U.S. health officials on Tuesday authorized a plan to stretch the nation’s limited supply of monkeypox vaccine by giving people just one-fifth the usual dose, citing research suggesting the reduced amount is about as effective. 

The so-called dose-sparing approach also calls for administering the Jynneos vaccine with an injection just under the skin rather than into deeper tissue — a practice that may rev up the immune system better. Recipients would still get two shots spaced four weeks apart. 

The unusual step is a stark acknowledgment that the U.S. currently lacks the supplies needed to vaccinate everyone seeking protection from the rapidly spreading virus. 

That includes 1.6 million to 1.7 million Americans considered by federal officials to be at highest risk from the disease, primarily men with HIV or men who have a higher risk of contracting it. Vaccinating that group would require more than 3.2 million shots. 

White House officials said the new policy would immediately multiply the 440,000 currently available full doses into more than 2 million smaller doses. 

“It’s safe, it’s effective, and it will significantly scale the volume of vaccine doses available for communities across the country,” Robert Fenton, the White House’s monkeypox response coordinator, told reporters. 

The Biden administration declared monkeypox a public health emergency last week in an effort to slow the outbreak that has infected more than 8,900 Americans. 

The FDA authorized the approach for adults 18 and older who are at high risk of monkeypox infection. Younger people can also get the vaccine if they are deemed high risk, though they should receive the traditional injection, the agency said. 

FDA officials stressed that the second dose is critical to ensuring protection. 

“We feel pretty strongly that the two doses are necessary because, in part, we don’t have any evidence that three, six, eight months later people will be adequately protected by a single dose,” said Dr. Peter Marks, the FDA’s vaccine chief. 

Regulators pointed to a 2015 study showing that inoculation with one-fifth of the traditional two-dose vaccine generated a robust immune-system response comparable to that of the full dose. About 94% of people receiving the smaller dose had adequate levels of virus-fighting antibodies, compared with 98% of those receiving the full dose, according to the study funded by the National Institutes of Health. 

The NIH is planning an additional trial of the technique. And Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said her agency is starting to track real-world vaccine effectiveness in U.S. communities. 

But some experts and advocates worried that with little data to support the policy, it could backfire if it reduces vaccine effectiveness. 

“We have grave concerns about the limited amount of research that has been done on this dose and administration method, and we fear it will give people a false sense of confidence that they are protected,” said David Harvey of the National Coalition of STD Directors in a statement. 

The smaller doses require a different type of injection that penetrates only the top layer of skin, rather than the lower layer between the skin and muscle. That’s a less common technique that may require extra training for some health practitioners.  

“Intradermal administration is certainly something that has been used for other vaccines, including the smallpox vaccine, which was administered to hundreds of millions of people during the 20th century,” said Anne Rimoin, director of UCLA’s Center for Global and Immigrant Health. 

The shallower injection is thought to help stimulate the immune system because the skin contains numerous immunity cells that target outside invaders. 

Rationing vaccine doses is common in Africa and other parts of the world with limited health resources. In recent years the World Health Organization has endorsed the strategy to address outbreaks of yellow fever, polio and other diseases. 

Both the U.K. and Canada have adopted a single-dose vaccine strategy prioritizing people who face the highest risk from monkeypox. And health departments in several large U.S. cities adopted a similar strategy amid limited supplies, including New York, San Francisco and Washington. 

Officials said Tuesday that anyone who previously received a full first dose can get the smaller amount for their second dose. 

U.S. officials have shipped more than 625,000 full vaccine doses to state and local health departments.  

The Biden administration has come under fire for not quickly marshaling millions more doses from the strategic national stockpile.  

The FDA approved the Jynneos vaccine in 2019 to prevent smallpox and monkeypox based, in part, on studies in monkeys.  

Additional human studies showed people who received Jynneos had an immune response similar to those who received an older smallpox vaccine. But Jynneos hasn’t been tested in humans with either monkeypox or its relative smallpox, which was eradicated decades ago. 

 
…

The World Meteorological Organization or WMO reports the month of July was one of the three warmest on record globally. This, despite a weak La Nina event, which is supposed to have a cooling influence.

Meteorologists warn the heatwave that swept through large parts of Europe last month is set to continue in August. They note July was drier than average in much of Europe, badly affecting local economies and agriculture, as well as increasing the risk of wildfires.

WMO Spokeswoman Clare Nullis says Britain’s Met Office has issued another advisory warning of a heat buildup throughout this week. However, she says temperatures are not expected to reach the extreme, record-setting temperatures of more than 40 degrees Celsius seen in July.

