Uncategorized
September 21, 2023
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7 minutes Read

With Demand for Mental-Health Care Soaring on Campus, Faculty and Students Are Stepping Up to Help

After the pandemic shut down Duke University’s campus in 2020, public-policy professor Nick Carnes worried about how his students would fare both educationally and emotionally. Wanting to help in whatever way he could, he added a simple message to his email signature.

“A note to students,” he wrote. “Please let me or another Duke professor know if you’re having any problems with your safety, well-being, or access to educational or other resources, or if you need to talk about anything right now, and/or if you know of another student who is having trouble. When in doubt, please reach out.”

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Three years later, with campus back to pre-pandemic normal, Carnes hasn’t found a reason to delete the message. “A lot of students will probably roll their eyes,” he says. “But you want them to have so internalized your availability to help with a crisis that they find it sort of corny and laughable when you remind them of that.”

Not so long ago, it might not have been obvious that a public-policy professor would be willing to talk through his student’s stressors and struggles. But these days, with teenagers and young adults reporting mental-health issues in record numbers, Carnes is part of a growing trend.

Colleges have long offered on-campus health and counseling centers, but demand for mental-health support is surging such that many schools can’t meet it through traditional means. Rather than solely recruiting more therapists—a costly and difficult proposition, given that the U.S. behavioral-health field is short thousands of needed clinicians—colleges and universities across the U.S. are leaning on faculty, staff, and even students to help bridge the gap.

“The mental-health crisis is significantly increasing the demand for services and we have fewer people coming into the profession and a lot of people leaving the profession,” says Sarah Reives-Houston, who runs a behavioral-health program at the University of North Carolina at Chapel Hill (UNC). Expanding the availability of community support is a faster and more feasible—not to mention more affordable—approach than training up a new generation of therapists, and one that could ultimately be more effective, Reives-Houston says, because it “broadens the net.”

Training faculty, staff and students

UNC has so far coached more than 900 faculty, staff, and students in Mental Health First Aid, a research-backed program that teaches people to identify and respond to signs of mental distress in others. Participation is mostly voluntary and, perhaps unsurprisingly, Reives-Houston says demand has been highest among faculty and staff specializing in “helping professions,” such as nursing and social work. In the future, she says, the school plans to focus its recruitment in departments like business and the sciences to reach more people.

The need is clear. In a survey taken by about 7,000 U.S. college students during the 2022-2023 academic year, 41% reported recent symptoms of depression, 36% said they’d recently felt anxiety, and 14% said they’d considered suicide in the past year. Another survey from a few years prior found that 60% of students had experienced “overwhelming” anxiety and half said they’d been so depressed it was difficult to function.

Carnes, the Duke professor, admits it can be daunting to help when students reach out to talk. “I’m not a psychologist. I’m not a therapist,” he says. “There’s always a fear in my mind, ‘What if a student asks me a question I don’t know how to answer?’ But I had to get over that fear, because when students do ask things I can’t answer, I can still refer them to people who can.”

The responsibility to ensure students “not only do their best, but feel their best” can’t stop at the campus counseling center, says Sian Beilock, a cognitive scientist who recently became president of Dartmouth. During their college years, young adults are “acquiring the skills and habits that will be with [them] forever,” Beilock says. “It’s such an important time to make sure that students are equipped with the tools to help themselves.”

To that end, when Beilock took the reins at Dartmouth earlier this year, she debuted a campus well-being plan that includes training on Mental Health First Aid and suicide prevention for many faculty and staff; the creation of a new chief health and wellness officer position; and a policy that allows students to take time away from academics to tend to their mental or physical health without losing campus access and while receiving financial assistance for health insurance, if necessary.

Starting as early as elementary education, schools often act as a “de facto mental health hub,” for students, says Dr. Asha Patton-Smith, a child and adolescent psychiatrist with Kaiser Permanente in Virginia. Students go to school almost every day—or, in the case of many college students, live there 24/7. It can be easier to deliver care in this familiar and accessible environment, rather than leaving young people to navigate the traditional mental health system, with its high price tags, long waits, and inadequate supply of clinicians.

Studies show this approach works at various levels of schooling. Among adolescents, school-based health programs can improve well-being and reduce suicidal ideation, drug use, and risky sexual behavior, according to the U.S. Centers for Disease Control and Prevention. On college campuses, meanwhile, there’s evidence to support programs that teach coping skills and mindfulness, as well as regular screenings for mental-health issues, according to a report from the American Council on Education (ACE).

But the ACE report also notes that programs meant to train non-professionals in mental-health support aren’t universally shown to be effective in studies. After training, participants typically report more knowledge about mental health and more confidence about the idea of intervening if someone is in need—but that doesn’t always translate to actually intervening, nor does it mean the person who is struggling goes on to receive formal care. “We are not recommending the complete abandonment” of these programs, the authors write in the ACE report, but they shouldn’t be a campus’ only solution.

Peer support is one approach that can augment these programs—and one in use at schools like Washington University in St. Louis, which operates Uncle Joe’s Peer Counseling and Resource Center, a hotline through which students can talk with trained peer counselors 24/7. In-person office hours are also available from the college-student-friendly hours of 10 p.m. to 1 a.m., and the programs’ volunteers can connect students with other resources on campus or in the community if necessary.

Receiving help from peers

“Unlike traditional counseling where you might have a counselor who’s 20 or 30 years older than you, we’re at a similar spot in life,” says Mallory Leff, a senior who co-directs the program. “Being able to talk to someone who seems closer to a friend than an adult is an easier step for people to take.”

Bringing peers together is the cornerstone of nonprofit Radical Hope’s program, too. The group trains students at dozens of colleges across the country—including New York University, Northeastern University, and Delaware State University—to lead a free four-week curriculum designed to help their peers learn self-care, social-connection, and coping skills. The idea, says CEO Liz Feld, is to help students improve well-being and build resilience before they reach a crisis point.

“A lot of the issues that they’re dealing with are not issues that should ever rise to the level of needing clinical help,” Feld says. “What they really need is to talk to people who’ve had similar experiences, who share their thoughts and fears and anxieties and excitement about this chapter in their lives.”

That rings true for Delaney Dardet, who co-directs Uncle Joe’s with Leff in St. Louis. “We can’t have the same experiences as someone else,” she says. “But just to know that there’s another voice and ear on campus that you can talk to” can make all the difference.

Faculty, staff, and even students are now helping to support well-being on college campuses.

Uncategorized, healthscienceclimate

Health – TIME

Faculty, staff, and even students are now helping to support well-being on college campuses.

Uncategorized
September 20, 2023
48 views
4 minutes Read

Biden Administration Announces $600M to Produce No-Cost COVID Tests

WASHINGTON — The Biden administration announced Wednesday that it is providing $600 million in funding to produce new at-home COVID-19 tests and is restarting a website allowing Americans to again order up to four free tests per household — aiming to prevent possible shortages during a rise in coronavirus cases that has typically come during colder months.

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The Department of Health and Human Services says orders can be placed at COVIDTests.gov starting Sept. 25, and that no-cost tests will be delivered for free by the United States Postal Service.

Twelve manufacturers that employ hundreds of people in seven states have been awarded funding and will produce 200 million over-the-counter tests to replenish federal stockpiles for government use, in addition to producing enough tests to meet demand for tests ordered online, the department said. Federal officials said that will help guard against supply chain issues that sparked some shortages of at-home COVID tests made overseas during past surges in coronavirus cases.

Dawn O’Connell, assistant secretary for preparedness and response at HHS, said the website will remain functional to receive orders through the holidays and “we reserve the right to keep it open even longer if we’re starting to see an increase in cases.”

“If there is a demand for these tests, we want to make sure that they’re made available to the American people for free in this way,” O’Connell said. “But, at this point, our focus is getting through the holidays and making sure folks can take a test if they’re going to see Grandma for Thanksgiving.”

The tests are designed to detect COVID variants currently circulating, and are intended for use by the end of the year. But they will include instructions on how to verify extended expiration dates, the department said.

The initiative follows four previous rounds where federal officials and the U.S. Postal Service provided more than 755 million tests for free to homes nationwide.

It is also meant to complement ongoing federal efforts to provide free COVID tests to long-term care facilities, schools, low-income senior housing, uninsured individuals and underserved communities which are already distributing 4 million per week and have distributed 500 million tests to date, the department said.

O’Connell said manufacturers would be able to spread out the 200 million tests they will produce for federal use over 18 months. That means that, as demand for home tests rises via the website or at U.S. retailers when COVID cases increase around the country, producers can focus on meeting those orders — but that they will then have an additional outlet for the tests they produce during period when demand declines.

“We’ve seen every winter, as people move indoors into heated spaces, away from the outside that, over each of the seasons that COVID’s been a concern, that we have seen cases go up,” O’Connell said.

She added that also “there’s always an opportunity or chance for another variant to come” but “we’re not anticipating that.”

“That’s not why we’re doing this,” O’Connell said. “We’re doing this for the fall and winter season ahead and the potential for an increase in cases as a result.”

HHS Secretary Xavier Becerra said that the “Biden-Harris Administration, in partnership with domestic manufacturers, has made great strides in addressing vulnerabilities in the U.S. supply chain by reducing our reliance on overseas manufacturing.”

“These critical investments will strengthen our nation’s production levels of domestic at-home COVID-19 rapid tests and help mitigate the spread of the virus,” Becerra said in a statement.

The Department of Health and Human Services says orders can be placed at COVIDTests.gov starting Sept. 25.

Uncategorized, Biden Administration

Health – TIME

The Department of Health and Human Services says orders can be placed at COVIDTests.gov starting Sept. 25.

Uncategorized
September 20, 2023
43 views
9 minutes Read

What Psychedelics Can Teach Us About Play

We are in the midst of a new psychedelic renaissance. Drugs like MDMA and psilocybin are being ushered into mainstream medicine, promoted as miracle cures for a host of psychiatric woes. But as psychedelics come to be seen as treatments for various types of psychological suffering, we are overlooking one of their most precious offerings: the potential for play.

“Neuroplasticity” is the word many mental health professionals are now using to describe the positive effect of psychedelics; a process in which the brain sort of loosens up, becoming flexible and open to learning (Children’s brains, for instance, are highly plastic.) Plasticity is why researchers believe psychedelics show promise in helping individuals who are suffering from psychological complaints related to obsessiveness, ruminations, and habits—what professionals diagnose as “depression,” “anxiety,” and “addiction.” And it’s one reason psychedelics help people in general, moving them from a sense of repetitiveness in their lives to a more expansive, awakened encounter with the world.

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Neuroplasticity primarily focuses on cognition, emphasizing the role of thinking. But that’s where the idea of a more flexible brain misses the most interesting and most human element in psychedelics: Experience, not just thinking, has always been the central way psychonauts talk about the effects of these medicines, especially in regard to mystical experiences: When we “open the doors of perception,” we’re not just thinking differently, we’re experiencing differently; encountering the world in a new or altered way through our thoughts, yes, but just as importantly, through our feelings, perceptions, intuition and gut instincts.

In our increasingly data-driven society, where the measurable and visible aspects of life often receive higher validation and credibility, the significance of subjective experience—the sentient (experiencing) “you” that interacts with the world—is diminishing. That’s a problem, since you really can’t describe a soul or a self without starting with the idea that they are, at base, sites of experience. Things get soulless fast when we define people as merely thinkers.

In this sense, it is no coincidence that prominent researchers are studying the transformative effects of psychedelics consider mystical experiences as the core therapeutic component of these substances. Neuroplasticity fails to encapsulate this crucial aspect in any shape or form. On the other hand, play, its more profound, engaging, and spiritual cousin, does.

Play has been given too “fun” a rap in our culture. For children and adults alike, play can obviously involve fun and amusement. But play is so much more than that, and is very serious business.

To understand what I mean by play, imagine a lump of clay in your hand. It exists independently of you. Yet here you are, able to mold it. That’s the first thing to understand about play: It’s the act of taking something into your hands or mind and experiencing it as pliable.

Play is most awesome and even magical in its ability to make us see possibility and malleability in things that, unlike wet clay, appear completely inert. Think about a child playing with their toys. These toys are manufactured by others, and thus exist in an external world to the child, and they can be as solid as a wood block. Yet the child playing with them experiences their toys as if they are as compliant, as ready for possibility, as wet mud in their hands. When we adults play with ideas, we’re doing something very similar, looking at all angles of some theory or concept that may seem like settled law. That’s what places this mindset at the center of psychological change, which depends on our ability to take a more flexible and innovative approach to old narratives about ourselves, and to see possibility in revisions to those stories that often motivate us to alter our lives and change our relationship to our suffering.

In many ways, proponents of psychedelic-induced plasticity seek precisely this quality—a departure from habitual thoughts and behaviors through a more flexible worldview. However, they fall short by limiting their focus to thinking.

Back to the clay: you shape it, forming something entirely unique. Whatever you make from it, this clay will become a creation: something from you that exists independently of you.

That’s the next thing to understand about play: Through it, the invisible landscapes of our inner lives merge with the visible world we all perceive in our own unique ways. When we play, we always play with someone or something: it’s always a relationship, an encounter between the “me” of our original, creative impulses and a “not-me” of a world that goes on without us, as the great psychoanalyst D.W. Winnicott called it in his seminal 1971 book Playing and Reality. Play thus acts as an antidote to the isolation and disconnection inherent in psychological suffering—it is inherently collaborative and connective.

Think, for a moment, about listening to your favorite song. While you may have had nothing to do with the creation of this cherished gift from the land that is not-you, what you gain from listening to it is tremendously dependent on your own unique being: You chose the song, the song means something to you, it reflects your particular taste in music and it might be your favorite because it resonates so powerfully with your own memories and experiences. In fact, it’s nothing to you without your “me.” It’s also nothing if it were never written or played by the “not-me” of musicians. The whole event is a collaboration between the ineffable space of your unique soul and a world made by others; and the end result is a one-of-a-kind encounter.

Winnicott called the in-betweenness generated in play transitional meaning a sort of experiential space and a particular state of mind you enter when you play, created between (a subjective) you and the (objective) world. Not unlike a psychedelic trip in this way, with its sense of interconnectedness, a loss of a solid ego state, and a deep feeling of being related to everything. “The sensation that the partition between ‘here’ and ‘there’ has become very thin is constantly with me,” wrote Bill W., the founder of AA, about his psychedelic journey, capturing well the “here” of “me,” and the “there” of “not me,” and a thinning of the barrier between the two.

When you’re in this transitional space, you experience what Winnicott called “going-on-being”: a sense of life coursing through you, your soul stirring, and a self emerging alive here on earth. “It is in playing and only in playing,” wrote Winnicott. “that the individual child or adult is able to be creative and to use the whole personality, and it is only in being creative that the individual discovers the self.” So here’s another important aspect of play: it conjures you to life.

Play also evokes our perception of life within other living beings. As you mold the clay, you perceive it as imbued with vitality. If that sounds a little far out, recall the child playing with her toys: an intrinsic element of her play is her summoning of life to those toys, seeing them as animated.

This, too, is a central element of the psychedelic experience—the recognition that the world around us is alive, vivid, animated, its vitality extending beyond our individual existence. Remarkable, when you think about it—how play performs two really important tasks that are both central elements of religion (especially early religions) and central themes in psychedelic experiences: stirring souls to a feeling of greater aliveness and animating the world around us.

None of us always vibrantly experiences the relationship between the outer world and our inner life. We sometimes feel lonely, isolated, dislocated and empty inside. These feelings (and lack of feelings) come up when we’ve not been able to enter into a playful mindset. Play is always about being in relationship, since play is always an act of playing with something else, whether that be other people and beings, toys, ideas, imagination, words, tools, instruments.

