(NEW YORK) — For decades, doctors have encouraged patients to monitor their cholesterol levels, with studies showing that heart disease risk increases with high levels of low-density lipoprotein (LDL), also known as the “bad cholesterol,” and not enough high-density lipoprotein (HDL), also known as the “good cholesterol.”
Diet, exercise and medications like statins can help people regulate their good and bad cholesterol levels.
But now, doctors are recognizing the importance of a third type of cholesterol — lipoprotein (a).
Lipoprotein (a) has been increasingly recognized as a standalone predictor for cardiovascular disease due to its inflammatory properties that accelerate clot formation in the blood vessels.
Scientists are still learning more about lipoprotein (a). Testing is available but not universally recommended. For now, drugs to treat high levels are not available, but may soon be on the horizon.
But, for anyone whose parents, grandparents, or relatives have developed heart disease at a young age, doctors say it’s important for everyday people to ask their doctors about lipoprotein (a), which may be a culprit.
Should I ask for my lipoprotein (a) levels to be checked, and is it covered by insurance?
“Anyone who has a strong family history of heart disease or has had evidence of heart disease that is premature — that is, before the age of 55 in men and before 65 years of age in women — should consider lipoprotein (a) testing,” Chair in Preventative Cardiology and Professor of Medicine at Tulane University School of Medicine in New Orleans, Louisiana, Dr. Keith Ferdinand, says. “[It] may be a good way to predict if you are at increased risk beyond the conventional lipid panel.”
Lipoprotein (a) testing can also be measured in those whose cholesterol levels do not improve with standard cholesterol-lowering medications, says Associate Professor of Medicine at Beth Israel Deaconess Medical Center in Boston, Dr. Stephen Juraschek.
The American Heart Association supports once-in-a-lifetime measurement of lipoprotein (a) in people at risk for cardiovascular disease, differing from practice guidelines across Europe and Canada, which recommend measuring lipoprotein (a) at least once in all adults.
As a result, some insurance plans do not cover lipoprotein (a) testing. Be sure to talk to your doctor about whether lipoprotein (a) testing is appropriate for you.
What can I do if my lipoprotein (a) levels are high?
“Unfortunately, there is no treatment available,” says Ferdinand.
But doctors say knowledge is power — and people with high levels can take other steps to lower their heart disease risk.
For example, efforts should be made to lower LDL to a target level with cholesterol-lowering medications, according to Juraschek. People should also focus on improving “blood pressure, avoidance of smoking, weight loss, physical activity and control of blood glucose levels,” says Ferdinand.
What treatment options are on the horizon to improve lipoprotein (a) levels?
“There are studies now looking at two different medications that specifically target one of the proteins involved in production of lipoprotein (a), and we probably won’t have the results of those clinical trials for another 2-3 more years,” says Professor of Cardiology and Director of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease in Baltimore, Maryland, Dr. Roger Blumenthal.
There are eight ongoing clinical trials investigating novel drugs that directly target how lipoprotein (a) is made on a molecular level. All but one of the ongoing trials are using an injectable form of these novel drugs that are administered subcutaneously, or underneath the skin.
“Some of the most advanced of these therapies are in stage 3 trials, which will be needed prior to FDA approval,” says Juraschek.
“Although lipoprotein (a) cannot be lowered through lifestyle modifications, this does not dismiss the importance of building healthy habits,” says Associate Professor of Cardiology and Director of the Preventive Cardiovascular Health Program, Yale School of Medicine in New Haven, Connecticut, Dr. Erica Spatz. “Committing to a regular exercise routine and eating a more plant-forward diet can significantly reduce total cardiovascular risk, which is even more important if lipoprotein (a) is elevated.”
(NEW YORK) — For Belinda Mosby, the nightmares started in March.
Mosby had been working at Carelon Behavioral Health, one of the new 988 Suicide and Crisis Lifeline hotline centers in New Hampshire, for two months. When Mosby started the job in January 2023, she said she was enthusiastic. After 25 years working in the mental health industry as a prison behavioral health specialist, substance abuse counselor and mobile crisis responder, she knew how dire the crisis was. She also said she knew she could help.
“I’m 25 years of preparing for this,” Mosby told ABC News of her thinking at the time.
But quickly, she said she felt overwhelmed. Callers were in such severe distress, she told ABC News. Call after call, Mosby said she began to feel a discomfort set in that she couldn’t shake.
First came the anxiety, Mosby said. Then, the nightmares, followed by panic attacks. The attacks grew so severe that even imagining another call could set the chain in motion, Mosby said.
Part of Mosby liked the job, she said: the ability to help people at a critical moment in their mental health crisis. But she said part of her also worried about how the work was impacting her own health.
“Just the thought of the job — that’s how bad it was,” Mosby said.
In July 2022, amid historic rates of mental health illness, the Biden administration launched 988 — the new national suicide prevention hotline — to reinvigorate the country’s previous, antiquated network. Since its launch, the White House has invested nearly $1 billion into 988, and the hotline has served more than seven million Americans, Danielle Bennett, a spokesperson for the Substance Abuse and Mental Health Services Administration (SAMHSA), told ABC News.
That figure — which is a group of people almost double the entire population of Los Angeles — is 40% more than were served over the same period before the hotline’s launch in 2022, according to SAMHSA data.
