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Daily Archives: June 26, 2022
Urging Extension of Resolution on Cross-Border Humanitarian Assistance into Syria, Secretary-General Tells Security Council ‘Our Aid is Reaching…
Posted: June 26, 2022 at 10:21 pm
Syrian Representative Claims Turkish Regime Benefits from Cross-Border Mechanism, But Trkiyes Delegate Insists No Hidden Agenda Except to Save Lives
The Secretary-General of the United Nations today urged the Security Council to extend the resolution that allows cross-border deliveries of lifesaving aid into north-west Syria for another 12 months, as speakers diverged over what form future assistance should take amidst unprecedented humanitarian need throughout the country.
Antnio Guterres, Secretary-General of the United Nations, highlighting his report on the matter (document S/2022/492), underscored that humanitarian needs in Syria are at their highest since the start of the war over 11 years ago. People are living on the brink, no longer able to cope, he stressed, and the current United Nations humanitarian appeal requires $4.4billion to assist people inside Syria and another $5.6billion to support refugees in the region. The generous pledges made at the sixth Brussels Conference must be paid, and he appealed to donors to follow through and increase their support.
Turning to the situation in north-west Syria, where 2.8million people are displaced and more than 90percent of the population requires aid, he stressed that all channels to deliver life-saving aid should be made and kept available. The United Nations cross-border operation in Syria is one of the most heavily scrutinized and monitored aid operations in the world, he said, underscoring that there is no doubt that our aid is reaching people in need. Because crossline assistance is not presently at the scale needed to replace the cross-border response, he urged the Council to maintain consensus on allowing cross-border operations for an additional 12 months.
Martin Griffiths, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, also underlined the imperative of retaining the ability to deliver assistance from across the Turkish border for an additional 12 months. There are 4.4million people living in north-west Syria, and 20percent more people require aid than did in 2021. Without United Nations cross-border access, hunger will increase, medical cases will go untreated, millions will be at risk of losing shelter assistance and access to water will decrease. We need to face reality, he stressed: There has been progress and there will be more, but needs are rising and the resolution must be renewed.
Echoing those remarks was Iyad Agha, Non-Governmental Organization Forum Coordinator for NGO Forum Northwest Syria, who underscored that the cross-border operation cannot be replaced by a non-governmental-organization-led response or by crossline operations without resulting in a massive humanitarian impact. Pointing out that the circumstances in north-west Syria that led to the authorization of cross-border support are still the same if not worse, he called on the Council to reauthorize the provisions of the cross-border resolution for at least 12 months. There are more than 4million reasons to renew the authorization, he added, as that is the number of people whose lives depend on this humanitarian operation.
In the ensuing discussion, many Council members supported the renewal of the cross-border resolution for an additional 12 months, underscoring that crossline operations cannot currently replace the cross-border mechanism for the delivery of aid. Others stressed that resolution 2585 (2021) has not been fully implemented, pointing out that only five crossline convoys have occurred in the past year and emphasizing that humanitarian relief must respect Syrias sovereignty and not be politicized.
The representative of Ireland, also speaking for Norway, noting that the futures of Syrian children are being mortgaged away so that families can eat, recalled progress since the Council unanimously adopted resolution 2585 (2021), with almost 320,000 individuals directly supported and 2.9million indirect beneficiaries across the country since January. While calling on all parties to support crossline deliveries, she said that the cross-border operation at Bab al-Hawa remains indispensable.
Brazils representative, however, pointed out that the costs of humanitarian operations are rising due to global increases in the prices of food and fuel. Sustainable solutions to ongoing conflicts are needed. He urged a thorough assessment of the potential consequences of unilateral sanctions on the civilian population during this acute economic crisis and escalating hunger.
The representative of the United Arab Emirates similarly emphasized that the cross-border aid delivery mechanism should not be considered a long-term solution, underlining the need for an increase in the number of crossline convoys in conjunction with additional support for early recovery projects. Noting the ongoing escalation on the Turkish-Syrian border, he stressed that the cross-border mechanism should not be used to justify political interests or interfere in Syrias affairs.
On that point, Syrias representative said that the Turkish regimes threat to establish a so-called safe zone in northern Syria demonstrates its subversive policies to destabilize Syria by supporting terrorism, displacing people and effecting demographic change. Spotlighting Western countries refusal to enhance the delivery of humanitarian aid from within Syria, he stressed that the Turkish regime and its terrorist agents are the only beneficiaries of the cross-border mechanism.
The representative of Iran, noting that unilateral sanctions have stymied the implementation of resolution 2585 (2021), said that the Syrian Governments ability to achieve economic and social stability was undermined by these illegal measures. The provision of humanitarian aid is essential because of the dire situation in Syria, and he stressed that political circumstances should not prevent assistance from reaching people.
However, Trkiyes representative underscored the moral imperative to extend the cross-border mandate, stressing that such extension should not be politicized. United Nations cross-border operations are among the most sophisticated, scrutinized and transparent humanitarian assistance systems ever established. There is no hidden agenda at issue here the aim is nothing but to save lives, he stressed.
Also speaking were representatives of Ghana (also speaking for Gabon and Kenya), United States, Russian Federation, United Kingdom, Mexico, China, France, India and Albania.
The meeting began at 3:04 p.m. and ended at 5:08 p.m.
Opening Remarks
ANTNIO GUTERRES, Secretary-General of the United Nations, calling attention to his report on the humanitarian situation in Syria (see document S/2022/492), underscored that humanitarian needs in Syria are at their highest since the start of the war over 11 years ago, as the worlds largest refugee crisis continues to impact the region and the world. The figures are stark, he said, noting that 14.6million people need humanitarian assistance; 12million people are food insecure; 90 per cent of the population live below the poverty line; infrastructure is crumbling; and economic activity halved during a decade of conflict, regional financial crises, sanctions and the COVID-19 pandemic. People are living on the brink, no longer able to cope, he stressed. The United Nations current humanitarian appeal requires $4.4billion to assist people inside Syria and another $5.6billion to support refugees in the region. The generous pledges made at the sixth Brussels Conference must be paid, and he appealed to donors to follow through and increase their support.
The needs in Syria are too great to address through immediate life-saving efforts alone, he continued, pointing out that more than one quarter of the appeal is intended to support early recovery and resilience. Through projects already under way, millions will benefit from the rehabilitation of damaged hospitals, schools, water systems and other basic infrastructure. These programmes also help communities by providing opportunities for work and generating income. Turning to the situation in north-west Syria, he underlined that the needs there continue to increase, as 2.8million people are displaced and more than 90percent of the population requires aid. Recalling his consistent position regarding the importance of maintaining and expanding access including through crossline and cross-border operations he stressed that all channels to deliver life-saving aid to people in need across Syria should be made, and kept, available.
The United Nations cross-border operation into Syria is one of the most heavily scrutinized and monitored aid operations in the world, he said, underscoring that there is no doubt that our aid is reaching people in need. While increasing crossline assistance was an important achievement, it is not presently at the scale needed to replace the massive cross-border response. To that end, he urged the Council to maintain consensus on allowing cross-border operations by renewing resolution 2585 (2021) for an additional 12 months. He stressed that it is a moral imperative to address the suffering of the 4.1million people in the area who need aid and protection, noting that 80percent of those in need in north-west Syria are women and children. He also added a call to all Council members to encourage the parties to engage in meaningful negotiations for peace, stating that we cannot give up on the people of Syria.
Briefings
MARTIN GRIFFITHS, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, confirmed the Secretary-Generals remarks, which paint a grim picture. Hostilities were continuing at the frontlines and in pockets across the country, killing more civilians, including murders in Al Hol camp and a car bomb killing the Head of Office of a humanitarian partner organization in Al Bab city on 15June. On 10June, the Damascus airport, damaged by an airstrike, was shut down and remains closed as of today, leading the United Nations Humanitarian Air Service to suspend its operations. Meanwhile, landmines continue to threaten communities. Reminding all parties that international humanitarian law requires them to respect civilians and civilian objects, he stressed that the number of people in need is the highest it has ever been during more than 11 years of war; this was a crisis of hunger, water and economy.
Against that dismal backdrop, he noted that the Council will soon discuss the renewal of resolution 2585 (2021), adding that so far this year 2.9million people have benefited from humanitarian aid efforts. From January to April, health sector partners trained close to 15,000 health-care workers and rehabilitated 106 health care facilities that service up to 400,000 people; education partners have restored over 1,500 classrooms. Since the adoption of resolution 2585 (2021), five crossline convoys have been deployed, opening access to north-west Syria for the first time since 2017 and providing food for over 43,000 people each time.
Stressing the need for timely approvals and security guarantees, especially for safe passage, as well as funding, he underlined the imperative of retaining the ability to deliver assistance across the border from Trkiye for an additional 12 months. There are 4.4million people living in north-west Syria, over 90percent of whom need humanitarian assistance. That was 20percent more than last year, when the United Nations sent some 800 trucks of cross-border aid there, reaching 2.4million people each month. Last year, the United Nations spent over $420million inside north-west Syria, including $151million allocated through the Syria Cross Border Humanitarian Fund. Without United Nations cross-border access, hunger will increase, medical cases will go untreated, millions will be at risk of losing shelter assistance and access to water will decrease. The United Nations monitoring mechanism will also stop, decreasing transparency and accountability. We need to face reality, he said: There has been progress and there will be more, but needs are rising and the resolution must be renewed.
IYAD AGHA, Non-Governmental Organization Forum Coordinator, NGO Forum Northwest Syria, stressed that, as the number of people in need are rising, the capacity to respond is decreasing due to reduced funding and other competing humanitarian crises around the world. Generations of Syrian children have been born and raised in camps. Access to clean water, food on a regular basis and four walls to call home are luxuries they are not willing to dare to dream about, he said. However, millions living in north-west Syria have benefited from United Nations-led cross-border assistance. This operation cannot be replaced by a non-governmental-organization-led response or by crossline operations without resulting in a massive humanitarian impact. Were this to occur, the north-west would experience a quick and catastrophic deterioration in the humanitarian situation due to the high levels of aid dependency there. The current cross-border operation reaches almost 60percent of the 4.1million people in need of assistance each month and, in sectors like food security, the United Nations supports up to 80percent of all food assistance through the cross-border mechanism.
The United Nations plays a vital role in procurement, providing stability and reliability in the humanitarian supply chain, he continued, adding that non-governmental organizations rely heavily on the United Nations unique ability to obtain pharmaceuticals, vaccines and key medicines. Pointing out that the circumstances in north-west Syria that led to the authorization of cross-border support are still the same if not worse, he underscored the need to maintain this modality. There is currently no viable alternative to replace the response being delivered through the cross-border modality, he stressed, and he called on the Council to reauthorize the provisions of the cross-border resolution for at least 12 months to ensure that the United Nations cross-border response into north-west Syria remains in place. There are more than 4million reasons to renew the authorization, he added, as that is the number of people whose lives depend on this humanitarian operation.
Statements
GERALDINE BYRNE NASON (Ireland), also speaking for Norway, reported that their countries foreign ministers undertook a visit to Bab al-Hawa and learned more about the situation there, along with the extraordinary work of the United Nations and non-governmental organizations in delivering cross-border aid to the north-west of Syria. She pointed out that 14.6million people across Syria are in need of humanitarian assistance, including over 4million in need in north-west Syria alone. Twelve million people are food insecure, with almost 2million more at risk of food insecurity. Food prices continue to rise and rates of malnutrition soar. The futures of children are mortgaged away so that families can eat, she said, pointing to children withdrawn from school to work or forced into early marriages. Across Syria, only one third of schools are fully functional and more than 1.5million children currently in education are at risk of dropping out, particularly those with disabilities.
