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US, Russia, China won't join global initiative to offer fair access to COVID-19 vaccines. Why not?
The U.S., China, and Russia are in a "vaccine race" that treats a global challenge like a winner-take-all game.
The board game "Pandemic" tasks players with stopping deadly diseases as they spread across the world. But what separates "Pandemic" from its winner-take-all peers is that it's a collaborative endeavor. Players either pull together to stamp out their microscopic foes, or they all lose.
Commentators have naturally drawn comparisons between the game and the COVID era it has become emblematic of, and those parallels have become more fitting lately. On September 21, the World Health Organization (WHO) announced that 156 countries had joined the COVAX Facility, a worldwide collaboration to develop a vaccine and distribute it strategically and equitably.
But as any "Pandemic" fan will tell you, there are always those players: the ones who cut ties with the others, who play to be the most powerful, who reinterpret the goal as domination in a zero-sum game of their own devising. Unfortunately for WHO and its allies, three big global players have refused to play cooperatively: China, Russia, and the United States.
All for one (vaccine)
Launched this April, the Access to COVID-19 Tools (ACT) Accelerator brought together a panoply of governments, scientists, businesses, and global health organizations with the goal of accelerating the development, production, and distribution of an efficacious COVID-19 vaccine. The "vaccines pillar" of this initiative is the COVAX Facility.
COVAX is coordinated by the WHO, the Coalition for Epidemic Preparedness Innovations (CEPI), and Gavi, the Vaccine Alliance. The program maintains a diverse portfolio of COVID-10 vaccines, monitoring each to identify promising candidates. It has also partnered with manufacturers to ease investment risks and serves as a purchasing pool for self-financing countries, while offering fundraising efforts to poorer ones.
"[G]overnments from every continent have chosen to work together, not only to secure vaccines for their own populations, but also to help ensure that vaccines are available to the most vulnerable everywhere," Seth Berkley, CEO of Gavi, said in a release. "With the commitments we're announcing today for the COVAX Facility, as well as the historic partnership we are forging with industry, we now stand a far better chance of ending the acute phase of this pandemic once safe, effective vaccines become available."
In an interview with Vox, Berkley noted that the ACT Accelerator is the largest global collaboration since the Paris Climate Agreement. He added, "This type of solidarity is critical because otherwise what you're going to end up with is just a constant reintroduction of infections and the inability to go back to normal."
As of Monday, 64 higher-income countries and 92 low- and middle-income countries—representing nearly two-thirds of the world's population—have signed commitments to COVAX. Thirty-eight more are expected to sign soon.
COVAX's goal is to have 2 billion doses by the end of 2021. Experts estimate this amount will cover high-risk and vulnerable people, as well as healthcare workers, worldwide. Participating nations must cover those populations before administering vaccines according to national priorities. As part of the agreement, countries agree to support equal access to the vaccine once it becomes available, a move aimed at preventing hoarding and price gouging.
Currently, CEPI is supporting nine candidate vaccines, of which eight are in clinical trials.
Why has the U.S. backed out?
The United States is gambling that its bilateral deals with various pharmaceutical companies will win the "vaccine race." This U.S.-only initiative, named (sigh) Operation Warp Speed, has already spent approximately $10 billion and is pushing to deliver 300 million doses by January 2021. Many experts worry this speedy push through the regulatory path could result in premature and dangerous approvals.
China and Russia have likewise bet on their own high-priced ponies. Russia is touting an unvetted vaccine nicknamed (double sigh) "Sputnik V." This vaccine has only concluded phase 1 and 2 trials with a small number of participants, yet Russia claims to have already received international requests. Meanwhile, China has administered tens of thousands of doses of a vaccine before completing phase 3 clinical trials.
An additional barrier to the United States' participation: COVAX is a WHO-led initiative. Earlier this year, President Donald Trump admonished the WHO as a corrupt organization and claimed it assisted China in covering up the coronavirus outbreak and its severity. Though he presented no evidence for the accusation, Trump has used it as the basis for his threat to cut ties with, and funding for, the agency.
"The United States will continue to engage our international partners to ensure we defeat this virus, but we will not be constrained by multilateral organizations influenced by the corrupt World Health Organization and China," said Judd Deere, a spokesman for the White House, said in a statement.
