Category: Health

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Biden Makes New Push for Vaccinations, however Specialists Say Extra Is Wanted

Biden Makes New Push for Vaccinations, but Experts Say More Is Needed

Most power rests in the hands of states, employers, or private institutions.

Dr. Ezekiel J. Emanuel, a professor of bioethics and health policy at the University of Pennsylvania, said the United States is unlikely to make significant progress on its vaccination campaign without mandates.

“I like to say that a mandate is legal, ethical and effective,” he said. “Ultimately, jobs will probably have to.”

In his speech, Mr Biden said his government was not giving up trying to convince people that vaccination was in their best interest and in the interest of the country. However, he did not mention the need for states, private companies, schools, and other institutions to start requiring people who refused to be vaccinated.

White House press secretary Jen Psaki admitted in comments to reporters Tuesday that some businesses, schools and other institutions were beginning to need vaccines. But she said the administration has no intention of encouraging her to do so.

“We will leave it to them to make these decisions,” said Ms. Psaki.

But others say the government could be more aggressive.

Lawrence O. Gostin, professor of global health law at Georgetown University, said that while the federal government’s powers to issue mandates are limited, the Biden government still has significant powers to recommend it. It could allocate more funding to vaccination detection systems and create incentives for colleges, universities and organizations to request a vaccine to be offered, he said.

“Vaccine mandates have been very successful in the US and around the world, even in politically difficult situations, because they make vaccination the standard,” said Gostin. “To be unvaccinated must be a difficult decision, not an easy one.”

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Disputes over masks are 75% of FAA’s unruly-passenger complaints on planes

Disputes over masks are 75% of FAA's unruly-passenger complaints on planes

A traveler wearing a face mask is seen at Ronald Reagan Washington National Airport in Arlington, Virginia on February 2, 2021.

Ting Shen | Xinhua News Agency | Getty Images

Much of the Federal Aviation Administration’s recalcitrant passenger reports on aircraft come from passengers who refuse to comply with mask requirements to protect against the spread of Covid-19.

About 75% of reports of recalcitrant passengers since Jan. 1 began with people refusing to wear their masks and escalated from there into profanity, screaming matches and even physical violence, the agency said on Tuesday.

The FAA introduced a “zero tolerance” policy with heavy fines earlier this year aimed at curbing unruly passengers after an increase in incidents, but that hasn’t stopped travelers from berating airlines, disrupting flights, and even two to knock teeth out of the mouth of a flight attendant.

“It’s gotten out of hand,” said Paul Hartshorn, spokesman for the Association of Professional Flight Attendants, which represents American Airlines’ more than 20,000 flight attendants. “It really gets to the point where we have to defend ourselves.”

The current federal mask requirements require travelers on trains, buses, commercial flights and at airports to wear face masks. The mandate, which was extended in the spring, currently expires on September 13th.

So far this year, the FAA has fined untrue travelers $ 682,000, identifying potential violations in 540 cases and taking enforcement actions in 83 cases.

The agency on Tuesday released the details of eight cases of recalcitrant travelers fined between $ 7,500 and $ 21,500 for disputes stemming from their refusal to wear masks, including two cases where passengers were other passengers hit.

Flights have been delayed and even diverted due to unruly passengers, many of whom refuse to wear face masks properly or at all. The agency does not disclose the identity of the fined passengers, but does say that passengers have 30 days to appeal the fines.

Health officials generally consider airplane travel safe with regards to Covid, but they have said it depends on passengers’ compliance with mask requirements and other guidelines.

“Although we have seen overall cases of transmissions on airplanes, this is a safe form of travel even from a Covid perspective,” said Dr. Mike Ryan, Executive Director of the World Health Organization’s Emergency Health Program, at a briefing on Monday. “The problem is what happens when you get to your destination, what you’re exposed to, and what you take home.”

Health officials are also warning of unnecessary travel, especially with the advent of the highly contagious Delta variant as many people vacation abroad to make up for more than a year of pandemic lockdown at home.

“Nobody says it is not safe to take a vacation, but we try to say that it is not time to open up to it completely,” said Ryan.

– CNBC’s Leslie Josephs contributed to this report.

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It’s By no means Too Late to Be taught Find out how to Swim

It’s Never Too Late to Learn How to Swim

“It’s Never Too Late” is a new series that tells the stories of people who decide to make their dreams come true on their own.

Vijaya Srivastava’s first 68 years were decidedly on land. She walked the Berkeley Hills in the San Francisco Bay Area, spent time with her young grandchildren, and volunteered in the library. None of this required immersion in water, which suited her well, which was terrifying with water. The fear of drowning was a big issue.

