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    Trump health cuts create ‘real danger’ around disease outbreaks, workers warn

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    Mass terminations and billions of dollars’ worth of cuts at the Department of Health and Human Services (HHS) have gutted key programs – from child support services to HIV treatment abroad – and created a “real danger” that disease outbreaks will be missed, according to former workers.Workers at the HHS, now led by Robert F Kennedy Jr, and in public health warned in interviews that chaotic, flawed and sweeping reductions would have broad, negative effects across the US and beyond.While Donald Trump’s administration is cutting the HHS workforce from 82,000 to 62,000 through firings and buyouts, grant cuts by Elon Musk’s so-called “department of government efficiency” (Doge) have also had a stark impact on state governments – and resulted in firings at state public health agencies.At the South Carolina department of public health, for example, more than 70 staff were laid off in March due to funding cuts.“Disease surveillance is how we know when something unusual is happening with people’s health, like when there are more food-poisoning cases than usual, or a virus starts spreading in a community,” an epidemiologist at the department, whose role was eliminated, said. “It’s the system that lets us spot patterns, find outbreaks early, and respond before more people get sick.”“When you lose public health staff, you lose time, you lose accuracy, you lose responsiveness, and ultimately that affects people’s health,” they added. “Without us, outbreaks can fly under the radar, and the response can be delayed or disorganized. That’s the real danger when these roles get cut.View image in fullscreen“It’s invisible work, until it’s not. You may not think about it day to day, but it’s protecting your drinking water, your food, your kids’ schools and your community.”A spokesperson for South Carolina’s public health department declined to comment on specifics, but noted employees hired through grants are temporary. “When funding for grants is no longer available, their employment may end, as happened with some temporary grant employees who were funded by these grants,” they said.In Washington, the HHS has been cut harder by Doge than any other federal department. Hundreds of grants to state, local and tribal governments, as well as to research institutions, have been eliminated, worth over $6.8bn in unpaid obligations.The HHS receives about a quarter of all federal spending, with the majority disbursed to states for health programs and services such as Medicare and Medicaid, the insurance programs; medical research; and food and drug safety. Trump’s budget proposal calls for cutting the department’s discretionary spending by 26.2%, or $33.3bn.RFK Jr, who has a history of promoting conspiracy theories and medical misinformation, was nominated by Trump and approved by the Senate along party lines, with Mitch McConnell the sole Republican dissenter.Following a reduction in force of 10,000 employees on 1 April, Kennedy Jr claimed 20% of the firings were in error and that those workers would be reinstated, though that has not happened.An HHS spokesperson blamed any such errors on data-collection issues, and did not comment on any other aspects of the Guardian’s reporting.Aids relief program ‘dismantled’At the Centers for Disease Control and Prevention, an operating division of the HHS, employees working on maternal and child health at the President’s Emergency Plan for Aids Relief (Pepfar) program were shocked to be included in the reduction in force, as earlier in the administration their work had received a waiver for parts of the program from federal funding freezes.All federal experts on HIV prevention in children overseas were fired as part of the reduction in force.“Our concern initially was that it was a mistake with the name. We hoped around that time it came out that there were 20% errors, that we would be included,” said an epidemiologist who was included in the reduction in force, but requested to remain anonymous as they are currently on administrative leave. They also noted that they were in the middle of planning and delivering a new pediatric HIV treatment medication set to be dispersed this year, and that that work was now at risk.View image in fullscreenThey said 22 epidemiologists in the branch of their CDC division had been fired. Pepfar was created in 2003 by George W Bush to prevent mother-to-child HIV transmission and credited with saving 26 million lives.“We were very shocked on April 1 that we were put immediately on admin leave,” said another epidemiologist affected by the reduction in force at the CDC. “We really feel our branch being cut was a mistake. The state department had said services were a priority and needed to continue, but then we were cut by HHS.”They noted HIV treatment had already stopped in regions of countries that had been reliant on USAID programs, such as Zambia.“It is one of the most successful global health programs in history, data driven with high levels of accountability and the dollars spent achieve impact. Our concern now is, yes, they are continuing Pepfar in name, but they are dismantling all the systems and structure that allowed it to succeed,” they added. “The US made a huge investment in this program in 20 years and a lot of it is now undone. We’ve now disrupted those systems that could have reduced and eventually removed US investment in these programs.”‘Long-term impact’ on US familiesInside the HHS, the Administration for Children and Families is responsible for enforcing court-ordered child-support payments. For every dollar it receives in federal funding, ACF says it is able to collect $5 in child support.A child-support specialist with the HHS, who requested to remain anonymous for fear of retaliation, said reductions in force at the department have increased workloads on those who were not fired by multiple times, making it so state and tribal agencies have no way of ensuring they are compliant with federal requirements.“The regional staff with direct oversight of the program are gone,” they said. “There are entire regions that have two staff members managing a quarter of the work for the program with no management, no support, no knowledge of the program.”After the Trump administration took office, the agency was under an unofficial stop-work order, where staff were not permitted to provide guidance or support to grantees or even answer phones, until late February, the specialist said. A reduction in force followed on 1 April, when, the child-support specialist claimed, about half the ACF staff working on child support were fired.Their department is responsible for overseeing child-support programs at state, tribal and local levels. States “could very well lose millions of dollars in funding” if ACF does not provide key training and assistance and the states do not have qualified staff, the specialist cautioned. “And that is the long-term impact to vulnerable children and families in the country.”They added: “The entire function of the program is to give economic stability to children and families, so that they do not depend on any other government program, or their reliance on these programs is lower, because the children are supported by both parents.”‘A living hell’At the Centers for Medicare and Medicaid Services, also within the HHS, one of 300 workers terminated as part of a reduction in force claimed it had been illegal, and had not followed any proper procedures. The National Treasury Employees Union has filed a grievance over how the firings were carried out, including incorrect information on notices.They explained that, on 1 April, they received a generic letter informing them of an intent of reduction in force. Hours later, they were locked out of their government logins. “We started emailing the management that was left, trying to get clarification on what our status was. Nobody could give us an answer,” the worker said.On 7 April, they discovered through their paystub that they had been placed on administrative leave, despite never receiving a notice. They didn’t receive an RIF notice until weeks later, after requesting it.“Based on my tenure, and as a disabled veteran, I should at least have a chance of reassignment,” they said. “I’m not mad about losing my job. It happens. I’ve been laid off. The first time was in the private sector, and it was way more humane, more empathetic, and I was given different offers.“This, on the other hand, is unbridled hate. This administration has gone out of their way to make it a living hell for all of its public servants.” More

