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Tag: iab-diseases and conditions

  • Scientists parse another clue to possible origins of Covid-19 as WHO says all possibilities ‘remain on the table’ | CNN

    Scientists parse another clue to possible origins of Covid-19 as WHO says all possibilities ‘remain on the table’ | CNN

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    CNN
     — 

    There’s a tantalizing new clue in the hunt for the origins of the Covid-19 pandemic.

    A new analysis of genetic material collected from January to March 2020 at the Huanan Seafood Market in Wuhan, China, has uncovered animal DNA in samples already known to be positive for SARS-CoV-2, the coronavirus that causes Covid-19. A significant amount of that DNA appears to belong to animals known as raccoon dogs, which were known to be traded at the market, according to officials with the World Health Organization, who addressed the new evidence in a news briefing on Friday.

    The connection to raccoon dogs came to light after Chinese researchers shared raw genetic sequences taken from swabbed specimens collected at the market early in the pandemic. The sequences were uploaded in late January 2023, to the data sharing site GISAID, but have recently been removed.

    An international team of researchers noticed them and downloaded them for further study, the WHO officials said Friday.

    The new findings – which have not yet been publicly posted – do not settle the question of how the pandemic started. They do not prove that raccoon dogs were infected with SARS-CoV-2, nor do they prove that raccoon dogs were the animals that first infected people.

    But because viruses don’t survive in the environment outside of their hosts for long, finding so much of the genetic material from the virus intermingled with genetic material from raccoon dogs is highly suggestive that they could have been carriers, according to scientists who worked on the analysis. The analysis was led by Kristian Andersen, an immunologist and microbiologist at Scripps Research; Edward Holmes, a virologist at the University of Sydney; Michael Worobey, an evolutionary biologist at the University of Arizona. These three scientists, who have been digging into the origins of the pandemic, were interviewed by reporters for The Atlantic magazine. CNN has reached out to Andersen, Holmes and Worobey for comment.

    The details of the international analysis were first reported Thursday by The Atlantic.

    The new data is emerging as Republicans in Congress have opened investigations into the pandemic’s origin. Previous studies provided evidence that the virus likely emerged naturally in market, but could not point to a specific origin. Some US agencies, including a recent US Department of Energy assessment, say the pandemic likely resulted from a lab leak in Wuhan.

    In the news briefing on Friday, WHO Director-General Tedros Adhanom Ghebreyesus said the organization was first made aware of the sequences on Sunday.

    “As soon as we became aware of this data, we contacted the Chinese CDC and urged them to share it with WHO and the international scientific community so it can be analyzed,” Tedros said.

    WHO also convened its Scientific Advisory Group for the Origins of the Novel Pathogens, known as SAGO, which has been investigating the roots of the pandemic, to discuss the data on Tuesday. The group heard from Chinese scientists who had originally studied the sequences, as well as the group of international scientists taking a fresh look at them.

    WHO experts said in the Friday briefing that the data are not conclusive. They still can’t say whether the virus leaked from a lab, or if it spilled over naturally from animals to humans.

    “These data do not provide a definitive answer to the question of how the pandemic began, but every piece of data is important in moving us closer to that answer,” Tedros said.

    What the sequences do prove, WHO officials said, is that China has more data that might relate to the origins of the pandemic that it has not yet shared with the rest of the world.

    “This data could have, and should have, been shared three years ago,” Tedros said. “We continue to call on China to be transparent in sharing data and to conduct the necessary investigations and share results.

    “Understanding how the pandemic began remains a moral and scientific imperative.”

    CNN has reached out to the Chinese scientists who first analyzed and shared the data, but has not received a reply.

    The Chinese researchers, who are affiliated with that country’s Center for Disease Control and Prevention, had shared their own analysis of the samples in 2022. In that preprint study posted last year, they concluded that “no animal host of SARS-CoV2 can be deduced.”

    The research looked at 923 environmental samples taken from within the seafood market and 457 samples taken from animals, and found 63 environmental samples that were positive for the virus that causes Covid-19. Most were taken from the western end of the market. None of the animal samples, which were taken from refrigerated and frozen products for sale, and from live, stray animals roaming the market, were positive, the Chinese authors wrote in 2022.

    When they looked at the different species of DNA represented in the environmental samples, the Chinese authors only saw a link to humans, but not other animals.

    When an international team of researchers recently took at fresh look at the genetic material in the samples – which were swabbed in and around the stalls of the market – using an advanced genetic technique called metagenomics, scientists said they were surprised to find a significant amount of DNA belonging to raccoon dogs, a small animal related to foxes. Raccoon dogs can be infected with the virus that causes Covid-19 and have been high on the list of suspected animal hosts for the virus.

    “What they found is molecular evidence that animals were sold at that market. That was suspected, but they found molecular evidence of that. And also that some of the animals that were there were susceptible to SARS-CoV2 infection, and some of those animals include raccoon dogs,” said Maria Van Kerkhove, WHO’s technical lead for Covid-19, in Friday’s briefing.

    “This doesn’t change our approach to studying the origins of Covid-19. It just tells us that more data exists, and that data needs to be shared in full,” she said.

    Van Kerkhove said that until the international scientific community is able to review more evidence, “all hypotheses remain on the table.”

    Some experts found the new evidence persuasive, if not completely convincing, of an origin in the market.

    “The data does point even further to a market origin,” Andersen, the Scripps Research evolutionary biologist who attended the WHO meeting and is one of the scientists analyzing the new data, told the magazine Science.

    The assertions made over the new data quickly sparked debate in the scientific community.

    Francois Balloux, director of the Genetics Institute at University College London, said the fact that the new analysis had not yet been publicly posted for scientists to scrutinize, but had come to light in news reports, warranted caution.

    “Such articles really don’t help as they only polarise the debate further,” Balloux posted in a thread on Twitter. “Those convinced by a zoonotic origin will read it as final proof for their conviction, and those convinced it was a lab leak will interpret the weakness of the evidence as attempts of a cover-up.”

    Other experts, who were not involved in the analysis, said the data could be key to showing the virus had a natural origin.

    Felicia Goodrum is an immunobiologist at the University of Arizona, who recently published a review of all available data for the various theories behind the pandemic’s origin.

    Goodrum says the strongest proof for a natural spillover would be to isolate the virus that causes Covid-19 from an animal that was present in the market in 2019.

    “Clearly, that is impossible, as we cannot go back in time any more than we have through sequencing, and no animals were present at the time sequences could be collected. To me, this is the next best thing,” Goodrum said in an email to CNN.

    In the WHO briefing, Van Kerkhove said that the Chinese CDC researchers had uploaded the sequences to GISAID as they were updating their original research. She said their first paper is in the process of being updated and resubmitted for publication.

    “We have been told by GISAID that the data from China’s CDC is being updated and expanded,” she said.

    Van Kerkhove said on Friday that what WHO would like to be able to do is to find the source of where the animals came from. Were they wild? Were they farmed?

    She said in the course of its investigation into the pandemic’s origins, WHO had repeatedly asked China for studies to trace the animals back to their source farms. She said WHO had also asked for blood tests on people who worked in the market, as well as tests on animals that may have come from the farms.

    “Share the data,” Dr. Mike Ryan, executive director of WHO’s health emergencies program, said Friday, addressing scientists around the world who might have relevant information. “Let science do the work, and we will get the answers.”

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  • Sleep like a pro with these 6 expert tips | CNN

    Sleep like a pro with these 6 expert tips | CNN

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    Editor’s Note: Dana Santas, known as the “Mobility Maker,” is a certified strength and conditioning specialist and mind-body coach in professional sports, and is the author of the book “Practical Solutions for Back Pain Relief.”



    CNN
     — 

    How you sleep each night plays a vital role in how you perform in your daily life. So, it’s no wonder that professional sports teams tap the expertise of sleep doctors to ensure their elite athletes get the quality sleep they need to perform at the highest levels.

    As a mobility coach who works in Major League Baseball, I can attest that during spring training, when every day starts early, players and coaches alike dread losing an hour of sleep when we “spring forward” for Daylight Saving Time.

    It’s not just professional baseball players who struggle. A 2022 study found that more than 30% of adults have reported an hour of sleep debt — when you sleep less than your body needs — while nearly 1 in 10 adults had a sleep debt of two hours or more.

    Adults need at least seven hours of solid sleep at night, according to the US Centers of Disease Control and Prevention. Sleep debt and irregular sleep duration are linked to an increased risk of heart disease, dementia, obesity and mood disorders such as depression and anxiety.

    I asked two of my favorite MLB sleep experts to share some of the same tips they provide to professional baseball players, so that anyone can learn to sleep like a pro.

    It’s important to get the recommended seven-plus hours of sleep nightly.

    Sticking with a regularly scheduled bedtime and wake time helps, according to Dr. Cheri D. Mah, a sleep physician specializing in the sleep and performance of elite athletes. “Our bodies like regularity and will anticipate sleep with a regular sleep schedule,” Mah said. “As a reminder, set a daily alarm on your phone to go off 30 minutes before you want to start your wind-down routine.”

    Pay attention to what your body and brain are telling you about your sleep schedule, suggested Dr. Chris Winter, a neurologist and host of the “Sleep Unplugged” podcast. “If you go to bed at 9 p.m. but it always takes you two hours to fall asleep, why not try going to bed later?”

    If you want to sleep better, you need an environment conducive to sleep. “Make your room like a cave,” Mah said, “You want it to be really dark, quiet and cool — as well as comfortable.”

    She recommends getting comfortable bedding, using blackout curtains or eye masks, wearing earplugs and setting the room temperature at 60 to 67 degrees Fahrenheit (about 16 to 19 degrees Celsius).

    Do you judge how well you slept based on how fast you fell asleep?

    The amount of time it takes you to fall asleep, called the speed of sleep latency, is an inaccurate gauge for sleep quality, according to Winter. How long it takes to fall asleep varies from person to person. The consensus of most sleep experts, including Winter, is that the average sleep latency is five to 20 minutes.

    “Someone who is asleep ‘before their head hits the pillow’ is not a champion sleeper any more than an individual who can eat their entire dinner in three minutes is a highly nutritious eater,” Winter said. “That can often be a red flag and not a sign of great sleep.”

    Many people jump right into bed with a racing mind, Mah said, which results in difficulty sleeping. She suggests that her clients create a 20- to 30-minute wind-down routine to help them transition to sleep. Activities could include gentle yoga, breathing exercises and reading, “just not on a tablet or phone that emits sleep-disturbing blue light frequencies,” she said.

    Doing activities such as gentle yoga shortly before bedtime can help to ease a racing mind.

    Both Mah and Winter report that getting people to refrain from technology use the hour before bedtime presents the biggest challenge for their clients. “It’s hard to convince people to change a behavior that doesn’t cause immediate pain,” Winter added.

    Despite the popularity of “night cap” cocktails, Mah and Winter agree that alcohol is an impediment to sleep. They suggest that it be avoided entirely or at least not enjoyed in the hours before bed. They also recommend limiting caffeine intake later in the day. “Caffeine has a half-life of about six hours, so it’s best to cut it out in the late afternoon and early evening,” Mah added.

    Along with all the other health benefits of regular exercise, research shows a strong link with better quality sleep, which Winter frequently points out to his clients. “If you are complaining about your sleep and not exercising, you better have a good reason for not doing it,” he said. “From a research perspective, it is far more effective at deepening sleep and improving its quality than any fad tech gadget in existence today … and it’s free!”

    There is one caveat: Because some research has shown that the benefits of exercise are mitigated and can even hurt sleep quality when performed later at night, avoid vigorous exercise at least one hour before bed.

    Sleep debt is the difference between your needed amount of sleep and the sleep you actually get, accumulating over time, if not paid back.

    Many clients come to Mah without any knowledge of the concept of sleep debt and the need to repay it. More so, she said they are surprised to find that “it often takes longer than one night or one weekend to significantly pay back accumulated sleep debt.”

