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  • 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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  • 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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  • 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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  • Texas sued by women who say state’s abortion bans put their health at risk | CNN Politics

    Texas sued by women who say state’s abortion bans put their health at risk | CNN Politics

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    CNN
     — 

    Several women who say Texas’ abortion bans posed significant risks to their health have sued the state this week, opening a new front in the legal battles that have emerged since the Supreme Court overturned national abortion rights protections last year.

    Five women allege in the lawsuit that uncertainty around when medical emergency exemptions in Texas’ abortion laws apply exacerbated medical emergencies that put their lives, health and fertility in danger.

    “To the extent Texas’s abortion bans bar the provision of abortion to pregnant people to treat medical conditions that pose a risk to the pregnant person’s life or a significant risk to their health,” the lawsuit says, “the Bans violate pregnant people’s” rights under the state constitution’s provisions protecting fundamental rights and the right to equality.

    The lawsuit is not seeking to block Texas’ abortion bans outright. Rather, the women – who are joined by two medical providers in the lawsuit – ask the court to clarify that abortions can be performed when a physician makes a “good faith judgment” that “the pregnant person has a physical emergent medical condition that poses a risk of death or a risk to their health (including their fertility).”

    The women’s complaint details harrowing stories of being denied abortion care when they faced emergency complications in their pregnancies, which were all wanted. They filed the lawsuit in state court in Austin, Texas.

    Texas, its Attorney General Ken Paxton, the Texas Medical Board and its Executive Director Stephen Brint Carlton are listed as defendants in the lawsuit. Neither Paxton’s office nor a spokesperson for the state medical board responded to a request for comment from CNN. Gov. Greg Abbott’s office also did not immediately respond to CNN’s inquiry.

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  • Elite athletes with genetic heart disease can safely return to play with diagnosis and treatment, early study suggests | CNN

    Elite athletes with genetic heart disease can safely return to play with diagnosis and treatment, early study suggests | CNN

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    CNN
     — 

    In a new study, most elite athletes with a diagnosed genetic heart disease did not experience serious or fatal symptoms of their condition, such as sudden cardiac death. The research suggests it can be “feasible” and “safe” for athletes to continue to participate in their sport.

    Among a sample of 76 elite athletes with a genetic heart disease who had competed or are still competing in either Division I university or professional sports, 73 out of the 76 did not experience a cardiac event triggered by their disease during the study period, according to researchers behind a late-breaking clinical trial presented Monday at the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology.

    Among those elite athletes with a genetic heart disease, 40 of them – 52% – were asymptomatic, the study abstract finds.

    Over the years, researchers have become more aware of alarming reports about elite athletes experiencing heart problems, or even suddenly collapsing during games.

    “For athletes with genetic heart conditions, and I would add non-athletes, the tragedies occur when we don’t know of their condition,” said Dr. Michael Ackerman, a genetic cardiologist at Mayo Clinic in Rochester, Minnesota, who was a senior author of the new research. “When we know of their condition, and we assess the risk carefully and we treat it well, these athletes and non-athletes, they can expect to live and thrive despite their condition.”

    The new research has not yet been published in a peer-reviewed journal, but the findings suggest that many athletes with a genetic heart disease can decide with their health care professionals on whether to continue competing in their sport and how to do so safely, instead of being automatically disqualified due to their health conditions.

    “In sports, historically, we’ve been paternalistic and de-emphasize patient preference and risk tolerance, but we know that athletes come from all walks of life. They are intelligent and when there’s scientific uncertainty, their values should be incorporated in medical decision-making,” Dr. J. Sawalla Guseh, cardiologist at Massachusetts General Hospital, who was not involved in the new study, said during Monday’s scientific session.

    “Shared decision-making when done well can have very favorable outcomes,” he said.

    Elite basketball, hockey, soccer and football players, were among the 76 athletes included in the new study, conducted by researchers at Mayo Clinic and other institutions in the United States. They wrote in their study abstract that this is the first study to their knowledge describing the experience of athletes competing at the NCAA Division I level or in professional sports with a known genetic heart disease that puts them at risk of sudden cardiac death.

    The athletes in the study were cleared for return-to-play at either a NCAA Division I school or at the professional level. They were studied over an average of seven years, and all had been diagnosed with a genetic heart disease in the past 20 years, being treated at either Mayo Clinic, Morristown Medical Center, Massachusetts General Hospital or Atrium Health Sports Cardiology Center.

    “Only three of them had a breakthrough cardiac event, which means after they were diagnosed and treated, they were still having an event,” said Katherine Martinez, an undergraduate student at Loyola University in Baltimore, who helped conduct the research as an intern in the Mayo Clinic’s Windland Smith Rice Sudden Death Genomics Laboratory.

    Fainting was the most common event, and one athlete received a shock with an implantable cardioverter defibrillator, or ICD. None of the athletes died.

    “The majority of these athletes went on to continue their career with no events at all,” Martinez said. But most of the athletes in the study – 55 of them, or 72% – were initially disqualified from competing by their primary provider or institution after their diagnosis. Most ultimately opted to return to play with no restrictions after undergoing comprehensive clinical evaluations and talking with their doctors.

    While each sports league has its own set of rules, historically, some people diagnosed with a genetic heart disease that puts them at an increased risk for sudden cardiac death have been restricted from competitive sports, the researchers wrote in their study abstract.

    “Just because you were given this diagnosis, doesn’t mean that your life, your career, the future that you see for yourself is over, but taking a second opinion from an expert who knows what they’re doing and is comfortable with shared decision-making is the next step,” said Martinez, who worked on the new research alongside her father, Dr. Matthew Martinez, director of Atlantic Health System Sports Cardiology at Morristown Medical Center and an author of the new research.

    Regarding the new study, “the take-home message is, if you have one of these findings, seek out an expert who’s going to help you identify a safe exercise plan for you and determine what level you can continue to safely participate in,” he said. “This is the next best step – the next evolution – of how we manage athletes with genetic heart disease.”

    Leaving their sport due to a genetic heart disease can be “very destructive” for athletes who have devoted their lives to excelling in competitions, said Dr. Lior Jankelson, director of the Inherited Arrhythmia Program at NYU Langone Heart in New York, who was not involved in the new research.

    Yet he added that these athletes still need to consult with their doctors and be watched closely because some genetic diseases could be more likely to cause a serious cardiac event than others.

    The new study highlights that “the majority of athletes with genetic heart disease could probably – after careful, meticulous expert risk-stratification and care strategy – participate in sports,” Jankelson said. “But at the same time, this is exactly the reason why these patients should be cared only in high-expertise genetic cardiology clinics, because there are other conditions that are genetic, that could respond very adversely to sports, and have a much higher risk profile of developing an arrhythmia during intense activity.”

    Separately, the NCAA Sports Science Institute notes on its website, “Though many student-athletes with heart conditions can live active lives and not experience health-related problems, sudden fatality from a heart condition remains the leading medical cause of death in college athletes.”

    For athletes with a genetic heart disease, their symptoms and their family history of cardiac events should be considered when determining their risks, said Dr. Jayne Morgan, a cardiologist with Piedmont Healthcare in Atlanta, who was not involved in the new research.

    “Certainly, there is concern with elite athletes competing and whether or not they are being screened appropriately,” Morgan said. But she added that the new research offers “some understanding” to the mental health implications for athletes with a genetic heart disease who may be required to step away from a competitive sport that they love.

    “This study, I think, begins to go a long way in identifying that we may not need to pull the trigger so quickly and have athletes step away from something that they love,” Morgan said.

    The new study is “timely” given the recent national attention on athletes and their risk of sudden cardiac death, Dr. Deepak Bhatt, director of Mount Sinai Heart in New York City, who was not involved in the research, said in an email.

    “These are some of the best data showing that the risk of return to play may not be as high as we fear,” Bhatt said about the new research.

    “Some caveats include that the majority of these athletes were not symptomatic and about a third had an implantable defibrillator,” he added. “Any decision to return to the athletic field should be made after a careful discussion of the potential risks, including ones that are hard to quantify. Input from experts in genetic cardiology and sports cardiology can be very helpful in these cases.”

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  • Bempedoic acid improved heart health in patients who can’t tolerate statins, study finds | CNN

    Bempedoic acid improved heart health in patients who can’t tolerate statins, study finds | CNN

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    CNN
     — 

    Bempedoic acid may be an alternative for people who need to lower their cholesterol but can’t or won’t take statins, according to a large study published Saturday in the New England Journal of Medicine.