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      ‘It’s back to drug rationing’: the end of HIV was in sight. Then came the cuts

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      This year the world should have been “talking about the virtual elimination of HIV” in the near future. “Within five years,” says Prof Sharon Lewin, a leading researcher in the field. “Now that’s all very uncertain.”Scientific advances had allowed doctors and campaigners to feel optimistic that the end of HIV as a public health threat was just around the corner.Then came the Trump administration’s abrupt cuts to US aid funding. Now the picture is one of a return to the drugs rationing of decades ago, and of rising infections and deaths.But experts are also talking about building a new approach that would make health services, particularly those in sub-Saharan Africa, less vulnerable to the whims of a foreign power.The US has cancelled 83% of its foreign aid contracts and dismantled USAid, the agency responsible for coordinating most of them.Many fell under the President’s Emergency Plan for Aids Relief (Pepfar) programme, which has been the backbone of global efforts to tackle HIV and Aids, investing more than $110bn (£85bn) since it was founded in 2003 and credited with saving 26 million lives and preventing millions more new infections. In some African countries it covered almost all HIV spending.View image in fullscreenThere is a risk, says Lewin, director of Melbourne University’s Institute for Infection and Immunity and past president of the International Aids Society, of “dramatic increases in infections, dramatic increases in death and a real loss of decades of advances”.There is no official public list of which contracts have been cancelled, and which remain. It appears that virtually no HIV-prevention programmes funded by the US are still in operation, save a handful principally providing drugs to stop pregnant women passing on the infection to their babies. Countries report disruption to the most basic measures, such as condom distribution.Some treatment programmes have been spared, but not those whose focus conflicted with the Trump administration’s war on “gender ideology” or diversity, equity and inclusion (DEI), such as those working with transgender communities. Doctors, nurses and other healthcare workers have been laid off, while worried patients are hoarding drugs or stretching supplies, according to UNAids surveillance. UNAids itself has lost more than half of its funding.Even programmes that have survived the cull have faced turmoil since February, with instructions to stop work rescinded but with no certainty that funding will continue.View image in fullscreenIn only one example, the Elizabeth Glaser Paediatric Aids Foundation says it has had to halt HIV treatment for 85,000 people in Eswatini, including more than 2,000 children, and tests for thousands of pregnant women and babies to prevent transmission and begin life-saving medication.Access to drugs represents an “immediate crisis”, Lewin says. “If people with HIV stop the medications, then not only do they get sick themselves, which is tragic, but they also then become infectious to others.”As clinics on the frontline of treating the disease scrabble to secure access to basic drugs, scientists at this month’s Conference on Retroviruses and Opportunistic Infections in San Francisco were hearing that HIV might soon be preventable with a once-a-year injection.The drug lenacapavir was already generating huge excitement in the field, after trial results showed that a six-monthly jab could prevent HIV. New results from the manufacturer Gilead suggest that a tweak to the formula and how it is given could see its protective effects last even longer.Nevertheless, Lewin says, the mood at the meeting, packed with many of the world’s leading HIV specialists, was “dire”.As well as programme cancellations, there are “huge concerns around science and what’s going to happen to the [US] National Institutes of Health, [whose] funding of science has been so significant on every level”, she says.Some scientists in receipt of US funding have been told to remove their names from DEI-linked research, she says, even though DEI is fundamental to the HIV response.View image in fullscreen“I don’t mean that in a sort of touchy-feely way, I mean that’s what we need to do: you need to actually get those treatments to these diverse communities.”In 2022, 55% of all new HIV infections were within “key populations”, such as gay men, other men who have sex with men, sex workers, transgender people, prisoners and people who inject drugs.Prof Linda-Gail Bekker, of South Africa’s Desmond Tutu Health Foundation, has seen US funding for three trials of potential HIV vaccines involving eight countries cancelled and only reinstated after an appeal to the US supreme court.“We’re running around like chickens without heads to at least get one going, because the vaccines are sitting in the fridge and will expire,” she says.She led the lenacapavir trial that showed it offered 100% protection to young women in sub-Saharan Africa, but now worries about HIV/Aids prevention “falling off the radar completely”.The global community had been making headway towards the United Nations’ goal of ending Aids by 2030, she says, with a five-year plan to use “amazing new innovative tools and scale them up”, which would have led to “less dependence on foreign aid and more self-reliance” as new infections fell and attention shifted to maintaining treatment for people with HIV.“All of that is hugely at risk now because, without these funds, our governments will have to step up but they will concentrate on treatment,” she says. “We know they will do that, because that is what we did for the first 30 years.”Efforts to control Aids were entering “the last mile”, which was always likely to be more expensive, she says. “The people who were happy to come into health facilities, they would have come into health facilities.”It would be difficult to rely on government funding to reach the remaining groups, she says, not only because of fewer resources but also because in some countries it means targeting groups whose existence is illegal and unrecognised, such as sex workers or sexual minorities, and young girls may be reluctant to use government clinics if they are not supposed to be sexually active.“I feel like the odds are very stacked against us,” says Bekker, adding: “We’re obviously going to have to re-programme ourselves [and] formulate a different plan.”Pepfar had pledged funding to the Global Fund to Fight Aids, Tuberculosis and Malaria, to deploy 10m doses of lenacapavir in low-income countries. While the Global Fund has promised to maintain its commitment, it might receive fewer than the planned number of doses, Bekker fears.“Six months ago, I was saying the best thing we can do with lenacapavir is offer it to everybody in a choice environment. [Now] I think we’re gonna have to say who needs [injectable] prep,” she says, “and the rest have to do the best they can.“How do we make that decision? And what does that look like? It is back to sort of rationing.“When we started ARVs [antiretroviral drugs] way back in 2000,” Bekker recalls, “you would go, ‘you get treatment; you don’t, you don’t, you don’t’.“It feels terrible … but you have to get over that. You have to say it will be infection-saving for some people. And we’ve got to make it count.”View image in fullscreenFor Beatriz Grinsztejn, president of the International Aids Society, the disruption is critical and threatens many vulnerable people. But, she adds, it could present “an important opportunity for ownership – otherwise we are always left in the hands of others”.She worries about the impact of cuts to funding on younger scientists, with their potential loss from the research field “a major threat for the next generation”. But, she adds, the HIV community is “powerful and very resilient”.There have already been calls for new ways of doing things. It is “time for African leadership”, members of the African-led HIV Control Working Group write in the Lancet Global Health. There are now plans for Nigeria to produce HIV drugs and tests domestically.Christine Stegling, deputy director of UNAids, says it began “a concerted effort” last year to develop plans with countries about how their HIV programmes could become more sustainable domestically “but with a longer timeframe … now we are trying to do some kind of fast-tracking”.Governments are determined, she says, but it will require fiscal changes either in taxation or by restructuring debt.The goal of ending Aids by 2030 is still achievable, Stegling believes. “I think we have a very short window of opportunity now, in the next two, three months, to continue telling people that we can do it.“I keep on reminding people, ‘look, we need to get back to that same energy that we had when people were telling us treatment can’t be available in the global south, right?’ And we didn’t accept it. We made it happen.“We have national governments now who are also very adamant, because they can see what can happen, and they want to make it happen for their own populations.” More

