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Elon Musk Defies Management Mantras With His Rapid Overhaul at Twitter

In

Elon Musk’s

first week at Twitter Inc., he flouted much of the advice management gurus have dished out for decades.  

The billionaire’s swift actions stand in contrast to those of many new leaders, who often use the first 90 days to meet with employees, listen to concerns and assess how to improve a company’s products before embarking on strategy shifts, executives and corporate advisers say.  

“At a minimum, this is an untraditional approach,” said

Joel Peterson,

the former chairman of

JetBlue Airways Corp.

, who has served on dozens of corporate boards and advised chief executives across industries. “It’s iconoclastic, it’s unusual, it’s not what everybody would do—but I don’t really fault him for it.” 

Sweeping layoffs at Twitter have eliminated roughly half of the company’s workforce.



Photo:

Leonardo Munoz/VIEWPress/Getty Images

Mr. Musk—who once described himself to The Wall Street Journal as a “nano manager” steeped in the smallest details—appears to be employing many of the management tactics he deployed in building his other companies,

Tesla Inc.

and Space Exploration Technologies Corp., executives and advisers say. Those include a hands-on obsession over product decisions, a distaste for corporate structures and a focus on speed. Tesla is now the world’s most-valuable car company, and SpaceX is the world’s busiest rocket-launch operation.

Management specialists have long said that the first few months of an executive’s tenure are critical, a time when corporate chiefs can plot their agenda and begin to reset a corporate culture. Well-known books on the subject, such as “You’re in Charge—Now What?” say that new leaders should strike a balance, setting expectations internally and shaping their management team, while learning about the organization, too. 

Peter Crist,

chairman of Crist Kolder Associates, an executive-search firm, said new leaders typically spend the initial months looking to understand the talent within a company, learning employees’ strengths and weaknesses before making changes to staffing.

“Normally, a CEO from the outside coming in isn’t going to wipe the slate clean on the first day,” Mr. Crist said, adding that swift personnel changes can create uncertainty for the workers that remain. “There has to be both a stabilization of the enterprise model and importantly a stabilization of the talent, and it’s got to get done relatively soon,” he said.

Mr. Musk is hardly the first corporate iconoclast. He is also more than familiar with Twitter, having more than 100 million followers. 

Twitter Purchased by Elon Musk: A Timeline of How It Happened

On top of that, he is acquiring a company that for years lagged behind its rivals in attracting users and generating revenue, and the industry broadly is facing a slowdown in growth and other challenges that have slashed the valuations of companies such as

Facebook

owner Meta Platforms Inc. 

Some of Mr. Musk’s early actions struck corporate veterans as routine. He spent part of his week meeting with advertisers on video calls and in other settings, aiming to reassure customers that the platform remained a safe place for brands, the Journal reported. Several large advertisers, including

General Mills Inc.

and

Pfizer Inc.,

temporarily paused their advertising. Mr. Musk tweeted on Friday that Twitter had experienced a massive drop in revenue, which he said was due to “activist groups pressuring advertisers.”

Hubert Joly,

former CEO of retailer

Best Buy Co.

, said listening tours with customers and employees can be helpful in the initial period of engineering a turnaround. When Mr. Joly took the reins of Best Buy in 2012, he spent days in retail stores observing customer behavior and holding pizza meetings with staffers. In those gatherings, he asked three questions to employees: “‘What’s working? What’s not working? What do you need?’” Mr. Joly said.

Elon Musk has purchased Twitter, ending a monthslong saga over whether or not he would go through with his offer to acquire the social media platform. WSJ takes an inside look at the tweets, texts and filings to see exactly how the battle played out. Illustration: Jordan Kranse

Mr. Joly said that while he wanted to act fast, he resisted the temptation to quickly close stores or cut head count, as some proposed, or to immediately impose his ideas on the organization without understanding the existing dynamics. “My job was easy: Show up, ask these questions, listen carefully, take notes, and do what I was told because they had all of the answers,” he said of employees.

Mr. Musk has solicited feedback from some Twitter users, including prominent ones. He asked the author Stephen King whether he would consider paying a price of $8 a month to have his account verified. Members of Mr. Musk’s team also polled Twitter users about a subscription feature. 

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What do you think of Musk’s management style? Join the conversation below.

Twitter on Saturday said it has begun rolling out software updates to charge users $7.99 a month for its Twitter Blue subscription service, up from $4.99 currently. Subscribers get their accounts verified, a service that has been free and offers a blue check mark to notable accounts.

Mr. Musk has said in the past that he believes CEOs err when they allocate too much of their schedule to meetings, rather than focusing on refining a product. “Spend less time on finance, spend less time in conference rooms, less time on PowerPoint and more time just trying to make your product as amazing as possible,” he said in a Journal interview in 2020. 

During an executive’s first few days at a company, though, leaders can become overwhelmed, advisers say. Some say it is important to focus on key strategic decisions, assemble a team and then delegate. 

At an investment forum in New York on Friday, Mr. Musk said that after buying Twitter, he is now working 120 hours a week instead of his typical 70 or 80 hours. Still, he expected that to eventually change. “Once Twitter’s set on the right path, it’ll be much easier to manage than SpaceX or Tesla,” Mr. Musk said.

Write to Chip Cutter at chip.cutter@wsj.com

Copyright ©2022 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8



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Inside a Chinese iPhone Plant, Foxconn Grapples With Covid Chaos

HONG KONG—

Foxconn Technology

2354 -0.76%

Group is scrambling to contain a weekslong Covid-19 outbreak at an iPhone factory in central China, trying to appease frightened and frustrated workers during a crucial period for smartphone orders.

In Foxconn’s main Zhengzhou facility, the world’s biggest assembly site for

Apple Inc.’s

AAPL 7.56%

iPhones, hundreds of thousands of workers have been placed under a closed-loop system for almost two weeks. They are largely shut off from the outside world, allowed only to move between their dorms or homes and the production lines.

Many said they have been confined to their quarters for days and that distribution of food and other essentials has been chaotic. Many others say they are too scared to carry on working because of the risk of getting infected.

Foxconn on Wednesday denied what it said were online rumors that 20,000 cases had been detected at the site and said that for “the small number of employees affected by the pandemic,” it is providing necessary supplies.

“A sudden outbreak disrupted our normal life,” Foxconn said Friday in a post to its workers on

WeChat,

a social-media platform. “An orderly progress in both pandemic prevention and output depends on the efforts of all staff,” it said. It outlined plans to ensure proper food supplies and mental well-being support and pledged to respond to workers’ concerns.

Asked about the workers’ details of the situation at the site, Foxconn didn’t respond. Earlier when asked about the situation, the company referred to its Wednesday statement as well as to its Friday post on WeChat.

Covid-19 lockdowns, corruption crackdowns and more have put China’s economy on a potential crash course. WSJ’s Dion Rabouin explains how China’s economic downturn could harm the U.S. and the rest of the world. Illustration: David Fang

“It’s too dangerous to go to work,” a 21-year-old worker who has been confined to his dorm told The Wall Street Journal, saying that he was skeptical about the company’s claim that there was a low level of infections at the plant.

The disruption at Foxconn is the latest example of the economic and societal toll from China’s rigid pandemic control policies—which include swift and sweeping lockdowns, mass testing and compulsory quarantines to crush the virus whenever it appears. While Beijing says the virus is too potent to allow any easing of its zero-Covid policy, businesses must convince their employees that there is little risk coming to work when there are signs of an outbreak.

