Tuesday, April 12, 2022

MOST LUNG CANCER VICTIMS NEVER SMOKED
Some smokers develop genetic defenses against lung cancer, study finds


Researchers may have discovered why only some smokers develop lung cancer. 

Photo by Myriams-Fotos/Pixabay

April 11 (UPI) -- Some cigarette smokers may have genes that protect them from the genetic mutations that cause lung cancer, a study published Monday by Nature Genetics found.

The analysis of the cells lining the lungs of both smokers and non-smokers, both with and without lung cancer, found that smokers had more of the genetic mutations that cause lung cancer even if they do not develop the disease, the data showed.

However, while the number of genetic mutations detected in lung cells increased in parallel with the amount and length of time people smoked, this increase stopped at a certain point -- 23 "pack-years," which equates to smoking one pack per day of cigarettes for 23 years, the researchers said.

This suggests that some long-time, heavy smokers are able to "suppress further mutation accumulation" because they have "proficient systems for repairing DNA damage or detoxifying cigarette smoke," study co-author Dr. Simon Spivack said.

RELATED Tobacco use declined among U.S. adults in 2020, CDC reports

Still, whether some smokers can indeed develop this protection and how they do so, needs to be confirmed in larger studies, he said.

"Some heavy smokers may develop resistance to these genetic mutations or inherit resistance to these mutations," Spivack, a professor of medicine, epidemiology and population health and genetics at Albert Einstein College of Medicine in New York City and a pulmonologist at Montefiore Health System, told UPI in a phone interview.

"However, this doesn't mean it's safe for some people to smoke -- we know the more people smoke, the more risk you have for developing lung cancer," he said.


RELATED Study: White people more likely than Black people to be screened for lung cancer

Nearly 240,000 people in the United States will be diagnosed with lung cancer this year, about 80% of them smokers, the American Cancer Society estimates.

However, although the majority of lung cancer cases involve smokers, not all smokers develop lung cancer, Spivack and his colleagues said.

About 13% of adults in the United States are active smokers, the lowest level since the 1960s, according to the Centers for Disease Control and Prevention.

RELATED Lung cancer screening has saved more than 10,000 lives in the U.S.

For this study, Spivack and his colleagues used a technology called single-cell multiple displacement amplification, which was developed by Einstein College of Medicine researcher Jan Vijg, and allows for genetic analysis of individual cells.

They used the approach to assess lung epithelial cells, or those lining the walls of the lungs, in 14 "never-smokers" ages 11 to 86 years and 19 smokers ages 44 to 81 years. The cells were collected from patients who were undergoing bronchoscopy for diagnostic tests unrelated to cancer, according to the researchers.

The analysis revealed that genetic mutations accumulated in the lung cells of both non-smokers and smokers as they age, the data showed.

"Age increases these mutations in everybody and smoking further increases them, even if you don't develop lung cancer" Spivack told UPI.

However, significantly more mutations were found in the lung cells of the smokers in the study, the researchers said.

The number of cell mutations detected in lung cells increased along with the number of pack years of smoking, with one pack-year equating to one pack of cigarettes smoked per day for one year, they said.

Still, the rise in genetic mutations in lung cells stopped after the 23 pack-years of exposure.

The findings could help identify smokers who are at higher risk for lung cancer and thus warrant close monitoring, the researchers said.

" We don't yet know whether or not our findings will inform future diagnosis or treatment of lung cancer, but it is a step in the right direction," Spivack said.


CDC to begin month-long full agency review amid criticism over COVID-19 response


CDC Director Dr. Rochelle P. Walensky testifies before the House COVID-19 subcommittee at the U.S. Capitol in Washington on April 15, 2021. 
File Photo by Amr Alfiky/UPI | License Photo

April 11 (UPI) -- The Centers for Disease Control and Prevention will begin a month-long review and evaluation of the agency on Monday over its response to the COVID-19 pandemic.

Jim Macrae, who served as acting administrator of the Health Resources and Services Administration for two years, will conduct the comprehensive review of the agency, which has been scrutinized for its handling of the outbreak.

CDC Director Dr. Rochelle Walensky also selected three senior officials -- acting Principal Deputy Director Deb Houry, Chief Operating Officer Robin Baily and Chief of Staff Sherri Berger -- to gather feedback and solicit suggestions.

"Over the past year, I have heard from many of you that you would like to see CDC build on its rich history and modernize for the world around us," Walensky wrote in an agency-wide email announcing the review last week.

RELATED COVID-19 worldwide down to around million cases, 3,500 deaths per day

"I am grateful for your efforts to lean into the hard work of transforming CDC for the better. I look forward to our collective efforts to position CDC and the public health community for greatest success in the future."

Walensky said the review will focus on the CDC's core capabilities, including the public health workforce, data modernization, laboratory capacity, health equity, rapid responses to disease outbreaks and preparedness.

"At the conclusion of this collective effort, we will develop new systems and processes to deliver our science and program to the American people, along with a plan for how the CDC should be structured to facilitate the public health work we do," she wrote in the email.

Five former CDC heads have expressed support for the review.
 File Photo by David Tulis/UPI

The agency has faced criticism for its response dating back to former President Donald Trump's administration, which saw a slow rollout of tests and strict requirements for testing in the early days of the pandemic amid perceived resistance from Trump to act.

Criticism has persisted under President Joe Biden, when the CDC has been criticized for releasing complicated guidance on masking, quarantining and booster doses, as well as inflexibility in adapting to variants like Omicron.

"Never in its 75-year history has [the] CDC had to make decisions so quickly, based on often limited, real-time and evolving science," Walensky said.

"As we've challenged our state and local partners, we know that now is the time for CDC to integrate the lessons learned into a strategy for the future."

Five former CDC heads have expressed support for the review.

"This needs to be done as rapidly as possible because, heavens, you can create a scope so big and so complicated that we could do a 10-year study and it wouldn't really be enough," said Dr. Bill Roper, who served as CDC director from 1990 to 1993 under President George H.W. Bush. "I think her calling for a one-month review is a very smart idea."

