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SharecloseShare pageCopy linkAbout sharingimage copyrightEPAUS President Joe Biden has ordered intelligence officials to “redouble” efforts to investigate the origins of Covid-19, including the theory that it came from a laboratory in China. He said the US intelligence community was split on whether it was the result of a lab accident, or emerged from human contact with an infected animal.Mr Biden asked the groups to report back to him within 90 days. China’s embassy in the US warned against “politicising” origin tracing. “Smear campaigns and blame shifting are making a comeback, and the conspiracy theory of ‘lab leak’ is resurfacing,” the embassy said in a statement posted on its website, which did not directly mention Mr Biden’s remarks.”To politicize origin tracing, a matter of science, will not only make it hard to find the origin of the virus, but give free rein to the ‘political virus’ and seriously hamper international cooperation on the pandemic,” it said. Since it was first detected in the Chinese city of Wuhan in late 2019, more than 168 million cases of Covid-19 have been confirmed worldwide and at least 3.5 million deaths reported. Wuhan: City of silenceCovid map: Where are cases the highest?Has India’s deadly second wave peaked?Authorities linked early Covid cases to a seafood market in Wuhan, leading scientists to theorise the virus first passed to humans from animals. But recent US media reports have suggested growing evidence the virus could instead have emerged from a laboratory in China, perhaps through an accidental leak. Lab leak theory goes mainstreamIn what passes for relative transparency in the US government, the Biden administration has conceded the American intelligence community is split on Covid-19’s origins – it could be the lab or animal-to-human contact – and no-one is near certain about it.That marks a big shift from the derision heaped on the lab theory by many in the media and politics last year, when Donald Trump, Secretary of State Mike Pompeo, Senator Tom Cotton and others floated the idea.Mr Trump and Mr Pompeo didn’t help the situation, however, as they were coy about the grounds for their suspicion. And their theories floating alongside more far-fetched ones, such as that the disease was manufactured in a Chinese lab. That possibility still seem highly unlikely.The public may never know the full truth about the virus’ origins, particularly if China continues to be uncooperative. Mr Biden is pledging a full investigation, however, and if the US finds conclusive evidence of a lab leak, it will mean more than just a few prominent figures having to eat crow and re-evaluate their trust in authoritative “conclusions”. It could place very real strain on US-China relations for years to come.Why is President Biden doing this now?In a White House statement released on Wednesday, President Biden said he had asked for a report on the origins of Covid-19 after taking office, “including whether it emerged from human contact with an infected animal or from a laboratory accident”.On receiving it this month, he asked for “additional follow-up”.Mr Biden said the majority of the intelligence community had “coalesced” around those two scenarios, but “do not believe there is sufficient information to assess one to be more likely than the other”.image copyrightGetty ImagesThe president has now asked agencies to “redouble their efforts to collect and analyse information that could bring us closer to a definitive conclusion”, and report to him within 90 days. He concluded by saying the US would “keep working with like-minded partners around the world to press China to participate in a full, transparent, evidence-based international investigation and to provide access to all relevant data and evidence”.Beijing has previously suggested Covid-19 could have come from a US laboratory instead.In its statement on Wednesday, the Chinese embassy said it supported a full investigation into “some secretive bases and biological laboratories all over the world”. Mr Biden’s statement came as CNN reported that the president’s administration this spring shut down a state department investigation into whether the virus could have leaked from a Wuhan lab, deeming the probe an ineffective use of resources.What do we know about the lab theory?The laboratory leak allegations were widely dismissed last year as a fringe conspiracy theory, after then-President Donald Trump said Covid-19 had originated from the Wuhan Institute of Virology. Many US media outlets described such claims as debunked or false.In March this year, the World Health Organization (WHO) issued a report written jointly with Chinese scientists on the origins of Covid-19, saying the chances of it having started in a lab were “extremely unlikely”. The WHO acknowledged further study was needed.But questions have persisted and recent reports attributed to US intelligence sources say three members of the Wuhan Institute of Virology were admitted to hospital in November 2019, several weeks before China acknowledged the first case of the new disease in the community.Wuhan marks its anniversary with triumph and denial’Wuhan whistleblower’ remembered one year onAnthony Fauci, President Biden’s chief medical adviser, has maintained he believes the virus was passed from animals to humans, though he conceded this month he was no longer confident Covid-19 had developed naturally.Mr Biden’s statement comes the day after Xavier Becerra, US secretary for health and human services, urged the WHO to ensure a “transparent” investigation into the virus’s origins.”Phase 2 of the Covid origins study must be launched with terms of reference that are transparent, science-based and give international experts the independence to fully assess the source of the virus and the early days of the outbreak,” Mr Becerra said.Bat scientists find new coronavirus evidenceOn Tuesday, Mr Trump sought to take credit in an emailed statement to the New York Post. “To me it was obvious from the beginning but I was badly criticised, as usual,” he said. “Now they are all saying: ‘He was right.'”