“But it is well above average. Temperatures in France this week, well above average. In Switzerland, many parts of Switzerland well above average. And as I said, continuing the trend that we saw in July, Spain saw its hottest ever month in July. So, not just the hottest July but the hottest ever month on record.”

Nullis says Europe and other parts of the world will have to get used to and adapt to the kind of heatwaves WMO’s Secretary-General Petteri Taalas calls “the new normal.”

While Europe was sweltering under extreme heat in July, WMO reports Antarctic Sea ice reached its lowest July level on record. This follows a record low Sea ice level in June. While Europe saw a lot of heat in July, Nullis notes big chunks of the Antarctic did as well.

“It is important to bear in mind there is quite a big sort of monthly and year-to-year variability in Antarctica. So, the fact that it was the lowest on record in June and in July does not mean necessarily that this is a long-term irreversible trend.”

WMO reports the long-lasting drought in parts of Europe also is set to continue. It warns below-normal precipitation in many parts of Europe will cause or worsen drought conditions and likely trigger more forest fires.
…

Five southern African countries, with more than half the continent’s elephants, are conducting a first-ever aerial census to determine the elephant population and how to protect it. 

Light aircraft will fly simultaneously across the plains of Angola, Botswana, Namibia, Zambia and Zimbabwe — in a conservation area known as the Kavango-Zambezi Trans-frontier Conservation Area (KAZA) — in an exercise that will run until October 20.

KAZA is home to an estimated 220,000 elephants, and the five countries are keen to know the exact figures and the animals’ distribution patterns. 

More than 130,000 of the animals are found in Botswana, which has the world’s largest elephant population. 

Botswana’s National Parks and Wildlife director, Kabelo Senyatso, said the population count will be key in the management of the elephants. 

The data primarily will be used to guide decision-making by the five partner states, Senyatso said, including land-use planning, managing human-elephant conflict, hunting, and tourism.

Senyatso said the exercise is critical for a region with a high number of trans-boundary elephants. 

“It is important that as managers of the resource, we have a clear understanding of where they are and how they are distributed across the landscape,” Senyatso said. “It is an exciting project, the first of its kind. We expect the data on the patterns to be analyzed starting early 2023 such that by quarter one of 2023, we would already be having preliminary data that we can share with the public and for our decision-making.”      

KAZA’s executive director, Nyambe Nyambe, said the elephant count will determine a scientific approach to the management of the elephant populations.      

“It is highly anticipated that it will generate science-based information on the population distribution and other factors and is a reaffirmation of the KAZA partner states’ commitment to the joint pursuit of science-led conservation supported by accurate and reliable data,” Nyambe said. “The results from this survey will become the cornerstone for the long-term protection and management of Africa’s largest trans-boundary elephant population.”     

Botswana-based conservationist Map Ives said revealing the elephant migration patterns across the five countries’ borders is key. 

“We hope to see what the results come up with,” Ives said. “What we will be interested in seeing is not only how many elephants there are but the distribution, therefore, and what the likelihood of those elephants moving between countries is. We know that this population is one single contiguous population.”          

While elephant populations are increasing in the KAZA region, elsewhere on the African continent the numbers are decreasing due to loss of habitat and poaching. 

 
…

A new philanthropic project hopes to invest $100 million in 10 countries, mostly in Africa, by 2030 to support 200,000 community health workers, who serve as a critical bridge to treatment for people with limited access to medical care.

The Skoll Foundation and The Johnson & Johnson Foundation announced Monday that they donated a total of $25 million to the initiative. The Global Fund to Fight AIDS, TB and Malaria, which will oversee the project, matched the donations and hopes to raise an additional $50 million.

The investment seeks to empower the front-line workers that experts say are essential to battling outbreaks of COVID-19, Ebola and HIV.

“What have we found out in terms of community health workers?” said Francisca Mutapi, a professor at the University of Edinburgh, who helps lead a multiyear project to treat neglected tropical diseases in multiple African countries. “They are very popular. They are very effective. They are very cost effective.”

On a recent trip to Zimbabwe for research, Mutapi described how a community health worker negotiated the treatment of a parasitic infection in a young child who was part of a religious group that doesn’t accept clinical medicine.

“She’s going to the river, getting on with her day-to-day business, and she notices that one of the children in her community is complaining about a stomachache,” said Mutapi.

The woman approached the child’s grandmother for permission to bring the child to a clinic, which diagnosed and began treating the child for bilharzia. That would not have happened without the woman’s intervention, Mutapi said.

Ashley Fox, an associate professor specializing in global health policy at Albany, SUNY, said evidence shows community health workers can effectively deliver low-cost care “when they are properly equipped and trained and paid – that’s a big caveat.”