Through play, we also encounter the vitality within the space between ourselves and the external world. While the idea that this middle space has a life of its own seems a little mystical, I’ll bet you know the experience of an “us” that has its own spirit and character. Think of a great night out with friends. Do you think back on one friend making that night great, or do you think about the group, and a sort of unique spirit to that group? If you chose the latter, that is what I’m writing about: a sense of an unseen party to your party, the unique space you formed by relating.

Because we live in ecologies, life is something that flows between us. Play gives us access to this living middle element since it’s an inherently collaborative and relational activity. As do psychedelic experiences, by the way.

Psychedelics are not magic bullets, but they do hold great magic. In the religious realm, they are the substances people have been taking for centuries as a way to reach the divine, and the encounters people experience today with deities can’t be swept under the rug as mere drug-induced states. Psychedelics also offer access to deep secular magic: a conjuring of life in one’s being and in others, an alertness to the strange and beautiful novelty of the world around us, an experiencing of one’s connection to this world, and the ability to take what seems solid within us and mold it like clay.

In other words, to do the thing we are already equipped to do, since it is the most human thing to do: play.

Psychedelics, while not magic bullets, hold great magic. One of them is to invoke our ability to play, writes Ross Ellenhorn.

Uncategorized, freelance

Health – TIME

Psychedelics, while not magic bullets, hold great magic. One of them is to invoke our ability to play, writes Ross Ellenhorn.

Uncategorized
September 20, 2023
43 views
24 minutes Read

The Man Who Thinks He Can Live Forever

In a neat little neighborhood in Venice, Calif., there’s a block of squat, similar homes, filled with mortals spending their finite days on the planet eating pizza with friends, blowing out candles on birthday cakes, and binging late-night television. Halfway down the street, there’s a cavernous black modern box. This is where Bryan Johnson is working on what he calls “the most significant revolution in the history of Homo sapiens.”

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Johnson, 46, is a centimillionaire tech entrepreneur who has spent most of the last three years in pursuit of a singular goal: don’t die. During that time, he’s spent more than $4 million developing a life-extension system called Blueprint, in which he outsources every decision involving his body to a team of doctors, who use data to develop a strict health regimen to reduce what Johnson calls his “biological age.” That system includes downing 111 pills every day, wearing a baseball cap that shoots red light into his scalp, collecting his own stool samples, and sleeping with a tiny jet pack attached to his penis to monitor his nighttime erections. Johnson thinks of any act that accelerates aging—like eating a cookie, or getting less than eight hours of sleep—as an “act of violence.”

Johnson is not the only ultra-rich middle-aged man trying to vanquish the ravages of time. Jeff Bezos and Peter Thiel were both early investors in Unity Biotechnology, a company devoted to developing therapeutics to slow or reverse diseases associated with aging. Elite athletes employ therapies to keep their bodies young, from hyperbaric and cryotherapy chambers to “recovery sleepwear.” But Johnson’s quest is not just about staying rested or maintaining muscle tone. It’s about turning his whole body over to an anti-aging algorithm. He believes death is optional. He plans never to do it.

Outsourcing the management of his body means defeating what Johnson calls his “rascal mind”—the part of us that wants to eat ice cream after dinner, or have sex at 1 a.m., or drink beer with friends. The goal is to get his 46-year-old organs to look and act like 18-year-old organs. Johnson says the data compiled by his doctors suggests that Blueprint has so far given him the bones of a 30-year-old, and the heart of a 37-year-old. The experiment has “proven a competent system is better at managing me than a human can,” Johnson says, a breakthrough that he says is “reframing what it means to be human.” He describes his intense diet and exercise regime as falling somewhere between the Italian Renaissance and the invention of calculus in the pantheon of human achievement. Michelangelo had the Sistine Chapel; Johnson has his special green juice.

But when I showed up at Johnson’s house one Monday in August, I wasn’t really there to figure out if his elaborate age-defying strategies actually worked. I assumed that given my family history of cancer and personal fondness for pepperoni pizza, I probably won’t live long enough to find out. Instead, I spent three days observing Johnson to learn what a life run by an algorithm would look like, and whether the “next evolution of being human” would have any real humanity at all. If living like Johnson meant you could live forever—a big if!—would it even be worth it?

Kate Tolo opens the door to Johnson’s house and welcomes me inside. Tolo, a 27-year-old former fashion strategist who is originally from Australia, is Johnson’s chief marketing officer and most loyal disciple. Two months ago, she became the first person aside from Johnson to commit to Blueprint, making her the first test of how Blueprint works on a female body. Tolo is known as “Blueprint XX.”

The home is beautiful and devoid of clutter, with floor-to-ceiling windows looking out on the pool and lush greenery outside. It reminds me of an Apple Store in a jungle. Tolo offers me a little bowl of special chocolate, which had been “un-dutched,” stripped of heavy metals, and sourced only from regions with high polyphenol density. It tastes like a foot. She also makes me a juice-like concoction that contains chlorella powder with spermidine, amino complex, creatine, collagen peptides, cocoa flavanols, and ceylon cinnamon. Tolo and Johnson call it the Green Giant, but it looks almost black, like the stuff that washes off a duck after an oil spill. She manages to mix it without getting any of the dark sludge on her immaculate white jumpsuit. “It moves through some people’s digestive system faster than others,” she chirps, gesturing to the nearby bathroom. I take a tentative sip. It tastes like Gatorade, but sandy.

Johnson walks into the room, wearing a green T-shirt and tiny white shorts. He has the body of an 18-year-old and the face of someone who had spent millions attempting to look like an 18-year-old. His skin is pale and glowing, which is partly because of the multiple laser treatments he’s done, and partly because he had no hair on his entire body. The hair on his head is “not dyed,” Johnson says, but he does use a “gray-hair-reversal concoction” which includes “an herbal extract” that colors the hair a darkish brown. He gestures to my Green Giant, and then toward the bathroom. “Did you warn her?” he asks Tolo. I pretend to take another sip.

The next day, Johnson walks me through his morning routine, step-by-step. He woke up at 4:53 a.m, but delayed most of his routine until I arrive at 7 a.m. to observe him. His bedroom has almost nothing in it: no photos, no books, no television, no glass of water, no phone charger, no chair with piled-up clothes he tried on once, no dry cleaning he meant to put away, no towels, no mirror, no nothing. “I only sleep in here,” he says. “No work, no reading.” The only two objects in the room besides his bed are a laser face-shield he uses for collagen growth and wrinkle reduction, and the device he wears on his penis while he sleeps to measure his nighttime erections. “I have, on average, two hours and 12 minutes each night of erection of a certain quality,” he says. “To be age 18, it would be three hours and 30 minutes.” Nighttime erections, he says, are “a biological age marker for your sexual function,” one that also has implications for cardiovascular fitness. The erection tracker looks like a little AirPods case with a turquoise strap, like a purse worn by a penis. (No penises were viewed in the reporting of this article.)

When Johnson wakes up and removes the device, he weighs himself on a scale that uses “electrical impedance” to measure his weight, body-mass index, hydration level, body fat, and something called “pulse wave velocity,” which he explained but I didn’t quite grasp. “I’m in the top 1% of ideal muscle fat,” he says. Then he turns on his light-therapy lamp (which mimics sun exposure) for two to three minutes to reset his circadian rhythm. He takes his inner-ear temperature to monitor changes in his body, and starts off with two pills of ferritin to boost his iron, along with some vitamin C. He washes his face, uses a cream to prevent wrinkles, and puts on a laser light mask for five minutes, with red and blue lights designed to stimulate collagen growth and control blemishes. By this time, it’s typically about 6 a.m., and Johnson walks downstairs to start his day.

The Blueprint supplement regimen is arranged on Johnson’s kitchen counter, organized from left to right. He begins with eye drops for his pre-cataracts, then uses a little vibrating device against the side of his nose to stimulate a nerve that apparently helps his eyes create tears. Johnson makes his Green Giant, then starts taking more pills in between sips of dark-green sludge. “It’s what my body has asked for,” he says. Does he ever miss coffee, even a little? “I love coffee, it’s so fun,” he says. “It’s an addictive escalation drug for me.”

At this point, he begins doing special exercises to increase his grip strength. Then he heads to his home gym—decorated with a floor-to-ceiling wallpaper photograph of a forest—and starts an hour-long routine. Johnson can leg-press 800 lbs., but his daily workout isn’t much more advanced than something you’d see from a very enthusiastic guy at the gym: a series of weights, planks, and stretches. He does this seven days a week; he adds on a high-intensity workout three days a week. Occasionally, during these high-intensity workouts, he’ll wear a plastic mask to measure his VO2 max, or the maximum rate of oxygen consumption during physical exercise. Johnson’s VO2 Max is in the top 1.5% of 18-year-olds, he says.

After his workout, Johnson eats a meal of steamed vegetables and lentils that have been blended until they resemble a mush the color of a sea lion. He and Tolo don’t name their meals “breakfast,” “lunch,” or “dinner.” They call them “first meal,” “second meal,” and so on. This is first meal. He offers me some “nutty pudding,” which is made from macadamia-nut milk, ground macadamia and walnuts, chia seed, flaxseed, Brazil nuts, sunflower lecithin, ceylon cinnamon, and pomegranate juice. It’s the color of a pencil eraser and tastes a little dusty, but it’s not too different from a vegan yogurt, if you like that sort of thing.

Johnson insists all this is about something much bigger than getting ripped and maintaining a youthful glow. “Most people assume death is inevitable. We’re just basically trying to prolong the time we have before we die,” he says. Until now, he adds, “I don’t think there’s been any time in history where Homo sapiens could say with a straight face that death may not be inevitable.”

Experts strongly disagree. “Death is not optional; it’s written into our genes,” says Dr. Pinchas Cohen, dean of the Leonard Davis School of Gerontology at the University of Southern California. Cohen emphasizes that living longer in the future is certainly possible: over the course of the 20th century, human life expectancy rose from around 50 to more than 80. But living forever is not. “There’s absolutely no evidence that it’s possible,” Cohen says, “and there’s absolutely no technology right now that even suggests that we’re heading that way.”

“If you want immortality, you should go to a church,” adds Dr. Eric Verdin, CEO of the Buck Institute for Research on Aging. “If I believed even a little bit that it would be possible, I would be excited. It’s a pipe dream.” Verdin isn’t just skeptical of Johnson’s claims that he can achieve immortality; he’s skeptical of his claims of age-reversal altogether. “He professes to make everything transparent, but as a scientist it’s really impossible to understand the tools he’s using to assess his age,” Verdin says, adding that the Buck Institute reached out to Johnson to collaborate on some research, but never heard back. Johnson’s lack of interest in collaboration with independent scientists made Dr. Verdin even more skeptical. “I think if he wants to convince all of us that what he’s doing is valid, then he’s going to have to accept being challenged by colleagues,” he says. (Johnson doesn’t remember ignoring Verdin’s invitation, and says that he and Verdin have recently exchanged friendly emails.)

Some scientists do believe that limited age-reversal is possible. In still controversial and contested work, researchers at Harvard Medical School have claimed they’ve rejuvenated older mice, and are currently testing whether the aging clock can be turned back in human skin and eye cells. But those experiments are being done according to established scientific conventions. Johnson, in contrast, has made himself a human guinea pig, adopting nearly every age-related treatment at once and seeing what works.

It’s not just that medical professionals are skeptical of Blueprint’s ability to achieve immortality. They’re not even convinced Johnson’s routine is particularly healthy. Dr. Nir Barzilai, the director of the Institute for Aging Research at the Albert Einstein College of Medicine in New York City, met Johnson in May, at the annual retreat for the Academy for Health & Lifespan Research. Barzilai recalls that when Johnson showed up, the doctors present were concerned. “He looked sick. He was pale. I don’t know what he did with his face,” Dr. Barzilai says, adding that he was alarmed by Johnson’s lack of fat, which plays an important role in the body. “All these MDs, we all kind of agreed that he didn’t look so great.”

Barzilai also has serious reservations about Johnson taking so many supplements and treatments at once, warning that all the different pills could interact with one another in dangerous ways. “What he’s doing hasn’t proven to be safe, because some of the treatments he’s taking are actually antagonizing to each other,” he says, adding that doctors normally research the effects of one drug at a time, rather than the cumulative effects of more than 100 pills at once. “Even if it works for him, how do you know it works for you?” Barzilai says. Blueprint, he adds, is “not an experiment that we accept as scientists or doctors.”

Johnson did not make his own doctors available for an interview, nor did he provide details about his team. But he intends to bring Blueprint to the masses. Johnson puts all of his biological measurements online—from his resting heart rate to his plaque index to images of his intestines taken with a “small bowel camera”—and his YouTube videos about his exercise regimen and therapeutic experiments have been viewed by millions of people. Roughly 180,000 people signed up for his newsletter in the first five months, Tolo says. Blueprint’s first commercial product, sold on his website, is an allegedly cholesterol-reducing olive oil, sold in a black box emblazoned with a red-lit photo of Johnson and the slogan “Build your autonomous self.” Fifteen percent of Johnson’s daily diet consists of this olive oil. Two 25 oz. bottles cost $75. Tolo says they’ve sold out.

As Johnson, Tolo and I settle in to eat our “first meal” on his massive rust-colored couch, Johnson gestures to a bookshelf full of biographies: Ben Franklin, Harry Truman, Winston Churchill, Napoleon. “I have a relationship with the 25th century more than I have a relationship with the 21st century,” he says. “I don’t really care what people in our time and place think of me. I really care about what the 25th century thinks.”

Artificial intelligence “is clearly the most significant event in this part of the galaxy,” he says. “What is the equivalent response for humans to have to AI?” Given the looming AI revolution, Johnson argues that outsourcing the management of the body to an algorithm is the ultimate form of human-AI “alignment.” If everything from marketing to legal research to retail will soon be optimized by algorithms, why shouldn’t algorithms run our bodies as well? Johnson argues that automating the physical body is a form of evolutionary adaptation to what he believes is an inevitable, AI-dominated future.

But all this talk about the scope of history, and the march of technology, and the benefits of un-dutched chocolate seemed to be missing something, I say. Aren’t humans more than just brains and meat? Isn’t there some other ineffable element that makes us human: the feeling of watching your toddler play in a lake, the joy of popcorn with girlfriends at the movie theater, the grief of losing a family member, the frustration at a lost earring? Surely, there must be more to living than simply maintaining adequate oxygen in your spleen.

He doesn’t see it that way. “Whether we’re talking about falling in love, or having sex, or going to the baseball game, you’re talking about biochemical states in the body,” Johnson says. “You can remove everything and just say, ‘I’m experiencing this kind of electrical activity in my body and these kinds of hormones.’ We have a whole bunch of ideas about what it means to exist, we have all these ideas about what is happiness, and other things. We’re walking into a future where we no longer have control,” he continues. Which means “we are willing to divorce ourselves from all human custom. Everything: all philosophy, all ethics, all morals, all happiness.”

I try another approach. Let’s say you’re right, I ask Johnson. What if you do live forever? That means you’d outlive everybody you’d ever known on the planet. You’d watch your children and grandchildren and all your friends die before you. What would that be like? Is a life without the people you love worth living?

Johnson says that question reminds him of “senior night” before graduating from high school. “We say goodbye, we have been together all these years, and we’re probably not going to see each other again,” he says. “At every stage in life, we move through these transition states of relationships and new experiences,” he continues. “And at every stage, you could certainly pose that question, because the circumstances are going to change. Is it worth it to carry on?”

It strikes me as a weird way to answer a question about watching his own children die, but I turn to Tolo, who was silently eating her nutty pudding in a different corner of the couch. I ask her what she thought about the possibility of watching everyone she loves die before she does. It doesn’t seem like she’s considered this. “Hopefully they wouldn’t,” she says. “I really hope that as many people as possible can come along that journey.”

