World
CDC recommends Pfizer, Moderna COVID-19 shots over J&J's
Most Americans should be given the Pfizer or Moderna vaccines instead of the Johnson & Johnson shot that can cause rare but serious blood clots, U.S. health officials said Thursday.
The strange clotting problem has caused nine confirmed deaths after J&J vaccinations — while the Pfizer and Moderna vaccines don't come with that risk and also appear more effective, said advisers to the Centers for Disease Control and Prevention.
The panel recommended the unusual move of giving preference to the Pfizer and Moderna vaccines, and late Thursday the CDC's director, Dr. Rochelle Walensky, accepted the panel's advice.
Until now the U.S. has treated all three COVID-19 vaccines available to Americans as an equal choice, since large studies found they all offered strong protection and early supplies were limited. J&J's vaccine initially was welcomed as a single-dose option that could be especially important for hard-to-reach groups like homeless people who might not get the needed second dose of the Pfizer or Moderna options.
But the CDC's advisers said during a meeting Thursday that it was time to recognize a lot has changed since vaccines began rolling out a year ago. More than 200 million Americans are considered fully vaccinated, including about 16 million who got the J&J shot.
New data from unprecedented safety tracking of all those vaccinations persuaded the panel that while the blood clots linked to J&J's vaccine remain very rare, they're still occurring and not just in younger women as originally thought.
In a unanimous vote, the advisers decided the safer Pfizer and Moderna vaccines are preferred. But they said the shot made by J&J's Janssen division still should be available if someone really wants it — or has a severe allergy to the other options.
"I would not recommend the Janssen vaccine to my family members" but some patients may -- and should be able to -- choose that shot, said CDC adviser Dr. Beth Bell of the University of Washington.
The clotting problems first came up last spring, with the J&J shot in the U.S. and with a similar vaccine made by AstraZeneca that is used in other countries. Eventually U.S. regulators decided the benefits of J&J's one-and-done vaccine outweighed what was considered a very rare risk — as long as recipients were warned.
European regulators likewise continued to recommend AstraZeneca's two-dose vaccine although, because early reports were mostly in younger women, some countries issued age restrictions.
COVID-19 causes deadly blood clots, too. But the vaccine-linked kind is different, believed to form because of a rogue immune reaction to the J&J and AstraZeneca vaccines because of how they're made. It forms in unusual places, such as veins that drain blood from the brain, and in patients who also develop abnormally low levels of the platelets that form clots. Symptoms of the unusual clots, dubbed "thrombosis with thrombocytopenia syndrome," include severe headaches a week or two after the J&J vaccination — not right away — as well as abdominal pain and nausea.
While it's still very rare, the Food and Drug Administration told health care providers this week that more cases have occurred after J&J vaccinations since the spring. They occur most in women ages 30 to 49 -- about once for every 100,000 doses administered, the FDA said.
Overall, the government has confirmed 54 clot cases— 37 in women and 17 in men, and nine deaths that included two men, the CDC's Dr. Isaac See said Thursday. He said two additional deaths are suspected.
The CDC decides how vaccines should be used in the U.S., and its advisers called the continuing deaths troubling. In comparing the pros and cons of all the vaccines, the panelists agreed that side effects from the Pfizer and Moderna vaccines weren't as serious — and that supplies now are plentiful.
Nor is J&J still considered a one-and-done vaccine, several advisers noted. The single-dose option didn't prove quite as protective as two doses of the Pfizer and Moderna vaccines. Plus, with extra-contagious virus mutants now spreading, booster doses now are recommended.
For J&J recipients, a booster is recommended at least two months after vaccination. U.S. health officials had previously OK'd mixing vaccines for booster shots.
Several countries, including Canada, already have policies that give preference to the Pfizer and Moderna vaccines. But J&J told the committee its vaccine still offers strong protection and is a critical option especially in parts of the world without plentiful vaccine supplies or for people who don't want a two-dose shot.
While blood clots are rare, "unfortunately cases of COVID-19 are not," J&J's Dr. Penny Heaton said.
The U.S. is fortunate in its vaccine availability and Thursday's action shouldn't discourage use of J&J's vaccine in places around the world where it's needed, said CDC adviser Dr. Matthew Daley of Kaiser Permanente Colorado.