    Statins are the most commonly prescribed cholesterol-lowering drugs that help lower what’s known as the “bad” cholesterol, or low-density lipoprotein (LDL) cholesterol in the blood; more than 90% of adults who take a cholesterol-lowering medicine use a statin, according to the US Centers for Disease Control and Prevention.

    Statins are considered safe and effective, but there are millions of people who cannot or will not take them. For some people it causes intense muscle pain. Past research has shown anywhere between 7% and 29% of patients who need to lower cholesterol do not tolerate statins, according Dr. Steven Nissen, a cardiologist and researcher at the Cleveland Clinic and co-author of the new study.

    “I see heart patients that come in with terrible histories, multiple myocardial infarction, sometimes bypass surgery, many stents and they say, ‘Doctor, I’ve tried multiple statins, but whenever I take a statin, my muscles hurt, or they’re weak. I can’t walk upstairs. I just can’t tolerate these drugs,’ ” Nissen said. “We do need alternatives for these patients.”

    Doctors have a few options, including ezetimibe and a monoclonal antibody called a proprotein convertase subtilisin/kexin type 9, or PCSK9 inhibitors for short.

    Bempedoic acid, sold under the name Nexletol, was designed specifically to treat statin-intolerant patients. The FDA approved it for this purpose in 2020, but the effects of the drug on heart health had not been fully assessed until this large trial. The new study was funded in part by Esperion Therapeutics, the maker of Nexletol.

    For the study, which was presented Saturday at the American College of Cardiology’s Annual Scientific Session with the World Congress of Cardiology, Nissen and his colleagues enrolled 13,970 patients from 32 countries.

    All of the patients were statin intolerant, typically due to musculoskeletal adverse effects. Patients had to sign an agreement that they couldn’t tolerate statins “even though I know they would reduce my risk of a heart attack or stroke or death,” and providers signed a similar statement.

    The patients were then randomized into two groups. One was treated with bempedoic acid, the other was given a placebo, which does nothing. Researchers then followed up with those patients for up to nearly five years. The number of men and women in the trial were mostly evenly divided, and most participants, some 91%, were White, and 17% were Hispanic or Latino.

    The drug works in a similar way that statins do, by drawing cholesterol out of a waxy substance called plaque that can build up in the walls of the arteries and interfere with the blood flow to the heart. If there is too much plaque buildup, it can lead to a heart attack or stroke.

    But bempedoic acid is only activated in the liver, unlike a statin, so it is unlikely to cause muscle aches, Nissen said.

    In the trial, investigators found that bempedoic acid was well-tolerated and the percent reduction in the “bad” cholesterol was greater with bempedoic acid than placebo by 21.7%.

    The risk of cardiovascular events – including death, stroke, heart attack and coronary revascularization, a procedure or surgery to improve blood flow to the heart – was 13% lower with bempedoic acid than with placebo over a median of 3.4 years.

    “The drug worked in primary and secondary prevention patients – that is, patients that had had event and patients who were very high risk for a first event. There were a lot of diabetics. These were very high risk people,” Nissen said. “So the drug met its expectations and probably did a lot better than a lot of people thought it would do.”

    In the group that took bempedoic acid, there were a few more cases of gout and gallstones, compared with people who took a placebo.

    “The number is small, and weighing that against a heart attack, I think most people would say, ‘OK I’d rather have a little gout attack,’ ” Nissen said.

    Bempedoic acid had no observed effect on mortality, but that may be because the observation period was too short to tell if it had that kind of impact. Earlier trials on statins showed the same; it was only after there were multiple studies on statins that scientists were able to show an impact on mortality.

    Dr. Howard Weintraub, a cardiologist at NYU Langone Health who did not work on this study, said that while he knows some people will not consider a medication successful unless it reduces mortality, he thinks that is short-sighted.

    “I think there’s more to doing medicine then counting body bags,” Weintraub said.”Preventing things that can be life changing, crippling, and certainly change your quality of life forever going forward, and your cost of doing things going forward, I think is a good thing.”

    He was pleased to see the results of this trial, especially since the people in this study are often what he called “forgotten individuals” – the millions who could benefit from lowering their cholesterol, but can’t take statins.

    “It’s not like their LDL was 180 or 190 or 230, their LDL was 139. This is about average in our country,” Weintraub said. He said often doctors will just tell those patients to watch their diet, but he thinks this suggests they would benefit from medication.

    “Both groups primary and secondary prevention got benefit, which I think is impressive with the modest amount of LDL reduction,” Weintraub said.

    There are some limitations to this trial. It was narrowly focused on patients with a known statin intolerance. Nissen said the trial was not designed to determine whether bempedoic acid could be an alternative to statins.

    “Statins are the gold standard. They are the cornerstone. The purpose of this study was not to replace statins, but to allow an alternative therapy for people who simply cannot take them,” Nissen said.

    Bempedoic acid is a much more expensive drug than a statin. There are generic versions of statins and some cost only a few dollars. Bempedoic acid, on the other hand, has no generic alternative and a 30-day supply can cost more than $400, according to GoodRx.

    “I think what insurance companies need to recognize that even though this drug is going to cost more than statins, having a heart attack or a stroke or needing a stent is expensive. A 23% reduction in (myocardial infarctions) is a considerable reduction,” Weintraub said.

    In an editorial in the New England Journal of Medicine that accompanied the study, Dr. John H. Alexander, who works in the division of cardiology at Duke Clinical Research Institute, Duke Health, Durham said that doctors should take these results into consideration when treating patients with high cholesterol who can’t take statins.

    “The benefits of bempedoic acid are now clearer, and it is now our responsibility to translate this information into better primary and secondary prevention for more at-risk patients, who will, as a result, benefit from fewer cardiovascular events,” Alexander wrote.

    Dr. Manesh Patel, a cardiologist and volunteer with the American Heart Association who was not a part of the study, said that providers are already prescribing bempedoic acid for some patients, but with this new research, he thinks they will quickly be used with more statin-intolerant patients.

    “We continue to see that if we can lower your LDL significantly, we improve people’s cardiovascular health. And so we need as many different arrows in our quiver to try to get that done,” Patel said.

    Heart disease is the No. 1 killer for men and women in the world. One person dies every 34 seconds in the US from cardiovascular disease, according to the CDC. About 697,000 people in the US died from heart disease in 2020 alone – about the same number as the population of Oklahoma City.

    “Given the number of people that are eligible for statins, which are tens of millions of patients already, the number of people who cannot tolerate statins is in the millions,” Nissen said. “This is a big public health problem and I think we’ve come up with something that directly addresses this.”

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  • Person in Florida dies after brain-eating amoeba infection, possibly due to sinus rinse with tap water, health officials warn | CNN

    Person in Florida dies after brain-eating amoeba infection, possibly due to sinus rinse with tap water, health officials warn | CNN

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    CNN
     — 

    A person in Charlotte County, Florida, has died after being infected with the rare brain-eating amoeba Naegleria fowleri.

    The infection possibly resulted from “sinus rinse practices utilizing tap water,” according to a news release from the Florida Department of Health in Charlotte County. The release was issued in February to alert the public about the infection.

    On Thursday, the department confirmed that the infected person has died and officials are continuing to investigate the case.

    “An Epidemiological investigation is being conducted to understand the unique circumstances of this infection. I can confirm the infection unfortunately resulted in a death, and any additional information on this case is confidential to protect patient privacy,” Jae Williams, press secretary for the Florida Department of Health, said in an emailed statement.

    Infection with Naegleria fowleri “can only happen when water contaminated with amoebae enters the body through the nose,” according to the department’s news release.

    The Florida Department of Health in Charlotte County warned residents to only use distilled or sterile water when making sinus rinse solutions. Tap water should be boiled for at least a minute and cooled before using it for sinus rinsing, which typically involves a neti pot.

    Tap water that has not been sterilized isn’t safe to use as a nasal rinse since it’s not adequately filtered or treated, and so it may contain low levels of microorganisms, such as bacteria and protozoa, including amoebas, according to the US Food and Drug Administration’s website. Yet people cannot be infected by drinking tap water, as stomach acid typically kills those organisms.

    Naegleria fowleri is an amoeba, a single-celled living organism, that can be found in soil and warm freshwater, such as lakes, rivers, and hot springs throughout the United States. Commonly called the “brain-eating amoeba,” it can cause brain infections, which typically happens when amoeba-containing water travels up through the nose, such as while swimming.

    According to the US Centers for Disease Control and Prevention, about three people in the United States get infected each year, and these infections are usually deadly.