Zhengzhou’s flare-up—95 cases recorded in the city the past four days—began in early October, after people returned from other parts of the country from a one-week national holiday. At the first signs of Covid in the city, officials locked down some districts and began rounds of mass testing to stamp out the virus before it gained a foothold among Zhengzhou’s 12.7 million residents. As a major employer, Foxconn joined the campaign.

When more infections emerged at Foxconn midmonth, the company sought to maintain output by creating a “bubble” around its operations to lower the risk of exposure, a practice now common among major manufacturers in China to continue their business during a local outbreak.

Foxconn says it employs as many as 300,000 workers in Zhengzhou. Analysts estimate that the company produces half or more of Apple’s smartphones in the city, making it vital for delivering iPhones to consumers, including for the coming winter holiday season when demand for the handsets typically spikes.

Foxconn, in its statement on Wednesday, said that production at the site is “relatively stable” and that it is sticking to its operating outlook for the current quarter as the impact from the outbreak is controllable. It is set to report quarterly results Nov. 10.

Apple, in its quarterly earnings release Thursday, didn’t mention Foxconn’s Zhengzhou plant. Its chief financial officer said that supply is constrained for the new iPhone 14 Pro models due to strong demand.

Apple didn’t respond to requests for comment about conditions at the Foxconn plant.

Some workers interviewed by the Journal said many colleagues had refused to go back to the production lines. Others had simply left, they said, sometimes abandoning their belongings.

On Sunday, a state-run newspaper in Henan published official notices from various parts of the province welcoming their people to return, with quarantine protocols laid out.

Over the weekend, videos geotagged near the Foxconn site went viral on China’s social-media platforms, recording groups of people walking on highways or through farm fields carrying suitcases and backpacks. Other footage showed makeshift stations set up by local residents offering bottles of water in front of handwritten signs to support migrant Foxconn workers leaving for home.

Foxconn said in a statement Sunday that the situation is coming under control with help from authorities. The company said it is organizing transportation for workers who wish to return home and is coordinating production capacity with its plants elsewhere to minimize disruption. There is no shortage of medical supplies or daily necessities at the facility, it said.

Earlier on Friday, the company had posted a video on WeChat urging people to return to work. “The company needs people,” said a woman’s voice over footage of workers stepping off a bus. “If nobody comes to work, how can the company run?”

Another Foxconn employee said most of his dozen-strong team of night-shift workers had either been taken to a quarantine facility or had refused to return to work. Every night, he said, he saw workers covered in protective gear waiting to be taken away by bus.

“I don’t know who around me is a positive case,” said the worker, who has been confined to his dorm for a few days. “I’d be better off staying in the dorm.”

With so many stuck inside their quarters, sent to quarantine centers or simply absent from work, the pace of production at some assembly lines has slowed, two of the workers said.

Foxconn has created incentives to maintain production, according to Friday’s company notice.

Anyone turning up for work will get free meals and a daily bonus, it said. Those turning up every working day from Oct. 26 to Nov. 11 will get an award of 1,500 yuan, or about $200.

The 21-year-old employee who spoke to the Journal and who worked on an assembly line making an older iPhone version, said he had been confined to his quarters since Oct. 17, along with thousands of others.

Over the following days, meal deliveries were delayed and garbage was left unattended in the hallways, piling up on the ground floor as more dorms were locked down, he said.

A daughter of one worker said her mother was placed in the same dorm as some who tested positive. Some other workers made similar complaints.

Around 10 days ago, almost 300 employees from Foxconn suppliers were asked to move out of their dormitories and sleep in the factory, one of them said.

In photos he shared with the Journal, people slept on bedding and pillows placed on metal bed frames, under white fluorescent lights suspended from the hangar-like roof. Hygiene has become a problem, he said. Still, he said he isn’t supposed to leave the plant—and has nowhere to go if he did.

“Where can I go? Barriers are everywhere,” he said. “There are people manning every checkpoint.”

Business and the Pandemic

Write to Wenxin Fan at Wenxin.Fan@wsj.com and Selina Cheng at selina.cheng@wsj.com

Copyright ©2022 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

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Elon Musk Buys Twitter, Immediately Fires CEO and CFO

Elon Musk

fired several Twitter Inc. executives after completing his takeover of the company, according to people familiar with the matter, capping an unusual corporate battle and setting up one of the world’s most influential social-media platforms for potentially broad change.

Mr. Musk fired Chief Executive Parag Agrawal and Chief Financial Officer Ned Segal after the deal closed, the people said. Mr. Musk also fired Vijaya Gadde, Twitter’s top legal and policy executive, and Sean Edgett, general counsel. Spokespeople for Twitter didn’t comment.

Ask WSJ

The Musk-Twitter Deal

WSJ Financial Editor Charles Forelle sits down with Alexa Corse, WSJ reporter covering Twitter, at 1 p.m. ET Oct. 28 to discuss Elon Musk’s takeover of Twitter. What does the future hold for the platform? And what does this deal mean for Mr. Musk’s business empire?

Hours after those actions, Mr. Musk tweeted: “the bird is freed” in a seeming reference to Twitter, which has a blue bird as its logo.

Mr. Musk first agreed to buy Twitter in April for $44 billion, then threatened to walk away from the deal, before reversing course this month and committing to see through the acquisition. He previously indicated unhappiness with some of the top ranks at Twitter, at one point responding to a tweet from Mr. Agrawal with a poop emoji. He also used the site to mock Ms. Gadde, the top legal boss, tweeting an image overlaid with text that repeated allegations Twitter had a left-wing political bias.

It wasn’t immediately clear who would step into the top positions left vacant by Thursday’s exits. CNBC earlier reported the departures of Mr. Agrawal and Mr. Segal.

The deal, in which Twitter will again become a private company, adds to Mr. Musk’s expansive business reach, which includes running

Tesla Inc.,

the world’s most-valuable car company, and rocket company Space Exploration Technologies Corp., or SpaceX, among other endeavors. Mr. Musk, who had become Twitter’s largest individual shareholder, previously said he would pay for the acquisition mostly with cash, some contributed by co-investors, and $13 billion in debt.

There were signs this week indicating that Mr. Musk was moving closer to acquiring the social-media platform by Friday’s 5 p.m. deadline. Banks started sending money backing the deal, The Wall Street Journal reported. Mr. Musk also has changed his Twitter bio to “Chief Twit,” showed himself walking into the San Francisco headquarters of the social-media platform, and issued a statement on Twitter explaining his vision for the site to advertisers.

Closing the deal ends a monthslong saga of whether Mr. Musk would or wouldn’t purchase the company. The acquisition also puts one of the world’s most prominent social-media platforms under the control of the world’s richest person, with implications for the future of online discourse.

A self-described free-speech absolutist, Mr. Musk has pledged to limit content moderation in favor of emphasizing free speech. However, that approach risks causing conflicts with some advertisers, politicians and users who would prefer a more-moderated platform.

Elon Musk completed the deal for Twitter a day before a court-imposed deadline.



Photo:

Carina Johansen/NTB/Agence France-Presse/Getty Images

In a message to advertisers on Twitter on Thursday, Mr. Musk said he was buying the company to “have a common digital town square, where a wide range of beliefs can be debated in a healthy manner.” He said Twitter “cannot become a free-for-all hellscape, where anything can be said with no consequences!”

