Nicole Karlis

Experts say the delta surge may be the last major COVID-19 wave

Has the latest COVID-19 surge, fueled by the ultra-infectious delta variant, finally peaked in the United States?

On Wednesday, the COVID-19 Scenario Modeling Hub, a group of researchers who have been studying and following the trajectory of the pandemic, announced a new prediction stating that the worst of the delta surge is likely behind us. Through combining nine different mathematical models, the researchers forecast that cases will finally start to fall again throughout the next few months and that the U.S. will avoid another winter surge like last year.

"Any of us who have been following this closely, given what happened with delta, are going to be really cautious about too much optimism," Justin Lessler at the University of North Carolina, who helps run the hub, told NPR. "But I do think that the trajectory is towards improvement for most of the country."

Indeed, the U.S. is already starting to see this happen in real-time. As a whole, COVID-19 cases and hospitalizations are declining (once again) across the country and even the world. According to the World Health Organization's most recent report, the number of new COVID-19 cases fell to 3.6 million new cases globally, down from 4 million new infections the previous week. In parts of the U.S. where delta hit the hardest, like Florida and Texas, cases and hospitalizations have declined over the last week, too. Of course, this trend doesn't track everywhere across the country. In Ohio, some hospitals are at or reaching peak capacity, as the delta variant just now takes hold in various communities.

"I think in general, with delta, we're peaking as a country, but there are going to be some states where they're on a different timescale and those states are less populous so they probably won't wouldn't affect the overall U.S. numbers," said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center. "But it may get difficult in some of those states if there are high-risk individuals getting infected as we've seen, for example in Idaho, where they're worried about the ability to care for patients."

The country, Adalja emphasized, is pretty "heterogeneous" and even if U.S. numbers as a whole fall, that doesn't mean the delta surge is over for everyone. Still, a trend of cases and hospitalizations falling is a positive one.

For Americans who recall over a year of surges in case numbers followed by declines followed by another inevitable surge, this prediction might induce deja vu. The delta variant surge has been dubbed the fourth officially COVID-19 wave since the pandemic began, and it certainly threw the pandemic on a different track. Unlike previous surges from 2020 and early 2021, vaccines were widely available for most people who were eligible during delta variant's rise.

Now, as this wave crests, more people who previously were ineligible for vaccines will be able to obtain vaccinations. The two-shot Pfizer vaccine is expected to be approved in the coming weeks for children between the ages of five and 11; previously, the youngest vaccine-eligible age was 12.

While there have not been official lockdowns during the delta surge in the U.S. (unlike previous surges), some parts of the country tightened pandemic restrictions because of the delta variant. These generally included rules about wearing masks indoors, regardless of vaccination status, or denying entry to businesses if patrons lacked vaccine cards. Indeed, the delta variant delayed society's timeline for returning to any semblance of normalcy.

Unlike previous surges, experts like Adalja and those at the COVID-19 Scenario Modeling Hub do not believe another "surge" is in our future.

"I think you have to also define what it means by surge — are we going to see an acceleration of cases when it gets colder, less sunny, less humid and people have to go indoors? Yes, that's just based on the biology of the virus," Adalja said. "There will be more cases during those periods of time, but will they be deadly? That's really a function of who's getting infected and how protected the high-risk populations are."

Adalja added that after this wave, he does believe that many people will be protected by either the vaccines or natural immunity.

"I do think there's going to be a significant amount of immunity when you combine natural immunity plus vaccine induced immunity plus people who are now dead and not susceptible because they're dead," Adalja said.

Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California–San Francisco, said it is likely a lot of vaccinated people have been exposed to the delta variant and don't even know it.

"The thing about delta to remember is that we are not getting away from it — it's really transmissible, and we did not lock down our society. We tried to do masks in some places, but we didn't even do capacity limits and we opened schools at the same time," Gandhi said. "So what does this mean? It means a lot of people have been exposed to delta, and for the vaccinated, many of them don't know it."

If they did, they likely had a mild breakthrough case.

If doing the same thing over and over and expecting different results is insanity, then it's reasonable for expectations to need to be managed during yet another wind-down from yet another wave. While this fall might not be as relaxed and celebratory as life felt before delta happened, when cases were falling and vaccinations rates were rising, there is room to be optimistic. But does this mean the pandemic is finally nearing an end? That is a little more difficult to answer, Gandhi said.

"No one's defined an endpoint," Gandhi said. "I have really concluded that the endpoint is when everyone qualifies for a vaccine, including children; that's when there will be a relaxation that will be when we'll stop having articles that say, in the Washington Post, 'living with an unvaccinated child is like living through a fire alarm every day.'"

Similar to how the delta variant has affected different states and cities across the country, a sense of normalcy depends on where one is located, too. Blue states like California have more pandemic restrictions, like mask mandates indoors, compared to red states like Florida that have politicians who keep refusing to implement mask mandates. The Centers for Disease Control and Prevention has a set of recommendations for when the vaccinated should wear masks indoors, which includes wearing a mask indoors in public if a person is in an area of substantial or high transmission. Unvaccinated people are expected to wear masks regardless of transmission rates inside, which is partly why local jurisdictions reverted back to universal masking. Adalja said as COVID-19 cases fall, it's possible that some local governments will ease indoor masking restrictions.

"If you're in a place where those have fallen, then the CDC recommendations would not necessarily be applicable," Adalja said. "Some states or some counties may have gone beyond the CDC recommendations, but I think most of them would probably phase those out if they've fallen below the CDC threshold; I think you would see those types of things, not be enforced because transmission goes down."

Certainly getting more people vaccinated is the best way to slow transmission though, but at least for now gone are the days when symptoms of a cold — even for the vaccinated — could be easily brushed off. But as Gandhi noted, how the next phase of the pandemic looks in regards to masking and gatherings is largely a "blue state question"— as many red states didn't follow CDC recommendations at all once delta hit. Regardless of politics, both Adalja and Gandhi said we are moving to a phase of the pandemic where people have to learn to live with COVID-19 as an endemic disease.

"What does endemic mean? It means that you have to accept the highly transmissible respiratory variant," Gandhi said. "Whether you want to accept it or not, we have to accept the reality of endemicity."

No, the COVID-19 vaccines don't cause male infertility — but the virus might

Unsubstantiated rumors that the COVID-19 vaccine causes impotence have entered the public discourse because of comments made by rapper Nicki Minaj.

It started when Minaj recently tweeted that she would not be attending last week's Met Gala due to its vaccination requirement. "They want you to get vaccinated for the Met," she wrote in a since-deleted tweet. "If I get vaccinated it won't for the Met. It'll be once I feel I've done enough research. I'm working on that now."

Later, she suggested that the vaccine might be linked to male infertility, a suspicion that she said stemmed from a story she heard about her cousin's friend.

"My cousin in Trinidad won't get the vaccine cuz his friend got it & became impotent. His testicles became swollen," she wrote on Twitter. "His friend was weeks away from getting married, now the girl called off the wedding. So just pray on it & make sure you're comfortable with ur decision, not bullied."