Johnson chimes in again. “I think your question reflects Homo sapiens for the 21st century,” he says. “The underlying assumption is, they have roughly 70 years of life. That’s their starting frame: I’m going to die soon, and I can’t do anything about it. So I’m optimizing in this window of time… If you change the frame, and death is not inevitable, none of the previous practiced thought patterns work.”

My 21st century Homo sapien brain was not convinced. Johnson seemed to suggest that for humans to survive in an AI-aligned future, they may need to sacrifice part of what makes them human in the first place. I thought of Tuck Everlasting, the 1975 children’s novel about an immortal family whose inability to age sets them apart from the world, adrift from the life of everyone they meet, forever alone.

I left Johnson’s house and drove to the DoubleTree hotel in Marina Del Rey. The woman at the front desk handed me a chocolate chip cookie, as they usually do at DoubleTrees (which is why I stay there). My rascal brain wanted it. But it was an act of violence that would accelerate my inevitable death. I abandoned it on the counter and took my Blueprint-approved dinner—steamed broccoli, cauliflower, and lentils, with $75 dollar olive oil and absolutely no flavor—up to my room.

Johnson wasn’t always like this. He grew up in a small Mormon community in Utah. His grandfather owned a farm with horses, and Johnson and his four siblings spent most of their time outside, helping to harvest alfalfa and corn. Johnson served his Mormon mission in Ecuador, then went to Brigham Young University, followed by business school at the University of Chicago. He got married, had three children, and in 2007 he founded Braintree, a payment-processing company. Braintree acquired Venmo five years later. In 2013, the combined entity was sold to PayPal for roughly $800 million. Johnson walked away with more than $300 million.

Despite his financial success, Johnson recalls this as a painful time. He says he fell into a deep depression in 2004 and stayed there for 10 years. He was overwhelmed by building his company while raising three young children. Medication and therapy didn’t help. He was 50 pounds overweight and miserable, he says.

Within a year of selling his company, Johnson ended his marriage and left the Mormon church. In 2014, he plowed $100 million into the creation of the OS Fund, which invests in companies working in what Johnson calls the “programmable physical world”—his term for companies that use AI and machine learning to develop new technologies for therapeutics, diagnostics, and synthetic biology. In 2016, Johnson founded Kernel, a neurotechnology company that uses a specially designed helmet to measure brain activity. Its goal is to detect cognitive impairment at the earliest stages; for now, the company is looking for biomarkers for psychiatric conditions. It can also be used, as a fun side hobby, to measure the age of his brain.

One day during my visit, we drive to the company’s offices, which are about 20 minutes from Johnson’s home. Even though his mission in life is to “not die,” he still drives himself around LA in an electric Audi. (Extremely slowly.) Before he pulls out of his driveway, he utters his pre-driving mantra to himself: “Driving is the most dangerous thing we do.” Johnson is aware that his singular focus on living forever might make an accidental death somewhat embarrassing. “What would be more beautiful irony than me getting hit by a bus and dying?” he says.

In Kernel’s open-plan office, I’m brought into a small room, where a technician fits my head with what looks like a ski helmet with dozens of circular probes inside. I’m instructed to sit and watch a screensaver-type video of soft crystalline shapes morphing into each other. Later that day, my results appear in my email. It tells me that although I am 34, my brain age is 30.5.

On the way home, Johnson utters his pre-driving mantra again before inching through the streets of LA at about 16 m.p.h. As he’s explaining again why Blueprint is “the most significant revolution in the history of Homo sapiens,” a black Chevy truck pulls out of a Trader Joe’s parking lot. He swerves to avoid it, barely taking a breath before returning to comparing himself to Magellan and Lewis and Clark. “I’m not a biohacker. I’m not an optimization person,” he tells me. “I’m an explorer, about the future of being human.”

Even futuristic humans were mere mortals once. Tolo first reached out to Johnson in 2016, when she was working in fashion in New York City. The AI revolution was beginning to come into view. “I felt so strongly that the only way we could proceed as species would be to kind of latch ourselves onto AI,” she says. She saw a quote from Johnson in a tech newsletter, advocating for humans to “merge with AI,” and decided she wanted to work for him. After years of entreaties, a job finally opened up, and Tolo took a title and pay cut to become Johnson’s assistant at Kernel. “We’d spend hours in his office, just chatting about the future of humanity,” she says.

When she first started working for Johnson, Tolo was a typical twentysomething. She drank alcohol and milky lattes, ate fast food, and stayed up too late dancing with her friends. But early this year, she and Johnson began discussing whether she should try Blueprint as well, to see how the routine would affect a female body. Before committing, Tolo requested a 30-day trial period. That trial included committing to a rigorous sleep routine, adopting Johnson’s exact diet protocol, taking more than 60 pills a day, and doing 13 minutes of intense exercise and 39 minutes of moderate exercise every day. She also measured her ovulation and her menstrual cycle.

“When I was in my trial period, I would go out to brunch with friends, and I would bring my Blueprint food, and there is a bit of sadness,” Tolo says. “Because everyone else at the table is like, ‘Oh my God, this breakfast burrito is so good.’” Ultimately Tolo decided to commit to Blueprint for good. She concluded the health benefits outweighed the lifestyle costs. Tolo says her friends have adjusted to her Blueprint lifestyle. She’s moved her social life earlier in the day to protect her sleep schedule, and they’ve gotten used to her habit of bringing her own vegetable mush to restaurants. The decision, once made, was permanent. “It would also be the final decision in a way,” she says. “It’s like, I’m deciding to no longer decide again.”

Now, as Blueprint XX, she has given up “all the things that I’ve come to cherish in small ways about my life,” she says. She and Johnson think of themselves as a sort of futuristic Adam and Eve. They had even planned an Adam-and-Eve themed photoshoot to help people understand that they’re “talking about a revolution on the scale of the whole human race,” Johnson says. Even though Tolo is apparently as important to the future of humanity as Eve herself, she plated and served all the meals I ate on my visit, and, at least while I was there, seemed to do most of the dishes.

Johnson is currently single. His older son is serving a mission for the Mormon church, and his younger daughter is 13 and lives with her mother. So Johnson spends much of his time with his 18-year-old middle son, Talmage, who commits to the Blueprint diet, rest, and exercise routines, but skips the anti-aging therapies. He briefly donated blood plasma to Johnson in order to test whether it had a measurable impact on his father’s aging, but stopped once Johnson decided it didn’t work. Talmage, who is about to start his freshman year of college, says that he’s adopted many of his dad’s attitudes towards lifestyle and life extension. “The idea of having pizza is more painful than pleasurable for me,” he says.

Johnson says his lifestyle makes it very difficult for him to date, rattling off what he calls the “10 reasons why [women] will literally hate me.” The reasons include: eating dinner at 11:30 a.m., no sunny vacations, bed at 8:30pm, no small talk, always sleeping alone, and, of course, “they’re not my number one priority.”

Throughout my visit with Johnson, I could feel my rascal brain buzzing to life. Johnson venerates what he calls “the emergent self,” which is driven “more by computational guidance and less by human want.” And yet wanting, I thought, is what humans do. There is almost no experience more human than the experience of want. As I watched Johnson drink his immortality gruel and explain his religious commitment to bedtime, I was wondering: What did he want? Did he miss eating birthday cake? Staying up late dancing? Baseball games that stretch into long nights filled with hot dogs and beer? Johnson wanted an eternal life. But what is life without wanting?

There were so many things I wanted to do, even if I knew that each indulgence could bring me closer to death. I wanted to meet a friend for cocktails in Santa Monica. I wanted to snuggle into my hotel bed and watch And Just Like That, and I wanted to stay up too late texting my friends about it. I wanted to FaceTime my daughter, the one who had caused me to gain 30 happy pounds when I ate only butter pasta and cheese pizza for most of my pregnancy. I wanted to take the first plane home, even if it meant landing at 1 a.m. and getting four hours of sleep, so that I could be there when she wakes up and says “Up!” with the force of a commanding officer. I wanted eggs and bacon for breakfast. I didn’t want to stop wanting. Life’s too short.

With reporting by Leslie Dickstein

Bryan Johnson’s quest for immortality

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Health – TIME

Bryan Johnson’s quest for immortality

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September 19, 2023
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9 minutes Read

Cycle Syncing Won’t Fix Women’s Fitness

While most of the video series and programs available on the popular “holistic wellness”/fitness site Alo Moves—owned by the trendy activewear line Alo Yoga—are run by solitary instructors, the company’s newest offering is marked by photos and videos of a group of four women pulled close up against one another and roaming Hawaiian beaches.

It’s a clearly symbolic presentation of the company’s new SYNCD program, a collection of 24 videos designed to guide users through self-care and fitness activities customized for each of the four phases of the menstrual cycle. The program, which launched in late August, is the latest—and likely not the last—in a wave of offerings from fitness and wellness purveyors looking to latch onto the recent popularity of a workout method known as “cycle syncing.” Unlike the push-through-the-pain approach of training during menstruation women athletes have adopted for decades, cycle syncing invites those same people to instead allow their exercise—and often, other lifestyle elements—to be dictated by not only their periods, but their entire menstrual cycles. The four instructors leading SYNCD’s classes, Alo Moves says, are all enthusiastic practitioners of the strategy.

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Cycle syncing is one of the biggest topics in women’s health right now. Since the release of a Nike cycle-syncing program via their Training Club app in 2022, Google searches for the term have more than tripled. The last six months have seen an explosion of at-home programs and apps, including offerings from big players like the period-tracking app Flo, the activity-tracker WHOOP, and the at-home fitness company Tonal. On TikTok and Instagram, some personal fitness creators offer their own plans online for a fee, designed for followers to use alongside a period-tracking app. If your own favorite lifestyle or exercise brand doesn’t yet encourage cycle syncing, chances are high that they’ve got something in the works.

In theory, such an approach sounds like a welcome change, given that women have historically been excluded from sports science; in practice, experts say that these programs can be overly generous in their interpretations of a limited amount of research about the physical and emotional effects of the menstrual cycle. Where content creators and the companies behind new programs say cycle syncing can help people better attune to their bodies, critics worry that the technique could promote a harmfully reductive and narrow vision of how the menstruating body works.

The specificity of these programs simply can’t apply to everyone, says Tory Eisenlohr-Moul, a clinical psychiatrist at the University of Illinois at Chicago. “Given what we know about how differently people react to the cycle … you’re contributing to this misogynist idea that all females are driven by their hormones.”

Hormones throughout the cycle

Cycle syncing taps into the wellness world’s current obsession with hormones, the chemical messengers that drive key physiological functions of the body. A central idea promoted by the fitness and nutrition influencers who first made cycle syncing popular online is the idea that a healthy body is one in which unspecified hormones are “balanced.” Their goal is to regulate the body’s regulators, which in a healthy person fluctuate as needed in order to do things like maintain your core temperature and put you to sleep after a long day.

Unlike hormone balancing efforts, however, cycle syncing is about indulging, rather than controlling, the natural ebbs and flows of certain hormones. The menstrual cycle is operated by specific hormones, like follicle-stimulating and luteinizing hormones, and causes near-constant fluctuations in others, including estrogen, progesterone, and testosterone. We know a lot about what these patterns look like and some of their more standard effects on the body that appear throughout the four phases of a cycle. During the late luteal phase, for instance, which occurs just before menstruation, progesterone plummets, which can have a destabilizing effect on mood. In serious cases, this is recognized as premenstrual dysphoric disorder (PMDD), but nearly anyone who’s been a teenage girl or lived with one has experienced some of progesterone’s mental effects. Similarly well-documented peaks and valleys in libido, thermoregulation, skin health, and taste perception, are all possible, but vary from person to person.

While different syncing apps have different approaches—some are more geared for exercise fanatics, others have a more New Age vibe—they’re all pretty much the same when stripped down to their fitness plans. During the menstrual cycle, suggested exercises are simple activities along the lines of gentle yoga and pilates, though Nike suggests high-intensity interval training, or HIIT, for those who have the energy. HIIT tends to be recommended for the follicular phase, which occurs for roughly a week and a half following menstruation, when users are told to expect abundances of speed, power, and creativity. The much-shorter ovulatory phase is similarly high-octane, while in the luteal phase users are encouraged to embrace the natural energy letdown by focusing on flexibility exercises and other low-impact movement.

“Based on my experiences, and my knowledge about anatomy, and physiology, and the menstrual cycle, I think there’s some merit to it,” says Amy Tremback-Ball, a professor of physical therapy at Misericordia University who’s studied the menstrual cycle’s effect on college athletes. “For those who might be training for something and knowing that they’re going to push—like bumping up two miles or four miles in a run—I think there is a better time to do that to avoid injury.” Tremback-Ball, formerly an ultramarathoner, says that her most serious running injuries occurred during her luteal phase, when connective tissue can weaken.

However, none of the programs address the unique hormonal landscapes of the growing number of people who use any form of hormonal birth control, including pills, patches, and IUDs, as well as those who are pregnant, menopausal, suffering from endocrinological disorders, or using any sort of hormone therapy. While future products may address these populations, for now cycle-syncing apps remain exclusively focused on those with unaltered menstruation.

What does the research say?

Cycle-syncing programs frequently claim they’re designed using the latest research on athletic performance throughout the cycle, but often neglect to mention that just about all of that research has been done on elite female athletes, who aren’t representative of the typical customer of these programs. What’s more, the research is still less than a decade old, and the flurry of preliminary studies in recent years are still raising more questions than they answer. Among their findings include the possibility that building muscle could be easier during certain parts of the cycle and that there is a connection between the higher rates of orthopedic injuries in female athletes and looser, more injury-prone joints during the ovulatory phase, when the body is prepared for potential implantation. They’re groundbreaking findings, but it could be years before any universal real-world application materializes.

The preliminary studies most relied on by cycle-syncing programs are survey-based, and reiterate what people who menstruate have so often been told to ignore—that it can suck to exercise on your period. Researchers asking menstruating athletes including professional rugby and soccer players to report the effects of their cycle have all found that over 90% of respondents cite the menstrual phase as a time when they’re lower energy or feel less physically and mentally powerful. It’s the underlying, less-technical message of these types of studies—that the body can no longer simply be ignored—that cycle-syncing programs have latched onto.

Menstruation is just one piece of the puzzle

Eisenlohr-Moul, who studies menstrual hormones in the brain, says cycle-syncing programs seem to be predicated on the assumption that menstrual hormones are the most powerful forces in determining your mood and energy at any given moment. But it ignores the multitude of other physiological and mental factors that play a role in how someone feels. “Exercise is so much about the brain and your ability to make yourself do things that are sometimes physically uncomfortable,” she says. For those without PMDD and similar serious hormonal problems, factors like how much stress they’re under at work or how many hours they slept the night before can easily overshadow cyclical changes in mood or energy.

Be aware, too, Eisenlohr-Moul says, of what any new fitness program may be asking of you outside the gym. Alo Moves’s SYNCD includes not just workouts and meditation sessions, but guidance on making a turmeric tea for ovulatory pain and dry brushing the skin to promote general detoxification and decrease water retention. Though they may have value as enjoyable rituals, neither of these practices are backed by empirical evidence. They’re easy to skip, but “if you’re a person who kind of tends to spiral into a compulsive place with those kind of rules, then you might want to back off,” says Eisenlohr-Moul.

Tremback-Ball and Eisenlohr-Moul agree that cycle syncing should be viewed as more of a learning experience than a strict regimen, simply because the variety in how individuals experience their menstrual cycles can’t possibly be captured by a single program. In an ideal world, says Tremback-Ball, everyone who wanted to learn about cycle syncing for their own body would have an informed coach to help them develop an individualized program.

Eisenlohr-Moul recommends trying a program for a month or two if you’re interested, and to pay close attention to whether or not it actually makes you feel any better, or if it’s taking more effort than it’s worth.

“If your workout is not making you happy because it’s being dictated by something,” says Tremback-Ball, throw it out and “do what makes you happy.” Your hormones will be just fine.

