AI systems being developed to diagnose skin cancer run the risk of being less accurate for people with dark skin, research suggests. From a report: The potential of AI has led to developments in healthcare, with some studies suggesting image recognition technology based on machine learning algorithms can classify skin cancers as successfully as human experts. NHS trusts have begun exploring AI to help dermatologists triage patients with skin lesions. But researchers say more needs to be done to ensure the technology benefits all patients, after finding that few freely available image databases that could be used to develop or "train" AI systems for skin cancer diagnosis contain information on ethnicity or skin type. Those that do have very few images of people with dark skin.

Dr David Wen, first author of the study from the University of Oxford, said: "You could have a situation where the regulatory authorities say that because this algorithm has only been trained on images in fair-skinned people, you're only allowed to use it for fair-skinned individuals, and therefore that could lead to certain populations being excluded from algorithms that are approved for clinical use. Alternatively, if the regulators are a bit more relaxed and say: 'OK, you can use it [on all patients]', the algorithms may not perform as accurately on populations who don't have that many images involved in training." That could bring other problems including risking avoidable surgery, missing treatable cancers and causing unnecessary anxiety, the team said.

The use of whole genome sequencing could save the NHS millions of pounds, a study suggests, after it found a quarter of people with rare illnesses received a diagnosis for their condition through the technology. From a report: In some cases, the findings have provided reassurance for families that they have not passed their condition on to their children, while in others they have inspired life-changing treatments. Though individually uncommon, rare inherited diseases affect about 6% of the UK population, or roughly 3 million people. Traditionally, geneticists searched for the abnormalities underpinning such conditions by looking at the person's chromosomes through a microscope, but this is no good at spotting tiny, but often highly significant changes, such as single letter substitutions in the genetic code. Because of this, "many of the people who have a rare disease either live very long diagnostic odysseys to get an answer for why they are like they are, or they do not get an answer in their entire lifetime," said Prof Sir Mark Caulfield at Queen Mary University of London (QMUL), a former chief scientist at Genomics England. In 2013, the UK government launched the 100,000 Genomes Project to investigate whether WGS -- which involves reading through the entire 3bn pairs of letters in the human genome -- could help doctors better understand the cause of patients' symptoms, and identify other family members who may be at risk. Five years later, NHS England became the first national health care system in the world to offer WGS to people with undiagnosed rare diseases and cancer as part of routine care.

An anonymous reader quotes a report from Phys.Org: A University of Arizona-led effort to reconstruct Earth's climate since the last ice age, about 24,000 years ago, highlights the main drivers of climate change and how far out of bounds human activity has pushed the climate system. The study, published this week in Nature, had three main findings:

1.) It verified that the main drivers of climate change since the last ice age are rising greenhouse gas concentrations and the retreat of the ice sheets.
2.) It suggests a general warming trend over the last 10,000 years, settling a decade-long debate about whether this period trended warmer or cooler in the paleoclimatology community.
3.) The magnitude and rate warming over the last 150 years far surpasses the magnitude and rate of changes over the last 24,000 years.

There are different methods for reconstructing past temperatures. The team combined two independent datasets -- temperature data from marine sediments and computer simulations of climate -- to create a more complete picture of the past. The researchers looked at the chemical signatures of marine sediments to get information about past temperatures. Because temperature changes over time can affect the chemistry of a long-dead animal's shell, paleoclimatologists can use those measurements to estimate temperature in an area. It's not a perfect thermometer, but it's a starting point. Computer-simulated climate models, on the other hand, provide temperature information based on scientists' best understanding of the physics of the climate system, which also isn't perfect. The team decided to combine the methods to harness the strengths of each. This is called data assimilation and is also commonly used in weather forecasting. [...] Now, the team is working on using their method to investigate climate changes even farther in the past.

