March 2022 – Page 24 – BLOGGERPARUNG

Astronomers were skeptical about dark matter — until Vera Rubin came along

Posted on March 23, 2022 by BLOGGERPARUNG

Vera Rubin didn’t “discover” dark matter, but she put it on the map.

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Dark matter is a wild concept. It’s the idea that some mind-boggling percentage of all the matter in the universe may be invisible, and wholly unlike the matter that makes up Earth. Rubin is celebrated because she forced much of the astronomy community to take it seriously.

That reckoning moment came in 1985, when she stood in front of the International Astronomical Union and walked the audience through some of the data she had collected.

Her data showed that stars at the edges of multiple galaxies were moving in ways that didn’t make sense, according to the rules of physics. One possible explanation for this strange phenomenon, Rubin suggested, was the existence of a mysterious “dark matter” at the edges of the galaxy. In the decades since that talk, research into dark matter has exploded, revolutionizing astronomy.

In Bright Galaxies, Dark Matter, and Beyond, a new biography of Rubin, science journalist Ashley Yeager explains how Rubin, who died in 2016, grew from a young researcher whose bold ideas were initially ignored into the kind of scientist who could change an entire field. In 2020, we interviewed Yeager for an episode of the Unexplainable podcast about dark matter. A transcript of our conversation, lightly edited for length and clarity, follows.

Noam Hassenfeld

When did Vera Rubin first get interested in astronomy? What’s her origin story?

Ashley Yeager

About the age of 11 is when she started to look at the stars. Vera and her sister, Ruth, shared a bedroom in their Washington, DC, townhouse. And Ruth remembers Vera constantly crawling over her at night to be able to open the windows and look out at the night sky and start to track the stars. So clearly, Vera was captivated by the night sky. And that stuck with her.

She then went to Vassar, where she studied astronomy. [While at Vassar, she met a mathematician named Robert Rubin.] They ended up getting married. And that drove one of the biggest decisions in Vera’s life, because she wanted to go to graduate school for astronomy.

She’d gotten into Harvard, but Robert Rubin was at Cornell. He was well into his graduate studies. They had to make a choice, and Vera said, “Let’s stay together. I’ll come to Cornell with you and I’ll do my master’s in astronomy while you finish your PhD in physics.”

Noam Hassenfeld

Isn’t that kind of a wild choice? To choose Cornell based on a husband?

Ashley Yeager

It’s the late 1940s. And Vera, in some ways, was very traditional, even though she was nontraditional in other ways. She felt that she was expected to get married by the end of her four years at Vassar. That was still something that was societally kind of expected.

And I actually think it set her up to be more successful than maybe she would have been, had she gone to Harvard or Princeton or somewhere else, just because of the exposure that she got. There was intellectual freedom she had at Cornell, to be able to probe into different questions in astronomy that she probably would have been pushed away from, had she been in a more structured graduate program.

Noam Hassenfeld

So she’s at Cornell. She’s probing into questions. She’s got a lot of intellectual freedom. What are the big questions that are occupying her mind?

Ashley Yeager

The biggest one, which becomes her master’s thesis, is really the idea of “Does the universe rotate?”

Noam Hassenfeld

Wait, does the universe rotate?

Ashley Yeager

So, probably no. This was a question posed by a very eccentric astronomer named George Gamow. Vera’s husband actually showed Vera this paper that George Gamow had written about this idea. And she thought, “Well, why would we not try to answer that question?”

Noam Hassenfeld

The kind of question that, if she were at another university, maybe she wouldn’t have had the freedom to dive into?

Ashley Yeager

I think so. I get the sense, reading through the literature and looking through the history, that she probably would have been guided to a more traditional question.

And as she started to look through the data, the numbers started to suggest that there was this odd, sideways motion that perhaps could be interpreted as a universal rotation. She presented her idea to her master’s thesis adviser, William Shaw.

He says, “Your conclusion is really good. I want to present it under my name at this upcoming astronomy conference.”

And Vera is like, “No! I might not be a member of this society yet. But you’re not presenting my data for me. I’m going to present it under my own name, come hell or high water.”

Noam Hassenfeld

So does she?

Ashley Yeager

Yes. She goes to this meeting. Apparently, the drive from New York to Pennsylvania, where the meeting was, was harrowing. It was the winter, snowy. They had a newborn in the car. Her dad was actually driving because he was the only one with a car at the time.

But she gives the presentation, and the reaction is less than great. There are some heavy critics in the room. A lot of scoffing. She does have one person, Martin Schwarzschild, who encourages her. He says, “This is really interesting. But we need more data to be able to make this conclusion.”

And that’s a criticism that really sticks with her throughout her career. Later on, she really tries to have or collect as much data as possible to support her conclusions, just because of that experience.

Noam Hassenfeld

What happens next?

Ashley Yeager

She takes a little bit of a break, because she really has this strong sense of wanting to set up a home and start a family. There’s this moment in the early 1950s, when she’s at the playground with her son. She had been reading astrophysical journals to stay connected with what was going on in astronomy.

So her son’s playing in the sandbox and she’s reading the journal, and she just breaks into tears because she misses doing research so much. She misses that curiosity of asking questions and searching for data, and really trying to figure out the answers to how the universe works.

It’s at that point that her husband says, “You need to go back to school. It’s time. We’ll figure out child care. We’ll figure out how to get dinners made. But let’s do it.”

Noam Hassenfeld

So she goes back into astronomy. And eventually she starts doing research at Kitt Peak National Observatory, right? What’s that like?

Ashley Yeager

We’re talking late 1960s. This is a 84-inch telescope, very large. Vera is at the telescope with Kent Ford, her collaborator. They’re looking at this galaxy called Andromeda, which is our nearest neighbor. They’re looking at these really young, hot stars on the edge of the galaxy, and they’re trying to get the speeds of these stars — how fast are these stars going around Andromeda?

So they’re looking at the data, and they’re going, “Oh my gosh, this is not what we expected.” The assumption was that the stars closer in would fly around the sun fast, and the stars farther out would go super slow. But these stars were moving faster than they expected.

The only way for those stars far out in the galaxy to move that fast is [that] there’s got to be something happening out there that we don’t understand.

Noam Hassenfeld

What does she think is going on?

Ashley Yeager

Well, she’s not really sure. And again, she doesn’t like to make assumptions or speak without data. So she and Kent Ford, and a couple other people, they really start to do a systematic study of galaxies.

She does 20 galaxies, and then 40, and then 60. And they all show this bizarre behavior of stars, these stars out far in the galaxy, moving way, way too fast. So at that point, you know, the astronomy community is like, “Okay, we have to deal with this.”

In 1985, Vera Rubin gives this talk at the IAU. She says, “Nature has played a trick on us. That we have been studying matter that makes up only a small fraction of the universe. The rest of the universe is stuff that we don’t understand, and we can’t see it.”

And I think because she did this in so many galaxies — we’re talking 60 galaxies — there was really no denying it. It was really her work that pushed the community over the edge, to say we have to accept the idea that dark matter exists.

Noam Hassenfeld

It sounds like if you really want to upend our entire conception of the universe, you have to come with some data.

Ashley Yeager

Yeah, absolutely. Because she held onto that criticism of her master’s and PhD work — she would just go after the data, and really make sure that the story she told from that data rang true.

One of the things that made her a remarkable scientist is her perseverance. She did face a lot of roadblocks, especially because she was a woman in science in the 1940s, 1950s, 1960s. She had to really persevere. Unfortunately, she will never get to see or know what dark matter is. But I don’t know that she had a problem with that. She would take pride in the fact that she opened a whole new realm of astronomy and physics.

She basically created more questions than answers, and I think that’s the mark of a remarkable scientist: when you open up these questions that no one ever thought of before. When you create a whole new generation of scientists who can go and answer them.

Solar farms are often bad for biodiversity — but they don’t have to be

Posted on March 23, 2022 by BLOGGERPARUNG

Every several years — sometimes just once a decade — when the rains come in just the right amounts and at just the right times, rare flowers speckle the Mojave Desert in California. Some, like the Barstow woolly sunflower, emerge from plants no larger than a thumbnail. They spring forth from seeds that have persisted in the dry soil for years, waiting for just such a sporadic event.

In these brief “super-blooms,” the desert floor looks “like a carpet of wildflowers unfurled across the landscape,” said Karen Tanner, a researcher at University of California, Santa Cruz. The quick flash of flora helps replenish the seeds for future generations.

At other times, large sections of this deceptively fragile ecosystem look “like the moon,” Tanner said. Which, under the punishing sun, makes it seem like an ideal place to build large solar installations. Swaths of the desert, which spans four states, have already been converted to solar facilities, and more are on the way — in the Mojave and across the US. More than 4,600 square miles of land is projected to be covered by solar installations by 2030.

A massive expansion of solar electricity is a crucial part of US plans to reach 80 percent renewable energy by the beginning of the next decade. This is essential to cutting carbon emissions and slowing catastrophic climate change — which poses a dire threat to plants and animals the world over, humans included.

But the race to erect large-scale, maximally efficient solar operations could hurt local ecosystems if operators aren’t careful. Based on her research, Tanner suspects many of these solar projects as they are traditionally executed are causing more local harm than some realize. She has spent nearly a decade closely studying — often on hands and knees with a magnifying glass — experimental solar plots in the Mojave, all located within six miles of four large solar installations. Her most recent findings, published earlier this year, have noted that solar panels changed the immediate microhabitat and had a detrimental impact on rarer plants, such as the Barstow woolly sunflower.

One thing is clear to her: “It’s just not enough to do one survey in one year and be like, ‘Oh yeah, there’s nothing here. Go ahead and install the infrastructure,’” she said.

Solar doesn’t have to be a zero-sum game that prioritizes either clean energy or biodiversity, scientists told Vox. Many projects and studies are currently looking for ways that solar installations can better protect — and potentially even improve — local ecosystems, along with the bottom lines of operators and even nearby landholders like farmers. These solutions can be as simple as prioritizing native plants or picking a location that’s already been disturbed by humans.