In their efforts to put female-specific sports science to use, fitness programs risk pushing an oversimplified view of menstruation.

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Health – TIME

In their efforts to put female-specific sports science to use, fitness programs risk pushing an oversimplified view of menstruation.

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September 18, 2023
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14 minutes Read

The Case for Mediocrity

The night before my first book came out, I lay awake envisioning all the ways it could ruin my life. What if I get sued because I made a mistake? What if I get harassed online? What if I get such bad reviews I never work in journalism again?

I’d spent the past 18 months obsessing over the project, thinking about it on a loop. I often struggled to sleep, ruminating over all the ways it might fall short. I started seeing a therapist for the first time in my life. My career was at its high point, and I had accomplished a dream so big I’d never actually thought it would come true, but my mental health had never been worse.

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The fact that I was also living through and writing about the first years of the COVID-19 pandemic certainly didn’t help, but it was the stress of the book that really had me spiraling. By the time it was published in mid-2021, I was mentally and physically exhausted. I longed to do less, to forget about work and productivity and self-promotion and just…be.

As it turns out, I had—and have—plenty of company. Around the time my book came out, so many people were quitting their jobs the media began calling it the “Great Resignation.” Then people started “quiet quitting,” proudly doing the bare minimum at work without actually resigning. Now, lots of people want a “lazy-girl job” that’s low-stress and high-pay. That’s hardly an unprecedented desire, but it now seems to be pervasive. Federal data show that preference for part-time work is rising and, at least according to one 2022 study, the pandemic ushered in a “sharp decline” in the number of hours U.S. adults want to work. The idea of a four-day work week is gaining mainstream credibility, too. Increasingly, it seems, people are rejecting the stress and burnout traditionally baked into U.S. work culture in favor of a slower, more peaceful life.

These trends hit me on a core level. During all those sleepless nights leading up to my book’s publication, I began to reevaluate my relationship with ambition and what I want from my work and life. And the truth I came to is this: mediocrity is a far better fate than misery.

American ambition

Embracing mediocrity goes against everything Americans are taught to believe. Hard work has been valued throughout U.S. history, dating back to the Puritans who built New England on the belief that labor was inextricably linked with salvation. The idea that anyone can succeed with enough hard work forms the backbone of the “American Dream,” a phrase popularized in the 1930s. The concept of the American Dream has evolved over time—until the mid-1900s, the phrase was associated not with material wealth but with furthering the common good—but it has always placed a premium on progress, on striving to be better as both individuals and a people. In more recent decades, the American Dream has become closely aligned with the kind of economic prosperity required to own a big home, a nice car, and the latest iPhone, with cash to spare for a glamorous vacation every summer.

To pursue that prosperity in a deeply capitalist society, anyone not born into immense wealth has to work for it. So it’s perhaps no surprise that U.S. culture lionizes hard work and looks down on leisure, that we’re raised to earn and do and achieve as much as we can, to shoot for the moon and settle for landing among the stars. We are taught, from an early age, that we can be anything we want to be, that with enough elbow grease we can accomplish big things. The subtext being that we should accomplish big things, no matter what it takes to get there.

For a long time, I bought into that mindset. I was the straight-A high school student, the summa cum laude college graduate, the magazine intern happy to give up my personal time to write articles for free if it meant advancing my nascent career. It was only once I achieved the big thing and watched it tank my mental health that I realized what this mindset had cost not just me, but also others who subscribe to it.

As of 2023, more than three-quarters of U.S. adults report feeling stressed at work, almost 60% experience elements of burnout, and almost 20% feel they work in a “toxic” environment, according to the American Psychological Association. We often normalize these problems, turning them into topics for happy-hour venting sessions, but they are not trivial. Countless studies show that chronic stress is bad for the body and mind, and burnout is linked to everything from depression to premature death, research shows. Last year, the U.S. Surgeon General declared improving workplace mental health and well-being “a critical priority for public health.”

Some companies have responded to these warnings with anti-burnout programs and extra vacation time. But the solution, as I see it, requires a broader rejection of the ceaseless pursuit of greatness that often leaves our health and happiness in its wake.

How striving affects well-being

In 1922, a group of more than 1,500 high-ability U.S. children were enrolled in a study through which researchers would track them for years on end. Ninety years later, a pair of researchers used some of the resulting data to assess how ambition had affected the participants over the course of seven decades.

Perhaps unsurprisingly, people who self-identified (and were described by loved ones) as ambitious achieved more lucrative and prestigious careers. But when it came to life satisfaction and longevity, the researchers didn’t find a strong connection to ambition. In spite of their professional accomplishments and cushy salaries, go-getters were not significantly happier or healthier than less-ambitious people, although they weren’t significantly unhappier either.

Similar conclusions come up often in scientific studies. Researchers have found that countries with shorter average working hours tend to have happier populations; achieving a huge career goal may not bring lasting satisfaction; and traits that frequently accompany ambition, like perfectionism and desire for power, can predispose people to burnout, anxiety, and depression.

Meanwhile, things that reliably boost happiness and well-being—community, time in nature, movement, mindfulness, personal growth, and learning—are often seen as unserious pursuits for which only underachievers have time. Research suggests that, in work-obsessed modern society, busy people are regarded as higher-status than people with lots of leisure time, a reversal from previous eras when only the rich had time to relax. When busyness and productivity are brandished as badges of honor, it is daring to prioritize activities that result only in rest or relaxation or joy.

But these things, so often skipped or squeezed into our 48 hours away from the office each week, are what make life feel manageable and rewarding. “Feeling good within yourself is about way more than ambition and striving forward,” says Emma Bradshaw, who researches the relationship between aspiration and well-being at Australian Catholic University. “Sometimes sitting in place is perfectly healthy.”

Bradshaw’s work is guided by a school of thought called self-determination theory (SDT), which holds people have three key psychological needs: a feeling of choice and control over their actions, connection with others, and a sense of competence and achievement. But the type of achievement matters.

SDT research, including Bradshaw’s, suggests that people who are motivated by internal, or “intrinsic,” goals are more likely to feel fulfilled than people who are striving toward external, or “extrinsic,” markers of success. “Things like building quality relationships with other people, growing and learning new things about the world and about ourselves, contributing positively to the community…tend to be better for you, as opposed to things like wanting lots of money and wanting to be really beautiful and wanting to be popular,” Bradshaw says.

That’s not to say everyone who is successful, wealthy, or popular is unhappy, or even that ambition is inherently bad. Lots of successful people, Bradshaw says, tap into intrinsic motivation in their work, pursuing new projects because they genuinely enjoy the process or have a higher motivation for doing so. The problem is that we often chase promotions and raises and awards by default, even if those things are unlikely to bring lasting fulfillment or satisfaction without a deeper purpose.

Trying to obtain these external trappings of success can feel like forever chasing moving goalposts. “It’s infinite, how much money you could try to earn,” says Sheri Johnson, a psychology professor at the University of California, Berkeley, who has researched the relationship between ambition and mental health. “You may be stuck in that striving state without satisfaction.”

Who gets to be mediocre?

But giving it all up isn’t so simple, as scholar Avram Alpert learned when he wrote his recent book, The Good-Enough Life, which explores how the pursuit of greatness harms individuals, communities, and society at large. Initially, Alpert says, he wanted to focus on how learning to be pleased with “good” instead of “great” might affect individuals’ happiness and well-being. But it felt impossible to say with a straight face that people should “chill out and be good enough” in the face of huge societal barriers like wealth inequality, racism, and sexism.

“If you say, ‘I’m going to be good enough. I’m not going to be overly ambitious and I’m not going to pursue every last award and every last degree and I’m not going to try to rise to the top of the pyramid,’ and then you find you’re doing that but society isn’t respecting that,” Alpert wondered, where does that leave you?

Checking out of the greatness grind often requires a safety net that millions of Americans living paycheck to paycheck or in poverty simply don’t have. It is one thing to tell someone who is already financially comfortable that money can’t buy happiness. But what about someone struggling to pay the rent or put food on the table? How could anyone tell them to be content with less?

“We shouldn’t have layers of society where people have to work that hard and live in those dire conditions,” Alpert says. But since we do, choosing mediocrity is perhaps the greatest privilege of all—and one that historically has available only to white people, says Michael Harriot, author of Black AF History: The Un-Whitewashed Story of America.

“A Black person has to work twice as hard as a white person to get half as far,” Harriot says. That means choosing to be average often isn’t an option for people of color, just as it isn’t for others who have to swim against the current of discrimination every day, including those who are not able-bodied, cisgender, or heterosexual.

But, at the same time, “we can’t expend all of our energy and work ourselves to death trying to accomplish things that are unachievable because of systemic issues,” Harriot says. He bristles against the narrative that “rugged individualism and hard work is how [people of color] get ahead in America, when we know that’s not true.” Individuals can’t fight against centuries of systemic oppression on their own.

It was that realization that led Amil Niazi to write a viral 2022 essay about renouncing ambition, which she is now adapting into a book. Niazi felt for a long time that being exceptional was her only choice. “I’m an immigrant. I grew up very poor. I’m a woman of color,” Niazi says. “I was never able to be mediocre. I would not be able to be where I am today if I had just sat back and said, ‘It’s okay for me to be average.’”

But even decades of striving didn’t prevent Niazi from being passed over for professional opportunities and promotions, which she says often went to people—predominantly white men—who could relate to her bosses in ways she couldn’t. After years of burning out trying to play their game, Niazi decided to quit and start her own, leaving her job in media to freelance and create her own definition of success.

Accepting “good enough” in a world that wants great

Even as an objectively privileged white woman, I’m nervous to attach my name to an essay with anything positive to say about mediocrity. As much as I craved it in the depths of my pre-publication stress, I do not actually want—nor can I afford—to torpedo my career. Numerous times as I wrote this essay, I wondered, Do I really want to be known as the mediocrity girl? And if I feel uneasy, how could I expect anyone without my advantages to embrace this concept?

That fear says a lot about the culture we live in. It should not be controversial to say that life exists beyond work and achievement, that the ways we’ve been taught to strive are hurting us—all of us, but particularly those who are marginalized by systems of power. And yet it’s a scary thing to put in writing.

So how can I, and everyone, live a good-enough life when the world isn’t there yet? Alpert thinks it’s about applying the philosophy of good-enoughness to whichever “pockets” of your life you can, whether that’s sometimes taking on a behind-the-scenes role rather than seeking credit; adopting a hobby just for fun; or trying to remember that, as he puts it, “the things we find most meaningful and wonderful and purposeful,” like being with loved ones, are not lazy or frivolous, but vital.

Dr. Gordon Parker, a psychiatrist and founder of the Black Dog Institute, an Australian research organization focused on mental health, believes that aiming for a 20% more laidback lifestyle can enhance well-being, particularly for the kind of type-A people who are prone to perfectionism. In other words: you don’t have to reject the system in its entirety. Sometimes it’s about trying to do just a little bit less, and becoming okay with that.

That’s been the case for Kathleen Newman-Bremang, who has written about embracing mediocrity as a Black woman. Newman-Bremang was raised to believe she had to be excellent, always, to succeed in a system that wanted her to fail. But that constant pursuit left her exhausted and disillusioned. Eventually, Newman-Bremang realized the far more “radical act” was to embrace mediocrity, even with all the negative baggage that word carries.

“Maybe my worth is not weighed by my weariness. Maybe my worth is not what kind of worker I am,” she says. “If I am just mediocre professionally, that’s okay. That can still mean that I am a good person, a good friend, a good wife, a good dog owner.”

That mindset shift is a work in progress, Newman-Bremang says. She still has to remind herself to rest and take breaks. But she no longer believes that excellence is the only option.

I, like Newman-Bremang, have tried to embody that philosophy through a hundred tiny revolutions against capitalist culture. I do my work as well as I can, but I take my lunch breaks, I use my vacation time, I resist the urge to check email on weekends. These are privileges of secure white-collar work, to be sure, and I am grateful for them. But also: they should not be as revolutionary as they feel to me, and I remind myself of that when my inner voice tells me to do more, achieve more, produce more.

Bradshaw, the SDT researcher, also gave me a piece of advice that struck a chord. When you are presented with a decision, she told me, think about why you would agree to it. Is it because you genuinely want or need to do the thing, or because you think it will make you look good?

This, too, is perhaps not so revolutionary, but it felt that way to me. So much of what I’ve done in my life has been to appear impressive, to get my foot in the door so that someday I could step all the way through. But I’ve been through the door, now, and the room inside wasn’t all I imagined it to be.

Why “good enough” really is good enough.

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Why “good enough” really is good enough.

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September 16, 2023
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How to Avoid the Tripledemic of Respiratory Diseases This Winter

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“Tripledemic“ jumped into our vocabulary and lives last year, referring to the winter surges of three respiratory viruses—RSV (respiratory syncytial virus), flu (influenza), and COVID-19. The tripledemic of 2022 infected millions, overwhelmed hospital systems, and killed more than 100,000 people in the U.S. over the 4-month peak span of these viruses.

As much as we hoped that respiratory illness would fade with the COVID-19 public health emergency ending, we must recognize that these viruses will continue to impact us for years. As the school year begins, we already see short-term school closures due to respiratory illness. We are seeing new variants of COVID-19 that may also contribute to increased cases of disease.

However, the severe impact of the anticipated wave of respiratory illness this winter can be very different from last year. We can reduce the levels of severe viral disease seen over recent years, thanks to the remarkable development of new vaccines and therapeutics against these viruses. We can achieve this goal of preventing hospitalization and death by ensuring that individuals at the most significant risk for severe disease are vaccinated against each of these viruses before the late fall and winter months and receive prompt antiviral treatment when ill.

RSV, flu, and COVID-19 are respiratory pathogens spread by the breath, spoken word, and cough. As with most pathogens, some individuals are more vulnerable than others to these infections. RSV and influenza take their most significant toll on those less than one year and older than 65 years and in people with serious underlying medical conditions. COVID-19 also exerts its most severe impact on older people and those with underlying medical problems. Although less frequent than in adults, COVID-19 can also result in severe disease in children, more than 50% of whom have no underlying medical conditions, which is why COVID-19 vaccines are recommended for children six months and older by the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC).

During the respiratory season of 2022-2023, it was estimated that 100,000-200,000 people were hospitalized with RSV, 300,000-650,00 with flu, and 700,000 with COVID-19. During that surge, 6,000-10,000 people died from RSV, 19,000-58,000 from flu, and 75,000 from COVID-19. These numbers of deaths due to RSV were greater than the levels seen over the several years before the pandemic. It was remarkable that RSV and flu-related illnesses fell over the first two years of the COVID-19 pandemic, partly due to the mitigation measures against COVID-19, which also slowed the spread of these other respiratory viruses. Yet, with the relaxing of masking and other anti-COVID-19 mitigation measures, RSV and flu cases rebounded to exceed pre-pandemic levels. It is difficult to predict the patterns of RSV, flu, and COVID-19 over the coming months. But we can expect a rise in the activity of these viruses as population immunity from last year’s infections and vaccinations wanes and new viral forms appear.

This past year heralded important developments in the prevention of RSV. RSV infection among children under five years, which resulted in 58,000-80,000 hospitalizations and 100-300 deaths last year, can be prevented in several ways. If a pregnant individual is vaccinated against RSV, the transfer of immune protection from the parent to the fetus will protect the infant after birth, and such vaccines have recently been approved. If parents are not immunized against RSV during pregnancy, infants can receive a long-acting monoclonal antibody by injections to protect against severe disease for up to 6 months. This FDA-approved medication, Beyfortis, is now available through the Vaccines for Children (VFC) program and through pediatric care providers. The drug is approved for neonates and infants born during or entering their first RSV season and in children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season. RSV vaccines for those 60 years and older have also been approved, dramatically reducing cases in older people.

