npr--2020-12-24--'Trusted Messengers, Trusted Messages': How To Overcome Vaccine Hesitancy

The U.S. Department of Health and Human Services booked an unusual guest interviewer for one of its public health events this fall : Shulem Lemmer , the first Hasidic singer to sign with a major record label .
Lemmer has no particular expertise in public health , but he grew up in Brooklyn , home to many ultraorthodox Jews like himself .
He 's seen as a trusted messenger in parts of the Hasidic community that , despite suffering a disproportionate number of hospitalizations and deaths from COVID-19 , have on some occasions resisted New York 's pandemic restrictions .
@ @ @ @ @ @ @ aired — HHS changed its mind about having entertainers explain COVID-19 .
Still , public health experts say the idea of enlisting respected and well-known leaders to help explain the health message is exactly the right way to disarm and persuade skeptics — and more crucial than ever this winter as cases and deaths from the coronavirus surge all across the U.S .
`` As we continue to talk to people about the virus , `` waving journal studies and talking points wo n't work in many communities , '' says Robert Blendon @ @ @ @ @ @ @ policy and political analysis at Harvard T.H .
Chan School of Public Health .
That 's particularly true , Blendon notes , in ethnic and racial communities `` that have a history of being demonized , lied to , or exploited in the U.S. when it comes to their health . ''
Dr. Warren Reuben , director of Alabama 's Tuskegee University National Center for Bioethics in Research and Health , notes the lasting and continuing impact of generations of racism and racial disparities in health care that were underscored by the Tuskegee @ @ @ @ @ @ @ , but did n't start or end there .
`` That history evokes fear in Blacks that translates into many being fearful of clinical trials and has them anxious about the coronavirus vaccines , '' Reuben says .
Persistent racism in health care is one reason the National Medical Association announced that it will be vetting vaccine data itself and publishing its conclusions .
`` The times have called for this , '' says Dr. Leon McDougle , the NMA 's president , who himself has signed up to be a clinical trial @ @ @ @ @ @ @ .
The network is conducting late-stage clinical trials on vaccines to prevent COVID-19 , as well as on monoclonal antibodies for treatment .
Clergy consultants help get the word out To increase participation by communities of color , the network has also created a faith initiative , which includes `` faith ambassadors '' and more than 30 clergy-consultants from the Black , Latinx and American Indian/Alaska Native communities to help get the word out .
`` Black and brown communities are being disproportionately impacted by COVID-19 , '' McDougle notes .
`` We @ @ @ @ @ @ @ of the disparity because the vaccines do n't have representation from people of color . ''
According to a recent U.S. survey by the Kaiser Family Foundation , `` about a quarter ( 27 % ) of the public remains vaccine hesitant , saying they probably or definitely would not get a COVID-19 vaccine even if it were available for free and deemed safe by scientists . ''
That number jumped to 35 % among Black Americans surveyed .
Dr. Georges Benjamin , the long-time executive director of the American Public Health Association @ @ @ @ @ @ @ would do well to borrow a strategy that helped stem the AIDS epidemic : tailoring the message to different constituencies .
In that case , the health message first focused on safe sex in the gay community , he notes , and then , a couple of years later , added messaging on the risk of IV drug use as the virus moved into the heterosexual community .
Crucially , to gain the trust of many different groups in the U.S. , public health messengers must also demonstrate not just cultural awareness , @ @ @ @ @ @ @ J. Pérez-Stable , director of NIH 's National Institute on Minority Health and Health Disparities .
Even well-intended programs sometimes miss the mark .
For example , a smoking cessation campaign Pérez-Stable worked on years ago in the Latino community focused on the health of male smokers , but was n't successful , he says , until the messaging changed to stress the health benefits for the smoker 's wife and children if the men stopped smoking .
To make a public health message persuasive , personal stories from someone who is most @ @ @ @ @ @ @ Tom Frieden , a former director of the Centers for Disease Control and Prevention who now heads the global health initiative Resolve to Save Lives .
To cut through skepticism , he says , public health campaigns need `` trusted messengers and trusted messages . ''
Frieden points to Tips from Former Smokers , a CDC campaign he helped launch in 2012 , that shared the personal stories of illness and death from tobacco users , as well stories of those who had quit successfully .
The multifaceted campaign is credited with helping @ @ @ @ @ @ @ tailored online stories and videos from people who are African American , Native American , Asian American , Latino , LGBT , as well as one from veterans and another from people who grapple with mental illness .
`` What we have to do is insure that the informal work force is inclusive of all of these communities , '' says Loyce Pace , the president and executive director of the Global Health Council , and a member of President-elect Joe Biden 's COVID-19 task force .
NIH aims to do just that @ @ @ @ @ @ @ launched in September — the Community Engagement Alliance Against COVID-19 Disparities , that is hiring `` messengers who live , work , and worship in the same communities '' says Pérez-Stable .
These workers are leading outreach and engagement efforts in ethnic and racial minority communities disproportionately affected by the virus .
Dr. Mary Owen , director of the Center of American Indian and Minority Health at the University of Minnesota , says the impact of the coronavirus on Indian communities `` is so devastating that it is absolutely critical that we do @ @ @ @ @ @ @ high uptake of the flu vaccine among Native Americans as the example that it can be done .
Owen , a member of the Tlingit nation , says a successful strategy for the COVID-19 vaccine must recognize that there are 574 distinct tribes , each with its own leaders and influencers .
The best approach , she says , `` is for the states to find out who to reach out to in each tribe in order to gain the community 's trust . ''
Of course , not all Native people distrust @ @ @ @ @ @ @ but even a few folks not getting the vaccine is impactful in a population as small as ours . ''
Rita Carreón , vice president for health at UnidosUS in Washington , D.C. , notes that in many U.S. Latino communities her group works with , lay people who have been trained as community health workers — promotoras de salud – are trusted and already helping to dispel misinformation and misconceptions about COVID-19 and the vaccine needed to fight it .
`` They live in the community and relate to the community in @ @ @ @ @ @ @ Carreón says .
Some communities have built the infrastructure for vaccine education over the past 10 months by already going beyond standard messaging .
The Bay Area Regional Health Inequities Initiative , for example , based in Oakland , Calif. , is a consortium of eleven local health departments in the culturally and racially diverse region who are working with more than 200 community partner organizations to focus on health and economic opportunity .
`` BARHII was formed to address the durable , decade-wide gap in life expectancy that exists between communities in @ @ @ @ @ @ @ Jones , executive director of the organization .
`` That gap is the result of systemic factors , not individual choices , '' she says , `` so BARHII and our members focus on systemic solutions : safe and secure housing , universal basic income , medical bias , well-paying jobs for all residents , and climate resilience in the face of extreme heat and wildfires . ''
The COVID-19 pandemic , she says , `` has been a sobering demonstration of how Black and brown communities in particular are excluded from economic @ @ @ @ @ @ @ their needs and concerns is essential in maintaining public health . ''
The standard CDC guidance to isolate in your own room and bathroom if you have COVID-19 symptoms wo n't work if your home is small and crowded , notes Jones , or if you are an essential worker living paycheck to paycheck or self-employed , so do n't get sick-pay — or if you do n't have a home .
In neighborhoods that are largely Latino , BARHII 's member health departments hired Spanish speaking community workers to get the word @ @ @ @ @ @ @ have case workers speak through a translator .
That helped them gain enough trust so that many community members who were asked to isolate themselves after contracting the virus or enter quarantine because they were exposed accepted the agency 's help in finding temporary housing , food , and economic relief to make up for lost wages for that period .
All those interventions help stop the spread of the virus — and stop the pandemic .
`` Spanish speakers , '' Jones says , `` use correct idioms , may know the @ @ @ @ @ @ @ community , and understand specific fears — such as worries that filling out forms for the vaccine could risk deportation for themselves if they are undocumented or for undocumented family members living with them . ''
McDougle and others note that while resistance to immunization must be addressed , most people all across the U.S. are actually eager to be vaccinated — and help stop the pandemic .
`` We know many in our community already have their sleeves rolled up , '' he says , and it can feel patronizing for anyone @ @ @ @ @ @ @ the chief of staff of Agudath Israel of America , an Orthodox Jewish umbrella group , says the ultraorthodox community `` has always cared deeply about health — whether it is forming and managing Hatzalah , a massive volunteer ambulance corps , or emerging as the largest donors of [ convalescent ] plasma , which has been used to treat the virus . ''
In early October , for example , says Weinstock , the organization helped give out 400,000 masks in the New York City area , and they were all gone @ @ @ @ @ @ @ a lot of questions about the vaccine , based on a great deal of reading and community discussion .
This is all very new , '' says Weinstock .
`` But if their own doctors can assure them it 's safe and effective , then they are as motivated as any other group to be vaccinated and put the pandemic behind us . ''
Perhaps not surprisingly there is one trusted messenger in the U.S. who , community health leaders say , crosses many constituencies .
Unsolicited , both the NMA 's McDougle @ @ @ @ @ @ @ of Anthony Fauci — director of the National Institute of Allergy and Infectious Diseases and newly appointed chief medical adviser to President-elect Biden — as someone deeply trusted in their communities .
Fran Kritz is a health policy reporter based in Washington , D.C. , who has contributed to The Washington Post and Kaiser Health News .
Find her on Twitter : @ fkritz

