An advisory committee to the Centers for Disease Control and Prevention on Wednesday recommended that adults ages 60 and above, after consulting their doctors, receive a single dose of RSV vaccines from Pfizer and GSK.

The panel said seniors should use “shared clinical decision-making,” which involves working with their healthcare provider to decide how much they will benefit from a shot.

Outgoing CDC director Rochelle Walensky will decide whether to finalize the recommendation.

The panel’s decision moves the U.S. one step closer to making jabs against respiratory syncytial virus available to the public this fall, when the disease typically begins to spread at higher levels.

The recommendation also comes weeks after the Food and Drug Administration approved both vaccines, making them the world’s first authorized shots against RSV. 

The virus is a common respiratory infection that usually causes mild, cold-like symptoms, but more severe cases in older adults and children. Each year, RSV kills 6,000 to 10,000 seniors and a few hundred children younger than 5, according to the CDC. 

Pfizer and GSK on Wednesday both presented new clinical trial data to the panel, which provided a first glimpse of their shots’ durability after one RSV season. The season typically lasts from October to March in the Northern Hemisphere. 

A single dose of Pfizer’s shot was 78.6% effective in preventing lower respiratory tract disease with three or more symptoms through the middle of a second RSV season, according to new clinical trial results presented Wednesday. That’s down from more than 85% at the end of the first season in older adults. 

Pfizer said that efficacy fell to 48.9% at “mid-season two” for less severe forms of the disease in that age group, down from about 66%.

One dose of GSK’s shot was 78.8% effective against severe RSV disease after two seasons, compared with 94% after one season, the company said Wednesday. Severe disease refers to cases that prevent normal, daily activities.

For less severe RSV disease, efficacy declined to 67.2% over two seasons from 82% after one season.

Dr. Michael Melgar, a CDC medical officer who evaluated data on both shots, noted during a public meeting that both Pfizer and GSK still lack efficacy data on subgroups of the elderly population at the highest risk of severe RSV. 

Melgar said adults ages 75 and older and those with an underlying medical condition are underrepresented in the phase three clinical trials from both companies. Seniors with a weak immune system were excluded from the trials altogether, he said. 

Both companies said studies on those populations are ongoing. 

It’s still unclear how much the shots will cost. GSK said it will price its vaccine between $200 and $295. Pfizer said it will price its shot between $180 to $270.

The companies declined to guarantee the pricing.

The shots would help the U.S. combat the upcoming RSV season in the fall after an unusually severe RSV season last year. 

Cases of the virus in children and older adults overwhelmed hospitals across the country, largely because the public stopped practicing Covid pandemic health measures that had helped keep the spread of RSV low. 

“There’s a lot of impressions that, because it was a mild winter, that we’re having an earlier sort of explosion in the ticks that are born,” said Dr. Alexandra Yonts, a pediatric infectious diseases physician at Children’s National Hospital in D.C.

There are still simple ways you can protect yourself and your family.

“Top tips include insect repellent with 20% or higher DEET, wearing long-sleeved clothes,” Yonts said. “And then taking a shower or bath as soon as you come inside. That will rinse the mosquitoes or the ticks off and prevent hopefully infection.”

There are also key places on the body to check, where ticks are more likely to try to hide.

“The first place to check would be on the legs, around the cuffs of socks [and] pants,” Yonts said.

Ticks live in tall grass, wooded areas and small shrubs, according to the Lyme Disease Association, so the bugs are likely to end up low on your body after a hike or a trip to a farm.

“Checking behind the knee crevices sort of in the leg folds or the crotch where the legs meet, the body under the armpits, and in particular, girls with long hair checking under the scalp and in the hair” is important, Yonts said.

If you do find a tick in your search, carefully remove it with tweezers and then save it, if you can.

“We do recommend saving the tick and taking a picture of it,” Yonts said. “And an easy way to do that is to put the tick into a small plastic container and put it in the fridge or the freezer so it  doesn’t crawl around and you make sure it’s dead.”

“You can reach out to your doctor, send them that picture if you have it, and they will give you advice on what to do next,” Yonts said.

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Infected ticks can spread bacteria, viruses and parasites that make people sick. Lyme disease is the most common tick-borne infection in the U.S., with nearly a half-million Americans diagnosed with it each year.

Yonts says, depending on the type of tick you find, you may need to take an antibiotic. But most people recover quickly.

“We really have a beautiful area with lots of wonderful outdoor spaces — Rock Creek Park, surrounding national parks and regional parks,” Yonts said. “And we don’t want to tell people to not enjoy those. So we want you to do it safely.”

Your furry friends also need to be checked for ticks. Pets, especially long-haired dogs, can bring ticks into the home and should be checked every time they go out.

Tick season typically lasts through October.

In a new interview with Self, the singer revealed that she “almost died in January.”

The health scare occurred a few weeks after Kesha underwent an egg freezing procedure. At the time, she was in the Bahamas for a New Year’s Eve performance, when she suddenly felt very weak after the show.

A trip to the hospital revealed that Kesha was experiencing complications from her egg freezing procedure. While she didn’t share many details about the health scare, the star did reveal that she was transferred to a Miami hospital and spent nine days there.

“I finally feel recovered, but it took a couple months,” she said. “It was horrifying.”

Kesha revealed that the frightening yet rare complication she experienced was in part related to her weakened immune system, something she also spoke extensively about in the interview.

The singer said she was diagnosed in 2022 with common variable immunodeficiency (CVID), which the Mayo Clinic describes as “an immune system disorder that causes you to have low levels of the proteins that help fight infections.”

According to the Mayo Clinic, CVID can cause “repeated infections in your ears, sinuses and respiratory system” and an “increased risk of digestive disorders, autoimmune disorders, blood disorders and cancer.” 

Per the National Institute of Allergy and Infectious Diseases, CVID typically occurs in adults but can sometimes affect children. It’s tied to “a variety of different genetic abnormalities” that result in fewer antibodies, but the exact cause of most cases of CVID is unknown, the institute notes.

This is the first time the singer has spoken publicly about her condition, and she explained that she was hesitant to do so at first.

“I just never wanted to be the whiny, privileged girl,” she said. “Also, my image had been that of going out and having fun.”

The road to a diagnosis wasn’t easy for Kesha, who explained that she knew something was wrong when she was excessively tired every day. At first, she simply thought it was a result of her hectic schedule.

“When you’re lucky enough to have a song that catches on, you’re just trying to keep up. I had a really hard time saying no to interviews or photo shoots because I didn’t want to let my one chance fall away by not being able to fulfill every request. It led to severe exhaustion physically and mentally,” she said.

These days, Kesha is taking her health seriously and has learned to say no when she needs to. She’s also prioritizing rest.

“I learned after my diagnosis that sleep is the most important thing. I took that for granted for, God, about 29, 30 years. I feel like I’m just playing catch-up on my teens and 20s, still. But I try to get as much sleep as possible, and I have to protect that fiercely,” she said.

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Research shows bystanders are less likely to give life-saving CPR to certain groups of people in D.C., but some local doctors and D.C. sports teams joined together in the hopes of changing that — and tackling misconceptions about CPR along the way.

“This can happen to a football player, it can happen to your father,” Dr. Miriam Fischer said.

No matter who it happens to, experts say CPR can drastically improve a person’s chance of survival when given in the first few moments of a medical emergency.

A study published in 2022 states that women, as well as Black and Hispanic adults, are less likely to receive CPR from bystanders if they have a cardiac arrest in public in D.C.

“In 2021 alone, 92 out of every 100,000 Americans had an out-of-hospital cardiac arrest. On average, only 40% received bystander CPR and in D.C., we’re even lower than the national average,” Fischer said.

That’s why emergency physicians with MedStar Health made a series of short videos with players and staff from the Wizards, Capitals, Mystics and Georgetown Women’s Soccer to teach D.C.-area residents about the importance of bystander CPR.

“Our practice facility and our arena, our game day arena, are in Ward 8 of the city, which is in Southeast D.C. and, you know, we come face-to-face every day with disparities, right, in the community. So, knowing that Black and brown people and women are least likely to receive CPR from a bystander, should they need it, is kind of a startling statistic,” said Dr. Kala Flagg, the head of athlete rehabilitation for the Washington Mystics.

The three-minute videos will play during games and on the teams’ social media accounts.

Fischer said the videos not only teach the basics of CPR and how to use a defibrillator, but also clear up some misconceptions that keep people from jumping into action.

“You don’t need to be certified. You do not need to do mouth-to-mouth. Most cardiac arrests are from a heart problem. When help arrives, they can deal with breathing. Additionally, you cannot get in trouble for doing CPR. There are good Samaritan laws that protect you, and, finally, you can’t hurt somebody. Their heart has stopped,” she said.

Go here to watch the CPR videos.

Most got dropped for not filling out paperwork.

Though the eligibility review is required by the federal government, President’s Joe Biden’s administration isn’t too pleased at how efficiently some other states are accomplishing the task.

“Pushing through things and rushing it will lead to eligible people — kids and families — losing coverage for some period of time,” Daniel Tsai, a top federal Medicaid official recently told reporters.

Already, about 1.5 million people have been removed from Medicaid in more than two dozen states that started the process in April or May, according to publicly available reports and data obtained by The Associated Press.

Florida has dropped several hundred thousand people, by far the most among states. The drop rate also has been particularly high in other states. For people whose cases were decided in May, around half or more got dropped in Arkansas, Idaho, Kansas, Nevada, New Hampshire, Oklahoma, South Dakota, Utah and West Virginia.

By its own count, Arkansas has dropped more than 140,000 people from Medicaid.

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The eligibility redeterminations have created headaches for Jennifer Mojica, 28, who was told in April that she no longer qualified for Medicaid because Arkansas had incorrectly determined her income was above the limit.

She got that resolved, but was then told her 5-year-old son was being dropped from Medicaid because she had requested his cancellation — something that never happened, she said. Her son’s coverage has been restored, but now Mojica says she’s been told her husband no longer qualifies. The uncertainty has been frustrating, she said.

“It was like fixing one thing and then another problem came up, and they fixed it and then something else came up,” Mojica said.

Arkansas officials said they have tried to renew coverage automatically for as many people as possible and placed a special emphasis on reaching families with children. But a 2021 state law requires the post-pandemic eligibility redeterminations to be completed in six months, and the state will continue “to swiftly disenroll individuals who are no longer eligible,” the Department of Human Services said in statement.

Arkansas Gov. Sarah Huckabee Sanders has dismissed criticism of the state’s process.

“Those who do not qualify for Medicaid are taking resources from those who need them,” Sanders said on Twitter last month. “But the pandemic is over — and we are leading the way back to normalcy.”

More than 93 million people nationwide were enrolled in Medicaid as of the most recent available data in February — up nearly one-third from the pre-pandemic total in January 2020. The rolls swelled because federal law prohibited states from removing people from Medicaid during the health emergency in exchange for providing states with increased funding.

Now that eligibility reviews have resumed, states have begun plowing through a backlog of cases to determine whether people’s income or life circumstances have changed. States have a year to complete the process. But tracking down responses from everyone has proved difficult, because some people have moved, changed contact information or disregarded mailings about the renewal process.

Before dropping people from Medicaid, the Florida Department of Children and Families said it makes between five and 13 contact attempts, including texts, emails and phone calls. Yet the department said 152,600 people have been non-responsive.

Their coverage could be restored retroactively, if people submit information showing their eligibility up to 90 days after their deadline.

Unlike some states, Idaho continued to evaluate people’s Medicaid eligibility during the pandemic even though it didn’t remove anyone. When the enrollment freeze ended in April, Idaho started processing those cases — dropping nearly 67,000 of the 92,000 people whose cases have been decided so far.

“I think there’s still a lot of confusion among families on what’s happening,” said Hillarie Hagen, a health policy associate at the nonprofit Idaho Voices for Children.

She added, “We’re likely to see people showing up at a doctor’s office in the coming months not knowing they’ve lost Medicaid.”

Advocates fear that many households losing coverage may include children who are actually still eligible, because Medicaid covers children at higher income levels than their parents or guardians. A report last year by the U.S. Department of Health and Human Services forecast that children would be disproportionately impacted, with more than half of those disenrolled still actually eligible.

That’s difficult to confirm, however, because the federal Centers for Medicare & Medicaid Services doesn’t require states to report a demographic breakdown of those dropped. In fact, CMS has yet to release any state-by-state data. The AP obtained data directly from states and from other groups that have been collecting it.

Medicaid recipients in numerous states have described the eligibility redetermination process as frustrating.

Julie Talamo, of Port Richey, Florida, said she called state officials every day for weeks, spending hours on hold, when she was trying to ensure her 19-year-old special-needs son, Thomas, was going to stay on Medicaid.

She knew her own coverage would end but was shocked to hear Thomas’ coverage would be whittled down to a different program that could force her family to pay $2,000 per month. Eventually, an activist put Talamo in contact with a senior state healthcare official who confirmed her son would stay on Medicaid.

“This system was designed to fail people,” Talamo said of the haphazard process.

Some states haven’t been able to complete all the eligibility determinations that are due each month. Pennsylvania reported more than 100,000 incomplete cases in both April and May. Tens of thousands of cases also remained incomplete in April or May in Arizona, Arkansas, Indiana, Iowa, New Mexico and Ohio.

“If states are already behind in processing renewals, that’s going to snowball over time,” said Tricia Brooks, a research professor at the Georgetown University Center for Children and Families. “Once they get piles of stuff that haven’t been processed, I don’t see how they catch up easily.”

Among those still hanging in the balance is Gary Rush, 67, who said he was notified in April that he would lose Medicaid coverage. The Pittsburgh resident said he was told that his retirement accounts make him ineligible, even though he said he doesn’t draw from them. Rush appealed with the help of an advocacy group and, at a hearing this past week, was told he has until July to get rid of about $60,000 in savings.

Still, Rush said he doesn’t know what he will do if he loses coverage for his diabetes medication, which costs about $700 a month. Rush said he gets $1,100 a month from Social Security.

In Indiana, Samantha Richards, 35, said she has been on Medicaid her whole life and currently works two part-time jobs as a custodian. Richards recalled receiving a letter earlier this year indicating that the pandemic-era Medicaid protection was ending. She said a local advocacy group helped her navigate the renewal process. But she remains uneasy.

“Medicaid can be a little unpredictable,” Richards said. “There is still that concern that just out of nowhere, I will either get a letter saying that we have to reapply because we missed some paperwork, or I missed a deadline, or I’m going to show up at the doctor’s office or the pharmacy and they’re going to say, ‘Your insurance didn’t go through.’”

Lieb reported from Jefferson City, Missouri, and DeMillo from Little Rock, Arkansas. Also contributing were AP reporters Anthony Izaguirre in Tallahassee, Florida; Marc Levy in Harrisburg, Pennsylvania; and Arleigh Rodgers in Bloomington, Indiana. Rodgers is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

But, according to mounting research, they are also changing our brains for the worst.

And how could they not? The average American checks their smartphone 144 times per day, according to a survey by Reviews.com.

The mere presence of a smartphone can actually reduce the quality of our in-person conversations with others, according to a 2012 study. And extensive social media use can lead to increased feelings of isolation, according to a 2017 study.

If you find yourself reaching for your phone more than you’d like, it might be time to set some boundaries.

In her book “How to Break Up With Your Phone,” Catherine Price goes into actionable practices that can help you curb your phone usage. 

One of those will take you under 60 seconds and doesn’t require you to download any apps or set any limits. All you have to do is change your lock screen. 

‘Simply notice the urge and stay present’

Cutting down on iPhone usage has a lot to do with mindfulness, Price writes in her book. 

Say you catch yourself reaching for your phone mid-dinner. Pay attention to how you’re feeling without judging the feeling. 

“Practicing mindfulness means that instead of trying to fight your urge or criticizing yourself for having it, you simply notice the urge and stay present with it as it unfolds,” she writes. 

You can assess how you’re feeling by asking yourself a few questions, she says: 

• What does the craving feel like in your brain and in your body? 
• Why are you having this particular urge right now? 
• What reward are you hoping to receive, or what discomfort are you trying to avoid? 
• What would happen if you reacted to the impulse? 
• What would happen if you did nothing at all? 

Because being on our phones is so natural, slowing down every time you reach for it might be a challenge. 

That’s where the lock screen comes in. 

“Our lives are what we pay attention to,” Price writes in her book. 

The next time you pick up your smartphone, ask yourself, “What do you want to pay attention to?” 

To help you remember to ask this question, Price suggests writing it down on a piece of paper, taking a picture of it, and setting it as your lock screen. 

“That way, whenever you reach for your phone, you’ll be reminded to check in with yourself first,” she writes.

This takes you less than a minute and can lead to healthier phone habits that will allow you to keep the convenience a smartphone brings and hopefully shave off some of the more negative effects.

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Unlike the last two people to serve as head of the nation’s top federal public health agency, Cohen has prior experience running a government agency: She was secretary of the North Carolina Department of Health and Human Services from 2017 until last year. Before that, she held health-related jobs at two federal agencies.

“Dr. Cohen is one of the nation’s top physicians and health leaders with experience leading large and complex organizations, and a proven track-record protecting Americans’ health and safety,” President Joe Biden said in a statement.

She succeeds Dr. Rochelle Walensky, 54, who last month announced she was leaving at the end of June. Cohen’s starting date has not been announced. Her appointment does not require Senate confirmation.

