Malaria cases in Florida and Texas prompt CDC warning: What to ...

At least eight cases of locally acquired malaria have been reported in the U.S. over the past two months, the first time the disease has had a local spread in 20 years.

A public health alert was issued by the Centers for Disease Control and Prevention in June to advise doctors, public health authorities and the public about the risk.

Seven of the cases were identified in Sarasota County, Florida, and one was identified in Cameron County, Texas. None of the patients had traveled outside the state before falling ill.

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How often is malaria seen in the U.S.?

Malaria was declared eliminated as a major national public health problem in 1951. Now about 2,000 malaria cases are reported in the U.S. each year, typically in returning travelers. Florida and Texas identified 156 cases of malaria total in 2021; all were from returned travelers.

Rhoel Dinglasan, a professor of infectious diseases at the University of Florida’s College of Veterinary Medicine, told the Sarasota Herald-Tribune that cases of locally acquired malaria are not common. The last outbreak of malaria cases in the country was in 2003, when Palm Beach County recorded eight such cases.

Where is malaria most common?

Malaria is still a significant global problem even though it has been eradicated in many nations, including in the U.S., and there is no known method of transmission.

The majority of malaria cases and fatalities are found in Africa, where plasmodium faciparum, the most dangerous and widespread malaria parasite, is common. Only a few locations in other regions have transmission.

How is malaria spread?

Malaria is a serious and sometimes life-threatening disease caused by the bite of a female mosquito from the genus Anopheles, the vector that transmits malaria.

Most mosquitoes don’t carry disease. Those that do are called vectors. Among vector-borne diseases: West Nile virus, encephalitis, malaria, dengue fever and chikungunya in humans, or heartworm parasites in dogs.

How it can spread to humans:

When a mosquito bites

A stealth attack: A mosquito releases a substance in its saliva to numb the skin so people don’t feel its bite.

Infection: Diseases such as malaria are found in the mosquito's saliva.

Feeding: A mosquito uses its proboscis to pierce the skin and locate a blood vessel. The mosquito releases substances that prevent blood from clotting so it can feed longer. Mosquitoes can feed up to 10 minutes.

The itch: The immune system releases histamine to fight the presence of the invading bodies in the skin. The skin swells, making a red itchy bump after a mosquito bite.

What are the signs and symptoms of malaria?

Chills, fever, headache, nausea, body aches and diarrhea are a few of the common malaria symptoms, which are similar to those of the flu, common cold and COVID-19.

The most common symptoms are fever, chills, headaches, muscle aches and fatigue. These symptoms typically occur seven to 30 days after people are infected with the parasite. However, if the infection is untreated, more severe symptoms may appear, including impaired consciousness, difficulty breathing, convulsions, abnormal bleeding and more, which can ultimately lead to death.

How do you protect yourself against malaria?

The CDC recommends using "mosquito avoidance measures" when going outside, including:

Using EPA-approved mosquito repellent on skin and clothes.

Wearing long-sleeved shirts and pants, especially at night.

Staying in well-screened areas.

Sleeping under an insecticide-treated bed net when camping.

When traveling out of the country, especially to sub-Saharan Africa, the Indian subcontinent, Southeast Asia or tropical South and Central America, consult your doctor about what vaccines and medicines you can take to prevent diseases. Antimalarials help prevent malaria and are available only by prescription.

Contributing: Cheryl McCloud of the Florida Digital Optimization Team and Anne Snabes of the Sarasota Herald-Tribune; The Associated Press

50 States

From USA TODAY Network and wire reports

Alabama

Montgomery: Republican Gov. Kay Ivey recognized Ashley M. Jones, the state’s first Black poet laureate, a creative writing teacher who delves into inequality and the difficulty of being Black in America, in the same building where Southern delegates voted to form the Confederacy 160 years ago. Standing in the white-domed Capitol, Ivey presented Jones with a commendation for the honor, bestowed earlier this year by the Alabama Writers Cooperative for a four-year term that begins in January. “Everyone in this room, and I would add folks around the country, are proud of you for being honored with this well-deserved, historic recognition,” Ivey told Jones during the ceremony. As poet laureate, Jones will advocate for poetry and writing in general during lectures and appearances at schools, libraries and other institutions. “I am committed to making space for all of us who write,” she said. Jones’ appointment is “pretty revolutionary,” said Jeanie Thompson, an author and executive director of the Alabama Writers Forum. “She brings a strong statement, but she brings a lot of balance,” said Thompson. “And so I think that she will have things to say that people will hear.”

Alaska

Anchorage: The remains of a man found on Fire Island just west of Anchorage in 1989 have been identified through DNA and genome sequencing, Alaska State Troopers said. Troopers said the victim was Michael Allison Beavers, who owned an excavation business in Chugiak. He was reported missing in 1980. The decadeslong investigation started when human remains were discovered July 24, 1989. An autopsy concluded it was a Caucasian male between the ages of 35 and 50, and evidence found on the remains indicated the death was criminal, troopers said. Officials said it appeared the remains had been on the beach for at least a year, but the date of death couldn’t be determined. A DNA profile entered into the national missing persons database in 2003 came back with no match. Earlier this year, the Alaska Bureau of Investigation Cold Case Investigation Unit reopened the case. Bone samples retained in the case were sent to a private lab, where DNA was extracted and genome sequencing was used to create a comprehensive DNA profile. Beavers’ spouse reported him missing two months after he was last seen alive, in November 1979. Beavers, 40, left his home in Chugiak to travel to Seattle by car to contact a business associate. He never arrived, troopers said. The investigation into his disappearance stalled and closed in 1982. Ten years later, he was declared dead. Troopers said the investigation into his death continues, and anyone with information about his disappearance and death should contact authorities.

Arizona

Phoenix: A 25-foot-tall white pine installed in the state Capitol’s executive tower lobby was lit for the first time Wednesday by Gov. Doug Ducey during a celebration marking the start of the holiday season. The lighting of the Capitol tree is an annual tradition and brings together schoolchildren, state workers and the governor. This year’s celebration featured Christmas carols sung by students from Chandler High School’s choir, the Treblemakers. Last year’s tree lighting ceremony was forced to be held virtually because of the coronavirus pandemic. Ducey cheered the return to an in-person ceremony, noting at the time of last year’s lighting, vaccines were not available and the state’s economy was just starting to revive from effects of the pandemic shutdowns.

Arkansas

Little Rock: A federal appeals court upheld the 20-year prison sentence for a former pathologist at an Arkansas veterans hospital who pleaded guilty to involuntary manslaughter in the death of a patient he misdiagnosed. The three-judge panel of the 8th U.S. Circuit Court of Appeals rejected arguments by Robert Levy’s attorneys that the sentence was unreasonable. Levy pleaded guilty to misdiagnosing a patient with small cell carcinoma who died after being treated for a type of cancer he didn’t have. Levy falsified the patient’s medical record to state that a second pathologist agreed with his diagnosis, according to a plea agreement. Levy was fired from the Veterans Health Care System of the Ozarks in Fayetteville in April 2018. VA officials said in 2019 that outside pathologists reviewed nearly 34,000 cases handled by Levy and found more than 3,000 errors or missed diagnoses dating to 2005.

California

Riverside: Police are looking for a man dubbed the “snake burglar” who wriggled his way through a Southern California business and fled with several thousands dollars. Surveillance video showed the man slithering on his belly at the Rustic Roots salon in Riverside at about 5 a.m. last Friday after apparently getting into the business through a rooftop fire escape. “It just gave me chills up my spine,” owner Lori Hajj told KNBC-TV. Hajj said the thief she called the “snake burglar” stole hundreds of dollars worth of products, cash from the register and a safe with more than $8,000 inside. A security guard who was installing a new alarm system at the salon told KNBC-TV that the crook had been trying successfully to avoid a motion sensor. The same man might have tried to burglarize other businesses previously, including a local pizza parlor where security video showed a man crawling on his belly, the station said.