Reforms that include making the CDC director a Senate-confirmed, Cabinet-type post have been proposed in the Senate, and have passed its health committee with bipartisan support. The proposals are awaiting a vote in the full chamber.
EXPROPRIATE PG&E
California utility to pay $55 million for massive wildfires

By OLGA R. RODRIGUEZ and MIKE LIEDTKE

 In this Aug. 15, 2019, file photo, a Pacific Gas & Electric worker walks in front of a truck in San Francisco. Pacific Gas & Electric has agreed to pay more than $55 million to avoid criminal prosecution for two major wildfires started by its aging equipment in 2019 and 2021, prosecutors announced.
(AP Photo/Jeff Chiu, File)


SAN FRANCISCO (AP) — Pacific Gas & Electric, the nation’s largest utility, has agreed to pay more than $55 million to avoid criminal prosecution for two major wildfires sparked by its aging Northern California power lines and submit to five years of oversight in an attempt to prevent more deadly blazes.

The company didn’t acknowledge any wrongdoing in the settlement announced Monday with prosecutors in six counties ravaged by last year’s Dixie Fire and the 2019 Kincade Fire. The utility still faces criminal charges for a 2020 wildfire in Shasta County that killed four people.

The civil settlements are designed to accelerate payments to hundreds of people whose homes were destroyed so they can start rebuilding more quickly than those who suffered devastating losses in 2017 and 2018 blazes ignited by PG&E’s equipment. Those fires prompted the utility to negotiate settlements that included $13.5 billion earmarked for victims — money that still hasn’t been completely distributed.

The deal also thrusts the utility back into five years of independent oversight, similar to the supervision PG&E faced during its criminal probation after it was convicted of misconduct that contributed to a natural gas explosion that killed eight people in 2010.

Sonoma County District Attorney Jill Ravitch said that oversight was the biggest accomplishment to come from the settlement.

“We have limited tools and criminal law to deal with corporations and what we were able to do here was to get a five-year agreement that they will be overseen, that there will be an independent monitor, and that they will have to meet certain benchmarks,” she said Monday.


All told, PG&E has been blamed for more than 30 wildfires since 2017 that wiped out more than 23,000 homes and businesses and killed more than 100 people.

PG&E’s federal probation ended in late January, raising worries from the federal judge who tried to force the utility to reduce fire risks by requiring more maintenance and reporting. U.S. District Judge William Alsup warned that PG&E remained a “continuing menace to California” and urged state prosecutors to try to rein in the company that provides power to 16 million people.

In a joint statement covering five of the six counties that settled, prosecutors said PG&E will be “essentially on a five-year probation” to be overseen by Filsinger Energy Partners, which already acts as a safety monitor for California power regulators.

PG&E will have to underwrite the federal monitor’s costs, up to $15 million annually, in addition to the $55 million in other payments and penalties that the utility expects to incur in the settlement.

As part of their settlement, Sonoma County prosecutors agreed to drop 33 criminal charges filed last year that accused PG&E of inadvertently injuring six firefighters and endangering public health with smoke and ash from the Kincade Fire that began in October 2019.

Fire officials said a PG&E transmission line sparked the fire, which destroyed 374 buildings in wine country and caused nearly 200,000 people to flee as it burned through 120 square miles (311 square kilometers), the largest evacuation in county history.

Prosecutors in the other five counties were exploring criminal charges in last year’s Dixie Fire before cutting the deal that they said will result in far larger payouts than had they hauled PG&E into court. Because there were no deaths in the Dixie Fire, prosecutors said the utility would have paid a maximum penalty of about $330,000 if it had been found guilty in a criminal case.

Ravitch said state laws that limit punishment against a corporation to probation and fines helped motivate the settlement. She said if PG&E had been successfully prosecuted in the Sonoma County case it would have paid a fine of just $9.4 million, most of which would have gone to the state.

Instead, the county will now receive more than $20 million earmarked for nonprofits that help people affected by wildfires and for Santa Rosa Junior College so that it can expand fire safety and vegetation management programs. It will also reimburse the DA’s office for the costs of investigating and litigating the case, she said.

Even when PG&E pleaded guilty to 84 felony counts of involuntary manslaughter f or the deaths in the 2018 Camp Fire, the company was fined just $3.5 million.

In a statement, PG&E CEO Patti Poppe said the utility welcomed the chance to be more transparent — and ultimately more accountable — for its operations.

“We are committed to doing our part, and we look forward to a long partnership with these communities to make it right and make it safe,” Poppe said.

The money that that PG&E will pay as part of the settlements will account for a just sliver of its anticipated liabilities in the Kincade, Zogg and Dixie fires. As of December 31, PG&E estimated it will likely be held responsible for at least $2.3 billion in losses stemming from those wildfires. Some of the estimated $1.15 billion in damages caused by the Dixie Fire may be paid by a state-backed insurance fund that California lawmakers created after PG&E filed for bankruptcy in 2019.

The Dixie Fire burned nearly 1 million acres (3,900 square kilometers) in Butte, Plumas, Lassen, Shasta, and Tehama counties and destroyed more than 1,300 homes and other buildings. The blaze started on July 13, 2021 when a tree hit electrical distribution lines west of a dam in the Sierra Nevada, according to investigators with the California Department of Forestry and Fire Protection.

The settlement for the Dixie Fire was made by district attorneys in Plumas, Lassen, Tehama, Shasta and Butte counties, which will receive nearly $30 million.

Although her office participated in the Dixie Fire settlement, Shasta County District Attorney Stephanie Bridgett said she will continue to pursue a criminal case related to the Zogg Fire, which killed four.

___

Liedtke reported from San Ramon, California.


PG&E avoids criminal charges for role in Dixie, Kincade wildfires

Last year's massive Dixie fire destroyed 963,309 acres.


An aerial view taken on August 12 shows the devastation caused by the Dixie Fire after it burned through Greenville's historic Gold Rush-era town in California. 
File Photo courtesy of California Office of Emergency Services | License Photo

April 11 (UPI) -- Pacific Gas and Electric Company won't be criminally charged for its involvement in igniting the 2019 Kincade fire and the 2021 Dixie fire, a group of California district attorneys announced Monday.

The Kincade fire broke out in late October 2019. It destroyed more than 77,700 acres of vegetation across Sonoma County, Calif., over 13 days. Regulators concluded the fire was sparked by PG&E equipment.

Last year's massive Dixie fire, the second-largest in California history, ripped through 963,309 acres.