nickwinlund77 shares a report from SciTechDaily: Since the first observation of merging black holes by the Laser Interferometer Gravitational-Wave Observatory (LIGO) in 2015, astronomers have been repeatedly surprised by their large masses. Though they emit no light, black hole mergers are observed through their emission of gravitational waves -- ripples in the fabric of spacetime that were predicted by Einstein's theory of general relativity. Physicists originally expected that black holes would have masses less than about 40 times that of the Sun, because merging black holes arise from massive stars, which can't hold themselves together if they get too big. The LIGO and Virgo observatories, however, have found many black holes with masses greater than that of 50 suns, with some as massive as 100 suns. Numerous formation scenarios have been proposed to produce such large black holes, but no single scenario has been able to explain the diversity of black hole mergers observed so far, and there is no agreement on which combination of formation scenarios is physically viable. This new study, published in the Astrophysical Journal Letters, is the first to show that both large and small black hole masses can result from a single pathway, wherein the black holes gain mass from the expansion of the universe itself.

Astronomers typically model black holes inside a universe that cannot expand. "It's an assumption that simplifies Einstein's equations because a universe that doesn't grow has much less to keep track of," said Kevin Croker, a professor at the UH Mnoa Department of Physics and Astronomy. "There is a trade-off though: predictions may only be reasonable for a limited amount of time." Because the individual events detectable by LIGO-Virgo only last a few seconds, when analyzing any single event, this simplification is sensible. But these same mergers are potentially billions of years in the making. During the time between the formation of a pair of black holes and their eventual merger, the universe grows profoundly. If the more subtle aspects of Einstein's theory are carefully considered, then a startling possibility emerges: the masses of black holes could grow in lockstep with the universe, a phenomenon that Croker and his team call cosmological coupling. The most well-known example of cosmologically-coupled material is light itself, which loses energy as the universe grows. "We thought to consider the opposite effect," said research co-author and UH Manoa Physics and Astronomy Professor Duncan Farrah. "What would LIGO -- Virgo observe if black holes were cosmologically coupled and gained energy without needing to consume other stars or gas?"

An anonymous reader quotes a report from The Guardian: Scientists have shown how a fatty acid found in palm oil can encourage the spread of cancer, in work that could pave the way for new treatments. The study, on mice, found that palmitic acid promoted metastasis in mouth and skin cancers. In future, this process could be targeted with drugs or carefully designed eating plans, but the team behind the work cautioned against patients putting themselves on diets in the absence of clinical trials. The study adds to emerging evidence that diet can be used to enhance existing cancer treatments because certain nutrients are disproportionately relied on by tumor cells, or are required at critical stages such as metastasis.

The study built on previous work by the same team showing that, within a tumor, just a small subset of cells have the capacity to spread by traveling out of the tumor, reaching other organs and colonizing them. These specialized cancer cells appeared to rely particularly heavily on fatty acids and the latest work narrowed this down to palmitic acid, which is found in palm oil -- but also in a wide variety of foods such as butter and olive oil. The study, published in Nature, found that when palmitic acid was supplemented into the diet of mice, mouth and skin cancers were more likely to spread. Other fatty acids called oleic acid and linoleic acid -- omega-9 and omega-6 fats found in foods such as olive oil and flaxseeds -- did not show the same effect. Neither of the fatty acids tested increased the risk of developing cancer in the first place. The study suggested that exposure to palmitic acid caused changes to the function of genes in cancer cells that allowed them to sense fatty acids and consume them more efficiently. The presence of palmitic acid also appeared to send cancer cells into a "regenerative state" allowing them to form signaling networks beyond the tumor, which is known to be a crucial step towards spreading.

Camel Pilot writes: SpinLaunch is developing a launch system that uses kinetic energy as a cheap method to launch a projectile into orbit. They propose using a vacuum-sealed centrifuge spinning the projectile at near escape velocity speeds and releasing into orbit. A rocket engine would still be used to maneuver and position the satellite. They have built a 1/10th scale prototype in the New Mexican desert and have already launched test objects 10s of thousands of feet.

In a recent interview, CEO Jonathan Yaney said: "I find that the more audacious and crazy the project is, the better off you are just working on it -- rather than being out there talking about it. We had to prove to ourselves that we could actually pull this off."