The federal government has also developed community-centered sub-networks for veterans, LGBTQ+ individuals, Spanish speakers and the hard of hearing to meet each group’s distinct needs. The company Vibrant Emotional Health has the contract to administer the hotline, and the hotline is overseen by SAMHSA.
But now, some 988 workers such as Mosby — who were already in significant shortage — say they’re burning out and leaving the job. Data obtained by ABC News found that, in some states such as Oklahoma and Colorado, more than one-third of employees left within months of taking their first call. In addition, turnover rates continue to increase across the United States. In Washington, for example, state data shows attrition rates increased 1.5 times between 2022 and 2023.
As calls to 988 balloon with ever-higher demand, and as the line continues to provide much-needed services at a pressing time, officials are expressing concern about what the burnout trends among employees mean for the hotline.
“Staff burnout is high,” Tia Dole, the chief 988 officer at Vibrant Emotional Health, the organization appointed by the federal government to oversee the line, told ABC News.
In some cases, the job is putting workers’ own mental health in jeopardy, too, Dole said.
“It is hard to answer calls all day when you’re going through things yourself,” Dole added. “The people answering calls are people, too.”
High pressure, low bandwidth
For Chantel Aaron, operating the Carelon hotline was the culmination of her own journey of struggling with mental health challenges. Including hotlines she’d tried calling — hotlines that provided little relief at the time, Aaron said.
“I’ve always been a person who, if I don’t like something, I change it,” Aaron told ABC News.
Her first day working at the hotline was in January 2023, and Aaron said she remembers it vividly. “I got thrown in,” she said. The first contact was a repeat caller, she said, someone who’s chronically grappled with mental illness and the kind of patient the hotlines have struggled to care for.
The caller “was very belligerent and aggressive” and “didn’t want to hear solutions,” Aaron said.
In the weeks and months that followed, that kind of call was not a rare occurrence, Aaron said. And as she got further into her time with the hotline, she said she also noticed a parallel, growing challenge: Her colleagues were showing up less and less. Sometimes, even at peak hours, the only staff on the line would be Aaron and a colleague, she said. Shifts originally scheduled for eight hours became 12; Aaron said she picked up more night and weekend shifts.
“It was killing my spirit,” Aaron said.
Aaron’s experience is not unique. Since the earliest days of 988’s launch, centers around the country have faced major hurdles in hiring amid what the U.S. Government Accountability Office says are shortages in the behavioral health workforce.
Data obtained by ABC News from Nebraska’s Department of Health and Human Services showed that in 12 of 16 months since the hotline’s June 2022 rollout, there have been more vacancies than employed staff. In West Virginia, during those same six quarters, staffing has not once met the levels required by federal and state grants, according to data from the state obtained by ABC News.
There’s also growing turnover among the staff that centers are, in fact, able to hire.
In Washington, 988 staff attrition rates increased from 19% in 2022 to 30% in 2023, state data shows. In Oklahoma, more than one-third of 988 staff have turned over since July 2022, according to state data. In Colorado, turnover rates of employees who’d been on the job for more than three months reached 40%, according to state data. In those working for less than three months, the rates shot up to 60%, state data shows.
Other states have been more successful in terms of hiring and retention. For example, in Oklahoma, turnover rates dropped between 2022 and 2023, state data showed. In West Virginia, head count has steadily climbed every quarter: As of September 2023, vacancies were the lowest on record, and turnover had stabilized, according to state data.
But even standouts like these states haven’t been able to overcome broader headwinds facing the industry. State data shows West Virginia still has 20% less staff than required by the federal government. Oklahoma still has turnover rates that exceed 30%, according to state data.
Shortages and turnover are a major problem for the mental health workforce overall, according to a 2022 SAMHSA report. They can jeopardize care for patients and call operators alike, the report states.
“Burnout is one of the biggest workforce challenges we’re facing,” Monica Johnson, SAMHSA’s 988 director, wrote to ABC News.
Undertrained and overwhelmed
One major contributor to burnout in the mental health workforce, according to the 2022 SAMHSA report, is a “feelin[g] of inefficacy.” One of the major determinants of efficacy, some 988 operators told ABC News, was whether they felt they had the tools to handle calls.
All 988 hotline workers undergo basic training developed by Vibrant, the company that administers the hotline, while more in-depth training is left up to the discretion of individual states, Vibrant’s Dole said. This allows states to adopt their own standards customized to their specific constituents, she added.
Vibrant doesn’t claim its training can stand on its own.
“988 Lifeline-provided training resources are intended to offer a foundation that supplements the local training that crisis centers in the network provide,” Divendra Jaffar, a Vibrant spokesperson, told ABC News.
SAMHSA doesn’t have specific guidelines for what 988 crisis hotline operator training should include.
“There is not one standard nationwide crisis center training program for contact centers in the network, and that training can and does vary across the contact centers,” Bennett, at SAMHSA, said.
But the agency does discuss key elements for crisis care in 2020 guidance on best practice care. Some of those elements are not covered in the Vibrant training, according to Anthony Cava, a spokesperson for the California Department of Health Care Services.
For example, SAMHSA says in its guidance that crisis care staff should have training on “trauma-informed care” during orientation. Cava told ABC News the Vibrant modules don’t include instruction on “trauma-informed care,” and that California added a module to cover it. The SAMHSA guidelines also say crisis care staff should be prepared to handle substance abuse issues, but the Vibrant training doesn’t include modules on substance use, Cava told ABC News.
