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December 23, 2022

Dementia, stem cell, and mental health research

2022 has been an eventful year when it comes to medical research, but what are some of the most intriguing findings and trends? Our editors, Maria Cohut, Yasemin Nicola Sakay, and James McIntosh reflect on this year’s highlights in our December “In Conversation” episode.

While 2020 and 2021 may have stuck in the collective memory as two intense pandemic years, 2022 has also been an eventful one.

Google’s Year in Search report pinpoints some of people’s most pressing concerns at a global scale throughout 2022. One of these is the monkeypox epidemic, which the World Health Organization (WHO) declared a “public health emergency of international concern” in August.

The death of Queen Elizabeth II of Great Britain in September, after a record 70-year reign, garnered global interest, as did the impact of the ongoing conflict in Ukraine.

And the overturning of Roe v. Wade in the United States sparked concern among medical communities worldwide.

But 2022 has also seen a wealth of advances in medical research, from a new way of assessing potential dementia symptoms that may help to diagnose it up to 9 years sooner than the current standard to the discovery of an insulin-mimicking molecule that may, in the future, help treat diabetes.

This December, three of our editors — myself, the Feature Editor, Yasemin Nicola Sakay, the Global News Editor, and Managing Editor James McIntosh — joined the “In Conversation” podcast to talk about some of 2022’s research highlights.

These include the twists and turns dementia research has taken this year, why scientists are increasingly interested in the potential of psychedelics in mental health treatments, and how stem cell research is advancing at a steady pace.

Listen to this month’s installment of our podcast below, or on your preferred streaming platform.

This year has been a very charged one for dementia research. As many as 55 million people around the world live with a form of dementia, the most common form of which is Alzheimer’s disease.

While there are some treatments that target symptoms of dementia, such as memory loss and anxiety, there is currently no cure for Alzheimer’s disease and related neurodegenerative conditions.

One thing that would help researchers find better treatments to prevent or slow down the progression of dementia symptoms would be finding out its true cause and the mechanisms that drive it.

The ‘amyloid hypothesis’ controversy

In 2006, a study that appeared in the journal Nature lent credibility to what is now known as the “amyloid hypothesis,” which holds that an overaccumulation of beta-amyloid protein in the brain — forming sticky amyloid plaques — disrupts the communication between neurons, thus being largely responsible for the main symptoms of dementia, such as memory and thinking problems.

Since its publication, the Nature paper has been cited in over 2,200 other studies, and the amyloid hypothesis has informed the vast majority of the dementia research conducted until now.

Yet in July 2022, an assistant professor of neurology at Vanderbilt University called into question claimed that some of the images in the seminal study had been manipulated, which may affect the credibility of the amyloid theory.

While the 2006 Nature paper has not, at the time of writing, been retracted, the recent claims of scientific misconduct have caused an uproar among dementia experts, and given rise to many questions.

One question is: If the paper truly does build on inaccuracies, will this invalidate some of the findings in dementia research reported until now? Not so, some experts say.

Speaking to Medical News Today, Dr. Sara Imarisio, head of research at Alzheimer’s Research UK, explained that “the findings from the [Nature] paper were very specific and, contrary to some reports, have not significantly affected the progress or direction of research into Alzheimer’s.”

“Even for research groups who work in this particular area, findings that can’t be reproduced will be identified as controversial and lose credibility, while genuine findings will come to predominate and guide the direction of future studies.”

– Dr. Sara Imarisio

Indeed, some findings about amyloid plaques seem to hold true, as a recently developed drug, lecanemab, which attacks the accumulation of beta-amyloid in the brain, has shown clear promise in recent clinical trials, and its developers hope that the drug will be approved for use in people aged 65 years and older in the U.S. as soon as next year.

New research avenues

But scientists were already aware that beta-amyloid plaques are not the be-all and end-all of dementia research. How so? In our June 2022 podcast, we spoke with Dr. Kamar Ameen-Ali, a lecturer in biomedical science at Teesside University in the United Kingdom.

Dr. Ameen-Ali explained that the crux of the matter is this: Beta-amyloid accumulates in the brains of healthy people just as it does in those of people with dementia symptoms. What makes this protein disruptive in some cases but not others remains unclear.

This is one of the reasons why dementia research does not, and has never stopped at the amyloid hypothesis, influential as it may be.

The controversy has also meant that more and more researchers are looking into alternative or additional pathologies in Alzheimer’s disease and other forms of dementia, including the role of tau, another protein implicated in dementia, which, some experts say, may be a better indicator of Alzheimer’s disease progression.

In September, an animal study whose results appeared in PLOS Biology suggested that brain inflammation caused by a dysfunction in the blood-brain barrier may be a likely cause of Alzheimer’s disease.

“These findings may have a significant global impact on the millions of people living with Alzheimer’s disease,” Prof. Warren Harding, chair of Alzheimer’s WA, told MNT about the study.

And in November 2022, a study published in Nature argued that disruptive swelling along axons, which form the link between neurons, may be the true cause of Alzheimer’s symptoms.

One emerging treatment for dementia is stem cell therapy, thanks to the potential of stem cells — which are a kind of “blank slate” cells — to differentiate and “specialize” into cells with different functions, thus providing healthy cells to replace those that have experienced some degree of “damage.”

Stem cell research has made great strides this year, with scientists looking at the potential of stem cell treatment in many incurable or difficult-to-treat diseases.

In April 2022, for instance, a study whose findings appeared in npj Regenerative Medicine showed how implanting induced pluripotent stem cells in rats with Parkinson’s disease-like motor symptoms helped reverse those symptoms by replacing damaged neurons.

Speaking to MNT about the study results, Dr. Jeffrey Kordower, director of the ASU-Banner Neurodegenerative Disease Research Center at Arizona State University, said that they gave him “great confidence” about the treatment’s applicability in human patients in the future.

Another stem cell therapy highlight made the press in summer 2022, when the fourth, and oldest patient yet with HIV and leukemia achieved remission after receiving a stem cell transplant.

The patient, a 66-year-old man, achieved long-term remission of HIV 3 years after receiving a stem cell transplant for leukemia, which is a blood and bone marrow cancer.

“When I was diagnosed with HIV in 1988, like many others, I thought it was a death sentence. I never thought I would live to see the day that I no longer have HIV,” the patient declares in a statement for the press.

