CDC Move To Limit Investigations Into COVID Breakthrough Infections Sparks Concerns
3 years, 7 months ago

CDC Move To Limit Investigations Into COVID Breakthrough Infections Sparks Concerns

NPR  

CDC Move To Limit Investigations Into COVID Breakthrough Infections Sparks Concerns Enlarge this image toggle caption Image Point FR/NIH/NIAID/BSIP/Universal Images Group via Getty Images Image Point FR/NIH/NIAID/BSIP/Universal Images Group via Getty Images The Centers for Disease Control and Prevention has stopped tracking every case that occurs when a COVID-19 vaccine fails to protect someone. And as we look at these breakthrough infections, these are the ones we're most concerned about," CDC Director Rochelle Walensky said at a White House COVID-19 briefing on May 18. Careful study of breakthrough infections also could provide useful information for improving the vaccines as well as revelations about possible long-term health effects of these infections on people who don't initially develop symptoms or only become mildly ill. "To say that a breakthrough infection has no clinical consequence, it feels too early to say that," says Kavita Patel, a primary care physician at the Brookings Institution. Sponsor Message "CDC will continue to look at vaccine effectiveness in all populations including people with mild infections, and that's being done through special studies, vaccine effectiveness studies and other monitoring in different populations and settings," Dr. Marc Fischer, who's leading the CDC's vaccine breakthrough team, told NPR.

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History of this topic

Global Pandemic Threat: 100 Days to Save Lives
2 months, 2 weeks ago

Global Pandemic Threat: 100 Days to Save Lives

Hindustan Times  

A modelling study suggests that if a vaccine for SARS-CoV-2 had been developed within 100 days, an estimated 8.3 million deaths could have been averted globally. The study also estimated that productivity losses due to illness amounting to almost $1.4 trillion and $63 billion of hospitalisation costs would have been averted globally.

Has the next pandemic already started?
5 months, 2 weeks ago

Has the next pandemic already started?

Al Jazeera  

New cases of avian flu are raising alarm of a possible new pandemic. It is crucial to avoid repeating mistakes from the COVID-19 pandemic, especially when dealing with H5N1, where the risks could be even greater due to its high mortality rate. Tests should be made available worldwide – including in low- and middle-income countries – and prioritised in populations …

As COVID-19 ticks up in some places, US health officials recommend a fall vaccination campaign
6 months, 1 week ago

As COVID-19 ticks up in some places, US health officials recommend a fall vaccination campaign

Associated Press  

NEW YORK — With fresh COVID-19 cases bubbling up in some parts of the country, health officials are setting course for a fall vaccination campaign. What’s more, health officials have reported upticks this month in COVID-19-associated emergency room visits and hospitalizations, and a pronounced increase in positive test results in the southwestern U.S. It’s not clear whether that’s a sign …

As COVID-19 ticks up in some places, US advisers recommend a fall vaccination campaign
6 months, 1 week ago

As COVID-19 ticks up in some places, US advisers recommend a fall vaccination campaign

The Independent  

For free real time breaking news alerts sent straight to your inbox sign up to our breaking news emails Sign up to our free breaking news emails Please enter a valid email address Please enter a valid email address SIGN UP I would like to be emailed about offers, events and updates from The Independent. Please try again later {{ …

COVID-19 vaccines: Much ado about known unknowns
8 months ago

COVID-19 vaccines: Much ado about known unknowns

The Hindu  

There are things we know that we don’t know. This risk was identified and flagged back in 2021; packaging was modified to insert information associated with the side effects; even the WHO wrote about it first in May 2021 and then in 2023.Read Bindu Shajan Perapaddan’s report on the rare vaccine side-effect is “no secret” and they are “well aware …

Will we be prepared for "Disease X?" Misinformation could leave us vulnerable to a future pandemic
11 months ago

Will we be prepared for "Disease X?" Misinformation could leave us vulnerable to a future pandemic

Salon  

Pandemics have always been a major part of human history, they still dominate our present to some degree, and it would be prudent to prepare for them in the future to avoid the worst case scenario. “There's always the sense of ‘Is there another virus family out there that could cause a problem?’ They needed a “Disease X,” he said. …

World leaders to meet to discuss threat of hypothetical ‘Disease X’ in Davos
11 months, 3 weeks ago