Though the current number of these workers is not well documented, in 2017, the Africa Centers for Disease Control and Prevention estimated that the continent required 2 million to meet health targets. Many of these workers are women and unpaid, though The Global Fund advocates for some sort of salary for them.

“It’s hard to think of a better set of people that you would want to be paying if you think about it from both the point of view of creating good jobs as well as maximizing the health impact,” said Peter Sands, the fund’s executive director.

The Global Fund, founded in 2002, channels international financing with the aim of eradicating treatable infectious diseases. In addition to its regular three-year grants to countries, it will deploy these new philanthropic donations through a catalytic fund to encourage spending on some of the best practices and program designs.

Last Mile Health, part of the Africa Frontline First health initiative, has worked with the Liberian government to expand and strengthen its community health program since 2016.

In the early months of the COVID-19 pandemic, former Liberian president and Noble Peace Prize recipient, Ellen Johnson Sirleaf, convened Last Mile Health and other organizations to grapple with a response.

“We were all kind of seeing the Deja vu moment of recalling back to a couple of years ago where Liberia was beset by this tragic epidemic of Ebola,” said Nan Chen, managing director of Last Mile Health. “And as President Sirleaf reminded us: the tide was turned when we turned to the community.”

Along with the other organizations that specialize in the financing, research and policy of public health, they set about designing an initiative to expand community health programs and to capitalize on the attention the pandemic brought to the need for disease surveillance.

The catalytic fund is the result. “I think the pandemic has shone a light on the critical role of these health workers,” said Lauren Moore, vice president of global community impact at Johnson & Johnson.

Don Gips, CEO of the Skoll Foundation, emphasized that these workers also can raise early warnings that benefit people everywhere.

“It’s critical not just for delivering health care in Africa, but this is how we’ll also catch the next set of diseases that could threaten populations around the world,” said Gips, who is also the former U.S. ambassador to South Africa. 

Last Mile Health won a major donation from the Skoll Foundation in 2017 and has also received large donations from the Audacious Project from TED and Co-Impact, another funding collective. The organization’s co-founder, Raj Panjabi, now serves in the Biden administration.

“What philanthropy has noticed about Last Mile Health is that we were not only taking direct action on the problem by actively managing community health worker programs, but that we were seeing our innovation adopted in national policy at scale,” said James Nardella, the organization’s chief program officer.

SUNY’s Fox and other experts say linking the work of community health care workers to the national health system is a priority, along with securing sustainable funding for their programs.

The Global Fund said it will assist countries with the design of proposed community health care worker expansions over the next year.

Chen acknowledged there is no silver bullet for the issue of sustainability.

“Part of the work that organizations like Last Mile Health have to do is to sit in that discomfort and wrestle with it, with our partners, with donors, until we incrementally squeeze out the solution here,” Chen said.

Mutapi said eventually governments must fund the programs themselves and she argued the experiences of places like Zimbabwe and Liberia with community health workers could benefit people in other contexts as well.

“Actually, having lived on Scottish islands, which are inaccessible,” she said, the innovation of community health workers is “something that actually can be exported to Western communities that are remote because that connection between a health provider and the local community is really important for compliance and for access.” 
…

Sold-out hotels. Excitement that seems to grow by the day. The potential for hundreds of thousands of visitors, support staff, and more.

These are just a few of the factors being calculated into preparations for Artemis I, the first launch of NASA’s moon-focused Space Launch System rocket slated for Aug. 29. Standing 322 feet tall, it promises to be the biggest, most powerful rocket to launch from the Space Coast in years – bringing with it a level of excitement to match.

All told, Space Coast officials are expecting at least 100,000 visitors for the rocket’s first window, which includes opportunities on Aug. 29, Sept. 2, and Sept. 5 (Labor Day). Currently, T-0 on Aug. 29 is set for 8:33 a.m. ET. Pad 39B will host.

The rocket is part of NASA’s Artemis program, which aims to put humans back on the moon sometime this decade. That starts with the uncrewed Artemis I mission and its plan to take an Orion capsule on a four-to-six-week journey to the moon and back. Artemis II will do the same with astronauts, then Artemis III will put two astronauts on the surface sometime after 2024.

Hotels and tourism

The Space Coast isn’t a stranger to launch day crowds. During the space shuttle era that ran through 2011, half a million or more visitors would sometimes flood the area, scooping up hotel rooms and packing local businesses.

Since then, crowds have been smaller, but still significant. Even during the height of the coronavirus pandemic, thousands still flocked to Brevard County to see launches.