    If you’ve built up sleep debt, try going to sleep an hour earlier or sleeping an hour later over a few days — or however long it takes for you to feel adequately rested.

    Catching up on sleep can increase your daily alertness and help ward off inflammation.

    Catching up on your sleep isn’t just good for increasing daily alertness — a 2020 study found that adults who caught up on sleep were less likely to show elevated inflammation levels, which contribute to chronic disease.

    At the same time, it’s important not to stress about sleep, Winter said. Too much emphasis on things such as “falling asleep faster” or the notion that people “can’t sleep,” creates a sense of fear that he deems “highly problematic.”

    “It’s physiologically impossible to not sleep at all, so nature has you covered,” he said. “Control the variables you can control, like schedule, environment, etc., and put it out of your mind.”

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  • Lawmakers who struggle and have struggled with mental health see power in ‘telling the story’ | CNN Politics

    Lawmakers who struggle and have struggled with mental health see power in ‘telling the story’ | CNN Politics

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    Editor’s Note: If you or a loved one are facing mental health issues or substance abuse disorders, call The Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 or visit SAMHSA’s website for treatment referral and information services.



    CNN
     — 

    In the spring of 2019, Democratic Sen. Tina Smith of Minnesota was busy putting the finishing touches on a bill that sought to expand mental health care access for kids in schools.

    But she couldn’t shake the feeling she was being less than honest about just how personal the issue of mental health was for her.

    Smith was on the precipice of an election. She had no obligation to open up about her own depression that she says happened twice – once in college and once as a young mom. But in May 2019, on the floor of the US Senate, Smith, delivered a speech about mental health and admitted, “The other reason I want to focus on mental health care while I’m here is that I’m one of them.”

    “I remember being nervous,” Smith recalled of delivering the speech. “I was concerned that people would think that I was trying to like make it be about myself, but once I got beyond that, and I realized that there was power in me telling the story – me particularly being a United States senator, somebody who supposedly has everything all together all the time, then it started to feel really interesting, and I could see right away the value of it.”

    The National Alliance on Mental Illness estimates that one in five adults in the US – nearly 53 million Americans – experience mental illness every year. The Centers for Disease Control and Prevention reports more than 50% of Americans will experience mental illness in their lifetime. But for politicians – often far away from home, under high levels of stress and pressure, all risk factors for mental illnesses like depression and anxiety – talking about their own mental health is still a relatively rare admission.

    It’s why in February when Pennsylvania Sen. John Fetterman announced he was seeking inpatient treatment for clinical depression, lawmakers on both sides of the aisle celebrated not only his decision, but his transparency.

    “It’s tough in politics, there’s a lot of scrutiny, you’re clearly in the public eye a lot. There are consequences to the things you say and talk about, but I think in a circumstance like this, it helps the conversation,” Senate Republican Whip John Thune said. “It helps people realize and understand the impact that this disease has on people across the country.”

    Years after coming forward with her own experience, Smith said she doesn’t have any regrets. In light of the Fetterman news, she feels even more the importance to share.

    “I think that every time a somebody like John or me is open about their own experiences with mental illness or you know, mental health challenges, it just breaks down that wall a little bit more about people saying, ‘Oh, it’s possible to be open and honest and not have the whole world come crashing down on you,’” Smith said.

    It’s been decades since Smith experienced depression, but she said she still remembers so much about that time.

    “I thought I was just off,” Smith said. “Something is wrong with me. I’m not with it. I’m not doing well enough and then you start to sort of blame yourself, and I was sort of in that cycle,” Smith said.

    It was her roommate in college who first suggested she talk to someone. Reluctantly, Smith took herself over to student health services and started talking to a counselor. She said she started to feel better and eventually noticed her depression abated.

    But as Smith tells it, mental health is a continuum and about a decade later, as a young mom with two kids, she found herself experiencing depression once again. At the time, she said she was caught completely off guard.

    “This is the thing that’s so treacherous about depression in particular. You think that the thing that is wrong with you is you,” Smith said. “I’ll never forget my therapist telling me, she said ‘You’re clinically depressed. That’s my diagnosis. I think that you’d benefit from medication to help you.’”

    Smith said she initially resisted. But, after a continued conversation, she agreed to start medication as part of her treatment. She remembers it took time to work, but eventually she noticed a major improvement.

    When she emerged from her depression, Smith was in her early 30s. She said she hasn’t had a resurgence of depression since then, but that she does pay very close attention to her mental health now.

    There are 535 members of Congress and just a handful of them have shared personal stories related to mental illness. Most of those who have talked about their experiences publicly are Democrats. Most of the men who have shared their stories talk about them in the context of military service. In part, it’s a risk for lawmakers to get too personal. The history of reactions to politicians being open about their mental illness has been checkered in the last several decades.

    “People still remember Tom Eagleton,” Smith told CNN.

    In 1972, Eagleton was newly selected to be the running mate for Democratic presidential nominee George McGovern. He admitted to being treated for clinical depression and receiving electroshock therapy. Days later, he withdrew from the ticket even as he continued to serve for years in the Senate.

    Memories of those kinds of episodes impact members in how they approach talking about mental health, even in recent memory.

    “When I was in Congress, I did everything I could to keep everybody from finding out that I needed help,” former Rep. Patrick Kennedy told CNN.

    Kennedy represented Rhode Island in Congress from 1995 to 2011. He suffered from addiction and bipolar disorder. While he was there in 2006, he crashed his green Mustang convertible into a barrier outside the Capitol in the early morning. Following the crash, he pointed to sleeping pills as the culprit and checked himself into the Mayo Clinic for treatment.

    “And is the case with anybody with these illnesses is it is the worst kept secret in town and you are often the last one to realize in what bad shape you are. People won’t tell it to your face because you are a member of Congress, your staff is walking around on eggshells,” Kennedy said.

    “When I did go to treatment. I kind of did it after I had been revealed to be in trouble like I’d gotten in a car accident.”

    But when he got back, Kennedy heard from many colleagues about their own struggles with issues related to mental health.

    Kennedy predicts when Fetterman returns to the Senate, that might also happen to him.

    “I think he is going to have our colleagues from both the House and the Senate look for him in order to tell him what is going on with them. He’s the only one they know,” Kennedy said. “While stigma is going away, there is a less forgiving attitude toward people who suffer from mental illness and addiction.”

    The aftermath of January 6, 2021, was another moment where the conversation around mental health started to shift on the Hill. Suddenly, members and their staff had undergone a traumatic and shared experience in the workplace.

    Democratic Rep. Sara Jacobs of California was just four days into being a new member of Congress on January 6th when she was trapped in the gallery above the House floor with several other members of her party. The experience – the sound of gas masks being deployed, the frenzy to escape, the echo of a gunshot – left her reeling. Jacobs said she considered herself well positioned to seek help. She already had a therapist. But, she noticed some of her older colleagues didn’t have the same tools.

    “I remember actually, after January 6, talking to some of my colleagues here who were a bit older and encouraging them to seek therapy and to get help because it was just something that that wasn’t as accustomed for them,” she said.

    The group of lawmakers who were trapped in the gallery also sought therapy together via Zoom and kept in touch via a text chain.

    For Jacobs, the trauma of January 6 manifested itself in unexpected ways. Suddenly, fireworks – something she once loved – were triggering. Loud people chanting or gathering somewhere made her tense up. She said a lot of her colleagues also dealt with anger, “lots of anger toward colleagues who went back that night and continued to deny the election.”

    When her brother got married in the fall and had fireworks, she had to excuse herself to another room because “it was stressing my body, my nervous system so much.”

    Rep. Dan Kildee, a Democrat from Michigan, also came forward after January 6 to talk about his battle with post-traumatic stress disorder after that day.

    It wasn’t easy.

    “There is still a stigma. People still make their own judgments and that was one of the reasons I decided to talk about it so that people would see that it can happen to anybody. You just have to get the care that you need.”

    “Not everybody was accepting when I sought treatment. My former opponent ridiculed it,” Kildee said.

    For Jacobs, who has been taking medication for anxiety and depression since 2013, stories like Fetterman’s are a sign that maybe the discussions around mental health are beginning to change on the Hill and maybe even in the rest of the country.

    “I think there’s absolutely a generational divide. And there’s also a gender divide and that’s why I think it’s so incredibly brave that Fetterman not only got the treatment needed, but talk about it,” Jacobs told CNN. “I think for me as a young woman, I spent a lot of time with my friends and peers talking about mental health, talking about therapists and what we’re learning in therapy, but I know that that is not something that other generations really have felt open to do.”

    It’s not clear, ultimately, how Fetterman’s openness around his mental health will impact the Hill going forward. It’s not clear what resonance it will have in the rest of the country or even back home for voters. But for lawmakers who’ve taken steps already to share their stories, there is some hope that it could make a major difference.

    “It doesn’t take a statistician to tell you that of the 100 of us in the United States Senate, mental health issues are going to have touched every single one of us in one way or another,” Smith said. “I think it gives people some permission to maybe speak a little bit more openly about it.”

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  • 19th century chastity law endangers 21st century abortion medicine | CNN Politics

    19th century chastity law endangers 21st century abortion medicine | CNN Politics

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    A version of this story appears in CNN’s What Matters newsletter. To get it in your inbox, sign up for free here.



    CNN
     — 

    The Wild West of the post-Roe v. Wade legal landscape is focused on a lone federal judge in Amarillo, Texas, who could use a 19th century law to limit access to abortion medication for every American woman.

    The judge, 45-year-old Matthew Kacsmaryk, held a hearing Wednesday about whether he should impose a preliminary injunction that would require the US Food and Drug Administration to withdraw or suspend its approval of the drug, mifepristone, while a larger case progresses.

    Mifepristone is taken along with another drug, misoprostol, as part of the two-step medication abortion process. Misoprostol can be prescribed on its own, but it is considered less effective.

    Kacsmaryk, who sounded open to the idea of restricting access to mifepristone, will have to agree with some or all of these general points raised if he decides to issue an injunction:

    • That doctors who don’t perform abortions and live in Texas, where abortions are already banned, are harmed by abortions conducted elsewhere.
    • That an FDA approval conducted over the course of four years and finalized 23 years ago was so flawed that it should be rescinded.
    • That a single federal judge in Amarillo should do what no federal judge has ever done and unilaterally rescind an FDA approval.
    • That a drug, which studies suggest is on par with ibuprofen in terms of safety, is actually so harmful it should be reconsidered by the FDA.

    CNN’s Tierney Sneed wrote a longer list of takeaways from the hearing, where anti-abortion rights doctors and activist groups teed up their lawsuit in Kacsmaryk’s courtroom to further limit access to abortion care in the US.

    It’s important to note that no matter what Kacsmaryk does, it will be appealed up through the 5th US Circuit Court of Appeals and potentially to the Supreme Court.

    But perhaps the most incredible question Kacsmaryk faces is whether an 1870s chastity law named for an anti-vice crusader, Anthony Comstock, should be resuscitated and applied to the medicine that now accounts for a majority of US abortions.

    Comstock operated the New York Society for the Suppression of Vice and was a special agent of the US Postal Service. He was known for seizing contraband like contraceptives and condoms in the name of rooting out obscenity, according to the New York Historical Society.

    Mary Ziegler, a law professor at the University of California, Davis who has written about the Comstock Act for CNN Opinion, described Comstock as being “obsessed by what he saw as the decaying morals of a country preoccupied with sex.”

    Ziegler writes:

    The law he inspired barred not just the mailing of “obscene books” but also birth control and abortion drugs and devices. In the 19th and early 20th centuries, the Comstock Act was used to prohibit the mailing of many literary classics, from Geoffrey Chaucer’s “The Canterbury Tales” to works by James Joyce and Walt Whitman.