The FDA also warned this week that another dose of the J&J vaccine shouldn't be given to anyone who developed a clot following either a J&J or AstraZeneca shot.
The committee also heard some of the first data on reported side effects of Pfizer vaccinations in younger children. Early last month, the CDC recommended a two-dose series for that age group, and more than 7 million doses have been given so far. But few problems have been reported. Of the 80 reported cases of serious side effects, about 10 involved a form of inflammation that has been seen in male teens and young adults.
20 trapped miners rescued from flooded coal mine in north China
All the 20 miners who were trapped in a flooded coal mine for more than 30 hours in north China's Shanxi Province have been evacuated from the shaft safely at around 5:56 p.m. Friday and sent to hospitals for treatment, the local rescue headquarters said.
The accident took place at around 11 p.m. Wednesday at the coal mine in Duxigou Village, Xiaoyi City. Illegal mining was blamed for the accident, according to a preliminary investigation.
Read: UN leader urges 'concrete' moves on year-end vaccine goal
Rescuers on Friday morning established contact with the miners. The first trapped miner was lifted out of the shaft at around 2:15 p.m. Friday.
UN leader urges 'concrete' moves on year-end vaccine goal
U.N. Secretary-General Antonio Guterres exhorted the world Thursday to make “concrete" progress within days toward a now-distant goal of vaccinating 40% of the global population against COVID-19 before the year ends.
“Vaccine inequity is giving variants a free pass to run wild,” Guterres — working from home because of exposure to the coronavirus — told reporters by videoconference as countries grappled with the spread of the virus' omicron variant.
“The strategy of vaccine hoarding, the strategy of vaccine nationalism or the strategy of vaccine diplomacy has failed. This new variant has demonstrated this failure,” said Guterres, who came into contact last week with someone who tested positive for the virus; it's not clear which version. Guterres has since tested negative but said he’s remaining in isolation until the end of this week.
Also read: Covid-19 pandemic swells number of hungry by more than 50 mn in Asia-Pacific: FAO-UNICEF Report
Scientists have long warned that patchy vaccination raises the risk of worrisome coronavirus variants emerging. That’s because the more the virus spreads, the more chances it has to mutate.
While there are many unknowns about the new omicron variant, the World Health Organization says it’s spreading faster than any other variant to date.
With little more than two weeks to go, 98 countries have yet to meet the WHO's 40%-vaccinated target, Guterres said. Forty countries haven't vaccinated even 10%.
“All countries, especially those that have potential of responsibilities, must take concrete action in the coming days to make greater progress” toward the year-end goal, Guterres said. He added that they need to “be far more ambitious” in moving toward the WHO's next benchmark: inoculating 70% of the world by the middle of next year.
Also read: Vaccine makers racing to update COVID shots, just in case
The head of the vaccine alliance Gavi, which is leading a U.N.-backed push to get COVID-19 vaccines to developing countries, told The Associated Press on Tuesday of early signs that omicron fears are prompting rich countries to start withholding donations to the public-private partnership, which is the lead manager of the U.N.-backed COVAX program.
Roughly 10 billion vaccine doses have been delivered worldwide, the vast majority of them to rich countries. COVAX has delivered just over 700 million.
It initially aimed to distribute 2 billion doses by the end of this year but trimmed the goal in September to 1.4 billion.
Suspected arson in downtown Osaka building leaves 24 dead
A fire that spread from a fourth-floor mental clinic in an eight-story building in downtown Osaka in western Japan on Friday left 24 dead in what police were investigating as a possible case of arson and murder.
Police were searching for a man in his 50s to 60s who witnesses saw carrying a paper bag from which an unidentified liquid was dripping. He may have been among the 24 dead, or is one of the three people who were resuscitated and remain in serious conditions, or may have fled, a police investigator said on condition of anonymity because he wasn't authorized to speak to the media.
Fire officials who reached the building in the major business, shopping and entertainment area of Kitashinchi in Osaka found 27 people in a state of cardiac arrest, said Osaka fire department official Akira Kishimoto.
One woman was conscious and brought down by an aerial ladder from a window on the sixth floor and was being treated in a hospital, he said. Later Friday, 24 people were pronounced dead, the fire department said.
In Japan, the authorities customarily describe those without vital signs as being in "shinpai teishi," or a state of cardiac and pulmonary arrest, and do not confirm deaths until they are pronounced at hospitals and other necessary procedures are done.
