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WASHINGTON (AP) — The National Institutes of Health is beginning a handful of studies to test possible treatments for long COVID, an anxiously awaited step in U.S. efforts against the mysterious condition that afflicts millions.
Monday’s announcement from the NIH’s $1.15 billion RECOVER project comes amid frustration from patients who’ve struggled for months or even years with sometimes-disabling health problems — with no proven treatments and only a smattering of rigorous studies to test potential ones.
“This is a year or two late and smaller in scope than one would hope but nevertheless it’s a step in the right direction,” said Dr. Ziyad Al-Aly of Washington University in St. Louis, who isn’t involved with NIH’s project but whose own research highlighted long COVID’s toll. Getting answers is critical, he added, because “there’s a lot of people out there exploiting patients’ vulnerability” with unproven therapies.
Scientists don’t yet know what causes long COVID, the catchall term for about 200 widely varying symptoms. Between 10% and 30% of people are estimated to have experienced some form of long COVID after recovering from a coronavirus infection, a risk that has dropped somewhat since early in the pandemic.
“If I get 10 people, I get 10 answers of what long COVID really is,” U.S. Health and Human Services Secretary Xavier Becerra said.
That’s why so far the RECOVER initiative has tracked 24,000 patients in observational studies to help define the most common and burdensome symptoms –- findings that now are shaping multipronged treatment trials. The first two will look at:
— Whether taking up to 25 days of Pfizer’s antiviral drug Paxlovid could ease long COVID, because of a theory that some live coronavirus, or its remnants, may hide in the body and trigger the disorder. Normally Paxlovid is used when people first get infected and for just five days.
— Treatments for “brain fog” and other cognitive problems. They include Posit Science Corp.’s BrainHQ cognitive training program, another called PASC-Cognitive Recovery by New York City’s Mount Sinai Health System, and a Soterix Medical device that electrically stimulates brain circuits.
Two additional studies will open in the coming months. One will test treatments for sleep problems. The other will target problems with the autonomic nervous system — which controls unconscious functions like breathing and heartbeat — including the disorder called POTS.
A more controversial study of exercise intolerance and fatigue also is planned, with NIH seeking input from some patient groups worried that exercise may do more harm than good for certain long COVID sufferers.
The trials are enrolling 300 to 900 adult participants for now but have the potential to grow. Unlike typical experiments that test one treatment at a time, these more flexible “platform studies” will let NIH add additional potential therapies on a rolling basis.
“We can rapidly pivot,” Dr. Amy Patterson with the NIH explained. A failing treatment can be dropped without ending the entire trial and “if something promising comes on the horizon, we can plug it in.”
The flexibility could be key, according to Dr. Anthony Komaroff, a Harvard researcher who isn’t involved with the NIH program but has long studied a similarly mysterious disorder known as chronic fatigue syndrome or ME/CFS. For example, he said, the Paxlovid study “makes all sorts of sense,” but if a 25-day dose shows only hints of working, researchers could extend the test to a longer course instead of starting from scratch.
Komaroff also said that he understands people’s frustration over the wait for these treatment trials, but believes NIH appropriately waited “until some clues came in about the underlying biology,” adding: “You’ve got to have targets.”
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
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Disaster helped make the Arkansas Delta lowlands favorable for farming. It also contributed to the decline of Black-owned farmland.
The Great Mississippi Flood of 1927 was the most devastating flood in U.S. history. It displaced nearly 640,000 people, mostly in Arkansas, Mississippi and Louisiana. A disproportionate number of the displaced were Black. Some were held in refugee camps. Others fled for work elsewhere, hastening the Great Migration of Southern Black farmers.
Many of the Black farmers who were most impacted lived and worked in flood-prone areas, and that was not by accident. Minority farmers have long been saddled with poor land and not much of it. Most of the good farms belonged to white farmers.
“They homesteaded, they had options to go buy land when my ancestors were slaves,” said PJ Haynie, a fifth-generation row cropper who grows 1,000 acres of rice on the Arkansas Delta and co-owns a rice mill. “After slavery, most African Americans got what was left over, which was mostly marginal ground.”
Still, just two generations after the Emancipation Proclamation, Black farmers had accumulated an estimated 16 million acres of farmland in the country. Then decades of discrimination, largely by the Department of Agriculture, chipped away at that achievement. By 1990, Black farmers lost 90% of that land, while white farmers lost only 2% of their acreage.
But there are still Black farmers, who still face discrimination along with a newer challenge: climate change.