'Trusted Messengers, Trusted Messages': How To Overcome Vaccine Hesitancy
Enlarge this image toggle caption Spencer Platt/Getty Images Spencer Platt/Getty Images
The U.S. Department of Health and Human Services booked an unusual guest interviewer for one of its public health events this fall: Shulem Lemmer, the first Hasidic singer to sign with a major record label.
Lemmer has no particular expertise in public health, but he grew up in Brooklyn, home to many ultraorthodox Jews like himself. He's seen as a trusted messenger in parts of the Hasidic community that, despite suffering a disproportionate number of hospitalizations and deaths from COVID-19, have on some occasions resisted New York's pandemic restrictions.
In the end, the interview never aired — HHS changed its mind about having entertainers explain COVID-19. Still, public health experts say the idea of enlisting respected and well-known leaders to help explain the health message is exactly the right way to disarm and persuade skeptics — and more crucial than ever this winter as cases and deaths from the coronavirus surge all across the U.S .
'Waving journal studies and talking points won't work"
"As we continue to talk to people about the virus, "waving journal studies and talking points won't work in many communities," says Robert Blendon, professor emeritus of public health, policy and political analysis at Harvard T.H. Chan School of Public Health.
That's particularly true, Blendon notes, in ethnic and racial communities "that have a history of being demonized, lied to, or exploited in the U.S. when it comes to their health."
Dr. Warren Reuben, director of Alabama's Tuskegee University National Center for Bioethics in Research and Health, notes the lasting and continuing impact of generations of racism and racial disparities in health care that were underscored by the Tuskegee experiments on Black men in the 1930s, but didn't start or end there.
"Black and brown communities are being disproportionately impacted by COVID-19. We don't want to see a widening of the disparity because the vaccines don't have representation from people of color."
"That history evokes fear in Blacks that translates into many being fearful of clinical trials and has them anxious about the coronavirus vaccines," Reuben says.
Persistent racism in health care is one reason the National Medical Association announced that it will be vetting vaccine data itself and publishing its conclusions.
"The times have called for this," says Dr. Leon McDougle, the NMA's president, who himself has signed up to be a clinical trial participant with NIH's COVID-19 Prevention Network. The network is conducting late-stage clinical trials on vaccines to prevent COVID-19, as well as on monoclonal antibodies for treatment.
Clergy consultants help get the word out
To increase participation by communities of color, the network has also created a faith initiative, which includes "faith ambassadors" and more than 30 clergy-consultants from the Black, Latinx and American Indian/Alaska Native communities to help get the word out.
"Black and brown communities are being disproportionately impacted by COVID-19," McDougle notes. "We don't want to see a widening of the disparity because the vaccines don't have representation from people of color."
According to a recent U.S. survey by the Kaiser Family Foundation, "about a quarter (27%) of the public remains vaccine hesitant, saying they probably or definitely would not get a COVID-19 vaccine even if it were available for free and deemed safe by scientists." That number jumped to 35% among Black Americans surveyed.
Dr. Georges Benjamin, the long-time executive director of the American Public Health Association, says today's public health workers would do well to borrow a strategy that helped stem the AIDS epidemic: tailoring the message to different constituencies. In that case, the health message first focused on safe sex in the gay community, he notes, and then, a couple of years later, added messaging on the risk of IV drug use as the virus moved into the heterosexual community.
Showing 'cultural humility' is vital to gaining trust
Crucially, to gain the trust of many different groups in the U.S., public health messengers must also demonstrate not just cultural awareness, but "cultural humility" says Eliseo J. Pérez-Stable, director of NIH's National Institute on Minority Health and Health Disparities. Even well-intended programs sometimes miss the mark.
For example, a smoking cessation campaign Pérez-Stable worked on years ago in the Latino community focused on the health of male smokers, but wasn't successful, he says, until the messaging changed to stress the health benefits for the smoker's wife and children if the men stopped smoking.
To make a public health message persuasive, personal stories from someone who is most like you are critically important, agrees Tom Frieden, a former director of the Centers for Disease Control and Prevention who now heads the global health initiative Resolve to Save Lives. To cut through skepticism, he says, public health campaigns need "trusted messengers and trusted messages."
Frieden points to Tips from Former Smokers, a CDC campaign he helped launch in 2012, that shared the personal stories of illness and death from tobacco users, as well stories of those who had quit successfully.
YouTube
The multifaceted campaign is credited with helping a million smokers quit, and includes tailored online stories and videos from people who are African American, Native American, Asian American, Latino, LGBT, as well as one from veterans and another from people who grapple with mental illness.
"What we have to do is insure that the informal work force is inclusive of all of these communities," says Loyce Pace, the president and executive director of the Global Health Council, and a member of President-elect Joe Biden's COVID-19 task force.
"The best approach is for the states to find out who to reach out to in each tribe in order to gain the community's trust."
NIH aims to do just that with a new $12 million initiative launched in September — the Community Engagement Alliance Against COVID-19 Disparities, that is hiring "messengers who live, work, and worship in the same communities" says Pérez-Stable. These workers are leading outreach and engagement efforts in ethnic and racial minority communities disproportionately affected by the virus.
Dr. Mary Owen, director of the Center of American Indian and Minority Health at the University of Minnesota, says the impact of the coronavirus on Indian communities "is so devastating that it is absolutely critical that we do this right," and points to high uptake of the flu vaccine among Native Americans as the example that it can be done.
Owen, a member of the Tlingit nation, says a successful strategy for the COVID-19 vaccine must recognize that there are 574 distinct tribes, each with its own leaders and influencers. The best approach, she says, "is for the states to find out who to reach out to in each tribe in order to gain the community's trust."
Of course, not all Native people distrust the government, Owen notes, "but even a few folks not getting the vaccine is impactful in a population as small as ours."
Rita Carreón, vice president for health at UnidosUS in Washington, D.C., notes that in many U.S. Latino communities her group works with, lay people who have been trained as community health workers — promotoras de salud – are trusted and already helping to dispel misinformation and misconceptions about COVID-19 and the vaccine needed to fight it.
"They live in the community and relate to the community in terms of language and experiences," Carreón says.
Some communities have built the infrastructure for vaccine education over the past 10 months by already going beyond standard messaging. The Bay Area Regional Health Inequities Initiative, for example, based in Oakland, Calif., is a consortium of eleven local health departments in the culturally and racially diverse region who are working with more than 200 community partner organizations to focus on health and economic opportunity.
"BARHII was formed to address the durable, decade-wide gap in life expectancy that exists between communities in the Bay Area," explains Melissa Jones, executive director of the organization.
"That gap is the result of systemic factors, not individual choices," she says, "so BARHII and our members focus on systemic solutions: safe and secure housing, universal basic income, medical bias, well-paying jobs for all residents, and climate resilience in the face of extreme heat and wildfires."
The COVID-19 pandemic, she says, "has been a sobering demonstration of how Black and brown communities in particular are excluded from economic and social supports, and how centering their needs and concerns is essential in maintaining public health."
The standard CDC guidance to isolate in your own room and bathroom if you have COVID-19 symptoms won't work if your home is small and crowded, notes Jones, or if you are an essential worker living paycheck to paycheck or self-employed, so don't get sick-pay — or if you don't have a home.
In neighborhoods that are largely Latino, BARHII's member health departments hired Spanish speaking community workers to get the word out, Jones says, rather than have case workers speak through a translator.
That helped them gain enough trust so that many community members who were asked to isolate themselves after contracting the virus or enter quarantine because they were exposed accepted the agency's help in finding temporary housing, food, and economic relief to make up for lost wages for that period.
All those interventions help stop the spread of the virus — and stop the pandemic.
"Spanish speakers," Jones says, "use correct idioms, may know the person they are working with from the community, and understand specific fears — such as worries that filling out forms for the vaccine could risk deportation for themselves if they are undocumented or for undocumented family members living with them."
McDougle and others note that while resistance to immunization must be addressed, most people all across the U.S. are actually eager to be vaccinated — and help stop the pandemic.
"We know many in our community already have their sleeves rolled up," he says, and it can feel patronizing for anyone to assume otherwise.
Avrohom Weinstock, the chief of staff of Agudath Israel of America, an Orthodox Jewish umbrella group, says the ultraorthodox community "has always cared deeply about health — whether it is forming and managing Hatzalah, a massive volunteer ambulance corps, or emerging as the largest donors of [convalescent] plasma, which has been used to treat the virus."
In early October, for example, says Weinstock, the organization helped give out 400,000 masks in the New York City area, and they were all gone within hours.
"The community has a lot of questions about the vaccine, based on a great deal of reading and community discussion. This is all very new," says Weinstock. "But if their own doctors can assure them it's safe and effective, then they are as motivated as any other group to be vaccinated and put the pandemic behind us."
Perhaps not surprisingly there is one trusted messenger in the U.S. who, community health leaders say, crosses many constituencies. Unsolicited, both the NMA's McDougle and Unidos' Carreón invoke the name of Anthony Fauci — director of the National Institute of Allergy and Infectious Diseases and newly appointed chief medical adviser to President-elect Biden — as someone deeply trusted in their communities.
Fran Kritz is a health policy reporter based in Washington, D.C., who has contributed to The Washington Post and Kaiser Health News. Find her on Twitter: @fkritz


