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Health

Surgeon General says 13 is ‘too early’ to join social media

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CNN
 — 

US Surgeon General Vivek Murthy says he believes 13 is too young for children to be on social media platforms, because although sites allow children of that age to join, kids are still “developing their identity.”

Meta, Twitter, and a host of other social media giants currently allow 13-year-olds to join their platforms.

“I, personally, based on the data I’ve seen, believe that 13 is too early … It’s a time where it’s really important for us to be thoughtful about what’s going into how they think about their own self-worth and their relationships and the skewed and often distorted environment of social media often does a disservice to many of those children,” Murthy said on “CNN Newsroom.”

The number of teenagers on social media has sparked alarm among medical professionals, who point to a growing body of research about the harm such platforms can cause adolescents.

Murthy acknowledged the difficulties of keeping children off these platforms given their popularity, but suggested parents can find success by presenting a united front.

“If parents can band together and say you know, as a group, we’re not going to allow our kids to use social media until 16 or 17 or 18 or whatever age they choose, that’s a much more effective strategy in making sure your kids don’t get exposed to harm early,” he told CNN.

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New research suggests habitually checking social media can alter the brain chemistry of adolescents.

According to a study published this month in JAMA Pediatrics, students who checked social media more regularly displayed greater neural sensitivity in certain parts of their brains, making their brains more sensitive to social consequences over time.

Psychiatrists like Dr. Adriana Stacey have pointed to this phenomenon for years. Stacey, who works primarily with teenagers and college students, previously told CNN using social media releases a “dopamine dump” in the brain.

“When we do things that are addictive like use cocaine or use smartphones, our brains release a lot of dopamine at once. It tells our brains to keep using that,” she said. “For teenagers in particular, this part of their brain is actually hyperactive compared to adults. They can’t get motivated to do anything else.”

Recent studies demonstrate other ways excessive screen time can impact brain development. In young children, for example, excessive screen time was significantly associated with poorer emerging literacy skills and ability to use expressive language.

Democratic Sen. Chris Murphy, who recently published an op-ed in the Bulwark about loneliness and mental health, echoed the surgeon general’s concerns about social media. “We have lost something as a society, as so much of our life has turned into screen-to-screen communication, it just doesn’t give you the same sense of value and the same sense of satisfaction as talking to somebody or seeing someone,” Murphy told CNN in an interview alongside Murthy.

For both Murphy and Murthy, the issue of social media addiction is personal. Both men are fathers – Murphy to teenagers and Murthy to young children. “It’s not coincidental that Dr. Murthy and I are probably talking more about this issue of loneliness more than others in public life,” Murphy told CNN. “I look at this through the prism of my 14-year-old and my 11-year-old.”

As a country, Murphy explained, the U.S. is not powerless in the face of Big Tech. Lawmakers could make different decisions about limiting young kids from social media and incentivizing companies to make algorithms less addictive.

The surgeon general similarly addressed addictive algorithms, explaining pitting adolescents against Big Tech is “just not a fair fight.” He told CNN, “You have some of the best designers and product developers in the world who have designed these products to make sure people are maximizing the amount of time they spend on these platforms. And if we tell a child, use the force of your willpower to control how much time you’re spending, you’re pitting a child against the world’s greatest product designers.”

Despite the hurdles facing parents and kids, Murphy struck a note of optimism about the future of social media.

“None of this is out of our control. When we had dangerous vehicles on the road, we passed laws to make those vehicles less dangerous,” he told CNN. “We should make decisions to make [social media] a healthier experience that would make kids feel better about themselves and less alone.”

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US

Memphis releases video showing Tyre Nichols calling for his mother, beaten by officers now charged in his death

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Editor’s Note: This article contains graphic videos and descriptions of violence.



CNN
 — 

Tyre Nichols screamed for his mother and Memphis police officers struck him multiple times – including in the face while his hands were restrained – toward the end of the Black man’s deadly encounter with the officers this month, video released by the city shows.

And although paramedics arrive minutes after officers disengage, Nichols appears to be left multiple times on the pavement without assistance before an ambulance comes.

The city on Friday night released body camera and surveillance video of the January 7 traffic stop and beating that led to the 29-year-old’s death in hospital from his injuries three days later. The release comes a day after five Memphis police officers, who also are Black and have been fired, were charged with murder.

The footage drew stunned reaction from law enforcement experts and outrage from officials including President Joe Biden, who said it was “yet another painful reminder of the profound fear and trauma, the pain, and the exhaustion that Black and Brown Americans experience every single day.”

Live updates: Memphis releases Tyre Nichols arrest videos

Protesters in Memphis took to Interstate 55 Friday night after the videos’ release, blocking both lanes of the highway’s bridge connecting the western Tennessee city to Arkansas.

The basics of Nichols’ encounter were this: Police pulled Nichols over in Memphis in what they initially said was on suspicion of reckless driving. After officers pulled him out of his car, a struggle ensued and he ran away; minutes later, officers would catch up with him and hit or kick him numerous times, video shows.

Moments from the videos include:

During the first encounter after the traffic stop, at around 8:24 p.m., Nichols sounded calm, body cam video from an officer arriving at the scene shows.

As the officer approaches the scene, an officer is yelling at Nichols to “Get the fuck out of the car.”

Officers pull Nichols out of the vehicle and someone is heard saying, “Get the fuck on the ground and turn his ass around.” Nichols responds by saying, “I didn’t do anything,” and, “Alright, I’m on the ground.”