Growing up in India, she never had access to swimming pools. When she moved to the United States, the idea of ​​swiping back and forth just didn’t occur to her. Then one day her doctor mentioned that regular rounds would improve her health.

“I can’t swim,” admitted Ms. Srivastava, now 72. She had never put her face under water.

“Have you heard of lessons?” Asked the doctor.

“In my age?”

“Why not?”

What followed may have been a long time pondering this question. That didn’t happen. (The following interview has been edited and shortened.)

Q: What were your first steps?

A: The first thing I did was ask a neighbor if she’d like to take classes together. We hired a high school kid from Albany High. She had trained as a lifeguard – I liked that.

“Have you ever trained a senior?” We asked. She said no. OK.

We started classes three days a week.

After I made up my mind to study, that was it. I went to the swimming pool on the days between classes. I started dreaming about swimming. I would wake up excited. When I couldn’t fall asleep, I would swim in bed. My husband would say, “What’s wrong? This is not a pool … “

I also bought a lot of swimsuits – I thought one of them might be lucky. I later realized that you don’t need a 10. I donated some.

Have you studied swimming?

After my first lesson, I started googling. At first I just watched everything that had to do with swimming on YouTube. That got confusing. My daughter later told me about Total Immersion Swimming videos. There’s a guy who’s into the physics of swimming who has helped me a lot.

My grandchildren also went underwater and watched my breaststroke or sat in the hot tub and gave me thumbs up or thumbs down.

What were the greatest challenges?

To be petrified. Nothing had ever happened to me that scared me. I just knew that I could drown. For the longest time I stayed at the shallow end, four feet. I prayed before each lesson.

And not enough perseverance. My arms and legs weren’t ready. After half an hour I was so tired.

Was there a moment when everything clicked?

After a few months the instructor said to me, “It’s time to go to the other end.” I kept saying, “I’m not ready.” She said, “That’s you.”

Finally, I decided that if I don’t try, it will never happen. The teacher said she would be next to me all the time.

“But you are so small!” I told her. She promised me not to let myself drown.

So I started swimming. By the time I reached the 6 foot mark – I’m 1.70 m tall – I knew there was no turning around. Besides, I didn’t know how to turn around.

I finally made it to the other side. My condo neighbors were over in the hot tub. They had watched me fight for the past few months and now they all stood up and clapped for me.

I didn’t wave back until I caught my breath and swam back to the shallow end. There was no way I could remove my hand from the wall at the eight-foot end.

What would you have done differently at the beginning?

There isn’t much I would do differently. Maybe start earlier.

How has your new job changed your life?

When we talk about it – my nephews, my children – they sound so proud of me. Not many people my age or in my family swim. It feels good that I did that. I speak to my family at home in India. My brother can’t believe it.

What’s next?

I was talking to a friend about how to learn to dance – maybe we could take dance lessons?

What would you say to people who feel stuck and want to change something?

I liked that my neighbor swam with me. We’d motivate each other. If I was tired that day, she said, let’s just go for 20 minutes. Twenty minutes turns into half an hour.

Did your experience make you a different person?

Swimming a pool length for the first time when I was 68 – I will always remember that. Last Friday I swam 20 laps! It took me 52 minutes. I still take a break after laps. My next goal is to do this continuously without taking a break. I come there.

What do you wish you knew earlier about fulfillment?

I have a very good friend who told me to know your body, know yourself – which makes you happy, healthy, and angry. That’s always stayed with me. That helped me alot.

But there isn’t much in my life that I would change. If you are relaxed and happy in spirit, it will bring you health. You don’t need too many things in life.

What lessons can people learn from your experience?

Don’t give yourself an option to give up. I never thought of quitting. When I invest mentally, I don’t give up.

We are looking for people who decide that it is never too late to switch, change their life and make dreams come true. Should we talk to you or someone you know? Share your story here.

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Beforehand contaminated individuals would profit from vaccines

Previously infected people would benefit from vaccines

Dr. Scott Gottlieb believes people who have previously been infected with coronavirus would still benefit from receiving Covid vaccines.

In Tuesday’s interview on CNBC’s “Squawk Box,” the former Food and Drug Administration commissioner acknowledged that some individuals may think their antibodies generated from having the disease offer enough protection against future infection or illness and, as a result, forgo getting the Covid inoculation.

The reason to still receive the vaccine is “two-fold,” contended Gottlieb, who serves on the board of vaccine maker Pfizer.