Colorado

Fort Collins:Rocky Mountain National Park will have a timed-entry permit system for the third straight season, pending approval from the National Park Service. The park is proposing the system for 2022 with minor tweaks to what was implemented in 2021. The third-most visited national park implemented the pilot system in 2020 to address visitor congestion and resource damage. The park’s timed-entry permit system has been polarizing, with some visitors enjoying less congestion and others complaining about the restrictions that curtail spontaneous trips. Through August, the last month for which visitation numbers were available, the park saw nearly 3.3 million visitors compared with 2.2 million during the same time in 2020. In 2019, the park saw nearly 4.7 million visitors over the entire year. Park spokesperson Kyle Patterson said the park is continually adjusting the system based on data it has collected to help balance visitor experience with resource protection.

Connecticut

Hartford: Connecticut collected about $1.7 million during its first partial month of legalized online gambling and sports wagering, Gov. Ned Lamont said. The figures represent the state’s share of revenue collected Oct. 12-31. Roughly $1.2 million came from the state’s portion of online casino gambling revenue generated by the Mashantucket Pequot and Mohegan tribes, and approximately $513,000 came from sports betting revenue generated by the tribes and the Connecticut Lottery Corporation. The money will be deposited into the state’s general fund. Under the state’s new legalized system, Connecticut collects 13.75% of gross gambling revenue from sports wagering, and 18% from online casino gambling until 2026, when the rate increases to 20%. The state does not receive any payments on sports wagers placed at the southeastern Connecticut casinos owned by the two tribes, which currently have opened temporary sports book facilities.

Delaware

Dover: Children can now visit inmates at Delaware correctional facilities for the first time since the coronavirus pandemic began, correction officials said. The Delaware Department of Correction announced in a news release Tuesday that in-person visits at all of its facilities have been expanded to include children and youth under 18. The department said it’s making the change as COVID-19 vaccination expands to include children and aggressive COVID-19 mitigation measures continue in the correctional system. Visiting children must be accompanied by an adult visitor and inmate visits are limited to either one adult or one adult and one child. The department said all in-person inmate visits must be scheduled in advance through the facility and all visits are subject to COVID-19 screening. Commissioner Monroe B. Hudson Jr. emphasized that video visitation is available in all Delaware prison facilities and was expanded early in the COVID-19 pandemic.

District of Columbia

Washington:When United flight 2701 from Chicago landed at Ronald Reagan Washington National Airport on Wednesday afternoon, it became the first commercial flight to use 100% sustainable aviation fuel, WUSA-TV reported. It was an important milestone as the travel industry works to fight its contributions to climate change. “Today’s SAF flight is not only a significant milestone for efforts to decarbonize our industry, but when combined with the surge in commitments to produce and purchase alternative fuels, we’re demonstrating the scalable and impactful way companies can join together and play a role in addressing the biggest challenge of our lifetimes,” said United CEO Scott Kirby. The demonstration flight departed O’Hare Airport at 1 p.m. CST carrying 100 passengers, with an arrival time of 4 p.m. EST. The flight used 500 gallons of SAF -- a clean alternative to jet fuel -- in one engine and 500 gallons of jet fuel in the other. According to United, airlines are only allowed to use a maximum of 50% SAF on board, meaning past flights using SAF were a combination of the alternative fuel with conventional jet fuel. United Airlines has set a goal of being 100% green by reducing its GHG emissions 100% by 2050, without relying on traditional carbon offsets. To work towards this goal the company says it plans to buy 1.5 billion gallons of SAF; so far this year they’ve purchased more than 7 million gallons through the Eco-Skies Alliance program.

Florida

Miami: The Roman Catholic Archdiocese of Miami is making face coverings optional for unvaccinated and partially vaccinated students whose parents sign opt-out paperwork. The archdiocese made the announcement Tuesday, citing community COVID-19 statistics and the advice of physician advisors, the federal Centers for Disease Control and Prevention and the Miami-Dade County Department of Health. The CDC recommends mask-wearing in public indoor settings, including schools, in areas of substantial or high community transmission. As of Wednesday, Florida was the only state in the nation where transmission was low in nearly every county, according to the CDC’s COVID-19 data tracker. Face masks were already optional for fully vaccinated students and teachers who provided vaccination cards to the school or were confirmed through the FL SHOTS database, the archdiocese said in a statement. Public schools in Miami-Dade and Broward counties allowed parents to opt their children out of wearing masks in early November. If the data trends negatively again, archdiocese spokeswoman Mary Ross Agosta said measures will be put back in place.

Georgia

Grovetown:A nutrition manager at Cedar Ridge Elementary School has been arrested on charges of possession of methamphetamine found at the school, according to a press release from the Grovetown Department of Public Safety. At approximately 8:30 a.m., the department responded to the school where a small amount of methamphetamine was found in an employee restroom in the kitchen. After an investigation, the department believed it belonged to Kelley Nile, the nutritional manager. The Richmond County Sheriff’s Office K-9 Division responded to the campus and discovered an additional user amount of methamphetamine in the center console of Nile’s vehicle. Nile was arrested on charges of possession of schedule II narcotics and transported to the Columbia County Detention Center. The Columbia County School District said Nile is no longer employed by the school system. The school is in the process of notifying staff and parents about the situation.

Hawaii

Honolulu: The Hawaii State Department of Health said a laboratory has detected petroleum product in a water sample from an elementary school near Pearl Harbor amid heightened concerns that fuel from a massive Navy storage facility could contaminate Oahu’s water supply. The department said the test result from a University of Hawaii lab is preliminary, and it’s not yet known what type of petroleum was in the water. The sample was taken Tuesday at Red Hill Elementary School. The department is still awaiting test results of samples sent to a lab in California. For three days, hundreds of residents in Navy housing complained of a fuel-like odor coming from their tap water. Some have said they suffered from stomach pain and headaches. The department said all complaints have come from people using the Navy’s water system, and not from anyone who gets their water from Honolulu’s municipal water utility. The Navy and the utility have wells that draw on the Moanalua-Waimalu aquifer, which is located 100 feet below the Navy’s fuel storage tanks at Red Hill. The Navy on Sunday shut down a Red Hill well that draws water from the aquifer out of an “abundance of caution,” a spokesperson said. The department has advised all those using the Navy’s water not to drink their tap water. It’s recommending that those who can smell fuel in their water not to use it for bathing, washing dishes or laundry. The system provides water to about 93,000 people living in and near Pearl Harbor.

Idaho

Sugar City: State wildlife officials have euthanized three lion cubs in southeastern Idaho. Officials with the Idaho Department of Fish and Game captured and euthanized the cubs on Friday after they appeared in the backyards of homes in Sugar City. The cubs had been in the area for several days before being captured by wildlife officials. Idaho Department of Fish and Game spokesman James Brower told the East Idaho News that the mother was nowhere to be found, and the cubs were in poor health. It’s not known what happened to the mother. “We did a pretty thorough examination of these cubs, and they were fairly emaciated,” Brower said. “They were in really poor body condition, so they were not very healthy. There’s no rehabilitation center or place that you can take them to. They would have not made it on their own. They would have starved to death. They were pretty young.”

Illinois

Chicago: The city dropped its lawsuit against the police union in its fight over city employee COVID-19 vaccine orders, saying the complaint became unnecessary as more officers complied. The move follows a judge’s ruling last month to suspend an end-of-the-year city deadline for police officers to get vaccinated. Still, Mayor Lori Lightfoot vowed Wednesday that if union leaders revived talk of an “illegal work stoppage” over the mandate, the city would return to court. The city sued the Fraternal Order of Police Lodge 7 in October, accusing President John Catanzara of encouraging an “illegal strike.” The city said those who didn’t comply with the vaccine mandate would be placed on “no-pay status.” In public statements and on social media, Catanzara encouraged police to disobey the order. The union also sued. Lightfoot and police leaders said the mandate was put in place to protect officers and the public. More than 460 law enforcement officers have died of COVID-19, including four in Chicago, according to the Officer Down Memorial Page.