Officers yell at him to lie down and threaten to tase him. One officer tells him, “Bitch put your (hands) behind your back before I break them.”

Nichols can be heard telling them, “You guys are doing a lot right now. … I’m just trying to go home. I am on the ground!”

At 8:25 p.m., one officer sprays Nichols in the face with pepper spray. Nichols then struggles to his feet and begins running from the officer as one another shoots a taser at him that apparently didn’t make contact.

A struggle ensues. Nichols gets up and runs, and the officers chase him.

A different body camera video shows some of what happens when officers catch Nichols on a neighborhood street minutes later, around 8:34 p.m.

Nichols screams for his mom as the video shows an officer arriving at this scene.

– Source:
CNN
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Video: Lawyer shares Nichols called out for his mom 3 times

Officers tell Nichols to “give them his hand,” as a struggle ensues on the ground. An officer asks Nichols, “Do you want to get sprayed again?”

Two officers hit and kick Nichols as he is on the ground.

Nichols screams: “Mooooom!” and continues to call for his mom for a while.

An officer is eventually heard yelling at Nichols: “I’m going to baton the fuck out of you. Give me your fucking hands.”

A remotely operated pole-mounted police surveillance video in the neighborhood gives the clearest view of the blows. This shows officers hitting Nichols at least nine times without visible provocation.

When the camera first turns toward the scene, an officer shoves Nichols hard to the pavement with a knee or leg. Nichols is pulled up by his shoulders and then kicked in the face twice.

After being pulled up into a sitting position, Nichols is hit in the back with what appears to be a nightstick. After being pulled to his knees, Nichols is hit again.

Once pulled to his feet, the video shows officers hitting Nichols in the face multiple times while his hands are restrained behind his body, after which he falls to his knees. Less than a minute later, an officer appears to kick Nichols. More than three minutes after the encounter is first seen on this camera, officers let go of Nichols, and he rolls on his back.

One minute later, Nichols is dragged along the pavement and propped up in a sitting position against the side of a car, where he is largely ignored by officers for the next three-and-a-half minutes.

In a body-camera video, officers can be heard talking about the encounter.

“He swung – pow – almost hit me,” one officer says. “Then he reached for (inaudible) gun,” a second officer says.

One officer says Nichols “had his hand on my gun,” and “motherfucker was holding it.”

An officer later describes the traffic stop involving Nichols: “We tried to get him stopped. He didn’t stop.”

An officer says: “He drove around, swerved, nearly hit my car.”

Van Jones, a former special adviser to President Barack Obama, put it this way to CNN after seeing the videos: “(Nichols) goes from a voice from calm (during the initial encounter) to panic … to agony.”

“It’s clearly excessive force,” former New York City police Lt. Darrin Porcher told CNN. “What’s even more troubling is, no officer was wiling to intervene and say, ‘Stop.’ “

Ten minutes into the pole-camera video – a few minutes after officers disengaged – a person who appears to be a paramedic engages Nichols for the first time, around 8:41 p.m. But responders would repeatedly walk away from Nichols before an ambulance arrives.

Two minutes after paramedics started attending to Nichols, he is seen falling over to the side and seeming to hit his head hard against a piece of equipment after a bright light was shone in his face. No one appears to help Nichols as he tries to sit up, only to fall over again.

About a minute later, officers are seen crowding around Nichols, only to step away as he again falls onto his side.

First responders then spend nearly five minutes standing over Nichols, and occasionally shining a light toward his face, before walking away.

Read stepfather’s description of video: ‘No one rendered aid to him’

Nichols twists on the ground, unhelped. Medical equipment is finally brought back to Nichols’ side about three minutes later, the pole-camera video shows.

Footage shows that 21 minutes pass from when paramedics first appeared to arrive to when an ambulance finally pulls into view of the camera at 9:02 p.m.

Two deputies with the Shelby County sheriff’s office have been put on leave pending an investigation after the sheriff viewed the videos Friday.

“I have concerns about two deputies who appeared on scene following the physical confrontation between police and Tyre Nichols,” Sheriff Floyd Bonner Jr. said.

“I have launched an internal investigation into the conduct of these deputies to determine what occurred and if any policies were violated. Both of these deputies have been relieved of duty pending the outcome of the administrative investigation.”

Earlier, two fire department employees who were part of Nichols’ “initial patient care” were put on leave “while an internal investigation is being conducted,” department spokesperson Qwanesha Ward told CNN’s Nadia Romero.

The US Department of Justice has said it is conducting a federal civil rights investigation of Nichols’ death.

Earlier Friday, Memphis’ police chief said the video would show “acts that defy humanity.”

Police have not been able to find anything to substantiate the probable cause for reckless driving by Nichols before his fatal encounter, Chief Cerelyn “CJ” Davis told CNN’s Don Lemon ahead of the videos’ release.

Nichols’ mother, RowVaughn Wells, told CNN on Friday before the videos were released: “It’s still like a nightmare right now.”

“I’m still trying to understand all of this and trying to wrap my head around all of this,” Wells said. “I don’t have my baby. I’ll never have my baby again.”

Police officials in a number of major cities nationwide have said they are monitoring for any possible public outcry this weekend over what will be seen in the video footage.

Police nationwide have been under scrutiny for how they treat Black people, particularly since the Minneapolis police murder of George Floyd in May 2020 and the mass protest movement known as Black Lives Matter.

