YCLOAK

Patients who take blockbuster drugs like Wegovy or Ozempic for weight loss may face life-threatening complications if they need surgery or other procedures that require empty stomachs for anesthesia. This summer’s guidance to halt the medication for up to a week may not go far enough, either. 

Some anesthesiologists in the U.S. and Canada say they’ve seen growing numbers of patients on the weight-loss drugs who inhaled food and liquid into their lungs while sedated because their stomachs were still full — even after following standard instructions to stop eating for six to eight hours in advance. 

The drugs can slow digestion so much that it puts patients at increased risk for the problem, called pulmonary aspiration, which can cause dangerous lung damage, infections and even death, said Dr. Ion Hobai, an anesthesiologist at Massachusetts General Hospital in Boston. 

“This is such a serious sort of potential complication that everybody who takes this drug should know about it,” said Hobai, who was among the first to flag the issue. 

Nearly 6 million prescriptions for the class of drugs that include Wegovy and Ozempic were written between January and May in the U.S. for people who don’t have diabetes, according to Komodo Health, a health care technology company. The drugs induce weight loss by mimicking the actions of hormones, found primarily in the gut, that kick in after people eat. They also target signals between the gut and the brain that control appetite and feelings of fullness, and by slowing how fast the stomach empties. 

In June, the American Society of Anesthesiologists issued guidance advising patients to skip daily weight-loss medications on the day of surgery and hold off on weekly injections for a week before any sedation procedures. Dr. Michael Champeau, the group’s president, said the action was based on anecdotal reports of problems — including aspiration — from around the country. 

It’s not clear how many patients taking the anti-obesity drugs may be affected by the issue. But because the consequences can be so dire, Hobai and a group of colleagues decided to speak out. Writing in the Canadian Journal of Anesthesia, they called for the drug to be stopped for even longer — about three weeks before sedation. 

That accounts for how long semaglutide, the active medication in Wegovy, remains in the body, said Dr. Philip Jones, a Mayo Clinic anesthesiologist who is also deputy editor-in-chief of the journal. 

“When 90% of it is gone, which is after three weeks, hopefully everything should go back to normal,” Jones said. 

Champeau and Jones both acknowledged there’s not enough evidence to say for certain how long semaglutide should be held to make anesthesia safe. Many patients won’t see providers far enough in advance to stop the drug three weeks before procedures, Champeau noted. 

Aspiration occurs in one of every 2,000 to 3,000 operations that require sedation, and almost half of patients who aspirate during surgery develop a related lung injury. But case reports show recent patients on semaglutide had problems even when they stopped food as long as 20 hours before their procedures. 

“There’s nothing that says if you fast twice as long, it will be OK,” Champeau said. 

Among the several reports detailing potentially serious problems was one of Hobai’s patients, a 42-year-old man in Boston who recently began taking Wegovy, had to be intubated and suffered respiratory failure that put him in intensive care. He aspirated food that remained in his stomach despite fasting for 18 hours. 

In Chapel Hill, North Carolina, a 31-year-old-woman on a low dose of Ozempic had fasted for 10 hours before a routine endoscopy prior to bariatric surgery last fall. The procedure had to be stopped because solid food remained in her stomach and she was at high risk for aspiration, the report said. 

Since then, doctors have seen dozens of similar cases as use of the weight-loss medication has grown, said Dr. Elisa Lund, an anesthesiologist at the University of North Carolina at Chapel Hill School of Medicine. “It has exponentially increased,” she said. 

Hobai is completing a retrospective study of almost 200 patients taking semaglutide. While it’ll be published later this year, the work so far appears to confirm a small study from Brazil, he said. In that study, about a quarter of patients taking semaglutide had residual food in their stomachs during procedures requiring sedation — even after stopping the drug for 10 days. 

The American Society of Anesthesiologists advises doctors who are in doubt to treat patients who haven’t paused the drug as if they have full stomachs, which can mean using different types of sedation protocols or delaying procedures, if possible. Jones added that research is urgently needed to update guidelines for doctors and patients. 

Novo Nordisk, which makes Ozempic, Wegovy and similar drugs, said the firm’s clinical trial and post-marketing safety data did not show that the medications led to aspiration. But the drugmaker noted that the medications are known to cause delayed emptying of the stomach and that the labels warn of possible gastrointestinal side effects. 

Stopping the medications for three weeks can cause problems, too. Patients with diabetes will need another way to control their blood sugar and those seeking to lose weight may regain some, Hobai said. 

Hobai suggests that people using Wegovy and similar drugs tell their doctors before sedation and discuss the risks and benefits. 

“If you’re taking this drug and you need an operation, you will need to have some extra precautions,” he said. 
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Postal worker Eugene Gates Jr. was delivering mail in the suffocating Dallas heat this summer when he collapsed in a homeowner’s yard and was taken to a hospital, where he died.

