Issue 93

Molecular catfishing, hospital blood supplies, and the importance of fart jokes

May 17, 2020

Hello friend! Welcome to Scrap Facts.

I'm a reporter covering health and science with insatiable curiosity. I love everything I learn, not all of which gets its own story. Each week, I'll bring you some of my favorite facts that I picked up on the job or while out living life.

Archives from Tinyletter can be found here. Love Scrap Facts? Consider hitting the “like” button, or tell your friends to sign up!

The many Covid-19 vaccines in the pipeline have their own ways of duping our immune systems.

Found while reporting: We’ll need extraordinary measures to produce a Covid-19 vaccine.

Vaccines are biological catfish. They have to trick your B-cells, a type of immune cell, to make antibodies—something they normally do only if there’s an infection present. But the whole point of vaccines is that there is no infection actually present.

Vaccine developers can go about this trickery in a couple of ways—each requiring their own set of specialized equipment. To explain, I’d like you to pretend that the SARS-CoV-2 virus is a cartoonish villain. Like Yzma, from The Emperor’s New Groove:


Weakened or inactivated virus vaccines
take copies of virus itself, but physically or genetically modify it so it’s harmless. This would be like making replicas of Yzma but disarming her, like taking Kronk (her muscle man) away, or robbing her of her magical potions and capabilities. She’s suddenly just a little old lady that can’t do your body any harm, but she’s threatening enough that B-cells make defenses against her.

Subunit vaccines replicate a signature part of the virus. For SARS-CoV-2, that’s the S-protein it uses to enter our cells. For Yzma, it’s the purple and blue peacock-like piece on the back of her dress. They essentially tell B-cells, “If you see anyone wearing this peacock piece, they’re an infection.” The piece on its own can’t hurt the body, of course, but it’s still enough to get the B-cells into action.

Virus-like particle vaccines are a type of subunit vaccines, but take a slightly different approach: They mimic the virus’ outer shell, or Yzma’s purple dress and black cape. Like other subunit vaccines, they communicate that anyone with this particular covering is Bad News we need antibody defenses against.

Viral vector vaccines use another virus, like a genetically modified measles virus. This modified virus can sneak into our cells, but then replicate new genetic information that codes for a specific signature protein of another virus—like the S-protein of SARS-CoV-2, or Yzma’s signature peacock piece. Antibodies then learn to build up defenses against the signature protein, and anything else that has it.

Nucleic acid vaccines also sneak in genetic information that codes for a virus’ signature protein, but use our own cells to make it. It’d be like placing the instructions to make Yzma’s peacock piece on kitchen counter, or spamming your Instagram pages with ads about how cool Yzma’s piece is, and how easy it is to make on your own. Either way, your B-cells take the hint and still rev up their defenses against them—even though you made the threatening bit yourself, technically. No nucleic acid vaccines have ever been approved—but there’s a first time for everything.

Right now, the landscape of Covid-19 vaccines in the pipeline looks like this:

Each of these approaches to vaccines, called platforms, have to be made with their own, hyper-specialized equipment. Normally, it takes years to build up factories with this equipment. Realistically, existing manufacturing plants will have to repurpose their equipment for a SARS-CoV-2 vaccine, whenever one is ready. But this is the best case scenario because that way, there’d be a diverse supply chain that could meet the needs of billions of people globally.

US hospitals may be on the verge of a blood shortage.

Found while reporting: Why hospitals fear a critical blood shortage as the US reopens.

Blood supply and demand is a funny thing. Even though many blood banks were worried that there would be a shortage of blood (a concern with any kind of major disaster, like hurricanes or mass shootings), they couldn’t stock up on donations. This is because blood and its various components have limited shelf-lives.

If donations couldn’t be used in the specific timeframe, they’d be wasted.

Blood donation centers try to only collect what they need. And even though many people generously donated at the beginning of lockdowns here in the US, some had to actually shut their doors or turn donations away, because they didn’t want to over-collect. Hospitals didn’t need as much blood as they typically do because elective surgeries were postponed, and car crashes were down because fewer people have been driving.

But now, some hospitals have opened back up again for surgeries or other procedures that may require transfusions. And centers haven’t been able to collect their usual numbers of donations. Several of the folks I spoke with for this story were worried that they wouldn’t be able to keep up with increasing hospital demand for blood.

