150 million years ago, Laurasia

The massive neck dips, casting a curving shadow on the mossy ground. The dinosaur’s jaws close around its prize. The creature lifts its head, nearly dainty in scale, and contentedly gnaws a mouthful of ferns.

It’s the late Jurassic Period in the super continent of Laurasia, some 85 million years into the reign of the dinosaurs. The animal belongs to a herd of hefty herbivores who spend their days lumbering through an open landscape of conifers and gingkos, horsetails and monkey puzzle trees.

Paleontologists and volunteers gather at the dinosaur dig site near Bluff, Utah.

(Courtesy of Natural History Museum of Los Angeles County)

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It’s 10 tons at least, far longer than it is tall, its seemingly endless neck and tail held parallel to the ground in surprisingly delicate balance.

Stubby ankylosaurs graze in the distance; carnivorous allosaurs stalk for prey. Tiny mammals scamper out of the path of its thunderous footsteps.

One day the dinosaur will have a name: Gnatalie. One day it will crisscross continents that don’t yet exist, coming to rest in the Natural History Museum of Los Angeles County.

But all that is a long way off. On this day in prehistory, Los Angeles still lies beneath a shallow sea.

This far back in time, some details are too fuzzy to make out. We don’t know the dinosaur’s sex. We don’t know how it dies: illness or injury, predators or old age. But we know it lives three or four decades, and eventually the day comes when the dinosaur falls and does not rise again for many, many years.

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A hungry ecosystem devours its flesh and muscle. Rains come and the dinosaur’s bones wash into a river, where they lodge in the sandy bottom. Flowing water covers them in thin blankets of silt.

This is just the beginning.

80 million to 50 million years ago, Laramidia

Above ground, things live and die and disappear. But the dinosaur, encased in layers of sediment, is exempt from this endless cycle of growth and decay.

Millennia tick past. Those layers of soil compress into rock studded with the remains of forgotten creatures. More time goes by, and as the organic material in the bones wears away, water seeps into its place from the surrounding rock.

The water carries minerals, and with enough time — tens of thousands of years, or millions — mineral deposits fill up the bone-shaped cavities in the rock, creating perfect replicas of teeth that once chewed ferns and tibia that held up a giant.

Hundreds of scientists and volunteers spent more than 10 years excavating the fossils after their discovery in 2007.

(Courtesy of Natural History Museum of Los Angeles County)

Volcanoes set off a cascade of chemical changes in the environment that make their way to the subterranean rock. The area becomes rich in celadonite, a soft greenish mineral. Over time, the bones concealed in the ground turn the same emerald hue.

Somewhere in there an asteroid strikes, the planet burns, and the dinosaurs’ era comes to an end. Gnatalie’s fossils, already ancient, lie untroubled in Earth’s crust.

6 million years ago, North America

Continents shift and oceans spread. Unseen forces drive a massive plateau of rock upward, carving spectacular features that one day will have names: Grand Canyon, Arches, Monument Valley. Gnatalie rises with it.

2007, Utah

Time passes. Things happen. Ice ages, cave paintings, nation-states, Bach.

The earth the dinosaurs once trod is now a massive expanse of solid rock. The place where Gnatalie’s remains lie has a name: the Colorado Plateau.

The closest town has a name too — Bluff, Utah. Even that small outpost is miles from the desert where a dozen paleontologists are hiking, looking for signs of long-ago life.

In the rock they spy something that is not rock, something surprisingly green. They mark the place and agree to come back.

2008-2019, Utah

Led by Luis Chiappe, director of the Natural History Museum’s Dinosaur Institute, the paleontologists return with generators and tents and jackhammers and dental picks. Amid hordes of gnats they excavate that first fossil, which turns out to be a damaged leg bone.

Scientists Jonatan Kaluza, Fernando, Alyssa Bell and Pedro Mocho work to excavate fossils at the Gnatalie quarry.

(Courtesy of Natural History Museum of Los Angeles County)

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Beneath it is another one. And another. The Earth spills secrets like it’s been waiting for someone to ask.

Under the rock is a field of fossils, the commingled remnants of camarasaurs, sauropods, crocodiles, ankylosaurs, ornithopods — everything that washed into that long-gone river 150 million years ago.

The team returns every summer, year after year. Strewn throughout the bone bed are massive relics of something no one can quite identify, a mysterious dinosaur more numerous and better preserved than any other animal.