Before the videos’ were made public, Wells asked for supporters to be peaceful during demonstrations, saying at a vigil in Memphis on Thursday she wants “each and every one of you to protest in peace.”

“I don’t want us burning up our cities, tearing up the streets, because that’s not what my son stood for,” Wells said. “And if you guys are here for me and Tyre, then you will protest peacefully.”

A Memphis church is scheduled to hold Nichols’ funeral Wednesday.

The five Memphis police officers identified – Tadarrius Bean, Demetrius Haley, Justin Smith, Emmitt Martin and Desmond Mills Jr. – were fired January 20 for violating police policies including on use of excessive force, police said.

They were then charged this week. Each has been charged with second-degree murder, aggravated assault, two charges of aggravated kidnapping, two charges of official misconduct and one charge of official oppression, Mulroy, the Shelby County district attorney, said.

Martin and Haley were released from jail on a $350,000 bond, according to Shelby County Jail records, while Smith, Bean and Mills Jr. have been released after each posting a $250,000 bond.

The five former officers are scheduled for arraignment on February 17.

Blake Ballin, an attorney for Mills Jr., one of the officers, said he doesn’t believe his client “is capable of” the accusations, and his client is “remorseful” to be “connected to the death” of Nichols.

Ballin told CNN he has not yet seen the video, but has spoken to people who have. He urged those who watch the video to “treat each of these officers as individuals.”

“The levels of culpability amongst these five officers are different, and I expect that you’re going to see in this video that my client Desmond Mills is not, in fact, guilty of the crimes he’s been charged with,” Ballin said.



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World

FBI seizes website used by notorious ransomware gang

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CNN
 — 

The FBI has seized the computer infrastructure used by a notorious ransomware gang which has extorted more than $100 million from hospitals, schools and other victims around the world, US officials announced Thursday.

FBI officials since July have had extraordinary access to the so-called Hive ransomware group’s computer networks, FBI Director Christopher Wray said at a news conference, allowing the bureau to pass computer “keys” to victims so that they could decrypt their systems and thwart $130 million in ransom payments.

As of November, Hive ransomware had been used to extort about $100 million from over 1,300 companies worldwide – many of them in health care, according to US officials.

The dark-web website on which Hive listed its victims displayed a message in Russian and English Thursday that it had been taken over “as part of a coordinated law enforcement action” against the group by the FBI, Secret Service and numerous European government agencies.

“Simply put, using lawful means, we hacked the hackers,” Deputy Attorney General Lisa Monaco told reporters.

The Hive ransomware has been particularly rampant in the health care sector. One ransomware attack using Hive malicious software, in August 2021, forced a hospital in the US Midwest to turn away patients as Covid-19 surged, Attorney General Merrick Garland said.

Other reported US victim organizations of Hive include a 314-bed hospital in Louisiana. The hospital said it thwarted a ransomware attack in October, but that the hackers still stole personal data on nearly 270,000 patients.

“Hive compromised the safety and health of patients in hospitals – who are among our most vulnerable population,” said Errol Weiss, chief security officer for the Health Information Sharing and Analysis Center, a cyber threat sharing group for big health care providers worldwide. “When hospitals are attacked and medical systems go down, people can die.”

Thursday’s announcement is the latest in a series of Justice Department efforts to crack down on overseas ransomware groups that lock up US companies’ computers, disrupt their operations and demand millions of dollars to unlock the systems. Justice officials have seized millions of dollars in ransomware payments and urged companies not to pay off the criminals.

The ransomware epidemic grew more urgent for US officials after Colonial Pipeline, the major pipeline operator for sending fuel to the East Coast, shut down for days in May 2021 due to a ransomware attack from a suspected Russian cybercriminal. The disruption led to long lines at gas stations in multiple states as people hoarded fuel.

While the ransomware economy remains lucrative, there are signs that the US and international law enforcement stings are making a dent in the hackers’ earnings. Ransomware revenue fell to about $457 million in 2022, down from $766 million in 2021, according to data from cryptocurrency-tracking firm Chainalysis.

Cybersecurity professionals welcomed the Hive takedown, but some worried that another group would soon fill the void left by Hive.

“The disruption of the Hive service won’t cause a serious drop in overall ransomware activity but it is a blow to a dangerous group that has endangered lives by attacking the healthcare system,” John Hultquist, a vice president at Google-owned cybersecurity firm Mandiant, told CNN.

“Unfortunately, the criminal marketplace at the heart of the ransomware problem ensures a Hive competitor will be standing by to offer a similar service in their absence, but they may think twice before allowing their ransomware to be used to target hospitals,” Hultquist said.

Wray said the FBI would continue to track the people behind Hive ransomware and try to arrest them. It was not immediately clear where those people were located. The Department of Health and Human Services has descried Hive as a “possibly Russian speaking” group.

This story has been updated with additional details.

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Health

Many women underestimate breast density as a risk factor for breast cancer, study shows

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CNN
 — 

Dense breast tissue has been associated with up to a four times higher risk of breast cancer. However, a new study suggests few women view breast density as a significant risk factor.

The study, published in JAMA Network Open, surveyed 1,858 women ages 40 to 76 years from 2019 to 2020 who reported having recently undergone mammography, had no history of breast cancer and had heard of breast density.

Women were asked to compare the risk of breast density to five other breast cancer risk factors: having a first-degree relative with breast cancer, being overweight or obese, drinking more than one alcoholic beverage per day, never having children and having a prior breast biopsy.