This is in part because most centers are trying to keep more space between donors to reduce any possible spread of infection. (All blood centers only collect from healthy donors anyway, but just in case.) This means fewer people can come in at a time. More significantly, however, blood drives at offices or high schools and universities have been cancelled. Blood drives bring in between a quarter and nearly half of all donations, depending on the center.

If you can, please consider looking up your nearest independent blood center or Red Cross location to make an appointment in the next couple of weeks!

We need moments of joy to get through the hardest times in our lives.

Found while reporting: Finding moments of joy is the key to staying resilient.

In the last month, I came to my own mental crash as a result of constant reminders of a global situation that can feel hopeless. I took a few days off, felt refreshed, and came back to work excited to start reporting again. But then, last week, we had more awful news at my place of work. I still have my job, but so many of my wonderful, talented coworkers—so many of whom have been featured in this newsletter—have lost theirs. It sucks.

I’ve been thinking about happiness recently, and how in a lot of ways, that feeling of contentment feels so out reach right now. For a lot of reasons, we don’t feel secure or at peace, which are requisites happiness.

But joy, on the other hand, is still very much within our reach. Unlike happiness, joy is fleeting. It’s any kind of moment of pure delight or wonder. It can be silly—like taking time to see who can make the best fart noises by blowing raspberries—or it can be unbelievably tranquil, like catching the sunrise one early morning. Just any kind of moment that provides you a bit of escapism from the reality weighing on us.

Joy can tend to feel inappropriate, because it contradicts the gravity of a lot of situations. It also feels childlike, because it often comes from something so simple, and not all all complex like the majority of the problems adults face.

Ingrid Fetell Lee, a designer and writer, is a champion of joy. Joy is something that acts like a reset button for our our sympathetic nervous systems, which kick into gear when feel threatened. Stress responses are supposed to be temporarily, but for many of us, they’ve become prolonged. Experiencing moments of joy, she told me, allow our bodies a temporarily respite from stress, which helps us endure it in the long run. Holocaust survivors have said that humor—a form of joy—helped them make it through their horrific treatment.

Joy isn’t a replacement for happiness, and it’s certainly not the solution for the grief, financial stress, or loneliness many of us are feeling right now. But it’s what we’ve got. So, look for these moments when you can: smell homemade tacos, share dumb memes with friends, watch well-written sitcoms, read an incredible books, take a deep breath outside or through an open window, away from technology.
You can do this. I believe in you. ❤️

Animals of the week: Pets

With so many of us home for the foreseeable future, a lot of us in the United States have had the same thought: Now is finally the time to get that rescue cat or dog we’ve always wanted.

Counterintuitively, overall pet adoption hasn’t gone up. While there were initial spikes at first, it seems like overall adoption has gone down because shelters haven’t been able to stay open to take in new animals to rescue.

We got on this train, too.

This is Penelope. Or Lil Peen, Peener, Queen Peen, or OPTIMUS PEEN. These nicknames are silly and bring us joy. And it’s not like she answers anyway. She’s a cat.

That’s all for now—stay curious, friend ❤️

If you love Scrap Facts, consider hitting the “like” button at the bottom of this page, or sending it to a friend. You can also send your own scrap facts to scrapfacts@gmail.com to be featured in future editions. Wanna keep in touch outside of this newsletter? Follow me on Twitter and Instagram.

Top image by E. Y. Smith, headshot drawing by Richard Howard.

Issue 92

Particulate expulsions, the viral double whammy, and essential mice

April 19, 2020

Hello friend! Welcome to Scrap Facts.

I'm a reporter covering health and science with insatiable curiosity. I love everything I learn, not all of which gets its own story. Each week, I'll bring you some of my favorite facts that I picked up on the job or while out living life.

Archives from Tinyletter can be found here. Love Scrap Facts? Consider hitting the “like” button, or tell your friends to sign up!

It’s not just sneezing and coughing that expel thousands of potentially pathogenic particles.

Found while reporting: Where does the six-foot guideline for social distancing come from?

Screenshot from Quartz’ slack with my editor (Katie) and one of Quartz’ executive editors (Kira).

It’s true, folks. In looking at the scientific literature available describing just how far particles can be emitted from the body, I came across this fantastic table in this fantastic review of aerobiology.

