Coronavirus: The Tide Is Coming for Medicinal Cannabis
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By Zulfikar Abbany
The search for a vaccine for the new coronavirus, SARS-CoV-2, or indeed a medicinal drug to cure it, has taken researchers down both traditional and less traditional avenues.
They have looked at existing drug candidates, such as remdesivir, which was original developed to treat Ebola. In Germany, the first clinical trials for a coronavirus vaccine are based on a candidate developed for cancer immunology.
There's a study out of France that suggests nicotine — typically ingested via the often-lethal pastime of smoking — may protect people against the novel coronavirus, itself a potentially fatal lung infection.
And, now, preliminary research is emerging out of Canada that certain strains of the psychoactive drug cannabis may also increase resistance to the coronavirus. If the study, which is not yet peer reviewed, can be verified, it would appear that cannabis works in a similar way to nicotine.
"The results on COVID-19 came from our studies on arthritis, Crohn's disease, cancer and others," said Dr. Igor Kovalchuck, a professor of Biological Sciences at the University of Lethbridge, in an email to DW.
As with the research into nicotine's effect on the coronavirus, it is thought that some strains of cannabis reduce the virus' ability to enter the lungs, where it takes hold, reproduces and spreads.
In a paper on preprints.org, where scientists can publish non-peer-reviewed results, Kovalchuck and colleagues write that their specially developed strains of cannabis effectively stop the virus from entering the human body.
The study is one of many papers globally that have been shared on preprint websites, including preprints.org, in a bid to disseminate preliminary findings into potential COVID-19 treatments that have yet to undergo rigorous peer review.
The coronavirus needs a "receptor" to enter a human host. That receptor is known as an "angiotensin-converting enzyme II," or ACE2.
ACE2 is found in lung tissue, in oral and nasal mucus, in the kidneys, testes, and gastrointestinal tracts, they write.
And the theory is that by modulating ACE2 levels in those "gateways" to the human host, it may be possible to lower our susceptibility, or vulnerability, to the virus. It could basically reduce our risk of infection.
"If there's no ACE2 on tissues, the virus will not enter," said Kovalchuck.
No Common or Garden Cannabis
Some in the science community say medicinal cannabis may help to treat a range of conditions from nausea to dementia. But medicinal cannabis is not the same as what you might call recreational cannabis.
Those more "common or garden varieties" of cannabis — or street cannabis — are known for their Tetrahydrocannabinol (THC) content. That's the main psychoactive agent in the drug.
The Alberta-based researchers, meanwhile, have focused on strains of the plant, Cannabis sativa, that are high in an anti-inflammatory cannabinoid, cannabidiol (CBD) — one of the other main chemicals in cannabis, aside from THC.
They have developed more than 800 new Cannabis sativa variants, with high levels of CBD, and identified 13 extracts which they say modulate ACE2 levels in those humans gateways.
"Our varieties are high in CBD, or balanced CBD/THC, because you can give a higher dose and people will not be impaired due to the psychoactive properties of THC," said Kovalchuck.
Low Funding, Low Knowledge
Kovalchuck also heads a company called Inplanta BioTechnology, with Dr. Darryl Hudson, who has a PHD from the University of Guelph — another Canadian institute where research is ongoing into the use of cannabinoids in medicine.
But funding for cannabinoid research is "still hard," he said. And that's the case in other countries, too.
Some researchers in the UK say that may be because there are misconceptions among the general public and politicians about medicinal cannabis, perhaps even a fear that people will become addicted or try to self-medicate, using just any old form of cannabis they can find.
Those researchers say themselves that it is vital to be clear about the information and to avoid sensationalism.
"Researchers have to be particularly careful when disseminating their results given the socio-political volatility of medicinal cannabis use," said Chris Albertyn, a Research Portfolio Lead at King's College London, and an expert on cannabinoids and dementia.
The best way to get through that, says Albertyn, is to implement open, transparent research methods.
"In this instance, the current research from Canada has just unveiled a potential therapeutic 'mechanism of action' but that would need to be validated and tested in well-designed, robust clinical trials before any meaningful clinical conclusions can be drawn," he said.
That would include pre-registering clinical protocols and analysis methods, publishing in open access journals, double-blind placebo controlled trials, and strict, independent peer review by the clinical academic community, said Albertyn.
A turning tide
The problem is that without sufficient funding and further research, there is too little knowledge about cannabinoids — whether it's positive or negative research results — some say we just won't know until we do the research.
"But there is ENORMOUS interest now," said Kovalchuk in his email. And that's his emphasis. "The tide is coming."
While he and his co-authors say even their most effective extracts require large-scale validation, they say they may be a "safe addition" to the treatment of COVID-19. An addition, mind, alongside other treatments.
So, large-scale verification pending, medicinal cannabis could be developed into "easy-to-use preventative treatments," such as a mouthwash or a throat gargle in both clinical and home use.
Reposted with permission from Deutsche Welle.
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By Eric Tate and Christopher Emrich
Disasters stemming from hazards like floods, wildfires, and disease often garner attention because of their extreme conditions and heavy societal impacts. Although the nature of the damage may vary, major disasters are alike in that socially vulnerable populations often experience the worst repercussions. For example, we saw this following Hurricanes Katrina and Harvey, each of which generated widespread physical damage and outsized impacts to low-income and minority survivors.
