scientificamerican--2020-11-12--Here's How Scientists Want Biden to Take on Climate Change

For the past four years , climate experts have watched with dismay as Donald Trump ’ s presidential administration has systematically weakened climate regulations , bolstered the use of fossil fuels that drive rising temperatures , and sidelined government climate science and scientists .
These actions have combined to set the country behind on the crucial work of reducing greenhouse gas emissions to keep the worst impacts of climate change at bay—and of protecting vulnerable communities and ecosystems .
The election of Joe Biden has changed the prospects for action .
The former vice president ran on a platform that @ @ @ @ @ @ @ climate change , including rejoining the Paris climate agreement ( which the U.S. exited on November 4 ) and setting a goal of net-zero carbon emissions by 2050 .
Climate scientists and environmental advocates have applauded these goals but warn that it will take substantial work to reach them .
Among other things , the Biden administration needs to help transition U.S. energy systems , gird against future damage from climate-fueled disasters , and make sure policies incorporate considerations of equity and justice .
To gauge what specific actions climate scientists want to @ @ @ @ @ @ @ to researchers who work in a variety of areas and asked them to answer one question : What is the most important action you want to see the Biden administration take to address climate change ?
Below are their answers , lightly edited for style and grammar .
Aradhna Tripati , climate scientist and founder of the Center for Diverse Leadership in Science , University of California , Los Angeles Like COVID-19 , climate change amplifies systemic injustices and disproportionately harms Black , brown , Indigenous and low-income people .
The most important @ @ @ @ @ @ @ implement a systemic set of reforms to support climate justice .
We don ’ t have time to wait .
Communities throughout the U.S. have experienced climate disruptions made worse by political inaction .
Since 1980 there were 279 events that cost more than $ 1.8 trillion .
These disasters cost the U.S. in dollars , but they cost many people their health , homes and jobs .
In doing so , they leave scars on families and communities and threaten to further fragment society .
Systemic reform for climate justice includes subsidizing @ @ @ @ @ @ @ for low-income communities while investing in green jobs training in these communities .
The most heavily impacted communities must be supported to work with partners in developing and implementing resilience plans tailored to their own needs .
The Green New Deal must be emplaced while ensuring that communities of color and low-income communities benefit from the social and economic opportunities of addressing climate change .
Representation at all levels is critical .
Biden needs to create a national coalition that supports higher education for students from these communities as emergent leaders who will @ @ @ @ @ @ @ as engines for reducing economic inequality .
I ’ m not going to sugarcoat this : the pace and scale of what we need to do over the next three decades to address climate change is Herculean .
Every sector of the economy affects climate change , and every sector is vulnerable to climate impacts .
But the most important action a Biden administration can take to address climate change is kick-starting a new era of equitable transportation mobility without oil .
The transportation sector is now the largest source of our carbon @ @ @ @ @ @ @ pollution have long been sources of injustice and inequity .
The next transportation system has to be different , and it can be .
This isn ’ t just about scaling up public transit , which we ’ ll need to electrify and scale up by about a factor of five or more .
This isn ’ t just about encouraging the rapid construction of accessible communities , safe streets for bicyclists and pedestrians , and widespread deployment of green infrastructure , all of which are needed at large scales .
This isn @ @ @ @ @ @ @ fleet of gasoline vehicles with electric vehicles ( EVs ) , although there are about 250 million cars and trucks in the U.S. that can stay on the road for 15 to 20 years or more .
It ’ s all of these , at scale , at the same time .
An “ EVs for clunkers ” program is necessary but not sufficient .
We need an “ equitable clean mobility for clunkers ” program that enables a rapid and just transition to a clean-energy economy .
It ’ s doable , @ @ @ @ @ @ @ necessary .
Kim Cobb , paleoclimatologist and director of the Global Change Program , Georgia Institute of Technology There are the obvious things , like rejoining the Paris Agreement and setting ambitious targets for fuel efficiency and other things you will find on the top 10 lists of executive action on climate .
But to be honest , I ’ m most excited that science will once again be the guide to policy across the entire federal landscape , given that climate and energy policy touches so many aspects of our lives and @ @ @ @ @ @ @ ’ m eager to see the speedy removal of a number of leaders in key positions who are openly hostile to climate science .
It seems clear that efforts to undermine any progress on climate change will continue until Inauguration Day—and likely beyond .
Lastly , while everyone is rightly focused on reducing future emissions and the harm they will bring , I hope that the new administration adopts an aggressive program to assist communities that are already reeling from climate damages today .
Investments in accelerating the science of climate resilience will @ @ @ @ @ @ @ decades , especially when that work is grounded in advancing climate justice .
President-elect Biden ’ s publicly released plan to address climate change is , by far , the most ambitious proposed by any American president or president-to-be .
Achieving net carbon neutrality in the U.S. by 2050 would represent a tremendous success after decades of delay and inaction at the federal level .
Just as important is the campaign ’ s stated commitment to climate adaptation—taking action to reduce the societal impacts from the increasing extreme weather events scientists know are @ @ @ @ @ @ @ The campaign also emphasizes the need to ensure these climate mitigation and adaptation activities proceed in an equitable way that promotes environmental justice and in a manner that leaves no one behind—both of which are also critically important considerations .
In my view , this is a plan well matched to the huge magnitude of the crisis we ’ re facing .
That ’ s the good news .
The not so good news : it ’ s unclear how much of this ambitious climate plan will actually be possible to implement in @ @ @ @ @ @ @ likely that the Biden-Harris administration will almost immediately take a series of executive actions to reverse many Trump-era policies that stalled or reversed progress on climate action—such as rejoining the Paris Agreement , replacing the many Trump-era political appointees who have been openly hostile toward climate science and attempting to use the existing regulatory authority of certain agencies , especially the Environmental Protection Agency , to achieve some modest emissions cuts .
But large-scale legislative interventions—which will be absolutely necessary to make substantial progress toward net carbon neutrality by 2050—will require congressional approval @ @ @ @ @ @ @ , passing any substantive climate legislation will likely be a very steep uphill battle .
The now very conservative U.S. Supreme Court , too , may become an obstacle to even some forms of executive action or agency rulemaking , given the expectation of major court challenges .
Overall , I am genuinely optimistic that there will be tangible progress on addressing climate change and its societal impacts during the incoming administration ’ s tenure .
It is an indisputably positive sign that we ’ re entering a renewed era of evidence-based decision-making @ @ @ @ @ @ @ somewhat less confident that the hyperpartisan political reality of the U.S. today will allow for the kind of highly ambitious , large-scale changes that are necessary to truly get a handle on climate change over the course of the next couple of decades .
But I remain hopeful .
Farhana Sultana , research director for Environmental Collaboration and Conflicts at the Program for the Advancement of Research on Conflict and Collaboration , Syracuse University Climate breakdown is a matter of survival of peoples and the planet .
It is an intersectoral , international @ @ @ @ @ @ @ that are comprehensive .
To do this meaningfully , I think the most important action the Biden administration can do is to undertake all its policies and actions through a climate justice lens—which would enable seeing the interconnections across sectors and policies—and approach action with equity , accountability and justice in mind .
This means addressing a range of issues , such as international cooperation , trade , financing , policies on agriculture , transportation , energy , housing , industry , etc .
Starting with rejoining the Paris Agreement and following through @ @ @ @ @ @ @ addressing fossil fuel divestment , ethically transitioning to renewable energy sources that account for social and ecological impacts , shifting production and consumption patterns to reduce the U.S. ’ s greenhouse gas emissions , and addressing climate migration and displacement—to name just a few steps .
Furthermore , climate justice necessitates acknowledging and addressing issues of racial justice , Indigenous justice and various social inequities .