She went on to recall progress since the Security Council unanimously adopted resolution 2585 (2021), with almost 320,000 individuals directly supported, and 2.9million indirect beneficiaries across the country since January. As of late May, $195million had been contributed to early recovery and resilience objectives, she noted, stressing that further progress will be enabled with a renewal of the resolution. Calling on all parties to support crossline deliveries, she said that cross-border operation at Bab al-Hawa remains indispensable, which is one of the most heavily monitored in the world. Reiterating the call for renewal of resolution 2585 (2021), she underscored that a failure to do so would end the delivery of life-saving aid to millions of vulnerable people in Syria.
HAROLD ADLAI AGYEMAN (Ghana), also speaking for Gabon and Kenya, expressed deep concern about the persistent challenges facing people in Syria, including civilian casualties resulting from mine explosions, sporadic air strikes and shelling and food insecurity that caused a precedented number of women and children suffering from malnutrition. In addition, the reduced water levels of the Euphrates River and the Alouk water station have given rise to acute water shortages. Denouncing the continued atrocities committed by terrorist groups such as Islamic State in Iraq and the Levant (ISIL), also known as Daesh, and the Hayat Tahrir al-Sham, he expressed equal concern about the increasing number of deaths of humanitarian aid workers in the country.
Noting that the United Nations cross-border operations benefits almost 60percent of the 4.1million Syrians in need of humanitarian assistance each month, he commended the scale-up in the crossline aid delivery of essential humanitarian supplies to about 43,000 people in the north-west. Aid delivery across the front lines is equally essential, he said, calling for the continuation of the crossline aid delivery mechanism. Urging the Security Council to unanimously support the renewal of resolution 2585 (2021), he called for the removal of all physical and administrative obstructions impeding the delivery of life-saving aid to the people in Syria.
LINDA THOMAS-GREENFIELD (United States) said that upon last years renewal of the cross-border humanitarian mechanism, millions of Syrians could breathe a sigh of relief as the Council had put politics aside. Aid workers reach 2.4million people and feed 1.8million in Syrias north-west every month, pulling families back from the brink of famine. In a recent visit to Syria, she verified that the Bab al-Hawa border crossing is one of the most closely monitored and inspected in the world, as the work there sets a gold standard. Progress has been made on everything promised in resolution 2585 (2021). However, as every worker told her, crossline aid alone can reach thousands but not millions, and the situation is worse than ever, with the price of a food basket at record levels for the eighth consecutive month. Without cross-border aid, millions will die. Witnessing desperation in the eyes of aid workers, she condemned attacks on them and called for renewal and expansion of the cross-border mechanism, as the current operation is not reaching the bare minimum of those in need. We can get this done, because it is not about politics, she stressed. The vote could not be more straightforward.
DMITRY POLYANSKIY (Russian Federation), noting reports of food and fuel crises, expressed regret that the Secretary-Generals report does not pin responsibility on the United States because of its unilateral sanctions and ongoing occupation of north-east Syria. The fuel shortage is affecting the operation of water-supply plants and power stations, and farmers are being impacted. Pointing out that humanitarian workers decry Western sanctions which present obstacles to financial and logistical operations he said statements by Washington, D.C., and other capitals that unilateral sanctions are targeted and balanced ring hollow. He went on to stress that the humanitarian situation continues to worsen through tragic events that undermine security, spotlighting the series of Israeli air strikes on an airport near Damascus on 10June that forced a humanitarian route on which the lives of more than 2million people depend to close. On that, he said the lack of reaction by those parties who are so thrilled about humanitarian deliveries to Syria is astonishing. Recalling that only five cross-line convoys have occurred in the past year, he asked whether this was the Councils intention when it adopted resolution 2585 (2021) and underscored that organizing humanitarian deliveries in coordination with Damascus is possible to all parts of the country.
BARBARA WOODWARD (United Kingdom), emphasizing that the Council should take decisions that alleviate suffering and contribute to peace and security in Syria, pointed to the need to heed the advice of humanitarian actors on the ground. Recalling her countrys ministerial delegations visit to the Turkish-Syrian border, she highlighted the enormous effort that goes into ensuring regular and transparent cross-border operations. An end to that mandate would be catastrophic, she stressed, adding that the closure of previous crossings should serve as a clear warning: needs in the north-east have escalated since the closure of Yaroubiyah. Her country has pledged nearly $200million in humanitarian support in 2022 to bolster ongoing early recovery across all areas of Syria, including urban and rural livelihoods, rehabilitation of water networks and quality education for children. Urging delegates to review the evidence and listen to the experts, she stressed that Council resolution 2585 (2021) should be renewed and expanded.
RONALDO COSTA FILHO (Brazil) said his countrys position has remained unchanged since the start of this conflict in 2011: only a Syrian-owned and Syrian-led, United Nations-facilitated political process, with due regard for the preservation of Syria`s territorial integrity and sovereignty, will alleviate the immeasurable suffering that this conflict has inflicted. The Council must recognize, once and for all, that it faces a very serious problem. Despite the best efforts of the World Food Programme (WFP) and all United Nations agencies, as well as other humanitarian organizations, resources are not unlimited. As food and fuel prices soar worldwide, so do the costs of humanitarian operations. Sustainable solutions to ongoing conflicts are needed. During this acute economic crisis and escalating hunger, a thorough assessment of the potential deleterious consequences of unilateral sanctions on the civilian population is also essential. A ceasefire is urgently needed in Syria. He once again called on all parties to refrain from harming civilians and to comply with international humanitarian law.
ALICIA GUADALUPE BUENROSTRO MASSIEU (Mexico) said the guidelines for this discussion must be the humanitarian needs of the Syrian population without any politicization. This briefing shows the difficult context in which Syrians find themselves. The scope provided by the Bab al-Hawa border crossing cannot be replaced. About 800 trucks carrying humanitarian aid have entered this crossing per month and have reached 2.4million people. This crossing is crucial as people receive food and nutritional assistance through it. It is essential to maintain humanitarian access. Therefore, it is essential to renew this crossing for 12 more months. She appealed to all Council members to be guided by the humanitarian needs of the people who have endured this conflict for 11 years.
MOHAMED ABUSHAHAB (United Arab Emirates) noted that the cross-border aid delivery mechanism adopted by the Security Council eight years ago is an exceptional and temporary measure. It should not be considered as a long-term solution. There is a need for commensurate humanitarian plans, namely an increase in the number of crossline convoys in conjunction with additional support for early recovery projects. On the matter of northern Syria and the ongoing escalation on the Turkish-Syrian border, he stressed that the cross-border aid delivery mechanism should not be used to justify political interests, nor should it be used as a tool to interfere in Syrias affairs, as misuse will undermine its credibility as a purely humanitarian mechanism. In this regard, he stressed the importance of the delivery of humanitarian aid through the Bab al-Hawa crossing via United Nations humanitarian agencies and their partners on the ground. Highlighting the urgency of providing protection for humanitarian workers, he called on all parties to allow crossline convoys to pass through smoothly and without hindrance. Recalling resolution 2585 (2021), he urged States to consider how to intensify early recovery efforts by rehabilitating and rebuilding the infrastructure that was destroyed. In addition, international programs in food security, water, electricity, and health should be strengthened as key parts of such efforts.
JUN ZHANG (China) said that although resolution 2585 (2021) has played a role in helping Syria, it has not been fully and effectively implemented. The Council must analyze obstacles to humanitarian relief, in full respect of the sovereignty of Syria and the Governments ownership of crossline delivery, which should be the primary avenue of assistance. However, he noted there have only been five successful crossline deliveries, which face a litany of obstacles that should not doom further efforts. The Council must make explicit demands to ensure their effectiveness and safe passage. Stressing that key infrastructure must be fully protected, he cited a letter from the Syrian representative on 13June, condemning the Israeli attack on Damascus International Airport. Humanitarian relief must not be politicized, with priority given to funding early recovery projects without preconditions. Member States must actively engage in dialogue towards cross-border aid delivery which is solely an extraordinary arrangement that must comply with relevant Council resolutions, maintain transparency and impartiality, and face a clear timeline to being phased out. He called for the immediate lifting of unilateral sanctions on Syria, which have cost the country tens of billions of dollars.
NATHALIE BROADHURST ESTIVAL (France) joined other speakers in pointing out that in north-west Syria, 4.1million people need assistance, while 70percent of the population is experiencing food insecurity; the Russian war of aggression against Ukraine has further aggravated the situation. She also observed that even if crossline convoys were deployed regularly, they could not replace cross-border operations, which bring aid to more than 2.4million people each month. In comparison the five crossline convoys deployed since last August have provided aid to fewer than 50,000 people. Eightypercent of food aid in the north-west is transported by cross-border convoys, she added, although they are subject to the discretion and whims of the Syrian regime. A renewal of the cross-border mechanism, for at least twelve months, is therefore essential. Calling on all Council members to show unity and make decisions on solely humanitarian considerations, she stressed that they have a moral duty to save lives. Reconstruction of the country, however, can only begin when a political process in line with resolution 2254 (2015) is firmly under way. She recalled that nearly 96percent of the humanitarian funding announced for the 2022 comes from the European Union and its member States, United States, United Kingdom, Canada, Norway and Japan.
RAVINDRA RAGUTTAHALLI (India), noting that the number of people needing humanitarian assistance in Syria has now crossed 14.5million, stressed that decisive progress on the political track remains an imperative. Calling on all stakeholders, including external players, to commit to a Syrian-led and Syrian-owned United Nations-facilitated political process, he underscored that the launch of a military operation in north-eastern Syria could destabilize an already fragile situation. Also stressing the need to scale up humanitarian assistance, he pointed to falling production of food staples and issues related to water shortage, particularly in the Euphrates river basin. Voicing concern about the growing activities of terrorist groups such as ISIL/Daesh, he drew attention to the situation of internally displaced persons and noted that India has extended development assistance and human resource development support to Syria.
FERIT HOXHA (Albania), Council President for June, speaking in his national capacity, said today, World Refugees Day, a record high number of 100million people are currently displaced globally. This means that 1 in every 78 people on earth has been forcibly uprooted. Forty-twopercent of them are children. The Syrian crisis has entered its twelfth year and more than 14.6million Syrians are dependent on humanitarian aid to survive. This includes 4.1million people living in the north-west, where more than 70percent of the people are food insecure and are largely reliant on cross-border humanitarian assistance. In two weeks, on July10, the Council will vote on cross-border authorization of the only remaining border crossing point for humanitarian aid into Syria, Bab al-Hawa, under resolution 2585 (2021). For millions of Syrians needing life-saving assistance, there is no other alternative. He called on the Council to reauthorize the provisions of the cross-border resolution to maintain the Bab al-Hawa border crossing in north-west Syria.
BASSAM SABBAGH (Syria) emphasized that the Government is enhancing its efforts to restore security and stability and overcome the repercussions of the crisis through reconciliation and work to repair infrastructure. However, terrorism against Syria persists, especially through the Turkish regimes threatened aggression and Israels direct aggression. On that point, he said that Israels 10 June attack on the Damascus International Airport forced that facility to close, which has political, humanitarian, military and economic repercussions that will be suffered by all Syrians and countries in the region. All United Nations deliveries of humanitarian workers and life-saving supplies through that airport were forced to end following this attack, but certain Western delegations continue to obfuscate and prevent the Council from condemning this violation of international law.