The influenza vaccine is modified yearly in anticipation of the expected flu strain and is recommended for those six months and older. The flu vaccine, with doses specific for children and adults, becomes available in the fall and comes in forms administered by injection or a nasal spray. This year’s vaccine is designed to target several different flu strains. In addition to vaccines, several anti-flu medications, including Tamiflu, effectively reduce flu severity if started within a few days of illness onset.

Although cases, hospitalizations, and deaths due to COVID-19 are much lower now than over the previous three years, this virus remains a serious public health threat, with more than 100,000 deaths over the current year. COVID-19 will also be a top-five cause of death for adults and a top-ten cause of death for children. As with RSV and flu, severe disease due to COVID-19 is preventable through vaccination.

For individuals who develop COVID-19 infections, disease severity can also be markedly reduced by oral antiviral agents, including Paxlovid and Mulnupiravir. More than 80% of adults in the US have received at least one dose of a COVID-19 vaccine, and 70% have completed the primary series. Because the protection from these vaccines phase after about six months, booster shots are recommended, but only 17% of the US population has a current booster shot. Like the flu vaccine, booster vaccinations are adapted to the anticipated circulating virus type, the Omicron variant. On September 12, 2023, the CDC recently recommended that everyone six months and older get updated COVID-19 vaccines from Moderna and Pfizer-BioNTech that better match the current circulating virus strains. These new vaccines will be available within a week of the announcement.

More than 700 million doses of COVID-19 vaccine have been administered in the U.S., and data clearly show that COVID-19 vaccines are very effective in reducing severe disease risk and have an excellent safety record, as shown in very recently presented data. Notably, the risk of myocarditis following last fall’s updated COVID-19 vaccine was minimal, with two confirmed myocarditis out of about 650,000 doses, which is lower than after the primary series.

There is recent discussion has been about when to get flu or COVID-19 booster shots. Because the effectiveness of the flu and COVID-19 vaccines can wear off after six, it makes the most sense to get these vaccines in late October or November before the anticipated peak of illness during wintertime. Until there is a combination respiratory pathogen vaccine, these vaccines need to be administered separately. Flu and COVID-19 vaccines can be given simultaneously. Still, since the RSV vaccine is new, it has been recommended to wait two weeks after the RSV vaccine before other immunizations until more data are available.

Common sense public health measures also play a role in combatting the tripledemic, as we can spread viruses to others when we are infected. First, we must avoid others, especially those with vulnerabilities, when ill. We also now have home testing available to diagnose each virus separately or in combination. This can lead to prescribing antiviral medication and treating symptoms when coupled with telemedicine or in-person office visits. Mask use may also be considered in high-risk settings, especially for those who are medically vulnerable.

As part of this discussion of tripledemic action, we also need to recognize that issues related to COVID-19 have become politically polarized to the point where facts about the disease, its impact, its treatment, and its prevention are ignored. But we also need to recognize that COVID-19 now takes its place among the other common respiratory pathogens, and we have strong medical tools to address tripledemic viruses.

With all the amazing preventative tools and treatments we now have, we can look forward to saying, “tripledemic severe disease, no more.”

The U.S. will face RSV, flu, and COVID-19 this winter, but we have the tools to beat them

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The U.S. will face RSV, flu, and COVID-19 this winter, but we have the tools to beat them

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September 15, 2023
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Success of MDMA in PTSD Study Could Pave the Way for U.S. Approval of the Psychedelic

The psychedelic drug MDMA can reduce symptoms of post-traumatic stress disorder, researchers reported in a new study published Thursday.

The company sponsoring the research said it plans later this year to seek U.S. approval to market the drug, also known as ecstasy, as a PTSD treatment when combined with talk therapy.

“It’s the first innovation in PTSD treatment in more than two decades. And it’s significant because I think it will also open up other innovation,” said Amy Emerson, CEO of MAPS Public Benefit Corporation, the research sponsor.

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Earlier this year, Australia became the first country to allow psychiatrists to prescribe MDMA and psilocybin, the psychoactive ingredient in psychedelic mushrooms. The drugs are gaining wider cultural acceptance in the U.S. in part because of efforts by the nonprofit advocacy group Multidisciplinary Association for Psychedelic Studies.

For the new study, researchers measured symptoms in 104 people with PTSD who were randomly assigned to get either MDMA or a dummy pill during three sessions, one month apart. Both groups received talk therapy.

Common side effects in the MDMA group were muscle tightness, nausea, decreased appetite and sweating. But only one person in the MDMA group dropped out of the study.

After treatment, 86% of the MDMA group improved on a standard PTSD assessment compared to 69% of the placebo group. The assessment measures symptoms such as nightmares, flashbacks and insomnia.

By the study’s end, 72% of people in the MDMA group no longer met the diagnostic criteria for PTSD, compared to about 48% of the placebo group.

“The results that they got are very exciting,” said Barbara Rothbaum, who directs the Emory Healthcare Veterans Program in Atlanta. She was not involved in the research, which was published in the journal Nature Medicine.

PTSD also can be treated with other medications or talk therapy.

“They are very effective, but nothing is 100% effective,” Rothbaum said. “So we absolutely need more options for treatment.”

Before MDMA could be prescribed in the U.S., the Food and Drug Administration would need to approve it and the Drug Enforcement Administration would need to change its classification. MDMA is currently classified as Schedule 1, on par with heroin and deemed to have “no currently accepted medical use and a high potential for abuse.”

___

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.

In a study of 104 people with post-traumatic stress disorder, the psychedelic MDMA effectively reduced symptoms when used alongside talk therapy.

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In a study of 104 people with post-traumatic stress disorder, the psychedelic MDMA effectively reduced symptoms when used alongside talk therapy.

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September 14, 2023
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With the Decongestant SNAFU, the FDA Tries Something New

It’s easy to understand how a medicine like phenylephrine got onto pharmacy shelves in the first place. The common decongestant, used most often as an ingredient in multidrug cold medications like DayQuil and Sudafed PE, was initially designated as “safe and effective” by the Food and Drug Administration (FDA) in 1976, when the agency was newly—and less stringently than today—greenlighting drugs that had been on the market for years before the agency had established any efficacy standards. After a full review of 14 studies (12 unpublished and two published) from pharmaceutical companies—a fair body of evidence for the time—the panel of experts assigned to evaluate over-the-counter allergy medications ruled that phenylephrine was effective.

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Except phenylephrine has never worked. What’s puzzling, then, is how it stayed on those shelves for 50 years without a challenge. That changed on Sep. 12, when a different FDA advisory committee looking in part at that same early research voted 16-0 that the common oral form of phenylephrine is ineffective, opening the door for products claiming it works as a decongestant to be pulled from stores altogether. Though a final decision by agency authorities could take months and face legal challenges, the panel vote alone could be a death blow to the medication, which appears in products that together account for nearly $1.8 billion in U.S. spending each year.

Experts agree that an over-the-counter medication shouldn’t easily be able to go half a century without being reevaluated against new scientific standards. The FDA has since the late 1960s required that over-the-counter medications meet formal standards for both safety and efficacy, but since its initial market purge of medications that didn’t meet those criteria in the early 1970s, such approvals have really only been called into question over safety concerns. “In 50 years, I don’t ever remember a drug being removed from the market because it wasn’t effective,” says Leslie Hendeles, a professor emeritus at the University of Florida’s College of Pharmacy and an FDA consultant. In other words, if it isn’t broken, the FDA usually doesn’t have the bandwidth to fix it. The story of phenylephrine, then, isn’t just an example of the agency’s past oversights, but could be what Hendeles calls the “poster child” of a new effort to clean them up in every aisle.

Though it’s popular now, phenylephrine became the main over-the-counter decongestant through a sort of process of elimination. The 1976 panel that allowed it to stay on the market after the FDA updated its standards also approved two other decongestants: pseudoephedrine and phenylpropanolamine. The studies that formed the basis for phenylephrine’s approval were shaky by today’s standards; Hendeles says that the results are riddled with statistical anomalies, and that “some even had fraudulent data.”

At the time, phenylephrine was the least common of the three. Around the turn of the century, however, large studies began to demonstrate an association between phenylpropanolamine and deadly brain bleeds, and so the market for phenylephrine and pseudoephedrine increased.

Most manufacturers who used phenylpropanolamine switched to pseudoephedrine around 2000, Hendeles says—the most popular allergy medications at the time, including Claritin D, which led the market, all contained pseudoephedrine along with the standard antihistamines, which fight allergy symptoms triggered by the immune system, like itchiness and swelling. But pseudoephedrine at the time was also the easiest-to-acquire form of one potential key ingredient in the production crystal meth, and with the passage of the Combat Methamphetamine Epidemic Act of 2005, any medication containing it could no longer be sold on shelves; you didn’t need a prescription, but it was only accessible by pharmacists and all sales were tracked. “Companies didn’t want to lose the income from sales in front of the counter,” Hendeles says, “and phenylephrine could be purchased in grocery stores, convenience stores, airports, cruise ships—everywhere.” Reformulations and new options with phenylephrine proliferated. Today, there are 261 over-the-counter products containing the drug.

But not all manufacturers made the switch. Schering-Plough (since bought out by Merck), the maker of Claritin D, was hesitant, says Hendeles. “They were effective, and they didn’t want to make the switch unless it was going to give them the same efficacy,” he says. Internally, the company ran some of the first studies of phenylephrine since the 1970s, and sure enough, they showed that the last over-the-counter option was ineffective. So they chose to keep making Claritin D with pseudoephedrine, even though it meant the drug would have to go behind the counter. The makers of Zyrtec and Allegra followed suit with their pseudoephedrine products.

Around the same time, in 2007, Hendeles’s University of Florida colleague Randy Hatton filed a public records request that granted him access to the dozen original studies on phenylephrine that the FDA had initially looked at decades earlier. Together, the two researchers concluded that the evidence showed oral phenylephrine at the allowed dose was no better than a placebo, and immediately filed a citizen’s petition asking the FDA to require pharmaceutical companies to test doses higher than the maximum allowed 10 mg of phenylephrine. In response, the agency assembled the Non-Prescription Drug Advisory Committee (NDAC) to address Schering-Plough’s findings and the concerns raised by Hendeles and Hatton.

Amid conflicting presentations and interpretations of research given by the petitioners, manufacturers, and the Consumer Healthcare Products Association, which represents the industry, the NDAC ultimately voted “yes” on a resolution that the evidence on phenylephrine was “suggestive of efficacy.”

Hendeles didn’t agree then, and today claims that the meeting was far from thorough and fair. “The head of the [NDAC] said that the ideal outcome of this meeting would be for the committee to say that it’s effective and didn’t need additional studies,” he says. “He said, ‘that way, we won’t have to change the monograph’”—referencing, Hendeles says, the established rule sheet for a family of drugs. According to Hendeles, a chronically understaffed and underfunded FDA may have simply not been able to give the issue the attention it deserved at the time.

In the FDA’s own recounting of the 2007 meetings, the agency suggests that some consultants present were likely swayed by the fact that studies have actually shown that phenylephrine can be an effective nasal decongestant. Of course, what the NDAC was supposed to be assessing in this case was its efficacy as an oral decongestant, processed in the gut. That the body metabolizes a drug differently based on method of administration isn’t unusual, but can certainly make specifying its usage more confusing.

Following those meetings, the FDA also asked companies manufacturing oral phenylephrine test higher-dosage versions of their drugs, as Hendeles had requested. But two extensive studies by Merck found that even 40 mg of phenylephrine—a whopping four times the largest dosage being sold in Claritin pills in stores—was no more effective than a placebo. In 2015, “when we saw the results of this dose ranging study, Dr. Hatton and I went and submitted another petition” to the FDA, Hendeles says. “This time that petition was actually to remove the drug from the marketplace.”

Though it took another half decade, that second petition, and its support from groups including the American Pharmacy Association, is a big part of what finally got the FDA to take its most recent look at phenylephrine. Another reason for the FDA’s recent move was the Coronavirus Aid, Relief, and Economic Security Act, passed in 2020, which enabled the agency to more easily revise over-the-counter approvals and recommendations.

If the FDA does decide to take phenylephrine off the market, it may signal to the market that more medications might be subject to new regulatory scrutiny. In the allergy aisle alone, Hendeles has a few other products in his crosshairs, including the cough suppressant dextromethorphan, found in Robitussin, and the mucus thinner guaifenesin, found in Mucinex. “The data that’s in the literature suggests that neither of those two are effective,” he says.

For now, with no given timeline for a final decision from the FDA, phenylephrine is still on the market. Still, with flu season coming, a word to the wise and congested: It’s time to get comfortable with nasal spray.

If the ineffective decongestant is removed from the market, other over-the-counter drugs could be up for reevaluation next.

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If the ineffective decongestant is removed from the market, other over-the-counter drugs could be up for reevaluation next.

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September 14, 2023
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Firefighters Fear the Toxic Chemicals in Their Gear Could Be Causing Cancer

BOSTON (AP) — Boston firefighter Daniel Ranahan had heard about colleagues getting cancer but he was stunned when doctors discovered a tumor in his chest.

He was only 30 and had been in the Boston Fire Department less than a decade. But as he investigated his diagnosis of Hodgkin’s lymphoma in October 2020 and sought successful treatment, he learned he and others wore gear that contained the toxic industrial compound PFAS.

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“You always hear about the dangers. You just never think it’s going be you,” said Ranahan, who stopped working due to the cancer and is among thousands of firefighters nationwide who sued PFAS manufacturers and companies that make firefighting gear and foam, seeking damages for their exposure.

“These guys put this on day in and day out to protect neighborhoods and wherever they are working,” he said. The Associated Press was not given access to his doctors due to the ongoing litigation, making it difficult to independently verify his claims.

The multi-layered coats and pants worn by firefighters have become the latest battleground over PFAS, or per-and polyfluoroalkyl substances. It’s found in everything from food packaging to clothing and is associated with health problems including several types of cancer. In March, the Environmental Protection Agency for the first time proposed limits on the chemicals in drinking water.

The news that PFAS compounds are in their gear — primarily meant to repel water and contaminants like oil and prevent moisture-related burns — is worrisome to firefighters.

The International Association of Fire Fighters or IAFF says that cancer has replaced heart disease as the biggest cause of line-of duty deaths. Firefighters have been shown to be at higher risk than the general population of getting several types of cancer.

Firefighters are exposed to a laundry list of carcinogens coming from fires burning hotter and faster than ever before — often due to increased petroleum products in homes. But as they learn more about PFAS, firefighters have grown suspicious that their personal protective equipment or PPE is sickening them.

“We had no idea that the gear that we were putting on every day was essentially loaded with PFAS,” said IAFF General President Edward Kelly, who was elected in 2021 on a campaign in part to address dangers of PFAS in gear.

Sam Dillon, president of Boston Firefighters, Local 718, said the union had to act.

“When we break it down, the problem to us becomes very simple,” he said. “There is proven science that PFAS is a known carcinogen. There is also proven science that PFAS is in protective gear that firefighters wear. So when its brought to our attention that there is a known carcinogen in the protective ensemble that our members wear, it is grave concern to the union and it’s our job to address that issue.”

One defendant in the lawsuits, 3M Co., said in a statement that it “manufactures a variety of personal protective equipment products that meet nationally recognized standards to help protect first responders facing high-hazard environments.” Last year, the company announced it would stop manufacturing PFAS by the end of 2025 and would work to discontinue using the chemicals in its products.

Another defendant, W. L. Gore & Associates, says the PFAS compound PTFE used in its clothing is nontoxic and safe.

“Based on the body of available and reliable science, Gore concludes its firefighting products are not the cause of cancers impacting firefighters, who by the nature of their important work are sometimes exposed to cancer-causing chemicals from fires,” said company spokesperson Amy Calhoun.

The American Chemistry Council said in a statement that “PFAS-based materials are the only viable options for some key equipment that meet the vital performance properties required for firefighting gear.”