Vibrant did not comment specifically to ABC News about inconsistencies between its training and SAMHSA’s recommendations.
Beyond the Vibrant training, centers “are required to be certified by an independent accreditation authority,” Bennett at SAMHSA said — a process that Vibrant oversees. However, these accreditation authorities’ standards can vary widely. For example, the American Association of Suicidology only requires 30 hours of training. In other cases, according to Vibrant documents, no certification or licensure is required for 988 centers “assuming there is a demonstrable need for a center in that area.” There are seven centers that have had provisional acceptance, and these centers are expected to pursue accreditation following their admittance to the network, Jaffar added.
In New Hampshire, where Carelon Behavioral Health is located, “staff training varies depending on the role the provider fills and their level of education,” Jennifer O’Higgins, a senior policy analyst for the state’s Department of Health and Human Services, told ABC News. The state didn’t provide any other details on its training requirements or whether they added modules on top of the Vibrant training.
Soon after Clara Rodriguez started taking calls for Carelon in June 2023, Rodriguez said she started doubting whether she was prepared to handle the workload.
Rodriguez said she was taking calls with people who ran the gamut of mental illness: adults and children, all with diverse gender, racial and ethnic backgrounds. People who were struggling with hallucinations and delusions, Rodriguez said; people who were actively suicidal or homicidal.
It didn’t take long before Rodriguez said she felt overwhelmed. Rodriguez had no behavioral health experience before joining the line and said she only received two weeks of training, mostly via 45-minute online modules, before starting at the hotline. According to Johnson at SAMHSA, there are no strict credentialing requirements for call operators, so long as these operators receive high-quality training during their onboarding process.
But Rodriguez said she felt these didn’t meet what she would consider a high-quality standard.
“Those [were] intro courses, like me reading something online,” she said. “I found myself undertrained.”
“We take the training, supervision and support of our staff seriously,” Tina Gaines, a Carelon spokesperson, wrote to ABC News in response to the allegations of Rodriguez and others.
The feeling of being undertrained weighed heavily on Rodriguez, she said.
“Answering a call where someone says they’re tired and had a bad day is very different from answering a call with someone who says they have a gun to their head,” she said. “I don’t have the experience to de-escalate a situation like that.”
Although not specifically addressing Carelon, Vibrant acknowledged the impact a lack of training might have on 988 centers.
“If there is a lack of training, there is absolutely a possibility of organizational disintegration,” David Obergfell, Vibrant’s assistant vice president of 988 center engagement, told ABC News.
Rodriguez said the limited training and long hours weighed on her. Even after months on the line, she said questioned her abilities.
“Am I capable,” Rodriguez said she would ask herself. “Am I competent?”
According to the 2022 SAMHSA report, a “sense of failure” is also commonly associated with burnout. For Rodriguez, at a certain point, she said these concerns became personal.
“I [started] feeling like if my parents called, or if someone else I loved called, I would be highly upset if I found out someone answering on the end of the call has not been trained properly to do the job,” Rodriguez said.
“They’re calling a line for hope”
For Mosby, Rodriguez and Aaron, their feelings of inadequate training combined with the pressures of the job gradually caught up.
Rodriguez, like Mosby, said she’s been fighting overwhelming anxiety, panic attacks and nightmares. Aaron said she also, at times, has had a difficult time coping with situations that are deeply triggering.
According to SAMHSA, burnout has close and potentially long-lasting ties to one’s one well-being.
“Helping people in crisis can take a toll,” SAMHSA’s Johnson wrote to ABC News. “In many cases, [988 operators are] talking to people on the worst days of their lives.”
Rodriguez said she eventually mustered the courage, for her sake, to air these challenges to a supervisor. She’s been struggling, she told them, as have her colleagues, and she thought that was a reason some were choosing to leave.
But, in contrast to SAMHSA’s 2020 guidance, Rodriguez said her supervisor responded by saying that “some people just weren’t meant for the job.”
“[We] consistently uphold the standards and training at our call centers,” Gaines, at Carelon, wrote to ABC News.
In January, Vibrant and Carelon parted ways after failing to agree on the terms of contract renewal. Carelon continues to provide services to a handful of state partners.
“Vibrant Emotional Health is well-equipped to manage natural evolution within the 988 Lifeline network,” Jaffar, at Vibrant, wrote to ABC News.
Experienced altogether, the challenges faced by hotline workers have forced a reckoning among people such as Mosby, Rodriguez and Aaron.
Mosby left the job in September. She said she doesn’t know if, or when, she’ll reenter behavioral health work.
Given how much working the line has impacted her own well-being, Rodriguez said she also struggled. In October, Rodriguez said she’d ideally like to find another job sooner rather than later.
“If I could leave tomorrow,” she said at the time, “I would.”
Rodriguez recently told ABC News she left her job by early January.
Still, 988 continues to fill a critical void in providing mental health services, she said. Over and over, Rodriguez said she’s witnessed firsthand how much the line can help people. Rodriguez said she also continues to encourage people to call 988, especially given how few other options may be available for so many.
“They’re calling a line for hope,” Rodriguez said.