The Biden administration should be diverse and representative of different constituents , scholars , scientists and communities .
Greater engagement with local communities and movements in formulating @ @ @ @ @ @ @ lead to more transformative outcomes .
Ultimately , climate change connects us all but in extremely uneven and unequal ways .
So the U.S. needs to step up to do the right thing in working with peoples , institutions and policies across the world to enact better climate justice .
Marshall Shepherd , director of the atmospheric sciences program , University of Georgia The Biden administration was a win for planet Earth .
There are immediate actions essential to restoring leadership within U.S. climate science and policy circles .
The obvious low-hanging fruit @ @ @ @ @ @ @ .
Other critical actions will involve restoring science integrity in key climate-focused agencies .
The EPA must feel empowered to “ protect.
” And federal scientists participating in the forthcoming National Climate Assessment should not feel constrained by agendas , ideology or meddling political appointees .
It will also be critical that the administration reconcile that marginalized frontline communities suffer disproportionately from hurricanes , heatwaves , flooding and drought .
Climate policy will need to be approached from the perspective of science , technology , energy , equity and justice .
Strong messages @ @ @ @ @ @ @ scientists to head science-related agencies .
Science is our friend , not an enemy , and it is hopeful that this administration can convey that message .
Kitchen-table issues of Americans likely have a climate component wrapped in them , whether they are obvious or not : the economy , health , water , infrastructure , food production , and more .

For the past four years, climate experts have watched with dismay as Donald Trump’s presidential administration has systematically weakened climate regulations, bolstered the use of fossil fuels that drive rising temperatures, and sidelined government climate science and scientists. These actions have combined to set the country behind on the crucial work of reducing greenhouse gas emissions to keep the worst impacts of climate change at bay—and of protecting vulnerable communities and ecosystems.
The election of Joe Biden has changed the prospects for action. The former vice president ran on a platform that included specific, ambitious measures to tackle climate change, including rejoining the Paris climate agreement (which the U.S. exited on November 4) and setting a goal of net-zero carbon emissions by 2050. Climate scientists and environmental advocates have applauded these goals but warn that it will take substantial work to reach them. Among other things, the Biden administration needs to help transition U.S. energy systems, gird against future damage from climate-fueled disasters, and make sure policies incorporate considerations of equity and justice.
To gauge what specific actions climate scientists want to see taken, Scientific American reached out to researchers who work in a variety of areas and asked them to answer one question: What is the most important action you want to see the Biden administration take to address climate change? Below are their answers, lightly edited for style and grammar.
Aradhna Tripati, climate scientist and founder of the Center for Diverse Leadership in Science, University of California, Los Angeles
Like COVID-19, climate change amplifies systemic injustices and disproportionately harms Black, brown, Indigenous and low-income people. The most important action for a Biden administration is to implement a systemic set of reforms to support climate justice. We don’t have time to wait. Communities throughout the U.S. have experienced climate disruptions made worse by political inaction. Since 1980 there were 279 events that cost more than $1.8 trillion. These disasters cost the U.S. in dollars, but they cost many people their health, homes and jobs. In doing so, they leave scars on families and communities and threaten to further fragment society.
Systemic reform for climate justice includes subsidizing the clean energy transition and green infrastructure for low-income communities while investing in green jobs training in these communities. The most heavily impacted communities must be supported to work with partners in developing and implementing resilience plans tailored to their own needs.
The Green New Deal must be emplaced while ensuring that communities of color and low-income communities benefit from the social and economic opportunities of addressing climate change. Representation at all levels is critical. Biden needs to create a national coalition that supports higher education for students from these communities as emergent leaders who will generate ethical and innovative solutions and act as engines for reducing economic inequality.
Constantine Samaras, associate professor of civil and environmental engineering, Carnegie Mellon University
I’m not going to sugarcoat this: the pace and scale of what we need to do over the next three decades to address climate change is Herculean. Every sector of the economy affects climate change, and every sector is vulnerable to climate impacts. But the most important action a Biden administration can take to address climate change is kick-starting a new era of equitable transportation mobility without oil.
The transportation sector is now the largest source of our carbon emissions. And our infrastructure choices and pollution have long been sources of injustice and inequity. The next transportation system has to be different, and it can be. This isn’t just about scaling up public transit, which we’ll need to electrify and scale up by about a factor of five or more. This isn’t just about encouraging the rapid construction of accessible communities, safe streets for bicyclists and pedestrians, and widespread deployment of green infrastructure, all of which are needed at large scales. This isn’t just about replacing a legacy fleet of gasoline vehicles with electric vehicles (EVs), although there are about 250 million cars and trucks in the U.S. that can stay on the road for 15 to 20 years or more. It’s all of these, at scale, at the same time. An “EVs for clunkers” program is necessary but not sufficient. We need an “equitable clean mobility for clunkers” program that enables a rapid and just transition to a clean-energy economy. It’s doable, and more importantly, it’s necessary.
Kim Cobb, paleoclimatologist and director of the Global Change Program, Georgia Institute of Technology
There are the obvious things, like rejoining the Paris Agreement and setting ambitious targets for fuel efficiency and other things you will find on the top 10 lists of executive action on climate. But to be honest, I’m most excited that science will once again be the guide to policy across the entire federal landscape, given that climate and energy policy touches so many aspects of our lives and our economy. In particular, I’m eager to see the speedy removal of a number of leaders in key positions who are openly hostile to climate science. It seems clear that efforts to undermine any progress on climate change will continue until Inauguration Day—and likely beyond. Lastly, while everyone is rightly focused on reducing future emissions and the harm they will bring, I hope that the new administration adopts an aggressive program to assist communities that are already reeling from climate damages today. Investments in accelerating the science of climate resilience will reap dividends in the coming years and decades, especially when that work is grounded in advancing climate justice.
Daniel Swain, climate scientist, University of California, Los Angeles
President-elect Biden’s publicly released plan to address climate change is, by far, the most ambitious proposed by any American president or president-to-be. Achieving net carbon neutrality in the U.S. by 2050 would represent a tremendous success after decades of delay and inaction at the federal level. Just as important is the campaign’s stated commitment to climate adaptation—taking action to reduce the societal impacts from the increasing extreme weather events scientists know are inevitable over the next few decades. The campaign also emphasizes the need to ensure these climate mitigation and adaptation activities proceed in an equitable way that promotes environmental justice and in a manner that leaves no one behind—both of which are also critically important considerations. In my view, this is a plan well matched to the huge magnitude of the crisis we’re facing.
That’s the good news. The not so good news: it’s unclear how much of this ambitious climate plan will actually be possible to implement in the current political environment. It seems likely that the Biden-Harris administration will almost immediately take a series of executive actions to reverse many Trump-era policies that stalled or reversed progress on climate action—such as rejoining the Paris Agreement, replacing the many Trump-era political appointees who have been openly hostile toward climate science and attempting to use the existing regulatory authority of certain agencies, especially the Environmental Protection Agency, to achieve some modest emissions cuts.
But large-scale legislative interventions—which will be absolutely necessary to make substantial progress toward net carbon neutrality by 2050—will require congressional approval. Without Democratic control of the Senate, passing any substantive climate legislation will likely be a very steep uphill battle. The now very conservative U.S. Supreme Court, too, may become an obstacle to even some forms of executive action or agency rulemaking, given the expectation of major court challenges.
Overall, I am genuinely optimistic that there will be tangible progress on addressing climate change and its societal impacts during the incoming administration’s tenure. It is an indisputably positive sign that we’re entering a renewed era of evidence-based decision-making in Washington, D.C. I am somewhat less confident that the hyperpartisan political reality of the U.S. today will allow for the kind of highly ambitious, large-scale changes that are necessary to truly get a handle on climate change over the course of the next couple of decades. But I remain hopeful.
