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Tag: Death rates

  • Crossing guards face life-threatening dangers on the job

    WASHINGTON — Anthony Taylor will never forget the look of horror on the student’s face. The school crossing guard was walking into the crosswalk in front of Washington Township High School in Indianapolis when a car with a young boy and his mom, who was dropping him off at school, suddenly appeared. The mom’s eyes grew wide, and the boy began vigorously hitting on his mother’s chest.

    “Next thing, it was boom, lights out. That’s all I remember,” Taylor said. He woke up in the hospital hours after undergoing surgery for a fractured pelvis and other broken bones.

    In many ways, Taylor was lucky. Despite the broken bones and the pins and metal plates to heal his body from that August 2018 collision, he returned to work.

    Across the country, school crossing guards like Taylor, who stand in the cold, rain or heat to protect children, face the risk of injuries from drivers who may be distracted or in a hurry.

    An investigation by The Associated Press and Cox Media Group Television Stations found that over the past 10 years, hundreds of school crossing guards — many of them of retirement age or older — have suffered injuries on the job after being hit by a vehicle, and dozens of them have died.

    A full accounting is impossible. No federal agencies and just two states track how many crossing guards are injured or killed each year. And local police accident reports often have no code to distinguish between school crossing guards and other pedestrians hit near schools.

    “Officers rarely stop to consider whether the injured ‘pedestrian’ was on duty.” said former Cornelius, North Carolina, Police Chief Bence Hoyle.

    A database compiled by AP and Cox Media Group shows that 230 school crossing guards across 37 states and Washington, DC, were struck by vehicles. Nearly three dozen were killed in these collisions. The cases, compiled from incident and accident reports requested from nearly 200 police departments, represent only a portion of guards injured and killed nationwide.

    The investigation shows that in these cases, drivers who hit or even kill crossing guards rarely face serious consequences. Of the incidents involving 183 crossing guards where an outcome could be determined, nearly half resulted in traffic citations — such as “failure to yield to a pedestrian.” About a quarter of the drivers weren’t ticketed at all, while just over a quarter faced criminal charges. Police said several factors go into whether or not a driver who hits a crossing guard is charged, including things such as weather conditions or negligence by the person operating the vehicle.

    Taken as a whole, these incidents highlight a largely underreported problem: Crossing guards, tasked with protecting children as they navigate busy streets in front of schools, can be casualties of dangerous roadways.

    “It’s a huge responsibility to step out in front of a vehicle,” said Dacia Maisonave, a crossing guard trainer in Seminole County, Florida. “It is unfortunate that our crossing guards don’t have a lot of laws. The only thing they really have to protect them is the stop paddle.”

    The lack of a system to track injuries and deaths of crossing guards has hampered efforts to develop better safety measures or even assess just how dangerous the job is, experts say. School crossing guard protection remains a patchwork of state and local policies.

    The U.S. Bureau of Labor Statistics publishes survey data for on-the-job injuries and deaths across most industries, but school crossing guards are included in a job category with road construction flaggers — and the agency does not publish a fatality rate for it.

    The AP calculated its own fatality rates for nearly 200 job classifications with at least 10,000 workers and 10 deaths in 2023, the most recent year of available records. Crossing guards and flaggers were in the top fifth of deadliest jobs, the AP’s analysis found, on par with power line installers and air transportation workers. It’s the only occupation in that top fifth that interacts with children daily.

    Other federal agencies also rarely capture details specific to school crossing guards’ injuries or deaths. The National Highway Traffic Safety Administration’s records on fatal accidents specify whether a school bus was involved or the crash happened within a designated school zone. But no information is captured about whether a victim was a crossing guard.

    Very few accident reports filed through the Occupational Safety and Health Administration mention school crossing guards.

    Only two states have made a serious effort to track crossing guard safety: New Jersey and Massachusetts.

    After examining the deaths of 16 crossing guards struck by motor vehicles and more than 230 injuries between 1993 and 2008, the New Jersey Department of Health launched a program aimed at crossing guard safety in February.

    Officials in New Jersey said they target school zones for recurring safety inspections and have already issued eight serious violations and 30 others to employers for noncompliance. But even this pioneering effort faces limitations.

    “Since there are no crossing guard standards in New Jersey, there is only so much we can do but to make sure they have appropriate training,” says Assistant State Labor Commissioner Justin Baker.

    New Jersey state officials said they work with local police to provide training and proper equipment, including reflective vests.

    Michael Flanagan, director of the Department of Labor Standards in Massachusetts, said his state began tracking school crossing guard injuries and deaths when a guard was fatally struck in 2012. In 2022, he said the state mandated that cities and towns report crossing guard injuries.

    Labor experts say more can be done to make the job safer. Among possible solutions that remain underused in the U.S, experts say, are installing smart crosswalk systems with flashing LED lights, raised crosswalks, automated speed cameras or requiring all guards to wear high-visibility gear.

    Flanagan said ultimately the most effective measure for protecting cross guards from injuries and deaths comes from talking to and educating motorists.

    “Crossing guards are out there, and just slow down and be aware of that and look out for them,” he said.

    School crossing guards are employed by local police departments, school districts or private companies hired by schools. Many of them are older adults or retirees — of the 160 cases where AP and Cox Media Group were able to document ages, more than half were older than 65.

    In interviews, many guards say they enjoy their jobs. But they also recount almost daily close calls with hurried and distracted drivers who ignore posted warning signs and the guards themselves, even in crosswalks.

    Travis Callis, a former crossing guard in Martinsburg, West Virginia, said while he’s never been hurt, he’s had several close run-ins, including an instance where a car was so close he could feel its heat on the back of his legs.

    “I’m holding the sign up and they’re just driving at me,” he said.

    In some cases, collisions can kill.

    Last year, Stanley Brucker, 61, was working as a crossing guard at Fort Mill Elementary School in South Carolina when he was struck by a car as he was holding a stop sign and directing traffic.

    Video captured by a passing school bus shows a vehicle hitting Brucker and flipping him over the car as he stands in the crosswalk. He was transported to a nearby hospital but later died.

    Brucker was the fourth crossing guard to be hit or killed while working for the school district. His death caused many of the district’s crossing guards to refuse to show up for two days after they learned the driver who hit him wouldn’t face charges.

    “There is no indication that the driver of the vehicle was driving in a dangerous or reckless manner,” local prosecutors in the 16th Circuit Solicitor’s Office said in a statement at the time.

    Brucker’s family sees it differently and has filed a lawsuit against the school district and the driver who struck him.

    The lawsuit accuses the Fort Mill School District of choosing locations for crossing guards that were not “reasonably safe,” citing “the actual conditions on the site in the middle of a busy highway and by the numerous past instances of injury to crossing guards.” No trial date has been set for the case to be heard.

    In response to questions about the lawsuit, a spokesperson for the district wrote: “In light of the pending litigation, in which the actions of traffic guards employed by the company providing guards to the district is an issue, the district, on advice of counsel, is unable to respond further.” The Fort Mill School District and the driver who hit Brukcer have both asked the court to dismiss the lawsuit.

    Before the start of this school year, district officials informed parents that public schools in Fort Mill will not have traffic guards. The district has installed a new traffic system to help improve safety in the absence of traffic guards.

    Rutledge Young, an attorney in Charleston, South Carolina, representing Brucker’s family, said Brucker was doing what he was told to do.

    “I believe that Mr. Brucker was doing his job and was killed as a result,” Young said.

    Across the country, data compiled by AP and Cox Media Group shows similar instances of guards being killed and drivers not facing criminal charges.

    James Arthur Holland of Lexington, Kentucky, a crossing guard with the local police department, was hit and killed in 2023 by a driver while working outside an elementary school.

    Police found that the driver did not have insurance or a driver’s license, and the vehicle’s registration had expired.

    Police said the incident was not a result of speeding or impairment, but environmental conditions. The driver was given various traffic citations, but no criminal charges were filed.

    Kevin VanFleet, a detective in the Simi Valley Police Department in California, said each collision must be looked at individually. He said several factors go into deciding if a driver is going to be charged, including what police — who rarely witness the accident — find during their investigation and whether local prosecutors feel charges are warranted.

