Immuno-Suppressed Patients Take Longer to Clear Covid-19, Allowing Time for More Mutations and New Variants

(p. 14) When people with H.I.V. are prescribed an effective antiretroviral and take it consistently, their bodies almost completely suppress the virus. But if people with H.I.V. aren’t diagnosed, haven’t been prescribed treatment, or don’t, or can’t, take their medicines consistently each day, H.I.V. weakens their immune systems. And then, if they catch the coronavirus, it can take weeks or months before the new virus is cleared from their bodies.

When the coronavirus lives that long in their systems, it has the chance to mutate and mutate and mutate again. And, if they pass the mutated virus on, a new variant is in circulation.

“We have reasons to believe that some of the variants that are emerging in South Africa could potentially be associated directly with H.I.V.,” said Tulio de Oliveira, the principal investigator of the national genetic monitoring network.

In the first days of the pandemic, South Africa’s health authorities were braced for soaring death rates of people with H.I.V. “We were basically creating horror scenarios that Africa was going to be decimated,” said Salim Abdool Karim, an epidemiologist who heads the AIDS institute where KRISP is housed. “But none of that played out.” The main reason is that H.I.V. is most common among young people, while the coronavirus has hit older people hardest.

An H.I.V. infection makes a person about 1.7 times as likely to die of Covid — an elevated risk, but one that pales in comparison with the risk for people with diabetes, who are 30 times more likely to die. “Once we realized that this was the situation, we then began to understand that our real problems with H.I.V. in the midst of Covid was the prospect that severely immunocompromised people would lead to new variants,” Dr. Abdool Karim said.

. . .

. . . a single variant can rattle the world, as Omicron has.

The origin of this variant is still unknown. People with H.I.V. are not the only ones whose systems can inadvertently give the coronavirus the chance to mutate: It can happen in anyone who is immunosuppressed, such as transplant patients and those undergoing cancer treatments.

By the time the KRISP team identified the second case of a person with H.I.V. producing coronavirus variants, there were more than a dozen reports of the same phenomenon in medical literature from other parts of the world.

Viruses mutate in people with healthy immune systems, too. The difference for people with H.I.V., or another immunosuppressing condition, is that because the virus stays in their systems so much longer, the natural selection process has more time to favor mutations that evade immunity. The typical replication period in a healthy person would be just a couple of weeks, instead of many months; fewer replications mean less opportunities for new mutations.

. . .

. . ., South Africa’s efforts to tackle the variant issue, and be transparent about it, have come at a steep price, in the form of flight bans and global isolation.

“As scientists, especially in the kind of forefront, we debate playing down the H.I.V. problem,” Dr. de Oliveira mused in his lab last week. “If we are very vocal, we also risk, again, big discrimination and closing borders and economic measures. But, if you are not very vocal, we have unnecessary deaths.”

For the full story, see:

Stephanie Nolen. “A Variant Hunt on Dirt Roads and in the Lab.” The New York Times, First Section (Sunday, December 5, 2021): 1 & 14.

(Note: ellipses added.)

(Note: the online version of the story was updated Dec. 6, 2021, and has the title “The Variant Hunters: Inside South Africa’s Effort to Stanch Dangerous Mutations.” The online version says that the New York edition of the print version had the title “A Variant Hunt From the Labs To Dirt Roads.” The title of my National edition of the print version was “A Variant Hunt on Dirt Roads and in the Lab.”)

120 Million Added People Face Food Scarcity Due to Covid-19

(p. A1) An estimated 270 million people are expected to face potentially life-threatening food shortages this year — compared to 150 million before the pandemic — according to analysis from the World Food Program, the anti-hunger agency of the United Nations. The number of people on the brink of famine, the most severe phase of a hunger crisis, jumped to 41 million people currently from 34 million last year, the analysis showed.

The World Food Program sounded the alarm further last week in a joint report with the U.N.’s Food and Agriculture Organization, warning that “conflict, the economic repercussions of Covid-19 and the climate crisis are expected to drive higher levels of acute food insecurity in 23 hunger hot spots over the next four months,” mostly in Africa but also Central America, Afghanistan and North Korea.

The situation is particularly bleak in Africa, where new infections have surged. In recent months, aid organizations have raised alarms about Ethiopia — where the number of people affected by famine is higher than anywhere in the world — and (p. A5) southern Madagascar, where hundreds of thousands are nearing famine after an extraordinarily severe drought.

. . .

In South Africa, typically one of the most food-secure nations on the continent, hunger has rippled across the country.

. . .

An estimated three million South Africans lost their jobs and pushed the unemployment rate to 32.6 percent — a record high since the government began collecting quarterly data in 2008.