npr--2020-12-24--U.S. Cyber Agency: SolarWinds Attack Hitting Local Governments

Updated at 3:30 a.m .
ET A U.S. cybersecurity agency said Wednesday that the far-reaching attack into the IT management company SolarWinds discovered earlier this month has infected more systems than previously thought .
The U.S. Cybersecurity and Infrastructure Security Agency , also known as CISA , said Wednesday that the hack not only affected key federal agencies , but also computer systems used by state and local governments , critical infrastructure entities and other private sector organizations .
There is also evidence that other networking software may have been compromised , CISA said .
The cybersecurity agency said it @ @ @ @ @ @ @ Assertion Markup Language ( SAML ) tokens as well .
SAML tokens are complex password handlers that allow different programs to communicate , allowing for one single log-in to access various services .
The hackers attached malware to a software update for SolarWinds ' Orion system , which is used by many federal agencies and thousands of companies worldwide to monitor their computer networks .
It 's known that the hack has so far infected several computer systems within the U.S. government , including at the departments of Treasury , Commerce , and @ @ @ @ @ @ @ 40 of its customers were also affected by the hack .
CISA said that the agency is `` tracking a significant cyber incident '' having an impact on networks across federal , state , and local governments .
The message shared by CISA on Wednesday did n't detail which local governments or other entities may have been affected by the malware and details remain scarce .
`` This threat actor has the resources , patience , and expertise to gain access to and privileges over highly sensitive information if left unchecked , '' @ @ @ @ @ @ @ .
Russia 's foreign intelligence service , the SVR , is believed to have carried out the hack .
Kremlin officials have denied this charge .
Reuters has previously reported that Pima County , Arizona was among the targets of the attack .
SolarWinds says that nearly 18,000 of its customers received the software update that included the malware from March to June of this year .

U.S. Cyber Agency: SolarWinds Attack Hitting Local Governments
Enlarge this image toggle caption Olivier Douliery/AFP via Getty Images Olivier Douliery/AFP via Getty Images
Updated at 3:30 a.m. ET
A U.S. cybersecurity agency said Wednesday that the far-reaching attack into the IT management company SolarWinds discovered earlier this month has infected more systems than previously thought.
The U.S. Cybersecurity and Infrastructure Security Agency, also known as CISA, said Wednesday that the hack not only affected key federal agencies, but also computer systems used by state and local governments, critical infrastructure entities and other private sector organizations.
There is also evidence that other networking software may have been compromised, CISA said. The cybersecurity agency said it is investigating signs of abuse of Security Assertion Markup Language (SAML) tokens as well. SAML tokens are complex password handlers that allow different programs to communicate, allowing for one single log-in to access various services.
The hackers attached malware to a software update for SolarWinds' Orion system, which is used by many federal agencies and thousands of companies worldwide to monitor their computer networks. It's known that the hack has so far infected several computer systems within the U.S. government, including at the departments of Treasury, Commerce, and Energy. Microsoft has said at least 40 of its customers were also affected by the hack.
CISA said that the agency is "tracking a significant cyber incident" having an impact on networks across federal, state, and local governments. The message shared by CISA on Wednesday didn't detail which local governments or other entities may have been affected by the malware and details remain scarce.
"This threat actor has the resources, patience, and expertise to gain access to and privileges over highly sensitive information if left unchecked," CISA said in its message posted online.
Russia's foreign intelligence service, the SVR, is believed to have carried out the hack. Kremlin officials have denied this charge.
Reuters has previously reported that Pima County, Arizona was among the targets of the attack.
SolarWinds says that nearly 18,000 of its customers received the software update that included the malware from March to June of this year.


npr--2020-12-24--WATCH: Octopuses Punch Fish, Sometimes For No Apparent Reason

WATCH : Octopuses Punch Fish , Sometimes For No Apparent Reason What have eight legs , hunt among a group of fish and can throw a mean sucker punch ?
According to research published in Ecology last week , the answer would be octopuses ( yes , octopuses , not octopi—we asked ) .
Octopuses punch fish .
Deliberately .
Sometimes there 's a reason , but other times , there 's no discernible excuse .
Researchers caught this behavior on video .
The first time researcher Eduardo Sampaio witnessed this phenomenon , he laughed .
Normally that 'd be @ @ @ @ @ @ @ underwater wearing scuba equipment .
`` I almost choked on my regulator , '' he said in an interview with NPR 's Morning Edition .
`` When I saw it for the first time , I just burst out laughing . ''
The octopus is typically a solitary creature , but sometimes an octopus might take part in a hunting party made up of fishes .
A grouper 's gestures , for example , can clue an octopus into the location of prey .
Sampaio and his co-researchers were studying this mutually beneficial @ @ @ @ @ @ @ punching fish while hunting .
Although researchers have observed octopuses punching fish before , the behavior happening in the context of a hunting party is new .
And it can come suddenly , out of nowhere , Sampaio said .
`` You can see there some punches are almost like a small boop , '' Sampaio said .
`` And the other ones that even the whole arm curls up and uncurls afterwards , you know , like the motion of a boxer doing a punch . ''
The punches are fairly rare @ @ @ @ @ @ @ to observe , he said .
The research prompts many questions he said , like `` Is there a species that the octopus prefers to punch ? ''
In some cases , the researchers were able to determine the reason the underwater bully decided to strike .
Sometimes it 's a partner-control mechanism , Sampaio explained , to drive the fish away from the octopus ' next meal .
Or it can be to control where the fish is swimming .
Or it can be a form of punishment , he said .
@ @ @ @ @ @ @ the fish — with no discernible incentive .

WATCH: Octopuses Punch Fish, Sometimes For No Apparent Reason
What have eight legs, hunt among a group of fish and can throw a mean sucker punch?
According to research published in Ecology last week, the answer would be octopuses (yes, octopuses, not octopi—we asked).
Octopuses punch fish. Deliberately. Sometimes there's a reason, but other times, there's no discernible excuse. Researchers caught this behavior on video.
The first time researcher Eduardo Sampaio witnessed this phenomenon, he laughed. Normally that'd be fine but at the time he was underwater wearing scuba equipment.
"I almost choked on my regulator," he said in an interview with NPR's Morning Edition. "When I saw it for the first time, I just burst out laughing."
The octopus is typically a solitary creature, but sometimes an octopus might take part in a hunting party made up of fishes. A grouper's gestures, for example, can clue an octopus into the location of prey. Sampaio and his co-researchers were studying this mutually beneficial behavior when they came across an octopus punching fish while hunting.
Although researchers have observed octopuses punching fish before, the behavior happening in the context of a hunting party is new. And it can come suddenly, out of nowhere, Sampaio said.
"You can see there some punches are almost like a small boop," Sampaio said. "And the other ones that even the whole arm curls up and uncurls afterwards, you know, like the motion of a boxer doing a punch."
The punches are fairly rare, so it's not so easy to observe, he said. The research prompts many questions he said, like "Is there a species that the octopus prefers to punch?"
In some cases, the researchers were able to determine the reason the underwater bully decided to strike.
Sometimes it's a partner-control mechanism, Sampaio explained, to drive the fish away from the octopus' next meal. Or it can be to control where the fish is swimming. Or it can be a form of punishment, he said.
And sometimes the eight-legged creature just punches the fish — with no discernible incentive.


npr--2020-12-24--How Worried Should We Be About The New U.K. Coronavirus Variant?

