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n: An Alternative to Injection

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Over the past 18 months, the world has been amazed at how fast scientists can develop vaccine candidates against COVID-19. The majority of these vaccinations are administered via hypodermic injection, which allows the vaccine's ingredients to be swiftly assimilated into the bloodstream. However, some require multiple doses, and most must be kept at controlled, often super-cold temperatures until they can be administered by trained personnel, creating major logistical challenges.

Several researchers, including ourselves, are working on a technology that aims to provide the advantages of injectable vaccines without the drawbacks-and without the traditional needle stick: microneedles. While the technology still has a long road to the clinic, having entered human trials less than 10 years ago, we believe this it is the future of vaccine delivery, and the ongoing pandemic has highlighted the need to accelerate its development.

Basically, an array of tiny needles measuring just hundreds of microns is attached to a backing, permitting bandage-like application. Drugs can be encapsulated within water-soluble microneedles that dissolve when the patch is placed on the skin, allowing the drug to be released. Importantly, the microneedles pierce the outermost layer of tissue to allow greater absorption of the drugs compared to creams or other kinds of medical patches such as nicotine patches, but they do not penetrate deep enough to stimulate pain receptors. The patch can be self-administered and is as easy and painless as taking a pill.

The patch has its limitations. Being such a small medical device, for example, the maximum drug dose is less than 1 mg. But for treatments that do not require a high dosage, including vaccines (both antigen-based ones and nanoparticle ones, such as those used for mRNA vaccines against COVID-19), hormones, and drugs with elevated potency, microneedles are ideal. In addition to being user friendly, microneedles could elicit a more robust immunological response.

Conventional vaccine injection bypasses the skin's immune system and introduces the antigen into the muscle or subcutaneous tissue, thereby inducing a systemic immune response. Yet, the skin, our biggest organ, also has a superb immunogenicity capacity due to the presence of many antigen-presenting cells. By delivering antigens there, microneedles could capitalize on this local response to boost the protection provided by vaccines. Indeed, animal studies suggest that microneedles elicit higher antibody production and better cellular response.

Moreover, because microneedles are a dry formulation, they allow drugs to maintain their activity even without storing them at the low temperatures required of many injectable vaccines. For example, one study has shown that a vaccine for influenza can be stable for six months at 25 °C and at least a few weeks at 40 °C if incorporated into microneedles. This is critical for ensuring vaccinations reach far-flung corners of the world that do not have the resources to maintain the cold chain.

Another issue is vaccine wastage. For example, in some cases only a portion of the dose is used before a vaccine expires. It can also happen that healthcare personnel decide not to vaccinate a patient when there are not enough patients to use the whole vial. According to estimates, the wastage rates for 10-dose vials may be as high as 25 percent for liquid vaccines and 40 percent for freeze-dried vaccines. With microneedle patches, there is no wasted drug. And there are no needles that require special disposal procedures.

There are plenty of hurdles yet to be overcome. We need further clinical studies in human volunteers to demonstrate safety and efficacy of this vaccine approach, and the scale-up of production is still in its infancy. On a lab scale, usually we fill molds with the polymer solutions via vacuum or centrifugation. Once dried, the final formulation is demolded and secured to a backing. This is tedious and not practical for mass production.

Additionally, the majority of vaccinations are sterilized by filtering, which is not feasible for solid microneedle patches. While the solution may be sterilized before being placed in the molds, the final product will also need to undergo sterilization by some alternative technique not yet developed.

The recent pandemic and the possibility of others is a wake-up call to focus on these challenges. In the last year and a half, several institutions and biotech companies announced preclinical studies for a SARS-CoV-2 vaccine utilizing microneedle patches. Big pharmaceutical companies will certainly step up and invest more over the coming years in microneedle-based products. Injections have been used for centuries, but the necessity for a worldwide immunization effort is a persuasive reason to try to move forward.

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Over the past 18 months, the world has been amazed at how fast scientists can develop vaccine candidates against COVID-19. The majority of these vaccinations are administered via hypodermic injection, which allows the vaccine's ingredients to be swiftly assimilated into the bloodstream.

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Record heat, fire danger plague West after hottest summer on record for U.S. - The Washington Post

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Record heat, fire danger plague West after hottest summer on record for U.S. - The Washington Post

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A siege of dry lightning could ignite new blazes in northern California and Oregon into Friday

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Wealthier Nations Disregarding WHO Call for COVID-19 Booster Moratorium | The Scientist Magazine®

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Wealthier Nations Disregarding WHO Call for COVID-19 Booster Moratorium | The Scientist Magazine®

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Update (August 17, 2021): The US Food and Drug Administration will recommend that mRNA COVID-19 vaccine recipients get booster shots eight months after their second dose of the vaccine, multiple outlets report. According the Associated Press, the announcement is expected as soon as this week. This means those who received their vaccinations in December 2020 and January 2021 could receive boosters as soon as mid-September, Update (August 13, 2021):In the United States, people recovering from solid organ transplants and others with compromised immune systems are now eligible for a third shot of either currently authorized mRNA vaccine, the Food and Drug Administration announced yesterday. The Centers for Disease Control and Prevention's independent advisory committee is expected to separately recommend the move in today's meeting, reports Whether boosters will become more widely available this fall remains an open question, Acting FDA Commissioner Janet Woodcock notes in the agency's statement. "The FDA is actively engaged in a science-based, rigorous process with our federal partners to consider whether an additional dose may be needed in the future," she says. The New York Times. The New York Times reports; boosters will be with the same brands as the primary vaccinations.
"Inevitably, there will be a time when we'll have to give boosts," National Institute of Allergy and Infectious Diseases Director Anthony Fauci tells NBC 's Today Show.

In a press briefing Wednesday (August 4), Director General of the World Health Organization Tedros Adhanom Ghebreyesus implored countries to consider a temporary moratorium on COVID-19 booster shots-until at least the end of September-to allow countries with lower vaccination rates to catch up.

More than 80 percent of the vaccines distributed to date have gone to high and upper middle-income countries, Tedros notes, "even though they account for less than half of the world's population."

"I understand the concern of all governments to protect their people from the Delta variant, but we cannot and we should not accept countries that have already used most of the global supply of vaccines using even more of it while the world's most vulnerable people remain unprotected," he adds.

Several nations, including Germany and Israel, have already rejected the idea of waiting, Reuters reports. "We want to provide the vulnerable groups in Germany with a precautionary third vaccination and at the same time support the vaccination of as many people in the world as possible," the country's health ministry tells the outlet. Israel began urging its older citizens to get booster shots at the end of July.

Other nations have similarly indicated plans to provide booster shots in the fall. French President Emmanuel Macron says the country is working on a roll-out plan for boosters in September, according to Reuters; the UK is also preparing to offer additional shots in September, The Washington Postreports.

While the United States has not yet decided whether boosters will be offered, White House press secretary Jen Psaki tells The New York Times that the Biden administration considers the juxtaposition of boosters with primary vaccinations to be "a false choice."

"We can do both," she adds, noting the administration's efforts to distribute vaccines globally.

According to their developers, both the Pfizer-BioNTech and Moderna vaccines will likely need boosters to maintain protection, especially against the Delta variant. According to The Wall Street Journal, Moderna President Stephen Hoge says "a dose three of a booster will likely be necessary to keep us as safe as possible" in a business call Wednesday. "What we see is the potential for waning immunity."

Public health experts continue to note that the likelihood of a vaccine-resistant variant emerging is higher in areas with low vaccination rates. "New variants are most likely to arise in unvaccinated populations," Ruth Karron, a medical doctor and epidemiologist with Johns Hopkins University, tells . "So the more of the world that's unvaccinated, the more we are all at risk."

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Wealthier Nations Disregarding WHO Call for COVID-19 Booster Moratorium

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Update (August 17, 2021): The US Food and Drug Administration will recommend that mRNA COVID-19 vaccine recipients get booster shots eight months after their second dose of the vaccine, multiple outlets report. According the Associated Press, the announcement is expected as soon as this week.

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Like Humans, Walruses and Bats Cuddle Infants on Their Left Sides | The Scientist Magazine®

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Like Humans, Walruses and Bats Cuddle Infants on Their Left Sides | The Scientist Magazine®

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ANDREY GILJOV, UNIVERSITY OF ST. PETERSBURG Human mothers will usually cradle their infants on their left sides, such that they can gaze into each other's left eyes, a position thought to favor processing in the brain's right hemisphere. A new study in Biology Letters today (January 10) shows that walruses and flying foxes are no different, having such lateralized cuddling biases during maternal care, too.

"Several decades ago, it was a popular belief that [this] brain asymmetry is only a human thing," says the lead author of the study, Andrey Giljov, a zoologist at St. Petersburg University. But recent research has shown that in addition to humans, primate mothers tend to hold their infants to the left, and some of Giljov's previous work demonstrated that several species of mammal infants...

A bias towards keeping a social partner on a certain side, the new study explains, reflects specialization of the brain's right hemisphere for processing social information, as visual information is handled by an animal's contralateral brain hemisphere. The work reveals that flying foxes and walruses not only have a left-biased cuddling preference, but also tend to rest face-to-face in the position that allows mother and young to keep each other within their left visual fields.

It's basically solidifying the hypothesis that social information is processed more efficiently in the right hemisphere from a behavioral perspective.-Heather Hill,
University of St. Mary's

Although walruses and flying foxes might seem like unusual study subjects, Giljov and colleagues had their reasons: They wanted mammals that have singleton offspring and tend to cradle their young for relatively long periods of maternal care. Indian flying foxes ( Pteropus giganteus) and pacific walruses ( Odobenus rosmarus divergens) were just right, but they weren't easy to find. For the walruses, he and his colleagues made an expedition to the Arctic, to Kolyuchin Island in the Russian Chukchi Sea, and they went to Sri Lanka to observe the flying foxes.

The group had only old data from the end of the 19th century to go by to find the whereabouts of the bat colonies in Sri Lanka, Giljov says. The expedition crew spent days searching for them, often having to gesticulate what they were looking for to villagers. After having one bat colony fly away and another transpire to consist purely of males, they came across two colonies they were able to observe.

During the day, the drowsy, five- to six-month-old pups clung to their mothers, occasionally licking their mothers' faces, resting face-to-face, and suckling. The researchers documented left-right bias in all of these behaviors, finding that there was a significant preference for left visual-field positioning in all but suckling. "The infant can see mothers with the left eye and the mother can see the infant with the mother's left eye," Giljov says.