The darker side of solar

Solar installations, on the scale needed to supply power grids, are massive by necessity, transforming the lands where they’re located into a new kind of built environment. They can alter everything from sun exposure to moisture to surface temperatures. This can have unintended and unexpected impacts on local plants, animals, and even the area’s microbiome.

Photovoltaic panels shade the land while blocking some areas from rainfall and dousing others with heavy runoff. This changes the growing conditions for plants, with implications for other connected species. The other prominent form of solar, concentrating solar — in which mirrors focus the sun’s rays — generates so much heat that it “can incinerate insects and burn the feathers of birds that fly through,” Jeffrey Lovich, a research ecologist with the US Geological Survey who studies the environmental impacts of these installations, wrote to Vox.

In areas like the US Southwest, solar installations appear to contribute to bird mortality. Scientists aren’t entirely sure why this is, but one prevailing idea, known as the “lake-effect” hypothesis, is that migrating waterfowl making their way through the arid landscape mistake the installations for bodies of water and crash into them.

Large solar facilities in particular can also fragment important wildlife habitat or migration corridors via fences and landscape alteration, and can restrict gene flow for animal as well as plant populations.

Operators of these installations are generally keen to cut the costs of construction and maintenance, so most solar facilities replace the existing land cover with graded packed dirt, gravel, or mowed grass, further harming local biodiversity. “‘Blade-and-grade’ site prep that removes all vegetation clearly has a negative effect on biodiversity,” Lovich said. He expects mowed grass would “stress plant communities and the animals that use them.”

Many of the impacts remain unknown. It’s often difficult for researchers to gain access to solar facilities and the environmental data they collect — “even though the majority of facilities are situated on publicly owned lands,” Lovich and colleagues noted in a 2017 paper.

But it’s possible to dial down the potential harms of big solar farms. The type of solar infrastructure — whether concentrated solar or photovoltaic, and whether panels are fixed or rotating, high, or low — affects the potential downsides of large-scale installations. So does the nature of the landscape itself.

How solar can help native plants and crucial pollinators

Some solar operators are reimagining their facilities as prime protected habitats for native plants, bringing back key local species and potentially improving lands that humans have already disturbed. “Solar can be a net benefit in terms of restoring a native habitat and improving ecosystem services, like storm water control and carbon storage and sequestration,” said Leroy Walston, a landscape ecologist with Argonne National Laboratory who studies the relationship between renewable energy and the environment.

One in-vogue mitigation measure is pollinator-friendly foliage. At one experimental solar installation in Minnesota, pollinator-friendly plants helped boost energy yields a tad (by making the microclimate a touch cooler) and slightly reduced long-term maintenance costs (due to less-frequent mowing), according to a 2019 analysis from the Center for Business and the Environment at Yale University. The report also noted bigger wins: The plants helped reduce erosion, increasing groundwater stores and bolstering crop yields.

Experts have brought up concerns that solar operators will use a few flowers to green the image, but not the substance, of their operations. To help prevent this, some 15 states now have pollinator-friendly solar scorecards that aim to measure the actual impact of solar projects on the crucial creatures that carry pollen from plant to plant.

“They are voluntary, but they do help solar facilities to attain an objective certification that they’re pollinator-friendly, that’s been helpful to encourage some use of pollinator habitat at solar facilities,” said Heidi Hartmann, a colleague of Walston who works as a program manager for land resources and energy policy at Argonne. For example, the California renewable electricity provider MCE is now asking its facilities on arable land to use “reasonable efforts” to hit a certain score on these pollinator tallies.

Walston calls for an even broader approach to solar — one that focuses not only on bees and butterflies, but on native habitat restoration overall. Native plants are keenly tuned to the local environment, thriving in specific climate conditions, improving soil retention, and often benefiting the widest range of other area species, in ways non-native, flashy pollinator species might not.

Hartmann and Walston have modeled the impact of switching from maintained grass to native plantings. They found that in the US Midwest, native plants would bring in three times the number of pollinators. They’d also boost the carbon storage potential of the soil by 65 percent and would be more effective, once established, at keeping weeds at bay, which could reduce the need for harmful herbicide use.

“The equation is complex,” said Alyssa Edwards, vice president of environmental affairs at solar producer Lightsource BP, about the company’s impact on local habitats. Lightsource advertises itself as protecting ecosystems and boosting biodiversity. “Pollinator habitat, considerations of seed availability, vegetation height, insurance requirements, fire risk, and cost all come into play. Not to mention that pollinator habitat may not be the right choice for all sites, as other initiatives may be more valuable contributions to sustainability.” The company, a joint venture with the oil and gas giant BP, says it’s working on various solar projects that incorporate pollinator habitat, conservation of short-grass prairie land, and even animal grazing.

Wildlife corridors are another way solar installations could help support biodiversity. But for large sites to become a part of corridors, they may require substantial adjustments to fencing and other built infrastructure (and even then, they’d probably pose barriers to some larger species).

As more sites incorporate biodiversity as a benchmark, the devil is in the details. Tanner and others have found that solar panels can actually increase the number of plant species that grow beneath them, especially in harsh environments like the desert. However, some of these additional species are invasive or threaten to outcompete the smaller, rarer native ones that could tolerate such extreme desert conditions.

These kinds of wrinkles make it all the more important that scientists and operators actually measure their impact on ecosystems — that they’re “pausing for a moment and considering what sort of species we are considering that are making up the diversity,” Tanner said.

Build solar on lands that humans have already messed with, one expert says

Solar operators tend to look for new sites based on sun and climate conditions, but also proximity to the existing power grid — and a utility company in the market for their energy. Scientists told Vox that firms should also look for places that humans have disturbed, because the local ecosystem may have less to lose.

Lovich suggests siting more solar farms on “brown fields, roof tops, abandoned agricultural fields, dry lakes, and even airports — where wildlife are unwanted.” They’re also well-suited for canals and human-made reservoirs, where they’re sometimes called “floatovoltaics,” not least because they can slow water loss by evaporation. These less-conventional arrangements may have higher up-front costs, but the eventual environmental costs will be lower.

Building on an ecologically sensitive site can also be costly. Take for example BrightSource Energy, which spent at least $56 million relocating threatened desert tortoises from its Ivanpah solar development site in the Mojave Desert. Although these efforts allowed the project to go through, scientists are still learning about the consequences. An early study found that the relocated tortoises needed more time and effort to settle into normal movement patterns, potentially exposing them to additional threats. But as Lovich pointed out, “since tortoises are long-lived, results for the long term are not yet available.”

Such experiences have not deterred other desert sun-seeking operations. “Solar farms are operating or planned in excellent tortoise habitat affecting hundreds to thousands of tortoises,” Lovich said. Simply moving the tortoises — pricey as it may be — is not a sure cure. “Translocation has a checkered history of success,” he said.

Lovich is currently studying the impact of the Gemini Solar Project in Nevada, which would cover 11 square miles of publicly owned tortoise habitat and is home to hundreds of these long-lived, vanishing animals. For this project, the plan is to capture the animals, place them in a holding center for up to two years during construction, and then release them into the facility grounds “to see how they fare,” Lovich said.

“All energy sources will come with a cost to some wildlife,” Lovich and his colleagues noted in a 2020 paper. “The best mitigation strategy is to avoid developing sensitive and pristine areas.”

Other landscapes would not only tolerate solar farms, but could benefit from them. For example, a pollinator-friendly solar installation could add yield for farmers whose soy, citrus, almonds, cotton, or alfalfa needs some pollination help. More than 500 solar facilities already exist within easy buzzing-distance — less than a mile — from these crops in California, Massachusetts, and North Carolina, respectively, according to a 2018 study by Walston, Hartmann, and their colleagues. Nationally, more than 1,350 square miles of cropland would benefit if existing solar installations added pollinator-friendly plants, they concluded.

As solar has moved into lands that could otherwise be farmed, it has caused some tension with local residents. But solar farms and actual farms don’t necessarily need to be in opposition. It’s possible to co-locate solar and crops into “agrivoltaic systems,” which can feature grazing grass, corn grown for biogas, and even lettuce and tomatoes that may flourish under solar panels. Other crops could even be grown under semi-transparent solar panels.

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Solar can protect plants and animals while it helps the planet

Redesigning solar developments — and steering them to the places where they won’t cause harm — isn’t easy. Maximizing energy output means finding locations with the right combinations of sun, temperature, wind, and humidity (one study pegged the best spots as croplands, grasslands, and wetlands) and packing solar-harvesting devices as densely as possible. All of these often work at cross-purposes with supporting a diverse range of plant and animal species.

Additionally, permits for these facilities are typically done at a very local level. (President Barack Obama had instructed these sorts of projects on federal lands to have a mitigation strategy — an order that President Donald Trump struck down his second month in office.) So it’s a patchwork of different levels of regulations and approval processes, some of which are more in tune with thoughtful evaluation of sites and long-term impacts. There is “more education that can be done at local government levels,” Hartmann said.

Without more thorough before-and-after research, we may remain in the dark about how these large facilities are changing the landscapes they cover. If site evaluations are performed over a relatively brief period of time — such as a single season in the run-up to the construction of a solar farm — operators could easily miss key aspects of biodiversity, like the Barstow woolly sunflower, which waits for just the right pattern of rare desert rain to emerge.

“We’re just starting to scratch the surface and determine how different organisms are likely to respond” to solar, said Tanner, the UC Santa Cruz researcher. For now, it behooves us to mess with their environment as little as possible, she noted, and to preserve as much as we can. “Especially in a context of climate change, we don’t know what species are going to be able to pass through that aperture in the future.”

As the world barrels toward climate catastrophe, scaling up carbon-neutral energy production as quickly as possible couldn’t be more urgent. “We need all the help we can get, and we need to move quickly,” Tanner said. On a planetary scale, clean electricity can help safeguard all species, and could arguably be worth the trade-off if it harms a few local species in the process.

But maybe there doesn’t need to be a trade-off, Tanner suggested. “I’m not sure it’s an either-or question,” she said.

What we actually know about the vaccines and the delta variant

Posted on March 23, 2022 by BLOGGERPARUNG

The Covid-19 pandemic has changed, and with it, so has the effectiveness of the vaccines.

