurry to distribute vaccine
WASHINGTON (Reuters) – The United States on Wednesday widened its network for administering COVID-19 vaccines to doctors and nurses on the frontlines of a pandemic killing more than 3,000 Americans a day, even as a major storm threatened to slow progress on the East Coast.
While medical professionals at a growing number of hospitals rolled up their sleeves, lawmakers on Capitol Hill said they were nearing a long-elusive bipartisan deal on $900 billion in economic relief to pandemic-hit U.S. workers and businesses.
The aid package, to be attached to a massive spending bill that must pass by Friday to avert a federal shutdown, was not expected to include COVID-relief funds for state and local governments, as Democrats wanted, or protections for companies from pandemic-related lawsuits, as sought by Republicans.
Rollout of the first tranche of 2.9 million doses of a newly authorized vaccine from Pfizer Inc and German partner BioNTech SE was in its third full day, with shipments headed to 66 more distribution hubs nationwide.
A second vaccine from Moderna Inc could win emergency-use approval from the U.S. Food and Drug Administration this week.
Express delivery companies FedEx and United Parcel Service, sharing a leading role in vaccine shipments, said they were monitoring potential impacts of heavy ice and snow that began to disrupt transport along the Eastern Seaboard.
U.S. Army General Gustave Perna, overseeing the government’s Operation Warp Speed campaign, said FedEx and UPS have developed contingency plans to keep any delayed vaccine shipments secure until they can be “delivered the next day.”
“We are on track with all the deliveries we said we were doing,” Perna told reporters at a briefing. He cited a minor glitch involving four trays of vaccine – two sent to California and two to Alabama – that arrived at temperatures lower than prescribed. The trays in question were shipped back to Pfizer and later replaced, Perna said.
Some 570 other vaccine distribution centers received the bulk of the initial batch of shipments on Monday and Tuesday, and an even larger wave was due for delivery to 886 additional locations on Friday, Perna said.
From each distribution site, vaccine doses were divided up among area hospitals and administered to healthcare workers, designated as first in line to be immunized. Some were also going to residents and staff of long-term care facilities. Later vaccine rounds will go to other essential workers, senior citizens and people with chronic health conditions.
U.S. President-elect Joe Biden, who has said he would get the vaccine publicly to help instill confidence in its safety, is expected to receive his first injection as soon as next week, according to his transition team.
Biden, 78, is in a high-risk category for the coronavirus due to his age.
It will take several months before vaccines are widely available to the public on demand, and opinion polls have found many Americans hesitant about getting inoculated.
Political leaders and medical authorities in the meantime have launched a media blitz assuring Americans that the vaccines are safe while urging them to avoid growing weary of social distancing and mask-wearing while the pandemic rages on.
“It is not over yet,” Dr Anthony Fauci, a member of the White House coronavirus task force, told CBS News. “Public health measures are the bridge to get to the vaccine, which is going to get us out of this.”
Data shows surging infections and hospitalizations are driving healthcare systems to the breaking point across much of the country, with many intensive care units at or near capacity.
The United States reported at least 3,459 additional coronavirus deaths on Wednesday alone, a record that marks the fourth time in a week the daily toll has surpassed 3,000, according to a Reuters tally. The seven-day average has topped 2,500 lives lost every 24 hours for the first time this week.
To date, COVID-19 deaths total more than 304,000 nationally, while the mounting case load of 16.7 million known infections represents roughly 5% of the U.S. population.
With hospitalizations setting a record for the 19th day in a row – nearly 113,000 patients under treatment on Wednesday – health experts warn that fatalities will rise higher still in the weeks ahead, even as the vaccine campaign steadily expands.
Another 2 million doses of the Pfizer vaccine and 5.9 million doses of Moderna’s vaccine could be allocated next week, U.S. Health Secretary Alex Azar told a conference call. Both require two doses, given three or four weeks apart, for each person inoculated.
In all, the United States has options to buy up to 300 million doses of those vaccines, Azar said, plus hundreds of millions more doses of vaccines yet to receive approval, including some single-dose drugs.
The United States could have a surplus supply of vaccines in the future, if all the vaccines it has secured are authorized for use, Azar said, which could eventually benefit other countries.
The Trump administration was also in talks to secure additional antibody treatment doses from Regeneron Pharmaceuticals Inc and Eli Lilly and Co, Operation Warp Speed chief adviser Moncef Slaoui told the same conference call.
Reporting by Susan Heavey, Manas Mishra, Anurag Maan, Lisa Shumaker and, Richard Cowan; Writing by Daniel Trotta and Steve Gorman; Editing by Steve Orlofsky, Aurora Ellis and Grant McCool
Our Standards: The Thomson Reuters Trust Principles.