Farhana Sultana, research director for Environmental Collaboration and Conflicts at the Program for the Advancement of Research on Conflict and Collaboration, Syracuse University
Climate breakdown is a matter of survival of peoples and the planet. It is an intersectoral, international and intersectional issue, thus necessitating actions that are comprehensive. To do this meaningfully, I think the most important action the Biden administration can do is to undertake all its policies and actions through a climate justice lens—which would enable seeing the interconnections across sectors and policies—and approach action with equity, accountability and justice in mind. This means addressing a range of issues, such as international cooperation, trade, financing, policies on agriculture, transportation, energy, housing, industry, etc. Starting with rejoining the Paris Agreement and following through on international commitments, it also requires addressing fossil fuel divestment, ethically transitioning to renewable energy sources that account for social and ecological impacts, shifting production and consumption patterns to reduce the U.S.’s greenhouse gas emissions, and addressing climate migration and displacement—to name just a few steps.
Furthermore, climate justice necessitates acknowledging and addressing issues of racial justice, Indigenous justice and various social inequities. The Biden administration should be diverse and representative of different constituents, scholars, scientists and communities. Greater engagement with local communities and movements in formulating, implementing and overseeing climate-related work can lead to more transformative outcomes.
Ultimately, climate change connects us all but in extremely uneven and unequal ways. So the U.S. needs to step up to do the right thing in working with peoples, institutions and policies across the world to enact better climate justice.
Marshall Shepherd, director of the atmospheric sciences program, University of Georgia
The Biden administration was a win for planet Earth. There are immediate actions essential to restoring leadership within U.S. climate science and policy circles. The obvious low-hanging fruit is to rejoin the Paris climate agreement. Other critical actions will involve restoring science integrity in key climate-focused agencies. The EPA must feel empowered to “protect.” And federal scientists participating in the forthcoming National Climate Assessment should not feel constrained by agendas, ideology or meddling political appointees. It will also be critical that the administration reconcile that marginalized frontline communities suffer disproportionately from hurricanes, heatwaves, flooding and drought. Climate policy will need to be approached from the perspective of science, technology, energy, equity and justice. Strong messages can also be sent by appointing actual scientists to head science-related agencies. Science is our friend, not an enemy, and it is hopeful that this administration can convey that message. Kitchen-table issues of Americans likely have a climate component wrapped in them, whether they are obvious or not: the economy, health, water, infrastructure, food production, and more.


scientificamerican--2020-11-13--Divide and Conquer Could Be Good COVID Strategy

Public health experts shake their heads at the chaotic political divisions and inconsistent policies that have undermined attempts to control the spread of COVID-19 through much of the world .
But a new study by mathematicians in Germany and the U.K. has applied the tools of chaos theory to show that divisions of a constructive kind could actually bring the pandemic under control much more effectively .
The research was done at the University of Oxford , Göttingen University , and the Max Planck Institute for Dynamics and Self-Organization .
The group built a mathematical model of coronavirus transmission that @ @ @ @ @ @ @ the number of infections fluctuates over time .
They noticed that case counts within small populations sometimes drop all the way to zero as long as people are wearing masks , social distancing , and taking the other standard precautions .
Those spontaneous extinctions of the disease made them wonder : if the small towns or counties did more to isolate themselves from neighboring communities , would that sometimes extinguish COVID-19 enough that they could lift restrictions and resume more of normal life for longer period , until the disease popped up again @ @ @ @ @ @ @ indeed , this kind of divide-and-conquer strategy can work , at least in theory .
They published that result in the journal Chaos .
[ Philip Bittihn and Ramin Golestanian , Stochastic effects on the dynamics of an epidemic due to population subdivision ] Then , in a follow-on study published in a preprint , which has yet to be peer-reviewed , the group ran simulations using county-level data from Germany , England , Italy , New York State , and Florida .
For each place , they compared two scenarios .
In @ @ @ @ @ @ @ nationwide restrictions like those that Western European countries have just put back into effect .
In the second scenario , restrictions on movement kick in whenever infection rates rise above a threshold , but the restrictions are applied county by county—or even neighborhood by neighborhood within large cities—so that the population is effectively subdivided into groups no bigger than 200,000 people .
For example , under this alternative strategy , a big outbreak could force the Upper West Side of Manhattan to restrict non-essential movements for several weeks , but in other neighborhoods @ @ @ @ @ @ @ , and restaurants could remain open , so long as case counts stayed low .
The researchers found that , even when they allowed for modest intermingling among communities , this approach of local control could cut by about 80 percent the number of days that most people would have to spend living under tough restrictions .
Their models predict that these benefits of local control might take a few months to become obvious .
But they also suggest that a subdivision strategy could save many , many lives over the long run @

Full Transcript
Public health experts shake their heads at the chaotic political divisions and inconsistent policies that have undermined attempts to control the spread of COVID-19 through much of the world. But a new study by mathematicians in Germany and the U.K. has applied the tools of chaos theory to show that divisions of a constructive kind could actually bring the pandemic under control much more effectively.
The research was done at the University of Oxford, Göttingen University, and the Max Planck Institute for Dynamics and Self-Organization. The group built a mathematical model of coronavirus transmission that accounts for the inherently random ways that the number of infections fluctuates over time. They noticed that case counts within small populations sometimes drop all the way to zero as long as people are wearing masks, social distancing, and taking the other standard precautions.
Those spontaneous extinctions of the disease made them wonder: if the small towns or counties did more to isolate themselves from neighboring communities, would that sometimes extinguish COVID-19 enough that they could lift restrictions and resume more of normal life for longer period, until the disease popped up again?
A rigorous mathematical analysis showed that indeed, this kind of divide-and-conquer strategy can work, at least in theory. They published that result in the journal Chaos. [Philip Bittihn and Ramin Golestanian, Stochastic effects on the dynamics of an epidemic due to population subdivision]
Then, in a follow-on study published in a preprint, which has yet to be peer-reviewed, the group ran simulations using county-level data from Germany, England, Italy, New York State, and Florida. For each place, they compared two scenarios. In the first, leaders impose statewide or nationwide restrictions like those that Western European countries have just put back into effect. In the second scenario, restrictions on movement kick in whenever infection rates rise above a threshold, but the restrictions are applied county by county—or even neighborhood by neighborhood within large cities—so that the population is effectively subdivided into groups no bigger than 200,000 people.
For example, under this alternative strategy, a big outbreak could force the Upper West Side of Manhattan to restrict non-essential movements for several weeks, but in other neighborhoods on the island, schools, offices, and restaurants could remain open, so long as case counts stayed low.
The researchers found that, even when they allowed for modest intermingling among communities, this approach of local control could cut by about 80 percent the number of days that most people would have to spend living under tough restrictions.
Their models predict that these benefits of local control might take a few months to become obvious. But they also suggest that a subdivision strategy could save many, many lives over the long run.
—Wayt Gibbs
(The above text is a transcript of this podcast)


scientificamerican--2020-11-12--An Emerging Tool for COVID Times: The Portable MRI

Among other things , the pandemic of 2020 has emphatically reinforced the need for both patients and their doctors to get reliable medical results quickly .
The advent of rapid antigen testing for COVID-19 , for example , is changing the way we think about how we approach the disease and prevent its spread .
But what if we could think bigger ?
What if one of the most useful diagnostic tools in health care could be wheeled to your hospital room bedside , rather than requiring you to be physically moved to another wing—or even another building entirely—in order @ @ @ @ @ @ @ decades , we ’ ve used magnetic resonance imaging ( MRI ) to create detailed anatomical images of organs and structures inside the body .