Mapping Social Vulnerability<p>Figure 1a is a typical map of social vulnerability across the United States at the census tract level based on the Social Vulnerability Index (SoVI) algorithm of <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1540-6237.8402002" target="_blank"><em>Cutter et al.</em></a> . Spatial representation of the index depicts high social vulnerability regionally in the Southwest, upper Great Plains, eastern Oklahoma, southern Texas, and southern Appalachia, among other places. With such a map, users can focus attention on select places and identify population characteristics associated with elevated vulnerabilities.</p>
Fig. 1. (a) Social vulnerability across the United States at the census tract scale is mapped here following the Social Vulnerability Index (SoVI). Red and pink hues indicate high social vulnerability. (b) This bivariate map depicts social vulnerability (blue hues) and annualized per capita hazard losses (pink hues) for U.S. counties from 2010 to 2019.<p>Many current indexes in the United States and abroad are direct or conceptual offshoots of SoVI, which has been widely replicated [e.g., <a href="https://link.springer.com/article/10.1007/s13753-016-0090-9" target="_blank"><em>de Loyola Hummell et al.</em></a>, 2016]. The U.S. Centers for Disease Control and Prevention (CDC) <a href="https://www.atsdr.cdc.gov/placeandhealth/svi/index.html" target="_blank">has also developed</a> a commonly used social vulnerability index intended to help local officials identify communities that may need support before, during, and after disasters.</p><p>The first modeling and mapping efforts, starting around the mid-2000s, largely focused on describing spatial distributions of social vulnerability at varying geographic scales. Over time, research in this area came to emphasize spatial comparisons between social vulnerability and physical hazards [<a href="https://doi.org/10.1007/s11069-009-9376-1" target="_blank"><em>Wood et al.</em></a>, 2010], modeling population dynamics following disasters [<a href="https://link.springer.com/article/10.1007%2Fs11111-008-0072-y" target="_blank" rel="noopener noreferrer"><em>Myers et al.</em></a>, 2008], and quantifying the robustness of social vulnerability measures [<a href="https://doi.org/10.1007/s11069-012-0152-2" target="_blank" rel="noopener noreferrer"><em>Tate</em></a>, 2012].</p><p>More recent work is beginning to dissolve barriers between social vulnerability and environmental justice scholarship [<a href="https://doi.org/10.2105/AJPH.2018.304846" target="_blank" rel="noopener noreferrer"><em>Chakraborty et al.</em></a>, 2019], which has traditionally focused on root causes of exposure to pollution hazards. Another prominent new research direction involves deeper interrogation of social vulnerability drivers in specific hazard contexts and disaster phases (e.g., before, during, after). Such work has revealed that interactions among drivers are important, but existing case studies are ill suited to guiding development of new indicators [<a href="https://doi.org/10.1016/j.ijdrr.2015.09.013" target="_blank" rel="noopener noreferrer"><em>Rufat et al.</em></a>, 2015].</p><p>Advances in geostatistical analyses have enabled researchers to characterize interactions more accurately among social vulnerability and hazard outcomes. Figure 1b depicts social vulnerability and annualized per capita hazard losses for U.S. counties from 2010 to 2019, facilitating visualization of the spatial coincidence of pre‑event susceptibilities and hazard impacts. Places ranked high in both dimensions may be priority locations for management interventions. Further, such analysis provides invaluable comparisons between places as well as information summarizing state and regional conditions.</p><p>In Figure 2, we take the analysis of interactions a step further, dividing counties into two categories: those experiencing annual per capita losses above or below the national average from 2010 to 2019. The differences among individual race, ethnicity, and poverty variables between the two county groups are small. But expressing race together with poverty (poverty attenuated by race) produces quite different results: Counties with high hazard losses have higher percentages of both impoverished Black populations and impoverished white populations than counties with low hazard losses. These county differences are most pronounced for impoverished Black populations.</p>
Fig. 2. Differences in population percentages between counties experiencing annual per capita losses above or below the national average from 2010 to 2019 for individual and compound social vulnerability indicators (race and poverty).<p>Our current work focuses on social vulnerability to floods using geostatistical modeling and mapping. The research directions are twofold. The first is to develop hazard-specific indicators of social vulnerability to aid in mitigation planning [<a href="https://doi.org/10.1007/s11069-020-04470-2" target="_blank" rel="noopener noreferrer"><em>Tate et al.</em></a>, 2021]. Because natural hazards differ in their innate characteristics (e.g., rate of onset, spatial extent), causal processes (e.g., urbanization, meteorology), and programmatic responses by government, manifestations of social vulnerability vary across hazards.</p><p>The second is to assess the degree to which socially vulnerable populations benefit from the leading disaster recovery programs [<a href="https://doi.org/10.1080/17477891.2019.1675578" target="_blank" rel="noopener noreferrer"><em>Emrich et al.</em></a>, 2020], such as the Federal Emergency Management Agency's (FEMA) <a href="https://www.fema.gov/individual-disaster-assistance" target="_blank" rel="noopener noreferrer">Individual Assistance</a> program and the U.S. Department of Housing and Urban Development's Community Development Block Grant (CDBG) <a href="https://www.hudexchange.info/programs/cdbg-dr/" target="_blank" rel="noopener noreferrer">Disaster Recovery</a> program. Both research directions posit social vulnerability indicators as potential measures of social equity.</p>
