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Omicron is the 15th letter of the Greek alphabet…and yes, the COVID-19 variant that carries its name is the 15th “variant of concern” since the Alpha variant first arrived in the US over two years ago. Delta was the only other one that got really (in)famous…but all of your favorite fraternity and sorority letters have had their named variants too.
The current surge is a massive one because Omicron is extremely contagious.
And, just like previous variants, it is transmissible by asymptomatic (or pre-symptomatic) individuals for several days.
That’s the main reason why it is so difficult to contain.
Since the beginning of the pandemic, the Johns Hopkins Coronavirus Resource Center reports over 69 million confirmed cases and over 860,000 deaths related to COVID in the US. (Global numbers are over 343 million cases and 5.5 million deaths as of January 21, 2022.)
There is not one person, one industry, or one corner of the world that has not felt the impact of this scourge.
Pandemic fatigue is real. We are all desperate to return to normal, but most of us aren’t even sure what normal even looks like anymore.
It can sometimes feel like all the news is bad news…but there are several reasons to be hopeful in 2022.
Many people who are exposed to Omicron will not develop any symptoms at all.
For those who do develop symptoms, the onset will typically be 2-3 days after exposure and commonly include fever, headache, sore throat, sinus congestion, cough, and gastrointestinal symptoms like heartburn and diarrhea.
Omicron patients are far less likely to experience the loss of smell and taste that was so common with previous variants. For most people, these symptoms are mild to moderate in intensity and resolve completely within 10 days.
Note: Although it’s true that “most” people with Omicron will have a mild/moderate illness, it’s also true that individuals who have been vaccinated and/or boosted are more likely to have a mild course and have a significantly lower risk of hospitalization and death than unvaccinated individuals.
The Omicron variant is now the dominant strain worldwide and in the US. It spreads much more easily than previous strains but it also causes less severe disease.
This explains the phenomenon of “uncoupling” which refers to the extremely high caseloads with relatively lower levels of hospitalizations and deaths relative to previous strains.
Although Omicron is less likely to cause severe disease, there are still over 150,000 people currently hospitalized with it in the US, and over 25,000 of them are in intensive care.
It’s no picnic.
But, the challenges of the last two years have led to advances and improvements in the way that we treat Covid patients, both at home and in the hospital. Antiviral medications and monoclonal antibodies are being used in an outpatient setting, and hospital and ICU care has advanced dramatically for the sickest patients.
Early in the pandemic, it became clear that older people and those with chronic conditions, including obesity, were at greater risk for more serious diseases if they contracted COVID-19.
That remains true, but new science has shown that individuals who are overweight or obese now have a new problem to worry about.
Obesity may impact the effectiveness of Covid vaccines.
A new study suggests that lean or normal-weight individuals have a more robust antibody response after a COVID vaccine.
This may result in a shorter duration of protection and/or lower vaccine effectiveness in obese or overweight individuals. Additional studies demonstrate that elevated blood pressure and excessive abdominal fat lead to suboptimal antibody responses after vaccination.
If you needed another reason to lose weight and get your blood pressure in control…you’ve got it.
There are two main technologies that are used to determine whether or not an individual has COVID. Both methods use a nasal or throat swab to collect the sample to be tested.
- Polymerase Chain Reaction (PCR): PCR is a technique that replicates tiny amounts of genetic material so that it can be detected. It is the most reliable way to diagnose COVID but PCR tests can take 24-72 hours to provide results.
- Rapid Antigen Test: Antigens are specific proteins on the surface of a virus that can be detected using technology and tools that are similar to the way we test for hormones in pregnancy. One line = negative. Two lines = positive.
Both PCR and Rapid tests can be expected to remain positive for 7-10 days after initial infection.
In some cases, tests may remain positive for significantly longer.
This persistent positivity has prompted the CDC and many other health authorities to modify isolation and quarantine regulations to include the days since exposure, symptom onset, or first positive test in the regulations.
There is also a blood test that can look for antibodies that were made by the immune system in response to either infection or vaccination.
Antibodies can days to weeks to develop after infection and may remain in the blood for months after recovery. As such, antibody tests are not useful for diagnosing an active COVID infection.
COVID-19 Vaccine Update:
The Congressional Budget Office estimates that the Federal Biomedical Research and Development Authority alone has spent over $20 billion on COVID vaccine development.
