Enlarge/ Residents line up for COVID-19 testing on November 30, 2020 in Chicago.
The co-owner of a Chicago-based lab has pleaded guilty for his role in a COVID testing scam that raked in millions—which he used to buy stocks, cryptocurrency, and several luxury cars while still squirreling away over $6 million in his personal bank account.
Zishan Alvi, 45, of Inverness, Illinois, co-owned LabElite, which federal prosecutors say billed the federal government for COVID-19 tests that were either never performed or were performed with purposefully inadequate components to render them futile. Customers who sought testing from LabElite—sometimes for clearance to travel or have contact with vulnerable people—received either no results or results indicating they were negative for the deadly virus.
The scam, which ran from around February 2021 to about February 2022, made over $83 million total in fraudulent payments from the federal government’s Health Resources and Services Administration (HRSA), which covered the cost of COVID-19 testing for people without insurance during the height of the pandemic. Local media coverage indicated that people who sought testing at LabElite were discouraged from providing health insurance information.
The list included five vehicles: a 2021 Mercedes-Benz, a 2021 Land Rover Range Rover HSE, a 2021 Lamborghini Urus, A 2021 Bentley, and a 2022 Tesla X. There was also about $810,000 in an E*Trade account, approximately $500,000 in a Fidelity Investments account, and $245,814 in a Coinbase account. Last, there was $6,825,089 in Alvi’s personal bank account.
On Monday, the Department of Justice announced a deal in which Alvi pleaded guilty to one count of wire fraud, taking responsibility for $14 million worth of fraudulent HRSA claims. He now faces up to 20 years in prison and will be sentenced on February 7, 2025.
Enlarge/ Polio victim Larry Montoya is at the airport for the arrival of cases of vaccine, which were distributed as part of the KO Polio campaign, September 5, 1962.
Public sentiment on the importance of safe, lifesaving childhood vaccines has significantly declined in the US since the pandemic—which appears to be solely due to a nosedive in support from people who are Republican or those who lean Republican, according to new polling data from Gallup.
In 2019, 52 percent of Republican-aligned Americans said it was “extremely important” for parents to get their children vaccinated. Now, that figure is 26 percent, falling by half in just five years. In comparison, 63 percent of Democrats and Democratic leaners said it was “extremely important” this year, down slightly from 67 percent in 2019.
Overall, only 40 percent of Americans now say it is extremely important for parents to vaccinate their children, down from 58 percent in 2019 and 64 percent in 2001.
More broadly, 93 percent of the Democratic group said it was “extremely” or “very” important for parents to vaccinate their children this year, while only 52 percent of the Republican group said the same.
On the other end of the spectrum, 11 percent of the Republican group said vaccinating children was “not important at all,” and an additional 8 percent said it was “not very important.” For the Democratic group, only 1 percent was reported in each of those categories.
Dangerous disinformation
Perhaps most concerning, the data indicated that a growing number of Americans view vaccines as more dangerous than the diseases they prevent—including polio, measles, tetanus, rotavirus, diphtheria, whooping cough, meningitis, and RSV, among others. Now, 20 percent of Americans overall think vaccines are more of a threat than the dangerous diseases they effectively prevent.
The partisan divide is most stark on this sentiment. In 2019, the two parties were about the same. Twelve percent of the Republican group and 10 percent of the Democratic group held this erroneous belief. But now, a whopping 31 percent of the Republican group say vaccines are a more significant threat than dangerous diseases, while the percentage among the Democratic group fell to 5 percent.
Republicans and Republican leaners are much more likely than Democrats and Democratic leaners to believe the false and debunked claim that vaccines are linked to autism—19 percent of the Republican group believe this falsehood compared to 4 percent of the Democratic group.
The polling data aligns with national vaccination trends tracked by the Centers for Disease Control and Prevention. During the pandemic, rates of routine vaccination among kindergartners slipped from the protective target of 95 percent—which prevents infectious diseases from spreading widely—to 93 percent. Additionally, nonmedical exemptions from vaccinations have reached an all-time high of 3 percent nationally. At least 10 states have exemption rates at or above 5 percent, preventing them from reaching the protective target of 95 percent vaccination coverage.