Mr. Musk said the platform must be “warm and welcoming to all” and suggested Twitter could let people “choose your desired experience according to your preferences, just as you can choose, for example, to see movies or play videogames ranging from all ages to mature.”

Mr. Musk’s decision to go through with the Twitter takeover came two weeks before a trial in Delaware was set to begin over the stalled deal. The judge presiding over the legal clash agreed to pause the litigation, granting a request by Mr. Musk for more time to complete the takeover. The judge gave Mr. Musk until Oct. 28 to follow through with his offer, or said she would schedule a November trial.

Mr. Musk offered in April to buy Twitter for $54.20 a share—higher than the company was valued at the time. In the months since the deal was struck, Twitter has faced efforts by Mr. Musk to abandon the deal, a whistleblower complaint in which Twitter’s former head of security accused the company of security and privacy problems, and unsuccessful talks to negotiate a lower price with Mr. Musk.

The New York Stock Exchange has suspended Twitter shares from trading, starting Friday. The stock closed Thursday at $53.70.

Mr. Musk’s takeover leaves big questions over the future of the platform, including how he might revamp its business model and how he might implement changes he has proposed for the way it polices content.

Like other social-media companies, Twitter heavily relies on digital advertising and has faced headwinds in recent months due to broad economic uncertainty. It will also be saddled with billions in debt as a result of the deal, and payments on those loans will add costs for a company that has posted a loss in eight of its past 10 fiscal years.

Twitter will be saddled with billions of dollars in debt as a result of the deal.



Photo:

Godofredo A. Vásquez/Associated Press

The deal turned into a wild business drama with little precedent. Mr. Musk moved to buy Twitter in April. After signing a merger agreement, however, he accused the company of misrepresenting the prevalence of fake and spam accounts on its platform, which Twitter denied.

He formally tried to abandon the deal in July, prompting Twitter to sue him to enforce the original merger agreement. Mr. Musk countersued.

In early October, Mr. Musk suddenly abandoned his legal battle with Twitter, with little public explanation. After his reversal, he tweeted that “Buying Twitter is an accelerant to creating X, the everything app.” He previously suggested he could create a social-media platform named X.com if he didn’t buy Twitter.

Eric Talley, a law professor at Columbia University, said after the most recent about-face that several factors were piling up against Mr. Musk, including rulings from the court denying some of Mr. Musk’s discovery requests. Chancellor Kathaleen McCormick, who was overseeing the case in Delaware, had called some of his data requests “absurdly broad.”

“He has spent months with various attempts to figure out ways out of this deal,” Mr. Talley said. “All those windows had started to close and some of them closed completely.”

Vijaya Gadde, Twitter’s top legal executive, whom Elon Musk mocked on the site, is among the ousted executives.



Photo:

Martina Albertazzi/Bloomberg News

Mr. Musk’s specific plans for the company remain unclear. He could return Twitter to public ownership after just a few years, the Journal previously reported.

By taking Twitter private, the billionaire entrepreneur likely can take more risks to jump-start the company’s business. “It’s going to be bumpy,” said Youssef Squali, lead internet analyst at Truist Securities. “He can take it away for a couple of years, really kind of re-engineer the whole thing,” Mr. Squali said.

Mr. Musk has suggested he wants to shift Twitter away from its advertising-heavy business model to other forms of revenue, including a greater emphasis on subscriptions. Advertising accounted for more than 90% of Twitter’s revenue in the second quarter of this year.

He said he would allow former President Donald Trump back on the platform, though Mr. Trump has said he doesn’t intend to return to it. Twitter banned Mr. Trump in the wake of the Jan. 6, 2021, attack on the U.S. Capitol, citing what the company called the risk of further incitement of violence.

“Twitter is obviously not going to be turned into some right wing nuthouse. Aiming to be as broadly inclusive as possible,” Mr. Musk said in a message that was among a trove released as part of the legal battle.

The prospect of Mr. Musk taking over Twitter, as well as the subsequent uncertainty over the deal, roiled many Twitter employees. Twitter has told employees that they will hear from Mr. Musk on Friday, according to an internal note reviewed by the Journal.

Write to Alexa Corse at alexa.corse@wsj.com

Copyright ©2022 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8



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RSV, other viruses push several children’s hospitals to capacity

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Children’s hospitals are under strain in the United States as they care for unusually high numbers of kids infected with RSV and other respiratory viruses.

It’s the latest example of how the pandemic has upended the usual seasonal patterns of respiratory illnesses, denying a respite for health-care professionals ahead of a potential hectic winter as the coronavirus, influenza and other viruses collide.

Respiratory syncytial virus, a common cause of cold-like illness in young children known as RSV, started surging in late summer, months before its typical season from November to early spring. This month, the United States has been recording about 5,000 cases a week, according to federal data, which is on par with last year but far higher than October 2020, when more coronavirus restrictions were in effect and very few people were getting RSV.

Hospitals are worried about child RSV this year. Here’s what to know.

“It’s very hard to find a bed in a children’s hospital — specifically an intensive care unit bed for a kid with bad pneumonia or bad RSV because they are so full,” said Jesse Hackell, a doctor who chairs the committee on practice and ambulatory medicine for the American Academy of Pediatrics.

Nearly three-quarters of pediatric hospital beds are occupied, according to federal health data. Rhode Island, the District of Columbia and Delaware report more than 94 percent of pediatric beds occupied. Maine, Arizona, Texas, Kentucky, Oklahoma and Missouri reported between 85 and 90 percent of beds occupied. The data is limited to facilities that report the information.

Several children’s hospitals in the D.C. area have been at capacity for weeks; 18 children were waiting for a room in the ICU on Tuesday at Children’s National in the District.

D.C. Realtor Kate Foster-Bankey was more attuned to RSV after she started hearing from clients whose children were afflicted with the virus in recent weeks, including one whose child was admitted to Children’s National.

Then her 3-year-old daughter Isabelle fell ill, becoming lethargic, complaining of a fast heartbeat and not eating. They waited two hours in the packed waiting room of a pediatric urgent care center where Foster-Bankey, a mother of four, was used to seeing only a handful of patients.

During a follow-up visit Tuesday, Isabelle was transported by ambulance to the emergency room of a children’s hospital, where she tested positive for RSV and had to wait until the following morning for a bed.

“It sounds like in covid, we gutted our pediatric care,” said Foster-Bankey, 41. “Kids shouldn’t have to wait in a waiting room with a bunch of other sick kids for hours.”

At Connecticut Children’s Hospital, the emergency room is so full that patients are being triaged in hallways. Teens with bone fractures and appendicitis are being diverted or transferred to adult-care centers to create additional space for respiratory patients. Hospital officials are considering the possibility of enlisting the help of the National Guard to set up tents and care for the influx of patients.

Over the past nine days, 110 children with RSV have come in to the emergency room, and at times as many as 25 children with RSV were waiting for an inpatient bed, said Juan Salazar, physician in chief at Connecticut Children’s. He said that for the first time in his career he has had to mandate doctors in other specialties such as endocrinology and rheumatology work with RSV patients — a situation reminiscent of the “all hands on deck” approach many adult hospitals took in March 2020, when the coronavirus began to sweep through the United States.

“During my tenure here I haven’t seen anything like this,” said Salazar, who has worked in infectious diseases for 30 years.

For decades, fear and failure in the hunt for an RSV vaccine. Now, success.