The directive came as health officials and scientists have renewed calls for a more rigorous examination.WASHINGTON — President Biden ordered U.S. intelligence agencies on Wednesday to investigate the origins of the coronavirus, indicating that his administration takes seriously the possibility that the deadly virus was accidentally leaked from a lab, in addition to the prevailing theory that it was transmitted by an animal to humans outside a lab.In a statement, Mr. Biden made it clear that the C.I.A. and other intelligence agencies had not yet reached a consensus on how the virus, which prompted a pandemic and has killed almost 600,000 Americans, originated in China. But he directed them to conduct a deeper investigation and report back to him in 90 days.“I have now asked the intelligence community to redouble their efforts to collect and analyze information that could bring us closer to a definitive conclusion,” the president said.Mr. Biden’s statement, his most public and expansive yet on the question of how the virus spread to humans, came as top health officials renewed their appeals this week for a more rigorous inquiry. And it followed mounting criticism of a report from an international team of experts convened by the World Health Organization that largely dismissed the possibility that the virus had accidentally escaped from a Chinese laboratory called the Wuhan Institute of Virology.Deep uncertainty remains about the origins of a virus that spread to every part of the globe over 17 months. The assessments of scientists are largely unchanged: Many believe that a so-called natural spillover from animal to human remains the most plausible explanation. While U.S. intelligence agencies have collected some new evidence, the additional information is not enough to allow them to draw definitive conclusions about long-simmering theories regarding the lab in the city of Wuhan, the center of the outbreak.But the president’s carefully worded directive underscored a new surge in interest about the lab, which President Donald J. Trump and some of his top aides repeatedly blamed for the pandemic. Some scientists attributed the renewed focus on the lab to Mr. Trump’s departure from the White House — and being less identified with the theory — while others said it reflected the deep frustrations with the recent W.H.O. report that was co-written by Chinese scientists.Even before Mr. Biden’s order, U.S. intelligence agencies had intensified their work on the origins of the pandemic, according to American officials, driven at least in part by the growing openness of some scientists to the theory that the coronavirus might have accidentally leaked out of the research lab.President Biden said in a statement on Wednesday that the intelligence community had “coalesced around two likely scenarios” but had not definitively answered the question.Doug Mills/The New York TimesIn recent weeks, more officials have said it is at least a possible explanation and it deserves serious examination based on some new intelligence. Details of that information remain unclear, but officials concede there is no major new material that has decisively shifted internal thinking or allowed them to draw higher-confidence conclusions.Avril D. Haines, the director of national intelligence, has been working with various intelligence agencies, bringing together officials with divergent views to discuss them, to review the shifting science and to push for additional intelligence collection.Still, Mr. Biden’s order was an abrupt example of presidential intervention in the collection of raw data by those charged with collecting and analyzing intelligence on his behalf. Presidents are often hesitant to appear becoming overly involved in the preparation of the intelligence briefings they receive, though Mr. Biden has been active in asking for intelligence reports on issues including Russian aggressions and domestic terrorism.The president had asked in March for an internal assessment of the virus’s origins, which was delivered to him two weeks ago in his Presidential Daily Brief of intelligence, according to a senior White House official and an administration official. That started a discussion, the officials said, about declassifying some of the findings and having intelligence officials issue a public statement.The statement — which described the lack of consensus among intelligence agencies — was ready this week, but Mr. Biden felt it would not help clarify the issue for the public, according to the senior official. And on Tuesday, China took a hard line against cooperating with the W.H.O. on further inquiries, which prompted Mr. Biden to press for a more robust United States investigation, the official said. The president announced that investigation in his statement on Wednesday.It was unclear whether Mr. Biden was also moved to act by a public shift in opinion by some scientists or political pressure from Mr. Trump’s Republican allies on Capitol Hill, who have repeatedly accused the president and Democrats of refusing to take the lab origin theory seriously.Seizing a lull on the Senate floor on Wednesday night, Senators Mike Braun of Indiana and Josh Hawley of Missouri, both Republicans, passed their bill to declassify intelligence related to any potential links between the Chinese lab and the origins of the pandemic through unanimous consent. It came after the Senate on Tuesday unanimously agreed to include two Republican provisions to a huge package of China legislation aimed at prohibiting sending American funding to the Wuhan Institute of Virology or to China-based “gain of function” research, in which scientists intentionally try to make a pathogen more powerful.“For over a year, anyone asking questions about the Wuhan Institute of Virology has been branded as a conspiracy theorist,” Mr. Hawley said. “The world needs to know if this pandemic was the product of negligence at the Wuhan lab, but the C.C.P. has done everything it can to block a credible investigation.”In the past several days, the White House had played down the need for an investigation led by the United States and insisted that the W.H.O. was the proper place for an international inquiry. Mr. Biden’s statement on Wednesday was an abrupt shift, though officials declined to be specific about what had changed behind the scenes to warrant the presidential order.