Appalachian Food for Health, a diabetes prevention virtual program, is scheduled for from 10 a.m. to noon Friday

The second annual "Appalachian Food for Health" virtual event, focusing on diabetes prevention, is scheduled from 10 a.m. to noon Friday, July 30. Click here to register.

The event is hosted by Shaping Our Appalachian Region, the Foundation for A Healthy Kentucky, and the Community Farm Alliance. 

The virtual discussion will be led by Martha Yount and Jann Knappage, who will provide an overview of the Nutrition Education Program hosted by the University of Kentucky.

Attendees will also learn about eating and cooking healthy while on a budget from Sabrina McWhorter, lifestyle blogger and founder of Eat Wild Appalachia.

Following the presentations, there will be two breakout rooms highlighting policy and programming.

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Beshear strongly recommends in-school masking; coronavirus infections and Covid-19 cases in ICUs have doubled in 10 days

Kentucky Health News graph from initial, unadjusted daily reports; to enlarge, click on it.

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear issued what he called "strong recommendations" Monday for all students and teachers not vaccinated against the coronavirus to wear masks during the upcoming school year, and said schools that want to "optimize safety" should have all students and employees wear masked. 

“If we truly want as many in-person classroom days [as possible], these are steps that school districts will need to take,” Beshear said at a news conference. He said school officials' decisions should be driven by "what gives us the best chance to have our kids in school the maximum number of days in the midst of a pandemic? That is it, folks; that should be our North Star." 

The mask guidance specifically pointed to children under 12 because they are not able to be vaccinated yet. Beshear said he expects vaccines will be available to them in the fall or winter. 

Asked if his recommendations will become mandates if the surge in virus cases continues, Beshear said that nothing is off of the table.  

"I'm not gonna take anything off the table when it comes to the health of our people," he said, adding that he expects school districts will do the right thing if there are outbreaks, as they have in the past. 

Asked about the politics of this decision, Beshear said, "This is a moment where we need the courage of some really great elected officials out there: superintendents, board members." Superintendents are chosen by school board members.

"We're not asking all that much when you look at keeping kids in school and protecting them, and we need the buy-in from those local school districts. . . .  And yes, that may mean that you've got to go through some tough school-board meetings, but it's the right thing to do. That's what you signed up for." 

Education Commissioner Jason Glass also called for the courage and leadership by educators to follow the governor's guidance: "We need to call again upon your professionalism and dedication to continue many of those same mitigation efforts from this past spring to keep our schools open and safe for in-person learning."

Ten days earlier, the state recommended that people who aren't fully vaccinated wear masks in schools, and that use of masks by everyone should be considered in schools that have students who can't be vaccinated, low vaccination rates, or "inability to monitor the vaccine status of students and/or teachers and staff."

Now, rather than talking about knowledge of vaccination status, the state has shifted to testing. It is offering a federally funded testing program for grades K-12. The voluntary program is being offered in partnership with the Centers for Disease Control and Prevention and it will be up to schools on how to use it.

Kentucky Health News graph from state data; to enlarge, click on it.

Daily numbers: The recommendations come as every metric used to measure the coronavirus in Kentucky is worsening, including cases, positivity rate, hospitalizations, intensive care and ventilator use.  

The state reported 783 new virus cases Monday, bringing the seven-day rolling average to 886, more than double what it was 10 days ago. The share of Kentuckians testing positive for the virus is 7.89%. In the state's Monday-to-Sunday reporting weeks, those rates have risen four weeks in a row. 

Kentucky hospitals reported 486 patients with Covid-19, more than double the number of 12 days ago; 159 are in intensive care, a number that has more than doubled in 10 days; and 71 of those are on a ventilator, a number that has more than doubled in eight days.

Stack said since July 1, the weekly case numbers and positivity rate have quintupled and the hospitalizations, intensive care unit admissions and ventilator use have tripled. He said health-care providers are already exhausted and that from their view "This is entirely a preventable tragedy." since vaccines are available. 

Vaccinations: As virus cases have surged, vaccinations have increased, but only slightly. In the reporting week that ended Sunday, Kentucky averaged 6,766 vaccinations a day, 15% more than the week before, according to CDC data compiled by The Washington Post.

The state says 2.3 million Kentuckians have received at least one dose of a vaccine, 51.5% of the population; 45.3% have been fully vaccinated. Of those 12 and older, 60.4% have received at least one dose.