World leaders to meet to discuss threat of hypothetical ‘Disease X’ in Davos

The Independent  

For free real time breaking news alerts sent straight to your inbox sign up to our breaking news emails Sign up to our free breaking news emails Sign up to our free breaking news emails SIGN UP I would like to be emailed about offers, events and updates from The Independent. It’s known by the placeholder name of Disease X, …

Covid-19 not a concern for most US adults, who are split on the latest vaccine and other precautions, KFF survey finds
1 year, 1 month ago

Covid-19 not a concern for most US adults, who are split on the latest vaccine and other precautions, KFF survey finds

CNN  

CNN — Most adults in the United States are not worried about getting sick with Covid-19 or spreading it over the holidays, a new survey from KFF found. Concern about rising cases and hospitalizations is slightly higher, with nearly half of adults saying they are “very” or “somewhat” worried that Covid-19 hospitalizations will increase this winter – about the same …

Opinion: Scientists have become sitting ducks. We need leaders to step up and defend us
1 year, 3 months ago

Opinion: Scientists have become sitting ducks. We need leaders to step up and defend us

LA Times  

In April 2020, when President Trump and Anthony Fauci appeared at a news conference to discuss the pandemic, the backlash against COVID scientists was already building. During the pandemic, our team at the Texas Children’s Hospital and Baylor College of Medicine developed a low-cost COVID vaccine that was scaled for production in India and Indonesia, where almost 100 million doses …

5 Things COVID Experts Personally Won't Do Right Now In This Latest Surge
1 year, 3 months ago

5 Things COVID Experts Personally Won't Do Right Now In This Latest Surge

Huff Post  

andreswd via Getty Images Here's how infectious disease experts are managing their COVID-19 risk. “As I have gray hair, I’m in a higher-risk group just on the basis of age, so I’ve been wearing my mask at indoor events continuously,” Schaffner said. “My wife and I are major caregivers for a family member who is receiving cancer chemotherapy, so we’re …

U.S. approves updated COVID vaccines to rev up protection this fall
1 year, 3 months ago

U.S. approves updated COVID vaccines to rev up protection this fall

The Hindu  

The U.S. approved updated COVID-19 vaccines Monday, hoping to rev up protection against the latest coronavirus strains and blunt any surge this fall and winter. It’s part of a shift to treat fall updates of the COVID-19 vaccine much like getting a yearly flu shot. “Vaccination remains critical to public health and continued protection against serious consequences of COVID-19, including …

US approves updated COVID vaccines to rev up protection this fall
1 year, 3 months ago

US approves updated COVID vaccines to rev up protection this fall

Associated Press  

WASHINGTON — The U.S. approved updated COVID-19 vaccines Monday, hoping to rev up protection against the latest coronavirus strains and blunt any surge this fall and winter. It’s part of a shift to treat fall updates of the COVID-19 vaccine much like getting a yearly flu shot. “Vaccination remains critical to public health and continued protection against serious consequences of …

FDA approves updated COVID vaccines to rev up protection this fall
1 year, 3 months ago

FDA approves updated COVID vaccines to rev up protection this fall

LA Times  

Single-dose vials of Pfizer’s updated COVID vaccine for adults, which was approved by U.S. regulators on Monday. The U.S. approved updated COVID-19 vaccines Monday, hoping to rev up protection against the latest coronavirus strains and blunt any surge this fall and winter. “Vaccination remains critical to public health and continued protection against serious consequences of COVID-19, including hospitalization and death,” …

Opinion: We’ve made huge advances against COVID. Why is it still killing so many people?
1 year, 7 months ago

Opinion: We’ve made huge advances against COVID. Why is it still killing so many people?

LA Times  

Many immunocompromised and older people are still terrified of COVID. COVID never treated all groups equally, and some older people and immunocompromised individuals still face the highest risk of serious illness. Even for severely immunocompromised people — namely a fraction of those with malignancies or autoimmune disorders who take a drug that depletes their antibody response, as well as patients …

WHO, Believes Disease X Could Create A Pandemic Like Situation, All You Need To Know
1 year, 7 months ago

WHO, Believes Disease X Could Create A Pandemic Like Situation, All You Need To Know

News 18  

As the world gradually returns to a sense of normalcy following the unprecedented challenges posed by the Covid-19 pandemic, the scientific and public health communities remain steadfast in their preparations for future outbreaks and pandemics. As the global community reflects on the challenges and lessons learned from the Covid-19 pandemic, the pursuit of knowledge and preventive measures against future outbreaks …

The CDC is changing the way it monitors COVID-19 in the U.S.
1 year, 8 months ago

The CDC is changing the way it monitors COVID-19 in the U.S.