An anonymous reader quotes a report from Bloomberg: Unsealed emails reveal the role baby-powder maker Johnson & Johnson played in a report that an industry group submitted to U.S. regulators deciding whether to keep warnings off talc-based products linked to cancer. The emails -- unsealed in the state of Mississippi's lawsuit against J&J over its refusal to add a safety warning -- show J&J and its talc supplier chose the scientists hired by their trade association, the Personal Care Products Council, to write the 2009 report assessing talc-based powders' health risks. They also show the researchers changed the final version of their report at the companies' behest. The U.S. Food and Drug Administration said it relied in part on the report in its decision to forgo a warning for the product.

The emails among executives of J&J and Rio Tinto Minerals, its supplier at the time, provide a behind-the-scenes glimpse of dealings between companies and their industry group that successfully fended off a cancer warning on talc-based powders for nearly 40 years. Now, almost 39,000 users and their families are suing J&J, most claiming their ovarian cancers and those of loved ones were linked to asbestos, the potent carcinogen in the products pulled from U.S. and Canadian shelves in May 2020. Dependence on industry data creates a situation that's ripe for lobbyists to exert pressure on the FDA. The unsealed emails pull back the curtain on how such efforts get launched, who pays for them, and who has a hand in delivering the final product to regulators.

While the practice of companies having a say in industry group submissions to the FDA isn't new or illegal, the emails reveal just how involved J&J got in a report meant to assess product safety -- down to selecting individual scientists to produce it and having them write an executive summary. J&J denied any wrongdoing in its decision not to acknowledge its input to the report that the PCPC lobbying group sent to the FDA. [...] FDA officials acknowledged they weighed the PCPC's response to the citizens' petitions demanding a warning for talc-based powders before finding there was "inconclusive evidence" the mineral caused ovarian and other forms of cancer. "The FDA reviewed and considered all of the information submitted to us in the two petitions, the comments received in response to the petitions, and additional scientific information," said Tara Rabin, a spokeswoman.

Astronomers have detected a record number of gravitational waves, in a discovery they say will shed light on the evolution of the universe, and the life and death of stars. From a report: An international team of scientists have made 35 new observations of gravitational waves, which brings the total number of detections since 2015 to 90. Gravitational waves are ripples in the fabric of spacetime, created by massive cosmic events -- such as pairs of black holes smashing together -- up to billions of light years away. Waves from these cataclysmic collisions were detected by the Laser Interferometer Gravitational-Wave Observatory (Ligo) observatory in the US and the Virgo instrument in Italy between November 2019 and March 2020. The first detection of gravitational waves, announced in 2016, confirmed a prediction Albert Einstein made a century earlier based on his general theory of relativity. Monash University researcher Shanika Galaudage, a collaborator in the Australian branch of the project known as OzGrav, described gravitational waves as a game-changing "new window into the universe."

"Another space agency, about one-tenth the size of NASA, is thinking outside of the planet-sized box in its search for Martian life," reports CNET: With its Martian Moons Exploration mission (or MMX), the Japan Aerospace Exploration Agency, or JAXA, later this decade will touch down on a world no spacecraft has visited before: Phobos, one of Mars' mystifying moons. Scientists at JAXA, and other astronomers, hypothesize that on this curious moon they may find signs of ancient microbes that were catapulted off the surface of Mars and flung across the cosmos. The remains of these unwitting spacefaring organisms have been untouched for millions of years and, soon, could be plucked from Phobos' face and returned to Earth.

When an asteroid collides with a planet, the planet unleashes a mighty sneeze of dust and rock. The faster the asteroid smashes into the surface, the bigger the sneeze... [I]f the asteroid impact is powerful enough, the sneeze will fling dust and rock into space... Just like a human sneeze contains microbes, the material ejected by a planet may also contain microscopic life — or the remnants of it. If the asteroid death blast doesn't melt the rock and the microbes to mere atoms, there's a chance they can float into the cosmos... Mars is scarred by impacts from drifter asteroids that slammed into the surface over the planet's life. If these impacts were to hit in just the right spot, at just the right angle and just the right time, there's a chance the ejected material would make it to Phobos, Mars' curious, potato-shaped moon. Phobos has the closest orbit of any known moon to its parent body, circling the red planet at a distance of just 6,000 kilometers (3,700 miles), about the same as the distance between Tokyo and Honolulu....