Creating embryo and brain models from stem cells

Stem cell research has also reached other intriguing and much-debated heights this year. In August 2022, two different research teams reported having successfully created embryo models in the laboratory, using not sperm and egg cells, but stem cells to do so.

The embryo models managed to develop rudimentary structures, including a beating heart, blood stem cell circulation, a head region with folds, and the beginnings of a gut tube.

They are also viable enough to allow researchers to delve deeper into the study of embryonic development. Models like these can also help researchers steer free of experiments with potential ethical implications.

Other researchers managed to create brain organoids — models of brain tissue — from stem cells in the lab. Such models can help scientists learn more about rare neurological conditions, such as microcephaly, where the size of the brain is reduced compared to that of a healthy brain.

More widely, researchers could use models of brain tissue to better understand the way in which viruses, such as SARS-CoV-2, might attack and affect the brain, and to further dementia research.

The importance of stem cell donation

Our own Managing Editor, James McIntosh, donated stem cells earlier this year to help further research on better treatments for people with blood cancers and blood disorders. James talks about his experience at length in a “Through My Eyes” personal perspective article.

When a person donates blood, they can also choose to donate stem cells, which are separated through a process called “apheresis.” It may seem like an unsettling experience, but, James wrote, it was nowhere near as scary as a first-time stem cell donor might think.

In his article, he explains how apheresis works:

“All the heavy lifting was going to be done by a cell-separating machine. The nurse inserted a needle into a vein in my left arm from which my blood was drawn into the machine. The machine then separated the blood into its separate components: red blood cells, white blood cells, plasma, and platelets. Once the blood was separated, the parts containing my precious stem cells were taken away, leaving the rest of the blood to return to me. The nurse inserted another needle into a vein in my right arm, and the blood was able to rejoin my bloodstream here from the machine.”

James encourages everyone who can to donate stem cells for treatment and research: “Stem cells are a vital part of treatment for several serious conditions while also showing a lot of potential in the development of new therapies for currently untreatable diseases. As a result, it is very important for there to be people willing to donate their stem cells. Many will be able to save lives by joining a donation register.”

Our January 2022 podcast on blood donations and transfusions further explains how blood donation works, how to prepare, what the different types of blood donation are, and why this is such a vital part of medical treatment and research.

Another research avenue that has been gaining ground in 2022 is the use of psychedelics in the treatment of anxiety and depression.

Around the world, hundreds of millions of people live with anxiety or depression, which can severely affect their quality of life.

The standard treatments for these mental health conditions include psychotherapy and cognitive behavioral therapy (CBT), as well as medications such as serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) — also known as “antidepressants” — which are meant to help rebalance the levels of key chemicals in the brain.

However, according to some estimates, up to 30{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of adults living with major depressive disorder have treatment-resistant depression, which does not respond to standard lines of treatment.

And around 50{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of adults with generalized anxiety disorder do not respond to first-line treatments, such as antidepressants.

In a bid to find more effective ways of addressing the symptoms of hard-to-treat depression and anxiety, researchers have turned to a sometimes-controversial line of inquiry, namely psychedelics, particularly ketamine, LSD, and psilocybin, the psychoactive compound in magic mushrooms.

What do psychedelics do?

These drugs are, for the most part, illegal in the U.S. and elsewhere, at least for personal use, but researchers can study their effects in humans under closely supervised, clinical trial conditions, and the results of some of these studies have been intriguing.

In our May 2022 podcast, we spoke to Dr. Adrian Jacques Ambrose, medical director of the Columbia Psychiatry Practice Office.

“For anxiety disorder, as well as panic disorder, there’s hyperactivation of what we call the fear network. [By this] I mean specific parts of the brain that includes the thalamus, the amygdala, the hippocampus, and the striatum,” Dr. Ambrose explained.

And since the human brain has a negativity bias — meaning it tends to hold onto negative memories and emotions — this may exacerbate the negative thinking that occurs in anxiety and depression.

Dr. Ambrose believes that standard treatments such as antidepressants may not always work “because of their lack of specificity.” In contrast, psychopharmacological treatments may be able to “rewire” the parts of the brain involved in this vicious cycle of negative thoughts.

Indeed, a study whose results appeared in JAMA Psychiatry in October 2022 concluded that ketamine can ease depression symptoms in as little as 4 hours by “updating” negative beliefs that people with severe depression hold about themselves and the future.

“We observed each patient before and after ketamine and found an early cognitive effect on beliefs about the future. Notably, patients started to show an optimism bias in belief updating 4 hours after [the] first, single infusion. At one week of treatment, the optimist bias in belief updating correlated to the clinical antidepressant effect,” says study author Dr. Liane Schmidt.

And in November, a study from NEJM found that a single, 25-milligram dose of a synthesized formulation of psilocybin also relieved the symptoms of treatment-resistant depression, although the exact way in which psilocybin acts on the brain remains unclear.

The catch

While studies such as the ones mentioned above seem to indicate that psychedelics may indeed be the way to go when it comes to severe anxiety and depression, they all come with a series of caveats.

In the JAMA Psychiatry study, the participants received ketamine infusions, which is a very specific method of administration. They also received their regular antidepressant treatment throughout the study period.

Speaking to MNT, Dr. Guochuan Emil Tsai, neuropsychiatry expert and CEO of the company SyneuRx, not involved in the study, pointed out that:

“Ketamine infusion is available but not commonly used. It’s usually reserved only for treatment-resistant depression and can only be done in facilities that offer IV infusion and can monitor patients. It would be similar to a dialysis center. Ketamine is also a Schedule III controlled substance with inherent risks.”

The NEJM study came with an even greater caveat: Although psylocibin did help reduce depression symptoms in most of the participants, about a week after the treatment, the most commonly reported side effects were suicidal ideation and intentional self-injury.

“It’s not a recreational process — it”s not like do-it-yourself self-help,” Dr. David A. Merrill, psychiatrist, and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, CA, not involved in the study, told MNT in an interview.

“It really needs to be done with professionally trained, licensed, or certified practitioners who understand the power of these drugs to create a mind-altered state. Dissociation, even at times hallucinations, [are] part of the journey of psychedelics to open the mind to new possibilities, but that journey needs to be supported with professional help,” stressed Dr. Merrill.