“One, we believe the vaccine provides a more durable and broader immunity, so it’s going to protect you better against the variants,” he said, alluding to the highly transmissible delta variant, which is causing concern for public health officials.

“Two, if you’ve been previously infected and even if you get a single dose of the vaccine — forget getting both doses of the vaccine, just a single dose of the vaccine — you get a very robust immune response,” Gottlieb said.

Pfizer’s vaccine requires two shots for fully immunity protection, as does Moderna’s vaccine. Johnson & Johnson makes a single-dose vaccine. Those are the only three vaccines approved for emergency use in the U.S.

“It’s sort of the best of both worlds if you’ve been previously infected and you get vaccinated,” said Gottlieb, who led the FDA from 2017 to 2019 in the Trump administration. “At least with one dose, you do develop a broad, very deep, very durable immunity based on the data that we’ve seen so far, so there’s still a lot of compelling reasons why you’d want to get vaccinated even if you’ve been previously infected.”

More than 157 million people in the U.S., or 47.4% of the population, have been fully vaccinated against Covid, according to data compiled by the Centers for Disease Control and Prevention. Around 182.4 million people, or nearly 55% of the population, have received at least one dose.

After an aggressive push this spring to deliver the Covid shots to Americans, the pace of uptake slowed. In response, state and local officials — and businesses, too — launched various promotional efforts to encourage vaccination.

Nevertheless, among some people, hesitancy remains. According to the CDC, as of last week, about 1,000 counties in the U.S. had less than 30% of residents vaccinated.

The increasing presence of the delta variant, in both the U.S. and across the globe, adds urgency to calls for more people to get vaccinated. The variant, first discovered in India, has shown to make the vaccines slightly less effective, but still provide protection against severe disease, especially.

“We expect to see increased transmission in these communities unless we can vaccinate more people,” CDC Director Dr. Rochelle Walensky said Thursday, referring to those roughly 1,000 U.S. counties with low vaccination rates.

“Preliminary data over the last six months suggest 99.5% of deaths from Covid-19 in the states have occurred in unvaccinated people,” she added. “The suffering and loss we are now seeing is nearly entirely avoidable.”

Disclosure: Scott Gottlieb is a CNBC contributor and is a member of the boards of Pfizer, genetic testing start-up Tempus, health-care tech company Aetion Inc. and biotech company Illumina. He also serves as co-chair of Norwegian Cruise Line Holdings’ and Royal Caribbean’s “Healthy Sail Panel.”

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A Nearer Have a look at the Colon Situation That Hospitalized the Pope

A Closer Look at the Colon Condition That Hospitalized the Pope

On Sunday evening, Pope Francis was operated on for a colon disease called “symptomatic stenotic diverticulitis”. The elective surgery, performed at the Gemelli Hospital in Rome, took about three hours, according to the Holy See Press Office.

Francis, 84, is generally healthy and this is the first time he has been hospitalized since he became Pope in 2013. He is vigilant and breathing alone, according to a Vatican spokesman, and is expected to be for. stay in the hospital seven days.

To a man his age, the illness, surgery, and expected recovery sound reasonable, doctors said, and he should be able to make a full recovery.

“I’m a little surprised, but not worried, about seven days in the hospital,” said Dr. Philip S. Barie, Professor Emeritus of Surgery at Weill Cornell Medical College. “That’s probably out of caution and the fact that he’s 84.”

Despite its intimidating name, symptomatic stenotic diverticulitis is a relatively common and treatable condition.

It starts out as a mild condition called diverticulosis, which is essentially a collection of bags in the wall of the colon, usually on the left side. Diverticulosis is very common: around two in three people have the pouches by the time they are 60 or 70 years old.

For most people, the bags do not cause any problems, other than occasional blood in the stool. But about 10 to 15 percent of people with diverticulosis have their pouches clogged and inflamed, which can bring patients to the emergency room.

This inflammation, called diverticulitis, “is also incredibly common,” said Dr. David R. Flum, professor of surgery at the University of Washington at Seattle.

Diverticulitis affects 3 to 5 million people each year in the United States alone and is usually treated with only antibiotics. However, in some severe cases, surgery may be required – which is also not uncommon.

“Diverticulitis is one of the most common reasons for colon surgery in the United States,” said Dr. Flum.

It is believed that diverticulosis is the result of a Western diet that is low in fiber and high in processed foods. It is common in the United States and certain countries like Scotland, and much less common in African countries, for example.