LA Times  

Dr. Nirav Shah, principal deputy director for the CDC, said the country will be able to maintain “good sight lines” into the state of COVID-19 in America. With the federal government’s three-year-old public health emergency set to expire next Thursday, the agency will begin to track COVID-19 cases alongside other respiratory illnesses, said Dr. Nirav D. Shah, the CDC’s principal …

Vaccine developers can't keep up with COVID's mutations
1 year, 8 months ago

Vaccine developers can't keep up with COVID's mutations

Salon  

In April, the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention both updated their recommendations for COVID vaccines, providing more flexibility for higher-risk individuals who want additional protection from the SARS-CoV-2 virus that causes COVID-19. The bivalent vaccines may not stand up very well against these new strains, which are evolving so fast that some …

FDA advisers set to consider one-and-done annual covid booster plan
1 year, 11 months ago

FDA advisers set to consider one-and-done annual covid booster plan

Live Mint  

The message has come through loud and clear that Americans have already had enough of frequent Covid shots. The new strategy would require health officials to meet each year to review which strains of the virus should be included in the shots, just as they do with flu, for use in September. “I don’t think that we can chase after …

FDA’s advisors back plan to simplify COVID-19 vaccinations
1 year, 11 months ago

FDA’s advisors back plan to simplify COVID-19 vaccinations

LA Times  

Syringes with COVDI-19 vaccines are prepared at a free public clinic in Lynwood last year. “We’re still protected against severe disease, thank goodness,” even after the latest Omicron strains cropped up, said FDA advisor Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia. The first step: The FDA advisory panel voted unanimously that people should get the same …

New data insights can help prevent pandemics, says health expert
1 year, 11 months ago

New data insights can help prevent pandemics, says health expert

The Hindu  

When COVID-19 pandemic hit, the health systems of most nations were unprepared to deal with the public health crisis or the economic impact of the crisis. We as part of the Pandemic Prevention Initiative, believe that we can use the new data insights at various levels -- clinical, genomic surveillance data or waste water and environment surveillance data, human behaviour …

Lessons From COVID: What The World Needs to Learn to Tackle Future Pandemics
1 year, 11 months ago

Lessons From COVID: What The World Needs to Learn to Tackle Future Pandemics

The Quint  

The costly lesson from COVID: why elimination should be the default global strategy for future pandemics Getty Images Imagine it is 2030. An upgraded pandemic response to eliminate at source The process by which the WHO currently decides whether to declare a public health emergency of international concern has drawn criticism for being too slow. Elimination makes sense for other …

DC Edit | Preparedness is the key to tackling any spike in Covid
2 years ago

DC Edit | Preparedness is the key to tackling any spike in Covid

Deccan Chronicle  

China has blown its Covid control strategy to the extent that a global uptick of fresh cases is projected. The BF.7 is the runaway pathogen in the Chinese outbreak of 2022, and it is going to dominate the narrative from here on as it may not take much time for the strain to land anew in India, even though four …

COVID-19: no need for scaremongering, precautions needed, say health experts
2 years ago

COVID-19: no need for scaremongering, precautions needed, say health experts

The Hindu  

Even as the Central and State governments have called for a general alert over a possible rise in COVID-19 cases, public health experts have warned against scaremongering over COVID-19. Public health experts point out that as the new virus variants coming into circulation are the sub variants of Omicron, which in itself was less lethal than Delta, there was no …

Hospitals should stop mass testing for Covid, says influential panel of infectious disease experts
2 years ago

Hospitals should stop mass testing for Covid, says influential panel of infectious disease experts

Daily Mail  

An influential panel of infectious disease experts recommended hospitals stop testing all new admissions for Covid, which they argue is coming at too high a cost for patients and providers. An influential panel of experts, Society for Healthcare Epidemiology of America, are now discouraging hospitals from burdensome testing which adds to hospital wait times and crowding as well as the …