A doctor at one of the hospitals treating the victims said he believed many of them died after inhaling carbon monoxide as they had limited external injuries. Police said the cause of deaths could not be determined until the bodies were autopsied.
Also read: Fire guts 4 resorts, 3 eateries in Sajek Valley, no casualties
One of clients said the clinic was popular and was always crowded with 15-20 people waiting, especially on Fridays when special counselling and programs were available for those preparing to return to work after taking a sick leave, NHK said.
Authorities are investigating a possibility that the smoke filled the floor so quickly that the victims had no time to escape, Nippon Television said.
CDC recommends Pfizer, Moderna COVID-19 shots over J&J's
Most Americans should be given the Pfizer or Moderna vaccines instead of the Johnson & Johnson shot that can cause rare but serious blood clots, U.S. health officials said Thursday.
The strange clotting problem has caused nine confirmed deaths after J&J vaccinations — while the Pfizer and Moderna vaccines don't come with that risk and also appear more effective, said advisers to the Centers for Disease Control and Prevention.
The panel recommended the unusual move of giving preference to the Pfizer and Moderna vaccines, and late Thursday the CDC's director, Dr. Rochelle Walensky, accepted the panel's advice.
Until now the U.S. has treated all three COVID-19 vaccines available to Americans as an equal choice, since large studies found they all offered strong protection and early supplies were limited. J&J's vaccine initially was welcomed as a single-dose option that could be especially important for hard-to-reach groups like homeless people who might not get the needed second dose of the Pfizer or Moderna options.
Also read: Pfizer confirms COVID pill’s results, potency versus omicron
But the CDC's advisers said during a meeting Thursday that it was time to recognize a lot has changed since vaccines began rolling out a year ago. More than 200 million Americans are considered fully vaccinated, including about 16 million who got the J&J shot.
New data from unprecedented safety tracking of all those vaccinations persuaded the panel that while the blood clots linked to J&J's vaccine remain very rare, they're still occurring and not just in younger women as originally thought.
In a unanimous vote, the advisers decided the safer Pfizer and Moderna vaccines are preferred. But they said the shot made by J&J's Janssen division still should be available if someone really wants it — or has a severe allergy to the other options.
“I would not recommend the Janssen vaccine to my family members” but some patients may -- and should be able to -- choose that shot, said CDC adviser Dr. Beth Bell of the University of Washington.
The clotting problems first came up last spring, with the J&J shot in the U.S. and with a similar vaccine made by AstraZeneca that is used in other countries. Eventually U.S. regulators decided the benefits of J&J's one-and-done vaccine outweighed what was considered a very rare risk — as long as recipients were warned.
European regulators likewise continued to recommend AstraZeneca's two-dose vaccine although, because early reports were mostly in younger women, some countries issued age restrictions.
COVID-19 causes deadly blood clots, too. But the vaccine-linked kind is different, believed to form because of a rogue immune reaction to the J&J and AstraZeneca vaccines because of how they're made. It forms in unusual places, such as veins that drain blood from the brain, and in patients who also develop abnormally low levels of the platelets that form clots. Symptoms of the unusual clots, dubbed “thrombosis with thrombocytopenia syndrome,” include severe headaches a week or two after the J&J vaccination — not right away — as well as abdominal pain and nausea.
Also read: US expands Pfizer COVID boosters, opens extra dose to age 16
While it’s still very rare, the Food and Drug Administration told health care providers this week that more cases have occurred after J&J vaccinations since the spring. They occur most in women ages 30 to 49 -- about once for every 100,000 doses administered, the FDA said.
Overall, the government has confirmed 54 clot cases— 37 in women and 17 in men, and nine deaths that included two men, the CDC's Dr. Isaac See said Thursday. He said two additional deaths are suspected.
The CDC decides how vaccines should be used in the U.S., and its advisers called the continuing deaths troubling. In comparing the pros and cons of all the vaccines, the panelists agreed that side effects from the Pfizer and Moderna vaccines weren't as serious — and that supplies now are plentiful.
Nor is J&J still considered a one-and-done vaccine, several advisers noted. The single-dose option didn't prove quite as protective as two doses of the Pfizer and Moderna vaccines. Plus, with extra-contagious virus mutants now spreading, booster doses now are recommended.
