How a Contrast Media Shortage Is Affecting Medical Scans in the U.S.

A COVID-19 lockdown in China temporarily shut down an important production facility for iodinated contrast media, a drug commonly used to enhance medical scans. Here’s how the shortage is impacting health care.

Fact checked on May 24 2022 by Vivianna Shields, a journalist and fact-checker with experience in health and wellness publishing.
Hospitals across the United States are being impacted by a recent shortage of iodinated contrast media (ICM). Given to patients intravenously during certain medical scans, this type of medication enhances the ability to see blood vessels and organs, helping health care professionals diagnose potential problems—such as infection, inflammation, and cancer—based on those images.
 
“Imaging is a multidisciplinary consult service that extends to impact most areas of medicine,” Laveil Allen, MD, executive medical director of the Vanderbilt University Medical Center Radiology Department, told Health. The contrast is what allows providers to see clearly through a patient’s body, much like eyeglasses can assist our vision. “Imaging services are the eyes of medicine, and preserving our vision is an essential component to providing care,” he adds.

The shortage is being caused by the temporary shutdown of a GE Healthcare production facility for ICM in Shanghai, China, due to a COVID-19 lockdown. The company is one of the major contrast media manufacturers, alongside Bracco, Bayer, and Guerbet. “When that plant was shut down, GE was suddenly unable to meet the supply-demand of its existing customers,” Matthew Davenport, MD, FACR, vice-chair of the American College of Radiology (ACR) Commission on Quality and Safety, told Health.


“They have since moved up the production capability in their facility in Cork, Ireland, and began airlifting contrast media to the United States. Nonetheless, there’s still an acute supply chain shortage,” said Dr. Davenport. He added that GE has informed that a level of normalcy should be reached by June 30, but considering the backlog and potential shipping challenges the crisis could continue throughout the summer.

Affected Hospitals and Health Systems
The shortage is affecting all hospitals that relied on GE Healthcare as their preferred vendor. According to Dr. Davenport, most health systems have agreements to buy contrast from specific manufacturers. “Any place that had preferred vendor contracting with GE was massively affected because they didn’t have any redundancy in their supply,” he said.
 
The extent to which each institution will be impacted also depends on how much stockpile of ICM they had before the shortage. “I’m familiar with some institutions which had a pretty large stockpile, so they’re going to be able to ride this out without too much effect,” said Dr. Davenport. “Others do not have much contrast available, and they will not necessarily make it to the end of the shortage. So, it is a serious issue.”
Mitigation Strategies
In an attempt to avoid a situation where the contrast media simply runs out, institutions around the country are adopting strategies to reduce its use to the minimum amount necessary. The ACR recently released a statement recommending a series of mitigation strategies.
The committee includes using alternative exams that don’t require ICM, such as magnetic resonance imaging (MRI) or ultrasound. In certain cases, providers may opt to perform a CT scan without contrast.
“Appendicitis is a good example,” said Dr. Allen. “We routinely scan the patient with contrast to identify if they have appendicitis. It can increase the sensitivity and specificity of the exam. But we can also identify it on a non-contrast CT exam.”
It is also possible to reduce the dose of contrast based on the patient’s weight. Another measure that has been adopted is to repackage contrast media into smaller volumes to eliminate waste. Non-urgent exams and procedures may also be postponed.
According to Dr. Allen, he and his colleagues at the Vanderbilt University Medical Center immediately formed a radiology command center to develop a series of tactics to handle the shortage when they were first alerted. The changes, according to an article accepted for publication by the Journal of the American College of Radiology, reduced contrast usage by about 50% in less than seven days at their health system.
 
“The big thing is that we want to make sure we have contrast for our most critically ill patients to perform life-saving imaging or procedures that require contrast,” said Dr. Allen. The use of ICM is indispensable, for example, in cases of stroke, when it is used to diagnose the condition through a CT scan and to potentially treat it through neurointervention. Contrast is also necessary in cases of a heart attack during cardiac catheterization, a procedure that is used both to diagnose and treat the condition.
Impact on Patients
With these measures in place, patients with scheduled exams or procedures may get a call from their hospital to postpone their appointment. Or they may learn they will undergo a different imaging technique than what was originally planned.
“These decisions are being made thoughtfully by physicians and other health care providers who have the patient’s best interests in mind,” said Dr. Davenport. “They never want to be in the situation where they have to make these decisions, but they’re doing it in a way that is as thoughtful as possible and putting the patient first. So, I think there is some amount of reassurance to this.” Dr. Davenport noted that it is always a good idea to talk to your health care provider to discuss the alternatives.
“Because your examination is altered from what it was originally scheduled to be, it does not mean that your care will be any less,” added Dr. Allen. “We will not sacrifice our patients’ care. Just be cognizant that you may have been scheduled for one exam, and you may be contacted and instructed that you’re going to get an alternate exam to find an answer to the same problem.”

