Publisher Health

A trove of more than 100,000 WhatsApp messages exchanged between Matt Hancock, then the British health secretary, and other government figures revealed the scramble to coordinate the virus response.Britain’s top civil servant warned in October 2020 that Prime Minister Boris Johnson was a “nationally distrusted” figure who should not announce new social-distancing rules in the depths of the coronavirus pandemic.The health secretary at the time, Matt Hancock, disparaged an eminent medical researcher who had publicly criticized Britain’s handling of Covid as a “complete loudmouth.” Mr. Hancock also mocked “Eat Out to Help Out,” a program to lure people back to restaurants sponsored by Rishi Sunak, referring to it as “eat out to help the virus get about.”Those and many other unfiltered remarks are in more than 100,000 WhatsApp messages exchanged among Mr. Hancock, other ministers and aides as they tried to control the coronavirus outbreak in 2020 and 2021. They were handed to The Daily Telegraph, a British newspaper, by Isabel Oakeshott, a journalist who obtained them while helping Mr. Hancock write a book, “Pandemic Diaries,” about those desperate days.The Telegraph’s daily drip of disclosures in recent days has riveted Britain’s political classes, set off a nasty public row between Mr. Hancock and Ms. Oakeshott, and provided another telling reminder of how politicians can be tripped up by text messages that seem ephemeral in the moment but are forever preserved in cyberspace.What is less clear is whether the leaks will advance the public’s understanding of how Britain handled the pandemic. Ms. Oakeshott said that there was an overwhelming public interest to release the messages. But critics, including Mr. Hancock, have argued that the Telegraph is publishing them selectively to propagate a narrative that the government overreacted in imposing lockdowns.A nurse at a London hospital in 2021 holding a telephone to the ear of a Covid patient so that her daughter could speak to her.Andrew Testa for The New York Times“What I found shocking was the callous nature of the messages — the banter, the humor, and how casual they were about making decisions that affected people and their lives,” said Prof. Devi Sridhar, head of the global public health program at the University of Edinburgh.Politics in BritainNorthern Ireland Trade Deal: The British government and the European Union struck a deal to end a dispute over post-Brexit trade rules for Northern Ireland, an agreement that may resolve one of the thorniest legacies of Britain’s withdrawal from the bloc.Nicola Sturgeon Resigns: The resignation of Scotland’s leader removes one of the most formidable figures from British politics, one who has dedicated her life to the cause of Scottish independence.Ghosts of Prime Ministers Past: Prime Minister Rishi Sunak is making moves to recharge his government. But he is being stymied by his ousted predecessors, Liz Truss and Boris Johnson, who are not fading away.Worker Strikes: Crippling strikes across multiple industries have Britain’s Conservative government facing a “winter of discontent,” just as a Labour government did 44 years ago.The WhatsApp dump, she said, offered a revealing glimpse of government officials, under intense pressure, as they scrambled to formulate health policies amid rapidly changing, often conflicting information.Still, for all the juicy nuggets, the disclosures have yet to produce any genuine surprises about the broader policy, she said.“All this has done is make people retreat to their fixed positions,” said Professor Sridhar, who wrote her own book about the pandemic, “Preventable.” “What a shame, because they’ve stirred up a lot of anger and trauma. Because of the salacious nature of it, this has become very gossipy.”Parliament had already begun an inquiry into the handling of the pandemic, which could shed light on these issues in a more deliberative manner. Mr. Hancock said that he had turned over the texts and other material to the committee, adding in a statement, “There is absolutely no public interest case for this huge breach.”Fraser Nelson, a columnist for the Telegraph, disagreed, arguing that the texts show how politicians, operating with “complete power and no transparency,” can become blasé about huge decisions. “Pretty much every democracy in the world was locked down,” he said, “but only in Britain have we pulled back the curtain.”To be sure, the flaws in the British pandemic response are well established: Mr. Johnson waited longer than other European countries to impose a lockdown, then kept the restrictions in place for months, prompting fierce internal debate among his ministers. Lack of testing was a huge early problem, most likely worsening the death toll among older people living in nursing homes. There were persistent tensions between scientists advising