To the best of scientists’ knowledge, sneezing is by far one of the most explosive actions our bodies are capable of, in terms of particles emitted. This is why it’s particularly important to use your elbow to stifle your sneezes, instead of your hands or letting it out in the open. Coughing could be bad, too, considering that coughing fits usually include several at once. And, this is why, even with normal talking, we need to be wary that there’s the possibility that we can transmit potentially infectious particles over time.

Of course, like most of the literature available about disease transmission, none has been tested specifically with SARS-CoV-2. But even so, because there’s limited evidence that the virus can be spread through fecal transmission, some doctors are recommending that anyone infected with Covid-19 use their own bathroom if possible, to avoid getting family members sick.

Reporters’s notebook: This story started off with a simple question: Why does the US Centers for Disease Control say that 6 feet (2 meters) is the safe distance we should be apart? What is the science that justifies it?

In short, there isn’t actually a single paper that serves for the basis of those guidelines. There’s a very old one from nearly a century ago that suggests that large droplets, like the ones we emit when we cough and sneeze that carry SARS-CoV-2, can only travel 3 feet. But some studies from the SARS pandemic in 2003 suggested that the virus could actually be spread to people 6 feet away. Because the SARS-CoV-2 virus is so similar to SARS, it seems that the 6 foot guideline will stick.

But the CDC never actually confirmed that for me. I asked them for two weeks to respond to my inquiry about where these guidelines came from. I had a spokesperson tell me to do some other internet reading (which is where I had started), but otherwise: No response. We make all of this clear in the article.

I don’t think that makes the CDC any less credible; I think that they’ve got one of the toughest jobs in the world right now. They’re providing information to America, a country where some people have a concept of freedom that means no one can tell them what to do. Already, some people have decided to ignore the national social-distancing guidelines that stop Covid’s spread. It seems to me like the agency was worried that if they said there was no specific study to back those guidelines up, no one would listen, which would be incredibly dangerous.

It makes perfect sense that they would come up with that guideline based on the existing science. But for all of us there is a fear of saying “I don’t know” when it comes to the specifics of Covid.

A lot of Covid-19 infections come in two waves.

Found while reporting: What scientists know about Covid-19 immunity can help us fight the pandemic.

The first thing that happens to many people who develop Covid-19 is they feel tired. This is similar to what you’d feel with a cold or a flu.

Sometimes, that’s it. Mild cases are part of what makes this virus so spreadable—and therefore so dangerous. Unfortunately, for other cases, this is a false sense of security. After a day or so of feeling better, the full effects of the infection take hold: The fever, the aches, the coughing, the GI symptoms—possibly the lack of smell and taste, too.

This is because the immune system works in waves. It has some weapons against viruses, even when it doesn’t know what they are: It has T-cells, which attack any virus. But the body only has a limited supply of T-cells. If they’re not enough and the infection still is running rampant, the immune system has to try something else, while the T-cells replenish, and antibodies—the more specialized attacks—develop.

In the meantime, the body unleashes its ultimate weapon against invaders: cytokine storm, or a fever and the resulting inflammation. This cytokine storms makes the body inhospitable for the virus. Unfortunately, it is also…not that great for our organs. Fevers feel terrible for a reason, on top of having to deal with all the other havoc the infection is unleashing.

Sometimes, the fever combined (eventually) with the new T-cells and antibodies can finally get rid of it. Other times, it’s too much for parts of the body. That’s awful. But hopefully, by studying the way the immune system naturally works, scientists can figure out the best ways to intervene with treatments.

Animal of the issue: Genetically modified mice.

Credit: Getty Images

Ah, the humble mouse: A household pest, cheese enthusiast, and critical tool for the advancement of science.

Genetically modified mice are some of the only areas of scientific research that are still being maintained in the lab. Scientists have been using mice for research on medical conditions for ages. But genetically modified mice to model Alzheimer’s are special.

Humans are the only creatures who develop Alzheimer’s disease. It’s a specific pathology in the brain. It results in buildups of amyloid and tau, followed by inflammation, which ultimately leads to dementia.

The vast majority of Alzheimer’s disease occurs in old age. A number of genetic and environmental factors cause it, but scientists aren’t sure what these are. Mice are great models for this, because they only take two years to reach their version of old age, and their neurological systems are comparable to ours.

They also can be genetically modified. Scientists can take mouse embryos (think IVF for mice) and insert mutations known to be related to Alzheimer’s in humans. When the pups are born, scientists can selectively breed them together to make sure that their offspring have the same mutation, and then perform the same IVF + gene editing procedure again, and so on. Eventually, the mice have four or five mutations associated with Alzheimer’s.