“What has changed is he wants to give another 90 days to dig a little deeper, to double down — the I.C. to double down their efforts,” said Karine Jean-Pierre, the deputy White House press secretary, referring to the intelligence community. “The W.H.O. doing their thing and the I.C., doing what they’re doing currently is not mutually exclusive.”Paramedics transporting a man believed to be Hong Kong’s first coronavirus patient, in January 2020.Lam Yik Fei for The New York TimesThe scientific and political debate about how the virus became a global threat to humans has been simmering since the beginning of the pandemic. For much of that time, scientists around the world have concluded that it most likely emerged from an infected animal.There was clear evidence for the coronavirus having emerged naturally through the recombination of genetic material from different bat coronaviruses, said Dr. Robert Garry, a virologist at the Tulane University School of Medicine. The data so far bears the hallmarks of natural recombination, he said, and no signs of human intervention.“The pieces are out there,” Dr. Garry said. “These viruses mix bits and pieces all the time.”But others have long suspected that the global health crisis was man-made, pointing to the Chinese lab as the likely source of the pathogen. Mr. Trump repeatedly accused the Chinese of covering up their complicity. Peter Navarro, Mr. Trump’s trade adviser, suggested that it had been created in a Chinese bioweapons lab.Days before he left office, Secretary of State Mike Pompeo released a fact sheet about the Wuhan Institute of Virology, outlining evidence that the virus might have emerged accidentally from the facility. Among other data points Mr. Pompeo released was that the government had “reason to believe that several researchers inside the W.I.V. became sick in autumn 2019, before the first identified case of the outbreak, with symptoms consistent with both Covid-19 and common seasonal illnesses.”The Wall Street Journal reported on Sunday that the information about the sick researchers released by Mr. Pompeo had been contained in intelligence documents prepared at the end of the Trump administration.At least two intelligence documents produced in recent months discuss the sick workers, according to an American official. One is narrowly focused on information about the three people, and a broader document put the intelligence in the context of what is known about the origins of the coronavirus.Days before leaving office, Mike Pompeo, the secretary of state under President Donald J. Trump, publicly outlined evidence that the virus might have emerged accidentally from the Wuhan lab.Erin Schaff/The New York TimesThe intelligence on the three workers came from outside the United States intelligence agencies’ own collection, which means its veracity is more difficult to authenticate. The source of the information was unclear, but several American officials said they believed the report that the three researchers got sick.American intelligence officials do not know whether the lab workers contracted Covid-19 or some other disease, like a bad flu. If they did have the coronavirus, the intelligence may suggest that they could have become sick from the lab, but it also could simply mean that the virus was circulating in Wuhan earlier than the Chinese government has acknowledged.Also toward the end of Mr. Trump’s term, State Department officials began examining the origins of the virus and concluded that it was highly unlikely to have appeared naturally and thus was likely the product of laboratory work.CNN first reported the effort and suggested that the group’s efforts had been shut down by the Biden administration, prompting scathing Republican criticism. A State Department spokesman, Ned Price, denied that, saying that the team’s findings were briefed to senior officials in the department’s arms control bureau in February and March.“With the report delivered, the work was ended,” Mr. Price said.Mr. Trump issued a statement on Tuesday boasting of his early insistence that the Wuhan lab was the source of the virus. “To me, it was obvious from the beginning,” he said. “But I was badly criticized, as usual.”Despite the absence of new evidence, a number of scientists have lately begun speaking out about the need to remain open to the possibility that the virus had accidentally emerged from a lab, perhaps after it was collected in nature, a lab origin distinct from a creation by scientists.“It is most likely that this is a virus that arose naturally, but we cannot exclude the possibility of some kind of a lab accident,” Dr. Francis Collins, the director of the National Institutes of Health, told senators on Wednesday.Some scientists attributed the shift in part to the fact that the more extreme proponents of a lab leak hypothesis, like Mr. Navarro, had drowned out the more measured discussions of how lab workers could have accidentally carried the virus outside.Scientists had been reluctant to discuss the lab leak hypothesis last year because they had been on guard against disinformation, said Marc Lipsitch, a Harvard epidemiologist.“Nobody wants to succumb to conspiracy theories,” he said.But the March report by the group of W.H.O.-chosen experts in collaboration with Chinese scientists, dismissing the possibility of a lab leak as “extremely unlikely,” compelled some scientists to speak out.“When I read that, I was very frustrated,” said Akiko Iwasaki, an immunologist at Yale University. Along with Professor Lipsitch, she signed a letter published in the journal Science this month saying that there was not enough evidence to decide whether a natural origin or an accidental laboratory leak caused the coronavirus pandemic.“I think it’s really an unanswered question that really needs more rigorous investigation,” Dr. Iwasaki added.Uncertainty remains about the origins of the virus, which continues to cause havoc in countries like India. India’s official coronavirus statistics report about 27 million cases and over 300,000 deaths as of Tuesday.Anindito Mukherjee/Getty ImagesFrom the earliest weeks of the outbreak, the Chinese government has worked to delay, deflect or block independent investigation of the virus’s origins.Chinese officials said in early 2020 that the outbreak began at a Wuhan market, and they blamed illegal wildlife sales there. They did so despite having evidence that undermined that theory: Early data showed that four of the first five coronavirus patients had no clear links to the market. The government resisted accepting an international scientific mission.The World Health Organization gave early cover to China’s dissembling, incorrectly praising Chinese disease surveillance with spotting an outbreak that it had actually missed. The health organization publicly announced that China had agreed to share biological samples — but never followed up to say that the government had failed to deliver on that promise.While American officials have collected some new intelligence, it is not enough to allow them to draw definitive conclusions about long-simmering theories regarding the lab in Wuhan.Hector Retamal/Agence France-Presse — Getty ImagesChina has also pushed conspiracy theories, including that the disease was spread by the American military, and argued that any origin investigation should start in Europe, not in China. Chinese officials and state media have also frequently taken a defensive stance.On Wednesday, Zhao Lijian, a Foreign Ministry spokesman, sidestepped a question about whether the W.H.O. would be permitted to do further investigation in China, saying that an “authoritative study report” with “many significant conclusions” had already been issued.Instead, Mr. Zhao sought to deflect attention from China, pointing to what he called the reports of Covid-19 being detected as early as 2019 in other parts of the world. He also referred again to the baseless theory that the virus came from a United States Army lab.“China takes the origin-tracing work seriously with a responsible attitude, and has made positive contributions that are widely recognized,” Mr. Zhao said. “If the U.S. side truly demands a completely transparent investigation, it should follow China’s lead to invite the W.H.O. experts to the U.S.”Even as the debate about the virus’s origins has resurfaced in recent weeks, there has been little public discussion of the issue in China. On Wednesday, many on Chinese social media were more preoccupied with discussing the death of Yuan Longping, a prominent plant scientist, and a deadly ultramarathon in the northwestern Chinese region of Gansu.Reporting was contributed by

A team of international researchers has assembled an atlas of microorganisms present in 60 cities around the world.For centuries, naturalists have mapped the world’s flora and fauna. They have assembled atlases of migratory birds and cold-water fishes, sketched out the geography of carnivorous animals and alpine plants.Now, an enormous international team of researchers has added a new volume to the collection: an atlas of microorganisms that can be found in the world’s subways. It contains data collected by more than 900 scientists and volunteers in 60 cities on six continents, from Stockholm to Shanghai, Sacramento to Sydney.“We had a coordinated phalanx of people with swabs and masks, collecting genetic material from cities around the world,” said Christopher Mason, a geneticist at Weill Cornell Medicine who led the research.Although each city had its own unique microbial profile, there was a “core urban microbiome” that all of the cities shared, they found. The scientists, members of the international MetaSUB consortium, also discovered more than 10,000 previously unidentified species of viruses and bacteria. They published the findings in the journal Cell on Wednesday.“We have taken a deep dive into the urban centers to find a breadth and treasure trove of new life-forms,” Dr. Mason said. “The railings and the benches of our cities have sometimes just as much or more diversity than what you find in a rain forest.”The source and function of many of these microbes remains unknown, and the research reveals how much is left to learn about the microorganisms that surround us. But the findings should not be cause for alarm, the scientists stress.“We don’t see anything that we are worried about,” said David Danko, one of the paper’s authors and the director of bioinformatics for MetaSUB. “People are in contact with these all the time.” He added, “We don’t want people to be scared of these microbes, because these are just part of the ecosystem that we as humans live in.”Subway surveyorsMicrococcus luteus, magnified 10,000 times, produces body odor. It was one of 31 species of bacteria — the “core urban microbiome” — found in nearly every sample in every city.Janice Haney Carr/CDCThe colors in a MetaSUB heatmap indicate relative abundance of the taxa, in this case, Micrococcus luteus.MetaSUBSample collection for the new study began in 2015, after Dr. Mason’s research on the microbes of the New York City subway system drew international interest. In response, he created the MetaSUB consortium to study the microbes present in cities around the world.Teams of researchers and volunteers fanned out across the mass transit systems of 60 cities, collecting thousands of samples from 2015 to 2017. They swabbed a wide variety of surfaces, including turnstiles, railings, ticket kiosks and benches inside transit stations and subway cars. (In a handful of cities that did not have subway systems, the teams focused on the bus or train system.)The scientists’ subterranean sampling expeditions often attracted attention. Some commuters grew so curious that they joined the volunteer swabbing corps, while others insisted that they absolutely did not want to know what was living on the subway poles. Passengers occasionally misunderstood what the researchers were doing with their tiny swabs. “One man effusively thanked us for cleaning the subway,” Dr. Mason said.The researchers also collected air samples from the transit systems of six cities — New York, Denver, London, Oslo, Stockholm and Hong Kong — for a companion paper on the “air microbiome” that was published on Wednesday in the journal Microbiome.“This is huge,” said Erica Hartmann, a microbiologist at Northwestern University who was not involved in the study. “The number of samples and the geographic diversity of samples — that’s unprecedented.”Then the team extracted and sequenced the DNA from each sample to identify the species it contained. In total, across all of the surface samples, they found 4,246 known species of microorganisms. Two-thirds of these were bacteria, while the remainder were a mix of fungi, viruses and other kinds of microbes.But that was just the beginning: They also found 10,928 viruses and 748 kinds of bacteria that had never been documented. “We could see these were real — they’re microorganisms — but they’re not anywhere in any database,” said Daniela Bezdan, the former executive director of MetaSUB who is now a research associate at the University Hospital Tübingen in Germany.The vast majority of these organisms probably pose little risk to humans, experts said. Nearly all of the new viruses they found are likely to be bacteriophages, or viruses that infect bacteria, Dr. Danko said. Moreover, genetic sequencing cannot distinguish between organisms that are dead and those that are alive, and no environment is sterile. In fact, our bodies rely on a rich and dynamic community of microbes in order to function properly.