As the Delta variant courses through New York City, many young Black New Yorkers remain distrustful of the vaccine.

A construction site safety manager in Queens said that as a Black man, he was more worried about the prospect of being stopped by the police than he was about getting Covid-19.

A graduate student in the Bronx who had not gotten vaccinated said her worst fears seemed confirmed when a vaccine that the government was directing to Black and poorer neighborhoods was briefly suspended over a small number of dangerous blood clots.

And a civil rights activist in the Bronx said he grew suspicious when he heard last year that politicians were prioritizing minority neighborhoods for coronavirus vaccinations.

“Since when does America give anything good to Black people first?” said the activist, Hawk Newsome, a 44-year-old Black Lives Matter leader who is unvaccinated.

All three situations reflect a trend that has become a major concern to public health experts: Young Black New Yorkers are especially reluctant to get vaccinated, even as the Delta variant is rapidly spreading among their ranks. City data shows that only 27 percent of Black New Yorkers ages 18 to 44 years are fully vaccinated, compared with 48 percent of Latino residents and 52 percent of white residents in that age group.

This vaccination gap is emerging as the latest stark racial disparity in an epidemic full of them. Epidemiologists say they expect this third wave will hit Black New Yorkers especially hard.

“This is a major public health failure,” said Dr. Dustin Duncan, an epidemiologist and Columbia University professor.

In interviews, dozens of Black New Yorkers across the city — an aspiring dancer in Brownsville, a young mother of five in Far Rockaway, a teacher in Canarsie, a Black Lives Matter activist in the Bronx, and many others — gave a long list of reasons for not getting vaccinated, many rooted in a fear that during these uncertain times they could not trust the government with their health.

The fact that the virus hit Black neighborhoods disproportionately during the first wave made

many extra wary of getting vaccinated: They feel that they have survived the worst and that the health authorities had failed to help them then.

But ultimately, many also said they would get vaccinated if forced to do so.

“If it’s going to be mandatory to work, I’ll have no choice,” said Kaleshia Sostre, a 27-year-old from Red Hook, Brooklyn, who teaches parenting classes to young mothers.

In Canarsie, Brooklyn, a 21-year-old college student, Justin Mercado, said Mayor Bill de Blasio’s recent announcement that dining in a restaurant would require proof of vaccination got his attention. He is now likely to get vaccinated.

“I want to go on a date sometime and enjoy life as much as I can before this strain shuts us back down,” Mr. Mercado said.

For months, the city had focused its vaccination campaign on older residents who are at higher risk of hospitalization and death.

But lately the city has begun to reach out more to young New Yorkers, offering $100 payments for first doses, urging students to get vaccinated before school starts and nudging employers to pressure their employees to get vaccinated.

“We’re not done yet,” said Dr. Torian Easterling, the chief equity officer of the New York City Health Department. “We’re continuing to announce more interventions and more strategies to support New Yorkers getting vaccinated.”

In interviews, Black men and women said that much of their distrust of the coronavirus vaccine was shaped by their own experiences with discrimination or their identity as Black Americans.

“I’m supposed to worry about getting sick when I go outside, versus getting killed by a cop or something like that?” said Jayson Clemons, 41, the construction site safety manager from Queens. After years of trying to be careful not to give the police a reason to stop him — avoiding cars with window tint or rims, and making sure when commuting that his attire clearly marked him as a construction worker — he said he refused to be preoccupied by Covid-19.

He said he would rather put his trust in masks and hand sanitizer — which he credits with keeping him healthy as he worked at construction sites throughout the pandemic — than a new vaccine that the government is pushing people to take. “They came out with one so fast for Covid, and now they want to pay you to take it,” he said. “It seems fishy.”

Some Black women described the need they felt to conduct their own research — and ask around — before deciding if the coronavirus vaccine was safe.

“It takes a little bit of hyper-vigilance when you’re a woman of color,” said Jazmine Shavuo-Goodwin, 31, who believes she encountered medical racism when doctors were dismissive of her severe stomach problems. “There’s a lot of homework you have to do, because your doctors may not truly listen to you, to your full complaint, before they’ve already diagnosed you.”

Ms. Shavuo-Goodwin helps manage dental clinics for Medicaid patients and is studying to be a clinical therapist. Both her job and school require her to be vaccinated against coronavirus, but she has yet to get a shot.

“I’m out of compliance,” said Ms. Shavuo-Goodwin, who is Black and lives in the South Bronx. “I have done heaps of research looking for things that would make me confident and comfortable getting the vaccine, but honestly I haven’t.”