Likewise, the walrus calves preferentially adopted a position that allowed them to keep their mothers in their left visual fields when floating before diving down to suckle and when resting in their mothers' embrace.

ANDREY GILJOV, UNIVERSITY OF ST. PETERSBURG For Heather Hill, an associate professor of psychology at St. Mary's University in San Antonio, Texas, who was not involved in the study, the results reflect her own observations in beluga whale calves, who also appear to like to keep their mum to their left. "It's basically solidifying the hypothesis that social information is processed more efficiently in the right hemisphere from a behavioral perspective, and it's really beginning to show the diversity of species that have evolved this capacity," she says.

Gillian Forrester, a senior lecturer in psychology at Birkbeck, University of London who was not involved in the study, praises the robust methodology, and agrees with the authors' interpretation that the behavior aids right-hemisphere processing. Although it has been suggested that right handedness might be a reason for humans' preferential holding of babies to the left, she notes that left-handed people also like to hold their babies to the left.

Animal studies have shown that the right hemisphere is important in the recognition of dominant and novel external stimuli, Forrester explains. In humans, it "seems to be our dominant hemisphere for emotions and social behaviors and identifying other individuals. . . . We're actually more expressive on our left sides of the faces than we are on the right, because of that right-hemisphere dominance."

The expedition crew spent days searching for flying foxes, often having to gesticulate what they were looking for to villagers.

Giorgio Vallortigara, a professor of neuroscience at the center for mind/brain sciences at the University of Trento in Italy, isn't surprised by the results. He has studied lateralized brain functions as early as his undergraduate work in the 1980s, when he noticed that domestic chicks have a preference in pecking to one side. He later found that chicks use their left eye for recognizing conspecifics, and believes that the right hemisphere is particularly talented at this task.

Vallortigara, who was not involved in the study, says that this cerebral lateralization might have evolved, for instance, to allow the brain to perform two tasks at once. "If you put language in the left hemisphere," he explains, "you have a homologous region in the right hemisphere that is of use for other functions."

It's this type of speculation that Vallortigara says ought to be the focus of investigations into cerebral asymmetry going forward. "The overall field should now move from the level of the description . . . to an investigation of the 'why,'" he says. "What is causing this brain asymmetry? What is it in the brain that makes the two hemispheres to play different roles? . . . I think this is the challenge for the future for brain asymmetry research."

A. Giljov et al., "Facing each other: mammal mothers and infants prefer the position favoring right hemisphere processing," Biology Letters, doi:10.1098/rsbl.2017.0707, 2018.

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Like Humans, Walruses and Bats Cuddle Infants on Their Left Sides

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ANDREY GILJOV, UNIVERSITY OF ST. PETERSBURG Human mothers will usually cradle their infants on their left sides, such that they can gaze into each other's left eyes, a position thought to favor processing in the brain's right hemisphere.

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Baby Talk: Bat Pups Babble Like Human Infants | The Scientist Magazine®

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Baby Talk: Bat Pups Babble Like Human Infants | The Scientist Magazine®

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Before sunrise, Ahana Fernandez walks into a Costa Rican forest, carefully sets up her recording equipment near a grove of trees, and then waits. And watches. The trees are nurseries for the greater sac-winged bat ( Saccopteryx bilineata), where each mother bat roosts close to her pup. When Fernandez notices one of the baby bats opening its mouth to chatter, she points her camera and microphone in its direction to listen in.

After following the same 20 pups from birth to weaning, recording and analyzing their tiny utterances, Fernandez and her colleagues made an observation they published yesterday (August 19) in : infant bats babble in much the same way human infants do.

Babbling isn't the same as crying or trying to communicate something to an adult-Fernandez calls it "vocal play." Human babbling happens when babies play with the building blocks of language by practicing certain sounds or syllables before being able to string them into coherent words and phrases-the same way they play with toy blocks before being able to build elaborate structures. "Babbling is meant to be this really important phase of development that we have to do as humans on the route to speech," says University of St Andrews interdisciplinary bat researcher Sonja Vernes, who was not involved with the research.

Fernandez, who is a postdoctoral researcher at the Natural History Museum of Berlin, says that other researchers, including her coauthor and museum colleague Mirjam Knörnschild, had suspected bats of babbling before this study. But this is the first time the vocalizations have been fully characterized and compared to human babbling, which includes traits such as repetition and rhythmicity.

"People have known about this before, but this was the first description of this in a really clear and elegant manner," says University of California, Berkeley, neurobiologist and bat researcher Michael Yartsev, who was not involved with the study. Fernandez notes that in her study, the babbling was often initiated by the pups and could last for several minutes.

Outside of humans, babbling is actually quite rare. With this new study, bats join a small group of babbling species that includes songbirds and pygmy marmosets. The authors note in their paper that Egyptian fruit bat babies may also be babblers, but that hasn't been confirmed yet, and no other bat species are known to babble.

The fact that greater sac-winged bats roost in trees in small family units and are active during the day made them an attractive study candidate, says Fernandez. Fernandez, who with colleagues did their field work at study sites in Panama and Costa Rica over the course of multiple breeding seasons. At all observation sites, the researchers undertook a careful process to habituate the colony to their presence, gradually approaching the bats and spending more and more time near them over the two weeks before the pups were born. It required a lot of patience, says Fernandez, as well as the occasional fending off of boa constrictors.

Vernes notes that it's very valuable to observe the animals in their natural environments. "I think that was really impressive to produce this dataset in such challenging conditions," she adds.

Bat Talk 101

Fernandez says the vocal repertoire of adult bats includes 25 distinct syllables, which are defined as a sound sandwiched by silence. These syllables can be mixed and matched into complex "songs" for mating and territory defense, as well as communication between a mother and her pups.

By recording and analyzing how the pup chatter changed over time, Fernandez and colleagues identified several syllables from the adult repertoire that the pups incorporated into their babbling. They found that there is an initial spurt in syllable acquisition soon after the pups start babbling, and that this seems to taper off over time.

Fernandez notes that none of the pups mastered all 25 syllables by the time of weaning. "Interestingly, the same subset of syllables is also completely missing in all of the pups," she says. "And those syllables belong to the courtship song." She says the pups can produce some of the syllables from the song, but "the entire full-blown courtship song only happens during mating season," which suggests that perhaps the pups aren't acquiring those syllables simply because they aren't hearing them during their babbling phase.

Alternatively, she speculates that as the pups mature, there could be hormonal cues that help them learn the language of love only once they're old enough to need it.

A batty model organism

Because so few animal species exhibit this human-like patterns of vocal learning by imitation and babbling, sac-winged bats could be a useful model for learning more about language skill acquisition, says Fernandez. "I think we can learn many things about our own language by investigating biological foundations of language in other species."

In contrast to human babies, bat pups can be used for invasive studies to learn which genes or neurons control vocal learning behavior-and can even potentially be used to model language learning disorders. "Like with a mouse, you can get really deep into the mechanistic underpinnings of these things," says Vernes. Plus, she adds, "you're a bit limited in how much time you can put a baby in an MRI scanner."

Now that she knows more about pup babbling in the wild, Fernandez says she wants to take her studies into the lab to study how social influences affect the rate of language learning, as well as about the molecular foundations of babbling.

"By studying their communication, I get a small glance into their cognitive world-how they might perceive the world [and] what the world looks like to them," says Fernandez. "And I think this is so intriguing."

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Baby Talk: Bat Pups Babble Like Human Infants

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Before sunrise, Ahana Fernandez walks into a Costa Rican forest, carefully sets up her recording equipment near a grove of trees, and then waits. And watches. The trees are nurseries for the greater sac-winged bat ( Saccopteryx bilineata), where each mother bat roosts close to her pup.

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What We Know About Mu, the WHO’s Latest Variant of Interest | The Scientist Magazine®

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What We Know About Mu, the WHO’s Latest Variant of Interest | The Scientist Magazine®

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Tthe Mu variant (also known as B.1.621) is the latest form of SARS-CoV-2 to be designated a " Variant of Interest" by the World Health Organization. The agency announced the designation had been made in last week's epidemiological update, citing an uptick in Mu infections in Ecuador and Colombia, where the variant was first identified in January. In Colombia, it underlies nearly 40 percent of cases, according to WHO data.

According to Public Health England, the variant shares mutations with other variants, most notably the Beta ( B.1.351) variant first identified in South Africa. These include the E484K and K417N mutations, which researchers have linked to immune escape. K417N is also seen in the " Delta plus " variant. Additionally, Mu has the P681H mutation seen in the Alpha (B.1.1.7) variant, which is associated with increased transmissibility.

Detailed studies of the Mu variant's characteristics have yet to be conducted, but it exhibited Beta-like escape of vaccine-induced immune protection in preliminary data presented to the WHO's Virus Evolution Working Group, reports. Infectious disease researcher Paúl Cárdenas with Universidad San Francisco de Quito in Ecuador tells The Washington Postthat he has studied Mu and that the data suggest the variant is more transmissible than the original SARS-CoV-2, adding that Mu has outcompeted Gamma and Alpha in Ecuador and Colombia.

Still, vaccine developers appear confident. "To date, we are encouraged by both the real-world data and laboratory studies of the vaccine and see no evidence that the virus or circulating variants of concern regularly escape protection," Pfizer spokesperson Kit Longley tells the Post via email.

In its update, the WHO called for more research on the Mu variant, including how it may interact with the highly contagious Delta (B.1.617) variant.

According to Outbreak.info, a data aggregation site maintained by three Scripps Research labs, Mu has been detected in at least 46 countries as of September 7, including the United States, where Delta continues to dominate but more than 2,100 cases of Mu have been reported. Mu has been detected in every US state except Nebraska. As of September 7, the site shows California leading US Mu cases with 399 cases reported, followed by Florida (305 cases) and New York (203 cases). In Alaska (147 cases), the variant accounts for about 4 percent of infections.

The New York Times reports that Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, says US officials are keeping a close eye on the Mu variant. "We take everything like that seriously, but we don't consider it an immediate threat right now."

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What We Know About Mu, the WHO's Latest Variant of Interest

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Tthe Mu variant (also known as B.1.621) is the latest form of SARS-CoV-2 to be designated a " Variant of Interest" by the World Health Organization. The agency announced the designation had been made in last week's epidemiological update, citing an uptick in Mu infections in Ecuador and Colombia, where the variant was first identified in January.

