The boa constrictor’s choke hold is an iconic animal attack. By coiling around its prey, a snake can squeeze the life out of a victim in mere minutes before gulping it down whole (SN: 8/9/15). But it’s been unclear just how Boa constrictor squeezes so hard — or swallows something as big as a monkey — without suffocating itself.
Now, experiments show that when one part of a boa constrictor’s rib cage is compressed — preventing the part of its lungs enclosed there from drawing in air — the snake can move another section of its rib cage to inflate its lungs there. Boas and other snakes probably couldn’t have started throttling and swallowing large prey without this ability, researchers report March 24 in the Journal of Experimental Biology.
Biologist John Capano of Brown University in Providence, R.I., and colleagues implanted metal markers on the ribs of three boa constrictors, about one-third and halfway down the animals’ bodies. Tracking those markers in X-ray videos of the animals let the researchers map rib motions over different parts of the snakes’ lungs.
In these videos, the team wrapped a blood pressure cuff around different parts of the animals’ bodies. Then, the scientists increased the cuff’s pressure until the rib cage couldn’t move in that area — mimicking the effect of a snake using that part of its body to grip or gulp down prey.
When gripped by a cuff about one-third of the way down their body, snakes breathed by moving some ribs closer to their tails. When wrapped in a cuff about halfway down their body, snakes breathed by moving some ribs closer to their heads. “They can basically just breathe wherever they want,” Capano says. That makes him wonder whether snakes also adjust their breathing during other activities that compress their bodies, such as slithering.
Like two great songwriters working side by side and inspiring each other to create their best work, the Magellanic Clouds spawn new stars every time the two galaxies meet.
Visible to the naked eye but best seen from the Southern Hemisphere, the Large and Small Magellanic Clouds are by far the most luminous of the many galaxies orbiting the Milky Way. New observations reveal that on multiple occasions the two bright galaxies have minted a rash of stars simultaneously, researchers report March 25 in Monthly Notices of the Royal Astronomical Society: Letters.
Astronomer Pol Massana at the University of Surrey in England and his colleagues examined the Small Magellanic Cloud. Five peaks in the galaxy’s star formation rate — at 3 billion, 2 billion, 1.1 billion and 450 million years ago and at present — match similarly timed peaks in the Large Magellanic Cloud. That’s a sign that one galaxy triggers star formation in the other whenever the two dance close together. “This is the most detailed star formation history that we’ve ever had of the [Magellanic] Clouds,” says Paul Zivick, an astronomer at Texas A&M University in College Station who was not involved in the new work. “It’s painting a very compelling picture that these two have had a very intense set of interactions over the last two to three gigayears.”
Even as the two galaxies orbit the Milky Way at 160,000 and 200,000 light-years from Earth, they also orbit each other (SN: 1/9/20). Their orbit is elliptical, which means they periodically pass near each other. Just as tides from the moon’s gravity stir the seas, tides from one galaxy’s gravity slosh around the other’s gas, inducing star birth, says study coauthor Gurtina Besla, an astrophysicist at the University of Arizona in Tucson.
During the last encounter, which happened 100 million to 200 million years ago, the smaller galaxy probably smashed right through the larger, Besla says, which sparked the current outbreak of star birth. The last star formation peak in the Large Magellanic Cloud occurred only in its northern section, so she says that’s probably where the collision took place.
Based on the star formation peaks, the period between Magellanic encounters has decreased from a billion to half a billion years. Besla attributes this to a process known as dynamical friction. As the Small Magellanic Cloud orbits its mate, it passes through the larger galaxy’s dark halo, attracting a wake of dark matter behind itself. The gravitational pull of this dark matter wake slows the smaller galaxy, shrinking its orbit and reducing how much time it takes to revolve around the Large Magellanic Cloud.
The future for the two galaxies may not be so starry, however. They recently came the closest they’ve ever been to the Milky Way, and its tides, Besla says, have probably yanked the pair apart. If so, the Magellanic Clouds, now separated by 75,000 light-years, may never approach each other again, putting an end to their most productive episodes of star making, just as musicians sometimes flounder after leaving bandmates to embark on solo careers.
People who grow up outside of cities are better at finding their way around than urbanites, a large study on navigation suggests. The results, described online March 30 in Nature, hint that learning to handle environmental complexity as a child strengthens mental muscles for spatial skills.
Nearly 400,000 people from 38 countries around the world played a video game called Sea Hero Quest, designed by neuroscientists and game developers as a fun way to glean data about people’s brains. Players piloted a boat in search of various targets.
On average, people who said they had grown up outside of cities, where they would have presumably encountered lots of meandering paths, were better at finding the targets than people who were raised in cities. What’s more, the difference between city dwellers and outsiders was most prominent in countries where cities tend to have simple, gridlike layouts, such as Chicago with its streets laid out at 90-degree angles. The simpler the cities, the bigger the advantage for people from more rural areas, cognitive scientist Antoine Coutrot of CNRS who is based in Lyon, France, and his colleagues report.
Still, from these video game data, scientists can’t definitively say that the childhood environment is behind the differences in navigation. But it’s plausible. “As a kid, if you are exposed to a complex environment, you learn to find your way, and you develop the right cognitive processes to do so,” Coutrot says.
Other bits of demography have been linked to navigational performance, including age, gender, education and even a superior sense of smell (SN: 10/16/18). Figuring out these details will give doctors a more precise baseline of a person’s navigational abilities. That, in turn, might help reveal when these skills slip, as they do in early Alzheimer’s disease, for instance.