Dr. Barie recalled a senior United Nations official from Africa who had been stationed in New York for more than 20 years. The man’s dietary change during this time was enough to “develop a disease that he probably would not have gotten if he had stayed in his home country,” said Dr. Barie.

A low-fiber diet, especially if too little water is consumed, can lead to constipation. “The stool becomes smaller, harder, and harder to pass. In order to pass it, you have to create more pressure in your colon and push more, ”explained Dr. Barie.

The pressure causes the lining of the colon to sag. And if leftovers like cucumber or tomato seeds get stuck in the bags, they can ignite the food.

Each episode of diverticulitis can gradually scar and thicken the colon wall, eventually shrinking the passage about 90 percent from its typical width to just a quarter of an inch – the diameter of a # 2 pencil.

If there is no movement at all, the patient can develop a colon obstruction that requires emergency surgery. But more often, people like Francis have symptoms that are so debilitating that they consider elective surgery.

Diverticulosis causes few symptoms and can go unnoticed. The symptoms become noticeable in the inflamed state of diverticulitis.

The spectrum of symptoms varies depending on the severity of the stricture and its location in the colon. If symptoms are bad enough, doctors may order a colonoscopy to identify the stricture.

Francis could have had gas or abdominal cramps and possibly had enough pain to consider elective surgery, said Dr. Barie.

In milder stages, diverticulitis can be treated on an outpatient basis with oral antibiotics. More severe cases may require hospitalization and intravenous antibiotics.

Some severe cases could be treated long-term with only medical-grade fiber, probiotics to alter gut bacteria, and an aspirin-like drug that reduces inflammation in the colon. Dr. Flum is leading a large study comparing medical management to surgery. The start of the study was delayed by the pandemic, but is expected to be completed by 2025.

When a patient has had many attacks of diverticulitis, surgery is often the only option. “Until it gets to the point where it’s scarred and too tight, we don’t have a lot of medical options,” said Dr. Flum.

In operations like the one Francis most likely underwent, doctors remove a portion of the colon called the sigmoid colon, where diverticulitis is most common. You can remove up to a few inches to a foot of the colon and sew the cut ends.

The Pope’s operation was most likely performed using laparoscopy, which requires far fewer incisions than traditional methods. Still, up to one in five people who have this surgery can develop infections, so “infection prevention is an important thing,” said Dr. Barie.

For the first month, Francis can follow a low residue diet aimed at avoiding large bowel movements. Then he may be advised to eat a high-fiber diet to prevent diverticulitis elsewhere in the colon – although this is unlikely at his age as it takes time to develop.

It’s also a good sign that he’s fine overall. In 1957, an upper lung lobe was removed from him due to complications from tuberculosis. And for the past few years, his breathing seemed to be strained while he was speaking. In 2019, a cataract was removed from him and he was vaccinated against the coronavirus in January.

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Singapore minister on Covid-19 vaccination program, opening of borders

Singapore minister on Covid-19 vaccination program, opening of borders

SINGAPORE – Singapore aims to immunize 75% of its population by early October to gradually relax border restrictions as the coronavirus becomes endemic over time, trade minister Gan Kim Yong told CNBC on Tuesday.

“Covid-19 is likely to be endemic in the future. That is why vaccination is so important. Because the transmission will continue and you will be confronted with a new variant from time to time when the virus mutates, “Gan told the” Squawk Box “from CNBC Asia.”

He said the goal is to vaccinate at least two-thirds of the country by August 9, when Singapore celebrates its national day, which marks the country’s independence after separating from Malaysia in 1965.

Data from the scientific publication Our World In Data showed that by July 3, nearly 37% of Singapore’s 5.6 million residents were fully vaccinated. This is a significantly higher percentage compared to more populous neighbors like Malaysia and Indonesia, who each vaccinated nearly 8% fully. and 5% of their population.

Vaccines can help limit transmission to some extent and reduce the severity of the disease, the minister said. This ensures that Singapore’s hospitals and medical facilities are not overwhelmed and would allow the country to “continue to live with Covid-19”.

Singapore’s national vaccination program runs vaccinations from Pfizer and Moderna, but some private clinics have been allowed to administer Sinovac for those who prefer the Chinese-made vaccine.

Travel corridors and reopening of borders

Vaccination rate will be an important marker in easing border restrictions to allow non-resident travelers to enter Singapore, Gan said.

“We hope that by the end of September or beginning of October we can cover 75% or more (of the population). Then we can open up our borders more to allow more.” Visitors to Singapore come both for business and pleasure, “added Gan.

Discussions about the establishment of travel corridors with Hong Kong and Australia have not yet produced any concrete results this year.

