Month: March 2023

Pandemic 3 Years Later: Has COVID-19 Won?

WPScienLeave a comment

On the third anniversary of the COVID-19 pandemic, the virus is still spreading, and the death toll is nearing 7 million worldwide. Yet most people have resumed their normal lives, thanks to a wall of immunity built from infections and vaccines.

The virus appears here to stay, along with the threat of a more dangerous version sweeping the planet.

“New variants emerging anywhere threaten us everywhere,” said virus researcher Thomas Friedrich of the University of Wisconsin-Madison. “Maybe that will help people to understand how connected we are.”

Saturday marks three years since the World Health Organization first called the outbreak a pandemic, March 11, 2020, and the United Nation’s health organization says it’s not yet ready to say the emergency has ended.

The virus endures

With the pandemic still killing 900 to 1,000 people a day worldwide, the stealthy virus behind COVID-19 hasn’t lost its punch. It spreads easily from person to person, riding respiratory droplets in the air, killing some victims but leaving most to bounce back without much harm.

“Whatever the virus is doing today, it’s still working on finding another winning path,” said Dr. Eric Topol, head of Scripps Research Translational Institute in California.

We’ve become numb to the daily death toll, Topol says, but we should view it as too high. Consider that in the United States, daily hospitalizations and deaths, while lower than at the worst peaks, have not yet dropped to the low levels reached during summer 2021 before the delta variant wave.

At any moment, the virus could change to become more transmissible, more able to sidestep the immune system or more deadly. Topol said we’re not ready for that. Trust has eroded in public health agencies, furthering an exodus of public health workers. Resistance to stay-at-home orders and vaccine mandates may be the pandemic’s legacy.

Fighting back

There’s another way to look at it. Humans unlocked the virus’ genetic code and rapidly developed vaccines that work remarkably well. We built mathematical models to get ready for worst-case scenarios. We continue to monitor how the virus is changing by looking for it in wastewater.

“The pandemic really catalyzed some amazing science,” said Friedrich.

The achievements add up to a new normal where COVID-19 “doesn’t need to be at the forefront of people’s minds,” said Natalie Dean, an assistant professor of biostatistics at Emory University. “That, at least, is a victory.”

Dr. Stuart Campbell Ray, an infectious disease expert at Johns Hopkins, said the current omicron variants have about 100 genetic differences from the original coronavirus strain. That means about 1% of the virus’ genome is different from its starting point. Many of those changes have made it more contagious, but the worst is likely over because of population immunity.

Matthew Binnicker, an expert in viral infections at the Mayo Clinic in Rochester, Minnesota, said the world is in “a very different situation today than we were three years ago — where there was, in essence, zero existing immunity to the original virus.”

That extreme vulnerability forced measures aimed at “flattening the curve.” Businesses and schools closed, weddings and funerals were postponed. Masks and “social distancing” later gave way to showing proof of vaccination. Now, such precautions are rare.

“We’re not likely to go back to where we were because there’s so much of the virus that our immune systems can recognize,” Ray said. Our immunity should protect us “from the worst of what we saw before.”

Real-time data lacking

On Friday, Johns Hopkins did its final update to its free coronavirus dashboard and hot-spot map with the death count standing at more than 6.8 million worldwide. Its government sources for real-time tallies had drastically declined. In the U.S., only New York, Arkansas and Puerto Rico still publish case and death counts daily.

“We rely so heavily on public data and it’s just not there,” said Beth Blauer, data lead for the project.

The U.S. Centers for Disease Control and Prevention still collects a variety of information from states, hospitals and testing labs, including cases, hospitalizations, deaths and what strains of the coronavirus are being detected. But for many counts, there’s less data available now and it’s been less timely.

“People have expected to receive data from us that we will no longer be able to produce,” said the CDC’s director, Dr. Rochelle Walensky.

Internationally, the WHO’s tracking of COVID-19 relies on individual countries reporting. Global health officials have been voicing concern that their numbers severely underestimate what’s actually happening and they do not have a true picture of the outbreak.

For more than year, CDC has been moving away from case counts and testing results, partly because of the rise in home tests that aren’t reported. The agency focuses on hospitalizations, which are still reported daily, although that may change. Death reporting continues, though it has become less reliant on daily reports and more on death certificates — which can take days or weeks to come in.

Then and now

“I wish we could go back to before COVID,” said Kelly Forrester, 52, of Shakopee, Minnesota, who lost her father to the disease in May 2020, survived her own bout in December and blames misinformation for ruining a longtime friendship. “I hate it. I actually hate it.”

The disease feels random to her. “You don’t know who will survive, who will have long COVID or a mild cold. And then other people, they’ll end up in the hospital dying.”

Forrester’s father, 80-year-old Virgil Michlitsch, a retired meat packer, deliveryman and elementary school custodian, died in a nursing home with his wife, daughters and granddaughters keeping vigil outside the building in lawn chairs.

Not being at his bedside “was the hardest thing,” Forrester said.
…

US Lifts COVID Test Requirement for Chinese Travelers

WPScienLeave a comment

A requirement that travelers to the U.S. from China present a negative COVID-19 test before boarding their flights expired Friday after more than two months as cases in China have fallen.

The restrictions were put in place December 28 and took effect January 5 amid a surge in infections in China after the nation sharply eased pandemic restrictions and as U.S. health officials expressed concerns that their Chinese counterparts were not being truthful to the world about the true number of infections and deaths. The requirement from the U.S. Centers for Disease Control and Prevention expired for flights leaving after 3 p.m. Eastern time Friday.

When the restriction was imposed, U.S. officials also said it was necessary to protect U.S. citizens and communities because there was a lack of transparency from the Chinese government about the size of the surge or the variants that were circulating within China.

The rules imposed in January require travelers to the U.S. from China, Hong Kong and Macau to take a COVID-19 test no more than two days before travel and provide a negative test before boarding their flight. The testing applies to anyone 2 years and older, including U.S. citizens.

China saw infections and deaths surge after it eased back from its “zero COVID” strategy in early December after rare public protests of the policy that confined millions of people to their homes and sparked demands for President Xi Jinping to resign.

But as China eased its strict rules, infections and deaths surged, and parts of the country for weeks saw their hospitals overwhelmed by infected patients looking for help. Still, the Chinese government has been slow to release data on the number of deaths and infections.