It takes about two years to breed and edit the right mouse, and then two years for that mouse to age. Halting research now would put researchers back all that time. So that’s why researchers and lab technicians are still going in, one at a time, to care for these genetically modified mice, to keep them alive during this time. You can read the full story here.

Hey, real talk: This time sucks. I’m having a hard time, too. But I’m focusing on trying to even out those peaks and valleys when I can. I don’t have any advice — there’s lots of that going around online. I just wanted you to know you’re not alone.

That’s all for now—stay curious, friend ❤️

If you love Scrap Facts, consider hitting the “like” button at the bottom of this page, or sending it to a friend. You can also send your own scrap facts to scrapfacts@gmail.com to be featured in future editions. Wanna keep in touch outside of this newsletter? Follow me on Twitter and Instagram.

Top image by E. Y. Smith, headshot drawing by Richard Howard.

Issue 91

Read the news like a science writer, Covid-19 and pharmaceuticals, and CORVIDS

April 6, 2020

Hello friend! Welcome to Scrap Facts.

I'm a reporter covering health and science with insatiable curiosity. I love everything I learn, not all of which gets its own story. Each week, I'll bring you some of my favorite facts that I picked up on the job or while out living life.

Archives from Tinyletter can be found here. Love Scrap Facts? Consider hitting the “like” button, or tell your friends to sign up!

Health and science news is at the forefront of everyone’s minds right now. I recently wrote a guide to reading new news like a science writer. You’ll need healthy amounts of skepticism and optimism. This doesn’t mean you should dismiss everything you read. It means that you remember that new information may be true, but hasn’t had time to be validated by other studies just yet—and also that scientists are doing their best. You can read the full story here:

If you’re looking for consistently good science writing about Covid-19, follow these folks on Twitter. They’re just a starter list, but they’ll give you quality information you can trust.

Alex Ossola, Quartz

Tim McDonnell, Quartz

Katie Palmer, Quartz

Chase Purdy, Quartz

Amrita Khalid, Quartz

Michael Coren, Quartz

Wudan Yan, freelance

Roxanne Khamsi, freelance

Laura Helmuth, Washington Post

Sharon Begley, STAT

Helen Branswell, STAT

And for a newsletter that addresses FAQs and ways that Covid-19 is shaping the world, make sure to sign up for Quartz’s Need to Know newsletter. It comes to your inbox a few times a week. I contribute regularly.

Covid-19 sneaks its way into your cells like a successful phishing attempt.

Found while reporting: The coronavirus’s survival mechanism is what makes it so dangerous.

Like spam emails, viruses often look like something our cells should let into them.

Image of a screenshot of an email phishing attempt from “sars.cov.too@gmail.com), posing as an ACE2 hormone. Credit: Daniel Wolfe.

SARS-CoV-2 has a protein around its shell of genetic material. This shell happens to look an awful lot like a hormone called ACE2, which is normally involved our temporary stress response. It helps constrict our blood vessels to raise our heart rate and blood pressure. The ACE2 receptor, a handy protein that hangs out on cells’ membranes, normally lets the ACE2 hormone in. But SARS-CoV-2 tricks this receptor, which is how our cells become infected with the virus. They replicate like crazy and burst through the membrane to find more ACE2 receptors to trick.

It’s a devilishly sneaky process—and one of the reasons that it takes is so long to get sick. SARS-CoV-2 hangs out in the throat for a while, where it can carry out this covert mission without causing us too much trouble. By the time it reaches our lungs, we may start to feel sick—but at that point, we’ve been feeling essentially fine for up to two weeks. We’ve had a lot of time to potentially infect others.

One reader recently asked Quartz “I have heard that ibuprofen has commonly been found to have been taken by Covid-19 victims and that acetaminophen is a safer choice to take. True or not?”

My answer in the Need to Know newsletter from April 1:

The concern over ibuprofen, the active ingredient in Advil, comes from one of its cellular side effects: It may raise the number of so-called ACE2 receptors throughout the body, which the novel coronavirus uses to sneak into our cells. In theory, more ACE2 receptors could lead to more entry points for the virus, leading to a more severe infection.