Melted aluminum attests to the heat of the wildfire in Greenville, Calif., on August 12. 
File Photo by Terry Schmitt/UPI | License Photo

Prosecutors representing the impacted counties of Plumas, Lassen, Tehama, Shasta and Butte settled with PG&E for the company's role in the Dixie wildfire that raged for 103 days, according to the California Department of Forestry and Fire Protection.

As part of the settlement on both cases, the utility has until the summer to pay people initially left homeless in the Dixie fire.

An independent safety monitor may also oversee the company, at the request of the district attorneys in the settlement.


Bricks from the Masonic Lodge litter the street in Greenville, Calif., on August 12. 
File Photo by Terry Schmitt/UPI | License Photo

PG&E will have to pay nearly $30 million to organizations and local charities that came to the aid of those directly impacted by the fire.

The company must also keep making expensive improvements in the safety and reliability of its infrastructure in the North State region of California.

PG&E is required to pay penalties and investigation costs to the district attorneys' offices, and cannot raise raise to cover money lost in the settlement.

In 2020, the company pleaded guilty to 84 counts of involuntary manslaughter in the 2018 Camp Fire in California.
EXPLAINER: Where do US opioid trials, settlements stand?
By GEOFF MULVIHILL

Signs are displayed at a tent during a health event on June 26, 2021, in Charleston, W.Va. The effort to hold drug companies, pharmacies and distributors accountable for their role in the opioid crisis has led to a whirlwind of legal activity around the United States. New legal settlements are being reached practically every week to provide governments money to fight the crisis, and in some cases funds for medicines to reverse overdoses or to help with treatment. (AP Photo/John Raby, File)

The effort to hold drug companies, pharmacies and distributors accountable for their role in the opioid crisis has led to a whirlwind of legal activity around the U.S. that can be difficult keep tabs on.

Three trials are underway now, in Florida, West Virginia and Washington state. New legal settlements are being reached practically every week to provide governments money to fight the crisis and in some cases funds for medicines to reverse overdoses or to help with treatment. More settlements are likely on the way.

More than 3,000 lawsuits have been filed by state and local governments, Native American tribes, unions, hospitals and other entities in state and federal courts over the toll of opioids. Most allege the industry created a public nuisance in a crisis that has been linked to the deaths of 500,000 Americans over the past two decades.

Collectively, businesses have faced settlements, judgements and civil and criminal penalties totaling more than $47 billion in the last 15 years. The three main entities targeted are the companies that manufactured and sold the pills; the businesses that distributed them; and the pharmacies that dispensed them.

An overview of the litigation and settlements involving the various companies:

PURDUE PHARMA


Purdue is the maker of OxyContin, an extended-release version of oxycodone that packed higher doses into pills. The drug, released in 1996, became a heavily marketed blockbuster drug — and is associated closely with the epidemic’s first wave.

Like other opioids, it was promoted not just for post-surgery and cancer pain but for chronic pain — an area where doctors previously were reluctant to prescribe such powerful drugs.

Faced with thousands of lawsuits, the company went into bankruptcy protection in 2019 to help reach a settlement.

A deal is now in place, but it’s not final.

It calls for members of the Sackler family who own the company to give up their stakes, making way for it to become a new entity — to be known as Knoa Pharma — with profits funding the fight against the opioid crisis. Additionally, family members are to pay $5.5 billion to $6 billion over time, with a portion of the money going to individual victims.

Earlier this year, three members of the family attended an online hearing in which parents described losing children to addictions that started with OxyContin, and people recovering from addictions described their journeys.

As part of the exchange, Sackler family members would get protection from lawsuits over opioids.

For the settlement to be finalized, a higher court must overturn a judge’s ruling that threw out an earlier version of the deal. A hearing on that is scheduled for April 29 before the U.S. 2nd Circuit Court of Appeals in New York.

In the meantime, activists and some members of the U.S. Senate are asking the Justice Department to consider charges against family members.

OTHER DRUGMAKERS


In a major court victory for drugmakers last year, a California judge ruled against some local governments in their case against pharmaceutical companies Johnson & Johnson, Endo International and Teva Pharmaceutical Industries.

Some of those drugmakers — Johnson & Johnson, Allergan and Teva — are now on trial in West Virginia.

But companies have largely been settling suits.

Mallinckrodt, which was a leading producer of generic oxycodone, also used bankruptcy court to reach a settlement, agreeing to a $1.6 billion nationwide deal in 2020.

Johnson & Johnson has agreed to a $5 billion nationwide settlement. It was announced alongside a separate settlement involving the three biggest drug wholesalers. The company’s Janssen subsidiary stopped selling its fentanyl patches and pain pills in the U.S. in 2020. J&J was also the first drugmaker to be held liable for the opioid crisis in a trial, though the Oklahoma state Supreme Court later overturned the ruling.

Endo made the opioid Opana, which was eventually removed from the market. The company has been reaching individual settlements with states. Deals since last year with Florida, New York, Texas, West Virginia and some district attorneys in Tennessee have totaled well over $200 million.

Late last year, a New York jury found Teva partly responsible for the state’s opioid crisis through its marketing of the fentanyl drugs Actiq and Fentora. Most of the other companies the state and two counties sued settled before or during a trial last year. A separate trial is to be held to determine damages.

Since the New York trial, Teva has reached settlements with Texas, Florida and Rhode Island totaling more than $250 million. It will also provide drugs to reverse overdoses and treat addictions.

Allergan, now a subsidiary of AbbVie, has been settling suits involving the extended-release morphine pill Kadian. It reached one major settlement with New York last year. Since then, it has been part of the multi-company settlements in Florida and Rhode Island.

Executives from drugmaker Insys were convicted in 2019 of bribing doctors across the U.S. to prescribe their sublingual fentanyl spray Subsys. Company founder John Kapoor was sentenced to 5 1/2 years in federal prison.

The company also paid $225 million to resolve federal investigations into allegations that it paid kickbacks and used other illegal marketing tactics.

DISTRIBUTION COMPANIES

The three big national companies — AmerisourceBergen, Cardinal Health and McKesson — finalized their settlement, worth a total of $21 billion over 18 years, in February.

The deal, combined with Johnson & Johnson’s, is expected to be the single biggest settlement between companies in the drug industry and governments.

The total amounts include separate settlements covering all federally recognized Native American tribes.