He went on to say that the Turkish regimes threat to establish a so-called safe zone in northern Syria demonstrates its subversive policies to destabilize Syria by supporting terrorism, displacing people and effecting demographic change. Further, Western countries have both directly and indirectly refused to implement resolution 2585 (2021), reneging on commitments to enhance the delivery of humanitarian aid from within Syria. They continue to focus on the cross-border mechanism evident in the disparity between the number of cross-border and crossline convoys and propagate misinformation, while fighting implementation of the resolution on the ground. Stressing that the Turkish regime and its terrorist agents are the only beneficiaries of the cross-border mechanism, he pointed out that the so-called donor community has unnecessarily linked early recovery and resilience to politicized conditions.
MAJID TAKHT RAVANCHI (Iran) said the 11-year conflict, as well as occupation and terrorism, has created enormous hardships for the Syrian people. The situation has been aggravated by the unilateral sanctions that have stymied the implementation of resolution 2585 (2021), which calls for the provision of basic services and early recovery and reconstruction projects. This has impeded Syria's reconstruction efforts and hampered humanitarian aid delivery in many ways, including delaying the return of refugees and displaced persons. The Syrian Government's ability to achieve economic and social stability and improve the living conditions of Syrians was undermined by these illegal measures. Because of the dire situation in Syria, the provision of humanitarian aid is essential and political circumstances should not prevent humanitarian aid from reaching people. Yet this must be done with full respect for Syria's sovereignty, territorial integrity and national unity.
He went on to say that the Israeli regime continues to violate Syria's sovereignty and territorial integrity while the Council remains mute in this regard. He strongly condemned Israel's prolonged occupation of the Syrian Golan and its numerous breaches of Syria's sovereignty and territorial integrity. This includes the most recent attacks that targeted civilians and civilian infrastructure, particularly terrorist attacks against Damascus International Airport. These terrorist acts violate international law, international humanitarian law and Syria's sovereignty and jeopardize regional stability and security. He called on the Council to abandon its double standard and condemn the repeated Israeli acts of aggression unequivocally, holding this lawless regime accountable for its aggressions and malicious activities.
FERIDUN HADI SINIRLIOLU (Trkiye) said the worst manmade humanitarian crisis since the Second World War is still unfolding in Syria, with 4.1million of the 4.4million living in north-west Syria requiring humanitarian aid, and 2.8million people internally displaced. The Bab al-Hawa border crossing delivers aid to 2.4million people, with 800 trucks every month, and has provided 2million doses of COVID-19 vaccines. There is no hidden agenda at issue here the aim is nothing but to save lives, he stressed. The international community cannot turn a blind eye to millions of Syrians in desperate conditions, and the best way to help is through the United Nations cross-border operations, which is one of the most sophisticated, scrutinized and transparent humanitarian assistance systems ever established. Those operations are consistently inspected by the United Nations monitoring mechanism, and there have been no instances of non-humanitarian items found in the consignments.
Extension of the cross-border mandate is a moral imperative, must be guided by humanitarian considerations and should not be politicized, he continued. Without the monitoring mechanism, efforts will become less accountable and less transparent. The mechanism was a reflection of the international communitys commitment to the independence, unity and sovereignty integrity of Syria. Giving an overview of his countrys assistance, he noted that Trkiye provides temporary protection to almost 4million Syrians, adding that, over the past 11 years, more than 750,000 Syrian babies have been born in his country. Syrians want to see a united Council, he said, urging the Council to preserve the indispensable cross-border mechanism. Responding to the statement made by the representative of Syria, he said: I do not consider him as my legitimate counterpart. His presence here is an affront to the millions of Syrians who have suffered countless crimes at the hands of the regime.
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Bear in Brockton; day in the life of a firefighter; edgy clothing: 5 top stories last week – Enterprise News
Posted: at 10:21 pm
BROCKTONA black bear was caught onvideo wandering through a Brockton yard near north Pearl Street and Healey Terrace.
On Thursday, traffic on Route 495 in Middleborowas halted after an injuredblack bear was reported in the median of the highway.The Large Animal Response Team ultimately euthanized the bear.
Have you ever wondered what it's like to be a Brockton firefighter?Enterprise reporter Namu Sampath spent a day with Squad A to give you a behind-the-scenes look at what it's like to be a firefighter in Brockton.
The sixth annual Tutu Run and SparkleFest in honor of Sydney Craven was heldat the East Bridgewater Commercial Club.Sydney unexpectedly stopped breathing in her sleep nine days shy of her second birthday in 2015.
A 3-alarm blaze ravaged aBrockton home on Taber Avenue, leaving theresidents reeling.
In case you missed it, here are fivestories from the past week throughout the Brockton area that resonated with our readers.
It was about 6 a.m. Friday morning asKyle Boucher was working at his desk at homewhen he heard his mother screaming from another room."She's like, 'You got to see what the camera just picked up a couple hours ago,'" Boucher said.They have cameras set up around the exterior of their house. At first, as Boucher watched what the cameras had recorded, he thought he saw a panther walk across his backyard.Then he realized it was an approximately 200-pound black bear.
Black bear in Brockton yard: Bear caught on video wandering through Brockton yard, city alerts public to be on lookout
Video of bear in Brockton yard: Brockton resident catches black bear on camera wandering through backyard
0700, that's firefighter speak for 7 a.m., and the timethe eight Squad A firefighters who work the day shift at station one on Pleasant Street in downtown Brockton come in to work.The morning starts busy, after roll call and a quick run through the day by their captain andlieutenant, Shawn Kerr and Chris O'Reilly, respectively,the firefighters get moving on their tasks: making sure their equipment is sound, getting their gear readyandcleaning the station.Before 9:30 a.m., the firefighters have already respondedtotwo calls from Brockton residents asking for help.
What it's like to be a firefighter: Have you ever wondered what it's like to be a Brockton firefighter?
The sixth annual Tutu Run and SparkleFest in honor of Sydney Craven was heldat the East Bridgewater Commercial Club.Sydney unexpectedly stopped breathing in her sleep nine days shy of her second birthday in 2015.
Tutu Run photos: The sixth annual Tutu Run and Sparklefest honors East Bridgewater's Sydney Craven
Sparkle Box library: Sparkle Box library dedicated to East Bridgewater toddler at Central Elementary School
First Tutu Run: East Bridgewater toddler's memory will sparkle at Saturday event
A Brockton man needed an outlet to battle his depression. He found art wasthe best way, which led him to design an edgy clothing brand, Local Lost Boyz.Devin Ryan, 28, felt a void in his life in 2017 when he created thisbrand. To the young designer, it was an extension of his mental state and a way to express how he feltinside.Were all a little lost, even if its mentally, physically, or emotionally lost, Ryan said.
Edgy clothing business: Brockton man starts edgy clothing biz as outer expression of his inner struggles
Clothing photos: Brockton man finds himself with Local Lost Boyz clothing brand
Traffic on Route 495 in Middleborowas halted Thursday morning after an injuredblack bear was reported in the median of the highway.At 11:10 a.m., Massachusetts State Police reported that a car struck a black bear on the highway. Staff from the Massachusetts Environmental Police and MassWildlife arrived at the scene and tranquilized the bear, according to MassWildlife's Communications CoordinatorEmily Stolarski.Wildlife experts examined the bear anddetermined the animal "sustained significant injuries" and could not be relocatedaway fromthe highway. The Large Animal Response Team ultimately euthanized the bear.
Injured bear euthanized: Injured black bear euthanized on Route 495 in Middleboro
Staff writer Kathy Bossa can be reached by email at kbossa@enterprisenews.com. Support local journalism by purchasing a digital or print subscription to The Enterprise today.
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Do! Abilene This Week, June 27-July 3, 2022 – Abilene Reporter-News
Posted: at 10:21 pm
Staff report| Abilene Reporter-News
TUESDAY, JUNE 28
Texas Cowboy Reunion
STAMFORDThe 92nd annual Texas Cowboy Reunion will open at 9 a.m. at the Texas Cowboy Reunion rodeo grounds. A preview party and art sale with live music by Jake Hooker & The Outsiders will begin at 6 p.m. For ticket information, go to texascowboyreunion.com.
Business workshop
Texas Tech Small Business Development Center Abilene will conduct a workshop, How to Start a Small Business, from 2-3 p.m. in the Texas Tech Training Center, 749 Gateway St., Suite 301. To make a reservation, call 325-670-0300.
Square dance workshop
TYEThe Wagon Wheel Squares will conduct a square dance workshop at 6 p.m. at the Wagon Wheel. Tracey Dowell will be the caller.
WEDNESDAY, JUNE 29
Fire recovery
The Texas A&M AgriLife Extension will conduct a workshop for people affected by the Mesquite Heat Fire from 9 a.m. to 1 p.m. at the Taylor County Extension Office, 1982 Lytle Way. To register, or for information, call 325-672-6048.
Texas Cowboy Reunion
STAMFORDThe 92nd annual Texas Cowboy Reunion will continue at 9 a.m. at the Texas Cowboy Reunion rodeo grounds. A concert by Jody Nix & The Texas Cowboys will begin at 9:30 p.m. For ticket information, go to texascowboyreunion.com.
THURSDAY, JUNE 30
Texas Cowboy Reunion
STAMFORD The 92nd annual Texas Cowboy Reunion will continue at 8 a.m. at the Texas Cowboy Reunion rodeo grounds. A concert and dance featuring Dylan Wheeler and Colton Rice will begin at 9:30 p.m. For ticket information, go to texascowboyreunion.com.
Make Your Mark Gala
The Make Your Mark Gala, benefiting Big Brothers Big Sisters in honor of the life of Mark Rogers, will begin at 5:30 p.m. at the Abilene Convention Center, 1100 N. Sixth St. A dinner will be served, with an auction and live entertainment. For tickets or information, go to MakeYourMarkGala.com.
Nights at the NCCIL
Cliff Wilke will present an art program inspired by Walter Wick, "Nights at the NCCIL," at 6 p.m. at the National Center for Children's Illustrated Literature, 102 Cedar St. Tickets are $40, and include art supplies, two drink tickets and snacks. For tickets, go to nccil.org.
FRIDAY, JULY 1
Texas Cowboy Reunion
STAMFORDThe 92nd annual Texas Cowboy Reunion will continue at 8 a.m. at the Texas Cowboy Reunion rodeo grounds in Stamford. A concert and dance featuring William Clark Green and Slade Coulter will begin at 9:30 p.m. For ticket information, go to texascowboyreunion.com.
Movie at the library
A free showing of "Moana" will begin at 3 p.m. at the Abilene Public Library, 202 Cedar St.
Sea tales
As a part of the Abilene Public Library's "Sea Tales" program, a showing of the documentary "Aliens of the Deep" will begin at 4 p.m. at the South Branch Library in the Mall of Abilene.
Fourth of July celebration
CISCO The Cisco Chamber of Commerce will conduct a Fourth of July celebration at 6:30 p.m. at 1300 Front St., behind Cisco High School. A fireworks show will begin at dark, and food trucks will be available.
'Hello, Dolly!'
A production of the musical "Hello, Dolly!" Will be presented at 7:30 p.m. at the Paramount Theatre, 352 Cypress St. Tickets start at $12. For tickets or information, go to paramountabilene.com.
SATURDAY, JULY 2
Texas Cowboy Reunion
STAMFORDThe 92nd annual Texas Cowboy Reunion will continue at 8 a.m. at the Texas Cowboy Reunion rodeo grounds. Events include a fiddling contest at 11 a.m., cowboy symposium at 1:30 p.m. and a concert and dance featuring Giovannie and The Hired Guns and Holt Jones at 9:30 p.m. For ticket information, go to texascowboyreunion.com.
Independence Day celebrations
ROSCOE An Independence Day celebration will begin with a parade at 10 a.m. in downtown Roscoe. A mudbog will begin at noon at George Parks Baseball Field, with live music starting at 4 p.m. downtown and fireworks at 10:15 p.m.