So in the course of studying psychopharmacological treatments, a few questions remain: What are the safest doses and delivery methods? Do the benefits outweigh the risks? And who would most benefit from these interventions?

Our editorial team hopes that, in 2023, we may be one step closer to finding the answers to these and other questions that could transform healthcare practices for the better, and that our audience will continue to join us in our exploration of medical innovations.

June 7, 2022

Elon University / Today at Elon / School of Communications publishes 25th edition of its research journal

In the spring 2022 issue of the Elon Journal, 6 student scientists delve into a range of media-similar matters, together with the media framing of mass shooters and whether the portrayal of these perpetrators changed immediately after the 2020 Black Life Make any difference protests.

The Faculty of Communications has posted the spring 2022 issue of the Elon Journal of Undergraduate Study in Communications, featuring university student study on subjects ranging from Instagram’s part enabling poisonous, parasocial associations among athletes and lovers to the illustration of marginalized identities in predominately white Television set displays.

The spring 2022 situation of the Elon Journal includes six university student-manufactured content articles delving into media-connected subjects.

The problem consists of six investigate papers authored by School of Communications college students, such as a topical assessment of online news protection of Black and white mass shooters, and regardless of whether the portrayal of these perpetrators changed soon after the 2020 Black Life Make a difference protests.

Michaela VanDerVelden executed the aforementioned investigation, completing a qualitative information evaluation of 36 content regarding mass shootings. Her results suggest that posts about Black perpetrators have been much less possible to include mental overall health conversations. Additionally, VanDerVelden discovered that the posts have been much more very likely to involve behavioral facts about the shooter that were being irrelevant to the criminal offense.

In his From the Editor letter, Professor Harlen Makemson famous that for decades bloggers and citizen journalists have been shaping general public discourse and upending the previous media purchase. “In the period of social media, the phenomenon of consumers developing indicating has only mushroomed, as the spring 2022 edition of the Elon Journal demonstrates,” he wrote.

For instance, Olivia Archer’s posted investigation examines how Instagram facilitates parasocial relationships in between admirers and specialist athletes, with often distressing results. Archer performed a quantitative assessment to master how supporters of professional tennis gamers Naomi Osaka and Eugenie Bouchard engaged with on-line written content. Furthermore, Madeline Distenfeld investigated how TikTok consumers have shaped debates all over fast vogue and sustainable manner.

While focused on audience perceptions and not social media, Jeremy Palladino investigated how fictional figures with symptoms of aphasia, a psychological ailment producing issue with speech generation or language comprehension, are portrayed in scripted movie and tv. As part of a semi-structured concentration team, a college or university-aged audience assessed 3 characters (Hodor from “Game of Thrones,” Timmy from “South Park,” and Michael Armstrong from “Hot Fuzz”) and talked about their first reactions of people displaying aphasia.

Legacy media’s portrayals of constituent teams in culture was also tackled in the most-current journal difficulty. Matisse Gilmore used quantitative methodology to examine the appearance of marginalized identities in primetime television sitcoms, and her findings reveal there has been advancement in illustration. Also, Emily Holland done a written content analysis of women’s appearances in Tremendous Bowl commercials, a mostly unexamined space in the latest yrs.

For this spring 2022 situation, Makemson assembled an editorial board of much more than 20 communications school users who participated in the many blind-evaluation course of action to pick out the very best pupil perform.

The Elon Journal commenced in spring 2010, with spring and fall editions every single calendar year. The spring 2022 journal marks the 25th edition.

The Council on Undergraduate Study catalogs much more than 200 scholar exploration journals in the country, and the Elon Journal is a person of the couple that focuses on undergraduate university student analysis in journalism, media and communications.

March 11, 2022

The problem with endometriosis research

Women’s reproductive health attracts far less research funding than almost all other medical research. As for endometriosis — a condition that affects around 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of women of reproductive age — the lack of research is particularly striking. This debilitating condition can impact day-to-day life, education, work, and mental health, but its cause remains unclear, and there is no cure for it. Why is it so underresearched?

Why is endometriosis still so underresearched? Image credit: Michele Pevide/Getty Images.

“That time of the month,” “shark week,” “crimson tide,” “got the painters in,” “on the blob,” “visit from Aunt Flo,” “the curse” — these are just a few of the many euphemisms for something experienced by 50{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the female adult population: menstruation. But why are there so many? Are we afraid to call it by its name?

Could it be that society’s reluctance to speak plainly about periods is one of the reasons why issues with women’s reproductive health are so underrecognized and underresearched?

Most females start to menstruate between the ages of 9 and 15. Monthly cycles continue until the menopause, which, on average, happens at around 52 years of age. So most women will have in the region of 450 periods during their life.

For around 20{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of women, these are merely a monthly inconvenience. But for more than 80{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, they are accompanied by some measure of pain. And for 1 in 4 women, the pain can be severe enough to impact daily life.

We often normalize period pain as “part of being a woman.” For many, mild to moderate pain associated with menstruation can be controlled with over-the-counter pain relief, diet, and exercise.

However, debilitating pain is another matter. Menstrual Matters, a nonprofit online information hub, states that period pain “should not be regularly severe and debilitating.”

If it is, there is likely to be an underlying cause, which may need medical investigation. For pain that persists, occurs in the run-up to periods, and does not respond to pain relief, that cause may be endometriosis.

Endometriosis is “a systemic disease that is often painful and chronic.” Current estimates suggest it affects 176 million reproductive-age women worldwide.

Symptoms can include:

debilitating pain during menstruation
excessive bleeding during periods
pelvic pain at other times of the month
lower back pain
pain when emptying the bladder or bowels
pain during and after sexual intercourse

In severe cases, endometriosis can cause fertility issues. Some 40{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of women with infertility also have endometriosis.

The condition is characterized by the growth of tissue similar to the endometrium, or womb lining, in areas outside the uterus. This tissue — endometrial lesions — commonly grows in the following areas, though it can also infiltrate other parts of the body, such as the:

ovaries
fallopian tubes
ureters
bowels and bladder
abdominal wall

In line with the menstrual cycle, the lesions grow and bleed, forming scar tissue. This bleeding, inflammation, and scarring cause the characteristic pain of endometriosis.

A major issue with endometriosis is getting a diagnosis.