He added, "This president will spare no expense to ensure that any new vaccine maintains our own FDA's gold standard for safety and efficacy, is thoroughly tested, and saves lives."
By shirking COVAX, these countries hope to gain peerless access to a vaccine. Each could secure large numbers of doses for its citizens while also reaping the political boons to follow. In the United States, President Trump has pinned his re-election bid on a timely vaccine, while Chinese officials seem posed to use a vaccine to repair diplomatic ties.
But the loss of such rich economies will prove a blow to COVAX and the ACT Accelerator. Vaccines are notoriously expensive and risky to develop; the costs to manufacture doses at scale will be immense. WHO Director-General Tedros Adhanom Ghebreyesus stated the ACT Accelerator would cost roughly $30 billion, and the final bill for the tools to combat novel coronavirus would be at least $100 billion. But that's a pittance compared to the $10 trillion already spent on the pandemic so far.
"COVID-19 is an unprecedented global crisis that demands an unprecedented global response," Tedros said. "Vaccine nationalism will only perpetuate the disease and prolong the global recovery. Working together through the COVAX Facility is not charity, it's in every country's own best interests to control the pandemic and accelerate the global economic recovery."
The winner won't necessarily take all
By COVAX's count, there are 170 COVID-19 vaccines in development. None have been approved, few have reached phase 3, and most will fail to exit clinical trials. While one or two may be ready by year's end, they probably won't be a corona-cure-all. They will likely be similar to flu vaccines, reducing the contraction risk and the severity of symptoms.
"We all recognize that flu vaccine, in a year when it's efficacious, you have what, 50% protection? And in a year when it's poor you have 30% or less than that—and still we use that," Marie-Paule Kieny, WHO assistant director-general of Health Systems and Innovation, told Stat.
That means any country to pass the approval finish line won't necessarily win it all. After approval, it will still take a global effort to manufacture and distribute doses. Without blanketed protection, even countries with a high inoculation rate will risk reintroduction of the virus from those still struggling to contain it.
As any player of "Pandemic" will tell you, when a player decides to go it alone, they don't just make the game more difficult. They diminish the trust and cooperation for many games to come.
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Northwell Health is using insights from website traffic to forecast COVID-19 hospitalizations two weeks in the future.
- The machine-learning algorithm works by analyzing the online behavior of visitors to the Northwell Health website and comparing that data to future COVID-19 hospitalizations.
- The tool, which uses anonymized data, has so far predicted hospitalizations with an accuracy rate of 80 percent.
- Machine-learning tools are helping health-care professionals worldwide better constrain and treat COVID-19.
The value of forecasting<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTA0Njk2OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyMzM2NDQzOH0.rid9regiDaKczCCKBsu7wrHkNQ64Vz_XcOEZIzAhzgM/img.jpg?width=980" id="2bb93" class="rm-shortcode" data-rm-shortcode-id="31345afbdf2bd408fd3e9f31520c445a" data-rm-shortcode-name="rebelmouse-image" data-width="1546" data-height="1056" />
Northwell emergency departments use the dashboard to monitor in real time.