the government and ministers setting the policies.What the messages do is flesh out the rivalries and alliances between ministers who were balancing public heath concerns with personal ambition. For Mr. Hancock and Mr. Johnson, the pandemic became a career-altering ordeal.The National Covid Memorial wall in London, opposite the Houses of Parliament. Flaws in the British pandemic response have already been well established.Andrew Testa for The New York TimesMr. Johnson was forced out of office largely for violating his own social-distancing rules by attending Downing Street parties held during lockdowns. Mr. Hancock resigned after a tabloid paper published photos of him in a steamy embrace with one of his senior aides, also a violation of social-distancing guidelines. He later appeared on a reality TV show, “I’m a Celebrity … Get Me Out of Here!” and has said that he will not run for re-election as a member of Parliament.Mr. Hancock’s messages show an on-the-make politician who once hoped that the pandemic could vault his career to the next level. When a London paper published a plan to cut the approval time for a vaccine, he texted an aide, “I CALLED FOR THIS TWO MONTHS AGO. This is a Hancock triumph!”Yet at other times, Mr. Hancock seemed a determined policymaker, battling ministers who he believed were prioritizing the economy over public health. When Alok Sharma, who served as business secretary, proposed loosening the test-and-trace requirements for diners at restaurants, Mr. Hancock texted the cabinet secretary, Simon Case, to say that he could not understand “why Alok is against controlling the virus. Strange approach.”“Pure Conservative ideology,” Mr. Case replied in a comment that drew fire from critics who said that it was improperly partisan for a civil servant. Mr. Case, who was appointed by Mr. Johnson, is also in hot water for arguing that trusted local officials, not the prime minister — whom he deemed untrustworthy — should roll out new guidelines.In his statement, Mr. Hancock expressed chagrin about the embarrassment the leaks were causing his former colleagues. He said that he worked with Ms. Oakeshott for more than a year on the book, which was published last December and which drew heavily from the WhatsApp messages, as well as from other sources.He claimed that she had broken a confidentiality agreement in publishing the texts and had distorted them by not providing context. “Releasing them in this way gives a partial, biased account to suit an anti-lockdown agenda,” he said.Ms. Oakeshott, a former political editor of The Sunday Times, did not deny breaching a legal agreement. But she said that she had been willing to take that risk and denied that The Telegraph, which has editorialized against lockdowns, was publishing them selectively. Editors, she said, had assigned eight people to comb through 2.3 million words of texts, four times the length of Tolstoy’s “War and Peace.”“The paper has been extraordinarily careful not to cherry-pick bits of conversation,” she noted. “The team has been meticulous about the process.”In the staticky world of London journalism, Ms. Oakeshott has long been a lightning rod. In 2019, she published confidential diplomatic cables in which Kim Darroch, a former British ambassador to Washington, told colleagues that President Donald J. Trump “radiates insecurity” and presided over a dysfunctional White House. Mr. Trump called him a “very stupid guy,” and Mr. Darroch was forced to resign.A Covid testing site in London in 2020. The messages that have been released flesh out the rivalries and alliances between ministers who were balancing public heath concerns with personal ambition during the pandemic. Andrew Testa for The New York TimesThe latest furor led Cathy Newman, an interviewer from a British station, Times Radio, to ask Ms. Oakeshott, “How can any source trust you again?” (Ms. Oakeshott abruptly ended the interview.) But others, like Julia Hartley-Brewer, a conservative columnist, have defended her. “Why are commentators so intent on killing the messenger, instead of focusing on the substance of the message?” Ms. Hartley-Brewer wrote in The Telegraph.Even critics like Professor Sridhar said that the messages yielded useful, if irksome, details. The government, for example, once hand-delivered a Covid test to the home of Jacob Rees-Mogg, then leader of the House of Commons, so that one of his children could be tested, at a time when there was an acute nationwide shortage of tests.Amid the pervasive sense of dread in the texts, there were also moments of gallows humor. Mr. Hancock once asked Michael Gove, a fellow minister, to explain the goals of a coming government meeting on the pandemic.“Letting people express concerns in a therapeutic environment before you and I decide the policy,” Mr. Gove wrote.“You are glorious,” Mr. Hancock replied.

