This is one of them: Drinking several cups of caffeinated coffee or tea a day may protect against Type 2 diabetes, coronary heart disease and stroke, NBC reports.

The findings, published Tuesday in the Journal of Clinical Endocrinology & Metabolism, add to existing research suggesting that daily coffee drinkers have better heart health than nondrinkers — provided they don’t drink too much caffeine.

“Caffeine intake at different doses could have different health effects,” the study’s co-lead author Chaofu Ke, an associate professor in the department of epidemiology and biostatistics at Soochow University in China, wrote in an email. 

Ke and a group of researchers in China and Sweden analyzed the coffee and tea drinking habits of 188,000 people ages 37 to 73 from the U.K. Biobank, a large database that contains anonymous health information, who had completed questionnaires about their beverage intake over the past 24 hours. They also looked at responses from about 172,000 people who specified that they drank caffeinated coffee or tea. None of them had a history of cardiometabolic disease — defined by a diagnosis of at least two of the three conditions: Type 2 diabetes, coronary heart disease or stroke — when the study began. 

The researchers followed up with the participants after about 12 years.

Drinking two to three cups of coffee or up to three cups of tea a day was the sweet spot, the researchers found.  

People who consumed about 200 to 300 milligrams of caffeine daily had a lower risk of cardiometabolic disease, compared to people who drank less than 100 mg a day. Coffee drinkers, in particular, had the lowest risk — a nearly 50% reduction — while people who got the 200 to 300 milligrams of caffeine from tea or a mix of both beverages were about 40% less likely to develop cardiometabolic disease. For tea drinkers, cardiometabolic risk decreased the most for those who drank up to three cups daily, but the benefits tapered off after that. 

Even for people who consumed more than 400 mg of caffeine a day — just 4% of the study’s caffeine drinkers — the stimulant didn’t appear to have negative consequences for their cardiometabolic health. 

And among those who did eventually develop cardiometabolic disease, drinking moderate amounts of coffee every day was still associated with lower risk of developing another cardiometabolic disease. 

Moderate caffeine intake was also associated with certain metabolites — compounds produced when the body digests foods and drinks — that are linked to better heart health.

“Moderate caffeine intake may regulate levels of these metabolites,” Ke said. 

Dr. Luke Laffin, co-director of the Center for Blood Pressure Disorders at Cleveland Clinic, said that the findings need to be taken in context.

“It can give us an idea, but we can’t draw any conclusions,” said Laffin, who wasn’t involved with the research. “Everything in moderation is probably the best way to do it. If someone is having a couple cups of coffee a day, this suggests that dose might be protective.”

However, some types of heart disease can make caffeine intake more dangerous, he said. 

“Too many cups of coffee can raise blood pressure in someone who already has hypertension,” Laffin said. 

Studies have also shown a link between high caffeine intake and a greater risk of dementia and stroke. Other studies have shown positive links between caffeine and kidney health, Type 2 diabetes and heart failure. 

Dr. Stephen Kopecky, a preventative cardiologist at the Mayo Clinic in Rochester, Minnesota, said that, in addition to a person’s underlying health issues, the way a person consumes caffeine likely makes a big difference in how it affects their health. 

“The message I don’t want to get out there is that caffeine is good, so let’s take more of it. We have never found that taking what is good in the diet and putting it in a pill is equally beneficial,” Kopecky said. 

An important caveat of the study is that it only included people who regularly drank coffee or green or black tea, all of which contain hundreds or thousands of chemical compounds, only one of them being caffeine. 

“It’s likely all of these components that have an impact, but they have to be together,” Kopecky said.

Although the researchers did adjust for some heart disease factors, such as smoking, obesity, exercise and diet, a lot remains unknown about what other habits they may have in addition to drinking caffeine, which could affect their risk. 

“It’s hard to do a study that controls for everything,” Laffin said, adding that a daily cup of coffee is just fine for most people. 

Kopecky agreed, adding that consuming caffeine in energy drinks, which often have added sugar, artificial sweeteners and other additives, or caffeine shots, is definitely something to avoid. 

And when it comes to tea and coffee, keep it simple. 

“People need to be scrupulous about what else is in their coffee aside from caffeine,” Laffin said. 

“If you are going to your favorite coffee shop and ordering a coffee with whipped cream and sugary syrup, you’re consuming a lot of calories, which can contribute to cardiometabolic disease.”

The story first appeared on NBCNews.com. More from NBC News:

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Wastewater samples have detected a significant escalation in an enterovirus called D68, which, in rare cases, has been linked to acute flaccid myelitis, or AFM. The illness affects the nervous system and causes severe weakness in the arms and legs. This most often occurs in young children. 

“We are detecting EV-D68 nucleic acids in wastewater across the country now, and the levels are increasing,” said Alexandria Boehm, program director of WastewaterSCAN, a nonprofit monitoring network and a professor of civil and environmental engineering at Stanford University.

That’s the first clue to suggest that the nation might see an increase in AFM this year, said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security and author of “Crisis Averted: The Hidden Science of Fighting Outbreaks.”

“The second clue,” she said, “is that the time of year is right.”

Historically, September has been the biggest month for AFM cases.

Anyone who’s ever had the sniffles probably had an enterovirus; they’re that common. Most of the time, the viruses cause mild symptoms, such as a runny nose, cough, headache and generalized feelings of “meh.”

The D68 enterovirus strain started causing more serious problems in 2014, when the U.S. saw, for the first time, a spike in pediatric AFM. That year, 120 kids were diagnosed.

There’s no cure or specific treatment for the paralysis. Even with years of intensive physical therapy, many are left with life-altering disabilities.

A viral mystery

Though a few dozen cases have been reported every year since then, larger waves of AFM have followed an every-other-year pattern, spiking again in 2016 (with 153 cases) and in 2018 (with 238 cases).

The pattern stopped in 2020 when the nation went into lockdown because of the Covid pandemic, drastically reducing viral spread. That year, just 32 cases were logged. The spread of D68 picked up again in 2022 as lockdowns were lifted.

Curiously, a rise in AFM cases didn’t follow.

“We saw the virus that was previously driving the AFM cases, but we didn’t see the AFM cases associated with it,” said Dr. Kevin Messacar, an infectious disease specialist at Children’s Hospital Colorado, who treated some of the earliest AFM cases in 2014.

It’s a mystery that any virologist would appreciate. While experts try to predict how viruses will behave, the bugs are always working to stay a few steps ahead.

It could be that the virus itself has changed, or that more people in the U.S. have been exposed and now have a level of immunity to D68. “We’re still trying to figure it out,” Messacar said.

So far in 2024, 13 AFM cases have been confirmed, according to the Centers for Disease Control and Prevention. Since 2014, 758 cases have been logged.

The implication is that hundreds of families and their children have been left with lasting, life-altering paralysis because of a virus.

Some recovery after years of physical therapy

The Kagolanu family in Los Altos, California, was in a heated game of Monopoly one Friday night in November 2014 when 7-year-old Vishnu’s head began, inexplicably, to tilt to one side. Vishnu admits that even though he was losing the game, this wasn’t attention-seeking behavior.

“My dad was like, ‘Hey, what are you doing? Move your head back straight,'” Vishnu, now 17, said. “I just thought, I can’t do that.”

Within an hour, Vishnu lost all ability to move his arms and legs. “I couldn’t get myself off the floor,” he said.

Vishnu was one of the first to be diagnosed with AFM in 2014. At that time, no one had connected the dots between D68 and the “mystery illness.”

“We didn’t understand what was going on. Even the doctors couldn’t find out what was going on,” said Saila Kagolanu, Vishnu’s mother. “That was the worst experience of my life.”

Doctors warned Vishnu’s family that he might never regain function of his arms and legs. The poor prognosis crushed Vishnu. He’d always thrived as “king of the playground” when it came to sports and other physical activities.

“Seeing my legs go progressively smaller every day” was devastating, he said. “I couldn’t move.”

Vishnu spent years undergoing physical therapy to regain the ability to walk. That was successful. Otherwise, there’s not much doctors can do. His right shoulder remains limp.

Testing a possible treatment

“We all get really frustrated every time we get to this point, and we don’t have antiviral medicines that are readily available,” said Dr. Buddy Creech, a pediatric infectious disease physician at Vanderbilt University Medical Center in Nashville. “We don’t have much to offer these kids.”

Creech and his colleagues are working toward a solution. They’ve begun safety studies of a monoclonal antibody that would, ideally, stop D68 in its tracks.

“In mouse studies, it prevented infection that would lead to AFM,” Creech said. The study is expected to take years before the treatment is considered safe and effective.

Meanwhile, young people like Vishnu Kagolanu are attempting to move on and even inspire others with AFM. In recent years, he started a nonprofit called Neurostronger, which works to raise funds for and increase awareness of kids with neurologic conditions.

“Growing up with AFM is hard,” Kagolanu said. “But at the same time, there are ways to get around some of those obstacles. There are ways to find joy.”

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The Senate vote was Democrats’ latest attempt to force Republicans into a defensive stance on women’s health issues and highlight policy differences between Vice President Kamala Harris and former President Donald Trump in the presidential race, especially as Trump has called himself a “leader on IVF.”

The 51-44 vote was short of the 60 votes needed to move forward on the bill, with only two Republicans voting in favor. Democrats say Republicans who insist they support IVF are being hypocritical because they won’t support legislation guaranteeing a right to it.

“They say they support IVF — here you go, vote on this,” said Illinois Sen. Tammy Duckworth, the bill’s lead sponsor and a military veteran who has used the fertility treatment to have her two children.

The Democratic push started earlier this year after the Alabama Supreme Court ruled that frozen embryos can be considered children under state law. Several clinics in the state suspended IVF treatments until the GOP-led legislature rushed to enact a law to provide legal protections for the clinics.

Democrats quickly capitalized, holding a vote in June on Duckworth’s bill and warning that the U.S. Supreme Court could go after the procedure next after it overturned the right to an abortion in 2022.

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The bill would establish a nationwide right for patients to access IVF and other assisted reproductive technologies and a right for doctors and insurance companies to provide it, an effort to pre-empt state efforts to limit the services. It would also require more health insurers to cover it and expand coverage for military service members and veterans.

Republicans argued that the federal government shouldn’t tell states what to do and that the bill was an unserious effort. Only Republican Sens. Susan Collins of Maine and Lisa Murkowski of Alaska voted with Democrats to move forward on the bill both times.

Meanwhile, Republicans have scrambled to counter Democrats on the issue, with many making clear that they support IVF treatments. Trump last month announced plans, without additional details, to require health insurance companies or the federal government to pay for the fertility treatment.

In his debate with Harris earlier this month, Trump said he was a “leader” on the issue and talked about the “very negative” decision by the Alabama court that was later reversed by the legislature.

South Dakota Sen. John Thune, the No. 2 Senate Republican, said that Democrats are trying to create a political issue “where there isn’t one.”

“Let me remind everybody that Republicans support IVF, full stop,” Thune said just before the vote.

The issue has threatened to become a vulnerability for Republicans as some state laws passed by their party grant legal personhood not only to fetuses but to any embryos that are destroyed in the IVF process. Ahead of the its convention this summer, the Republican Party adopted a policy platform that supports states establishing fetal personhood through the Constitution’s 14th Amendment, which grants equal protection under the law to all American citizens. The platform also encourages supporting IVF but does not explain how the party plans to do so.

Republicans have tried to push alternatives on the issue, including legislation that would discourage states from enacting explicit bans on the treatment, but those bills have been blocked by Democrats who say they are not enough.

Sen. Rick Scott, a Florida Republican, said in a floor speech then that his daughter was currently receiving IVF treatment and proposed to expand the flexibility of health savings accounts. Republican Sens. Katie Britt of Alabama and Ted Cruz of Texas have tried to pass a bill that would threaten to withhold Medicaid funding for states where IVF is banned.

Cruz, who is running for reelection in Texas, said Democrats were holding the vote to “stoke baseless fears about IVF and push their broader political agenda.”

“I’m not sure that people are aware of this,” said Dr. Thomas Sollecito, chief of oral medicine at the University of Pennsylvania.

Hormonal changes — mainly a sharp drop in estrogen — can reduce bone density and saliva production and harm your gums. All of that can affect your teeth.

Oral care experts say there are ways to counteract these effects and keep your menopausal mouth healthy.

Menopause, perimenopause and dental symptoms

Menopause happens when a woman goes 12 consecutive months without a menstrual period. But some of the hormone-related dental problems may begin during perimenopause, when the ovaries gradually make less estrogen, said Dr. Maiara Hister-Cockrell, a dentist with the University of Texas Health San Antonio.

One of the biggest concerns is less saliva, which Sollecito called “one of the most important fluids in our body.”

When the saliva flow slows, it can cause dry mouth, which brings a greater risk of mouth soreness, oral yeast infections and cavities. Those risks are even higher when people take medicines for high blood pressure or diabetes that can also cause dry mouth, Hister-Cockrell said.

Less saliva also means less of its bacteria-killing enzymes and tooth-strengthening minerals, said Dr. Sally Cram, a periodontist in Washington, D.C.

When your mouth is dry, she said, “those bacteria are proliferating and you’re more prone to get tooth decay.” And if decay festers, tooth loss is possible.

Decreasing bone density and receding gums exacerbate these problems. If the socket that holds the tooth is less dense, Sollecito said, it’s more vulnerable to bone loss. And gum recession can leave some tooth surfaces without the enamel that protects them from cavities.

Women in this phase of life are also more likely to develop periodontal disease, when plaque and bacteria collect under gums and around teeth.

“Gum tissue starts to get red and swollen,” said Cram, a spokesperson for the American Dental Association. “It bleeds and it starts pulling away from the teeth, creating deeper crevices around the teeth that are clearly harder to keep clean.”

Some people experience “burning mouth syndrome.” Hister-Cockrell said a burning sensation can extend to the tongue, palate and lips.

“As you could well imagine,” Sollecito added, “this could all really spiral out of control.”

What can you do?

The first line of defense, experts said, is good oral hygiene and nutrition. Eat a balanced diet low on sweets and high on calcium-rich foods. Brush carefully with fluoride toothpaste at least twice a day and floss regularly.

“An electric toothbrush can be more helpful than manual toothbrushing,” Cram said. “See your dentist regularly and ask them: Am I doing a good job? And if I’m not, what could help me do a better job?”

Patients should also ask their dentists whether they should be seen more than twice a year, as well as consider in-office fluoride treatments to strengthen the surface of their teeth and prescription high-fluoride toothpaste.

At home, experts said, treating dry mouth is a priority. So stay hydrated.

“None of us really probably drink enough water throughout the day,” Cram said.

People can also use over-the-counter dry mouth sprays, lozenges or rinses. In severe cases, Sollecito said they can ask their dentist about prescription medications that increase the amount of saliva in the mouth but come with side effects. There are also prescription medications for burning mouth syndrome.

“The bottom line,” Cram said, “is most oral conditions and problems during menopause are totally preventable” by paying attention, taking good care of your teeth at home and regularly going to the dentist.

___

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

The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

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People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

More recently, Consumer Reports found a concerning amount of the toxic metal in a third of cinnamon powders purchased from more than a dozen grocery stores in the Northeast.

There is no safe limit of lead to consume. At the same time, completely eliminating the heavy metal in food isn’t feasible, because lead is a naturally occurring element in the Earth’s crust. Trace amounts can infiltrate the food supply in various ways, including in places where foods are grown, raised or processed, experts say.

However, the recent findings raise questions about why the Food and Drug Administration hasn’t already proposed limits on lead in foods meant for young children.

“This issue with the cinnamon and the lead and other issues with heavy metals in baby and children’s food is all emblematic of a larger problem that I think the FDA is trying to get a handle on,” said Laurie Beyranevand, director of the Center for Agriculture and Food Systems at Vermont Law and Graduate School. “I’m not sure if the FDA is doing it as quickly as people would feel comfortable with.”

After a major FDA investigation late last year into lead-contaminated apple cinnamon fruit puree, the FDA began screening cinnamon imports, followed by several warnings and recalls of some brands for elevated lead levels.

That prompted Consumer Reports to test brands across 17 mainstream and niche grocery stores.

It found high levels of lead in 12 products, with levels reaching 3.5 parts per million.

The United Nations’ Food and Agriculture Organization has a proposed international safety standard of 2.5 ppm for spices that include cinnamon.

Anything above 1 ppm would trigger a recall in New York — the only state in the U.S. that regulates heavy metals in spices — Consumer Reports noted.

“There are some products in here that are up to three times that, which is concerning,” said Dr. Adam Keating, a pediatrician with Cleveland Clinic Children’s.

Keating’s primary concern is with children and pregnant women who ingested the cinnamon on a regular basis as opposed to just a single instance.

“A single sprinkle of cinnamon in a dose in one dish would be different than if they were eating the product every day,” said Keating, who was not involved in the Consumer Reports testing. “Regular ingestion of lead is the main concern that we have, particularly with children and pregnant women, because the most profound effect of lead is developmental delays and learning problems.”

The FDA currently does not set limits for heavy metals in spices, including cinnamon, although it does set limits for certain foods, such as candy made with sugar.

Last year, the agency proposed limits on lead levels in processed baby food that it says could reduce exposure to the contaminant by as much as 27%. Those guidelines are not expected to be finalized until next year, however.

“I’m not totally sure why they have not done that yet,” Beyranevand said. “Maybe it’s difficult to do in a number of different products, but it feels like at least with cinnamon, given the prevalence of the findings and the fact that there’s been so much lead, it feels like it would move the agency to set some sort of action level.”

The FDA did not immediately respond to a request for comment.

Lead exposure can be harmful to people of all ages, Keating said, but it is particularly dangerous for children. High levels of lead can lead to serious health problems in kids, including learning and behavior issues, reduced IQ and damage to the brain and nervous system, according to the FDA and the Centers for Disease Control and Prevention. Additionally, lead exposure can cause hearing and speech problems.

Many children may not have any obvious symptoms, Keating said. He recommended that parents get their children in for routine lead screening at 1 and 2 years of age.

Consumer Reports advised people to check their homes for the products and throw them out.

The consumer product testing group also said that people might consider sticking with mainstream brands.

Of the 12 products that contained high levels of lead, 10 of them were from relatively unfamiliar brands sold mainly in small markets specializing in international foods, according to the report’s findings.

The FDA has wound down some of its response efforts to its cinnamon applesauce investigation but will continue to monitor other products in stores for high lead levels.

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The clinic had worked hard to explain the limits of the law, which was part of Gov. Ron DeSantis’ of tighter immigration policies. The clinic posted signs and counseled patients: They could decline to answer the question and still receive care. Individual, identifying information wouldn’t be reported to the state.

“We tried to explain this again and again and again, but the fear was real,” Grace Medical Home CEO Stephanie Garris said, adding the woman finally did go to an emergency room for treatment.

Texas will be the next to try a similar law for hospitals enrolled in state health plans, Medicaid and the Children’s Health Insurance Program. It takes effect Nov. 1 — just before the end of a presidential election in which immigration is a key topic.

“Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants,” Texas Republican Gov. Greg Abbott said in a statement announcing his mandate, which differs from Florida’s in that providers don’t have to tell patients their status won’t be shared with authorities.

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Both states have high numbers of immigrants, ranging from people who are in the U.S. without legal permission to people who have pending asylum cases or are part of mixed-status families. And while the medically uninsured rate in these two states — neither of which have expanded Medicaid — are higher than the national average, research has shown immigrants tend to use less and spend less on health care.