“I think the most important thing is not to freak out,” said Noah Fierer, a microbiologist at the University of Colorado Boulder, who was not involved in the research. “Most of these aren’t pathogens, most of them are probably innocuous, and some may actually be beneficial.”Some of the novel microbes they found might also turn out to be sources of novel drugs or other useful compounds. “The amount of microbial diversity is just incomprehensibly vast,” Dr. Hartmann said. “There’s so much out there that we just don’t really understand, and there could be all kinds of nifty biotechnologies and all kinds of fun chemistries that we’re not aware of yet.”City signaturesA “sunburst” on the MetaSUB dashboard shows the relative abundance of each taxa in a given sample.MetaSUBCutibacterium acnes, one of the 31 “core urban microbiome” species. About half of those species typically live in and on the human body, especially the skin.Bobby Strong/CDCIn this enormous collection of microbes, however, the scientists were able to identify 31 different species of bacteria, what they called the “core urban microbiome,” that were present in nearly every sample in every city.Roughly half of these species are bacteria that typically live in and on the human body, especially the skin. They include Cutibacterium acnes, which feeds on the oil on our faces, and Micrococcus luteus, which contributes to the production of body odor by breaking down the compounds in our sweat. (Skin bacteria also made up half of the microbes swirling around in the air, the scientists found.)The core microbiome also contained soil bacteria as well as some more unexpected species, like Modestobacter marinus, which is typically associated with the ocean. The researchers are not sure why it is in the world’s subway stations, but its high tolerance for salt and ability to withstand radiation may make it especially hardy; it is known to grow well on stone.In fact, several of the species in the core microbiome have similar characteristics which may help them survive in seemingly inhospitable environments. “A steel railing is probably not a pleasant place to live, but they may have adapted to survive there,” Dr. Mason said.For the time being, that is just one of several possible theories. “We aren’t able to give a satisfying answer yet for what some of these things are actually doing,” Dr. Danko said.Beyond this core microbiome, there was enormous variation between cities. Some geographic clustering was evident: The microbial profiles of North American and European cities were distinct from those of East Asian cities. And the closer together two cities were, on average, the more similar their microbial profiles.In fact, the cities’ microbial signatures were distinctive enough that the scientists could identify, with 88 percent accuracy, where a sample had come from. “Give me your shoe, and if I sequence it, I could probably tell you where you came from in the world,” Dr. Mason said.What’s driving these differences is not entirely clear. Climate and geography both play some role: Cities closer to the Equator had more microbial diversity than those that were farther away, while some coastal cities had microbes that are typically associated with water.Commuters in different cities may also be shedding different microbes from their bodies. Previous research has shown that the human microbiome varies individually by age, sex, geography and a variety of lifestyle factors, including diet and medication use.“What we can speculate, based on other studies, is that the human skin microbiota may be a reflection of the demographics of the commuters, which is different between cities,” said Marius Dybwad, a principal scientist at the Norwegian Defence Research Establishment who leads MetaSUB’s air initiative.But there’s a lot that remains a mystery, and a lot of variation that remains unexplained. “There’s probably not one explanation,” Dr. Fierer of the University of Colorado Boulder said. “Some cities might have more soil blowing around, or different food items, or different plants contributing microbes to the air that land on the surface, or different hygiene practices — I mean, there’s hundreds of different explanations. But it’s pretty cool that they could see that.”Persistent resistanceCommuters in Hong Kong last summer.Yik Lam/ReutersThe researchers also compared the genetic sequences they found to databases of genes that may give microorganisms the ability to thwart antibiotics and other antimicrobial compounds. These “antimicrobial resistance genes” were widespread, present in air and surface samples from every city, but their type and abundance varied enormously from city to city.“It does not surprise me that they identified antimicrobial resistance genes,” Dr. Hartmann said. “They’re everywhere, and antimicrobial resistance is an ancient function that way predates humans and human uses of antimicrobials.”Microorganisms use their own, self-made antimicrobial compounds to fight off other microbes, and antimicrobial resistance is a natural adaptation; finding these genes does not mean that there are dangerous superbugs lurking in our subways.“It is not possible to infer anything about health risk from this information alone,” Dr. Dybwad said. “We do not have evidence showing that the organisms are actually alive and metabolically active.”But a global catalog of antimicrobial resistance genes may ultimately help scientists understand more about the biological defenses that microbes have evolved and help public health officials monitor resistance genes that might be prevalent in their area.“Can we give some kind of heads-up about what to look for?” Dr. Danko said. “Can we track the spread of bacteria or genes that will make bacteria resistant to antibiotics in the future? Can we use this as a way to inform public health departments in the use of antibiotics going forward?”In the meantime, the work continues. The researchers in the consortium hope to learn more about the biology and ecology of the species they’re finding, as well as how they might influence human health. Last year, they began sampling urban hospitals, wastewater and public spaces to look for traces of SARS-CoV-2, the virus that causes Covid-19.And they are continuing to venture into the world’s subway systems, armed with sterile swabs and collection tubes. “We keep finding new things,” Dr. Mason said. “If we stop finding any new species, maybe we’ll stop and say, ‘OK, I think we’ve exhausted most of what you can find in the subway.’”