Winds howl at over 300 kilometers per hour, battering at a two-story wooden house and ripping its roof from its walls. Then comes the water. A 6-meter-tall wave engulfs the structure, knocking the house off its foundation and washing it away.
That’s the terrifying vision of researchers planning a new state-of-the-art facility to re-create the havoc wreaked by the most powerful hurricanes on Earth. In January, the National Science Foundation awarded a $12.8 million grant to researchers to design a facility that can simulate wind speeds of at least 290 km/h — and can, at the same time, produce deadly, towering storm surges. No facility exists that can produce such a one-two punch of extreme wind and water. But it’s an idea whose time has come — and not a moment too soon.
“It’s a race against time,” says disaster researcher Richard Olson, director of extreme events research at Florida International University, or FIU, in Miami.
Hurricanes are being made worse by human-caused climate change: They’re getting bigger, wetter, stronger and slower (SN: 9/13/18; SN: 11/11/20). Scientists project that the 2022 Atlantic Ocean hurricane season, spanning June 1 to November 30, will be the seventh straight season with more storms than average. Recent seasons have been marked by an increase in rapidly intensifying hurricanes linked to warming ocean waters (SN: 12/21/20).
Those trends are expected to continue as the Earth heats up further, researchers say. And coastal communities around the world need to know how to prepare: how to build structures — buildings, bridges, roads, water and energy systems — that are resilient to such punishing winds and waves.
To help with those preparations, FIU researchers are leading a team of wind and structural engineers, coastal and ocean engineers, computational modelers and resilience experts from around the United States to work out how best to simulate these behemoths. Combining extreme wind and water surges into one facility is uncharted territory, says Ioannis Zisis, a wind engineer at FIU. “There is a need to push the envelope,” Zisis says. But as for how exactly to do it, “the answer is simple: We don’t know. That’s what we want to find out.”
Prepping for “Category 6” It’s not that such extreme storms haven’t been seen on Earth. Just in the last few years, Hurricanes Dorian (2019) and Irma (2017) in the Atlantic Ocean and super Typhoon Haiyan (2013) in the Pacific Ocean have brought storms with wind speeds well over 290 km/h. Such ultraintense storms are sometimes referred to as “category 6” hurricanes, though that’s not an official designation.
The National Oceanic and Atmospheric Administration, or NOAA, rates hurricanes in the Atlantic and eastern Pacific oceans on a scale of 1 to 5, based on their wind speeds and how much damage those winds might do. Each category spans an increment of roughly 30 km/h.
Category 1 hurricanes, with wind speeds of 119 to 153 km/h, produce “some damage,” bringing down some power lines, toppling trees and perhaps knocking roof shingles or vinyl siding off a house. Category 5 storms, with winds starting at 252 km/h, cause “catastrophic damage,” bulldozing buildings and potentially leaving neighborhoods uninhabitable for weeks to months.
But 5 is as high as it gets on the official scale; after all, what could be more devastating than catastrophic damage? That means that even monster storms like 2019’s Hurricane Dorian, which flattened the Bahamas with wind speeds of up to nearly 300 km/h, are still considered category 5 (SN: 9/3/19).
“Strictly speaking, I understand that [NOAA doesn’t] see the need for a category 6,” Olson says. But there is a difference in public perception, he says. “I see it as a different type of storm, a storm that is simply scarier.”
And labels aside, the need to prepare for these stronger storms is clear, Olson says. “I don’t think anybody wants to be explaining 20 years from now why we didn’t do this,” he says. “We have challenged nature. Welcome to payback.”
Superstorm simulation FIU already hosts the Wall of Wind, a huge hurricane simulator housed in a large hangar anchored at one end by an arc of 12 massive yellow fans. Even at low wind speeds — say, around 50 km/h — the fans generate a loud, unsettling hum. At full blast, those fans can generate wind speeds of up to 252 km/h — equivalent to a low-grade category 5 hurricane.
Inside, researchers populate the hangar with structures mimicking skyscrapers, houses and trees, or shapes representing the bumps and dips of the ground surface. Engineers from around the world visit the facility to test out the wind resistance of their own creations, watching as the winds pummel at their structural designs. It’s one of eight facilities in a national network of laboratories that study the potential impacts of wind, water and earthquake hazards, collectively called the U.S. Natural Hazards Engineering Research Infrastructure, or NHERI.
The Wall of Wind is designed for full-scale wind testing of entire structures. Another wind machine, hosted at the University of Florida in Gainesville, can zoom in on the turbulent behavior of winds right at the boundary between the atmosphere and ground. Then there are the giant tsunami- and storm surge–simulating water wave tanks at Oregon State University in Corvallis.
The new facility aims to build on the shoulders of these giants, as well as on other experimental labs around the country. The design phase is projected to take four years, as the team ponders how to ramp up wind speeds — possibly with more, or more powerful fans than the Wall of Wind’s — and how to combine those gale-force winds and massive water tanks in one experimental space.
Existing labs that study wind and waves together, albeit on a much smaller scale, can offer some insight into that aspect of the design, says Forrest Masters, a wind engineer at the University of Florida and the head of that institution’s NHERI facility.
This design phase will also include building a scaled-down version of the future lab as proof of concept. Building the full-scale facility will require a new round of funding and several more years.
Past approaches to studying the impacts of strong wind storms tend to use one of three approaches: making field observations of the aftermath of a given storm; building experimental facilities to re-create storms; and using computational simulations to visualize how those impacts might play out over large geographical regions. Each of these approaches has strengths and limitations, says Tracy Kijewski-Correa, a disaster risk engineer at the University of Notre Dame in Indiana.