Texas and Florida have a long history of challenging the federal government’s immigration policies by passing their own. And their Republican leaders say the hospital laws counter what they see as lax enforcement at the border by the Biden administration — though Florida’s early data is, by its own admission, limited.

Florida GOP state Sen. Blaise Ingoglia, who sponsored the hospital bill, said in a written statement that the law is “the strongest, and most comprehensive state-led, anti-ILLEGAL immigration law,” but did not respond to The Associated Press’ questions about the impact of the law on the immigrant community or on hospital patients.

Luis Isea, an internal medicine doctor with patients in hospitals and clinics in central Florida, said the law “is creating that extra barrier” for patients who are already exposed to many disparities.

Immigrant advocate groups in Florida said they sent thousands of text messages and emails and held clinics to help people understand the limitations of the law — including that law enforcement agencies wouldn’t know an individual’s status because the data would be reported in aggregate.

But many outreach calls from health workers went unanswered. Some patients said they were leaving Florida, as a result of the law’s impact on getting health care and on employment; the DeSantis’ administration tied the hospital mandate to other initiatives that invalidated some driver’s licenses, criminalized transportation of migrants lacking permanent status and changed employment verification policies.

Others, advocates say, languished in pain or needed to be persuaded. Verónica Robleto, program director at the Rural Women’s Health Project in north central Florida, fielded a call before the law took effect in July 2023 from a young woman who didn’t have legal permission to be in the U.S. and was afraid she would be separated from her child if she gave birth at the hospital.

“She was very afraid (but) she did end up going after speaking with me,” Robleto said.

Whatever data Florida and Texas do collect likely will be unreliable for several reasons, researchers suggested. Health economist Paul Keckley said the report released by Florida state officials could have “incomplete or inaccurate or misleading” data.

For one, it’s self-reported. Anyone can decline to answer, an option chosen by nearly 8% of people admitted to the hospital and about 7% of people who went to the emergency room from June to December 2023, the Florida state report said. Fewer than 1% of people who went to the emergency room or were admitted to the hospital reported being in the U.S. “illegally.”

The Florida Agency for Health Care Administration acknowledged large limitations in their analysis, saying it didn’t know how much of the care provided to “illegal aliens” went unpaid. It also said it was unable to link high levels of uncompensated care with the level of “illegal aliens” coming to a hospital, saying it’s “more associated with rural county status than illegal immigration percentages.”

The agency didn’t immediately respond to requests for comment and more information. Its report noted that for much of the last decade, the amount of unpaid bills and uncollected debts held by Florida hospitals has declined.

In Florida and in Texas, people who aren’t in the U.S. legally can’t enroll in Medicaid, which provides health insurance for low-income people — except in the case of a medical emergency.

Multiple factors can affect the cost of care for people who are in the U.S. without legal permission, experts said, especially the lack of preventive care. That’s especially true for people who have progressive diseases like cancer, said Dr. James W. Castillo II, the health authority for Cameron County, Texas, which has about 22% of the population uninsured compared to the state average of 16.6%.

At that point, he said, “it’s usually much harder to treat, much more expensive to treat.”

In the News

Crime and Courts Sep 13

Mexican cartel leader ‘El Mayo' Zambada pleads not guilty to US charges

Uvalde School Shooting Sep 12

Poor training marred Border Patrol response to Uvalde school shooting, report says

Texas Abortion law Sep 6

Texas sues to stop rule shielding medical records of women who seek out of state abortions

Texas community groups, policymakers and immigration attorneys are partnering with Every Texan, a nonprofit focusing on public policy and health care access, to encourage people to not answer the status question, said Lynn Cowles with Every Texan.

And in Florida, the deportation fears are subsiding but questions about the purpose of the law remain.

“How much of this is substantive policy and good policy versus how that fared, I leave that for others to speculate,” said Garris with the Orlando clinic. “But I know the practical effect of the law was egregious and demeaning to patients who are living here, working here. It’s just insulting.”

___

Salomon reported from Miami, and Shastri reported from Milwaukee.

___

The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

Health Jun 14

KP.3 COVID variant is dominant in the US: What are the symptoms?

People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

The Emmy Award winner, known for his roles on “The Dick Van Dyke Show,” “Chitty Chitty Bang Bang” and “Mary Poppins,” is still holding his own in the gym. But he didn’t always live this way. “If I’d known I would have lived this long, I would have taken better care of myself,” he told CBS News in 2023.

Now that he’s lived nearly 10 decades, including a legendary career that’s earned him the respect of multiple generations, here’s what the actor has shared about how he manages his health.

He regularly works up a sweat

At 98, Van Dyke has got an impressive gym routine. “My wife, god bless her, makes sure I go to the gym three days a week and do a full workout,” the actor told CBS News, referring to wife Arlene Silver.

He called the gym his “secret weapon,” in an exclusive with Entertainment Tonight.

But looking after his physique isn’t something he took up recently. On top of a career chock-full of dance, in 1974, Van Dyke revealed he also did yoga on The Dick Cavett Show. “I do it in the morning when I get up,” he said at the time. He called it both relaxing and strenuous — particularly the sit-ups. “It’s a great exercise, but it’s tiring. It’s hard.”

He previously struggled with alcohol use

Van Dyke publicly revealed he was dealing with alcoholism and checked into a hospital for three weeks to address his addiction in 1972. After that, he worked to change the stigma about the disease.

“It’s a physical disease,” Van Dyke said on The Dick Cavett Show in 1974. “It has nothing to do with the person not being mature enough not to drink too much. It’s a true addiction, like a heroin addiction.”

While he barely drank in his 20s, as invitations to parties mounted in his 30s, he found himself drinking more and eventually realized he had problem, he added.

In 2016, he told Oprah Winfrey that alcohol was his crutch in social settings. “I was very shy — with strangers — I couldn’t talk to people,” the then-90-year-old said. “And I found if I had a drink, it would loosen me up. The barriers went down, and I became very social. That’s what got me started.”

A friend once warned him about his drinking habits, but Van Dyke shrugged him off, he told Dick Cavett. Van Dyke estimates that he drank heavily for about seven years. So, by the time he realized he needed help, he was in too deep and had to work at his recovery for many years.

Van Dyke said he’s long tried to pinpoint the exact moment his drinking habits shifted but can’t. “When did I go from the point when I drank with my friends at a party or something to the point where I’d began to drink way ahead of them?” he wondered.

Now that he’s sober, he doesn’t miss it. “I like life too much without it. Now that I’m completely free of it, I don’t have any desire to ever drink again.”

He quit smoking

Once Van Dyke sought help for alcoholism, he also addressed his smoking habits. “Trying to quit smoking, that was twice as hard,” Van Dyke said on the Really No Really podcast in 2023.

“It was much worse than the alcohol,” he added, saying it took him “forever” to quit. “I’m still chewing the nicotine gum. It’s been 15 years, I think.”

He suffered from mysterious headaches

In 2013, Van Dyke was forced to cancel public appearances for health reasons.

That April, the entertainer was set to receive the Lifetime Achievement Award for Bettering Humanity through Comedy from New York’s 92Y, but he had to pull out. His reps said he was dealing with “fatigue and lack of sleep resulting from symptoms of a yet-to-be diagnosed neurological disorder,” according to Entertainment Tonight.

That same month, the star took to X to share additional details and ask for advice: “My head bangs every time I lay down. I’ve had every test come back that I’m perfectly healthy. Anybody got any ideas?”

The following month, he shared an update revealing he suspects his dental work was to blame, TODAY.com previously reported. “It seems that my titanium dental implants are the cause of my head pounding,” he wrote on X. “Has anyone else experienced this? Thanks for all your replies.”

He does work he still looks forward to

In addition to looking after his health and making necessary life changes, it seems the final key to Van Dyke’s longevity is contentment. “If I’m not enjoying myself, I’m really bad. I am,” Van Dyke quipped to CBS News.

“It’s such a blessing to find a way of making a living that you love, that you’d do for nothing. I feel so sorry for people who hate their jobs. I look forward to going to work every morning,” he said.

Van Dyke’s legendary career is still bringing him joy, as it did when he first broke out on the scene. He says that’s because he’s never wasted a moment doing something he didn’t love. “Get your living done first and have the nerve to try something,” he advised.

This article first appeared on TODAY.com. Read more from TODAY here:

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The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

Health Jun 14

KP.3 COVID variant is dominant in the US: What are the symptoms?

People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

Health Jun 14

KP.3 COVID variant is dominant in the US: What are the symptoms?

People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

As chaplain for the men’s team for 30 years, she’s famous as the “basketball nun” — stealing the show and people’s hearts when the Loyola Ramblers made it to the Final Four at the 2018 NCAA basketball tournament.

Known simply as Sister Jean, she leads the team in a pre-game prayer before matches and serves as a good luck charm. Enthusiastic, uplifting and knowledgeable about basketball, “she’s like another coach,” one of the players told the Chicago Tribune. “She knows her stuff.”

Born on Aug. 21, 1919, the centenarian continues to work at least five days a week, commuting from her apartment to campus via shuttle bus, and offering advice, support and hugs to students in her office. She uses an iPad, a computer and is active on email, but it’s the personal connection with young people that matters most.

“I love every bit of it. … It just makes me very joyful,” Sister Jean tells TODAY.com. “I don’t consider it really working. I just have so much fun. These students are a joy to work with. I learn so much from them, and I know they learn from me.”

She celebrated her 105th birthday with seven parties organized by the university, students and the assisted living community where she resides.

The nun is a member of the Sisters of Charity of the Blessed Virgin Mary. She’s spent her life working as a teacher, administrator and principal. She’s also coached basketball and other sports.

“I feel fine” at 105, Sister Jean says. “I eat well, I sleep well and hopefully I pray well.”

Here are some of the secrets of her longevity:

Be around young people

“I love being around young people. They keep me alive, healthy, and vibrant,” she writes in her memoir, “Wake Up With Purpose!: What I’ve Learned in My First Hundred Years.”

“My interactions with those students are why I’ve never regretted not having children of my own.”

Never retire

Sister Jean actually did try retirement in 1994 at age 75, but found she didn’t want to give up working — a sentiment common among people who live extraordinarily long lives.

That same year, she was asked to be the chaplain for the men’s basketball team, which became “the most transformational and transcendent position of my life,” she writes in her book.

Given the team’s schedule, she sometimes works until 9:30 at night and on the weekends. She’ll be attending every home game this year.

“There’s more work for me to do. I don’t like to sit around. I just like talking to people or doing something good for others,” she says as fall activities get underway at the university. “We’re going to be very busy, but that’s fun.”

It’s important to have a purpose in life, but since people spend so much time at work, they should make a change if they don’t like their job or career, she advises.

Keep moving forward

Sister Jean is comfortable with modern technology, stays on top of the news and calls adaptability her “superpower.”

“If you’re not moving forward, you’re going to get left behind real quick,” she writes in her book.

The nun calls herself the queen of the selfie since so many people want a photo with her. It makes them happy, so she’s happy to do it, she says.

Inherit great genes

The centenarian believes a lot of her longevity comes from her father’s side of the family. He lived to be 95, and several of his siblings made it to a similar age.

“When my 95 came along, I thought, ‘I’ve got to really get ready to go to God.’ But I’m still here,” she says.

Wake up and go to sleep joyfully

If you don’t take care of yourself, you can’t take care of anybody else, Sister Jean says. It’s important to set aside quiet time for prayer and reflection to take care of the mind, she adds in her book.

The nun wakes up at 5 a.m. and pauses for a 30-minute meditation.

Then at night, she takes time to think about all the good things she did that day.

“I still go to bed every night with a smile on my face, gratitude in my heart, and love in my soul,” she writes in her book.

Eat in moderation

Sister Jean says she eats pretty much everything, but not too much of anything.

Lunch is her heavier meal, and then she eats more lightly at dinner time, opting for soup and a salad or a sandwich.

She used to be very careful about her diet when she was younger, but has taken a more relaxed approach in recent years.

“Perhaps I don’t watch my diet so much at breakfast. Sometimes I have eggs and bacon and toast,” the centenarian notes.

“But I think to myself, I’m 105, what difference does it make?”

For her birthday, Sister Jean enjoyed chicken fricassee, homemade noodles, peas and pound cake — the meal she always asked her mom to make for her special day.

Stay positive and joyful

Sister Jean says she’s never been depressed and believes it takes too much energy to be stressed out.

She credits her good mental health to her parents, who created a happy home for her, and her two brothers even when times were tough during the Great Depression — a warmth that has always stayed with her. They also fostered her love of sports, which she calls the best teacher of teamwork.

“I learned a lot of that from my mom and dad. They were so positive all the time,” she says.

“They told us that we could really do things if we really tried, and I certainly believe that.”

Her parents and brothers have died, but she talks to them all the time. “I know they hear me in heaven,” she writes.

This article first appeared on TODAY.com. Read more from TODAY here:

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The research, published in the journal Endocrinology, is the first to look at how chemicals found in the environment may affect the brain, possibly leading to early puberty, Dr. Natalie Shaw, a pediatric endocrinologist at the National Institute of Environmental Health Sciences and co-senior author of the study, told NBC News.

However, it’s too early to say whether musk ambrette is definitely playing a role in the early puberty trend, experts stress — though there may be some small steps that parents can take to err on the side of caution.

Here’s what to know about the research, musk ambrette and the products that contain it.

Puberty starting earlier in girls and boys

Research from 2020 shows that the average age of starting puberty for girls has decreased by about three months each decade from 1977 to 2013. A study from 2012 found that boys were hitting puberty anywhere from six months to two years earlier than previous research had indicated.

And a large study in May 2024 published in JAMA, which looked at over 70,000 females born between 1950 and 2005, found that the average age at which girls had their first periods has decreased, and it’s taking longer on average for periods to become regular.

The reason behind the drop in age at which children are starting puberty has eluded experts for years. Some have pointed to the rise in obesity in children, less nutritious diets, and exposure to phthalates, a substance added to plastics, but nothing is proven.

Shaw believes that because the change in puberty onset has happened so quickly, it’s likely due to “environmental factors,” she told NBC News.

Starting puberty early has been linked to adverse health outcomes, such as increased risk of breast, endometrial and testicular cancers; diabetes; heart disease; obesity; and psychological issues.

Musk ambrette may play a role in rise in early puberty, new research finds

To conduct the study, the researchers looked at over 10,000 compounds using a library of licensed pharmaceuticals, environmental chemicals and dietary supplements.

They found that musk ambrette, which is a synthetic form of musk, may be able to attach to a receptor in the brain associated with puberty and prompt it to release a hormone called GnRH, which affects the sexual maturation of organs and production of sex hormones, like estrogen, testosterone and progesterone.

“The ability of these compounds to stimulate these brain receptors raises the possibility that they may prematurely activate the reproductive axis in children,” Shaw tells TODAY.com via email.

There were several types of chemicals that the researchers identified that could influence puberty, including cholinergic agonists, a type of medicine, and musk ambrette.

“Musk ambrette is of potential concern for children because it can be found in personal care products. A limited number of studies in rats also suggest that it can cross the blood-brain barrier. Children are less likely to encounter cholinergic agonists in their daily lives,” Shaw explains.

“It is important to conduct confirmatory studies in girls with early puberty, but these compounds deserve greater attention,” she adds.

What is musk ambrette?

Musk ambrette is a synthetic form of musk. It’s often used to add scent to personal care and household products or as a flavoring food additive, Michael Hansen, Ph.D., senior scientist at Consumer Reports, tells TODAY.com.

The Flavor and Extract Manufacturer Association (FEMA), a major flavor trade group in the U.S., does not give musk ambrette its “generally recognized as safe” designation. The European Union has prohibited the use of musk ambrette in cosmetics, and Canada has also restricted it.

“Exposure to (musk ambrette compounds) is also of concern because they can bioaccumulate in human tissues,” Shaw explains. “Studies have detected these compounds in maternal blood, umbilical cord blood, and breast milk, highlighting potential risks for children.”

What products contain musk ambrette?

A range of products in the U.S. may contain musk ambrette. According to Hansen and Shaw, these include:

• Detergents
• Soaps
• Air fresheners
• Cleaning products
• Perfumes, especially inexpensive or counterfeit fragrances
• Essential oils
• Cosmetics and other scented personal care products, like shampoos, deodorant and body wash
• Spices
• Some foods

“If I had to guess, I would suspect that the bulk of the exposure (to musk ambrette) is coming in through personal care products,” Hansen says. “Since it’s a fragrance, that means … you’re inhaling it. … That goes straight into the mucous membranes (in the nose), which are far easier for chemicals to get to the brain.”

What can parents do?

Some experts say it’s too early in the research to suggest that parents consider taking action to reduce their children’s exposure to musk ambrette, and it would also be premature to ban or restrict it, based on this research.

However, Shaw and Hansen both agree there’s no harm in trying to limit kids’ exposure to the chemical and its related compounds, such as musk xylene and musk ketone. And Hansen says the research ideally should lead to follow-up studies looking at musk ambrette exposure in communities more likely to experience early puberty.

In the mean time, Hansen suggests avoiding products that have musk ambrette on the ingredients label. However, know that some products that use musk ambrette may only list it as synthetic or natural fragrance or flavoring, Hansen adds.

So, you may want to consider just cutting back on scented products where the scent isn’t necessary, such as lotions, shampoos and body washes.

This article first appeared on TODAY.com. Read more from TODAY here:

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The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

Health Jun 14

KP.3 COVID variant is dominant in the US: What are the symptoms?

People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

Health Jun 14

KP.3 COVID variant is dominant in the US: What are the symptoms?

People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

“Both have a lot of health benefits,” Julia Zumpano, a registered dietitian with the Cleveland Clinic Center for Human Nutrition, tells TODAY.com. For example, the two oils are both rich in “healthy fats that have been shown to reduce inflammation and protect against heart disease,” she says.

They also contain helpful vitamins and antioxidants, registered dietitian Grace Derocha, a spokesperson for the National Academy of Nutrition and Dietetics, tells TODAY.com.

But there are some big differences, especially when it comes to choosing how and when to cook with avocado oil versus olive oil, the experts say.

Fat content

Nutritionally, avocado oil and olive oil are very similar, Zumpano says, though there are some slight differences. When it comes to calories and fat content per serving, “they’re almost the same,” she adds.

In 1 tablespoon of avocado oil, you’ll get about 124 calories and 14 grams of fat, including around 2 grams of saturated fat, 2 grams of polyunsaturated fat and 10 grams of monounsaturated fat.

In 1 tablespoon of olive oil, you’ll get 119 calories and 13.5 grams of fat, including about 2 grams of saturated fat, 1.5 grams of polyunsaturated fat and 10 grams of monounsaturated fat.

Both are low in saturated fat, which has been linked to increases in cholesterol. Yet they’re “rich in monounsaturated fats,” Derocha says, which are especially helpful for heart health. In particular, they’re both good sources of oleic acid, an omega-9 fatty acid and monounsaturated fat, Zumpano says.

“Essentially, both are good overall as a heart-healthy oil to use,” Derocha says.

Other nutrients

In addition to those healthy fats, both avocado oil and olive oil contain a slew of other nutrients. However, they contain slightly different combinations of those vitamins, antioxidants and beneficial plant compounds.

Both contain vitamin E, which boasts benefits for skin health and has antioxidant properties. But, Zumpano says, olive oil comes with slightly more than avocado oil.

“Antioxidant-wise, both of them have very powerful antioxidants, but olive oil does contain slightly higher values,” she adds.