    “Not everybody that is involved in a collision, let’s say, with a pedestrian in a crosswalk, or perhaps a crossing guard in a crosswalk, is going to receive an infraction ticket. It depends on the severity of it,” VanFleet said

    One common explanation for drivers hitting crossing guards that emerges from a review of traffic and incident reports is the glare of sunlight.

    “The sun was in my eyes,” appears repeatedly in reports obtained by AP and Cox Media Group.

    Last year, Patricia Davis, a guard in Monroe County, Georgia, about an hour east of Atlanta, was hit by a truck while helping students cross.

    The driver told law enforcement that the sun was directly in his eyes, and he didn’t see Davis until his truck struck her. Davis was taken to the hospital after suffering minor injuries. The driver was not charged. Police labeled the collision an accident.

    Dave Peavy, 76, a crossing guard in Gardner, Kansas, wasn’t as fortunate. Peavy, a Vietnam veteran who wore a Santa hat and passed out candy to kids crossing his intersection, was hit and killed by a car as he stepped out to stop traffic. The driver, who was not charged, told police that sunlight blinded him, and he never saw Peavy.

    Crossing guards said these cases and dozens more like them highlight how drivers rarely face serious consequences when one of them is severely injured or killed.

    Beyond distracted drivers and the glare of sunlight, experts point to multiple other factors that compromise crossing guard safety.

    The higher hoods of today’s SUVs and trucks create larger blind spots that reduce visibility. Many school zones lack adequate traffic-slowing measures like speed bumps or automated enforcement cameras. And many local roads are designed to prioritize vehicle flow over pedestrian safety and have inadequate sight lines and insufficient buffer zones around crosswalks.

    Still, former Police Chief Hoyle in North Carolina said drivers should be held accountable for injuring or killing crossing guards. He suggests raising speeding tickets in school zones to $1,000 and implementing license plate recognition systems to track down reckless drivers.

    “The penalties should be much higher, making drivers think twice about speeding through a school zone,” Hoyle said.

    VanFleet, the Simi Valley Police Department detective in California, said greater police presence in school zones would likely be more effective than fines.

    “It’s not so much the cost of the infraction it would be that would cause a deterrence,” he said. “It would be having more officers out there doing more enforcement.

    Among the incidents where AP and Cox Media Group could determine an outcome, around a quarter resulted in criminal charges. About 40% of those criminal charges occurred when the driver fled the scene.

    Last year in Uvalde, Texas, elementary school crossing guard George Juarez was hospitalized after a pickup truck hit him and the driver fled the scene.

    The driver hit the crossing guard after making an illegal left turn as Juarez attempted to redirect the truck that struck him.

    The driver was charged with driving while intoxicated with an open container, and failure to stop and render aid.

    The driver that hit and killed Steven Winn, a 67-year-old crossing guard in Layton, Utah, just after he helped a group of elementary students cross to school, was also charged with an even more serious offense — negligent homicide.

    Families who lose loved ones in fatal traffic accidents say the unexpected financial burden can be staggering, since many guards are retirees who work part-time and don’t have benefits. Dozens of current and former guards or their families have set up GoFundMe pages to help cover medical and funeral costs.

    Those who survive hits can endure a long, painful recovery as well as mounting medical expenses.

    Ron Ferguson was hit by a truck in 2020 while directing traffic in front of a local high school in Texarkana, Texas. The collision left him with a cracked skull, missing teeth and lingering damage to his left ear. Ferguson spent two weeks sedated while recovering.

    He couldn’t breathe on his own or get out of bed, and needed nearly a month of grueling rehabilitation. Today, he said, he has mostly recovered, but some scars from the accident remain and he still has trouble with his memory.

    “There are times I could see people now that I cannot remember their names,” he said.” But I can see the face. And then gradually I’ll start remembering.”

    Crossing guards say they aren’t just waiting for officials to act to protect them.

    Many of them have organized on social platforms like TikTok through series like “Crossing Guard Chronicles,” set up by former Atlanta crossing guard Shante Joseph to educate the public about the dangers guards face. Others have joined Facebook groups like the National Association of School Crossing Guards, a platform that allows guards to share experiences and advocate for reform.

    They are also pushing their employers to provide items they think will make the job safer, such as body cameras, which some have already bought with their own money.

    The guards said they would also like to see increased police supervision in school zones and license plate recognition systems to help police spot bad drivers.

    Ultimately, they say they would like to see drivers treat crossing guard safety as seriously as the safety of the children they protect.

    Still, despite the daily dangers they face, many school crossing guards say they continue to enjoy what they see as an important and much-needed function.

    That’s why Anthony Taylor, the school crossing guard in Indianapolis, said he returned to his duties as a crossing guard after suffering severe injuries.

    “I like what I do, and I enjoy being around the public,” Taylor said. “That’s what made me decide that, hey, I’m going back to finish out what I was there to start.”

    ___

    This story is a collaboration between The Associated Press and Cox Media Group’s local television stations. It is part of The AP Local Investigative Reporting Program. The program offers AP members workshops, reporting tools, and collaboration with AP journalists to help apply investigative techniques.

    Dasia Garner is the 2025 Ida B. Wells Society for Investigative Reporting Intern. Gary Fields and River Zhang contributed reporting.

    Contributing to this story from Cox Media Group Television Stations were: Jodie Fleischer, Josh Wade, Ted Daniel, WFXT Boston, Tina Terry and Michael Praats, WSOC Charlotte, Michele Newell and Mitchell Lierman, WSB-TV Atlanta, John Bedell, WHIO-TV Dayton, Shannon Butler, WFTV Orlando, Deja Mayfield, WJAX/WFOX Jacksonville, Brooke Gardner, KIRO Seattle, Amy Hudak and Alex Popichak, WPXI Pittsburgh.

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  • Beyoncé endorses Kamala Harris in joyful speech at Houston rally: ‘I’m here as a mother’

    Beyoncé endorses Kamala Harris in joyful speech at Houston rally: ‘I’m here as a mother’

    “I’m not here as a celebrity, I’m not here as a politician. I’m here as a mother,” Beyoncé said at a campaign rally for Kamala Harris.

    “A mother who cares deeply about the world my children and all of our children live in, a world where we have the freedom to control our bodies, a world where we’re not divided,” she said Friday night in Houston.

    “Imagine our daughters growing up seeing what’s possible with no ceilings, no limitations,” she continued. “We must vote, and we need you.”

    At the end, Beyoncé, who was joined onstage by her Destiny’s Child bandmate Kelly Rowland, introduced Harris. “Ladies and gentlemen, please give a big, loud, Texas welcome to the next president of the United States, Vice President Kamala Harris,” she said.

    She did not perform — unlike in 2016, when she performed at a presidential campaign rally for Hilary Clinton in Cleveland.

    Houston is Beyoncé’s hometown, and Harris’ presidential campaign has taken on Beyonce’s 2016 track “Freedom,” a cut from her landmark 2016 album “Lemonade,” as its anthem.

    Harris first used the song in July during her first official public appearance as a presidential candidate at her campaign headquarters in Delaware. That same month, Beyoncé’s mother, Tina Knowles, publicly endorsed Harris for president.

    Beyoncé gave permission to Harris to use the song, a campaign official who was granted anonymity to discuss private campaign operations confirmed to The Associated Press.

    Arriving in the back-half of “Lemonade,” “Freedom” samples two John and Alan Lomax field recordings, which document Jim Crow-era folk spirituals of Southern Black churches and the work songs of Black prisoners from 1959 and 1948, respectively. It also features Pulitzer Prize winner Kendrick Lamar.

    Kinitra D. Brooks, an academic and author of “The Lemonade Reader,” says the song “‘Freedom” is so important because it shows that freedom isn’t free. The freedom to be yourself, the political freedom … it’s the idea that you must fight for freedom, and that it is winnable.”

    The Harris rally in Houston highlighted the perilous medical fallout from the state’s strict abortion ban and putting the blame squarely on Donald Trump.

    Since abortion was restricted in Texas, the state’s infant death rate has increased, more babies have died of birth defects and maternal mortality has risen.