The bottom line remains the same: The mRNA vaccines from Pfizer/BioNTech and Moderna that are most prevalent in the US are still quite effective in preventing any illness from the novel coronavirus, and extremely effective in preventing the kind of severe illness that leads to hospitalization and death. On Wednesday, the Centers for Disease Control and Prevention confirmed those basic facts with its most robust data yet.

But the statistics that were widely publicized when those vaccines were first approved in December — the ones that showed vaccines were 95 percent effective in preventing all illness and 100 percent effective in stopping hospitalization or death — are now thoroughly out of date. The risk that a vaccinated person would experience symptoms if they contract Covid-19 is higher than it was back then, even if it is still significantly lower than if the person were unvaccinated. The now-dominant delta variant is likely to blame.

So exactly how effective are the vaccines against this new, more dangerous iteration of the virus? And how long does immunity provided by the vaccines actually last?

We are finally starting to get some concrete answers to these questions. The vaccines did appear to lose some of their effectiveness in preventing any kind of illness as the delta variant became dominant, especially for people who are at highest risk from Covid-19. But the protection against severe illness held steady, according to the three CDC studies published this week.

The number of breakthrough infections is “increasing as the delta wave proceeds,” Eric Topol, director of the Scripps Research Translational Institute, told me. “But still, protection versus hospitalizations and deaths is very solid.”

With this new evidence of waning vaccine efficacy, the Biden administration announced plans this week to immediately make immunocompromised patients eligible for a booster shot and recommended that all vaccinated people get a third shot eight months after their second dose.

The new data and new guidance reflect this new chapter in the pandemic. Vaccinated people should still feel confident that they are protected against the worst outcomes from Covid-19. But the large number of unvaccinated Americans, and the delta variant’s potency, has contributed to surges in infections.

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Some caution — continuing to wear masks and avoiding large indoor gatherings, for example — can help protect against the high level of spread currently in the US, experts said. Even with the powerful protection of vaccines, it’s possible to get sick after a coronavirus exposure.

We now know more than ever about Covid-19 vaccines and the delta variant

The Covid-19 vaccines were initially tested against the original version of the coronavirus, and they performed incredibly well. But delta has proven somewhat more capable of evading the vaccines and may cause more severe illness than its predecessors, based on early research out of the United Kingdom, one of the first places where delta took hold. The new CDC data is a big step forward because it brings our understanding of the vaccines closer to the present.

One of this week’s CDC studies tracked new cases and hospitalizations from early May to late July in New York. The study period covers the transition from the “alpha” variant to delta, which became dominant by the start of July, but only includes part of the recent surge in reported cases.

The vaccines grew less effective in preventing all illness as the delta variant took over, CDC researchers found. In May, vaccines had an estimated 90 percent effectiveness at preventing new cases. By mid-July, the estimated effectiveness had dropped to just under 80 percent. By that point, vaccinated people were more likely to get infected and actually feel sick. Breakthrough infections became more common.

But the vaccines have remained resilient against severe symptoms, with the estimated effectiveness against hospitalization holding steady around 95 percent from the start to the end of the study period.

“There was a reduction in vaccine effectiveness against SARS-CoV-2 infection, but not against hospitalization,” Celine Gounder, clinical assistant professor of medicine and infectious diseases at the NYU School of Medicine, told me. “The vaccines remain highly protective against hospitalization in all age groups.”

It’s important to remember that “severe” illness is a clinical term that might not align with the common parlance. A vaccinated person who becomes ill with Covid-19 might still feel very sick.

“Severe disease isn’t that you feel sick like a dog and are laid up in bed,” Gounder said. “Severe disease means your lungs are failing, your oxygen levels are dropping, and you need to be in the hospital.”

In other words, the vaccines have gotten less effective at stopping Covid-19 in its tracks but are still extremely good at protecting people from the kind of severe cases that need hospital beds or ventilators. Many patients with breakthrough infections can recover at home.

How the vaccines affect long Covid remains an open question. Preliminary evidence seems to suggest that they help alleviate (but not always eliminate) those long-term symptoms.

Why are vaccines somewhat less effective against infection than before?

The CDC researchers were careful to say the reasons for diminishing vaccine effectiveness are uncertain, but there are some things they’re confident about. The delta variant causes a substantially higher viral load than its predecessors — there is more of the virus when a person gets infected — and the sheer amount of the virus a person contracts may play a role. At the same time, people are now taking fewer precautions against Covid-19 than they were last fall and winter, the researchers said, making it more likely that they’ll be exposed to a high viral load.

Or to think of it another way: The rapid spread of delta in the unvaccinated population means vaccinated people are getting exposed to the virus more often, and being exposed to more of it than they were before.

Data from other countries shows a wide range of vaccine effectiveness against infection with the delta variant, but studies have generally found the protection is less robust than it was against the alpha variant. Still, in all cases, the vaccines available in the US continue to impress in their ability to prevent the worst outcomes.

A second CDC study examined national data to determine whether the vaccines are becoming less effective at stopping severe illness over time. Like the New York study, it found that vaccines are extremely effective — about 90 percent at preventing hospitalization due to Covid-19.

Reassuringly, there was not a meaningful difference in the vaccine’s ability to stop hospitalization as time wore on. The researchers estimated the vaccine’s effectiveness against hospitalization in two time periods: two to 12 weeks after patients received a second dose, and 13 to 24 weeks after that second dose.

They did not find a meaningful decline almost six months after patients received a second dose of the vaccine — which is very good news.

“There was no reduction in vaccine effectiveness over time,” Gounder said, “which demonstrates that protection against hospitalization did not drop over time or after the emergence of the delta variant.”

The best protection for the most vulnerable is everybody getting vaccinated

While the vaccines have generally held up well against the delta variant, some of the people most vulnerable to Covid-19 do not receive the same level of protection.

For people with compromised immune systems, the CDC researchers found that the vaccines were less effective at preventing hospitalization. That finding supported the Biden administration’s plan to make those people immediately eligible for a third shot, experts said.

For immunocompromised individuals, it’s also possible that immunity may wane more over time — but that didn’t happen, according to this research. Their level of protection appeared to be constant during the six-month period covered by the study.

The third CDC study evaluated vaccine effectiveness for nursing home residents, a population particularly vulnerable to Covid-19 and one of the first groups to get vaccinated at the beginning of this year. That study did find declining effectiveness over time against any illness for those Americans, from 75 percent pre-delta to about 50 percent post-delta.

That drop-off may partly reflect the nature of this population. Older people’s immune systems are not as strong as younger people’s; older adults already experienced a lower baseline vaccine effectiveness rate than the general population before delta took over (75 percent versus 90 percent). The decline also probably reflects the basic fact that the delta variant is better at evading the vaccines than the alpha variant was.

“It makes sense to give an extra dose of vaccine to vaccinated nursing home residents,” Gounder said. “But what will have an even bigger impact on protecting those nursing home residents is to vaccinate their caregivers.”

As of late July, about 60 percent of nursing home workers had been vaccinated, substantially lower than the 80 percent rate among residents. The Biden administration announced on Wednesday that it would require nursing homes to mandate all their workers be vaccinated if the facilities want to receive federal health care funding.

Over the long run, so long as a substantial portion of the US population remains unvaccinated, there will be risks to everybody. Currently, 72 percent of the 18-and-over population and 60 percent of the entire US population are vaccinated, according to the New York Times tracker. That leaves millions of people without protection against the virus. Some of them are children not yet eligible for the vaccine, but millions of people who are currently eligible and could receive the vaccine for free still haven’t done so.

“Your risk depends on your vaccination status and what’s happening in your community,” Gounder told me. “Vaccines aren’t an immunity on/off switch for individuals. Vaccines work additively and synergistically across populations.”

Gounder deployed some hypothetical math to explain how risk works under different vaccination scenarios. If a country has a baseline of 1 million “units” of risk for each person, because the virus is very widespread, a 95 percent effective vaccine would reduce that risk to 50,000.

But if the baseline risk is 100, because the country contains the virus through vaccinations and mitigation measures, the vaccinated person faces just 5 units of risk. That huge difference in risk depends on how rampantly the virus is spreading in the overall population.

“This isn’t about individualism, individual rights, individual responsibility, and individual protection,” Gounder said. “This is about community immunity.”

How a cheap antidepressant emerged as a promising Covid-19 treatment

Posted on March 23, 2022 by BLOGGERPARUNG

Since Covid-19 patients started showing up at clinics and hospitals a year and a half ago, doctors and researchers have been hard at work trying to figure out how to treat them. Most drugs and treatments haven’t panned out, producing either no results or small ones in large-scale clinical trials. Many of the few that work are expensive and difficult to administer.

Hydroxychloroquine, enthusiastically endorsed by President Trump last year, has been shown to have no measurable benefits. New drugs like monoclonal antibodies — proteins meant to imitate the immune system’s response to the disease — have been approved by regulators but must be administered by a doctor through an IV or series of injections.

But scientists haven’t stopped searching, and the results of a new massive clinical trial suggest they’re getting somewhere. In a large, randomized clinical trial conducted with thousands of patients over the past six months, researchers at McMaster University tested eight different Covid-19 treatments against a control group to figure out what works.

One drug stood out: fluvoxamine, an antidepressant that the Food and Drug Administration has already found to be safe and that’s cheap to produce as a generic drug.

These new results follow some promising findings in small-scale trials last year. In those smaller studies, researchers found that fluvoxamine was strikingly good at reducing hospitalization for Covid-19 patients — but small-scale trials can sometimes turn up spurious good results, so those findings were obviously tempered by a lot of caveats.

This study, called the TOGETHER study, is a lot bigger — more than 3,000 patients across the whole study, with 800 in the fluvoxamine group — and supports the promising results from those previous studies. The authors released it this week as a preprint, meaning that it is still under peer review.

Patients given fluvoxamine within a few days after testing positive for Covid-19 were 31 percent less likely to end up hospitalized and similarly less likely to end up on a ventilator. (Death from Covid-19 is rare enough that the study has wide error bars when it comes to how much fluvoxamine reduces death, meaning it’s much harder to draw conclusions.) It’s a much larger effect than any that has been found for an outpatient Covid-19 treatment so far.