All three vaccines being used in the United States have received an emergency authorization from the Federal Drug Administration. At least one of the vaccines is expected to get full approval by the fall.

When the vaccination campaign began last year, Mr. de Blasio said he intended to prioritize the same Black and Latino neighborhoods that were hardest hit during the devastating initial wave.

Covid-19 vaccine side effects, explained

What’s now clear: an injection with either vaccine, both of which use mRNA technology, can feel more intense than other routine vaccinations (such as the flu shot) — with side effects for some recipients such as pain, headache, and fatigue. And this may be especially true for Moderna’s vaccine: About 16 percent of people who got the shot in clinical trials experienced a “severe” adverse reaction, a classification the FDA uses to refer to side effects that require medical attention and prevent people from going about their daily activities.
“We should anticipate that if you got vaccinated that day, you may not want to go to work,” Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College, said of the vaccines. That’s why health systems are being warned to stagger immunizing their workforces, to avoid “potential clustering of worker absenteeism,” as the vaccine expert group advising the Centers for Disease Control and Prevention (CDC) put it.
These side effects are known as reactogenicity, and vaccine developers and regulators allow for some level of reactogenicity in all approved vaccines. They can be a sign of the body’s immune response kicking into gear, said Saad Omer, director of the Yale Institute for Global Health.

After months of waiting, we finally have detailed information on the safety and efficacy of the first Covid-19 vaccines that will be distributed in America.
On Thursday, a committee that advises the Food and Drug Administration will meet to determine whether the Moderna vaccine should get an emergency use authorization. Ahead of the decision, the agency shared the most comprehensive data to date on what we know about the shot. The same process happened last week with the Pfizer/BioNTech vaccine, which is now being rolled out across America following an EUA Friday night.
While both vaccines had already been shown to be highly effective, the new data provides a much more granular picture of their side effects and safety profiles.

“Think about [reactogenicity] as mouth wash — it’s hurting while it’s working,” Omer said. “The key is to prepare people to know this will happen — this may hurt a little, give you a bit of fever — but these are short-term, known side effects that you need to be aware of.”
The stakes for clearly communicating information about each vaccine’s risks and benefits are high: More than a quarter of Americans reported that they would probably or definitely refuse to take a Covid-19 vaccine, according to a late-summer survey by the Kaiser Family Foundation, even if it were freely available and deemed safe by regulators. And with the pandemic spreading further and faster in America than just about anywhere else in the world, it’s critical that people don’t feel caught off guard by the side effects or spread misinformation about the vaccine.
To achieve that, transparency is key, said Brendan Nyhan, a Dartmouth professor of political science who has been thinking about how to build trust in the Covid-19 vaccines. “Millions of people are going to get this vaccine and we know huge numbers of people are going to have normal side effects, which are often indicating that the vaccine is working. We want to build trust with people so there are no surprises when that happens.”
In that spirit, here’s what we know about the side effects of these two shots and how to think about them.
What mild and moderate side effects really mean
Before we get into the weeds, it’s helpful to understand how these companies classify side effects in the first place. In general, vaccine developers seeking approval in the US market use the FDA’s “toxicity assessment scale” to grade side effects and other adverse events from 1 to 4, from mild and moderate to severe and life-threatening.
Grade 1 “mild” side effects are generally easily tolerated and don’t interfere with a person’s regular activities. Grade 2 “moderate” effects may interfere with regular activities, grade 3 “severe” effects are incapacitating and need medical attention, and grade 4 are “potentially life-threatening,” usually requiring an emergency room visit or hospitalization. Let’s use the example of headache following vaccination. Here’s how the FDA would classify it:
Mild: “No interference with activity”

Moderate: “Repeated use of nonnarcotic pain reliever > 24 hours or some interference with activity”
Severe: “Any use of narcotic pain reliever or prevents daily activity”
Potentially life-threatening: “ER visit or hospitalization”
So a mild side effect is one you’d notice but doesn’t require any special care or keep you from living your life; a moderate side effect can keep you home from work but doesn’t warrant medical intervention; severe adverse events require medical care and definitely interfere with your normal life; and potentially life-threatening is just what it sounds like and usually involves a visit to or stay in the hospital.
In vaccine studies, these events are broken down into “local” reactions (meaning they’re specific to one part of the body, like pain or tenderness where the vaccine is injected) and “systemic,” whole-body reactions (like fever or fatigue).

For a vaccine to win FDA approval, any reactions people have during clinical trials have to be mostly mild and moderate. And that’s because the safety bar for vaccines is really high, even compared to medicines.