The lowest vaccination rates rates continue to be among Kentuckians under 50, with those 40-49 hovering at 52%. "We all need to do better," Beshear said. 

Stack displayed an updated version of a graph showing that unvaccinated Kentuckians are infected at a rate of 5:1 when compared to vaccinated people in Kentucky. 

State Dept. for Public Health graph shows cases declined as vaccinations increased, until the stronger Delta variant became dominant and caused infections in some people who had been vaccinated.

He also stressed the safety of the vaccines in the face of several myths: "Let me be very, very clear. There is no debate here, there's no two sides of the story here, there is fact, and there is fallacy . .. They do not damage your fertility . . . There are no magnets in these vaccines. . . .  Those persons peddling in those falsehoods are killing people, and it is a tragedy. These vaccines work. They are safe." 

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Somerset doctor says spread, strength of Delta variant mean it's too late to 'vax it or mask it'; both needed in high-spread areas

By Kevin Kavanagh

Republished from Infection Control Today

Dr. Jerome Adams, surgeon general in the Trump administration, said this month that the guidelines the Centers for Disease Control and Prevention issued in May on removing of masks were “premature” and “wrong.” Two years ago, most would not believe such a statement, but after the last year and a half, Adams’s statement is viewed by many as just another instance of misguided policy from the CDC. At issue was the May 14 policy reversal of no longer requiring vaccinated individuals to wear masks. The CDC stated it was based solely on science. However, many felt that this would open the door for no one to wear masks. Unfortunately, this is what appears to have happened.

Kevin Kavanagh, M.D.

Then came the Delta variant, virus which is up to 2.25 times as infectious as the wild type virus and has a higher replication rate producing 1,000 times more virons. In addition, it appears to be able to evade immunity. Israel reports vaccine efficacy has dropped to 64% in preventing symptomatic disease, down approximately 30 percentage points. Thus, there is concern that even vaccinated individuals can develop symptomatic diseases and may spread the virus. Most agree that the vaccines are effective in preventing deaths and hospitalizations, but even mild to moderate disease carries the risks of long Covid-19.

Thus, neither masks nor vaccinations will truly afford safety in areas where there is high viral spread. Each is a layer of armor and all need to do both until this virus dissipates.

The CDC and our federal response cause concern. In 2020, advisements on masking were reversed once asymptomatic spread was identified. In the public’s eye, this was held by many to be a sign of incompetence rather than evolving science. But since then, there have been a number of missteps in dealing with the coronavirus, SARS-CoV-2.

The rapidity of viral spread around the world, along with case reports from choirs, restaurants, and hospitals made an extremely strong case for aerosolization of SARS-CoV-2 -- so strong that 239 international scientists asked the World Health Organization and other public-health organizations on July 6, 2020, to recognize aerosolized spread of the virus. The National Academies of Science issued an expensive report on SARS-CoV-2 airborne transmission in October 2020. On Feb. 15, 2021, warnings were sent to the White House, CDC and the National Institutes of Health regarding SARS-CoV-2 aerosolization by 12 prominent infectious-disease authorities. Their letter called for strengthening of CDC guidelines for small-droplet spread with attention to the provision of respirators (N-95 masks) to workers and those exposed to SARS-CoV-2 aerosols.

But it took until May 6 for the CDC to recognize that airborne transmission can be a major spread of the virus. Ironically, a week later the CDC removed the masking requirement for those who are vaccinated, making the need for N-95 masks much less. Others are starting to follow former Surgeon General Adams’ advice. On July 19, 2021, the American Academy of Pediatrics recommended that all children over the age of 2, regardless of vaccination status, wear masks in schools this fall.

One of the safeguards which was present in 2020 was the presence of civilian scientists on the White House Coronavirus Task Force. However, on January 20, President Biden dissolved his Covid-19 transition task force, removing non-governmental employees, including some who later signed the Feb. 15 letter.

Needless-to-say, early recognition of aerosolization would require the use of N-95 masks and make upgrading ventilation systems an imperative. Proper interventions require infrastructure changes and allocation of significant resources. We also need to implement a comprehensive system of genomic sequencing of viral specimens to track community spread. Throughout this pandemic testing has been woefully inadequate in the United States, unless of course you are a member of a professional sports team.