“This is a huge finding,” study co-author Ed Mills, a professor of health sciences at McMaster University, told me. “The game changers are things we already had in the cupboards.”

What makes this result potentially such a big deal is that fluvoxamine is inexpensive and has already been FDA approved for obsessive-compulsive disorder (OCD), so any doctor can prescribe it for Covid-19 using their clinical judgment (what’s called “off-label” prescribing). It’s a pill, which means it doesn’t need to be administered in a hospital or by a medical professional.

To be clear, these results have just been released, and clinicians around the world will want to take a close look at them as they decide whether or not to prescribe fluvoxamine. Future research could also moderate this exciting result.

Here’s what we know: This is a large and well-designed study that affirms previous studies that pointed in the same direction. More research is needed, but the results from this trial might already start changing how we treat Covid-19. And the way researchers stumbled upon the drug as a potential treatment is a worthwhile story in itself about the scientific process and the unseen and often unheralded work that’s helping humanity fight the pandemic.

The shifting landscape of Covid-19 treatment

Covid-19 treatments fall into two categories: treatment for severe illness, generally administered in the hospital to reduce the risk of death; and treatment for the onset of illness, which hopefully reduces the odds that a patient will need to be hospitalized at all.

The FDA has granted emergency authorization to a variety of Covid-19 treatments, but the evidence base for many is limited and the effect sizes have tended to be small. Hopes were high for repurposed antiviral drugs, for instance. Many of them are routinely administered and at least one was shown to reduce the length of hospital stays, but some studies have found no effect on mortality.

The same is true of convalescent plasma, transfusions of blood proteins from people who recovered from Covid-19. After more than a year of research, it mostly looks like these treatments aren’t effective, though there’s still lots we don’t know.

The FDA has issued emergency use authorization for monoclonal antibody treatments — proteins that mimic the ones the immune system would produce to fight off the virus — for those at severe risk from Covid-19. Monoclonal antibodies are also infused intravenously or as a series of four injections. They cost $2,100 a dose, which in the US is paid by the federal government so they are free to patients. They seem to work best when given early, pre-hospitalization, and while under those conditions they appear to be highly effective. However, getting people who recently tested positive for Covid-19 and still have mild symptoms to a medical setting for an intravenous infusion or four injections is a logistical challenge — and the cost and the difficulty of delivery mean monoclonal antibodies will never be an option in much of the world.

Corticosteroids, which are powerful anti-inflammatory medicines, have a solid track record. Studies have found that administering the cheap steroid dexamethasone, which can be given as a pill or an infusion, to patients hospitalized with Covid-19 reduces their risk of death. But because it can constrain the immune system, it isn’t recommended early in the course of the disease, when the main concern is the direct damage from the virus.

That leaves a glaring hole: Where are cheap, outpatient treatments that can reduce the risk of hospitalization in the first place and don’t require a medical professional to administer in a medical setting? Fluvoxamine could hopefully fill that gap.

Fluvoxamine’s journey, explained

Fluvoxamine is an antidepressant, and in the US, it’s mostly prescribed for treating OCD. It is what is known as an SSRI, short for selective serotonin reuptake inhibitor — the same class of drugs as popular antidepressants like Zoloft, Prozac, and Lexapro.

Through an unusual journey, it ended up on scientists’ radars as a potential Covid-19 treatment — and subsequent research seems to bear that out.

Years ago, before the novel coronavirus had infected its first patient, Angela Reiersen, a psychiatrist at Washington University in St. Louis, was studying patients with a rare genetic disorder called Wolfram syndrome, which affects cellular stress responses. She noticed that they seemed to tolerate some SSRIs well and others poorly and dove into the differences in SSRI chemistry to figure out why.

It turned out that one of the SSRIs that worked well, fluvoxamine, binds to a receptor in cells that regulates cellular stress response and the production of cytokines, proteins that tell the body something is wrong and cause inflammation. Researchers at the University of Virginia found that fluvoxamine reduced inflammation in animals. Reiersen wondered if that was why it worked well for her patients.

Then the pandemic hit. One leading theory of what happens when patients suffer through Covid-19 is that cells damaged by the disease release tons of cytokines, which then causes inflammation in the lungs that can make it hard to breathe and cause lasting tissue damage. Early in the pandemic, Reiersen went to her colleagues at the Washington University School of Medicine in St. Louis with a wild idea: Fluvoxamine might help Covid-19 patients.

Eric Lenze, a leading clinical researcher, agreed they should test it with a randomized controlled trial. “I emailed him on March 25, 2020. We got the trial started by April 10,” Reiersen told me.

They spent the spring and summer recruiting and treating Covid-19 patients. By the fall, they had results: Of the 152 participants, half in the placebo group (receiving a sugar pill rather than active medication) and half in the fluvoxamine group, six patients in the placebo group had met their study’s threshold for respiratory difficulties. None in the fluvoxamine group had.

The results were published in the Journal of the American Medical Association. “What I think is the most supported mechanism is an anti-inflammatory effect,” Reiersen told me. “Fluvoxamine can reduce the level of these chemicals called cytokines, which are involved in inflammation, so you’d get less damage in the lungs.”

The results were promising, but 152 patients isn’t that many. Reiersen and Lenze started recruiting for a larger-scale trial, looking for more evidence that fluvoxamine could be a first-line Covid-19 treatment.

In the meantime, evidence was coming in from other angles, too. After a mass outbreak in California, researchers gave affected people the option to take fluvoxamine; 65 people opted to take it and 48 declined. None of those who took it required hospitalization, while six did among those who declined it.

In France, Nicolas Hoertel, a psychiatry researcher at the University of Paris who is not affiliated with the TOGETHER study, had conducted and published an observational study finding that patients on certain antidepressants were less likely to have severe Covid-19. “This effect is not just fluvoxamine, but it’s not all antidepressants,” he told me.

Observational studies don’t assign patients a specific treatment but just record what treatment they receive and how well they do. They don’t involve randomization, so they can be misleading if, say, people on antidepressants are systemically different from people not on antidepressants or if people who agree to try an experimental medication are healthier than people who refuse. So the results from these studies couldn’t be taken as definitive — but it was additional data.

The limited, promising literature around fluvoxamine prompted its inclusion in the large-scale study of treatments for Covid-19 run by Ed Mills at McMaster University and primarily conducted in Brazil. Dubbed the TOGETHER study after other prominent mega-clinical trials like RECOVERY and SOLIDARITY by other organizations, it randomized patients across eight prospective treatments, including metformin (a diabetes medication), hydroxychloroquine (an antimalarial), and ivermectin (an antiparasite).

The team announced their results at an August 6 symposium that was sponsored by the National Institutes of Health. Most of the treatments failed: Their study couldn’t detect an effect. “A lot of drugs against Covid just don’t work very well,” Mills told me. Two other treatments were still in progress, and it was too early to rule out the chance that they’ll work.

But fluvoxamine was a different story. In the trial, it improved patient outcomes substantially — and while it’s not the first drug to do that, ease of delivery and price give it the potential to have an outsized impact on patient care, especially outside the rich world.

Do we know enough to recommend fluvoxamine to Covid-19 patients?

In the research conducted so far, fluvoxamine was prescribed to patients who started experiencing Covid-19 symptoms.

In the TOGETHER study, they typically visited a doctor to enroll in the trial — and start taking medication or a placebo — three days after their symptoms began.

The results of the study are strong enough that researchers are suggesting changing clinical practice to recommend fluvoxamine to people with symptomatic Covid-19.

“We have now growing evidence from different kinds of research — technical, clinical — indicating that [treatment with certain antidepressants] is very likely to be effective in Covid,” Hoertel said. “The likelihood of benefits is very high.”

Critical to changing clinical recommendations is having enough information about the risks and benefits of a treatment. Since fluvoxamine is decades old, its risks are already well understood.

“We know a great deal about the safety and tolerability of fluvoxamine,” Lenze told me. “It can cause in about one-quarter of people some nausea, which is usually mild. It’s not fatal even in overdose, it’s been around for over a quarter of a century so there’s not going to be any unpleasant surprises about safety issues, and it’s really easy to use — it’s just a pill. I don’t see anything that should stop people from taking it.”

There are still things scientists want to know about fluvoxamine, including exactly how it works within the body. And pinning down precisely how much the drug reduces hospitalization and death will definitely take more evidence — though from the 31 percent reduction in hospitalizations in the McMaster study, the researchers who spoke to Vox think it’s likely that the effect is real and sizable.

The TOGETHER trial hasn’t yet been peer-reviewed, though I spoke with numerous unaffiliated researchers who’d seen the results and found them convincing.

“Bottom line, in my opinion at least, Ed [Mills]’s finding proves that the drug works,” Lenze told me.

“We’ve all been burned by promising studies of these repurposed drugs, and it’s quite reasonable to reserve final judgment until we see the complete data, and even other studies. … But this already feels different from hydroxychloroquine and company given the high quality of the research,” Paul Sax argued in NEJM Journal Watch Infectious Diseases. “We might finally be onto something.”

Another possibility to account for when looking at clinical trial data is publication bias — studies that find results get published, while those that find null results often don’t. Lenze is attempting a large-scale replication of his small-scale fluvoxamine study from last year, and so far hasn’t been able to validate the huge reduction in hospitalizations he found the first time around — mainly because recruiting for Covid-19 clinical trials in the US has gotten increasingly difficult as most high-risk people are vaccinated and not at risk of hospitalization, and unvaccinated people are less likely to enroll in clinical trials or adhere to a recommended course of medication. (The TOGETHER study got around this problem by recruiting in Brazil.)

Another worry is that variants will make our understanding of Covid-19 treatments obsolete as soon as we develop one. The TOGETHER study was mostly conducted before the delta variant predominated in Brazil. There’s no strong reason to think fluvoxamine wouldn’t work against delta, but we’ll need additional research to see if the effect size remains the same.