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      Trump’s NIH pick makes pitch for good science – in this administration?

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      Donald Trump’s nominee to run the National Institutes of Health (NIH), Jay Bhattacharya, told senators he was committed to ensuring scientists “have the resources they need” – even as the $48bn agency he hopes to lead has become a focus of the administration’s ideological war and cost-cutting efforts.At a confirmation hearing on Wednesday, Bhattacharya made a pitch for free scientific inquiry and an examination of the chronic disease epidemic, now a cornerstone of Republican health rhetoric, while hoping to serve in an administration that has frightened scientists into self-censorship.“Science should be an engine for freedom – knowledge and freedom. It shouldn’t be pushing mandates for vaccines,” said Bhattacharya, referring to pandemic-era mandates, and articulating a vein of libertarian thinking that has rejuvenated Republican health rhetoric in the time since. “If science is a force for freedom and knowledge, it will have universal support.”Bhattacharya ignored the Republican party’s role in sowing distrust of the scientific establishment, argued “good data” would change minds and, in the words of one senator, strained credulity by asserting the US president would not ask him to do anything illegal.For a man whose pandemic-era rise was built on questioning authority, some assertions landed between wishful thinking and willful blindness. But for all of Bhattacharya’s remarkable answers, dissent was muted.Some in academia now see Bhattacharya as the least bad option to run the NIH. And, after confirming Robert F Kennedy Jr, the nation’s leading vaccine critic, to lead the department of health, there is little doubt Republicans have the votes.“Maybe I’m naive, senator,” Bhattacharya said in response to a question about vaccine skepticism, “but I believe very fundamentally that research, if replicable, if done right, is so persuasive will move people to take actions.”Bhattacharya was at one time a low-profile researcher at Stanford University, himself receiving $3.7m in NIH grants, according to an agency database. His star rose among conservatives when he advocated against lockdowns in 2020. He was ostracized by the scientific establishment and blacklisted by Twitter – only to be invited to the platform’s headquarters by the billionaire Elon Musk.In turn, he became a darling of the right: hosting his own podcast devoted to questioning medical consensus, working as an expert witness in courts (even if courts did not always find him convincing) and often appearing on Catholic radio programs.But Bhattacharya’s pitch for free scientific inquiry is in striking conflict with the administration’s actions. His nomination comes as the research world has been rattled by mass firings, funding freezes, censorship and a measles outbreak that claimed the first American life in nearly a decade.Some of the most pressing questions came from the Republican senator Bill Cassidy, a physician from Louisiana who has steadfastly refused to engage in the anti-vaccine conspiracy theories peddled by some colleagues.“There is now a child who died of a vaccine preventable disease in Texas,” Cassidy said about the measles outbreak.Would the nominee spend even more taxpayer dollars to research a link between vaccines and autism when the idea has been “exhaustively” debunked?“I don’t think there’s a link between the [measles, mumps and rubella] vaccine and autism,” said Bhattacharya. “The only reason I’m not saying wholeheartedly yes” – that federal dollars could be better spent elsewhere – is “there are people who might disagree with me.”“There are people who disagree that the world is round,” Cassidy retorted. “People still think Elvis is alive.”“My sense, my inclination is to give people good data,” said Bhattacharya. “That’s how you address those concerns.”“I’m not sure at what end point we say we have good data,” said Cassidy, appearing unsatisfied.At the NIH alone, the Musk-led “department of government efficiency” (Doge) fired roughly 1,200 workers. Bhattacharya characterized this as “personnel decisions” to which he was not privy. The administration has also frozen grant funding in a probably illegal scheme, is still gumming up orders to thaw funding and is seeking to cut $4bn from grants that primarily go to universities and colleges.Trump touted his campaign to end “the tyranny of diversity, equity and inclusion policies all across the entire federal government” in his state of the union speech only the evening before – a policy that in practical terms is an ideological review of NIH grants.“I wasn’t involved in any decision making at the NIH up to this point,” was a common refrain for Bhattacharya when questioned about whether he would protect research funding.More broadly, the funding freezes and proposed cuts have sown chaos in the research world – academic institutions have frozen hiring, postgraduate researchers are struggling to find placements amid budget cuts, and delayed funding has many researchers worried their projects are on the verge of shuttering.Arguably the most pointed question of the hearing came from the Democratic senator Maggie Hassan of New Hampshire: “If directed by the president to take action that would break the law, would you follow the law or would you follow the president’s directive?”“Senator, I don’t believe the president will ever ask me to break the law,” said Bhattacharya.Hassan said: “Well, that strains credulity given, especially the last few weeks, and it’s a disappointing answer.” More

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      Saying ‘women’ is not allowed, but ‘men’ and ‘white’ are OK? I’m (not) shocked | Arwa Mahdawi