If you or a loved one is struggling with a mental health crisis or considering suicide, call or text 988.
In this photo illustration, ZYN nicotine cases and pouches are seen on a table, Jan. 29, 2024, in New York. (Michael M. Santiago/Getty Images)
(NEW YORK) — A type of nicotine pouches designed for adults is facing scrutiny on Capitol Hill, while also exploding in popularity online and among young people.
The pouches, sold under the brand name ZYN, have long been popular in Europe, but are now taking hold in the United States with the help of so-called “Zynfluencers” on social media.
The hashtag #ZYN has amassed more than 700 million views on TikTok alone. With their popularity on social media, the pouches have gained the attention of Gen-Z, some of whom are under the age of 18.
Here are three things to know about the pouches, and the controversy:
1. ZYN is marketed as a tobacco-free alternative to smoking
ZYN is manufactured by Swedish Match, a Stockholm-based company. The parent company of Swedish Match is Philip Morris International, which is headquartered in Connecticut.
The product is a small pouch that you place between your upper lip and gum for “up to one hour,” according to the company’s website.
The pouches come in flavors ranging from cinnamon and citrus to coffee and peppermint.
Swedish Match describes ZYN as an “alternative to smoking or dipping,” noting on its website, “For those consumers concerned about the health effects of smoking or dipping, the best thing to do is quit.”
ZYN pouches contain nicotine, the addictive product used in cigarettes, cigars and most e-cigarettes.
The health risks of using nicotine include everything from increased blood pressure to increased heart rate, increased heart attack risk and a narrowing of the arteries, research shows.
According to Swedish Match, ZYN pouches are required by the U.S. Food and Drug Administration to come with a warning that notes the product contains nicotine and that nicotine is “an addictive chemical.”
2. Medical experts say it’s too early to know the impact of nicotine pouches on kids
While ZYN pouches contain a smaller amount of nicotine compared to traditional cigarettes, medical experts say nicotine-containing products are a health risk for young people under the age of 18, in particular.
Consuming nicotine in high amounts can put young people at risk of acute nicotine toxicity, which can cause agitation, a fast heart rate and vomiting, according to the U.S. Centers for Disease Control and Prevention.
Prolonged nicotine use can also increase the risk of cardiovascular and respiratory disorders.
Nicotine exposure can hinder brain development in adolescents and young adults, which can continue into the mid-20s, the CDC says.
“If you take kids that are in their teenage years, and you make them lifelong users, four or five decades later, I don’t know what the health consequences would be,” Dr. Panagis Galiatsatos, a pulmonary and critical care medicine physician and spokesperson for the American Lung Association, told ABC News’ Good Morning America.
Philip Morris International told GMA in a statement that the company is “focused on” preventing young people under the age of 21 from using its products.
“ZYN is designed for adults aged 21 or older who are currently using nicotine products and wish to continue using nicotine,” the company said in a statement. “Our marketing practices — which prohibit the use of social media influencers — are focused on preventing underage access and set the benchmark for the industry.”
3. Legislators are calling for a crackdown
Amid the rise in ZYN’s popularity, Senate Majority Leader Chuck Schumer called for federal action to regulate nicotine when it comes to marketing the product to kids.
Last week, Schumer, a Democrat from New York, urged the FDA to investigate ZYN over its marketing practices.
“A simple search of social media for ZYN will generate an eye-popping amount of content,” Schumer said at a Jan. 21, press conference. “Most of you probably haven’t heard of it, but your kids probably have.”
“It’s a pouch packed with problems — high levels of nicotine,” said Schumer, who previously led the charge against vapes and e-cigarettes being marketed to children. “So today, I’m delivering a warning to parents, because these nicotine pouches seem to lock their sights on young kids — teenagers, and even lower — and then use the social media to hook ’em.”
According to the CDC, around 1 in every 100 high school students last year reported using nicotine pouches in the past 30 days.
If you or someone you know is struggling with nicotine addiction or other substance abuse or mental health concern, free and confidential help is available 24 hours a day, 7 days a week. Call the National Substance Abuse and Mental Health Services Administration (SAMHSA) helpline at 1-800-662-HELP (4357).
(OREGON) — Oregon government officials have declared a 90-day state of emergency to address Portland’s growing fentanyl crisis.
Gov. Tina Kotek, Multnomah County Chair Jessica Vega Pederson and Portland Mayor Ted Wheeler each issued an emergency declaration on Tuesday following a recommendation from the Portland Central City Task Force.
Overdose deaths from synthetic opioids, mainly fentanyl, have increased by 533% between 2018 and 2022 in Multnomah County, where Portland is located, according to the county’s health department.
“Our country and our state have never seen a drug this deadly and addictive, and all are grappling with how to respond,” Kotek said in the announcement. “The Chair, the Mayor and I recognize the need to act with urgency and unity across our public health and community safety systems to make a dent in this crisis.”
The state of emergency order allows officials to dedicate resources to responding to the crisis and to establish a command center in Portland, which will offer access to day services and “improve connection to care,” according to the announcement.
The command center will also share and publicly report data on the impact of fentanyl in the city, as well as identify what gaps in service exist, respond to them and allocate resources to do so, the announcement further states.