Indiana

Lafayette:Six African penguins died at the Columbian Park Zoo after falling ill with avian malaria, zoo officials said. The zoo announced Tuesday that the penguins died despite around-the-clock care that included anti-malarial medications intended to halt their infections. Zoo Director Neil Dale said in a news release that the zoo’s three remaining African penguins were in critical condition after also contracting the illness, the Journal & Courier reported. Avian malaria is a parasitic disease caused by a “plasmodium” that’s transmitted through the bites of infected mosquitos, the zoo said. This disease only affects birds and is not transmissible to humans or other zoo animals. Dale said the first African penguin fell ill on Oct. 24 and despite the zoo veterinary team’s efforts, it died four days later. Five other penguins later died. The zoo’s Penguin Cove exhibit opened at the zoo in July after being pushed back several times because of the COIVD-19 pandemic. Dale said the zoo is working with the exhibit’s design team and continuing to consult experts for preventative measures that would help ward off exposures to the illness.

Iowa

Cedar Rapids: Former television news anchor Tiffany O’Donnell has been elected mayor of Cedar Rapids. O’Donnell garnered 68% of the vote to businesswoman Amara Andrews’ 32% in Tuesday’s runoff election. The runoff was triggered when no candidate reached a majority 50% of the vote in the Nov. 2 general election. O’Donnell, a former news anchor for television station KGAN and chief executive of Iowa-based women’s leadership group Women Lead Change, campaigned on finishing cleanup from last year’s derecho, fixing city streets and accelerating flood recovery. O’Donnell will take office in January at the end of incumbent Mayor Brad Hart’s term.

Kansas

Wichita: A lawsuit filed against a Wichita car dealership by the wife of a police officer injured when he was run over by a sport utility vehicle from the business has been settled for an undisclosed amount. Officer Brian Arterburn was critically injured in February 2017 when he was hit by an SUV driver while putting down stop sticks to stop the vehicle as police chased it. Arterburn’s wife, fellow Wichita police officer Claudale Arterburn, sued Eddy’s Chevrolet Cadillac, its owners and the driver of the SUV, Justin Terrazas. The dealership has said that the vehicle was stolen and that it has “no clear understanding” of how Terrazas came to have it in his possession, the Wichita Eagle reported. But the lawsuit alleged Eddy’s Chevrolet Cadillac gave Terrazas access to the vehicle and did not report the car was stolen for two months before the chase, despite being told it was being used for criminal activity. Terrazas pleaded guilty to charges in the case and was sentenced to nearly 29 years in prison. The lawsuit, which had sought $75 million in actual and punitive damages, had been set to go to trial before the settlement was announced Tuesday.

Kentucky

Louisville:Gov. Andy Beshear said he will propose devoting $10 million to support an expansion of Waterfront Park into western Louisville. The 22-acre park expansion will connect downtown and West Louisville along the Ohio River in the state’s largest city, officials said. The total cost of the expansion is $50 million. “For so many people in this city, Waterfront Park is not just a place, it’s an experience,” Beshear said. “It’s the backdrop for some of their happiest moments with family and friends. It’s time that this experience is accessible to all members of the Louisville community.” Beshear will submit his budget proposals to the legislature early next year. The park expansion site will be in the Portland neighborhood within West Louisville. The expansion will include plazas, gardens and an observation pier at the river’s edge that can accommodate events, performances and other gatherings.

Louisiana

Baton Rouge:In two short weeks, Miss Louisiana, Julia Claire Williams, will compete on the national stage for the title of Miss America. “I really am most looking forward to visiting with all of the state title holders,” Williams said. “They’re such kind, strong, compassionate, impactful, young women, and to stand amongst them to compete for this job is such an honor.” The competition, which takes place Dec. 16 at the Mohegan Sun Casino in Uncasville, Connecticut. The centennial Miss America competition was set to take place last year, but it was canceled because of the pandemic. Williams works as an emergency room scribe for St. Francis Medical Center in Monroe. She is a graduate of University of Louisiana Monroe and hails from Kinder in the southwest part of the state. Williams said she has enjoyed fulfilling the role of Miss Louisiana, including her social impact initiative, which focuses on serving disadvantaged and disabled youth. Although there isn’t one specific facet she has enjoyed more than the others, she said the job has helped her grow as a person. Through her experience, Williams said she has increased her public speaking skills and grown in her adaptability.

Maine

Kennebunk: The federal government is providing a small meat processor in Maine with $200,000 to help rebuild from a devastating fire last year. The U.S. Department of Agriculture is giving the money to Nest & Mullen LLC of Kennebunk, Democratic Rep. Chellie Pingree said Tuesday. The fire destroyed a processing plant in September 2020. The grant will help the business recover and rebuild, Pingree said. She said the fire “not only destroyed their plant, but it shook the foundation of their entire business and threatened their livelihood.” Nest & Mullen is a five-generation farm and butcher shop, Pingree said. The money is through USDA’s Meat and Poultry Inspection Readiness Grant program. The agency announced $32 million in grants to dozens of processing facilities earlier in the week.

Maryland

Annapolis: Gov. Larry Hogan outlined preparation plans in the state for the omicron variant of COVID-19, urging people to get vaccinated and to get a booster shot if enough time has gone by since they have been vaccinated. The governor spoke at a news conference not long after after the White House announced that a person in California who had been vaccinated against COVID-19 became the first in the U.S. to have an identified case of the omicron variant. The state’s Board of Public Works approved an emergency procurement Wednesday to acquire additional special reagents and supplies to further expand the state’s capacity to track and detect variants of the coronavirus. The board also voted to extend the state’s genomic sequencing agreements to track various mutations of the coronavirus with the University of Maryland and Johns Hopkins University. Through agreements with the University of Maryland and Johns Hopkins University, Maryland is now sequencing at nearly three times the level recommended by public health experts, the governor’s office said.

Massachusetts

Boston: Massachusetts is deploying three mobile units to administer monoclonal antibody treatment to high-risk individuals who have been exposed to or have COVID-19, Gov. Charlie Baker said. The clinics have the capacity to treat up to 500 patients a week with therapies that can help reduce the severity of the disease and keep COVID-19-positive individuals from being hospitalized. Two of the new mobile units – currently in Fall River and Holyoke – began administering monoclonal antibody treatment to patients last week, according to the administration. A third unit is set to be deployed to Everett on Friday. The mobile clinics will increase access to monoclonal antibody treatment in Massachusetts, according to Baker. The mobile clinics can be relocated based on demand. Referral from a health care provider is required for treatment at any of the three new mobile clinics. Treatment will be provided at no cost to the patient and offered regardless of immigration status or health insurance. Patients should talk to their doctor about whether monoclonal antibody treatment is right for them.

Michigan

Grand Rapids: An 11-year-old girl who survived a plane crash that killed her father and three other people was released Wednesday from a rehabilitation hospital. “She’s Laney, she’s great and she’s our miracle,” said Christie Perdue of Gaylord, referring to her daughter Laney. Laney was one of five people in a plane that crashed on Beaver Island off Michigan’s northern Lower Peninsula on Nov. 13. The family believes Laney survived because her father, Mike, shielded her during the crash. Laney was released from Mary Free Bed Rehabilitation Hospital in Grand Rapids. “We’ve gone from no walking to a wheelchair to a walker and now to crutches,” Christie Perdue told WOOD-TV. “Her goal was to go home on crutches.” Mike Perdue died, along with the pilot and a couple. The crash is being investigated by a federal transportation agency. “Our community has just surrounded us with love,” Christie Perdue said. “Laney’s getting letters from schools all over Michigan, letters from New York and Minnesota, and we are just so grateful.”