The U.S. decision to lift restrictions comes at a moment when U.S.-China relations are strained. U.S. President Joe Biden ordered a Chinese spy balloon shot down last month after it traversed the continental United States. The Biden administration has also publicized U.S. intelligence findings that raise concern Beijing is considering providing Russia weaponry for its ongoing war on Ukraine.
…

California Bank is Seized by US in 2nd-Largest Failure of a US Bank

WPbizLeave a comment

The United States rushed to seize the assets of Silicon Valley Bank on Friday after it experienced a run on the bank.

Silicon Valley, the nation’s 16th-largest bank, failed after depositors — mostly technology workers and venture capital-backed companies — hurried to withdraw money this week as anxiety over the bank’s balance sheet spread. It is the second biggest bank failure in U.S. history, behind Washington Mutual during the height of the financial crisis more than a decade ago.

Silicon Valley was heavily exposed to the tech industry and there is little chance of contagion in the banking sector similar to the chaos in the months leading up to the Great Recession more than a decade ago. The biggest banks — those most likely to cause a systemic economic issue — have healthy balance sheets and plenty of capital.

In 2007, the biggest financial crisis since the Great Depression rippled across the globe after mortgage-backed securities tied to ill-advised housing loans rippled from the United States to Asia and Europe. The panic on Wall Street led to the collapse of the storied Lehman Brothers, founded in 1847. Because major banks had extensive exposure to one another, it led to cascading disruption throughout the global financial system, putting millions out of work.

There has been unease in the banking sector all week and the collapse of Silicon Valley pushed shares of almost all financial institutions lower Friday, shares that had already tumbled by double digits since Monday.

Silicon Valley Bank’s failure arrived with incredible speed, with some industry analysts on Friday suggesting it was a good company and still likely a wise investment. Silicon Valley Bank executives were trying to raise capital early Friday and find additional investors. However, trading in the bank’s shares was halted before the opening bell on Wall Street because of extreme volatility.

Shortly before noon eastern, the Federal Deposit Insurance Corporation moved to shutter the bank. Notably, the FDIC did not wait until the close of business to seize the bank, as is typical in an orderly wind down of a financial institution. The FDIC could not immediately find a buyer for the bank’s assets, signaling how fast depositors had cashed out. The bank’s remaining uninsured deposits will now be locked up in receivership.

The bank had $209 billion in total assets at the time of failure, the FDIC said. It was unclear how much of its deposits were above the $250,000 insurance limit at the moment, but previous regulatory reports showed that much of Silicon Valley Bank’s deposits exceeded that limit.

The FDIC said Friday that deposits below the $250,000 limit would be available Monday morning.

Silicon Valley Bank appeared stable this year, but on Thursday it announced plans to raise up to $1.75 billion to strengthen its capital position. That sent investors scurrying and shares plunged 60%. They fell further on Friday before the opening of the Nasdaq, where it is traded.

As its name implied, Silicon Valley Bank was a major financial conduit between the technology sector, its founders and startups as well as its workers. Hundreds of companies held their operating capital with the bank, and it was seen as good business sense to develop a relationship with Silicon Valley Bank if a founder wanted to find new investors or go public.

“We saw building a relationship with Silicon Valley Bank as a logical step, given their reach,” said Ashley Tyrner, CEO of FarmboxRx, a company that delivers food as medicine to Medicaid and Medicare recipients. While Tyrner has money in other banks and can make payroll, she said a good portion of her business’ profits are now locked up with the bank.

Silicon Valley’s connections to the tech sector became a liability rapidly. Technology stocks have been hit hard in the past 18 months after a growth surge during the pandemic and layoffs have spread throughout the industry.

At the same time, the bank was hit hard by the Federal Reserve’s fight against inflation and an aggressive series of interest rate hikes to cool the economy.

As the Fed raises its benchmark interest rate, the value of bonds, typically a stable asset, start to fall. That is not typically a problem as the declines lead to “unrealized losses,” or losses that are not counted against them when calculating the capital cushion than banks can use should there be a downturn in the future.

However, when depositors grow anxious and begin withdrawing their money, banks sometimes have to sell those bonds before they mature to cover that exodus.

That is exactly what happened to Silicon Valley Bank, which had to sell $21 billion in highly liquid assets to cover the exodus of deposits. It took a $1.8 billion loss on that sale.

Tyrner said she’s spoken to several friends who are backed by venture capital. She described those friends as being “beside themselves” over the bank’s failure. Tyrner’s chief operating officer tried to withdraw her company’s funds on Thursday but failed to do so in time.

“One friend said they couldn’t make payroll today and cried when they had to inform 200 employees because of this issue,” Tyrner said.
…

Another US Hiring Surge: 311,000 Jobs Despite Fed Rate Hikes

WPbizLeave a comment

America’s employers added a substantial 311,000 jobs in February, fewer than January’s huge gain but enough to keep pressure on the Federal Reserve to raise interest rates aggressively to fight inflation.

The unemployment rate rose to 3.6%, from a 53-year low of 3.4%, as more Americans began searching for work but not all of them found jobs.

Friday’s report from the government made clear that the nation’s job market remains fundamentally healthy, with many employers still eager to hire. Fed Chair Jerome Powell told Congress this week that the Fed would likely ratchet up its rate hikes if signs continued to point to a robust economy and persistently high inflation. A strong job market typically leads businesses to raise pay and then pass their higher labor costs on to customers through higher prices.

February’s sizable job growth shows that so far, hiring is continuing to strengthen this year after having eased in late 2022. From October through December, the average monthly job gain was 284,000. That average has surged to 351,000 for the past three months.

Economists pointed to other data in Friday’s report that suggested that the job market, while still hot, may be better balancing employers’ need for workers and the supply of unemployed people. More people have been coming off the sidelines to seek work, a trend that makes it easier for businesses to fill the millions of jobs that remain open.

The proportion of Americans who either have a job or are looking for one has risen for three straight months to 62.5%, the highest level since COVID struck three years ago. Still, it remains below its pre-pandemic level of 63.3%.

With more potential hires to choose from, employers seem under less pressure now to dangle higher pay to attract or retain workers. Average wage growth slowed in February, rising just 0.2%, to $33.09, the smallest monthly increase in a year. Measured year over year, though, hourly pay is up 4.6%, well above the pre-pandemic trend. Even so, that’s down from average annual gains above 5% last year.

What the Fed may decide to do about interest rates when it meets later this month remains uncertain. The Fed’s decision will rest, in part, on its assessment of Friday’s jobs data and next week’s report on consumer inflation in February. Last month, the government’s report on January inflation had raised alarms by showing that consumer prices had reaccelerated on a month-to-month basis.