Additionally, the Multnomah County Health Department will launch education campaigns promoting youth drug prevention, according to the announcement, including how effective recovery is and reducing stigma when it comes to treatment. The department will publicize the messages on platforms including digital media, billboards, and streaming audio.
According to the announcement, there will also be “continued missions between the Portland Police Bureau and Oregon State Police to hold individuals selling the drug accountable.”
“If you or a loved one is struggling with a fentanyl addiction, we hear you, we see you and we are taking this crisis seriously,” Chair Jessica Vega Pederson said in the announcement. “We are acting with shared leadership to take urgent action today to respond to the very human toll fentanyl takes in our community, including overdoses, fatalities and day-to-day suffering, and the fear so many families are experiencing as a result.”
Fentanyl is up to 50 times stronger than heroin and about 100 times stronger than morphine as a pain reliever, according to the U.S. Drug Enforcement Administration.
Even in relatively small doses, fentanyl can be deadly. Because of its potency, it is often added to other drugs and yet is “nearly impossible” to detect without testing those drugs, according to the Centers for Disease Control and Prevention (CDC).
The increasing role of fentanyl in overdose deaths is a trend seen nationwide. A CDC report last year showed more than 107,000 people died of drug overdoses from January 2019 to June 2022. Of those, more than two-thirds were linked to synthetic opioids, mainly illicitly manufactured fentanyl.
The CDC says more than 150 people die every day from overdoses related to synthetic opioids, including fentanyl.
(NEW YORK) — A pharmaceutical company has presented new data for an experimental drug that they say can reduce acute pain, raising the possibility of an alternative to addictive opioids.
In a press release, Vertex says two studies showed that the new drug, VX-548, showed a “clinically meaningful reduction” in pain over a 48-hour period, compared to a placebo. The studies evaluated people who had recently undergone surgery and needed something to treat “acute pain” that lasts a short time.
Vertex described the drug as “safe and well tolerated” in the studies. The study results haven’t yet been vetted as part of the normal scientific review process.
The company plans to ask the Food and Drug Administration for approval of VX-548 in mid-2024 to treat “moderate-to-severe acute pain.”
For decades, researchers have been looking for ways to treat significant pain without using opiate-based painkillers, such as oxycodone, hydrocodone and morphine. Opioids generally work better than other medications for that purpose but also carry the risk of addiction. Fentanyl, a synthetic opioid typically used to treat severe pain, is even more powerful and also carries the risk of addiction.
Beginning in the 1990s with the increasingly widespread prescription of pharmaceutical opioids, overdoses from opioid abuse have skyrocketed since. According to the Centers for Disease Control and Prevention, 220 people in America died each day from an opioid overdose in 2021, which they say is six times the number of opioid overdose deaths in 1999.
VX-548 is an oral medication that works by blocking pain signals in the peripheral nervous system, the area outside the brain and spinal cord. This makes the medication different from opioids, which act on the brain and spinal cord.
Researchers are hopeful this means the drug wouldn’t carry the the same risk of addiction, if studies continue to go well and the drug is ultimately approved.
(NEW YORK) — Elon Musk announced that his company Neuralink implanted a brain chip in a human in a preliminary clinical study. If research studies continue to look promising, devices like these could one day be a “game changer” for people with limited motor function, experts told ABC News.
Neuralink says its goal is to help people living with debilitating conditions, including paralysis, communicate and control external devices with their thoughts.
The patient who received the implant is “recovering well,” Musk said in a post on X Tuesday.
Musk’s company is not alone in developing this type of technology. In recent years, research teams from across the globe have announced early but promising studies of brain-machine interface devices.
Here’s what else to know about Neuralink:
Neuralink’s implant
Neuralink was founded in 2016 by Musk and a team of scientists and engineers. The company says its mission is to “create a generalized brain interface to restore autonomy to those with unmet medical needs,” according to its website.
The company says its device can interpret neural activity so a person can operate a computer or smartphone by simply thinking.
People paralyzed from a stroke, a traumatic brain injury or a spinal cord injury could see the benefits, the company says.
“This would be a major game changer if it could be proven to be safe and effective,” Dr. Leah Croll, a neurologist and assistant professor at Temple University, told ABC News.
Human trials after animal testing
The FDA approved Neuralink for human trials in May after years of testing on animals.
The company has previously demonstrated the ability of the implant to stimulate movement in pigs and monkeys, even demonstrating a monkey with a brain chip playing a video game.
Musk said the first human users will be those who lost the use of their limbs.
“Imagine if Stephen Hawking could communicate faster than a speed typist or auctioneer, that is the goal,” Musk said.
Science fiction into reality
Neuralink’s engineers aren’t the only ones exploring this emerging science.
Last year, Swiss researchers said they combined artificial intelligence and brain and spine implants to help a man paralyzed in a motorcycle accident walk again.
And a woman who had lost her voice to paralysis was able to have a conversation with her husband again, with the help of a mind-controlled avatar, the Swiss researchers said.
“I really do think that in my lifetime as a physician I’ll be able to use this type of technology to help my patients and I cannot wait for that day to come,” Croll said after Musk’s announcement Tuesday.
(PHILADELPHIA) — The Philadelphia Department of Public Health is warning that several people may have recently been exposed to hepatitis A at a grocery store.
An employee at a ShopRite, located in the northeast part of the city, was confirmed to have “acute hepatitis A” and was working behind the meat counter between Jan. 4 and Jan. 21 while possibly contagious, said officials.
