Health
Horace Hale Harvey III, a Pioneer in Providing Abortions, Dies at 93
On July 1, 1970, one of the first independent abortion clinics in the country opened on the Upper East Side of Manhattan. New York State had just reformed its laws, allowing a woman to terminate her pregnancy in the first trimester — or at any point, if her life was at risk. All of a sudden, the state had the most liberal abortion laws in the country.
Women’s Services, as the clinic was first known, was overseen by an unusual team: Horace Hale Harvey III, a medical doctor with a Ph.D. in philosophy who had been performing illegal abortions in New Orleans; Barbara Pyle, a 23-year-old doctoral student in philosophy, who had been researching sex education and abortion practices in Europe; and an organization known as Clergy Consultation Service on Abortion, a group of rabbis and Protestant ministers who believed that women deserved access to safe and affordable abortions, and who had created a referral service to find and vet those who would provide them.
What distinguished Women’s Services — a nonprofit that first operated out of a series of offices on East 73rd Street and charged on a sliding scale, starting at $200 — was its counselors. They were not medical professionals, but regular women, many of whom had had abortions themselves. Their role was to shepherd patients through the abortion process, using a model of a pelvis to explain the procedure in detail, accompanying the women into the procedure room and sitting with them afterward. They also reported on the doctor’s performance. It was a model that other clinics would adopt in the months and years to come.
The clinic’s humane approach was in stark contrast to the attitude of many hospital personnel at the time, Jane Brody of The New York Times wrote in 1970. “Don’t make it too easy for the patient,” one administrator put it, summing up the hospital’s philosophy. “If it’s too easy, she’ll be back here in three months for another abortion.”
Women’s Services had some other unique features as well. The waiting areas were cheerfully decorated, with piped-in music, and the operating tables had stirrups cushioned with brightly colored pot holders, a flourish Dr. Harvey, who died on Feb. 14, had brought with him from his days working out of hotel rooms in New Orleans.
Unlike many illegal abortion providers in those pre-Roe v. Wade days, who made the process as bare-bones and speedy as possible in anticipation of a police raid, Dr. Harvey had not only softened the atmosphere of his New Orleans procedure room to make it less terrifying; he had also offered the women cookies and Coca-Cola afterward, to help them recuperate.
“Harvey’s conviction was that even a healthy patient would feel sick, in the face of a cold, sterile hospital environment,” Arlene Carmen and the Rev. Howard Moody, the leaders of Clergy Consultation Service, wrote in their 1973 book about the group, “Abortion Counseling and Social Change From Illegal Act to Medical Practice.” “Since abortion was not a sickness, the atmosphere associated with hospitals needed to be avoided.”
Dr. Harvey was 93 when he died at a hospital in the town of Dorchester, in England, after a fall, his daughter Kate Harvey, said. He had lived in England for many years.
Women’s Services opened with $15,000 in funding from Dr. Harvey. Ms. Pyle, who was the administrator, described in an interview the chaotic early days, as clients poured in from all over the country. The clinic operated from 8 a.m. to midnight, with personnel working two shifts. Ms. Pyle slept on a couch in the building. On average, she said, the clinic performed about 72 abortions a day.
Newspapers wrote glowing reports, singling out Dr. Harvey as an innovator. But after less than a year, Ms. Carmen and Mr. Moody, of the Clergy Consultation Service, discovered to their horror that Dr. Harvey had been operating without a medical license. He had surrendered it in 1969, after the Louisiana authorities learned that he was performing illegal abortions. He had to go, and quickly, before he jeopardized Women’s Services’ legal status.
Dr. Harvey had become an abortion provider to combat what he felt was an epidemic of unsafe abortions at a time when unmarried women were denied access to contraceptives, and when comprehensive sex education was discouraged. Low-income women suffered disproportionally.
As a teenager, raised as a conservative Christian, Dr. Harvey had gone through a period of soul-searching, concluding that he was an atheist. During the Vietnam War, he registered as a conscientious objector; instead of fighting, he worked as a health counselor at a Y.M.C.A. Later, in New Orleans, he set up an independent sex-education program, giving lectures, answering questions by telephone and handing out brochures on college campuses.
To Dr. Harvey, the importance of abortion was the idea of preventing “the loss of potential for women,” Ms. Harvey, his daughter, said. “It was a matter of principle to him.”