Ahead of the February jobs data, many economists had said they thought the Fed would announce a substantial half-point increase in its key short-term interest rate, rather than a quarter point hike as it did at its meeting in February. Friday’s more moderate hiring and wage figures, though, led some analysts to suggest that the central bank may not need to move so aggressively at this month’s meeting.

“There’s clear signs of cooling when you dig deeper into the numbers,” said Mike Skordeles, head of economics at Truist, a bank. “I think it makes the case for the Fed to say … we’ll still hike rates, but we’re not going to do” a half-point hike.

The Fed’s final determination, though, will rest heavily on Tuesday’s report on consumer prices.

“Everything now hinges on February’s CPI report,” said Paul Ashworth, an economist at Capital Economics.

When the Fed tightens credit, it typically leads to higher rates on mortgages, auto loans, credit card borrowing and many business loans. Its rate hikes can cool spending and inflation, but they also raise the risk of a recession.

Even for workers who have received substantial pay raises, ongoing high inflation remains a burden. Consumer prices rose 6.4% in January compared with a year ago, driven up by the costs of food, clothing and rents, among other items.

Frustrated by wages that aren’t keeping up with inflation, Rodney Colbert, a cook at the Las Vegas convention center, joined a strike Thursday by the Culinary Workers union to demand better pay and benefits. Colbert said that his hourly pay was $4-$5 less than what cooks were paid at casinos on the Las Vegas Strip.

“I’ll average approximately 28 hours a week, and that’s not enough,” Colbert said. “Just in the past two years, my rent has gone up $400, so that’s a lot.”

Nationally, nearly all of last month’s hiring occurred in mostly lower-paid services industries, with a category that includes restaurants, bars, hotels and entertainment adding 105,000 jobs, its second straight month of strong gains. Warmer-than-usual weather likely contributed to the increase. With the weather likely allowing more building projects to continue, construction companies added 24,000 jobs.

Retailers added about 50,000 jobs last month, health care providers 63,000. Local and state governments — some of them flush with cash from stimulus programs — added 46,000 jobs.

Much of that job growth reflects continuing demand from Americans who have been increasingly venturing out to shop, eat out, travel and attend entertainment events — activities that were largely restricted during the height of COVID.

“We’ve created more jobs in two years than any administration has created in the first four years,” President Joe Biden said Friday about the employment report. “It means our economic plan is working.”

Economists note, however, that the very strength of the job market is itself contributing to the high inflation that continues to pressure millions of households.

In February, in contrast to the solid hiring in the services sector, manufacturers cut 4,000 jobs. And a sector that includes technology and communications workers shed 25,000 jobs, its third straight month of losses. It is a sign that some of the announced layoffs in the economy’s tech sector are being captured in the government’s data.

Last month, the government reported a surprising burst of hiring for January — 517,000 added jobs — though that gain was revised down slightly to 504,000 in Friday’s report. The vigorous job growth for January was the first in a series of reports to point to an accelerating economy at the start of the year. Sales at retail stores and restaurants also jumped, and inflation, according to the Fed’s preferred measure, rose from December to January at the fastest pace in seven months.

The stronger data reversed a cautiously optimistic narrative that the economy was cooling modestly — just enough, perhaps, to tame inflation without triggering a deep recession. Now, the economic outlook is hazier.
…

NASA’s Artemis Moon Missions Promise Diverse Crews

WPScienLeave a comment

As the world waits for NASA to announce the first crews in its Artemis missions to the moon, VOA’s Kane Farabaugh talks with several astronauts hoping to make the cut as the space agency promotes diversity in its ranks. Camera: Adam Greenbaum
…

US Semiconductor Manufacturing Expected to Ramp Up With New Deal

WPEntLeave a comment

A global shortage of semiconductor chips in the automotive industry starting in 2020 has motivated many countries to increase their domestic manufacturing. The United States has allocated more than $50 billion to promote semiconductor production and research stateside as the global need for the chips is expected to double over the next decade. Keith Kocinski has more from New York.
Camera: Keith Kocinski and Rendy Wicaksana
…

La Nina, Which Worsens Hurricanes and Drought, Is Gone

WPScienLeave a comment

After three nasty years, the La Nina weather phenomenon that increases Atlantic hurricane activity and worsens Western drought is gone, the National Oceanic and Atmospheric Administration (NOAA) said Thursday.

That’s usually good news for the United States and other parts of the world, including drought-stricken northeast Africa, scientists said.

The globe is now in what’s considered a “neutral” condition and probably trending to an El Nino in late summer or fall, said climate scientist Michelle L’Heureux, head of NOAA’s El Nino/La Nina forecast office.

“It’s over,” said research scientist Azhar Ehsan, who heads Columbia University’s El Nino/La Nina forecasting. “Mother Nature thought to get rid of this one because it’s enough.”

Global impact

La Nina is a natural and temporary cooling of parts of the Pacific Ocean that changes weather worldwide. In the United States, because La Nina is connected to more Atlantic storms and deeper droughts and wildfires in the West, La Ninas often are more damaging and expensive than their more famous flip side, El Nino, experts said, and studies show.

Generally, American agriculture is more damaged by La Nina than El Nino. If the globe jumps into El Nino, it means more rain for the Midwestern corn belt and grains in general and could be beneficial, said Michael Ferrari, chief scientific officer of Climate Alpha, a firm that advises investors on financial decisions based on climate.

When there’s a La Nina, there are more storms in the Atlantic during hurricane season because it removes conditions that suppress storm formation. Neutral or El Nino conditions make it harder for storms to get going, but not impossible, scientists said.

Over the last three years, the U.S. has been hit by 14 hurricanes and tropical storms that each caused $1 billion or more in damage, totaling $252 billion in costs, according to NOAA economist and meteorologist Adam Smith. La Nina and people building in harm’s way were factors, he said.

Influence of climate change

Climate change is a major factor in worsening extreme weather, alongside La Nina, scientists said and numerous studies and reports show. Human-caused warming is like an escalator going up – It makes temperatures increase and extremes worse – while La Nina and El Nino are like jumping up and down on the escalator, according to Northern Illinois University atmospheric sciences professor Victor Gensini.

La Nina has also slightly dampened global average temperatures, keeping warming from breaking annual temperature records, while El Nino slightly turbocharges those temperatures, often setting records, scientists said.