A 2019 review in the American Journal of Obstetrics and Gynecology (AJOG) explained why this might be:

“Despite its high prevalence and cost, endometriosis remains underfunded and underresearched, greatly limiting our understanding of the disease and slowing much-needed innovation in diagnostic and treatment options.”

Researchers acknowledge that endometriosis presents complex diagnostic challenges. Because the symptoms vary so much, the condition is often misdiagnosed as bowel and digestive disorders.

One 2020 United States study recorded that 75.2{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of patients reported being misdiagnosed with another physical health (95.1{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}), a mental health problem (49.5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}), or both before they received an endometriosis diagnosis.

This study reported that misdiagnosis with a mental health problem was more common in those with younger age of endometriosis symptom onset.

The difficulty often leads to long delays between first reporting symptoms and a diagnosis of endometriosis. On average, women wait some 8.5 years for endometriosis to be confirmed, with some waiting much longer.

Doctors go through several stages to diagnose the condition, starting with palpating the abdomen to feel for lesions. They may use transvaginal ultrasound and MRI scans, but these do not always show lesions.

Healthcare professionals can only make a firm diagnosis of endometriosis by laparoscopy. This is a surgical process done under general anesthesia where a camera is inserted through a small incision in the abdomen to view the pelvic organs.

A 2021 focus group study in the Netherlands identified several issues with diagnosing endometriosis:

Most women do not feel their symptoms are taken seriously.
Many women believe their experiences of menstruation are normal, often because of what they are told by their mothers, so they do not seek treatment.
Medical professionals find it hard to differentiate between “normal” menstrual complaints and signs or symptoms suggestive of endometriosis.

Initially, most women are offered nonsteroidal anti-inflammatory drugs such as ibuprofen. However, little research has been done into whether these alleviate the severe pain caused by endometriosis, and anecdotal evidence suggests they have little effect.

As endometriosis is estrogen-dependent, medications that inhibit estrogen can be effective in controlling pain and inhibiting the growth of lesions. These include oral birth control pills and shots (Depo-Provera). However, some women experience side effects from these, such as headaches, irregular bleeding, and weight gain.

Gonadotropin-releasing hormone treatments offer an alternative. By suppressing reproductive hormones, they also restrict the growth of lesions. The side effect of suppressing these hormones is menopausal symptoms, such as hot flashes, tiredness, sleep issues, vaginal dryness, and joint pain. However, people can take low dose hormone replacement therapy to alleviate these.

For severe pain, or when other treatments have proven ineffective, surgery will be considered. Laparoscopy, as well as being used for diagnosis, is also used to remove endometrial lesions.

Most people gain short-term pain relief after the removal of lesions, and for some, the effect is long lasting. However, according to the American College of Obstetricians and Gynaecologists, up to 80{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of women see their pain return within 2 years.

As a last resort, hysterectomy — removal of the uterus — may be considered, but evidence for its benefits in treating endometriosis is inconclusive. It is a major irreversible procedure, and a woman who has a hysterectomy will no longer have periods or become pregnant.

In the U.S., endometriosis is diagnosed in approximately 1 in 10 women of reproductive age — diabetes is diagnosed in around 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the U.S. population, both male and female.

In 2020, the U.S. government announced that funding for endometriosis research would be doubled to $26 million annually. In the same year, the National Institutes of Health (NIH) reported research spending on diabetes of $1,156 million.

Why the discrepancy? A 2021 study into gender disparity in research funding found that the “NIH applies a disproportionate share of its resources to diseases that affect primarily men, at the expense of those that affect primarily women.”

The authors went further, stating that diseases affecting primarily or solely men tended to be overfunded, whereas those affecting mostly or only women were underfunded.

And the pattern is repeated in the United Kingdom, where a 2018 analysis by the U.K. Clinical Research Collaboration found that only 2.1{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of publicly funded medical research went to reproductive health and childbirth.

According to Emma Cox, Chief Executive of Endometriosis UK, the National Institute for Health Research has funded more than 8,000 projects since its inception in 2006, only 11 of which address endometriosis.

“Women’s health, including endometriosis, has historically attracted far less research funding than other areas. We think this is because of a mixture of taboo and ignorance — whatever the reason, we are determined to put it right.”

– Emma Cox, Endometriosis UK

Lack of funding is not the only problem. Endometriosis is a complex condition. The symptoms vary so much between women that doctors used to think it was more than one condition. Therefore, it can be hard for researchers to know where to begin.

Some research has been done on animal models, but there are obstacles. Since primates are the most similar to people, they would be the best animals for modeling endometriosis. However, there are many objections to their use.

To avoid this problem, a team led by Prof. Philippa Saunders, chair of reproductive steroids at the University of Edinburgh, is developing a mouse model to study endometriosis. “The lowest species in which we can really do something meaningful is the mouse. That’s why the mouse is such an important model in reproductive research,” she says.

The researchers are studying the early development of the disease, with the aim of finding indicators of endometriosis in the blood. They hope this might provide a way of identifying the disease early before damage occurs.

However, Prof. Saunders is frustrated by the lack of funding for endometriosis research: “This progress was only possible because of increased pressure from patient groups who have been much more vocal over the last few years, working with clinical professionals to lobby funders.”

According to the 2019 review of endometriosis research in AJOG, “[c]omprehensive and interdisciplinary approaches to disease management and increased education and disease awareness for patients, healthcare providers, and the public are needed to remove stigma, increase timely and accurate diagnosis and treatment, and allow for new advancements.”

Emma Cox is one of many calling for more action:

“We would like government and other funders to address the historic underfunding of endometriosis research in order to identify the cause of the condition, work towards a cure, and develop better treatments. Developing better treatments is vital given that endometriosis can be a chronic and debilitating condition and current treatment options don’t work for everyone.”

As recently as 2020, the UK’s All-Party Parliamentary Group (APPG) on Endometriosis report highlighted that the cause of the condition was still unclear.

“Historically, with limited investment in research into women’s health in general, there’s been so little investment in research into endometriosis that we don’t even know what causes it, and without knowing the cause, a cure cannot be found,” it says.

The APPG called for “[c]ommitment for vital investment in research into the cause of endometriosis, treatment and management options, and diagnosis,” adding that:

“Without investment in research, this condition will rob the next generation of women [of] the education, care, and support they deserve.”