Horace Hale Harvey III was born on Dec. 7, 1931, in New Orleans into a once-prominent family that had developed what is known as the Harvey Canal, which became part of the Intracoastal Waterway in 1924. His father, Horace Hale Harvey Jr., was a gambler, and the family was poor; they moved around a lot as he tried various professions, including setting up a loan company. His mother, Florence (Krueger) Harvey, was a secretary.
Horace studied philosophy at Louisiana State University, earning a bachelor’s degree in 1955, and a medical degree there in 1966. In 1969, he received a master’s degree in public health and a Ph.D. in philosophy, both from Tulane University, in New Orleans.
Dr. Harvey moved to England after leaving the New York abortion clinic — a choice he made, his daughter said, because he approved of Britain’s National Health Service. He settled on the Isle of Wight, another considered choice: According to his research, it had the highest average temperature and received more hours of sunlight than anywhere else in England.
Dr. Harvey worked briefly in public health in his new country, advising on cervical cancer screening procedures, but spent most of his time researching aging — to prepare for his own old age — reading philosophy and attending to his duties as a landlord.
He had bought Puckaster Close, a rambling Victorian house, turning it into apartments that he renovated in a style as “quirky and characterful” as Dr. Harvey himself, his son, Russell, said.
In addition to his daughter and son, Dr. Harvey is survived by three grandchildren. His marriage to Helen Cox, a school headmistress, ended in divorce.
Health
Guava for Weight Loss Is a Real Thing—Here’s the Juicy Truth
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Health
Single workout cuts cravings, offering new hope for smokers trying to quit
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If you’re trying to quit smoking, try a brisk walk or bike ride to curb your craving for a cigarette.
Researchers found that just one workout can reduce the urge to light up. But the type of exercise you do and how you do it makes a big difference.
High-intensity, aerobic exercise is most effective at reducing people’s cigarette cravings, a review of 59 randomized controlled trials involving more than 9,000 adults found.
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“Single-bout exercise reduced acute cravings immediately and up to 30 minutes post-exercise, but not longer-term cravings,” the authors of the study, published in the Journal of Sport and Health Science, reported.
Aerobic exercise is the most effective form of exercise for reducing cravings for cigarettes, researchers found. (iStock)
The research team highlighted other key findings from their study of “exercise-based interventions for smoking cessation.”
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Exercise training made people between 15% and 21% more likely to abstain from smoking than those who didn’t exercise, the authors found.
Researchers found that exercise curbs people’s cigarette cravings for up to 30 minutes after they stop exercising. (iStock)
Regular exercise also caused smokers to cut back by an average of two cigarettes per day.
In addition to being a free and accessible method for reducing smoking, exercise is also effective at reducing anxiety and stress, which drive many people to smoke.
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The authors suggest that because exercise boosts feel-good hormones, such as dopamine, and reduces the stress hormone cortisol, smokers who work out feel less inclined to use nicotine as a brain reward.
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Exercise should be integrated into other smoking cessation programs to enhance quit success, the authors concluded.
Exercise releases similar feel-good brain chemicals that people get from cigarettes, researchers suggested. (iStock)
They also noted that none of the trials addressed vaping and recommended that future research target the use of electronic cigarettes.
Health
Hantavirus Vaccines and Treatments Are in the Pipeline
The deadly hantavirus outbreak aboard the cruise ship MV Hondius has put the spotlight on a rare pathogen that typically attracts relatively little attention, even from scientists.
There are no targeted treatments for hantaviruses, which are typically carried by rodents, and no widely available vaccines. So when passengers began falling ill in the middle of the Atlantic Ocean, doctors and public health experts were limited in what they could offer.
“It’s kind of a wake-up call,” said Dr. Vaithi Arumugaswami, an infectious disease researcher at the University of California, Los Angeles. “Our tool kit is almost empty.”
That’s not for lack of trying. A handful of scientific teams around the world have been working — for decades, in some cases — to develop hantavirus treatments and vaccines. But it has not been easy to find funding or nurture commercial interest in medical interventions for a type of pathogen that does not infect humans often and does not spread easily between people.
“It’s not an airborne, highly contagious viral threat, so it hasn’t been as high a priority for groups trying to prevent pandemics,” said Jay Hooper, a virologist at the United States Army Medical Research Institute of Infectious Diseases.