For J&J recipients, a booster is recommended at least two months after vaccination. U.S. health officials had previously OK’d mixing vaccines for booster shots.
Several countries, including Canada, already have policies that give preference to the Pfizer and Moderna vaccines. But J&J told the committee its vaccine still offers strong protection and is a critical option especially in parts of the world without plentiful vaccine supplies or for people who don't want a two-dose shot.
While blood clots are rare, “unfortunately cases of COVID-19 are not,” J&J’s Dr. Penny Heaton said.
The U.S. is fortunate in its vaccine availability and Thursday's action shouldn't discourage use of J&J's vaccine in places around the world where it's needed, said CDC adviser Dr. Matthew Daley of Kaiser Permanente Colorado.
The FDA also warned this week that another dose of the J&J vaccine shouldn't be given to anyone who developed a clot following either a J&J or AstraZeneca shot.
The committee also heard some of the first data on reported side effects of Pfizer vaccinations in younger children. Early last month, the CDC recommended a two-dose series for that age group, and more than 7 million doses have been given so far. But few problems have been reported. Of the 80 reported cases of serious side effects, about 10 involved a form of inflammation that has been seen in male teens and young adults.
Tornado, storm death toll at 90 after Ky teen's body found
A Kentucky neighborhood ravaged by a tornado by got more bad news Thursday: the body of a missing teenager was found.
Nyssa Brown was the seventh member of her family to die in the tornado that hit Bowling Green last week. Warren County coroner Kevin Kirby said the 13-year-old's body was found Thursday morning in a wooded area near her subdivision.
The girl’s parents, three siblings ranging in age from 4 to 16, and a grandmother also died in the tornado.
Also read: On a single Kentucky street, the tornado killed 7 children
According to Kirby, eight children were among the 12 victims who died on a single street, Moss Creek Avenue. Also among the dozen were five relatives from another family.
Overall, there were 17 storm-related fatalities in Warren County, Kirby said.
The teen's death pushed the total of storm-related casualties in five states to 90, including 76 in Kentucky.
Also read: 8 factory workers dead, 8 missing from US tornado: Spokesman
Powerful typhoon hits Philippines, nearly 100,000 evacuated
A powerful typhoon slammed into the southeastern Philippines on Thursday and was blowing across island provinces where nearly 100,000 people have been evacuated from high-risk areas that could be devastated by flash floods, landslides and tidal surges, officials said.
Forecasters said Typhoon Rai, which had sustained winds of 185 kilometers (115 miles) per hour and gusts of up to 230 kph (143 mph), blew from the Pacific Ocean into the Siargao Islands. There were no immediate reports of casualties or major damage but military and coast guard rescue personnel were helping residents stranded by fast-rising waters.
Disaster-response officials said about 10,000 villages lie in the projected path of the typhoon, which has a 400-kilometer (248-mile)-wide rain band and is one of the strongest to hit the country this year.
The Philippine coast guard said it has grounded all vessels, stranding nearly 4,000 passengers and ferry and cargo ship workers in dozens of southern and central ports. Several mostly domestic flights have been canceled and schools and workplaces were shut in the most vulnerable areas.
More than 98,000 people have been evacuated to safety, the government's disaster-response agency said. Crowding in evacuation centers was complicating efforts to keep people safely distanced after authorities detected the country’s first infections caused by the omicron variant of the coronavirus. Intensified vaccinations were also halted in provinces likely to experience stormy weather.
Also read: Pandemic Olympics endured heat, and now a typhoon’s en route
The Philippines is among the hardest-hit in Southeast Asia by the pandemic, with confirmed infections of more than 2.8 million and more than 50,000 deaths. Quarantine restrictions have been eased and more businesses have been allowed to reopen in recent weeks after an intensified vaccination campaign helped reduce infections to a few hundred from more than 26,000 in September. The detection of the omicron cases this week, however, has set off the alarm and the government renewed calls for people to avoid crowds and get vaccinated immediately.
Gov. Ben Evardone of Eastern Samar province said he suspended vaccinations in his region of nearly half a million people due to the typhoon. More than 70% of villagers in the province have gotten at least one shot, and Evardone expressed concern because some vaccines stored in Eastern Samar will expire in a few months.
Overcrowding is unavoidable, he said, in the limited number of evacuation centers in his province, where more than 32,000 people have been moved to safety.