Some of the recent SpaceX Crew Dragon launches, which take astronauts to the International Space Station from KSC, have drawn between 100,000 and 250,000 visitors, according to Peter Cranis, executive director of the Space Coast Office of Tourism. It wouldn’t be a stretch to expect more than 100,000 for Artemis I.

“I think the crewed launches and these Artemis launches are going to be of equal interest to people,” Cranis said. “I would expect certainly over 100,000, if not more, coming for that.”

As of June, Cranis said, Brevard County had 10,734 hotel rooms and 4,500 vacation rental units. Each unit can obviously accommodate more than one person, but those numbers likely won’t be impacted by spectators driving from Orlando, for example, to see the launch without staying overnight.

Speaking to the greater launch cadence, Cranis said Artemis also supports his office’s efforts at marketing the Space Coast. Both KSC and Cape Canaveral Space Force Station have hosted 32 launches this year, a pace not seen since the 1960s.

“Our marketing line is we’re the only beach that doubles as a launch pad and now that’s a message we can put out there because the frequency is so elevated,” he said. “Being known for that is something that makes us special among our peers who obviously have beaches to promote, but no space program.”

Just glancing at hotel room listings shows a rapidly dwindling supply among those that haven’t been sold out.

The space-themed Courtyard by Marriott Titusville – Kennedy Space Center is one of the area’s newest hotels. Completed this year and opened to the public in April, it boasts views of KSC and Cape Canaveral Space Force Station pads and even has a rooftop “Space Bar” specifically for launch viewing.

All the Courtyard’s rooms, along with the Space Bar, are sold out for Artemis I.

“We’ve had more and more people discover the hotel since it opened in April, with steadily increasing room bookings and patronage of The Space Bar on the roof,” said Glen White, director of corporate communications for Delaware North. The company franchised the Courtyard hotel brand and paid for the project.

“We also anticipate having people book rooms and visit the Space Bar to feel the excitement of seeing Artemis on the launch pad in the days leading up to launch,” White said.

Delaware North’s main Space Coast operation is the Kennedy Space Center Visitor Complex, which is expecting to sell out its Artemis day offerings.

“We are expecting capacity crowds at Kennedy Space Center Visitor Complex for the upcoming Artemis launch,” said Therrin Protze, the visitor complex’s chief operating officer. “(The visitor complex) will offer special Artemis launch viewing packages that will include some of the closest public viewing opportunities with distinctive experiences like live commentary from space experts and access to select exhibits and attractions.”

Artemis I’s launch ties in with the complex’s recently opened “Gateway: The Deep Space Launch Complex” exhibit, which focuses on the future of spaceflight. Inside the new exhibit is a scale model of the SLS rocket, a flown Orion capsule similar to the one on Artemis I, and other items like a ceiling-mounted SpaceX Falcon Heavy booster.

The visitor complex’s tickets for Artemis I viewing will go on sale 11 a.m. Tuesday, Aug. 2, at the Kennedy Space Center website.

Kennedy Space Center and media

Crowds gathering to see the launch as spectators aren’t the only visitors expected on the Space Coast. Hundreds of media members from around the world have signed up to cover the liftoff, too.

KSC’s public affairs team confirmed at least 700 media have signed up so far, a figure that dwarfs typical launches and is closer to crowds seen during the space shuttle program. Heather Scott, a spokesperson for the Space Force’s Space Launch Delta 45, said the military branch will also be pitching in to help manage media.

“The growing sense of energy and excitement that has been steadily building around Kennedy and among our workforce in the last year is tangible,” said Mike Bolger, director of KSC’s Exploration Ground Systems. “A sense of anticipation is growing daily as we close in on launching this amazing rocket and spacecraft.”

From an employee perspective, launch day car passes that can be used to bring personal vehicles – and family and friends, in most cases – are highly sought after.

And it’s not just about launch day viewing: employees not directly working on Artemis have been handling non-critical items for those who are, even going as far as buying their lunch to help free up time.

“Our teams are laser-focused on walking SLS and Orion through the final steps before its maiden flight around the moon, but the excitement across the center is palpable,” KSC Director Janet Petro said. “You can see it in peoples’ faces, you can hear it in their voices, and when we all stand together with our eyes to the sky on launch day, I don’t think there will be a feeling in the world like it.”
…

Stem cell scientists say they have created “synthetic embryos” without using sperm, eggs or fertilization for the first time, but the prospect of using such a technique to grow human organs for transplantation remains distant.

The breakthrough was hailed as a major step forward, though some experts said the result could not fully be considered to be embryos and warned of future ethical considerations.

In research published in the journal Cell this week, scientists at the Weizmann Institute of Science in Israel said found a way to have mouse stem cells self-assemble into embryo-like structures in the lab.

