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When I told friends that my wife and I were heading to Johannesburg -- which had just been hit by torrential rain and flooding — for a family wedding over Easter, they joked about how lucky we were to be able to take deep baths and long showers.Like many Capetonians, we've endured months of quick 90-second showers, bucket washes or baths that are only centimeters deep and grey water to flush the toilet or water our parched garden. 447

Who gets to be first in line for a COVID-19 vaccine? U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.“Not everybody’s going to like the answer,” Dr. Francis Collins, director of the National Institutes of Health, recently told one of the advisory groups the government asked to help decide. “There will be many people who feel that they should have been at the top of the list.”Traditionally, first in line for a scarce vaccine are health workers and the people most vulnerable to the targeted infection.But Collins tossed new ideas into the mix: Consider geography and give priority to people where an outbreak is hitting hardest.And don’t forget volunteers in the final stage of vaccine testing who get dummy shots, the comparison group needed to tell if the real shots truly work.“We owe them ... some special priority,” Collins said.Huge studies this summer aim to prove which of several experimental COVID-19 vaccines are safe and effective. Moderna Inc. and Pfizer Inc. began tests last week that eventually will include 30,000 volunteers each; in the next few months, equally large calls for volunteers will go out to test shots made by AstraZeneca, Johnson & Johnson and Novavax. And some vaccines made in China are in smaller late-stage studies in other countries.For all the promises of the U.S. stockpiling millions of doses, the hard truth: Even if a vaccine is declared safe and effective by year’s end, there won’t be enough for everyone who wants it right away -- especially as most potential vaccines require two doses.It’s a global dilemma. The World Health Organization is grappling with the same who-goes-first question as it tries to ensure vaccines are fairly distributed to poor countries -- decisions made even harder as wealthy nations corner the market for the first doses.In the U.S., the Advisory Committee on Immunization Practices, a group established by the Centers for Disease Control and Prevention, is supposed to recommend who to vaccinate and when -- advice that the government almost always follows.But a COVID-19 vaccine decision is so tricky that this time around, ethicists and vaccine experts from the National Academy of Medicine, chartered by Congress to advise the government, are being asked to weigh in, too.Setting priorities will require “creative, moral common sense,” said Bill Foege, who devised the vaccination strategy that led to global eradication of smallpox. Foege is co-leading the academy’s deliberations, calling it “both this opportunity and this burden.”With vaccine misinformation abounding and fears that politics might intrude, CDC Director Robert Redfield said the public must see vaccine allocation as “equitable, fair and transparent.”How to decide? The CDC’s opening suggestion: First vaccinate 12 million of the most critical health, national security and other essential workers. Next would be 110 million people at high risk from the coronavirus -- those over 65 who live in long-term care facilities, or those of any age who are in poor health -- or who also are deemed essential workers. The general population would come later.CDC’s vaccine advisers wanted to know who’s really essential. “I wouldn’t consider myself a critical health care worker,” admitted Dr. Peter Szilagyi, a pediatrician at the University of California, Los Angeles.Indeed, the risks for health workers today are far different than in the pandemic’s early days. Now, health workers in COVID-19 treatment units often are the best protected; others may be more at risk, committee members noted.Beyond the health and security fields, does “essential” mean poultry plant workers or schoolteachers? And what if the vaccine doesn’t work as well among vulnerable populations as among younger, healthier people? It’s a real worry, given that older people’s immune systems don’t rev up as well to flu vaccine.With Black, Latino and Native American populations disproportionately hit by the coronavirus, failing to address that diversity means “whatever comes out of our group will be looked at very suspiciously,” said ACIP chairman Dr. Jose Romero, Arkansas’ interim health secretary.Consider the urban poor who live in crowded conditions, have less access to health care and can’t work from home like more privileged Americans, added Dr. Sharon Frey of St. Louis University.And it may be worth vaccinating entire families rather than trying to single out just one high-risk person in a household, said Dr. Henry Bernstein of Northwell Health.Whoever gets to go first, a mass vaccination campaign while people are supposed to be keeping their distance is a tall order. During the 2009 swine flu pandemic, families waited in long lines in parking lots and at health departments when their turn came up, crowding that authorities know they must avoid this time around.Operation Warp Speed, the Trump administration’s effort to speed vaccine manufacturing and distribution, is working out how to rapidly transport the right number of doses to wherever vaccinations are set to occur.Drive-through vaccinations, pop-up clinics and other innovative ideas are all on the table, said CDC’s Dr. Nancy Messonnier.As soon as a vaccine is declared effective, “we want to be able the next day, frankly, to start these programs,” Messonnier said. “It’s a long road.”___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. 5581