For example, lab research suggests that oleocanthol, an antioxidant compound unique to extra virgin olive oil, has pain-relieving properties similar to ibuprofen, Zumpano notes. Oleocanthol may also have benefits for brain health.

Meanwhile, avocado oil provides the antioxidant lutein, which is helpful for eye health, Derocha says.

Ultimately, either oil will provide a good dose of beneficial plant compounds and nutrients.

Smoke point

Perhaps the biggest difference between these two oils are their smoke points, meaning the temperatures at which they begin to burn and produce smoke.

Olive oil has a lower smoke point, Derocha says, which is in the range of 375 degrees Fahrenheit. If you’re using extra virgin olive oil, which is unrefined, Zumpano typically recommends keeping the temperature around 350 to 375 or below. That means most olive oil will be better suited to lower-heat cooking, like simmering in a pan, or used at room temperature and drizzled over salads or veggies.

(Note that refined olive oil can be heated to higher temperatures.)

On the other hand, avocado oil has a higher smoke point, up to about 520 degrees Fahrenheit, the experts say. Even at high heat, avocado oil “doesn’t have a burnt flavor, and it also retains all those nutrients,” Derocha says. “So when you’re thinking of high-heat cooking methods, like frying, roasting or grilling, you want to go (with) avocado oil.”

Zumpano agrees: “If I’m going to pan-fry or if I’m coating potatoes to roast at a higher temperature, I’ll use an avocado oil,” she explains. “If I’m using a lower-temperature cooking or room temperature, like seasoning or flavoring salads, I’ll use an olive oil.”

Flavor

Your mileage may vary here, but the experts agree that avocado oil generally has a more neutral taste than olive oil.

Avocado oil has a mild and slightly nutty or buttery taste. But, depending on the variety of olives used, your olive oil may have a distinctive sweet, fruity flavor or even some spicy, peppery notes, Derocha says.

That’s most evident in extra virgin olive oils, which are the result of the first cold-pressing of the olives, Zumpano explains. With more refined olive oils, you’ll get less of those flavors but also less of the nutrients, TODAY.com explained previously.

Olive oil also has a lower acidity level than avocado oil, which is why it’s often paired with a vinegar, Derocha notes.

If you’re making a salad dressing, sauce or olive oil cake, that profound olive flavor might be exactly what you’re going for. “Sometimes it’s very specific to certain foods,” Zumpano says. “It actually enhances the flavor of Mediterranean-style dishes,” she adds.

But, with its milder taste, avocado oil tends to be more versatile — especially in baked goods, the experts agree.

Should you use avocado oil or olive oil?

Both avocado oil and olive oil are plant-based oils that provide a good mixture of healthy fats, vitamins and antioxidants. One isn’t really healthier than the other, the experts say.

“They have slightly different compositions that are for slightly different purposes, but I think they’re equally as healthful,” Zumpano says.

So, which should you use? It depends on what you’re making.

Because it has a milder flavor and higher smoke point, avocado oil is better for high-heat cooking. You can easily roast vegetables, pan-fry meat and bake with avocado oil.

Olive oil has a more noticeable peppery and sweet flavor, and it also has a lower smoke point. That means it’s better to save olive oil for low-heat cooking, like stove-top simmering, or to use it as a topping or salad dressing ingredient.

Keep in mind that there’s a huge variety of olive oils out there — even among extra virgin olive oils. Some are better suited to cooking while other higher-quality olive oils have more intense flavors and are best saved for drizzling or dipping.

It’s important to be selective when purchasing your olive oil. First, check that it’s in an opaque container, Zumpano says, which helps preserve the oil by protecting it from exposure to light.

And check for the harvest date on the bottle, Derocha adds. “Olive oil is best consumed one to two years from the harvest date on the package,” she explains. “And if it doesn’t have a harvest date, that also tells you something.”

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

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Liraglutide lowered body mass, slowed weight gain and improved health markers in kids ages 6 through 11, according to research presented Tuesday at a medical conference and published in the New England Journal of Medicine.

Based on the results of the trial, drugmaker Novo Nordisk has asked U.S. regulators to expand use of the medication for kids in that age group, a company spokesperson said Tuesday. If approved, the drug would be the first authorized to treat the most common type of obesity that affects more than 20% of U.S. kids ages 6 through 11, according to the U.S. Centers for Disease Control and Prevention.

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“To date, children have had virtually no options for treating obesity,” said Dr. Claudia Fox, a pediatric obesity expert at the University of Minnesota who led the study. “They have been told to ‘try harder’ with diet and exercise.”

Side effects were common among those given the drug, particularly gastrointestinal effects such as nausea, vomiting and diarrhea. And experts said doctors and parents would need to carefully consider those risks and the lack of data about the long-term use of such drugs in young kids.

“Having a medication for that age group, if approved, would be a really nice tool to have, but we’re also going to have to be careful about how widely we start using it,” said Dr. Melissa Crocker, a pediatric obesity specialist at Boston Children’s Hospital who wasn’t involved in the study. “And I would answer that differently at 6 than I would at 11.”

Liraglutide is in a class of so-called GLP-1 drugs that include blockbuster medications like Wegovy and Mounjaro. The medications mimic hormones that affect appetite, feelings of fullness and digestion. It’s taken as a daily injection and is approved under the brand name Victoza to treat diabetes in adults and children ages 10 and older and as Saxenda to treat obesity in adults and children ages 12 to 17.

The new study, paid for by Novo Nordisk, included 82 children with a mean age of 10 and a baseline weight of about 155 pounds (70 kilograms). The average starting BMI was 31, above the threshold for childhood obesity. More than half the children had obesity-related health problems such as insulin resistance, asthma or early puberty. The results were presented at the annual meeting of the European Association for the Study of Diabetes in Madrid.

In the trial, 56 children received daily injections of up to 3 milligrams of liraglutide for nearly 13 months, while 26 got dummy medications. The kids were followed for six months afterward.

All the children received individual counseling to help them follow a plan that called for a healthy diet and 60 minutes a day of moderate to high-intensity exercise.

Researchers found that kids who took the drug for more than a year reduced their body mass index — a measure of height and weight that can account for a child’s natural growth – by 5.8%. Children who received the dummy medication saw their BMI increase by 1.6%.

At the same time, children who received the drug slowed weight gain to 1.6% of their body weight during that period, compared with a 10% gain for those who got sham drugs.

The study found that 46% of kids who got the drug lowered their BMI by at least 5%, an amount that has been linked to improvements in health problems tied to obesity. In kids who received placebo, 9% met that mark. Lower measures of blood pressure and blood sugar were detected in children who received the drug, researchers noted.

Side effects, mostly mild to moderate, were reported in nearly 90% of both groups of participants. Gastrointestinal side effects including nausea and vomiting were reported in 80% of kids who received the drug, compared with 54% who received sham medications. Serious side effects were reported in seven children using liraglutide and two who took placebo. Six participants taking the drug left the trial because of the side effects, while no one taking placebo stopped treatment.

In the six-month follow-up, children in both groups who stopped treatment increased BMI and gained weight, the study found. The trial has been extended to include more treatment and follow up, with results expected in 2027.

Fox receives research funding from Novo Nordisk and drugmaker Eli Lilly paid directly to her institution. Those companies are also conducting trials with more powerful weekly injections of Novo’s Wegovy and Lilly’s Zepbound in kids as young as 6.

Dr. Alaina Vidmar, a pediatric obesity specialist at Children’s Hospital Los Angeles who wasn’t involved in the new study, said she has used liraglutide off-label to treat young kids and would welcome approval of the drug to increase flexibility and access.

The drug treats the underlying physiology of obesity, which is a complex, chronic disease that can occur at any age. Early use can prevent obesity and life-threatening health problems from extending into the teen years — and adulthood.

“We want these kids to have long, healthy lives,” Vidmar said. “The sooner that we can start, the more likely we can stop them from getting early onset diabetes, early onset heart disease, sleep apnea, all of those things. Doing nothing is not the right answer.”

___

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

The new study, published Monday in the Proceedings of the National Academy of Sciences, is more evidence of how disruptions to daily routines may have contributed to behavioral problems, an increase in eating disorders, anxiety and depression in adolescent girls and boys, NBC News reported.

Scientists at the university’s Institute for Learning & Brain Sciences (I-LABS) began the study using MRIs in 2018 to see how the brain structure of 160 teens from the Seattle area developed over time. The participants, a nearly equal number of boys and girls, ranged in age from 9 to 19 at the start of the study. 

Lead researcher Patricia Kuhl, co-director of I-LABS, said that after Covid lockdowns began in 2020, they couldn’t do brain scan follow-ups until 2021. So they shifted the focus of the study to learn how the lockdowns had affected adolescent brain structure.

By measuring the thickness of the cerebral cortex — the outer layer of tissue in the brain which controls higher level functions of the brain like reasoning and decision-making — they discovered the brains of teen boys had prematurely aged 1.4 years. The brain scans of the girls showed accelerated aging of 4.2 years, according to the study.

The cerebral cortex naturally thins as we age. Chronic stress can also cause similar changes in the brain. But in the three-year period between the first scan and the follow-up, there was much more thinning than the researchers expected.

“As we age, the thinning of the cortex is associated with less fast-processing time, with less flexible thinking, with all of the things that we associate with aging,” Kuhl said. “All of the teens in general showed this accelerated aging.”

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For teenage girls the aging was more pronounced. The thinning was found to be widespread throughout the female brain, occurring in 30 regions across both hemispheres and all lobes, the scans showed. In the male brain, the thinning was limited to only two regions, both in the occipital lobe, which affects distance and depth perception, face recognition and memory. 

The greater influence on girls could be due to differences in the importance of social interaction for girls versus boys, Kuhl said. Boys tend to gather for sports and physical activity. Adolescent girls may rely on personal relationships for emotional support and self-identity.

“When girls and women are stressed, there is a natural response to get together and talk about it, and we release oxytocin and other neurotransmitters that make us feel better, said Dr. Ellen Rome, head of adolescent medicine at Cleveland Clinic Children’s Hospital. Rome was not involved in the new research. 

What does the premature brain aging mean in the day-to-day lives of young people who navigated pandemic restrictions, often alone in their rooms, taking classes over Zoom or missing social connections? 

Are there long-term risks for ‘pandemic brains’?

The research doesn’t prove the lockdowns caused the brain changes — mental health disorders were rising among children even before Covid. It does suggest, however, that the thinning of the cortex can be connected to increased anxiety, depression and other behavioral disorders, Kuhl said. 

Another brain scan study in 2022 from Stanford University showed similar changes in cortical thickness in teen brains during Covid restrictions. The Stanford researchers compared the stress and disruptions of the pandemic to childhood trauma such as violence, neglect and family dysfunction. 

The pandemic was a traumatic time for everyone, Kuhl said. For young people — at a time in their lives when they’re already experiencing intense changes in their emotional and behavioral development — the isolation was even more damaging for their emotional health. 

“The pandemic was dramatic and unexpected, of course, but dramatic and catastrophic in a way, not only for physical health, but mental health,” she said.

Since 2021, several reports on youth mental health from the Centers for Disease Control and Prevention revealed unprecedented levels of hopelessness and suicidal thoughts among teenage girls and boys. In early August, a CDC survey released found a small improvement in teen mental health, although 53% of young women in high school say they are still feeling persistent sadness. 

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In brain development there are periods of time when certain types of learning are most effective, said Dr. Jonathan Posner, professor of psychiatry at Duke University School of Medicine. For example, it’s much easier to learn language as a young child than as an adult.

“The teenage years are hugely important for social development,” said Posner, who was not part of the new study. “If you don’t have those social interactions, there’s just not the opportunity to have that social learning.” 

The cortex can’t regrow and continues to shrink throughout life. It’s not yet clear whether the young people’s prematurely aging “pandemic brains” could be at higher risk for disorders like ADHD and depression and, possibly, even diseases like Alzheimer and Parkinson, Kuhl said.

Seattle mom Karin Zaugg Black, 54, saw how the pandemic affected her two children during more than a year of remote school classes. Her daughter Delia, 14, was in seventh grade; Sam, 10, in fourth. 

Delia especially felt the loss of social interaction. 

“When she reflects back on that time, she was definitely like, ‘Yeah, it was really hard. I felt like I had no friends, and that was really difficult,’” Black said about her daughter’s time during the pandemic.

“Their social skills are behind. You know, sort of they lost that ability to navigate in the social world with their peers,” she said.

The good news is Delia, now a senior in high school, has regained a lot of the social interaction muscle she lost during the pandemic. 

Experts say the loss doesn’t have to be permanent if young people’s social interactions and connections have recovered since the pandemic. 

“Fortunately, kids are really resilient, and we can get them back out there and help them catch up,” said Posner. “But we also don’t want to deceive ourselves that this was nothing. It had a significant impact on growth and development.” 

This article first appeared on NBCNews.com. More from NBC News:

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A team of dietitians at the hospital unloaded the week’s shipment of fresh food for patients with diabetes and pre-diabetes Thursday morning.

Then, they piled fresh green beans, apples, squash, carrots and other healthy foods into bags.

“Food is a huge part of the disease state,” said Sarah Roberts, a clinical dietitian for Children’s National. “It’s very important that families understand the importance of using these whole grains, these fruits and vegetables in their diet because when we’re looking at the disease state, we want to tackle it from all points.”

Pre-diabetes and diabetes patients with food insecurity at Children’s National receive three bags of food tailored to their medical needs as part of a food pharmacy program with the Capital Area Food Bank.

Roberts said they’ve seen an increase in patients reporting food insecurity in recent years. Patients’ guardians fill out screenings when they visit the hospital.

“That was another reason for starting the food pharmacy is not only the increase of food insecurity during the in the pandemic, but the increase of type 2 diabetes during the pandemic,” she said.

The proper foods can treat, prevent and, in some cases, reverse a diagnosis of diabetes, experts say.

“I’ve lost about 50-60 pounds just because I’ve been able to have good choices,” Children’s National patient Iman Bangura told News4 via a video call.

Bangura, who has type 2 diabetes, has been in the food pharmacy program for more than a year.

For her, the food pharmacy isn’t just her way out of a food desert, it’s helping change family history.

The food pharmacy served about 30 patients a month when the program began in 2021. Now, more than 200 families a month receive the fresh and healthy groceries.

Roberts said it’s been a vital tool in providing well-rounded care.

“If we’re in here doing these educations with these patients about fresh fruits and vegetables and they’re not able to purchase those things on their own and get those in the store, then it feels like we’re not fully meeting the needs of those patients,” she said.

Scialfa shared the news in “Road Diary: Bruce Springsteen and the E Street Band,” which premiered at the Toronto Film Festival on Sunday, Sept. 8, according to Variety.

“This affects my immune system, so I have to be careful what I choose to do and where I choose to go,” the 71-year-old said in the film. “Every once in a while, I come to a show or two, and I can sing a few songs on stage, and that’s been a treat. That’s the new normal for me right now, and I’m OK with that.”

Variety reported Scialfa didn’t attend the premiere for the documentary. The current state of her health and whether she is receiving treatment for her myeloma is unclear.  

E Street Band was founded in 1972, nearly two decades before Springsteen and Scialfa married in 1991. In 2014, she, along with the rest of E Street Band, was inducted into the Rock & Roll Hall of Fame.

What is multiple myeloma?

The cancer Scialfa was diagnosed with, multiple myeloma, creates cancerous plasma cells in the bone marrow, which prevent the body from producing antibodies and reducing the ability to fight off infection, per Mayo Clinic. It’s not clear what causes it and there’s no cure.

Not everyone with multiple myeloma receives treatment. In some cases, if the cancer is not progressing and not causing symptoms, doctors may opt for a wait-and-see approach. It’s not clear if Scialfa needed or still needs treatment for her myeloma.

Symptoms of multiple myeloma include:

• Bone pain, especially in the hips, spine or chest
• Digestive issues, such as nausea, constipation and loss of appetite
• Mental issues, such as tiredness and brain fog
• Infections
• Weight loss
• Weakness
• Thirst and needing to pee more than usual

The cancer is more common in people in their late 60s, as well as men, Black people and those with a family history of multiple myeloma. Treatments, if needed, include immunotherapy, CAR-T cell therapy, chemotherapy, bone marrow transplant, radiation and more.

Between 42% and 82% of people diagnosed with multiple myeloma survive for four years or more, according to Cleveland Clinic.

Bruce Springsteen’s health issues

Scialfa isn’t the only band member who’s had to deal with illness. In 2023, Springsteen revealed health issues of his own. The “Born to Run” singer announced via X that he and the E Street Band would be postponing their shows because Springsteen had a peptic ulcer.

In 2024, he announced via Instagram that he’d be postponing additional concert dates until the following year on doctor’s orders due to “vocal issues,” TODAY.com reported at the time.

A few months later, Springsteen shared additional details about the ordeal with SiriusXM’s E Street Radio. “When I had the stomach problem, one of the big problems was that I couldn’t sing,” Springsteen said. “You sing with your diaphragm. My diaphragm was hurting so badly that when I went to make the effort to sing, it was killing me. So, I literally couldn’t sing at all.”

Springsteen’s also gotten candid about his mental and physical health. In 2012, Springsteen told The New Yorker that he’d dealt with “intervals of depression.” Scialfa added that therapy has helped him.

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

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But Stafford, a maternal-fetal medicine physician at the University of Texas Health Sciences Center in Houston, quickly realized something was wrong: She couldn’t find a heartbeat. The unborn baby boy had already died in the womb. 

Soon after, the mother’s syphilis test — given to all women before delivery — came back positive. The infection had been silently passed from mother to son.

It’s a death, Stafford said, that could’ve been prevented with early detection and a shot of penicillin. 

Syphilis, a sexually transmitted infection, was nearly eliminated in the U.S. at the beginning of the 21st century but has made a dramatic comeback. In 2022, the Centers for Disease Control and Prevention reported more than 200,000 syphilis cases — the highest counts since 1950. Congenital syphilis has similarly increased tenfold over the past decade, the CDC says, even though 90% of cases are fully preventable.

Syphilis in the U.S.

More than 200,000 cases were reported in 2022, the most since 1950.

The return of syphilis is the result, experts say, of poorly funded prevention programs over the past two decades and difficulties in diagnosis; syphilis is referred to as the “great imitator” because its symptoms can vary so widely. Most people don’t show symptoms or know they’re infected, and even if they do visit the doctor’s office, there’s no guarantee they’ll be properly diagnosed.

Stafford said her patient didn’t have the resources to seek prenatal care, and no doctor or public health worker had ever told her that she should get tested for syphilis. So, when the patient noticed a small rash on her belly, she didn’t think too much about it, Stafford added.

“There’s a lot of people who are seen in private practice, hospital ERs, or walk-in centers, and those clinicians are not necessarily thinking of syphilis, they’re not necessarily getting a sexual history,” said Dr. Kenneth Mayer, an infectious disease physician and medical research director of the Fenway Institute in Boston. With a generation of doctors who saw few, if any, syphilis cases during their training, Mayer said that “the issue is tests not being done in the first place.”

The all-encompassing nature of the Covid pandemic added fuel to this fire, as public health departments redirected STI resources toward fighting the coronavirus.

“The solutions for controlling syphilis are relatively straightforward. We’re not talking about high tech approaches or a novel therapeutic,” said Dr. Dave Chokshi, chair of the Common Health Coalition and a former New York City Commissioner of Health. “It simply revolves around closing gaps in testing and treatment.”