La Nina tends to make western Africa wet, but eastern Africa, around Somalia, dry. The opposite happens in El Nino, with drought-struck Somalia likely to get steady “short rains,” Ehsan said. La Nina has wetter conditions for Indonesia, parts of Australia and the Amazon, but those areas are drier in El Nino, according to NOAA.

El Nino means more heat waves for India and Pakistan and other parts of South Asia and weaker monsoons there, Ehsan said.

Signs that La Nina’s leaving

This particular La Nina, which started in September 2020 but is considered three years old because it affected three different winters, was unusual and one of the longest on record. It took a brief break in 2021 but came roaring back with record intensity.

“I’m sick of this La Nina,” Ehsan said. L’Heureux agreed, saying she’s ready to talk about something else.

The few other times that there’s been a triple-dip La Nina have come after strong El Ninos, and there’s clear physics on why that happens. But that’s not what happened with this La Nina, L’Heureux said. This one didn’t have a strong El Nino before it.

Even though this La Nina has confounded scientists in the past, they say the signs that it’s leaving are clear: Water in the key part of the central Pacific warmed to a bit more than the threshold for a La Nina in February, the atmosphere showed some changes, and along the eastern Pacific near Peru there’s already El Nino-like warming brewing on the coast, L’Heureux said.

Think of a La Nina or El Nino as something that pushes the weather system from the Pacific with ripple effects worldwide, L’Heureux said. When there are neutral conditions like now, there’s less push from the Pacific. That means other climatic factors, including the long-term warming trend, have more influence in day-to-day weather, she said.

Without an El Nino or La Nina, forecasters have a harder time predicting seasonal weather trends for summer or fall because the Pacific Ocean has such a big footprint in weeks-long forecasts.

El Nino forecasts made in the spring are generally less reliable than ones made at other times of year, so scientists are less sure about what will happen next, L’Heureux said. But NOAA’s forecast said there’s a 60% chance that El Nino will take charge come fall.

There’s also a 5% chance that La Nina will return for an unprecedented fourth dip. L’Heureux said she really doesn’t want that but the scientist in her would find that interesting.
…

US Requires New Info on Breast Density With All Mammograms

WPScienLeave a comment

All U.S. women getting mammograms will soon receive information about their breast density, which can sometimes make cancer harder to spot.

The new requirements, finalized Thursday by the Food and Drug Administration, are aimed at standardizing the information given to millions of women following scans to detect breast cancer. Regulators first proposed the changes in 2019; health care providers will have 18 months to comply with the policy.

Some states already require that women receive information on breast density.

About half of women over age 40 have dense breasts, with less fatty tissue and more connective and glandular tissue. That tissue appears white on X-rays, the same color as growths in the breast, making mammograms harder to read. Dense breast tissue is one of the factors that can increase a woman’s chances of developing cancer.

Under the new rules, women with dense breasts will receive a written memo alerting them that their status “makes it harder to find breast cancer.” Those patients will also be directed to speak with their doctor about their results.

Professional guidelines don’t specify next steps for women identified with dense breasts, but some physicians may recommend additional forms of scanning, including ultrasound or MRI.
…

WHO Chief: Too Much Salt Can Kill You

WPScienLeave a comment

Sodium is essential for the smooth functioning of muscles and nerves and maintaining the proper balance of water and minerals. But too much sodium in the diet can kill.

“Almost 2 million deaths each year are associated with excessive sodium intake,” said Tedros Adhanom Ghebreyesus, director-general of the World Health Organization.

“Too much sodium can lead to high blood pressure and increase the risk of cardiovascular diseases,” he said. “And yet globally, average sodium intake is more than double the WHO recommendation for adults of less than 2,000 milligrams per day, or 5 grams of salt.”

That is equivalent to one teaspoon of salt a day.

A WHO report launched Thursday explores for the first time the progress countries have made in implementing sodium intake reduction policies. A survey of WHO’s 194 member states showed “the world is off track to achieve its global target of reducing sodium intake by 30% by 2025.”

The report finds that only 5% of WHO member states “are protected by mandatory and comprehensive sodium reduction policies,” and 73% of WHO member states “lack full range of implementation of such policies.”

Francesco Branca, director of WHO’s Department of Nutrition for Health and Development, noted that reducing sodium intake is one of the most cost-effective ways to improve health and reduce the burden of non-communicable diseases “as it can avert a large number of cardiovascular events and deaths at very low program costs.”

Cardiovascular diseases are the leading cause of death globally, claiming an estimated 17.9 million lives. WHO reports that more than four out of five of these deaths are due to heart attacks and strokes, with one-third occurring prematurely in people under age 70.

9 nations succeed

The report finds that only nine countries — Brazil, Chile, Czech Republic, Lithuania, Malaysia, Mexico, Saudi Arabia, Spain and Uruguay — have fully enacted WHO’s recommended policies to reduce sodium intake.

Tom Frieden, CEO of Resolve to Save Lives, cites Chile as a leader in the implementation of lifesaving sodium-reduction policies.

Speaking in a webinar among fellow experts that followed the report’s launch, Frieden said Chile had “passed the law of food labeling and advertising that simultaneously required mandatory front-of pack warning labels, including on sodium; restricted marketing of products that have those warning labels; and banned the procurement of the sale of those products in schools.”

He noted that Argentina, Brazil, Mexico and Uruguay had all passed similar policies, following Chile’s lead.

Branca noted that a significant proportion of sodium in the diet comes from processed and highly processed foods sold in many high-income countries and increasingly in low- and middle-income countries.

“Government-led mandatory maximum limits for sodium-processed foods promote industrywide reformulations,” he said. “They create a marketplace that restricts the less healthy food options regardless of where people shop, or how much they understand or have access to information on labels.”

Frieden said self-regulation by the food manufacturing industry has repeatedly proven to be ineffective and “voluntary policies are often ignored.”

“In fact, a mandatory approach creates a level playing field,” because it can keep companies that take positive steps from feeling as though they must conduct business at a competitive disadvantage.

In addition to the existing proven strategies to reduce sodium, Frieden said, countries can consider new, innovative measures, such as increasing the availability and use of sodium and salt substitutes.

“Recent studies show that these substitutes significantly decrease not only blood pressure, and not only heart attack and strokes, but even death from cardiovascular events,” he said.