Lobbying groups and charities in both the U.K. and U.S. are working hard to raise awareness of endometriosis. But what is really needed is government commitments to fund more research.

Whether these will be forthcoming remains to be seen.

December 25, 2021

The year in medical research

2021 has been an eventful year, particularly in medical research. Medical News Today’s editors reflect on some of the year’s highlights.

In 2021 we reached the 1-year mark since World Health Organization (WHO) declared the start of the COVID-19 pandemic, and the world of medical research continues to grapple with this public health crisis.

Throughout this year, researchers, healthcare workers, and public health experts have been working tirelessly to find the best ways of limiting the impact of SARS-CoV-2, the virus that causes COVID-19.

According to WHO data, over 8 billion COVID-19 vaccinations have taken place globally, using 29 approved vaccines. Little wonder then that one of the top Google searches of 2021 has been “COVID vaccine.”

However, pandemic-related news has been just part of this year’s global storyline.

Research into the unknowns of the microcosm that is the human body was in the spotlight, as scientists wondered whether the microbiome is, in effect, a kind of organ in its own right.

Research in mouse models may have uncovered the likely cause of Alzheimer’s disease: an overabundance of toxic fat-protein complexes in the blood.

And on December 16, the Democratic Republic of Congo declared its 13th Ebola outbreak — which lasted a little over 2 months — over.

It has also been a busy year for Medical News Today‘s writers and editors, as the ongoing pandemic has impacted health journalism just as much as it has affected other sectors.

In this month’s “In Conversation” podcast, our editorial team discusses the research and topics that stuck with us this year, and we reflect on what we would like to see in medical research going forward.

Previously, we mentioned the fascination that the human microbiome holds over medical researchers. In sum, it is the genome of the microorganisms that inhabit the human body, which includes bacteria, fungi, and viruses.

Most of us are perhaps more familiar with bacteria, especially those present in the gut. Researchers have linked gut bacteria to a wide array of health phenomena, including, most recently, weight loss, heart disease, and inflammation.

Our body’s most surprising permanent lodgers are viruses, which we tend to associate with infections and ill health. However, not all viruses are the same, and scientists believe that many might even play a positive role in health,

Back in February 2021, scientists from the Wellcome Sanger Institute and the European Bioinformatics Institute in Hinxton, United Kingdom, reported that they had established a comprehensive “atlas” of bacteria-eating viruses that inhabit the human gut. These viruses are called bacteriophages or phages for short.

This new database indicates that the human gut contains over 140,000 different phages. While most of these viruses can only infect and attack a single bacterial species, around 36{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of phages may have the capability to infect several types of bacteria.

Researchers identify previously unknown phages regularly. One study from October 2021 reported on a newly identified phage that occurs in the human gut. The scientists dubbed it LoVEphage, which stands for “lots of viral elements.”

Currently, it is unclear what role or roles this and other bacteriophages might play in human health. Yet, it is becoming increasingly apparent that they could provide the key to some unanswered questions.

“Everyone knows that gut bacteria are important,” said our Senior News Editor, Tim Newman. “That’s something that has become common knowledge over the last 20-30 years. But these bacteriophages kill bacteria. So if gut bacteria are really important to health, then these phages will be as well.”

One way bacteriophages interest scientists is through their potential for offering an alternative to antibiotics in an era when antibiotic resistance is becoming a widespread problem. Indeed, one study published this autumn suggests that a naturally occurring phage can successfully reduce the spread of the bacterium that causes dysentery.

It is no secret that, like many other fields, medical research and healthcare are gravely affected by structural racism and other forms of discrimination. This impacts who receives healthcare and whether they feel able and confident to seek medical assistance in the first place.

There are many expressions of structural racism in medicine, and one of these is through the visual representation of skin conditions. For years, visual reference material about skin conditions has taken white skin as the standard.

Yet, it stands to reason that signs of dermatological issues will present differently on skins of different tones and colors. So, not including accurate visual representations for the full spectrum of skin colors results in untreated conditions, often leading to fatalities.

For example, around one-quarter of African American people with skin cancer only receive a diagnosis once the cancer has already spread to the lymph nodes. And while white adults in the United States who have received a diagnosis of melanoma have a 5-year survival rate of 92{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, African American people with skin cancer have a 5-year survival rate of 67{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.

One global initiative — called Project IMPACT, built on the clinical decision support system software VisualDx — is now working to level these disparities by creating and sharing a catalog of images that show how different skin conditions appear on darker skins.

Earlier this year, Ana Sandoiu, News Editor II at MNT, interviewed Dr. Nada Elbuluk about systemic discrimination in healthcare and the development of Project IMPACT, which she helped launch. Dr. Elbuluk is a skin of color expert, practicing dermatologist, and dermatology professor at the Keck School of Medicine at the University of Southern California in Los Angeles.

“[I]n our interview, it quickly became clear that basically worse disease outcomes [for] morbidity and mortality that result from these inequities are the main reason why resources, such as the one that VisualDx created, are so important,” said Ana.

She called the statistics showing the lower survival rates for African Americans with skin cancer “chilling numbers,” pointing out that they mean one thing: Black Americans do not receive timely care for this condition.

“[W]hen Black Americans do reach the doctor’s office, and they get a diagnosis, it’s either already at a late stage, or as Dr. Elbuluk pointed out in her interview with me, these biases in dermatology and medical practice that favor white skin could mean that a lot of these conditions may be missed altogether or misdiagnosed,” Ana noted.

Dr. Elbuluk and her colleagues also found a shockingly low number of published research articles looking at how skin discoloration, acne, and eczema affect People of Color.

According to her, such articles are “in the single digits,” and this situation will likely impact outcomes for People of Color who, as the expert’s research shows, often seek dermatological care for these same conditions.

“Having that cultural competence, or cultural humility, which is a more recent term, is really important. When patients feel that they’re seen and they’re heard and they’re acknowledged, it makes a difference,” Dr. Elbuluk told Ana.

“[T]hose things carry a lot of weight for patients, and if I’m a patient of color and my physician understands what’s pertinent to me, to my background, [and] to how I take care of my hair or my skin, all of that is so important in making a connection with the patient.”