NOT REAL NEWS: A look at what didn't happen this week
2 years ago

NOT REAL NEWS: A look at what didn't happen this week

The Independent  

For free real time breaking news alerts sent straight to your inbox sign up to our breaking news emails Sign up to our free breaking news emails Please enter a valid email address Please enter a valid email address SIGN UP I would like to be emailed about offers, events and updates from The Independent. The article suggests that these …

Virus control to focus on alleviating symptoms
2 years, 1 month ago

Virus control to focus on alleviating symptoms

China Daily  

The target for future COVID-19 epidemic control will focus on alleviating the symptoms of patients as scientists reached the consensus two years ago that the novel coronavirus is not going to disappear, a senior Chinese disease prevention expert said. Gao Fu, former director of the Chinese Center for Disease Control and Prevention, said, "We need to control the disease, rather …

As COVID-19 spikes in California, booster shots could make all the difference
2 years, 1 month ago

As COVID-19 spikes in California, booster shots could make all the difference

LA Times  

With coronavirus cases and hospitalizations rising in Los Angeles County, officials are voicing new confidence in the effectiveness of the updated COVID-19 booster shot. New data has found that the updated COVID-19 vaccines offer “significant additional protection” against symptomatic infection in people who were previously vaccinated or boosted with the older formula. “We have seen very low uptake of the …

Vaccinated people now make majority of COVID deaths in US: Report
2 years, 1 month ago

Vaccinated people now make majority of COVID deaths in US: Report

India TV News  

In a startling revelation, a Washington Post analysis has found that more vaccinated people are now dying of the Covid disease and 58 per cent of coronavirus deaths in August in the US "were people who were vaccinated or boosted". The death among vaccinated people is increasing due to the waning efficacy of Covid vaccines and "increasingly contagious strains of …

WHO ranks world’s worst pathogens at risk of sparking pandemics
2 years, 1 month ago

WHO ranks world’s worst pathogens at risk of sparking pandemics

The Independent  

The World Health Organization said on Monday that it is developing a new priority list of pathogens with the potential to spark global pandemics or outbreaks. “To support this effort the R&D Blueprint will convene 20-25 viral family groups of experts to independently review the science and to shortlist viruses of concern,” the WHO said in a statement. “Targeting priority …

Disease X, other future pandemics causing pathogens to be identified by WHO
2 years, 1 month ago

Disease X, other future pandemics causing pathogens to be identified by WHO

Live Mint  

The World Health Organization will soon be updating the list of priority pathogens, including “Disease X”, that can cause future outbreaks and pandemics. The WHO, in a statement, said that the health body is convening over 300 scientists who will consider the evidence on over 25 virus families and bacteria and the “Disease X”, which can cause a serious international …

WHO identifying potential pandemic pathogens
2 years, 1 month ago

WHO identifying potential pandemic pathogens

Live Mint  

The World Health Organization said on Monday it was thrashing out a new list of priority pathogens that risk sparking pandemics or outbreaks and need to be kept under close observation. "Targeting priority pathogens and virus families for research and development of countermeasures is essential for a fast and effective epidemic and pandemic response," said WHO emergencies director Michael Ryan. …

Time for increased action against COVID-19: WHO Chief Scientist
2 years, 3 months ago

Time for increased action against COVID-19: WHO Chief Scientist

The Hindu  

In light of the World Health Organization Director General Tedros Adhanom Ghebreysus’ declaration that the end of the COVID-19 pandemic is nigh, nations wonder whether they can let their guard down and resume ‘normalcy’ as it existed pre-pandemic. “As the Director General said: ‘These policy briefs are an urgent call for governments to take a hard look at their policies …

Explained | Is there any end of the COVID-19 pandemic in sight?
2 years, 3 months ago

Explained | Is there any end of the COVID-19 pandemic in sight?

The Hindu  

The story so far: “We are not there yet, but the end is in sight.” At a press conference on September 14, World Health Organization director General Tedros Adhanom Ghebreyesus said: “Last week, the number of weekly reported deaths from COVID-19 was the lowest since March 2020. We have never been in a better position to end the pandemic.” The …

WHO says COVID end is ‘in sight,’ deaths at lowest level since March 2020
2 years, 3 months ago

WHO says COVID end is ‘in sight,’ deaths at lowest level since March 2020

LA Times  

The head of the World Health Organization said Wednesday that the number of COVID-19 deaths worldwide last week was the lowest reported since March 2020, marking what could be a turning point in the years-long pandemic. “Now is the time to run harder and make sure we cross the line and reap all the rewards of our hard work.” In …

EXPLAINER: Is COVID-19 winding down? Scientists say no.
2 years, 4 months ago

EXPLAINER: Is COVID-19 winding down? Scientists say no.