Walensky, a former infectious disease expert at Harvard Medical School and Massachusetts General Hospital, took over at the CDC in 2021 — about a year after the pandemic began.

Cohen, 44, will take over after some rough years at the CDC, whose 12,000-plus employees are charged with protecting Americans from disease outbreaks and other public health threats.

The Atlanta-based federal agency had long been seen as a global leader on disease control and a reliable source of health information. But polls showed the public trust eroded, partly as a result of the CDC’s missteps in dealing with COVID-19 and partly due to political attacks and misinformation campaigns.

Walensky started a reorganization effort that is designed to make the agency more nimble and to improve its communications.

Cohen was raised on Long Island, New York. Her mom was a nurse practitioner. Cohen has a medical degree from Yale and a master’s in public health from Harvard.

She also has been an advocate. She was a founding member and former executive director of Doctors for America, which pushes to expand health insurance coverage and address racial and ethnic disparities. Another founder was Dr. Vivek Murthy, the U.S. surgeon general. The group formed in the midst of an effort to organize doctors into political action and support Barack Obama’s candidacy for president.

Cohen started working for the federal government in 2008 at the U.S. Department of Veterans Affairs, where she served as deputy director for women’s health services. She later held a series of federal jobs, many of them with the Centers for Medicare and Medicaid Services, rising to chief operating officer.

In 2017, she took the health and human services job in North Carolina. A top adviser to Democratic Gov. Roy Cooper, Cohen was the face of her state’s response to the coronavirus, explaining risks and precautions while wearing a gold chain adorned with a charm of the Hebrew word for “life.”

Some residents dubbed her the “3 W’s lady” for her constant reminders to wear a mask, wash hands frequently, and watch the distance from other people. One man even wrote a country-rock ballad praising her with the refrain: “Hang on Mandy, Mandy hang on.”

In 2020, Cohen refused to support President Donald Trump’s demands for a full-capacity Republican convention in Charlotte with no mask wearing. Her office later said it would accommodate the GOP by relaxing the state’s 10-person indoor gathering limit, but it remained adamant about masks and social distancing. Trump ultimately moved the main events from Charlotte.

Cohen resigned the state post in late 2021, saying she wanted to spend more time with her family and pursue new opportunities. She then took a leadership post at Aledade Inc., a Maryland-based consulting company.

___

Former AP writers Bryan Anderson and Ricardo Alonso-Zaldivar contributed to this report.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The U.S. Food and Drug Administration on Friday recommended that Covid vaccine manufacturers make single-strain shots for the fall that target omicron subvariant XBB.1.5, the dominant strain of the virus nationwide.

“Based on the totality of the evidence, FDA has advised manufacturers who will be updating their COVID-19 vaccines, that they should develop vaccines with a monovalent XBB 1.5 composition,” the agency said in a release, referring to pharmaceutical companies Pfizer, Moderna and Novavax.

Monovalent means a shot is designed to protect against one variant of Covid.

XBB.1.5 is a descendant of the omicron variant, which caused cases in the U.S. to spike to record levels early last year. It is also one of the most immune-evasive strains to date.

XBB.1.5 accounted for nearly 40% of all Covid cases in the U.S. in early June, according to data from the Centers for Disease Control and Prevention. That proportion is slowly declining, while cases of the related variants XBB.1.16 and XBB.2.3 are rising.

The FDA’s decision is consistent with what an advisory panel to the agency recommended on Thursday.

That panel unanimously voted that new jabs should be monovalent and target a member of the XBB family. Advisors also generally agreed that targeting XBB.1.5 would be the most ideal option.

The FDA’s selection is also good news for Pfizer, Moderna and Novavax.

The three companies have already been developing updated versions of their shots that target XBB.1.5. Preliminary data each company presented Thursday suggests that those jabs produce strong immune responses against all XBB variants.

“Novavax is encouraged by today’s FDA announcement, and the company’s XBB 1.5 COVID vaccine candidate is being manufactured at commercial scale with the intent to be in market for the fall vaccination campaign,” a Novavax spokesperson said in a statement to CNBC.

Pfizer said it will be able to deliver a monovalent shot targeting XBB.1.5 by July. Moderna and Novavax have not provided specific timelines for delivery.

Dr. Peter Marks, head of the FDA’s vaccine division, suggested Thursday that the updated vaccines could be available to the public around September.

The study, which will be presented Friday in Chicago at ENDO 2023, the annual meeting of the Endocrine Society, adds to a growing body of evidence that highlights the flaws of using BMI to measure obesity. Obesity, in the simplest terms, refers to when a person has an excess of fat in the body.

BMI — which is calculated using a person’s height and weight — is the standard way to determine whether someone has obesity or is overweight. A BMI of 30 and above falls into the obese category for most people; 25 to under 30 is considered overweight. It’s ubiquitously used by medical professionals to determine who is at risk for Type 2 diabetes and heart disease and who qualifies for anti-obesity medications and weight loss surgery.

According to the new study, BMI misses a lot of cases of obesity. Researchers looked at data from almost 10,000 U.S. adults collected from 2011 to 2018 and found that almost 36% had obesity based on their BMI. Use of a different measure of obesity — a person’s body fat percentage — put that figure at 74%. The study has not yet been published in a peer-reviewed journal.

Read the full story on NBCNews.com here.

The makers of weighted swaddles and sleep sacks liken them to a parent’s hand resting gently on an infant’s chest or to the sensation of “being held and hugged.”

But the American Academy of Pediatrics says placing weight on babies while they’re sleeping poses an alarming and potentially fatal risk — and the group is calling for a closer examination of the potential danger. 

Weighted sleep sacks and swaddles could hypothetically increase the risk of sudden infant death syndrome by making it harder for babies to arouse themselves in response to hazards, such as lack of oxygen, the AAP said in a letter Thursday to the Consumer Product Safety Commission and ASTM International, a technical standards development organization.

Read the full story on NBCNews.com here.

The U.S. Food and Drug Administration‘s independent panel of advisors on Thursday recommended that updated Covid shots for the fall and winter target one of the XBB variants, which are now the dominant strains of the virus nationwide. 

The committee unanimously voted that the new jabs should be monovalent — meaning they are designed to protect against one variant of Covid — and target a member of the XBB family.

Those strains of Covid are descendants of the omicron variant, which caused cases to surge to record levels early last year. They are some of the most immune-evasive strains to date.

Advisors also generally agreed that the new shots should specifically target a variant called XBB.1.5. The panel only discussed that specific strain selection and did not vote on the matter.

XBB.1.5 accounted for nearly 40% of all Covid cases in the U.S. as of early June, according to data from the Centers for Disease Control and Prevention. That proportion is slowly declining, and cases of the related XBB.1.16 and XBB.2.3 variants are on the rise. 

Advisors noted that XBB.1.5 appears most ideal for the fall since vaccine manufacturers Pfizer, Moderna and Novavax have already started to develop jabs targeting the strain.

“The 1.5 looks good. It seems like it’s the most feasible to get across the finish line early without resulting in delays and availability,” said Dr. Melinda Wharton, a senior official at the National Center for Immunization and Respiratory Diseases. “The vaccine we can use is the vaccine that we can get. And so it feels like this would be a good choice.”

The FDA typically follows the advice of its advisory committees, but is not required to do so. It’s unclear when the agency will make a final decision on strain selection.

There is also uncertainty about which age groups the FDA and CDC will advise to receive the updated shots this fall.

But the panel’s recommendation is already a win for Pfizer, Moderna and Novavax — all of which have been conducting early trials on their respective XBB.1.5 shots ahead of the meeting.

“Novavax expects to be ready for the commercial delivery of a protein-based monovalent XBB COVID vaccine this fall in line with today’s [advisory committee] recommendation,” said John Jacobs, the company’s president and CEO.

The U.S. is expected to shift vaccine distribution to the private sector this fall. That means the vaccine makers will start selling their new Covid products directly to health-care providers and vie for commercial market share. 

The panel’s recommendation coincides with a broader shift in how the pandemic impacts the country and the world at large. 

Covid cases and deaths have dropped to new lows, governments have rolled back stringent health mandates like masking and social distancing and many people believe the pandemic is over altogether.  

But Dr. Peter Marks, head of the FDA’s vaccine division, said the agency is concerned that the U.S. will have another Covid wave “during a time when the virus has further evolved, immunity of the population has waned further and we move indoors for wintertime.”

Updated Covid vaccines that are periodically updated to target a high circulating variant will restore protective immunity against the virus, said Dr. David Kaslow, a senior official in the FDA’s vaccine division. 

It’s a similar approach to how the strains are selected for the annual flu shot. Researchers assess strains of the virus in circulation and estimate which will be the most prevalent during the upcoming fall and winter.

But it’s unclear how many Americans will roll up their sleeves to take the updated shots later this year. 

Only about 17% of the U.S. population — around 56 million people —have received Pfizer and Moderna’s boosters since they were approved in September, according to the CDC.

More than 40% of adults 65 and older have been boosted with those shots, while the rate among younger adults and children ranges between 18% and 20%.

Those boosters were bivalent, meaning they targeted the original strain of Covid and the omicron subvariants BA.4 and BA.5. 

Pfizer, Moderna and Novavax shot data

During the meeting, Pfizer, Moderna and Novavax presented preliminary data on updated versions of their shots designed to target XBB variants. 

Moderna has been evaluating shots targeting XBB.1.5 and XBB.1.16 — another transmissible omicron descendant, according to Rituparna Das, the company’s vice president of Covid vaccines. 

Preclinical trial data on mice suggests that a monovalent vaccine targeting XBB.1.5 produces a more robust immune response against the currently circulating XBB variants than the authorized bivalent shot targeting BA.4 and BA.5, according to Das. 

She added that clinical trial data on more than 100 people similarly demonstrates that the monovalent XBB.1.5 vaccine produces protective antibodies against all XBB variants. All trial participants had previously received four Covid vaccine doses.

Das said that comprehensive protection against XBB strains is likely due to the fewer unique mutations between the variants, which means their composition is similar.

There are only three unique mutations between the variants XBB.1.5 and XBB.1.16, according to Darin Edwards, Moderna’s Covid vaccine program leader. By comparison, there are 28 mutations between omicron BA.4 and BA.5.

That means the immune response an updated shot produces against XBB variants will likely be similar, regardless of which specific variant it targets, Edwards said.

Pfizer also presented early trial data indicating that a monovalent vaccine targeting an XBB variant offers improved immune responses against the XBB family. 

The company provided specific timelines for delivering an updated vaccine, depending on the strain the FDA selects. 

Pfizer will be able to deliver a monovalent shot targeting XBB.1.5 by July and a jab targeting XBB.1.16 by August, according to Kena Swanson, the company’s senior principal scientist.

Pfizer won’t be able to distribute a new shot until October if the FDA chooses a completely different strain, Swanson said.

Novavax did not provide a specific timeline for delivering a shot targeting XBB.1.5, but noted that an XBB.1.16 shot would take eight weeks longer.

Novavax unveiled preclinical trial data indicating that monovalent vaccines targeting XBB.1.5 and XBB.1.16 induce higher immune responses to XBB subvariants than bivalent vaccines do. 

Data also demonstrates that an XBB.1.5 shot produces antibodies that block XBB.2.3 from binding to and infecting human cells, according to Dr. Filip Dubovsky, Novavax’s chief medical officer.

Dubovsky said the trial results support the use of a monovalent XBB.1.5 shot in the fall.

Novavax’s jab uses protein-based technology, a decades-old method for fighting viruses used in routine vaccinations against hepatitis B and shingles.

The vaccine works differently than Pfizer’s and Moderna’s messenger RNA vaccines but achieves the same outcome: teaching your body how to fight Covid.

The Centers for Disease Control and Prevention report examined the homicide and suicide rates among 10- to 24-year-olds from 2001 to 2021.

The increase is alarming and “reflects a mental health crisis among young people and a need for a number of policy changes,” said Dr. Steven Woolf, a Virginia Commonwealth University researcher who studies U.S. death trends and wasn’t involved in the CDC report.

Experts cited several possible reasons for the increases, including higher rates of depression, limited availability of mental health services and the number of guns in U.S. homes.

Guns were used in 54% of suicides and 93% of homicides among the age group in 2021, the most recent year for which statistics were available.

“Picture a teenager sitting in their bedroom feeling desperate and making a decision, impulsively, to take their own life,” Woolf said. If they have access to a gun, “it’s game over.”

Suicide and homicide were the second and third leading causes of death for 10- to 24-year-olds, after a category of accidental deaths that includes motor vehicle crashes, falls, drownings and overdoses. Other researchers have grouped the data by the method of death, and concluded that guns are now the biggest killer of U.S. children.

Earlier this year, Woolf and other researchers looking at CDC data noted dramatic increases in child and adolescent death rates overall at the beginning of the pandemic, and found suicide and homicide were important factors.

The report also found:

—Suicide and homicide death rates remained far higher for older teenagers and young adults than they were for 10- to 14-year-olds.

—In 2021, there were about 2,900 suicides in youths ages 10 to 19, and 4,200 in 20- to 24-year-olds. About 3,000 homicide deaths were reported in the younger group, and nearly 3,900 in the adults in their early 20s.

—The homicide death rate jumped from 8.9 deaths per 100,000 teens aged 15 to 19 in 2019 to 12.3 in 2020. It rose to 12.8 deaths per 100,000 in 2021, the highest since 1997, according to CDC data.

—Homicide deaths became more common than suicide deaths among 15- to 19-year-olds, while suicide was more common in the younger and older age groups.

—While large increases were seen in homicide rates for young Black and Hispanic people in the U.S., there were not significant increases for their white counterparts, other CDC data shows.

—Among 20- to 24-year-olds, the homicide death rate jumped 34% from 2019 to 2020 — from 13.4 per 100,000 population to 18 per 100,000. It held stable in 2021, but the suicide rate rose enough in 2021 — to 19.4 per 100,000 — to surpass the homicide rate.

Suicide death rates in children and teens were rising before COVID-19, but they jumped up at the beginning of the pandemic. Dr. Madhukar Trivedi, a psychiatrist at the University of Texas Southwestern Medical Center, said the reasons may be hard to pinpoint, but that isolation during COVID-19 lockdowns could be a factor.

“There is a misperception that if you talk to young people about depression, they’ll get depressed. A don’t-ask, don’t-tell policy for depression is not effective,” Trivedi said. “The earlier we can identify the ones who need help, the better chance we’ll have at saving lives.”

If you or someone you know needs help, please contact the National Suicide Prevention hotline at 988, or reach out to the Crisis Text Line by texting ‘Home’ to 741741, anytime.

The dozen employees at Riverside Regional Medical Center — one nurse practitioner, 10 registered nurses, and one unit secretary — are welcoming babies, or have given birth, this year. The women are expecting a combined six girls, three boys and three bundles of joy whose sex is unknown to the moms.

Two of the women gave birth to daughters in March and May, and there’s more to go: Four babies are due in July, three in August, one in September, one in October and one in November.

“This is the most we have had historically in one year in our unit. Five are first-time moms,” a spokesperson from Riverside Regional Medical Center tells TODAY.com in an email.

According to Haley Bradshaw, who is 35 weeks pregnant with her second child, a boy, the women share camaraderie.

“We all feel extremely supported and we don’t have to worry about much if anyone needs anything,” she tells TODAY.com. “We’re all here to step in and help if someone takes a break or has a doctor’s appointment. We have each other’s backs.”

“We work better as a team because we know what we’re in for,” Jackie Cox, who is 36 weeks pregnant with her fifth child, a girl, tells TODAY.com.

With 52 nurses employed in the NICU, only a few pregnant employees overlap during any given 12-hour day or night shift.

Cox says being pregnant together has deepened their friendships, whether through discussing pregnancy problems or baby names.

Cox and Bradshaw say they plan to work until the end of their pregnancies — and it’ll save a trip to the hospital. Bradshaw will be a returning patient, as she delivered her first child at the hospital.

In the meantime, seeing patients’ reactions to their bellies is always fun.

“They laugh it off with us,” says Bradshaw. 

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“I was told it was nothing to worry about,” Devaney Hogan, 38, of Boston, tells TODAY.com. “They said, ‘Yeah, I wouldn’t worry about it. You’re scheduled for your physical at the end of October, just come in then.’”

Still, she scheduled an appointment with her OB-GYN and underwent tests, which revealed why she had a bump: It was stage 3 HER2 positive invasive ductal carcinoma breast cancer.

“My bikini saved my life,” she says.

Lump leads to diagnosis

After finding the “pea-sized” lump and being told by her doctor’s office it was nothing to worry about, Devaney Hogan says she talked to her friends about it. One spoke up.

“My really good friend who’s a nurse said, ‘Absolutely not. Don’t settle for not being seen,’” Devaney Hogan recalls. “She’s like, ‘I don’t care what the doctor said. I don’t care if they’re not worried. Just get this checked. You have three babies — you need to be OK.’”

She called her OB-GYN in the hope she could be examined soon.  

“Through a fair amount of pushing and persistence, I was able to get an appointment the following week,” she says. “I probably could have pushed it off and been like, ‘I’m busy, I’ve got stuff going on,’ and I’m very grateful that I did it.”

Her doctor referred her to a breast cancer facility, and she was again reassured that there was “nothing to worry about.” She was told she could get a mammogram and biopsy, but she felt “there was zero urgency” in their recommendations. Still, she scheduled the tests.