“It’s impossible to observe social distancing, it will really be tough,” Evardone told The Associated Press. “What we do is we cluster evacuees by families. We don’t mix different people in the same place as a precaution.”
Also read: Typhoon In-fa hits China’s east coast, canceling flights
About 20 storms and typhoons batter the Philippines each year. The archipelago is also located in the seismically active Pacific “Ring of Fire” region, making it one of the most disaster-prone countries in the world.
UK COVID cases hit record; Top doctor warns of worse to come
The U.K. recorded the highest number of confirmed new COVID-19 infections Wednesday since the pandemic began, and England’s chief medical officer warned the situation is likely to get worse as the omicron variant drives a new wave of illness during the Christmas holidays.
Professor Chris Whitty described the current situation as two epidemics in one — with omicron infections rising rapidly even as the country continues to grapple with the older delta variant, which is still causing a large number of infections. Public health officials expect omicron to become the dominant variant across the U.K. within days. Omicron already accounts for a majority of cases in London.
The U.K. recorded 78,610 new infections on Wednesday, 16% higher than the previous record set in January. While scientists are still studying the risks posed by the highly transmissible omicron variant, Witty said the public should be braced for the figures to continue rising in coming weeks.
“There are several things we don’t know,’’ Whitty said. “But all the things we do know are bad, the principal one being the speed at which this is moving. It is moving at an absolutely phenomenal pace.’’
The comments came on the day that the U.K. government implemented new rules ordering masks to be worn in most indoor settings in England and requiring proof of vaccination or a negative coronavirus test to enter nightclubs and large crowded events.
Britain is also accelerating its the national vaccination program, with a goal of offering a booster dose to every adult by the end of December. The government said within days it will open new mass vaccination centers at sports stadiums around the country, including Wembley, the 90,000-seat national soccer stadium in London.
Whitty advised people to limit their social contacts, putting a priority on those that are the most important.
“I am afraid there will be an increasing number of omicron patients going into the NHS, going into hospital, going into intensive care, and exact ratios we don’t yet know, but there will be substantial numbers,’’ he said. “That will begin to become apparent, in my view, fairly soon after Christmas."
Despite the surge in infections, daily coronavirus-related deaths in the U.K. are well below last winter’s peak. Britain recorded 165 deaths on Wednesday, compared with a record 1,820 on Jan. 20.
Public health officials credit widespread vaccination with weakening the link between COVID-19 infections, hospitalizations and deaths.
Meanwhile, Britain is moving forward with a public inquiry into how the government has responded to the pandemic. Prime Minister Boris Johnson on Wednesday announced that Heather Hallett, a former Court of Appeal judge, would chair the inquiry, which is due to begin next spring.
“She brings a wealth of experience to the role and I know shares my determination that the inquiry examines in a forensic and thoroughgoing way the government’s response to the pandemic,” Johnson said.
After pressure from bereaved families, Johnson agreed to hold an inquiry on his government’s handling of the pandemic, which has left more than 146,000 people in Britain dead, the highest toll in Europe after Russia. The probe will have the power to summon evidence and to question witnesses under oath.
The pressure group Bereaved Families for Justice said the announcement of a chairperson was a “positive step” but “comes far too late.”
“We’ve been calling for an inquiry since the end of the first wave, and we will never know how many lives could have been saved had the government had a rapid review phase in summer 2020,” said Matt Fowler, the group’s co-founder. “With the omicron variant upon us, the inquiry really cannot come soon enough.”
Hallett said she would be consulting bereaved families and others on the inquiry’s terms of reference.
“I shall do my utmost to ensure the inquiry answers as many questions as possible about the U.K.’s response to the pandemic so that we can all learn lessons for the future,” she said.
Hallett oversaw inquests into the deaths of 52 people killed in the July 7, 2005 bombings on London’s transit system. Last month, she was appointed to lead an inquiry into the death of Dawn Sturgess, who died in 2018 after being exposed to Novichok, the Soviet-made nerve agent used to poison former Russian spy Sergei Skripal in the English city of Salisbury.
Because of Hallett’s position with the COVID-19 probe, the government plans to find someone else to lead the inquiry to explore allegations of Russian involvement in Sturgess’ death.