The US government will pay Moderna $176 million to develop an mRNA vaccine against a pandemic influenza—an award given as the highly pathogenic bird flu virus H5N1 continues to spread widely among US dairy cattle.
The funding flows through BARDA, the Biomedical Advanced Research and Development Authority, as part of a new Rapid Response Partnership Vehicle (RRPV) Consortium. The program is intended to set up partnerships with industry to help the country better prepare for pandemic threats and develop medical countermeasures, the Department of Health and Human Services said in a press announcement Tuesday.
In an announcement of its own Tuesday, Moderna noted that it began a Phase 1/2 trial of a pandemic influenza virus vaccine last year, which included versions targeting H5 and H7 varieties of bird flu viruses. The company said it expects to release the results of that trial this year and that those results will direct the design of a Phase 3 trial, anticipated to begin in 2025.
The funding deal will support late-stage development of a “pre-pandemic vaccine against H5 influenza virus,” Moderna said. But, the deal also includes options for additional vaccine development in case other public health threats arise.
“mRNA vaccine technology offers advantages in efficacy, speed of development, and production scalability and reliability in addressing infectious disease outbreaks, as demonstrated during the COVID-19 pandemic,” Moderna CEO Stéphane Bancel said in the announcement. “We are pleased to continue our collaboration with BARDA to expedite our development efforts for mRNA-based pandemic influenza vaccines and support the global public health community in preparedness against potential outbreaks.”
US health officials have said previously that they were in talks with Moderna and Pfizer about the development of a pandemic bird flu vaccine. The future vaccine will be in addition to standard protein-based bird flu vaccines that are already developed. In recent weeks, the health department has said it is working to manufacture 4.8 million vials of H5 influenza vaccine in the coming months. The plans come three months into the H5N1 dairy outbreak, which is very far from the initial hopes of containment.
Botched response
The US is badly fumbling its response to the unprecedented outbreak, drawing criticism from US-based and international experts alike. Genetic analyses suggest that the virus has been spreading among the country’s dairy cattle since late last year. But, it wasn’t until months later, on March 25, that the US Department of Agriculture confirmed the first four infected herds in two states (Texas and Kansas). Since then, the outbreak has spread to around 140 herds in 12 states—at least.
Some farms are refusing to test, and experts expect that there is a significant number of undocumented herd infections, particularly given the widespread detection of inactivated H5N1 in the commercial milk supply. Further, of the 140 herds with documented infections, federal officials do not know how many are still actively infected rather than recovered. It is unclear if infected cows can become reinfected, and if so, how quickly after an infection.
While the risk to the general public is considered to be low currently, farm workers are at higher risk of contracting the infection. To date, there have been three confirmed infections among dairy farm workers—one in Texas and two in Michigan, which has had a uniquely robust response to the outbreak. Still, with hundreds to thousands of farm workers at risk of contracting the virus, only 53 people in the country to date have been tested for H5 influenza.
In a presentation in London last month, global health leader Seth Berkley said it was “shocking to watch the ineptitude” of the US response to the H5N1 outbreak. He, like other experts, questioned whether the US public health community has learned or improved from the failures of the COVID-19 pandemic.
Similar to problems during the pandemic, a key barrier to the H5N1 response is resistance from farmers and farm workers to partner with state and federal health officials. Federal agencies have limited authority within states, but they have announced an array of assistance programs for dairy farms, including compensatory funding and access to personal protective equipment for farm workers. They have also issued guidance and restrictions to tighten biosecurity measures. But there has been little voluntary participation on both fronts.
For instance, officials figured out early in the outbreak that movement of cattle, workers, and equipment between farms is the main way H5N1 is spreading among dairies. In April, the USDA required testing of a portion of cows prior to their movement across state lines. But movement within states is governed by states. In a survey last month, which captured data from 54 percent of affected farms at the time, more than 60 percent of farmers said they continued to move cattle off their infected farms after the onset of clinical signs of infection in their animals.
The more the virus expands its footprint across US dairy farms, adapts to its newfound mammalian host, and comes in contact with humans, the more and more chances it has to leap to humans and gain the ability to spread among us.