Carla Gates said she’s sure heat was a factor in her 66-year-old husband’s death, even though she’s still waiting for the autopsy report. When Eugene Gates died on June 20, the temperature was 36.6 Celsius and the heat index, which also considers humidity, had soared over 43.3 Celsius.

“I will believe this until the day I die, that it was heat-related,” Carla Gates said.

Even when it seems obvious that extreme heat was a factor, death certificates don’t always reflect the role it played. Experts say a mishmash of ways more than 3,000 counties calculate heat deaths means we don’t really know how many people die in the U.S. each year because of high temperatures in an ever-warming world.

That imprecision harms efforts to better protect people from extreme heat because officials who set policies and fund programs can’t get the financial and other support needed to make a difference.

“Essentially, all heat related deaths are preventable. People don’t need to die from the heat,” said epidemiologist Kristie L. Ebi, who focuses on global warming’s impact on human health as a professor at the University of Washington.

With a better count, she said, “you can start developing much better heat wave early warning systems and target people who are at higher risk and make sure that they’re aware of these risks.”

Currently, about the only consistency in counting heat deaths in the U.S. is that officials and climate specialists acknowledge fatalities are grossly undercounted.

“Deaths are investigated in vastly different ways based on where a person died,” said Dr. Greg Hess, the medical examiner for Pima County, Arizona’s second most populous county and home to Tucson. “It should be no surprise that we don’t have good nationwide data on heat-related deaths.”

Many experts say a standard decades-old method known as counting excess deaths could better show how extreme heat harms people.

“You want to look at the number of people who would not have died during that time period and get a true sense of the magnitude of the impact,” Ebi said, including people who would not have suffered a fatal heart attack or renal failure without the heat.

The excess deaths calculation is often used to estimate the death toll in natural disasters, with researchers tallying fatalities that exceeded those that occurred at the same time the previous year when circumstances were average.

Counting excess deaths was used to calculate the human impact of a heat wave in Chicago that killed more than 700 people in July 1995, many elderly Black people who lived alone. Researchers also counted excess deaths during the COVID-19 pandemic to provide more complete information about deaths directly and indirectly related to the coronavirus.

But as things stand now, the Centers for Disease Control and Prevention reports just 600 to 700 heat deaths annually in the United States. A study published last month in the journal Nature Medicine estimated more than 61,000 heat-related deaths last summer across Europe, which has roughly double the U.S. population but more than 100 times as many heat deaths.

Dr. Sameed Khatana, a staff cardiologist at the Philadelphia VA Medical Center and assistant professor at the University of Pennsylvania’s Perelman School of Medicine, has said deaths in which heat contributed significantly to fatalities from causes like heart failure should also be considered.

Khatana participated in research published last year that counted excess deaths in all U.S. counties. The findings suggested that from 2008 to 2017 between 3,000 to 20,000 adult deaths from all causes listed on death certificates were linked to extreme heat. Heart disease was listed as the cause of about half of the deaths.

After the Pacific Northwest heat wave in summer of 2021, the Canadian province of British Columbia reported more than 600 deaths due to heat exposure while Oregon and Washington each initially reported a little more than 100 such fatalities.

“It’s frustrating that for 90 years public health officials in the United States have not had a good picture of heat-related mortality because we have such a bad data system,” said Dr. David Jones, a Harvard Medical School professor who also teaches in the epidemiology department at the Harvard T.H. Chan School of Public Health.

There is no uniformity among who does the counting across U.S. jurisdictions. Death investigations in some places might be carried out by a medical examiner, typically a physician trained in forensic pathology. In other locales, the coroner could be an elected sheriff, such as the one in Orange County, California. In some small counties in Texas, a justice of peace might determine cause of death.

Utah and Massachusetts are among states that do not track heat-related deaths where exposure to extreme heat was a secondary factor.

The CDC, which is often several years behind in reporting, draws information on heat deaths from death certificate information included in local, state, tribal and territorial databases.

The CDC said in a statement that coroners and others who fill out death certificates “are encouraged to report all causes of death,” but they may not always associate those contributing causes to an extreme heat exposure death and include the diagnostic codes for heat illnesses.

Hess, the Arizona coroner, said determining environmental heat was a factor in someone’s death is difficult and can take weeks or even months of investigation including toxicological tests.

“If someone was shot in the head, it’s pretty obvious what happened there,” Hess said. “But when you find a body in a hot apartment 48 hours after they died, there is a lot of ambiguity.”

Hess noted that Pima County this year began including heat-related deaths in its tally of environmental heat fatalities. Maricopa County, home to Phoenix, America’s hottest big city, for years has included heat-related deaths. Clark County, Nevada, home to Las Vegas, now also considers deaths in which heat was a contributing factor.

Maricopa’s Public Health Department counted 425 “heat associated” deaths last year, including those where heat was a secondary factor, such as a heart attack provoked by high temperatures.