In a world first study of daily ambient fine particulate matter (PM2.5) across the globe, a Monash University study has found that only 0.18% of the global land area and 0.001% of the global population are exposed to levels of PM2.5 – the world’s leading environmental health risk factor – below levels of safety recommended by Word Health Organisation (WHO).
Importantly while daily levels have reduced in Europe and North America in the two decades to 2019, levels have increased Southern Asia, Australia, New Zealand, Latin America and the Caribbean, with more than 70% of days globally seeing levels above what is safe.
A lack of pollution monitoring stations globally for air pollution, has meant a lack of data on local, national, regional and global PM2.5 exposure. Now this study, led by Professor Yuming Guo, from the Monash University School of Public Health and Preventive Medicine, and published in the journal, Lancet Planetary Health, has provided a map of how PM2.5 has changed across the globe in the past decades.
The research team utilised traditional air quality monitoring observations, satellite-based meteorological and air pollution detectors, statistical and machine learning methods to more accurately assess PM2.5 concentrations globally, according to Professor Guo.
“In this study, we used an innovative machine learning approach to integrate multiple meteorological and geological information to estimate the global surface-level daily PM2.5 concentrations at a high spatial resolution of approximately 10km ×10km for global grid cells in 2000-2019, focusing on areas above 15 μg/m³ which is considered the safe limit by WHO (The threshold is still arguable),” he said.
The study reveals that annual PM2.5 concentration and high PM2.5 exposed days in Europe and northern America decreased over the two decades of the study — whereas exposures increased in southern Asia, Australia and New Zealand, and Latin America and the Caribbean.
In addition, the study found that: Despite a slight decrease in high PM2.5 exposed days globally, by 2019 more than 70% of days still had PM2.5 concentrations higher than 15 μg/m³. In southern Asia and eastern Asia, more than 90% of days had daily PM2.5 concentrations higher than 15 μg/m³. Australia and New Zealand had a marked increase in the number of days with high PM2.5 concentrations in 2019. Globally, the annual average PM2.5 from 2000 to 2019 was 32.8 µg/m3. The highest PM2.5 concentrations were distributed in the regions of Eastern Asia (50.0 µg/m3) and Southern Asia (37.2 µg/m3), followed by northern Africa (30.1 µg/m3). Australia and New Zealand (8.5 μg/m³), other regions in Oceania (12.6 μg/m³), and southern America (15.6 μg/m³) had the lowest annual PM2.5 concentrations. Based on the new 2021 WHO guideline limit, only 0.18% of the global land area and 0.001% of the global population were exposed to an annual exposure lower than this guideline limit (annual average of 5 μg/m³) in 2019.According to Professor Guo, the unsafe PM2.5 concentrations also show different seasonal patterns “included Northeast China and North India during their winter months (December, January, and February), whereas eastern areas in northern America had high PM2.5 in its summer months (June, July, and August),” he said.
“We also recorded relatively high PM2.5 air pollution in August and September in South America and from June to September in sub-Saharan Africa.”
He added that the study is important because “It provides a deep understanding of the current state of outdoor air pollution and its impacts on human health. With this information, policymakers, public health officials, and researchers can better assess the short-term and long-term health effects of air pollution and develop air pollution mitigation strategies.”

Rob Burrow has received an award from Prime Minister Sunak for his campaigning on motor neurone disease (MND).In a special ceremony at Downing Street, the former Leeds Rhinos star accepted the 2,000th ‘Points of Light’ award, which recognises outstanding individual volunteers. Burrow was diagnosed with MND in 2019 and has campaigned for three years for better research into the disease. In 2022 the government pledged to fast-track £50-million of funding into research for a cure.