. . .

In Duncan Village, the sprawling township in Eastern Cape Province, the economic lifelines for tens of thousands of families have been destroyed.

Before the pandemic, the orange-and-teal sea of corrugated metal shacks and concrete houses buzzed every morning as workers boarded minibuses bound for the heart of nearby East London. An industrial hub for car assembly plants, textiles and processed food, the city offered stable jobs and steady incomes.

“We always had enough — we had plenty,” said Anelisa Langeni, 32, sitting at the kitchen table of the two-bedroom home she shared with her father and twin sister in Duncan Village.

For nearly 40 years, her father worked as a machine operator at the Mercedes-Benz plant. By the time he retired, he had saved enough to build two more single family homes on their plot — rental units he hoped would provide some financial stability for his children.

The pandemic upended those plans. Within weeks of the first lockdown, the tenants lost their jobs and could no longer pay rent. When Ms. Langeni was laid off from her waitressing job at a seafood restaurant and her sister lost her job at a popular pizza joint, they leaned on their father’s $120 monthly pension.

Then in July, he collapsed with a cough and fever and died of suspected Covid-19 en route to the hospital.

“I couldn’t breathe when they told me,” Ms. Langeni said. “My father and everything we had, everything, gone.”

For the full story, see:

Christina Goldbaum and Joao Silva. “No Job, No Food: Virus Deepens Global Hunger.” The New York Times (Friday, August 6, 2021): A1 & A5.

(Note: ellipses added.)

(Note: the online version of the story was updated Aug. 6, 2021, and has the title “No Work, No Food: Pandemic Deepens Global Hunger.”)

World Population Decline Will Slow Global Warming

(p. 1) All over the world, countries are confronting population stagnation and a fertility bust, a dizzying reversal unmatched in recorded history that will make first-birthday parties a rarer sight than funerals, and empty homes a common eyesore.

Maternity wards are already shutting down in Italy. Ghost cities are appearing in northeastern China. Universities in South Korea can’t find enough students, and in Germany, hundreds of thousands of properties have been razed, with the land turned into parks.

Like an avalanche, the demographic forces — pushing toward more deaths than births — seem to be expanding and accelerating. Though some countries continue to see their populations grow, especially in Africa, fertility rates are falling nearly everywhere else. Demographers now predict that by the latter half of the century or possibly earlier, the global population will enter a sustained decline for the first time.

A planet with fewer people could ease pressure on resources, slow the destructive impact of climate change and reduce household burdens for women.

For the full story, see:

Damien Cave, Emma Bubola and Choe Sang-Hun. “World Is Facing First Long Slide in Its Population.” The New York Times, First Section (Sunday, May 23, 2021): 1 & 17.

(Note: the online version of the story was updated May 24, 2021, and has the title “Long Slide Looms for World Population, With Sweeping Ramifications.”)

In North Equatorial Africa, Air Pollution Declines with Economic Growth

(p. A9) LAGOS, Nigeria — Rapidly growing countries generally see sharp increases in air pollution as their populations and economies expand. But a new study of air quality in Africa published on Monday [Feb. 8, 2021] has found the opposite: One of the continent’s most vibrant regions is becoming less polluted.

The study, published in Proceedings of the National Academy of Sciences, found that levels of dangerous nitrogen oxides, a byproduct of combustion, in the northern part of sub-Saharan Africa have declined sharply as wealth and population in the area have increased.

. . .

The reason, according to researchers, is that an increase in pollution from industry and transportation in the area studied — from Senegal and Ivory Coast in the west to South Sudan, Uganda and Kenya in the east — appears to have been offset by a decline in the number of fires set by farmers.

For the full story, see:

Shola Lawal. “As Economies Get Bigger, Air Pollution Falls in Africa.” The New York Times (Tues., February 9, 2021): A9.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the story has the date Feb. 8, 2021, and has the title “A Surprise in Africa: Air Pollution Falls as Economies Rise.”)

The National Academy of Sciences study mentioned above is:

Hickman, Jonathan E., Niels Andela, Kostas Tsigaridis, Corinne Galy-Lacaux, Money Ossohou, and Susanne E. Bauer. “Reductions in No≪Sub≫2≪/Sub≫ Burden over North Equatorial Africa from Decline in Biomass Burning in Spite of Growing Fossil Fuel Use, 2005 to 2017.” Proceedings of the National Academy of Sciences 118, no. 7 (2021): e2002579118.

Dictator Rawlings Transformed Ghana from Dictatorship to Democracy

I heard a plausible plenary lecture a few years ago at an APEE meeting where the African speaker argued that African autocrats would never voluntarily give up power, because doing so would mean they would trade personal riches for personal poverty. It was a sad but plausible argument, though one that makes Jerry Rawlings’s life especially intriguing.