GPs have told the BBC that they are facing a “tsunami of patients” as we start to emerge from lockdown. NHS figures for England show that in March of this year, GPs saw more than 28 million patients – one of the highest numbers on record – and a rise of 20 per cent on the previous month. The Royal College of GPs is warning that without urgent resources they will no longer be able to meet patient demand.Filmed by Stephen FildesEdited by Stephen Fildes and Phillip EdwardsProduced by Ruth Clegg

The ruling was a milestone in yearslong efforts to make the OxyContin manufacturer pay for its role in the opioid crisis, but some plaintiffs feel the plan doesn’t go far enough.A federal bankruptcy judge in New York indicated Wednesday that he would permit Purdue Pharma’s proposal to remake itself as a nonprofit company to be put to a vote by thousands of plaintiffs, who have sued to compel the maker of OxyContin to help pay for the terrible costs of the opioid epidemic.The restructuring plan is at the centerpiece of an intensely negotiated blueprint for a collective settlement with more than 600,000 claimants who contend that for two decades the company falsely and aggressively marketed its prescription opioid OxyContin as a nonaddictive painkiller, and as a result contributed to hundreds of thousands of opioid-related overdoses and deaths.Besides protecting the company from further legal action over opioids, the plan includes a blanket release from civil lawsuits for Purdue’s owners, members of the billionaire Sackler family.The issue of the Sacklers’ liability has been perhaps the most contentious in the proceedings, ever since Purdue filed for bankruptcy protection in 2019, seeking a shield against rapidly accruing lawsuits. The individual Sacklers, members of one of the wealthiest families in the United States, did not seek bankruptcy protection, but they argue that they should be covered by the same release from all present and future lawsuits that their company would be given if the plan is confirmed.In return, the Sacklers have agreed to relinquish ownership of Purdue and contribute $4.5 billion to the settlement, including $225 million to the federal government. The money would be paid in installments over nine or 10 years, most of it going to a national opioid abatement trust fund, which would then be disbursed to states and municipalities to support addiction prevention and treatment programs.Judge Robert D. Drain, of the U.S. Bankruptcy Court for the Southern District of New York in White Plains, said that the plan provisionally cleared the legal hurdles of sufficiency, and that he was waiting for a handful of issues to be resolved before the plan is distributed.Purdue is expected to mail out information packets next week that describe the reorganization plan to the roughly 614,000 claimants in the bankruptcy case, with voting to conclude by July 14.A final confirmation hearing is scheduled for Aug. 9, at which Judge Drain likely will hear a flurry of final challenges to the plan that will almost certainly include the question of whether the Sacklers personally can be shielded from further opioid-related lawsuits.Once the packets are sent out, energetic lobbying for passage of the plan will most likely ensue during the next six weeks, as voters weigh the calculus of accepting less money than they wished in exchange for the immediacy of relief. Even if an overwhelming majority of claimants votes in favor of the plan, as seems apparent at the moment, ultimate approval is up to the judge.“It’s not unprecedented, but it’s highly controversial” for a bankrupt company’s owners to be released from future litigation as part of a settlement, said Adam J. Levitin, a law professor specializing in bankruptcy at Georgetown University Law Center. “It’s not even clear that the bankruptcy court has the jurisdiction to do this,” as the Sacklers are not parties to the bankruptcy themselves.Judge Drain has long urged the negotiators to work quickly, because no money can flow to the claimants until the bankruptcy case is concluded.According to the plan, the reconstituted, as-yet unnamed company would fund about a half-dozen trusts, including separate ones for tribes, adults and children. Proceeds from the sales of the nonprofit’s overdose-reversing medications as well as from moderate quantities of OxyContin would continue to be pumped into these trusts.But more than 100,000 individual claimants, including relatives of people who died from prescription overdoses, would receive relatively paltry compensation, ranging roughly from $3,000 to $48,000 apiece — before lawyers’ fees and costs are deducted.Indeed, more than a half-billion dollars overall will go toward fees and costs accrued by plaintiffs’ public and private lawyers.The oversight of the new trusts will also be expensive. The trust distribution is incredibly complex, said Lindsey Simon, an assistant professor at the University of Georgia School of Law, who has closely followed the case. “From my perspective, the biggest question is how much money will get eaten up in the administration of all those trusts,” she said.Scott Bickford, a lawyer who represents individuals, families and babies who showed symptoms of withdrawal from drugs they were exposed to in utero, noted that the current proposal did dedicate $60 million for programs to assist these children.But he contended that more than half the children affected would not receive anything from the settlement because of the strictness of the criteria imposed.Echoing a sentiment expressed throughout Wednesday’s seven-hour hearing, he said, “As with any compromise, no side got what it truly wanted.”With the exception of a group of two dozen dissenting states and a coalition of school districts, however, almost all the plaintiff groups have said the Purdue plan is fit to be put to a vote.Most of the claimants also have cases pending against many other opioid manufacturers, distributors and dispensers.During Wednesday’s hearing, the judge noted that the mediation of disputes — between groups of plaintiffs, between plaintiffs and Purdue, and between diverse Sacklers and Purdue and plaintiffs — was continuing.As part of its legal obligation to account for its finances, Purdue commissioned an independent forensic audit of the Sackler withdrawals and expenditures, which showed that from 2008 through 2017, family members withdrew $10.4 billion in cash from the company and took another $1.4 billion in noncash transactions. Lawyers representing members of the Sackler family have said that about half that amount has gone to paying taxes.Marshall Huebner, the lead bankruptcy lawyer for Purdue, said that while the company could continue to pursue the Sacklers to determine whether family members had fraudulently siphoned company cash into their own accounts, such a process would be lengthy and contentious and vacuum up funds that could otherwise swiftly go toward ameliorating the opioid crisis.According to the Centers for Disease Control and Prevention, overdose deaths, including those from fentanyl and heroin, rose to rates during the past year that exceeded any year of the opioid epidemic.Should voters reject the bankruptcy plan and instead choose to pursue the Sacklers, Mr. Huebner said, “lawyers would make billions and the claimants potentially get little to nothing, and it’s years and years away.”Lawyers for one group of Sackler descendants have introduced a website with documents and talking points intended to respond to the prevailing narrative about the involvement of family members in the epidemic.Andrew M. Troop, a lawyer for the two dozen states that oppose the plan, said that it fell short of revealing the full extent of the family members’ wealth. A recent investigation by the House Committee on Oversight and Reform found that the Sacklers are collectively worth about $11 billion.