Minnesota

St. Paul: The Minnesota Department of Health said it’s not approving anxiety disorders as a qualifying condition for medical marijuana, unlike neighboring North Dakota and three other states. State Health Commissioner Jan Malcolm said there’s not enough scientific evidence of benefits of medical cannabis use when compared to the possibility of “unintended consequences.” No new conditions will be added to the existing list of 17 qualifying health issues. “We received many comments from health care practitioners treating patients with anxiety disorder, and they urged us to not approve it as a qualifying medical condition,” Malcolm said. North Dakota added anxiety disorders to its accepted uses two years ago, when it immediately became the most commonly cited condition. Minnesota did agree to add infused edibles in the form of gummies and chews to a list of approved products that includes pills, vapor oil, liquids, topicals, powdered mixtures, and orally dissolvable medicines like lozenges. “Expanding delivery methods to gummies and chews will mean more options for patients who cannot tolerate current available forms of medical cannabis,” Malcolm said.

Mississippi

Tupelo: A downtown Tupelo neighborhood has joined the National Register of Historic Places. Advocates learned about the designation in late September, the Northeast Mississippi Daily Journal reported. The largely residential area includes hundreds of parcels on about 163 acres of land. Chris Grimes, vice president of the Historic Downtown Neighborhood Association, helped organize the effort. Grimes owns a historic home in the newly designated neighborhood that dates to 1870 and will now be able to apply for tax credits for some of the restoration work that’s underway, the Daily Journal reported. He had initially sought National Register designation only for his home, but the Mississippi Department of Archives & History thought other homes should be included, according to the newspaper. Downtown Tupelo and other neighborhoods in the city already have the designation. “Believe it or not, it’s easier to get a neighborhood on the register than it is to get an individual home,” Grimes said. Mississippi has more than 1,300 listings in the register, the nation’s official list of sites, structures and objects deemed worthy of preservation for their significance.

Missouri

Independence:The Harry S. Truman Presidential Library & Museum was scheduled to reopen with limited hours Thursday. The museum will initially reopen on Thursdays through Saturdays from 9 a.m. to 3 p.m. for those who bought advance tickets online. Visitors will be required to wear masks. The museum reopened in July after a two-year renovation project but was closed again in October when COVID-19 cases began to increase in Jackson County. “The pandemic has presented a lot of challenges, but we are prepared and anxious to open our doors to make history come to life for our visitors,” museum Director Kurt Graham said. The nearly $30 million renovation was the most extensive project at the museum since it was built in 1957. It offers more exhibits and artifacts, along with interactive exhibits, and a new layout that walks visitors through Truman’s life from his Missouri childhood through his presidency and his later years.

Montana

Billings: Wildlife workers and volunteers scrambled Wednesday to save trout and other fish stranded by an abrupt drop in water levels on a river that’s renowned among anglers. A malfunctioning gate that lets water out of Hebgen Dam just west of Yellowstone National Park caused flows into the Madison River to plummet early Tuesday, according to dam operator NorthWestern Energy. That left side channels cut off from the main river and some areas with no water. Some fish have died, according to outfitters who provided photos of fish lying on exposed rock beds that normally would be covered with water. More fish are at risk in the cut-off side channels, fly fishing shop owner Kelly Galloup said. Galloup said bigger trout likely moved to deeper pools as water levels dropped. But he expected a significant impact on fish born last year that were too small to escape the sudden drop in flows. There was no immediate estimate of the number of fish stranded, but Galloup said hundreds had been rescued Tuesday.

Nebraska

Omaha: The number of people hospitalized in Nebraska with the coronavirus continues to climb and reached 555 on Tuesday, which was the highest since last winter. The state said 14% of the hospitalized patients were between the ages of 20 and 44, and doctors at several of Nebraska’s largest hospitals said younger patients have been showing up in intensive care units more often. Although the number of hospitalizations remains well below last fall’s peak of 987, the state’s hospital capacity is strained because hospitals were busy with other patients before COVID-19 cases increased this fall. The state said only 13% of the adult ICU beds and 20% of the pediatric ICU beds were available Tuesday. Dr. Matthew Donahue, the acting state epidemiologist, said unvaccinated Nebraskans are 10 times more likely to be hospitalized than people who have been vaccinated. He said the spread of the coronavirus’ highly contagious delta variant has fueled the rise in cases. The seven-day rolling average of daily new cases in Nebraska decreased over the past two weeks, going from about 864 per day on Nov. 15 to about 771 per day on Monday. But the number remains high.

Nevada

Reno: A union for drivers and the operator of metro Reno’s transit bus system said they have reached a tentative agreement to settle a contract dispute that dramatically reduced service during the past three weeks. Officials of Teamsters Local 533 and Keolis International said Tuesday normal service would resume immediately if the agreement is approved by a vote of represented employees later this week. Terms of the proposed settlement were not immediately available. Only a handful of routes ran during the strike, leaving thousands of riders without public transportation. Teamsters 533 President Gary Watson said some issues between the union and Keolis remained unresolved but that union officials were hopeful that those can be resolved in the coming months. Keolis Vice President Mike Ake said the tentative agreement resulted from productive negotiation sessions held over the weekend. The strike began Nov. 9 after the union rejected the “best and last offer” proposed by Keolis, which operates the system for the Regional Transportation Commission of Washoe County.

New Hampshire

Exeter:The 23rd annual Festival of Trees benefitting the Community Children’s Fund kicked off in-person Wednesday morning at the Town Hall after a fully virtual event last year. The event was spread out over two days in an effort to manage the number of visitors. Bidding on the 51 Christmas trees donated and decorated by local businesses was done online. Organizers said they were elated to be able to restart the event in-person at the Town Hall after a year marred by the pandemic. The Christmas trees, all donated by Ace Hardware, feature a variety of goodies for the lucky winners ranging from candy to Guinness beer. Foss Motors has a double donation tree where the dealership will match the buyer’s bid up to $2,000 to be donated to a charity of the buyer’s choosing. And, as always, there is the gift card tree, which features gift certificates from local businesses totaling $2,800.

New Jersey

Trenton: Republican lawmakers scorned statehouse rules requiring proof of either COVID-19 vaccination or a negative test to enter the building and sought to halt the mandate with a lawsuit. Assembly and Senate Republicans, who are in the minority, sued late Wednesday seeking to stop the requirement and set the stage for a confrontation with law enforcement officials. That’s because both chambers have scheduled votes for the afternoon, when legislators are expected to gather to cast their votes. GOP Assembly member Brian Bergen walked into the statehouse complex unstopped by officials and didn’t show proof required under the policy set by the State Capitol Joint Management Commission, the panel made up of administration and legislative officials that sets rules for the building. “It’s unfair and completely discriminatory policy. they’re essentially creating two classes of people, vaccinated and unvaccinated,” he said in an interview. Legislators who don’t follow the protocol won’t be permitted into the legislative chambers, according to Assembly Speaker Craig Coughlin’s spokesperson Kevin McArdle, who added that leaders have spoken with state police and the attorney general’s office.

New Mexico

Santa Fe: Gov. Michelle Lujan Grisham said she will pursue a 7% pay increase for educators and staff at K-12 public schools, as well as higher minimum salaries for teachers at various career stages. The proposal would boost salaries for more than 50,000 public school workers across the state at an annual cost of about $280 million. The Legislature convenes in January to craft a general fund spending plan for the fiscal year that starts July 1. The governor’s office estimated the proposed changes would increase the statewide average for teacher pay to just over $64,000 a year. New Mexico’s minimum teacher salaries would increase to between $50,000 and $70,000, depending on experience and certifications. Current minimums ranging from $41,000 to $60,000 were set in 2019. The proposed changes would bring New Mexico roughly in line with the recent national average for teacher pay of about $64,000.