Minaj's incredible reach — 22.8 million follow her on Twitter — combined with the anatomical peculiarity of the anecdote helped make her story about her cousin go viral, spawning memes, condemnations from public health officials, and even sparking a rebuttal from Trinidad and Tobago's Health Minister, who said there was no record of any such incident in the Caribbean nation.

As other health experts attested as well, there is no scientific evidence that the COVID-19 vaccine will negatively affect a male reproductive system. Yet contracting the virus itself can cause male reproductive health issues.

"I am not aware of any evidence that any of the COVID-19 vaccines cause male infertility, impotence, or swollen testicles," Allan Pacey, Professor of Andrology at the University of Sheffield, told Salon. "However, I am aware of published reports that catching COVID-19 can be associated with testicular pain, an increased frequency of erectile dysfunction, and a temporary reduction in sperm production."

Channa Jayasena, a Clinical Senior Lecturer and Consultant in Reproductive Endocrinology and Andrology at Imperial College, concurred.

"There is no evidence that the COVID-19 vaccine causes impotence or testicle swelling in men," Jayasena said. "However, a recent study suggests that mild COVID-19 infection (not the vaccine) may slightly reduce your sperm count and quality."

Indeed, this message has been confirmed by the Centers for Disease Control and Prevention (CDC), the Society for Male Reproduction and Urology (SMRU), the Society for the Study of Male Reproduction (SSMR) and many more medical experts.

There have been studies specifically related to COVID-19 vaccines and fertility. Ranjith Ramasamy, Director of Reproductive Urology at the University of Miami, co-authored a study looking at sperm count in 45 men between the ages of 18 and 50 years old.

"In this study, no significant changes in sperm parameters were seen following COVID-19 mRNA vaccination of males at 3- and 6-month follow-up," Ramasamy told Salon. "Thus far, vaccines have been proven to be safe and effective in combating COVID-19 with no evidence indicating they can negatively impact the sexual health of males or females."

Despite this, Minaj's comments reflect an ongoing false narrative in anti-vaccine and alternative health groups: that vaccines cause infertility in both women and men. Similar to unsubstantiated fear around how the COVID-19 vaccines might harm a woman's reproductive system, male infertility is often used as a way to cause fear around getting vaccinated.

But why are the two — vaccines and fertility — often linked in anti-vaccine propaganda?

Experts speculate that it is, in part, because fears of infertility play on common, deep human fears. In some cases, a lack of research around a topic can create a breeding ground for misinformation. And other times, myths stem from a misinterpretation of a study.

Unlike some previous instances of scientific misinformation having its origin in retracted studies, it is unclear exactly where myths about the COVID-19 vaccines harming the male reproductive system originated from. Aside from Minaj's remarks, it is possible that scientific evidence around fevers causing a temporary decline in sperm count have been manipulated.

As the Society for Male Reproduction and Urology (SMRU) and the Society for the Study of Male Reproduction (SSMR) explained in a joint statement: "It should be noted that about 16% of men in the Pfizer/BioNtech COVID-19 vaccine clinical trial experienced fever after the second dose. Fevers can cause temporary declines in sperm production."

Therefore, if a man experiences fever as the result of the COVID-19 vaccine, the joint statement said, that man may experience a temporary decline in sperm production.

"But that would be similar to or less than if the individual experienced fever from developing COVID-19 or for other reasons," the statement explained.

Conversely, there is scientific evidence that suggests getting infected with COVID-19 can affect male fertility, as multiple researchers described. Ramasamy worked on a separate study where he and his colleagues analyzed the autopsy tissues of the testicles of six men who died of COVID-19 infection. They found that in three of the men, there was a decreased number of sperm. The same study showed that a COVID-19 infection could lead to severe erectile dysfunction. The researchers speculated it could be because the infection causes reduced blood supply to the penis.

As Ramasamy previously wrote: "These findings are not entirely surprising. After all, scientists know other viruses invade the testicles and affect sperm production and fertility."

Any women or men who are concerned about their reproductive health and COVID-19 should get vaccinated, experts advise.

"I would urge all men (and women) to get vaccinated when they get the opportunity," said Pacey.

FDA panel rejects mass booster plan — undermining Biden's hopes

It looks like most Americans won't be rolling up their sleeves for a third COVID-19 vaccine shot this year — at least those under the age of 65.

On Friday, a federal advisory committee of 18 people voted against the Biden administration's mass booster plan to offer third Pfizer vaccine shots to everyone over the age of 16. Two members of the committee voted in favor of the plan to offer mass booster shots, while the remainder of the committee voted no. If a majority of the committee voted yes, boosters would have been offered to people 16 and over who received their last dose nearly eight months ago.

Then, in a rare second vote, the panel voted unanimously Friday to recommend emergency use authorization of a booster dose of Pfizer's vaccine in people 65 and older and those at high risk of severe COVID-19 six months after full vaccination.

The first vote that rejected the Biden administration's plan came as a surprise. The rejection of the booster plan ultimately hinged on a lack of adequate data that showed a third shot would slow transmission among people who get infected despite vaccination, and data suggesting that the antibodies from a third shot wouldn't wane over time as well. The panel questioned the accuracy of comparing data from Israel to the situation in the U.S., and questioned whether a third dose would increase the rare risk of heart inflammation that has been seen in mostly younger men after the second dose.

"I don't think a booster dose is going to significantly contribute to controlling the pandemic," said panelist Dr. Cody Meissner of Tufts University on Friday. "And I think it's important that the main message we transmit is that we've got to get everyone two doses."

Many members of the committee, assembled by the Food and Drug Administration, also expressed doubts about the effectiveness of a mass booster plan compared to one that would target specific groups — like people over the age of 65.

The FDA has yet to make its own decision on the recommendation, but their recommendation generally follows what's decided among the expert panel like the one that met today. Today's vote was the first step in the process for the FDA to officially approve boosters. A CDC advisory committee is scheduled to meet next week, as another step of the process, to debate who should get boosters and how many months after their second dose they should receive them.

In August, the U.S. Department of Health and Human Services (HHS) announced they were putting a plan together for booster shots. In the announcement, public health officials stated starting the week of September 20, 2021, people who were fully vaccinated and about eight months away from their last second shot would be eligible for a third.

"At that time, the individuals who were fully vaccinated earliest in the vaccination rollout, including many health care providers, nursing home residents, and other seniors, will likely be eligible for a booster," the statement read. "We would also begin efforts to deliver booster shots directly to residents of long-term care facilities at that time, given the distribution of vaccines to this population early in the vaccine rollout and the continued increased risk that COVID-19 poses to them."

As this so-called booster roll-out date neared, the initial plan appeared to be in flux. Since Moderna, maker of one of three approved COVID-19 vaccines in the US, hasn't provided adequate data on boosters, the Pfizer vaccine was the only possibility for a third shot to get into arms this month. While the Biden administration appeared to be confidently moving forward with approving a third Pfizer shot for everyone over the age of 16, a bit of a backlash and debate in the scientific community surfaced.