    Comstock himself proudly carried a gun and scoured the mail for cases involving information about abortion or contraception, even if a doctor provided it. By Comstock’s standard, the law was a great success: he claimed to have destroyed 15 tons of books, arrested more than 4,000 people and driven at least 15 people to suicide.

    While Congress has acted to relax elements of the Comstock Act, including to allow the mailing of contraceptives, it is still technically on the books with regard to the mailing of anything that could be used for an abortion.

    During the Covid-19 pandemic, the FDA dropped its requirement that a person obtain mifepristone in person. A prescription is still required.

    In December, the Department of Justice notified the US Postal Service that the Comstock Act did not apply as long as “the sender lacks the intent that the recipient of the drugs will use them unlawfully.”

    The FDA permanently removed the in-person requirement in January, hoping to guarantee more access to the medication after the Supreme Court ended Roe v. Wade last June.

    The group that brought the Texas lawsuit, the Alliance for Hippocratic Medicine, wants to reapply the Comstock Act and restrict the mailing of abortion medication.

    The FDA’s already exhaustive and detailed drug approval process was especially scrutinized for mifepristone, which was more commonly known as part of the RU-486 regimen when it became available to American women at the turn of the century.

    It had been available in Europe for a dozen years before that. Here’s CNN’s report from September 2000.

    That the drug works safely as a means of abortion is not really up for dispute as a medical matter after all that time, according to CNN’s Jen Christensen, who explains more about the medication in this article about mifepristone.

    Another CNN data analysis suggests mifepristone is safer than penicillin and Viagra.

    Mifepristone has a death rate of 0.0005% – five deaths for every 1 million people in the US who used it. Penicillin’s death rate is four times greater. Viagra’s is 10 times greater, according to the analysis by CNN’s Annette Choi and Will Mullery.

    Kacsmaryk had a long history of challenging laws providing greater access to reproductive rights before he became a federal judge. While he has promised to be an impartial judge, every Democrat and one Republican, Sen. Susan Collins of Maine, opposed his nomination in 2019.

    Now Kacsmaryk is the only federal judge at the courthouse in Amarillo, which almost guarantees he hears cases filed there.

    So it may be no coincidence that the group challenging use of mifepristone set up an outpost months before filing its lawsuit. The group is based in Tennessee, but one of the doctors named as a plaintiff in the lawsuit practices near Amarillo.

    However one feels about judicial shopping and whether that happened in this case, the word appears to be out that a conservative judge is alone in Amarillo and open for business.

    According to a CNN profile, Kacsmaryk has also put on hold Biden administration policies related to immigration and overseen cases related to vaccine requirements and gender identity. Last December, he halted a federal program in Texas that allowed minors to get birth control without their parents’ consent.

    That suit regarding the birth control program established in 1970 was brought by a Texas father “raising each of his daughters in accordance with Christian teaching on matters of sexuality,” which he said forbids premarital sex.

    Kacsmaryk agreed, even citing the Catechism of the Catholic Church in his decision to say “contraception (just like abortion) violates traditional tenets of many faiths, including the Christian faith Plaintiff practices.”

    His sister described him to The Washington Post as an anti-abortion rights activist and detailed her own decision to give a child up for adoption rather than seek an abortion.

    “He’s very passionate about the fact that you can’t preach pro-life and do nothing,” Jennifer Griffith told the Post. “We both hold the stance of you have to do something. You can’t not.”

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  • Why is it difficult for children to get a bed at pediatric hospitals? It’s more complicated than you think | CNN

    Why is it difficult for children to get a bed at pediatric hospitals? It’s more complicated than you think | CNN

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    CNN
     — 

    Effie Schnacky was wheezy and lethargic instead of being her normal, rambunctious self one February afternoon. When her parents checked her blood oxygen level, it was hovering around 80% – dangerously low for the 7-year-old.

    Her mother, Jaimie, rushed Effie, who has asthma, to a local emergency room in Hudson, Wisconsin. She was quickly diagnosed with pneumonia. After a couple of hours on oxygen, steroids and nebulizer treatments with little improvement, a physician told Schnacky that her daughter needed to be transferred to a children’s hospital to receive a higher level of care.

    What they didn’t expect was that it would take hours to find a bed for her.

    Even though the respiratory surge that overwhelmed doctor’s offices and hospitals last fall is over, some parents like Schnacky are still having trouble getting their children beds in a pediatric hospital or a pediatric unit.

    The physical and mental burnout that occurred during the height of the Covid-19 pandemic has not gone away for overworked health care workers. Shortages of doctors and technicians are growing, experts say, but especially in skilled nursing. That, plus a shortage of people to train new nurses and the rising costs of hiring are leaving hospitals with unstaffed pediatric beds.

    But a host of reasons building since well before the pandemic are also contributing. Children may be the future, but we aren’t investing in their health care in that way. With Medicaid reimbursing doctors at a lower rate for children, hospitals in tough situations sometimes put adults in those pediatric beds for financial reasons. And since 2019, children with mental health crises are increasingly staying in emergency departments for sometimes weeks to months, filling beds that children with other illnesses may need.

    “There might or might not be a bed open right when you need one. I so naively just thought there was plenty,” Schnacky told CNN.

    The number of pediatric beds decreasing has been an issue for at least a decade, said Dr. Daniel Rauch, chair of the Committee on Hospital Care for the American Academy of Pediatrics.

    By 2018, almost a quarter of children in America had to travel farther for pediatric beds as compared to 2009, according to a 2021 paper in the journal Pediatrics by lead author Dr. Anna Cushing, co-authored by Rauch.

    “This was predictable,” said Rauch, who has studied the issue for more than 10 years. “This isn’t shocking to people who’ve been looking at the data of the loss in bed capacity.”

    The number of children needing care was shrinking before the Covid-19 pandemic – a credit to improvements in pediatric care. There were about 200,000 fewer pediatric discharges in 2019 than there were in 2017, according to data from the US Department of Health and Human Services.

    “In pediatrics, we have been improving the ability we have to take care of kids with chronic conditions, like sickle cell and cystic fibrosis, and we’ve also been preventing previously very common problems like pneumonia and meningitis with vaccination programs,” said Dr. Matthew Davis, the pediatrics department chair at Ann & Robert H. Lurie Children’s Hospital of Chicago.

    Pediatrics is also seasonal, with a typical drop in patients in the summer and a sharp uptick in the winter during respiratory virus season. When the pandemic hit, schools and day cares closed, which slowed the transmission of Covid and other infectious diseases in children, Davis said. Less demand meant there was less need for beds. Hospitals overwhelmed with Covid cases in adults switched pediatric beds to beds for grownups.

    As Covid-19 tore through Southern California, small hospitals in rural towns like Apple Valley were overwhelmed, with coronavirus patients crammed into hallways, makeshift ICU beds and even the pediatric ward.

    Only 37% of hospitals in the US now offer pediatric services, down from 42% about a decade ago, according to the American Hospital Association.

    While pediatric hospital beds exist at local facilities, the only pediatric emergency department in Baltimore County is Greater Baltimore Medical Center in Towson, Maryland, according to Dr. Theresa Nguyen, the center’s chair of pediatrics. All the others in the county, which has almost 850,000 residents, closed in recent years, she said.

    The nearby MedStar Franklin Square Medical Center consolidated its pediatric ER with the main ER in 2018, citing a 40% drop in pediatric ER visits in five years, MedStar Health told CNN affiliate WBAL.

    In the six months leading up to Franklin Square’s pediatric ER closing, GBMC admitted an average of 889 pediatric emergency department patients each month. By the next year, that monthly average jumped by 21 additional patients.

    “Now we’re seeing the majority of any pediatric ED patients that would normally go to one of the surrounding community hospitals,” Nguyen said.

    In July, Tufts Medical Center in Boston converted its 41 pediatric beds to treat adult ICU and medical/surgical patients, citing the need to care for critically ill adults, the health system said.

    In other cases, it’s the hospitals that have only 10 or so pediatric beds that started asking the tough questions, Davis said.

    “Those hospitals have said, ‘You know what? We have an average of one patient a day or two patients a day. This doesn’t make sense anymore. We can’t sustain that nursing staff with specialized pediatric training for that. We’re going to close it down,’” Davis said.

    Registered nurses at Tufts Medical Center hold a

    Saint Alphonsus Regional Medical Center in Boise closed its pediatric inpatient unit in July because of financial reasons, the center told CNN affiliate KBOI. That closure means patients are now overwhelming nearby St. Luke’s Children’s Hospital, which is the only children’s hospital in the state of Idaho, administrator for St. Luke’s Children’s Katie Schimmelpfennig told CNN. Idaho ranks last for the number of pediatricians per 100,000 children, according to the American Board of Pediatrics in 2023.

    The Saint Alphonsus closure came just months before the fall, when RSV, influenza and a cadre of respiratory viruses caused a surge of pediatric patients needing hospital care, with the season starting earlier than normal.

    The changing tide of demand engulfed the already dwindling supply of pediatric beds, leaving fewer beds available for children coming in for all the common reasons, like asthma, pneumonia and other ailments. Additional challenges have made it particularly tough to recover.

    Another factor chipping away at bed capacity over time: Caring for children pays less than caring for adults. Lower insurance reimbursement rates mean some hospitals can’t afford to keep these beds – especially when care for adults is in demand.

    Medicaid, which provides health care coverage to people with limited income, is a big part of the story, according to Joshua Gottlieb, an associate professor at the University of Chicago Harris School of Public Policy.

    “Medicaid is an extremely important payer for pediatrics, and it is the least generous payer,” he said. “Medicaid is responsible for insuring a large share of pediatric patients. And then on top of its low payment rates, it is often very cumbersome to deal with.”

    Pediatric gastroenterologist Dr. Howard Baron visits with a patient in 2020 in Las Vegas. A large portion of his patients are on Medicaid with reimbursement rates that are far below private insurers.

    Medicaid reimburses children’s hospitals an average of 80% of the cost of the care, including supplemental payments, according to the Children’s Hospital Association, a national organization which represents 220 children’s hospitals. The rate is far below what private insurers reimburse.

    More than 41 million children are enrolled in Medicaid and the Children’s Health Insurance Program, according to Kaiser Family Foundation data from October. That’s more than half the children in the US, according to Census data.

    At Children’s National Hospital in Washington, DC, about 55% of patients use Medicaid, according to Dr. David Wessel, the hospital’s executive vice president.

    “Children’s National is higher Medicaid than most other children’s hospitals, but that’s because there’s no safety net hospital other than Children’s National in this town,” said Wessel, who is also the chief medical officer and physician-in-chief.

    And it just costs more to care for a child than an adult, Wessel said. Specialty equipment sized for smaller people is often necessary. And a routine test or exam for an adult is approached differently for a child. An adult can lie still for a CT scan or an MRI, but a child may need to be sedated for the same thing. A child life specialist is often there to explain what’s going on and calm the child.

    “There’s a whole cadre of services that come into play, most of which are not reimbursed,” he said. “There’s no child life expert that ever sent a bill for seeing a patient.”

    Low insurance reimbursement rates also factor into how hospital administrations make financial decisions.

    “When insurance pays more, people build more health care facilities, hire more workers and treat more patients,” Gottlieb said.

    “Everyone might be squeezed, but it’s not surprising that pediatric hospitals, which face [a] lower, more difficult payment environment in general, are going to find it especially hard.”

    Dr. Benson Hsu is a pediatric critical care provider who has served rural South Dakota for more than 10 years. Rural communities face distinct challenges in health care, something he has seen firsthand.

    A lot of rural communities don’t have pediatricians, according to the American Board of Pediatrics. It’s family practice doctors who treat children in their own communities, with the goal of keeping them out of the hospital, Hsu said. Getting hospital care often means traveling outside the community.

    Hsu’s patients come from parts of Nebraska, Iowa and Minnesota, as well as across South Dakota, he said. It’s a predominantly rural patient base, which also covers those on Native American reservations.