In late April, Haynie wore boots nearly up to his knees. His rice field was damp but drying quickly considering the fact that just days earlier it was full of standing water. Still, he had no trouble digging a rice seed from the dirt with his pocketknife. A shoot pushed through the bran. Alive.
“Because these fields are so flat and it’s such low-lying land, rice is the only thing that won’t drown out when you get a 6-inch rain in the middle of the summer,” Haynie said, turning the grain in his hand. “Corn, soybeans, cotton — they don’t like to get their feet wet.”
He sliced open a bag of one of his latest crops: medium-grain rice, one specialty of a California rice industry that’s suffered from years of drought. It drove that state’s rice production down 50% last year.
His daughter, a pre-med student, worked on the family farm a couple of summers back. She visited his rice mill and turned to her father on the way home.
“And her exact words were, ‘We can feed the world, Dad,’” Haynie said.
As the water rises, the rice still grows
“Rice is a tough crop to grow, but it’s a rewarding one because you’re growing food rather than feed,” said Brandy Carroll, director of the Arkansas Farm Bureau’s commodities division. “It’s a nice thing to look at your fields and think about how many people you can feed from your crops.”
Carroll knows. She grew up in Poinsett County, Arkansas, flagging the rice-seeding planes to the furrows on her family farm before GPS took over that hard work.
Now, she said, the crop is generates a billion dollars in annual revenue in the state, with Arkansas growing between 1.1-1.5 million acres each year. For many years, Arkansas has been the No. 1 rice-producing state in the nation, growing just under half of the nation’s crop, Carroll said.
These lowlands, with the sort of mineral-rich alluvial soil favorable for farming and a subterranean aquifer that spans the Delta, are well-adapted to rice.
“And in many cases, not much else,” Carroll said. “There’s hardpan under the topsoil that holds water, which is great for rice, but challenging for other crops at times.”
Rice requires quite a lot of water, and there is no shortage of water in Arkansas. This year was especially wet, according to the National Weather Service in Little Rock, Arkansas. Through April, Pine Bluff got 27.79 inches of rain — that’s 9.06 inches above average.
“When we have a wet year, the rice is happy and so are the farmers,” Carroll said.
Arkansas has another advantage over other rice-growing states, positioned as it is with access to both the Arkansas and Mississippi rivers, important shipping arteries. And though the state exports some “rough” or unmilled rice, the rice milling industry is booming.
Since agriculture is a big part of the economy in the Delta, that’s crucial. Processing the state’s rice in mills such as Haynie’s adds value and keeps a lot of cash right in the Delta, Carroll said.
The challenges of rice
But as with anything that grows in the ground, rice farming has its challenges. Though rice likes hot humid days, it prefers to cool off at night. When the temperatures don’t drop, the grain has a tendency to break.
The Arkansas Rice Research and Promotion Board is working with the University of Arkansas in a collaborative breeding program, created with funds invested by farmers, to develop a strain of rice that’s more heat tolerant.
“These farmers are investing their own money to adapt and thrive and flourish and continue to provide a product that customers want,” Carroll said. “That’s important when you’re attempting to sell 1 million acres of rice. They’re making sure their product is adapted to our changing world.”
Another downside of rice is that it’s one of the leading methane-emitting crops. The standing water it tolerates acts as a natural herbicide and pest control, but it also creates an anaerobic environment that emits greenhouse gas.
Haynie is the chairman of the National Black Growers Council, which has a partnership with the Ducks Unlimited Rice Stewardship. Together in 2022, they received $80 million through a USDA program to support sustainable rice farming, some of it earmarked specifically for historically underserved farmers.
“We’re (trying) to showcase and lead and grow the next generation, and the only way we can do this is to share knowledge,” Haynie said in an interview shortly after the grant was awarded.
Robot farmers?: Machines are crawling through America’s fields. And some have lasers.
Haynie, for example, uses several growing methods to reduce methane, including eliminating the standing water that traps it, when possible.
Sharing strategies like these can make Black-owned farms more sustainable, which creates value and protects Black-owned farms, PJ Haynie said.
“What I say is that, if we protect the herd, the herd will grow,” he said. “If we protect the small amount of Black farmers that are left in America, it will create opportunities for their children and grandchildren, their nieces and nephews.”
Rice, he believes, has the potential to do that.