The study, which examined patients infected early in the pandemic, found they were significantly more likely than people who didn’t get Covid to experience lingering reflux, constipation and other issues.Stomach pain, constipation, diarrhea, vomiting, bloating — these are symptoms frequently reported by people with long Covid. Now, a large new study reports that Covid patients were significantly more likely to experience gastrointestinal problems a year after infection than people who were not infected. The study, published on Tuesday in the journal Nature Communications, compared medical records of 154,068 Covid patients in the Veterans Health Administration system with about 5.6 million patients of similar age and other characteristics who had not contracted the coronavirus. Covid patients were 36 percent more likely to have long-term gastrointestinal problems that they did not have before their infection, with 9,605 of them experiencing issues affecting the digestive system, intestines, pancreas or liver.The most common diagnoses were acid-related disorders, like gastroesophageal reflux disease (known as GERD) and peptic ulcer disease, which were identified in more than 2,600 patients. “There seems to be some dysregulation that points to a major imbalance in acid production,” said the senior author of the study, Dr. Ziyad Al-Aly, chief of research and development at the V.A. St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis.More on the Coronavirus PandemicLab Leak: New intelligence has prompted the Energy Department to conclude that an accidental laboratory leak in China most likely caused the pandemic, though U.S. spy agencies remain divided over Covid’s origins.New Drug’s Long Odds: A promising new treatment quashes all Covid variants, but regulatory hurdles and a lack of funding make it unlikely to reach the United States market anytime soon.Dangers Remain for Seniors: For older Americans, the Covid pandemic still poses significant threats. But they are increasingly left to protect themselves as the rest of the country abandons precautions.N.Y.C.’s Mandate: New York City will end its aggressive but contentious vaccine mandate for municipal workers, Mayor Eric Adams announced, signaling a key moment in the city’s long battle against the pandemic.Serious inflammatory illnesses — like acute pancreatitis and cholangitis, which is inflammation of the bile duct system — affected a much smaller percentage of patients, but they were nonetheless more common among those who had Covid than those who had not.“With all of these disorders there is an increased odds ratio, meaning that the people who had Covid and survived for 30 days or longer were more at risk of each of these categories,” said Dr. Saurabh Mehandru, a professor of gastroenterology at the Icahn School of Medicine at Mount Sinai in New York who was not involved in the study.Long Covid patients were also at higher risk of gastrointestinal symptoms, the most common being constipation, abdominal pain and diarrheaACE2, the receptor for SARS-CoV-2 (the virus that causes Covid-19), is shown in green, with intestinal epithelial cells in red and cell nuclei in blue. As shown, ACE2 covers a large surface of the small intestinal epithelium.Minami Tokuyama//MehandruLab at the Icahn School of Medicine at Mount SinaiThe study, like others drawing on the database of veterans, involves a patient population that is largely white and male with an average age of about 61. Still, the same patterns were seen among the study’s 37,000 post-Covid Black patients and nearly 17,000 post-Covid female patients, Dr. Al-Aly said.The patients became infected during the pandemic’s early waves, testing positive for the coronavirus between March 1, 2020, and Jan. 15, 2021, the overwhelming majority before vaccines were available. Dr. Al-Aly and Dr. Mehandru noted that the experience might be different for people infected more recently. Newer virus variants might have different effects, they said, and some research suggests that vaccines can reduce the risk of various long Covid symptoms. There are several reasons coronavirus infections may fuel long-term gastrointestinal problems. Dr. Mehandru, who has studied some possible causes, said his team and others had found that a protein the virus attaches to on some cell surfaces, called the ACE2 receptor, was abundant in the lining of the small intestine. Those receptors might provide a way for the virus to directly enter the digestive system, he said. It’s also possible that some viral fragments remained after infections resolved, keeping patients’ immune systems activated and generating inflammation-related symptoms.Another possibility is the “gut-brain connection,” said Dr. Mehandru, explaining that “when we’re stressed we have intestinal manifestations.” And, he added, “some of the symptoms could also be because of a generalized state of being unwell or having illness outside of the intestines, which could impact how we move our bowels or mean that we feel bloated or have acid reflux.”Dr. Al-Aly said most long Covid patients had other symptoms besides gastrointestinal problems, suggesting that the condition was “too complex to have just one mechanism that explains all of it.”The new study did not identify whether certain previous health conditions, like diabetes or cardiovascular disease, put people at greater risk of post-Covid gastrointestinal problems. Like many other long Covid studies, it did find that people whose initial infections were severe enough to warrant intensive care or other hospitalization were more prone to long-term symptoms. Still, people with mild initial infections — who make up a majority of Covid patients — were nonetheless at greater risk than people who were not infected.Underscoring the significance of post-Covid symptoms, the study found that long Covid patients were at greater risk of gastrointestinal problems than nearly six million people in the veterans database before the pandemic. It also found that people hospitalized with a coronavirus infection were more likely to develop long-term gastrointestinal issues than people hospitalized with the flu.Dr. Al-Aly did sound one note of optimism. While some symptoms of long Covid, like fatigue and brain fog, can be intractable for months despite different therapies, many gastrointestinal symptoms are treatable. “Obviously, there’s no one treatment for all of this,” he said. “But I think these are diagnoses and signs and symptoms that could be managed.”