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  • The Return of Measles

    The Return of Measles

    Measles seems poised to make a comeback in America. Two adults and two children staying at a migrant shelter in Chicago have gotten sick with the disease. A sick kid in Sacramento, California, may have exposed hundreds of people to the virus at the hospital. Three other people were diagnosed in Michigan, along with seven from the same elementary school in Florida. As of Thursday, 17 states have reported cases to the CDC since the start of the year. (For comparison, that total was 19, plus the District of Columbia, for all of 2023, and just 6 for 2022.) “We’ve got this pile of firewood,” Matthew Ferrari, the director of the Center for Infectious Disease Dynamics at Penn State, told me, “and the more outbreaks that keep happening, the more matches we’re throwing at it.”

    Who’s holding the matchbook? There’s an easy answer to who’s at fault. One of the nation’s political parties, and not the other, turned against vaccines to some extent during the pandemic, leading to voter disparities in death rates. One party, and not the other, has a presumptive presidential candidate who threatens to punish any school that infringes on parental rights by requiring immunizations. And one party, but not the other, appointed a vaccine-skeptical surgeon general in Florida who recently sidestepped standard public-health advice in the middle of an outbreak. The message from Republicans, as The Washington Post’s Alexandra Petri joked in a recent column, can sound like this: “We want measles in the schools and books out of them!”

    But the politics of vaccination, however grotesque it may be in 2024, obscures what’s really going on. It’s true that vaccine attitudes have become more polarized. Conservative parents in particular may be opting out of school vaccine requirements in higher numbers than they were before. In the blood-red state of Idaho, for example, more than 12 percent of kindergartners received exemptions from the rules for the 2022–23 school year, a staggering rate of refusal that is up by half from where it was just a few years ago. Politicized recalcitrance is unfortunate, to say the least, and it can be deadly. Even so, America’s political divides are simply not the cause of any recent measles outbreak. The virus has returned amid a swirl of global health inequities. Any foothold that it finds in the U.S. will be where hyperlocal social norms, not culture-war debates, are causing gaps in vaccine access and acceptance. The more this fact is overlooked, the more we’re all at risk.

    Consider where the latest measles cases have been sprouting up: By and large, the recent outbreaks have been a blue-state phenomenon. (Idaho has so far been untouched; the same is true for Utah, with the nation’s third-highest school-vaccine-exemption rate.) Zoom into the county level, and you’ll find that the pattern is repeated: Measles isn’t picking on Republican communities; if anything, it seems to be avoiding them. The recent outbreak in Florida unfolded not in a conservative area such as Sarasota, where vaccination coverage has been lagging, but rather in Biden-friendly Broward County, at a school where 97 percent of the students have received at least one MMR shot. Similarly, the recent cases in Michigan turned up not in any of the state’s MAGA-voting, vaccine-forgoing areas but among the diverse and relatively left-wing populations in and around Ann Arbor and Detroit.

    Stepping back to look at the country as a whole, one can’t even find a strong connection—or, really, any consistent link at all—between U.S. measles outbreaks, year to year, and U.S. children’s vaccination rates. Sure, the past three years for which we have student-immunization data might seem to show a pattern: Starting in the fall of 2020, the average rate of MMR coverage for incoming kindergarteners did drop, if only by a little bit, from 93.9 to 93.1 percent; at the same time, the annual number of reported measles cases went up almost tenfold, from 13 to 121. But stretch that window back one more year, and the relationship appears to be reversed. In 2019, America was doing great in terms of measles vaccination—across the country, 95.2 percent of kindergartners were getting immunized, according to the CDC—and yet, in spite of this fantastic progress, measles cases were exploding. More than 1,200 Americans got sick with the disease that year, as measles took its greatest toll in a generation.

    It’s not that our high measles-vaccination coverage didn’t matter then or that our slightly lower coverage doesn’t matter now. Vaccination rates should be higher; this is always true. In the face of such a contagious disease, 95 percent would be good; 99 percent much better. When fewer people are protected, more people can get sick. In Matthew Ferrari’s terms, a dropping immunization rate means the piles of firewood are getting bigger. If and when the flames do ignite, they could end up reaching farther, and burning longer, than they would have just a year or two ago. In the midst of any outbreak large enough, where thousands are affected, children will die.

    Read: The good news about vaccine hesitancy

    Despite America’s fevered national conversation about vaccines, however, rates of uptake simply haven’t changed that much. Even with the recent divot in our national vaccine rates, the country remains in broad agreement on the value of immunity: 93 percent of America’s kindergartners are getting measles shots, a rate that has barely budged for decades. The sheer resilience of this norm should not be downplayed or ignored or, even worse, reimagined as a state of grace from which we’ve fallen. Our protection remains strong. In Florida, the surgeon general’s lackadaisical response to the crisis at the Broward County elementary school did not produce a single extra case of the disease, in spite of grim predictions to the contrary, almost certainly thanks to how many kids are already vaccinated.

    At the same time, however, measles has been thriving overseas. Its reemergence in America is not a function of the nation’s political divides, but of the disease’s global prevalence. Europe had almost 60,000 cases last year, up from about 900 in 2022. The World Health Organization reports that the number of reported cases around the world surged to 306,000, after having dropped to a record low of 123,000 in 2021. As the pandemic has made apparent, our world is connected via pathogens: Large outbreaks in other countries, where vaccination coverage may be low, have a tendency to seed tiny outbreaks in the U.S., where coverage has been pretty high, but narrow and persistent cracks in our defenses still remain. (In 2022, more than half of the world’s unvaccinated infants were concentrated in just 10 countries; some of these are measles hotspots at this moment.) This also helps explain why so many Americans got measles in 2019. That was a catastrophic year for measles around the world, with 873,000 reported cases in total, the most since 1994. We had pretty good protection then, but the virus was everywhere—and so, the virus was here.

    Read: Florida’s experiment with measles

    In high-income countries such as the U.S., Ferrari told me, “clustering of risk” tends to be the source of measles outbreaks more than minor changes in vaccine coverage overall. Even in 2019, when more than 95 percent of American kindergarteners were getting immunized, we still had pockets of exposure where protection happened to be weakest. By far the biggest outbreak from that year occurred among Hasidic Jewish populations in New York State. Measles was imported via Israel from the hot spot of Ukraine, and took off within a group whose vaccination rates were much, much lower than their neighbors’. In the end, more than 1,100 people were infected during that outbreak, which began in October 2018 and lasted for nearly a year. “A national vaccination rate has one kind of meaning, but all outbreaks are local outbreaks,” Noel Brewer, a professor at the University of North Carolina at Chapel Hill and a member of the federal Advisory Committee on Immunization Practices, told me. “They happen on a specific street in a specific group of houses, where a group of people live and interact with each other. And those rates of vaccination in that specific place can drop well below the rate of coverage that will forestall an outbreak.”

    We’ve seen this time and time again over the past decade. When bigger outbreaks do occur in the U.S., they tend to happen in tight-knit communities, where immunization norms are radically out of sync with those of the rest of American society, politics aside. In 2014, when an outbreak of nearly 400 cases took hold in Ohio, almost entirely within the Amish community, the local vaccination rate was estimated to be about 14 percent. (The statewide number for young children at that time was more than 95 percent.) In 2011 and 2017, measles broke out among the large Somali American community in Minnesota, where anti-vaccine messaging has been intense, and where immunization rates for 2-year-olds dropped from 92 percent 20 years ago to 35 percent in 2021. An outbreak from the end of 2022, affecting 85 people in and around Columbus, Ohio, may well be linked to the nation’s second-biggest community of Somalis.

    Care must be taken in how these outbreaks are discussed. In Minnesota, for example, state health officials have avoided calling out the Somali community, for fear of stigmatizing. But another sort of trouble may arise when Americans overlook exactly who’s at risk, and exactly why. Experts broadly agree that the most effective way to deal with local outbreaks is with local interventions. Brewer pointed out that during the 2019 outbreak in New York, for example, nurses who belonged to local Jewish congregations took on the role of vaccine advocates. In Minnesota, the Department of Health has brought on more Somali staff, who coordinate with local Somali radio and TV stations to share its message. Yet these efforts can be obscured by news coverage of the crisis that points to a growing anti-science movement and parents giving up on vaccination all across the land. When measles spread among New York’s orthodox Jews, The New York Times reported on “an anti-vaccine fervor on the left that is increasingly worrying health authorities.” When the virus hit Columbus, NBC News noted that it was “happening as resistance to school vaccination requirements is spreading across the country.”