As syphilis cases surge, doctors and public health officials are starting to develop innovative and sometimes unconventional strategies to screen people for syphilis and curb the spread of the disease. 

Most often, that comes down to figuring out how to get people tested, a task that’s far easier said than done.

Spreading the word about syphilis

Given these challenges, some public health departments have launched eye-popping awareness campaigns, trying to raise the alarm among both the public and health care providers. 

A few years ago, Donna Fox, the HIV and STI manager at the Toledo-Lucas County Health Department in Ohio, noticed that about one-fifth of syphilis cases in the area were among people who reported paying for sex. 

So, trying to be proactive — and a bit provocative — Fox and her team ran billboards across the county in 2022 saying, “Paying for Sex? Get Tested!”

“We had to go bold, and we had to get to the point,” she said. The pushback was inevitable — “you might have to say something to your 10-year-old who can read,” Fox conceded — but the impact was measurable. From 2021 through 2022, the number of syphilis appointments scheduled via the county health department jumped by almost 50%, and syphilis cases dropped by 12%, she said.

Of course, syphilis doesn’t just spread among sex workers, so last year, Fox’s team broadened the campaign, keeping the same look and feel but instead saying “Syphilis is Serious” with “Spreading Locally!” overlaid over the side.

Other billboard campaigns across the country have featured giant bloodshot, infected eyes with the blurry words “Eye Syphilis is Serious” and a black silhouette of a pregnant woman with a red belly saying “Syphilis Can Be Fatal to Your Baby.” While these billboards are factually true, Mayer describes how this kind of fear-based campaign, or “loss frame,” draws lots of attention but may not be particularly effective at motivating behavioral changes for STIs.

“We’re not telling anybody not to have sex,” Fox said. “We’re telling people to have safe sex,” and to get tested afterward.

The sex positivity message isn’t just for the public. The Toledo-Lucas health department also launched an educational campaign for clinicians, reminding them to take a sexual history of all patients — since the county saw syphilis in people ages 15 to 72 last year — and to order a blood test if they suspect an STI, since the standard “pee in a cup” test can’t detect syphilis.

“Many physicians haven’t seen syphilis, and they’ve got a million things to know,” Fox said. “If we don’t talk to the physicians, we’re not going to get the testing we need done.”

Stafford, the maternal-fetal medicine doctor in Houston, has taken a more hands-on approach. Texas mandates syphilis testing for pregnant women at three points — during their first prenatal visit, around the 28-week mark and before delivery — but in reality, these tests are often missed. So, last year, Stafford launched an alert in UTHealth’s electronic medical records, prompting providers to test their pregnant patients for syphilis at each of the prescribed times. The simple tweak helped increase screening rates from 2% to 47% at all three timepoints, while decreasing congenital syphilis cases by half.

Chokshi sees this as another good example of the public health and health care systems working hand-in-hand, with the former “setting the parameters of what standard of care should look like” and hospitals making it a reality. 

Make syphilis testing convenient

Beyond greater awareness, access to testing and treatment needs to be quick, easy and convenient, Chokshi said. 

Indian Country has led the way on this, partly by necessity: American Indian and Alaska Natives have the highest syphilis rates of any racial or ethnic group, almost seven times higher than white people. 

As such, tribes across the U.S. have turned to incentives, giving people $10 gift cards if they come in for STI testing or treatment, said Jessica Leston, founder of the Raven Collective, an Indigenous public health organization.

“We’re just helping people pay for gas and child care and get food on their table,” Leston said. At Cass Lake Indian Hospital’s pharmacy in rural Minnesota, the strategy increased STI testing tenfold, according to one study, with over 70% of the patients who got a test not having a primary care provider.

In 2023, a coalition of tribal communities partnered with Johns Hopkins School of Medicine to ramp up a program called I Want the Kit, which sends at-home STI test kits in the mail. The tests come in unmarked envelopes with instructions on how to collect a sample and send back the test. Results come back in a week or two, and patients are linked to health care resources if the test comes back positive.

Even with these programs, syphilis testing can be overshadowed by more immediate concerns.

In California, for example, half of pregnant women with syphilis reported methamphetamine use, and a quarter were homeless. In the state’s rural Shasta County, near the Oregon border, almost 100% of pregnant woman with syphilis similarly have a substance use disorder and 90% are unhoused, said Trojan Carvajal,
a supervising public health nurse in the county’s STI unit.

In April 2023, Shasta County launched the CommUNITY Mobile Care Clinic, an RV retrofitted with a reception area and two exam rooms, bringing STI tests and treatments to the county’s most vulnerable — from homeless camps to pop-ups with the local LBGTQ community center. Importantly, there’s no STI branding on the mobile clinic itself, allowing people to feel more comfortable walking in to get tested.

Last year, one-third of all syphilis tests performed by Shasta County were done through the mobile clinic, according to Jai Winchell, a community education specialist with the county’s public health department. These people would likely have never sought syphilis services otherwise, Winchell said, but with this mobile clinic crisscrossing the county and arriving at their doorsteps, they can get tested and treated in just 30 minutes.

Piggybacking syphilis services

Shasta County’s mobile clinic also offers other services, including test strips for deadly drugs like fentanyl and xylazine, naloxone to reverse overdoses and referrals to addiction counselors, as well as water, snacks and dental kits, Winchell said. The idea is to address overlapping concerns together, while also attracting those who wouldn’t have considered STI testing, if not for the package deal.

This approach also helps build trust, said Dr. Arlene Seña, an infectious diseases physician at the University of North Carolina Chapel Hill, showing how mobile clinic staff are invested in you as a person with various needs, rather than a singular problem to be solved. “It might be more costly, but it’s also much, much more effective and helpful to the community,” Seña said.

Syphilis services can also be integrated with general health care services. In March, Stafford launched a rapid testing program at two Houston hospitals aimed at all pregnant women admitted to the emergency department. The program, called Preg-Out, was set up on an opt-out basis, so everyone got tested unless they refused. It took about 15 minutes, and women were offered prenatal care regardless of the result.

“We noticed that pregnant patients, especially those that end up having a child with congenital syphilis, often frequent the ED and don’t get tested,” Stafford said. In the three-month pilot, Stafford said testing rates for pregnant women increased twelvefold, with about 35% of their partners wanting to get tested as well. 

Other hospitals have implemented opt-out screening programs for all patients, including Grady Memorial Hospital in Atlanta in one of their urgent care centers and the University of Chicago in their emergency department. Not every hospital has the resources to test everyone, Seña said, so she believes prioritizing pregnant patients, as done in Houston, can be a high-impact first step.

“You can’t just rely on public health departments to do the brunt of the work for STI recognition and prevention,” she said. “You have to go hand in hand with other providers in the community.”

The future ahead

The U.S. got syphilis rates down before, but that was in the 1990s, when HIV was ravaging through America. 

“What changed behavior then was lethal, hard-to-treat disease,” said Mayer, from Fenway Health. “Now, you have a generation of people who may be less informed,” leading to lower rates of condom use and STI screening rates. 

However, it’s also a time of innovation. In June, the CDC recommended doxycycline post-exposure prophylaxis for high-risk groups — essentially, a morning after pill for STIs. If taken within 72 hours of condomless sex, so-called DoxyPEP reduces syphilis rates by over 70%, and Fenway Health, where half of patients are LGBTQ, has already begun ramping up distribution, Mayer said. Meanwhile, other researchers like Seña have been working on developing a syphilis vaccine, but that’s probably several years down the line.

“Our task right now is to arrest the growth in cases,” said Chokshi, from the Common Health Coalition, and he’s optimistic that these innovative awareness, testing and treatment campaigns can do that. But permanently bending the syphilis curve will require scaling these efforts nationally and promoting greater coordination between health care and public health.

“There’s no reason that the endgame can’t be, once again, trying to eliminate syphilis — this historic scourge that is completely preventable and treatable,” Chokshi said.

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The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

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People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

This is the 14th person in the U.S. sickened with bird flu since March, when the virus was detected in cows, after infecting wild birds and mammals worldwide. One other person was infected in 2022.

The risk to the general public remains low, U.S. Centers for Disease Control and Prevention officials said in a statement. No unusual flu activity has been detected in the U.S., including in Missouri, officials said.

The latest case was confirmed after the person, an adult, was hospitalized on Aug. 22 with other medical conditions, officials with the Missouri Department of Health and Senior Services said in a statement.

The person tested positive for influenza A, and CDC officials later confirmed it to be bird flu. The person received antiviral medication and has since recovered and gone home, health officials said. It’s not clear whether the hospitalization was caused by the bird flu infection or the person’s existing health conditions, said Lisa Cox, a spokesperson for the Missouri health department.

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Health officials didn’t release the person’s name, age or hometown. No close contacts of the person have been infected, CDC officials said.

The case raises questions about how the person was exposed to the virus. All the previous U.S. infections were among people who worked around cows and poultry.

Bird flu has been detected in nearly 200 dairy herds in 14 states, but not in Missouri, according to the Agriculture Department. Bird flu has also been found in commercial and backyard flocks and in wild birds. The person did not report drinking raw milk, which can contain live virus, Cox said.

The investigation is continuing, officials said.

It’s the first case detected through routine influenza surveillance rather than through targeted efforts to identify people infected with bird flu through exposure to infected cows and poultry, officials said.

___

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

This summer, we saw a surge in Covid cases, that started in early June. And health experts predict that flu season could start early this year, too.

“For everyone aged six months and above, the recommendation is to get both a Covid and a flu booster,” Dr. Jen Brull, president-elect of the American Academy of Family Physicians, tells CNBC Make It.

The “flu [shot] is widely available. Covid was approved, is being released and is available in some places now. [It] should be widely available within the next few weeks to everyone.”

RSV (respiratory syncytial virus) season typically starts in October, and certain groups are more susceptible to severe outcomes from the virus than others, making its vaccine vital to receive.

Here are the vaccines that Brull recommends getting this fall season, and when it’s best to get them.

Here’s what you need to know about vaccines for fall and winter, from a doctor

1. The newest Covid vaccine

“Every year there is a new strain that’s going to cause grief, and the CDC is watching for that, and the FDA is watching for that, and the people who develop that updated [vaccine] are watching for that,” Brull says.

“And they are targeting the strain that is most likely to be prevalent and dangerous, just like we do for influenza.”

The new Covid vaccine will target the Omicron variant, KP.2, Brull tells Make It. The variants that are spreading the most in the U.S. at the moment are similar to KP.2, The New York Times reported.

When should you get the updated Covid vaccine? Brull suggests getting the vaccine as soon as it is available to you. “It is also okay, especially if you are at higher risk, or if you’ve had Covid in the last couple of months, or if you got a late summer booster of the last Covid vaccine because perhaps you’re at increased risk, to wait just a little bit longer into the fall.”

How much will it cost? Insurance plans typically cover the Covid vaccine, and you can usually receive it for free, Brull says. However, people who are uninsured could pay as much as $200 for the updated Covid vaccine this fall, according to The Washington Post. There may be programs available through a local health department or public health department where those who are uninsured can get the vaccines for little to no cost, Brull notes.

2. The updated flu shot

This one may come as no surprise, as the annual flu shot has been recommended for everyone above the age of six months for decades.

Some groups are at a higher-risk of severe complications from the flu, according to the CDC, including:

• People over the age of 65
• Children younger than five years old, especially those under the age of two
• Pregnant people
• Those with certain medical conditions, including diabetes, heart disease and asthma

“But even for people with none of those risk factors, you can end up quite ill with influenza, and there’s really no rhyme or reason who ends up in the ICU versus who has a mild case,” Dr. Andrew Pavia, chief of the division of pediatric infectious diseases at the University of Utah, told Make It last year.

When should you get the newest flu shot? Last year, Pavia told Make It, “you’re fine to get your vaccine in early September, [but] waiting until October may give you a little more protection against the late flu season.” Brull suggests getting your flu shot at the same time that you receive your Covid vaccine because “there may be a slight boost to your immunity if you get more than one vaccine at a time,” and you won’t forget to get the vaccines as you might have if you decided to delay receiving them.

How much will it cost? With an insurance plan, you can usually access the flu vaccine for free, Brull says. “For adults who are uninsured, oftentimes, health departments will carry vaccines for adults at low or no cost,” she adds.

3. The RSV vaccine

Unlike the Covid and flu shots, the RSV vaccine is mainly administered to infants and adults ages 60 and older who are at a higher risk of severe outcomes from the condition.

“Everyone can get RSV, but usually the people who become most ill are the young and the old,” Brull says.

Infants younger than 8 months old should receive the RSV vaccine if they’re born during this RSV season, which typically begins in October and ends in March, or are entering their first RSV season, according to the CDC.

The newest updates on the recommendations for adults who should receive the new RSV vaccine are:

• Anyone aged 75 and older should get the vaccine.
• Those between the ages of 60 and 74, should receive the RSV vaccine only if they have certain chronic medical conditions like heart disease or lung disease, or are living in nursing homes.

“This recommendation is for adults who did not get an RSV vaccine last year. The RSV vaccine is not currently an annual vaccine, meaning people do not need to get a dose every RSV season,” according to the CDC.

When should you get the RSV vaccine? At-risk groups should receive the RSV vaccine as soon as it becomes available, Pavia told Make It last year.

How much will it cost? Coverage for the RSV vaccine is variable, Pavia said. With certain Medicare plans, the RSV vaccine is fully covered. But if you don’t have insurance coverage, you could pay a hefty price to receive the shot, Pavia said.

“Private insurance could cover it, but they’re not legally required to do it for 12 months. So your insurance company might or might not cover it,” Pavia told Make It.

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An AP analysis of Food and Drug Administration data shows that agency staffers have not returned to roughly 2,000 pharmaceutical manufacturing firms to conduct surveillance inspections since before the pandemic, raising the risks of contamination and other issues in drugs used by millions of Americans.

The firms that are overdue for safety and quality inspections represent about 42% of the 4,700 plants that are currently registered to produce drugs for the U.S. and previously underwent FDA review before May 2019, the AP found. The plants make hundreds of critical medicines, including antibiotics, blood thinners and cancer therapies.

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Under FDA’s own guidelines, factories that haven’t been inspected in five or more years are considered a significant risk and are supposed to be prioritized for “mandatory” inspections. Most of the overdue plants are in the U.S., but more than 340 are in India and China, countries that together make up the largest source of drug ingredients used in low-cost U.S. prescriptions.

“Generic drugmakers are under intense pressure to cut their costs and some will do that by cutting quality,” said David Ridley of Duke University, who studies the pharmaceutical industry. “If they’re not inspected, then we won’t know about it until — in a few tragic cases — it’s too late.”

Tainted eyedrops from an Indian factory led to an outbreak of antibiotic-resistant bacteria that sickened more than 80 Americans last year. Four people died and more than a dozen others were blinded. The plant never registered with the FDA.

Prior to COVID-19, dozens of common medications made at FDA-regulated plants were recalled due to traces of cancer-causing contaminants. The FDA didn’t open its first overseas outposts until 2008, after dozens of U.S. deaths were linked to a contaminated blood thinner imported from a Chinese plant that hadn’t been inspected.

“The U.S. drug supply is the safest on the planet and no other regulator conducts more inspections than the FDA,” said FDA Associate Commissioner Michael Rogers, noting that the agency has increased drug inspections each year since 2021 while prioritizing foreign factories.

But last year’s inspection numbers were still down almost 40% from the pre-pandemic period, when the FDA averaged around 4,300 annual inspections. Rogers offered no date for when the backlog of uninspected plants might be cleared.

The agency’s work has been hampered by a wave of staff departures, he said, including longtime inspectors who have found new jobs that often allow them to work from home.

“There’s a significant cost to the agency associated with the loss through attrition of an experienced investigator," Rogers said. "We need to retain these people, and we are.”

The FDA halted all but the most “mission critical” inspections in March 2020. It gradually restarted prioritized inspections later that year, but regular international visits did not resume until 2022.

In a statement, the FDA said that it receives inspection details from international partners, including European regulators, which help the agency decide whether a visit is necessary. The agency also began using video and other online tools to evaluate plants remotely during COVID-19, although those aren't equivalent to physical inspections.

The FDA’s struggles overseeing the global pharmaceutical supply have been documented by the Government Accountability Office, which has flagged the area as a “high risk” issue every year since 2009.

Beginning in the 1990s, drugmakers began shifting manufacturing overseas, first to Puerto Rico, and then to Asia in search of cheaper labor and materials. The FDA has largely been playing catch-up ever since.

“We have to recognize that this is the world we live in and we have to adapt to it,” said Dr. Stephen Ostroff, FDA’s former chief scientist. “That has to include being able to get into these facilities and take a look at what they’re doing, particularly in India and China.”

'Cascade of failure'

The FDA keeps a confidential list of drug facilities to inspect, prioritizing them based on potential risks.

The AP created its own list by compiling public records of FDA inspections from before COVID-19 and tracking which firms haven’t received a follow-up within five years. The data accounts for the vast majority of inspections, but has some omissions, including visits required for new drug approvals and those that are part of ongoing government investigations.

The AP's tally of overdue plants also doesn’t include any of the new facilities that have registered with the agency since COVID-19 but haven’t yet had an initial inspection. FDA’s internal list of sites for inspection has increased 14% over the past five years, the agency noted last year.

The FDA said in a statement that it “must be judicious and apply a risk-based approach,” due to the “enormity” of its workload and limited budget.

“We prioritize the inspections that pose the greatest risk to public health,” the agency said.

On a global basis, FDA says only 6% of sites inspected last year had serious problems. But rates are higher in India, where 11% of plants were cited for violations, the most of any country.

Nearly 90% of FDA’s foreign inspections in fiscal 2023 were announced in advance, according to FDA correspondence with Congress obtained via public records requests. The GAO and other government watchdogs have long raised concerns about the practice, which typically gives companies up to 12 weeks to correct or conceal potential problems.

Even with the advanced warnings, the FDA has found egregious violations in overseas factories.

When agency staffers visited Intas Pharmaceuticals’ plant in northwest India for the first time in nearly three years they found what they called a “cascade of failure.” Among the violations, inspectors saw an employee “pouring acetic acid in a trash bin” to destroy company documents used for drug testing. Elsewhere inspectors found “plastic bags filled with torn and discarded” documents relating to quality control measures.

“This kind of behavior has been pointed out to the FDA time and time again by people like me for the last 10 years,” said Dinesh Thakur, a former pharmaceutical industry executive who became a whistleblower for the U.S. government. In 2013, his work led to a $500 million settlement with Indian drugmaker Ranbaxy for falsifying generic drug data.

“If you do not prosecute people who do this kind of wrongdoing, it gives the implicit signal that the FDA will give companies a pass,” Thakur said.

In the case of Intas, FDA issued a warning letter — which has no legal repercussions — and blocked some of the company’s exports to the U.S., while attempting to maintain shipments of the critical chemotherapy drug cisplatin. That strategy backfired in June 2023 when Intas abruptly shuttered the plant, triggering a nationwide shortage of cisplatin, which is used in more than a half-dozen cancers.

FDA inspections in India have been accelerating, but 160 plants are overdue, including some which haven’t been inspected since 2015 yet continue shipping pain pills, antibiotics and other medications to the U.S., according to AP's analysis.

Mexico, France and Spain also have over 100 overdue firms between them.

In China, political tensions have made inspections even more challenging. Just two fulltime FDA inspectors are based in the country, where about 185 factories are overdue. Former FDA officials say the Chinese government has withheld visas from inspectors unless the U.S. reciprocates for Chinese nationals seeking to enter the U.S.