In HHS’s Tuesday announcement of the Moderna award, Dawn O’Connell, assistant secretary for Preparedness and Response, spoke to the growing concern that the H5N1 outbreak could spark another pandemic. “The award made today is part of our longstanding commitment to strengthen our preparedness for pandemic influenza,” O’Connell said. “Adding this technology to our pandemic flu toolkit enhances our ability to be nimble and quick against the circulating strains and their potential variants.”
The North Carolina State Senate on Wednesday voted 30–15, along party lines, in favor of a Republican bill that would make it illegal for people in the state to wear a mask in public for health reasons. The bill is now moving to the House, where it could potentially see changes.
The proposed ban on health-based masking is part of a larger bill otherwise aimed at increasing penalties for people wearing masks to conceal their identity while committing a crime or impeding traffic. The bill was largely spurred by recent protests on university and college campuses across the country, including North Carolina-based schools, against the war in Gaza. In recent months, there have been demonstrations in Raleigh and Durham that have blocked roadways, as well as clashes on the nearby campus of the University of North Carolina at Chapel Hill. Some demonstrators were seen wearing masks in those events.
But the bill, House Bill 237, goes a step further by making it illegal to wear a mask in public for health and safety reasons, either to protect the wearer, those around them, or both. Specifically, the bill repeals a 2020 legal exemption enacted amid the COVID-19 pandemic, which allowed for public health-based masking for the first time in decades.
Prior to 2020, laws dating back to 1953 largely prohibited public masking. The prohibition was part of a crackdown on “secret societies” at the time, or more specifically, an attempt to curtail the activities of the Ku Klux Clan in the state. Exemptions only existed for things like holiday costumes, theater productions, gas masks, and members of public parades or ceremonies that had obtained permits.
On Wednesday, North Carolina residents with compromised immune systems spoke—while masked—during a public comment section. Simone Hetherington told lawmakers that masking was the only way to protect herself in public from illness and feared passage of the bill would prevent her from doing so, according to reporting by the Associated Press.
But, according to The News & Observer, Republicans were dismissive of that possibility, arguing that in the decades prior to the pandemic, when public masking was largely illegal, they couldn’t recall anyone being prosecuted for wearing a mask for health reasons.
Raleigh-based news outlet WRAL quoted Sen. Sydney Batch, a Democrat from Wake, who criticized the bill along with fellow Democratic colleagues. Batch, a cancer survivor, spoke of how her husband and children wore masks to protect her while she underwent cancer treatments that weakened her immune system. “This bill criminalizes their behavior and mine,” she said. “We talk a lot about freedoms in this chamber. I hear it all the time. I should have the freedom—my children and my husband should have the freedom—to wear masks in order to protect and save my life, without fear of being arrested and charged.”
The US Department of Agriculture this week posted an unpublished version of its genetic analysis into the spillover and spread of bird flu into US dairy cattle, offering the most complete look yet at the data state and federal investigators have amassed in the unexpected and worrisome outbreak—and what it might mean.
The preprint analysis provides several significant insights into the outbreak—from when it may have actually started, just how much transmission we’re missing, stunning unknowns about the only human infection linked to the outbreak, and how much the virus continues to evolve in cows. The information is critical as flu experts fear the outbreak is heightening the ever-present risk that this wily flu virus will evolve to spread among humans and spark a pandemic.
But, the information hasn’t been easy to come by. Since March 25—when the USDA confirmed for the first time that a herd of US dairy cows had contracted the highly pathogenic avian influenza H5N1 virus—the agency has garnered international criticism for not sharing data quickly or completely. On April 21, the agency dumped over 200 genetic sequences into public databases amid pressure from outside experts. However, many of those sequences lack descriptive metadata, which normally contains basic and key bits of information, like when and where the viral sample was taken. Outside experts don’t have that crucial information, making independent analyses frustratingly limited. Thus, the new USDA analysis—which presumably includes that data—offers the best yet glimpse of the complete information on the outbreak.