“Imagine that changing the brand of salt that you use could reduce the risk of death by 10% or 15%.”
…

China Criticizes Dutch Plan to Curb Access to Chip Tools 

WPEntLeave a comment

China’s government on Thursday criticized the Netherlands for joining Washington in blocking Chinese access to technology to manufacture advanced processor chips on security and human rights grounds.

A Dutch minister told lawmakers Wednesday that exports of equipment that uses ultraviolet light to etch circuits on chips would be restricted on security grounds. ASML of the Netherlands is the only global supplier. Industry experts say a lack of access to ASML’s most advanced technology is a serious handicap for China’s efforts to develop its own chip industry.

Washington in October blocked Chinese access to U.S. tools to make advanced chips that it said might be used in weapons or in equipment for the ruling Communist Party’s surveillance apparatus. The Biden administration is lobbying European and Asian allies to tighten their own controls.

A Chinese foreign ministry spokeswoman complained that “an individual country,” a reference to the United States, was trying to “safeguard its own hegemony” by abusing national security as an excuse to “deprive China of its right to development.”

“We firmly oppose the Netherlands’s interference and restriction with administrative means of normal economic and trade exchanges between Chinese and Dutch enterprises,” said the spokeswoman, Mao Ning. “We have made complaints to the Dutch side.”

Mao appealed to the Netherlands to “safeguard the stability of the international industrial and supply chain.”

ASML’s extreme-ultraviolet, or EUV, equipment uses light to etch microscopically precise circuits into silicon, allowing them to be packed more closely together. That increases their speed and reduces power demand.

The Dutch government has prohibited ASML from exporting its most advanced machines to China since 2019, but the company is allowed to supply lower-quality systems.

Chinese manufacturers can produce low-end chips used in autos and most consumer electronics but not those used in smartphones, servers and other high-end products.

Dutch Prime Minister Mark Rutte and U.S. President Joe Biden held talks in January on ASML’s chip machines.
…

What to Know About Prescription Drugs Promising Weight Loss

WPScienLeave a comment

WeightWatchers, the 60-year-old diet firm, announced this week it would acquire a telehealth company whose providers prescribe anti-obesity drugs for growing numbers of eager online subscribers.

The $132 million deal with Sequence is just the latest commercial push into the red-hot market for prescription drugs that promises significant weight loss. For months, the diabetes drug Ozempic has been touted on social media by celebrities, even though it’s not approved for weight loss. The demand for it sparked shortages.

WeightWatchers will be introducing its roughly 3.5 million subscribers to a new generation of medications that go beyond behavioral changes like gym workouts and diet tracking. Obesity experts say the drugs may revolutionize treatment of the disease that affects 42% of American adults.

Here’s a look at the promise of these new medications and cautions about their use.

What are these new diet drugs?

The drugs that have generated most buzz are from a class of medications called GLP-1 agonists. Two of the most popular, Ozempic and Wegovy, are different doses of the same drug, semaglutide.

Ozempic has been used for six years to treat Type 2 diabetes and is not approved for weight loss. Wegovy was approved in 2021 to treat obesity in adults, and late last year to treat kids and teens 12 and older.

Doctors prescribe the medications to people with diabetes alone, or to people who are obese or who are overweight with additional health problems. Most of these types of drugs are delivered through weekly injections.

Supply problems and soaring demand last year led to a shortage of the drugs, but manufacturer Novo Nordisk said those have been replenished.

How do the drugs work?

They mimic the action of a gut hormone that kicks in after people eat, boosting the release of insulin, blocking sugar production in the liver and suppressing appetite.

A newer drug called tirzepatide mimics the action of two hormones for even greater effect. The Eli Lilly and Company drug, sold under the brand name Mounjaro, is now approved to treat diabetes. But the FDA granted fast-track status to review it to treat obesity. A decision is expected this spring.

With lower appetite and a greater feeling of fullness, people using these drugs eat less and lose weight.

How effective are the drugs?

In a clinical trial, adults who took Wegovy saw a mean weight loss of nearly 35 pounds, or about 15% of their initial body weight. Adolescents lost about 16% of their body weight.

A clinical trial of Mounjaro, which is still being studied, saw mean weight loss of 15% to 21% of body weight depending on the dose, compared with a weight loss of about 3% for people taking a placebo, or a dummy drug.

Why not just diet and exercise?

In a typical weight-loss program where participants rely only on diet and exercise, about a third of people enrolled will lose 5% or more of their body weight, noted Dr. Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine.

Most people find it difficult to lose weight because of the body’s biological reactions to eating less, he said. There are several hormones that respond to reduced calorie intake to increase hunger and maintain body mass.

“There is a real physical phenomenon,” he said. “There is a resistance mechanism that is a coordinated effort by the body to prevent you from losing weight.”

What are the side effects of the drugs?

The most common side effects are short-lived gastrointestinal issues such as nausea, vomiting, diarrhea, stomach pain and constipation.

Other possible side effects include thyroid tumors, cancer, inflammation of the pancreas, kidney and gallbladder and eye problems. People with a family history of certain thyroid cancers or a rare, genetic endocrine disorder should avoid the drugs.

What should consumers watch out for?

These new medications could be an effective part of a multifaceted approach to weight loss, said Dr. Amy Rothberg, a University of Michigan endocrinologist who directs a virtual weight management and diabetes program called Rewind.

But she worries that programs like WeightWatchers are primarily interested in boosting enrollment — and profits.

“My hope is that they do their due diligence and have real monitoring of the patients taking the drugs,” she said.

It’s important to make sure that patients are taking the drugs for the intended purpose, to make sure there’s no reason they shouldn’t take the drugs and that they’re monitored for side effects, she said.
…

Plastic Entering Oceans Could Nearly Triple by 2040, Research Finds

WPScienLeave a comment

Plastics entering the world’s oceans have surged by an unprecedented amount since 2005 and could nearly triple by 2040 if no further action is taken, according to research published on Wednesday.

An estimated 171 trillion plastic particles were afloat in the oceans by 2019, according to peer-reviewed research led by the 5 Gyres Institute, a U.S. organization that campaigns to reduce plastic pollution.

Marine plastic pollution could rise 2.6-fold by 2040 if legally binding global policies are not introduced, it predicted.

The study looked at surface-level plastic pollution data from 11,777 ocean stations in six major marine regions covering the period from 1979 to 2019.

“We’ve found an alarming trend of exponential growth in microplastics in the global ocean since the millennium,” Marcus Eriksen, co-founder of the 5 Gyres Group said in a statement.