But crucially, we don’t have to answer every unanswered question for doctors to prescribe fluvoxamine to patients. Researchers do have answers to the questions of “Is the drug safe?” and “Does the balance of evidence suggest significant improvement in patient outcomes?” The evidence on those two points looks convincing, so even though there’s lots more to learn, the researchers and clinicians studying fluvoxamine feel ready to say that the drug is a good idea.

One question lots of doctors and patients have about a Covid-19 treatment, of course, is: “Is it FDA-approved?” Fluvoxamine is FDA-approved — but for OCD, not for Covid-19. In fact, Lenze told me, ”I don’t think the FDA ever will approve it for Covid. The reason the FDA will never approve it for Covid is exactly the reason it’s so useful for Covid, namely it’s cheap and it’s widely available. No one can make any money off it, so no one is going to spend the money to appeal to the FDA to approve it.”

Doctors can prescribe drugs the FDA has approved as a treatment for one condition to treat another condition off-label, using their clinical judgment. Doctors may vary in how comfortable they feel with it, but it is common and fully permitted by US regulations.

How Covid-19 is changing the process of clinical trials

One other thing about the emergence of fluvoxamine worth discussing is the process by which it happened: a new approach to clinical trials that is changing how we find new treatments.

Conducting clinical trials takes a long time. Most people will not be eligible to join a given trial. Finding the eligible ones and recruiting and enrolling them is time- and labor-intensive.

In order to find moderate-effect sizes and be confident in the results, a clinical trial needs to enlist thousands of patients, but that also means it will take much longer to recruit for and conduct — and with Covid-19, delays have costs in human lives. Clinical trials on this scale are expensive, too. TOGETHER is funded by private philanthropists, including Fast Grants, an initiative by Silicon Valley billionaire Patrick Collison and economist Tyler Cowen to speed pandemic response by getting grant money out rapidly.

For the past year, Mills has been using a new approach to clinical trials in order to test potential Covid-19 treatments faster. The key thing was to conduct them in parallel using what’s called an adaptive platform trial. “They’re multi-armed, so you’re testing lots of substances at a time, which allows you to only have one control group,” Mills told me. “What all of the useful trials in Covid have in common is that they’re an adaptive platform trial.”

Running, say, eight clinical trials, with eight control groups, requires many thousands of patients to get an informative sample, which can take a long time. Having eight experimental groups sharing a single control group cuts the number of patients required nearly in half.

This study model reallocates patients among treatment groups once a given treatment has been demonstrated not to work. That leads them to have larger, more convincing sample sizes for the most promising treatments. “You make decisions based on the data that emerges early,” Mills said. “After you have randomized 200 patients to the drug, if you can’t tell that it’s working, it’s probably not a very good drug. Every drug that’s not showing effects is a waste of patients.”

Fluvoxamine was one of eight treatments Mills and colleagues tested. Over time, as other treatments showed no effect, more patients got randomized to the fluvoxamine arm of the trial — letting the researchers learn more about the drug that seemed the most promising.

Mills says that played a huge role in their ability to quickly figure out what worked and what didn’t. “Prior to Covid, it was really just MD Anderson [the cancer hospital in Houston] doing this design. I think it’s going to be how almost all clinical trials happen going forward.”

Vaccines are great — but treatments are as badly needed as ever

Now that there are Covid-19 vaccines, the race for a treatment might seem less urgent than it was last year. But researchers say that mindset would be a mistake.

Vaccine uptake has stalled in most rich countries around 60 to 70 percent, and the delta variant means that the virus is still spreading. Effective treatments could mean dramatically fewer people hospitalized in places where hospitals are overwhelmed.

In poor countries, the situation is starker. Vaccines are not yet widely available, and the prospects for mass vaccinations are grim. And many existing treatments for Covid-19 are unaffordable for the global poor. That’s where fluvoxamine’s promise really comes in.

“It’s $2,000 for a dose for a monoclonal antibody,” Mills told me. “Our drug costs $4.” The supply chain, too, is simpler. Fluvoxamine doesn’t need to be kept in a freezer, doesn’t expire quickly, and can be mass-manufactured cheaply. If it continues to show health benefits for Covid-19 patients, making it widely available in poor countries could help them weather delta.

The fight to discover new treatments isn’t over, either. When I talked with Mills, he was excited about research in the UK finding that steroid inhalers — another cheap, widely available medication — reduced Covid-19 hospitalizations. Mills is also in the process of enrolling patients for a study of both steroids and fluvoxamine, to see whether the benefits are greater when patients take both drugs. “We go from having no drugs for early treatment that are cheap and widely available to having two,” he told me. “What does it look like if we use them together?”

The world is still months of research away from an answer to that question. But even the partial answers available today might make all the difference for some patients.

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What full FDA approval for Covid-19 vaccines really means

Posted on March 23, 2022 by BLOGGERPARUNG

Nearly nine months after the first Americans received their shots, the Covid-19 vaccine from Pfizer/BioNTech received full approval from the Food and Drug Administration for people 16 and older on Monday. This could help increase the number of people willing to get vaccines and make it easier to compel those who are less willing — if health officials can cut through the mounting confusion around their efficacy, booster shots, and the threat of the delta variant.

Covid-19 vaccines from Johnson & Johnson, Pfizer/BioNTech, and Moderna have thus far been distributed across the US under emergency use authorizations. This form of limited approval allows the FDA to fast-track the distribution of drugs, vaccines, and medical devices during a public health emergency, like a pandemic.

Getting an emergency use authorization requires data from clinical trials showing that an intervention is safe and effective, but the bar for full approval is higher. Now, with 200 million people at least partially vaccinated, the FDA has effectively removed the asterisks from Pfizer/BioNTech’s mRNA vaccine.

“While millions of people have already safely received Covid-19 vaccines, we recognize that for some, the FDA approval of a vaccine may now instill additional confidence to get vaccinated,” said Janet Woodcock, acting commissioner of the FDA, in a statement on Monday.

Full approval grants the vaccine manufacturers permission to advertise their products and allow them to continue selling them after the public health emergency around Covid-19 ends. For doctors, full approval also allows them to use vaccines off-label, potentially as booster shots.

But perhaps the most significant change would be a potential boost in public confidence in the vaccines, amid a rising tide of confounding information. Full approval could serve as a valuable messaging tool and help close some of the lingering gaps in immunization across the country.

A significant share of unvaccinated people — millions of people, according to polling — say that full approval will increase the likelihood that they’ll get a Covid-19 vaccine. These individuals may be hesitating “because they know there will be much more data available at the time of an approval … three times as much data on safety and three times as much data on effectiveness,” said Sidney Wolfe, founder and senior adviser at the health research group at Public Citizen.

More employers may also be willing to require vaccines among their workers (some have already begun to do so). And full approval from the FDA could bolster support for these vaccines in other countries that look to the US agency for its rigor. However, to get the maximum public health value out of a full approval, messengers from the president on down to local doctors have to be ready to explain what it all means.

Full approval requires long-term evidence that Covid-19 vaccines are safe and effective

For vaccines, the FDA grants emergency use authorizations after it reviews at least two months of follow-up results for clinical trial participants who received the actual injection. For full approval, known in FDA-speak as a “biologics license application,” the agency wants to see six months of data to ensure there are no widespread problems or to detect adverse reactions. Both reviews examine safety and efficacy while also studying what the optimal distribution strategy might be.

In May, Pfizer and BioNTech submitted their license application. Moderna began its application in June, and Johnson & Johnson said it will begin the process later this year.

With vaccines in general, almost all complications that occur tend to happen shortly after the vaccine is administered, often within a day or two. Most side effects of the Covid-19 vaccines in the US tend to be mild or moderate, ranging from pain at the injection site to fatigue to fever. A very small number of recipients reported severe allergic reactions shortly after their shots, which is why most vaccine clinics have a waiting period where they can monitor patients for 15 to 30 minutes.

But in clinical trials, some extremely rare complications can be hard to detect even among tens of thousands of people after following them for two months. In April, the CDC and FDA paused the distribution of the Johnson & Johnson Covid-19 vaccine after 15 people reported a rare blood-clotting disorder out of the 8 million people who had received a dose at that point. After investigating, regulators concluded the benefits of the vaccine far outweigh the risks and allowed distribution to resume.

Monitoring clinical trial participants over six months also yields more information about how long protection from the vaccine lasts and whether any subsets of the population are more vulnerable. And it presents an opportunity to see how well the vaccines hold up against variants that were not widely circulating earlier in the pandemic.

This additional information — not just from clinical trials but from wide-scale distribution — helps the FDA identify any risks and better tailor its recommendations for use of the vaccine. Full approval also requires inspections of vaccine production facilities, looking at how the shots are made and how they’re packaged to ensure that production is consistent.

“That’s a much larger package of data, and that in itself means it takes much longer” to review, Wolfe said.

The licensing process for vaccines usually takes about a year. By granting full approval to the Pfizer/BioNTech vaccine just four months after the companies applied, Covid-19 vaccines have broken yet another speed record.

One caveat is that the full vaccine license only applies to the specific age groups included in a given clinical trial. The original trials mainly included adults, and Covid-19 vaccine testing in younger children has only recently begun, so the FDA has fully approved the Pfizer/BioNTech vaccine for use in adults 16 and older. Children 12 to 15 can continue to receive the shot under the emergency use authorization that was already in place.

Full FDA approval for a Covid-19 vaccine may help convince the hesitant

At this point, the majority of adults in the US have received at least one dose of a Covid-19 vaccine under an emergency use authorization. The spread of the delta variant has increased the rate of new vaccinations, which reached more than a million doses in a day on August 19, but the rate is still far below the April peak of more than 4.4 million doses per day. There remain pockets of the country where fewer than half of all eligible people have been vaccinated, and these regions are driving the rise in new Covid-19 cases, hospitalizations, and deaths.

There are several factors that divide the vaccinated from the unvaccinated, including political affiliation, race, income, and age. The reasons these people cite vary, such as a lack of access, a belief that Covid-19 isn’t that serious, and concerns that the vaccines have not been fully vetted.