“That bump was something. That bump was stage 3 HER2 positive and invasive breast cancer that had spread to my lymph nodes,” Devaney Hogan says. “I very well could have brushed it off and waited. And I was told had I waited, we’d be in a very different scenario.”

She underwent 12 rounds of chemotherapy, a double mastectomy, lymph node removal and radiation to treat her cancer. Recent scans found some residual cancer, so she started chemotherapy again, which will last until next year, and she will undergo reconstructive surgery in November.

When she was 35, Devaney Hogan actually had a mammogram because of recurrent mastitis in one breast. That made the diagnosis even more surprising.

“There were no other symptoms,” she says. “I did not present in any way or have a family history or other symptoms that would put me at high alert.”

Navigating motherhood, her career as a vice president at a tech company and cancer has felt tough at times.

“Cancer can somewhat be glamorized and dramatized on TV, so you have this expectation of what it’s going to be, and suddenly I’m going to transition from a busy mother with a career to a very sick person,” Devaney Hogan says. “The reality is you get the diagnosis and then you come home, and your kids are still yelling at you for not opening their string cheese the right way.”

She took a leave of absence from work to focus on treatment and recovery.

“I really started to think of this as the new job in my life,” she says. “I was going to be dedicating hours a week to … ensuring I got though this.”

As she went through treatment, though, she pondered her diagnosis.  

“You never expect it to be you. Maybe that’s an awful thing to say,” she says. “I feel great, and I exercise and eat well, and it’s shocking.”

She also felt like she knew her body well and wondered how she missed the lump.

“How was I so blindsided by the fact that this disease could get me,” Devaney Hogan says. “That’s where I started brewing this idea of squeezing and thinking about ways I could help ensure other women didn’t have to think about breast cancer awareness only as a performative act … in October.” 

Season for Squeezin’

Prior to her diagnosis, Devaney Hogan thought about breast cancer awareness in October as an event that meant she needed to find pink clothes for her children to wear to school or raising awareness of an illness that impacted older women. She wondered if there was something she could do that could make breast cancer prevention more relevant to women under the recommended age for a mammogram. Season for Squeezin’ was born.

“Unfortunately, breast cancer is impacting a growing number of younger women,” she says. “Why not meet them and the place they are in the summer and focus on the things they can do really tangibly?”

Devaney Hogan reached out to swimsuit makers, asking to include tags with information about breast cancer detection and the Season for Squeezin’ campaign. Heidi Fish — known for designing one of the bikinis Padma Lakshmi wore in Sports Illustrated — agreed to include the tags. Devaney Hogan recently learned that Imsy Swimwear and Kortni Jeane Swimwear will also use the tags.

Most medical groups no longer recommend routine self-breast exams as a way to screen for breast cancer because research hasn’t found that they improve breast cancer detection or survival rates, according to Mayo Clinic. However, it is recommended to be familiar with your breasts so you can recognize changes and what’s normal versus what’s not — and take this information to a health care provider as soon as possible.

“We were founded to drive the message of giving yourself a squeeze each time you suit up in your swimwear,” she says.

She’s launching a campaign the week of June 18 to encourage people to take pictures of themselves in their swimsuits holding fruit and tag five of their friends to do the same — she hopes it reminds people to familiarize themselves with their breasts.

Since her diagnosis and starting Season for Squeezin’, Devaney Hogan has learned a lot about herself. Throughout her career in the tech industry, others have told her to “tone it down” or be “demure” if she wanted to succeed. But she found that staying true to herself has made a huge difference.

“Being myself has saved my life. I was comfortable pushing for what I needed, speaking up and (leaning) into my ability to build relationships,” she says. “It’s terrible it takes a diagnosis like breast cancer to accept and celebrate who you are.”

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Many Americans feel wealthy — but don’t necessarily measure it in dollars and cents. Well-being, not money, has become the leading measure of wealth for most adults today, according to the new Charles Schwab “Modern Wealth” survey.

It takes an average net worth of $2.2 million to be considered “wealthy,” the survey found — but that’s the estimate respondents gave for other people.

What about you? Are you rich? How much money does it take for you to consider yourself wealthy? 

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Of the 1,000 adults surveyed, about 48% say they already feel wealthy. Yet their average net worth is $560,000 — about a quarter of what they think others need to be rich.

Millennials are overwhelmingly more likely to say they feel wealthy — with 57% of those ages 26 to 41 saying they feel this way, compared to only about 40% of Gen Z, Gen X and baby boomers. For millennials who say they feel wealthy, their average net worth is about $530,000. 

Wealth is a ‘very personal’ definition

“The definition of wealth is very personal, and it should be unique to one’s experience,” said certified financial planner Preston D. Cherry, founder and president of Concurrent Financial Planning in Green Bay, Wisconsin. He stresses the importance of having a financial plan based on your own wants and needs.

“If you do nothing, then nothing will happen,” said Cherry, who is a member of CNBC’s Financial Advisor Council.

Americans’ views about what it takes to be wealthy have changed since pre-pandemic times. 

When Schwab did its Modern Wealth Survey before the pandemic in 2020, people said the average net worth it takes to be considered wealthy was $2.6 million. In 2021, that figure dropped to $1.9 million, then went up to $2.2 million in 2022 — where it’s stayed this year.  

How wealth and well-being intersect

When asked to characterize what being wealthy means to them, respondents overall mentioned their well-being (40%) more often than money (32%) and assets (26%). In 2017, the top response to what wealth means was money (27%). 

“Whether they know it or not, well-being is much more important,” said CFP and financial psychologist Brad Klontz, a managing principal of Your Mental Wealth Advisors in Boulder, Colorado.

“One of the risks we run is thinking a certain amount of money is going to bring us happiness, bring us peace, improve our lives, improve our relationships,” said Klontz, who is also a member of CNBC’s Financial Advisor Council.

“Unfortunately some people will sacrifice what matters most to them ultimately, in their goal to achieve an arbitrary wealth number.”

Yet, nearly two-thirds, 62%, of adults in the Schwab survey say enjoying healthy relationships with their loved ones better describes what wealth means than having a lot of money (38%). And, 7 in 10 adults say wealth is about not having to stress over money, not having more of it. 

SIGN UP: Join top advisors, investors, market experts, technologists, and economists at the virtual Financial Advisor  Summit on Thursday, June 15. They’ll discuss the market risks ahead, potential buying opportunities and tools advisors can use to generate consistent returns. Go to cnbcevents.com/financial-advisor to register.

The unidentified 54-year-old man died after he was infected with the bacteria Vibrio vulnificus, which can be carried in oysters and other shellfish, according to St. Louis County Department of Public Health.

County health department investigators found the man ate the oysters sometime in the week before his death. He was treated at an area hospital and died on June 8, officials said.

The man purchased the oysters from The Fruit Stand & Seafood in Manchester, Missouri, about 20 miles west of St. Louis. County health officials are urging anyone who recently purchased oysters from the market to dispose of them as investigators work to determine the source of the oysters.

“There is no evidence that the business did anything to contaminate the oysters, which likely were already contaminated when the establishment received them,” health department investigators said in a press release.

Officials added all of the remaining oysters in the market were embargoed by the health department.

Symptoms of vibriosis include abdominal cramping, nausea, vomiting, fever and chills, according to the St. Louis County Department of Public Health.

The department noted severe illness and death from vibriosis is rare and typically occurs in people with a weakened immune system.

The Centers for Disease Control and Prevention said people can reduce their risk of vibriosis by following these tips:

• Always cook oysters or other shellfish before eating: Don’t eat them raw or undercooked.
• Always wash your hands with soap and water after handling raw shellfish.
• Avoid cross-contaminating cooked shellfish with raw shellfish and its juices.
• Stay out of salt water or brackish water if you have a wound (including from a recent surgery, piercing or tattoo) if there’s a possibility it could come into contact with salt water or brackish water, raw seafood or raw seafood juices, or cover the wound with a waterproof bandage.
• Wash cuts thoroughly with soap and water if they have been exposed to seawater or raw seafood or its juices.
• Contact your medical provider if you develop a skin infection or if your skin has come into contact with salt water or brackish water, raw seafood or raw seafood juices.

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So, when Jenna’s oldest daughter, Mila, 10, saw a scale recently at a friend’s home, she didn’t know what it was. 

“There was a scale in the bathroom, and Mila was like, ‘What is that?’ Because I don’t own a scale,” Jenna said on TODAY with Hoda & Jenna on Monday, June 12. “I don’t want to be beholden to some number on a machine that makes me feel bad.”

When Mila learned what it was, she started “weighing everything” with it, Jenna said, including the family cat, Hollywood. Co-host Hoda Kotb called Jenna’s choice to not have a scale “a lesson” and pointed out that focusing too much weight can lead people to be “constantly adjusting.”

Added Jenna: “Why would we waste our one precious life thinking about our body not being good enough?”

The former first daughter has been open about her own body image issues when she was around Mila’s age, sharing in March on TODAY that when she was in the fourth grade, she wrote in her diary that her new year’s resolution was to lose weight.

Now that she’s a mom, Jenna says she wants to demonstrate positive self-talk to Mila and her two other children, Poppy, 7, and son Hal, 3. She’s said she’s been inspired by the way her mom, Laura Bush, modeled body confidence to her and her twin sister, Barbara, growing up, explaining her mother “never talked about diet” or “the way she looked.”

“She definitely would never self-hate in front of us. I want to make sure I’m modeling that type of love to my kids,” Jenna said on TODAY in March. “Mila and I will go for walks, they see me work out, they play sports, I encourage them to stay active, but we’re not sitting around talking bad about ourselves.”

Jenna has spoken in the past about how damaging it can be to focus on scale readings.

In 2019, she and Hoda Kotb revealed their weights on live TV during a segment about intermittent fasting. 

The goal of their intermittent fasting was “to be healthy” and not to lose weight. Still, Jenna shared at the time that whenever she steps on a scale, she tends to fixate on that single number.

“I was reminded why I don’t weigh myself yesterday because I was playing with my kids, and I kept having that one number in my head,” she told Hoda.

These days, Jenna says she measures health by how she feels inside, not by her weight or appearance.

“It’s not just about looking skinny or looking a certain way or fitting into your jeans,” she said. “It’s about feeling healthy all the way around.”

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I never had a headache or a seizure, which are typical symptoms of a brain tumor.

My first symptom was having phantom smells. I was smelling things that weren’t there — like restaurant exhaust or fried steak — typically early in the morning when I was waking up. I don’t live near a restaurant, so I knew that something was wrong.

I’m a former ICU nurse and after doing a little bit of research, I found olfactory hallucinations are a classic neurological symptom that can be caused by a sinus condition, Alzheimer’s disease or a brain tumor.

I went to my primary care physician and over the course of 2017, I made regular trips to her because the olfactory hallucinations were continuing in frequency, duration and intensity. Her prescription was: Use nasal spray. I thought, “That’s reasonable, I’ll start there.” When the spray didn’t work over months, she said, “Just use it more.”

As the symptoms were progressing, I requested that she order an MRI. I said, “There’s something wrong with my head. When I lie down, it feels like there’s a brick pressing on my forehead.” In response, she dismissively said, “You don’t have a brain tumor” and refused to write the order for the MRI.

‘I was afraid I would go blind’

During this time, my mother died. I asked myself: “Was I having these symptoms because I was grieving her loss?” But that question was answered in pretty short order when a new symptom appeared: It felt as though my right eye was on fire and going to blow out of my head. The pain was so intense I was afraid I would go blind.

I never went back to my primary care physician. She had summarily dismissed all the classic neuro symptoms for more than a year. I was just so done with all this gaslighting.

I went to an ophthalmologist and I told him, “It feels like my eye is going to explode and there’s something in my head.” And he said, “You have dry eye, so use drops four times a day.” I was dismissed again.

I sought out an ear, nose and throat doctor to get an evaluation of my sinuses, but everything was clear so he suggested I see a neurologist. When I saw the first neurologist who was available to demand an MRI of my head, his response was the same as the PCP’s. He said, “You don’t have a brain tumor.”

But finally, he wrote the order. Two days after the MRI, I was sitting at the salon getting my hair cut when my cell phone rings and it’s the neurologist. He blurts out, “You were right, you do have a brain tumor.”

The MRI showed it was the size of an egg and located in the frontal lobe, where executive functioning lives. The tumor grew so large that it started impinging on my eye.

70 medical visits

Almost a year-and-a-half after my first PCP visit, I finally had a definitive diagnosis. My first thought was, “Am I going to die? Will I ever be able to work again?”

I underwent brain surgery on April 10, 2018. The tumor turned out to be a benign meningioma.

I now celebrate two birthdays every year: April 10 and my actual birthday.

But there were eye and recovery complications. The tumor had been pressing on the back of my eye for so long that when that pressure was removed, the retina in the back of my right eye peeled off like wall paper.

I have since had five eye surgeries and procedures. In all, I’ve had about 70 medical visits from the time I had the first symptoms.

After the brain surgery, I slept 22 hours a day for two weeks. When I was able to get up and move around, I walked into the kitchen and I couldn’t remember how to make toast and coffee. That terrified me, but I refused to give in to that.

I did jigsaw puzzles and crossword puzzles — anything I could to challenge my brain. I also enrolled in a brain rehab program.

It took four years to get all of my executive functioning back. The vision in my right eye will never be the same again, but my brain is completely back and I am so grateful.

I wouldn’t take no for an answer when I was being dismissed. I had to be my own medical advocate, and it’s exhausting.

A lot of people get intimidated by their physicians. They don’t want to challenge them or they think they don’t know enough to challenge them, particularly women. I’m hoping this story might help other women not give up when you’re too tired to continue to fight for yourself. But you must continue to persist. It is your health.

This interview was edited and condensed for clarity.

U.S. Food and Drug Administration staff on Monday said updated Covid boosters should target XBB omicron subvariants for the upcoming fall and winter vaccination campaign. 

The U.S. should use a monovalent vaccine targeting either XBB.1.5, XBB.1.16, or XBB.2.3, collectively the dominant strains nationwide, the staff said in a briefing document. 

The FDA staff made the conclusion ahead of a meeting on Thursday, when a panel of external advisors to the agency will recommend a strain for new Covid shots to target later this year. There is no set date for when the vaccination campaign will begin.

Vaccine manufacturers will be expected to update their shots once that strain is selected.

Pfizer, Moderna and Novavax are already developing versions of their respective vaccines targeting XBB.1.5 and other circulating variants.

The upcoming strain selection will be crucial to those companies’ abilities to compete in the fall, when the U.S. is expected to shift vaccine distribution to the private sector. That means all three companies will start selling their updated Covid shots directly to health-care providers.

The FDA staff’s decision comes weeks after an advisory group to the World Health Organization recommended that Covid booster shots target XBB variants. 

Scientists have said XBB strains are some of the most immune-evasive subvariants to date.

Those strains accounted for more than 95% of Covid cases in the U.S. as of early June, according to the FDA staff. 

They noted that the proportion of XBB.1.5 cases is declining, but both XBB.1.16 and XBB.2.3 are “on the rise.” 

Last year’s Covid boosters were bivalent, meaning they targeted the original strain of the virus and omicron variants BA.4 and BA.5. Those variants dominated cases nationwide last fall and winter. 

Uptake has been sluggish. Only about 17% of the U.S. population has gotten Pfizer’s and Moderna’s bivalent boosters since they were approved in September, according to the Centers for Disease Control and Prevention.

Doctors used metal plates to reconstruct his lower legs and Kelly spent months learning to walk again. So began his plodding journey into the depths of substance use disorder, a downward spiral that would gradually weaken his body and consume his mind, pulling him farther and farther away from the person he once was: a supportive husband and father, a hard-working professional, a proud veteran.

After his prescribed painkillers ran out, Kelly repeatedly traveled to Florida to take advantage of the state’s loosely regulated pain management clinics. Finally, he turned to a combination of heroin and cocaine that sometimes cost $500 per day.

More than a decade later, his substance use is more manageable and less expensive, though it remains a controlling force in his life. He takes buprenorphine, a prescription medication that’s considered the gold standard for treating opioid addiction by reducing cravings and easing withdrawal symptoms.

He gets the medication through a mobile health clinic housed in a retrofitted van, which parks in some of Baltimore’s most drug-ravaged communities, including Kelly’s neighborhood. Doctors and nurses meet with patients, write prescriptions and provide basic wound care, hepatitis C treatment, packages of the overdose reversal agent naloxone and more, all free of charge.

The clinic exemplifies an ongoing shift in the nation’s approach to stemming overdose deaths, which surged during the pandemic to unprecedented heights as the potent synthetic opioid fentanyl replaced heroin in drug markets across the country.

The so-called harm reduction model, which has received endorsement and funding from the Biden administration, offers potentially life-saving services to opioid users, without requiring abstinence in return.

Advocates say it acknowledges the importance of keeping people alive, first and foremost, while they confront the sometimes insurmountable challenges associated with recovery. Critics argue it enables illegal activity.

In Baltimore’s “Healthcare on the Spot” program, most patients continue using street drugs, but the vast majority report using less, according to clinic staff.

“Being an addict, it’s more complicated than people think,” said Kelly, 49. “We built this web we’re entangled in. We didn’t get here overnight and we’re not gonna get better overnight. You can’t just snap out of it.”