Associated Press  

Is the coronavirus on its way out? Topol said the virus “just has too many ways to work around our current strategies, and it’ll just keep finding people, finding them again, and self-perpetuating.” HOW WILL THE VIRUS MUTATE? “Every time we think we’ve seen the peak transmission, peak immune escape properties, the virus exceeds that by another significant notch,” Topol …

US CDC endorses updated Covid boosters, shots to begin soon
2 years, 4 months ago

US CDC endorses updated Covid boosters, shots to begin soon

India Today  

The US Centers for Disease Control and Prevention on Thursday endorsed updated Covid-19 boosters, opening the way for a fall vaccination campaign that could blunt a winter surge if enough Americans roll up their sleeves. The CDC’s advisers struggled with who should get the new boosters and when because only a similarly tweaked vaccine, not the exact recipe, has been …

CDC Advisers Weigh Who Needs Updated COVID Booster And When
2 years, 4 months ago

CDC Advisers Weigh Who Needs Updated COVID Booster And When

Huff Post  

LOADING ERROR LOADING COVID-19 boosters updated to match the newest omicron strains are about to roll out, and government advisers met Thursday to decide who should roll up their sleeves ― and when. The original COVID-19 vaccines still offer strong protection against severe illness and death, especially among younger and healthier people who’ve gotten at least one booster. The new …

WHO alert on ‘new’ Covid variants amid rise in hospitalisation, deaths. 5 points
2 years, 4 months ago

WHO alert on ‘new’ Covid variants amid rise in hospitalisation, deaths. 5 points

Live Mint  

New COVID cases have jumped by 15% and deaths by 35% globally in the last few weeks, World Health Organisation has alerted and further noted, that more variants with such intense circulation will be seen in the coming days. “Future variants will be more transmissible, may have further immune escape but we do not know if they will be more …

Even if you're the president, it's hard to avoid a breakthrough COVID infection
2 years, 5 months ago

Even if you're the president, it's hard to avoid a breakthrough COVID infection

NPR  

Even if you're the president, it's hard to avoid a breakthrough COVID infection Enlarge this image toggle caption Jim Watson/AFP via Getty Images Jim Watson/AFP via Getty Images Few Americans are shielded as heavily from the coronavirus as President Biden. Sponsor Message These sorts of breakthrough infections have been climbing steadily as the highly transmissible BA.5 omicron subvariant spreads throughout …

FDA grapples with whether to modify COVID vaccine for fall
2 years, 6 months ago

FDA grapples with whether to modify COVID vaccine for fall

LA Times  

The Food and Drug Administration will debate Tuesday whether it’s time to update COVID vaccine formulas. “This is science at its toughest,” said FDA vaccine chief Dr. Peter Marks, adding that a final decision is expected within days of the advisory panel’s recommendation. In an analysis prepared for Tuesday’s meeting, FDA officials acknowledged targeting last winter’s version of Omicron is …

There will be another pandemic, infectious disease experts say. Here are 6 ways we can prepare for it
2 years, 7 months ago

There will be another pandemic, infectious disease experts say. Here are 6 ways we can prepare for it

CNN  

CNN — More than two years into the Covid-19 pandemic, we have reached a crossroads. “What we don’t want is to have our children, and perhaps our grandchildren, forget what we’ve been through.” Whether we’re going to apply lessons from the current pandemic remains to be seen, Frieden said, but doing so is key to ending that cycle, so that …

The AP Interview: US ‘vulnerable’ to COVID without new shots
2 years, 7 months ago

The AP Interview: US ‘vulnerable’ to COVID without new shots

Associated Press  

WASHINGTON — White House COVID-19 coordinator Dr. Ashish Jha issued a dire warning Thursday that the U.S. will be increasingly vulnerable to the coronavirus this fall and winter if Congress doesn’t swiftly approve new funding for more vaccines and treatments. “That leaves a lot of us vulnerable.” Jha predicted that the next generation of vaccines, which are likely to be …