Phobos is practically hugging Mars, and moves around the planet so quickly that if you were to observe it from the surface, you'd be able to see it rise and set twice every Martian day. Its proximity to the red planet has led JAXA scientists and engineers to speculate about the potential for finding the remnants of Martian microbes on the moon's surface. "If Martian life once existed and was widespread elsewhere on Mars, the chance that its dead remains exist also on Phobos is, in my opinion, relatively high," says Ryuki Hyodo, a planetary scientist at JAXA's Institute of Space and Astronautical Science... It's possible, JAXA believes, that Phobos could be a satellite cemetery, unwittingly holding molecular evidence of long-dead microorganisms....

With a planned sample return date of 2029, MMX would be the first time samples have been returned from the Martian sphere. While the space agency estimates just 0.1% of Phobos' soil likely originated on Mars, there's a chance MMX could bring back the first samples of the red planet to Earth.

Long-time Slashdot reader fahrbot-bot shared this report from the New York Times about a "particularly unusual" star about 150 light-years away that's orbited by three planets: What's unusual is the inclinations of the outer two planets, HD 3167 c and d. Whereas in our solar system all the planets orbit in the same flat plane around the sun, these two are in polar orbits. That is, they go above and below their star's poles, rather than around the equator as Earth and the other planets in our system do.

Now scientists have discovered the system is even weirder than they thought. Researchers measured the orbit of the innermost planet, HD 3167 b, for the first time — and it doesn't match the other two. It instead orbits in the star's flat plane, like planets in our solar system, and perpendicular to HD 3167 c and d. This star system is the first one known to act like this...

The unusual configuration of HD 3167 highlights just how weird and wonderful other stars and their planets can be. "It puts in perspective again what we think we know about the formation of planetary systems," said Vincent Bourrier from the University of Geneva in Switzerland, who led the discovery published last month in the journal Astronomy & Astrophysics.

"Planets can evolve in really, really different ways."

So how exactly did the universe come into existence? "A recent astronomical measurement recorded in a laboratory at the South Pole is causing scientists to revisit their theories..." writes Don Lincoln, a senior scientist at the Fermi National Accelerator Laboratory: In the intervening decades [since 1929], observations have only strengthened the case for the Big Bang theory, but they have also made it clear that the theory is incomplete. For instance, in its earliest incarnation, the Big Bang couldn't explain why the universe was so uniform. Astronomers in the Northern Hemisphere who looked deep into space see the same thing on average as ones that live in the Southern Hemisphere. Traditional Big Bang theory predicts that there should be small differences in temperature, clumpiness of large clusters of galaxies and other properties. But both sides look the same.

However, in 1980, physicist Alan Guth proposed an extension to the theory that could reconcile some of the inconsistencies between theory and observation, including the unexpected uniformity. His extension is called cosmic inflation theory and it claims that in the first moments of the birth of the universe it expanded faster than the speed of light.... However, if inflation is true, we should be able to prove it. Although the universe was once glowing hot, the expansion of the universe has cooled it off and that glow has morphed into microwaves that astronomers have been able to detect since 1964. This relic of the Big Bang is called the cosmic microwave background, or CMB. Inflation theory predicts that the microwaves of the CMB should be polarized...

The CMB can be polarized in two ways: B-modes, which are swirly patterns, and E-modes, which are more of a straight-line pattern. And, if inflation theory is correct, we'd expect to see some mix of B-modes and E-modes, while if it isn't correct — in other words, if the expansion of the universe did not happen as quickly as the theory suggests — researchers should only see E-modes... Astronomers used a telescope facility called BICEP-3 (short for Background Imaging of Cosmic Extragalactic Polarization) to study the CMB and its polarization. The telescope's South Pole location, with its altitude of nearly two miles above sea level and incredibly dry air, is an ideal place to conduct this kind of research. BICEP-3 scientists combined their data with measurements at other facilities and found no indication of B-modes originating from the CMB. If B-modes are present in the CMB, they are very small.

