In Laredo, a bus brigade is vaccinating Mexican citizens with COVID-19 shots that Texans aren't using - The Texas Tribune

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NUEVO LAREDO, Mexico — The COVID-19 vaccine shot that went into Nohemi Lima Eusebio’s arm as she sat on a dusty yellow school bus at the U.S. border checkpoint in Laredo was just days away from going in the trash in Dallas.

The dose had been in a batch earmarked for Texas residents, but it was about to expire at a clinic nearly 500 miles away because nobody used it.

Instead, it turned out to be a potential lifesaver for Lima Eusebio, a 44-year-old single mom whose job in the close quarters of a factory across the border in Nuevo Laredo put her at risk for the virus and made her fear for the safety of her loved ones.

“I was worried a lot because my elderly mom lived with me, and I was worried that going to work was a risk of contracting the virus, and I would infect my mom and my [15-year-old] daughter,” she said.

Carol Esteban waits for her COVID-19 vaccine while on the bus on March 4 in Laredo. Credit: Sergio Flores for The Texas Tribune

Getting a shot in her hometown — where persistently high demand and low supply meant long lines at places that had vaccines — took hours and made her miss too much work.

That’s how Lima Eusebio wound up in a secure area of the Gateway to the Americas International Bridge on a cloudy weekday morning earlier this month, sitting on the bus with her sleeve rolled up, surrounded by her factory coworkers.

As the bus idled on the Laredo side of the bridge, Mexican and U.S. health care workers traipsed down the aisle carrying vaccine doses stacked in buckets hanging around their necks — the kind that children use to sell gum to tourists on the corners near the mercado in downtown Nuevo Laredo.

They injected Lima Eusebio, signed her vaccine card and then the bus turned around and took them all back into Mexico.

The dose Lima Eusebio received, flown down on a private plane piloted by the attorney son of Laredo’s local top health official, was among nearly 200,000 that have been administered to Nuevo Laredo residents since last summer — part of a unique binational vaccination program that’s credited with bringing up vaccine rates and fighting the virus on both sides of the Rio Grande.

“This is a very essential humanitarian effort because, in order to get herd immunity in our area, we need to make sure everybody's vaccinated to avoid variants and to avoid cross-border transmission,” said Victor Treviño Jr., who oversees the program and whose father, Dr. Victor D. Treviño, is the Laredo Health Authority.

First: A nurse passes out patients’ CDC vaccination cards. Middle: Vaccines left over from U.S. health providers sit in a bag ready to be administered to patients. Last: A bus driver heads toward the international bridge between Laredo and Nuevo Laredo.

Launched last June as the state grappled with both a rising wave of deaths related to the delta variant and a sharp drop in demand for the vaccine in Texas and nationally, the cross-border vaccination program aimed to address a dismally low vaccine rate — an estimated 7% at the time — in Nuevo Laredo that was creating problems in highly vaccinated Laredo, which was reporting 10 times that vaccination rate, among the highest in the state.

It was also a good way, organizers said, to use up doses that had suddenly become a surplus in the U.S., where nearly 50% of the population were fully vaccinated by the time the Laredo program was up and running.

Meanwhile, Mexico’s early vaccine rollout was painfully slow because the country’s government had prioritized people in rural areas where social distancing was easier. The rollout was also hampered by logistical issues, with some people reportedly waiting in line for up to 12 hours for their first dose. By the time the cross-border vaccination program launched in June, Mexico was reporting only a 10% vaccination rate.

Buses wait at the international crossing point between the U.S. and Mexico, carrying workers from Nuevo Laredo to get vaccinated. Credit: Sergio Flores for The Texas Tribune

About 10 months after its launch, the program is still giving about 2,000 doses per day, Treviño Jr. said — which means the buses going back and forth across the bridge represent roughly 10% of the total doses being administered across Texas on a daily basis.

Nuevo Laredo, which has nearly half a million residents, has seen its vaccination rate soar to about 50% now, by most estimates — still far below Laredo’s 96.5% rate but seven times more than when the program began.