    Two different public-health responses can be undertaken in concert, the experts told me: You treat the problem at its source, and you also take the chance to highlight broader trends. A spate of measles cases in one community becomes an opportunity for pushing vaccination everywhere. “That’s always an important thing for us to do,” Ferrari said. Even so, the impulse to nationalize the problem will have its own, infelicitous effects. First, it’s meaningfully misleading. By catastrophizing subtle shifts in vaccination rates, we frighten many parents for no reason. By insisting that every tiny outbreak is a product of our national politics, we distract attention from the smaller measures that can and should be taken—well ahead of any upsurge of disease—to address hyperlocal vaccination crises. And by exaggerating the scale of our divisions—by asserting that we’ve seen a dangerous shift on a massive scale, or an anti-vaccine takeover of the Republican Party—we may end up worsening the very problem that worries us the most.

    We are a highly vaccinated nation, our politics notwithstanding. Telling people otherwise only fosters more division; it feeds the feeling that taking or refusing measles shots is an important mode of self-expression. It further polarizes health behavior, which can only widen the cracks in our defenses. “We have become quite militant and moralistic about vaccination,” Brewer told me, “and we probably would do well to be less absolute.” Measles outbreaks overseas are growing; measles outbreaks here will follow. Their specific causes ought not be ignored.

    Daniel Engber

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  • As temperatures soared in Europe last year, so did heat-related deaths, study finds

    As temperatures soared in Europe last year, so did heat-related deaths, study finds

    BERLIN — Scientists say crushing temperatures that blanketed Europe last summer may have led to more than 61,000 heat-related deaths, highlighting the need for governments to address the health impacts of global warming.

    In their study, published Monday in the journal Nature Medicine, researchers examined official mortality figures from 35 European countries and found a marked increase in deaths between late May and early September last year compared with the average recorded over a 30-year period.

    The increase in heat-related deaths was higher among older people, women and in Mediterranean countries, they found. But the data also indicated that measures taken in France since a deadly heatwave two decades ago may have helped prevent deaths there last year.

    “In the pattern of summer mean temperatures in Europe during the summer of 2022, we don’t see borders,” said co-author Joan Ballester of the Barcelona Institute for Global Health. The highest temperatures were recorded across a swath of the southwestern Europe, from Spain to France and Italy.

    “But when we look at the heat related mortality, we start to see borders,” Ballester told The Associated Press. While France had 73 heat-related deaths per million inhabitants last summer, Spain’s rate was 237 and Italy’s was 295, the study found.

    “Possibly France drew lessons from the experience of 2003,” he said.

    France’s warning system includes public announcements with advice on how to stay cool and encouraging people to drink water and avoid alcohol.

    Not all of the heat-related deaths calculated across Europe last summer were linked to climate change. Some would have occurred even if summer temperatures had stayed in line with the long-term average. But there is no doubt that the intense heat in 2022 — which saw numerous European records tumble — led to higher mortality rates, as other studies on heat deaths have also shown.

    The authors calculated that there were over 25,000 more heat-related deaths last summer than the average from 2015 to 2021.

    Without appropriate prevention measures, “we would expect a heat-related mortality burden of 68,116 deaths on average every summer by the year 2030,” the authors said. They forecast that figure would rise to over 94,000 by 2040 and more than 120,000 by mid-century.

    Governments in Spain and Germany recently announced new measures to address the effects of hot weather on their populations. In Switzerland, a group of seniors is citing the danger posed to older women by intense heat in a court case seeking to force the the government to take tougher climate action.

    One difficulty for researchers is that heat-related deaths are often happening in people with pre-existing conditions, such as cardiovascular disease, said Matthias an der Heiden of Germany’s Robert Koch Institute, who was not involved in the study. This means that heat is not the underlying cause of deaths and therefore not recorded in the cause of deaths statistics. This can cloak the significant impact that heat has on vulnerable people, with up to 30% more deaths in certain age groups during periods of hot weather.

    “The problem is going to get more acute due to climate change and medical systems need to adjust to that,” he said.

    An der Heiden also noted that the Nature study estimated almost double the number of heat deaths in Germany last year than his institute. While the discrepancy can be explained by the different threshold values for heat used, it indicates the need for a more detailed description of heat-related mortality that distinguishes between moderate and intensive heat, he said.

    According to co-author Ballester, the impact of heat depends greatly on the overall health of the population, particularly with regard to heart and lung disease.

    Other measures, already being implemented in countries such as France, include raising awareness about the dangers of high temperatures and identifying individuals who need special attention during heatwaves, he said.

    “These are cheap, cost effective measures,” said Ballester.

    He dismissed the suggestion that rising temperatures around the globe could, on balance, be beneficial due to fewer deaths during the winter months, noting the manifold risks posed to human civilization by rapid climatic change.

    “In my opinion and the opinion of all the climate scientists, the less the climate is modified, the better,” said Ballester. “That’s why it’s so important that we start, as soon as possible, mitigating climate change and reducing vulnerability.”

    ___

    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.

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  • Do Overdoses Look Different Now?

    Do Overdoses Look Different Now?

    Most likely, the person’s skin color will change. An ashy tone might creep in, or they could turn a shade of blue. If too much fluid pools in their mouth or lungs and mixes with air, foam will appear at their lips. There might be a sound, too—that of light snoring. These are some of the main symptoms of an overdose. Although the drug causing the reaction might be different, the symptoms look the same. “An overdose is an overdose,” Soma Snakeoil, a co-founder of the Sidewalk Project, a harm-reduction organization, told me.

    But although overdose symptoms have not shifted, the ability to treat it has, most notably because of the availability of naloxone, the medication that can quickly reverse an overdose and that was approved in late March to be sold over the counter, as Narcan. This move happened at least in part because in the past few decades, the entire context of an overdose in the United States has changed. The U.S. has entered its fourth wave of the opioid crisis, and the death toll is different now: Overdoses have been steadily increasing for many years, but this wave, also known as the “era of overdoses,” has seen the highest number of fatal overdoses yet. “I think what makes this current crisis so unique is the volume” of overdoses, John Pamplin II, an epidemiologist at Columbia’s school of public health, told me. And that is happening because the drugs have changed too. “It’s not necessarily that more people are using drugs,” Emilie Bruzelius, an epidemiology researcher at Columbia’s school of public health, told me. “The opioids that people are using now are incredibly strong, and they’re more likely to cause an overdose.”

    The result is that any person using drugs has a higher chance of overdosing than ever before. “There’s no population segment that is insulated,” Bruzelius said. “It’s really affecting everybody now.”

    The origins of the opioid crisis can be traced back to 1999. As doctors prescribed opioids more and more—OxyContin prescriptions for non-cancer-related pain alone increased from about 670,000 in 1997 to 6.2 million in 2002—related deaths rose swiftly. In that same period, the number of deaths increased almost 30 percent, to nearly 9,000. This first wave largely affected white people: By 2010, the opioid mortality rate was more than two times higher for white people than Black people.

    That year, a second wave began, in which overdose deaths involving heroin grew most dramatically. By 2015, heroin overdose deaths surpassed the number of deaths attributable to opioid pills. This time, the total opioid mortality rate grew for both Black and white populations; death rates increased by an average of at least 30 percent a year beginning in 2010, and accelerated even faster after 2013. In this same period, illicitly manufactured fentanyl—a synthetic opioid approved for pain relief—was being slipped into heroin, counterfeit pills, cocaine, and other drugs. Many of the people taking these drugs did not realize that they were taking fentanyl at all, leading to a third wave of overdoses. Mortality skyrocketed. In 2017, synthetic opioids were responsible for more than 28,000 deaths, while opioid-pill and heroin overdose deaths had leveled off at about 15,000. The demographics of the crisis continued to shift too, and in 2020, the fastest increases in death rates was experienced by Black and Indigenous Americans, surpassing the death rate of white Americans, Pamplin told me.