“When compared to other known and perhaps more well-known breast cancer risks, women did not perceive breast density as significant of a risk,” said Laura Beidler, an author of the study and researcher at the Dartmouth Institute for Health Policy and Clinical Practice.

For example, the authors report that dense breast tissue is associated with a 1.2 to four times higher risk of breast cancer compared with a two times higher risk associated with having a first-degree relative with breast cancer – but 93% of women said breast density was a lesser risk.

Dense breasts tissue refers to breasts that are composed of more glandular and fibrous tissue than fatty tissue. It is a normal and common finding present in about half of women undergoing mammograms.

The researchers also interviewed 61 participants who reported being notified of their breast density and asked what they thought contributes to breast cancer and how they could reduce their risk. While most women correctly noted that breast density could mask tumors on mammograms, few women felt that breast density could be a risk factor for breast cancer.

Roughly one-third of women thought there was nothing they could do to reduce their breast cancer risk, although there are several ways to reduce risk, including maintaining a healthy, active lifestyle and minimizing alcohol consumption.

Breast density changes over a woman’s lifetime, and is generally higher in women who are younger, have a lower body weight, are pregnant or breastfeeding, or are taking hormone replacement therapy.

The level of breast cancer risk increases with the degree of breast density; however, experts aren’t certain why this is true.

“One hypothesis has been that women who have more dense breast tissue also have higher, greater levels of estrogen, circulating estrogen, which contributes to both the breast density and to the risk of developing breast cancer,” said Dr. Harold Burstein, a breast oncologist at the Dana-Farber Cancer Institute who was not involved in the study. “Another hypothesis is that there’s something about the tissue itself, making it more dense, that somehow predisposes to the development of breast cancer. We don’t really know which one explains the observation.”

Thirty-eight states currently mandate that women receive written notification about their breast density and its potential breast cancer risk following mammography; however, studies have shown that many women find this information confusing.

“Even though women are notified usually in writing when they get a report after a mammogram that says, ‘You have increased breast density,’ it’s kind of just tucked in there at the bottom of the report. I’m not sure that anyone is explaining to them, certainly in person or verbally, what that means,” said Dr. Ruth Oratz, a breast oncologist at NYU Langone’s Perlmutter Cancer Center who was not involved in the study.

“I think what we’ve learned from this study is that we have to do a better job of educating not only the general public of women, but the general public of health care providers who are doing the primary care, who are ordering those screening mammograms,” she added.

Current screening guidelines recommend women of average risk of breast cancer undergo breast cancer screening every one to two years between ages 50 to 74 with the option of beginning at age 40.

Because women with dense breast tissue are considered to have higher than average cancer risks, the authors of the study suggest women with high breast density may benefit from supplemental screening like breast MRI or breast ultrasound, which may detect cancers that are missed on mammograms. Currently, coverage of supplemental screening after the initial mammogram varies, depending on the state and insurance policy.

The authors warn that “supplemental screening not only can lead to increased rates of cancer detection but also may result in more false-positive results and recall appointments.” They say clinicians should use risk assessment tools when discussing tradeoffs associated with supplemental screening.

“Usually, it’s a discussion between the patient, the clinical team, and the radiologist. And it’ll be affected by prior history, by whether there’s anything else of concern on the mammogram, by the patient’s family history. So those are the kinds of things we discuss frequently with patients who are in such situations,” Burstein said.

Breast cancer screening recommendations differ between medical organizations, and experts say women at higher risk due to breast density should discuss with their doctor what screening method and frequency are most appropriate.

“I think it’s really, really important that everyone understands – and this is the doctors, the nurses, the women themselves – that screening is not a one size fits all recommendation. We cannot just make one general recommendation to the entire population because individual women have different levels of risks of developing breast cancer,” Oratz said.

For the nearly one-third of women with dense breast tissue that reported there was nothing they could do to prevent breast cancer, experts say there are some steps you can take to reduce your risk.

“Maintaining an active, healthy lifestyle and minimizing alcohol consumption address several modifiable factors. Breastfeeding can decrease the risk. On the other hand, use of hormone replacement therapy increases breast cancer risk,” said Dr. Puneet Singh, a breast surgical oncologist at the MD Anderson Cancer Center who was not involved in the study.

The researchers add that there are approved medications, such as tamoxifen, that can be given for those at significantly increased risk that may reduce the chances of breast cancer by about half.

Finally, breast cancer doctors say that in addition to appropriate screening, knowing your risk factors and advocating for yourself can be powerful tools in preventing and detecting breast cancer.

“At any age, if any woman feels uncomfortable about something that’s going on in her breast, if she has discomfort, notices a change in the breast, bring that to the attention of your doctor and make sure it gets evaluated and don’t let somebody just brush you off,” Oratz said.

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US

A Florida woman is barricading herself inside a Daytona Beach hospital room after shooting her terminally ill husband

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CNN
 — 

A woman has confined herself to a room inside a Daytona Beach, Florida, hospital after shooting her terminally ill husband on Saturday, police say.

Officers arrived at the Advent Health Hospital after receiving a report of about a person being shot, Daytona Beach police said in a release obtained by CNN affiliate WESH.

“Officers have evacuated staff and patients around the room, and at this time the female is not seen as a threat to staff or patients. No one else has been injured,” the release said. “We are currently negotiating with the female to get her to surrender and come out of the hospital.”