“The store is aware of the situation and is working collaboratively with the Health Department,” the agency wrote in a statement.
While calling the risk of infection “very low,” the health department says beef or pork purchased from the store during this period and since frozen “should be discarded as a precaution.” Additionally, anyone who has handled or eaten raw or undercooked beef or pork purchased from the store’s meat counter between Jan. 4 and Jan. 21 should be vaccinated against hepatitis A “as soon as possible,” the health department says.
“People who have previously received two doses of Hepatitis A vaccine OR have had Hepatitis A in the past do not need to be vaccinated,” the department of health further notes.
No details about the infected worker are available, and it’s unclear how many people may have been exposed to the hepatitis A virus due to possible secondary exposures from people who brought meat home or potential cross-contamination at the store, a spokesperson for the Philadelphia Department of Public Health told ABC News. It’s assumed that the infected employee was unvaccinated, the spokesperson said.
So far, there have been no additional reports of hepatitis A and no other ShopRite locations have been affected, according to the Philadelphia Department of Health.
The Philadelphia Department of Health began offering free hepatitis A vaccines on Saturday to anyone who may have been exposed, with 61 people vaccinated as of Monday morning, the spokesperson told ABC News.
Hepatitis A is a very contagious infection that affects the liver and is caused by the hepatitis A virus, according to the Centers for Disease Control and Prevention (CDC).
The virus is found in the stool and blood of infected people and is spread through close, personal contact with an infected patient or by eating contaminated food and drink, even in microscopic amounts, the CDC says.
The CDC says a person can transmit hepatitis A without showing symptoms and can do so up to two weeks before symptoms appear. Symptoms include yellowing of the skin or eyes, loss of appetite, stomach pain, nausea, vomiting, fever and diarrhea.
There are no specific treatments for hepatitis A, with doctors typically recommending rest, adequate nutrition, and fluids, according to the CDC.
Most people recover completely, but in rare cases, hepatitis A can lead to liver failure and death, but this is more common among those with underlying conditions such as chronic liver disease, according to the CDC.
To protect against hepatitis A, the CDC recommends receiving the hepatitis A vaccine. There are two types: one given as two shots six months apart, and the other a combination vaccine that protects against hepatitis A and B and that is given as three shots over six months.
If someone has been exposed to the virus, experts say a single shot of the hepatitis A vaccine given within two weeks may prevent the virus from taking hold.
(NEW YORK) — The Centers for Disease Control and Prevention (CDC) is warning clinicians to remain on alert for measles cases due to a growing number of infections.
Between Dec. 1, 2023, and Jan. 23, 2024, there have been 23 confirmed cases of measles including seven cases from international travelers and two outbreaks with five or more infections each, according to an email sent this week.
Cases have been reported in Pennsylvania, New Jersey, Delaware and the Washington, D.C. area so far.
Most of these cases were among children and adolescents who had not been vaccinated against measles, despite being eligible.
According to the CDC, most measles cases in the U.S. occur when unvaccinated or partially vaccinated Americans travel internationally, contract the disease and then spread it to those who are unvaccinated upon their return.
The federal health agency said the increase in cases in the U.S. reflects a global rise in infections and that there is a “growing global threat.”
“Due to the recent cases, healthcare providers should be on alert for patients who have: (1) febrile rash illness and symptoms consistent with measles (e.g., cough, coryza, or conjunctivitis), and (2) have recently traveled abroad, especially to countries with ongoing measles outbreaks,” the CDC wrote in its message.
If health care workers suspect a patient has measles, the CDC says the patient should be isolated immediately for at least four days from when symptoms appear and local or state health departments should be notified. The patient should then be tested, post-exposure prophylaxis should be provided to close contacts and all contacts who are not up to date on their measles vaccinations should be vaccinated.
Measles is a very contagious disease with the CDC saying every individual infected by the virus can spread it to up to 10 close contacts if they are unprotected including not wearing a mask or not being vaccinated.
Complications from measles can be relatively benign, including rashes, or they can be much more severe, such as viral sepsis, pneumonia, or brain swelling.
The CDC says anybody who either had measles at some point in their life or who has received two doses of the MMR (measles, mumps, rubella) vaccine is protected against measles.
One dose of the measles vaccine is 93% effective at preventing infection if exposed to the virus. Two doses are 97% effective.
In 2000, measles was declared eliminated from the U.S., thanks to a highly effective vaccination campaign, but outbreaks have popped over the last few years in unvaccinated pockets of the country.
Between November 2022 and February 2023, 85 children were sickened with measles in Ohio, 80 of whom were unvaccinated.
In California, an unidentified person with measles who visited Disneyland caused an outbreak, infecting 125 people between December 2014 and February 2015.
(NEW YORK) — For years, respiratory syncytial virus (RSV) has been the most common reason infants are hospitalized in the U.S. and has hospitalized thousands of elderly people every year.
After decades of trying to develop a vaccine, they became available ahead of this season for the first time for adults aged 60 and older and for pregnant people between 32 weeks’ and 36 weeks’ gestation.
Additionally, for the first time ever, an injectable monoclonal antibody shot to protect babies aged 8 months and younger and certain high-risk children under 24 months also hit the market.