They started by collecting cells from the skin of mice, then made them return to the state of stem cells.

The stem cells were then placed in a special incubator designed by the researchers, which continuously moved to mimic a mother’s womb.

The vast majority of the cells failed to form anything.

But 50 — 0.5 percent of the 10,000 total — collected themselves into spheres, then embryo-like structures, the researchers said.

After eight days — around a third of the 20-day mouse gestation period — there were early signs of a brain and a beating heart, they added.

They were described as 95% similar to normal mouse embryos.

‘Time will tell’

If human organs could one day be grown in a lab, the technique could provide life-saving transplants for thousands of people every year.

Stem cell scientist Jacob Hanna, who led the research, told AFP, “The big problem for transplantation is that you need to find a matching donor and the DNA is never identical to the patient.”

But using the new technique, one day scientists could take cells from a patient’s liver, for example, use them to make stem cells, grow a synthetic embryo then “transplant them back into the patient,” Hanna said.

“The cell will be made from the patient, so it will be the exact DNA — no need to find donors and there can be no rejection,” he added.

While they were the most advanced synthetic embryo-like structures ever grown, some scientists not involved in the research warned against calling them “embryos.”

“These are not embryos,” French stem cell scientist Laurent David told AFP.

He preferred to call them embryoids, the name for a group of cells that resemble an embryo.

However, David welcomed the “very convincing” research, which he said could allow further experiments to understand exactly how organs form.

Beyond organs, Hanna said the embryoids could also help identify new targets for drugs and potentially help find solutions for a range of issues such as pregnancy loss, infertility, endometriosis and preeclampsia.

“Time will tell,” he said.

Hanna, a Palestinian who led the research at the institute in Israel, said, “Science is my escape from the harsh reality I face while living in my homeland.”

“And I am one of the very ‘lucky’ ones,” he added.

The first author of the Cell study is a PhD student from the Palestinian enclave of Gaza, who needs a special permit regularly renewed to allow him to work at the institute in the Israeli city of Rehovot, Hanna said.

Ethical implications

Hanna has founded a company, Renewal Bio, that he said “will be focusing on testing potential clinical applications of human synthetic embryoids.”

He said they had ethical approval for such testing in Israel and it was legal in many other countries such as the U.S. and U.K.

“We should remember that synthetic embryos are embryoids and not real embryos and do not have the potential to become viable,” he said.

But researchers not involved in the study said it was very early to consider using such a technique for humans.

Alfonso Martinez Arias of Spain’s Pompeu Fabra University said the breakthrough “opens the door to similar studies with human cells, though there are many regulatory hoops to get through first and, from the point of view of the experiments, human systems lag behind mouse systems.”

And aiming to get similar results from human cells is likely to open an ethical can of worms.

“Although the prospect of synthetic human embryos is still distant, it will be crucial to engage in wider discussions about the legal and ethical implications of such research,” James Briscoe of Britain’s Francis Crick Institute said.
…

Early Europeans drank milk for thousands of years before they evolved the ability to fully digest it as adults, scientists say.

New results published in the journal Nature suggest that being able to digest the lactose in milk wasn’t usually much of an advantage for ancient people in Europe. Instead, the new study suggests that famine and disease made lactose intolerance deadly.

The new discovery challenges the long-standing assumption that dairy farming spread through ancient populations alongside the genetic quirks that prevent adults from losing the ability to digest lactose.

Like other young mammals, human children produce an enzyme called lactase that breaks down lactose. The gene for lactase usually turns off in adulthood because aside from humans, adult mammals don’t drink milk.

Without lactase, lactose from milk ends up feeding gut microbes that produce gas, which can cause uncomfortable digestive problems.

“You’ll get some cramps. You’ll get some diarrhea. Might fart a bit more. It might be unpleasant for you,” said geneticist Mark Thomas of University College London, who led the genetics work for the new study. “It might be embarrassing, but you’re not going to die.”

But when our ancient ancestors suffered through plagues or famines, getting diarrhea from drinking milk was probably more than just uncomfortable, the authors suggest.

“Then we’re talking about a life-threatening condition,” Thomas said.

About one-third of people alive today have a genetic variant that keeps their lactase gene from turning off. This trait has evolved independently multiple times in the ancestors of people now living in parts of Africa, the Middle East, South Asia and Europe.

Scientists long assumed that lactase persistence evolved alongside the spread of dairy farming, which happened over a few thousand years beginning around 7000 BC.

However, earlier studies revealed that lactase persistence was vanishingly rare in Europe until about 3,000 years ago. But after that, it took only a few thousand years for the trait to become widespread — the blink of an eye in evolutionary time.