Researchers floated this idea in the journal The Lancet in mid-March. After that, anxiety about ibuprofen went, well, viral, despite a lack of concrete evidence that the drug worsens infections. The WHO and the European Medicines Agency have stated that ibuprofen is still an acceptable way to treat fevers and aches related to Covid-19 (or any illness) at home. So is acetaminophen, the active ingredient in Tylenol, which doesn’t lead to higher levels of ACE2.

North Korea has one lone drug manufacturing plant.

Found while reporting: How Covid-19 could disrupt pharmaceutical supply chains.

If you take any prescription drugs, it likely went through four separate exchanges of hands: One plant made the active ingredient, another put it together in a drug, another shipped it to your pharmacy, and your pharmacy gave it to you. It’s a highly globalized process, which makes sense: It’s cheaper to make some products in countries with looser regulations, and to set up specialized factories that only manufacture a particular type of drug.

This means, of course, that the whole system is incredibly fragile. How fragile? We don’t know—the US Food and Drug Administration keeps track of where these drug manufacturing companies are, but not what they do. That’s proprietary information or the drug companies. Most of these companies are in the US, but India and China have the second and third densest concentrations of plants that make either active pharmaceutical ingredients, or drugs themselves.

Image description: A bubble map of the concentration of API and drug manufacturing plants. Note: If you read this story on qz.com, you can hover over each country to see exactly how many plants it has.

Notably, in their list of over 10,000 plants, I found that North Korea has one lone drug manufacturing plant. I have no idea what the country make there, but I suppose they have to find some way to provide medications to their citizens.

Image description: the same map above, zoomed in over North Korea, South Korea, and Japan.

Covid-19 causes lung complications beyond typical pneumonia.

Found while reporting: Some of the drugs used to keep people on ventilators are in short supply.

Perhaps unsurprisingly, the American Society of Health-Systems Pharmacists started reporting shortages of some of the drugs needed to support intubated patients in March. That group counts shortages as anything that may cause a doctor to use different medication, or a hospital pharmacy to use different kinds of medications. (The FDA counts shortages as anything a manufacturing company reports; so far, there’s only been one shortage of drugs directly related to Covid-19, but there’s usually a list of some 100+ drugs that are in shortage by their standards.)

The hospital pharmacists, nurses, and anesthesiologists I spoke to for this story were particularly worried about a drug that isn’t in shortage yet, but could be: propofol.

Propofol is a drug officially brought to market in the 1980s by the company that is now AstraZeneca. It’s one of the best anesthetic drugs around: Doctors give it through an injection instead of a mask (which can cause feelings of suffocation), it doesn’t build up in the body (which would mean patients couldn’t receive a constant flow of it), and even though it’s stronger than the previously used anesthetics, its effects wear off quickly.

Propofol is important for people on ventilators because it also works to temporarily paralyze muscles. This way, the person being intubated (getting the breathing tube down their windpipe) doesn’t fight it, and they don’t gag or vomit.

Some ventilators allow people to breathe a little on their own; but that’s not necessarily what people with Covid-19 need. The virus damages the lungs so quickly and severely, it causes ARDS, or acute respiratory distress syndrome. With ARDs, the lungs need to be completely paralyzed to heal, while the machine breathes for them. In this case, doctors would want to keep someone on propofol (and other drugs) for longer.

Propofol is the only drug in its class. No other drugs have the exact effects that it does. While pharmacists and clinicians may be able to find workarounds, these substitutes come with compromises that make treatment a lot harder.

Animal of the week: Corvids

Image description: A crow squawking and shirking its head back into its body.

I have a weekend shift yesterday, so I wrote this quiz about the underrated family of songbirds that include crows, ravens, jays, magpies, and nutcrackers. That’s a hint to one of the questions!

That’s all for now—stay curious, friend ❤️

If you love Scrap Facts, consider hitting the “like” button at the bottom of this page, or sending it to a friend. You can also send your own scrap facts to scrapfacts@gmail.com to be featured in future editions. Wanna keep in touch outside of this newsletter? Follow me on Twitter and Instagram.

Top image by E. Y. Smith, headshot drawing by Richard Howard.

Issue 90

The Business of Fertility, aka "Big Baby"

March 22, 2020

Hello friend! Welcome to Scrap Facts.

I'm a reporter covering health and science with insatiable curiosity. I love everything I learn, not all of which gets its own story. Each week, I'll bring you some of my favorite facts that I picked up on the job or while out living life.

Archives from Tinyletter can be found here. Love Scrap Facts? Consider hitting the “like” button, or tell your friends to sign up!