Alternatives to animal testing are gaining momentum.In 1937, an American drug company introduced a new elixir to treat strep throat — and unwittingly set off a public health disaster. The product, which had not been tested in humans or animals, contained a solvent that turned out to be toxic. More than 100 people died.The following year, Congress passed the Federal Food, Drug and Cosmetic Safety Act, requiring pharmaceutical companies to submit safety data to the U.S. Food and Drug Administration before selling new medications, helping to usher in an era of animal toxicity testing.Now, a new chapter in drug development may be beginning. The F.D.A. Modernization Act 2.0, signed into law late last year, allows drug makers to collect initial safety and efficacy data using high-tech new tools, such as bioengineered organs, organs on chips and even computer models, instead of live animals. Congress also allocated $5 million to the F.D.A. to accelerate the development of alternatives to animal testing.Other agencies and countries are making similar shifts. In 2019, the U.S. Environmental Protection Agency announced that it would reduce, and eventually aim to eliminate, testing on mammals. In 2021, the European Parliament called for a plan to phase out animal testing.These moves have been driven by a confluence of factors, including evolving views of animals and a desire to make drug development cheaper and faster, experts said. But what is finally making them feasible is the development of sophisticated alternatives to animal testing.It is still early for these technologies, many of which still need to be refined, standardized and validated before they can be used routinely in drug development. And even advocates for these alternatives acknowledge that animal testing is not likely to disappear anytime soon.But momentum is building for non-animal approaches, which could ultimately help speed drug development, improve patient outcomes and reduce the burdens borne by lab animals, experts said.“Animals are simply a surrogate for predicting what’s going to happen in a human,” said Nicole Kleinstreuer, director of the National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods.“If we can get to a place where we actually have a fully human-relevant model,” she added, “then we don’t need the black box of animals anymore.”Animal AttitudesAnimal rights groups have been lobbying for a reduction in animal testing for decades, and they have found an increasingly receptive public. In a 2022 Gallup poll, 43 percent of Americans said that medical testing on animals was “morally wrong,” up from 26 percent in 2001.The Rights of AnimalsLab Animals: Standard ethical guidelines encourage minimizing the use of, and harm to, animals used in research. Some experts propose an additional courtesy: repayment.Invertebrates: As intelligent cephalopods like octopuses and squids become more important in science, some people are seeking to give them the same protections as lab mice and monkeys.Volunteers Only: A farm sanctuary in New York is investigating the inner lives of cows, pigs and chickens, but only if the animals choose to participate in the studies.A Case for Equal Rights: In her latest book, the philosopher Martha C. Nussbaum argues for increased legal standing for animals. David Marchese asked her about it.Reducing animal testing “matters to so many people for so many different reasons,” said Elizabeth Baker, the director of research policy at the Physicians Committee for Responsible Medicine, a nonprofit group that advocates for alternatives to animal testing. “Animal ethics is actually quite a big driver.”But it is not the only one. Animal testing is also time-consuming, expensive and vulnerable to shortages. Drug development, in particular, is rife with failures, and many medications that appear promising in animals do not pan out in humans. “We’re not 70-kilogram rats,” said Dr. Thomas Hartung, who directs the Johns Hopkins Center for Alternatives to Animal Testing.Moreover, some cutting-edge new treatments are based on biological products, such as antibodies or fragments of DNA, which may have targets that are specific to humans.“There’s a lot of pressure, not just for ethical reasons, but also for these economical reasons and for really closing safety gaps, to adapt to things which are more modern and human relevant,” Dr. Hartung said.(Dr. Hartung is the named inventor on a Johns Hopkins University patent on the production of brain organoids. He receives royalty shares from, and consults for, the company that has licensed the technology.)Brave New BiologyCultures of cerebral organoids in a lab at the Johns Hopkins Hospital in Baltimore.Gabriella Demczuk for The New York TimesIn recent years, scientists have developed more sophisticated ways to replicate human physiology in the laboratory.They have learned how to coax human stem cells to assemble themselves into a small, three-dimensional clump, known as an organoid, that displays some of the same basic traits as a specific human organ, such as a brain, a lung or a kidney.Scientists can use these mini-organs to study the underpinnings of disease or to test treatments, even on individual patients. In a 2016 study, researchers made mini-guts from cell samples from patients with cystic fibrosis and then used the organoids to predict which patients would respond to new drugs.Scientists are also using 3-D printers to produce organoids at scale and to print strips of other kinds of