Heightened concerns about gear

The PFAS has been in the gear for decades. But the wife of retired Worcester, Massachusetts fire lieutenant Paul Cotter who had cancer raised concerns about PFAS in gear in 2016. Until then, many firefighters had not heard of PFAS or did not know it was in their gear.

Gear makers told Diane Cotter there were only trace amounts of PFAS and it was safe. “I was attacked by firefighters when discussing the idea that chemicals in the gear could be causing cancer,” she said.

Cotter sent patches of gear to Graham Peaslee, a University of Notre Dame professor who studies PFAS, for testing.

“It was loaded with PFAS. That was the first eye opening moment that there may be more than just trace amounts,” said Peaslee, who also found the chemicals on gloves and in firehouse dust.

“They come off and they pose risks,” he said.

Courtney Carignan, an exposure scientist and epidemiologist at Michigan State University, said she found PFAS at twice the levels of the general population in the blood of more than half of the 18 firefighters she tested in Nantucket and Fall River, Massachusetts. She also found PFAS in gear was transferred to the skin of firefighters.

But Carignan is still investigating how much the gear contributed to increased levels of PFAS in the blood and whether PFAS exposure may be causing or contributing to cancer.

“Even though we know PFAS is in the gear, we still don’t know how much exposure that is,” she said.

Firefighters take action

The revelation of PFAS in the gear sparked a campaign by firefighters to find safer alternatives and to hold companies responsible.

Lawsuits on behalf of firefighters argue they were exposed to significant PFAS levels and companies knew the gear contained PFAS and that it can cause serious health problems. The suits also allege companies misrepresented their products as safe.

The IAFF, which represents more than 340,000 U.S. and Canadian firefighters, decided in 2021 to no longer accept sponsorships or advertising from the chemical industry and to oppose PFAS in turnout gear. A Congressional bill introduced in July would accelerate the search for safer alternatives and support firefighter training to reduce exposure from existing gear.

Seven states including Washington, New Hampshire and New York passed bills requiring companies to disclose PFAS in their gear, according to Safer States, a coalition of environmental health groups. Several more states introduced or enacted bills this year that provide funds to purchase PFAS-free gear or prohibit manufacture or sale of gear containing the chemicals, according to Emily Sampson, an environment policy analyst at the National Conference of State Legislatures.

No easy fix

For most fire departments, there is no easy fix. Replacing gear is expensive — one set can cost upwards of $4,000 — and finding alternatives has proven challenging. Some companies are promoting a PFAS-free outer layer but that doesn’t solve the problem because the other two layers still contain PFAS, the IAFF said.

Among the hurdles, according to a IAFF lawsuit filed in March, is that the National Fire Protection Association or NFPA standard for gear can only be met with PFAS-infused material. The suit accuses the NFPA of working with several gear makers to maintain that requirement. It seeks damages and an end to the standard.

Chris Dubay, NFPA vice president and chief engineer, said in a statement that the standard “does not specify or require the use of any particular materials, chemicals or treatments for that gear.” He said the group has no “special agreements or relationships with any company or organization” in development of standards.

“The manufacturers who are producing this gear owe it to the fire service to come up with an alternative,” Brockton Fire Chief Brian Nardelli, who has heard of companies promoting gear with less PFAS but is reluctant to buy it for his 231-member department without more proof.

Instead, his department tries to limit firefighter exposure to gear that’s been integral to firefighter identity. They would take it everywhere, including charity events. Now, Brockton discourages firefighters from wearing turnout gear in living quarters and encourages them to wash it after fires. It’s stored on trucks and is only to be worn for serious calls like fires and car accidents.

“Guys have seen everyone who has gotten cancer, guys dying from cancer,” said William Hill, the president of the Brockton Fire Fighters Local 144 who was successfully treated for testicular cancer. “Being told that PFAS is in the gear, guys don’t want to take the chance of being overexposed.”

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Associated Press climate and environmental coverage receives support from several private foundations. See more about AP’s climate initiative here. The AP is solely responsible for all content.

Firefighters are starting to worry that the PFAS in their gear could be increasing their risk for cancer.

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Firefighters are starting to worry that the PFAS in their gear could be increasing their risk for cancer.

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September 14, 2023
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7 minutes Read

There’s No Sign of Widespread COVID-19 Mandates. Republicans Are Warning of Them Anyway

As Americans fend off a late summer COVID-19 spike and prepare for a fresh vaccine rollout, Republicans are raising familiar fears that government-issued lockdowns and mask mandates are next.

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It’s been a favorite topic among some of the GOP’s top presidential contenders. Florida Gov. Ron DeSantis told reporters that people are “lurching toward” COVID-19 restrictions and “there needs to be pushback.” South Carolina Sen. Tim Scott posted online that the “radical Left” seeks to bring back school closures and mandates. And former President Donald Trump urged congressional Republicans to stop the Biden administration from bringing back COVID-19 “mandates, lockdowns or restrictions of any kind.”

“The radical Democrats are trying hard to restart COVID hysteria,” Trump told supporters in Rapid City, South Dakota, during a recent campaign stop. “I wonder why. Is there an election coming up by any chance?”

While some individual schools and colleges have implemented temporary mask requirements, there is no sign that anyone in federal or state leadership is considering widespread COVID-19 restrictions, requirements or mask mandates. The administrations of several Democratic governors denied that any such moves are even under discussion. The overriding sentiment is to leave the decisions to individuals.

“No COVID-19 public health restrictions or mask requirements are being considered by the Murphy administration,” said Christi Peace, spokesperson for New Jersey Gov. Phil Murphy.

“There are no impending mass lockdowns or mask mandates for New Mexico,” said Jodi McGinnis Porter, spokeswoman for the New Mexico Department of Public Health.

It was largely the same message from Democratic governors’ offices in several other states that responded to an inquiry about whether any COVID-19 mandates were under consideration. That included Connecticut, Kansas, Louisiana, Massachusetts, Michigan and Oregon.

Pennsylvania Gov. Josh Shapiro, a Democrat, made clear his opposition to COVID-19 lockdowns as well as mask and vaccine mandates when he was campaigning for office last year: “This is an area where I think folks got it wrong,” he said of school and business shutdowns. His office echoed the same sentiment in its response to the AP this week, saying, “The administration’s view is that there is no need to impose restrictions.”

In the two most populous Democratic-led states, California and New York, the state health departments recommend getting the updated vaccine, but have no requirements for the shot or mask wearing. New York Gov. Kathy Hochul was asked during a news conference Wednesday about whether she would consider mask or vaccine mandates: “We are in a place where we’re seeing low numbers; not requiring such actions today,” she said.

Elisabeth Shepard, spokesperson for Oregon’s Democratic governor, Tina Kotek, noted that the federal public health emergency for the virus outbreak ended in May.

“Currently, COVID-19 lockdowns and mask mandates are not being discussed and the governor has no plans to institute these measures,” she said.

Still, the misleading narrative has proven a convenient scare tactic for Republicans in their efforts to woo voters who see Democrats as oppressive leaders targeting their freedoms.

The GOP presidential hopefuls hammering this message in the last week join a chorus of conservative lawmakers and far-right pundits who have spent the last month warning that tyrannical COVID-19 measures are looming.

In August, conspiracy theorist Alex Jones claimed an anonymous “high-level manager in the TSA” and an unnamed “Border Patrol-connected” source told him that Transportation Security Administration workers would soon need to wear masks and that COVID-19 lockdowns would return in December.

The U.S. Centers for Disease Control and Prevention said the claims were “utterly false,” but they still were amplified by influential Republicans, including Rep. Lauren Boebert of Colorado, who posted on X that she wrote to the TSA demanding answers.

Later last month, when a Black liberal arts college in Atlanta announced it had reinstated a temporary mask mandate in response to student infections, Rep. Marjorie Taylor Greene, a Republican from Georgia, posted on X that “Americans have had enough COVID hysteria. WE WILL NOT COMPLY!”

The school, Morris Brown College, has since lifted the requirement but is keeping in place other policies, including contact tracing and temperature checks on campus.

Some of the outcry from conservatives has been in response to President Joe Biden’s comments last month on COVID-19’s recent uptick, which has led to an increase in hospitalizations and deaths nationwide — though a fraction of what the country saw in past surges.

“As a matter of fact, I signed off this morning on a proposal we have to present to the Congress a request for additional funding for a new vaccine that is necessary — that works,” Biden told reporters during a visit to South Lake Tahoe. “And tentatively — not decided finally yet — tentatively, it is recommended that, it will likely be recommended that everybody get it no matter whether they’ve gotten it before or not.”

The CDC on Tuesday endorsed those new shots for everyone 6 months and older, and the vaccines will be available at pharmacies, health centers and some doctor offices as soon as this week. But a new federal vaccine mandate is not under consideration, according to a White House official who requested anonymity to discuss the administration’s thinking.

A federal mask mandate is also not on the table.

“To be clear, the rumors of a federal mask mandate are not true,” said Jeff Nesbit, assistant secretary for public affairs for Health and Human Services. “We now have a range of tools for people to protect themselves from the impact of COVID-19, including vaccines, at-home testing and treatments. Masking is one of several steps people may choose to take to protect themselves if they wish.”

Reinstated mask requirements across the country have so far been limited to a handful of local schools and businesses. One example is a Maryland elementary school that required students who were exposed in a classroom’s outbreak to wear masks at school for 10 days.

But these isolated measures have sparked outrage from conservatives who have used them to energize their supporters.

Sen. J.D. Vance of Ohio last week unveiled the “Freedom to Breathe Act,” a bill that would block the federal government from imposing mask mandates for domestic flights, public transit and schools. His call for unanimous passage of the bill failed, with Democratic Sen. Ed Markey of Massachusetts calling it a “red herring” meant to deflect from the GOP’s prioritization of “gimmicks over people.”

Greene, the Republican from Georgia, introduced a companion bill in the House. She has said she won’t vote to avoid a government shutdown unless the government ends coronavirus mandates, which have already largely been reversed.

Misinformation experts say there’s a strategy to Republicans’ foreboding claims about impending mandates: They remind voters of the negative feelings they had early in the pandemic — and associate those with Democrats.

“Wearing a mask doesn’t have to be connected to anxiety, fear, anger and other strong emotions, but for many people it is,” said Lisa Fazio, a Vanderbilt University psychology professor who studies the spread of false claims. “No one wants to go back to those feelings, so Republicans are trying to tie those negative feelings and memories to their political opponents.”

Meanwhile, some of the Republican-led states where state leaders are railing against COVID-19 measures have been the hardest hit by the recent surge. Data shows Mississippi had the highest COVID-19 death rate per 10,000 people in the last week of August.

Early that week, the state’s Republican governor, Tate Reeves, pledged to block any widespread restrictions, posting online that the state would “live in self-determination, not top-down fear.”

___

Associated Press data journalist Nicky Forster and writers Joey Cappelletti, Mike Catalini, Sara Cline, Jill Colvin, John Hanna, Susan Haigh, Maysoon Khan, Seung Min Kim, Steve LeBlanc, Morgan Lee, Marc Levy, Lisa Mascaro and Andrew Selsky contributed to this report.

___

The Associated Press receives support from several private foundations to enhance its explanatory coverage of elections and democracy. See more about AP’s democracy initiative here. The AP is solely responsible for all content.

GOP presidential candidates are warning about supposed widespread COVID-19 mandates and school closures that are not real.

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Health – TIME

GOP presidential candidates are warning about supposed widespread COVID-19 mandates and school closures that are not real.

Uncategorized
September 13, 2023
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6 minutes Read

What to Know About the New COVID-19 Vaccine Booster

In a long-awaited update to the COVID-19 vaccine schedule, the U.S. Centers for Disease Control (CDC)’s vaccine committee recommended that everyone six months or older should get another booster shot.

In a long-awaited update to the COVID-19 vaccine schedule, the U.S. Centers for Disease Control (CDC) recommended on Sept. 12 that everyone six months or older should get another booster shot. CDC director Dr. Mandy Cohen endorsed the recommendation made by the agency’s committee of outside vaccine experts.

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That shot will be the newest vaccine greenlit by the Food and Drug Administration (FDA) just a day earlier. The FDA approved mRNA vaccines made by Moderna and Pfizer-BioNTech that target the XBB.1.5 variant for everyone 12 years or older, and issued an emergency use authorization for mRNA vaccines for children six months to 11 years. The FDA’s actions also mean that the updated vaccine is the only one authorized or approved against COVID-19; the previous booster, against BA.4/5 is no longer authorized.

In a 13-1 vote, the CDC’s panel of vaccine experts decided that near-universal vaccination for everyone six months or older would provide the best protection against another serious surge in infections this fall and winter. Hospitalizations due to COVID-19 have been increasing since mid-July, CDC scientists reported, and while most of those have involved young children and older people, half of the children under five who have been hospitalized did not have underlying health conditions, a reminder that even otherwise healthy people can experience serious COVID-19 illness.

Despite the near unanimous vote in favor of recommending the vaccine for most people, committee members raised several concerns. First, the new vaccines target the XBB.1.5 variant—which is no longer the virus causing the most infections in the U.S., but was the dominant virus earlier in the summer, when the FDA made the decision to switch to a new vaccine. At the time, the agency advised manufacturers to start producing shots targeting that variant. But XBB.1.5 has since been replaced by a handful of new strains, including EG.5.1 and BA.2.86. Moderna, Pfizer, and Novavax all presented data to the committee showing that their XBB-targeted vaccines generated good antibody responses against these new variants as well, but only Moderna’s data involved human cells while Pfizer and Novavax provided data from animal studies. (Novavax has not yet submitted a request to the FDA to authorize its XBB vaccine, but expects to do so soon when its studies are complete.)

Some members questioned whether the updated vaccine should be recommended for most people, or just for those at highest risk of COVID-19 complications, such as the very young, the elderly, and those with compromised immune systems. Dr. Matt Daley, senior investigator at the Institute for Health Research at Kaiser Permanente Colorado, and the head of the CDC’s work group that reviewed the vaccine safety and effectiveness data, said that when the group began discussions earlier this summer, they did not assume that the updated vaccine would be recommended for everyone. “We viewed this as an opportunity to re-evaluate the vaccination program, and started from a blank slate,” he said. The work group therefore asked the CDC for more detailed data on who was being hospitalized, who was experiencing more severe disease, and who was dying from COVID-19, so it could better understand if certain populations were more vulnerable to complications and could benefit from vaccination. What they saw was that “Disease burden does vary greatly by age, but serious illness occurred across all age groups including among those without underlying medical conditions,” Daley said. “That was the most persuasive argument for me for universal vaccination.”

Those data, coupled with the fact that many people did not get the most recent booster, means that overall immunity against SARS-CoV-2 is dropping, said Dr. Sandra Fryhoffer, associate professor of medicine at Emory University who was representing the American Medical Association at the meeting. “We are all more susceptible.”

Most of the committee members agreed, but Dr. Pablo Sanchez, professor of pediatrics at Ohio State University-Nationwide Children’s Hospital, was the only member to vote against the recommendation. “I think we need to let the public know that the data on children is not there,” said Sanchez. “We need to level with our patients and say what is known and what is unknown rather than make a blanket recommendation, especially for groups for whom there isn’t data.” Sanchez argued for a recommendation that focused on the most vulnerable groups, such as people over 65 years, the immunocompromised, and pregnant people, and encouraged other groups to make individual decisions about getting vaccinated after discussing their risks and benefits with their doctors.

Some committee members shared Sanchez’s concerns about the lack of data, but also pointed out that without a universal recommendation, current inequities in vaccine access would only deepen since those without access to health care would not benefit from individual discussions about their need for a vaccine.