It reports there were 59 heat-associated deaths confirmed this year through Aug. 5, with another 345 under investigation. The latest count follows the hottest month in Phoenix on record, and a record 31 consecutive days that hit 43.3 Celsius or higher.

Dallas, which regularly sees summer highs above 37.7 Celsius, sweltered through an excessive heat warning this month and also grapples with oppressive humidity.

Carla Gates, whose mail carrier husband died, noted cities worldwide now must learn to deal with extreme weather. She said her spouse, with 36 years on the job, tried to protect himself by taking a chest filled with ice and several bottles of cold water on his rounds.

“Our climate has changed,” she said. “And I don’t think it’s going back to how it was 20 years ago. So we’re going to have to get used to it and we’re going to have to make some adjustments.”

Now she wants to honor her husband by pushing legislation to ensure people working outside are better protected from the heat. Gates noted that the day her husband died he was in an old mail truck without working air conditioning.

“I don’t wish this on anyone, anyone to get a phone call that their loved one died working, doing something that they love in the heat,” she said.
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With field temperatures soaring above 150 degrees at times, 10-year-old baseball player Emmitt Anderson and his teammates from Alabama thought better of kneeling when they gathered near the mound for pregame prayers at a recent regional youth baseball tournament here.

“It was too hot on our knees,” Anderson said of the artificial surface. “We just stood up.”

High heat proved considerably harder to handle than fastballs up in the strike zone at the DYB World Series this week. Temperatures reached 105 degrees, with the heat index peaking at 117.

Some spectators and umpires required treatment for heat-related symptoms. A few passed out and were briefly hospitalized.

“The heat was so extreme, I just knew it was a matter of time before something happened,” said Dr. Kelsey Steensland, an anesthesiologist from Dothan, Alabama, who was there to watch her 10-year-old son, Finn, play for a team representing their state.

During opening ceremonies, she rushed to help an elderly woman who’d collapsed and didn’t regain consciousness for several minutes.

“This was a medical emergency,” Steensland said. “It was more than just giving someone a glass of water.”

With climate change driving average global temperatures higher, organizers, players and spectators taking part in quintessentially American traditions such as midsummer youth baseball championships are having to pay closer attention to the heat — and become more resourceful about mitigating its effects.

A case in point is the DYB World Series, which features teams from 11 Southern states competing in multiple age groups up to 12 years old. Formerly known as Dixie Youth Baseball, DYB was established in 1955.

“The number one priority to any event that anybody puts on outdoors is the safety and health of the participants,” DYB Commissioner William Wade said. “We’ve got to do the best we can to preach whatever safety we can.”

Large evaporative coolers — which pull air over water to cool it before blowing it back out — were placed in dugouts. It was the first time B.J. Branigan, who coached a team from the New Orleans area, had ever seen that.

During the first four days of the six-day tournament, when temperatures were hottest, games were halted every two innings for five-minute “heat breaks.” Cases of water were supplied to coaches, players and umpires.

Many also wore wet cooling towels on the back of their necks.

Sail shades over the stands helped keep fans out of direct sunlight at the Ruston Sports Complex — a newly built facility that drew widespread praise from tournament participants and attendees. But some expressed concern over the way the artificial turf fields, “infilled” with black rubber pellets for cushioning, became so hot at times that one could easily see air rippling from convection just above the surface.

“One day they advised us that the temp was 167 on the field — and it felt like it,” umpire Tim Ward said, noting that he’d never been so hot in 25 years of calling balls and strikes. “You couldn’t stand still. You had to keep moving or your shoes would start getting soft on the bottom, and the heat was radiating up into you.”

Ward was behind home plate that day, wearing a mask and chest protector, and passed out between innings.

When he regained consciousness, he was being treated in the dugout, and was taken soon after by ambulance to a hospital. He missed one day of games and returned to umpire again before the tournament ended.

Any proposal to cancel or postpone the tournament would have been met with considerable opposition. It was getting close to the start of the school year for some players, and these were their highest-stakes games of the season. Parents and grandparents had booked hotels and traveled from as far as Virginia.

Spectators tried to adapt on the fly.

Many showed up with hand-pulled wagons to move newly purchased, lithium-ion battery powered misting fans to seating areas, where they were rigged to buckets of water.

“I’ve never experienced any kind of heat like this before. You can feel your eyes drying out,” said Steensland, who watched games with a misting fan pointed at her and her 7-month-old daughter.

“You’re either prepared or you’re not,” she said. “And the people that come prepared have a wagon full of hundreds of dollars of equipment — chairs, fans, tents. You have to have industrial grade fans to get through temperatures like this.”

Experts say heat exhaustion and heat stroke are likely to become more common in the coming decades. Signs of heat illness include heavy sweating, dizziness, muscle spasms, nausea and loss of consciousness. One of the more common ways people die from extreme heat is cardiovascular collapse because of the extra energy the heart expends to help the body respond.