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      From banning books to policing wordsThanks to the intolerant left, nobody can say the word “women” anymore! Do you remember when that was a major talking point in certain quarters? Prominent columnists wrote endless pieces declaring that the word “women” had “become verboten”. The thought police, these people claimed, were forcing everyone to say “bodies with vaginas” and “menstruators” instead. Even the likes of Margaret Atwood tweeted articles with headlines like: “Why can’t we say ‘woman’ anymore?”That, of course, was complete nonsense. While there was certainly a push for more inclusive language, nobody with any influence was trying to ban the word “women”.Now, however? Now, it’s a very different story. Thanks to Donald Trump’s sweeping executive orders attacking “gender ideology” and DEI programs, the word “women” – along with a number of other terms – is quite literally being erased. The likes of Nasa have been busy scrubbing mentions of terms related to women in leadership from public websites in an attempt to comply with Trump’s executive orders, for example. Agencies like the Centers for Disease Control and Prevention (CDC) have taken down numerous webpages related to gender in the wake of Trump’s orders – although a federal judged ordered on Tuesday that they should be reinstated.Meanwhile, the National Science Foundation (NSF) has an internal list of hot-button words (which include “women”, “gender”, “minority”, “biases”) that they are cross-referencing against active research projects and grant applications. The Washington Post reports that once one of these very dangerous words is identified, staff then have to go through a flowchart to see whether a research project should be flagged for further review.The National Institutes of Health and multiple university research departments are going through a similar dystopian exercise. Researchers at the University of California at San Diego, for example, have said their work is now at risk if it contains language deemed potentially problematic, including the word “women”.Rebecca Fielding-Miller, a UCSD public health scientist, told KPBS that the list of banned words circling in scientific communities was Orwellian and would hamper important research. “If I can’t say the word ‘women,’ I can’t tell you that an abortion ban is going to hurt women,” Fielding-Miller said.Fielding-Miller also noted that it was illuminating to see which words hadn’t been flagged as problematic. “I guess a word that’s not on here is ‘men’, and I guess a word that I don’t see on here is ‘white’, so I guess we’ll see what’s going on with white men and what they need,” Fielding-Miller added.Amid all the anxiety about what you are allowed to say in this brave new world, a lot of researchers are erring on the side of caution. Some scientists have said that they are considering self-censoring to improve their chances of getting grants. Others are gravitating towards “safe” topics – like, you know, issues that concern white men. This is a dance we’ve seen many times before: Republicans will advance ambiguous, and possibly unconstitutional, legislation. Because no one knows what the hell is going on or how they might get punished for violating these vague new laws, people self-censor and aggressively police themselves.So, I guess this is where we are now: Republicans aren’t just banning books, they’re policing words. An administration effectively fronted by Elon Musk – a self-proclaimed “free speech absolutist” – is so touchy about the language that we use that scientists are now self-censoring. It’s so prescriptive about what things are called that it’s blocking journalists from events for continuing to refer to the Gulf of Mexico instead of the Gulf of America. It’s so obsessed with controlling how we think that it’s erasing references to trans people from the website for the Stonewall national monument. Under the disingenuous guise of “restoring freedom of speech”, the Trump administration has made clear it is intent on controlling the very words we use.Errol Musk, who impregnated his former stepdaughter, says Elon is a bad dadElon Musk seems to get some of his extreme views about pro-natalism from his father, Errol, who also has multiple children. Errol has even fathered two kids with his former stepdaughter, who was only four years old when he married her mother. I bring this up because Errol is currently in the news calling Elon a terrible father. He’s certainly not wrong about that – the Tesla billionaire seems to treat his kids like props rather than people – but his statements bring to mind certain adages about pots and kettles as well as glass houses.Investigation launched into human egg trafficking ringThailand and Georgia have said they are investigating a human-trafficking ring accused of harvesting human eggs from Thai women who came to Georgia thinking they’d be surrogates. Instead, they were reportedly held captive and had their eggs harvested. This story is just the latest example of the way in which the global egg trade has given rise to black markets and abuse. Last year, for example, a Bloomberg Businessweek investigation reported that Greek police had identified up to 75 cases of alleged theft of eggs taken from the ovaries of IVF patients at a clinic on Crete.Infant mortality rates rise in US states with abortion bans, study findsJust your latest reminder that anti-abortion activists are in no way “pro-life”.Domestic violence study that strangled rats should not have been approved, animal advocates argueThe rats were non-fatally strangled as part of research that aimed to improve the detection of brain injury resulting from intimate partner violence.The Syrian feminists who forged a new world in a land of warThe Guardian has a fascinating piece on the autonomous region of Rojava, in north-eastern Syria, which has a government with arguably the most complete gender equality in the world.A pregnant woman in the West Bank was shot by Israeli soldiersSondos Shalabi, 23, was eight months pregnant. Her killing comes as Israeli settlers are unofficially annexing large areas of the occupied West Bank and escalating violence has displaced around 40,000 Palestinians. The West Bank is becoming another Gaza.How Sasha DiGiulian broke climbing’s glass ceilingThe big-wall climber talks to the Guardian about sexism in climbing – including a tendency for routes that women have climbed getting “immediately downgraded by male climbers”.The ‘puppygirl hacker polycule’ leaks numerous police filesThe group told the Daily Dot there are not “enough hacks against the police”, adding: “So we took matters into our own paws.”The week in pawtriarchyPalmerston is a black-and-white cat who was – until recently – retired after a long and distinguished career as chief mouser for the UK’s Foreign and Commonwealth Office in London. The “DiploMog” has emerged from retirement to start work work as feline relations consultant to the new governor of Bermuda. If only the US would learn from this: government needs more cats and fewer Doges. More

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      Judge blocks Trump from cutting billions in medical research funding

