Plus, looking at evidence that vaccines cause irregular menstrual cycles, Brazil tells women to 'avoid pregnancy,' and more. Email not displaying correctly?
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** A medical study linked the AstraZeneca vaccine to blood clots. Now what?
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A vial of AstraZeneca vaccine against COVID-19 sits on a general practitioner's table in Amsterdam, Netherlands, Wednesday, April 14, 2021. (AP Photo/Peter Dejong)

The results of a new study are an important yet incremental scientific step in the effort to figure out why, rarely, some people develop blood clots after getting the AstraZeneca COVID-19 vaccine.

The study, from the United Kingdom, was published in the New England Journal of Medicine ([link removed]) and “involved clinical and lab evaluation of 23 previously healthy patients who experienced blood clots and thrombocytopenia (low platelet counts) 6 to 24 days after receiving the first dose of the AstraZeneca vaccine.”

The study concludes, “In all cases reported to date, this syndrome of thrombocytopenia and venous thrombosis appears to be triggered by receipt of the first dose of the ChAdOx1 nCoV-19 vaccine.”

The study adds a very important detail. It says the risk of developing a low platelet count among people who get the vaccine appears to be about the same as among people who did not get the vaccine. And the study points out that younger women appear to be the most susceptible to this rare condition, but it may not be limited to that demographic:

The events reported in this study appear to be rare, and until further analysis is performed, it is difficult to predict who may be affected.

The study also addresses the use of the drug heparin, which is commonly given in blood clot cases. The study does not prove heparin to cause greater harm, but says we need more data before we know that for sure. In the meantime, the study says doctors should use something else for anticoagulation.

The vaccine, as you know, is not used in the U.S. A similar vaccine produced by Johnson & Johnson is currently under review.


** Is the COVID-19 vaccine causing irregular menstrual cycles?
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Some women say ([link removed]) that after they got the COVID-19 shot, they began experiencing irregular and even concerning menstrual cycles. Salon reports ([link removed]) what Dr. Kate Clancy, an associate professor of anthropology at the University of Illinois ([link removed]) , found in a survey of 22,000 people (keep in mind this is a survey and not a scientific peer-revied study, but it does reflect the need for some real studies on this matter):

“People who have historically menstruated, but are not menstruating now because they are, for instance, trans on gender-affirming hormones, on long-acting reversible contraception, or are postmenopausal — we are hearing from all three of those groups that some number of them have experienced bleeding when they had not for a very long period of time,” Clancy said. Clancy added that this wasn’t a universal experience, but that many had reported it. Among “people who expected to menstruate,” Clancy said they received three different common responses: “no change,” “absent or late,” and “heavy and early.”

I want to say again, there is no evidence of a connection between the vaccines and these anomalies that many women are reporting. But we do not know if there is no evidence because there is no connection or because there has not been enough investigation.

Kathryn Schubert, President and CEO of the Society for Women's Health Research ([link removed]) , told Salon she thinks questions about a woman's menstrual cycle should “absolutely” be incorporated and an expected standard in clinical trials that include women.

“Anytime you're including women in a clinical trial or a study design, it needs to be a part of the thinking,” Schubert said. “Standard questions are more along the lines of, ‘If you’re a person of reproductive age, are you on birth control?’ or ‘Could you be pregnant?’”

Health.com delves into this conversation with this ([link removed]) :

“Menstrual cycles can be altered or influenced by many factors, including stress, poor sleep, exercise, and some medications,” said Dr. Gloria A. Bachmann, ([link removed]) associate dean for women’s health at the Rutgers Robert Wood Johnson Medical School in New Jersey. “Therefore, it wouldn’t be that unusual for some women to notice, after receiving the vaccination, changes in their period, such as it coming on earlier, or having a heavier flow, or noticing more cramping than they usually have.”


** Will the Johnson & Johnson vaccine become ‘dudes only?’
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By the end of this week, we should have some Centers for Disease Control and Prevention and Food and Drug Administration guidance on the future of the one-dose Johnson & Johnson vaccine. One option might be to limit it to men. The Atlantic explains ([link removed]) that if the experts narrow the vaccine, it could increase skepticism about its safety.


** Brazil tells women to ‘delay pregnancy’ due to COVID-19
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In a stunning announcement ([link removed]) , Brazilian Health Ministry official Raphael Parente said, “If it’s possible, delay pregnancy a little until a better moment.” He said the recommendation was partly due to the stress on the health system but also due to the more easily transmissible variant known as P.1, which has shown up in Brazil. “The clinical experience of specialists shows that this new variant acts more aggressively in pregnant women,” Parente said.