Vaccines “are given to healthy people who have in many cases absolutely nothing wrong with them. And we are talking about [giving them] to literally billions of people. Even rare side effects if they’re serious matter enormously,” said Charles Weijer, a professor of medicine and an ethicist at Western University in Alberta, Canada. “We’re more willing to accept adverse effects [with drugs], provided those are counterbalanced by benefits to the patient.”
Mostly mild and moderate side effects: that’s the safety profiles of both the Moderna and Pfizer/BioNTech vaccines — and that’s why the FDA in the US, and drug regulators in other countries around the world, are rushing to bring them to market. But there are important differences between the two vaccines.
What we know about Moderna and Pfizer/BioNTech side effects
Now, let’s look at the best data we’ve got on the vaccines. It comes from the FDA’s analyses of phase 2 and 3 clinical trials ahead of their emergency use authorization meetings on December 10 for Pfizer/BioNTech and December 17 for Moderna. (The companies also released their own data but we focused on the agency’s independent reviews here.)
The reviews show the vaccines are both safe and that they’re wildly successful at preventing Covid-19 infections (with about a 95 percent efficacy rate). That’s important at a time when more than 3,000 Americans are dying from Covid-19 each day on average.
They also give a sense of what side effects we might expect when these are rolled out. The Pfizer/BioNTech vaccine caused mild or moderate reactions in most people, but severe reactions were rare. Moderna didn’t share the details of its vaccine trial’s mild and moderate side effects, but the FDA said mild and moderate is how they’d characterize the bulk of them. A key difference with the Moderna vaccine, however, is that we know severe reactions were more common in the trials.
Let’s get into what this means, but with a couple of caveats first. Because we have no head-to-head study of the two vaccines and the companies haven’t reported side effect data in the same way, doing apples-to-apples comparisons is tricky, said Hilda Bastian, an expert in reading medical evidence who has been analyzing the coronavirus vaccine data. The vaccines also come in different doses: 30µg in the case of Pfizer/BioNTech and 100µg with Moderna. While they’re supposed to be delivered in two shots per person, the time intervals are different: the Pfizer/BioNTech shots are three weeks apart and Moderna’s are four weeks.
Pfizer/BioNTech and Moderna also tested their products on different populations. “Some of the differences affect risks and so could be affecting outcomes,” said Bastian. For example, there were more people of Hispanic/Latino background and with chronic lung disease in the Pfizer/BioNTech trial than the Moderna trial, she added. And in the real world, when the vaccines roll out to millions, the side effects may again look different.
With all that in mind, here’s what we know about each shot. For Pfizer/BioNTech the most common side effects overall, according to the FDA’s analysis of the data, were local reactions at the site of injection (including pain, redness, swelling), fatigue, headache, muscle pain, chills, joint pain, and fever. Again, these were mostly classified as mild or moderate. Severe reactions, meanwhile, were rare — occurring in 0 to 4.6 percent of participants, depending on the specific side effect. (There were no severe fevers reported, for example, but 4.6 percent of the age 18-55 study participants experienced severe fatigue after the second dose of the vaccine.)
In general, side effects popped up more after the second dose than the first. They also happened less frequently in people 55 and younger, the FDA said. You can see the breakdown of adverse events data in younger adults (18-55) in the chart below following dose 1, and if you click through, following dose 2. (Note: Pfizer/BioNTech found no potentially life-threatening (grade 4) adverse reactions linked to the vaccine in the population they analyzed for safety.) READ MORE: https://apple.news/AZvmcYrtKQWObJ00qk6feuw

One day, many realities, as COVID-19 cuts an uneven swath across L.A.

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The pandemic may have slowed the city, but it hasn’t stopped it.

Starting well before dawn, essential workers toil at factories and markets and restaurants. Some remain deep into the night; the lucky ones work from home. Parks and beaches and hiking trails beckon those desperate for a break.

But COVID-19 has not been an equal-opportunity scourge. Those who see no choice but to work outside their homes are far more exposed than those who have the luxury of sheltering in place. Those in crowded households are far more likely to fall ill than those who live alone or in small families.

A Times analysis, based on Los Angeles County data, shows that someone living in the heavily immigrant Pico-Union neighborhood, for example, is seven times more likely to contract the disease — and 35 times more likely to die — than someone in relatively affluent Agoura Hills.

The Times sent reporters across the city to capture one day, Wednesday, in the life of the coronavirus pandemic. Here is what they found:

4 a.m. | Los Angeles Flower Mart

Sunrise Wholesale Flowers at The Original Los Angeles Flower Market

Most of Los Angeles was still asleep, but the heart of L.A.’s flower district on Wall Street was already full of life — of both the human and plant variety — a cacophony of color. Buckets of lilies, roses, baby’s breath, chrysanthemums, sunflowers, hydrangeas and daisies were being carted through the cavernous Original Los Angeles Flower Market.