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      A federal judge in Massachusetts blocked Donald Trump’s administration from cutting scientific research grants from the National Institutes of Health (NIH) after 22 mostly Democratic-leaning states sued.The Trump administration sought to impose a 15% cap on “indirect costs” for grants – money that goes toward overhead, such as keeping the lights on in labs or maintaining advanced equipment. On Tuesday, major universities filed a second lawsuit, calling the administration’s actions “flagrantly unlawful” in a complaint.“A cut to [indirect costs] for NIH grants is a cut to the medical research that helps countless American families whose loved ones face incurable diseases or untreatable debilitating conditions,” a group of university associations said in a statement.Indirect costs, “are the real and necessary costs of conducting the groundbreaking research that has led to so many medical breakthroughs over the past decades”, they said.Speedy court action to block the proposed cuts comes at a time when the Trump administration is teasing the idea of ignoring courts, prompting fears of a constitutional crisis.“To hand his billionaire backers another tax cut, Trump tried to slash funding for critical disease prevention research, including for pediatric cancer,” Ken Martin, Democratic National Committee chair, said in a statement.“We aren’t going to sit back as Trump goes after America’s kids.”The NIH is an arm of the Department of Health and Human Services. With a budget of $48bn, it is the world’s largest public funder of biomedical and behavioral research, with impacts that ripple across the scientific world.NIH grants fund a vast array of science, especially including early stage research that leads to blockbuster drugs. The agency’s grants have contributed to many of the drugs Americans are now familiar with, including statins such as Lipitor and curative hepatitis C drugs such as Harvoni.NIH-funded basic or applied research has also contributed to 386 of the 387 drugs the Food and Drug Administration approved between 2000 and 2019, and more than 100 Nobel prizes have been awarded to scientists based on NIH-funded work.In one of the first social media posts since Trump’s inauguration, the NIH said that the 15% cap on indirect costs would save $4bn per year, and singled out Harvard, Yale and Johns Hopkins as spending too much on overhead.skip past newsletter promotionafter newsletter promotionAlthough the NIH’s budget is less than 1% of all federal spending, the scientific agency has become a target of the Trump administration, and cutting the NIH serves multiple aims.The move comes ahead of an expected debate to extend Trump’s 2017 tax cuts. The cuts helped billionaires pay less in taxes than the working class for the first time. An extension is expected to add to a huge budget deficit.Many of Trump’s supporters also criticized the NIH following the Covid-19 pandemic, and laid out plans to dramatically reorganize it in Project 2025. Additionally, cutting NIH grants hits American universities, including many elite research institutions, in their pocketbooks. The administration has repeatedly attacked such universities as bastions of liberalism.This is not the first time Trump proposed cutting scientific research. In 2017, his budget attempted to slash scientific research funding.Within scientific circles, many agree the NIH could benefit from reform. However, many also argue the process needs to be transparent and involve stakeholders. More

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      ‘The science of fluoride is starting to evolve’: behind the risks and benefits of the mineral

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      A national conversation about fluoride’s health benefits exploded this fall after a federal toxicology report, court ruling and independent scientific review all called for updated risk-benefit analysis.Fluoride, a naturally occurring mineral in some regions, has been added to community water supplies since the mid-20th century when studies found exposure dramatically reduced tooth decay.The controversy, heightened by description of the mineral as “industrial waste” by Robert F Kennedy Jr, Donald Trump’s pick to lead the US health department, highlights questions some towns are now wrestling with: should the mineral’s well-established protective effects against tooth decay be prioritized lest Americans, and especially children, be subject to unnecessary pain and shame from an unhealthy smile? Or should the possibility of neurodevelopment effects be prioritized, even as studies continue?“Fluoride is the perfect example of helping people without them even having to do anything,” said Dr Sreenivas Koka, the former dean of the University of Mississippi Medical Center’s school of dentistry. The state is a “dental desert”, where there is only one dentist for every 2,120 residents. “Fluoride in the water – all you have to do is drink water and you’ll get the benefit.”Fluoride is added to about 72% of community water supplies in the US, according to the Centers for Disease Control and Prevention (CDC). The CDC again endorsed the practice in a scientific statement this May, saying it found no “convincing scientific evidence linking community water fluoridation with any potential adverse health effect or systemic disorder such as an increased risk for cancer, Down syndrome, heart disease, osteoporosis and bone fracture, immune disorders, low intelligence, renal disorders, Alzheimer disease, or allergic reactions”.Still, controversy over water fluoridation recently made headlines after two high-profile reports and a federal court ruling. The US National Toxicology Program set off a firestorm in August when it published a systematic review that found with “moderate confidence” that children exposed to fluoride levels twice those recommended for drinking water (1.5mg per liter versus the recommended 0.7mg per liter) “are consistently associated with lower IQ in children”.Then, in October, a new Cochrane Review lowered the estimated impact of fluoride, citing the widespread use of fluoride in toothpaste beginning in 1975.