Future estimates suggest that US spending on COVID vaccine research, development, and deployment will soon reach $50 billion.
The return on that massive investment is extremely difficult to calculate.
Covid vaccines are different than other vaccines in both form and function.
Let’s start with function.
The first vaccine ever developed and deployed at a population scale was for smallpox.
That was over 200 years ago in 1798.
Since then, the list of diseases that have available vaccines in the US has grown to 24 different infectious diseases…with COVID being number 25. (The number of vaccines is far greater because there are multiple vaccines for single illnesses and combinations of vaccines for multiple illnesses.)
Up until COVID surged into our lives…it was a matter of fact that vaccines were used to prevent illness.
The idea was that if you got the vaccine…you would not get the infection, nor could you pass it on to someone else.
COVID changed that.
Unlike our other vaccines, COVID vaccines do not reliably prevent transmission of the illness.
But, they do make it less severe, less likely to result in hospitalization, and less likely o result in death.
Those are all good things indeed…but we can all agree that preventing the infection entirely would be better.
COVID vaccines are also different in terms of form.
That is, they are new and structurally different than all of the other available vaccines.
The difference is that COVID vaccines like the ones made by Pfizer and Moderna employ a technology that is based on mRNA.
(Note: The Johnson & Johnson COVID vaccine does not use mRNA technology…it is more similar to our more traditional vaccines that use inactivated viruses.)
Messenger RNA (mRNA)
If you think of DNA as the original manuscript or the source code…mRNA is a bit like a screenshot that can be copied, pasted, and sent. mRNA carries genetic code from DNA inside the nucleus out to ribosomes which are where protein manufacturing occurs.
In other words, mRNA brings the blueprints to the protein factory.
Messenger RNA really is a messenger molecule.
In the case of mRNA vaccines, mRNA that was created in a laboratory provided the blueprints for the manufacture of a very specific type of protein called an antibody.
Antibodies are proteins that can bind to specific sites on a virus.
When they lock on, they sound a biochemical alarm that attracts immune cells to the virus to kill it and dispose of it.
mRNA does not enter the nucleus of a cell, and it does not alter DNA.
It simply provides an instruction manual for the manufacture of an antibody that is specific to the spike protein of the coronavirus that causes COVID.
Once those antibodies are made, the mRNA from the vaccine is destroyed.
Although mRNA vaccine technology is new and almost seems like science-fiction, there are several reasons that mRNA vaccines have an advantage:
- Adjuvants: Chemical adjuvants are ingredients that are added to traditional vaccines to stimulate a stronger immune response. Because mRNA vaccines work differently than traditional vaccines, they do not require the same adjuvants, so the ingredient list is actually “cleaner” than many traditional vaccines.
- Preservatives: mRNA is an unstable molecule that requires extremely cold temperatures to maintain its integrity. Those cold temperatures reduce the need for extra preservatives which are required in traditional vaccines.
There also appears to be at least one significant disadvantage to mRNA vaccines compared to older vaccine technology…the protection that they provide does not last as long.
It appears that the protection that mRNA vaccines for COVID provide “wears off” after about 6 months. And that brings us to the discussion of boosters.
The CDC currently recommends booster shots for everyone 12 years and older.
Booster eligibility begins five months after getting the second dose of the Pfizer or Moderna vaccines or two months after a single dose of the Johnson & Johnson vaccine.
In the scientific community, there is a strong consensus that boosters are useful for people over age 50.
In younger individuals, and in those who have had a recent COVID infection…the question of boosters remains far from settled.
The current data does suggest that booster shots do indeed confer additional benefit against the Omicron variant.
Boosted individuals, regardless of age, have a milder illness and less risk of hospitalization and death than those who have not had the booster.
But, Omicron tends to run a fairly mild course anyway…and, although the vaccines are generally safe and well-tolerated for most people, they are not risk-free.
As of January 21, 2022, there have been over 530 million doses of the COVID vaccine administered in the US. (There have been over 9 billion doses administered worldwide.)
That is a lot of vaccines.
Given the massive scale of the COVID vaccine campaign, it’s quite clear that COVID vaccines are generally safe.
But, they are not 100% safe. mRNA vaccines have been associated with:
- Common side effects: mRNA vaccines often cause pain, redness, and swelling in the arm where the injection was given. In the 24-48 hours after the injection, commonly reported side effects to include: fatigue, headache, muscle pain, chills, fever, and nausea.