In particular, there have been a series of clashing reviews and arguments among scientists on whether or not boosters are really needed. A study published in The New England Journal of Medicine argued that those who received a third Pfizer shot in Israel were far less likely to get a severe case of COVID-19 than those who received two shots. However, a group of scientists wrote in The Lancet that there's not enough evidence to suggest boosters are needed at this time.

Two of the authors of the paper are scientists at the Food and Drug Administration. According to the New York Times, Dr. Philip Krause and Dr. Marion Gruber is poised to leave this fall, in part because they were upset over the initial booster announcement.

As Salon previously reported, boosters are already controversial in part because mass distribution of them would decrease the supply of available vaccines that could be distributed in more needy nations with less vaccine access. Previously, the World Health Organization (WHO) called for a moratorium on booster shots in affluent countries throughout September. Yet Israel, Germany, and the UK had already approved COVID-19 booster shots for the elderly and those with underlying conditions.

"Even while hundreds of millions of people are still waiting for their first dose, some rich countries are moving towards booster doses," said WHO Director-General Tedros Adhanom Ghebreyesus. "So far more than 4 billion vaccine doses have been administered globally. More than 80% have gone to high and upper middle income countries, even though they account for less than half of the world's population."

In the U.S., many have been obtaining booster shots illicitly, in many cases lying about their vaccine status to pharmacists or traveling to neighboring states where their vaccine information is not on state records.

Some feared the Biden administration's push for boosters was politically motivated.

"Weeks ago, the administration decided that the public needs cake and deserves cake, and so shall have cake," John Moore, a virologist at Weill Cornell Medicine, told the New York Times. "Now, the public expects cake and would be very annoyed if its cake was taken away at this point."

According to AP News, Sharon Alroy-Preis of Israel's Ministry of Health previously said a third shot improves protection against COVID-19 by tenfold in people ages 60 and older.

"It's like a fresh vaccine," bringing protection back to original levels and helping Israel "dampen severe cases in the fourth wave," she said.

Currently, in the U.S., a third vaccine dose is approved for certain immunocompromised people.

The weird geology of Mars is causing problems for NASA's rover

Earlier this month, the Perseverance rover set out to collect some rock samples on Mars. It was supposed to be a key moment in the rover's historic sample-return mission, one in which Perseverance was to collect, store and return Martian rock and soil samples to Earth. (The rocket that will pick up the samples hasn't launched yet, and may not for almost a decade; currently, Perseverance is doing the grunt work of collection.) To date, Perseverance had been highly successful: its risky landing worked perfectly, and Ingenuity, the 4-pound helicopter that hitched a ride to Mars on Perseverance's back, overcame massive barriers to become the first powered-controlled flight on another planet. Compared to those feats, Perseverance's next task — drilling out a finger-sized hole in a rock — seemed simple. But after the drilling, the collection tube came back empty. Mission control was in disbelief.

As Salon previously reported, scientists rushed to figure out why the sample went missing. Did the drill somehow miss? It didn't seem so — images from the Red Planet revealed there was a hole in the rock.

So what happened once the drill came out of the rock?

After some sleuthing, NASA's Perseverance team determined that the rock most likely crumbled into "small fragments" — essentially, a powder. While the pulverization of the rock sample was disappointing to the team, it was also a lesson in Martian geology.

"It's certainly not the first time Mars has surprised us," said Kiersten Siebach, an assistant professor of planetary biology at Rice University and participating scientist on the science and operations team for Perseverance. "A big part of exploration is figuring out what tools to use and how to approach the rocks on Mars."

Siebach explained that something similar sometimes happens to geologists here on Earth. Certain rocks look solid, their appearance having been retained by their chemistry. But weathering events and erosion can weaken that chemistry.

"If you've hiked in California, sometimes it looks like you're hiking next to a rock. But if you kick it, it falls apart into dust," Siebach said. "It's probably something like that, where there's been more weather than anticipated."

Mars is a curious place, geologically speaking. The surface of the planet is rocky, dusty; and thanks to previous missions like the Sojourner rover, Spirit, Opportunity and Curiosity, we know that the soil is toxic. High concentrations of perchlorate compounds, meaning containing chlorine, have been detected and confirmed on multiple occasions. In some spots, there are volcanic basaltic rocks like the kind that we have on Earth in Iceland, Hawaii or Idaho.

Raymond Arvidson, professor of earth and planetary sciences at Washington University in St. Louis and a Curiosity science team member, explained that one big difference between Earth and Mars though is that Earth has active plate tectonics — meaning that Earth's surface is comprised of vast, continent-spanning "plates" that move and shift and abut against each other, creating valleys and mountains. Such geology has given Earth places like Sierra Nevada mountain range. Mars, however, never had plate tectonics.

"So those very primitive rocks that are called the basaltic, like we have in the oceans — that's the dominant mineralogy and composition of rocks on Mars," Arvidson said. "It's basically a basalted planet — not as complicated as here, not as many rocks." Jezero Crater, a 28 mile-wide impact crater and former lake located north of the Martian equator, is where Perseverance touched town. Arvidson noted that the crater has diverse geology: "It has clays, it has faults and carbonate, many of them produced [around] three and a half billion years ago."

For that reason, scientists believe Jezero may be an ideal spot to search for ancient signs of microbial life on Mars. Perseverance is now headed to the next sampling location in South Seitah, which is within Jezero Crater.

Notably, the tubes and instruments on Perseverance were built to collect more solid samples, and that's because the aim of this mission is to see if these rocks contain evidence of microbes, or any ancient fossilized life.

"Do these rocks contain evidence for life?" Arvidson asked. "To answer those questions, you need to get the rock back to Earth."

Arvidson said that these soft sedimentary rocks that turn into powder when you drill are "everywhere" on Mars. Previous rovers encountered them too.

"For example with Curiosity, which landed in Gale Crater in 2012 — and we'd been driving up the side of the mountain called Mount Sharp — we encountered soft sedimentary rocks that were easy to drill, and we'd get powders back," Arvidson said. "Then we found really hard rock that we couldn't drill into, so we gave up. Jezero is going to have hard rocks and soft rocks."

As Siebach previously mentioned, what happened with Perseverance is a learning experience. Scientists, Siebach said, rely on a basaltic signal from orbit to determine the mineralogy and composition of Jezero Crater's floor.

"It's a little bit ambiguous. . . we don't see a strong signal of hydration or something in these rocks in particular, instead, they look like most rocks on Mars which means they have a lot of these volcanic minerals and some dust on top," Siebach noted. However, orbital surveillance is not foolproof. "We don't know whether this crater floor was actually volcanic," Siebach added.

Hence, scientists won't always be certain about the consistency of the sample areas they choose to drill. But once on Mars, it's a mix of science, educated guessing, and luck to really find what they're looking for to bring back home.

"Some of these rocks could have a composition that makes it look igneous, when they could be sedimentary or igneous rocks," Siebach said. "That's the kinds of compositions we're seeing that makes it challenging and fun."

Siebach emphasized she has confidence that Perseverance will have success in sampling some of the other rocks.

"Those surprises and those unexpected events are what drives our curiosity and asking more questions, and learning more about this history of Mars that is written in these rocks," Siebach said. "If the sampling doesn't go as we expect, those surprises are inherent to discovery, and will drive us to learn more."