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Should Human-Animal Chimeras Be Granted “Personhood”? | The Scientist Magazine®

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Should Human-Animal Chimeras Be Granted “Personhood”? | The Scientist Magazine®

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ISTOCK, LEPTOSPIRA There are several emerging biotechnologies that raise ethical questions regarding the definition of personhood. One of these innovations is xenotransplantation, which uses gene editing (CRISPR-Cas9) and stem cell technologies to create human-pig or human-sheep chimeras that can grow human organs for transplantation. While most people understand that pigs growing human livers and kidneys could save lives, there is an ethical fear that these technologies may generate animals that incorporate human cells into their brains or sex organs -situations that require broader discussions regarding the question whether such organisms attain the status of personhood.

For example, is there a percent composition of human neurons incorporated into an animal's brain that renders such a chimera human? Similarly, other stem cell technologies exist to create mice that produce human sperm or eggs. If human gametes from these mice are used to generate a healthy baby, would that baby be considered...

Human status and personhood have different meanings. Biologically, the term "human being" refers to an animal that genetically belongs to the species Homo sapiens. Many religious scholars include "ensoulment"-defined as the instant a human being attains a soul-as a characteristic of human status. In general, personhood denotes a set of capacities that imply both the ability to engage in certain sophisticated behaviors and an elevated moral standing deserving of certain legal protections. Specifically, many secular ethicists have described personhood using capacity-based definitions (that is, the ability to think creatively, reason, and engage in self-motivating activities; the capacity to communicate; or the presence of self-awareness). The difficulty with both religious and secular definitions of human status or personhood is that we have no established scientific methods to accurately assess these criteria.

How we define human status and apply personhood to any organism underscores a central tenet of bioethics and social justice-respecting the quality and value of life.

I would like to present a slightly different approach from the above-mentioned criteria that addresses the definitions of human status and personhood in human-animal chimeras. First, any living organism that has human status also attains personhood status. But conferring personhood does not necessarily confer human status. Second, human status is given to any individual born from a human being and/or derived from human gametes regardless of its capacity-based functions or cognitive capabilities. The extension of this criterion would be that a child born from human gametes regardless of the source of these human cells would also be regarded as human.

Thus, an embryo produced using gamete-like cells obtained from human blood or human sperm or eggs produced from a genetically altered mouse would still attain both human and personhood status. Similarly, a human embryo created in vitro from human gametes and transplanted into an artificial placenta or genetically altered animal that contains a human uterus, would still have human status. These technologies are not hypothetical-ectogenesis, or development outside the natural womb, has already been shown to preserve premature lambs, and xenotransplantation biotechnologies used to produce human-pig chimeras could be applied to other animals to generate, say, a cow with a human uterus.

It is interesting that the Bible and the Talmud (the Jewish book of Law) subtly address the role of human gametes and being born from a human as intrinsic definitions of a human being. According to the Bible, Adam, having been created by God, was not born from a human being nor created from human sperm or eggs. Thus, God had to declare this living creation as a "human being." In addition, there is a fascinating discussion in the Talmud that examines the human status of a "Golem"-a mythical organism that looked fully human but was neither born from humans nor created from human gametes. The fact that the Golem was not born from a human and lacked the capacity to speak or think creatively, Talmudic scholars state that this Golem was not considered to be a human being.

According to Jewish and Catholic traditions, human beings are the most advanced living organism s on earth, in part because of their capacity to speak and to think creatively. While animals such as nonhuman primates or human-animal chimeras may exhibit human-like cognitive capacities, they will still be considered nonhuman animals according to both traditions. In contrast, personhood status and rights reflect society's perception and understanding of whether an organism possesses human-like cognitive capacities. Thus, society has the right to use its moral compass to decide what animals should possess personhood status.

Another consideration for granting personhood status is the definition of "life." Jewish thought maintains that only a living organism can attain personhood. This criterion conflicts with the decision of Saudi Arabian government officials, who recently became the first to grant full citizenship to a robot, the artificially intelligent Sophia, developed by Hanson Robotics.

Biotechnologies can elicit complex ethical challenges that need to be discussed and addressed. I believe that an animal that has been engineered with human brain cells or human neural organoids does not necessarily attain a human state. Being human requires the creation of an embryo from human gametes or being born from a human. However, a human-animal chimera that expresses basic human-based cognitive capacities or human-like behaviors (that is, advanced communication skills, the ability to override basic instincts, etc.) can be granted personhood status reflected in legal or moral rights not normally given to animals. For example, society can confer these organisms with limited autonomy and prohibit their use in clinical drug trials based on our perception of their ability to provide consent. As with other medical ethical dilemmas, personhood status of any living organism must be assessed on a case-by-case basis. How we define human status and apply personhood to any organism underscores a central tenet of bioethics and social justice-respecting the quality and value of life.

John D. Loike is Professor of Biology at Touro College and University Systems.

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Opinion: Should Human-Animal Chimeras Be Granted "Personhood"?

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ISTOCK, LEPTOSPIRA There are several emerging biotechnologies that raise ethical questions regarding the definition of personhood. One of these innovations is xenotransplantation, which uses gene editing (CRISPR-Cas9) and stem cell technologies to create human-pig or human-sheep chimeras that can grow human organs for transplantation.

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Why So Many Young People Hate STEM Courses - Scientific American

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Why So Many Young People Hate STEM Courses - Scientific American

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Ever since I can remember, I was constantly asking questions. My parents called me "Miss Inquisity" because of it. I was that quirky kid on the playground who played with butterflies and spied for ladybugs. After I came home from school, I binged How It's Made on the Science Channel. Oh, that's what makes my bubble gum so sticky! Or, this is what they put in Oreos, really? I thought to myself. Seeing all this, you'd think that STEM would be the perfect fit for me, right? For a long time, I thought so too. My initial impressions of the field were that it would satisfy my unrelenting desire to know why. But as I grew up, this only seemed farther from the truth.

In high school, when I finally had the academic freedom to explore my interests, I took full advantage. Planning my own classes, I loaded up on every science course I could find. Chemistry, biology, you name it, and it was on my schedule. Though I wasn't sure exactly what it was I wanted to pursue in STEM yet, I hoped that these courses would help me find out. Come junior year, I was still undecided and even more concerned because it was supposedly the hardest point of high school. I had some of the most difficult classes on my agenda. AP chemistry, precalculus AB-most of my peers would barely give these a second glance. But once I started studying the material, I finally understood why they held back, why I consistently heard so many of my friends ask "When am I ever going to use this?" or "When is this ever going to help me?"

Much to my disappointment, the reality of studying these "hard sciences" is far removed from the way it is shown in the media-unlike anything I'd seen in watching all those episodes of How It's Made. When you have so many formulas, constants and theorems to memorize, it is far too easy to get lost in the complexity of it all. After all, how motivating is it to remember a bunch of numbers when you don't really know why it even matters to use them? And trust me when I say I completely empathize! It is hard.

This is why I nearly give up on pursuing STEM. I clearly remember a moment in AP chemistry, reviewing the basics of elemental composition, when I asked myself, Why do I even need to know this, what is the point of it all? I was drumming my mechanical pencil on the table for five minutes straight, stumped on this one problem, and barely had the stamina to continue. Thankfully, the assignment wasn't due till a week later when I finally had the wake-up call I never knew I needed.

I didn't expect to have such a breakthrough in my AP psychology class, but it was Ms. Brown's unique approach to instruction that made me reconsider the idea of throwing it all away-my desire to pursue STEM, that is. She forewarned us that neuroscience was one of the more challenging units this year, and after my recent fallout with chemistry, I honestly wasn't looking forward to it.

After she gave our class a brief overview of the unit, she immediately divided us into Zoom breakout rooms to analyze real-world scenarios using neuroscience terminology. I remember one in particular about a man who suffered cerebral trauma in a car accident and couldn't feel any pain. She surprised us by popping into our room, waiting patiently for an answer. I always hated the awkward silence, and for no other reason than to just break the tension I quipped "Well, the adrenal gland of the endocrine system releases adrenaline, decreasing sensation to pain, allowing the man to feel temporarily stronger, taking control of his situation." She commended my participation and lightly scolded the students with their cameras turned off as she left the room.

I think I might like this, I thought to myself.Shortly, one of my peers unmuted and said "Wow, you're really good at this!" But at the time, I didn't think it was so much my skill, as much as how I loved that neuroscience had reignited my passion for discovering the why. What makes people happy, biologically, what is really going on? What factors in our brains are conspiring to create a certain thought, reaction or emotion? But even more than these provocative questions was the idea that there is still so much we don't know about the brain-meaning just that much more for me to discover!

So, if you really want to know why more young people aren't entering STEM, I hope you'll remember this story. While I may not have a concrete answer, I do have my experiences, and, knowing why -where your learning is going to take you-is one powerful feeling.

This is an opinion and analysis article; the views expressed by the author or authors are not necessarily those of Scientific American.

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Why So Many Young People Hate STEM Courses

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Ever since I can remember, I was constantly asking questions. My parents called me "Miss Inquisity" because of it. I was that quirky kid on the playground who played with butterflies and spied for ladybugs. After I came home from school, I binged How It's Made on the Science Channel.

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Vaccine Mandates Are Lawful, Effective and Based on Rock-Solid Science - Scientific American

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Vaccine Mandates Are Lawful, Effective and Based on Rock-Solid Science - Scientific American

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The U.S. has reached a worrying plateau in its COVID-19 vaccination coverage, with just half of the population fully vaccinated. This coincides with pandemic fatigue, or weak compliance with COVID-19 risk-mitigation measures such as masking and distancing, and the highly infectious Delta variant, which accounts for more than 83 percent of infections. We're at an inflection point in the pandemic, with coronavirus infections soaring by about 140 percent in the past two weeks.

Reflecting deep concern over lagging vaccinations, the Biden administration recently mandated vaccinations for all federal workers and contractors (with masking and regular testing as an alternative option), while the Department of Veterans Affairs issued mandates for all frontline health workers at its facilities.President Joe Biden also ordered the military to move toward compulsory vaccinations.

California, New York City and New York State are leading the way in requiring that government workers get vaccinated or else submit to weekly testing. And New York City just announced its "Key to NYC Pass," requiring proof of vaccination for access to most indoor activities, including gyms, restaurants and performances, beginning on September 13-the first policy of its kind in the U.S. Meanwhile more hospitals and long-term care facilities are implementing mandates following a joint statement from 100 medical and nursing groups urging compulsory vaccinations. And when schools of higher education return in the fall, nearly 600 colleges and universities will require vaccination. That's true in the private sector as well as a rising tide of businesses-including Uber, Facebook, Google, Netflix and Delta Air Lines- mandate vaccinations for workers.