– Dr. Nada Elbuluk

Racism is not the only issue that medical research and healthcare have had to face in 2021. They have also had to contend with the gender data gap, as evidenced by reports that some people who menstruate experienced unusual periods following a COVID-19 vaccine.

The gender data gap refers to the phenomenon that, historically, researchers have taken men’s lives and the male body as the standard of health and well-being and then applied them to female bodies.

However, it has become increasingly evident that females experience many conditions, such as coronary heart disease and ADHD, differently. The gender data gap means that many females with these conditions do not receive an accurate diagnosis.

Earlier this year, a study looking at sex bias in clinical trials concluded that females were most underrepresented in the area of oncology, which is the study of cancer. Other neglected areas include neurology, immunology, cardiology, and genitourinary disease.

Little wonder then that reports of the COVID-19 vaccines potentially disturbing menstrual cycles caused confusion: Do the vaccines really cause these disturbances, and if so, what might the mechanisms be, and who is most at risk of experiencing them?

There is currently only one study that gathered data about COVID-19 vaccines and menstrual changes. Dr. Katharine Lee, a postdoctoral research fellow in the Division of Public Health Sciences at the Washington University School of Medicine in St. Louis, MO, and Dr. Kathryn Clancy, an associate professor in the Department of Anthropology at the University of Illinois at Urbana-Champaign conducted the study. I interviewed them in July 2021.

They set up a survey — now closed, with data analysis pending — asking people who menstruate about their experiences back in spring, after Dr. Clancy and then Dr. Lee experienced changes to their periods following vaccination.

The study, however, only looks at the prevalence of such menstrual changes and not at the potential mechanisms, which, hopefully, future studies will cover.

Understanding how often such changes might occur post-vaccination is only the first step in a long process.

Researchers are yet to determine whether these disturbances to menstrual cycles are due to COVID-19 vaccines since many independent factors can affect periods, including chronic stress — and an ongoing pandemic, as well as vaccine hesitancy, can be prominent stress factors.

Looking out for how new vaccines might impact menstrual cycles at the clinical trial stage could go a long way towards clarifying the presence — or absence — of causal links.

Yet when I interviewed Dr. Lee, she expressed some surprise and disappointment that the researchers behind COVID-19 vaccine development and testing do not seem to have given much thought to how these vaccines might affect periods.

“I think just remembering to ask about differences in the menstrual cycle as part of standard clinical testing of vaccines might be nice, given that we expect a huge immune response, and we know that huge immune response[s] can disrupt lots of other inflammatory pathways in people. Menstrual cycles tend to be something that people who have periods pay attention to, and [they] notice when things get a little bit wonky […].”

– Dr. Katharine Lee

In the meantime, an editorial that appeared in The BMJ also called for more investigation into the potential link between COVID-19 vaccines and changes to periods.

Data cited in the editorial at the time of publication indicate that over 30,000 people in the United Kingdom alone had reported disturbances to menstrual cycles following vaccination.

Our News Editor, Yasemin Nicola Sakay, was most struck by the debates around the so-called Freedom Day in the United Kindom, home to the MNT offices.

On July 19, 2021, British authorities announced Freedom Day when they lifted almost all previous pandemic restrictions — including requiring people to wear masks indoors and on most means of public transport.

While some members of the public, tired of the sense of isolation that obligatory mask-wearing and physical distancing can give, rejoiced at this decision, some public health experts criticized it as unwise, suggesting that it might lead to surges in SARS-CoV-2 infections.

At the time, a study conducted by Imperial College London found that new infections with the Delta variant were on the rise in unvaccinated 5-12-year-olds and in 18-24-year-olds who had only just become eligible to receive a COVID-19 vaccine.

In an open letter published in The Lancet at the end of July, several signatories warned about lifting the restrictions too soon.

“My epidemiology colleagues are concerned that this virus has a high propensity to mutate, and the ‘survival of the fittest’ principle will ensure that new variants are adapted to their environment better than the ones they replace,” one of the signatories, Prof. Trish Greenhalgh, told Yasemin.

In hindsight, her prediction appears to have come true. At present, the U.K. is facing an alarming rise in cases of COVID-19, mainly attributed to the spread of the new Omicron variant of SARS-CoV-2.

Keeping one key restriction in place could have made a significant difference, Yasemin explained: “[A]lmost all of the scientists [I interviewed] converged on one point, and that was that some restrictions, namely mask-wearing, should remain in place. And that decision was science-based because COVID-19, as we know, is an airborne disease and SARS-CoV-2 particles spread through the air.”

Yet there has been and continues to be widespread resistance to mask-wearing. The concept of psychological reactance, which refers to the phenomenon whereby people react adversely to messages concerning public health, may help explain it.

A study that appeared in PLOS ONE in February suggests that to address psychological reactance and improve adherence to mask-wearing, those generating the public health messages should focus more on highlighting personal choice and its impact on the individual and on those around them.

“[D]o it for yourself or someone you love,” said Yasemin when asked what she would tell people who are unsure about using face masks. She and our other editors encourage all of our readers to reflect on how small choices — such as wearing a mask or not — could alter the lives of those at high risk of developing severe COVID-19.

Looking to 2022, MNT‘s editors would like to see more exciting research on the intriguing, mysterious inhabitants of the human body, such as phages.

We also hope there will be an increased focus on health equity in research and healthcare and that health workers and public health experts will continue to empower those who seek medical advice by listening closely to all their concerns.

Finally, we hope to see more research into how emerging COVID-19 vaccines and therapies affect people who are immunocompromised and into ways of offering more protection to those at risk of becoming seriously ill.

In the meantime, may we all stay healthy and safe!

October 3, 2021

Today’s coronavirus news: Pfizer submits preliminary research on COVID-19 vaccine for kids aged five to 11; Ontario reports another 704 COVID-19 cases and seven more deaths

The latest coronavirus news from Canada and around the world Saturday. This file will be updated throughout the day. Web links to longer stories if available.

8:00 p.m.: Three Alaska hospitals have now instituted crisis protocols that would allow them to ration care if needed as the state recorded the worst COVID-19 diagnosis rates in the U.S. in recent days.

According to data collected by Johns Hopkins University Center for Systems Science and Engineering, one person in every 84 in Alaska was diagnosed with COVID-19 from Sept. 22 to 29. The next highest rate was one in every 164 people in West Virginia.