But the truly exciting science will happen when the samples get back to Earth eventually.

"We will be able to learn so much about Mars from those samples," Siebach said.

Unvaccinated pregnant women face a high risk of severe COVID-19

A new report published earlier this month is shedding new light on the risk of being pregnant and unvaccinated against COVID-19.

The study, published in The Journal of the American Medical Association (JAMA), compared childbirth outcomes between pregnant women with and without COVID-19 between March 1, 2020, and February 28, 2021. What researchers found was that out of 869, 079 women's health retrospectively analyzed, 18 ,715 (2.2%) had contracted COVID-19. Among the infected cohort, preterm births were more common, along with ICU admission rates, intubation and in-hospital mortality rates. In fact, 0.1% of women with COVID-19 died in the hospital, compared to the 0.01% of uninfected women who died.

Notably, women who had COVID-19 in the JAMA study were more likely to be Black or Hispanic compared to women who didn't get infected.

To date, the study is the largest of its kind, yet it is one of a handful showing similar findings. This study also comes at a time when the pregnancy-related mortality rate in the U.S. has been on the rise over the last 10 years, especially among Black mothers.

Doctors across the country like Dr. Arianna Cassidy, a fellow in Maternal Fetal Medicine at the University of California–San Francisco who has been working with pregnant women for six years, described what she's seeing as "unprecedented."

"Every flu season, women who are pregnant who get the common seasonal flu are at higher risk for needing to go to the ICU, needing help breathing and even higher risk for dying. That was particularly stark during the H1N1 outbreak in 2009," Cassidy said. "We know that women pregnant women are at a higher risk for getting sicker from respiratory illnesses, but the degree of illness that we see in pregnancy with COVID — especially for unvaccinated pregnant women, both how sick they get and how many people we are seeing [in the hospital] — is just unprecedented."

Dr. Melissa Simon, an obstetrician gynecologist and professor at Northwestern University's Feinberg School of Medicine, agreed with Cassidy's assessment.

"We are seeing more pregnant individuals coming in with severe COVID-19 disease that is severe enough to require intensive care unit, admission and intubation," Simon said, calling it "concerning, because we're talking about not just the health of the pregnant person themselves but also the fetus." "This is really serious," Simon continued. "The numbers are increasing, and we could prevent that — the vaccinations could prevent that."

And the crisis among pregnant women appears to only be getting worse. Data published by the Centers for Disease Control and Prevention (CDC) shows over the last month and half there has been a rise of pregnant women being diagnosed with COVID-19, with the exception of last week. While updated research like the JAMA study shows the risk of severe COVID-19 outcomes among pregnant women is high, vaccination rates are not. Less than 25 percent of pregnant people have received at least one dose of a vaccine, according to the CDC, as of July 31, 2021.

Experts in women's health say vaccine hesitancy is common among pregnant women because misinformation runs rampant on social media, particularly in anti-vaccination and alt-health wellness groups on Facebook, Instagram or TikTok. Much of the time, myths stem from a misinterpretation of a study.

For example, the false claim that the COVID-19 vaccine can cause miscarriages likely stemmed from reports in the Vaccine Adverse Event Reporting System (VAERS) in the US. (Critically, anyone can report their experience after getting inoculated in this system.) While miscarriages were reported, there is no evidence that the miscarriages were related to vaccination; indeed, a recent study has found that the miscarriage rate among vaccinated people was similar to what's expected among the general population, which is 12.5 percent.

Similarly, there has been another popular myth that is believed to have started with a shared petition started by an ex-Pfizer scientist named Michael Yeadon, who has become popular in anti-vax circles. Yeadon, who has been known to spread COVID-19 misinformation, suggested that the bespoke protein in mRNA vaccines could cause infertility or harm a pregnancy. Since then, researchers have found no connection between the vaccine and infertility. Yet the mere idea that the bespoke protein the mRNA vaccines would cause infertility doesn't check out either, because of how mRNA vaccines work.

"They [the proteins] don't live in our bodies for very long — we receive the vaccine and the vaccine teaches our immune system to make these antibodies against the spike protein of the coronavirus," Cassidy said. "We haven't seen any data at all that vaccines themselves are durable enough to make it to a placenta, like make it all the way through a mom's body and get to the placenta, let alone, cause problems with placentas."

Cassidy pointed to a separate CDC analysis that also found no increased risk of miscarriage due to COVID-19 vaccines.

Both Cassidy and Simon agreed that the lack of information about vaccines, COVID-19 and pregnancy during the beginning of the pandemic created a breeding ground for misinformation. During the COVID-19 vaccine clinical trials, pregnant women were actively excluded.

"It's a structural issue that has been long standing in research in this country for a long time, excluding pregnant and birthing and lactating persons," Simon said. "And that's really unfortunate because when certain groups are left behind from being included in clinical trials, there is relatively less data."

But now the data is here, and doctors and women's health organizations are urging pregnant women to get vaccinated. Especially since the novel coronavirus itself can, in contrast, lead to worse pregnancy outcomes.

Simon emphasized the urgency of "getting the message out consistently and clearly to all pregnant persons."

Simon added: "No one should deny you a chance to get the vaccine if you are pregnant, I think it's really important to get the message out there to people who are pregnant."

Here's what FDA approval really means

On Monday morning, the Food and Drug Administration (FDA) granted full approval to the Pfizer/BioNTech COVID-19 vaccine. Previously, the highly efficacious two-shot mRNA vaccine was being distributed under what is called "emergency use authorization," a regulatory standard that is different from "full" approval. Full approval of the vaccine, which is now officially named Comirnaty (koe-mir'-na-tee), is a huge milestone, as it is the first COVID-19 vaccine to be fully approved by the FDA in the United States.

"While this and other vaccines have met the FDA's rigorous, scientific standards for emergency use authorization, as the first FDA-approved COVID-19 vaccine, the public can be very confident that this vaccine meets the high standards for safety, effectiveness, and manufacturing quality the FDA requires of an approved product," said Acting FDA Commissioner Janet Woodcock, M.D. "While millions of people have already safely received COVID-19 vaccines, we recognize that for some, the FDA approval of a vaccine may now instill additional confidence to get vaccinated."

As Woodcock said, the FDA previously approved the Pfizer vaccine for emergency use authorization (EUA) for people over the age of 12. The first EUA approval happened on Dec. 11, 2020, for individuals 16 years of age and older. Today, Comirnaty is officially FDA-approved for use in the United States for those 16 and over; adolescents between 12 and 16 can still get the vaccine under the EUA approval, though it has not yet been FDA-approved for those under 16.

The approval arrives at a historical moment in which the rate of COVID-19 vaccination has slowed precipitously in the United States, while the highly transmissible delta variant has become a dominant strain. Following the announcement, President Joe Biden said in a speech that he hopes this news will motivate unvaccinated Americans to get inoculated. He also advised corporate, state and local governments to "require your employees to get vaccinated or face strict requirements."

Official "approval" and "emergency use authorization" — what's the difference?