** Michigan reports ‘record high’ number of children hospitalized with COVID-19
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49 children have been hospitalized ([link removed]) with COVID-19 in Michigan, and cases among kids ages 10 to 19 hit a record high. Let’s keep this in context while not losing the serious nature of the data. COVID-19 has, until now, largely been a concern for seniors and people with other health issues.

Youth athletes are the biggest drivers of coronavirus infections in the state. This week, the state reported 312 ongoing or new school outbreaks ([link removed]) , which include infections linked to classrooms, after-school activities and sports.

Here are the current CDC guidelines ([link removed]) about children and risks.


** Should schools require masks?
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Students at Wyandotte County High School wear masks as they walk through a hallway on the first day of in-person learning at the school in Kansas City, Kansas, on March 31, 2021. (AP Photo/Charlie Riedel, File)

This is especially eyebrow-raising considering the above story.

Florida’s Department of Education says this fall, schools should make masks optional. “The data shows us that districts’ face covering policies do not impact the spread of the virus,” Florida Education Commissioner Richard Corcoran said in a letter to school districts around the state, the Sarasota Herald-Tribune reports ([link removed]) .

Manatee County School Board Chairman Charlie Kennedy called masks “useless virtue signaling.”


** The global COVID-19 infection rate is the highest ever
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Click on this interactive ([link removed]) to explore the data. As you can tell, Brazil and India are the hottest hot spots. While cases are rising in more than half of the states in America, the global picture is grim.
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(CNBC)


** Mass transit wonders if riders will come back
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The week after Labor Day may tell us a lot about the near-term future of mass transit ([link removed]) in America. That may be about the time when workplaces try to get people back into the offices. Ridership on buses, trains and subways is way down nationwide.


** Why are realtors opposing the eviction ban? A hearing will occur April 29.
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The New York Times calls out the National Association of Realtors ([link removed]) for supporting an end to a national ban on evictions.

In November, members of the National Association of Realtors — the nation’s largest industry group, numbering 1.4 million real estate professionals — tried to persuade ([link removed]) a federal judge to remove it. Both the Alabama and the Georgia Associations of Realtors sued the federal government over the matter, and the national association is paying for all of the legal costs. A hearing is scheduled for April 29 ([link removed]) .

According to the N.A.R., landlords may not in fact be the scrappiest among us. The “moratorium continues to devastate millions of housing providers,” the trade group said in a statement that a spokesman asked me to attribute to Christie DeSanctis, its director of federal banking, lending and housing finance policy. Also “nearly half of all rental units are mom-and-pop operations,” which the N.A.R. defines as entities that own four units or fewer.


** Can dogs really sniff out the coronavirus?
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A trainer of the Russian Aeroflot Airlines' canine service works with a sniffer dog in a training center of Sheremetyevo Airport, outside Moscow, Russia, Friday, Oct. 9, 2020. The canine service of Russian Aeroflot Airlines have trained sniffer dogs to detect coronavirus from infected people. (AP Photo/Pavel Golovkin)

Researchers at the University of Pennsylvania claim that in a study ([link removed]) , nine dogs were able to identify positive coronavirus samples with 96% accuracy on average after three weeks of training. The study says:

Dogs were then tested on their ability to spontaneously recognize heat-treated urine samples as well as heat-treated saliva from hospitalized SARS-CoV-2 positive patients. Dogs successfully discriminated between infected and uninfected urine samples, regardless of the inactivation protocol, as well as heat-treated saliva samples.

The Miami Herald points out ([link removed]) that this is one in a series of tests that uses dogs to sniff out COVID-19:

A study ([link removed]) out of Germany trained eight dogs for a week using scent holes with hidden metal containers filled with nose and throat samples from COVID-19 infected or non-infected patients. The dogs were able to correctly identify 94% of the 1,012 patient samples.

Another project ([link removed]) in Paris presented eight dogs with 198 sweat samples, half of which were COVID-19 positive. When hidden in a row of negative samples, the dogs detected the positive ones 83–100% of the time.

Don’t be surprised if dogs show up at big venues to scan crowds. Miami Heat basketball ([link removed]) games already use them. So does NASCAR ([link removed]) .


** Will Biden change cigarette rules and ban menthol/reduce nicotine?
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This sounds like a pretty big deal for cigarette smokers ([link removed]) .

The FDA has a couple of weeks to respond to a citizen’s petition to ban the use of menthol ([link removed]) and reduce the amount of nicotine in all cigarettes sold in the United States. The Biden administration has not said where it stands on the proposed rule change but has until April 29 to respond. The Washington Post reports ([link removed]) :

Civil rights organizations and African American health groups ramped up pressure on the Biden administration to ban menthol cigarettes, accusing the tobacco industry of targeting Black communities for decades and demanding government action on what they said was an urgent social justice issue.