Salazar and other doctors said one possible reason for the rise in RSV cases is that “pandemic babies” born in the past three years had been protected from respiratory pathogens due to social distancing and masking.

Salazar said another theory suggests children exposed to covid-19 have weakened immune systems, even if they had asymptomatic or mild cases. Even if babies had asymptomatic or mild cases, he said it’s possible that the percentage of infection-fighting B-cells might have dropped, creating “a certain level of immunosuppression” just as they are getting hit with a viral infection.

“So the virus has found a very susceptible population and spread very quickly,” Salazar said.

Texas Children’s Hospital, the nation’s largest pediatric medical center, had more than 40 RSV inpatients as of Friday, with several children in intensive care.

James Versalovic, pathologist in chief at Texas Children’s, said the surge of RSV outside of the typical season could be attributed to how different respiratory viruses interact with each other and how the pandemic changed children born in recent years.

“Their immune systems and immunity may have been altered in ways that we’re just beginning to appreciate,” he said, adding that the pandemic has changed humankind’s “pattern of susceptibility to respiratory viruses.”

Covid is making flu and other viruses act in unfamiliar ways

Hackell, of the American Academy of Pediatrics, said masking during the pandemic simply delayed the normal infection pattern for respiratory pathogens. “We are seeing a lot more cases at one time where they used to be spread out,” he said.

RSV, which mostly infected infants and toddlers before the pandemic, has now been seen in children older than 3, said Andrew Pavia, an infectious-disease expert at the University of Utah Health and Intermountain Primary Children’s Hospital.

Most RSV and other respiratory illness cases will not require hospitalizations. But when so many children are getting sick at once, even a small percentage requiring hospital care can exhaust beds.

Elizabeth Murray, a pediatric emergency medicine physician at the University of Rochester-Golisano Children’s Hospital, said her hospital is seeing between 20 and 30 more patients a day because of the crush of respiratory illnesses. About a fifth of patients have RSV. Some are staying in the emergency department or post-surgical areas instead of getting a traditional room because the hospital is getting full.

“We have to use spaces a little more creatively,” Murray said.

Marc Lashley, a pediatrician at New York’s Allied Physicians Group, one of the largest pediatric organizations in the country, said his pediatric practice is experiencing a busier fall because of rising RSV cases.

“It is pretty labor intensive to keep them out of the hospital,” Lashley said, recommending parents keep sick children at home to reduce the spread of illness and the strain on the health-care system. “We don’t want children to live in a bubble, but we do want parents to be prudent if a child has cold symptoms, which is how RSV can start.”

Few Americans get updated covid shots ahead of expected winter surge

Experts also have been concerned about stubbornly low coronavirus vaccination and booster rates in children, as authorities prepare for a winter influx fueled by variants adept at infecting people despite previous shots and infections.

While children tend to have milder cases of covid-19, hospitals can still be overwhelmed by pediatric cases during waves of mass infection when the small percent of children who do fall severely ill amounts to thousands.

The staff at Intermountain Primary Children’s Hospital, which was at 92 percent capacity as of Friday, is bracing for a confluence of RSV, flu and covid-19 surges.

“The ingredients are in place for all three waves overlapping,” Pavia said.

When coronavirus receded last year, other viruses roared back

It’s why medical experts are amplifying their pleas for people to get vaccinated for influenza and coronavirus — and to beware of multiple viruses hitting at once.

“If you are not immunized and you get infected, you are going to have much more severe infection,” said Angela Myers, division director for infectious diseases at Children’s Mercy Kansas City, which is also experiencing an uptick in RSV cases.

For Foster-Bankey, whose 3-year-old daughter was admitted to a hospital with RSV this week, the virus proved unpredictable.

Doctors had prepared to discharge Isabelle Thursday, but her oxygen levels dipped dramatically and she nearly passed out. She was put on overnight oxygen support and started to rebound Friday, cheering up after playing with an Elsa doll.

After three nights in the hospital, Isabelle was able to return home in time for dinner Friday. Her older sisters welcomed her back with a new pumpkin headband.

Jenna Portnoy contributed to this report.

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Borgs are giant genetic elements with potential to expand metabolic capacity

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    Iran Protests Are Proving a Durable Challenge to the Islamic Republic

    Three weeks after antigovernment protests erupted across Iran—sparked by the death of a woman detained for allegedly violating the country’s strict Islamic dress code—the movement has proved more durable than previous challenges to Tehran’s leaders and could pose a continuing threat.

    Students across the country rallied outside universities on Sunday, chanting slogans including “death to the dictator,” and schoolgirls marched in the streets of Tehran waving their veils in the air, a gesture that has become a central expression of dissent. The governor of Kurdistan province on Sunday ordered universities closed, likely to avoid more protests. Stores across the country stayed closed as part of a widening strike of shopkeepers.

    The demonstrations are unlikely to topple the government, at least in the short term, activists and political analysts said. But the deep disaffection they represent and the fact that they target a key pillar of the Islamic Republic and its foundational ideology make them a significant test.

    Since the death of Mahsa Amini, a 22-year-old woman taken into custody by Iran’s morality police in September, protesters who initially focused on women’s rights have broadened their aims, calling for more freedom in life and politics and the ouster of the country’s Islamic leadership.

    At the heart of the protests is the Islamic head covering, or hijab, which has been mandatory for Iranian women since 1983, four years after the Islamic revolution that brought the Islamic clerics to power.

    “This moment is significant because it has unleashed the potential for longer-lasting civil disobedience,” said Narges Bajoghli, a Johns Hopkins University anthropologist who studies Iran. “Given that half the population must veil, this issue cuts across class, ethnicity and social position.”

    Protests broke out in Iran in 2009 against the result of the country’s election.



    Photo:

    Ben Curtis/Associated Press

    Mass protests in the streets of big cities—dispersed by the authorities with force—have given way to sporadic but frequent and widespread demonstrations involving women removing their headscarves. It is a type of everyday resistance that is difficult for authorities to stop.

    The spontaneous, unpredictable nature of the movement creates a form of whack-a-mole for security forces who are already stretched thin in Tehran and beyond, while images of pro-government toughs using force against unveiled schoolgirls is amplifying public anger.

    The hijab is central to the Islamic Republic’s raison d’être. It is the most visible symbol of adherence to its ultraconservative interpretation of Islam, in which women’s dignity must be protected by modest clothing. And it is a political tool to control half of the population in the public sphere.

    The movement has upended the Iranian authorities’ playbook for suppressing protests. Tehran has used violence to put down previous uprisings, even as other Middle Eastern governments tumbled. Iranian leaders have managed to consolidate their hold on power and go back to business as usual.

    Previous mass protests were rooted in allegations of election fraud or economic hardship, and never captured the support of enough Iranians to overwhelm the government or force it to make significant concessions.

    The latest protests have unprecedented support from Iranians across class, gender and age, and come after years of economic hardship that has driven millions of Iranians into desperation.

    Protesters in Tehran chant slogans during a demonstration over the death of a woman who was detained by the morality police.



    Photo:

    Associated Press

    Universities and schools have become the most recent hotbeds of opposition, with girls as young as high-school age and preteens removing headscarves and telling Education Ministry officials and paramilitary commanders to “get lost.”

    Artists have jumped in with work that supports civil disobedience. Last week, an anonymous artist poured red paint in famous fountains in Tehran in a work he called “Tehran Drowned in Blood,” according to photos and footage posted by activist network 1500tasvir.