The market reopened May 7 after being shut for two months due to COVID-19.

“We are all adjusting to the new norm,” said Qiana Rivera, as she separated bunches of green fronds. One of the market’s vendors, Rivera is grateful to be back at work. “It was so nice to come back and see our regular customers.”

But it’s been challenging too. Many vendors, like David Ramirez, say business has suffered tremendously. Ramirez is barely breaking even: “We are just trying to survive,” he said.

Summer is typically peak wedding season, a lucrative time for the flower market, but most gatherings and celebrations have been postponed or canceled. “This should be a good season for us, but we are really struggling,” Ramirez said.

It’s not just the sellers who are having difficulties. During the two-month shutdown, growers across California threw out thousands of flowers and lost millions of dollars.

Many Flower Market customers are florists doing their best to drum up work despite the decline in events, but individual shoppers have also begun to visit the market again too.

Charlotte Redmond, a phlebotomist who is now testing people for COVID-19, stopped by before work.

She was browsing the house plants, looking for pothos and air plants. “Testing for COVID all day is wearing me out,” Redmond said. “My happy place is my garden now — the plants make me feel peaceful.”

Not wearing a mask makes you selfish, not an independent-thinker

At this moment COVID-19 is ravaging the United States like, well…a disease during a pandemic, and it’s all because a bunch of whiny, selfish, disillusioned, wannabe “patriots” refuse to wear masks. Part of the reason for this is because 30+ years of Fox News has created a large swath of the populace who believes: Science isn’t real, affordable health care isn’t for everyone and “personal freedom” is more important than the greater good. The failure of the Trump administration to act like grownups and handle this thing like they actually give a damn about Americans can’t be stressed enough, but that’s an entirely different article. Right now, I’d like to break things down for the people who continue to insist that the economy be ruined and hundreds of thousands of people die, just because they don’t want to be very minorly inconvenienced.

Quite simply put, not wearing a mask makes you a bad person. It doesn’t make you a patriot. It doesn’t make you an independent thinker. It isn’t you totally showing those “libtards.” It just means that you genuinely don’t care about anyone other than yourself. Let me explain.

First off, the science is incredibly damning. It has been proven repeatedly by scientists and health care professionals that wearing a mask stops you from spreading the disease, which is especially important since many people who have it are asymptomatic. But for those of you who really only care about yourselves, I’ve got good news: The Los Angeles Times reported recently that masks offer much more protection against coronavirus than we previously thought.

The Washington Post helped put this in perspective earlier this week when they explained that the populations of Britain, Germany, Japan, and South Korea are roughly the equivalent of the United States. Collectively those countries had 1,205 confirmed new cases of COVID on Sunday, whereas the U.S. had 58,349 on that same day. This terrifyingly vast chasm is due to people in the U.S. disregarding masks, social distancing, testing and contact tracing.

But enough about facts, since, if you’re an anti-masker you obviously don’t care about pesky things like that. Let’s talk about your feelings instead.

If you genuinely care about being a patriot, then how could you not wear a mask? Patriotism is about being willing to make sacrifices for something greater than yourself.

If you’re an “All Lives Matter” person, how is not wearing a mask doing anything to protect any lives at all?

If you believe that wearing a mask is bad for you, why do surgeons wear them during surgery and why do special ops soldiers wear them on missions?

Even if there’s just a 5 percent chance that masks work, isn’t that enough for you to be mildly inconvenienced?

It takes so little to be part of the solution to this cataclysm right now. No one is asking you to hide Jews in your attic or escaped slaves in your basement. You don’t have to sit in a trench for months or parachute behind enemy lines. You don’t have to strike for fair labor practices or fight to integrate schools. You just have to wear a damn mask. That’s all you have to do to save hundreds of thousands of lives and businesses. You can do it and still wear sweatpants.

So please, wear your damn mask so we can get things back to normal-ish soon.

This kind of mask can actually spread the coronavirus. Here’s how to fix it

SAN FRANCISCO — 

There’s a certain kind of N95 mask that’s actually bad to wear for public health during the coronavirus pandemic.

San Francisco’s health officer warns that N95 masks with a vent on them actually cause a person’s germs to spread, rather than containing them close to the wearer’s face.

The warning is in the San Francisco health order, which says that any mask with a one-way valve — designed to facilitate easy exhaling — “allows droplets to be released from the mask, putting others nearby at risk.”

“As a result, these masks are not a face covering under this order and must not be used to comply with this order’s requirements,” said the health order, signed by Dr. Tomás Aragón, the health officer for San Francisco.