The updated vaccine will be the first COVID-19 shot to be distributed in the way most vaccines have in the past, prior to the pandemic, on the commercial market for around $120-$130 per dose, rather than purchased and provided for by the government. That means that pharmacies and doctors’ offices will purchase the vaccines at their own cost and get reimbursed for the shots. Most insurers, including Medicare and private companies, will continue to cover the vaccine, without co-pays, since it is recommended by the CDC.

The Vaccines for Children program will provide shots for uninsured and underinsured younger kids. For older children and adults without adequate insurance coverage, the CDC announced that it will purchase shots and make them available at state and local health departments, as well as through retail pharmacies that participate in the Bridge Access Program until 2024. To sustain the program beyond that for adults, the agency hopes to secure additional funding to launch a permanent Vaccines for Adults program and extend the shots it provides beyond COVID-19 vaccines.

The CDC recommends most people should get the updated COVID-19 vaccine, especially as hospitalizations from infections increase.

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Health – TIME

The CDC recommends most people should get the updated COVID-19 vaccine, especially as hospitalizations from infections increase.

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September 13, 2023
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4 Ways to Help Your Child Adapt to Life’s Rapid Changes

If you’re a parent, you often feel that life today is complicated, overloaded, and moving at warp speed. Technological advances like AI are creating exponential change, the world is getting hotter, and the future is hard to imagine–both for ourselves and our kids. The world is brimming with uncertainty as life races forward. Scientists are calling our era “The Great Acceleration,” and it’s creating unprecedented challenges for us as we raise our children.

As mental health professionals working with families, we meet so many parents who are afraid that their kids aren’t equipped for all this change and uncertainty—and to be honest, we’re worried, too. In our practices, we see wonderful, talented kids who are also brittle and anxious, struggling with motivation, acting out with anger and frustration, or disappearing into their devices. Teens who struggle to know themselves, faltering into adulthood. And the data confirms that kids’ mental health is truly suffering: According to the Centers of Disease Control and Prevention’s Youth Risk Behavior Survey, in 2021, more than 40% of high school students showed signs of depression and even pre-pandemic nearly one in three adolescents had an anxiety disorder.

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Parents want so much to help, but we’re stuck in an outdated model for how to do so. Parents of younger kids worry their child will be left behind—or if they aren’t ahead of the curve, an early reader, or in the advanced math group. Parents of teens worry they should focus on the “right” extracurriculars, the “right” college. But in a time of unprecedented change, being “right” or “ahead” shouldn’t—and simply, can’t—be the goal. The goal posts move before kids can ever reach them.

Instead of prioritizing pushing our kids ahead, we should be equipping them to stay grounded, able to bend in the wind without breaking: unafraid of uncertainty, able to cope with tough feelings, not dependent on others for motivation, evaluations, or solutions. Parents’ loving but fearful focus on achievement of all kinds–academic, athletic, extracurricular–in the hopes of fueling kids’ future success is misplaced. Kids today don’t need more achievement —they need more adaptability. Less focus on their IQ and more on their AQ.

AQ, or Adaptability Quotient, is a buzzy new business term, but we believe the “intelligence” of adaptability is the skill kids most need. Adaptability allows humans to survive and innovate. Uncertainty abounds, and parents struggle to try to have the answers to questions they’ve never even considered. But our kids don’t need answers all the time, or to believe that answers always exist. Our reassurance is hollow anyway. Perhaps, then, the word “maybe” should be our new parenting mantra. If we can admit when we don’t know and learn to be ok with it, it might help them thrive in the “maybe,” too.

Every time our child asks for certainty, we should take a cue from the emoji of the wondering, shrugging lady in the purple shirt. When we parent for adaptability, we are empathetic, supportive, but not overly involved or reactive. Think about offering curiosity and asking them what they think the solution should be. We need to provide kids with the confidence that while we, and they, don’t have all the answers, we will still be ok. We can adapt.

Sounds good, right? But how do you do it? It’s not easy and may require shifting your parenting mindset. It might look like focusing less on physical safety or comfort, and more on what helps kids develop psychological strength. Things like mindfulness and self-care, learning to tolerate difficult emotions, and practicing resilience in the face of failure; valuing our connections with one another and focusing on gratitude over grievances; redefining success as not what you achieve but how you adapt.

Once we decide to prioritize building adaptability in our kids, how to do it becomes a series of strategic choices across childhood. Here are some strategies for your playbook:

Do less

Less is often more with parenting, and much of the time doing nothing is the hardest – and best – parenting move. Allow your child to feel hurt or afraid or uncomfortable. Be present, be empathetic, just don’t immediately intervene. A kid will only become adaptable when given the opportunities to do so. And they will sense a parent’s confidence in them in that pause.

Manage uncertainty, instead of fixating on it

At best all we can provide our kids is the illusion of control rather than actual absolute safety, and this cycle of fearing danger and the unknown increases anxiety and makes kids fragile. For example, when we track our kids’ whereabouts via their phones, we’re assuaging our own anxiety at the expense of their freedom and independence. To build adaptability, parents need to equip their kids to manage uncertainty and risk and to express confidence rather than fear.

Set–and hold–some limits on our on-demand, instant gratification world.

Help your child develop self-control over the unlimited amount of dopamine (a feel-good brain chemical) available to them thanks to modern life. Don’t let kids become dependent on technology’s frequent hits of neurochemical reinforcement that keep us scrolling, playing, and posting. We can all become immune to real life’s more subtle but far more sustaining pleasures if we spend too much time in the digital world. Get your kids outside, let them be bored, encourage low-tech creativity and real-life interactions with others.

Embrace difficult emotions like fear, sadness, and uncertainty.

Teach your child to be awake to themself, to know how they feel and to be unafraid of those feelings. Show them that feelings are simply clues, not facts, and that often if we wait long enough, they will change by themselves. Accept their emotional discomforts just like inevitable physical discomforts. Practice riding the wave.

Parenting is hard, and good intentions can have a boomerang effect. Too much help erodes independence. Too much praise saps motivation. Too much protection can grow anxiety. Finding the balance is always challenging. But we all need to make peace with our fundamental lack of control over what we so badly desire: providing our kids the smoothest possible path to a happy and successful future.

Instead, let’s equip our kids for whatever terrain they encounter. For an unknowable future with jobs we’ve never imagined and technological advances we have not yet dreamed. Let’s prepare them to be successful in the ways that count: In knowing themselves, and in being independent, creative thinkers who can adapt and overcome challenges—who can hit the curveball out of the park, and who can recover from striking out.

‘Perhaps the word “maybe” should be our new parenting mantra,’ write Heather Tedesco, Jennifer Weaver, and Catherine McCarthy.

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Health – TIME

‘Perhaps the word “maybe” should be our new parenting mantra,’ write Heather Tedesco, Jennifer Weaver, and Catherine McCarthy.

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September 12, 2023
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Common Nasal Decongestant Doesn’t Actually Work, According to FDA Advisors

A panel of US regulatory advisers said phenylephrine, a main component of over-the-counter cold medicines including some versions of Procter & Gamble Co.’s Nyquil, doesn’t actually work.

The committee of 16 advisers to the Food and Drug Administration voted unanimously on Tuesday that scientific evidence doesn’t prove that the nasal decongestant is effective when taken orally at recommended doses. The majority of panelists agreed that further studies to test higher doses of the drug would not be worthwhile.

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The advisory committee’s decision isn’t binding, but the FDA’s own staff have also questioned phenylephrine’s efficacy. If the agency follows the panel’s recommendation, it could next begin a process to remove the drug from the market, forcing manufacturers, including P&G, Kenvue Inc. (Sudafed) and Reckitt Benckiser Group (Mucinex), to reformulate many popular cough and cold products.

The companies didn’t respond to requests for comment.

Consumers spent about $1.8 billion on products containing phenylephrine in 2022, according to the FDA, although many cold remedies with the decongestant also contain other active ingredients like antihistamines and cough suppressants.

Phenylephrine has increasingly been used as a substitute for pseudoephedrine in many non-prescription cold remedies. Commonly found in forms of Sudafed, pseudoephedrine can be used to make illegal forms of methamphetamine. Since 2006, the US government has been requiring medicines containing it to be kept behind the counter.

Pharmacist’s dilemma

If products with phenylephrine remain on the market, pharmacists would face an ethical dilemma over whether to recommend products that don’t work, said Diane Ginsburg, a clinical professor of pharmacy practice at the University of Texas at Austin and one of the outside experts on the panel. “That just erodes trust that patients have with us,” she said at the meeting on Tuesday.

Panelists and industry representatives voiced concerns that taking the products off drugstore shelves would confuse consumers and potentially restrict people’s ability to self-treat with easily accessible over-the-counter remedies.

Others responded that remedies like nasal sprays and cold medicines kept behind the pharmacy counter are still available and effective, and that continuing to market ineffective products would present greater risks for patients.

“People really don’t like change, and this is going to change how the cold and cough aisle looks,” said panelist Susan Blalock, a behavioral scientist at the University of North Carolina’s Eshelman School of Pharmacy. “FDA really shouldn’t underestimate the communication challenges.”

With assistance from Fiona Rutherford.

A panel of advisers to the U.S. FDA said that phenylephrine, a main component of over-the-counter cold medicines, doesn’t actually work.

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A panel of advisers to the U.S. FDA said that phenylephrine, a main component of over-the-counter cold medicines, doesn’t actually work.

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September 12, 2023
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6 minutes Read

Why It Takes Forever to Get a Doctor’s Appointment

Recently I faced consoling a patient of mine who couldn’t understand why I was unable to “hop on the phone” to discuss her new back pain. When she finally got an appointment with me weeks later, I decided to be honest. I shared that I had 1,300 patients who call me their primary doctor. After I’m done seeing patients at 5 PM, I tend to 50 to 100 messages and notifications. I take three to four hours of work home with me every night.

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I didn’t share these stats to elicit sympathy, but soon our roles had reversed. My patient overflowed with apologies and demanded to know who was doing this to me.

This is the paradox that defines modern American medicine: Doctors are working harder and longer, all while patients can access us less. As a practicing internal medicine physician and oncologist, I believe we reached this unsustainable state due to fundamentally misaligned division of labor – between human and machine, between doctors and support staff, and between what is paid for and what good medical care requires.

As a doctor, I am no stranger to hard work. But the ways doctors’ workloads are exploding are largely clerical and bureaucratic. Ironically, a big culprit is electronic medical records. Paper records were converted to electronic charts over a decade ago, with the incredible potential to connect enormous amounts of patient data seamlessly. However, the very technology that was supposed to reduce doctors’ work has drastically increased it. Doctors today spend two hours doing computer tasks for every one hour facing patients. Ordering something as simple as Tylenol requires doctors to click between fourteen and sixty-two times, with the confusion causing errors in up to 30 percent of cases. The number of clicks in one ten-hour shift in the emergency room approaches four thousand. Nearly 60 percent of doctors’ notes are identical, and therefore redundant, to the previous ones. The practical result is that doctors spend hours digging through disorganized charts, sleuthing for critical patient data that gets buried under an avalanche of noise. In an era where multibillion dollar software promises to ease data-sharing, the process for providers to input and find health data remains manual, labor intensive, and error prone.

Our current solution to these technologic glitches is leaning on people to serve the needs of the electronic charts. It was supposed to be the other way around. Support staff becomes crucial, yet patching logistical holes often falls to doctors. Recently I prescribed a medication that took 22 clicks, waiting on hold with an insurance company, tracking down a denial letter, writing an appeal, documenting all these phone calls, and keeping my patient apprised through messaging. How many of those steps needed to be done by me? In my estimate, only about half of my daily work actually needs to be done by an MD. The best run clinics understand this and train medical assistants to do much more than stock clean gowns and take vital signs. These clinics also hire nurses who can manage tasks such as refilling prescriptions, triaging patient calls, and answering messages. But while team support and delegation has caught on in the hospital setting, it lags in primary care where the doctor often plays all roles at once.

Managing a patient’s case in this fragmented system requires better tech and team support. It also requires time. In comes the final mismatch: between what is paid for and what medical care requires. Despite pushes in recent years for payment models that focus on value, the vast majority of health care organizations in the U.S. still operate according to fee-for-service. Here, health organizations or doctors get paid based on discrete services they provide. In primary care, that service has been commodified into the office visit. Nothing else directly counts as paid work: not communicating with patients in between visits, not following up on test results, not digging through medical records, and not discussing cases with other doctors. Moreover, fee-for-service generally reimburses more for visits with new patients than appointments with patients following up. With the financial incentives stacked to book as many patients as possible in face-to-face visits, appointments get compressed to fifteen minutes and a typical primary care doctor’s panel swells to over 2,000 patients. All the extra works spills into doctors’ off hours. Meanwhile, each patient competes against thousands for coveted appointments. When attempts to secure timely appointments fail, patients turn to messaging, moving the deluge for doctors to another uncompensated channel that many practices are now trying to disincentivize by tacking on a charge.

The result is a perfect storm that drives good doctors out of traditional medical practices while patients lose outlets to communicate with them. I wish I could have called my patient. But doctors must pick their poison: they speed up and miss important details, spend their nights and weekends carrying over work, or leave. The options for leaving include going part-time (because everyone knows the secret that part-time is actually full-time), joining concierge practices that cap at 200 patients compared to 2,000, or quitting medicine entirely. Patients who can’t get appointments navigate their own lose-lose options: they try to self-manage medical concerns, turn to urgent care or emergency rooms for non-emergency issues, or get billed when they send messages asking for help.

Fixing this crisis will involve profoundly rethinking how we allocate the resources we already have. For years, the labor needed to assemble disparate pieces of a fragmented health care system continued to climb, while the party line to doctors remains the same: Just one more thing. One more click. One more message. One more workaround. Just squeeze it in, we don’t know how, but do it anyway, and do remember if anything goes wrong the responsibility is fully yours. This way of thinking is why primary care doctors are tasked with squeezing 26.7 hours of work into a single day. It is why nearly half of doctors report burnout with bureaucratic demands the number-one cause (this stayed true both before and during the Covid pandemic). And it’s partly why the average wait to see a new doctor is 26 days and getting longer. Some fixes like changing payment models will be harder to spread. But other improvements, such as training staff to tackle clerical work and investing in quality improvement initiatives to augment the technology, can be made now. With every proposed innovation, we must finally take seriously the questions: Does this help doctors or make their lives harder? Will this let doctors know their patients better or deepen the divide?

For a doctor who has led life-and-death emergency responses to talk so fervently of paperwork and scheduling might seem ridiculous. It is. But ignoring the mundane is how medicine reached this untenable state; putting it off any longer is costing us time, energy, and lives.

Doctors are working harder and longer, all while patients can access them less.

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Health – TIME

Doctors are working harder and longer, all while patients can access them less.

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September 12, 2023
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6 minutes Read

Too Many Mothers Are Dying in Childbirth. Here’s How They Can Be Saved

With recent reports of difficult pregnancies and births from celebrities like Beyonce, Serena Williams, and Alyson Felix, and the death of Olympian Tori Bowie during childbirth, the long-overlooked dangers of maternal and child mortality have become increasingly prominent.

In a new report published by the Bill & Melinda Gates Foundation, the global health philanthropic group highlights lagging progress in achieving United Nations (UN) goals for lowering mother and child deaths, along with innovative ways of addressing the problems with relatively inexpensive and easy to implement solutions that the group projects could cut such deaths by as much as half, saving 2 million lives

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“Every death matters,” says Bill Gates, of the group’s decision to draw attention to maternal and child mortality. Under current circumstances, the world will not reach the UN Sustainable Development Goals (SDG) to reduce maternal mortality to less than 70 per 100,000 live births and neonatal mortality to lower than 12 per 1,000 live births by 2030. Currently, maternal mortality has plateaued at 150 to 160 per 100,000 live births since 2015, and child mortality ranged from 16 to 18 per 1,000 live births in the same period. “Global health does not get the attention it deserves, and we want to remind people that the UN did pick these goals, and we are off track,” says Gates.