“We need a strong legally binding U.N. global treaty on plastic pollution that stops the problem at the source,” he added.

Microplastics are particularly hazardous to the oceans, not only contaminating water but also damaging the internal organs of marine animals, which mistake plastic for food.

Experts said the study showed that the level of marine plastic pollution in the oceans has been underestimated.

“The numbers in this new research are staggeringly phenomenal and almost beyond comprehension,” said Paul Harvey, a scientist and plastics expert with Environmental Science Solutions, an Australian consultancy focused on pollution reduction.

The United Nations kicked off negotiations on an agreement to tackle plastic pollution in Uruguay in November, with the aim of drawing up a legally binding treaty by the end of next year.

Environmental group Greenpeace said that without a strong global treaty, plastic production could double within the next 10 to 15 years, and triple by 2050.

A separate international treaty was agreed on Sunday to help protect biodiversity in the world’s high seas.
…

Netherlands Responds to US China Policy With Plan to Curb Semiconductor Tech Exports

WPEntLeave a comment

The Netherlands’ government on Wednesday said it planned new restrictions on exports of semiconductor technology to protect national security, joining the United States’ effort to curb chip exports to China. 

The U.S. in October imposed sweeping export restrictions on shipments of American chipmaking tools to China, but for the restrictions to be effective, they need other key suppliers in the Netherlands and Japan, who also oversee key chipmaking technology, to agree. The allied countries have been in talks on the matter for months. 

Dutch Trade Minister Liesje Schreinemacher announced the decision in a letter to parliament, saying the restrictions would be introduced before the summer. 

Her letter did not name China, a key Dutch trading partner, nor did it name ASML Holding NV, Europe’s largest tech firm and a major supplier to semiconductor manufacturers, but both will be affected. It specified one technology that would be affected: “DUV” lithography, the second-most advanced machines that ASML sells to computer chip manufacturers. 

“Because the Netherlands considers it necessary on national security grounds to get this technology into oversight with the greatest of speed, the Cabinet will introduce a national control list,” the letter said. 

ASML said in a response it expected to have to apply for licenses to export the most advanced segment among its DUV machines, but that would not affect its 2023 financial guidance. 

ASML dominates the market for lithography systems, multimillion-dollar machines that use powerful lasers to create the minute circuitry of computer chips. The company expects sales in China to remain about flat at $2.3 billion in 2023 – implying relative shrinkage as the company expects overall sales to grow by 25%. Major ASML customers such as Taiwan Semiconductor Manufacturing Co. and Intel are engaged in capacity expansion. 

ASML has never sold its most advanced “EUV” machines to customers in China, and the bulk of its DUV sales in China go to relatively less advanced chipmakers. Its biggest South Korean customers, Samsung and SK Hynix, both have significant manufacturing capacity in China. 

The Dutch announcement leaves major questions unanswered, including whether ASML will be able to service the more than $8 billion worth of DUV machines it has sold to customers in China since 2014. 

Schreinemacher said the Dutch government had decided on measures “as carefully and precisely as possible … to avoid unnecessary disruption of value chains.” 

“It is for companies of importance to know what they are facing and to have time to adjust to new rules,” she wrote.  

Japan is expected to issue an update on its chip equipment export policies as soon as this week.
…

Are Americans Ready for More Drone Deliveries?

WPEntLeave a comment

Drones are routinely used in warfare, law enforcement and agriculture. Now more and more U.S. businesses are using them to deliver cookies and coffee right to your front door. VOA’s Julie Taboh has more. Camera: Adam Greenbaum, Chad Baugh 
…

Key US Intelligence Official Casts Shade on TikTok, Chinese Tech

WPEntLeave a comment

Add a top U.S. intelligence official to the list of Americans expressing concern about Chinese-made technology and Chinese social media platforms like TikTok. 

General Paul Nakasone, who heads both the U.S. Cyber Command and the National Security Agency, told lawmakers Tuesday there are multiple reasons to be wary of China’s rapid expansion in cyberspace, calling Beijing “a very formidable foe.”

“TikTok concerns me for a number of different reasons,” Nakasone said during a Senate Armed Services Committee hearing. “One is that the data that they have. Secondly is the algorithm and the control. Who has the algorithm?”  

Third, he said, “is the broad platform” both for unleashing potential influence operations but also for the ability to give China a way to “turn off the message.” 

Last month, the United States moved forward with plans to ban TikTok — a social media app used by more than 100 million Americans — from government devices. Some U.S. lawmakers have called for giving U.S. President Joe Biden the ability to ban use of the social media app nationwide. 

Others, however, object to giving Biden the ability to issue a blanket nationwide ban, arguing TikTok is only a small part of a larger issue.  

“The threat that everyone is talking about is TikTok, and how it could enable surveillance by the Chinese Communist Party or facilitate the spread of malign influence campaigns in the U.S,” Democratic Senator Mark Warner told reporters.”Before TikTok, however, it was Huawei and ZTE, which threatened our nation’s telecommunications networks. And before that, it was Russia’s Kaspersky Lab.”

“We need a comprehensive, risk-based approach that proactively tackles sources of potentially dangerous technology before they gain a foothold in America,” he said.

The Restrict Act, being pushed by Warner and others, would establish a rule-based process — informed by the U.S. intelligence community and directed by the Department of Commerce — to identify and address foreign technological threats. 

For its part, TikTok’s parent company, ByteDance, has dismissed concerns it would improperly use user data as “political theater.” 

But concerns about Chinese companies and Chinese technology keep growing. 

On Sunday, The Wall Street Journal reported U.S. defense officials are worried that  Chinese-made ship-to-shore cranes used at many of America’s ports could be used to spy on materials being shipped in and out of the U.S. 

“Communist China has monopolized the port crane industry, and I will continue to spearhead efforts to decouple from the regime in Beijing and incentivize the near-shoring and reshoring of our strategic manufacturing capabilities,” Republican Congressman Carlos Gimenez told VOA when asked about the potential for Chinese espionage at U.S. ports. “I will fight to protect our critical infrastructure from the CCP’s espionage tactics.”

Tensions also have been rising since the U.S. shot down what it identified as a Chinese spy balloon last month after it had traveled across much of the continental United States.

And Biden is expected to issue an executive order in the coming days that would tighten rules on the ability of U.S. companies to invest in China. 

China’s Foreign Minister Qin Gang chastised the U.S. Tuesday, telling reporters in Beijing that Washington’s China policy has “entirely deviated from the rational.” 