“In this facility, we want to bring together all of these methodologies,” to get as close as possible to recreating what Mother Nature can do, Kijewski-Correa says.
It’s a challenging engineering problem, but an exciting one. “There’s a lot of enthusiasm for this in the broader scientific community,” Masters says. “If it gets built, nothing like it will exist.”
In December 1987, my family moved from sweltering Florida to a snow-crusted island in the Niagara River just north of Buffalo, N.Y. There on Grand Island, I heard for the first time about a place called Love Canal. Right across the river, not a mile away, lay an entire neighborhood that had been emptied out less than a decade before by one of the worst environmental disasters in American history.
In the 1940s and ’50s, Hooker Chemical dumped about 20,000 tons of toxic waste into the canal, eventually covering it with soil and selling the land to the city of Niagara Falls for a dollar. The city built a school on it, and houses sprang up around it. For years, residents would smell strange odors in their homes, and kids would see chemicals bubbling up on the playground, but it wasn’t until the late 1970s that local officials began to take notice. Eventually, testing revealed dangerous levels of toxic chemicals along with increased rates of certain cancers in adults, as well as seizures, learning disabilities and kidney problems in children.
To me as a kid, the area surrounding Love Canal was an eerie abandoned neighborhood where teenagers would drive around at night to get creeped out. The place is truly haunting. The stories I heard of toxic chemicals gurgling up in people’s backyards stayed with me, and in 2008, I returned as an environmental reporter to write about Love Canal’s legacy. Only then did I understand the magnitude of the crisis.
And only now, with the publication of Paradise Falls, do I fully comprehend the human tragedy of Love Canal and the neighborhood called LaSalle that straddled it. Journalist Keith O’Brien chronicles events primarily through the lens of the people who lived there. He focuses on the period from Christmas 1976 to May 1980, when President Jimmy Carter signed a federal emergency order that evacuated more than 700 families. Having covered the story myself, I was puzzled at first to see that O’Brien covered such a tight time frame in a story that developed over decades. He skims quickly through the history of chemical dumping and touches only briefly on follow-up studies of residents in the 1980s. But he fills more than 350 pages with a narrative of the main crisis period so gripping it could almost be a thriller. As the disaster unfolds, there are horrific discoveries, medical mysteries and plenty of screaming neighbors. The whole narrative is pulled directly from O’Brien’s extensive research, including interviews and documents that had been stored for decades.
Chapters hop between the perspectives of key residents and the scientists and officials dealing with the crisis, but the story is told chronologically and in great detail. In fact, there’s so much detail that we even learn the type of cookies (oatmeal) served to the officials from the U.S. Environmental Protection Agency who housewife-turned-activist Lois Gibbs famously took hostage in a publicity stunt.
O’Brien’s previous book, Fly Girls, was about pioneering female aviators of the 1920s and ’30s. So perhaps it’s no surprise that he has again focused on heroines. Gibbs was the public face of Love Canal, but many of the other women who took action got far less attention. O’Brien brings their stories to light. There was Elene Thornton, a Black resident of public housing who fought for her neighbors; Bonnie Casper, a young congressional aide who rallied government action; and Beverly Paigen, a scientist who risked her job studying a problem her superiors wanted to drop.
But perhaps the most poignant story, told in heartbreaking detail, is that of Luella Kenny. She was a cancer researcher living with her family in a house that backed up to a creek near Love Canal when her 6-year-old son Jon Allen fell ill with mysterious symptoms. Doctors ignored her at first, but eventually the child grew so sick he was hospitalized with a kidney disease called nephrotic syndrome.
O’Brien narrates the family’s days with stunning clarity, capturing small but moving moments like Jon Allen gathering fallen chestnuts in the hospital parking lot and rolling them between his small, swollen fingers. By the time I read of Jon Allen’s death, even though I already knew the outcome, I cried. I felt as if I knew these people personally by the end of the book, and any misgivings I had initially about O’Brien’s approach disappeared. There are many ways to tell a story, but sometimes the simplest way — the perspective of those who lived it — is best.
Fragmenting planets sweeping extremely close to their stars might be the cause of mysterious cosmic blasts of radio waves.
Milliseconds-long fast radio bursts, or FRBs, erupt from distant cosmic locales. Some of these bursts blast only once and others repeat. A new computer calculation suggests the repetitive kind could be due to a planet interacting with its magnetic host star, researchers report in the March 20 Astrophysical Journal.
FRBs are relative newcomers to astronomical research. Ever since the first was discovered in 2007, researchers have added hundreds to the tally. Scientists have theorized dozens of ways the two different types of FRBs can occur, and nearly all theories include compact, magnetic stellar remnants known as neutron stars. Some ideas include powerful radio flares from magnetars, the most magnetic neutron stars imaginable (SN: 6/4/20). Others suggest a fast-spinning neutron star, or even asteroids interacting with magnetars (SN: 2/23/22). “How fast radio bursts are produced is still up for debate,” says astronomer Yong-Feng Huang of Nanjing University in China.
Huang and his colleagues considered a new way to make the repeating flares: interactions between a neutron star and an orbiting planet (SN: 3/5/94). Such planets can get exceedingly close to these stars, so the team calculated what might happen to a planet in a highly elliptical orbit around a neutron star. When the planet swings very close to its star, the star’s gravity pulls more on the planet than when the planet is at its farthest orbital point, elongating and distorting it. This “tidal pull,” Huang says, will rip some small clumps off the planet. Each clump in the team’s calculation is just a few kilometers wide and maybe one-millionth the mass of the planet, he adds.