How Worried Should We Be About The New U.K. Coronavirus Variant ?
A new variant of the coronavirus is sweeping through England .
At the same time , the country is reporting a record-high number of COVID-19 cases – nearly 40,000 on Wednesday — as well as surges in hospitalizations and deaths .
In London last week , an estimated 2 % of people in private households tested positive for the coronavirus , The Independent reported .
So the big question is : Are these events connected ?
Is the new variant causing this surge ?
Now British scientists are @ @ @ @ @ @ @ the take-home message is sobering .
The new variant , which contains 17 mutations , appears more transmissible and harder to control in terms of spread .
`` Given all the biological and epidemiological evidence that has come together in the past few weeks , I think the picture is getting more and more consistent with something pretty serious , '' says mathematical modeler Nick Davies , who led the study .
Davies is part of a group of scientists in the United Kingdom , called SPI-M , whose job is to use @ @ @ @ @ @ @ spread in order to guide policymakers ' decisions .
Last week , when health officials announced the rise of this new variant , Davies was skeptical it was responsible for the surge in the U.K. : `` Because one possible explanation for a rise in hospitalizations could just be that we 've just come out of lockdown in these regions , and maybe people have gone back to more normal movement and contact . ''
And besides , all viruses mutate .
That 's normal .
The vast majority of time the mutations @ @ @ @ @ @ @ the virus more dangerous .
But then a few days later , Davies watched a news presentation from South Africa , and his skepticism evaporated .
COVID-19 is also surging there .
At the same time , scientists there have detected a new variant , which shares surprisingly similarities with the U.K. one .
Both versions contain a mutation called N501Y .
This mutation has appeared in previous variants and is already known to increase how tightly the virus binds to human cells .
And so Davies went to work .
He inserted @ @ @ @ @ @ @ into computer models .
He wanted to know why the new variant was spreading so quickly .
He tested out four key hypotheses .
Could the new variant : • Infect people who already had COVID-19 ?
• Be more transmissible ?
( That is , when people catch the new variant , would they be likely to spread it to more people than when they 're infected with other versions ? )
The mathematical models , published online Wednesday but not yet peer-reviewed , pointed to one of these four hypotheses .
@ @ @ @ @ @ @ for us to explain what we 're seeing , '' Davies says .
Specifically , the study suggests the new variant is about 50 % more transmissible than previous versions of SARS-CoV-2 , the virus that causes COVID-19 .
But the data ca n't yet rule out the possibility that other factors also contribute to the new variant 's domination in England .
There 's also no evidence the variant causes more severe disease than previous versions .
And scientists do n't know why this variant is likely more transmissible .
Previous studies @ @ @ @ @ @ @ U.K. variant may infect human cells more easily .
And it may generate more copies of itself inside a person .
`` When you swab people who have coronavirus infection , the people who are infected with this new variant tend to have more copies of the virus on the swab , '' says Davies , who 's also part of the London School of Hygiene & Tropical Medicine .
No matter the underlying reason , policymakers should take this new variant very seriously , says epidemiologist Bill Hanage of the Harvard T.H @ @ @ @ @ @ @ If it 's indeed 50 % more transmissible , it will be difficult to stop its spread .
`` Given the assumptions in their models , it 's really quite hard to avoid a situation very much like what happened last spring , in terms of hospital bed capacity and surges , without a very high rate of vaccination , '' Hanage says .
That said , Hanage says there 's no reason for people to panic or be scared .
`` It 's not a magic virus , '' he says — @ @ @ @ @ @ @ Mackay at the University of Queensland also wrote on Twitter .
`` We have actually come across a large number of ways that we can use to stop it .
However , we need to redouble our efforts in that direction . ''
The variant will likely come to the U.S. — if is n't here already .
The study strongly suggests that people should be even more diligent about preventive measures : avoiding large gatherings .
wearing masks , physical distancing and washing hands .
On top of that , Hanage says @ @ @ @ @ @ @ getting out at a very , very high rate . ''
Because right now , scientists believe the vaccine will still be effective with this new variant .
And Hanage says the quicker we immunize the vulnerable members of a community the safer the whole community will be from the original and future versions of the novel coronavirus .

How Worried Should We Be About The New U.K. Coronavirus Variant?
Enlarge this image toggle caption Kateryna Kon/Science Photo Library via Getty Images Kateryna Kon/Science Photo Library via Getty Images
A new variant of the coronavirus is sweeping through England. At the same time, the country is reporting a record-high number of COVID-19 cases – nearly 40,000 on Wednesday — as well as surges in hospitalizations and deaths. In London last week, an estimated 2% of people in private households tested positive for the coronavirus, The Independent reported.
So the big question is: Are these events connected? Is the new variant causing this surge?
Now British scientists are starting to answer that question. And the take-home message is sobering. The new variant, which contains 17 mutations, appears more transmissible and harder to control in terms of spread.
"Given all the biological and epidemiological evidence that has come together in the past few weeks, I think the picture is getting more and more consistent with something pretty serious," says epidemiologist Nick Davies, who led the study.
Davies is part of a group of scientists in the United Kingdom, called SPI-M, whose job is to use mathematical models to predict how diseases will spread in order to guide policymakers' decisions.
Last week, when health officials announced the rise of this new variant, Davies was skeptical it was responsible for the surge in the U.K.: "Because one possible explanation for a rise in hospitalizations could just be that we've just come out of lockdown in these regions, and maybe people have gone back to more normal movement and contact."
And besides, all viruses mutate. That's normal. The vast majority of time the mutations are harmless. They don't make the virus more dangerous.
But then a few days later, Davies watched a news presentation from South Africa, and his skepticism evaporated. COVID-19 is also surging there. At the same time, South African scientists have detected a new variant, which shares surprisingly similarities with the U.K. one. Both versions contain a mutation called N501Y. This mutation has appeared in previous variants and is already known to increase how tightly the virus binds to human cells.
And so Davies went to work. He inserted the data on the new U.K. variant into computer models. He wanted to know why the new variant was spreading so quickly. He tested out four key hypotheses. Could the new variant:
Infect people who already had COVID-19? Infect children more easily? Spread more quickly than previous versions? Be more transmissible? (That is, when people catch the new variant, would they be likely to spread it to more people than when they're infected with other versions?)
The mathematical models, published online Wednesday but not yet peer-reviewed, pointed to one of these four hypotheses. "Increased transmissibility is the easiest way for us to explain what we're seeing," Davies says.
Specifically, the study suggests the new variant is about 50% more transmissible than previous versions of SARS-CoV-2, the virus that causes COVID-19. But the data can't yet rule out the possibility that other factors also contribute to the new variant's domination in England. There's also no evidence the variant causes more severe disease than previous versions.
And scientists don't know why this variant is likely more transmissible. Previous studies, with another variant, suggest the U.K. variant may infect human cells more easily. And it may generate more copies of itself inside a person. "When you swab people who have coronavirus infection, the people who are infected with this new variant tend to have more copies of the virus on the swab," says Davies, who's also part of the London School of Hygiene & Tropical Medicine.
No matter the underlying reason, policymakers should take this new variant very seriously, says epidemiologist Bill Hanage of the Harvard T.H. Chan School of Public Health. If it's indeed 50% more transmissible, it will be difficult to stop its spread.
"Given the assumptions in their models, it's really quite hard to avoid a situation very much like what happened last spring, in terms of hospital bed capacity and surges, without a very high rate of vaccination," Hanage says.
That said, Hanage says there's no reason for people to panic or be scared. "It's not a magic virus," he says — that's the message virus expert Ian Mackay at the University of Queensland also wrote on Twitter.
"We have actually come across a large number of ways that we can use to stop it. However, we need to redouble our efforts in that direction."
The variant will likely come to the U.S. — if isn't here already. The study strongly suggests that people should be even more diligent about preventive measures: avoiding large gatherings. wearing masks, physical distancing and washing hands. On top of that, Hanage says, "the vaccine needs to be getting out at a very, very high rate."
Because right now, scientists believe the vaccine will still be effective with this new variant. And Hanage says the quicker we immunize the vulnerable members of a community the safer the whole community will be from the original and future versions of the novel coronavirus.


npr--2020-12-24--At The Vatican, A Christmas Eve Mass Shaped By The Pandemic

At The Vatican , A Christmas Eve Mass Shaped By The Pandemic To a world upended by the coronavirus , Pope Francis offered a timeless message during a Christmas Eve Mass that was itself shaped by the ongoing pandemic .
The Mass was celebrated in a smaller rear section of St. Peter 's Basilica , and only 100 or so people were present , Reuters reported .
In normal times without a pandemic , the Mass is celebrated in the main part of the basilica before some 10,000 people .
All in attendance wore masks except for the pontiff and @ @ @ @ @ @ @ pews sat at a distance from one another .
The Mass began two hours earlier than is traditional , so that those attending could make it home by the 10 p.m. curfew in place as part of Italy 's measures to stem the pandemic .
The service was streamed live on the Vatican 's YouTube channel .
Italy went into a modified lockdown on Thursday , the first of three such periods between Christmas Eve and Jan. 6 , following a steep increase in COVID-19 cases in recent weeks .
On Wednesday , @ @ @ @ @ @ @ 553 deaths .
`` The birth of Jesus is the 'newness ' that enables us to be reborn each year , and to find , in Him , the strength needed to face every trial , '' the pontiff said in his homily , according to the Vatican 's news service .
He also spoke of the need to help those in poverty , reflected on `` our injustice toward so many of our brothers and sisters '' – and offered a reminder Jesus was himself an outcast .
`` The Son of @ @ @ @ @ @ @ order to tell us that every outcast is a child of God , '' Francis said , according to Reuters .
`` God came among us in poverty and need , to tell us that in serving the poor , we will show our love for him . ''