With settlement money starting to flow to state and local governments, officials are figuring out how to prioritize it. The funds are arriving at a precarious time: The number of U.S. overdose deaths from all drugs topped 100,000 in a 12-month period for the first time last year. The majority of those deaths are from opioids — and particularly illicit synthetic versions including fentanyl.

Unlike the tobacco settlements of the 1990s, there are safeguards intended to steer most of the opioid settlement funds to addressing the crisis. Public health experts have ideas for how to do that, but the decisions are up to government officials.

The distribution companies also went to trial last year in West Virginia. A judge has not yet ruled.

Closing arguments in Washington state’s trial against the distributors are expected this week.

PHARMACIES


Pharmacy chains have been sued less often than companies that make or distribute opioids. In one groundbreaking case, a federal jury in Ohio last year found CVS, Walgreens and Walmart recklessly distributed massive amounts of pain pills in Lake and Trumbull counties.

Late last month, CVS settled in Florida. That left Walgreens to go to trial Monday.

CONSULTING COMPANY


Global consulting firm McKinsey & Company also reached deals last year with the states, Washington, D.C., and U.S. territories for advising businesses on how to sell more prescription opioids amid the overdose crisis. Those settlements totaled more than $600 million.

A group of U.S. senators is pushing for a federal investigation, saying there were conflicts when the company consulted on opioid-related issues both for companies and the U.S. Food and Drug Administration.
AMERICAN EXCEPTIONALISM
Efforts to make protective medical gear in US falling flat

By DAVID A. LIEB

1 of 8
Jim Schmersahl, owner of Halcyon Shades, poses in a "clean room" used in making N-95 masks at the company's production facility Friday, March 18, 2022, in University City, Mo. Halcyon is small company that normally makes window shades, but when the pandemic hit, its sales plummeted. Halcyon applied for the state grants to make PPE as a way to try to keep its employees at work and keep the company afloat. (AP Photo/Jeff Roberson)


UNIVERSITY CITY, Mo. (AP) — When the coronavirus pandemic first hit the U.S., sales of window coverings at Halcyon Shades quickly went dark. So the suburban St. Louis business did what hundreds of other small manufacturers did: It pivoted to make protective supplies, with help from an $870,000 government grant.

But things haven’t worked out as planned. The company quit making face shields because it wasn’t profitable. It still hasn’t sold a single N95 mask because of struggles to get equipment, materials and regulatory approval.

“So far, it has been a net drain of funds and resources and energy,” Halcyon Shades owner Jim Schmersahl said.

Many companies that began producing personal protective equipment with patriotic optimism have scaled back, shut down or given up, according to an Associated Press analysis based on numerous interviews with manufacturers. Some already have sold equipment they bought with state government grants.

As COVID-19 was stressing hospitals and shuttering businesses in 2020, elected officials touted the need to boost U.S. production of protective gear: “All this stuff should be made in the United States and not in China,” Florida Gov. Ron DeSantis said in remarks echoed by others.

Yet many manufacturers who answered the call have faced logistical hurdles, regulatory rejections, slumping demand and fierce competition from foreign suppliers. On April 1, Florida-based American Surgical Mask Co. became one of the latest to close.

“I’m just done with the fight,” CEO Matt Brandman told the AP.

After the initial scramble for PPE subsided, many industry newcomers faced difficulty selling products. Government agencies sometimes wanted huge quantities at tough-to-meet deadlines. Hospital systems tended to contract with established suppliers. Retail sales waned after every virus surge.

“At the end of the day, when everybody said they wanted American-made, nobody’s buying, not even the state,” said Tony Blogumas, vice president of Green Resources Consulting, a rural Missouri firm that received an $800,000 state grant but has sold only a few thousand masks. “We’re kind of upset about the whole situation.”

Missouri Gov. Mike Parson also is disappointed. His administration divided $20 million in federal COVID-19 relief funds among 48 businesses for the production of masks, gowns, sanitizer and other supplies. Parson hoped to seed a permanent field of manufacturers.

“I’m still a firm believer in that — that we need to be making PPE here in this state,” Parson said. “Unfortunately, a lot of entities went right back to where they were getting it before.”

The onset of the pandemic revealed that the U.S. was highly dependent on foreign countries for protective gear. When China limited exports because of its own battle against COVID-19, U.S. stockpiles plummeted. Prices skyrocketed as federal officials, governors and health care systems competed for supplies.

Though federal stockpiles have been replenished, shriveling domestic production has raised concerns that state governments, medical facilities and others could again get stuck scrambling for gear during a future pandemic.

The AP identified more than $125 million in grants to spur production of pandemic supplies made to over 300 business in 10 states — Alabama, Hawaii, Indiana, Kansas, Louisiana, Maryland, Massachusetts, Missouri, New York and Ohio. It’s possible that grants were awarded in additional states, but there is no central clearinghouse to track them.

In November 2020, Alabama awarded one of the single largest grants — nearly $10.6 million from federal pandemic relief funds — to HomTex Inc. The company was to equip a new Selma facility to make 250 million surgical masks and 45 million N95 masks annually. The plant returned $1.8 million of the state grant and has yet to make anything due to a lack of customers.

“I can’t produce product that I can’t sell,” HomTex President Jeremy Wootten said.

Other companies also had trouble living up to political hype.

In October 2020, New York announced eight grants that then-Lt. Gov. Kathy Hochul, now the governor, said were “a model for how we build back better for the post-pandemic future.” Those included $800,000 for newly formed Altor Safety and $1 million for startup firm NYPPE.

But NYPPE’s equipment wasn’t ready until February 2021, by which time the market had changed, President Connor Knapp said.

So Knapp tapped the brakes on his plans. NYPPE still hasn’t sold any N95 masks because it lacks regulatory approval. It just recently scaled up production of surgical masks, after obtaining a U.S. Food and Drug Administration certification that came with its purchase of Altor Safety.

Some PPE manufacturers point to federal regulations as part of the reason for their struggles. Three-ply masks need FDA approval to be marketed for medical use — an important designation for building a long-term customer base.

That process can be time-consuming. Facing delays, Angstrom Manufacturing in Missouri ended up buying another business that already had FDA approval, President Chris Carron said. By then, it was fall 2021 — a year after it received a state grant.