During opening ceremonies, the featured guest speaker was Louisiana Tech baseball coach Lane Burroughs. He tried to mentally prepare players and their families by noting, “It’s August in Louisiana. … We’re going to have to dominate those elements, won’t we?”

Casey Anderson, Emmitt’s father, smiled as he recalled that pep talk.

“I don’t know about dominating,” he said. “More like enduring and surviving.”

But parents and coaches said they heard virtually no complaints from the kids, who seemed thrilled to have a chance to end their season at the marquee event of every DYB season.
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Scientists are wondering if global warming and El Nino have an accomplice in fueling this summer’s record-shattering heat.

The European climate agency Copernicus reported that July was one-third of a degree Celsius (six-tenths of a degree Fahrenheit) hotter than the old record. That’s a bump in heat that is so recent and so big, especially in the oceans and even more so in the North Atlantic, that scientists are split on whether something else could be at work.

Scientists agree that by far the biggest cause of the recent extreme warming is climate change from the burning of coal, oil and natural gas that has triggered a long upward trend in temperatures. A natural El Nino, a temporary warming of parts of the Pacific that changes weather worldwide, adds a smaller boost. But some researchers say another factor must be present.

“What we are seeing is more than just El Nino on top of climate change,” Copernicus Director Carlo Buontempo said.

One surprising source of added warmth could be cleaner air resulting from new shipping rules. Another possible cause is 165 million tons (150 million metric tons) of water spewed into the atmosphere by a volcano. Both ideas are under investigation.

The cleaner air possibility

Florida State University climate scientist Michael Diamond says shipping is “probably the prime suspect.”

Maritime shipping has for decades used dirty fuel that gives off particles that reflect sunlight in a process that actually cools the climate and masks some of global warming.

In 2020, international shipping rules took effect that cut as much as 80% of those cooling particles, which was a “kind of shock to the system,” said atmospheric scientist Tianle Yuan of NASA and the University of Maryland Baltimore County.

The sulfur pollution used to interact with low clouds, making them brighter and more reflective, but that’s not happening as much now, Yuan said. He tracked changes in clouds that were associated with shipping routes in the North Atlantic and North Pacific, both hot spots this summer.

In those spots, and to a lesser extent globally, Yuan’s studies show a possible warming from the loss of sulfur pollution. And the trend is in places where it really can’t be explained as easily by El Nino, he said.

“There was a cooling effect that was persistent year after year, and suddenly you remove that,” Yuan said.

Diamond calculates a warming of about 0.1 degrees Celsius (0.18 degrees Fahrenheit) by midcentury from shipping regulations. The level of warming could be five to 10 times stronger in high shipping areas such as the North Atlantic.

A separate analysis by climate scientists Zeke Hausfather of Berkeley Earth and Piers Forster of the University of Leeds projected half of Diamond’s estimate.  

Did the volcano do it?

In January 2022, the Hunga Tonga-Hunga Ha’apai undersea volcano in the South Pacific blew, sending more than 165 million tons of water, which is a heat-trapping greenhouse gas as vapor, according to University of Colorado climate researcher Margot Clyne, who coordinates international computer simulations for climate impacts of the eruption.

The volcano also blasted 550,000 tons (500,000 metric tons) of sulfur dioxide into the upper atmosphere.

The amount of water “is so absolutely crazy, absolutely ginormous,” said Holger Vomel, a stratospheric water vapor scientist at the National Center for Atmospheric Research who published a study on the potential climate effects of the eruption.

Volmer said the water vapor went too high in the atmosphere to have a noticeable effect yet, but that effects could emerge later.

A couple of studies use computer models to show a warming effect from all that water vapor. One study, which has not yet undergone the scientific gold standard of peer review, reported this week that the warming could range from as much as 1.5° C (2.7° F) of added warming in some places to 1° C (1.8° F) of cooling elsewhere. 

But NASA atmospheric scientist Paul Newman and former NASA atmospheric scientist Mark Schoeberl said those climate models are missing a key ingredient: the cooling effect of the sulfur.

Normally huge volcanic eruptions, like 1991’s Mount Pinatubo, can cool Earth temporarily with sulfur and other particles reflecting sunlight. However, Hunga Tonga spouted an unusually high amount of water and low amount of cooling sulfur.

The studies that showed warming from Hunga Tonga didn’t incorporate sulfur cooling, which is hard to do, Schoeberl and Newman said. Schoeberl, now chief scientist at Science and Technology Corp. of Maryland, published a study that calculated a slight overall cooling — 0.04° C (0.07°F).

Just because different computer simulations conflict with each other “that doesn’t mean science is wrong,” University of Colorado’s Clyne said. “It just means that we haven’t reached a consensus yet. We’re still just figuring it out.”