Now , improvements in radiology imaging technique have enabled the industry to build smaller low-magnetic-field MRIs and move them into the clinical environment—basically , the first portable versions of this equipment .
For emergency physicians like me , bedside imaging could open entire fields of possibility .
More research needs to be done on this innovative device , but the early results are encouraging—enough that doctors and hospitals @ @ @ @ @ @ @ use a portable MRI — and a few have already put such units into limited use , as they learn more about their capabilities .
Here ’ s a scenario that fits our times : You become ill with COVID and begin experiencing neurologic symptoms ( such as headache , slurred speech or weakness ) that are consistent with a possible stroke , and you wind up in the ER .
But when the nurse and physician enter your room to begin assessing you , they don ’ t come alone .
Instead @ @ @ @ @ @ @ ( POC ) MRI , just 57 inches tall .
The doctor conducts a brief exam—but instead of then calling the radiology suite to try to get you scheduled for an MRI study , on a machine often located in the basement or another part of the hospital , this mini-MRI stands ready at the bedside .
Imaging is performed right there ; results start appearing within minutes .
Quickly , we could know if you might require a clot-busting drug like tissue plasminogen activator ( tPA ) for stroke , or if @ @ @ @ @ @ @ .
Perhaps an ill newborn is in the intensive care unit ( ICU ) , on monitors , connected to wires , and with a feeding tube in place .
Imaging is needed , but “ it can be a huge production to get a neonate down to MRI , ” says Christine Glastonbury , interim chief of neuroradiology at the University of California , San Francisco .
“ So , for this sort of thing , a portable MRI done right in the neonatal unit is magical.
” The machine , called @ @ @ @ @ @ @ .
It can be plugged into a standard electrical wall outlet and then controlled with a wireless tablet like an Apple iPad .
The chief medical officer for Hyperfine , Khan Siddiqui , tells me that it takes about 30 minutes of training for new users to learn to operate and navigate the system .
( I ’ ve spent more time learning how to draw blood . )
The potential upside to this point-of-care technology for the brain is enormous .
An entire diffusion-weighted MRI sequence for stroke , for example , @ @ @ @ @ @ @ minutes , Siddiqui says .
And the resolution and level of anatomic detail that we can see on traditional MRI scanners is nothing short of extraordinary .
If Swoop can approach that kind of detail , which is not yet clear , it will constitute a major breakthrough .
“ We ’ ve flipped the concept from having to get patients to the MRI to bringing the MRI to the patients , ” says Yale ’ s division chief of neurocritical care and emergency neurology , Kevin Sheth , who is an academic @ @ @ @ @ @ @ write this , a friend ’ s daughter is in a hospital ICU because of COVID-19 .
With cardiac , lung and abdominal issues , her blood pressure is too unstable for her to be safely transported out of the ICU to a CT scan several floors away .
In circumstances such as hers , a device like Swoop could be lifesaving .
Hyperfine ’ s mission , Siddiqui tells me , is to “ democratize health care by making medical imaging accessible around the world.
” With some 4.7 billion people lacking @ @ @ @ @ @ @ , that ’ s perhaps a tall ambition .
Still , with the devices “ being portable and cheaper , you should be able to ship them to places where you can really change medicine in other countries , ” says Glastonbury at UCSF .
“ I love this sort of genius invention.
” As physicians , we sometimes wait hours to get imaging studies scheduled , and we worry about our patients ’ conditions worsening during that down time .
In the world of portable MRIs , we would have immediate answers @ @ @ @ @ @ @ to leave their beds in order for us to get them .
Beyond that , MRI technology is much safer than CT scans because it doesn ’ t throw off ionizing radiation , which has the potential to cause cancer years down the road .
There may be cost savings , too .
“ Sometimes patients are admitted overnight for MRIs , ” says Susan Lewis , an emergency physician at Scripps Mercy Hospital .
“ This could eliminate the cost of a hospital admission .
We could get MRIs faster , cheaper @ @ @ @ @ @ @ ] department.
” Traditional MRI machines are vastly more expensive , and they have powerful , heavy magnets that need supercooling with liquid nitrogen or helium , requiring that they be placed in bunker-style , copper-shielded rooms .
They consume some 35 times more energy than a device like Swoop .
Conventional MRIs are also very noisy for patients , the narrow scanning tubes can be prohibitive for some with claustrophobia ( though open MRIs are in use too ) , and the strong magnetic field generated means some patients with passive metal @ @ @ @ @ @ @ , bullets , etc.— can not undergo scans at all .
Now they can , according to Siddiqui .
But there ’ s always a tradeoff .
For one thing , the quality of images produced by the Swoop system isn ’ t perfect .
Although they ’ ve improved significantly over the past two years , Sheth says , “ they still need to get much , much better—but we are just at the beginning of this journey.
” Deep learning ( AI technology ) offers the potential to optimize images as @ @ @ @ @ @ @ scanning .
Without question , the significance of a device like this is going to be related to image quality .
As a physician , though , what I really want to know at the bedside is whether or not disease is present .
If the Swoop image is of a somewhat lower resolution , for example , could I still identify a stroke ?
This is a base-level consideration .
In a prospective study published in JAMA Neurology in September , performed in critically ill patients at Yale New Haven Hospital ’ @ @ @ @ @ @ @ team found that the portable MRI machine identified important neurologic findings like stroke , brain tumor and traumatic brain injury in 29 out of 30 patients .
An abstract published in Neurology , meanwhile , looked at the POC MRI scanner ’ s use in stroke and brain bleeds and concluded that the low-field MRI system appeared safe and viable in a complex ICU environment .
A second abstract conducted on 36 stroke patients found a “ pathologic lesion ” on every exam , while sensitivity for any type of brain bleed was @ @ @ @ @ @ @ about 1 in 10 , although we don ’ t know whether these were significant .
The authors concluded that more work is needed to evaluate this approach across a range of different brain bleed characteristics .
Hyperfine only recently received FDA clearance in August to use Swoop for brain imaging across all age groups .
According to the company , at least 25 institutions already have these scanners , including Massachusetts General Hospital and Yale New Haven Hospital .
COVID-19-related demand , along with advantages such as the ability to clean the @ @ @ @ @ @ @ sterilizing an MRI suite ) , has led to the company expediting its manufacturing , Siddiqui says .
The machines are being used in neuro-ICUs , pediatric ICUs , outpatient neurology clinics and stroke rehabilitation centers , among others .
The Gates Foundation recently purchased 20 scanners for screening purposes to look at infant asphyxia and brain development in malnourished children .
Hyperfine ’ s innovation with Swoop comes from its small size , portability and some proprietary technology .
While Swoop has much going for it , evidence-based research in various settings @ @ @ @ @ @ @ yield and performance .
( Half a dozen papers are in review , Siddiqui says . )
A body of research exists from as far back as the 1980s on the use of low-field scanners that demonstrates promising results with such technology , but “ the last 20 years of development of MR sequences – and the techniques to improve image quality at 1.5 Tesla ( high field ) – had never happened at low field , ” Siddiqui says .
“ This is where we have to catch up with the research.
@ @ @ @ @ @ @ MRI , using small , cost-effective , easily installed scanners , has shown the feasibility of its use intraoperatively , in the neonatal ICU , and in orthopedic offices using “ extremity scanners ” to image arms and legs .
What will need to become clearer in the clinical realm are things like who performs the scans , and for which patients and conditions the technology should be used .
How do the images obtained here compare in quality to those from conventional MRI ?
Does the machine replace CT or high-field MRI @ @ @ @ @ @ @ for screening and dedicated purposes ?