Exhalation vents can make the face cooler and reduce moisture buildup inside a face covering, the U.S. Centers for Disease Control and Prevention said — but the vents allow unfiltered exhaled air to escape. That defeats the point of wearing a mask, which is to keep potentially infectious oral droplets from spraying outward to other people.

To convert the N95 masks that have vent holes in the front, simply place a piece of tape over the external vent to cover it, health experts said.

As many as 20% to 50% of people infected with the coronavirus may never show severe signs of illness yet can still infect others. That’s why, health officials say, it’s so important to wear masks to keep the pandemic under control. It’s no coincidence that many nations that haven’t seen a sustained, out-of-control spread of the coronavirus have a public that universally wears masks when outside of the home, experts say.

San Francisco and other health officials around the country have urged the public to wear cloth face coverings to reduce the spread of the coronavirus. A couple dozen California counties require the wearing of face masks while in public — including Los Angeles, San Diego and Sacramento counties, as well as the nine-county San Francisco Bay Area — while other areas have made it a recommendation.

But there has been a backlash in a number of California counties, and officials have rescinded requirements to wear a mask. The latest to do so was Orange County, California’s third most populous county.

In general, officials suggest members of the public wear cloth face coverings, rather than N95 and surgical face masks that should be reserved for healthcare workers.

“If you are currently using a medical mask, keep using it as long as you can. Only throw it away when it gets dirty or damaged,” the San Francisco health department said.

The End of Meat Is Here

Is any panic more primitive than the one prompted by the thought of empty grocery store shelves? Is any relief more primitive than the one provided by comfort food?

Most everyone has been doing more cooking these days, more documenting of the cooking, and more thinking about food in general. The combination of meat shortages and President Trump’s decision to order slaughterhouses open despite the protestations of endangered workers has inspired many Americans to consider just how essential meat is.

Is it more essential than the lives of the working poor who labor to produce it? It seems so. An astonishing six out of 10 counties that the White House itself identified as coronavirus hot spots are home to the very slaughterhouses the president ordered open.

In Sioux Falls, S.D., the Smithfield pork plant, which produces some 5 percent of the country’s pork, is one of the largest hot spots in the nation. A Tyson plant in Perry, Iowa, had 730 cases of the coronavirus — nearly 60 percent of its employees. At another Tyson plant, in Waterloo, Iowa, there were 1,031 reported cases among about 2,800 workers.

Sick workers mean plant shutdowns, which has led to a backlog of animals. Some farmers are injecting pregnant sows to cause abortions. Others are forced to euthanize their animals, often by gassing or shooting them. It’s gotten bad enough that Senator Chuck Grassley, an Iowa Republican, has asked the Trump administration to provide mental health resources to hog farmers.

Despite this grisly reality — and the widely reported effects of the factory-farm industry on America’s lands, communities, animals and human health long before this pandemic hit — only around half of Americans say they are trying to reduce their meat consumption. Meat is embedded in our culture and personal histories in ways that matter too much, from the Thanksgiving turkey to the ballpark hot dog. Meat comes with uniquely wonderful smells and tastes, with satisfactions that can almost feel like home itself. And what, if not the feeling of home, is essential?

And yet, an increasing number of people sense the inevitability of impending change.

Animal agriculture is now recognized as a leading cause of global warming. According to The Economist, a quarter of Americans between the ages of 25 and 34 say they are vegetarians or vegans, which is perhaps one reason sales of plant-based “meats” have skyrocketed, with Impossible and Beyond Burgers available everywhere from Whole Foods to White Castle.

Our hand has been reaching for the doorknob for the last few years. Covid-19 has kicked open the door.

At the very least it has forced us to look. When it comes to a subject as inconvenient as meat, it is tempting to pretend unambiguous science is advocacy, to find solace in exceptions that could never be scaled and to speak about our world as if it were theoretical.

Some of the most thoughtful people I know find ways not to give the problems of animal agriculture any thought, just as I find ways to avoid thinking about climate change and income inequality, not to mention the paradoxes in my own eating life. One of the unexpected side effects of these months of sheltering in place is that it’s hard not to think about the things that are essential to who we are.

We cannot protect our environment while continuing to eat meat regularly. This is not a refutable perspective, but a banal truism. Whether they become Whoppers or boutique grass-fed steaks, cows produce an enormous amount of greenhouse gas. If cows were a country, they would be the third-largest greenhouse gas emitter in the world.

According to the research director of Project Drawdown — a nonprofit organization dedicated to modeling solutions to address climate change — eating a plant-based diet is “the most important contribution every individual can make to reversing global warming.”

Americans overwhelmingly accept the science of climate change. A majority of both Republicans and Democrats say that the United States should have remained in the Paris climate accord. We don’t need new information, and we don’t need new values. We only need to walk through the open door.