    Read: What those in power are missing about the opioid epidemic

    The new, fourth wave is characterized by more mixing of different drugs. “People are overdosing from cocaine and fentanyl or methamphetamines and fentanyl or methamphetamines and fentanyl and heroin,” Bruzelius told me. Recently, xylazine—a non-opiate sedative also known as “tranq”—has infiltrated the fentanyl supply, resulting in what the DEA has deemed the deadliest threat yet.

    This is the context in which the FDA approved Narcan to be sold over the counter. Narcan packages naloxone as a nasal spray, and the FDA argued that its approval could “help improve access to naloxone, increase the number of locations where it’s available, and help reduce overdose deaths throughout the country.” By binding to opioid receptors, naloxone blocks the effects of opiates in the system. This reverses the impact of an overdose, restoring normal breathing.

    But drug policies in America tend to swing, pendulum-like, from one extreme to the other, David Courtwright, a historian at the University of North Florida, told me: A response focused on care for drug users might give way to a more punitive policy. Already, some critics of Narcan’s availability have pushed to restrict its use on the grounds that an effective overdose treatment could encourage drug use—even though there’s “just no kind of scientific or empirical backing” for those arguments, Bruzelius said. Here, the simplest logic holds: If overdoses are affecting every community in America, better to have an accessible treatment everywhere.

    Zoya Qureshi

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  • Air Force expands cancer review of nuclear missile personnel

    Air Force expands cancer review of nuclear missile personnel

    The Air Force is expanding its review of cancers among its nuclear missile corps

    ByTARA COPP Associated Press

    February 22, 2023, 9:56 AM

    WASHINGTON — The Air Force’s review of cancers among its nuclear missile corps will include all personnel who worked on, guarded, supported or operated the nation’s ground-based warheads, Air Force Global Strike Command announced Wednesday.

    Nine officers who had worked as missileers — the airmen who launch the warheads from underground silos and control centers — at Montana’s Malmstrom Air Force Base were diagnosed with with non-Hodgkin lymphoma, a type of blood cancer, Lt. Col. Daniel Sebeck of U.S. Space Force reported last month in a briefing obtained by The Associated Press.

    Since that briefing, more missileers and missile support crew have come forward to the AP and other media outlets to report they, too, have been diagnosed with either non-Hodgkin lymphoma or other types of cancers.

    The Air Force review will extend beyond Malmstrom to include F.E. Warren Air Force Base in Wyoming and Minot Air Force Base in North Dakota. Together the three bases operate 450 silos that house the nation’s arsenal of ground-based nuclear warheads carried by Minuteman III intercontinental ballistic missiles.

    Malmstrom was one of the sensitive military locations over which a suspected Chinese spy balloon loitered as it transited the United States earlier this month.

    The “Missile Community Cancer Study,” to be conducted by the Air Force School of Aerospace Medicine, will look at all ICBM wings and all Air Force personnel who support the ICBM mission. It will review environmental factors at the missile bases and silos, and examine “the possibility of clusters of non-Hodgkin’s lymphoma” among missileers and those who maintained, guarded and supported the bases, the head of Air Force Global Strike Command, Gen. Thomas Bussiere, said in a statement.

    The review will look at active-duty medical data and the Department of Veterans Affairs’ cancer registry data, mortality data and public cancer registries. Col. Lee Williams, the command’s surgeon general, said there was not yet a timeline for the study.

    The Air Force has also established a website to address the missileer community concerns.

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  • Pope makes final bid for peace, forgiveness in South Sudan

    Pope makes final bid for peace, forgiveness in South Sudan

    JUBA, South Sudan — Pope Francis made a final appeal for peace in South Sudan on Sunday as he celebrated Mass before tens of thousands of people to close out an unusual mission by Christian religious leaders to nudge forward the country’s recovery from civil war.

    On the last day of his African pilgrimage, Francis begged South Sudanese people to lay down their weapons and forgive one another, presiding over Mass at the country’s monument to independence hero John Garang before an estimated 70,000 people, including the country’s political leadership.

    “Even if our hearts bleed for the wrongs we have suffered, let us refuse, once and for all, to repay evil with evil,” Francis said. “Let us accept one another and love one another with sincerity and generosity, as God loves us.”

    His message aimed to revive hopes in the world’s youngest country, which gained independence from the majority Muslim Sudan in 2011 but has been beset by civil war and conflict.

    President Salva Kiir, his longtime rival Riek Machar and other opposition groups signed a peace agreement in 2018, but the deal’s provisions, including the formation of a national unified army, remain largely unimplemented and fighting has continued to flare.

    “We have suffered a lot,” said Natalima Andrea, a 66-year-old mother of seven who wiped a tear from her eye as she waited for Francis’ Mass to begin. “We need a permanent peace now and I hope these prayers would yield to lasting peace.”

    In a bid to spur the process along, Francis was joined on the novel ecumenical peace mission by the Archbishop of Canterbury, Justin Welby, and the moderator of the Church of Scotland, the Rt. Rev. Iain Greenshields. The aim of the Catholic, Anglican and Presbyterian leaders was to push Kiir and Machar to recommit themselves to the 2018 deal.

    Welby and Greenshields joined Francis on the altar at Mass on Sunday and were to accompany him on the flight back to Rome.

    The three also aimed to put a global spotlight on the plight of the country, oil-rich and yet one of the world’s poorest, where humanitarian needs are soaring for the 2 million people who have been displaced by continued clashes and years of above-average flooding. Watchdogs’ allegations of corruption are also widespread; some South Sudanese upon the pope’s arrival noted that his modest vehicle was overshadowed by local officials’ luxury ones.

    During the three-day visit, Francis, Welby and Greenshields sought to draw attention to the plight of South Sudan’s most vulnerable people, the women and children who have borne the brunt of displacement and make up the majority of people living in temporary camps.

    They raised in particular the plight of women in a country where sexual violence is rampant, child brides are common and the maternal mortality rate is the highest in the world.

    “If we look at South Sudan, I would just use one word: South Sudan is a patriarchal country,” said Elizabeth Nyibol Malou, a lecturer in economics at the Catholic University of South Sudan. Citing cultural norms in which wealth is passed down to male heirs and women are married young for dowries, she said it is a constant struggle to keep girls in school.

    Women in South Sudan, she said, “are tired. They are struggling. They are frustrated, and they’re stuck.”

    Edmund Yakani, executive director of the Community Empowerment for Progress Organization, said the visit of the three leaders was an important push to the peace process.

    He called it a “critical exposure of our political leaders towards their personal responsibility for making peace and stability prevail in the country.”

    ___

    Trisha Thomas contributed.

    ___

    Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

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  • Pope makes final bid for peace, forgiveness in South Sudan

    Pope makes final bid for peace, forgiveness in South Sudan

    JUBA, South Sudan — Pope Francis made a final appeal for peace in South Sudan on Sunday as he celebrated Mass before tens of thousands of people to close out an unusual mission by Christian religious leaders to nudge forward the country’s recovery from civil war.

    On the last day of his African pilgrimage, Francis begged South Sudanese people to lay down their weapons and forgive one another, presiding over Mass at the country’s monument to independence hero John Garang before an estimated 70,000 people, including the country’s political leadership.

    “Even if our hearts bleed for the wrongs we have suffered, let us refuse, once and for all, to repay evil with evil,” Francis said. “Let us accept one another and love one another with sincerity and generosity, as God loves us.”

    His message aimed to revive hopes in the world’s youngest country, which gained independence from the majority Muslim Sudan in 2011 but has been beset by civil war and conflict.

    President Salva Kiir, his longtime rival Riek Machar and other opposition groups signed a peace agreement in 2018, but the deal’s provisions, including the formation of a national unified army, remain largely unimplemented and fighting has continued to flare.

    “We have suffered a lot,” said Natalima Andrea, a 66-year-old mother of seven who wiped a tear from her eye as she waited for Francis’ Mass to begin. “We need a permanent peace now and I hope these prayers would yield to lasting peace.”

    In a bid to spur the process along, Francis was joined on the novel ecumenical peace mission by the Archbishop of Canterbury, Justin Welby, and the moderator of the Church of Scotland, the Rt. Rev. Iain Greenshields. The aim of the Catholic, Anglican and Presbyterian leaders was to push Kiir and Machar to recommit themselves to the 2018 deal.

    Welby and Greenshields joined Francis on the altar at Mass on Sunday and were to accompany him on the flight back to Rome.