- Lymph node swelling: It is common for axillary (armpit) lymph nodes to become enlarged on the side where the COVID vaccine was administered. The enlargement can persist for several weeks after the vaccine. Because axillary lymph node enlargement can also occur in breast cancer, this otherwise minor side effect can strike fear in many women after the vaccine. As a result, many experts are now recommending that women avoid unnecessary testing and delay mammograms and for one month after getting a COVID vaccine to allow time for enlarged lymph nodes to subside.
- Anaphylaxis: This is a severe allergic reaction that has been reported in approximately 5 people per million who receive a COVID vaccine.
- Thrombosis with thrombocytopenia syndrome (TTS): This is a rare blood clotting disorder that has been reported after the Johnson
& Johnson vaccine at a rate of 57 cases per 17 million doses.
- Guillain-Barré Syndrome (GBS): This is a neurological disorder that has been reported at increased rates after J&J vaccines. At present, there appears to be no increase in GBS with mRNA vaccines.
- Myocarditis and pericarditis: Myocarditis is inflammation of the heart muscle. Pericarditis is inflammation of the lining that surrounds the heart. Both are serious and painful, but not usually life-threatening. As of January 2022, CDC and FDA have verified 1,213 reports of myocarditis after a COVID vaccine, typically in males younger than 30 who have received an mRNA vaccine.
It’s important to remember that over 9 billion doses of the COVID vaccine have been administered globally, over 530 million doses of which have been injected into the arms of Americans.
That is a lot of people.
And tragically, even if COVID (or COVID vaccines) never existed…some of those people would get sick and some of them would die.
But, COVID does exist.
And so do COVID vaccines.
And some of the people who got one of those 9 billion doses of COVID vaccine will get sick and die in the days to weeks afterward.
Whether the vaccine was directly involved in that sickness or death is not always so easy to sort out.
In public health, there is no such thing as zero risk.
COVID has risks.
Vaccines have risks.
Societal shutdowns have risks.
We need to consider them all.
And then, the goal in any public health initiative should be to choose the path that leads to the lowest total risk.
We call that total harm reduction.
It is also critical to point out that the path to total harm reduction for any one individual might be different than the path for another individual.
And, perhaps more importantly the path to total harm reduction for an entire country, might be different than the path for any one individual in that country.
It is precisely that divergence that has led to all of the social and political drama we see playing out all around us.
I believe that the outcome of any infection (including COVID) can be improved with attention to the health of the immune system.
This pandemic should be seen as an opportunity to shore up our defenses and improve the chances that we come out the other side in one piece.
Here is a list of the most important ways that you can support your immune system:
But first, a disclaimer:
I’m not a virologist, immunologist, epidemiologist, or infectious disease expert.
The approach that I have always taken and the one that still makes sense today is rooted in the idea that:
Every infection is a RELATIONSHIP.
It’s a relationship between an organism (in this case, a coronavirus) and a host (in this case, you.)
The outcome of that relationship depends on factors related to both the organism AND the host.
In much the same way that a cheetah catches and kills the weakest/slowest antelope in the herd…the coronavirus does the same thing.
The healthy, fast antelopes at the front are more likely to be spared….it’s the ones who are at the back of the pack (older, weaker, sicker, etc) who are most vulnerable.
So…when an organism like this is in the community…it’s like the cheetah on the prowl. You need to do everything you can to stay at the front of the pack.
Below, you’ll find my list of top ten natural approaches to keeping your immune system strong…to keep you at the front of the pack.
But before we get to that…my second disclaimer:
The suggestions below have not been proven as treatments for COVID-19, nor are they substitutes for the advice from your physician or local public health authority. The strategies below are reasonable and they are safe, and as such …I believe that these suggestions are worth a try.
1) Social Distancing: I know it feels like “everything” is canceled, but I’d like to remind you that:
- Your family is not canceled.
- You can still call your friends.
- Your imagination still works.
- Conversations aren’t canceled.
- Music is still here.
- Long walks are still allowed.
- The beach, the mountains, the lakes, the rivers, the woods…still open.
- Books have been waiting for you.
- Hope is still alive.
- And…self-care is open for business.