Dr. Joshua Horenstein, a cardiologist at Advent Health Hospital, was working in the emergency department when he learned of the shooting incident.

“Someone came in screaming in the emergency department that this was not a drill and to shelter in place,” Horenstein told CNN while hiding in a supply room with a nurse.

Horenstein said he was finally able to leave the supply room after roughly 90 minutes.

Daytona Beach Police are expected to hold a press conference Saturday afternoon, according to a tweet on the department’s verified Twitter account.

Police are asking people to stay away from the area.

CNN has reached out to hospital staff, some who are currently on lockdown inside the hospital.

The status of the woman’s husband is unclear at this time.

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Health

These healthy diets were associated with lower risk of death, according to a study of 119,000 people across four decades

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Eat healthy, live longer.

That’s the takeaway from a major study published this month in JAMA Internal Medicine. Scientists led by a team from the Harvard T.H. Chan School of Public Health found that people who most closely adhered to at least one of four healthy eating patterns were less likely to die from cardiovascular disease, cancer or respiratory disease compared with people who did not adhere as closely to these diets. They were also less likely to die of any cause.

“These findings support the recommendations of Dietary Guidelines for Americans that multiple healthy eating patterns can be adapted to individual food traditions and preferences,” the researchers concluded, adding that the results were consistent across different racial and ethnic groups. The eating habits and mortality rates of more than 75,000 women from 1984 to 2020 over 44,000 men from 1986 to 2020 were included in the study.

The four diets studied were the Healthy Eating Index, the Alternate Mediterranean Diet, the Healthful Plant-Based Diet Index and the Alternate Healthy Eating Index. All four share some components, including whole grains, fruits, vegetables, nuts and legumes. But there are also differences: For instance, the Alternate Mediterranean Diet encourages fish consumption, and the Healthful Plant-Based Diet Index discourages eating meat.

The Alternate Mediterranean Diet is adapted from the original Mediterranean Diet, which includes olive oil (which is rich in omega-3 fatty acids), fruits, nuts, cereals, vegetables, legumes and fish. It allows for moderate consumption of alcohol and dairy products but low consumption of sweets and only the occasional serving of red meat. The alternate version, meanwhile, cuts out dairy entirely, only includes whole grains and uses the same alcohol-intake guideline for men and women, JAMA says.

The world’s ‘best diets’ overlap with study results

The Mediterranean Diet consistently ranks No. 1 in the U.S. News and World Report’s Best Diets ranking, which looks at seven criteria: short-term weight loss, long-term weight loss, effectiveness in preventing cardiovascular disease, effectiveness in preventing diabetes, ease of compliance, nutritional completeness and health risks. The 2023 list ranks the top three diets as the Mediterranean Diet, the DASH Diet and the Flexitarian Diet. 

The DASH (Dietary Approaches to Stop Hypertension) Diet recommends fruits, vegetables, nuts, whole grains, poultry, fish and low-fat dairy products and restricts salt, red meat, sweets and sugar-sweetened beverages. The Flexitarian Diet is similar to the other diets in that it’s mainly vegetarian, but it allows the occasional serving of meat or fish. All three diets are associated with improved metabolic health, lower blood pressure and reduced risk of Type 2 diabetes.

Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health and co-author of the latest study, said it’s critical to examine the associations between the U.S. government’s Dietary Guidelines for Americans and long-term health. “Our findings will be valuable for the 2025-2030 Dietary Guidelines Advisory Committee, which is being formed to evaluate current evidence surrounding different eating patterns and health outcomes,” he said.

Reducing salt intake is a good place to start. In 2021, the Food and Drug Administration issued new guidance for restaurants and food manufacturers to, over a two-and-a-half-year period, voluntarily reduce the amount of sodium in their food to help consumers stay under a limit of 3,000 milligrams per day — still higher than the recommended daily allowance. Americans consume around 3,400 milligrams of sodium per day, on average, but the Centers for Disease Control and Prevention recommends that people consume less than 2,300 milligrams each day.

Related: Eating 400 calories a day from these foods could raise your dementia risk by over 20%

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Health

Flu, Covid-19 and RSV are all trending down for the first time in months

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CNN
 — 

A rough respiratory virus season in the US appears to be easing, as three major respiratory viruses that have battered the country for the past few months are finally all trending down at the same time.

A new dataset from the US Centers for Disease Control and Prevention shows that the number of emergency department visits for the three viruses combined – flu, Covid-19 and RSV – have dropped to the lowest they’ve been in three months. The decline is apparent across all age groups.

Measuring virus transmission levels can be challenging; health officials agree that Covid-19 cases are vastly undercounted, and surveillance systems used for flu and RSV capture a substantial, but incomplete picture.

But experts say that tracking emergency department visits can be a good indicator of how widespread – and severe – the respiratory virus season is.

“There’s the chief complaint. When you show up to the emergency room, you complain about something,” said Janet Hamilton, executive director at Council of State and Territorial Epidemiologists. “Being able to look at the proportion of individuals that seek care at an emergency department for these respiratory illness concerns is a really good measure of the respiratory disease season.”

In the week following Thanksgiving, emergency department visits for respiratory viruses topped 235,000 – matching rates from last January, according to the CDC data.

While the surge in emergency department visits early in the year was due almost entirely to Omicron, the most recent spike was much more varied. In the week ending December 3, about two-thirds of visits were for flu, about a quarter were for Covid-19 and about 10% were for RSV.

Grouping the impact of all respiratory viruses together in this way offers an important perspective.