They nickname the unknown species “Gnatalie,” after the pests that plague them as they work.

The green fossils are each wrapped in a plaster jacket and carefully loaded into a truck for the 700-mile drive to the museum at Exposition Park.

2008-2022, Los Angeles

At the Natural History Museum of Los Angeles County, in rooms the public aren’t allowed to wander, preparators carefully clean, weigh and catalog each fossil. At benches they brush and gently scrape dust from fossilized bone, with the gentle dexterity of dentists cleaning Jurassic-era teeth.

Gnatalie, at this point, is a puzzle waiting to be assembled. But nature doesn’t make this game easy.

The staff has to sort through hundreds of fossils. They know they have found some kind of sauropod — a long-necked, long-tailed quadruped. The strange green dinosaur has the neck of a barosaur, a diplodocus-like spine. A review of the quarry’s haul reveals a long length of vertebrae from a single animal that connects the two and solves the riddle: Gnatalie, Chiappe confirms, is indeed a previously undiscovered species.

Various dinosaur fossils lie in temporary storage at Research Casting International in Trenton, Canada.

(Ian Willms / For The Times)

Dinosaurs are hardly ever found in their entirety, and this one is no exception. From a half-dozen fossil skeletons, paleontologists assemble a representative of the Gnatalie species, their best educated assumption of what the animal looked like. On a computer screen, the dinosaur’s internal architecture is put back together for the first time in millennia.

There are plans for this animal. The museum is opening a new welcome center, and space needs something big and bold. The answer is right there in the prep lab — the world’s only green dinosaur skeleton.

Two hundred bones are packed in crates, each in its own custom foam cradle. They are loaded onto trucks with specialized suspension, and a fleet carrying priceless cargo begins the 2,600-mile journey north.

2022-2024: Trenton, Canada

Research Casting International’s unassuming warehouse sits on the bank of a quiet bay about 100 miles east of Toronto. Outside, beavers gnaw at the vegetation around the chilly waters. Inside is a steampunk fossil carnival.

Fossil mounting technicians Nevin Dallman and Kevin Krudwig perform final adjustments on Gnatalie in RCI’s workshop.

(Ian Willms / For The Times)

In one corner the lanky, headless skeleton of a Quetzalcoatl appears ready to take flight. Welding sparks fly nearby as a worker puts finishing touches on the joints in a replica T-rex toe.

The rearing barosaurus in the rotunda of New York’s American Museum of Natural History, the T-rex and triceratops locked in battle in the Natural History Museum’s main hall in L.A. — all of them first took form here in founder Peter May’s workshop.

And in the back of the cavernous warehouse, in a secure hangar, Gnatalie stands for the first time in 150 million years.

It’s 75 feet from nose to end, longer than the letters in the Hollywood sign are tall. A quirk in the fossilized sacrum, a bone in the lower back, means that the animal’s neck curves slightly to the left, giving the impression of a dinosaur turning its head curiously toward an unexpected sight.

Hand-forged armatures connect some 350 bones to an underlying steel skeleton. Two-thirds are real fossils. The remainder are 3D-printed replicas of pieces nature didn’t preserve well, each hand-painted and textured to match the real bone.

As RCI employees walk through remaining work to be done on the mount, museum staff visiting from Los Angeles mark the location of the future hall’s entryway with painter’s tape on the warehouse floor.

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Timelapse video of installation of the 75 feet long dinosaur on display at the Natural History Museum. (Natural History Museum)

“We want that jaw-dropping moment that compels you to want to learn more about the specimen,” says Chris Weisbart, associate vice president for exhibits.

The dinosaur will stand on a specially constructed platform that provides a better view to the public and keeps the neck and tail beyond reach of over-eager visitors tempted to jump up and touch it.

Nature makes most of the decisions about how a dinosaur mount will look, but there is a little room for interpretation within the realm of the scientifically plausible. At the moment, Chiappe, May and paleontologist Pedro Mocho are locked in an intense discussion about the precise positioning of an ulna. Chiappe carries a laptop around the front leg so that Mocho, watching via Zoom from his office in Lisbon, Portugal, can examine the bone.

“It’s a weird angle,” Mocho says finally. The leg needs adjusting.

“We have quite a lot of work to do,” Chiappe says, looking somewhat abashed.