“It’s now one of the most highly vaccinated cities in Mexico,” Treviño Jr. said.

Shots arrive by car, plane and 18-wheeler

The doses used by the Laredo program are donated by providers like doctors, hospitals and pharmacies who would rather give away their excess supplies than throw them out, the senior Treviño said.

They’re picked up by car, plane and truck — any secure way they can find, organizers said.

“Sometimes there are 18-wheelers that are coming from other states passing through Dallas or San Antonio or somewhere, and we coordinate with trucking companies and if they can pick them up, they do that,” Treviño Sr. said. “So it’s quite a show. But it’s worth the effort.”

A provider that donated nearly 20,000 doses this week had initially “tried to give them back to the state because they said demand completely stopped,” said Treviño Jr., who frequently picks up the doses in his plane or car. “But they said to use them or transfer them.”

Workers in Nuevo Laredo enter vaccination records on computers in early March. Credit: Sergio Flores for The Texas Tribune

The state stopped warehousing doses months ago after supplies exceeded the demand, so providers now order them directly from the federal government, which purchases them and allocates them at no cost to the providers.

“It’s a bedrock public health principle that reducing an infectious disease on one side of a border will help reduce that disease on the other side, especially when there is a lot of cross-border traffic,” said Chris Van Deusen, spokesperson for the Texas Department of State Health Services.

Texas health officials say the state is not directly involved in the program, other than to track the doses donated by Texas providers to the binational effort. But they say that addressing the virus on both sides of the border is an effective approach for this vibrant and close-knit border community.

The program is slated to continue at least through April, when it will be reevaluated to see if it’s still needed.

A look at the numbers shows that there’s still very much a demand: Last week, Treviño Jr. said he picked up 10,000 doses in his car from a provider in San Antonio. This week, he’ll be picking up 17,000 more.

Aimee Garcia walks down the bus aisle while vaccinating Nuevo Laredo residents against COVID-19. Credit: Sergio Flores for The Texas Tribune

A spin class sparks a solution

Laredo and Nuevo Laredo have been linked for the better part of two centuries, their downtowns separated by only a narrow slice of river.

“It’s one city. It just happens to be in two countries,” said state Rep. Richard Peña Raymond, a Laredo Democrat and early proponent of the program.

Adults and children in Nuevo Laredo often go to work and school every day in Laredo, and a large number of Laredoans have family on the other side of the river. Traveling back and forth for shopping, medical care and celebrations is the norm.

“We work hand in hand, and we feel like we have the same purposes because we cross the bridge daily,” said Estefania Araiza, a Nuevo Laredo nurse who administers doses on the bus for the program.

Last summer, Treviño Sr. was disturbed by the vaccination numbers.

Laredo had one of the highest vaccination rates in the state, but the hospitals were still getting patients every day who were close to death, many of them Nuevo Laredo residents. Treviño, who is also a family doctor, said he had patients from Nuevo Laredo whose family members weren't yet vaccinated. Doctors and nurses across the river were dying at an alarming rate, he said, because they couldn’t get vaccinated.

Treviño knew that there was no way to truly protect both cities unless both sides of the border were highly vaccinated.

Victor Treviño Jr. holds a tray of COVID-19 vaccines on a bus. Credit: Sergio Flores for The Texas Tribune

One day in late May, Treviño’s son was brainstorming the problem with a friend while they pedaled side by side in a spin class at a Laredo gym.

They talked about collecting expiring doses and delivering them to Nuevo Laredo, but that idea came with a raft of logistical issues, the biggest of which was that the U.S. government had no authorized program to donate those doses.

And even if the U.S. government approved cross-border donations, the doses would likely end up mired in the same kinds of logistical problems that were bogging down Mexico’s vaccination effort.

“It was almost impossible to get a shot” in Mexico at the time, recalled Araiza, the nurse who helps administer the vaccine on the buses.