A bubble agreement would have enabled people from Hong Kong or Australia to travel to Singapore and vice versa without quarantine.

“We decided not to call it a travel bubble because it tends to burst,” said Gan. “We will continue to do our best to discuss with our partners and the discussion is moving forward.”

Singapore and its partners need to be prepared for potential travel corridors by making sure infection rates stay low and vaccination rates high, Gan said.

The city-state plans to conduct studies that will allow vaccinated travel between Singapore and several other destinations, he added. First, it will be done in small groups to test the process, and if those efforts are successful, it will be expanded to let more travelers into the country, Gan said.

“This will be very important for us to do it safely, build trust and allow us to refine our actions and process to ensure we can continue to protect Singapore and our visitors,” he added .

Loosen restrictions further

Singapore tightened restrictions in May as locally transmitted cases spiked and the highly contagious Delta variant was discovered in the city-state. These strict measures included a ban on eating in restaurants and grocery stores and restricting public social gatherings to two people.

Some of those measures have since been relaxed as cases are now under control and only a handful of unrelated infections are reported in the community each week.

We always believe that we have to find a very careful balance between protecting life on the one hand and preserving livelihoods on the other.

Gan Kim Yong

Minister for Trade and Industry

“We have to be careful and take a cautious approach as we open up our economy and our community,” said Gan, the former health minister and still co-chair of Singapore’s Covid-19 task force.

“This is to ensure that we can continue to keep public health under control and ensure the safety of Singaporeans,” he said, adding, “We always believe that we can strike a very careful balance between protecting life and protecting ourselves Life “must find a livelihood on the other side.”

If things keep moving steadily forward, Gan said Singapore will allow in-person dining for up to five people from July 12th. Currently, only groups of two people are allowed to dine together outside of homes.

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Birthday Events as Virus Vector

Birthday Parties as Virus Vector

KJ Seung, the director of strategy and policy for Partners in Health’s response to Covid in Massachusetts, who helped set up the contact tracing system, said it had been difficult for contact tracing authorities to clearly demonstrate that people were interacting with the in small private gatherings Virus infected.

Public revelations, like those at a factory or a wedding, were easier for her to follow. People often didn’t share the evenings when they had a cousin for dinner or drove a friend home from work, be it out of shame or forgetfulness – and when they did, they were reluctant to give names.

“Small social gatherings are the hardest places to keep track of,” he said. But “when we spoke to tracers across the country, they said, yes, people get infected at these little gatherings.”

So much of the pandemic-related behavior – including using masks and taking vaccines – seems to vary across people’s political party. However, the study found that birthdays in Republican and Democratic areas of the country resulted in similar increases in Covid infections. This suggests that while Democratic households were more likely to wear a mask when going for a walk, they may have been less different than Republicans in visiting a trusted friend.

“This element of your home is definitely a safe place and when you have your friends and family at home it just doesn’t feel risky,” said Dr. Ashish Jha, the dean of the School of Public Health at Brown University, who called the paper “creative” for finding an unusual way to capture disease transmissions that are otherwise difficult to measure.

For many Americans, birthday celebrations have become a lot safer in the past few months. The Centers for Disease Control and Prevention say it is safe for fully vaccinated individuals to gather indoors without wearing face coverings.

But for those who remain unvaccinated, the study is a reminder that even activities that feel safest pose a risk of infection. In many parts of the country, unvaccinated people are grouped by region or social group, which means birthday parties – and other such festive, private occasions – can still be risky.

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5 issues to know earlier than the inventory market opens Wednesday, June 30

5 things to know before the stock market opens Wednesday, June 30

Here are the top news, trends, and analysis investors need to start their trading day:

1. Wall Street will close the first half of 2021 with solid profits

Traders on the floor of the New York Stock Exchange, June 25, 2021.

Source: NYSE

US stock futures were flat on Wednesday, a day after the S&P 500 and Nasdaq hit record highs again. The Dow Jones Industrial Average, which was up more than 100 points early Tuesday, closed slightly higher and stayed around 1.4% off its record high in early May. The 10-year government bond yield ticked lower on Wednesday, trading around 1.46% on better-than-expected ADP job data.

At the beginning of the last day of June and the first half of the year, the S&P 500 led the most important benchmarks with an increase of 14.3% since the beginning of the year. The Nasdaq gained 12.7% over the course of the year. The Dow was up 12% in 2021, although it has lagged recently, seeing a slight monthly decline. The S&P 500 and the Nasdaq rose in June. All three benchmarks saw solid gains in the second quarter.