Are these mandates lawful and ethical? The short answer is emphatically yes. And there is strong behavioral science evidence that mandates will be highly effective.

The Lawfulness of COVID-19 Mandates

Businesses: Both the Department of Justice and the Equal Employment Opportunity Commission (EEOC) have ruled that businesses may lawfully require workers to get a COVID-19 vaccine as a condition of coming to the workplace. However, businesses must grant legitimate medical or religious exemptions. The only major court ruling to date upheld Houston Methodist Hospital's COVID-19 vaccine mandate. The private sector has wide discretion in setting conditions for workers and customers, and businesses have a legal and ethical duty to keep the workplace safe.

Currently all COVID-19 vaccines are administered under an emergency use authorization (EUA) and are not fully licensed. The DOJ and EEOC specifically stated that employer mandates may occur even under an EUA. The U.S. is already acting as if the vaccines were fully approved, with public health agencies recommending that all eligible Americans get a shot. In any event, the Food and Drug Administration recently announced it is expediting full licensure of the Pfizer vaccine, which is likely to occur by September, with other vaccines not far behind. When the FDA does approve COVID-19 vaccines, more businesses are likely to require immunizations.

Federal and state governments: States have long had the constitutional authority to mandate vaccinations, which the Supreme Court has upheld twice, first in 1905 and then in 1922. The federal government, however, has limited power to mandate vaccines. It can only require them to prevent transmission of a dangerous infectious disease across state lines or international borders. The federal government has never sought to require nationwide vaccinations, and the courts probably would not allow it. To date, all state government mandates have been for fully approved vaccines. Thus, it is likely cities and states would wait to mandate COVID-19 vaccines until they are fully licensed. But when governments act as employers, they would be in a similar legal position as businesses. Thus, federal and state worker COVID-19 vaccine mandates are fully lawful even under an EUA.

K-12 schools: Every state and Washington, D.C., require routine vaccinations, such as for measles, mumps and rubella, as a condition of school attendance. While state mandates vary, all are based on a long list of childhood vaccinations recommended by the Centers for Disease Control and Prevention. In 1922 the Supreme Court upheld school mandates, and all courts have recognized the states' authority to mandate fully approved vaccines. Schools must offer medical exemptions for those who may be harmed by vaccines, but they do not have to grant religious or conscientious objections. Six states offer neither personal nor religious exemptions for school mandates, a move that the courts have upheld. Because K-12 COVID-19 mandates would be issued directly by the government, they are likely to require full FDA licensure. Further, the FDA's EUA for Pfizer's COVID vaccine currently applies only to people aged 12 years and older, and the other two COVID vaccine EUAs are only for adults. Clinical trials for children younger than 12 years old are currently underway but may not report full results until late this year or early 2022.

Institutions of higher education (IHEs): In most respects, IHEs are in a similar position to businesses. IHEs have long required vaccinations of students-for human papillomavirus, meningococcus and influenza, for example. A federal court has already ruled that Indiana University's COVID-19 mandate is a reasonable, science-based measure to ensure student health and safety. And the U.S. Court of Appeals for the Seventh Circuit just affirmed that Indiana University's mandate was lawful. IHEs act in loco parentis and thus have a duty to care for the safety and security of students on campus. While most IHE COVID-19 mandates apply to students, many also apply to faculty and staff.

Antivaccination Laws

While there is a rising tide of governments, businesses and IHEs mandating COVID-19 vaccines, some states are actually seeking to restrict vaccine mandates. More than a dozen states have enacted laws prohibiting mandatory COVID-19 vaccinations or even "proof of vaccination" (so-called vaccine passports). Many more have bills pending. A number of governors have issued executive orders prohibiting COVID-19 vaccine mandates or vaccine passports. These edicts restrict private businesses, schools and IHEs from asking for proof of vaccination. COVID-19 has been politicized like no virus before. From AIDS and tuberculosis to Zika, influenza and Ebola, states previously acted to enhance public health powers. A multitude of states are doing the opposite during this pandemic, tying the hands of health officials to act quickly and decisively. That will not only make it harder to fight COVID-19 but also the next health crisis.

States have wide powers to regulate businesses, so even if these laws and executive orders are harmful, they still may be lawful. The exception may be states' attempts to regulate businesses that operate in interstate or international commerce. There is litigation regarding Florida's attempt to ban the cruise ship industry from requiring passengers and crew to show their vaccination status. Recently a federal court of appeals unanimously voted against a CDC order regulating cruise ships, which Florida had challenged. It was a bizarre case because the decision reversed the appeals panel's earlier 2-1 ruling, which temporarily blocked a lower court's decision to uphold Florida's ban, and the appeals court has yet to give its reasoning for the change. The Constitution is quite clear that Congress holds the sole power to regulate interstate and international commerce.

Are Vaccine Mandates Effective?

There is considerable behavioral scientific data that vaccine mandates are effective. That includes both "hard" mandates (required vaccinations for school or workplace attendance) and "soft" mandates (the choice to vaccinate or undergo regular testing and indoor masking). Hospitals that have required influenza vaccinations have achieved and maintained far higher coverage than those that make it voluntary. At the same time, K-12 school and IHE mandates have given the U.S. high vaccination rates.

Many business and educational mandates fall into the "hard" category-that is, students or workers cannot attend classes or the workplace unless they are fully vaccinated. "Soft" mandates "nudge" people to get vaccinated. When getting a vaccine is the "easier" or "default" option, most opt for the jab. Thus, when given the choice between getting a vaccine or having to undergo one to two SARS-CoV-2 tests weekly and masking up, most people will eventually roll up their sleeves. How do we know? Well, in states that have wide and easy exemptions for childhood vaccines, a significant number of parents opt out. But if a state makes getting the exemption hard, such as requiring a written declaration, a doctor's certificate or attending vaccine literacy classes, vaccine hesitancy melts away. The same will happen for COVID-19 vaccinations.

Are COVID-19 Vaccine Mandates Ethical?

People cite bodily integrity, personal liberty and freedom as the most common justifications for refusing vaccines. But these arguments don't hold water. It's true that everyone has the right to refuse a medical intervention for their own good. But vaccines not only protect the person vaccinated but also that person's family, neighbors, and classmates or co-workers. No one has the right to go into a crowded classroom or workplace unmasked and unvaccinated. Vaccine mandates do not unethically discriminate. Discrimination is wrong when it is based on irrational reasons or animus, such as discrimination based on race, gender or disability. But vaccine mandates are simply a tool, and they apply equally to everyone. They don't impute blame or seek to shame the unvaccinated. They are intended only to keep the entire population safe. Finally, requiring proof of vaccination does not violate a person's privacy. Individuals are free to decline to give information about whether they received a shot, but if they do decline, they must expect reasonable consequences to ensure everyone's health. Additionally, federal health information privacy rules apply principally to health care providers and not to businesses or schools. There is also a public health exception to privacy rules.

Requiring people to get a vaccine is part of the fabric of American history going back to the Revolutionary War. General George Washington compelled troops to get a smallpox variolation, saying it was necessary to safeguard soldiers and to win the war. And not only is mandating vaccination lawful, but it is also an ethical responsibility. For far too long, Americans have asked the question, "What entitlements do I have as a rights-bearing citizen?" It's now time to ask, "What duties do I owe to my neighbors, my community and my country?" Getting a COVID-19 vaccine as the nation and the world are undergoing a historic health crisis is badly needed for the common good and mutual solidarity.

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Vaccine Mandates Are Lawful, Effective and Based on Rock-Solid Science

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The U.S. has reached a worrying plateau in its COVID-19 vaccination coverage, with just half of the population fully vaccinated. This coincides with pandemic fatigue, or weak compliance with COVID-19 risk-mitigation measures such as masking and distancing, and the highly infectious Delta variant, which accounts for more than 83 percent of infections.

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Science Must Be for Everyone - Scientific American

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Science Must Be for Everyone - Scientific American

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As scientists and engineers, we feel privileged to have careers that contribute to the progress of knowledge and understanding. The rewards of participating in research and discovery and of mentoring emerging scientists are immense. Science itself is an extraordinary and essential institution. It continues to thrive after centuries of human ingenuity and effort, and to provide significant advancements for societal well-being in areas such as understanding and mitigating global environmental change, achieving innovations for improving public health, and creating technological solutions to widespread societal challenges.

However, science does not happen in a vacuum; it is a social process and therefore exhibits cultural norms and social patterns that affect scientific practices and outcomes. Opportunities and entryways into STEM careers are unequally available to all members of our society, with the result that the practice of science is limited demographically. Further, the benefits of the scientific enterprise have disproportionately benefited members of the upper echelons, and the scientific enterprise has too often been aligned with injustices that reinforce the oppression of the racially disenfranchised, women and LGBTQ communities. Finally, the culture of science has evolved in ways that reinforce its image as a career path that is unwelcoming to socially subordinated groups.

When budding scientists first enter the discipline, it is usually because we are inspired by curiosity, passionate about understanding the natural world and/or eager to contribute to a better society. We don't typically know much about the culture of science at first. And we certainly do not realize the enormous historical legacy nor the social and power dynamics of the science ecosystem we are becoming a part of. We begin our careers in a focused disciplinary area, and we very slowly learn how to navigate the science system, the idiosyncrasies of the academy and the requirements for success in a STEM career. Not everyone who enters stays.

Looked at as a whole, the scientific enterprise comprises a system of people, ideas, projects, resources, norms and institutions. A " science of science" approach effectively highlights the deep interconnectedness between scientists, knowledge creation and knowledge, but it requires more study regarding the links between the diversity or lack of diversity of scientists and knowledge outcomes. This is because those who participate in science are not at all reflective of our society. African Americans, Latinos, American Indians and other racially disenfranchised persons represent only about 9 percent of STEM academic positions in the United States, and that number has barely grown over four decades. This percentage is in sharp contrast to the changing demography in the U.S. Women (primarily white women) now earn approximately 41% of STEM doctorate degrees and have increased their share of STEM academic positions to approximately 39% but are not at parity with men especially at higher career positions. Attrition of female scientists increases as they move up the career ladder, with a 19.5% higher dropout rate over male scientists.

Meanwhile, calls for broadening participation in STEM fields are increasing and many investments in excellent programs aimed at advancing STEM diversity, equity and inclusion have been made. Thus far, the majority of efforts have been directed at increasing entry opportunities and training a diverse STEM workforce: so-called "pipeline interventions." So why has meaningful progress been so slow? The long answer involves a clear-eyed view of obstacles to equity (especially systemic racism and sexism in our society and therefore our science system), overrepresentation of a narrow demographic in STEM, outdated but entrenched leadership models, uniquely imbalanced and potentially harmful power dynamics in the academy, and many other issues. The short answer? It's the system, not the participants. This means that we should be focusing more of our efforts on systemic reform for the future of science.