New York

New York City: The holly, jolly, best time of the year got a light-filled launch Wednesday, when the towering Christmas tree at Rockefeller Center was officially turned on. The 79-foot Norway spruce, covered with more than 50,000 lights in a rainbow of colors and bearing a crystal-covered, 900-pound star, was lit in a midtown Manhattan ceremony again open to the public, in contrast with last year’s virus-impacted event. The lighting was televised on NBC and hosted by NBC “Today” anchors Al Roker, Savannah Guthrie, Hoda Kotb and Craig Melvin. Among the musical performances were Harry Connick Jr., Norah Jones, Brad Paisley and Alessia Cara. The high-kicking Radio City Rockettes were also part of the celebration. This year’s tree came from Elkton, Maryland, where it stood for more than 80 years outside a family home. The first Christmas tree was placed in Rockefeller Center by men working there in 1931.

North Carolina

Raleigh: Democratic Gov. Roy Cooper vetoed legislation that would bar officials from counting mail-in absentee ballots received after Election Day, even if their envelopes were postmarked on or before that date. Cooper’s veto was expected, given that Republicans pushed through the measure on party lines. Any GOP attempt to override his veto also is likely to fail given that Republicans majorities in both the House and Senate aren’t veto-proof. Republicans haven’t overturned any of Cooper’s previous 12 vetoes this year. Current law says envelopes postmarked by the day of the primary or general election can count if they are received within a three-day grace period. Republicans insist the bill would boost confidence in election outcomes by the public and help the media call results more quickly.

North Dakota

Bismarck:Gov. Doug Burgum said the Federal Motor Carrier Safety Administration has granted his request for another extension of the hours of service waiver for drivers of commercial vehicles transporting water and livestock feed to help North Dakota livestock producers affected by continuing drought conditions. Burgum first granted a similar 30-day waiver in an executive order Sept. 22, and the FMCSA previously extended the waiver through Nov. 23. Under the new extension, the waiver will remain in effect through Dec. 24 or until the end of the emergency, whichever is earlier. Thursday’s U.S. Drought Monitor report showed 9% of North Dakota remains in extreme drought, mostly in the northwest corner, 33% is in severe drought, 30% is in moderate drought and 21% is rated as abnormally dry.

Ohio

Columbus:The Ohio Police & Fire Pension Fund is asking lawmakers to boost the required employer contribution rates to the retirement system. The fund is backing legislation that would increase employer contribution rates to 26.5% of payroll for police and firefighters, up from 19.5% and 24%, respectively. An estimate for how much that would cost Ohio’s 900 local police and fire departments was not immediately available. “I think that the employers, mayors, etc, understand the essential nature of recruiting and retaining public safety officers – not just through COVID but we’ve had a lot of social unrest,” said fund Director Mary Beth Foley. “So we need them and they need a defined benefit plan that they can rely upon, they need disability benefits to be ensured.” The employer contribution was last increased in 1986. Foley said the goal is to move legislation, which has yet to be introduced, through the House and Senate by December 2022. Over the past eight years, employee contribution rates increased by 2.25% to 12.25% and retirees have been forced to pay more for health care benefits.

Oklahoma

Oklahoma City: A human skull found in southwestern Oklahoma 16 years ago has been identified as that of a missing Muskogee woman, the Oklahoma State Bureau of Investigation said. The skull is that of Rebecca Jean Boyd, who was 29 when she disappeared in 2002, the OSBI said. The skull, found in a field by a farmer in Kiowa County in July 2005, was known only as Kiowa Jane Doe. “We are happy that Rebecca’s family has her back and can give her the proper burial that she deserves,” said OSBI Director Ricky Adams. “Now our Cold Case Unit is going to determine how she ended up in that field and who is responsible.” No other remains have been found and a suspected cause of death has not been determined, according to OSBI spokeswoman Brook Arbeitman. “We have a lot of questions that need to be answered,” Arbeitman said. “The first step was to get her identified.” Arbeitman said Boyd was visiting relatives in Lawton when she was last seen on July 26, 2002. Boyd was reported missing four days later and was identified when the skull matched a DNA profile of Boyd that had been entered into a national missing persons database.

Oregon

Salem: A Canadian energy company canceled a controversial natural gas pipeline and marine export terminal on the southern Oregon coast after failing to obtain all necessary state permits. Opponents of the Jordan Cove project, which would have created the first liquefied natural gas export terminal on the West Coast in the lower 48 states, rejoiced at the news. The marine export terminal would have been located at Coos Bay, with a 230-mile feeder pipeline crossing southern Oregon. Many landowners, Indian tribes and environmentalists had objected, saying the project by Calgary-based Pembina Pipeline Corp. could spoil the environment and would have contributed to global warming by producing greenhouse gases. In 2019, protesters filled the Oregon State Capitol and occupied the governor’s office until they were hauled away by state police. Supporters of the project to ship U.S. and Canadian natural gas to Asia said it would create jobs and help the economy. The Coos Bay City Council last year approved dredging part of the bay to increase the width and depth of the shipping channel. The Federal Energy Regulatory Commission approved the project in March 2020. Democratic Gov. Kate Brown threatened to go to court to stop the project if it didn’t obtain every permit required from state and local agencies. The Oregon Department of Environmental Quality denied a water quality certification for the project, and the Department of State Lands refused to grant another extension to Pembina to file documents in its application for a permit to dredge sediment out of Coos Bay.

Pennsylvania

Harrisburg: TV stations in Philadelphia, New York City and Cleveland said they are taking down the “Dr. Oz Show,” now that the show’s host, Mehmet Oz, has formally become a candidate for U.S. Senate in Pennsylvania. The stations were compelled by the Federal Communications Commission’s “equal time” rules that give rival candidates the ability to request matching air time. Oz, 61, will bring his unrivaled name recognition and wealth to a wide-open race that is expected to be among the nation’s most competitive and could determine control of the Senate in next year’s election. This is the celebrity heart surgeon’s first run for public office, but he is facing a crowded Republican primary. The longtime New Jersey resident said he moved to Pennsylvania a year ago.

Rhode Island

Portsmouth: An animal shelter has tripled the reward it is offering to $15,500 for help identifying the people who abandoned two dogs found by the side of a road in Portsmouth on Thanksgiving morning. The Potter League for Animals is offering the reward for information about the people who left the two female dogs, WPRI-TV reported. Police said the dogs appeared to be “lethargic and emaciated,” when they were found near a sports complex. They were treated by an emergency veterinarian. One of the dogs had to be euthanized because of her poor health, police said. The animal shelter initially offered a $5,000 reward but contributions from anonymous donors increased the amount of the reward, the station reported. Anyone with information can call Portsmouth police.

South Carolina

Charleston: Laura Cantral, the executive director of the Coastal Conservation League, one of South Carolina’s most influential environmental groups, is stepping down, prompting a nationwide search for her replacement. Cantral is leaving at the end of December, the organization said in a Wednesday news release. Cantral took over the organization four years ago after the Conservation League’s founder and longtime leader Dana Beach stepped down. The group has worked to oppose offshore drilling, preserve fragile coastal ecosystems against development and advocate to protect other natural resources along the state’s coast. The organization said Cantral is departing for personal family reasons and will move to Atlanta next year. The group’s board of directors will begin searching for a replacement in the coming weeks.

South Dakota

Wagner:Wagner High School principal and activities director Neil Goster, who was accused of making racist comments toward Native Americans last summer, resigned more than two weeks ago, along with his wife, Cindy, who was a fourth-grade teacher. In a special school board meeting in Wagner two weeks ago, the Goters’ resignations from the Wagner Community School District were accepted by the board in a 5-0 vote. Two board members were absent at the time of the vote. Local residents called on Neil Goter to resign in July and August after LaJuanda Stands and Looks Back alleged in a formal letter that Goter made racist comments to her and other Indigenous people in the town on the Yankton Sioux Reservation. Stands and Looks Back alleged that on July 24, Goter told her and a group of Native American women at a golf course that “my face is so red, I must be Native American.” She was told administrative action was taken by the district after her allegations, but it’s unknown what action was made. According to the Department of Education’s Teacher 411 webpage, Neil and Cindy Goter’s teaching certificates are still active until July 2026. Superintendent Matt Yost would not comment on the story when reached by the Argus Leader. Attempts to reach both Neil and Cindy Goter at their listed phone numbers and email addresses were unsuccessful.