Undetected spread
One of the big takeaways is that USDA researchers think the spillover of bird flu from wild birds to cattle began late last year, likely in December. Thus, the virus likely circulated undetected in dairy cows for around four months before the USDA’s March 25 confirmation of an infection in a Texas herd.
This timeline conclusion largely aligns with what outside experts previously gleaned from the limited publicly available data. So, it may not surprise those following the outbreak, but it is worrisome. Months of undetected spread raise significant concerns about the country’s ability to identify and swiftly respond to emerging infectious disease outbreaks—and whether public health responses have moved past the missteps seen in the early stages of the COVID-19 pandemic.
But another big finding from the preprint is how many gaps still exist in our current understanding of the outbreak. To date, the USDA has identified 36 herds in nine states that have been infected with H5N1. The good news from the genetic analysis is that the USDA can draw lines connecting most of them. USDA researchers reported that “direct movement of cattle based upon production practices” seems to explain how H5N1 hopped from the Texas panhandle region—where the initial spillover is thought to have occurred—to nine other states, some as far-flung as North Carolina, Michigan, and Idaho.
Enlarge/ Bayes factors for inferred movement between different discrete traits of H5N1 clade 2.3.4.4b viruses demonstrating the frequency of movement.
Enlarge/ Putative transmission pathways of HPAI H5N1 clade 2.3.4.4b genotype B3.13 supported by epidemiological links, animal movements, and genomic analysis.
Putative transmission pathways of HPAI H5N1 clade 2.3.4.4b genotype B3.13 supported by epidemiological links, animal movements, and genomic analysis. [/ars_img]The bad news is that those lines connecting the herds aren’t solid. There are gaps in which the genetic data suggests unidentified transmission occurred, maybe in unsampled cows, maybe in other animals entirely. The genetic data is clear that once this strain of bird flu—H5N1 clade 2.3.4.4 genotype B3.13 —hopped into cattle, it could readily spread to other mammals. The genetic data links viruses from cattle moving many times into other animals: There were five cattle-to-poultry jumps, one cattle-to-raccoon transmission, two events where the virus moved from cattle to domestic cats, and three times when the virus from cattle spilled back into wild birds.
“We cannot exclude the possibility that this genotype is circulating in unsampled locations and hosts as the existing analysis suggests that data are missing and undersurveillance may obscure transmission inferred using phylogenetic methods,” the USDA researchers wrote in their preprint.
For some, having to work from home during the COVID-19 pandemic was stressful. Parents balanced job duties while caring for children. Some struggled to set up a home office and adjust to new tools, like video conferencing. Lonely workdays at home added to social isolation. The line between work and life blurred.
For others, working from home was a boon—comfort, convenience, flexibility, no commuting or rush-hour traffic, no office-environment distractions. When the acute aspects of the pandemic receded, some who at first struggled began to settle into a work-from-home (WFH) groove and appreciated the newfound flexibility.
Then, bosses began calling their employees back to the office. Many made the argument that the return-to-office (RTO) policies and mandates were better for their companies; workers are more productive at the office, and face-to-face interactions promote collaboration, many suggested. But there’s little data to support that argument. Pandemic-era productivity is tricky to interpret, given that the crisis disrupted every aspect of life. Research from before the pandemic generally suggested remote work improves worker performance—though it often included workers who volunteered to WFH, potentially biasing the finding.
For a clearer look at the effect of RTO policies after the pandemic, two business researchers at the University of Pittsburgh examined a sample of firms on the S&P 500 list—137 of which had RTO mandates and 320 that clearly did not between June 2019 and January 2023. The researchers collected publicly available data on each company, including financial data and employee reviews. They then looked at what factors were linked to whether a firm implemented an RTO policy—such as the company’s size, financial constraints, and CEO characteristics—as well as the consequences of the RTO mandates—employee satisfaction and financial metrics of the firms.
Overall, the analysis, released as a pre-print, found that RTO mandates did not improve a firm’s financial metrics, but they did decrease employee satisfaction.
Drilling down, the data indicated that RTO mandates were linked to firms with male CEOs who had greater power in the company. Here, power is measured as the CEO’s total compensation divided by the average total compensation paid to the four highest-paid executives in the firm.