All of these advisements tend to mitigate the seriousness of SARS-CoV-2 and lessen the need for interventions. We need to have a paradigm shift in the way we view this virus, planning and implementing strategies to allow us to live with an endemic pathogen. We need to treat respiratory pathogens with the same vigor and diligence we put forth to prevent water, surface and foodborne disease.

The advice that you’re safe if you “vax it OR mask it” no longer holds with the Delta variant. We must do both. We also need to be taking this virus seriously. We need to remember that many civilizations in the past have been brought down by infectious disease, and species have gone extinct. What separates mankind from the rest of the biosphere is our intelligence and ability to leverage science. If we do not do this, we are in no better position than a tadpole. Unfortunately, almost all of our leaders appear to be hoping the virus will miraculously disappear. This did not work last year, and it will not work in 2021.

Kevin Kavanagh of Somerset is a retired physician and founder of Health Watch USA.

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Here are answers to frequently asked questions about the coronavirus, the Covid-19 disease and the vaccines

MedPage Today illustration

By Melissa Patrick
Kentucky Health News

One of the many challenges facing Kentuckians who remain unvaccinated against the coronavirus is that they still have unanswered questions about vaccines, some based on facts and others based on myths. This story is an attempt to sort through some of those questions and to counter misinformation. 

This information is not only for the unvaccinated. Kentucky Health News encourages individuals who have already been vaccinated to use it as a resource when talking to their loved ones about getting vaccinated, since friends and family have proven to be highly influential in persuading them to do so.  

Covid-19 is no worse than the seasonal flu, right? Wrong. While influenza and Covid-19 are both contagious respiratory illnesses, they are caused by different viruses. Covid-19 appears to be more contagious and to spread more quickly, and is more deadly. Preliminary estimates from the Centers for Disease Control and Prevention are that the U.S. had 38 million flu cases and 22,000 deaths from it in the 2019-20 flu season, for a death rate of 0.06 percent. The U.S. has had nearly 34 million confirmed cases of the coronavirus and nearly 607,000 deaths from Covid-19, for a death rate of 1.79%. In Kentucky, there have been 473,503 cases and 7,308 deaths. a death rate of 1.54%.

Kids don't get it, do they? Yes, they do. Children can be infected with the virus, and can get sick from Covid-19 and spread the virus to others without knowing they have it. In Kentucky, 15.5% of cases have been in people under 20. Most children have mild symptoms or no symptoms, but some have become severely ill from the disease and a few have died. They can also get a rare but serious condition, Multisystem Inflammatory Syndrome in Children, that sometimes doesn't show up until weeks after the infection. Kentucky has had more than 50 reported cases, according to the CDC. The more contagious variant of the virus that recently became dominant seems to affect them more; the American Academy of Pediatrics and Children's Hospital Association's weekly Children and Covid-19 State Data Report says more than 23,500 child cases of Covid-19 were reported between July 8 and 15, nearly double what was reported in late June. 

These vaccines were developed very quickly; how can we be sure that they have been fully researched and proven? The vaccines were developed, tested and given emergency-use authorization in under a year, thanks to years of previous research on related coronaviruses. Researchers had also been working on the technology for years and the timing, and federal funding by Congress and the Trump administration allowed companies to run multiple trials at the same time, saving lots of time. Surgeon General Vivek Murthy said on Twitter, "There were no corners cut in making these vaccines, what was cut was actually red tape."

Chart from University of Kentucky College of Medicine; for a larger version, click on it.

Then why haven’t they been permanently licensed? There has always been a long, deliberate process at the Food and Drug Administration to fully approve a drug, involving a review of much more data over a longer time than is required for emergency use authorization. The FDA has until January to review the materials, but has said it expects to make a decision on full approval within two months. 

Why hasn't the military required them? It appears that they are waiting on the full approval of the vaccine by the FDA before doing so. At this time they are voluntary. The Army has directed commands to prepare to administer mandatory Covid-19 vaccines as early as Sept. 1, pending full approval of the FDA licensure, reports Army Times. The Navy also recently told sailors to expect a mandatory vaccination program as soon as final approval is granted.