“Studies conducted in 1975 or earlier showed a clear and important effect on prevention of tooth decay in children,” Cochrane Review researchers wrote. “However, due to the increased availability of fluoride in toothpaste since 1975, it is unlikely that we will see this effect in all populations today.”The public debate comes as the National Institutes of Health (NIH), the world’s largest publicly funded research agency, is both a key funder of research advancing society’s understanding of fluoride’s non-dental health effects and an agency squarely in Trump’s crosshairs.The agency is one of the top targets for cuts and restructuring. Paradoxically, that could mean that critics such as Kennedy cut research on fluoride, even as the NIH funds research into potential detriments. The incoming administration has not made proposals on how to improve oral health in the US.Fluoride’s health benefits were investigated in the early 20th century, when a Colorado Springs dentist questioned why town residents had brown, mottled and decay-resistant teeth – now known as fluorosis.It was later found that fluoride naturally occurred at high levels in Colorado Springs, causing the cosmetic defects. Its decay-resistant properties were confirmed in a landmark 1945 study in Grand Rapids, Michigan, which found children in Grand Rapids were 60% less likely to develop dental caries (better known as cavities) with fluoride added to water.By 1999, the CDC hailed water fluoridation as one of public health’s greatest victories, alongside seat belts and vaccination. That view was buttressed by a 2015 Cochrane Review, considered the gold standard, that found fluoridating water at 0.7mg per liter led to a nearly 26% reduction in tooth decay, a figure still cited by the American Dental Association (ADA) and American Academy of Pediatrics (AAP) today.The need for preventive oral health solutions is profound in the US – more than 68 million people lack dental insurance and about one in four adults said in a survey they have avoided the dentist because of cost.In addition, school children lose an estimated average of 34m school hours each year due to unexpected dental visits; 2 million Americans visit the emergency room each year because of tooth pain; half a million travel abroad for cheaper care and one in five American seniors lack a single natural tooth. Lack of dental access is so common in some areas, doctors in prison frequently have patients who have never seen one.“One of the things I routinely ask young people in juvenile jail is: ‘Do you have a doctor? Do you have a dentist?’” said Dr Fred Rottnek, former medical director of St Louis county jails in Missouri and now a professor of community medicine at Saint Louis University School of Medicine. “A lot of them have never reported going to the dentist.”Modern inquiry into fluoride’s non-dental health effects began to pick up pace in 2015, when the National Toxicology Program (NTP) requested a systematic review on fluoride’s impact on neurodevelopment. By 2019, toxicology researcher Bruce Lanphear, of Simon Fraser University in Canada, co-authored a study finding fluoride exposure was associated with decreased IQ, which would later be incorporated into the NTP’s systematic review.“That gives you an indication that the science of fluoride is starting to evolve – it wasn’t set in stone 70 years ago,” he said.Lanphear, and a small group of like-minded toxicology researchers, argue now is the time for us to “pause and have an independent scientific committee look at all this new evidence” as “we have a lot of new science specifically about fluoride and the developing brain,” he said.Critics were buttressed again when a federal court ruled in September that the Environmental Protection Agency (EPA) needed to evaluate fluoride under the Toxic Substances Control Act.But physicians, dentists and mainstream professional associations from the American Dental Association to the American Academy of Pediatrics stand by recommendations for fluoridated water.While some towns step away from fluoride, communities such as Buffalo, New York, are restarting programs.“This is a shame if we don’t take advantage of what we know from the science,” said Koka about the preventive effects of fluoride. “Are there challenges to doing it right? Yes, but should they be so strong they overcome trying at all? That’s a tragedy.”The CDC has also refined guidance about fluoridation in recent years. In 2015, its water fluoridation recommendations went down to 0.7mg per liter of water, from 0.7 to 1.0mg per liter dependent on climate. Later, the CDC issued a 2019 report that advised parents of children younger than two to speak with their dentist about fluoridated toothpaste, and reminded parents of children younger than three to use only a “grain of rice”-sized “smear”.As critics argue that federal agencies’ recommendation lag behind, the US government’s National Institutes of Health (NIH) has become one of the chief funders of research into fluoride’s potential impacts on IQ.“Getting funding from the NIH shows they are interested in this important question,” said Christine Till, an assistant professor at York University in Canada and a co-investigator with Lanphear, whose grant studying tooth dentin and neurodevelopment in Canada was funded by the NIH, but turned down by the Canadian government.Others, such as Ashley Malin, epidemiology professor at University of Florida, and Dana Goin, assistant professor of epidemiology at Columbia University, have also received NIH funding to research fluoride’s non-dental health effects. Malin is studying fluoride’s impact on children’s sleep and Goin is investigating reproductive health effects.“There is a lot of ongoing work in this area, particularly in the US,” said Goin. “Hopefully, the results from these studies will help determine whether EPA drinking water regulations and CDC recommendations for water fluoridation are adequately balancing improvements in dental health from fluoridation versus any potential negative effects.”Goin’s current funding builds on her previous work, which found water fluoridation was not associated with small-for-gestational age or preterm births. She is now exploring whether fluoride is associated with gestational diabetes.Malin added that it’s a sign of “progress” that the studies can be discussed: “Over a decade ago, to even ask the question of whether optimally fluoridated, or the concentration in drinking water, could be impacting neurodevelopment was quite controversial.” More