But Nakasone told lawmakers that politicians and businesses alike would be smart to be careful about how they make use of Chinese-made platforms and technology. 

“What I would do is ensure that the areas that are most sensitive to our operations are well-sensored, and I have the confidence that’s what’s being utilized there. I understand where that information may be going,” the CYBERCOM commander said.  

“I would take a very, very hard look at anything that would come from an adversarial nation,” Nakasone said, though he acknowledged it would be “very difficult” to proceed with an all-out ban of Chinese products. 

“So much of what we do is based upon international trade,” he said, “and China has the corner on some things.”
…

France Reports Bird Flu in Foxes Near Paris, WOAH Says

WPScienLeave a comment

France has reported an outbreak of highly pathogenic H5N1 bird flu among red foxes northeast of Paris, the World Organization for Animal Health (WOAH) said on Tuesday, as the spread of the virus to mammals raised global concerns.

After three foxes were found dead in a nature reserve in Meaux near where gulls had died, one of the foxes was collected and tested, WOAH said in a report, citing French authorities.

The World Health Organization last month described the bird flu situation as “worrying” due to the recent rise in cases in birds and mammals and that it was reviewing its global risk assessment in light of recent developments including cases of human transmission in Cambodia.

Avian influenza, commonly called bird flu, has been spreading around the world in the past year, killing more than 200 million birds, sending egg prices rocketing and raising concern among governments about human transmission.

The virus infected a cat in France in late December.

It has also been detected in minks in Spain, foxes and otters in Britain, sea lions in Peru and grizzly bears in the United States.
…

Sri Lanka Closes In on $2.9 Billion IMF Deal After China Support

WPbizLeave a comment

Sri Lanka looks set to get a sign-off on a long-awaited $2.9 billion four-year bailout from the International Monetary Fund (IMF) on March 20 after the crisis-hit country secured new financing support from China.

The IMF and the island nation confirmed on Tuesday that Sri Lanka had received assurances from all its major bilateral creditors, a key step to deploy financing and an important moment for the country engulfed in its worst economic crisis since independence from Britain in 1948.

Sri Lankan President Ranil Wickremesinghe told parliament there were signs the economy was improving, but there was still insufficient foreign currency for all imports, making the IMF deal crucial so other creditors could also start releasing funds.

“Sri Lanka has completed all prior actions that were required by the IMF,” Wickremesinghe said, and that he and the central bank governor had sent a letter of intent to the IMF.

“I welcome the progress made by Sri Lankan authorities in taking decisive policy actions & obtaining financing assurances from all their major creditors, incl. China, India & the Paris Club,” IMF chief Kristalina Georgieva said on Twitter, adding that she looked forward to presenting the IMF-supported program to the executive board on March 20.

Approval is expected since the board generally will not add items to its agenda unless its members are ready to act.

The country’s international debt and currency soared higher on the news, with bonds adding around 3 cents in the dollar, while the Sri Lankan rupee jumped as much as 7.8% to a 10-month high. Stocks closed more than 2% higher.

A new letter by the Export-Import Bank of China (EXIM) sent on Monday to Sri Lanka resolved the stalemate. Sources close to the talks said EXIM provided “specific and credible” financing assurances for a debt restructuring, with a specific link to the IMF program and clear language on debt sustainability.

The first tranche of funding was expected to be released shortly after the board meeting, the sources added.

In a letter in January, EXIM had offered Sri Lanka a two-year debt moratorium, but sources said this was not enough to meet IMF conditions.

“This is a positive development: it might be the first time that China provides textbook financing assurances to the IMF outside of a Common Framework process,” said Theo Maret, senior research analyst at Global Sovereign Advisory, in Paris.

By end-2020, Sri Lanka owed EXIM $2.83 billion, or 3.5% of its external debt, according to IMF data. In total, Sri Lanka owed Chinese lenders $7.4 billion, or nearly a fifth of public external debt, by end-2022, calculations by the China Africa Research Initiative showed.

IMF financing provides an anchor for countries to unlock other funding sources. Sri Lanka was in negotiations with India, its second biggest creditor, to extend a $1 billon credit line due to expire by March 17, two sources said.

Sri Lanka needs to repay about $6 billion on average each year until 2029 and will have to keep engaging with the IMF, Wickremesinghe said.

Countries in debt distress such as Zambia and Sri Lanka have faced unprecedented delays in securing IMF bailouts as China and Western economies have clashed over how to provide debt relief.

Sri Lanka has been waiting for about 187 days to finalize a bailout after reaching a preliminary deal. This compares to a median of 55 days it took low- and middle-income countries over the past decade to go from preliminary deal to board sign-off, according to data compiled by Reuters.

“Debt restructurings both within and outside the Common Framework have been taking longer than usual due to issues with creditor coordination and foot-dragging by China,” said Patrick Curran at Tellimer. “The restructurings in Sri Lanka and Zambia are likely to set important precedents for future restructurings.”

Chinese Foreign Minister Qin Gang said on Tuesday that Beijing would continue to participate in the settlement of international debt problems in a constructive manner.

Responding to a question on the sidelines of an annual parliament meeting, Qin also said China should be the last to be accused of causing debt traps and called on other parties to share the burden.
…

US NSA Director Concerned by TikTok Data Collection, Use in Influence Operations

WPEntLeave a comment

U.S. National Security Agency director Paul Nakasone on Tuesday expressed concern about Chinese-owned video app TikTok’s data collection and potential to facilitate broad influence operations.

In response to a lawmaker’s question about any concerns he has on the influence of TikTok on American children, Nakasone told a Senate hearing, “TikTok concerns me for a number of different reasons.”

Nakasone said his concerns include “the data that they have.”

“Secondly is the algorithm and the control of who has the algorithm,” Nakasone added.

Nakasone ended his comments by asserting that the TikTok platform could enable sweeping influence operations. Nakasone said his concern is not only the fact that TikTok can proactively influence users, but also its ability to “turn off the message,” and noted its large number of users.

The app is used by more than 100 million Americans.

The NSA, part of the Defense Department, is the agency responsible for U.S. cryptographic and communications intelligence and security.

A TikTok representative did not immediately respond to a request for comment.

TikTok, a unit of China’s ByteDance, has come under increasing fire over fears that user data could end up in the hands of the Chinese government, undermining Western security interests. TikTok Chief Executive Shou Zi Chew is due to appear before the U.S. Congress on March 23.