So, does that mean that the theory of inflation must be thrown out? No, although the data has disproved some of the simpler theories of inflation, it isn't sensitive enough to rule out the more complex versions. Still, the failure to observe CMB B-modes is unsettling, causing some scientists to go back to the drawing board.

An anonymous reader quotes a report from Green Market Report: Exclusively-natural psychedelic drug discovery company Filament Health Corp. received authorization from the FDA authorization to initiate the first clinical trial using naturally-sourced psychedelic substances. The news caused the stock to jump over 11% in early trading. The company said that this approval is the first for the direct administration of psilocin rather than its prodrug psilocybin and will administer Filament's three proprietary botanical drug candidates. The phase 1 trial is led by the Translational Psychedelic Research Program (TrPR) at the University of California San Francisco (UCSF).

The phase 1 trial has been designed to include 20 healthy subjects and will examine the effects of Filament's three proprietary botanical drug candidates: PEX010 (oral psilocybin), PEX020 (oral psilocin), and PEX030 (sublingual psilocin). As a result of the need for psilocybin to convert into psilocin before becoming active in the human body, the direct administration of psilocin may yield several therapeutic benefits such as faster onset time, greater consistency, increased bioavailability, and lessened side effects. These potential attributes are being studied in the authorized trial. In addition, psilocin is an ideal candidate for sublingual delivery because of the bypassing of the gut, where the conversion to psilocybin is thought to primarily occur. To date, synthetic manufacturers have been unable to produce a stable formulation of psilocin and enter it into a clinical trial. "We are excited to announce this milestone as validation of our ability to cultivate variable psychedelic biomass and transform it into pharmaceutical-grade drug candidates," said Chief Executive Officer, Benjamin Lightburn. "Our innovative technology has allowed us to create IP-protected botanical drug candidates of oral psilocin, sublingual psilocin, and oral psilocybin, and to enter them into an FDA-approved natural psychedelic clinical trial. Our candidates enjoy significant IP protection, unlike most other psychedelics currently under clinical investigation."

Amazon's Kuiper Systems asked U.S. regulators for permission to launch another 4,538 satellites that would bolster its constellation as it competes with Elon Musk's SpaceX for broadband-from-space customers. From a report: The additions would bring Kuiper's constellation to 7,774 satellites, the company said in a filing Thursday with the Federal Communications Commission. The companies are joining a rush to offer internet service from orbits near the Earth, spurred in a part by decreasing launch costs. Low orbits offer minimal lag time for data to bounce between a user on the ground and the spacecraft. Kuiper's request was among nine applications, submitted under an FCC deadline, that requested authorization for a total of more than 35,000 spacecraft. That's more than seven times the number aloft today. Those figures don't include nearly 30,000 additional satellites proposed by segment leader SpaceX, which already has launched more than 1,700 of its Starlink spacecraft.

Uneven vaccine coverage and a relaxation of preventive measures have brought Europe to a "critical point" in the pandemic, the World Health Organization has said, with cases again at near-record levels and 500,000 more deaths forecast by February. From a report: Hans Kluge, the WHO's Europe director, said all 53 countries in the region were facing "a real threat of Covid-19 resurgence or already fighting it" and urged governments to reimpose or continue with social and public health measures. "We are, once again, at the epicentre," he said. "With a widespread resurgence of the virus, I am asking every health authority to carefully reconsider easing or lifting measures at this moment." He said that even in countries with high vaccination rates, immunisation could only do so much.

"The message has always been: do it all," Kluge said. "Vaccines are doing what was promised: preventing severe forms of the disease and especially mortality ... But they are our most powerful asset only if used alongside public health and social measures." Catherine Smallwood, WHO Europe's senior emergency officer, said countries that had mostly lifted preventive measures had experienced a surge in infections.