human tissue, such as skin.Another approach relies on “organs on a chip.” These devices, which are roughly the size of AA batteries, contain tiny channels that can be lined with different kinds of human cells. Researchers can pump drugs through the channels to simulate how they might travel through a particular part of the body.In one recent study, the biotech company Emulate, which makes organs on chips, used a liver-on-a-chip to screen 27 well-studied drugs. All of the drugs had passed initial animal testing, but some had later turned out to cause liver toxicity in humans. The liver-on-a-chip successfully flagged as many as 87 percent of the toxic compounds, the researchers reported in Communications Medicine last December.Researchers can also link different systems together, connecting a heart-on-a-chip to a lung-on-a-chip to a liver-on-a-chip, to study how a drug might affect the entire interconnected system. “That’s where I think the future lies,” Dr. Kleinstreuer said.Compound ComputationsNot all the new tools require real cells. There are also computational models that can predict whether a compound with certain chemical characteristics is likely to be toxic, how much of it will reach different organs and how quickly it will be metabolized.The models can be adjusted to represent different types of patients. For instance, a drug developer could test whether a medication that works in young adults would be safe and effective in older adults, who often have reduced kidney function.“If you can identify the problems as early as possible using a computational model that saves you going down the wrong route with these chemicals,” said Judith Madden, an expert on “in silico,” or computer-based, chemical testing at Liverpool John Moores University. (Dr. Madden is also the editor in chief of the journal Alternatives to Laboratory Animals.)Some of the approaches have been around for years, but advances in computing technology and artificial intelligence are making them increasingly powerful and sophisticated, Dr. Madden said.Virtual cells have also shown promise. For instance, researchers can model individual human heart cells using “a set of equations that describe everything that’s going on in the cell,” said Elisa Passini, the program manager for drug development at the National Center for the Replacement, Refinement and Reduction of Animals in Research, or NC3Rs, in Britain.In a 2017 study, Dr. Passini, then a researcher at the University of Oxford, and her colleagues concluded that these digital cells were better than animal models at predicting whether dozens of known drugs would cause heart problems in humans.Scientists are now building entire virtual organs, which could eventually be linked together into a sort of virtual human, Dr. Passini added, though some of the work remains in early stages.In the short term, a virtual lab animal might be more achievable, said Cathy Vickers, the head of innovation at NC3Rs, which is working with scientists and pharmaceutical companies to develop a digital model of a dog that could be used for drug toxicity testing.“It’s still a big push to develop a virtual dog,” Dr. Vickers said. “But it’s about building that capacity, building that momentum.”A chimpanzee who had spent most of his life in biomedical research was prepared to retire to a chimpanzee sanctuary in northern Georgia.Melissa Golden for The New York TimesReduce or ReplaceMany potential animal alternatives will require more investment and development before they can be used widely, experts said. They also have limitations of their own. Computer models, for instance, are only as good as the data they are built on, and more data is available on certain types of compounds, cells and outcomes than others.For now, these alternative methods are better at predicting relatively simple, short-term outcomes, such as acute toxicity, than complicated, long-term ones, such as whether a chemical might increase the risk of cancer when used over months or years, scientists said. And experts disagreed on the extent to which these alternative approaches might replace animal models. “We’re absolutely working toward a future where we want to be able to fully replace them,” Dr. Kleinstreuer said, although she acknowledged that it might take decades, “if not centuries.”But others said that these technologies should be viewed as a supplement to, rather than a replacement for, animal testing. Drugs that prove promising in organoids or computer models should still be tested in animals, said Matthew Bailey, president of the National Association for Biomedical Research, a nonprofit group that advocates for the responsible use of animals in research.“Researchers still need to be able to see everything that happens in a complex mammalian organism before being allowed to move to the human clinical trials,” he said.Still, even this more conservative approach could have benefits, said Nicole zur Nieden, a developmental toxicologist at the University of California, Riverside, who said that she thought the wholesale replacement of animal testing was unrealistic.In particular, she said, the new approaches could help scientists screen out a greater number of ineffective and unsafe compounds before they ever get to animal trials. That would reduce the number of animal studies researchers need to conduct and the limit the chemicals lab animals are exposed to, she said, adding, “We will be able to reduce the suffering of test animals quite tremendously.”