The current culture of our science system is an anachronism in today's world and must change with the times. Today's system remains rooted in norms and practices that were established decades ago by and for a narrow subset of society. Criteria for entry and advancement, definitions of excellence and success, institutional policies and values, and the incentive systems that determine STEM career trajectories all require a reboot if we are to diversify the system beyond the relatively unencumbered and advantaged members of society.

This is becoming increasingly clear via surveys of the scientific community as well. To its participants, our science system is increasingly perceived as highly competitive, aggressive, demographically exclusionary and still jarringly reflective of its historical roots in a Eurocentric, white, patriarchal society. To be a "successful" scientist today, one must follow a fairly predictable track up the career ladder that is increasingly competitive, monetized and metricized - raising the question whether we have come to a place where we value what we can measure rather than measure what we should value. One must continually compete for research funding, and one's advancement, promotion and credibility are linked to how much grant funding is brought into one's institution. This model can be even more challenging for scientists from racially disenfranchised groups and for women because of social and family pressures that may affect them differently, especially in early career stages. Also, research shows that women and racial minorities in STEM often wish to pursue scientific questions that are different from those of the socially dominant community of scientists.

The pressure to obtain research dollars is matched only by the pressure to publish research findings as quickly and as often as possible in the 'highest-impact' journals, and to increase the number of citations your publications attract (measured by various widely utilized performance metrics). Like research funding, the publish-or-perish treadmill also suffers from the question of what is most interesting to those in power in the science system. And our peer review system - depending on how it is implemented - suffers from explicit and implicit biases. Driven by metric-based criteria for recognition and promotion, thre prevalent transactional models of leadership in STEM do not select for a diverse, collaborative workforce.

Self-promotion is also a required skill in this environment. To succeed, one should be marketing oneself and garnering as much social media attention as possible (measured by Altmetric Attention scores and other indices). It's obvious where this road can lead in terms of science quality and the social dynamics of vying for attention. In addition, subordinated groups in science are not as visible to the science press as are the dominant groups, and they are not perceived as the faces of science thought leadership. At times, social attention for scholars of color and for women may result in negative attention and/or retribution; see the recent case of Pulitzer Prize-winner Nikole Hannah-Jones, author of the New York Times ' 1619 Project, and the associated UNC tenure controversy.

The established measures of success select for highly competitive rather than collaborative environments; a STEM workforce lacking diversity; a narrow demographic at the top; a style of mentoring that elevates the success of mentors more than that of mentees; and potentially harmful environments for groups underrepresented in science. For example, a recent report on sexual harassment in STEM issued by the National Academy of Sciences reports that academic science is second only to the military in rates of gender harassment, taking an astonishing and corrosive toll on women who enter STEM fields. Minority scientists, who are too often unrepresented in scientific departments, are immersed in unwelcoming environments and historically not given credit for their research contributions. Given this state of affairs, the failure to "move the needle" on diversity, equity and inclusion in STEM seems not only understandable but inevitable. Even if successful in their fields, these dynamics can present a gauntlet of stressful hazards to the personal well-being of scientists. The toll is also seen in the harm done to institutional reputations when the behavior of some scholars becomes public.

So, why should we all care about this? Isn't science progressing faster all the time? Isn't the rate of research publications steadily increasing? Don't many foreign scientists come to the U.S. to work in our first-class science system? Well, yes, all true-but creating systemic culture change in STEM in order to diversify the STEM workforce matters critically for the future advancement of science and the translation of its benefits to society. True diversity, equity and inclusion within the scientific community will have a major positive impact for addressing the increasingly complex issues that lie at the heart of the science-society-policy intersection. It matters significantly - arguably more than any other issue - for the future of science.

It matters because scientific conclusions are shaped by the kinds of questions asked, by who conducts research, and by who asks scientific questions (e.g., do health trials include all demographic sectors of society?). It matters because research demonstrates that better science outcomes, enhanced innovation, and increased creativity result from broader perspectives and diverse participants (e.g., are diverse viewpoints at the innovation tables?). It matters because research priorities that determine who benefits from science and technological advances are set differently by different identities in science (e.g., are technological advances considering impacts on all communities?). It matters because the vital link between scientific outcomes and evidence-based public policy relies on public trust in science-and public trust in science in turn relies on full participation, engagement and representativeness in science.

And finally, it matters because the scientific enterprise in the U.S. is funded largely by the public and should therefore include and benefit the entire public. Our science system is supported by societal investments, the so-called "Science Bargain" or "Science-Society Contract." Many in science are unaware of a 1945 report called Science: The Endless Frontier, but that report was a landmark policy document for government (public) support of science in this nation. The report was published at the end of World War II by Vannevar Bush, director of the federal Office of Scientific Research and Development at the time.

Bush argued that government spending on university-based and research institution-based science during the war effort should be continued in our postwar society but redirected to the nation's scientists who were pursuing basic research at our top universities. Thus, research universities and the federal government (and thereby the U.S. public) entered into an implicit partnership, with the shared goal of stimulating knowledge generation in the service of society. It seems obvious that, because the public underwrites the scientific effort in the U.S., the entire public deserves to fully participate in the system and to fully benefit from its advances. But that part of the vision remains unrealized at this moment in time.

And, if none of those arguments (societally relevant science, more innovative science, more representative science, enhanced public trust in science, financially responsible science) are persuasive, then transforming our science system towards a more just, equitable and inclusive enterprise is still imperative-because it is the morally right thing to do. In the current social context of renewed attention to addressing societal inequities and injustices across many of our American institutions, we cannot leave a science reckoning out of the mix. Science, too, is a social justice issue. A healthy debate regarding the historical inequities of the science system is already underway. Who gets to participate in science? Who benefits from it? Who is sometimes harmed by it? Who sets the important research priorities? When viewed through a social justice lens, the deep misalignment between societal demographics and practicing scientists today is clearly even more unsustainable.

The goal, then, is to build a STEM culture of inclusivity and a more representative science that becomes normative through a coordinated, systemic transformation.We have a unique opportunity to transform the current science paradigm given the social and political times we live in and given that the system is already recently disrupted. To succeed, long-entrenched obstacles to this vision will need to be dismantled: the aforementioned culture of science is one such obstacle. But there is much more: inequity in educational opportunity; myths of meritocracy; oversimplified metrics for success; entrenched legacy attitudes about excellence, competition and the faces of leadership; career advancement and tenure criteria that do not necessarily align with the values of diverse stakeholders; unwelcoming or hostile work environments in classroom, laboratory and fieldwork; and more.

In a sense, reforming our science system is both simple and complicated: simple in the sense that we just need the political will to transform; complicated in the sense that we are seeking to transform a complex and highly interconnected system with reinforcing feedback dynamics yet many disconnected components. These components include STEM educational systems, higher education, academic institutions, scientific disciplines and professional societies, individual scientists, science policies, the science publishing industry, research funding agencies, and more. All these components must coordinate and align for significant systemic change to occur. For example, increasing diversity of the STEM pipeline and those at early career stages will not ultimately be successful if the culture of academic institutions does not change to accommodate the lives of diverse participants or if bias keeps them marginalized or drives them out of the system.

Because advancing equity, diversity and inclusion in the scientific enterprise is therefore a systems-based challenge, it will require a more coordinated and centralized effort that includes all the embedded components working together towards common goals. Although complex and challenging, such an undertaking will be more than worth the effort. With enormous challenges and possibilities in front of us, science needs all hands on deck. Let's create a science system that is by all and for all, adjust the course of the astonishing human history of science towards a more just and inclusive enterprise, and fulfill a more complete vision of the science-society bargain.

This is an opinion and analysis article; the views expressed by the author or authors are not necessarily those of Scientific American.
Any opinion, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation or United States government, the AAAS, or any of the authors' home institutions.

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Racism and sexism are obstacles to making the scientific enterprise worthy of its public funding

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How COVID, Inequality and Politics Make a Vicious Syndemic - Scientific American

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How COVID, Inequality and Politics Make a Vicious Syndemic - Scientific American

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It is folly to respond to COVID by focusing only on the coronavirus that causes it, because the virus alone did not dictate the catastrophic impact. For instance, in the U.S., the illness initially hit urban populations hard. But the virus has traveled to more rural areas over time, and recently the impact has shifted to Southern states. In those areas, people younger than 70 years old have been dying more frequently from COVID than they have elsewhere. These same states have had fewer people getting vaccinated and protected. The mortality trends are strongly tied to the increased burden of cardiovascular and metabolic illnesses in the American South, which existed before the virus hit but have made its impact worse. Poorer access to health care has also been a factor in these sad Southern numbers because many of these same states refused to expand Medicaid under the Affordable Care Act. Even before the pandemic, states that expanded Medicaid showed improved health; those that refused expansion did not. As COVID took hold, states with Medicaid expansions were better able to ramp up testing and tracing and to provide health care coverage to people who were suddenly out of work.

The larger lesson of COVID is that social and biological risk are deeply entangled. Viruses may cause disease in individuals, but pandemics play out in populations. This disease, like previous pandemics, reflects political, economic and social conditions. One way to understand these dynamics is through the concept of syndemics.

The term syndemic refers to the synergies among epi demics. The idea involves three claims. First, political-economic forces with historical depth lead to entrenched social, economic and power inequities. Second, those inequities shape the distribution of risks and resources for health, leading to the concentration of disease in specific parts of a population. And third, some overlapping diseases make one another worse because of biological interactions.

COVID is not inherently syndemic. Syndemics are not properties of diseases but rather of systems. Syndemics reminds us that, while we can understand viruses in the lab, the distribution of disease depends on complex, real-world interactions among political-economic structures, ecological contexts and human biology. In other words, context matters. Local histories and power structures influence where conditions cluster, how they interact and why some people suffer more.

In the U.S., conditions were ripe for a syndemic to emerge. A deep history of systemic racism and white supremacy in the country had two immediate consequences. First, race-based residential segregation, the racialized structure of the workforce, and racial inequities in the prison system, among other factors, meant that Black and Indigenous people and other people of color were more likely to be exposed to SARS-CoV-2, the virus that causes COVID. In contrast, the accumulated advantages of whiteness meant that white people were more likely to be in professions that allowed them to work from home, reducing exposure. Second, because of the same political-economic and social inequalities, Black and brown people were already suffering disproportionately from poor health conditions such as hypertension and diabetes. There are biological interactions between these conditions and COVID, such as when chronic inflammation from diabetes is augmented by acute inflammation from SARS-CoV-2, leading to an intense immunological reaction that can damage multiple organs.