    “Baraye,” a song composed from tweets about Iranian women’s struggle for freedom by singer Shervin Hajipour, has become an anthem of the uprising.

    Iranian public-opinion surveys are often unreliable. But the number of people espousing staunch support for the Islamic Republic appears to be shrinking.

    According to a poll in March by Gamaan, an independent research group based in the Netherlands, 18% of Iranians want to preserve the values and ideals of the Islamic Revolution. The survey involved about 17,000 respondents living in Iran. A 2020 study by the group found 72% of Iranians opposed mandatory veiling.

    The crackdown by security forces on demonstrators has fueled more public anger. Dozens have been killed, including at least three teenage girls whose faces have become rallying images of the movement. On Saturday, state television was hacked by a group of activists who posted the pictures of the three girls during a live broadcast, and projected onto the screen an image of Supreme Leader

    Ali Khamenei

    in flames.

    “Every family, to some extent, has been harassed by the state,” said Fatemeh Haghighatjoo, a former Iranian lawmaker now based in the U.S. as executive director of the Nonviolent Initiative for Democracy, a pro-democracy activist group. “This dissatisfaction and anger has been there, beneath the skin of society, for a number of years.”

    Protesters near a rally in Tehran in 2009.



    Photo:

    /Associated Press

    Adding to the uncertainty of the leadership, there have long been rumors of the declining health of 83-year-old Mr. Khamenei, who has been in power since 1989. Were he to die, the forced shuffle of power would likely embolden protesters further and potentially create cracks in the leadership.

    Protesters have responded to government violence by adapting. Many have sought refuge inside universities or taken to rooftops to chant slogans such as “Death to the dictator.” Others prepare for clashes with law enforcement.

    “We are no longer frightened,” said a protester in Tehran who had been beaten by members of the Basij militia during a recent rally for not covering her hair.

    When preparing for a protest, the woman said she wears dark clothing, removes her jewelry, covers her tattoos and dons a surgical mask. She said she packs extra clothes, water, a lighter and vinegar in case she and fellow demonstrators are hit with tear gas or worse.

    “I don’t usually take my phone with me, and if I do, I make sure to delete all the information that would cause trouble for me,” she said.

    The Islamic Republic has clashed with the population in the streets numerous times since its inception in 1979, and with increased frequency.

    SHARE YOUR THOUGHTS

    Do you think the protests in Iran will fundamentally change the governance of the country? Join the conversation below.

    Student protests in 1999 and the Green Movement in 2009, which protested against alleged vote rigging, as well as demonstrations in 2017 and 2019 against the government’s economic policies, all mostly called for reforms within the existing system. Now, Iranians are calling for a wholesale overthrow of the Islamic Republic.

    The current movement has no designated leaders and no coordinating body. That is both a strength and a potential weakness, said Mohammad Ali Kadivar, associate professor at Boston College and an expert on pro-democracy movements in Iran.

    The leaderless nature makes it difficult for the government to decapitate the movement. The arrest in 2011 of opposition leaders Mir-Hossein Mousavi and Mehdi Karroubi practically ended the Green Movement. But it also makes the movement less agile in making tactical changes, and if the government at a later stage wants to negotiate, it needs leaders to do that with, Mr. Kadivar said.

    The real strength of the movement lies in its inclusion of marginalized groups, Mr. Kadivar said. Ms. Amini, whose death sparked the protests three weeks ago, was a Sunni-Muslim Kurdish woman in a majority Shia country. “Everything about her identity was marginalized,” he said. “The leadership of women is new, and the cross-ethnic solidarity wasn’t there before.”

    Unions of bus drivers, oil workers and teachers have in the past gone on strike in protest against poor economic conditions, and if they coordinate efforts, they could dramatically shift the balance of power, said Roham Alvandi, an associate professor at the London School of Economics with expertise in Iranian history.

    “The question is if they can translate these protests into something like a general strike,” Mr. Alvandi said, adding that the uprising is still in its early days. “If they can, then I think this is pretty much the end of this regime.”

    So far, the unions aren’t known to have coordinated large-scale action.

    Protesters are also younger than they ever have been. In recent days, footage has emerged of Iranian children and high-school students confronting government officials and stomping on pictures of Mr. Khamenei and his predecessor,

    Ruhollah Khomeini.

    “The Islamic Republic is going to have a hard time governing this generation,” Mr. Kadivar said.

    Write to Sune Engel Rasmussen at sune.rasmussen@wsj.com

    Copyright ©2022 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

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    BAE, U.S. in Talks to Restart M777 Howitzer Production After Ukraine Success

    British arms maker

    BAE Systems

    BAESY 2.41%

    PLC said it was considering restarting production of the M777 howitzer, as the big gun’s performance on Ukrainian battlefields revives interest in the weapon.

    BAE said several countries had expressed an interest in buying M777s, production of which is currently being wound down. The inquiries come after Ukrainian forces have been using the artillery piece to deadly effect against Russian troops in recent months.

    The company said it was now in talks regarding the restart with the U.S. Army, which runs the weapon’s program. The U.S. government must approve any foreign sales. The U.S. Army declined to comment, referring queries on the matter to BAE.

    The M777’s potential resurrection exemplifies how the war in Ukraine could reshape the global armaments industry. High-profile weaponry including the U.S. M142 High Mobility Artillery Rocket System, or Himars, and the Anglo-Swedish NLAW portable antitank missile, which have proven very effective against Russian forces, are likely to win new orders, analysts say. Meanwhile, the poor performance of many Russian arms is expected to dent their sales on global markets.

    The M777 has allowed Ukraine’s forces to fire a wider variety of projectiles than was possible with older weapons.



    Photo:

    Sergey Kozlov/Shutterstock

    The howitzer, a class of mobile, long-barreled, battlefield gun, has long been a cornerstone of modern artillery. However, it has taken on a more prominent role in the war in Ukraine than in other recent conflicts such as the one in Afghanistan or the second war in Iraq.

    The performance of the M777 in particular has been enhanced by the increasing use of precision GPS-guided shells, rather than traditional unguided shells. The M777 is also one of the most plentiful pieces in Ukraine’s Western-supplied artillery, which includes at least 170 of the guns received from the U.S., Australia and Canada.

    Easy for troops to operate and less expensive than many other similar types of Western artillery, the M777’s reliability and versatility have drawn attention among military specialists and analysts.

    “The demonstration of the effectiveness and utility of a wide variety of artillery systems is what is coming out of the Ukraine conflict,” said Mark Signorelli, a vice president of business development at BAE, one of the world’s largest defense companies.

    BAE said that if inquiries from prospective M777 buyers, which include countries in Central Europe, turned into actual orders, it could lead to up to 500 new howitzers.

    Easy for troops to operate and less expensive than similar types of artillery, the M777’s reliability and versatility have drawn the attention of military specialists.



    Photo:

    David Moir/REUTERS

    “Inquiries don’t always turn into contracts,” said Mr. Signorelli. To restart the M777 production line profitably, the company needs at least 150 unit orders, he added.

    The U.S. Army isn’t expected to add to its stockpile of M777s. The Army and Marines have purchased more than 1,000 of the guns, which entered service in 2005.

    The M777 was primarily manufactured in the U.K. but often assembled in the U.S., and the program is currently in the final stages of producing its last orders, for India.