    “These kids are traveling 100, 200 miles within their own state to see a subspecialist,” Hsu said, referring to patients coming to hospitals in Sioux Falls. “If we are transferring them out, which we do, they’re looking at travels of 200 to 400 miles to hit Omaha, Minneapolis, Denver.”

    Inpatient pediatric beds in rural areas decreased by 26% between 2008 and 2018, while the number of rural pediatric units decreased by 24% during the same time, according to the 2021 paper in Pediatrics.

    Steve Inglish, left, and registered nurse Nikole Hoggarth, middle, help a father with his daughter, who fell and required stiches, inside the emergency department at Jamestown Regional Medical Center in rural North Dakota in 2020.

    “It’s bad, and it’s getting worse. Those safety net hospitals are the ones that are most at risk for closure,” Rauch said.

    In major cities, the idea is that a critically ill child would get the care they need within an hour, something clinicians call the golden hour, said Hsu, who is the critical care section chair at the American Academy of Pediatrics.

    “That golden hour doesn’t exist in the rural population,” he said. “It’s the golden five hours because I have to dispatch a plane to land, to drive, to pick up, stabilize, to drive back, to fly back.”

    When his patients come from far away, it uproots the whole family, he said. He described families who camp out at a child’s bedside for weeks at a time. Sometimes they are hundreds of miles from home, unlike when a patient is in their own community and parents can take turns at the hospital.

    “I have farmers who miss harvest season and that as you can imagine is devastating,” Hsu said. “These aren’t office workers who are taking their computer with them. … These are individuals who have to live and work in their communities.”

    Back at GBMC in Maryland, an adolescent patient with depression, suicidal ideation and an eating disorder was in the pediatric emergency department for 79 days, according to Nguyen. For months, no facility had a pediatric psychiatric bed or said it could take someone who needed that level of care, as the patient had a feeding tube.

    “My team of physicians, social workers and nurses spend a significant amount of time every day trying to reach out across the state of Maryland, as well as across the country now to find placements for this adolescent,” Nguyen said before the patient was transferred in mid-March. “I need help.”

    Nguyen’s patient is just one of the many examples of children and teens with mental health issues who are staying in emergency rooms and sometimes inpatient beds across the country because they need help, but there isn’t immediately a psychiatric bed or a facility that can care for them.

    It’s a problem that began before 2020 and grew worse during the pandemic, when the rate of children coming to emergency rooms with mental health issues soared, studies show.

    Now, a nationwide shortage of beds exists for children who need mental health help. A 2020 federal survey revealed that the number of residential treatment facilities for children fell 30% from 2012.

    “There are children on average waiting for two weeks for placement, sometimes longer,” Nguyen said of the patients at GBMC. The pediatric emergency department there had an average of 42 behavioral health patients each month from July 2021 through December 2022, up 13.5% from the same period in 2017 to 2018, before the pandemic, according to hospital data.

    When there are mental health patients staying in the emergency department, that can back up the beds in other parts of the hospital, creating a downstream effect, Hsu said.

    “For example, if a child can’t be transferred from a general pediatric bed to a specialized mental health center, this prevents a pediatric ICU patient from transferring to the general bed, which prevents an [emergency department] from admitting a child to the ICU. Health care is often interconnected in this fashion,” Hsu said.

    “If we don’t address the surging pediatric mental health crisis, it will directly impact how we can care for other pediatric illnesses in the community.”

    Dr. Susan Wu, right, chats with a child who got her first dose of the Pfizer-BioNtech Covid-19 vaccine at Children's Hospital Arcadia Speciality Care Center in Arcadia, California, in 2022.

    So, what can be done to improve access to pediatric care? Much like the reasons behind the difficulties parents and caregivers are experiencing, the solutions are complex:

    • A lot of it comes down to money

    Funding for children’s hospitals is already tight, Rauch said, and more money is needed not only to make up for low insurance reimbursement rates but to competitively hire and train new staff and to keep hospitals running.

    “People are going to have to decide it’s worth investing in kids,” Rauch said. “We’re going to have to pay so that hospitals don’t lose money on it and we’re going to have to pay to have staff.”

    Virtual visits, used in the right situations, could ease some of the problems straining the pediatric system, Rauch said. Extending the reach of providers would prevent transferring a child outside of their community when there isn’t the provider with the right expertise locally.

    • Increased access to children’s mental health services

    With the ongoing mental health crisis, there’s more work to be done upstream, said Amy Wimpey Knight, the president of CHA.

    “How do we work with our school partners in the community to make sure that we’re not creating this crisis and that we’re heading it off up there?” she said.

    There’s also a greater need for services within children’s hospitals, which are seeing an increase in children being admitted with behavioral health needs.

    “If you take a look at the reasons why kids are hospitalized, meaning infections, diabetes, seizures and mental health concerns, over the last decade or so, only one of those categories has been increasing – and that is mental health,” Davis said. “At the same time, we haven’t seen an increase in the number of mental health hospital resources dedicated to children and adolescents in a way that meets the increasing need.”

    Most experts CNN spoke to agreed: Seek care for your child early.

    “Whoever is in your community is doing everything possible to get the care that your child needs,” Hsu said. “Reach out to us. We will figure out a way around the constraints around the system. Our number one concern is taking care of your kids, and we will do everything possible.”

    Nguyen from GBMC and Schimmelpfennig from St. Luke’s agreed with contacting your primary care doctor and trying to keep your child out of the emergency room.

    “Anything they can do to stay out of the hospital or the emergency room is both financially better for them and better for their family,” Schimmelpfennig said.

    Knowing which emergency room or urgent care center is staffed by pediatricians is also imperative, Rauch said. Most children visit a non-pediatric ER due to availability.

    “A parent with a child should know where they’re going to take their kid in an emergency. That’s not something you decide when your child has the emergency,” he said.

    Jaimie and Effie Schnacky now have an asthma action plan after the 7-year-old's hospitalization in February.

    After Effie’s first ambulance ride and hospitalization last month, the Schnacky family received an asthma action plan from the pulmonologist in the ER.

    It breaks down the symptoms into green, yellow and red zones with ways Effie can describe how she’s feeling and the next steps for adults. The family added more supplies to their toolkit, like a daily steroid inhaler and a rescue inhaler.

    “We have everything an ER can give her, besides for an oxygen tank, at home,” Schnacky said. “The hope is that we are preventing even needing medical care.”

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  • Takeaways from the Texas hearing on medication abortion drugs | CNN Politics

    Takeaways from the Texas hearing on medication abortion drugs | CNN Politics

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    Amarillo, Texas
    CNN
     — 

    Over the course of about four hours of arguments, a federal judge in Texas asked questions that suggested he is seriously considering undoing the US Food and Drug Administration’s approval of a medication abortion drug and the agency’s moves to relax the rules around its use.

    But the judge, US District Judge Matthew Kacsmaryk, an appointee of former President Donald Trump, also indicated he was thinking through scenarios in which he could keep the drug’s 2000 approval intact while blocking other FDA rules.

    Anti-abortion doctors and medical associations are seeking a preliminary injunction that would require the FDA to withdraw or suspend its approval of the drug, mifepristone, and that would block the agency’s more recent regulatory changes making the pills more accessible.

    Here are takeaways from the hearing:

    Kacsmaryk showed a particular interest in the arguments by the abortion opponents that the FDA approved mifepristone in an unlawful way.

    He zeroed in on a claim by the abortion foes that the studies that the FDA looked at when deciding whether to approve the drug did not match the conditions under which the agency allows it to be administered.

    Erik Baptist, attorney for the challengers, alleged that those studies all featured patients who received ultrasounds before being treated with the drug, which is not among the FDA’s requirements for prescribing abortion pills. Baptist accused the FDA of “examining oranges and declaring apples to be safe.”

    Kacsmaryk returned to that “apples to oranges” argument several times throughout the hearing.

    Justice Department attorney Daniel Schwei defended the FDA’s approach, arguing that the relevant law gives the FDA discretion to determine what studies are adequate for approving a drug’s safety. He also said the challengers’ claims were factually flawed, because the FDA also was looking at studies where the patients did not receive an ultrasound.

    Kacsmaryk was similarly focused on a claim by the plaintiffs that the FDA violated the law in the special, accelerated process that it used to approve mifepristone in 2000.

    At one point the judge revealed in the hearing that he had downloaded a list of the other drugs the FDA had approved through the process. He ticked through the list of drugs, which were made up mostly of treatments for HIV and cancer, and he asked the Justice Department for its “best argument” for why mifepristone fit into the list.

    One of the sharpest questions from the judge was whether the anti-abortion activists could point to another analogous case when a court intervened in the way he is being asked to intervene here.

    Baptist conceded there was none and blamed FDA delays in addressing citizen petitions and challenges. Later in the hearing, Baptist raised other times the FDA had suspended or withdrawn drugs based on court cases in other contexts, arguing those cases showed that Kascmaryk had the authority to grant the plaintiffs’ request.

    Attorneys for the defendants – which include both the FDA and a drug company that manufactures mifepristone and intervened in the case – pushed back on those examples. They said that the plaintiffs were relying on patent cases, where the dispute was between a brand name drug and a generic counterpart, and those examples were not analogous here.

    The medication abortion lawsuit targets actions the FDA took around medication abortion pills before last summer’s Supreme Court reversal of Roe v. Wade’s abortion rights protections.

    While that decision, known as Dobbs v. Jackson Women’s Health Organization, didn’t play a major role in Wednesday’s arguments, the judge referenced it and suggested it could have an impact on his thinking about the case.

    He brought up Dobbs early on in the hearing and raised it specifically in connection with a friend of the court brief filed by 22 GOP-led states supporting the challengers.

    The judge noted that the red states’ brief argued that the FDA’s actions were infringing on their state laws concerning abortion pills.

    He asked Erin Hawley, an attorney for the challengers, whether Dobbs was an “intervening event” that has “changed the landscape” around the relationship between state and federal government concerning abortion policy.

    Hawley agreed, calling it a “sea change.”

    If Kacsmaryk has any sore feelings over the blow up around his efforts to keep Wednesday’s hearing plans quiet, he didn’t show them at the proceedings.

    When questioning both sides of the case, Kacsmaryk had a restrained, straight-forward tone. He had occasional follow-up questions for the plaintiffs, but did not aggressively push back on their arguments. The substance of his questions for the FDA’s defenders was more skeptical, but he kept with the measured approach in his questioning, and avoided any pushiness when grilling the government and the drug company about the approval process.

    At the end of the hearing, he thanked the parties, as well as those who filed dozens of friend of the courts briefs, for their “superb” briefing. He also acknowledged the logistical hurdles the lawyers at the hearing went through to get to his courthouse in Amarillo, which is a several hours’ drive from Texas’ biggest cities.

    Left unmentioned by the judge was the fact that he tried to delay the announcement of the hearing until the evening before, which would have made it difficult for members of the public and the media to attend Wednesday’s proceedings. When there was blowback to The Washington Post reporting about his plan – laid out in a private teleconference with attorneys where he pointed to death threats and harassment that had been directed to the courthouse staff – he announced the hearing on Monday.

    The courtroom was open to the public, but only with limited seating: 19 seats for reporters and 19 for members of the public. By 6 a.m. CT Wednesday there were already lines outside the courtroom to claim those seats. Those attendees were not allowed to bring electronics in with them, and if they left the courthouse, they were not allowed back in.

    Kacsmaryk warned at the beginning of the hearing that anyone who disrupted the proceedings would be immediately removed without warning. But there were no such disruptions.

    Kacsmaryk wrapped up the hearing without any explicit timeline for when he’ll rule, telling the parties he would issue an order and opinion “as soon as possible.”

    While he was arguing, Schwei, the DOJ attorney, requested that the judge – if he were to rule against the FDA – to immediately put that ruling on pause so it could be appealed. The judge stopped short of promising an automatic stay in the event of an adverse ruling, but he acknowledged he understood what DOJ was asking for.