While the race to develop a safe coronavirus vaccine is on, there's new evidence other vaccines could help people survive the virus.A husband and wife professor team from Louisiana State University and Tulane University worked together on research about the MMR vaccine. That stands for measles, mumps and rubella.Most children get the vaccine. It could explain why kids are less impacted by COVID-19.Testing on mice found these kinds of "live" vaccines boosted cells' ability to fight off sepsis.Sepsis is ultimately what's causing organ problems and inflammation in many adults who have contracted the novel coronavirus.“The idea behind it is, if these live attenuated vaccines are inducing the cells that will inhibit or dampen the sepsis, that gives the regular immune response time enough to get rid of the infection,” said Dr. Paul Fidel, a professor at LSU.The results of the "live" vaccine test on mice were undeniable.Researchers also point to what happened on the USS Roosevelt, where more than 1,200 sailors contracted the virus. A few were hospitalized and one died.All U.S. Navy recruits get MMR vaccinations.The professors are starting a grassroots campaign for adults to get the MMR booster.“If we're right, wow you would have the cells that would inhibit or dampen the sepsis if you ever got infected with COVID and if we're wrong, so OK you have a booster for MMR and that can’t hurt you at all,” said Fidel.“I think this concept with live attenuated vaccines inducing this response that controls the inflammation as opposed to targeting the actual viral infection, it’s going to serve as a stop gap measure until we get a real legitimate vaccine developed that’s been shown to be efficacious and safe,” said Dr. Mairi Noverr, a professor at Tulane’s school of medicine.The MMR vaccine theory is being tested on primates now. There's a push for human trials, especially with health care workers and people in nursing homes. 1948

What started as a simple gesture of kindness during the lunch hour resulted in more than 900 cars “paying it forward” over the course of over two and a half days at a Minnesota Dairy Queen. Customers in the drive thru continued to pay for the order of the car behind them.According to the Brainerd, Minnesota, Dairy Queen, the chain started around lunch time on December 3. By the end of the first day, 280 cars participated by the close of business.December 4 started with paid forward from the night before, and it went from there. More than 500 cars in the drive thru paid it forward on December 4. The streak continued through December 5."It makes people feel good. Our whole crew was pumped about it, let's keep it going, our fans, we had people come here just because they heard about it and wanted to be a part of it,” store assistant manager Sandra Quam told WCCO. 884

When we hear our phone go off and see an unknown number, we're not very likely to answer, but that habit is creating some issues for contact tracers.People are hired to get in touch with anyone who's been in contact with someone who has been diagnosed with COVID-19.With people not answering calls from contact tracers, controlling the coronavirus becomes more difficult.But it doesn't mean contact tracers give up.“In some cases, when contact tracers call someone, and that person is uncomfortable talking to them on the phone, in some counties, they will actually send someone to that person's home to conduct an in-person interview, if they're more comfortable doing that,” said Steve Waters, founder and CEO of CONTRACE.Even when contact tracers do manage to get someone on the phone, it can be difficult to get information from them. This is a result of all the spam calls trying to scam people.That's why contact tracers say it's all about establishing trust in that cold call.“If you have a cultural understanding of the people that you are calling, that goes a long way to begin with,” said Waters. “I think you are more likely to be trusting of someone who has the demeanor and cultural understanding of your region, than somewhere across the country.”CONTRACE was founded when coronavirus cases started popping up in the U.S. It helps public and private groups with contact tracing efforts.The group encourages every state and local government to work with phone providers to help people know that calls are coming from contact tracers.Ideally, the call would be identified as the local health department or contact tracing program. 1650