About half of the world's fossil fuel assets will be worthless by 2036 under a net zero transition, according to research. From a report: Countries that are slow to decarbonise will suffer but early movers will profit; the study finds that renewables and freed-up investment will more than make up for the losses to the global economy. It highlights the risk of producing far more oil and gas than required for future demand, which is estimated to leave $11tn-$14tn in so-called stranded assets -- infrastructure, property and investments where the value has fallen so steeply they must be written off. The lead author, Jean-Francois Mercure of the University of Exeter, said the shift to clean energy would benefit the world economy overall, but it would need to be handled carefully to prevent regional pockets of misery and possible global instability. "In a worst-case scenario, people will keep investing in fossil fuels until suddenly the demand they expected does not materialise and they realise that what they own is worthless. Then we could see a financial crisis on the scale of 2008," he said, warning oil capitals such as Houston could suffer the same fate as Detroit after the decline of the US car industry unless the transition is carefully managed.

Pfizer's oral antiviral drug was found to reduce the risk of hospitalization or death from COVID-19 by 89%, according to interim results from a mid-to-late-stage study announced by the company on Friday. From a report: Antiviral drugs can be a key pandemic-fighting tool, as not everyone will get vaccinated against the virus and it may take years to fully inoculate people in certain countries -- particularly given current gaps in global vaccine supplies. Pfizer CEO Albert Bourla said in a statement that these findings from the phase 2/3 study marked "a real game-changer in the global efforts to halt the devastation of this pandemic." Pfizer's antiviral pill, PAXLOVID (PF-07321332), was developed specifically to treat COVID-19, by blocking activity of the main enzyme the virus needs to multiply. This was co-administered with a low dose of ritonavir, which is widely used in combination treatments for HIV infection.

An anonymous reader quotes a report from The Guardian: The virus that causes Covid-19 does not infect human brain cells, according to a study published in the journal Cell. The findings will raise hopes that the damage caused by Sars-CoV-2 might be more superficial and reversible than previously feared. The study contradicts earlier research that suggested the virus infects neurons in the membrane that lines the upper recesses of the nose. This membrane, called the olfactory mucosa, is where the virus first lands when it is inhaled. Within it are olfactory sensory neurons (OSNs), which are responsible for initiating smell sensations. They are tightly entwined with a kind of support cell called sustentacular cells.

In the new study, Belgian and German researchers claim that the virus infects sustentacular cells but not OSNs. "That is just a critical distinction," said the senior author Peter Mombaerts, who directs the Max Planck Research Unit for Neurogenetics in Frankfurt, Germany. "Once you believe that olfactory neurons can be infected, there is a quick route into the olfactory bulb and then you're in the brain already." The olfactory bulb, at the front of the brain, is where neural input about odors is first processed. If the virus penetrated this structure it could theoretically spread to deeper brain regions where it could do lasting damage -- especially since, unlike OSNs, most neurons are not regenerated once lost. But if the virus only infects the sustentacular cells, then the damage could be less long-lasting. Both pathways could explain the olfactory dysfunction that afflicts an estimated half of all Covid-19 patients. In one in 10 of those, the loss or change of smell is long-term, perhaps permanent. Mombaerts says this could be the result of support for the OSNs breaking down, even if they themselves are not infected. They may function below par, or stop functioning altogether, until the sustentacular cells regenerate.

Scientists identified a specific gene that doubles the risk of respiratory failure from Covid-19 and may go some way to explaining why some ethnic groups are more susceptible to severe disease than others. From a report: Researchers from the University of Oxford found that a higher-risk version of the gene most likely prevents the cells lining airways and the lungs from responding to the virus properly. About 60% of people with South Asian ancestry carry this version of the gene, compared with 15% of people with European heritage, according to the study published Thursday. The findings help explain why higher rates of hospitalization and death may have been seen in certain communities and on the Indian subcontinent. The authors cautioned that the gene cannot be used as a sole explanation as many other factors, such as socioeconomic conditions, play a role. Despite a significant impact from the virus to people with Afro-Caribbean ancestry, only 2% carry the higher-risk genotype. People with the gene, known as LZTFL1, would particularly benefit from vaccination, which remains the best method of protection, the authors said. The findings raise the possibility of research into treatments specific to patients with this gene, though no tailored drugs are currently available.