Before the analysis, the researchers hypothesized that RTO mandates may be used to blame employees for poor firm performance. But, companies that have institutional ownership—such as hedge funds or endowments—would not fall for such a “blame game” and would thus would be less likely to implement an RTO mandate. The data supported those hypotheses. Firms with weaker stock performance before employees were able to return to the office were more likely to enforce RTO mandates. However, institutional ownership decreased the probability of RTO mandates.
Although CEOs often justified RTO mandates by arguing it will improve the company’s performance, “Results of our determinant analyses are consistent with managers using RTO mandates to reassert control over employees and blame employees as a scapegoat for bad firm performance,” the researchers concluded.
Unsurprisingly, the researchers also found that RTO mandates were linked to decreases in employee satisfaction. Specifically, after an RTO mandate, employees’ ratings significantly declined on overall job satisfaction, work-life balance, senior management, and corporate culture. But their ratings of factors unrelated to RTO did not change, indicating that the RTO mandate was driving dissatisfaction.
The study has limitations, including a short time frame to look at long-term outcomes of RTO policies and a time frame that overlapped with a labor shortage. Worker responses may be different in a tight labor market. Still, the study adds some data to the ongoing debate—and feuds—over RTO policies.
The Centers for Disease Control and Prevention is putting clinicians on alert about the growing risk of measles cases and outbreaks amid a global surge in transmission.
Between December 1, 2023, and January 23, 2024, there have been 23 confirmed measles cases in the US, including seven direct importations by international travelers and two outbreaks with more than five cases each, the CDC noted. Most of the cases were in unvaccinated children and teens.
Measles outbreaks in the US are typically sparked by unvaccinated or undervaccinated US residents who pick up the infection abroad and then, when they return, transmit the disease to pockets of their communities that are also unvaccinated or undervaccinated.
Globally and in the US, vaccination rates against measles—via the measles, mumps, and rubella vaccine (MMR)—have fallen in recent years due to pandemic-related health care disruption and vaccine hesitancy fueled by misinformation.
“The increased number of measles importations seen in recent weeks is reflective of a rise in global measles cases and a growing global threat from the disease,” the CDC’s outreach message, titled “Stay Alert for Measles Cases,” read.
According to data from the World Health Organization, the European region saw an over 40-fold rise in measles cases in 2023 as compared with 2022. The region tallied over 42,200 measles cases last year, compared with just 941 in 2022.
This week, the WHO reported a rapid escalation of measles cases in Kazakhstan (which the WHO considers part of the European region). Kazakhstan has recorded the highest incidence of measles cases in the region, with 13,677 cases in 2023. That corresponds to over 639 cases per million in the population. In the news release Tuesday, Kazakhstan’s health minister reported that there are “currently 2,167 children in hospital with measles, 27 of them in a serious condition.”
The outbreak is largely spurred by unvaccinated children who missed their routine immunizations during the pandemic. Sixty-five percent of the reported measles cases are in children under age 5, the WHO noted. The country is now trying to catch children up on their vaccines to curb the outbreak.
“Measles is highly infectious, but fortunately, can be effectively prevented through vaccination,” WHO’s Regional Director for Europe, Hans Henri P. Kluge, said in the news release. “I commend Kazakhstan for the urgent measures being taken to stop the spread of this dangerous disease.”
Meanwhile, measles is flaring up in many other places. Last week, the UK Health Security Agency warned of the potential for an ongoing measles outbreak to spread. As of January 18, there were 216 confirmed cases and 103 probable cases in the West Midlands region since October 2023. Authorities warned that any areas with low MMR vaccination rates are at risk of an outbreak.
The vast majority of Americans have received their MMR vaccines on schedule. In this case, the two standard, recommended doses are considered 97 percent effective against measles, and the protection is considered for life. But anyone who is unvaccinated or undervaccinated is at high risk of infection in the event of an exposure. The virus can linger in air space for up to two hours after an infected person leaves the area, the CDC notes, and is highly infectious—up to 90 percent of unvaccinated people exposed will fall ill. Once infected, people are infectious from four days before the telltale measles rash develops to four days afterward.