Why this trait would evolve so quickly was a mystery.

“Lactase persistence has been under enormous amounts of natural selection over the last eight to ten thousand years … more than any other part of the genome in Europeans,” said Thomas. “It was, for a very long period of time, the one trait upon which life and death pivoted more than any other. … It’s insane. It just defies explanation.”

Searching for an explanation, the authors sought to reconstruct the history of milk use in the region over the past 9,000 years. They examined fat residues left on more than 7,000 pottery shards collected at 550 archaeological sites across Europe.

“When people were cooking … fat liquefies and then penetrates into the pores of the pottery,” said organic geochemist and study co-author Mélanie Roffet-Salque of the University of Bristol. “It’s quite stunning, really. But thousands of years later when archaeologists excavate a piece of pottery that had been discarded and then we analyze the pottery, it’s still there.”

The pottery shards showed that milk consumption was widespread across most of Europe for thousands of years before most Europeans became lactose tolerant.

Studying health data on modern Britons, the researchers didn’t find any evidence that drinking milk hurts the health of modern adults who don’t produce lactase.

Surprisingly, using data on ancient population fluctuations to approximate when and where ancient Europeans dealt with famine and disease, the researchers found that sickness and hunger might explain the evolution of lactase persistence better than milk consumption.

Famine could have forced ancient people to drink more milk than usual as other food sources ran out. And both malnutrition and disease could have made lactose-induced diarrhea very dangerous. Severe diarrhea can kill — it is still the second leading cause of death for children under 5 worldwide.

Shevan Wilkin, a biomolecular archaeologist at the University of Zurich who reviewed the new paper, said the research was an important step forward but that she’s not necessarily convinced that famine and disease alone can explain the evolution of lactase persistence.

“The reason I don’t know if I think they’re right, I also don’t know if I think they’re wrong, is before 2,000 years ago, there were absolutely times of famine,” Wilkin said.

Thomas said he’d like to see similar studies done in Africa, where lactase persistence evolved independently three different times. Wilkin agreed, noting that Europe is over-studied, and that future research should focus on other regions, including central Asia, where people drink lots of milk despite lacking a genetic variant that keeps lactase from turning off in adults.

“I think it’d be really interesting to apply this [in] multiple places,” said Wilkin. “It’s just such a cool and ambitious undertaking, and I think it’s really going to spur a ton of new studies.”
…

As a sex worker and adult film actor, Roc was relieved when he was among the first Spaniards to get a monkeypox vaccine. He knew of several cases among men who have sex with men, which is the leading demographic for the disease, and feared he could be next. 

“I went home and thought, ‘Phew, my God, I’m saved,’ ” the 29-year-old told The Associated Press. 

But it was already too late. Roc, the name he uses for work, had been infected by a client a few days before. He joined Spain’s steadily increasing count of monkeypox infections that has become the highest in Europe since the disease spread beyond Africa, where it has been endemic for years. 

He began showing symptoms: pustules, fever, conjunctivitis and tiredness. Roc was hospitalized for treatment before getting well enough to be released. 

Spanish health authorities and community groups are struggling to check an outbreak that has killed two young men. They reportedly died of encephalitis, or swelling of the brain, that can be caused by some viruses. Most monkeypox cases cause only mild symptoms. 

Spain has confirmed 4,942 cases in the three months since the start of the outbreak, which has been linked to two raves in Europe, where experts say the virus was likely spread through sex. 

The only country with more infections than Spain is the much larger United States, which has reported 7,100 cases. 

Global count

In all, the global monkeypox outbreak has seen more than 26,000 cases in nearly 90 countries since May. There have been 103 suspected deaths in Africa, mostly in Nigeria and Congo, where a more lethal form of monkeypox is spreading than in the West. 

Health experts stress that this is not technically a sexually transmitted disease, even though it has been mainly spreading via sex among gay and bisexual men, who account for 98% of cases beyond Africa. The virus can be spread to anyone who has close, physical contact with an infected person, their clothing or bed sheets. 

Part of the complexity of fighting monkeypox is striking a balance between not stigmatizing men who have sex with men, while also ensuring that both vaccines and pleas for greater caution reach those currently in the greatest danger. 

Spain has distributed 5,000 shots of the two-shot vaccine to health clinics and expects to receive 7,000 more from the European Union in the coming days, its health ministry said. The EU has bought 160,000 doses and is donating them to member states based on need. The bloc is expecting another 70,000 shots to be available next week. 

To ensure that those shots get administered wisely, community groups and sexual health associations are targeting gay men, bisexuals and transgender women. 