Such syndemic interactions are likely one reason worldwide excess deaths in 2020 far outpaced the already shocking number of deaths directly attributed to COVID that year. These conditions made the anemic U.S. federal response to the disease in 2020 even more deadly. By continually downplaying the threat and moving to reopen crowded businesses while infections were still accelerating, the Trump administration allowed the virus to spread along the fault lines of society. Syndemic interactions with preexisting inequities in health and the conditions of life meant that the hardest-hit communities were already suffering from concentrated poverty, substandard housing, less access to health care, disproportionate police surveillance and incarceration, greater exposure to air pollution, less access to healthy food and higher rates of cardiometabolic disease. The pandemic made many of these conditions worse. For instance, there were unequal impacts of the economic fallout throughout 2020, and the current economic recovery continues to leave many Black communities and other communities of color behind. And earlier this year, failures to prioritize equity in vaccine distribution allowed glaring inequities to grow.

It didn't have to be this way. Consider the case of New Zealand. There are many differences between that country and the U.S., but they share a common history of European settler colonialism and enduring social, economic and health inequities among white, Asian, Pacific Islanderand Indigenous people. New Zealand had, and has, the background for syndemics. But when COVID brushed its shores, Prime Minister Jacinda Ardern closed down the country.Her "go hard, go early" approach, embodied in the nearly five-week lockdown that she instituted in March 2020, focused on protecting her "team of five million." She also urged New Zealanders to care for one another, to be compassionate.The nation has been largely successful in keeping COVID under control. Drawing on long-standing pandemic preparedness plans, Ardern employed basic public health principles to stop the disease in this smaller, less dense population.

Many other countries responded with strong public health leadership, implementing swift lockdowns and controlling the disease. For example, Rwanda's government shut everything down and tightly controlled the spread of COVID in 2020, in part through established trust within the system and what the country's former minister of health Agnes Binagwaho described as " compassionate leadership" in a 2020 International Journal of Health Policy and Management paper. A national lockdown ensued a week after the first case was confirmed, followed by extensive contact tracing and testing. Today Rwanda is fighting a new spike in cases by pushing to vaccinate as many citizens as possible, but accessing enough vaccines is difficult because of global inequities in immunizations.

Inequality takes lives. Demographer Elizabeth Wrigley-Field recently showed that Black people in the U.S. experience pandemic-scale premature mortality every year. Like the influenza pandemic a century ago, COVID exacted a staggering toll, instantly reducing life expectancy in the U.S. by more than a year. Yet even the reduced life expectancy of white Americans remains higher than it has ever been for Black Americans, and the reductions in life expectancy for Black and Latino populations are expected to be three to four times greater than for white people.

When a novel coronavirus is introduced into that context of inequality and allowed to spread, it is a recipe for disaster-and not only for the targets of racial oppression but for everyone. Another recent study estimated that, if the U.S. government had paid reparations to descendants of enslaved people-an essential step toward liberty and justice for all-then the overall transmission rate of the virus, regardless of ethnic or racial background, would have been between 31 and 68 percent lower than it was. Everyone would have been better off.

If the pandemic begins to recede, we hope the world will not return to a "normal" that was not working for everyone. COVID will not be the last pandemic threat we face. To reduce the suffering from the next one, we must reduce the suffering people experience now. The larger lesson of syndemics is that a more equal society is also a healthier one.

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How COVID, Inequality and Politics Make a Vicious Syndemic

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It is folly to respond to COVID by focusing only on the coronavirus that causes it, because the virus alone did not dictate the catastrophic impact. For instance, in the U.S., the illness initially hit urban populations hard. But the virus has traveled to more rural areas over time, and recently the impact has shifted to Southern states.

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How to Reduce Racial Disparities in Smoking Deaths - Scientific American

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How to Reduce Racial Disparities in Smoking Deaths - Scientific American

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Recent analyses by the World Health Organization and the U.S. Centers for Disease Control and Prevention (CDC) suggest an association between smoking and the severity of COVID-19 in hospitalized patients. CDC data also show that African Americans are experiencing a disproportionate number of COVID-19 cases, hospitalizations and deaths compared with other racial and ethnic groups.These findings further raise the visibility of both racial health disparities in the United States and the importance of quitting smoking, two issues that intertwine in a way that compounds the risk of poor health outcomes among African American communities.

Despite similar rates of smoking prevalence, African Americans have higher mortality rates associated with smoking, including lower cancer survival rates, than white Americans ( U.S. Department of Health and Human Services, 2020). Moreover, data from a variety of clinical trial, cross-sectional and population-based studies reliably converge to demonstrate that African Americans are less likely to quit smoking than white Americans even though they are equally motivated to quit and may make more quit attempts ( Fagan, 2016, in Health Disparities in Respiratory Medicine).

A recent prospective study identified several social determinants of health (SDoH)-conditions in which we are born, grow, live, work and age), including but not limited to lack of homeownership, lower income and increased neighborhood disadvantages-to be significant contributing factors to racial disparity in smoking cessation ( Nollen et al., 2019). Additionally, increased subjection to high-risk environmental factors, such as the elevated presence of tobacco-selling retailers and housing that permits smoking, increases smoking initiation and exposure to secondhand smoke, making it more challenging to quit. Also, limited access to quality health care coverage can reduce access to prescription cessation therapies and other evidence-based approaches.
ADDRESSING CULTURAL ISSUES
As with many other societal issues, COVID-19 disparities result from various factors, including discrimination, reduced access to and utilization of health care; occupation; education; income and wealth gaps; crowded housing; and homelessness ( Centers for Disease Control and Prevention, 2021). Recent studies indicate that discrimination, wealth, and neighborhood problems are the primary drivers of disparity (Nollten et al., 2019). Particularly with respect to smoking, socioeconomically disadvantaged communities are plagued with a greater degree of tobacco retail outlets, increasing exposure and risk for both initiation and relapse ( Kirchner, 2013).

It is important to recognize that racial disparities in smoking cessation occur in the context of more significant cultural issues and reflects the mistrust that many Black Americans have for the medical system. This mistrust is primarily a consequence of the medical community's historical bias toward addressing white Americans' health needs, often at the expense of Black Americans' health and well-being. This bias is reflected in the lack of diversity in clinical trials and the medical system's failure to address health needs that are more prevalent and cause more deaths in Black communities, such as tobacco-related cancer mortality.

This lack of trust, access, and socioeconomic factors can drive Black smokers to choose less-effective over-the-counter (OTC) smoking cessation therapies rather than prescription options. The former allows them to have direct control over their health care choices and does not require a physician's office visit. It is therefore essential to develop culturally tailored communications and address unique barriers to smoking cessation therapy ( Webb et al., 2017).
NEW APPROACHES
Effectively addressing racial cessation disparities requires new approaches that are more effective for the physiologic and psychologic aspects of tobacco addiction and tailored to African American specific challenges. Mobile technology-based approaches may have particular utility in addressing racial disparities. Data from a Pew study suggest that African Americans are more likely to access health information on their phones compared with whites. The National Cancer Institute has a text-based messaging program, SmokefreeTXT, to support smoking cessation, which has demonstrated improved completion rates but lower quit rates for African Americans compared with whites ( Robinson et al., 2020).

While many of these are societal issues that must be addressed holistically, novel cessation methods and mobile health (mHealth) apps can empower members of at-risk populations, including African Americans, to overcome barriers to quitting. A potential benefit of mobile health (mHealth) apps designed to support smoking cessation is their ability to integrate context sensing (e.g., GPS) information with patient-provided data about where they smoke. This enables the system to send alerts when an individual approaches a location where he or she is likely to smoke, helping to support smoking cessation. Alerts include reminders to use a nicotine lozenge or gum before arriving at a smoking trigger and sends messages that encourage and motivate them to adhere to smoking cessation goals.

Importantly, mHealth approaches also have the potential to provide mechanisms for standardizing and harmonizing SDoH assessments and providing real-time, actionable recommendations that can enhance SDoH interventions. This could be particularly helpful in reducing demand on overburdened community health centers and health providers while also enabling data collection and integration to inform precision population health care. Automated data integrations that have the capacity to generate actionable recommendations can enhance patient-provider efficiency, trust and clinical experience, collectively increasing the likelihood for treatment engagement and positive health outcomes ( Heckman et al, 2015). These complementary data-driven approaches are necessary steps towards health equity-informed precision population health care.

QuitBuddy is the first mHealth app to offer precision population health care by integrating established theories of relapse risk; evidence-based treatment; smartphone/GPS technology, and SDoH. As such, it offers high-impact solutions to address health disparities across a wide range of tobacco-related chronic diseases that disproportionately affect underserved populations. This novel app is undergoing pilot testing and will also be evaluated for its ability to promote smoking abstinence and prevent relapse through the delivery of just-in-time adaptive interventions, as well as to augment SDoH intervention effectiveness for smoking cessation and relapse.

The development of additional prescription smoking cessation therapies may also help address barriers that make it less likely for African Americans to quit smoking. Current prescription smoking cessation therapies, while effective, may cause side effects decreasing treatment engagement, regardless of race. Cytisinicline, a plant-based, naturally occurring alkaloid structurally similar to nicotine, has been shown to aid in smoking cessation. Cytisinicline has been used for decades in Eastern Europe and Asia because of its safety, tolerability, efficacy and cost-effectiveness. It is currently being evaluated in a phase III clinical trial in the United States. If approved, its potential for improved tolerability could provide an important new and more accessible therapy.

In addition to mHealth apps and additional pharmaceutical smoking cessation therapies, developing culturally tailored modes of cognitive behavioral therapy that address barriers to cessation common in the African American community is also critical to improving quit rates for this population ( Webb et al., 2017).
EVIDENCE-BASED OPTIONS ARE CRITICAL FOR SUCCESS
Evidence-based options, whether technological, pharmacologic or psychological, lead to increased quit rates. The importance of new approaches is especially critical for people who have been unable to quit with existing pharmacologic therapy, as studies show that cessation rates are higher when these individuals switch to a new therapy rather than trying again with a therapy that didn't result in long-term abstinence ( Heckman et al., 2017). Ensuring African Americans have effective, evidence-based smoking cessation options requires that they and their needs play a central role in the studies used to generate the base of evidence. Recognizing and addressing the distinct needs and challenges of African Americans seeking to quit smoking is essential for improving their quit rates-which is a key component in reducing racial disparities in various health outcomes and optimizing health equity.