Baltimore’s overdose death rate is significantly higher than the statewide and nationwide averages, with more than 1,000 lives lost in 2020, the most recent data available. The city makes up about 10% of Maryland’s population but logs more than 35% of its overdose deaths.

Though efforts to address the problem have fallen short of achieving large-scale change, Baltimore has long been ahead of the curve. The city launched a needle exchange program in 1994, and in recent years, officials have focused on expanding access to naloxone while reducing low-level narcotics and drug paraphernalia arrests. A local organization runs another mobile treatment program that parks outside the city’s jail and offers buprenorphine prescriptions to people getting released.

“We should be thinking about harm reduction on a spectrum. Some people want to stop using, others want to use safer. This is about truly meeting people where they are,” said Dr. Letitia Dzirasa, who served as the city’s health commissioner until recently being appointed deputy mayor. “It’s also about reducing the stigma. Because this is a disease, not a moral failing.”

—

The Spot van has a waiting area, two small exam rooms and an even smaller bathroom. During private consultations, medical providers often address their patients like old friends. They might discuss family dynamics, housing issues, mental health concerns, long-term goals, recent substance use and more.

The clinic coordinates with several pharmacies across the city so patients can get their prescriptions filled almost immediately after leaving the van. They don’t need an ID or health insurance to enroll. And there’s just one requirement for them to keep getting buprenorphine through the clinic: They have to demonstrate they’re taking the medication somewhat regularly.

Buprenorphine, which received federal approval for treatment of opioid use disorder in 2002, binds to opioid receptors in the brain without producing a euphoric high. Often prescribed under the brand name Suboxone, it typically comes in orange strips that dissolve under the tongue.

Research shows the drug significantly reduces a person’s risk of overdose and death. Despite its effectiveness, a relatively small percentage of people experiencing opioid addiction are prescribed the medication. In contrast to methadone treatment, which is highly regulated and often requires patients to visit a clinic every day, buprenorphine prescriptions can last weeks or months.

In December 2022, federal lawmakers passed legislation making it easier for doctors to prescribe buprenorphine, recognizing its life-saving potential. Drug overdoses nationwide have claimed more than 100,000 lives annually since 2020, with about two-thirds of them related to fentanyl.

Asked why they sought treatment, many Spot patients said they’re just tired — tired of chasing fentanyl’s dangerous high and living in perpetual fear of withdrawal sickness, wondering whether the next dose would kill them, sometimes even hoping it would.

“You’re using just to feel normal, spending all your money on dope,” said Saprena Culver, 40, who enrolled in the program earlier this year. “It controls your whole entire life, your whole entire being.”

Culver’s four children are living with relatives in West Virginia, but she thinks about them constantly and hopes to be reunited soon. She said this isn’t her first time seeking treatment: She previously spent 12 years participating in a methadone program, which had stricter rules. Even though she ultimately was kicked out after relapsing, she found the added accountability measures helpful.

It’s currently not uncommon for people to buy Suboxone off the street, often to stave off debilitating withdrawal symptoms, which means some Spot patients could be profiting off their prescriptions.

Despite their firm belief in expanding access to the medication, clinic staff are continuously grappling with how best to serve people who aren’t ready to stop using.

—

Kelly grew up in Baltimore, where his paternal grandparents settled after migrating from Ireland.

Always an adrenaline junkie, he competed on his high school’s wrestling team and joined the Marines in 1992. He served eight years on active duty, including stints in Egypt, Thailand and elsewhere around the world. Kelly said he couldn’t believe his luck, finding a job that let him fulfill a lifelong dream, experience other cultures and get paid to work out.

It was through the military that he met his future wife, a fellow Marine. Their son was born in 2000 and spent much of his childhood in Baltimore.

Sometime after the marriage dissolved, mother and son moved to Florida while Kelly stayed put. He was living in his grandmother’s southwest Baltimore rowhouse, which he later inherited.

During a recent visit, an unopened package of naloxone lay on the kitchen table alongside dishes, pans and groceries. A framed photo showed a teenage Kelly competing in a wrestling match, muscles bulging as he overpowered his opponent. A sign above the front door bestowed “Irish Blessings” upon the building’s occupants.

Kelly’s beloved dog, an elderly, Pomeranian-long haired Chihuahua mix named Annie Oakley, bounded down the carpeted staircase and wriggled across the linoleum kitchen floor, wagging her tail for attention.

“She runs this house,” Kelly said, laughing and hugging her to his chest. He recalled a time when he overdosed and Annie alerted a neighbor, who found him unconscious and called an ambulance.

The three-story brick rowhouse is sturdy and well-maintained. For Kelly, it’s filled with family memories spanning generations. But the interior has seen better days, with sparse furniture and cluttered surfaces. Kelly rents out rooms, sometimes to people experiencing addiction and desperate for somewhere to stay, which he said can create a volatile environment.

The previous few weeks were especially tough. He developed a leg infection after a bicycle accident and was dealing with a dispute involving a former tenant who owed someone money. Pain and stress, he said — two common triggers of addiction.

“I’m trying to do right every day,” he said, stroking the top of Annie’s head. “But sometimes, it’s like you’re damned if you do, damned if you don’t.”

His face softened talking about his son, who is in college studying to become an environmental engineer. Scrolling through his phone, Kelly proudly displayed a recent photo of him. Something worth fighting for, he thought. He becomes nostalgic thinking about the years before his addiction, when he was a hard-working dad.

Kelly said he wants more people to understand the realities of substance use disorder, how it gradually consumes your life until you almost don’t recognize yourself anymore. He compared the process to a “road full of IEDs” — you’re so focused on sidestepping immediate danger that you don’t realize you’re headed deeper into hostile territory.

Kelly was visiting his family in Florida when he first tried taking Suboxone several years ago, hoping to avoid using heroin around his son. While the medication reduces his opioid cravings, he said it makes him feel dull and doesn’t do much for the persistent pain he still experiences from the roofing accident. That demands something stronger.

Meanwhile, heroin and fentanyl are readily available for purchase in his neighborhood, which has suffered from rising poverty and population loss in recent decades.

“You can’t blame it on your surroundings, but they don’t make it any easier,” he said.

—

Every Monday morning, the Spot van parks in west Baltimore’s Upton community, a historic Black cultural hub once known for its renowned jazz clubs, upscale shops and vibrant nightlife.

Now a shadow of its former self, the neighborhood is filled with visible impacts of the local drug trade: dealers doing business outside vacant buildings, their customers nodding drowsily on public benches, stumbling through alleys and trying to scrounge up enough money to make it through another day.

Baltimore police cruisers routinely patrol the area, part of the city’s crime-fighting strategy to increase law enforcement presence in communities plagued by gun violence.

Less than a block from the van’s parking spot, a tangle of deflated balloons commemorates a January shootout that wounded three people and killed two, including a young mother who was waiting to pick up a takeout order when she and her children were caught in the gunfire.

Lenwood Johnson, 62, often visits the location.

After about three months on buprenorphine, Johnson said he has significantly reduced his opioid use, keeping more money in his pockets and allowing him to stay sober for family visits and other important occasions. He also is taking fewer risks with fentanyl because he’s not desperate to maintain a consistent supply.

An ex-correctional officer at Baltimore’s jail, Johnson said he started using opioids decades earlier when an arrest for marijuana possession derailed his budding law enforcement career.

The Spot program, which launched in 2018, operates under a partnership between the Baltimore City Health Department and the Johns Hopkins University School of Medicine. It typically serves about 900 patients annually. An estimated 40% have a recent history of intravenous drug use, almost 75% are Black and more than half are experiencing homelessness or housing instability.

“The population we’re serving, many of these people are profoundly underserved and mistrustful of the health system,” said Dr. Kathleen Page, a Johns Hopkins medical school professor who helped launch the program. “Building trust is a big part of it.”

Darryl Jackson Sr., who enrolled last year along with his adult son, said the clinic sometimes feels like the only source of stability in his life. He recently had to leave the apartment where stayed and has been researching rental assistance programs, which are often mired in bureaucracy and hobbled by impossibly long waitlists.

Jackson, 58, said he can’t tolerate shelter environments because he’s a stickler for cleanliness. He takes pride in maintaining a neat appearance. After a career in construction, he still dresses almost exclusively in canvas work pants and sneakers. But on the inside, he struggles to keep his addiction in check and stave off a growing feeling of hopelessness. He recently returned to the Spot van after some missed appointments.

“They care,” he said. “So I keep coming back.”

Program staff are acutely aware of the daily hurdles facing Jackson and other participants. Sometimes it seems like a miracle when they show up at all.

“I cannot imagine living a day in the shoes of my patients,” Dr. Amanda Rosecrans, clinical chief, said in a March interview. She had received news earlier that morning about a patient’s recent death, which is a tragically common occurrence as overdoses and gun violence plague Baltimore’s poorest communities.

For this vulnerable population, stable housing is the single most important piece of the recovery equation, said Bobby Harris, the program’s medical director.

“If folks need housing, how are you supposed to focus on anything else when you don’t feel safe?” he said.

When the big picture seems overwhelming, he focuses on treating the patients in front of him.

Islah Hadith, 45, said her life changed drastically after she discovered the clinic in 2019.

That was several years after she broke her ankle playing basketball and was prescribed Percocet. When her refills ran out, she went into withdrawal and started buying pills off the street. Despite working and raising children, she said she was living in a haze, not fully present.

Hadith said she arrived at the Spot van nervous and ashamed, but left feeling hopeful.

She started taking buprenorphine and stopped using other opioids. After about four years on the medication, she recently began reducing her doses to wean herself off. She also sought therapy and severed ties with people and places that could jeopardize her progress.

“It doesn’t get easier, but it does get better,” she said.

—

When Kelly showed up to the clinic last month, his infected leg had taken a serious turn for the worse. He could barely walk, hobbling down the sidewalk and up the van’s steps, leaning heavily on a metal cane. His shoulders hunched, as if his body would soon collapse under the crushing weight of addiction.

“It hurts like hell,” he said, smiling through the pain.

Despite this latest setback, he was clear-eyed and upbeat, having recently returned from visiting family in Florida. The trip gave him a break from Baltimore and left him feeling somewhat more positive. He envisioned moving out of the city, maybe to South Carolina, where he could focus on work and start a new chapter.

Kelly said he’s grateful for the support system he has, though he worries about becoming a burden. His addiction still threatens some of his most precious relationships.

He thought about what it would look like to truly prioritize his health: What if he started taking the Suboxone more consistently and stopped muddying the waters with illicit drugs? What if he could finally give his family the support and stability they deserve?

He planned to check into the hospital later that afternoon and get his leg checked. But first, he was headed to the pharmacy to fill his prescription. One step at a time.

Sun protection is key, which may mean changing or adding extra steps to your skin care routine during the summer months.

Dr. Sandra Lee, board-certified dermatologist and cosmetic surgeon also known as Dr. Pimple Popper, joined TODAY to separate some summer skin care facts and myths.

Myth: The sun is always stronger on hotter days

While the sun is generally stronger in the summer when the days are warmer, the intensity of ultraviolet (UV) radiation from the sun varies based on a number of factors.

The most important thing to look at is UV index, Lee said on TODAY.

The UV index measures the intensity of UV radiation from the sun on a scale from 0 to 11, with 0 indicating no sunlight (at night, for example), and 11+ indicating extreme UV radiation (you can burn in less than 10 minutes), according to The Skin Cancer Foundation.

“If it’s high, that’s when you have the most risk of damage (to your skin) from the sun. … Anything above 5 is concerning,” says Lee.

While it’s important to wear sunscreen every day regardless of the UV index, you may need extra protection (for example, higher SPF or more frequent reapplications) on days when it’s higher, TODAY.com previously reported.

The UV index is not a measure of heat, and a higher UV index does not necessarily mean it’s hotter outside. For example, the UV index can be higher on a 70-degree sunny day than it is on a 100-degree sunny day, depending on the time of year, time of day, location, altitude and other factors that influence UV levels.

Likewise, the UV index can be still be high on overcast or cloudy days. “Sometimes when its super cloudy, you can get less UV radiation penetrating, but even if (the clouds) are patchy, a lot of sun can reflect off of that,” says Lee.

Simply put, you can’t rely on the temperature outside or looking at the sky to determine how strong the sun will be that day. Always check the UV index before going outside, says Lee. It’s available on most weather apps and the Environmental Protection Agency‘s website.

Myth: Sun exposure can clear up your pimples

You might’ve heard that spending time in the sunshine can help clear up your skin. However, Lee says this is a myth that can actually result in long-term skin damage.

“The sun can temporarily improve your acne but not in the long run because you’ll get browns spots, and the sun will darken these,” says Lee.

Sun exposure and heat can also cause the skin to produce more oil, says Lee, which may make blemishes or acne worse. You also run the risk getting a face sunburn, especially if you’re using acne products that make the skin more sensitive to sun.

It is true that moderate sunlight can help the body produce vitamin D, which can support your immune system and improve your mood, TODAY.com previously reported.

But any unprotected UV exposure can damage the skin, causing signs of premature aging, like discoloration and wrinkles, and increase the risk of skin cancer — which is why sunscreen is a must. Everyone can benefit from wearing facial sunscreen daily, and always opt for products with at least SPF 30 or higher.

Fact: You should avoid applying perfume before going in the sun

If you’re thinking of spritzing your neck and chest with perfume or cologne before spending time in the sun, think again, says Lee.

“If you go out in the sun, it can cause a rash and blistering in some people,” says Lee, referencing a condition called photodermatitis. This occurs when certain allergens or chemicals on the skin are activated by UV rays (also called a phototoxic reaction), triggering a severe sunburn, eczema-like reaction (dermatitis), or hives, according to Mount Sinai.

Many perfumes and colognes are made with bergamot oil, which contains chemicals called furocoumarins, which can trigger a skin reaction in the sun — this is called “Berloque photodermatitis,” says Lee. These are also found in citrus fruits — if you’ve heard of a “margarita sunburn,” this is a similar skin reaction from furocoumarins in limes activated by the sun, per the Cleveland Clinic.

So if you plan to spend time outside in the sun, don’t liberally spray your neck and chest with perfume beforehand, says Lee. Instead, try to apply perfume in areas that won’t get as much sun and always use sunscreen on any exposed skin, no matter what.

Fact: The higher the SPF, the longer the sunscreen will protect you

“Technically the higher the SPF is supposed to mean how much longer you can be out in the sun,” says Lee. So SPF 100 would protect you for more minutes than SPF 50. However, higher SPFs also give people a “false sense of security,” says Lee.

“People think if it’s SPF 100 that they can stay out for (many more) hours, but it will rub off or you’ll sweat it off,” says Lee. So lathering on a high SPF sunscreen once in the morning or before leaving the house won’t insure you for a full day out in the sun — you’ll want to bring that bottle with you.

Regardless of the SPF, it’s very important to reapply your sunscreen at least every two hours (and after swimming), says Lee, especially if you’re spending prolonged time in the sun. If you know you’ll sweat a lot or go in the water, consider using a water- or sweat-resistant SPF product.

Myth: SPF refers to all UVA and UVB protection

“Technically, SPF only really refers to UVB protection, but both UVB and UVA rays are dangerous,” says Lee. Ultraviolet B rays have a shorter wavelength and are associated with sunburns, whereas ultraviolet A rays have a longer wavelength and are associated with skin aging, per the Skin Cancer Foundation.

Both types of rays can damage the skin and increase the risk of skin cancer, which is why it’s important to protect against them.

“You really want to look at broad-spectrum protection, (which) means it is blocking UVB and UVA rays,” says Lee.

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The drug, Leqembi, received conditional approval from the Food and Drug Administration in January based on early results suggesting it could slow Alzheimer’s progression by several months. The FDA now is reviewing more definitive results to decide whether the drug should receive the agency’s full endorsement.

The decision carries extra significance because insurers have held off on paying for the infused treatment until it has full FDA approval.

The FDA panel of outside advisers voted 6-0 that a large company study confirmed the drug’s benefits for patients with mild or early Alzheimer’s. The nonbinding vote amounts to a recommendation for full approval, and the FDA is scheduled to issue a final decision on the matter by July 6.

The FDA’s initial OK for Leqembi came via the agency’s accelerated approval program, which allows early access to drugs based on laboratory and biological measures suggesting that they might help patients. The drug, marketed by Eisai and Biogen, helped clear a brain plaque that is a hallmark of Alzheimer’s.

The FDA panel reviewed more recent data from an 1,800-patient study in which people taking the drug showed a modestly slower rate of decline on measures of memory, judgment and other cognitive tests.

Health & Wellness Jun 9

FDA advisors endorse Alzheimer's treatment Leqembi, paving way for full approval this summer

news May 12

Alzheimer's Treatment Leqembi Could Cost Medicare Up to $5 Billion Per Year, Study Estimates

“For an illness like this where we don’t have very much, these are meaningful changes for patients with Alzheimer’s,” said Dr. Merit Cudkowicz of Harvard Medical School. “A couple more months in the highly functional state is really meaningful.”

Drugs approved via the accelerated pathway can technically be withdrawn by the FDA if their benefits aren’t confirmed, though regulators rarely take that step. Gaining full approval allows medications to stay on the market indefinitely.

Normally the process of converting an accelerated approval attracts little attention, and FDA rarely convenes its advisers to weigh in on such decisions.