Then the fireworks start. Neutron stars spew a wind of radiation and particles, much like our own sun but more extreme. When one of these clumps passes through that stellar wind, the interaction “can produce really strong radio emissions,” Huang says. If that happens when the clump appears to pass in front of the star from Earth’s perspective, we might see it as a fast radio burst. Each burst in a repeating FRB signal could be caused by one of these clumps interacting with the neutron star’s wind during each close planet pass, he says. After that interaction, what remains of the clump drifts in orbit around the star, but away from Earth’s perspective, so we never see it again.
Comparing the calculated bursts to two known repeaters — the first ever discovered, which repeats roughly every 160 days, and a more recent discovery that repeats every 16 days, the team found the fragmenting planet scenario could explain how often the bursts happened and how bright they were (SN: 3/2/16).
The star’s strong gravitational “tidal” pull on the planet during each close pass might change the planet’s orbit over time, says astrophysicist Wenbin Lu of Princeton University, who was not involved in this study but who investigates possible FRB scenarios. “Every orbit, there is some energy loss from the system,” he says. “Due to tidal interactions between the planet and the star, the orbit very quickly shrinks.” So it’s possible that the orbit could shrink so fast that FRB signals wouldn’t last long enough for a chance detection, he says.
But the orbit change could also give astronomers a way to check this scenario as an FRB source. Observing repeating FRBs over several years to track any changes in the time between bursts could narrow down whether this hypothesis could explain the observations, Lu says. “That may be a good clue.”
If you’re an aspiring life-form, you might want to steer clear of planets around orange dwarf stars.
Some astronomers have called these orange suns “Goldilocks stars” (SN: 11/18/09). They are dimmer and age more slowly than yellow sunlike stars, thus offering an orbiting planet a more stable climate. But they are brighter and age faster than red dwarfs, which often spew large flares. However, new observations show that orange dwarfs emit lots of ultraviolet light long after birth, potentially endangering planetary atmospheres, researchers report in a paper submitted March 29 at arXiv.org.
Using data from the Hubble Space Telescope, astronomer Tyler Richey-Yowell and her colleagues examined 39 orange dwarfs. Most are moving together through the Milky Way in two separate groups, either 40 million or 650 million years old. To Richey-Yowell’s surprise, she and her team found that the ultraviolet flux didn’t drop off from the younger orange stars to the older ones — unlike the case for yellow and red stars. “I was like, `What the heck is going on?’” says Richey-Yowell, of Arizona State University in Tempe.
In a stroke of luck, another team of researchers supplied part of the answer. As yellow sunlike stars age, they spin more slowly, causing them to be less active and emit less UV radiation. But for orange dwarfs, this steady spin-down stalls when the stars are roughly a billion years old, astronomer Jason Lee Curtis at Columbia University and colleagues reported in 2019.
“[Orange] stars are just much more active for a longer time than we thought they were,” Richey-Yowell says. That means these possibly not-so-Goldilocks stars probably maintain high levels of UV light for more than a billion years.
And that puts any potential life-forms inhabiting orbiting planets on notice. Far-ultraviolet light — whose photons, or particles of light, have much more energy than the UV photons that give you vitamin D — tears molecules in a planet’s atmosphere apart. That leaves behind individual atoms and electrically charged atoms and groups of atoms known as ions. Then the star’s wind — its outflow of particles — can carry the ions away, stripping the planet of its air.
But not all hope is lost for aspiring life-forms that have an orange dwarf sun. Prolonged exposure to far-ultraviolet light can stress planets but doesn’t necessarily doom them to be barren, says Ed Guinan, an astronomer at Villanova University in Pennsylvania who was not involved in the new work. “As long as the planet has a strong magnetic field, you’re more or less OK,” he says.
Though far-ultraviolet light splits water and other molecules in a planet’s atmosphere, the star’s wind can’t remove the resulting ions if a magnetic field as strong as Earth’s protects them. “That’s why the Earth survived” as a life-bearing world, Guinan says. In contrast, Venus might never have had a magnetic field, and Mars lost its magnetic field early on and most of its air soon after.
“If the planet doesn’t have a magnetic field or has a weak one,” Guinan says, “the game is over.”
What’s needed, Richey-Yowell says, is a study of older orange dwarfs to see exactly when their UV output declines. That will be a challenge, though. The easiest way to find stars of known age is to study a cluster of stars, but most star clusters get ripped apart well before their billionth birthday (SN: 7/24/20). As a result, star clusters somewhat older than this age are rare, which means the nearest examples are distant and harder to observe.
Obstetrician Cynthia Gyamfi-Bannerman was treating patients in New York City when the COVID-19 pandemic swept in. Hospitals began filling up. Some of her pregnant patients were among the sick.
It was a terrifying time. Little was known about the virus called SARS-CoV-2 to begin with, much less how it might affect a pregnancy, so doctors had to make tough calls. Gyamfi-Bannerman remembers doctors getting waivers to administer the antiviral drug remdesivir to pregnant COVID-19 patients, for instance, even though the drug hadn’t been tested during pregnancy.
“Our goal is to help the mom,” she says. “If we had something that might save her life — or she might die — we were 100 percent using all of those medications.”
These life-or-death decisions were very familiar to obstetricians even before the pandemic. Pregnant women have long been excluded from most drug testing to avoid risk to the fetus. As a result, there’s little data on whether many medications are safe to take while pregnant. This means tough choices for the roughly 80 percent of women who will take at least one medication during pregnancy. Some have serious conditions that can be dangerous for both mother and fetus if left untreated, like high blood pressure or diabetes.