At The Vatican, A Christmas Eve Mass Shaped By The Pandemic
Enlarge this image toggle caption Vincenzo Pinto/AFP via Getty Images Vincenzo Pinto/AFP via Getty Images
To a world upended by the coronavirus, Pope Francis offered a timeless message during a Christmas Eve Mass that was itself shaped by the ongoing pandemic.
The Mass was celebrated in a smaller rear section of St. Peter's Basilica, and only 100 or so people were present, Reuters reported. In normal times without a pandemic, the Mass is celebrated in the main part of the basilica before some 10,000 people.
All in attendance wore masks except for the pontiff and a small choir. Those in the pews sat at a distance from one another.
The Mass began two hours earlier than is traditional, so that those attending could make it home by the 10 p.m. curfew in place as part of Italy's measures to stem the pandemic. The service was streamed live on the Vatican's YouTube channel.
Italy went into a modified lockdown on Thursday, the first of three such periods between Christmas Eve and Jan. 6, following a steep increase in COVID-19 cases in recent weeks. On Wednesday, Italy reported 13,908 new confirmed cases and 553 deaths.
Vatican News YouTube
"The birth of Jesus is the 'newness' that enables us to be reborn each year, and to find, in Him, the strength needed to face every trial," the pontiff said in his homily, according to the Vatican's news service.
He also spoke of the need to help those in poverty, reflected on "our injustice toward so many of our brothers and sisters" – and offered a reminder Jesus was himself an outcast.
"The Son of God was born an outcast, in order to tell us that every outcast is a child of God," Francis said, according to Reuters.
"God came among us in poverty and need, to tell us that in serving the poor, we will show our love for him."


npr--2020-12-24--'Balloon Boy' Parents Pardoned By Colorado Governor For 2009 Hoax

The so-called balloon boy incident captivated television audiences in 2009 as the parents of a 6-year-old — appropriately named Falcon — reported he had been carried away in a large , UFO-like balloon , thousands of feet in the air .
News media helicopters tracked the balloon .
The National Guard sent another two helicopters in a rescue attempt .
Denver International Airport was temporarily closed as thousands awaited news of the boy 's fate .
Falcon 's parents , Richard and Mayumi Heene , told authorities he was accidentally carried thousands of feet into the sky in a homemade @ @ @ @ @ @ @ after the balloon landed , authorities did not find Falcon inside .
Instead , he had been hiding in a box in the family attic the entire time .
It turned out to be a lot of hot air .
The parents pleaded guilty to a few crimes surrounding the incident after authorities said it was a hoax planned by the family .
On Wednesday , Colorado Gov .
Jared Polis pardoned the parents in the so-called balloon boy incident .
`` In the case of Richard and Mayumi Heene , the 'balloon @ @ @ @ @ @ @ ready to move past the spectacle from a decade ago that wasted the precious time and resources of law enforcement officials and the general public , '' Polis said in a statement .
`` Richard and Mayumi have paid the price in the eyes of the public , served their sentences , and it 's time for all of us to move on , '' he added .
`` It 's time to no longer let a permanent criminal record from the balloon boy saga follow and drag down the parents for the @ @ @ @ @ @ @ pardon scrubs the crimes from their records and will allow Richard Heene — who was convicted of a felony – to vote and pursue a general contractor 's license .
`` The balloonacy has ended , '' said David Lane , the family 's longtime attorney , according to Colorado Public Radio .
`` I commend the governor very strongly for realizing that despite all the public attention this case got , it was an unjust conviction .
Given that , he recognized that you do n't coerce people into pleading guilty , @ @ @ @ @ @ @ his great credit , '' Lane said .
Polis ' statement did not question the integrity of the conviction , only saying the family deserved to move on .
His office declined to comment further , per a request by Colorado Public Radio .
Despite pleading guilty in 2009 , the parents maintain their innocence .
They argue that they pleaded guilty only to avoid a worse punishment .
Mayumi Heene was not a U.S. citizen at the time , and the couple said they feared she would be deported .
Their three @ @ @ @ @ @ @ — even defended the claims in an original heavy metal song titled `` Balloon Boy , No Hoax . ''
`` Ever had one of those days/ Where everything went wrong , '' now-teen Falcon Heene sang .
`` We told the truth/ The Sheriff lied . ''
The family had the sympathy ( and doubts ) of many immediately following the incident .
But their story began to unravel quickly after an interview on CNN 's Larry King Live .
When asked why he was hiding , Falcon answered : `` You @ @ @ @ @ @ @ the show . ''
`` Man , '' his father chimed in .
`` No , '' his mother said .
The family — featured twice on the popular reality TV series Wife Swap — was accused of planning the stunt to garner fame .
`` There is absolutely no doubt in our minds this was a hoax .
It was a publicity stunt done with hopes of better maneuvering themselves for a reality TV show , '' Larimer County Sheriff Jim Alderden said in 2009 .
The couple served stints in jail @ @ @ @ @ @ @ in restitution to authorities .
The judge also issued a unique punishment — the couple could not seek a way to monetize the experience whatsoever .
Colorado 8th Judicial District Chief Judge Stephen Schapanski blasted the couple during their hearing , telling them they `` exploited their children , the media and the emotions of people all over the country for money . ''
`` I 'm very , very sorry .
And I want to apologize to all the rescue workers out there , '' Richard Heene said at the time , @ @ @ @ @ @ @ a hoax .
He and his wife sought pardons from Polis a year ago , their attorney said .
The governor pardoned or granted clemency to 21 others on Wednesday .
`` I 'm flying high , '' Heene told The Denver Post after Polis granted the pardon .
`` This is just fantastic . ''

'Balloon Boy' Parents Pardoned By Colorado Governor For 2009 Hoax
Enlarge this image toggle caption Chris Schneider/Getty Images Chris Schneider/Getty Images
The so-called balloon boy incident captivated television audiences in 2009 as the parents of a 6-year-old — appropriately named Falcon — reported he had been carried away in a large, UFO-like balloon, thousands of feet in the air.
News media helicopters tracked the balloon. The National Guard sent another two helicopters in a rescue attempt. Denver International Airport was temporarily closed as thousands awaited news of the boy's fate.
Falcon's parents, Richard and Mayumi Heene, told authorities he was accidentally carried thousands of feet into the sky in a homemade weather balloon experiment gone wrong.
But after the balloon landed, authorities did not find Falcon inside. Instead, he had been hiding in a box in the family attic the entire time.
It turned out to be a lot of hot air.
The pardon
The parents pleaded guilty to a few crimes surrounding the incident after authorities said it was a hoax planned by the family. On Wednesday, Colorado Gov. Jared Polis pardoned the parents in the so-called balloon boy incident.
"In the case of Richard and Mayumi Heene, the 'balloon boy' parents, we are all ready to move past the spectacle from a decade ago that wasted the precious time and resources of law enforcement officials and the general public," Polis said in a statement.
"Richard and Mayumi have paid the price in the eyes of the public, served their sentences, and it's time for all of us to move on," he added. "It's time to no longer let a permanent criminal record from the balloon boy saga follow and drag down the parents for the rest of their lives."
The pardon scrubs the crimes from their records and will allow Richard Heene — who was convicted of a felony – to vote and pursue a general contractor's license.
"The balloonacy has ended," said David Lane, the family's longtime attorney, according to Colorado Public Radio.
"I commend the governor very strongly for realizing that despite all the public attention this case got, it was an unjust conviction. Given that, he recognized that you don't coerce people into pleading guilty, so he has pardoned them, to his great credit," Lane said.
Polis' statement did not question the integrity of the conviction, only saying the family deserved to move on. His office declined to comment further, per a request by Colorado Public Radio.
Claims of innocence
Despite pleading guilty in 2009, the parents maintain their innocence.
They argue that they pleaded guilty only to avoid a worse punishment. Mayumi Heene was not a U.S. citizen at the time, and the couple said they feared she would be deported.
Their three sons — Ryo, Bradford and Falcon — even defended the claims in an original heavy metal song titled "Balloon Boy, No Hoax."
"Ever had one of those days/ Where everything went wrong," now-teen Falcon Heene sang. "We told the truth/ The Sheriff lied."
The story begins to deflate
The family had the sympathy (and doubts) of many immediately following the incident. But their story began to unravel quickly after an interview on CNN's Larry King Live.
When asked why he was hiding, Falcon answered: "You guys said that we did this for the show."
"Man," his father chimed in. "No," his mother said.
The family — featured twice on the popular reality TV series Wife Swap — was accused of planning the stunt to garner fame.
"There is absolutely no doubt in our minds this was a hoax. It was a publicity stunt done with hopes of better maneuvering themselves for a reality TV show," Larimer County Sheriff Jim Alderden said in 2009.
The couple served stints in jail and were ordered to pay $36,000 in restitution to authorities. The judge also issued a unique punishment — the couple could not seek a way to monetize the experience whatsoever.
Colorado 8th Judicial District Chief Judge Stephen Schapanski blasted the couple during their hearing, telling them they "exploited their children, the media and the emotions of people all over the country for money."
"I'm very, very sorry. And I want to apologize to all the rescue workers out there," Richard Heene said at the time, although maintaining his assertion it wasn't a hoax.
He and his wife sought pardons from Polis a year ago, their attorney said. The governor pardoned or granted clemency to 21 others on Wednesday.
"I'm flying high," Heene told The Denver Post after Polis granted the pardon. "This is just fantastic."