How well does it diagnose conditions like strokes , different types of brain bleeds or tumors ?
And who maintains POC MRI quality control ?
Many questions remain .
Then again , the mini-MRI on wheels has just left the starting gate .
“ We are doing the work , and others will do the research too , ” Sheth said .
Let ’ s see how Swoop goes .
I can tell you that my colleagues and I would love to have one ( or two @ @ @ @ @ @ @ doors during this pandemic .
In fact , we have joked before that we wished we could just MRI everybody that walked in , so we would know what was wrong with them .
That wish may be closer to coming true than we think .

Among other things, the pandemic of 2020 has emphatically reinforced the need for both patients and their doctors to get reliable medical results quickly. The advent of rapid antigen testing for COVID-19, for example, is changing the way we think about how we approach the disease and prevent its spread.
But what if we could think bigger? What if one of the most useful diagnostic tools in health care could be wheeled to your hospital room bedside, rather than requiring you to be physically moved to another wing—or even another building entirely—in order to make use of it?
For decades, we’ve used magnetic resonance imaging (MRI) to create detailed anatomical images of organs and structures inside the body. Now, improvements in radiology imaging technique have enabled the industry to build smaller low-magnetic-field MRIs and move them into the clinical environment—basically, the first portable versions of this equipment. For emergency physicians like me, bedside imaging could open entire fields of possibility.
More research needs to be done on this innovative device, but the early results are encouraging—enough that doctors and hospitals may begin imagining just how they would use a portable MRI — and a few have already put such units into limited use, as they learn more about their capabilities.
Here’s a scenario that fits our times: You become ill with COVID and begin experiencing neurologic symptoms (such as headache, slurred speech or weakness) that are consistent with a possible stroke, and you wind up in the ER. But when the nurse and physician enter your room to begin assessing you, they don’t come alone. Instead, they bring with them a point-of-care (POC) MRI, just 57 inches tall.
The doctor conducts a brief exam—but instead of then calling the radiology suite to try to get you scheduled for an MRI study, on a machine often located in the basement or another part of the hospital, this mini-MRI stands ready at the bedside. Imaging is performed right there; results start appearing within minutes. Quickly, we could know if you might require a clot-busting drug like tissue plasminogen activator (tPA) for stroke, or if there was unusual swelling in the brain.
Perhaps an ill newborn is in the intensive care unit (ICU), on monitors, connected to wires, and with a feeding tube in place. Imaging is needed, but “it can be a huge production to get a neonate down to MRI,” says Christine Glastonbury, interim chief of neuroradiology at the University of California, San Francisco. “So, for this sort of thing, a portable MRI done right in the neonatal unit is magical.”
The machine, called Swoop, is a product of Hyperfine. It can be plugged into a standard electrical wall outlet and then controlled with a wireless tablet like an Apple iPad. The chief medical officer for Hyperfine, Khan Siddiqui, tells me that it takes about 30 minutes of training for new users to learn to operate and navigate the system. (I’ve spent more time learning how to draw blood.)
The potential upside to this point-of-care technology for the brain is enormous. An entire diffusion-weighted MRI sequence for stroke, for example, can be completed in nine to 11 minutes, Siddiqui says. And the resolution and level of anatomic detail that we can see on traditional MRI scanners is nothing short of extraordinary. If Swoop can approach that kind of detail, which is not yet clear, it will constitute a major breakthrough.
“We’ve flipped the concept from having to get patients to the MRI to bringing the MRI to the patients,” says Yale’s division chief of neurocritical care and emergency neurology, Kevin Sheth, who is an academic partner collaborating with Hyperfine.
As I write this, a friend’s daughter is in a hospital ICU because of COVID-19. With cardiac, lung and abdominal issues, her blood pressure is too unstable for her to be safely transported out of the ICU to a CT scan several floors away. In circumstances such as hers, a device like Swoop could be lifesaving.
Hyperfine’s mission, Siddiqui tells me, is to “democratize health care by making medical imaging accessible around the world.” With some 4.7 billion people lacking access to any form of medical imaging, that’s perhaps a tall ambition. Still, with the devices “being portable and cheaper, you should be able to ship them to places where you can really change medicine in other countries,” says Glastonbury at UCSF. “I love this sort of genius invention.”
As physicians, we sometimes wait hours to get imaging studies scheduled, and we worry about our patients’ conditions worsening during that down time. In the world of portable MRIs, we would have immediate answers, and patients wouldn’t need to leave their beds in order for us to get them. Beyond that, MRI technology is much safer than CT scans because it doesn’t throw off ionizing radiation, which has the potential to cause cancer years down the road.
There may be cost savings, too. “Sometimes patients are admitted overnight for MRIs,” says Susan Lewis, an emergency physician at Scripps Mercy Hospital. “This could eliminate the cost of a hospital admission. We could get MRIs faster, cheaper and safely right in the [emergency] department.”
Traditional MRI machines are vastly more expensive, and they have powerful, heavy magnets that need supercooling with liquid nitrogen or helium, requiring that they be placed in bunker-style, copper-shielded rooms. They consume some 35 times more energy than a device like Swoop. Conventional MRIs are also very noisy for patients, the narrow scanning tubes can be prohibitive for some with claustrophobia (though open MRIs are in use too), and the strong magnetic field generated means some patients with passive metal in their bodies—rods, screws, plates, bullets, etc.—cannot undergo scans at all. Now they can, according to Siddiqui.
But there’s always a tradeoff. For one thing, the quality of images produced by the Swoop system isn’t perfect. Although they’ve improved significantly over the past two years, Sheth says, “they still need to get much, much better—but we are just at the beginning of this journey.” Deep learning (AI technology) offers the potential to optimize images as well as to shorten the duration of scanning.
Without question, the significance of a device like this is going to be related to image quality. As a physician, though, what I really want to know at the bedside is whether or not disease is present. If the Swoop image is of a somewhat lower resolution, for example, could I still identify a stroke? This is a base-level consideration.
In a prospective study published in JAMA Neurology in September, performed in critically ill patients at Yale New Haven Hospital’s Neuroscience ICU, Sheth and his team found that the portable MRI machine identified important neurologic findings like stroke, brain tumor and traumatic brain injury in 29 out of 30 patients. An abstract published in Neurology, meanwhile, looked at the POC MRI scanner’s use in stroke and brain bleeds and concluded that the low-field MRI system appeared safe and viable in a complex ICU environment.
A second abstract conducted on 36 stroke patients found a “pathologic lesion” on every exam, while sensitivity for any type of brain bleed was 89 percent. So, it missed about 1 in 10, although we don’t know whether these were significant. The authors concluded that more work is needed to evaluate this approach across a range of different brain bleed characteristics.
Hyperfine only recently received FDA clearance in August to use Swoop for brain imaging across all age groups. According to the company, at least 25 institutions already have these scanners, including Massachusetts General Hospital and Yale New Haven Hospital. COVID-19-related demand, along with advantages such as the ability to clean the machine in minutes (as opposed to sterilizing an MRI suite), has led to the company expediting its manufacturing, Siddiqui says. The machines are being used in neuro-ICUs, pediatric ICUs, outpatient neurology clinics and stroke rehabilitation centers, among others. The Gates Foundation recently purchased 20 scanners for screening purposes to look at infant asphyxia and brain development in malnourished children.
Hyperfine’s innovation with Swoop comes from its small size, portability and some proprietary technology. While Swoop has much going for it, evidence-based research in various settings is still needed to determine its clinical yield and performance. (Half a dozen papers are in review, Siddiqui says.) A body of research exists from as far back as the 1980s on the use of low-field scanners that demonstrates promising results with such technology, but “the last 20 years of development of MR sequences – and the techniques to improve image quality at 1.5 Tesla (high field) – had never happened at low field,” Siddiqui says. “This is where we have to catch up with the research.” A resurgence of interest in low-field MRI, using small, cost-effective, easily installed scanners, has shown the feasibility of its use intraoperatively, in the neonatal ICU, and in orthopedic offices using “extremity scanners” to image arms and legs.