(p. A22) Jerry Rawlings, a former Ghanaian Air Force officer who led two military coups before steering his country toward democracy with an authoritarian hand, died on Thursday in the nation’s capital, Accra.

. . .

By the time he left office voluntarily 22 years later, he had served two presidential terms brought about by free elections and had established Ghana as a rare democratic example on the continent. Today, peaceful handovers of power are routine in the country, hardly the case with the country’s neighbors.

Mr. Rawlings’ contradictory legacy — brutal beginnings, uncompromising military rule, then free elections — underscores the difficult path to democratic governance still faced by many African nations. But in Ghana at least, where Mr. Rawlings is regarded as something of a founding father after the country’s difficult first steps, democracy is an assumption.

Given Ghana’s first experiences of him, that outcome would not have been predicted. He appeared at first to have all the makings of one of the continent’s classic military autocrats.

For the full obituary, see:

Adam Nossiter. “Jerry Rawlings, Strongman Turned Statesman Who Steered Ghana to Democracy, Dies at 73.” The New York Times (Friday, November 13, 2020): A22.

(Note: ellipsis added.)

(Note: the online version of the obituary has the date Nov. 12, 2020, and has the title “Jerry Rawlings, From Coup-Plotter to Ghanaian Statesman, Dies at 73.”)

Even Chimps Seek Cool Comfort

Some humans reject air conditioning. Chimps are unable to create air conditioning. But when they discover a cool cave in a hot summer, they spend time in the cave.

(p. D2) Everyone needs to cool off on a scorching summer day, even chimpanzees. Where do the primates go on sizzling days when woodlands and forests don’t provide respite from the heat?

Caves.

. . .

In southeastern Senegal, temperatures spike to 110 degrees Fahrenheit and fires burn large parts of the landscape over a seven-month dry season. Several natural cave formations pock the terrain, and they can be up to 55 degrees cooler than the surrounding grasslands.

For the full story, see:

Priyanka Runwal. “Why Chimp Moms Flock to Caves on the Savanna.” The New York Times (Tuesday, August 11, 2020): D2.

(Note: ellipsis added.)

(Note: the online version of the story was updated on August 6, 2020, and has the same title as the print version.)

See also:

Diamond, Arthur M., Jr. “Keeping Our Cool: In Defense of Air Conditioning.” Economics & Business Journal: Inquiries & Perspectives 8, no. 1 (Oct. 2017): 1-36.

600-Year-Old Ginkgo Trees Are as Vigorous as 20-Year-Old Ginkgo Trees

(p. D2) . . . a January [2020] study on ginkgo trees, which can live for over a thousand years . . . found that 600-year-old ginkgos are as reproductively and photosynthetically vigorous as their 20-year-old peers. Genetic analysis of the trees’ vascular cambium — a thin layer of cells that lies just underneath the bark, and creates new living tissue — showed “no evidence of senescence,” or cell death, the authors wrote.

For the full story, see:

Cara Giaimo. “Holding On; Can Trees Live Forever? A New Study Adds Kindling to the Debate.” The New York Times (Tuesday, August 4, 2020): D2.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story was updated July 27, 2020, and has the title “Can Trees Live Forever? New Kindling for an Immortal Debate.”)

The January 2020 study mentioned above is:

Wang, Li, Jiawen Cui, Biao Jin, Jianguo Zhao, Huimin Xu, Zhaogeng Lu, Weixing Li, Xiaoxia Li, Linling Li, Eryuan Liang, Xiaolan Rao, Shufang Wang, Chunxiang Fu, Fuliang Cao, Richard A. Dixon, and Jinxing Lin. “Multifeature Analyses of Vascular Cambial Cells Reveal Longevity Mechanisms in Old Ginkgo biloba Trees.” Proceedings of the National Academy of Sciences 117, no. 4 (Jan. 28, 2020): 2201-10.

“The Licensing and Rollout” of Ebola Vaccine Was Accelerated

(p. 4) To combat Ebola in Congo, one of the world’s poorest nations, health workers are taking a multifaceted approach.

They have worked to win over communities that were sometimes uncooperative — even hostile.

They have drawn on technological innovations, notably a transparent enclosure known as the cube that allows medical workers to reach in and treat patients suffering from the contagious disease through plastic sleeves.

And they have used vaccines, developed relatively recently, which have made it possible to limit the spread of the epidemic.

. . .

The “cube” was . . . a big trust builder.

With transparent walls and integrated plastic sleeves and gloves, the air-conditioned chambers allowed medical teams to tend to Ebola patients without having to put on cumbersome protective gear. The cubes also allowed patients and their family members to see each other without risk of infection.