Lesser suspects

Lesser suspects in the search include a dearth of African dust, which cools like sulfur pollution, as well as changes in the jet stream and a slowdown in ocean currents.

Some nonscientists have looked at recent solar storms and increased sunspot activity in the sun’s 11-year cycle and speculated that Earth’s nearest star may be a culprit. For decades, scientists have tracked sunspots and solar storms, and they don’t match warming temperatures, Berkeley Earth chief scientist Robert Rohde said.

Solar storms were stronger 20 and 30 years ago, but there is more warming now, he said. 

Look no further

Still, other scientists said there’s no need to look so hard. They say human-caused climate change, with an extra boost from El Nino, is enough to explain recent temperatures.

University of Pennsylvania climate scientist Michael Mann estimates that about five-sixths of the recent warming is from human burning of fossil fuels, with about one-sixth due to a strong El Nino.

The fact that the world is coming out of a three-year La Nina, which suppressed global temperatures a bit, and going into a strong El Nino, which adds to them, makes the effect bigger, he said.

“Climate change and El Nino can explain it all,” Imperial College of London climate scientist Friederike Otto said. “That doesn’t mean other factors didn’t play a role. But we should definitely expect to see this again without the other factors being present.” 
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The U.S. government said Friday it will spend up to $1.2 billion for two pioneering facilities to vacuum carbon out of the air, a historic gamble on a still developing technology to combat global warming that is criticized by some experts.

The two projects — in Texas and Louisiana — each aim to eliminate 1 million tons of carbon dioxide per year, equivalent in total to the annual emissions of 445,000 gas-powered cars.

It is “the world’s largest investment in engineered carbon removal in history,” the Energy Department said in a statement.

“Cutting back on our carbon emissions alone won’t reverse the growing impacts of climate change,” Energy Secretary Jennifer Granholm said in the statement. “We also need to remove the CO2 that we’ve already put in the atmosphere.”

Direct Air Capture (DAC) techniques — also known as Carbon Dioxide Removal (CDR) — focus on CO2 that has already been emitted into the air, which is helping to fuel climate change and extreme weather.

Each of the projects will remove 250 times more CO2 from the air than the largest carbon capture site currently in operation, the Energy Department said.

The U.N.’s International Panel on Climate Change (IPCC) considers capturing carbon dioxide directly from the atmosphere one of the methods necessary to combat global warming.

But the sector is still marginal — there are just 27 existing carbon capture sites commissioned worldwide, according to the International Energy Agency, though at least 130 projects are under development.

And some experts worry that use of the technology will be a pretext for continuing to emit greenhouse gases, rather than switching more quickly to clean energies.

Direct capture “requires a lot of electricity for extracting CO2 from the air and compressing it for pipes,” Stanford University professor Mark Jacobson told AFP.

“Even in the best case, where the electricity is renewable, that renewable electricity is then prevented from replacing a fossil electricity source on the grid, such as coal or gas.”

That means such technology is nothing more than a “gimmick,” he said, adding: “It will only delay our solution to the climate problem.”

Storing CO2 underground

U.S. nonprofit Battelle is the prime contractor on the Louisiana project, which will inject captured CO2 for storage deep underground.

It will partner with another American company, Heirloom, and the Swiss firm Climeworks, already a sector leader that operates a plant in Iceland with an annual capacity to capture 4,000 tons of CO2 from the air.

The Texas project will be led by the American company Occidental and other partners, including Carbon Engineering. It could be developed to eliminate up to 30 million tons of CO2 per year, according to a statement from Occidental.

“The rocks in the subsoil of Louisiana and Texas are sedimentary rocks, very different from Icelandic basalts, but they are perfectly viable for storing CO2,” Helene Pilorge, an associate researcher at the University of Pennsylvania studying carbon capture, told AFP.

The two projects should create 4,800 jobs, according to the Energy Department. No start date is yet confirmed for either.

They will be funded by President Joe Biden’s major infrastructure bill passed in 2021.

The Energy Department previously announced plans to invest in four projects to the tune of $3.5 billion.

Direct capture differs from carbon capture and storage (CCS) systems at source, such as factory chimneys, which prevent additional emissions from reaching the atmosphere.

In May, the Biden administration announced a plan to reduce CO2 emissions from gas-fired and coal-fired power plants, focusing in particular on this second technique.
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Monsoon season can exacerbate the outbreak as infected people overwhelm hospitals
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About 49,500 people took their own lives last year in the U.S., the highest number ever, according to new government data posted Thursday.

The Centers for Disease Control and Prevention, which posted the numbers, has not yet calculated a suicide rate for the year, but available data suggests suicides are more common in the U.S. than at any time since the dawn of World War II.

“There’s something wrong. The number should not be going up,” said Christina Wilbur, a 45-year-old Florida woman whose son shot himself to death last year.