    The three also aimed to put a global spotlight on the plight of the country, oil-rich and yet one of the world’s poorest, where humanitarian needs are soaring for the 2 million people who have been displaced by continued clashes and years of above-average flooding. Watchdogs’ allegations of corruption are also widespread; some South Sudanese upon the pope’s arrival noted that his modest vehicle was overshadowed by local officials’ luxury ones.

    During the three-day visit, Francis, Welby and Greenshields sought to draw attention to the plight of South Sudan’s most vulnerable people, the women and children who have borne the brunt of displacement and make up the majority of people living in temporary camps.

    They raised in particular the plight of women in a country where sexual violence is rampant, child brides are common and the maternal mortality rate is the highest in the world.

    “If we look at South Sudan, I would just use one word: South Sudan is a patriarchal country,” said Elizabeth Nyibol Malou, a lecturer in economics at the Catholic University of South Sudan. Citing cultural norms in which wealth is passed down to male heirs and women are married young for dowries, she said it is a constant struggle to keep girls in school.

    Women in South Sudan, she said, “are tired. They are struggling. They are frustrated, and they’re stuck.”

    Edmund Yakani, executive director of the Community Empowerment for Progress Organization, said the visit of the three leaders was an important push to the peace process.

    He called it a “critical exposure of our political leaders towards their personal responsibility for making peace and stability prevail in the country.”

    ___

    Trisha Thomas contributed.

    ___

    Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

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  • Pope encourages South Sudanese, will raise plight of women

    Pope encourages South Sudanese, will raise plight of women

    JUBA, South Sudan — Pope Francis sought Saturday to console the long-suffering people of South Sudan as he opened his first full day in a country beset by conflict, poverty and humanitarian crises by encouraging priests and nuns to serve their flocks by joining in their tears.

    After arriving in the world’s newest country on the first-ever papal visit Friday, Francis was spending Saturday ministering first to church personnel and then to South Sudanese who have been forced by fighting, flooding and other crises to leave their homes.

    Francis was highlighting in particular the plight of South Sudanese women, half of whom are married before age 18, are subject to rampant sexual violence and then face the world’s highest maternal mortality rate.

    “Let us ask ourselves what it means for us to be ministers of God in a land scarred by war, hatred, violence, and poverty,” Francis said in St. Theresa Cathedral in the capital, Juba. “How can we exercise our ministry in this land, along the banks of a river bathed in so much innocent blood, among the tear-stained faces of the people entrusted to us?”

    Lush in oil and other natural resources but beset by years of civil war and conflict, South Sudan is one of the world’s poorest countries and is responsible for Africa’s worst refugee crisis: More than 2 million people have fled the country and another 2 million are displaced within its borders.

    Joined by Archbishop of Canterbury Justin Welby and the Presbyterian head of the Church of Scotland, Francis is seeking to draw global attention to the country’s plight. The aim of the novel ecumenical visit is to encourage South Sudan’s political leaders to implement a 2018 peace accord ending a civil war that erupted after the overwhelmingly Christian country gained independence from mostly Muslim Sudan in 2011.

    The deal and many of its key provisions, including the formation of a national unified army, has stalled amid political infighting and continued clashes around the country that have forced the postponement of the first presidential election for another two years.

    At the cathedral on Saturday, Francis urged South Sudan’s bishops, priests, nuns and seminarians not to join religious life for social prestige, but to serve their flocks by accompanying them.

    “It is precisely this art of stepping into the middle of our brothers and sisters that the church’s pastors need to cultivate: the ability to step into the middle of their sufferings and tears, into the middle of their hunger for God and their thirst for love,” he said.

    On a day when South Sudan’s suffering women are expected to take the pride of place, Francis heard of the horrific sacrifices some nuns have made. Sisters Mary Daniel Abut and Regina Roba Luate of the Congregation of the Sacred Heart Sisters were killed in a 2021 ambush along with two others.

    “Thank you, on behalf of the entire Church, for your dedication, your courage, your sacrifices and your patience,” Francis said.

    Women and girls in South Sudan live a “hellish existence,” the United Nations Commission on Human Rights in South Sudan said in a report last year based on several years of interviews.

    “South Sudanese women are physically assaulted while being raped at gunpoint, typically held down by men while being abused by others. They are told not to resist in the slightest way, and not to report what happened, or they will be killed,” the report said.

    “It’s hard to convey the level of trauma of South Sudanese women whose bodies are literally the war zone,” commission chair Yasmin Sooka said late last year.

    In his arrival speech Friday, Francis raised the plight of women and called for them to be protected and promoted.

    Among those on hand for his visit to the cathedral on Saturday was Sister Regina Achan, who said Francis’ visit would encourage other sisters to keep serving.

    “We stand with them because we are their voices, we don’t run away at difficult times,” said Achan.

    Francis’ visit, she added, would awaken “serenity and peace in our hearts that we may work for peace and justice in this country.”

    Francis issued a blunt warning on Friday to President Salva Kiir and his onetime rival and now deputy Riek Machar that history will judge them harshly if they continue to drag their feet on implementing the peace accord.

    Kiir for his part committed the government to return to peace talks — suspended last year — with groups that didn’t sign onto the 2018 accord. And late Friday, the Catholic president granted presidential pardons to 71 inmates at Juba’s central prison in honor of the ecumenical pilgrimage, including 36 on death row.

    Francis has changed Catholic Church teaching to hold that capital punishment is inadmissible in all circumstances.

    ___

    Cara Anna contributed from Nairobi, Kenya.

    ___

    Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

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  • U.S. Deaths Drop in 2022, But Still Higher Than Pre-Pandemic Levels

    U.S. Deaths Drop in 2022, But Still Higher Than Pre-Pandemic Levels

    By Cara Murez and Robin Foster 

    HealthDay Reporters

    THURSDAY, Dec. 15, 2022 (HealthDay News) – More than two years after the pandemic began, there is a bit of good news on death rates in the United States: They should be lower this year than during the past two years once final numbers are tallied.

    Still, they have not dropped to levels seen before COVID swept across the country, preliminary data shows.

    Deaths are expected to remain about 13% higher than 2019 numbers for 2022. But they should be 7% lower than in 2021 and 3% lower than in 2020, based on an estimate of the first 11 months of 2022, the Associated Press reported.
     

    Though the death rate typically goes up annually as the population grows, so many people died during the first two years of the pandemic that it sped the pace.

    Unless there is a big surge this month, this could be the first annual decline since 2009, the AP reported.

    “We’re [still] definitely worse off than we were before the pandemic,” Amira Roess, a George Mason University professor of epidemiology and global health, told the AP.

    COVID will remain the third-largest killer for 2022, behind heart disease and cancer, even with the reduced numbers.

    The deadliest year in U.S. history was 2021, with 3.4 million deaths, the AP reported.

    Still, the U.S. COVID-19 vaccination program has prevented more than 3.2 million deaths since it began in late 2020, according to a modeling study released this week from the Commonwealth Fund.

    “We all really would expect that the number of deaths — and the number of severe cases — would decrease, due to a combination of immunity from natural infection and vaccination … and treatment,” Roess said.

    COVID has killed more than 1.1 million Americans, the AP reported, including 73,000 deaths alone in January, despite the overall lowered numbers this year.

    That was the third deadliest month since the beginning of the pandemic, the AP reported.

    “The bulk of mortality was concentrated during that Omicron wave at the beginning of the year,” Iliya Gutin, a University of Texas researcher tracking COVID mortality, told the AP.

    Heart disease deaths have also risen, though they, too, will be down from 2021, said Farida Ahmad, who leads mortality surveillance at the U.S. Centers for Disease Control and Prevention.

    Preliminary data did not reveal whether the number of cancer deaths would change. However, provisional drug overdose death rates for the first seven months of 2022 suggest those numbers stopped rising early this year.

    More information

    The World Health Organization has more on global cases of COVID-19.

     

     

    SOURCE: Associated Press

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  • U.S. Deaths Drop in 2022, But Still Higher Than Pre-Pandemic Levels

    U.S. Deaths Drop in 2022, But Still Higher Than Pre-Pandemic Levels

    By Cara Murez and Robin Foster 

    HealthDay Reporters

    THURSDAY, Dec. 15, 2022 (HealthDay News) – More than two years after the pandemic began, there is a bit of good news on death rates in the United States: They should be lower this year than during the past two years once final numbers are tallied.