However, the experience of doctors getting their patients immunized has been varied across the country. Supply chain issues hampered efforts and some parents have been reluctant to vaccinate their children, health care experts told ABC News.
“So, before the onset of the RSV season this year, there was so much excitement in the pediatric medical community about these new tools,” Dr. Allison Bartlett, professor of pediatric infectious diseases at the University of Chicago Medicine Comer Children’s Hospital, told ABC News. “We now have what should be an absolute game-changing set of tools. But I have to say, I’m disappointed by the number of families who elected not to provide protection to their babies.”
New RSV vaccines, immunizations
RSV is a common respiratory virus with most children affected by their second birthday, according to the Centers for Disease Control and Prevention (CDC).
Although it typically causes mild, cold-like symptoms and most people recover in one to two weeks, it can be a serious infection for infants and older adults, resulting in hospitalization, the CDC said. Up to 80,000 children younger than age 5 are hospitalized every year.
For babies under 8 months old, two monoclonal antibody shots became available. Monoclonal antibodies are proteins manufactured in a lab that mimic the antibodies the body naturally creates when fighting an infection.
Though given as an intramuscular injection, this shot is different than a vaccine, which activates the immune system.
One of the monoclonal antibody shots, Beyfortus, manufactured by AstraZeneca and Sanofi, reduces the risk of severe RSV disease by about 80%, according to the CDC.
‘Discouraging’ uptake
However, uptake varied across the country. Dr. Alexy Arauz Boudreau, associate chief for pediatrics at Massachusetts General Hospital, told ABC News between 80% and 90% of families in her patient population had their children immunized against RSV.
Comparatively, Bartlett said the immunization was offered to parents of newborns before hospital discharge and more than half of families declined, which she called “discouraging.”‘
She added that in conversations with colleagues who take care of older patients, vaccines available for “that population are being underutilized as well, unfortunately.” CDC data shows just 21.1% of older adults in the U.S. have been vaccinated.
Dr. Eric Biondi, associate chief medical officer for the Johns Hopkins Children’s Center, said he did not have a single parent ask about the RSV immunization.
Vaccine hesitancy, supply chain issues
The doctors said there are various reasons why uptake may not have been as high as they were hoping. Some parents may have been nervous about a new product, despite clinical trial data showing it to be safe and effective.
Other parents may not have even been aware that the product was available or may be experiencing vaccine fatigue, or shot fatigue, due to the COVID-19 pandemic, health care experts told ABC News.
“We’ve kind of been inundated with stuff from the CDC and other places over the last few years that I think there’s. … maybe there’s a little more apathy toward more guidelines,” Biondi said. “Not that they’re wrong or bad, but you can only stay on high alert for so long.”
Then, there were supply chain issues. Officials from the Biden administration met with manufacturers and partners of RSV immunizations including Sanofi, AstraZeneca and Thermo Fisher, in fall 2023 and urged them to speed up production as physicians faced an alarming shortage.
Sanofi, one of the makers of Beyfortus, said in a statement last month that there were some “implementation barriers, including commercial payer coverage and coding issues” and that demand outpaced supply.
The company said it has delivered enough doses to make 1.4 million babies in the U.S. eligible to receive Beyfortus.
As of Dec 2023, 28% of mothers with babies under 8 months said they got their infant the shot, according to a new CDC survey.
While the doctors told ABC News they believe the availability of these tools likely had some effect on hospitalization rates, next year will likely be more telling.
“My suspicion is once the supply chain issues kind of correct themselves, and more kids are getting it, I think next year might be more telling as to how much of an impact [the immunization] really has on the hospital side,” Biondi said.
Bartlett said she’s hopeful that between this winter and fall, there will be more conversations with parents about the real-world implications of the monoclonal antibody shot that will result in more infants getting protected before the next RSV season.
“Our goal with these prevention tools that we have is to put the children’s hospitals out of business,” she said. “You know, we won’t be sad if our ICUs are not full of children with RSV infections. We would much rather than be home and healthy and happy.”
(ATMORE, Ala.) — An Alabama man has become the first ever person executed via a new method, nitrogen gas, on Thursday.
Kenneth Eugene Smith, 58, was sentenced to death for his alleged role in the 1988 murder of Elizabeth Sennett. Her husband, Charles Sennett, allegedly hired someone — who, in turn, hired two men, including Smith — to kill his wife and make it look like a burglary gone wrong.
Smith was to be executed in November 2022 via lethal injection, but, despite multiple attempts, officials were not able to insert an intravenous line to administer the drugs before the death warrant expired.
However, medical and legal experts told ABC News that nitrogen gas as a method for execution is untested and there’s no evidence the method will be any more humane or painless than lethal injection.
“I’ve never heard anyone say, ‘We’ve got this new method of execution. We’ve looked at it carefully. We know that this method of execution will cause a death that will not be cruel. Here’s the evidence,'” Dr. Joel Zivot, an associate professor in the department of anesthesiology at Emory University School of Medicine, told ABC News. “That’s what needed to be said. No one has said that.”
Three states — Alabama, Mississippi and Oklahoma — have approved nitrogen gas as a form of execution and Alabama Gov. Kay Ivey defended the method in a statement to ABC News last week.