Treviño Jr. and his friend discussed administering the shots to Mexican citizens in Laredo, but dismissed the idea because at the time, the bridge was closed to all but essential workers from Nuevo Laredo.

“What if we vaccinate them on the bridge?” Treviño Jr. suggested. That way, people who did not have essential worker status wouldn’t technically be entering the U.S. as long as the buses didn’t leave the secured checkpoint area, which would work as long as border officials agreed to the plan.

The friend was enthusiastic and, while they pedaled in the spin class, placed a call to Carmen Lilia Canturosas, a relative who was running for mayor of Nuevo Laredo at the time — she won the election a few weeks later.

She used her connections to get the program rolling — her father and brother were both former mayors, “so she knew everyone,” Treviño Jr. said.

After winning her election, Canturosas called the Mexican Consulate in Laredo, who reached out to U.S. Customs and Border Protection, which runs the checkpoints on the U.S. side of border bridges. CBP officials agreed to let them vaccinate people in the secure area of the bridge only if the Nuevo Laredo residents stayed on the buses.

Passengers transfer between buses at a pick-up and drop-off location on March 3 in Nuevo Laredo, Mexico. Workers were transported across the international bridge to receive COVID-19 vaccines. Credit: Sergio Flores for The Texas Tribune

A few weeks later, the factory workers and their families arrived at the bridge on factory-owned school buses for shots. Trevino’s father, meanwhile, reached out to a prominent doctor’s association in Nuevo Laredo and began getting groups of front-line health workers vaccinated on buses owned by hospitals. Modern buses owned by Mexican bus lines soon joined the effort as more people signed up for shots.

Then in November, the international bridges reopened to all visitors on the U.S.-Mexico border just in time for the Christmas holiday, and popularity of the program exploded, Treviño Jr. said.

For Fabiola Escobar, a 32-year-old factory worker, getting the opportunity to get her booster shot on the bus with her coworkers rather than miss another day of work trying to get one in Nuevo Laredo was a game changer.

She can be less fearful, she said. And she can start getting back to normal life.

“When the pandemic first started, we were all worried we’d get sick and for it to get more serious,” Escobar said. “But now that we have our boosters, I feel like we can be less worried and work more comfortably.”

In late November, Nuevo Laredo city officials honored the senior Treviño’s efforts to vaccinate their residents, which included several programs in addition to the buses, by awarding him the keys to their city in a unanimous decision.

“It is a monumental effort we’re doing,” Treviño Sr. said. “And hopefully it’ll go down in history.”

Sergio Flores and Uriel J. Garcia contributed to this story.

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Fauci: Americans should be prepared for new COVID-19 restrictions - Fox News

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White House chief medical adviser Dr. Anthony Fauci on Sunday warned about the potential for the reinstatement of COVID-19 restrictions in the U.S.

In an interview on the BBC's "Sunday Morning," Fauci said U.S. residents "need to be prepared for the possibility" of restrictions being put back into place.

FAUCI SAYS HE DOES NOT ANTICIPATE MAJOR COVID-19 SURGE IN US

Presenter Sophie Raworth asked if a new infectious COVID-19 variant could lead to future lockdowns and mask mandates. 

"I don't want to use the word ‘lockdowns.’ That has a charged element to it. But, I believe that we must keep our eye on the pattern of what we're seeing with infections," he said, noting that the U.S. is currently moving toward normalcy. 

"Having said that, we need to be prepared for the possibility that we would have another variant that would come along," Fauci noted. "And then, if things change and we do get a variant that does give us an uptick in cases and hospitalization, we should be prepared and flexible enough to pivot toward going back – at least temporarily – to a more rigid type of restrictions, such as requiring masks indoor."

Dr. Anthony Fauci testifies before the Senate Health, Education, Labor and Pensions Committee on Capitol Hill on Nov. 4, 2021. (Chip Somodevilla/Getty Images)

Cases, hospitalizations and deaths have fallen rapidly in the U.S. since the winter's COVID-19 surge. 