According to polling from the Kaiser Family Foundation, almost one-third of unvaccinated people said they would be more inclined to get a shot if it graduates from an emergency use authorization to a full license. Full FDA approval could mean a lot for this last group of people.

But convincing people to get shots is not the job of the FDA; that falls to other public health messengers, and they have to be prepared to seize the opportunity. “It can have a modest effect or be a game changer, depending on how it’s handled,” said Drew Altman, president and CEO of the Kaiser Family Foundation. “It’s a question then of what the president does, what state and local public health leaders do, what the experts on television do.”

It’s not clear that people who cite the lack of FDA approval as a reason for not getting vaccinated are genuinely concerned with regulatory procedure or whether that’s just a proxy for general hesitancy. There’s also widespread confusion about the approval process: Kaiser’s polling also showed that at least two-thirds of US adults believed that Covid-19 vaccines already had full approval or weren’t sure about their regulatory status.

As for vaccine mandates, it’s already legal for private and public institutions to require their employees and customers to get shots. Companies like Google, Disney, and Walmart have begun to require many workers to get Covid-19 vaccines. But full approval could tip more employers, airlines, event venues, and other institutions that are on the fence to impose vaccinate mandates.

“I would look for significant movement on the part of more employers after full approval comes down from the FDA,” Altman said.

Now that the Pfizer/BioNTech vaccine is fully approved for people 16 and older, that doesn’t mean Moderna and Johnson & Johnson will stop distributing their vaccines under emergency use authorizations. While one of the conditions for granting an emergency use authorization is that there is no FDA-approved alternative available, emergencies like Covid-19 affect the calculus, the agency told Vox.

“For example, if the approved vaccine is only available in limited quantities, that vaccine may not be considered adequate to address the public health emergency,” said an FDA spokesperson in an email. “Another example would be if the vaccine is approved for use only in a limited population, then that vaccine may not be considered adequate to address the public health emergency for other populations.”

All the while, the dynamics of the pandemic are still changing, particularly with the surging delta variant of the coronavirus. While vaccines remain highly protective against severe Covid-19, delta seems to have increased the likelihood of breakthrough infections. Recent CDC data suggests that the shots aren’t as protective for vulnerable people like older adults who were vaccinated many months ago.

To counter this, the FDA is now on the verge of approving booster doses for many Covid-19 vaccine recipients. Meanwhile, the Centers for Disease Control and Prevention has gone back to recommending face masks in some circumstances for vaccinated people.

For health officials, it’s a fine line to walk: reassuring people vaccines are safe and effective while also noting that precautions are still needed. Regulators like the FDA also have to balance the needs of an urgent public health crisis with taking the time to go through the proper procedures.

And there are tough challenges that will remain even after a vaccine gets the bright green light from the FDA. There are still parts of the US where vaccination rates remain stubbornly low, and many unvaccinated people are not just hesitant but outright refusing to get immunized. Convincing these holdouts is difficult, but necessary, because as long as they remain unprotected, the virus will have ample opportunity to wreak havoc.

Update, August 23, 10 am ET: This article has been updated with the FDA’s full approval of the Pfizer/BioNTech vaccine.

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How to think about hurricane recovery, according to 3 experts

Posted on March 23, 2022 by BLOGGERPARUNG

The remnants of Hurricane Ida reached the New York City area on Wednesday, battering the region with record rainfall that flooded streets, subways, and basements. New York and New Jersey declared states of emergency, and officials in the Northeast had reported more than two dozen deaths as of Thursday afternoon. Ida, which made landfall in Louisiana on Sunday, tied for the fifth-strongest hurricane in US history and has been blamed for deaths across seven states. The toll is likely to rise as surveys of the damage continue.

Ida is one of a slew of summer disasters — among them deadly heat waves and catastrophic fires — reminding Americans that the climate crisis is already here. “We face some really challenging questions in Louisiana and across the United States,” Andy Horowitz, a Tulane University historian who wrote Katrina: A History, 1915-2015, told Vox on Monday, the day after the storm swept through his home city of New Orleans. “I think that should, basically, scare the shit out of us.”

Coastal communities urgently need to shore up infrastructure, from levees to sea walls to subway systems, and some will need to consider the much more drastic step of relocation, Horowitz said. In a time of worsening storms and sea-level rise, these conversations can’t be restricted to the Gulf Coast. “We’re talking about Staten Island as well,” he said. “We’re talking about the New Jersey coast. We’re talking about basically anyone who can drive to the water.”

The history of disasters like Hurricane Katrina, Horowitz said, can help us understand America’s possible future — both its vulnerabilities and its path to recovery. He said the policy responses, from lifesaving investments in infrastructure to ambitious climate policies that could eventually stabilize global temperatures, should be sweeping and swift.

In the age of climate change, a livable future will depend not only on physical infrastructure but on social support systems and a disaster recovery process that is democratic and relentlessly focused on equity, experts told Vox. In the view of Khalil Shahyd, a Louisiana native and a senior policy adviser for equity and environment at the Natural Resources Defense Council, this process should prioritize people over property.

Human choices have created a baseline of vulnerability

Two days before Hurricane Ida made landfall in Louisiana, Horowitz taught a class called “The Climate Crisis.” Over video chat from his home in New Orleans, he asked his students to close their eyes and think about what the climate crisis meant to them.

The exercise was supposed to be theoretical, but Horowitz found himself thinking about how his shirt was wet with sweat: He had spent the morning moving pieces of patio furniture so Hurricane Ida wouldn’t turn them into projectiles. He also thought about what he would be doing that afternoon: picking up his two young children, evacuating the city, and driving to a rental apartment in Birmingham, Alabama.

The Gulf Coast of the US is vulnerable to deadly hurricanes like Katrina and Ida for a host of reasons, many of them man-made, as my colleagues Umair Irfan and Benji Jones reported this week. Ocean and air temperatures are rising because humans are burning fossil fuels, and rising temperatures can infuse storms with more energy and water vapor. The state’s oil and gas industry has contributed to a boom in low-lying waterfront construction, even as rising seas wash away parts of Louisiana’s coastline. Communities of color are often on the front lines.

“There’s nothing natural or inevitable about those vulnerabilities,” Horowitz told Vox. Hurricanes should draw our attention to human choices, he said: our decisions about where to build, which communities can settle on high ground or behind levees, who should control shared resources such as power grids. (Louisiana’s private electricity provider, Entergy, suffered “catastrophic transmission damage” during Hurricane Ida that left a million people without power during a heat advisory; the company’s backup gas power plant, which was rammed through a local approval process with help from paid actors, did not come to the rescue.)

As Shahyd watched the news last week that Hurricane Ida would strike New Orleans, he had flashbacks to watching from afar as Hurricane Katrina approached the city. “You just get this dread,” he said from Washington, DC. “Am I going to have to watch my city drown again?”

Most of Shahyd’s family evacuated for Hurricane Ida, but one of his uncles stayed behind in a Morgan City mobile home, and one of his brothers stayed in Metairie because of another ongoing disaster — the Covid-19 pandemic. The brother quarantined at home because he worried that his son, who is 12 and vaccinated for Covid-19, had a breakthrough infection. “It could not have been worse timing for them,” Shahyd told me. “My brother was saying that he had never seen that much rain before in his life.”

National disasters like Covid-19 and Hurricane Ida are “compounding crises,” said Allison Plyer, chief demographer at the Louisiana nonprofit The Data Center. “This is compounding trauma.” The difficulties are both psychological and practical: For many, 2021 has been another year of financial instability, Plyer added.

Disasters are especially catastrophic when they’re mapped onto poverty and inequality, as was true for both Katrina and Ida. “The most important thing to being resilient in a disaster is some savings in the bank, so you can put gas in your car and maybe pay for a hotel room,” Plyer said. But one out of every five households in New Orleans does not have access to a vehicle, she added, making evacuation extremely difficult.

New Orleans was an unequal place before Hurricane Katrina. But more than a decade after the hurricane, the problem had worsened. Twenty-six percent of New Orleans households — and more than a third of Black households — had zero net worth, according to a 2016 report by the nonprofit Prosperity Now. The same report showed that the unemployment rate for Black households was three times the rate for white households. More than 31 percent of Black households earned below the poverty line — six times the rate for white households.

Worsening inequity results in large part from nationwide policy choices, Plyer pointed out. “What drives inequity is federal policies, not local policies,” she said. “That acceleration of inequity, post-Katrina, was within a national context of accelerating inequity.”

In a majority-Black city like New Orleans, inequity is closely linked to structural racism, Shahyd said. “The persistence, the maintenance, and the sustaining of poverty is the most egregious impact of racism,” with the exception of police killings, he said. “There’s no better representation of that fact than the city of New Orleans — a city that is so celebrated, a city that is so loved, a city that produces so much value, economically, spiritually, culturally. It’s dependent on the impoverishment of a great many of its people.”

Disaster recovery is climate policy

Hurricane Katrina helped reveal a pattern to American catastrophes: “Disasters accelerate pre-existing trends, and they also accelerate inequity,” Plyer said. Covid-19 has followed this trend, she said, and this summer’s disasters like Hurricane Ida probably will too — unless we collectively do something about it.

In 2006, about a year after Hurricane Katrina, four researchers published a perspective in Proceedings of the National Academy of the Sciences that considered 60 years of New Orleans history, ending with the aftermath of Hurricane Katrina. In New Orleans, the storm sped up population and income declines, the paper concluded — not least because federal support was devastatingly slow to arrive, and local recovery policies were mismanaged.

The relief that did come was not shared equally. Post-Katrina policies supported homeowners, even though renters — who tend to be lower-income — made up half of New Orleans residents. “Missing from rapid recovery has been adequate attention to the needs of evacuees who lived in rental housing, especially public housing,” the 2006 study said.

Shahyd added that developers and property owners had an outsized influence over the rebuilding of New Orleans: “If you’re not an owner of property, then you have no stake in or claim to much of the investments and resources that go into a post-disaster recovery.” He worries that this pattern could repeat itself after Hurricane Ida.