“Pregnant women are essentially like everybody else,” Gyamfi-Bannerman says. They have the same underlying conditions, requiring the same drugs. In a 2013 study, the top 20 prescriptions taken during the first trimester included antibiotics, asthma and allergy drugs, metformin for diabetes, and antidepressants. Yet even for common drugs, the only advice available if you’re pregnant is “talk to your doctor.” With no data, doctors don’t have the answers either.
What’s frustrating to many doctors and researchers is that this lack of information is by design. Even the later stages of most clinical trials, which test a new drug’s safety and efficacy in people, specifically exclude pregnant people to avoid risk to the fetus. But in the wake of a pandemic that disproportionately harmed the pregnant population, researchers are questioning more than ever whether this is the best approach.
Typically, researchers have to justify excluding certain groups, such as older adults, from clinical trials in which they might benefit. “You never have to justify why you’re excluding pregnant people,” says Gyamfi-Bannerman, who now heads the obstetrics, gynecology and reproductive science department at the University of California, San Diego. “You can just go ahead and exclude them.
“The exclusion of pregnant people in clinical trials is a huge, historic problem,” she says, “and it really came to light with COVID.”
Pregnant in a crisis Teresa Mathews was 43 years old when she found out she was pregnant in June 2020, just as the pandemic was tearing across the United States. “I was really worried,” she says. In addition to her age as a risk factor, Mathews has sickle cell trait, meaning she carries one defective gene copy that makes her prone to anemia and shortness of breath. COVID-19 also causes shortness of breath, so Mathews feared her unborn child could starve for oxygen if she caught the virus.
What’s more, the baby would be her first. “I don’t want to say it melodramatically, but it was my last chance of having a baby, right? So I didn’t really want to take chances.” She went into full lockdown for the rest of her pregnancy.
For good reason. A study during the pandemic’s first year in England found that pregnant women who got the virus were about twice as likely to have a stillbirth or early birth. And the U.S. Centers for Disease Control and Prevention reported in November 2020 that pregnant women are about three times as likely as other women to land in intensive care with COVID-19, and 70 percent more likely to die from the infection (SN Online: 2/7/22). So when the race for a vaccine began, many doctors and officials hoped that vaccines would be tested in pregnant women and shown to be safe. There were promising signs: The U.S. Food and Drug Administration encouraged vaccine developers to include pregnant women in their trials. A large body of previous research suggested that risks would be low for vaccines like those for COVID-19, which do not contain live viruses.
But ultimately the three vaccines that the FDA cleared for use in the United States, from Pfizer/BioNTech, Moderna and Johnson & Johnson, excluded pregnant people from their initial clinical trials. After its vaccine was authorized for emergency use in December 2020, Pfizer began enrolling pregnant women for a clinical trial but called it off when federal officials recommended that all pregnant women get vaccinated. The company cited challenges with enrolling enough women for the trial, as well as ethical considerations in giving a placebo to pregnant individuals once the vaccine was recommended.
When pregnant people were excluded from vaccine trials, doctors knew it would be difficult to convince pregnant patients to take a vaccine that hadn’t been tested during pregnancy.
Mathews says she would have been willing to get vaccinated while pregnant if there had been data to support the decision. But the choice was made for her. Her daughter, Eulalia, was born healthy in February 2021, shortly before the vaccines became available to all adults in Mathews’ hometown of Knoxville, Tenn. At that point, there was still no clear guidance on whether to get vaccinated while pregnant or nursing. Officials at the National Institutes of Health in Bethesda, Md., were worried about that lack of direction. Diana Bianchi, director of the National Institute of Child Health and Human Development, called for more COVID-19 vaccine research in the pregnant population in a February 2021 commentary in JAMA. She wrote, “Pregnant people and their clinicians must make real-time decisions based on little or no scientific evidence.”
Meanwhile, social media and pregnancy websites filled the void with conspiracy theories and scary stories about vaccines causing infertility or miscarriages. Alarmed, the American College of Obstetricians and Gynecologists warned last October that “the spread of misinformation and mistrust in doctors and science is contributing to staggeringly low vaccination rates among pregnant people.”
Indeed, the CDC had issued an urgent health advisory the month before warning that only 31 percent of pregnant people were fully vaccinated, compared with about 56 percent of the general population. (CDC and many experts favor “pregnant people” as a general term. Science News is following the language used by sources, and refers to pregnant women when a study population was designated as such.)
“Every week, I look at the number of pregnant people who have died due to COVID. Right now, the most recent statistic is 257 deaths,” Bianchi said in January. “I look at that and I say, that was a preventable statistic.”
After the vaccines received emergency use authorization, the CDC analyzed the outcomes for nearly 2,500 vaccinated pregnant people and found no safety concerns related to pregnancy. The agency recommended vaccination for anyone who is pregnant, lactating or considering becoming pregnant. But that recommendation arrived more than six months after the first vaccine became available. Since then, the vaccines have also proved to be highly effective in pregnancy. More than 98 percent of COVID-19 critical care admissions in a group of more than 130,000 pregnant women in Scotland were unvaccinated, researchers reported in January in Nature Medicine. And all of the infants who died had unvaccinated moms.
“The story of COVID is yet another cautionary tale,” says Anne Lyerly, a bioethicist at the University of North Carolina at Chapel Hill who trained as an obstetrician and gynecologist. “It highlighted what we’re up against.” Researchers have an ethical duty, she says, not only to protect fetuses from the potential risks of research, but also to ensure that “the drugs that go on the market are safe and effective for all the people who will take them.”