In short, FDA approval means that at least six months of sufficient data has been rigorously examined by the public health agency to determine a vaccine's safety and efficacy. From a bureaucratic standpoint, "full" approval of any vaccine was impossible to meet earlier because of time requirements and available data.

Importantly, that doesn't mean there wasn't a rigor to attaining an emergency use authorization which also requires specific conditions to be considered. Indeed, EAUs are often granted in situations when "there are no adequate, approved, and available alternatives." That was certainly that case with COVID-19. In other situations, the FDA can grant early access to a vaccine through a process known as expanded access.

On a call with reporters on Monday, Dr. Peter Marks, the FDA's top vaccine regulator, explained in depth the process the FDA followed to approve Comirnaty.

"We are highly rigorous in what we do, and we don't just look at what the summaries of data are, we go down to the level of the individual patients," Marks said. "What took time, is that we actually go and we monitor a percentage of the sites where the clinical trials were conducted in order to make sure that the data that was collected with accuracy, and matches what was submitted to the agency."

Marks said that the agency inspected specific facilities that are manufacturing the Pfizer vaccine.

"We went through [thousands] of patients' data to make sure we looked at adverse events, efficacy data, and we did our own analyses, in addition to the company's analyses, and then we also did benefit risk assessments based on our real world data that has emerged since the vaccine has now been used in hundreds of millions of people globally," Marks added.

Pfizer and BioNTech submitted their request for the full approval on May 7, 2021. Marks said FDA personnel worked day and night to sift through the data and grant approval 97 days later.

What did the data show?

When the FDA first issued an emergency use authorization for the Pfizer-BioNTech COVID-19 vaccine, the agency made the decision based on safety and effectiveness data from a randomized, controlled, blinded ongoing clinical trial of 37,586 individuals.

In order to grant full approval, the FDA reviewed updated data from this same clinical trial which included a longer duration of follow-up and more participants. These varying factors determine that the vaccine is actually 91% effective in preventing COVID-19 — a slight decrease from the 95% effectiveness found during the EUA process.

In the updated data used for full approval, half of the participants were followed for safety outcomes and concerns for four months; 12,000 vaccine recipients were followed for six months. According to this data, the most commonly reported side effects were pain, redness and swelling at the injection site, fatigue, headache, muscle or joint pain, chills, and fever. The FDA conducted an additional analysis in data regarding myocarditis and pericarditis following the vaccine. Investigators observed the risk was higher among males under 40 compared to females and older males; it is highest in males 12 through 17 years of age. Most of the participants were able to resolve their symptoms, but some did require intensive care support.

The research teams still highly advocate for COVID-19 vaccines for this population as the health risks from the virus are far greater than those linked to the vaccine.

The FDA and Centers for Disease Control and Prevention (CDC) will continue to monitor any safety concerns.

"These studies will include an evaluation of long-term outcomes among individuals who develop myocarditis following vaccination with Comirnaty," the FDA stated. "In addition, although not FDA requirements, the company has committed to additional post-marketing safety studies, including conducting a pregnancy registry study to evaluate pregnancy and infant outcomes after receipt of Comirnaty during pregnancy."

What changes now that the Pfizer vaccine is FDA approved?

Official FDA approval does grant some changes that the public will notice. First, the name is different. Second, Pfizer and BioNTech can directly market the shot to consumers now — prepare to possibly see some ads and commercials. The full approval could also push individuals, companies and schools to mandate vaccinations.

A Kaiser Family Foundation survey released in July found that 16 percent of adults surveyed who remained unvaccinated said the vaccine was "too unknown." Officials hope FDA approval will sway a number of vaccine hesitant people to get inoculated. A few individuals explicitly said they wanted full FDA approval before getting vaccinated.

What about the delta variant?

Notably, the data collected and examined by the FDA to authorize full approval happened before the delta variant took hold in the United States. On Monday, Marks said there is "real world evidence" that suggests that the vaccine is still effective against the delta variant. However, data coming out of Israel suggests "with time, immunity from the vaccine does tend to wane."

"So that's something we'll be following closely, and obviously we'll be leaning into consideration of the thoughts regarding boosters etcetera as we move into the fall," Marks said.

What about children under 12?

Marks said the FDA is still waiting for Pfzier and BioNTech to submit data from their clinical trials of people under the age of 12.

"Currently there are still trials ongoing here, and so the agency has to wait for the company to submit the data from those trials, so that we have a good safety data set because we certainly want to make sure that we get it right in the children ages five through 11 and then, even in younger children after that," Marks said. "And so we will obviously move swiftly once those data are submitted."

As Salon previously reported, late September is the earliest parents of 5 to 11 year olds could expect their children to be eligible for vaccination.

Can you get 'long COVID' from a breakthrough infection? Here's what we know

Early data from various states shows that COVID-19 breakthrough cases are becoming more common than they were earlier this summer. Whether that's because of the ultra-contagious delta variant or because the populace is socializing more remains unclear.

While that doesn't mean vaccinated people aren't protected from the coronavirus — a large majority of hospitalizations and deaths are still among the unvaccinated — the realization that a vaccinated individual can still get and spread COVID-19 has left many among their ranks recalculating their own personal risks, especially in parts of the country where transmission rate are high.

Public health experts have special guidelines for those who contract a breakthrough COVID-19 case, meaning when a fully vaccinated person catches the coronavirus. According to the Centers for Disease Control and Prevention (CDC), when a vaccinated person tests positive they should self-isolate for 10 days. This means potentially missing work, school and other responsibilities.

In general, breakthrough cases are far less severe than "regular" COVID-19 cases that occur among the unvaccinated. In particular, those with breakthrough cases are far less likely to be hospitalized, although it does happen occasionally. Some counties, such as Douglas County in Oregon, actually track and report the vaccination status among their hospitalized COVID-19 patients; for instance, in their August 18, 2021 report, they noted that of 59 hospitalized COVID-19 patients, 51 were unvaccinated.

Still, the fear of contracting a breakthrough case is acute among many of the vaccinated, in part because of the risks of contracting COVID-19. Up to 10 percent of those who contract COVID-19 have long-term symptoms long after the virus has cleared their body, according to University of Alabama researchers. Patients have coined a term, "long Covid," to describe symptoms from a COVID-19 infection that last for more than one month.

People who experience long Covid sometimes refer to themselves as "long-haulers." Some long-haulers eventually experience full recoveries, while others do not. The long Covid symptoms patients report include (but aren't limited to) fatigue, brain fog, confusion, shortness of breath, headaches and chest pain. Notably, not everyone who became a long-hauler had a severe infection or was hospitalized after their COVID-19 diagnosis.

Doctors' current understanding of long Covid stems from pre-vaccine days. However, experts say it's likely a concern among the vaccinated who fear contracting COVID-19.

"I don't think we know that it does happen yet because we're still so early in the process of understanding what happens when people are infected despite vaccination," said Dr. Dave O'Connor, a professor of virology at the University of Wisconsin-Madison. "But biologically it's hard to think of reasons why it won't happen."