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      ‘It’s just gotten crazy’: how the origins of Covid became a toxic US political debate

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      ‘It’s just gotten crazy’: how the origins of Covid became a toxic US political debateNew report supporting theory the coronavirus leaked from a Chinese lab has sparked the latest eruption in a long fight over how the virus started, clouding efforts to pursue a neutral, fact-based inquiryWhite House official John Kirby, standing at the podium where Donald Trump once railed against the “China virus” and praised the healing powers of bleach, faced questions on Monday about the origins of Covid-19. He had no choice but humility. “There is not a consensus right now in the US government about exactly how Covid started,” Kirby admitted. “There is just not an intelligence community consensus.”The renewed interest in a genuine scientific mystery followed a report in the Wall Street Journal that the US Department of Energy had determined the coronavirus most likely leaked by accident from a Chinese laboratory.This startling assessment appeared to have a solid foundation: according to the Washington Post, it was based on an analysis by experts from the national laboratory complex, including the “Z-Division”, known for carrying out some of the American government’s most secretive and technically challenging investigations of security threats from adversaries such as China and Russia.But the claim was not officially confirmed by the energy department or Kirby, and it came with a caveat: the department had “low confidence” in its assessment, which was provided to the White House and certain members of Congress, the Journal said.Even so, gleeful Republicans seized on the findings to claim vindication in their pursuit of the lab leak theory, triggering a fresh round of toxic debate in Washington and on social media.Opponents say there is still no hard evidence for a lab leak, as many scientists still believe the virus most probably came from animals, mutated and jumped into people. They note that the loudest champions of the lab leak hypothesis are often also trafficking in rightwing conspiracy theories, for example about the top infectious disease expert Anthony Fauci.But the two do not necessarily go hand in hand. Some scientists and other observers argue that the lab leak theory cannot be ruled out and should be kept separate from the racist propaganda that often accompanies it. It demands careful investigation, not peremptory dismissal or acceptance, they contend.It is the latest chapter in a long fight over the origin of a virus that has caused close to 7m deaths worldwide, clouding efforts to pursue a neutral, fact-based inquiry. In its loud opinions, blue v red certainties and lack of nuance, the melee echoes clashes over pandemic lockdowns, masks and vaccines, as well as the investigation into Trump’s alleged collusion with Russia.Bill Galston, a former policy adviser to Bill Clinton, said: “Isn’t this just like everything else in American politics, where a partisan position on one side invites a partisan response by the other? There’s a lot of what might be called reactive thinking going on because of the high degree of polarisation and the high stakes. Charges without foundation invite responses without foundation.”Calling for public hearings into the matter, Galston, a senior fellow at the Brookings Institution thinktank in Washington, warned: “If this isn’t lifted out of the crucible of political debate right now, it’ll just get worse and worse.”Studies by experts around the world have indicated that Covid-19 most likely emerged from a live animal market in Wuhan, China. The hypothesis that it originated from an accidental lab leak was initially dismissed by most public health experts and government officials.In February 2020, the Lancet medical journal published a statement that rejected the lab leak theory, signed by 27 scientists and expressing “solidarity with all scientists and health professionals in China”. It asserted: “We stand together to strongly condemn conspiracy theories suggesting that Covid-19 does not have a natural origin.” (The journal later disclosed that the organiser of the letter had links to the Wuhan lab at the center of the controversy.)That the lab leak theory was being pushed by Trump, who long played down the virus and used xenophobic language such as “China virus”, and his secretary of state, Mike Pompeo, may have contributed to the instinctive eagerness of some to dismiss the hypothesis – and to ostracise scientists who dared question the mainstream orthodoxy.“From the start, the lab leak theory was never properly framed and parsed,” David Relman, a microbiology and immunology professor at Stanford University in Palo Alto, California, wrote in an email. “The hypothesis of a lab-associated origin became synonymous with deliberate efforts to engineer viruses and malevolent intent, and this has not been helpful. The emotions, assumptions about motives, obstructionism by the Chinese government, and poor scrutiny of the evidence have only made things worse.”Jackson Lears, a history professor at Rutgers University in New Brunswick, New Jersey, echoed this view: “People who consider themselves Democratic party sympathisers and liberals uncritically arrayed themselves against this. It was a kind of a lockstep reaction against Trump, as in so many matters.”The lab leak hypothesis did begin to receive scrutiny after Joe Biden ordered an intelligence investigation in May 2021. The 90-day review was intended to push US intelligence agencies to collect more information and review what they already had.But the review proved inconclusive. A report summary said four members of the US intelligence community believed with low confidence that the virus was first transmitted from an animal to a human, and a fifth believed with moderate confidence that the first human infection was linked to a lab. Two agencies – including the CIA – remain undecided.Without the equivalent of a special counsel delivering a final report, the White House is left in a fog of uncertainty that satisfies no one. Lears commented: “There should have been a more carefully orchestrated investigation, more centralised, more high profile, with more legitimacy. Splitting it up and into many agencies is a way of defanging the whole situation.”Others agree that the multiple investigations give Biden a political headache, especially at a moment of rising tensions with China over trade, Taiwan, Ukraine and a recent spy balloon shot down after transiting US airspace.Laurie Garrett, a columnist at Foreign Policy magazine who spent time in China during the Sars outbreak, witnessing how animal markets operated, said: “The president said, ‘I want the relevant agencies in the government to take a close look at this.’ Well, every agency has its own prism, its own skill set.“In Britain if you asked the Home Office, MI5, the Metropolitan Police, the London School of Hygiene and Tropical Medicine and the British Medical Association to take a look, you would get seven different answers and that’s the situation that the Biden administration has created for itself. By trying to appease all the screaming and cut the rightwing Republicans off at the knees on this, they’ve essentially opened up a Pandora’s box because every single agency is going to have a different way of looking at the problem.”Many scientists, including Fauci, who until December served as Biden’s chief medical adviser, say they still believe the virus most likely emerged in nature and jumped from animals to humans, an established phenomenon known as a spillover event. But the reports of dissent in the intelligence community will give enough oxygen to those with doubts, good faith or otherwise.Jeremy Konyndyk, president of Refugees International and formerly USAid’s lead official for Covid-19, likens it to a Rorschach test. He said: “The priors that you come in with are going to shape a lot of how you interpret the evidence, because ultimately, the evidence may suggest one way or another, but it’s not definitive one way or another.“If you want to craft a narrative that justifies the lab leak theory, you can do so. If you want to craft a narrative that justifies a natural origin, natural spillover, market amplification theory, you can do so. There’s not enough on either side to definitively rule in or out either.”But that does not make them equally plausible, Konyndyk added. “The preponderance of evidence strongly points to a natural spillover, occurring at and certainly amplified at the market.” Konyndyk noted how online debate about the issue has become toxic, with proponents of the lab leak making death threats to scientists. “There’s been some really irresponsible behaviour and they’re not trying to turn the temperature down.“That has prompted in turn very strong views from some of the more vocal folks who believe in the natural origin theory because they’re getting attacked on Twitter with a larger and larger army of trolls. It’s just gotten crazy.”Earlier this month, Republicans in the House of Representatives issued letters to current and former Biden administration officials for documents and testimony, exploring the hypothesis of a lab leak. Congressman Brad Wenstrup, chair of the House oversight panel’s virus subcommittee, has accused US intelligence of withholding key facts about its investigation.Garrett, author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance, added: “My concern about where we are right now with this whole Wuhan origins question is that several very serious, real issues are getting conflated and they’re being manipulated for political purposes by people who don’t understand the issues at all and don’t care.“We’re not hearing in these congressional hearings this is what we should do to strengthen the chemical, biological warfare agreements and make lab research safe in the world. Nobody’s saying that. They couldn’t care less. That’s not their agenda. Their agenda is to tear down a man who was seen on camera in a live press conference putting his hand over his face and shaking his head as President Trump said, ‘Maybe bleach can cure Covid.’”TopicsCoronavirusUS politicsInfectious diseasesMicrobiologyMedical researchBiologyfeaturesReuse this content More

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      Why is the American right suddenly so interested in psychedelic drugs? | Ross Ellenhorn and Dimitri Mugianis