“Nitrogen hypoxia is the method previously requested by the inmate as an alternative to lethal injection,” she said. “This method has been thoroughly vetted, and both the Alabama Department of Corrections and the Attorney General’s Office have indicated it is ready to go. The Legislature passed this law in 2018, and it is our job to implement it. I am confident we are ready to move forward.”
What is nitrogen hypoxia?
Nitrogen hypoxia is the term for a means of death caused by breathing in enough nitrogen gas to deprive the body of oxygen — in this case, intended to be used as a method of execution.
The protocol in Alabama calls for an inmate to be strapped to a gurney and fitted with a mask and a breathing tube. The mask is meant to administer 100% pure nitrogen, depriving the person of oxygen until they die.
About 78% of the air that humans breathe is made up of nitrogen gas, which may lead people to believe that nitrogen is not harmful, according to the U.S. Chemical Safety Board.
However, when an environment contains too much nitrogen and the concentration of oxygen becomes too low, the body’s organs, which need oxygen to function, begin shutting down and a person dies.
State officials have argued death by nitrogen gas is a humane, painless form of execution and that the person would lose consciousness before they die.
Problems surrounding lethal injection
Lethal injection has been the method used for most executions in the modern era, according to the Death Penalty Information Center, a non-profit that provides data and analysis on capital punishment.
States and jurisdictions can use a one-, two- or three-drug combination. The three-drug combination involves, firstly, an anesthetic or sedative, then a drug to paralyze the prisoner and, lastly, a drug to stop the heart, the DPIC said.
The one and two-drug method typically use an overdose of an anesthetic or sedative to perform the execution.
Lethal injection was seen as a more humane form of execution that would lead to instantaneous death, Zivot said.
“It replaced the firing squad, it replaced electrocution, it replaced the gas chamber, it replaced hanging, all these kinds of methods are a lot more visual than lethal injection,” he said. “It looked like a prisoner was kind of closing their eyes and falling off to sleep and then dying.”
However, problems have arisen with lethal injections in the form of botched executions. Officials have struggled to find veins, intravenous lines have clogged with the deadly chemicals and prisoners have had violent reactions to the dispensed drugs.
Additionally, there have been shortages of the drugs used for lethal injection.
“Companies that made the drugs used in the lethal injection, some of them did not want to participate in making drugs for killing people,” Jeffrey Kirchmeier, a professor of law at City University of New York School of Law, told ABC News. “So, states, fairly recently. in the last decade or so, began experimenting with different drugs with lethal injection not with a lot of science behind it, but using different drugs that they could access.”
In 2016, Zivot was examining autopsy reports of prisoners who were executed via lethal injection and found that the inmates’ lungs were twice as heavy as they normally weigh. He asked a colleague at Emory to check, and he found the same thing.
They discovered that prisoners who had received lethal injections were suffering from pulmonary edema, which is when fluid builds up in the lungs, making it difficult to breathe. Further research Zivot conducted with NPR found similar results.
“It seemed to me that this was death akin to drowning,” Zivot said. “You are drowning in your own secretions … Lethal injection is actually a myth. The myth is that this is a peaceful death and not a cruel death, and that’s just not true.”
The controversy surrounding execution by nitrogen gas
“So, [officials] think that it will kill quickly, and that this kind of death will appear to be without suffering, will not be cruel, and that’s their claim,” Zivot said.
However, Alabama’s published protocol has been heavily redacted, which initially made it unclear exactly how the execution would be performed, and officials were not planning to release any documentation of the execution afterward, according to Zivot.
“That’s definitely one of the concerns here because so much about executions are done in secrecy,” Kirchmeier, who teaches courses that include capital punishment, said. “It’s a government act, the government is doing this and so it should be something that people have access to, that the media has access to.”
In court, Smith argued there are several ways his execution could go wrong including the mask may not fit properly, or it may dislodge. Additionally, he said the method could cause him to suffer hypoxia short of death, a stroke or leave in him a vegetative state if the method fails.
Kirchmeier also said doctors are not ethically allowed to help with executions including lethal injection or nitrogen gas, so the procedures are not done by doctors with medical expertise.
A court ruled earlier this month that Alabama could proceed with the execution and that it did not find that the method would constitute as “cruel and unusual punishment.”
On Wednesday, the Supreme Court declined Smith’s last-minute request to halt the execution.
Numerous organizations called on Alabama to stay the execution, including the U.N. Human Rights Office, saying execution via nitrogen gas could be classified as torture and violate international human rights treaties.
“We have serious concerns that Smith’s execution in these circumstances could breach the prohibition on torture or other cruel, inhuman or degrading treatment or punishment, as well as his right to effective remedies,” Ravina Shamdasani, spokesperson for the U.N. Human Rights Office, said during a press briefing earlier this month,
Additionally, Sant’Egidio Community, a Catholic charity affiliated with the Vatican, made an appeal to Alabama to halt the execution, calling it “barbaric” and “a new, downward standard of humanity.”
Medical and legal experts told ABC News that despite Alabama officials arguing that nitrogen gas is not cruel, there is no evidence to show that is the case.
“It’s very difficult to kill people humanely, and that’s what the long history of the death penalty has shown [with] these changes in execution methods,” Kirchmeier said. “Every one is hailed as a new method that will be more humane than the previous one, but here we are, after more than 200 years since the country was formed, states are still experimenting with new ways to execute people.”