Tennessee

Sewanee: Reuben Brigety, the University of the South’s vice chancellor and president, said he will resign later this month and would accept a position as U.S. ambassador to South Africa if offered. In a letter Wednesday, Brigety said he decided to leave the post Dec. 21. He wrote that he would accept a nomination for the ambassador job if President Joe Biden nominates him, saying news reports have indicated Biden intends to do so. Brigety, a former U.S. ambassador to the African Union, said “it would be unfair to prolong any uncertainty at the University.” The White House has not yet announced a nomination. Additionally, the role requires Senate confirmation. “I have been profoundly honored to serve as the 17th vice-chancellor of the University of the South, and I had expected to serve Sewanee for a long time to come,” Brigety wrote. “Yet I also know that I would not decline my obligation to serve my country if asked by the president of the United States.” Brigety took office in June 2020 as the first African American vice chancellor at the university also known as Sewanee. He previously served as dean of the Elliott School of International Affairs at George Washington University.

Texas

Houston: An appeals court halted a federal judge’s order that stopped Texas from enforcing its ban on mask mandates in the state’s schools, allowing the prohibition to remain in effect. In a 15-page ruling, the 5th U.S. Circuit Court of Appeals in New Orleans granted a request by Texas Attorney General Ken Paxton to stay the ruling by U.S. District Judge Lee Yeakel. The appeals court on Nov. 24 had granted an administrative stay while it issued a formal ruling on Paxton’s request. The 5th Circuit’s ruling on Wednesday means Yeakel’s decision will be on hold while the case goes through the appeals process. The appeals court will ultimately issue a final ruling on his order. The federal judge ruled on Nov. 10 that the ban ordered by Republican Gov. Greg Abbott through an executive order violated a federal law protecting disabled students’ access to public education. The nonprofit advocacy group Disability Rights Texas, which had filed the lawsuit that prompted Yeakel’s ruling, argued Abbott’s ban prohibited accommodations for disabled children particularly vulnerable to COVID-19. In granting the stay, the appeals court said that Paxton would likely win in his appeal, the students represented by Disability Rights Texas likely do not have standing to challenge the ban and the students and the group had not exhausted all remedies under the Individuals with Disabilities Education Act, a federal law that makes available a free public education to eligible U.S. children with disabilities.

Utah

St. George: Nate Brooksby was selected as the Washington County sheriff after the local Republican Party gathered in a special election to decide who would replace Sheriff Cory Pulsipher, who retired because of health problems. Brooksby, who had been the department’s chief deputy, beat out Jared Redfearn with 106 out of 140 votes. The position opened outside of the regular election cycle after Pulsipher announced he would be retiring effective Wednesday. This isn’t the only change in the department leadership, as Undersheriff James Standley also retired this fall. After Standley left the department, Brooksby was appointed to replace him as undersheriff by Pulsipher so Brooksby would be “brought up to speed” on the department’s budget and projects, according to a press release.

Vermont

Colchester: More than 300 Vermont National Guard soldiers are beginning to return to the state, many after nearly a year deployed overseas. The first of the soldiers returned on Wednesday. All are scheduled to be home by Dec. 10. The 172nd Law Enforcement Detachment deployed in January 2021 to support the U.S. Europe Command. Soldiers of the 3rd Battalion of the 172nd Infantry (Mountain) departed in February for the U.S. Central Command. The two units were the first of several to deploy throughout the first half of 2021, with a total of more than 950 Vermonters deploying to various locations across Europe, Africa and Southwest Asia. The soldiers of the the law enforcement detachment operated as the primary law enforcement element on Mihail Kogalniceanu Air Base in Romania. The soldiers from the 3rd Battalion participated in a variety of missions, including assisting with security at the Kabul during the August evacuations from Afghanistan.

Virginia

Richmond: Virginia has launched a new system to improve the response to mental health emergencies. The Marcus Alert system launched Wednesday in five regions in the state, news outlets reported. The system is named for Marcus-David Peters, who was fatally shot in 2018 by police after he charged an officer amid a behavioral health crisis. It will start as a pilot program in Richmond, Virginia Beach, Prince William County, Bristol and adjacent Washington County, and five counties in the northern Piedmont. It must expand to all parts of the state by July 1, 2026. It’s part of a rollout of new services financed by Virginia’s Medicaid program to help people in behavioral crises in their communities to avoid sending them to state mental hospitals, private emergency rooms and juvenile detention centers. The system aims to use regional call centers to alert mental health teams to potential psychiatric emergencies, quickly assess risks and dispatch professionals to help the person in crisis by persuasion instead of force.

Washington

Olympia: Republican state Sen. Keith Wagoner said he plans to challenge newly appointed Democratic Secretary of State Steve Hobbs in next year’s election. Hobbs was sworn into office Nov. 22 following his appointment by Gov. Jay Inslee to replace Kim Wyman, a Republican. Wyman – the fifth consecutive GOP secretary of state in Washington dating to 1965 – resigned to take a key election security job in the Biden administration. Wagoner said voters have long shown a preference for a Republican secretary of state and Inslee failed to recognize that by naming Hobbs, who was a Democratic state senator since 2007. Hobbs’ appointment lasts until the November 2022 election, which will determine who serves the remaining two years of Wyman’s four-year term. Hobbs said he plans to enter that race.

West Virginia

Huntington: Union maintenance and service workers at Cabell Huntington Hospital ratified a contract late Wednesday to end a month-old strike, the hospital announced. Members of the Service Employees International Union District 119 ratified the three-year contract covering more than 900 workers at the hospital, which said in a statement that employees could likely begin returning to work as soon as Friday. The statement did not disclose details of the contract, which Dr. Kevin Yingling, the hospital’s president, called “fair and equitable.” Under an earlier offer, the hospital had asked union members to begin paying health insurance premiums. “We value all of our employees as each plays an important role in delivering reliable, quality care to our patients,” said hospital Chief Operating Officer Tim Martin. “We are committed to being the best employer in the region with outstanding wages and benefits and this contract confirms that. We look forward to welcoming back our coworkers and resuming normal operations.”

Wisconsin

Milwaukee:FPC Live, a division of Madison-based Frank Productions and one of the world's largest concert promoters, announced plans to operate a built-from-scratch music venue in the Historic Third Ward, adjacent to the southern end of Maier Festival Park. Actually, it would be two venues – an 800-person-capacity room and a 4,000-person- capacity room – with separate entrances, both housed in the same 108,000-square-foot facility. Pending approvals, including from the Historic Third Ward Architectural Review Board and the City of Milwaukee Board of Harbor Commissioners, construction on the venue could begin in early 2022 and would open in the second half of 2023. The new concert venue would be the latest in Milwaukee's entertainment-building boom. The Milwaukee Bucks' Fiserv Forum, constructed for $524 million, opened in 2018. This year saw the openings of the Bradley Symphony Center, following a $90 million renovation of the Warner Grand Theatre, and the reopening of Summerfest's American Family Insurance Amphitheater after a $51.3 million upgrade.

Wyoming

Cheyenne: Gov. Mark Gordon made state District Court judge John G. Fenn his first appointment to the state Supreme Court. Fenn has served on the Fourth Judicial District bench for Johnson and Sheridan counties since 2007. He previously was an attorney in private practice in Sheridan for 13 years. Fenn’s experience as a judge has earned him respect in Wyoming’s legal community, Gordon said in a statement Thursday. “He has shown himself to be keenly aware of the impact of Wyoming Supreme Court decisions, not only on the law, but also with particular attention to the consequences for the individuals involved in these cases,” Gordon said. Fenn replaces Justice Michael Davis, who is retiring, and will begin on the state high court on Jan. 17. Fenn is a graduate of Big Piney High School and holds undergraduate and law degrees from the University of Wyoming. He helped develop Wyoming’s new Chancery Court created by legislation signed by Gordon in 2019, according to the governor’s office.