Good intentions Increasingly, scientists are questioning what Gyamfi-Bannerman calls a “knee-jerk” tendency to exclude pregnant individuals from clinical trials. In 2009, Lyerly and colleagues formed the Second Wave Initiative to promote ethical ways to include pregnant women in research. As their ideas have spread, more researchers — mostly women — have held conferences and spearheaded research. Collectively, they’re pushing back on the prevailing culture “that pregnant people need to be protected from research instead of protected through research,” Bianchi says.
“We got here with good intentions,” says Brookie Best, a clinical pharmacologist at UC San Diego who studies medication use among pregnant people. “There were some terrible, terrible tragedies of pregnant people taking a drug and having bad outcomes.”
The most famous of these was thalidomide. Starting in the late 1950s, the drug was prescribed for morning sickness, but it had never been tested in pregnant people. By the early 1960s, it became clear that it caused birth defects including missing or malformed limbs (SN: 7/14/62, p. 22). Afterward, drug companies were reluctant to take on the risk, or legal liability, of potential birth defects. While the FDA enacted new safety rules in response to the thalidomide disaster, the agency did not require testing during pregnancy before drugs went to market.
In 1977, the FDA recommended the exclusion of all women of childbearing age from the first two phases of clinical trials. When the U.S. Congress passed a bill in 1993 requiring that women and minorities be included in clinical research, the requirement did not extend to pregnant women. Some scientists still see plenty of good reasons not to include pregnant women in clinical trials. For example, reproductive epidemiologist Shanna Swan has seen unexpected health effects crop up long after substances were deemed safe. With that in mind, Swan, of the Icahn School of Medicine at Mount Sinai in New York City, says that observational studies that follow women and their children after a drug has been approved remain the best approach. These studies are “expensive, and very slow,” she admits, but safer.
For decades, that level of precaution has extended to essentially all medications. As a result, the reproductive effects of a medicine aren’t usually discovered until long after a drug enters the market. Even then, such research is not required for most new drugs, so doctors and researchers must take the initiative. Typically, this happens through pregnancy registries, which enroll pregnant volunteers who are taking a particular drug and follow them throughout pregnancy or beyond.
But voluntary registries leave huge data gaps. A 2011 review of 172 drugs approved by the FDA in the preceding decade found that the risk of harm to fetal development was “undetermined” for 98 percent of them, and for 73 percent there was no safety data during pregnancy at all.
That doesn’t mean all those drugs are dangerous. Relatively few drugs cause major birth defects, and many of those fall into known classes. For example, ACE inhibitors used to control blood pressure have been linked to a range of issues, including kidney and cardiovascular problems in infants, when taken during pregnancy. But the potential for more subtle, long-term effects has been trickier to tease out.
For instance, several studies in the 2010s reported links between mothers taking antidepressants during pregnancy and their kids having developmental problems like attention-deficit/hyperactivity disorder and autism spectrum disorder. Some moms became afraid to treat their own depression. But in 2017, studies of siblings found no difference in these conditions among children who had been exposed to antidepressants in the womb and those who had not (SN: 5/13/17, p. 9). More likely, the problem was the depression the mom was experiencing, the studies suggested, not the drugs.
No legal requirement How the contents of a pregnant woman’s medicine cabinet might affect her child depends on a host of factors, including how the drug works and whether it crosses the placenta. The main way to gauge whether a drug may harm a fetus is through animal studies called developmental and reproductive toxicology, or DART, studies. But drug companies often don’t begin these studies until they’ve already gotten clinical trials rolling.
This creates a catch-22, because clinical trials can’t include pregnant people until DART studies suggest it’s safe to do so. That’s why Lyerly and others pushing for change say that pharmaceutical companies should start doing these studies earlier, before clinical trials begin.
In 2018, the FDA issued draft guidance to help the pharmaceutical industry decide how and when to include pregnant people in clinical trials (SN Online: 5/30/18). That guidance is an encouraging first step, Lyerly says, but it didn’t change any of the stringent rules for when pregnant people could be included in research.
Plus, it’s all completely voluntary, says Leyla Sahin, acting deputy director for safety in FDA’s Division of Pediatric and Maternal Health. “We advise industry…. We tell them we recommend that you include pregnant women in your clinical trials,” Sahin says. “But there’s no requirement.”
In fact, the FDA doesn’t even have the legal authority to create a requirement. In that sense, Sahin says, “we’re where pediatrics was 20 years ago.” Until Congress passed the Pediatric Research Equity Act of 2003, children were routinely excluded from clinical trials just as pregnant women are now. The pediatric law required drug companies to gather data on the safety and effectiveness of medications in children and to provide FDA an appropriate plan for pediatric studies.
Congress could pass a similar law for pregnancy. And in 2020, a government task force recommended exactly that to the Department of Health and Human Services, which oversees FDA. But “it’s almost like it’s gone into this black hole,” Sahin says. “We haven’t heard from HHS. We haven’t heard from Congress.” Stocking the medicine cabinet Until clinical trials during pregnancy become more routine, pregnant people face an untenable choice — take a drug without knowing its safety, or leave their medical conditions untreated.
Case in point: A group of 91 doctors and scientists published a consensus statement in September 2021 in Nature Reviews Endocrinology warning that acetaminophen, the most commonly used drug during pregnancy, may harm fetal development. Research suggests the drug disrupts hormones, with effects ranging from undescended testicles in male infants to an increased risk of ADHD and autism spectrum disorder in boys and girls.
But as is often the case with drugs and pregnancy, there’s not exactly a consensus among doctors about what pregnant people should do. In response to the new paper, the American College of Obstetricians and Gynecologists issued a statement saying the evidence wasn’t strong enough to suggest doctors should change their standard practice, which is to recommend acetaminophen be taken as needed and in moderation.