What will need to become clearer in the clinical realm are things like who performs the scans, and for which patients and conditions the technology should be used. How do the images obtained here compare in quality to those from conventional MRI? Does the machine replace CT or high-field MRI, or do we use it more for screening and dedicated purposes? How well does it diagnose conditions like strokes, different types of brain bleeds or tumors? And who maintains POC MRI quality control?
Many questions remain. Then again, the mini-MRI on wheels has just left the starting gate. “We are doing the work, and others will do the research too,” Sheth said.
Let’s see how Swoop goes. I can tell you that my colleagues and I would love to have one (or two) of these roll through our ER doors during this pandemic. In fact, we have joked before that we wished we could just MRI everybody that walked in, so we would know what was wrong with them. That wish may be closer to coming true than we think.


scientificamerican--2020-11-12--As the Oceans Warm, Hurricanes Stay Stronger Longer

Hurricane season is drawing to a close , but not before setting a record .
Tropical Storm Theta became the 29th named Atlantic storm this week , making 2020 the busiest season on record .
And it ’ s not just the total number of storms that ’ s remarkable .
At least nine storms this year underwent a process known as rapid intensification , quickly gathering strength over a short period of time as they moved across the ocean .
According to at least one expert , only 1995 saw more storms rapidly intensify in a single season .
@ @ @ @ @ @ @ , and the speed at which they ’ ve strengthened , in part to abnormally warm oceans this year .
This season ’ s unusual activity has reignited scientific discussions about the ways in which climate change may affect future hurricane activity .
And now , just a few weeks before hurricane season officially ends , scientists have identified yet another way warming waters may influence Atlantic storms .
As ocean waters heat up , cyclones may be able to hold their strength for longer as they move over land , according to @ @ @ @ @ @ @ .
It ’ s a topic that ’ s been largely overlooked by hurricane research so far , according to study authors Lin Li and Pinaki Chakraborty , scientists at Okinawa Institute of Science and Technology Graduate University in Japan .
“ As is not uncommon in research , we stumbled our way into this problem , ” Chakraborty told E & E News in an email .
The authors were studying the evolution of landfalling hurricanes using model simulations .
They kept noticing strange features in the storms ’ behaviors that they @ @ @ @ @ @ @ , they realized that there was a likely link between climate change and a hurricane ’ s behavior after landfall .
“ And that led us to this study , ” Chakraborty said .
The new study examined records of hurricanes hitting North America over the last 50 years .
It found that these storms are weakening more slowly over time .
In the late 1960s , a typical hurricane would lose about 75 % of its strength in the first 24 hours after making landfall .
Today , a comparable storm loses @ @ @ @ @ @ @ same amount of time .
Generally speaking , hurricanes start weakening the second they make landfall .
That ’ s mainly because hurricanes draw energy from the ocean ’ s heat—and once that energy source disappears , the storm begins to decay .
As a result , hurricanes tend to inflict less damage as they move inland , typically fizzling out entirely within a few days .
The new study suggests that rising ocean temperatures may help slow down this effect .
Warmer waters allow hurricanes to store more moisture .
And wetter @ @ @ @ @ @ @ investigated using a model that simulates the behavior of hurricanes .
The model suggested that sea surface temperatures were the cause of the slower-weakening trend .
To find out why this was happening , the researchers ran a series of simulations involving both normal hurricanes and “ dry ” hurricanes—storms containing no moisture at all .
The dry hurricanes weakened far faster than their wet counterparts .
There may be one other factor contributing to the 50-year trend , the researchers note .
It ’ s probably still related to climate change—but it @ @ @ @ @ @ @ oceans .
Some studies suggest that Atlantic hurricanes shift eastward as the climate warms , meaning they ’ re more likely to make landfall on the East Coast than the Caribbean or the Gulf of Mexico .
And hurricanes tend to weaken more slowly in eastern regions .
Why this happens is still a mystery , according to Chakraborty .
It might have something to do with landscape differences on the East Coast versus the Gulf Coast .
Or it could involve differences in wind conditions .
But scientists still don ’ t @ @ @ @ @ @ @ looks only at Atlantic hurricanes making landfall in North America .
It doesn ’ t necessarily indicate that the same patterns are happening elsewhere around the world .
But Chakraborty suspects similar trends are true in other places .
“ We have done a preliminary analysis of typhoons in the Pacific basin and we find that our main results ... hold for this basin , ” he said .
As temperatures continue to rise , he expects these trends to continue .
If that ’ s the case , hurricanes could inflict more @ @ @ @ @ @ @ hold their strength longer , they could pose a bigger threat both to coastal areas and to inland communities as they move across land .
That ’ s on top of all the other ways climate change may juice hurricanes in the coming years .
Studies suggest that warming also contributes to stronger storms , with higher wind speeds and more rainfall .
Put together , these factors would likely exacerbate the damaging influence of slower-decaying storms , according to Purdue University researchers Dan Chavas and Jie Chen .
In a published comment @ @ @ @ @ @ @ that the new study “ highlights a key component of risk models that has been largely overlooked so far.
” “ More generally , the current results indicate the need to broaden our thinking about how climate change affects tropical cyclones after landfall , ” they wrote .
“ Integrating this understanding into hurricane models should help to improve our predictions of the future risks posed by individual storms and over the long term.
” Reprinted from Climatewire with permission from E & E News .
E & E provides daily coverage of @ @ @ @ @ @ @ .

Hurricane season is drawing to a close, but not before setting a record. Tropical Storm Theta became the 29th named Atlantic storm this week, making 2020 the busiest season on record.
And it’s not just the total number of storms that’s remarkable. At least nine storms this year underwent a process known as rapid intensification, quickly gathering strength over a short period of time as they moved across the ocean.
According to at least one expert, only 1995 saw more storms rapidly intensify in a single season.
Experts have attributed the flurry of storms, and the speed at which they’ve strengthened, in part to abnormally warm oceans this year.
This season’s unusual activity has reignited scientific discussions about the ways in which climate change may affect future hurricane activity. And now, just a few weeks before hurricane season officially ends, scientists have identified yet another way warming waters may influence Atlantic storms.
As ocean waters heat up, cyclones may be able to hold their strength for longer as they move over land, according to a study published this week in Nature.
It’s a topic that’s been largely overlooked by hurricane research so far, according to study authors Lin Li and Pinaki Chakraborty, scientists at Okinawa Institute of Science and Technology Graduate University in Japan.
“As is not uncommon in research, we stumbled our way into this problem,” Chakraborty told E&E News in an email.
The authors were studying the evolution of landfalling hurricanes using model simulations. They kept noticing strange features in the storms’ behaviors that they couldn’t immediately explain.
Eventually, they realized that there was a likely link between climate change and a hurricane’s behavior after landfall.
“And that led us to this study,” Chakraborty said.
The new study examined records of hurricanes hitting North America over the last 50 years. It found that these storms are weakening more slowly over time.
In the late 1960s, a typical hurricane would lose about 75% of its strength in the first 24 hours after making landfall. Today, a comparable storm loses only about half its intensity in the same amount of time.
Generally speaking, hurricanes start weakening the second they make landfall. That’s mainly because hurricanes draw energy from the ocean’s heat—and once that energy source disappears, the storm begins to decay.
As a result, hurricanes tend to inflict less damage as they move inland, typically fizzling out entirely within a few days.