Does this new type of vaccine change your DNA? "Covid-19 vaccines do not change or interact with your DNA in any way," the CDC says. The new types of vaccines deliver instructions "to our cells to start building protection against the virus that causes Covid-19." Johns Hopkins University says, "The messenger RNA from two of the first types of Covid-19 vaccines does enter cells, but not the nucleus of the cells where DNA resides. The mRNA does its job to cause the cell to make protein to stimulate the immune system, and then it quickly breaks down — without affecting your DNA." 

What are the issues with the Johnson & Johnson vaccine? Is it still recommended? In April 2021, the J & J (Janssen) single-dose vaccine was paused while the FDA and the CDC investigated a very small number of cases of blood clots in people who had received it, nearly all of them adult women younger than 50. The FDA and CDC recommended that administration of the vaccine could safely resume. 

In July, the FDA added a new warning about the J & J vaccine because it was linked to a rare neurological condition, Guillain-Barré syndrome. Preliminary research found 100 people, out of more than 13 million U.S. doses, who had developed the syndrome after receiving the vaccine; one died and 95 were hospitalized. The FDA said in a news release that after evaluating the information it has determined that “the known and potential benefits” of the vaccine “clearly outweigh the known and potential risks.”

What are the side effects? The most common side effects are pain, redness and swelling on the arm where you got the shot. Other side effects are tiredness, headache, muscle pain, chills, fever and nausea. Side effects after a second shot may be more intense. There have been two confirmed cases of the rare blood clot following the Moderna vaccine, out of 137 million doses.

Serious adverse reactions after a coronavirus vaccination are rare, says the CDC. Anaphylaxis, which can occur after any vaccination, is severe and has occurred in 2 to 5 people per million vaccinated in the U.S. Clinics keep people 15 minutes after the shot to make sure they don't have a reaction.

As of July 19, there have been 1,148 reports of myocarditis or pericarditis among people 30 and younger who received a coronavirus vaccine. Most cases have followed the Pfizer or Moderna vaccine, particularly in male adolescents and young adults. The CDC has confirmed 674 cases; almost 340 million doses have been given, mostly the two-dose vaccines.

Will I need a booster shot? Boosters are common for many viral infection because the vaccine effect may wane. There is concern that the vaccines won't offer sufficient protection against new variants and that high-risk individuals, including seniors, who have weaker immune systems, will need them, Medical News Today reports. The CDC and FDA say they are “prepared for booster doses if and when the science demonstrates that they are needed.”

I don't need a vaccine if I've already had the coronavirus, do I? The CDC recommends that those who have been infected with the virus should be vaccinated because we don't how long or strong the resulting immunity is. "While there is no recommended minimum interval between infection and vaccination, current evidence suggests that the risk of reinfection is low in the months after initial infection but may increase with time due to waning immunity," the CDC says. 

I got fully immunized, but then got infected. How did that happen? No vaccine is 100% effective, health officials say. The Pfizer and Moderna vaccines are about 95% effective in preventing Covid-19 in those without prior infections. The Johnson & Johnson vaccine has a 72% overall efficacy rate and an 86% efficacy against severe disease in the U.S. Research is still ongoing to determine the effectiveness of each vaccine against the Delta variant, but so far most studies show that they are protective, especially against severe illness and death. Healthline reports on a number of studies that support the effectiveness of the three approved vaccines against the Delta variant. 

A study published in the New England Journal of Medicine found that after two doses, the Pfizer vaccine was 88% effective against the highly contagious Delta variant, compared with 31% after one dose. Health officials told The Washington Post that the Moderna vaccine likely offers a similar level of support. Some small studies show that the J&J vaccine is effective against Delta and other variants, but a New York University study that has not been peer-reviewed, shows that it is far less effective against Delta other variants than earlier strains, Forbes reports.

Why are we hearing so much about the Delta variant? It is now by far the dominant strain in the U.S. and Kentucky, and is reported to be about 225 percent more transmissible than the original strain of the virus. 

Chart from UK College of Public Health; click it to enlarge.

People who are not fully vaccinated are most at risk from the Delta variant. Also, a low vaccination rate in a community creates an opportunity for local outbreaks that have the potential to overwhelm the health-care system. Unvaccinated people, those who work in the public, and those who are considered high-risk are encouraged to wear a mask in indoor spaces. Some health officials say everyone should be doing so, especially in places with rising rates of infection. Children under 12 have not been approved for a vaccine, so they are also considered high-risk.