5 children die in bouncy castle accident in Australia
Five children died and four others were in critical condition on Thursday after falling from a bouncy castle that was lifted 10 meters (33 feet) into the air by a gust of wind at a school on Australia's island state of Tasmania.
The school was holding a celebration to mark the end of the school year.
The children who died included two boys and two girls in year 6, which would make them 10 or 11 years old, said Tasmania police Commissioner Darren Hine. Police later Thursday confirmed a fifth child died in the hospital.
Five other children were being treated, including four in critical condition. Hine said an investigation is underway.
Also read: On a single Kentucky street, the tornado killed 7 children
Images published by the Australian Broadcasting Corporation showed police officers consoling each other as paramedics provided first aid to victims.
Parents arrived at the school gate to collect their children as helicopters ferried the injured to hospitals.
Tasmania state Premier Peter Gutwein called the incident “simply inconceivable... I know this is a strong and caring community that will stand together and support one another."
Tasmania police commander Debbie Williams told reporters “several children fell from the jumping castle. It appears they may have fallen from a height of approximately 10 meters."
“This is a very tragic event and our thoughts are with the families and the wider school community and also our first responders,” Williams said.
Also read: African children should get world's 1st malaria vaccine: UN
SKorea bans gatherings of 5 or more people amid virus surge
South Korea will prohibit private social gatherings of five or more people nationwide and force restaurants to close at 9 p.m., rolling out the country’s toughest coronavirus restrictions yet as hospitals grapple with the deadliest month of the pandemic.
Prime Minister Kim Boo-kyum said Thursday that the new measures will be enforced for at least 16 days after taking effect on Saturday, saying there’s an urgent need to bring the country to a “standstill” with the delta-driven surge overwhelming stretched hospitals and exhausted medical workers.
Schools in the densely populated capital Seoul and nearby metropolitan areas, where the virus has hit hardest, will also go back to remote learning after fully reopening in November.
The Korea Disease Control and Prevention Agency reported 7,622 new cases on Thursday, close to the daily record of 7,850 set a day earlier. That brought the national caseload to 544,117, with nearly 97,000 added in December alone.
Most of the transmissions were in the capital region, where officials say more than 86% of intensive care units designated for COVID-19 treatment are already occupied amid a spike in hospitalizations and deaths.
More than 890 virus patients died this month, bringing the country’s death toll to 4,518. As of Thursday morning, a record 989 patients were in serious or critical condition.
Read: Global Covid cases top 272 million
“During this period of standstill, the government will reinforce the stability of our medical response capabilities,” said Kim, Seoul’s No. 2 behind President Moon Jae-in, during a virus meeting. “We ask our people to respond to these efforts by actively getting vaccinated.”
The viral surge has been a huge setback for President Moon Jae-in’s government, which had significantly eased social distancing rules in November while declaring a phased return to pre-pandemic normalcy.
While focusing on improving the economy, officials had predicted that the country’s rising vaccination rates would keep hospitalizations and fatalities down. But there has been a surge in serious cases among people in their 60s or older, including those whose immunities have waned after getting inoculated early in the vaccine rollout that began in February.
More than 81% of the population of over 51 million has been fully vaccinated, but only 17% of people have received booster shots.
After hesitating for weeks, officials moderately tightened social distancing rules last week, banning gatherings of seven or more people in the Seoul metropolitan area and requiring adults to verify their vaccination status to use restaurants and other businesses, but such measures didn’t meaningfully slow the virus’ spread.
Jung Eun-kyeong, KDCA’s commissioner, said the country could see daily infections exceed 10,000 or 20,000 in the coming weeks if it fails to meaningfully slow transmissions now. She said that would push the number of serious cases to between 1,600 and 1,900, possibly beyond what hospitals could handle without sacrificing their non-COVID-19 care.
“We are seeing an average of 4,700 new cases in the Seoul metropolitan area, which is significantly higher than the maximum 3,600 level the hospital system could manage,” Jung said during a briefing.
Read: US faces a double coronavirus surge as omicron advances
Health Minister Kwon Deok-cheol said the four-person gatherings limit will only be applied to fully vaccinated adults. Those who aren’t fully vaccinated will be required to eat alone at restaurants, Kwon said. The rules won’t be applied to children 18 years or younger. Restaurants, coffee shops, gyms and karaoke venues will be required to close at 9 p.m., while movie theaters, concert halls and private cram schools will have to close at 10 p.m.