    An appeal would first go to a panel of three judges of the 5th US Circuit Court of Appeals, arguably the most conservative appeals court in the country. The panel’s decision could then be appealed either to the full 5th Circuit or the US Supreme Court.

    Beyond these procedural questions, Kacsmaryk seemed to be grappling with the practical impact of a ruling in favor of the plaintiffs. He asked plaintiffs’ attorneys, the DOJ lawyers and the attorneys for the drug company Danco whether it would be possible for him to block some but not all of the FDA actions the challengers were targeting. He returned to the question again when the plaintiffs were back up for the rebuttal.

    He also pressed Baptist, the attorney for the abortion opponents, on whether the plaintiffs were seeking an order that the FDA begin the withdrawal of the drug – a process that would take months – or if they thought the judge could directly take if off the market.

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  • Chinese billionaire arrested and charged in alleged fraud conspiracy that bilked investors of more than $1 billion | CNN Politics

    Chinese billionaire arrested and charged in alleged fraud conspiracy that bilked investors of more than $1 billion | CNN Politics

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    New York
    CNN
     — 

    Chinese billionaire and proclaimed dissident Guo Wengui was arrested Wednesday and charged with defrauding thousands of followers out of more than $1 billion through complex investment schemes, US prosecutors announced Wednesday.

    Guo, a staunch critic of the Chinese government who is exiled in Manhattan and close to former Donald Trump adviser Steve Bannon, was taken into custody in New York on Wednesday morning. He is charged with defrauding or misappropriating investor money using different schemes, including his media company GTV Media Group, a farm loan program through Himalaya Farm Alliance, and a cryptocurrency called Himalaya Coin.

    Guo is also known as Ho Wan Kwok and Miles Guo.

    Prosecutors said instead of using the money the way he promised potential investors, Guo directed the funds to invest in a hedge fund to benefit GTV and a relative, to cover the maintenance payments for his $37 million, 145-foot luxury yacht, a New Jersey mansion and a custom-built Bugatti sports car valued at $4.4 million. Prosecutors said in a letter to the judge that they are seeking his detention, arguing he poses a serious risk of flight.

    CNN has reached out to Guo’s lawyer for comment.

    Guo co-founded two nonprofit organizations, the Rule of Law Foundation and the Rule of Law Society, that prosecutors allege he used to attract a following who believed in many of his ideas.

    Those nonprofits were linked to a group promoting the theory that the novel coronavirus was likely engineered in a Chinese lab. The Rule of Law organizations were co-founded by Guo and Bannon.

    Bannon has not been charged in this case.

    Bannon was arrested in 2020 on Guo’s yacht on unrelated fraud charges stemming from a border wall fundraising effort. Bannon was pardoned by Trump but indicted on similar state charges. Bannon has pleaded not guilty.

    50,000 square foot New Jersey mansion owned by Guo Wengui, according to the US Justice Department.

    Prosecutors said they have seized $634 million from 21 bank accounts and a Lamborghini Aventador SVJ Roadster.

    In addition to criminal charges of conspiracy, wire fraud, securities fraud, international money laundering and obstruction of justice, Guo was also sued by the Securities and Exchange Commission.

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  • Not just casinos: Macao reimagines tourism post-pandemic | CNN

    Not just casinos: Macao reimagines tourism post-pandemic | CNN

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    Editor’s Note: Sign up for Unlocking the World, CNN Travel’s weekly newsletter. Get the latest news in aviation, food and drink, where to stay and other travel developments.


    Macao, China
    CNN
     — 

    Like many of his peers, Dan McAulay was furloughed from his job as a pilot during the pandemic.

    Being based in Macao, a city that had one of the world’s strictest approaches to the coronavirus pandemic, he found himself with a lot of time on his hands.

    McAulay and his wife, Rebeca Fellini, started learning how to distill alcohol as a lockdown hobby. And by the end of the nearly three years that Macao was a relative fortress, they had grown their pastime into a bona fide business – a gin brand called Owl Man, a play on the Chinese pronunciation of the city’s name “Ah Mahn.”

    Now, McAulay is back in the skies with Air Macau and Fellini manages the distillery’s day-to-day business.

    Even though their business was born during lockdown, they – like so many other businesses around the city – are pinning their hopes on the return of tourism.

    Macao, an hour’s ferry ride from Hong Kong, is the only place in China where gambling is legal.

    Often called the “Vegas of Asia,” in pre-pandemic times it wasn’t unusual to see a high-spending “whale” helicopter in and out of the city for a single afternoon at the craps table.

    As a result, the city’s primary economy is the casinos and the businesses supporting them, from hotels to spas to high-end shops.

    Macao only has about 600,000 residents – compared to seven million in Hong Kong – but brings in six times as much revenue as Las Vegas in a typical year.

    Before the pandemic, 80% of Macao’s government revenue came from the gaming industry. Big players like Wynn, Venetian and MGM all have a significant presence in the city.

    Covid threw that all into a tailspin. Nearly three years of intermittent lockdowns and blocked travel from the mainland and Hong Kong had a devastating effect on the city’s primary source of income.

    But it also provided time for innovation.

    “The government realized they can’t focus all their efforts on gaming and (tourists from) the mainland. Gastronomy is one of their big pushes,” explains McAulay.

    “Being the only distillery in Macao, it’s working out amazing for us. The hotels and casinos are encouraged to support local food and beverage companies. It has given us quite a strong start.”

    He isn’t the only entrepreneur who used the tourism slowdown to rethink his business model.

    Asai, who uses only his first name professionally, owns several Portuguese restaurants and cafes around the territory. As a former Portuguese colony, Macao is known for food traditions like egg tarts, African chicken and bacalao (codfish fritters).

    But Asai wants visitors to know there’s still an active, thriving Portuguese community in Macao – and they’re offering more than the usual favorites.

    Egg custard tarts, or pasteis de natas in Portuguese, are one of the most popular souvenirs from Macao, with long lines at establishments like Lord Stow’s and Margaret’s.

    Pasteis de Chaves is a small, trendy-looking cafe that wouldn’t be out of place in Brooklyn. Though it does sell egg tarts, its name comes from the signature offering – beef stuffed pastries that offer a savory complement to the sweet eggy ones.

    Across the road, Three Sardines is a romantic, dimly lit spot specializing in petiscos, a Portuguese equivalent of tapas with small plates like fried octopus and grilled peppers.

    “Competition is high for Portuguese restaurants, but many are localized twisted versions of Portuguese food,” says Asai, who has been in Macao for 18 years and stayed through the pandemic. “We try to offer more traditional and unique experiences. This is a niche and helped us survive the pandemic.”

    Chef Pedro Almeida behind the bar at Three Sardines.

    Now, he is one of many local business owners looking outward for the first time in several years as tourists slowly trickle back to Macao.

    Like Owl Man, Asai’s restaurant group has received government support as Macao diversifies its food and drink scene.

    For instance, he and head chef Pedro Almeida worked with the Macau Government Tourist Office (MGTO) on a video to explain the origin of egg tarts and how they’re different in Macao and Portugal.

    As the first international tourists began returning to Macao in February 2023, it was clear that a lot had changed.

    Many small neighborhood restaurants closed during lockdown, and those that have reopened have had trouble staffing up after so many workers left the city permanently.

    But new attractions have opened as well, with casinos trying to diversify their offerings and become more family-friendly.

    The city’s first-ever outdoor zip line, ZipCity, opened at Taipa’s Lisboeta casino complex in January 2023. The timing worked out well, as mainland Chinese tourists flooded the city during Lunar New Year – a representative for the company says that ZipCity operated “at 90% capacity” during that holiday week.

    The ZipCity zipline is 338 meters (about 1,100 feet) long.

    Despite the pandemic, ongoing construction projects were still completed – if not necessarily on schedule.

    Popular Japanese immersive art experience TeamLab opened an outpost at the Venetian in June 2020, and a new British-themed resort, The Londoner, opened in 2021 complete with penthouse suites designed by David Beckham.

    Arguably the city’s most well-known landmark, the ruins of St. Paul’s Church, has been reinvigorated by a new on-site VR experience that enables visitors to see what the church looked like during different historical periods.

    The city is rolling out incentives to bring back those tourists, as well.

    People coming over via ferry from Hong Kong qualify for a buy-one-get-one free boat ticket if they’re staying at least one night in a hotel – an incentive to stay longer and not just make it a day trip.

    Most businesses and vendors in Macao, including taxi drivers, will accept Hong Kong dollars – while very few of their counterparts in Hong Kong will accept the Macanese pataca.

    Macao’s tourism authority also announced programs aimed at international travelers, including deals on package trips.

    On the ground, things look lively.

    Weekend ferries from Hong Kong have been selling out, and popular areas like Senado Square and the Guia Fortress – which is part of the city’s UNESCO-listed historical center – are thronged with visitors.

    That includes casinos as well. On a recent mid-week visit, tables at the MGM and Venetian casinos were full of both gamblers and gawkers.

    Macao dropped its mask mandate on February 26, with Hong Kong following suit a week later. However, many casino-goers still sported masks indoors once it became voluntary, perhaps due to the close quarters at blackjack tables.

    For now, though, tourism is mostly regional.

    According to data from Macao’s tourism authority, the majority of visitors arriving in January 2023 were from mainland China, Hong Kong, Taiwan, the Philippines and Indonesia.

    In January 2019, 3.4 million tourists came to Macao, with most from mainland China. In January 2023, 1.4 million visited, most during the Lunar New Year holiday.

    Hometown airline Air Macau has been steadily ratcheting up capacity to add more flights from Singapore and Taipei, two of Macao’s biggest markets. More mainland China routes will return by March 26.

    Low-cost Asian carriers like Cambodia Airways and Thai Vietjet also brought back their pre-pandemic air links.

    “I think everyone expected (tourism) to bounce back, but talking to all our friends in the hotels and casinos, they’re saying their fourth quarter predictions have bounced back faster than they anticipated,” says McAulay, the Owl Man co-founder.

    “I think it’s re-energizing.”

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  • First on CNN: Kamala Harris to make first trip to Iowa since becoming vice president | CNN Politics

    First on CNN: Kamala Harris to make first trip to Iowa since becoming vice president | CNN Politics

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    CNN
     — 

    Vice President Kamala Harris on Thursday will make her first trip to Iowa since taking office for an abortion rights event, a White House official told CNN.

    Harris will travel to Des Moines to convene a roundtable with local leaders about the fight to protect reproductive rights.

    The last-minute, high-profile trip comes after flurry of activity from Republicans presidential hopefuls who’ve descended on the early caucus state, like former President and current candidate Donald Trump and potential 2024 GOP candidate Ron DeSantis. GOP politicians have begun to woo caucus-goers who favor personal politicking, as the state is set to play its traditional role in kicking off the party’s 2024 nominating contest.

    President Joe Biden, who is expected to launch a 2024 reelection bid, has been absent from the state after urging national Democrats to replace Iowa first-in-the-nation caucuses with South Carolina, a primary state where the majority of Democratic voters are Black, which propelled him to the nomination in 2020. The Democratic National Committee adopted the president’s changes last month but the vice president’s visit to Iowa underscores how Democrats do not intend to fully abandon the state, despite its Republican-leaning trends.

    Harris’ trip will also come a day after a federal judge overseeing a challenge to the federal government’s approval of a medication abortion drug will hold a hearing in the case. The vice president has become the Biden administration’s lead messenger on the issue after the Supreme Court overturned Roe v. Wade last summer, holding that there is no longer a federal constitutional right to an abortion.

    This week, she slammed attacks on medication abortion and warned that preventing doctors from prescribing mifepristone, the first drug in the medication abortion process, could have wider ramifications.