A bipartisan group of 12 U.S. senators is set to introduce legislation on Tuesday that would give Commerce Secretary Gina Raimondo new powers to ban TikTok and other foreign-based technologies if they are found to pose national security threats.

The U.S. government’s Committee on Foreign Investment in the United States (CFIUS), a powerful national security body, in 2020 unanimously recommended ByteDance divest TikTok because of fears that user data could be passed on to China’s government.
…

US Economy Advancing Faster Than Expected: Central Bank Chief

WPbizLeave a comment

Federal Reserve Chair Jerome Powell said Tuesday the U.S. economy is advancing at a faster pace than expected, which could prompt central bank policy makers to raise interest rates at a faster pace than originally planned to curb spending and borrowing in hopes of reining in the continuing increase in consumer prices.

 

Policy makers at the central bank had signaled their intent to increase its benchmark interest rate by a quarter of a percentage point at upcoming meetings over several months. But Powell told the Senate Banking Committee that may not be enough to curb the U.S. inflation rate, which rose 6.4% over the 12 months ending in January, about three times the 2% pace the Fed considers acceptable.

 

“The latest economic data have come in stronger than expected, which suggests that the ultimate level of interest rates is likely to be higher than previously anticipated,” Powell said. “If the totality of the data were to indicate that faster tightening is warranted, we would be prepared to increase the pace of rate hikes.”

 

The Fed raised its benchmark interest rate, which affects borrowing costs for both businesses and consumers, by a quarter-point to a range between 4.5% and 4.75% last month, easing the pace of rate boosts following increases of a half percentage point in December and 0.75% in November.

 

The Fed had projected increasing the rate to between 5% and 5.5% and keeping it there until 2024, but the faster economic growth could alter those plans and push policy makers to increase the benchmark rate even higher.

 

“We will continue to make our decisions meeting by meeting,” Powell said. “Although inflation has been moderating in recent months, the process of getting inflation back down to 2% has a long way to go and is likely to be bumpy.”

 

Some U.S. economists have continued to predict that the economy, the world’s largest, will dip into a recession in the coming months, but that has yet to occur. Employers continue to add hundreds of thousands of new workers to their payrolls month after month — 517,000 in January alone — and the national unemployment rate is 3.4%, a 53-year low.

 

A report for hiring in February is due out Friday.

 

Fed policy makers last met February 1, but economic data revisions since then showed consumer price increases and the demand for more workers late last year didn’t slow as much as first reported.   

 

A robust labor market is usually favorable for workers looking for higher pay and hundreds of thousands of U.S. workers have switched jobs for bigger salaries as the country continues to recover from the 2020 coronavirus pandemic.

 

Powell told lawmakers that “strong wage growth is good for workers but only if it is not eroded by inflation.”

 

“We have more work to do,” he said. “Our policy actions are guided by our dual mandate to promote maximum employment and stable prices. Without price stability, the economy does not work for anyone.”
…

Venezuelans Struggling to Afford Food — Even With Access to Dollars  

WPbizLeave a comment

Like many Venezuelans, Carmen Mendoza has learned to get by with a patchwork of different income streams in different currencies – her pension, renting out a property, and roughly $150 per month her two daughters send from Spain.

But it is no longer enough.

Resurgent inflation is devouring the income of Venezuelans — even the relatively privileged ones like Mendoza who have access to U.S. dollars.

That is leaving them hungry and struggling to buy food and medicine, they told Reuters.

“Neither dollars or bolivars are enough. I can’t afford anything,” said 68-year-old Mendoza, who lives in Los Teques, the capital of Miranda state.

Hunger is a familiar specter in Venezuela, which suffered years of hyperinflation in the second half of the last decade, as the government of President Nicolas Maduro printed money to pay its debts amid a slow-down in oil prices.

Many Venezuelans were left to scour through garbage to find food, and millions fled the country to build new lives across South America and beyond.

Maduro relaxed currency controls in 2019, allowing a de facto dollarization. Combined with orthodox economic policies including limiting the expansion of credit, reducing public spending, and raising taxes, inflation fell to single digits for about a year.

But in late 2022, Venezuela’s consumer price growth began to accelerate sharply. As countries around the world have grappled with rising inflation in the wake of the coronavirus pandemic, Venezuela’s price growth has been spurred by growing demand for dollars, increased government spending, and weakening of the bolivar, prompting fears of a renewed era of hyperinflation.

Prices rose over 37% in December compared to the previous month, according to a non-governmental group of economists who calculate indicators in the absence of official data, and who estimated 2022 inflation at over 300%.

Even Venezuelans who benefited from dollarization through remittances or salary payments are being hit by the higher prices, while those earning in bolivars have seen their meager earnings decline further.

Since the start of this year, Yaselin Garcia, 32, has watched as groceries bought with the $20 she makes each week selling cigarettes and other items have dwindled to just 15 eggs, 3 kilograms of corn flour, some grains and some cheese.

“If I were earning in bolivars I wouldn’t be able to buy anything,” said the mother-of-four in Los Teques.

Monthly private sector pay averages $139 and public sector salaries are around $14 per month, according to the Venezuelan Observatory of Finances, while the average family grocery shop comes in at some $370 per month.

“Wage increases are lagging behind,” said economist Asdrubal Oliveros, director of local analyst firm Ecoanalitica. “The purchasing power of salaries paid in dollars has fallen.”

Oscar Lochunga, 66, sells vegetables at a street market in the capital, Caracas, but is seeing demand fall each week as people limit their purchases.

“Whether you pay in bolivars or dollars it is not enough,” Lochunga said, sitting in front of his stall.

Markets are full of food which few can buy, which pushes people to skip meals or rely on help from charities, said Ania Pulido, a nutritionist at advocacy group the Venezuelan Observatory for Food Security and Nutrition.

Money “which today got you 20 products by tomorrow won’t even get you…. half that,” Pulido said.

Some 50% of Venezuelan households live in poverty, according to a national poll carried out by the Universidad Catolica Andres Bello, and 41% of those polled said they skip one meal per day.

For Yusmary Tovar, 42, who cares for her 5-year-old daughter and her elderly mother, $80 in monthly earnings from cleaning houses and babysitting is no longer enough.

Tovar has a kidney problem and must use a catheter to urinate. The catheters’ high cost forces her to boil them in water and reuse them.

“You get ill just thinking about how to make it through one day to the next,” she said.
…