Data from the Johns Hopkins Coronavirus Resource Center shows the U.S. reported 42,967 new cases and 985 new deaths in the past day, whereas daily deaths in January exceeded 4,000. 

According to the Centers for Disease Control and Prevention (CDC), the highly transmissible BA.2 omicron sub-variant that is spreading across the globe currently makes up 54.9% of cases. 

LONG COVID SYMPTOMS MAY DEPEND ON THE VARIANT A PERSON CONTRACTED

Fauci cautioned that the "same conditions" that appear to be driving the resurgence of cases in Europe are happening in the U.S. 

"It's the greater transmissibility of the BA.2, it's the relaxation of restriction, particularly in the context of indoor masking in congregate settings, and also the fact that immunity, due to both vaccination as well as people who have been previously infected, tends to wane with SARS-CoV-2 – particularly with omicron," he said. 

Last week, Fauci said he does not expect another major COVID-19 surge. 

"I would not be surprised at all, if we do see somewhat of an uptick," Fauci told a Washington Post event. "I don't really see, unless something changes dramatically, that there would be a major surge."

With the administration now out of funds for a fourth COVID-19 vaccine dose, America's pandemic future is murky. 

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On Tuesday, the Food and Drug Administration (FDA) moved to authorize a second booster of the Moderna and Pfizer-BioNTech COVID-19 vaccines for people ages 50 and older. 

The CDC is expected to weigh in on the decision.

The Associated Press contributed to this report.

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COVID cases up almost 70% as new variant arrives in Monroe County - Democrat & Chronicle

Covid Cases, Testing and Omicron News: Live Updates - The New York Times

A common area at the Rochester Institute of Technology campus in Rochester, N.Y., in January.Libby March for The New York Times

With the pandemic entering a new phase in the United States marked by fewer precautions and the rise of the even more transmissible Omicron subvariant BA.2, the Biden administration has begun stressing the importance of mitigating the risk of indoor aerosol transmission, the primary driver of the pandemic.

The Environmental Protection Agency recently issued expert guidance to building managers, contractors and business owners, with two pages of recommendations that codify the best practices on ventilation, air filtration and air disinfection from academic experts and federal agencies of the last two years. The agency said implementation could be underwritten with federal funds from the $1.9 trillion American Rescue Plan, which President Biden signed into law a year ago.

Alondra Nelson, chief of the White House Office of Science and Technology Policy, said last week that the guidance was part of an initiative called the Clean Air in Buildings Challenge. In a blog post titled, “Let’s Clear the Air on Covid,” she cited the guidance and said, “Now, we all need to work collectively to make our friends, family, neighbors, and co-workers aware of what we can do or ask for to make being indoors together safer.”

“For decades, Americans have demanded that clean water flow from our taps and pollution limits be placed on our smokestacks and tailpipes,” Dr. Nelson wrote in the post. “It is time for healthy and clean indoor air to also become an expectation for us all.”

U.S. federal health authorities were initially slow to identify airborne transmission of the virus. It was only in October 2020 that the Centers for Disease Control and Prevention recognized that the virus can sometimes be airborne, long after many infectious disease experts warned that the coronavirus traveled aloft in small, airborne particles. Scientists have been calling for a bigger focus on addressing that risk for more than a year.

The initiative is “really a big deal,” said William Bahnfleth, a professor of architectural engineering at Pennsylvania State University and head of the Epidemic Task Force at the American Society of Heating, Refrigerating and Air-Conditioning Engineers. “It’s making the start that is often the most difficult part.”

The society, whose roots go back to the dawn of the skyscraper in the late 19th century, is a global nonprofit technical society that, among other things, develops the consensus indoor air quality standards referenced in U.S. building codes.

Dr. Bahnfleth’s task force was created as the pandemic began sweeping the world in March 2020, and the new federal recommendations track closely with its guidance. He said the pandemic had given momentum to the long-overdue drive to improve the country’s “mediocre” air quality standards for buildings, noting that the existing standards had failed to protect people from coronavirus infections.