Angstrom Manufacturing president Chris Carron poses for a photo with machinery the company uses to make surgical masks Wednesday, March 23, 2022, in Ste. Genevieve, Mo. (AP Photo/Jeff Roberson)

Companies need approval from the National Institute for Occupational Safety and Health to market products as N95 respirators, which filter at least 95% of airborne particles.

During the first two years of the pandemic, NIOSH approved 30 new manufacturers — more than seven times the typical number during a similar pre-pandemic period, according to agency data. Some applications remain pending, while numerous others were denied.

Halcyon Shades’ N95 certification was rejected in October because its samples didn’t have head straps attached. While the company works on another application, its equipment sits idle inside the clear plastic-sheet walls of a “clean room” specially built to shield materials from airborne contaminants. Partially finished masks remain paused on a conveyor belt, waiting to be deposited into a cardboard box.

Without federal approval, “we’re just dead in the water,” said Schmersahl, the company owner.

Progress reports filed with the Missouri Department of Economic Development show that nearly all its PPE grant recipients faced challenges by July 2021, especially with sales.


Jim Schmersahl, owner of Halcyon Shades, poses with a machine used to make N-95 masks Friday, March 18, 2022, in University City, Mo. (AP Photo/Jeff Roberson)

Patriot Medical Devices, which received $750,000 from Missouri, hired nearly 100 people as it cranked out millions of masks during a COVID-19 surge in late 2020 and early 2021, CEO Rick Needham said. Fewer than 10 employees remain.

“We felt it was our patriotic duty to do something to help solve the problem,” Needham said. But, he added, “It’s frankly a little bit of a dysfunctional business model at this point.”

Ohio awarded $20.8 million to 73 businesses to manufacture pandemic-related supplies, according to state data. Of 60 businesses that complied with a recent reporting deadline, more than one-third no longer produced PPE by the end of 2021.

Cleveland Veteran Business Solutions, which received a $500,000 grant to get into the PPE business, made about 5 million surgical masks beginning in August 2020. It ultimately halted production in the face of cheaper imports and sold its machines this year, co-founder Taner Eren said.

“It was surprising and disappointing strategically that there wasn’t support for a local PPE manufacturing industry,” Eren said.

The business was among several dozen that banded together to form the American Mask Manufacturer’s Association with the goal of sustaining the industry. The group’s membership has dwindled as more and more go out of business.

Association organizers say the industry has reached a critical point. They want the federal government to treat PPE manufacturers like the nation’s defense industry — entering into long-term contracts to perpetually replenish a stockpile for future pandemics or emergencies.

“If the federal government doesn’t come in and help support the U.S. manufacturing base, it’s almost certainly going to go back to China, and we’ll be just as vulnerable as we were in early 2020 and 2019,” said Brent Dillie, the association chairman and co-founder of Premium-PPE, a Virginia manufacturer started during the pandemic that has shed about two-thirds of its roughly 300 employees.

Infrastructure legislation signed by President Joe Biden took a step toward bolstering domestic suppliers. Effective in February, it required new contracts for PPE purchased by the departments of Health and Human Services, Homeland Security and Veterans Affairs to run for at least two years and be awarded to U.S. producers — unless there’s not sufficient quantity and quality at market prices.

The health and veterans departments said they haven’t bought anything yet. Homeland Security hasn’t answered the AP’s questions. Documents show the government solicited bids due Dec. 6 for up to 381 million U.S.-made surgical masks over three years for its stockpile. No deal has been announced.

Other documents show the government is looking to contract with three major suppliers — 3M, Moldex, and Owens & Minor — for a total of $115 million in U.S-made N95 masks over three years. A justification document says noncompetitive contracts are necessary to preserve capacity for future coronavirus surges or emergencies.

The Biden administration also formed a task force of experts from federal agencies, health care providers, PPE manufacturers and distributors to develop a national strategy for ensuring a “resilient public health supply chain.” Its work is expected to extend for years.

Some manufacturers said they can’t wait long for a federal life preserver.

Dentec Safety Specialists is wrapping up a contract to supply 125,000 rubber reusable respirators and 500,000 filtration cartridges from its Kansas facility for the national stockpile, said President Claudio Dente. It needs more orders soon to prevent layoffs, he said.

“I thought that COVID would really change the mindset of the people, the governments and manufacturing,” Dente said. But he added: “The general marketplace is reverting back to their old ways -- meaning looking to buy product from China.”
National Urban League finds State of Black America is grim



A girl in a stroller plays with a squirt gun as a woman pushes her past a Black Lives Matter mural in the Shaw neighborhood in Washington, Monday, July 13, 2020. The National Urban League released its annual report on the State of Black America on Tuesday, April 12, 2022, and its findings are grim. This year’s Equality Index shows Black people still get only 73.9 percent of the American pie white people enjoy.
(AP Photo/Andrew Harnik, File)


ATLANTA (AP) — The National Urban League released its annual report on the State of Black America on Tuesday, and its findings are grim. This year’s Equality Index shows Black people still get only 73.9 percent of the American pie white people enjoy.

While Black people have made economic and health gains, they’ve slipped farther behind whites in education, social justice and civic engagement since this index was launched in 2005. A compendium of average outcomes by race in many aspects of life, it shows just how hard it is for people of color to overcome systemic racism, the civil rights organization says.

“These numbers change so little and so slowly. What it tells me is that this institutional disparity based on race seems to be built into American society,” National Urban League President Marc Morial said in an interview.

The index shows not only that median household income for Black people, at $43,862, is 37% less than that of white people, at $69,823. Black people also are less likely to benefit from home ownership, the engine of generational wealth in America. Census data shows Black couples are more than twice as likely as whites to be denied a mortgage or a home improvement loan, which leads to just 59% of the median home equity white households have, and just 13% of their wealth.

“In that area of wealth, we’ve seen almost no change, none, since the civil rights days,” Morial said. “The wealth disparity has gotten wider.”

Among dozens of health measures, one stands out: Life expectancy has declined slightly for African Americans, so a Black child born today can expect to live to 74.7, four years less than a white baby. And lifelong inequities loom: Black women are 59% more likely to die as a result of bearing a child, and 31% more likely to die of breast cancer. Black men are 52% more likely to die of prostate cancer.

Overdoses afflict the races about equally, while white people are 55% more likely to drink themselves to death through cirrhosis or chronic liver disease. Among people 15-24, white people are more than twice as likely to commit suicide, while Black men are nine times more likely to die by homicide.