Fairbanks Memorial Hospital activated the protocol Friday because of a critical shortage of bed capacity and staffing, along with the inability to transfer patients to other facilities. Two other Alaska hospitals, in Anchorage and Bethel, have invoked the same protocol.

Fairbanks Chief Medical Officer Dr. Angelique Ramirez said the decision to move to crisis standards was because of many factors, including community spread caused by the low vaccination rates and a high number of patients waiting to be admitted.

Statewide, 60{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of eligible Alaskans are fully vaccinated. The Fairbanks North Star Borough is the third-worst region for vaccination rates in Alaska, with just under 52{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of eligible residents vaccinated.

7:00 p.m.: Public Safety Canada says a contingent from the Canadian Armed Forces is expected to “be in position” Monday to decide where to deploy eight critical care nurses that will help Alberta combat the fourth wave of COVID-19.

The federal agency also says the Canadian Red Cross is planning to provide up to 20 medical professionals, some with intensive care unit experience, to augment or relieve existing staff working in Alberta’s hospitals.

Premier Jason Kenney announced Thursday that the province was finalizing a deal to secure eight to 10 intensive care ward specialists from the military, likely to be based in Edmonton, to help in hospitals.

He also said up to 20 trained Red Cross medical workers, some with intensive care experience, would be deployed in central Alberta.

Alberta is dealing with a COVID-19 crisis that has seen well over 1,000 new cases a day for weeks while filling intensive care wards to almost twice normal capacity.

The province’s health delivery agency has had to scramble and reassign staff to handle the surge of intensive care patients far above the normal capacity of 173 beds.

5:00 p.m.: New Brunswick is reporting a record-smashing 140 new COVID-19 infections and four deaths in a single day as the Maritime province continues to grapple with the the pandemic’s fourth wave.

Health officials say the deaths include a person aged 30 to 39 in the Fredericton region, a person aged 50 to 59 in the Edmundston region and two people aged 70 to 79 in the Fredericton and Moncton regions.

The four deaths bring the total number of COVID-19-related deaths in the province to 64.

Officials say among the 140 new cases, 94 are people who are unvaccinated, 34 are fully vaccinated and 12 are partially vaccinated.

New Brunswick currently has 44 people hospitalized due to the virus, with 17 in intensive care.

The province says 35 of the patients in hospital — or nearly 80 per cent — are unvaccinated while nine are either partially or fully vaccinated.

“Healthy younger people are getting sick as well as older individuals,” Premier Blaine Higgs said in a statement.

“Of the 140 cases announced, 88 are under 40. Those in that age bracket are less likely to end up in hospital but they still carry and can transmit the virus.”

In addition to the 140 new cases, the province reported 49 recoveries from COVID-19 on Saturday, bringing the number of active cases to 764.

The province said public safety officers will be conducting spot checks at churches this weekend, many of which have been the sites of recent COVID-19 exposures.

Officials said while the vast majority of churches have been following the rules, concerns remain that not all are and fines will be issued to institutions and individuals who break the mandatory public health rules.

“Four more New Brunswickers lost to the virus is a grim reminder of the continuing toll COVID-19 is taking on our communities and on people at every stage of life,” Dr. Jennifer Russell, the province’s chief medical officer of health, said in a statement.

While the number of hospitalizations remains manageable for now, the admissions place an extreme burden on the province’s health-care system, she said.

“We expected cases to climb and they may continue to do so for the next little while until we see the impact of the additional measures brought in last week.”

New Brunswick reimposed a state of emergency in late September to deal with the sudden spike in COVID-19 cases.

That followed a decision two months earlier to drop all of its COVID-19 restrictions — the first jurisdiction in Atlantic Canada to do so.

At the time, some infectious disease experts warned New Brunswick would face a surge in Delta-variant cases in the fall, mainly because of the decision to drop mask requirements in indoor public places.

The mask order has now been reinstated, along with a number of other health-protection measures. They include new rules to limit contacts, ensure physical distancing and require certain businesses and events to have vaccination or masking-and-testing policies.

3:45 p.m.: A one-day vaccine campaign, with more than 35 clinics across the City of Toronto, got underway on Saturday.

Mayor John Tory announced the launch of #Vax25, a COVID-19 inoculation push to promote vaccine clinics in the city’s 25 wards.

“I continue to urge eligible residents to get vaccinated now to help protect themselves and the progress we have made fighting this pandemic and reopening schools and businesses,” Tory said as he thanked city councillors for teaming up for the initiative.

#Vax25 features at least one clinic per ward supported and promoted by the ward’s councillor.

Read the full story here: Toronto launches one-day #Vax25 vaccine push throughout the city’s 25 wards

2:30 p.m.: Health Canada has received drugmaker Pfizer’s preliminary research on the effectiveness of its COVID-19 vaccine in children aged five to 11.

The drugmaker confirmed Saturday it provided the initial trial data to the federal department for review as it prepares to make a formal submission — possibly later this month — seeking authorization to use the product in children.

Pfizer Canada spokeswoman Christina Antoniou said the submission will be a request for full authorization.

She said the new drug submission process for COVID-19 vaccines offers the same flexibility as the interim order authorization pathway did, including allowing the company to submit a rolling submission.

“In other words, [it’s] not an emergency use authorization but a full approval under which we would continue to submit new data as it becomes available,” Antoniou said in an email.

Pfizer’s vaccine was initially given the green light for use in Canada last December. The two-shot vaccine, developed in partnership with German pharmaceutical company BioNTech, is currently available for those aged 12 and older.

Pfizer and BioNTech said last week that researchers found the vaccine antibody responses in children were just as strong as those found in teenagers and young adults getting regular-strength doses.

The companies submitted the research to the U.S. Food and Drug Administration last week and plan to request emergency use authorization of their vaccine in children ages five to 11 “in the coming weeks.”

Pediatric studies evaluating the safety and efficacy of Pfizer’s COVID-19 vaccine in children aged six months to age five is ongoing, with initial results expected before the end of the year, Antoniou said.

12:15 p.m.: Quebec is reporting 640 additional cases of COVID-19 today and five more deaths due to the pandemic.

The vast majority of cases are due to the contagious Delta variant, which accounted for 86.9 per cent of infections sequenced between Sept. 12 and Sept. 18.