Credit: Northwell Health<p>One unique benefit of forecasting COVID-19 hospitalizations is that it allows health systems to better prepare, manage and allocate resources. For example, if the tool forecasted a surge in COVID-19 hospitalizations in two weeks, Northwell Health could begin:</p><ul><li>Making space for an influx of patients</li><li>Moving personal protective equipment to where it's most needed</li><li>Strategically allocating staff during the predicted surge</li><li>Increasing the number of tests offered to asymptomatic patients</li></ul><p>The health-care field is increasingly using machine learning. It's already helping doctors develop <a href="https://care.diabetesjournals.org/content/early/2020/06/09/dc19-1870" target="_blank">personalized care plans for diabetes patients</a>, improving cancer screening techniques, and enabling mental health professionals to better predict which patients are at <a href="https://healthitanalytics.com/news/ehr-data-fuels-accurate-predictive-analytics-for-suicide-risk" target="_blank" rel="noopener noreferrer">elevated risk of suicide</a>, to name a few applications.</p><p>Health systems around the world have already begun exploring how <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315944/" target="_blank" rel="noopener noreferrer">machine learning can help battle the pandemic</a>, including better COVID-19 screening, diagnosis, contact tracing, and drug and vaccine development.</p><p>Cruzen said these kinds of tools represent a shift in how health systems can tackle a wide variety of problems.</p><p>"Health care has always used the past to predict the future, but not in this mathematical way," Cruzen said. "I think [Northwell Health's new predictive tool] really is a great first example of how we should be attacking a lot of things as we go forward."</p>
Making machine-learning tools openly accessible<p>Northwell Health has made its predictive tool <a href="https://github.com/northwell-health/covid-web-data-predictor" target="_blank">available for free</a> to any health system that wishes to utilize it.</p><p>"COVID is everybody's problem, and I think developing tools that can be used to help others is sort of why people go into health care," Dr. Cruzen said. "It was really consistent with our mission."</p><p>Open collaboration is something the world's governments and health systems should be striving for during the pandemic, said Michael Dowling, Northwell Health's president and CEO.</p><p>"Whenever you develop anything and somebody else gets it, they improve it and they continue to make it better," Dowling said. "As a country, we lack data. I believe very, very strongly that we should have been and should be now working with other countries, including China, including the European Union, including England and others to figure out how to develop a health surveillance system so you can anticipate way in advance when these things are going to occur."</p><p>In all, Northwell Health has treated more than 112,000 COVID patients. During the pandemic, Dowling said he's seen an outpouring of goodwill, collaboration, and sacrifice from the community and the tens of thousands of staff who work across Northwell.</p><p>"COVID has changed our perspective on everything—and not just those of us in health care, because it has disrupted everybody's life," Dowling said. "It has demonstrated the value of community, how we help one another."</p>
Scientists used CT scanning and 3D-printing technology to re-create the voice of Nesyamun, an ancient Egyptian priest.
- Scientists printed a 3D replica of the vocal tract of Nesyamun, an Egyptian priest whose mummified corpse has been on display in the UK for two centuries.
- With the help of an electronic device, the reproduced voice is able to "speak" a vowel noise.
- The team behind the "Voices of the Past" project suggest reproducing ancient voices could make museum experiences more dynamic.
Howard et al.<p style="margin-left: 20px;">"While this approach has wide implications for heritage management/museum display, its relevance conforms exactly to the ancient Egyptians' fundamental belief that 'to speak the name of the dead is to make them live again'," they wrote in a <a href="https://www.nature.com/articles/s41598-019-56316-y#Fig3" target="_blank">paper</a> published in Nature Scientific Reports. "Given Nesyamun's stated desire to have his voice heard in the afterlife in order to live forever, the fulfilment of his beliefs through the synthesis of his vocal function allows us to make direct contact with ancient Egypt by listening to a sound from a vocal tract that has not been heard for over 3000 years, preserved through mummification and now restored through this new technique."</p>
Connecting modern people with history<p>It's not the first time scientists have "re-created" an ancient human's voice. In 2016, for example, Italian researchers used software to <a href="https://www.smithsonianmag.com/smart-news/hear-recreated-voice-otzi-iceman-180960570/" target="_blank">reconstruct the voice of Ötzi,</a> an iceman who was discovered in 1991 and is thought to have died more than 5,000 years ago. But the "Voices of the Past" project is different, the researchers note, because Nesyamun's mummified corpse is especially well preserved.</p><p style="margin-left: 20px;">"It was particularly suited, given its age and preservation [of its soft tissues], which is unusual," Howard told <em><a href="https://www.livescience.com/amp/ancient-egypt-mummy-voice-reconstructed.html" target="_blank">Live Science</a>.</em></p><p>As to whether Nesyamun's reconstructed voice will ever be able to speak complete sentences, Howard told <em><a href="https://abcnews.go.com/Weird/wireStory/ancient-voice-scientists-recreate-sound-egyptian-mummy-68482015" target="_blank">The Associated Press</a>, </em>that it's "something that is being worked on, so it will be possible one day."</p><p>John Schofield, an archaeologist at the University of York, said that reproducing voices from history can make museum experiences "more multidimensional."</p><p style="margin-left: 20px;">"There is nothing more personal than someone's voice," he told <em>The Associated Press.</em> "So we think that hearing a voice from so long ago will be an unforgettable experience, making heritage places like Karnak, Nesyamun's temple, come alive."</p>
New research suggests you can't fake your emotional state to improve your work life — you have to feel it.