FDA Commissioner Robert Califf has acknowledged his discomfort with the current situation.

“Even if we do periodic inspections, it’s not the same as a society where you have more freedom of information,” Califf told lawmakers at a hearing last year. “I am very concerned about it.”

Help wanted

The FDA could seemingly address its inspection backlog by hiring more investigators or assigning extra work to current staffers. But the agency is struggling to hold onto inspectors who can often earn far more working for the companies they now regulate.

On a call with FDA stakeholders in May, Rogers warned that “our attrition rates and our inability to retain our staff” would soon impact the agency’s ability to oversee drugs and other medical supplies.

The FDA currently has 225 vacancies on its inspection workforce, nearly four times as many as before COVID-19, according to agency records.

New inspectors generally start at an annual salary of about $40,000 and can eventually rise to over $100,000. Job postings alert applicants they may have to travel “up to 50% of the time.”

In 30 years as an FDA inspector, Jose Hernandez experienced firsthand the grueling pace and pressures of the job.

When he began doing international inspections in the mid-1990s, it was on a volunteer basis and employees spent no more than six weeks per year outside the U.S. By the end of his government career, Hernandez was traveling overseas more than four months per year, making multiple trips to Asia.

For each one-week inspection, he said he might need another week or more to write up his report, particularly if he found serious violations. Hernandez says that extra time and attention to detail wasn’t always appreciated by his managers.

“They just wanted people who are like bean counters: walk in, walk out and find nothing so that they can get this report through the system and make their numbers,” he said.

Hernandez retired from the FDA in 2014, earning just over $100,000 in his final year. Today he is a private consultant and says former FDA inspectors can easily earn more than $250,000 working for industry.

“Now I fly business class, I stay in nice hotels, I rest when I get there and nobody tells me what to do,” Hernandez said. “I made the right decision.”

FDA says it's exploring ways to make the jobs more attractive, including extra pay for experienced staffers and offering more flexible, comfortable travel arrangements.

Testing for quality

The slowdown in inspections has attracted scrutiny from lawmakers and raised new questions about whether FDA’s decades-old approach is working.

House Republicans have peppered the agency with dozens of inquiries about the program since 2023. In their most recent letter, members of the Energy and Commerce Committee ask regulators to explain why FDA staffers making high-priority inspections in Asia are reporting less than half as many violations today compared with pre-COVID-19.

“The committee is concerned that FDA’s fear of triggering additional drug shortages is driving the decreased rate that FDA issues warning letters,” states the June letter.

FDA’s Rogers rejected the argument, saying inspectors follow strict guidelines when conducting inspections and that decisions about managing drug shortages are handled separately by other parts of the agency.

A pilot program requested by the U.S. Defense Department takes an alternative approach to monitoring the drug supply. The Pentagon is collaborating with a private laboratory, Valisure, to evaluate 40 prescription drugs critical to military personnel, testing them for contaminants, dosing and other issues. Initial findings from the two-year program found serious flaws in about 10% of a subset of drugs tested, according to results shared with the AP.

Laboratory testing of imported drugs has long been standard practice in Europe, where more than 70 private labs operate alongside government regulators.

The testing approach has attracted interest from experts concerned that FDA’s method — rooted in physical inspections and reviewing paperwork — may not be up to the task of uncovering manufacturing problems on the other side of the world.

Stanford University Dr. Kevin Schulman believes in incentivizing U.S. pharmacy chains and drug distributors to only purchase drugs from high-quality manufacturers.

Currently, U.S. companies decide which generic drugs to buy based on whichever company has the lowest price, Schulman said. “Purchasers say, ‘Well, it’s the FDA’s job to worry about quality, not ours,’" he said.

Even as the FDA struggles to recover from COVID-19 and reinspect plants worldwide, Schulman sees a potential upside.

“Maybe this is the straw that breaks the camel’s back,” he said. “That, in fact, we should just admit that one U.S. agency can’t regulate the entire global manufacturing for this critically important market.”

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The latest survey numbers show the teen vaping rate fell to under 6% this year, down from 7.7% in 2023. More than 1.6 million students reported vaping in the previous month — about one-third the number in 2019, when underage vaping peaked with the use of discrete, high-nicotine e-cigarettes like Juul.

This year’s decline was mainly driven by a half-million fewer high school students who reported using e-cigarettes in the past month, officials said. Vaping was unchanged among middle schoolers, but remains less common in that group, at 3.5% of students.

“This is a monumental public health win,” FDA’s tobacco director Brian King told reporters. “But we can’t rest on our laurels. There’s clearly more work to do to further reduce youth use.”

King and other officials noted that the drop in vaping didn’t coincide with a rise in other tobacco industry products, such as nicotine pouches.

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Sales of small, flavored pouches like Zyn have surged among adults. The subject of viral videos on social media platforms, the pouches come in flavors like mint and cinnamon and slowly release nicotine when placed along the gumline. This year’s U.S. survey shows 1.8% of teens are using them, largely unchanged from last year.

“Our guard is up,” King said. “We’re aware of the reported growing sales trends and we’re closely monitoring the evolving tobacco product landscape.”

The federal survey involved more than 29,000 students in grades 6 through 12 who filled out an online questionnaire in the spring. Health officials consider the survey to be their best measure of youth tobacco and nicotine trends. Thursday’s update focused on vaping products and nicotine pouches, but the full publication will eventually include rates of cigarette and cigar smoking, which have also hit historic lows in recent years.

Officials from the FDA and Centers for Disease Control and Prevention attributed the big drop in vaping to recent age restrictions and more aggressive enforcement against retailers and manufacturers, including Chinese vaping companies who have sold their e-cigarettes illegally in the U.S. for years.

Use of the most popular e-cigarette among teens, Elf Bar, fell 36% in the wake of FDA warning letters to stores and distributors selling the brightly colored vapes, which come in flavors like watermelon ice and peach mango. The brand is part of a wave of cheap, disposable e-cigarettes from China that have taken over a large portion of the U.S. vaping market. The FDA has tried to block such imports, although Elf Bar and other brands have tried to find workarounds by changing their names, addresses and logos.

Teen use of major American e-cigarettes like Vuse and Juul remained significant, with about 12% of teens who vape reporting use of those those brands.

In 2020, FDA regulators banned fruit and candy flavors from reusable e-cigarettes like Juul, which are now only sold in menthol and tobacco. But the flavor restriction didn’t apply to disposable products, and companies like Elf Bar stepped in to fill the gap.

Other key findings in the report:

• Among students who current use e-cigarettes, about 26% said they vape daily.
• Nearly 90% of the students who vape used flavored products, with fruit flavors as the overwhelming favorite.
• Zyn is the most common nicotine pouch among teens who use the products.

Pharmacies began giving out the vaccines — which are recommended for everyone ages 6 months and older — last month. The Centers for Disease Control and Prevention recommends getting a flu shot either this month or next, since flu activity typically picks up in the fall, with cases reaching their peak sometime from December to February. 

It takes around two weeks for the vaccine to become fully effective. 

“You really want to think about getting your appointment or making your plan to get vaccinated sometime around the last half of September through the end of October,” said Dr. Judith O’Donnell, chief of infectious diseases at Penn Presbyterian Medical Center in Philadelphia.

This year’s flu shots are trivalent, meaning they protect against three flu viruses: two versions of influenza A and one type of influenza B. For more than a decade, flu shots in the U.S. also protected against a fourth strain of influenza B, but that strain hasn’t circulated since March 2020, so the Food and Drug Administration’s vaccine advisory committee elected this year to exclude it.

What to know about flu shots

Although most people need one dose of the vaccine, children up to 8 who haven’t been vaccinated for flu before should get two shots at least four weeks apart. The CDC recommends that unvaccinated children get their first shot right away.

Because adults ages 65 and up have the highest risk of severe illness from flu, they should ask for certain shots that produce a stronger immune response than a standard flu vaccine. The CDC recommends three options for this age group: Fluzone High-Dose, Flublok or Fluad. The first two are high-dose vaccines, meaning they contain a greater amount of antigen, an ingredient that triggers an immune response. Fluad, meanwhile, contains an ingredient that helps boost the immune response, called an adjuvant. 

“You have to really shop around and figure out where that’s available, because it won’t be available everywhere,” said Amanda Joy, a physician assistant at MedStar Health, a health care provider in the Washington, D.C., area. She suggested calling ahead to doctor’s offices or pharmacies.

Last year, around 25,000 people died of the flu in the U.S. and 400,000 were hospitalized.

The effectiveness of flu vaccines at preventing doctor’s visits tends to vary from year to year. Scientists choose which strains to target based on what’s circulating in other parts of the world, but it’s not a guarantee that those strains will dominate in the U.S.

“In an optimal year, you get up to about 80% [effectiveness]. In a bad year, maybe 30%,” said Dr. Michelle Barron, senior medical director of infection prevention and control at UCHealth.

Australia offers a window into what the U.S. can expect, since its flu season lasts from around June to September. This year, there weren’t an outsized number of hospitalizations or deaths.

“It looks like it was a fairly typical flu season. It didn’t necessarily start early, which was our concern last year,” Barron said.

Although some people with egg allergies may be hesitant to get flu vaccines, given that most are egg-based, the shots are still safe for that group. Joy said people with lingering concerns can seek out Flucelvax, a vaccine that’s developed using mammalian cells instead. 

Covid and flu shots can be administered at the same time

Health experts expect flu and Covid to deliver a one-two punch during the fall and winter, as they have in past years. Although the summer wave of Covid cases hasn’t died down yet, experts anticipate another wave this winter, perhaps at the same time that flu cases peak.

The new Covid vaccines target the KP.2 variant, which became dominant in the U.S. at the end of April. A genetically similar strain, KP.3.1.1, has since taken over, but the latest vaccine should still offer better protection against it than previous Covid shots.

The shots are recommended for everyone 6 months and older. Children up to 4 years old should get at least one dose of the new formula, and potentially two or three if they’ve never been vaccinated before, according to the CDC.

Everyone else should get one dose. People who recently had Covid can wait to get their shot until three months after their infection, since they’re likely to have some immunity already. 

The Covid and flu shots can be safely administered at the same time, in the same arm or different ones. The CDC recommends getting both at once for convenience, though it’s unclear if this brings additional advantages. A small study published in April found that co-administering Covid and flu shots boosted the antibody response to Covid in blood samples, but experts aren’t sure if that translates to more protection.

Getting the shots at once might also slightly increase side effects, according to a CDC study, though the reactions are still generally mild.

“You may feel some aches and some chills and maybe a low-grade temperature if you get them both together, but you could also get that from each individually,” Joy said.

She added that when finding a time to get any vaccine, it’s best to hold off if you’re feeling unwell.

“You may not get the full response you want if you’re getting vaccines while you’re sick, so it’s much better to wait ‘til you’re healthy,” she said.

How much do the shots cost?

Flu shots are available at doctor’s offices, pharmacies, health clinics and through some workplaces.

CVS and Walgreens have both Covid and flu vaccines in stock, but Walmart pharmacies only offer flu shots right now. Walmart said it’s prepared to administer Covid shots as supply becomes available. 

People with insurance shouldn’t have to pay out-of-pocket for the vaccines as long as they get them from an in-network provider. Covid and flu shots are also covered for children without insurance through the government-run Vaccines for Children Program. 

Adults without insurance may be able to find free or low-cost vaccines at some federally qualified health centers or state or local health departments, but supply can be limited. Otherwise, the Covid vaccine costs around $150 to $200 — a difference from past years, when they were free regardless of insurance status. The CDC’s Bridge Access Program, which paid for Covid shots for uninsured adults, ended in August.

Flu vaccines can range from $25 to more than $100, depending on the shot.

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The Food and Drug Administration released new standards in March of 2023 in an effort to help more women detect breast cancer sooner. The FDA gave providers until Sept. 9, 2024 to comply with the new rule for them to include a note on mammogram reports noting if their patients have dense breasts.

“It’s really an opportunity to put the power back into the hands of the patients and letting them know what type of density they have,” Molly Guthrie, with the Susan G. Komen Breast Cancer Foundation, told News4.

About half of women over the age of 40 in the U.S. have dense breast tissue, which can make cancers more difficult to spot on a mammogram, the FDA said. Dense breasts have also been identified as a risk factor for developing breast cancer.

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D.C. resident Cheryl Shaw beat breast cancer in 2008, but said she never imagined it would come back 11 years later.

“As a mom, as a grandma, I want to be around for them,” Shaw said. “You know, I have a lot more to do in life. I’m not done.”

When her cancer came back, doctors didn’t discover it until it was already in stage 3, even though she’d had a mammogram just months before.

It wasn’t detected because Shaw has dense breasts with a lot of tissue. But she said doctors hadn’t warned her about her breast density.

“If we don’t know what’s going on with our bodies, if we don’t know what the cause is or we don’t know what to look for, we don’t know what questions to ask,” she said.

Those with dense breasts may need to get MRIs or ultrasounds, depending on other risk factors.

According to the Centers for Disease Control and Prevention, breast density can change over time.

Women are more likely to have dense breasts if they’re younger, have a lower body weight, and are pregnant or breastfeeding.

Shaw is now in remission. She works at the Smith Center for Healing and the Arts on U Street, helping give back to cancer patients and spreading awareness on the importance of screenings.

“Some people see cancer as something they don’t want to know about, and that if they find out about it, they’re no longer gonna be here. But the reality is, there’s so many survivors and I’m one of them,” she said.

Black women are more than three times as likely to die from pregnancy or childbirth as white women in Oklahoma, which consistently ranks among the worst states in the nation for maternal mortality.

“Tulsa is suffering,” said Corrina Jackson, who heads up a local version of the federal Healthy Start program, coordinating needed care and helping women through their pregnancies. “We’re talking about lives here.”

Across the nation, programs at all levels of government — federal, state and local — have the same goals to reduce maternal mortality and erase the race gap. None has all the answers, but many are making headway in their communities and paving the way for other places.

Jackson’s project is one of more than 100 funded through Healthy Start, which gave out $105 million nationally in grants this year. Officials call Healthy Start an essential part of the Biden administration’s plan for addressing maternal health.

Other approaches to the crisis include California halving its maternal mortality rate through an organization that shares the best ways to treat common causes of maternal death and New York City expanding access to midwives and doulas two years ago. Several states passed laws this year aiming to improve maternal health, including a sweeping measure in Massachusetts. And last week, the U.S. Department of Health and Human Services announced more than $568 million in funding to improve maternal health through efforts such as home visiting services and better identifying and preventing pregnancy-related deaths.

Locally and nationally, “we need to really identify the birthing people who are at potentially the greatest risk,” New York City health commissioner Dr. Ashwin Vasan said, “and then wrap our arms around them throughout their pregnancies.”

A Healthy Start in Tulsa

Besides coordinating prenatal and postpartum care — which experts say is crucial for keeping moms alive — local Healthy Start projects provide pregnancy and parenting education and referrals to services for things like depression or domestic violence. The local efforts also involve women’s partners and kids up to 18 months. And they focus on issues that influence health, such as getting transportation to appointments.

“You try to get them in their first trimester and then work with them to delivery day, and then we also work with the babies to make sure that they reach their milestones,” Jackson said.

Jackson got help from the local Urban League as a single mom, and felt called to give back to her community. She’s been with Healthy Start for more than 25 years, first through Tulsa’s health department and recently through a nonprofit she started that received about $1 million in federal funds this fiscal year.

“I’m just like a mom to this program,” Jackson said.

Oklahoma overall has a maternal mortality rate of about 30 per 100,000 live births, significantly higher than the national average of about 23. But in Jackson’s quarter-century tenure, she said, there have been no maternal deaths among clients.

Pivotal to Healthy Start’s success are care coordinators like Krystal Keener, a social worker based at Oklahoma State University’s obstetrics and gynecology clinic, where clients get prenatal care. One of her responsibilities is to educate clients about health issues, like how to spot the signs of preeclampsia or how much bleeding is too much after delivery.

She also helps with practical matters: Many clients don’t have cars, so they call Keener when they need a ride to a prenatal visit, and she assists in scheduling one.

With doctors, Keener serves as a patient advocate. On a recent afternoon, Keener sat in on a prenatal appointment for Areana Coles. A single mom, Coles was joined by her 5-year-old daughter, who was born prematurely and spent time in intensive care.

Coles, 25, said Healthy Start is “probably the best thing that’s happened in this pregnancy.” She called Keener “an angel.”

Together they navigated several recent medical concerns, including dehydration and low potassium levels that put Coles in the hospital.

With Coles’ due date approaching, Keener talked about what to watch for around delivery and shortly after, like blood clots and postpartum depression. She advised Coles to take care of herself and “give yourself credit for small things you do.”

During an ultrasound a few minutes later, Coles watched Dr. Jacob Lenz point to her unborn baby’s eyes, mouth, hand and heart. He printed an image of the scan, which Coles immediately showed her daughter.

Keener said she’s gratified that Coles would not be giving birth prematurely this time.

“You made it to term – yay!” she told her client.

Coles smiled. “My body can do it!”

Improving medical care

While programs like Healthy Start focus on individual patient needs, other efforts manage the overall quality of medical care.

California has the lowest maternal mortality in the nation — 10.5 per 100,000 live births, less than half the national rate. But that wasn’t the case before it created a “maternal quality care collaborative” in 2006.

Founded at Stanford University’s medical school in partnership with the state, it brings together people from every hospital with a maternity unit to share best practices on how to deal with issues that could lead to maternal injury or death, like high blood pressure, cardiovascular disease and sepsis.

“When you look at the rate of maternal death in the United States compared to California, they basically ran neck-and-neck until it was established,” said Dr. Amanda Williams, clinical innovation adviser for the collaborative. “At that time they totally separated and California started going down. The rest of the country started going up.”

In the collaborative, hospitals get toolkits full of materials such as care guidelines in multiple formats, articles on best practices and slide sets that spell out what to do in medical emergencies, how to set up medical teams and what supplies to keep on the unit. The collaborative also tackles issues such as improving obstetric care by integrating midwives and doulas – whose services are covered by the state’s Medicaid program.

At first, some doctors resisted the effort, figuring they knew best, Williams said, but there’s much less pushback now that the collaborative has proven its value.

MemorialCare Miller Children’s & Women’s Hospital Long Beach started participating around 2010. The collaborative helps “vet through all the research that’s out there,” said Shari Kelly, executive director of perinatal services. “It’s just so important to really understand how we as health care providers can make a difference.”

For example, if a woman loses a certain amount of blood after a vaginal delivery, “we know to activate what we call here a ‘code crimson,’ which brings blood to the bedside,” Kelly said. “We can act fast and stop any potential hemorrhage.”

She said the collaborative has also helped reduce racial inequities — bringing down the rate of cesarean sections among Black moms, for example.

In July, U.S. Centers for Medicare & Medicaid Services proposed a similar initiative to California’s, focused on the quality of maternal care nationwide: the first baseline health and safety requirements for maternal emergency and obstetric services in hospitals.

A community perspective

Experts said getting maternal mortality under control at a national level requires tailoring solutions to individual communities, which is easier when programs are locally run.

New York City has a goal of reducing maternal mortality overall — and specifically achieving a 10% drop in Black maternal mortality by 2030. Statewide, Black residents are about four times more likely to die from pregnancy or childbirth than white residents.

The city is starting with, among others, low-income residents and those living in public housing. The New Family Home Visits Initiative gives pregnant people and those who’ve given birth visits from professionals such as nurses, midwives, doulas and lactation consultants. Vasan said more than 12,000 families have gotten visits since 2022.