Social Vulnerability as a Measure of Equity<p>Given their focus on social marginalization and economic barriers, social vulnerability indicators are attracting growing scientific interest as measures of inequity resulting from disasters. Indeed, social vulnerability and inequity are related concepts. Social vulnerability research explores the differential susceptibilities and capacities of disaster-affected populations, whereas social equity analyses tend to focus on population disparities in the allocation of resources for hazard mitigation and disaster recovery. Interventions with an equity focus emphasize full and equal resource access for all people with unmet disaster needs.</p><p>Yet newer studies of inequity in disaster programs have documented troubling disparities in income, race, and home ownership among those who <a href="https://eos.org/articles/equity-concerns-raised-in-federal-flood-property-buyouts" target="_blank">participate in flood buyout programs</a>, are <a href="https://www.eenews.net/stories/1063477407" target="_blank" rel="noopener noreferrer">eligible for postdisaster loans</a>, receive short-term recovery assistance [<a href="https://doi.org/10.1016/j.ijdrr.2020.102010" target="_blank" rel="noopener noreferrer"><em>Drakes et al.</em></a>, 2021], and have <a href="https://www.texastribune.org/2020/08/25/texas-natural-disasters--mental-health/" target="_blank" rel="noopener noreferrer">access to mental health services</a>. For example, a recent analysis of federal flood buyouts found racial privilege to be infused at multiple program stages and geographic scales, resulting in resources that disproportionately benefit whiter and more urban counties and neighborhoods [<a href="https://doi.org/10.1177/2378023120905439" target="_blank" rel="noopener noreferrer"><em>Elliott et al.</em></a>, 2020].</p><p>Investments in disaster risk reduction are largely prioritized on the basis of hazard modeling, historical impacts, and economic risk. Social equity, meanwhile, has been far less integrated into the considerations of public agencies for hazard and disaster management. But this situation may be beginning to shift. Following the adage of "what gets measured gets managed," social equity metrics are increasingly being inserted into disaster management.</p><p>At the national level, FEMA has <a href="https://www.fema.gov/news-release/20200220/fema-releases-affordability-framework-national-flood-insurance-program" target="_blank">developed options</a> to increase the affordability of flood insurance [Federal Emergency Management Agency, 2018]. At the subnational scale, Puerto Rico has integrated social vulnerability into its CDBG Mitigation Action Plan, expanding its considerations of risk beyond only economic factors. At the local level, Harris County, Texas, has begun using social vulnerability indicators alongside traditional measures of flood risk to introduce equity into the prioritization of flood mitigation projects [<a href="https://www.hcfcd.org/Portals/62/Resilience/Bond-Program/Prioritization-Framework/final_prioritization-framework-report_20190827.pdf?ver=2019-09-19-092535-743" target="_blank" rel="noopener noreferrer"><em>Harris County Flood Control District</em></a>, 2019].</p><p>Unfortunately, many existing measures of disaster equity fall short. They may be unidimensional, using single indicators such as income in places where underlying vulnerability processes suggest that a multidimensional measure like racialized poverty (Figure 2) would be more valid. And criteria presumed to be objective and neutral for determining resource allocation, such as economic loss and cost-benefit ratios, prioritize asset value over social equity. For example, following the <a href="http://www.cedar-rapids.org/discover_cedar_rapids/flood_of_2008/2008_flood_facts.php" target="_blank" rel="noopener noreferrer">2008 flooding</a> in Cedar Rapids, Iowa, cost-benefit criteria supported new flood protections for the city's central business district on the east side of the Cedar River but not for vulnerable populations and workforce housing on the west side.</p><p>Furthermore, many equity measures are aspatial or ahistorical, even though the roots of marginalization may lie in systemic and spatially explicit processes that originated long ago like redlining and urban renewal. More research is thus needed to understand which measures are most suitable for which social equity analyses.</p>
Challenges for Disaster Equity Analysis<p>Across studies that quantify, map, and analyze social vulnerability to natural hazards, modelers have faced recurrent measurement challenges, many of which also apply in measuring disaster equity (Table 1). The first is clearly establishing the purpose of an equity analysis by defining characteristics such as the end user and intended use, the type of hazard, and the disaster stage (i.e., mitigation, response, or recovery). Analyses using generalized indicators like the CDC Social Vulnerability Index may be appropriate for identifying broad areas of concern, whereas more detailed analyses are ideal for high-stakes decisions about budget allocations and project prioritization.</p>
By Jessica Corbett
Sen. Bernie Sanders on Tuesday was the lone progressive to vote against Tom Vilsack reprising his role as secretary of agriculture, citing concerns that progressive advocacy groups have been raising since even before President Joe Biden officially nominated the former Obama administration appointee.