Published6 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, ReutersBy Michelle RobertsDigital health editorA controversial new treatment for a condition called vitiligo that can restore pigment to the skin might soon be offered on the NHS, if UK experts approve it. Some call ruxolitinib a miracle cream because it can return skin’s natural colour and get rid of whitened patches. But it carries some potentially serious side effects. Others question whether vitiligo should be celebrated rather than masked or corrected.Ruxolitinib (brand name Opzelura) must be prescribed by a doctor because the treatment requires monitoring. Opzelura risks and benefitsIt can affect the body’s immune system, which might leave users more prone to infections such as coughs and colds, for example.A stronger pill formulation of the same drug is already used to treat some cancers.In trials of the cream for vitiligo, some users developed acne and redness affecting the area of skin where it was applied. But it was an effective treatment for nonsegmental vitiligo – the most common type – where patches or blotches of depigmentation appear on both sides of the body. About half of those who used it twice a day experienced a significant improvement, and about one in six had almost a complete repigmentation within three months. The list price for a tube is $2,000 (£1,660) in the US where it is already approved for use. European regulators look set to recommend it, too, for people aged 12 and over. What is vitiligo and what causes it?Vitiligo is thought to be an autoimmune condition where the person’s own body starts attacking cells in the skin that make protective pigment. This causes visible whitened patches or blotches that are prone to sun damage. Vitiligo affects all races but is more noticeable in people with skin of colour. It is not infectious or contagious.Experts say living with vitiligo can be psychologically devastating, causing anxiety, depression, low self-esteem and even suicidal thoughts.Consultant dermatologist Dr Viktoria Eleftheriadou says some people with vitiligo may feel like they have lost their ethnic identity.She said: “The risk of this can be higher among people of colour, as the condition is more noticeable in people with darker skin tones.”She says it would be good to offer people the choice of a treatment.Winnie Harlow, one of the world’s most recognisable models, has embraced having vitiligo rather than trying to hide her patches, although she has said she found living with it as a child “incredibly isolating”. “I vividly recall being in third grade and trying to befriend two girls who would run away from me because their mothers didn’t want them to ‘catch’ what I had, as if I were contagious,” she told Cosmopolitan magazine. She describes her skin condition as one of her “greatest gifts”. “It has taught me, from the time I was a little girl, to use it as a megaphone: to be louder, prouder, and always fuelled by passion and love. It’s helped me look beyond my own cover – and everyone else’s, too.”Emma Rush, founder and chief executive of Vitiligo Support UK, says while it is great to see models raising public awareness, “there is a gap between the average model and the average person on the street”.She says many people find having vitiligo on your face can be particularly distressing. “My face is now covered with it. I don’t recognise old pictures of myself from before I had it. It’s like I was a different person. “I can wear make-up to cover it but I can’t just walk around unnoticed without it. It helps with that first encounter so people don’t stare.”When it starts on the face it is often around the mouth and eyes and those are the parts that people look at. It can be catastrophic experience in a society that is focused on appearances.”Having a condition that can turn your skin white is not just impacting your skin colour, either. When your appearance changes, it can come with a whole raft of assumptions about where you come from and who you are. “Some people say they feel like they have lost a depth of their identity or had something taken away from them by the disease.”She says having it as a new treatment option would be “an absolute godsend”. Teacher Joti Gata-Aura was diagnosed with vitiligo in her early 20s. At that time, she says, she would have been willing to try almost anything to remedy it. Image source, Joti Gata-Aura”I battled with it for a very, very long time. I was constantly searching for treatments,” she said. “I hadn’t accepted the skin I was in.””I’m