“My son should not have died,” she said. “I know it’s complicated, I really do. But we have to be able to do something. Something that we’re not doing. Because whatever we’re doing right now is not helping.”

Experts caution that suicide is complicated, and that recent increases might be driven by a range of factors, including higher rates of depression and limited availability of mental health services.

But a main driver is the growing availability of guns, said Jill Harkavy-Friedman, senior vice president of research at the American Foundation for Suicide Prevention.

Suicide attempts involving guns end in death far more often than those with other means, and gun sales have boomed — placing firearms in more and more homes.

A recent Johns Hopkins University analysis used preliminary 2022 data to calculate that the nation’s overall gun suicide rate rose last year to an all-time high. For the first time, the gun suicide rate among Black teens surpassed the rate among white teens, the researchers found.

“I don’t know if you can talk about suicide without talking about firearms,” Harkavy-Friedman said.

U.S. suicides steadily rose from the early 2000s until 2018, when the national rate hit its highest level since 1941. That year saw about 48,300 suicide deaths — or 14.2 for every 100,000 Americans.

The rate fell slightly in 2019. It dropped again in 2020, during the first year of the COVID-19 pandemic. Some experts tied that to a phenomenon seen in the early stages of wars and natural disasters, when people pull together and support each other.

But in 2021, suicides rose 4%. Last year, according to the new data, the number jumped by more than 1,000, to 49,449 — about a 3% increase vs. the year before. The provisional data comes from U.S. death certificates and is considered almost complete, but it may change slightly as death information is reviewed in the months ahead.

The largest increases were seen in older adults. Deaths rose nearly 7% in people ages 45 to 64, and more than 8% in people 65 and older. White men, in particular, have very high rates, the CDC said.

Many middle-aged and elderly people experience problems like losing a job or losing a spouse, and it’s important to reduce stigma and other obstacles to them getting assistance, said Dr. Debra Houry, the CDC’s chief medical officer.

Suicides in adults ages 25 to 44 grew about 1%. The new data indicates that suicide became the second leading cause of death in that age group in 2022, up from No. 4 in 2021.

Despite the grim statistics, some say there is reason for optimism. A national crisis line launched a year ago, meaning anyone in the U.S. can dial 988 to reach mental health specialists.

The CDC is expanding a suicide program to fund more prevention work in different communities. And there’s growing awareness of the issue and that it’s OK to ask for help, health officials say.

There was a more than 8% drop in suicides in people ages 10 to 24 in 2022. That may be due to increased attention to youth mental health issues and a push for schools and others to focus on the problem, CDC officials said.

But even the smaller number masks tragedy for families.

Christina Wilbur lost her 21-year-old son, Cale, on June 16 last year. He died in her home in Land O’ Lakes, Florida.

Cale Wilbur had lost two friends and an uncle to suicide and had been dealing with depression. On that horrible morning, he and his mother were having an argument. She had confronted him about his drug use, his mother said. She left his bedroom and when she returned he had a gun.

“I was begging him not too, and to calm down,” she said. “It looked like he relaxed for a second, but then he killed himself.”

She describes her life since as black hole of emptiness and sorrow, and had found it hard to talk to friends or even family about Cale.

“Everything reminds me of what’s missing,” she said.

It’s hard to find professionals to help, and those that are around can be expensive, she said. She turned to support groups, including an organization called Alliance of Hope for Suicide Loss Survivors that operates a 24/7 online forum.

“There’s nothing like being with people who get it,” she said.
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Russia launched its first mission to the moon in nearly 50 years on Friday, racing to land on the lunar south pole before a spacecraft from India gets there.

The launch of the Luna-25 craft to the moon was Russia’s first since 1976, when it was part of the Soviet Union, and is being conducted without assistance from the European Space Agency, which ended cooperation with Russia after its invasion of Ukraine.

The Russian lunar lander is expected to reach the moon on August 23, about the same day as an Indian craft that was launched July 14.

Only three governments have managed successful moon landings: the Soviet Union, the United States and China. India and Russia are aiming to be the first to land at the moon’s south pole.

Study ‘is not the goal’

Roscosmos, Russia’s space agency, said it wants to show Russia “is a state capable of delivering a payload to the moon,” and “ensure Russia’s guaranteed access to the moon’s surface.”

“Study of the moon is not the goal,” said Vitaly Egorov, a popular Russian space analyst. “The goal is political competition between two superpowers — China and the USA — and a number of other countries which also want to claim the title of space superpower.”

Sanctions imposed on Russia after it invaded Ukraine make it harder for it to access Western technology, impacting its space program. The Luna-25 was initially meant to carry a small moon rover, but that idea was abandoned to reduce the weight of the craft for improved reliability, analysts say.

“Foreign electronics are lighter, domestic electronics are heavier,” Egorov said. “While scientists might have the task of studying lunar water, for Roscosmos the main task is simply to land on the moon — to recover lost Soviet expertise and learn how to perform this task in a new era.”