Educational gaps abound: Black and white preschoolers are roughly equally prepared, but the classrooms they enter are starkly different. Schools with more minority students are more likely to have inexperienced, less trained and even uncertified teachers. Fewer of these students are enrolled in the STEM classes that can lead to higher-paying jobs. Black students are less likely to graduate college.

The index uses U.S. Justice Department statistics to chart social justice differences, noting that Black people have been more than twice as likely as white people to experience threats or uses of force during police encounters, and three times more likely to be jailed if arrested. In 2020, they were 93% more likely to be victims of hate crime.

Measuring civic engagement, the index cites 2020 Census data showing that white people are about 5% more likely to be registered and to actually vote than Black people.

Morial chose to release the report in Atlanta, where a concentration of historically Black colleges have long represented high achievement among African Americans, in part because its survey shows a declining faith among young people that voting can make a difference. The Urban League is responding by launching a “Reclaim Your Vote” campaign.

“Georgia is ground zero for voter suppression. The legislature’s actions after Jan. 6 have been sweeping in their aggressiveness to suppress the vote,” Morial said. “We’ve got to remain resolute, to push back against this. We cannot give in. We cannot give up.”
Russian war worsens fertilizer crunch, risking food supplies

By GEOFFREY KAVITI, CHINEDU ASADU and PAUL WISEMAN

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Farmers offload livestock manure from a truck, that will be used to fertilize crops due to the increased cost of fertilizer that they say they now can't afford to purchase, in Kiambu, near Nairobi, in Kenya Thursday, March 31, 2022. Russia's war in Ukraine has pushed up fertilizer prices that were already high, made scarce supplies rarer still and squeezed farmers, especially those in the developing world struggling to make a living. (AP Photo/Brian Inganga)


KIAMBU COUNTY, Kenya (AP) — Monica Kariuki is about ready to give up on farming. What is driving her off her 10 acres of land outside Nairobi isn’t bad weather, pests or blight — the traditional agricultural curses — but fertilizer: It costs too much.

Despite thousands of miles separating her from the battlefields of Ukraine, Kariuki and her cabbage, corn and spinach farm are indirect victims of Russian President Vladimir Putin’s invasion. The war has pushed up the price of natural gas, a key ingredient in fertilizer, and has led to severe sanctions against Russia, a major exporter of fertilizer.

Kariuki used to spend 20,000 Kenyan shillings, or about $175, to fertilize her entire farm. Now, she would need to spend five times as much. Continuing to work the land, she said, would yield nothing but losses.

“I cannot continue with the farming business. I am quitting farming to try something else,” she said.

Higher fertilizer prices are making the world’s food supply more expensive and less abundant, as farmers skimp on nutrients for their crops and get lower yields. While the ripples will be felt by grocery shoppers in wealthy countries, the squeeze on food supplies will land hardest on families in poorer countries. It could hardly come at a worse time: The U.N. Food and Agriculture Organization said last week that its world food-price index in March reached the highest level since it started in 1990.

The fertilizer crunch threatens to further limit worldwide food supplies, already constrained by the disruption of crucial grain shipments from Ukraine and Russia. The loss of those affordable supplies of wheat, barley and other grains raises the prospect of food shortages and political instability in Middle Eastern, African and some Asian countries where millions rely on subsidized bread and cheap noodles.


“Food prices will skyrocket because farmers will have to make profit, so what happens to consumers?” said Uche Anyanwu, an agricultural expert at the University of Nigeria.

The aid group Action Aid warns that families in the Horn of Africa are already being driven “to the brink of survival.”

The U.N. says Russia is the world’s No. 1 exporter of nitrogen fertilizer and No. 2 in phosphorus and potassium fertilizers. Its ally Belarus, also contending with Western sanctions, is another major fertilizer producer.

Many developing countries — including Mongolia, Honduras, Cameroon, Ghana, Senegal, Mexico and Guatemala — rely on Russia for at least a fifth of their imports.

The conflict also has driven up the already-exorbitant price of natural gas, used to make nitrogen fertilizer. The result: European energy prices so high that some fertilizer companies “have closed their businesses and stopped operating their plants,” said David Laborde, a researcher at the International Food Policy Research Institute.

For corn and cabbage farmer Jackson Koeth, 55, of Eldoret in western Kenya, the conflict in Ukraine was distant and puzzling until he had to decide whether to go ahead with the planting season. Fertilizer prices had doubled from last year.

Koeth said he decided to keep planting but only on half the acreage of years past. Yet he doubts he can make a profit with fertilizer so costly.

Greek farmer Dimitris Filis, who grows olives, oranges and lemons, said “you have to search to find” ammonia nitrate and that the cost of fertilizing a 10-hectare (25-acre) olive grove has doubled to 560 euros ($310). While selling his wares at an Athens farm market, he said most farmers plan to skip fertilizing their olive and orange groves this year.

“Many people will not use fertilizers at all, and this as a result, lowers the quality of the production and the production itself, and slowly, slowly at one point, they won’t be able to farm their land because there will be no income,” Filis said.

In China, the price of potash — potassium-rich salt used as fertilizer — is up 86% from a year earlier. Nitrogen fertilizer prices have climbed 39% and phosphorus fertilizer is up 10%.

In the eastern Chinese city of Tai’an, the manager of a 35-family cooperative that raises wheat and corn said fertilizer prices have jumped 40% since the start of the year.

“We can hardly make any money,” said the manager, who would give only his surname, Zhao.

Terry Farms, which grows produce on 2,100 acres largely in Ventura, California, has seen prices of some fertilizer formulations double; others are up 20%. Shifting fertilizers is risky, vice president William Terry said, because cheaper versions might not give “the crop what it needs as a food source.″

As the growing season approaches in Maine, potato farmers are grappling with a 70% to 100% increase in fertilizer prices from last year, depending on the blend.

“I think it’s going to be a pretty expensive crop, no matter what you’re putting in the ground, from fertilizer to fuel, labor, electrical and everything else,” said Donald Flannery, executive director of the Maine Potato Board.

In Prudentopolis, a town in Brazil’s Parana state, farmer Edimilson Rickli showed off a warehouse that would normally be packed with fertilizer bags but has only enough to last a few more weeks. He’s worried that, with the war in Ukraine showing no sign of letting up, he’ll have to go without fertilizer when he plants wheat, barley and oats next month.