'Pandemic phase' over for US, but...': Dr. Fauci's Covid assessment
2 years, 8 months ago

'Pandemic phase' over for US, but...': Dr. Fauci's Covid assessment

India TV News  

Dr. Anthony Fauci has given an upbeat assessment of the current state of the coronavirus in the United States, saying the country is “out of the pandemic phase” when it comes to new infections, hospitalizations and deaths, but that it appears to be making a transition to COVID-19 becoming an endemic disease — occurring regularly in certain areas. Fauci, the …

Is Covid-19 endemic yet? Experts aren’t so sure
2 years, 8 months ago

Is Covid-19 endemic yet? Experts aren’t so sure

CNN  

This is the weekly edition of CNN’s coronavirus newsletter. “I think we’ve done a huge disservice using the word ‘endemic,’ frankly,” Michael Fraser, executive director of the US Association of State and Territorial Health Officials, told an audience of mostly public health officers during a panel discussion at the 2022 Preparedness Summit in Atlanta on Thursday. “We tend to think …

Time of Pandemics
2 years, 9 months ago

Time of Pandemics

Al Jazeera  

Antibodies, vaccine trials and the social factors determining health – what can we learn from the HIV experiences in the global south, in this time of COVID-19? This exploration, by South African filmmaker Rehad Desai, unpicks connections between the two pandemic experiences, from a global south perspective. This HIV vaccine research, and its extensive clinical trial infrastructure in South Africa, …

'Pandemic is not over': WHO's warning as Covid-19 cases surge globally
2 years, 9 months ago

'Pandemic is not over': WHO's warning as Covid-19 cases surge globally

Hindustan Times  

The World Health Organization on Wednesday warned that the world will continue to battle with surging Covid-19 infections and its emerging variants until all countries are covered with high vaccination. Until we reach high vaccination coverage in all countries, we will continue to face the risk of infections surging and new variants emerging that evade," said WHO director-general Tedros Adhanom …

2 years into pandemic, world takes cautious steps forward
2 years, 9 months ago

2 years into pandemic, world takes cautious steps forward

Associated Press  

PORTLAND, Ore. — With COVID-19 case numbers plummeting, Emily Safrin did something she hadn’t done since the pandemic began two years ago: She put her fears aside and went to a concert. “Everyone was supposed to be vaccinated or have a negative test, and I said, ‘What the heck, I’m just gonna live my life,’” Safrin said of her concert …

'Prepare for new COVID-19 variants': Joe Biden tells pandemic-weary Americans
2 years, 10 months ago

'Prepare for new COVID-19 variants': Joe Biden tells pandemic-weary Americans

Firstpost  

In his first State of the Union Address on Tuesday, Biden said thanks to the progress the country has made last year, COVID-19 need no longer controls the lives of the Americans. President Joe Biden has urged Americans to prepare themselves for new coronavirus variants as he launched a new initiative aimed at helping COVID-19-infected people to get tested at …

What COVID Breakthrough Infections Might Look Like In The Future
2 years, 10 months ago

What COVID Breakthrough Infections Might Look Like In The Future

Huff Post  

agrobacter via Getty Images Infectious diseases experts explain what they think breakthrough COVID-19 infections will look and feel like moving forward. They were designed to prevent severe disease, and they’ve done that extraordinarily well,” said Dr. Jaimie Meyer, a Yale Medicine infectious disease doctor and associate professor of medicine at Yale School of Medicine. “As antibodies wane and vaccines wane, …

CDC Stands By Mask Guidance As Fauci Says ‘Full-Blown Pandemic Phase' Nearly Over
2 years, 11 months ago

CDC Stands By Mask Guidance As Fauci Says ‘Full-Blown Pandemic Phase' Nearly Over

Huff Post  

LOADING ERROR LOADING The U.S. may soon exit “the full-blown pandemic phase” of COVID-19, Dr. Anthony Fauci said Tuesday. CDC Director Dr. Rochelle Walensky, speaking in a separate interview Tuesday, said she’s “cautiously optimistic” about the nation’s current trajectory, but that the agency wouldn’t alter its guidance until deaths and case numbers dropped. Dr. Rochelle Walensky, director of the Centers …

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