Concerned Veterans of America will present the Red, White & Blue Bash from 4-11 p.m. in the SoDA District Courtyard, 817 S. Second St. Live music, free food, cornhole and a watermelon seed spitting contest will be available.
BROWNWOOD A Fourth of July bash will open at 8:30 p.m. at Wild Duck Marina at Lake Brownwood, with a fireworks show at 9:40 p.m. and a concert by Johnny Cooper at 10:15 p.m. Tickets start at $25, and are available via eventbrite.com.
Movie at the library
A free showing of "Pirates of the Caribbean: At World's End" will begin at 2 p.m. at the Abilene Public Library, 202 Cedar St.
'Hello, Dolly!'
A production of the musical "Hello, Dolly!" Will be presented at 7:30 p.m. at the Paramount Theatre, 352 Cypress St. Tickets start at $12. For tickets or information, go to paramountabilene.com.
MONDAY, JULY 4
Fourth of July
BUFFALO GAPThe Buffalo Gap Chamber of Commerce will conduct a Fourth of July parade at 9 a.m. starting at Buffalo Gap Church of Christ, and continuing to the Old Settlers Reunion Grounds. Awards will be given for best floats and costumes. For information, call 325-572-3097.
SWEETWATERA Fourth of July parade will begin at 9:30 a.m. through downtown Sweetwater, with lineup starting at 9 a.m. on Ash Street. The annual "Sparks in the Park" fireworks show will begin about 9:30 p.m. at Newman Park.
The annual Hillcrest Neighborhood Parade will begin at 10 a.m., starting at 2490 Campus Court. Hillcrest Church of Christ will provide an ice cream social following the parade.
The Abilene Community Band will present a patriotic concert at 7 p.m. on the east lawn of Episcopal Church of the Heavenly Rest, 602 Meander St. Visitors are encouraged to bring lawn chairs, blankets and snacks. Admission is free.
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Summer 2022: The hot job is saving lives – The Gloversville Leader Herald – Gloversville Leader-Herald
Posted: at 10:21 pm
The nation is currently weathering through its second year of a lifeguard shortage, forcing pools around the country to either shorten their hours, reduce capacity, or close altogether. And despite social distancing, mask regulations and other COVID-19 restrictions loosening up, some Capital Region pools have not been immune to the struggle.
Schenectady and Clifton Park are just twocommunitiesstruggling to fill their lifeguard positions.
We have a good team of lifeguards right now but we could probably definitely stand to have a few more, said Julie Rouse, the unit director of the Rotterdam Boys & Girls Clubhouse and aquatics director of Schenectady City Pools.
The Boys & Girls Clubs of Schenectady employ the lifeguards for the citys pools, including the Central Park Pool, the Front Street Pool, the Quackenbush Pool and the Hillhurst Pool. A few years ago, when lifeguard numbers were normal, their team would be made up of approximately 50 to 60 lifeguards. Now their numbers are in the 30s.
We have 35 lifeguards now and I would love to see us have 40 to 42 lifeguards, said Rouse.
Due to needed repairs, Hillhurst Pool will remain closed this season. The decision, made by the city of Schenectady, brought both disappointment to the community and slight relief to the strain of filling lifeguard positions.
Im always sad to see a swimming pool close because that means that there is less of an opportunity in the summer for a neighborhood [to swim], said Rouse. As far as staffing goes, it was certainly a little sigh of relief.
The Town of Clifton Park has faced similar challenges with its three municipal pools, Country Knolls, Barney Road and Locust Lane.
Phil Barrett, the town supervisor, said historically the pools end their seasons on Labor Day. But in recent years, this has not been possible due to the shortage of lifeguards. Barrett also said usually one of the pools can remain open until the end of the season, but only because the other two pools close early and those guards are recruited to the remaining pool.
The varying ages of guards pose an issue within itself. Many high school student guards are still finishing the school year as the pools are opening for the summer. For most of them, the school day ends past 2 p.m., therefore college-aged guards are relied on to cover the hours before that.
Additionally, many college students are needed to fill head lifeguard and other management positions and to teach swim lessons. But many of them have internship commitments or will leave for college before the pool season concludes.
Lauren Sposili, 21, one of the oldest lifeguards at Locust Lane Pool, has worked there for about five years and was promoted to a head guard position last summer. She said she is still seeing the effects of the COVID-19 pandemic on the number of lifeguards available. Sposili said that the two-year gap of time when lifeguard training courses werent availablerestricted adolescents from getting the required lifeguard certification.
I definitely would say the atmosphere has changed. I mean, the guards, were trying to do our best with the shortage of employees, were all working as many hours as we can with our busy schedules. So were trying to kind of help out as much as we can, Sposili said.
Lifeguards at Schenectadys pools will undergo a similar strain. Ideally, the lifeguards would be working six hours each day. Because of the lack of lifeguards, however, they can now expect to work a minimum of five 8-hour days every week. Although it will be extra work, Rouse said the lifeguards are ready to take on the job.
Theyre pretty upbeat and positive, and its something we communicate a lot about, said Rouse. In order to protect the lifeguards from over-exhaustion, sun exposure, and other dangers, the pools have multiple supervisorswho will be watching over the pools and the guards tomake sure they are drinking enough water, getting enough rest, and feeling steady and alert. All supervisors are willing and ready to step up into a lifeguard chair if need be.
The pools are providing various incentives to try to draw people to lifeguarding. One of the key challenges has been training. Not only do training courses take a lot of time and energy, but they are also expensive, costing upwards of $400 or sometimes more for those looking to lifeguard at a State Park beach or waterfront.
In all of the regions except for Long Island, you have to show up having American Red Cross certification in lifeguarding, they want the waterfront extension, you need first aid CPR, and AED so you have multiple certifications that you need to take and all of those cost (s), said Ryan Clark, the president of the New York State Lifeguard Corps, which employs approximately 1,100 lifeguards at 87 parks and campgrounds managed by the states Office of Parks, Recreation and Historic Preservation and Department of Environmental Conservation. The initial cost up-front could be prohibitive.
To try to mitigate the expense of the training, the Schenectady pools are offering a payment plan to interested lifeguards. Rather than being required to pay for the training course upfront, they have the option of paying gradually over time, lessening the financial burden.
Additionally, the American Red Cross is lending a helping hand to Capital Region pools, knowing how much their businesses are struggling.
Now, many facilities are faced with recruiting, hiring and training 100% of the staff required to operate safely including lifeguards, Water Safety Instructors and managers, Abigail Adams, regional communications director of the American Red Crosss Eastern New York Region, said in a statement.
Saratoga County partnered with the American Red Cross to offer free lifeguard training classes to adolescents 15 and older this past May and early June at the Ballston Spa High School and Clifton Parks Locust Lane Pool. Barrett was happy to see 28 participants and looks forward to hopefully offering this free opportunity in the future.
Competition with other industries has also proven to be a challenge.
Currently, staff shortages go beyond the aquatic industry and the increased competition for workers has made it difficult for aquatic facilities to hire and retain staff, Adams said.
As other companies, such as Target and Costco, raise their starting wages, New York pools and beaches are finding it difficult to draw in potential hires, as they can easily find less physically laborious jobs for the same or higher pay.
With the significant increases that minimum wage has gotten over the years and, really, deservedly so we had our competitive advantage really erased, said Clark. You can get a job at Costco for $17 you dont need to save somebodys life, you dont need to be fit, you dont need to know first aid CPR or anything, so I think the job had become less attractive for the money.
To combat this, New York State Governor Kathy Hochul announced a significant pay increase for state lifeguards on Wednesday. Previously, the starting pay rate for lifeguards working at upstate New York State Park beaches and pools and Department of Environmental Conservation campgrounds and day-use beaches was $14.95 per hour. Now, after a 34% increase, they will be making $20 per hour.
Were so appreciative that she realized what an issue this was getting lifeguards into chairs this summer, said Clark.
Lifeguards are needed across the nation now more than ever before.
There are drownings that are happening day after day after day in the same locations and that is something that we really need to work together, not only in our own community and backyard but really across the board because its a national problem, said Rouse.
But becoming a lifeguard will not only help pools struggling to stay open, it will also teach skills that can be utilized in other areas of life, outside the workplace. Sposili emphasized the importance of such skills in the community at a pool party or a barbeque, for example. Something may go wrong in one of those scenarios, but there may not be someone present that knows what to do.
Having that skill set of the lifeguard training as well as the CPR and first aid can help someone you love or someone youre close to, Sposili said.
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How Does Deforestation Affect the Carbon Cycle? – EARTH.ORG
Posted: at 10:21 pm
Carbon is an essential element for all life forms on Earth. The intake and output of carbon are necessary components of all plant and animal life, whether these life forms absorb carbon to help manufacture food or release it as part of respiration. Maintaining the stability of the carbon cycle is therefore crucial for the well-being of living species. Yet, human activities such as burning fossil fuels and cutting down forests are disrupting the balance of the cycle, releasing huge amounts of greenhouse gases and contributing to climate change. How does deforestation affects the carbon cycle and what are some of the solutions that could reduce the impact of this phenomenon?
The carbon cycle describes the process in which carbon atoms continually travel from the atmosphere into different organisms in the Earth and then back into the atmosphere, over and over again. These atoms encounter several major reservoirs along the cycle, including the atmosphere, oceans, lithosphere, terrestrial biosphere, aquatic biosphere, as well as fossil fuels. Since the Earth is a closed system, the total amount of carbon found here remains unchanged. However, the amount of carbon in a specific reservoir can change over time as carbon moves from one reservoir to another.
Maintaining a balance of carbon among the different reservoirs which requires the amount of carbon naturally released from reservoirs to be equal to the amount they absorb is imperative. Yet, through human interventions first and foremost deforestation the carbon cycle is facing a loss in balance, with more carbon gases released into the atmosphere under the clearance of forests.
Figure 1: The Carbon Cycle
Deforestation is the conversion of forested areas to non-forest land use such as arable land, urban use, logged area, or wasteland. Tough its rate has been declining substantially, deforestation remains a pressing problem that cannot be ignored. Among the direct causes of deforestation is agricultural expansion, with forests being converted to cropland and pasture in order to grow crops and raise livestock, infrastructure expansion resulting from urbanization as well as logging both illegal and legal.
Since 1990, humans have cleared around 420 million hectares of forests worldwide. Tropical rainforests such as the Amazon rainforest in South America, the Congo rainforest in Africa, as well as the tropical islands in Southeast Asia, are among the most affected by deforestation. Around 17% of the Amazon has been lost in the last 50 years, mainly owing to forest conversion for cattle ranching. In 2019, 1.17 million acres of primary forest disappeared in Congo, second only to Brazils total deforestation that year. This continuous and ongoing clearance of forests has a major impact on the environment and the carbon cycle.
Figure 2: Annual Deforestation, 2015
You Might Also Like: 8 Phenomenal Rainforest Facts That Will Blow Your Mind
Carbon travels from the atmosphere to biomass reservoirs through photosynthesis: in this process, plants absorb carbon dioxide and sunlight to create fuel required for the development of their structures, including tree trunks, roots, branches, and leaves.
Along with oceans, forests are important carbon sinks, capable of holding 861 gigatons of carbon. The Amazon, the worlds largest rainforest, is a natural carbon sink and provides one of the greatest services for planet: absorbing and storing carbon dioxide from the atmosphere. Its ability to do so is crucial in our fight against the climate crisis. In trees and carbon-rich solid, the forest stores the equivalent of four to five years worth of human-made carbon emissions, up to 200 gigatons of carbon. Yet, as a result of persistent deforestation and a sharp increase in wildfires, the Amazon has been converted into a source of carbon, and is now emitting a greater amount of carbon dioxide than it is absorbing. Forest fires produce three times more carbon than the forests can absorb, thus creating a negative loop. As Yadvinder Malhi a professor of ecosystem science at the University of Oxford explains: If our sink is disappearing argues Malhi youre losing the service that the biosphere provides.