“We have quite a lot of time,” May says with a smile.

2024: Los Angeles

On Sunday the Natural History Museum of Los Angeles County will open the long-awaited $75-million NHM Commons expansion.

Earlier in the year the museum asked the public to name their new dinosaur — not the species, which will get its scientific moniker when the long process of publishing the discovery is complete, but the mounted skeleton that people will come to visit, the green dinosaur that belongs to L.A. alone.

Visitors and media view Gnatalie in the new Welcome Center at the NHM Commons on Nov. 13.

(Genaro Molina / Los Angeles Times)

They threw out some options. Sage, for the native plant and earthy green color? Olive, a symbol of peace? Dinosaur enthusiasts voted to keep the name that stuck as soon as it came out of the Earth: Gnatalie.

Gnatalie will spend the rest of its fossilized existence welcoming visitors, its head arcing gently toward the windows, bony face turned toward the future Lucas Museum.

The height of the hall’s doors means that the shorter a visitor is, the better their perspective. Children coming to see the green dinosaur will gasp before their parents do. Small mammals will scamper at Gnatalie’s feet again.

The pulse oximeter, a device that measures the degree to which red blood cells are saturated with oxygen, is one of healthcare’s most fundamental tools.

So when Dr. Noha Aboelata learned that research stretching back decades showed that the devices routinely failed patients with darker skin tones, she took action.

Aboelata, the founder and chief executive of East Oakland’s Roots Community Health Center, urged the Food and Drug Administration to require makers of pulse oximeters to test their devices on people of color, and to warn consumers about the risk of false readings.

Attorneys for Roots wrote to companies that made or sold pulse oximeters in California, asking them to improve their products and disclose their limitations. When none responded, the clinic filed a lawsuit to force a change in practices.

A year later, Roots and Aboelata are celebrating their first wins.

Minneapolis-based Medtronic, a leading provider of the devices to hospitals, reached a settlement with Roots last month.

Medtronic agreed to provide brochures and advisory labels on pulse oximeters sold to California hospitals, informing users that the devices can artificially inflate blood oxygen estimates on patients with darker skin. In exchange, Roots dropped its claims against the company.

In a statement, Medtronic said it “looks forward to working with Roots, the FDA and other key stakeholders to ensure health equity can be achieved through technology, educational efforts, and partnerships.”

Three other companies that sell directly to consumers also agreed to place informational labels on their products.

The suit is proceeding against CVS, Walgreens, GE HealthCare and five other defendants that have not settled, Roots attorney Jonathan Weissglass said.

CVS and GE said they wouldn’t comment on pending legislation. Walgreens didn’t immediately respond for comment, but said earlier this year that it also would not comment on pending litigation.

The settlements are a step toward resolution for a pervasive yet frequently overlooked problem that has haunted medicine for decades.

“This pulse ox issue should never have been allowed to happen, and once it was known, it should not have been allowed to continue,” Aboelata said. “I’m still talking to people every week who don’t know about it.”

A pulse oximeter shines a light that passes through the patient’s skin, blood and tissues, and then measures how much light comes out the other side. They’re typically clipped on a fingertip.

Before pulse oximeters were widely adopted in the 1980s, the only way to gauge a patient’s blood oxygen saturation was to draw blood from their arterial vein, a painful procedure that had to be followed by immediate laboratory analysis.

Oxygen-rich blood absorbs more infrared light. So does melanin, the pigment that helps determine skin, hair and eye color. As a result, patients with darker skin tones are more likely to get pulse oximeter readings that show their blood oxygen saturation to be higher than it actually is.

As early as 1990, researchers noted that Black patients were more likely to get deceptively high “pulse ox” readings when hypoxic, or suffering from low oxygen.

In 2005, UC San Francisco’s Hypoxia Research Laboratory found the devices were more likely to overestimate oxygen saturation in patients with dark skin than in those with light skin, results the lab confirmed in a follow-up study two years later.

Yet many providers — including those like Aboelata, who focused on addressing racial inequities in healthcare — were unaware of this data. This became a matter of life and death during the COVID-19 pandemic, when pulse oximeter readings became the primary metric hospitals used to determine who should get care.

CDC guidelines instructed providers to start anyone with pulse ox readings below 90% on oxygen therapy.