It's important to remember that unvaccinated people are places for the virus to mutate even more, perhaps into even stronger variants. At Fort Bragg, N.C., Force Health Protection Officer Lt. Col. Owen Price, said on a podcast that we are "one mutation away from kind of rolling back down the hill." He added, "I know everybody is Covid-spent, everybody’s over it. But we have to get to a point where there’s no safe haven for the virus to go, and we’re only going to do that through vaccination — and if we don’t get there, we’re going to back-slide."

Can vaccines affect fertility? "The Covid-19 vaccine will not affect fertility," say physicians at Johns Hopkins University in Baltimore. They said the myth sprang from a false report on social media that the Pfizer and Moderna vaccines would affect not only the spike protein on the surface of the virus, but another spike protein that is involved in growth and attachment of the placenta in pregnancy. "The two spike proteins are completely different and distinct, and getting the Covid-19 vaccine will not affect the fertility of women who are seeking to become pregnant, including through in vitro fertilization methods," the doctors say. The CDC says, "There is currently no evidence that Covid-19 vaccination causes any problems with pregnancy, including the development of the placenta. In addition, there is no evidence that female or male fertility problems are a side effect of any vaccine, including Covid-19 vaccines."

What about microchips? There are no microchips or any kind of device in the vaccines, but this hasn't stopped about one in five people from thinking it's true. First and foremost, it is physically impossible; James Heathers of The Atlantic examined the notion in detail. A related myth is that the vaccine can make you magnetic. The CDC says, "Covid-19 vaccines do not contain ingredients that can produce an electromagnetic field at the site of your injection. All Covid-19 vaccines are free from metals." 

Where can I get more information? And how do I tell truth from deception? The Immunization Action Coalition provides a list of questions you should ask when evaluating health information online, such as the original source of the information and who manages it. The University of California-San Francisco offers tips on how to find credible sources of health information, including red flags to watch for, including outdated or anonymous information, possible conflicts of interest, one-sided or biased information, if there is a claim of a miracle or a secret cure, or if no evidence is cited.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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Beshear honors health-care workers at Morehead

A screenshot of the crowd showed at least one masked person, at far left. (WKYT; click to enlarge)

Hundreds of front-line health-care workers gathered at St. Claire Regional Medical Center in Morehead Wednesday night to get thanks from Gov. Andy Beshear and others for their work during the pandemic.

“You all engaged in one of the most remarkable acts of heroism that I've ever seen,” Beshear said, speaking in the past tense – though he said the next day that the recent surge of coronavirus cases poses the prospect that the health-care system in some places could be overwhelmed.

Showing emotion, Beshear said, “The hardest thing I've ever done in my life is to read out the ages and the counties and the genders of those we lost over and over every day. But I showed up every day because I didn't want anybody else to have to do that. But you were sitting there holding their hands and you knew their names and you were going to talk to their family members. And that is something so special that we needed you for above and beyond your regular jobs. You are all super-heroes.”

The state no longer lists the age, sex and county of Kentuckians who die from Covid-19. Deaths are averaging fewer than four per day; two months ago, the average was about eight per day.

Dr. Steven Stack, who became state public-health commissioner about a month before the pandemic hit, told the workers, "Up until March last year, I would have been in an emergency department. I would have been on the front lines with all of you. So as much as this has been difficult and hard, and as much as I've had this incredible privilege to get to serve with and advise a governor and support a state, it does feel in a way like I've been on the sidelines throughout this. Because I would have been in the Emergency Department with all of you. So I want to thank you very much for what you have done.”

The local star at the event was Beshear's senior adviser, Rocky Adkins of Sandy Hook, who was a state representative in the area for many years before challenging Beshear in the 2019 gubernatorial primary. He tearfully thanked St. Claire employees for helping his father, then 84, survive Covid-19 last year.

“My father started his journey of whipping Covid at St Claire,” Adkins said. “If any of you are in this room that treated my father, thank you from the bottom of my heart because I want to report to you your good work. My father has fully recovered. My father is on a tractor. My father is plowing, disking, and raising a half-acre garden and doing it without any oxygen whatsoever. My father is healed because of your good work, and I appreciate that from the bottom of my heart.”