npr--2020-12-24--California Is 1st State To Hit 2 Million Cases, And Hospitals Are Out Of ICU Beds

California Is 1st State To Hit 2 Million Cases , And Hospitals Are Out Of ICU Beds The number of confirmed cases of the coronavirus in California has surpassed 2 million , according to Johns Hopkins University , as the virus has spread with startling speed in the state .
It 's the first state to pass that number .
In the last day , according to Johns Hopkins , California saw 43,986 new cases and 319 deaths .
The state 's first million cases happened over the course of nearly 10 months , as the Los Angeles Times noted @ @ @ @ @ @ @ weeks .
Cases in the state have skyrocketed over the last two months .
The positivity rate has been steadily rising in that period , and is now at 12.4 % — 5 points higher than it was three weeks ago .
The surge is overwhelming hospitals in many parts of the state .
More than 19,700 people are currently hospitalized with the virus , with more than 4,000 people in intensive care .
ICU capacity is under enormous strain .
By the state 's count , there were 1,302 ICU beds available @ @ @ @ @ @ @ people .
In Los Angeles County , the Times found that as of 9 a.m. Sunday , there were just 30 available ICU beds – a county that 's home to 10 million people .
In Southern California and the San Joaquin Valley , ICU capacity is zero , according to the state Department of Public Health .
`` We do n't have space for anybody .
We 've been holding patients for days because we ca n't get them transferred , ca n't get beds for them , '' Alexis Lenz , @ @ @ @ @ @ @ center in Imperial County , told The Associated Press .
California ranks 36th among the 50 states , the District of Columbia and Puerto Rico in cases per 100,000 people since the pandemic began , the Times reported .
`` Another spike in cases in the winter holidays will be disastrous for our hospital system and ultimately will mean many more people simply wo n't be with us in 2021 , '' said Los Angeles County Public Health Director Barbara Ferrer , the AP reported .
California has seen more than 23,600 coronavirus-related @ @ @ @ @ @ @ .
A map of California on the state 's coronavirus dashboard is a sea of purple , a color that indicates high case numbers – all but three counties are at the `` widespread '' risk level .
The number of new daily cases has declined somewhat in the past few days .
`` We are experiencing a modest decline in the rate of the growth , '' Gov .
Gavin Newsom said Wednesday , according to the AP .
A decline over three days `` does n't necessarily make a trend ... @ @ @ @ @ @ @ a possible sign of some good news . ''
Health workers and officials urged Californians to stay home and not gather for Christmas and New Year 's celebrations .
Los Angeles Mayor Eric Garcetti said public health officials have drawn `` a straight line '' between the surge happening now and gatherings that happened at Thanksgiving .
`` If you gather for the holidays , our hospitals will be overrun , '' Garcetti said on Monday , local outlets reported .
`` If people do n't stay home for Christmas this year , @ @ @ @ @ @ @ 's , it 's hard for me to even imagine , '' Patrick Macmillan , a physician in Fresno County , told the AP .
`` I think it will break the health care system if people do n't stay home . ''

California Is 1st State To Hit 2 Million Cases, And Hospitals Are Out Of ICU Beds
Enlarge this image toggle caption Mario Tama/Getty Images Mario Tama/Getty Images
The number of confirmed cases of the coronavirus in California has surpassed 2 million, according to Johns Hopkins University, as the virus has spread with startling speed in the state.
It's the first state to pass that number. In the last day, according to Johns Hopkins, California saw 43,986 new cases and 319 deaths.
The state's first million cases happened over the course of nearly 10 months, as the Los Angeles Times noted. The second million took just six weeks.
Cases in the state have skyrocketed over the last two months. The positivity rate has been steadily rising in that period, and is now at 12.4% — 5 points higher than it was three weeks ago.
The surge is overwhelming hospitals in many parts of the state. More than 19,700 people are currently hospitalized with the virus, with more than 4,000 people in intensive care.
ICU capacity is under enormous strain. By the state's count, there were 1,302 ICU beds available in a state of nearly 40 million people.
In Los Angeles County, the Times found that as of 9 a.m. Sunday, there were just 30 available ICU beds – a county that's home to 10 million people.
In Southern California and the San Joaquin Valley, ICU capacity is zero, according to the state Department of Public Health.
"We don't have space for anybody. We've been holding patients for days because we can't get them transferred, can't get beds for them," Alexis Lenz, an emergency room physician at the medical center in Imperial County, told The Associated Press.
California ranks 36th among the 50 states, the District of Columbia and Puerto Rico in cases per 100,000 people since the pandemic began, the Times reported.
"Another spike in cases in the winter holidays will be disastrous for our hospital system and ultimately will mean many more people simply won't be with us in 2021," said Los Angeles County Public Health Director Barbara Ferrer, the AP reported.
Enlarge this image toggle caption Mario Tama/Getty Images Mario Tama/Getty Images
California has seen more than 23,600 coronavirus-related deaths since the beginning of the pandemic.
A map of California on the state's coronavirus dashboard is a sea of purple, a color that indicates high case numbers – all but three counties are at the "widespread" risk level.
The number of new daily cases has declined somewhat in the past few days.
"We are experiencing a modest decline in the rate of the growth," Gov. Gavin Newsom said Wednesday, according to the AP. A decline over three days "doesn't necessarily make a trend ... but it's a modest indication of a possible sign of some good news."
Health workers and officials urged Californians to stay home and not gather for Christmas and New Year's celebrations.
Los Angeles Mayor Eric Garcetti said public health officials have drawn "a straight line" between the surge happening now and gatherings that happened at Thanksgiving.
"If you gather for the holidays, our hospitals will be overrun," Garcetti said on Monday, local outlets reported.
"If people don't stay home for Christmas this year, we're going to see something that's, it's hard for me to even imagine," Patrick Macmillan, a physician in Fresno County, told the AP. "I think it will break the health care system if people don't stay home."


npr--2020-12-24--How The Rockets-Thunder Delay Could Foreshadow Challenges To This NBA Season