What is deep acting?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTQ1NDk2OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTY5MzA0Nn0._s7aP25Es1CInq51pbzGrUj3GtOIRWBHZxCBFnbyXY8/img.jpg?width=1245&coordinates=333%2C-1%2C333%2C-1&height=700" id="ddf09" class="rm-shortcode" data-rm-shortcode-id="9dc42c4d6a8e372ad7b72907b46ecd3f" data-rm-shortcode-name="rebelmouse-image" data-width="1245" data-height="700" />
Arlie Russell Hochschild (pictured) laid out the concept of emotional labor in her 1983 book, "The Managed Heart."
Credit: Wikimedia Commons<p>Deep and surface acting are the principal components of emotional labor, a buzz phrase you have likely seen flitting about the Twittersphere. Today, "<a href="https://www.bbc.co.uk/bbcthree/article/5ea9f140-f722-4214-bb57-8b84f9418a7e" target="_blank">emotional labor</a>" has been adopted by groups as diverse as family counselors, academic feminists, and corporate CEOs, and each has redefined it with a patented spin. But while the phrase has splintered into a smorgasbord of pop-psychological arguments, its initial usage was more specific.</p><p>First coined by sociologist Arlie Russell Hochschild in her 1983 book, "<a href="https://www.ucpress.edu/book/9780520272941/the-managed-heart" target="_blank">The Managed Heart</a>," emotional labor describes the work we do to regulate our emotions on the job. Hochschild's go-to example is the flight attendant, who is tasked with being "nicer than natural" to enhance the customer experience. While at work, flight attendants are expected to smile and be exceedingly helpful even if they are wrestling with personal issues, the passengers are rude, and that one kid just upchucked down the center aisle. Hochschild's counterpart to the flight attendant is the bill collector, who must instead be "nastier than natural."</p><p>Such personas may serve an organization's mission or commercial interests, but if they cause emotional dissonance, they can potentially lead to high emotional costs for the employee—bringing us back to deep and surface acting.</p><p>Deep acting is the process by which people modify their emotions to match their expected role. Deep actors still encounter the negative emotions, but they devise ways to <a href="http://www.selfinjury.bctr.cornell.edu/perch/resources/what-is-emotion-regulationsinfo-brief.pdf" target="_blank">regulate those emotions</a> and return to the desired state. Flight attendants may modify their internal state by talking through harsh emotions (say, with a coworker), focusing on life's benefits (next stop Paris!), physically expressing their desired emotion (smiling and deep breaths), or recontextualizing an inauspicious situation (not the kid's fault he got sick).</p><p>Conversely, surface acting occurs when employees display ersatz emotions to match those expected by their role. These actors are the waiters who smile despite being crushed by the stress of a dinner rush. They are the CEOs who wear a confident swagger despite feelings of inauthenticity. And they are the bouncers who must maintain a steely edge despite humming show tunes in their heart of hearts.</p><p>As we'll see in the research, surface acting can degrade our mental well-being. This deterioration can be especially true of people who must contend with negative emotions or situations inside while displaying an elated mood outside. Hochschild argues such emotional labor can lead to exhaustion and self-estrangement—that is, surface actors erect a bulwark against anger, fear, and stress, but that disconnect estranges them from the emotions that allow them to connect with others and live fulfilling lives.</p>
Don't fake it till you make it<p>Most studies on emotional labor have focused on customer service for the obvious reason that such jobs prescribe emotional states—service with a smile or, if you're in the bouncing business, a scowl. But <a href="https://eller.arizona.edu/people/allison-s-gabriel" target="_blank">Allison Gabriel</a>, associate professor of management and organizations at the University of Arizona's Eller College of Management, wanted to explore how employees used emotional labor strategies in their intra-office interactions and which strategies proved most beneficial.</p><p>"What we wanted to know is whether people choose to engage in emotion regulation when interacting with their co-workers, why they choose to regulate their emotions if there is no formal rule requiring them to do so, and what benefits, if any, they get out of this effort," Gabriel said in <a href="https://www.sciencedaily.com/releases/2020/01/200117162703.htm" target="_blank">a press release</a>.</p><p>Across three studies, she and her colleagues surveyed more than 2,500 full-time employees on their emotional regulation with coworkers. The survey asked participants to agree or disagree with statements such as "I try to experience the emotions that I show to my coworkers" or "I fake a good mood when interacting with my coworkers." Other statements gauged the outcomes of such strategies—for example, "I feel emotionally drained at work." Participants were drawn from industries as varied as education, engineering, and financial services.