This is just an example of how human interventions have interfered with the balance and stability of the carbon cycle. Through a technique called slash-and-burn a farming method that involves the cutting and burning of plants in a forest or woodland the carbon stored in trees is released, returning back to the atmosphere. Soil, without trees or vegetation, will also become a large source of accumulated carbon emissions, especially when the soil is rich in partially decayed organic matter known as peat. Without forest cover, previously inundated peat soil is left exposed and wil gradually oxidise and decay. During these processes, huge amounts of carbon stored in the soil are released back into the atmosphere.
Depending on the forest-clearing method, the release of carbon from the biosphere back to the atmosphere may take place at different speeds. For example, clearance by burning causes immediate release of carbon. However, twigs, branches or stumps, and many other components of the forest biomass that are left after harvesting will decay over time, releasing stored carbon back into the atmosphere in a much slower process that takes years or even decades.
Afforestation and reforestation are common ways to restore forests. The first one is the conversion of long-time non-forested land into the forest, while reforestation refers to the replanting of trees on more recently deforested land. Since most emissions of carbon from deforestation occur immediately, afforestation and reforestation might not be adequate in removing carbon from the atmosphere due to their slow process and should be adopted only as a long-term solution. In the meantime, other short-term solutions are needed.
To begin with, local governments should provide financial incentives and actively work with forest communities to encourage the sustainable harvesting of non-wood forest products such as rubber, cork, produce, or medicinal plants to substitute wood. Low-impact agricultural activities such as shade farming a farming practice that leaves many of the original rainforest trees to provide shade for shade-loving crops can also be promoted to the communities to further discourage deforestation.
Unfortunately, most conservation and protected areas in the world are not well-funded and thus more prone to deforestation. To tackle this issue, the World Wide Fund for Nature (WWF) initiated the Project Finance for Permanence (PFP), a programme that creates funds to support the proper management of protected areas around the world as well as promote the creation of new ones.
Besides solutions on a local scale, international organisations such as the United Nations play a huge role. A great example of an effective campaign to reduce deforestation is REDD (Reducing Emissions From Deforestation and Forest Degradation), a collaborative programme first initiated by the UN in 2005. REDD provides incentives to change the ways in which forest resources are used. The programme funds environmentally-friendly forest management, restricts poor forest management, and introduces carbon trading as an economic incentive.
REDD+ an extension of the REDD programme was introduced in 2013 by the United Nations Framework Convention on Climate Change (UNFCCC). This climate change mitigation solution puts further emphasis on the role of conservation, sustainable management of forests and enhancement of forest carbon stocks in developing countries by developing and implementing national action plans and public policies. Once the action plan of a country is verified, REDD+ can provide financial support to implement strategies to tackle forest degradation and reduce deforestation.
As of January 2020, a total of 50 developing countries have submitted a REDD+ forest reference level or forest reference emission level for technical assessment to UNFCCC, covering more than 70% of the total forest area in developing countries. Through periodical assessments, the UNFCC can keep track of the conservation progress made by the countries, providing further support and assistance when necessary.
EO Position: The problem of deforestation will continue to be an ongoing challenge that warrants our attention. Besides its effect on the carbon cycle, the detrimental impacts of this phenomenon on the Earths biodiversity, water cycle, soil, and public health need to be addressed as well. Aside from the action taken by local government and international organizations, all of us could also take part in protecting the forest by purchasing products that are certified as sustainably produced or harvested. With substantial help from different parties, the negative impact brought by deforestation could certainly be alleviated, if not eliminated, in the coming future.
You Might Also Like: 10 Deforestation Facts You Should Know About
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Viridian Therapeutics to Participate in June Investor Conferences – GuruFocus.com
Posted: at 10:21 pm
WALTHAM, Mass., June 01, 2022 (GLOBE NEWSWIRE) -- Viridian Therapeutics, Inc. ( VRDN), a biotechnology company advancing new treatments for patients suffering from serious diseases underserved by current therapies, today announced that Jonathan Violin, Ph.D., President and Chief Executive Officer of Viridian, will participate in two fireside chats at the Jefferies Healthcare Conference being held in New York on June 8 -10, 2022 and the JMP Securities Life Sciences Conference in New York on June 15 - 16, 2022.
The live webcast and a replay of the fireside chats can also be accessed under Events in the Investors section of the Viridian Therapeutics website.
About Viridian Therapeutics
Viridian Therapeutics is a biotechnology company advancing new treatments for patients suffering from serious diseases but underserved by todays therapies. Viridians most advanced program, VRDN-001, is a differentiated monoclonal antibody targeting insulin-like growth factor-1 receptor (IGF-1R), a clinically and commercially validated target for the treatment of thyroid eye disease (TED). Viridians second product candidate, VRDN-002, is a distinct anti-IGF-1R antibody that incorporates half-life extension technology and is designed to support administration as a convenient, low-volume, subcutaneous injection. TED is a debilitating autoimmune disease that causes inflammation and fibrosis within the orbit of the eye which can cause double vision, pain, and potential blindness. Patients with severe disease often require multiple remedial surgeries to the orbit, eye muscles and eyelids. Viridian is based in Waltham, Massachusetts.
Investor and Media ContactJohn JordanViridian TherapeuticsVice President, Investor Relations& Corporate Communications617-272-4691[emailprotected]
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OptimizeRx Brings Real-World Evidence-Driven Engagement Programs to Social Media With New Exclusive Partnership – GlobeNewswire
Posted: at 10:21 pm
ROCHESTER, Mich., June 23, 2022 (GLOBE NEWSWIRE) -- OptimizeRx Corp. (the Company)(Nasdaq: OPRX), a leading provider of point-of-care technology solutions helping patients start and stay on therapy, today announced a major extension of its omni-channel platform reach through an exclusive partnership with Equals 5. The new extension is the only healthcare provider (HCP)-level solution providing targeted physician engagement on social media platforms. The partnership marks the first time real-world data from healthcare and social data can be used in combination to deliver valuable treatment information to physicians on social media platforms.
We chose to collaborate with OptimizeRx because we were looking for a partner with capabilities and data that, together, could enhance both our technologies, creating true omni-channel coverage in reaching HCPs, commented Ron Scalici, co-founder of Equals 5. OptimizeRxs application of AI to real-world data assets that can determine the right time to engage HCPs at the moment their patients most need it is unique in the market, and perfectly complements the technology weve built which enables us to reach those same HCPs on social media. We couldnt be more excited about the possibilities to make meaningful connections between life sciences and physicians this way.
The only HCP-level engagement solution offering true-omni channel reachLife sciences organizations can now confidently deliver the same message on webpages, social media, and clinical workflow from within a single healthcare communications platform. The Companys Therapy Initiation and Persistence Platform, is the only HCP engagement solution that offers true omni-channel reach at the physician-level including:
allowing for true surround sound of brand awareness for life sciences.
Steve Silvestro, chief commercial officer at OptimizeRx, stated, Were extremely impressed by the Equals 5 technology. On initial testing, were seeing average match results for up to 84% of the HCPs that our clients have prioritized to reach on social media. Our partnership means that life sciences companies now have a true option for the reinforcement of their messaging that is specific to an HCPs specialty across all digital channels from one entry point: our Therapy Initiation and Persistence Platform. This powerful platform enhancement creates a new avenue for specialty brand amplification outside of the EHR.
Organizations taking a highly structured approach to their social media strategies see 20-40% higher engagement with their audiences overall, according to a recent McKinsey analysis(1). What this means for life sciences companies is the ability to truly engage with their customers on social media in a more meaningful and productive way with the ability to execute on more integrated engagement strategies.
Will Febbo, OptimizeRx CEO, noted, The launch of this extension is part of the transformational digital shift in healthcare that we are leading. The offering is a true industry game changer and opens the opportunity for life sciences companies to broadly reach HCPs through social media channels, including Facebook and Instagram. Our Therapy Initiation and Persistence Platform is the only HCP engagement solution that combines true interoperability between longitudinal patient data, the EHR and now social media to deliver healthcare resources to physicians and patients based on an HCPs actual patient population.
About Equals 5Equals 5 is an all-in-one pharma marketing platform that reaches physicians where they spend most of their free time on social media. Equals 5's proprietary engine allows to target HCPs by NPI number, giving pharma marketers the ability to serve specific healthcare providers with relevant and timely information to help them make the right decisions for their patients.
About OptimizeRxOptimizeRx is the best-in-class health technology company enabling care-focused engagement between life sciences organizations, healthcare providers, and patients at critical junctures throughout the patient care journey. Connecting over 60% of U.S. healthcare providers and millions of their patients through the most intelligenttechnology platform embedded within aproprietary digital point-of-carenetwork, OptimizeRxhelpspatients start and stay on their medications.
For more information, follow the company onTwitter,LinkedInor visitwww.optimizerx.com.
Important Cautions Regarding Forward-Looking StatementsThis press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Words such as anticipates, believes, estimates, expects, forecasts, intends, plans, projects, targets, designed, could, may, should, will or other similar words and expressions are intended to identify these forward-looking statements. All statements that reflect the Companys expectations, assumptions, projections, beliefs, or opinions about the future, other than statements of historical fact, are forward-looking statements, including, without limitation, statements relating to the Companys growth, business plans, and future performance. These forward-looking statements are based on the Companys current expectations and assumptions regarding the Companys business, the economy, and other future conditions. The Company disclaims any intention or obligation to publicly update or revise any forward-looking statements, whether because of new information, future events, or otherwise, except as required by applicable law. Forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified. Future events and actual results could differ materially from those set forth in, contemplated by, or underlying the forward-looking statements. The risks and uncertainties to which forward-looking statements are subject include, but are not limited to, the effect of government regulation, competition, and other risks summarized in the Companys Annual Report on Form 10-K for the fiscal year ended December 31, 2021, its subsequent Quarterly Reports on Form 10-Q, and its other filings with the Securities and Exchange Commission.
OptimizeRxContactAndy DSilva, SVP Corporate Financeadsilva@optimizerx.com
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References:(1) Social Media as a Service Differentiator: How to win - https://www.mckinsey.com/business-functions/operations/our-insights/social-media-as-a-service-differentiator-how-to-win
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Outcomes of COVID-19 in Inflammatory Rheumatic Diseases: A Retrospective Cohort Study – Cureus
Posted: at 10:18 pm
Background
Similar to coronavirus disease 2019 (COVID-19), the pathogenesis of inflammatory rheumatic diseases includes cytokines dysregulation and increased expression of pro-inflammatory cytokines. Although current data from international studies suggest that rheumatic diseases are associated with a higher risk of COVID-19 infection and worse outcomes, there is limited literature in Saudi Arabia. This study aims to evaluate the outcomes and length of hospital stay of COVID-19 patients with inflammatory rheumatic diseases in Saudi Arabia.
This was a single-center retrospective cohort study that included 122 patients with inflammatory rheumatic diseases and documented coronavirus disease 2019 (COVID-19) infection from 2019 to 2021. Patients with suspected COVID-19 infection, non-inflammatory diseases, such as osteoarthritis, or inflammatory diseases but without or with weak systemic involvement, such as gout, were excluded.