    From 1962 to 2021, only four out of 154 people in the United States survived a brain-eating amoeba infection, according to the CDC. Just last year, a boy died who was infected after swimming at Lake Mead, another child in Nebraska died who was infected after swimming, and a Missouri resident died with the infection after visiting a beach in Iowa.

    Signs and symptoms of infection are initially severe headaches, fever, nausea and vomiting and they can progress to a stiff neck, seizures, hallucinations, and coma. The infection is treated with a combination of drugs, including the antibiotic azithromycin, the antifungal fluconazole, the antimicrobial drug miltefosine and the corticosteroid dexamethasone.

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  • NFL star Aaron Rodgers went to a darkness retreat to contemplate his future. What is that and how does it work? | CNN

    NFL star Aaron Rodgers went to a darkness retreat to contemplate his future. What is that and how does it work? | CNN

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    CNN
     — 

    For four days this week, home for Green Bay Packers quarterback Aaron Rodgers was a pitch-black room. There were no phones, no television, no lights or distractions. Just Rodgers, alone with his thoughts, in a cabin built specifically for prolonged isolation in the dark.

    When the four-time NFL MVP announced plans earlier this month to contemplate his NFL future in isolation at a “darkness retreat,” many were left scratching their heads.

    “It’s just sitting in isolation, meditation, dealing with your thoughts,” Rodgers said earlier this month. “We rarely even turn our phone off or put the blinds down to sleep in darkness. I’m really looking forward to it.”

    Rodgers is no stranger to alternative therapies. He credits psychedelics like psilocybin and ayahuasca for helping to alleviate his fear of death and deepening a sense of self-love. The football star said he has done “many meditation and yoga retreats” in the past and defended his decision to try darkness therapy as one of several practices “that have stimulated my mind and helped me get in a better headspace and have a greater peace in my life.”

    But what exactly happens in a darkness retreat? And is it just another new-age fad or perhaps something that could benefit the rest of us?

    A darkness retreat is exactly what it sounds like: a prolonged stay in a space completely devoid of light. One of the centers offering the practice is Sky Cave Retreats, nestled in the Cascade-Siskiyou wilderness, in Southern Oregon, near Klamath Falls.

    “The reasons for doing this range from people wanting to know themselves more, to people who want to rest, reset and relax, to those who want to explore consciousness and deepen their meditation practice,” said Scott Berman, who owns Sky Cave Retreats along with his wife Jill, adding the darkness helps illuminate what really matters by stripping away the constant bombardment of sensory input and stimulation many people experience in their hectic modern lives.

    “When someone goes into the darkness, all these things that were important to them like money, fame, power, status, being worthy – they all become insignificant and meaningless in the dark,” Berman said. “In the dark, all you have is the present moment which reveals what is truly meaningful – whether it’s love, forgiveness, peace – and it begins to transform you as you truly authentically touch what is most important to you.”

    The center currently operates three stand-alone cabins built specifically for prolonged isolation in the dark – earth-sheltered caves, which on the outside are somewhat reminiscent of a Hobbit home. Each space contains a bed, a toilet, sink and a bathtub, as well as a low table for eating and a carpeted area for yoga and meditation. Participants can leave at any time – the doors are never locked – and there is a light switch for emergencies which is protected by a childproof guard so it isn’t flipped on by accident.

    The cost includes three meals a day, which Berman delivers personally all at once in the evening (through a lightproof double-sided food box) to minimize the disturbance. This is when participants have an opportunity for a conversation, which could be 10 seconds or 30 minutes, according to Berman, depending on the person’s needs.

    Participants typically spend three to four days in the darkness at a cost of $250 a night and are encouraged to take an extra day before and after to integrate the experience.

    Each space contains a bed, a toilet, sink and a bathtub, as well as a low table for eating and a carpeted area for yoga and meditation.

    Burak Dalcik, a 27-year-old salesman from Arlington, Virginia, said the four days he spent in the dark at Sky Caves Retreats in January gave him clarity about his priorities. He found he no longer labeled experiences as positive or negative, but rather allowed them to come and to go, which led to less stress and anxiety at work and in his personal life. He also said he started calling his mom, who lives back in Turkey, more frequently.

    “It just really trims all the unnecessary fat and allows you to focus on some of the most important things and really allows you to understand who you are,” said Dalcik. “There’s nothing New Age about this – it boils down to can you just sit by yourself with yourself? And if you can’t, you should probably get pretty curious about why.”

    Berman cautions the retreat isn’t for everyone, nor should it be seen as a quick fix to one’s troubles.

    “It’s not like this magical, mind-blowing, amazing experience – it can be extremely difficult and uncomfortable,” Berman said. “But in the darkness, discomfort is the door to transformation. There’s an acceptance and a profound love that people start to experience when they’re no longer resisting that part of themselves.”

    For now, there is limited research on how darkness retreats impact the human brain and body. Some centers claim the experience can help heal traumas or activate the pineal glad, another claim is darkness therapy increases melatonin production in the brain.

    “That’s totally false,” said Dr. David Blask, the head of the Laboratory of Chrono-Neuroendocrine Oncology at Tulane University School of Medicine. “There may be some psychological benefits that people derive from a darkness retreat that they feel are important for them, but certainly not from a strict endocrine neuroendocrine or biochemical physiological standpoint.”

    Dr. Marek Malůš, a psychologist at the University of Ostrava in the Czech Republic who has been studying darkness therapies since 2010, sees the technique as a promising therapeutic tool.

    “Your thoughts, memories, emotions, inner world and mental processes become much more balanced and integrated,” Malůš said.

    While he and his colleagues are working to secure funding for additional studies, Malůš said preliminary research showed just four days in a darkness chamber was enough to help increase mindfulness and self-esteem, lower symptoms of depression and anxiety, while improving parasympathetic nervous system functions, which helps with stress management and lowering burnout symptoms. Subjects reported feeling the benefits three weeks after the experience.

    Berman said he hopes to see more scientific research into the benefits of darkness retreats, but cautions against anyone seeking to use the retreat for some sort of natural high.

    “If somebody’s coming here because they want to have a so-called DMT experience, you’ve come into the wrong place,” he said. “But there is a lot of benefit in not looking outside of ourselves for confirmation of our worth and using the darkness to illuminate our true nature.”

    For those who aren’t able to commit the time or money for a darkness retreat but want a taste of some of the benefits, Berman suggests starting small at home.

    “It’s about becoming accustomed to authentically slowing down, putting the phone away, turning out the lights, closing the blinds and just resting,” he said. “Not to get somewhere, not to heal but just to be curious about what’s actually happening within yourself.”

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  • Murder of Vermont woman solved after more than 50 years using DNA found on a cigarette and the victim’s clothing | CNN

    Murder of Vermont woman solved after more than 50 years using DNA found on a cigarette and the victim’s clothing | CNN

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    CNN
     — 

    More than 50 years after Rita Curran’s roommate found her strangled to death in her room, police in Vermont say they have identified the killer using DNA found on a cigarette butt and Curran’s clothing.

    Investigators identified William DeRoos, a man who lived in Curran’s Burlington apartment building, as the person responsible with the help of advances in DNA technology and genetic genealogy, police in Vermont’s most populous city announced Tuesday.

    DeRoos died of a drug overdose in San Francisco in 1986, police said. The case is now closed.

    On the night of the July 1971 killing, DeRoos, who lived with his wife two floors above Curran, had a fight with his spouse and left their apartment to “cool down,” according to a Burlington police investigation report.

    Curran, 24, was later found dead, severely beaten after apparently having put up a “vicious struggle,” a detective wrote at the time. Investigators are now “unanimously certain” DeRoos was responsible, the report released Tuesday says.

    But when investigators questioned DeRoos and his wife the next morning, the couple said they had been together all night and didn’t hear or see anything. After police left, DeRoos told his wife if they were questioned again, she should not admit that he had left the apartment “or they would go after him” because he had a criminal history, police said during a news conference Tuesday.

    A break in the case finally came in 2014 when a DNA profile was extracted from a cigarette butt that had been found next to Curran’s body, Detective Lt. James Trieb said at the news conference. Though the profile was submitted to a national criminal database for DNA, he said, no matches were made. That meant the person with that DNA likely never had genetic material entered into the database, possibly because the person didn’t have a felony conviction.

    In 2019, Trieb reopened the case and decided to take a new approach.

    Instead of having a single detective work the cold case alone – the department’s usual strategy – he treated the crime as if it had just been committed, bringing in a team of detectives and expert technicians to review and discuss it, his investigation report says.