A 2020 study of thousands of patients at the University of Michigan found that Black patients, compared with white patients, had nearly three times the rate of “occult hypoxia” — low blood oxygen that goes undetected because pulse oximeter readings are in the normal range.

After reading the study, a pharmacist and cardiologist from the University of Michigan looked at 204 patient records from their hospital.

In a study published in February, they found that Black patients’ blood oxygen readings on pulse oximeters were on average 6% higher than the actual blood oxygen levels measured in their arterial blood samples. In contrast, pulse oximeters overestimated white patients’ blood oxygen by just 1% on average.

Artificially high blood oxygen readings could lead physicians to underestimate how much blood is pumping from a patient’s heart or overestimate the degree of resistance in the patient’s vascular system, the researchers said.

“Those sorts of measurements can impact how we care for patients with heart failure, and can impact their candidacy for more intense treatment options like heart transplants and heart pumps,” cardiologist Dr. Scott Ketcham said.

Currently, the FDA recommends — but doesn’t require — that pulse oximeter makers ensure that in their clinical trials, either two participants or 15% of total participants are “darkly pigmented” people, a definition open to interpretation.

In February 2021, the FDA issued a safety notice cautioning users that pulse oximeters can be thrown off by a number of variables, including skin pigment.

In February, an agency advisory panel recommended that the FDA require that new devices be tested on at least 24 people whose skin tones collectively span the Monk Skin Tone scale, a 10-color palette often used to train artificial intelligences to recognize people of different colors.

The proposal would divide the scale into three parts, with each part represented by at least 25% of study participants.

Though the FDA indicated that it would issue new guidelines for pulse oximeter manufacturers by Sept. 30, it has not done so yet. The agency is working to release the updated guidance “as expeditiously as possible,” a spokesperson said.

The FDA also funded a study at UCSF’s Hypoxia Research Laboratory to better understand the relationship between skin pigment and pulse ox accuracy. The research team is preparing its results for publication now, said Dr. Phil Bickler, director of the UCSF lab and an investigator on the study.

Until then, making sure their devices work equally well for users of all skin tones is optional for manufacturers.

When Manhattan Beach-based BodiMetrics, a maker of wearable health monitors, sought FDA clearance for its most recent smart ring fitness tracker, the company opted to broaden the range of skin tones represented in its study population. One-third of its study population had darker skin pigment, compared with the FDA-recommended minimum of 15%.

“It’s a lot more money to do the clinical studies [to] prove that we didn’t have a pigmentation problem,” BodiMetrics founder and chief operating officer Neil Friedman said. “But that was our goal … to make sure that people had a device that properly measured their blood oximetry and prevented them from being misdiagnosed or potentially dying.”

Canadian health officials announced Tuesday that a teenager infected with H5N1 bird flu from an unknown source is in critical condition.

According to British Columbia Provincial Health Officer Bonnie Henry, the child is suffering from acute respiratory distress and was hospitalized on Friday.

The teen is the first presumptive case of H5N1 bird flu in Canada.

“Our thoughts continue to be with this person and their family,” said Henry.

Authorities believe the virus was acquired via an animal source; however, the teen was not on a farm nor near any known wild birds or backyard poultry — common reservoirs for the disease.

According to a CBC interview with Henry, the teen did not have any contact with birds but did interact with a variety of other animals — including a dog, cats and reptiles — in the days before becoming ill. Testing on those animals has so far been negative.

The health authorities are also tracing people the teen was in contact with; so far they have not identified other infections.

The situation is “horrifying,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University. “The idea that we have a child, a teenager, who is seriously ill from this virus is just really an utter tragedy. But sadly, it’s not surprising, given everything we’ve known about H5N1 and its potential to cause illness.”

She noted that since the late 1990s, when this current strain of bird flu originated in China’s Guangdong province, the fatality rate was close to 60%. That number is likely inflated, she said, as presumably most people tested for the disease were those who went to hospitals or clinics to seek treatment; people who had mild symptoms, or were asymptomatic, were likely not tested.

Nevertheless, Nuzzo said, while this virus could “be a lot less deadly than what we’ve seen to date,” it could still be far more deadly than any pandemic we’ve seen in a long time, including COVID.

She said the case causes her concern for three reasons: The first is the severity of the teen’s illness. The second is that “we don’t understand how the teenager got infected,” she said. Her third concern is how government officials are dealing with this outbreak, which she described as “letting it continue to spread from animals to people, without trying to do more to get ahead of it.”