But concerns about the cost and effectiveness of new plaque-targeting drugs like Leqembi have attracted new scrutiny to the process from academics, members of Congress and health insurers.

Medicare, the federal health plan that covers 60 million seniors, has essentially blocked coverage of Leqembi and a similar drug, Aduhelm, pending full FDA approval. That policy, which has little precedent, was announced last year amid concerns that Aduhelm, priced at $28,000-a-year, would drive up costs for Medicare recipients.

The federal program provides health insurance for the vast majority of people with Alzheimer’s, and private insurers tend to follow its lead.

Leqembi is priced similarly at $26,500 per year and the handful of patients who have received it to date have mainly had to pay out of pocket.

Facing pressure from Alzheimer’s advocates and patients, Medicare’s administrator, Chiquita Brooks-LaSure, has made clear the program will immediately begin covering the drug if it gets FDA’s full OK.

But last week she announced extra requirements even after Medicare coverage begins: All patients receiving the drug will need to be enrolled in a federal registry to track Leqembi’s safety and effectiveness. That approach is occasionally used for complex new medical devices, but rarely for drugs.

The move was criticized by advocacy groups, including the Alzheimer’s Association, which has lobbied the federal government for months to begin paying a drug that they say could potentially help many thousands of Americans.

Leqembi is the first drug that’s been convincingly shown to slow Alzheimer’s by targeting the underlying biology of the disease. The delay in progression amounts to about five months, and some experts disagree on whether the difference is enough to meaningfully improve people’s lives.

But most FDA panelists were impressed by Eisai’s results, which they said showed significant differences in patients’ cognitive abilities and function, as well as reduced burden for caregivers.

The study, funded by Japanese drugmaker Eisai, tracked patients for 18 months using a scale measuring key indicators of cognitive function. At the end of the trial, patients receiving Leqembi declined more slowly — a difference of less than half a point on the scale — than patients who received a dummy infusion.

The drug was also associated with potentially serious side effects, including swelling of the brain and small bleeds in brain vessels.

Three patients taking Leqembi died during the study, two after experiencing a stroke linked to brain bleeding. But FDA reviewers said it was unclear whether the drug played a role in the deaths due to other underlying factors affecting the patients, including the use of blood-thinning medications that can increase the risk of bleeding.

“There are adverse effects,” said Dr. Robert Alexander of the University of Arizona, who chaired the panel. “But they’re monitorable and I think the benefit is clear.”

The hard-to-miss sign issues a “‘Gonorrhea Alert!” in large letters and features a picture of the Titanic crashing into the tip of an iceberg. It’s one of several appearing across 16 states as part of a nationwide campaign by the advocacy group AIDS Healthcare Foundation and aims to raise awareness about a new strain of antibiotic-resistant gonorrhea that was detected in the U.S. earlier this year.

“It’s a call to action for the individual to think about gonorrhea, to have conversations about gonorrhea with their partners,” said Mike McVicker-Weaver, an AHF regional director for Washington, D.C., Maryland, and Virginia.

Gonorrhea is a bacterial sexually transmitted infection. It may present without symptoms, and if left untreated, can result in pelvic inflammatory disease, infertility, and other health problems.

According to the Centers for Disease Control and Prevention, gonorrhea is the second most common STI in the U.S., behind chlamydia. Gonorrhea has progressively developed resistance to the antibiotic drugs currently prescribed to treat it, the agency said. This has contributed to the recent rise in reported gonorrhea cases. In 2021, there were 710,151 reported gonorrhea cases in the U.S. compared to 677,769 in 2020 and 616,392 in 2019, according to the CDC.

Earlier this year, health officials in Massachusetts announced it had detected a “concerning” new strain of gonorrhea that resisted response to five commonly-used classes of antibiotics.

“The discovery of this strain of gonorrhea is a serious public health concern which DPH, the CDC, and other health departments have been vigilant about detecting in the US,” Public Health Commissioner Margret Cooke said in a statement. “We urge all sexually active people to be regularly tested for sexually transmitted infections and to consider reducing the number of their sexual partners and increasing their use of condoms when having sex. Clinicians are advised to review the clinical alert and assist with our expanded surveillance efforts.”

AHF said its Wellness Centers currently provide free testing and prevention for gonorrhea and other STDs in multiple locations across the country.

McVicker-Weaver said larger-scale efforts are needed to draw attention to the underlying risk.

“We know now that gonorrhea is resistant to the main lines of treatment for it. It’s rare, still, to run into those strains of gonorrhea, but it’s there. So, without a robust public health response, it’s going to become a real crisis,” he said.

A panel of independent advisors to the Food and Drug Administration on Friday unanimously endorsed the Alzheimer’s drug Leqembi made by Eisai and Biogen, paving the way for full approval of the treatment this summer. 

The advisors voted 6-0 that Eisai’s data demonstrated a clinical benefit to patients. The FDA is not required to follow the advisors’ recommendation, but the panel’s vote for Leqembi will weigh heavily in favor of full approval.

The FDA is expected to make a final decision on Leqembi on July 6. The agency’s decision will determine whether Medicare broadly covers the treatment. The program for seniors is severely restricting coverage of Leqembi right now because it was previously approved through an expedited process.

Eisai has set the annual list price of Leqembi at $26,500 per year.

The advisory committee for Leqembi was unusually small, with just six voting members.

Dr. Teresa Buracchio, acting head of the FDA’s neuroscience office, said the smaller-than-usual committee resulted from a number of experts recusing themselves from Friday’s meeting due to conflicts of interest.

“While this group is small, it contains the appropriate expertise necessary to have a robust discussion on the topic at issue today,” Buracchio said.

Leqembi is the second Alzheimer’s treatment from Eisai and Biogen to come under FDA review, after the controversial approval of the drug Aduhelm in the summer of 2021.

The drug regulator granted expedited approval to Aduhelm, developed by the two companies, despite 10 out of 11 advisory committee members concluding that the treatment did not demonstrate a clinical benefit. A congressional investigation subsequently found that the approval of Aduhelm was “rife with irregularities.”

Sen. Bernie Sanders, chair of the Senate Health Committee, told the Health and Human Services Department in a letter Wednesday that the “FDA has a special responsibility to restore the public trust after its inappropriate relationship with Biogen during the agency’s review of a prior Alzheimer’s drug, Aduhelm.”

FDA sees clinical benefit, but there are risks

Eisai’s study of Leqembi found the drug slowed cognitive decline in early Alzheimer’s patients by 27%. The antibody is administered twice monthly through intravenous infusion. It targets a protein called amyloid, often referred to as plaque, that builds up in the brain and is associated with the disease.

Buracchio told the panel that the agency views these results as clinically meaningful for patients.

But Leqembi also carries serious risks of brain swelling and bleeding. During the study, 13% of patients who received Leqembi had swelling and 14% had bleeding.

The swelling and bleeding are normally mild without obvious symptoms, but these episodes can be life-threatening, according to the FDA.

There were three deaths in the study that are possibly related to Leqembi, though the FDA was unable to draw definitive conclusions in its review.

Two patients who died suffered cerebral hemorrhages after receiving the infusions. They had been administered blood thinner medications. A third patient who died had an underlying condition called cerebral amyloid angiopathy in which the blood vessels in the brain are weak, which can lead to bleeding.

Dr. Deniz Erten-Lyons, an FDA official, told the panel that taking blood thinners during treatment with Leqembi might increase the risk of cerebral hemorrhages.

Several groups expressed strong opposition to FDA approval of Leqembi during the meeting’s public comment section Wednesday. 

Nina Zeldes with the Public Citizen‘s Health Research Group said the FDA has not been presented with clearly compelling evidence that Leqembi has a clinical benefit. Zeldes said serious safety concerns associated with the treatment outweigh the benefit based on the current data. 

Dr. Dona Kim Murphey, a neurologist with Doctors for America, said Eisai’s study was flawed because Black Americans, who are at higher risk of Alzheimer’s disease, were severely underrepresented in the trial. Black Americans represented 2.3% of participants who received Leqembi during the trial.

“With racialized instance of Alzheimer’s and brain bleeding in Black patients and with their significant underrepresentation in this trial, I cannot as a neurologist advise this group with lecanemab data,” Murphey said.

Small panel due to conflicts of interest

Buracchio said panel was smaller than usual due to experts recusing themselves due to conflicts of interest.

The FDA’s decision on whom to include in Friday’s meeting was impacted by a letter from the Alzheimer’s Association that advocated for Leqembi’s full approval, Burrachio said. At least one member of the FDA advisory committee, Dr. David Weisman, signed that letter.

Weisman was originally granted a waiver to participate in Friday’s meeting despite serving as the principal investigator for Biogen and Eisai clinical trials on Leqembi and Aduhelm at Abington Neurological Associates.

Weisman subsequently recused himself from the meeting and did not participate.

Acting Chair Dr. Robert Alexander was granted a waiver to lead the panel Friday despite holding stocks valued up to $150,000 in companies that compete with Eisai and Biogen. The FDA disclosure did not name the companies.

Alexander is the chief scientific officer of the Alzheimer’s Prevention Initiative at the Banner Alzheimer’s Institute. Banner is conducting an Alzheimer’s clinical trial for a competing firm, and Alexander receives $50,000 to $100,000 in salary per year from funding supporting the trial.

Bryan Marshall, who heads the office that manages the FDA’s advisory committees, asked the agency to grant Alexander a waiver because he has unique expertise that is “invaluable” to Friday’s meeting.

Medicare coverage, price controversy

Leqembi is technically already available on the U.S. market after receiving fast-track approval in January, but very few seniors can access the expensive treatment because Medicare is restricting coverage to only people who are participating in clinical trials. There are no clinical trials underway.

As consequence, most seniors can only access Leqembi if they can afford to pay for the drug out of pocket. Leqembi has a list price of $26,500 per year.

Medicare has promised to broadly cover Leqembi on the same day the FDA fully approves the drug. The Veterans Health Administration is already covering the treatment for veterans.

Sen. Sanders said the price of Leqembi is “unconscionable” and called on HHS Secretary Xavier Becerra to take action to slash the price in a letter ahead of the meeting this week.

Sanders said seniors would face substantial out-of-pocket costs even if Medicare covers Leqembi. The price of the drug would also put a substantial financial burden on the program for seniors, raising premiums even for people who are not using the medication, he said.

Even with the windows and doors closed and sealed, it’s still possible for some pollution to make its way into your home. And certain activities around the house, such as vacuuming or burning essential oils, can actually make indoor air quality worse. And turning on certain devices, like your kitchen vent, may even bring the outdoor air inside.

Here’s what to know about running your AC when air quality is bad and how to stay safe.

Should you run your AC when air quality is bad or when it’s smoky outside?

Yes, you can run your AC when air quality is bad, as it is currently in much of the United States due to the wildfire smoke from Canada — but only do so if it’s recirculating inside air, which means that it’s not pulling air in from the outdoors, Dr. Roshini Rajapaksa of NYU Langone said in a June 8 segment on TODAY.

When it’s smoky outside, air conditioners that pull air from outside can bring fine particulate matter, or tiny airborne particles, from the smoke into your home, which can have negative health effects.

Many window units pull in air from outside into the home and do not have strong filtration systems, whereas centralized AC and AC units attached to walls tend not to pull in air from the outside and usually filter well the little bit that might get inside, according to Good Housekeeping’s experts.

The most effective type of air filter for fine particulate matter, used in many air conditioners and HVAC systems, are HEPA filters, which “theoretically remove remove at least 99.97% of dust, pollen, mold, bacteria, and any airborne particles with a size of 0.3 microns,” according to the United States Environmental Protection Agency.

When running AC in poor air quality, it’s important that its filter is up to date, so consider replacing it.

You can also buy air purifiers with HEPA filters, which are not only safe to run when the air quality is poor — it’s recommended, if you have one, NBC News medical correspondent Dr. Natalie Azar said in a June 8 segment on TODAY.

Azar stressed the importance of air circulation when spending time indoors (which is highly recommended) when air quality is poor outside. Air conditioners that are not pulling air from outside are one way to circulate air indoors, but you can also use box fans.

If you’re going to use a built-in fan or vent in your home to circulate air, such as in the kitchen or bathroom, make sure it’s not pulling in air from outside, Azar added.

What happens if you go out in unhealthy air quality?

If you go outside in unhealthy air quality, especially from wildfire smoke, you inhale fine particulate matter, or small particles found in dust, smoke, vehicle exhaust, etc., which can cause airways to constrict.

“When we inhale, the particles (from smoke) stimulate our airways to become inflamed to not function normally,” Dr. Ronald Crystal, a pulmonologist and the chair of genetic medicine at Weill Cornell Medicine, previously told TODAY.com.

For healthy individuals, i.e. people without respiratory conditions such as asthma, COPD or post-COVID breathing problems and people without underlying heart problems, the effects of breathing in poor quality air are likely to be short term, such as irritation, like a tickle in your throat, Crystal said.

Examples of short-term symptoms due to unhealthy air quality include light coughing, eye burning or irritation, headaches, fatigue and chest tightness. (If you’re concerned by any of your symptoms or you start to have trouble breathing, wheezing, heavy coughing or dizziness, seek medical attention.)

Inhaling fine particulate matter can also increase risk of infection and worsen allergies, Azar said.

How to keep indoor air safe when air quality is poor

When air quality is poor, it’s important to spend as much time inside as possible, especially for pets, children, pregnant people and those with underlying health conditions.

To keep your indoor air as safe as possible, experts recommend:

• Use an air purifier, or an air conditioner that pulls in inside air and has an up-to-date, effective air filter. If your air purifier is small, run it in a smaller room and say in there as much as possible.
• Keep doors and windows closed and sealed.
• Run a box fan.
• Avoid running any fans that pull in outside air, such as hood vents in the kitchen or vents in the bathroom.
• Avoid burning essential oils or candles.
• Avoid smoking or vaping inside.
• Avoid vacuuming.
• Avoid cooking foods indoors that will produce a lot of smoke or fumes, such as frying or grilling.

Crystal speculated that the unhealthy air quality will dissipate in the next few days. So it’s important to continue to check the air quality in your area before going outside and take appropriate precautions, such as wearing a N95 or KN95 mask, avoiding exercising or other strenuous activities outside and limiting time outdoors.

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A panel of independent advisors to the Food and Drug Administration unanimously recommended Thursday that the antibody nirsevimab be approved for use to protect infants from respiratory syncytial virus, the leading cause of hospitalization among newborns.

If the FDA approves nirsevimab, the antibody would become the first medical intervention available in the U.S. that can protect all infants from RSV. The FDA, which is not obligated to follow the recommendation of its advisory panel, is expected to make a final decision on nirsevimab in the third quarter.

Nirsevimab is a monoclonal antibody made by AstraZeneca. The medication would be marketed by Sanofi.

The advisory panel voted 21-0 to recommend its approval.

In a separate vote, the advisors also recommended nirsevimab’s use in children up to 2 years old who remain vulnerable to the virus in their second RSV season. That vote was 19-2.

RSV kills nearly 100 babies in the United States every year, according to scientists.

Infants hospitalized with RSV often require oxygen support, intravenous fluids and are sometimes placed on a ventilator to support their breathing.

The virus is a major public health threat. A surge in RSV infections last year overwhelmed children’s hospitals leading to calls for the Biden administration to declare a public health emergency in response.

RSV circulates at the same time as the flu and Covid-19, which puts added pressure on hospitals.

There is a second monoclonal antibody used against RSV called palivizumab. But this antibody is only for preterm infants and those with lung and congenital heart conditions that are at a high risk of severe disease. Palivizumab also has to be administered monthly.

Nirsevimab, by contrast, would also be administered to healthy infants, who make up a majority of the hospitalizations. It is also given as a single dose, which would make administration easier.

Nirsevimab is not considered a vaccine because it is a monoclonal antibody.

It is unclear whether the federal Vaccines for Children program will provide nirsevimab for uninsured and underinsured children for free because the antibody is regulated as a drug.

Nirsevimab is already approved in Canada, Europe and the United Kingdom.

Nimish Patel, an expert on medications for infectious disease, said nirsevimab performed “extraordinarily well” in both premature and term babies.

“The once-seasonal dosing is a huge advance and this is probably the closest thing to an RSV vaccine that we have and it really moves the field forward,” said Patel, a member of the FDA committee and a professor of clinical pharmacy at University of California, San Diego.

Effectiveness

Nirsevimab was up to 75% effective at preventing lower respiratory tract infections that required medical attention and 78% effective at preventing hospitalizations, according a review by the FDA.

A more conservative estimate by FDA put the antibody’s effectiveness at about 48% against lower respiratory tract infections that required medical attention. This estimate assumed patients with missing data on their health outcomes had lower respiratory tract infections that required medical attention.

Nirsevimab is administered as a single injection with the dose depending on the infant’s weight. Infants that weigh less than 5 kilograms would receive a 50 mg injection for their first RSV season, and those weighing 5 kilograms or greater would receive a 100 mg injection.

Children less than 2 years old who remain at risk for severe RSV in their second season would receive a single 200 mg injection of nirsevimab.

Safety

The FDA did not identify any safety concerns in its review of nirsevimab.

Other monoclonal antibodies have been associated with serious allergic reactions, skin rashes and other hypersensitivity reactions.