Acetaminophen is an active ingredient in more than 600 medications, including Tylenol, and is estimated to be used by up to 65 percent of pregnant people in the United States. It has long been the preferred pain medication and fever reducer during pregnancy because the FDA recommends against the anti-inflammatory drugs known as NSAIDs — such as ibuprofen and aspirin — in the second half of pregnancy. Those drugs have been linked to rare fetal kidney problems and low amniotic fluid levels.
While at the University of Copenhagen, clinical pharmacologist David Kristensen began studying acetaminophen’s effects on fetal development after noticing that the drug is structurally similar to chemicals that disrupt hormones. In 2011, he and colleagues published animal and human studies linking acetaminophen use during pregnancy with concerning effects in infants, including undescended testicles.
“My ears perked up when I heard that,” says Swan, the Mount Sinai reproductive epidemiologist and coauthor of the 2021 acetaminophen review. She had seen similar effects with maternal exposure to phthalates, chemicals used in plastics that are known to alter the activity of hormones needed to regulate fetal development.
She and colleagues surveyed 25 years of acetaminophen studies. The group found that five out of 11 relevant studies linked prenatal acetaminophen use to urogenital and reproductive tract abnormalities in children, and 26 out of 29 epidemiological studies linked fetal exposure to acetaminophen with neurodevelopmental and behavioral problems. The strength of these links varied, but were “generally modest,” the authors wrote.
“We’re looking at subtle effects here,” Swan says, “but that doesn’t mean that they’re not important.” With such widespread use, “there’s a good chance that a fair number of offspring are affected.”
Although Swan is wary of testing new drugs in pregnant women, she would like to see better research on medications during pregnancy. “There’s a whole range of options short of doing human study,” she says.
To start with, Swan says, scientists need better data on what medications pregnant women are taking, and how much. That means more studies should ask women to keep daily logs of every pill they take. Researchers can also do more studies of drugs’ reproductive effects in animals, she notes, and even transplant human tissues such as brain, liver or gonads into animals to learn how they respond to drugs.
Not the same vulnerability The cultural shift around pregnancy research may be gaining momentum.
Government-funded research is one key area for change. In 2016, the 21st Century Cures Act established an interagency task force on research specific to pregnant and lactating women. It included officials from NIH, CDC and FDA, as well as medical societies and industry. One of the task force’s recommendations was acted upon in 2018: removing pregnant women as a “vulnerable” group in a federal regulation called the Common Rule, which governs federally funded research. Pregnant women had been listed along with children, prisoners and people with intellectual disabilities as vulnerable and thus requiring special protections if included in research.
Unlike the other groups in that list, pregnant people “don’t have a diminished capacity to provide informed consent,” says Lyerly, the bioethicist at the University of North Carolina. That rule change alone could help “change the culture of research.”
Meanwhile, researchers are forging ahead with studies on many drugs used during pregnancy. HIV drugs are among the most studied, says Best of UC San Diego, in part because the virus can pass from pregnant women to their fetuses. “So right off the bat, everybody knew that we needed to treat these [pregnant] patients with medication,” she says. Yet data on HIV drugs during pregnancy lagged as much as 12 years after FDA approval. Many pregnant women appear to be willing to participate in research. More than 18,000 pregnant people had enrolled in the COVID-19 vaccine pregnancy registry as of March, and every year many volunteer for other pregnancy registries.
Gyamfi-Bannerman says that in her experience, plenty of pregnant patients are willing to volunteer, even for experimental drugs, if there’s potential to benefit from the drug and they will be monitored closely. At Columbia University, she helped lead a clinical trials network called the Maternal Fetal Medicine Units Network that specifically studies complications during pregnancy. “It’s a very safe and protective environment,” she says.
As for next steps, a few policy changes could make a big difference, Best says, like “getting those preclinical studies done earlier and allowing people who accidentally get pregnant while participating in a clinical trial to make the choice of whether or not to stay.” Right now, “if you get pregnant, you’re out. Boom, that’s it,” she says. “But they were already exposed to the risk, and now they’re not getting the benefit. And so we don’t think that’s actually ethical.”
Thalidomide was prescribed to pregnant women to treat morning sickness, without ever having been tested in pregnant women. “We took the wrong lesson from thalidomide,” Lyerly says. “The first lesson of thalidomide is that we should do research, not that we shouldn’t.”
As science journalists, we’re accustomed to data. We sift through it and talk it over with experts. We pay close attention to the stories that numbers can tell. But at this point in the pandemic, many of us are having a hard time finding the story. That’s because the numbers aren’t there.
Data on coronavirus infections in the United States have become less reliable, many experts say. Fewer people are getting tested, local governments have stopped reporting results, and home test results rarely make it into official counts (SN: 4/22/22). To be sure, there are still official numbers to be found. They don’t look great. Hospitalizations are low compared with earlier in the pandemic, but they’re rising again, and the case counts that do exist are ticking up, too. After dipping in March, the tally in the United States is back up to more than 100,000 known cases a day. A third of Americans now live in places with “medium to high” levels of virus spread.
With these not-so-great numbers in mind, it’s not a stretch to assume that the missing data probably wouldn’t tell us a cheery story either. We are almost certainly undercounting cases in the United States. And we’re not alone. Amid worldwide declines in testing and sequencing to see where coronavirus is spreading and how it’s changing, “we are blinding ourselves to the evolution of the virus,” Tedros Adhanom Ghebreyesus, the head of the World Health Organization, said May 22.