Nikita Gibbs, a registered nurse who has worked at the Morehead's coronavirus testing site every day received a "Service Above Self" award. “She has seen over a hundred thousand nostrils, and she is exposed herself almost 3,000 times to Covid-positive patients. We all know her as the girl and scrubs the wears cowboy boots.”

"Gibbs said the journey has been a difficult one," reports Karyn Czar of WUKY. "But like all her counterparts, one she felt called to do." She told Czar, “It was definitely pretty terrifying at first because I do have a four year[-old] now at home, and she's my pride and joy. So taking that home to her, I was definitely on edge about that. I just wanted to make sure that I help serve my community and the best way that I could.”

Gibbs and other health professionals told Czar that the best way you can thank them is by getting vaccinated. “I really encourage you to get vaccinated, because it is not just for you but the people around you and your loved ones … All my family is vaccinated,” Gibbs said. “I have strongly supported it. Every friend that I talk to, I strongly support getting it.”

Few masks were visible at the event. Beshear said at his press conference the next day that everyone wore a badge saying they had been vaccinated for the virus.

Information for this story was also gathered from WUKY and WKYT.

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130 rural health clinics in Kentucky will get federal money to increase confidence in safety of the coronavirus vaccines

The U.S. Department of Health and Human Services is sending $100 million to more than 1,980 rural health clinics for outreach efforts meant to increase locals' confidence in the safety of coronavirus vaccines, according to a press release. The list has 130 clinics in Kentucky.

David Bolt

Through the Rural Health Clinic Vaccine Confidence Program, clinics can publicize vaccination sites and partner with other public-health entities to create strategies to increase vaccine confidence. Clinics can also use the funding to improve health literacy on vaccines in general. "Compliance is governed by Health Resources and Services Administration rules and regulations, just like any other HRSA grant,” Kentucky Primary Care Association CEO David Bolt told Kentucky Health News.

"This funding is vitally important to Covid-19 vaccination efforts in local communities," Bolt said. "Trusted medical providers at our rural health clinics talk to their patients every day about the safety and effectiveness of the Covid-19 vaccines. Having additional resources will help them reach even more people and further address vaccine hesitancy issues at the community and neighborhood levels."

The funding, announced in May, is part of nearly $1 billion the American Rescue Plan Act authorized for three major programs strengthening pandemic response efforts in rural areas. In addition to the Rural Health Clinic Vaccine Confidence Program, HRSA is providing $460 million to more than 4,600 rural health clinics for coronavirus testing. Another $398 million will go to small rural hospitals for testing and mitigation.

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FactCheck: Origin of the novel coronavirus remains unclear, but U.S. Sen. Rand Paul overstates the case for the Chinese lab

By Lori Robertson and Jessica McDonald

FactCheck.org

At a July 20 U,S. Senate hearing, Republican Sen. Rand Paul and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, once again had a testy exchange over whether the U.S. funded gain-of-function research in China, with each man accusing the other of “lying.”

Gain-of-function research is defined by the U.S. government generally as aiming to “increase the ability of infectious agents to cause disease by enhancing its pathogenicity or by increasing its transmissibility.”

Paul also suggested that the research was tied to “4 million people dying around the world” from Covid-19, but then backed off the implication, saying, “No one’s saying those viruses” studied in the paper in question “caused it.”

Fauci and Paul sparred at a Senate committee hearing.

Most of the exchange was like a flashback to the clash between the two men at a May 11 Senate hearing, which we’ve written about. But the senator also made a false claim about theories on the origins of the SARS-CoV-2 virus, which causes Covid-19.

Paul said that “all the evidence is pointing that it came from the lab,” but there is no evidence linking the novel coronavirus to a lab — only speculation. As we’ve explained, many scientists with expertise in coronaviruses consider a lab escape unlikely and a natural spillover of the virus from an animal to a human the most likely scenario, based on the data we have so far. Several of those scientists summarized their reasoning in a July 7 paper, which has not yet been peer-reviewed.

We’ll recap here what we’ve written about the contention between Paul and Fauci. For more, we refer readers to our two stories on these topics: “The Wuhan Lab and the Gain-of-Function Disagreement” and “The Facts – and Gaps – on the Origin of the Coronavirus.”

Gain-of-Function

As we wrote in May, there’s no dispute that some U.S. funding went to China’s Wuhan Institute of Virology. The disagreement is over whether the research the lab conducted with the money was gain-of-function research.