Google owner Alphabet has launched an artificial intelligence company to discover new drugs. From a report: UK-registered Isomorphic Labs will use technology from its sister company DeepMind to "to accelerate drug discovery, and ultimately, find cures for some of humanity's most devastating diseases," said Demis Hassabis, the head of DeepMind, in a blog post. He added that he would also become the chief executive of Isomorphic Labs. Scientists around the world were awed in July when DeepMind unveiled how its AlphaFold2 technology could be used to predict the shape of every protein in the human body with almost perfect accuracy.

DeepMind's model can solve one of the trickiest problems in biology by taking a sequence of amino acids and mapping the twists and turns of its shape. The algorithm could help replace or enhance painstaking laboratory work to identify the structures of proteins, which dictate how they behave. Pharmaceutical companies and academic researchers are eager to use the tool -- which DeepMind has made available on an open source basis -- to discover new targets for drugs. Its speed could cut the time to discovering innovative treatments, although the process of clinical trials is still likely to take several years. DeepMind said it would use the technology to try to find treatments for Chagas disease and Leishmaniasis, two of the most deadly diseases in the world.

Months-long silences. Mysterious rejections. Here's what's behind the shortages of a critical tool for ending the pandemic. ProPublica: A few weeks ago, a ProPublica reporter decided to test his kids for COVID-19. They had the sniffles, and with a grandparent set to visit he wanted to minimize the risk that they were infectious. This was the problem that quick, cheap COVID-19 tests were supposed to help fix. No need to go to a clinic or wait days for results. Just pick up a pack of tests at a local pharmacy whenever you want, swab your nose and learn within 15 minutes if you're likely to pass the virus along. So the ProPublican went to his neighborhood CVS, hoping to buy the required pack of two for $23.99. They were out of stock. Then he went to Rite Aid. They didn't have the tests either. Then Walgreens, then another CVS. All out of stock. The only supplier with a few tests to offer was his sister, who happened to have a few tucked away. It's a familiar experience for many Americans. But not for people in Britain, who get free rapid tests delivered to their homes on demand. Or France, Germany or Belgium, where at-home tests are ubiquitous and as cheap as a decent cappuccino. So why are at-home tests still so pricey and hard to find in the United States?

The answer appears to be a confounding combination of overzealous regulation and anemic government support -- issues that have characterized America's testing response from the beginning of the pandemic. Companies trying to get the Food and Drug Administration's approval for rapid COVID-19 tests describe an arbitrary, opaque process that meanders on, sometimes long after their products have been approved in other countries that prioritize accessibility and affordability over perfect accuracy. After the FDA put out a call for more rapid tests in the summer of 2020, Los Angeles-based biotech company WHPM, Inc. began working on one. They did a peer-reviewed trial following the agency's directions, then submitted the results this past March. In late May, WHPM head of international sales Chris Patterson said, the company got a confusing email from its FDA reviewer asking for information that had in fact already been provided. WHPM responded within two days. Months passed. In September, after a bit more back and forth, the FDA wrote to say it had identified other deficiencies, and wouldn't review the rest of the application. Even if WHPM fixed the issues, the application would be "deprioritized," or moved to the back of the line.

"We spent our own million dollars developing this thing, at their encouragement, and then they just treat you like a criminal," said Patterson. Meanwhile, the WHPM rapid test has been approved in Mexico and the European Union, where the company has received large orders. An FDA scientist who vetted COVID-19 test applications told ProPublica he became so frustrated by delays that he quit the agency earlier this year. "They're neither denying the bad ones or approving the good ones," he said, asking to remain anonymous because his current work requires dealing with the agency. FDA officials said they simply want to ensure that rapid tests detect even low levels of the virus, since false negative test results could cause people to unwittingly spread the disease. They blame the test shortages on an absence of the kind of sustained public funding that European governments have provided. Without it, manufacturers have lacked confidence that going through the FDA's process would be financially worth the trouble.