We’ve never had a perfect count of COVID-19 cases, of course. Early on in the pandemic, before testing ramped up in some places, scientists found clues about COVID-19’s transmission in odd places. Wastewater testing, for instance, spotted signs of the virus getting flushed down the toilet (SN: 5/28/20). That dirty water continues to be an indirect, but helpful, measure of viral loads in a community. Here in Oregon, where I live, some wastewater spots again show increases in coronavirus, suggesting a surge.
Even more indirect measurements can give us additional hints. Early on in the pandemic, “smart” thermometers connected to the internet generated fever data used to map risk of getting sick by region. Internet searches for words and phrases, such as “chills,” “fever” and “I can’t smell,” also pointed to virus hot spots.
My favorite digital sign of illness comes from online reviews of Yankee Candles. One-star reviews (“No scent.” “Embarrassed as this was a gift.”) tracked neatly with a rise in COVID-19 cases in 2020 and the subsequent loss of smell. Just last week, more one-star reviews showed up, notes Twitter user @drewtoothpaste, who compiled the latest complaints. “No smell.” “Absolutely no scent.” “Very disappointing!!!” These one-star reviews are not airtight evidence of COVID-19 rates — not by any stretch. But they add to the broader picture that we are not yet done with this pandemic, as much as we would all love to be. We are still experiencing disruptions to our lives, illness, suffering and sadness. Very disappointing indeed.
To better understand this particular moment in the pandemic, I talked with data expert Beth Blauer of Johns Hopkins University. She’s been tracking metrics of the pandemic since it started. In the earliest days, she helped build databases, including a widely used COVID-19 tracker, that ultimately became the Coronavirus Resource Center at Hopkins. Those tools get data out to other scientists, health experts, government leaders, journalists and people who want to keep up with the latest numbers. The interview has been edited for length and clarity.
SN: How solid is the testing data right now in the United States?
Blauer: The testing data in this country is crumbling…. We’re barely getting data out of the application-based resources that come with home tests. And the home tests are running 10 bucks apiece. That’s cost prohibitive for people who live below the poverty line. Even middle-income people are not spending $20 for a pack of two. [Free tests are available in the United States, but it’s not known how many of those tests are reaching people who need them.]
We are flying blind. Completely. We are in a surge right now, but we don’t even appreciate fully how big of a surge this is.
SN: Any guesses?
Blauer: I have no idea. Anecdotally, I’m sure you and I both know a ton of people who have COVID-19 or who just got over it. All the mitigation strategies are not being spun up to meet the rising demand that a surge, like we’re in right now, calls for, which means we’re just going to be getting a lot more COVID-19. People are going on vacations, they’re traveling, graduations, all of these things are just going forward. So yes, we’re seeing some increase in hospitalization, but I don’t think we have any idea how much disease there is in the community. SN: I’ve had trouble gauging my risk from COVID-19 in everyday life. Is that typical?
Blauer: It’s a mess. I think a lot of people are sensing that. And it dilutes our capacity to have faith in science and in all the things that have happened over time. It is confusing. It’s like, “Oh, we have just as much COVID, but we can go to parties? And school is in?” Everything all of a sudden gets called into question.
[That uncertainty highlights a] need to really think critically about our public health infrastructure in this country.
SN: How should we be living with this virus right now?
Blauer: We all acknowledge that we need social anchoring in our communities. We need to see people. We can’t hide away in our houses forever. But that means we have to think about what it means to live with a pathogen like COVID-19 out there. And we’re not giving ourselves all the best tools to be able to do that.
I work in a building where right down the hall, people are getting chemotherapy. I feel a responsibility to the community that I’m not giving them a disease that could potentially kill them. That’s not happening in a lot of places. For me, it’s sad. It’s like a loss of collective empathy, and I don’t think we should not talk about that.
I think I would feel the very same way even if I wasn’t leading this effort here at Hopkins. But I don’t know. Maybe it’s because I feel the toll of a million Americans who have died. I’ve experienced loss in my life. I do have a lot of empathy. But I don’t think I’m overdoing it.
SN: But you’re not saying we should all hunker down and stay away from people.
Blauer: No. We’re done with that. But we have to start integrating and really putting into place these habits [masking, testing and adjusting behavior when needed]. Because I think it’s the only way we get out of this.
From cylindrical nanotubes to the hollow spheres known as buckyballs, carbon is famous for forming tiny, complex nanostructures (SN: 8/15/19). Now, scientists have added a new geometry to the list: a twisted strip called a Möbius carbon nanobelt.
Möbius strips are twisted bands that are famous in mathematics for their weird properties. A rubber band, for example, has an inside and an outside. But if you cut the rubber band crosswise, twist one end and glue it back together, you get a Möbius strip, which has only one face (SN: 7/24/07).
In 2017, researchers created carbon nanobelts, thin loops of carbon that are like tiny slices of a carbon nanotube. That feat suggested it might be possible to create a nanobelt with a twist, a Möbius carbon nanobelt. To make the itsy-bitsy twisty carbon, some of the same researchers stitched together individual smaller molecules using a series of 14 chemical reactions, chemist Yasutomo Segawa of the Institute for Molecular Science in Okazaki, Japan, and colleagues report May 19 in Nature Synthesis.
While carbon nanotubes can be used to make new types of computer chips and added to textiles to create fabric with unusual properties, scientists don’t yet know of any practical applications for the twisty nanobelts (SN: 8/28/19; SN: 2/8/19). But, Segawa says, the work improves scientists’ ability to make tiny carbon structures, especially complicated ones.