How ducks, geese and swans see the world – and why this puts them at risk in a changing environment
Our airspace has only started to become cluttered recently – many birds are struggling to navigate through it.
Each year, millions of birds fly into power lines, wind turbines and the other man-made structures that litter the open air space. These collisions frequently result in the death of birds and, if power systems go down, disrupt our lives and pose financial challenges for power companies.
Numerous bird species, including macaws in Brazil, geese and swans in the UK, and blue cranes in South Africa have been found to be susceptible to collisions with power lines. But any flying bird can fall victim to such a collision.
In some places, these collisions happen so often that they can jeopardise local populations of endangered species.
But birds are highly evolved flying machines. They can fly in tightly packed flocks that weave and turn to our delight and wonder. So why do they fly into things?
How birds see the world
Exploring the reasons behind why birds are victims of collisions has led to new ideas that challenge our fundamental perception of what birds are. In the past, scientists have described birds as “a wing guided by an eye”. This implies that flight has been central to moulding bird vision throughout their evolution.
But now it is safe to conclude that a bird is instead best characterised as “a bill guided by an eye”. Rather than flight, the main driver of the evolution of bird vision has been the key tasks associated with foraging, in particular detecting food items and getting the bill to the right place at the right time in order to seize them. Alongside the detection of predators, this is the task that bird vision has to get right day in, day out.
Birds differ in how much the view from each eye overlaps (called the binocular field of view). The more the eyes look straight ahead, the more the view from each eye will overlap – much as human eyes do – thus broadening the binocular field. For a bird such as a duck, with its eyes positioned high up on either side of the head, the view from each eye will be very different (with smaller binocular field).
We measured binocular field size across a broad range of 39 species of duck, geese and swans. We found that the key driver of diversity in vision between species is their diet and how they forage for food.
Birds that primarily use their vision to locate foods such as seeds, or selectively graze on plants, tend to have broader binocular fields.
However, the binocular fields of species like mallards and pink-eared ducks are much narrower. These birds rely less on their eyes for foraging and more on touch cues from their bills. The vision of birds like these instead provides them with a comprehensive view of the region above and behind their heads.
Birds certainly need to have some visual coverage in front of them. But with eyes placed high on the side of the head, resulting in a very narrow binocular field, they are restricted to retrieving rather scant detail from the distant scene ahead. What matters to them more is placing their bill accurately at a close distance and seeing who is coming at them from the side or from behind.
This finding is not confined to ducks, geese and swans. It probably generalises to all birds, except perhaps some owls (which have more front-facing eyes and rely upon sound to locate prey). The great majority of birds are therefore vulnerable to collisions.
However, it is larger birds like geese, swans and bustards that face real problems. Their restricted forward vision is compounded by flying fast and being unable to change direction quickly. These birds also often fly in flocks, and at dusk and dawn when the light level is lower.
Warning birds of hazards ahead
Understanding the vision of birds from the perspective of foraging and predator detection improves our understanding of what causes collisions. But, more importantly, it allows us to do something about it.
We must not assume that a bird’s view of the world is the same as ours. We are specialised primates with eyes on the front of our heads, and we see the world in a very different way to birds, not only with respect to visual fields but also acuity and colour vision. So, we must try to take a proper “birds’ eye view” of the problem.
Birds are also flying fast. But, as they do so, they are taking in only gross information of what lies ahead – much as we do when driving our cars. As with car hazard warnings, it is necessary to alert birds using markers that may seem excessive.
Birds that are vulnerable to collisions have evolved to fly in airspace that only recently has started to become cluttered. To be clearly visible to a bird, especially to species like ducks and geese, devices that warn birds about hazards ahead must be large, highly contrasting and produce flicker.
When marking hazards, there is no place for subtlety.
Jenny Cantlay received funding from NERC and the RSPB for her doctoral research on avian vision whilst at Royal Holloway University.
Graham Martin does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.africa brazil uk
What happens if a university goes bust?
Universities face growing costs but no prospect of increased funding.
Governments face difficult choices when industries fail. They can stand by while private businesses collapse and see the resulting loss of jobs and revenue. Or they can step in and use public money to prop up these firms.
The Scottish government intervened in 2019 to rescue Ferguson Marine, the last shipbuilding firm on the river Clyde, but faces ongoing controversy on whether it broke state aid rules in doing so. And, of course, the global financial crisis of 2008 saw the UK government intervening to rescue banks such as RBS that were seen as “too big to fail”.