“I think what I most fear will be similar is that again, we have this sort of forced evacuation and depopulation of the city,” Shahyd said. “While many of us are going to be thinking about recovery and restoration, and getting home, other people are going to see that rapid, forced depopulation as an opportunity to reimagine urban space.”

Climate policy should be an integral part of recovery, he added. “Support for oil and gas is a bipartisan issue in Louisiana,” Shahyd pointed out. Democratic Louisiana Gov. John Bel Edwards has pledged reductions in fossil-fuel pollution, but he has also resisted some of President Biden’s climate policies and taken steps to protect fossil fuel industries. (The governor’s office did not respond to a request for comment.)

“Louisiana will continue to get hit with bigger and more frequent storms, and then require federal emergency declarations, and all these federal resources — all the while we’re still continuing to pump the oil, refine the gas, burn the fossil fuels as the dominant sector of our economy,” Shahyd said. “The state has to begin to take more responsibility.”

When it comes to climate change, Horowitz added, “There is no policy solution under serious consideration in the US right now that risks being too big for the challenge.”

Investing in a safer and more livable world

Plyer lives in Louisiana, but she spent the week following the news of the storm from her sister’s house in New Jersey. On Wednesday, Ida reached her all the way from the Gulf of Mexico, and she spent the night mopping water out of a neighbor’s basement. At least one person died in the county where her sister lives.

“The good news is that we have the technology now to really see these hurricanes coming,” Plyer said. “The bad news is that we haven’t made the investments in infrastructure and equity to ensure that our communities can be resilient in the face of these disasters.”

For all the reasons for pessimism in American history, Plyer said, she did find one reason to be hopeful: “There’s a few examples of places hit by disasters that broke from their historical paths.”

This process of changing the future depends on three things, she went on. First, communities should use the interruption in the status quo to transform key institutions. Second, they should take advantage of large recovery investments to strengthen those institutions. And third, they should capitalize on new opportunities, such as renewable energy.

As disasters affect more of the US, from California to Louisiana to New Jersey, more places will grapple with climate change and try to recover from shocks in ways that build resilience. “The future is here,” Plyer said. “We have to prepare for climate change, and have the infrastructure and housing and systems of support that we need to adapt.”

And as communities prepare for the worst and do their best to recover from disasters, they should empower local residents to make decisions themselves, Shahyd and Horowitz said.

The value of a city like New Orleans, Shahyd said, “is not based on its real estate, but its people.” Recovering communities should elevate the voices of the most vulnerable residents, he said, and allow them to choose whether to return and rebuild or relocate. “If we organize people, then they will represent themselves.”

“It seems most important to me that we have a relentless focus on the legitimacy of a democratic process that brings about those decisions,” Horowitz said. “People have to feel collective authorship of these decisions.”

Disaster recovery and climate adaptation sound daunting, Horowitz went on, but they can also be hopeful. “When you think about what the solutions might be, they’re often phrased in frightening terms about displacement or retreat or people losing their jobs,” he said. “But in fact, the solution, the redress to the climate crisis, would build a more safe, secure, viable, livable, humane world.”

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One of the worst public health dangers of the past century has finally been eradicated

Posted on March 23, 2022 by BLOGGERPARUNG

On Monday, the United Nations announced an environmental and public health milestone: the end of the use of leaded gasoline in automobiles and road vehicles worldwide.

The last holdout was Algeria, which had large stockpiles of leaded gasoline; in July, those stockpiles ran out, and Algeria has now made the transition to unleaded gasoline.

Lead poisoning causes immense societal harm: brain damage, chronic illness, lowered IQ, elevated mortality. Lead exposure in childhood has been linked with violent crime rates decades later. Extremely high lead levels can lead to seizures, coma, and death. Lower levels tend to cause less detectable harm, but there’s no safe level of lead exposure: Scientists’ current best guess is that any lead exposure at all causes harm.

Many of lead’s dangers have been known for decades. Leaded gasoline was invented by a General Motors research lab in the 1920s, and already at that time, there were people noticing that children exposed to high levels of lead suffered devastating health consequences. But Thomas Midgley Jr., leaded gasoline’s inventor, campaigned to convince the world that it was safe. (Midgley also invented ozone-depleting refrigerants called CFCs, which would end up being banned by the 1987 Montreal Protocol; he’s been called a “one-man environmental disaster.”)

For more than 50 years after the invention of leaded gas, virtually all cars around the world pumped aerosolized lead into the air.

In the 1970s, though, following more research firmly establishing lead’s harms, rich countries started addressing the problem. In the US, the Clean Air Act imposed restrictions on lead pollution, and a few years later, the Environmental Protection Agency mandated that gas pumps offer unleaded gas, as the first step toward a transition away from leaded fuels.

The EPA estimates that the amount of lead used in automotive gasoline in the US fell by 99 percent between 1976 and 1989. Measured blood lead levels followed. Crime rates dropped, too. Those benefits were realized even though the lead used in gasoline (and in paint and other consumer products) before bans on its use is still widespread in our soil and dust and still posing a major public health challenge.

In 1996, the EPA completely banned leaded gasoline for on-road vehicles. Japan and Europe issued their own bans over the same time period. In 2000, China and India followed.

How the United Nations phased out leaded gasoline worldwide

In 117 countries around the world, though — largely low-income ones — leaded gasoline was still in use.

In 2002, the UN’s Environment Program (UNEP) launched a sustained effort to phase out leaded gasoline, called the Partnership for Clean Fuels and Vehicles.

UNEP Director Inger Andersen describes it as a “UN-backed alliance of governments, businesses and civil society,” and its tactics were quite flexible: convincing governments of policy bans, teaching businesses how to make cleaner vehicles, finding investment for better refineries, and in one case navigating a massive bribery scandal, when it turned out that a leaded gasoline producer, the chemical company Innospec Ltd., was fighting to keep its product legal in Indonesia by bribing government officials.

The UN’s initiative saw fast adoption in sub-Saharan Africa, where 25 countries signed on to a plan to de-lead their gasoline in 2005. It made slower progress elsewhere, especially in the Middle East, where many countries had enormous stockpiles of leaded gasoline.

In 2011, a study by Peter L. Tsai and Thomas H. Hatfield estimated the phaseout of leaded gas was increasing global GDP by 4 percent, or $2.4 trillion (counting health savings as well as social benefits from higher IQ and lower crime).

They also estimated the direct benefits in lives saved at 1.2 million a year. The phaseout of leaded gasoline has been the “single most important strategy” for combating lead poisoning, they conclude, “with the economic benefits exceeding costs by more than 10 times.”

And while there’s a lot of academic debate about the exact magnitude of lead’s effect on crime, there’s no debate that transitioning away from lead fuels passes almost any cost-benefit analysis: Poisoning your entire population is just really bad, and transitioning away from leaded fuels is one of the cheapest ways to dramatically reduce lead poisoning.

By 2014, automotive leaded gasoline was legal only in parts of Algeria, Iraq, Yemen, Myanmar, North Korea, and Afghanistan.

By 2016, it was just Algeria, Yemen, and Iraq. And now, two decades after the campaign kicked off, cars everywhere in the world will use unleaded gas.

The road ahead

The end of leaded gasoline in automobiles is a big step forward, and one worth celebrating. But the fight to end lead poisoning’s effects on our world and on the next generation has a lot further to go.

In the US, leaded gasoline in cars has been illegal for more than 25 years. But the lead from that gasoline has settled in the soil and dust, and still contributes to poisoning children today.

The Centers for Disease Control and Prevention tracks lead exposure across the country. In 2018, the most recent year for which data is available, it found that in most states, between 1 and 5 percent of children had more than 5 micrograms per deciliter of lead in their blood — enough to potentially cause them serious health problems and lifelong harm. (Children exposed to lead in the US today are mostly exposed through soil and dust ingestion. Often, dust has lead in it because paint in old houses contains lead.)

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Worldwide, UNICEF estimates that around one in three children have lead levels in excess of the 5 µg/dL line. While leaded gasoline for automotives has historically been the single biggest contributor to lead levels in population centers, there are others: heavy industry, inadequate battery recycling and disposal, decaying pipes, and lead-based pottery glazes, for example.

In the US, lead-based fuels, though illegal on the road, are still allowed in aviation and a few other specialized contexts — and there’s no real progress toward phasing them out. While they cause a lot less lead exposure than automotive leaded gasoline did, the fact that there’s no known safe level of lead exposure should still give us pause — even the smaller exposures from these rarer sources can cause problems.

The end of leaded gasoline throughout the world will do a lot to fight lead poisoning by itself, but ideally it would be accompanied by measures to attack the other ways lead enters children’s bodies. The bipartisan infrastructure bill making its way through the US Congress includes money for lead remediation measures and lead pipe replacement — but it’s probably not enough to replace all aging lead pipes in the US.

UNICEF calls for “completely removing the potential for exposure to lead in areas where children live, play and learn,” and while it would be a tremendous expense, it would have a tremendous return. Poisoning the next generation is about as shortsighted as it gets, and investment in lead protection is an investment in our future.

Celebrating — and learning from — humanity’s achievements

The UN is frequently criticized as “bloated, undemocratic”, not focused on the world’s biggest problems, and not capable of moving us toward meaningful solutions.

But the worldwide elimination of leaded gasoline in cars is a genuine achievement worth celebrating — and worth examining, to see how the world can use the tactics that triumphed against leaded gasoline to combat the other huge problems requiring international coordination that face us in the 21st century.

The team at work on it has already expanded their focus to the next crucial transition for road vehicles: a move from gasoline-based ones to lower-emissions and zero-emissions alternatives. The leaded-gas initiative “is testament to the power of multilateralism to move the world towards sustainability and a cleaner, greener future,” Andersen, the director of UNEP, argued in a press release accompanying the announcement. “We are invigorated to change humanity’s trajectory for the better through an accelerated transition to clean vehicles and electric mobility.”

They’re also at work phasing out lead paint, another major source of household lead exposure.

The road map that the UN used for the fight against leaded gasoline — a combination of technological solutions that made it easier to switch away from lead in engines, political coalition-building, partnerships with businesses, and a few prosecutions of bad actors who used bribery to keep lead in business — is a road map that can be applied to challenges like climate change as well.