    Maximum firing range:

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    Maximum firing range:

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    2005

    U.K. / U.S.

    Max firing range:

    Max rate of fire:

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    2005

    U.K. / U.S.

    Phillips O’Brien, professor of strategic studies at the University of St. Andrews in Scotland, said that Himars and other Western rocket-launch systems have probably been more important in destroying Russian logistics and control centers.

    “But when it comes to engaging Russian military forces directly in the field, the M777s, one assumes, are carrying a larger burden,” he said.

    The M777 has positives and negatives when compared with rival guns. Unlike the German Panzerhaubitze 2000 and French Caesar howitzer, which are also being used in Ukraine, the M777 has to be towed. It also has a lower fire rate than those other European weapons, according to an officer in Ukraine’s military intelligence.

    However, the M777 has found favor with Ukrainian forces for its greater accuracy and ease of use, he said.

    The M777 fires standard Western ammunition, meaning Ukraine is less reliant on dwindling supplies of Russian-made shells, said Mark Cancian, a senior adviser with the CSIS International Security Program and a former artillery officer in the U.S. Marine Corps. The M777 can also fire a wider variety of projectiles, including guided shells, than the Soviet artillery that had been in Ukraine’s armory, he added.

    The M777 howitzer was also used by U.S. forces during the war in Afghanistan.



    Photo:

    LIU JIN/Agencerance-Presse/Getty Images

    The U.S., the U.K. and Sweden have given the howitzer new capabilities by creating GPS-guided shells that are far more precise than earlier-generation unguided projectiles.

    The 155mm Excalibur shells, developed by

    Raytheon Technologies Corp.

    and BAE, can strike within less than 10 feet of a target, even at their maximum range of around 30 miles, according to Pentagon and company documentation. Targeting of traditional artillery shells grows increasingly imprecise with firing distance because of wind and other factors. Even modern unguided Western-made artillery shells can land as much as 500 feet from a target located 15 miles away.

    That kind of precision, previously achievable only with laser-guided projectiles or expensive air-to-ground explosives, is changing combat. U.S. Himars rocket launchers and larger M270 Multiple Launch Rocket Systems use similar GPS-guided missiles that have wrought crippling damage on Russian forces.

    SHARE YOUR THOUGHTS

    Should the U.S. and BAE restart production of the M777 howitzer? Why or why not? Join the conversation below.

    While the rockets used in U.S. guided missile systems cost $150,000 each, the sort of standard shell used in an M777 is $800, Mr. Cancian said, citing Department of Defense budget documents. A guided Excalibur shell is around $68,000, he said.

    But as the U.S. and its allies supply Ukraine they are depleting their own inventories. The war has, for instance, run down U.S. stocks of ammunition used in howitzers, and the Pentagon has been slow to replenish its arsenal.

    Dormant supply lines often can’t be switched on overnight, and surging production of active lines can take time.

    BAE estimates that it would take some 30 to 36 months to restart full production of the M777, not least because the company needs a new supplier of titanium material and suppliers to produce the weapon’s lightweight components.

    Write to Alistair MacDonald at alistair.macdonald@wsj.com and Daniel Michaels at daniel.michaels@wsj.com

    Corrections & Amplifications
    Modern unguided Western-made artillery shells can land as much as 500 feet from a target located 15 miles away. A previous version of this article incorrectly said their inaccuracy could be as much as one mile. (Corrected on Oct. 9)

    Copyright ©2022 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

    Read original article here

    Elon Musk Unveils Prototype of Tesla’s Humanoid Robot Optimus, Says It Will Cost Less Than a Car

    Mr. Musk first laid out the vision for the robot, called Optimus, a little more than a year ago at Tesla’s first-ever AI day. At the time, a dancer in a costume appeared onstage. This time, Mr. Musk presented a prototype at the gathering that unfolded late Friday in Palo Alto, Calif.

    The early prototype, which still had wires showing, took a few steps, waved to the crowd, and performed some basic dance moves.

    Tesla’s robot is expected to cost less than a car, with a price point below $20,000, Elon Musk said.



    Photo:

    Tesla

    Mr. Musk quipped the robot could do a lot more, but limited its activity for fear it could fall on its face. The robot’s appearance on stage marked the first time it operated without a tether, Mr. Musk said.

    “Our goal is to make a useful humanoid robot as quickly as possible,” he said, with the aspiration of being able to make them at high volume and low cost. “It is expected to cost much less than a car,” he said, with a price point below $20,000. Customers should be able to receive the robot, once ordered, in three to five years, Mr. Musk said. It isn’t yet for sale.

    He later showed off a nonfunctioning, sleeker model that he said was closer to the production version.

    “There’s still a lot of work to be done to refine Optimus,” he said, saying that the concept could evolve over time. “It won’t be boring.”

    The battery-powered robot should be able to handle difficult chores, Tesla said, including lifting a half-ton, 9-foot concert grand piano. Mr. Musk added it would have conversational capabilities and feature safeguards to prevent wrongdoing by the machine.

    Elon Musk last year unveiled the idea of the robot Optimus with a dancer in a costume.



    Photo:

    TESLA/via REUTERS

    “I’m a big believer in AI safety,” said Mr. Musk, who has previously expressed concerns about how such technology could be used. He said he thinks there should be a regulatory authority at the government level.

    The Tesla boss painted a vision of Optimus as helping Tesla make cars more efficiently, starting with simple tasks and then expanded uses. He has also suggested the robot could serve broader functions and potentially alleviate labor shortages.

    “It will, I think, turn the whole notion of what’s an economy on its head, at the point at which you have no shortage of labor,” Mr. Musk said Aug. 4 at Tesla’s annual shareholder meeting. On Friday, he added: “It really is a fundamental transformation of civilization as we know it.”

    Elon Musk unveiled a prototype of Tesla’s humanoid robot Optimus, part of an effort to shape perception of the company as more than just a car maker. The Tesla CEO said the robot is expected to cost less than a car. Photo: Tesla

    When he first unveiled the Optimus concept, Mr. Musk said such a robot could have such an impact on the labor market it could make it necessary to provide a universal basic income, or a stipend to people without strings attached.

    Tesla has also encountered problems with automation. Early efforts to rely heavily on automated tools to scale up vehicle production suffered setbacks, and the company had to rely more heavily than planned on factory workers. Mr. Musk later tweeted: “Yes, excessive automation at Tesla was a mistake. To be precise, my mistake. Humans are underrated.”

    One of the big questions around Tesla’s humanoid robot is its central purpose, said

    Chris Atkeson,

    a Carnegie Mellon University robotics professor. If Tesla’s main goal is to improve manufacturing, a quadruped likely would have been easier to build than a humanoid robot, in part because additional legs make it easier to balance, he said.

    SHARE YOUR THOUGHTS

    What do you think of the Tesla robot? Join the conversation below.

    Mr. Musk, who has been instrumental in popularizing electric vehicles and pioneered landing rocket boosters with his company SpaceX, also has a record of making bold predictions that don’t immediately pan out. Three years ago at an event about automation, he projected that more than a million Tesla vehicles would be able to operate without a driver by the middle of 2020, positioning the company to launch a robot taxi service. That hasn’t happened.

    Mr. Musk for some time has said Tesla aimed to be more than just a car company and reiterated that message on Friday. He called the company “a series of startups.”

    Mr. Musk billed the latest event, like last year’s, as one aimed at recruiting engineers in fields such as artificial intelligence, robotics and chips.