The FDA did not find any cases of serious allergic reactions in the nirsevimab trials and cases of skin rash and hypersensitivity reactions were low in infants who received the antibody. But Dr. Melissa Baylor, an FDA official, said cases of these side effects will likely occur if nirsevimab is approved.

Twelve infants who received nirsevimab in the trials died. None of these deaths were related to the antibody, according to the FDA’s review.

Four died from cardiac disease, two died from gastroenteritis, two died from unknown causes but were likely cases of sudden infant death syndrome, one died from a tumor, one died from Covid, one died from a skull fracture and one died of pneumonia.

“Most deaths were due to an underlying disease,” Baylor said. “None of the deaths appeared to be related to nirsevimab.”

There has been very close attention to safety due to historical failures in the development of RSV vaccines. Scientists first tried to develop a vaccine in the 1960s with an inactivated virus, but that shot actually made disease from RSV worse in some children when they received their first natural infection, resulting in the death of two infants.

Manish Shroff, head of patient safety at AstraZeneca, said the company will keep a close eye on the safety of nirsevimab through a large global monitoring system: “Safety is of utmost importance,” he said.

Baylor said there are also unanswered questions about how nirsevimab would interact with vaccines in development that confer protective antibodies to the fetus by administering the shot to the mother.

It’s unclear if giving nirsevimab to infants whose mothers received such RSV vaccines would provide additional protection or create potential safety issues, Baylor said.

The FDA’s advisors endorsed Pfizer’s maternal RSV vaccine that protects infants in May. The agency is expected to make a decision on Pfizer’s shot in August.

It’s called donation after circulatory death, a method long used to recover kidneys and other organs but not more fragile hearts. Duke Health researchers said Wednesday that using those long-shunned hearts could allow possibly thousands more patients a chance at a lifesaving transplant — expanding the number of donor hearts by 30%.

“Honestly if we could snap our fingers and just get people to use this, I think it probably would go up even more than that,” said transplant surgeon Dr. Jacob Schroder of Duke University School of Medicine, who led the research. “This really should be standard of care.”

The usual method of organ donation occurs when doctors, through careful testing, determine someone has no brain function after a catastrophic injury — meaning they’re brain-dead. The body is left on a ventilator that keeps the heart beating and organs oxygenated until they’re recovered and put on ice.

In contrast, donation after circulatory death occurs when someone has a nonsurvivable brain injury but, because all brain function hasn’t yet ceased, the family decides to withdraw life support and the heart stops. That means organs go without oxygen for a while before they can be recovered — and surgeons, worried the heart would be damaged, left it behind.

What’s changed: Now doctors can remove those hearts and put them in a machine that “reanimates” them, pumping through blood and nutrients as they’re transported –- and demonstrating if they work OK before the planned transplant.

Wednesday’s study, conducted at multiple hospitals around the country, involved 180 transplant recipients, half who received DCD hearts and half given hearts from brain-dead donors that were transported on ice.

Survival six months later was about the same –- 94% for the recipients of cardiac-death donations and 90% for those who got the usual hearts, the researchers reported in the New England Journal of Medicine.

The findings are exciting and show “the potential to increase fairness and equity in heart transplantation, allowing more persons with heart failure to have access to this lifesaving therapy,” transplant cardiologist Dr. Nancy Sweitzer of Washington University in St. Louis, who wasn’t involved with the study, wrote in an accompanying editorial.

Last year, 4,111 heart transplants were performed in the U.S., a record number but not nearly enough to meet the need. Hundreds of thousands of people suffer from advanced heart failure but many never are offered a transplant and still others die waiting for one.

Researchers in Australia and the U.K. first began trying DCD heart transplants about seven years ago. Duke pioneered the U.S. experiments in late 2019, one of about 20 U.S. hospitals now offering this method. Last year, there were 345 such heart transplants in the U.S., and 227 so far this year, according to the United Network for Organ Sharing.

In the Duke-led study, nearly 90% of the DCD hearts recovered wound up being transplanted, signaling that it’s worthwhile for more hospitals to start using the newer method.

Sweitzer noted that many would-be donors have severe brain injuries but don’t meet the criteria for brain death, meaning a lot of potentially usable hearts never get donated. But she also cautioned that there’s still more to learn, noting that the very sickest patients on the waiting list were less likely to receive DCD hearts in the study.

Schroder said most who received DCD hearts already had implanted heart pumps that made the transplant more difficult to perform, even if they weren’t ranked as high on the waiting list.

The study was funded by TransMedics, which makes the heart storage system.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Board of Public Works approved the funds to pay for 35,000 doses that would last several years, if necessary. The stockpile, acquired in April, includes 30,000 doses of mifepristone and 5,000 doses of misoprostol. The powerful spending panel is comprised of Gov. Wes Moore, Comptroller Brooke Lierman and Treasurer Dereck Davis.

Moore, a Democrat, noted before the vote that the drug has been available for decades and has fallen under “a very unique and distinct attack.”

The governor said he wanted to be clear “that reproductive freedom is non-negotiable: that my administration will continue to defend and protect women’s reproductive freedom and access to essential health care here in the state of Maryland. Full stop.”

Lierman, a Democrat, described the stockpiling as “a really important opportunity for Maryland to double down on expressing its support for women and our reproductive choices.”

“By moving quickly when the federal court system created uncertainty around the future use and availability of mifepristone, the emergency stockpile will preserve this medication as an important option for individuals seeking safe reproductive health care here in the state of Maryland,” Lierman said.

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Moore announced in April that the state would stockpile the drug through a memorandum of understanding with the University of Maryland Medical System in response to the legal challenges. Later that month, the U.S. Supreme Court decided to leave access to mifepristone unchanged at least into next year as appeals play out.

A court case that began in Texas sought to roll back Food and Drug Administration approval of the drug. Lower courts had said that women seeking the drug should face more restrictions on getting it while the case continues, but the Supreme Court disagreed.

The controversy arose less than a year after the Supreme Court’s conservative majority overturned Roe v. Wade and allowed more than a dozen states to effectively ban abortion.

The New York City area has been smothered in a cloud of thick smoke due to wildfires in the eastern Canadian provinces of Quebec and Nova Scotia over the past few days —and it is not any better Wednesday.

The New York State Department of Environmental Conservation extended its citywide air quality health advisory through midnight Wednesday, and those who have underlying health conditions are advised to avoid outdoor activity as much as possible. Long Island and the Hudson Valley are under the air quality advisory as well.

With the air quality being so dismal, who is most at risk healthwise when it comes to wildfire smoke?

According to the Center for Disease Control and Prevention, wildfire smoke is a mix of gases and fine particles from burning trees and plants, buildings, and other material.

The health effects of wildfire smoke are far and wide, according to the Environmental Protection Agency. They can range from eye and respiratory irritation to more serious conditions, including reduced lung function. Exposure can also exacerbate asthma, Chronic Obstructive Pulmonary Disease, and heart failure, prompting premature death, according to both the EPA and CDC.

The CDC notes that breathing in smoke can impact people right away and can cause:

• Coughing
• Trouble breathing
• Wheezing
• Asthma attacks
• Stinging eyes
• Scratchy throat
• Runny nose
• Irritated sinuses
• Headaches
• Tiredness
• Chest pain
• Fast heartbeat

Children, pregnant women, and the elderly are most vulnerable to smoke exposure. Responders are also most at risk, according to the CDC.

On Tuesday, the city made recommendations out of precaution to protect New Yorkers, including limiting outdoor activities and staying inside when possible. Additionally, the city also recommends wearing a high-quality mask.

“Currently, we are taking precautions out of an abundance of caution to protect New Yorkers’ health until we are able to get a better sense of future air quality reports. We recommend all New Yorkers limit outdoor activity to the greatest extent possible. Those with preexisting respiratory problems, like heart or breathing problems, as well as children and older adults may be especially sensitive and should stay indoors at this time,” the city said.  

It’s the latest legal skirmish over mandates in former President Barack Obama’s signature health care law, commonly known as “Obamacare,” which took effect 13 years ago.

Enforcing the judge’s order could jeopardize preventive care for at least some of an estimated 150 million insured people, Alisa Klein, arguing for the administration, told three 5th U.S. Circuit Court of Appeals judges in New Orleans.

Jonathan Mitchell, arguing for the law’s challengers, said a stay on the ruling is unnecessary. Insurers and employers who provide employee health insurance would be unlikely to drop preventive coverage before the case is finally resolved because they would risk prosecution if they lose, he argued. “No rational employer or insurer can take the risk,” he said.

That drew a skeptical response from Judge Leslie Southwick. “I don’t quite see how that fits into our analysis,” said Southwick, who during the hearing asked attorneys to try to reach an agreement on how and when the lower court ruling should be enforced pending appeal. “You may be right, but it really is speculation if you want us to apply some of our sense of how insurance companies react.”

The March ruling by U.S. District Judge Reed O’Connor affected requirements for coverage driven by recommendations by the U.S. Preventive Services Task Force. O’Connor ruled that because the task force is made up of volunteers, enforcing its recommendations violates the Constitution’s Appointment Clause, which lays out how government officials can be appointed.

As appeals continue, the administration isn’t attempting to block immediate enforcement of O’Connor’s ruling as it applies to the handful of Texas plaintiffs who filed suit. But it should not apply to the millions of people affected nationwide, Klein argued.

Southwick questioned that assertion. “Once the district court decided that all these decisions were beyond the authority of the body that made it, I’m not sure what relief would have been appropriate,” he said.

Not all preventive care is affected under the judge’s ruling. An analysis by the nonprofit KFF foundation found that some screenings, including mammography and cervical cancer screening, would still be covered without out-of-pocket costs because the task force recommended them before the health care law was enacted in March 2010.

O’Connor, a nominee of former President George W. Bush, is the same judge who ruled more than four years ago that the entire Obama health care law was unconstitutional. That ruling was overturned by the U.S. Supreme Court.

Those suing the federal government in this case include a conservative activist and a Christian dentist who oppose coverage for contraception and HIV prevention on religious grounds. The appellate judges are Edith Brown Clement and Southwick, who were also nominated by Bush; and Stephen Higginson, nominated by Obama.

An immediate ruling is not expected.

Two Democratic lawmakers are calling on Medicare to provide more information on how the program will make good on its promise to cover Alzheimer’s treatments for seniors.

Rep. Anna Eshoo, the ranking Democrat on the House Subcommittee on Health, and Rep. Nanette Barragan said Medicare has failed to answer basic questions about how its coverage plan will work.

The lawmakers told Chiquita Brooks-LaSure, who heads the Centers for Medicare and Medicaid Services (CMS), in a letter Monday that it is still “very unclear” how seniors will access the new treatments.

Medicare has promised to cover Alzheimer’s antibody treatments on the same day the medications receive full approval by the Food and Drug Administration.

The federal health program will cover the treatments through Part B of the program for seniors. Part B typically covers treatments that seniors can’t administer at home on their own, such as infusions.

Under this policy, seniors could receive coverage for Eisai and Biogen’s antibody-infusion treatment Leqembi as soon as this summer. The FDA is expected to make a decision on Leqembi July 6.

Leqembi slowed cognitive declined by 27% in a clinical trial, though the treatment also carries risks of brain swelling and bleeding.

But Medicare will require patients to visit a doctor who participates in a so-called registry that collects real-world data on how the drug works.

Eshoo and Barragan told Brooks-LaSure that they are worried the registry could present a barrier to care.

Brooks-LaSure said last week that CMS will help set up a national registry to make it easy for doctors and clinicians to enter the required data on patients who are taking the drug.

But the lawmakers said CMS has published no details about how the required registry will actually work. The agency has not said when the registry will be live, what data must be collected, and how patients can find doctors who are participating in the system, Eshoo and Barragan said.

“At minimum, Congress, doctors, and patients deserve to have the answers to the above questions immediately,” they said.

Medicare needs to clearly define how the registry will work and make sure the system is not burdensome to patients and doctors, they added.

The lawmakers called on CMS to ensure that the registry does not create disparities in access for Black, Hispanic and Native Americans as well as people living in rural areas.

What’s more, Eshoo and Barragan said Medicare should consider dropping the registry requirement altogether.

“There needs to be clarity and transparency about the standards for coverage for FDA-approved treatments for deadly diseases with unmet medical needs,” the lawmakers said. “Please do not allow CMS’s demand for additional evidence generation be a barrier to patient care.”

The findings were presented Sunday at the American Society of Clinical Oncology’s annual meeting in Chicago and simultaneously published in the New England Journal of Medicine.

The data is the first to show how a targeted treatment for early-stage lung cancer impacts survival, said Dr. Roy Herbst, the trial’s principal investigator and deputy director at Yale Cancer Center. The drug, called osimertinib and sold under the name Tagrisso, is directed at a specific receptor that helps cancer cells grow.

“I think we’re curing some patients,” Herbst said. “We’re really showing progress in lung cancer like never before.”

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In an international study of 682 lung cancer patients, roughly half of the participants were given the daily pill for three years, while the other half received a placebo. Five years after their diagnosis, 88% of those who took the pill were still alive, compared with 78% of the placebo group. The study was funded by AstraZeneca and included people from more than 20 countries across the U.S., Europe, South America, Asia and the Middle East. 

Read the full story at NBCNews.com 

For two-time cancer survivor Teresa Giannelli, a visit to a chiropractor saved her life, as she says she never imagined the disease would come into her life more than once.

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Giannelli, 60, survived thyroid cancer due to prompt detection and treatment but when she was in remission for more than 3 years, a visit to the chiropractor gave her an unexpected diagnosis.

“After visiting the chiropractor, the doctor did some exams and told me I had multiple myeloma,” Giannelli says. “I had never heard that word in my entire life.”

Giannelli says that at the time, she couldn’t understand how a chiropractor was giving her such news, a doctor who doesn’t specialize in cancer.

“The doctors wouldn’t give me an explanation, I battled cancer once, and that second time, it wasn’t even linked to the thyroid,” she said. “They would just tell me, ‘You’re just unlucky'”.

Multiple Myeloma is known to affect the bone marrow, weaken bones, kidneys, and damage other organs.

“The first thing I thought at the time of diagnosis was my children, just them,” Giannelli said.

Her daughter, Andrea Aellos, explains how a complex situation like this made her mature at a very young age, and taught her the value to live life, every day.

“My whole life took a back seat, my personal life, my classes, my job, everything,” she says. “My priority was my mom, she was the only thing that mattered to me.”

Aellos recalls cutting her hair above her shoulders once her mom shaved her hair because of the chemotherapy as an act of support.

“I cut my hair without thinking about it too much,” “I thought my mom looked beautiful with her head shaved, I was planning to shave mine too but she wouldn’t let me,” she said.

Giannelli says she is grateful to her daughter for having the courage to help her during her worst moments. Thanks to her strength, she beat cancer for a second time and today she just focuses on living one day at a time.

FAMILY STRENGTH

Another cancer survivor, Silvia Trevisiol, 46, recalls the moments when she was diagnosed with Hodgkin lymphoma second-stage cancer. At the time, her 13-year-old daughter told her that she wasn’t going to let her mom wear bandanas whenever she lost her hair, so she asked her to wear wigs instead. “I didn’t want people to feel sorry for me, so that’s what I did, I would just tell people I had a new look,” Trevisiol says.

She remembers how frustrated she felt because she couldn’t take control of the situation. Trevisiol says she had to go from being a very impatient type of person, to letting life decide for her.

“My daughter was my strength, I would sleep with her, somehow I found reassurance and hope, she made me stronger,” Trevisiol said.

According to Trevisiol, besides her diagnosis, she also dealt with anxiety, but it didn’t last long since her daughter was always by her side, reminding her to continue fighting.

“My daughter Sabrina told me, “I don’t get you, you can’t be lying on the sofa like that if there’s people that’s actually dying,” she said.”I swear, I couldn’t believe that a 12-year-old girl was giving me such a lesson.”

Trevisiol says that after her diagnosis, she tried to continue her life as usual but the fear was always present.

“Some days I slept in my closet praying, hiding from the fear of not knowing what was going to happen,” she said.

After six months of starting treatment, she was cancer-free. Now, she’s trying to take the best out of this experience and says the little moments are what make her feel alive.

“It doesn’t matter what your hair looks like, or your body, or the material things you own…at the end of the day, none of that matters.”

In addition to having her children close, Trevisiol says it was essential for her recovery to have her husband’s company, giving her strength and motivation to continue.

According to a study by the Fred Hutchinson Cancer Research Center, a woman is six times more likely than a man to separate or divorce shortly after being diagnosed with cancer. This study examined the role gender plays in so-called “partner abandonment” and found that the longer the marriage, the more likely it was to remain intact.

These two women agree that “living one day at a time” and their families are the most important. According to both of them, family will always be there in the most difficult times, when it is needed most.

This is Maryland’s first confirmed case of measles since 2019, the Montgomery County Health Department said in a release Friday.

The infected person may have exposed the public to the disease on two occasions, health officials said:

• At the Cabin John Ice Rink in Bethesda on Wednesday, May 24, from 6-9 p.m.
• In a professional office building at 16220 Frederick Road in Gaithersburg on Tuesday, May 30 from 11 a.m. to 2 p.m.

“People, especially those who are not vaccinated against measles, who were at either of these locations during the possible exposure times should monitor themselves for any early symptoms of measles, especially fever,” the release said.