    Still, they have not dropped to levels seen before COVID swept across the country, preliminary data shows.

    Deaths are expected to remain about 13% higher than 2019 numbers for 2022. But they should be 7% lower than in 2021 and 3% lower than in 2020, based on an estimate of the first 11 months of 2022, the Associated Press reported.
     

    Though the death rate typically goes up annually as the population grows, so many people died during the first two years of the pandemic that it sped the pace.

    Unless there is a big surge this month, this could be the first annual decline since 2009, the AP reported.

    “We’re [still] definitely worse off than we were before the pandemic,” Amira Roess, a George Mason University professor of epidemiology and global health, told the AP.

    COVID will remain the third-largest killer for 2022, behind heart disease and cancer, even with the reduced numbers.

    The deadliest year in U.S. history was 2021, with 3.4 million deaths, the AP reported.

    Still, the U.S. COVID-19 vaccination program has prevented more than 3.2 million deaths since it began in late 2020, according to a modeling study released this week from the Commonwealth Fund.

    “We all really would expect that the number of deaths — and the number of severe cases — would decrease, due to a combination of immunity from natural infection and vaccination … and treatment,” Roess said.

    COVID has killed more than 1.1 million Americans, the AP reported, including 73,000 deaths alone in January, despite the overall lowered numbers this year.

    That was the third deadliest month since the beginning of the pandemic, the AP reported.

    “The bulk of mortality was concentrated during that Omicron wave at the beginning of the year,” Iliya Gutin, a University of Texas researcher tracking COVID mortality, told the AP.

    Heart disease deaths have also risen, though they, too, will be down from 2021, said Farida Ahmad, who leads mortality surveillance at the U.S. Centers for Disease Control and Prevention.

    Preliminary data did not reveal whether the number of cancer deaths would change. However, provisional drug overdose death rates for the first seven months of 2022 suggest those numbers stopped rising early this year.

    More information

    The World Health Organization has more on global cases of COVID-19.

     

     

    SOURCE: Associated Press

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  • Women’s clinic in South Sudan a casualty of distracted world

    Women’s clinic in South Sudan a casualty of distracted world

    MINGKAMAN, South Sudan — In a country where the maternal mortality rate is one of the highest in the world, a small clinic dedicated to reproductive health care for more than 200,000 people is about to be shut down. The worried-looking mothers know too well what might happen next.

    “If the hospital closes, we will die more because we are poor,” said one expectant mother who gave her name only as Chuti. She was attending a monthly checkup at the Mingkaman reproductive health clinic in this town on the White Nile River, and it might be her last.

    The United Nations has said it intends to end the clinic’s operations by December because of a lack of funding from European and other supporters. It is just one casualty among many in developing countries as humanitarian donors have been stretched by one crisis after another, from COVID-19 to Russia’s invasion of Ukraine. The U.N. would not say how much it costs to run the clinic.

    A loss like the clinic is of critical importance for people in places like Mingkaman, which along with the rest of South Sudan has struggled to cope with the aftermath of a five-year civil war, climate shocks like widespread flooding and lingering insecurity that includes shocking rates of sexual violence.

    The U.N. Commission on Human Rights in South Sudan has said the war in Ukraine has led to a dramatic cut in funding for emergency medical care for people who have been sexually assaulted. “It’s not that sexual violence ebbs and flows, it’s going on all the time, largely unseen,” commissioner Barney Afako said. The commission also has asserted that the government has failed to invest in basic services like health care.

    This reproductive health clinic in the capital of Awerial county in central South Sudan serves a community largely of people displaced by the civil war and the floods. It is where women who once gave birth at home now come to deliver their children. It is also where women who are assaulted come for care.

    The maternal mortality rate in South Sudan was 789 deaths per 100,000 live births in 2019, according to the World Health Organization. That’s more than double the rate in more developed neighboring Kenya, according to U.N. data, while the U.S. rate was 23 deaths per 100,000 live births in 2020, according to the Centers for Disease Control and Prevention.

    At least 250 women give birth in the Mingkaman clinic every month, said Teresa Achuei, the site manager with the organization IMA World Health, which runs the facility. She said she knew of only three women who have died while giving birth in the community, all of them outside the clinic.

    Now, she said, hundreds of women could be at risk. “Our aim, our mission, is to reduce maternal mortality rate. Every woman should deliver safely. If the facility closes, there will be many deaths in the community,” she told The Associated Press during a visit in mid-October.

    The clinic was founded in 2014, the year after South Sudan’s civil war began. Set up in tents as a temporary way to serve people displaced by fighting, it remains makeshift but works around the clock.

    It is a center of activity in Mingkaman, a community on one of South Sudan’s muddy main highways without reliable electricity and running water. The military is present to respond to flares of violence. Many women support their families by collecting firewood from the nearby forest to sell or work in modest local hotels.

    Multiple women expressed concern about the clinic’s coming closure.

    “It will be worsening for us because it was helping us,” said Akuany Bol, who delivered her three children there. She looked miserable while waiting for a midwife to examine her child.

    Andrew Kuol, a clinical officer, said the facility receives an average of 70 to 80 patients per day. It often admits 20 patients a day, or twice the number of beds.

    Some women must be treated on the ground.

    Kuol said the clinic faces shortages of medicines including malaria drugs, post-rape drugs, antenatal drugs and others, again because of waning donor support.

    The nearest hospital is in the city of Bor in the neighboring state of Jonglei, where the clinic’s more complicated cases are sent. Getting there is complicated, too. With no bridge between the states, it can take an hour for a boat to cross the Nile.

    As in much of South Sudan, travel is challenging. And current circumstances mean few of the people here can easily relocate for health care or anything else.

    “These (displaced people) are not going anywhere because there is still insecurity and also the flooding,” said James Manyiel Agup, the Awerial county director for health here in Lakes state. He urged the U.N. partners to continue supporting the facility to save lives.

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  • Medium COVID Could Be the Most Dangerous COVID

    Medium COVID Could Be the Most Dangerous COVID

    I am still afraid of catching COVID. As a young, healthy, bivalently boosted physician, I no longer worry that I’ll end up strapped to a ventilator, but it does seem plausible that even a mild case of the disease could shorten my life, or leave me with chronic fatigue, breathing trouble, and brain fog. Roughly one in 10 Americans appears to share my concern, including plenty of doctors. “We know many devastating symptoms can persist for months,” the physician Ezekiel Emanuel wrote this past May in The Washington Post. “Like everyone, I want this pandemic nightmare to be over. But I also desperately fear living a debilitated life of mental muddle or torpor.”

    Recently, I’ve begun to think that our worries might be better placed. As the pandemic drags on, data have emerged to clarify the dangers posed by COVID across the weeks, months, and years that follow an infection. Taken together, their implications are surprising. Some people’s lives are devastated by long COVID; they’re trapped with perplexing symptoms that seem to persist indefinitely. For the majority of vaccinated people, however, the worst complications will not surface in the early phase of disease, when you’re first feeling feverish and stuffy, nor can the gravest risks be said to be “long term.” Rather, they emerge during the middle phase of post-infection, a stretch that lasts for about 12 weeks after you get sick. This period of time is so menacing, in fact, that it really ought to have its own, familiar name: medium COVID.

    Just how much of a threat is medium COVID? The answer has been obscured, to some extent, by sloppy definitions. A lot of studies blend different, dire outcomes into a single giant bucket called “long COVID.” Illnesses arising in as few as four weeks, along with those that show up many months later, have been considered one and the same. The CDC, for instance, suggested in a study out last spring that one in five adults who get the virus will go on to suffer any of 26 medical complications, starting at least one month after infection, and extending up to one year. All of these are called “post-COVID conditions, or long COVID.” A series of influential analyses looking at U.S. veterans described an onslaught of new heart, kidney, and brain diseases (even among the vaccinated) across a similarly broad time span. The studies’ authors refer to these, grouped together, as “long COVID and its myriad complications.”