Happy Spring, friend.

Today, the days are officially longer than the nights now. Go outside if that’s possible for you. If that isn’t possible, open your window—remember that carbon dioxide buildups from constant exhalation in rooms make you sleepy and dull. Be safe and kind to others, friend, and enjoy some scrap facts from my fertility series. If you’re not already a QZ member, you can get 40% off your membership to read this guide (and so many more!) by using the code QZFLASHSALE.

An illustration of a blue egg and a pink sperm swimming toward it. Credit: Daniel Wolfe.

Limited access to information plus high-strung emotions create an irrational market.

Found while reporting: The whole gosh-darn series.

I chose to explore the science of fertility care because it’s an opposite force to those driving our globally aging population. I have never reported on a topic where I found it more difficult to get objective information, I told my colleague Jenni Avins for the newsletter Quartzy:

Jenni: What surprised you about this topic?

Foley: I’m not at a point in my life where I want to have kids, and I think what was most surprising was that purely objective, unbiased information is actually really hard to find. I just can’t imagine having to navigate this information in a heightened emotional state.

There’s RESOLVE (the National Infertility Association), the Society for Assisted Reproductive Technology, and the American Society for Reproductive Medicine, which to various degrees provide information for prospective parents. But other than those big societies, it’s either really technical stuff—like papers from embryologists—or stuff that clinics put out, but the clinics are trying to get you to come to them. FertilityIQ is good too, but, again, they’re trying to get you to buy their courses.

And because clinics are trying to sell you services, it’s like: “There are all these things you can do if you absolutely want to be a parent. But if you decide you don’t want to go further, then I guess you don’t want to be a parent.” Nobody is there to say: “It’s okay when you want to stop.”

You can read the full interview here.

The problem with a lack of clear, objective information is that it creates almost a predatory field for people who may already be vulnerable. By the time most people seek out fertility care, they desperately want a child. They will pay the thousands of dollars they can for medications, intrauterine insemination, and eventually in vitro fertilization, or IVF, as long as they can. If they can’t, they may try to borrow money from families, take out loans, or head to crowd-funding sites like GoFundMe. If they can only afford one round, they may pressure doctors to transfer multiple embryos to their uteruses—a choice that could result in multiple pregnancies, which is dangerous for both the pregnant person and their unborn children.

It’s an incredibly difficult field to navigate even when you’re not personally emotionally invested in it—my heart goes out to those who are going through it right now.

The world’s first embryologist was ignored for her work.

Found while reporting: How fertility care went from an evolutionary need to a luxury good.

There was a trio of scientists who contributed to the birth of Louise Brown, the first IVF baby, in 1978. One of scientists who developed IVF, Robert Edwards, won a Nobel Prize for his work in 2010. The second was Patrick Steptoe, who was constantly referenced in conjunction with Edwards. And the third was Jean Purdy. But she was largely forgotten in the scientific community—despite collaborators best efforts.

Sigh.

Purdy was the world’s first embryologist. She was responsible for culturing embryos to grow in the lab, until they were five days old when they are officially blastocysts—a term she also coined. She was so essential to the research that when she had to stop coming into work in order to take care of her mother, all research stopped for months. Edwards and Steptoe spoke out that she should be recognized for her contributions—and she has been, posthumously—but during her time, she was yet another victim of sexism.

Taking gender-affirming hormones does not render a transgender person sterile.

Found while reporting: Fertility care has opened more doors for trans people to have biological children.

This was my favorite story to report for this series because it is the happiest.

An image of Trystan, Biff, and one of their sons, Leo, all reading books on the couch. Courtesy of Trystan Reese.

Fertility care has opened another door for LGBTQ+ people to have kids and expand their families. Which is great! But one area that it has lagged is with regard for trans folks—particularly those who have decided to take gender-affirming hormones.

One such person is Trystan Reese, who, at 37, gave birth to a son. Trystan and his husband, Biff, already had two children through adoption. He had written off having biological kids. He was assigned female at birth, but as a young adult, he knew he was transgender. At 22, he legally changed his name and started taking testosterone—which he assumed would render him sterile. Plus, he didn’t know any trans people with kids. Kids require a certain level of love and stability, which he didn’t know was in the cards for him as a member of a marginalized community.