We cannot claim to care about the humane treatment of animals while continuing to eat meat regularly. The farming system we rely on is woven through with misery. Modern chickens have been so genetically modified that their very bodies have become prisons of pain even if we open their cages. Turkeys are bred to be so obese that they are incapable of reproducing without artificial insemination. Mother cows have their calves ripped from them before weaning, resulting in acute distress we can hear in their wails and empirically measure through the cortisol in their bodies.

No label or certification can avoid these kinds of cruelty. We don’t need any animal rights activist waving a finger at us. We don’t need to be convinced of anything we don’t already know. We need to listen to ourselves. We cannot protect against pandemics while continuing to eat meat regularly. Much attention has been paid to wet markets, but factory farms, specifically poultry farms, are a more important breeding ground for pandemics. Further, the C.D.C. reports that three out of four new or emerging infectious diseases are zoonotic — the result of our broken relationship with animals.

It goes without saying that we want to be safe. We know how to make ourselves safer. But wanting and knowing are not enough.

These are not my or anyone’s opinions, despite a tendency to publish this information in opinion sections. And the answers to the most common responses raised by any serious questioning of animal agriculture aren’t opinions.

Don’t we need animal protein? No.

We can live longer, healthier lives without it. Most American adults eat roughly twice the recommended intake of protein — including vegetarians, who consume 70 percent more than they need. People who eat diets high in animal protein are more likely to die of heart disease, diabetes and kidney failure. Of course, meat, like cake, can be part of a healthy diet. But no sound nutritionist would recommend eating cake too often.

If we let the factory-farm system collapse, won’t farmers suffer? No.

The corporations that speak in their name while exploiting them will. There are fewer American farmers today than there were during the Civil War, despite America’s population being nearly 11 times greater. This is not an accident, but a business model. The ultimate dream of the animal-agriculture industrial complex is for “farms” to be fully automated. Transitioning toward plant-based foods and sustainable farming practices would create many more jobs than it would end.

Don’t take my word for it. Ask a farmer if he or she would be happy to see the end of factory farming.

Isn’t a movement away from meat elitist? No.

A 2015 study found that a vegetarian diet is $750 a year cheaper than a meat-based diet. People of color disproportionately self-identify as vegetarian and disproportionately are victims of factory farming’s brutality. The slaughterhouse employees currently being put at risk to satisfy our taste for meat are overwhelmingly brown and black. Suggesting that a cheaper, healthier, less exploitative way of farming is elitist is in fact a piece of industry propaganda.

READ MORE: https://www.nytimes.com/2020/05/21/opinion/coronavirus-meat-vegetarianism.html?action=click&module=Opinion&pgtype=Homepage

American vandal: Trump reveals our staggering incompetence before the whole world Now the country that planned D-Day can’t handle delivering medical supplies — and it’s not just about Trump

Since the day after Donald J. Trump as elected in 2016, I’ve been fretting about the effect of his obvious unfitness and incompetence for the “world order” as we have known it. I’ve made clear that I don’t believe there’s any reason why the U.S. should be the perpetual guarantor of security for half the world, nor is it forever obligated to provide some kind of Pax Americana. That was a consequence of America’s unique position after World War II, having had the good fortune to escape the destruction of our homeland, which left us in the position of the last country standing. To our credit (and for our own profit) we did handle the aftermath of that war more competently than the world handled the aftermath of World War I.

But it has been clear to me from the moment Donald Trump came down that elevator that if he won, the world order as we knew it, which was already unstable, was going to be turned upside down with no coherent plan to replace it. His one simple understanding of the world was that he, and the United States, have been treated unfairly. Of course, nothing could be further from the truth. America and Donald Trump had it all.

Throughout the Cold War and the red-baiting and the military adventurism and the overweening self-regard that we assumed was our right as the Leader of the Free World, we managed to do a lot of things wrong and the price for that has been high. This is true even though, as Salon’s Andrew O’Hehir wrote in this searing account of America’s precipitous decline as revealed by the coronavirus, the American people hardly noticed:

We have an ingrained national tendency to behave as if the rest of the world simply doesn’t exist — or, on a slightly more sophisticated level, as if it were just a colorful backdrop for our vastly more important national dramas.

O’Hehir rightly observes that empires inevitably collapse, but America’s almost childlike inability to admit it even is an empire, even as it crumbles, may be unique in human history.

Still, for all its myopic arrogance, the one thing America clearly did right — and was justifiably proud of — was to create a technologically advanced society that was the envy of the world. For all our faults, Americans knew how to do things. We could get the job done.