    The team began retesting evidence, Trieb said, and decided to analyze the cigarette DNA using genetic genealogy – a process that uses DNA databases for genealogy research to identify possible family members of the person whose DNA is unmatched.

    An outside genetic genealogy expert then concluded that the cigarette DNA had strong connections to relatives of DeRoos, both on the paternal and maternal sides.

    “She was certain that it was William DeRoos” who put his DNA on the cigarette, the police report says.

    cnn world rugby bryan habana dnafit rugby spc_00013322.jpg

    Why your DNA may be solving cold cases

    Investigators then found a living half-brother of DeRoos who was willing to provide a DNA sample, and that sample bolstered the conclusion that the cigarette DNA belonged to DeRoos, the report says.

    Finally, investigators found that DNA left on Curran’s ripped house coat also matched the DNA on the cigarette butt, the report reads. Investigators re-interviewed his then-wife, who admitted that she had lied about DeRoos’ alibi.

    At the news conference, acting Burlington Police Chief Jon Murad said the day was “filled with mixed emotions.”

    “Ultimately, those emotions are ones of relief, of pride for me (and) for this department, but mostly of gratitude to a family that has been through an incredible ordeal for more than half a century,” he said.

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  • Rihanna tells us she’s pregnant in the most entertaining way | CNN

    Rihanna tells us she’s pregnant in the most entertaining way | CNN

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    CNN
     — 

    Rihanna didn’t introduce a new song during her Apple Music Super Bowl LVII Halftime Show performance Sunday night but she did introduce a new pregnancy.

    The entertainer sang a medley of her biggest hits while visibly pregnant with her second child, her representative has confirmed to CNN.

    Online speculation about the pregnancy began as Rihanna opened her performance in Glendale, Arizona, on a floating stage wearing an all-red ensemble that appeared to show off a baby bump.

    Last May, Rihanna welcomed her first child with rapper A$AP Rocky.

    The singer spoke about motherhood during an interview as she prepared for her halftime show performance, saying becoming a mother made her feel like she can do anything.

    “When you become a mom, there is something that just happens where you feel like you can take on the world,” said the musical icon and entrepreneur.

    “The Super Bowl is one of the big stages in the world, so as scary as that was – because I haven’t been on stage in seven years – there’s something exhilarating about the challenge of it all,” said Rihanna, who last toured in 2016. “It’s important for me to do this this year. It’s important for representation. It’s important for my son to see that.”

    The pregnancy didn’t appear to slow Rihanna down during the performance break from the Kansas City Chiefs and Philadelphia Eagles showdown. She danced and belted out some of her best-known hits, surrounded by a crew of dancers dressed in white. She opened the show with “B**ch Better Have My Money,” before moving on to other entries on her long list of chart toppers, including, “We Found Love,” “Rude Boy,” “Work,” “Only Girl (In the World)” and “Umbrella.”

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  • YouTube star MrBeast helps 1,000 blind people see again by sponsoring cataract surgeries | CNN

    YouTube star MrBeast helps 1,000 blind people see again by sponsoring cataract surgeries | CNN

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    CNN
     — 

    YouTube superstar MrBeast is making the world clearer – for at least 1,000 people.

    The content creator’s latest stunt is paying for cataract removal for 1,000 people who were blind or near-blind but could not afford the surgery.

    “We’re curing a thousand people’s blindness,” says MrBeast – real name Jimmy Donaldson – in the Saturday video, which reached over 32 million views as of Sunday afternoon.

    The video features touching before-and-after footage of patients seeing with clear vision after finishing the surgery. The YouTuber also gave cash donations and other gifts to some of the participants.

    Jeff Levenson, an ophthalmologist and surgeon, worked with Donaldson to perform the first round of surgeries in Jacksonville, Florida. Levenson has coordinated the “Gift of Sight” program for over 20 years, which provides free cataract surgery for uninsured patients who are legally blind due to cataracts.

    “Half of all blindness in the world is people who need a 10-minute surgery,” Levenson says in the video, referring to the cataract removal surgery.

    Levenson explained to CNN he became inspired to help people access cataract surgery after undergoing his own cataract correction surgery.

    “In the days and weeks after my own cataract surgery, I was stunned by how bright and beautiful and vivid the world was,” he said. “But I was shocked by the idea that there are hundreds of millions, probably 200 million people around the world, who are blind or nearly blind from cataracts and who don’t have access to the surgery.”

    Levenson got a call from a member of Donaldson’s team in September. “I had never heard of MrBeast,” he said. “So I almost hung up. But I gratefully did not hang up.”

    They started by calling homeless shelters and free clinics to create a list of patients in the Jacksonville area who needed cataract surgery but could not afford it. Eventually, they had a group of 40 patients – and Levenson performed all of their surgeries in a single day, starting at 7 a.m. and ending at 6 p.m.

    Levenson said that patients were in “disbelief that somebody would actually seek them out to to rescue them from blindness, and then have the kindness and generosity of spirit to offer the surgery.”

    The ophthalmologist also connected Donaldson’s team with SEE International, for which he serves as the chief medical officer. The nonprofit provides free eyecare around the world to patients in need. The organization helped Donaldson reach even more patients, for a total of 1,000 surgeries completed around three weeks. The video shows patients receiving the surgery in Jamaica, Honduras, Namibia, Mexico, Indonesia, Brazil, Vietnam and Kenya.

    Levenson said he hopes the video and Donaldson’s generosity inspire “a concerted effort to end needless blindness.”

    “If MrBeast can light a fire, and if we can get governmental and private support behind it, we can end half of all the blindness in the world,” he said. “Without all that much cost, and with incredible gains in human productivity and human potential.”

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  • Why urgent care centers are popping up everywhere | CNN Business

    Why urgent care centers are popping up everywhere | CNN Business

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    New York
    CNN
     — 

    If you drive down a busy suburban strip mall or walk down a street in a major city, chances are you won’t go long without spotting a Concentra, MedExpress, CityMD or another urgent care center.

    Demand at urgent care sites surged during the Covid-19 pandemic as people searched for tests and treatments. Patient volume has jumped 60% since 2019, according to the Urgent Care Association, an industry trade group.

    That has fueled growth for new urgent care centers. A record 11,150 urgent care centers have popped up around the United States and they are growing at 7% a year, the trade group says. (This does not include clinics inside retail stores like CVS’ MinuteClinic or freestanding emergency departments.)

    Urgent care centers are designed to treat non-emergency conditions like a common cold, a sprained ankle, an ear infection, or a rash. They are recommended if patients can’t get an immediate appointment with their primary care doctor or if patients don’t have one. Primary care practices should always be the first call in these situations because they have access to patients’ records and all of their health care history, while urgent care sites are meant to provide episodic care.

    Urgent care sites are often staffed by physician assistants and nurse practitioners. Many also have doctors on site. (One urgent care industry magazine says, in 2009, 70% of its providers were physicians, but that the percentage had fallen to 16% by last year.) Urgent cares usually offer medical treatment outside of regular doctor’s office hours and a visit costs much less than a trip to the emergency room.

    Urgent care has grown rapidly because of convenience, gaps in primary care, high costs of emergency room visits, and increased investment by health systems and private-equity groups. The urgent care market will reach around $48 billion in revenue this year, a 21% increase from 2019, estimates IBISWorld.

    The growth highlights the crisis in the US primary care system. A shortage of up to 55,000 primary care physicians is expected in the next decade, according to the Association of American Medical Colleges.

    But many doctors, health care advocates and researchers raise concerns at the proliferation of urgent care sites and say there can be downsides.

    Frequent visits to urgent care sites may weaken established relationships with primary care doctors. They can also lead to more fragmented care and increase overall health care spending, research shows.

    And there are questions about the quality of care at urgent care centers and whether they adequately serve low-income communities. A 2018 study by Pew Charitable Trusts and the Centers for Disease Control and Prevention found that antibiotics are overprescribed at urgent care centers, especially for common colds, the flu and bronchitis.

    “It’s a reasonable solution for people with minor conditions that can’t wait for primary care providers,” said Vivian Ho, a health economist at Rice University. “When you need constant management of a chronic illness, you should not go there.”

    Urgent care centers have been around in the United States since the 1970s, but they were long derided as “docs in a box” and grew slowly during their early years.

    They have become more popular over the past two decades in part due to pressures on the primary care system. People’s expectations of wait times have changed and it can be difficult, and sometimes almost impossible, to book an immediate visit with a primary care provider.