The experts designing a single vaccine to defeat all Covid-19 ...

University of Cambridge researchers Lara Marks and Ankur Mutreja spoke to key players in the global push to create a vaccine that protects against every possible mutation of the virus

Sars-CoV-2, the virus responsible for Covid-19, has turned the world upside down. Experts have predicted that it will claim the lives of between nine million and 18 million worldwide. This is in addition to destroying the livelihoods, mental health and education of countless others. The pandemic will probably wreak havoc for many years to come, despite the remarkable speed of vaccine development. This is not helped by the emergence of new variants sweeping the world, which pose a serious threat to the success of vaccination and upcoming treatments.

It is difficult to predict the future pattern of Sars-CoV-2. Many scientists believe it will continue to circulate in pockets around the globe, meaning that it will become endemic in the same way as flu. In this context, the number of infections remains relatively constant with occasional flare-ups that run the danger of turning into a pandemic. A lot depends on how widely the population around the world can be vaccinated and how long immunity lasts after natural infection or vaccination.

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Long term, the best solution would be to develop a universal vaccine - one that would help protect against all current variants of the coronavirus and any others that arise in the future. Without it, the world runs the risk of recurrent pandemics.

Given the difficulties encountered in creating a universal flu vaccine, this may seem a tall order. But a number of scientists believe it is possible based on the rapid development of the Sars-CoV-2 vaccines.

Covid-19 is in fact the third major infectious disease outbreak to have been triggered in the last two decades by a new coronavirus jumping from animals into humans, the other two being Sars and Mers.

To get a sense of how far a pan-coronavirus vaccine has progressed, we spoke to a number of key players in the field. We are both experts in this area but come at it from very different angles – Lara Marks is a historian of medicine with an interest in biotechnology and vaccines, while Ankur Mutreja has experience in tracking outbreaks and developing vaccines for infectious diseases. From our conversations, there appear to be a number of encouraging vaccine candidates on the horizon - it is even possible that one could be developed for use in humans within 12 months.

‘The holy grail’

One of the first people we spoke to was Richard Hatchett, the CEO of the Coalition for Epidemic Preparedness Innovations (Cepi). Set up in 2017, Cepi is a global partnership between public, private, philanthropic and civil society organisations that aims to compress the development of vaccines against emerging infectious diseases into 100 days - a third of the time achieved with the first Covid-19 vaccines.

Envisaging equitable access to vaccines for all countries, in January 2021, Cepi announced it would raise and invest US$3.5bn in vaccine research and development to strengthen global preparedness to pandemics, of which $200m has been put aside to develop a universal coronavirus vaccine. Such a vaccine would offer protection against a broad range of coronaviruses, regardless of their variants. This would reduce the need to modify the vaccine on a regular basis.

Hatchett described these vaccines as the “holy grail”. But he argued it may take years of investment. He said: “If you want to grow a tree, the best thing to have done is to have planted it 20 years ago. And if you didn’t do that, then the next best thing is to plant it today.”

When asked about what the best vaccine would be going forward to deal with SARS-CoV-2, Hatchett replied: “We do not actually know specifically yet. This is really our first engagement with this virus, obviously, and we’ve watched it expand and unfold over time…

“We’re still gathering data and gaining experience on this. I think we need to have some humility about what we know currently and what we can know. We just have to be vigilant.”

Why is Sars-CoV-2 mutating?

None of the scientists we interviewed were surprised to see Sars-CoV-2 mutating. All viruses mutate. They often undergo random genetic changes because the virus replication machinery is not perfect. It is a bit like a game of “telephone” where children repeat what they thought they heard, making mistakes all along the way so that the final message is very different from the original one. Whenever a virus develops one or more mutations, it is considered a “variant” of the original virus.

The mutation process helps viruses to adapt and survive any onslaught from the host’s immune system, vaccination or drug treatment and natural competition. Viruses change faster when under such pressures.

Scientists have been monitoring the genetic variations in Sars-CoV-2 since the start of the pandemic. They do this by sequencing the total RNA (genome) of the virus collected from patient samples. The genome is the complete set of genetic instructions an organism needs to function and thrive.

Scientists in China managed to sequence the first Sars-CoV-2 genome just one week after the first patient was hospitalised with unusual pneumonia in Wuhan. First drafted on 5 January 2020, the sequence revealed the virus to be a close relative of Sars-CoV-1, a human coronavirus which caused an outbreak of a severe respiratory disease Sars that first appeared in China in 2002 and then spread to many other countries. It also resembled a Sars-like coronavirus found in bats.

Comprising a single-strand of RNA, the Sars-CoV-2 genome turned out to be the longest genome of any known RNA virus. With the aid of sequencing, scientists were quickly able to pinpoint the genes that carry the instructions for the spike protein, the part of the virus that helps it to invade human cells. This became an important target for the development of Covid-19 vaccine.

Initial genome sequencing data suggested that Sars-CoV-2 mutated much slower than most other RNA viruses, being half the rate of the virus responsible for flu and a quarter of that found for HIV. But its mutation rate has gathered speed over time, helped by the large reservoir of people it has infected and selection pressures.

Not all mutations are bad news. In some cases, they weaken the virus, with the variant disappearing without a trace. But in other cases, they enable the virus to enter a host’s cells more easily or to escape the immune system more effectively, making it more difficult to prevent and treat.

So far, five new variants of concern have emerged with Sars-CoV-2. The first (alpha) was detected in southeast England in September 2020. Others were found shortly thereafter in South Africa (beta), Brazil (gamma), India (delta) and Peru (lambda). What is troubling about these new variants is that they are more transmissible, making them spread faster, which increases the likelihood of reinfection and a resurgence in cases. Every Sars-CoV-2 virus out there today is a variation of the original and new variants will continue to appear.

Preliminary research suggests that the first-generation of vaccines offer some protection against the new variants, helping to reduce severe disease and hospitalisation. However, they will probably become less effective over time as the virus mutates further and the immunity that people have gained, either through vaccination or natural infection, wanes.

Looking for weak spots

In terms of a universal coronavirus vaccine, the ultimate question, Hatchett believes, is whether there are any weak spots that are “conserved across coronaviruses as a viral family to which you can develop immune responses that effectively protect you”.

The key issue in creating a universal vaccine is how broad a coverage the vaccine should offer. This was also pointed out to us by Andrew Ward at the Scripps Research Institute in California. As he put it, “creating a universal vaccine is itself highly challenging. For example, scientists have tried for years but not yet succeeded in developing a universal vaccine for flu.

“Nor have they yet managed to create one for HIV. In part, this is because the surface proteins found on these viruses frequently change their appearance. This makes it difficult for our immune system to recognise the virus.”

But scientists have made enormous advances in recent years in understanding the interaction between the immune system and viruses that cause flu and HIV. They are now deploying this knowledge to build a universal vaccine for coronaviruses, which do not change as fast.

A long history of vaccine innovation

One of the reasons for optimism with a universal coronavirus vaccine is the successful development of the Sars-CoV-2 vaccine. Made in record time, the foundation for the vaccine was laid many years ago. Until the 1980s, most vaccines were developed by modifying a virus or bacteria to make it no longer dangerous. This was achieved by weakening or inactivating the pathogen so that it could be injected safely to stimulate an immune response. While highly successful for protecting against a host diseases like measles, polio, rabies and chickenpox, this approach didn’t prove effective in all diseases.

By the 1980s, vaccine production stood on the cusp of change, helped by the emergence of biotechnology. Where this was first successfully applied was in the development of a vaccine against hepatitis B, which is estimated to cause more deaths worldwide than TB, HIV or malaria.