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      Why is the American right suddenly so interested in psychedelic drugs?Ross Ellenhorn and Dimitri MugianisMagic mushrooms are no magic cure for society’s ills, and a substance as powerful as psychedelics can be dangerous if it falls into the wrong hands Psychedelic therapies are receiving unprecedented financial and political support – and much of it comes from the right. Peter Thiel has invested extensively in the emerging psychedelic therapeutic industry. Jordan Peterson is a psilocybin fan. In 2018, the Mercer Foundation donated $1m to the Multidisciplinary Association for Psychedelic Studies (Maps), the leading US psychedelics research organization, for studies of MDMA treatment of PTSD in veterans.The Mercer family also supports the American right wing and climate crisis denial. They’re a long way from Woodstock – but Maps and some other psychedelic advocates seem glad for any support they can get.Democrats shouldn’t focus only on abortion in the midterms. That’s a mistake | Bernie SandersRead moreTo be sure, there are plenty of leftists and liberals who endorse the medical use of psychedelics. In July, Alexandria Ocasio-Cortez offered a successful amendment to the new $768bn defense spending bill to support increased research into psychedelic treatment for veterans and active-duty service members. So did Dan Crenshaw, a navy veteran and Republican representative from Texas. Matt Gaetz, Republican from Florida and noted misogynist, offered a similar amendment.Psychedelics have long been associated with utopian experiments. Today, some researchers dream of finding a scientific basis for the hypothesis that psychedelics might help end intractable political conflict. Last year, Maps and Imperial College London organized a joint ayahuasca trip for Israelis and Palestinians. In 2018, Imperial College received much attention for a tiny study suggesting that one dose of psilocybin therapy reduced support for “authoritarian attitudes”. Could psychedelics be the cure for anti-democratic tendencies? Rick Doblin, founder of Maps, has even suggested that psychedelic use could help stop environmental degradation.Psychedelics can certainly increase openness – but this can be openness to Nazism, eco-fascism or UFO cults as well as to peace and love. Julius Evola, an Italian philosopher and fascist admired by both Hitler and Steve Bannon, was a staunch LSD advocate. Governor Greg Abbott of Texas, who recently made headlines for sending buses of migrants to New York, Washington and Chicago, signed a 2021 state bill to study the medical benefits of psychedelics. Steve Bannon supports legalized psychedelics, too.As professors Brian Pace and Neşe Devenot point out in their work rebutting the science on psychedelics as a kind of medicine for authoritarianism, psychedelics have never had a purely leftwing fanbase. Andrew Anglin, the founder of the neo-Nazi website Daily Stormer, experimented extensively with psychedelics in his youth. The founder of 8chan, the now-defunct extremist message board that hosted the manifestos of several mass shooters, was inspired by a mushroom trip.Why is the American right so intrigued by these substances today? The most obvious answer is money. As psychedelics are absorbed into mainstream medicine, they promise to become another American cash cow. Money will come from patents on novel formulations and by patenting and providing the associated treatment techniques.There may be political factors at play, as well. Was the Mercer Foundation’s donation to Maps motivated by a desire to shore up American military resources by palliating the harms suffered by those sent to fight those wars? The military-industrial complex is even more lucrative than the pharmaceutical sector, but those weapons still require human beings to deploy them. Is rightwing psychedelic funding an attempt to ensure the continued viability of American wars around the world?And, if MDMA is so helpful in the treatment of PTSD, why are veterans given special priority in a society that has traumatized so many people? What about the trauma of racism, of poverty, of police violence and mass incarceration – problems actively increased by rightwing policies supported by people like the Mercers?Psychedelics have the potential to help people break out of repetitive, destructive thoughts, to help them discover new possibilities and new joy. But the effects of psychoactive drugs can never be detached from their setting.It’s foolish to imagine positive transformation achieved with the help of Rebekah Mercer, Steve Bannon or Greg Abbott. After all, these are the same people who vociferously oppose universal healthcare and deny climate change. With their support, we can expect psychedelic medicine for the elite, as a tool of state power or an engine of conspiracy theories, rather than a liberationist psychedelic movement. Until we have universal, single-payer healthcare, the benefits of psychedelic therapy will be out of reach for most Americans.And it’s naïve to expect psychedelics to change your mind for the better (in Michael Pollan’s formulation) when they’re a gift of the right wing, or when they’re offered within a framework of gross inequality. Look at Burning Man: this pseudo-utopia has become a playground of Silicon Valley’s ultra-rich. It leaves the desert strewn with thousands of abandoned bicycles and produces 12-hour traffic jams in the desert – which is hotter than ever thanks to our profligate burning of fossil fuels. With the wrong company, a journey of self-discovery can lead to even deeper solipsism. In fact, the illusion of transcendence can be used to justify greater selfishness, even cruelty.Psychedelic therapies – like all other forms of care – should be available to those who need them, not only to those with money and connections and political utility. In the psychedelic community there’s a lot of talk about “integration”, a processing of your trip. But this “integration” is too often limited to the individual. To be truly beneficial, psychedelics should be integrated into a social vision of equality and justice, one that opposes the sacrifice of human life and health at the altar of military spending and empire building, one that values every life regardless of race, nationality, religion, gender or class.Magic mushrooms are no magic cure for society’s ills, and a substance as powerful as psychedelics can be dangerous if it falls into the wrong hands. Psychedelic advocates need to stop cozying up to the right and expand their mission to encompass a commitment to broader social justice.
      Ross Ellenhorn is a sociologist, psychotherapist and author and the founder and CEO of Ellenhorn. His new book, Purple Crayons: The Art of Drawing a Life, is out on 1 November. Dimitri Mugianis is a harm reductionist, activist, musician, poet, writer, and anarchist, with over two decades of experience as a psychedelic practitioner. Ellenhorn and Mugianis are the founders of Cardea
      TopicsUS politicsOpinionMedical researchPeter ThielSteve BannonGreg AbbottHealthcommentReuse this content More

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      Divisive 2016 US election linked to higher risk of heart trouble

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      How stressful can an election campaign really be? Potentially life-threatening, researchers say, at least in the case of the 2016 US presidential election. The divisive campaign may have raised the risk of abnormal heart rhythms and worsened high blood pressure in people with underlying cardiovascular disease, two studies suggest.One study focused on nearly 2,500 people (mostly white, with an average age of about 71) with implanted cardiac devices in North Carolina, a swing state in the 2016 election that was subjected to fiercely negative political commercials and campaign events.Researchers examined the incidence of cardiac arrhythmias (too fast or too slow heartbeats or irregular heart rhythms) in a six-week period spanning before and after the election, and compared it with two six-week control periods June/July 2016 and October/November 2015.There was a 77% rise in the risk of cardiac arrhythmias during the election phase versus the control periods, even after accounting for factors including age and underlying medical conditions, according to the study published in the Journal of the American Heart Association.In particular there was an 82% rise in the incidence of atrial arrhythmias, an abnormal heart rhythm that begins in the heart’s upper chambers and can lead to blood clots, stroke and other complications. There was a 60% jump in the rate of ventricular arrhythmias, an abnormal heart rhythm involving the heart’s lower chambers that can lead to cardiac arrest.The study’s lead author, Dr Lindsey Rosman, an assistant professor of medicine at the University of North Carolina, said previous research had indicated that acute cardiovascular events tend to rise in the aftermath of events such as natural disasters and terrorist attacks. “But the direct link between a stressful political election and an increase in cardiac events hasn’t been established – until now.”The researchers also assessed whether the risk of arrhythmia differed by political party affiliation. Surprisingly, people who voted for the losing candidate, Hillary Clinton, did not experience a higher rate of arrhythmias compared with those who voted for the winner, Donald Trump.A separate study investigated changes in blood pressure among different ethnic groups. Readings from about 2,000 non-Hispanic white people, non-Hispanic people of colour, and Mexican Americans in the pre-election period (May to October 2016) were compared against 1,700 randomly selected participants from the three groups a year into the new presidency (November 2017 to April 2018.)The researchers found significant increases in blood pressure among black and Mexican American participants with hypertension, but no significant rises in people who did not already have hypertension (regardless of their ethnic background.The lead author, Dr Andrew Hwang, an assistant professor of clinical science at High Point University, North Carolina, said it was possible that the passage of time may have played a role in worsening blood pressure measures. “However, given that the 2016 US election was a major national event, we may be able to suspect that the election may have contributed, in part, to changes in blood pressure.” More