Anyone who was exposed and develops a fever should contact their health care provider. People with any symptoms should refrain from childcare, school, work or other public activities, according to health officials.

Early symptoms of measles are a fever over 101°F, runny nose, cough and red watery eyes.

“Usually, one to four days after the early symptoms, a red rash appears on the face and spreads to the rest of the body. A person with measles is contagious beginning four days before the rash appears until four days after the rash begin,” officials said.

Pregnant people, children under 1 year old and people who are immunocompromised are at heightened risk of complications from measles, officials said. People in those groups who may have been exposed in Montgomery County can contact their health care provider to discuss a medicine called immune globulin, a preventative treatment option.

Measles was declared eradicated in the United States in 2000, meaning the virus is no longer “constantly present” in the country, but there are sometimes cases and outbreaks linked to travel, according to the Centers for Disease Control and Prevention.

Five cases of measles were identified in Maryland in 2019. Virginia officials warned of two possible exposures in Fairfax County last year.

While thousands of Taylor Swift fans across the country have lived their Wildest Dreams after seeing her live on stage, some may have a tough time remembering the concert in the upcoming days.

Some concert-goers during “The Eras Tour” have reported an inability to remember much of what they witnessed.

“Anyone else not remember anything from the concert?” a Reddit post in the r/taylorswift channel read.

“Pretty much the next day it felt like I totally forgot everything, and more so now weeks later, like I wasn’t actually present for the concert,” one user replied.

Similar comments can be seen across social media platforms.

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But experts say there’s an explanation — and it’s a phenomenon they know all too well.

“Well, it’s fascinating that it takes a Taylor Swift concert and multiple concerts for this to become topical, because this is something that happens. It’s a normal process, actually,” said Dr. Robert Shulman, associate professor and acting chair for the Department of Psychiatry and Behavioral Sciences at Rush University Medical Center.

“It’s a normal phenomenon that when one is excited, and one has a lot of sensations coming in and they’re sort of hyper-focused on one thing, you know, that they may not be able to process in memory,” he explained.

Shulman said the so-called “concert amnesia” results in fans having only “snippets of memory.” They are able to remember going to the concert, but can only remember bits and pieces of the experience.

“It’s not really a full amnesia. At no point does anybody describe a fugue state where they wake up and, you know, they’ve been to the concert and are home, they don’t know how they got there, they don’t remember being anywhere.”

What Causes Post-concert Amnesia?

According to Shulman, long-term memories require the “transfer of short-term memory to the areas where long-term memory is held.” That typically occurs in the days and weeks after an event.

“So when one has a whole lot of adrenaline and corticosteroids circulating because they’re excited and jumping up and down and ‘this is the greatest thing ever,’ yeah, you’re not going to remember everything start to finish because of that. Because it interferes with how memory works,” he said.

Fans who experience this can try to recover some of their memory by listening to a song or seeing the performance played back.

“Sometimes it takes a cue,” he said. “You know, such as listening to the song, it may bring back the memory of listening and seeing the song being performed in the concert so that that’s the way you do it.”

For those attending the performances and looking to prevent amnesia from happening, Shulman said it can be as simple as practicing mindfulness.

“If you want to process as much as you can … I think the best way to do it is to is to maybe not get so caught up in the moment and such and, you know, practice a little mindfulness. You sort of step back, and you sort of survey the crowd, and you try and take it all in and what does it mean and and such. There will be visual memories. There will also be emotional memories,” he said.

Either way, Shulman said the inability to remember shouldn’t be seen as a deficiency.

“I just hope everybody enjoys they enjoy their experience anyway, and continues to enjoy the experience,” he said. “You know, even though you don’t recall stuff … folks will probably recall the emotion, that it was a great event and they had a great fun and they shouldn’t be too upset that maybe they don’t have the specifics down.”

The U.S. Food and Drug Administration has authorized the temporary importation of an unapproved chemotherapy drug from China in effort to ease an acute shortage of cancer drugs in the United States, according to an update posted to the agency’s website Friday.

Qilu Pharmaceutical, which makes and markets cisplatin injections in China, received FDA permission to export the drug to the U.S. market weeks ago, a document shows.

A letter dated May 24 from Qilu’s deputy general manager notified health care professionals of the approval.

Qilu is coordinating with a Toronto-based company, Apotex, to distribute 50-milligram cisplatin vials in the U.S.

Health care providers can begin ordering the drug Tuesday through their wholesalers.

Cisplatin is a generic drug that has been available for decades in the U.S. and is distributed by several approved manufacturers. Those manufacturers have been unable to keep up with demand. Qilu’s version of cisplatin is not approved in the U.S.

Qilu, which is headquartered in the city of Jinan in Shandong province, says it is one of the 10 largest drug manufacturers in China.

The FDA told CNBC this week the agency was considering imports of unapproved chemotherapy drugs, but it did not at that time disclose the names of any manufacturers who might provide that medication.

An FDA spokesperson said the agency assesses the quality of unapproved drug imports to make sure they are safe for U.S. patients.

Doctors say some cancer patients could die if the national shortage of drugs such as cisplatin is not resolved soon. At least 13 other cancer drugs are in short supply across the U.S.

The cancer drug shortages have forced some hospitals to ration medications by reducing the dosage to extend the supply and prioritizing patients who have a better chance of being cured.

Cisplatin is widely used to treat testicular, lung, bladder, cervical and ovarian cancers among other disease states. Up to 20% of cancer patients are treated with cisplatin and other platinum-based chemotherapy drugs, according to the National Cancer Institute.

The World Health Organization says the drug is an essential part of basic health care.

The national shortage of cisplatin began in February after a pharmaceutical company based in India temporarily halted production for the U.S. market.

Intas Pharmaceuticals decided to temporarily stop production after an FDA inspection last year found a “cascade of failure” in its quality control unit.

A spokesperson for Intas told CNBC this week the company is working with the FDA to restart production for the U.S., but no date has been set yet.

In March, Kevin Maginnis embarked on a 100-day journey to lose 50 pounds by only eating McDonald’s. Now that he’s finished the challenge, he shared the results on the TODAY show on June 1.

When the 57-year-old started going viral for his unusual weight loss methodology, he raised plenty of eyebrows. But by Day 43, he had already lost 33 pounds.

On Thursday, Maginnis stopped by Studio 1A to celebrate the last day of his unconventional experiment and revealed that he’d lost 58.5 pounds. When he started, he weighed 238 pounds and he’s now down to 179.5 pounds.

“I feel amazing,” he said on TODAY.

Before and after: Maginnis lost over 50 pounds.TODAY

Maginnis’ methods were quite straightforward: Eat three meals a day from the fast food chain, but cut the portions in half. He also skipped snacks and only drank water, about 80 to 90 ounces a day.

Nothing on the McDonald’s menu was off limits — including fries and dessert — and Maginnis didn’t work out or count calories during the experiment.

Maginnis said his bloodwork shows that his health has improved. He said he lowered his level of triglycerides, a type of fat that circulates in the body, by 205 points and his cholesterol by 65 points.

Beforehand, Maginnis was prediabetic, but he said his A1C levels (which measures your average blood sugar levels over the past three months) are now in a healthy range.

Halfway through the challenge, Maginnis’ wife, Melody, joined him. In 40 days, she’s lost 17 pounds, her husband shared.

Maginnis live in Studio 1A.Nathan Congleton / TODAY

Now that Maginnis has reached his goal weight, the next step is embarking on a workout routine.

“(I plan to) increase the beast in me. We’re going to be doing an ice plunge. I’m going do a 100-foot rope climb,” he said, adding that the latter goal is his “personal Everest.”

Maginnis is looking forward to eating a filet mignon on Friday, and he plans to eat three quarters of his meals moving forward to maintain his weight.

Maginnis understands that many people question his methods, but he said the initial part of his experiment was focused primarily on weight loss.

“Are there better micronutrients or macronutrients for brain health? Absolutely. But when it comes to getting rid of obesity, reduce the size of the meals,” he said.

TODAY.com previously consulted registered dietitian Frances Largeman-Roth to determine how healthy Maginnis’ weight loss approach is.

Largeman-Roth agreed that cutting calories is important, but suggested that anyone looking to shed some pounds focus on a more well-rounded method.

“Even though Kevin is cutting his meals in half, he’s still getting well over the recommended 2,300 milligrams of sodium daily. One bacon, egg and cheese biscuit contains 1,330 milligrams of sodium, and a Big Mac has over 1,000 milligrams without ketchup or mustard,” she explained.

Largeman-Roth also emphasized the importance of physical activity, adding that, without this, weight loss eventually plateaus.

“And let’s remember that health isn’t just about the number on the scale. It’s also about cardiovascular health and other measures,” she added.

This story first appeared on TODAY.com. More from TODAY:

• Walking this number of steps a day only a few days a week has major health benefits
• What are hidden sugars? The sweet stuff lurking in your favorite healthy foods
• What do spider bites look like? Experts share important warning signs

This story uses functionality that may not work in our app. Click here to open the story in your web browser.

It may have been a much lesser-known virus that surged for months.

Most were unaware of the respiratory virus known as hMPV, or human metapneumovirus, which can feel like a bad case of the common cold. But at its peak in mid-March, the Centers for Disease Control and Prevention saw positive testing for hMPV at around 11% — which was about 36% higher than the pre-COVID average. 

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“The virus doesn’t cause a severe infection so we don’t always test it everywhere on every patient,” said Dr. Marina Keller, an epidemiologist who treats infectious diseases at Westchester Medical Center.

While the virus, which the CDC says was discovered just over 20 years ago, generally doesn’t lead to severe illnesses, in rare cases it can lead to pneumonia. And while the peak season for it is coming to the end, it is another virus to be aware of.

According to Dr. Keller, HMPV symptoms are similar to other respiratory viruses. Symptoms include:

• Runny nose
• Sore throat
• Fever
• Cough
• Nasal congestion
• Shortness of breath

“For most of the population, it’s like other respiratory viruses, common cold. But it can be more worrisome for people who have other medical problems,” said Dr. Keller.

Those with weaker immune systems are more at risk — younger children and the elderly, especially. As the urgency regarding COVID fades and many have ditched their facemasks in most settings, it could contribute to more cases springing up.

“It is definitely possible. As we take our masks off, get a little bit more lax with our common sense precautions for viral infection, that we do see more viruses,” Dr. Keller said.

Dr. Keller says stay home if you or your kids feel sick. And, at the very least, there’s always one things that helps prevent viruses from spreading.

“Hand washing never goes out of style, prevents all kinds of viruses,” she said.

There is no treatment or vaccine for hMPV, though scientists are working on the latter. Symptoms can be treated with standard over-the-counter medications. The CDC said the estimated incubation period is three to six days, and how long those infected feel symptomatic can depend on severity, though it is similar to other respiratory illnesses.

How Is hMPV Spread?

Here’s how the virus can go from one person to another, according to the CDC:

• Particles or droplets from coughing and sneezing
• Close personal contact, like shaking hands
• Touching objects or surfaces that have the viruses on them then touching the mouth, nose, or eyes

The virus generally starts spreading in winter and lasts through the spring.

Users say berberine, which is found in a number of plants, including barberry plants, helps curb appetite and improve blood sugar levels, resulting in weight loss. Google searches for “berberine” began to increase at the end of March before they spiked in late May.

Berberine is rising in popularity as demand increases for medications like Ozempic and Wegovy, known for their weight loss effects.

Ozempic and Wegovy are part of a class of drugs called GLP-1 agonists, which mimic a hormone that helps reduce food intake and appetite. They are highly effective, but they are in short supply in the U.S. They are also expensive — around $1,000 or more out of pocket — and need to be prescribed by a doctor.

By comparison, berberine appears to be widely available online, and it usually ranges in price from $15 to $40 for a month’s supply. 

Read the full story on NBCNews.com here.

Pacino’s girlfriend, Noor Alfallah, is eight months pregnant. The “Scarface” star already has three other children: daughter Julie Marie, 33, and 22-year-old twins Anton and Olivia.

Pacino’s friend and former co-star Robert De Niro welcomed his seventh child last month at age 79.

Research published over the last decade suggests that babies born to older men have an increased risk of arriving prematurely or developing birth defects, certain cancers or neurodevelopmental disorders, though the overall risk is still low.

“Older guys have been having babies since biblical days. It’s not a new phenomenon. What we didn’t understand was they might be producing kids with a higher risk of problems,” said Arthur Caplan, a professor of medical ethics at NYU’s Grossman School of Medicine.

The medical community does not have a consistent definition of so-called advanced paternal age, but the American Urological Association and American Society for Reproductive Medicine jointly recommend that doctors talk to men ages 40 and up about the increased risk of adverse health outcomes in their offspring.

Read the full story on NBCNews.com here.

Medicare Part B will cover treatments for Alzheimer’s disease that receive U.S. Food and Drug Administration approval, according to the federal agency that administers the program for seniors.

Anyone who has Medicare Part B and meets “eligibility criteria” will be covered for new antibody treatments such as Leqembi once the FDA approves them, said Chiquita Brooks-LaSure, the administrator of the Centers for Medicare & Medicaid Services, on Thursday.

Part B is an optional part of the Medicare program for seniors that typically covers the costs of drugs patients cannot administer themselves, such as infusions.

The new policy will provide broader access to treatments, such as Leqembi, that slow cognitive decline.

But patients will have to participate in so-called registries that collect real-world data on how the drugs work.

Brooks-LaSure said the expanded coverage will go into effect on the same day the FDA approves an Alzheimer’s antibody treatment. The FDA is expected to make a decision about Leqembi on July 6.

The drug regulator’s committee of independent advisors is set to meet on June 9 to discuss the data supporting Eisai’s and Biogen’s application for the FDA to fully approve Leqembi.

The expanded coverage policy would apply to any other Alzheimer’s antibody treatment that receive full approval from the FDA. Eli Lilly is planning to submit such an application for its antibody donanemab.

The FDA granted accelerated approval to Leqembi in January, but Medicare severely restricts coverage for Alzheimer’s antibody treatments that are cleared under that expedited pathway.

As a result, seniors currently cannot access Leqembi unless they are able to personally afford the drug’s $26,500 annual price.

The Alzheimer’s Association, which lobbies for patients living with the disease, for months has called on Medicare to drop restrictions on Leqembi and fully cover the drug.

“We continue to believe that registry as a condition of coverage is an unnecessary barrier,” said Robert Egge, the association’s chief public policy officer.

Brooks-LaSure told Congress in April a registry “in no way limits people getting access to the drug.” She said at the time the goal is to set up the system when the FDA makes its decision on Leqembi on July 6.

CMS will facilitate a nationwide portal in which clinicians can enter the required data, Brooks-LaSure said Thursday.

Her agency is also in talks with multiple organizations planning to set up their own registries, she said.

A study in a leading medical journal recently projected Leqembi could cost Medicare up to $5 billion a year.

The move was first announced last year by Health Canada and is aimed at helping people quit the habit. The regulations take effect Aug. 1 and will be phased in. King-size cigarettes will be the first to feature the warnings and will be sold in stores by the end of July 2024, followed by regular-size cigarettes, and little cigars with tipping paper and tubes by the end of April 2025.

“This bold step will make health warning messages virtually unavoidable,” Mental Health and Addictions Minister Carolyn Bennett said Wednesday.

The warnings — in English and French — include “poison in every puff,” “tobacco smoke harms children” and “cigarettes cause impotence.”

Health Canada said the strategy aims to reduce tobacco use below 5% by 2035. New regulations also strengthen health-related graphic images displayed on packages of tobacco.

Bennett’s statement said tobacco use kills 48,000 Canadians every year.

Doug Roth, chief executive of the Heart & Stroke charity, said the bold measure will ensure that dangers to lung health cannot be missed.

The Canadian Cancer Society said the measure will reduce smoking and the appeal of cigarettes, thus preventing cancer and other diseases.

Rob Cunningham, senior policy analyst at the Canadian Cancer Society, said health messaging will be conveyed in every puff and during every smoke break. Canada, he added, will have the best tobacco health warning system in the world.

Tobacco advertising, promotion and sponsorship are banned in Canada and warnings on cigarette packs have existed since 1972.

In 2001, Canada became the first country to require tobacco companies to include picture warnings on the outside of cigarette packages and include inserts with health messages.

The legislation codifies an existing executive order from former Gov. Steve Sisolak last year — who lost reelection to Lombardo — that bars state agencies from assisting in out-of-state investigations that could lead to the prosecution of abortion patients who travel to Nevada. It also ensures medical boards and commissions that oversee medical licenses do not discipline or disqualify doctors who provide abortions.

Lombardo, who describes himself as “pro-life” and was endorsed by the National Right to Life Committee, said on the campaign trail that he would respect the will of voters who codified abortion rights up to 24 weeks in a 1990 referendum vote. He was the only Republican to defeat a state Democratic incumbent in the last election.

“I want to thank (Lombardo) for following through on his commitment to ensuring that Nevada won’t participate in prosecutions of women who come here to exercise their reproductive rights,” said Democratic Senate Majority Leader Nicole Cannizzaro, who sponsored the legislation, in a statement Tuesday.

Lombardo is one of the only Republican governors — following Vermont Gov. Phil Scott and former Massachusetts Gov. Charlie Baker — to sign a law enshrining protections for abortion.