The Luna-25 was launched from the Vostochny Cosmodrome in Russia’s Far East. The spaceport is a pet project of Russian President Vladimir Putin and is key to his efforts to make Russia a space superpower and move Russian launches from the Baikonur Cosmodrome in Kazakhstan.

Previous crash

A previous Indian attempt to land at the moon’s south pole in 2019 ended when the lander crashed into the moon’s surface.

The lunar south pole is of particular interest to scientists, who believe the permanently shadowed polar craters may contain water. The frozen water in the rocks could be transformed by future explorers into air and rocket fuel.

“The moon is largely untouched and the whole history of the moon is written on its face,” said Ed Bloomer, an astronomer at Britain’s Royal Observatory, Greenwich. “It is pristine and like nothing you get on Earth. It is its own laboratory.”

The Luna-25 is to take samples of moon rock and dust. The samples are crucial to understanding the moon’s environment ahead of building any base there. “Otherwise, we could be building things and having to shut them down six months later because everything has effectively been sandblasted,” Bloomer said.
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Nearly a third of U.S. hospital pharmacists say they were forced to ration, delay or cancel treatments as drug shortages in the United States approach an all-time high, according to a survey released Thursday.  

The shortages are especially critical for chemotherapy drugs used in cancer treatment regimens, with more than half of the 1,123 pharmacists surveyed saying they had to limit the use of such treatments.  

The survey was conducted June 23-July 14 by the American Society of Health-System Pharmacists (ASHP), an association that represents more than 60,000 pharmacists and technicians. 

The drugs in shortage include vital therapies such as steroids, cancer treatments and antibiotics.  

According to the survey, while spikes in demand cause short-term scarcity such as for diabetes drug Ozempic, most severe and persistent shortages are driven by economic factors including extreme price competition among generic drugmakers. 

“Purchasing at the cheapest price has led to a race to the bottom, which has basically disincentivized any investment in quality and manufacturing,” said Michael Ganio, senior director of pharmacy practice and quality at ASHP.  

The number of U.S. drugs in shortfall — at 309 by the end of the second quarter — is already near a 10-year peak, according to the association, compared with an all-time high of 320 drugs.  

“In some cases, there are no alternatives to the affected drugs, which puts patients at risk. This issue requires quick action from Congress to address the underlying causes of shortages,” said ASHP CEO Paul Abramowitz.  

In June, the U.S. Food and Drug Administration said it was seeking new suppliers to ease shortages of methotrexate, one of the most commonly used cancer drugs, building on its push to shore up two other scarce chemotherapy medicines.
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The World Health Organization says traditional medicine plays a pivotal role in the health and well-being of people and the planet and should be seen as complementary to modern medicine and be integrated into national health systems.

Traditional healers have used their knowledge of plants and potions for centuries to treat people with multiple ailments. Much traditional indigenous and ancestral knowledge of traditional medicine is frequently used in health care across the world.

“We are seeing a lot of increasing demand and increasing interest in traditional medicine at the moment,” said Rudi Eggers, WHO director for integrated health services. “Traditional medicine has become a global phenomenon.”

He said 170 out of 194 countries have reported to WHO “that they used traditional medicine in some form, such as acupuncture, herbal medicine, yoga, and indigenous medicine in their countries. In fact, for millions of people, of course, it is the first choice for health care. In some cases, the only choice for health care.”

The WHO says that around 40 percent of modern pharmaceutical products have roots in traditional medicine.

“Many traditional medicines were the basis for some of the classic scientific and medical technologies that have led to some of the major medical breakthroughs, including drugs like aspirin or artemisinin for malaria, and even smallpox inoculation,” said Shyama Kuruvilla, the WHO lead for the Global Center for Traditional Medicine.

Next week, WHO is convening the Traditional Medicine Global Summit in Gandhinagar, Gujarat, India. The two-day high-level meeting will explore the role of “traditional, complementary, and integrative medicine in addressing pressing global health challenges.”

WHO Director-General Tedros Adhanom Ghebreyesus noted the “important and catalytic role” traditional medicine can play in achieving the goal of universal health coverage and in meeting global health-related targets that were disrupted by the COVID-19 pandemic.

He said, “Bringing traditional medicine into the mainstream of health care…can help bridge access gaps for millions of people around the world” and would be an important step toward people-centered and holistic approaches to health and well-being.

Kuruvilla agreed that holistic well-being is at the core of all traditional medicine systems, adding that there are existing legal measures and commitments aimed at achieving this goal.

“For example, at the United Nations, the heads of states and governments in 2019 committed to looking at evidence-based ways to integrate traditional medicine into national health systems,” she said. “There are many existing commitments and frameworks that now needed to be implemented.”

Evidence essential, say experts

WHO officials say traditional medicine has contributed to breakthrough discoveries and continues to hold out great promise of other game-changing achievements.