In Barcelona, BCN Checkpoint, which focuses on AIDS/HIV prevention in gay and trans communities, is now contacting at-risk people to offer them one of the precious vaccines. 

Pep Coll, medical director of BCN Checkpoint, said the vaccine rollout is focused on people who are already at risk of contracting HIV and are on preemptive treatment, men with a high number of sexual partners and those who participate in sex with the use of drugs, as well as people with suppressed immune responses. 

But there are many more people who fit those categories than doses, about 15,000 people just in Barcelona, Coll said. 

The lack of vaccines, which is far more severe in Africa than in Europe and the U.S., makes social public health policies key, experts say. 

Contact tracing more difficult

As with the coronavirus pandemic, contact tracing to identify people who could have been infected is critical. But, while COVID-19 could spread to anyone simply through the air, the close bodily contact that serves as the leading vehicle for monkeypox makes some people hesitant to share information. 

“We are having a steady stream of new cases, and it is possible that we will have more deaths. Why? Because contact tracing is very complicated because it can be a very sensitive issue for someone to identify their sexual partners,” said Amós García, epidemiologist and president of the Spanish Association of Vaccinology. 

Spain says that 80% of its cases are among men who have sex with men and only 1.5% are women. But García insisted that will change unless the entire public, regardless of gender or sexual orientation, grasps that having various sexual partners creates greater risk. 

Given the dearth of vaccines and the trouble with contact tracing, more pressure is being put on encouraging prevention. 

From the start, government officials ceded the leading role in the get-out-the-word campaign to community groups. 

Sebastian Meyer, president of the STOP SIDA association dedicated to AIDS/HIV care in Barcelona’s LGBTQ community, said the logic was that his group and others like it would be trusted message-bearers with person-by-person knowledge of how to drive the health warning home. 

Community associations that represent gay and bisexual men have bombarded social media, websites and blogs with information on monkeypox safety. Officials in Catalonia, the region including Barcelona that has over 1,500 cases, are pushing public service announcements on dating apps Tinder and Grindr warning about the disease. 

But Meyer believes fatigue from the COVID-19 pandemic has played a part. Doctors advise people with monkeypox lesions to isolate until they have fully healed, which can take up to three weeks. 

“When people read that they must self-isolate, they close the webpage and forget what they have read,” Meyer said. “We are just coming out of COVID, when you couldn’t do this or that, and now, here we go again. … People just hate it and put their heads in the sand.”
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Scientists say that climate change is increasing the likelihood of lightning strikes across the United States, after lightning struck at a square near the White House, leaving three people dead and one more in critical condition. 

The hot, humid conditions in the U.S. capital on Thursday were primed for electricity. Air temperatures topped out at 34 degrees Celsius, 3 C higher than the 30-year normal maximum temperature for August 4, according to the National Weather Service. 

More heat can draw more moisture into the atmosphere, while also encouraging rapid updraft, two key factors for charged particles that lead to lightning. A key study released in 2014 in the journal Science warned that the number of lightning strikes could increase by 50% in this century in the United States, with each 1 C of warming translating into a 12% rise in the number of lightning strikes. 

Fast-warming Alaska has seen a 17% rise in lightning activity since the cooler 1980s. And in typically dry California, a siege of 14,000 lightning strikes during August 2020 sparked some of the state’s biggest wildfires on record. 

Beyond the United States, there is evidence that lightning strikes are also shooting up in India and Brazil. 

Bolts rarely hit people

But even as lightning strikes increase, being hit by one is still extremely rare in the United States, experts say. Roughly 40 million lightning bolts touch down in the country every year, according to the U.S. Centers for Disease Control and Prevention, with the odds of being struck at less than 1 in a million. 

Among those who are hit, about 90% survive the ordeal, the CDC says. The country counted 444 deaths from lightning strikes from 2006 through 2021. 

The two men and two women struck by lightning on Thursday while visiting Washington’s Lafayette Square, just north of the White House, were not so lucky when a bolt hit the ground during a violent afternoon thunderstorm. 

The lightning hit near a tree that stands meters from the fence that surrounds the presidential residence and offices across from the square, which is often crowded with visitors, especially in the summer months. 

All four victims suffered life-threatening injuries and were taken to area hospitals. Two later died: James Mueller, 76, and Donna Mueller, 75, from Janesville, Wisconsin, the Metropolitan Police Department said. 

“We are saddened by the tragic loss of life,” the White House said in a statement on Friday. “Our hearts are with the families who lost loved ones, and we are praying for those still fighting for their lives.” 

Later Friday a third victim, a 29-year-old male, was pronounced dead, the Metropolitan Police Department said. Further details on the victim were being withheld until the person’s family could be notified. 