Nurse Shinda Cover-Bowen works for the initiative’s Nurse Family Partnership, which has her visiting some families for 2 1/2 years, well beyond the pregnancy and birth. She said “that consistency of someone being there for you and listening to you and guiding you on your mother’s journey is priceless.”

Being grounded in the local community — and its history — is also crucial for Healthy Start projects. The lingering effects of racism are evident in Tulsa, where in 1921, white residents are estimated to have killed 100-300 Black people and destroyed homes, churches, schools and businesses in the Greenwood section. That’s where Jackson lives now, and where health disparities persist.

Being relatable is valuable for Black women, who may distrust the health care system, Jackson said. Plus, knowing the community makes it possible to work closely with other local agencies to meet people’s needs.

Denise Jones, who enrolled in Healthy Start in February, has struggled with anxiety, depression and drug addiction, but has been sober since April.

In mid-July, baby items filled her room — a crib, a bassinet, tiny clothes hanging neatly in a closet — in anticipation of her child’s arrival. Jones, 32, flipped through a baby book, pointing to a sonogram of her son Levi, who would be born within a couple of weeks.

She said she feels healthy and blessed by the help she’s gotten from Healthy Start and Madonna House, a transitional living program run by Catholic Charities of Eastern Oklahoma.

“I have professionals that are working with me and give me support. I didn’t have that with my other pregnancies,” she said. “I’m at one with my baby and I’m able to focus.”

___

Associated Press data journalist Nicky Forster in New York contributed to this report.

___

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

Each year, the Centers for Disease Control and Prevention looks to countries in the Southern Hemisphere as a potential indicator for what’s to come in the United States.

Some countries in South America and Africa experienced an earlier start to their flu seasons, which typically run from April to September and sometimes last until October or November, the CDC said in late August.

Influenza A, specifically H3N2 viruses, were predominant in Australia and South America, particularly in Chile, Ecuador and Uruguay, where there were high levels of severe flu-related disease and hospitalizations, the CDC said.

In Africa, influenza A H1N1 viruses dominated, though influenza B has increased in recent weeks, according to the CDC.

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The CDC said getting a flu vaccine is the best form of protection against severe illness and hospitalization.

A local doctor told News4 some people might want to get their shot as soon as possible as flu activity typically begins in America in October. It usually takes two weeks after a flu shot to build strong immunity.

“If you are in a high risk group, you know, 65 and older [or] you’re a pregnant person, then what you would want to do is get it as soon as possible so you can get that extra bit of protection as soon as you can. However, if you’re not in a high risk group, I would recommend waiting probably until the tail end of September or beginning of October. I think those are a great time so that you can get it to last all throughout the flu season,” said Dr. Adrian Dyer, a family medicine physician for MedStar Health.

It’s safe to get a flu shot and the new COVID-19 shot at the same time, according to the CDC. But Dyer said it’s alright to spread them out, if that’s what a patient prefers.

“You don’t have to do all the shots in one visit. You can space them out. Take one today. Take another one in two weeks. Take it slow,” Dyer said.

Children younger than 9 who have never had a flu shot before should get two doses this year, at least four weeks apart, according to the CDC. Kids in that same age group who have only had one shot during previous flu seasons may also need two shots this year.

In an interview with Australian Women’s Weekly, the 60-year-old explained why she opted against the standard treatment in favor of what she called a more “holistic” approach.

“It was a shock, it was unexpected, it was confusing, it was daunting in so many ways,” the Sports Illustrated swimsuit model said of the diagnosis in the interview published Monday. “And it really gave me an opportunity to dig deep in my inner sense to find a solution that worked for me.”

Macpherson, who has an upcoming book, “elle,” said it was difficult for her to take this nontraditional path.

“I chose an holistic approach. Saying no to standard medical solutions was the hardest thing I’ve ever done in my life. But saying no to my own inner sense would have been even harder,” she wrote, according to excerpts quoted by Australian Women’s Weekly.

“Sometimes an authentic choice from the heart makes no sense to others … but it doesn’t have to.”

She conceded this approach isn’t for everyone.

“People thought
I was crazy but I knew I had to make
a choice that truly resonated with
me,” Macpherson wrote. “To me, that meant addressing emotional as well as physical factors associated with breast cancer. It was time for deep, inner reflection. And that took courage.”

Macpherson’s two sons, Flynn, 19, and Cy, 14, disagreed over their mom’s choices.

“Cy simply thought that chemo kills you. And so he never wanted me to do it because he thought that was a kiss of death,” she wrote. “Flynn, being more conventional, wasn’t comfortable with my choice at all. He is my son, though, and would support me through anything and love me through my choices, even if he didn’t agree with them. My children were extremely supportive in their different ways but I knew they felt very scared.”

Her medical team consists of a naturopathy practitioner, a holistic dentist, an osteopath, a chiropractor and therapists, according to Australian Women’s Weekly.

She’s alive and well today.

“In traditional terms, they’d say I’m in clinical remission, but I would say I’m in utter wellness. And I am!” Macpherson said.

“Truly, from every perspective, every blood test, every scan, every imaging test … but also emotionally, spiritually and mentally — not only physically. It’s not only what your blood tests say, it’s how and why you are living your life on all levels.”

Macpherson has a history of publicly embracing unconventional and controversial approaches to medicine. She once dated disgraced British physician Andrew Wakefield and helped him promote his anti-vaccine movie, “1986: The Act.”

Wakefield is best known for making a discredited link between measles vaccines and autism, a disproven claim that made him a prominent figure in the anti-vaccine movement.

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Most states in the South and Southeast, including Florida, Georgia, Kentucky, Mississippi, Oklahoma, Texas, Virginia and the Carolinas, are facing heat warnings on this Labor Day, according to the National Weather Service.

Extreme heat can be dangerous for anyone, of any age. For many people living in those areas, relentlessly high temperatures can be especially dire.

In states such as Alabama, Georgia, Louisiana, Mississippi, Georgia and South Carolina, the rates of chronic diseases such as diabetes, heart disease and kidney disease are among the highest in the U.S.

Those diseases make it harder for bodies to cool themselves effectively during heat waves.

“People who have chronic health conditions are going to be more susceptible, particularly when you get sustained high-heat, high-humidity days,” said Dr. John Sherner, chair of medicine at MedStar Washington Hospital Center. “Their body is not going to be able to regulate temperature as tightly, so when the environment gets hotter, they’re going to get hotter more quickly.”

While no part of the U.S. is spared when it comes to rising heat or prevalence of underlying illnesses, the two often merge dangerously in the South and Southeast.

Monday’s heat risk forecast

“Major” and “extreme” heat risk levels pose a danger to people without effective cooling or hydration.

Under those conditions, the body’s natural impulse is to dilate, or widen, the blood vessels so that more blood gets to the skin to expel as much internal heat as possible. The heart has to work hard to make this happen.

It’s those Southern states that, historically, have had higher numbers of residents whose underlying health problems make it more difficult to do the work necessary to maintain a healthy body temperature.

Heart failure, for example, is a condition in which the heart isn’t able to pump oxygen-rich blood at full strength to the entire body, even in normal temperatures.

Heart failure hospitalization rates from 2019 to 2021

Among those 65 and older, Medicare beneficiaries in the eastern U.S. had the highest rates of hospitalization related to heart failure.

According to 2019-21 data from the Centers for Disease Control and Prevention, older adults on Medicare living in Southern and Eastern states had the highest rates of hospitalization for heart failure in the country.

Strains on hospital systems

“We’re seeing a lot of heart failure,” said Dr. Joanne Skaggs, associate chief medical officer of adults at OU Health University of Oklahoma Medical Center, said, as well as “a significant amount of patients who are dehydrated and feeling dizzy” in emergency departments.

The combination is creating “a lot of strain on an already strained” health care system, she said.

Patients with diabetes or other chronic disease are at even greater risk for heart failure, according to the CDC.

“I had a couple that literally cooked themselves,” said Dr. David Obert, University Medical Center of Southern Nevada in Las Vegas. The pair, both older adults, stayed in their house for three days after their air conditioner broke, and developed significant kidney failure.

‘A cycle we can’t seem to break’

Heat waves are increasingly longer and more intense each year.

2023 was the hottest year ever recorded, according to the National Oceanic and Atmospheric Administration, and there is a 77% chance that 2024 will break that record.

“Unfortunately, this is a cycle that we can’t seem to break,” said Kimberly McMahon, public program manager at NOAA’s National Weather Service.

This summer, the National Integrated Heat Health Information System developed a federal strategic plan designed to explore critical issues surrounding heat’s impact on health. McMahon is a co-chair.

“If we know that heat is deadly — and we’re actually very good at forecasting how hot it’s going to be — why do we continue to have so many deaths?” she said.

Staying safe in the heat

• Drink water. When you think you’ve had enough, drink more.
• Recognize the signs of heat-related illnesses, including cramping, muscle spasms, dizziness, headaches, weakness, nausea and confusion. Those are signals that a person may need medical attention.
• Seek help if you do not have access to air conditioning or other ways of cooling down.

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More often than not, disputing it can reveal errors and potentially lead to a more affordable bill, according to a study published Friday in JAMA Health Forum.

“If there’s a bill that you receive that doesn’t look quite right or that you can’t afford, pick up the phone and call the billing office,” said lead study author Erin Duffy, director of research training at the USC Schaeffer Center for Health Policy and Economics. “When people do, most get positive results.”

According to the survey’s results, about 1 in 5 people said they got a medical bill they disagreed with or couldn’t afford over the past year, 61.5% of whom said they contacted billing offices to address their concerns. Most people who didn’t call billing offices said they thought it wouldn’t make a difference, Duffy said. 

“Most of the time, the bill was corrected,” she said. “And even people who just felt it was unfair, even if they could afford it, a lot of them were able to negotiate a lower price.”

Among those who reached out about a billing error, almost three-quarters reported that the mistake was corrected, the study found. About 62% of people who reached out about an unaffordable bill said they got a payment plan or price drop; about 76% who wanted to negotiate said they got financial help or had their bill canceled.

The survey’s findings come as more than half of adults in the United States say they’ve had medical debt in the past five years, according to a 2022 survey from KFF, a nonprofit group that researches health policy issues. Another report from KFF finds that people in the U.S. owe at least $220 billion in medical debt. 

Dr. Adam Gaffney, a critical care physician at the Cambridge Health Alliance in Massachusetts, said medical debt can “ruin people’s financial futures,” including hurting their ability to get a loan or a mortgage. People have also had their wages garnished, he said, or have been sued by hospitals over unpaid medical bills.

Duffy notes that certain individuals in the survey were more inclined to dispute a medical bill: extroverts and people tend to be more skeptical, competitive and upfront about their opinions. 

People without a college degree, those with low financial literacy and the uninsured were the least likely to dispute a bill, she added. 

The study was based on survey responses from more than 1,100 adults in the U.S. between Aug. 14 and Oct. 14 of last year.

How to dispute a medical bill

The first thing you should do if something looks wrong on a medical bill is make sure the bill is yours, said Michele Johnson, executive director of the Tennessee Justice Center, a law firm and nonprofit advocacy group. That’s especially important if you have a common last name, she added.

“I’ve gotten bills before that aren’t even mine,” she said. “My husband’s name is Hill, my name is Johnson, and it’s happened repeatedly. So is it your bill? That’s the first thing to ask.”

Johnson also suggested asking the hospital for an itemized bill, which will provide a detailed list of all the services, treatments and procedures a patient got during the visit. Hospitals are required to send an itemized bill within 30 days of a request.

“We have seen situations where an infant baby boy is charged for a pregnancy test,” she said. “When they give you the itemized statement, look to see if those are services that you actually used or could have used.” And then call the billing office if something looks wrong. 

The No Surprises Act, which was signed into law in 2020, protects people from getting surprise medical bills when they get medical services from an out-of-network provider at an in-network facility, Johnson said. (In-network means the health care provider signed an agreement with your health insurance to accept a discounted rate; out-of-network means no agreement is in place.)

“If you’re in an insured hospital and see a doctor who is in-network for you, they can’t then have an anesthesiologist that is out-of-network,” Johnson said. 

People without insurance and those not using their insurance for a service can get a “good faith” estimate of the cost of care before their visit, she added. Then, if someone gets a bill that is at least $400 more than the estimate, they can dispute it. 

Many hospitals also offer financial assistance, also known as charity care, she said. Nonprofit hospitals are required to have a charity care policy and make it available to read on their website. If eligible, Johnson said, people can get the cost of their care reduced or even for free — even if they’ve already been billed. 

Johnson also advised against using credit cards to pay off a bill, if at all possible. That’s because a proposed rule from the Consumer Financial Protection Bureau that’s expected to take effect next year will remove medical debt from credit reports.

Johnson recommended requesting a payment plan instead. 

“Medical bills are treated differently than credit card debt,” she said. “You don’t want to pay that over the top of essentials like housing or food, which often our elderly clients will do even for bills they don’t actually owe.” 

Johnson said patients should remember that they can and should dispute a bill if they feel something is wrong.

“We think of health care bills as this whole other thing, like a black box that we don’t have any access to, because the American health care system is very much, there’s a power dynamic that really makes patients feel vulnerable and helpless,” she said. “But the truth is, if they’re charging you money, there are certain rules that protect you as a consumer and that enable you to push back.”

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The Food and Drug Administration authorized Novavax‘s updated protein-based Covid vaccine for emergency use in people ages 12 and up on Friday, paving the way for the shot to compete with Pfizer and Moderna‘s jabs this fall and winter. 

Novavax’s vaccine targets the highly contagious omicron subvariant JN.1, which began circulating widely in the U.S. earlier this year. JN.1 only accounted for 0.2% of cases circulating nationwide as of this week, according to the latest Centers for Disease Control and Prevention data. 

Novavax manufactures protein-based vaccines, which cannot be quickly updated to target another strain of the virus.

Despite that, the biotech company has noted that its shot provides protection against descendants of JN.1 that are currently dominant in the U.S., including KP.2.3, KP.3, KP.3.1.1 and LB.1.

“Our updated vaccine targets JN.1, the ‘parent strain’ of currently circulating variants, and has shown robust cross-reactivity against JN.1 lineage viruses,” Novavax CEO John Jacobs said in a statement.

Novavax said it expects its shot to be “broadly available” in thousands of locations across the U.S., including retail and independent pharmacies and regional grocers.

Shares of Novavax rose more than 8% on Friday following the announcement. 

The FDA’s decision comes only a week after it approved a new round of messenger RNA shots from Pfizer and Moderna, which both target another offshoot of JN.1 called KP.2. Last year, the agency authorized Novavax’s shot nearly a month after clearing vaccines from its rivals, putting the company at a disadvantage. 

Public health officials see Novavax’s vaccine as a valuable alternative for people who don’t want to take mRNA shots from Pfizer and Moderna, which use a newer vaccine method to teach cells how to make proteins that trigger an immune response against Covid. Novavax’s shot, meanwhile, fends off the virus with protein-based technology, a decades-old method used in routine vaccinations against hepatitis B and shingles.

It’s unclear how many people will get a new Covid shot this fall and winter. 

Only around 22.5% of U.S. adults received the latest round of shots that came out last fall, according to CDC data through early May. 

The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

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KP.3 COVID variant is dominant in the US: What are the symptoms?

People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

It was the first time any living human had received a pig organ transplant.

“You never know what the news is, but my dad opened his eyes, and he was awake, and he was doing well. It was incredible,” Bennett Jr. said.

Bennett’s father, David Bennett Sr., had severe congestive heart failure and wasn’t a candidate for a human transplant. He knew he would likely die soon. There was nothing more to do — other than take a chance on a novel, cutting-edge surgery. Bennett Sr. and his son agreed it was worth the risk.  

The achievement made headlines around the world after the transplant surgery in January 2022. The results at first seemed promising, and some family members even began to entertain the idea that Bennett Sr. might eventually leave the hospital.

“There were definitely futuristic conversations, just about home setup and who was going to take care of him and how that would look,” Bennett Jr. said. “Everybody was very optimistic and hopeful.”

But two months later, Bennett Sr.’s body rejected the heart and he died at age 57. In a paper, his doctors at the University of Maryland Medical Center explained that his body had likely produced too many antibodies that fought off the new organ. A drug he’d been given may also have increased the odds of rejection, and a virus in the pig heart further complicated matters. 

Three other patients have followed in Bennett Sr.’s footsteps and received pig organs, most recently a pig kidney transplant in April. Together, they represent the pioneer patients of the burgeoning field of xenotransplantation. For their families, three of which spoke to NBC News about the experience, the journey came with a roller coaster of emotions, from uncertainty to blind hope — and, ultimately, admiration for their loved one’s decision. 

“I would love to still have my dad here, obviously, but I know that his sacrifice wasn’t for nothing,” Bennett Jr. said.

None of the patients survived more than three months. To the public, that might seem like failure. But to the families, the transplants accomplished their goals: to buy their loved ones more time and advance research that could potentially save lives one day.

“Larry approached it in this way: He was going to die. It was inevitable, and it was coming soon,” said Ann Faucette, whose husband of nearly 38 years, Lawrence Faucette, was the second person to receive a pig heart. “So why not offer up his body as a test subject for them to get as much data, do as much research as they could, so in the future there’s that other option for people who need those transplants?”

The promise of xenotransplants lies in the shortage of available human organs. An estimated 17 people die in the U.S. each day waiting for an organ transplant, according to the Health Resources and Services Administration. Because pig organs are more readily available, doctors envision a future in which these operations are as common as a hip replacement. 

But at this early stage, the Food and Drug Administration has only approved xenotransplants for patients on the verge of death with no other options. 

Like Bennett Sr., Lawrence Faucette qualified for a pig heart because he was dying of heart failure. Ann Faucette said that after the surgery, her husband was able to play cards and do physical therapy on an exercise bike. It was a contrast to the day before the surgery, when his heart had stopped and needed to be revived with an internal defibrillator. 

“We’re having full-on conversations. We’re watching football,” Ann said. “It’s like normal life, as normal as it can be in a hospital.”

She focused on the positives: “I was in denial. This was going to work. He was going to get better. He was going to come home,” Ann said.

Her two sons, now 29 and 31, “saw that the end could be at any point, so they made sure that they told Larry how they felt,” she added — that they loved him.

At her husband’s request, Ann bought a new chair for their house in Frederick, Maryland, in preparation for his return. The day it was delivered, she learned his condition had worsened.

“While I’m waiting for the chair, I get the call that they want to put Larry on ECMO,” she said, referring to a life-support device.

He died of transplant rejection roughly two weeks later, less than six weeks after the surgery. 

His doctors said Faucette’s recovery was complicated by the fact that his strength had declined shortly before the operation. 

The two xenotransplants after that followed a similar pattern: After surgery, the patients began to feel much better, then suddenly worsened after several weeks.

Brittany Harvill’s mother, Lisa Pisano, received a genetically modified pig kidney in April. Within a week, she had noticeably improved, Harvill said.

“She’s like, ‘I feel great.’ You could see the color in her face,” she said. “She looked like a whole new person.”

Before the surgery, Pisano could hardly walk due to shortness of breath and extreme fatigue. She had heart and kidney failure, so her surgery was more complicated than the others: Doctors implanted a mechanical heart pump eight days before the pig kidney. After the surgery, Pisano seemed more alert than ever, according to Harvill. She FaceTimed her grandchildren from the hospital, watched cooking shows and hung out with her daughter.