Indian. I have brown skin – I’m not a fair-skinned Asian person. So when I had vitiligo I stood out and I covered up my skin for many, many years. “I hid my skin so much.”Now aged 45, her outlook has changed and she campaigns about body positivity and mentors young people to help them with self-confidence. “I’ve done so much work on being happy in the skin you are in and being confident in who you are.”She says identity is still a big issue. “My identity was stripped when I lost my pigment. “It’s taken so long for me to accept this white skin.”It does, for me, add the extra layer of having to… not justify myself, but explain who I am, and that can sometimes be quite difficult, especially now that my skin is whiter than some of my English friends. That’s difficult because I am proud of my background and culture.”She said people needed to make their own choices about living with vitiligo. “It might not be a disability, it might not be an illness, but people psychologically have been ripped apart because of this condition and I think it is so important that while I’m in a good place right now, I wasn’t in a good place when I was diagnosed. “People are going through what I went through 20 years ago. This could be light at the end of the tunnel for many people.”Current treatments for vitiligo that result in a return of patients’ natural skin colour are limited and have variable effectiveness, which means that if one treatment worked well for one patient it might not work for another at all, says the British Association of Dermatologists. The most commonly used ones – phototherapy, tacrolimus and topical corticosteroids – can all have their downsides. For example, there are side effects associated with the long-term use of strong topical steroids, and phototherapy sessions usually require repeat trips to hospital for several months.Ruxolitinib would need to be approved by the drug regulator, the MHRA, to be sold or prescribed in the UK. The advisory body NICE is planning to assess its merits and risks and whether the cost can be justified for the NHS to provide to patients. More on this storyMother ‘comes out’ as having vitiligo6 February 2017The teen Primark model with vitiligo22 January 2019Related Internet LinksVitiligo Support UK – FacebookThe Vitiligo SocietyBritish Skin FoundationThe BBC is not responsible for the content of external sites.

Published3 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, GuinnessBy Max MatzaBBC NewsA Canadian brother and sister born at 22 weeks have been named by Guinness as the world’s most premature twins. Adiah and Adrial Nadarajah were born at 126 days, overtaking the previous record of 125 days early set in 2018 by twins in the US state of Iowa. If the children had been born even one hour earlier than 22 weeks, life-saving measured would not have been attempted by the hospital, Guinness says. A full-term pregnancy is usually 40 weeks, making them 18 weeks premature.Mum Shakina Rajendram said that when she began labour at just 21 weeks and five days, doctors told her that the babies “were not viable” and had “0% chance of survival”.It was her second pregnancy, after she lost her first just a few months earlier in the same hospital near their home in Ontario. Image source, GuinnessFather Kevin Nadarajah said that the hospital told them they would be unable to help with such an early pregnancy, leaving him awake at night praying with a “face streaming with tears”.Most hospitals do not attempt to save children born before 24 to 26 weeks. But luckily, the couple were able to move to Mount Sinai Hospital in Toronto, which has a specialist neonatal intensive care unit.On Mrs Rajendram’s second day of labour – 21 weeks and six days into the pregnancy – she was told that if the children were born even a few minutes before 22 weeks, they would be left to die. Despite heavy bleeding, she said she tried her best to “hold the babies in” for a few more hours.Her water eventually broke 15 minutes after midnight. Less than two hours after entering 22 weeks in the womb, the children were born. Adiah and Adrial have now lived to be one year old, despite serious medical issues early on.”We watched the babies almost die before our eyes many times,” Mrs Rajendram said. While they are still being closely followed by doctors, the siblings are “doing great”.The most premature baby ever born was Curtis Means of Alabama, who was born at 21 weeks and one day. Image source, GuinnessMore on this storyUS boy certified as world’s most premature baby11 November 2021