And separate from all of that, it’s worth taking a moment to rejoice in humanity’s achievements over death, disease, and our own self-inflicted horrors. Leaded gasoline and its mass use was one of the biggest mistakes of the 20th century. Ending it is one of the first big global triumphs of the 21st.

What an enormous global study can tell us about feeling better during the pandemic

Posted on March 23, 2022 by BLOGGERPARUNG

During the pandemic, I’ve spent a lot of time alone. I live by myself. I work from home. At times, I experienced fits of fidgetiness and restlessness, contributing to feelings of burnout.

Here’s what helped: reappraising the situation.

What I was feeling was isolation, and the loneliness that comes with it. Instead of letting it gnaw at me, I tried to remember: Loneliness is normal, sometimes even useful. I remembered that sadness existed in part to remind me of something I really value, the company of other people. I knew, when the opportunity arose, I’d reorient myself to immersion with others. And when that time came, I’d embrace it; it was a reminder that I was still capable of feeling the joy I had been lacking. And as a consolation, that felt good.

Cognitive reappraisal — sometimes called cognitive reframing — is most commonly encountered in therapy, where it’s used to regulate emotions. It’s a component of cognitive behavioral therapy, a whole suite of strategies that can encourage positive patterns of thinking and behavior.

Reappraisals are useful. But they’re not something people learn exclusively in the context of clinical care. It’s arguably a skill we all can benefit from. And by “we all,” I mean just about everyone, all across the globe.

Recently, hundreds of researchers in 87 countries published the results of the largest cognitive reappraisal study to date in Nature Human Behavior. They were asking a simple question: Could they make people feel better about the pandemic, if only for one moment in time, by teaching reappraisals? The study, which amassed data on more than 20,000 participants, came back with a resounding answer: yes.

The new study validates the concept of reappraisal. But it also suggests that it could potentially be feasible to deploy as a large-scale global health intervention.

It’s a simple skill, but it could help many people foster resilience in a chaotic world.

Cognitive reappraisal, explained

The peer-reviewed paper in Nature Human Behavior is the most recent project from the Psychological Science Accelerator, a group of hundreds of researchers who combine their resources to pull off psychological studies with massive participant pools and an unusually rigorous methodology.

Near the start of the pandemic, the group put out a call for project proposals to test psychological interventions that could, simply, help people feel better.

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“The reason why we choose cognitive reappraisal is because it has been the most widely studied and well-understood strategy,” Ke Wang, the Harvard Kennedy School doctoral student who first proposed this massive project, explains. It’s also a strategy that people don’t always use spontaneously on their own: It helps to be taught.

(The group has two other papers testing different psychological interventions, on how public health messaging in the pandemic can influence behavior. Of note: They’re testing whether “loss aversion,” an influential idea that suggests people respond more strongly when they think they have something to lose, encourages people to protect their health during a pandemic.)

Cognitive reappraisal works because “there’s a link between our thoughts and our feelings,” Kateri McRae, a University of Denver psychologist who studies emotion and who was not involved in this study, says. “A lot of times, our feelings are preceded by certain thoughts.” So when we shift our thoughts, that can precipitate a change in our emotions.

It can be a strategy to cope with a bout of anxiety or depression, or it can just be used to foster mental health resilience. “Individuals who report greater amounts of well-being and daily positive emotion report using reappraisal more frequently than people who report daily negative emotion,” McRae says — though she adds that “there is a little bit of a chicken-and-egg thing here.” What comes first: Do positive people reappraise, or do reappraisers become positive people? “But I certainly think that most people consider it to be something that might serve as a buffer.”

Once you get the hang of the technique, it’s easy to apply reappraisal thinking to many different situations. For instance, sometimes when I felt the excruciating boredom of the pandemic winter lockdown, I tried to reappraise the feeling of boredom as peacefulness, the absence of a bad thing. “I’m lucky to be bored,” I’d think. It would make the bitter pill go down more easily.

Emotion regulation passes a massive worldwide test

Wang and the hundreds of other authors wanted to see if they could teach thousands of people around the world similar coping strategies, to help deal with the stress of the pandemic.

They conducted a preregistered study — meaning a study where the methods and analysis plans are locked into place before data collection begins, to help ensure rigor — and tested two subtly different reappraisal methods, targeting negative emotions associated with living through the pandemic.

The first method is called “refocusing.” It might be better described as “looking on the bright side.”

Let’s say you’re feeling sad, staying home during a lockdown. You can refocus your thoughts to some of the more positive aspects of staying at home. Like: “Staying at home is not that bad,” as Wang explains. “You may find more time to spend with your family, or do things you may not have had time to do, such as cooking.”

Another is called “reconstruing.” This goes a little beyond just looking at the bright side of any particular burden, trying to find an overall less-negative narrative to tell ourselves about the pandemic. It’s less about finding the positive in our individual circumstances and more about looking at the big picture in a new light.

In reconstruing the burdens of the pandemic, for example, you could think: “In the past, people have overcome many challenges that seemed overwhelming at the time, and we will overcome Covid-19 related challenges too,” as the study text suggested to participants.

This isn’t about becoming a blinkered robot that’s only allowed to think positive thoughts. “In our intervention, we’re not forcing them to feel positive all the time,” Wang explains. “We’re teaching them to use it to regulate emotions.” It’s about intervening when thoughts become distressing.

It’s not about never acknowledging negative thoughts, either. “I think there’s a really delicate balance between acknowledging the reality, allowing people to sometimes sit with negativity, but also realizing that positive interpretations of things are possible,” McRae says.

In the study, participants were assigned to read about refocusing, reconstruing, or two control conditions. Participants took a survey before they learned the technique to assess their baseline emotional state. Afterward, they were measured again and asked to assess their feelings overall about the pandemic, and how they are responding to it.

Notably, both techniques fared equally well in decreasing people’s negative emotions, and the effects, the authors report, aren’t just statistically significant — they seemed to make a big practical difference for people.

The difference in feelings between those who learned reappraisals, compared to those who did not, was as big as the difference between people who had faced extreme hardships due to the pandemic, compared to those who had not. That’s a notable improvement. (Of course, the interventions are not “guaranteed” to work for any particular individual. The study reported changes on average.)

Also, the interventions didn’t seem to decrease willingness to engage in Covid-safe behaviors like masking. “Some people may worry that if you improve emotions, people may be less cautionary,” Wang says. “But we don’t find that in our study.”

Notably, too, the interventions — which were translated by a team of hundreds of people into 44 languages — broadly worked in every country tested, though there was some variability. The interventions were most effective in Brazil, Germany, and Hungary, and they were least effective in Russia, Romania, and Egypt. “So far, we haven’t found anything that can systematically explain what country can benefit more or less,” Wang says. (The researchers didn’t have representative samples in all the countries studied, so there could be a lot of reasons why they found the variation.)

A psychological finding you can trust

The narrower conclusion of this study, that cognitive reappraisal works, is not super surprising. “The finding that reappraisal decreases negative emotion and increases positive emotion is something that has been replicated over and over and over ad nauseam,” McRae says. “I couldn’t just get that finding published if I really wanted to, because it’s been so well-established.”

But there were aspects of the study that are new and significant. “I think this scale, scope, and timeliness to speak to the crisis we’re in right now were the most impressive parts about it,” she says.

There’s a burgeoning research movement in psychology dedicated to testing out single-session interventions, delivered either online or remotely. Mental health care is often inaccessible and expensive, so the more psychological interventions that can be unbundled from a whole suite of intensive therapy, the more good they can potentially do around the world. Many people whose distress doesn’t rise to the level of a mental health diagnosis could still benefit, the study suggests.

That said, there’s still more work to do here. Other researchers not involved in the project wish it had studied these participants over time, to see if the intervention had a lasting effect.

“A study this large would have provided a particularly informative test of whether a single-session universal intervention could exert lasting, more generalized effects,” says Jessica Schleider, a Stony Brook University psychologist who specializes in studying single-session psychological interventions. “I do think it’s scientifically valuable to know that reappraisal can provide in-the-moment support this broadly, and it can be recommended as one coping option to try for folks in distress.”

The authors of the paper acknowledge this limitation, and some others. The study had people view photos reminding them of Covid-19 stresses, which “might not represent local situations for different groups of participants,” the authors report. It also doesn’t represent all the myriad emotional triggers we encounter living during a pandemic. But most of all, they see this work as foundational for other questions.

The Psychological Science Accelerator, the group behind the massive undertaking of the paper, was launched in response to psychology’s “replication crisis.” Over the past decade, many famous psychological theories have collapsed under rigorous re-testing. As many as 50 percent of all psychology papers might not be replicable, though no one knows the true extent of the rot in the foundations of psychology. There have also been some high-profile cases of outright data fraud related to some of psychology’s most popular findings. The Accelerator, which operates on a shoestring budget (it reports that this study of tens of thousands of people cost only $17,000, much of which came from individual lab members), is seeking to rebuild the field on a firmer foundation.

It’s a “credibility crisis,” Patrick Forscher, a psychologist and member of the Accelerator who worked on the reappraisal paper, says. “Because there are more issues rather than just replicability. So my personal view is that you can look at a lot of psychological findings and just put a question mark on them — not that they’re definitely false. We know that some of the practices that were used to produce a lot of those findings are, themselves, not all that credible.”

The latest test of cognitive reappraisals puts the science of mental health interventions on a firmer foundation. Psychology encompasses a lot of flimsy ideas that claim to make your life better. Here’s one that seems to actually work.

Month: March 2022

We have to accept some risk of Covid-19

Why it’s so hard to be a nurse in America, according to two nurses

Astronomers were skeptical about dark matter — until Vera Rubin came along

Solar farms are often bad for biodiversity — but they don’t have to be

What we actually know about the vaccines and the delta variant

How a cheap antidepressant emerged as a promising Covid-19 treatment

What full FDA approval for Covid-19 vaccines really means

How to think about hurricane recovery, according to 3 experts

One of the worst public health dangers of the past century has finally been eradicated

What an enormous global study can tell us about feeling better during the pandemic