In a letter Friday to Health and Human Services Secretary Xavier Becerra, 10 groups demanded that the Food and Drug Administration start the regulatory process to ban menthol, saying such a move was long overdue.

“The predatory marketing of menthol cigarettes and other flavored tobacco products must be stopped and we should all recognize this as a social justice issue, and one that disproportionately impacts youth and communities of color,” said the letter, whose signers included the African American Tobacco Control Leadership Council, ([link removed]) the NAACP and the National Medical Association, which represents African American physicians.


** The language techniques that lawyers used in closing arguments in the Chauvin trial
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In this image from video, prosecutor Jerry Blackwell, gives rebuttal during closing arguments as Hennepin County Judge Peter Cahill presides Monday, April 19, 2021, in the trial of former Minneapolis police Officer Derek Chauvin, in the May 25, 2020, death of George Floyd at the Hennepin County Courthouse in Minneapolis, Minn. (Court TV via AP, Pool)

Like all of you, I watched the closing arguments in the Derek Chauvin trial with intensity and searched for any “moments” that might drive a jury decision. Two things stuck out to me from a writing and presentation perspective.

I was surprised that the defense showed so much of the arrest and “use of force” video. But it occurred to me that using that video over and over has the potential of hardening the jurors from the shock of what they were seeing. Not showing it might have made it seem the defense was running from the video, but showing it again and again normalizes it.

It makes me think about how news coverage of shocking events has that same hardening effect when we show shocking images again and again.

My learned colleague Roy Peter Clark taught us a couple of decades ago that one way to write stronger sentences is to place the most powerful words at the end of the sentence.

Some of the lines that lawyers delivered in the closing arguments in the Chauvin trial resonate for the very reasons Roy explained. I will offer some of those lines after I explain Roy’s word order technique — a technique that everyone from Morgan Freeman to the Beatles has used. Just examine the copy from the famous Visa commercial ([link removed]) and imagine it in Freeman’s voice:

Hours before his race in 88, Dan Jansen’s sister Jane passed away.

He’d promised her he would win gold; he didn’t.

Until six years later; then, he skated a victory lap with his daughter … Jane.

The sentences end with power words: “passed away,” “didn’t,” “Jane.” Roy says that makes the word and the thought behind it hang in your ear.

“To write a more memorable sentence, put the power word at the end” is stronger than “Put the power word at the end to write a more memorable sentence.”

I have long argued that the phrase “In God we trust” would be stronger if we followed Roy’s rule and wrote, “We trust in God.” It is interesting how that sentence becomes so overtly religious when you change the word order.

After Roy taught me that lesson, I began examining movie scripts and song lyrics.

The most well-known sentence in “Gone With the Wind” follows Roy’s power word framework. Rhett Butler says, “Frankly my dear, I don’t give a damn.” That “damn” was coarse and abrupt at the time. It would have been less so if he had said “I don’t give a damn my dear, frankly,” or “I don’t, frankly, give a damn, my dear.” Word order matters.

Consider these lines that the attorneys in the Chauvin trial used to hang in the juror’s mind:

“You were told that Mr. Floyd died because his heart was too big, but the truth of the matter is the reason George Floyd is dead is because Mr. Chauvin’s heart was too small.”

“The fact that is so simple that a child can understand it. In fact, the child did understand it when the 9-year-old girl said, ‘Get off of him.’”

“The court’s final instructions will guide you to try to recognize your biases, recognize what we bring to the table and analyze the evidence from the perspective of the evidence itself.”

“Remember, we don’t look at this incident from the perspective of a bystander. We do not look at this incident from the perspective of the people who are upset by it. We look at it from the perspective of a reasonable police officer.”

“You’re not required to accept nonsense.”

“Make no mistake: This is not a prosecution of the police. It is a prosecution of the defendant.”

“This was not policing. It was unnecessary. It was gratuitous. It was disproportionate. And he did it on purpose. He did not trip and fall and find himself upon George Floyd’s … neck.”

“This case is exactly what you thought when you saw it first.” “It’s exactly what you saw with your eyes … It’s what you felt with your gut. It’s what you now know in your heart. This wasn’t policing. This was murder.”

Writers know that you remember what you feel longer than what you know. But when you can deeply impress facts into a reader’s (or viewer’s or listener’s) memory with vivid emotions, then the facts become unforgettable.

We’ll be back tomorrow with a new edition of Covering COVID-19. Are you subscribed? Sign up here ([link removed]) to get it delivered right to your inbox.
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