    Urgent care sites are typically open for longer hours during the weekday and on weekends, making it easier to get an appointment or a walk-in visit. Around 80% of the US population is within a 10-minute drive of an urgent care center, according to the industry trade group.

    “There’s a need to keep up with society’s demand for quick turnaround, on-demand services that can’t be supported by underfunded primary care,” said Susan Kressly, a retired pediatrician and fellow at the American Academy of Pediatrics.

    Health insurers and hospitals have also become more focused on keeping people out of the emergency room. Emergency room visits are around ten times more expensive than visits to an urgent care center. During the early 2000s, hospital systems and health insurers started opening their own urgent care sites, and they have introduced strategies to deter emergency room visits.

    Additionally, passage of the Affordable Care Act in 2010 spurred an increase in urgent care providers as millions of newly insured Americans sought out health care. Private-equity and venture capital funds also poured billions into deals for urgent care centers, according to data from PitchBook.

    Urgent care centers can be attractive to investors. Unlike ERs, which are legally obligated to treat everyone, urgent care sites can essentially choose their patients and the conditions they treat. Many urgent care centers don’t accept Medicaid and can turn away uninsured patient,s unless they pay a fee.

    Like other health care options, urgent care centers make money by billing insurance companies for the cost of the visit, additional services, or the patient pays out of pocket. In 2016, the median charge for a 30-minute new insured patient visit was $242 at an urgent care center, compared with $294 in a primary care office and $109 in a retail clinic, according to a study by FAIR Health, a nonprofit that collects health insurance data.

    “If they can make it a more convenient option, there’s a lot of revenue here,” said Ateev Mehrotra, a professor of health care policy and medicine at Harvard Medical School who has researched urgent care clinics. “It’s not where the big bucks are in health care, but there’s a substantial number of patients.”

    Mehrotra research has found that between 2008 and 2015, urgent care visits increased 119%. They became the dominant venue for people seeking treatment for low-acuity conditions like acute respiratory infections, urinary tract infections, rashes, and muscle strains.

    Some doctors and researchers worry that patients with primary care doctors – and those without – are substituting urgent care visits in place of a primary care provider.

    “What you don’t want to see is people seeking a lot care outside their pediatrician and decreasing their visits to their primary care provider,” said Rebecca Burns, the urgent care medical director at the Lurie Children’s Hospital of Chicago.

    Burns’ research has found that high urgent care reliance fills a need for children with acute issues but has the potential to disrupt primary care relationships.

    The National Health Law Program, a health care advocacy group for low-income families and communities, has called for state regulations to require coordination among urgent care sites, retail clinics, primary services, and hospitals to ensure continuity of patients’ care.

    And while the presence of urgent care centers does prevent people from costly emergency department visits for low-acuity issues, Mehrotra from Harvard has found that, paradoxically, they increase health care spending on net.

    Each $1,646 visit to the ER for a low-acuity condition prevented was offset by a $6,327 increase in urgent care center costs, his research has found. This is in part because people may be going to urgent care for minor illnesses they would have previously treated with chicken soup.

    There are also concerns about the oversaturation of urgent care centers in higher-income areas that have more consumers with private health care and limited access in medically underserved areas.

    Urgent care centers selectively tend not to serve rural areas, areas with a high concentration of low-income patients, and areas with a low concentration of privately-insured patients, researchers at the University of California at San Francisco found in a 2016 study. They said this “uneven distribution may potentially exacerbate health disparities.”

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  • Opinion: Women don’t have to die from cervical cancer | CNN

    Opinion: Women don’t have to die from cervical cancer | CNN

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    Editor’s Note: Dr. Eloise Chapman-Davis is director of gynecologic oncology at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. Dr. Denise Howard is chief of obstetrics and gynecology at NewYork-Presbyterian Brooklyn Methodist Hospital and a vice chair of obstetrics and gynecology at Weill Cornell Medicine. The views expressed in this commentary are their own. Read more opinion on CNN.



    CNN
     — 

    As doctors who specialize in women’s reproductive health, we are on the front lines of a preventable crisis. Imagine treating a woman with advanced cancer who has a five-year survival rate of 17%, knowing that she should have never developed the deadly disease in the first place.

    This is what we are facing with cervical cancer. Yet we have the clinical tools not only to lower but also eliminate nearly all the roughly 14,000 new cases and 4,300 deaths from cervical cancer each year.

    Denise Howard

    We have effective screenings: the traditional Pap smear and the HPV test. If these screening tests are abnormal, additional tests can determine who needs further treatment to prevent the development of cancer. Importantly, we have the HPV vaccine, which protects against high-risk human papillomavirus (HPV) types that cause the majority of cervical cancer cases and is nearly 100% effective, according to the National Cancer Institute.

    A report published earlier this month shows the vaccine’s tremendous impact. The US saw a 65% drop in cervical cancer rates from 2012 through 2019 among women ages 20-24, the first to have received the vaccine. The vaccine, combined with screening, could wipe out cervical cancer and make it a disease of the past.

    But the percentage of women overdue for their cervical cancer screening is growing, and, alarmingly, late-stage cases are on the rise.

    We have had the heartbreaking experience of seeing mothers in the prime of life die from this avoidable disease, leaving small children behind — even women who had an abnormal screening but never received follow-up care. It’s devastating to see an otherwise healthy person slowly die from a preventable cancer.

    Simply put, cervical cancer should never occur. This Cervical Cancer Awareness Month, we should commit to making that a reality. Here is what needs to happen.

    Eliminating cervical cancer requires commitment at multiple levels, from public awareness campaigns with culturally appropriate messaging that broadcasts the power of the vaccine and screenings to prevent cancer to resources that ensure all women have easy access to routine health exams.

    Timely screening reminders and systems to prioritize follow-up care are essential. Too many women with abnormal screenings don’t receive their results, reminders or follow-up instructions they understand and, therefore don’t receive the proper treatment. Barriers also include logistical challenges like transportation and language issues. Studies suggest that 13% to 40% of cervical cancer diagnoses result from lack of follow-up among women with an abnormal screening test.

    Gynecology and primary care practices should be vigilant about reaching and monitoring patients with suspicious test findings. Large health systems can leverage the power of the electronic health record to track abnormal tests and ensure these women receive the proper follow-up.

    Pediatricians should encourage parents of children 9 and older to get the HPV vaccine and stress its safety. About 60% of teenagers are up to date on their HPV vaccines, according to the US Centers for Disease Control and Prevention. Physicians not recommending the vaccine and parents’ rising concerns about its safety, despite more than 15 years of evidence that it is safe and effective, have been cited as top reasons why more children aren’t receiving this lifesaving vaccine.

    College campuses should do large-scale, catch-up vaccination outreach. These students are at high risk for contracting HPV, yet only half report having received the full HPV vaccine series. This service should be provided at no cost to students.

    Stark racial disparities also must be addressed. As Black women physicians, we are frustrated that Black women continue to be more likely to die from the disease than any other race, according to the American Cancer Society. The system failures contributing to this tragedy range from Black women receiving less aggressive treatment to barriers around access to affordable routine health care and the high-quality, specialized treatment needed to treat cancer. Everyone deserves access to quality care.

    Older patients should be told that approval of the HPV vaccine has been extended up to age 45 and to discuss with their doctor whether it’s right for them. Insurance providers should cover the cost of the vaccine for these older ages.

    Women should see a gynecologist on a regular basis well into their older years. We see patients with cervical cancer in their 60s and 70s who haven’t been screened in 20 years. Many people stop seeing a gynecologist after childbearing or menopause, but this shouldn’t be the case. Getting quality gynecological exams throughout a woman’s life is critical to preserving it.

    We also need to empower women to be their own advocates through health education. Women should receive their screening result with an explanation of what it means and any next steps clearly delineated. No news after a screening is not good news. In an ideal world, women would see their HPV status as essential information with the power to save their lives.

    Education makes a difference. At NewYork-Presbyterian and Weill Cornell Medicine, we produced a series of easy-to-understand, publicly available videos on cervical cancer and the HPV vaccine. We showed several of the vaccine videos to more than 100 parents in one of our pediatric practices that serves mostly low-income families as part of a pilot study. Their knowledge scores on a questionnaire about the vaccine and HPV that they completed before and after watching the videos increased nearly 80%, and roughly 40% of the unvaccinated children received the HPV vaccine within one month. We aim to expand this effort.

    We have the tools to prevent cervical cancer but fail to use them effectively. It’s unacceptable, and we can no longer ignore the problem. It’s time for a full-scale offensive focused on all fronts to make cervical cancer a disease of the past.