Now the country that sent men to the moon and brought them home again, all the way back in the 1960s, is a fumbling mess, unable to manage the simple logistics of getting supplies from one place to another or coordinating a national set of guidelines in a public health crisis. The vaunted CDC, long thought of as the greatest scientific disease research facility in the world, fumbled in making a test that had already been produced in other countries.

Donald Trump is a completely incompetent leader — we know this. Literally any other president would have done a better job. He couldn’t accept that the crisis was real and that his “plan” to spend the year holding fun rallies and smearing his Democratic rival was going to be interrupted by his duties as president. So he lived in denial until the situation was completely out of hand. Other leaders would have listened to experts and pulled together a team that knew how to organize a national response. And no other president would be so witless as to waste precious time and resources with magical thinking about quick miracle cures.

But it’s not just him, is it? The U.S. government seems to have lost its capacity to act, and the private sector is so invested in short-term profit-making that it’s lost its innovative edge. The result is that the United States of America, formerly the world’s leader in science and technology, now only leads the world in gruesome statistics and body counts.

It’s still unclear exactly why the CDC felt it had to make its own test when another test, created by a German lab, was already available. According to those in the know, Americans just don’t use tests from other countries, ostensibly because our “standards” are so high. Apparently, they aren’t. In this case, the test we created was faulty, causing weeks of delay, and there was some kind of contamination in the lab. How can this be?

The government’s inefficiency and ineptitude in producing, locating and distributing needed medical supplies, combined with Trumpian corrupt patronage toward his favored states, is staggering. Stories of FEMA commandeering shipments of gear that were already paid for by states, and governors having to bid against each other for supplies because the federal government refused to use its power to take control in a global emergency, are simply astonishing. The country that planned the D-Day invasion is incapable of coordinating the delivery of medical supplies to New York City?

Apparently so. And the world is watching. The New York Times’ Michelle Goldberg wrote:

“If you look at why America rose so much after 1945, it was because America attracted the best scientists in the world,” Klaus Scharioth, Germany’s ambassador to America from 2006 to 2011, told me. “America attracted expertise. You had the feeling that all governments, be they Republicans or Democrats, they cherished expertise.” Like many Americanophiles abroad, Scharioth has watched our country’s devolution with great sadness: “I would not have imagined that in my lifetime I would see that.”

Sen. Tom Cotton of Arkansas, a rising Republican leader, evidently wants to ensure that American never attracts any expertise again:

If Chinese students want to come here and study Shakespeare and the Federalist Papers, that’s what they need to learn from America. They don’t need to learn quantum computing. It is a scandal to me that we have trained so many of the Chinese Communist Party’s brightest minds.

The rest of the world is moving on without us. This week 20 global leaders held a conference call pledging to “accelerate cooperation on a coronavirus vaccine and to share research, treatment and medicines across the globe.” No one from the United States was among them.

Why bother? No U.S. pledge of any kind is worth the paper it’s printed on and in any case, the U.S. is clearly unwilling to work cooperatively with the rest of the world anymore, even in a global catastrophe.

I think this says it all:

This pandemic is the first real global threat of the 21st century. It won’t be the last. These are the kinds of great, unprecedented challenges we are going to face going forward. Not only is the U.S. not leading the response, it’s barely participating in it.

The election of Donald Trump was about more than just this presidency. It signaled that America was no longer capable of competently governing itself, much less leading the world. Our devastatingly disorganized, scattershot response to the COVID-19 crisis has revealed that this problem goes much deeper than our politics. We couldn’t have lost our ability to do anything right at a worse time.

SOURCE:https://www.salon.com/2020/04/27/american-vandal-trump-reveals-our-staggering-incompetence-before-the-whole-world/

Are Face Masks the New Condoms?

If people with no symptoms are spreading the coronavirus, as some studies suggest, it may be time to give face masks the kind of advertising and promotion that support condoms as lifesavers.

Are face masks going to become like condoms — ubiquitous, sometimes fashionable, promoted with public service announcements? They should be, one virus researcher says, if early indications are correct in suggesting that Covid-19 is often spread by people who feel healthy and show no symptoms.

David O’Connor, who studies viral disease at the University of Wisconsin-Madison, said: “If a substantial amount of transmission occurs before people feel sick, how do you stop that? By the time people feel sick and seek care, all the testing and isolation in the world would be too little, too late.”

Dr. O’Connor, who researches H.I.V. and other viruses, including the new coronavirus, said some recent research had shifted his thinking about the current pandemic.

“H.I.V. is also spread while people feel fine,” he wrote in an email, “and consistent, correct condom use is a barrier to sexual virus transmission that works.”

READ MORE: https://www.nytimes.com/2020/04/18/health/coronavirus-mask-condom.html?action=click&module=Well&pgtype=Homepage&section=Health