The first hepatitis B vaccine was developed by Maurice Hilleman at Merck. Approved in 1981, it was the first vaccine to protect against cancer. Chronic hepatitis B is a major cause of liver cancer. In fact, it is second only to tobacco as a human carcinogen. What was novel about the hepatitis B vaccine was that instead of using the whole hepatitis B virus, which was difficult to grow in the laboratory, it used only a coat surface particle of the virus. This was a major breakthrough for vaccine technology.

Another vaccine that uses virus particles is the one against the human papillomavirus (HPV) that causes cervical cancer, a disease that globally kills 260,000 women every year. First licensed in 2005, the HPV vaccine took years to develop. It consists of tiny proteins that look like the outside of four types of real HPV produced in yeast.

Synthetic vaccines

Vaccine technology underwent a further revolution following the outbreak of the swine flu pandemic that swept the world for 19 months from January 2009. The pandemic killed between 151,700 and 575,400 people worldwide. Caused by an H1N1 influenza virus, the episode was an important reminder of the speed that pandemics can strike and the chaos they can sow. It was also a salutary lesson for companies who developed hundreds of millions of licensed vaccine doses to counter the pandemic. Although achieved within just six months, a historical record, this was not fast enough - by then, the peak of infections had passed.

Part of the delay was because of the time it took to grow enough of the virus in eggs or cultured mammalian cells. Another method, using genetic engineering to produce the virus, proved much faster, but was hampered by regulatory hurdles. Determined to accelerate vaccine availability for future pandemics, from 2011, vaccine experts put in place a new strategy that took advantage of advances in genomics and the open sharing of electronic sequence data. Coupled with a new ability to synthesise genes, these tools gave scientists the power to design genome segments from a virus to prepare vaccines to train the body to recognise and target a real virus if it invaded.

Critically, the new synthetic approach moved vaccine development away from the time-consuming process of isolating and shipping viruses between different sites and then growing them at scale. All that was needed was to download the relevant sequence data from the internet and synthesise the right genes to generate relevant viral components to start vaccine development. Speed was not the only advantage the new method offered. It also reduced any potential biohazard risks involved in manufacturing the vaccine.

Attention was also paid to making the testing process more efficient. Usually the slowest part of vaccine development, such testing often takes years to complete. Tests are first conducted in animals, to assess the safety, the strength of the immune response stimulated and protective efficacy of the vaccine candidate. Once this is done it is tested in humans.

Human trials are run in three phases, each with increasing numbers of people and escalating costs. One means to reduce the time needed and cut costs was to take advantage of new biomarkers. These provided a means to measure both normal and pathological processes as well as responses to a drug. Such biomarkers made it possible to determine the toxicity and efficacy of a candidate much earlier in the clinical trial process and to run multiple trials in parallel without compromising on safety.

In 2011, a group of scientists from the companies Novartis and Synthetic Genomics, as well as the Craig Venter Institute (a non-profit research organisation), proved they could develop a vaccine candidate in a matter of days.

Their approach was first successfully put to the test in March 2013, when Chinese health officials reported a novel strain of avian influenza had infected three people. Within just a week of gaining access to the virus’s genome sequence, the Novartis team, headed by Rino Rappoli, managed to create a fully synthetic RNA-based vaccine ready for pre-clinical testing, which proved safe and elicited a good immune response.

Marking the switch from what Rappouli calls “analogue vaccines” to “digital vaccines”, the 2013 work provided a template for when Covid-19 was declared a pandemic on 11 March 2020. The first dose of the Covid-19 vaccine candidate, developed by Moderna, was ready for phase I testing in humans by 16 March 2020. Many other vaccine candidates soon entered the pipeline thereafter.

New understandings

What also helped propel the first Covid-19 vaccines forward was the explosion in knowledge about the atomic structure of proteins found on the surface of viruses and antibodies that bound to them. According to Ward, this was greatly helped by advances in cryo-electron microscopy which as he says “opened up the door for HIV and other pathogens”. With the technique, Ward and his colleagues discovered that coronaviruses gained entry and fused with human cells with the help of a small loop of amino acids, called S-2P, on the top of their spike proteins. This laid an important foundation for creating the Covid-19 vaccines.

Another critical development was the discovery of broadly neutralising antibodies (bNAbs). First isolated in the early 1990s in the serum of people living with HIV-1, these antibodies only appear in some people after years of infection. Such antibodies have the advantage that they can neutralise multiple diverse strains of the virus in one stroke.

Finding the bNAbs, critically, opened up a new avenue for vaccine design. In particular, it offered the possibility of creating a universal vaccine against flu and also a vaccine for HIV which so far has been difficult to do because it mutates so fast. Several groups had already made progress in this field before Covid-19 struck, which they quickly turned towards coronaviruses. Their goal was to create a vaccine to stimulate the production of bNAbs targeting the receptor binding domain (RBD) located on the coronavirus’ spike protein.

One approach, outlined to us by Barton Haynes, an immunologist at Duke University, involves attaching little bits of the RBD, from multiple coronaviruses, to a protein nanoparticle for use as a vaccine candidate. Promisingly, this was shown in monkeys to not only block Sars-CoV-2 and its new concerning variants but also Sars-CoV-1 and a group of bat coronaviruses which could spill over to humans in the future.

Another potential vaccine was described to us by Pamela Bjorkman, a structural immunologist at the Caltech. Her team developed it based on a virus particle platform first devised at Oxford University, in 2016.

She said: “Their vaccine presents many different RBD fragments, from a variety of animal coronaviruses, grafted onto small proteins attached to a nanoparticle scaffolding. Tests in mice showed a single dose of the vaccine could neutralise multiple human and animal coronaviruses, including ones not included in the vaccine design.”

According to our interview with Jonathan Heeney, a comparative pathologist at the the University of Cambridge, his group has also developed a promising broad coverage coronavirus vaccine. Based on detailed screening of the virus’s structure they have synthesised DNA constructs to plug into conventional vaccine platforms and the latest mRNA vaccine technology.

The vector is specially designed not to trigger unintentional hyper-inflammatory responses, which can sometimes be life threatening. In animal studies, their candidate provided protection against a variety of sarbecoviruses, which cover Sars-CoV-1, Sars-CoV-2 and many bat coronaviruses.

All three outlined approaches have yet to be tested in humans. The Cambridge one is set to enter phase 1 trials in the autumn and the one at Duke University is nearing that milestone too. Both the Cambridge and Caltech candidates have the attraction that they can be produced as a heat-stable and freeze-dried powder. This will make their storage and distribution much easier than the current mRNA vaccines (Moderna and Pfizer). It will also make production much cheaper, which is vital to ensuring equitable access to the vaccine across the world and bringing the pandemic under control.

New pandemics

While scientists have the tools to develop a pan-coronavirus vaccine within a year, its creation would not be the end of the story. Growing population density, human mobility and ecological change means that the world will continue to face the threat of new pandemics.

Meeting this challenge will require a high degree of outbreak vigilance, political will and international cooperation as well as continued investment in vaccine development well beyond the end of the Covid-19 pandemic. As the World Health Organization (WHO) put it in September 2020, “a global pandemic requires a world effort to end it - none of us will be safe until everyone is safe”.

Access to vaccines is also only one arm of what is needed to combat pandemics. What Sars-CoV-2 has also taught us is the importance of rapid frontline genomic sequencing on the ground to swiftly detect newly emerging threats. As Hatchett argues, the key to radically reducing epidemic and pandemic risk to the world is through “earlier detection, earlier sequencing, and earlier more tailored public health responses”.

Lara Marks, visiting research fellow, history of biomedical sciences, University of Cambridge, and Ankur Mutreja, group leader, global health (infectious diseases), University of Cambridge.

This article is republished from The Conversation under a Creative Commons licence. Read the original article.

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