People were afraid of the treatment centers, where so many had died. But the cubes won trust for the health care workers, said Augustin Augier, chief executive of the Alliance for International Medical Action, the nonprofit aid group that developed the chambers.

“We asked the community to come and visit so they could see what was actually happening,” Mr. Augier said.

At least 500 patients were fully treated in the cubes, which could be set up in 90 minutes and reused up to 10 times, Mr. Augier, said.

But the key factor in curbing the spread of Ebola was the introduction of powerful vaccines and lifesaving antiviral drugs.

In early November 2018, the W.H.O. accelerated the licensing and rollout of the injectable Ebola vaccine Ervebo, made by the American pharmaceutical company Merck. Preliminary study results showed a 97.5 percent efficacy rate, prompting Congo, along with Burundi, Ghana and Zambia, to license the vaccine for wider distribution.

Nearly 300,000 doses of the vaccine have been administered in Congo, said Dr. Moeti of the W.H.O.

For the full story, see:

Abdi Latif Dahir. “Congo, Fresh From 2-Year Ebola Battle, Eyes New Virus.” The New York Times, First Section (Sunday, April 12, 2020): 4.

(Note: ellipses added.)

(Note: the online version of the story has the date April 11, 2020, and has the title “Congo Was Close to Defeating Ebola. Then One More Case Emerged.”)

Millennials Blame Capitalism for “the Crushing Burden of College Debt”?

(p. A22) “Millennials don’t remember the Cold War,” said Maurice Isserman, a history professor at Hamilton College who has studied democratic socialism. “They don’t react in the same way to the word ‘socialist’ and associate it with totalitarian communism.”

Instead, young voters have experienced a structural shift in the economy, including the 2008 financial crisis and the crushing burden of college debt, that has given them a more critical view of capitalism, he said.

For the full story, see:

Patricia Mazzei and Sydney Ember. “Sanders’s Views on Cuba Split Young and Old Voters.” The New York Times (Saturday, February 29, 2020): A22.

(Note: the online version of the story has the date Feb. 28, 2020, and has the title “Sanders Is Stirring Cold War Angst. Young Voters Say, So What?.”)

Government Ban on Motorbikes and Rickshaws Spreads Coronavirus in Nigeria

(p. A10) “I feel scared,” said Karo Otitifore, an elementary schoolteacher waiting at a bus stop in Yaba, the Lagos suburb where the Italian patient was being treated. “I try to sit tight, squeeze my whole body so that I won’t have to have too much body contact with people.”

. . .

He waited at a crowded bus stop for a bus crammed with passengers. A recent ban — unrelated to coronavirus — on the city’s fleet of motorcycle taxis and auto-rickshaws meant that many Lagosians are in even closer contact than usual, raising the risk of exposure should the virus spread.

For the full story, see:

Ruth Maclean and Abdi Latif Dahir. “First Confirmed Diagnosis In Nigeria Adds Pressure On a Weak Health System.” The New York Times (Saturday, February 29, 2020): A10.

(Note: ellipsis added.)

(Note: the online version of the story was updated Feb. 29, 2020, and has the title “Nigeria Responds to First Coronavirus Case in Sub-Saharan Africa.”)

Commuters Riot after Lagos Governor Bans Motorbikes and Rickshaws

LAGOS — It is dark when Abisoye Adeniyi leaves home on the packed Lagos mainland, weaving through cars and minibuses. She reaches her bus stop as the sun rises.

The 23-year-old Nigerian lawyer used to hop on a motorbike – known locally as an okada – for a quick ride to the bus that carries her from the mainland, where most of Lagos’s 20 million residents live, to work in the island business district.

Since the bikes, along with motorized yellow rickshaws called kekes, became illegal in most of the city on Feb. 1 [2020], Adeniyi has added a 30-minute walk to her journey – stretching the commute to nearly two hours.

“It has not been easy at all,” she said.

Lagos state Governor Babajide Sanwo-Olu outlawed the loosely regulated motorbikes and rickshaws, citing safety and security concerns.

Gridlock in the megacity, whose traffic jams were already ubiquitous, has intensified to the point that riots with burning tyres broke out and #LagosIsWalking trended on Twitter showcasing residents with ruined shoes.

For the full story, see:

Reuters. “Burning Tires and Sore Feet: Lagos Bristles Under Bike Ban.” The New York Times (Monday, February 17, 2020). Online at: https://www.nytimes.com/reuters/2020/02/17/technology/17reuters-nigeria-transportation-ban.html?searchResultPosition=2

(Note: bracketed year added.)