2. Bed Bath & Beyond’s revenues are impacted by turnaround costs

Shoppers exit a Bed Bath & Beyond store in New York.

Michael Nagel | Bloomberg | Getty Images

Bed Bath & Beyond shares rallied in the premarket on Wednesday after the retailer reported mixed results for the first quarter. Sales exceeded estimates, but profits were missed. Costs related to the company’s turnaround efforts, including marketing expenses, weigh on margins. The company raised its full-year sales forecast ahead of the important back-to-school shopping season. Stocks of Bed Bath & Beyond, which saw some strength in meme stock trading earlier this month, rose 68% at the close of trading on Tuesday in 2021.

3. Three companies will make their public debuts

A logo of the ride-hailing giant Didi Chuxing can be seen on a building in Hangzhou in the eastern Chinese province of Zhejiang.

STR | AFP | Getty Images

Didi Global is expected to start trading on the New York Stock Exchange on Wednesday after setting its IPO at $ 14 per share and raising $ 4.4 billion. That gives the China-based ride-hailing company an initial valuation of about $ 73 billion.

Digital advertising company Taboola will be launched on Wednesday following its merger with ION Acquisition Corp. 1, a special purpose vehicle for acquisitions, to start trading on Nasdaq. The SPAC transaction will raise $ 526 million when completed.

Clear, number 19 on CNBC’s Disruptors 50 list this year, is expected to trade on the NYSE on Wednesday after valuing its initial public offering of $ 31 per share and raising more than $ 400 million. Clear, known for its frequent flyer identification service, introduced the Health Pass during the Covid pandemic.

4. ADP publishes strong June private employment report

People walk past a Help Wanted sign in the Queens borough of New York City on June 4, 2021 in New York City.

Spencer Platt | Getty Images News | Getty Images

ADP reported Wednesday that U.S. company jobs rose 692,000 in June. That easily exceeds estimates. However, in May the value of positions in the private sector, while still strong, was revised significantly down to 886,000. During the Covid pandemic, the ADP report wasn’t a good indicator of what the government’s monthly employment report might be showing. Economists expect Friday’s job data to show that around 700,000 new jobs outside of agriculture were created in June. The country’s unemployment rate is expected to fall to 5.7%. Weekly jobless claims are published on Thursday.

5. When the real estate boom begins to fizzle out, mortgage demand falls

A sign advertising home loans for purchase or refinance with a Bank of America in New York.

Scott Mlyn | CNBC

High home prices are finally starting to take some of the boom out of the Covid-induced real estate boom. Mortgage demand fell 6.9% for the week, according to the Mortgage Bankers Association. That is the lowest level in almost a year and a half. Home purchase mortgage applications fell 5% weekly and 17% annually. That’s the slowest pace since early May 2020 when the lockdowns were in full effect. Refinancing requests decreased by 8% weekly and 15% annually.

– Reuters contributed to this report. Follow all market activity like a pro on CNBC Pro. Get the latest on the pandemic with coronavirus coverage from CNBC.

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Juul Is Preventing to Hold Its E-Cigarettes on the U.S. Market

Juul Is Fighting to Keep Its E-Cigarettes on the U.S. Market

Sales have slumped by $ 500 million. The workforce was reduced by three quarters. Operations in 14 countries were discontinued. Many state and local lobbying campaigns have ceased.

Juul Labs, the once high profile e-cigarette company that became a public health villain for many people because of its role in the steam wave of teenagers, is acting as the shadow of its former selves, spending the pandemic largely out of the public eye in the so-called “Reset” mode. Now its survival is at stake as it launches a large-scale campaign to convince the Food and Drug Administration to keep selling its products in the United States.

The agency is trying to meet a September 9 deadline to determine whether Juul’s devices and nicotine capsules have sufficient public health benefits as a safer alternative for smokers to stay in the market despite their popularity with young people who have never smoked but became addicted to nicotine after using Juul products.

Major health organizations, including the American Heart Association, the American Lung Association, the American Academy of Pediatrics, and the American Cancer Society’s Cancer Action Network, asked the agency to reject Juul’s application.

“There’s a lot at stake,” said Eric Lindblom, senior scientist at the O’Neill Institute for National and Global Health Law at Georgetown University and former FDA advisor on tobacco. “If the FDA messes up on this case, they’ll face public health lawsuits.”

Juul spares no expense to push back. Last week the company agreed to pay $ 40 million to settle just one Lawsuit (with North Carolina) filed against thousands to avoid an upcoming jury trial. The company had made an urgent deal to avoid parental and teenage testimony in the courtroom while the FDA is reviewing its vaping products.