The new study suggests that rising ocean temperatures may help slow down this effect. Warmer waters allow hurricanes to store more moisture. And wetter hurricanes decay more slowly.
The researchers investigated using a model that simulates the behavior of hurricanes. The model suggested that sea surface temperatures were the cause of the slower-weakening trend.
To find out why this was happening, the researchers ran a series of simulations involving both normal hurricanes and “dry” hurricanes—storms containing no moisture at all. The dry hurricanes weakened far faster than their wet counterparts.
There may be one other factor contributing to the 50-year trend, the researchers note. It’s probably still related to climate change—but it’s likely secondary to the warming oceans.
Some studies suggest that Atlantic hurricanes shift eastward as the climate warms, meaning they’re more likely to make landfall on the East Coast than the Caribbean or the Gulf of Mexico. And hurricanes tend to weaken more slowly in eastern regions.
Why this happens is still a mystery, according to Chakraborty. It might have something to do with landscape differences on the East Coast versus the Gulf Coast. Or it could involve differences in wind conditions. But scientists still don’t know for sure.
The new study looks only at Atlantic hurricanes making landfall in North America. It doesn’t necessarily indicate that the same patterns are happening elsewhere around the world.
But Chakraborty suspects similar trends are true in other places.
“We have done a preliminary analysis of typhoons in the Pacific basin and we find that our main results ... hold for this basin,” he said.
As temperatures continue to rise, he expects these trends to continue.
If that’s the case, hurricanes could inflict more damage in the future. If storms hold their strength longer, they could pose a bigger threat both to coastal areas and to inland communities as they move across land.
That’s on top of all the other ways climate change may juice hurricanes in the coming years. Studies suggest that warming also contributes to stronger storms, with higher wind speeds and more rainfall.
Put together, these factors would likely exacerbate the damaging influence of slower-decaying storms, according to Purdue University researchers Dan Chavas and Jie Chen. In a published comment on the new research, they noted that the new study “highlights a key component of risk models that has been largely overlooked so far.”
“More generally, the current results indicate the need to broaden our thinking about how climate change affects tropical cyclones after landfall,” they wrote. “Integrating this understanding into hurricane models should help to improve our predictions of the future risks posed by individual storms and over the long term.”
Reprinted from Climatewire with permission from E&E News. E&E provides daily coverage of essential energy and environmental news at www.eenews.net.


scientificamerican--2020-11-12--Pfizer's Early Results Bode Well for a COVID Vaccine Approval This Year

After a week during which the U.S. had nearly a million new COVID cases , pharmaceutical company Pfizer and its German partner BioNTech announced on Monday that a preliminary analysis suggests their experimental vaccine is more than 90 percent effective at preventing the disease .
The welcome news signifies that efforts to slow the worst pandemic in more than a century might finally be bearing fruit .
The news was reported following an early look at data on 94 cases from Pfizer ’ s phase III clinical trial , which has so far enrolled nearly 44,000 people .
Questions remain @ @ @ @ @ @ @ the vaccine prevents severe disease in the elderly and other vulnerable populations .
Still , the preliminary results—announced in a press release— “ are extremely encouraging , ” says Paul Offit , a pediatrician and director of the Vaccine Education Center at the Children ’ s Hospital of Philadelphia .
“ It means that the vaccine is likely to be very effective as we look at more participants in the trial , moving forward.
” Developing a new vaccine ordinarily takes years .
But Pfizer ’ s candidate began clinical testing only months @ @ @ @ @ @ @ SARS-CoV-2 , the coronavirus that causes COVID .
Given in two doses three weeks apart , the vaccine contains a genetic blueprint , known as mRNA , for the virus ’ s “ spike ” protein .
The infusion of viral mRNA triggers human cells to make and display the spike , prompting an immune reaction against future infection .
Although some laboratories have created such gene-based vaccines for other human illnesses , none has been commercialized in the U.S. Pfizer is one of four U.S. companies with vaccines against COVID that are @ @ @ @ @ @ @ the nation ; a fifth company , Novavax , plans to start its phase III trial later this month .
Three firms—Moderna , Johnson & Johnson and AstraZeneca—have received funding to develop their interventions from Operation Warp Speed , a federal program aiming to begin mass inoculations against COVID in the U.S. by early next year .
( Operation Warp Speed has promised $ 1.95 billion for manufacturing and distributing Pfizer ’ s vaccine , but it has not supported its development . )
The three companies ’ vaccines also deliver spike protein @ @ @ @ @ @ @ .
And Pfizer ’ s new results “ give us reason to be optimistic for all of them , ” says Larry Corey , a virologist at the COVID-19 Prevention Network , which is helping to coordinate Operation Warp Speed ’ s clinical trials .
Offit concurs , adding that while the genetics-based approach appeared promising in animals , Pfizer ’ s efficacy data provide the first solid and eagerly awaited evidence that it can also succeed in people .
The company had initially planned to look at the data when the combined @ @ @ @ @ @ @ ( control ) and vaccinated groups reached 32 .
If , at that point , the vaccine was 80 percent protective or better—meaning that there were five times more sick people among the control group than there were in the vaccinated one—then an independent panel of reviewers could declare it successful .
Pfizer and the Food and Drug Administration later changed course and scheduled a data readout once the total number of cases reached 62 .
But with the pandemic raging , there were 94 cases to assess by the time the review @ @ @ @ @ @ @ to be well tolerated so far .
But to comply with FDA requirements , trial investigators still need to monitor side effects for an average of two months after participants get a second dose .
Bill Gruber , Pfizer ’ s senior vice president of vaccine clinical research and development , predicts the company will wrap up that safety evaluation by next week .
If all goes well , the company will apply for an emergency use authorization ( EUA ) to start making the intervention publicly available to a limited group—most likely @ @ @ @ @ @ @ risk of severe disease—by mid-December , Gruber says .
That date “ is probably the earliest it would be granted , ” he adds .
Pfizer plans to continue the trial until a final analysis is conducted at 164 cases—which Gruber predicts will be reached by the end of the month—so that investigators can assess additional end points .
The company ’ s recent announcement concerns the level of protection achieved seven days after the second dose ( and 28 days after the first ) .
Trial investigators will now extend their review @ @ @ @ @ @ @ the second dose is administered , thus giving infected individuals more time to become symptomatic .
Even if the FDA grants an EUA , Pfizer will follow subjects for two years from the start of the trial to assess whether the vaccine has any rare side effects , how long its protection lasts and whether it protects against severe disease .
Gruber acknowledges that the company would “ feel an ethical responsibility ” to vaccinate the control subjects , even though doing so would compromise the trial ’ s ability to monitor efficacy @ @ @ @ @ @ @ will see the advantage of remaining in the trial , ” he says .
“ We have to navigate with regulatory authorities to navigate that path.
” One approach under discussion would be to give everyone in the control group the vaccine and give the vaccinated people a placebo .
“ That way , everyone is protected , and you can follow them for a year or two .
And if the vaccine is safe and durable for an extra year , there would be little [ risk of infection ] in the @ @ @ @ @ @ @ a long time ago , ” Corey says .
“ That ’ s a strategy we ’ ve been thinking about , and we hope that people in the trial will consider it.
” For now , experts eager to see Pfizer 's clinical trial data will have to wait until they are published .
Company representatives claim that up to 42 percent of the trial participants are Asian , Black , Latinx , or Native American—and that up to 45 percent of all the participants are between 56 and 85 years old @ @ @ @ @ @ @ know is : How many cases are over 65—and especially over 70 years old ?
” Offit says .
“ A 56-year-old person is not nearly as likely to die of COVID as a someone over 70 , and that ’ s an example of why we need to see the data .