The vast majority (81.1%) of the patients were females. Rheumatoid arthritis was the most common primary rheumatological diagnosis. The admission rate was 34.5% with an overall mortality rate of 11.5%. Number of episodes of COVID-19 infection, mechanical ventilation, cytokine storm syndrome, secondary bacterial infection, number of comorbidities, rituximab, diabetes mellitus, hypertension, chronic kidney disease, and heart failure were significantly associated with a longer hospital stay. Additionally, hypertension, heart failure, rituximab, mechanical ventilation, cytokine storm syndrome, and secondary bacterial infection were significantly associated with higher mortality. Predictors of longer hospitalization were obesity, numberof episodes of COVID-19 infection, mechanical ventilation, number of comorbidities, and chronic kidney disease, whereas, hypertension was the only predictor of mortality.
Obesity, number of episodes of COVID-19 infection, mechanical ventilation, number of comorbidities, and chronic kidney disease were significantly associated with higher odds of longer hospitalization, whereas, hypertension was significantly associated with higher odds of mortality. We recommend that these patients should be prioritized for the COVID-19 vaccine booster doses, and rituximab should be avoided unless its benefit clearly outweighs its risk.
Since the outbreak of coronavirus disease 2019 (COVID-19), in Wuhan, China, many studies have been conducted to investigate the effect of COVID-19 on the course of multiple diseases. Although it is primarily a respiratory disease that manifests as pneumonia, it could potentially affect other organs and systems including the heart, kidney, gastrointestinal tract, nervous and immune systems, and blood [1].
COVID-19 usually manifests as mild-to-moderate self-limiting respiratory symptoms, such as fever, cough, shortness of breath, and loss of taste and smell. On the other hand, in a severe form of the disease, some patients may require hospitalization and intubation with mechanical ventilation [2,3]. Several factors have been associated with poor outcomes in COVID-19, including old age and preexisting comorbidities, such as diabetes mellitus (DM), hypertension (HTN), and chronic pulmonary diseases [4,5]. Current data suggest that rheumatic diseases impose an additional risk of COVID-19 infection and are associated with poorer outcomes. This risk varies based on the underlying rheumatic disease, comorbidities, and treatments [6].
Autoimmune connective tissue diseases are chronic diseases with female predominance. The most common connective tissue diseases aresystemic lupus erythematosus (SLE), scleroderma, myositis, rheumatoid arthritis (RA), and Sjogrens syndrome [7,8]. The pathogenesis of these conditions is highly complicated, and it includes excessive production of pro-inflammatory cytokines, and therefore, high disease activity could result in flares with severe systemic symptoms and increased inflammatory markers. Similarly, COVID-19 has been associated with cytokine dysregulation and increased expression of pro-inflammatory cytokines, which can cause cytokine storm syndrome (CSS) [9,10]. Furthermore,patients who are already on immunosuppressants are more vulnerable to infection [11,12].
Due to the variability of the results among different studies concerning the outcomes of rheumatic patients with COVID-19, and due to limited literature in Saudi Arabia, we aimed to study the impact of autoimmune connective tissue diseases and immunosuppressants on COVID-19 severity, hospitalization, intensive care unit admission rates, and mortality in Saudi Arabia.
We sought to evaluate the outcomes (as mortality/survival) and length of hospital stay (if hospitalization was needed) of polymerase chain reaction (PCR)-positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients with known inflammatory rheumatic diseases.
This was a single-center retrospective cohort study that took place in King Abdulaziz Medical City (KAMC), Ministry of National Guard-Health Affairs (MNG-HA), Riyadh, Kingdom of Saudi Arabia.KAMC is an academic government-funded tertiary hospital that combines clinical care, training, academics with research, and state-of-the-art medical technologies.
All adult patients with systemic inflammatory rheumatic diseases and PCR-proven COVID-19 infection, from 2019 to 2021 were included. Initially, 192 patients were identified, but after applying the inclusion and exclusion criteria, only 122 were eligible. Patients with suspected COVID-19 infection, non-inflammatory diseases, such as osteoarthritis and fibromyalgia, or inflammatory diseases but without or with weak systemic involvement, such as gout, were excluded.
The required data were obtained by screening electronic medical records(via the KAMC electronic system - BestCare; Seoul, South Korea: ezCaretech Co.) of allrheumatology patients who were seen in the clinic or admitted to the hospitalfrom 2019 to 2021. The following data were collected: demographics, comorbidities (such as diabetes mellitus, hypertension, and chronic kidney disease), primary rheumatological diagnosis, symptoms of COVID-19, number of episodes of COVID-19 infection (patients with more than one COVID-19 infection after recovery of the first COVID-19), steroid dose, immunosuppressants, length of admission (in weeks), length of ICU admission, mechanical ventilation, cytokine storm syndrome, secondary bacterial infection, and outcomes (as mortality or survival). To know the number of episodes of COVID-19 infection, reinfection was defined as having a positive PCR test for SARS-CoV-2 after having two negative PCR tests in a previously infected patient. Cytokine storm syndrome was defined as a serum ferritin level of at least 10g/L, and secondary bacterial infection was defined as having a positive, respiratory or blood, bacterial culture after COVID-19 diagnosis.
Statistical Package for the Social Sciences (SPSS) version 22 (Armonk, NY: IBM Corp.) was used for data analysis. Categorical variables were presented as frequencies and percentages, whereas, numerical variables were presented as meanstandard deviation. Due to the small sample size, Fisher's exact test was used instead of chi-square to test the association between categorical variables, and independent sample t-test was used to test the association between numerical variables. Multivariate logistic regression analysis was done to assess the predictors of COVID-19 infection mortality and hospitalization by calculating the adjusted odds ratios, and odds ratios were reported with 95% confidence interval. A test was considered significant if two-sided p-value was <0.05.
The study was approved by the Institutional Review Board of King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia (#RC20/665/R). Informed consent was waived because of the retrospective nature of this study. Access to the data was restricted to the researchers. The confidentiality of all patients was protected, and no names or medical record numbers were used. Privacy and confidentiality were assured and all the data, both hard and soft copies, were kept in a secure place within the National Guard-Health Affairs premises.
The demographics of the patients are shown in Table 1.There were a total of 192 rheumatology patients with COVID-19, only 122 of whom were eligible for inclusion. The vast majority (n=99, 81.1%) of the patients were females with a mean age of 48.316 years and an average BMI of 30.86.4 kg/m2. RA, SLE, psoriasis, and antineutrophil cytoplasmic antibodies (ANCA)-positive vasculitis were the most common primary rheumatological diagnoses, accounting for 41.8%, 24.6%, 8.2%, and 5.7% cases, respectively (Figure 1).The most notable associated comorbidities were HTN, DM, hypothyroidism, chronic kidney disease (CKD), heart failure (HF), and bronchial asthma, accounting for 32.0%, 27.9%, 11.5%, 10.7%, 6.6%, and 5.7% cases, respectively (Figure 2).
Lower respiratory tract symptoms, such as cough and shortness of breath, were the most prominent COVID-19 symptoms with a percentage of 48.4%. Other common COVID-19 presenting symptoms were upper respiratory tract (45.1%) and gastrointestinal symptoms (10.7%). Only five (4.1%) patients had a history of two COVID-19 infections. The majority (65.6%) of the patients did not require hospitalization. However, 16.4% required admission for 7 days, 11.5% for eight to 30 days, and 6.6% for >30 days.
The overall mortality rate was 11.5%. A small fraction of the patients (n=17) required ICU admission. Of those, 14 required intubation with mechanical ventilation with a mortality rate of 85.7%. Secondary bacterial infection was only identified in eight (6.6%) patients, four of whom have died. None of the patients who developed CSS (n=4) have survived.
On Fisher's exact test, having more than one COVID-19 infection, intubation with mechanical ventilation, CSS, secondary bacterial infection, and having more than one comorbidity were significantly associated with longer hospital stay (p=0.006, <0.001, 0.006, 0.01, and <0.001, respectively) (Table 2).Moreover, patients with DM, HTN, CKD, and HF were significantly more likely to have longer hospital stay (p=0.001, 0.003, 0.003, and 0.011, respectively). However, only HTN and HF were significantly associated with higher mortality (p=0.002 and 0.006, respectively) (Table 3).
As a part of their treatment regimen for an underlying rheumatological disease, 60.7% of the patients were on prednisone, 46.7% were on hydroxychloroquine, 28.7% were on methotrexate, 9.8% were on anti-TNF (infliximab or etanercept), 9.0% were on mycophenolate and azathioprine, and 4.9% were on rituximab and tocilizumab. Of the aforementioned immunosuppressants, only rituximab was significantly associated with longer hospitalization and mortality (p=0.046, 0.001). No significance was found between steroid dose and hospital length of stay (p=0.605) or mortality (p=0.821) (Tables 2, 3).
Females had more favorable survival compared to males (p=0.025). Intubation with mechanical ventilation, CSS, secondary bacterial infection, and hospital length stay were associated with higher mortality rates (p0.001, <0.001, 0.006, and 0.001, respectively). Having a higher number of comorbidities was not associated with higher mortality (p=0.11) (Table 3).
In multivariate regression model, obesity (odds ratio {OR}=60.669, 95% confidence interval {CI} 3.53-1042.413, p=0.005), number of COVID-19 infection (OR=59.08, 95% CI 2.532-1378.362, p=0.011), intubation with mechanical ventilation (OR=23.238, 95% CI 3.15-171.434, p=0.002), number of comorbidities (OR=7.11, 95% CI 1.911-26.454, p=0.003), CKD (OR=6.178, 95% CI 1.706-22.38, p=0.006), and HTN (OR=5.291,95% CI 1.266-22.112, p=0.022) were significantly associated with higher odds of hospitalization (Table 4).The only comorbidity that was significantly associated with higher odds of mortality was HTN (OR=5.291, 95% CI 1.266-22.112, p=0.022) (Table 5).
Autoimmune connective tissue diseases are chronic inflammatory diseases with highly complicated pathogenesis that includes excessive production of pro-inflammatory cytokines. Similarly, COVID-19 has been associated with cytokine dysregulation and increased expression of proinflammatory cytokines [9-11]. Patients who are already on immunosuppressive medications are logically more vulnerable to infections [11,12]. Current data suggest that rheumatic diseases are associated with an additional risk of COVID-19 infection and poorer outcomes [6]. In this study, we explored the impact of autoimmune connective tissue diseases and immunosuppressive medications on COVID-19 severity, hospitalization, intensive care unit admission, and mortality rates in Saudi Arabia.
Our patients had a mean age of 48.316 years with females being predominant (81.1%). This is attributed to the fact that inflammatory autoimmune diseases generally have female predilection [7,8]. This is in accordance with other studies, as DSilva et al. who studied the outcomes of 52 COVID-19-infected patients with rheumatic diseases, also reported female predominance. Compared to previously published studies, our patients had a relatively younger mean age [13,14]. Overall hospital mortality of COVID-19 is generally between 15% and 20% and can reach up to 60% in older patients. However, it highly varies across cohorts, reflecting differences in the completeness of testing and case identification, variable thresholds for hospitalization, and differences in outcomes [15-17]. Hospital mortality ranges from less than 5% in patients younger than 40 years to 35% in 70-79 years and greater than 60% in 80-89 years [18]. In our study, the mortality rate was 11.5%, and the mean age was 48.3 which is in compliance with some of the studies. To clarify, Montero et al. reported a mortality rate of 16% [12]. The two percentages are close, and probably our study would have a higher mortality rate if it was delayed further. In contrast, Sharmeen et al. mentioned a mortality rate of 5.9% [19]. Although both Montero and Sharmeen studies have published their works in August 2020, the mortality rates are utterly different. It is hard to judge whether, for example, patients with low mortality rates have been vaccinated and therefore had a milder form of the disease or specific immunosuppressive regimen could have protected those patients. Another factor that could potentially contribute to the differences in mortality rate is the mean age. In our study, the mean age was 48.3 years, whereas, in Montero and Sharmeen they were 60.9 and 57 years, respectively [12,19]. This could not explain the low mortality rate reported in Sharmeen's study.It is also important to mention that our mortality rate might not reflect the actual percentage due to the small sample size and the following limitations: 1) we do not have a unified database for all patients throughout Saudi Arabia and so we could not include patients from other hospitals. 2) Many patients were non-eligible for follow-up in our institution (MNG-HA, KAMC), and so, they might have died outside our institution. 4) Many patients might have died after we collected the data. 3) Many patients, even if eligible, lives outside Riyadh and so cannot be followed up. In our country,Saudi Arabia, at least 56,707,289 doses of COVID vaccines have been administered so far though the mortality rate in our study is still high [20].