Juul has not made his 125,000-page application public with the agency. But it paid $ 51,000 to devote the entire May / June issue of the American Journal of Health Behavior to publishing 11 studies, funded by the company, showing evidence that Juul products help smokers quit stop. (A spokesman for Juul said editors turned down any of the company’s filings.) That fee included an additional $ 6,500 to make the subscription newspaper available to everyone.

Three members of the magazine’s editorial board resigned because of the deal.

And Juul’s federal lobbying has remained robust. According to the Center for Responsive Politics, which tracks policy spending, $ 3.9 million was spent on federal lobbying in 2020. Altria, the large tobacco company that owns part of Juul, spent nearly $ 11 million.

According to analysts, Juul’s share of the vaping market has shrunk significantly last year from a high of 75 percent in 2018 to 42 percent. However, some public health experts are concerned that FDA approval will lay the foundation for the company’s growth and expand its reach again.

Juul has long denied having knowingly sold its products to teenagers, and for several years has made a public commitment to do everything possible to keep them away from minors. In its deal with North Carolina, the company did not admit that it was deliberately targeting teenagers.

In an interview, Joe Murillo, Juul’s chief regulatory officer, said, “We have a better chance of converting smokers than ever before, but we will only get that opportunity if we continue to combat underage use and continue to act like high-ranking people regulated company that we are. “

The company is filing for approval for its iconic vaping device, once called the iPhone of the e-cigarette, with tobacco and menthol-flavored pods in two nicotine strengths: 5 percent, which is the same as the nicotine in an average pack of cigarettes, and 3 percent.

The decision is one of several critical issues the FDA has wrestled with – including the agency’s recent approval of a controversial Alzheimer’s drug and decisions on thousands of vaping products made by companies other than Juul – without a standing one Commissioner. President Biden has not yet announced a candidate.

A House panel recently interviewed Acting Commissioner Dr. Janet Woodcock on the agency’s plans for Juul. She said the agency will base its decision on sound scientific evidence and that it cannot anticipate the application, which is still under consideration.

The decision will be based to a large extent on answering two questions: Will more smokers use Juul products as an exit from conventional cigarettes than non-smokers as entry into nicotine? And can Juul really keep the products out of the reach of children?

Most of Juul’s published research in the magazine issue it purchased tracks the 12 month experience of 55,000 adults who purchased a Juul starter kit. The researchers, all paid by Juul, concluded that 58 percent of the 17,000 smokers who stayed in the study had quit after 12 months. Twenty-two percent remained double users of both conventional and e-cigarettes, but reduced their smoking by at least half.

Elbert D. Glover, who was editor and editor of the journal but retired shortly after the issue appeared, said the journal followed its standard protocol for scientists reviewing studies before publication.

The steady decline in Americans smoking is a public health success story. The rate has dropped from 42 percent in 1965 to 14 percent in 2019. Still, smoking remains the leading cause of preventable deaths, with approximately 480,000 people dying from smoking-related diseases each year, according to the Centers for Disease Control and Prevention.

E-cigarettes, which hit the market in the early 2000s, were designed to give smokers the nicotine solution they craved without the carcinogens produced by burning cigarettes. But until the launch of Juul in 2015, no e-cigarette had gained wide acceptance among the public.

Juul’s sleek design and novel use of nicotine salts in the pods made for a nicotine-rich, low-irritation experience in mango, mint, and other flavors that quickly became a fad, especially with high and middle school students. Public health officials feared that instead of helping adults quit smoking, Juul was making a new generation of nicotine addicts, with potentially harmful effects on the health of their developing brains and other health risks.

Juul’s rapid growth stayed under the FDA’s radar until 2018 when the agency declared a youth vaping epidemic.

“The FDA has created a wide open Wild West marketplace around these vaping products and unfortunately Juul and others have taken advantage of it,” said Clifford E. Douglas, director of the University of Michigan Tobacco Research Network. “What happened next screwed up a truly extraordinary public health opportunity to reduce harm. It is our duty to come back to it to serve public health. “

Mr Douglas believes Juul is now marketing its vaping products more responsibly and that they could play a role in reducing the harm to cigarette smokers.

Mr. Lindblom, the former tobacco advisor to the FDA, has been very critical of Juul, but believes that the FDA cannot take into account the bad behavior of the past.

“The FDA has to look ahead to this and can’t really punish Juul, but it can certainly take into account how popular Juul is with teenagers,” he said.