    But the risks described above might well be most significant in just the first few weeks post-infection, and fade away as time goes on. When scientists analyzed Sweden’s national health registry, for example, they found that the chance of developing pulmonary embolism—an often deadly clot in the lungs—was a startling 32 times higher in the first month after testing positive for the virus; after that, it quickly diminished. The clots were only two times more common at 60 days after infection, and the effect was indistinguishable from baseline after three to four months. A post-infection risk of heart attack and stroke was also evident, and declined just as expeditiously. In July, U.K. epidemiologists corroborated the Swedish findings, showing that a heightened rate of cardiovascular disease among COVID patients could be detected up to 12 weeks after they got sick. Then the hazard went away.

    This is all to be expected, given that other respiratory infections are known to cause a temporary spike in patients’ risk of cardiovascular events. Post-viral blood clots, heart attacks, and strokes tend to blow through like a summer storm. A very recent paper in the journal Circulation, also based on U.K. data, did find that COVID’s effects are longer-lasting, with a heightened chance of such events that lasts for almost one full year. But even in that study, the authors see the risk fall off most dramatically across the first two weeks. I’ve now read dozens of similar analyses, using data from many countries, that agree on this basic point: The greatest dangers lie in the weeks, not months, after a COVID infection.

    Read: Long COVID could be a ‘mass deterioration event’

    Yet many have inferred that COVID’s dangers have no end. “What’s particularly alarming is that these are really life-long conditions,” Ziyad Al-Aly, the lead researcher on the veterans studies, told the Financial Times in August. A Cleveland Clinic cardiologist has suggested that catching SARS-CoV-2 might even become a greater contributor to cardiovascular disease than being a chronic smoker or having obesity. But if experts who hold this assumption are correct—and the mortal hazards of COVID really do persist for a lifetime (or even many months)—then it’s not yet visible at the health-system level. By the end of the Omicron surge last winter, one in four Americans—about 84 million people—had been newly infected with the coronavirus. This was on top of 103 million pre-Omicron infections. Yet six months after the surge ended, the number of adult emergency-room visits, outpatient appointments, and hospital admissions across the country were all slightly lower than they were at the same time in 2021, according to an industry report released last month. In fact, emergency-room visits and hospital admissions in 2021 and 2022 were lower than they’d been before the pandemic. In other words, a rising tide of long-COVID-related medical conditions, affecting nearly every organ system, is nowhere to be found.

    If mild infections did routinely lead to fatal consequences at a delay of months or years, then we should see it in our death rates, too. The number of excess deaths in the U.S.—meaning those that have occured beyond historic norms—should still be going up, long after case rates fall. Yet excess deaths in the U.S. dropped to zero this past April, about two months after the end of the winter surge, and they have stayed relatively low ever since. Here, as around the world, overall mortality rates follow acute-infection rates, but only for a little while. A second wave of deaths—a long-COVID wave—never seems to break.

    Even the most familiar maladies of “long COVID”—severe fatigue, cognitive difficulties, and breathing trouble—tend to be at their worst during the medium post-infection phase. An early analysis of symptom-tracking data from the U.K., the U.S., and Sweden found that the proportion of those experiencing COVID’s aftereffects decreased by 83 percent four to 12 weeks after illness started. The U.K. government also reported much higher rates of medium COVID, relative to long COVID: In its survey, 11 percent of people who caught the virus experienced lingering issues such as weakness, muscle aches, and loss of smell, but that rate had dropped to 3 percent by 12 weeks post-infection. The U.K. saw a slight decline in the number of people reporting such issues throughout the spring and summer; and a recent U.S. government survey found that about half of Americans who had experienced any COVID symptoms for three months or longer had already recovered.

    This slow, steady resolution of symptoms fits with what we know about other post-infection syndromes. A survey of adolescents recovering from mononucleosis, which is caused by Epstein-Barr virus, found that 13 percent of subjects met criteria for chronic fatigue syndrome at six months, but that rate was nearly halved at one year, and nearly halved again at two. An examination of chronic fatigue after three different infections—EBV, Q fever, and Ross River virus—identified a similar pattern: frequent post-infection symptoms, which gradually decreased over months.

    Read: It’s not just long COVID

    The pervasiveness of medium COVID does nothing to negate the reality of long COVID—a calamitous condition that can shatter people’s lives. Many long-haulers experience unremitting symptoms, and their cases can evolve into complex chronic syndromes like ME/CFS or dysautonomia. As a result, they may require specialized medical care, permanent work accommodations, and ongoing financial support. Recognizing the small chance of such tragic outcomes could well be enough to make some people try to avoid infection or reinfection with SARS-CoV-2 at all costs.

    But if you’re like me, and trying to calibrate your behaviors to meet some personally acceptable level of COVID risk, then it helps to keep in mind the difference between the virus’s medium- and long-term complications. Medium COVID may be time-limited, but it is far from rare—and not always mild. It can mean a month or two of profound fatigue, crushing headaches, and vexing chest pain. It can lead to life-threatening medical complications. It needs recognition, research, and new treatments. For millions of people, medium COVID is as bad as it gets.

    Benjamin Mazer

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  • DEA: Fake pills containing fentanyl helping drive OD deaths

    DEA: Fake pills containing fentanyl helping drive OD deaths

    WASHINGTON (AP) — An increasing number of fake prescription pills that contain potentially deadly fentanyl are helping drive overdose death rates to record levels in the U.S., including some now manufactured in rainbow colors designed to look like candy, federal officials said Tuesday.

    Drug Enforcement Administration agents are working to crack down on violent drug cartels in Mexico believed to be trafficking the drugs into the U.S., Attorney General Merrick Garland said. Between May and September, the DEA and local police around the country seized more than 10 million fentanyl pills and hundreds of pounds of powder, he said.

    Vastly powerful synthetic drugs like fentanyl are behind record overdose deaths in the U.S. Law enforcement officials nationwide have been struggling to combat the surge of drugs in urban and rural communities. The global coronavirus pandemic has overshadowed the American opioid epidemic, but when overdose deaths surpassed 100,000 during the 12-month period ending in April 2021, it rocketed back into the public consciousness.

    “I read too many reports on too many cases, including too many young people who ended up dying after taking just one pill laced with fentanyl, often disguised as something else,” Garland said.

    First reported in February, the rainbow pills have been seized in 21 states now, DEA Administrator Anne Milgram said. While fentanyl is still more commonly disguised as oxycodone or another prescription drug, the rainbow pills are on the increase.

    “We believe it is being marketed and aimed at young people,” Milgram said.

    Senate Majority Leader Chuck Schumer, D-N.Y., also sounded the alarm this weekend about the rise of the drug in New York City and Long Island as he pushed for new funding to fight its spread.

    Two Mexican drug cartels are responsible for the majority of fentanyl in the U.S., federal authorities said. The Sinaloa Cartel and the Jalisco New Generation Cartel buy precursor chemicals from China, then traffic them into the U.S., where they are sometimes sold on social media platforms.

    Over the last four months, authorities have investigated nearly 400 cases, 51 of them linked to overdoses and 35 tied directly to the two cartels. In addition to being pressed into fake pills, fentanyl powder is also moved into other drugs like cocaine and heroin, Milgram said.

    “Our top operational priority has been and will continue to be to defeat these two cartels,” she said.

    Fentanyl is a synthetic opioid that can be 50 times more potent than heroin, and even a tiny amount can be lethal. Fake prescription pills are especially dangerous because it’s difficult to tell how strong they are.

    About two-thirds of overdose deaths in the U.S. have been linked to fentanyl or other powerful, illicitly made synthetic opioids.

    Jonathan Caulkins, a professor of operations research and public policy at Carnegie Mellon University, said containing synthetics with law enforcement is a challenge because the drug can be made in labs anywhere rather than grown in fields like cocaine or heroin — and because it is so potent and is trafficked in smaller amounts.

    “How the heck is law enforcement supposed to find a few metric tons in an economy that trades megatons of raw materials?” Caulkins asked.

    Caulkins said the best ways to deal with the fentanyl crisis is to put money toward treatment and increasing the availability of naloxone, a drug that reverses overdoses — but added that using arrests to reduce the supply may be worth trying.

    ___

    Associated Press writer Geoff Mulvihill in Cherry Hill, New Jersey, contributed to this report.

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