Nearly $600,000 from a National Institutes of Health grant to the U.S.-based EcoHealth Alliance went to the Wuhan lab, a collaborator on the six-year project to study the risk of the future emergence of coronaviruses from bats. The grant was canceled in April 2020.

The NIH, EcoHealth Alliance and the lead researcher in Wuhan all say the experiments weren’t gain-of-function, and there’s no evidence that Fauci lied to Congress, as Paul asserted in the July 20 hearing, given that the NIH unequivocally backs up Fauci’s statement that the grant-backed research “was judged by qualified staff up and down the chain as not being gain-of-function.”

In a May 19 statement, NIH Director Dr. Francis S. Collins said that “neither NIH nor NIAID have ever approved any grant that would have supported ‘gain-of-function’ research on coronaviruses that would have increased their transmissibility or lethality for humans.”

Scientists have differing opinions on what counts as gain-of-function research, however, and which experiments would yield valuable insights into pathogens and how to combat them, and which are not worth the risks.

Paul cited Richard Ebright, a professor of chemistry and chemical biology at Rutgers University and a critic of gain-of-function research, who disagrees with the NIH. Ebright has said that the EcoHealth-Wuhan lab research “was — unequivocally — gain-of-function research.” And Paul cited a 2017 paper, published in the journal PLOS Pathogens, partly thanks to funding from that EcoHealth Alliance grant.

The paper was published shortly before the U.S. government lifted a three-year pause on gain-of-function research “that may be reasonably anticipated to confer attributes to influenza, MERS, or SARS viruses such that the virus would have enhanced pathogenicity and/or transmissibility in mammals via the respiratory route,” per the White House’s 2014 announcement.

On July 20, Paul addressed Fauci: "This research matches, indeed epitomizes the definition of gain-of-function research, done entirely in Wuhan, for which there was supposed to be a federal pause. Dr. Fauci, knowing that it is a crime to lie to Congress, do you wish to retract your statement of May 11th, where you claimed that the NIH never funded gain-of-function research in Wuhan?"

Fauci replied, "Senator Paul, I have never lied before the Congress, and I do not retract that statement. This paper that you were referring to was judged by qualified staff up and down the chain as not being gain-of-function."

Again, the NIH says the EcoHealth grant didn’t fund gain-of-function research. “No dispensation was needed as no gain-of-function research was being conducted,” a spokesman for EcoHealth told us.

The 2017 paper, authored primarily by Wuhan Institute of Virology researchers including Shi Zhengli, determined that bat coronaviruses in a cave in Yunnan, China, had “all of the building blocks” of the SARS coronavirus, which caused an outbreak in 2003. Shi is famous for her work tracking down the origins of the SARS epidemic.

The authors “speculate that the direct ancestor” of the SARS virus may have been a result of recombination — or the natural combining of genetic material — of precursors of these bat coronaviruses. And the authors found that the bat coronaviruses had the potential for direct transmission to humans.

A few of their experiments combined different elements of viruses to better understand what’s required to infect human cells. Specifically, the 2017 research used the backbone of WIV1, a bat SARS-like virus reported in 2013, and swapped in the spike protein of two newly identified bat coronaviruses to see if they, like WIV1, can use the human ACE2 receptor to enter human cells. The researchers found that both chimeric viruses could use ACE2 to infect and replicate in human cells in culture. (The researchers attempted to make six other chimeric viruses, but when put into monkey cells the viral constructs did not replicate.)

Is that gain-of-function? Again, there are different definitions and opinions on that. We reached out to the NIH asking for a more detailed explanation of why the 2017 paper didn’t meet its definition, and we’ll update this story if we get a response.

Dr. Stanley Perlman, a professor of microbiology and immunology at the University of Iowa who studies coronaviruses, told us that in the type of research conducted under the EcoHealth grant “these viruses are almost always attenuated,” meaning weakened. He also said that making a virus that could infect human cells in a lab doesn’t mean the virus is more infectious for humans. Viruses adapt to the cell culture, he said, and may grow well in a cell culture but then not actually infect animals very well.

For her part, Shi told The New York Times in June that her lab had never conducted experiments “that enhance the virulence of viruses.”