How The Rockets-Thunder Delay Could Foreshadow Challenges To This NBA Season The start of the NBA 2020-2021 season is already off to a bumpy start with the postponement of the Houston Rockets vs. Oklahoma City Thunder matchup Wednesday because of coronavirus issues .
It was just Day 2 of competition for the fledgling NBA season .
This could foreshadow future issues for the league , which is starting a season during a raging pandemic .
It is no longer playing games in the controlled environment of the so-called bubble , as it did earlier this year in Florida to finish @ @ @ @ @ @ @ announced its decision to move the Rockets-Thunder game off its Wednesday schedule just hours before its scheduled tipoff in Houston , saying it was `` in accordance with the league 's Heath and Safety Protocols . ''
The Rockets were unable to dress the minimum of eight players to proceed with the game .
The league said three Rockets players returned coronavirus tests that were either positive or inconclusive , and four other players were quarantining due to contact tracing protocols .
Additionally , Houston superstar James Harden was barred from playing because @ @ @ @ @ @ @ 's health and safety rules .
He was fined $ 50,000 for attending a private indoor party with more than 15 people earlier in the week .
Video surfaced this week of the former league MVP and three-time scoring champion partying maskless , reportedly at a Christmas party in the Houston area .
For his part , Harden has been unhappy about his situation in Houston and has been pushing for a trade .
As several media outlets have reported , including The New York Times , Harden said in a now-deleted Instagram @ @ @ @ @ @ @ '' for a friend , refuting reports that the video was taken at a strip club .
There 's no word on when the Rockets-Thunder game will be held .
And there are no plans as of Thursday to move Houston 's next game against the Portland Trail Blazers .
Harden is mandated to quarantine for four days and must test negative for the virus through Saturday to play in Oregon Dec. 26 , according to a source with direct knowledge of Harden 's status .
`` Welcome to the new normal , @ @ @ @ @ @ @ .
`` Even asymptomatic cases — positive tests , even if accompanied by a healthy individual — will have the power to grind the gears of this season , if not to a halt , at least to a lurching and awkward reality . ''
All of this presents a unique set of challenges for NBA Commissioner Adam Silver , who successfully rebooted the NBA season in July with 22 teams playing at a single location in Florida .
The league had been shut down since March 11 , when the severity and @ @ @ @ @ @ @ beginning to become clear .
The format produced wildly entertaining play , culminating in the Los Angeles Lakers winning the NBA championship over the Miami Heat .
Perhaps the biggest achievement , as NPR 's Reese Oxner reported , is that the NBA reported zero positive coronavirus cases inside the bubble .
The new season , however , presents new obstacles .
Thirty franchises are participating in games .
It makes enforcing coronavirus protocols a challenge , to say the least , increasing the likelihood of games being postponed , at best , @ @ @ @ @ @ @ possible that the season could get postponed ? ''
Silver said during an interview with ESPN on Monday .
`` Of course .
Nobody can predict precisely the trajectory of this virus .
It 's been terrible , frankly . ''
Other leagues like the NFL and college football have been hard-hit by athletes contracting the virus , leading to games being postponed or rescheduled .
Several games at the collegiate level were canceled altogether .
Silver is attempting to hold an entire season of a contact sport that is played indoors .
@ @ @ @ @ @ @ least six franchises , including Houston , will welcome some of its fans into arenas .
`` Now that we 're trying something new , an indoor sport ... [ with ] different protocols that we have n't had in place before , '' Silver said .
`` I think we would n't be acting responsibly and I would n't be acting responsibly if I said it 's full steam ahead no matter what . ''
The commissioner also noted that `` there 's no way we 'd ever jump the line '' @ @ @ @ @ @ @ COVID-19 vaccines .
Silver said that because the majority of players are young and healthy , `` they will not be a high priority '' for the vaccine , but he added that some older NBA personnel would be given priority for the vaccine .

How The Rockets-Thunder Delay Could Foreshadow Challenges To This NBA Season
Enlarge this image toggle caption Carmen Mandato/Getty Images Carmen Mandato/Getty Images
Updated 3:32 p.m. ET
The start of the NBA 2020-2021 season is already off to a bumpy start with the postponement of the Houston Rockets vs. Oklahoma City Thunder matchup Wednesday because of coronavirus issues.
It was just Day 2 of competition for the fledgling NBA season.
This could foreshadow future issues for the league, which is starting a season during a raging pandemic. It is no longer playing games in the controlled environment of the so-called bubble, as it did earlier this year in Florida to finish out the previous season.
The NBA announced its decision to move the Rockets-Thunder game off its Wednesday schedule just hours before its scheduled tipoff in Houston, saying it was "in accordance with the league's Heath and Safety Protocols."
The Rockets were unable to dress the minimum of eight players to proceed with the game.
The league said three Rockets players returned coronavirus tests that were either positive or inconclusive, and four other players were quarantining due to contact tracing protocols.
Additionally, Houston superstar James Harden was barred from playing because he was in violation of the league's health and safety rules. He was fined $50,000 for attending a private indoor party with more than 15 people earlier in the week.
Video surfaced this week of the former league MVP and three-time scoring champion partying maskless, reportedly at a Christmas party in the Houston area.
For his part, Harden has been unhappy about his situation in Houston and has been pushing for a trade. As several media outlets have reported, including The New York Times, Harden said in a now-deleted Instagram post that he attended an "event" for a friend, refuting reports that the video was taken at a strip club.
There's no word on when the Rockets-Thunder game will be held. And there are no plans as of Thursday to move Houston's next game against the Portland Trail Blazers.
Harden is mandated to quarantine for four days and must test negative for the virus through Saturday to play in Oregon Dec. 26, according to a source with direct knowledge of Harden's status.
"Welcome to the new normal," Bill Reiter of CBS Sports said. "Even asymptomatic cases — positive tests, even if accompanied by a healthy individual — will have the power to grind the gears of this season, if not to a halt, at least to a lurching and awkward reality."
All of this presents a unique set of challenges for NBA Commissioner Adam Silver, who successfully rebooted the NBA season in July with 22 teams playing at a single location in Florida. The league had been shut down since March 11, when the severity and scope of the coronavirus pandemic was just beginning to become clear.
The format produced wildly entertaining play, culminating in the Los Angeles Lakers winning the NBA championship over the Miami Heat. Perhaps the biggest achievement, as NPR's Reese Oxner reported, is that the NBA reported zero positive coronavirus cases inside the bubble.
The new season, however, presents new obstacles. Thirty franchises are participating in games. It makes enforcing coronavirus protocols a challenge, to say the least, increasing the likelihood of games being postponed, at best, or fully stopped.
"Is it possible that the season could get postponed?" Silver said during an interview with ESPN on Monday. "Of course. Nobody can predict precisely the trajectory of this virus. It's been terrible, frankly."
Other leagues like the NFL and college football have been hard-hit by athletes contracting the virus, leading to games being postponed or rescheduled. Several games at the collegiate level were canceled altogether.
Silver is attempting to hold an entire season of a contact sport that is played indoors. And unlike the bubble format, at least six franchises, including Houston, will welcome some of its fans into arenas.
"Now that we're trying something new, an indoor sport ... [with] different protocols that we haven't had in place before," Silver said. "I think we wouldn't be acting responsibly and I wouldn't be acting responsibly if I said it's full steam ahead no matter what."
The commissioner also noted that "there's no way we'd ever jump the line" when it comes to NBA athletes receiving COVID-19 vaccines.
Silver said that because the majority of players are young and healthy, "they will not be a high priority" for the vaccine, but he added that some older NBA personnel would be given priority for the vaccine.


npr--2020-12-24--The Worst Of COVID Should Be Over For One Hard-Hit Brazilian City. But It's Not