“Everyone is entitled to know what the Sacklers are worth today,” Mr. Troop said in the hearing. “Gauging a settlement and gauging a claim has a lot to do with what are they worth.”But Judge Drain said that the $11 billion figure was misleading and that plaintiffs shouldn’t think they could claw back the entire amount. He said Sackler family members held varying amounts, and some were more involved in Purdue’s opioid strategies than others.“It’s not like Scrooge McDuck, who takes a bath in his vault of cash in his apartment,” Judge Drain said in the hearing. “There’s not one Scrooge McDuck — there are a lot of them.” And it’s not all cash, he added.Purdue lawyers agreed to add more information about the Sackler holdings to help inform the voting creditors. The creditors have been divided into groups, according to what kind of claims they have made, so that dozens of hospitals in the case, for example, will not have to vote against the 7,600 states and municipalities, which have different stakes and interests.Judge Drain said that fundamentally the plan was about collecting money to abate the opioid crisis.It is fair for parties to say the current amount is insufficient, he said, although he noted that negotiations were ongoing. Final amendments must be submitted seven days before the voting deadline.But ultimately, he added: “People have a decision to make for the people of their states. ‘Do I take the risk of taking nothing or a lot less, or do I go along with the settlement?’”

A team of international researchers has found that the Tsimane indigenous people of the Bolivian Amazon experience less brain atrophy than their American and European peers. The decrease in their brain volumes with age is 70% slower than in Western populations. Accelerated brain volume loss can be a sign of dementia.
The study was published May 26, 2021 in the Journal of Gerontology, Series A: Biological Sciences and Medical Sciences.
Although people in industrialized nations have access to modern medical care, they are more sedentary and eat a diet high in saturated fats. In contrast, the Tsimane have little or no access to health care but are extremely physically active and consume a high-fiber diet that includes vegetables, fish and lean meat.
“The Tsimane have provided us with an amazing natural experiment on the potentially detrimental effects of modern lifestyles on our health,” said study author Andrei Irimia, an assistant professor of gerontology, neuroscience and biomedical engineering at the USC Leonard Davis School of Gerontology and the USC Viterbi School of Engineering. “These findings suggest that brain atrophy may be slowed substantially by the same lifestyle factors associated with very low risk of heart disease.”
The researchers enrolled 746 Tsimane adults, ages 40 to 94, in their study. To acquire brain scans, they provided transportation for the participants from their remote villages to Trinidad, Bolivia, the closest town with CT scanning equipment. That journey could last as long as two full days with travel by river and road.
The team used the scans to calculate brain volumes and then examined their association with age for Tsimane. Next, they compared these results to those in three industrialized populations in the U.S. and Europe.

To help patients manage their mental wellness between appointments, researchers at Texas A&M University have developed a smart device-based electronic platform that can continuously monitor the state of hyperarousal, one of the signs of psychiatric distress. They said this advanced technology could read facial cues, analyze voice patterns and integrate readings from built-in vital signs sensors on smartwatches to determine if a patient is under stress.
Furthermore, the researchers noted that the technology could provide feedback and alert care teams if there is an abrupt deterioration in the patient’s mental health.
“Mental health can change very rapidly, and a lot of these changes remain hidden from providers or counselors,” said Dr. Farzan Sasangohar, assistant professor in the Wm Michael Barnes ’64 Department of Industrial and Systems Engineering. “Our technology will give providers and counselors continuous access to patient variables and patient status, and I think it’s going to have a lifesaving implication because they can reach out to patients when they need it. Plus, it will empower patients to manage their mental health better.”
The researchers’ integrated electronic monitoring and feedback platform is described in the Journal of Psychiatric Practice.
Unlike some physical illnesses that can usually be treated with a few doctor visits, people with mental health needs can require an extended period of care. Between visits to a health care provider, information on a patient’s mental health status has been lacking. Hence, unforeseen deterioration in mental health has a limited chance of being addressed. For example, a patient with anxiety disorder may experience a stressful life event, triggering extreme irritability and restlessness, which may need immediate medical attention. But this patient may be between appointments. On the other hand, health care professionals have no way to know about their patients’ ongoing struggle with mental health, which can prevent them from providing the appropriate care.
Hence, patient-reported outcomes between visits are critical for designing effective health care interventions for mental health so that there is continued improvement in the patient’s wellbeing. To fill in this gap, Sasangohar and his team worked with clinicians and researchers in the Department of Psychiatry at Houston Methodist Hospital to develop a smart electronic platform to help assess a patient’s mental wellbeing.

The carefully orchestrated dance between the immune system and the viral proteins that induce immunity against COVID-19 may be more complex than previously thought. A new study by investigators at Brigham and Women’s Hospital used an ultrasensitive, single-molecule array (Simoa) assay to detect extremely low levels of molecules in the blood and measured how these levels change over the days and weeks following vaccination. The team found evidence of circulating protein subunits of SARS-CoV-2, followed by evidence of the body mounting its immune response and then clearing the viral protein to below the level of single-molecule detection. Results are published in Clinical Infectious Diseases.