“There’s a strong interest in thinking about respiratory diseases in a more holistic way,” Hamilton said. “Transmission is the same. And there are certain types of measures that are good protection against all respiratory diseases. So that could really help people understand that when we are in high circulation for respiratory diseases, there are steps that you can take – just in general.”

Now, Covid-19 again accounts for most emergency department visits but flu and RSV are still the reason behind about a third of visits – and they’re all trending down for the first time since the respiratory virus season started picking up in September.

More new data from the CDC shows that overall respiratory virus activity continues to decline across the country. Only four states, along with New York City and Washington, DC, had “high” levels of influenza-like illness. Nearly all states were in this category less than a month ago.

Whether that pattern will hold is still up in the air, as vaccination rates for flu and Covid-19 are lagging and respiratory viruses can be quite fickle. Also, while the level of respiratory virus activity is lower than it’s been, it’s still above baseline in most places and hospitals nationwide are still about 80% full.

RSV activity started to pick up in September, reaching a peak in mid-November when 5 out of every 100,000 people – and 13 times as many children younger than five – were hospitalized in a single week.

RSV particularly affects children, and sales for over-the-counter children’s pain- and fever-reducing medication were 65% higher in November than they were a year before, according to the Consumer Healthcare Products Association. While “the worst may be over,” demand is still elevated, CHPA spokesperson Logan Ramsey Tucker told CNN in an email – sales were up 30% year-over-year in December.

But this RSV season has been significantly more severe than recent years, according to CDC data. The weekly RSV hospitalization rate has dropped to about a fifth of what it was two months ago, but it is still higher than it’s been in previous seasons.

Flu activity ramped up earlier than typical, but seems to have already reached a peak. Flu hospitalizations – about 6,000 new admissions last week – have dropped to a quarter of what they were at their peak a month and a half ago, and CDC estimates for total illnesses, hospitalizations and deaths from flu so far this season have stayed within the bounds of what can be expected. It appears the US has avoided the post-holiday spike that some experts cautioned against, but the flu is notoriously unpredictable and it’s not uncommon to see a second bump later in season.

The Covid-19 spike has not been as pronounced as flu, but hospitalizations did surpass levels from the summer. However, the rise in hospitalizations that started in November has started to tick down in recent weeks and CDC data shows that the share of the population living in a county with a “high” Covid-19 community level has dropped from 22% to about 6% over the past two weeks.

Still, the XBB.1.5 variant – which has key mutations that experts believe may be helping it to be more infectious – continues to gain ground in the US, causing about half of all infections last week. Vaccination rates continue to lag, with just 15% of the eligible population getting their updated booster and nearly one in five people remain completely unvaccinated.

Ensemble forecasts published by the CDC are hazy, predicting a “stable or uncertain trend” in Covid-19 hospitalizations and deaths over the next month.

And three years after the first Covid-19 case was confirmed in the US, the virus has not settled into a predictable pattern, according to Dr. Maria Van Kerkhove, the World Health Organization’s technical lead for the Covid-19 response.

“We didn’t need to have this level of death and devastation, but we’re dealing with it, and we are doing our best to minimize the impact going forward,” Van Kerkhove told the Conversations on Healthcare podcast this week.

Van Kerkhove says she does believe 2023 could be the year in which Covid-19 would no longer be deemed a public health emergency in the US and across the world, but more work needs to be done in order to make that happen and transitioning to longer-term respiratory disease management of the outbreak will take more time.

“We’re just not utilizing [vaccines] most effectively around the world. I mean 30% of the world still has not received a single vaccine,” she said. “In every country in the world, including in the US, we’re missing key demographics.”

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Health

U.S. investigating first cases of “concerning” new drug-resistant gonorrhea strain

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Health authorities in Massachusetts announced Thursday they have identified two cases of a new strain of gonorrhea that appears to have developed resistance to a broad swath of antibiotic treatments.

Both patients got better after getting injections of ceftriaxone, the main drug currently recommended to treat cases of the sexually transmitted infection. But state health officials warn the strain that infected them shows signs of at least some resistance to almost every drug to treat the bacteria, the first of its kind confirmed in the U.S. to date.

Investigators are now working with the Centers for Disease Control and Prevention to test other samples collected from gonorrhea cases in the state. Massachusetts is also conducting contact tracing to find out if the drug-resistant strain has spread to others.

“The discovery of this strain of gonorrhea is a serious public health concern which DPH, the CDC, and other health departments have been vigilant about detecting,” Margret Cooke, head of the Massachusetts Department of Public Health, said Thursday in a statement.

Gonorrhea is the second most common sexually transmitted infection reported to health authorities in the U.S., behind chlamydia, according to the CDC.

Many who are infected by the bacteria often have little to no symptoms. However, some can develop bleeding, discharge, and more serious complications that can lead to infertility and pain.

The initial case was identified in a patient who went to a primary care clinic with symptoms of urethritis, a kind of irritation that can make it difficult to urinate. Samples examined by the state’s health laboratory flagged a “concerning” pattern later verified by follow-up testing by the CDC.

A spokesperson for the state declined to clarify additional details about the two cases, beyond those identified in the department’s announcement and alert to providers. 

No direct connection has been identified between the two cases. One had no recent travel history, suggesting the strain could be spreading within the state.

“We urge all sexually active people to be regularly tested for sexually transmitted infections and to consider reducing the number of their sexual partners and increasing their use of condoms when having sex,” Cooke said.