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The provisions were a major flashpoint in one of the closest governor’s races of the 2022 midterms and became the latest reflection point for how Republican lawmakers and candidates navigate abortion policy debates in blue to purple states. Lombardo originally said he would repeal the executive order, but said months later he would uphold it, a reversal that Sisolak’s campaign repeatedly emphasized. In February, he signaled that he would sign the bill, which does not add any additional protections to Sisolak’s executive order.

“Governor Lombardo made a campaign commitment to ensure that Nevada would not participate in prosecuting those seeking legal medical care in the state,” spokesperson Elizabeth Ray said in a statement. “Today, Governor Lombardo kept that commitment.”

Cannizzaro told The Associated Press last month that she was not aware of particular cases of outside states prosecuting women who have come to Nevada for abortions, but said that could happen with more restrictive laws coming from other states. She referenced restrictions approved in neighboring Idaho and Utah.

Democratic-controlled states from California to Colorado to Rhode Island have approved similar legislation to the one in Nevada.

Nevada’s state Senate advanced the legislation last month, with two Republican women joining Democrats in support of the bill. Following the vote, the Nevada Republican Party said it was “horrified” that the two voted for the measure, exposing an intra-Republican rift about how to handle abortion legislation in a post-Roe world. In other cases, that involves to what extent abortion access should be restricted. The Nevada GOP did not immediately respond to a request for comment about Tuesday’s signing.

Earlier this month, Nevada’s Democratic-controlled Legislature advanced a resolution that would enshrine the existing abortion rights in the state constitution, which would make it much harder to repeal. After passing the 2023 session, it must also pass in 2025 before appearing in front of voters on the 2026 ballot. That process does not include the governor’s approval.

__

Norovirus and salmonella, germs that can cause severe illness, were the most common cause of 800 outbreaks, which encompassed 875 restaurants and were reported by 25 state and local health departments.

Investigators with the Centers for Disease Control and Prevention called for better enforcement of “comprehensive food safety policies,” which emphasize basic measures like hand washing and keeping sick workers off the job.

Although 85% of restaurants said they had policies restricting staff from working while sick, only about 16% of the policies were detailed enough to require workers to notify managers and to stay home if they had any of the five key symptoms — including vomiting, diarrhea, and sore throat with fever.

About 44% of managers told the CDC their restaurants provided paid sick leave to workers. That’s a problem, according to Mitzi Baum, the chief executive of STOP Foodborne Illness, a nonprofit advocacy group.

She said it means workers are forced to choose between earning money or showing up sick — or there’s social pressure not to leave fellow employees short-staffed.

“If there’s a positive food safety culture, you’re not penalized for illness,” Baum said.

It can be hard for consumers to know when sick workers might be on the job, she said, but there are some signs to look for: “Is your server sniffing? Are they sneezing? How are they handling the utensils?”

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About 48 million people a year in the U.S. are sickened by foodborne illness, including 128,000 who are hospitalized and 3,000 who die, according to the CDC.

Carter, now 95, remains at home with former President Jimmy Carter, 98, who has been at home receiving hospice care since early this year.

“She continues to live happily at home with her husband, enjoying spring in Plains and visits with loved ones,” the family said via The Carter Center, the global humanitarian organization the couple founded in 1982, less than two years after Jimmy Carter’s landslide defeat.

Married nearly 77 years, the Carters are the longest-married first couple in U.S. history.

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The family noted in its statement that Rosalynn Carter has spent her long public life advocating for individuals and families affected by mental illness and for those in caregiving relationships with loved ones.

“Mrs. Carter often noted that there are only four kinds of people in this world: those who have been caregivers; those who are currently caregivers, those who will be caregivers, and those who will need caregivers,” the family statement reads. “We are experiencing the joy and the challenges of this journey.”

The Carters have been visiting only with family and close friends since the former president’s announcement in February that he would forgo further medical intervention after a series of short hospital stays.

The family has not disclosed any specific diagnosis for either the former president or the former first lady. The statement Tuesday said the Carter family would have no further comment.

The Carters often described themselves as “full partners” throughout his political career and their long public life that followed. Rosalynn Carter campaigned vigorously for her husband in his bids for Georgia governor and the presidency. She used her platform to prioritize mental health awareness, working to address the stigma attached to the condition.

After their White House years, Rosalynn Carter continued her mental health advocacy at The Carter Center, and she traveled extensively with her husband as part of their work promoting democracy globally and fighting disease in the developing world.

One in 10 older Americans have dementia, the family’s statement said. “We recognize, as she did more than half a century ago, that stigma is often a barrier that keeps individuals and their families from seeking and getting much-needed support. We hope sharing our family’s news will increase important conversations at kitchen tables and in doctor’s offices around the country.”

Eleanor Rosalynn Smith was born in Plains on Aug. 18, 1927. Jimmy Carter’s mother, a nurse, delivered her in the Smith family home. Lillian Carter brought her young son back a few days later to visit, allowing the future president and first lady to meet as preschooler and newborn.

They were married July 7, 1946.

Jimmy Carter enjoyed telling everyone that his wife was “more political” than he was, a point she did not protest.

“I would be out there campaigning right now if Jimmy would run again,” she wrote just a few years after his defeat. “I miss the world of politics.”

The season also presents unique risks to children’s health and safety, according to experts. Whether kids are enjoying the summer at home, going on vacations or heading to camp, it’s important to ensure they are having fun safely.

We spoke to pediatric emergency medicine physicians about some of the top reasons why children end up in the ER during summer, risky activities they wouldn’t let their own children do and how parents can ensure their kids stay safe this summer.

Play with fireworks

When asked about this nostalgic summer activity, the experts unanimously agreed that fireworks should be left to the professionals and enjoyed from a safe distance. That means no home fireworks, even the legal ones.

Every summer, children come into the emergency room with injuries related to fireworks — unsurprisingly, these tend to spike around the Fourth of July, Dr. Brent Kaziny, medical director of emergency management at Texas Children’s Hospital, tells TODAY.com.

These range from minor to third-degree burns, severe injuries to the face or eyes, and even losing fingers or hands, says Kaziny. In 2021, there were nine deaths in the U.S. due to fireworks, according to the U.S. Consumer Product Safety Commission.

Fortunately, most of these injuries can be prevented by not setting off fireworks at home, the experts note. If parents still want to take that risk, Kaziny emphasizes that children should never be allowed to touch or light any of the fireworks, including sparklers.

“Parents need to recognize that sparklers can get up to temperatures of over 2000 degrees Fahrenheit. It’s essentially like a welding torch type of heat,” says Kaziny. He recommends safer alternatives like glow sticks, especially for young children.

“Fireworks can be such a fun part of celebrating summer holidays, but it’s really not worth a devastating lifelong injury for your child,” Dr. Caitlin Farrell, a pediatric emergency medicine physician at Boston Children’s Hospital and injury prevention researcher at Harvard Medical School, tells TODAY.com.

Go in or around home pools unsupervised

Swimming pools are one of the joys of summer, but also one of the biggest dangers for kids, the experts say. Drowning is the leading cause of death for children ages 1 to 4 in the United States, and most of these drownings occur in home swimming pools, according to the U.S. Centers for Disease Control and Prevention.

Drownings and submersion injuries often happen quickly and quietly, Dr. Meghan Martin, a pediatric emergency medicine physician at Johns Hopkins All Children’s Hospital, tells TODAY.com. Because of this, she says kids should never be left in or around a swimming pool unsupervised. “Avoid stepping away, even for just a second, because that’s when it all happens,” says Martin.

Always make sure there is a designated “water-watcher” supervising kids in the pool, says Farrell, especially when young kids or toddlers are in the water. Parents should also teach children about pool safety as early as possible so they know not to get in the water when adults aren’t around and how to get out, Farrell adds.

Ideally, Farrell says home swimming pools should have a four-sided pool fence that self-locks or self-latches and is at least four feet tall.

“There is no hack for safety when it comes to kids around water; it’s making sure you have your full attention on the kids and then early swim lessons,” says Martin.

Swim in a rough ocean

Relaxing at the beach is a favorite summer activity for many families. However, the ocean presents unique risks — and drowning accidents in natural water (including oceans) are common among kids, especially those ages 5 to 14, according to CDC data.

Before going to the beach, always check the weather conditions and surf zone forecast, the experts note. “When you’re at the beach, make sure you’re paying attention to any advisories related to undertows or rip tides,” says Kaziny. If there are beach flags raised or lifeguard warnings, always listen to them, he adds.

In any case, if the ocean seems too rough or the current too strong, Martin recommends parents keep children out entirely, especially if they are young or not strong swimmers.

When children do swim in the ocean, they should be accompanied by parents or closely supervised, Kaziny says. U.S. Coast Guard-approved life jackets or floaties can offer an extra layer of protection. “The biggest thing that you can do (to protect) younger kids is get them in swim lessons,” says Kaziny.

Another beach safety tip from Martin is teaching children how to swim out of a rip tide, which involves swimming parallel to the beach and never against the current. “Even the strongest swimmers can fall into this trap,” she notes.

Spend time in the sun without protection

Sunshine can be one of the best parts of summer, but it’s important for parents to take steps to protect children from too much exposure to ultraviolet (UV) rays, the experts note.

“Every summer, we see some really bad sunburns in kids, especially in infants,” says Martin, adding these include second-degree sunburns that blister and damage the skin.

A history of one or more sunburns during childhood has been found to increase the risk of developing skin cancer as an adult, according to the CDC. Sun protection is key for both children and adults all summer long, the experts note.

“Babies under 6 months should really be out of direct sunlight,” Kaziny says, adding that parents should bring an umbrella or pop-up shelter to provide extra shade when spending time outside.

All children should wear sunscreen before spending time out in the sun, says Kaziny. The sunscreen should be broad spectrum (protects against UVA/UVB rays), he adds, and at least SPF 15 but ideally higher. “Make sure that you’re reapplying regularly or at least every two hours and after they get in the water and dry off,” says Kaziny.

In addition to sunscreen, Kaziny recommends children wear hats, sunglasses and protective clothing, like long-sleeved rash guards when possible.

If a child gets sunburned, parents should ensure they drink plenty of fluids and use over-the-counter pain relievers, as well as medicated lotions, says Kaziny. Parents should always reach out to their child’s pediatrician if they have concerns or questions.

Children are also at risk for sun poisoning, a severe sunburn that can mimic an allergic reaction or flu-like illness, per the Cleveland Clinic — on top of scorched skin, it can cause a fever, chills, severe rash, nausea, dehydration and dizziness.

Ride a bike without a helmet

Bicycle accidents occur year-round, but they surge among kids in the summer when school is out and people are spending more time outside, says Farrell. Resulting injuries can range from cuts and bruises to broken bones and traumatic brain injuries, TODAY.com previously reported.

“When kids fall and hit their head or injure their brain … these can be devastating injuries (with) a lifetime consequence,” says Farrell, adding that it’s essential for all children to wear helmets every time they ride a bike, no matter how close to home.

“Older kids often don’t think they need a helmet because they’re good bike riders and they’re not afraid of falling,” says Farrell. But emergency room visits prove otherwise. Adolescents and teens have some of the highest rates of bicycle-related injuries treated in emergency departments in the U.S., per the CDC.

No matter how experienced the bike rider, accidents can happen, the experts note. “(Helmets) are a simple safety rule that we know saves lives,” says Farrell, adding that parents should consistently wear helmets as well to model this behavior for children.

A final word on child safety

These aren’t the only popular activities that are risky or unsafe for children. TODAY.com reported previously that pediatric emergency medicine also experts caution against these activities year-round: driving ATVs, jumping on trampolines unsupervised, touching unfamiliar pets, riding in the front seat of a car under the age of 13, and going into another home without asking about firearms.

Early findings from the National Institutes of Health’s study highlight a dozen symptoms that most distinguish long COVID, the catchall term for the sometimes debilitating health problems that can last for months or years after even a mild case of COVID-19.

Millions worldwide have had long COVID, with dozens of widely varying symptoms including fatigue and brain fog. Scientists still don’t know what causes it, why it only strikes some people, how to treat it – or even how to best diagnose it. Better defining the condition is key for research to get those answers.

“Sometimes I hear people say, ’Oh, everybody’s a little tired,'” said Dr. Leora Horwitz of NYU Langone Health, one of the study authors. “No, there’s something different about people who have long COVID and that’s important to know.”

The new research, published Thursday in the Journal of the American Medical Association, includes more than 8,600 adults who had COVID-19 at different points in the pandemic, comparing them to another 1,100 who hadn’t been infected.

By some estimates, roughly 1 in 3 of COVID-19 patients have experienced long COVID. That’s similar to NIH study participants who reported getting sick before the omicron variant began spreading in the U.S. in December 2021. That’s also when the study opened, and researchers noted that people who already had long COVID symptoms might have been more likely to enroll.

But about 2,230 patients had their first coronavirus infection after the study started, allowing them to report symptoms in real time -– and only about 10% experienced long-term symptoms after six months.

Prior research has suggested the risk of long COVID has dropped since omicron appeared; its descendants still are spreading.

The bigger question is how to identify and help those who already have long COVID.

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The new study zeroed in on a dozen symptoms that may help define long COVID: fatigue; brain fog; dizziness; gastrointestinal symptoms; heart palpitations; sexual problems; loss of smell or taste; thirst; chronic cough; chest pain; worsening symptoms after activity and abnormal movements.

The researchers assigned scores to the symptoms, seeking to establish a threshold that eventually could help ensure similar patients are enrolled in studies of possible long COVID treatments, as part of the NIH study or elsewhere, for apples-to-apples comparison.

Horwitz stressed that doctors shouldn’t use that list to diagnose someone with long COVID — it’s a potential research tool only. Patients may have one of those symptoms, or many -– or other symptoms not on the list — and still be suffering long-term consequences of the coronavirus.

Everyone’s doing studies of long COVID yet “we don’t even know what that means,” Horwitz said.

The prevailing theory points to three possible factors: First, the infant is at a critical stage of development during the first year of life. Second, the baby is exposed to a stressor, such as sleeping face down, which can lower the amount of oxygen in their blood while raising the level of carbon dioxide. And third, the infant has an underlying abnormality that makes it harder to survive that traumatic event.

A study published Thursday in the Journal of Neuropathology & Experimental Neurology points to one such abnormality.

Researchers from Boston Children’s Hospital and Rady Children’s Hospital in San Diego found that a particular brain receptor likely involved in helping babies gasp for air was altered in some infants who died of SIDS. The receptor in question is part of the serotonin system, which plays an important role in regulating involuntary body functions like heart rate, breathing and blood pressure.

SIDS usually happens during an infant’s sleep, and though it’s rare, it’s the leading cause of death among babies between one month and one year old in the U.S. The Centers for Disease Control and Prevention attributed nearly 1,400 infant deaths to SIDS in 2020.

Read the full story on NBCNews.com

It’s a simple questionnaire patients fill out before the appointment.

“This allows us to have early detection and follow up for depression, which impacts our lives and saves lives, too,” Inova Behavioral Health Services President Dr. Linda Lang said.

Every patient starts by answering two basic questions about their mental health, Lang said.

“The questions are basically asking over the last two weeks, how often have you been bothered by little interest or pleasure in doing things,” she said. “And then the second question is feeling down, depressed or hopeless.”

Depending on how patients answer, they may get prompted to answer a few follow-up questions. If the screening shows warning signs for depression or self-harm, patients can get help in real time.

“A high score, which is 25 or greater, will trigger us to connect a patient with a behavioral health consultant right there in the office,” Lang said.

The new screening tool is being used across Inova Health System for anyone who’s seeing a primary care physician or visiting the emergency department and specialty clinics.

The rollout began in April, and they’ve already had success, Lang said.

“We were able to make a connection and get those patients into treatment where they otherwise would not have even really been asked the question,” Lang said. “So, we feel like this is absolutely serving the community and transforming the way we care for our community.”

According to the Centers for Disease Control and Prevention, almost 20% of people are affected by depression, and the pandemic has only made matters worse.

“Our memory can be affected by depression, our ability to sleep well, our appetite,” Lang said. “It is part of our total life and total health, and I think we want to see people holistically now and have it really be woven into everything that we think about.”

If you or someone you know needs help, please contact the National Suicide Prevention hotline at 1-800-273-8255, or reach out to the Crisis Text Line by texting ‘Home’ to 741741, anytime.

The analysis of data from more than 3,500 older participants showed that those who took a daily Centrum Silver pill over a period of three years had better memories than those who received a placebo treatment, according to the report published in The American Journal of Clinical Nutrition.

The effects seen in the study are “very, very encouraging,” said study co-author Adam Brickman, a professor of neuropsychology at the Vagelos College of Physicians and Surgeons at Columbia University.

“Cognitive change and memory loss are a top health concern for older adults,” he said. “And we don’t have many strategies to mitigate the changes that come with aging. So it’s encouraging that a supplement can help address one of the main health concerns older adults have.”

To explore whether a daily multivitamin could benefit cognitive function, the researchers turned to participants in the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), a multi-year study that has enrolled 21,442 older men and women to investigate the effects of cocoa supplements and multivitamins on cognition and the risk of cancer and cardiovascular events.

Haleon, formerly known as Pfizer Consumer Healthcare, makes Centrum Silver and provided vitamins used in the trial. Mars Edge, part of the Mars candy and snack maker, partially funded the study with the National Institutes of Health. Neither company had any role in designing the trial or input in the findings. 

Read the full story on NBCNews.com here.