O'Connor said that's because in breakthrough infections — or what some infectious disease experts are now suggesting we call "infection despite vaccination" — high levels of viral genetic material appear in the upper respiratory tract. In fact, according to a study by scientists at the University of Oxford scientists, people who contract the delta variant after being fully vaccinated carry a similar amount of the coronavirus as those who are unvaccinated and get infected. What's a little less clear, O'Connor said, "is what's happening in the lower respiratory tract, or the lungs, and where most of the damage is being done by the virus."

However, O'Connor said if infections despite vaccination follow the same trajectory as unvaccinated infections, it is likely a proportion of these individuals will go on to develop long COVID.

"But we don't know that yet, we simply don't have enough data from people who have had these infections despite vaccination," O'Connor said. "First, it'll probably come in anecdotes of people who were infected despite vaccination and then start reporting those long COVID symptoms — the fatigue, the brain fog, you know all the different constellation of symptoms that people have reported, and then eventually you'd expect this to be substantiated in larger cohort studies where researchers and doctors enroll individuals who self-report they're having these symptoms, and then look for commonalities between them."

Scientists like O'Connor don't have definitive data on long Covid and breakthrough cases because, as O'Connor said, the data is still sparse. One recent study published in the New England Journal of Medicine of Israeli healthcare workers showed the potential risk of long Covid after an infection despite vaccination: 39 percent of 1,497 fully vaccinated healthcare workers got COVID-19. While most of the cases were mild or asymptomatic, seven out of 36 people had persistent symptoms of prolonged loss of smell, persistent cough, fatigue, weakness, muscle pain, or labored breathing.

Notably, the study is a small sample size. However, as O'Connor suspected, similar anecdotal evidence is surfacing in the United States.

Heather Bury is a 43-year-old woman living in the Southwest suburbs of Chicago who received the Johnson & Johnson vaccine on April 4, 2021. Nearly a month later, she struggled with her typical seasonal allergies — but one day, these allergies felt a bit off.

"I started to feel run down, foggy-brained, and there was a cough," Bury said. "Then right before I left work, the chest constriction started; I went to immediate care, where they prescribed an antibiotic, but strongly suggested I get a Covid test."

Bury tested positive for COVID-19 on May 7, 2021; afterward, her symptoms worsened. Bury told Salon she felt like an "elephant" was sitting on her chest. On May 10, she was admitted to the emergency room, where she was told she had COVID-19 pneumonia in both lungs. Bury was discharged a week later, but still has "so many crazy lingering conditions" nearly three months later. Brain fog, exhaustion, concentration issues, having trouble finding words, migraines — "the list really seems endless," Bury said.

Bury said her doctors have been extremely helpful during her recovery. But since she had a rare breakthrough case, she is "a trial and error patient," as she described herself.

"They had never dealt with somebody who has had the vaccine," Bury said. "They're trying to help you, but they don't know how to help you yet."

According to the CDC, 8,054 people have had a severe COVID-19 breakthrough case that led to hospitalization, out of the more than 166 million people who have been vaccinated. Notably, 25% of those hospitalizations were reported asymptomatic or not related to COVID-19.

As we know from COVID-19 cases in unvaccinated people though, it's not just those who have severe cases who experience long Covid. When asked what Dr. O'connor would tell people who are scared about the potential long-term effect of having long Covid after a breakthrough infection, O'Connor said, "I'm right there with them."

"I'm vaccinated, and I most certainly do not want to get a breakthrough infection," O'Connor said. "My concern isn't so much that I'm going to be hospitalized — it's that I'm worried that I would be in that sizable fraction of people who have long COVID symptoms."

O'Connor added that vaccinated people won't be living in uncertainty for too much longer.

"The truth is we just don't have enough data right now to have clarity on how often long Covid will occur, and whether it's going to be different in people who are previously vaccinated, compared to people who have not yet been vaccinated," O'Connor said. "I expect that we'll be getting more clarity on this over the next couple of months."

How a right-wing obsession with a veterinary drug emerged as a tactic to undermine COVID-19 vaccines

In November 2020, a pre-print study touting the safety and efficacy of an anti-parasitic drug called Ivermectin was published on the Research Square website, a platform where scientific studies are submitted before they are peer-reviewed and accepted by a journal. The study, led by Dr. Ahmed Elgazzar of Egypt's Benha University, claimed that in a randomized control trial of nearly 600 people, hospitalized COVID-19 patients who "received ivermectin early reported substantial recovery."

In the search for a COVID-19 wonder drug, the preprint study seemed promising. But then, in July 2021, the paper was pulled "due to ethical concerns." Those concerns included alleged plagiarism and calculation of data points that were "mathematically impossible," according to The Guardian.

Despite the retraction, the anti-parasite drug is allegedly flying off shelves of local farmer supply stores, according to various local news reports who say some feed stores are struggling to keep it in stock.. That's because the drug has become a political flashpoint, enveloped by the culture wars just like nearly everything else related to the pandemic.

Indeed, Republicans politicians like Sen. Ron Johnson (R-Wis.) have promoted Ivermectin as a COVID treatment. Robert Malone, a doctor who has spread COVID-19 vaccine misinformation on platforms like "Tucker Carlson Tonight," alleged to have personally used the drug to treat COVID-19, further popularizing it among followers of Carlson's show. The response to Malone's latest Ivermectin-related tweet reveals how many of his followers are using the so-called treatment to undermine the available COVID-19 vaccines. "You don't need a #vaccine, people," one commented. "Ivermectin works," another one chimed in.

Without a prescription, the only way for a layperson to obtain Ivermectin would be at a feed store or farm supply store, which sell the drug as a horse de-wormer. Some such stores report having to put up signage reminding their customers that the drug is approved for horse consumption, not human consumption.

Salon reached out to Tractor Supply Company, whose spokesperson would not share sales numbers, but did note that the retail chain has put up "signs to remind our guests that these products are for animal use only."

"The product sold in our stores is only suitable for animals and is clearly labeled as such," the spokesperson said via email. "The anti-parasite drug Ivermectin has not been approved by the Food and Drug Administration (FDA) for use in treating or preventing COVID-19 in humans; if customers have questions about COVID-19, we suggest consulting a licensed physician and finding more information at FDA website."

Meanwhile, right-leaning politicians abroad have been promoting the drug. The presidential administration of Jair Bolsonaro in Brazil has spent "millions" to promote un proven drugs like Ivermectin as COVID-19 treatments, according to an NPR report. In India and elsewhere in Latin America, Ivermectin has gained momentum. Craig Kelly, an Australian member of Parliament, has repeatedly promoted Ivermectin.

The obsession over Ivermectin, and its politicization, is curious from an economic standpoint. Unlike climate change denialism or other anti-science culture wars, there is no lobby group profiting off of Ivermectin sales to the extent that they might pull politicians' strings. So why have so many on the right seized on an unproven drug as a COVID-19 treatment?

According to Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center, the right-wing obsession with Ivermectin may be important to that demographic merely because it sows distrust in science in general while stirring up vaccine skepticism.