Gonorrhea’s “alarming” drug resistance

For years, health authorities have been working to respond to the “alarming” ability that gonorrhea has to develop resistance against antibiotics that have been deployed to combat it. 

In 2013, the CDC named gonorrhea as one of the three most urgent threats posed by antibiotic-resistant bacteria. Both U.S. and world health authorities have launched campaigns to curb new cases of gonorrhea in hopes of controlling the bacteria until vaccines and new treatments are developed.

The Massachusetts cases are the first confirmed in the lab to have developed the ability to sidestep six of the seven drugs that health authorities track for potential resistance. It carries a change to the “penA60 allele” – a gene mutation – which has been linked to previous ceftriaxone-resistant cases in Nevada, the United Kingdom, and Asia.

“This case is a reminder that antimicrobial-resistant gonorrhea remains an urgent public health threat nationally and internationally; all providers in all clinical settings need to remain vigilant,” Dr. Laura Hinkle Bachmann, chief medical officer of the CDC Division of STD Prevention, said Thursday in a letter to providers.

Ceftriaxone injections, boosted with other oral antibiotics like azithromycin and doxycycline, have been the last recommended treatment for gonorrhea since 2012. At the time, laboratory data showed a related drug known as cefixime had been losing effectiveness and risked creating resistance to ceftriaxone too.

Only one drug tested against the Massachusetts strain by the CDC’s panel – gentamicin – showed no sign of reduced susceptibility. However, that drug is already generally considered a less effective treatment for gonorrhea.

Scientists have pursued new drugs for gonorrhea like zoliflodacin, which showed promising early results in a 2018 study backed by the National Institutes of Health. That drug is currently being studied in clinical trials and has not been approved by the Food and Drug Administration for gonorrhea.

“Timely identification and treatment, as well as rapid public health response, are essential to keeping patients safe and reducing the risk of community transmission. We must all remain alert for potential gonococcal treatment failures as we combat the growing threat of antimicrobial resistance,” Bachmann said.

Alexander Tin

CBS News reporter covering public health and the pandemic.

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Health

Decreasing rates of childhood immunization are a major concern. Our medical analyst explains why

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CNN
 — 

Vaccine rates for measles, polio, diphtheria and other diseases are decreasing among US children, according to a new study from the US Centers for Disease Control and Prevention.

The rate of immunizations for required vaccines among kindergarten students declined from 95% to approximately 94% during the 2020-21 school year. It dropped further — to 93% — in the 2021-22 school year.

That’s still a high number, so why is this drop in immunization significant? What accounts for the decline? What might be the consequences if these numbers drop further? If parents are unsure about vaccinating their kids, what should they do? And what can be done on a policy level to increase immunization numbers?

To help us with these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician, public health expert and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.”

CNN: Why is it a problem that childhood immunization rates are declining?

Dr. Leana Wen: The reduction of vaccine-preventable diseases is one of the greatest public health success stories in the last 100 years.

The polio vaccine was introduced in the United States in 1955, for example. In the four years prior, there were an average of over 16,000 cases of paralytic polio and nearly 2,000 deaths from polio each year across the US. Widespread use of the polio vaccine had led to the eradication of polio in the country by 1979, according to the CDC, sparing thousands of deaths and lifelong disability among children each year.

The measles vaccine was licensed in the US in 1963. In the four years before that, there were an average of over 500,000 cases and over 430 measles-associated deaths each year. By 1998, there were just 89 cases recorded — and no measles-associated deaths.

These vaccines are very safe and extremely effective. The polio vaccine, for example, is over 99% effective at preventing paralytic polio. The measles vaccine is 97% effective at preventing infection.

We can do this same analysis for other diseases for which there are routine childhood immunizations.

It’s very concerning that rates of immunization are declining for vaccines that have long been used to prevent disease and reduce death. That means more children are at risk for severe illness — illness that could be averted if they were immunized. Moreover, if the proportion of unvaccinated individuals increases in a community, this also puts others at risk. That includes babies too young to be vaccinated or people for whom the vaccines don’t protect as well — for example, patients on chemotherapy for cancer.

CNN: What accounts for the decline in vaccination numbers?

Wen: There are probably many factors. First, there has been substantial disruption to the US health care system during the Covid-19 pandemic. Many children missed routine visits to the pediatrician during which they would have received vaccines due to pandemic restrictions. In addition, some community health services offered also became disrupted as local health departments focused on Covid-19 services.

Second, disruption to schooling has also played a role. Vaccination requirements are often checked prior to the start of the school year. When schools stopped in-person instruction, that led to some families falling behind on their immunizations.

Third, misinformation and disinformation around Covid-19 vaccines may have seeded doubt in other vaccines. Vaccine hesitancy and misinformation were already major public health concerns before the coronavirus emerged, but the pandemic has exacerbated the issues.

According to a December survey published by the Kaiser Family Foundation, more than one in three American parents said vaccinating children against measles, mumps, and rubella shouldn’t be a requirement for them to attend public schools, even if that may create health risks for others. This was a substantial increase from 2019, when a similar poll from the Pew Research Center found only 23% of parents opposed school vaccine requirements.

CNN: What are some consequences if immunization rates drop further?

Wen: If immunization rates drop further, we could see more widespread outbreaks. Diseases that were virtually eliminated in the US could reemerge, and more people can become severely ill and suffer lasting consequences or even die.