Viruses can travel in a variety of ways. Early in the pandemic, health officials assumed the coronavirus was transmitted primarily through droplets expelled during coughing or sneezing, as is the flu, or perhaps through contact with contaminated surfaces. But many scientists noted mounting evidence that the coronavirus was airborne, spreading in tiny particles adrift in indoor spaces.

Akin to the rating system for high-quality masks, whose high-tech filtering material trap at least 94 to 95 percent of the most risky particles (N95s, KN95s and KF94s), the filters used in building ventilation systems have what is known as a MERV rating. The higher the rating, which runs from 1 to 16, the better the filter is at trapping particles.

The new federal guidelines advise buildings to upgrade to at least a MERV 13 filter, which traps 85 percent or more of risky particles. Before the pandemic, many buildings used MERV 8 filters, which are not designed for infection control.

Long before the pandemic, studies showed that indoor air quality affects the health of students and workers. A Harvard study of more than 3,000 workers showed that sick leave increased by 53 percent among employees in poorly ventilated areas. Improved ventilation has also been associated with better test scores and fewer school absences.

“Improving indoor air has benefits beyond Covid-19,” Dr. Nelson wrote. “It will reduce the risk of getting the flu, a common cold, or other diseases spread by air, and lead to better overall health outcomes.”

Correction: 

March 27, 2022

Because of an editing error, an earlier version of this article misstated the amount of the American Rescue Plan that President Biden signed into law last year. It was $1.9 trillion, not $1.9 billion.

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Men's use of diabetes drug just before conception is linked to a 40% increase in birth defects, study finds - CNN

(CNN)Metformin use by men in the three-month period before they conceived a child was linked to a 40% higher risk of birth defects in the offspring, according to a study published Monday in the journal Annals of Internal Medicine.

Metformin is a first-line drug in the treatment of type 2 diabetes.

The research, which was done out of Denmark, used national registries to follow over 1 million births between 1997 and 2016 and compared the risk of major birth defects in babies based on paternal exposures to diabetes medications. The study observed only children who were born to women under 35 and men under 40. Babies born to women with diabetes were excluded.

The researchers considered men exposed to metformin if they filled a prescription for it in the three months before conception, which is how long it takes the fertilizing sperm to fully mature.

According to the study, the frequency of birth defects in babies born to men who had a type 2 diabetes diagnosis but who were not taking metformin was 3.1% (1,594 children), but the frequency was 4.6% (788) in children with paternal exposure to metformin during the preconception period.

Genital birth defects, seen only in male babies, was the only birth defect in the study that was found to be associated with a statistically significant increased risk after paternal metformin use.

Men who took metformin before or after the three-month maturation period did not have an increased risk of having a baby with birth defects. Similarly, the babies' unexposed siblings were not affected.

Because previous research has shown that diabetes can compromise sperm quality and impair male fertility, the researchers also compared the rates of birth defects in the babies of men who took insulin to those who took metformin in order to ensure that a diabetes diagnosis itself was not a contributing factor. They found that insulin use was not associated with a change in the birth defect rate.

The researchers did not find any significant association between birth defects and paternal exposure to diabetes medication other than metformin.

However, the authors note that they did not have data on other aspects of diabetes, such as glycemic control or medication compliance, as they assessed data only on when prescriptions were filled. In addition, babies who had paternal metformin exposure also tended to have parents who were older and of a lower socioeconomic status, which may play a role.

In an editorial published alongside the study, Germain Buck Louis, a reproductive and perinatal epidemiologist at George Mason University who was not involved in the research, said there is evidence from past studies to suggest that "altered testosterone levels may be an underlying mechanism raising concern about the antiandrogenic activity of oral diabetes pharmacologic agents, including metformin" to explain these findings.

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Louis also noted that due to the limitations of this study, further research is needed to find out whether men taking metformin should make any considerations, especially given the high prevalence of diabetes that may require metformin use.

There are currently no US Food and Drug Administration warnings against the use of metformin by men planning to have children.