But there are promising vaccines and treatments in development. And some of them, experts said, could be moved through the pipeline rapidly if hantavirus interventions became a priority.
“I do think there are things that are sitting there on the bench that could be quickly developed,” said Dr. Ronald Nahass, the president of the Infectious Diseases Society of America. “But nothing is ready.”
Vaccine development
There are two main types of hantaviruses: Old World viruses, which circulate primarily in Asia and Europe, and New World viruses, which are found in the Americas. The cruise ship outbreak has been linked to a New World virus known as the Andes virus, which is endemic to South America and is the only hantavirus known to spread between people.
There are vaccines that target some of the Old World viruses in Asia, but their efficacy is modest, experts said. And there are no licensed vaccines for the New World viruses, which include the Sin Nombre virus endemic to rodents in the western United States.
But there are some in development. Dr. Hooper and his colleagues have developed a DNA vaccine for the Andes virus, which proved promising in a small phase 1 trial. Under certain dosing regimens, the researchers found, more than 80 percent of participants produced neutralizing antibodies. “It’s pretty amazing,” said Dr. Hooper, who is an inventor on multiple hantavirus vaccine patents owned by the U.S. government. “Getting these kinds of neutralizing antibodies in humans is impressive.”
There were drawbacks, including that the vaccine seemed to require at least three doses. But the vaccine is ready for further development “if there’s a need,” Dr. Hooper said. “We’ve done the science. It’s just other forces that are required to move vaccines forward — markets, government demand.”
Other teams have potential vaccines in earlier stages of development. For instance, Bryce Warner, a hantavirus researcher at the University of Saskatchewan, and his colleagues are exploring a variety of approaches, including a nasal vaccine that they hope might spark a more robust immune response in the airway.
But the research, which is being conducted in hamsters, is still in early stages, and hantavirus vaccine candidates can be challenging to move forward. Scientists lack good large-animal models for hantaviruses, Dr. Warner said, and human cases are rare enough to make trials tricky. “It’s very difficult to conduct a clinical trial when you only have a limited number of cases annually,” he said. “You don’t have the numbers of people to really show a robust effect.”
Drug hunting
Currently, the primary treatment for hantavirus infection is supportive care, which may include supplemental oxygen or heart-lung bypass machines. Doctors also sometimes prescribe an existing antiviral drug, called ribavirin, but there is not strong evidence that it is effective for New World viruses, scientists said.
The hunt for new drugs is underway, though. At U.C.L.A., Dr. Arumugaswami and his colleagues found that favipiravir, an antiviral approved to treat influenza in Japan, inhibited the Andes virus in human cells. They also identified several compounds that had broad antiviral activity, blocking hantaviruses as well as other types of viruses, in human organoids, miniature clusters of tissue that mimic the function of organs.
Other teams have been working to develop therapeutic antibody treatments, often working from blood samples collected from hantavirus survivors. “We were able to isolate the natural antibodies that people are making and basically winnow them down and find one that was really good,” said Kartik Chandran, a virologist at the Albert Einstein College of Medicine in New York. “We actually found several.”
When Dr. Chandran and his colleagues tested these antibodies in hamsters, one produced especially encouraging results: It seemed to work against both Old and New World hantaviruses and was effective even when given relatively late in the course of infection, Dr. Chandran said.
(Dr. Chandran is listed as an inventor on patents for hantavirus antibodies.)
Several other teams have also produced antibodies that were broadly effective in small animals, but that is where a number of potential products have stalled, experts said.
“We have a lead drug, and now what we need is someone to pay the money, which would be something like $40 million, to go the next step,” said Dr. James Crowe, director of the Vanderbilt Center for Antibody Therapeutics. “We have neither government nor foundation nor company support to do that. So we’re just waiting to find a partner.”
(Vanderbilt University has applied for patents related to these antibodies; Dr. Crowe is listed as the inventor.)
Experts said that they hoped the current outbreak might help bring attention to a family of often-overlooked viruses.
“Certainly judging by just my inbox and text messages, there’s a renewed interest in these agents, and renewed interest in maybe at least revisiting where they are in the priority list,” Dr. Chandran said.
Whether that interest can be sustained after the virus fades from the headlines remains to be seen, experts acknowledged.
“Raising awareness never hurts,” Dr. Warner said. “We’ll see whether or not it leads to anything tangible, at least in terms of funding and resources for advancing some of these things that are lacking for hantavirus.”
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