“I would bring pictures and then we would talk about what the kids were up to,” Harvill said.

But the demands of the transplant proved too much for Pisano’s other organs. Doctors prescribed blood-pressure medication, but it ultimately led to the rejection of the kidney. Pisano died in hospice care on July 7, around 12 weeks after the transplant.

Harvill said her mom was confident in her decision, but she still wishes Pisano had lived long enough to see her granddaughter, Olivia, go off to kindergarten.

“One thing that upsets me is that my mom would have loved to be there for that,” she said through tears.

Harvill believes the kidney transplant “100% would have worked” had it not been for her mom’s heart issues.

“Now I think the doctors definitely know, people that are as sick as my mom maybe aren’t the best people to do it,” she said.

Indeed, the surgeons who’ve done the xenotransplants and other experts in the field say these first four patients were not ideal candidates, since those on death’s door are likely to be too weak to support a new organ.

“If we could choose patients who are much more likely to do well, then we’d get a better idea about how successful it’s going to be,” said Dr. David Cooper, a physician investigator of transplant surgery at the Massachusetts General Research Institute, who did not perform any of the operations.

But for the FDA to approve such a transplant in a healthier patient, Cooper said, the agency wants to see more consistent one-year survival in studies done in animals. Privately, doctors had hoped that would be the case for the human patients. 

“We hoped for six months, and maybe a year. Out of ignorance, we felt our animal data supported that. We actually thought we’d do better in the humans,” said Dr. Bartley Griffith, clinical director of the cardiac xenotransplantation program at the University of Maryland School of Medicine, who operated on Faucette and Bennett Sr.

The only xenotransplant patient who recovered enough to return home was Rick Slayman, who received a pig kidney at Massachusetts General Hospital in March. He had terminal kidney disease, diabetes, high blood pressure and heart disease. 

Slayman’s family declined to be interviewed. According to his surgeon, Dr. Tatsuo Kawai, the dialysis Slayman had required before the transplant was no longer needed afterward, and his only struggle was climbing the three flights of stairs to his apartment.

Still, Slayman died less than eight weeks after his surgery, from what doctors suspect was a fatal arrhythmia. An autopsy showed that his heart disease was more advanced than his doctors had thought.

“The autopsy didn’t show any rejection or any abnormality in the kidneys, so in terms of transplant, we think this was successful,” said Kawai, who directs the Legorreta Center for Clinical Transplant Tolerance at Mass General.

The Bennett, Faucette and Harvill families do not regret their loved ones’ participation in the experimental transplants. Each saw any extra time as a gift, and they remain optimistic about xenotransplantation’s potential. Harvill compared the situation to the first human heart transplant in 1967. That patient died after 18 days, but thousands of such transplants are now performed in the U.S. each year.

The families are also aware of how much doctors learned from each surgery.

“The excitement in their voices and on their faces when they talk about the data that Larry was able to give them … it makes me grateful,” Faucette said.

On her wedding anniversary, she baked around 500 cookies for the hospital’s nursing staff.

Dr. Robert Montgomery, who did Pisano’s surgery and directs the NYU Langone Transplant Institute, said many people on the transplant waiting list are interested in a xenotransplant.

“I can’t tell you how many people call my office every week who want this. That’s what I think is underappreciated, is how desperate people are,” he said.

All of the researchers are eager to try another transplant as soon as they can find the right candidate and get FDA approval.

“We are at a place now where we feel 100% better informed,” Griffith said. “Whether that’ll translate to our next patient living a year, we’re not sure, but we moved from total ignorance to a really good idea of what our enemy is.”

This article first appeared on NBCNews.com. Read more from NBC News here:

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Wright, a Purple Heart recipient and a retired U.S. Army Staff Sergeant, received in-patient treatment in 2013 for post-traumatic stress disorder and anxiety.

“I wasn’t participating with them because I didn’t trust them,” Wright tells TODAY.com of his care team.

He eventually decided to start doodling during sessions to pass the time.

“Next thing you know, they were like the meeting is over. And I’m like, ‘OK, that’s crazy. It went by so fast.’ And they were like, ‘Today was a great day for you. You were talking. You were expressing yourself.’ I found out the whole time I was drawing, I was talking and engaging with the people,” Wright recalls.

After he completed his in-patient care, Wright says he went to get a tattoo. He had a good experience with the artist, who was also a friend who encouraged him to become a tattoo artist.

“Maybe I can do this,” Wright remembers thinking to himself. “I knew (that) I knew how to draw. I’ve been drawing since I was probably 2 years old. I bought a little kit. Never turned around.”

Wright has more than 100 tattoos himself and has given out thousands to people across the country to advance his mission of bringing mental wellness through tattoos.

His business, Marzmade Mobile Tattoo Studio, is based in New Jersey. He has a parlor in his home and a converted bus he uses to bring tattoos to people. He’s also on TV, with appearances in “Power Book III: Raising Kanan” and “Black Ink Crew: Chicago.”

Wright is among a cohort of veterans living with PTSD and anxiety. A 2024 study published in the Journal of Psychiatric Research estimated that 3 in 10 U.S. veterans report anxiety symptoms. According to the U.S. Department of Veterans Affairs, that 7% of veterans experience PTSD at some point in their lives.

For fellow veterans, Wright offers free tattoos so they can experience the lightbulb moment he did through art. He has given away more than 1,000 tattoos to them.

“I saw the correlation of tattooing and trauma, and I know about the trauma we have, especially when we get out,” Wright says. “I have tattoos over battle scars, and I’ve also tattooed over battle scars.”

Wright says most of the veterans he inks get tattoos in honor of their military service, and they trade war stories during the session.

“I can talk to you about the things you’re going through because I’ve been through it … as well as giving you a dope tattoo,” he adds.

Wright’s approach is clinically sound, experts say.

‘Reintegrate that painful memory’

Chase Cassine, a licensed clinical social worker in New Orleans who has worked with veterans, describes Wright’s work as “reintegration through tattoo therapy.”

“This is beneficial to both the tattoo artist and the person receiving the tattoo,” Cassine tells TODAY.com

“The tattoo is a symbol. The tattoo can also symbolize being a part of a group, being a part of a status, being able to commemorate a memory. But, also in that memory may be (another) painful memory. So you talk about what has happened and you can reintegrate that painful memory to a meaningful memory as a way to take back your power,” Cassine explains.

Tattoo therapy with Wright was particularly effective for Matt Davies, a Navy veteran who received a tattoo from Wright in 2020. Davies, who lives with PTSD, says he previously saw licensed therapists whom he did not find helpful.

“It felt more comfortable to talk with Daniel about the things that had happened to me than … with a licensed therapist because most therapists that you go to with the VA have no military background, so you’re speaking one language and they’re speaking another,” Davies says.

“It does get frustrating when you’re trying to convey what is happening, and you’re using terms that only a service member would use,” Davis adds. “This makes the ability to talk about it so much easier.”

‘Mimicking wartime adrenaline’

There’s also the physical side of getting a tattoo that helps, Wright and Cassine say.

“In the process of (getting) that tattoo, your adrenaline is so high that it’s mimicking wartime adrenaline,” Wright says. “When you were in wartime, you saw things. You smelled things. You heard things. Just think about it like this lid was opened and all of these smells and sensory things were put into your jar, and then it closed when you left wartime. And you’ve never had that much adrenaline to open it up again. I’m giving you that adrenaline to open a jar, and we’re talking about it to help release it.”

Davies says tattoo therapy helped him unlock “answers” he hadn’t previously known.

“When I went to meet with Daniel, we started talking about our time in the service, which led into a deeper conversation as to the things that we miss, the traumas that are associated with being in the service and also acclimating to life outside of the military,” Davies says.

“I believe my session was around five hours long, and we talked the entire time. It was very profound because I was able to finally feel like I got answers and not feel so alone or isolated with my feelings,” Davies adds.

Raising awareness of tattoo therapy

Wright mainly uses social media and digital platforms to advertise the free tattoos that he offers veterans. He has interested veterans enter a raffle and the winner gets the tattoo.

Davies says social media is how he heard about Wright. Davies won the raffle and they “hit if off” from there.

Cassine says tattoo therapy is a novel way to have impactful mental health conversations that actually land with the person.

“It may not be traditional, and sometimes we’ve got to get out of that framework, too. They have found therapeutic ways to help them cope with stress, with faith, with love, with trauma — tattoo therapy, speaking therapy, all these different things,” Cassine says.

There are other shops offering tattoo therapy, such as Tattoo Therapy BK and Therapy Ink NYC.

But Wright appears to be one of the only artists offering free tattoos for veterans.

“Everybody says the military is a band of brothers and sisters, and that is true,” Wright says. “But, when you get out or retire, it’s like you’re out of sight, out of mind. Everybody forgets about you. It’s not the same camaraderie you had every day. And that is one of the biggest traumas we deal with. I started bridging that gap.”

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The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

Health Jun 14

KP.3 COVID variant is dominant in the US: What are the symptoms?

People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

The man, identified by his family as Steven Perry, tested positive for the virus known as EEE or triple E, and was hospitalized with severe central nervous system disease, the New Hampshire Department of Health and Human Services said on Tuesday.

Perry was a resident of Hampstead, a town in southern New Hampshire about 45 miles north of Boston.

The 41-year-old was healthy and had no underlying medical conditions, his family told affiliate NBC Boston. However, Perry’s disease progressed rapidly, and he went to the hospital on Aug. 12.

Perry died one week later at Massachusetts General Hospital on Aug. 19, 2024, according to his obituary.

“It is with heavy hearts that the family acknowledges that Steven left those that he loved far too soon after being stricken by a sudden and rare brain infection,” the obituary read.

Previously, Perry tested positive for eastern equine encephalitis, a rare infection caused by a virus spread to humans through the bite of an infected mosquito, TODAY.com previously reported.

It is the first human case of eastern equine encephalitis in New Hampshire in 10 years. The last human EEE infection reported in the state was in 2014, when authorities identified three cases, including two deaths, the DHHS said.

EEE cases have also been reported in Massachusetts, Vermont, Wisconsin and New Jersey.

So far in 2024, at least five human cases of eastern equine encephalitis have been confirmed in the U.S. All five were the more severe (neuroinvasive) form of the disease, according to the latest data from the U.S. Centers for Disease Control and Prevention.

At this time, the case count is on par with previous years. Only a handful of cases are reported in the U.S. annually — in 2019, there were 38, the highest in a decade, TODAY.com reported previously.

Most people infected with EEE do not develop symptoms. If symptoms do occur, these typically begin two to 10 days after being bitten by a mosquito and include fever, chills, muscle aches, and joint pain.

EEE can also cause severe neurologic disease. About 5% of people infected with the virus develop severe swelling of the brain or the spinal cord, Dr. Daniel Pastula, chief of neuro-infectious diseases and global neurology at the University of Colorado School of Medicine, previously told TODAY.com.

Symptoms of neuroinvasive EEE include a high fever, behavioral changes, vomiting, seizures and coma. About 30% of people with EEE will die, per the CDC. However, many survivors are left with lasting mental and physical problems.

Most cases are reported between July and September, with activity peaking around August. As the end of summer approaches and the U.S. enters peak mosquito season, the threat of mosquito-borne diseases looms.

“We believe there is an elevated risk for EEEV infections this year in New England given the positive mosquito samples identified,” New Hampshire state epidemiologist Dr. Benjamin Chan said in a release.

In Massachusetts, several communities are on high alert due to a recent case of EEE in a man in his 80s. The case has prompted officials to spray for mosquitoes and some towns to enact voluntary curfews and nighttime park closures.

What’s more, the U.S. is also seeing increased activity of another mosquito-borne virus, West Nile. As of Aug. 27, there have been 289 cases of West Nile virus reported in 33 states, per CDC data.

There is no treatment or vaccine for eastern equine encephalitis. Preventing mosquito bites is the best way to protect yourself against EEE and other mosquito-borne diseases.

The CDC recommends people take the following steps:

•  Use an EPA-registered insect repellent
• Wear pants and long sleeve shirts outdoors
• Limit activity outdoors from dusk to dawn, when mosquitoes are most active

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The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

Health Jun 14

KP.3 COVID variant is dominant in the US: What are the symptoms?

People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

The study tracked 30 years of living kidney donation and found that by 2022, fewer than 1 of every 10,000 donors died within three months of the surgery. Transplant centers have been using older data – citing a risk of 3 deaths per 10,000 living donors – in counseling donors about potentially deadly surgical complications.

“The last decade has become a lot more safe in the operating room for living donors,” said Dr. Dorry Segev, a transplant surgeon at NYU Langone Health. He co-authored the study published in the journal JAMA.

Newer surgical techniques are the key reason, said Segev, calling for guideline updates to reflect those safety improvements – and maybe increase interest in living donation.

He often finds transplant recipients more worried about potential risks to their donors than the would-be donors themselves.

“For them, this is even more reassuring to allow their friends or family to donate on their behalf,” Segev said.

Thousands of people die each year waiting for an organ transplant. It’s possible for living donors to give a one of their two kidneys or part of a liver, the only organ that regenerates.

With nearly 90,000 people on the U.S. list for a kidney transplant, finding a living donor not only shortens the yearslong wait — those organs also tend to survive longer than ones from deceased donors.

Yet last year, just 6,290 of the nation’s more than 27,000 kidney transplants came from living donors, the most since before the pandemic. Safety isn’t the only barrier to living donation. So is awareness, as many patients are reluctant to ask. And while the recipient’s insurance covers medical bills, some donors face expenses such as travel or lost wages as they recover.

The NYU team analyzed U.S. records of more than 164,000 living kidney donations from 1993 through 2022 and found 36 post-surgical deaths. Most at risk were male donors and those with a history of high blood pressure.

Only five of those deaths occurred since 2013. That period coincided with U.S. transplant centers switching to minimally invasive kidney removal as well as adopting a better way to stop renal artery bleeding, Segev said.

“Over time, it’s a safe operation that’s become even safer,” important for would-be donors to know, said Dr. Amit Tevar of the University of Pittsburgh Medical Center, who wasn’t involved in the study.

But there are long-term risks to consider, too, he stressed — including whether a donor’s remaining kidney is expected to last the rest of their life.

The risk of a donor later experiencing kidney failure also is small and depends on such factors as obesity, high blood pressure, smoking and family history of kidney disease. Risk calculators help doctors determine a potential donor’s likelihood of later-in-life trouble, and transplant centers may have slightly different eligibility criteria.

“There’s no such thing as a moderate- or high-risk donor — either you’re perfect or you’re not,” is how Tevar puts the decision to accept or turn away a potential donor.

Doctors once thought young adults were the ideal living donor. But Segev said there’s a shift toward more older living donors because it’s easier to correctly predict that they won’t outlive their remaining kidney.

If a living donor later experiences kidney failure, they get priority for a transplant, he noted.

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

The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

Health Jun 14

KP.3 COVID variant is dominant in the US: What are the symptoms?

People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

The variant has been largely spreading overseas with countries like Denmark, Germany, the UK and the Netherlands seeing the largest spikes, but the variant has also appeared to begin a climb in the U.S., according to researchers.

So what should you know about it?

Here’s an explainer:

What is the XEC variant?

According to Eric Topol, director of the Scripps Research Translational Institute in California, the XEC variant “appears to be the most likely one to get legs next.”

At this juncture, the XEC variant appears to be the most likely one to get legs next. Its current status nicely tracked by @Mike_Honey_ 's threadhttps://t.co/4AnLa3MXfz

— Eric Topol (@EricTopol) September 15, 2024

Topol reported the subvariant is a “recombinant of KS.1.1 and KP.3.3” variants and has been “showing up in many countries with a growth advantage.” He added, however, that it could take time to learn the variant’s full extent.

The variant’s rise comes from a recent mutation, Topol told the LA Times.

While KP.3, nicknamed the FLuQE variant, and its subvariant KP.3.1.1, or the deFLuQE variant, each had mutations of their own, XEC took the mutation even further, making it a “very pathogenic, very immune evasive variant.”

He noted that it could be behind a recent wave that is sickening people who otherwise may not have contracted COVID.

Where is it spreading?

The variant’s prominence remains largely abroad, with XEC still not widely detected enough to make it on the U.S. Centers for Disease Control and Prevention variant proportions data tracker.

According to the CDC estimates, the dominant variant in the U.S. is still KP.3.1.1, which represents more than half of COVID cases currently.

Data reported over the weekend showed the highest percentages of the variant seen in Denmark, the Netherlands, Germany and the UK.

Will vaccines prevent against the XEC variant?

Experts have long said the COVID virus will continue to mutate.

This fall’s vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.

While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.

A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.

This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.

What are the symptoms?

It’s not clear if the new variant will bring with it a change in symptoms.

As of now, the symptoms for COVID remain the same:

• Cough
• Sore throat
• Runny nose
• Sneezing
• Fatigue
• Headache
• Muscle aches
• Altered sense of smell
• Congestion
• Fever or chills
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

Recent reports have centered on specific gastrointestinal symptoms related to the virus.

Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said “gastrointestinal issues including nausea, vomiting, and diarrhea” have been previously identified as possible symptoms of COVID-19.

“We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual,” Jetelina told NBC Chicago in July.

Last fall, a Chicago-area doctor said she’s noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.

Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.

“We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends,” she said. “One patient was just very, very tired. Like she couldn’t really do much. And that’s when you know … it’s different. It’s not just coughing and shortness of breath. We still see that though.”

She suggested consulting with your doctor if your symptoms don’t begin to improve outside of the recommended isolation period.

How long does COVID last?

As for timing, symptoms can last for several days, but in some cases, even longer.

“Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC),” according to the CDC.

Such symptoms can last for weeks and possibly even years.

Previous timing guidelines centered around five to 10 days, however.

What to do if you test positive?

In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.

Health Jun 14

KP.3 COVID variant is dominant in the US: What are the symptoms?

People can return to work or regular activities if their symptoms are mild and improving and it’s been a day since they’ve had a fever, but the CDC still recommends those with symptoms stay home.

“The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication,” the guidance states.

Once activities are resumed, the CDC still recommends “additional prevention strategies” for an additional five days, including wearing a mask and keeping distance from others.

The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.

As part of the guidance, the CDC suggests:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors. 

The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation’s third leading cause of death early in the pandemic to 10th last year.

Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.

Where can you get free COVID tests?

On the heels of the summer wave of COVID-19 cases, Americans will be able to get free virus test kits mailed to their homes, starting in late September.

U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.

The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.

“If you look at just the cost of obesity in the U.S., it’s a disease that costs Americans more than $400 billion a year,” Lars Fruergaard Jørgensen said in an interview on “NBC Nightly News,” “And we are actually providing products that’s actually helping take that cost burden off.”

Tune into “NBC Nightly News” at 6:30 p.m. ET/5:30 p.m. CT tonight for more.

Jørgensen, who spoke to NBC News before the company’s “quiet period” ahead of their last earnings report, called accusations that the company is operating as a drug cartel “unfounded.”

His comments come ahead of a highly anticipated Senate committee hearing in September, where he is scheduled to testify about the U.S. pricing of the drugmaker’s hugely popular diabetes and weight loss drugs.

Vermont Sen. Bernie Sanders, chair of the Health, Education, Labor and Pensions Committee, told NBC News in June that he plans to ask Jørgensen why the drugmaker charges up to 10 to 15 times more for Ozempic and Wegovy in the U.S. than it does in other countries. Novo Nordisk charges around $1,300 a month for Wegovy in the U.S., according to a HELP Committee report, while the drug can be purchased for $186 a month in Denmark; $137 in Germany; and $92 in the United Kingdom.