"Clinical guidance is needed to help couples planning pregnancy weigh the risks and benefits of paternal metformin use relative to other medications," Louis wrote.

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A TMPRSS2 inhibitor acts as a pan-SARS-CoV-2 prophylactic and therapeutic - Nature.com

Abstract

The COVID-19 pandemic caused by the SARS-CoV-2 virus remains a global public health crisis. Although widespread vaccination campaigns are underway, their efficacy is reduced due to emerging variants of concern (VOCs)^1,2. Development of host-directed therapeutics and prophylactics could limit such resistance and offer urgently needed protection against VOCs^3,4. Attractive pharmacological targets to impede viral entry include type-II transmembrane serine proteases (TTSPs), such as TMPRSS2, whose essential role in the virus lifecycle is to cleave the viral spike protein to expose the fusion peptide for cell entry^5,6. Here, we identify and characterize a small-molecule compound, N-0385, which exhibits low nanomolar potency and a selectivity index of >10⁶ at inhibiting SARS-CoV-2 infection in human lung cells and in donor-derived colonoids⁷. In Calu-3 cells it inhibits entry of SARS-CoV-2 VOCs, B.1.1.7, B.1.351, P.1 and B.1.617.2. Importantly, in the K18-human ACE2 transgenic mouse model of severe SARS-CoV-2 disease, we found that N-0385 affords a high level of prophylactic and therapeutic benefit following either multiple or even a single administration. This demonstrates that TTSP-mediated proteolytic maturation of spike is critical for SARS-CoV-2 infection in vivo and suggests that N-0385 provides a novel effective early treatment option against COVID-19 and emerging SARS-CoV-2 VOCs.

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Author notes

1. These authors contributed equally: Tirosh Shapira, I. Abrrey Monrea

Affiliations

1. Department of Microbiology and Immunology, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada

   Tirosh Shapira, Andrea D. Olmstead, Guang Gao, Connor A. H. Thompson, Aaleigha Chin & François Jean

2. Department of Microbiology and Immunology, Cornell University College of Veterinary Medicine, Ithaca, NY, USA

   I. Abrrey Monreal, David W. Buchholz, Brian Imbiakha, Mason Jager, Julie Sahler, Gerlinde R. Van de Walle, Avery August, Gary R. Whittaker & Hector C. Aguilar

3. Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Institut de Pharmacologie de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada

   Sébastien P. Dion, Antoine Désilets, Thierry Vandal, Eric Marsault, Pierre-Luc Boudreault & Richard Leduc

4. Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada

   Guang Gao & Ivan Robert Nabi

5. Department of Population Medicine and Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA

   Mathias Martins & Diego G. Diel

6. Department of Medicine, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada

   William D. Rees & Theodore Steiner

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1. Tirosh Shapira
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Corresponding authors

Correspondence to Richard Leduc, Hector C. Aguilar or François Jean.

Supplementary information

Supplementary Information

This file includes compound synthesis schemes and characterization of final compounds (Supplementary Schemes 1 to 10); Supplementary Tables that summarize high-resolution mass measurements (Supplementary Tables 1–8); and Supplementary Figures summarizing isotopic profiles, UPLC-MS, and NMR analysis of peptidomimetic compounds (Supplementary Figures 1–27).

Reporting Summary

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Video 1

| Representative video from a 3D volume rendering of SARS-CoV-2 B.1.617.2 Delta-infected cells. Hoechst is shown in blue, dsRNA in green, nucleocapsid in red, and actin in cyan. Images captured with a Leica TCS SP8 STED 3× laser scanning confocal microscope.

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Shapira, T., Monreal, I.A., Dion, S.P. et al. A TMPRSS2 inhibitor acts as a pan-SARS-CoV-2 prophylactic and therapeutic. Nature (2022). https://ift.tt/uotmjbE

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• Received: 14 May 2021

• Accepted: 18 March 2022

• Published: 28 March 2022

• DOI: https://ift.tt/uotmjbE

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