They caution, however, that recommendations on any new therapy or treatment must be based on solid scientific evidence.

“Advancing science on traditional medicine should be held to the same rigorous standards as in other fields of health,” said John Reeder, WHO director of both the department of research for health and the special program for research and training in tropical diseases.

“We need to treat traditional interventions with the same respect we give to other more Western medical interventions and that means examining them closely and critically and scientifically in the same way,” he said.

Summit will highlight best practices

WHO reports next week’s summit will explore research and evaluation of traditional medicine. It also will be an opportunity to showcase countries’ experiences, explore regional trends and discuss best practices.

While traditional medicine has proven its value over many centuries, WHO officials say it cannot replace modern medical care.

Kim Sungchol, head of WHO’s traditional, complementary, and integrative medicine unit, observed that traditional and modern medicines have two different but complementary approaches to health.

“There is a certain advantage of each system,” he said. “For example, modern medicine is quite good and good in emergency care, in communicable disease management, and antibiotics.

“On traditional medicine, one of the unique characteristics that it has is the more holistic approach. It is much advanced in the promotion and prevention, particularly linked to non-communicable diseases,” he said. “So, we have to see the two things differently. We have to identify the strengths of each system to work together to best serve the well-being of the people and planet. That is our purpose.”
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Virgin Galactic rocketed to the edge of space with its first tourists Thursday, including a former British Olympian who bought his ticket 18 years ago and a mother-daughter duo from the Caribbean.

The space plane glided back to a runway landing at Spaceport America in the New Mexico desert, after a brief flight that gave passengers a few minutes of weightlessness.

Cheers erupted from families and friends watching from below when the craft’s rocket motor fired after it was released from the plane that had carried it aloft. The rocket ship reached about 88 kilometers high.

Richard Branson’s company expects to begin offering monthly trips to customers on its winged space plane, joining Jeff Bezos’ Blue Origin and Elon Musk’s SpaceX in the space tourism business.

Virgin Galactic passenger Jon Goodwin, who was among the first to buy a ticket in 2005, said he had faith that he would someday make the trip. The 80-year-old athlete — he competed in canoeing in the 1972 Olympics — has Parkinson’s disease and wants to be an inspiration to others.

“I hope it shows them that these obstacles can be the start rather than the end to new adventures,” he said in a statement.

Ticket prices were $200,000 when Goodwin signed up. The cost is now $450,000.

He was joined by sweepstakes winner Keisha Schahaff, 46, a health coach from Antigua, and her daughter, Anastatia Mayers, 18, a student at Scotland’s University of Aberdeen. Also on board: two pilots and the company’s astronaut trainer.

It was Virgin Galactic’s seventh trip to space since 2018, but the first with a ticket-holder. Branson, the company’s founder, hopped on board for the first full-size crew ride in 2021. Italian military and government researchers soared in June on the first commercial flight. About 800 people are currently on Virgin Galactic’s waiting list, according to the company.

Virgin Galactic’s rocket ship launches from the belly of an airplane, not from the ground, and requires two pilots in the cockpit. Once the mothership reaches a height of about 15 kilometers, the space plane is released and fires its rocket motor to make the final push to just over 80 kilometers up. Passengers can unstrap from their seats, float around the cabin for a few minutes and take in the sweeping views of Earth, before the space plane glides back home and lands on a runway.

In contrast, the capsules used by SpaceX and Blue Origin are fully automated and parachute back down.

Like Virgin Galactic, Blue Origin aims for the fringes of space, quick ups-and-downs from West Texas. Blue Origin has launched 31 people so far, but flights are on hold following a rocket crash last fall. The capsule, carrying experiments but no passengers, landed intact.

SpaceX, is the only private company flying customers all the way to orbit, charging a much heftier price, too: tens of millions of dollars per seat. It’s already flown three private crews. NASA is its biggest customer, relying on SpaceX to ferry its astronauts to and from the International Space Station. since 2020.

People have been taking on adventure travel for decades, the risks underscored by the recent implosion of the Titan submersible that killed five passengers on their way down to view the Titanic wreckage. Virgin Galactic suffered its own casualty in 2014 when its rocket plane broke apart during a test flight, killing one pilot. Yet space tourists are still lining up, ever since the first one rocketed into orbit in 2001 with the Russians.

Branson, who lives in the British Virgin Islands, watched Thursday’s flight from a party in Antigua. He had held a virtual lottery to establish a pecking order for the company’s first 50 customers — dubbed the Founding Astronauts. Virgin Galactic said the group agreed Goodwin would go first, given his age and his Parkinson’s.
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Paris’ escape from record temperatures gripping parts of Europe this summer could be a short-term reprieve. A study finds the city could have the most heatwave-related deaths of any European capital by 2050 — when temperatures may soar to 50 C (122 F). For VOA, Lisa Bryant has more from Paris.
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