    “But if extremists and politicians can override FDA approval and remove one medication from the shelves – in this case, abortion medication – one must ask: What medication is next?” Harris said in a recent press call with local media and coalition outlets.

    Harris has held dozens of events on access to abortion care since last year, meeting with activists and state lawmakers about abortion rights in deep red and swing states.

    Recently, Iowa State House Republicans introduced a bill that would ban all abortions in the state, determining that life begins at conception. Iowa’s Supreme Court ruled last year that the state Constitution does not protect the right to an abortion, clearing the way for the state’s Republican legislative majority to potentially enact stricter abortion measures.

    This story has been updated with additional details.

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  • US sues Rite Aid for missing opioid red flags | CNN Business

    US sues Rite Aid for missing opioid red flags | CNN Business

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    CNN
     — 

    The Justice Department on Monday filed a lawsuit against Rite Aid for allegedly violating the Controlled Substances Act, alleging that the company “knowingly filled unlawful prescriptions for controlled substances.”

    In a statement, Attorney General Merrick Garland said the Department of Justice is “using every tool at our disposal” to hold Rite Aid accountable for contributing to the opioid epidemic.

    Associate Attorney General Vanita Gupta said “Rite Aid’s pharmacists repeatedly filled prescriptions for controlled substances with obvious red flags, and Rite Aid intentionally deleted internal notes about suspicious prescribers. These practices opened the floodgates for millions of opioid pills and other controlled substances to flow illegally out of Rite Aid’s stores.”

    In the complaint, The Justice department alleges that from May 2014 to June 2019, Rite Aid filled thousands of unlawful combinations of prescriptions known as “the trinity” which included prescriptions for “excessive quantities of opioids, such as oxycodone and fentanyl.”

    Rite Aid pharmacists were accused of ignoring obvious signs of misuse and intentionally deleting some pharmacists’ internal warnings about suspicious prescribers, such as “cash only pill mill???”

    “These practices opened the floodgates for millions of opioid pills and other controlled substances to flow illegally out of Rite Aid’s stores,” Associate Attorney General Vanita Gupta said.

    The Justice Department said the prescriptions, who were issued illegally, “lacked a legitimate medical purpose, were not for a medically accepted indication, or were not issued in the usual course of professional practice.”

    Rite Aid is one of the country’s largest pharmacy chains, with more than 2,330 stores in 17 US states. It did not immediately respond to requests for comment.

    The Justice Department accused Rite Aid of violating the federal False Claims Act by submitting false prescription claims to government health care programs such as Medicare and Medicaid.

    It joined a whistleblower lawsuit filed in 2019 by two pharmacists and a pharmacy technician from Rite Aid stores in Pennsylvania, North Carolina and West Virginia.

    The Justice Department occasionally joins whistleblower cases it considers stronger.

    It has also sued Walmart and drug distributor AmerisourceBergen Corp over their alleged roles in the nation’s opioid crisis.

    More than 500,000 people died from drug overdoses in the United States from 1999 to 2020, including more than 90,000 in 2020 alone, according to the US Centers for Disease Control and Prevention.

    Reuters contributed to this report.

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  • Media outlets urge judge to announce his plans for a hearing in blockbuster medication abortion case | CNN Politics

    Media outlets urge judge to announce his plans for a hearing in blockbuster medication abortion case | CNN Politics

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    CNN
     — 

    Several media organizations asked a federal judge on Monday to publicly announce his plans to hold a hearing Wednesday in a blockbuster medication abortion case after the judge reportedly moved to keep the hearing under wraps.

    “Across the ideological spectrum, the public is intensely interested in this case,” the organizations wrote in their letter to US District Judge Matthew Kacsmaryk.

    The case concerns a challenge brought by anti-abortion doctors and medical associations to the federal government’s 2000 approval of a drug used to terminate pregnancies. Medication abortion is the most common method of abortion in the United States.

    “The Court’s delayed docketing of notice of Wednesday’s hearing, and its request to the parties and their counsel not to disclose the hearing schedule publicly, harm everyone, including those who support the plaintiffs’ position and those who support the defendants’ position,” the media outlets added.

    At 7 weeks pregnant she wanted an abortion. Here’s why she turned to a doctor in Austria

    The letter pointed to reporting by The Washington Post on Saturday that said on Friday, Kacsmaryk held a private phone call with the lawyers in the case and told them he was scheduling a hearing for Wednesday but not announcing those plans on the case’s docket until Tuesday evening. The judge reportedly told the lawyers not to publicize the hearing plans in the meantime.

    Kacsmaryk is currently considering the plaintiffs’ request for a preliminary injunction that would “withdrawal or suspend” that approval while the lawsuit plays out.

    If the judge grants the request to block access to the drug nationwide, it could make the pills harder to obtain even in states where medication abortion is legal.

    The media outlets told Kacsmaryk that the “Court’s attempt to delay notice of and, therefore, limit the ability of members of the public, including the press, to attend Wednesday’s hearing is unconstitutional, and undermines the important values served by public access to judicial proceedings and court records.”

    Kacsmaryk’s courtroom is in Amarillo, Texas – a division in the northern Texas panhandle that is a several hours’ drive from Texas’ biggest cities and accessible only by a limited number of direct flights.

    According to the Post, Kacsmaryk told the case’s lawyers he was holding off until Tuesday to announce the Wednesday hearing to limit the potential for protests and disruptions to the proceedings.

    “The Court cannot constitutionally close the courtroom indirectly when it cannot constitutionally close the courtroom directly,” the media outlets wrote.

    “The United States Supreme Court has made clear that, because of our historical tradition of public access to judicial proceedings, and because of the structural necessity of such access to ensure government transparency and accountability, the circumstances in which a courtroom can be closed without violating the First Amendment and common law rights of access are rare.”

    The organizations signing onto the letter are the Reporters Committee for Freedom of the Press, The Washington Post, NBCUniversal News Group, ProPublica, Inc., Texas Press Association, The Freedom of Information Foundation of Texas, The Markup, and Gannett Co., Inc.

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  • Washington Post: Judge keeps plans for medication abortion hearing out of public view for now | CNN Politics

    Washington Post: Judge keeps plans for medication abortion hearing out of public view for now | CNN Politics

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    CNN
     — 

    A federal judge has set a hearing for next week in a blockbuster medication abortion case in Texas but took a series of highly unusual steps to delay making the public aware that such a hearing was being scheduled, The Washington Post reported.

    US District Judge Matthew Kacsmaryk, who is hearing the case, held a private call Friday with the case’s lawyers and scheduled the hearing for Wednesday, according to the Post. The call was not publicly noticed on the case’s docket, nor did the judge issue a public order announcing that Wednesday’s hearing had been scheduled. The case is not under seal.

    In the case, anti-abortion doctors are asking the judge – an appointee of former President Donald Trump – to undo the federal government’s 2000 approval of pills used to terminate a pregnancy. Such a move could cut off access nationwide to the most common method of abortion.

    Kacsmaryk told the lawyers on the call, according to the newspaper, that he would hold off on publicly announcing the Wednesday hearing until Tuesday evening, so as to limit disruptions and potential protests at the proceeding. He also asked that the attorneys on the call – which reportedly included the Justice Department’s lawyers who are defending the drug’s approval, lawyers for the anti-abortion activists who are challenging it, and lawyers for a company that distributes the drug and has intervened in the case – not to publicize the hearing plans before then.

    The judge’s efforts to limit transparency around Wednesday’s hearing comes in a case that has major implications for access to abortion and is arguably the biggest legal battle over the procedure since the Supreme Court overturned nationwide abortion protections in a ruling last June.

    Voicemails left by CNN on Sunday morning with the court’s clerk’s office and with Kacsmaryk’s chambers about the Post’s Saturday night report were not immediately returned.

    The case is unfolding in Amarillo – a far-flung court division in Texas’ northern panhandle that is a several hours’ drive from the state’s biggest cities and has only limited direct flight routes. Federal judicial proceedings typically play out in public.

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  • Iran arrests more than 100 people over suspected poisonings of schoolgirls | CNN

    Iran arrests more than 100 people over suspected poisonings of schoolgirls | CNN

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    CNN
     — 

    Iran has arrested more than 100 people “in connection with” the suspected poisoning of hundreds of schoolgirls across the country, according to the state-run IRNA news agency.

    Citing a statement from Iran’s Interior Ministry, IRNA said the people had been “identified, arrested and investigated” in several cities, including the capital Tehran.

    “Initial inquiries show that a number of these people, out of mischief or adventurism and with the aim of shutting down classrooms and influenced by the created psychological atmosphere, have taken measures such as using harmless and smelly substances,” the statement read.

    Iran has seen a wave of suspected poisonings, carried out almost entirely at girls’ schools, in recent months.

    While Iranian politicians have suggested the girls could have been targeted by hardline Islamist groups, activists believe that the poisonings may be linked to the nationwide protests that erupted last September over the death of Mahsa Ami. Many schoolgirls have been active in the protests, removing their mandatory headscarves in classrooms, tearing up pictures of Supreme Leader Ayatollah Ali Khamenei and calling for his death.

    Medics, parents and teachers have accused the Iranian government of attempting to silence the victims.

    Iran’s Supreme Leader Ali Khamenei previously called the suspected poisonings an “unforgivable crime” and called for “severe punishment” for anyone found responsible.

    Among those arrested, the ministry said, were “individuals who have had hostile motives, tried to create fear and horror among people and students, shut down schools, and created pessimism toward” the Iranian government.

    They would remain “under investigation until required assurances are achieved,” the statement said, adding that the number of poisoning cases at girls’ schools across the country had been decreasing “over the past several days.”

    The first suspected poisonings happened in November at a high school in the city of Qom which saw 18 schoolgirls hospitalized, according to Iranian state media.

    A mother of two daughters from Qom previously told CNN that both girls, who attended different schools, had suffered significant health issues after being poisoned.

    One girl experienced nausea, shortness of breath and numbness in her left leg and right hand while the other now had “difficulty walking,” she said.

    Growing alarm in Iran after report hundreds of schoolgirls were poisoned

    Another incident in the city took place in February when more than 100 students from 13 schools were hospitalized after what Iranian state news agencies described as “serial poisonings.”

    Both the United States and United Nations have called on Iranian authorities to fully investigate the suspected poisonings and hold those responsible to account.

    The White House on Monday said there must be a “credible, independent” investigation of poisonings among schoolgirls in Iran, suggesting it could be within the purview of the United Nations to look into the matter.

    Previously, the Biden administration had noted Iran itself was conducting an investigation. But questioned by CNN’s Phil Mattingly on Monday, press secretary Karine Jean-Pierre said the situation could fall within the mandate of the UN’s independent fact-finding mission on Iran.

    “We are closely following this deeply concerning situation that we’re seeing in Iran,” she said. “The continued poisoning of schoolgirls across Iran is unconscionable. There must be a credible, independent investigation (and) accountability for those responsible.”

    She said if the poisonings were related to recent protests, it was “well within” the UN fact-finding mission’s mandate.

    “The possibility that girls in Iran are being possibly poisoned for simply for trying to get an education is shameful, it’s unacceptable,” she said.

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  • Parents of sailor who died by suicide urge Pentagon to implement mental health measure named in his honor that became law over a year ago | CNN Politics

    Parents of sailor who died by suicide urge Pentagon to implement mental health measure named in his honor that became law over a year ago | CNN Politics

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    CNN
     — 

    More than a year after Congress signed into law a bill meant to help service members struggling with severe mental health problems, the Pentagon still has not issued guidance to the services to put the bill into practice.

    “We hear the rhetoric all the time, but we need action,” said Democratic Rep. Seth Moulton, who co-sponsored the Brandon Act. “They’ve been sitting on their hands and more Americans die every day as a result.”

    The Brandon Act is named after Brandon Caserta, a young sailor whose parents described him as a “very charismatic and upbeat young man” who “always helped everyone he could.”