This is basically science by press release at this point , which is always a little frustrating.
” Pfizer ’ s plant in Kalamazoo , Mich. , is now ramping up manufacturing toward a goal of supplying 50 million vaccine @ @ @ @ @ @ @ up to 1.3 billion doses in 2021 .
Corey acknowledges that the first COVID vaccines out of the gate may not be the best , however .
And Pfizer ’ s mRNA candidate comes with several key disadvantages : it requires two doses , and it has to be stored at temperatures below –70 degrees Celsius .
The cold-temperature restriction could be problematic , especially in low- and middle-income countries .
By contrast , Johnson & Johnson ’ s vaccine requires only one dose and does not need subzero storage .
A phase @ @ @ @ @ @ @ currently underway .
Still , the apparent success of Pfizer ’ s vaccine “ increases our optimism that the others will work as well , ” says Dan Barouch , director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston and a co-developer of the Johnson & Johnson vaccine .
“ No single vaccine can supply the global market .
We are going to need several to put this pandemic behind us.
” Read more about the coronavirus outbreak from Scientific American here .
And read @ @ @ @ @ @ @ here .

Editor’s Note (11/18/20): After this story was published, Pfizer announced results from its final analysis of 170 confirmed cases, showing its vaccine is 95 percent effective. A Pfizer press release claimed the vaccine’s “efficacy was consistent across age, gender, race and ethnicity demographics” and that it exceeded 94 percent in adults older than 65. Earlier this week, the company Moderna announced that, based on an early analysis of its data, its COVID-19 vaccine was 94.5 percent effective and appeared to prevent severe disease. Both the Pfizer and Moderna vaccines are based on mRNA and must be stored at cold temperatures. But Moderna said its vaccine was stable for 30 days in a refrigerator and 12 hours at room temperature, according to the New York Times.
After a week during which the U.S. had nearly a million new COVID cases, pharmaceutical company Pfizer and its German partner BioNTech announced on Monday that a preliminary analysis suggests their experimental vaccine is more than 90 percent effective at preventing the disease. The welcome news signifies that efforts to slow the worst pandemic in more than a century might finally be bearing fruit.
The news was reported following an early look at data on 94 cases from Pfizer’s phase III clinical trial, which has so far enrolled nearly 44,000 people. Questions remain about how long protection lasts and whether the vaccine prevents severe disease in the elderly and other vulnerable populations. Still, the preliminary results—announced in a press release—“are extremely encouraging,” says Paul Offit, a pediatrician and director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “It means that the vaccine is likely to be very effective as we look at more participants in the trial, moving forward.”
Developing a new vaccine ordinarily takes years. But Pfizer’s candidate began clinical testing only months after scientists published the genome sequence for SARS-CoV-2, the coronavirus that causes COVID. Given in two doses three weeks apart, the vaccine contains a genetic blueprint, known as mRNA, for the virus’s “spike” protein. The infusion of viral mRNA triggers human cells to make and display the spike, prompting an immune reaction against future infection. Although some laboratories have created such gene-based vaccines for other human illnesses, none has been commercialized in the U.S.
Pfizer is one of four U.S. companies with vaccines against COVID that are now in phase III clinical trials in the nation; a fifth company, Novavax, plans to start its phase III trial later this month. Three firms—Moderna, Johnson & Johnson and AstraZeneca—have received funding to develop their interventions from Operation Warp Speed, a federal program aiming to begin mass inoculations against COVID in the U.S. by early next year. (Operation Warp Speed has promised $1.95 billion for manufacturing and distributing Pfizer’s vaccine, but it has not supported its development.) The three companies’ vaccines also deliver spike protein genetic material, albeit using different strategies. And Pfizer’s new results “give us reason to be optimistic for all of them,” says Larry Corey, a virologist at the COVID-19 Prevention Network, which is helping to coordinate Operation Warp Speed’s clinical trials.
Offit concurs, adding that while the genetics-based approach appeared promising in animals, Pfizer’s efficacy data provide the first solid and eagerly awaited evidence that it can also succeed in people.
The company had initially planned to look at the data when the combined number of COVID cases in the placebo (control) and vaccinated groups reached 32. If, at that point, the vaccine was 80 percent protective or better—meaning that there were five times more sick people among the control group than there were in the vaccinated one—then an independent panel of reviewers could declare it successful. Pfizer and the Food and Drug Administration later changed course and scheduled a data readout once the total number of cases reached 62. But with the pandemic raging, there were 94 cases to assess by the time the review actually took place.
The vaccine appears to be well tolerated so far. But to comply with FDA requirements, trial investigators still need to monitor side effects for an average of two months after participants get a second dose. Bill Gruber, Pfizer’s senior vice president of vaccine clinical research and development, predicts the company will wrap up that safety evaluation by next week. If all goes well, the company will apply for an emergency use authorization (EUA) to start making the intervention publicly available to a limited group—most likely including first responders and people at high risk of severe disease—by mid-December, Gruber says. That date “is probably the earliest it would be granted,” he adds.
Pfizer plans to continue the trial until a final analysis is conducted at 164 cases—which Gruber predicts will be reached by the end of the month—so that investigators can assess additional end points. The company’s recent announcement concerns the level of protection achieved seven days after the second dose (and 28 days after the first). Trial investigators will now extend their review to look for protection two weeks after the second dose is administered, thus giving infected individuals more time to become symptomatic.
Even if the FDA grants an EUA, Pfizer will follow subjects for two years from the start of the trial to assess whether the vaccine has any rare side effects, how long its protection lasts and whether it protects against severe disease. Gruber acknowledges that the company would “feel an ethical responsibility” to vaccinate the control subjects, even though doing so would compromise the trial’s ability to monitor efficacy. “My hope is that participants will see the advantage of remaining in the trial,” he says. “We have to navigate with regulatory authorities to navigate that path.” One approach under discussion would be to give everyone in the control group the vaccine and give the vaccinated people a placebo. “That way, everyone is protected, and you can follow them for a year or two. And if the vaccine is safe and durable for an extra year, there would be little [risk of infection] in the second year for those who got it a long time ago,” Corey says. “That’s a strategy we’ve been thinking about, and we hope that people in the trial will consider it.”
For now, experts eager to see Pfizer's clinical trial data will have to wait until they are published. Company representatives claim that up to 42 percent of the trial participants are Asian, Black, Latinx, or Native American—and that up to 45 percent of all the participants are between 56 and 85 years old. “But what I want to know is: How many cases are over 65—and especially over 70 years old?” Offit says. “A 56-year-old person is not nearly as likely to die of COVID as a someone over 70, and that’s an example of why we need to see the data. This is basically science by press release at this point, which is always a little frustrating.”
Pfizer’s plant in Kalamazoo, Mich., is now ramping up manufacturing toward a goal of supplying 50 million vaccine doses—enough for 25 million people—in 2020 and up to 1.3 billion doses in 2021. Corey acknowledges that the first COVID vaccines out of the gate may not be the best, however. And Pfizer’s mRNA candidate comes with several key disadvantages: it requires two doses, and it has to be stored at temperatures below –70 degrees Celsius. The cold-temperature restriction could be problematic, especially in low- and middle-income countries. By contrast, Johnson & Johnson’s vaccine requires only one dose and does not need subzero storage. A phase III clinical trial for that intervention is currently underway.
Still, the apparent success of Pfizer’s vaccine “increases our optimism that the others will work as well,” says Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston and a co-developer of the Johnson & Johnson vaccine. “No single vaccine can supply the global market. We are going to need several to put this pandemic behind us.”
Read more about the coronavirus outbreak from Scientific American here. And read coverage from our international network of magazines here.