“The question is: Where Brazil is going to buy more fertilizer from?” he said. “We have to find other markets.″

Other countries are hoping to help fill the gaps. Nigeria, for example, opened Africa’s largest fertilizer factory last month, and the $2.5 billion plant has already shipped fertilizer to the United States, Brazil, India and Mexico.

India, meanwhile, is seeking more fertilizer imports from Israel, Oman, Canada and Saudi Arabia to make up for lost shipments from Russia and Belarus.

“If the supply shortage gets worse, we will produce less,” said Kishor Rungta of the nonprofit Fertiliser Association of India. “That’s why we need to look for options to get more fertilizers in the country.”

Agricultural firms are providing support for farmers, especially in Africa where poverty often limits access to vital farm inputs. In Kenya, Apollo Agriculture is helping farmers get fertilizer and access to finance.

“Some farmers are skipping the planting season and others are going into some other ventures such as buying goats to cope,” said Benjamin Njenga, co-founder of the firm. “So these support services go a long way for them.”

Governments are helping, too. The U.S. Department of Agriculture announced last month that it was issuing $250 million in grants to support U.S. fertilizer production. The Swiss government has released part of its nitrogen fertilizer reserves.

Still, there’s no easy answer to the double whammy of higher fertilizer prices and limited supplies. The next 12 to 18 months, food researcher LaBorde said, “will be difficult.″

The market already was “super, super tight” before the war, said Kathy Mathers of the Fertilizer Institute trade group.

“Unfortunately, in many cases, growers are just happy to get fertilizer at all,” she said.

___

Asadu reported from Lagos, Nigeria, and Wiseman from Washington. Contributing to this story were: Tatiana Pollastri in Sao Paulo, Brazil; Debora Alvares in Brasilia, Brazil; Sheikh Saaliq in New Delhi; Lefteris Pitarakis in Athens; Jamey Keaten in Geneva; Joe McDonald and Yu Bing in Beijing; Lisa Rathke in Marshfield, Vermont; Dave Kolpack in Fargo, North Dakota; Kathia Martínez in Panama City; Christoph Noelting in Frankfurt; Fabiola Sánchez in Mexico City; Veselin Toshkov in Sofia, Bulgaria; Tarik El-Barakah in Rabat, Morocco; Tassanee Vejpongsa and Elaine Kurtenbach in Bangkok; Ilan Ben Zion in Jerusalem; Edie Lederer at the United Nations; and Aya Batrawy in Dubai.
From art to advertising: The history of the poster

Even in ancient times, merchants listed their goods on stone plaques to attract customers. Centuries later, the first advertising posters were unveiled, as a new exhibition shows.



A man looking at the famous US army recruitment sign in Michigan, in 1940

Uncle Sam's intense gaze is inescapable in an image where his outstretched index finger conveys a clear message: "I Want You for the U.S. Army."

The 1917 poster reminded young men of their patriotic duty to fight for the homeland in World War I. Designed by New Yorker James Montgomery Flagg, who is said to have modeled Uncle Sam on his own face, the US Army also advertised with this poster during World War II — and still does to this day. The cult ad is world-famous.

So it's no coincidence that the Museum Folkwang in Essen in western Germany picked "We Want You!" as the title for its current exhibition on the history of posters, presenting designs derived from cartoons, illustrations and historical photographs from the 18th century up to present-day — along with perspectives for the future.

After all, according to curator Rene Grohnert, posters will always exist — even when they take on a digital form. He strongly believes in the saying, "A picture is worth a thousand words."


A United Colors of Benetton advertisement from 1989 was the work of Italian photographer and art director, Oliviero Toscani


Ancient stone tablet origins

The ancestors of the poster were stone tablets on which ancient Egyptians scratched symbols.

The Romans put up wooden plaques with public notices in busy squares, and in the Middle Ages poster-like notices would hang on market squares or in front of churches.

But the modern poster first appeared in the mid-15th century, with the invention of the printing press by Johannes Gutenberg.

Then around 1796, Bavarian musician and playwright Alois Senefelder invented lithography, a vital technology for modern poster design and a precursor to modern offset printing.

Inspired on a rainy day when observing how the image a leaf was outlined on a piece of limestone, the process he created allowed the reproduction of a drawn motif on a stone slab to be transferred onto paper.

From then on, Senefelder's invention enabled the mass reproduction of posters for everything from event promotion to politics.

German printer Ernst Litfass invented advertising columns in 1854

Poster artists in demand

Early poster design was initially managed by printers and lithographers. But they were unable to meet the growing quality demands of customers, leading an increasing number of artists to be hired to design posters as well.

French artist Jules Cheret became known as the father of the modern poster. He founded his own lithography workshop in 1866 and created around 1,200 posters in 40 years.

Equally well known was Cheret's compatriot, Henri de Toulouse-Lautrec, who wrote poster history with his artworks for the famous Parisian variety shows at the Moulin Rouge. He spent almost every evening capturing the energy of the extravagant nightlife in the Montmartre theater in his drawings.

Henri de Toulouse-Lautrec (l) redefined lithography and poster art in works advertising Paris' Moulin Rouge night club

In Germany, Art Nouveau motifs became popular around the turn of the century. One of the most famous posters of the era was one designed by Alfons Mucha for the play "Gismonda," starring then world-famous actress Sarah Bernhardt. All the publicly displayed copies of the poster were quickly stolen by art lovers.
The poster as advertising

Posters with elaborate designs by artists are still created for museums and theaters today but the focus of posters since the 1920s has been advertisement, with the brand and the product replacing lavish ornamentation, notes curator Rene Grohnert.

Throughout the 20th century, the poster kept evolving, with advertising influenced by the art movements of its time, from Bauhaus style to Art Deco.


10 ESSENTIAL FACTS ABOUT BAUHAUS
It started as an actual school
In 1919, Walter Gropius became the director of a new institution, the Staatliches Bauhaus, also simply known as the Bauhaus, which merged the former Grand Ducal School of Arts and Crafts and the Weimar Academy of Fine Art. Even though Gropius was an architect and the term Bauhaus literally translates as "construction house," the school of design did not have an architecture department until 1927.
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Some played with psychedelic motifs during the 1960s counterculture; others became even more provocative in the 1980s, advertising with AIDS patients.