Beating the odds
Haynie co-owns Arkansas River Rice, a Pine Bluff rice mill, with Alabama farmer Billy Bridgeforth. The operation, which Haynie said is the only Black-owned rice mill in the United States, can process 22 metric tons of grain an hour. Both men, who also help run farms founded by their formerly enslaved ancestors, offer reasonable rice packaging rates for small farmers and serve as mentors to other growers.
“The work that we’re doing out here on the farm, the brand that we’re trying to move in the rice mill, and also the rice that we’re buying from other farmers,” he said. “That’s never happened in the Black farming community before, and that’s exciting.”
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In Pine Bluff, Arkansas, nearly 80% of the population is Black. But its white farmers have an advantage. The majority of the Black farmers in the Delta have smaller operations, which means less payout in the way of crop insurance, Haynie said.
That’s just one of the reasons Black farmland ownership has dramatically declined across the U.S., he said.
“Black farmers are still dealing with the inequities of the past at the hands of the federal government, which are still creating present-day disparities,” he said.
Haynie’s family beat the odds. Besides the Arkansas land, Haynie farms in all four counties of Virginia’s Northern Neck, a peninsula that juts into the brackish water where the Potomac River meets the Chesapeake Bay.
Haynie’s great-great-grandfather the Rev. Robert Haynie was born on the Northern Neck as a slave. After emancipation, he purchased 60 acres of land on Sept. 14, 1967, at the age of 44.
“And by the grace of God, we still own it and have grown it from the original 60 acres,” Haynie said.
When asked what he thought his grandfather would say about the farm, the acres of row crops, the state-of-the-art mill, Haynie paused.
“I hope that he would say job well done,” he said. “And I hope that my ancestors would be able to see the seeds that I’m trying to plant for the future.”
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ORLANDO, Fla. (AP) — The oldest historically Black collegiate fraternity in the U.S. says it is relocating a planned convention in two years from Florida because of what it described as Gov. Ron DeSantis’ administration’s “harmful, racist and insensitive” policies towards African Americans.
Alpha Phi Alpha Fraternity said this week that it would move its 2025 convention from Orlando to another location that is yet undecided. The convention draws between 4,000 and 6,000 people and has an economic impact of $4.6 million, the fraternity said.
The decision comes after the NAACP and other civil rights organizations this spring issued a travel advisory for Florida, warning that recently passed laws and policies are openly hostile to African Americans, people of color and members of the LGBTQ+ community.
Willis Lonzer, the fraternity’s general president, said in statement on Wednesday that the decision was motivated in part by Florida’s new education standards that require teachers to instruct middle school students that slaves developed skills that “could be applied for their personal benefit.”
“Although we are moving our convention from Florida, Alpha Phi Alpha will continue to support the strong advocacy of Alpha Brothers and other advocates fighting against the continued assault on our communities in Florida by Governor Ron DeSantis,” Lonzer said.
An email seeking comment on Saturday about the fraternity’s decision was sent to Jeremy Redfern, the governor’s press secretary and the governor’s office.
DeSantis, who is running for the 2024 GOP presidential nomination, has come under fire this week over Florida’s new education standards. Among those criticizing the Florida governor on Friday was a rival for the Republican nomination, U.S. Sen. Tim Scott of South Carolina, the sole Black Republican in the Senate.
Responding to the criticism, DeSantis said Friday that he was “defending” Florida “against false accusations and against lies. And we’re going to continue to speak the truth.”
In May, the NAACP joined the League of United Latin American Citizens (LULAC), a Latino civil rights organization, and Equality Florida, a gay rights advocacy group, in issuing travel advisories for the Sunshine State, where tourism is one of the state’s largest job sectors. The groups cited recent laws that prohibited state colleges from having programs on diversity, equity and inclusion, as well as critical race theory, and the Stop WOKE Act that restricts certain race-based conversations and analysis in schools and businesses.
They also cited laws that they say made life more difficult for immigrants in Florida and limited discussions on LGBTQ topics in schools.
At least nine other organizations or associations have pulled the plug on hosting conventions in Orlando and Fort Lauderdale, two of the state’s most population convention cities, because of Florida’s political climate, according to local media reports.
Florida is one of the most popular states in the U.S. for tourists, and tourism is one of its biggest industries. More than 137.5 million tourists visited Florida last year, marking a return to pre-pandemic levels, according to Visit Florida, the state’s tourism promotion agency. Tourism supports 1.6 million full-time and part-time jobs, and visitors spent $98.8 billion in Florida in 2019, the last year figures are available.
Follow Mike Schneider on Twitter at @MikeSchneiderAP