Origins of SARS-CoV-2

In the July 20 hearing, Paul, again tied the U.S. funding of the Wuhan lab to the origin of the SARS-CoV-2 pandemic, and after the hearing, the hashtag #FauciLiedPeopleDied began trending on Twitter. But as Fauci correctly said, there’s no evidence the lab had a coronavirus that could possibly be manipulated enough to lead to the SARS-CoV-2 virus, according to several experts. Paul then said he wasn’t implying that.

Here’s part of that exchange:

Paul: "It’s a dance, and you’re dancing around this because you’re trying to obscure responsibility for 4 million people dying around the world from a pandemic."

Fauci: "I have to … well, now you’re getting into something. If the point that you are making is that the grant that was funded as a sub award from EcoHealth to Wuhan created SARS-CoV-2, that’s where you were getting. Let me finish. …"

Paul: "We don’t know if it didn’t come from the lab, but all the evidence is pointing that it came from the lab, and there will be responsibility for those who funded the lab, including yourself. …"

Fauci: "I totally resent the lie that you are now propagating, senator, because if you look at the viruses that were used in the experiments that were given in the annual reports that were published in the literature, it is molecularly impossible."

Paul: "No one’s saying those viruses caused it. No one is … We’re saying they are gain-of-function viruses, because they were animal viruses that became more transmissible in human and you funded it. And you won’t admit the truth. …"

Fauci: "And you are implying that what we did was responsible for the deaths of individuals. I totally resent that."

Paul: "It could have been. It could have been."

Fauci: "And if anybody is lying here, Senator, it is you."

There’s no evidence that the Wuhan laboratory, with or without funding from an NIH grant, created SARS-CoV-2.

Many scientists remain open to a lab escape of a natural virus, but fewer entertain the notion that SARS-CoV-2 was engineered. While this cannot be ruled out entirely, multiple coronavirus experts view this as implausible. And the only way SARS-CoV-2 could have come from the lab, whether manipulated or a naturally occurring virus, is if the Wuhan lab was in possession of a virus much more similar to SARS-CoV-2 than the coronaviruses that have been identified.

Robert F. Garry, a virologist at Tulane University School of Medicine, told us a coronavirus would have to be “at least 99%” similar to SARS-CoV-2 and “probably” 99.9% similar “to make that kind of switch in the lab at all.”

“There’s just no evidence,” he said, that the Wuhan Institute of Virology “had anything close to that.”

Shi announced in late January 2020 that a bat virus the lab named RaTG13 shares 96.2% of its genome with SARS-CoV-2, which is the highest percentage of any known virus. But experts say speculation that RaTG13 could have been changed to become SARS-CoV-2 is misplaced.

That’s because RaTG13’s genome still differs from SARS-CoV-2 by more than 1,000 nucleotides. “RaTG13 is too divergent to be this ancestral virus,” David Robertson, the head of viral genomics and bioinformatics at the University of Glasgow, told us.

Shi says there is only a genome sequence for RaTG13 anyway — live virus was never isolated from the sample.

Notably, other teams have subsequently found three other bat viruses that are more closely related to SARS-CoV-2 than RaTG13 when factoring in viral recombination — although they, too, are not precursors to the virus.

Paul claimed: “We don’t know if it didn’t come from the lab, but all the evidence is pointing that it came from the lab.” That’s not the case.

“On lab-leak, there’s no evidence that SARS-CoV-2 escaped from a lab other than the coincidence of the Wuhan Institute of Virology being there,” Robertson told us.

Many scientists who study coronaviruses say what data we do have points to a natural spillover as the likely origin, given the presence of similar viruses circulating in bats, the links of many of the first COVID-19 cases to animal markets in Wuhan and past spillover events with other coronaviruses. But without identification of a near-identical virus in a bat or other animal, scientists cannot be completely certain.

FactCheck.org is a nonpartisan, nonprofit that monitors the factual accuracy of what is said by major U.S. political players. It is a project of the Annenberg Public Policy Center of the University of Pennsylvania. The APPC was established by publisher and philanthropist Walter Annenberg to create a community of scholars to address public-policy issues. FactCheck's Covid-19/Vaccination Project is funded by the Robert Wood Johnson Foundation; it says the foundation has no control over editorial decisions, and the conclusions it reaches "do not necessarily reflect the views of the foundation. The goal of the project is to increase exposure to accurate information about Covid-19 and vaccines, while decreasing the impact of misinformation."

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