Each day, 800 mothers around the world die giving birth, and the chance that their babies survive past their first year is less than 37%.

That sobering reality is more concerning when considering previous success in lowering maternal and child mortality rates. Thanks to the UN’s Millennium Development Goals (MDG), which set ambitious targets for lowering deaths by improving access to basic health care including childhood vaccines, contraceptives, and bed nets to ward off malaria-carrying mosquitoes, mortality among mothers giving birth dropped 3% annually from 2000 to 2015, and child mortality declined 2% yearly in the same period. “We’ve never seen a reduction like that and 2000 to 2015 was a magical period,” says Gates. “We achieved something miraculous.”

Those encouraging trends, however, have stalled. The MDGs were replaced with SDGs, a set of 17 global sustainability goals that extended the MDG targets, including eliminating poverty and hunger, improving access to quality education, achieving gender equality, and moving to affordable and clean energy. They also include health goals of reducing maternal and child mortality, addressing HIV, expanding prevention and treatment programs for substance abuse, and implementing stricter tobacco control regulations. Continued political and civil unrest, as well as unstable economies, not to mention the emergence of climate priorities, have created a more competitive space for achieving health targets, says Gates.

Goalkeepers, a Gates Foundation initiative begun in 2017 to support and accelerate achieving the SDGs, tracks progress toward the targets, and this year, documents that at current rates, targets for lowering maternal and child mortality won’t be met by 2030.

One reason for the slowdown may be an artifact of the remarkable success of the MDGs. “There comes a point when you start to see plateaus [in your outcomes],” Laura Lamberti, deputy director of maternal, newborn, and child health discovery and tools at the Gates Foundation said during a briefing. “Even if you are delivering high quality interventions and have high coverage of them, those interventions are addressing some of the leading causes of mortality, and you reach a point where the existing package of care is not addressing what is causing the residual deaths that continue to occur.”

That’s why the current report highlights solutions that focus more on expectant mothers, and their health before delivery, as well as on the delivery itself. One major cause of maternal mortality in childbirth is the excessive loss of blood, but in many busy birthing centers, it’s hard for doctors, nurses, or midwives to gauge how much blood a woman is losing, and how much is too much. A simple cup device hung on the bed allows nurses and doctors at a glance to see which women are bleeding excessively and prioritize treating them.

There are five ways to stop postpartum bleeding—uterine massage, examining the genital tract, administering IV fluids, and two drugs—which health professionals traditionally tried one at a time. But a study involving 200,000 women in Africa showed that using all five at once could lower risk of postpartum bleeding by 60%, and the Foundation is working with local health facilities to train people to optimize their use simultaneously.

Even simpler ways to address such bleeding, which is more common among women who have low iron levels or are anemic, is to provide them with iron supplements. While pills are common, women need to take them for about six months to build up adequate levels in their blood, and the pills can cause side effects. The Goalkeepers report includes the example of a Nigerian obstetrician who found that giving women a single 15-minute intravenous infusion of iron during a prenatal visit, could treat anemia and significantly lower the chance of bleeding after giving birth.

Infections are another common cause of complicated delivery and mortality, but a trial conducted in sub-Saharan Africa found that treatment with a common antibiotic, azithromycin, can cut risk of sepsis infections, a danger during childbirth, by a third. Broader use of azithromycin could also help in the U.S., where 23% of maternal deaths are due to sepsis.

Gates says the Foundation is continuing to research ways to drive down mortality rates by supporting several large trials around the world that focus on understanding, for example, the major drivers behind diarrhea and pneumonia among children, two of the major causes of death in the first few years of life.“ Getting the information about deaths, particularly very young deaths, guides our work in a pretty profound way,” says Gates of the continued effort to broaden the database. For example, that knowledge is underscoring the importance of basic needs such as good nutrition for babies and young children, which is critical for good development.

But even inexpensive and simple solutions won’t be effective if they aren’t in the hands of midwives, doctors, and nurses at delivery centers. Gates is optimistic this can happen, though. “We can start accumulating lives saved very quickly. We show that 2 million lives can be saved by the end of the decade, if we implement some of these measures, which is a mind-blowing number,” he says. “That could be well over 6 million by the end of the next decade. And that’s taking into account difficulties in delivering some of these solutions. If we have perfect delivery of them, the lives saved would be more than double that.”

The Gates Foundation’s 2023 Goalkeepers report proposes ways to prevent maternal and newborn deaths, even in wealthy countries.

Uncategorized, healthscienceclimate

Health – TIME

The Gates Foundation’s 2023 Goalkeepers report proposes ways to prevent maternal and newborn deaths, even in wealthy countries.

Uncategorized
September 12, 2023
43 views
9 minutes Read

Finding Power in My Panic Attacks

Trouble started in the form of rivulets of sweat dampening the waistband of my underwear. It was a bluebird afternoon in Phoenix in December of 2020, mid 60s, desert dry, and my heart was jackhammering against my ribcage. Breathing felt like I was sucking air through a stir straw. A small ABC News crew was arrayed before me, ready to broadcast the report I’d written that day, but with my vision narrowed to a needle’s eye, I could barely see them. I tried to swallow away the sandiness in my mouth but realized I’d forgotten how.

[time-brightcove not-tgx=”true”]

“I can’t swallow! How do I swallow?”

I quickly recognized my body’s reaction for what it was: not a stroke or a heart attack, but a panic attack. I knew this with certainty because I’d endured hundreds of moments like this in the past two decades. There was nothing specific that brought on this particular panic—and that’s what is often so terrorizing about them.

But the news waits for no panic attack. We were about to go live on World News Tonight, and the director counted me down for the live portion of my report. What first came out of my mouth was I imagine to be the sound a chicken makes when it lays an egg. Still, I managed to get through the report without an event, even if it wasn’t as polished as it was when I’d rehearsed it. My colleagues appeared to be none the wiser. Which, at the time was what I was going for.

Panic in our society is encased in an almost impenetrable block of shame and stigma, and over two decades, I had become so ashamed by my bouts of panic that I’d assiduously hidden them, even from myself: When I documented them in my journals, I wrote in a kind of shorthand, a cuneiform indecipherable even to me.

In the months prior to that Phoenix afternoon, I had given myself a crash course in panic. I read medical journals, books on evolutionary science, how-to guides. But I hadn’t yet summoned the courage to reveal my secret. Only my wife and my therapist knew of my hidden affliction.

What I’d found in all that research stunned me. I learned panic was far more common than I’d imagined. According to a study published in the Journal of American Medicine, about 28% of Americans will experience a panic attack in their lifetime—that’s as many as 90 million people, more than the population of Germany. Many panic experts, like Dr. Michael Telch who heads University of Texas’s Laboratory for the Study of Anxiety, believe the figure is closer to 50%.

A panic attack is one of the few mental health phenomena that trick a sufferer into thinking they are going to die. And sadly, its chronic underdiagnosis increases the suffering of millions. Kelly Kropholler spent 17 years under the headset as an emergency dispatcher in California answering many hundreds of calls for both panic and heart attacks. Panic so closely mimicked a heart attack that it fooled even her practiced ears. “All of those physical symptoms of [peak] anxiety present as a heart attack clinically,” she told me, “[those suffering panic] breathe really shallow or really fast, feel sweaty, feel tightness in the chest, complain of numbness.”

So it shouldn’t be surprising that, according to a study published in 2022 in the journal Psychiatry, 40% of patients presenting at the nation’s emergency departments with cardiac symptoms actually meet the criteria for “panic-related anxiety (i.e. panic attacks or panic disorder.)” That is over 3 million people a year think they’re having a heart attack when in fact they are enduring a panic attack.

Read More: How I Handle Panic Attacks at Work

That study also found that once panic patients are cleared of cardiac concerns—informed their heart is not the problem—only 1-2% of them are “evaluated and treated for anxiety in this setting.” Put differently, over 98% of patients go untreated for the ailment responsible for bringing them to the hospital. A different survey of ER departments, published in 2018 in the journal BMC Emergency Medicine, found that fewer than half are even informed that they’ve suffered a panic attack. Being told merely that “it’s not your heart,” without being told the source of your terrifying symptoms, can cause a one-off panic to bloom into full blown panic disorder.

My own first brush with panic took place as I was defending my senior thesis in college. For years afterward, as my career in radio and TV progressed, I suffered what I thought of as “nerves” during my live reports. It would be 13 years before I would put a name to those bouts, recognizing them as the classic symptoms of panic disorder. It’s not that I lacked for introspection or self-awareness in that time; I had begun therapy at 12, was well versed in the language of anxiety, trauma, and treatment. It’s that panic is regarded in a way that differs from common anxiety—it is too often seen as a mark of someone self-evidently “broken.”

Dr. Mitch Prinstein, Chief Science Officer at the American Psychological Association, laments the enormous gap between panic sufferers’ need for psychiatric support and what’s typically offered. Most Americans, he says, will remember the 15-minute dental hygiene lesson they got in kindergarten, which has helped prevent tooth decay and cavities in generations of children. “Where is the 15-minute intervention to stop emotional dysregulation, depression, suicidality, anxiety, substance use?” he asked.”

Thirty-nine states plus Washington DC mandate sex education, but not a single state mandates mental health education. Why aren’t all middle schoolers taught what anxiety is, what a panic attack is, and how best to manage them? What would it have meant for me two decades ago, as a 21-year-old college senior, to recognize that my sudden episodes of “nerves,” which made me feel like I was molting into a werewolf, were in fact textbook panics attacks, and to have had help in treating them?

We all end up paying for that lack of intervention. In concrete terms there is the cost to our healthcare system of all those ER false alarms. That’s to say nothing of work absenteeism. Anxiety disorders likely cost the economy over $50 billion in 2020. According to the White House, and based on data from 2020, 29% of Social Security Disability Insurance beneficiaries were people with mental health disorders “or 2.4 million people—a share larger than beneficiaries who cannot work due to injuries, cancer, or diseases of the circulatory and nervous system, combined.”

Familiar as my panic in Phoenix may have been, it still stung. Over the previous year I had committed to meditating and medicating away my panic. That afternoon punctured my fantasy of having been cured.

Immediately after our live shot, I raced to Sky Harbor airport, dragging my carry-on and my shame hangover onto a Southwest flight bound for Los Angeles. Scanning Southwest’s self-seating aisle, I slumped into 13C, next to a woman quietly crocheting. We got to talking.

It turned out she was no stranger to panic attacks. We communed over the extent to which the condition had touched our lives. As we did, I felt the sensation of a burden being lifted. This, sharing I realized, was good medicine.

Inspired, I started confessing my panic to colleagues, friends, strangers at parties, pretty much anyone who would listen. I set out in search of more formal settings to share—support groups. When I failed to find any nearby in Los Angeles, I enlisted the help of the National Alliance on Mental Illness, the Anxiety and Depression Association of America, and the American Psychological Association. Even with their generous assistance, I was able to find on their registries only three operational panic-specific support groups in the country. By comparison, there are nearly 62,000 AA groups in the U.S.

I am fortunate. I have a loving family and sympathetic colleagues, offering me both the emotional bandwidth and the means to support my journey toward the end of panic, a multi-year effort during which I tried everything including cognitive behavioral therapy, SSRIs, benzos, breathwork, ketamine, psychedelic mushrooms, and other hallucinogens.

Not everyone has the same luxury, nor should they have to. We desperately need a more effective support structure for the panic and anxiety sufferers in our midst. We need support groups to fill the yawning void that I encountered when I first sought help. We need to embrace the range of treatments now available to sufferers—not just the prescription pills we reflexively reach for in our search for a silver bullet (though prescription pills indeed work for some), but for alternative therapies like the ones I tried.

In my journey, I found comfort in the words of holistic psychiatrist Ellen Vora, who allowed me to recognize the therapeutic power of crying. She told me we need “a cultural rebrand around crying,” and I’d argue that we need a similar cultural rebrand around both panic and anxiety disorders.

Part of the reason for panic’s quiet prevalence may be that its sufferers typically do not explode. They implode. Their anxiety does not spill out into the streets, into fights or car wrecks. They often suffer unnoticed—unseen and unheard. It is all the more incumbent upon us, then, to open our eyes and ears to their hardship.

For those still in panic’s chokehold, I can offer a few gentle words of counsel. Science tells us that the peak of an attack will likely last only 15 to 60 seconds – the time it takes for your brain to assess a threat. You will survive it; panic attacks won’t kill you, even if it feels like they will. And you’re more capable, even in the most severe throes of panic, than you think. This is why people can continue driving capably, or reporting in my case, in the midst of a panic.

To the unafflicted—or to those who haven’t yet suffered their first panic attack—I ask for understanding. We are your friends, family members, your colleagues. There are more of us than you think.

“There was nothing specific that brought on this particular panic—and that’s what is often so terrorizing about them,” writes Matt Gutman.

Uncategorized, freelance

Health – TIME

“There was nothing specific that brought on this particular panic—and that’s what is often so terrorizing about them,” writes Matt Gutman.

Uncategorized
September 11, 2023
46 views
3 minutes Read

The FDA Approves New COVID-19 Vaccine Booster Shots To Protect Against Recent Strains

WASHINGTON (AP) — The U.S. approved updated COVID-19 vaccines Monday, hoping to rev up protection against the latest coronavirus strains and blunt any surge this fall and winter.

The Food and Drug Administration decision opens the newest shots from Moderna and Pfizer and its partner BioNTech to most Americans even if they’ve never had a coronavirus vaccination. It’s part of a shift to treat fall updates of the COVID-19 vaccine much like getting a yearly flu shot.

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There’s still another step: The Centers for Disease Control and Prevention must sign off. A CDC advisory panel is set to issue recommendations Tuesday on who most needs the updated shots. Vaccinations could begin later this week, and both the COVID-19 and flu shot can be given at the same visit.

A third vaccine maker, Novavax, said its updated shot is still being reviewed by the FDA.

COVID-19 hospitalizations have been rising since late summer although—thanks to lasting immunity from prior vaccinations and infections—not nearly as much as this time last year.

But protection wanes over time and the coronavirus continually churns out new variants that can dodge prior immunity. It’s been a year since the last time the vaccines were tweaked, and only about 20% of adults ever received that earlier update.

“Vaccination remains critical to public health and continued protection against serious consequences of COVID-19, including hospitalization and death,” FDA vaccine chief Dr. Peter Marks said in a statement. “We very much encourage those who are eligible to consider getting vaccinated.”

Just like earlier vaccinations, the fall round is cleared for adults and children as young as age 6 months. FDA said starting at age 5, most people can get a single dose even if they’ve never had a prior COVID-19 shot. Younger children might need additional doses depending on their history of COVID-19 infections and vaccinations.

The FDA pointedly isn’t calling this latest round a “booster” but instead a vaccine updated to better match the currently circulating virus. The new recipe targets an omicron variant named XBB.1.5 — replacing outdated combination vaccines that mixed protection against the original coronavirus strain and an older version of omicron.

And while even the XBB.1.5 variant is no longer dominant, FDA determined that it’s close enough to coronavirus strains causing most COVID-19 illnesses today to offer good cross-protection. Like earlier versions, they’re expected to be most protective against COVID-19’s worst consequences rather than mild infection.

But while the FDA’s decision allows for wide use of the updated shots, the CDC will decide how strongly different groups are urged to get them.

Federal officials have said the shots still will be free to most Americans through private insurance or Medicare. But for the uninsured or underinsured, the CDC is working with health departments, clinics and certain pharmacies to temporarily provide free shots.

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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.

To protect against a COVID-19 surge this fall and winter, the U.S. FDA approved updated Moderna and Pfizer vaccines for the newest variants.

Uncategorized, COVID-19, wire

Health – TIME

To protect against a COVID-19 surge this fall and winter, the U.S. FDA approved updated Moderna and Pfizer vaccines for the newest variants.