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  • A lot of people hide their cancer diagnosis from their bosses. These companies aim to change that | CNN Business

    A lot of people hide their cancer diagnosis from their bosses. These companies aim to change that | CNN Business

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    CNN
     — 

    After having surgery to remove a small cancerous tumor from his neck last year, Publicis Groupe CEO Arthur Sadoun decided to tell his employees, clients and shareholders of his condition. He still needed to undergo radiation and chemotherapy, and explained to them what that would mean for his work schedule.

    While deciding to go public was difficult for Sadoun because it meant showing vulnerability both as a person and as a leader of one of the world’s largest advertising agencies, he said he received thousands of compassionate responses from both inside and outside Publicis after doing so.

    What shocked him most, he said, was how many people told him they hid their own cancer diagnosis from their employers for fear of losing their job or being perceived as weak. Instead, they took vacation days for treatments or scheduled very early morning procedures so they could work the same day, Sadoun told CNN. Some even hid their children’s cancer treatments from their boss, he added.

    “That is crazy,” Sadoun said. “I started 2022 with cancer and left it with a mission.”

    That mission is to create a worldwide campaign to encourage employers to eradicate the stigma and anxiety of having cancer at work.

    The initiative — called the #WorkingWithCancer Pledge — launched Tuesday at the 2023 World Economic Forum in Davos, Switzerland.

    Many of the world’s best-known companies have agreed to the pledge already. They include Bank of America, Citi, Disney, Google, L’Oréal, Marriott, McDonald’s, Meta, Microsoft, Nestlé, PepsiCo, Toyota, Unilever and Walmart.

    Employers who take the pledge promise “to abolish job fear and insecurity that exist for cancer sufferers in the workplace.”

    Signatories also pledge to do a better job publicizing to their workforces the benefits they already have in place for employees with cancer and for employees taking care of a family member with cancer. They will also consider ways to do more.

    Walmart, for instance, notes on the #WorkingWithCancer Pledge site that it currently offers access to high-quality care in the United States through its Centers for Excellence Program, and that the care is often free for employees, including travel and lodging if necessary for both the employee and their caregiver. The company also said it provides free counseling with a licensed therapist, educational resources and experts on cancer, as well as leave-of-absence programs.

    In terms of forward-looking pledges, Publicis is committing to its employees worldwide that it will:

    • Secure the job and salary of any employee suffering from cancer for at least 1 year so they can focus on their health treatment
    • Offer career support to any affected employee after they return to work to help them assess whether they wish to do the same job or try something different, depending on their capacities after treatment
    • Provide affected employees with an internal community of trained volunteers who can offer support “so that our employees don’t feel alone at a challenging time”
    • Offer custom support to employees serving as caregivers to a family member with cancer so they can get what they need in terms of flexibility and time to both “maintain their energy at work and as a caregiver.”

    Leading cancer institutions, including Memorial Sloan Kettering, are backing Sadoun’s initiative.

    His hope is that if the world’s biggest companies go public with what they are doing both to help employees with cancer and to make it easier to talk about it at work, smaller companies may follow their lead.

    Given how prevalent cancer diagnoses are — and how, thanks to improved treatments and early detection, it can be more of a chronic disease than a death sentence in many instances — “Not only will we have to live with [cancer],” Sadoun said, “we will have to work with it.”

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  • Alabama attorney general says people who take abortion pills could be prosecuted | CNN Politics

    Alabama attorney general says people who take abortion pills could be prosecuted | CNN Politics

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    CNN
     — 

    Alabama’s Republican attorney general said this week that women in the state who use prescription medication to terminate their pregnancies could be prosecuted under a chemical-endangerment law, even though Alabama’s anti-abortion law does not intend to punish women who receive abortions.

    Steve Marshall made the comments in the wake of a decision earlier this month by the US Food and Drug Administration to allow certified pharmacies to dispense the abortion medication mifepristone to people who have a prescription.

    “The Human Life Protection Act targets abortion providers, exempting women ‘upon whom an abortion is performed or attempted to be performed’ from liability under the law,” Marshall said in a statement to AL.com on Tuesday. “It does not provide an across-the-board exemption from all criminal laws, including the chemical-endangerment law—which the Alabama Supreme Court has affirmed and reaffirmed protects unborn children.”

    The chemical endangerment law was passed in 2006 amid high drug usage in Alabama with aims of protecting children from chemicals in the home, but district attorneys have successfully applied the law to protect fetuses of women who used drugs during pregnancy.

    It’s unclear if there are any pending cases against women in Alabama in the wake of the FDA’s announcement. CNN has reached out to Marshall’s office for comment.

    At least one Democrat, Alabama state Rep. Chris England, argued on Twitter that the chemical endangerment law is “extremely clear” and under it, a woman could not be prosecuted for taking a lawfully prescribed medication.

    “Any prosecutor that tries this, or threatens it, is intentionally ignoring the law,” England wrote on Thursday morning.

    Emma Roth, an attorney with Pregnancy Justice, a nonprofit that provides legal representation for women charged with crimes related to pregnancy, said on Twitter that the effect of Marshall’s comments will be to create “a culture of fear among pregnant women.”

    The comments are “extremely concerning and clearly unlawful,” Roth elaborated in a statement to CNN. “The Alabama legislature made clear its opposition to any such prosecution when it explicitly exempted patients from criminal liability under its abortion ban.”

    The chemical endangerment law says it does not require reporting controlled substances that are prescription medications “if the responsible person was the mother of the unborn child, and she was, or there is a good faith belief that she was, taking that medication pursuant to a lawful prescription.”

    Mifepristone can be used along with another medication, misoprostol, to end a pregnancy. Previously, these pills could be ordered, prescribed and dispensed only by a certified health care provider. During the Covid-19 pandemic, the FDA allowed the pills to be sent through the mail and said it would no longer enforce a rule requiring people to get the first of the two drugs in person at a clinic or hospital.

    Marshall’s comments underscore the legal uncertainty wrought by the Supreme Court’s decision last year to end the federal right to an abortion. In the wake of the Dobbs decision, several Republican-led states passed strict anti-abortion laws, while several others, including Alabama, that had passed so-called trigger laws anticipating an eventual overturn of Roe v. Wade, saw their new restrictions go into effect.

    While the anti-abortion movement seeks to prevent abortions from taking place, it has often opposed criminalizing the women who undergo the procedure.

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  • NICU mom stays by her son’s side after his nurses leave to strike | CNN Business

    NICU mom stays by her son’s side after his nurses leave to strike | CNN Business

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    New York
    CNN
     — 

    Lora Ribas hasn’t left her son’s bedside in four days.

    Her one-year-old baby, Logan, has been in the neonatal intensive care unit (NICU) since he was born. For the past three and a half months, he’s been under the care of Mount Sinai Hospital where thousands of nurses are currently striking.

    Logan was born prematurely at 27 weeks and is on a ventilator because his lungs were underdeveloped.

    Mount Sinai’s NICU has been consistently understaffed even before the strike, Ribas said. But since Mount Sinai’s nurses began picketing Monday, new travel nurses have replaced Logan’s primary care nurses – nurses who don’t fully understand her son’s needs, she said.

    Ribas said she’s too scared to leave her son alone under the care of the new travel nurses. She took a leave from work to stay by his side.

    “It’s scary to think that I can’t even go to the bathroom without me being concerned,” Ribas told CNN.

    Although the travel nurses are trying to compensate, they “don’t really know my son” and are still learning where supplies are around the unit, Ribas said.

    They aren’t able to give him one-on-one care because of the staffing shortages, according to the mom, and she said the staffing levels are even lower at night.

    Two nurses currently working inside Mount Sinai Hospital told CNN Monday that additional traveling nurses have not shown up as expected on their floors to replace nurses that are striking, causing stress for patients and staff.

    Mount Sinai Health System did not immediately respond to CNN’s request for comment.

    In preparation for the strike, Mount Sinai announced Friday it would transport newborns in its intensive care unit to other area hospitals. But the most critical babies – like Logan – have stayed in the hospital’s NICU unit. One NICU nurse at Mount Sinai who spoke to CNN on condition of anonymity, said moving a NICU baby to another hospital can be a risky move.

    “It’s a big journey for a baby who’s never been outside the hospital,” she told CNN. “It’s not anything that we want to happen. We want our babies to stay.”

    The more critical the baby’s condition is, the more complicated a transfer to another hospital becomes, the nurse explained.

    “You would need at least a doctor or nurse practitioner, a respiratory therapist if the patient is on respiratory support and a transport nurse to work the pumps and administer medicine if needed,” she said.

