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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 U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.“Not everybody’s going to like the answer,” Dr.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

WILMINGTON, Del. – Sen. Kamala Harris of California will be Joe Biden’s running mate in the 2020 presidential election.The presumptive Democratic nominee announced Tuesday that Harris will join him on the ticket. If she and Biden win in November, she would become the first woman and African-American elected as vice president.Biden’s selection comes after weeks of vetting several candidates for the role, all of which were women because the former vice president vowed to run alongside a female prospect.The Biden campaign said Harris and Biden will deliver remarks from Delaware on Wednesday.Tweeting from her official account, Harris said, "Joe Biden can unify the American people because he's spent his life fighting for us. And as president, he'll build an America that lives up to our ideals. I'm honored to join him as our party's nominee for Vice President, and do what it takes to make him our Commander-in-Chief."Harris is a U.S. senator and African American leader from California. She also made a name for herself as a presidential candidate, running against Biden himself during this election. Some Biden advisers don't like how she attacked Biden during the campaign, not to mention her time as a prosecutor could hurt her with some voters.Biden officially clinched the party’s nomination in June, when he reached the 1,991 pledged delegates needed.Biden is expected to accept the nomination during the Democratic National Convention, which will be held virtually next week due to COVID-19 concerns. It was originally set to be held in Milwaukee. Harris will also speak during the event, along with other top Democrats.This story is breaking and will be updated. 1685

WINNIPEG, Manitoba (AP) — Canadian fashion mogul Peter Nygard has been arrested in Winnipeg. Court records show Nygard, 79, was arrested under the Extradition Act and is set to appear in a Winnipeg courtroom this afternoon.According to the U.S. Attorney’s Office for the Southern District of New York, Nygard faces a nine-count indictment in the United States on racketeering, sex trafficking, and related crimes.Manhattan federal prosecutors stated Nygard’s charges relate to a “decades-long pattern of criminal conduct involving at least dozens of victims in the United States, the Bahamas, and Canada, among other locations.”Earlier this year, U.S. federal authorities raided the Manhattan headquarters of the Canadian fashion mogul in February. This search came amid claims he trafficked and sexually assaulted dozens of teenage girls and women.The FBI searched the designer’s Times Square offices less than two weeks after 10 women filed a lawsuit accusing Nygard of enticing young and impoverished women to his estate in the Bahamas with cash and promises of modeling opportunities.According to prosecutors, from 1995 to 2020, Nygard used his international fashion brand to recruit and pay for sex with the victims, who were put on the payroll as “models” or “assistants.”Prosecutors said Nygard allegedly referred to the victims as his “girlfriends,” which required them to travel and stay with him at his palatial properties in California, the Bahamas, and Canada.According to the press release, Nygard allegedly hosted so-called “Pamper Parties,” named for their buffet, open bar, and spa treatments, to recruit more girls and young women.According to prosecutors, he allegedly would use a “girlfriend” or employee to scout out a chosen victim — who would then be forced into sexual activity and paid in cash.Prosecutors said Nygard also is accused of hosting sexual “swaps” with other friends and business associates, who would bring a “date” to trade for sex with one of his “girlfriends.”Nygard kept the “girlfriends” under constant surveillance, insisting they needed his permission to leave the properties, prosecutors said.According to the AP, several of Nygard’s victims claim they were 14 or 15 years old when the fashion mogul gave them alcohol or drugs and then raped them. 2300

While not as many Americans are expected to travel for Thanksgiving as usual, 56% of Americans are intending on traveling according to data from Tripadvisor. Tripadvisor says that this year's figures are down from an estimated 70% of Americans travelling in 2019.Tripadvisor surveyed Americans from October 16 to 20, so it is possible increased travel restrictions associated with a rise in cases could scare off some from traveling by Thanksgiving. Many states are telling travelers to quarantine for two weeks before coming into contact with others. The vast majority of those traveling, 76%, say they will drive to their Thanksgiving destination, compared to just 11% who say they will fly.The survey found that 22% are staying in a hotel or vacation rental to practice social distancing from friends and family."Despite COVID-19 concerns, the majority of Americans are still traveling this Thanksgiving. The way in which consumers travel, however, will look very different from past years," said Christopher Hsi, Consumer Market Research Lead Analyst for Tripadvisor. "This year, we can expect shorter trips with smaller groups of people for more intimate, close knit gatherings. Many are taking day trips (24%) or spending one night at their destination. Americans are also continuing to avoid big cities, instead opting for warm weather and beach destinations in southern states. We do see, however, that Boomers are less likely to travel this year compared to last (29% vs. 51%)."Whether Americans can safely travel for the holidays remains up for debate, as many public health experts warn that informal gatherings have contributed to the spread of the virus, which has been killing roughly 1,000 Americans per day in recent days.“Unfortunately, the COVID-19 epidemic is worsening, and small household gatherings are an important contributor to the rise in COVID-19 cases,” the CDC said.The CDC issued guidance for holiday gatherings. Part of the recommendations say masks should be worn at holiday gatherings involving people who are not from the same household, and that guests stay 6 feet apart. The CDC also advises against handshakes and hugs.One public health expert says following these guidelines is dependent on your risk tolerance.“I am very risk tolerant,” Dr. Amesh A. Adalja, a senior scholar at the Johns Hopkins Center for Health Security, said in August. “I am an infectious disease physician. I have taken care of people with the coronavirus. Both of my parents are physicians. I don’t take any special precautious with my parents. I don’t think they take any special precautious with me.“I think physicians might be risk tolerant, but I have not changed my behaviors with people I see regularly, other than if they’re telling me they have a fever, and then I might say ‘stay away’ because I don’t want to be quarantined and not be able to work.”Adalja agrees, however, that there is a risk in attending family gatherings, and while face coverings are effective, they're not a panacea.If you ask Dr. Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, he is opting not to see extended relatives amid the pandemic.“Personally, in our family, we will not have our family get together,” Murrays said about Thanksgiving. “I am particularly cautious. That would be our strategy. Certainly, we have avoided, on a personal level, we have avoided any indoor exposure to friends or family and have restricted any exposure at all to outdoor interaction where we can maintain 6 feet or more.” 3579

With Hurricane Laura intensifying, forecasters predict it could be a Category 3 storm or higher. Marco was minor in comparison.There's already trouble for low lying areas of the Gulf Coast. Storm surge washed away about 500 feet of a levee in Grand Isle, Louisiana. The National Guard put up sandbags to protect the island.With predictions of possibly 11 feet of storm surge and 15 inches of rain, it could prove too much for other areas.“If they have a failure and in some cases, there will be failures, then the internal areas will flood and it’s very difficult then, once you have a breach in the levee, to keep the water from the outside coming in,” said Gerald Galloway, P.E., PhD.Hurricane Katrina hit the lower 9th ward 15 years ago this month.A billion network of new levees and floodwalls were put in. The Army Corps of Engineers said the system will stop providing adequate protection in as little as four years because of rising sea levels and shrinking levees.There are up to 100,000 miles of levees nationwide, most of them in serious need of repair.Levees received a "D" on the American Society of Civil Engineers' national infrastructure report card.“Where you have a challenge is those areas that are not yet protected. That’s going to be a problem and where they are outside the levees in some distance and there isn’t any normal flood protection,” said Galloway.Galloway's life's work is in flooding, partially with the Army Corps of Engineers. If water overtops levees, he says the best-case scenario is for pumps to get it out, or homes elevated, or at the very least people are evacuated. 1621

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