The need for admission of COVID-19 patients in the general population depends mainly on their age and preexisting comorbidities, such as chronic respiratory diseases and DM [21,22]. The likelihood of hospitalization increases with age up to a maximum of 18.4% in patients 80 years old [23].In our study, the admission rate was 35%, which is much higher than the global admission rate of the general population. This high percentage could partially be explained by the fact that we included all rheumatology patients with documented COVID-19 from 2019 to 2021. At the beginning of the pandemic, with the lack of clear guidelines, institutions tended to admit COVID-19 positive patients till their swaps came negative. This is a possible explanation for the high admission rate seen in our study. Previously published studies are in agreement with our high admission rate. To emphasize, Gianfrancesco et al. reported an admission rate of 46% [15]. Similarly, Montero et al. also mentioned a high admission rate that is 68% [12]. In addition to what we mentioned above, another explanation could be disease-specific factors as patients with inflammatory diseases might need more medical attention. This is not only limited to rheumatology patients, it is also seen with other autoimmune diseases. To clarify, Sahraianet al. reported a hospitalization rate of 25% in multiple sclerosis patients infected with COVID-19, which is also much higher than the admission rate of the general population in the age group associated with multiple sclerosis patients [24].
In our study, number of COVID infections, CSS, secondary bacterial infection, number of comorbidities, DM, HTN, CKD, and HF were significantly associated with a longer hospital stay. A lot of these factors are in agreement with other studies. For example, DSilva et al. reported several factors that have been significantly associated with longer hospital stay including older age, number of comorbidities, and DM [14]. Moreover, Stradner et al. also reported the same thing. They found that old age and comorbidities, such as HTN, DM, cardiovascular and pulmonary diseases, and end-stage kidney disease were significantly associated with longer hospitalization [25].
Some reports found that rituximab use is not associated with worse outcomes or course of disease in patients with COVID-19. In our study, the only medication that was significantly associated with longer hospitalization and higher mortality was rituximab. Similarly, Tepasse et al., Stradner et al., and Alpizar-Rodriguez et al., in their studies, concluded that rituximab is associated with a higher risk of severe disease and/or mortality in patients with COVID-19 infection [25-27]. Ideally, immunoglobulin levels should be obtained in all patients prior to rituximab prescription. Unfortunately, to the best of our knowledge, our institution does not mandate immunoglobulin levels prior to rituximab prescription, which could explain the high mortality rate and hospitalization in our study. Though it is crucial to keep in mind that our findings are consistent with the literature [25-27]. Possibly due to the small sample size, we have not found any significance with steroid use nor with other immunosuppressants. However, in Gianfrancesco's study, prednisone 10 mg/day was associated with a higher hospitalization rate. Conversely, it has been found that TNF- inhibitoruse was associated with less hospitalization rate [15].
The susceptibility to and severity of COVID-19 is highly influenced by patients comorbidities, such as hypertension, and dysregulated innate immune response as in patients with inflammatory autoimmune diseases [9,11,12,28,29]. This might be due to enhanced expression of angiotensin-converting enzyme 2 (ACE2) receptors on the surface of several organs and epithelial cells. COVID-19 infects epithelial cells through binding with ACE2 and initiates inflammation, endothelial activation, tissue damage, and disordered cytokine release [29,30]. Although, in our study, all the included patients were known to have inflammatory rheumatologic diseases, according to literature, those patients are more likely to be infected with and to develop severe COVID-19. To emphasize, DSilva et al. reported that in COVID-19 patients, the need for intubation with mechanical ventilation was more common in patients with known rheumatologic diseases compared to the general population. Patients with autoimmune inflammatory diseases already have high cytokines and immune dysregulation [14]. The high levels of cytokines intensify the destructive progression that leads to additional epithelial cells dysfunction and inflammation [29,31,32]. Altogether, these disorders ultimately lead to multi-organ failure and death. Comorbidities and suppressed immunity have been found as primary reasons for the exacerbated rate of infection and mortality of COVID-19 [29,30,33]. This is another explanation for the high mortality rate as a lot of those patients are chronically on immunosuppressants. In COVID-19 patients, cellular immunity fails to provide adequate protection due to the viruss ability to escape the innate immunity and induce a functional decline in T-cell counts [29]. The literature identifies TNF- and IL-6 receptor inhibitors to be effective in treating COVID-19 among patients with rheumatic diseases as during recovery of COVID-19, decreased levels of IL-6 and TNF- increase the total T-cell counts [34,35]. In our study, we have not found any protective role for TNF- and IL-6 receptor inhibitors, probably due to the small sample size.
The studied population should be prioritized for the booster dose of COVID-19 vaccine. Those patients are particularly at increased risk of severe infection, and so they should have more precautions. Rituximab should be avoided unless it is the only option with the benefit clearly outweighing the risk. Prompt seeking medical attention is also recommended to prevent morbidity and mortality.
This study is mainly affected by its single-centered retrospective design and the small sample size. The small sample size limited our statistical analysis as we could not perform Kaplan-Meier survival curve. The results could have been affected by the fact that vaccination-related data were not available and so the effect of vaccination on patients outcomes was neglected in the study. We plan to do a follow-up study to assess the effect of vaccination on the outcomes of inflammatory rheumatic diseases.
Over a third (34.5%) of the patients required hospital admission. Predictors of longer hospitalization were obesity, number of COVID-19 infections, mechanical ventilation, number of comorbidities, HTN, and CKD, whereas, HTN was the only predictor for mortality. Furthermore, rituximab was significantly associated with longer hospitalization and higher mortality. Based on what we found, we recommend that patients with inflammatory rheumatic diseases should be prioritized for the COVID-19 vaccine booster dose, and rituximab should be avoided unless its benefit clearly outweighs its risk.
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Pfizer says tweaked COVID-19 shots boost omicron protection – Boston Herald
Posted: at 10:18 pm
Pfizer announced that tweaking its COVID-19 vaccine to better target the omicron variant is safe and works just days before regulators debate whether to offer Americans updated booster shots this fall.
The vaccines currently used in the U.S. still offer strong protection against severe COVID-19 disease and death especially if people have gotten a booster dose. But those vaccines target the original coronavirus strain and their effectiveness against any infection dropped markedly when the super-contagious omicron mutant emerged.
Now with omicrons even more transmissible relatives spreading widely, the Food and Drug Administration is considering ordering a recipe change for the vaccines made by both Pfizer and rival Moderna in hopes that modified boosters could better protect against another COVID-19 surge expected this fall and winter.
Pfizer and its partner BioNTech studied two different ways of updating their shots targeting just omicron, or a combination booster that adds omicron protection to the original vaccine. They also tested whether to keep todays standard dosage 30 micrograms or to double the shots strength.
In a study of more than 1,200 middle-aged and older adults whod already had three vaccine doses, Pfizer said over the weekend that both booster approaches spurred a substantial jump in omicron-fighting antibodies.
Based on these data, we believe we have two very strong omicron-adapted candidates, Pfizer CEO Albert Bourla said in a statement.
Pfizers omicron-only booster sparked the strongest immune response against that variant.
But many experts say combination shots may be the best approach because they would retain the proven benefits of the original COVID-19 vaccine while adding new protection against omicron.
And Pfizer said a month after people received its combo shot, they had a 9- to 11-fold increase in omicron-fighting antibodies. Thats more than 1.5 times better than another dose of the original vaccine.
And importantly, preliminary lab studies show the tweaked shots also produce antibodies capable of fighting omicrons genetically distinct relatives named BA.4 and BA.5, although those levels werent nearly as high.
Moderna recently announced similar results from tests of its combination shot, what scientists call a bivalent vaccine.
The studies werent designed to track how well updated boosters prevented COVID-19 cases. Nor is it clear how long any added protection would last.
But the FDAs scientific advisers will publicly debate the data on Tuesday, as they grapple with whether to recommend a change to the vaccines recipes ahead of similar decisions by other countries.
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Devi Sridhar’s ‘Preventable’ Review: The Countries That Handled COVID-19 Best – Foreign Policy
Posted: at 10:18 pm
During a recent trip to London, I saw almost no one wearing a maskexcept for American tourists, who were easily identifiable because they wore them even when they were outside. Restaurants have recovered and are packed; reservations are down only 13 percent from before the pandemic, compared with 40 percent in New York. For me, a visiting American comparing London to his homeland, the impression is that the cityand the countryhas moved on from COVID-19.
But England has not moved on from its failed initial response to COVID-19 and the decisions surrounding it, which remain controversial. Starting in February 2020, the country pursued a libertarian strategy of trying to reach herd immunity, before lurching to a severe lockdown in late March. England cycled through lockdowns of varying severity over roughly the next year. People were ordered to stay at home, and nonessential businesses were closed; at times, it was an offense to leave your home without a reasonable excuse. The National Health Service (NHS) attempted an effort at test and trace from May 2020 to January 2021, but this proved to be completely useless.
I happened to be marooned in London throughout most of 2020, having arrived only days before the initial lockdown was imposed on March 23. I remember how empty Londons streets were during that period, except for the speeding ambulances. While I never caught COVID-19, my doctor didperhaps because of the NHSs lack of personal protective equipment and overall lack of preparedness for a pandemic. Prime Minister Boris Johnson nearly died from the virus. And it was recently revealed, in a scandal known as Partygate, that during lockdown, when group gatherings were forbidden, Johnson hosted parties in the prime ministers residence at No. 10 Downing St. Wine was wheeled in from a nearby shop in a suitcase. Johnson survived a recent no-confidence vote by his own Conservative Party but so narrowly that his premiership remains threatened.
The debate in England about these COVID-19 policies is immensely sensitivegiven the staggering number of deathsand highly politicized, with the Labour press arguing the government did not do enough during COVID-19 and some of the Tory press arguing the government did too much by enacting lockdowns.
Devi Sridhars Preventable: How a Pandemic Changed the World & How to Stop the Next One is a notable contribution to the still-raging debate. Sridhar, a professor of global public health at the University of Edinburgh, is broadly associated with the Labour-aligned stancethat is, the need to suppress the virus even if this was achieved through the curtailment of individual liberties such as freedom of movement. She has advised Scottish First Minister Nicola Sturgeon, as well as the World Health Organization, on COVID-19 and is a divisive figure in the U.K. because of these associations and her support for strict border closures.
Preventable itself is a wide-ranging book. It is in part a work of advocacy for a more muscular response by governments to pandemics and a work of analysis, comparing different countries methods of trying to control the spread of COVID-19.