But posters were not only designed to advertise goods but also political messages: The Nazis used them for propaganda purposes, as did the communist regimes of the Eastern bloc. The youth of the 1960s (and later generations) hung posters of the revolutionary Che Guevara on their walls. Other famous posters of the time spoke out against against nuclear weapons, the Vietnam War, pollution and overpopulation.

Mass media then changed the entire approach of advertising, with television bringing product advertising directly into people's living rooms.

The poster, however, remained. "It was then less to provide information than to remind people of something they had previously seen," says Grohnert.

Posters can still be seen on advertising pillars, invented back in 1854, though today these relics have been updated and now rotate in the 21st century with the posters illuminated from behind.

But the future looks different, says Grohnert. "The poster has been integrated into an overall concept," he says, noting how at a bus or train stop an illuminated advertising poster can be combined with information and "roof greening" to create "a piece of street furniture."

In the age of digitalization, the poster is far from old hat.

The poster exhibition "We Want You!" runs at the Folkwang Museum Essen until August 28, 2022.


ELECTION POSTERS: GERMAN POLITICS OVER THE YEARS
The 1940s — Reconstruction
After the Second World War, Germany lay in ruins. Many things had to be rebuilt — including the political party landscape. When the first Bundestag or Parliament was formed in 1949, none of the parties could secure a third of the public votes. Coalitions had to be formed. The issues, however, were similar: reconstruction, economic integration, and the desire for a united Germany.
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This article was translated from the German.

Indonesia: Thousands of students protest rumored election delay

President Joko Widodo had promised not to delay elections in order to hold on to power, but many say his statements don't convince. Monday's protests echoed those that ousted President Suharto in 1998.

Protesters stormed the parliament, demanding that the 2024 election dates be kept intact

Thousands of students in major cities across  Indonesia on Monday protested a rise in food prices and a possible extension of President Joko Widodo's term in office.

Wearing neon jackets and raising megaphones, the students rallied in South Sulawesi, West Java and the capital, Jakarta, following rumors that President Widodo could shift 2024 general elections in an attempt to hold on to power.

That would be against the country's two-term limit. Widodo is currently in the final years of a second term, before the next election, in 2024.

Students in Indonesia have previously led massive protests to ensure a democracy

Demonstrators chanted about protecting Indonesia's democracy and limiting soaring fuel and food prices.

''We demand that the lawmakers do not betray the country's constitution by amending it,'' one protest coordinator, identified as Kaharuddin, told The Associated Press. ''We want them to listen to people's aspirations.''

Police fired tear gas and water cannon at the protesters. 

Jakarta police said a university lecturer who was participating in the protest sustained "grave" injuries after a "nonstudent" group battered
and stomped on him. Six officers who tried to help the lecturer were also injured, according to police.

Avoiding a repeat of strongman rule

Monday's protests echoed those from almost two decades ago, when student-led demonstrations toppled the regime of President Suharto, who led for decades with an iron fist. He was ousted in 1998.

Widodo has high approval ratings, but many reject an illegal extension of his tenure

Unlike Suharto, Widodo has maintained some popularity, according to recent polls.

But "Jokowi," as the president is also known, has been heavily criticized for not speaking out strongly against rumors of a possible postponement of elections set for February 2024.

Powerful political figures, including two ministers, who publicly backed a delayed election have fueled rising tensions.

Widodo himself has publicly spoken out against the idea. He told his cabinet last week to focus on addressing the country's economic woes, stressing that "nobody should bring up a (presidential) term extension or election delay anymore.”

But there is still strong skepticism regarding the president's intentions.

Influential politicians publicly supported a postponement of the 2024 elections

Crowds of demonstrators storming the parliament building at Monday's protests said halting elections would threaten the country's democracy.

Indonesian police fired tear gas and deployed water cannons on the protesters. Reporters say rocks were thrown into the complex after nonstudent demonstrators joined the rally.

Lawmakers addressed the students, vowing to keep election dates intact.

sl/fb (AFP, AP, dpa, Reuters)

Egypt: Jailed pro-democracy activist receives UK citizenship

Alaa Abdel-Fattah's family hopes that his UK citizenship can secure his release from prison. The activist has spent much of the past decade behind bars, along with many other Egyptian political prisoners.

Alaa Abdel-Fattah is one of Egypt's most prominent activists

The Egyptian activist Alaa Abdel-Fattah, who rose to prominence during the 2011 revolution, has been given British citizenship, his family said on Monday.

Abdel-Fattah has been in prison for three and a half years and the move is seen as a means to pressure the Egyptian government to grant his release.

The activist began a hunger strike at the beginning of the Islamic holy month of Ramadan to protest the conditions in which he is being held.

"For two and a half years, he has been kept in a cell without sunlight, with no books, no exercise. His visitations have been cut to one family member, for 20 minutes a month, through glass, with not a moment of privacy or contact," his sisters said in a statement.

Who is Alaa Abdel-Fatah?

Abdel-Fattah has spent much of the past 10 years in prison. He had also been arrested under former President Hosni Mubarak — who was overthrown in the 2011 revolution — and Mohammed Morsi, who briefly served as president before he was ousted in 2013.

In December, the activist was sentenced to five years in prison after a court convicted him of spreading false news. Separate charges accuse the 40-year-old of misusing social media and being a member of a terrorist group.

Abdel-Fattah's family say he is being held in inhumane conditions in Cairo's Tora prison

His family and Egyptian lawyers said in 2021 that Abdel-Fattah had been tortured inside Cairo's Tora prison.

"This is a British citizen detained unlawfully, in appalling conditions, simply for exercising his basic rights to peaceful expression and association,'' Daniel Furner, one of the family lawyers, told the AP news agency.

Hope for release

Abdel-Fattah obtained British citizenship through his mother, Laila Soueif, who was born in London. She is also a professor of mathematics at Cairo University.

His sisters, Mona and Sanaa, were also given UK citizenship. They said in a statement that their brother has requested to speak with the family's lawyers in the UK "so that they can take all possible legal measures regarding not only the violations he has been subjected to, but all the crimes against humanity he has witnessed during his imprisonment."

The Egyptian government under President Abdel Fattah el-Sissi has released several political prisoners with dual citizenship in recent years after agreeing to give up their Egyptian citizenship.

But rights groups say about 60,000 political prisoners remain locked up in Egypt.