2) Foods To Eat: The best fuel for your immune system is a minimally-processed, plant-based, anti-inflammatory diet. That means eating foods that come from farms and fields…not factories.
- Eat vegetables, fruit, beans, nuts, seeds, whole grains…and if you choose to eat animal products like meat, poultry, eggs, dairy, make sure that they come from healthy animals that were farmed in an organic, sustainable, regenerative way.
- Eat lots of spices: ginger, garlic, turmeric, oregano, thyme, rosemary all have antiviral and immune-supportive properties.
- Drink lots of green tea. It contains an immune-supportive compound called EGCG. Pro tip: dark chocolate contains EGCG too!
3) Foods To Avoid:
- Avoid added sugar, high fructose corn syrup, and foods or drinks that contain added sweeteners. Honey is the sweetener of choice.
- Avoid the unhealthy fats found in fried food, and foods processed with ultra-processed “vegetable oils”
- Minimize ultra-processed foods in general. Shelf-stable foods in cans, jars etc should only have a shortlist of ingredients that you can read and recognize.
4) The Three S’s:
- Sleep: 7 hours minimum. More if you’re sick. Don’t stay up late watching the “bad news”…turn it off an hour before bed.
- Stress: We can’t eliminate stress, but the way we respond to it is a choice that is in our control. Uncertainty is fuel for anxiety and these are uncertain times. But remember, panic almost never helps anything.
- Smoking: There has never been a better time to stop smoking.
5) Physical activity: The gym is closed. Keep your physical activity going…but keep it gentle. Super heavy exercise can depress immunity while moderate exercise improves immunity. Long walks, hikes, short runs, bike rides…try to move your body outside.
- Hydration: Stay hydrated. No need to overdo it. Consider using your last sip to gargle…believe it or not, there is actually some research that suggests gargling water might decrease the risk of respiratory infection.
- Humidification: Viruses do better in dry air. Consider using a humidifier.
- Hygiene: Yes, hand washing. For at least 15 seconds. Focus on your fingertips.
7) Vitamins and Minerals:
- Vitamin A: Commonly used in doses of:
- 5,000-10,000 IU is a reasonable dose for prevention
- Up to 100,000 IU for three days for treatment
- DO NOT USE in pregnancy, nursing, or liver disease.
- Vitamin C:
- 1-3 grams per day for prevention
- up to 10,000 mg (or 10 grams) for treatment.
- Divide doses throughout the day to improve bowel tolerance
- Vitamin D: Target lab test level of 40-60
- 2000-4000 IU daily
- Prevention: 15-30 mg daily,
- Up to 75 mg daily for treatment.
- Zinc acetate or gluconate in lozenges is probably best.
- Too much in one dose will cause nausea. Divide it up.
8) Other supplements:
- Probiotics: There is an entire ecosystem of microorganisms that live within our bodies. When that ecosystem is healthy, we are more likely to be healthy as well. Take a high-quality probiotic daily.
- N-Acetylcysteine (NAC):
- 1800mg daily in divided dose for prevention.
- Associated with a higher likelihood of asymptomatic infection
- Quercetin: A bioflavonoid compound found in onions. Canadian research is promising for antiviral and
- 1000mg daily.
- Monolaurin: Derived from lauric acid which is found in coconut: 300mg three times per day with food.
- Propolis: An antimicrobial product produced by honeybees. Commonly used in throat sprays.
9) Herbal Medicines:
- Elderberry (Sambucus nigra): One tablespoon syrup two to four times per day. Lots of discussions online about the possibility that elderberries might increase the risk of “cytokine storm” in viral infections. There is no reliable evidence that concerns me.
- Skullcap (Scutellaria baicalensis): Has been studied in China in test tubes against Coronavirus: Typical product in a capsule might contain 350-500mg of a fried herbal extract. Take two of those three times daily.
- Andrographis (Andrographis paniculata): Look for a product that contains andrographolides…shoot for 50-60mg of andrographolides per day.
- Astragalus (Astragalus membranaceus): A famous and well-studied herbal immunomodulator. Look for a product that contains a standardized extract and take about 2 grams, that’s 2000 mg daily.
- Cordyceps (Cordyceps sinensis): Commonly known as the “caterpillar fungus, this is a medicinal mushroom widely known for use in lung disease. Typical doses are about one gram (1000mg) daily for prevention and up to three grams in the case of illness.