    Tesla has long bet on automation to keep the company ahead of competitors. The company’s cars are outfitted with an advanced driver-assistance system, known as Autopilot, that helps drivers with tasks such as maintaining a safe distance from other vehicles on the road and staying centered in a lane.

    Tesla engineers detailed some of the AI work the company is doing, including to underpin its driver-assistance technology. Mr. Musk said the company’s development of a powerful, AI-focused computer could allow Tesla to offer the number-crunching capability as a service to others, not unlike cloud-computing offerings provided by the likes of

    Amazon.com Inc.

    The company is developing and selling an enhanced version of Autopilot that brings more automated driving into cities. Tesla calls the system Full Self-Driving, or FSD, although it doesn’t actually make vehicles autonomous and the company tells drivers to keep their hands on the wheel while operating the car.

    Tesla said Friday that it now has 160,000 customers with the software. Mr. Musk said rollout of the technology beyond the U.S. and Canada depends on gaining regulatory approval, though it should be feasible from a technology perspective by year-end.

    Tesla has steadily raised the price of FSD, which now retails for $15,000. AI has been at the heart of Tesla’s efforts to develop more advanced driver-assistance features and, eventually, fully autonomous vehicles.

    Tesla said the software that is used to take on more driving functions also underpins operations of the humanoid robot.

    Tesla’s pursuit of automation has increasingly come under scrutiny. The National Highway Traffic Safety Administration, which regulates auto safety, opened a probe into Autopilot last year after a series of crashes involving Teslas that struck first-responder vehicles stopped for roadway emergencies.

    Two U.S. senators have also asked the Federal Trade Commission to investigate whether Tesla has been deceptive in its marketing of Autopilot and FSD.

    The electric-car maker has long said that driving with Autopilot engaged is safer than doing so without it. Tesla points to internal data showing that crashes were less common when drivers were using Autopilot, though some researchers have criticized the company’s methodology.

    Write to Meghan Bobrowsky at Meghan.Bobrowsky@wsj.com and Rebecca Elliott at rebecca.elliott@wsj.com

    Copyright ©2022 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

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    Surge of respiratory illnesses in children straining some hospitals’ capacity


    The surge in children’s respiratory illnesses, including rhinovirus and enterovirus, is pushing pediatric emergency departments and health systems toward capacity in some parts of the country.

    Infectious disease experts say they are seeing a higher-than-expected rate of certain pediatric infections other than COVID-19. There is no one reason for this uptick, but factors include time of the year and relaxed pandemic restrictions.

    Hospitals across multiple states — including Washington, Colorado, Texas, Ohio, Louisiana, New Jersey and Massachusetts — have told ABC News they are feeling this crush and expect things to worsen as the school year proceeds and winter approaches.

    Seattle Children’s Hospital is “experiencing unprecedented Emergency Department (ED) volumes and inpatient census,” Dr. Tony Woodward, medical director of emergency medicine and Emergency Medicine Division chief at Seattle Children’s, told ABC News in a statement.

    There has been a particular upward trend in respiratory viruses, along with the background of COVID-19 and other standard viruses, Woodward said, adding that he expects the coming RSV and flu season to further amplify the trend.

    “While we’re still seeing some patients requiring hospitalization specifically with COVID-19, other respiratory and gastrointestinal illnesses are making our patients sick,” Woodward said. “We are already seeing significant viral activity, which we expect to increase as kids are now back in school and the winter viral and flu season is approaching.”

    Enteroviruses can cause respiratory illness ranging from mild — like a common cold — to severe, according to the Centers for Disease Control and Prevention. In rare instances, severe cases can cause illnesses like viral meningitis (infection of the covering of spinal cord and brain) or acute flaccid myelitis, a neurologic condition that can cause muscle weakness and paralysis.

    RSV — or respiratory syncytial virus — can also cause mild, cold-like symptoms, and in severe cases, can cause bronchiolitis or pneumonia, according to the CDC. “Most people recover in a week or two, but RSV can be serious, especially for infants and older adults,” the CDC says.

    Seattle Children’s is seeing more than double the number of respiratory visits associated with the rise in rhinovirus than they have at any time in the past year — statistically significant, Dr. Russell Migita, attending physician and a clinical leader of emergency services at Seattle Children’s Hospital, told ABC.

    They’ve also seen an early rise in RSV, Migita said. “In typical years, RSV starts to rise in November and peaks in February. Last year, it started in August. This year, September/October.”

    Woodward added that “wildfire smoke has also exacerbated respiratory and other health concerns for many children in the region.”

    Blanscape/Shutterstock

    A nurse administers inhalation therapy to a pediatric patient in a stock photo.

    In response to the recent emergency department surges, Woodward said the hospital has increased physician staffing and opened additional beds.

    In Colorado Dr. Kevin Messacar, infectious diseases specialist at Children’s Hospital Colorado and associate professor at University of Colorado School of Medicine, told ABC they’ve been grappling with a significant uptick in enterovirus D68 for about the past two months.

    “This year has been a very significant year in terms of an uptick,” Messacar said. “Many hospitals throughout the country servicing children are very busy and very full. Still providing great care to the kids who need it, but we are all on the lookout for the aftermath of this respiratory wave.”

    In an advisory to pediatricians and hospitals shared with ABC News, the New Jersey Department of Health warned of increasing levels of enterovirus and rhinovirus activity earlier this month, and noted the state is seeing a similar “surge” like other parts of the country.

    A spokesperson for the department said they are “monitoring and watching hospitalizations and Pediatric Intensive Care Unit census daily throughout the state,” adding that officials have planned a call with hospitals “to assess pediatric capacity” amid the surge.

    Doctors at RWJ Barnabas Health System in New Jersey are seeing that upward trend in cases firsthand, where a wave of children’s enterovirus cases in recent weeks has pushed their pediatric ICUs to capacity, Dr. Uzma Hasan, division director of pediatric infectious disease at Cooperman Barnabas Medical Center, told ABC News.

    “Approximately two weeks ago we started to see the numbers steadily rising, and the ICUs were starting to hit capacity with these kids coming in with respiratory symptoms,” Hasan said.

    It has impacted asthmatic children and those with chronic lung disease particularly hard, but there have also been kids without any major underlying conditions who “seemed to have a pretty significant illness progress in a short period of time,” Hasan added.

    Children with chronic lung disease, premature babies and kids with asthma are considered especially high risk. Families of kids with asthma should have an action plan with how to deal with an asthma exacerbation if they become ill, Hasan said.

    With regards to capacity, Hasan noted that staff had been in communication with state officials “to figure out which sites have ICU beds available to make sure these kids coming into the ER setting are getting accommodated.”

    One bittersweet silver lining of the pandemic, Hasan said, was how it had drilled hospitals and doctors on how to implement surge protocols and react to emergencies quickly, through COVID’s many intense waves — something has helped them handle the influx in respiratory cases of late. While hospitals are still understaffed and many doctors are grappling with burnout, they’ve been able to figure out ways to shuffle limited resources around where they’re needed most, and how to stay nimble with shifting beds, patients and staff around fast.

    “I think one good thing that came out of COVID — if I can say that — is we’ve learned to plan ahead of the game,” Hasan said. “When we started seeing the numbers of patients showing up in the pediatric ERs rise and ICUs starting to fill up with kids, we got together pretty quickly to come up with a plan.”