    But in June 2018, Caserta took his own life at Naval Air Station Norfolk, Virginia. In letters to his parents and to his friends, Caserta said he was constantly hazed and bullied in the Navy, and he saw no other way out.

    He notified his commanders he was depressed but they took no action and showed no sympathy, according to Brandon Caserta’s father Patrick, who served 22 years in the Navy.

    “They said, ‘Suck it up and get back to work,’” Patrick Caserta told CNN. “You can’t have that. That’s now how you deal with it.”

    The Brandon Act was included in the 2022 National Defense Authorization Act. If a service member seeks mental health services or self-reports a problem, the Act requires a mental health evaluation. It also allows service members to seek confidential help outside the chain of command.

    “His letter led us to this,” Teri Caserta, Brandon’s mother, told CNN. “He wanted us to do something about suicide and the toxicity that happens in our military system. That’s why we created the Brandon Act.”

    But 15 months after it was passed the law has not been implemented and the Defense Department hasn’t followed through its requirements and issued guidance for the military. Therefore, the mental health evaluations and the confidential reporting required by the law are still not available to service members.

    In 2021, the latest year for which numbers are available, 519 US service members died by suicide. Though a slight decrease from the previous year’s 582 suicides, the trend over the last decade and more has been increasing.

    Last year, three sailors assigned to the USS George Washington died by suicide in a single week. Then, in December, four sailors at a faculty in Norfolk, Virginia died by suicide in one month.

    “DoD needs to do this,” said Moulton bluntly. “Active-duty service members don’t have a way to report mental health issues outside the chain of command because DoD just hasn’t gotten out of their own bureaucratic way to implement this act. It just requires the Secretary of Defense and his department to do their job.”

    The issue of military suicides has plagued the Department of Defense for decades. According to a 2021 study from Brown University, more than 30,000 active-duty personnel and veterans died by suicide during the 20-year War on Terror, which is more than four times the number of combat deaths in Iraq and Afghanistan combined.

    The Defense Department is currently working on implementing the requirements of the Brandon Act, according to a spokesperson.

    “Due to the complexity of the requirement, publication of policy to establish self-initiated referrals for a mental health evaluation via a commander or supervisor is currently in development,” said Cmdr. Nicole Schwegman, who stressed that there are mental health services available for members of the military seeking help or an evaluation.

    “A full continuum of mental health and wellness support is available worldwide to ensure access to care,” Schwegman said, including specialty and primary care clinics, as well as virtual health platforms.

    Last month, the Pentagon’s Suicide Prevention and Response Independent Review Committee unveiled 127 recommendations to combat military suicides, including a waiting period for gun purchases on base and raising the minimum age for buying firearms on base.

    The Pentagon said it would review the recommendations closely.

    “Even one suicide is too many, and we will exhaust every effort to promote the wellness, health, and morale of our total force,” said Pentagon press secretary Brig. Gen. Pat Ryder after the release of the recommendations.

    But for the parents of Brandon Caserta, the committee’s recommendations and the Pentagon’s promises to review its report smack of more waiting and less action.

    “As painful as this has been, had someone else done this before us, our son would still be alive,” said Patrick Caserta. “We want to be that person that saves lives later on.”

    Editor’s Note: If you or a loved one have contemplated suicide, call The National Suicide and Crisis Lifeline at 988 or 1-800-273-TALK (8255) to connect with a trained counselor.

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  • Chinese city proposes lockdowns for flu — and faces a backlash | CNN

    Chinese city proposes lockdowns for flu — and faces a backlash | CNN

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    Hong Kong
    CNN
     — 

    A Chinese city has sparked a backlash on social media after saying it would consider the use of lockdowns in the event of an influenza outbreak.

    The city of Xi’an – a tourism hotspot in Shaanxi province that is home to the famous terracotta warriors – revealed an emergency response plan this week that would enable it to shut schools, businesses and “other crowded places” in the event of a severe flu epidemic.

    That prompted a mixture of anxiety and anger on China’s social media websites among many users who said the plan sounded uncomfortably similar to some of the strict zero-Covid measures China had implemented throughout the pandemic and which have only recently been abandoned.

    “Vaccinate the public rather than using such time to create a sense of panic,” one user wrote on Weibo, China’s equivalent of Twitter.

    “How will people not panic given that Xi’an’s proposal to suspend work and business activities were issued without clear instruction on the national level to classify the disease?” asked another.

    While cases of Covid in China are falling, there has been a spike in flu cases across the country and some pharmacies are struggling to meet demand for flu remedies.

    However, Xi’an’s emergency response plan will not necessarily be used. Rather, it outlines how the city of almost 13 million people would respond to any future outbreak based on four levels of severity.

    At the first and highest level, it says, “the city can lock down infected areas, carry out traffic quarantines and suspend production and business activities. Shopping malls, theaters, libraries, museums, tourist attractions and other crowded places will also be closed.”

    “At this emergency level, schools and nurseries at all levels would be shut down and be made responsible for tracking students’ and infants’ health conditions.”

    The backlash comes as the central government in Beijing has emphasized the need to open the country back up following the removal of all Covid restrictions in January.

    Throughout the pandemic, China had enforced some of the world’s most severe Covid restrictions, including lockdowns that stretched into months in some cities. It was also one of the last countries in the world to end measures such as mass testing and strict border quarantine periods, even amid growing evidence of the damage being done to its economy.

    Xi’an itself was subject to a draconian lockdown between December 2021 and January 2022, with 13 million residents confined to their homes for weeks on end – and many left short of food and other essential supplies. Access to medical services was also affected. In an incident that shocked and angered the nation, a heavily pregnant woman was turned away from a hospital on New Year’s Day because she didn’t have a valid Covid-19 test, and suffered a miscarriage after she was finally admitted two hours later.

    Residents take nucleic acid tests in a closed community in Xi'an in January 2022.

    Shortly before China removed its pandemic era restrictions the country had been rocked by a series of demonstrations against its zero-Covid policy.

    Memories of being confined to their homes and of panic buying that in some areas led to food shortages remain fresh in people’s minds and the idea of a return to Covid-style measures appears to have hit a nerve.

    However, some voices called for calm.

    Epidemiologist Ben Cowling, from the University of Hong Kong’s School of Public Health, said he saw the rationale of the move.

    “I think it’s quite rational to make contingency plans. I wouldn’t expect a lockdown to be needed for flu, but presumably there are different response levels,” he said.

    One user on Weibo expressed a similar sentiment: “It is merely the revelation of a proposal, not putting it in place. It is quite normal to take precautions given this wave of flu is coming at us very strong.”

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  • Mental health startup exposes the personal data of more than 3 million people | CNN Politics

    Mental health startup exposes the personal data of more than 3 million people | CNN Politics

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    Washington
    CNN
     — 

    A mental health startup exposed the personal data of as many as 3.1 million people online. In some cases, possibly sensitive information on mental health treatment was leaked, according to a company statement and a Department of Health and Human services filing.

    Cerebral, a California-based firm that connects people suffering from anxiety and depression with mental health professionals via video calls, said it discovered the “inadvertent” data exposure more than three years after it started using “pixels” – a common method that companies and advertisers use to track user behavior for marketing purposes.

    The company determined in January that tracking pixels had been sharing client and user data to “third-party platforms” and “subcontractors” that it didn’t name, according to a privacy notice near the bottom of its website.

    Cerebral said it was unaware of any misuse of the protected health information that was disclosed. But privacy advocates have for years warned that such data troves can be used to aggressively market products at consumers and infringe on their privacy.

    Some of the data potentially exposed in the Cerebral breach includes answers to online “self-assessments” about mental health that Cerebral asks prospective clients to fill out. That can include questions on whether someone is experiencing panic attacks, abusing alcohol or has a personality disorder, CNN’s review of the online assessments found.

    Cerebral said in a statement to CNN on Friday that it was “committed to correcting historical errors and leading the industry in privacy standards moving forward.”

    Cerebral notified the Department of Health and Human Services (HHS), which said in a filing this month that the breach affects over 3.1 million users. The department investigates potential violations of the Health Insurance Portability and Accountability Act (HIPAA), a law that requires medical providers to safeguard patient data.

    Rachel Seeger, a spokesperson for the HHS Office for Civil Rights, said the office typically “does not comment on open or potential investigations.”

    Cerebral said in its public statement that it had disabled the tracking pixels on its platforms and stopped sharing data with subcontractors “not able to meet all HIPAA [Health Insurance Portability and Accountability Act] requirements.”

    “It is important to note that Cerebral never impermissibly transmitted clinician generated notes or clinician communications,” the company told CNN.

    Cerebral spokesperson Chris Savarese did not respond to emailed questions about which and how many platforms and contractors to which the company disclosed the client health information.

    Some analysts argue that the broader market for data tracking tools is out of control. A group of conservative Catholics has spent millions of dollars to buy mobile data that identified priests who used gay dating and hookup apps, the Washington Post reported this week.

    Andrea Downing, who has done extensive research on pixel tracking and privacy, said patients are often unaware of how much personal data health care startups collect and potentially transmit to other parties.

    “What is in the fine print or the details of how data is being shared for advertising is not apparent to us when we’re going through the trauma of a diagnosis and seeking knowledge,” said Downing, who is co-founder of Light Collective, a digital rights nonprofit.

    “The only thing that is incentivizing change right now is the threat of liability,” Downing told CNN.

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  • Opinion: I was diagnosed with colon cancer at a young age. We’re seeing a lot more cases like mine | CNN

    Opinion: I was diagnosed with colon cancer at a young age. We’re seeing a lot more cases like mine | CNN

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    Editor’s Note: Sara Stewart is a film and culture writer who lives in western Pennsylvania. The views expressed here are solely the author’s own. View more opinion articles on CNN.



    CNN
     — 

    If I could pick one refrain I heard the most from doctors and nurses during my months of treatment for colon cancer in 2018, it’d be this: “You’re so young!” Often, they would follow this up by telling me they were seeing more and more people my age, and younger, being similarly diagnosed. Their distress has been confirmed in a new report released last week, at the start of Colorectal Cancer Awareness Month.

    “(T)he proportion of colorectal cancer cases among adults younger than 55 increased from 11% in 1995 to 20% in 2019. There also appears to be an overall shift to more diagnoses of advanced stages of cancer. In 2019, 60% of all new colorectal cases among all ages were advanced,” CNN noted from the report.

    I was 45 the year I received my shocking diagnosis: stage-3 colon cancer. It was just a few months after the American Cancer Society changed its recommendation for the age at which people should get routine colonoscopies, revising it downward from age 50 to, wouldn’t you know it, 45.

    Because I’m a relentlessly inquisitive patient — sometimes to the annoyance of my doctors — I would always ask their thoughts on the reason for this trend of younger colorectal cancer diagnoses. And always the answer would be the same: some variation of “well, it’s hard to say.”

    While I recognize medical professionals find it difficult to speculate, and might be in legal jeopardy if they do, I also find it infuriating that there isn’t more open discussion about the link between industrially-produced toxins and colorectal cancer. The National Cancer Institute reported in 2020 on scientists “examining factors in the environment as potential causes of early-onset colorectal cancer. Such factors include things like air and water pollution, chemicals in soil and food, and pesticide use.”

    A Spanish study concluded that same year that “residing in the proximity of industries may be a risk factor for colorectal cancer.” But there have been scant studies since then focusing on connecting colorectal cancer and environmental toxins. Considering it’s the fourth most commonly-diagnosed cancer in this country and the second leading cause of cancer deaths, it stands to reason there ought to be substantially more studies dedicated exclusively to it.

    There is a tendency, when one experiences the terror of a potentially fatal disease, to want to deal with it and then, if you’re very lucky, put it behind you. But as the years go on in the wake of my treatment — I’ll be at my five-year mark of no evidence of disease this summer — I find myself increasingly frustrated with a lack of systematic investigation of possible environmental causes.