Because heat and moisture are often needed to make lightning, most strikes happen in the summer. In the United States, the populous, subtropical state of Florida sees the most people killed by lightning. 
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One in eight people who get coronavirus develop at least one symptom of long COVID, one of the most comprehensive studies on the condition to date suggested on Thursday. 

With more than half a billion coronavirus cases recorded worldwide since the start of the pandemic, there has been rising concern about the lasting symptoms seen in people with long COVID. 

However, almost none of the existing research has compared long COVID sufferers with people who have never been infected, making it possible that some of the health problems were not caused by the virus. 

A new study published in The Lancet journal asked more than 76,400 adults in the Netherlands to fill out an online questionnaire on 23 common long COVID symptoms. 

From March 2020 to August 2021, each participant filled out the questionnaire 24 times.  

During that period, more than 4,200 of them, 5.5%, reported catching COVID. 

Of those with COVID, more than 21% had at least one new or severely increased symptom three to five months after becoming infected. 

However nearly 9% of the control group, which did not have COVID, reported a similar increase in some symptoms. 

This suggested that 12.7% of those who had COVID — around 1 in 8 — suffered from long-term symptoms, the study said.  

The research also recorded symptoms before and after COVID infection, allowing the researchers to further pinpoint exactly what was related to the virus. 

It found that common long COVID symptoms include chest pain, breathing difficulties, muscle pain, loss of taste and smell, and general fatigue.

‘Major advance’

One of the study’s authors, Aranka Ballering of the Dutch University of Groningen, said long COVID was “an urgent problem with a mounting human toll.” 

“By looking at symptoms in an uninfected control group and in individuals both before and after SARS-CoV-2 infection, we were able to account for symptoms which may have been a result of non-infectious disease health aspects of the pandemic, such as stress caused by restrictions and uncertainty,” she said. 

The authors of the study said its limitations included that it did not cover later variants, such as delta or omicron, and did not collect information about some symptoms such as brain fog, which have since been considered a common sign of long COVID. 

Another study author, Judith Rosmalen, said “future research should include mental health symptoms” such as depression and anxiety, as well as aspects like brain fog, insomnia and a feeling of malaise after even minor exertion. 

Christopher Brightling and Rachael Evans, experts from Britain’s Leicester University who were not involved in the study, said it was “a major advance” on previous long COVID research because it had an uninfected control group. 

“Encouragingly, emerging data from other studies” suggest there is a lower rate of long COVID in people who have been vaccinated or infected with the omicron variant, they said in a linked Lancet comment. 
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The United States has declared monkeypox a public health emergency, the health secretary said Thursday, a move expected to free up additional funding and tools to fight the disease. 

The declaration came as the tally of cases crossed 6,600 in the United States on Wednesday, almost all of them among men who have sex with men. 

“We’re prepared to take our response to the next level in addressing this virus, and we urge every American to take monkeypox seriously,” Health and Human Services Secretary Xavier Becerra said at a briefing. 

The declaration will also help improve the availability of monkeypox data, U.S. Centers for Disease Control and Prevention Director Rochelle Walensky said, speaking alongside Becerra. 

The World Health Organization also has designated monkeypox a “public health emergency of international concern,” its highest alert level. The WHO declaration last month was designed to trigger a coordinated international response and could unlock funding to collaborate on vaccines and treatments. 

Biden earlier this month appointed two top federal officials to coordinate his administration’s response to monkeypox, following declarations of emergencies by California, Illinois and New York. 

First identified in monkeys in 1958, the disease has mild symptoms including fever, aches and pus-filled skin lesions, and people tend to recover from it within two to four weeks, according to the WHO. It spreads through close physical contact and is rarely fatal. 

Anthony Fauci, Biden’s chief medical adviser, told Reuters on Thursday that it was critical to engage leaders from the gay community as part of efforts to rein in the outbreak, but cautioned against stigmatizing the disease and its victims. 

“Engagement of the community has always proven to be successful,” Fauci said. 

Unlike when COVID-19 emerged, there are vaccines and treatments available for monkeypox, which was first documented in Africa in the 1970s. 

The U.S. government had distributed 156,000 monkeypox vaccine doses nationwide through mid-July. It has ordered an additional 2.5 million doses of Bavarian Nordic’s vaccine. 

The first U.S. case of monkeypox was confirmed in Massachusetts in May, followed by another case in California five days later. 
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NASA discusses its upcoming test flight to the moon. Plus, another look deep into the history of our universe, and we remember a beloved fictional pioneer in spaceflight. VOA’s Arash Arabasadi brings us “The Week in Space.”
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