Because these different responses come not only from state capacity but also ideology, reaction to Sridhars book has been accordingly split. The U.K. progressive, anti-populist press is mostly supportive. The Guardian, where she is a contributor, was glowing. The Financial Times, which seems to advocate trusting the expertsparticularly one as establishment as Sridhar (she co-wrote a book with Chelsea Clinton)as an almost moral duty, was even more positive, getting straight to the political point in its review: Preventable argues that the poor leadership skills of populist leaders (such as Johnson, Donald Trump and Brasils Jair Bolsonaro) condemned some of the countries best equipped to fight the pandemic to failure in 2020.
The story in the Tory press, which tends to be skeptical of COVID-19 lockdown measuresand Sturgeonwas very different. The Spectator, in an article titled Please dont do a hit job: An interview with Devi Sridhar, proceeded to do exactly that and was personal in its conclusion: Now virtually the whole worldwith the exception of hermit kingdom Chinais living with Covid, being a former pin-up for Zero Covid is no longer quite such good box office. A pre-publication article in the Spectator was even nastier, listing the book in a guide to all the titles which wont be flying off the bookshelves in the forthcoming months. (It actually was a bestseller.) The article concluded: With such an avalanche of epidemiological musing remember the words of Christopher Hitchens: Everyone has a book in them and that, in most cases, is where it should stay.
The truth however is that Sridhars book is highly nuanced and the author too intellectually heterodox and empirically oriented to be constrained by a single ideological perspective. There is no doubt she felt countries should have developed a COVID-19 control strategy. But unlike lockdown true believers, Sridhar is very candid that containment policies such as school closures involve trade-offs and can cause harm. As she writes, School closures have far reaching and detrimental effects. Many children, especially in poorer countries, will never return to formal schooling again.
It is tempting to now relitigate COVID-19 policy decisions made then by citing recent academic research questioning the efficacy of lockdowns. Both pro- and anti-lockdown camps have become amateur epidemiologists. Though they argue endlessly about science, neither side acknowledges the glaring political contradictions in each of their approaches: Zero-COVID adherents tend to be globalists who dream of a borderless world (for people, goods, services, and finance)except when it comes to COVID-19, where free movement and activity must be tightly prescribed. Anti-lockdown populists pretty much feel the opposite in every respect.
One could read and critique Sridhars initial policy advicefavoring a more aggressive response to the pandemic, including tight border controls, social distancing, and the banning of nonessential travelwith the benefit of hindsight, but this would not be a very fruitful approach or a good use of the readers time. For one, Sridhar changes her thinking in response to changing evidence. As an example, she updated her analysis of the cost and benefits of school closures as more data came in showing the developmental harm closures caused to children and the limited risk of COVID-19 transmissions from schools.
More broadly, it is a fact that countries differed in the efficacy of their initial policy response to COVID-19 even if these policies didnt always work in the long term. Some, like Taiwan, were able to contain the virus and had low early death rates. Others, such as the United States, which devotes more resources to health care than any other country in the world, could not mount an effective response at all.
Indeed, the core of Preventable, and what I believe will be its lasting contribution, is how and why countries responded to COVID-19 differently. Rich countries did not necessarily handle the pandemic better than poor ones, showing that something else is at work besides money. The specifics are complex, which is why the book exceeds 400 pages.
Sridhars framework is essentially political. [W]ith the right politics and leadership, much of the suffering and death [from COVID-19] was largely preventable, she writes. It is worth looking more closely at the initial policy successes of some countries and failures of others, as detailed in Preventable.
South Korea. South Koreas response to COVID-19 was informed by its recent experiences with another virus: MERS (Middle East respiratory syndrome) in 2015. That experience did not go well: South Korea had the largest outbreak outside of the Middle East. As a result of MERS, South Korea put policies and planning in place for pandemics that proved critical when COVID-19 hit.
South Koreas plans did not rely on a national lockdown, and schools were largely kept open, though social distancing was deployed. Instead, Sridhar writes, the core of the South Korean response has been the test/trace/isolate system and by March 2020 it had the highest per capita test rate in the world with results back within twenty-four hours. In comparison, she notes, during this period the U.K. was only offering testing in hospitals.
If someone tested positive, South Korean public health teams traced that persons activity over the previous week using phone and credit card data and closed-circuit TV. They were then asked to isolate at home or in specialized isolation centers, where their symptoms were continuously monitored to see if they required hospitalization. South Korea, according to Sridhar, attributed its low death rate to this monitoring system. The low oxygen levels stemming from COVID-19 may not be detectable by patients themselves, and so often in the United States patients showed up at hospitals when they were already gravely ill.
Sridhar terms the South Korean model, which is based on testing rather than lockdowns, reasonably effective. But, as she points out, it also involved something else: trust in the government and that it wouldnt misuse the personal data it had gathered.
Senegal. Senegal is another one of the books case studies of success and one barely known in the global north. As of March 2021, it ranked second, right after New Zealand, in FP Analytics COVID-19 Global Response Index.
President [Macky] Sall knew to go early, go hard and keep it simple, Sridhar writes. Once COVID-19 was confirmed in the county, Sall closed schools and air travel and shut down large gatherings. This applied to mosques, with many choosing to worship from home.
Sridhar praises the countrys messaging efforts, including the use of religious leaders and musicians who released a single about beating the virus, Daan Corona. Senegals success also built on a more traditional disease management and surveillance infrastructure developed for infectious diseases such as Ebola.
As Sridhar writes, What Senegals story shows is that even in the context of limited resources and scientific uncertainty, certain countries reacted quickly and effectively to prevent a crisis. Senegals success rested on leadership, messaging, testing, but also financial support for those who were impacted by COVID-19 restrictions and had no way to earn a living, allowing them to isolate.Italy. Two regions in Italy, Lombardy and Veneto, make for a clear case study within the same country of differing COVID-19 policy responses and their impact. Veneto took a strict containment approach accompanied by mass testing. Lombardys focus was on treating cases once they occurred rather than trying to prevent them. The results of these different strategies: Lombardys case fatality rate was three times that of Veneto, as of April 2020.
In Sridhars telling, these outcomes were not surprising, and what happened next in Lombardy was almost inevitable: As the pandemic worsened and Lombardy became a death zone, it implemented almost medieval extreme lockdown measures. There was almost no exit from or entry into afflicted areas. She was not surprised by this turn of events: Around the world, before vaccines became widely available, mitigation strategies [allowing the virus to spread] have always resulted in lockdown measures.
New Zealand. New Zealand was distinctive in the Anglophone world for successfully pursuing a COVID-19 elimination strategyof trying to eliminate the virus altogether rather than just flattening the curve through containment. (Australia attempted this, too.) To accomplish this, New Zealand closed its borders to everyone but citizens and long-term residents, who themselves were forced to quarantine in hotels if they chose to enter the country. In March 2020, the country entered a state of emergency with a stay-at-home lockdown.
The elimination strategy was successful: The country went 102 days without cases. But Sridhar also points out that it was not without its challenges, which she itemizes: Not everyone cooperated with lockdown and test and trace; lockdown took a psychological toll; and the closed border ruined tourism and separated families. Despite these misgivings, Sridhar titles her section on the country, The Paradise of New Zealand.
Sweden. Sridhar contrasts New Zealands approach with that of Sweden, which is typically held up as the poster child for the success of a laissez-faire or anti-lockdown approach. Underlying its hands-off approach to COVID-19 was the public health authorities belief that the only sustainable way to deal with this kind of respiratory pathogen would be to let it flow through the population and avoid the economic and social costs of lockdown.
Hence, Sweden did not pursue lockdowns or test and trace for that matter. Schools and restaurants stayed open and so did the border. These policies were in stark contrast to the containment measures deployed by other Scandinavian countries.
Did the Swedish lax approach work? Sridhar writes: The debate is polarized. In her analysis, Swedens gamble did not pay off. Swedes paid a heavy price in that lives were lost unnecessarily. And, as the year progressed, Sweden went the same way as its Scandinavian neighborsinto suppression, she writes.
Among the analyses in Preventable of COVID-19 responses across countries and regions, one consistent finding is that poorer countries that took the approach of aggressively trying to contain the pandemicsuch as Greece or the Czech Republicfared better than richer countries, such as France, that were more hands-off, at least initially.
It is true that many of the countries that handled the first wave well, such as South Korea, New Zealand, and Senegal, struggled as time went on. But their strategies bought time until vaccines were available. And their economies were not as devastated as those of countries with laxer policies, according to Sridhar: [T]hose countries that responded effectively and controlled the virus, like Taiwan, South Korea, Denmark and Norway, had faster economic recovery compared with countries like Britain, Spain and Sweden.
But there is a puzzle in these overall patterns of response. It is clear from Sridhars telling that countries that undertook a coordinated national response involving test and trace and isolation handled the initial outbreak much better than the disorganized response of the United States and the U.K. Yet it is the latter two countries that were first able to develop effective vaccines.
Is this just a coincidence?
There is a reason to think not. The answer to this puzzle is found outside of Preventable, or even epidemiology writ large, and instead is provided by a niche area of political science studying economic development and varieties of capitalism.
Chalmers Johnson in his book MITI and the Japanese Miracle describes two economic systems, plan-rational vs. market-rational economies, a distinction common in the literature on the varieties of capitalism. Plan-rational economies are characterized by their governments focus on planning, with economic growth the overarching goal. (The Soviet Union was plan ideological, according to Johnson, so not part of this grouping.) In plan-rational economies, the state has a developmental orientation, and there is a great deal of state intrusion into the economy. Market-rational economies, in contrast, are centered on market efficiency, with the government playing primarily a regulatory rather than a planning role.
For Johnson, Japan was the exemplifier of the plan-rational system, with the United States the standard-bearer of the market-rational system. There are strengths and weaknesses in each system.
When there is a crisis where there is no consensus about what the long-term goal should be, and therefore how to plan for it, the plan-rational system stumbles. The market-rational system is better at coming up with new answers. Johnson writes that the great strength of the market-rational system lies in its effectiveness with dealing with critical problems. [Its approach] helps to promote action when problems of an unfamiliar or unknown magnitude arise.
Johnson doesnt discuss pandemics, but his dual-system typology, which is found elsewhere in political science, applies in this case. Plan-rational economies were distinguished by their planning and state effectiveness at controlling the pandemicbut only initially. In contrast, the more flexible market-rational U.S. and U.K. systems came through when it came to developing vaccines.
This typology of plan rational vs. market rational doesnt map precisely to countries responses to the pandemic, but it roughly does, with COVID-19 control standouts of Taiwan and South Korea falling into the camp of plan rational.
The typology can be seen again in countries behavior once vaccines were developed. The United States and U.K. reverted to typeor rather, continued as typewith no planning for the next crisis. There were to be no more Operation Warp Speeds in the United States. In alignment with market efficiency, the U.K. made aggressive moves to rapidly sell off its vaccine manufacturing and innovation center, which had proved so useful in vaccine development. (Kate Bingham, who led the U.K. vaccine task force, denounced the governments overall approach.)
And China, too, continues on its pre-chosen path. Even though vaccines are now readily available, it insists on pursuing a zero-COVID strategy, an authoritarian policy imposed at great cost.
The question is whether the United States can broaden its market-efficient economic approach, which has many strengths, to include planning capabilities, too. As Preventable demonstrates, planning was critical for early pandemic control, though in the long run it was not sufficient. Both approaches are needed. If the United States had added a bit more planning to the mix, many lives could have been saved during the initial outbreak.
The risks facing the United States going forward go well beyond just pandemics. Coronaviruses arent the only threat emanating from China. China poses unprecedented economic and military challenges to the United States. It is moving to a new economic model, one that combines state planning with market forces. By expanding its own economic model, the United States can respond more effectively to these new threats. Losing this competition is preventable.
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Devi Sridhar's 'Preventable' Review: The Countries That Handled COVID-19 Best - Foreign Policy
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