Many of Juul’s critics don’t believe the company deserves another chance. They are wary of the “company reset” announced in September 2019 when KC Crosthwaite, a top executive at Altria, the maker of Marlboro cigarettes, became CEO of Juul.

Mr. Crothwaite pulled the plug on some of Juul’s controversial state and urban lobbying campaigns. It closed its stores in Juul’s overseas markets around the world, with the exception of the UK and Canada, although Juul is still sold through distributors in Ukraine, Russia, Italy and the Philippines. In response to public pressure, he took mint-flavored pods, which accounted for 70 percent of sales, off the market. And he stopped all US advertising.

“We have to put trust at the center of our actions,” he wrote in an email to the company’s employees last summer.

Critics claim that most of these changes were made at gunpoint – after the FDA threatened to close the deal if teenagers continued to have access to Juul.

For these public health advocates, Altria’s purchase of a $ 12.8 billion stake in Juul in December 2018 makes them even more suspicious.

“The Marlboro man broke into Juul and now wants us to trust them,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids.

The Federal Trade Commission is now trying to clear up the Altria-Juul deal, claiming that the two companies entered into a series of agreements that excluded competition in violation of antitrust laws.

The commission claims that Altria and Juul started out as competitors in the e-cigarette markets, but as Juul became more popular, Altria countered its competitive threat by discontinuing its Mark Ten e-cigarette in exchange for a share of Juul’s profits. Both companies reject the allegations.

Even if the FDA allowed Juul products, perhaps with restrictions, the company would face significant business hurdles.

When Juul was forced to discontinue its fruity flavor pods, new competitors, sometimes nicknamed Juulalikes, flooded the vacuum with cheap disposable e-cigarettes in flavors like Cherry Frost and Dinner Lady Lemon Tart. Altria now estimates Juul’s worth below $ 5 billion, a fraction of its $ 38 billion valuation when Altria acquired 35 percent of the company as part of the 2018 deal.

If Juul survives, the company will most likely spend the next few years settling thousands of lawsuits.

Fourteen states and the District of Columbia sued Juul for money to help fight the youth vaping crisis. A criminal investigation into the company by the Justice Department is ongoing.

There is also cross-district litigation in a federal court in California that has grouped nearly 2,000 cases under the supervision of a judge, much like handling opioid cases.

Whether there would still be a company that the plaintiffs could enforce depends on the FDA

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Health

Boris Johnson says England on monitor to carry Covid restrictions

Britain's Boris Johnson to get AstraZeneca vaccine

Prime Minister Boris Johnson gives an update on the coronavirus Covid-19 pandemic during a virtual press conference inside 10 Downing Street on March 18, 2021 in London, England.

Tolga Akmen – WPA Pool | Getty Images

LONDON — U.K. Prime Minister Boris Johnson on Monday detailed the final steps in the easing of England’s lockdown rules, with a final decision due to be taken on July 12.

“If we can’t reopen our society in the next few weeks when we will be helped by the arrival of summer and the school holidays, we must ask ourselves ‘when will we be able to reopen?'” Johnson told a press briefing at Downing Street.

“Freedom Day” — or “Step 4” in the government’s long-term plan to ease restrictions — will take place on July 19 if the government’s “four tests” for easing Covid restrictions are met.

The tests include looking at data to confirm that the vaccine rollout is continuing successfully, and that infection rates do not risk a surge in hospitalizations. These will be assessed on July 12 following a review of the latest data.

Johnson said Monday that there would be no limits on how many people can meet socially, or where they can meet. He said that regulations mandating face masks would be lifted and people would no longer be instructed to work from home.

All remaining businesses that are currently closed, like nightclubs, would be allowed to reopen and social-distancing rules would also end.

Johnson reiterated that Covid will become a virus that we learn to live with as we already do with flu, conceding that a reopening would likely lead to more deaths.

“It has grown ever clearer that these vaccines are indeed successful with the majority of those admitted to hospital unvaccinated.”

The lifting of restrictions in England had previously been slated for June 21 but was delayed as the highly transmissible delta variant spread throughout the U.K.

While infection rates have risen, hospitalizations and deaths have not surged, indicating that coronavirus vaccines are working to prevent severe infections.

The British government has previously signaled a reluctance to keep restrictions in place any longer than is strictly necessary. This is despite some concerns among medical experts and opposition politicians that restrictions could be lifted too soon as the variant spreads in the U.K., Europe and beyond.

Britain’s Covid immunization program has been one of the fastest in the world, with 86% of the adult population now having received a first dose of a vaccine, and 63.8% having received two doses, government data shows.