The most recent data from the Higher Education Statistics Agency for the financial year ending in 2022 shows that (excluding pension adjustments, which can skew accounts for particular years) 24% of UK universities reported a deficit.
The Russell Group, which represents an elite group of research-intensive universities, claims it faces an average shortfall of £2,500 on every home undergraduate taught, and that this could grow to £5,000 by 2029-2030.
The outgoing vice-chancellor of Sheffield Hallam University, Sir Chris Husbands, recently suggested that calls to increase fee levels could be perceived as being tone deaf. Faced with their core undergraduate activities being unprofitable, universities have diversified their income by recruiting more international students, despite UK immigration policy limiting their ability to do so.
With no immediate prospect of increased funding either from government or through increased fee levels for domestic students, such restrictions on international recruitment together with damaging rhetoric from the government about so-called “rip-off degrees” means it is no longer unthinkable that a UK university might fail.
To consider what might happen if a university went out of business, we can look at what transpires when other businesses – such as banks – go bust.
Of the brand names that collapsed during the 2008 global financial crisis, few will remember the Heritable Bank. It held 22,000 accounts, making it comparable to the number of students at a mid-size university.
The cost to UK taxpayers of rescuing the Heritable Bank was £500m. The government, via the Financial Services Compensation Scheme, paid compensation to Heritable’s customers and, while some of these monies were recouped, the upfront costs were significant and the endgame did not see all of the cost recovered.
Part of the solution when Heritable failed was that another provider, ING, took on its customers. Were a university to become insolvent, thousands of students would find themselves marooned part-way through a degree programme, with no obvious route to complete it. There is no guarantee that another university would want to absorb a collection of “new” students, especially at fee levels that are already acknowledged to be below the break-even point.
Consequences for students
Even if a neighbouring university was given incentives to step in by the government, there would be practical issues to consider. Despite a potential merger under consideration in Australia, there is little history of mergers between universities in the UK.
The government could step in to avert a crisis. However, compared with the crisis in financial services in 2008, there is no equivalent compensation scheme in place and the public finances are in poorer health. In combination, this means there is no certainty of a government rescue package – and there may be a real reluctance to interfere in the market.
Almost inevitably, a series of messy class action lawsuits would result, with students seeking recompense for fees paid, perhaps over multiple years, that did not result in the qualification advertised. Worse, the shockwaves felt in one university could easily rock confidence in others. Future students might become more interested in the annual financial reports of a prospective university than its traditional prospectus.
Pulling down communities
Beyond the students, there would be significant economic consequences for the region, town or city concerned. Universities are typically large employers, sometimes the biggest in the area, and often refer to themselves as “anchor institutions” – central to the local economic ecosystem in the same way that a household-name retailer might be key to the viability of a shopping mall.
Yet anchors can also drag. In the case of a university failure, the potential for large numbers of high-skilled roles to disappear would be matched by a set of economic ripples that would be felt more widely.
This could range from housing, hospitality and retail being starved of income, to these and many other sectors suffering a shortage of a part-time, flexible workers. There are 142 members of Universities UK, and the 130 universities operating in England are estimated to contribute £95bn to the economy each year. Somewhere between £0.5bn and £1bn is a reasonable estimate of the amount attributable to any one university.
Finally, there would be political consequences. Electorates, of course, comprise many current, past and future students. Accusations would follow that jobs, qualifications and potential futures had been squandered.
The university sector is not immune to the kind of industrial or technological revolutions that have swept through other industries. But neither is it a purely commercial sector. Some of our policymakers and regulators might regard a university failure as an indication that the market is working. If so, they should be careful what they wish for.
Robert MacIntosh does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.uk
Nine women share what it’s like to have a miscarriage
Ten years of studying miscarriage has taught me that no two women will have the same experience.
Miscarriage is a common woman’s health experience, but one that affects people differently. Ten years of studying miscarriage has taught me that no two women will have the same experience, and that the same woman is likely to experience separate miscarriages very differently.
There’s also a great deal of variation in types of miscarriage and a lack of understanding of this, which often leaves women adrift.
A miscarriage is the loss of a pregnancy during the first 23 weeks. It’s estimated that one in five pregnancies end in miscarriage, with most occurring in the first 12 weeks. My research focuses on these early miscarriages.
Approximately 1 in 100 women in the UK experience recurrent miscarriage, which is defined as having three or more miscarriages consecutively. And black women in the UK are 43% more likely than white women to experience a miscarriage.
This article is part of Women’s Health Matters, a series about the health and wellbeing of women and girls around the world. From menopause to miscarriage, pleasure to pain the articles in this series will delve into the full spectrum of women’s health issues to provide valuable information, insights and resources for women of all ages.