But then, he fell in love—first with his husband, and then with their two adopted children. “I truly wanted to create life, and to have that experience be a physical manifestation of this love that I never thought I’d find out in this world,” he told me.

Trystan was able to get great care from one a fertility clinic in Portland, Oregon that is LGBTQ+ friendly. There are many of these across the country, and even some awesome scientists researching how to make this kind of care more successful. But still, a lot of people aren’t aware that this kind of care exists, and could be for them! It’s got a long way to go, but it’s another chance for people to grow their families.

Animal of the week: Pigs

An image of a small spotted pig munching on some grass.

Like many of you, I now find myself working in close quarters with my partner constantly. This means that he has seen my daytime eating habits (read: constant snacking), the way I prefer to keep my desk (read: unorganized to the untrained eye, but I know my system), and my showering habits (read: only when I’m sure I’m done exercising for the day—why waste water? [Editor’s note: she is *never* done exercising for the day.]). The spare bedroom that we’ve converted to my office is now known as the Pig Sty. Which means that (in an extremely “I’m baby” voice, I’m Piggy.

I don’t mind because pigs are wonderful creatures. They’re are smart and playful. They’re fast. They don’t really like being muddy—they figured out that it’s an excellent way to compensate for the fact that evolution hasn’t blessed them with sweat glands. [Editor’s note: Katherine has sweat glands. They work extremely well.]

And surprisingly, their bodies—including their embryos—are surprisingly similar to our own.

Pigs have been instrumental in advancing transplant research. They’ve received genetically modified baboon hearts—and lived!—and grown working lung tissue. But they also were the animal model basis of work by Jonathan van Blerkhom. Starting in the 1970s and 80s, he used pig embryos to show that it’s possible to carry out IVF in a minimalist setting. His work is the basis of the organization The Walking Egg, a non-profit that hopes to bring IVF to developing countries for hundreds, not thousands, of dollars.

Some of the discoveries he made with them were actually an accident—he had to find a way to transfer pig embryos from one site to another, which is how he learned that a simple thermos would suffice instead of a lab-grade incubator. He also used them to figure out that a simple titration will create the specific gaseous environment that embryos need—about 90% nitrogen, 5% oxygen, and 5% carbon dioxide.

Based on research with pig embryos, van Blerkhom and his colleagues figured out how to successfully do human IVF successfully for about $200. About 200 couples in Belgium have had kids that way—it works! But it would also disrupt the status quo of expensive treatment.

One last personal request: If you are healthy, please, please stay away from others. Please forgo your group meetups for now (even runs), and only meet up with healthy loved ones who have quarantined for two weeks—assuming you have too, and you can get to them without taking public transportation. Isolation sucks, but it’s not permanent. Deaths are, though. The sooner we can take Covid-19 with the gravity it deserves, the faster we’ll get through this.

Special thanks to Ben Daniels for this issue—he’s a generous copy editor, a public health expert, and he makes sure I eat more than just trail mix and kale.

That’s all for now—stay curious, friend ❤️

If you love Scrap Facts, consider hitting the “like” button at the bottom of this page, or sending it to a friend. You can also send your own scrap facts to scrapfacts@gmail.com to be featured in future editions. Wanna keep in touch outside of this newsletter? Follow me on Twitter and Instagram.

Top image by E. Y. Smith, headshot drawing by Richard Howard.

Issue 89

Covid-19, but ALSO some non-Covid-19 news

March 16, 2020

Hello friend! Welcome to Scrap Facts.

I'm a reporter covering health and science with insatiable curiosity. I love everything I learn, not all of which gets its own story. Each week, I'll bring you some of my favorite facts that I picked up on the job or while out living life.

Archives from Tinyletter can be found here. Love Scrap Facts? Consider hitting the “like” button, or tell your friends to sign up!

I’m back!

It’s been odd being out of your inbox during such a major global health crisis. I’ve been working on an exciting series I’m thrilled to share with you—but that means I haven’t been reporting as much as I’d like on Covid-19.

Instead, I’ve observed most of the news around this pandemic from afar. Seeing the news and watching the public’s reaction to it, I’m worried:

My biggest concern is that the message about social distancing to stop the spread of the virus isn’t hitting home. Many people are correctly assuming that they won’t get sick with Covid-19. Most of us won’t, and if we do, it’ll be mild.