    In the category of “risk factors” for younger colorectal cancer patients, there are a few regular culprits, grouped under “lifestyle”: certain diets, lack of exercise, excessive weight. For what it’s worth: I am a healthy eater, a thin person and a fitness fanatic with no genetic conditions that would favor colorectal cancer. I’m not arguing that these conditions aren’t contributors, but given the scope of the increase in diagnoses, it seems worth considering that something else could be at play.

    A couple of recently-interviewed experts seem to agree. Dr. Kimmie Ng, director of the Young-Onset Colorectal Cancer Center at the Dana Farber Cancer Institute, told NBC News that “it isn’t just diet and lifestyle, there is something else. We see so many young patients with colorectal cancer who follow very healthy lifestyles and diets.” And Dr. Folasade P. May, an associate professor of medicine in the University of California, Los Angeles Vatche and Tamar Manoukian Division of Digestive Diseases, says that “when something is affecting people who have their birth years in common, then we know it’s something in the environment that has led this whole group of people to have higher rates.”

    Yes! Finally!

    There are an alarming number of reports linking cases of cancer, including colon cancer, to environmental toxins. Industrial toxins and heightened colon cancer rates (often, among other cancers) have been linked in Pompton Lakes, New Jersey; Merrimack, New Hampshire; Satellite Beach, Florida; Akron, Ohio; a school near Ground Zero; Rikers Island, a jail in New York; Juliette, Georgia; and Peterborough, Ontario – the latter being the former site of a General Electric plant.

    Of course, as the Satellite Beach story acknowledges, “The complex interplay of genes and infectious and chemical agents obscure cancer’s many causes. Relatively small numbers of cases to work with, limited available data on occupational risks, lifestyle and demographic factors also complicate cluster investigations.” I’m aware that it’s rare for cancer cluster investigations to find an increase in cancer rates because cancer is so common, and it’s rarer still to find a clear cause for the cancer.

    But I don’t think anyone could reasonably argue there isn’t a large-scale problem with carcinogens in our environment. We are at a global tipping point where, as The Guardian reported last year, “the cocktail of chemical pollution that pervades the planet now threatens the stability of global ecosystems upon which humanity depends.” A study released just last month found that “at least 330 species are contaminated with cancer-causing ‘forever chemicals.’” Those chemicals, known as PFAS and present in widely-used items such as nonstick pans and firefighting foam, are only just now under consideration by the Environmental Protection Agency (EPA) to restrict their presence in drinking water in this country.

    The sheer scale of the problem seems completely overwhelming. So we need to do the things that are within our power, prevention-wise: making healthy choices and being more open in talking to doctors about worrying symptoms, even if it’s embarrassing (it is). Colonoscopies should be available, maybe even recommended, for people in their 30s and early 40s. Perhaps even in their 20s.

    For prevention on an environmental level, I’d like to suggest a model I found here in western Pennsylvania, when I wrote about a tiny town called Grant Township. The people here were fighting an oil and gas company’s attempt to install a fracking waste well that could potentially poison their groundwater with cancer-causing chemicals. As the residents in this coal-centric region know all too well, the only way to prevent toxic pollution is to stop it from happening in the first place. Once it’s in the ground, or air, or water, deep-pocketed companies can and will obfuscate and litigate for years while regular people get sick and die. (I’m still regularly freaked out by the sight of neon-orange streams and rivers in this part of the country, visible proof of the dangers of mine runoff.)

    Six years after my story ran, I’m thrilled Grant is still free from toxic dumping – and has garnered some major attention for its efforts. Jon Perry, a then-township supervisor in Grant, asks in a New Republic story: “Should a polluting corporation have the right to inject toxic waste, or should a community have the right to protect itself?” Their case is currently in front of the state supreme court, so we will soon know Pennsylvania’s stance. (The oil and gas company, for its part, has said in federal district court that Grant’s pushback “is deliberate, arbitrary, and irrational, exceeds the limits of governmental authority, amounts to an abuse of official power, and shocks the conscience.”)

    As we watch colorectal cancer numbers ticking disturbingly upward in the young, maybe it’s time to start asking that kind of question more often and more loudly. Is it easy? No. Is it worth it? Ask anyone who’s survived the hell of chemotherapy, and you’ll have your answer.

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  • The US economy added 311,000 jobs in February, outpacing expectations | CNN Business

    The US economy added 311,000 jobs in February, outpacing expectations | CNN Business

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    Minneapolis
    CNN
     — 

    The US economy added 311,000 jobs in February, according to the latest monthly employment snapshot from the Bureau of Labor Statistics, released Friday.

    That’s a pullback from the blockbuster January jobs report, when a revised 504,000 positions were added, but shows the labor market is still emitting plenty of heat.

    The unemployment rate ticked up to 3.6% from 3.4%.

    February’s net job gains surpassed economists’ estimates for a more modest month, with only 205,000 to be added. Separately, downward revisions to December’s and January’s totals weren’t that drastic.

    While Friday’s report is a strong one, that’s actually bad news in the broader context of the Federal Reserve’s campaign to curb high inflation, said PNC Financial Services chief economist Gus Faucher.

    “It’s much hotter than the economy can run, and so this means the Fed is going to have to continue to hike interest rates,” he told CNN. “And that makes a recession more likely.”

    Barring a surprisingly low Consumer Price Index inflation report next week, Faucher said he expects the Fed to go forward with a half-point rate hike at its March 21-22 meeting, which would be a higher pace than the recent, more moderate quarter-point increase.

    The Fed has been battling for almost a year to slow the economy and crush the highest inflation in 40 years, but the labor market continues to defy those efforts.

    “Coming up on the one-year anniversary of the Fed’s first rate hike, we never thought we would see the economy churning out 311,000 more jobs this month,” said Chris Rupkey, chief economist of FwdBonds, in a statement. “The party is on and the labor market is having a blast. The economy clearly is not landing, it is soaring.”

    The monthly job gains remain well above pre-pandemic norms, when roughly 180,000 jobs were added per month between 2010 and 2019, BLS data shows. However, the labor market remains tight and imbalances continue to persist in the ongoing recovery efforts from the devastating pandemic.

    Labor turnover data released earlier this week for January showed that there were 1.9 job openings for every person looking for one. Fed Chair Jerome Powell has frequently highlighted how the labor market remains short of pre-pandemic growth projections by more than 3 million people.

    The pandemic accelerated expected demographic trends (the aging out of the massive Baby Boom generation) with increased retirements; people also dropped out of the workforce for care-related needs and health concerns such as long Covid; and there were hundreds of thousands of workers who died from Covid.

    February’s employment report showed a 0.1 percentage point increase in the labor force participation rate to 62.5% — the highest its been since April 2020. However, it remains below pre-pandemic levels of 63.4%.

    Additionally, there was some upward movement in the jobless rate, which increased 0.2 percentage points to 3.6%.

    “Contributing to upward pressure here, there were more people looking for work,”said Mark Hamrick, senior economic analyst at Bankrate.

    Industries with notable job gains included leisure and hospitality, retail trade, government and health care. After being crushed during the pandemic, the leisure and hospitality has been steadily adding back employees and trying to meet increased demand from consumers shifting their spending from goods to services.

    Average hourly earnings — a closely watched metric as the Fed seeks to evaluate the impact of rising wages on inflation — grew 0.2% month-on-month and were up 4.6% over the year before.

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  • McConnell treated for concussion after suffering fall at DC hotel | CNN Politics

    McConnell treated for concussion after suffering fall at DC hotel | CNN Politics

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    CNN
     — 

    Senate Minority Leader Mitch McConnell is being treated for a concussion and is staying at a hospital for observation after a fall at a hotel in Washington, DC, on Wednesday evening.

    “Leader McConnell tripped at a dinner event Wednesday evening and has been admitted to the hospital and is being treated for a concussion. He is expected to remain in the hospital for a few days of observation and treatment,” David Popp, communications director for McConnell, said in a statement released Thursday afternoon.

    “The Leader is grateful to the medical professionals for their care and to his colleagues for their warm wishes,” the statement said.

    The fall happened at the Waldorf Astoria hotel in Washington, DC, which was formerly the Trump International Hotel, according to a source familiar with the matter.

    McConnell was attending an event for the Senate Leadership Fund, a McConnell-aligned super PAC, another source familiar with the matter said.

    The 81-year-old is the Senate’s longest-serving GOP leader, known for helping the party achieve key Republican priorities, including stocking the Supreme Court with conservative justices, passing Trump-era tax cuts and frequently thwarting Democrats’ legislative agenda.

    His hospitalization this week comes as the Senate is narrowly divided, with Democrats controlling the chamber by a 51-49 margin.

    Democratic Sens. John Fetterman of Pennsylvania and Dianne Feinstein of California have also been hospitalized in recent weeks, with Fetterman seeking treatment for depression and Feinstein for shingles.

    Lawmakers from both sides of the aisle have publicly sent McConnell well wishes.

    Senate Majority Leader Chuck Schumer opened his floor remarks on Thursday by wishing McConnell a “speedy and full recovery” and noted that he called McConnell Thursday morning and spoke briefly with his staff.

    House Minority Leader Hakeem Jeffries said he and his fellow House Democrats were praying for a “swift and a full and a speedy recovery,” a sentiment echoed by Senate Minority Whip John Thune, the second-ranking Republican in the Senate.

    The minority leader previously fell at his Kentucky home in 2019, fracturing his shoulder.

    This story and headline have been updated with additional information.

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  • Michigan Senate votes to repeal 1931 abortion ban | CNN Politics

    Michigan Senate votes to repeal 1931 abortion ban | CNN Politics

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    CNN
     — 

    The Michigan state Senate on Wednesday voted to repeal the state’s 1931 abortion ban as well as its sentencing guidelines.

    The bills were passed 20-18, along party lines in the Democratic-controlled Senate after passing the House last week and were sent to Democratic Gov. Gretchen Whitmer for her signature. Democrats control the governor’s office and the state legislature for the first time in four decades.

    Whitmer has been a vocal supporter of abortion rights, using the issue as a driving force in her 2022 reelection campaign. The governor filed a lawsuit against several county prosecutors in her state last year in an attempt to prevent the 1931 ban from taking effect after the US Supreme Court overturned Roe v. Wade.

    The Michigan law, which was invalidated by the 1973 high court decision but remained on the state’s books, prohibits abortions even in cases of rape or incest, except to preserve the woman’s life.

    Michigan state Senate Majority Leader Winnie Brinks previously told CNN one of the first priorities of the new legislature would be to repeal the ban that was put back in play after the Supreme Court’s ruling last summer.

    In September, a state court declared the abortion ban unconstitutional and blocked it from being enforced, allowing abortion to remain legal in the state.

    Michigan voters enshrined abortion rights in the state constitution during the midterms, a move that was intended to help block the ban from taking effect.

    But reproductive rights advocates see the bills’ passage through the legislature as “major step forward.”

    “This is proof positive that elections matter,” Mini Timmaraju, president of NARAL Pro-Choice America, said in a statement. “Michiganders made clear in the midterms that they overwhelmingly support reproductive freedom, and repealing this oppressive pre-Roe ban sends an unmistakable signal that Michigan will always fight for abortion access.”

    Democratic state senators celebrated the bills’ passage in the legislature Wednesday.

    “My abortion was necessary to save my life,” state Sen. Rosemary Bayer said on Twitter. “I’m glad I’m here today because of that, and to be able to vote on this bill and ensure this life-saving healthcare is protected and kept safe and legal here in Michigan.”

    Republicans in the Michigan state Senate, however, oppose the new effort and have described it as “dangerous.”

    “While Senate Republicans have introduced legislation to strengthen safeguards for women, Senate Democrats are rushing dangerous bills to repeal long-standing protections for women and the unborn,” GOP state Sen. Joseph Bellino said in a statement.

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