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Vaginal bleeding which may be followed by pain in the lower abdomen and cramping are the main signs of a miscarriage. However, 1-5% of pregnancies end in a missed miscarriage: when no pain or bleeding occurs despite the pregnancy not progressing.
This is typically diagnosed by an ultrasound. For a number of the women I interviewed, this happened at their routine 12-week scan. It can be a shocking, unexpected and distressing experience – as Shirley explained:
I went for my scan at the [hospital] and we saw a very small foetus. I was chatting away and then the sonographer said, “I have bad news” – and they told us the baby had passed away at ten and a half weeks.
Nicole described being “gobsmacked” when she was told at her 12-week scan that “there was a sac but nothing else”. She continued:
To me, a miscarriage is when you bleed and have cramps, but I had none of that. I had no idea what a missed miscarriage was … I had no idea the pregnancy had ended.
The 12-week rule
Many of the women I interviewed spoke about the unwritten “12-week rule” of not disclosing a pregnancy until after this point, in case of complications or loss. But following a miscarriage, many women described this wait as being an unhelpful tradition which left them feeling isolated, as family and friends didn’t know what they were going through.
For Nicole and Shirley, there was certainty about the pregnancy ending, but this isn’t always the case. For some women, a diagnosis of miscarriage may be more drawn out.
Grace went to an Early Pregnancy Assessment Unit when she experienced pain during early pregnancy. She had not experienced any bleeding, but had a feeling that things “weren’t quite right”. An ultrasound was unable to locate the pregnancy. She was told her dates might be out and it might be too early to identify the pregnancy, or that it might be a miscarriage. She explained what happened next:
I had a [hormone] test and the levels [indicated] that I was lower in weeks than my actual dates … I had to go back two days [later] and have another test done.
The second blood test revealed that her pregnancy was not continuing, and Grace later miscarried.
Miscarriages are often understood to involve cramping and bleeding followed by the spontaneous expulsion of the foetus or pregnancy tissue. But this scenario rarely, if ever, happened to the women I interviewed. Indeed, miscarriages are often drawn out over days, weeks or even months.
When Miranda first contacted me, she said:
My missed miscarriage was identified quite early, at approximately seven to eight weeks … [but] the process has taken nearly three months.
When I first interviewed Miranda, she was still undergoing her miscarriage and did so for six months in total. While her experience is unusual, it illustrates how varied miscarriages can be.
Women are often told a miscarriage “will be like a heavy period”, yet most of the women I interviewed said that this is woefully inaccurate. Grace said:
This whole idea of a heavy period was not my experience. I was having contractions [and] passing a lot of blood.
‘I blame myself’
Many of the women I spoke with felt responsible for their miscarriage, as Liv described:
I still blame myself … I’ve had doctors, nurses, family, friends and everyone tell me not to blame myself, but I think I [always] will.
Anxieties about fertility and future reproduction were common, as was apprehension during subsequent pregnancies. Marianne told me:
I felt really anxious, especially between finding out I was pregnant at ten weeks and feeling the baby kick for the first time.
Many women also described feelings of failure, as Vicky and Emma did:
I had this real sense that there was something wrong with me.
I’m faulty and I can’t do what women are supposed to be able to do … You just feel fundamentally broken as a woman.
However, some women, such as Ruth, also expressed relief following a miscarriage:
I would have had a medical termination. I’m really glad I didn’t have to … I feel very relieved that it has happened this way.
Views of miscarriage
In the Early Pregnancy Assessment Unit where I was based, after a miscarriage women are offered access to specialist counsellors – a service many made use of and found helpful in navigating their feelings of loss and grief.
The recognition of the way miscarriage affects those who experience it is very welcome because in the past, miscarriage was seen as an unfortunate if routine event – but one that women would and should recover from quickly.
However, over the past 30 years, miscarriage has progressively been framed as the loss of a baby for which the appropriate response is one of bereavement. While many women I interviewed did, indeed, experience grief and distress in the face of their loss, not all did.
This is important because over the 10 years I’ve been researching miscarriage, I’ve become concerned that this latter group of women are not served by current clinical and public approaches to pregnancy loss. At times, this results in women feeling as though there is something wrong in the way they are experiencing their miscarriage.
This is why it’s important to recognise that, just as the physical experience of miscarriage varies, so too do the emotional and psychological experiences.
Susie Kilshaw receives funding from The Wellcome Trust. Wellcome Trust University Award in the Humanities and Social Science Grant number: 212731/Z/18/Z (2019-2025).uk
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