Yet for those who will get severely ill, it’ll be bad. Like, not-enough-hospital-beds bad. And it seems like it’s hard to comprehend how the healthy among us will directly impact those of us who are more vulnerable. This at-risk population includes older adults, those with pre-existing lung issues, or suppressed immune systems. (That said, a perfectly healthy person still could experience major complications. We’re likely to see more of these surprisingly severe cases as the pandemic continues.)

Viruses (technically virions, but now’s not the time to be pedantic) do not care who they infect. They do not care if they make people sick or not; that’s collateral damage that isn’t their concern. Their only goal is to reproduce, and they can only do that if they have an ample supply of host cells. (Again, technically viruses have no desires, because they don’t have brains. They’re intracellular parasites.)

The more contact we have with each other, the more likely it is that the virus can jump to more potential hosts. Healthy folks have immune systems that keep the virus in check. They won’t feel sick; but they’re still hosts. And they’re still capable of passing it on to others.

We all have parents or grandparents or other loved ones who fall into the “vulnerable” category. We all want to protect those people desperately, and would never dream of putting them in danger by exposing them to the virus if we knew we could. But it’s a lot harder for us to imagine our second or third degree connections—people we don’t know—and how our actions could affect them. Some of these farther connections are undoubtedly vulnerable individuals. Any kind of social engagement right now puts those vulnerable people at risk.

On the flip side of that, the benefit of protecting these second and third degree connections is hard to see. We’ll never know who we save by not giving the virus a chance to jump from one person to another.

It’s like a scaled-down version of the way we think about climate change: We know that some people are going to be victims of extreme weather resulting from climate change, but it’s hard to imagine that our own meat-eating habits or energy consumption contribute to any particular storm.

The difference is, with climate change we’ll never be able to prove that one person’s specific habit contributes to a specific storms. With the spread of Covid-19, our individual actions could actually kill specific individual people down the line—someone’s grandparent, someone’s friend, etc.

Please, please limit your social contact over the next few weeks. Do not go to bars, restaurants, group fitness classes, or public spaces, if you can avoid it. It sucks, I know: I’ve felt the day-to-day effects of it in my own life: running groups and races called off, missed parties, no public transportation, figuring out how to change apartment space to accommodate two adults working from home. Each of these little stressors adds to an acute anxiety that I like to carry in a specific spot on the left side of my upper back. I’ve cried and argued with my partner, who works in public health, because I didn’t want his concerns and precautions to be true. (He is right.)

This is an opportunity for us to do the right thing to protect other human beings. That’s what’s going to matter much more than missed happy hours when we look back on this time.

By the way, pandemics like this one will not be a once-in-a-lifetime experience for most of you reading this newsletter. We’ve had three different coronavirus diseases (a generic term for a particular type of virus) jump from animals to humans since 2000—SARS, MERS, and now Covid-19. The more we press into animals’ territory through deforestation and urbanization, the more likely it is that more viruses will make the zootonic jump, too. AND, because global populations are aging, these pandemics will likely affect an even larger percentage of people. We need to learn how to handle these types of pandemics now to do so better in the future.

Anyway, onto the good stuff!

If you find yourself having a lot more reading time on your hands and needing a break from coronavirus news, I’ve got just the series for you:

For the past six weeks, I’ve gone deep into the world of fertility care, which popped up just 40 years ago. It’s the other side of the coin of reproductive rights—individuals or couples who want to have kids can, even if there are a social or biological factors that would normally prohibit them from doing so.

And it’s big business (for “Big Baby,” as I like to call it). The field is a combination of state-of-the-art technology and a vulnerable client base of hopeful parents. In short, capitalism has worked its magic and turned having a baby into a luxury good.

You can now enjoy the series online. On Thursday, I’ll be sending a special edition of Scrap Facts with everything else I learned reporting this series. If you have any questions for me about the topic, reply to this email and I’ll answer them in Thursday’s issue! I’ll also take your questions on Covid-19, or direct you to the best resources, because now is a time for information sharing.

That’s all for now—stay curious, friend ❤️

Special thanks to Ben Daniels for this issue—he’s a generous copy editor and a public health expert who has informed a lot of my thinking.

If you love Scrap Facts, consider hitting the “like” button at the bottom of this page, or sending it to a friend. You can also send your own scrap facts to scrapfacts@gmail.com to be featured in future editions. Wanna keep in touch outside of this newsletter? Follow me on Twitter and Instagram.

Top image by E. Y. Smith, headshot drawing by Richard Howard.

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