- Japanese Honeysuckle (Lonicera japonica): Animal studies have demonstrated an immunomodulatory effect. Often appears in Chinese formulas with Forsythia (below) and other herbs listed here.
- Forsythia (Forsythia suspensa): A beautiful spring flowering bush and a famous Chinese herbal medicine. Herbal formulas for lung infections often include a Forsythia extract.
10) Be Flexible: Have you ever seen a palm tree in a hurricane? They survive the storm because they are flexible. There is a storm coming…we’re going to stay calm, take it day by day, and ride it out together.
And now, my final disclaimer:
The information presented here is for educational purposes only. It is not a treatment or prevention for COVID-19 or any other medical problem. It is not a substitute for medical advice from your personal physician and is not a substitute for the advice from your local, state, or federal authorities
What is a Coronavirus?
Coronaviruses are a large family of viruses that can infect people and many animals, including camels, cattle, cats, and bats. There are many types of coronaviruses, including some that give people a common head or chest cold. Other coronavirus diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) are extremely dangerous but are much less widespread than colds and COVID-19
Coronaviruses are a large family of viruses that can infect people and many animals, including camels, cattle, cats, and bats. There are many types of coronaviruses, including some that give people a common head or chest cold. Other coronavirus diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) are extremely dangerous but are much less widespread than colds and COVID-19.
COVID-19 is a dangerous disease caused by a virus discovered in December 2019 in Wuhan, China. It is very contagious and has quickly spread around the world.
COVID-19 most often causes respiratory symptoms that can feel much like a cold, a flu, or pneumonia, but COVID-19 can also harm other parts of the body.
- Most people who catch COVID-19 have mild symptoms, but some people become severely ill.
- Older adults and people who have certain underlying medical conditions are at increased risk of severe illness from COVID-19.
- Hundreds of thousands of people have died from COVID-19 in the United States.
- Vaccines against COVID-19 are safe and effective.
I’ve heard that putting Vicks VapoRub under your nostrils helps to keep germs out. Is this something that might help to keep someone from getting infected with COVID19?
This is a great question! Alas, like so many things in life, there’s a kernel of truth in this rumor, but it won’t work in practice and could actually make you very sick.
The active ingredients in Vick’s VapoRub are camphor, eucalyptus oil, and menthol, which work together to suppress coughs and produce a warming sensation on the skin that is soothing when you’re sick.
In fact, VapoRub catapulted to popularity during the pandemic flu of 1918 and has been a popular over-the-counter remedy for respiratory illnesses ever since.
Camphor, eucalyptus oil, and menthol all have antibacterial properties, so using them to create a protective barrier between your own nose and the respiratory secretions that cause COVID-19 may seem like a no-brainer.
Unfortunately, besides being extremely uncomfortable, using VapoRub in your nostrils puts you at risk of developing an extremely ominous-sounding illness called exogenous lipoid pneumonia (ELP), which results from the aspiration or inhalation of fat-like material of an animal, vegetable, or mineral origin.
Long story short, the petrolatum base of VapoRub, when inhaled, can travel to the lungs, where it collects and causes ground-glass opacities — a type of damage also associated with COVID-19.
If you’re feeling ill from any respiratory ailment, using VapoRub on your chest or in a vaporizer may soothe your symptoms.
Your healthcare provider can also advise you on other methods to soothe congestion and body aches. But if you’re looking for good ways to prevent the spread of COVID-19, we would suggest that you put down the Vick’s, and reach for the hand soap instead.
This news story has not been updated since the date is shown. Information contained in this story may be outdated. For current information about MIT Medical’s services, please see relevant areas of the MIT Medical website.
Visit our Coronavirus Resource Center for more information on coronavirus and COVID-19.
What does NCCIH do?
We conduct and support research and provide information about complementary health products and practices.
A pharmacist holds a container of chlorine dioxide at the Farmacia Boliviana in Cochabamba, Bolivia.
- Bolivia's new health minister, Edgar Pozo, at a press conference Sunday said consuming toxic bleach chlorine dioxide as a COVID-19 treatment is now permitted.
- It has no medical value and is potentially deadly if consumed, according to medical authorities including the FDA and WHO.
- Despite this, a determined campaign by advocates of the substance, also called Miracle Mineral Solution, persuaded many to take it.