She said the virus may in the end not end up becoming more virulent or efficient at moving between people, “but I don’t think we want to wait around and on the chance that it might.”

Since the virus appeared in North American wild birds in 2021, human cases have mostly presented as mild. Since 2022, there have been 47 human cases in the U.S. — 25 in dairy workers, 21 in poultry workers, and one case in Missouri where the source has not yet been identified.

However, a recent study from the U.S. Centers for Disease Control and Prevention shows the virus is more widespread in dairy workers than had previously been assumed. An examination of antibodies in 115 dairy workers from Michigan and Colorado showed that eight people were positive for the disease, or 7% of the study population — indicating that either workers were not reporting illness, or they were asymptomatic.

Nuzzo also pointed to a recent study published in Nature, led by Yoshihiro Kawaoka, an H5N1 expert at the University of Wisconsin, in Madison, that showed the virus that infected the first reported dairy worker in Texas had acquired mutations that made it more severe in animals as well as allowing it to move more efficiently between them — via airborne respiration.

When Kawoaka exposed ferrets to this viral isolate, 100% died. In addition, the amount of virus they were initially exposed to didn’t seem to matter. Even very low doses caused mortality.

Kawoaka told The Times in an interview that the mutations seen in this particular isolate have appeared elsewhere in past outbreaks in birds and mammals, “so in that sense, it’s a very orthodox mutation.”

On Wednesday, Canadian health authorities announced they had genetically sequenced the virus in the teen, and it is the newer D1.1 version that has affected poultry flocks in the Pacific Northwest this fall, and was likely carried by wild birds migrating south. It is not the version being seen in dairy cows or dairy workers, which has been called B3.13. Both are of the H5N1 2.3.4.4b clade that has been wreaking havoc across North and South America since 2021, and in Europe, Asia and Africa since 2020.

Fortunately, the mutated isolate that infected the lone dairy worker in Texas has not been seen since. It’s unclear why the worker did not present with more severe symptoms.

However, there are a few hypotheses.

Kawaoka’s research shows “inefficient replication” of the virus in human corneal cells. If the worker was exposed by a splash of contaminated milk to the eye, or a rub of the eye with a contaminated glove, the virus may have been stalled out — unable to replicate like it could have had the worker been exposed via inhalation.

Nuzzo said there are other hypotheses — which she stressed are just hypotheses — including one that posits people who were exposed to the H1N1 swine flu outbreak in 2009 may have acquired some immunity to the “N1” part of the virus.

The other goes back to a person’s first influenza exposure.

There is a scientific hypothesis called the “original antigenic sin” that suggests that a person’s first exposure to a particular virus “may sort of kind of set the tone” for that person’s immune system going forward — so this worker’s first flu exposure may have provided his immune system with the defenses needed to suppress H5N1.

“There are a lot more questions than answers at this point. So there are a lot of interesting hypotheses for why the more recent cases have been mild, there’s not enough evidence to simply discard more than two decades worth of evidence about this virus that tells us that it could be quite deadly,” said Nuzzo.

As human flu season ramps up, Nuzzo said it’s critically important that people do what they can to prevent the spread of disease.

She said both seasonal flu and H5N1 vaccines should be provided to dairy workers.

Unfortunately, she said, “our surveillance efforts for trying to find outbreaks on farms, while getting better, are still not even close to what we need to know about these outbreaks.”

In the meantime, vaccines and antiviral medications need to be on hand.

“The news of a deeply serious human case of bird flu is a massive wake-up call that should immediately mobilize efforts to prevent another human pandemic,” said Farm Forward Executive Director Andrew deCoriolis. “We could have prevented the spread of bird flu on poultry farms across America, and we didn’t. We could have prevented the spread of bird flu on dairy farms, and we didn’t.”

“Factory farms notorious for raising billions of sickly animals in filthy, cramped conditions provide a recipe for viruses like bird flu (H5N1) to emerge and spread,” said deCoriolis in a statement. “We are now on the cusp of another pandemic and the agencies responsible for regulating farms and protecting public health are moving slower than the virus is spreading.”

As of Wednesday, there have been 492 dairy herds infected with H5N1 across 15 states. More than half, 278, are in California. Two pigs in Oregon have also been infected.