This is an opinion and analysis article; the views expressed by the author or authors are not necessarily those of Scientific American.

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Bryan W. Heckman, Anne Davis, James E.K. Hildreth

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How to Reduce Racial Disparities in Smoking Deaths

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Recent analyses by the World Health Organization and the U.S. Centers for Disease Control and Prevention (CDC) suggest an association between smoking and the severity of COVID-19 in hospitalized patients.

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Apple's New Child Safety Technology Might Harm More Kids Than It Helps - Scientific American

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Apple's New Child Safety Technology Might Harm More Kids Than It Helps - Scientific American

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Recently, Apple released three new features designed to keep children safe. One of them, labeled "Communication safety in Messages," will scan the iMessages of people under 13 to identify and blur sexually explicit images, and alert parents if their child opens or sends a message containing such an image. At first, this might sound like a good way to mitigate the risk of young people being exploited by adult predators. But it may cause more harm than good.

While we wish that all parents want to keep their children safe, this is not the reality for many children. LGBTQ+ youth, in particular, are at high risk of parental violence and abuse, are twice as likely as others to be homeless, and make up 30 percent of the foster care system. In addition, they are more likely to send explicit images like those Apple seeks to detect and report, in part because of the lack of availability of sexuality education. Reporting children's texting behavior to their parents can reveal their sexual preferences, which can result in violence or even homelessness.

These harms are magnified by the fact that the technology underlying this feature is unlikely to be particularly accurate in detecting harmful explicit imagery. Apple will, it says, use "on-device machine learning to analyze image attachments and determine if a photo is sexually explicit." All photos sent or received by an Apple account held by someone under 13 will be scanned, and parental notifications will be sent if this account is linked to a designated parent account.

It is not clear how well this algorithm will work nor what precisely it will detect. Some sexually-explicit-content detection algorithms flag content based on the percentage of skin showing. For example, the algorithm may flag a photo of a mother and daughter at the beach in bathing suits. If two young people send a picture of a scantily clad celebrity to each other, their parents might be notified.

Computer vision is a notoriously difficult problem, and existing algorithms-for example, those used for face detection-have known biases, including the fact that they frequently fail to detect nonwhite faces. The risk of inaccuracies in Apple's system is especially high because most academically-published nudity-detection algorithms are trained on images of adults. Apple has provided no transparency about the algorithm they're using, so we have no idea how well it will work, especially for detecting images young people take of themselves-presumably the most concerning.

These issues of algorithmic accuracy are concerning because they risk misaligning young people's expectations. When we are overzealous in declaring behavior "bad" or "dangerous"-even the sharing of swimsuit photos between teens-we blur young people's ability to detect when something actually harmful is happening to them.

In fact, even by having this feature, we are teaching young people that they do not have a right to privacy. Removing young people's privacy and right to give consent is exactly the opposite of what UNICEF's evidence-based guidelines for preventing online and offline child sexual exploitation and abuse suggest. Further, this feature not only risks causing harm, but it also opens the door for wider intrusions into our private conversations, including intrusions by government.

We need to do better when it comes to designing technology to keep the young safe online. This starts with involving the potential victims themselves in the design of safety systems. As a growing movement around design justice suggests, involving the people most impacted by a technology is an effective way to prevent harm and design more effective solutions. So far, youth haven't been part of the conversations that technology companies or researchers are having. They need to be.

We must also remember that technology cannot single-handedly solve societal problems. It is important to focus resources and effort on preventing harmful situations in the first place. For example, by following UNICEF's guidelines and research-based recommendations to expand comprehensive, consent-based sexual education programs that can help youth learn about and develop their sexuality safely.

This is an opinion and analysis article; the views expressed by the author or authors are not necessarily those of Scientific American.

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Apple’s New Child Safety Technology Might Harm More Kids Than It Helps

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Recently, Apple released three new features designed to keep children safe. One of them, labeled "Communication safety in Messages," will scan the iMessages of people under 13 to identify and blur sexually explicit images, and alert parents if their child opens or sends a message containing such an image.

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Credit... Eric Baradat/AFP via Getty Images

Mr. Scully, a senior speechwriter for President George W. Bush, is the author of "Dominion: The Power of Man, the Suffering of Animals, and the Call to Mercy."

PHOENIX - In politics, issues of true importance aren't always the ones that consume our attention. My candidate for the most underrated of all public concerns is the treatment of animals, an issue as revealing as any about our character and sense of fairness. If you want hard evidence to track the moral progress of humanity, watch how we deal with other creatures who are defenseless against our power and will.

A case in point: The National Park Service is about to allow 12 hunters into the supposed sanctuary of Grand Canyon National Park. The hunters, selected by lottery from more than 45,000 applicants, will be allowed to kill one bison each, in what one hunting website described as a "once in a lifetime" experience.

This "pilot lethal removal program," set to begin on Monday, apparently is the Park Service's idea of rational, sober-minded conservation. Outside the world of blood sport and the game-management bureaucracy, it should rightly strike most people as an appalling betrayal of trust in a national park where hunting is prohibited.

So the fate of 12 bison in the coming weeks, and possibly more if this "pilot" program turns into a regular affair, has implications beyond the reach of the Colorado River. What will follow from this - at Rocky Mountain National Park, for instance, or Yellowstone or elsewhere?

The bison live on the canyon's North Rim. As in Yellowstone, the herd has long presented visitors with a happy, peaceable, uplifting scene.

Given the somber history of the species - what Theodore Roosevelt called the "merciless and terrible" annihilation of the American bison - why would anyone begrudge this herd a safe stretch of earth?

There was a day when as many as 60 million bison ranged from the Yukon all the way to Mexico, including in Northern Arizona. Here is a humble herd of some three or four hundred bison left to enjoy refuge in a 1.2-million-acre park. We can't just let them be? The targeted bison don't belong in a national park but hunters do?

Where they fail to inspire compassion, animals inspire in certain people a flair for elaborate rationalization. Here the pretext for "bison reduction actions," in the euphemistic parlance of the scheme, is laid out in a 2017 Initial Bison Herd Reduction Environmental Assessment. The document is a case study in ecological hyper management, filled with so much fretting about the natural impacts of bison and the potential for herd expansion that you're left wondering how the American landscape ever survived tens of millions of them.

For such intolerable offenses as foraging, drinking, defecating, wallowing and kicking up some dirt, these native animals are treated throughout the study as a constant disturbance, as if the ideal of management were sterile, picture-perfect scenery instead of a lived-in ecosystem.

To make the bison look bad takes some work-intensive phrasing. If one is straining to give a bison hunt a scientific-sounding rationale, the creatures' natural behaviors raise alarm over "the potential for increasing impacts" on park resources, "erosion potential," "soil disturbance," "potential concerns about changes to local hydrology," "potential damage" to archaeological sites, and on and on.

Are any of these dreadful developments really so bad as to warrant a bison cull? No. And if the concern is controlling the bison population in the park, there are other ways to do that than killing them.

Yet in the herd-reduction assessment, relocation of the entire herd, fertility control and other nonlethal alternatives are dismissed as impractical or not considered, even though some bison in the recent past were captured and relocated anyway, in coordination with Native American tribes, leaving one to wonder: Why couldn't all of them be moved to a place where they wouldn't be harassed or shot at? Or why not control the herd with the contraceptive vaccine PZP, administered by marksmen directing darts at the females, which has contained bison elsewhere?

A more hysterical version of the Park Service's trumped-up case comes from the Arizona congressman Paul Gosar, a legislative hand in all of this. Disturbed that bison were "wreaking havoc," causing "devastation," threatening no less than "the wonder that is the Grand Canyon," Mr. Gosar called on the government to "empower" hunters - and they were, in a 2019 law that allows the interior secretary to use "qualified volunteers" to "reduce the size of a wildlife population" within a national park.

Hunters already are empowered under a corresponding program of the Arizona Game and Fish Department, which not only authorizes killing in areas close to the park, but also offers coaching in technique. In recent years, hundreds of bison near the park have been killed by hunters. The spirit of the program can be seen in a "bison hunter packet" the state furnishes to participants. The trick, the packet explains, is to lie in wait by water holes and shoot them when they're thirsty and make sure they don't "retreat to safety" in Grand Canyon National Park.

This tawdry business explains why the bison have been congregating in the park for longer periods, adding to those impacts that trouble the Park Service. The creatures are smart enough to realize that leaving the park means danger. Wildlife management in this case might be trying to solve problems of its own making. And to make credible the Park Service's own argument that this is not a "hunt" but merely a supervised "lethal removal," the last thing it should have done is solicit applications from "skilled volunteers" who no doubt included trophy hunters.

An agency whose very logo features a bison, in keeping with its protective mission, should have found another way. The National Park Service is overseen by the Department of the Interior, and we can hope that Secretary Deb Haaland (who, as she reported on Twitter, recently delighted in the sight of free-roaming bison) will see the cold and contrived design of the plan, and call off the hunt. It represents the worst elements of Interior Department policy in the four years before she arrived.

Who better, indeed, than our first Native American interior secretary to extend leniency to these animals, in recognition of their travails in all the rank abuses of the 19th century? Fairness, honor, and charity all counsel her to set the Park Service straight and to spare the bison from further grief. At the Grand Canyon and elsewhere, these creatures are a welcome presence and a sight to admire, living reminders that America has put the days of "merciless and terrible" annihilation firmly in our past.

Matthew Scully, who was a senior speechwriter for President George W. Bush, is the author of "Dominion: The Power of Man, the Suffering of Animals, and the Call to Mercy."

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Mr. Scully, a senior speechwriter for President George W. Bush, is the author of "Dominion: The Power of Man, the Suffering of Animals, and the Call to Mercy." PHOENIX - In politics, issues of true importance aren't always the ones that consume our attention.

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NPR: Dear Mum, Your Son The Doctor Thinks You Should Get A COVID Vaccine

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NPR: Dear Mum, Your Son The Doctor Thinks You Should Get A COVID Vaccine

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Vaccines are not readily available in many countries. Yet when a limited supply does arrive, people are not always interested. On March 25, South Sudan received 132,000 doses of the AstraZeneca COVID-19 vaccine through the COVAX program, the global effort to provide vaccines to poorer countries. They were free to all comers. But there was no rush to get the vaccines. As of August 3, only 56,989 vaccine doses have been administered in country of approximately 12 million people. South Sudan returned some 72,000 doses to COVAX, which were shipped to Kenya instead. South Sudanese physician Edward Kenyi, now living in the U.S., plans to send this letter to his mother, Elizabeth, who's reluctant to take the vaccine, to try and change her mind.
Dear Mum,

The last time I called you on the phone a few weeks ago, you told me you were yet to take the COVID-19 vaccine. Although I have been telling you to take it for weeks, you said you are still waiting for the right time.