"Politics got injected into it, and then Ivermectin became a crusade for certain individuals, as a way to kind of deflect the importance of the vaccine," Adalja told Salon. "It's the same kind of story of the politics of this pandemic that's driven a lot of the interest in Ivermectin — and when I do interviews on ivermectin I get a slew of hate mail."

Yet such promotion of unproven drugs can be dangerous. According to the United States Food and Drug Administration (FDA), there have been "multiple reports of patients who have required medical support and been hospitalized after self-medicating with ivermectin intended for horses."

Ivermectin, as previously mentioned, is often used to treat or prevent parasites in animals. Reminiscent of how anti-malaria drug hydroxychloroquine was touted by former President Donald Trump as a treatment for COVID-19 despite there being little sound scientific evidence to support such a claim, Ivermectin has become weaponized in a way to distract efforts from getting the unvaccinated vaccinated. This kind of misinformation costs lives — not only because humans should not be taking Ivermectin that is meant for animals, but also because there is no scientific evidence to suggest that it treats COVID-19.

"There's no evidence that Ivermectin has a beneficial effect in treating COVID-19," Adalja said. "Studies that are there are of poor quality, none of which really has an unequivocally positive result. One of the studies which was touted to provide the most evidence has been shown to be invalid study."

Adalja was referring to Elgazzar's study. Salon reached out to Elgazzar twice and did not receive a comment prior to publication.

Imran Ahmed, CEO of Center for Countering Digital Hate, said that promoting the idea that treatments like Ivermectin or hydroxychloroquine can treat COVID-19 fall into one of three categories of misinformation promoted by anti-vaccine influencers. The three misinformation categories, Ahmed said, include "COVID isn't dangerous," "vaccines are dangerous," and the idea that you "can't trust doctors."

"This is all part of the spreading of the idea that vaccines might not be the safest way of dealing with this," Ahmed said.[It's part of] 'the government's trying to kill you with a vaccine,' and blah, blah. It's an extremist narrative."

Meanwhile, the World Health Organization (WHO) has issued a warning against its use with the exception of clinical trials.

"The current evidence on the use of Ivermectin to treat COVID-19 patients is inconclusive," WHO stated in March 2021. "Until more data is available, WHO recommends that the drug only be used within clinical trials."

As Nature has reported, there are risks to people taking the unchecked drug to treat COVID-19. Not only has it been linked to convulsions, lethargy and disorientation; it can impede researchers' ability to conduct clinical trials.

Alejandro Krolewiecki, an infectious-disease physician at the National University of Salta in Orán, Argentina, told Nature that the more people take it, especially in Latin America countries, "the more difficult it will be to collect the evidence that regulatory agencies need, that we would like to have, and that will get us closer to identifying the real role of this drug."

It's not a fluke: Allergy season is out of control this year

If you've felt like your seasonal allergies are worse this year, you're not alone. Higher temperatures are linked with longer tree and grass pollen seasons.

According to a recent study published in the journal Scientific Reports, temperature increases in northern California are worsening pollen-related allergies, while precipitation changes are associated with more mold spores in the air.

"Climate change is really a problem for health, and we are living and breathing the effects of climate change now," said the study's senior author, Kari Nadeau, professor of medicine and of pediatrics at Stanford School of Medicine.

Nadeau, according to a news release, became interested in the subject because she noticed that patients said their seasonal allergies were getting worse.

"As an allergist, it is my duty to follow the pollen counts, and I was noticing that the start date of the tree pollen season was earlier every year," Nadeau said. "My patients were complaining, and I would say, 'This is such a tough year,' but then I thought, wait, I'm saying that every year."

In the study, researchers collected data at a National Allergy Bureau–certified pollen counting station in Los Altos Hills, California. They indexed tree, grass, weed pollens and mold spores in the air weekly throughout an 18-year-period, from 2002 through 2019. In their analysis, the researchers found that the pollen season in northern California now starts earlier and ends later. Specifically, local tree pollen and mold spores grew by 0.47 and 0.51 weeks per year, each year of the study. The researchers also found links between allergen levels and environmental changes.

While the study is local to northern California, the trend tracks across the United States.

Beyond environmental changes, higher atmospheric carbon dioxide levels are believed to be connected to higher levels of pollen, too. A separate study published in 2000 found that ragweed plants , a culprit of seasonal hay fever, grew in size when they were exposed to more carbon dioxide. According to the Union of Concerned Scientists, carbon dioxide increases plant growth rate. That's a particularly frightening prospect in the case of weeds like ragweed.

"In the fall, ragweed is a major culprit in allergies because when it's warmer it grows longer," Kenneth Mendez, the president and CEO of the Asthma and Allergy Foundation of America, previously told Salon. "Frost is the first thing that kills ragweed, the first frost, so the later and later you have a longer growing season the worse the allergies will be."

In 2018, a study published in the journal PLOS ONE by researchers at the University of Washington and the University of Massachusetts at Amherst found that ragweed will expand its reach as temperatures rise. Using machine learning, researchers calculated that in roughly 35 years its ecological range will move northward, bringing hay fever to regions it has never been before. Seasonal allergies can be a trigger for asthma.

Last year, masks coincidentally provided some relief for allergy sufferers. Pollen grains range in size from 200 microns to 10 microns, and masks were able to block some of them out when people stepped outside.

As vaccination rates rise, Americans are collectively looking forward to spending this summer outside and unmasked, in contrast to last year's dismal pandemic summer that many spent cooped up inside. Yet for more and more allergy-sufferers, seasonal allergies are putting a damper on the joy we associate with summer weather.

Could a human actually be engulfed by a whale? A marine biologist weighs in

Last week, headlines about a humpback whale briefly "swallowing" a lobster diver in Cape Cod splashed across news outlets. "Diver describes being nearly swallowed by a humpback whale," CNN reported of the modern-day Jonah. "MA lobster diver survives being swallowed by whale," The Daily Beast stated.

For the record, the diver wasn't swallowed; indeed, it is inaccurate to say that because he was allegedly engulfed in the humpback whale's mouth, and did not go down the whale's esophagus. According to the Cape Cod Times, Michael Packard was on his second dive of the day just before 8 AM, about 10 feet above the sandy ocean floor, when he was engulfed by a humpback whale.

"All of a sudden, I felt this huge shove and the next thing I knew it was completely black," Packard said. "I could sense I was moving, and I could feel the whale squeezing with the muscles in his mouth."

At first, he thought he was getting attacked by a great white shark, but said he quickly realized it was a whale because he couldn't feel any teeth and hadn't suffered from any immediate injuries. On the Jimmy Kimmel Show, Packard said he was "struggling and banging and kicking," as he thought he was going to die. He estimated in a Reddit thread that he was in the whale's mouth for 30 to 40 seconds, and that he was released when the whale surfaced.

Since the story has been published, many skeptics have voiced their opinions on whether or not the account is true. According to The New York Post, the lack of barotrauma from ascending from 45 to 35 feet deep to the surface in such a short amount of time would likely cause more serious injuries. Yet, as a lobster diver, Packard is presumably an experienced diver, and perhaps knew how to adjust his body to avoid compression or decompression injuries.