- Business Insider previously reported how lawmakers in Bolivia embraced the substance despite warnings from the nation's own health ministry.
- But last month the old government lost power, allowing the newly-installed Pozo to effectively overturn that advice.
- Visit Business Insider's homepage for more stories.
Bolivia's new minister of health publicly endorsed consuming a type of toxic bleach to treat COVID-19, despite clear evidence of its dangers.
The statement at the weekend by Edgar Pozo was part of a wave of change brought in by Bolivia's new government, which won a recent election after embracing the substance chlorine dioxide as a coronavirus treatment.
It was the latest victory in Bolivia for advocates of chlorine dioxide, also known as "Miracle Mineral Solution," who have found success in the South American nation.
In other countries, advocates have faced prosecution for falsely portraying the substance as an effective treatment.
The toxic substance has been falsely hailed by a sprawling alternative medicine movement as a miracle cure.
Medical authorities including the US Food and Drugs Administration have warned that it is potentially lethal if consumed in large doses, and has no medical benefits.
At a press conference on Sunday, Pozo described the use of the substance, chlorine dioxide, as "permissible."
Here is a video of the event, in Spanish:
Pozo told reporters: "[Chlorine Dioxide] is approved by law, that is to say that access to this alternative medicine is permissible, in a way with which our traditional medical unit is going to begin to produce a broader knowledge about its benefits, about its actions, about the therapeutic approach this substance has."
"We are beginning a process, we are beginning to listen to both medicines and it is our obligation to have to take serious steps, calmly, carefully."
He announced that the ministry would conduct a study into its use, as part of a review of indigenous treatments of the disease.
Although presented in the language of science, Pozo's recommendation cuts across warnings from authorities including the World Health Organization and the US Food and Drug Administration.
The comments risk further fueling the popularity of the toxic substance in Bolivia.
People there have seized on the bleach in the absence of widely available healthcare, activists have told Business Insider.
According to local media reports, people across Bolivia have been hospitalized after taking chlorine dioxide, which is more commonly used in the production of paper.
A front-line medic in September forwarded to Business Insider images of the internal injuries the substance caused to a patient who'd been hospitalized after consuming it.
The embracing of the substance by a national government marks a new triumph for medical misinformation.
Miracle Mineral Solution, or MMS, has long been hailed as the cure for a range of illnesses by a global network of conspiracy theorists.
Pozo's comments are a dramatic reversal of the ministry's stance under the previous government when it warned in June that the substance "puts the health of the population that consumes or intends to do so at serious risk," and said that its popularity was based on rumors and misinformation.
Kate Centellas, an associate professor in sociology and anthropology at the University of Mississippi, told Business Insider that the newly-empowered MAS party had pledged support for traditional medicines as part of its election platform.
But she said that it was too soon to tell if Pozo was offering his unqualified support for legalizing chlorine dioxide.
"Since chlorine dioxide was approved by the MAS senate, I suspect it is difficult to distance himself from it.
I do sense some hedging on his part because he's not allowing it to be considered part of traditional medicine but as something distinct," she said of Sunday's press conference.
The movement advocating MMS as a panacea for a range of illnesses originates in a fake Florida church, whose leader was recently arrested in Colombia for selling the substance.
The US Food and Drugs Administration, the World Health Organization and Spain's leading medical regulator have all issued urgent warnings against consuming the substance.
Last week, the Pan-American Health Organization, in response to its surging popularity in Bolivia, warned in a tweet that the substance "is not a medication."
Business insider has chronicled how a group of renegade medics, COMUSAV, and a German alternative medicine advocate, Andreas Kalcker, began to push the substance as a COVID-19 cure in Bolivia over the summer.
The popularity of the substance spread as authorities struggled to cope with the pandemic.
In what some experts characterized as a ploy to exploit anger at the previous government over its poor response to the pandemic, MAS pushed a bill through the Senate in August legalizing the bleach.
The party has said it wants the substance to be widely available to COVID-19 patients in pharmacies and health centers.
The government of President Jeanine Añez refused to ratify the bill though.
With the sweeping triumph of the MAS in November's presidential election and the appointment of a new health minister, the last obstacle to the legalization of the substance was removed.
Yelena Dzahnova and Ruqayyah Moynihan contributed reporting for this article.