I hope this letter will persuade you once and for all that the time is right now.

Mum, since the beginning of the pandemic, when cases were rising in South Sudan and many people were dying of COVID-19, I implored you to take the necessary precautions to avoid catching the disease. You're in your 70s, which puts you among the most vulnerable groups of people at risk of getting seriously ill ... and of dying.

Before the vaccines were invented, you told me you heard messages broadcast over the radio every day and saw many big posters on the streets advising all to wash their hands often, use face masks and practice physical distancing to stay healthy.

Every time I spoke to you, you were either going to a funeral for a relative or returning from the marriage ceremony of another. You said even at these funerals and marriages, they talked about precautions.

You told me that at some of the funerals you attended, no one would declare the cause of death - but that many people suspected COVID-19.

In those early months of the pandemic, you seemed to take the disease seriously. You were concerned about me in America, where the disease was affecting many people, and advised me to be very careful.

However, with time you have stopped taking the disease seriously. You told me you heard the disease is no longer a threat in Juba, where you live, because the number of people testing positive or dying from it has declined. I know that this is not true. Here's what the numbers say. As of the end of July 2021, there have been 11,090 confirmed cases of COVID-19 with 120 deaths, reported to the World Health Organization.

And when I've urged you to avoid going to funerals for the time being to avoid exposure to the virus, or to at least wear your face mask, you told me that people you know say Black people are immune in general - and if they're not, they do not get serious disease.

Mum, as a medical doctor and a public health physician who spends my days raising awareness about the pandemic, I feel pained that you are not following the simple steps that we advocate. Why do you trust the rumors and stories from WhatsApp group messages more than your own son? I wonder why my messages are not resonating with you and many members of my family.

The growing toll of COVID-19 has not had any impact. Even when lockdowns were initiated in Juba, you still felt compelled to go to funerals, telling me it would look bad if you did not show up.

Now that a vaccine against the virus that causes COVID-19 has been developed and found to be very effective in preventing the disease, you are not convinced that you should be vaccinated. Remember the last discussion we had? I told you I had completed my vaccine doses. You were surprised that I took the vaccine what with all the wild rumors circulating about it in the country.

Mum, how can you believe the stories that the vaccines cause infertility? You also told me someone mentioned to you that Bill Gates is implanting microchips into Africans in order to control them - and that you have seen the video of a key sticking like a magnet to the arm of someone who was vaccinated.

There is no evidence that any of these things are true. Whoever is responsible for developing and circulating these stories is going to hurt millions of people.

How can I convince you that as a medical professional, I believe in vaccines, which are safe and effective against the virus? The rumors you hear every day are just that: rumors. There is no shred of evidence to support them.

Let me tell you these facts, again: The vaccines are effective and very safe. Even though the percentage of Africans who have been vaccinated is low due to lack of supply, millions of African people have already taken the vaccine, and they're doing fine. The few reports about side effects like blood clots and severe reactions are minimal, compared to the protections you will get from being vaccinated.

I was thrilled that when I told my little sister that I was vaccinated, she went ahead and got her vaccine. I was excited that at last, someone is stepping forward to show you that it is possible safe to take the vaccine and be protected. She had no complaints arising from the vaccines. Shouldn't this fact help you make up your mind?

Mum, the vaccines are free of charge. It is the best protection for you at your age, and you should seriously consider taking the shot. Vaccines prevented us from the childhood illnesses you feared years ago. And the new COVID vaccines will keep us safe from this new plague. Why would you trust those vaccines then and not these? The COVID vaccines, like the childhood vaccines, have been tested to make sure they are effective and safe. Safety has always been the marker for bringing any vaccine to the public.

Mum, I am appealing to you to rethink your stand and take the step to take the vaccine. Once vaccinated, you will be safe. And, you won't have to endure any more of my pestering - we can talk about whatever you want to!
Born and raised in South Sudan, and now living in Baltimore, Edward Kenyi is a medical doctor working as a technical adviser for Jhpiego, a Johns Hopkins University global health affiliate. As a member of the South Sudanese Health Professional Association, he participates in live webinars on various online streaming platforms to raise awareness on COVID-19 prevention and debunk myths surrounding vaccines globally and within his community in the U.S. Your turn: Share Your Letters
Take the jab, mum.

Sincerely,

Your son,

Edward

If this story inspired you to write a personal letter to a vaccine-hesitant family member or loved one, we'd love for you to share it with us. Email a copy of the letter to goatsandsoda@npr.org, and we may feature an excerpt in an upcoming story. Be sure to include your name, age and location.

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Opinion: Dear Mum, Your Son The Doctor Thinks You Should Get A COVID Vaccine

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Vaccines are not readily available in many countries. Yet when a limited supply does arrive, people are not always interested. On March 25, South Sudan received 132,000 doses of the AstraZeneca COVID-19 vaccine through the COVAX program, the global effort to provide vaccines to poorer countries. They were free to all comers.

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"Hello? Hello?" The Pain Of Pandemic Robocalls

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"Hello? Hello?" The Pain Of Pandemic Robocalls

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Busy week? I had news meetings, family stuff, and interviews, of course. And then I got a call from an officious, digitized voice that said they were the IRS. It informed me they've noticed suspicious activity on my account. Not a good start to the day.

Soon, more bad news. A call from a similar-sounding robo-voice - maybe they're siblings - said they've noticed suspicious activity on my credit card account.

But good news, a minute later: a peppy, friendly, recorded voice, told me my spotless driving record entitled me to receive a great new deal on car insurance.

Then I remembered: I have no driving record. I have no driver's license, although that did not discourage another genial recorded voice who called a few minutes later to offer a great new deal on a car warranty because of my immaculate driving history.

By the way, I also have spotless record in performing brain surgery.

I take no poetic license when I say that on any given day, I get dozens of calls to say that I've won a vacation, a home alarm system, or discounts on scores of pharmaceuticals. I get calls to warn me of suspicious activities on my Social Security or credit card accounts, and calls imploring me to donate to groups that sound faintly familiar, but are likely just cleverly monikered scams. 40% of robocalls reportedly are.

Spam is a unifier in these times of partisan divides. A survey conducted by Business Insider this year reports that 80% of Democrats say they received spam calls, 79% of Republicans, and equal percentages of men and women, rich and poor.

46% of Americans surveyed said they received spam calls every day. But like the weather and infrastructure legislation, nobody seems to know what to do about it. Software can dial thousands of random numbers in seconds. All scammers need is a few to answer.

But it struck me this week that there may be something especially inconsiderate about these calls during these times. More of us are working at home. So many of us feel isolated and anxious, especially on a week like this, when masks are back, infections are on the rise, and the pandemic can seem unremitting. The ring of the phone can be piercing. We answer, whatever the number, because we worry it could be vital news about family or friends. Or we answer for a chance to hear another human voice. Press pound if you're feeling a little lonely, anxious, or overwhelmed.

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Opinion: "Hello? Hello?" The Pain Of Pandemic Robocalls

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Busy week? I had news meetings, family stuff, and interviews, of course. And then I got a call from an officious, digitized voice that said they were the IRS. It informed me they've noticed suspicious activity on my account. Not a good start to the day. Soon, more bad news.

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Hundreds Of Dead Migratory Birds In New York City Prompt Calls For Dimming Lights

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Hundreds Of Dead Migratory Birds In New York City Prompt Calls For Dimming Lights

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subscribe to Short Wave podcast

Early Tuesday morning, Melissa Breyer set out to do her usual volunteer work - collecting the bodies of migratory birds who had died colliding with skyscrapers in downtown Manhattan.

That morning was much worse than usual. In just over an hour, Breyer picked 226 tiny, lifeless bodies off the sidewalks around the World Trade Center. Another 35 had died but fallen onto inaccessible awnings. Thirty were still alive in need of veterinary aid and were transferred to the care of a wild bird rehabilitation center.

"When you have 226 dead window-struck migratory birds from one morning, it's hard to get them all in one photo," she wrote on Twitter, with a picture showing dozens of birds, many of them warblers, in all shades of yellow, brown and grey.

"Lights can be turned off, windows can be treated. Please do something," she pleaded.

In New York City, between 90,000 and 230,000 birds are killed each year when they collide with building glass, according to research by NYC Audubon, the group that runs "Project Safe Flight," the volunteer operation Breyer participated in.

Nationwide, a study from 2019 found that the number of bird deaths caused by building collisions could be as high as one billion.

Fatal collisions spike twice a year during migration seasons, when birds migrate through big cities on their way to and from their winter habitats in Central and South America.

"Birds are driven off course by light pollution. They're often attracted to bright city lights," said Sirena Lao, a researcher at the San Francisco Bird Observatory, speaking to NPR earlier this year. "So birds will veer off course and fly towards these cities, which leads them to even more hazards."

As a result, wildlife advocates have long advocated for dimming unnecessary lights during migratory seasons - a call that has been renewed this week by bird groups in New York after Tuesday's mass die-off.

Wild Bird Fund, a rehabilitation center based in New York, received more than 70 injured birds on Tuesday, including the ones collected by Breyer.

"There is an easy measure that could be implemented today to reduce the staggering bird mortality happening across our city: Turn off all unnecessary lighting, from 11PM-6AM through Nov. 16," the group tweeted.

The World Trade Center responded to Breyer's tweets, thanking her for bringing the issue to the facility's attention.

"We are actively encouraging our office tenants to turn off their lights at night and lower their blinds wherever possible and are investigating additional precautions," the company wrote.

Jordan Barowitz, a spokesperson for the Durst Organization, co-developer of One World Trade Center, told The Associated Press in an email, "The first 200 feet of One WTC are encased in glass fins that are non-reflective. This design was chosen because it greatly reduces bird strikes which mostly occur below 200 feet and are frequently caused by reflective glass."

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Hundreds Of Dead Migratory Birds In New York City Prompt Calls For Dimming Lights

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subscribe to Short Wave podcast Early Tuesday morning, Melissa Breyer set out to do her usual volunteer work - collecting the bodies of migratory birds who had died colliding with skyscrapers in downtown Manhattan. That morning was much worse than usual.