Regardless, this latest tale of a man getting caught in a whale's mouth touches on an ongoing narrative in human history that intersects with the mysteriousness of whales, and perhaps our subconscious fear of their size. Humpback whales usually range from 39 to 52 feet in length and weigh around 36 metric tons — which equates to around 79,000 pounds. That's about the same weight as a fully loaded big rig semi truck. And while Packard's situation is very rare, it is not the first time there has been a report of such an incident.

In the late nineteenth century a man reported being trapped in a whale's mouth, although the accuracy of his story has been debated as well. Most famously, there's the biblical story of Jonah and the whale, in which the prophet Jonah allegedly spent three days and three nights in a whale's stomach. More recently, in California in November 2020, kayakers got in the way of a whale feeding by the surface — an incident that was documented on video.

But clearly, the most important question is one of plausibility. Does Packard's story add up? And if Packard, as he claims, did get engulfed in a whale's mouth, what would that be like?

To help answer these questions, I interviewed comparative anatomist Joy Reidenberg, Ph.D., who is a professor at the Icahn School of Medicine at Mount Sinai; her research focuses on whales. As always, this interview has been condensed and edited for clarity.

So, what would it be like inside a humpback whale's mouth? Especially 45 feet below the surface?

It's about the size of a small Volkswagen Bug. Think about the size of a Beetle car, in terms of the volume — and that's when it's fully expanded. Getting into a whale's mouth is kind of like getting into a small car. It's got about that much room, but you take out all the chairs in the car, the wall and, of course, the walls are going to be very different depending which part you reach out and touch.

Once you're inside a space like that, the throat and tongue area is extremely stretchy. So I would imagine it's a lot like jumping on a bouncy castle, one of those air castles, that kids play on. The sides will be very hard because there's the jaw itself which will have closed around you at that point. So that's bone, that will be hard, and the upper jaw is also made of bone, and it has the baleen plates hanging down from it on either side.

So, imagine a Polynesian hut with the statue roof that has the palm fronds on it. It's kind of like having that kind of material all around you on either side. It's very hairy, very brushy, a bit pointy — maybe a little bit more like hairs than like palm fronds — but just imagine that there's there's a lot of this hairy stuff hanging down on either this side, but very stiff bristles of hair are baleen plates which are used for filter feeding. So they have a brushy surface on the inside, but the plates themselves look like giant fingernails, and they're made of the same kind of material as your own fingernails. So while they're hairy on the tongue side, on the outside, they are very stiff almost like the edges of your fingernails are.

What is it like to touch the baleen plates?

If you push against them, they might feel like wire mesh, but it has a little bit of give to it. You couldn't swim between the plates because you could barely get your pinky finger in between each plate — that's how close together they are, and that particular pattern allows for water to be pushed out between the plates. The hairs trap the food that they're eating, like a sieve. You wouldn't be able to swim out through those planes, you'd have to wait for the whale to open its mouth to get back out again.

And I imagine it's pretty dark in there too?

Absolutely. Well, you know, it's pretty dark anyway if you're diving near the bottom of the sea floor which is where this guy was — I'm not sure how deep he was. But when you're inside the whale's mouth it would just be dark because there's no light in there. And so that's why I've only described that you'd feel as opposed to what you would see. You might not even see this whale coming. I'm sure trying to eat him wasn't intentional — which is why he was released — but if you are a fish, the camouflage of the whale's mouth is perfectly adapted for the way that it feeds. The inside throat area is actually black where the tongue is. So it's just like darkness coming toward you.

It doesn't really look like anything that you would recognize. Looking down from the surface of the ocean it's pretty dark. And if you look up, it's pretty light. So the baleen plates are lighter colored, they look a little bit more like sky, whereas the tongue looks more like the darkness you'd see if you look down in the water.

So what would it be like in a whale's mouth for 30 to 40 seconds?

Well, it's a long time if you think about it. Most people can't even hold their breath for that long. The problem is twofold: one is that you become very disoriented right away because you're now being swept up inside this animal's mouth. If you're trying to force your way out, you don't even know which way is out because everything's dark. But at least you know you won't be swallowed.

Right... because that's impossible?

Yes, it is impossible for a whale to actually swallow him. I want to draw that distinction. I know people are thinking of [Packard] as some modern day Jonah, but if you believe the story of Jonah, literally, Jonah was swallowed by technically a big fish. In those days, they didn't have the taxonomy we have today.

So whales were considered fish, but we don't know if they really meant giant fish or meant a giant whale.

Anyway, a whale's throat is actually pretty small. I've dissected a lot of whales, and I've tried to put my arm down the throat of a dead whale, and I can barely get my arm down that throat. So it'd be really hard for my whole body to go down that throat. It's too small of an opening, and that's because these animals are not swallowing large prey — they're swallowing lots of little tiny things. Feeding is kind of like drinking a thick milkshake for them. They squeeze out the water and then they have this flurry of little tiny fish or tiny shrimp-like animals that they swallow, and that flurry can go down to very small things. They don't want to drink the seawater — the kidneys have to work extra hard to get rid of all that extra salt. So they exclude the water by pushing it out through the baleen plates, and essentially licking off the baleen plates to get the snack that they want to eat, and just swallow the flurry of little tiny fish.

So if a whale has got a diver in their mouth, it would be like if you eat cherries and there's a pit — you feel it with your tongue you know it's there, you're like — I have to spit that out.

Do you know if the whale could have tasted the diver?

That's a really good question and nobody knows for sure because no one can really ask a whale: "Does it taste good?" But I will say anatomically there are taste buds in whales. It's been studied more in those small-toothed whales like dolphins. It's not really clear on the big whales. But there are anatomical structures that are taste buds, but they're just not as prevalent as the ones we have and it's not clear what they sense they work. Whales could be sensing salinity, or the mucus that sits on the outside of a fish's body, to know that it's fish and not a rock or whatever they might be scooping up, especially for feeding at the bottom, which is what this whale was doing.

So what would the journey to the surface be like?

Well, the whale would probably be trying to squeeze out the water at that point so they could then swallow its prey. At that point it would realize, "hey, there's nothing in here, and there's a thing that's way too large to just be prey because it's not compressing when I squeeze these muscles." So I imagine it would get tighter around the person as the muscles contract that throat area; your Volkswagen is starting to collapse.

To me, the biggest danger is actually the fact that the whale is moving to the surface. When you change pressures, which you would be doing if you are heading to the surface, the air in your body starts to expand. And as a diver, if you get panicked you could really injure yourself by not releasing the extra air, because you might get scared and hold your breath, which is you know a lot of us, We're scared, we freeze, and we hold our breath. That's the worst thing for a diver to do if they're being pulled up towards the surface. As an experienced diver, he probably knew to continue to breathe out when he felt the weight if he realized he was in a whale, which I assumed he did pretty soon afterwards. When you realize the whale was taking him upwards, he probably was breathing out, which is a good thing to do because then the air in his lungs would not tear the lung tissue as it expands.

And then what about when he reached the surface, how much force does the whale use to spit something out?

I'm sure it's hardly any pressure at all. It's just a little push to push him out.

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