    Ribas said her son’s primary nurses who are striking right now are heartbroken they had to leave him and have been calling her to check on his status.

    “He has really wonderful primary nurses,” she said. “They were in tears having to leave him because my baby suffered cardiac arrest two days before the strike happened, and so now I’m dealing with that plus the shortage of staff. Which is very scary.”

    The nurses strike at two private New York City hospitals – Montefiore and Mount Sinai – involving over 7,000 nurses entered its second day Tuesday. Montefiore said it was holding bargaining sessions Tuesday. Mount Sinai has no plans to do so, according to the nurses’ union.

    The sticking point continues to be enforcing safe staffing levels, New York State Nurses Association (NYSNA) union officials said.

    A pediatric oncology nurse at Mount Sinai who administers chemotherapy to children with cancer said it’s hard to leave her patients to strike, but she knows it’s in the best interest of their care.

    “We love these patients more than anything,” Melissa Perleoni said, “and it breaks our heart – at least it breaks my heart – to be out here but I have to do this for the future of their care.”

    Ribas said she hopes hospital management reaches a contract with the nurses soon.

    “The nurses are the heart of the NICU, and they do need to figure it out before it becomes a different situation – because every single minute, every hour, the babies are running a very, very high risk of even dying in here.”

    “There’s nothing that could bring your kid back. Nothing,” she said.

    – CNN’s Tami Luhby, Vanessa Yurkevich and Mark Morales contributed to this report

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  • Nurses at Mount Sinai Morningside and West reach tentative agreement as more than 7,000 nurses still due to strike | CNN Business

    Nurses at Mount Sinai Morningside and West reach tentative agreement as more than 7,000 nurses still due to strike | CNN Business

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    New York
    CNN
     — 

    Mount Sinai Morningside and West hospital reached a tentative agreement with the state nursing union on a new contract Sunday, avoiding a strike Monday morning, according to a news release from the union.

    Nurses at two other area hospitals, Mount Sinai Hospital and Montefiore Bronx, are still due to strike after not reaching agreements.

    Both hospitals are back at the bargaining table with New York State Nurses Association nurses today – if a tentative agreement is not reached, then approximately 3,625 nurses at Mount Sinai and approximately 3,500 nurses at Montefiore Bronx will strike at 6 a.m. Monday. The union said during a news conference Sunday morning that negotiations could go into the early morning.

    The new tentative agreement at Morningside and West brings the anticipated number of nurses to strike down from 8,700 to about 7,125. The tentative agreement improves staffing, protects benefits and increases salaries over three years.

    That brings seven of the 12 New York hospitals in negotiations to reach tentative agreements or new contracts.

    “The time is now to settle fair contracts that help nurses deliver the care that all New Yorkers deserve. We are fighting to improve patient care and will do whatever it takes to win,” NYSNA President Nancy Hagans said in a statement Sunday.

    New York City’s Mount Sinai Hospital is continuing to move infants out of intensive care units to other area hospitals, is diverting ambulances to other facilities and postponing elective surgeries and heart surgeries ahead of a planned nursing strike Monday.

    In a statement late Saturday, the hospital said it has been negotiating “in good faith” with the nursing union on a new contract. Mount Sinai has agreed to meet with NYSNA nurses after walking out on a bargaining session Thursday, the union said Sunday.

    A Mount Sinai spokesperson told CNN on Saturday the hospital system is actively bargaining with the Mount Sinai Morningside and West campuses under separate union agreements.

    But if agreements aren’t reached at several New York City area hospitals, thousands of nurses will strike on Monday morning.

    The hospital said Sunday its current wage offer “is identical” to ratified agreements at NewYork-Presbyterian and Maimonides – and would increase a Mount Sinai nurse’s base salary by 19.1 percent over three years.

    “But NYSNA’s inconsistent bargaining, unwillingness to accept this offer, and insistence on moving forward with a strike has left us no choice but to take significant actions to care for our patients,” the hospital statement said.

    Seven neonatal intensive care unit infants were safely transferred Saturday to partner hospitals in New York City, a hospital spokesperson told CNN on Sunday. Another six will be transferred Sunday from the NICUs at Mount Sinai Hospital and Mount Sinai West, the spokesperson said.

    “In addition, we have transferred close to 100 patients from the affected hospitals – The Mount Sinai Hospital, Mount Sinai West and Mount Sinai Morningside – to unaffected hospitals within the Mount Sinai system and partner hospitals in NYC and we continue to safely discharge patients who were schedule to go home.” All elective surgeries have been postponed, the spokesperson said.

    The NYSNA hit back Saturday at comments from Mount Sinai, which said Friday it was transferring infants in its neonatal intensive care units to other area hospitals because of the strike notice, adding the hospital was dismayed by the union’s “reckless” actions.

    “As a labor and delivery nurse who helps mothers to bring babies into this world, I find it outrageous that Mount Sinai would compromise care for our NICU babies in any way. We already have NICU nurses caring for twice as many sick babies as they should,” Matt Allen, the union’s regional director, said.

    “It’s unconscionable that Mount Sinai refuses to address unsafe staffing in our NICU and other units of the hospital but is now stirring fears about our NICU babies in contract negotiations,” he added.

    In a statement Saturday, the NYSNA said nurses at BronxCare and The Brooklyn Hospital Center reached tentative agreements that will improve safe staffing levels and enforcement, increase wages by 7%, 6%, and 5% annually during their three-year contract, and retain their healthcare benefits.

    On Saturday, nurses at NewYork-Presbyterian announced they had agreed to ratify their deal, but it was a close vote – 57% nurses voted yes and 43% were against.

    “Voting on whether to ratify a contract is a key component of union democracy. Just like in any democracy, there is rarely 100 percent consensus,” Hagans said in a statement.

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  • Amid negotiation gridlock between Mount Sinai Hospital and the nursing union, newborns in intensive care are caught in the middle, one nurse says | CNN Business

    Amid negotiation gridlock between Mount Sinai Hospital and the nursing union, newborns in intensive care are caught in the middle, one nurse says | CNN Business

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    CNN
     — 

    Crucial union negotiations between Mount Sinai Hospital and the New York State Nurses Association appear to be at a standstill and both parties say the other is refusing to return to the bargaining table.

    As the impasse continues between the hospital and union, the most vulnerable patients – newborns in Mount Sinai’s neonatal intensive care unit – are caught between the opposing sides, causing worry among families, one Mount Sinai nurse, who declined to provide her name out of fear of repercussions, told CNN.

    With thousands of New York nurses poised to strike early Monday morning, one of Manhattan’s famed hospitals announced Friday it would transport newborns in its intensive care unit to other area hospitals in preparation for the strike.

    A Mount Sinai Health System spokesperson confirmed to CNN Friday that neonatal intensive care unit infants would be transferred to other area hospitals because of the strike notice.

    “We are seeking a resolution [to the strike.] The impact is great,” the spokesperson told CNN.

    A NICU nurse at Mount Sinai Hospital told CNN that families of patients in the unit have been deeply concerned about moving their sick infants from one hospital to another. Moving the babies to a different facility can be “very stressful” for a NICU patient, the nurse said, as well as the parents.

    “They’ve asked us all week what’s going to happen to their babies, and what’s going to happen next week,” the nurse said.

    “It’s a big journey for a baby who’s never been outside the hospital,” she told CNN. “It’s not anything that we want to happen. We want our babies to stay. We want to be taking care of them. And it’s kind of shocking, and actually a little infuriating, that the hospital is letting it get to this point.”

    The more critical the baby’s condition is, the more complicated and riskier a transfer to another hospital becomes, the nurse explained.

    “You would need at least a doctor or nurse practitioner, a respiratory therapist if the patient is on respiratory support and a transport nurse to work the pumps and administer medicine if needed,” she said.

    The nurses who care for the sick infants often grow close to the families and develop a trusting relationship with them, especially because some babies spend weeks or even months in the NICU, the nurse told CNN.

    “They’re comfortable leaving their babies with us when they aren’t able to be there,” she said. “We keep in contact with the families after their babies have gone home – so we really do develop a close bond to these families.”

    “We treat our babies in the hospital like they’re our own kids. We’re very protective of them,” she added.

    New York State Nurses Association President Nancy Hagans has said the goal of the negotiations is to improve patient care and staffing, get fair wages and to recruit and retain nurses.

    Negotiations between the health system and the nurse’s union have been ongoing since September, a Mount Sinai Health System spokesperson told CNN Saturday, but low staffing levels have afflicted the NICU unit for years, the nurse told CNN.