The Worst Of COVID Should Be Over For One Hard-Hit Brazilian City .
But It 's Not In Brazil 's jungle metropolis of Manaus , nurse Francinete Simões thought she had seen the last COVID-19 death at the urgent care center where she works in July .
Hospitals finally had space to take critical patients again after a violent initial wave of the virus left many of the city 's dead in mass graves .
But in recent weeks , Simões says , hospitals are `` filling up , and I 'm seeing people die again . ''
The state @ @ @ @ @ @ @ close between December 26 and January 10 as a virus containment measure for this city of 2.2 million .
The teeming port city 's recent resurgence should sound an international alarm about how widely the virus can spread when poorly controlled , say researchers .
One study , which tested blood donations over a series of months to count COVID cases , estimates the virus may have attacked as many as 76 % of Manaus residents by October .
`` Some people think that the virus will go away immediately once infections reach @ @ @ @ @ @ @ immunologist Ester Sabino of the University of São Paulo , the lead researcher of the study published in the journal Science Magazine .
`` But for a while , it just moves slower , continuing to kill people . ''
While much of the world still faces long waits for a vaccine , says Sabino , if the virus is unchecked , `` slower or faster , what 's happening in Manaus can happen anywhere . ''
For its part , Brazil 's government has yet to announce a clear vaccination timeline .
@ @ @ @ @ @ @ outbreak is inequality — both in access to adequate housing and access to healthcare — says epidemiologist Jesem Orellana of the Oswaldo Cruz Foundation ( Fiocruz ) , Brazil 's national health research institute .
More than 53 % of households are in tightly packed poor neighborhoods .
At the start of the pandemic , Manaus was the only city in its state of 4 million that had intensive care beds , and it suffered from a doctor shortage .
Most people seeking care in the city could only reach it via tightly @ @ @ @ @ @ @ the virus up and down the [ Amazon ] river , '' says Fiocruz microbiologist Felipe Naveca , who has sequenced strains of the virus across the state .
Naveca also believes that a high number of virus strains were introduced to Manaus through its international airport ; the city is a free trade zone with frequent business traffic from Europe and Asia .
He sequenced four strains of SARS-CoV-2 in the state that have not been identified elsewhere in Brazil , but match strains identified in Colombia , Denmark and the United @ @ @ @ @ @ @ of the virus on March 13 .
City authorities responded with physical distancing measures such as moving non-essential city jobs to remote work and suspending licenses for large events .
They also increased access to health services , including opening a field hospital , says health department spokesperson Renildo Rodrigues .
Public schools closed on March 17 , non-essential services were ordered to close on March 23 , and nonresident foreigners were banned from flying into the country on March 30 .
Face masks were not required until May 11 .
Orellana describes @ @ @ @ @ @ @ as `` slow and deadly . ''
By the end of May , over 2,000 people had died of COVID-19 , according to the government 's count .
Cellphone data show only around half of Manaus residents practiced physical distancing in April and May .
`` Many people did n't believe the pandemic was real , '' says Simões , the nurse .
Manaus is a stronghold of voters for Brazil 's president Jair Bolsonaro , who has repeatedly dismissed COVID-19 as a `` little flu . ''
On June 1 , the @ @ @ @ @ @ @ By the end of the month , COVID-19 deaths had fallen to around five per day from a high of more than 50 per day at the end of April .
Sabino and her fellow researchers , a group from Brazilian , U.K. , and U.S. institutions , attribute the decreased deaths in part to growing population immunity .
In June , `` the population was more aware , principally due to the high numbers of deaths in April and May 2020 , which led them to better adhere to protective measures , @ @ @ @ @ @ @ of the state 's health department .
She says that deaths may also have fallen due to an increase in the number of available hospital beds and health workers ' improved understanding of how to deal with the virus .
Costa Pinto said she was aware of the study published in Science reporting much higher numbers than the government but would not comment on it .
The state 's official count of confirmed virus cases is 3.5 % of the population .
While Manaus 's scientific community widely considers the state numbers an @ @ @ @ @ @ @ study 's reliance on blood donors to draw conclusions about the wider population , even after the authors mathematically adjusted to account for donors ' limited age range ( 16 to 69 ) and for the fact that most were men .
In June , a household survey by the Federal University of Pelotas found a much lower rate of residents with COVID antibodies than the blood donor study for the same time period .
The Science authors mention the household survey in their article , writing that it was not carried out @ @ @ @ @ @ @ less sensitive test .
Their own estimate also includes extra calculations to reflect the waning of antibodies over time .
Others , including microbiologist Natália Pasternak , say the study was `` very well-conducted work '' that acknowledges its limitations and now must be `` well-interpreted . ''
Pasternak directs the scientific literacy NGO Instituto Questão da Ciência .
`` It 's not always possible to do a good population sample , '' she says .
`` This kind of study is one more scientific tool . ''
Blood donor studies are currently @ @ @ @ @ @ @ the pandemic , including in the United States .
The Centers for Disease Control and Prevention is conducting a nationwide blood donor survey of SARS-CoV-2 antibodies that is directed by one of Sabino 's co-authors , Michael Busch of the Vitalant Research Institute .
Busch and Sabino are part of a 20-year partnership between U.S. and Brazilian blood researchers , the REDS Brazil program , backed by the National Institutes of Health .
There is scientific consensus in Manaus about one thing : the outbreak is far from over .
`` Everyone must @ @ @ @ @ @ @ Monteiro , an infectologist in the public health system .
`` People are relaxing , even saying that the pandemic is over in Manaus , which will cost more lives . ''
Catherine Osborn is a Brazil-based journalist and a frequent contributor to NPR .

The Worst Of COVID-19 Should Be Over For 1 Hard-Hit Brazilian City. But It's Not
Enlarge this image toggle caption Michael Dantas/AFP via Getty Images Michael Dantas/AFP via Getty Images
In Brazil's jungle metropolis of Manaus, nurse Francinete Simões thought she had seen the last COVID-19 death at the urgent care center where she works in July. Hospitals finally had space to take critical patients again after a violent initial wave of the virus left many of the city's dead in mass graves.
But in recent weeks, Simões says, hospitals are "filling up, and I'm seeing people die again." The state government has now ordered non-essential businesses to close between December 26 and January 10 as a virus containment measure for this city of 2.2 million.
The teeming port city's recent resurgence should sound an international alarm about how widely the virus can spread when poorly controlled, say researchers. One study, which tested blood donations over a series of months to count COVID cases, estimates the virus may have attacked as many as 76% of Manaus residents by October.
"Some people think that the virus will go away immediately once infections reach a herd immunity level," says immunologist Ester Sabino of the University of São Paulo, the lead researcher of the study published in the journal Science Magazine. "But for a while, it just moves slower, continuing to kill people."
While much of the world still faces long waits for a vaccine, says Sabino, if the virus is unchecked, "slower or faster, what's happening in Manaus can happen anywhere." For its part, Brazil's government has yet to announce a clear vaccination timeline.
An Inequality-Laced Petri Dish
A key factor behind Manaus's explosive outbreak is inequality — both in access to adequate housing and access to healthcare — says epidemiologist Jesem Orellana of the Oswaldo Cruz Foundation (Fiocruz), Brazil's national health research institute. More than 53% of households are in tightly packed poor neighborhoods. At the start of the pandemic, Manaus was the only city in its state of 4 million that had intensive care beds, and it suffered from a doctor shortage. Most people seeking care in the city could only reach it via tightly packed boats, which "quickly spread the virus up and down the [Amazon] river," says Fiocruz microbiologist Felipe Naveca, who has sequenced strains of the virus across the state.
Naveca also believes that a high number of virus strains were introduced to Manaus through its international airport; the city is a free trade zone with frequent business traffic from Europe and Asia. He sequenced four strains of SARS-CoV-2 in the state that have not been identified elsewhere in Brazil, but match strains identified in Colombia, Denmark and the United Kingdom.
Manaus first identified a case of the virus on March 13. City authorities responded with physical distancing measures such as moving non-essential city jobs to remote work and suspending licenses for large events. They also increased access to health services, including opening a field hospital, says health department spokesperson Renildo Rodrigues. Public schools closed on March 17, non-essential services were ordered to close on March 23, and nonresident foreigners were banned from flying into the country on March 30. Face masks were not required until May 11.
Orellana describes authorities' overall response to the virus as "slow and deadly." By the end of May, over 2,000 people had died of COVID-19, according to the government's count.
Cellphone data show only around half of Manaus residents practiced physical distancing in April and May. "Many people didn't believe the pandemic was real," says Simões, the nurse. Manaus is a stronghold of voters for Brazil's president Jair Bolsonaro, who has repeatedly dismissed COVID-19 as a "little flu."
On June 1, the state allowed businesses to begin reopening. By the end of the month, COVID-19 deaths had fallen to around five per day from a high of more than 50 per day at the end of April.
Sabino and her fellow researchers, a group from Brazilian, U.K., and U.S. institutions, attribute the decreased deaths in part to growing population immunity.
In June, "the population was more aware, principally due to the high numbers of deaths in April and May 2020, which led them to better adhere to protective measures," says Rosemary Costa Pinto, director of the state's health department. She says that deaths may also have fallen due to an increase in the number of available hospital beds and health workers' improved understanding of how to deal with the virus.
Costa Pinto said she was aware of the study published in Science reporting much higher numbers than the government but would not comment on it. The state's official count of confirmed virus cases is 3.5% of the population.
Questioning The Data Collection Method
While Manaus's scientific community widely considers the state numbers an undercount, some have criticized the Science study's reliance on blood donors to draw conclusions about the wider population, even after the authors mathematically adjusted to account for donors' limited age range (16 to 69) and for the fact that most were men.
In June, a household survey by the Federal University of Pelotas found a much lower rate of residents with COVID antibodies than the blood donor study for the same time period. The Science authors mention the household survey in their article, writing that it was not carried out at a citywide scope and used a less sensitive test. Their own estimate also includes extra calculations to reflect the waning of antibodies over time.
Others, including microbiologist Natália Pasternak, say the study was "very well-conducted work" that acknowledges its limitations and now must be "well-interpreted." Pasternak directs the scientific literacy NGO Instituto Questão da Ciência. "It's not always possible to do a good population sample," she says. "This kind of study is one more scientific tool."
Blood donor studies are currently underway across the world to better understand the pandemic, including in the United States. The Centers for Disease Control and Prevention is conducting a nationwide blood donor survey of SARS-CoV-2 antibodies that is directed by one of Sabino's co-authors, Michael Busch of the Vitalant Research Institute. Busch and Sabino are part of a 20-year partnership between U.S. and Brazilian blood researchers, the REDS Brazil program, backed by the National Institutes of Health.
There is scientific consensus in Manaus about one thing: the outbreak is far from over.
"Everyone must remain on alert," says Quezia Monteiro, an infectologist in the public health system. "People are relaxing, even saying that the pandemic is over in Manaus, which will cost more lives."
Catherine Osborn is a Brazil-based journalist and a frequent contributor to NPR.