</p><p>The results, <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fapl0000473" target="_blank" rel="noopener noreferrer">published in the Journal of Applied Psychology</a>, revealed four different emotional strategies. "Deep actors" engaged in high levels of deep acting; "low actors" leaned more heavily on surface acting. Meanwhile, "non-actors" engaged in negligible amounts of emotional labor, while "regulators" switched between both. The survey also revealed two drivers for such strategies: prosocial and impression management motives. The former aimed to cultivate positive relationships, the latter to present a positive front.</p><p>The researchers found deep actors were driven by prosocial motives and enjoyed advantages from their strategy of choice. These actors reported lower levels of fatigue, fewer feelings of inauthenticity, improved coworker trust, and advanced progress toward career goals. </p><p>As Gabriel told <a href="https://www.psypost.org/2021/01/new-psychology-research-suggests-deep-acting-can-reduce-fatigue-and-improve-your-work-life-59081" target="_blank" rel="noopener noreferrer">PsyPost in an interview</a>: "So, it's a win-win-win in terms of feeling good, performing well, and having positive coworker interactions."</p><p>Non-actors did not report the emotional exhaustion of their low-actor peers, but they also didn't enjoy the social gains of the deep actors. Finally, the regulators showed that the flip-flopping between surface and deep acting drained emotional reserves and strained office relationships.</p><p>"I think the 'fake it until you make it' idea suggests a survival tactic at work," Gabriel noted. "Maybe plastering on a smile to simply get out of an interaction is easier in the short run, but long term, it will undermine efforts to improve your health and the relationships you have at work. </p><p>"It all boils down to, 'Let's be nice to each other.' Not only will people feel better, but people's performance and social relationships can also improve."</p>
You'll be glad ya' decided to smile<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="88a0a6a8d1c1abfcf7b1aca8e71247c6"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/QOSgpq9EGSw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>But as with any research that relies on self-reported data, there are confounders here to untangle. Even during anonymous studies, participants may select socially acceptable answers over honest ones. They may further interpret their goal progress and coworker interactions more favorably than is accurate. And certain work conditions may not produce the same effects, such as toxic work environments or those that require employees to project negative emotions.</p><p>There also remains the question of the causal mechanism. If surface acting—or switching between surface and deep acting—is more mentally taxing than genuinely feeling an emotion, then what physiological process causes this fatigue? <a href="https://www.frontiersin.org/articles/10.3389/fnhum.2019.00151/full" target="_blank">One study published in the <em>Frontiers in Human Neuroscience</em></a><em> </em>measured hemoglobin density in participants' brains using an fNIRS while they expressed emotions facially. The researchers found no significant difference in energy consumed in the prefrontal cortex by those asked to deep act or surface act (though, this study too is limited by a lack of real-life task).<br></p><p>With that said, Gabriel's studies reinforce much of the current research on emotional labor. <a href="https://journals.sagepub.com/doi/abs/10.1177/2041386611417746" target="_blank">A 2011 meta-analysis</a> found that "discordant emotional labor states" (read: surface acting) were associated with harmful effects on well-being and performance. The analysis found no such consequences for deep acting. <a href="https://doi.apa.org/doiLanding?doi=10.1037%2Fa0022876" target="_blank" rel="noopener noreferrer">Another meta-analysis</a> found an association between surface acting and impaired well-being, job attitudes, and performance outcomes. Conversely, deep acting was associated with improved emotional performance.</p><p>So, although there's still much to learn on the emotional labor front, it seems Van Dyke's advice to a Leigh was half correct. We should put on a happy face, but it will <a href="https://bigthink.com/design-for-good/everything-you-should-know-about-happiness-in-one-infographic" target="_self">only help if we can feel it</a>.</p>
Archaeologists discover a cave painting of a wild pig that is now the world's oldest dated work of representational art.
- Archaeologists find a cave painting of a wild pig that is at least 45,500 years old.
- The painting is the earliest known work of representational art.
- The discovery was made in a remote valley on the Indonesian island of Sulawesi.