    “For over three years now, we’ve been understaffed,” she said.

    The number of patients in the unit surges and falls regularly, according to the nurse, but as patient levels rise, staffing levels stay the same. The unit can surge to 64 patients, she said.

    “You feel like you’re not actually giving your all to your patients,” she said. “You’re really pulled very thin.”

    Paying close attention to infant patients is especially important, according to the nurse, because unlike other patients – even small children – they can’t verbalize pain or discomfort.

    “You really have to be on top of their vital signs and general assessment. And when you’re not able to spend as much time as you need to with them, some things do get missed,” she said. “And it’s very unfortunate.”

    CNN has reached out to the hospital regarding the nurse’s comments on low staffing.

    More than 8,700 nurses are prepared to strike Monday morning if tentative contract agreements are not reached at several hospitals, Hagans, the union president, said at a virtual news conference Saturday morning.

    As of Saturday, negotiations across New York’s hospitals were continuing at Montefiore Bronx and the Mount Sinai Morningside and West campuses, according to the nurse’s union.

    But the president of the nurse’s union told reporters Saturday the main Mount Sinai Hospital complex left the bargaining table late Thursday and no further bargaining sessions have been scheduled since.

    A Mount Sinai Health System spokesperson told CNN that hospital management is “waiting for the union to come back to us” to resume negotiations.

    The hospital said it put forth a deal at Thursday evening’s bargaining session was the same one the union agreed to for nurses at the NewYork-Presbyterian Hospital. Tentative agreements have also been reached with union nurses at Maimonides Medical Center in Brooklyn and Richmond University Medical Center in Staten Island.

    Mount Sinai also said it has offered a 19.1% compounded pay raise over three years, which is the same offer other hospital systems in the city have made.

    The NICU nurse at Mount Sinai said that nurses in her unit don’t want to strike and are hoping that they can come to an agreement with the hospital before Sunday night.

    “It truly breaks our heart having to strike and leave our patients, but unfortunately you have to do some drastic things sometimes,” she told CNN.

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  • NYC nursing union says 8,700 nurses prepared to strike Monday if tentative contract agreements not reached at remaining hospital | CNN Business

    NYC nursing union says 8,700 nurses prepared to strike Monday if tentative contract agreements not reached at remaining hospital | CNN Business

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    New York
    CNN
     — 

    More than 8,700 nurses are prepared to go on strike Monday at 6 am ET if tentative contract agreements are not reached at several New York City hospitals, New York State Nurses Association (NYSNA) President Nancy Hagans said at a virtual press conference Saturday morning.

    That’s a drop from the original estimate of 9,500, after tentative agreements were reached late Friday and Saturday morning with other facilities.

    In a statement Saturday, the NYSNA said nurses at BronxCare and The Brooklyn Hospital Center reached tentative agreements that will improve safe staffing levels and enforcement, increase wages by 7%, 6%, and 5% annually during their three-year contract, and retain their healthcare benefits.

    Negotiations are continuing at Montefiore Bronx and the Mount Sinai Morningside and West campuses ahead of Monday’s planned strike, Hagans said. The union president told reporters Saturday that the main Mount Sinai Hospital complex left the bargaining table late Thursday and has not reached out to the union to schedule any further bargaining sessions since.

    A Mount Sinai spokesperson told CNN the hospital system is actively bargaining with the Mount Sinai Morningside and West campuses under separate union agreements. The spokesperson added that management is “waiting for the union to come back to us” and resume negotiations for nurses at the main Mount Sinai hospital facility.

    On Saturday, nurses at NewYork-Presbyterian announced that they agreed to ratify their agreement, but it was a close vote – 57% nurses voted yes and 43% were against.

    “Voting on whether to ratify a contract is a key component of union democracy. Just like in any democracy, there is rarely 100 percent consensus,” Hagans said in a statement.

    To date, nurses at five New York City hospitals who were slated to strike on Monday have now reached tentative agreements or contracts.

    The NYSNA also hit back Saturday at comments from Mount Sinai, which said Friday it was transferring infants in its Neonatal Intensive Care units to other area hospitals because of over the strike notice, saying that the hospital was “dismayed by NYSNA’s reckless actions.”

    Matt Allen, the union’s regional director, said, “As a labor and delivery nurse who helps mothers to bring babies into this world, I find it outrageous that Mount Sinai would compromise care for our NICU babies in any way. We already have NICU nurses caring for twice as many sick babies as they should.”

    He added, “It’s unconscionable that Mount Sinai refuses to address unsafe staffing in our NICU and other units of the hospital but is now stirring fears about our NICU babies in contract negotiations.”

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  • Arrest of Idaho students murder suspect brings ‘a great sense of relief’ to university campus before a return to classes this week, provost says | CNN

    Arrest of Idaho students murder suspect brings ‘a great sense of relief’ to university campus before a return to classes this week, provost says | CNN

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    CNN
     — 

    Following the stabbing deaths of four students in November, the tight-knit University of Idaho community was shaken for weeks, but the recent arrest of a suspect may allow the campus to regain a sense of security as students return to classes this week.

    “I think I speak for many in our community that there’s a great sense of relief, but it’s bittersweet because this is still a horrible tragedy,” the university’s provost and executive vice president Torrey Lawrence told CNN Friday.

    Bryan Kohberger, 28, is charged with the murders of students Kaylee Goncalves, 21; Madison Mogen, 21; Xana Kernodle, 20; and Ethan Chapin, 20, who were found brutally stabbed to death in an off-campus home in Moscow, Idaho, on November 13.

    The gruesome killings rattled the campus community and city of Moscow, which had not seen a murder since 2015. Anxieties only worsened as weeks passed without a named suspect, leading some students to leave campus and complete the semester remotely.

    Classes resume on Wednesday following the winter break, and though students who are still uncomfortable being on campus have the option to attend remotely, most students are planning to return, Lawrence said.

    “The timing of this for our students was probably good,” the provost said, adding, “Hopefully we can really just be focused on classes starting and on that student experience that we provide.”

    Security will remain heightened on campus, he said, though some measures such as a state patrol presence are no longer in place.

    Still, the “very peaceful, safe community” students enjoyed before the killings has experienced a “loss of innocence,” he said.

    Kohberger, who is the sole suspect, was pursuing a PhD in criminal justice at nearby Washington State University at the time of the killings and lived just minutes from the scene of the killings, according to authorities.

    Investigators say phone records indicate Kohberger was near the victims’ home at least 12 times between June 2022 and the present day, according to an affidavit detailing the evidence against him. The records also show the suspect was near the residence on the morning of the killings, court documents say.

    DNA recovered from the the Kohberger family’s trash was linked to DNA found on a tan leather knife sheath found on the bed of one of the victims, according to the affidavit. The DNA in the trash is believed to belong to the biological father of the person whose DNA was found on the sheath, the document says.

    The suspect’s white Hyundai Elantra was also seen close the victims’ home around the time of the killings, according to investigators. Kohberger received a new license plate for the car five days after the killings, Washington state licensing records and court documents reveal.

    Kohberger had his initial court appearance in Idaho on Thursday and did not enter a plea at the hearing.

    Before Kohberger’s arrest, authorities noted that the suspect thoroughly cleaned his vehicle and was seen wearing surgical gloves repeatedly outside his family’s Pennsylvania home, a law enforcement source tells CNN.

    The source, who spoke on the condition of anonymity, was briefed on observations made by investigators during four days of surveillance leading up to Kohberger’s arrest at his family home.

    Kohberger “cleaned his car, inside and outside, not missing an inch,” according to the law enforcement source.

    A surveillance team assigned to Kohberger was tasked with two missions, according to multiple law enforcement sources: keep eyes on Kohberger so they could arrest him as soon as a warrant was issued, and try to obtain an object that would yield a DNA sample from Kohberger, which could then be compared to DNA evidence found at the crime scene.

    Kohberger was seen multiple times outside the Pennsylvania home wearing surgical gloves, according to the law enforcement source.

    In one instance prior to Kohberger’s arrest, authorities observed him leaving his family home around 4 a.m. and putting trash bags in the neighbors’ garbage bins, according to the source. At that point, agents recovered garbage from the Kohberger family’s trash bins and what was observed being placed into the neighbors’ bins, the source said.

    The recovered items were sent to the Idaho State Lab, per the source.

    Last Friday, a Pennsylvania State Police SWAT team then moved in on the Kohberger family home, breaking down the door and windows in what is known as a “dynamic entry” – a tactic used in rare cases to arrest “high risk” suspects, the source added.

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