“Because of our ultra-sensitive method, we’re able to corroborate that the mRNA vaccine is operating as intended, stoking the body’s immune response,” said co-corresponding author David Walt, PhD, a member of the faculty in the Department of Pathology at the Brigham. Walt is also a member of the Wyss Institute and is a Howard Hughes Medical Institute Professor. “We were able to detect extremely low levels of viral protein and see that as soon as the body begins generating antibodies, those levels declined to undetectable.” Walt has a financial interest in Quanterix Corporation, the company that developed the ultra-sensitive digital immunoassay platform used in this work.
To conduct their study, Walt and colleagues measured levels of SARS-CoV-2 protein subunits in plasma samples collected from 13 participants who received two doses of the Moderna (mRNA-1273) vaccine. Specifically, the team measured levels of SARS-CoV-2 antigens Spike, S1, and Nucleocapsid. The team examined plasma collected at 10-13 timepoints between 1 and 29 days after the first injection and 1-28 days after the second injection. The average age of participants was 24 and the percentage of female participants was 46.
The team found that 11-of-13 participants had low levels of SARS-CoV-2 protein (S1 subunit) as early as one day post-vaccination. S1 subunit protein level peaked on average five days after the first injection. In all participants, the level of S1 protein declined and became undetectable by day 14. Spike protein was detected in 3-of-13 participants an average of 15 days after the first injection. After the second vaccine dose, no S1 or Spike was detectable.
The team collected corresponding antibody data and showed that the immune response began to mount after the viral proteins were produced. Increased antibody levels correlated with viral protein clearance from plasma.
The researchers note that the level of translated protein detected was extremely low and disappeared once antibodies were detected. All participants in the study were healthy volunteers who were vaccinated but not infected with SARS-CoV-2.
“The vaccine is designed to introduce mRNA into the body, which is then translated into the Spike protein. It is the Spike protein that can activate the immune system, which in turn creates antibodies to prevent future infections,” said co-first author Alana Ogata, PhD, a postdoctoral fellow in the Walt lab. “We observed that antibodies that target Spike and S1 proteins are generated as early as 1-2 days after circulating S1 is detected, followed by the clearance of proteins. Additionally, we see that the second dose does not result in circulating protein but does provide an additional boost in antibody levels, as expected.”
Researchers note that limitations of the current study include the small sample size and potential biases that result from enrolling healthy, young adults, which may not be representative of the general population. The research team plans to continue their plasma studies in other populations, including pregnant people and children, to further understand the dynamics between viral proteins and the immune response.
Funding for this work was provided by gifts to the Brigham from Amos and Barbara Hostetter and the Chleck Family Foundation. Walt is an inventor of the Simoa technology, founder of the company and serves on its Board of Directors. Walt’s interests were reviewed and are managed by Brigham and Women’s Hospital and Mass General Brigham in accordance with their conflict of interest policies. The anti-SARS-CoV-2 Simoa assays in this publication have been licensed by Brigham and Women’s Hospital to Quanterix Corporation.
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In a paper published today in Science Advances, researchers from the University of Pittsburgh School of Medicine showed that inhalable nanobodies targeting the spike protein of the SARS-CoV-2 coronavirus can prevent and treat severe COVID-19 in hamsters. This is the first time the nanobodies — which are similar to monoclonal antibodies but smaller in size, more stable and cheaper to produce — were tested for inhalation treatment against coronavirus infections in a pre-clinical model.
The scientists showed that low doses of an aerosolized nanobody named Pittsburgh inhalable Nanobody-21 (PiN-21) protected hamsters from the dramatic weight loss typically associated with severe SARS-CoV-2 infection and reduced the number of infectious virus particles in the animals’ nasal cavities, throats and lungs by a million-fold, compared to placebo treatment with a nanobody that doesn’t neutralize the virus.
“By using an inhalation therapy that can be directly administered to the infection site — the respiratory tract and lungs — we can make treatments more efficient,” said co-senior author Yi Shi, Ph.D., assistant professor of cell biology at Pitt. “We are very excited and encouraged by our data suggesting that PiN-21 can be highly protective against severe disease and can potentially prevent human-to-human viral transmission.”
Previously, Shi and colleagues discovered a large repertoire of over 8,000 high-affinity SARS-CoV-2 nanobodies. From this repertoire, the scientists selected an ultrapotent nanobody (Nb21) and bioengineered it into a trimeric form to further maximize its antiviral activity. The resulting PiN-21 is by far the most potent antiviral nanobody that has been identified, according to the researchers’ review of published studies.
The experiments showed that PiN-21 was protective when administered intranasally at the time of infection. Hamsters in the PiN-21 treatment group did not lose any body weight, unlike the placebo-treated animals who lost up to 16% of their initial body weight after a week of infection. For the average adult human, the rate of the weight loss would correspond to shedding roughly 20 pounds in a week.
Even more impressively, inhalation of aerosolized nanobodies at an ultra-low dose reduced the number of infectious virus particles in the lung tissue by 6-logs (or a million-fold). Animals who received aerosolized PiN-21 nanobodies had milder changes in the lung structure and a lower degree of inflammation than those who received the placebo.