    STOCK PHOTO/Getty Images

    Still, that plan could be threatened as the country heads deeper into fall, flu season, and RSV season — not to mention additional surges of COVID-19.

    “The biggest worry is that we may see a concomitant rise in all these respiratory viruses — and whether we will be able to accommodate the kids who are coming in with severe respiratory symptoms,” Hasan told ABC. “We’re bracing ourselves for what’s next to come.”

    Ochsner Health in Louisiana is also seeing an “influx” of children’s respiratory infections.

    “Like other hospitals across the region and the country, Ochsner Health is currently experiencing an influx of viral pediatric respiratory illnesses,” Dr. William Lennarz, pediatrics system chair of Ochsner Health, told ABC News in a statement.

    “Our Emergency Department volumes have seen an increase due to the flu virus and other normal seasonal respiratory viruses like RSV,” Lennarz said. “We are closely monitoring cases of respiratory illness and have a model in place to accommodate increased patient numbers and resources needed to care for these patients.”

    The Boston area, meanwhile, has seen a similar spike in pediatric respiratory illnesses.

    “Reduced population-wide immunity, the dropping of COVID mitigation efforts and increased mixing in schools and daycares is likely responsible for driving the surge in pediatric cases of acute respiratory illness both in our region and nationally,” Boston Children’s Hospital chief innovation officer and ABC News contributor Dr. John Brownstein said, adding the challenges of emergency department and inpatient capacity, alongside staff shortage, are “only adding more fuel to this fire.”

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    Inside the Russian-Occupied Ukrainian City Living Under Threat of Nuclear Disaster

    In the Russian-occupied Ukrainian city that hosts Europe’s largest nuclear-power plant, residents are taping up windows in fear of a radioactive leak and sticking close to home as fighting rages around the complex and Moscow-installed authorities gear up for a possible annexation of the region by Russia.

    Residents in Enerhodar, a city that has been under Russian occupation for more than five months, paint a picture of a pitched battle on the front lines in Ukraine’s south that risks sparking Europe’s biggest nuclear disaster since Chernobyl in 1986.

    Enerhodar has become the focus of an international crisis as Russia and Ukraine trade blame for attacks on the city’s sprawling Zaporizhzhia nuclear plant. The plant is being defended by hundreds of Russian soldiers—effectively transforming it into a military garrison—who are facing off against Ukrainian soldiers stationed just a few miles away.

    There has been no reported damage to the reactors and no radioactive release so far, but Ukraine said plant staff had to close one of six reactors over the weekend after a high-voltage power line was severed and three radiation monitors damaged.

    The Zaporizhzhia nuclear-power plant is being defended by hundreds of Russian soldiers.



    Photo:

    ALEXANDER ERMOCHENKO/REUTERS

    “God forbid something irreversible happens,” Ukrainian President

    Volodymyr Zelensky

    said in a video address Sunday. “No one will stop the wind that will spread radioactive pollution.”

    The city, with a prewar population of 53,000 and whose name means “the giver of energy,” has been running out of food supplies and begun circulating the Russian ruble as reserves of Ukraine’s hryvnia currency run out, residents say.

    Andriy, a former car salesman and a 36-year-old resident of Enerhodar, said that occupying authorities told residents the area around the plant is mined and that unexploded ordnance from cluster munitions litters the city.

    “They told us that the Ukrainians were shelling the plant and that it was necessary to seal window frames with Scotch tape so that if they hit the warehouse of radioactive waste, the dust would not enter our homes,” he said by phone. “They say that the first day will be the most dangerous, so you have to stay at home and not go out. Everyone is afraid that something will happen to the plant.”

    Occupation authorities in Enerhodar have begun circulating the Russian ruble as reserves of Ukraine’s hryvnia currency run out.



    Photo:

    ALEXANDER ERMOCHENKO/REUTERS

    Andriy said Russian forces positioned beside the plant are firing artillery from the city at Ukrainian forces positioned across the Dnipro River near Nikopol. At night he sees what look like tracer bullets in the sky as the Russians fire antiaircraft guns from the territory of the station.

    Communications with Enerhodar residents are steadily worsening as the occupying authorities tighten their control and fear spreads among locals. Many people worry that their phones have been tapped. Russia is also gradually disconnecting Ukrainian telecom providers and attempting to roll out Russian cell service. Sim cards from major Ukrainian providers no longer work properly.

    “People are afraid,” said the Ukrainian mayor of Enerhodar,

    Dmytro Orlov,

    who fled after the occupation. “Workers of Europe’s largest nuclear power plant go to work not knowing if they’ll return home after their shift, or whether everything is fine with their loved ones while they’re away.”

    One Enerhodar woman in her early 60s said shelling of the city has become much more frequent in recent days, adding that she has seen trucks and armored personnel carriers driving regularly toward the plant complex. The woman said residents are trying to go about their daily lives, buying produce from local markets because supermarket prices have become too high, and increasingly paying in Russian rubles circulated by occupation authorities as supplies of Ukraine’s hryvnia run out.

    Himars—long-range rocket launchers from the U.S.—have helped Ukraine target Russian ammunition stores, command posts and fuel depots, slowing down Moscow’s forces. As Washington sends more weapons, WSJ looks at why Kyiv is asking for other advanced tools. Photo composite: Eve Hartley

    People fear speaking in public, she said, afraid that a passerby could inform on them to the occupation authorities. The woman said her son, a city council member before the war, is now in hiding after having failed to escape to Ukrainian-controlled territory. He was sleeping in friends’ garages and basements, escaping both the Russian-installed government and the constant shelling.

    “Most people keep their opinions to themselves because you can’t know what your interlocutor might do,” said Yury, a local resident. He added that many Russian-installed officials and security service members now appear in civilian clothing, making residents even more afraid of inadvertently saying something that could be used against them.

    “Sometimes people you know disappear,” the woman said. “We think they probably said something wrong.” Mr. Orlov, the mayor, said several hundred residents of the city have been abducted and are being held in Russian custody, and months have passed in some cases with no information about their whereabouts. The Kremlin didn’t immediately respond to a request for comment.

    When Russia took control of Enerhodar in early March, residents like Andriy and Yury came out to stage protest rallies and shout “Ukraine!” and “Go home!” at the occupying troops. The last protest, on April 2, was violently dispersed by Russian troops and outward signs of dissent quickly disappeared as Russia installed a collaborationist administration in the city and clamped down, residents say.

    The Russian-installed head of the surrounding Zaporizhzhia region, Evgeny Balitsky, on Monday announced a coming referendum on whether the region should join Russia. Andriy, the local resident, said police are checking courtyards and building entrances for posters and leaflets against the referendum and searching for anyone who distributes them.

    The woman in her 60s said fear is rising that battles raging in the area could cause damage that would leak radioactive chemicals.

    “It’s scary to live near the plant,” she said. “Some fear that storage facilities have already been destroyed and are emitting radiation, and we just don’t know about it. People are afraid that if it explodes, we will all die here.”

    She said most residents still hold out hope that Ukraine, which has announced a major counteroffensive on southern areas taken by Russia, will liberate Enerhodar too. But the occupation is becoming entrenched.

    “It feels like most people are on Ukraine’s side,” she said. “But they are getting tired of waiting.”

    A serviceman with a Russian flag on his uniform standing guard near the nuclear-power plant in early August.



    Photo:

    ALEXANDER ERMOCHENKO/REUTERS

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