Overall hospitalizations declined by nine to 301, while the number of people in intensive care dropped by one to 83.

About 89 per cent of Quebec’s eligible population 12 and over have received one shot of vaccine, and 84 per cent have received two doses.

11:15 a.m.: Ontario is reporting another 704 COVID-19 cases and seven more deaths, according to its latest report released Saturday morning.

The province reports 401 COVID-19 cases were confirmed in unvaccinated people, 44 were partially vaccinated, and 198 cases in fully vaccinated people.

There are 274 people currently hospitalized with COVID-19 in the province, including 141 patients in intensive care testing positive for COVID-19. There are 110 people on ventilators. Locally, there are 150 cases in Toronto, 67 in Peel Region, 46 in York Region with 70 cases in Ottawa, 44 in Hamilton, 32 in Windsor and 32 in Niagara.

Ontario has administered 37,333 vaccine doses since its last daily update, with a total 21,847,046 vaccines given as of 8 p.m. Friday night.

According to the Star’s vaccine tracker, 11,263,479 people in Ontario have received at least one shot, or about 86.4 per cent of the eligible population 12 years and older. The province says 10,583,567 people have completed both vaccination shots, or approximately 81.2 per cent of the eligible population.

7:44 a.m.: Canadians overwhelmingly support the idea of requiring vaccine passports to gain admittance to public places such as restaurants, bars and gyms, a new poll suggests.

Fully 78 per cent of respondents to the Leger poll said they strongly support (56 per cent) or somewhat support (22 per cent) requiring proof of vaccination against COVID-19 to visit non-essential public places where numerous people typically congregate, including concert halls and festivals.

Just 13 per cent said they strongly oppose a proof-of-vaccination requirement, variations on which are being introduced by provincial governments across the country. Another nine per cent said they’re somewhat opposed.

Support ranged from a low of 70 per cent in the Atlantic Provinces to a high of 86 per cent in British Columbia. Eighty-one per cent of Alberta respondents also supported the move, although their province has been the most reluctant to adopt a vaccine passport system.

The poll of 1,537 Canadians was conducted Sept. 24-26, as health care systems in both Alberta and Saskatchewan were being overwhelmed by soaring cases of the Delta variant of the COVID-19 coronavirus.

The online poll cannot be assigned a margin of error as internet-based surveys are not considered random samples.

Seventy-four per cent of respondents said governments should not lift all public health restrictions now. Just 18 per cent supported lifting them.

Opposition to relaxing public health orders included 76 per cent of respondents in Alberta, where Premier Jason Kenney lifted most restrictions over the summer, only to have to reimpose some recently as the fourth wave of the pandemic swept the province.

Unsurprisingly given their provinces’ struggles with the fourth wave of the pandemic, Kenney and Saskatchewan Premier Scott Moe ranked the lowest among provincial first ministers for their handling of the health crisis.

Fully 80 per cent of Alberta respondents said they were very or somewhat dissatisfied with Kenney’s performance, and 74 per cent of Saskatchewan respondents felt the same about Moe.

By contrast, 74 per cent of Quebec respondents expressed satisfaction with Premier François Legault’s handling of the pandemic, 61 per cent of British Columbians were satisfied with Premier John Horgan and 52 per cent of Ontarians were satisfied with Premier Doug Ford’s performance.

Fifty-seven per cent nationally said they were satisfied with the federal government’s handling of the pandemic while 61 per cent expressed satisfaction with their municipal governments.

Respondents were split over the state of the pandemic in Canada, with 39 per cent saying they think the worst is over, 22 per cent saying we’re in the worst period of the crisis now and another 21 per cent saying the worst is yet to come. Nineteen per cent didn’t know.

7:43 a.m.: When Russians talk about the coronavirus over dinner or in hair salons, the conversation often turns to “antitela,” the Russian word for antibodies — the proteins produced by the body to fight infection.

Even President Vladimir Putin referred to them this week in a conversation with his Turkish counterpart Recep Tayyip Erdogan, bragging about why he avoided infection even though dozens of people around him caught the coronavirus, including someone who spent a whole day with the Kremlin leader.

“I have high titres,” Putin said, referring to the measurement used to describe the concentration of antibodies in the blood. When Erdogan challenged him that the number Putin gave was low, the Russian insisted, “No, it’s a high level. There are different counting methods.”

But Western health experts say the antibody tests so popular in Russia are unreliable either for diagnosing COVID-19 or assessing immunity to it. The antibodies that these tests look for can only serve as evidence of a past infection, and scientists say it’s still unclear what level of antibodies indicates protection from the virus and for how long.

The U.S. Center for Disease Control and Prevention says such tests should not be used to establish an active COVID-19 infection because it can take one to three weeks for the body to make antibodies. Health experts say tests that look for the virus’s genetic material, called PCR tests, or ones that look for virus proteins, called antigen tests, should be used to determine if someone is infected.

7:42 a.m.: It’s a milestone that by all accounts didn’t have to happen this soon.

The U.S. death toll from COVID-19 eclipsed 700,000 late Friday — a number greater than the population of Boston. The last 100,000 deaths occurred during a time when vaccines — which overwhelmingly prevent deaths, hospitalizations and serious illness — were available to any American over the age of 12.

The milestone is deeply frustrating to doctors, public health officials and the American public, who watched a pandemic that had been easing earlier in the summer take a dark turn. Tens of millions of Americans have refused to get vaccinated, allowing the highly contagious Delta variant to tear through the country and send the death toll from 600,000 to 700,000 in 3 1/2 months.

Saturday 7:42 a.m.: California will become the first U.S. state to require COVID-19 vaccinations for children to attend public and private schools in person in a mandate that could effect millions of students.

Gov. Gavin Newsom on Friday announced that the coronavirus shot will be added to 10 other immunizations already required for school kids, including those for measles and mumps.

Exemptions would be granted for medical reasons or because of religious or personal beliefs but the exemption rules haven’t been written yet pending public comment.

Any student without an exemption who refuses to get the vaccine would be forced to do independent study at home.

“We want to end this pandemic. We are all exhausted by it,” Newsom said during a news conference at a San Francisco middle school after visiting with seventh graders.

“Vaccines work. It’s why California leads the country in preventing school closures and has the lowest case rates,” Newsom said.

Read Friday’s coronavirus news.