“It is clear that Novo Nordisk is ripping off the American people,” Sanders said.

The cost of obesity-related care in the U.S. is substantial.

A report published last year from KFF, a nonprofit group that researches health policy issues, found that in 2021, people with employer-based health insurance who were overweight or had obesity had an average of $12,588 in total annual health costs, which is more than double the $4,699 in health spending for those who were not overweight or didn’t have obesity. People who are overweight or have obesity also face higher out-of-pocket costs: an average of $1,487, compared to $698 for those without those conditions.

Still, Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee, said at Ozempic and Wegovy’s current prices, the savings that could be gained from reducing the burden of obesity-related care aren’t enough to make up for the large increase in spending on the drugs.

“For many people, these drugs might be a very good option for improving their health, but it is unlikely that they will reduce total spending,” Dusetzina said. “In general, the price of these drugs would need to come down a lot in order to have a chance for them to produce overall savings in health care spending.”

A complex health care system

Jørgensen said that he “volunteered” to come speak with the committee about the cost of Ozempic and Wegovy at the September hearing. His announcement to do so came three days after Sanders threatened to hold a vote to subpoena the company’s president, Doug Langa.

Jørgensen said he plans to talk about the “complexities of the U.S. health care system, which is a system we take part in but we cannot change.”

“That takes policy change,” he said, blaming insurance companies and pharmacy benefit managers, or PBMs, for the high out-of-pocket costs patients pay for the drugs.

PBMs work with insurers to negotiate rebates, or discounted prices, from the drug companies, in exchange for including the drug in their coverage. But as PBMs become more consolidated and hold more influence over what drugs patients are covered for, experts say they may be inflating drug costs.

In July, the Federal Trade Commission published an interim report on how PBMs are driving up costs for patients.

“I do acknowledge that some patients have poor insurance,” Jørgensen said. “And if you have poor insurance, it can be difficult to afford your medicines. And for those we have patient support programs where we try to help them out.”

Jørgensen also said the U.S. needs to have a “discussion around what’s the value of these medicines” for patients.

Cynthia Cox, a vice president at KFF and the director of its program on the Affordable Care Act, said that while the drugs can prevent and reduce a number of obesity-related diseases, the cost of the medications remains expensive and it’s unclear how long people will need to stay on them to maintain weight loss and improved health.

“​​The widespread use of these drugs for weight loss is still relatively new, so I’m not sure there is enough long-term data to fully weigh the costs and benefits,” Cox said.

This article first appeared on NBCNews.com. Read more from NBC News here:

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TikTokers have seized on the treat’s mouthwatering colors and popularized a quick method involving the microwave. They promise the signature glassy coating with only a couple of ingredients and in just five minutes, but doctors in multiple countries are speaking out to warn parents of an uptick in burns, some severe enough to require skin grafts.

In order to reach the “hard crack” stage for that shiny coating, sugar must be heated to at least 300 F, much hotter than just boiling water. And, because it is sticky and viscous, it can result in prolonged skin contact that may make a scalding injury much more dangerous.

Surgeon Dr. Colleen Ryan of Boston hospital Shriners Children’s said in an Aug. 14 press release that they recently saw two patients with just this injury in the space of only two weeks, and that international word of mouth among doctors is reporting multiple cases of deep burns occurring with the technique shown on social media.

Australian food scientist and dietitian Ann Reardon of How to Cook That is sounding the alarm as well, in a YouTube video explaining the potential dangers of using an appliance that can only accommodate plastic or glass, for a recipe that should be made in a heatproof metal pan. As she shows in the video, even microwave-safe plastic containers can collapse or leak molten sugar at those high temperatures. Other injuries, she reports, could result if a superheated glass container is moved from the microwave to a cold kitchen counter, where the temperature shift can cause shattering.

Does this mean that gorgeous homemade tanghulu is out of reach? Although it must be done with proper equipment and appropriate supervision, working with sugar syrup is absolutely possible in a home kitchen — if you know the right tricks.

When we caught up with content creator Emmy Cho of Emmymade to ask about her own tanghulu attempt, she recounted something of a journey to getting the glassy texture just right.

“It’s so beautiful and catches people’s eyes, but for me, it was a real lesson in sugar chemistry,” Cho told TODAY.com. Her first attempt seized up, but she found the key was adding corn syrup, which interferes with the organization of the sucrose molecules into crystals. She also found that you really do have to heat it to that scorching 300 F to get that characteristic crunch.

Cho reiterates the messages that sugar syrups should never be made in the microwave, and that kids must have supervision even if using a metal pan on the stovetop.

“I think I kind of equate it to deep-fat frying,” she says, “but even more dangerous, because it’s sticky.”

That said, she hopes parents will take this warning to heart by seeking out ways to include their children in meal preparation, safely.

“I’m all for experimenting!” Cho says. “You have to teach your kids how to cook, both so they are capable and for their long term health.” She suggests “finding their interest point,” noting that while one of her kids enjoys helping cook entire meals with her, the other is more interested in the math of weighing baking ingredients. She has taken a gradual approach to making sure they know their way around the kitchen.

“It’s small steps — first they had to make their own breakfast, and then later they had to pack their snacks.” These days, they’re responsible for making their own lunches in addition to participating in dinner prep.

That time spent together will lead to the competence that can help prevent kitchen accidents like burns.

You could even make her new fried chicken version of tanghulu: “Glass KFC.” As Cho always says, “Take a big bite!” —  just don’t use the microwave.

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

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Fauci, who also served as the chief medical adviser for the Biden administration, was sent home on Saturday and is now recovering, according to his spokesperson. He is expected to fully recover.

The virus first entered the U.S. in 1999, and it has become the leading cause of mosquito-borne disease in the country, per the CDC. 

According to the Department of Health and Human Services, the West Nile virus (WNV) is the most common mosquito-borne disease in the US, and around 2,205 cases are reported each year.

But what is the West Nile virus and what are its symptoms? Here’s what to know

What is the West Nile Virus?

The West Nile virus is a disease that most commonly spreads through mosquito bites, according to the Centers for Disease Control and Prevention.

The virus was first detected in the U.S. in 1999 after two men in New York City tested positive for the virus, which it is believed first arrived in the country through an infected mosquito or bird.

So far, over 200 cases of West Nile have been detected nationwide in 2024, according to CDC data.

What are the symptoms of West Nile virus?

Approximately 80% of the people infected with WNV will not develop any symptoms. 20% will experience mild flu-like symptoms such as fever and less than 1% will develop severe long-term effects which sometimes can be deadly, according to HHS.

The symptoms include:

• Body aches
• Diarrhea
• Fever
• Headache
• Vomiting

Among the most serious complications are meningitis, paralysis or death.

When do West Nile symptoms start to show?

Symptoms generally appear between two to 14 days after being bitten but sometimes it could be several weeks before symptoms show up in immunocompromised people, according to the CDC.

How to cure West Nile virus?

According to the CDC, there is no specific treatment for West Nile virus though doctors usually recommend pain medication for headaches and antiemetic therapy and rehydration to treat nausea and vomiting.

How to protect yourself from West Nile virus?

The best way to protect yourself from West Nile is to dress in loose-fitting clothing that covers arms and legs when outside. Using air conditioning and adding screens to open doors and windows is also recommended.

Fauci, 83, who was chief medical adviser to President Joe Biden, became a household name during the Covid pandemic. Fauci left as director of the National Institute of Allergy and Infectious Diseases in 2022.

“Tony Fauci has been hospitalized with a case of West Nile virus. He is now home and is recovering,” a spokesperson said in a statement Saturday.

He is expected to make a full recovery.

West Nile virus is commonly spread through infected mosquitos, and there is no vaccine or treatment. As of Aug. 24, there were 216 human West Nile cases reported in 33 states. Of those cases, 142 were neuroinvasive, meaning people developed a severe form of the disease such as inflammation of the brain or the membranes surrounding the brain and spinal cord. These cases typically require hospitalization.

Several hundred to several thousand cases are reported in the United States each year. Most cases are reported in August and September.

Disease experts said that more West Nile virus had been circulating this summer than was expected, with at least seven states having confirmed human cases by June 25. A record-breaking number of mosquitoes in and around Las Vegas were found to have been carrying the virus earlier this year.

This article first appeared on NBCNews.com. Read more from NBC News here:

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Here are some of their top tips for getting a good night’s rest.

4 tips for a good night’s rest from sleep experts

1. Consider these 5 signs you might need a sleep divorce

A sleep divorce is not as drastic as it sounds. It simply means sleeping apart from your partner, whether in separate beds or separate bedrooms, to get the best sleep, Shelby Harris, a licensed clinical psychologist and director of sleep health at Sleepopolis, told Make It in 2022.

“I actually recommend that couples sometimes do this, and it doesn’t mean that their relationship is in trouble,” Harris said. “It just means they’re actually valuing their relationship and their health as well.”

You may want to consider a sleep divorce if you, and/or your partner:

• Snore loudly
• Have different sleep patterns/schedules (early bird vs. night owl)
• Move a lot while sleeping
• Are a light sleeper or find that alarms interrupt your sleep
• Have different preferences when it comes to temperature of the room, bedding, etc.

Harris suggested trying to problem-solve first to see if you can sleep in the same bed peacefully. And if you decide to implement a sleep divorce, make sure it’s a mutual decision presented respectfully and that your sleeping arrangements are similar (not one partner sleeping on the couch while the other sleeps in a cozy bed).

2. Try a sleep expert’s bedtime routine

Dr. Richard Schwab, chief of the division of sleep medicine at the University of Pennsylvania Perelman School of Medicine, shared his sleep routine with Make It in 2022.

“I think the most important thing in terms of what I should do for my sleep is go to bed at the same time and get up at the same time, each day,” Schwab said.

His preferred sleep time is 11:30 p.m. and he usually wakes up at 6:30 a.m.

Schwab also determined through trial and error how many hours of sleep he needs each night. “I need about six or seven and half hours of sleep, and if I don’t get that I’m going to be sleepy,” he said.

To get optimal sleep, Schwab recommended setting the ambience in your room by making sure it’s your preferred temperature and light exposure. He also got a larger bed to accommodate his wife and children.

3. Make these simple changes if you’re a night owl with a 9-to-5 job

“We all have a slight genetic orientation to one of two types, either being a morning person or an evening person,” Rebecca Robbins, an assistant professor of medicine at Harvard Medical School’s Division of Sleep Medicine, told Make It in December of 2023.

Yet, the common 9-to-5 work schedule of many jobs just doesn’t align with the internal clocks of night owls, and that can be difficult.

Here are seven ways that Robbins suggests thriving at work as a night owl:

• Head outdoors and get enough sun exposure during the day
• Avoid caffeine in the afternoon
• Aim to follow the same sleep and wake time daily
• Use blue light devices like “happy lights” at work
• Workout in the morning
• Get certain things done in the evening like passion projects
• See if you can change your work schedule

4. Remember melatonin is a bit more effective for sleep than magnesium

Two popular supplements touted for prompting sleep are melatonin and magnesium, but of the two, one is more effective, according to licensed clinical psychologist Shelby Harris.

“Melatonin is the most common natural sleep aid that can help gradually shift the body’s circadian rhythm when taken properly,” Harris said in February.

“Before taking magnesium or melatonin for sleep, it’s important to establish proper sleep hygiene and habits.”

These are some suggestions Harris shared for developing good sleep hygiene:

• Stick to a consistent sleep schedule
• Relax before you plan to go to bed
• Stay off of your electronic devices directly before bedtime
• Don’t drink caffeine at least eight hours before sleeping

This “can all be helpful in enhancing your body’s natural melatonin production, thus making it easier to fall asleep.”

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My life has demanded a certain amount of courage. I was born in Cleveland, Ohio, in 1922, shortly after the start of Prohibition. My father, who was a bootlegger, got into a turf war with the mafia, and he was killed in our driveway when I was just two years old. 

I got married a month after my 19th birthday and went straight from my mother’s home to my husband’s. Three kids and 25 years later, I left that unhappy marriage and loved being out on my own.

In my 40s, I had my first experience of supporting myself and being myself. I started writing for newspapers and later, after I remarried, had the luxury of writing novels full time. 

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Today, as a 101-year-old in Austin, I’m living the kind of life I feel fortunate to have. I still do things I love — like publishing my ninth book earlier this year, spending time with people I love, and reading. It’s a quieter life than I had as a younger woman, but these years are good ones. I wish more people my age knew that. 

Here are eight lessons I’ve learned that have helped me live a long, happy life: 

1. Don’t ever believe you’re ‘done’

Some cultural ideas are good, but many are wrong. People give up on their lives much too early. 

When your mind focuses on what the culture teaches us — that we’re done when we get past a certain age — it gets into our sense of self. If our sense of self is to be alone and sad and useless when we are 70, 80, 90, whatever, we believe it. And that’s really dangerous. 

People have gifts that they may not know they have, and it may take a lifetime to find them. 

2. Talk to friends of all ages

My friends are a wonderful source of wisdom, energy and authenticity. 

I have a few friends that are two and three generations younger. I’ve learned from them, and I think they’ve learned from me. Each decade teaches us something else. 

There’s a huge difference between being 30 or 40 and being 90 or 100. And yet, when we come together, it can be fabulous because we all have much to teach each other. It gives us another way to think about things.

When I get together with my friends, we mostly talk. Talk is exhilarating when it’s good.

3. Let little things make your day

It’s not the top of the mountain that makes us happy. It’s the small pleasures. 

Our culture often tells us that if you want to be successful, it’s a big thing. It’s a big effort. It’s about big returns. But that doesn’t work. I don’t even know if the mountaintop exists, but small pleasures do exist, and they can be dynamite. 

We have to understand ourselves so that we can be authentic and find the little things that make us happy. For me, one is reading. Another is being with people I care deeply about — which can be family or friends. It’s a phone call, a visit, an idea, a worry shared. 

4. Have the courage to be authentic

Courage is probably, for me, the bottom line. It takes courage to look at yourself clearly, to know yourself, and to be authentic. 

But it gives you energy, confidence, and an understanding of yourself and others. In the long run, I believe that being authentic — disagreeing with someone, for example — makes even difficult relationships stronger. 

Being authentic doesn’t come easily. It takes some work to learn about yourself. But it’s worth it.

5. Do things you love

When I’m writing, I feel different. I feel better. I feel happier, I feel more centered. I feel more confident. Other writers I know tell me they feel the same thing. There’s really something magical about creative work. Of course, it’s not magic; it’s an expression of the human soul.

The pleasures you get from doing something creative that you love are tied to parts of the self that are not always available or conscious. 

It goes back to knowing yourself and being authentic. The way I get that is by writing. For someone else it might be painting or dancing. Sometimes I’ll come back and I’ll see something I wrote and think, “That’s good.” That means it opened my unconscious. That’s where the gems are.

6. Move your body, rest your mind

For about seven years, I’ve worked out with a trainer twice a week. For a 101-year-old, I’m strong. I can lift 10-pound weights and get up off a chair holding the weights. I’m so proud of that.

When I had pneumonia and I was in the hospital, someone there told me that my exercising probably saved my life. So it isn’t just a good idea — it’s essential.

At the same time, you have to get a lot of rest. The brain needs rest in order to rejuvenate.

7. Don’t get stuck in negativity

Negative thinking is common, and it’s a killer.

Why do some people feel optimistic and some, no matter what they say, it comes out negative? It’s how we’re born, I believe. We come into the world optimists or pessimists. Some people have such difficult times in their lives. If a pessimist would say, “Why me?” I would say, “Why not?”

It’s very hard to overcome negative thinking, but to the extent that we can, we need to acknowledge the positive and try to move forward with optimism.

8. Do what you know you need to do

As I’ve gotten older, I’ve often been asked, “What’s your secret?” I don’t have a secret.

Longevity is what everyone knows to be true. We all know: Exercise, good diet, a healthy personal relationship with a partner, an understanding of yourself, a career that’s good for you — these are the keys to a happy life. 

But there’s a gap between what we know and what we do. The problem for so many people is doing it. And that’s more mysterious than I can explain.

This as-told-to interview has been edited.

Babette Hughes is a writer who recently published her ninth book, “Lessons in Evil,” at the age of 101. She was born in Cleveland, Ohio, and grew up in the time of Prohibition and bootleggers. Though she’d previously published a memoir titled “Lost and Found,” she didn’t publish her first novel, “The Hat,” until 2015. She lives in Austin.

Stav Ziv is a contributors editor at CNBC Make It.

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The 17-year-old stood up during his father’s speech and said, “That’s my dad,” later adding, “I love you, Dad.”

The governor and his wife, Gwen Walz, revealed in a People interview that their son was diagnosed with nonverbal learning disability as a teenager.

A 2020 study estimated that as many as 2.9 million children and adolescents in North America have nonverbal learning disability, or NVLD, which affects a person’s spatial-visual skills.

The number of people who receive a diagnosis is likely much smaller than those living with the disability, said Santhosh Girirajan, the T. Ming Chu professor of biochemistry and molecular biology and professor of genomics at Penn State.

“These individuals are very intelligent and articulate well verbally, but they are typically clumsy with motor and spatial coordination,” he told NBC News. “It’s called a learning disorder because there are a lot of cues other than verbal cues that are necessary for us to keep information in our memory.”

People with NVLD often struggle with visual-spatial skills, such as reading a map, following directions, identifying mathematical patterns, remembering how to navigate spaces or fitting blocks together. Social situations can also be difficult. 

“Body language and some of the things we think about with day-to-day social norms, they may not be able to catch those,” Girirajan said.

Unlike other learning disabilities such as dyslexia, signs of the disability typically don’t become apparent until adolescence. 

Early in elementary school, learning is focused largely on memorization — learning words or performing straightforward mathematical equations, at which people with NVLD typically excel. Social skills are also more concrete, such as playing a game of tag at recess. 

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“But as you get older, there’s a lot more subtlety, like sarcasm, that you have to understand in social interactions, that these kids might not understand,” said Laura Phillips, senior director and senior neuropsychologist of the Learning and Development Center at the Child Mind Institute, a nonprofit organization in New York.

In her own practice, she typically sees adolescents with NVLD, who usually have an average or above average IQ, when school demands more integrated knowledge and executive functioning, such as reading comprehension or integrating learning between subjects. They also usually seek help for something else, usually anxiety or depression, which are common among people with NVLD. 

Sometimes misdiagnosed as autism

Amy Margolis, director of the Environment, Brain, and Behavior Lab at Columbia University, is part of a group of researchers that is beginning to call the disability “developmental visual-spatial disorder” in an effort to better describe how it affects people who have it.

People with NVLD are “very much verbal,” Margolis said, contrary to what the name suggests.

The learning disability is sometimes misdiagnosed as autism spectrum disorder. Margolis led a 2019 study that found that although kids with autism spectrum disorder and NVLD often have overlapping traits, the underlying neurobiology — that is, what’s happening in their brains to cause these traits — is unique between the two conditions.

Margolis is trying to get NVLD recognized by the DSM-5, the handbook health care providers use to diagnose mental health conditions. Without such official recognition, people with NVLD can struggle to get the resources they need, such as special class placements or extra support in school.

“Without an officially recognized diagnosis, it’s hard for parents to understand how to seek information, and then communicate to other people what kinds of things might be challenging for their kid,” Phillips said, adding that widespread awareness is key to helping these families navigate NVLD.

This story first appeared on NBCNews.com. More from NBC News:

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