We are already seeing some consequences: Last summer, there was a confirmed case of paralytic polio in an unvaccinated adult in New York. It’s devastating that a disease like polio has been identified again in the US, since we have an extremely effective vaccine to prevent it.

There is an active measles outbreak in Ohio. As of January 17, 85 cases have been reported. Most of the cases involved unvaccinated children, and at least 34 have been hospitalized.

CNN: If parents are unsure of vaccinating their kids, what should they do?

Wen: As parents, we generally trust pediatricians with our children’s health. We consult pediatricians if our kids are diagnosed with asthma and diabetes, or if they have new worrisome symptoms of another illness. We should also consult our pediatricians about childhood immunizations; parents and caregivers with specific questions or concerns should address them.

The national association of pediatricians, the American Academy of Pediatrics, “strongly recommends on-time routine immunization of all children and adolescents according to the Recommended Immunization Schedules for Children and Adolescents.”

CNN: What can be done to increase immunization numbers?

Wen: There needs to be a concerted educational campaign to address why vaccination against measles, mumps, rubella, chickenpox, polio and so forth is so crucial. One of the reasons for vaccine hesitancy, in my experience, is that these diseases have been rarely seen in recent years. Many people who are parents now didn’t experience the devastation of these diseases growing up, so may not realize how terrible it would be for them to return.

Specific interventions should be targeted at the community level. In some places, low immunization levels may be due to access. Vaccination drives at schools, parks, shopping centers, and other places where families gather can help increase numbers. In other places, the low uptake may be because of vaccine hesitancy and misinformation. There will need to be different strategies implemented in that situation.

Overall, increasing immunization rates for vaccine-preventable childhood diseases needs to be a national imperative. I can’t underscore how tragic it would be for kids to suffer the harms of diseases that could be entirely prevented with safe, effective and readily available vaccines that have been routinely given for decades.

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US

Women living in states with abortion bans suffer greater economic insecurity

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New York
CNN
 — 

Women living in states that restrict or ban abortion face greater economic insecurity than those living in states where they have access, new research finds.

Since the nearly seven months since the Supreme Court overturned Roe v. Wade, half of all states – 26 in total – have implemented new abortion restrictions or all-out bans.

In nearly all 26 states, there are lower minimum wages, unionization levels, access to Medicaid and unemployment benefits, as well as higher rates of incarceration than states with more lenient abortion policies, according to new research by the Economic Policy Institute.

“These economic policies all compound on each other. And you add to that an abortion ban, it just compounds this financial stress, this economic insecurity,” said Asha Banerjee, an economic analyst with the institute and the author of the report.

Last year, Treasury Secretary Janet Yellen made a similar argument to the Financial Oversight Council.

“I believe that eliminating the right of women to make decisions about when and whether to have children would have very damaging effects on the economy and would set women back decades,” Yellen told lawmakers in May.

The lack of abortion access has the greatest economic impact on women of color, especially those already in dire financial conditions, according to Banerjee.

“In many of these states, especially the states which have banned abortion, many of the women who are facing economic challenges already are also women of color,” she said.

Raising the minimum wage is a powerful tool that has been known to have significant impact on closing racial income gaps. But nearly two-thirds of abortion restrictive states have a $7.25 minimum wage, the lowest legal hourly wage for most workers in the United States.

The average minimum wage across the 26 states is $8.17, lower than the average $11.92 for states with no restrictions. (Many of those states also have a higher cost of living, however.)

“If the person denied an abortion is also working a minimum wage job, the negative economic effect is compounded,” the report states.

Many of those low-wage jobs also do not offer benefits like health care, which is why access to Medicaid is critical.

“Medicaid is a lifeline for low-income families and low-income women when jobs might not offer adequate healthcare. Medicaid in the immediate postpartum period is especially important,” said Banerjee.

Just 12 states have not expanded Medicaid benefits since the 2010 Obamacare law, and all of them have restrictive abortion policies.

However, some states with total abortion bans, with few exceptions, have expanded Medicaid, including Missouri. And in five other abortion restrictive states (Idaho, Missouri, Nebraska, Oklahoma and South Dakota later this year) residents voted to expand the benefit.

Access to unemployment insurance is another key indicator of a state’s commitment to economic support for residents. Forty-two percent of residents have access to unemployment benefits in states that have abortion protections. Compare that to 30% in states with abortion restrictions.

Even if unemployment is accessible, the amount differs from state to state. For example, in Mississippi, a state with a total abortion ban with limited exceptions, weekly unemployment checks average $217. Meanwhile in Massachusetts, which has a more protective 24-week abortion ban – checks average $556 weekly.

“When you have unemployment insurance it helps create financial stability. These states which have abortion bans also have really terrible unemployment insurance systems with really low benefits which do not help one support oneself,” said Banerjee.

Although women make up a smaller percentage of those incarcerated than men, it is the economic category with the greatest difference between abortion protected and abortion-restricted states. The rate of incarceration in states with restrictive or total bans on abortion is more than one and a half times higher than the rate of incarceration for states with abortion protections.

“It’s very much a racial justice issue because Black and Hispanic women are very disproportionately incarcerated. And that has huge economic impacts on future earnings and the ability to get a job,” said Banerjee.

In some states with abortion restrictions and higher rates of incarceration – legislation has suggested also criminalizing women, doctors or anyone aiding a woman in seeking an abortion.

“The incarceration argument is especially important because in these states where abortion bans have come into play, there’s a huge criminalization aspect,” said Banerjee.

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